The following is a letter that I’ll be sending to my Senators. I am posting it here for discussion purposes.
You realize that the present system leaves 50 million uncovered , passes the health care cost into our products inhibiting our ability to compete and will bankrupt us as it sheds customers. We can not continue down this path either.
The final bill is not determined. Insurance company competition has to be provided. Medicare is going broke because it is the insurer of last resort. As insurance companied drop sick or elderly, Medicare picks them up . They have the sickest demographic and are expected to control costs. Actually they do need a lot of control. they are letting medical companies and doctors cheat the tax payers on an ongoing basis.
The current direction, seems to me, is going to enrich the insurance companies, and to make them even MORE instrumental in health care decisions. This will especially be true if they drop the “public option.”
The whole problem with health care in the US, seems to me, is the profit motive on the part of insurance companies, who make all ultimate decisions. This is compounded by the profit motive for hospitals, doctors, etc.
Would we allow the police department to be run on a profit-basis? Then why the hell do we allow health care to be run that way? And, sadly, I don’t see this bill fixing it. The fix is to throw out and overhaul the whole damn system, not to spoon-feed the insurance companies.
I agree with you. I want UHC, but this bill is not the way to do it.
No. The problem is we restrict competition and tie health insurance to employment.
Why is health care like the police? One might as well ask why we would allow grocery stores to operate on a profit basis. We all need to eat, right?
Profit is not inherently bad. Unless you explain why you need to nationalize health care, just saying “profit” isn’t an argument for doing so.
The short answer is that some people think that the police, and health care, should be available to all. The market is great at some things, but not so much at ensuring that.
Though the main reasons to socialize it have less to do with the fact that health care is privatized and more to do with the fact that the prevalence of insurance in paying for it throws the whole set of market dynamics out of whack, reducing most of the benefits that make a private market system good in the first place.
There’s two separate issues here: Health Insurance and Health Care.
Health Insurance is insurance against unusual and expensive events. Heart attack, cancer, broken limb, etc. This type of insurance is actually quite reasonable. You can get a family plan with a $10k family deductible for around $200/mo. That means once your family has spent $10k in the year, the insurance will pick up the rest. Everyone should have this type of insurance because anyone can rack up $50k from an accident regardless of their health.
Health Care is care for minor or regular health issues. Checkups, colds, sprains, etc. This is where it doesn’t make sense to provide it in a for-profit system. Profit itself is not even the issue. It’s the fact that there’s a whole system that has to be paid for to support these usual and expected medical expenses. Even if the insurance companies make zero profit, someone is still paying for the insurance companies buildings, employees, publications, utilities, etc.
The problem is that health care cannot be ignored. If your car breaks down you can take the bus. But if your body has problems you can’t just hop into a different body. So you need to visit the doctor for normal health issues. But now that health care is bundled with health insurance, the cost of care has gone way up. Why does it cost $150 to have the doc look at you for 5 minutes? It’s because you don’t care about the cost. Your insurance says you only pay $10 for the visit, so you don’t do any price shopping. The docs know this, so they don’t try to compete with their rates. They’ll have a high rate and write off whatever the insurance company doesn’t reimburse. If you walk in without insurance, you’ll have to pay the full $150. And the receptionist will say “Pay up front, if you don’t mind.”
But the big problem with having health care and health insurance be run by for-profit companies is that they are more than happy to skyrocket your rates or drop you once you stop becoming profitable for them. And once they drop you, you can’t get back in. They seem to act surprised that you actually get sick. “How dare you get cancer! Shame on you.” Unless you are uber-rich, you’re not going to be able to afford any sort of major treatment without insurance.
The only solution I can see is if all of America is in a single risk pool and we all pay the same premium. A giant group plan. And it would seem natural for the govt to run it. But I don’t think the current bill is the right way to do it.
This is an excellent example of the best being the enemy of the good. I too would like true UHC, but if we don’t pass some version of the bills out there now we aren’t going to get anything for another 20 years.
You’ve never heard of food assistance programs?
The issue is whether or not the pursuit of profit degrades the general quality of healthcare provided. No one is saying someone who goes to the trouble and expense to become a doctor, nurse, or other medical professional shouldn’t be rewarded for their hard work and the service they provide with pay befitting the value of their service, but the question here is dog eat dog take any thing you can get your hands capitalism the best, or a more universal model?
The sorry state of costs and limited access to healthcare in America compared to other industrialized nations says dog eat dog isn’t the best way. Doctors make us healthy, but other then add inefficiency (as measured in GPD spent on healthcare compared to results), what do insurance companies do?
I personally favor the UK’s approach, Universal Healthcare, and private profit driven options if you so desire, and can pay. Their lowered costs and generally better health (a great feat considering the culinary blasphemy they call food) are a testament to that.
If there was as little competition in groceries as there is in health insurance, I would have no qualms against nationalizing all supermarkets.
I loved your post and agree 100% with everything you said.
I sympathize with the OP’s dilemma, but come down barely on the other side. Barely.
It became obvious to me back when the first committee meetings started up, and nobody was asked to present the case for a single-payer plan. Its not that single-payer plans were discussed and rejected, its that single payer wasn’t on the table. Actually, it wasn’t even in the room, single payer was denied entrance to the building by the security guards…
And I don’t think we correctly estimated the resistance, thinking there would be some resistance, some bargaining, give a little, get a little, the business as usual. Didn’t expect the insurance industry to go batshit pizza, screaming, tearing their hair and daubing themselves with shit.
Way it looks, we’re likely to get a whole lot of not much. But we should pass something anyway, its a cold blooded realpolitik assessment.
We get something, anything, and start in immediately working towards more. Lean on the resistance, keep up the pressure. If the tighty-righties had been willing to bend, make a bunch of folks happier, they wouldn’t have those folks as their enemy. Do now.
Or maybe if they hadn’t been so public about their screaming shit fits, they might have been able to blame the Dems for not trying hard enough. Tough sell to begin with, blaming the other guy for not making you do something. Made a lot tougher by the bombastic and public displays of over-my-dead-penis obstructionism.
We weren’t going to win this in one swell foop, wasn’t realistic to expect that we might. But they can’t spend money like that all the time, they can’t keep up hysteria forever.
Demand, negotiate, accept, nail down, resume demanding. Repeat as necessary. Democracy is a bitch, but I love her.
For my part I will not be completely satisfied with anything short of single-payer. However, I don’t know about the Senate bill, but the bill the House approved –
– would at any rate be a vast improvement over what we’ve got now. Half a loaf, y’know?
Exactly. It would be incredibly unrealistic to think that something so major could be perfect right out of the box. The system is going to need maintenance and adjustments over the years, sure - but that is no reason at all not to get going. It’s been long enough, and there’s no better time than now. If we don’t get the program established, we can’t make the improvements. Politics is the art of the doable.
And we aren’t ever going to get single-payer. That was never a realistic option.
Do those food assistance programs nationalize grocery stores? No. And so that has nothing to do with the post you responded to.
Agreed. Just like home owners insurance only covers things like your home burning down and doesn’t pay to replace a burnt out light bulb.
And I think that’s why the high deductible policies coupled with the tax deductible HSAs were a great start, but that made way too much sense. Actually, the largest reason why such a policy won’t/didn’t succeed is that you still have too many people, especially the elderly and poor on traditional government medical programs that don’t promote any type of competition.
Just look at an itemized hospital statement or physician statement and tell me if such prices would continue in a pure competitive market with consumers making informed choices.
Whether or not the bills are a good idea objectively, it would seem to me that any great undertaking, be it a war or major domestic legislation, needs public support. This bill doesn’t have it. For that alone, it should not be passed until the Democrats can bring the public on board.
As for its objective merits, it’s just not paid for. The CBO score assumes cuts that are not likely to happen. For example, part of the savings is supposed to come from reducing provider payments, but Congress has been avoiding cutting provider payments for years.
I want everyone to have access to affordable health care, but nothing is worth exploding the deficit. If the debt has to be inflated away, or the unthinkable happens and we default, we’ll have more uninsured then than we do now.
The CBO scoring shows this bill REDUCING the deficit by $130 million annually.
Cite for health care not having public support?
So most folks don’t expect it to affect them, and those who think it’ll make 'em worse off outnumber those who think it’ll improve their lot (both as a matter of finances and access to care) – and while they’re split on whether it’ll improve or worsen medical care around the country, those who think it’ll be worse for the country’s finances outnumber those who think it’ll be an improvement.
People want change. Do they want this change?
It has, but the picture is complicated: