Chile Forum

Dagny,
Your disenchantment with military medical care is instructive. Could it be that your negative experience with military doctors and nurses is because, in general, their qualifications and training are inferior to their counterparts in civilian life? Also, it is my understanding that, since it is basically the same labor pool, the quality of medical care provided by civilian doctors and nurses is similar whether they are working within the framework of a PPO/HMO, Medicare, or in private practice.

john wrote:Dagny,
Your disenchantment with military medical care is instructive. Could it be that your negative experience with military doctors and nurses is because, in general, their qualifications and training are inferior to their counterparts in civilian life? Also, it is my understanding that, since it is basically the same labor pool, the quality of medical care provided by civilian doctors and nurses is similar whether they are working within the framework of a PPO/HMO, Medicare, or in private practice.

John, you raise some good points. Though I don't want to paint with too broad a brush, in my personal opinion the overall quality of military healthcare professionals is less than in the private sector. It is important to point out the difference between officers who make a career out of military healthcare and those who use the military education benefits to pay for their schooling before moving into the private sector - there is an institutional mindset that infects the former. Based on my experience and accounts from friends, I think most of the horror stories stem from the nurses, lab techs, orderlies etc.
Ultimately, it is the culture of the organization that is to blame. The military is so burdened by bureaucracy that protocol trumps patients. Promotion is based more on time and rank than on performance.
Since there is no threat of malpractice suits, complacency can more easily breed mistakes.
Because of this, I recoil when I think of the same government that spawned the US military being the guiding force behind healthcare for this entire nation.

Ah, I don't feel like a vigorous response today

But I enjoy the thoughtful responses-Dagny, yes that was the photo I was thinking of, thank you for finding it.

Eeuu, yes I worry about deficit spending and credit extended as the president is indeed the man that brought credit cards to Chile and i think credit is a real problem here. It can be used for good or evil and many people here still still don't seem to understand how it works. Especially now there will be loans etc. We will see. The healthcare comparison (US and Chile) can't be direct for the reasons you mentioned and more but i think Chile has some interesting examples. Chile basically has a government plan that runs side by side with private plans. The private plans are better and cost more. I think thats fair. For instance, in the government plan, a woman may be in a maternity ward with many other mothers. A private plan may allow for a private room. But everyone has access to the shots for the recent flu for instance. All kids have access to basic vaccinations. Retired people get free government care. If you have the money, you can sign up for more stellar care with private plans. You could get that heart transplant at 90 if you want to pay more. I don't how that translates to the US. We have to accept there are different levels for care and it is about money...I'm one of those who wants to be sure I get cancer treatment now for easily curable varieties-breast cancer comes to mind-but for the terminal kind, I just want painkillers(lots).

Another great point Dagny

Since there is no threat of malpractice suits, complacency can more easily breed mistakes.

. We have to be careful with tort reform because of that I think. And John made a good point-all insurance is not created equal. The more choices we have the better I think.

Laura,
Sorry for the late response to your earlier reply.
Here goes....

1. No I didnt realize prosperity comes from a health care system. I know of no direct link from financial success to universal healthcare other than people are alive.
2. I do like what I have heard of Chiles system especially admins description of the 0-2000k, 2-10k and 10k+ catastrophic breakdown, quite interesting and I think it mates the best of both worlds.
3. Medicare-waste and fraud - agreed 100%, however I dont believe that the supposed decrease in Medicare funding is going to decrease any of that, most govt programs tend to propagate fraud, waste and corruption in the end since there are no incentives for the people.
4. Bigger is better - tough analogy because in many cases bigger makes things cheaper for people but I know where you are going. I dont believe in too big to fail and I believe that GM and Chrysler and many others should have been allowed to fail. We all know that jobs would be lost but sometimes you must go back 1 step to go forward. They need to redo that entire system and the unions were not helping and yet still control most aspects.
I am a small biz owner and want to compete and have had the opportunity to do so whether it was at Walmart or the single store in town, my own adversity has been about how creative I can be, what I can offer that sets myself apart. I was told many times I couldnt because I was small but I did nearly every time and now our biggest customer for foods and wines is Costco. So on that note, I dont believe that all the big companies take everything although working for one is certainly easier. Fear rules more than actuality.
5. I dont believe Pinera will change anything that has been done, they indicate that frequently but I believe what he can do is open the small business which is key to the next step in Chiles future that the left didnt have the opportunity or interest to do.
6. Lastly, I think people are too caught up in healthcare as what defines socialism or a country, this is unfortunately due to the press that has surrounded our new plans which I think are blown a million times out of proportion in terms of what they mean and how that affects other issues of the country, its just 1 issue.

AS for IVA, its somewhat different than consumption. IVA is a tax on each part of a final end product. Those taxes are applied as each part is made and sold and that tax is paid by the next buyer and in the end these taxes have been added together. It is different since the value of the final product is different and each part but it doesnt change consumption. If you buy a spring for a Toyota thats $50 vs one for an Audi thats $100, the value changes but the consumption is the same and bears little in the end on the actual consumption as those that would buy would buy regardless. Consumption is trying to reduce the volume of items not the type and IVA does little to change that.