As part of his salary and benefits - not out of some act of charity.
“Covers” in the sense that there’s one level of service for everyone, and it’s poorer than the level of service most Americans are used to, especially for “non-urgent” surgeries – but better than the level of service uninsured Americans get.
I’m betting that you won’t.
No they aren’t, and no it hasn’t.
Because you are a part of a society. You choose to live in an environment where everybody is expected to pay a share of the cost of living in that society, so “keeping what (you) earn” isn’t an option from the get-go. You don’t get to decide whether or not to spend money on schools, police, fire, etc. Those things are accepted as things that make our country worthwhile to live in, or you would be living in a cave somewhere. There are those who opt out, and try to live on their own in the boonies, but if you live in a community, you pay your share of what makes that community tick. If you really think you’re not already paying for the healthcare of people who can’t afford it, you’re deluding yourself.
Workers’ compensation coverage is not part of his salary or benefits. If he’s treating for an occupational condition under his own coverage, that’s his own fault.
There’s one level of service for everyone under US insurance plans, too. What’s your point?
ETA: that was in response to Bricker.
Good point. My son wants a Wii U, but I’m a bit strapped this month. Can you buy it for him, please?
Obviously not.
Because even though we’re all a part of society, we also recognize there’s a line. The current discussion is asking, in effect, why that line should be drawn with healthcare costs allocated to the group instead of to the individual. Of course, in a sense, it’s a moot point, since the answer to that question is: because we, as a society, have spoken via our elected officials and said it should be thus.
Interesting, I don’t know of anyone in the UK that has been refused “non-urgent” surgery because of a pre-existing or non-disclosed condition.
Do we sometimes have to wait to get it for free? yep. If someone has a greater medical need they get to jump the queue.
I’d challenge your assertion that, overall, the NHS level of service for the “most” UK citizens is “poorer” than for most USA citizens. Anecdotally that is not what I get from my USA colleagues. They are fairly well off and have a really good employer insurance scheme and yet they can regale me time after time with horror stories of out-of -pocket expenses, refused treatments and astronomical pre, neo and post-natal bills.
What evidence has led you to your conclusions here?
There’s a clear distinction to be made here, which is that a centralized system for healthcare increases efficiency. Conversely, the market appears to be the best system for allocating consumer electronics.
Having experience both systems (and having parents who’ve worked under BUPA and the NHS in the UK and in private medicine in the US), I can say that the aggregate level of patient care in the US is unquestionably better - when you actually get it. American hospitals are nicer places to be, American physicians are (mostly) more qualified, and American medical equipment is more advanced.
Of course, the “when you get it” part is the big issue. UK patients don’t have to worry about whether there is a hole in their insurance coverage that will force them to pay out of pocket for an operation, and are not declined because of pre-existing conditions, and so on. Personally, I would much rather that than have slightly better patient care.
Straw man.
The idea that a couple of years of universal coverage is going to, in and of itself, going to result in huge savings, is not one that has been put forth.
The fact that low severity ED visits decreased at all is honestly surprising. The fact that more people who had conditions that really required an Emergency Room visit actually went, when they had coverage, not so much so.
As for the issue of prevention saving money - the article you link to then justifies its position by quoting this one. Its point? Not all prevention measures save money and we need to look at which ones give the best bang for the buck. Indeed when prevention measure are advised they are often explicitly not expected to save money; they are hopefully more often supposed cost effectively increase quality of life years saved (QALY). Sometimes measures touted as “prevention” do more harms than goods (prostate cancer screening for example). Placing a dollar value on a life year saved however is something that our society often fails to approach rationally - until we do we will irration care rather than ration it.
Parts of the law that are under appreciated:
Insurance companies are limited to no more than 20% of their collected premiums on things other than direct medical care (things like advertising and administrative costs). If they do they need to rebate money to customers.
It transitions payment from predominantly fee for service to payment based on documented value provided. (See here.) Health care delivery systems have already been changing in anticipation of this (we have been for several years) and the cost curve is already inflecting.
Even with decent insurance in the USA, there are significant wait times to see many doctors. I work at a large university with an associated medical school/health system. Wait times for specialists varies between 3 and 6 months, I had to wait 6 weeks for an appointment with my GP for a physical. You need to schedule a routine OB/GYN appointment a good 3 months ahead. My ENT is easily scheduling 4 months out.
My grandparents in Ottawa have a much easier time scheduling their doctors appointments and than I do. Maybe because of where they are, they haven’t had any issues with treatment wait times. My grandmother assumed her hip replacement wait would be 3-4 months, she had one scheduled in 6 weeks.
I personally, would like to see everyone in the US covered in a single payer system. I think it would greatly reduce costs for everyone in the long run.
Pardon my slow response but I’m having a hard time keeping up with your changing arguments. First public healthcare is more expensive. Now it’s less expensive but when we compare what those with the most money get in a private system to what everyone in a public system gets, the public system is slower for some items.
I agree it’s slower to get some things when everyone gets them - not just those who have health insurance and don’t have preexisting conditions or whose insurance has found another excuse not to pay. Are there any other metrics you’d like to try? Say life expectancy? Infant mortality? The world health organization ranks the US 37th and Canada 30th out of 191 countries. I’m not impressed with the bang you’re getting for your buck.
Don’t have much factual information to counter your “There is no doubt”. Perhaps if you have basis for making this assertion I could try and comment on it?
I’d quibble that the word “aggregate” is the right one here. Seeing as that suggests that the* total *amount of care given is better, that doesn’t seem to align well with the insurance hassles and uncovered millions.
I would not disagree that the potential care available is among the best in the world but how many USA citizens get to experience that without the attendant problems and costs of insurance?
As you say in your second paragraph, it is all about whether that excellent care is available to enough people. A country with VW’s and Ford’s attainable for all has a better transport system than one with Ferrari’s and donkey-carts.
Nope, just don’t spend enough time here to adequately put together a “debate”, so I’m going to bow out now.
For the record, however, my argument never changed. I simply stated that for socialized healthcare to give the same level of immediate availability that I have with my private pay insurance (like my knee surgery) it would cost more per capita. That is the reason for waiting lists - multiple people competing for the same, limited resources.
Yes. Waiting lists exist. I have some experience with this, on both sides of the border.
A family member (from the Canadian side of the family) just had a hip replacement in Canada. She had to wait for, I think, four months from the time it was determined that she needed a replacement until she got it. There was some talk about how that wait was longer than usual (even in her remote and rural area of Canada), and about how there must have been some screw-up in the paperwork somewhere, but there was admittedly a wait.
I had a knee replacement in the United States. The need for a replacement was the direct result of a horrific accident I had during a very brief time when I was uninsured. I got emergency care, which involved surgery and a two-week hospital stay (this care left me in debt for years). But I got no follow-up care, and basically couldn’t walk for more than a couple of blocks for years. Eventually I had my knee replaced (paid for by the insurance I have through my employer). All was then well with my knee.
Which system is better? This goes beyond any questions of “efficiency” and the like.
Under one system, everyone gets care. They might have to wait a bit for treatment for non-life-threatening stuff. They might have to travel a bit (although some of that is due to Canada’s geography, not some inherent flaw in the system – Canada is huge and thinly populated and people from small towns, too small to support a hospital, might have to travel to the nearest hospital).
Under the other, those who have good private insurance get what they need, right away (well, at least that’s the official story. We’ve all had the experience of fighting with our health insurance carriers about what they will and will not cover). Those who don’t have insurance get, well, next to nothing. They’ll be treated in an emergency room and sent home as soon as they’re ambulatory. If they’re truly destitute, they’ll qualify for Medicaid, and if they can find a doctor who accepts Medicaid, they can see that doctor. More likely they can go to a clinic somewhere.
So we’ve got rationing too, even if we obscure that fact by calling it something else.
It’s a choice between two conceptions of government, and different conceptions of the social contract. Canadians, in my experience, are generally happy with the choice they’ve made, even if they gripe a bit about waits and traveling.
I needed knee surgery (lots of it). I didn’t get it for ages, as I said in my post above.
We ration health care at least as much as Canada does, if not more so. We just have a different way of doing it. We deny everything but emergency care to those without insurance or the means to pay cash.
Like I said, it’s more than just a choice based on efficiency. There is an ethical choice to be made. What do we value more, our economic freedom to earn what we can and not have money confiscated from us by taxation, or the health and well-being of all of our fellow countrymen/women? Forget the economics of health care, that is the choice. We have to pick one.
(Bolded by me)
I don’t see anyone stepping up to the plate. Any charity or free care that anyone gets under the current system is paid for by a hodgepodge system. The hospital picks up some of the tab in emergency room visits and passes the cost on to other patients. Some patients might be able to get into a charity or indigent program. Many others will not be able to find help and simply won’t receive care until their health condition reaches an emergency level. This disorganization is not any good. Many people either go without care at all or don’t get care until they reach a catastrophe situation, at which point their care will be vastly more expensive and they may have a lower survival rate at that point, too.
I don’t think “taking care of our neighbors without nanny state involvement” will be enough. This is a large country with lots of people in it who need help. It needs to be organized.
It’s sad. Then there’s people like me who depend on having a job to have insurance. Without that, there’d be no way to have insurance on my own since I have pre-existing conditions. So what, if I lose my job I have to hope that I can find a charity program to pay for my care? I need regular followup, too, so I need regular insurance, not just a wing and a prayer. There’re a lot of people out there like me.
“UHC” is one of those terms that gets thrown around a lot, like “national health care,” without much regard to what it really means. Liberals make it sound utopian, and conservatives make it sound like a nightmare.
But there’s a huge range of stuff covered by the term. The UK’s NHS is really a national health care system. The doctors are government employees. The hospitals are state-owned.
Then there’s Canada. They have national health insurance (actually, it’s not even national – it’s provincial), but most doctors are not government employees.
And I think Germany has some kind of hybrid system.
It’s not a choice between a laissez-faire paradise that would make Ayn Rand happy or a Stalinist dystopia of collectivization.
Sooo… you’re saying you know more about medicine than someone who actually completed a formal program of study in it? How nice for you. So you’re saying everyone else should do that? Or maybe you just got lucky in your guessing.
Actually, being on disability doesn’t automatically qualify you for foodstamps. That is determined by a combination of income and assets so it’s possible to have no income and still not qualify. Also, in most places the wait for government housing is 5-10 years, or even more. Energy assistance doesn’t cover everyone either.
I can only assume you have never actually been poor in the last 25 years, because only someone ignorant of the reality can paint so rosey a picture.
People on disability are actually permitted to earn up to a certain limited amount per month. Again, you are displaying ignorance. Please come back when educated.
Unlikely. You’ll also have no savings and extremely limited assets.
If you want to live in a libertarian utopia go find an island or one of those “failed states” and carve out an enclave for yourself. The rest of us might want to live in a civilized society with a safety net.
My understanding is there are providers and payers which can be public or private. The UK has public funding and public providers (same as US VA system). Canada has public funding but private providers (same as US medicare). The Netherlands has private funding and private providers (same as private insurance in the US).
But they all generally agree that health care is a human right, that nobody should be denied valuable care because of inability to pay (within the confines of a finite system, ie no rational system is going to pay 1 billion to give an extra week of life to a cancer patient when money isn’t infinite) and that the state has a role in making health care affordable both by funding it and regulating the industry. The US doesn’t really subscribe to those ideas on the national level and in that regards we stand alone with an overpriced, inhumane system. The culprits, from what I understand, are the fact that our national ideology promotes the concept of individualism and because of racial divisions (health care is seen by some, at least in dog whistle politics, as funded by white people and being used to pay for unearned health care for blacks and latinos).
He may not, but I will. I don’t have insurance so the only times I’ve gone to the doctor are when I’ve had something that wouldn’t get better without antibiotics (bladder infection; lyme disease), and I paid the bills myself. There are other issues I could seek medical care for (asthma, allergies, GERD, hey why not finally try medication for ADHD too?), and if I’m going to be forced to be insured, why not?
There’s a big difference between going to the doctor for allergies, asthma etc and going for every sniffle and minor ache. I used to have insurance with a $2 copay -so low that I don’t know why they bothered. I still didn’t go for every sniffle
My insurance went went about $500 with the passage of the healthcare bill.