To address the OP, the cost of treatment would be paid for by the insurance company, so in your hypothetical its an extra cost for them. However you are ignoring that the insurance company would have a larger and better risk pool (of premiums) to pay that treatment from, because health insurance would be mandatory.
Without mandatory health insurance you run the risk of an ‘insurance death spiral’:
Yes I do.
By temperment (studied math in school)
By training (teacher in an urban area. I have stories ranging from a student watching his father die and blaming himself because the phone was in the other room to being personally threatened with death a few times. you get too attached and you have a breakdown but you can’t help yourself)
By experience (sometimes you need to bury the pain so deep that you hope it goes away, but it never does. i was interviewed about an incident that was a painful reminder. circuit-breaker clicks off. the next day i walked by the front of the apartment complex and read a note posted. circuit breaker too slow and i wept unashamed tears. i have been going in the back way for a month now)
So that is how I deal with it. My mom and ex lost their houses and eventually filed bankrupcy because they kept refiing and spending the money like drunken Joe Don at a titty bar. My mom - no sympathy. My ex, she was near economic collapse then lost her job so click “Let’s deal with the situation.”
Maybe I’m an ass, but as empathetic as I may be to a person’s suffering, I just cannot jump that emotional hurdle and buy in personally when it was their own bad choices. Maybe that’s why I have such a hard time with the UHC.
<You> Their situation is horrible.
<Me> Fuck 'em. Should of bought insurance when he had the chance.
<You> But he’s a HUMAN BEING for God’s sake!
<Me> Yeah! A stupid one.
But in all fairness, I have the utmost compassion for people suffering through outside circumstances. Read my previous post. Circumstances screwed you over? You get as-free-as-it-can-be emergency AND PRIMARY care. I will gladly pay money to help honest down-on-their-luck people get healthy and stay healthy, but I won’t pay for someone who manufactured their own bad luck.
If insurance wasn’t tied to an employer, and individuals could get the same rates as large groups, and insurance companies couldn’t drop you/raise rates when they actually have to start paying, then Jshore would not be in his current predicament. But that is the situation we are in.
But you do already if you have insurance of any kind. You may not catch a pan of oil on fire and burn down your kitchen, but if enough other people do then insurance rates will reflect that. You may not run a red-light and hit someone, but your car insurance rates are based on the fact that someone else will.
What kills me is when people oppose a rational solution based on the emotion that they “don’t want to pay for someone else’s stupidity”. Well through my high insurance rates and medical bills I am paying for the stupidity of those who oppose UHC. Let me repeat this again as it seems to allude many UHC opponents: every other industrialized country in the world has UHC, has lower medical costs, and has better results.
Well, yeah I can understand for things like HIV or drug/alchohol abuse. In cases like those, you wanna be like " Look! Why should I have to pay for YOUR self centeredness?" It does seem like HIV and drug alcholol issues are about wallowing in " oh poor me. This happened to me just randomly! Im such a helpless victim!"
But what about conditions where its congential? I have a disorder which means I’m very medically complex. I NEVER see my GP, to the point where one time when I ran into him at the ER, when I was having post surgerical issues, I didnt know who he was. Yet, b/c I was unlucky enough to be born with hearing loss, low muscle tone etc I’m automaticly uninsurable.
My wife’s retina detached, and had about $50K of operations to get it kind of working again. Luckily, we have good insurance. But she didn’t do anything stupid to cause this. People who have heart attacks may not do anything stupid either. So the situations are very different.
As you know, insurance for the very poor already exists. Low income working people are the real victims. They are in jobs not good enough to pay for their insurance, and they can’t afford it. People who lose their jobs with a pre-existing condition are really screwed. In your plan, how much are you planning to take from a guy making $30K a year with a family? Does he get to eat and rent? You really want this poor guy who had a medical problem living under the cloud of debt his entire life?
The government recoups this cost of doing business today through taxes, and that means more on the rich because that is where the money is. If you agree that the government should insure the poor, why not also the hard working almost poor who can’t afford insurance? Public option here we come, and I’m all for it.
I agree with you. These are obstacles that should be eliminated, and I’m no expert, but I can’t understand any reason why such matters couldn’t be fixed. Interestingly, they require changes to how the system works, changes in law certainly, but no government funding.
Great OP, as others have said. This is an issue I’ve wrestled with before in other threads, and I believe there’s no good solution to it.
There are a lot of people (including me) who believe that your Option #5, the mandatory health insurance scheme, is blatantly unconstitutional. The constitutionally honest way is as RTFirefly said in post 16; make it a true public service and implement taxes to pay for it (as an aside: not the highly gamed version in the current bill, which assumes miracles like $200b from ‘docfix’ and $500b from Medicare’s fraud/waste/abuse to pay for itself).
Do you think this idea can be practically translated into a comprehensive law, and more generally, a national health policy? That you could accurately systemically differentiate between the groups?
I get the impression that you have an open mind and really want to understand the issue. Here is the basic problem we are facing. if healthy/young people opt out of insurance then the rates will be high for everyone else. Also, preventing insurance companies from not covering pre-existing condition will not work if you wait to buy insurance until you find out that you have a medical problem that requires expensive treatment. This is very different than car or home insurance, because in those cases you don’t know in advance that you are about to have a claim.
The only way to make things work is for everyone to have “insurance” at all times. So how do we do it? Well we can make everyone buy insurance, which many people find unsettling, or we can make health care a service and fund it through taxes. Progressives prefer the latter, pragmatists prefer the former, and for the life of me I can’t figure out what conservatives want to do.
Let’s ignore poor people for the moment. Imagine a healthy college grad who decides he’d rather start investing money rather than buy health insurance. He knows that chances are he will be better off 10 years from now because his investments will have grown. Now imagine that he suddenly discovers he has cancer, or has a stroke, or starts to go blind, or a number of other conditions that can strike out of nowhere. The only way a voluntary, private insurance system works is if we let him remain untreated. If we provide a safety net to the uninsured then we create incentives to not buy insurance, while also having a back-door universal health care system that we pay for through taxes.
Note that we have a problem even if you ignore poor people or risk takers. Now this would be an interesting problem if we had to figure out how to create a system that was affordable and effective from scratch. But we don’t, we have every other industrialized country in the world to look to for examples. We can pick the best one, but even if we picked the worst it would still be cheaper than our current system and have better results.
The only problem we have is ideology. To some people it is more important to be ideologically pure than be pragmatic and make things better.
Have you really thought this through? It’s a pretty simple calculus. If you are not willing to let people who cannot afford healthcare die in the street, then someone will have to bear the costs. The best way to do that is with some form of universal healthcare that covers the majority of the population. You can bitch and moan all day about being right, but it really boils down to two choices: do you want to be “right”, or do you want to save money?
Your insistence on punishing people who make bad choices, even if it were possible to delineate “good” from “bad”, will cost you a lot of money. How much is it worth to you to punish the homeless guy who drinks himself to death, or the the soccer mom to smokes and eats junk food?
Maybe it’s easier to see the error of your ways when dealing with a different, but related issue. Homelessness and High School Graduation rates are two issues that are similar to healthcare due to the fact that a small minority eat up a disproportionate amount of resources, and, more importantly, our sense of fairness and practicality are at odds. One proposed solution to the problem, wrt homelessness, is the power-law theory of homelessness.
Many power-law advocates have endorsed giving that 10% free housing and food. Why? Because the cost of giving them housing, encouraging permanent dependency, was far less that the cost of the police complaints, emergency room visits, and crime. High school graduation rates are similar in many regards.
Again, we have a small portion of the total having a disproportionate effect. My basic point is that there are situations where punishing people does more hard the good. When you are dealing with finite resources, it’s irresponsible to waste them in the name of retribution. Or as Gladwell wrote in the first link:
Here is an interesting factoidon one group that makes bad choices:
People are really hung up on not paying the cost for people that make bad choices, but I don’t see any data backing it up. Especially on the SDMB you’d expect less emotion and more reason.
ETA: maybe non-smokers and non-risk takers should pay *higher *rates. That would be “fair”, no?
The best I can tell is that conservatives want everyone to self-insure up to a deductible limit, which is fairly high for the catastrophic policies I’ve seen. I think we’ve covered the problems with this approach a lot of times.
Isn’t that pretty much the Massachusetts/Obama plan?
One of the differences with auto insurance is that some cars are so unsafe, your friends and insurance companies will all say “Junk it! Even a $400 clunker, if that’s all you can afford, will be better than that car!” The debate needs to be frank: Some people’s health makes it uneconomic to provide them with health care.
Some people believe that love for one’s fellow man overrides the “economic” issue and requires that some level of health care be extended to everyone. I’m not sure, but I think many European nations understand that and surveys report that they freely sacrifice taxes altruistically. America needs to decide whether to follow their example. When I read of healthy Americans afraid that their premiums or taxes will go up with UHC, I wonder what they could possibly be smoking to ever imagine otherwise!!
Many agree that the most important problem with American health care is its high costs. It is disappointing to see that proposed legislation makes no attempt to mitigate that.
A solution I would favor, which would reduce costs by bypassing insurance bureaucracies, would be to simply provide some level of government-financed health care for everyone. Problems with this – I’m curious to hear what Dopers say here – is that this would involve huge immediate wealth transfers. Stockholders in insurance companies would suffer. Companies whose employee health care benefits are obsoleted might see their stocks soar.
But for heaven’s sakes! Healthy people worried that their taxes or premiums might rise? Of course they will with the present legislation! That politicians ever implied otherwise is a travesty and proof that American discourse has fallen to “Who can say something stupider than the last guy.”
It may be that Every other industrialized country in the world has UHC, lower healthcare costs, and better results. Aside from that I guess they just let their ideology get in the way of practicality.:rolleyes:
What about AIDS? What about the kids who are profoundly mentally affected and who have ten gazillion medical problems? It does seem like a lot of the parents of those kids want the best of the best medical care for their profoundly affected kids.(and they don’t live that long and basicly have the existance of a baby, and they have a brain malformation so there’s no hope of them improving)
What about people who are chronicly in and out of rehab? (and don’t even try to remain sober/straight?)
The total spending on all infectious disease is about 1.3% of medical expenses. AIDs is some small percent of that, and I’m not sure what percent of that is from unprotected sex vs other causes. Looking at that as a reason to oppose UHC is cutting off your nose to spite your face.
On the other hand, I have no data to show how many babies made the bad choice to be born “profoundly mentally affected”. I kinda suspect the one that does that creepy E-Trade commercial though.
Quick word of advice. Make sure you look into your options while you still have insurance. Years ago, I had let me Cobra lapse then looked into insurance and it made it much more difficult, as I was currently UNinsured. Good luck.
I’m against most types (including this one) of government expansion in health care, but I can’t for the life of me understand the “How dare they say I must have health insurance! I live in a free country!” argument.
Would it make you feel any better if they just “taxed” the premium amount from you and gave you “free” health insurance? It’s functionally the same thing, only Obama is trying to do this by keeping the private health insurance structure intact. IMHO, it is a continuation of the anti-Hannah Montana “Worst of Both Worlds” health care that we have: It is basically a free market with the government a major player in it.
I like the alternate universe fire insurance analogy upthread. You can’t possibly insure against something that is guaranteed to happen to everyone. Routine care needs to be affordable, competitive, and paid for out of pocket. We should have insurance for major things like cancer, heart disease, and the like that most people do not get in their lifetimes.
We need to loosen some regulations and some drug laws so that I don’t need a doctor visit and a prescription to continue getting medication that I know and have been told that I will need for the rest of my life. You don’t need to pay an electrician when you can wire your home yourself, and you shouldn’t have to pay a doctor when you can fix what is wrong with you. Nurses, pharmacists, and others who take courses should be able to write prescriptions.
I could go on, but this idea that the free market is to blame is not true when there is so much government intervention in the market.