Universal health care has become a major issue in this campaign. The statistic I’m heard is that up to 47 million americans lack health insurance – or about 16% of the country. (http://www.nchc.org/facts/coverage.shtml) Now those 16% are almost entirely the lower income section of society, and past elections have shown that lower income voters generally are less likely to vote than higher income voters.
That leaves 84% of society (and probably 90%+ of likely voters) for whom universal health care is not an issue that personally affects them. Some of these people may believe in universal health care on general principle; but if you believe voters vote their wallets, then it seems odd that the major candidates are pushing an issue which doesn’t directly affect the majority of their voters.
So which demographic group is pushing the debate on universal health care? Is it a media driven issue? Is it coming from the so-called “liberal elite”? Is it the candidates who think that 16% will vote for them and push them over the top in the election? Or is it really being driven by the lower income individuals whose voices are traditionally not heard?
The majority of people who take time to vote are people who want good policies and people in our government – decent, public-spirited people. They will not agree on what good policies are, and some may disagree violently on what principles to follow in deciding whether a policy is good or not, but most are not so selfish.
Really selfish people often decide that their time is worth more than their votes.
While those 16% are probably in the lower income segment of society, they are not in the lowest income segment, because the lowest income segment can be covered by Medicaid. So they might not be as politically disengaged as you are thinking. Many of the uninsured are working poor. This aspect of reporting on “the uninsured” is a bit confusing, since those who are currently publicly insured are usually not counted as uninsured.
Also, you don’t have to be in the 16% currently uninsured to be concerned about access to health care. Of those who are covered, many may be concerned about what will happen if they lose their jobs. Most people in the middle class know someone just like them who lost a job to downisizing, offshoring, etc. Others may be paying an arm and a leg for private coverage or COBRA and don’t think they can keep up with the rising cost, or are concerned that claims they make will make it possible to get/afford coverage in the future.
Another good reason to be concerned, even if you are confident in your own coverage, is the tendency of the uninsured to defer basic healthcare and wind up getting worse results at greater expense by using emergency care. This hurts everyone, as the cost is distributed among the insured, paying patients.
Health care voters include caring people from every income strata. There are wealthy people who think a country can be measured by how it treats the the least of us.
There are also people like me. I have health care, but I also realize that this might be an issue better handled by government.
First of all, uninsured people are a burden on our system. It just isn’t illegal immigrants. People without health insurance will use the most expensive form of health care, the emergency room. Most can’t afford to go to a doctor for a slight pain. They wait until it is something serious.
Also, health insurance is a cost upon US business. Canada, with their national health program, is often a less expensive place to locate because the company doesn’t have to pay health insurance.
Uh, no. Just like in the USA, health insurance is a benefit that employers in Canada pay in order attract and maintain good employees. Every province is different in how they run their coverages, but there’s not not a 100% coverage of everything. For example my company provides workers in Ontario insurance for medicine, dental (over the age of 13), and optometry that is not covered by the “universal” system. Although your point is valid in that the costs are less, it’s still important to point out that even the Canadian (Ontario) system doesn’t pay for such basic things.
Also note that not everyone with health care has “good” health care. In fact, the movie Sicko was not about people without health care, it was about people with health care who ended up with enormous out-of-pocket costs or were denied certain treatments or access to facilities because of their carrier or plan.
I used to be covered under Ford’s insurance growing up. As an independent adult, even with health care, I still am really choosy about what I decide to get treated for and what I don’t because I just don’t have as good insurance as I used to.
With all the money my company pays to insure my partner (a family of 3) and me (a single person with an HSA), I would much rather nix those costs and have the company pay a little extra in taxes to know that neither of us would have any out-of-pocket expenses when it came down to it. That’s why I’d vote for universal health care.
The thing is, no one is proposing such a system. No one is going to dismantle the existing private health care system. It won’t – can’t – happen. Both Democrat candidates are espousing systems whereby you must purchase private health insurance. Certain income levels will have different degrees of help in meeting that goal, and the degree of what’s required is different between the two major Democrat candidates. Neither of them address what will happen with existing coverage. Neither of them address specifically how such help would be covered. Universal, catastrophic coverage may be a noble goal, but this isn’t what’s being proposed. Ensuring that people that currently don’t have insurance, have a crappy policy, isn’t much better than not having a policy at all. Because the majority of Americans are happy with the way things are, you won’t find that they’ll be all that happy to destroy the way things are for the small percentage that are affected. While we may be smart here at the SDMB, the majority of the people have no idea what’s being proposed, other than “oh, universal care… I’ll vote for him!”
Another concerned catagory, not included in your 16% uninsured, would be those with existing conditions who are worried that they won’t, under the current system, be able to switch jobs and continue being insured. I know a couple of people in this grouping.
The idea that there are 47 million uninsured is basically unfounded. For instance, up to two-thirds of the “uninsured” have insurance at some point during the year. If you switch jobs and are temporarily without insurance, then you are counted in that 47 million “uninsured.” It also includes many people who are eligible for government health programs but for whatever reason do not sign up for them. It also includes the rich who choose not to buy insurance.
The idea that we have some sort of “crisis” of the uninsured is a myth of modern politics. There are certainly problems with our health care system. There are some people out there who go for long periods without health insurance. But to think there are 47 million people in this category and that they cause serious problems for our health care system is to be ignorant of the basic facts of health care policy in this nation.
The fact that the majority of Americans have insurance now != the majority of Americans being happy with the way things are. Some who are covered find the current system expensive and insecure, and some are philosophically troubled by its somewhat arbitrary nature. One thing the candidates have plenty of is pollsters. Even McCain has a healthcare reform platform. The candidates are responding to something–public concern. Even a sizable chunk of American business is not happy with the way the system is now. This cite references small business, but that’s not to say many large businesses (e.g. automakers) aren’t also unhappy with the current system http://www.businessforsharedprosperity.org/Health+Care/Small+Business+Majority
I think the majority of Americans were happy with the way things were 15 years ago, witness the failure of the Clinton plan back then, but the tide of public opinion has turned.
I disagree, but more importantly I disagree that the italicized portion is the only relevant question. Health care expenses are a leading cause of personal bankruptcy Medical Bills Leading Cause of Bankruptcy, Harvard Study Finds)
and the current health insurance system is inefficient for workers and businesses. Maybe you feel, and have some data to back it up, that healthcare is being delivered adequately. It is costing a higher % of GDP to do so than other countries, though. See exhibit 4 here http://www.kff.org/insurance/snapshot/chcm010307oth.cfm
Even if you do not feel our current system is a problem for health care delivery, there’s a strong case that it is a problem for our economy.
Have you looked at the data of the bankruptcy study? It has nothing to do with the uninsured. Losing two-weeks of work-related income because of an illness, for instance, affects both the insured and uninsured. The “birth of a new family member” has what to do with insurance status?
No, I don’t feel it is being delivered adequately. But considering that the government pays for around 50% of the nation’s health care and heavily regulates the other 50%, I’m unconvinced that our problem is too *little * government involvement in this sector.
My mom had to go to the hospital for a few days because of abdominal pain while they were visiting me in California in 2004. We tried to find a hospital that would take their insurance, but the insurance company came up with some BS reason why they shouldn’t have to cover her hospital stay (they did later end up paying for at least most of it), like that she didn’t see her primary care doctor first (she was 3000 miles away, idiots). The hospital somehow got hold of my address, and was sending bills for $40,000 to her at my address. It’s rather scary to get a bill that huge in the mail, even if you know you won’t have to pay it.
Insurance companies have people they pay to come up with BS reasons to deny people coverage- it’s one of the ways they make a profit. Don’t kid yourself- it could happen to you, even if you’re insured and make sure you only go to doctors or hospitals that will accept your insurance.
I’m 99.99% certain that Mr. Neville and I could not buy meaningful (not just catastrophic, with prescription drug coverage) private insurance coverage (we both have pre-existing conditions). Fortunately, he has a job (tenure-track faculty) that does give us coverage and he’s very unlikely to lose his job and our insurance.
Quoted from your link, and to your first point "The co-occurrence of medical and job problems was a common theme. For instance, one debtor underwent lung surgery and suffered a heart attack. Both hospitalizations were covered by his employer-based insurance, but he was unable to return to his physically demanding job. He found new employment but was denied coverage because of his preexisting conditions, which required costly ongoing care. Similarly, a teacher who suffered a heart attack was unable to return to work for many months, and hence her coverage lapsed. A hospital wrote off her $20,000 debt, but she was nonetheless bankrupted by doctors’ bills and the cost of medications.
A second common theme was sounded by parents of premature infants or chronically ill children; many took time off from work or incurred large bills for home care while they were at their jobs."
I don’t see how you can read that and not understand that losing your insurance when you lose your job is a significant contributor to bankruptcy. It also touches on your question about birth of a new family member. If the birth results in serious health problems for the mother or the child, it is not rocket science to see how that could result in the loss of the mother’s employment-based health insurance.
To your second point, I’m open to solutions from the private sector, too, but I am not really seeing any promising contenders. The government essentially created the employment-based system by allowing tax breaks for employer-provided benefits. The answer is not necessarily more or less government action, but almost certainly different government action.
Perhaps, but I’m just going by the data in the report. It merely says that the birth of a child was a factor in almost 8% of bankruptcies. It does not break that down, so how exactly that birth played into the bankruptcy is an open question. Twenty-one percent said that a two-week (or longer) loss of a job for the debtor of his/her spouse contributed to the bankruptcy. Again, without more data it is hard to quantify exactly what this means.
My point is that trying to use this study to discuss the effect of insurance on bankruptcy isn’t supported by the data. It does, at another point, touch on the correlation of insurance and bankruptcy:
“Nearly four-tenths (38.4 percent) of debtors who had a ‘major medical bankruptcy’ had experienced a [health insurance] lapse, compared with 27.1 percent of debtors with no medical cause. Surprisingly, medical debtors were no less likely than other debtors to have coverage at the time of filing.”
Not exactly a strong statement.
Perhaps, but since this is GQ I think we should leave that to a GD.
