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Massachusetts Makes Health Insurance Mandatory
Iron Condor writes "Massachusetts is the first state to require its residents to secure health insurance, a plan designed to get as close as practically possible to statewide universal health care. Presidential hopeful and former Massachusetts governor Mitt Romney originally introduced the idea in 2004. Effective July 1, 2007, the law, which uses federal and state tax dollars, is aimed at making health insurance affordable to all residents of the state, including low-income populations. Those who fall below the federal poverty line may be eligible for health care at no cost."
You know, a few years back I was in San Diego and went to Toorcon (excellent conference by the way - please support it) and I got in to this discussion late at night on socialised health care.
For those that don't know, the United Kingdom spends eighty billion pounds a year on healthcare, funded directly through taxes. His central point was: "Don't you feel like you're being ripped off paying for the health care of jobless people when you're busting a gut earning a living?"
I think it's an important question and one that needs answering if the United States is going to replace their broken healthcare system. My answer is simply that even ignoring the people who don't work, it is still a better deal for you if you have socialised health care.
Free market economies work best when prices are elastic; that is, where changes in price affect the demand for the product. This allows price to signal the level of available supply and prevent shortages of goods. The problem with healthcare is that it is not elastic. If I have cancer, a broken leg or some other ailment I have to get it fixed - regardless of the cost.
In a profit making company, this means raising the price indefinitely sees no reduction in demand. This leads to an ever increasing cost that outstrips inflation. The American system compounds this because a lot of white-collar workers get insurance plans from their companies. Companies have deeper pockets than an individual ever could so the prices increase still further!
Socialised health care delivers better value for money because of the enormous purchasing power of the government. The NHS can purchase millions of shots in one go. That allows you to hammer the drug companies on price and share the proceeds with the population. In the American system, it is you against the drug company and you are needy; you are willing to pay anything to fix yourself. In short you're screwed.
There are also other economic benefits. Heathier and less desperate neighbours translates to less crime and increase productivity. It pays to insure that the daughter of a crack-addict prostitute get first class health care and education - if only to increase their chances of escaping the poverty trap and contribute more to the economy.
It also pays because you can remove the inefficent insurance companies. If everybody is covered then there is no need to have a bureaucracy to decide if a person is covered.
Socialised health care is not evil communism, it is a practical solution to the health care of your nation. I don't see anybody complaining about the socialised road, garabage collection, fire, police and military. When you trust the security of your nation to the government, why do you not trust your healthcare to them too?
I'd I've seen the benefits first hand. When a friend of mine, at the age of 20 developed Lukemia, put his Computer Science course on hold, checked in to the local hospital and began his treatment straight away. He was cured and back in education the following year. I fear that had he born in the United States, he would not have been able to continue with his studies, in fact, he probably would have been bankrupt. Socialised healthcare not only save his life, but his future.
Simon
So, from here on, Massachusetts residents are obliged by law to make money for a profit-oriented company (that may or may not actually cover their ailments).
Wow, that's progress.
No, no sig. Really.
ThePromenader
...what's the point in having insurance for all, if insurance companies will just deny all the claims due to conditions obscured in legalese?
Finally the US is starting to catch up with the civilised world.
Now Mass residents will have a healthcare system rivaling the UK NHS
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I can just imagine now all the people who are above the "poverty line" and still can't get health insurance because of pre-existing conditions. Or they just can't afford it.
Lets just require that people not be poor!
That'll fix it!
I have looked at the Mass health insurance plan. I may be misunderstanding something, but their idea seems to be to get rid of uninsured by declaring it illegal. The closest equivalent I can think of is to stop New Orleans floods by declaring it illegal for levees to break.
They haven't gone a single step forward in fixing the underlying problem of why healthcare costs so much.
(disclaimer: I live in Mass. and my health insurance has not gone down. In fact it went up)
i highly recommend for people to watch sycko
after watching this i am shocked, USA is in a bigger mess than i taught!
as a European i am happy i don't have to make tough choices when it comes to my health, if i need treatment i would get treatment with little hassle
i highly recommend for any Americans with Irish roots to come back here (u wont get hassle getting citizenship!) the economy in last 10 years has grown so much the country is unrecognizable, and u get quality health care (its not perfect but compared to the US...)
I listened to the whole program and this is perhaps the worst idea I've heard towards overcoming the pervasive lack of health insurance. Most of the people who don't have health insurance don't have it because they can't afford it. A somewhat decent plan costs a couple hundred dollars a month for individuals and several hundred for families. The people who can't afford these prices don't choose buying an iPhone and a new HDTV over getting health insurance--they don't have the money in the first place.
While the state claims that the prices will be lower because of this law, they've established a council to look into ways of lowering costs--and their suggestions won't be implemented until at least 2008. So for the rest of this year at least, costs aren't any cheaper than they were before this law went into effect. And knowing most insurance companies, if they can reduce their costs, it's unlikely they'd ever pass those savings onto consumers willingly.
They say there won't be a penalty for people who genuinely can't afford health insurance, but the state gets to arbitrarily draw the line between who makes enough money and who doesn't. And when it comes to providing services for citizens, governments don't usually err on the side of compassion.
So how is this better than leaving things alone?
Does this mean that someone who is denied health insurance in any other state will be able to move to Massachusetts and be guaranteed to be approved for health insurance? Will high risk people who are denied in other states have higher insurance premiums to pay than "lower risk" insurees in Mass?
Will there even be an application process if accepting me is compulsory? Will this give insurance companies less loopholes to try to out of paying for my expensive procedure. For example, as pointed out in "Sicko", insurance companies routinely deny expensive insurance procedures by finding things on the insurance application to invalidate their contract with the patient. If one can argue to a judge that the insurance company had to approve them no matter what, I'd assume that this makes Massachusetts a much safer place to be able to depend on the health care and insurance that you are paying for than anywhere else in the country.
I think these are pretty important questions, but I can't seem to find the answer anywhere.
This is simply a mandate that each resident carries some form of health insurance. Read that again: this is not subsidized health care; this is simply a law that creates an annual tax penalty for residents who cannot prove that they are insured. Bottom line - it ensures that any health insurer who operates within Massachsuetts is virtually guaranteed to earn business from the constituency here.
In the first year of this program, residents who elect to defy the mandate and do not purchase coverage will be subject to a paltry $219 lien on their taxes as punishment. Given that this is far less of an economic burden than paying the mandated premiums, anyone who can do math and is healthy would be advised to consider paying the penalty. Anyone who doesn't fit into either of those two categories probably already has health insurance - and those who don't more than likely exist at polar ends of the economic spectrum: they either print their own money and can pay for health-care as needed or they are poor and can't afford the tax penalty or the premium. Of course, for this group (earning 30K or less per year as an individual and 60K per year or less as a family of 4) - the premium costs are gratis under the new Massachusetts law.
Massachusetts has found a way to make public health policy in this country even more ludicrous than it already is. They have taken a system that was a dangerous marriage between public policy and corporate interest and have fully endorsed the idea that health insurance should be the business of private enterprise and that mandating the purchase of that insurance by enacting silly laws and tax penalties is the business of the state. Taken together, the whole thing seems rather sinister at the surface, and that's because it is. It shows either an utter disregard for the concept of insurance or a determined attempt to exploit the public ignorance of personal risk assessment. It's hard in fact to find ANY real benefit for the citizens of Massachsuetts in this mess.
The sales pitch by proponents of the legislation is that it will lower the average premium cost for the entire populace; as healthy individuals are forced to subscribe to an insurance plan, the revenues generated from their participation will offset the increasing costs of paying out benefits to subscribers who are sick. This really is like any other insurance that you can buy: the insurer needs to have as many (if not more) low risk subscribers who pay their premiums such that formerly low risk subscribers who become high risk can be paid the proper benefit when the time comes. But in this instance, the insurance industry won't have to break a sweat to get those low-risk subscribers on board. In fact, they don't even have to get off the couch - the statewide mandate ensures that unless there is some pandemic that makes everyone in Massachusetts sick, there will always be a pool of low-risk subscribers who generate a reliable revenue stream.
People wonder how this is a bad thing? Why would decreasing the average cost of health insurance for all individuals actually be a detrement to people? Well, first of all - because everyone must participate or be penalized financially, this is less of an insurance system and more of a welfare system: everyone is putting their money into the pool, and those who need the money more than others are allowed to take from the pool. In this case however, the twist is that the people responsible for managing this money are actually taking ownership of it and making business decisions on its use. While in a government-regulated welfare program revenues can have no other purpose than to cover expenses, insurance companies have a profit motive - an extra hand that dips into the pool of contributed funds every so often and takes a little something for itself. This isn't in and of itself evil - we deal with big corporations every day. However, there aren't any laws out there that require me to buy $10 of goods at Wal-Mart each day, that is precisely what Massachusetts has done with health insur
this should have been done a long time ago, America stands out as being an extremely wealthy country but with a dire health service, having the highest infant mortality rates in the developed world, not that many countries have a truly satisfactory health service, better then nothing though.
prepare the survey weasels.
You know it makes sense, Massachusetts!
When all you have is a hammer, everything looks like a nail.
And all we have are lawyers.
"Those who fall below the federal poverty line may be eligible for health care at no cost."
Wow! I guess there *is* a such thing as a free lunch.
"The average reporter we talk to is 27 years old......They literally know nothing." - Ben Rhodes
The law should mandate health insurance like it does car insurance. It's not necessarily for the protection of the driver but for other drivers on the road. I absolute don't buy the argument that people should be free to make choices, including NOT buying health insurance. Just like you are not free to drive uninsured, we should not be free to go about without health insurance because when we don't go see the doctor, who knows what potentially contagious disease we are carrying? How can we fight SARS and bird flu when many won't go to doctors simply because they can't afford it? I think it's a wise way to spend my taxes to help other people in need even when a small portion of them are "free-loader" of the society. At least people can go to the doctor when they begin to feel sick. The alternative is that they won't go to the doctor until it's too late and cost even MORE of my taxes or spread some uncontrollable disease in my community. Then there is the collective bargaining power of the government to hospital and drug companies which will also drive down the cost of medical service.
The only possible interpretation of any research whatever in the 'social sciences' is: some do, some don't
I consider it a step in the right direction. Yes, it's "socialism at its finest", but it's a matter of being human, IMO.
Yes, the ones that need this the most are also the ones that can hardly pay for it. So you, the healthy guy, spend more on your insurance than you'll ever get out of it, most likely. Still, I prefer being healthy and "ripped off" to being sick and "enjoying" my stay in the hospital on someone else's expense.
But that doesn't mean that we have to "level" the field. You can still get "better" plans for more money. Here, the solution is simple: You have a standard insurance. Which covers most of your medication, operations and a stay in the hospital. You want more, you can get more, you just pay more. You want a certain doctor? Pay for it. You want to lie alone in a room in the hospital? Pay for it. You want certain medicaments instead of the standard? Pay for it. You want painkillers where there are usually none required (like in most tooth related issues)? Pay for it.
Yes, the "extras" cost more than they're worth. Most of the time (a shot of painkiller for a simple tooth drilling costs about 15 bucks, a room for yourself in a hospital is a few hundred bucks extra a day). But that's how it works here. You get what you need from your health care. You want comfort? Pay for it.
We used to have a Bill of Rights. Now, with the rights gone, all we have left is the bill.
The cry from Republicans has always been that socialized medicine is some slippery slope to communist rule because doctors won't be their own bosses anymore.
The truth is though that you can't apply capitalism to medicine because if you're dying of a heart attack or some other emergency you can't choose between Macy's prices and Walmart's prices in ERs. You go where the ambulance will take you.
You can almost never pin doctors or hospitals down much with "What will this cost?"
You are at the mercy of the bill they will send and if you are uninsured you can be sure it will be approaching if not beyond what you can earn in a year to stay in the hospital a few days.
It's an unconscionable system in America.
Look at the effort to discredit Michael Moore's "Sicko".
The rich bastards running HMOs are stooping to outrageous levels to stop and discredit Moore. And they might succeed again with the FOX Noise crowd.
I'm from Australia here, and I've never understood how the US health care system worked until I saw Moore's documentary, SiCKO.
I would watch American movies and TV shows, and wouldn't understand when you guys talk about, getting a job with 'health benefits'. Here in Australia, the only thing I worry about getting a job is if it pays right.
If I go to the GP (family doctor in the US), or need to go to the hospital, paying the bills is the last thing on my mind. It's all taken care of. Medicines are also subsidised by the government. You collect virtually any prescription for $3.
Honestly, I was surprised you guys let it get that bad. Then again, I wasn't surprised the reason it went the way it did: through greed and politics.
In my view it is impossible in eight minutes to read the article (to see the issues covered) and type out the post as provided.
In other words, it is in my view highly unlikely this was a 'spontaneous reaction', but a pre-written statement that was posted because it fitted the occasion.
If I had pointed this out about one of several other topics - say, a topic that pointed out the benefits of DRM and the loss that was caused to a specific media producer from piracy, and instantly got a very long and well-written reply in support of DRM - I strongly doubt it would have been moderated 'troll'.
(I am a licensed insurance agent)
:)
Those middle class people in Massachusetts who have pre-existing conditions, will be driven into homelessness. For absolutely certain. No questions asked. Out the door and to the loaves and fishes NOW.
These people will pay $1000 premiums per month - I work with these insurance companies and I see it happening daily in California - and in many cases their contractually agreed upon coverage will get denied.
The raw numbers cannot be denied, and cannot be resisted. The numbers - the the number of people with pre-existing conditions, their income, and their health insurance premiums - all clearly say that a large number of lower and middle-middle class will start paying fines, or going homeless, or leaving Massachusetts.
This is all out war on the middle class, and many will leave, and when they do, the rich will be paying more to support the health care-driven tax increases to support the poor and then the rich will start leaving and badebadebadethatsallfolks!
I hope this law is rigorously enforced. Tie it into SSN's and whichever SSN isn't insured, fine 'em. That'll bring quite a swift end to this law.
--- Grow a pair, liberals... stop letting the Republicans bully you!
the United Kingdom spends eighty billion pounds a year on healthcare
Hm, nominal spending is more than that. Now I don't know much about the NHS (other than that it doesn't work) but I do know a bit about government contracts in the UK, and I would be very surprised indeed if more than about 50-60% of that went on anything of even peripheral value to healthcare.
Here, the Times (rapidly becoming a tabloid but never mind) has something on it:
Annoyingly chatty but probably basically correct article.
To put it another way, the UK NHS is like the US DoD; they're both ways to funnel money from the taxpayer to those who position themselves to recieve it. The NHS, however, which is regarded almost with veneration by most British people and which doesn't have to fight actual wars, is far more corrupt; buildings built, bought, sold and knocked down within the space of a few years, and so on. But the NHS long ago passed the point where it's powerful enough to keep going forever -- it's quite a political power broker in fact, which is why you *do* get reasonable free healthcare from it in much of Wales and Scotland.
Meanwhile, in England, health care does cost money -- you pay over the counter for even a basic dental checkup. You don't want to? Then take out some private health insurance. It's a fast growing sector in the UK. Good!
I imagine that there are people who find it hard to afford, though, what with all the taxes they're paying. And that's bad. But what can you do?
Whence? Hence. Whither? Thither.
...to tax everyone, and have the state provide the healthcare, like in Australia, the UK and most other sensible Western countries?
Compulsory health insurance will just make the insurers raise their prices, because they know that everyone just has to put up with it.
-- Even if a god did exist, why the fsck should I worship it?
Like driver's insurance, it "solves" the problem by saving the government money. (in expensive accidents with uninsured motorists, the government would inevitably have to pick up the bill. Forcing everybody to have driver's insurance "solves" the problem) So long as everyone has insurance, the government doesn't need to support a large medicaid service and can point their finger back to the insurance provider.
What this legislation shows more than anything else is that the Massachusetts legislature subscribes to the idea that anything that's good to do should be mandatory, and enforced with the threat of violence if you decline to comply.
-jcr
The only title of honor that a tyrant can grant is "Enemy of the State."
http://news.bbc.co.uk/1/hi/scotland/6700685.stm
http://society.guardian.co.uk/nhsperformance/stor
http://news.bbc.co.uk/1/hi/health/6266124.stm
etc etc etc etc etc ad nauseam.
The UK has been throwing tens of billions of pounds at the system in order to try to reduce the waiting but you know that's temporary while the lists are in the news. At some point reality will kick in (again) and they'll rediscover they really can't afford £105 billion (even more next year) every year. The people of course blame immigration for the spiralling costs and waiting lists, because it's simple to do so, but in reality it's just the wrong model.
In the majority of EU countries some form of compulsory health insurance is in use. There's no particular need for the state to own and operate hospitals. Free market economies work best when prices are elastic; that is, where changes in price affect the demand for the product. This allows price to signal the level of available supply and prevent shortages of goods. The problem with healthcare is that it is not elastic. Hmm, perhaps, but we're not talking about the price of healthcare.
We're talking about the cost of healthcare insurance which is an entirely different thing. Where it's too expensive people simply don't get it, as is evidenced by the fact that millions of Americans don't have insurance. What drives up healthcare insurance costs is the legal requirement to treat people without insurance. Who bears that cost? The people paying for insurance. This is the wrong model as well.
Deleted
A few comments from this Massachusetts resident...
First off, this wasn't Romney's idea at all - the entire thing was proposed and implemented by the (extremely Democratic) state legislature. The MittFlopper had zero to do with it - absolutely nothing - he simply made sure to grab credit at the time (now he's distancing himself).
Personally, I think our country is jaw-droppingly stupid to not implement single-payer health care (aka Medicare for Everyone, aka What Almost All Other Industrialized Countries Do). That being said, the Massachusetts initiative has produced a number of very affordable plans, so I do think it's better than nothing.
Here are my ideas based on what I know about it (I don't live there but I have watched enough US hospital shows on TV to know a little about it :)
:)
1.Completely ban health insurance companies from specifying which treatment options a patient must take if they are to be covered (e.g. "you must use our preferred hospital" or "we wont cover you for that really expensive test even though the doctor says you should have it") or from charging differently based on what options are picked. This change doesn't mean they have to provide coverage for stuff like baldness cures (ala that one Simpsons episode) or whatever other non-life-threatening treatments they don't currently cover
2.Do whatever is necessary to increase choice of provider. If there are more options for people to pick from then we will see insurance companies competing for business (here in Australia, health funds spend big money trying to convince you to switch to their policy)
Those 2 provisions would be a good start in fixing the system. Feedback from those who know more about the system would be nice
Studies have shown that healthcare is not perfectly inelastic. A 1970s RAND study, the most comprehensive one ever conducted (in that it utilized a true double-blind experimental setup spanning multiple years and involving thousands of participants at a total cost of $300 million dollars), demonstrated that people that have insurance with lower copays do, on average, rack up a lot higher healthcare expenses than those without insurance. (I forget the exact numbers, but it was something like people with 20% copays on average spend some ~50% more on healthcare than people with 95% copays). This demonstrates that healthcare demand is clearly NOT perfectly inelastic, but instead does depend quite strongly upon private price levels.
Not so far unless you qualify for subsidies. Anyway, as far as where they think the savings are going to come from, I haven't heard anything. The math doesn't work out. Have you even heard the term "preventive care" even mentioned once with this. It's just a scheme to force more people to subsidise the system. In a lot of cases, people currently opt out because they're healthy and not having insurance is cheaper. That's what I did for a while. Saved 5 or 6k a year that way. Luckily I have an employer plan or I'd be throwing away that money now.
> "Don't you feel like you're being ripped off paying for
:)
> the health care of jobless people when you're busting a
> gut earning a living?"
You make good points in your post and feeling ripped off is a feeling everyone gets when paying taxes.
In Ireland it is free to some extent but not totally free, however if you do incur medical costs you can claim the money back from your taxes to almost the same amount. Also certain things are free by default (eg. Eye/Dental check ups). So it is not like you are being ripped off.
I will disagree with you. I cut myself last year. It wasn't particularly deep, but it scared me enough from the huge gash it left behind. Only the skin got cut, but because it was on a Sunday, my doctor's office was closed, and I had to go to the hospital. I had to get 20 some stiches (actually, just staples). I never saw a doctor, just a type of nurse. I also got a tentanus shot and 2 X-Rays done to make sure no metal was left in the wound. I was expecting the cost to be $1000 max, probably less as it was just 45 minutes. My doctor said he would have charged me $250 for the same service.
/.er is a rare thing. Don't stare at me too much.)
I got a bill for $3000. I got this bill because I was uninsured. I know the insurance would have paid only $500 but the hospital screws you if you are uninsured. This system would bankrupt me if it was anything more serious. I'm a person too poor for insurance, but still have assets (a car) and thus don't qualify for government help (until I'm broke - i.e. lose my car). I could not fight the bill - I was told that since they did not bill me fraudulently (no double billing basically), the bill was what it was.
I can't go to the doctor for fear of high bills. Even if it would be cheaper in the long run. If I need to get tests done, I can barely afford it, I'm just scraping by. I am young and relatively healthy, but I still have issues time to time. It makes me sick to my stomach when I think of how much I get charged as a private person and what the breaks the health insurance industry gets. It's downright unfair.
Since I have relatives up there, I am moving to Canada soon. I know many Canadians complain about the system, but none would trade it in for the American system. I see the light, I'm moving out of here. I won't miss it. I'll pay the higher taxes if it means that I don't have to worry about rotting in the street or being close to my death before I get help. Fuck all of you blasting Socialized Medicine - it's a safety net for people like me - like the original poster of this thread said: healthcare is a necessity, not a luxury - unless you don't mind dying early or being crippled for life.
(Yeah, I know being a poor
What's this got to do with "news for nerds"?
I wrote my first program at the age of six, and I still can't work out how this website works.
If you are in a car wreck or get shot, you are already insured for catastrophic loss whether you know it or not.
Either you have private insurance, or anything you can't afford will be picked up by the taxpayer or the hospital's indigent fund. The indigent fund comes from, you guessed it: patients who can afford to pay the bill.
This means most middle- and upper-class people pay to insure those who can't afford it.
There is one major difference between this and socialized medicine or mandatory insurance systems:
In most states, those with lower-middle-class incomes or higher but few assets can choose not to contribute to the system then rely on the taxpayer when they need services. This is fundamentally unfair. Socialized medicine and mandatory insurance restore fairness by taking away this choice.
The other way to restore fairness is inhumane or even barbaric: Deny emergency services outright to people who can afford to pay insurance but choose not to. This means letting people suffer and die. It's also poor economic policy if the person is likely to recover and continue contributing to the economy.
Knowledge is how to play a game, intelligence is how to win, wisdom is knowing what game to play.
I predict another statist train wreck, driving the golden spike through the MA taxpayer's heart. Bssically until the freedom of choice drives out inferior failing medical systems (ahem), throwing more (mandatory) money (fuel) at it only increases the size of the (society threatening) conflagration. Those who are able to effectively control their heart disease, blood pressure, diabetes and chronic illnesses through intelligent, cheaper natural means also will be left out here.
Required Health Insurance?
Well, the state should start up it's OWN low cost, non-profit Health Insurer.
Your Drivers License or non-driver's license id card becomes a Health Card.
FREE to all residence, it is paid for by the state, via taxes on tobacco, alcohol, gambling, and
having the state take over all alcohol sales - beer, wine, and the hard stuff.
Pennsylvania earns over $400 million a year in Alcohol sales - (Does not sell Beer) via the State Store profits.
The State should run a few For profit entities like that to lower taxes and enrich useful programs...
Why?
Because they are the people who prepare your food and clean your house.
Having money in the bank or paid up health insurance doesn't protect you from catching TB.
Has health insurance become like that? Because mainly businesses are buying it for thier employees as a benefit, the price (groupe rate) is artificially high?
What if something were done to DISCOURAGE businesses from offering health care as benefits? What if the fair value of those benefits were TAXED AS INCOME?
If so, would businesses start to drop coverage as a benefit, individuals would have to start buying it on their own (like car insurance) and the prices would drop?
Switzerland (not part of the EU) has the same system, obligatory healthinsurance for all. You can pick and choose your medical insurance, and the insurers are restricted so that they don't overcharge, and those that can't afford it get it paid by the state. Works fairly well and is a good compromise for those who want total state provided healthcare and those who want to choose which one they want.
What a ridiculous statement. My grandparents are all deceased but my all four of my partner's ones are still alive, thanks in no small part to the NHS.
In the last few years one has had a pacemaker fitted, one has had knee surgery and also a heart attack, and a third has had surgery on both knees. All three at least 80 years-old and all three had these operations and treatments in timely manner, all on the NHS at no cost to them at all. All three could not praise the staff that treated them high enough.
To suggest that the old get poor care from the NHS is ridiculous. If that were so then these people wouldn't have received the excellent treatment that has allowed them to carry on not just living, but living full, pain-free lives.
"Accept that some days you are the pigeon, and some days you are the statue." - David Brent, Wernham Hogg
And because so much health insurance is purchased by employers as a business expense, the price tends to be higher than if purchased privately.
Is that it is primarily corrective instead of primarily preventative.
"God fights on the side with the best artillery." - Napoleon, Marshal of France - speaking truth to power
"Don't you feel like you're being ripped off paying for the health care of jobless people when you're busting a gut earning a living?"
What a shower of inhuman, hypocritical, fascist bastards.
I'm a atheist (and, by American logic, therefore evil), and even I can see that this is JUST WRONG.
Simple-minded, simplistic, ignorant and typical American attitude. So just where is this god of yours?
Can you say Social Darwinism?
The law should mandate that the employers provide healthcare to any full-time employee (or the employee pays like 25% of it). This is enforced in Germany, even down to a McDonalds. Yes, it increases prices for some things (McDonalds is slightly more expensive) but also enough discount places (Germany is Aldi's home country, food is cheaper there IMO but I am digressing).
Look at it this way, each and everybody who works needs to use their salary to buy health insurance anyway - this money will not come magically from Heaven. However, in America, employees like Wal-mart let their employees fall below the poverty line, don't let many get in full-time hours, etcetara and the result is that many Wal-mart employees do not have insurance and the government (i.e. the taxpayers) foot the bill. The result is that Wal-mart gets to have "lower" prices (hidden cost to society), drive more scrupulous competitors out of business, and so on and so forth.
Wal-Mart, in Germany, failed. They were under the same rules on how to treat employees. Last year they pulled out their 80 supercenters and sold them to a competing chain store. They claimed that they could not compete (Germany has many discount chains) -- this is part of the reason. They were not allowed to unload the hidden costs to society - they had to play fair.
When I catch a serious contagious disease, I want to be able to sue the person who coughed and gave it to me. I'll then sue everyone else who has come into contact with me for "time wasted" by my immune system getting rid of their bacteria instead of dealing with the first problem. When I get cancer, I want to be able to claim a little bit from each and every firm responsible for producing gaseous carcinogens, for increasing the probability of dangerous cell mutation. When I find I have an inherited disease, I want to be able to sue my parents for not creating me up to spec.
But don't worry, if I intentionally cause myself harm - let's say, I dunno, I decide to overeat, or stop my careful exercise regime, or decide it'd be fun to play chicken on the railway tracks - I promise to pay for every last penny of care.
Because, you see, little of what ails ya is actually your fault, so taking "individual responsibility" as god, I look forward to a world where payment for healthcare really is made by those responsible for causing the problems. In the meanwhile, I recommend all Libertarians build bubbles for themselves, as the bacteria/virus incubator will be reduced to classification as an agent of biological warfare (or "initiation or force", or whatever you Ayn-fans call it) in this dystopia.
I'm a Canadian that used to live in the USA. One of the things that always amazed me is how your health insurance can obligate you to stay working for a company.
:(
Essentially, once you're diagnosed with a disease or condition, it's impossible to change to another provider because they won't cover pre-existing conditions. This means that if you leave a job (or are fired), you have to personally keep paying very high rates to your old company's provider in order to keep insurance. Your new employer (if any) will usually not take on those costs, because they have their own provider and plan - which you don't qualify for due to the pre-existing condition. It's a vicious circle.
However, I lived in Massachusetts as well, and I did like some aspects of the co-pay system there. In Canada, anyone can go to the doctor whenever they like, and it's free. So, you get mothers dragging their kids to the doctor every time they sneeze, and all kinds of other useless visits to hospitals and so forth. Having even a token co-pay (exempted for those below poverty) reduces needless visits. I think most visits on my plan in the USA were $10 or something, which is enough.
So - my ideal world would be the Canadian system, plus a small co-pay. Unfortunately most of Canada's best doctors move to the USA so they can get rich instead.
MadCow.
I used to have a sig, but I set it free and it never came back.
So for now you are required to get insurance. What next, required genetic testing? Pre-natal screenings for possible conditions, requiring you to get an abortion if the fetus is not "in the acceptable range"?
Yeah, I know it's way out there... but have you seen Gattaca? The rate the US is going, I'm... disturbed.
Vote monkeys into Congress. They are cheaper and more trustworthy.
Employment and Healthcare should be disconnected.
The reason is to try to get employers OUT of the healthcare providing business, and to encourage more private purchase, which will drive prices down.
Not all hospitals have indigent funds and those that do have strict guidelines. Three years ago, I was in the hospital for several days and was denied indigent funds. I couldn't afford health insurance (unless I wanted to eliminate food from my budget). Apparently, making $20k per year for two people was too much for the hospital and I was told I'd haven't to pay my $10k hospital bill. Just because the hospital has an indigent fund doesn't mean they are going to help you. They don't want to give out money any more than insurance companies do.
Of course, this may vary with whatever state you're living in because different states, different cities, and different hospitals have different rules.
This will have a really bad effect on small businesses who don't have a large enough pool of employees to get the lowest rates from the insurers. Healthy employees will chose to get their own insurance, leaving only those that have medical issues using the business's insurance, which will drive up the premiums further.
If politicians really want to fix the issue, require all doctors to advertise their prices in advance for every procedure (they have a charge code for everything to work with insurance companies). Then require every insurance company to provide their negotiated rates, copay amounts, etc, for every charge code before you purchase the insurance (put it online or in a booklet that you can review at an agents office if you like). Make it illegal to discriminate against someone based on their medical history, only their lifestyle (e.g. smoker, high risk job, and age) should be considered. And finally, require coverage for all preventive procedures (e.g. yearly physical and blood work). Yes, requiring coverage may make the rate go up, but any doctor can be selected, and now they have to show their rates in advance, allowing the law of supply and demand to actually work.
If we are going to have government subsidized health care, that can be done very easily now. Have doctors bill the government for preventive procedures, but beyond that, make everything a tax credit that only kicks in after you've spent x% of your income on medical expenses. Right now it's a deduction that only reduces your income, and not your tax. Having that x% keeps people from abusing the system. They can even have a list of maximum rates for each charge code just like they have a per diem published now. Sadly, this is much to simple, and there are too many lobbyist, for this to ever happen. And knowing our congress, they wouldn't fix the AMT and it would end up undoing everything they just wrote into law.
MA is using community rating in combination with the requirement for coverage. Unsubsidized health plans run about $350/month, for those making over 50k. I don't see the problem. (the law subsidizes health plans for those under a certian income).
Now where are we Canadians supposed to drive to for timely health care? America was always a backup plan in case you ended up on a long waiting list (or were a Prime Minister who didn't want to queue up with his electorate).
I'm not sure where you get your facts, but that simply isn't true, and ironically points to the biggest flaws with health care in the US. If you get shot, or are in an accident, the hospitals are required by law to take you in. However, the flaws of the US system are:
Yes, you have a few horror cases when people have died in waiting rooms etc, but they are simply not the norm. Highlighting those stories while sidestepping the very real problems of health care in the US is simply dishonest and doesn't help solve the problem.
I live in Massachusetts, and what this has created is a set of mandatory, sub-standard, overpriced health plans that the self-employed and very small businesses (2-5 people) cannot afford. I know of people who now have to choose between losing thier personal deduction on thier taxes AND pay a yearly fine that increases substantially every year in order to be able to buy food and pay thier rent, OR buy into this bastardization of a health care system. Whenever the government FORCES you to buy something in order to live an average life, it's a TAX, and that's what the self-imposed dictatorship of taxachusetts has done to the citizens here, a gigantic tax increase of unprecedented proportions. For some reason the retards in my state keep voting for these facists.
...is that it subsidizes the poor, but ignores the sick. Anyone with a pre-existing condition (which can be as mild as taking an antidepressant or being on one blood pressure medication) can, and will, be raked over the coals by the insurance industry with no price cap or subsidy. Most of the "universal" health care plans talk about subsidizing the cost of the poor, but they make little mention of the people that pay the most out of pocket for health care--the chronically ill. The segment that pays the most for health care never get mentioned in these universal health care debates. They are just expected to keep paying out the nose. The people who actually need health care can ill afford it, which seems to make little sense. Why have the "best healthcare system in the world" if no one has affordable access to it?
I know that opponents to universal health care blame the sick for their situation, assuming that most of us are fat slobs who eat at McDonalds every day, never get out of the chair, and have diabetes and heart disease as a result. The problem is that most chronically ill people are sick through no fault of their own.... The 9 year old kid with brain cancer... your mom with rheumatoid arthritis... your college roommate with Crohn's disease... nothing they did (or didn't do) created or contributed to their current condition. It is unfair to blame the sick for wanting access to health care.. after all, that IS what it is all about. Health care is about treating the sick, not the healthy. If the sick don't have access to health care, then why have health care available at all?
And what is defined as "affordable"? It seems that the Romney plan is well over $300 a month for very sparse coverage with pages of exceptions... that hardly sounds affordable, especially when most of that money is going into the insurance company's pockets instead of to the actual cost of healthcare.
We'll see how this system pans out... I think the big sticking point is that it is compulsory and subsidizes private insurance companies (who certainly don't work for the public interest). I 'm sure these issues rub a lot of people the wrong way.
Thanks,
Mike
Either you have private insurance, or anything you can't afford will be picked up by the taxpayer or the hospital's indigent fund. The indigent fund comes from, you guessed it: patients who can afford to pay the bill.
This means most middle- and upper-class people pay to insure those who can't afford it.
There is one major difference between this and socialized medicine or mandatory insurance systems:
In most states, those with lower-middle-class incomes or higher but few assets can choose not to contribute to the system then rely on the taxpayer when they need services. This is fundamentally unfair. Socialized medicine and mandatory insurance restore fairness by taking away this choice.
I think you make a valid point that it is currently an unfair system where who choose to bludge can be allowed to do so.
Social security ( before it was raided over and over) and other such systems at least forced those earning monies to provide for their retirement in some sort of fashion.
Would a medi - care -cade -slurpy mandatory state tax not make sense ?
The President could make a federal request to all of the States ( I think the politicians should pay for DC itself ) to implement such universal coverage, of course this would have to be worded so as to allow each state to decide the implementation details;
At least this would possibly preserve the freedom for consumers to choose their home state in part as to how it implements the funds as deliverable services ?
Maybe California could decide to have state funded energy vortex healing (
You don't have to go all the way to Europe to find an example of socialized health care. Try up North in Canada. Canadians generally like to complain about the short comings of medicare. The popular perception amongst Canadians and Americans alike seems to be that, if you're able to afford it, care in the U.S. is better. However, some studies have shown that this isn't the case at all, and the quality of care is actually about equal or even better in Canada in some areas. This seems difficult to believe when you consider how much less Canada spends per capita on healthcare than the U.S., and even more so when you consider that, for that money, they cover everyone. However, bear in mind that, in addition to the advantages mentioned above, we don't have an entire industry of insurance-men and lawyers riding piggy-back on top of our hospitals the way they do in the U.S..
Socialized healthcare works. I'm glad we use it up here and will never vote for a politician that even dares to dream dismantling it. That being said, Canada's system has some drawbacks which you should study and try to avoid. It's a tad off topic, so I won't go into too much depth. However, one of the biggest problems with socialized healthcare is drawing the line between necessary procedures/drugs that everyone is entitled to and procedures which they have to pay for themselves, while at the same time not making it inordinantly difficult to pay for those procedures.
If you want perfect teeth in Canada, you pay for it. Braces are not deemed a medical necessity. However, private dentist clinics are everywhere so this is not a problem. Lots of companies offer dental plans, and you can also buy private insurance very similar to medical insurance in the U.S.. Finding a place that will do esoteric cosmetic surgery that has no non-frivolous applications can be difficult. Facial reconstruction? No problem. Labia sculpting? Good luck. Also, good luck finding a company plan that includes boob-jobs. (To be totally honest, there is one bar in town that has gained notoriety for it's policy of funding breast augmentations for employees. Let's consider them an exception to the rule.)
Another, somewhat chilling aspect of socialized medicine is that the state has to do cost/benefit analysis when deciding what procedures to perform. If an ninety-year-old in the U.S. can pay for hip replacement surgery he or she will get it if it kills them. In Canada, the cost of the operation, the risk to the patient, and the low benefit (a ninety-year-old is statistically unlikely to get much use out of a new hip) may mean that the patient won't get anything other than a wheelchair. This is not a system in which the patient is always right.
People like to bring up the fact that fire departments are a public service because you need the fire on your neighbour's house put out right away, regardless of whether he can pay. So what if he gets an serious infectious disease? Be nice if he could get treated before it spreads to your family. Same goes for the junky who walked into the cornerstore just before you did, getting whatever germs he might be carrying all over the door handle, the counter, the change that the cashier is about to give to you...
The earlier in the transmission chain that a disease gets treated, the fewer people get infected. It's a pity more people don't see that.
I would...
1) Outlaw private health insurance.
2) Provide "Life and Limb" coverage to all residents.
3) Fund charities and charitable clinics, to help the
extreme poor get additional services.
4) Rejoice! B/c now I have the best damn medical system in the world!
:T:R:A:N:S:
It's not a good system, but everything else is worse.
"And yet everything has a value."
Unobtainium is worthless. Next up, a rant....(not aimed at "you" personally).
The Australian system is similar to the UK's NHS, so much so that we look after each others tourists for "free". I was an asthmatic teenager when the "establishment" told us universal health care was a communist plot that was crippling the UK and would bankrupt the country. 30+yrs later and we are far from bankrupt, we have "world class" prevention, care, teaching and research. I belive "the system" saved my son's life and it definitely kept me out of bankruptcy.
As for footing the bill for "non-taxpayers" (depending on political expediency the Australian term for non-taxpayers is either "bludgers" or "battlers").
I spent all of my 20's at the "trailer trash" end of the socio-economic scale. Happily, I am now in the "high income" bracket where I am supposed to "top up" with private cover for stuff such as dentistry and silcone tits - personally I prefer the extra $500 "fine" at tax time and pay for my own dentistry...anyway...When you do the math it turns out I am paying to cover 5-6 non-taxpayers, yet I have only two (grown) kids and I'm no longer married (to the lazy bitch...sorry...that just slipped out, see the "political expediency" comment earlier).
The reason I am not only glad but proud to pay the levy is that I hope the system works for those 5-6 people as well as it did for me in the past. The reason I don't buy "mandatory top up" insurance is because it is medicinal "fluff" that I can afford. Most of all I don't want a return to the partisan politics where one side refuses to acknowledge the inherent "social evil" in a system that can routinely take eveything the patient's family has, and then promptly hang the patient with red tape.
How do my costs compare to the cost of similar cover in the US?
From comparing notes with one or two US slashdotters in the past I belive my 1.5% levy on taxable income is considerably less than HALF of what similar cover (and care) would cost in the US, the exact ratio varies from state to state. Not very scientific I know, but I also know that the death rate from asthma in the US has now overtaken that of Australia, this is despite Australia having one of the highest incidence rates in the world. Make what you will of the facts and figures and competing "-isims", I know first hand it's not me and my five "battlers" who are getting "ripped off".
And did you exchange a walk on part in the war for a lead role in a cage? - Pink Floyd.
wow it is with great pleasure and surprise that I welcome this news...
maybe in a few centuries the US will come out of stone age!
> "Massachusetts is the first state to require its residents to secure health insurance.....
> Those who fall below the federal poverty line may be eligible for health care at no cost."
Maybe something's changed since I got a master's in health care administration, but I seem to remember that health insurance costs money. Free health care (which is what I assume is what is meant by "health care at no cost") is the opposite of that. If you're going to give something to some people, you're not requiring them to secure it, you're offering it to them. So WTF is this supposed to mean? All those reddish green people are going to get free expensive insurance? Or are those greenish red people going to have to buy insurance for no money? If they are offered health care for free and they turn it down, are they breaking the law that says they have to secure it? Or maybe by "secure" they don't mean "obtain", but rather another meaning such as "locked". I'm thinking it's "locked" because that's the opposite of "free", and that'd make it self-contradictory like the rest of the article.
Stories like this are going to turn me into Lewis Black.
"I may be synthetic, but I'm not stupid." -- Bishop 341-B
Of course not. It's either your own fault, or god hates you. There are no accidents, period.
What would happen if we were to create a federal law completely exempting medical establishments from any and all federal taxes, if and only if, such medical establishments are willing to see patients on a sliding scale? The sliding scale will be government mandated. Perhaps a simple doctor visit would warant $20 for someone who is below the 110% of the poverty level, for example.
If you think it is a good idea for a healthcare facility to take patients on a sliding scale have not yet seen the dark side of patient dumping. Look it up. Healthcare is a business. They limit the amount they dole out for free and next to free. It cuts into the bottom line. In poorer neighborhoods where the higher percentage of the population pays less, then taken for granted things like CAT scan and MRI are simply not there. The hospital can no longer afford one. When they can no longer afford one, care that would normaly use that diagnostic would be reduced to band-aids and asprin and maybe exploritory surgery. Surgery for insertion of a stint stops being an option. Treatment is now just perscription based blood thinners and hope he doesn't die soon.
The truth shall set you free!
So where do you draw the line between "wasted" money and money well spent?????
This is the problem when you start thinking like you do. The moment you start qualifying who should and shouldn't get medical care, then you have to start making HARD decisions -- like who gets it and who doesn't.
So, in this case -- the guy goes out, gets drunk, and cuts his hand. You complain about footing the bill because he was drunk and did something stupid. All I am saying is that if you are going to do this, you'd better be prepared to start drawing lines in cases where it isn't so clear. How about a car accident that wasn't their fault? Would you be comfortable paying for that? Is that wasted money? After all, maybe they were stupid and pulled out in front of someone. What about an accident where someone fell off a ladder? That's pretty dumb if you ask me. So is that money any more or less wasted than the guy who cut his hand while drunk?
My point is this: the moment you start qualifying *why* someone should or shouldn't get care, it forces you to clearly define those lines. And by doing that -- you have to leave someone out. Lines get drawn for a reason, otherwise, your answer would simply be "healthcare for all people, regardless of why". So how do you draw those lines and determine what is "wasted" vs. "well spent???
Good for you. Hopefully soon this will be the case over the whole USA.
Three years ago, I was in the hospital for several days and was denied indigent funds.
Because of that many hospitals deny expensive proceedures and instead get the patient stable and send him on. Hopefully elsewhere. Do a google search for patient dumping. They get stable and discharged, not treated and recovered.
The truth shall set you free!
I cut off the end of my finger with a drop saw. Picked up the piece and off to hospital. Emergency surgery for reattachment, in hospital for 5 days with leeches, lots of drips and painkillers. After 5 days the tip died, so back home for another week before it was removed and I had a skin graft to cover up the end. Numerous trips back to hospital for checkups, as well as weekly hand therapy to get movement & desensitation of my "new" finger. The therapists told me to come back whenever I liked if I was having problems. The interesting part (especially after seeing an extract from Michael Moore's movie about someone in a similar situation in the US and how he had to choose which of the two fingers he cut off he could afford to have reattached) was that the total cost to me was... $0. It's this way for most everyone in Australia.
What about cases where there is no choice. Where the alternative is death? If the person can't pay - under your system - they die. Does it really have to be that way? Surely, we as a Great Country, can do better than that. If someone is injured in a car accident, do we really want to be first asking, "maam, can you pay?? Maam? Can you pay? Please maam....just answer....can you pay?".
No, that is not how things should be.
The fact is, we as human beings, are always going to want more medical care and longer lives. There are always going to be people who can't pay the going rate. You can't ignore them, for they are too many so the next best alternative is to provide SOME level of healthcare to the maximum amount of people. And that takes money and a system that is fair. Yes, there will be waste and inefficiencies but the overall level of healthcare will go up and you will have achieved your goal (more healthy population). If all you are focused on, is the bottom line -- well....there isn't much point to any of this, is there?
I feel the only real way we're probably going to solve health care problems is if we solve the problem of inflation. Maybe then it will free up some resources so people can get the basic needs of life.
The central thrust of your argument is that, because health care is a necessity, the government should provide it. But you forget that scarcity ALWAYS exists, and whether you are a socialist or a capitalist doesn't change that at all. In the case of socialist systems, everyone does not get a particular good or a service.
For example, in the UK, proposals have been aired so that no one who smokes will actually get health care, and, the government makes policy decisions such that some people will not get a particular treatment. The only way that you can get it, thus, is to pay it out of pocket. Basically, you get rationing. It's no different with health than it is with gasoline in Iran. Sure, its theoretically available to everyone, but, no one ever actually has it, because the caps have to be artificially put into place.
In the USA, on the other hand, if you have the money or benefits, you can find health insurance that works for your lifestyle. I might, for example, pay a higher premium because I smoke, but, I'm still going to get my million dollar cancer cure at the end of the day, and insurance commpanies will still have made money off of me even after writing that check. Thus, for people willing to pay anything, and they do, there is superior health care. For a time, in the USA, there were more MRI's in absolute terms in the Philadelphia area than in all of Canada. The wait time was short, whereas things have to be scheduled more.
It's readily apparent that scarcity exists. Slapping a socialist label on it will undermine health care for the vast majority of people that do have it. Sure, 40 million people in the USA may not have adequate health coverage, but what about the 250 million people that DO.
The issue, in both cases, is that advancing technology has made health care more expensive. 50 years ago, there was an x-ray machine and the doctor or nurse just did it. Now, the medical dollar must support a bevy of things from CAT scanners to MRIs, real time medical monitors, all of which are attended by a fleet of technicians, who are nearly as expensive as the doctors. Over time, what will happens is that automation will visit the field of medicine, rather than just absolute discovery, as is the case now, and that will drive down the cost of medicine. Doctors are already comfortable with sending samples to a lab technicians for results, and often times those techs are now overseas. Imagine when computers give you the bacteria counts, etc, and suddenly you don't need all those techs any more than you need people to manually turn rubber to form tires with. Right now, car makers make more cars than they ever did, and with far less people, and the same thing is going to happen to medicine.
So, does that mean that government cannot help at all? No. The answer not some foolish to turn to a socialism that we already know screws the overwhelming majority. The answer is a set of prudent investments by the government in medical automatician research, so that we can get the hardware and the software needed to reduce the cost of medicine, and not just simply shuffle resources around, as the socialists would have us do.
This is my sig.
Would be to establish an EU and USA joint research program aimed at creating new technologies to improve automation in medicine. Regardless of economic system, you would find lower overall costs as time went on, reducing tax burdens for EU citizens and checking the increase in health care premiums in the USA, making health care more accessible for everyone, worldwide.
This is my sig.
I really fail to understand how anybody could be against it.
If you can start with the assumption that you think everybody should have healthcare available to them, anyway.
It simply costs less to run - consider every single person/advert in the chain between you signing up with healthcare, going to hospital and coming back after an operation.
Socialized healthcare at a stroke allows you to remove huge layers of management and cost from the system. You still go to hospital, but less people get paid along the way - and as all those salaries/adverts etc are ultimately coming out of your pocket...
If the USA left Europe to its own devices, every European nation would have the bomb within 20 years. I would not be so convinced that the past is something in the past. The Polish Prime Minister recently pointed out, when arguing for a higher share of votes within the EU, that his country would have 20 million more people today if not for the German genocide of World War II.
Poland knows that any EU assurance of defence against Russia is worthless, because, it's always been worthless for the entire nation's history. So, as soon as the USA leaves NATO, and hence Poland, Poland goes and gets the atomic bomb. Now, do the Germans sit there with a cross border state, without the bomb? I don't think so.
I, even though I am tempted at times to pull the plug on Europe, still calm myself down periodically. NATO exists for a reason. With the USA and Canada on one side, and Europe on the other (particularly France and the UK), the Atlantic Ocean is essentially turned into a lake for nations of similar cultural leanings. This makes trade between the continents so common that we take it for granted.
In a world without NATO, the Atlantic becomes a battleground again. Or, at least, some nations will not be able to trade. I imagine the Germans would feel the need to have a large navy again... Do we remember the lessons of 1914? Or is it too long in the past!
This is my sig.
FTFA: "Those who choose not to abide by the law will be subject to penalty."
1. I tell state to fuck off and do not buy health insurance
2. State issues fone for non-compliance
3. I tell state to fuck off and do not pay fine
4. State puts me in prison for not paying fine
5. State provides my health care while in prison
6. Profit!
Otional scenario:
4. State seizes my home and assets to recoup fine
5. I am now below poverty level and qualify for free health care
6. Profit!
Ignorance is curable, stupid is forever.
Are you suggesting that having a single payer (the government) is a good way to remove inefficent bureaucracy? The larger the entity the larger and more inefficient the bureaucracy, and there is no larger entity than the US government. Some of your arguments above are quite valid, but this one actually works against you.
In the case of medicine, you're totally wrong. Medicare, the US state system, has admin and other overhead costs that come to 1 percent. In the case of private health insurance that figure is dwarfed: admin and other overheads (including profits, of course) can be as much as 30 percent.
Imagine a $10,000 operation. On Medicare, the cost (to the system that foots the bill) of the admin, etc would come to about $101 ($10,000 x (100/99)). With a private health insurer, that same op would have admin and other costs of as much as $4,285 on top of the original $10,000.
Which seems like a better deal to you? Paying into a big pot and having $10,101 come out of it to pay for an op or paying into a different pot and, assuming that the people looking after the pot say that you can have your op, having $14,285 come out of that pot for the same procedure?
Given the same amount of money, do you want to guess which pot will be able to treat more patients and save more lives?
Medicare is very efficient. The only people who'll try to tell you otherwise are people with a vested interest (most usually of the folding green, cha-ching kind) in maintaining the status quo.
"Accept that some days you are the pigeon, and some days you are the statue." - David Brent, Wernham Hogg
A majority of hospitals (and all teaching hospitals I believe) in France are public; but there is a non-trivial ratio of private hospitals.
Most of said private hospitals charge based on an agreement with the public health insurance; some do not, but don't get to have their cost reimbursed by it.
IMHO our medical industry is in fine condition. We have the best state of the art medical equipment, better doctors, research and development and more access points to them than most countries in the world. What mucks it all up is the greedy, exploitive, inflationary, predatory, over-complicated concept of insurance...An industry that does not produce one damn physical product. Take insurance out of the equation and it would be easy to repair any damage already done by this type of out of control avarice. One should be able to see how this is true of anything that exists in the current American system of "business as usual". If I am a contractor I am mandated by law to possess all kinds of insurance, too numerous to list them all, from liability to workman's comp and not to mention an insurance rider on any piece of equipment or tool (human or non-human) I may need to run an effective business. In order for me to pay for all this, as I see unnecessary crap, I have to pay my employees less and charge my customers more to try and eek out a living. Why should I pay a good percentage of my income to some jerk sitting at a desk somewhere pushing a pencil in a high-rise building surrounded by the trappings of wealth to not produce one damn viable product but manages through a ridiculous game of chance to grab the entire economy by the balls ?. You will find this ludicrous and inflationary trend in any and all business and private arena's. My jaw dropped when auto insurance was made mandatory by penalty of law. The fact that there are millions of people out there that in their wildest dreams simply cannot afford it just seems to whoosh over people's heads. What are they supposed to do with the paltry wage that most employers pay their minions ?. Live in a box , don't eat, but pay that insurance extortion.
I was trying to think of something that has not been approached as insurable by these predators and the only thing I could think of that insurance has not exploited YET (insert drum roll)... is a Fart. Of course I am sure that if, some representative of this heavily marketed seemingly so necessary non-product producing industry reads this, they are probably thinking about having Britney Spears or Paris Hilton fart in a bottle and cap it so they can insure it for a million bucks. Our health care is fine folks, the problem is all the greedy government lobbied and sanctioned profiteering hands holding the door closed between the people and their health care. Imagine a world where one simply pays for whatever product or service that is offered. It's a slippery slope and Massachusetts has one foot on the downhill with the insurance industries lobbies hands on their back.
Most medical expenses come late in life. Those people do not continue contributing to the economy if they recover, they continue burdening the economy.
Contribute to civilization: ari.aynrand.org/donate
Free market economies work best when prices are elastic; that is, where changes in price affect the demand for the product. This allows price to signal the level of available supply and prevent shortages of goods. The problem with healthcare is that it is not elastic. If I have cancer, a broken leg or some other ailment I have to get it fixed - regardless of the cost.
There is a valid point in this area, but it's not the one you think.
Note that you could say the same thing about food, among many other basic needs. If you're hungry, you have to get food, regardless of the cost. Yet, we can buy cheap food in a very competitive market.
The price signals for food works just like you describe, despite it being a even more desperately needed good than health care.
Price signals for food are loud and clear. Ads proclaiming the low prices of all kinds of suppliers are everywhere. For health care, there is almost complete silence. If you can figure out why that is, you have solved this puzzle.
This would be a better post if I had a complete answer to that, but I don't.
I believe one factor is that it's actually illegal for medical providers to advertise their prices. Another is that the insurance system hides many of the costs, while randomly passing through some. And there are similar but smaller problems in car repairs, for reasons I don't fully understand.
DIGG SUCKS!!!!! Stop trying to become it. Two completely non-nerd non-tech stories in two days.. Things are not looking good here for the future of slashdot. If I want a discussion on the politics of health I will go someplace that discusses that. And for the people going to respond "Don't read it" Digg is our warning. See what happened over there when they started letting these sorts of discussions. For a community forum to remain a place for intelligent dialog it need to remained focused. If we've learned anything from the web, it's that.
Man
you guys have it tough! The problem to me seems to be that Americans are wedded to 'freedom'. I'm quoting the word on purpose. In many ways I am more free in the Netherlands (can smoke dope, can afford healthcare, will have at least 25 days of vacation a year etc...). But... I pay more taxes, on pretty much everything. The state decides; if I don't pay, I go to jail. I have no choice not to insure my health; i'm not free!
You in America are more free in that respect. Unfortunately, you are also f***ed over by pretty much every large company that's out there, be it Wallmart, Microsoft, big Pharma, you name it. But you are 'free' not to be their customer. Yeah right! You have to eat, you have to have healthcare etc....
The word freedom is the red flag for the American bull. Any time anyone (typically Democrat) suggests anything that might actually improve the living of the Americans (healthcare, labor laws), all any Republican has to do is spout some crap about loosing "freedom", and everyone backs off; oh dear, don't want to lose my "freedom".
A more rational approach would help the U.S. people a lot. It used to be that the U.S. was the shining example for the world, but that definitely has passed.
Good luck
Bart
I personally think that the Massacheussets law is a step in the right direction. I am not inherently opposed to socialized health care, but I do not believe that it is the right choice in the US. In fact, both parties here have a history of attacking doctors and health care providers using extremely unfair tactics in order to save medicare money. I do not want to see this practice escalate because the government is the only show in town insurance-wise (right now they are limited by the fact that doctors can refuse to take government-insured patients when the government starts being overly hostile towards health care providers).
I personally do not think that the role of the US government, or those of its member States, should be to insure people's assets against medical expenses simply because they have proven that they are incapable of acting honorably towards doctors. In particular I have detailed knowledge of:
1) Reagan Administration (Republican) attempts to politicize and criminalize minor billing errors (most of which did *not* result in additional fees being paid by Medicare or Medicaid). In essence the opinion of DHHS under Reagan was that any mistake relating to billing codes relating to Medicare or Medicaid cases was a criminal offence regardless of any harm caused to Medicare or Medicaid. During this time, many physicians refused to take Medicaid cases because of the risk of prosecution for an innocent clerical error.
2) Gov. Locke's (Democrat, Washington State) attemts to "fight fraud" among Medicaid billing by holding doctors legally accountable for the "crime" of charging more than median amounts regardless of whether there was any evidence of wrongdoing or not.
In short, what Australia decides to do is their business, but my government is not to be trusted in this area.
My own view is that I would like to see inexpensive preventative care plans offered by state governments to those without other insurance. The goal is not to provide "health insurance" but rather to get the uninsured in to preventative care so that the overall costs of treatment can be reduced and the rest of us get stuck with a smaller bill. In short, this provides no asset protection (anyone who does not want to have to declare bankrupcy if running up medical bills still needs to buy insurance, but at least this way those bills are less). This would provide universal preventative coverage.
Note that the Massacheussets law does *not* provide universal coverage in any sense because it has a large number of loop holes that may exclude a surprising number of individuals and businessesT. For example, those who cannot afford coverage are exempted from the law, and employers with less than ten employees are still not required to offer health insurance. In short the individuals who are most at risk to running up very high medical expenses and then leaving them to the rest of us are unlikely to be covered under any sort of cost control measures under this legislation.
Perhaps both approaches (mandating that those who can purchase health insurance do, and providing preventative care plans to those who cannot) would be best.
LedgerSMB: Open source Accounting/ERP
You can get affordable health insurance - with the ability to go to ANY doctor - if you look for it. Too many in society just expect it to handed to them, or refuse to actually do some basic research. In my case, it meant calling an insurance broker out of the Yellow Pages, and talking for 5 minutes.
Affordable health insurance is available if you just look for it. Given that - worst case, after maximum deductibles - I'm responsible for $3500/year. About half the UK average. And I don't have to wait to see a doctor, don't have to deal with queues, get to choose - and stick with - my doctor, and have a very affordable copay.
My last contract gig offered health insurance; I was shocked how many of my fellow contractors took it! By turning down the insurance, I was able to negotiate for an extra $4/hour, which means that AFTER I paid for my own health insurance, I'm still up $550/month in income...
Browsing at +1 - no ACs, I ignore their posts. So refreshing!
I hope they do realize that the Government isn't just going to print this money and give it to them. I also hope people are not so stupid to realize that this is their money, at least those who work; with a nice cut for the government employees taken out of it.
So in short they are using taxes to fund yet another socialist type of program. Lord knows the government runs so many other programs well... let me think... there is... well I am sure they will get one right someday...
The more I learn about science, the more my faith in God increases.
It is not as easy to get into college as it used to be. Where exactly are you going to get an education for $30,000 (unless you stay with your parents and pay instate tuition)? A two year degree is worthless. A four year degree might allow you to make about $35,000 to $48,000. It only goes up slightly for a Masters degree at $66,000 and a PhD top out at a little less than $100,000. Again, based on the $30k quote I am assuming you are talking either about the Midwest or down South. Out West or East a good university will eat that money in about a year or so. If you want to really have a shot at a large income you need a professional degree (MBA, JD or MD). This is a very costly degree at around $40,000 a year. An example would be getting a JD at three years, just going to school is going to cost you $120,000 (no living expenses). Don't even get me started on med school.
Just one data point from a Massachusetts resident. A neighbor who is an oncologist and experienced observer of the scene said one of the main impetus for the Massachusetts plan is the reduced number of very wealthy individuals from Saudi Arabia who since 9/11 no longer come with their cash to the Boston area for top-flight medical care: they are more likely to go to Germany or Switzerland now. These were the people that were replenishing (indirectly) the free care pool which has been dramatically drying up over the last few years. For many decades this was a generous and essential ingredient of the health care environment here. It sounds odd, but this is one of those backstories you would only hear from someone in the arena, and certainly not from the media.
"Those who fall below the federal poverty line may be eligible for health care at no cost."
And those who don't will fall below the federal poverty line after securing health care!
The race isn't always to the swift... but that's the way to bet!
... see the movie Sicko.
The parent comment, and others, minimize the issue. The issue is fraud by the medical profession. The medical system in the U.S. is broken.
Okay, this is an exaggeration to try to be funny: If you open your window on a quiet night, you can hear the crying of hundreds of people. Film studio executives in Hollywood are crying because they have to spend $20 million to market a movie that cost $20 million to film, but Michael Moore is invited to sell his movie Sicko from the podium in the U.S. federal government's House of Representatives, and the New York Times publishes a photograph, shown in the NYT article For Filmmaker,`Sicko' Is a Jumping-Off Point for Health Care Change. Quote from the article: "Even the haters agree this film is genius!"
When I last checked Fandango.com, there were 1651 "must see" ratings, 115 "go" ratings, and only 62 lower ratings. Sicko is the highest rated movie ever, apparently.
Complaining about Michael Moore is evidence of ignorance. He does the best he can. Do not demand that your evidence be sugar-coated and delivered on a silver plate. Get it where you can, and cross-check it carefully, or know you are purposely avoiding being part of the solution to the problems.
For those whose real purpose is having a way to act out their anger, while hiding it from themselves, get help. Work on resolving your anger, rather than listening to anger sellers like Rush Limbaugh.
One last thing: If you had educated yourself about what the U.S. government is doing and has done, you would have known that Michael Moore's movie Fahrenheit 451, while faulty in presentation, was entirely based on fact. For example, George W. Bush really does hold hands in an affectionate way with Saudis who control the Saudi government. Osama bin Laden's major complaint was that the U.S. government was supporting a Saudi government he thinks should be replaced. I'm against violence from any source, but certainly a Saudi citizen like bin Laden has a right to object to a regime in his own country that many Saudis say is repressive.
Insurance is something you buy in advance, in case you need it because of a car wreck, house fire, sickness, etc.
...then why on earth would you expect a health insurance company to write a new policy that will pay for your pre-existing condition?
If you're already sick, or if you're already pregnant, then you don't need insurance. What you "need" is for someone else to pay your bills.
Every time I hear someone say "I couldn't get insurance because of a preexisting condition" I mentally translate it to: "I couldn't find an insurance company dumb enough to pay for the ailment I already have."
Insurance companies manage risk. It's what they do. Why would they intentionally take on a 100% risk (an already sick person)?
Would you call Geico from the scene of your car wreck and demand a new policy that covers your smashed up car?
Would you call Allstate from outside your burning house and demand a new homeowner's policy with coverage for the current fire?
"All of this cost me nothing ( except 3 weeks paid holiday from work )"
If i had to take 3 weeks off because of an injury I would lose my job. No doubt about it, and then i would of course lose my insurance & go broke over unpaid bills.
When im sick, i still go to work, injured? work (maybe light duty) Holidays? work (have to go in an hour) I doubt ive had 3 weeks paid vacation in my lifetime.
Ive got to get out of this fucking joke of a country. Happy fourth of july!
I lived in Mass during the debate and launch of this program and it was/is a joke.
While unemployed between jobs, as a healthy 30something non-smoking, no medical issues, male, I would have had to pay $350-400 per month as an individual for a plan without even basic prescription coverage. There is no competition in Mass since it is so highly regulated. There is an undeclared oligopoly on health plans of basically 3 groups = Harvard-Pilgrim/Partners, BlueCross/BlueShield, and Tufts that cover the non-poor. There are a few low-income plans, but very few and very limited (no assets, low income, etc.).
When I lost my job, the COBRA was $478 for an individual - I cannot even imagine what it woulda been for family. Who can afford that? If you go to eHealthinsurance.com you can find plans in neighboring New Hampshire for $100-150 per month with prescription coverage, catastrophic coverage and good deductibles. I used to live in California and paid $85/month for UCSF plan with full coverage. Clearly Mass's cost base is outrageous and out-of-control. So when I moved to Texas, I get excellent coverage, but for only $117 per month, I feel $100-150 per month with max $5,000 out-of-pocket per annum is very reasonable with prescription/procedure/visit copays.
The really sad thing is that the head of the Mass Program was the CEO of Tufts Health (at least when I left) and the committee tasked with figuring out what 'reasonable' premiums are were settling for $300 per month for healthy individual. And they were busy patting themselves on the back. How is that reasonable? Women are even worse off! They have way more visits (gyne stuff) than men do and their rates are higher - not to mention fear od detailing mother/sister/aunt with breast cancer.
Anyway, the point is much of the comments are correct in that:
- demand is inelastic (treatment or death?)
- UKs NHS doesnt pay doctors enough (fine with me, i dont want a doc who was in it for the money aka boob-jobber)
- nationalized health care that is simply a mandate for consumers to buy for-profit insurance (like Mass) does NOTHING to keep costs under control and actually reduces what little demand elasticity there is and offering 'tax credits' to offset the poor doesnt help the low-income person make the monthly premiums until April of the next year. (especially since the costs of policing the system will offset potential savings and will be paid through increased taxes anyway)
- a better plan is a personal insurance mandate coupled with companies' requirement to offer the health care coverage cash directly to employee and then there will be true price competition among insurers for individual plans.
- the best plan is to levee a 1.5% income tax (1.5% matching from employers with no cap like FICA) and expand Medicaid to cover all. I think employers would be Phase it in by age group over time like 60+ and 20 then 50+ and 30 then everyone - by mixing healthy and unhealthy offsets risk. Also 60+s earn heaps of money so income tax will fill coffers as young are usually very healthy. This would remove the burden from employers thus increase the purchasing power by grouping everyone together and make all of the budgets/expenditures of federal agency 100%/immediately transparent.
- sadly America's expanding obesity problem will make any solution fall apart rather quickly, unless the government was smart enough to impose a fat/smokers 'unhealth' tax. If you weigh too much for your height (with physician exception for heavily muscled people) then you must, rightly, pay a higher percentage of income since you will be a disproportionate burden through your own unhealthy choices. And even better, reduce the tax rate if you are healthy. This would be certified by physician at annually required checkup - invasive you say? corrupt you say? Well, multiple States have mandatory, annual auto inspections and economic studies have shown the benefits greatly outweigh the costs. Are we willing to submit to mandatory auto inspections
I said that health insurance was pretty heavily regulated. You think I said that health care was pretty heavily regulated.
There is a substantial difference. Sorry, you should slow down when you read, I think.
Basically, if a doctor thinks that an insurance provider is denying required treatment, the proper avenue to get this resolved is to fax the state insurance regulatory body and cc the insurance provider. This gets issues resolved really fast and for fairly obvious reasons.
LedgerSMB: Open source Accounting/ERP
Not just factually dubious, factually bullshit.
It is so interesting hearing conservative whack jobs talk about the bottom line as the ultimate measure of success in an endeavor. Then have them develop selective hearing loss when the bottom line is revealed for a social justice policy like universal health insurance. For example, average life expectancy at birth in the UK is 78.7, in the US its 78. Average spending on health care in the US as a percentage of GDP is 15% in the UK its 9.4%. (And remember for that 15% we don't cover about 15% of the population, while the UK covers 100%.)
So either the British are significantly healthier than us, it is cheaper to provide inexpensive preventative care for all in the long run, or there is a large sucking sound that is coming from the health insurance industry and Pharma taking about 30% off the top of what we spend.
I will tell you the only two thing that is keeping my partner and I from immigrating to Canada is the fact that it would be hard(er) to take his parents with us and I hate cold weather. With global warming and time, Canada looks a whole lot better. And this is a sentiment that I have heard from a lot of my colleagues. Few physicians want to work in a system where 15% of people are uninsured, where people die for lack of simple basic preventative care, where in order to write your patient an rx for an antibiotic, you have to check one of a thousand formularies to determine which they will pay for. For a group of people who, when they started medical school were largely idealistic and wanted to help people, this is a soul-crushing system. However our kids, parents, whatever obligation prevents us from moving. But leave it for a few years, and you may find that the trend of Canadian Physicians emigrating to the US, which slowed and then halted in 2004, may reverse course with US physicians emigrating to Canada.
Nick
Or does it drive up the price because health insurers can then charge the "corporate rate" instead of rates individuals could afford?
It isn't the governments job to keep us healthy, it is our own responsibility. If the government hadn't messed with healthcare at all, and left it to the individual, it would not be broken. State sponsored healthcare is 100% socialism.
but bad for people. Massachusetts law isn't "socialized medicine" it is corporate welfare for the insurance companies. Support single payer universal health care legislation such as California SB840 and/or the bill in congress HR676.
I may not be a smart man, but I know what an inode is.
* The US healthcare system is not free market, so much as fascistic. It's a rat's nest of politicized regulation and taxes, costing $169 billion annually.
* Swiss healthcare features both universal care and private providers. It provides a means-tested entitlement to those who can't afford care, while allowing those who can afford it to choose competing private insurers. It does require everyone to have health insurance [*], but under this system, such a requirement works.
[*] This does offend my libertarian sensibilities, but I think it's utterly irresponsible for an individual to not have health insurance and force people to give them emergency care, lest they die in the streets.
$50/month??? Where the fuck do you live that health insurance costs $50/month?
General Relativity: Space-time tells matter where to go; Matter tells space-time what shape to be.
If could open a non-profit healthcare company, this is how it would be. It would be based upon the thesis that people who strive to be healthy would tend to wind up being so, and that active health maintenance reduces the overall cost of heatlhcare.
There would be no group plan, just a flat rate for all.
Twice yearly checkups are not merely free, they are mandatory.
Doctors would be able to prescribe smoking cessation, draft exercise regimes and general health maintenance counsiling.
Covering all right off the bat in this country would not be possible. This company would only be open to minors initially and those without pre-existing conditions. That policy would continue until the company has enough capitol to insure everyone else.
In that case, you're translating it wrong. You don't need to be a 100% risk to be undesirable - being a 6% risk when 2.5% is the average is enough. Not every preexisting condition needs treatment.
Something like half of incomce taxes go to crazy military spending. Is it not perverse that billions of dollars can go into bombing Iraq, but to spend that on saving lives and livelihoods is somehow wrong??
Suddenly, insurance companies would have to compete because they know that it is easy for clients who are sick of paying insane premiums while getting denied service will bolt no matter how many boob jobs they approve.
My company pays about $900/month to insure myself and my wife. We could be similarly insured for about $250/month in the private market, since we're young and healthy.
The problem is, since we're young and healthy, it costs far less to provide us with healthcare than the people I work with who are, say, 45 years old. So what happens when you let people just take the money instead of the insurance? People like me leave the employer insurance pool and get private insurance, and then the company ends up spending $1600/month to insure the people who are left. Except now at $1600/month, even more people would pay less with private insurance, so now THEY leavue the employer pool, and you're left with a company that is now paying $5,000 a month for the diabetics and others with chronic diseases and the rest of us are all on private insurance.
Of course, this doesn't really happen. Because once isnrance starts costing $1,600, $5,000 month, and the company is BOTH paying that for the people who actually take the insurance, and giving it ot the people who don't take the insurance, the company just decides to stop offering insurance at all. Now nobody is insured.
Employer-provided health insurance works the way it does because it's the only way it can work.
paintball
It's not a good system, but everything else is worse.
That was the most succinct way to express this whole thing. Health care is extremely inelastic, and normal cost-benefit analysis goes out the window. Capitalism and profit motive is great for the economy (generation of wealth), but it simply doesn't work for Healthcare. Bravo!
In Soviet Russia, articles before post read *you*!
The factor that'll destroy America will not be terrorists, Al-Qaida, or illegal aliens, but this. See you waiting in long queues, filling tons of forms, and small businesses going bancrupt. In 50 years time, we will see the most valuable Americans emigrating to other countries. And this'll be the end of this democracy, by no means the longest lasting. Cheerio.
Wait, what? I suggest you go and study the economics of money in a lot more detail before you go around blaming our reasonably low inflation rate for all our problems. It's much, much more complicated than that - most of the things that seems obvious about monetary policy become much less obvious as you get more details on how the system actually works.
-- The act of censorship is always worse than whatever is being censored. Always.
Yes there is still paperwork obviously, but there is a lot less.
I'm British, so the NHS 'looks after' me. I'm sure there is some paper being shuffled around in the background, but less of it (nobody is running behind me totting up the bill).
Erm I've got no problem using generics, you want an aspirin, or some fancy ass branded-aspirin? If you mean cheaper drugs, then that is an issue. Drugs have to prove their clinical worth before being available - so some new/expensive/unproven drugs are not available and people want them. This is no different to the situation you'd have trying to get your insurance to pay for the same drug. NHS has started a new scheme to help out with this though, they will become available, but will only be paid for if there is a clinical response (which seems quite reasonable).
Government doesn't mandate salary, it offers one - you want to be an NHS nurse or doctor, you can take it - fail to see how this differs from any other job.
Finally your last point. Surely to take that to it's conclusion, then surely you should have a private fire service and police. "Help I'm being attacked?" 'Are you insured with us?'
Surely the point is there are services that everybody needs and improve society as a whole. I don't want my neighours house to burn down next to mine and I don't want him coughing TB about. Put his house fire out, stop him being infectious and even from a purely selfish point of view it makes my life better.
I can't believe you got trolled.
The law says that no one can be denied coverage. Even for pre existing conditions. Now we know the insurance companies will charge SOMEONE a higher rate. What's your tax rate in MA now? Double that in say 5 years. Then again after 3 more years.
One of the things I remember (and this was in 1992!) was a woman who was wired up for surgery on a brain tumor, but they canceled it at the last minute because her insurance had run out. She had to go home to die. I've been thinking lately that insurance premiums (and the related lawyers fees) are two of the things that are driving basic costs out of control for everyone. How many people work now as contractors so they're nominal "employer" won't have to pay insurance costs?
I'll be 40 next year, and doubt I'll ever own a house of my own, and I dread the prospect of having a heart attack or otherwise becoming ill and ending up in the bankruptcy/insurance company nightmare of modern healthcare. Insurance company's goals are to reduce costs above all else, not to provide the service you're paying for. After all, it's a perfect scam, take in $x amount of money every month, pay out as few people as possible, and profit, profit, profit!!!
The doctors are against a state system because they won't make as much $, and we know what the insurance companies think. OTOH, if I'm reading this Massachusetts bill correctly, it sounds like a bone headed move to make everyone pay and contribute to a broken system rather than fix the damn system itself.
I think a better system would be to do away with insurance altogether--yes, NO INSURANCE! Eliminate the concept completely. Make universal healthcare something we pay for out of our taxes, instead of funding the endless Democrat/Republican love fest. You see a doctor, you get medicine--fancy that! Costs are limited rather than charging whatever your group policy will bear. The only things you would pay for would be purely optional surgery like tummy tucks and nose jobs. As it is I'd get better and cheaper care dressing up in a fur suit and going to see my veterinarian.
Of course nothing is perfect--many people are against smoking today, but what about soft drinks and cheeseburgers? Do you want the state telling you everything you should or should not do to keep you healthy? What about extreme sports?
But not much can be worse than the system we have, where something like 25% of the money is spent keeping track of the expenses, and every thing can and is charged, so in the process of breaking down each bill to the smallest element for the insurance companies the overhead to run it all results in aspirin pills that cost $4.
In a society where medicine is so expensive people don't take their doses because they can't afford it, or mothers stay in maternity wards sometimes as little as 12 hours, the hospital rolling out red carpet treatment because it's for profit now and you want to keep more customers, and the insurance companies saying spend as little as possible, something is VERY wrong. Now if you excuse me I'll go ride my bicycle to stay healthy and save gas and all that crap.
Well with those numbers, it would be hard. Fortunately, I know many people who do not have degrees and make much more than that. Hell, my brother drives truck (intra-state) and makes 35.
This point is the blind leading the sightless. The whole problem with socialized medicine is the childish entitlement mentality. What are you guys doing running around making sure everyone is getting their fair share?
While our health care system is, indeed, broken, it is less broken than most other health care systems, including and especially Britain and Canada's. This kind of question is not really an important question -- it is not why most of the opponents oppose socialized medicine.
I don't know who you are -- you could be an economist for all I know. Perhaps you are a leading expert on health care economics. But, this little analysis of yours is absurd, and you really don't know anything about what you are talking about. If what you are saying is true, then no prices for anything would be elastic. When the clutch goes out on your car, you need a mechanic to fix it. That doesn't make the market for such services inelastic. Some people fix it themselves, but the vast majority of us do not. Similarly, when one dislocates their shoulder, some people will fix it themselves, but the vast majority of us will not. Some people with terminal cancer just decide it's their time to go or resort to their own "treatments", but most of us get professional help. When someone has problem with the plumbing in their house, they usually get a plumber, but some people don't. The fact that people seek out services or have a need for services doesn't make the price for those services inelastic.
What makes the price for a given service inelastic isn't the fact that almost anyone will get that service from someone if they need it, but rather if they don't have a choice of providers to get that service from. And, that is precisely what would be the case with socialized medicine. And, that is also part of what is wrong with American health care. It is not caused by the need for services but by intervention to prevent a competitive market for providing those services. This happens, for instance, by way of the fact that it is illegal to get prescription drugs except by way of authorization from certain professionals, the fact that it is illegal to get certain medications by any means, the fact that it is illegal for people to perform services unless they are licensed to do so, and so on. At any rate, the price for medical care is every bit as intrinsically inelastic as mechanical work on your car is. In other words, it's not.
Furthermore, another thing that is wrong with American health care is the fact that we get way more services than we need. And, that is also what is really wrong with your analysis -- this idea or attitude that a little health care always makes things better. You gain nothing from superfluous services. If you tear your ACL, you will quite frequently get an unnecessary x ray "just in case" you might have broken something. Right now,
Actually, folks over 65 in the US already do have single-payer insurance - Medicare. Turns out that once Americans make it to 65, their medical outcomes become similar to the rest of the industrialized world, presumably because their health care system starts to look like that in the rest of the industrialized world.
2 years at a community college doesn't break the bank, and doesn't really hurt a transcript. 2 more years at any decent University(yes, public universities in the Midwest get to count as decent) is only going to be ~$15,000 a year). If everybody went to Harvard, it wouldn't be.
Way more engineers than you would ever believe make way more than $60,000 a year with nothing more than a bachelors. There are also plenty of non college edumacated small business owners who are creaming your PhD number.
Of course, all of that would take hard work for someone who had to find a way to pay for it themselves, but that never stopped anybody willing to work hard.
Nerd rage is the funniest rage.
Honestly, how come, *EVERY TIME* there's a clearance sale on state legislators, I miss it? Hmmm? Is there a special list I have to be on? What's the deal here?
1 in 4 Maine children in struggle with hunger.
All we, the US, has to do is allow special visa's for foreign doctors to immigrate with the stipulation that they work in some sort of affordable health care for 5 years. I know, it needs a lot of fleshing out. The point is that the real problem in health care today is the utter lack of competition. The health care industry in America has managed to free itself from free market economics and we already HAVE defacto socialized health care, it's just run by industry instead of government and happens to exempt all those pesky poor people.
1 in 4 Maine children in struggle with hunger.
That's my point, but we have to tear that system down one piece at a time.
Right now we need to prove that health insurance companies, when allowed free reign in places like Massachusetts, will bring ruin to a state. Next we need to prove that health insurance companies bring ruin, period.
Baby steps and all.
--- Grow a pair, liberals... stop letting the Republicans bully you!
Also, Insurance is subsidized for most of the state's population. People living below the federal poverty line got it FREE and it's still heavily subsidized for others until they reach THREE TIMES the federal poverty income (about $62,000 for a family of four in MA).
What this DOESN'T get rid of is deductibles and co-pays. Those can be THOUSANDS of dollars for the simplest thing. However, it IS a step in the right direction-and if they had required this LAST year, I and my family would have probably not been homeless in Massachusetts this past year.Why should my federal taxes help out a state try and institute socialized medicine? Do this on the state's dime, not mine!!!
Healthcare is expensive in this country because of regulation of the marketplace. If the government didn't have such a high cost of doing business imposed upon the healthcare market, we might see lower prices. Also not to mention that the FDA is absolutely unconstitutional. Also the government is the worst organization to handle anything because governments are always the least efficient organizations.
But the idea of national healthcare comes down to property. Why should I give up my property that I earned to someone else who hasn't earned it? Shouldn't I have a choice of whether or not to be charitable? Besides if if my donations are at the threat of jail time then it really isn't charity. Real charity comes from the heart and can't be forced; otherwise it's outright theft.
Libertas in infinitum
I have familiarity with this, because my wife has an expensive and lifelong pre-existing condition.
The bottom line is, if you've had health coverage for 12 months or more, there is no such thing as a pre-existing condition in the US. An insurer for an individual policy and accept or reject you based on your pre-existing condition, he can charge you a higher rate based on your pre-existing condition, but he cannot accept you but refuse to cover whatever your pre-existing condition is.
Furthermore, if you are joining a group plan (any plan offered by your employer is going to be a group plan) there is also no such thing as a pre-existing condition. The plan must take you, you only pay the group rate, and they must cover your condition, assuming that the plan normally covers that condition.
The above has been the case since 1996. Your experience may vary if it was pre-HIPAA. Some assembly required. Batteries not included. I am not a lawyer.
"Avoid employing unlucky people - throw half of the pile of CVs in the bin without reading them." -- David Brent
Hmmm.
What about the incredibly huge waiting lists for treatment?
What about the huge waiting lists to get on a waiting list?
What about the thousands of Brits who cannot see a dentist?
What about the horror stories I've heard about filthy NHS hospitals and the rampant rate of infections?
What about people who can afford to going for private care rather than chancing their lives on the NHS?
What about those blogs by doctors in the NHS system who aren't as enthusiastic about the NHS as you are?
Canada has socialized healthcare as well. Have you watched Dead Meat?
Isn't it true that the NHS avoids a lot of expense by simply eliminating whole classes of new drugs and limiting patients to the most inexpensive drugs regardless of how the side effects impacts the patient?
Isn't it true that the NHS tries to limits costs by requiring doctors to only work a set number of hours, including specialists?
Isn't it true that if you need a heart operation and the only available heart doctor has already maxed out his allowed work hours that you're totally fucked?
*shrug* socialized medicine sounds great until you realize that there is still the need to pay for it. Then you inevitably must make the choice between increasing the amounts paid or limiting the treatments allowed.
I never said people would be denied coverage. I said the premiums would go right through the roof. Do not lecture me on knowing what I'm talking about when it is clear as the cloudless day that you mis-read what I wrote.
Either that or if there are caps on premiums, there'll be hell to pay for the insurance companies themselves, at least in the minds of their shareholders.
--- Grow a pair, liberals... stop letting the Republicans bully you!
Some of the health care reforms and HMO take-over in the 90s drastically lowered Doctor incomes. They had to change how they practice medicine, and start ordering extra tests to keep their incomes up, etc. This caused a temporary savings in spending as they ratcheted down reimbursements, and then an increase as they over treated... basically, the doctors had become accustomed to a lifestyle and kept supporting it.
However, the newer, younger doctors, were unable to start practices as easily in the 80s, as it became difficult to get on the HMO lists, etc. More of them work for the older doctors for lower pay, more work at hospitals, coops, clinics, etc. Doctors make less money.
But, you won't see the effects for decades... you SEE it in Canada and Britain, whose single payer systems are starting to suffer, badly. The best and brightest don't go into medicine, or leave for the US, you're importing your Doctors.
Why don't you see it for decades? Let's look at the status quo...
Imagine you're a 45 year old specialist, making great money, $500k/year. You're living on $400k, putting away $100k, and planning to retire in 5 years at age 50. Now, your income is cut by the HMOs by 20%, you're now making $400k, living on $400k. You now have to wait for your older investments to fund retirement, so you wait until 60. Nobody is going to shed a tear for this guy, but the income cut kept him in practice an extra 10 years, so you see an increase in doctors.
Now, shouldn't less income mean you work less, or find other work, it depends. If you're a 21 year old biology major junior, you might decide that instead of spending 4 years in medical school and 6 years in residency, you'll spend 3 years in law school, expecting to make more money. Sure SOME Doctors make half a million, but lots "get by" at $100k-$200k... sure that's a lot of money, but remember that they have an extra $200k in education, plus 6 years as a resident to specialize in elite specialties. So at age 32 they are making $100k+, but all their friends that went to law school are making $100k+, and have been working for 7 years, own a house, etc.
Another scenario, you're 31, in your 5th year as a resident for your specialty, and the HMOs start chopping pay. Now, if you could go back at 22, you might decide to go to law school and be on your way at 25, but if you switch to law school now, you'll be 34 when you finish, competing with 25 year olds. You do your 6th year and suck it up and bear.
When pay cut, the older doctors stayed on longer, so we saw no shortage. The people in the residency track trucked on, because the "wasted time" is a sunk cost... Those in their 1st year saw the changes, and cut their losses and went into family practice. Others in med school found specialties that didn't take 6 years before you earned a living.
Basically, for a good 10 years after the HMO crack-down, we had a surge in doctors, as retirements got delayed. We also kept all our doctors in the pipeline because their next best alternative sucked. A 4th or 5th year resident was better off spending 2-3 more years to complete their specialty than they were switching to a new option...
However, in another 10 years, we're going to see the consequences of cutting doctor pay... we'll have more intelligent lawyers, and less intelligent doctors. We'll import doctors because American doctors are still better paid than British or Canadian doctors, and they'll import doctors from India who speak fluent English and find the British/Canadian doctors paid better. However, this model isn't sustainable.
If you compare most doctors in their 30s with those in their 50s, really talk to them, the former are NOT as intelligent as the latter. We have a decade or two of doctors that aren't that bright (the brightest got a JD), and we're going to lose our elite older doctors to retirement.
I'm really excited to see if the Massachusetts experiment works. Each state needs to tailor theirs differently, New York with its
What keeps prices high is government intrusion on the free market. I have chronic bronchitis, meaning it comes around about once a year. The same medication always fixes it, yet every time I come down with bronchitis, I have to go to the doctor (which can vary depending if I'm at school or not), pay them whatever ridiculous fee to get the first medication that doesn't work, come back again to get the second medication that doesn't work, and then finally get the same fucking medication I always get that always works.
Canadian health care doesn't work very well, but it works somewhat ok because it largely benefits from America's (somewhat) capitalist health industry. Foreigners scoff at our system yet consume our medication.
Everyone is rejoicing that the state of Massachusetts is FORCING you to get health insurance? Is this a joke? What fucking right do you have to tell me I have to pay for health insurance? What's next, forcing me to eat right and get daily exercise? Outlaw any dangerous activity, like physical sports? How about making it illegal to live in a city that's below sea level? All of this will come with national health coverage.
I don't live in the socialist republic of Massachusetts and what the tax payers their decide to do with their money is frankly their business. If they want to create their own little national health care system in Massachusetts more power to them, as long as they are not violating the constitution or laws set forth by the federal government (of which their are way too many) then frankly the only people who's business this is, is the citizens of Massachusetts.
This is the beauty of the state system in this country, don't like the way a state is doing things? I would not have a problem with a state health care system if it could meet a few requirements.
1. I could opt out of this system, I would not pay the taxes for it, but I would not be allowed to use those services.
2. The system was self supporting, i.e. the system would not be allowed to take from the general fund to pay its expenses, it would have to pay for itself out of the State Health care taxes.
I have experienced government health care and would not wish it on anyone, but if a person wants to be part of that system, more power to them, just don't force me use it and pay for it.
I read most of the replies, including those about non-US public health insurance systems. Here is how it is working in France (sorry for my english). Please remind there are 63 million people in France when reading the following).
Our public health insurance, named Sécurité sociale, was created as such after WW2 (but it really began around 1890). It is a public monopoly, distinct from the State and the Government, entirely funded wy insured people. Its funds are mainly provided by workers and bosses from taxes on wages (general regime). Other regimes are funded by students (free for grant holders), independent workers, farmers, etc.
Sécurité sociale is divided in two parts : public pension fund, and health insurance. I'll just talk about the second (although their situations are the same), with the perspective of the average insured person.
You must have a family doctor (named médecin traitant). It will tell you to go a specialist (for all the specialities but eyes, teeth and gynecology). You'll be partly refunded (about 70% minus 1 euro) only if you consult your family doctor first AND this family doctor is a health service doctor (fare 1). Your prescribed drugs will be partly refunded (from 45% to 75%) by the Assurance maladie (public health service).
Most people (from upper lower-classes) do have a complementary health asssurance to refund what the Assurance maladie does not refund. But the primary health assurance is a public monopoly (and will last as such). Public health assurance is free for poor people (CMU). I don't know if foreigners can benefit of the CMU or not.
All your hospital costs will be refunded (fully or in part) if is a medical necessity and provided the treatment is recognized by the Assurance maladie. General daily costs in hospitals (named Forfait journalier, about 15 euros/day) is not refunded by the Assurance Maladie.
So the health is a very little spending for French people in general (but complementary insurances are expensive). You can even benefit from the tiers-payant if you have a complementary insurance : you won't pay the doctor or drug costs, the complementary insurance will do it for you immediatly.
The biggest problem since 20 years is the Assurance maladie debt of 12 billions euros. It is mainly due by the drug cost (overconsumption). There are plans to reduce this debts : increased taxes on wages (RDS), refund of generic drugs (patent-free drugs) only when both patented drugs and generic ones are available, etc.
The other problems include the poor refund of optical and dental costs. But generally speaking, French are very attached to their public insurance systems, and often moan about reforms of the Assurance maladie. To my opinion, as a grant-holder student, I couldn't afford any health cost if there were no public insurance system.
In Australia if you earn over $50,000 a year ($100,000 for couples) give or take a few rules.. then if you do not have the minimum level of private health insurance (which normally has a minimum of $500 excess for the hospital cover) then they tax you an extra 1%.
The Australian Tax Office applies the Medicare Levy. This levy is 1.5% of your taxable income. Most people have to pay this. This pays for our system where you have a Medicare coverage service done, eg go to your GP and get charged $50, and Medicare pays back a percentage, eg $25.
Private health insurance in Australia is getting so expensive that the Govt and Private Health insurers now have taken several steps to try and avoid a full revolt by the public. The first is the private health insurance rebate. This reduces all private health insurance by at least 35%. For older people it can reduce it by 35% or 40% depend on your age.
However, what they also do is 'load' your health insurance. If you do not have private health insurance by your 31st birthday then for each year that you are not covered by health insurance they add a loading of 2% per year (when you do join private health insurance). This is called Lifetime Health Cover. It is designed to force 30 to 45 year old people to take out insurance early.
For most people, here is how it works:
You take your taxable income of you or you and your spouse, add or subtract according to the various rules (each child increases how much taxable income you can earn by $1500 per year before they slog the extra 1% on you for not being covered) and you work out how much extra tax you are going to pay anyway. So, if your total taxable income is going to be $65,000 then you are looking at having $650 ripped out of your pocket at tax time. So, you go out and look for private health insurance that will be accepted by the tax office for $650 or less. This means you at least get something out of the money you are going to lose. Usually the something is ambulance cover and minimum hospital cover which limits how much they can charge you for a visit to $500.
This works because it is enforced at tax time. If you cannot prove that you were covered by private health insurance and you earn more than $50,000 then they extract it (pro-rata mind you, so if you are covered for 50% of the year then you only pay 0.5%) from you as part of your yearly tax return.
How about we not go into how the major private health insurance companies in Australia have raised their premiums by ~$5 per year for the last 3 years...
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I just wanted to comment because i don't think that there are many healthcare workers that post here.
I work in the ER in San Diego. The number of people who do not pay their bills and are not insured is INSANE. As a hospital we typically get paid less then 20% of what we bill to individual patients. It's slightly better with medicAID and mediCAL and your various insurance companies, but it's still a percentage (about 60%). I'm always amazed by how little my health insurance pays out to the doctors that I see. The number of undocumented immigrants is substantial as well, and the immigrants expect the healthcare to be free. Border Patrol has to bring in anyone that complains of anything to have them checked out by a doctor. 95 times out of a hundred, unless its a smuggler, border patrol will simply drop these people off at our hospital so that they don't have to cover the cost of care. For the record I'm sure similar things happen in cities across the nation with one demographic or another and law enforcement, just to keep things fair and not turn this to an immigration debate.
In addition to this it is ILLEGAL for us to turn anyone away, no matter the complaint. I someone comes in for a paper cut then they must be seen by a doctor. Now I understand the logic in this, everyone should have the right to medical care, but it's a little ridiculous when someone comes in for a hang nail. It also adds to the patient load and the overall cost when those people don't pay their bill.
Because of the people who don't pay, the people that do pay get slapped with the portion of their bills as well. When figuring out prices for services they take total cost for that service the year previous and divide it by the number of paying patients, and adjust that for the percentages mentioned earlier and inflation as well as a profit. This puts the cost well above what people are able to pay out of pocket.
Look around in your communities, a lot of hospitals are being forced to close their emergency rooms just because they're not financially sustainable, they are a money loosing enterprise. This leads to even more congestion in the hospitals that do stay open.
The US healthcare system is floundering, and will fail in the next few years unless something can be done. I'm personally not in favor of expanding the government bureaucracy to include healthcare, as the saying goes "the bureaucracy is expanding to meet the needs of the bureaucracy". The government can't do anything efficiently, it's just not an efficient way of doing things and leaves room for pork-barrel spending and bribery. Some form of a free market needs to be maintained, but the system as it stands now -SUCKS- for everyone involved, patient and provider alike. Something needs to be done. I'm grateful that SYCKO has brought attention to this problem, and i'm really happy to finally hear people talking about it.
It is very clear to me from your post that you are not a medical professional. I you were you would know that your premise is off. With that I mean your premise that health care prices are NOT elastic. They very much ARE elastic. There are so many unnecessary tests and medication, so many costly procedures that are performed without any real benefit over less costly alternatives simply because the patient has a wrong idea of real value. A patient looking for an answer or a cure when there is none will spend more than 10 times the resources required for the initial diagnosis. BTW If you want to toot the benefits of social health care you may want to step outside the UK. The UK NHS is little better than the US if you compare it to the system in Belgium or Holland. Then again there you see the adverse affects that I'm talking about more clearly as well. Over consumption of medication, unnecessary procedures and mass testing and vaccination of the entire population for just about any disease know to man (I may be exaggerating just a tad) has brought the overall cost to 18.000.000.000 for a population of a little 10.000.000. Projects like free mammography for all women aged 35 and higher have more than tripled the amount of cancer surgery without any real impact on the number of actual cancers. (This is because cancer incidence does not necessarily mean that the unidentified tissue will actually develop into cancer) These increased and unnecessary operations have increased the likelihood of cardiac and vascular problems with the patient that have undergone the surgery and all of this is payed by everyone. Overconsumption is NOT just a problem with the well insured American patients in their privatized system, but also in the highly socialized government health care system of Belgium. Neither provides a solution to this problem and the fact does remain that patients and doctors experimenting with new treatments and looking for answers were there are none to constitute a VERY elastic pricing that right up the alley of the free market. Sure, if you break a leg you have to fix it, but there are more than one way to fix it and to revalidate afterwards. Faster, ways, slower ways, more expensive ways. The options are endless. The only way your argument can make any sense is if there are clear and conservative definitions on which treatments are considered "non elastic" required basic healthcare and which are elective and nice to have. If we don't take the best of both worlds, socialize ONLY the absolute basics and privatize the rest we will continue to fail with either system.
If you don't mind, could you tell me if it would make any difference, overall, if the national debt were wiped out in America?
thats a great thing they are doing in Mass. i have been thinking loong and hard about not only the health care system. i shouldnt have to save up a few 1000 bucks and hope i never get sick. that should be the states concern. if one of thier tax payers get sick, they can no longer pay tax. to me, this seems like an investment. but as it is, they could give a rats ass about me, and most likely you (unless your rich). it seems that thruout the country and allthe 'systems' that i must use, the state wants to keep me dumb, and broke, and to die young.
i would like more than just health care socialized. more than the fire and police depts. the needed services should be either free, to the tax payers, no matter how much tax you pay, or on a sliding scale according to a pay stub or something of the sort.i was going to a state funded dentist. it was a sliding scale. i was amazed at how much it cost to get a cavity filled, than god i only hadda pay 15% ofthe bill. id still be paying on it had it not been 60 dollars.
yea, a state dentist. why cant the same be done with doctors? its the same basic idea. iam an american, and i should be treated as such.
there was a time in history when people wanted to be an American. where we were the richest nation in the world, when we did have the best health care system inthe world, where our schools were good. when our votes counted. now we only have the most police dept. of any nation, and the biggest military. is this something to be proud of?
Here's the real question. If Arabs, as many liberals say, are incapable of having a democracy, as Iraq would seem to prove, and the only way they can really be governed is with a violent strong man, then, how does multiculturalism stack up?
The bottom line is, you either can impose democracy militarily, and the USA simply hasn't quite figured out how to do so correctly, or, the other cultures are not as good, and should be treated as such.
Either the liberal belief in imposing democracy is wrong, or, the liberal belief that all cultures are equal is wrong! Either way you slice it, George W Bush had the theory right, but failed to adequately put his plan into implementation.
This is my sig.
So people understand, this may make big news and may sound like a major shift in thinking but MA already was paying for a Statewide health plan, it's called medicare/medicaid.
A hand up and a foot on every chest...
So people understand everyone in the US gets health care already. They go to the hospital emergency room. No hospital, except the catholic hospitals, refuse care. I am sure there are exceptions to this rule since the US is a very large place but here in the 12345 no one is refused care even at the catholic hospital, except for one but they just ship you to another facility.
A hand up and a foot on every chest...
Take the total amount spent by US citizens (and employers) per capita compared to what we spend on "evil-socialized-communist" health-care in Canada, you guys spend multiple times as much for a system that sucks.
Here's the problem that I have with the constant U.S./Canada comparisons: how do we know that the same services are being delivered at that price?
I don't think that any country, even Canada, has the range of lifestyle and dietary issues that we have here in the U.S., and which drive a large portion of healthcare costs. Even if the systems were exactly the same in the U.S. and $RANDOM_COUNTRY, what's to say that the per-capita cost would be the same? There are a lot of things that can change costs; it's not like "keeping one person healthy" is some sort of fixed constant.
Furthermore, speaking as an American, I have an idea of how people get when they know their tax money is being spent on something. A publicly-funded, single-payer healthcare system would be an invitation for the government to start regulating all sorts of stuff. People would demand it -- they're not going to want their tax dollars used to pay for "some asshole's smoking habit," or somebody else who likes to drive without a seatbelt, or someone else who likes to go hang-gliding at night.
Perhaps this doesn't happen in other countries with public healthcare. I'm glad to hear it. But America is a basically intolerant country full of intolerant people who love to dictate how the people around them can live their lives. A public healthcare system would be a wonderful bully pulpit that they could use to essentially dictate everything: from what you can eat, to how much exercise you have to do, to what kind of recreation you do -- or you'll lose your only source for health care.
If the difference in per-capita cost between Canada's system and the U.S.'s is what it takes to keep the various strains of Puritans, neo-prohibitionists, safety freaks, militant vegetarians, anti-gunners, etc. that we breed in this country -- basically whatever crackheads happen to be inhabiting Congress now, or at any point in the future -- from getting a firmer grip on private life, than that's a price I'm happy to pay. And considering the greater sacrifices that have been made over the years for the poor excuse for a 'free society' that we have left, I'm not really interested in a lot of whining otherwise.
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1. Exhibit A: Public Schools
As an undergraduate, all of my friends who could not hack it in Engineering school became either Education or Business majors. Although I would love to teach, I just cannot afford the huge pay cut. If you are wealthy in this country, you send your kids to private school unless you happen to live in a very swanky area where the teachers happen to be paid well above the state average. And in my city, such areas also correspond to very low minority and poor populations. So why would I want government employed Doctors that get paid far less than they would otherwise?
2. Exhibit B: Lawyers
Unless a socialized health care system includes some provision to limit frivolous legal action, this country's broken legal system will ruin it before it gets off the ground.
3. Exhibit C: If you are Upper Middle Class
Why should I vote for a socialized health care system when I worked my butt off for a big house on the big side of town? My local hospital is very swanky and includes world-class doctors. *My* health-care is excellent. If I have a sore foot, well, I can get an MRI by the end of the week. When my Mother came down with Breast-Cancer... not a problem! We have world-class cancer researchers here in Pittsburgh... and she could afford it. So now she is fine. It is probably true that on average, the socialized systems in Europe are better for the average citizen... but why would I vote for *worse* health care for me?
4. And the #1 reason: The government is 100% guaranteed to screw it up.
Enough said.
In typical "conservative", goofball, "must privatize everything" fashion, this is quite typical of their thinking.
Now they mandate that everyone has to have insurance... which is not the same thing as everyone getting health care. So now conservatives are free to harvest more money and provide nothing. You can find endless complaints of patients being denied treatment because their health insurance claimed life-saving medicine or surgery was unnecessary.
This plan is simply more of the same, non-working, conservative solutions which have failed Americans. Just like the Republican's recent Medicare "reform", which ended up simply being a money transfer from Medicare to big pharma.
The sooner America finally kicks conservatives to the curb, the better off the country will be.
The other way to restore fairness is inhumane or even barbaric: Deny emergency services outright to people who can afford to pay insurance but choose not to. This means letting people suffer and die. It's also poor economic policy if the person is likely to recover and continue contributing to the economy.
It seems poorer economic policy to bring more people closer to the poverty level by taxing everyone for healthcare. Its also not as black and white as you see it.
Should the 500lbs people be free from suffering and kept alive at any expense, even though its their own fault? Should we really be concerned if someone is suffering because they blew off their hand with an M80? How about dumb college kids that binge drink? Or people that ride bikes when the roads are covered in ice and snow?
I'm sorry, but I don't think we should be stopping stupid people from suffering the consequences of their own poor judgement. All it does is drag down more people to the lowest levels.
Well, when or if that happens, you guys can fight it then. You got a nice constitution and everything, (though it may be a bit battered and tarnished right now), should be pretty good protections against that.
That's too short-sighted and dangerous an attitude for me to support, considering the gravity of the problem.
Everywhere I look, I see the government prying further and further into private life. I don't think it's a "problem" that can be pushed off until some time down the road, it's happening right now, almost inexorably. I think "the people" are losing right now, as it is; handing control of healthcare to the government is going to just accelerate that process further.
The problem is by bringing the government into healthcare, is creating a public interest in what used to be purely private affairs. Right now, it's not really anybody else's business if I smoke a cigarette, or have a few fingers of Jack D., in the privacy of my home after work. At most, it's between me, other people in my house, and perhaps with my insurance company. But if the government is going to pick up the entire tab for my healthcare, then suddenly there's a public interest in taking away my right to ingest what I want. (Or alternately, they can threaten to cut off my healthcare coverage if I don't comply with their lifestyle guidelines, and with a single-payer system, there won't be a lot of alternative choices.) After all, the people who don't drink or smoke, aren't going to want to see precious resources squandered on my consciously-chosen, obviously antisocial, habits.* It's the exact same argument that's used to justify seat-belt and helmet laws, and those got through just fine in 49 states without the weight of taxpayer healthcare to bolster them: this isn't just theoretical.
It's not clear that the Constitution would be of much help, either. Historically, the Constitution has been stretched, or just ignored, whenever it was convenient for the government to do so. Look at the bastardization of the Commerce Clause -- and that's ignoring an intent (limitation of Federal powers) that many of the founders felt strongly enough about to actually write down. There are no such enshrined protections for personal privacy.**
It is far easier to not give a government power, than for the people to give it and then try to get it back. Placing healthcare in the hands of the government -- particularly the Federal government -- would allow an unprecedented expansion of power into the private lives and choices of citizens. To give the government that power is a huge risk, and I'm not willing to take or support a gamble with stakes that high.
Bottom line: yes, the healthcare system is fucked up. But the government is fucked up even worse. In fact, they're probably the one bunch of weasels that I trust less than the weasels running the insurance companies. To give them the high ground from which they could wage war against lifestyles they disagree with is insane. If a thousand dollars or two thousand dollars per person, per year, is what we pay to keep politics as far from medicine as we can, than I think it's money well spent.
* Not only that, but do you really think that the hordes of Evangelicals, heck, even moderate Christians, are going to allow their tax dollars to be used in a public-health system for abortions or contraception? You'd be looking at a way to expand the Hyde Amendment to not only affect people on Medicare/Medicaid, but virtually everyone in the country. Particularly given the Supreme Court that's now in place, that's not a direction I want to go in.
** The entire 'right to privacy' in the U.S. rests on a rather shaky legal foundation; Google "penumbra argument" if you want to read about it. Although its effects are nice, it's mostly a legal fiction created by a few bright Supreme Court Justices, and it could evaporate just as quickly.
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I should elaborate on this figure.
This is how much you pay for health insurance just to avoid being slogged an extra 1% tax. So, if you earn $60K then for $600 you get something. Normally these types of health insurance do not cover very much and if you do find yourself in hospital you will be handing your wallet to them.
You are correct though - friends of mine have serious ailments that require hospital care as part of their existence (diabetes does that to you). In their case, yes, they pay $1000 to $1500 a month for 'health insurance'. Ouch.
I was merely pointing out how most people are forced into having health insurance - whether they need it, like it, want it.. or not.
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I have been reading with disbelief have we all gone mad , allot of you guys don't know , not all states in the US require people to have car insurance at all!
In new hampshire all that is required is your car/truck/van/MotorCycle needs to be registered in the state , thats all!
n/t
So... Nobody wants to tell this opponent of Socialized Medicine how wrong he is?
Facts and reason are stubborn things, I guess.
Thanks, you are right, Fahrenheit 911.