Once again, tort reform does nothing to control costs. Defensive medicine is either a myth or simply an irrational response by doctors. From Dr. Gawande’s article, which I clinked above:
It might be a good thing from a fairness perspective, but it has no effect on the cost of care. The obvious flaw with MSAs is that they require you to save your money until you can afford care. It’s a lousy way to use your money. If you can save that kind of money, you would do better to put it in a 401K and borrow against it if you need it. FSAs are great, but don’t really amount to much, and they exist right now. I have one, pre-tax.
These ideas are all recycled from 1995. The Republicans could have passed them then, and Clinton would probably have signed them. We have to assume there was a reason for that. How about a policy proposal that Republicans actually believe in?
You say you aren’t opposed to a government “safety net” but that you don’t feel you have a moral obligation to chip in for anyone’s healthcare expenses. Isn’t that a contradiction, since the government safety net has to be funded by taxes? What program can you imagine that works as a safety net but doesn’t end up costing you?
I have those same types of problems with my private insurance company. Frankly, I have doubts that any for-profit insurance provider is looking out for MY best interests when it comes time to pay a claim. If you have no confidence in the government and I have no confidence in the private sector, what’s the alternative?
If you break the link between employment and insurance, then how does anyone except the youngest, healthiest people in a group find insurance? If you lower Medicare limits, won’t that result in fewer physicians choosing to accept Medicare? Without sweeping legislation, will addressing one problem cause another problem to become more serious?
Are you suggesting that premature babies should not receive aggressive treatment? That high-risk pregnancies should be aborted? That idiot parents should be sterilized? Should stage 3 and stage 4 cancers not be aggressively treated? Who will make those decisions?
Do you favor a national healthcare education program to help consumers understand why an immunization is better than a trip to the emergency room? How should it be conducted, and who should pay for it?
Since I’m the parent of one of those 20% of people on the margins, I ask your indulgence for going back to that issue. Which of the scenarios in my earlier post would you support, or is there another solution that I’ve overlooked?
And yet every other western democracy, regardless of size, has already made the decision that they need UHC.
What is the nature of this US-unique internal “diversity” that affects this discussion?
Fine, except that removal of anti-competition needs to come with consumer protections, or the only insurance available will meet only the least-regulated state’s requirements. Viz. the credit card industry and Delaware and South Dakota.
No. Medicare began in 1965 or so. Are you claiming the Court holds the position that seniors have a legal right to health care? Are you saying Congress could not repeal Medicare tomorrow?
None - what I’m saying is that while I don’t feel an obligation to provide a safety net, I have no problem doing so as part of the social contract. My limit is much, much lower than what is currently proposed, hence a safety net as opposed to a public option.
In addition, almost no one talks about medical charities, like the Shriners, who do a ton of good, and are funded via private grants and donations. I think that a UHC-type plan will make those donations drop, as people who see less in their paycheck figure “Well, I’m already paying for it through the gov”
Sure, and I have had some issues too with private insurance. The striking difference to me is that I can go find another solution under a private system, but under UHC, I have no other option. Our insurance wasn’t working for us, so we went with a HSA/catastrophic combo. If someone has a different issue, they can look for other options. Under UHC, this simply isn’t possible for most pay scales.
Don’t you think that if we break the employer link, lots of other pools will spring up? Pools to serve the rich, the poor, the Christians, the furries, whatever? Insurance companies exist to serve the market, but if the market is locked into a employer-based system, there is no reason to innovate.
Re: Medicare - it’s screwed ten ways to Sunday. It’s a broken system that’s broke financially. I think most of the reason why Washington is pushing UHC is because they need healthy people in the pool, since Medicare is going broke. They are unwilling to look for other market answers, and just want to push everyone in.
Sweeping legislation will only make bad decisions permanent. If we go slowly, then we have an opportunity to experiment without destroying everything. It’s like trying to balance a raft on the river - you move everything around, but one at a time, to see what keeps us level, and therefore, what’s best for everyone.
Yes, I am suggesting that some premature babies should not receive aggressive treatment and that some high-risk pregnancies should be aborted- and I say that as someone who’s had several friends with prematurity issues. Obviously I don’t support sterilization.
My direct point is that logic and fairness would dictate that if I have to think of the pool, then others should have to, and that includes tricky medical decisions.
Re: cancers and the like - do you think that aggressive cancers will receive full treatment under UHC? Are you under the impression that if we just get enough people in the pool, that everything balances out and everyone gets what they want/need?
This is an interesting question, and one I don’t know my feelings on. In my gut, I don’t think a special educational grant is needed - all of that type of information is readily available and free. I’m thinking of the availability of broadcast news, internet on library computers, conversations with friends, paying attention to their own body, etc. If someone is completely unaware of basic health, then they are, IMO, being willfully ignorant.
Well, as Bricker correctly pointed out, using your daughter personalizes the debate. And, I cannot really pick an option, since I know nothing of your daughter’s situation. Is she a minor? Unemployable? Drug Addict? Terminal? Physically or mentally disabled?
With no information, I can have no opinion, since the variables are too great. This is the reality of the margins, which is why no sweeping, UHC style care can be efficient.
I’m a little surprised at your dodging the issue, Bricker. I’m personalizing the issue just like you personalized the issue when you said “I don’t believe there’s a right for society to pay for your care if you’re sick.” That’s a philosophical position, not a dispassionate cost-benefit analysis.
You choose to throw up a straw man – what if my daughter could live for two extra years at a cost of $20, so I’ll throw a straw man right back: what if my daughter has a treatable but chronic illness like diabetes or MS? Instead of living two years, she could live a normal lifespan and continue to work.
For the record, she is not a minor, she is employed (by a small business that does not provide insurance), she does not use drugs, she has no chronic illness, nor is she physically or mentally disabled. She simply has “pre-existing conditions” that have not been a health factor since she was a child, but for which insurance companies have decided are too risky to provide individual health insurance.
Why do Republicans have such a boner about wanting to purchase across state lines? Is it to send us all to the state with the least regulations and oversight?
***Remember, this is based on what information provided thus far…
So she’s completely able to work, but chooses to get a job that provides no insurance, knowing she’s uninsurable otherwise?
She needs to find another job where she can get insurance. That’s all.
I find it disheartening that you support UHC so your daughter can get covered. Yes, she may be less happy in that job, but oh well. All people make choices everyday that come down to being a little less happy vs. taking care of yourself. And I find it ridiculous that you think I should be willing to part with a portion of my ever-dwindling supply of money because she doesn’t want to switch jobs.
So you are of the opinion that everyone with pre-existing conditions who is denied insurance simply has to CHOOSE to find a job with insurance? How is this going to operate country wide? I’m honestly baffled by how you think this is going to work?
Have you checked to see if your state has an insurance pool for otherwise ininsurable people? Most states have a program like this. Also, families can create a pool if there are enough healthy people in your family. It may cost other members of the family more but it’s a way to spread the costs.
Why shouldn’t I be able to purchase a bare bones plan if that is what I want? Why should I pay more per month to cover sex reassignment surgery that I’ll never get? Every state has a list of what is allowed and what is not allowed. Obviously, insurance companies will offer plans with more bells and whistles for those interested but, for those who cannot afford insurance, having a very basic plan that, at the very least, covers emergencies would help these people.
No, I think it’s more of a case that they’d rather have people fight out of state insurance commissions and make it more difficult to challenge decisions that insurers make.
), but I’d really like to see a more incremental approach to reform.