# If Not For Medicare, How Would Seniors Get Health Care? **URL:** \ **Category:** Great Debates\ **Created:** [February 3, 2010, 3:46pm UTC](https://boards.straightdope.com/t/if-not-for-medicare-how-would-seniors-get-health-care/527529 "2010-02-03T15:46:04Z")\ **Posts on this page:** 20\ **Page:** 7
**Author:** ![Kimstu](https://avatars.discourse-cdn.com/v4/letter/k/ecd19e/32.png) [@Kimstu](https://boards.straightdope.com/u/Kimstu)\ **Post date:** [February 5, 2010, 4:39pm UTC](https://boards.straightdope.com/t/if-not-for-medicare-how-would-seniors-get-health-care/527529/121 "2010-02-05T16:39:47Z")
> [@Bricker](#): > > And if we restricted abortion, I have to say that we’d be morally obligated to provide some form of universal health care, pre-cradle to grave. This isn’t a logically consistent argument. We **do** restrict abortion in the later stages of pregnancy, and even in many situations where an abortion is legally permitted, a pregnant woman who wants one can’t get one for practical reasons (clinics too far away, “waiting period” rules too burdensome, etc.) The situations that **gonzomax** describes already exist for many women. If you really felt that the possibility of women being trapped in pregnancies where they can’t afford to pay for a baby’s health care but can’t obtain an abortion was a sufficient justification for providing UHC, you’d be advocating UHC right now. ---
**Author:** ![Bricker](https://avatars.discourse-cdn.com/v4/letter/b/977dab/32.png) [@Bricker](https://boards.straightdope.com/u/Bricker)\ **Post date:** [February 5, 2010, 4:55pm UTC](https://boards.straightdope.com/t/if-not-for-medicare-how-would-seniors-get-health-care/527529/122 "2010-02-05T16:55:48Z")
> [@Kimstu](#): > > This isn’t a logically consistent argument. We **do** restrict abortion in the later stages of pregnancy, and even in many situations where an abortion is legally permitted, a pregnant woman who wants one can’t get one for practical reasons (clinics too far away, “waiting period” rules too burdensome, etc.) The situations that **gonzomax** describes already exist for many women. > > If you really felt that the possibility of women being trapped in pregnancies where they can’t afford to pay for a baby’s health care but can’t obtain an abortion was a sufficient justification for providing UHC, you’d be advocating UHC right now. Not at all. I don’t feel that the very few women trapped under our current scheme represent any significant reason to change. But if we meaningfully restricted abortion, that would obviously include many more women (born and unborn) and that would tip the scale. ---
**Author:** ![Blalron](https://avatars.discourse-cdn.com/v4/letter/b/35a633/32.png) [@Blalron](https://boards.straightdope.com/u/Blalron)\ **Post date:** [February 5, 2010, 4:58pm UTC](https://boards.straightdope.com/t/if-not-for-medicare-how-would-seniors-get-health-care/527529/123 "2010-02-05T16:58:39Z")
> [@Bricker](#): > > I doubt very seriously that these questions are designed to answer: “Why did you try to use a poetic phrase to justify governmental policy?” The specific reason I thought of it was that Justice Stevens quoted that phrase in his concurring opinion in Washington vs Glucksberg, upholding the right of the state to prohibit assisted suicide. Since you aren’t playing along with my Socratic method, I’ll supply the answer. The state has a clear interest in the protection and preservation of human life. A health care plan to further that goal would survive a rational basis test. Do you agree or disagree with this statement? I’m also wondering why you are bringing up abortion in this thread, as if you had the power to hold health care hostage over this issue. Why? If you truly valued human life, you’d take whatever victories you could get in that regard instead of making what you consider to be perfect be the enemy of the good. ---
**Author:** ![jasg](https://avatars.discourse-cdn.com/v4/letter/j/f0a364/32.png) [@jasg](https://boards.straightdope.com/u/jasg)\ **Post date:** [February 5, 2010, 6:45pm UTC](https://boards.straightdope.com/t/if-not-for-medicare-how-would-seniors-get-health-care/527529/124 "2010-02-05T18:45:11Z")
> [@Bricker](#): > > I expect my employer will continue to permit me to participate in their group plan, as they are required to do by my contract. Serious question from a job seeker. Where can I apply for that sort of job? As a software engineer, I have never worked for an organization that offered employment contracts or retirement healthcare. ---
**Author:** ![Bricker](https://avatars.discourse-cdn.com/v4/letter/b/977dab/32.png) [@Bricker](https://boards.straightdope.com/u/Bricker)\ **Post date:** [February 6, 2010, 12:13am UTC](https://boards.straightdope.com/t/if-not-for-medicare-how-would-seniors-get-health-care/527529/125 "2010-02-06T00:13:01Z")
> [@Blalron](#): > > The state has a clear interest in the protection and preservation of human life. A health care plan to further that goal would survive a rational basis test. Do you agree or disagree with this statement? Absolutely. There has been some talk about the unconstitutional basis for a health care plan, but that ship sailed seventy years ago. By all modern precedents, there is no constitutional bar to UHC. > [@](#): > > I’m also wondering why you are bringing up abortion in this thread, as if you had the power to hold health care hostage over this issue. Why? If you truly valued human life, you’d take whatever victories you could get in that regard instead of making what you consider to be perfect be the enemy of the good. No. It’s not a matter of saving human life. It’s a matter of applying a consistent framework to how we create policy. Think how many people die in automobile accidents every year. “If you really cared about human life, you’d demand a total ban on cars.” Right? Of course not. Because we accept that a certain number of deaths each year is inevitable if we wish to enjoy the benefits of the car-based society. So, too, in this instance. I’m not claiming I have an power to tie thew two together; I am saying that the claims baout craing baout human life ring hollow from a people that are perfectly happy to slaughter unborn children right and left. Of course, you may disagree that there is such a thing as an “unborn child.” And I disagree that society has an obligation to provide health care for all its members. Both of us offer unproven assertions. I recognize that the people have spoken and my abortion view is in the minority. I accept that. Would that you do the same for UHC. ---
**Author:** ![Bricker](https://avatars.discourse-cdn.com/v4/letter/b/977dab/32.png) [@Bricker](https://boards.straightdope.com/u/Bricker)\ **Post date:** [February 6, 2010, 12:16am UTC](https://boards.straightdope.com/t/if-not-for-medicare-how-would-seniors-get-health-care/527529/126 "2010-02-06T00:16:40Z")
> [@jasg](#): > > Serious question from a job seeker. Where can I apply for that sort of job? As a software engineer, I have never worked for an organization that offered employment contracts or retirement healthcare. I would imagine that employment contracts, severance packages, and guarantees with respect to retirement benefits would be offered by many software engineering outfits at a certain point in your career. ---
**Author:** ![sinjin](https://avatars.discourse-cdn.com/v4/letter/s/ebca7d/32.png) [@sinjin](https://boards.straightdope.com/u/sinjin)\ **Post date:** [February 6, 2010, 12:32am UTC](https://boards.straightdope.com/t/if-not-for-medicare-how-would-seniors-get-health-care/527529/127 "2010-02-06T00:32:39Z")
\*\*Bricker \*\*can you please answer my question and **jsag** ’s in regards to this statement by yourself: > [@](#): > > I expect my employer will continue to permit me to participate in their group plan, as they are required to do by my contract. **jasg** : > [@](#): > > Serious question from a job seeker. Where can I apply for that sort of job? As a software engineer, I have never worked for an organization that offered employment contracts or retirement healthcare. **sinjin** : > [@](#): > > What if your employer goes bankrupt or is bought by another company that does not honor your company’s prior commitment? FTR, not a snarky question, this is happening a lot of late. It seems that most if not all of the folks against UHC have a pretty nice insurance policy provided by their employers and don’t believe or refuse to believe that their policy will ever disappear. Why do you feel so secure? How can the rest of us get that same security? Do you realize that many people who felt the same way you do subsequently found out that they were SOL when they were laid off or their company was bought out by another who significantly reduced their benefits or their company went bankrupt? How do you address this situation? ninja’d while typing. ---
**Author:** ![Voyager](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/voyager/32/133_2.png) [@Voyager](https://boards.straightdope.com/u/Voyager)\ **Post date:** [February 6, 2010, 12:42am UTC](https://boards.straightdope.com/t/if-not-for-medicare-how-would-seniors-get-health-care/527529/128 "2010-02-06T00:42:01Z")
> [@Bricker](#): > > I would imagine that employment contracts, severance packages, and guarantees with respect to retirement benefits would be offered by many software engineering outfits at a certain point in your career. You’d imagine wrong. I’m not sure what he meant by employment contract, since most employment is at-will. Good companies do give severance packages, but I know of no top ranked silicon valley companies that give any sort of retirement benefits besides 401K matching. I have a pension (tiny) and maybe some tiny retirement benefits from Lucent, stemming from the old AT&T, but no new employees have it. And to prove that **sinjin** ain’t just whistling Dixie, my neighbor who used to be a manager at GM just lost his retirement health care. ---
**Author:** ![sinjin](https://avatars.discourse-cdn.com/v4/letter/s/ebca7d/32.png) [@sinjin](https://boards.straightdope.com/u/sinjin)\ **Post date:** [February 6, 2010, 12:42am UTC](https://boards.straightdope.com/t/if-not-for-medicare-how-would-seniors-get-health-care/527529/129 "2010-02-06T00:42:35Z")
> [@Bricker](#): > > I would imagine that employment contracts, severance packages, and guarantees with respect to retirement benefits would be offered by many software engineering outfits at a certain point in your career. And at what point in his career would that be? Can he expect it at 40, 50, 110? In what industry today is there any type of medical insurance benefit guaranteed with respect to retirement? How’s that working out for those in the airline business or those that worked for Enron? ---
**Author:** ![Bricker](https://avatars.discourse-cdn.com/v4/letter/b/977dab/32.png) [@Bricker](https://boards.straightdope.com/u/Bricker)\ **Post date:** [February 6, 2010, 12:55am UTC](https://boards.straightdope.com/t/if-not-for-medicare-how-would-seniors-get-health-care/527529/130 "2010-02-06T00:55:43Z")
> [@sinjin](#): > > It seems that most if not all of the folks against UHC have a pretty nice insurance policy provided by their employers and don’t believe or refuse to believe that their policy will ever disappear. Why do you feel so secure? How can the rest of us get that same security? Do you realize that many people who felt the same way you do subsequently found out that they were SOL when they were laid off or their company was bought out by another who significantly reduced their benefits or their company went bankrupt? How do you address this situation? It’s not clear to me how a successor company could simply refuse to honor the contract. Perhaps you could explain how you picture that working? I suppose the company could go bankrupt. And my first reaction is that I bet it won’t. Literally. Of course, I hedge my bets. I have other retirement assets, and would seek to get another health are plan while still covered by the first - taking a post-retirement job, for example, something where I could negotiate a small salary but participation in the group plan. Given the current HIPPA regs forbid an insurer from excluding you based on any pre-existing condition that hasn’t needed treatment in the past six months, it seems highly unlikely that I’d be caught with an unexpected company bankruptcy with not even enough warning to manage that six-month window. But if, in spite of the long odds against it, that happens, then I’m prepared to get sick and die, which is, after all, the ultimate fate that waits me at some point, and which I’ll assume God has some urgent need for my arrival in Heaven at just that point in time. What I won’t do is reach into your pocket and say, “Hey, since I’ve had some bad luck here, why don’t you pay for me?” ---
**Author:** ![jasg](https://avatars.discourse-cdn.com/v4/letter/j/f0a364/32.png) [@jasg](https://boards.straightdope.com/u/jasg)\ **Post date:** [February 6, 2010, 1:13am UTC](https://boards.straightdope.com/t/if-not-for-medicare-how-would-seniors-get-health-care/527529/131 "2010-02-06T01:13:03Z")
> [@jasg](#): > > Serious question from a job seeker. Where can I apply for that sort of job? As a software engineer, I have never worked for an organization that offered employment contracts or retirement healthcare. > [@Bricker](#): > > I would imagine that employment contracts, severance packages, and guarantees with respect to retirement benefits would be offered by many software engineering outfits at a certain point in your career. I have never found that to be true in the commercial software industry. Perhaps in the ‘executive suites’, but that is above my pay grade. If, as you say, you have an employment contract and a guarantee of retirement healthcare, you are truly fortunate. ---
**Author:** ![Dangerosa](https://avatars.discourse-cdn.com/v4/letter/d/22d042/32.png) [@Dangerosa](https://boards.straightdope.com/u/Dangerosa)\ **Post date:** [February 6, 2010, 1:29am UTC](https://boards.straightdope.com/t/if-not-for-medicare-how-would-seniors-get-health-care/527529/132 "2010-02-06T01:29:52Z")
> [@Bricker](#): > > Those are very compelling arguments. And if we restricted abortion, I have to say that we’d be morally obligated to provide some form of universal health care, pre-cradle to grave. We do restrict abortion. In the third trimester. Parental notification laws. ---
**Author:** ![gonzomax](https://avatars.discourse-cdn.com/v4/letter/g/e8c25b/32.png) [@gonzomax](https://boards.straightdope.com/u/gonzomax)\ **Post date:** [February 6, 2010, 1:31am UTC](https://boards.straightdope.com/t/if-not-for-medicare-how-would-seniors-get-health-care/527529/133 "2010-02-06T01:31:30Z")
> [@fruitbat](#): > > So if you don’t want rationing, then UHC should cover any treatment, at any cost, for anything you might want or need? > > This is what I don’t get. If you want universal coverage I don’t see how you can have it without giving something up. I think I will fall in love with the first politician who explains that if you want a benefit it comes with sacrifice. You cant have complete universal coverage of everything with no rationing because it simply costs too much. Amazing. The top 19 industrial nations cover their citizens for health care. You do not go bankrupt for getting sick or having an accident. Their people do not live in fear of getting sick. Their family will survive , they will not get thrown in the street for committing the crime of getting sick. Yep they pay taxes for it. their taxes go to health care. Every damn one love their system when compared to ours. They pay less. they get more . We have the most expensive system in the world. Our system is rated 37 best in the world. What is it that makes you unable to understand we pay billions to insurance companies that retard health care. They fight health care. They deny health care. Doing so. increases profits. it is just plain wrong. ---
**Author:** ![sinjin](https://avatars.discourse-cdn.com/v4/letter/s/ebca7d/32.png) [@sinjin](https://boards.straightdope.com/u/sinjin)\ **Post date:** [February 6, 2010, 1:35am UTC](https://boards.straightdope.com/t/if-not-for-medicare-how-would-seniors-get-health-care/527529/134 "2010-02-06T01:35:10Z")
> [@](#): > > It’s not clear to me how a successor company could simply refuse to honor the contract. Perhaps you could explain how you picture that working? I guess I’m confused by your employment contract. I am a tenured prof at a private university and Mrsin works as an exempt management employee for a large US company. I sign a year to year contract. If the University decides to eliminate my department they are required to give me one year notice and nothing more. Mrsin signs no contract at all and is an at will employee. If his company gets bought out he will either be laid off by the new company if he doesn’t fit their demographic or be required to accept whatever terms the new company offers. This is the way things work for most salaried employees in the US. > [@](#): > > I suppose the company could go bankrupt. And my first reaction is that I bet it won’t. Literally. Do you work for the state or federal government? > [@](#): > > Of course, I hedge my bets. I have other retirement assets, and would seek to get another health are plan while still covered by the first - taking a post-retirement job, for example, something where I could negotiate a small salary but participation in the group plan. Given the current HIPPA regs forbid an insurer from excluding you based on any pre-existing condition that hasn’t needed treatment in the past six months, it seems highly unlikely that I’d be caught with an unexpected company bankruptcy with not even enough warning to manage that six-month window. I suggest you do not go to the doctor ever again. Once you are diagnosed with high blood pressure, high cholesterol, or heaven forbid adult onset diabetes forget about your HIPPA exclusion. Also try not to get injured in a car wreck. Or get cancer… > [@](#): > > But if, in spite of the long odds against it, that happens, then I’m prepared to get sick and die, which is, after all, the ultimate fate that waits me at some point, and which I’ll assume God has some urgent need for my arrival in Heaven at just that point in time. Good luck with that. Say hi to the FSM for me. > [@](#): > > What I won’t do is reach into your pocket and say, “Hey, since I’ve had some bad luck here, why don’t you pay for me?” I hope you and Rand live happily ever after together. Really. ---
**Author:** ![Bricker](https://avatars.discourse-cdn.com/v4/letter/b/977dab/32.png) [@Bricker](https://boards.straightdope.com/u/Bricker)\ **Post date:** [February 6, 2010, 9:01am UTC](https://boards.straightdope.com/t/if-not-for-medicare-how-would-seniors-get-health-care/527529/135 "2010-02-06T09:01:04Z")
> [@Dangerosa](#): > > We do restrict abortion. In the third trimester. Parental notification laws. Fascinating. ---
**Author:** ![Bricker](https://avatars.discourse-cdn.com/v4/letter/b/977dab/32.png) [@Bricker](https://boards.straightdope.com/u/Bricker)\ **Post date:** [February 6, 2010, 9:05am UTC](https://boards.straightdope.com/t/if-not-for-medicare-how-would-seniors-get-health-care/527529/136 "2010-02-06T09:05:20Z")
> [@sinjin](#): > > I suggest you do not go to the doctor ever again. Once you are diagnosed with high blood pressure, high cholesterol, or heaven forbid adult onset diabetes forget about your HIPPA exclusion. Dropping the obvious opinion from the rest of your post… this seems to be a strictly factutal claim. Since I don’t see any exceptions in the HIPPA regulation for what you describe, and since you’re not the first person to either implictly or explicitly describe a nightmare scenariio that seems to ignore the HIPPA rules, I am going to ask for a cite. ---
**Author:** ![gonzomax](https://avatars.discourse-cdn.com/v4/letter/g/e8c25b/32.png) [@gonzomax](https://boards.straightdope.com/u/gonzomax)\ **Post date:** [February 6, 2010, 3:28pm UTC](https://boards.straightdope.com/t/if-not-for-medicare-how-would-seniors-get-health-care/527529/137 "2010-02-06T15:28:44Z")
> [@fruitbat](#): > > Gonzo, saying the insurance companies are solely responsible obscures that costs that consumers demand. We test more than other countries, even if the test is unnecessary. We demand all treatments be available regardless of any cost/benefit calculation. European countries do ration care. They will pay for some things and not others, you have to wait for certain types of care. I am OK with that. > > You can’t just preserve the current wildly expensive system and make the government pay for it. That would not magically make costs fall. There has to be an element of sacrifice. We would have to give up something to change the system. Is that something that people are willing to do? If that is true, why do we have worse results? More testing and worse results, hardly sounds like a prescription another country would want to take. Think about it. We do more testing and have worse results. That would indicate the tests are for the benefit of those who give tests ,not the patients. Tests are just a way to suck money out of the system. Who are these mythical people who are demanding more tests? Are you like that. I resist tests when i go. Sacrificing testing would be easy if we got better results. We are the 37th rated health care system. That means the medical care we give does not work very well. How can you defend it like that? When the medics discovered that breast cancer testing was actually doing more harm than good, stories saying it saved lives came out all over the news. Anecdotal ,personal stories that did not disprove the data ,were all over . But the fact remained, too much testing resulted in incorrect results, and needless invasive procedures. Our system is broken. ---
**Author:** ![jasg](https://avatars.discourse-cdn.com/v4/letter/j/f0a364/32.png) [@jasg](https://boards.straightdope.com/u/jasg)\ **Post date:** [February 6, 2010, 4:59pm UTC](https://boards.straightdope.com/t/if-not-for-medicare-how-would-seniors-get-health-care/527529/138 "2010-02-06T16:59:38Z")
> [@sinjin](#): > > Do you work for the state or federal government? I think you nailed it, the only employers I can come up with that might offer Bricker both employment contracts and guaranteed retirement health care are the TriCare program for the uniformed services and Federal Employee Retirement programs for government agencies like the NIH. ---
**Author:** ![sinjin](https://avatars.discourse-cdn.com/v4/letter/s/ebca7d/32.png) [@sinjin](https://boards.straightdope.com/u/sinjin)\ **Post date:** [February 6, 2010, 11:13pm UTC](https://boards.straightdope.com/t/if-not-for-medicare-how-would-seniors-get-health-care/527529/139 "2010-02-06T23:13:21Z")
> [@Bricker](#): > > Dropping the obvious opinion from the rest of your post… this seems to be a strictly factutal claim. Since I don’t see any exceptions in the HIPPA regulation for what you describe, and since you’re not the first person to either implictly or explicitly describe a nightmare scenariio that seems to ignore the HIPPA rules, I am going to ask for a cite. I must have misunderstood your post. > [@](#): > > Given the current HIPPA regs forbid an insurer from excluding you based on any pre-existing condition that hasn’t needed treatment in the past six months, it seems highly unlikely that I’d be caught with an unexpected company bankruptcy with not even enough warning to manage that six-month window. So are you saying that if you do have a pre-existing condition you’re going to the stop treatments during the six-month pre-existing condition window? And if you happen to get sick during that 6 months you’ll avoid medical care to keep your fictitious pristine health record? I’m confused. And again, do you work for the feds? If so…lucky you! Just another little datum point; my daughter changed jobs a couple of weeks ago and is not covered by the new company’s insurance until 3/1/2010. The cost of the cobra policy for the roughly 6 week interim period is $1700. They are both healthy and her only pre-existing condition is food allergies. That’s the cost for her and one 6 month old child!! For most middle class folks that’s at the very least a mortgage payment. Does this make any sense to any kind of reasonable person? ---
**Author:** ![Bricker](https://avatars.discourse-cdn.com/v4/letter/b/977dab/32.png) [@Bricker](https://boards.straightdope.com/u/Bricker)\ **Post date:** [February 7, 2010, 1:34am UTC](https://boards.straightdope.com/t/if-not-for-medicare-how-would-seniors-get-health-care/527529/140 "2010-02-07T01:34:47Z")
> [@jasg](#): > > I think you nailed it, the only employers I can come up with that might offer Bricker both employment contracts and guaranteed retirement health care are the TriCare program for the uniformed services and Federal Employee Retirement programs for government agencies like the NIH. Nonsense. I don’t work for the government. I have a private employer. I have an employment contract. And my employment contract includes guaranteed retirement health care. [Previous page](https://boards.straightdope.com/t/if-not-for-medicare-how-would-seniors-get-health-care/527529.md?page=6) [Next page](https://boards.straightdope.com/t/if-not-for-medicare-how-would-seniors-get-health-care/527529.md?page=8)