"No one should die because they can't afford health care"

Great Debates
101

No, because Bismark did not live in today’s world with global pressures competing for cheap labor and scarce resources such as petroleum. Bismark’s world did not have a rising China, India, etc that would cause EU social programs (as they are currently structured) to become a handicap.

If France had a completely closed economic system that could create all the energy (nuclear or oil), food, technology, military weapons, etc, with no imports from outside its borders, then its social programs could be sustained by its own internal resources ad infinitum.

However, that’s not true for France (nor is it true for the USA.) If France doesn’t grow and can’t compete on a global marketplace (exporting wine, champagne, croissants, whatever) to trade for importing the resources it needs… including healthcare technology, drugs, etc then the system is not sustainable. That’s what the prime minister of France, Sweden, etc is trying to convey.

msnbc is both liberal and unreliable.

No, I didn’t think he was abolishing it. I’m just pointing out that the social spending system (such as France) that many Americans point to as a shining example is not financially sustainable.

I expect the USA over time will move towards more social programs such as France. But at the same time, France will move towards free-market (privatized) systems such as the USA. The 2 ideologies will converge.

However, to just assume that France’s social safety net is correct is just being ignorant.

That is true but people don’t look at free schools and roads with the same emotions because it’s not a tradeoff of being alive or dead. Because people would (naturally) spend an infinite amount of money or accumulate infinite debt for health treatment because of the human drive to stay alive. This dynamic puts the government at a insurmountable disadvantage for containing costs.

If the government has to compromise and says it can build a 2-lane road instead of a 4-lane highway because of budget constraints, the citizens for the most part can understand that. But if the government says that it can’t pay for a certain cancer treatment because it budget constraints then that reason becomes unacceptable.

102

What I was getting from him that there was not a moral imperative to give any treatment at all when someone gets sick, and they can’t afford it.

The expense cap problem is a lot more subtle. First, what is the extent of the problem? Sure there are a limited number of people who need long term, expensive, care, but what percentage is this? There are also plenty of people who fall over dead very cheaply.
Second, it is not like the problem begins with UHC. Most people in this situation are in the UHC program we have now called Medicare. How many new cases would we get with any sort of public option. How do insurance companies handle it now? Lots of people have nasty things to say about them, but pulling the plug on granny isn’t one of them.

The death panels didn’t have anything to do with this issue, but how are we going to have a rational discussion if when someone asks a reasonable question about it, like yours, is going to inspire the right to go apeshit? Do we let the people decide, with directives, like we do now (and risk spending a lot) do we use a panel to decide, or do we decide based on how fat the wallet of the sick person is?

However, I’m guessing that it isn’t that big an issue, really.

103

Again, I agree with much of this.I feel the need to point out though, that its equally not helpful when the left goes apeshit and feels the need to demonize someone who points out that, in the end, you must take money out of one person’s pocket and have it benefit someone else. I’m not saying that there is anything inherently wrong with that. Most everyone is willing to do that to a degree. And the question isn’t really the expense of a particular procedure, but how many procedures and the total cost of them. Whatever that number is, we need to divide it among those who can and do pay. Whether this is in a premium paid to an insurance company or taxes paid to the government, that’s the reality of it. So, the question becomes how much extra will people be willing to pay in order to care for others?

One thing that gets under many people’s skin about this is that you’re giving people less incentive to take care of their own health. Look at auto insurance. It’s required of everyone who drives. If you don’t have it, you are fined. If you get caught, they can pull your license. You can choose not to have it and not drive and everybody is happy. But with health insurance, no one can say they won’t get sick or have an accident. So you can/will have people who already chose to not take care of themselves through diet and behavior going to the doctor willy-nilly. So the group with a great real need can now go to the doctor for anything they want (real) and you and I get to pay for it. I don’t know about you, but that doesn’t sit right with me. Beither from a personal money-out-of-my-pocket point of view or wise public policy.

I don’t know what the answer is, but I don’t think it a good idea to dismantle the system we have—intentionally or through unintended attrition. The whole equation gets even more skewed the more progressive the tax code is. I forget what percent of the people currently pay income tax (I think it’s just over 50), but that means that half of us are paying to take care of the other half. It’s one thing to assume more of the burden for those things that benefit us all (military, roads, etc.) but quite another to ask some to pay for the results of someone else’s drug use or other irresponsible behavior. To take class out of this all together, should smokers pay more than non-smokers? Should people who engage in extreme sports pay more than a homebody? A stuntman pay more than a librarian?

But now I’ve gone off on a tangent…

104

But how many of these procedures are being done now, with the cost going to other customers when the patient who can’t pay declares bankruptcy? For essential procedures, will you agree that they should be done regardless of ability to pay? Will you agree that it is not good for families to go bankrupt or lose their homes because of them? Don’t you think some sort of UHC is saner than the system we have today, which both hurts families and rips off health care providers.

If what you say is true, we should be able to predict several impacts. First, those without insurance should be healthier than those with. Second, countries with UHC, like Canada, should have significantly higher rates of obesity than the US. Instead we have the most “free market” system and the worst obesity problem.
People who are poor are going to eat worse than those who are well to do because crap food is cheaper than good food, and those with money often have more time for exercise and meal planning. I agree that we have to do something about the obesity problem, but cutting exposure to health care isn’t it. My doctor yelled at me to exercise more, and I am thin, have excellent blood pressure, and ridiculously good cholesterol levels. If a person with a problem saw a doctor regularly, perhaps they’d get pushed into doing something about it.
And I already get to pay for anyone in my insurance pool to go to the doctor anytime he or she wants, pretty much. Hasn’t been a problem.

I would love a situation where everyone pays income tax. Now, if we were truly socialist we’d all be making the same amount and paying the same amount, which would thrill you no end. So, be careful what you wish for. The only reasonable way I can see of solving this “problem” is to pay those on the bottom enough so that every working person pays taxes, with enough left over to live one. How would you propose to do it? Cutting taxes on the rich just increased the deficit. If you want to cut spending, how about signing up for my proposal to only allow tax cuts one year after spending cuts. Given political realities, we’d never see another tax cut again.
Insurance companies charge more for people with voluntary bad habits, like smoking. Drug use would be something to add. Extreme sports people get their own special insurance, based on the true risk. My brother used to sky dive, I’ll ask him if he had to pay more, but I’m not sure how risky that sport really is.

105

So far, we have spent about $915B over seven years. That’s about a hundred billion less than Obama has spent in his first seven months. And about a third less than he wants to spend on health care.

The idea that the war in Iraq has broken the back of the US, while spending two or three times as much on pork and earmarks, is laughable.

Tu quoques are kind of stupid, but since that is the best you can come up with…

Regards,
Shodan

106

Is at least some proportion of the other half working? If so, why aren’t they in a higher tax bracket? Why should we be offended at compensating working people better? (Oh, and stay-at-home parents totally count as working, ftr.)

107

Study says most corporations pay no U.S. income taxes | Reuters Your bitching about the wrong people. Poor people would not have much to toss in ,but corporations avoid taxes like the plague. That should be stopped. They receive great services and pay zip. Some get millions of tax money back. The tax system is broken.

108

I do think that one thing that could get done rather quickly if the task was insurance reform, would be to find a way to offer catastrophic health insurance. This type of insurance, like long-term disability insurance, is not very expensive. I think the government can find a way to offer it, or regulate insurance companies to offer it, in away that most anyone can get it. I’d be an advocate to finding a solution for that. One thing I’m not an advocate of: a friend and I were arguing over health care reform, and as an example she pointed to a 30-year-old couple she knows. They, naturally, would love to buy a house. They did. But helped pay for it by foregoing insurance. They then became apoplectic when one of them got sick and they had pretty good incomes (over $100,000) but no insurance. Now these people I have ZERO sympathy for. We all make choices. And if you can afford insurance and don’t buy it, you’re gambling. If you win, good for you. If you don’t, live with it. It’s you’re own damn fault.

I’m not sure how what I said lead to what you wrote. I don’t think one necessarily follows from the other. I’m just not understanding your logic here.

It is my belief that every able-bodied, able-minded person should contribute to the big kitty. I’m not advocating the same amount of money, us the same percentage. The truth of it is that that still makes for a highly progressive tax structure, with the wealthier paying WAY more money than the poor—in direct proportion to their wealth. As I’ve offered in previous debates about this. I would make an allowance for people under a certain threshold to contribute in non-monetary ways. Parks, need cleaning up, fields need to be mowed, snow shoveled, leaves raked, schools painted, etc.

As far as risk, almost every injury I’ve had has been through sports, skiing, surfing, hiking, biking. My insurance always covered it, and there was no special “extreme-sports” fee. I think there should be. I also think I shouldn’t pay for someone else’s bad decisions. If someone wants to live on fast food and soda and smoke and drink alcohol like there’s no tomorrow, that is their problem. You remove stuff like this from being covered and I’ll be much more receptive.

109

Everyone should contribute. Everyone should kick in in a way that goes beyond what serves them well in their day-to-day lives. See my previous post.

110

Do conservatives want to save money or do they want to avoid the cost-saving scourges of rationing and death panels?

111

For the first part, I wonder why the market doesn’t offer this. I’ve looked at some almost catastrophic policies, but the best for a family looked to be about $1,000 a year with a $5,000 K deductible, and paying 80% after. That’s about $6,000 out of pocket before any benefit, and $1,000 even if no one gets sick. Given the odds, I can see why people don’t want these kinds of policies.
For your second part, I absolutely agree. Any reform should require this type of person to buy insurance and stop trying to game the system. And I don’t have any sympathy either in the current situation. I wonder if their mortgage involves an exploding ARM - that takes the same kind of mindset.

I took you as meaning that access to low cost health care enables people to become obese (or make other poor choices), since they don’t have to pay for the consequences. If I misread you, my apologies.

I suspect the working poor, who I have the most sympathy for, are putting in enough hours already. I can kind of see this for people on welfare without children at home or disabilities - but I’m not sure how many that will be. I’d hate to lay off city workers and make their lives easier in order to put people on welfare to work.

I’d hardly call hiking and biking extreme. Hell, I’d be a lot safer in the woods than in some parts of New York.

Smoking is purely discretionary. Drinking is mostly so, but some amount of alcohol may be helpful, and it is hard to draw the line by self reporting. Obesity is somewhat genetic; I am lucky enough to eat lots of stuff and not gain weight, even at my age, and my father is the same. There is also the problem of causality. Statistically it may be true that obesity leads to heart problems, but some people have heart problems without being obese, and some who are might have issues from other causes. My mother in law, who was rail thin, had to watch her cholesterol level very carefully. She never had heart problems, but if she did would she merit coverage for being thin while not for being fat? How much of a nanny state should we be? We’d almost have to come up with a solution to the nature vs. nurture problem to make it practical. Except for not smoking, almost all of my healthy practices seem to be genetically determined, not determined from force of will. I don’t think I deserve credit for that.

112

I think it is insane that people wouldn’t spend a $1,000 for their family in order to protect their futures. Insane. and I’d think those numbers could come down. Here’s an idea. If you can prove you have insurance, you can buy into a very cheap catastrophic plan, maybe subsidized by the government.

No, that’s not what I was trying to say. To be honest, I’m not sure what my point was, but that wasn’t it. I would presume no causality between people having low cost health care and becoming obese. Although it does remove an incentive for people to make healthier decisions. There have been programs offered on small scales (Blue Shield of California had one) that rewarded people financially for making healthy changes in their lives. This is akin to having lower premiums for them. I can only assumed it worked as they continued it for a second year.

I’m willing to forgive the burden for those who are disabled or have a highly unusual situation at home, but 95-99% of able-bodied people should contribute. I actually think this would have the added benefit of making what is often a population who feels outside of society feel more part of it.

You underestimate my stupidity on a mountain bike.

As little as possible.

I think that we can forgive most of these natural advantages and disadvantages, as they may balance themselves out for the most part. But actively choosing riskier behavior, whether it be sky diving or smoking, should be a burden that is shoulder by the person making the decision to do those things.

And I’m in a stellar mood right now. I just got a call telling me that I’ve been approved for regular health insurance (I was in some high-risk pool (inappropriately)). My monthly premiums will now go from just under $900/month to just under $300/month. Ahhhhhhhhh.

113

I’ll research what is available if I have the time, but the problem I see is that what is not catastrophic for me and you is catastrophic for the working poor. Many of the stories I’ve read involving people who have lost everything due to illness involves being laid off due to sickness and then losing what insurance they had (and not being able to buy more, due to expense and the pre-existing condition.) Government subsidized or even paid insurance would at least keep the hospital bills paid, but where does it cut in? Set too low and it pays for people who can afford the bills, set too high and it doesn’t cover those who need to be covered. Income might be okay, but not savings, since you don’t want to reward those who do not save. We also don’t want a system which doesn’t encourage early care which can help prevent catastrophes.

That’s clearly a good thing. But what of the people on the bottom who will have to be heavily subsidized? Incentives won’t mean anything then, and I’ll again argue that a lot of the obesity problem comes from economic circumstances, not willful lack of attention to diet. I have no clue as to how to solve that problem.

Excellent. You see, Obamacare works! :smiley:

114

Not everyone can buy health insurance. Are you actually so ignorant that you don’t know that?

People can be flat out denied due to pre-existing conditions.
People can be priced out of the market, offered insurance for thousands of dollars a month.
People can have their insurance decide to not cover something their doctor thinks they need.
People can have their insurance dropped after they get sick and then not be able to get it again.
People can have one issue and reach their yearly or lifetime cap of benefits.

Please, try to educate yourself before making claims like that.

115

Actually you suggesting that the stimulus package is pork and earmarks is laughable. :smiley:

116

Who would have guessed that might life would be made better by a Muslim President? Just goes to show ya…

117

For those of you dead set against the public option, what do you think should happen to people who have a non-fatal condition starting in early childhood which requires treatment or monitoring for the rest of their life that is not caused by any lifestyle choice of them or their parents?

118

I agree with you entirely, I worked at a hospital for several years, and saw what you say happen frequently. I imagine if the tables were turned and the person saying “no universal health care” found himself poor without insurance he would sing a different tune. I am retired, a serious illness could wipe out everything I own, so I am paying one-fourth of my entire income for medicare and a supplement so my children will have a house to live in.

It’s not easy, but I am willing to do it. There are a lot of willing people with no money. The graft in the system is huge. I saw doctors signing charts of their friend’s patients so they could get a check. I saw people that were going to die in a few hours subjected to a battery of unneeded tests so they could be charged on the account, it was disgusting to me.

Let’s clean it up now.

119

[QUOTE=Voyager
snip
Do you really think it is okay for a hard working person to lose everything he built up and saved for over the years because of an illness?

[/QUOTE]

Are you going to be the Czar for determining this ‘hard working’ criteria?

120

The treatment for my broken leg of 12 years ago would have cost more than $100k if not covered by insurance. As it was, I was 2 days short of having insurance at a new job (not eligible for COBRA, because my previous employer was too small). Thank goodness IL had a state law which required group plans to cover preexisting conditions, or I would have had to declare bankruptcy.

Those first 2 days of care cost me $4500 out of pocket. And that is for treatment which would have been basically the same 100 years ago: ambulance to hospital, X-rays, drugging me full of painkillers, and then having a doctor and a nurse or two hold me down while they yanked the leg bones back into some semblance of alignment. Oh, and they kept me overnight just to make sure I didn’t have a head injury or anything, but that was just for observation - no IV or anything, besically they just came to check on me once in a while to make sure I was as lucid as the painkillers allowed.

So should working people have to go bankrupt over a broken leg? The hospital was kind enough to hook me up with a payment plan for the $4500, which I did fulfill over a prolonged period, but not all hospitals are so friendly, and although $4500 was a significant amount of money for me (I was fresh out of grad school and had a relatively crappy admin job), at least I didn’t have a family to support, and I had a desk job that I could still do even with a broken leg (and my employer was kind enough not to fire me when I had to spend 2 weeks out of the office less than a month into the job). Not everyone is so lucky.