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Universal Health Care - yay or nay?
Posted by cindalou • 10/05/07 • Subscribe to this Discussion [RSS] • Report This Topic
Topics: edwards, election, Fred Thompson, health, health care, Hillary Clinton, John Edwards, obaba, President, presidential
I'd like to bring a discussion from mikster's excellent health care post at realitybanned.blogspot.com/2007/10/sure-theres-lots-of-choices-for-health.h...
back here for some more discussion.
My take is very similar to Mark Valenti's, posted below:
About ten years ago, I believed in the seemingly lofty goal of "universal health care". Who wouldn't support that goal? Doesn't everyone have a "right" to health care?
I was just a kid then. It was easy to agree with a meaningless campaign promise such as "Affordable Health Care for All". It takes effort to actually research the topic and understand economic logic, history and facts.
Once I questioned the sound bites, I realized that government intervention in the market (e.g., Medicare, FDA, physician licensing, insurance regulations) is the reason for artificially high health care prices.
So-called Universal Healthcare amplifies all problems because it:
1) Destroys patient incentives to find the best possible prices for the best possible services/products available.
I have worked in the health care field in various capacities for the past ten years and I see a majority of patients who currently receive "free" (read: taxpayer-funded) healthcare continually seek care for the most minor afflictions. Why wouldn't they? It's "free" to them so they visit the doctor's office several times a month. "Free" prescriptions for over-the-counter medication such as Tylenol are very common. Patients who refuse to wait for an appointment make their way to the ER for things such as headaches. If you were ever an ER nurse, I know you can verify this.
The current U.S. mostly statist healthcare system also decreases incentives to "shop around" for people who are not receiving direct taxpayer-funded care. If you are paying a set amount per month and your copay is ten dollars per office visit no matter where you go, why bother to look for a better price? Government imposed wage controls during the 1940's carry a large part of the blame for this current state of affairs. Unable to offer competitive salaries, companies started to offer healthcare benefits as a way to lure prospective employees into jobs.
2) Destroys physician incentives to provide competitive care and destroys drug companies' incentives to provide new drugs and treatments.
With no incentive to provide quality care, physicians and nurses leave the government-monopolized area for better opportunities in a freer country. Shortages result. Drug companies are hindered by price controls and regulations and soon cease research and development of new medication. In the U.S., start-up drug companies cannot afford to run the FDA gauntlet, so the market is dominated by a few established corporations.
3) Steals from your wallet to pay for my health care.
Yes, you do have a right to health care, just as you have a right to food, shelter and property. However, you have no "right" to force others to provide these things for you - All "free" medical care is paid for through taxes stolen from other people.
I know of one seemingly healthy individual who went to his physician's office 51 times in 26 months. He receives "free" health care from the State, so his trips did not cost him a dime. Who pays for his medications? Who pays for the physicians', nurses' and office staff wages during his visits? If you work within the health care industry, I would bet you could recount similar stories. In my experience, this type of abuse is the rule, not the exception.
4) The quality of "free" health care will deteriorate and the average citizen will get sicker.
As the poor and middle-class wait in agony for simple procedures, those with resources can travel to other countries for treatment. But hey, your moral arrogance and justification of coercion makes you feel good, doesn't it?
5) Destroys your privacy.
Suddenly your problems are mine and mine are yours. If you are eating unhealthy foods or driving a motorcycle without a helmet, I have a direct interest in your business - you are going to see a doctor on my tax dollars. Your neighbors might support government bans on smoking, "unsafe" sex or other "risky" behaviors to reduce costs. Politicians will use the federal bureaucracy to force you and your family to comply with programs such as the "New Freedom Commission on Mental Health".
6) Destroys your liberty.
When you blindly support a system that gives politicians and bureaucrats the power to force others to follow a plan, those politicians and bureaucrats will receive their orders from those with the most money - and you can guarantee this will not be you, your friends or your family. The power of government will be used against you as you are forced to use medicines or accept treatments from well-connected health care companies.
A quick search shows that the pharmaceutical companies gave $29,370,351 to political campaigns in 2002. Who do you think has the ear of those elected politicians? You?
On the other hand, if government power is eliminated (e.g., abolish the FDA - whose restrictions benefit the most powerful companies by eliminating most competition), those same companies would have to use their funds and resources to sell their drugs to the most people in the least expensive, most reliable and safest way. They would need to outperform their competitors to get your money - otherwise they lose business.
User Comments
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on the other hand, you have college "professors" (actually adjuncts) who are teaching four, five, sometimes six or seven classes at two, three, four different universities just to make ends meet. because each university considers them "part-time" (even tho they teach more classes than a "full-time" professor at many schools), they get no health insurance. they get crap for pay. but they are working and they are dedicated to their jobs.
they go to the doctor for an infection. there's no money for tests. antibiotics. two months later, another infection. the doctor doesn't even run a blood test. more antibiotics.
after two years ... a "doc-in-a-box" discovers a hemoglobin of 5.8. a hematologist diagnoses a lymphoma.
6 months of chemo without insurance.
this was not caused by a lack of the patient taking care of himself.
this could have been caught earlier and without a week long hospital stay.
the doctor was unconcerned about tests for this patient without health insurance.
this was the most inexpensive doctor the patient could find ... the only one he was able to afford.
had there been good, regular health care ongoing, this would not have been so expensive in terms of stress, time and drugs (from the doctor's point of view, not even the patient's)
for every jerk who goes too often because it's free, there are those who don't go because it's too expensive.
there are those who DIE because they are not LUCKY enough to have a job which subsidizes their health insurance.
the issue is not that some people abuse the system. the issue is that the system ALLOWS them to abuse it. why don't the doctors tell your "51 times in 26 months" asshole to bugger off? why do they let him get away with it? triage him and get him out.
What? He might have a real issue this time and the office doesn't want the liability? get a better triage system.
you speak of social darwinism. if you can't survive what happens to you, then obviously, you're not fit enough to survive. it's this kind of thinking that leads to people who run AWAY from a burning building instead of running TOWARD it to help someone. people who do not rush into a collapsing building in the hopes of saving just one more.
you speak of isolation, cindalou. not community. you speak of cold, black and white situations in which you know all the answers.
life is not that simple. life is not a zero tolerance policy in which just one moment of forgetting means you DESERVE the worst possible consequences ... the same consequences as the person who deliberately acts to hurt others.
social darwinism is selfish. it is actually against the human nature of community.
it is unnatural.-
George Mason University (a public institution in the Commonwealth of Virginia) lets its part-time employees buy into a health insurance policy. But adjuncts are excluded, because they have a couple weeks between semesters where they supposedly don't work. Disheartening, to say the least.
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Well, no doubt when I veer away from the silly, inane things I post about normally in my blog the discussion/comments seem to get a little heated. Which is fine for the most part. I may actually do a follow up post this weekend because I think you've missed the point of what I actually posted Cindy. To clarify my thoughts in here would take too long. And then after that I plan on reverting back to my normal silly self. But this is one issue I definitely take very seriously.
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Universal health care does not have to be run by the government. Instead, the government would become nothing more than a competitor in the marketplace. If people are happy with their insurance coverage, they should be allowed to stick with their current health care provider. If they are not happy with the coverage like I'm, they can switch to a government-run program. More is always better. That's the spirit of competition and capitalism.
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Except that the government does not compete. They are not set up to compete. And those who elect to avoid the Walter Reed Care Plan (You DO understand that a LOT of vets carry health insurance and stay the hell out of the VA) are paying for their own care, and that of those in the "public" program".
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Ender,
Thanks for continuing our discussion over here. I appreciate hearing anecdotes. I agree with you actually on much of your post. Social Darwinism is unnatural. It's not human nature to not care for others. I also agree that we cannot break life up into black and white situations. I am all for social, liberal, communities. I belong to several coops myself.
Here's where we don't see eye to eye: the federal government is not a living entity. It knows no compassion. It's a system. I prefer to go to my local doctor and pay him/her in cold hard cash. No middle man, no relying on you to pay for me, no any of the 6 things I mentioned above. This is becoming more and more difficult to do because of government intervention.
I reiterate something that means a lot to me.
Under a libertarian (constitutional) society/government, liberal, communistic, anarchist, conservative, ... all ideas and people can coexist. Socialist communities can develop. People are free to do what they desire, within the binds of our consitution. The same cannot be said for a socialist country.
I admire your desire to help others. I simply suggest that going through the federal government is not the best way to proceed.-
As someone with a lifelong health issue that forced me to really understand the fine print when an insurance company mentions "pre-existing conditions" I have to say that movement away from universal coverage and insurance portability is completely the wrong way for our society to head if we want to compete in the world.
If we want to get ahead in the world or at least hold our own we have to roll back privatization of both healthcare and education. They go hand in hand. Healthy children do better in school. People with access to good health care regardless of their job are more likely to take a job that allows them help their community instead of basing their job choices on the benefit package.
I do a lot of volunteer work for two different organizations that help women get off of public assistance and into jobs. I admire the folks who work there full time and I wish I could join them, but my health requires me to have good health insurance at all times and even if they offered comparable coverage, the "pre-existing condition" problem would kick in.
I am very much in favor of free market economics in MOST of the economy. If the market drives the cost of a garbage disposal up or down it is not that important in the grand scheme of things. However, when you allow market forces unlimited control over health, education, energy, and the food supply you are playing with fire and people get burned. I'd suggest you go ask any farmers with polyculture crop systems in the midwest, but alas, there aren't many left.
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mikster - I had a feeling the discussion on your blog may have been steered a bit off course (by me, no less). That is one reason why I took it here
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neoauteur: Good post. Can the government offer cheaper, better health insurance (while not increasing tax) than private insurance companies? That'll be interesting to see. I've a feeling private insurance companies would try in vane to compete, as the government would find some way of subsidizing (taxing for) their program.
I personally would prefer to completely bypass the middle man, opt out of all insurance (except maintain coverage for emergences, prenatal care) and take care of myself and my family without relying on a third party.-
Insurance companies are so crooked that it isn't even right. They aren't offering the best healthcare to anyone. They are offering whatever they need to in order to get by.
Insurance companies be it auto, medical, or whatever exist to make a profit. End of story. There is no compassion, we are just a widget to them. This week I was in a car accident with a guy rear ending me going thirty. I didn't need to go to the ER but it was pretty obvious I needed to see a doctor. I just moved to the area so I need to get a new primary care physician. Looking at my insurance plan there were three that I could choose from that weren't ridiculously far away.
I had to wait four days to go in, my insurance wouldn't approve me to go to the ER or urgent care. When I got in the Doctor said, "I wish you would have gotten in sooner." Thanks insurance companies!
"Why should I put my money into a pot when I know full well it's going towards supporting someone else's poor lifestyle choices?"
That pisses me off. Out of the 47 million people without healthcare do you think it is people that lead a poor lifestyle? There is a large majority of young professionals that just can't afford it because the system is obviously broken. My taxes get spent on a lot of things I don't agree with... you know like a war that is costing us billions of dollars a month. But that is part of being a part of society, you pay in to reap the benefits of living in this country.
We need to remove the business portion from caring for the populace.
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Well, I'm Canadian and we've had universal health care for many years and wouldn't want to live without it, especially since there's no health insurance option where I work. The system here works very well, no system is perfect, but I truly believe it's better than no system at all. Politicians here would have an extremely difficult time tyring to make our health system public, as a matter of fact, if they try it usually means the end of their political career. -
Cindalou, you are speaking a foreign language to me. "Suddenly your problems are mine and mine are your"--nothing sudden about that. It's the way that most of the world operated for hundreds and hundreds of years, in communities, with mutual concern and a sense of obligation to support one another. It's the "me, me, me" mentality that's come upon us rather suddenly. -
This has been an interesting, and eye opening topic so far for me. As I stated before I'll probably do a follow up post. And I'm sure this thread is going to get a lot of diverse opinions as well as my blog has.
But it's going on midnight here and I need my beauty sleep... or something to that effect. Hopefully everyone will play 'nice' though.
Nighty, night.-
Well, not everyone who has a health issue has it because it's self-inflicted and I think that would be pretty difficult to prove since there's plenty of science out there proving that illness is caused by genetics more so than diet.
For example, my father had a genetic nurological disease and my mother has alzheimers, neither of them were financially well-off and I'm glad I don't live in a country where they'd be refused health care either because they couldn't afford it or because it was determined that they didn't take care of themselves enough when they were younger. That's insane.
I was going to make a comment on school taxes, but I see techfun already did that. And the other point techfun made is that people living at or under the poverty line can't afford fresh food. You don't punish someone because they have an illness and have the misfortune of being poor, you HELP them. Both my parents lived pretty healthy lives and they still ended up ill in their 70s and thank goodness they didn't have to pay for the multitude of tests and healthcare they received. Sure they paid for it with their taxes over the years, but if every gives a litte then everyone gets a lot when it's needed. My parents received the same healthcare as the financially privledged people in the country received. It's equal. Rich people and poor people get sick & die regardless of their lifestyle. We're all gonna die of something, and it's usually from some form of illness. It's not like you just die one day, there's usually an illness that leads up to that. And no matter how much fresh food you eat, what time you go to bed, or how much you exercise you're gonna get old, ill & die.
I'm just glad I'm a Canadian where the majority of the people think the same way about health care as I do. I'm really not sure what's going on in America with the thought process regarding health care. It is interesting that it's the only developed country without a national healcare system.
Having said all that...I see my post got posted out of order, lol sorry about that I obviously hit the wrong button.
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DrowseyMonkey - glad to hear from a Canadian who supports the system. I've heard a lot of horrible health care stories from Canadians, but that doesn't mean it's bad (or good) for everyone.
Many people I know see no problem with universal health care. Then I watch them destroy themselves with bad lifestyle and dietary choices. If a system was in place where I was federally forced to pay for their health woes, should I not have a right to argue in court for a law prohibiting what I believe to be unhealthy actions? That could mean no beer, mandatory bedtimes, no processed foods, etc. Scary thought. That's just rewording #5 in the list above.-
Ummm...no. That's an ubsurd idea to mandate your personal beliefe of healthy habits because you pay taxes. It's called taking care of everyone, not putting money into a pot so you can force your morality upon others.
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Cindalou, based on that reasoning, would it be fair for Christians who believe in creationism instead of evolution to withhold all or part of their school taxes since it is going to teach information they don't approve of? Seems like a very slippery slope to me.
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MadameX:
You can do whatever it is you like so long as it does not infringe on the rights of any other individual. That's the libertarian 'mantra'. It's not new. It's also not a black and white as it sounds, but it can dissolve a lot of otherwise complex issues.
That mutual concern to support one another is a local concern. The federal government cannot and should not presume to know the black and white answers for each individual community. Each community, whether it be a state, a city, a church, whatever, should be able to exist without the government assuming it knows what is best.
I may know what is best for my brother or close friend in peril, but it's far-reaching to say that I know what is best for a random person in California. The federal government should divvy up responsibility to the states and their local communities to decide what is best to do within the respective states and communities. -
Drowsey,
Why should I put my money into a pot when I know full well it's going towards supporting someone else's poor lifestyle choices? That's asinine. Drinking excess beer, getting little to no sleep, and processed foods have been proven (many times over) to be, at the least, unhealthy. It would not be imposing a moral law, it'd be imposing a scientific fact. I do not, however, endorse this idea whatsoever. Do whatever you want want so long as it doesn't infringe on anyone else's rights.
I don't impose my beliefs on anyone else, but if others impose their beliefs on me (federally mandated universal health care, for instance), then I'd find it a bit hypocritical.-
Question Cindlou: Do you think that most of the poorer people in the US who are the main consumers of heavily processed foods wouldn't prefer to eat fresh, organic, free-range foods if they could?
Processed foods = Cheap Calories -
techfun
cheap calories = diabetes
When I had a good job and good health insurance and my doctor told me I had diabetes, my mom turned me on to the South Beach Diet. It Really worked for me. I lost weight, my blood sugar came way down and I ceased to need any diabetes meds. I felt great, basically ate whatever I wanted, never counted calories or struggled with it.
But I did spend A lot of money on expensive high quality proteins and vegetables and the high fiber, low glycemic 'wraps' which in my supermarket cost 4 times the price of a plain old 'bad carbs' regular loaf of bread.
After being outsourced and taking an enforced vacation from the health care system as my finances slowly sank on down into poverty. As a poor person of course I ate a lot of cheap startches. They're cheap and they fill you up.
When my two year vacation from health care had ended, my blood pressure which had been under control was stratospheric (the nurse who took the measurement quipped 'it's a miracle you didn't have a stroke walking around with a number like that', my diabetes was out of control from eating too much startchy high glycemic index food. And it was clear to me that it was either blind luck or a flat out miracle that prevented me from having a fatal complication to my two year vacation from the health care system.
Call me a socialist, call me an a$$hole, I don't care. Federalizing health care would reduce it's cost by completely eliminating the stratospherically insane amounts that insurance company bureaucracy and insurance company profits add to Everyone's bill. I don't have the figures but Social Security, a government bureaucracy spends only a tiny percentage of their budget on administering the program and of course add nothing for profit being a government agency. The figure for private insurance companies is something like 20 times hire.
My Ron Paul scorecard so far:
Ending the War On Drugs (of 10 pts) 10
Opposing Univeral Health Care 0
A net wash. Thanks for posting this Cindy and please continue to share information on Dr. Paul's positions.
For any who want to discuss this further, I am linking this thread to a new thread over in the Ron Paul group so that it will be easy to find and we will have a specific place to look for discussions
I hope as we add groups for other candidates the same thing can be done, our own blog catalog voters pamplet. -
Social Security, as a success example of government involvement? You're kidding right?
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Dane: The big problem with social security is that it was treated like that Ronco rotisserie cooker and they thought they could "set it and forget it".
Ask the hundreds of thousands of people who lost any hope of a livable retirement in depression and they would tell you it was a great success. the problem is that it should have phased out and replaced or otherwise revamped over time to keep up with the demographic changes in this country. It was started at a time when the income gap in this country was MUCH smaller. -
I would say the bigger problem is that it completely follows the Ponzi model. If you and I were to set up a business offering retirement "insurance" exactly like the SS system, but voluntary rather than compulsory, we would go to prison for it.
The math doesn't change because the gov't runs it. And yet many of us factor our decisions on who would be a better leader based on who convinces us that they can keep this ponzi scheme in the air the longest. -
SS is an f'ing mess...
However all government programs aren't evil. Wisconsin's welfare/work program is actually pretty impressive. -
It seems to me that there is nothing wrong with a government providing a minimum standard of sustainence or care to those who can't afford it. Even Austrian School economist Freidrich Hayek admitted this. The problem with "Universal" healthcare is that it is not for only those who can't afford the service but for everyone. I wonder if your objection still stands if the service is only for those who truly need it and the brunt is paid for by the Teresa Heinz Kerrys out there, instead of diverting such funds into their own pet perpetuities?
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libdrone,
Excellent post. I can sympathize with your diabetic concerns as I have type II diabetes, celiac disease and am lactose intolerant. That's what I blog about (recipes, etc). We agree on many accounts. We disagree on one concept: I believe government intervention worsens the problem, you believe it helps.
techfun,
It's a matter of priorities. I am a physics grad student. I make very little compensation and I am surrounded by people who consider pizza and beer the best incentives to life. They also scoff at healthier less-starchy alternatives to their everyday meals. It's not the price that deters them, that's for sure. It's priorities, it's the idea that they are not responsible for their own health, it's their perception of taste, and it's ignorance.
On the bright side, more and more people are realizing this and making their own health a personal priority. I have seen first hand over the past few years how prices in less-healthy industries have gone up (& healthier food prices have gone down) as the demand for healthier foods and practices have gone up.
Personal anecdotes aside, I believe anyone can live healthier if they make it a priority.-
So if someone gets cancer it is their fault because of the lifestyle they have led?
You are making sweeping generalizations that the sick are sick because of the life they lead. It is idiotic... I need to stay away from this thread before my head explodes. -
Cindy,
First, I love some of the recipes on your blog and agree we have similar food concerns, though the diet you need to follow to be health and feel good seems considerably more restrictive than what I need.
But I take issue with your statement that our disagreement is that I feel government involvement would help and you feel it would harm. This argument does not address my point that insurance bureaucracy and obscene profits greatly increase everyone's health care costs. I am less for getting the government into the health care business than in getting the insurance companies out of it.
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I would just point out that there is a reason most vets carry health insurance on themselves. Government health plans ain't all you might hope they would be.
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pointlessbanter,
I'm sorry I have not been more clear in distinguishing between lifestyle and hereditary diseases. You are correct in that some cancers and other diseases are conditions that an individual has no control over.
All medical conditions are aggravated by poor lifestyle and diet choices. Many medical conditions, such as type II diabetes, heart disease, hypertension, and certain forms of cancer are lifestyle diseases and can be completely avoided or controlled.
For instance, both type I and II diabetes run very strongly in my family. My father and all of his siblings suffer from type II diabetes due to poor lifestyle choices. Two of my aunts have lost eyesight and toes due to diabetic complications. This helped alert me early to the necessity of preventing such a situation from occurring. I have control over my diabetic preledictions through only diet and exercise.
Diseases like Alzheimer's and autism are certainly helped by better lifestyle choices. Alzheimer, for example, can be kept at bay for a longer time period by keeping the mind active through reading, critical thinking, crossword, and whatnot. There is also much evidence that the symptoms of autism are alleviated with a gluten free, casein free diet.
It's lifestyle changes like the ones I listed above for which each individual is responsible. It is not the position of the federal government, in my opinion, to enforce or restrict these lifestyle changes. Universal Health Care would restrict my ability to get certain herbs and minerals which I need to treat myself. (I can talk about CODEX later). Universal Health Care would also restrict the quality and access that I have to specialists and doctors which are necessary for my conditions. This is in part already true - naturopaths (sp), chiropractors, etc are rarely covered/subsidized by insurance companies. -
Yes but lifestyle changes are impacted by people's wealth. Have you ever gone grocery shopping in the inner city? Oh that's right you can't because there are no groceries stores.
Have you been into corner shops in these parts of the city? Probably not. Try to find health food, try to find even healthy alternatives.
The other day I went to a corner store a few blocks away from me just to grab something to drink. The only milk they had was whole milk and the only juice I could find was two things of orange juice. Everything else in there was processed food.
This is such a nuanced discussion that you are trying to just paint with a broad brush. Which is exactly the problem with discourse in this country. Be it health care, illegal immigration, or any major issue.
It's easy to say that people should lead a better life. Not everyone has had the benefits you or I have probably had in life. In society there are going to be people that are economically deprived, uneducated, or just plain stupid. Should those people be punished because they aren't in our position?
And Dane, I would take shitty health care over no health care any day of the week.
I am not some liberal guy that just thinks that we should magically be covered. The system needs to be fixed 47 million people don't have health care, isn't that kind of a red flag? We need to take the profit out of the system, we need reform. To simply say that some people will abuse the system and you don't want to pay for it is wrong. Every single right in this country is abused in some way or another. There are jerks, you can't turn your back on your fellow HUMANS because you don't like a couple. I guess public education should be dismantled because there are some kids that skip school or don't care. Why not get rid of band because there are a couple of kids that hate playing the trombone?-
"And Dane, I would take shitty health care over no health care any day of the week."
Define no health care. There are already health care programs specifically for those who are low income. More than one. The express purpose of these programs was to ensure that people didn't go without health care, and yet after decades of operation the claim is still being made.
So for decades the US Government has been "providing access to health care" for those who can't afford it with programs that 1) don't seem to be actually providing that care according to the current debate, 2)has been a significant factor in driving the overall costs of heath care up across the board, 3) still manages to limit that care despite the lack of a profit motive.
And instead of talking about making sure these systems that are already in place are doing what they are supposed to do, we are talking about letting the same bunch of mismanaging "public servants" just take the whole mess and apply the same broken system to everyone? That's what universal health care is. Over priced, poorly implemented, under purposed, inadequate care for all.
All of these government "care" programs are systemic failures. They do not do what they are intended to do. And they fail at higher costs than purely profit driven system succeed. From Medicare and Medicaid to the VA and Walter Reed. And not just the Health related "care" programs either.
Does any of this mean I don't think we need to implement ways for people who can not afford heath care to receive it? No not at all. First of, in a moment of complete UNlibertarinanes (okay, that's not a word, but you get it), I fully support the concept of hospital emergency rooms being REQUIRED (as they already are) to provide urgent care without regard to ability to repay.
Secondly I think a system whereby the government takes on a substantial portion of the actual incurred costs of health care for people who simply can not afford to pay for it is a commendable goal. But that isn't "universal" coverage. Also the system is so freakin rife with fraud right now that it's insane. And that fraud is committed equally by all three partnerss in the crime, providers, underwriters and government. I believe that in the case of the first two the "game" was implemented as a defensive measure against the third, and ultimately each other.
When a hospital or a doctor submits a bill to an insurance company, they pay a percentage of it. The hospital writes the rest off. The hospital then submits larger bills for the same procedure in the future. When the hospital submits a bill to the government programs, they are prohibited by law from charging over a certain amount. So the next time they submit a bill to a private pay or an insurance company, the increase the amount to cover the lost revenue from the government billing. The insurance companies respond to this inflation (gotta love a gov't that can create inflation *without* printing more bills) by reducing the percentages of the inflated bills they pay. It's a sick cycle, that was created by the very body we are now talking about giving the whole enchilada to.
PS
Your analogy about getting rid of band because a couple kids don't like playing trombone is flawed. The more accurate analogy swings toward forcing all the kids in band to play trombone. Then forcing all the kids in school to join the band. Then telling the music teacher they can only teach pop goes the weasel and Mary had a little lamb, then telling them they can only have the first fifteen bars of the sheet music to teach it from. -
The problem isn't necessarily the poor. You are correct there are health care programs for them. But what is the income level defined for that, like 20K or under. (I think I read it was like 18K year but don't quote me on that.)
I read in Newsweek, when I was in the doctor's office oddly enough, that the average out of pocket expense for medical care for workers paying for it through employers or in other ways has risen to around $3,6000 per year. If you make 25-30K that is over a tenth of your salary. People choose not to enroll into their employers health care program because they can't afford that. The people that fall into this category make up a bulk of that 47 million.
I am not going to argue against the idea that a totally government run program would be ripe with inefficiency. That is a bi-product of what our government has become and both sides of the aisle are to be blamed for that. Our government needs reform so bad that it isn't even funny but I am disappointed to say that nobody can make the sweeping changes that need to be made in Washington in the current political and social conditions that exist in this country.
However, something needs to be done about our current situation in regards to the medical issues within this country. Reading some of the accounts of what HMO's have done to people by not approving the proper treatments because they didn't want to spend more money is disgusting to me as a human being.
I don't know what the answer is. Maybe a creation of a national insurance with pre negotiated and FAIR fees for hospital services would work. Keeping the private insurance companies for people that can afford it and choose to go with that. There has to be some sort of middle ground that can be agreed upon that will benefit everyone involved.
Our country has a lot of serious issues right now that people pretty much brush off because they have a job, a standard of living, and can live with blinders.
Shit I said I wouldn't post in this thread anymore... I need to write my paper on Dank Cook and Tila Tequila. -
Dane said: "Define no health care. There are already health care programs specifically for those who are low income. More than one."
The problem is that huge numbers of people slip through those cracks. Medicaid is administered differently in every state. In some states, it doesn't cover children over the age of 14. In some states, it's available to everyone, but only after a "spenddown" is met, and the spenddown based on even a minimum-wage income can be several thousand dollars--with no way to pay those first several thousand dollars, that patient never reaches the point of coverage. More importantly, very often he's never able to get the diagnostic visits and tests that might identify the illness that Medicaid would treat.
Couple that with the fact that hospitals and even many doctors charge individual patients without health coverage much higher rates than they charge insurance companies, and you have a very large pool of people who don't qualify for the current programs and have no chance in the world of being able to pay for their own medical care.
At any given time, there are approximately 44 million Americans with no health coverage at all. -
"There has to be some sort of middle ground that can be agreed upon that will benefit everyone involved."
Yes. This is one of those issues where the disagreement's really are NOT about where we want to go, but how we should get there.
Personally I don't think 10-15% is an onerous level for something as important, and lets be honest, costly to provide and research, as health care. Many in the US allocate more than that to personal transportation without batting an eye, despite having many less expensive options available to them.
That's a problem of human nature that sales people identified long ago. We spend money on wants not needs.
You know I don't have any hard figures, and I'm not inclined to look for any right now (I might later) but my gut is that writing a check for 1,800 or even 3,600 to insurance companies for everyone making less than say 40-50,000 a year would cost less than the current system and provide for more affordable, and better health care than the current system, or the "universal" systems on proposal.
This also means that employers still have to be sold that the system they are offering their employees is good, as opposed to an non competing national insurance, while providing for those who can't (or won't, for a safety check at the upper end of the scale) allocate a reasonable amount of their income to their health care.
Sorry about this, feel free to not respond, and good luck with the paper. -
Dane, I agree that that's not an unreasonable portion of income for something so important, although I think that the reason it's notable is that it has increased dramatically in just the past twenty years and is projected to continue to rise.
A couple of points, though--while I agree with your "needs v. wants" point (I was dismayed the other day when someone who has five televisions in her home suggested to me that no one could really afford to tithe 10% anymore), but we can't ignore the fact that millions of people making $6-7/hour are stretched pretty tight just to survive; they probably honestly can't afford the 10% without sacrificing something else critical. And as that percentage continues to increase, if current projections are accurate, that group will continue to grow.
The second is that while your suggestion (maybe serious, maybe just on the fly--I'm not sure) that we simply cover that expense for people below a certain income level is practical and probably, without digging into it, WOULD be considerably less expensive, I don't think it would ever pass in the United States because it's a clear example of an expenditure that would benefit only a certain sector of society, and the "what's in it for me" contingent is far too strong ever to allow that to happen, even if it was a money-saver all-around in the long run. -
[edit] Two posts up, not the last one [/edit]
I understand that MadameX. But I find that to be the biggest argument against a universal system. They can't get the limited programs right, how can we expect them to get it right universally?
And Medicaid is just ONE of the programs out there. None of the others work any better. here in Missouri, I don't believe there is a paydown. but there is a $10 co-pay. According to Mrs. Morgan, who works as an ER admitting clerk these copays are rarely even paid at the emergency room, and the emergency room has replaced the doctor's office for many of those on the program because the Doctor's office can demand the copay, but the emergency room can not. Understand that I am still in favor of requiring the emergency room to see these people because I would rather we lose $10 on millions of unneeded ER visits than turn away one who did need it. But the system that creates this situation needs to be repaired or replaced, not expanded. -
Yes, and isn't it sad that we would, as a nation, prefer to pay a larger final bill for less delivered value, than be left feeling that some one else got something we didn't get even if we didn't need it?
I sometimes think the "special interest groups" argument is specious. We're a nation of 300 million odd special interest groups.
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Yes why should we have no health care. -
I also live in a country with "universal health care" and let me tell you that we have no problems with the 6 points you listed.
All parties in my country are in favor of the system we have, no matter if they are on the left or right side. The American fear of universal health care seem very absurd to us.-
Jungl, I think (though I'm just guessing) that the difference might be in the relative sizes of our countries, and maybe in our track record. The United States is too big and has too many people living in vastly different economic environments to employ a blanket system for just about anything and have it work. Take, for instance, the "federal poverty level" guidelines, which allow one to achieve all the basics in Arkansas but fall short of covering even rent on a crappy apartment in New York City (without even thinking about little things like...oh...FOOD).
The other is that, frankly, we (by which I mean those who would control the thing) can't be trusted.
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jungl,
If you don't me asking, what country are you referring to?-
Norway.
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I was an ER nurse for years, and yes people came in for hangnails as well as chronic, not emergent problems. But some of them really had been trying to find their way to affordable health care, such as the free clinics but simply couldn't get in due to overcrowding
I had a patient, a very young man who had a heart attack. He worked at WalMart. He worked hard. It was only after his heart attack that he found out his insurance was lousy. His employer simply didn't take responsibility to provide their employees with decent insurance.
There are always those who fall somewhere in between - not looking for a freebie, working 40 plus hrs. a week, and one unexpected illness can ruin them.
It's a multi faceted problem. Presently everyone has access to healthcare..the question really is can they afford it?
I honestly think that's why more people are seekng natural alternatives to health, keeping better informed and seeking disease prevention.
I'm seeing a big trend also with insurance companies and Medicaid, Medicare, to keep people out of the hospital and self empower them through education, good follow up to health problems with case management.
Having even a bad healthcare plan probably is somewhat better than having none at all. But only because it decreases the entire burden on the system, not necessarily because it helps the individual.-
kab, I think that it helps the individual in one sense--it gets them through the door to find out what's going on in the first place. Even if it turns out that the plan is terrible and the patient ends up with bills it will take years to pay or ends up filing for bankruptcy, he got the tests and the diagnosis and the intervention, which might not have happened at all if he hadn't had insurance information to give over the phone when he tried to schedule the appointment.
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I agree completely. I've advised my patients to do just that when they're backed into a corner. Sadly enough also I've had people die because they won't go to the hospital due to the expense - or maybe they were just in denial - I don't know. I try to counsel them re: ways to manage financially but sometimes no matter what you propose people sometimes won't seek healthcare at all because of the monetary issue.
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"At any given time, there are approximately 44 million Americans with no health coverage at all."
"the average out of pocket expense for medical care for workers paying for it through employers or in other ways has risen to around $3,6000 per year. If you make 25-30K that is over a tenth of your salary."
That's correct. I am "forced" to pay about 1/10 of my salary to an insurance company (my 'company'/school does not let me opt out the insurance). I don't need or want most of what I am forced (well, technically I could quit my job) to pay for. I wish I could join the rest of the 44 million and opt out of my "health coverage". I've found much better care and treatment from practitioners who do not accept insurance (practitioners who accept insurance are limited in what they can provide). The best "health coverage" is your own personal health awareness coupled with a personal/family HSA + high deductible plan (if you are relatively healthy). I'd much prefer the health insurance plan outlined in "The New Health Insurance Solution" by Paul Zane Pilzer. If you are interested in this topic, I highly recommend this book.-
I don't believe you can claim force here. Since the requirement (though I didn't know there was such a thing in existence) is a contractual part of your employment, and you employment contract was not an act of force.
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Just this one sentence alone, "I wish I could join the rest of the 44 million and opt out of my health coverage" shows you have no understanding of the problem. Obviously you've never had a catastrophic illness or condition in your family which could wipe you out financially.
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"I couldn't afford health insurance, so I became a Christian Scientist"
— Caption from a New Yorker cartoon by William Haefeli
www.cartoonbank.com/product_details.asp?sid=122245 -
jungl,
Awesome! Glad to know universal health care can work at a local level. Norway has a population of about 5 million people. That is about half the population of new york city, new york. The united states has a population of more than 300 million people. -
Dane,
I agree. That's why force was in quotation. I was referring to the potential plan to federally force/require insurance. -
YES univresal Health care for everyone and quit throwin around tax payers dollars! Yes to Healthe care!
harleyblues -
mikster,
Quite the contrary. Read some of my posts above. I have type II diabetes, celiac disease, and am lactose intolerant. My immediate family is plagued with lifestyle diseases such as diabetes. My father has had 3-4 heart attacks, a pace maker, an angioplasty, a stint, and quadruple heart bypass surgery. My mother has a pretty serious thyroid disorder. My family has been poor but always relied on health insurance and conventional doctors to take care of their health.
My fiance's family, on the other hand, never had health insurance. They were also poor, but believed their health problems were their own personal responsibility. He's one of 6 children. His grandparents had a history of diabetes and cancer, yet I've never met a healthier group of people before in my life.
I'm personally working overtime just to afford my recent doctor's bill racked up from celiac disease. A simple 9 minute endoscopy cost me over $6000 for the procedure alone. This does not include doctor and hospital fees. In the end, all I learned was that my free independent research into my health issues were correct.-
Exactly my point. You've never gone without insurance, or your family, that could wipe you out financially.
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And as far as arguments of government inefficiencies they are flawed and weak. Who allows these inefficiencies to occur? We have done, as a populace, a very poor job holding our public officials accountable in this area. Complaints in this area should be pointed at the apathetic attitude we in this country as a whole demonstrate in this area. Rather than pawn off the argument on this perhaps we need to fix the root causes of government inefficiencies.
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Apathy and non participation are nothing new.
Sure, address the cause of Government inefficiencies (and ineffectiveness, the worse problem), but lets not dump more of the important stuff of our lives in their kitty before hand.
The arguments are not weak or flawed. How the Government became inept is not material to the fact that it is when discussing granting it even more powers to mismanage.
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The cost of healthcare is everyone's responsibility. It's simply not just the government's. For example, obesity is an epidemic. What sort of burden do you think that places on healthcare? So, here it falls on the consumer.
Capitalism is encouraged in the US. So every employer tries to provide the least costly healthcare plan to their employees. Here part of the problem falls on big business.
Many self employed people don't/can't insure themselves. So hospitals have to eat the cost of the healthcare provided to uninsured. Here again, another healthcare consumer issue.
Insurance companies pay tons of money for programs aimed at prevention. It's not like they're not trying at all.
Lastly, as consumers of healthcare, when's the last time you advocated loudly for yourself? People just don't get involved. Government officials will listen - they want to get elected! Get involved!
Short story. My friend had a motorcycle accident and broke his leg. His insurance paid for physical therapy. It was a burden to go three times a week and it was going to be brief anyway - but he had a lot more recuperation to do. He convinced his insurance company to pay for exercise equipment in the home because he advocated for himself
So reform has to come from more than one direction.-
Dane,
This is in response to your remark "the real problem was you couldn't be married and on each other's insurance". That is factually false. Both of our employers at the time he became to sick allowed covering a domestic partner under the same terms and prices as covering a spouse. And at various times we had been on each other's group policies as a spouse, our choice of plan determined by the total cost for both going together on either plan vs each on our own plan. At the time of Joel's illness and forced retirement I was with an employer that paid me very little but provided no cost excellent insurance for the employee and spouse coverage was very expensive so he was on his own employers' plan. And once he was retired for a medical disability, the "pre-existing" condition problem (see JD's posts above) made it of little or no value to try to put him on my plan.
Much as I appreciate the implied support of equal marriage rights implicit in your post, I want to make clear that that issue had Nothing to do with this one.
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There is another aspect to this debate that I don't think has been addressed and would like to throw into the mix. Dane pointed out above that there are health care programs for the poor and this is true but they work in a ridiculous and counter productive way. If you are Extremely low income (think someone whose only income is a $500/month disability check) AND you have a serious health condition you will qualify for medicaid and be issued a coupon which will allow you to receive health care from any licensed practitioner or facility in your state. If you are not seriously ill, however, you don't get the Medicaid coupon so no check ups, no routine or preventative care.
When my late partner Joel first became too sick to work and went on disability retirement ($600/month) we struggled for some 14 months to pay the $800+ per month insurance premiums on his COBRA so that he could continue to receive treatment. When we got to a point where we had quite literally sent our entire life savings to an insurance company, he became officially indigent, the Medicaid coupon was issued and he then got the same care, from the same doctors at the same hospital and our bill went from 800+ to nothing.
I defy anyone to convince me this is a rational system.-
You're right. Existing somewhere in the middle gets you no help. Actually my sister discovered this truth years ago. She flat out informed me her life would be alright because she inteneded to maintain all of her living standards at poverty level. She had a bad paying job that she actually really loved. Her employer provided her with no insurance because they are a family owned business. Her house was in a shambles and she qualified for heating assistance plus got a new roof. When she needed medical help she got it. She could not have existed any other way.
There's no question that being "officially indigent" has advantages. -
So my point would be, how can we think it wise to let the same people who gave us this situation give more of it to more people. And this is precisely how the VA, a current example of gov't health care in the US operates right now.
It's health care by crisis management. It's great if you're too late and dying, but incapable of preventing you getting there. Why are we hell bent on "solving" the problem by handing it to the very people who have done so much to exacerbate it?
All COBRA does is permit you to keep your insurance by electing to pick up the employers portion and pay it out of your own pocket. Not very helpful if your income simultaneously drops to nothing.
I do think that insurance companies *should* be on the hook for the duration of any condition developed while under coverage without regard to the ability to continue premium maintenance. The idea that they serve the purpose of risk dispersion is deftly nullified by the removal of that dispersion at the precise moment of need. If higher overall premiums or better investments, or even tax and other advantages are necessary to make that possible, then that is what is necessary.
All of that said, for your specific problem, I would venture to say the bigger problem was not that your partner lost his job do to the illness, but that our current ideas of marriage as a religiously based, state licensed convention, precluded your access to the very thing I did just last week. My wife dropped her policy and I picked her up on mine. In your case it was more a failure of a social construct of partnership that fails to reflect reality. or rather, this was the the first line that should have prevented the situation you found yourself in. Only because it failed, did the second failure have opportunity to occur.
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"But I take issue with your statement that our disagreement is that I feel government involvement would help and you feel it would harm. This argument does not address my point that insurance bureaucracy and obscene profits greatly increase everyone's health care costs. I am less for getting the government into the health care business than in getting the insurance companies out of it."
Then we agree completely Ron Paul, by the way, also wants to get insurance companies out of the mix.-
Does he have a proposal for catastrophic illness, Cindalou? If insurance companies were out of the mix, what would happen to the ordinary person who ended up fighting cancer or some such with a $300,000 price tag?
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if the person was lucky, they'd do what i did. find a dr who would treat me anyway. get better. declare bankruptcy. no way in hell i'd ever pay all that off. not as a teacher.
if the person wasn't as lucky as i would ... they'd forego treatment and die. or tey'd get a few treatments they could, prolong their suffering, and die. -
Exactly who, if the insurance companies are out, and you don't want the government in, would handle this? How would it be funded? You're making less, and less sense Cindy.
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I would expect that Cindy is think along the lines of tax exempt medical savings accounts.
It's a popular alternative concept, but the big problem with it is that it, again, loses the benefits of risk dispersal.
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Dane,
The way I envision it is this: I work for Pierce County Library System, an independent, quasi county governmental body. Our paychecks are issued by the county and we are considered State employees for the purposes of benefits.
Under our current union contract, the library contributes $460/month per employee, applied towards the employees choice of three or four different insurance plans. Any unspent premiums revert back to the library's budget and do not belong to the individual employee.
The insurance company in this case is an HMO which contracts with a large primary health care provider with a network of clinics and hospital affiliations across the state.
What I would like to see would be I and/or my employer if it was a benefit negotiated as part of my employment contract, would pay the agreed upon amount directly to a health care provider of my choice, but it would not be through an insurance company that rakes of 40-60% of the take and the $460 dollars my employer and I already spend would be enough to cover myself and my family rather than only being sufficient to fund individual coverage as is now the case.-
It would be enough to cover medical care for you and your family as long as you don't really need any significant care, Libdrone, but what would happen if you found out that you had a brain tumor or sustained burns over a significant percentage of your body or any of the many things that can easily cost hundreds of thousands of dollars?
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You've removed all of the benefits of risk dispersal with that, Alan.
I think you are trying to find a way to fix the problem in a way that no profits are taken. But without the potential for profit, no risk dispersal is possible. And the high levels of profit involved in underwriting are directly tied to the high levels of risk the people involved in it take. A single catastrophic incident can erase an underwriter's profits for months and even years.
Though the gov't attempts to do risk dispersal, you end up paying even more, because they can only do it through inflation, since there is no actual income separate from the taxes funding it.
The reason that an employer can't do it, in general is that 1) they don't have significant enough a pool to spread the risk across, and 2) because the premiums we are paying are a very small amount of the profits of any underwriter. The real money comes from the investments made with these premiums.
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as I understand the terms of the policy I have now I would be covered for those things with only the listed deductibles and a fairly low maximum annual out of pocket which even on my poverty level wages as a new page with no union seniority I can scrape up as needed. This is fiscally possible of course because all state employees are part of the pool but only some of them will at some point need the most expensive care.
The solution I am envisioning continues the risk sharing principle of group insurance but eliminates the huge heft that insurance companies add to the total cost spread out to all of the members of the pool.
That, was my point, not that $460/month would necessarily be sufficient for my actual needs in any particular month. Hope that clarifies and please do pick at other holes you see. -
mikster, I don't believe _I_ have ever said that I don't want the government in. I said that getting the insurance companies out was my primary concern, rather than getting the government in but yes, I am talking about the government universally administering the program rather than the hodge podge of federal, state, local and private programs the sum of which (there are figures somewhere to back this up)add like 40% to our total health care costs.
By comparison, social security, a universal government run "insurance" program has administrative and over head expenses of something like 2%.
Yes, there are huge financial problems with the social security system, but inefficiency in administering the program and issuing millions of checks on time each month to millions of disabled and retired Americans is NOT one of them.
The Republican's and the Democrats want the insurance companies to continue getting their take and sending in campaign contributions, the Libertarians so distrust the government that they adamantly resist using it when it is the best possible solution. And people who are poor and sick continue to suffer. Is there any way we as a nation can move past this?-
Well, to our misfortune (
) the Libertarians have little effect on any real outcomes. -
Dane,
I want to acknowledge that as you have amply documented VA health care is irrevocably FUBAR. It is a relatively small government program that covers only the fraction of the population which have served in the armed forces and I believe that much of the problems with it can be traced to Rummy using the DOD primarily as a cash cow for the Halliburtons of the world while starving the nuts and bolts of the system that actually takes care of sick grunts.
The reason social security can spend such a low perecentage of its budget on overhead is because 1) it has a huge pool (pretty much everyone in the country),2) it has no competition and no need for marketing, advertising, image consultants, obscene executive salaries, etc and 3) it can spread the legitimate administrative expenses (rent, payroll, competitive executive salaries across its huge pool, something that can never work in a competitive private insurance market.
Markets are a useful tool but they are not a panacea or the answer to every problem. In this case, having the government cover everyone and and everyone pays through payroll tax really IS the best way to solve the problem. But I feel like I'm pissin in the wind since as I said all the political parties have their own agenda that prevents them from looking to what best solves the problem for all Americans. -
I'm not going to let you politicize that issue, Alan. Veteran affairs are near and dear to my heart, these are my brothers and sisters in arms in a very real sense to me. We have had these problems since long before this country collectively knew who Rumsfeld was or that Halliburton existed.
For those who would leap to the other end, the systemic problems with the VA existed before anyone outside Arkansas had heard of Clinton either.
The problems aren't caused by a party or an administration. Neglecting the VA seems to be a truly bipartisan effort.
I was going to write more, but it's best I check myself on this one. I don't think you really meant to make political points on the issue, but my short hairs stand up at the hint of it on this issue. -
As for the markets being the only answer. I believe it was I, the wild eyed crazy anti government raging capitalist libertarian, who actually suggested further up the page that one solution might involve the government actually cutting checks to underwriters covering the employee portion of insurance premiums up to a generous amount, and covering an income ceiling that would by no ones definition exclude anyone stricken by poverty.
The problem with a pure government solution is that the only way they can increase the amount of money in the fund is to print new money, thus devaluing the funds already there, which does nothing to increase the real amount in the fund, or to raise the amount of the contribution, or to limit the ability to collect. Since we know that by default everyone dies, and everyone gets sick, everyone will collect. This means that everyone has to pay in at a level that covers expenses.
The majority of the money available to pay insurance claims does NOT come from premiums. It comes from realizing gains on the investment of those premiums. This money is newly created wealth. The Government can only increase the fund through debt.
The reason I oppose gov't insurance is based more in mathematics than political affiliation, though I freely admit a bias of (I believe well earned) mistrust in the Government. -
Dane,
I apologize if I inappropriately politicized an issue that is dear to you. And your remark about the neglect of the VA predating the man from Hope points up to me how much my own biases were at play in that post. For that I thank you.
But I fail to see why a plan that removes undeniably duplicative administrative and marketing functions and spreads the risk over the entire population as the pool with a rewards and benefit structure that emphasizes routine checkups and screenings and preventative care, could not overall reduce the total cost of health care to be divided proportionally among every single one of us, which the sum total of us, one way or another Are paying for today. (remember as previously discussed when people who did not receive routine preventative care developed serious conditions, they end up on the public dime full ride. how much of that cost could be reduced if every single American has checkups and preventative care on a routine basis?)
I'm not a socialist. I don't have a problem with companies earning profit. But again, markets are not a panacea and this is an instance where an efficient monopoly would be more effective than a market that has proven remarkably inefficient. Public utility companies are an example of legal monopolies that are more effective than markets for a vital public service. -
"But I fail to see why a plan that removes undeniably duplicative administrative and marketing functions and spreads the risk over the entire population as the pool..."
Yes a program of encouraging preventative medicine would reduce the overall cost initially. But it would also increase life expectancy. That's a good thing, but it doesn't bode well for paying for health care from a premium only money fund. 1/3 of expenses happen in middle age and half in the "senior" years.
www.pubmedcentral.nih.gov/articlerender.fcgi?artid=1361028
Those senior years figures will increase as average life expectancy increases. And just as with SS all of the payouts will be ocuring after the individual has stopped paying into the system. So there has to be an adequate pool of currently working people paying enough to support current expenses which are growing faster than the population is growing. The only government solutions are to print more money (debt), raise taxes (debt) or issue bonds (debt).
The private sector underwriters obtain these addition funds by creating new wealth (growth) through investing the premiums. The premiums we pay now could not make a dent in the actual payouts of claims. Forget overhead. it is these investments that make it possible to do any of this in the first place.
The government could simulate it by continually introducing new debt to cover the old debt, but eventually the check comes due. I don't think we have the right to saddle out great grandchildren with the bill for our health.
Also I don't see where it is necessary for the government to become the care provider in order to initiate programs encouraging routine maintenance. The smart money would of course target the employers with this information as they have a vested interest in a healthy and stable workforce. Doubt that? Look at how many employers require prospective employees to pass drug screens right now with no legal requirement to do so. It costs less to screen for it, than it does to deal with it later. Same with preventive medicine, it's just not widely recognized yet. But it's coming into play. My little company of around 120 employees recently brought in a counseling service. Any employee or household resident can see these counselors for sessions related to many different aspects of home and family from drug problems, to financial counseling, marriage counseling, and much more. And the company pays for it. It's more cost effective to provide this service than to deal with the results of these things not being taken care of. And this is in rural Missouri! Rural Missouri! Not SF,CA.
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Those who think healthcare is expensive now... just wait until it's free. I've written many posts on the subject of universal healthcare or socialized medicine. My most recent post deals with the huge problems of babies dying needlessly in Britain due to the staff shortages brought about by their National Healthcare System. Post can be found at this link. theconservativepost.com/WordPress/?p=181 -
"You're making less, and less sense Cindy."
My posts have been a bit rushed recently, sorry for that.
In fact, I said something incorrect on my last post. Ron Paul does not want to get insurance companies out of the mix. He is not in favor of the government-employer-employee relationship, but he does not want to remove insurance companies.
Rather than ask "how do we pay for $300,000 medical bills?", it's a better question to ask "how can we reduce that $300,000 bill?".
The following are bills Congress should pass to reduce health care costs and leave more money in the pockets of families:
HR 3075 provides truly comprehensive health care reform by allowing families to claim a tax credit for the rising cost of health insurance premiums. With many families now spending close to $1000 or even more for their monthly premiums, they need real tax relief – including a dollar-for-dollar credit for every cent they spend on health care premiums – to make medical care more affordable.
HR 3076 is specifically designed to address the medical malpractice crisis that threatens to drive thousands of American doctors – especially obstetricians – out of business. The bill provides a dollar-for-dollar tax credit that permits consumers to purchase "negative outcomes" insurance prior to undergoing surgery or other serious medical treatments. Negative outcomes insurance is a novel approach that guarantees those harmed receive fair compensation, while reducing the burden of costly malpractice litigation on the health care system. Patients receive this insurance payout without having to endure lengthy lawsuits, and without having to give away a large portion of their award to a trial lawyer. This also drastically reduces the costs imposed on physicians and hospitals by malpractice litigation. Under HR 3076, individuals can purchase negative outcomes insurance at essentially no cost.
HR 3077 makes it more affordable for parents to provide health care for their children. It creates a $500 per child tax credit for medical expenses and prescription drugs that are not reimbursed by insurance. It also creates a $3,000 tax credit for dependent children with terminal illnesses, cancer, or disabilities. Parents who are struggling to pay for their children's medical care, especially when those children have serious health problems or special needs, need every extra dollar.
HR 3078 is commonsense, compassionate legislation for those suffering from cancer or other terminal illnesses. The sad reality is that many patients battling serious illnesses will never collect Social Security benefits – yet they continue to pay into the Social Security system. When facing a medical crisis, those patients need every extra dollar to pay for medical care, travel, and family matters. HR 3078 waives the employee portion of Social Security payroll taxes (or self-employment taxes) for individuals with documented serious illnesses or cancer. It also suspends Social Security taxes for primary caregivers with a sick spouse or child. There is no justification or excuse for collecting Social Security taxes from sick individuals who literally are fighting for their lives.
Dane,
You are correct. I was referring to a high deductible health savings account. This is only really an option for young, healthy citizens with low current risk. With a high deductible, high cost surgeries (> $2000) are covered, there is risk dispersal, and the money saved from the low premiums can be used for any other form of health care, alternative or conventional.-
Even if you reduce $300,000 by 50% which would be a MAJOR cut, its still $150,000. Someone who is that position would have trouble if it was reduced by 90%.
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"Well, to our misfortune ( ) the Libertarians have little effect on any real outcomes."
Dane, what if they did?-
Then I could finally vote for some one who would actually hold office. And there would be a party like you wouldn't believe.
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techfun,
Yes, that would be a terrible position to be in and I've no doubt many people are or have been in such a predicament. High deductible low premium HSA's are the way to go now, as anything over ~ $2000 is covered and you can save money (less premium -> save it) tax free for health purposes in order to cover the deductible and your other health related bills. -
Excuse me for popping in and out so quickly this weekend. Family stuff and all.
Since I'm a little pressed for time, and since I really want to throw my thoughts in on this topic (for which I do not have a solution, btw) I'll just add this quote that sums up my feelings on national health care quite nicely:
"National Health Insurance means combining the efficiency of the Postal Service with the compassion of the IRS .... and the cost accounting of the Pentagon." - Louis Sullivan/Connie Horner quoted by Novak in Forbes -
Dane,
Replying to "The problem with a pure government solution is that the only way they can increase the amount of money in the fund is to print new money..."
Why couldn't a quasi governmental organization invest surplus funds in the open market, just as my library does-- we get our tax income in a lump sum once a year and earn interest on the money until the period in which it is needed. I know of no reason why a "US Health Authority" could not invest it as well as insurance companies do, using the exact same method insurance companies do, but hiring competent investment managers at competitive salaries. Honesty, no I don't see that the government can only borrow or print money. There is nothing to prevent it from investing.
posting this at the outside because with the huge number of replies it is getting difficult to find new posts in the middle of the minefield.-
Simply because if the money were in investments it would not be available for use in the general fund to buy votes with.
It isn't that they haven't the ability, it's that they haven't the will.
This is, incidentally, what makes SS a ponzi scheme. It isn't invested to create new money, so all current payments are drawn from current deposits (actually, it passes through the general fund first it and is spent, then debt is issued to replace it to make payouts). -
Also if the government did invest money, it wouldn't be long before congress was dictating investments based on political goals rather than sound investment principles. And that would be disastrous, from both sides.
(think riders on bills requiring the Office Of Health Investment to invest 25% of FY 2009 premiums in Halliburton International submitted by the Junior Senator from Texas as an example I'm sure you will appreciate) -
Dane,
Your cynicism is noted but does not address the argument. As I mentioned, I work for a quasi governmental organization who's budget is carefully calculated and includes the interest income earned between the time taxes are paid in and expenses come due. Our library's income is not paid off to buy votes, and our budget clearly shows how our patron's tax dollars are professionally managed to provide interest income. And the fact that the voters who pay the taxes that are our budget recently voted not only to renew but to increase those taxes (passed by a very comfortable margin I might add) suggests to me that the people we serve feel we provide value and are a worthy use of their money.
If your cynicism will not permit you to accept the possibility of the efficiencies to be had by putting everyone in the country into one pool and running it as a mega HMO how about if we pass laws encouraging counties to go into the HMO business and give them a big federal help if they enact a plan that covers everyone in a means and manner approved by voters. Would you be able to accept that as a better alternative to our current situation, which you seem to acknowledge is awful but mightily resist any suggestion of fixing? -
Well, as I mentioned before I think the ultimate bill would be significantly less if the fed simply cut a check to the underwriters who handled the accounts for each employees policies, covering a generous premium, up to an unarguable level of income above poverty (unaffordability). I really wouldn't care if that underwriter were a municipal interest, a county see, a private corporation or whatever. As long as the monies were invested soundly.
I do protest the cynicism label in this case as I am basing my expectations on current practices with another universal insurance fund currently being managed by the fed in exactly the way I describe.
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yes, but as they say in the investment biz, past performance no guaranty of future results. I think that the greater efficiency available by putting everyone into the pool outweighs the potential for fiscally irresponsible abuse of the invested funds which could be effectively controlled IF the political will exists to exert such control.
I made the suggestion about doing it at a county level because I know personally as I said of a county level program funded by taxpayers that professionally manages and invests revenues to pay future expenses and so I offer it as an example. To my thinking the reasons it works in the instance I cited is because the quasi government organization is Independent and not a direct part of any pure government agency, it hires competent professional management for both overseeing the core mission of providing library services to the communities that pay taxes to us and for managing and overseeing the funds which our taxpayers entrust to us. These taxpayers do so by popular vote, giving them a mechanism to withdraw funding if they feel we spend their money unwisely. And I have heard no arguments why this could not work for health care in the same way it works for library services.
And yes, you have provided numerous and good examples of wasteful, inefficient and bad government programs. But if in discussing problems such as health care we are required to assume as settled that the programs of today that do not work, absolutely can not be replaced and reformed into better designed and implemented programs that do work, I fear there is little point in discussing health care at all since I do not believe it possible for us to fix health care without creating a government that actually works for the people (which as I have argued I have personally seen work effectively on a local- county- level). -
So we kind of agree that this would be a workable solution if we super glued the doors to the capitol building shut and let the librarians run health care!
Actually, now that I think about it, I don't recall ever meeting a librarian who didn't seem to care. And I don't recall meeting a representative who I really believed did. You may be on to something here.
We NEED a Librarocracy in this country!
;) ;)
A little fun at the end of a cool debate. -
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Seriously.... wtf
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Nay I say! -
I am all for it. -
In Canada, Universal Health Care (UHC) works alright but is fairly expensive and has the failing that a disproportionate portion of the population uses most of the resources. However, using only 10-11% of GDP, Canada is able to provide this care in contrast to 17% of GDP used in the US without achieving UHC. Regarding the disproportionate usage, I am not talking about people with chronic diseases either. A lot of money is spent on people in the lower end of the socio-economic spectrum whose lifestyles will cause them to use the hospital resources more frequently.
The excess use of the medical system by the poor comes from obesity from food choices, substance abuse issues such as alcohol and drugs and in more extreme cases, ignorant actions that result in injury.
While I am neither a socialist nor a rabid conservative, being for or against UHC on its own is too simple and it is necessary that we look at what it entails. If it means helping all the people all the time, then it is incredibly expensive and inefficient, but if there are protections in place to limit the overuse and these protections are not eroded overtime by those with a purely left wing agenda, then it can be very beneficial.
When put in place properly, Universal Health Care can help those who are legitimately stricken by conditions and would otherwise become destitute. Without such a system, those with illness are left to rot and rather than being happier, contributing members of society, are left as miserable individuals with little hope of contributing.
I commented on Medicare in this regard in the story:
www.wellescent.com/blog/siteblog.php?entry=24-month-medicare-rule-hurts-med...
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