Lesson from the British Healthcare system: (in Debates)

http://www.nytimes.com/2010/07/25/world/europe/25britain.html?_r=2&hp=&pagewanted=all

Obamacare just will not work.

This message brought to you by not me.

I take it "TourneyPrizes" is just Ranger in disguise then.

*sigh* Admins, prepare for another flame war.

So, I'm confused what exactly is going on. Someone dumb it down for me.

Ranger posted as TourneyPrizes by accident after I awoke him with the estate tax thread...

our debates forum was looking so lonely yet you guys just passed her over for the fake-breasted barbie doll look alike!

Shh, Novice, a lot of people don't read the LINKS threads.

yes it was me.

Best not to feed a sleeping bear.

There is no mention of the Obamacare in that article, nor is there any mention of doing away with the NHS or universal health care in Britain.

This is akin to me reading an article about iPhone flaws and using it to claim that the droid smart phones are doomed to fail.

Frankly I expected better.

Wow. I just read the article. I'm interested in knowing how in any way either the current or proposed health care system in Britain has anything, at all, whatsoever, to do with the health care reform signed into law in this country.

"Did you hear? Many Pacquiao and Floyd Mayweather failed to come to an agreement on a proposed prize fight."
"See! That proves that soccer sucks and is un-American! SOCIALIST!"

Wha? Who feeds sleeping bears? They'd choke to death. I really hope you mean "wake a sleeping bear," 'cause that's a weird mental image.

If I understand it..

decentralize =/= desocialize

(I guess I should actually put 's' instead of 'z' as we are talking about Britain)

"the most radical reorganization of the National Health Service, as the system is called, since its inception in 1948. "

So it's been 60 years? And they're restructuring it? But basically, they're trying to make it more efficient? So what's your point?

PS.
As always the phrase 'Obamacare' makes your credibility disappear instantly.

I only briefly scanned the thread, but what is it with this Care and Bears??

There is a good and bad side to this, but i.ll. Explain when i get in. I also fail to see the relevance to the new us healthcare system

OK, the good;

It's been recognised for a while that the NHS is placing too much emphasis on administration and beuracracy. More pencil pushers, less matrons for example. Focusing on Targets over saving lives.

That sort of stuff.

This 'cut' is to come form here. The excess administration, which by all accounts could do with the trimming.

The bad;

Giving the cash directly to the GPs in essence is just syphoning the cash into Private Healthcare.

So you're taking it away from the service itself, and increasing Privte healthcare the Government doesn't pay for (but we would to use it).

Ideally the cutbacks form administration should be redirected into the service itself.

But the Tories wouldn't be able to line thier own pockets if they did that...

With Obamacare the US is moving toward a government centered model.

The new head for Medicare/Medicaid is Dr Berwick a huge proponent of the British system.

Now the Brits are realizing that instead of government control, local control is best.

So the are moving the opposite of what we are in Obamacare.

The US reforms bear zero resemblance to either iteration of the British systems. This is just another excuse to use the word "Obamacare" and rant against the President on these forums.


Good. Either version of the British system is much better than ours, with or without the reforms passed by Democrats this year.


So? I saw nothing in the article that says they are moving in the direction of a strictly privatized, for profit system where the lower class is cut out entirely. They are not scrapping NHS in favor of a terrible system like ours, they are merely cleaning it, and it seems that not everybody thinks even that is going to be beneficial.


And still, the two systems don't come anywhere even near resembling each other. What a shame we can't move closer to the British model, new or old.

Um.. what? What is it about health care in Britain that you would actually want that's worth losing everything you currently have?

Your post is implying that in the US, the lower class is entirely cut out of health care. Surely you want to clarify that, since you know full well it isn't true.

That I would currently have it to begin with.


Actually, for all intents and purposes it is. I can't get preventative health care at all. I tried applying for state aid, but I was told they were over budget and would not be accepting new applicants. I'm sure being a single male with no kids had something to do with it as well.

I could go to the emergency room in the case of uh, I don't know, a freakin' emergency!!! Of course, by then, it's too late. And they slap me with a huge bill anyway that I can't afford. I've already been there, done that.

I could forgo paying rent, buying food, and all that jazz to buy private insurance. Yeah, because that's a solution. And if it was they would just take my money and deny service anyway due to pre-existing conditions, a loophole that thankfully will be fixed with the reforms already passed.

If you're a kid, you can get CHIP. If you're military, you can get a plethora of things (starting with Tricare). If you're old, you can get Medicare. If you're poor, you can get Medicaid (I might have those reversed.. I never remember which is which.) And then, of course, there is the PHS, government-run free clinics in every major city, along with places run by independent private non-profits.

After all of that, you can get your own private insurance yourself by calling up any provider.

Show me your checkbook, and I'll show you how to make ends meet.

I fall just over the Medicaid line; poor enough not to afford health care, not poor enough to get medicaid. This is the hole that was addressed several times by Democrats during the health care debate.

If your argument here is "you just haven't looked into it enough," you can stop now.


Read my post better next time.


Show me yours, and I'll show you where you can afford just a slightly higher tax rate to ensure all your fellow Americans don't have to endure what I, my co-workers, and many of my friends do.

LB you go to college?

I work at one. Will also be resuming classes next month after a long layoff due to financial and personal reasons.

Can I ask why you didn't attend shortly or immediately after high school?

High school? That's going back quite a long way.

Anyway, why do you ask?

B/c if we're going to get personal. We can't pretend there isn't a reason why some people's checkbooks look better than others. I can't speak for NS, but I can show you were I take an 18k loan to pay for the half of my college tuition that I can't cover with my scholarships. I can also show you the 5 AP tests I took to save me a few grand in college and the countless hours I spent studying to pass them. As well as the time I spend studying in college.

Nightstrike made it personal. Regardless of my background, it has little to do with the overall picture of the health care issue in this country, which is exactly what I focused on until Nightstrike entered the discussion.


Nightstrike made what I considered a rather condescending remark and I retaliated. It's what I do when someone gets snarky.


Absolutlely irrelevant to the health care debate.

But since we're on the topic, I think working in education gives me quite a leg up on the ins and outs of financial aid. Trust me when I say you don't know anything about the system that I don't.

And that sums it up.

I prefer the healthcare we currently have. Access to which MD I want. Ability to get surgery on my schedule, not the governments.

Opposed to rationing and waiting. When the government takes central command and control, the do nothing but mess it up, go over budget and run it inefficiently.


Ah, the key point. Just tax and tax and tax. Do not worry about controlling spending, just tax some more.

How about doing things that will certainly lower health costs. Instead of letting the government take central control. And we all know the government is free of waste and full of employees that work their hardest each day. *sarcasm alert*

What is an appropriate tax LB? 40%, 50%, 60%? Higher?

How about letting those who actually succeed enjoy the benefits of what they do? is that a new concept for you or do you wish to be on the public payroll all your life?

In S. Florida NOONE does not have access to health care. Aside from all the ways NS described there are a lot of public health clinics still in operation. As a physician I have frequently had our social workers in the hospital help people find doctors and clinics for less than market rate.


So basically you want the best care possible only if someone else pays for it? While you are free to contribute nothing to society?

How fair is that to me or others that actually have a job and produce?


What preventative health care do you need? Smoking cessation? Screening for breast cancer or prostate cancer? Exactly what are you trying to prevent?

Again, where I live I know of nobody that goes without medical care. As long as they put the time and effort into finding those places that offer it. There are even physicians who give deep discounts for those paying in cash. And work with those who cannot afford the bill upfront.

I assume that you are aware that there is private insurance in the Britain that allows for service you desire?

I would just prefer the option to see -A- doctor, period.


Who said anything about not controlling spending? If anything I'd prefer spending me reigned in from other areas, like defense, to help cover the cost.

Just more mindless "tax and spend" accusations from the right.


So we agree that this is a problem that needs fixing, then? Or are you somehow claiming that I turn a blind eye to this?


On which income level?


You can't enjoy just being wealthy? It has to be super-duper wastefully wealthy to be enjoyed?


There we go Ranger, that's what I've come to expect from you! A personal attack! Never mind the issue of the lower class not getting health care. Just hurl around some personal attacks at progressives and you'll be able to sip champagne out of diamond glasses from the comfort of the biggest of your sixth mansions. All the while people are getting cut from care for preexisting conditions.


I want access to some care. But this isn't just about me. It's about the millions of others in the same situation. See Ranger, I have the ability to look at the broader picture here. It's not just personal for me.


Another personal attack. I don't vote the way Ranger wants, so I "contribute nothing to society."

Admins, be warned again. This is going to turn ugly real fast if he keeps this crap up.


I know you're not in the habit of reading my posts Ranger. I know you're really just here to spew Glenn Beck style idiocies without actually taking into account anything at all said on the opposing side. But in the interest of not making yourself look stupid, please in the future read what I write instead of making ignorant assumptions. For your own sake. Please.


A rather upscale neighborhood, I take it?


Several things, but one I will name here today: severe acid reflux. I've had it to an extent since I was a kid, but being so young I thought it was normal, until it started to worsen as a young adult. I was unable to get it treated properly at the time, which I'm sure you can guess why. Now later in life, I have to take Prilosec (or a cheap off-brand) every single morning to keep it in check, or I'm in so much pain I'm barely able to function.

And I tried a so-called "free clinic." They gave me some free samples of Prilosec and sent me on my merry way. So much for that as a solution. I need better treatment, and even if I could afford private insurance now - and yes, I HAVE looked at several plans - I will get denied for a pre-existing condition anyway, even if it isn't the acid reflux.

But again, this isn't just about me. This is about getting heath care to the many, many people in this country who need it and CANNOT afford it.
Not "don't want to afford it."
Not "lazy."
Not "can afford it and spent it all on that big screen TV instead."
CANNOT afford it.

Yes I do.

However, people already pay into the public health service for their care. So those going into the private sector are double paying.

And I never understood that if the governmental system is so great (according to all the liberals that want the US to go to such a system), why is there a need for a private sector? Does that mean the public sector is giving so substandard care to where a private sector is needed to get quality care?

Are there really 2 standards in the UK? 1 for the common everyday person and 1 for those who can afford to pay more?

In the US, we currently have a pseudo type of system like that. Without all the governmental controls and invasion.

But why would I want to double pay to get the same quality and type of service I get here?

Yes there is.

As for why, it makes other people rich.

Again, if you would read my posts, you would see everyone who come to the hospital I work at gets health care, even if they cannot afford it.

And FYI, it is in the middle of a poor to lower middle class neighborhood. Very ethnic area about 20 min from where I live.


Any income level? I take it from your answer to my query, you think 90% is a fair tax level at the super high income?

But let us say 500k a year. What is an appropriate tax for that income level?

For 1M?

2M?

When is enough tax enough? How much is too much?


And yet nothing in Obamacare, which you state you love, addresses this problem. What we got is more governmental bureaucracy, more governmental panels and more politicians making policy decisions without ever being on the front lines of practice.

If we truly get a fix for what is broken, including some conservative ideas, we might get a better solution.


I want to be able to enjoy the rewards considering all the risks/time I invested in my career. If that means I get super-duper wealthy, that is just great. Since the person next to me has the same chances I did. Perhaps more given my background.

But who are you to decide who gets to be wealthy or super-duper wealthy? Cannot you be happy with the ability to succeed? With the knowledge that if you take a chance you can get well rewarded? Or are you a person who thinks that nobody should ever be allowed to fail?


And again that is a completely false statement. There are many programs that NS discussed that allow poor people access to care. Right now, prior to Obamacare, 85% of people had insurance. Whether government or private. And 3-5% of the rest have access to Medicaid but have not yet signed up. 5% more are illegals. Each situation is personally different, but I know nobody who needs care that does not get it. I know of my wife's mother, who was destitute, who had the best care, including chemo for lung cancer.


Ah, no. I am spewing what most conservatives believe. You should be able to succeed with limited if any governmental interference. Not everyone will, but those that do can reap the rewards. None of this "government is the solution to all your problems".


Again, I know of nobody who cannot get help if they need it.

About your own condition, I know of at least 5 people who get FREE Nexium directly from the pharmaceutical company due to their income level. All they did is contact the rep for the company, state their problem and the company gave them free drugs. Great PR for the company.

But you may be one of the few that slips through the cracks. So it is best to change the whole style of healthcare in America for those few?


Perhaps then, for the time being, you should lower your income a bit, qualify for Medicaid, and go to school. You may have to do without cable TV or a cell phone for a bit, but you will then qualify for healthcare.

As the IP of this thread, Britain is now seeing the error of a centralized system and is moving towards decentralization. While the US is going in the opposite way.

Yes and no. They are paying the small percent of their taxes that funds the public health system and they are paying their private insurance. The money coming out of their taxes does not 'double' the cost. If they were using the same doctors and wait times through their private insurance then I would consider that a double payment.


I'm not sure how efficient the US model really is. The 2001 OECD numbers put US health spending at 13.9% of GDP... Britain is at 7.5%

The NHS, to my understanding, provides a very high quality of care, the private system is there because of wait-times, etc, for non-emergency medicine.


Yes, why is that bad?


There probably have evolved similarities, though with less 'formal' protection for the folks on the bottom end. Don't know if I would use the term 'invasion' though.


Again, you would not be doubling what you currently pay but there would be some additional cost. Whether this acceptable ultimately boils down to your social view-point.
Personally I think education and health care should be provided for all as I feel a healthy, well educated, population makes for a 'better' and more productive society. This, however, is my personal believe, and there is no authoritative measure of who is correct here.

As we live in democratic lands Ranger we should endeavor to acknowledge each others beliefs for what merits they do possess. Unfortunately in situations like this one side will be made happy by the government and one side will be outraged.

I think of it like a coin flip... while it's up in the air we can argue until we are blue in the face as to why it should land heads or tails but once it hits the ground it'll only show one side.

Perhaps we need to work together on a 3 sided coin :-)

"Hi. So you're on a 6 month waiting list for your procedure. Well, the funds that have been taken out of the Service, instead of being redirected back into it, with the aim to reducing waiting times and increasing performance, over the red tape administration currently, have instead been given to me.

Which I've used to set up a private practice, at the same hospital, on a Wednesday, my day of from being a GP.

I can fit you in next week, at the same place you should be going to in 6 months time. As long as you can pay my fee."

No. The 'Brits' aren't doing anything of the sort. The new Government (which no one actually voted for /sigh) is doing what it always used to.

Taking money out of public services to line pockets. At the expense of the 'Brits' at large.

Let's give more access to cash to these guys...

http://www.dailymail.co.uk/news/article-1052874/Britains-highest-paid-GP-barred-practising-claims-NHS-fraud.html

http://www.yourashford.co.uk/kent-news/GP-jailed-for-%C2%A3200,000-fraud-newsinkent36702.aspx?news=local

http://www.shropshirestar.com/latest/2010/03/06/gp-surgery-swindler-spared-jail-over-job-lies/

Maybe they won't need to use Fraud to support thier lifestyles with the changes. They just agree to give it to themselves...

GL,

There is fraud in the US also. The head of HCA had fines in the millions of dollars. Local radiologists have went to jail for Medicare fraud. It unfortunately does happen. However the amount of waste due to physician fraud is far less than the governmental waste. At least it is how I see things in the US.

However, do you expect better utilization of funds coming from the government or from local physicians?

Most docs actually do care about their patients and want them to get healed when sick.

Most politicians? Concerned with getting reelected. At least that is the perception I have in the US.

I would rather stick with local instead of governmental control. Which is finally being realized in the UK.

Obamacare is the process of moving control of healthcare and the healthcare decisions to the government, away from the patient and their physician.

The Government.

Who is already dealing with said funds, and accountable.

Now, more 'administration' will have to be set up, to monitor the funding GPs will get, as currently it comes from the Service itself, and now they'll have sole control over it.

Which is just more money lost to red tape and administration, rather than being chanelled back into the service itself.

Really, all this is going to do is make the GPs (and whoever assossiated) richer, at our expense, as our health system is being driven toward us using Private healthcare over the NHS.

No.

No

Am I doin' right?

no Titan, the brits changed that back in 1984

2 + 2 = 5

No

(There, got it right that time.)

About where it is now. Less for people making about half that. Much lower for people making ~50k. Zero for people making ~20k or less. Further tax credits for those who own small business with certain stipulations (for example, must hire x number of employees, offer benefits at a certain gross income level, etc.).

Note that I'm to the right of Obama on this issue, which I've mentioned on several threads that you have failed to read, including the ones where you do nothing except yell "socialist!" at me.

This is the point where I think taxes should start getting big. A minimum of 50%. Nobody needs one million or more a year. For the ultra rich, the old money establishments, the real tycoons of the country and corporate CEOs taking home pay and bonuses in the hundreds of millions of dollars per year after they lay off 30,000 employees, those who are not just in a different class than the rest of us, but nearly a different caste, upwards of 90%. And if they hike their pay up higher while laying off even more people, raise it higher. And use those hundreds of millions to give health care to every American, and to invest in companies that do create jobs, and treat their employees more like people than assets.


Look at you refusing to read anything I've ever typed on these forums for the 148,546,986th time. I've always described the reforms as "a small step in the right direction," and horribly flawed, watered down, and nowhere near what we needed.


I've been waiting to see some conservative ideas that puts health care in the hands of people who can't afford another monthly bill. I've never seen a conservative offer one.


It also means you should get taxed more.


I'm not. With a more progressive tax rate, the rich will still be rich, and the poor will still be poor. That won't change. But no CEO, executive, old money brat with an inheritance, or even doctor is worth 10,000 times what a factory worker makes busting his butt for 60 hours, seven days a week. NOBODY is worth that much. Period. This doesn't mean they are equal, or even deserve the same pay. It means nobody is worth hundreds of millions per year. Especially in this economic climate.


I believe people should not be responsible for the failures of others. How many people lost their jobs in the financial crisis of the Bush era, through no fault of their own? And how many of those CEOs gave themselves bonuses as they layed off those workers? How many even gave themselves pay increases!?

Tax these villains into oblivion, I say, and use that money to help out - or create jobs for - the people who had to suffer for the failure of the evil, greedy men.

And give them health care.


I addressed all of them.

That poor people can't get proper care because they haven't explored the options available is a myth of the Right. It simply doesn't hold true in the real world.


As noted above, I'm not eligible. Not yet, at least.


I don't count them. You can stop discussing the illegals, as I have told you to do on other threads, because I am not counting them in my discussion. In other words, on this point we agree.


I am not familiar with Nexium. Is it a cure for acid reflux? What benefit does that drug have over Prilosec?


If I do that I may as well live in a cardboard box. And as stated I will be resuming my education next month.


And still, both end results are so far from each other that it amounts to comparing apples and oranges.

I'm trying to intentionally ignore this thread, but I will go ahead and comment on this:


Regardless of what's viewed as socially fair, it's worth noting that many CEOs losing 90% would push hard to go overseas. Those doing business in the U.S. would still face tax consequences, but they can easily drop below 90%.

While I think having anything other than a progressive system in the U.S. is naive, 90%+ ain't happenin'.

It would be for the top executives, not the businesses themselves. The idea would be to get the largest corporations to invest that money into new jobs, among other areas, rather than wasting it all on one person.

If they are using money to create new jobs and invest in the well being of our country and its citizens instead of the richest pockets of America, I'd instead give the business a nice fat tax cut.

The problem with high taxes is that it leads to people trying less to build their business. Therefore hiring less people and the vicious cycle continues.

The US has the 2nd highest business tax rate - 35%. Businesses that do not need to be in the US are leaving. While the thought in more taxes = more revenue, that is not always the case.

It seems you want to tax those who caused the crisis into oblivion. Great, I do also. Let us start with Fannie and Freddie who started this who thing. But wait, the new Financial Overhaul law does nothing of the sort. Fannie and Freddie remain untouched and bleeding taxpayer money. What about accountability for Congress and the government who turned a blind eye to all the abuses, both Republicans and Democrats?

There are plenty of people making 1M or more who did it honestly, with hard work and a bit of luck. I have met quite a few in S. Florida and New York. You then tax them into oblivion and they stop hiring/spending and the cycle continues.

You state nobody is worth 100s of million of dollars a year. I disagree completely. Tom Cruise is worth 25M a picture if the producing company recoups it and then some. King James is worth 100M if he bring more people to the Heat's arena. CEO's that make their company profitable are worth it, as long as they play by the rules.

And when your sick and need heart surgery, perhaps then you can see how a doctor can be worth many times what a factory worker makes. Not 10,000x as you stated, but some degree more.

I state you love Obamacare not as it currently is but more as a path to what yours and other liberals true goal-government run health care for all paid by those "rich" people. If Obamacare makes it through the court system intact, it will quickly lead to a single payer government system. I had thought you understood this in our discussions, I was wrong. Basically moving health care decisions out of the person/physician realm to the government realm.

I guess a the main point we disagree on is the taxation system. I believe that you should be able to reap the benefits of hard work, high risk and just good luck. If you LEGALLY can make millions a year, great! You won the lottery. But almost everyone US citizen has the same chance to do the same. That is what makes America the "Land of Opportunity". Dropping the over taxation hammer is just plain wrong.

It seem you believe that there should be some maximum amount someone can make before we tax the hell out of them. Not realizing that not many people get jobs from poor people. It is the "rich" who create the jobs. Other than government ones.

2 more points I need to address:

1) You stated "I've been waiting to see some conservative ideas that puts health care in the hands of people who can't afford another monthly bill. I've never seen a conservative offer one."

I have to call you out on this. Numerous times in numerous threads I have offered conservative ideas about how to make healthcare affordable. To repeat for the 148,546,986th time, allow insurance companies compete over state lines and malpractice reform. Not abolishing malpractice but changing it to a system that stops all the defensive medicine I see everyday.

2) Nexium is the next generation Prilosec. The purple pill you see on TV.

Do you not realize that a good CEO grows a company and increases it profit?

If they are worth it to the company, great! If not, they will have little job security. And those golden parachutes have to stop.

A more successful business=more jobs.

Excessive taxation will just move the top talent overseas, perhaps not the company. And in some cases the CEO is the company.

I may be completely wrong but it seems to me that you are very angry at the top earners in society. For something a few bad apples did. Not every CEO is a crook. Not every doctor out to fraud the government. Not every successful small business owner is a cheat.

Plenty of people made their money honestly and through hard work and smart choices. To penalize everyone due to a few bad people is just wrong on many levels.

Obviously those that cheat and break the law need to have the full force of the law brought down up them.

And I believe I was incorrect characterizing you as a pure Socialist. I believe you are a Democratic Socialist who believes in a free market society where the unknowing populace is protected from the big bad corporations via progressive taxation and extensive regulation.

This quote got me thinking about previous comments ranger. In that same breath. Not every person making low wages and wanting some help is just out to get a free hand. My new wife and myself last year made about 70k. We work at a top wage cookie factory in a country town. We do well here in our area. Because of problems in our past our credit history we have problems trying to buy a house, but are working on it. We currently pay health insurance from work, car insurance, rent, utilities, phone, food... we don't have much extra at the end of the week but we get by, but when something bad happens... car breaking down, medical bills that we weren't expecting we barely survive. We make too much money to get any help, but don't make enough to really save either. What should we do? Turn off some of the few nice things we try to get like internet, cell phones, just so we can afford the huge doctor bills we get when we have bronchitis, or tonsilitis like my daughter had recently? Health care even with insurance is expensive and there should be something done about the cost. Yes I know you went to school forever and deserve to make more money than I do, but you do. Where is the point that I can get decent care and afford it? That is my question?

Titan, Ranger made a grossly innacurate, blanket assumption, that has no factual basis.

I then refuted it


Ranger made it again a post later.

This didn't require, nor deserve, any sort of explaination a second time around.

Even if by 'Brits' Ranger ment the British Government, they have by far not 'realized' anything was the 'best' way of running things. They've just decided to make themselves and others richer by taking funding away from the Service itself and pushing it into private business.

Unless by some perverse twist of reasoning, that is actually the 'best' way of running a country and a National Health Service...

Now I'm more than happy if anyone wants to actually debate this point, and explain exactly how it's the 'best' way to run a National Health Service. But I doubt there's any arguement for it anyone could back.

(GL waits warily. Knowing they are coming for him. But he's ready. He'll make it difficult for his competition. Area secured ahead of time, counter measures in place, and sight lines free. Let them come...)

GL,

You seem very set on the point that moving from a central system to one where physicians control the health care dollars is bad. You seem to think that every GP is out to get rich from this new idea and all doctors are greedy bastards that have to have controls to stop them from taking over things.

I completely disagree, 1 million percent.

Please tell me where the government has run anything well except the military. They almost never run something on time and on budget.

The new government "(which no one actually voted for /sigh)" is doing the proper thing and moving away from central command and control.

I guess, unlike you, I have little to no faith in government doing what is right for the individual. Too much bureaucracy, too many layers of paper pushers.

I would rather have local control and I believe the British (or Brits) have realized this is best for healthcare.

Any evidence to support your beliefs? Becuase the all the 'Brits' I know who I've talked to about this think the idea is stupid and greedy.

Let me put it this way. The Government approaches GPs and says to them;

"Hi. We're taking this lump sum out of the NHS funding, and giving it to you directly. Now, the 'intention' is obviously for you guys to all decide to put this back into your NHS practices, putting the Services cash back into the Service.

But.

We know you all have private practices as well, which earn you far more cash than working for the NHS does.

And we're giving you total control over how you allocate and spend this money.

Instead of using this to either give yourselves massive bonuses, perks, or funding for your own Private businesses, you *will* put it all back into the Service, where you won't see anywhere near the potentail personal gain.

Right? Scouts honour? No crossed fingers!"

You'd have to be naieve to think that access to this cash, with no regulatory body, and no direction as to where it's going, will result in it being used to better the health service, over lining personal pockets.

And I don't think you're naieve in the slightest Ranger.

"This is a return to old fundholding days ﾖ you eliminate PCTs and save money in that area ﾖ then hand the money to surgeries who then have to employ costly individual financial management in each practice which costs money ﾖ you get a lottery of services available in different practices, not consistent treatment. I have been a practice manager since 1983 and consider this to be a backward step ﾖ much more straightforward would have been to eliminate some layers of bureaucracy at PCT level, less form-filling for practice managers and more time devoted to real patient care"

Don't get me wrong, I think just as many Politicans (and big businessmen) are the same as well. (And no I don't think *all* are, I'm not that bitter and negative. Yet. But percentages don't really matter here.)

I said as much about Politicans and this decision in posts above.

We have a system of that now in the US. We have primary care physicians as "gatekeepers" and they run a patients care with a lump sum from the HMO given to them for their patients. Called capitation. And the health service we get is spectacular.

And trust me, there will be a regulatory body, there has to be. Conmpared to the current system of bureaucrats making health care decisions? I would much rather have local instead of state control.

It is easier to prosecute bad physicians then it is to get rid of corrupt politicians.

http://medical-dictionary.thefreedictionary.com/capitation

To Sox:

You get care right now. You can go to the ER and get outstanding care. Do you think it is your right to have a cell phone, or cable TV? When I was a student and resident, I did not have cable or a cell phone. I drove a 8 year old car that barely made it to class.

It seems you want the very best of medical care, here in the US, and not have to fully pay for it.

Ranger is bitter.

Sox:

>What should we do? Turn off some of the few nice things we try to get like internet, cell phones, just so we can afford the huge doctor bills we get when we have bronchitis, or tonsilitis like my daughter had recently?

Yes.

You aren't going to like this answer, but yes, definitely, absolutely. If you bring 70k a year into your household, and you have a wife and kids (going to guess a family of 4), then yes, you are *POOR*. You aren't middle class, you are poor. You can't live on luxuries, and a cell phone / net access is a luxury that you need to do without.

Especially if you don't see a way to increase that cash flow relatively quickly (1 to 2 years), you definitely need to cut out every non-essential. You need to put every spare penny towards emergency funds and towards debt payments. You need to get yourself to a zero debt situation QUICKLY. Then, and ONLY then, can you start thinking about luxuries like a cell phone.

This right here is exactly why poor people stay poor. I have counseled countless people that say things like "Well, I should be able to have a cell phone." Yeah? Why? You're poor. You don't get a cell phone. You get out of debt. You aren't *entitled* to anything. And THIS right here is the fundamental flaw in all of these "poor people should get free stuff" discussions.

I have a friend who pulls in around 40k a year. He's got a wife, kids, two car payments, rents a house from his parents, credit cards out the you-know-what, and a financial plan that would make you puke. He's not entitled to anything.

Nobody is entitled to anything. You get what you work for. If you are only working for 70k a year, then that's what you get. If you want more, then take on a second job. Generate more. Produce more. But don't expect more for doing the same thing.

The biggest difference between people that stay poor and people that stop being poor is that the latter are willing to work for something more. They say "Ok, cancel the tv, the phone, the internet.. Shut off the AC, sell the car, take the bus to work, shop at wallmart with coupons only if stuff is also on sale, work a second job..." And a couple *YEARS* later, you know what they say? "No, I don't need to finance that new civic."

But the poor that stay poor... they aren't willing to do what's required that others do. They want an easier pathway. Well, life ain't easy. They get this idea that they should be allowed to have some niceties just because commercials on tv tell them they should. Well you know what? That's not reality.

I said it to LB earlier, and I'll say it again to anyone: Show me your checkbook, and I'll show you how to get what you want. It's possible. People in general, however, just aren't willing to go without their precious luxuries to get their family to a stable spot. They'd rather just have someone else bail them out.

That's what I'm tired of in all of these discussions. I went through those hard times and I got myself out, not on the backs of others, but through my own hard work. I'm in a very hard time myself right now, and I'm not mooching off of society. I'm working once again to get myself back on top. And I will, because of that attitude.

I'm tired of seeing people say "I want what others have, but I don't want to do what others did." If that's your attitude, then tough. It doesn't work that way. You can't take what you didn't earn and expect things to work out. Again, if you're making 70k a year pre-tax in a household of 4 and you're paying for a cell phone, you're heading in the wrong direction.

Hrmpf.

With all of that said, I will concede that a lot of this attitude that's rampant across the US does tend to stem from a changing trend in advertising that focuses on teaching Americans that they should be able to have what they didn't earn. It's hard to turn off that tv and stop letting yourself be brainwashed by the very same corporations you hate. But once you do, once you start to see the actual reality of life, things do get easier. Well, ok, they get a lot harder first... but after that, they get a little easier. Somewhat.

Cyc: NS is bitter :(

Where in the heck are you getting your data? The poverty line for a family of 4 is roughly $25,000, varying state by state. A family of four earning $70k/anum is NOT poor. $70k for a family of four exceeds the median income for that family size in most states! Holy crap-oly...

But your initial point stands... cable and cell phones are luxury goods. Regardless of your income level, if you can't sustain your lifestyle, CUT BACK. I work with indebted families each and every day. Some have no income whatsoever, and a couple earn $15k/month. Some of my clients are doctors, some (many) are teachers, some are lawyers, and some (many) are factory workers. It's not about how much you make, it's about how much you spend.

I kill you!

I had a lovely story saved in a text doc to copy and paste when my target slipped up. I hope you feel happy knowing you ruined it. Shame on you. Shame!

Ranger and Nightstrike may be bitter but we are both realists.

Like NS, I had a period of 12 years where I went to school and did residency. During those times, to save money I cut back on everything. I was fiscally responsible and made my own way to where I am now.

It is tiring to read of people expecting luxury items with the expectation that essentials should be paid for by ithers processed through the government

So if you have to drop your cell phone or cable, do it to pay your bills. They are LUXURY items.

Internet access is fast becoming a necessity. For instance, my bank no longer sends paper statements. Unless you pay. The alternative? Online banking.

Additionally we live some distance from our nearest supermarket. The charge for ordering online is cheaper than the cost of petrol.

Your idea of what are luxuries these days are outdated Ranger.

You got a pen and paper? What do you need paper statements for?

JW - steal wifi, go to the library, hang out in the parking lot of a place that offers free wifi, etc etc etc. If you hung out in chat more, you'd know that I spend a good chunk of time at the house of someone borrowing wifi from a neighbor.

The point is that there are ways to adapt. You have to be creative.

The ability to do that depends a lot on where you live NS. For instance at my mom's house the nearest library is about 30 miles away and I don't think they even have any internet access there. She grocery shops only once every two months or so because of the costs of making the trip into town just to get anything.

Demi - the poverty line and being poor are different. If you bring in 70k a year for 4 people in most demographics, you can't afford luxuries. I consider that poor, and I highlighted it because too many people consider that "good enough to have a car/phone/net/tv". It's not. What's 70k come to for take home pay? Depending on contributions and tax bracket, maybe 50k? That's a grand a week roughly.

Given your field, you probably know the old axiom that no more than one weeks' pay should go to rent. Think he's in a place for 1k/mo? Doubtful, but I hope so. That leaves 3k/mo. 10% of gross should be going to a cash fund (or equivalent liquid for emergencies, so that's about $600 a month. We're down to 2400. We need to eat. 4 people at a grand a month is feasible if he really pulls out all the stops regarding frugal living (gotta be a SMART shopper). Now let's talk car. Dirt cheap ghetto insurance for basic liability that you don't want to admit to having is going to be around 50 a month. Of course, if you pay monthly instead of annually or 6/mo, then you pay more. The reality is that he probably has better insurance, so let's say 150/mo. He didn't mention a car payment, just insurance, so I'm going to give the benefit of the doubt here and say that the car is wholly owned. Driving a car is 50 cents a mile according to the IRS (well, 48 cents...) Average commute is 36 miles. There's 260 work days in a year, so let's say 4680 / yr.. Can I say $400 a month for car maintenance? We're down to $850 left, and have yet to pay utilities or other basic necessities.

Yes, poor. I don't care about poverty levels. Poor.

People who have been in a clan with me will know how limited my internet access has been over the past year. No wifi near me that isn't locked down, trust me I've tried. The library limits access to certain sites. For instance financial and social networking are off limits. Work has a very severe firewall that blocks almost everything including emails and cb

And yes, Ranger is right. The reality here is that people expect to be able to pay for luxuries, and have me pay for their necessities. Meanwhile, I paid the price for what I have, and others think it's ok to just take that away from me.

There's a good joke that equates this stuff to school work. Basically, you have two kids in school. One works like crazy, studying, doing extra projects, really learning. The other never comes to class and goes and gets laid every day. The first gets an A, the second an F. How would the first kid feel if the teacher said "Hey, you know what... we're going to take your A away from you and give some of it to this slacker that deserves nothing so that he can pass. He now gets a C, and you get a B. Your GPA is going to suffer, but that's ok if it means that more kids can graduate (even if they are fully unqualified)." Well, in the joke, at the end, it says something like "Welcome to the Republican party..." but the intent is obvious: You don't deserve what you don't earn.

JW - WEP + BT4 = what I'm on right now.

I just want to say that I really shouldn't be harping on Sox in all of this. He posted his own situation, and I latched onto it because it's a perfect example for certain things. But that doesn't mean that it's right to say "Sox is poor" every other sentence. So, apologies to Sox for that.

Lesson from reading through this thread:

Germany has a high national debt, no-one (who asks the state for money) has to live without internet, everyone has health-care.

The US has THE HIGHEST national debt, there are people (who would ask the state for money) who have to live without internet, a lot of people have no health-care.

The land of the free?

Highest due to the new administration spending like mad people. I do believe the US has one of the highest percentage of internet users in the world. Ahead of France, Germany, and Canada. The same as the UK. And we have over 85% of people with some degree of health


Damm right!!! Free to make one's own decisions. Free to go out and become successful and reap the benefits of what you do without the undo burden of excessive taxation-for now. Freedom of life, liberty and the pursuit of happiness. Free to choose your own religion.

Not the land of free internet or free cable TV. Not the land of free cell phones for all. Not that type of freedom if that is what you are implying.

I have to 2nd NS's statement. But it is an example of some of the entitlements people expect in society today. However, some things are luxuries and should be thought of as such.

I certainly personally do not believe Sox is poor. He has a roof over his and his families head. He and his wife puts food on the table. They are free to do what they wish, within limits of course.

Gotta quote the GNU here....

"Free as in speech, not free as in beer."

http://www.gnu.org/philosophy/free-sw.html

NS: you do realize how disastrous for the economy living like you would be if everyone did it right? The US is where it is because the majority of the population live paycheck to paycheck. I'm not saying it's the best way of doing things, I'm just pointing out that your version would cause far more harm than what is likely to be the result of the current healthcare reform.

Well, good thing I wasn't on earlier to respond. I might have said a few things that would have gotten me banned or fined, had I actually taken any of your comments personally.

That being said. I never, and I repeat, never said I expect anyone to pay for anything of mine. I work my behind off daily to make what I make. Your numbers are wrong for my part of the country NS. My rent is 450$ a month. Does that explain where I live a bit better? One grand a month for food, I guess you haven't lived rough. I spend on average 500$ a month give or take on food and we eat rather well. We moved to a house that is less than 1 mile from our place of employment just to save on gas. So that figure is out the window. Oh and 2nd job? Impossible. To make the 70k to 80k we made last year we worked plenty of overtime. There was a two month stretch where I worked 80+ hours per week. This being forced overtime. I don't have time for a 2nd job. The area of the country I live in I would say most everyone around is near or at the poverty level which is around 20k I think right now. So yes in my area making 70k is middle class. Yet after all of this I can't afford medicine? Why? Because our system isn't right. What other country out there has medicine manufacturers putting on commercials trying to get people to try their medicine? Those commercials cost money, and the money that that costs gets passed on to me. The consumer. Why should an antibiotic with insurance still cost me upwards of 50$ or more? For generic? I shouldn't have to get rid of things like internet, which is a necessity in my book, not that much of a luxury, and a cell phone, which costs about the same as getting a house phone, but I guess having a way to communicate with work or family is a luxury also. There are things in our country that are wrong. Medicine shouldn't be big business. When things are a business there is only one thing that is important and that is profits. Medicine shouldn't be a profit. That is my opinion. I might be wrong, but that is how I feel. Coming from the bottom, which I admit is my fault, that is where I come from. Yes I believe doctors should get paid and paid well, but I'm sure they do. I don't see any doctors at the dhs office filing out for food stamps, or getting help with their light bills.

All this talk of what is earned and what is deserved just makes me sick. If you think I don't work my ass off as much as you do then really this discussion has ended. I work hard for what I make. I come home from a factory where the temp inside by the ovens is upwards of 120 degrees farenheit every day. I work 8 to 12 to 16 hours a day in that heat and still get my job done and enjoy my work. I make a decent wage for my area and bring home enough to support my family, but yet at the end of the day I am still hoping that nobody gets sick because one good sickness takes every bit of extra money we have saved up. I don't even want to think about retirement. I am saving in a 401k but nothing else. There isn't money anywhere else. So what am I supposed to do then.

You guys keep talking like it is so easy. Yes I am sure you had tough times in college and with loans, and everything, but we are past that point in life. We are adults with kids, responsibilities and with the prices of things there just isn't a way to make it in the end. I mean I'll make it, don't get me wrong, but I don't see where it gets better.

Oh well I have rambled on enough. Good thing I had time to read all the responses before I let go with a crazy response... oh this one is kinda crazy oh well.

Thanks man... the real world has so many perspectives and people often forget because of ideology just how different things might be for some folks.

The bottom line with all this is simple. The country moved in a direction where we said we don't think people should be destitute because they get sick. Folks who've managed through intelligence, right behavior, and hard work to prepare themselves for such problems take issue with the idea of making health care a right. As long as democracy exists and we inhibit education and critical thinking we're likely to end up in this kind of situation. If the majority lives paycheck to paycheck (and in doing so supports the insanely unsustainable US economy) you can expect folks to fall down when times
are tough. It's easy to believe that in a country as rich as ours, that those who suffer (often times not of their own doing) should be taken care of. Governments were created for just this sort of thing, and the balance of democracy never stops moving.

I wanted to say one thing I've heard mentioned over and over again. Some people have said that things like:


I don't think this is true. Not everyone has the same opportunity to succeed, I think it's a very sexy rationalization that people choose to believe though. Some people don't know what they don't know. Some people don't know how to live frugal or spend wisely, simply because they haven't been exposed to those kinds of ideas before.

Even more then health care, I think free higher-level education would be a great place to invest lots of money in to improve the well-being of all American citizens.

Quoted before its used as a "Why give poor people things they didn't earn" comeback.

Actually, Georgia, Tennessee, and other states use lottery profits to provide college scholarships. If you live in Georgia and maintain a B average in high school, college is covered.

You do have to "earn" it with the aforementioned B average and maintain a decent GPA in college, but otherwise college is covered up to a certain cost.

Being frugal doesn't help the economy, it helps you.

Spending a little more than you should, but also investing enough to make it after retirement.

That's how you help the economy.

I must admit, I hate being in debt so I don't follow my own advice, but I guess I just look out for myself over the economy as well.

Certainly. However, with such uncertainty as to the future of the economy, most small and large businesses are not spending.

Let me ask, has anyone here actually owned a small business and had to make payroll? Had to pay insurance? Had to go out and get more business?

Theories are just that, theories. What works in reality is massively different.

I used to be a small business owner and I still know quite a few. With all the new taxes coming in America Jan 1, nobody is spending to expand or even hire.

I believe Wraith was referring to individuals as opposed to small businesses.

The problem is that the US economy can't afford to have people stop spending (consumerism ftw) and at the same time a growing portion of the US population can't afford to keep spending.

Oh, and with regards to the estate taxes, wasn't 2010 the only year recently when they weren't in effect? I seem to recall some mention of reverting to 2001 levels starting 2011. Is this really a new tax in that case?

He may be referring to the end of the Bush tax cuts...

Yup.

One big problem is that according to the US tax code, most small businesses file as individuals according to the IRS.

And most "rich" people are in fact small businesses unto themselves. With their pool guy/gal, lawn people, nannies, etc....


That is for another debate. One where even some democrats realize letting these lapse would be bad for the economy in its current state.


And I think NS may be the only one who agrees with me on most of my points. That America is a land of opportunity. Not a land of getting stuff for free. I want everyone to have the same opportunity to succeed. What they decide to do with that opportunity is up to them. Succeed and enjoy the fruits of your labor.

and the same opportunity to fail...

I'm sure you're ok with people having their lives destroyed because they get sick. The reality is that a large portion of the population isn't, as long as we choose to keep folks ignorant and base our economy on wanton consumerism we're sentencing a percentage of our population to a life of bankruptcy and destitution. Again, I don't necessarily think that it's wrong to be ok with this, just as long as you're not surprised when the majority vote doesn't always go your way. On the up side, the tactics of fear and misinformation are extremely effective in riling up folks and keeping them from voting for people who also believe that being sick isn't a financial death sentence.

There are plenty of methods for "poor" people to be able to get medical care.

And if one has to spend ones savings to be cured, that is one of life's curves that you have to deal with. My parents declared bankrupty when my mom fell ill in order to qualify for medicaid. And it treated he just fine until she passed on.

Sorry dude, life is not fair. But you do have an opportunity to make it in America. At least until these liberals take and take and take until it is no longer worth it to try. And then nobody wins.


Both parties use these tactics novice. Do not kid yourself into believe it is only Republicans that do this.

But again, at what point is too much tax? 90% as LB says? 30%?

The "poor" would not have access to their flat screen TVs, cable, cell phones etc.. without the "rich" and their "wanton consumerism" driving the cost on these items down.

And certainly the opportunity to "fail", with the opportunity to try again and again.

Just because someone lacks the guts or fortitude to try to make it on their own does not mean others should have to pay for that cowardice.

Because someone wants to work for the man, does not mean those that try and take chances have to pay for their luxury items all the while giving them free medical care, free food, free housing. Should not people have to pay something?

47% of all people last year paid ZERO federal income tax. How fair is that to people who actually took a chance and gambled with their future and did well?

I'm sorry for your loss, but what you described is not a scalable or tenable solution for all citizens of the US. It's a good thing we have leaders who can think of the big picture when making policy decisions.


Adjusting the tax burden away from the rich and onto the poor did not seem to illicit this same reaction from you, so I will attribute this discrepancy to your own biases.

This dude http://www.forbes.com/2009/07/09/tax-wealthy-health-care-opinions-columnists-bruce-bartlett.html Talks about why things are the way they are, and why never raising taxes is pretty much why we are at the place we are now.


The rich are not the only ones who drive prices down, if the poor did not recklessly spend beyond their means, product prices wouldn't drop either. Both the rich and the poor are tied together in many ways. The reason we have Wal-mart, and the reason why prices go down is almost BECAUSE people spend more money then they have on things.


Again I go back to education, if someone is uneducated, I would argue that they are much more vulnerable to the marketing that makes them feel they NEED that item in order to be okay. It is your own education that allows you to reflect marketing and such that tries to change your attitude about yourself based on products.


Your worry that poor people don't pay federal taxes is silly because they do, they pay it differently then rich people do though. Unless they lived in a state without sales tax, they paid local sales tax to their state. They also pay social security and medicare taxes. Here, since you probably won't listen to me, maybe this guy will show you: http://www.999ideas.com/working-poor.html

Rich people pay those taxes too Fex...

Titan, please read the entire 999ideas article before responding, as you would have seen your comment rebuffed already.

I'd say Fex has a very good point regarding education:

If you look at the US Census data (wiki has 2003's):
Median income for highschool drop-outs = 22k
Median income for people with some college = 45k
The median on college grads is over 65k

So someone who drops out of highschool to get a job to help pay their family's rent is likely to be stuck below 40k/yr for life.
Someone who's family can afford to send them to university for 4yrs is likely gonna pull down double that.

Born with equal opportunity my eye.
(and yes, go ahead and repeat that 'if the work hard and get student loans and scrimp and save... blah, blah' argument, fact is, not every one has an equal opportunity)

Oh, and in the US economy there HAS TO BE POOR PEOPLE.
Not all 150million (or whatever it is) working age people can work hard, take risks, land 100k/yr jobs (hell even 50k/yr jobs). I'm sure it would be nice if the all worked hard to become doctors... only who would pay them. (and what would we do for garbage collection, grocery store staff, etc?)

But education would help at least.

Loch: what you're missing is that folks who believe that the poor deserve the suffering and illness they've earned by cleaning up our trash and working harder than I can possibly imagine don't care that people born into poverty are more likely to be shot than go to college.
That's fair, the natural world needs someone to suffer and die. The conservative ideology insists that we are not capable of effectively combating that at an acceptable cost. Wealth redistribution is viewed as being as soul killing to the wealthy as the rape, malnutrition, and whoredom that the poor experience daily. People who believe that it's right for government to act as a safety net are insane by this system of ethics. It's criminal in the nonconservative mind to limit the financial freedoms of a single person regardless of the purpose.

Ok. I will try to take these on without getting out of control. These comments ranger make me stop reading your posts. You take all people that aren't in your bracket and slap labels on us. Where have I ever said I want you to pay for my food. I don't get food stamps. I don't even apply, but I have in the past. Does that make me a coward? Those comments really take away from your smarts in my mind. I usually read everything you say and try to think of things from your perspective also, but here is the thing. With comments like that I can see that you have no clue about the other half at all. You may say you came from some low income hard times, but if you did, I doubt you would type half the garbage you type. I have never lacked guts when it comes to my life. I joined the military and had plans on going to college using the Gi bill, but things changed. My life changed. You can't take as many chances when there are kids involved. I didn't have any kids of my own, they were there already. Yes I could have chosen to not fall for a woman and just lived on my own, but that isn't what happened. So with these kids there I had to get a job and support them. This is what I did and I don't regret that at all. Did that make me a coward because rather than push for college or a better life I took care of some other man's kid because he was a deadbeat. Most people I talk to say that takes courage to raise another persons kid as your own.

Now the second quote there is just comical. Do you even know what money brackets get approved for food stamps and such? Do you really believe that a woman and two kids should just have to go hungry because they only make 14k a year? Yes there are people out there that make that much money Ranger. Now yeah, it would be nice if this woman could change her life and make 100k a year, but well as was said before if everyone could make 100k a year then that would be the new poverty level. You take the poor like they chose to be poor. Like they wanted to be where they are. Like they didn't try to do better. Not every person can try and succeed and become wealthy. No matter how much you think that that can happen. It can't, and if you think it can then you are seriously living in a fantasy land.

Now lets go to the last point. I will even give an example here. Lets say I make 40k a year and you make 250k. Right off the bat there is a pretty straight tax for everyone that covers social security and stuff that is about 12% or so if I recall correctly. That is about 4,800 for the 40k worker and 30k for the 250k worker. This leaves the 40k worker at about 35,200 and the 250k worker at 220k. Now lets get to food, water, gas, electric, rent, things like that and ... well you can see here that the 40k worker when it's all said and done probably has next to nothing in the end and the 250k worker will have plenty left over. What should you tax that 40k worker? What more can you take away from him? Just try to show me where that 48% of the bottom should pay more? Oh and just so you know. The lower 48% probably don't even make 40k. Heck, cheapest rent I see where I am is 400 per month. That alone is 4,800 a year. Imagine that if you only make 20k a year, and tell me how that person should pay more tax.

That person shouldn't make $20k or even $40k a year. If they want to feel entitled to the other two, life and pursuit of happiness, they should go to school and become doctors. You snooze, you lose.

Hard times in college for some people means drinking champagne from plastic cups, or stripping to make some extra cash.

So Ranger, nice tips?

No JW,

Hard times in college is sharing an apartment with 6 other guys.

Eating noodles with ketchup, and doing laundry in the sink to save money. Not having a car in college and bumming rides from friends. Taking out loans for both undergraduate and medical school to the tune of 6 figures.


I guess that depends on your definition of happiness. Those making 20k a year have life. As I stated, there are plenty of methods to get medical care if your "poor". Having a cell phone, cable, a car are all luxury items that people now thing of being a necessity for "happiness". Things that more successful people owe them.

"Hard times in college is sharing an apartment with 6 other guys.

Eating noodles with ketchup, and doing laundry in the sink to save money. Not having a car in college and bumming rides from friends. Taking out loans for both undergraduate and medical school to the tune of 6 figures."

That's your idea of hard times? Lol, I grew up in a house without a washing machine, or enough money to go to the launderette. Washing clothes in our apartment took place in the bath. We never had a car, never had a phone and had an old black and white TV that my aunt gave us. Some years I went without presents at Christmas so my mum could buy my younger sister a present. We were lucky enough to eat well because my mum worked for a wholesale meat company and to supplement her wages she was given joints of meat, chickens, and the like, otherwise we would have been growing up on a worse diet than your student one.

Taking out loans to the tune of 6 figures? Some people can't even get loans because their income is so low, never mind loans to go to university or medical school. And your debt was through choice, I can't imagine you were forced to go to medical school.

No, the old "I've been through hard times thing" is starting to sound very stale sir.

And yet now you have a washing machine, a car, money to eat out. Money to raise Emma properly. Seems to me you are successful, extremely so.

So please tell me where you do not have access to life and pursuit of happiness. American version.

Most people in America have those things and yet still complain when they have to actually pay for medical care and not take that trip or have to lose their cell phone or cable TV.


I do not know how it is in Britain, but in America people who are "poor" easily quality for student aid and/or scholarships. I was not forced to go to medical school, but it is a career I enjoy and gives me financial security. If you are typing about loans that people cannot afford to buy a TV or cell phone, that is great. They should not afford them if they cannot. Loans to open a small business is likely on a case by case basic based upon a prospectus of their business. Loans to go to school are easily to obtain in American. Especially after the Obama administration nationalized the student loan business in order to get Obamacare passed.

Sounds like another "let us hate the successful guy for doing well and not wanting to pay his 'fair share'"

Sorry Johnny, but in the US we have the most progressive tax system. While the "rich" do not pay more as a percentage of their income than other countries, we pay the most compared to the lower income brackets.

How fair is that to those who are successful? Not very IMO.

I look at Bill Gates or even Lebron as a great success story. Someone who made something of themselves that perhaps I one day can emulate. Others seem to look at them as a big money pit of which they want more.

I guess things just depend on your view.

Missed the part where Warren Buffet claimed to only pay 17% while his secretary payed 30% eh?

To be honest, I don't disagree that people need to learn to live within their means.
I have never bought anything where I didn't have cash in hand to do so (I don't own property, though I would make an exception in that case). On the other hand I have co-workers come in with their brand new $200 cell phones one day and then complain the next day that they need to borrow money for rent. But who is responsible to the growth of this mentality?

Sometimes I wonder though, would Steve Jobs be so rich if there weren't millions of Americans buying iPhones and iPods when they really can't afford them?

"Money to raise Emma properly."

That's GL's daughter. We are not the same person!!!

^ that got an honest lol out of me.... hehe

Bah, you guys are both in Britain, talking that weird language that I can never understand... you might as well be the same!

Hehehehehe. ;)

G Beee originally thought we were multis! Luckily since then, some CBers have met us both IRL, otherwise I'm sure one of us would have been reset!

Back on topic, personal wealth or situation doesn't really have a bearing though. I've been through both. My folks worked hard to improve their and their families 'quality' of life.

None of it has any bearing on how we feel society should function.

If I win multi million pounds on the lottery (after buying CB a new server!), I still won't change my opinion of how the NHS should be running.

I'd just be lucky enough to be able to afford Private treatment, should I ever want it.

Still, I don't see how the OP relates to the thread topic in the slightest.

They're most certainly not the same. GL is much more likely to get you in trouble.

How fair was the ex BP bosses 11Million pound payoff? Fairness. What's that? It doesn't exist in big business.

:D

Conversations drift after 109 replies... And in the end, no one has a different viewpoint.

LoL! ;) Getting back to;


Be thankful I've not reverted to rhyming slang, me old pitch! ;)

Not true, I went from believing that the nature of life requires different perspectives to exist to wondering what in the hell it would take to get some folks to appreciate their fellow human beings.

Some perspectives are like saying that because some people cheat on tests that we shouldn't have school at all. It's frustrating to try and be zen about the philosophical divide between the feast and famine contingents. I can appreciate the conservative perspective, almost more than I can manage to empathize with the totalitarian left, but the inability to understand that there are other factors in play besides having worked harder than the man next to you just breaks my heart.

Well, it's not that stark, Novice. Even the far far right supports helping people out.

The biggest differences in all of this stuff that boils down to, essentially, "giving to those in need", are two fold:

1) Whether people should give to others of their own free will, and not be forced to
2) How much the person on the receiving end has to do to get the free stuff


For #2, there's a joke somewhere on the net about a democrat and a republican, where they both try to save a guy drowning in a lake. The former throws a rope to him and walks away (thus not holding the other end on dry land), while the latter throws the rope halfway and says "Swim to me and I'll pull you in."

I prefer the latter.

I'm all for helping people. Just, I'm not for giving out free lunches. Can't pay? Fine.. Wash dishes. But don't skimp out on the check.

What about those that can't?

Do what the Spartans did and throw them off a cliff at birth?

Works for me :)

Honestly, though, there's a difference between "can't" and "won't". Our system really does help people who legitimately "can't". But, if you're one of those who "won't"... well... you'll drown. I have no compassion for that.

Oh yeah, there's a world apart. I have no symptahy for the 'won'ts'.

It's like the asylum seeker debates over here. I have more against people who grew up here, and do nothing but abuse the system, than those who have deliberately come here to try to build a better life for themselves.

Well, then I guess it's at what point we deem someone a wonter instead of a canter.

Judging won't from can't isn't exactly simple. Creating a system capable of doing that fairly is pretty much impossible.

As an example, my sister is on disability because of schizophrenia. She is also prone to chemical dependency and not taking her prescribed medication. She is certainly in the can't crowd, but because of her inability to deal with the medication and it's side effects she would totally fail in a system that required clean drug tests to qualify for disability. Any system created to prevent abuse is itself subject to a whole other level of abuse. What's frightening to me is that the people abusing the system are often the ones most capable of getting around the preventive measures put in place, so the only people being caught are those who do in fact actually need help.

It is well known that at least in America, conservatives give far more to charities than liberals. You can google this or can read this article from the NYT, a liberal rag:

http://www.nytimes.com/2008/12/21/opinion/21kristof.html?_r=3

I personally give quite a lot to a few local charities with respect to both money and time.

I would give even more if those foolish liberals stop wanting to take more and more and more.

The only thing that will likely change with the increased tax rates is my donates to charity.

I would much rather give myself to whom I want than give money to the government. And then watch it cycled through 10 mid level government managers (paying their salaries along the way), through 10 different committees, then through ACORN on its way to someone possibly sitting on the couch, watching TV, chatting on the cell phone, laughing at the person working at Burger King who is trying to make something of themselves.

Which brings us back the primary post of the thread. The British realizing that local control of funds is far superior and more efficient than governmental control. Withstanding the possible abuses at the local level with local GPs. Which is probably far far less than the abuses at the governmental level. Which has less oversight.

To go back to the original post, its not really about efficiencies with the changes to our health system; its about savings. The new government are cutting most public spending by 25%, but may take that to as high as 40%. Decentralisation of the health services administration is one way of achieving that, though at the cost of hundreds of jobs, and with no guarantees of success.

One of the lasting legacies of a government in the 80s that closed down our homegrown industries in favour of trading with other countries is that we actually have very few major employers outside of the public sector anymore. In some areas they are practically the only employer apart from retail and restaurants.

Not only that, but one of the electorial promises of this 'Government' was that front line services wouldn't be hit by cuts, and that their spending was 'ringfenced'.

Aparantly, this might not be true...

/sigh

< someone possibly sitting on the couch, watching TV, chatting on the cell phone, laughing at the person working at Burger King who is trying to make something of themselves.

Again Ranger, statements like this is what makes me just really stop reading a word you type. You make it sound like every person receiving help is that person. Unfortunately some people do that, and it hurts the people that need help. What's that saying, one bad apple spoils the bunch. The fact that every time you talk about someone getting your money through the government it is some person that doesn't help themselves.

Have you been to a burger king lately? Go to one. I will be willing to bet that most of the employees there are now middle aged people instead of the old traditional young students. Do you know why Ranger, because in our economic times burger king is about all some people can find out there. So in the end you have a lot of young students finding it hard to get a job. My step-daughter turned 16 in Feb and it took her almost 2 months of applying to every fast food place in town before a friend recommended her for a job at Sonic and she finally got a job. Every place that used to just be simple to get a job when you were a teenager were full. You want to know why, because people are taking whatever they can and still need help. They aren't sitting on their asses and hoping to get people to take care of them. They are trying to get a 2nd job, but you don't seem to take into account those people Ranger, just the ones that sit on their butt and don't do anything hoping for a handout.

Until you start looking at everyone and not just taking the worse of the group you will never fully understand why this country needs some of the assistance programs we need out there. Until that point it is useless to continue this conversation or debate or whatever, because you have it set in your head where your money is going and how it shouldn't go there and you don't seem to really care that it might actually be helping some family that needs it instead of some couch sitting don't want to do nothing person. :)