Topic: health care bill

[Markcb750]

She received treatment didn't she?  Is she now dead from Lupus because she was denied the chemo therapy?



FYI we all have stories:

My niece has a complex neurological disease related to MS, she is 40 YO has been put on SS, and recieves very expensive chemo every 90 days.  
She was kicked off her employers policy when she was unable to work a few years ago.

  

[Caaveman82]

Why did she require gastric bypass in the first place?

She was fat. Though if she had not gone in for it she may not have found out she had lupus till it was too late. First time you might have ever heard of some one being over weight helping someone's health eh?

She received treatment didn't she?  Is she now dead from Lupus because she was denied the chemo therapy?



FYI we all have stories:

My niece has a complex neurological disease related to MS, she is 40 YO has been put on SS, and recieves very expensive chemo every 90 days. 
She was kicked off her employers policy when she was unable to work a few years ago.

 

She recieved treatment all the way up till she found out that she had lupus. She started at that company 34 years ago as a secretary and worked her way up to vice president. She had put a lot in the pot and got crapped on. I understand we all have stories but I guess the main difference is I care for people other than myself. Call me crazy or a socialist, I call it having a little compassion.


Also do you know what lupus is? It's an auto-immune disease, there is no cure. Meaning she is now constantly sick and still needs a liver transplant which she can no longer afford because she already gave all her money to the hospitals. Oh yeah she can't get medicade either.

[edbikerii]

The only verifiable examples I've heard of people getting sent home to die come from the world of socialized medicine:

* New York City Health and Hospitals Corporation routinely schedules chemotherapy and radiation treatments for cancer patients several months into the future, guaranteeing that when (if) they come back, the cancer will be terminal.

* Rationing of chemotherapy for NHS patients is well-documented.

* Long waiting periods for simple procedures like CT scans.

Do you know of dying people who sit in hospitals with known illnesses and they are tossed out...

It does not happen. They are treated; Every Hospital has a social worker staff that evaluates the situation and finds a way to take care of the problem. I am sure there is some delay, and I am sure some fall through the cracks, but she would be treated.  Although not at a hospital of her choosing.

Go to a hospital, ask them the question, they will inform you.

[Roach Carver]

"but I guess the main difference is I care for people other than myself."

wow, I feel like such a tool. If only everyone were able to have your level of compasion what a beautiful world it would be. where is my coca cola.?

[Markcb750]

I have had a friend die of lupus, but that was many decades ago.  
today it can be managed and some forms forced into remission.


She is being treated isn't she?


I know its an ugly process, and no one should be forced into this.

I think you feel I am on the other side of this debate, I am not.  My point is we pay for this now. Reorganizing how it works is not going to change how much we all pay, it may rearrange which bean counter gets our money to buy a Bentley.  

The new law, makes some attempt to do this, unfortunately the congress did not wright this law, the insurance industry did, so who do you think will get the Bentley.  

[Jordan]

Don't know why it took that long, maybe because while it is federal the states run it. I had a bunch of denials based on what I thought frivolous technicalities not related to the actual illnesses, Reams of paperwork and appeals until I finally went to federal court for the final decision. Hard to deal with all of that when you are ill and facing financial ruin. I have the impression that this is how they setup programs, make them so hard to navigate that a large percent of people just give up. I understand that some states it is a lot easier, with less hoop jumping. Maybe that makes fraud more prevalent. I don't know. I need to add that it has been 2 years and things are leveling out money wise, creditors appeased etc. I just think that most Americans go about their business, are lucky to stay healthy and pursue the proverbial American Dream, and don't give these things much thought unless misfortune hits home. Then they are unpleasantly surprised when they find things like insurance, health care, assistance programs and the like, are not what they have been told they were. When your world comes crashing down, reality hits with a vengeance.

[andy750]

There has been a lot of misinformation in this thread and so I thought it would be useful to offer a comparison of two healthcare systems and two wage earners; UK versus USA.

Comparsion of US vs UK taxes for healthcare

Some interesting comparative data since some would have you believe the European/Uk wage earner pays a lot more in taxes than the American wage earner.

UK wage earner pays around 33% of salary to tax (which includes health insurance tax).

The benefits of the UK wage earner:

1.   Free health care. ~$10 prescription charges.
2.   At least 4 weeks holiday per year (usually get 20 -30 business days off per year) with 6 months sick pay if you need it. Usually another 6 months on half-pay (depends on employer but this is true for nurses for example). Extra holidays include the 9 bank holidays a year.

The downside of the UK wage earner:

1.   May have to wait for a non-urgent operation. Wait time has improved dramatically in last 5 yrs. Life-saving operations have no wait time (obviously).

The USA wage earner pays around 25-30% tax depending on exemptions. If you pay too much you get it back at the end of the year and if too little you pay more.

The benefits of the USA wage earner:

1.   Pays monthly premiums (100s of $s) for health care with $x deductible (someone quoted $3500 here in this thread). If working for an employer the true cost is not known as the employer is paying for some (?%) of the premium.
2.   Co-pay is paid every time visit the doctor. Usually $20 -$25.
3.   Vacation time – usually 2 -4 weeks. With ~9 public holidays/year.
4.   Immediate access to doctors and surgery. Wait times in ER or to see doctor is same as UK/Euro. i.e. turn up to see doctor at 9am it usually takes at least 30 min to see him. ER can take longer if non-life threatening condition. 3 -5 hrs is not uncommon.

Downside to the USA wage earner:

1.   Coverage can be denied if have pre-existing condition.
2.   There are limits on how much healthcare you can receive in terms of insurance $. If you are chronically sick then you better hope you get better before the money runs out.
3.   Prescription medicine can be very expensive if you are unlucky to have the wrong condition and if have a high deductible/insurance cap it can become personally very expensive. Painkillers can easily run $300/month.
4.    Sick pay? I don’t know how much you get in the US or how long for (is it available?).
5.   Profits from health insurance goes to insurance company/shareholders. Incentive to maximize profits – see point 1.
6.   If stop working for the same employer you “lose” all your health insurance benefits. Better hope you find another job or don’t get sick before you do.
7.   Overall US health care is much more complex than the UK/Euro system.

At the end of the day does the US wage earner have more take home money/benefits than the UK wage earner? The answer is no. (many examples of comparisons but here is one here  - http://en.wikipedia.org/wiki/Standard_of_living_in_the_United_States). It works out about the same adjusted to cost of living in the respective countries.

And does the USA have a better standard of health care than the UK?  The answer is no (on a national average) but you can see from the above the answer is both subjective and complicated by many variables. While someone in NYC might enjoy the benefits of having world class research hospitals at their doorstep, the same will not be true for someone living in Harrisburg, Mississippi (a state where the level of child mortality is extremely high –and overall national average is higher than most other industrialized countries).

So overall while the UK does have a single-payer system the cost to the taxpayer may/may not work out the same/cheaper/more than the USA taxpayer depending on the condition you have. At the simplest level: in the UK everyone gets access to free healthcare at any age. In the USA that is not the case. In the USA you are paying twice - once for Medicaid and once for personal insurance.

cheers
Andy
 

 

[edbikerii]

Yes Andy, there has been a lot of misinformation in this thread, and you are just as guilty as anyone else.  I'm not about to even consider picking apart your biased analysis of the US vs. UK healthcare plans point-by-point.  That's been done before -- both here and a million other places on the Internet and in the media.  Pick your source, and you'll hear what you want to hear.

I just need to point out that your "appeal to authority" strategy of trying to present your biased comparison as if it were all true and unbiased will only work on those that are too feeble-minded to verify those points for themselves.

There has been a lot of misinformation in this thread and so I thought it would be useful to offer a comparison of two healthcare systems and two wage earners; UK versus USA.

...

[Laminar]

Why did she require gastric bypass in the first place?

She was fat. Though if she had not gone in for it she may not have found out she had lupus till it was too late. First time you might have ever heard of some one being over weight helping someone's health eh?

She received treatment didn't she?  Is she now dead from Lupus because she was denied the chemo therapy?



FYI we all have stories:

My niece has a complex neurological disease related to MS, she is 40 YO has been put on SS, and recieves very expensive chemo every 90 days. 
She was kicked off her employers policy when she was unable to work a few years ago.

 

She recieved treatment all the way up till she found out that she had lupus. She started at that company 34 years ago as a secretary and worked her way up to vice president. She had put a lot in the pot and got crapped on. I understand we all have stories but I guess the main difference is I care for people other than myself. Call me crazy or a socialist, I call it having a little compassion.


Also do you know what lupus is? It's an auto-immune disease, there is no cure. Meaning she is now constantly sick and still needs a liver transplant which she can no longer afford because she already gave all her money to the hospitals. Oh yeah she can't get medicade either.

[BobbyR]

Yes Andy, there has been a lot of misinformation in this thread, and you are just as guilty as anyone else.  I'm not about to even consider picking apart your biased analysis of the US vs. UK healthcare plans point-by-point.  That's been done before -- both here and a million other places on the Internet and in the media.  Pick your source, and you'll hear what you want to hear.

I just need to point out that your "appeal to authority" strategy of trying to present your biased comparison as if it were all true and unbiased will only work on those that are too feeble-minded to verify those points for themselves.

There has been a lot of misinformation in this thread and so I thought it would be useful to offer a comparison of two healthcare systems and two wage earners; UK versus USA.

...

I think that Andy is spot on with his analysis. The workers in Europe do for the most part have more liberal sick time and vacation. The expense numbers seem close to what I am paying and I do pay 32% flat income tax under the AMT. I do not like this Bill as it is written in favor of the Insurance Industry. As the Irish say, they shook hands with the Devil.

[Caaveman82]

Why did she require gastric bypass in the first place?

She was fat. Though if she had not gone in for it she may not have found out she had lupus till it was too late. First time you might have ever heard of some one being over weight helping someone's health eh?

She received treatment didn't she?  Is she now dead from Lupus because she was denied the chemo therapy?



FYI we all have stories:

My niece has a complex neurological disease related to MS, she is 40 YO has been put on SS, and recieves very expensive chemo every 90 days. 
She was kicked off her employers policy when she was unable to work a few years ago.

 

She recieved treatment all the way up till she found out that she had lupus. She started at that company 34 years ago as a secretary and worked her way up to vice president. She had put a lot in the pot and got crapped on. I understand we all have stories but I guess the main difference is I care for people other than myself. Call me crazy or a socialist, I call it having a little compassion.


Also do you know what lupus is? It's an auto-immune disease, there is no cure. Meaning she is now constantly sick and still needs a liver transplant which she can no longer afford because she already gave all her money to the hospitals. Oh yeah she can't get medicade either.

Unfortunately it most certainly is.

[Inigo Montoya]

Just to throw this in.
I am sure some will see it as biased.

http://www.kaiserhealthnews.org/Graphics/2010/022310-Bill-comparison.aspx

[BeSeeingYou]

Just to throw this in.
I am sure some will see it as biased.

http://www.kaiserhealthnews.org/Graphics/2010/022310-Bill-comparison.aspx

It is funny watching the Republicans turn themselves inside out being for something they were against and against something they were for.  Maybe we could call it their "John Kerry Moment".  Now we have the party that whines for tort reform and constantly bickers about frivolous lawsuits filing frivolous health care lawsuits across the country that will clog the courts and cost the taxpayers millions of dollars and have no chance of success other than political grandstanding.  

[edbikerii]

So, point-by-point it will be, then.

First, Andy's "analysis" ignores all taxes except income tax.  What kind of nonsense is that?  What about fuel tax, VAT, etc?

Second, Andy's analysis of sick time, etc., is completely subjective, and he has NO supporting evidence.  Every American employer is different, many provide disability insurance in addition to the existing payroll-tax-provided disability insurance, and every American has the FREEDOM to purchase whatever kind of long or short-term disability insurance they wish.

How many employees would YOU hire if you knew you might be liable to pay their salary for six months if they get sick?  Would you hire someone with a pre-existing condition?  I guess it doesn't matter, since in the UK they'll end up on "the dole" anyway.

Third, since 1996 HIPAA has prevented insurers from denying a person group coverage if they have a pre-existing condition.  Amazingly, this point has been evaded in EVERY debate of "reform" I've ever seen.  Now Andy is outright lying about it in his point number 6.

Fourth, Andy ignores well-documented cases of chemotherapy rationing under NHS.

Fifth, Andy ignores well-documented wait times for surgeries and diagnostic procedures under NHS.

Sixth, Andy's claims of child mortality rates may have nothing to do with healthcare.  For all we know, parents in Harrisburg, MI may have higher rates of neglect or abuse, or may even have more murderers than other places.  This is a common rhetorical point for proponents of healthcare "reform", but it has no proven tie to healthcare.

Seventh, Andy's claims of a better standard of care in the UK are completely unsubstantiated.

Alright, that's enough for me for now.  Obviously tons more information can be found with a simple google search, so if you care to know more, go do your own homework.


I do agree with Andy that there is an uneven DISTRIBUTION of health care in the US.  It is true that in NYC you have ACCESS to the best health care providers in the world, whereas in Harrisburg, MI, the quality of doctor may not be as good.  Certainly the health care bill does NOTHING to change that.

I also agree that the US taxpayer (now less than 33% of the population of the US) does pay twice for insurance because he is forced to pay for Medicaid.

[edit: changed numbering of points]

I think that Andy is spot on with his analysis. The workers in Europe do for the most part have more liberal sick time and vacation. The expense numbers seem close to what I am paying and I do pay 32% flat income tax under the AMT. I do not like this Bill as it is written in favor of the Insurance Industry. As the Irish say, they shook hands with the Devil.

[Bob Wessner]

Third, since 1996 HIPAA has prevented insurers from denying a person group coverage if they have a pre-existing condition.  Amazingly, this point has been evaded in EVERY debate of "reform" I've ever seen.  Now Andy is outright lying about it in his point number 6.

Some truth to this, but not entirely complete as to all the circumstances.

"HIPAA's is a federal law that:

Limits the ability of a new employer plan to exclude coverage for preexisting conditions;
Provides additional opportunities to enroll in a group health plan if you lose other coverage or experience certain life events;
Prohibits discrimination against employees and their dependent family members based on any health factors they may have, including prior medical conditions, previous claims experience, and genetic information; and
Guarantees that certain individuals will have access to, and can renew, individual health insurance policies.
HIPAA is complemented by state laws that, while similar to HIPAA, may offer more generous protections. You may want to contact your state insurance commissioner's office to ask about the law where you live. A good place to start is the Web site of the National Association of Insurance Commissioners at www.naic.org.
One of the most important protections under HIPAA is that it helps those with preexisting conditions get health coverage. In the past, some employers' group health plans limited, or even denied, coverage if a new employee had such a condition before enrolling in the plan. Under HIPAA, that is not allowed. If the plan generally provides coverage but denies benefits to you because you had a condition before your coverage began, then HIPAA applies.
Under HIPAA, a plan is allowed to look back only 6 months for a condition that was present before the start of coverage in a group health plan. Specifically, the law says that a preexisting condition exclusion can be imposed on a condition only if medical advice, diagnosis, care, or treatment was recommended or received during the 6 months prior to your enrollment date in the plan. As an example, you may have had arthritis for many years before you came to your current job. If you did not have medical advice, diagnosis, care, or treatment – recommended or received – in the 6 months before you enrolled in the plan, then the prior condition cannot be subject to a preexisting condition exclusion. If you did receive medical advice, diagnosis, care, or treatment within the past 6 months, then the plan may impose a preexisting condition exclusion for that condition (arthritis). In addition, HIPAA prohibits plans from applying a preexisting condition exclusion to pregnancy, genetic information, and certain children.
If you have a preexisting condition that can be excluded from your plan coverage, then there is a limit to the preexisting condition exclusion period that can be applied. HIPAA limits the preexisting condition exclusion period for most people to 12 months (18 months if you enroll late), although some plans may have a shorter time period or none at all. In addition, some people with a history of prior health coverage will be able to reduce the exclusion period even further using “creditable coverage.” Remember, a preexisting condition exclusion relates only to benefits for your (and your family’s) preexisting conditions. If you enroll, you will receive coverage for the plan’s other benefits during that time.
Although HIPAA adds protections and makes it easier to switch jobs without fear of losing health coverage for a preexisting condition, the law has limitations. For instance, HIPAA:
Does not require that employers offer health coverage;
Does not guarantee that any conditions you now have (or have had in the past) are covered by your new employer's health plan; and
Does not prohibit an employer from imposing a preexisting condition exclusion period if you have been treated for a condition during the past 6 months."

  - U.S. Department of Labor

[andy750]

Thanks Bob that was a very informative link. Particular attention to the last part....

"For instance, HIPAA:
Does not require that employers offer health coverage;
Does not guarantee that any conditions you now have (or have had in the past) are covered by your new employer's health plan; and
Does not prohibit an employer from imposing a preexisting condition exclusion period if you have been treated for a condition during the past 6 months"

So basically your employer and the insurance industry (not the government or even you ) can control your health care coverage.

Of course the alternative is to take your pre-existing conditions and you can pay even more money and take your business elsewhere but this will depend on how much you can afford. Where does it all end? Better get that second and third job to allow YOU to have more control. So you work more to pay for it all, which leads to more stress, less vacation time, more time away from the family, likely end up eating cheap food to save money, and your health suffers as a result  . Great system.

First, Andy's "analysis" ignores all taxes except income tax.  What kind of nonsense is that?  What about fuel tax, VAT, etc?

In the comparison I made it allowed a "standard of living" comparison which included the above and I stated this at the end of my post that money in your pocket at the end of the day was not significantly different between the two wage earners.

If you want to nitpick then VAT is included in the price you pay so it goes unnoticed (was 17.5% last time I checked in the UK). For example lets say the cost of a meal in a resteraunt is $40 in the UK. That is what you pay. Tip is optional and at most 10% usually. In the US its $40 + 15-25% tip depending on how generous you are. That extra 15 -25% soon adds up especially for a couple or family of four dining out where the cheque is usually $100+. Sales tax in the US varies from states like Mass (6% I think) to 11% in LA. Yes gas is super-cheap in the US and yet you still moan when it hits $4/gallon.

Overall when you add the taxes up they equate to a similar standard of living yet the benefits are different.

BTW Ed- when you call someone a liar be very careful. Your are saying they are being untruthful and deceitful on purpose. I am not. This information is freely available for anyone to check for themselves and its not a case of cherry picking either as you like to suggest.

Andy

[Roach Carver]

I said it before and will say it again. what is so wrong with someone having a second job. as far as poor health due to poor diet, I guarantee that a person can eat healthy for not a whole lot of money. chicken and vegetables, rice, beans etc. come on. people eat bologna and hot dogs because they like them. I know I do.

[Inigo Montoya]

Actually if you add up a bill for "junk" food and a bill for "good" food, the good food on average does cost more. Of course this depends on what type of junk you buy.
Also, certain areas of the country, notably the north central states, do not get very good quality of fruits and veggies in the winter months. And what we do get is priced even higher.

[Jordan]

Your right about the food costs, my grocery bill has increased substantially since diabetes reared its ugly head, no more fast carb, high calorie, sugar packed, good tasting junk they call food for me(but agribusiness vs agriculture is a whole other hornets nest), while also not on the subject, have you ever wondered why throughout history all over the world, whenever politicians at any level, intact any wonderful life changing laws for their peoples, they always make themselves exempt from participating?

[BeSeeingYou]

Actually if you add up a bill for "junk" food and a bill for "good" food, the good food on average does cost more. Of course this depends on what type of junk you buy.
Also, certain areas of the country, notably the north central states, do not get very good quality of fruits and veggies in the winter months. And what we do get is priced even higher.

 Here in Minneapolis with it's strong community co-op food stores we get excellent veggies year round even organic if you want to pay a bit more.  It's not cheap that's for sure but we have made that choice.  You would probably be shocked at our food budget because of the fresh organic stuff.  Outside of the larger cities it may be more of an issue.  Last fall while in Montana my wife was dismayed at the quality and choice in the small town where we stayed.

[demon78]

Srust are you shopping in the !00 mile rule?
Bill the demon.

[Inigo Montoya]

I would expect mpls to have a bit better selection being a pretty major hub for air and land shipping. That makes a big difference but yeah if you go to smaller towns, it sure stinks.

[Rocking-M]

There has been a lot of misinformation in this thread and so I thought it would be useful to offer a comparison of two healthcare systems and two wage earners; UK versus USA.

Comparsion of US vs UK taxes for healthcare

Some interesting comparative data since some would have you believe the European/Uk wage earner pays a lot more in taxes than the American wage earner.

UK wage earner pays around 33% of salary to tax (which includes health insurance tax).

The benefits of the UK wage earner:

1.   Free health care. ~$10 prescription charges.
2.   At least 4 weeks holiday per year (usually get 20 -30 business days off per year) with 6 months sick pay if you need it. Usually another 6 months on half-pay (depends on employer but this is true for nurses for example). Extra holidays include the 9 bank holidays a year.

The downside of the UK wage earner:

1.   May have to wait for a non-urgent operation. Wait time has improved dramatically in last 5 yrs. Life-saving operations have no wait time (obviously).

The USA wage earner pays around 25-30% tax depending on exemptions. If you pay too much you get it back at the end of the year and if too little you pay more.

The benefits of the USA wage earner:

1.   Pays monthly premiums (100s of $s) for health care with $x deductible (someone quoted $3500 here in this thread). If working for an employer the true cost is not known as the employer is paying for some (?%) of the premium.
2.   Co-pay is paid every time visit the doctor. Usually $20 -$25.
3.   Vacation time – usually 2 -4 weeks. With ~9 public holidays/year.
4.   Immediate access to doctors and surgery. Wait times in ER or to see doctor is same as UK/Euro. i.e. turn up to see doctor at 9am it usually takes at least 30 min to see him. ER can take longer if non-life threatening condition. 3 -5 hrs is not uncommon.

Downside to the USA wage earner:

1.   Coverage can be denied if have pre-existing condition.
2.   There are limits on how much healthcare you can receive in terms of insurance $. If you are chronically sick then you better hope you get better before the money runs out.
3.   Prescription medicine can be very expensive if you are unlucky to have the wrong condition and if have a high deductible/insurance cap it can become personally very expensive. Painkillers can easily run $300/month.
4.    Sick pay? I don’t know how much you get in the US or how long for (is it available?).
5.   Profits from health insurance goes to insurance company/shareholders. Incentive to maximize profits – see point 1.
6.   If stop working for the same employer you “lose” all your health insurance benefits. Better hope you find another job or don’t get sick before you do.
7.   Overall US health care is much more complex than the UK/Euro system.

At the end of the day does the US wage earner have more take home money/benefits than the UK wage earner? The answer is no. (many examples of comparisons but here is one here  - http://en.wikipedia.org/wiki/Standard_of_living_in_the_United_States). It works out about the same adjusted to cost of living in the respective countries.

And does the USA have a better standard of health care than the UK?  The answer is no (on a national average) but you can see from the above the answer is both subjective and complicated by many variables. While someone in NYC might enjoy the benefits of having world class research hospitals at their doorstep, the same will not be true for someone living in Harrisburg, Mississippi (a state where the level of child mortality is extremely high –and overall national average is higher than most other industrialized countries).

So overall while the UK does have a single-payer system the cost to the taxpayer may/may not work out the same/cheaper/more than the USA taxpayer depending on the condition you have. At the simplest level: in the UK everyone gets access to free healthcare at any age. In the USA that is not the case. In the USA you are paying twice - once for Medicaid and once for personal insurance.

cheers
Andy
 

Thanks for the post, I'm all for the single payer system as you have shown exist in the UK. That is the direction I hope things are headed.
Check your pm.

[BobbyR]

I think that this thread is becoming way too personal. I would suggest people take a deep breath and think a bit before they write.

This current Bill sucks and I hope it will evolve over time. I would personally prefer a single payer pool Profesionally managed by non government people.
 
I have known Canadians who have had Cancer diagnosed on Friday and treatment started Monday, no waiting. There are things that really can wait. I work with a guy from Glasgow Scotland and his Dad is being treated for Prostate Cancer and is being treated using the same Varian Rapidarc technology I am. I am sure there may be a longer time spent in the waiting room, but the quality of the care is the same.   

When it come to Cancer I have done a lot of research and had a lot of help getting under the headlines and into the real numbers. When you read about a breakthrough treatment many times they are considered successful because they extended survival 18 months, and it is not a good quality of life 18 months. Is it worth the investment to prolong suffering for 18 months? It may sound cold, but it does not serve the patient very well and uses up resources.

Before you say, it is easy for you to say. I have refused a adjunct treatment that has horrible and long lasting side effects in more than 25% of the cases, for a best case disease control improvement of 5%. So I am walking the talk.

Back to my original point, I would ask that people posting here take a moment to subdue their passions a bit. Lively debate is fun, when it becomes personal the exchange of useful information gets lost.  

[HavocTurbo]

Have you given any more thought to your reform of medicaid/care Ed?

Since we already pay for it, why not just up the weekly take and eliminate the insurance companies. Then go through that horrible and dilapidated system piece by piece and make it into a similar model that some other countries have.

Then all you have to do is change the name from medicare/aid to the National Health.

Seeing as how we already pay for it anyway.

I for one am totally for not paying for medical care twice.