Indulging Our Health Care Fantasies

[Don]

The problem with Obama's health care plan (http://www.reason.com/news/show/134112.html)


There are only three ways to pay for this expansion of health insurance coverage: increased taxes, reduced benefits, or shiny gold ingots falling out of the sky. Voters emphatically prefer the latter option, so that is the one most likely to be embraced by Congress and the administration.

...

But when most people talk about reform, what they really mean is guaranteeing the same or better coverage than they now have, but at a lower price. A recent Kaiser Family Foundation/Harvard School of Public Health poll found that 49 percent of Americans aren't willing to pay more in insurance premiums or taxes.

Of those who could accept higher taxes to finance a new system, most are thinking of higher taxes on someone else. As the researchers explained, "The only options with majority support were those likely to impact the fewest people, in particular smokers and the wealthy."

Even among the uninsured, the enthusiasm for insurance is muted. When another Kaiser poll asked uninsured adults how much they would be willing to pay to get coverage, only 64 percent would fork out $100 a month and just 29 percent would pay $200. Given that most are not poor, why is it so important to provide the uninsured with something they don't value highly?

Old Ben Franklin's just full of wisdom today.

When the people find that they can vote themselves money, that will herald the end of the republic.

Bottom Line: Are YOU willing to pay more to provide universal health care?

[Fran]

I already do pay towards providing universal health care. It works out not bad :) As for paying more, that's complicated, because Scotland has a different system to England & Wales, so I don't know if I DID pay more whether it would be going to prop up England's rickety NHS or Scotland's fairly stable one. Not that it matters. I think I'd pay more if necessary. Our government doesn't often ask our opinion, though, and especially not now it's falling to bits ;)

[shawkins]

Bottom Line: Are YOU willing to pay more to provide universal health care?

Yes.

[Fullback]

I have great and inexpensive health care. Believe it or not, not everyone lives in the US.

[Don Allen]

The problem though, which is really never articulated in these debates is that as it stands, health care costs this nation billions of uncounted dollars in :lost productivity, non-essential testing, lawsuits, denied claims, and general burecracy.
The argument that every american can find health care if they need it is blatently false, I'm living proof. After losing a job and insurance to boot I thought I could manage by paying for my own care if needed, well I was wrong.

1 mri 1500.00, followed by a battery of tests to determine my illness 10,000, before a surgery could be recommended another 10- 15 k. I went without and damn near died when my gallbladder blew up. I was lucky, my wife's insurance on her new job just covered and picked up the bill. Multiply me by millions, and thats the problem.

[raburrell]

I'm a little more sour on universal health care than I used to be. My husband's 15 year old nephew dropped dead earlier this month (in the UK) from a heart condition that a first year medical student should have been able to diagnose. He went into the ER complaining of massive chest pain, they diagnosed an infection after a stethoscope examination (the doc determined a chest x-ray was unecessary), sent him home with painkillers. Four hours later, he was dead of a massive aortic rupture.

Maybe it was too late to do anything by that point anyhow, but... :(

[Fran]

I'm a little more sour on universal health care than I used to be. My husband's 15 year old nephew dropped dead earlier this month (in the UK) from a heart condition that a first year medical student should have been able to diagnose. He went into the ER complaining of massive chest pain, they diagnosed an infection after a stethoscope examination (the doc determined a chest x-ray was unecessary), sent him home with painkillers. Four hours later, he was dead of a massive aortic rupture.

Maybe it was too late to do anything by that point anyhow, but... :(

I'm very sorry for your family's loss. But would the outcome have been different if your nephew's family were paying for the care themselves? Would a chest x-ray be done automatically in the US? Once again, I'm sorry :(

[raburrell]

I'm very sorry for your family's loss. But would the outcome have been different if your nephew's family were paying for the care themselves? Would a chest x-ray be done automatically in the US? Once again, I'm sorry :(

The only thing I have to go on is a conversation with my boss, who was once chief of critical care medicine at a very well-respected hospital here in the states. He was flabberghasted at the care my nephew received (and at the very least that a chest x-ray wasn't performed). The doctor there deemed it 'not medically necessary'.

Thank you for the condolences.

[Williebee]

There's this old political adage, at least around here: The only fair tax is one someone else is paying.

[Albedo]

America blows more money (http://assets.opencrs.com/rpts/RL34175_20070917.pdf) per head on health care than any other nation. Odds are if you brought in UHC you'd end up paying less.

[Don]

Yeah, because the more involved gooberment gets in anything, the cheaper it ends up being. :D

[Albedo]

Look at the graph, Don. How cumzit the USA has the lowest share of public funding (<50%) yet still manages to not only spend twice the amount of total dollars as comparable countries (say Oz), but also outspends everyone but Norway, Iceland and Luxembourg in purely public dollars? On the other hand nations with a very high proportion of public expenditure, e.g. the UK or Sweden, have only moderate costs. It seems the massive inefficiencies in the American system aren't closely related to the degree of guvt involvement at all.

[mscelina]

But, of course, the Obama administration's proposed health care legislation (the Kennedy-Dodd bill) states that over ten years' time, this legislation will cost the American taxpayer 1.3 trillion dollars--and some of that money will be raised by cutting Medicare/Medicaid benefits (313 billion) and federal payments to hospitals (200 billion) while the rest (some 600 billion and change) will come from raising taxes.

http://news.yahoo.com/s/ap/20090615/ap_on_go_pr_wh/us_obama_doctors_13 (http://news.yahoo.com/s/ap/20090615/ap_on_go_pr_wh/us_obama_doctors_13)

I don't think the question really is if we're willing to pay more for universal health care. Quite frankly,I already pay exhorbitant insurance costs and my major health complaint isn't even covered. I think the real question is whether we're able to successfully reform the medical system in this country so that it's geared more toward the patient and preventative health care and less toward the financial rewards of the insurance and medical industries. I think and have always thought that universal health care would be beneficial to all Americans but only if it were implemented in such a way that it wouldn't bankrupt the government, that the quality of our medical care didn't decrease and that the ease of obtaining medical care wouldn't suffer. I don't think the administration has thought this legislation through very clearly. Sure, on the surface it all looks fine and dandy but let's be realistic here--where is the money coming from to pay for this? From tax raises that haven't been implemented yet? By cutting already existing medical benefits in the Medicare and Medicaid programs? By taking money away from hospitals and other medical institutions that sorely need it? ( Oh, and let's not forget that about 10 billion dollars of that 1.3 trillion is pure pork for playgrounds and street beautification projects--thank goodness those poor people on Medicaid will be able to look at lovely streets once their benefits are cut!)

Despite the President's exhortations that we have to pass this healthcare legislation NOW, I'd be more comfortable with paying extra money for universal health care if I were convinced that the government had actually taken the time to analyze this issue carefully, had come up with the best and most beneficial methods with which to pay for this huge package, that medical care wouldn't suffer and that no one on current government assistance for healthcare would suffer unduly in the rush to get things done. And, of course, if all the pork was shredded from the bill from the get go.

[AMCrenshaw]

Bottom Line: Are YOU willing to pay more to provide universal health care?

Absolutely, if there were no other options. Better for me to spend money on health care than on wants and needs invented by bad commercials.


AMC

[cethklein]

We already do pay more to provide it. Why do you think healthcare costs are so high? Go down to your local health department and looks at all the people there who have no intentions of ever paying.

I went there awhile back to get stage two of a Hep B vaccine. The lady at the counter asked "Are you paying?" I replied "I have a choice?" he said "well, technically yes. Half the people in here will never pay." I said 'yes, i'm going to pay." She replied "well, you'll get right in"

They bumped me to the head of the line. It was nice to, for once, be rewarded for doing the right thing. People don't pay, doctors have to raises costs which jacks up insurance rates. Same with emergency rooms. We have a large illegal immigrant population here, and they go to the ER for things as simple as a cold because by law they cannot be turned away. they don't even pretend they're gonig to pay. A friend of mine works there and said that sometimes as many as 50% of the patients they see in a gien week NEVEr pay.

We've had universal healthcare for years, we just didn't know it. It's definitely nothing new.

[Robert Toy]

With the clock ticking on health care reform legislation, President Obama has guaranteed American taxpayers that his administration will pay for any overhaul without adding to the deficit.

Obama claims to have the money on the table. His White House is proposing a $635 billion "down payment" on health care reform, with half of that financed by revenue proposals including a limit of the value of itemized deductions for families earning over $250,000 a year.

Yup, no deficit…just gonna tax the shit out of you.

ETA: The moment he lost the AMA

"I'm not advocating caps on malpractice awards, which I personally believe can be unfair to people who've been wrongfully harmed, but I do think we need to explore a range of ideas about how to put patient safety first, how to let doctors focus on practicing medicine, how to encourage broader use of evidence-based guidelines," he said.

Obama also told the AMA that rising health care costs could force the United States to follow in the footsteps of a bankrupt automaker.

"If we do not fix our health care system, America may go the way of GM -- paying more, getting less and going broke," he said.

[nighttimer]

Well, the one thing I do know from working at a hospital is there are a LOT of sick people in this country and the healthcare field is still a growth industry as I watch a nearby children's hospital start slapping up a new 12-story building and new parking garages.

If you have good health care coverage and great health you probably don't see the need for an overhaul of the system.

If you have a chronic condition, no job and a need for medicine or a procedure to stay healthy or alive, you absolutely need something better than we've got.

America is a great place to be when you're sick, but you'd better have the cash to pay for it if you don't have health coverage.

[joyce]

Well, the one thing I do know from working at a hospital is there are a LOT of sick people in this country and the healthcare field is still a growth industry as I watch a nearby children's hospital start slapping up a new 12-story building and new parking garages.

If you have good health care coverage and great health you probably don't see the need for an overhaul of the system.

If you have a chronic condition, no job and a need for medicine or a procedure to stay healthy or alive, you absolutely need something better than we've got.

America is a great place to be when you're sick, but you'd better have the cash to pay for it if you don't have health coverage.

I second this! Unfortunately, I once had great health coverage but now I have none. Perhaps other areas of the country have places you can go if you're sick and get treatment....not here. Unless you want to give up your job and live off the government, you can't get treated without those good old American greenbacks. It would be a dream if I could go to a doctor and get the treatments I've been told I need but I can't afford it. Four years ago I had to refinance my house to pay over $40K in medical bills because my hubby almost died. Now that resource has dried up. Unless you've done without and have needed medical treatment but can't afford it, I don't see how a person can understand how it feels. Something needs to be done with this system because everyone isn't looking for a handout and free care. Some people just want to be able to get affordable health care

[Bird of Prey]

With the clock ticking on health care reform legislation, President Obama has guaranteed American taxpayers that his administration will pay for any overhaul without adding to the deficit.

Obama claims to have the money on the table. His White House is proposing a $635 billion "down payment" on health care reform, with half of that financed by revenue proposals including a limit of the value of itemized deductions for families earning over $250,000 a year.

Yup, no deficit…just gonna tax the shit out of you.

ETA: The moment he lost the AMA

"I'm not advocating caps on malpractice awards, which I personally believe can be unfair to people who've been wrongfully harmed, but I do think we need to explore a range of ideas about how to put patient safety first, how to let doctors focus on practicing medicine, how to encourage broader use of evidence-based guidelines," he said.

Obama also told the AMA that rising health care costs could force the United States to follow in the footsteps of a bankrupt automaker.

"If we do not fix our health care system, America may go the way of GM -- paying more, getting less and going broke," he said.

You know, Robert, coming from you, able to take full advantage of the French health care system, I find your criticism of universal health care astonishing. By your own admission, you paid almost nothing - if anything at all - and had extraordinary care in France, did you not?? Given your posts, I certainly thought as much. So would you deny that to others who can't afford the "screw em" system if you can't pay big bucks - and here's the kicker - you gotta be healthy or nobody's gonna insure ya. . . . I really don't understand you.

[Robert Toy]

You know, Robert, coming from you, able to take full advantage of the French health care system, I find your criticism of universal health care astonishing. By your own admission, you paid almost nothing - if anything at all - and had extraordinary care in France, did you not?? Given your posts, I certainly thought as much. So would you deny that to others who can't afford the "screw em" system if you can't pay big bucks - and here's the kicker - you gotta be healthy or nobody's gonna insure ya. . . . I really don't understand you.
Since I never said that, I don't understand me either

What I did say

http://www.absolutewrite.com/forums/showpost.php?p=3639038&postcount=25

http://www.absolutewrite.com/forums/showpost.php?p=3639262&postcount=27

http://www.absolutewrite.com/forums/showpost.php?p=3640186&postcount=32

[Bird of Prey]

Well, Robert, I suppose if I were French words wouldn't escape me. If I were an average French citizen - given all your benefits - I imagine I'd know exactly what I'd say. But then you're a lucky man, eh?? We'll chalk it up to luck. Everybody gets lucky sometimes, gets to be cared for on the public dole - even a foreign dole - and they don't even have to be grateful for it.

[Robert Toy]

Well, Robert, I suppose if I were French words wouldn't escape me. If I were an average French citizen - given all your benefits - I imagine I'd know exactly what I'd say. But then you're a lucky man, eh?? We'll chalk it up to luck. Everybody gets lucky sometimes, gets to be cared for on the public dole - even a foreign dole - and they don't even have to be grateful for it.
WTF are you talking about?

Did you read my previos posts, try the one dated Aug 08.

I paid for my care, public dole had nothing to do with it.

[Gregg]

I don't trust the government to run any program fairly or efficiently.

[Bird of Prey]

WTF are you talking about?

Did you read my previos posts, try the one dated Aug 08.

I paid for my care, public dole had nothing to do with it.

You didn’t read all the fine print…I barely shelled out anything beyond the 11% social taxes and 40% income tax. The major difference, someone who was unemployed or a student making a basic living gets the exact same benefits coverage I do.

ETA: There is NO cash out when you go to the doctor, drug store or hospital. . . .

Of course it is reasonable, fair and just.

Unlike the U.S. system the French did not have to dismantle a drug, hospital and medical system based solely on outrageous profits.

It is worth every penny!

[Robert Toy]

You didn’t read all the fine print…I barely shelled out anything beyond the 11% social taxes and 40% income tax. The major difference, someone who was unemployed or a student making a basic living gets the exact same benefits coverage I do.

ETA: There is NO cash out when you go to the doctor, drug store or hospital. . . .

Of course it is reasonable, fair and just.

Unlike the U.S. system the French did not have to dismantle a drug, hospital and medical system based solely on outrageous profits.

It is worth every penny!

What percentage of your gross income do you pay for healthcare?

ETA: You don't pay for a dole

[Robert Toy]

you have me totally confused.

[Bird of Prey]

What percentage of your gross income do you pay for healthcare?

I'd say it's closing in on thirty percent, only I don't get to trust my doctors and I have a big fat deductable, and let's not forget the ol' CAP. A million or two doesn't go very far when it comes to sick people, but who the fuck cares?? They SHOULD worry about losing their homes because they're sick. After all, it's not the insurance company's fault that the misfortunate got sick. . . . And btw, why should the young and strong have to pay for anybody else anyway? Why should they have to pay for you?

[Robert Toy]

I'd say it's closing in on thirty percent, only I don't get to trust my doctors and I have a big fat deductable, and let's not forget the ol' CAP. A million or two doesn't go very far when it comes to sick people, but who the fuck cares?? They SHOULD worry about losing their homes because they're sick. After all, it's not the insurance company's fault that the misfortunate got sick. . . . And btw, why should the young and strong have to pay for anybody else anyway? Why should they have to pay for you?
you're ranting

I'm sorry you have such a fucked up insurance system and that you feel that you dislike the "young and strong" having to pay for everyone else.

NOT MY FAULT, NOT THE FAULT OF THE FRENCH SYSTEM AND IF EVEN IT WAS...TOUGH SHIT.

you need to take a nap

[mscelina]

I'd say it's closing in on thirty percent, only I don't get to trust my doctors and I have a big fat deductable, and let's not forget the ol' CAP. A million or two doesn't go very far when it comes to sick people, but who the fuck cares?? They SHOULD worry about losing their homes because they're sick. After all, it's not the insurance company's fault that the misfortunate got sick. . . . And btw, why should the young and strong have to pay for anybody else anyway? Why should they have to pay for you?

*bolding mine*

Just because you're young and strong doesn't mean you can't get sick, does it? You'd probably be able to scrape up a modicum of credibility when you rant about things you don't understand if you'd attempt even feebly to avoid using broad generalizations and unsubstantiated opinions in place of fact.

[Duncan J Macdonald]

Bottom Line: Are YOU willing to pay more to provide universal health care?
No. Health Care is not a Federal perrogative.

[benbradley]

I heard this interview earlier this evening:
http://marketplace.publicradio.org/display/web/2009/06/15/pm_health_care_q/
Here's what I think is the most pertinent exchange:
...
Ryssdal: Well, let me make sure I understand that. If doctors and hospitals are making less money, what is that do for the quality of care? I'm just trying to think about the argument that's going to come up on Capitol Hill on this one.

MELNICK: Quality will have to suffer in some way. Whether it's through reduced access, whether it's through slower development of new technology. There are a number of economists who feel that health-care is expensive for good reason. And the reason is that it's valuable. That new innovation and new technology, while it may add to the cost of the health-care system, also brings with it tremendous benefits. The real challenge is can we develop a system to do the research to identify those things that are going to be high value in the first place, and to screen out those things that are low value and not adopt them as quickly as we have in the past. And that will be a challenge, but I think there's potential savings there. I don't know any country that has done it very well so far, because new innovation is just so complex and hard to predict.
I hope SOME country is willing to pay more, so medical research will continue at the pace it has been in recent decades, so as I get older and get some of those ailments older people are supposed to get, there will be ways of treating them, at least somewhere in the world, so I can go there and get treated.

[benbradley]

No. Health Care is not a Federal perrogative.
But it MUST be in the Constitution somewhere - ever since then-First-Lady Hillary Clinton's plan was published and discussed in the '90's, I've heard over and over that health care is a basic human right...

[dclary]

There are rights, and there are privileges. Health care is a privilege. Greedy people, needy people, and the people who want the greedy and needy to be beholden to them are all for changing our perception of it.

There is no human right to quality health care. The universe will not provide for you if you do not provide for yourself. That's called a responsibility.

The needies, greedies, and their handlers are just trying to be clever about it, and seeing what they can do about getting someone else to foot the bill.

[benbradley]

Just because you're young and strong doesn't mean you can't get sick, does it?
Well, there's a fine point here - I'm not sure how health insurance is priced (if or how much of it is age-based), but car insurance discriminates by age - those under 25 pay more because of the extra risks of that age group.

Then again, a lot of under-25's would rather pay for a fast car and the high cost of insurance for it than for health insurance, and that's what they do. Of course, they would NEVER get in a bad wreck that requires hospitalization...

[aquacat]

Bottom Line: Are YOU willing to pay more to provide universal health care?

I'm willing to pay whatever it takes to live in a civilized country which recognizes that we all do better when we ALL do better.

So yes.

[Williebee]

Health care is a "privilege"?

What about those laws that say hospitals can't turn patients away?

[dclary]

Health care is a "privilege"?

What about those laws that say hospitals can't turn patients away?

If you had continued reading you'd have answered this question all by yourself.

[mscelina]

Health care is a "privilege"?

What about those laws that say hospitals can't turn patients away?

I believe--and I could be wrong, but I believe--that the way that worked out legally was that any hospital that receives federal money is obligated by the government to treat any individual that presents in an emergency. When I was a kid in Tennessee in the early eighties, Vanderbilt University Hospital turned away a gentleman brought in by ambulance to their emergency room because he didn't have insurance. he died en route to another hospital in the city, and the resulting lawsuit's decision was based on the above statement. I'll try to dig up the citation for you later. Vanderbilt tried to get out of legal responsibility by stating that they were a private hospital, but lost the case because it is an adjunct of a university that receives federal money.

[Williebee]

I did continue reading. I was even nice enough to read it again, just for you.

There are rights, and there are privileges. Health care is a privilege. Greedy people, needy people, and the people who want the greedy and needy to be beholden to them are all for changing our perception of it.

There is no human right to quality health care. The universe will not provide for you if you do not provide for yourself. That's called a responsibility.

The needies, greedies, and their handlers are just trying to be clever about it, and seeing what they can do about getting someone else to foot the bill.

Was there a secret code?

[mscelina]

I did continue reading. I was even nice enough to read it again, just for you.



Was there a secret code?

There is. Run and check the Mona Lisa. I think it's written on it in flourescent paint.

[dclary]

Red Rum! Red Rum!

[Williebee]

Run and check the Mona Lisa. I think it's written on it in flourescent paint.

I always knew there was something secret painted on the Mona Lisa. I just
expected it to be: "For a good time, call..."

[mscelina]

I always knew there was something secret painted on the Mona Lisa. I just
expected it to be: "For a good time, call..."

"...Francois, King of France and Burgundy. Do not bother if your last name is Boleyn or if you have syphilis."

heh. I've been reading too much fifteenth century history lately.

[Bird of Prey]

*bolding mine*

Just because you're young and strong doesn't mean you can't get sick, does it? You'd probably be able to scrape up a modicum of credibility when you rant about things you don't understand if you'd attempt even feebly to avoid using broad generalizations and unsubstantiated opinions in place of fact.


You simply have no idea what I was saying. Absolutely none. You're so anxious to be hostile that you don't even attempt to understand my position and refute the actual position. Do you ever read my posts in context? I suppose it doesn't matter. A conversation with you is impossible for me.

[Lyra Jean]

I already pay for medicare and medicaid. It's taken out of my check. Here's a real world example.

My friend who was 20 at the time lost her job and of course her insurance. She tried to get onto medicare/medicaid but was told that she was not eligible. Because she had no children, was not an immigrant, and was not a minority. She had some pressing medical needs that she could not get done because she had no insurance. She also wasn't eligible for food stamps either.

She found a job that hired her for 8 hours a week. The job market was not and is still not huge here. The whole time she was working where she had benefits and the job she had where she was only hired for 8 hours a week they took money out of her check for medicare/medicaid. She now has a new job and is waiting for benefits to kick in.

So, yeah I would pay for universal health care because I'm already paying for healthcare for other people. Why can't I be eligible for it as well?

[nighttimer]

There are rights, and there are privileges. Health care is a privilege. Greedy people, needy people, and the people who want the greedy and needy to be beholden to them are all for changing our perception of it.

There is no human right to quality health care. The universe will not provide for you if you do not provide for yourself. That's called a responsibility.

The needies, greedies, and their handlers are just trying to be clever about it, and seeing what they can do about getting someone else to foot the bill.

And which category do people who are born with chronic diseases or children whose parents can't afford healthcare or older people who have worked all their lives but can't pay for their prescription medicines fall into?

The needies or the greedies?

The United States spends a higher portion of it's GDP (15.3%) than Japan, Germany, Switzerland or the United Kingdom yet still lags in both infant mortality rates and life expectancy. We pay more, get sicker and die sooner. Best healthcare in the world? Hardly.

Were you aware there is universal health care in both Afghanistan and Iraq? You should be. You're paying for it with funding for the wars.

Thanks for proving yet again that John Kenneth Galbraith knew what he was talking about when he said, "The modern conservative is engaged in one of man's oldest exercises in moral philosophy; that is, the search for a superior moral justification for selfishness."