I think these are valid questions - with one change.
I would rephrase your third question as follows -
Should the government – either directly or through some 3rd party – establish a program to cover people who can’t get insurance any other way, no matter what the cost?
If the answer is Yes, this implies that health care costs will continue to rise under taxpayer-funded UFC. If the answer is No, we are saying what BobLibDem’s cartoon suggests.
Regards,
Shodan
But see, **John **and Bricker, that ship has already sailed. We as a society have already decided that we will provide needed health care to those unable to pay. Recall, we don’t put indigent people out for the lions, we instead require them to be accepted whenever they can walk, crawl or stumble into an emergency room. Clearly we have already made a societal decision and then a governmental regulation here. The starting point of the debate is not *whether *poor people have a right to care. The debate is by what mechanisms will that care be funded.
Will we continue the present insane system of charges, charge-backs, “losses” and the rest of it whereby ever-increasing insurance rates are needed to cover uncontrollable “uninsured” payouts for emergency care forcing an inward spiral in which fewer and fewer can afford coverage but the total dollars spent on coverage continue to climb? Or can we find another system whereby these same people, and the same needed treatments, are funded in a more direct and transparent manner?
And this of course doesn’t even encompass the huge waste of manpower and efficiency society absorbs by failing to provide preventative and/or early treatment care, which is of course not part of a care delivery system based upon current emergency room-only restrictions.
I don’t think that is necessarily true. I believe it is possible to cover everybody regardless of medical condition and because of the size of the pool, that overall costs won’t go up.
My sticking points on “health care reform”:
Very much what Bricker said - I don’t have a problem with helping people in need, with, say, a “safety net” insurance provided by the government. But I do not remember anything in the Constitution saying health care is a right, nor do I feel that I have a moral obligation to chip in for anyone healthcare expenses.
I have several family members involved with government run care, through the VA, Medicaid and Medicare. Their problems range from regular old people issues to diabetes to severe and total disability. Every one of them regularly reports issues with administration problems, denial of services and low quality of care. This, coupled with the studies indicating that Medicare is going bankrupt, and the absolute mess that Social Security is in, means that I have zero faith in the government being able to administer any kind of UHC with any skill, efficiency or logic. Political whores are always the worst people to put in charge.
I think that the current proposals are far, far too sweeping. There are problems with the health system, but that system is made up of many parties. If we need reform, then we should start small. Maybe a little tort reform, break the link between employment and insurance, look into lowering Medicare limits, etc. I see no reason to push through a sweeping bill, because I don’t feel it’s been investigated enough, and once it’s in place, we’re in it for the long haul, no matter what damage it may do.
I do not want to share a pool with idiots. For every daughter who is uninsurable, there are 500 moms who drag their kid in for the sniffles. There was a recent thread that talked about the issues with really premature babies, and whether the parents should have pursued the birth seeing as the kid may not even live, at a cost of tens, if not hundreds, of thousand of dollars. If I have a duty to contribute to the pool and take out less than I have put in, do they not have a duty to make choices for that premie while keeping the pool in mind?
I think that American’s relationship to their health spending is at a complete disconnect. Yes, I feel that you should pay for that $200 checkup out of pocket. Americans spend $110 billion a year on fast food, but balk at paying for a round of vaccinations for their kids. Medical “insurance” bears no real relationship to what insurance actually is, and I think this should be done away with. People need to pay attention to health care costs, not depend on the docs and insurance companies, or the government, to figure it out for them.
The people who are stuck - i.e. too “rich” for aid programs, but too “poor” for paying for health care have the most compelling stories, but are, frankly, only on the margins. It seems ridiculous that we would toss out a system that works for 80% of the populace for the people on the margins, particularly since many of those people are only there temporarily.
I recognize that we should be trying to do something to help the people on the margins. But I also feel that there are many other ways it could be done, without disrupting (much) of the current system. In regard specifically to the two bills currently pending, I feel that its laughable that anyone could support them as they are illusions of reform and filled with special treats and unanswered questions.
I contribute a great deal of money to charity, and I contribute hours as well. I have no problem with “paying for it” as a matter of personal choice, and I walk that walk. I have no problem with addressing individual exeptions, that make sense, and providing for them.
My problem is transforming this from “It’s a good idea,” to “It’s a legally enforceable right,” as a starting point.
I agree with the list Cererbus provided, one item of which was Tort Reform. But here’s what I don’t get: if Obama thinks it can be helpful and is willing to include it, why not just pass a bill doing that right away? If it will help, and it has support from the other side and can pass easily, just pass the damn thing!
I’d like to see Cererbus’s list enacted. Then if we need more five years down the road, we can look at it then. But I think the things on his list will improve the situation to some degree. If it’s a large degree, then we are looking at a very different problem. If not, then we know we need more substantive changes.
I think those are fine starting points.
This is precisely the attitude I see with those arguing from your position. I see HCR as it’s been offered up as detrimental to the country, so I don’t advocate it. I’m willing to forego the benefits it would afford me.
No.
Because “your daughter” personalizes the debate. Now we’re talking about your daughter, not the country as a whole. I don’t wish your daughter any ill. But surely you’ll concede your analysis is not dispassionate. If your daughter had a terminal illness, but could have her life extended by two years at a cost of $20 million, what kind of a parent would you be to fail to argue for that decision?
But as a country, we cannot subsidize medical treatment like that, can we?
I don’t see how that’s possible. Even assuming some gains in efficiency, you’re 1) adding more people and 2) increasing the amount of care per person. There’s another problem with costs, and I don’t know what we can really do about it: that is the advancements in medicine bring more expensive treatments to more people. MRIs, Cat scans, modern prostheses, and God knows what else is being developed right now, will continue to make health care both more effective and more expensive.
-Transferable policies from state to state
-Regulate the ability of an insurance Co to reject a customer without a counter offer
-tax rebates for the self insured (offsets tax free benefit of employee policies)
-allow employees of large corporations the option to opt out and receive 1/2 the money spent in wages.
-ability to buy policies based on needs
Because he doesn’t think it would be a good thing. It would just be a bonanza for the malpractice insurance companies and little if any savings would trickle down to consumers, who would give up their right to just compensation for medical mistakes. It isn’t in there because it you take the current Senate bill and add tort reform, it would still get zero Republican support.
I don’t see how adding high-cost patients to a lower-cost pool can avoid pushing up the costs overall. You can dilute the costs and spread them around, but the overall cost has to go up. If I understand you correctly.
I have a pool of 10 people, each paying $100 a year into the pool. Nine of them consume $90 a year in health care, and one consumes $100. All is well. Now we add another person, who consumes $200 while still paying $100. Where do you get the extra $100?
If you happen to find a whole bunch of folks who consume the same $90 per year and who self-insure, and force them into the pool, you can get the $100 from them, but that means that their costs have to go up or you won’t any extra money in the pool to pay for the high-cost individual.
If Obama-care is predicated on the idea that there are people out there who could afford to buy health insurance but just don’t want to, I am sure that is true in some instances but it doesn’t mean that forcing them to biuy into a pool means that overall costs are going down. Just the opposite - you are compelling people to pay for health care (for other people) that they don’t want. You aren’t saving them any money.
You can certainly argue that they should be compelled to pay for other people’s health care, but that is a different argument from saying that overall costs haven’t gone up.
Another factor is that once you force people to buy into a pool, you lose the self-rationing factor. If I am paying for my own health care, I don’t tend to spend any more than I have to. But, as Milton Friedman says, “sunk costs are sunk”, and if I am paying for insurance anyway, I have no objection to the MRI that costs thousands for my bad back (I have had two) even though it has no therapeutic value at all.
Regards,
Shodan
It appears you have chosen this as the starting point of health care reform so you can take the opposite opinion. You are framing it in a way so you can reject it.
When people talk about a right to health care, they are speaking from a normative position, not a legal one. For example, “In a country as rich as the United States, people have the right not to die because they do not have health care.” This is not saying the constitution grants a right to health care. Rather, it suggests our society is at a level where we should not have people dropping dead around us when we can prevent it. Of course you will find people reading this right into the constitution, but that is not all people.
Forgetting that, how do you respond to people such as me who do not feel health care is a right, but that health care reform (eg. single payer) is necessary for the long-term sustainability of our country? If we are simply not able to compete globally because we are spending an inordinate amount of money on health care and innovation is stifled because people are tied to their employer to survive, isn’t health care reform a rational choice?
They’re in the pool already. Where do you think the money for those emergency-room visits by the uninsured comes from?
I really would like to know why the Republican leadership has said basically nothing about any of these allegedly “Republican” proposals over the last few years, instead of yammering about “death panels” and voting No on everything. Anybody got an explanation?
While I agree with your overall sentiment (that Republican leaders have been no-shows on this issue) McCain did talk about some of these ideas during the presidential campaign. Specifically, the idea about eliminating tax breaks for companies and transferring those to individuals. That’s actually a huge issue, and we’re the only country in the world that had that as our staring point before adopting any type of UHC.
ETA: Was it during the campaign, or more recently? Can’t recall, but he has point that forward.
This all hinges on what “just compensation” is, right? Is it really helpful to society that a judgement is $200,000,000 as opposed to $25,000,000?
Except that when the distinction is not made clear, the normative position becomes the legal one after a few years, doesn’t it?
I don’t agree that our ability to compete globally is compromised.
That’s how progress works.
What about people that are paying for their own insurance (typically through their employers) but then get denied on technicalities, or find that insurance doesn’t cover enough of the costs? Thousands of people in this country go bankrupt ever year who had health insurance, but who cannot pay the tens or hundreds of thousands of dollars asked of them even beyond that coverage.
If you get treatable cancer but your employer-provided insurer drops you because you’re too expensive, only the richest will be able to afford the tens or hundreds of thousands of dollars in expenses involved. Would you support any protections at the upper end of the expense scale, so a serious illness doesn’t come so often with unavoidable bankruptcy even for the reasonably well-off?
Because it sounds like you feel that should just be a death sentence. Get sick -> insurance drops you like a hot potato -> don’t have $100,000+ dollars for treatment -> die or go bankrupt. I’m guessing that’s not actually how you feel, so what’s the solution?
-P