http://www.budget.gov.ie/2008/financialstatement.html#_Toc184577394

This is last years budget which tell you how much was spent on health. Do you think I made it up.

Ron Paul does not have Ireland foremost in his thoughts and that is what I believe an Irish version of Ron Paul would say.

Health care is the biggest industry on Earth and pfiser is roughly the same size as British Petrolium.

If Paul could do just one thing then it would be to get rid of the Federal Reserve. To see what life would be like without it just look at the US in 1912 before it was introduced.

If Paul were president he would only have say in federal law. State laws are different and city laws are different again. It seems a lot of Irish people don't know how it works back here.

Take education. Those that pay for the schools are the inhabitants of the town. There is no need for the federal department of education and there is an argument to be made that there is no need for the state department of education. Meanwhile the students are as thick as turnips.

The problem with your way of thinking is that you are content to accepy as fact that the EU should be able to dictate the law to you. That is a slave mentality

youngdan wrote:

http://www.budget.gov.ie/2008/financialstatement.html#_Toc184577394

This is last years budget which tell you how much was spent on health. Do you think I made it up.

Ron Paul does not have Ireland foremost in his thoughts and that is what I believe an Irish version of Ron Paul would say.

Health care is the biggest industry on Earth and pfiser is roughly the same size as British Petrolium.

If Paul could do just one thing then it would be to get rid of the Federal Reserve. To see what life would be like without it just look at the US in 1912 before it was introduced.

Hmm. I'm no fan of Ron Paul, but even his policies probably wouldn't result in a near-immediate reduction of the US population back below the 100m mark.

youngdan wrote:

http://www.budget.gov.ie/2008/financialstatement.html#_Toc184577394

This is last years budget which tell you how much was spent on health. Do you think I made it up.

Ron Paul does not have Ireland foremost in his thoughts and that is what I believe an Irish version of Ron Paul would say.

Health care is the biggest industry on Earth and pfiser is roughly the same size as British Petrolium.

If Paul could do just one thing then it would be to get rid of the Federal Reserve. To see what life would be like without it just look at the US in 1912 before it was introduced.

If Paul were president he would only have say in federal law. State laws are different and city laws are different again. It seems a lot of Irish people don't know how it works back here.

Take education. Those that pay for the schools are the inhabitants of the town. There is no need for the federal department of education and there is an argument to be made that there is no need for the state department of education. Meanwhile the students are as thick as turnips.

The problem with your way of thinking is that you are content to accepy as fact that the EU should be able to dictate the law to you. That is a slave mentality

I still don't know why you think it would be cheaper to put everyone on private. I was hoping you had a credible source but it looks as though you are speculating. As for the EU, Europe has always been our largest trading partner. And they have regulations that have to be adhered to if we want to trade there. It's the same with the US and Brazil, to use two contentious examples. Are they slaves? Now, short of invading Brussels and dismantling their regulatory laws (which doesn't sound very free-tradey to me) we have no choice but to abide by EU rules (which we have a say in) or we can take our trade somewhere else. I can't see the EU caving in at the threat of that.

ibis wrote:

youngdan wrote:

http://www.budget.gov.ie/2008/financialstatement.html#_Toc184577394

This is last years budget which tell you how much was spent on health. Do you think I made it up.

Ron Paul does not have Ireland foremost in his thoughts and that is what I believe an Irish version of Ron Paul would say.

Health care is the biggest industry on Earth and pfiser is roughly the same size as British Petrolium.

If Paul could do just one thing then it would be to get rid of the Federal Reserve. To see what life would be like without it just look at the US in 1912 before it was introduced.

Hmm. I'm no fan of Ron Paul, but even his policies probably wouldn't result in a near-immediate reduction of the US population back below the 100m mark.

How sure of that are you ?

905 wrote:

I still don't know why you think it would be cheaper to put everyone on private. I was hoping you had a credible source but it looks as though you are speculating.

He couldn't have a credible source, because it isn't the case. You can pretty much draw a graph with most privatised and most expensive at one end, and the opposite at the other. Healthcare in the US absorbs 15.2% of GDP, expected to rise to 19.5% by 2017. To put it another way, the US spends $5,711 per capita on healthcare, compared to the UK's $2,317 and France's $3,038:



Now, the usual wriggle is to argue about the health outcomes in the US, but US health outcomes aren't anything to rave about. If one picks the right set of figures, one can show the US ahead of competitors, but it's usually done by picking only the diseases of the affluent white community, while comparing the overall cost.

One quick question sorts it out, really - is US health two and a half times better than UK health? Where would you rather get sick?

All of this brings us back to an article I pointed out a few weeks back, which gives the lie to the whole idea of private welfare (charities) being more efficient than public welfare, and applies equally to private healthcare. Libertarianism is simply an argument that the wealthy shouldn't have to contribute anything to the societies they make their money in - an argument which is both intellectually and morally bankrupt.

Quote :

Libertarianism is simply an argument that the wealthy shouldn't have to contribute anything to the societies they make their money in - an argument which is both intellectually and morally bankrupt.

Well said. The reason that public health services were developed was both because voters demanded them and also because they help to provide a fit and healthy workforce.

Libertarianism as put forward in the US today assumes a shrunken economy in which the profit margins are eroded and the workforce is dispensible. A council of despair that would be self-fulfilled under a Libertarian regime.

ibis wrote:

One quick question sorts it out, really - is US health two and a half times better than UK health? Where would you rather get sick?

Easy, viva Castro! (Think about it, they kept him alive all this time)

The Irish figure is about 17 billion euros for a pop of over about 4 million. That is 4000 euro each. Take an average family of 5 so it is 20000 euros a year. Granted you might not be familiar with private health insurance here but take it from me it dosn't cost 20000 euros a year. The cost varies but 1000 DOLLARS a month would be a lot for a man to be paying for his family.

Not only would it be cheaper to put every Irish person on private medical care here but there would be enough money left over for a trip to Disney as well.

We are talking private health care here OK.

youngdan wrote:

The Irish figure is about 17 billion euros for a pop of over about 4 million. That is 4000 euro each. Take an average family of 5 so it is 20000 euros a year. Granted you might not be familiar with private health insurance here but take it from me it dosn't cost 20000 euros a year. The cost varies but 1000 DOLLARS a month would be a lot for a man to be paying for his family.

Not only would it be cheaper to put every Irish person on private medical care here but there would be enough money left over for a trip to Disney as well.

We are talking private health care here OK.

The GDP proportion attributable to health is well studied, and the figures are roughly as per the graph shown. Back of the envelope calculations are of little interest, particularly when they are out by at least a factor of ten. My health insurance costs for a family of 3 are about €1,800 a year, not €20,000.

That's as a self-employed person, mind. The comparable average costs in the US are, as far as I can tell, about $3,276 annually for family insurance for an employee, with the employer picking up the rest of the $12,000.

So, no, youngdan - your figures are utterly wrong, as is the contention behind them. The inability of private insurers to deliver adequate population healthcare is almost mathematical - there is an information asymmetry between customer and provider - the customer knows the state of their own health better than the provider. If you're in the pink of health, you wouldn't buy anything but the cheapest policy. If, on the other hand, you're utterly decrepit, you'll buy almost anything.

Insurers try to adjust the premiums to ensure they can make a profit on every policy, but a private insurer is not required to offer universal coverage, so any insurer can cherry-pick the young adults who are likely to be healthy, offering them policies for $500, or $250, or whatever they can get away with that gives them the largest share of this profitable market.

Up the other end of the market, the policies escalate in price, because the possible health costs of the really decrepit are enormous, and almost every customer in the 'decrepit' category will need some form of care. Unfortunately, the care you require bears no relation to your income, so this is a market the poor are immediately priced out of, and the middle class are soon priced out of in their turn.

After a relatively short period, then, the private health insurance market has cheap insurance for the young and healthy, and unaffordable premiums for the genuinely sick - and so we should expect to find that a good proportion of the population, particularly the most vulnerable, have no coverage whatsoever. Looking at the US, this is indeed what we find - 47 million people without health insurance.

youngdan wrote:

The Irish figure is about 17 billion euros for a pop of over about 4 million. That is 4000 euro each. Take an average family of 5 so it is 20000 euros a year. Granted you might not be familiar with private health insurance here but take it from me it dosn't cost 20000 euros a year. The cost varies but 1000 DOLLARS a month would be a lot for a man to be paying for his family.

Not only would it be cheaper to put every Irish person on private medical care here but there would be enough money left over for a trip to Disney as well.

We are talking private health care here OK.

Older people with illnesses in the US are paying that and a lot more, or are not able to get insurance at all, youngdan. I know people in this situation.

How are the figures wrong. You quote a figure of 15276 dollars and say my figures are out by a factor of 10 when I said 12000 was ballpark. Or are you saying the 20000 euro figure in Ireland is incorrect. Either way Ireland is paying for crap.

Am I not explaining fully enough that it is costing 20000 a family back there.

You say that you pay 1800 for your family and you are trying to argue a system that costd 20000 is better. Are you covered in the adequete sence that I am assuming that you are. If you are privatise the whole thing and save 18200 per family per year.

youngdan wrote:

How are the figures wrong. You quote a figure of 15276 dollars and say my figures are out by a factor of 10 when I said 12000 was ballpark. Or are you saying the 20000 euro figure in Ireland is incorrect. Either way Ireland is paying for crap.

Am I not explaining fully enough that it is costing 20000 a family back there.

You say that you pay 1800 for your family and you are trying to argue a system that costd 20000 is better. Are you covered in the adequete sence that I am assuming that you are. If you are privatise the whole thing and save 18200 per family per year.

Is Ibis figure for people in the US without insurance wrong?

We are not paying that much in Ireland compared with other Eu countries. Our problem is that a lot of what we pay is going to people who don't have a job to do. They should be reallocated to different work - and they will be before too long. With the private system, you are stuck with paying the shareholders for ever, they do nothing and you can't get rid of them.

youngdan wrote:

How are the figures wrong. You quote a figure of 15276 dollars and say my figures are out by a factor of 10 when I said 12000 was ballpark. Or are you saying the 20000 euro figure in Ireland is incorrect. Either way Ireland is paying for crap.

Am I not explaining fully enough that it is costing 20000 a family back there.

You say that you pay 1800 for your family and you are trying to argue a system that costd 20000 is better. Are you covered in the adequete sence that I am assuming that you are. If you are privatise the whole thing and save 18200 per family per year.

Um, no, I am explaining that medical insurance costs me €1800 a year, versus $12,000 a year in the US. That is a comparison of direct expenditure on health insurance, and is there simply because you brought the subject up, and appeared to be under the impression that health insurance costs in Ireland were of the order of €20K.

The important comparison is the overall cost of healthcare as a proportion of GDP, because, removed from the specific circumstances of individuals, it tells you how much your society is spending overall. Irish healthcare is expensive - as you say, overall about €4K per capita - and not great. You may have noticed that there's a certain degree of dissatisfaction with the healthcare system here.

US healthcare spending is higher yet - and UK spending is much lower. We are in the middle, and we have a semi-privatised model which over recent years has become more expensive at almost exactly the same rate as it has moved towards the US model. I would prefer to see us moving towards the UK 'free at point of service' model, because overall that is proven across the world to be the best value. We'd never be that cheap, because we're a smaller country (and if you look at the graph, you'll see that small-country healthcare costs are higher) - and at the moment, of course, we won't get there because we don't have a government with the political courage to trim the health administration bloat.

As I said, and any source will back me up, US healthcare costs per capita are the highest in the world, based on a private health care model. Places like the UK, with fully socialised medicine, spend a lot less per capita for the same results. The conclusion is obvious to all but the ideologically blinded.

ibis wrote:

US healthcare spending is higher yet - and UK spending is much lower. We are in the middle, and we have a semi-privatised model which over recent years has become more expensive at almost exactly the same rate as it has moved towards the US model. I would prefer to see us moving towards the UK 'free at point of service' model, because overall that is proven across the world to be the best value. We'd never be that cheap, because we're a smaller country (and if you look at the graph, you'll see that small-country healthcare costs are higher) - and at the moment, of course, we won't get there because we don't have a government with the political courage to trim the health administration bloat.

Trimming the health administration bloat .. I like that idea. Couldn't a government get a suicide-mission TD elected to do such a job like Harvey Keitel in Pulp Fiction only he wasn't suicidal. The TD wouldn't get re-elected probably but he'd get a few brown envelopes for the hatchet jobs. He wouldn't be cycling to work either but delivered in a Bradley.

Wouldn't Mary Harney not do something like this now for all of us as a favour.

By the way, how does the NHS amount to the 'best value' can you say? Wouldn't Ireland need to be a lot more populated is what struck me from reading your post.

Auditor #9 wrote:

ibis wrote:

US healthcare spending is higher yet - and UK spending is much lower. We are in the middle, and we have a semi-privatised model which over recent years has become more expensive at almost exactly the same rate as it has moved towards the US model. I would prefer to see us moving towards the UK 'free at point of service' model, because overall that is proven across the world to be the best value. We'd never be that cheap, because we're a smaller country (and if you look at the graph, you'll see that small-country healthcare costs are higher) - and at the moment, of course, we won't get there because we don't have a government with the political courage to trim the health administration bloat.

Trimming the health administration bloat .. I like that idea. Couldn't a government get a suicide-mission TD elected to do such a job like Harvey Keitel in Pulp Fiction only he wasn't suicidal. The TD wouldn't get re-elected probably but he'd get a few brown envelopes for the hatchet jobs. He wouldn't be cycling to work either but delivered in a Bradley.

Wouldn't Mary Harney not do something like this now for all of us as a favour.

By the way, how does the NHS amount to the 'best value' can you say? Wouldn't Ireland need to be a lot more populated is what struck me from reading your post.

An NHS type system in Ireland would be more expensive per capita than the NHS, because the bigger population there gives greater economies of scale (which is something else that's missing from privatised health care) - and that actually counts when we're talking about the kind of machines and drugs modern medicine requires. It would still be cheaper than privatised health care, at least partly because it would still have much larger economies of scale than private healthcare companies.

ibis wrote:

Auditor #9 wrote:

ibis wrote:

US healthcare spending is higher yet - and UK spending is much lower. We are in the middle, and we have a semi-privatised model which over recent years has become more expensive at almost exactly the same rate as it has moved towards the US model. I would prefer to see us moving towards the UK 'free at point of service' model, because overall that is proven across the world to be the best value. We'd never be that cheap, because we're a smaller country (and if you look at the graph, you'll see that small-country healthcare costs are higher) - and at the moment, of course, we won't get there because we don't have a government with the political courage to trim the health administration bloat.

Trimming the health administration bloat .. I like that idea. Couldn't a government get a suicide-mission TD elected to do such a job like Harvey Keitel in Pulp Fiction only he wasn't suicidal. The TD wouldn't get re-elected probably but he'd get a few brown envelopes for the hatchet jobs. He wouldn't be cycling to work either but delivered in a Bradley.

Wouldn't Mary Harney not do something like this now for all of us as a favour.

By the way, how does the NHS amount to the 'best value' can you say? Wouldn't Ireland need to be a lot more populated is what struck me from reading your post.

An NHS type system in Ireland would be more expensive per capita than the NHS, because the bigger population there gives greater economies of scale (which is something else that's missing from privatised health care) - and that actually counts when we're talking about the kind of machines and drugs modern medicine requires. It would still be cheaper than privatised health care, at least partly because it would still have much larger economies of scale than private healthcare companies.

That's intriguing - you're attributing the NHS success to a critical mass of population so? Does America not have a similar density or is their system rampant with corruption and other inefficiency? I heard that the Canadian system was THE model system for the world but the NHS mustn't be far behind. We should grow more people very quickly. We should give grants for new babies again.

In the first paragraph you suggest that I am mistaken about the Irish health costing 20000 and then in the next paragraph you say it costs 4000 per capita. Therefore we agree on 20000 for a family of 5 like I said.

Now what do you get for your payment of 1800 as it seems my assumption that this pays for private cover for your family is incorrect

Universal health insurance seems to work pretty well. I used it in Germany and the doctors were plentiful and good at their jobs.

The NHS needs a good going over too, but like the Irish system, needs to be improved not dumped.

Ireland probably only needs two "centre of excellence" hospitals with good free transport to them and plenty of local primary care clinics, maternity, and "step down" units locally. A few helicopters would sort out emergency access.

Lack of good transport and low population densities (interconnected issues) are a problem for delivering services.

Auditor #9 wrote:

ibis wrote:

Auditor #9 wrote:

ibis wrote:

US healthcare spending is higher yet - and UK spending is much lower. We are in the middle, and we have a semi-privatised model which over recent years has become more expensive at almost exactly the same rate as it has moved towards the US model. I would prefer to see us moving towards the UK 'free at point of service' model, because overall that is proven across the world to be the best value. We'd never be that cheap, because we're a smaller country (and if you look at the graph, you'll see that small-country healthcare costs are higher) - and at the moment, of course, we won't get there because we don't have a government with the political courage to trim the health administration bloat.

Trimming the health administration bloat .. I like that idea. Couldn't a government get a suicide-mission TD elected to do such a job like Harvey Keitel in Pulp Fiction only he wasn't suicidal. The TD wouldn't get re-elected probably but he'd get a few brown envelopes for the hatchet jobs. He wouldn't be cycling to work either but delivered in a Bradley.

Wouldn't Mary Harney not do something like this now for all of us as a favour.

By the way, how does the NHS amount to the 'best value' can you say? Wouldn't Ireland need to be a lot more populated is what struck me from reading your post.

An NHS type system in Ireland would be more expensive per capita than the NHS, because the bigger population there gives greater economies of scale (which is something else that's missing from privatised health care) - and that actually counts when we're talking about the kind of machines and drugs modern medicine requires. It would still be cheaper than privatised health care, at least partly because it would still have much larger economies of scale than private healthcare companies.

That's intriguing - you're attributing the NHS success to a critical mass of population so? Does America not have a similar density or is their system rampant with corruption and other inefficiency? I heard that the Canadian system was THE model system for the world but the NHS mustn't be far behind. We should grow more people very quickly. We should give grants for new babies again.

If you privatise health care, you are making a market place of health care providers. Unless one of them gets to be a monopoly, they'll always have a smaller economy of scale than a government monopoly.

youngdan wrote:

In the first paragraph you suggest that I am mistaken about the Irish health costing 20000 and then in the next paragraph you say it costs 4000 per capita. Therefore we agree on 20000 for a family of 5 like I said.

Now what do you get for your payment of 1800 as it seems my assumption that this pays for private cover for your family is incorrect

Dear me. The 4K figure per capita is the total expenditure on health in the economy. It doesn't represent anybody's personal direct cost. Multiplying that by 5 does indeed give a figure of 20K, just as multiplying the US figure of 7.5K per capita by 5 gives a figure of 37.5K.

youngdan wrote:

In the first paragraph you suggest that I am mistaken about the Irish health costing 20000 and then in the next paragraph you say it costs 4000 per capita. Therefore we agree on 20000 for a family of 5 like I said.

Now what do you get for your payment of 1800 as it seems my assumption that this pays for private cover for your family is incorrect

Here are some figures:

Ireland (WHO website)

Total population: 4,221,000


Gross national income per capita (PPP international $): 34,730


Life expectancy at birth m/f (years): 77/82


Healthy life expectancy at birth m/f (years, 2003): 68/72


Probability of dying under five (per 1 000 live births): 4


Probability of dying between 15 and 60 years m/f (per 1 000 population): 88/56


Total expenditure on health per capita (Intl $, 2005): 3,125


Total expenditure on health as % of GDP (2005): 8.2


USA

Statistics:

Total population: 302,841,000


Gross national income per capita (PPP international $): 44,070


Life expectancy at birth m/f (years): 75/80

Healthy life expectancy at birth m/f (years, 2003): 67/71


Probability of dying under five (per 1 000 live births): 8


Probability of dying between 15 and 60 years m/f (per 1 000 population): 137/80


Total expenditure on health per capita (Intl $, 2005): 6,347

Total expenditure on health as % of GDP (2005): 15.2


Figures are for 2006 unless indicated. Source: World Health Statistics 2008

Well, that pretty well nails it.

http://www.who.int/countries/usa/en/

**cactus before this with some lies, damned lies and damning statistics

ibis wrote:

The 4K figure per capita is the total expenditure on health in the economy. It doesn't represent anybody's personal direct cost.

Doesn't it amount to the same thing? Presumably the Americans don't pay tax directly into the health system as we do, it is paid privately. This amounts to the same thing surely or are you saying that in our case that cost (around 4k per head) is spread around in such a way as to lever it from the more fortunate and deliver it to the less fortunate - swings and roundabouts ?

Auditor #9 wrote:

**cactus before this with some lies, damned lies and damning statistics

ibis wrote:

The 4K figure per capita is the total expenditure on health in the economy. It doesn't represent anybody's personal direct cost.

Doesn't it amount to the same thing? Presumably the Americans don't pay tax directly into the health system as we do, it is paid privately. This amounts to the same thing surely or are you saying that in our case that cost (around 4k per head) is spread around in such a way as to lever it from the more fortunate and deliver it to the less fortunate - swings and roundabouts ?

Pretty much - which, in turn, is the root of the libertarian objection: rich people in Irish society pay the health costs of the poor as well as their own, and the healthy pay the costs of the sick.

Auditor #9 wrote:

**cactus before this with some lies, damned lies and damning statistics

ibis wrote:

The 4K figure per capita is the total expenditure on health in the economy. It doesn't represent anybody's personal direct cost.

Doesn't it amount to the same thing? Presumably the Americans don't pay tax directly into the health system as we do, it is paid privately. This amounts to the same thing surely or are you saying that in our case that cost (around 4k per head) is spread around in such a way as to lever it from the more fortunate and deliver it to the less fortunate - swings and roundabouts ?

As you say, those damned statistics. I assume that the WHO figures include public and private expenditure. There is public and private in the US too.

http://en.wikipedia.org/wiki/Public_hospital

Ireland spends much less per capita, much less as a percentage of GDP and people live longer. Child mortality in the USA is twice as high.

If you want to have a discussion fine but if you prefer to act stupid that is fine too.