That’s a fair comment for many New Zealanders as well. All too often you hear people complain about their taxes and then move onto how scandalous it is when someone they know has to wait for a non-life threatening operation. Hell I’ve done it myself. But at least our system doesn’t bankrupt large numbers of our citizens if they are unfortunate enough to get sick or be in an accident.
The logic goes something like this:
[ol]
[li]Poor people are poor because it’s their own damn fault![/li][li]Universal Healthcare would be paid for by MY TAX DOLLAR![/li][li]I don’t want MY TAX DOLLARS going to those damn poor people![/li][li]{snort} {spit} Effin’ A![/li][/ol]
See how that all flows?
I haven’t visited the UK, so I have no idea how the culture works over there. But over here in the US we have massive racial and class divisions. And universal health care is seen, I think, as taking away money from the middle class and whites and giving it to poor people, blacks and latinos. Add into that the strong strain of anti-statism, and any kind of reform becomes incredibly hard.
In fact the US was going to create a universal health care system in the 1940s, before even the UK did theirs in 1948. But southern politicians were worried it would lead to integration in the hospitals, and they rejected it. At least according to Paul Krugman that is the story.
It is a sad state of affairs, the divide and conquer strategy works well. Whites get pissed about having to offer health care to blacks and latinos (you’d be surprised how much ‘those mexicans getting free health care in California and Arizona’ comes up among people who never set foot in or pay taxes in those states) and middle class people getting pissed about paying more in taxes for health care for the poor. Add in all the multi-billion dollar interests willing to fund misinformation campaigns (death panels, communism, restricting choice, etc) and it becomes almost impossible for things to change.
We passed UHC on a national level in 2009, but it doesn’t start going into effect until 2014 and even then it will be an imperfect system. Plus it could be overturned between now and Jan 1 2014. Plus the only way to get it passed was to cement the power and influence of Rx and insurance companies. We mandate private insurance and eliminate public options. We don’t negotiated Rx prices, and the laws regarding generics and patents changed a bit. They had to get their share first before the law could be passed.
I think a state by state revolution is the only realistic way to go. Several states are looking at meaningful health reform, starting with Vermont. But states like California, Montana, Pennsylvania, Illinois, etc are also looking into statewide reform. I hope they succeed, but most are probably just pushing those ideas for show with no intent of changing them.
But since a well run UHC system is 20-50% cheaper than our current system, the financial pressures could push the states to push for major reforms.
While healthcare is still too expensive in the US, relative to other countries, the real crisis is the lack of healthcare for individuals. I don’t doubt that you can get a reasonably good deal. My large company got bought by an even larger company, and my insurance plan improved markedly, thanks to the larger market power of my new bosses. BTW they are not know for throwing away money, so the improvement is not out of generosity. I bet they got a better deal than what you got, and you get a better deal than what a small company gets.
As a member of a large group, I’ve never suffered through the agony that so many Dopers who buy insurance individually seem to suffer through. I suspect if your insurance provider started jerking around your employees you’d hear about it, and I bet you’d get listened to.
Out of curiosity, do you require employees not covered by another plan to buy health insurance? My old company did - I’m not sure about this one. There was a 0 option in the benefits election menu, but I don’t know if selecting it resulting in you having to proved alternate coverage.
Wow, so many things to discuss. I think I’ll just hone in on a few of my favorites:
The Hippocratic Oath is feel good bullshit. It’s also usually taken by medical students, often at the start of medical school when they know exactly jack about the practice of medicine. There are also a lot of different versions floating around. I’ve always liked the original, in which physicians swore to never perform euthanasia, abortions, and, interestingly, surgery. They also swore not to seduce their patients’ slaves, which makes me wonder what those ancient doctors were up to that they felt it was necessary to include this in the oath.
Why a 26 year old needs shoulder surgery in the absence of trauma is beyond me. Most conditions that require surgery at that age would be quite serious.
When a patient is listed as “self-pay” it means one of three things: a) They are getting a service not typically covered by insurance. b) They are independently fairly wealthy and do not have coverage by choice, but will happily pay their own bills. c) They don’t have insurance and you (and your staff) are going to get paid little to nothing. That last group is by far the most common. Most offices are happy to have the first two groups, but it can be hard to differentiate b) and c), so many do not bother.
If you have a non emergent condition and have no insurance, I would almost always advise you to find the local provider of charity care in the region, commonly the county hospital or large local teaching institution. You will have trainees involved in your care and it might not have all the amenities, but the care is often quite good. They will still send you a bill! But they often have programs for the indigent/low income to help with finances and more importantly, when you fail to pay the bill they are much less likely to harass you re: payments and collections. They accept that a large portion of their patient mix will simply never pay. A significant number may be poor, destitute, illegal and/or give false demographic information and that’s just the nature of providing indigent care.
Blow off a doctor’s office or private hospital and they will generally be much more aggressive. But whatever you do, don’t be afraid to negotiate. Someone mentioned that self-pay patients often get a much higher bill than insured patients but that number is completely arbitrary. You can negotiate both before and after service is provided and many physicians will accept a lesser payment over nothing at all/the hassle of collections, etc. I say physicians but it’s virtually never the md who makes these decisions. It’s usually someone in the business office. Some patients end up paying a token amount i.e. 5$/10$ a month on a five figure bill because some (not all) providers realize that they can’t really afford to pay any more but at least they’re making an effort. Of course in a true emergency you’re hosed. But that’s not what the OP sounded like.
As for the overhead discussion… eh, it’s complicated. For the record I’m a supporter of universal health care but the numbers most commonly quoted seem awfully misleading to me. But maybe that’s enough for one post…
It is not just a curiosity. It is a critical part of the financing of our health care program. Everyone must either participate or show that they have coverage from a spouse (or parent in rare cases). This is what makes the premiums for the 64 year old the same as the 22 year old. There is actually a significant population for whom the cost share they pay is more than the actuarial cost of their policy for their age and health. And that is after the company is picking up 80% of the premium. There is a tiny fraction of the population that incurs most of the cost, year after year.
Somehow the people who are hell bent on opposing socialization of health care are just fine with this kind of socialization.
The United States actually has a quite low tax burden when compared to other countries, but that doesn’t stop some people from ranting and raving like we pay more than anyone in the entire world. Californians too want more money for schools and for jails, but are dead set against any tax increases. This has led to lots of cutbacks in services - but apparently no recognition of this and continued puzzlement about why the crime rate has gone up and the roads are so bad.
Yes. We have a health care advocate service that proved very effective when the insurer was giving me the run-around.
I will be talking with a friend tonight who owns and manages a business with about 150 employees. I will see what his take is on this. The company does provide health care and the employee population is definitely older.
I don’t think that they are oblivious so much as that bitching about taxes is often a pasttime that is not related to getting rid of taxes or the services they pay for. People bitch about the weather, too, though they can’t influence it.
In Germany at least, which is said to have complaining about how bad things are as national pasttime, a lot of it is the attitude “maybe our current state of affairs is good compared to 3rd world or the US, but that’s low-hanging fruit; look at how country X has solution X for problem X and things are much better, we should implement that, too”.
Also, we too suffer from liberatarians (called FDP) and lobbyists trying to chisel away hard-won accomplishments, so moaning about things is often preventive to taking them away.
Sometimes it’s become so ingrained that people do it automatically: compared to other countries, the German rail system is pretty good, but all you’ll hear are complaints because the train was … OMG 3 min. late! Things are going to ruin! etc.
Thanks. Exactly the reason for the mandate in HCR, of course. This concept is so obvious that one must think those opposed to the mandate really want to destroy health care for all, since I’m sure they’d be against raising taxes to pay for the obvious gap for older people.
What about this argument is unique to health insurance? The same reasoning can be applied to internet browsers. Isn’t it incredibly inefficient to have teams of programmers working on Firefox, Chrome, and Safari. Plus you have to have HR people to support those workers, buildings to house them, managers to manage them etc. Plus there is all the money spent to advertise the different browsers, etc.
This argument works as well for every product. If you only have one entity offering a service they should be much more efficient than having multiple entities trying to offer the same service.
In those markets you don’t have a set of consumers who are not paying the lion’s share of the costs. Most of the overhead involved in health care financing involveds trying to shift costs to other players. Firefox, Chrome and Safari developers are paid to improve the product, and push each other to to improve theirs. There is some of that in the health insurance scheme, but a whole lot more of cost shifting effort.
I believe you are unsuccessfully indulging in what is known as the “finger pointing game” of medical corporations.
We have no medical insurance system in the United States, we have sucker taxpayers, and profitable medical corporations. Can’t actually say anyone is in the field of patient care.
Anyone who has enjoyed the quality of the beach lifestyle we have in Southern California is happy to have any kind of paycheck that allows them to stay at the never-ending party.
So, uh, your friend can’t afford medical care because maintaining the party lifestyle doesn’t allow moving to a better job? You might not want to mention that in the future if you’re arguing in favor of UHC. I generally favor some form of UHC but that’s only in spite of people like your friend.
Stop twisting the facts. This is sounding like a teabagger distraction. My friend loves the Southern California lifestyle, and does a job well below his education level because he wants to remain here. Many people make this sacrifice. My friend is about to lose everything because of shoulder muscle quirk that led to surgery. It is something that could happen to anyone.
If you can not stay on topic or contribute in a positive way to as serious situation, please just go post elsewhere. There are others who take this seriously…oh, I got it now…you work for a medical corporation. In that case you should be in jail.
I’m trying to help you here. As I said, I already mostly support UHC for lots of reasons–but they don’t include supporting a man-child lifestyle. If you’re trying to push people on the edge toward supporting UHC, you may simply want to omit the nature of your friend’s situation.
And no, I’m not a doctor, nor to I have any affiliation with any medical corporation.
You probably are a medical corporation, you sound like one. Cadillac or Lexus - critical choice, huh?
Why should someone have to give up their home and lifestyle due to a quirky shoulder muscle? Whatever his lifestyle, why should he have to give it up? He gives it up because doctors and medical corporations are greedy.
When guys with your attitudes go down, it is funny. Reminds me of the story of a big shot exec who fired a lot of people. Then years later in his retirement he ended up in Sun City Hospital with a nurse who’s father committed suicide from the layoff. When we heard the stories of the broken bones of that exec we laughed, and laughed, and laughed. Oh yeah, it always comes around! :smack:
(for those wondering why UHC is hard to get across in the US, this spirit of entitlement is exhibit 1-A for many, many people)