Allow Americans to purchase health insurance across state lines?

[LogikAndReazon]

Da obamacares fo da peoplezzz !!!!!!

 

[debbiedowner]

My career was as a health insurance and HMO executive. my title was VP of Underwriting and Compliance.

Health insurance and HMO's are governed by State Law. I had to file policies and rates with state health insurance Commissioners. The only time I ever had to deal with the Feds was regarding our policy issued to cover their employees. Each state has their own statues about what must be covered. For example, Nevada requires that acupuncture be covered. Most states don't. In order to be approved in each state, we had to file state amendments, with their particular deviations. I worked in one of the largest insurance companies in America, and all it took to be in compliance with all the states was one Director of Compliance and one administrative assistant. In short, if I were able to file one policy for approval for all states, instead of 50 policy amendments, I would have been able to save the HM0 about $120,000 per year. Divided by 230,000 insureds, that comes to a savings of half of one cent per insured per year.

And yet auto, home, and life insurance companies do it every single day.

But most have set up a separate corps in each individual state to abide by that state's insurance laws. I said most there may be one or two out there that only sell in specific states.

 

[BuckToothMoron]

You outlined that the US system of government is different, primarily we are less socialistic. Therefore making comparisons of the respective healthcare system is difficult. A few facts you glided over or didn't address- Japan is a geographical small country, as is Germany and France relative to the US. Japan, the largest of the examples you cited, is slightly more than a third of the population of the US with a much less diverse population which makes a single healthcare system more easily applied. Considering that lifestyle has a huge influence on healthcare needs, it should be obvious why smaller populations with similar lifestyles and less cultural diversity can more easily have a standardized system. Not to mention the relative size of government. Your attempt of comparisons of Japan, Germany, and France to the US fails in very important factors. And you never addressed the amount of money the US spends and thus provides to the world healthcare systems thru research and innovation. Again, your welcome.

You know, I like to debate. I like it because I think I'm good at it, my own personal little ego trip. But more importantly it helps me define my opinion and on rare occasions change it. Therefore I will always try to be both particular on the issues I talk about and the people I have a sustained conversation with. I also give myself certain rules I mostly stick to. I respect the person I talk to, I try to be polite. I try to stick to the points. I don't dodge the hard questions. I try distinguish between what I think and what I know. This means I put myself at an inherent disadvantage. I don't lie,insult, dodge, deflect or change the subject. I concede when the other person makes a decent point. I have found that it is frustrating when people I talk to don't hold themselves to any of these standards. You mostly have and I thank you for it. I'm sorry to tell you though, that this last post is a dodge. I will reply to the premise of it in the next post, but you seem to be unwilling to answer the premise of my last post.Explain to me how changing healthcare to the individual states,will improve your healthcare system in an appreciable way? Give a few examples? Make me see why it is better?

The most obvious example are the highly touted systems by socialist like yourself, that being the Scandinavian healthcare systems. They serve a small population in a close geographical area with a similar lifestyle. Here in the US we have a much more diverse, less homogenized population which is spread over a much bigger geographical area with very diverse lifestyles. The obesity rates, the rate of diabetes, the rate of different types of cancer varies drastically by region and states. They eat different food, they enjoy vastly different leisure activity, they have different industry, and they have different healthcare needs. It's silly to make a one size fits all system to cover such a diversity.

It is more efficient to allow states or region to be proactive and adjust their healthcare systems to the needs of the given population. Think about how we organize school systems. They are closely managed by states, and counties to fit the needs.

Another consideration is the potential for catastrophic failure. If all 330 million Americans are under one system, and they get it wrong, it will be catastrophic. If an individual states system fails it would be bad, but not as catastrophic as a failure across the entire country. Further, with each individual state designing and managing their system there exist the potential from learning from one another. States can see what works in other states or what fails and adapt their system accordingly.

Your argument to me sounds like someone claiming that he is able to up the value of his house by 50 percent by fixing a leaky faucet in the kitchen. Even if you right and that it is more efficient that states have full control over their health care system. Something that raises obvious questions, how to fund it for example, since not all states are equally strong economically and that would seem to cause serious problems in some states. And something that is partially the case now.
In the U.S., ownership of the health care system is mainly in private hands, though federal, state, county, and city governments also own certain facilities.

The non-profit hospitals share of total hospital capacity has remained relatively stable (about 70%) for decades.[47] There are also privately owned for-profit hospitals as well as government hospitals in some locations, mainly owned by county and city governments. The Hill-Burton Act was passed in 1946, which provided federal funding for hospitals in exchange for treating poor patients.[48]


US Department of Veterans Affairs vertical logo
There is no nationwide system of government-owned medical facilities open to the general public but there are local government-owned medical facilities open to the general public.
It doesn't fundamentally changes anything. So let me ask again. You give me a broad statement saying that needs vary from state by state so it's more efficient and therefore better. But let's look at your example of diabetes. Diabetes is treated by medicine and diet. Something that doesn't change from state to state. Cancer rates are 0.5 percent at it's highest and 0.35 percent at it's lowest annually. Hardly something that takes a completely different approach state by state CDC - Cancer Rates by U.S. State. Give me a real life practical example of it being better, if you do it state by state? As to your second argument. Laws don't work as an all or nothing proposition. Changes to our healthcare system happen constantly. It changes by budget constraints year by year. It changes by demographic changes. So saying that if we get it wrong we can't fix it, so it's better to hedge our bets is a bit silly.

Frankly, I have become bored discussing this with you. You are a hopeless socialist, and I am a committed conservative who lives in the most powerful, and by most measures, successful country in history. The fact that the USA is the standard around the world should make anyone with a rational and open mind envious. However I understand that many, especially those in European countries who know their best is behind them, tend towards jealousy, and that is expressed as arrogance.

Well if you are becoming bored you can stop of course. I'll reply to this post still though. It's interesting that you refer to me as arrogant here, while at the same time saying that you are committed to your political beliefs, while I'm hopeless believing in mine. It's interesting that you refer to me as arrogant while at the same time claiming our country is the most successful, in HISTORY no less. The British Empire spanned the Globe for over 2 centuries. The Roman Empire spanned most of Europe while being at the same leaps and bounds technologically above the rest. China was first unified 221 BCE, but The US is the sole superpower for 28 years and all of a sudden you are the most successful in history. They call this irony. I find it interesting you claim jealousy as my reason for comparing my system to yours. I've been clear as to why I want to stay in Belgium. If I'm jealous wouldn't in want to go to the US? I find it interesting that you now claim boredom as the reason you want to stop, just when I'm asking you to argue the merit of your assertion." We will fix healthcare by making the states responsible for it." To me it feels like a kid refusing to continue playing monopoly because the other person just build his hotel on park place.

I choose to cease this discussion with you because you are self-delusional and either a charlatan or simply not very bright. From your own link- cancer rates per 100,000 in Colorado (where I live) are as low as 363 per 100k. In New York they are as high as 511 per 100k. 511-363=148; 148/363 = 40.8 %. In other words, New York has a 40% higher occurrence of cancer in its population. I am not here to teach simple math to those who choose to be ignorant. BTW- if you further extrapolate those numbers, based on their relative populations, Colorado will have roughly 20,000 cancer patients per year, New York will have over 100,000. Which state will be spending more on treating cancer?

 

[Vandalshandle]

My career was as a health insurance and HMO executive. my title was VP of Underwriting and Compliance.

Health insurance and HMO's are governed by State Law. I had to file policies and rates with state health insurance Commissioners. The only time I ever had to deal with the Feds was regarding our policy issued to cover their employees. Each state has their own statues about what must be covered. For example, Nevada requires that acupuncture be covered. Most states don't. In order to be approved in each state, we had to file state amendments, with their particular deviations. I worked in one of the largest insurance companies in America, and all it took to be in compliance with all the states was one Director of Compliance and one administrative assistant. In short, if I were able to file one policy for approval for all states, instead of 50 policy amendments, I would have been able to save the HM0 about $120,000 per year. Divided by 230,000 insureds, that comes to a savings of half of one cent per insured per year.

And yet auto, home, and life insurance companies do it every single day.

But most have set up a separate corps in each individual state to abide by that state's insurance laws. I said most there may be one or two out there that only sell in specific states.

False. Only New York law is so heinous that insurers have to set up seperate companies there.

 

[EdwardBaiamonte]

If the Republicans are so keen on letting people buy insurance across state lines, why don't they just write a specific, standalone bill mandating just that,

and pass it? How hard could that be?

parliamentary rules, reconciliation, and state anti-trust exemption make it impossible. But yes conservative intellectuals are just as keen about interstate health care as interstate toothpaste.

 

[Cellblock2429]

That's one of the GOP's big selling points of their healthcare 'plan'.

Problem is, it's already allowed.

The Federal government does not prohibit it. Some states do.

oops.

Selling health insurance across state lines is a favorite GOP 'reform.' Here's why it makes no sense

"Selling insurance across state lines is a vacuous idea, encrusted with myths.

The most important myths are that it’s illegal today, and that it’s an alternative to the Affordable Care Act.

The truth is that it actually is legal today and specifically enabled by the Affordable Care Act. The fact that Republicans don’t seem to know this should tell you something about their understanding of healthcare policy. The fact that it hasn’t happened despite its enablement under the ACA should tell you more about about why it’s no solution to anything."

/---- and yet it works for home, life and auto insurance. Well tiddly dee.

 

[WorldWatcher]

Is insurance interstate commerce?
Sustaining the demurrer, the District Court held that "the business of insurance is notcommerce, either intrastate or interstate"; it "is not interstate commerce orinterstate trade, though it might be considered a trade subject to local laws either State or Federal, where the commerce clause is not the authority

Do you have a source for that?

That decision was by a lower court and was overturned by the SCOTUS. The case and SCOTUS reversal were cited in the link below. They said:

"Ordinarily courts do not construe words used in the Constitution so as to give them a meaning more narrow than one which they had in the common parlance of the times in which the Constitution was written. To hold that the word "commerce," as used in the Commerce Clause, does not include a business such as insurance would do just that. Whatever other meanings "commerce" may have included in 1787, the dictionaries, encyclopedias, and other books of the period show that it included trade: business in which persons bought and sold, bargained and contracted. And this meaning has persisted to modern times. Surely, therefore, a heavy burden is on him who asserts that the plenary power which the Commerce Clause grants to Congress to regulate "Commerce among the several States" does not include the power to regulate trading in insurance to the same extent that it includes power to regulate other trades or businesses conducted across state lines."



Allow Americans to purchase health insurance across state lines?


>>>>

 

[Marion Morrison]

Is insurance interstate commerce?
Sustaining the demurrer, the District Court held that "the business of insurance is notcommerce, either intrastate or interstate"; it "is not interstate commerce orinterstate trade, though it might be considered a trade subject to local laws either State or Federal, where the commerce clause is not the authority

Do you have a source for that?

That decision was by a lower court and was overturned by the SCOTUS. The case and SCOTUS reversal were cited in the link below. They said:

"Ordinarily courts do not construe words used in the Constitution so as to give them a meaning more narrow than one which they had in the common parlance of the times in which the Constitution was written. To hold that the word "commerce," as used in the Commerce Clause, does not include a business such as insurance would do just that. Whatever other meanings "commerce" may have included in 1787, the dictionaries, encyclopedias, and other books of the period show that it included trade: business in which persons bought and sold, bargained and contracted. And this meaning has persisted to modern times. Surely, therefore, a heavy burden is on him who asserts that the plenary power which the Commerce Clause grants to Congress to regulate "Commerce among the several States" does not include the power to regulate trading in insurance to the same extent that it includes power to regulate other trades or businesses conducted across state lines."



Allow Americans to purchase health insurance across state lines?


>>>>

It appears insurance companies exploit that as much as they can and some!

 

[Vandalshandle]

I have asked everyone who brings this idiotic topic up as to why they think that selling insurance across state lines is going to save anyone any money. Having been VP of Compliance for health insurance companies for half of my career, it is frustrating to see this ridiculous myth. Any insurance company can sell a policy in any state by simply filing a rider to the policy that changes a few paragraphs to bring it into compliance with any other state. It is typically a one page rider that may add a minor benefit or two that may not be required by another state. Once filed and approved, it is simply attached to every police sold in that state. If it costs $.25 per policy issued, I would be amazed.

 

[Freewill]

That's one of the GOP's big selling points of their healthcare 'plan'.

Problem is, it's already allowed.

The Federal government does not prohibit it. Some states do.

oops.

Selling health insurance across state lines is a favorite GOP 'reform.' Here's why it makes no sense

"Selling insurance across state lines is a vacuous idea, encrusted with myths.

The most important myths are that it’s illegal today, and that it’s an alternative to the Affordable Care Act.

The truth is that it actually is legal today and specifically enabled by the Affordable Care Act. The fact that Republicans don’t seem to know this should tell you something about their understanding of healthcare policy. The fact that it hasn’t happened despite its enablement under the ACA should tell you more about about why it’s no solution to anything."

The real problem, as I see it, is that in order for a company to issue insurances in another state, or any state, is they have to have contracts with the hospitals and most of the medical practitioners within the state. In my neck of the woods one company controls the two hospitals and the majority of medical practitioners. Thus they set the price of the contracts.

 

[Freewill]

I have asked everyone who brings this idiotic topic up as to why they think that selling insurance across state lines is going to save anyone any money. Having been VP of Compliance for health insurance companies for half of my career, it is frustrating to see this ridiculous myth. Any insurance company can sell a policy in any state by simply filing a rider to the policy that changes a few paragraphs to bring it into compliance with any other state. It is typically a one page rider that may add a minor benefit or two that may not be required by another state. Once filed and approved, it is simply attached to every police sold in that state. If it costs $.25 per policy issued, I would be amazed.

I thought that the insurance companies needed to have contracts with the hospital and practitioners, is this not correct? You know, they have to be "in network?"

 

[Vandalshandle]

I have asked everyone who brings this idiotic topic up as to why they think that selling insurance across state lines is going to save anyone any money. Having been VP of Compliance for health insurance companies for half of my career, it is frustrating to see this ridiculous myth. Any insurance company can sell a policy in any state by simply filing a rider to the policy that changes a few paragraphs to bring it into compliance with any other state. It is typically a one page rider that may add a minor benefit or two that may not be required by another state. Once filed and approved, it is simply attached to every police sold in that state. If it costs $.25 per policy issued, I would be amazed.

I thought that the insurance companies needed to have contracts with the hospital and practitioners, is this not correct? You know, they have to be "in network?"

They would have to have contracts with preferred providers if they are going to sell a PPO product. If they are going to sell indemnity products (and all health insurance was indemnity before 1984) then they don't even need provider contracts. Either way, it has nothing to do with state lines. PPO contract are negotiated by zip code, and are not limited by any artificial restrictions across state lines.

 

[Doc1]

I have asked everyone who brings this idiotic topic up as to why they think that selling insurance across state lines is going to save anyone any money. Having been VP of Compliance for health insurance companies for half of my career, it is frustrating to see this ridiculous myth. Any insurance company can sell a policy in any state by simply filing a rider to the policy that changes a few paragraphs to bring it into compliance with any other state. It is typically a one page rider that may add a minor benefit or two that may not be required by another state. Once filed and approved, it is simply attached to every police sold in that state. If it costs $.25 per policy issued, I would be amazed.

Same here, it drives me crazy. It's a silly canard that everyone repeats ad nauseum

 

[EdwardBaiamonte]

I have asked everyone who brings this idiotic topic up as to why they think that selling insurance across state lines is going to save anyone any money.

1+1=2 same reason selling toothpaste across state lines saves money. Still over your liberal head?? Of course it is. All the economic problems we have are caused by liberals who lack the IQ to understand capitalism.

 

[EdwardBaiamonte]

Same here, it drives me crazy. It's a silly canard that everyone repeats ad nauseum

imagine how stupid and liberal one has to be to think capitalism is a silly canard??

 

[forkup]

You know, I like to debate. I like it because I think I'm good at it, my own personal little ego trip. But more importantly it helps me define my opinion and on rare occasions change it. Therefore I will always try to be both particular on the issues I talk about and the people I have a sustained conversation with. I also give myself certain rules I mostly stick to. I respect the person I talk to, I try to be polite. I try to stick to the points. I don't dodge the hard questions. I try distinguish between what I think and what I know. This means I put myself at an inherent disadvantage. I don't lie,insult, dodge, deflect or change the subject. I concede when the other person makes a decent point. I have found that it is frustrating when people I talk to don't hold themselves to any of these standards. You mostly have and I thank you for it. I'm sorry to tell you though, that this last post is a dodge. I will reply to the premise of it in the next post, but you seem to be unwilling to answer the premise of my last post.Explain to me how changing healthcare to the individual states,will improve your healthcare system in an appreciable way? Give a few examples? Make me see why it is better?

The most obvious example are the highly touted systems by socialist like yourself, that being the Scandinavian healthcare systems. They serve a small population in a close geographical area with a similar lifestyle. Here in the US we have a much more diverse, less homogenized population which is spread over a much bigger geographical area with very diverse lifestyles. The obesity rates, the rate of diabetes, the rate of different types of cancer varies drastically by region and states. They eat different food, they enjoy vastly different leisure activity, they have different industry, and they have different healthcare needs. It's silly to make a one size fits all system to cover such a diversity.

It is more efficient to allow states or region to be proactive and adjust their healthcare systems to the needs of the given population. Think about how we organize school systems. They are closely managed by states, and counties to fit the needs.

Another consideration is the potential for catastrophic failure. If all 330 million Americans are under one system, and they get it wrong, it will be catastrophic. If an individual states system fails it would be bad, but not as catastrophic as a failure across the entire country. Further, with each individual state designing and managing their system there exist the potential from learning from one another. States can see what works in other states or what fails and adapt their system accordingly.

Your argument to me sounds like someone claiming that he is able to up the value of his house by 50 percent by fixing a leaky faucet in the kitchen. Even if you right and that it is more efficient that states have full control over their health care system. Something that raises obvious questions, how to fund it for example, since not all states are equally strong economically and that would seem to cause serious problems in some states. And something that is partially the case now.
In the U.S., ownership of the health care system is mainly in private hands, though federal, state, county, and city governments also own certain facilities.

The non-profit hospitals share of total hospital capacity has remained relatively stable (about 70%) for decades.[47] There are also privately owned for-profit hospitals as well as government hospitals in some locations, mainly owned by county and city governments. The Hill-Burton Act was passed in 1946, which provided federal funding for hospitals in exchange for treating poor patients.[48]


US Department of Veterans Affairs vertical logo
There is no nationwide system of government-owned medical facilities open to the general public but there are local government-owned medical facilities open to the general public.
It doesn't fundamentally changes anything. So let me ask again. You give me a broad statement saying that needs vary from state by state so it's more efficient and therefore better. But let's look at your example of diabetes. Diabetes is treated by medicine and diet. Something that doesn't change from state to state. Cancer rates are 0.5 percent at it's highest and 0.35 percent at it's lowest annually. Hardly something that takes a completely different approach state by state CDC - Cancer Rates by U.S. State. Give me a real life practical example of it being better, if you do it state by state? As to your second argument. Laws don't work as an all or nothing proposition. Changes to our healthcare system happen constantly. It changes by budget constraints year by year. It changes by demographic changes. So saying that if we get it wrong we can't fix it, so it's better to hedge our bets is a bit silly.

Frankly, I have become bored discussing this with you. You are a hopeless socialist, and I am a committed conservative who lives in the most powerful, and by most measures, successful country in history. The fact that the USA is the standard around the world should make anyone with a rational and open mind envious. However I understand that many, especially those in European countries who know their best is behind them, tend towards jealousy, and that is expressed as arrogance.

Well if you are becoming bored you can stop of course. I'll reply to this post still though. It's interesting that you refer to me as arrogant here, while at the same time saying that you are committed to your political beliefs, while I'm hopeless believing in mine. It's interesting that you refer to me as arrogant while at the same time claiming our country is the most successful, in HISTORY no less. The British Empire spanned the Globe for over 2 centuries. The Roman Empire spanned most of Europe while being at the same leaps and bounds technologically above the rest. China was first unified 221 BCE, but The US is the sole superpower for 28 years and all of a sudden you are the most successful in history. They call this irony. I find it interesting you claim jealousy as my reason for comparing my system to yours. I've been clear as to why I want to stay in Belgium. If I'm jealous wouldn't in want to go to the US? I find it interesting that you now claim boredom as the reason you want to stop, just when I'm asking you to argue the merit of your assertion." We will fix healthcare by making the states responsible for it." To me it feels like a kid refusing to continue playing monopoly because the other person just build his hotel on park place.

I choose to cease this discussion with you because you are self-delusional and either a charlatan or simply not very bright. From your own link- cancer rates per 100,000 in Colorado (where I live) are as low as 363 per 100k. In New York they are as high as 511 per 100k. 511-363=148; 148/363 = 40.8 %. In other words, New York has a 40% higher occurrence of cancer in its population. I am not here to teach simple math to those who choose to be ignorant. BTW- if you further extrapolate those numbers, based on their relative populations, Colorado will have roughly 20,000 cancer patients per year, New York will have over 100,000. Which state will be spending more on treating cancer?

This degenerated quickly. In your last 2 posts you have called me. Arrogant, jealous, a charlatan, not very bright or deliberately ignorant. I have seen this time and time again. Like I said before when I talk to people like you, no matter how polite I am, no matter how honest and well argued my points are, most of the people I argue against, start personally attacking when they feel they can't win the argument. I thought you would fall in that rare category of people who is capable of arguing the merits of his points without taking it personal. I was wrong. So this will be my last reply. I don't think you are worth talking to. As to your last post, just so you know that you weren't able to make this stick.
Naturally New York will spend more on cancer treatment. However that wasn't your assertion. You said if healthcare was run solely on state level it would be way cheaper. First of, as I mentioned before there are in total 212 federal hospitals in the US.Fast Facts on US Hospitals All the rest is community based. So what would actually change in your theoretical setup if you run it state by state besides completely bankrupt the poorer states? Second Colorado also has about 4 times fewer people than New York and can't match New York economically either List of U.S. states by Gross State Product (GSP) - Wikipedia. So it comes down to about 20000 extra cancer patients annually which have to be taken care of in a richer state. So according to you those 20000 would warrant an entirely different approach to health care??? And lastly since healthcare didn't start yesterday and as I established is community based, isn't it safe to assume that the healthcare system already has taken in consideration those extra cancer patients? I wish you a good life Buck.

 

[EdwardBaiamonte]

You said if healthcare was run solely on state level it would be way cheaper..

if toothpaste were delivered to 50 separate markets or states, each with its own toothpaste specifications, it would be way more expensive because there would be no national competition winner. America's only economic problem is that liberals lack the IQ to understand capitalism.

For the liberal IQ: which baseball team is better, a state champion or the national champion?? I take great pride in being able to explain things so that even a liberal can understand.

 

[usmbguest5318]

Allow Americans to purchase health insurance across state lines?

I think the concept is a good one, and I support it as such. Were I running for POTUS, I would never have proposed that specific "fix" because, though I don't know the specifics, I know enough about health insurance to know that it can only happen across state lines where any two or more states have equivalent health insurance statutes.

I don't know what the hell Trump was thinking when he floated that idea. I do know he hadn't "done his homework" on the matter before making the proposal. Trump does that a lot, which is part and parcel of why so much of what that man says cannot be believed or even taken seriously on a visionary level.

 

[EdwardBaiamonte]

it can only happen across state lines where any two or more states have equivalent health insurance statutes.

liberal and illiterate as usual!! States cant regulate tooth paste because it would violate anti trust laws. All feds have to do is rescind health care anti- trust exemption which would never have been granted in the first were it not for the ignorance of liberals who lack the IQ to understand capitalism.

 

[BuckToothMoron]

The most obvious example are the highly touted systems by socialist like yourself, that being the Scandinavian healthcare systems. They serve a small population in a close geographical area with a similar lifestyle. Here in the US we have a much more diverse, less homogenized population which is spread over a much bigger geographical area with very diverse lifestyles. The obesity rates, the rate of diabetes, the rate of different types of cancer varies drastically by region and states. They eat different food, they enjoy vastly different leisure activity, they have different industry, and they have different healthcare needs. It's silly to make a one size fits all system to cover such a diversity.

It is more efficient to allow states or region to be proactive and adjust their healthcare systems to the needs of the given population. Think about how we organize school systems. They are closely managed by states, and counties to fit the needs.

Another consideration is the potential for catastrophic failure. If all 330 million Americans are under one system, and they get it wrong, it will be catastrophic. If an individual states system fails it would be bad, but not as catastrophic as a failure across the entire country. Further, with each individual state designing and managing their system there exist the potential from learning from one another. States can see what works in other states or what fails and adapt their system accordingly.

Your argument to me sounds like someone claiming that he is able to up the value of his house by 50 percent by fixing a leaky faucet in the kitchen. Even if you right and that it is more efficient that states have full control over their health care system. Something that raises obvious questions, how to fund it for example, since not all states are equally strong economically and that would seem to cause serious problems in some states. And something that is partially the case now.
In the U.S., ownership of the health care system is mainly in private hands, though federal, state, county, and city governments also own certain facilities.

The non-profit hospitals share of total hospital capacity has remained relatively stable (about 70%) for decades.[47] There are also privately owned for-profit hospitals as well as government hospitals in some locations, mainly owned by county and city governments. The Hill-Burton Act was passed in 1946, which provided federal funding for hospitals in exchange for treating poor patients.[48]


US Department of Veterans Affairs vertical logo
There is no nationwide system of government-owned medical facilities open to the general public but there are local government-owned medical facilities open to the general public.
It doesn't fundamentally changes anything. So let me ask again. You give me a broad statement saying that needs vary from state by state so it's more efficient and therefore better. But let's look at your example of diabetes. Diabetes is treated by medicine and diet. Something that doesn't change from state to state. Cancer rates are 0.5 percent at it's highest and 0.35 percent at it's lowest annually. Hardly something that takes a completely different approach state by state CDC - Cancer Rates by U.S. State. Give me a real life practical example of it being better, if you do it state by state? As to your second argument. Laws don't work as an all or nothing proposition. Changes to our healthcare system happen constantly. It changes by budget constraints year by year. It changes by demographic changes. So saying that if we get it wrong we can't fix it, so it's better to hedge our bets is a bit silly.

Frankly, I have become bored discussing this with you. You are a hopeless socialist, and I am a committed conservative who lives in the most powerful, and by most measures, successful country in history. The fact that the USA is the standard around the world should make anyone with a rational and open mind envious. However I understand that many, especially those in European countries who know their best is behind them, tend towards jealousy, and that is expressed as arrogance.

Well if you are becoming bored you can stop of course. I'll reply to this post still though. It's interesting that you refer to me as arrogant here, while at the same time saying that you are committed to your political beliefs, while I'm hopeless believing in mine. It's interesting that you refer to me as arrogant while at the same time claiming our country is the most successful, in HISTORY no less. The British Empire spanned the Globe for over 2 centuries. The Roman Empire spanned most of Europe while being at the same leaps and bounds technologically above the rest. China was first unified 221 BCE, but The US is the sole superpower for 28 years and all of a sudden you are the most successful in history. They call this irony. I find it interesting you claim jealousy as my reason for comparing my system to yours. I've been clear as to why I want to stay in Belgium. If I'm jealous wouldn't in want to go to the US? I find it interesting that you now claim boredom as the reason you want to stop, just when I'm asking you to argue the merit of your assertion." We will fix healthcare by making the states responsible for it." To me it feels like a kid refusing to continue playing monopoly because the other person just build his hotel on park place.

I choose to cease this discussion with you because you are self-delusional and either a charlatan or simply not very bright. From your own link- cancer rates per 100,000 in Colorado (where I live) are as low as 363 per 100k. In New York they are as high as 511 per 100k. 511-363=148; 148/363 = 40.8 %. In other words, New York has a 40% higher occurrence of cancer in its population. I am not here to teach simple math to those who choose to be ignorant. BTW- if you further extrapolate those numbers, based on their relative populations, Colorado will have roughly 20,000 cancer patients per year, New York will have over 100,000. Which state will be spending more on treating cancer?

This degenerated quickly. In your last 2 posts you have called me. Arrogant, jealous, a charlatan, not very bright or deliberately ignorant. I have seen this time and time again. Like I said before when I talk to people like you, no matter how polite I am, no matter how honest and well argued my points are, most of the people I argue against, start personally attacking when they feel they can't win the argument. I thought you would fall in that rare category of people who is capable of arguing the merits of his points without taking it personal. I was wrong. So this will be my last reply. I don't think you are worth talking to. As to your last post, just so you know that you weren't able to make this stick.
Naturally New York will spend more on cancer treatment. However that wasn't your assertion. You said if healthcare was run solely on state level it would be way cheaper. First of, as I mentioned before there are in total 212 federal hospitals in the US.Fast Facts on US Hospitals All the rest is community based. So what would actually change in your theoretical setup if you run it state by state besides completely bankrupt the poorer states? Second Colorado also has about 4 times fewer people than New York and can't match New York economically either List of U.S. states by Gross State Product (GSP) - Wikipedia. So it comes down to about 20000 extra cancer patients annually which have to be taken care of in a richer state. So according to you those 20000 would warrant an entirely different approach to health care??? And lastly since healthcare didn't start yesterday and as I established is community based, isn't it safe to assume that the healthcare system already has taken in consideration those extra cancer patients? I wish you a good life Buck.

I'll stick to my opinion of you. You have an erroneous perception of your intellect and and without fail reframe others position. That is the reason people get frustrated and annoyed debating you. So stay in your little Belgium apartment in a country which really doesn't matter to anybody. Enjoy your free healthcare, and the grand old USA will continue to support you and other weaklings around the globe. If you want to gain respect from me, start by paying back the money the US payed to rebuild your country after we rescued you from the Germans.