The poor have no dental or optical. They are on their own and wind up pulling teeth because a root canal is more than 1000 bucks.
A large portion of the bankrupsies in America are due to illness. No insurance is very dangerous. The poor wait too long before they go to doctors and suffer for it.
[QUOTE=TimeWinder]
Why? I mean, you’ve got a lot of "much"s in there, but the evidence would seem to be against you. Every other stable democracy on earth, and many of the non-democracies, provide universal healthcare. If this system were so so so so so so so so so so so so so so horrible, as you imply, any of them can end it and go back to a US-style system (and their citizens would love them for it, since the system is horrible).
[/QUOTE]
Whoooooooooooosssssshhhhh!!!
Honestly, I think with our current system, we’re just a short wait away from disaster. It cannot continue like this-something’s gotta give.
[QUOTE=gonzomax]
A large portion of the bankrupsies in America are due to illness.
[/QUOTE]
I would very much like to see statistics on that subject.
We have a collections agent that handles our delinquent patients. He’s heard the statement that “it’s medical bills that made me go bankrupt!” too, but he gets to see their credit card statements. Often (he says), the person has bought himself vacations on his credit card, motorcycles, cellular phone bills, and is spending every penny that comes in without any margin for saving for a rainy day. I would wager that that is why people go bankrupt: they don’t plan ahead. They don’t prepare for the worst.
Sure, it’s the sudden injury, or the car accident, or the unforeseen medical expense that pushes them over the edge, but it’s the habit of instantly spending every penny you earn that causes you to be so near the edge in the first place. That’s a strategy that works fine as long as nothing unexpected ever happens, but when you do, you blame the doctor — or the auto mechanic, or the guy in the other car, or the fire department, or whatever it was you didn’t plan for.
Another reason people are wary of centralized health care is that it might encourage state and federal legislatures to pass intrusive nanny laws to try to drive down medical costs. Once “taxpayers” are paying for something, they’re going to want to point figures at the people who they think are using more than their fair share.
As an example, on the question of whether the Indian government should require AIDS tests before issuing marriage permits, one BBC reader commented:
(http://newsforums.bbc.co.uk/nol/thread.jspa?threadID=5073&&&edition=2&ttl=20061221044740)
Ironically, the poster was an American, but I think this is the kind of endgame that many libertarian Americans fear.
Medical Bills Leading Cause of Bankruptcy, Harvard Study Finds Causes of bankruptsy. Mr. Fish
[QUOTE=meara]
Another reason people are wary of centralized health care is that it might encourage state and federal legislatures to pass intrusive nanny laws to try to drive down medical costs.
[/QUOTE]
But it’s not like those costs aren’t being absorbed now, and paid for by you and me. And it’s the companies who are trying to reign in their healthcare costs that are playing the nanny role today. For example…
Nobody is reigning in health costs. They are double inflation for years. Plus you get diminished coverage on a steady basis. Not to forget larger copays and loss of prescription benefits.
Shuffling around the cost won’t help things. If you make the doctors pick up the bill, you’ll get, across the board, the worse but less expensive treatments that currently only the crappier HMOs are pushing.
[QUOTE=Renob]
Untrue. “Uninsured” does not mean someone cannot afford health insurance. Most of the uninsured are only uninsured for part of the year (likely due to changing jobs) and a good number are above 200% of the federal poverty level.
Not really. The number of uninsured is increasing (although it’s debatable about how “uninsured” this group really is), but the percentage stays pretty steady. Our population is increasing, so naturally the raw number of uninsured is increasing.
[/QUOTE]
Cite? Never mind, Here’s mine (warning PDF, and from gasp Democrats. I’ll just mention the percentages.
So you see this is not just a problem of the poor.
[QUOTE=Sal Ammoniac]
Or maybe not. People keep talking about how wonderful the American system is, when it just isn’t. The Commonwealth Fund did a great study (cite here) showing that the United States, when compared to Australia, Canada, Germany, New Zealand, and the UK came in dead last in the overall rankings, and last in 4 of 6 subcategories – all while spending 88% more per capita than our next most expensive rival (Canada). New Zealand, which ranked second overall, spends exactly a third of what we spend.
[/QUOTE]
Thanks for the cites. You saved me having to find them.
As you can see Book Monster, many conservatives have ideological problems with “socialized” medicine. Part of the problem is this American habit of thinking we are the best in everything. We think that about health care also, though it is demonstrably not true. Then there is the belief that the government screws everything up. The Veterans Administration system is quite good, actually.
A lot of the proposals are for a single payer system, in which the government basically takes on the role of all the insurance companies today. The doctors would still be private. In any doctor’s or dentists office you go to here, no matter how small, there is at least one person working full time on insurance issues. Insurance in the US is not rocket science - it is much, much harder. 
One thing that no one has mentioned is that lack of insurance tends to keep people from seeking preventative care, or delaying care until the problem gets worse - and more expensive. That’s one way a universal system would save money - reducing the paperwork is another.
The other common objection to universal healthcare, not mentioned in this thread yet, is the idea that people would use too much of it if it were free. I’ve never seen any data to back this up, and it’s not like there aren’t any hypochondriacs now. You’d think HMOs - often with low co-pays - would have this problem, but I’ve never heard of it.
Banking Even the middle class are not safe from the financial impact of getting sick.
The only ones who would suffer with nationalized medicine are the insurance companies.
Question-Do nationalized medicine programs cover dental or optical?
[QUOTE=gonzomax]
Medical Bills Leading Cause of Bankruptcy, Harvard Study Finds Causes of bankruptsy. Mr. Fish
[/QUOTE]
Your site says:
In other words, the “cause of bankruptcy” is whatever the filer said it was. I’m not sure that disproves what I said, that people tend to blame their bankruptcy on whatever bill it was they hadn’t planned for.
Even so, your cite also said that many of those filers had medical insurance, so it instead of proving your statement that “not having insurance is dangerous,” it seems to suggest that the insurance people have isn’t working either.
Or it shows working people can not afford to pay for health care. I provided more sites in anticipation of you trying to work around that one.
[QUOTE=Dinsdale]
Someone explain to me how it is “a good thing” to allow insurance companies to exclude "pre-existing conditions.
As it is, it seems a lot of companies jostling to provide health care to the healthiest and wealthiest segments of the population - arguably the segments least in need of commercial “insurance” against unfortunate developments.
[/QUOTE]
It’s not. It allows insurance companies to cherry-pick. If it were up to me I would desolve HMO’s and go back to the use of catestrophic insurance. What stops that from working is the point you are making. If people are turned down for insurance then there’s a problem with the system.
[QUOTE=Book Monster]
Wow, this thread has gotten *way * bigger than I ever thought it would!
While some of the finer details of health insurance and HMOS. POS’s et al still elude me, I was actually surprised that Americans (or at least some of the Americans in this discussion) see decent healthcare more as a luxury rather than a right. This is just so foreign to what I was raised to expect that it’s still a little hard to comprehend.
[/QUOTE]
I live in the States and I see healthcare as a right. If we can provide police under general welfare and security, then we can do healthcare under the same umbrella. We’ve been programmed a certain way for a while and it’s hard to break that programming. It’s even harder to break that programming when THAT much money is divested into keeping the programming a certain way.
Now, if we can somehow figure out how owning guns is a “right”, then you’re on your way to that Nobel Prize.
[QUOTE=gonzomax]
Or it shows working people can not afford to pay for health care. I provided more sites in anticipation of you trying to work around that one.
[/QUOTE]
Work around? I think you misunderstand me.
I work in a medical billing office, as I said. I work with weasely insurance companies daily. I have heard every excuse from them why they won’t pay for something, and you wouldn’t believe some of them. Moreover, most of the time the insurance company won’t tell the patient these excuses directly, but they make us tell the patient instead. I’ll tell you, if I ever switch insurance carriers, I know which ones I wouldn’t touch with a ten-foot pole.
I also work with weasely patients daily, why they won’t pay a bill “on principle” because they find every reason in the world why it’s not their responsibility to open their mail, who seem to think that we have to mail them a bill, call them personally to explain it, call the insurance company on their behalf without being asked and appeal for more money, call the patient back to explain why they owe it, then drive to their house and hold their hand while they write the check, and if we don’t do all those things, the patient shouldn’t be expected to pay anything — and any bill that’s “too small” we should just write off so they won’t be bothered, and any bill that’s “too big” we should send back to the insurance company until they pay 100%.
People are the same whether they work for The Big Faceless Corporations, or whether they’re the little guy trying to get by. Some people are responsible for themselves and plan ahead and save money for a rainy day, and some don’t.
I can’t blame bankruptcies on “medical bills” because I know some of those patients put themselves into their positions. I speak to 'em on the phone and I hear 'em say, “Go ahead and send me to collections! I don’t think I should have to pay that, because I have insurance.”
Well, yeah, they do have insurance, but they denied their claim, so they can wait around until hell freezes over, or they can call their insurance company to dispute their denial, or they can pay the damn bill. But some people simply won’t take responsibility.
Trust me. I work personally with many people who put themselves into these positions, and I also work with the ones who had catastrophic medical claims whose insurance companies abandoned them. I see personally where the problems are. I know the system of medical bills and insurance doesn’t work and I’m not arguing otherwise. I just can’t categorically say “Medical bills are evil and patients are all blameless victims,” because I know it’s not true.
[QUOTE=Fish]
I work in medical billing. Here’s my take on things:
Medicare is run from Washington, D.C., and is a federal-level program. It kicks in automatically as your primary insurance carrier at age 65, provided you have already retired. Other Medicare plans also kick in for various conditions, to cover certain things — for instance, Medicare Part A is available for people with end-stage renal disease and will pay for kidney dialysis.
Medicaid is a program that varies from state to state, and is run by a state government to more specifically target the needs of that state’s citizens. It may be known by different names in different states. Medicaid is available for those who qualify by dint of low income, pregnancy, short-term loss of income (such as being unable to work because you had back surgery).
Workers compensation is available to everybody who is injured on the job. The insurance is paid out of premiums deducted from your paycheck (that is, if the business is legal and above-board). The insurance may be run by the state, or it may be a private carrier if your employer qualifies as a self-insured company. If you’re injured as a result of your job, you do get coverage.
Tricare, or Champus is the insurance carrier for current and former members of the U.S. military. This is run by the U.S. government but is separate from Medicare.
Emergency rooms are (as mentioned earlier) are required by law to treat anyone who comes in, at least to the point of stabilizing the patient of any emergent condition. An ER does not have to do your liposuction or breast implants, or your routine allergy injections, or your physical checkups. If you come in with a broken leg, they will set it in a cast and send you on your way — but if you come back in four weeks later, they’re under no obligation to perform follow-up care, or give you a free wheelchair, etc.
Non-profit hospitals exist. In order to qualify for that status, the hospital must write off a certain amount of business as “charity.” Our local county hospital does so — a bit too much, perhaps, because we have found (since we work closely with them) that some of the patients which the hospital qualifies as “charity” can, in fact, pay their bills, and indeed may already have insurance. (I don’t believe our hospital checks too carefully before writing off someone’s bill.) Of course, the bills we send (as radiologists who merely read an X-ray or two) are small compared to the hospital’s potential fees for the Emergency Room visit.
Crime victims insurance exists in some areas, designed to help defray the costs of people who were the victims of crime.
Taxes pay for the above, to the best of my knowledge.
I think what you would call “universal health care” is what I’d call “private insurance,” which covers your car accidents, your house flooding or burning down or being burgled, your overall health and life, and so forth. Basically, if you’re no longer a child, if you or your parents can work, you’re not in the military, and you’re not retired, and you’re not in poverty, you’re expected to pay your own way. Whether this is right or not, I couldn’t say, but I believe that’s the intent.
[/QUOTE]
Thank you for clarifying the differences among all the above facilities.
Question: does an urgent care facility/clinic, by definition, fall into a category somewhere between a doctor’s office and a hospital?
Lately I've been wondering why more patients don't go to urgent care. It can be paid for out-of-pocket or billed to insurance. I found the co-payment to be the same as I would have paid to my doctor, but the waiting time isn't usually as long, since one can be seen by any doc on duty or by a physician's assistant who can perform the same duties. You can also get the prescriptions filled right there, and they can do labs as well. It sure as hell beats hanging around the emergency waiting room.
[QUOTE=Bridget Burke]
The insurance companies are making big profits on health insurance and mal practice insurance while the providers struggle with paying overhead.
[/quote]
Cite? I have a friend who works for an insurer and he says that margins are razor-thin: premiums only cover the outgoings and they make their profit on the interest from the premiums. Secondly, I know someone who’s a Name at Lloyds of London, and while there’ve been many good years, he’s only now recovering from the losses in the bad years.
Those are significant salaries to someone in the U.K.
As for socialised medicine, I’ve seen both sides. Here in the U.K., if you need emergency treatment (heart attack, broken bones etc), you’ll get it. Non-emergency treatment is a whole different matter. Over a decade ago, I had trouble with my wisdom teeth - I was in constant pain. I would have had to wait 6 months just for the initial consultation. I had it done privately and had the consultation within days and all four removed shortly thereafter. I now have private health insurance. But the NHS is a huge bureaucracy and consumes vast amounts of money. And it grows. I want a safety net, but I have no answers.
[QUOTE=gonzomax]
Medical Bills Leading Cause of Bankruptcy, Harvard Study Finds Causes of bankruptsy. Mr. Fish
[/QUOTE]
That study is completely flawed.
Another researcher examined it and concluded, “only about one-quarter of bankruptcy filers have debts that are primarily medical in nature. Far more common are bankruptcies related to credit card debts.” (http://www.aei.org/docLib/20060719_MedicalBillsAndBankruptcy.pdf)
http://content.healthaffairs.org/cgi/content/full/hlthaff.w5.63/DC1 Have another . I knew the Libertarian/Ferengi group would never accept any study that contradicts its preconceptions.