why not universal healthcare?

[Sarahfeena]

@Voyager

Here’s a Census Bureau Press Release:
which includes the following:

. (I posted this in one of the other threads on this.) If being uninsured was primarily by choice, you wouldn’t see this ethnic breakdown. Certainly young, healthy people might choose to not buy insurance, since it is on average not a good deal for them. They are part of the problem - not in the sense of suffering the lack of insurance, but in not contributing to fund those people who do need it. Remember, they’ll need it also given time.

Given the ethnic breakdown of the uninsured I’d expect far more of the uninsured can’t afford it rather than choose not to buy it. Any data to the contrary?

I don’t think your data says what you think it does. It is a broad-brush assumption that low income alone is why certain ethnic groups don’t tend to buy insurance. I would grant you that lower-income groups are going to be the ones who are least likely to have insurance, due to the cost and due to the fact that they tend to be working jobs that don’t offer it. But that doesn’t necessarily mean that they CAN’T afford it, only that it is more difficult for them to.

You are right that you would expect to see younger people as a large group without insurance, and since they are also the majority of minimum-wage employees, then low income must not be the only driving factor behind why certain people don’t have it. Cultural factors may be at work here, and I suspect they are.

[RickJay]

@catsix

Actually, it makes me like your system even less. I’d prefer a system that’s a lot more like car insurance, where it’s required by law, but it doesn’t cover things like oil changes and annual inspections.

You want to make it the LAW to buy private health insurance? What’s the sense in that?

And in terms of health, it’s far more cost effective to cover the routine things - like checkups and routine visits - than the catastrophic things. Health care is cheaper the more preventive the approach.

And the taxes are just magically going to go down despite the fact that the government starts shelling out even more money to provide long waiting lists and less options than I’ve got now? There’s no way that’s going to be saving me any money, and no, getting crappier health insurace and not being able to get what I have now is not an incentive.

Let me try to make this as clear as possible; you are paying more money, but getting absolutely nothing for it. Do you actually thhink that’s a good state of affairs? You complain about choice, but you’re not being given any choices: you STILL have to pay whether you like it or not, and even if you get nothing for it.

This doesn’t eliminate the possibility of having private coverage to increase your overall coverage and quality of care. My family gets private rooms in the hospital, because I have private coverage for that. I have dental insurance (which isn’t part of Canada’s medicare system at all, for some reason) private room coverage, a drug plan, eyewear, so on and so forth. All of that’s private; none of it is covered by the public system.

[mks57]

One thing that you need to consider is that people with health problems often lose their jobs, and that nice employer-subsidized health plan, if they were lucky enough to have one. If they can find another job, it is often part-time or lower income, with no health benefits. Then you run into the problem of insurers wanting to ditch anyone with a chronic or preexisting condition.

I think many people would be happier if the uninsured just hitched a ride on the next ice-flow and disappeared, never again to trouble those who have the strength of character needed to avoid major illness.

[Rysto]

@catsix

And the taxes are just magically going to go down despite the fact that the government starts shelling out even more money to provide long waiting lists and less options than I’ve got now? There’s no way that’s going to be saving me any money, and no, getting crappier health insurace and not being able to get what I have now is not an incentive.

US governments spend more on healthcare per capita than Canadian governments. In total, Americans spend twice as much as Canadians on health care(counting public and private spending), and get worse care on average.

[Voyager]

@Sarahfeena

I don’t think your data says what you think it does. It is a broad-brush assumption that low income alone is why certain ethnic groups don’t tend to buy insurance. I would grant you that lower-income groups are going to be the ones who are least likely to have insurance, due to the cost and due to the fact that they tend to be working jobs that don’t offer it. But that doesn’t necessarily mean that they CAN’T afford it, only that it is more difficult for them to.

It’s not a proof of anything, true, but it seems to argue against catsix’s claim that lack of insurance is just a free choice, and that those not able to afford it either shouldn’t have had kids or were spending the money on something frivolous. Who can say when this moves from being a choice to being effectively impossible. Who can say that parents who choose to save the money for transportation or clothes in the hopes of not having medical expenses are doing the wrong thing? Maybe they know how to go to emergency rooms and then not pay the bill. I think the point of some sort of universal health care is so that these parents don’t have to make these kind of choices.

You are right that you would expect to see younger people as a large group without insurance, and since they are also the majority of minimum-wage employees, then low income must not be the only driving factor behind why certain people don’t have it. Cultural factors may be at work here, and I suspect they are.

A lot of people on MW, at least according to the claims in other threads, are teenagers covered by their parents’ insurance. I don’t know if these people get counted as being uninsured - I’d assume they weren’t. Two low paid 20 year olds might well choose not to buy insurance, but two low paid 20 year olds with a child are probably not freely choosing to be uncovered.

[catsix]

DSeid said:
Poor? Don’t have kids.

What, exactly, is so unreasonable about 'If you can’t afford 'em, don’t have ‘em’?

You make $30K a year and a family plan costs $7K … ah you must be buying designer jeans and Starbucks every day.

Or maybe people think about health insurance wrongly. Nobody expects their car insurace to buy new tires, brakes, gasoline, and belts. They don’t expect their car insurance to pay for the annual inspection or registration do they? Does homeowner’s insurance pay for the grass to be mowed, the furnace to be cleaned and inspected, the walls to be painted or the carpet to be cleaned? No, what insurance exists for is a major, unforseen circumstance.

There is no way another model could cost less and I’ll just keep my fingers in my ears and say “LALALA” to anyone who provides the cites that America has healthcare costs worse than other industrialized nations with worse measurable outcomes.

Maybe I am paying more, but I’m getting better service and not waiting on a list to see a doctor.

I’ve said before and I will say again, every penny I spend is worth it.

Dinsdale said:
It seems to me that it is at least conceivable that a system could be devised where a certain base level of medical care was universal and funded by taxation, but that also allowed people with means the option of purchasing supplemental coverage.

I’ve seen absolutely no evidence whatsoever that this is going to save me a cent. I have no reason to think that it won’t cost more than what I pay now.

If you want to make some kind of very basic, catastrophic medical inusrance that covers hospitalization (like if you’re admitted) part of unemployment insurance, that’s fine with me. What I do not want is socialized health insurance.

Voyager said:
Certainly young, healthy people might choose to not buy insurance, since it is on average not a good deal for them.

Car insurance isn’t a good deal until you’re in a crash.

RickJay said:
You want to make it the LAW to buy private health insurance? What’s the sense in that?

You want to make it the LAW to buy private automobile insurance? What’s the sense in that?

Let me try to make this as clear as possible; you are paying more money, but getting absolutely nothing for it.

I’m getting a lot for it. Someone who has chosen not to make health insurance a priority is not getting anything. I’m fine with that system.

Rysto said:
US governments spend more on healthcare per capita than Canadian governments. In total, Americans spend twice as much as Canadians on health care(counting public and private spending), and get worse care on average.

That’s nice. How does it prove, at all, that taxes would be lower if we implemented the Canadian waiting list system? It doesn’t. Historically, taxes on the whole go UP, not down.

Voyager said:
Two low paid 20 year olds might well choose not to buy insurance, but two low paid 20 year olds with a child are probably not freely choosing to be uncovered.

Then they shouldn’t have a kid. Nobody should be having a kid unless they are prepared to take on all of the responsiblity for said kid, including paying for that kid’s health care.

[wonky]

@catsix

What, exactly, is so unreasonable about 'If you can’t afford 'em, don’t have ‘em’?

Two words: Shit happens.

[Guinastasia]

@catsix

What, exactly, is so unreasonable about 'If you can’t afford 'em, don’t have ‘em’?

I’m not going to weigh in on the whole insurance debate at this time, but while this advice may sound sensible, it doesn’t always work out that way. Birth control fails, and it’s often expensive-again, without insurance, it’s unlikely for these people to be able to afford the pill, or anything other than condoms, which do break. And not everyone believes in abortion.

Also, sometimes people CAN afford them when they get pregnant, and then somewhere down the line, are hit with hard times and become poor. What then?

[Voyager]

@catsix

Then they shouldn’t have a kid. Nobody should be having a kid unless they are prepared to take on all of the responsiblity for said kid, including paying for that kid’s health care.

But the kid is here. Do you take it from the parents and give it to someone who can afford health insurance? Abort it retroactively? Or do we, to teach the parents a lesson, arrange things so it doesn’t get decent care early, so that it either dies or gets sick in an expensive way which can be prevented early and cheaply.

Ah, for that moralistic paradise of Dickensian London.

[DSeid]

Let’s just leave it at the very basic reality check. Try to deal with the facts.

No matter what you think the poor should do, the poor will continue to have families.

The currrent system has individuals with employer-provided plans able purchase healthcare coverage as part of large groups and therefore at sizable discounts and, generally, without regard to pre-existing conditions. These individuals are further subsidized by the tax treatment of that compensation with the result that the most highly compensated get subsidized the most. Fewer get this than before.

Of the other 40% a portion has care through various governmental programs.

9% buy their own coverage. They buy it without the benefit of group volume discounting so they pay significantly more for the same benefits. They are cherry-picked extensively, and any hint of a past problem will result in uninsurability.

And almost 16% have no coverage. For some it is because no company will take them on as an individual. For some it is an unreasonable expense. And some just decide to roll the dice … money in the pocket betting on continued good health.

What happens to the uninsured? They still get care but it is catestrophic care provided in the most inefficient manner possible and the bills often go unpaid, to be recouped in extra expenses hidden in all of every paying patient’s bills. Society will not allow an ER to turn away someone with a heart attack or stroke in progress because they are uninsured. We do not pay for the care that would have prevented the catastrophe but we do pay for the expenses that result, albeit indirectly.

The expense of healthcare coverage for employees is convincing more and more companies to not offer such a benefit and those who do are at an increasing disadvantage in competition, both domestically and internationally.

These are the facts and they do not change because of what any of us think “should” be.

Do we want to live with those facts or can we create a situation that is less irrational? Can we do better for the American business community’s competitiveness, for our individual bottom lines, for our nation’s health, and for the well-being of all of our citizens? Obviously I think that a more rational approach is possible and that there are options that would also be palatable to the major players. Universal healthcare coverage* is desirable not only out of a sense of social justice but because it is in both society’s and our individual’s best interests. “Universal” need not mean “single payor” or “national” and, IMHO, those models are nonstarters. There are other ways to do it and your individual mandate proposal should be part of it. But such a requirement is not in and of itself enough.

Hillary Clinton’s original incompentent handling of healthcare reform poisoned the well for many years. Bush’s proposal of reform of the tax treatment of healthcare coverage benefits may poison that subject as well. But at least the subject is being addressed again.

*Your point about the word “insuruance” is well made. We are not talking about “insurance”, we are talking about coverage, of which insurance is one model to provide, but certainly not the only or best one…

[Magiver]

@space fish

If good ol’ American health care is so easily available why didn’t he just come down and get some of that?

because he was stuck in the hospital after the 2 heart attacks he suffered while waiting for the procedure. They were looking into moving him across the border.

It is not unusual for Canadians to do just that.

[Magiver]

@space fish

Translation if you’re an able bodied young adult and poor you’re screwed.

I missed that one. If you’re an able bodied young adult you are responsible for your actions. In the United States you can stumble out of High school without learning a thing and still get a job starting at $30,000/year the very next day.

[Johnny_L.A]

@Magiver

I missed that one. If you’re an able bodied young adult you are responsible for your actions. In the United States you can stumble out of High school without learning a thing and still get a job starting at $30,000/year the very next day.

Cite?

[Magiver]

@Johnny L.A.

Cite?

You need a cite that able bodied adults should be responsible for their actions?

[Johnny_L.A]

@Magiver

You need a cite that able bodied adults should be responsible for their actions?

No, a cite that it’s easy for someone to walk out of high school and get a $30,000 a year job the next day. Are you talking about joining the military? Do you mean only people just out of high school? A friend of mine is 31 years old with a college education. Know what kind of job he was able to get? Pushing around fish paste in a surimi factory for much less than $30K/year. If I could find a $30K job near my house, I’d take the pay cut and move out of L.A.

[Sarahfeena]

@Johnny L.A.

No, a cite that it’s easy for someone to walk out of high school and get a $30,000 a year job the next day. Are you talking about joining the military? Do you mean only people just out of high school? A friend of mine is 31 years old with a college education. Know what kind of job he was able to get? Pushing around fish paste in a surimi factory for much less than $30K/year. If I could find a $30K job near my house, I’d take the pay cut and move out of L.A.

He should look into working construction.

[RickJay]

@catsix

You want to make it the LAW to buy private automobile insurance? What’s the sense in that?

There is no such law. Anyone who doesn’t want to buy car insurance can simply opt not to drive cars, or drive their car around their own property. Car insurance is a condition of driving a car on a public road. If you don’t like paying for insurance, take a bus, or a train, or pay someone to join their carpool.

Forcing people to buy health insurance - which completely shoots down your “choice” argument, since a forced choice is no choice at all - would be a substantially more invasive requirement for the simple reason that the condition for having it would be, well, existing. You can choose to take a bus, but you didn’t ask to be born.

I’m getting a lot for it. Someone who has chosen not to make health insurance a priority is not getting anything. I’m fine with that system.

Perhaps you are not reading these posts carefully. You are paying a large amount of money towards a public insurance system that you derive no benefit from. You AREN’T being given a choice; you have to pay for it.

The evidence that a universal basic health care insurance system would be better is that every first world country that has one takes less money from the taxpayer to pay for it. That doesn’t preclude additional private coverage; it simply indicates that a universal preventive system has the potential to save you money. You may disagree and provide coutnerarguments and such, but don’t tell me there isn’t EVIDENCE that it wouldn’t help.

[What_Exit]

@Sarahfeena

He should look into working construction.

It is not always easy to get those good paying union construction jobs. The easy to get ones are more like $10 per hour which is only about $20k per year.

BTW: Great post DSeid.

Jim

[Johnny_L.A]

@Sarahfeena

He should look into working construction.

I just took a look at the state’s job board for that county. Since I don’t know the extent of my friend’s experience (I know he was working on becoming a journeyman electrician a couple of years ago, but left to do another job; and he does his own home remodelling – handy, since he’s living in my house) so I searched for entry level positions. Basically, what someone just out of high school would look for. There are ten jobs listed. Four of them require enlistment in the Army. One of the jobs is for a position he held – industrial mason. Hot, cold, heavy work that left him with a touch of carpal tunnel syndrome. So there are five jobs for which he could apply. Hundreds of views. And the ones that list compensation are $10/hour, not $30K/year.

[Johnny_L.A]

@What Exit?

The easy to get ones are more like $10 per hour which is only about $20k per year.

Which is borne out by what I saw in my brief search.