The most important thing is to realise that America has devised a healthcare system which is neither free market nor government controlled. It is the consequence of years of special interest lobbying.

People who are against Obamacare (and although from the UK I count myself among them) need to be less negative. The thing we need to emphasise isn't that we are against Obamacare, but what healthcare system we are for when the status quo is so intolerable. As evidence of this, the US government spends more per capita on healthcare than the UK government does.

We shouldn't let ourselves be cast as for the current system, which is exactly what you are inviting people to do. We should point to how things can be improved by ending tariffs on drugs, reforming patent laws (possibly removing them), repealing licensing laws as far as we can to allow smaller practises to challenge monopolies, changing how people's healthcare is tied up with their job, liberating people from the insurance model by opening up choice.

When there is so much to be *for* why are you so focused on what you are *against*?

@ Ghostmaker.

Excellent point-America's system is not free market. As far as not government controlled Medicare and Medicaid give government strict control of large and rapidly growning segments of American medicine because of the aging baby boomers and Obama's redefinition of Medicaid.

I'm as against Obamacare as I am third-party insurance companies.
Consumers need to be directly aware of the costs of American medicine.
For example a relative just broke a hip. The cost after Medicare-$500.
We have no effective realization of the cost at all.
How can an economic good be efficiently utilized without cost information.
It can't.
This is exactly why the Soviet Union collapsed.
Communist/Statist economic control has no effective pricing mechanism.
This fact leads to either shortages or bankruptcy.
The CEO of Whole Foods has a hybrid policy in place for which the statist media villified him during the Obamacare fiasco. (Passing Obamacare by resolution was a fiasco that I hope does not permanently damage the legislative branch.)

Individuals have a health savings account of $2,500 (the figure may be higher in 2011.)
They contribute to the account before taxes on their pay check.
Individuals then pay cash out of the account for medical services.
They know the cost of services they pay for because an insurance company does not handle it.
If they have money left over it carries to the next year.
Studies already show that individuals with these types of accounts use less medical services than individuals on third party insurance.
Why?
Third party insurance shields individuals consumers from pricing and they develop the mistaken perception that the good is free or much cheaper than it is.
Therefore they use more of it.

We should get government completely out of the health care industry.
Medicare and Medicaid need to go.

The only insurance during a transition that individuals should purchase is catastrophic care with a high deductible.
This would reintroduce the pricing mechanism to medical care over time and reduce costs.
In elective surgery, Breast Implants/Lasix eye surgery, the pricing mechanism has steadily reduced the cost of procedures in the last decade.

"For example a relative just broke a hip. The cost after Medicare-$500.
We have no effective realization of the cost at all."

yes, and i'm sure your relative would have been much more safety conscious if he/she had know the cost before breaking his/her hip.

This is why the free market is soo successful - supply/demand: by charging full price for medical care to the consumer you will reduce the demand, and this will mean people will be more healthy.

'This is exactly why the Soviet Union collapsed.
Communist/Statist economic control has no effective pricing mechanism.
This fact leads to either shortages or bankruptcy. '

Exactly! and this is why the Soviet got into space first, over spending on the space programme and slave labour rates meant the US couldn't compete - over production of space development/technology is of course just the opposite of a shortage, but in this case it is a result of precisely the same cause!

no wait, what i meant to say is, why did you feel the need to compare unfavorably with communist russia? You have no figures to back up your ascertain and culturally there are many things where the two differ which would make a direct comparison difficult... also the soviet union collapsed because of internal party policy - or self-sabotage.

@orathaic, is that sarcasm? I cry Poe. I can't tell if you're being absurd on purpose or not.

@Tettleton's Crew, so - you are against insurance of any kind? (except, mysteriously, "catastrophic care with a high deductable" in "a transition")

"This is why the free market is soo successful - supply/demand: by charging full price for medical care to the consumer you will reduce the demand, and this will mean people will be more healthy."

Silly argument, has to be said. It does mean that people will go for cheaper options, encouraging people to develop new techniques and systems that don't cost so much. As is, it isn't relevant how much it costs.

@orathaic, I mean in regards to your first post

I don't see why Medicare can't be the consumer in this market to drive down prices... after all it actually *is*... There is great power in numbers... If you speak for a plan of millions of customers, companies respond... they are going to want to be the supplier that you choose in the market. Medicare gets low prices for drugs this way... and it also sets the price it's willing to pay for procedures... aggressively low, I understand. This saves tons of money.

@TheGhostmaker, perhaps, if you object to comparing "Obamacare" to the current dysfunctional system (created under free-market practices - including the market called political lobbying) and you feel that "Obamacare" should be compared to how things *could* be... then maybe we should compare it to a system that *does* work. ...or is your success story only theoretical? We have 195 (+/-) countries in the world that act as laboratories for different systems... I suspect that most are free-market in regards to health care (i.e. you get it if you can afford it, you don't if you can't). Surely there are some success stories you can point to.

I like looking at the pictures of the Hammer & Sickle on the moon.
Ooops, the Soviets never made it to the moon.
Ooops, the Soviets collapsed.
What enduring lesson of progress are we drawing from the Soviet Union?
It's entertaining to read posts about "Soviet accomplishments."
American reached the moon in a decade without killing millions in Gulags to get it done.
Communists never did or do worry about human costs.
Maybe that's why communism is in total disrepute. Duh!

Undoubtedly my relative would have received an entirely different protocol of care without Medicare in place if all costs were born by the family.
Is someone more safety conscious driving a rental car the company is paying for or their own care.
Duh!

Anyone who claims that a free market has existed in the health care field in the United States since the widespread use of third-party insurance by corporations in the decade after WWII and the advent of Medicare doesn't need to smoke pot to lose touch with reality.
They already have.
In fact the free market for medical care is when a patient pays for services rendered at the time they receive the care without the participation of a third party payee.
It seems the definition of a free market is not well understood by some.

It's entertaining to watch people talk about the particulars of Obamacare as if the particulars are known at this point.
The Obama administration just found out a month ago that their own law extended Medicaid to millions of Americans who previously did not qualify and who belong to income groups the administration itself designates as "middle class."

The only basis for referring to Obamacare's effect on the health care industry is "a dramatically enlarged role for the Federal Government" and no free market whatsoever because of the individual mandate.

Obamacare destroys the free market in health care completely because it demands you pay for a health plan the government approves.
The absolute anti-thesis of the free market.

As far as discussing the particulars of Obamacare, Health and Human services changes those every single day, and a majority of the bill hasn't even been defined by HHS yet.

This is what I love about you free market blowhards. You take credit for the free market when it's convenient and then any flaws in the system are attributed to not being free market enough. Private health insurance is apparently not free market because people should pay themselves for expensive operations. Brilliant.

Reading arguments that Obamacare drives down costs without a corresponding discussion of the rationing and reduction of care caused by those reduced costs is entertaining.
It means that the individual has no real world experience or understanding of Medicare and the reduction in medical services already occurring because of cuts.
Better yet do look at the service given to veterans as a result of cuts.
You still receive care if you are willing to travel hundreds of miles to the dwindling number of facilities that supply medical care to vets.

It must be calming to travel through life out of touch with reality.

"American reached the moon in a decade without killing millions in Gulags to get it done. "

What the hell do gulags have to do with the space race? The more you talk the more idiotic you sound.

So the Americans got the moon, the Soviets got the first space station, the first spaceflight ever, the first satellite in space, the first space rover, etc.

I'll take that record of accomplishment. And guess what? The only reason the US did anything in space was because of the US *government*. SACRE BLEU!

Oh and the Soviets got into space without relying on Nazi scientists to do it. #Winning.

So, in your idea of the free market, Tettleton, you would exclude private insurance companies...? Didn't the free market *create* the insurance industry? What is your objection? See, people like to reduce/control risk... so, naturally, there is a market for that. Would you deny people their freedom? ...so... what you're really yearning for is a *less developed* free market. A free market that doesn't respond to the consumer in certain select categories of services (insurance, at least) that you object to.

Apparently the free market worshippers only like certain markets. Some markets are better than others.

Canadian (and probably British) patients wait considerably longer to see a specialist then American patients who can afford it. I have heard that many Americans won't go to a doctor when they should because of the cost (is this true).

In Canada, dental care is not covered under the universal health care and I know there are many students who don't see a dentist when they should because they have other priorities for there money.

I think that health care and education are two responsibilities that the government should provide to its citizens. (Perhaps we should start a thread debating what the government should and should not do)

Joey, no it isn't true that Americans don't go to the doctor because they can't afford it.
Americans do choose to spend their money on something besides medical care just like students who don't see a dentist in Canada because of other priorities.

Joey, you should rephrase your last statement.
It should say that you want government to force on set of citizens to pay for the healthcare of another set of citizens.
Government isn't a business that generates profits and dispenses those profits.
Government simply seizes the productive output of one citizen and spends however politicians decide to spend it.
Like on the bridge to nowhere.

Dexter, If you bother to read my posts I've already stated exactly what I advocate.
Here, I'll copy and paste it from a post higher up the thread that you didn't bother to read obviously.

This policy is already in places for employees of numerous American corporations.
Whole Foods is one.
Of course the government doesn't authorize the same program for individual Americans because that would undermine Obamacare's attempt to totally take over the United State's health care system.

Here is the passage you didn't bother to read.

ndividuals have a health savings account of $2,500 (the figure may be higher in 2011.)
They contribute to the account before taxes on their pay check.
Individuals then pay cash out of the account for medical services.
They know the cost of services they pay for because an insurance company does not handle it.
If they have money left over it carries to the next year.
Studies already show that individuals with these types of accounts use less medical services than individuals on third party insurance.
Why?
Third party insurance shields individuals consumers from pricing and they develop the mistaken perception that the good is free or much cheaper than it is.
Therefore they use more of it.

We should get government completely out of the health care industry.
Medicare and Medicaid need to go.

The only insurance during a transition that individuals should purchase is catastrophic care with a high deductible.
This would reintroduce the pricing mechanism to medical care over time and reduce costs.
In elective surgery, Breast Implants/Lasix eye surgery, the pricing mechanism has steadily reduced the cost of procedures in the last decade.

"Joey, no it isn't true that Americans don't go to the doctor because they can't afford it. "

What fantasy world are you living in? A typical doctor visit costs hundreds of dollars and that's if they don't do any tests.

"55 percent of all Americans say they can’t afford the cost of wellness visits out-of-pocket
81 percent of uninsured Americans say they can’t afford the cost of wellness visits out-of-pocket
76 percent of unemployed Americans say they can’t afford wellness visits costs out-of-pocket
25 percent of Americans did not see their physician for a wellness visit in the past year"

http://mobihealthnews.com/3913/ibm-proactive-health/

Here is a link to a price list of services offered by a doctor in Minnesota.

I'm sure most of you are completely unaware of what medical services cost because you've either had someone besides yourself pay for it completely or only took care of a co-pay.

Urgent Care:
One Problem: Visits start @ $45
Two Problems: Visits start @ $70
After Hours: Visits start @ $60

Primary Care
One Problem: Visits start @ $45
Two Problems: Visits start @ $70
Three Problems: Recommend Scheduling a Physical
After Hours: Visits start @ $60

Miscellaneous Services:
Depo Shot starts @ $80
Cortisone Injection $100
Toradol Shot $25
DOT Physical $65
Physical $140
Ear Flush $20
EKG $25
Microscopic $20
Neb Treatment $25
Pap $25
Paperwork $16 & Up
Strep Test $15
Surgery Negotiable
Tuberculosis testing $20
Urinalysis $15
Wart (one) $25

You spend more on sports tickets than a medical visit.

No, but should health care be a business? or should it be a service that is provided by the government.

What should the governmental do? Should they collect garbage? Deliver mail? Build roads/canals/railways (getting a little historical here)? Primary education?

There are private schools, privately operated toll roads, private garbage collection, and letter and parcel delivery, but I still think that the government should play a role in some of these.

The funny thing about critics of the free market in medicine is that the overwhelming majority of medical procedures that have "decreased" in price over the last decade are those not normally covered by insurance but in high demand by individuals.
Lasix surgery, plastic surgery, and lap band surgery are perfect examples.

While we're at it, let's also eliminate banks and loan companies... I want people to pay for houses on the spot - with their own money. Wait! Money itself separates people from the transaction... I propose outlawing money and going to a barter-only system. But wait!, can someone fully appreciate the value of a service if someone else did it for them? I favor every man for himself... if you can't do something completely on your own (build a house from the trees in your hard, sew your own clothes from cotton in your yard, hunt cattle and chickens, harvest broccoflower and high-fructose corn syrup like the pilgrims did) then you shouldn't be allowed to. Wait! This goes for families too... communist institutions that they are! No one should have kids unless they can do it by themselves. There - problem solved.

'the first intercontinental ballistic missile (1957), first satellite (Sputnik 1), first animal in space (the dog Laika on Sputnik 2), first human in space and Earth orbit (cosmonaut Yuri Gagarin on Vostok 1), first woman in space and Earth orbit (cosmonaut Valentina Tereshkova on Vostok 6), first spacewalk (cosmonaut Alexey Leonov on Voskhod 2), first Moon impact (Luna 2) and unmanned lunar soft landing (Luna 9), first space rover, first space station, and first interplanetary probe.'

"Communists never did or do worry about human costs. " - i'm glad you bring up the concept of human cost in reference to medical care... maybe you can explain it to me...

and Yes, sarcasm laden. My point was you get sick when you get sick, medical care is a neccesity.

And yes, you may choose to avoid spending money to reattach those severed fingers and instead just bandage the stumps, there are lots of options when you allow people pay for their own care.

"I don't see why Medicare can't be the consumer in this market " - indeed, collective bargaining on behalf of consumers makes a lot of sense as far as the efficiency goes.

'Oh and the Soviets got into space without relying on Nazi scientists to do it. #Winning. ' - i'm pretty sure the Soviets had access to Nazi Science, and in either case it doesn't matter whose technology/techniques you take advantage of...

The only relevance to the discussion is whether private industry using free market is better than centralised control. And the Soviet list of first compares favourably to the US equivalent, while the US space programme was entirely government funded (and effectively not free market, even when companies would compete for government contracts... they still had only one buyer, which has a huge impact on actual purchasing...)