You’re not hearing what these “advocates” are saying properly. The uninsured poor (working and non-working alike) may be the people who will see the most dramatic positive change in their quality of life by the institution of UHC, but UHC will cover everyone.
Depends how you define “KuKluxer,” of course. It would seem that to some people, just about anyone who does not accept the Egalitarian Hypothesis is a white supremacist.
Please feel free to educate me. Nobody here has seriously challenged my use of murder rate as a rough proxy for the size of the underclass in western nations. And the fact remains that the US has a much higher murder rate than places like the UK and Canada.
First, it’s a fact that the German system works although several groups don’t pay into UHC. I can’t vouch for the other European countries (Nava? Maastricht? Some of the UK Dopers? Could you certifiy for your country), but I strongly assume that they also have a choice.
Secondly, it’s well known because it’s been proven countless times that right-wing/consie politicans are lying (by ommission, by perverting facts, by inventing nonsense strawmen, by making up figures) when they are against something. (Yes, most politicans lie one way or the other; but I consider a difference between a normal lie, e.g. “The Earth is a perfect sphere*, this illustrates blah blah” and a whooping big lie, e.g. “The Earth is flat”.)
- Technically, the Earth is a Geoid. Which translates as Earth-shaped. Since it’s banged up due to gravity, plate techtonics and other geo-physics stuff, it’s not an exact sphere. But close enough for normal life.
So if you can quote any sensible politican in favour of UHC saying that everybody has to (will be forced?) to participate, then I’m ready to call them idiots. If you only heard this from right-wingers or know-nothing idiots (those people who heard from a guy in the pub, but don’t have any idea how a UHC works elsewhere) then I disregard this as not relevant.
NO! First, I didn’t say anything about taxes. Where did you get taxes from??? Surely you don’t equate everything in percentages with tax?
Employees pay a fee (premium?) into their own choosen UHC provider. E.g. I used to be a member of the DAK, then I switched to Taunus BKK (which had lower percentages at the start). The Taunus BKK owns and controls and dispenses the money in their own pot which they receive from employees and employers, and pays the doctors and hospitals from it.
The ministry of Health controls that the Taunus BKK and other UHC companies do what the law requires them to (that is provide the services they are obliged to). There is also a membership council that can advise the insurance company.
Also, I said that besides the self-employeed. everybody who earns above a certain level of salary (currently monthly gross salary of 4 050 Euros) is no longer obliged to insure himself in the UHC but has free choice between membership in the UHC or at a private insurance.
Also, in addition to your first point: From what I’ve gathered from posts over the years, in the current US system, some (big) employers make a special contract with an insurance company for special rates for their employees. Often this seems to mean a limited number of doctors who made a deal to accept memebers of this insurance company, or only certain procedures being provided for. Also, in some states, some version of almost-UHC for those whose employer doesn’t offer Health insurance is also available.
Those whose employer is too small or doesn’t want to have to look for themselves, so if there are any problems, they are fucked up.
Now, when a national UHC is made (with either one, or to have more choice, some big companies competing), all those existing state deals and all existing big employer contracts would be bundled together for efficiency (less overhead means less wasted money), more flexibility (more doctors available on your approved list). Each employee would then be offered a choice during this switch-over-period of staying in UHC or looking for a private insurance himself. I don’t see why this wouldn’t work.
(for the out-of-work people)
From the emloyment office of course, just like their out-of-work pay. It’s part of the Social Insurance system we have here: because many people are too stupid or short-sighted to make provisions against rainy days, some insurances are mandatory for employees, and the fees are automatically subtracted each month from the gross salary. These are:
UHC (half of 12 to 13 %)
Nursing insurance** ca. 1.x %
Unemployment insurance ca. 1.4 %
Pension insurance ca. 8.x %
Each of these insurances goes into a seperate pot, each is administered by a seperate institution, none of these are taxes.
** This was created in 1995, when the politicans finally realised that almost everybody would need nursing care in old age and old people’s homes, that most people didn’t have the wealth to pay for themselves, that the costs were skyrocketing (easily 4 000 Euros a month for an old people’s home or more) and that, if the UHC companies would continue paying this, they would loose too much money. So a seperate insurance was started.
Childless people pay a bit more for this one.
So if you loose your job, you have a right to get the money from the job office since you paid into it before, it’s not a charity or welfare. Some Dopers have said that they have funds privately saved to last them through x months or unemployment; this is similar on a bigger basis for everybody. (If you haven’t been lucky enough to find a job in 2 years, then you switch over to general welfare aid - Hartz IV)
(Family insurance)
Yes. Because the UHC is for the benefit of all of society not for the shareholders and CEOs of the insurance companies. I realize this may be a difficult concept for you to understand, since most Americans don’t seem to know about the social contract or similar aspects of a state.
We think it’s important that everybdoy gets insurance and therefore needed treatment, and children are the future, anyway.
Yes, those can save now. Until they become old, and their insurance suddenly throws them out before they cost too much money, or raises their fees /premiums to record level. The advantage of a fixed percentage is that it will never go beyond your income/salary; but a fixed amount of premium can. And while a young single may be able to afford 600 a month, when he's older and the premium is raised to 1 200 that may be more than his pension.
No longer arbitrarly deny? So they need a good reason, like saying that this pre-existing condition would be too expensive to insure? And some states is not all states. Or do you suggest that all those dopers who told of their personal problems finding affordable Health Care should move to one of those states?
That’s strange. There was a thread some time ago as to why dental insurance was seperate; from this I assumed that it was more expensive. The reason is of course that not everybody needs a surgery or expensive treatment during this life, but almost everybody will need fillings in his teeth at least, probably also bridges, inlays and 3rd teeth/dentures.
Aside from those posters who are name-calling, several arguments have been made that it would cost less at the start.
I don’t know where you get those figures from, and I don’t know how many insurance companies with how many employees you already currently have in the US. But a lot of small companies would merge and grow or go out of market.
Also, what about the current bureaucracy with the private insurances? Don’t tell me it’s easy for you to get money out of them or a procedure approved, because too many dopers have posted stories in the past about how much trouble they have.
First, ** WHO SAID IT WOULD BE A GOVERNMENT BUREAUCRACY WHO DOES UHC?** Apparently you didn’t read my post or anything about how UHC works in other countries. It’s regulated and controlled by the govt. but run by companies.
secondly (since this is the pit), go the fuck out of an existing country and take that stupid argument with you. (no offense). Because the existing govt. bureaucracy has problems, you want to keep the private sector unregulated? This has worked so well with finance companies after all, no regulation no control no govt. because govt. is bad.
I got an interesting fact for you: ** Nothing in this world is perfect** Learn to deal with it, or go fuck yourself. Just because something is 10% ineffiecent doesn’t mean it should be abolished. Just because something can’t be guaranteed to work 100% perfectly is no reason to not introduce it.
Now, if you knew that somebody incompetent (like Head of a Horse Assoc., or swindler, liar and thief) is designated to head this branch, then that would be valid concern. If you knew that republicans, with their contempt for public money and bad spending habits, had control of this branch’s money, then that would be valid concern.
Only Bush W is finally gone, so no immediate danger from there.
No argument, because that argument is too dumb to respond to. If you don’t believe in any government doing anything good, then leave the organized country to go live in anarchy where you belong, and don’t bother normal people.
Just to answer this one (although facts seem to be wasted here, since the Canucks have already pointed this out): Despite what the right-wing policitans and rabble-rousers tell you, the amount of people who abuse welfare is very low.
This is obvious from very different perspectives: the number of actual cheaters caught, as well as general pychological and sociological experiments and research.
This latter research shows that a society generally works with honesty - because people are social animals, most have an idea built in that it pays to be honest and decent now because you might need it also. In the long run, groups and communities can only work if most of the members are honest and decent. Otherwise there’s breakdown and the group no longer works as a group; but then from the ruins rises a new group which starts with honesty again.
Now you want to know how high? About 10% (± 5) of people in a group will cheat lie steal deceive. This happens in all societies in different tested situations. Whether it’s people who call in sick to work when they want a day off , or people who cash two welfare checks at once, or people who exaggerate the car damage to the insurance.
The second fact: Society can live with that percentage, and it won’t crash or go bancrupt from this. It’s normal background noise.
Now, if your figures show that 50% of people are cheating your insurance, or 80% lying about their income to the Tax office, then you have a problem and that needs to be addressed. First you have to find out though why people are doing that. Do they feel taht taxes are unreasonable? Do they think everybody else is doing this, so I’ll do it too so as not be the dumb one? Then you need to change the structure and educate people more on how the system works and they are hurting everybody.
Maybe people on welfare are not reporting additonal income because the normal welfare is too low to live on. Then you need to raise it. Etc.
But unless you can show me reliable (not right-wing) figures that 40% or more of the welfare receivers in the US cheat and are lazy then I don’t believe that.
Also, in Germany a lot of the unemployed can’t get another job because of the prejudices of the HR people, who throw away unlooked applications from people over 40 years. They write 250 or 300 applications without one positive reply, despite being qualified.
So stop the shit about people getting lazy when they have a safety net, or abusing a UHC system because it’s not true.
Nobody has seriously challenged per capita consumption of nachos as a rough proxy for the size of the underclass, either. Must be on to something!
If you seriously want to make such a claim, I’m happy to debate it.
This is why I sound like a parrot - I keep having to repeat myself. For one thing, I’d like to see a cite that the regular middle class thinks this is such a good idea - I have a feeling that you have stretched middle class to mean “two incomes”.
What straw man? That the true middle class gets stuck paying more taxes for less benefit than the poor and the rich?
And yet, for all these pages we are talking about UHC, not defense policies. Yes, it would be wonderful if the US government would quit running us into an even bigger hole by starting up wars every ten years or so, but is that really going to happen? All these people that say “we could afford UHC if we weren’t at war” don’t seem to know that if we weren’t at war, we might be able to get back to even, nevermind being able to afford a hugely expensive healthcare experiment. It’s not like the US is going to go isolationist all of a sudden and quit blowing billions of dollars on wars and defense.
Probably not for two reasons. For one, I’m on dialup, so it takes me quite a bit longer to load a page with graphics than it does several pages in here which are mostly text. For another, those links that I did look at didn’t seem to say anything different than what you all in here are.
Ah, no. I am asking you to prove what I believe to be a serious break with reality, given the past history of this country and it’s government.
Uh, when did this become about middle class disabled people? As for locking one into stasis, that is far better than going bankrupt. You may not be advocating any tax increases but I cannot believe that you continue ignore decades of history regarding new US federal government programs.
_
First you tell me that I have a persecution complex, then you admit that the rich don’t pay as much as the middle class does, at least not percentage wise. Which is it?
Actually, no. The Mexicans live lower class when they first come here, but since they have a high work ethic they tend to get into the middle class by the second generation. We have Mexicans living on either side of us and across the street, and we live in a house that was worth 3/4 million $ before the real estate crash. It just happens that our poor people here tend to be Mexican - in LA, they are probably split 50/50 black and Mexican (and no, I don’t have a cite, that is just an impression).
Uh, I really fail to see what distant countries have to do with whether or not UHC would work in the US. It just amazes me that so many people can assume that simply because UHC works in Germany or Canada, it must work here.
Your definition of trollish are those who don’t agree with your trust in the government and belief that if it works overseas, it must work here?
Parroting again unfortunately. Yes, it would cover everyone if it wasn’t an opt out system, but that doesn’t mean for the true middle class a) that it would cost less and b) that that care would improve or at least remain the same. It boggles me that people who are supposed to be intelligent and fighting ignorance would believe that the US government could set up anything without it costing billions of dollars, and that those billions would come from anywhere other than those who are already working.
It also boggles me that I say that over and over and you all that support UHC just ignore it like those things haven’t been going on for decades.
I don’t believe this. So much information is manipulated by right wing think tanks which are actually policy marketing firms to convince the public that specific programs aren’t viable. The fear of lack of funding was the same tactic used to make social security a pay in advance system instead of pay as you go under the Reagan administration. The result has been an enormous tax burden on the lowest wage earners. Moreover, the social security funds are used to finance budget shortfalls caused by tax cuts for the wealthiest Americans and corporations.
Don’t forget Bush’s Medicaid drug plan designed as a lottery jackpot for the pharmaceutical industry will either bankrupt the program or push the public harder towards health care reform. How can a President claim to represent the public when he agrees to pay the drug companies whatever price they desire. Bush didn’t even agree to pay market price. It’s an extremely perverse form of crony capitalism. There is nothing conservative or free market about the Republican Party. I don’t give the Democratic Party a pass either; they need to grow a pair.
Well, in my experience here, they all lie. They just say what they think a majority of voters want to hear.
I respond only to those here - who have said that the only way that UHC could be successful in the US would be if everyone had to participate.
OK, it begins to sound like you all have closer to what the US has than what, say, Canada has. You have a choice of plans and you pay your premiums directly to whichever plan you choose.
There was a short period of time when employers purchased true HMO plans, which forced their employees to go only to centralized health clinics and specific hospitals. It didn’t work really well, so that sort of plan is now rare, if not extinct. I have what is called an HMO now, but I have the choice between hundreds of doctors for my GP and scores for specialties. And if I need care outside of my home area, it is covered unlike the old days of HMO.
No, they can buy private insurance. Simply because employer sponsored insurance isn’t available doesn’t mean someone cannot buy insurance.
You are offering a choice. The leading plan here (in this thread) does not.
Well, in the US, these are taxes. Taxes are defined as money we pay to the government that we have no choice whether to pay or not. Do you have a choice as to whether or not you pay your unemployment insurance? What happens when you have been out of work so long that you have used up as much as you have paid in?
Because?
Even if you haven’t paid into it enough to cover two years worth of out-of-work?
Which doesn’t answer my question.
It’s wonderful that you can afford to cover those that choose not to work, but here we have so many of them that taking care of them has caused the middle class to shrink into almost nothing.
This doesn’t answer the question either. You seem to have no trouble expecting single people, the childless and the older folks to fund those with children.
Under HIPAA, a group plan insurer cannot deny anyone who has been covered by any other insurance prior to signing up to that plan. For example, I have quite a few pre-existing conditions and my husband has two, and we were not refused coverage for those conditions when he got his new job in November because we had been covered continually up to that time. That is the federal law. Some states have passed laws that don’t allow any group insurance to have a pre-existing clause at all. Even those states that haven’t added to HIPAA still have to follow the federal law, and their insurance companies can only deny those pre-existing conditions for a certain amount of time - six months seems to be the average.
That may be Europe. Most of the folks I know here don’t even go to the dentist every year. When we were both unemployed, we dropped both dental and vision insurance and we only carry them now because they are so cheap.
In Germany or do you believe that to be true of the US?
Oh dear. Do you have a cite for this utopia?
10% of the US population is a heck of a lot of people. And that doesn’t even cover those people who are not actively cheating.
Wait, what? We should raise welfare benefits because some folks are cheating on it by not reporting income?
That would be kind of hard to do since you seem to have pulled 40% out of your butt…
Uh huh. Must be nice to live where you are.
And it must be really depressing to live with you…
Thank you for noticing what happens when people are overburdened with taxes.
“I like paying taxes. With them I buy civilization."
-Oliver Wendell Holmes
I would bet that’s it’s low in the U.S. Do you have any statistics that suggest widespread welfare fraud?
I’m not able to find any useful numbers on the federal side, but this document (warning: PDF) provides some details on welfare fraud in the state of California (mostly LA county) in the year 2002. From the document (for the entire state of CA):
[ul]
[li] 421,022 cases referred for welfare fraud[/li][li] 34% of referrals had sufficient evidence to support the allegation[/li][li] 8% of those allegations had enough evidence to warrant prosecution[/li][li] Of the 12,353 cases prosecuted, 82% (~10,130) were successful[/li][/ul]
According to this site, Calfornia had 475,000 welfare cases in 2002 (which seems low to me, but works for illustration purposes). Taking all of this at face value, that would mean about 2% of California’s welfare cases involved some kind of fraud.
Personally, I’m comfortable with labeling something like that as “very low”.
It seems to me that there is a difference between “fraud” and “abuse.” “Abuse” is difficult to define, but it arguably includes people who have unprotected sex and bear children without any kind of reasonable plan for supporting themselves and the children (apart from collecting welfare).
So defined, I would guess that abuse of welfare is fairly widespread. (I’m not sure how one would measure this type of abuse, so I don’t have a cite.)
Yeah but, Mr. Holmes couldn’t have imagined this kind of mess, and LilShieste’s statistics not withstanding, handout fraud is a lot more prevalent than many of you would imagine. The statistics don’t take into account the subjective and circumstantial evidence that prove the fraud (obviouosly but not to the satisfaction of the court), and/or the fact that it might not be worth it to prosecute the offender due to cost. Imagine if even 1/3rd of those 421,022 cases had merit, that’s still 140,000 cases that the already strapped agencies cannot prosecute and the already overburdened courts couldn’t process in a timely manner.
I know personally of two people, both of them make upwards of $60,000 yearly and still take state aid to pay their utility bills and buy food. I know by proxy at least a dozen people who, after our Governor enacted the “every child has healthcare” deal, dropped their employer-paid coverage to go with the state paid policy because they wanted more money in their checks. The same people who, before the program took their kids off of their insurance to get money back in their checks, leaving their children uninsured, until open enrollment. Now, these are short examples, I know, but the point is that there is a group of people who WILL work the system for all it’s worth by any means they can if the system is flawed enough to allow it. Under subscriber-paid insurance like we have now, if you don’t have it, you don’t have it, you can’t sneak, lie and cheat your way into Blue Cross’s system. I agree there should be something available, but once you start handing it out, by god, people will take it, and not just the people who need it. I think if UHC is to succeed at all, that there needs to be a profit component to large companies in order for them to work, by default, at protecting the interest of the taxpayers.
I’ve been in some of the areas that the average person doesn’t get to. Some of the roughest neighborhoods in Chicago. I’ve spoken, doing interviews, with recipients of state aid of all kinds as a side job and learned a lot about the mindset and how the system works. The people that intend to defraud (and truly not all of them do) do so without compunction and with the combined experience of the generations that have gone before. It may be a low percentage, but when you’re talking about real dollars, the impact is big.
I think the only way to address the fraud is to hyper-criminalize it while at the same time relaxing what the state is able to do in the way of shutting off the tap if fraud is suspected and credible enough evidence can be found to sustain it.
Wait…I’m confused. Are we worried that Welfare Queens [sup]TM[/sup] are going to demand too many unrequired x-rays under UHC? How does “abuse of the system” apply to health care?