National Health Insurance Now, Not Later

[w¡n9Nµ7 §£@¥€r 123]

... back then the doctors and hospitals didn't charge what they do now. Sure it wasn't cheap to get sick but you weren't in danger of losing your home ...

Aren't we better off concentrating on why medical costs have outstripped inflation to such a degree? Instead of simply accepting the hyperinflation and subsidizing it (which is what universal healthcare would do)?

[Cassie 8]

No Gary you haven't made me angry. And I'm looking forward to reading about your trip and your and Luz's successful interview story. I really am.

I'm 'old fashioned' too - when it comes to matters of my family. I was raised also by families who worked hard and grew up with the Depression around them. The thing is - back then the doctors and hospitals didn't charge what they do now. Sure it wasn't cheap to get sick but you weren't in danger of losing your home or having your wages garnished because you had a medical calamity. Times are changing and this is a crisis in this country. No land as great as you believe this one is should have so many of its people in financial harms way because of a system so out of control. That's my old-fashioned belief.

Amen sister! The struggles you and Reba (and other VJ'ers I am sure) have gone through are prime examples of that.

Considering my pre-existing conditions / ongoing health problems / meds list, if my husband wasn't as fortunate as he was/is to have work that provided very very good health insurance, I wouldn't be sitting here in Oklahoma, and we'd be frequenting the Canadian version of VisaJourney. To me, that's a pretty sad state of affairs for the good ole USA.

[rebeccajo 14]

... back then the doctors and hospitals didn't charge what they do now. Sure it wasn't cheap to get sick but you weren't in danger of losing your home ...

Aren't we better off concentrating on why medical costs have outstripped inflation to such a degree? Instead of simply accepting the hyperinflation and subsidizing it (which is what universal healthcare would do)?

There's loads of logic there as well. Which is one reason nationalized medicine would be difficult to implement.

If the private business of medicine is shut down and given to run by a government who is currently showing itself to be so inept at financial management - there's no easy answer. Or at least not one I'm bright enough to fathom.

Edited February 9, 2007 by rebeccajo

[Ban Hammer 13,336]

... back then the doctors and hospitals didn't charge what they do now. Sure it wasn't cheap to get sick but you weren't in danger of losing your home ...

Aren't we better off concentrating on why medical costs have outstripped inflation to such a degree? Instead of simply accepting the hyperinflation and subsidizing it (which is what universal healthcare would do)?

nessa asked me about it and i gave her the following. given that most health care plans would run about $500 a month, those under a certain point would pay less, those above a certain point would subsidize those others.

the below is an example. feel free to correct/debate

individuals monthly salary..........................individual pays

1000........................................................100

2000........................................................200

3000........................................................300

4000........................................................400

5000........................................................500

6000........................................................600

7000........................................................700

8000........................................................800

9000........................................................900

10000......................................................1000

and so on. i'm sure it sounds great to anyone under that midpoint i suggested of $500 a month, but for those of us over it, it don't sound great.

Edited February 9, 2007 by charlesandnessa

[w¡n9Nµ7 §£@¥€r 123]

... back then the doctors and hospitals didn't charge what they do now. Sure it wasn't cheap to get sick but you weren't in danger of losing your home ...

Aren't we better off concentrating on why medical costs have outstripped inflation to such a degree? Instead of simply accepting the hyperinflation and subsidizing it (which is what universal healthcare would do)?

nessa asked me about it and i gave her the following. given that most health care plans would run about $500 a month, those under a certain point would pay less, those above a certain point would subsidize those others.

the below is an example. feel free to correct/debate

individuals monthly salary..........................individual pays

1000........................................................100

2000........................................................200

3000........................................................300

4000........................................................400

5000........................................................500

6000........................................................600

7000........................................................700

8000........................................................800

9000........................................................900

10000......................................................1000

and so on. i'm sure it sounds great to anyone under that midpoint i suggested of $500 a month, but for those of us under it don't sound great.

I think you misunderstood my point. That doesn't address what I was saying at all.

[Caladan 19]

Gupt, you have a point about rising healthcare costs. That's driven by a couple things. Let's take a look.

One, the state of insurance. That's a problem, but note that going to a single-payer system won't subsidize the high inflation rate, just because it will so radically change it that the same economic models won't apply. It makes more sense now for a doctor to order needless tests because otherwise the patient's insurance won't cover further care (and the doctor won't get paid.) The incentives are all backwards. That problem goes away with a single-payer plan because there's no incentive to order needless tests. Emergency rooms are another problem, because emergency visits are often covered by insurance (like the shitty high deductible kind), so, another bad incentive to run up costs there.

That's not to say there couldn't be other problems, just that it's not as easy as saying 'To pay what we do now, we'd need to take 15% of taxes!' The whole point of moving to single-payer is to reduce costs.

Two, one problem with rising costs is a small pool of unhealthy insurees. That's why group-rates through work are cheaper, because the company can tell the insurance company, here, here are 500 people who will buy this, and 300 of them are under 30. The insurance company realizes it can make a profit at a lower rate and needs to compete, so down go the prices. When it's just an individual, they get whomped with a high rate because chances are, the individual seeking it out needs it.

If you have a universal plan, then you get all those healthy young people buying in, and the rates per person can go down. So it's a mistake to generalize from what you'd pay for a decent HMO on your own to what it would cost when there's 300 million people in on it.

Three, medical care is a lot more technical than it was 30 years ago. It's more expensive because of more research and more drugs and new ways to treat things. That's a cost that isn't the fault of insurance.

Fourth, we're also getting better at treating people. Just take heart attacks. Deaths from those are down. That means, though, that people are more likely to suffer a second heart attack, and that means more medical costs. What would have been an early death at 52 is now a death at 75 with three heart attacks in between. This is not a cost that's the fault of insurance.

Fifth, prescription drugs. This is going to be the Achilles' heel in any universal plan. We can't subsidize it. Why? It works for Canada. Well, it works for Canada because the pharmaceutical companies don't mind cutting Canada a deal when they've got 300 million people just to the south captive under patent law. And tinkering with patent law is out of the question, because that just kills the incentive to research.

Sixth, malpractice suits. This ties in with my #1 above. A doctor has to order the tests because if he doesn't and he gets sued, his ### will be grass. Hence more tests. That's not a cost that's the fault of insurance. We need serious tort reform on this.

One last problem for a single-payer system. Much is made of Canada's "shortages", but people aren't always careful to say why, and so everyone imagines bureaucrats storming in and removing someone's artificial knee. It's actually a doctor and nurse shortage; they can get visas to the U.S., and make more money. One significant worry is whether, on a single-payer system, we would be able to pay young doctors enough to give them a reason to deal with the pains of training. We won't have the same problem as Canada, but doctors aren't idiots, and most of them can make more money easily, with less effort, in banking or investing. I have friends going through med school, and it's basically 10 years of making less than minimum wage and destroying your home life for the hopes of a lucrative, meaningful career once you're 35.

So. Well, you asked for an analysis.

Problems one and two are legitimate insurance-related reasons for health care cost increases. It's not at all clear that the costs would translate to the same percentage under a single-payer system; most indications say they'll drop. Problems three and four are the price of first-world medicine. That cost will stay relatively fixed. Problem six is probably the biggest driver of costs, and it's a lawsuit problem. Problems five and seven are perhaps not insurmountable, but where I'd like to see more from the politicians, because we cannot afford to disincentivize medicine. American pharmaceutical research is something we should be proud of. So is the high quality of American medicine.

Also bear in mind that this doesn't make private insurance illegal. We don't have to tax everyone to give them Club Med-style care, but for the love of little apples, this is the United States of America, we can put a man on the moon, we can make it so someone can go to a clinic when they have the sniffles without paying $200 for the five minute visit. This should just be common sense. Shining cities on the hill have healthy citizens.

But we can't afford to let this problem go until the baby boomers start having their heart attacks. (Though between the dumb wars, the housing market, their debt, and their general whinyness, the sooner they check out, the better. )

Oh, and Gary? Good luck to you and Luz; bring yourselves home a shiny visa!

[Boiler 45,499]

Please, enough of this it's all personal responsibility #######. I'm not for universal health coverage because I'm lazy, but because I think the lack of affordable health care is going to ###### over this country seventeen ways from Sunday when all the boomers start using the health care. 95% of medical expenses are incurred in the last six months of life, so look to see some pretty hefty bills.

Good insurance isn't affordable. It's tied to jobs. That might have been okay back in the days of getting your first job at 18 and retiring with the same firm at 55 with a pension. We are now in an economy where most people can expect to have several careers in their lifetime; that means that responsible people will face periods without insurance or underinsured. We are now in an economy that employs more part-time workers, where people work two jobs to make ends meet. You may have made it, gary, and you should be proud, but that economy just doesn't exist any more.

It's about as reasonable as me hoping for a good old 9-5 IBM job where I get to use my slide rule and compass.

Young adults my age have absolutely no incentive to seek out insurance now (again, see 95% of medical expenses), and anything an insurance plan needs is a large risk pool. People "before their third wedding anniversary" are exactly who you need to buy into this system; young, healthy, single people who aren't going to use their healthcare. The easiest way to get them to buy into it is to mandate it.

Many, many bankruptcies are caused by responsible, decent homeowning Americans irresponsibly contracting an illness and the insurance doesn't cover it, won't cover it, or finds a reason not to cover it. And if you really want to have fun, try to find an insurance plan that covers you when you're in your fifties if you have any kind of pre-existing condition.

Then how do you explain my story then? I am a boomer. I did it. Why can't others do it? Is my case so special? That economy that let me do it is still there. In fact it's better now than when I got my start in the early 80's. That was real hard times there. We got it easy now.

I am sorry but when I hear this "The easiest way to get them to buy into it is to mandate it." it makes my skin crawl. What about personal freedom? What if I don't want this shoved down my neck? I guess I am to old fashioned for some of you. I was raised on a farm by a father that lived through the depression. He instilled in me a sense of personal responsibility that has enabled me to make it. I don't know any other way. The more "progressive" among us just doesn't make much sense to me. To me it's crystal clear. If you want something then work for it. If you want it bad enough then you will get it. It's not the easiest path but it is IMO the most rewarding.

What happens when you reach retirement age?

Will your Employer continue to provide you with subsidised coverage?

or

Will you be buying your own private cover?

Just wondering.

[Boiler 45,499]

I have to respectably disagree. I have untold faith in the American people. I really don't think it will be very long and you will see someone that can offer health care in a much better way.

Who has the money to out lobby the current incumbants?

They have invested a lot of money in keeping the status quo, surely they should be rewarded for their investment?

Lobbyists have a lot of power, especially when it comes to supporting election campaigns. We'll sponsor you if you say no to:

Restrictions on CO2 emmissions

Well I will not be competing with Nancy Pelosi anyway.

[Caladan 19]

Many jobs here, if you retire from them, will include some sort of subsidized health care as part of the pension. That's fast becoming rare; many jobs don't offer insurance in the first place. I don't know if people are buying private insurance if they retire without health care, or if they are just winging it because they can't afford it but don't qualify for Medicare.

If you get laid off in your late fifties, though, good luck. My dad's self-employed, so he buys his own insurance, and it's next to impossible to find an insurance company that will insure a 55-year-old smoker who is otherwise has a perfect health history. They've still got that annoying catastrophic coverage, which will be great when one of them has an aneurysm, but not so much for detecting and treating high blood pressure.

[GaryC 7]

Many jobs here, if you retire from them, will include some sort of subsidized health care as part of the pension. That's fast becoming rare; many jobs don't offer insurance in the first place. I don't know if people are buying private insurance if they retire without health care, or if they are just winging it because they can't afford it but don't qualify for Medicare.

If you get laid off in your late fifties, though, good luck. My dad's self-employed, so he buys his own insurance, and it's next to impossible to find an insurance company that will insure a 55-year-old smoker who is otherwise has a perfect health history. They've still got that annoying catastrophic coverage, which will be great when one of them has an aneurysm, but not so much for detecting and treating high blood pressure.

I have had that catastrophic coverage before and it is a bit of a pain. But I look at it this way. The difference between a full policy and the catastrophic policy would be on the order of $300/month. My doctor charges $65 for an office visit. I could see the doctor a lot for the difference in price. If someone on the catastrophic policy wanted to see the doctor he still can. Most doctors will even take payments.

As far as retirement coverage goes there is Medicare after you turn 65. There are some very inexpensive supplement policies that will take up what Medicare doesn't cover. The children and the aged in our country are already covered. For the rest it can be had if it's wanted bad enough.

Edited February 9, 2007 by Iniibig ko si Luz forever

[rebeccajo 14]

And guess who runs Medicare?

THE GOVERNMENT.

[GaryC 7]

And guess who runs Medicare?

THE GOVERNMENT.

Yes, I know. It's pretty screwed up also. If that is the example of what a full national health care system would be then I want no part of it. But it is there and it does cover the aged and disabled.

Edited February 9, 2007 by Iniibig ko si Luz forever

[Boiler 45,499]

And guess who runs Medicare?

THE GOVERNMENT.

Yes, I know. It's pretty screwed up also. If that is the example of what a full national health care system would be then I want no part of it. But it is there and it does cover the aged and disabled.

So what are YOU going to do then?

Medicare/Mediccaid is a Socialist system so inappropriate for all the many many reason you have elequently previously stated.

It also also covers the main users of any Healtcare system, the young and the old. And has been pointed the US Gov with your taxes pays more for this subset than the majority of western countries pay for all their population.

[GaryC 7]

And guess who runs Medicare?

THE GOVERNMENT.

Yes, I know. It's pretty screwed up also. If that is the example of what a full national health care system would be then I want no part of it. But it is there and it does cover the aged and disabled.

So what are YOU going to do then?

Medicare/Mediccaid is a Socialist system so inappropriate for all the many many reason you have elequently previously stated.

It also also covers the main users of any Healtcare system, the young and the old. And has been pointed the US Gov with your taxes pays more for this subset than the majority of western countries pay for all their population.

I am planning ahead just like I always have. I am saving for my retirement so I don't have to depend on SS. If I stay with my company (I love it here so I think I will) my health care will be covered when I retire.

In reality I plan to retire in the Philippines. With what I will have saved I can afford to live comfortably for the rest of my life. I know that PI has no health coverage but it is cheap enough that I can afford to pay as I go. But if something catastrophic happens to my health I can alway come back to the US and take advantage of the company provided health care. In short I will take my future into my own hands just like I always have. I will not be asking the taxpayers to support me or to give me health care. I live what I preach. I follow my own advice.

[Boiler 45,499]

And guess who runs Medicare?

THE GOVERNMENT.

Yes, I know. It's pretty screwed up also. If that is the example of what a full national health care system would be then I want no part of it. But it is there and it does cover the aged and disabled.

So what are YOU going to do then?

Medicare/Mediccaid is a Socialist system so inappropriate for all the many many reason you have elequently previously stated.

It also also covers the main users of any Healtcare system, the young and the old. And has been pointed the US Gov with your taxes pays more for this subset than the majority of western countries pay for all their population.

I am planning ahead just like I always have. I am saving for my retirement so I don't have to depend on SS. If I stay with my company (I love it here so I think I will) my health care will be covered when I retire.

In reality I plan to retire in the Philippines. With what I will have saved I can afford to live comfortably for the rest of my life. I know that PI has no health coverage but it is cheap enough that I can afford to pay as I go. But if something catastrophic happens to my health I can alway come back to the US and take advantage of the company provided health care. In short I will take my future into my own hands just like I always have. I will not be asking the taxpayers to support me or to give me health care. I live what I preach. I follow my own advice.

GM pays more for its Medical Cover than for its steel. The Unions I understand prevent it from chopping its Mecical cover for retirees or ot would have done a long long time ago.

Most Companies in the UK and I belive in the US no longer offer final salary schemes. I can not imagine there will be many left. in a few years never mind 20 years, likewise how many privavte companies will be wiling to heavily subsidise retirees medical costs? Now a new company might for a short while, after all the numbers are by definition the number of retirees are small, but long term, no way. And of course you are totally dependent on the long term viability of the Company, I know people who have lost out significantly because their generous retirement benefits vapourised with the Company. My ex colleagues who were on a nice pension scheme found out one day it was disappearing, they caould not take away what had been earned, but the real benefits started accruing in the final years up to retirement.

Phillipines sounds a good idea, we will probably go home.