Form 3 1 Health Care Directive 2016: Fill & Download for Free

What would the US look like after 20 years of complete Democratic control?20 years isn't long enough to turn around the Titanic. The US is literally sinking, and drowning, under GOP rule. We are facing a healthcare crisis of epidemic proportions.The Democratic Party leadership is the only party capable of addressing healthcare, because it is the only party willing to face the problem head on.The GOP have swept it under the rug, and fought any decent healthcare for decades; while other countries have continuously addressed universal healthcare for their residents. They are now way ahead of the United States.The US is in imminent danger of being unable to compete on a global scale, because we refuse to provide affordable and accessible healthcare to everyone.Common sense tells us a prosperous nation needs affordable healthcare, affordable housing, healthy food, education and jobs.The Democratic Party has continuously fought for these critical needs for all Americans.If a head of a household does not have healthcare, access to healthcare, or simply can't afford healthcare, then they can't take care of themselves or their families. That's just an indisputable fact.This means that they may not be able to work, are way more likely to end up disabled, and living on the public dole. This is the antithesis of what anyone wants; especially for the GOP that wants nothing to do with healthcare.The argument against universal healthcare is that the US will not be economically free. Conservatives want a market based approach to healthcare. They see UHC as socialism.The weakness with this argument is that we have less economic freedom than other countries with universal healthcare.[1] In other words, top countries with universal healthcare, that are market based, blow us away.Edit: Mauritis now has UHC.Of the largest economies in the world, the US is the only one without UHC.Of the richest countries in the world, the US is the only one without UHC.Of the countries with the richest people in the world, the US is the only country without UHC.Healthcare: If a picture is worth a 1,000 words, then our world healthcare map is a masterpiece.“America is a health-care outlier in the developed world"[2]Notice the countries in red. The US and some countries in Africa are the only places without some form of universal healthcare. Of the 195 countries in the world, the US is the only country that joins the 40 left without UHC, all of which are war torn or impoverished. [3]Edit: Indonesia now has UHC.Let's get to whataboutism.Here is a list of the healthiest countries in the world. They all have UHC, and pay dramatically less than the US for their universal healthcare coverage. Notice that the US is not on this list.The US does make #1 on the list for the world's most expensive healthcare. Note this graph is from 2014, and the gap has become worse.With all of the money that the US spends on healthcare, one would expect that our healthcare outcomes would be better than those countries with UHC, who pay much less. Sadly, this is not the case.The US has the highest life expectancy right? No.Other comparable countries have a higher life expectancy. This applies to men and women, across races, and across projections to 2030.Let's look at infant mortality rates first.Infant mortality rates were highest in the U.S., with 5.8 fatalities out of every 1,000 live births. For other countries, the average infant mortality rate was 3.6 fatalities for every 1,000 live births.[4]Edit: 02/14/2020The latest CDC US Maternal mortality rates for 2018 are out [5]""new [maternal mortality] rate, while capturing just how poorly the U.S. ranks among other countries, is actually a significant underestimate of the problem."17.4 maternal deaths per 100,000 live births. The US ranks 55th in the world…behind Russia.The US has a very high Amenable Mortality Rate compared to other developed nations. [6] [7]These stats are from 2016, and they are getting worse because the US stats are getting worse.Even worse, the Amenable Mortality Rate within the US, compared state by state is a disaster. [8]The poor southern states rank substantially higher.[9] This map is interactive. If you go directly to the citation, the range in amenable mortality rates goes from the high 90s to over 143 for MS. Alabama is 112. Georgia is 103. South Carolina is 99.9. Tennessee is 114. Kentucky is 113. West Virginia is 108.9. Facts don't lie. These states all have the same thing in common. I also didn't get into the states, like TX at 95.The US Spends less than other countries right? No.In 2016, the US was spending 10K per capita. That is 2.5 times the average of similarly situated and wealthier countries.In 2016, the U.S. spent 17.8 percent of its gross domestic product (GDP) on healthcare. Other countries’ spending ranged from a low of 9.6 percent of GDP in Australia to a high of 12.4 percent of GDP in Switzerland[10]The U.S. has the best health care in the world right? Yes and No.We do a good job with cancer survival rates. We are right up there with Japan and Canada on 5 year colorectal and breast cancer rates.We also have excellent healthcare research, and 1,000s of drugs that are in trials.Remember, we pay dearly for those drugs…more than any other country in the world. American's literally have zero bargaining power against big pharma. That doesn't sound market based.Don't get fooled by the R & D argument either. Big Pharma spends twice as much on marketing than R & D. How about we see a few less tv ads and save the money on the cost of drugs.This self serving industry article disputes this and says it's because of the cost of free drugs. [11] Then stop the free drugs!! Just make them affordable! Don't give me BS excuses.The US has lead the way with hospital safety too.[12]Here is where we struggle:[13]We are facing a shortage of doctors.We are suffering in primary care.We have coordination of care issues. This leads to unnecessary delays of abnormal healthcare tests and treatment.We have hospital bed shortagesWe have serious obesity ratesThere are many more issues than what I listed in this short essay.The administrative costs added by insurance companies, billing entities inside hospitals, extremely expensive procedures and tests, drugs and comparable surgeries, are astounding compared to other countries with the same or better quality healthcare.So what's the point?The point is that we are nothing without our health.Anyone who has ever had a health scare, or faced a family member's health concerns, knows this.We are all literally one catastrophe away from being bankrupted by healthcare costs.[14]If you are young reading this and think that nothing will happen to you, I hope that you are right, but don't count on it.If you are older and reading this, either you know what I mean, or there is a good chance that you will learn soon enough.Your health isn't solely dependent on how well you eat, how much you exercise or how much you weigh.So many factors play into it, including genetics, and accidents, outside our control.That's the whole frickin’ point of insurance in the first place! It's a hedge against risk! You already are paying for everyone else's healthcare, and it's damned expensive! You can still end up in serious debt and bankruptcy anyway, and there is a good chance of it on our present trajectory.At least UHC actually gives us a hedge of protection; not a hedge that throws us off the cliff, which is what our current healthcare insurance system does anyway.My fellow Americans, we are facing a tsunami. We must move to higher ground, and I mean that literally and figuratively.Vote Blue 2020!P.S. A damning new study about US life expectancy was just released by JAMA. [15]P.S. [16] Another incredibly well written answer backs up everything that I am saying factually and historically. Reaganomics was the doom of America, and the continued denial of universal basic healthcare, will be its absolute downfall.His conclusion here:Footnotes[1] Conservative Think Tank: 10 Countries With Universal Health Care Have Freer Economies Than The U.S.[2] America is a health-care outlier in the developed world[3] List of countries with universal health care - Wikipedia[4] U.S. health spending twice other countries' with worse results[5] The New U.S. Maternal Mortality Rate Fails to Capture Many Deaths — ProPublica[6] America’s ranking on amenable mortality is an embarrassment - PNHP[7] Mortality amenable to healthcare - Peterson-Kaiser Health System Tracker[8] Mortality amenable to health care[9] Mortality amenable to health care[10] U.S. health spending twice other countries' with worse results[11] Do Biopharma Companies Really Spend More on Marketing Than R&D?[12] Health Costs: How the U.S. Compares With Other Countries[13] Health Costs: How the U.S. Compares With Other Countries[14] This Is the No. 1 Reason Americans File for Bankruptcy | The Motley Fool[15] Life Expectancy and Mortality Rates in the United States, 1959-2017[16] Frank Seward's share of George Tait Edwards's answer to What does the practice of the Washington Consensus of macroeconomics/austerity ultimately produce? in RealPolitics

As everything appears a nail to a hammer, so everything bends to market principles to a free marketer. However, healthcare isn't amenable to the free market.After all, we need healthcare the most when we are least in charge of ourselves and therefore least capable of negotiating a fair bargain on our own behalf. Loved ones would also be negotiating on our behalf with the proverbial gun to their heads. This is why a pure healthcare free market could only ever be a shakedown of a captive buyer by a seller engaged in a profiteering racket.Other developed countries have somehow understood this unalterable fundamental and accordingly arranged their healthcare systems to sustain some form of universal coverage while the US has unfortunately got its head stubbornly stuck up Ayn Rand's ass.November 19, 1945 was the closest the US came to a having a sensible healthcare policy when then-President Harry S. Truman proposed creating a federally run, universal health care plan, the national health insurance (NHI).Obviously that never came to pass and since then the US healthcare system has evolved to consist of an unnecessarily complex patchwork of private and public services, with most Americans reliant on employment-based private insurance (below from 1). Why are US employers involved in an individual's healthcare decisions anyway? How could a practice that so reeks of paternalism take root in the land of the free, home of the brave? Questions for sages of the ages to ponder.Implicitly assuming the current US healthcare system operates on free market principles is also inaccurate since it in fact doesn't. On the contrary, the evidence clearly suggests that the free market in the current US healthcare system is thumbs on the scale all the way. All too often free markets deviate wildly in practice from how they're supposed to operate in theory. Regulatory capture is usually the reason why.The current US healthcare system is best described as the monster child of singularly comprehensive regulatory capture and the population's learned helplessness, with hopelessly compromised US legislators serving as apparently hapless midwives; a system where patients, the people who should have the most say in what the system should be and how it should operate, instead turn out to have the least.The tyrannical hold of practices such as the Chargemaster - Wikipedia, fee-for-service and regulation-free drug pricing offer many unmistakable signs of deathly regulatory capture of the US healthcare system, which has thus become one that vainly attempts but fails to provide comprehensive yet affordable healthcare to all too many while those with deep pockets or in the US Congress avail of the best healthcare anywhere in the world.News reports on the US healthcare system are routinely replete with details of runaway costs that violate common sense, an unmistakable sign of thorough regulatory capture.A baby cost her mother's employer US $1 million (2).A US hospital charged $1877 to pierce a 5 year old's ears (3).Three stitches on a skinned knee cost $2299.11 while a child's forehead gash sealed with a dab of skin glue cost $1696 (4).Average pregnancy in the US costs $32093 (5) to $37341 on average (6), making US births the costliest in the worldA mother was bankrupted after giving birth to premature twins (7).The high price of insulin cost a diabetes patient his life from being compelled to engage in dangerous rationing (8).The Nobel Prize-winning physicist Leon Lederman auctioned his award for $756000 in 2015 to help pay for medical bills and care (9).Apparently no one knows how much anything can cost in a US hospital, from a knee surgery (10) to neck surgery (11) to ER visits (12).The normal laws of supply and demand don't work in the US drug market.For example, Novartis first marketed the anti-cancer drug, Gleevec (Imatinib), in 2001 with the price tag of $30000 per year and yet 11 years later in 2012, they priced it at $92000 per year, even as competitors had come up with comparable drugs in the interim. Instead of driving down cost as competition is supposed to do in a free market, Gleevec's price skyrocketed instead.More below on the extent to which drugs cost way more in the US than in other countries from 13.The gruesome irony is that, from the unlucky many at the bottom of the economic pyramid to the lucky few perched at its rarefied heights, all pay through their noses for the privilege of access to healthcare services in the US. Did I write all? My bad. US legislators avail themselves of the best healthcare at insultingly reasonable costs, thank you very much.Regardless how most of those at the receiving end fare, the sellers in this patchwork quilt are certainly making out like bandits, all at the expense of the US government, which gets bilked through its nose, as we see from the figure from 1. This means the US taxpayer gets bilked in turn, making US healthcare system a poster child for socialized cost-privatized profit.What else could happen after self-dealing lawmakers single-mindedly keep enacting legislations that prioritize healthcare product and service sellers at the expense of buyers/payers (public and private coverage) and consumers. This process has been in place for decades. A couple of salient examples,One of most consequential shots across the bow was the 1995 decision when the US NIH (14)“relinquished its right to require "reasonable pricing" on drugs and other products developed in cooperation between the Government and industry. The pricing policy had been opposed by business interests since it was imposed six years ago.Dr. Harold Varmus, director of the institutes, said the research agency would give up the option to review the introductory price of products developed from basic research sponsored by the Government. The policy was adopted in 1989 in response to criticism that drugs developed with substantial Government help were being marketed at excessive prices.”The Medicare part D expansion in 2003 deliberately hobbles Medicare from negotiating drug prices. If Medicare with its mammoth size can't negotiate drug prices, what chances the thousands of much smaller players in the US health insurance scene can do better?No surprise then that the US has the highest per capita prescription drug prices (below from 15).Innovations of the US healthcare system currently include such grotesqueries asPeople desperately soliciting funds from strangers on Go Fund Me to help pay for medical bills.Being able to declare personal bankruptcy to get medical debt forgiven.Job lock - Wikipedia, where millions of US workers toil in jobs they likely hate only so they can hang on to their employment-based healthcare coverage. This has all sorts of pernicious cascading effects, from poor morale and poor productivity at the individual level to lack of innovation and dwindling rates of entrepreneurship at the societal level.Adequate healthcare services fast evaporating in rural areas in lock-step with escalating costs that make operating them in such areas unsustainable.Patient dumping of indigents treated in ERs becoming ever more the norm as we see from viral videos of such malpractice.Popularity of medical NGOs like Remote Area Medical - Wikipedia who are greeted like rock stars when they swing through a town. This is literally true because RAM doles out free medical care at its pop-up clinics, which are usually held at local sports arenas, where people drive from even hundreds of miles away to camp out and stand in long queues to get access to even the most basic of medical services such as new eyeglasses or dental work.As costs soar to astronomical levels,US health insurance companies have taken to transferring more of the cost burden directly onto consumers through high-deductible plans and cost sharingUS employers, already stretched to breaking point from offering blindingly expensive health insurance plans to employees, are wholesale moving away from having employees altogether and instead opting for contractors sourced from staffing companies. When even global giants like Google have 1 contractor or more for every single full-time employee, it's obvious healthcare costs are literally breaking US companies' backs.Medical tourism where US patients access health services in poorer countries like India, which only deprives citizens of such countries even more of the already sub-optimal healthcare that already exists there.Such abominations have not only become the norm for many in the US, Americans themselves are so inured to this, they accept it as normal, quite a pathetic state of affairs indeed in the wealthiest country in the world.In a nutshell, US policy since the 1980s has systematically institutionalized price gouging and opacity on the part of service providers (sellers) even as it has hobbled the negotiating power of healthcare service payers, i.e., public and private coverage. Nothing in this process was inevitable or unavoidable. The public is largely apathetic, having been acculturated to the status quo through the process of learned helplessness. After all, how many Americans routinely live in other countries long enough to understand just how different and even equitable healthcare services could or indeed should be?The US is today thus ideal for those who are healthy and childless, a fool's paradise if ever there was one since even they are only a chance away from a catastrophic accident.Bibliography1. Dickman, Samuel L., David U. Himmelstein, and Steffie Woolhandler. "Inequality and the health-care system in the USA." The Lancet 389.10077 (2017): 1431-1441. http://www.rootcausecoalition.org/wp-content/uploads/2017/04/Inequality-and-the-health-care-system-in-the-USA.pdf2. 'We blame the sick for being expensive': the mother whose baby cost AOL $1m3. A Hospital Charged $1,877 to Pierce a 5-Year-Old’s Ears. This Is Why Health Care Costs So Much. — ProPublica4. As Hospital Prices Soar, a Stitch Tops $5005. Why does it cost $32,093 just to give birth in America?6. American Way of Birth, Costliest in the World7. Bankrupted by giving birth: having premature twins cost me everything | Jen Sinconis8. Insulin's High Cost Leads To Lethal Rationing9. Nobel Prize-winning physicist Leon Lederman dies at 9610. What Does Knee Surgery Cost? Few Know, and That’s a Problem11. After Surgery, Surprise $117,000 Medical Bill From Doctor He Didn’t Know12. Sarah Kliff brings transparency to ER prices, one hospital bill at a time13. Why the U.S. Pays More Than Other Countries for Drugs14. U.S. Gives Up Right to Control Drug Prices15. Kesselheim, Aaron S., Jerry Avorn, and Ameet Sarpatwari. "The high cost of prescription drugs in the United States: origins and prospects for reform." Jama 316.8 (2016): 858-871. https://preview.thenewsmarket.com/Previews/JOUR/DocumentAssets/446118.pdf

I'm more of a technocrat, but of late, I tend to vote with the Democrats.To preface, I'm reasonably successful, and I think that well regulated capitalism is the best engine for growth and mobility within our democracy. I also think that not every part of our lives is best handled by private industry, especially in cases where shareholder obligations are in direct conflict with the service being provided (such as health insurance).On to the 'why', which is fairly straight forward. From my perspective, the modern GOP has taken a dramatic, and irresponsible shift, toward ignorance, fear, and religious extremism.Ideology Trumps RealityHowever skeptical the individual, to entirely reject the concept that the Human species can affect the climate, a position entirely unsupported by fact or scientific consensus, is unacceptable. There is plenty of room to discuss how solutions to things like climate change will impact the economy and how those disruptions can be mitigated, I don't advocate immediately transitioning from oil/coal/etc..., but to completely ignore the issue because it doesn't coincide with your ideology is dangerous and foolish.On the extreme end of this spectrum, are people like Jim Inhofe, who claims that Humans quite literally cannot affect the environment. While he is free to believe whatever nonsense he likes, it is entirely unacceptable to have someone in a decision making capacity who is unable to differentiate his beliefs from reality. Not only that, but the fact that we do not hear significant criticism of this absurd and irresponsible position from other members of the GOP is truly disturbing, and hints that many of them may agree with him.While I think that climate change is currently the most significant issue along these lines, this problem extends to many other areas.Examples include:Stem cell researchBaseless support for vaccine deniersAttempting to control a women's choice when it comes to their own bodies.Pushing for failed 'abstinence only' sexual education programs.Discrimination against homosexuals.Attempts to redirect tax dollars to religious organizations.I also find the polarized 'black and white' view of the world and government to be dis-functional.Fiscal responsibilityPersonally, I subscribe the concept of financial responsibility. I think that deficit spending, as a standard practice, should be entirely avoided, so that during economic downturns, we're able to keep social safety-nets afloat, and prevent a downward spiral. To this end, I would be perfectly willing to accept either tax increases to support additional government spending, or cuts to both social programs and taxes, depending on which party was in control. What I do not accept as legitimate, are tax cuts without corresponding budget cuts, or spending increases without corresponding tax increases.There is zero evidence that Conservatives are financially responsible; in fact, they tend to advocate cutting taxes, while never having the support, or perhaps guts, to make legitimate cuts to existing social programs in order to balance the budget. This type of behavior is exceedingly childish, myopic, ideologically driven, and serves only to damage the government, at which point conservatives claim the government is broken and needs more tax cuts.Funding moonshot / next-gen research.Many organizations can't/won't do research on technology that is 10+ years out, even if there may be a significant pay off. I fully believe that government has a role to play here, as it did with DARPA, the space program, etc...Too many times, I see conservative members of congress scrambling to keep farm and oil subsidies in place, while at the same time slashing funding to the NSF. I consider this incredibly stupid and irresponsible. Its also enraging when you find out that many of the people involved directly benefit from the specific subsidies.Health careAs mentioned at the start, I don't think that private industry is always the best provider of every service. In that respect, I am a supporter of single payer health insurance via the government; however, since that is likely not achievable within our system, I think the ACA is a step in the right direction.There is significant empirical evidence, that despite conservative rhetoric that we are the 'best' in the world in terms of health care, we are actually paying significantly more, for more or less average outcomes. We are not significantly better in many quantifiable measures than other countries who practice some form of socialized, subsidized, or socialized with additional private insurance.When it comes to health care, the GOP doesn't seem to have any ideas past deregulating, and selling across state lines. More absurdly, many times when they speak about the issues now, they talk about keeping some of the 'nice' parts of the ACA, such as not being dropped for getting sick, but have no answers when it comes to how they would make up the costs.Economic policyHere my problem is very direct. I see conservative policies as supporting consolidation of wealth, inequality, and an inexorable march toward oligarchy. So far as I can tell, most data supports this, and I see it as being destabilizing and inefficient. I'm reasonably in sync with Nick Hanauer on this and many related issues. The economy needs a solid mix of supply and high enough wages to create sustained demand. Too much or too little of either is unbalanced and leads to destabilization.Conservative policies that support someone like Mitt Romney paying 14% taxes on his gains while a doctor, engineer, etc.. is paying 32%+, is not equitable from a social perspective. Some may argue that it is 'fair' because of corporate revenue being taxed 'twice', but I see that as a red herring. If anything its a sign that corporate tax rates should be reformed, not that we should maintain soft barriers that give undue advantage to the wealthy.