(think tank sitting around a room): How can we develop a health care system that is twice as expensive as anyone else’s but provides lower quality care, that discourages people from admitting they have illnesses to medical professionals, and which despite the cost will still leave huge segments uncovered when they need help the most. Also, at least 30% of the system should go to waste.
I agree with an earlier poster. Why aren’t we rioting? Probably for the same reason people in dictatorships don’t riot. We have never known any different. I have never known what it is like to live in a country with competent, affordable, reliable health care. If I did, maybe I would riot. But its more like a domestic violence situation where most of us in the US have never known this to be anything but 'normal. We’ve grown up with plutocracy, we’ve never known any alternative and we are constantly being told to think we are the greatest plutocracy on earth, and tons of people actually believe it. So we don’t riot.
In a lot of ways the recent bill was an attempt to save the health insurance system.
Individuals and small/medium businesses see premiums go up 20-30% a year. So they either drop coverage or take catastrophic plans.
Large businesses drop out all together and self insure. In the last few years the % of large businesses that self insure has skyrocketed because it is cheaper.
Health insurance companies now have to make due with lower income from fewer premiums (fewer large businesses paying premiums and whatever middle/small businesses and individuals that haven’t dropped out are picking high deductible plans).
To make up for revenue shortfalls the health insurance companies increase premiums by 20-30% a year. Wash, rinse, repeat.
The health insurance/care system is on the verge of collapse, and it should collapse. A 25% annual premium increase means prices double every 3 years. That isn’t sustainable for more than 6 years at the most.
85% of Americans* with healthcare insurance* think the private system is great. That figure doesn’t include the 45 million people (15% of Americans) who aren’t insured at all. I’m pretty sure they don’t think it’s great.
In a thread a few months ago I asked how many Dopers who had experience of both the US system and UHC preferred the US system. The answer was a resounding zero. Yes, this is a substantially left-leaning board, so a vote in favor of UHC is to be expected. But unanimous? I am right wing myself by SDMB standards, but would swap the US system for the UK’s (imperfect) NHS in a heartbeat. People who claim that US health care is the best in the world are either indulging in wishful thinking or listen to too much talk radio.
Don’t make up statistics like that. The amount of people who are unhappy with our present system are a huge majority. The Obama plan was originally backed by a majority. But the right wing and corporate news hammered it endlessly. The health companies ran constant ads lying about it. They had spokesmen on every single talk show beating on it until our easily convinced people began to doubt . Our system sucks.
Next year health companies have to use 85 percent of the premiums they collect on health care. can you image =that. Now they are jacking up premiums for no other reason than to grab as much money as possible. what does it take for people to understand what the real problems are: health care companies and a for profit health care system.
Please do not use the term “health care companies” when you mean “health insurance companies”. My wife works for one of the former, not the latter; there is a huge difference.
Please don’t falsely accuse me of making up statistics. The 85% satisfaction rate was quoted earlier in this thread and comes from a well-publicized Gallup Poll:
The fact that 45 million people are uninsured, and that that is 15% of the population, was also well publicized during the last election and comes from no less an authority than the US Census:
Since you seem to agree with me that the private system is messed I’m not sure why you are accusing me of being a liar, but it’s untrue and I don’t appreciate it.
While we’re trotting out statistics, how about the one showing the average time an uninsured person stays uninsured? Or other statistics that give a better picture of exactly who the uninsured are? They are very telling–there is not some massive group of uninsured people, there is only a small group of long-term uninsured, with lots of people falling into and out of the category in the short term.
Oddly enough, after writing this I found out a friend was hit by a car biking home from work. Nothing too serious but involved an ER visit and some imaging.
He’s got great insurance, so no worries. Except he happens to be part of my group plan, so his inability to predict a car running a stop sign is going to cause all our premiums to go up again next year.
This system blows.
And the worst part of this system is that there seems to be 10 Rand Rovers for every Danblathers.
I also think this system blows, but UHC and whatever the hell is in the health care reform bill would blow more. We need to untie insurance from employment and state residency.
I agree with the second line. However, can market forces ever work with something like health care? Capitalism works fine for consumables because the person, in the end, has a choice to go without. With health care that choice goes completely against our hard wiring for survival.
And what orifice did you pull that assertion out of? EVERY OTHER INDUSTRIALIZED COUNTRY IN THE WORLD has UHC with lower rates and better outcome. The only possible reason it wouldn’t work here is if we were too stupid. Please don’t try and show that is true.
This might be an interesting debate if only 75-80% of countries trying UHC saw better results, but 100%?
At what point do anecdotes become data, in your oh-so-humble opnion? Would it help if I added another friend who has been completely unable to find private insurance, because she has mild, intermittent asthma which has not once in her life requiresd treatment beyond a $50 inhaler? And she’s a freaking labor and delivery nurse? Who hasn’t been able to find a FT job with benefits since finishing her master’s, and isn’t eligible for group insurance through her employer because she works on-call depending on how busy labor & delivery is, so even though she works 40+ hours most weeks, she isn’t considered a FT employee?
Or is she not contributing enough to “the system” for you? At what point do you deem someone unworthy of medical care, or deserving of risking bankruptcy, or even death, because of inability to get insurance because of a relatively minor (or major, for that matter) issue over which he/she has no control?
Sorry Dan. It sucks. Wish you the best resolving it. The market for health insurance in the US if seriously fucked up. I’d usually be the first one calling for a market solution if I thought there was one, but I’m not sure how. I see three distinct problems with health insurance and a market for health care in general (I’m sure these have been mentioned here before):
A large portion of negotiation for services and price cannot take place, as one is often negotiating under duress. You cannot “shop around” for a better price when you need this blood transfusion today.
You cannot plan for future health care costs. Oh, sure, you can set aside money every month for emergencies, which is exactly what I do. But I cannot know what my future costs will be for health care. I can pretty easily plan ahead for other necessities: I know I will need water, food, and shelter. But I cannot predict the stroke that may hit me five years from now, or the car accident, or any other possibility. This is why we have health insurance.
But the problem with insurance is that it operates so differently for health care. In every other facet of life insurance is for unexpected events. But regular health care, for chronic conditions, is also included in health insurance. I’m not sure this is right*, but fail to see a better alternative.
I don’t know how to resolve these. UHC worries me for quite a few reasons, but in this case, it seems that it may be the best solution. I haven’t heard any others that seem as convincing.
*And yes, I suffer from a chronic illness that is managed by drugs obtained through my health insurance, so I haven’t “been there”, I am there.
I think it’s worth noting that in many situations it’s impossible to “shop around” even if you have time.
I once had a test ordered by a doctor that I knew was an interesting data point, but not super necessary for the situation. As I was paying for it myself (hadn’t met my deductible) I decided to find out what it cost to help decide if I really wanted to do it.
Doctor’s office who ordered the test had no clue what it would cost. They told me to call the lab.
Lab was part of the local hospital. I called and tried talking to someone who worked in the lab, that confounded them. I tried calling the billing department at the hospital. They had no clue, and were completely unhelpful and kept repeating that the price I’d pay depended on my insurance. I explained I understood that, and was just trying to get “rack rates.” That confused them even more. I tried to find out who in the hospital was responsible for setting rates. No luck.
I spent a good 2 hours trying to track down the cost for this one lab, and ultimately gave up. Apparently I was the first person ever to want to know the price of a health procedure before I had it.
You are making the common error of not properly separating out healh and health care and health insurance. They are distinct concepts.
The statistics do not show that countries with UHC have better health care than the US. They only show that those countries have healthier populations. When you look at the actual efficacy of health care (eg, cancer survival rates), the US does better.
The reason for this is that there is more that goes into how healthy a population is other than the quality of its health care. So, you can’t look at population health statistics alone to show that UHC is better than the US health care system.
emacknight – I’m sorry to hear about your friend. And yes, indeed the system blows. Athena, I once tried to “shop around” to take a blood test. The hospital that charged less was right near me (the one where I used to volunteer). They wouldn’t do it because my doctor didn’t have privelidges there, and thus wouldn’t release the results to him. A freaking blood test. I had to pay almost twice that.