We spend 3 trillion a year on health care, it would take a lot more than that.
FWIW, if our health care were as efficient as other wealthy nations (whose systems are more humane and have better results), we would only spend 1.5-2 trillion a year. We spend 18%, other wealthy nations spend 8-12%.
With that 1-1.5 trillion a year in savings we could do all of the following:
[ul]
[li]Eliminate the deficit and start paying off the national debt[/li][li]Make public college free to everyone who applied[/li][li]Completely fund the military[/li][li]Balance every state budget[/li][li]Triple our investments in renewable energy[/li][/ul]
The point of insurance is to spread risk. The problem is one of freeloading. Unfortunately, you can’t piss off freeloaders too much due to political costs.
No. For insurance to work risk must be spread. So everyone must pay premiums. No exceptions. The problem with Obamacare is the stick is not vicious enough. If it’s constitutional it won’t work without teeth.
Well, this isn’t generally true of insurance, since most forms of insurance are voluntary, and they seem to work just fine. So why would it be particulary true of health insurance?
Briefly since the board appears glitchy, houses and cars have more or less defined values or replacement values. Hell they can be replaced. Human life isn’t fungible. Not yet at least. And we live in a society where tax payers feel obligated to pay for medical expenses anyways. Might as well force everyone into insurance then right?
The difference is that with all those other forms of insurance is that if someone doesn’t pay the premiums, they don’t get the benefit. If you don’t have insurance on your home, no one pays to rebuild it after it burns down. If you don’t have comprehensive insurance on your car, you have to repair/replace in on your own if it’s damaged in a flood. If you don’t have life insurance, no one gives your family money if you die.* If you don’t have money to repair/rebuild/replace your car or your house, you no longer have the car or the house. As a society, we aren’t willing to do that with health care yet, at least not in emergency situations. The “freeloaders” are those who neither pay for insurance nor set aside enough money to pay for their own expenses and who only do so because they are secure in the knowledge that they won’t be left to die on the hospital steps.
they might get Social Security- but only if you paid into that system long enough
First, a disclaimer. I strongly support a single-payer system. I think many aspects of the health care industry would be better nationalized or run other than “for profit” (including supposed “not for profit” income generators.) I strongly believe in the right to SOME LEVEL of health care. What I do not accept is that everyone is entitled to UNLIMITED health care, or that every life is of INFINITE value – to be subsidized by others.
As said upthread, the wealthy have many advantages I don’t. The wealthy can afford much that I can’t. Why should their health care be different?
For every example of someone who received heroic medical care and proceeded to contribute, I could respond with several anecdotes of old people living outrageously expensive final years, or infants receiving millions in care with no hope of reaching maturity. Resources are not unlimited. They are “rationed” already. I’m simply making this aspect of rationing more explicit.
I admit I have no data as to how such a change would effect health care costs/insurance rates. Or individuals’ attitude towards the use of health care. I encounter far too many people who are of the attitude that, “If I’m paying this much for insurance, I’m sure going to USE it.” As though they are supposed to turn a profit off of their insurance. I’m not suggesting this change alone would “fix” whatever may be wrong with our current healthcare system.
Perhaps such a cap would also have an effect on how medical care is priced and provided. Could more efforts be directed towards prevention than heroic rescue attempts?
And yes, I am displeased that Medicare will pay for kidney transplants – and countless other treatments, no matter what one’s age. I would strongly support a reduction of services to people as they pass certain ages. Once you are over 85, I’d suggest anything other than palliative care ought to be the exception rather than the rule. You had a nice long run. We’ll make you comfortable as you enjoy whatever time you have left as best you can.
Some people lost the lottery in terms of genetics or just plain luck. Sucks to be them. Tomorrow I might get hit by a bus or be diagnosed with cancer and become one of them. I do not think I am worth millions of dollars to society today, and I hope I would not change my mind should I become less healthy and less productive tomorrow.
We’d need some sort of panel to make those decisions. Since we have less of something than we would ideally want, perhaps we could call it The Dearth Panel.
Life insurance deals with death, not life. It’s about making sure your survivors have enough money to pay their bills; you don’t get to use it during your life.* Keeping you from death for awhile longer, though, is kind of the point of health insurance.
*Life insurance policies with cash values, etc., are financial products combined with insurance, and behave like other forms of financial product.
The reason Medicare pays for dialysis is because when it was created in the mid 1960s, dialysis was a new procedure, but not new enough to be considered experimental, and there were a lot of people who needed dialysis but couldn’t get it because they had no other way to pay for it.
Nowadays, most dialysis patients are over 65 so they would be covered anyway, but even babies can be covered on Medicare if they need dialysis.
Some states have indeed tried putting various caps on Medicaid recipients; the two that come to mind immediately for me are Tennessee and Illinois, which put limits of FOUR prescriptions per recipient per month, which as one could imagine had results that were beyond disastrous. :mad: :smack:
The problem is that a $2 million lifetime cap is way too low with today’s prices. A LOT of people can be restored to a meaningful level of health for that price, often without on-going onerous charges.
I think we as a society should be more open to palliative care, hospice, and not turning every illness into a metaphor of fighting a war for Truth, Justice, and the American Way. Part of the problem of getting people to accept that, though, is reassuring them that they aren’t being condemned as too expensive, rather, there really isn’t some super-secret cure for what ails them. Then there’s the issue of permitting suicide (assisted or not) for those with terminal or serious intractable illnesses without it turning into societal pressure for people to die when they don’t want to die. A LOT of the problems are all tied up with money, of people being terrified that their lives are valued less, that they are seen as worthless or parasitical when in their minds they’re good people and not some sort of blood-sucking vermin
Anyone with that attitude towards healthcare has never suffered a serious illness or injury.
Ideally, yes.
However, the rude truth that politicians never address (and likely never will) is that when you insitute single-payer, or any time you get long-neglected people onto a health system, is that you will initially have an increase expenditures as all the neglected stuff gets caught up - physicals, vaccinations, things that should have been treated but haven’t been, and so forth. After all that gets caught up then costs either level off or even dip slightly.
Sometimes heroic rescue attempts ARE a good thing - advances in trauma treatment, for example, have lead to people who would have died 50 years ago being restored to health and function and I think that’s a good thing. I think organ transplants can do the same, too. Heart surgery to repair defects. All sorts of stuff.
But yeah, an 85 year old with advanced liver cancer probably shouldn’t be considered for certain procedures. On the other hand, I wouldn’t just say "so sorry, you get nothing. I mean, you could simultaneously have advanced liver cancer AND an abscessed tooth. I think we should do something about the tooth rather than just add yet another agony to the poor patient’s last weeks.
Here’s the problem with that:
Everyone ages differently. There are people who are 85 who have a reasonable chance of reaching 100 - that is, 15 more years of life - mentally competent and reasonably self-reliant. There are 40 year olds that realistically don’t have another 5 years, and those will suck. It makes more sense to put resources towards the healthy 85 year old than the enfeebled 40 year old.
Which is where QAYL’s come in (Quality Adjusted Years of Life) - arbitrary ages really aren’t the best way to do these things. The real question is how much life can this treatment buy and what is the quality of those years? What is considered tolerable or not?
As for Medicare paying for kidney transplants… it also pays for dialysis which is the only alternative other than death for those with failed kidneys. Yearly cost for dialysis is about $88,000 just for the dialysis, never mind any other medical problem, major or minor, the patient has. AFTER a kidney transplant cost to maintain a patient is about $20,000/year. In other words, once the transplant is done treating the patient cost one fourth per year as a patient that has not gotten a new kidney.
Sure, the transplant itself costs about $100,000 - but that’s less than the cost of a year and a half of dialysis. With the average kidney transplant patient living 15 years past the operation, and saving about $60,000 a year over dialysis, over 15 years a transplant is about $900,000 cheaper than dialysis.
Why does Medicare pay for kidney transplants? Over just a two years they are CHEAPER than dialysis! And given that a lot of patients live 10 years on dialysis (some as long as 20 or 30) we’re actually better off getting as many folks transplanted as possible.
And this is also part of the problem - we hear how expensive organ transplants are (and in absolute terms they are) but most of use don’t have the data/knowledge to understand that over time they are actually cheaper than some of the alternatives! (Aside from simply letting people die, of course - but I think most of us would find that repugnant).
Jesus christ. It’s like the US political system all over again: No Other Country Does This. For A Reason.
Do you not think it kind of defeats the object: yep, universal healthcare - great idea,
lets do that … unlesss you’re really quite ill at which point … nah.
How about we’re kind to each other and take responsibility for others’ welfare? For example, I happily pay school taxes even though I have no children, because I value the principle of universal education. Similarly, I value universal health care.
And, tbh, it doesn’t have to be entirely about you, you, you. For example, I am so, so pleased my parents, nephews and nieces don’t have to worry about healthcare their whole lives - my entire family, all my closest friends are taken care of.
No one needs charity, or some rich distant relative - everyone has the dignity of their own entitlement.
One story I haven’t heard much about lately, because it’s been superseded by heroin, is people who blow themselves up in meth lab explosions. Several burn units have had to close because the entire hospital was in danger of bankruptcy just from the uninsured meth makers who came in for treatment, and some medical ethicists have even discussed whether people who do this should receive any treatment other than comfort care.
