View Full Version : Interesting look at U.S., social mobility, and small business employment
rickrock305
02-19-10, 12:44
Apparently we are at the bottom of the list of self employment.
http://www.cepr.net/images/stories/sb1-sm-2009-08.jpg
http://www.cepr.net/index.php/publications/reports/int-comp-small-business/
This report discusses two aspects of economic mobility in the United States. The first is the question of intergenerational mobility, or the degree to which the economic success of children is independent of the economic status of their parents. A higher level of intergenerational mobility is often interpreted as a sign of greater fairness, or equality of opportunity, in a society.
The second aspect is the short-term question of the amount by which family incomes change from year to year. By studying short-term mobility we can determine whether incomes are rising or falling for families at different points in the income distribution. We can also determine whether the size of these income variations, or the level of annual income volatility, is changing over time. Increased volatility is undesirable to the extent that it represents an increase in economic insecurity.
The key findings relating to intergenerational mobility include the following:
Children from low-income families have only a 1 percent chance of reaching the top 5 percent of the income distribution, versus children of the rich who have about a 22 percent chance.
Children born to the middle quintile of parental family income ($42,000 to $54,300) had about the same chance of ending up in a lower quintile than their parents (39.5 percent) as they did of moving to a higher quintile (36.5 percent). Their chances of attaining the top five percentiles of the income distribution were just 1.8 percent.
Education, race, health and state of residence are four key channels by which economic status is transmitted from parent to child.
African American children who are born in the bottom quartile are nearly twice as likely to remain there as adults than are white children whose parents had identical incomes, and are four times less likely to attain the top quartile.
The difference in mobility for blacks and whites persists even after controlling for a host of parental background factors, children’s education and health, as well as whether the household was female-headed or receiving public assistance.
After controlling for a host of parental background variables, upward mobility varied by region of origin, and is highest (in percentage terms) for those who grew up in the South Atlantic and East South Central regions, and lowest for those raised in the West South Central and Mountain regions.
By international standards, the United States has an unusually low level of intergenerational mobility: our parents’ income is highly predictive of our incomes as adults. Intergenerational mobility in the United States is lower than in France, Germany, Sweden, Canada, Finland, Norway and Denmark. Among high-income countries for which comparable estimates are available, only the United Kingdom had a lower rate of mobility than the United States.
Key findings relating to short-run, year-to-year income movements include the following:
The overall volatility of household income increased significantly between 1990-91 and 1997-98 and again in 2003-04.
Since 1990-91, there has been an increase in the share of households who experienced significant downward short-term mobility. The share that saw their incomes decline by $20,000 or more (in real terms) rose from 13.0 percent in 1990-91 to 14.8 percent in 1997-98 to 16.6 percent in 2003-04.
The middle class is experiencing more insecurity of income, while the top decile is experiencing less. From 1997-98 to 2003-04, the increase in downward short-term mobility was driven by the experiences of middle-class households (those earning between $34,510 and $89,300 in 2004 dollars). Households in the top quintile saw no increase in downward short-term mobility, and households in the top decile ($122,880 and up) saw a reduction in the frequency of large negative income shocks.
For the middle class, an increase in income volatility has led to an increase in the frequency of large negative income shocks, which may be expected to translate to an increase in financial distress.
The median household was no more upwardly mobile in 2003-04, a year when GDP grew strongly, than it was it was during the recession of 1990-91.
Upward short-term mobility for those in the bottom quintile has improved since 1990-91, with no significant offsetting increase in downward short-term mobility.
Households whose adult members all worked more than 40 hours per week for two years in a row were more upwardly mobile in 1990-91 and 1997-98 than households who worked fewer hours. Yet this was not true in 2003-04, suggesting that people who work long hours on a consistent basis no longer appear to be able to generate much upward mobility for their families.
link to the full report...
http://www.cepr.net/documents/publications/small-business-2009-08.pdf
The reason it's called the American "Dream" - is because you have to be ASLEEP to believe it.
-George Carlin
ForTehNguyen
02-19-10, 12:53
its no surprise Europe has a huge rate of "self employment" which can be spin for unemployment. Europe has long had a stagnant economy and permanently high unemployment rates
rickrock305
02-19-10, 15:58
no comments huh? ;)
its no surprise Europe has a huge rate of "self employment" which can be spin for unemployment. Europe has long had a stagnant economy and permanently high unemployment rates
Yeah, I am going to call BS on this. What is the source for this data? How was it generated.
Granted, the US has many policies that discourage entrepreneurship, enterprise, and self-employment. But, we are nowhere near as bad as Europe. I have traveled to Europe often enough and I don't recall anyone being that entrepreneurial.
rickrock305
02-19-10, 20:43
if you read the link, its made very clear. you should read it BEFORE you call bullsh*t.
We use the most recently available, internationally comparable data from the Organization for Economic Cooperation and Development (OECD) to measure the share of employment in small businesses in 22 rich democracies.
OECD, 2009 OECD Country Statistical Profiles, http://stats.oecd.org/index.aspx?r=899636
if you read the link, its made very clear. you should read it BEFORE you call bullsh*t.
It said something about "employment in small business". Not self-employed. Big difference.
thopkins22
02-19-10, 23:56
Europeans and hippies have a habit of spinning poor numbers with BS.
As an example American health care(far from perfect;)) is routinely rated at the bottom of the barrel. This means nothing. If the people putting the reports out want to give more power to percentage of the population with "free" health insurance and less importance to quality of care or innovation, the US loses.
If you're into this kind of thing and I know RickRock is.... The numbers Europeans and the UN produce make the United States look like the worst offender in regards to reduction of CO2. Somehow they come to the conclusion that despite the fact that many(most:confused:) European countries had a larger increase in output of CO2 than the United States.
Belmont31R
02-20-10, 00:11
Yeah, I am going to call BS on this. What is the source for this data? How was it generated.
Granted, the US has many policies that discourage entrepreneurship, enterprise, and self-employment. But, we are nowhere near as bad as Europe. I have traveled to Europe often enough and I don't recall anyone being that entrepreneurial.
http://business.theatlantic.com/600%20unemployment%20in%20US%20and%20EU.jpg
I was stationed in Germany from 2003-2007, and their unemployment was about double what ours was just from what I heard locally. They also mask an even higher unemployment number with "paying" people to stay at home (such as women with children). We had a staff sgt married to a local national, and she was getting around 1K euros a month to be a "housewife".
That is what happens in a heavily taxed, overpaid, and restricted economy. Much like the union workers in the US who get paid to watch TV or some other worthless task just because they have to be on the clock despite their being no work for them.
Notice it takes a deep recession for our unemployment to match Europe's "good" numbers, and their stats should be at least double what their official count is if you include all the people the government's over their pay to do nothing.
Our GDP is barely lower than the entire EU, and the EU has 200M more citizens.
rickrock305
02-20-10, 00:48
If the people putting the reports out want to give more power to percentage of the population with "free" health insurance and less importance to quality of care or innovation, the US loses.
I wouldn't be so sure on the quality of care, thats very arguable.
http://www.rwjf.org/files/research/qualityquickstrikeaug2009.pdf
http://www.ahrq.gov/qual/nhqr08/Key.htm
For the past 6 years, the NHQR has summarized the state of health care quality. This undertaking is difficult, as no single national health care quality survey collects a standard set of data elements from the same defined population for the same period each year. Rather, data are available from a wide range of sources that focus on different populations and data years.
Despite these limitations, we find that health care quality in America is suboptimal.
And as to innovation, look at the amount of money we spend. It FAR outpaces any other nation.
http://www.nytimes.com/2006/10/05/business/05scene.html?partner=rssnyt&emc=rss
The National Institutes of Health’s current annual research budget is $28 billion, All European Union governments, in contrast, spent $3.7 billion in 2000, and since that time, Europe has not narrowed the research and development gap. America spends more on research and development over all and on drugs in particular, even though the United States has a smaller population than the core European Union countries. From 1989 to 2002, four times as much money was invested in private biotechnology companies in America than in Europe.
A little off topic, but I think it bears looking at the French healthcare model.
http://www.businessweek.com/magazine/content/07_28/b4042070.htm
Michael Moore's documentary Sicko trumpets France as one of the most effective providers of universal health care. His conclusions and fist-in-your-gut approach may drive some Americans up the wall. But whatever you think of Moore, the French system—a complex mix of private and public financing—offers valuable lessons for would-be health-care reformers in the U.S.
In Sicko, Moore lumps France in with the socialized systems of Britain, Canada, and Cuba. In fact, the French system is similar enough to the U.S. model that reforms based on France's experience might work in America. The French can choose their doctors and see any specialist they want. Doctors in France, many of whom are self- employed, are free to prescribe any care they deem medically necessary. "The French approach suggests it is possible to solve the problem of financing universal coverage...[without] reorganizing the entire system," says Victor G. Rodwin, professor of health policy and management at New York University.
France also demonstrates that you can deliver stellar results with this mix of public and private financing. In a recent World Health Organization health-care ranking, France came in first, while the U.S. scored 37th, slightly better than Cuba and one notch above Slovenia. France's infant death rate is 3.9 per 1,000 live births, compared with 7 in the U.S., and average life expectancy is 79.4 years, two years more than in the U.S. The country has far more hospital beds and doctors per capita than America, and far lower rates of death from diabetes and heart disease. The difference in deaths from respiratory disease, an often preventable form of mortality, is particularly striking: 31.2 per 100,000 people in France, vs. 61.5 per 100,000 in the U.S.
That's not to say the French have solved all health-care riddles. Like every other nation, France is wrestling with runaway health-care inflation. That has led to some hefty tax hikes, and France is now considering U.S.-style health-maintenance organization tactics to rein in costs. Still, some 65% of French citizens express satisfaction with their system, compared with 40% of U.S. residents. And France spends just 10.7% of its gross domestic product on health care, while the U.S. lays out 16%, more than any other nation.
To grasp how the French system works, think about Medicare for the elderly in the U.S., then expand that to encompass the entire population. French medicine is based on a widely held value that the healthy should pay for care of the sick. Everyone has access to the same basic coverage through national insurance funds, to which every employer and employee contributes. The government picks up the tab for the unemployed who cannot gain coverage through a family member.
SAFETY NET
But the french system is much more generous to its entire population than the U.S. is to its seniors. Unlike with Medicare, there are no deductibles, just modest co- payments that are dismissed for the chronically ill. Additionally, almost all French buy supplemental insurance, similar to Medigap, which reduces their out-of-pocket costs and covers extra expenses such as private hospital rooms, eyeglasses, and dental care.
In France, the sicker you get, the less you pay. Chronic diseases, such as diabetes, and critical surgeries, such as a coronary bypass, are reimbursed at 100%. Cancer patients are treated free of charge. Patients suffering from colon cancer, for instance, can receive Genentech Inc.'s (DNA ) Avastin without charge. In the U.S., a patient may pay $48,000 a year.
France particularly excels in prenatal and early childhood care. Since 1945 the country has built a widespread network of thousands of health-care facilities, called Protection Maternelle et Infantile (PMI), to ensure that every mother and child in the country receives basic preventive care. Children are evaluated by a team of private-practice pediatricians, nurses, midwives, psychologists, and social workers. When parents fail to bring their children in for regular checkups, social workers are dispatched to the family home. Mothers even receive a financial incentive for attending their pre- and post-natal visits.
A typical PMI can be found in Goutte d'Or, a poor neighborhood at the foot of Montmartre that has been home for the past 20 years to a swelling population of immigrants from Africa and Southeast Asia. On Rue Cavé, a tidy modern building is given over entirely to caring for expecting mothers, infants, and young children. The place usually is bustling with kids scrambling over toys, while mothers, often immigrants in colorful headdresses and with babies strapped to their backs, talk to their doctors as part of twice-monthly evaluations.
PMI and other such programs are starting to get attention in U.S. health-care circles. "If we really want to ensure that no child is left behind, then the PMI system is a good way to do it," says Daniel J. Pedersen, president of the Buffett Early Childhood Fund. "It's based on the practical idea that high-quality investments made at the start of a child's life will pay huge dividends to both the child and society in the future."
To make all this affordable, France reimburses its doctors at a far lower rate than U.S. physicians would accept. However, French doctors don't have to pay back their crushing student loans because medical school is paid for by the state, and malpractice insurance premiums are a tiny fraction of the $55,000 a year and up that many U.S. doctors pay. That $55,000 equals the average yearly net income for French doctors, a third of what their American counterparts earn. Then again, the French government pays two-thirds of the social security tax for most French physicians—a tax that's typically 40% of income.
Specialists who have spent at least four years practicing in a hospital are free to charge what they want, and some charge upwards of $675 for a single consultation. But American-style compensation is rare. "There is an unspoken and undefined limit to what you can charge," says Dr. Paul Benfredj, a gastroenterologist in Paris.
Many French doctors, in fact, earn more by increasing their patient load, or by prescribing more diagnostic tests and procedures—a technique, also popular in the U.S., that inflates health-care costs. So far France has been able to hold down the burden on patients through a combination of price controls and increased government spending, but the latter effort has led to higher taxes for both employers and workers. In 1990, 7% of health-care expenditures were financed out of general revenue taxes, and the rest came from mandatory payroll taxes. By 2003, the general revenue figure had grown to 40%, and it's still not enough. The French national insurance system has been running constant deficits since 1985 and has ballooned to $13.5 billion.
That's why France is gearing up to make changes. It already requires patients to register with a general practitioner before visiting a specialist, or else agree to a lesser reimbursement, much like many U.S. insurance plans. But France isn't likely to make major changes to a system most citizens say they like. Why would they? Says Shanny Peer, policy director at the independent French-American Foundation: "France gets better results for less money and everyone is covered."
not perfect, but IMO better than what we have here.
more on France's system...
http://www.npr.org/templates/story/story.php?storyId=92419273
If you're into this kind of thing and I know RickRock is.... The numbers Europeans and the UN produce make the United States look like the worst offender in regards to reduction of CO2. Somehow they come to the conclusion that despite the fact that many(most:confused:) European countries had a larger increase in output of CO2 than the United States.
And even with that larger increase, we are still the worst offenders when it comes to CO2 by far.
So its not just the "hippies" that play with the numbers. Its done on both sides. ;)
I wouldn't be so sure on the quality of care, thats very arguable.
http://www.rwjf.org/files/research/qualityquickstrikeaug2009.pdf
Not really. In most cases, the positive outcome for treatments of serious diseases are far better in the US than elsewhere. There is a reason people from all over the world come to the US for treatment of serious diseases and ailments -- the outcomes are far superior in most cases.
There are LOTS of problems with US Healthcare. UN rankings however are totally full of sh*t. They rank you based on how socialized you are, not based on quality of outcome. Their use of life expectancy is totally bogus. Quality of healthcare plays only a very small role in that. Environment, diet, amount of exercise, etc play a much much much bigger role.
The US system needs MAJOR MAJOR reform. The suggested reforms of the Democrats are 180 deg off the way that we need to go to reform the system. This has been discussed here several times already. Most people will not disagree that reforms should be made. However, the idea that gov can control a market without screwing it up is ludicrous and any "reform" based on that notion should be immediately dismissed.
rickrock305
02-20-10, 01:06
I was stationed in Germany from 2003-2007, and their unemployment was about double what ours was just from what I heard locally. They also mask an even higher unemployment number with "paying" people to stay at home (such as women with children). We had a staff sgt married to a local national, and she was getting around 1K euros a month to be a "housewife".
That is what happens in a heavily taxed, overpaid, and restricted economy. Much like the union workers in the US who get paid to watch TV or some other worthless task just because they have to be on the clock despite their being no work for them.
Notice it takes a deep recession for our unemployment to match Europe's "good" numbers, and their stats should be at least double what their official count is if you include all the people the government's over their pay to do nothing.
Our GDP is barely lower than the entire EU, and the EU has 200M more citizens.
http://www.taurillon.org/Europe-vs-USA-Whose-Economy-Wins
Now while it is true that the US has a better employment and unemployment record, the key to understanding the difference between the EU and the US lies in disaggregating employment by age group. If we compare employment rates in 2005 of the 25-55 age group, there is virtually no difference; e.g., the employment rates are 86 and 88 percent for the EU-15 and the US respectively (ignoring differences in how the data are recorded). The US data show a higher employment rate for youth (15-24) and a much higher rate for preretirement (55-64) and post retirement (65 and over) groups. What the average employment and unemployment figures hide is the agespecific nature of the ‘European problem’. The picture remains much the same when comparing the US and the EU-25.
Once again, the crucial element in understanding these differences is income distribution. At the youth end of the scale, young workers in the US get less education and those who go to university are more likely to work part-time than their European counterparts. At the older end of the scale, pension provision in the US is neither as broad nor as generous as in the EU, so people – particularly the poor who cannot afford to save for retirement – carry on working
you also have to take into account how these statistics are derived. the EU and the United States come to these numbers differently. And it is widely known that the official recorded number of unemployed people here in the states is lower than what it actually is.
rickrock305
02-20-10, 01:08
Not really. In most cases, the positive outcome for treatments of serious diseases are far better in the US than elsewhere. There is a reason people from all over the world come to the US for treatment of serious diseases and ailments -- the outcomes are far superior in most cases.
There are LOTS of problems with US Healthcare. UN rankings however are totally full of sh*t. They rank you based on how socialized you are, not based on quality of outcome. Their use of life expectancy is totally bogus. Quality of healthcare plays only a very small role in that. Environment, diet, amount of exercise, etc play a much much much bigger role.
i've actually seen other studies done outside of the U.N and WHO that rank the U.S a lot worse.
We do have the best cancer care in the world. but again, look at the cost. we FAR outspend any other nation. and yet we're still far from being the best healthcare system in the world.
France's infant death rate is 3.9 per 1,000 live births, compared with 7 in the U.S., and average life expectancy is 79.4 years, two years more than in the U.S. The country has far more hospital beds and doctors per capita than America, and far lower rates of death from diabetes and heart disease. The difference in deaths from respiratory disease, an often preventable form of mortality, is particularly striking: 31.2 per 100,000 people in France, vs. 61.5 per 100,000 in the U.S.
thopkins22
02-20-10, 01:09
I wouldn't be so sure on the quality of care, thats very arguable.
So say the authors of that paper. One of whom worked for Clinton and Carter and is a fellow at the "Urban Institute." The other was involved with Medicare, a program of course known for it's dedication to the privatization of medicine.:p
And as to innovation, look at the amount of money we spend. It FAR outpaces any other nation.
Because there is FAR more incentive to innovate here, there is far more capital directed towards it here. In fact, due to the fact that the American people often wind up subsidizing expensive care for the rest of the world because of their artificially low prices, our system also subsidizes developments that occur in the rest of the world because they can make money here.
A little off topic, but I think it bears looking at the French healthcare model.
Our nationalized radio network says so, so it must be true.... I actually like NPR, but it's dangerous listening for someone who can't recognize what is slant and what isn't.
And even with that larger increase, we are still the worst offenders when it comes to CO2 by far.You missed the point entirely. CO2 and it's "catastrophic" effects is a bunch of horse malarkey. The point was that they see fit to lecture us and show us graphs on our emmissions, when in fact they are farther off of their plan by a large margin.
thopkins22
02-20-10, 01:11
The US system needs MAJOR MAJOR reform.
I'd like to see the marketplace introduced into medicine. The pseudo market that exists is better than what the dems are proposing though.
rickrock305
02-20-10, 01:13
The US system needs MAJOR MAJOR reform. The suggested reforms of the Democrats are 180 deg off the way that we need to go to reform the system. This has been discussed here several times already. Most people will not disagree that reforms should be made. However, the idea that gov can control a market without screwing it up is ludicrous and any "reform" based on that notion should be immediately dismissed.
I'd have to say look closer at France's system. They have combined both private and government options.
I believe a combination of both government and private healthcare would be the best option. The government should provide options for those who cannot or choose not to pay for it, and there should also be the option of private healthcare. That way those that can afford it can get the better, private healthcare while those who cannot or choose not to get the government option. Thats just a rough synopsis.
I agree the Democrats are WAY off the mark, but probably for different reasons than you. For example, I believe any healthcare reform should have some type of public option. They completely caved on that almost immediately and instead it has become a giant giveaway to insurance companies.
France's infant death rate is 3.9 per 1,000 live births, compared with 7 in the U.S., and average life expectancy is 79.4 years, two years more than in the U.S. The country has far more hospital beds and doctors per capita than America, and far lower rates of death from diabetes and heart disease. The difference in deaths from respiratory disease, an often preventable form of mortality, is particularly striking: 31.2 per 100,000 people in France, vs. 61.5 per 100,000 in the U.S.
This is totally bogus comparison when ranking health care systems. If you look at actual health care for diabetes and heart disease I think the numbers show that the US system provides better care (they did when I looked at this last year but I cannot find it now). France has less diabetes and heart disease in the first place because the French are not as stupid when it comes to lifestyle as Americans. They have a lower mortality for these things not due to healthcare but due to lifestyle.
I'd have to say look closer at France's system. They have combined both private and government options.
I believe a combination of both government and private healthcare would be the best option. The government should provide options for those who cannot or choose not to pay for it, and there should also be the option of private healthcare. That way those that can afford it can get the better, private healthcare while those who cannot or choose not to get the government option. Thats just a rough synopsis.
I agree the Democrats are WAY off the mark, but probably for different reasons than you. For example, I believe any healthcare reform should have some type of public option. They completely caved on that almost immediately and instead it has become a giant giveaway to insurance companies.
A public option does not work in the long run. Too many people will choose to let others pay and that shifts costs to the private payers until the private payers cannot afford to pay any more.
And it is the antithesis of freedom and responsibility. It is un-American in the traditional sense, which embraces freedom and responsibility.
thopkins22
02-20-10, 01:20
I'd have to say look closer at France's system. They have combined both private and government options.
Because Joe Blow who works hard to purchase his family quality health insurance should also pay for some jackass.
I have a very good friend who is Canadian. Last year while visiting his family in Canada he was diagnosed with colon cancer. He was told that if his treatment would begin in SIX WEEKS. His physician there asked him if he was covered by Shell in the US, of course he was so he flew to Houston that night and began treatment at MD Anderson(about the best cancer treatment in the world,) the very next day.
Belmont31R
02-20-10, 01:20
you also have to take into account how these statistics are derived. the EU and the United States come to these numbers differently. And it is widely known that the official recorded number of unemployed people here in the states is lower than what it actually is.
An unemployed "worker" is still unemployed even if they are young or old.
I understand the difference in how the numbers are derived. We hide our actual numbers by basically only counting recently unemployed, and they pad their numbers by paying people to be things like housewives + all the other BS jobs they create and/or subsidize. They also work less, and have much more vacation time so a company has to hire more people to accomplish the same amount of work. Its basically a partially "fake" employment structure over there.
rickrock305
02-20-10, 01:22
So say the authors of that paper. One of whom worked for Clinton and Carter and is a fellow at the "Urban Institute." The other was involved with Medicare, a program of course known for it's dedication to the privatization of medicine.:p
that was just one example. there are many others out there if you care to look.
for example...some 65% of French citizens express satisfaction with their system, compared with 40% of U.S. residents
Because there is FAR more incentive to innovate here, there is far more capital directed towards it here. In fact, due to the fact that the American people often wind up subsidizing expensive care for the rest of the world because of their artificially low prices, our system also subsidizes developments that occur in the rest of the world because they can make money here.
right, we spend an inordinate amount of money on healthcare in this country. and a whole bunch of it goes to these pharma companies. i would hope they would at least be innovating. hopefully something other than more toxic drugs for things like "restless leg syndrome" and longer eye lashes. :rolleyes:
Our nationalized radio network says so, so it must be true.... I actually like NPR, but it's dangerous listening for someone who can't recognize what is slant and what isn't..
NPR isn't the only source. There are plenty of sources of fact on France's healthcare model and statistics. You conveniently ignored the Businessweek article.
nice cheap shot. i guess i was wrong to hope for meaningful discussion on this subject with someone who's mind is clearly made up. no amount of fact or anything else will sway your opinion so apparently we're done here.
You missed the point entirely. CO2 and it's "catastrophic" effects is a bunch of horse malarkey. The point was that they see fit to lecture us and show us graphs on our emmissions, when in fact they are farther off of their plan by a large margin.
I don't really see your point at all. Nor what bearing it has on this discussion.
rickrock305
02-20-10, 01:23
This is totally bogus comparison when ranking health care systems. If you look at actual health care for diabetes and heart disease I think the numbers show that the US system provides better care (they did when I looked at this last year but I cannot find it now). France has less diabetes and heart disease in the first place because the French are not as stupid when it comes to lifestyle as Americans. They have a lower mortality for these things not due to healthcare but due to lifestyle.
Proof?
rickrock305
02-20-10, 01:25
A public option does not work in the long run. Too many people will choose to let others pay and that shifts costs to the private payers until the private payers cannot afford to pay any more.
And it is the antithesis of freedom and responsibility. It is un-American in the traditional sense, which embraces freedom and responsibility.
I don't believe so. I believe plenty of people will choose to keep their private health care and insurance because the quality of care will probably be better.
Belmont31R
02-20-10, 01:28
I'd have to say look closer at France's system. They have combined both private and government options.
I believe a combination of both government and private healthcare would be the best option. The government should provide options for those who cannot or choose not to pay for it, and there should also be the option of private healthcare. That way those that can afford it can get the better, private healthcare while those who cannot or choose not to get the government option. Thats just a rough synopsis.
I agree the Democrats are WAY off the mark, but probably for different reasons than you. For example, I believe any healthcare reform should have some type of public option. They completely caved on that almost immediately and instead it has become a giant giveaway to insurance companies.
'
Government has no responsibility to provide health care for anyone, and has long term consequences no one who supports it likes to talk about.
Mixing the two systems means the gov gets to be cheap skates, and make the private sector pay a much larger burden than they otherwise would. Ask just about any doctor what a person with private insurance pays for an office visit, and then ask them how much medicaid pays them. One doctor I know of gets paid only 1/5th for an office visit from someone on medicaid than from someone with private insurance.
Going fully government (Tricare, VA) means reduced quality of care.
The best care is fully privatized.
you also have to take into account how these statistics are derived. the EU and the United States come to these numbers differently. And it is widely known that the official recorded number of unemployed people here in the states is lower than what it actually is.
I would bet the same is true in Europe -- they underreport it as well is my guess.
I would like to see what percentage of the population works for the government in Europe. According to the US Labor and Statistics people about 7.8-7.9% (2008) worked for the government in the US, including Federal, State, and Local governments.
I'd like to see the numbers for Europe. I was not able to come up with the right Google-Fu tonight to find it.
rickrock305
02-20-10, 01:35
An unemployed "worker" is still unemployed even if they are young or old.
not necessarily. it depends on what type of unemployment we're talking about.
As defined by the International Labour Organization, "unemployed workers" are those who are currently not working but are willing and able to work for pay, currently available to work, and have actively searched for work.
It is possible to be neither employed nor unemployed by ILO definitions, i.e., to be outside of the "labor force." These are people who have no job and are not looking for one. Many of these are going to school or are retired. Family responsibilities keep others out of the labor force. Still others have a physical or mental disability which prevents them from participating in labor force activities. And of course some people simply elect not to work, preferring to be dependent on others for sustenance.
I understand the difference in how the numbers are derived. We hide our actual numbers by basically only counting recently unemployed, and they pad their numbers by paying people to be things like housewives + all the other BS jobs they create and/or subsidize. They also work less, and have much more vacation time so a company has to hire more people to accomplish the same amount of work. Its basically a partially "fake" employment structure over there.
Eurostat, the statistical office of the European Union, defines unemployed as those persons age 15 to 74 who are not working, have looked for work in the last four weeks, and ready to start work within two weeks, which conform to ILO standards.
The Bureau of Labor Statistics measures employment and unemployment (of those over 15 years of age) using two different labor force surveys conducted by the United States Census Bureau (within the United States Department of Commerce) and/or the Bureau of Labor Statistics (within the United States Department of Labor) that gather employment statistics monthly. The Current Population Survey (CPS), or "Household Survey", conducts a survey based on a sample of 60,000 households. This Survey measures the unemployment rate based on the ILO definition. The data are also used to calculate 5 alternate measures of unemployment as a percentage of the labor force based on different definitions noted as U1 through U6:
* U1: Percentage of labor force unemployed 15 weeks or longer.
* U2: Percentage of labor force who lost jobs or completed temporary work.
* U3: Official unemployment rate per ILO definition.
* U4: U3 + "discouraged workers", or those who have stopped looking for work because current economic conditions make them believe that no work is available for them.
* U5: U4 + other "marginally attached workers", or "loosely attached workers", or those who "would like" and are able to work, but have not looked for work recently.
* U6: U5 + Part time workers who want to work full time, but cannot due to economic reasons.
Note: "Marginally attached workers" are added to the total labor force for unemployment rate calculation for U4, U5, and U6. The BLS revised the CPS in 1994 and among the changes the measure representing the official unemployment rate was renamed U3 instead of U5
It should also be noted that studies have found that the U.S. unemployment rate would be at least 2% higher if prisoners and jail inmates were counted.
The unemployment rate may be different from the impact of the economy on people. The unemployment figures indicate how many are not working for pay but seeking employment for pay. It is only indirectly connected with the number of people who are actually not working at all or working without pay. Therefore, critics believe that current methods of measuring unemployment are inaccurate in terms of the impact of unemployment on people as these methods do not take into account the 1.5% of the available working population incarcerated in U.S. prisons (who may or may not be working while incarcerated), those who have lost their jobs and have become discouraged over time from actively looking for work, those who are self-employed or wish to become self-employed, such as tradesmen or building contractors or IT consultants, those who have retired before the official retirement age but would still like to work (involuntary early retirees), those on disability pensions who, while not possessing full health, still wish to work in occupations suitable for their medical conditions, those who work for payment for as little as one hour per week but would like to work full-time. These people are "involuntary part-time" workers, those who are underemployed, e.g., a computer programmer who is working in a retail store until he can find a permanent job, involuntary stay-at-home mothers who would prefer to work, and graduate and Professional school students who were unable to find worthwhile jobs after they graduated with their Bachelor's degrees.
For the fourth quarter of 2004, according to OECD, (source Employment Outlook 2005 ISBN 92-64-01045-9), normalized unemployment for men aged 25 to 54 was 4.6% in the U.S. and 7.4% in France. At the same time and for the same population the employment rate (number of workers divided by population) was 86.3% in the U.S. and 86.7% in France.
This example shows that the unemployment rate is 60% higher in France than in the U.S., yet more people in this demographic are working in France than in the U.S., which is counterintuitive if it is expected that the unemployment rate reflects the health of the labor market.
a"fake" employment structure huh? :D thats a new one
I don't believe so. I believe plenty of people will choose to keep their private health care and insurance because the quality of care will probably be better.
It already is happening. One major reason for the huge increases in the costs of private healthcare is cost shifting by the govt due to underpayment for services. (And cost shifting for medicines by other countries to the US).
And if you had a choice of free care or pay yourself care, you would probably eventually end up in the free care boat.
Believe me, that is what happens.
rickrock305
02-20-10, 01:41
Government has no responsibility to provide health care for anyone, and has long term consequences no one who supports it likes to talk about.
they also have no responsibility to provide any of the other services we utilize. but they do.
Mixing the two systems means the gov gets to be cheap skates, and make the private sector pay a much larger burden than they otherwise would. Ask just about any doctor what a person with private insurance pays for an office visit, and then ask them how much medicaid pays them. One doctor I know of gets paid only 1/5th for an office visit from someone on medicaid than from someone with private insurance.
again, i would have to say take a look at France's system.
for example...
To make all this affordable, France reimburses its doctors at a far lower rate than U.S. physicians would accept. However, French doctors don't have to pay back their crushing student loans because medical school is paid for by the state, and malpractice insurance premiums are a tiny fraction of the $55,000 a year and up that many U.S. doctors pay. That $55,000 equals the average yearly net income for French doctors, a third of what their American counterparts earn. Then again, the French government pays two-thirds of the social security tax for most French physicians—a tax that's typically 40% of income.
Specialists who have spent at least four years practicing in a hospital are free to charge what they want, and some charge upwards of $675 for a single consultation. But American-style compensation is rare. "There is an unspoken and undefined limit to what you can charge," says Dr. Paul Benfredj, a gastroenterologist in Paris.
Going fully government (Tricare, VA) means reduced quality of care.
The best care is fully privatized.
i didn't say the best option is fully government. i said the best option is a combination of the two.
yes, the best care will be private. but for those who cannot afford it, they would have a government option. would it be as good as private care? of course not. which is why private care could and would still exist and do just fine.
Belmont31R
02-20-10, 01:43
I would bet the same is true in Europe -- they underreport it as well is my guess.
I would like to see what percentage of the population works for the government in Europe. According to the US Labor and Statistics people about 7.8-7.9% (2008) worked for the government in the US, including Federal, State, and Local governments.
I'd like to see the numbers for Europe. I was not able to come up with the right Google-Fu tonight to find it.
From the stats I could find France has 5.2 million public workers with a population of 63 million equals public sector work force is 12.X% of the population. Almost double ours, and our population is around 5X as much.
they also have no responsibility to provide any of the other services we utilize. but they do.
maybe they shouldn't
rickrock305
02-20-10, 01:46
It already is happening. One major reason for the huge increases in the costs of private healthcare is cost shifting by the govt due to underpayment for services. (And cost shifting for medicines by other countries to the US).
there are solutions to this problem, although they're complicated and would take some time to address.
And if you had a choice of free care or pay yourself care, you would probably eventually end up in the free care boat.
not necessarily. because as has been stated, the best healthcare will be the private healthcare. there are plenty of people in this country that could and would readily choose to pay for the private system to receive the top quality care.
Believe me, that is what happens.
your crystal ball told you so? :D
rickrock305
02-20-10, 01:47
maybe they shouldn't
ok. when your house catches on fire and burns to the ground, will you still be saying that? or perhaps when your loved ones have a heart attack or get in a car accident and die instead of being transported to the hospital, will you still feel the same way?
Belmont31R
02-20-10, 01:51
they also have no responsibility to provide any of the other services we utilize. but they do.
again, i would have to say take a look at France's system.
for example...
To make all this affordable, France reimburses its doctors at a far lower rate than U.S. physicians would accept. However, French doctors don't have to pay back their crushing student loans because medical school is paid for by the state, and malpractice insurance premiums are a tiny fraction of the $55,000 a year and up that many U.S. doctors pay. That $55,000 equals the average yearly net income for French doctors, a third of what their American counterparts earn. Then again, the French government pays two-thirds of the social security tax for most French physicians—a tax that's typically 40% of income.
Specialists who have spent at least four years practicing in a hospital are free to charge what they want, and some charge upwards of $675 for a single consultation. But American-style compensation is rare. "There is an unspoken and undefined limit to what you can charge," says Dr. Paul Benfredj, a gastroenterologist in Paris.
i didn't say the best option is fully government. i said the best option is a combination of the two.
yes, the best care will be private. but for those who cannot afford it, they would have a government option. would it be as good as private care? of course not. which is why private care could and would still exist and do just fine.
So because the government has strayed from its mandate we should go "all in" with a European style system?
No the best option is not a combination of the two because the government has the rule of law on its side, and which means its never going to play fairly. A big reason why private insurance is so high is because we are forced to take up the slack government health care creates by underpaying doctors. I think we are close if not more than half the people are currently on government health care, and at the most it pays about half of what private insurance does. If everyone's care cost the same no matter their method of payment private insurance would go down drastically and the government would be paying far more than they already are. But then we'd have 3 trillion a year deficits instead of the 1.X we currently have...so we gotta keep sticking it to those with private insurance...:rolleyes:
Paying for their medical school means higher taxes so we pay them anyways. Either the gov pays it, and their costs are lower but its made up in taxes or we let them pay it, and doctors charge more.
Big pharma is a problem but guess who has created regulations and laws enabling the problems there? Return to the free market, and drug costs would go down drastically.
Enable us to buy insurance across state lines, and costs go down.
But hey its just a system designed to force private insurance out the door at some point, and everyone will be on gov health care. The percentage goes up a little every year...just a matter of time.
Europe does some things right and better than we do.
Germany privatized their post office. And it works much better than the USPS does.
thopkins22
02-20-10, 01:52
for example...some 65% of French citizens express satisfaction with their system, compared with 40% of U.S. residents
A similar study was conducted in the UK with regards to dental care. A poll was taken of people who had undergone some antiquated and not very successful procedure(read: cheaper,)something like 85% were happy with the system. Upon being informed that the procedure had been almost entirely replaced with in the US with something much less invasive and more effective, the number dropped to about 15%.
i guess i was wrong to hope for meaningful discussion on this subject with someone who's mind is clearly made up. no amount of fact or anything else will sway your opinion so apparently we're done here.
My mind IS made up. But it's because I'm right. Facts, theory, history, and just about everything else is on my side.
For the umpteenth time...remove tax benefits for employers to "give" health benefits. It's money that you would have received in wages anyway. People will begin to buy actual insurance rather than prepaid health care. People will begin to actually care what things cost. Costs will plummet. Allowing physicians assistants and nurses to practice more medicine without doctors would be a huge help as well.
I don't expect State Farm to pay for my oil change or fill my gas tank, why do we expect health insurance to cover a trip to the doctor for the flu? More people with only catastrophic insurance is the best answer, and I've already explained how to achieve that.
Belmont31R
02-20-10, 01:55
ok. when your house catches on fire and burns to the ground, will you still be saying that? or perhaps when your loved ones have a heart attack or get in a car accident and die instead of being transported to the hospital, will you still feel the same way?
All those are local operations not national.
ok. when your house catches on fire and burns to the ground, will you still be saying that? or perhaps when your loved ones have a heart attack or get in a car accident and die instead of being transported to the hospital, will you still feel the same way?
yep! there are better ways to handle these things than state run
here in the Salt Lake Valley, most ambulances are already run by private companies.
there are solutions to this problem, although they're complicated and would take some time to address.
I am all ears. "natural economic law" basically dictates the outcome.
not necessarily. because as has been stated, the best healthcare will be the private healthcare. there are plenty of people in this country that could and would readily choose to pay for the private system to receive the top quality care.
Yes necessarily. On average, people will opt for the least expensive method. They have no way of judging the quality of future care.
This is why Wal-Mart does so well. Often inferior products and definitely inferior service but price reigns supreme.
your crystal ball told you so? :D
function of normal economic law. Most people most of the time will act in their own best interest (as they perceive it). No matter what govt does, that simple fact trumps all effort by the govt to make the economy work the way they want it to.
Belmont31R
02-20-10, 02:00
A similar study was conducted in the UK with regards to dental care. A poll was taken of people who had undergone some antiquated and not very successful procedure(read: cheaper,)something like 85% were happy with the system. Upon being informed that the procedure had been almost entirely replaced with in the US with something much less invasive and more effective, the number dropped to about 15%.
My mind IS made up. But it's because I'm right. Facts, theory, history, and just about everything else is on my side.
For the umpteenth time...remove tax benefits for employers to "give" health benefits. It's money that you would have received in wages anyway. People will begin to buy actual insurance rather than prepaid health care. People will begin to actually care what things cost. Costs will plummet. Allowing physicians assistants and nurses to practice more medicine without doctors would be a huge help as well.
I don't expect State Farm to pay for my oil change or fill my gas tank, why do we expect health insurance to cover a trip to the doctor for the flu? More people with only catastrophic insurance is the best answer, and I've already explained how to achieve that.
That is one the problems with government health care. People lose all sense of the cost of their care, and no longer treat it as something of value. My wife's aunt is a classic case of because its "free" she has no compunction about going to the doctor for every little thing and popping out 3 kids on the tax payer dollar, and that family will have their medical care paid by the state and federal governments their entire lives to the tune of hundreds of thousands of dollars. It has to take at least 5 productive members of society just to support their medical costs.
not necessarily. because as has been stated, the best healthcare will be the private healthcare. there are plenty of people in this country that could and would readily choose to pay for the private system to receive the top quality care.
and
But hey its just a system designed to force private insurance out the door at some point, and everyone will be on gov health care. The percentage goes up a little every year...just a matter of time.
Rickrock
There is your answer right there. It is already happening. More and more people are opting for the govt care already.
From the stats I could find France has 5.2 million public workers with a population of 63 million equals public sector work force is 12.X% of the population. Almost double ours, and our population is around 5X as much.
I lived in Germany twice. On the economy. I was not there in the military or govt service. Once I was there (86-87) working as a lay minister for my church and once I was working (91-93) for the German HQ of an American computer company in Munich (Digital Equipment GmbH, RIP, the German arm of Digital Equipment Corporation, RIP) Granted it was a while ago, but I doubt much has changed.
I was constantly amazed by the number of people I saw employed by the government out sweeping the roads, or doing road maintenance (and I am not talking the Autobahn). Every morning you would see large crews out sweeping the roads etc. Govt workers. And there was always a crew out working on the roads. A much larger crew than you will find in most places in the US doing the same sort and amount of work. I swear I saw them tear up a road, repave it, and 3 weeks later, do it again. Others (non Germans doing the same sort of stuff I was doing) I talked to had noticed the same sorts of things. We called it "Make work" work.
While I have no solid numbers, I think part of the European solution to unemployment is to employ as many as they can "afford" in public employment. The France numbers given and my own personal experience in Germany lead me to this conclusion.
Belmont31R
02-20-10, 02:46
I lived in Germany twice. On the economy. I was not there in the military or govt service. Once I was there (86-87) working as a lay minister for my church and once I was working (91-93) for the German HQ of an American computer company in Munich (Digital Equipment GmbH, RIP, the German arm of Digital Equipment Corporation, RIP) Granted it was a while ago, but I doubt much has changed.
I was constantly amazed by the number of people I saw employed by the government out sweeping the roads, or doing road maintenance (and I am not talking the Autobahn). Every morning you would see large crews out sweeping the roads etc. Govt workers. And there was always a crew out working on the roads. A much larger crew than you will find in most places in the US doing the same sort and amount of work. I swear I saw them tear up a road, repave it, and 3 weeks later, do it again. Others (non Germans doing the same sort of stuff I was doing) I talked to had noticed the same sorts of things. We called it "Make work" work.
While I have no solid numbers, I think part of the European solution to unemployment is to employ as many as they can "afford" in public employment. The France numbers given and my own personal experience in Germany lead me to this conclusion.
Thats what the socialist economic system brings. You have to create laws and tax people to get more people working because otherwise the socialist system cannot provide enough jobs for society, and communism is even worse.
Our recession numbers are close to their normal average, and our GDP is close to theirs despite the huge disparity in population. More people to do the same amount of work and production.
Well if you made people in the US do road work to earn their unemployment pay they would find jobs faster.
Belmont31R
02-20-10, 03:48
Well if you made people in the US do road work to earn their unemployment pay they would find jobs faster.
They would find jobs faster if employers were not taxed so high.
Also unemployment is a benefit people pay into through previous work. Another nanny state program that takes ability and economic freedom away from the people to in turn give the government more money and make people more reliant on big brother to put food on the table.
rickrock305
02-20-10, 12:09
So because the government has strayed from its mandate we should go "all in" with a European style system?
all in? no, not all in. but i think we can incorporate elements from their systems and make it work.
No the best option is not a combination of the two because the government has the rule of law on its side, and which means its never going to play fairly.
could you be more specific?
A big reason why private insurance is so high is because we are forced to take up the slack government health care creates by underpaying doctors.
maybe some doctors would be willing to work for cheaper. for example doctors fresh out of med school could work for the public system for a certain number of years before venturing to the private system. jsut a quick idea, but there are ways it can be done.
I think we are close if not more than half the people are currently on government health care,
you have some stats for this?
and at the most it pays about half of what private insurance does.
this is a complicated subject and probably worthy of a thread all its own. but a lot of it has to do with the exorbitant prices that hospitals and doctors charge for services.
If everyone's care cost the same no matter their method of payment private insurance would go down drastically and the government would be paying far more than they already are.
right, and that needs to be reformed as well. i'm with you on that one.
Big pharma is a problem but guess who has created regulations and laws enabling the problems there? Return to the free market, and drug costs would go down drastically.
you have way more faith in big pharma than i do. there are a handful of companies that control the market. how did that free market work for the banking system?
Enable us to buy insurance across state lines, and costs go down.
agreed. i think thats a stupid regulation.
But hey its just a system designed to force private insurance out the door at some point, and everyone will be on gov health care. The percentage goes up a little every year...just a matter of time.
no, i don't believe so. because as you already said, private insurance is better than government insurance. so those that can afford it will continue to.
what you describe is the symptom of a larger problem. the middle class is being gutted, resulting in more and more people unable to afford healthcare.
rickrock305
02-20-10, 12:11
Yes necessarily. On average, people will opt for the least expensive method. They have no way of judging the quality of future care.
This is why Wal-Mart does so well. Often inferior products and definitely inferior service but price reigns supreme.
function of normal economic law. Most people most of the time will act in their own best interest (as they perceive it). No matter what govt does, that simple fact trumps all effort by the govt to make the economy work the way they want it to.
i believe plenty of people would opt for paying for better care rather than settling for cheaper and worse care.
rickrock305
02-20-10, 12:14
and
Rickrock
There is your answer right there. It is already happening. More and more people are opting for the govt care already.
like i said, thats a symptom of a larger problem. the gutting of the middle class. healthcare costs are skyrocketing and more and more people can't afford it.
Belmont31R
02-20-10, 12:30
like i said, thats a symptom of a larger problem. the gutting of the middle class. healthcare costs are skyrocketing and more and more people can't afford it.
More people can't afford it because the government programs pay a fraction of what private healthcare does for the same treatment, and those shortfalls are passed onto those with private insurance.
Like I said I personally know of a doctor who gets reimbursed 1/5th of what private insurance pays for his medicaid patients, and medicare is about 1/2 of private insurance. The system was intentionally setup to drive up the costs of private insurance so less people can afford it, and move to a government plan. If government plans paid the same as private insurance private insurance would be far cheaper than it is right now. Those with private insurance are subsidizing the government programs in the form of higher premiums as well as those with no insurance who the government also forces doctors to treat without any payment.
The number of people on government programs goes up a few percentage points every year so eventually logic would dictate everyone will be forced to be on a government plan. The only people with private insurance and doctors will be only the wealthy, and the middle class (and below) will be on a government plan.
Our higher premiums are just another hidden tax the politicians have managed to hide from people, and if they paid the same as private insurance did these programs would cost in the trillions a year instead of the hundreds of billions they are now.
Government plans also have little to no incentive for people to not go to the doctor for every little thing. When you don't have to pay out of pocket for anything then what do you care how much something costs?
rickrock305
02-20-10, 12:58
More people can't afford it because the government programs pay a fraction of what private healthcare does for the same treatment, and those shortfalls are passed onto those with private insurance.
Like I said I personally know of a doctor who gets reimbursed 1/5th of what private insurance pays for his medicaid patients, and medicare is about 1/2 of private insurance.
ok, an example...when you go to the hospital and they give you a bandaid and charge you $10 for it. Medicare pays half that, which would be $5. Still an exorbitant profit margin. Its the runaway healthcare costs that lead to this problem, not the government vs private payment structure.
I do agree that they should all be paying the same amount for services though.
The system was intentionally setup to drive up the costs of private insurance so less people can afford it, and move to a government plan.
thats the downfall of a private, for profit system. shareholders demand that revenues continue to rise, so costs will continue to go up. thats the free market at work.
If government plans paid the same as private insurance private insurance would be far cheaper than it is right now.
no, it would not because they would continue to raise premiums in order to maximize profits. they're getting away with it at the exorbitant prices they have now, what motivation would they have to make it cheaper?
Those with private insurance are subsidizing the government programs in the form of higher premiums as well as those with no insurance who the government also forces doctors to treat without any payment.
Not sure how you derive that connection.
The number of people on government programs goes up a few percentage points every year so eventually logic would dictate everyone will be forced to be on a government plan. The only people with private insurance and doctors will be only the wealthy, and the middle class (and below) will be on a government plan.
exactly. like i said its a symptom of a larger problem which is the middle class being steadily eroded.
Our higher premiums are just another hidden tax the politicians have managed to hide from people, and if they paid the same as private insurance did these programs would cost in the trillions a year instead of the hundreds of billions they are now.
The problem is not the premiums but the exorbitant prices these hospitals and doctors charge.
Government plans also have little to no incentive for people to not go to the doctor for every little thing. When you don't have to pay out of pocket for anything then what do you care how much something costs?
This could be easily solved through a system of co-pays.
Well if you made people in the US do road work to earn their unemployment pay they would find jobs faster.
Actually....
In most states road work contracts work like this:
The project is put together with labor costs projected at the prevailing union wage.
The money is sent to the state DOT or the like.
The DOT provides some services like rerouting traffic and traffic control. However, the real WORK is bid out to private companies with preference going to union, woman owned, vet owned, minority ect shops.
The large outfits will then sub-contract out to smaller independents.
A few union guys and foreman will be put on the payroll to keep everything cool. Then, the sub-sub-contractors will sub-contract some undocumented Latin-American labor to actually work the shovels and hot asphalt.
So to recap, there is too much money being made by taking the skim off of the skim for anyone to even think of actually having Americans do this work.
Belmont31R
02-20-10, 18:42
ok, an example...when you go to the hospital and they give you a bandaid and charge you $10 for it. Medicare pays half that, which would be $5. Still an exorbitant profit margin. Its the runaway healthcare costs that lead to this problem, not the government vs private payment structure.
I do agree that they should all be paying the same amount for services though.
thats the downfall of a private, for profit system. shareholders demand that revenues continue to rise, so costs will continue to go up. thats the free market at work.
no, it would not because they would continue to raise premiums in order to maximize profits. they're getting away with it at the exorbitant prices they have now, what motivation would they have to make it cheaper?
Not sure how you derive that connection.
exactly. like i said its a symptom of a larger problem which is the middle class being steadily eroded.
The problem is not the premiums but the exorbitant prices these hospitals and doctors charge.
This could be easily solved through a system of co-pays.
Private insurance is a subsidy for the government programs because insurance has to pay so much more to make up the slack the government programs create.
Medicaid pays far fewer dollars for the same "care" insurance does, and insurance HAS to get charged more because of this if doctors and hospitals want to stay in business, and GASP make a profit. They are not a charity organization, and have lots of bills just like the rest of us.
Hospitals are expensive because you are paying for a lot more services and personnel. Yeah an aspirin and band aid cost a lot but that is the cost of doing business. They, too, have bills to pay, and hospitals do not sprout up out of nowhere. Last I checked a modern hospital is millions and millions of dollars to build, and they are staffed with professionals who get paid a professional's salary.
Private insurance is indeed making up the slack for government programs because government programs do not pay enough out for a hospital to stay in business, and have to charge insurance more than they otherwise would if everyone were paying the same amount for the same services. Insurance would be far cheaper if they got away with paying the same rates medicaid does.
Things are becoming harder on the middle class because they are being forced to provide complete lives to the poor and lazy. Very few rich actually pay taxes. Businesses do not. All these are regarded as business expenses, and are passed down to the consumer. Taxes on the rich directly translate into higher costs on the middle class in the form of higher costs everywhere they shop, and the "professional" services they seek out. Going to see that doctor gets to be more costly, that trip to the grocery store gets more expensive, etc.
The universal "idea" that keeps prices down is competition, and do to current laws there is very little competition in the market. If a business wanted to "maximize profits" as you put it they would, in a free market society, be faced with dozens of competitors who would be more than happy to take a cut in profit per capita for increased amounts of customers. In the system we have now competition is between only a few companies in most states, and thus competition is sorely lacking. That is due to government controls in the market place.
As more and more people are forced into government plans the more insurance is going to go up. It has to if the system is going to keep afloat. As more people enroll the less government pays out for medicare and medicaid reimbursement further driving up the costs of insurance. The amount the government has paid out in services has not corresponded to the amount of people in their programs.
Hospitals cost millions to build ,and staff.Room costs are in the neighborhood of $7000 per day. I can stay in a very nice ,as in 5 star+, motel with all services except medical ie. Dr. for less and get superior care. So where does the health care establishment get off in their exorbitant prices? BTW $7000/ day is semi private.
Part of it probably comes from the fact that doctors, nurses, and technicians are much more expensive to pay to have around than maids.
Bulldog1967
02-21-10, 16:04
The US system needs MAJOR MAJOR reform. The suggested reforms of the Democrats are 180 deg off the way that we need to go to reform the system. This has been discussed here several times already. Most people will not disagree that reforms should be made. However, the idea that gov can control a market without screwing it up is ludicrous and any "reform" based on that notion should be immediately dismissed.
Exactly.
Self employed here for the last 10 years.
Hospitals cost millions to build ,and staff.Room costs are in the neighborhood of $7000 per day. I can stay in a very nice ,as in 5 star+, motel with all services except medical ie. Dr. for less and get superior care. So where does the health care establishment get off in their exorbitant prices? BTW $7000/ day is semi private.
Sorry, we never paid anywhere near $7000 per day for a semi private room in a hospital. Even looking at the original charge before it got adjusted due to insurance agreements it was not near $7000/day. Where did you get this number from?
In fact, my wife had a baby 2 years ago and was in a private room (all maternity rooms are private at this hospital). She had a C-section and was in the hospital about 5 days. ALL the charges from the hospital, including nursing care, room and board, medicine, etc for my wife were less than $10k. That does not include the actual fees for the physicians who performed the C-section, nor for the Anesthesiologist, but does include everything that the hospital billed for, which was basically everything but the actual doctors fees. And that is before the insurance adjustments, which knocked it down a few $k.
However, hospital rooms have a much higher cost than a hotel room. Hospitals have to be built to certain standards. They are equipped with expensive equipment. AND, the hospital has to protect against liability so they pass that cost on to the patient. Hospitals get sued a lot more often than a hotel. Then, on top of that you have to figure the underpayment from the govt which gets passed on to the private patient, and also the costs for those people who do not pay their bills. A significant number of people in the hospital are so-called "frequent fliers" who are in and out all the time and who do not pay their own hospital bills. My wife is an RN and spent 2002-2009 in a normal medical/surgical floor and can tell scores of stories about such "frequent fliers."
thopkins22
02-21-10, 23:49
Part of it probably comes from the fact that doctors, nurses, and technicians are much more expensive to pay to have around than maids.
Wait...so you're saying that medical doctors/professionals(a relatively vital career in our society,) are people that we want to reward for hard work and success? I assumed that low wages and excessive regulation were the keys to getting the best and brightest in our hospitals.;) :p
ok, an example...when you go to the hospital and they give you a bandaid and charge you $10 for it. Medicare pays half that, which would be $5. Still an exorbitant profit margin. Its the runaway healthcare costs that lead to this problem, not the government vs private payment structure.
The runaway healthcare costs are CAUSED by this underpayment. That is not the only cause but is a major cause. The other major causes are all government induced as well btw. The government vs private payment structure as you cause it is a major cause of runaway healthcare costs. It is not a "greedy" healthcare system.
And your $10 bandaid is a strawman. First, show me a $10 bandaid on a legitimate itemized hospital bill. I have seen plenty of hospital bills and $10 bandaids and $5 tylenol pills were never on them. Second, such items and costs are a minimal part of the costs and revenue in a hospital. Overall, the government pays less than actual costs incurred to the hospital and doctors for care that they are paying for, in many many cases. I won't say all, but in many cases it is true. The deficit gets pushed over to he private payer. Even if the hospital did charge $10 for a bandaid, and medicare paid $5, which would seem to be a net gain for the hospital, the same patient cost the hospital Y$ for his time there and medicare only paid X$, with X<Y, so overall it was a net loss. This happens a lot.
i believe plenty of people would opt for paying for better care rather than settling for cheaper and worse care.
You can believe it, but most people would opt for the cheaper care. They already do. The number of people being paid for by the govt keeps going up and most people who are not in a govt program unfortunately get their healthcare through their jobs and take whatever they get. They could pay more and get better private policies but they don't.
In fact, in your govt run system, the care would be about the same in either case because the people are not making the decisions and choosing, they are all going to the same doctors and hospitals and getting their care and not seeing the details of the costs. The doctors and hospitals are not dumbing down the care for the govt people.
Well if you made people in the US do road work to earn their unemployment pay they would find jobs faster.
Good point! :D
like i said, thats a symptom of a larger problem. the gutting of the middle class. healthcare costs are skyrocketing and more and more people can't afford it.
Healthcare costs are skyrocketing due to cost shifting by the govt onto the private sector, and govt meddling in the healthcare system through coverage mandates, not allowing a real market for insurance, and providing unfair tax advantages for employer sponsored healthcare that private people do not get.
Additionally there is cost shift on pharmaceuticals by other countries onto the US through their socialized systems and price controls.
The govt has removed the market from healthcare pretty much completely and turned it into a service plan oriented system instead of a personal responsibility with insurance for catastrophic needs system like it needs to be. People need to be responsible for the first dollar spent on healthcare.
Healthcare needs to be rationed by the people themselves and their willingness to pay for it, not through a govt bureaucrat rationing in order to meet some sort of goal. Self-rationing through the market works. We have not had a real market for healthcare in a long time.
In the system we have now competition is between only a few companies in most states, and thus competition is sorely lacking. That is due to government controls in the market place.
It is even worse than this. Not only does the govt artificially destroy the market by not allowing cross-state purchase of insurance, for example, but many states have huge coverage mandates that spells out minimum coverage that ALL policies must provide, which jacks up costs, and also have guaranteed issue [meaning that they HAVE to issue you a policy even if you have lots of health issues coming in with you that are already known], and also community rating [meaning everyone has to pay the same amount no matter what, so the fit athletic person with good diet and lifestyle pays the same amount as the fat smoker slob]. All of this makes it hard to compete since there is really nothing to compete on, for the few players in the market, and also jacks up costs a huge amount. Some states also heavily regulate the rates companies are allowed to charge.
This could be easily solved through a system of co-pays.
No it couldn't. We already have co-pays in the current system.
We need PATIENT IS FIRST DOLLAR PAYER. We need a system in which the recipient of the healthcare is responsible for the costs first and foremost. Catastrophic insurance should be available for those who want to make sure that serious illness does not bankrupt them. Such plans typically have deductibles of $3k-$6k (per family) or so, which means that in effect, you pay for your own normal healthcare. Once you get past the deductible, we are talking more serious needs and they (insurance) then start paying according to some formula. Couple this with an HSA so you can put money away to cover this high deductible when you need it, but not lose the money like you do with the "Flexible Spending Account" stuff, and you come out ahead. If everyone was on such a plan, healthcare costs would be significantly lower.
We are currently on such a plan now. Offered through my wife's work, we don't have to pay anything for this plan (other normal low deductible plans cost a monthly fee) but we have a $3k family deductible I think (maybe $5k, I forget -- we never get close). One we hit the deductible we pay 20% and they pay 80% until we hit a maximum amount of out of pocket expenses, which is like $10k. The only exception to this is for well-person visits, which are assumed to be preventative. (Well baby/well child, physicals, regular checkups, etc). This we pay a straight $20 copay on for some reason. Probably to encourage us to get regular checkups.
This is a much better deal for us and for most people in the country. The other plans offered include no deductible plans, $500 per person $1500 per family, and $750/$1000 per person, $1500 per family. These plans would cost us a couple hundred to several hundred dollars a month. With these we would pay straight $20 copays for all visits and services inside the insurance companies member network of doctors and hospitals. But if you look at the costs, that few hundred to many hundreds of dollars per month we would be paying in the end come close to or surpasses our $3k and would come close to a $5k deductible. We don't go to the doctor that often so would have to pay against a $500 or $750/person deductible anyway, plus the monthly costs of the insurance, plus the copays. I bet that most people who opt for this sort of traditional plan do not hit their per person deductibles anyway, so end up paying lots per month, plus the bills before they it the deductible.
Instead we pay nothing, only pay our few hundred per person in bills, and stick any money we want to save for medical bills into an HSA that we get to keep until we retire and then use as normal retirement money (paying taxes on it then -- the money is put away pre-tax and used for medical expenses without being taxed).
Most of the country should be on such a plan. Healthcare costs would go way down if everyone was on such a plan and it would for all intents and purposes be a PATIENT FIRST DOLLAR PAYER plan.
Chad
rickrock305
02-22-10, 01:02
i feel like we're running around in circles at this point. besides, its way far off the topic of the thread anyway.
Belmont31R
02-22-10, 01:24
Hospitals cost millions to build ,and staff.Room costs are in the neighborhood of $7000 per day. I can stay in a very nice ,as in 5 star+, motel with all services except medical ie. Dr. for less and get superior care. So where does the health care establishment get off in their exorbitant prices? BTW $7000/ day is semi private.
One of my twins was in the ICU for 3 days (Dell Children's Hospital in Austin) with a head injury, and the total costs were around 15k including 2 CT scans, numerous consults with neuro surgeons, regular docs, other specialists, etc.
At the time I was paying out of pocket for BC/BS, and our total out of pocket expense was around $2500.
I'm not sure where you're getting the 7k a day just for the room but Ive never heard of it being anywhere near that much.
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