People DON’T know what’s best for them. Most people know that they want to be able to go to a health care provider of their choosing, not have to wait indefinitely for service and not go into bankruptcy if they suffer a major illness. But they are in no position to determine if universal health care, our current system or some other future system would best be suited for maximizing their health care needs.
And even if people did know these things, most people don’t have a choice. Their choice of health care provider is usually a secondary decision, based off of which company they work for.
So the way I see it, right now we have the worst of both options.
I confess, I’m a little unclear on what is meant by the policy proposals. What does it mean to eliminate private insurance: will private insurance be illegal, or will everyone be automatically enrolled in the public option, making private insurance obsolete?
I haven’t seen any of those details; I don’t think anyone has developed them yet.
I’m a Kaiser customer; they are a non-profit, and it is really nice having everything under one roof.
When I hear UHC, I don’t think about Europe, Canada, and Australia; I think Veteran’s Administration. That’s another obstacle to be overcome in the USA.
Yes, you should. But you live under the US healthcare system, so you don’t get to. You get the health insurance picked by your employer, or paying insane amounts out-of-pocket. Maybe some expensive or substandard individual scheme.
I don’t live under the US healthcare system. I have full UHC, I can get any private plan I want, or I can pay out of pocket. And if I do, I’d pay considerably less than in the US, despite living in a country with a higher cost of living. I can choose whats best for my family. You can’t. And your system is the reason.
To answer your original question directly (“Are there?”), yes there are ways to get UHC without outlawing private insurance. This has been done in the Netherlands and Switzerland, which are both structured similar to the ACA exchanges but with real teeth on mandates and better subsidies. Singapore also has a system that is a combination of private and public, and it’s structured very differently than the ACA.
Any UHC system will require government involvement. There’s no way around it. That much is proven worldwide beyond a reasonable doubt. But then once we get past that, we have to decide if the abolition of private insurance is a requirement. And the answer clearly is “no, it’s not required”. So, people may not like the fact that private insurance can exist with UHC. But it can, and in the US, it would be political suicide to do away with it. Might as well just hand the election to Trump if we go down that route.
I think a far more useful statistic would be to poll people who’ve just had a major medical illness or injury and see how many of them are happy with their health insurance.
So what? That doesn’t mean they don’t have access to health care. They might lack that access, or they might not.
What infuriated me about the Democrats and the ACA was, they said, effectively, “Oh no, people don’t have health insurance! Maybe if we have a monetary penalty for not having health insurance, that will inspire more people to have insurance!” And sure enough, it worked.
Now if they had said that every American was going to be charged 10% of their income, and that this money was going to fund health care for everyone, that might have worked. Maybe not; there’s still the problem that people in rural areas are definitely underserved when it comes to health care, and those people might balk at paying the same amount to cover everybody when they themselves are 40 miles from the nearest ER and are not going to get the same level of care. So they would vote against it. And they did.
There is no way in hell Trump can get EIGHT more years without breaking the constitution… in which case we’ve got more problems than just health insurance coverage.
Indeed. I live in a country with single-payer health care, and any politician who even hinted at undermining it would be utterly destroyed in an election. Americans who think their private health insurance is doing a good job for them simply have no understanding of the alternative, which as implemented in other countries is actually far more generous and less onerous than even Medicare in the US. I’ve also had private insurance for dental coverage, and it closely followed the American model for general health care: usually paid by the employer, out-of-pocket co-pays for everything – sometimes substantial amounts, limits on payouts, annoying paperwork, denials and arguments, etc. I shudder to think of my critically important general health care being managed in such a mercenary manner. It’s astounding that the OP thinks that any private company could provide better coverage than a universal public program that simply pays for all necessary health care services.
That said, I think that promising to abolish private health insurance is bad politics because of all the existing misconceptions out there, like those of the OP. Private health insurance should just be reduced by attrition over time from lack of demand, as it has in other countries.
Having been without health coverage a couple times in my life let me clarify something for you.
The ONLY treatment you are guaranteed access to in the US is the ER. Which MUST treat you IF your life is in danger. If your life is not in immediate danger they don’t have to do jack for you. (Many still try to help you, but they don’t have to do that.) And by “imminent” I mean “you’re going to die right now is something isn’t done”. Have cancer? Hope you have insurance because if you don’t you’re fucked. NO ONE has to treat you. Go to the ER? Well, you’re not dying right now so too bad. No insurance and you don’t get chemo, you don’t radiation, you don’t get surgery, you don’t get rehab, you don’t get jack. You might not even get painkillers.
If you don’t have health insurance by and large you don’t have access. There is a thread on this forum from a decade and change back about the utter bullshit I had to go through to get a fucking tetanus shot when I had no insurance. I was denied access even when I could prove I could afford to pay. As in, as soon as I said I had no insurance and was paying out of pocket the office drone would hang up the phone. It was an exhausting marathon of weeks to get a fucking tetanus booster, eventually requiring me to cross state lines to get it.
Is that clear enough for you? If you don’t have insurance you are a non-entity.
We have diabetics dying in this country because they can’t get insulin.
Please, stop deluding yourself. Those 8% of Americans don’t have healthcare coverage. That’s 20+ million people.
Waiting lists? If you don’t have insurance you don’t even get onto the list. Your wait is forever.
No, you should get to choose the health care you want and need for yourself and your family, and the hospitals and practitioners who provide it, without any limitations on who you may choose. The government’s only role here is to unconditionally pay for it. That’s exactly how single payer works, and it’s exactly NOT how private insurance works. None of the stipulations in that first sentence are true for private insurance. Single payer is what brings you real choice where it matters.
How do you know that? Where I live every citizen has what is in effect a version of Medicaid, and it works just fine.
The issue with healthcare is that there is a significant group of people who have long-term expenses that they simply would not be able to pay for themselves, and will never be profitable for an insurance company. Insurance is supposed to be about pooling risk, but healthcare costs are so long-term that it essentially amounts to pooling certainty. I have no idea if I’m more likely to total my car than anyone else with my car insurance, but I know I’m hundreds of times less likely to have to pay for expensive chemo in two months than someone who is in the middle of a multi-year chemo regimen. If I don’t either take it as an article of faith that I need to pay because it’s just part of living in our society to pay for their chemo, or get some sort of coercion to do it, I’m not going to do it, because it saves me money.
Since the ACA tax was eliminated we’re now living in a world where the insurance companies can’t discriminate based on preexisting conditions, but there will always be a large marginal group that loses money on average by buying non-discriminatory health insurance.
Unfortunately, this means that actually trying to make a rational justification for any universal healthcare proposal forces politicians to actually admit that they need to either force or incentivize you into paying for someone else’s care. I think Sanders/Warren have essentially taken the strategy of shouting their slogans (at varying volumes) in the hope that single-payer will become the norm and people will just like life better on the other side and not want to go back, rather than actually make the case which forces them to admit that they have to take freedom from people in order to make it work.
I am very heartened to see how aware people are of the true state of American health care as evidenced by the responses in this thread. Folks are much more aware than they were pre-ACA. Wonderfully encouraging!
It was obvious that the OP was not reading my responses in even a cursory fashion, since s/he didn’t acknowledge that I clearly stated I support Biden’s approach to add a public option to the existing ACA (that s/he claims to support) and strengthen its weaknesses through full participation via Medicaid expansion.
TruCelt, one of my sidelines is to send out COBRA Election Notices to employees who have terminated employment with their companies. The notices feel like a cruel joke to advise them of the premium amounts they must now bear in order to continue their coverage. For an average family, $3,200/month is not an unusual amount. For people out of work.
galen ubal, my late husband was Australian/Kiwi. He suffered the same culture shock at the American health care system as you did. Ours is an embarrassment when compared to many systems abroad.
survinga, I remember reading something long ago that outlined Singapore’s research into how best to set up a national health care system. Someone asked the relevant official if the American system was under consideration, and he replied it was. As an example of how not to do it.
Buck Gudot, I agree with your post #15, there is zero chance that Medicare for all will become a reality irrespective of who is in the White House come 2021. And if Warren does not temper her commitment to an instant conversion, she will lose either the primary if we’re lucky or the general election if we’re not. We can make a fair guess where the health industry oligarchs will throw their financial weight given a choice between Warren, who scares all oligarchs, and Biden, who doesn’t. Better the devil you know and all that.
Like it or not, this is the system we currently have, and making a successful common sense argument is often entirely different from making a successful political argument. Medicare for all suffers for being a common sense argument.
Thank you, Broomstick. I hadn’t been able to get back to the thread to reply to Hilarity N. Suze (because, ironically enough, I was busy with work for one of my clients, a health insurance company), but your reply was far more articulate and relevant than mine would have been.
We also need to remember that the candidates may have their plans but no plan survives contact with the enemy and progress, in this country, has some very, very determined enemies. Any plan offered by any of these candidates is likely to be signed by any other of them should it pass the House and Senate. Anti-Buttigiegcare ads, anybody?
But seriously, politics in this country is like the weirdest kind of baseball game where you have to swing for the fences simply to get on base. A good thing to remember when talking about MFA or O’Rourke’s gun proposals.