Health care

[DMC]

@xtisme

You want me to cite the fact that the US doesn’t have UHC?? Um…no. I refuse to cite something that stupid. If you don’t know by now, well…

No, I want you to cite the fact that the majority of American’s don’t want UHC. That was my claim that you said didn’t reflect reality. It does, and I demonstrated it, with thus far, no evidence to counter it. In fact, here is a ton of polls consolidated in one location, and they all return the same basic results. The majority of the population supports some form of UHC.

See above answer. Reality doesn’t conform to those polls…the US does not have UHC.

No, we don’t have UHC. That doesn’t mean the majority doesn’t want it.

How about this. Lets talk politicians. Which major politicians are running on a platform of UHC? Just presidential candidates, either party (though I seriously doubt any major 'Pub candidate is running on such a platform). Afaict, though several candidates support health care reform, none of the major candidates (with the exception of Kucinich and possibly Obama, though I can’t really figure his actual stance out) none of they are pushing for UHC. Does that not suggest something to you? Considering your assertion that 80% of voters (or even 80% of tax payers) supposedly WANT it (that would cross party lines btw and encompass a HUGE amount of the center)?

All of the major Democratic candidates are either pushing for UHC, or something very close to it. Many of them want to phase it in in steps, but they still are pushing it. Hard.

Hillary Clinton
Barack Obama
Joe Biden
John Edwards
Dennis Kucinich
Bill Richardson

In fact, there are even Republican candidates who are starting to acknowledge that the system as it is is broken, or has significant problems. Most are very careful in how they are going about it, as they don’t want “Socialized Medicine” thrown back in their faces. Also, they have to be very careful, as while almost exactly half of registered Republicans are for UHC, it’s quite possible that no small percentage of those Republicans (who are more likely to be found in the middle) are considering voting for a candidate outside of the party, while those tried and true strict party line voters are most likely to be in that other half, the ones who are against UHC.

Mike Huckabee
John McCain
Mitt Romney
Tom Tancredo
Sam Brownback
Ron Paul

It’s not some hidden issue, and in fact, a [bill]([URL=“Text of H.R. 676 (110th): United States National Health Insurance Act (or the Expanded and Improved Medicare for … (Introduced version) - GovTrack.us”[H.R. 676[/URL) pushing for a version of UHC has been in the past three sessions of Congress, although the Republican controlled Congress didn’t get it out of committee.

With all of that said, I’m not wholly confident that it will be done correctly, only that it will be done soon. If I were to guess, I’d guess that it will likely be implemented in phases, starting with ensuring that every single child in the country is insured. That could not only pass soon, I bet it would have broad bipartisan support. Once that is in place, work will begin on ensuring that all adults are insured. It can take many possible forms, and that’s where the slowdowns are going to occur. I expect the Democrats to push a government-centric form of UHC, while Republicans will likely push government-assisted insurance (possibly at the state level) for those who can’t get it through an employer, through either tax credits, reimbursements, or a similar method. There will also be huge debates about whether the health insurance industry will be involved in the process, or will be made unnecessary. That’s going to slow it down even further, as I can guarantee that they’ll be throwing metric shitloads of money around in an effort to fight it. Harry and Lousie, here we go again.

In summary, it’s going to happen, it’s a big issue now, and will only get bigger, but the devil is in the details.

[XT]

@DMC

All of the major Democratic candidates are either pushing for UHC, or something very close to it. Many of them want to phase it in in steps, but they still are pushing it. Hard.

Hillary Clinton
Barack Obama
Joe Biden
John Edwards
Dennis Kucinich
Bill Richardson

Reading through each of these links, its clear (as mud) that the majority of them are talking about health care REFORM…not a shinny new UHC system al la Europe. The exceptions are Biden (I think) and Kucinich (I’m sure of this one…he’s layed out the the most substance).

@DMC

In fact, there are even Republican candidates who are starting to acknowledge that the system as it is is broken, or has significant problems. Most are very careful in how they are going about it, as they don’t want “Socialized Medicine” thrown back in their faces. Also, they have to be very careful, as while almost exactly half of registered Republicans are for UHC, it’s quite possible that no small percentage of those Republicans (who are more likely to be found in the middle) are considering voting for a candidate outside of the party, while those tried and true strict party line voters are most likely to be in that other half, the ones who are against UHC.

When have the Republican’s not acknowledged that there were problems with the health care system? IIRC Bush mentioned it several times when he ran…in 2000! Again, these folks are talking (the key word, as with the Dems, is ‘talking’) about health care reform…not a UHC system. Hell, several of THESE links specifically say that we don’t need or want a UHC system…just need to fix what we have, make it more inclusive, etc (i.e. they are saying the same things most of the Dems are, just oriented toward their own base).

@DMC

In summary, it’s going to happen, it’s a big issue now, and will only get bigger, but the devil is in the details.

:dubious: I guess we’ll see. It looks to me as if Hillary is going to win the Dem’s nomination (still kind of early, but I think she is in the drivers seat atm), there is a better than good chance that the Dems will win the Presidency next year, and they are very strong now in the house and senate. I will await the coming of UHC in 2009 with bated breath…

-XT

[Weirddave]

@DMC

. If I were to guess, I’d guess that it will likely be implemented in phases, starting with ensuring that every single child in the country is insured. That could not only pass soon, I bet it would have broad bipartisan support.

Every single child in this country is insured. Or at least, has insurance available to them. Every single state offers free or dirt cheap health care for children based upon their families income. Here in Maryland (the specifics vary by state) it’s free if the family makes less than 200% of the federal poverty level, and available at a very low cost ($57/month no matter how many kids you have) at up to 300% federal poverty level. That means that a family of 4 can make up to $62,000/year and insure their kids for $57/month. There is no way you can convince me that that’s unaffordable. If a child of a family making more than $60K/year doesn’t have health insurance, I’m putting it on the adults in that family. There are a lot of problems with the health care system in the US today, but please spare me the “Won’t someone please think of the children” argument. Someone already has.

Finally, if you want to talk about UHC, fine, but can we be honest about it at least? According to the U.S. Department of Labor, by 2015, over $4 trillion will be spent on health care annually in the U.S. The current U.S. budget is about $3.5 trillion. Instituting UHC would more than double current government spending. At least a cursory acknowledgment of this fact from those pushing for UHC would be a refreshing change, along with maybe a sentence or two detailing how they plan to fund the increase.

[DMC]

@xtisme

Reading through each of these links, its clear (as mud) that the majority of them are talking about health care REFORM…not a shinny new UHC system al la Europe. The exceptions are Biden (I think) and Kucinich (I’m sure of this one…he’s layed out the the most substance).

Universal Health Care simply means that everyone is covered, not that it look like some specific European system. In fact, I’d prefer they take the best parts of several various systems, and learn from the mistakes of others. All Democratic candidates are wanting to implement a system that guarantees all are covered, i.e. universal.

:dubious: I guess we’ll see. It looks to me as if Hillary is going to win the Dem’s nomination (still kind of early, but I think she is in the drivers seat atm), there is a better than good chance that the Dems will win the Presidency next year, and they are very strong now in the house and senate. I will await the coming of UHC in 2009 with bated breath…

You can raise an eyebrow all that you want, but I never stated that we’d have UHC in 2009, and in fact, I outlined why it will be delayed much longer than the general public desires.

Are you still claiming that the majority of taxpayers and/or voters do not want UHC? If so, bring some evidence to the table.

[DMC]

@Weirddave

Every single child in this country is insured. Or at least, has insurance available to them. Every single state offers free or dirt cheap health care for children based upon their families income.

I’m guessing you’re talking about the underfunded, frequently enrollment frozen program known as SCHIP. If that’s it, then no, not every single child is insured or has free or cheap health care available to them. Utah, for instance, just unfroze their enrollment for the program due to budget shortfalls.

Finally, if you want to talk about UHC, fine, but can we be honest about it at least? According to the U.S. Department of Labor, by 2015, over $4 trillion will be spent on health care annually in the U.S. The current U.S. budget is about $3.5 trillion. Instituting UHC would more than double current government spending. At least a cursory acknowledgment of this fact from those pushing for UHC would be a refreshing change, along with maybe a sentence or two detailing how they plan to fund the increase.

You’ll be hard pressed to find many people who don’t work in the same industry as you do that think that it will necessary to spend $10,000 per person to get universal coverage 8 years from now. We’re already spending more per person than countries that have UHC.

[Weirddave]

@DMC

I’m guessing you’re talking about the underfunded, frequently enrollment frozen program known as SCHIP. If that’s it, then no, not every single child is insured or has free or cheap health care available to them. Utah, for instance, just unfroze their enrollment for the program due to budget shortfalls.

I think you just proved my point about cost, but beyond that I don’t see what point you are trying to make. The program exists, it’s available to Utah citizens. The problem comes because it’s been mismanaged. What magical UHC fairy are you going to produce to prevent a national program from being mismanaged?

You’ll be hard pressed to find many people who don’t work in the same industry as you do that think that it will necessary to spend $10,000 per person to get universal coverage 8 years from now. We’re already spending more per person than countries that have UHC.

I think you’d be hard pressed to find someone who isn’t trying to sell the gullible oceanfront property in Arizona who thinks that the way to make something more efficient is to let the government run it and the way to save money is to eliminate competition, but theres are the twin refrains that I hear coming out of the UHC camp endlessly. But let’s say you’re right. Let’s say that the magical UHC fairy from above makes UHC twice as efficient and half as expensive (history shows that’ll be half as efficient and twice as expensive, but hell, I’ll play it your way for the moment). That still means increasing federal spending by half again what it is now. Can we talk honestly about what that would mean? For taxes? For care? I’ll tell you what it would mean carewise, and if you’re honest you’ll admit it too. It would mean rationing of care. Every country in the world with UHC has it, we’ll be no different. Oh, I don’t mean emergency care, or life threating illnesses, those will get taken care of either way, I mean routine and non life threatening care. My Canadian wife had to wait several months to have her gall bladder removed, something that would have happened the next day down here. They were a couple of pretty uncomfortable (but not life threatening) months for her. That will become the norm down here. You may feel that the trade offs are worth it. That is a legitimate point of view, and if you’d like to, please feel free to make the argument. All I’m asking is that you make it HONESTLY and avoid all the pie in the sky UHC-utopia-is-within-our-grasp! bullshit that so many libs spout.

Personally, in case you care, I think the basic structure of health care in this country is OK as it is. The government needs to increase (yes, that’s right, I said the government needs to increase it’s spending and intrusion) state funded or assisted coverage for people who are 'tweeners (not poor enough for outright free care but too poor to afford full health plans on their own), probably through a voucher system, they need to work on curbing the rampant costs in the system (tort reform and simplified systems for paperwork and legal compliance), they need to stop blocking international competition (allow access to Canadian (and other? Maybe) drugs and they need to allow citizens to band into pools to lower their costs. That’ll fix a lot of what’s wrong now. Once that’s done we can look at what else need to be fixed. I don’t think health care is really any different than food or housing. Both are things that the social safety net will provide or assist with if your income warrants it. Both are things that you are expected to pay for yourself if you make a decent living. I see no reason, none, for health insurance to be any different. UHC is a drastic, fundamental change from what we have now, and the problems in the system don’t warrant that level of response.

[DMC]

@Weirddave

I think you just proved my point about cost, but beyond that I don’t see what point you are trying to make. The program exists, it’s available to Utah citizens. The problem comes because it’s been mismanaged. What magical UHC fairy are you going to produce to prevent a national program from being mismanaged?

Actually, I just proved my point. SCHIPS doesn’t guarantee healthcare for kids, and many states have frozen enrollment at various times due to funding issues. I’m still interested in you demonstrating that every single child has free or cheap access available to them. Here’s a nice little PDF that shows both the good (and there has been quite a bit of good, but that’s not the same as saying everyone can be covered via this) and the bad.

I think you’d be hard pressed to find someone who isn’t trying to sell the gullible oceanfront property in Arizona who thinks that the way to make something more efficient is to let the government run it and the way to save money is to eliminate competition, but theres are the twin refrains that I hear coming out of the UHC camp endlessly. But let’s say you’re right. Let’s say that the magical UHC fairy from above makes UHC twice as efficient and half as expensive (history shows that’ll be half as efficient and twice as expensive, but hell, I’ll play it your way for the moment). That still means increasing federal spending by half again what it is now.

I haven’t seen any reason to believe that it would even cost half that. But I’ll happily look at any evidence that you can provide that demonstrates that.

Can we talk honestly about what that would mean? For taxes? For care? I’ll tell you what it would mean carewise, and if you’re honest you’ll admit it too. It would mean rationing of care. Every country in the world with UHC has it, we’ll be no different.

We already are no different. On my previous insurance, my wife was unable to go to a doctor for the seventh time in a year, even though her PCP was the one setting up the appointments. They said “Six times a year, nothing more. Sorry”. While you might use a different dictionary that I, I call that rationing.

Oh, I don’t mean emergency care, or life threating illnesses, those will get taken care of either way, I mean routine and non life threatening care.

At this point, we don’t know whether her illness is life-threatening or not, as her testing was cut off due to the above. I’ve now switched jobs simply so that I could get a different insurance plan.

My Canadian wife had to wait several months to have her gall bladder removed, something that would have happened the next day down here. They were a couple of pretty uncomfortable (but not life threatening) months for her.

My American (expensively insured) wife has been trying to get tested for MS for almost six months now. Even with the approval of her PCP, some of the waits to see various specialists are measured in months. That’s not for a specific specialist, that’s for the first available one in the network.

That will become the norm down here.

It already is the norm for many of us.

You may feel that the trade offs are worth it. That is a legitimate point of view, and if you’d like to, please feel free to make the argument. All I’m asking is that you make it HONESTLY and avoid all the pie in the sky UHC-utopia-is-within-our-grasp! bullshit that so many libs spout.

I’m personally covered, and at this point, about as well as I can reasonably hope to be, without spending months looking for a job specifically based on the details of their insurance coverage, including specialist availability (try getting that info from a prospective employer). There are many who are either not covered, or covered with crappy (but expensive) insurance like I had previously. It is for those people that this needs to happen.

[Weirddave]

@DMC

Actually, I just proved my point. SCHIPS doesn’t guarantee healthcare for kids, and many states have frozen enrollment at various times due to funding issues. I’m still interested in you demonstrating that every single child has free or cheap access available to them. Here’s a nice little PDF that shows both the good (and there has been quite a bit of good, but that’s not the same as saying everyone can be covered via this) and the bad.

I had trouble reading the PDF, it doesn’t seem to like firefox at all, but even when I went at it with IE, the gist seemed to be (as you said), that SCHIP works reasonably well with some problems that are due mainly to allocation of funds. OK, it’s not perfect, but what is? I’ll allow your dispute to my statement that “health care is available to all kids” if you’ll allow that in the cases where it’s not, that lack is due to bureaucracy and the real world difficulty of getting the correct amount of funds in place a year before they are needed, something that UHC would struggle with too. In any event, SCHIP does a pretty good, not perfect, job of fulfilling it’s mission, would you agree?

I haven’t seen any reason to believe that it would even cost half that. But I’ll happily look at any evidence that you can provide that demonstrates that.

I don’t understand you here. Are you saying that UHC would cost just a quarter of what the US Dept of Labor projects (“Half that” in reply to my allowing for the sake of argument a 50% decrease in costs) or something else? I started with the figures from the DOL and voluntarily cut them in half for the sake of discussion, what are you asking me for proof of? If you think that UHC will result in a 75% reduction in costs, I think you are the one that needs to provide a source for that claim.

We already are no different. On my previous insurance, my wife was unable to go to a doctor for the seventh time in a year, even though her PCP was the one setting up the appointments. They said “Six times a year, nothing more. Sorry”. While you might use a different dictionary that I, I call that rationing.

OK, granted. That’s rationing. What makes you think it will be any different if the feds were running things? Seriously, this intrigues me. I’ve brought up points about the cost of UHC, which you have (not, I don’t think intentionally) ignored. SOMEBODY HAS TO PAY FOR ALL THIS. Right now we have individuals and employers paying for health care, some of it good, some of it not so good. If it was simply an issue of “those bastard insurance companies want to screw us out of our money and our lives”, I might agree with you, but there are real world costs here (whoever pays them, through whatever agency), I want to know how you propose to address them. Insurance companies are not paragons of virtue, Jesus fuck no, but the same reality that causes all the abuses that people so like to shout from the rooftops will also apply to the government, and the government is much less responsive to individuals than the private sector. UHC means a massive, unprecedented increase in government spending and involvement in our lives. Before I buy into that I want my common sense questions answered to my satisfaction.

At this point, we don’t know whether her illness is life-threatening or not, as her testing was cut off due to the above. I’ve now switched jobs simply so that I could get a different insurance plan.My American (expensively insured) wife has been trying to get tested for MS for almost six months now. Even with the approval of her PCP, some of the waits to see various specialists are measured in months. That’s not for a specific specialist, that’s for the first available one in the network.It already is the norm for many of us. I’m personally covered, and at this point, about as well as I can reasonably hope to be, without spending months looking for a job specifically based on the details of their insurance coverage, including specialist availability (try getting that info from a prospective employer). There are many who are either not covered, or covered with crappy (but expensive) insurance like I had previously. It is for those people that this needs to happen.

I fervently hope that your wife is able to get the treatment that she needs. That doesn’t change my core points here. There is a cost to all of this, and all I’m asking is for you to provide some reasoning pointing to how it would be different with a UHC system. My mother just had a miraculous recovery from cancer (thread here), but it’s taken 8 months for her to get to the point where she was able to start treatment (thank God it wasn’t necessary). The reason it took so long is because her coverage is thru medicade. They kept changing the rules and switching rules on her. It worked out in her case, but I have to tell you, I would rather she had been under treatment 6 months ago instead of fighting bureaucracies.

Also, I notice that you didn’t reply to any of the points I made referencing what I think needs to be changed in the system. Do you have any comments on that?