Universal Health Care

[Pooky 3,844]

However you frame it, the system will remain inequitable as long as there is a profit motive. Remove the profit from the equation and care becomes the primary driver of the healthcare system. To that end, you cannot maintain a system run by private enterprise and still have care as the primary focus.

Like it or not, the health industry will only provide cost-effective healthcare once private enterprise and profit are removed from the mix, and that only leaves government, be it local, state or federal. Take away the profit and you're left with healthcare.

P

take away the profit and you'll have a difficult time finding anyone to do the job.

Simplistic and naive. The US healthcare industry is the biggest in the world. The laws of supply and demand will ensure that the pharmaceutical companies will still be "in business". But take away the "insurance" companies, the "health claim specialists" and the rest of the carp that accompanies the current system of denial (not the river in Africa) and you free up resources to pay the professional at the sharp end of healthcare, so that money goes where it is needed within the system and doesn't leave the system in the form of excess profit.

P

[Pinocchio Liberal 268]

Heres some research for ya! Yep that thar fcukin free healthcare is the shite.

Hospitals were last night accused of keeping thousands of seriously ill patients in ambulance 'holding patterns' outside accident and emergency units to meet a government pledge that all patients are treated within four hours of admission.

Those affected by 'patient stacking' include people with broken limbs or those suffering fits or breathing problems. An Observer investigation has also found that some wait for up to five hours in ambulances because A&E units have refused to admit them until they can guarantee to treat them within the time limit. Apart from the danger posed to patients, the detaining of ambulances means vehicles and trained crew are not available to answer new 999 calls because they are being kept on hospital sites.

http://www.guardian.co.uk/society/2008/feb/17/health.nhs1

[GaryC 7]

I'd be inclined to agree with you if insurance costs were reasonable based on other financial indices, but they clearly aren't. If insurance companies were forced to provide affordable coverage to everyone (and by affordable, I mean a reasonable percentage of a household's income), even the very ill, the system would collapse, and even more insurance companies would go under. Insurance companies are for-profit businesses, which is at the root of the crisis.

Why would they collapse? They don't collapse in other countries that have affordable healthcare.

If insurance companies were forced to take on sick people who would then turn around and make gigantic claims while paying low (affordable) premiums, this would cut into profits. Many health insurance companies stay profitable by denying coverage to high-risk applicants. In a group plan scenario, economies of scale help pool the risk because healthy people (presumably) are paying into the pool. But outside group plans, the insurers need to pick and choose whom they cover to keep the profit margins high. Someone who pays $3500 a year in premiums but whose claims are $100,000K (not an uncommon scenario for a sick person) is obviously going to be a liability.

I have to disagree with that. If everyone were allowed to sign up for insurance the cost would be spread over a large number of people. Insurance companies may not make as much but they will still make money.

I am all for insurance reform. But a lot of other reforms must come with it. Malpractice reform is a big one. It drives the costs way up. In general our health care system works. It needs to be adjusted so more people can buy into it. They need to remove the "pre-exsiting conditions" clause on insurance. That would enable Ganja Girl to get her coverage without making everyone else pay for it. They need to make insurance portable. So people don't need to worry if their new job has insurance. The need to cap the costs for procedures that hospitals do. That would reign in the costs that drive insurance up. They need to regulate what insurance companies charge for high risk members.

I never said we don't need to reform things. I just don't want to junk the whole thing and turn it over to the government. Everyone need to pay for what they get, we just need to find a way to make everyone able to pay for what they need.

That's what Massachusetts is trying to do by requiring everyone to have insurance. It's crucial to get younger, healthier people into the pool to share the risk. Of course, these are the same people who have less money to put toward insurance. I understand the idea behind it, but as I mentioned, I don't think it's fair to require these individuals to buy an expensive product from a private company.

Not all health insurers make money. Look at all the HMOs that folded in the late 1990s and early 2000s, and the numerous mergers and acquisitions that have taken place since then. I can think of two insurers I've had in the last 10 years that are no longer in business. There are only a handful of really big insurers that have been around a while.

I know that conservatives don't like to think about it this way, but if you're paying into a pool (which everyone is, in a sense), you're paying for someone else's care. Others in Ganja Girl's hypothetical pool would also be paying for her care, and she for theirs.

The two bolded sentences are contradictory. Just because someone is paying into a larger pool doesn't mean that he or she isn't paying for someone else's care.

That is the essence of insurance. Everyone pays into a pool and spreads out the risk. They don't contradict each other at all. I understand all to well how it works. Those that want UHC or Single Payer UHC wants the governement to be the insurance company and everyone in America forced to join in. That is where the rub happens for me. I don't want to be forced into anything. I like the way my health care is done. The system we have now can be fixed. Lets fix it rather than junking the whole thing and turning it over to the government.

[Pooky 3,844]

Heres some research for ya! Yep that thar fcukin free healthcare is the shite.

Hospitals were last night accused of keeping thousands of seriously ill patients in ambulance 'holding patterns' outside accident and emergency units to meet a government pledge that all patients are treated within four hours of admission.

Those affected by 'patient stacking' include people with broken limbs or those suffering fits or breathing problems. An Observer investigation has also found that some wait for up to five hours in ambulances because A&E units have refused to admit them until they can guarantee to treat them within the time limit. Apart from the danger posed to patients, the detaining of ambulances means vehicles and trained crew are not available to answer new 999 calls because they are being kept on hospital sites.

http://www.guardian.co.uk/society/2008/feb/17/health.nhs1

There is, of course, the other extreme, when some pasty-faced government numpty decides to make a pledge without consulting the healthcare professionals that will be trying to uphold that pledge and so causes untold grief. Never hold up the UK as a shining example of the way it should be. Half a century ago, yes. Not now.

P

[SaadBell 0]

I guess I just don't compare buying a house with my daughter’s health. My daughter is my world, and to compare saving her life to like a decision on buying a car is crazy. So what do you decide? Your loved one, children, wife, mother, get sick, you don’t have any money, so in your eyes, oh well, let her die, her own fault for being poor and having a poor family. If that person dying of cancer can’t keep their job to keep their health insurance, than they are losers who deserve to die? I think I get how you feel now. Interesting, I have conscience that keeps me up at night, some have none, so life is easy, and everything is black and white. We call it thinning the herds, and it is all good until you become one of the ones that get thinned out. No one in this country should die because of profit, which is just sick. That man lost his life because someone wanted to increase their profits, and he is not the only one. Just pray you are never at their mercy and they deny you.

[Mr. Big Dog 10,747]

However you frame it, the system will remain inequitable as long as there is a profit motive. Remove the profit from the equation and care becomes the primary driver of the healthcare system. To that end, you cannot maintain a system run by private enterprise and still have care as the primary focus.

Like it or not, the health industry will only provide cost-effective healthcare once private enterprise and profit are removed from the mix, and that only leaves government, be it local, state or federal. Take away the profit and you're left with healthcare.

P

take away the profit and you'll have a difficult time finding anyone to do the job.

Simplistic and naive. The US healthcare industry is the biggest in the world. The laws of supply and demand will ensure that the pharmaceutical companies will still be "in business". But take away the "insurance" companies, the "health claim specialists" and the rest of the carp that accompanies the current system of denial (not the river in Africa) and you free up resources to pay the professional at the sharp end of healthcare, so that money goes where it is needed within the system and doesn't leave the system in the form of excess profit.

P

Agreed. Seriously, how anyone can sit there and defend this enormous red tape the private US system has built - which consumes more than a quarter of all health care - expenses is far beyond me. Just getting rid of that would lower cost dramatically. Then move care from the ER into the physician's office by making that possible for everyone and there's your next huge chuck of health care cost eliminated. It ain't that difficult.

[Pooky 3,844]

That is the essence of insurance. Everyone pays into a pool and spreads out the risk. They don't contradict each other at all. I understand all to well how it works. Those that want UHC or Single Payer UHC wants the governement to be the insurance company and everyone in America forced to join in. That is where the rub happens for me. I don't want to be forced into anything. I like the way my health care is done. The system we have now can be fixed. Lets fix it rather than junking the whole thing and turning it over to the government.

But where's the incentive for the industry to reform. The insurance companies are making money hand over fist, so why should they consider reform? The pharmaceutical companies have been doing all right, thank you, keeping cheaper drugs north of the Canadian border and generally out of the USA, so why should they reform?

The only way reform can happen in this country is by government intervention. And Capitol Hill is doing all right kow-towing to the insurance and pharmaceutical companies, so why should they push through reform?

P

[Ban Hammer 13,651]

However you frame it, the system will remain inequitable as long as there is a profit motive. Remove the profit from the equation and care becomes the primary driver of the healthcare system. To that end, you cannot maintain a system run by private enterprise and still have care as the primary focus.

Like it or not, the health industry will only provide cost-effective healthcare once private enterprise and profit are removed from the mix, and that only leaves government, be it local, state or federal. Take away the profit and you're left with healthcare.

P

take away the profit and you'll have a difficult time finding anyone to do the job.

Simplistic and naive. The US healthcare industry is the biggest in the world. The laws of supply and demand will ensure that the pharmaceutical companies will still be "in business". But take away the "insurance" companies, the "health claim specialists" and the rest of the carp that accompanies the current system of denial (not the river in Africa) and you free up resources to pay the professional at the sharp end of healthcare, so that money goes where it is needed within the system and doesn't leave the system in the form of excess profit.

P

you may wish to think of it as simplistic and naive, but the real simplistic and naive view here is the one of people believing they have a right to nhc just because they say they have that right. it's like a freaking star trek show around here "make it so, number 1!."

the laws of supply and demand will take effect, but not in the manner you "envision" in this supposed health care utopia. when doctors have their wages depressed because some beltway bandit decides the cap on their salary, when being the best does not result in higher pay, you'll see them heading outta this country in pursuit of higher wages in another country. and should the pharmaceutical companies have their profits restrained, well we've seen quite a few companies head offshore in the past few decades haven't we?

[Peikko 1,575]

It seems some will defend private health provision simply because they don't want to be 'forced into' a system. I guess no one has read the Taiwanese link. I thought it was awesome - it took all that was good from Universal Health care systems from around the world and made a really amazing system where you don't have to consult a GP before heading to the specialist. If you want the specialist, that's who you get. Incredible and something it would be fantastic to emulate.

[Dan J 277]

Its pretty simple really, there are people who take from the pool by getting care in emergency rooms and declaring bankruptcy, without paying anything into the pool.

To fix this we have two options.

1. Require everyone to contribute to the pool.

2. Require those who dont pay insurance to pay for care up front (or get no care, emergency rooms included), or make it impossible to declare bankrupcy on medical debt (Like student loans).

[SaadBell 0]

It seems some will defend private health provision simply because they don't want to be 'forced into' a system. I guess no one has read the Taiwanese link. I thought it was awesome - it took all that was good from Universal Health care systems from around the world and made a really amazing system where you don't have to consult a GP before heading to the specialist. If you want the specialist, that's who you get. Incredible and something it would be fantastic to emulate.

Anything is better than what we have now

[GaryC 7]

It seems some will defend private health provision simply because they don't want to be 'forced into' a system. I guess no one has read the Taiwanese link. I thought it was awesome - it took all that was good from Universal Health care systems from around the world and made a really amazing system where you don't have to consult a GP before heading to the specialist. If you want the specialist, that's who you get. Incredible and something it would be fantastic to emulate.

Anything is better than what we have now

But some things can be worse than what we have now. The US government acting as an insurance company is one of them.

[jundp 191]

Absolutely. This is an issue I feel very strongly about. The current system is a national embarrassment. That some kind of choice exists in this supposed free-market system is a fallacy. Seriously, what choice do you have? Whatever your employer offers and/or whatever you can afford (if you're healthy, that is).

I know that no system is perfect, but our system has to be scrapped and rebuilt. Australia's and Germany's systems need to be looked at seriously.

Thinking of people who have gone bankrupt because of illness makes me want to cry.

I'd gladly pay more in taxes to help fund a universal system. The amount flying out of my paycheck every month for insurance (not even considering copayments, deductibles, etc.)--insurance that I could very easily lose if laid off--is staggering.

I absolutely agree. I pay over $650 a month for my two children, and while I have excellent health care, I still pay copayments and prescriptions, and I have been fortunate in that I've never had to test the limits of the insurance. But $650 a month? For two children? With no pre-existing conditions.....

[Ban Hammer 13,651]

It seems some will defend private health provision simply because they don't want to be 'forced into' a system. I guess no one has read the Taiwanese link. I thought it was awesome - it took all that was good from Universal Health care systems from around the world and made a really amazing system where you don't have to consult a GP before heading to the specialist. If you want the specialist, that's who you get. Incredible and something it would be fantastic to emulate.

hmmm a small island, one big country on a continent with two states separate. yeah, i see the similarities.

[Empress of Groovy 373]

That is the essence of insurance. Everyone pays into a pool and spreads out the risk. They don't contradict each other at all. I understand all to well how it works. Those that want UHC or Single Payer UHC wants the governement to be the insurance company and everyone in America forced to join in. That is where the rub happens for me. I don't want to be forced into anything. I like the way my health care is done. The system we have now can be fixed. Lets fix it rather than junking the whole thing and turning it over to the government.

I guess the question is whether you think the funds should go to a taxpayer-funded pool (which I understand is open to bureaucratic abuse) or to a for-profit health insurance company's pool (which, as we know, is open to all kinds of abuse, bureaucratic and otherwise). Personally, I think that the the taxpayer-funded approach would be more equitable and, perhaps counterintuitively, less prone to abuse because the decision makers would be held accountable to the electorate. As it stands now, insurance companies can essentially do what they want--and fold or sell out if their lofty profit margins aren't being met. Even if, somehow, insurance were to be regulated to the point where premiums were affordable for everyone, what happens when the insurance company decides to close its doors? Can the company be forced into staying in business? Or to fund a transfer to another company? What if that company's policies are less generous, or don't cover certain things?