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Americans spend more on less health care

Health Care 2005

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#1 Spectacles

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Posted 17 July 2005 - 06:45 PM

We have a problem. I have no idea how to solve it, but it might be interesting to consider some possibilities.

Despite our conviction that we have "the best health care in the world," it appears that we're getting screwed.  

Insurance is unaffordable unless you have a good package through an employer. But employers are now struggling to provide insurance because it costs so much. (See GM.) So, it looks like soon there will be more Americans joining the ranks of the 45 million of us without health insurance unless something can be done to lower the cost of insurance and/or health care in general.

http://sptimes.com/2..._wrong_Rx.shtml

Quote

The latest study, conducted by Johns Hopkins University researchers and reported this month in Health Affairs, offers more evidence of the same. The United States spent $5,267 per person on health care in 2002. That's more than double, per capita, what 29 other industrialized nations spent. The total amounts to 14.6 percent of the U.S. gross domestic product. The United Kingdom, by comparison, spent 7.7 percent.

The costs are surging like an uncontrolled fever, and what the researchers found is that politicians are devoting an extraordinary amount of time to changes that have little appreciable impact.

The high-profile push to limit medical malpractice claims, for example, may help doctors in high-risk practices. But it won't do much to stem overall health care costs. Malpractice claims and legal bills account for less than 1 percent of health spending, the researchers said, and aren't appreciably higher than in other developed nations.

The push to get patients out of hospitals and doctor's offices for less expensive treatment options doesn't seem to help, either. Americans now see doctors less often and spend a fifth less time in hospitals than people in other countries. Yet we still pay more.

As the costs continue to climb, U.S. policymakers eventually will be forced to look at this confusing health care picture. Among the more infuriating realities is that a system that turns to Medicare for old people, Medicaid for poor people and employer insurance for workers still leaves 45-million people with no coverage at all. We pay more, per person, than any other industrialized nation and still leave almost one of every six people in the cold. That's bad medicine.

"Facts are stupid things." -Ronald Reagan at the 1988 Republican National Convention, attempting to quote John Adams, who said, "Facts are stubborn things"

"Although health care enrollment is actually going pretty well at this point, thousands and maybe millions of Americans have failed to sign up for coverage because they believe the false horror stories they keep hearing." -- Paul Krugman

#2 Spectacles

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Posted 17 July 2005 - 06:59 PM

Here's more:

http://www.medicalne...hp?newsid=27348

Quote

USA Spends More Per Capita on Health Care Than Other Nations, Study Finds
13 Jul 2005





The United States spends more on health care per capita than other industrialized nations but does not receive more services, according to a study published on Tuesday in the July/August issue of... Health Affairs, the Los Angeles Times reports. For the study -- led by Gerard Anderson, a health policy professor at Johns Hopkins Bloomberg School of Public Health -- researchers analyzed the health care costs of 30 nations in the Organization for Economic Cooperation and Development. The study found:

The nations examined spend a median of $2,193 per capita on health care;


The United States spent $5,267 per capita for prescription drugs, hospital stays and physicians visits in 2002, compared with $3,446 per capita for Switzerland, the next highest spender;


Health care spending accounted for 14.6% of the U.S. gross domestic product in 2002, a time when only two other nations -- Switzerland and Germany -- spent more than 10% of their GDP on health care;


The United States has 2.9 hospital beds per 1,000 residents, compared with a median of 3.7 beds per 1,000 residents among the other nations examined;


The United States had 2.4 physicians per 1,000 residents in 2001, compared with a median of 3.1 physicians per 1,000 residents among the other nations examined in 2002;


The United States had 7.9 nurses per 1,000 residents in the United States in 2001, compared with a median of 8.9 nurses per 1,000 residents among the other nations examined in 2002;


The United States has 12.8 CT scanners per one million U.S. residents, compared with a median of 13.3 scanners per one million residents among the other nations examined;


The United States appears to have more magnetic resonance imaging machines per capita than many of the other nations examined, but the machines are used only 10 hours daily in the United States, compared with a median of 18 hours daily in other nations; and


The average medical malpractice payment, which included both settlements and judgments, was $265,103 in the United States in 2001, compared with $309,417 in Canada and $411,171 in Britain.

So, if this study and its interpretations are accurate, we're paying a lot more for a little less.
"Facts are stupid things." -Ronald Reagan at the 1988 Republican National Convention, attempting to quote John Adams, who said, "Facts are stubborn things"

"Although health care enrollment is actually going pretty well at this point, thousands and maybe millions of Americans have failed to sign up for coverage because they believe the false horror stories they keep hearing." -- Paul Krugman

#3 Spectacles

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Posted 17 July 2005 - 07:06 PM

And more info, including another possible contributing factor (bolded):

http://www.latimes.c...1,5116336.story

Quote

The latest study bolsters a 2003 paper co-authored by Anderson entitled, "It's the Prices, Stupid," which identified fee differences as the primary cause for the gap. That report found, for instance, that the average cost of a one-day stay in a hospital in the U.S. was $2,434 in 2002, compared with $807 in Canada.

The "U.S. does not get commensurate value for its healthcare dollar," said Karen Davis, president of the Commonwealth Fund, a New York-based private, nonpartisan organization that supported the study.

Jack Lewin, chief executive of the California Medical Assn., said malpractice costs were probably only a small reason for the healthcare spending gap. He believes that the difference in spending has more to do with a uniquely American expectation for a high level of care.

"We have a little twinge in our knee, we want an MRI," he said. "We want to see a specialist immediately. We want care now. Some of that is good in terms of getting an early diagnosis. But it's expensive."

He added: "All of us baby boomers [want] to play tennis til 90 [that means] new hips, new knees. We're going to have it all. So until all of us as a society get more realistic about healthcare, I don't know that we're going to change this dynamic."


*

Heathcare spending

The United States has the highest per capita spending on healthcare among countries in the Organization for Economic Cooperation and Development, but that doesn't necessarily translate into more resources.

Highest per capita healthcare spending and OECD median in 2002

United States: $5,267

Switzerland: $3,446

Norway: $3,083

Luxembourg: $3,065

Canada: $2,931

OECD median: $2,193

"Facts are stupid things." -Ronald Reagan at the 1988 Republican National Convention, attempting to quote John Adams, who said, "Facts are stubborn things"

"Although health care enrollment is actually going pretty well at this point, thousands and maybe millions of Americans have failed to sign up for coverage because they believe the false horror stories they keep hearing." -- Paul Krugman

#4 eloisel

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Posted 17 July 2005 - 11:43 PM

Agreed we need some improvements.  Like you, I don't have a solution.  One of the things I'll be looking to the 2008 candidates is for ideas on healthcare solutions, along with other senior citizen issues.

#5 woody000

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Posted 18 July 2005 - 01:47 AM

*sigh* This is why a national health service is so important. Health-care should be for everyone, not just the rich. That really is THE solution. It might be difficult for the US government to balance their budget while they get used to it, but it's the morally right thing to do. It's quite sad when one of the few countries that still calls itself a CHRISTIAN country, is one where health services are privatised.

Edited by woody000, 18 July 2005 - 01:51 AM.


#6 TechHarper

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Posted 18 July 2005 - 03:25 AM

woody000, on Jul 17 2005, 11:47 PM, said:

*sigh* This is why a national health service is so important. Health-care should be for everyone, not just the rich. That really is THE solution. It might be difficult for the US government to balance their budget while they get used to it, but it's the morally right thing to do. It's quite sad when one of the few countries that still calls itself a CHRISTIAN country, is one where health services are privatised.

<{POST_SNAPBACK}>



Well, actually the U.S. doesn't call itself a Christian country and even if it did, that wouldn't dictate a socialized health care system.  Furthermore, the United States will likely have the hardest time trying to adopt such a system and, in my opinion, it will most likely fail if ever attempted.

The simple fact is that the nature of our republic almost always results in redundancies and additional costs.  I've read that those countries that have socialized healthcare have been having problems because new medical procedures and technology are so expensive.  Now imagine those problems in a country of nearly 300 million people that has beuracracies and governments with overlapping power.  The checks and balances inherent in our system carry with them a cost and in this case that cost would probably make the already high cost of a socialized health care program even higher.

As much as I would love for there to be healthcare for everyone, I seriously doubt it will be feasible.  The cost would simply be too high and there's no way you could convince Americans to pay the extraordinarily high taxes required.
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#7 woody000

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Posted 18 July 2005 - 03:50 AM

What's that sentence on your notes then? What about the pledge of allegiance? True, no country is really a Christian country, but I've heard many people say that the US is, yet in terms of the way it treats its people it's far from it. Anyway, that's a sidebar really.

It's not as expensive as you might think. In the UK, we don't pay extraordinarily high taxes. There is a lot less admin/bureaucracy costs that you have in private organisations. And private companies make a profit, where as with public health care, every penny goes into the health service itself. The US would have a harder time with a large population and larger slice of which is poor, but it's no where near as expensive as some would think.

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Edited by woody000, 18 July 2005 - 03:53 AM.


#8 Godeskian

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Posted 18 July 2005 - 03:59 AM

woody000, on Jul 18 2005, 09:50 AM, said:

It's not as expensive as you might think. In the UK, we don't pay extraordinarily high taxes. There is a lot less admin/bureaucracy costs that you have in private organisations. And private companies make a profit, where as with public health care, every penny goes into the health service itself. The US would have a harder time with a large population and larger slice of which is poor, but it's no where near as expensive as some would think.

I should add though that the NHS is about as good an example for private healthcare as there is imaginable. When you have people being told that it will be 18 months till treatment, folks left in Emergency Rooms for as much as a day before being seen, superbugs, lax standards and practises and everything else that goes wrong with it, you couldn't convince me to go NHS for anything.

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#9 woody000

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Posted 18 July 2005 - 04:01 AM

You say that but it's getting much better now, it was just starved of investment for ages. I suppose that depends which area you're in though, averages are always cold.

EDIT: And besides, the rich can still go private, but the important thing is that the poor can at least have some kind of health-care, rather than none at all.

Edited by woody000, 18 July 2005 - 04:02 AM.


#10 TechHarper

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Posted 18 July 2005 - 04:09 AM

woody000, on Jul 18 2005, 01:50 AM, said:

What's that sentence on your notes then? What about the pledge of allegiance? True, no country is really a Christian country, but I've heard many people say that the US is, yet in terms of the way it treats its people it's far from it. Anyway, that's a sidebar really.

It's not as expensive as you might think. In the UK, we don't pay extraordinarily high taxes. There is a lot less admin/bureaucracy costs that you have in private organisations. And private companies make a profit, where as with public health care, every penny goes into the health service itself. The US would have a harder time with a large population and larger slice of which is poor, but it's no where near as expensive as some would think.

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<{POST_SNAPBACK}>


At the risk of sidetracking this thread... the United States is based on secular laws.  Yes it's true that many people claim it's a Christian country, but making the statement doesn't make it true.  The first amendment to the Constitution more or less disproves this assertion:  "Congress shall make no law respecting an establishment of religion, or prohibiting the free exercise thereof; or abridging the freedom of speech, or of the press; or the right of the people peaceably to assemble, and to petition the Government for a redress of grievances."  There are many Christians in the country, that's a fact, but the U.S. is a secular government.

As for the actual issue involved, I would point out that the UK and the U.S. have different forms of government, different populations, and different situations.  Also, I would once again emphasize that the U.S. government has more redundancies and thus more expenses.  Finally, what Godeskin said.  I've heard similar complaints about the Canadian system as well.  So, unless the U.S. comes up with a novel approach that works better than systems already implimented and is specifically tailored for the checks and balances inherent in its government, I just don't see it happening.
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#11 woody000

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Posted 18 July 2005 - 04:36 AM

TechHarper, on Jul 18 2005, 09:09 AM, said:

At the risk of sidetracking this thread... the United States is based on secular laws. Yes it's true that many people claim it's a Christian country, but making the statement doesn't make it true. The first amendment to the Constitution more or less disproves this assertion: "Congress shall make no law respecting an establishment of religion, or prohibiting the free exercise thereof; or abridging the freedom of speech, or of the press; or the right of the people peaceably to assemble, and to petition the Government for a redress of grievances." There are many Christians in the country, that's a fact, but the U.S. is a secular government.


Fair enough, though while we're quoting documents, you should also note from that link I posted:

Quote

the United States signed the United Nations Universal Declaration of Human Rights, which states, "Everyone has the right to a standard of living adequate for the health and well-being of himself and of his family, including food, clothing, housing and medical care and necessary social services, and the right to security in the event of unemployment, sickness, disability, widowhood, old age or other lack of livelihood in circumstances beyond his control." (Article 25);

Quote

As for the actual issue involved, I would point out that the UK and the U.S. have different forms of government, different populations, and different situations. Also, I would once again emphasize that the U.S. government has more redundancies and thus more expenses.

It's true. But I still believe it's possible and in my own opinion it is the morally right thing, providing that it is possible. I do like America, I would even consider living there, as I am adequately rich, but I feel for the poor there.  

Quote

Finally, what Godeskin said. I've heard similar complaints about the Canadian system as well. So, unless the U.S. comes up with a novel approach that works better than systems already implimented and is specifically tailored for the checks and balances inherent in its government, I just don't see it happening.

<{POST_SNAPBACK}>


But as I said, the rich can still get better medical care if they wish. The important thing is that the poor have SOMETHING, regardless of how little money they have.

EDIT: Oh and by the way, if anyone wants the figures, to see the improvements to waiting times in the UK themselves, they are here: http://www.performan...k/waitingtimes/

Edited by woody000, 18 July 2005 - 04:40 AM.


#12 Godeskian

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Posted 18 July 2005 - 05:39 AM

woody000, on Jul 18 2005, 10:01 AM, said:

EDIT: And besides, the rich can still go private, but the important thing is that the poor can at least have some kind of health-care, rather than none at all.

Yes, and for reference, I don't find private healthcare all that extortionate. You can get decent medical care for a monthly bill that is less than Sky sattelite TV.

Of course, far more people have sky than medical insurance, but that's a choice you make.

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#13 Spectacles

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Posted 18 July 2005 - 06:50 AM

Quote

TehcHarper: So, unless the U.S. comes up with a novel approach that works better than systems already implimented and is specifically tailored for the checks and balances inherent in its government, I just don't see it happening.

Does our system really work better? (An honest question. :) )

We pay far more for less health care. Granted, it's state-of-the-art health care, but it's increasingly inaccessible because it's being priced out of reach.

By "checks and balances inherent in its government," are you referring instead to our economy? I ask because it's my understanding that our government doesn't have much to do with the insurance business--unless it comes to funding candidates' campaigns and sending insurance-friendly congressmen to the Bahamas for "conferences." There is a ton of money that the insurers pay to government officials to keep the balance tilted in their favor. So it seems to me that one thing we possibly need is a check to ensure some balance.

Does a system have to be laissez-faire for insurers and pharmaceutical and medical suppliers NOT to be socialist? Is there no in between? Would overseeing and regulating these industries to prevent price-gouging be un-American?

Edited to add that the last paragraph isn't directed toward TechHarper, who didn't indicate any of that. But it's more an effort to anticipate arguments that government needs to stay out health care altogether and let market forces determine pricing.

Edited by Spectacles, 18 July 2005 - 09:02 AM.

"Facts are stupid things." -Ronald Reagan at the 1988 Republican National Convention, attempting to quote John Adams, who said, "Facts are stubborn things"

"Although health care enrollment is actually going pretty well at this point, thousands and maybe millions of Americans have failed to sign up for coverage because they believe the false horror stories they keep hearing." -- Paul Krugman

#14 Anakam

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Posted 18 July 2005 - 08:59 AM

And people wonder why I'm rushing to get things taken care of, healthwise, before I go off my parents' insurance so I won't have to have complete coverage, like eye care.... should I manage to track down anything resembling insurance at all.

Is all that money really going to 'instant diagnosis' and new joints, things like that?  Umm, can the rest of us have a little care so we'll be healthy enough to actually work in 20 years, please? :p
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#15 Themis

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Posted 18 July 2005 - 11:31 AM

One big factor is the cost of drugs.  I don't know what advertising contributes to the cost, but I don't understand drug companies advertising on tv and in in print when the medications they advertise are only available by prescription.  Advertise in medical journals, maybe, but general consumer media?  I suppose the idea is that you'll go ask your doctor for that medication, but I certainly wouldn't want my doctor prescribing something just because I asked for it...

I also don't understand how clinics and other providers can post signs saying "no insurance?  We can discount."  Why don't they charge everybody less and maybe insurance wouldn't cost so much????

Our hospitals also have mostly private or 2-patient rooms as opposed to wards that I know some UK hospitals have.  

I read an article on the Medicare prescription plan last week and computed that I'll be spending a minimum of $2,000 a year on prescriptions when I retire - not that I expect to be able to afford to retire, but I assume a company wouldn't continue to pay for my private insurance when I reach Medicare age...

[BTW, [b]Woody[/b], the currency claims "in God we trust," not "in Jesus we trust."  So it is not necessarily a Christian statement.]

Emergency rooms pretty much have to treat anybody, but that's for real emergencies.  Where the system really falls down is in preventative care.  There are plans for the really poor and the really rich are ok.  More and more it's the middle where people don't have insurance and don't go to a doctor for routine checkups and prevantative care, which could save money and agony by catching things early.  There are things I would object to funding with my taxes, but if someone could come up with a way for everyone to get a checkup and needed immunizations yearly, I might be ok with that.

With states and companies facing budget crises over healthcare, it's gonna get worse before it gets better, and if there's a genius out there who can figure it out, that person should be worshipped.

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Edited by Themis, 18 July 2005 - 11:33 AM.

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#16 woody000

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Posted 18 July 2005 - 12:15 PM

Themis, on Jul 18 2005, 04:31 PM, said:

Our hospitals also have mostly private or 2-patient rooms as opposed to wards that I know some UK hospitals have. 

Most UK hospitals have wards. Tbh, it might not be what you're used to, but there's little wrong with wards. You have to be extra vigilant against super-bugs and the likes, but it's worth the cost cutting. I know I'd rather stay on a ward and think I'm helping the poor have medical care. Maybe I'm in a minority there, but I don't believe I should be. *looks around in an accusatory way*

People who need to be isolated, people with more serious problems and when there's room, long stay patients tend to be the ones with their own rooms.

Quote

[BTW, [b]Woody[/b], the currency claims "in God we trust," not "in Jesus we trust."  So it is not necessarily a Christian statement.]

Technically true. Although one look at the % of your population who are Christians as compared to other religions makes it clear why I focused on Christianity. :p

#17 TechHarper

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Posted 18 July 2005 - 01:18 PM

Spectacles, on Jul 18 2005, 04:50 AM, said:

Quote

TehcHarper: So, unless the U.S. comes up with a novel approach that works better than systems already implimented and is specifically tailored for the checks and balances inherent in its government, I just don't see it happening.

Does our system really work better? (An honest question. :) )

We pay far more for less health care. Granted, it's state-of-the-art health care, but it's increasingly inaccessible because it's being priced out of reach.

By "checks and balances inherent in its government," are you referring instead to our economy? I ask because it's my understanding that our government doesn't have much to do with the insurance business--unless it comes to funding candidates' campaigns and sending insurance-friendly congressmen to the Bahamas for "conferences." There is a ton of money that the insurers pay to government officials to keep the balance tilted in their favor. So it seems to me that one thing we possibly need is a check to ensure some balance.

Does a system have to be laissez-faire for insurers and pharmaceutical and medical suppliers NOT to be socialist? Is there no in between? Would overseeing and regulating these industries to prevent price-gouging be un-American?

Edited to add that the last paragraph isn't directed toward TechHarper, who didn't indicate any of that. But it's more an effort to anticipate arguments that government needs to stay out health care altogether and let market forces determine pricing.

<{POST_SNAPBACK}>


Spectacles, you misunderstood what I meant.  I'm not saying our current system works better, only that the additional costs inherent in our system of government would likely require a better socialized healthcare system (in other words, one with lower and/or fewer costs).

When I say "checks and balances inherent in its government" I mean that a socialized healthcare system will have to contend with the natural redundancies resultant from the checks and balances and will likely be more expensive.  This kind of thing happens all the time in the government (redundant paperwork, jobs, products, expenses, etcetera) and I fear what this would mean for the already expensive cost of healthcare.  I suppose another possibility is that the healthcare will be less expensive but the service will be unresponsive. *shrug*

An additional question I have (not specifically aimed at Spectacles, but anyone who wants to answer it) is how much will we pay the nurses and doctors under a theoretical socialized healthcare program in the United States?  There's already a shortage of both and cutting pay to cut costs would most definitely NOT be an option.
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#18 Cardie

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Posted 18 July 2005 - 01:23 PM

The time we'll get healthcare reform will be the time when it's such a burden on every other business except the insurance companies that they lobby Congress to clamp down on price-gouging.

In every industry where a majority of the customers pay through insurance rather than through what a majority of the population can reasonably afford on their unsubsidized income, rates are jacked up to take advantage of the subsidies.  This would probably happen with government-supported healthcare as well.  Medicare and Medicaid are getting hammered, even with their ceilings on payments.  I once scraped up my car on the side of my garage and decided it was cheaper in the long run to pay for it myself rather than let the insurance company know and have them raise my premiums.  When the body shop knew that no insurance adjuster was coming to look at the estimate, they cut the price 50%.

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#19 MuseZack

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Posted 18 July 2005 - 01:32 PM

Honestly, I think the thing that will at the end of the day make some form of national health care inevitable is genetic testing.  As screenings for various diseases and conditions get ever more sophisticated, insurance companies will come up with ever more creative excuses not to insure people.  The logical solution is to put everyone together to maximize the size of the risk pool-- and that means national health care.
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#20 TechHarper

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Posted 18 July 2005 - 01:39 PM

woody000, on Jul 18 2005, 10:15 AM, said:

Themis, on Jul 18 2005, 04:31 PM, said:

Our hospitals also have mostly private or 2-patient rooms as opposed to wards that I know some UK hospitals have.

Most UK hospitals have wards. Tbh, it might not be what you're used to, but there's little wrong with wards. You have to be extra vigilant against super-bugs and the likes, but it's worth the cost cutting. I know I'd rather stay on a ward and think I'm helping the poor have medical care. Maybe I'm in a minority there, but I don't believe I should be. *looks around in an accusatory way*

People who need to be isolated, people with more serious problems and when there's room, long stay patients tend to be the ones with their own rooms.

Quote

[BTW, [b]Woody[/b], the currency claims "in God we trust," not "in Jesus we trust." So it is not necessarily a Christian statement.]

Technically true. Although one look at the % of your population who are Christians as compared to other religions makes it clear why I focused on Christianity. :p

<{POST_SNAPBACK}>


Hi again.

Actually, you're not the only one who would like the poor to have medical care.  If I had my way, everything would be exactly like what you quoted from Article 25 of the United Nations Universal Declaration of Human Rights.  But, as we all know, most things are easier said than done.  And lest you think I'm in a position to afford healthcare for myself, I'm not.  After I move I'm not going to have any healthcare at all, so I honestly do feel for those who don't have it now.  I simply can't see a valid solution though.  That doesn't mean there isn't one and I certainly hope someone figures out a plan that isn't exorbitantly expensive but still manages to provide decent medical care.  I can hope for the best and expect the worst right? :)

Let's face it, there isn't a simple answer and just handing healthcare issues over to the federal government isn't the answer (not in my opinion).  A completely novel plan needs to be drafted if such a program is going to survive in the U.S.

As for the Christian country bit, our original national motto was "E Pluribus Unum" and "In God We Trust" was only added during the Cold War because communism had state enforced atheism (it heightened the "them versus us" mentality to add the religious messages).

In addition, our laws are secularly based, we have people of every faith living here in the U.S., and there are always court battles going on trying to determine what point is THE point seperating religion from government (and you'll notice that religious issues are almost always viewed as having little or no place in the government).  

If you're purely talking numbers, then yes, the majority of Americans identify themselves as Christians and we could thus label the U.S. as a Christian country.  This, however, might be seen as untrue by the many Jews, Muslims, Hindus, agnostics, atheists, Constitutional historians (:p) and countless others who aren't Christian or who know the history of our laws. ;)
"When the government fears the people, there is liberty; when the people fear the government, there is tyranny. - Thomas Jefferson
"A nation that limits freedom in the name of security will have neither." - Thomas Jefferson



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