Americans' #1 domestic priority: Government-guaranteed universal health insurance

Great Debates
41

[QUOTE=Balthisar]
Whenever I leave the USA, I’m uninsured wherever I’m at. Well, yeah, I may be reimbursed at some point for part of it, but for the sake of whoever’s providing treatment, I’m uninsured. Why the heck can’t you just visit the States just like anyone else in the world who visits not having coverage?
[/QUOTE]

Ummm… because I should not have to “visit” the United States… I am American. I was born in the US, and lived there my whole life till I was 30 and could no longer get insurance. I’d like to be able to live in my own country and have insurance… but under the US employer-based system I can’t.

I have tried to pay for my own insurance, but I get rejected everytime. So I left. Now I am a refugee so to speak.

42

[QUOTE=GomezK]
Ummm… because I should not have to “visit” the United States… I am American. I was born in the US, and lived there my whole life till I was 30 and could no longer get insurance. I’d like to be able to live in my own country and have insurance… but under the US employer-based system I can’t.

I have tried to pay for my own insurance, but I get rejected everytime. So I left. Now I am a refugee so to speak.
[/QUOTE]

Can’t you get an adequate J-O-B if you plan correctly? Even companies like Walmart have group health plans and the “group” is the part that is important. Lots of people pick a job strictly because they offer group health coverage.

43

[QUOTE=xtisme]
Um…quite. Thats why I asked you for a cite. IIRC, the actually percentage is something like 10-15%. Feel free to look it up to see if its closer to your own assertion.
[/QUOTE]

You know, neither you or GomezK need to look it up. I provided you the dang link already. It was 15.7% in 2004 and rising. (I had previously made the same mistake as GomezK, assuming that since 40% of the public was not covered by employer plans that they were uninsured. Truth is that the government provides a sizable percentage of coverage already and a few do have coverage on their own too.) Don’t exaggerate low either.

gonzomax, reform is possible without dealing out those major players, even helping them some. Single payor won’t do it though and therefore is DOA. Savings from universal coverage and reform could be dramatic. Right now (same cite) we spend $100 billion/yr on the uninsured, hospitals spend $34 billion on providing care for which that do not get direct compensation (burying it instead in your bills), paying for care that often would have been avoided by those who have insurance. As that cite states

Rational reform will, over the long term, likely save money while providing care of equal or better quality.

44

[QUOTE=DSeid]
You know, neither you or GomezK need to look it up. I provided you the dang link already. It was 15.7% in 2004 and rising. (I had previously made the same mistake as GomezK, assuming that since 40% of the public was not covered by employer plans that they were uninsured. Truth is that the government provides a sizable percentage of coverage already and a few do have coverage on their own too.) Don’t exaggerate low either.
[/QUOTE]

Um…I guestimated from memory from between 10-15%. How is this EXAGGERATING low? I was pretty friggin close from memory. :stuck_out_tongue: I note that you excuse his rather high (exaggeration?) of 40% by hand waving it away…a natural mistake, ehe?

-XT

45

We don’t need universal healthcare. What we need is the removal of the ‘gag-rule’ between healthcare providers.
Under the current system, you cannot call Hospital A and get a price for, say, an appendectomy. If you could, then you could call Hospital B and get their prices, and you could compare the two, and decide for yourself if you want to go to Hospital A, which is farther away, but the price is lower and they are as highly rated as Hospital B.
Not only do we need to remove the ‘gag-rule’ - we need to remove the middle-man transaction houses here in this country, with a direct-from-payer-to-provider system with instant payment.
This system is here, now, but I cannot say more without revealing too much about what I do, who I work for, or what the likely future of healthcare REALLY is in this country :wink:

46

Well sure, I could go work at WalMart, but I’d be taking a tremendous paycut from ~$120K to ~$25K. Would anyboody in their right mind do this? The US system of health care has driven me (and lots of other expats here) out. Now, when I bought my $350K apartment, all that cash got sent out of the US… If I’d have had health care in the US for a reasonable price, that money would have stayed in the country.

Thailand does a booming business in health care to Americans and the hospitals are of a higher standard than most in the US… for a fraction of the price.

47

GomezK

What you’re saying is simply not true anymore. You really want to move back? Move to Maryland. Full coverage for your pre-existing condition is available through MHIP. You said you’re 30. A plan with a $1000 deductible like you have now will cost you $170/month. Not as cheep as the $100 you get in Britain, but not $3k/month either. Not all states have a plan like this, but some do, and I think others need to follow their lead. In any event, if you’re so desperate to get home, there’s your answer.

A question for those of you touting savings through “reduced administrative costs” from a single payor plan. The vast majority of these administrative costs (not all, but most) are incurred to comply with government regulations. Why do you think that increasing the government presence in the system will somehow magically reduce the paperwork required. Have any of you ever dealt with the government?

48

xtisme, I guess it did annoy me that had posted the actual cite above your guess from memory. What am I? Chopped liver? And since I had made the same mistake as GomezK previously (past thread) it is of course natural and understandable. :slight_smile:

DirkGntly, yup. I’m in an ER with acute appendicitis needing emergent surgery and that’s exactly what I’d do. Shop around for the best price. Not your best example that one. You may want to revisit your future business model. The “gag rule” you speak of I presume refers to the rules preventing me from having any appearence of fixing prices with my competition. There is no gag preventing a hospital or a doctor from telling callers what their (full retail) prices are. Of course no one but the uninsured (or underinsured) are ever actually charged full retail. PPOs, HMOs, Gubbermint … all get substantial negotiated discounts.

Weirdave, single payor may be DOA but it must be noted that Medicare’s administrative costs run about 2% of total program spending while private insurance plans administrative costs run 14%! Cite. Countries with single payor consistently run substantially decreased administrative costs compared to the US model. In brief the data all directly disprove your contention. Single payor won’t happen for a variety of other reasons, but any other hybrid plan must be able to capture some of the same savings that a single payor plan would very realistically be expected to achieve.

49

[QUOTE=DSeid]
DirkGntly, yup. I’m in an ER with acute appendicitis needing emergent surgery and that’s exactly what I’d do. Shop around for the best price. Not your best example that one. You may want to revisit your future business model. The “gag rule” you speak of I presume refers to the rules preventing me from having any appearence of fixing prices with my competition. There is no gag preventing a hospital or a doctor from telling callers what their (full retail) prices are. Of course no one but the uninsured (or underinsured) are ever actually charged full retail. PPOs, HMOs, Gubbermint … all get substantial negotiated discounts.
[/quote]

You’re correct - it was a poor example. This would be for non-emergent-care, and acute appendicitis is definitely an emergent-care issue.

50

[QUOTE=DirkGntly]
We don’t need universal healthcare. What we need is the removal of the ‘gag-rule’ between healthcare providers.
Under the current system, you cannot call Hospital A and get a price for, say, an appendectomy. If you could, then you could call Hospital B and get their prices, and you could compare the two, and decide for yourself if you want to go to Hospital A, which is farther away, but the price is lower and they are as highly rated as Hospital B.

[/QUOTE]

There is no gag rule at all for the insurance companies who pay most of the bills, and who negotiate prices with doctors and hospitals. Do you really think that a single person, gag rule or no, could do as well as a big company. The fact that you need this care right now helps. Care you don’t need right now, like plastic surgery or Lazix, does feel the force of the market. I think that the customer having time to shop around is far more a reason than the lack of insurance.

Consider airline fares. Big companies negotiate deals with airlines, just like insurance companies do. Individuals can do better, but only because we can shop around well in advance of our need. I can imagine a Travelocity for medical care - except that empty beds are not the same as empty seats. Think of what you’d pay for airfare if every flight you took was booked the day before travel.

51

[QUOTE=DSeid]
xtisme, I guess it did annoy me that had posted the actual cite above your guess from memory. What am I? Chopped liver? And since I had made the same mistake as GomezK previously (past thread) it is of course natural and understandable
[/QUOTE]

Well, FWIW I don’t think you are chopped liver. :stuck_out_tongue: I apologize, I just missed your post. A lot of times I’m skimming threads from work and sometimes I miss stuff.

-XT

52

[QUOTE=DSeid]

Weirdave, single payor may be DOA but it must be noted that Medicare’s administrative costs run about 2% of total program spending while private insurance plans administrative costs run 14%! Cite. Countries with single payor consistently run substantially decreased administrative costs compared to the US model. In brief the data all directly disprove your contention. Single payor won’t happen for a variety of other reasons, but any other hybrid plan must be able to capture some of the same savings that a single payor plan would very realistically be expected to achieve.
[/QUOTE]

No, in fact it doesn’t, because if you read the cite you linked, it counts the profits that private health insurance companies make as part of their “administrative costs”. Talk about manipulating statistics for one’s own political agenda! That’s a pretty damn impressive example.

53

Why shouldn’t we count the blood money that the health insurance gangsters make from denying Americans healthcare as part of their costs? Fact is, 14 cents out of every dollar that goes into the corrupt and immoral health insurance companies who stand between Americans and their doctor doesn’t go to healthcare, while only 2 cents out of every dollar in the Medicare system is taken out of the healthcare system.

Golly, you say, that’s some angry rhetoric. You bet it is. And the reason why I’m so angry about it should be obvious. One day my wife or I will get sick and the health insurance companies will bankrupt us. You know it and I know and they know it. And I’m an educated, healthy, productive member of society, not some deadbeat. And that goes for the vast majoirty of Americans, not to mention American companies. They’re already eating General Motors, Ford and just about any small business you care to mention. The health insurance companies are depressing employment, sucking money from the middle class, and making sure your children will be serfs. They are the single worst and most corrosive influence on American life today, and something’s got to be done about it. And things are only going to get worse. Everybody saying universal health coverage won’t ever happen in America is not taking into account the fact that the current course is unsustainable. There is a lot of anger out there, and as things get worse, that anger is only going to grow until it reaches a tipping point. And Things. Are. Getting. Worse.

54

That’s a mighty purty speech thar Vibe. Got any facts behind it, or are you planning to pilot you way through the argument by the seat of your indignation? If your beef is with private companies showing a profit, then be up front about it. Why single out health insurance companies? Car insurance companies make profits, as do life insurance companies, oil companies, car companies, appliance companies, computer companies, lawn care companies, beauty parlors, retail stores, jewelery companies, restaurants, car washes and pet stores. Shall we eliminate their profit as well? If that’s the system you’re proposing, then fine. But be up front about it, and make your case to the American public. As angry as you think they are, I don’t believe that they will buy it.

55

[QUOTE=Weirddave]
That’s a mighty purty speech thar Vibe. Got any facts behind it, or are you planning to pilot you way through the argument by the seat of your indignation? If your beef is with private companies showing a profit, then be up front about it. Why single out health insurance companies? Car insurance companies make profits, as do life insurance companies, oil companies, car companies, appliance companies, computer companies, lawn care companies, beauty parlors, retail stores, jewelery companies, restaurants, car washes and pet stores. Shall we eliminate their profit as well? If that’s the system you’re proposing, then fine. But be up front about it, and make your case to the American public. As angry as you think they are, I don’t believe that they will buy it.
[/QUOTE]

Because people aren’t DYING because they’re denied car insurance, or life insurance.

56

[QUOTE=Guinastasia]
Because people aren’t DYING because they’re denied car insurance, or life insurance.
[/QUOTE]

Is there any statistical basis to your (appearent) claim that more people die in the US due to lack of health insurance than die in countries with full UHI? I’m curious as to the statistical extent of the problem. My impression (which could be flawed) is that folks who COULD live also die in such countries…its just that the decision process of who gets aid and who doesn’t is done in different ways.

From my own perspective, as someone who’s extended family does not always have access to formal health care (i.e. some of my family are not, er, citizens), one can generally get at least acute health care at an emergency room. This may not be optimal (from a lot of perspectives)…but it IS care of a sort.

Also, my totally anecdotal experience with some countries with UHC is that those systems aren’t always the most responsive either…especially for routine health or wellness care (granted, I’m most familiar with the system in the UK about 10 years ago…and mostly from friends who live there).
All that said, my own problem with UHI in the US is…cost. Sure, I freely concede that our current system is sub-optimal. It also costs WAY more than it has too…IMHO mostly because of the current levels of government interference, but I’m willing to say that the blame falls on the private providers too. And those costs do seem to be rising, while the quality of the healthcare, while still high for the majority of citizens, seems to be lowering (my own impression of course).

However, I’ve never seen a UHI plan that didn’t have serious holes in it wrt what its actual costs will be…most of them seem to simply want to get the ball moving by low balling the costs and they Kyoto us later, when we are already on the slippery slope, so to speak. :stuck_out_tongue:

In addition, while its quite possible that our Canadian bretheren and sisteren and their fine government can do this kind of thing flawlessly, I don’t have a similar faith in our own Government not to screw the pooch give half a chance. I just don’t think, looking at our own social programs, that its such a good idea attempting something like this…$700 hammers come to mind and government stooges making life or death decisions, huge bureaucratic kingdoms springing up, political pissing matches, etc etc. I shudder to think of all the money that could potentially be pissed away…and the half assed and shitty system that might spring up. I can certainly envision something worse that the current fucked up system…

-XT

57

My point isn’t that more people die because we don’t have UHI. It’s that health insurance is more of a necessity than anything Weirddave named.

58

[QUOTE=Guinastasia]
My point isn’t that more people die because we don’t have UHI. It’s that health insurance is more of a necessity than anything Weirddave named.
[/QUOTE]

So, if something is a necessity, then the companies that provide it are not allowed to profit, is that it? Tell me, who gets to determine where the line is drawn? Also, I’m not sure I buy that argument, at least not WRT what most people mean when they talk about “health insurance”. It’s not a right. It’s not a luxury. Is it a necessity? Sometimes; insurance that covers heart attacks, strokes and car accidents is pretty much a necessity. OTOH, health insurance that pays for things like bariatric surgery, cosmetic surgery, sex change operations and LASIK surgery IS pretty much a luxury. Where you draw the line determines to a large extent weather or not it’s a “necessity”. Frankly, there are a lot of things on the list I made earlier that are more “necessary” than insurance coverage for, say, a check up, and none more important than coverage for, say, liver cancer.

59

I didn’t say they’re not allowed to profit. I just don’t believe that health insurance, at least the way it’s run here in the US, is working anymore. I don’t think it’s right that people have to consider good health a luxury.

60

The answer to where to draw the line: Kerry had a great answer to this, courtesy of economist Brad Setser, where he would have had the Feds be a reinsurer to the insurers for catastrophic claims. I thought that was amazingly clever, but of course he lost the election. Unfortunately, no one among the Dem candidates this time around is reprising this idea, despite its evident simplicity and its non-offensiveness to anyone but committed idiot-logues.