This is really the case against UHC. We end up with a tiered system anyway unless direct payment for health care is outlawed. Those with the money will have the procedure or care necessary to save their lives or improve their quality of life. Those on a government plan may not be able to receive this level of care because we, as a society, have decided that saving the life of an 80 year old is just not worth it.
That’s too bad, because I am a supporter, in general, of UHC. A well-functioning democracy requires an educated population, so we should subsidize education; a well-functioning market requires a healthy workforce, so we should subsidize health care. (It helps that there are externalities involved in both things.) The question is how much we should subsidize. I don’t know what the limit is, but I will disagree with anyone who says there is no limit. It may turn out there’s no limit in practice, but that’s qualitatively different from saying there’s no limit at all.
48 hour maternity stays, mammograms for 40 year old women, NICU care for infants born before the 24th week of gestation - things like that are the easy ones.
Regards,
Shodan
There are better ways of handling small ailments. My center used to have advice nurses, who could either recommend OTC remedies or transfer you to the appointments desk if they thought you should see a doctor. They had the benefit of no doubt hearing from many people with the same symptoms. My insurance company has the same thing. The cost of taking off work and sitting in an office for a while is also fairly high. Doctors can also give feedback about what to do if the problem recurs. I know old people are supposed to visit the doctor for recreation, but none of our parents do, and I don’t see a lot of them when I go.
For me, I went to the doctor when I got rejected for giving blood because of a fluttery pulse. I had just drunk a ton of Mountain Dew for lunch, so I was positive that this was the reason. I actually went to get him to sign something to say I could donate again. Funny thing - the reason for the fluttery pulse was that I had atrial fibrulation, which sometimes results in blood polling in your heart and causing a stroke. Would I have gone if money were an issue? No way. But they caught it early, and the problem got resolved pills.
The cost to the insurance company of treating a major heart attack, or of me dying, would cover a lot of trivial visits.
I’m confused. We already have UHC for the elderly. Why would letting people under 65 in make this supposed problem worse?
I do not know what your coverage is like, nor who pays for it. For myself, my employer pays 100% of my health insurance costs, which is amazing, frankly. Still, I’d rather have that money than the health insurance.
That’s my point. You decided to go see a doctor but, given the circumstances you decribed, many, including myself, would have written it off as too much caffeine regardless of how much insurance we have. You were lucky that you went but, I’m sure, you can imagine people not wanting to waste an afternoon on something so seemingly trivial.
Yes, you and most on this board who are in favor of UHC know full well what the result will be. I’m not trying to convince you of anything…merely pointing out that many have a problem with this. Also, government subsidized anything will increase cost.
You are also thinking in the wrong direction. YOU owe it to your society to be educated and healthy…not the other way around. We are not children.
My point is that to keep the taxes or premiums low enough for all to afford we will have to ration care later in life. In reality this will not happen and the costs will spiral out of control. This is happening now…we all pay into medicare but only people over age 65 can use it. If we allow more people in we are not taking in more money but we ARE increasing the costs. There is no free lunch.
Not necessarily, but this would be a larger discussion than would fit in the margins of the OP.
Well you can lead a horse to water and all that, but YOU get a benefit when I pay for my own education. Since I do not receive all the benefits, but I assume all the costs, I will tend to underprovide my own education. That’s problematic for me and you both. If only there were some extra-market entity that could help correct such an imbalance…
If costs matter, why do we give prisoners unlimited free care for everything? I know it was some dumb court ruling but as I understand it it was only to the “community standard” such as maybe what a bum could get at an ER?
OK, but that bum gets billed and a judgment against him for life if they can find him, why isn’t the prisoner billed, made a judgment against, and even have to pay a deductable and co-pay since that is in fact our “community standard” now? I have read of heart transplants in California, we would not do such for anyone else without a billing.
While I am at it, if everyone wants free care for killers, why don’t the victims of crime get at least as good of free care too?
Yorick, putting people under 65 in Medicare would HELP it as the younger are healthier and they would be paying to join it, they would be helping the older ones in fact. The people against it are doctors wanting to charge 8 times the real fees they get for anyone without insurance or out of work. The biggest such group is those just under 65. It is to protect docs phony right to steal from these folks.
We could fix a lot by a law forbidding but one charge for any one procedure, if the doc takes 350 for a procedure, then he can’t charge anyone else but 350. No one can think of this???
I do not understand what this has to do with anyone’s comments in this thread. Is this meant to launch a new discussion point? What point? That you are for health care, unless it is people in prison? Or…?
Eris, huh??? The discussion was about costs, I am providing ways to cut costs, that is how it is related. Yes I will support some care for prisoners, but only after good people have it, not before.
I don’t quite see what you are getting at. You can make the case that society benefits from an educated population but this says nothing about the individual. My guess is your education, or lack thereof, is of no benefit to me. Conversely, your education benefits you entirely. If you are uneducated you would probably squeak by without costing society anything. Having an education does not change this fact but gives you access to more resources.
You don’t have to guess. All you have to do is imagine what the world would be like if everyone who was ever educated, but yourself, wasn’t.
Again, this is individual vs group. I don’t believe you can extrapolate that much. Your particular education level has no bearing on society.
Exactly - some proceses rely on economies of scale. Everyone (wel, 99%) can read road signs. Everyone can read their mail; the credit card companies would not exist in current form, if they had to send out a paid bill collector to show everyone their bill every month. Without critical mass - no credit cards, total cash economy. No ATM’s if 90% of the population couldn’t read. Every significant transaction would need a lawyer on hand to eplain the details - oh wait, theer would be no such transactions.
Just as we take for granted transportation; what would life be like if we could only travel at walking or horse speed? Without literacy who would find the parts and read the manual to fix your car? etc. etc. etc. Certainly there would be no internet.
In Canada, a doctor either works inside the UHC system or outside it. If he works outside, his patients receive no payment from the health plan. So they either get government-provided service at government rates, or pay the whole shot. There are very very few private health care providers. (This is only for government services; a doctor can do government-paid plastic surgery, ie. burn vicitims, and also do private plastic surgery for cosmetic reasons at market rates.)
the big problem is determining what is reasonable, especially in end-of-life scenarios. I think if it is likely to aid in real recovery or mitigate pain, it should be covered. If there is no long-term benefit, if it is just to make the doctor or family feel good about it, why bother?
We are paying our Medicare premiums in advance, in the same way we are paying our Social Security in advance. (I know the cash flow does not work that way.) If we made Medicare universal, we’d clearly have to increase Medicare payments - offset by decreases in our current health insurance payments. We’d decrease cost per person with a wider and healthier pool. But yeah, expanding the number of people in the program with no more revenue wouldn’t work at all well.
I have good insurance, but not that good. And you’ll be singing a different tune after you look at $60,000 worth of bills for retinal surgery (all paid except for $100 co-pay per operation.) Sure, most years I lose on the deal. Some years I get back a lot more than I put in.
The costs I were referring to are societal costs, by the way, not just costs to me. Even if my insurance would pay 100% of a week in intensive care, I cost society a lot less by catching the problem ahead of time. That is one way or reducing health care expenditures.