Healthcare?

I love Canada...
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Having first hand experience within the French system I'm going to keep touting it as the example America should follow

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.

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. talking 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,"

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? France gets better results for less money and everyone is covered.

No, not necessarily punishing anyone. I know, this is going to be a horrible analogy, but think of it as a fast car. Do you want a really fast, sexy car? For faster, better, more hands-on quality, you are going to have to pay more for it. Do you want an average car? That's where the Toyotas, Fords, Opels, KIAs are for. The very nature of capitalism necessitates that better quality = more money.

In Germany, you have two options: public health care, which is near universal and is insured by the federal government, or a private option. Public health care is managed by non-profit public corporations chartered through government ministries. It's cheap, it's affordable, and nearly everyone on the political spectrum, from your uber-conservative, lederhosen-wearing Bavarian Catholic to your East Berlin, Die Linke-voting intellectual socialist agree with. 88% of the population have this.

The other 12% have opted for private care, managed by private health consortiums. There's less lines, it's more intensive, and it's more expensive. That's not punishing anyone. That's the way it is, because people have opted out of the government-insured health system for a private one. You want to opt out for faster results? Okay, you're free to do so...but pay a little more.

I'm very satisfied with the public option here. It's very efficient, it's not expensive, and it works. This isn't a country where you line up behind a shack and get to see a ragtag doc wearing clothes donated from the Cuban government. Hardly. The hospitals and equipment are modern, the doctors and nurses are well paid, and its professional. And, my fellow Americans, it's nothing to worry about There is absolutely no reason why this can't be done in the U.S.. I guess this is what "socialism" looks like, despite the fact that Germany is one of the most capitalist societies on earth.

And since we live in societies that value choice, there's also no reason why there can't be a public option and a private option. Because a majority of the people like saving money and getting the biggest bang for their buck, they'll go for the public option. It's simple psychology.

MayorEmanuel,

It looks like the French system to pretty similar to the German one. I also repeatedly tout the system here. We should definitely try this in the States.

Except we got to win over the Republicans and the Tea Party, so we have to give it some appealing name like "Patriot Care" or "Not-Really-Commie-Because-You-Will-Live-Longer Care"

See, that's not what you originally said. You said that a private option is okay only if (or, as you put it, so long as) it costs more than the public option.

Also, don't double post.

And why not pay more? Don't you think there should be a cheaper, government insured public option? Or is this the classical conservative "private sector is cheaper" belief?

That I can agree with. It's more than likely not affordable at the current time. If we were not throwing money into the black holes that are Iraq and Afghanistan, as well as reducing the Defense Department budget, it might be feasible. In the end, I think military spending is one of our 800 pound gorillas in the room. And I mean, one of them.

As for the double posting...ooops...didn't know.

Obviously I'd like the public option to be a cheap as it reasonably could be, but in no way do I want the private sector to HAVE to offer higher priced plans. If there's a cheaper alternative, then I'd prefer it. Mandating that there can't be is just counterproductive.

Not even if we just stopped spending on the military altogether would that be true.

Streamlining the expenses of our military is of course a good idea, but if we start legitimately cutting, where do we cut? R&D, salaries, maintenance, logistics, NATO spending; what is unnecessary?

Well, the first point as to why the private option is more expensive here is for a number of factors. It is more or less reacting to supply and demand and available technology, the very nature of its clients, and government regulations. Since only 12% of the population use it, it financial options are limited. Also, because its clientele are more wealthy, private health firms elect to charge more from its limited base of customers. Finally, the German government maintains if you make roughly more than 4,000 euros a month, you can disavow the public option to join a private health firm. That effectively puts a cap on the numbers who can join, and this has been upheld by both conservative and socialist governments alike.

However, many people who do make over this minimum continue to stay on the public option. It's simply cheaper and the care is still roundly efficiently. So yes, the cheaper alternative to more expensive care is the public one, as continued governments believe that private health should be more expensive, and also the dictates of the economy have made it more expensive. Health care should not be competitive. If you don't like it, vote for other political parties, because the Volkspartei in the Bundestag--the mainstream parties--agree to this. Since these parties reflect popular opinions, it means that generally people in this country want private care to be more expensive.

Just my opinion, but many of the U.S. military bases we have here in Germany are unnecessary. The Cold War is over, the threat from the Fulda Gap is now only in history textbooks. Many bases are gone now or in the process of closing, yet those that remain I think are largely redundant, and most locals agree. In my opinion, we should have a reduced presence strictly limited to NATO operations. I'm not someone in the GAO, but I can tell you that I think our forces are far overstretched, and we need to cut expenditures or raise taxes. Yes, that means fewer men in uniform, less spending, less equipment. For example, we're in the process of building and planning three new aircraft carriers. I love navy ships like any dork does, but do we really need three new ones?

Also, we are spending nearly $6.7 billion a month in Afghanistan.
We spent $7.3 billion a month in Iraq in 2009.
In total, we have spent $795 billion in Iraq and $495 billion in Afghanistan. This is absurd.

This seems absurd to me, that we should literally enforce a block on the free market's greatest asset: competitiveness. By mandating that private healthcare can't move on the lower income market you're strangling efficiency. If a better alternative is available, then by God we shouldn't cast it out for being better!

When something as big as an aircraft carrier is commissioned there is more than enough justification behind it. To think that our administration would simply throw money into a pit without any reason is naive; if top military minds come to the conclusion that three new aircraft carriers are needed to maintain our edge then I'm inclined to believe them. Not just on their word, but by virtue of the entire process that getting major projects like this require. Enough eyes have passed over the request that it becomes far more questionable to act against this move than to support it.

In other words, if you want to throw military cuts at me, give me good reasons as to why these cuts aren't going to harm our strategic interests.

As you can see, these people are suffering from the lack of a competitive health care system...and this coming from a country that still has AAA credit rating (which the U.S. doesn't have anymore) and is number 6 in global competitiveness, only after the U.S. of A. This society has agreed that private health care should be more expensive. And the irony is...they live longer!

These kind of arguments are not even on the agenda in most developed first world nations, because they have been more or less agreed to by all mainstream sides of the political spectrum...except, of course, the United States.

Throwing over a trillion dollars into wars that stoke more fumes than extinguishes over the last ten years is not what many people would call "rational." And the three aircraft carriers...really, are they necessary when we have 11 of them already, more than everyone else...combined? Granted, I think a few are necessary, but I'm realistic about what money we can afford to use and what money we have to borrow endlessly...from China.

there are many things that can be cut or at least made more cost effective.

US tanks currently cost twice as much to keep running then any other NATO tank for the same performance.

the US army are push for air-burst grenade launchers that are for the most part useless in the numbers they want to order.

the US airforce is replacing the F-22 with the F-35 for over 350billion, and the kicker is that the jet has very little different from the f-22

the US navy is making 3 new aircraft carriers (we have 11 already with 2 inactive but still ready) and is making their next line of destroyers out fitted with a 65MJ rail cannon.

the only military branch that's not overly spending on useless things is the marines, and that's means alot when I"M saying something good about those jar heads

You could always raise taxes, but god forbid that ever happened. I think your population is about the same average age as European countries. If you look in the long term, I think it would be a far better option to have slightly higher taxes and some form of public healthcare.

Obviously right now is not a good time to overhaul the healthcare system but when our financial situation is more like it was in the 90's we should implement this.

No to better doctors for the wealthy. People must have equality in healthcare.

Well in Germany the public option is already amazing, I actually like the 2-tier system.

We already have 11 aircraft carries. I am pretty sure no other country has more than 1. :|

Here in New Jersey we have probably the highest tax rates in the nation, and still are at the bottom when it comes to unemployment.

I'll ignore this obvious logical fallacy.

Only to be immediately confronted with another after... For one, we still have a AAA credit rating from all three major rating agencies, for two, those ratings mean nothing whatsoever because the health of the bonds market isn't determined by some petty organization, and for three none of this attacks my point. You are simply insulting my nation, in a kind of indirect ad hominem. But the validity of my argument isn't contingent on your perception of US credit or competitiveness.

Again, this doesn't do anything to counter my point that you're literally subsidizing inefficiency. To force private companies into a situation where they can't provide cheap alternatives to the public option doesn't make rational sense.

We are winning the wars pretty clearly.

You don't think that the DoD and Congress wouldn't raise these concerns? If they have been commissioned, it's been for a reason. And unless you can prove we don't need them to maintain and expand our global influence and power, then I'm apt to agree with the DoD and Congress here.

China isn't an issue, nor should it be considered one.

Again, this doesn't do anything to counter my point that you're literally subsidizing inefficiency. To force private companies into a situation where they can't provide cheap alternatives to the public option doesn't make rational sense.

We are winning the wars pretty clearly.

You don't think that the DoD and Congress wouldn't raise these concerns? If they have been commissioned, it's been for a reason. And unless you can prove we don't need them to maintain and expand our global influence and power, then I'm apt to agree with the DoD and Congress here.

China isn't an issue, nor should it be considered one.[/quote:1i8qgp2l]

I agree that the downgrade of USA's credit rating by Standards and Poors isn't an issue, but your competitiveness has gone down over the last couple of years.
How do you know that public healthcare is inefficient? In many countries you can chose what you want, and most opt for public healthcare.
If by winning you mean spending trillions of dollars on what should/could have been popular revolutions then yes, we are winning. The wars in Iraq and Afghanistan(to a degree) were unnessesary. The invasions have only further antagonized relations with the people of the countries. If we instead had waited(as in Libya) to get public(from the locals) backing then the invations/liberations would have been much easier. The intervention in Libya is a perfect example of how I think it should have happened.
You really dont think China is a problem? When did you get so communistfriendly (I keeeed)

Youg guy's know why the US credit was down graded? They didn't like the way Congress handled the Debt Crisis. That's all.