Realist
Billie Jean is not my lover
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Happy said:
I'm attacking the idea.
It was not your idea.
I'm not shooting the messenger.
I'll do that later
Healthcare discounts to thin non-smokers
- Thread starter Happy
- Start date
I'm attacking the idea.
It was not your idea.
I'm not shooting the messenger.
I'll do that later
Sean K
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Free or subsidised health care should not be going to people who disregard generally accepted health threats that cause long term costly terminal illnesses. No one else should pay for stupidity.
It would certainly be difficult to monitor obesity because everyone has to eat. But how do governments regulate restricted substances. You could alway change the laws so that smokers need a prescription to purchase ciggarettes. Then you will generally have an idea who is smoking and can treat these people accordingly.
Billhill
Billhill
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The real problem lies in that we as a community have an expectation of world class medical care but are not prepared to pay for it. We have several choices ahead of us. One is to continue offering "universal" health care and decide how much we are prepared to pay for that through our taxes. This will probably lead to a lowering of healthcare quality and we see that occurring already in the public health system with the system stretched beyond capacity and a daily litany of medical mayhem from poorly trained overseas (read cheap) health staff.
We could choose to have a user pays system whereby you pay for what you consume. Healthcare in this country is considered a right along with "free" education and this option is politically unpalatable but would certainly solve the problems perceived by the thin non-smoking brigade about unfair distribution of taxes. It might be a lot less palatable when they reach the age of consumption for health care services.
The third option which is the one that is slowly developing and I believe will gain momentum over the long term is that healthcare will be means tested and if you earn a reasonable income you will be expected to provide for yourself through health insurance. This model is being acheived by stealth through the long waiting lists present in public hospitals and the public will eventually find providing for their own healthcare more palatable than relying on the public health system.
There are two main contributors to the healthcare crisis...one is the continued use of expensive "world class" healthcare expected by the community. Health costs grow at twice the CPI rate on a regular basis and a lot of the consumption is due to the expectation of the best technology and drugs available. The Federal Government already attempts to control costs by limiting the availability of services, drugs and prosthesis unless you are prepared to contribute yourself.
The other crisis is present throughout the western world with the aging population. This adds an increased burden on healthcare budgets as I described earlier, but also presents a problem due to the severe shortage of trained health professionals worldwide. This shortage is present in all skilled labour markets from tradesmen through to surgeons. In an effort to rein in costs the Governments have long had a policy of paying health professionals within the public system poorly compared to what they may earn privately or overseas. This has increased the shortage of skilled staff and the Governments in their wisdom employed overseas trained professionals on temporary contracts. Unfortunately a lot of these people are not up to speed with the expectations and standards demanded by the Australian health consumers and we end up with scandals such as Dr Death. Australian trained health professionals are acknowledged as being well trained and are welcome to work almost anywhere in the world. This creates a problem in attracting and retaining staff of suitable quality when they are free agents. Governments have finally acknowledge their contribution to the problem and started to offer better pay and conditions but given the long lag time between training and graduating we could easily be six to twelve years in a deepening crisis before their efforts may bear fruit. Unfortunately a large number of healthcare workers have left the public system with ill feeling due to the poor management,and would be unlikely to want to return.
It has also become much more difficult to attract people to university to learn to become our next generation of surgeons, radiologists etc. It is hard to attract people to train for twelve years earning less than $70,000pa when they could earn twice that working in the mines with significantly less chance of litigation.
We could choose to have a user pays system whereby you pay for what you consume. Healthcare in this country is considered a right along with "free" education and this option is politically unpalatable but would certainly solve the problems perceived by the thin non-smoking brigade about unfair distribution of taxes. It might be a lot less palatable when they reach the age of consumption for health care services.
The third option which is the one that is slowly developing and I believe will gain momentum over the long term is that healthcare will be means tested and if you earn a reasonable income you will be expected to provide for yourself through health insurance. This model is being acheived by stealth through the long waiting lists present in public hospitals and the public will eventually find providing for their own healthcare more palatable than relying on the public health system.
There are two main contributors to the healthcare crisis...one is the continued use of expensive "world class" healthcare expected by the community. Health costs grow at twice the CPI rate on a regular basis and a lot of the consumption is due to the expectation of the best technology and drugs available. The Federal Government already attempts to control costs by limiting the availability of services, drugs and prosthesis unless you are prepared to contribute yourself.
The other crisis is present throughout the western world with the aging population. This adds an increased burden on healthcare budgets as I described earlier, but also presents a problem due to the severe shortage of trained health professionals worldwide. This shortage is present in all skilled labour markets from tradesmen through to surgeons. In an effort to rein in costs the Governments have long had a policy of paying health professionals within the public system poorly compared to what they may earn privately or overseas. This has increased the shortage of skilled staff and the Governments in their wisdom employed overseas trained professionals on temporary contracts. Unfortunately a lot of these people are not up to speed with the expectations and standards demanded by the Australian health consumers and we end up with scandals such as Dr Death. Australian trained health professionals are acknowledged as being well trained and are welcome to work almost anywhere in the world. This creates a problem in attracting and retaining staff of suitable quality when they are free agents. Governments have finally acknowledge their contribution to the problem and started to offer better pay and conditions but given the long lag time between training and graduating we could easily be six to twelve years in a deepening crisis before their efforts may bear fruit. Unfortunately a large number of healthcare workers have left the public system with ill feeling due to the poor management,and would be unlikely to want to return.
It has also become much more difficult to attract people to university to learn to become our next generation of surgeons, radiologists etc. It is hard to attract people to train for twelve years earning less than $70,000pa when they could earn twice that working in the mines with significantly less chance of litigation.
kennas said:
Except health care is never free,we pay through medicare,taxes on fore mentioned items and outright taxes.Even people on welfare pay taxes however those long term recipients obviously don`t pay enough,so basically you would exclude those people.
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I contend that many things are rising faster than CPI, not just health care. Indeed, CPI is a cost of survival index rather than a cost of living index given what is in it. If it were to be accurate then there should have been few or preferably no changes to its composition over time, which is not the case in most countries.Shane Baker said:
A computer changes in price from $2000 to $1500. That's a 25% fall in the price of buying a computer. That is has become more powerful, and the software it uses has become correspondingly LESS efficient in order to use all that power, doesn't mean that it has crashed in price. It fell 25%, no more and no less. Same with everything else. You can't actually buy half a TV just because they have improved technology (but drastically reduced life span, another thing CPI fails to pick up). Etc...
I'm not convinced that health care costs are really rising dramatically when compared to the size of the overall economy rather than CPI. Rising yes, but not as much as government would have us believe.
IMO the greatest threat to health care costs is not smokers or the overweight but lawyers. Surgery etc is high risk by its very nature - you ought to accept that there is x % chance of it going wrong rather than expecting $$$ when it does. If you don't accept that there's a risk then don't have the surgery. Same with many things - we live in a risky world where not much has a zero chance of going horribly wrong.
Julia
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Great post, Shane.Shane Baker said:
Where does the figure of $70,000 p.a. come from? Surely that would only apply to, e.g. a first year house surgeon or possibly a registrar?
GP's would earn substantially more than that, and consultants much more again, as indeed they should, given the years of postgrad study required.
I've just had some landscaping done - grunt labouring work only in that I had done the plan and the bloke just had to place the rocks, shovel the mulch etc: $300 per day = around $100,000 p.a.
And then there was the carpet cleaner whose hourly rate equates to $112,000 p.a.
In both cases I've allowed for holidays and travelling time.
From a purely financial point of view it makes little sense to take on a huge HECS debt for such relatively small financial reward.
But the career satisfaction is another matter entirely.
Julia
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Hi Julia
Where does the figure of $70,000 p.a. come from? Surely that would only apply to, e.g. a first year house surgeon or possibly a registrar?
The figure is based on a final year registrar salary plus normal o'time in QLD as of two years ago. This is for someone who at that point had completed six years medical school, a couple of years as a junior doctor, five years registrar training to become a specialist....Usually a minimum of twelve years and often 15 years in total training. They are only paid after finishing their six years at university..and then they have a minimum of six years further training to complete at the registrars salary. GP's training and most specialist registrar training is similar in salary. The good money only comes after you have completed all the training (naturally). As you said it is hard to attract people to a profession that has this pay structure and expects the person to shoulder such a large HECS debt burden of up to $200K in advance.
Hi Smurf
While it is always possible to argue how the CPI is calculated it is accepted that in the western world the healthcare costs are rising (and have been for some time) above the CPI. This data is present in all western countries irrespective of how they calculate the CPI (different for all countries) or how they fund their health system. The US who has a predominantly employer and private funded model with 60% of health costs met by employer or private contributions has probably less interest in reining in costs compared to say the UK or Australian models. In fact, the UK and Australia spend the least as a percentage of GDP on healthcare. However it has been forecast that spending on health in Australia will increase from about 4% of GDP to over 9% of GDP even using a decreased growth rate for health costs
http://www.dfat.gov.au/budget/2002-...art4.pdf#search="costs of health care v CPI "
The chart on page 15 of the link below shows the US experience with health costs v CPI.
http://www.chcf.org/documents/insurance/HealthCareCosts06.pdf#search="costs of health care v CPI "
This sort of data is readily available for most western countries and shows similar trends in healthcare costs.
IMO the greatest threat to health care costs is not smokers or the overweight but lawyers. Surgery etc is high risk by its very nature - you ought to accept that there is x % chance of it going wrong rather than expecting $$$ when it does. If you don't accept that there's a risk then don't have the surgery. Same with many things - we live in a risky world where not much has a zero chance of going horribly wrong.
As a former health professional I can only agree with the concept of personal responsibility. Most Governments in Australia have altered the ability to pursue frivilous litigation in most states and this has improved the working environment for health professionals on this front. America spends over 14% of GDP on healthcare and 2% of GDP is on tort costs. This has an ongoing cost as doctors are discouraged from performing high risk procedures (obstetrics is a good example) and are instead encouraged to perform many unnecessary tests and procedures as a part of defensive medicine. This increases costs to the community due to increased health care costs and taxes to pay for it. Companies that develop new technology and drugs are discouraged from developing new products and if they do, they have to allow for funding of possible litigation as well as R&D costs (Vioxx is a good example).
Cheers
Shane
Where does the figure of $70,000 p.a. come from? Surely that would only apply to, e.g. a first year house surgeon or possibly a registrar?
The figure is based on a final year registrar salary plus normal o'time in QLD as of two years ago. This is for someone who at that point had completed six years medical school, a couple of years as a junior doctor, five years registrar training to become a specialist....Usually a minimum of twelve years and often 15 years in total training. They are only paid after finishing their six years at university..and then they have a minimum of six years further training to complete at the registrars salary. GP's training and most specialist registrar training is similar in salary. The good money only comes after you have completed all the training (naturally). As you said it is hard to attract people to a profession that has this pay structure and expects the person to shoulder such a large HECS debt burden of up to $200K in advance.
Hi Smurf
While it is always possible to argue how the CPI is calculated it is accepted that in the western world the healthcare costs are rising (and have been for some time) above the CPI. This data is present in all western countries irrespective of how they calculate the CPI (different for all countries) or how they fund their health system. The US who has a predominantly employer and private funded model with 60% of health costs met by employer or private contributions has probably less interest in reining in costs compared to say the UK or Australian models. In fact, the UK and Australia spend the least as a percentage of GDP on healthcare. However it has been forecast that spending on health in Australia will increase from about 4% of GDP to over 9% of GDP even using a decreased growth rate for health costs
http://www.dfat.gov.au/budget/2002-...art4.pdf#search="costs of health care v CPI "
The chart on page 15 of the link below shows the US experience with health costs v CPI.
http://www.chcf.org/documents/insurance/HealthCareCosts06.pdf#search="costs of health care v CPI "
This sort of data is readily available for most western countries and shows similar trends in healthcare costs.
IMO the greatest threat to health care costs is not smokers or the overweight but lawyers. Surgery etc is high risk by its very nature - you ought to accept that there is x % chance of it going wrong rather than expecting $$$ when it does. If you don't accept that there's a risk then don't have the surgery. Same with many things - we live in a risky world where not much has a zero chance of going horribly wrong.
As a former health professional I can only agree with the concept of personal responsibility. Most Governments in Australia have altered the ability to pursue frivilous litigation in most states and this has improved the working environment for health professionals on this front. America spends over 14% of GDP on healthcare and 2% of GDP is on tort costs. This has an ongoing cost as doctors are discouraged from performing high risk procedures (obstetrics is a good example) and are instead encouraged to perform many unnecessary tests and procedures as a part of defensive medicine. This increases costs to the community due to increased health care costs and taxes to pay for it. Companies that develop new technology and drugs are discouraged from developing new products and if they do, they have to allow for funding of possible litigation as well as R&D costs (Vioxx is a good example).
Cheers
Shane
Prospector
Not a scaredy cat anymore
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123enen said:
I am thinking that other people are saying this about you "I know a person and all of his friends end up injured in hospital. He is bad luck - stay away from him!
:
Realist
Billie Jean is not my lover
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kennas said:
Ok Kennas,
Anyone who has ever smoked, eaten a burger or fries, or drunk any alcohol must pay the full fee.
Anyone who has never smoked, never drunk any alcohol, never eaten anything fried, and never had a day without exercise gets the cheap premium.
There will be secret agents who will be videotaping you randomly as well, with huge fines for liars.
You happy now?
Prospector said:I am thinking that other people are saying this about you "I know a person and all of his friends end up injured in hospital. He is bad luck - stay away from him!
But Prospector , This isn't about bad luck. It's about lifestyle choices.
Management of sports injuries is a big business ( and burden ) in its own right, just like obesity management.
Why do we single out one lifestyle over another?
If we do not wish to "subsidise" obesity health care why should the obese "subsidise" sports injury sports injury health care. They both take huge hospital resource and both cost the community a lot of money.
Realist said:You happy now?
I am happy now too.
We should stop pretending silly burgers and take calculated responsibility for our life.
If I decide to go trekking and get lost, I should take insurance premium which would cover eventual rescue or if I don’t take insurance, get lost and rescued I should expect to pay for it, to the last penny.
Fair?
This is my decision to take additional risk and I should take good and bad.
If I decide to take known to damage my health substance, I should take necessary steps to look after myself when substance does damage and I need some medical help.
Fair?
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Happy said:
You are a lot like that sad robot from Hitchhikers Guide to The Galaxy.
You get to live in Australia, 1 of the best places on the planet, where we try to help our mates an those less fortunate than ourselves.
But all you can do is moan about the cost of everything.
People dont choose to be obese, most smokers would like to give up but its an addiction. Non smokers do get lung cancer, thin people do get heart disease.
Thats the whole point about having insurance an Medicare, so the unlucky people can get help.
I would hate to live in your selfish little world.
You couldnt care about anyone else in the world. You want all of us to be executed for crossing the road against the lights, but you chuck a sad if you think someone is being sarcastic.
God forbid that your precious little ego should be hurt.
Julia
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BloveldBloveld said:
This seems a rather unreasonable personal attack on Happy.
I can't see any basis from Happy's posts that he is either selfish or uncaring. He's merely suggesting that people should take responsibility for their lifestyle.
You are quite right to suggest that non-smokers also get lung cancer and that thin people can have heart disease. However, that's the only situation where you call it "luck". There is incontrovertible evidence that smoking and overeating contribute in large measure to almost all diseases, not just cancer and heart disease. Both factors, e.g. influence the likelihood of developing diabetes.
I don't believe we can (or should) ever restrict healthcare to only those who have taken all the right measures to maintain good health. That is simply not the nature of our society. However, I'm less than impressed when I see someone who has had one lung removed as a result of cancer (2 packets a day all his life and now aged 58) continue to smoke as soon as he gets out of hospital. Ditto someone who has had a few coronary bypasses but still eats junk and refuses to lose weight. Our hospitals and staff are stretched every day. We all need to take responsibility for doing our best to stay out of them.
Julia
Realist
Billie Jean is not my lover
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Well I agree with Bloveld.
So there... :blbl:
.
So there... :blbl:
.
Realist said:
Busted.
And few posts ago you said that you don't attack me, oh well people say one thing, think another and do something else.
Julia,
This type of reaction is quite common, people love to disappear and be faceless in the crowd and take absolutely no responsibility for their life, ie finances, diet, health and other activities.
You don't have to be obese ”” just a little overweight ”” to increase your risk of
http://www.chron.com/disp/story.mpl/front/4134939.html
So,who decides how much is a little!
http://www.chron.com/disp/story.mpl/front/4134939.html
So,who decides how much is a little!
Essence of the link to page above is -
‘Normal’ weight can be debated, but you don’t have to be genius to know when somebody has few too many extra kilograms.
People spread their risk when investing, but happily forget this with their own body.
To be nasty, it is not too bad when person dies, economy looses one employee if person is employed that is, and family losses family member and if loved they miss deceased more.
But above percentages looked at from the other side are, that person has 60% to 80% chance to live, and when with major health problems, this is going to be some kind of life.
‘Normal’ weight can be debated, but you don’t have to be genius to know when somebody has few too many extra kilograms.
People spread their risk when investing, but happily forget this with their own body.
To be nasty, it is not too bad when person dies, economy looses one employee if person is employed that is, and family losses family member and if loved they miss deceased more.
But above percentages looked at from the other side are, that person has 60% to 80% chance to live, and when with major health problems, this is going to be some kind of life.
Some US facts
http://cpsc.gov/library/boomer.pdf#search="sports injuries"
Sports-related injuries among those ages 35 to 54 - today’s baby boomers --
increased about 33% from 1991 to 1998. There were just under 276,000 hospital emergency room-treated injuries to persons 35 to 54 in 1991 compared to slightly more than 365,000 sports injuries to persons of these ages in 1998.
This increase in injuries, which occurred in 16 popular sports activities, was due primarily to baby boomers’ increased numbers participating in these sports.
When all medically-attended injuries in these popular sports were included,
CPSC estimated there were a total of more than 1 million injuries to baby boomers in 1998 (compared to 778,000 such injuries to persons 35 to 54 in 1991). These sports injuries to baby boomers cost the nation over $18.7 billion in 1998.
Baby boomers represented almost one-third of all Americans who participated
in sports in 1998. These 79.1 million people comprised over 29 percent of the total U.S. population. In 1998, there were 14 million more Americans in the 35 to 54 age group than in 1991.
…………………………………………………………………………………..
http://medicalcenter.osu.edu/patien.../otherhealthtopics/MensHealth/SportsInjuries/
Sports Injuries
In the United States, about 30 million children and teens participate in some form of organized sport. According to the National SAFE KIDS campaign, more than 3.5 million children ages 14 and under receive medical treatment for sports injuries each year. The majority of these injuries are from falls, collisions, overexertion or being struck by an object, and they usually occur during unorganized or informal sports activities.
http://cpsc.gov/library/boomer.pdf#search="sports injuries"
Sports-related injuries among those ages 35 to 54 - today’s baby boomers --
increased about 33% from 1991 to 1998. There were just under 276,000 hospital emergency room-treated injuries to persons 35 to 54 in 1991 compared to slightly more than 365,000 sports injuries to persons of these ages in 1998.
This increase in injuries, which occurred in 16 popular sports activities, was due primarily to baby boomers’ increased numbers participating in these sports.
When all medically-attended injuries in these popular sports were included,
CPSC estimated there were a total of more than 1 million injuries to baby boomers in 1998 (compared to 778,000 such injuries to persons 35 to 54 in 1991). These sports injuries to baby boomers cost the nation over $18.7 billion in 1998.
Baby boomers represented almost one-third of all Americans who participated
in sports in 1998. These 79.1 million people comprised over 29 percent of the total U.S. population. In 1998, there were 14 million more Americans in the 35 to 54 age group than in 1991.
…………………………………………………………………………………..
http://medicalcenter.osu.edu/patien.../otherhealthtopics/MensHealth/SportsInjuries/
Sports Injuries
In the United States, about 30 million children and teens participate in some form of organized sport. According to the National SAFE KIDS campaign, more than 3.5 million children ages 14 and under receive medical treatment for sports injuries each year. The majority of these injuries are from falls, collisions, overexertion or being struck by an object, and they usually occur during unorganized or informal sports activities.