# Would universal healthcare be more expensive or less than the current US system? **URL:** \ **Category:** Great Debates\ **Created:** [February 24, 2009, 8:01am UTC](https://boards.straightdope.com/t/would-universal-healthcare-be-more-expensive-or-less-than-the-current-us-system/487175 "2009-02-24T08:01:17Z")\ **Posts on this page:** 20\ **Page:** 16
**Author:** ![Desert\_Nomad](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/desert_nomad/32/177_2.png) [@Desert\_Nomad](https://boards.straightdope.com/u/Desert_Nomad)\ **Post date:** [March 10, 2009, 4:15am UTC](https://boards.straightdope.com/t/would-universal-healthcare-be-more-expensive-or-less-than-the-current-us-system/487175/301 "2009-03-10T04:15:46Z")
> [@curlcoat](#): > > Tens of thousands of dollars for an ER visit? Yes. My “2 pills and 5 minutes” in an ER in Las Vegas was $9,000. A friend’s fractured shoulder (from an auto accident) was treated in the ER in Reno and cost $17,000. He is a small business owner and has no insurance. Thankfully, I have only ever had to visit the ER in Breda, Netherlands and Siem Reap, Cambodia. Each cost me about $10… the first for a fractured foot and the second for some sort of “jungle fever” that was cured with a course of antibiotics. ---
**Author:** ![Desert\_Nomad](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/desert_nomad/32/177_2.png) [@Desert\_Nomad](https://boards.straightdope.com/u/Desert_Nomad)\ **Post date:** [March 10, 2009, 4:39am UTC](https://boards.straightdope.com/t/would-universal-healthcare-be-more-expensive-or-less-than-the-current-us-system/487175/302 "2009-03-10T04:39:35Z")
> [@curlcoat](#): > > Then work on getting the pre-exist laws changed. As long as you support a UHC, you are asking me to pay for all the people out there who right now can’t afford to pay premiums. I have. I have written to both my senators and congressmen as well as state legislatures. > [@curlcoat](#): > > Actually, no, since our house is worth more than we owe, even now, so our equity line of credit would cover that. And why is that? Because we didn’t take on much in the way of other expenses until that was true. Apparently the mother of the child left her job before it was born? And they just assumed that everything was going to go just fine with the pregnancy and birth? You kinda have to leave your job when it goes out of business and they close the office. ---
**Author:** ![tumbleddown](https://avatars.discourse-cdn.com/v4/letter/t/e9bcb4/32.png) [@tumbleddown](https://boards.straightdope.com/u/tumbleddown)\ **Post date:** [March 10, 2009, 7:44am UTC](https://boards.straightdope.com/t/would-universal-healthcare-be-more-expensive-or-less-than-the-current-us-system/487175/303 "2009-03-10T07:44:06Z")
> [@curlcoat](#): > > Since I didn’t say that, I don’t know why I’m answering either, except I suppose because I have 45 minutes to kill. Uh, yes, you did, in response to Desert Nomad back on page 2 of this thread. You said: > [@curlcoat](#): > > > [@Desert Nomad](#): > > > > Why do I have to pay for the police and fire departments to protect you? Why do I have to pay for the military to protect you? None of these protect me. > > You don’t - I’ve never used them. Are you trying to deny that this was you saying that you don’t use police protection? > [@](#): > > And all of that you posted about the number of companies that don’t offer group insurance? For one thing, you didn’t carve out those jobs that one should not expect to be making a living at, such as cashier at McDonalds or manning a gas station. You do that, your numbers of actual make a living jobs without group insurance drops quite a bit. Nice attempt to move the goalposts, but whether or not a job is meant to be one that the employee is meant to make a living at is irrelevant. “Making a living” has nothing to do with access to healthcare. And logically, the fact that some jobs _are_ low wage and always will be further enhances the argument for delinking employment and healthcare coverage completely. These jobs will always exist and someone will always have to do them. You’re making an argument that because someone doesn’t earn much money, it doesn’t matter if they are completely priced out of the healthcare market until such time as they’re able to do something different. > [@](#): > > Then, for another, like healthcare, insurance isn’t a right. If your employer doesn’t offer it, then you get a private plan. If you cannot afford a private plan, you get Medicaid. If you are making too much to qualify for Medicaid, what are you spending your money on? Do you know what the income limits for Medicaid are? A single person with no dependents cannot earn more than $200 per month to qualify for Medicaid in any state in the country. In some states the number is significantly lower, Alabama for instance, won’t consider anyone for Medicaid if they make more than _$111_ a month. That’s exceeded if someone works even 4 hours a week at minimum wage, even less if they earn more, and most fast food establishments and gas stations are paying more than minimum wage these days, if only by 25-50 cents an hour. Remember, the average cost of a private policy for a single individual (who has no pre-existing conditions) is $4,000 a year, or, after taxes, roughly 2 weeks income for someone working _full time_ at minimum wage, or the entirety of someone’s earnings if they part-time at minimum wage. But it’s also a full week’s wages, or so, for someone making $10 an hour. It’s extremely _easy_ to earn more than Medicaid allows and still not have enough to buy private insurance. > [@](#): > > So, why is it that you think I should be paying for insurance for people who would rather spend their money on other things? If all your example family is paying for is rent, food, fuel to get to work and back and utilities, then they would qualify for Medicaid. No, they wouldn’t. A family of four wishing to get Medicaid coverage can have an earned income (that is, money made from working rather than any public benefits) in my state of no more than **$514** which wouldn’t pay for a _room_ for them to live in let alone food, fuel or utilities. Clearly you have absolutely no clue what you’re talking about and can’t employ Google for 10 seconds to justify your statements. (Oh, btw, back to my Alabama example, the income limit for a family of 4 there? A whopping $194. And this is from a document revised on the 23 of January of this year. [Here’s a link to the pdf](http://www.medicaid.alabama.gov/documents/apply/2B-Qualifying/2B-1-Medicaid_Income_Limits_1-29-09.pdf)) Since your entire argument is based on presumption and wild guessing, and assumptions about who can and cannot afford insurance and who does and does not qualify for Medicaid, and you can’t take any time to educate yourself whatsoever, you need to do the honorable thing and stop trying to debate. ---
**Author:** ![Jayn\_Newell](https://avatars.discourse-cdn.com/v4/letter/j/f9ae1b/32.png) [@Jayn\_Newell](https://boards.straightdope.com/u/Jayn_Newell)\ **Post date:** [March 10, 2009, 12:36pm UTC](https://boards.straightdope.com/t/would-universal-healthcare-be-more-expensive-or-less-than-the-current-us-system/487175/304 "2009-03-10T12:36:20Z")
> [@curlcoat](#): > > You are without insurance? Actually, no. My husband’s job offers group coverage. That still left us paying ~$800 (or over a month’s rent) out of pocket for a couple hours in the ER to treat a migraine. My co-pays on medication are also now higher than the full price of the same drugs were in Canada. ---
**Author:** ![welby](https://avatars.discourse-cdn.com/v4/letter/w/d78d45/32.png) [@welby](https://boards.straightdope.com/u/welby)\ **Post date:** [March 10, 2009, 4:06pm UTC](https://boards.straightdope.com/t/would-universal-healthcare-be-more-expensive-or-less-than-the-current-us-system/487175/305 "2009-03-10T16:06:00Z")
> [@Ocean\_Annie](#): > > According to Harvard Medical Economists David Himmelstein and Steffie Woolhandler, private medical insurance wastes 350 billion a year or 2 percent of GDP on a bureaucracy that has nothing to do with medical care. \ > > Administrative costs at Blue Cross are nearly five times higher than Medicare’s and 11 times those in Canada’s single payer system. WRT to Medicare, I’ve already pointed out that Medicare administrative costs are higher because the current “estimate” of administrative costs leaves out some of the things most costly to private companies, e.g. buildings, employees, etc. I don’t think that’s a good comparison. (Cites from Post 255: [3% overhead hugely understated. (PDF)](http://www.cahi.org/cahi_contents/resources/pdf/CAHI_Medicare_Admin_Final_Publication.pdf) and [GAO says medicare doesn’t spend enough. (PDF)](http://www.gao.gov/new.items/d01592.pdf)) I don’t think Canada is much better, since the Blue Cross companies actually insure nearly [three times more](http://www.bcbs.com/about/) people than the Canadian single payer system. So that brings the debate down to whether it’s more expensive to administer more people, and if so, how much more? I’ll concede that it shouldn’t be 11 times more, but I’m not willing to concede that you can administer 103 million people for the same price you can administer 34 million. Size matters. Which reinforces what I’ve been saying: We have shown current government programs to be more expensive and less efficient than they need to be. The only data supporting UHC comes from other countries, all of which are having the same cost control problems we have. > [@](#): > > The U.S. health care system does the same type of analysis to determine what drugs it will and will not cover. The private insurance firms use cost-benefit ratios and ration care just like other health care systems in developed countries. > [@](#): > > The cancer drug, Avastin, you referenced in post 255 is astronomically expensive with limited benefits. After heavy lobbying, U.S. insurance has only recently offered limited payment for the drug. _Most patients have to a pay out of pocket for a significant percentage of the cost._[Avastin studies show the drug prolongs life by only a few months.](http://www.nytimes.com/2008/07/06/health/06avastin.html?pagewanted=1&_r=2&ref=health) Emphasis added. Right, but they have the option to pursue treatment outside the plan. The patient under discussion was told that if she purchased the drug herself, she would also have to finance the entirety of her remaining cancer treatment as a result. > [@](#): > > Actually, most pharmaceutical research is tax funded, either directly through NIH and universities or with tax subsidies and grants to drug companies. The U.S. pharmaceutical industry spends money to lobby, sue each other over copyright infringement, and advertise. And to pay stockholders. I’m willing to concede two out of three here. Patents must be defended, whether you personally approve or not. That’s a pretty fundamental part of business. In the end, though, you can’t really tell the drug companies what to do with thier profits. They earned it, it’s thier money. I am willing to concede that lobbying consumes a lot of money, but UHC won’t change that in the least. Nor will it change advertising much, because under UHC the drug companies will still want thier drugs prescribed, and they will go to the consumer to make that happen. I would support legislation to reduce or disallow lobbying. More to the point, I’d support legislation that allowed hunting lobbyists down and beating them with baseball bats. I would also support legislation that disallows drug advertising completely. I think it’s counterproductive, a huge waste, and contributes to the syndrome of “try any new drug” that seems to be out there. This money is better spent elsewhere, even if only to line the pockets of stockholders. > [@](#): > > According to the NIH, taxpayer-funded scientists conducted 55 percent of the research projects that led to the discovery and development of the top five selling drugs in 1995 (see Section III of report). PhRMA has not challenged the NIH document… So the remaining 45% comes from where? Private funding. Are we willing to possibly sacrifice nearly half of our drug R&D in exchange for showing the drug companies that we’re not happy with thier profit levels? > [@](#): > > …Drug industry R&D is made less risky by the fact that only about 22 percent of the new drugs brought to market in the last two decades were innovative drugs that represented important therapeutic gains over existing drugs. Most were “me-too” drugs, which often replicate existing successful drugs. Not surprising. These for-profit companies invest in less risky, profit making drugs. Minimizing risk and maximizing profits is the whole point of business. > [@](#): > > …In addition to receiving research subsidies, the drug industry is lightly taxed, thanks to tax credits. The drug industry’s effective tax rate is about 40 percent less than the average for all other industries, according to the Congressional Research Service. (See Section VII) Here is the real meat of the problem. Tax the fuckers. Tax them long and hard and deep and put that money directly into prescription drug programs or other forms of medical care for people who can’t afford it. I can defend thier business decisions, but I can see no reason to defend politicians and lobbyists who have managed to give them higher profits at what amounts to our expense. > [@](#): > > The share spent on R&D in those six firms in 1999 was matched in a recent Kaiser Foundation analysis which looked at the 10 largest firms in 1998, again finding 11 percent of sales going to R&D—and finding similar percentages over the whole decade. Comparable figures were reported for 2000 by Public Citizens… > > …Drug makers say they have to charge high prices to earn high profits to finance > research, or else we’ll all die. In fact, the industry’s widely-reported high profits don’t pay for research. They are what drug makers retain after paying for research and all their other expenses. It’s useful to recognize that the profits on prescription drugs themselves are higher than is suggested by the published and publicized figures from their annual reports and Fortune 500 data. Cite (pdf) > > The researchers’ estimate is based on the systematic collection of data directly from the industry and doctors during 2004, which shows the U.S. pharmaceutical industry spent 24.4% of the sales dollar on promotion, versus 13.4% for research and development, as a percentage of US domestic sales of US$235.4 billion. The disparity is there, but not as high as the researchers suggest. For example in the cite you provided, buried in the footnotes we find: > [@](#): > > 7 One caution is worth noting—sometimes such findings are misquoted, as if marketing spending alone were 2-3 times the share going to R&D. Companies’ annual reports usually include their administrative costs in with their marketing and advertising expenditures, and it is those combined marketing and administration figures that are double or triple the research funding. > [@](#): > > Most people are happy with their insurance until they suffer a serious illness. It gets really complicated for people with a chronic disease or parents of children with a chronic disease. > > [There is always the risk that you have insurance but not covered](http://health.usnews.com/articles/health/2007/09/16/insurance-coverage-caps-hit-cancer-patients-hard.html) It seems to me that both your example cite and mine (and many others both pro and con) tend to treat cancer costs as the bugaboo, with heart disease as a close second. As part of a move towards mroe inclusive care perhaps the cost of specific treatments and therapies can be reviewed with an eye towards reducing costs. However, as long as these costs remain high we’re not going to get cheaper care for more people no matter how you massage the numbers (I’m not accusing you of doing this, but researchers on both sides of the issue do, as evidence by both your cites and mine). The solution I can’t see is what to do about it. I advocate higher taxes on the drug companies, but know full well that’ll be reflected in price later, which makes the problem even larger. Dictating profit levels would set a scary precedent. The only way around it is to compete in some fashion to offer the same drugs at lower prices, but I don’t see how the government can get into the drug manufacturing business. We’ve been talking a lot of hypotheticals, but I’m not aware of any specific bill that’s been proposed to offer UHC aside from the [HR 676 Medicare For All](http://www.medicareforall.net/1index.html) bill, which is just an expansion of the already unworking Medicare system. Are there any workable plans that have been proposed? ---
**Author:** ![welby](https://avatars.discourse-cdn.com/v4/letter/w/d78d45/32.png) [@welby](https://boards.straightdope.com/u/welby)\ **Post date:** [March 10, 2009, 4:25pm UTC](https://boards.straightdope.com/t/would-universal-healthcare-be-more-expensive-or-less-than-the-current-us-system/487175/306 "2009-03-10T16:25:39Z")
> [@GorillaMan](#): > > That’s a complete and very ignorant misrepresentation of what happens in the NHS. The choice to pay for treatment applies only to that particular incident (typically a single hospitalisation or a single course of treatment) for a single condition. It in no way does it affect “the rest of your care for the rest of your life”, as you stated in post 255. Right, my fault. She would only have to pay for her _cancer_ treatments for the rest of her (now shorter) life. Much better. :rolleyes: The simple fact is, she asked for permission to supplement her care out of pocket and was denied, despite the fact that people who didn’t ask for permission to start the same treatment had no change to thier benefits. But that aside, the simple fact is that UHC isn’t covering all of her care or giving her the best available treatment due to costs. And that’s not an isolated case at all. It’s been done before with treatments for [kidney cancer](http://www.telegraph.co.uk/health/2512639/Kidney-patients-denied-too-expensive-life-extending-drugs.html), [multiple sclerosis, Alzheimers, and arthritis.](http://www.nytimes.com/2008/12/03/health/03nice.html?pagewanted=3&_r=1&hp&adxnnlx=1228310803-fEFC6NksZeqqtZNPsN6YIQ)(Page two) So yes, I misstated the results of paying for herself. I did not, however, misstate the actions of NICE or the criteria used in determining eligibility for treatment. Any more hairs you’d like to split? ---
**Author:** ![curlcoat](https://avatars.discourse-cdn.com/v4/letter/c/ea5d25/32.png) [@curlcoat](https://boards.straightdope.com/u/curlcoat)\ **Post date:** [March 11, 2009, 2:38am UTC](https://boards.straightdope.com/t/would-universal-healthcare-be-more-expensive-or-less-than-the-current-us-system/487175/307 "2009-03-11T02:38:56Z")
> [@Desert\_Nomad](#): > > Yes. My “2 pills and 5 minutes” in an ER in Las Vegas was $9,000. A friend’s fractured shoulder (from an auto accident) was treated in the ER in Reno and cost $17,000. He is a small business owner and has no insurance. Apparently, Nevada is far more expensive than even California. ---
**Author:** ![curlcoat](https://avatars.discourse-cdn.com/v4/letter/c/ea5d25/32.png) [@curlcoat](https://boards.straightdope.com/u/curlcoat)\ **Post date:** [March 11, 2009, 2:40am UTC](https://boards.straightdope.com/t/would-universal-healthcare-be-more-expensive-or-less-than-the-current-us-system/487175/308 "2009-03-11T02:40:05Z")
> [@Desert\_Nomad](#): > > You kinda have to leave your job when it goes out of business and they close the office. True. However, this doesn’t answer either of my questions. ---
**Author:** ![curlcoat](https://avatars.discourse-cdn.com/v4/letter/c/ea5d25/32.png) [@curlcoat](https://boards.straightdope.com/u/curlcoat)\ **Post date:** [March 11, 2009, 3:12am UTC](https://boards.straightdope.com/t/would-universal-healthcare-be-more-expensive-or-less-than-the-current-us-system/487175/309 "2009-03-11T03:12:12Z")
> [@tumbleddown](#): > > Uh, yes, you did, in response to Desert Nomad back on page 2 of this thread. You said: > Are you trying to deny that this was you saying that you don’t use police protection? There is a difference between having never used a thing and not planning to ever use it. > [@](#): > > Nice attempt to move the goalposts, but whether or not a job is meant to be one that the employee is meant to make a living at is irrelevant. “Making a living” has nothing to do with access to healthcare. It doesn’t? So, you expect that when a teenager gets a job at McD’s, he should be offered insurance? > [@](#): > > And logically, the fact that some jobs _are_ low wage and always will be further enhances the argument for delinking employment and healthcare coverage completely. Oh lord. So, to you, it is OK for someone to just wander into adult life working at a low paying job, but somehow they “deserve” healthcare? That I will have to pay for? > [@](#): > > These jobs will always exist and someone will always have to do them. You’re making an argument that because someone doesn’t earn much money, it doesn’t matter if they are completely priced out of the healthcare market until such time as they’re able to do something different. The argument is the same as the one when the liberals want to raise the minimum wage because “noone can live on it”. No one is supposed to live on minimum wage and those who blither into life expecting to shouldn’t be surprised when they can’t afford things like healthcare and/or insurance. > [@](#): > > Do you know what the income limits for Medicaid are? A single person with no dependents cannot earn more than $200 per month to qualify for Medicaid in any state in the country. In some states the number is significantly lower, Alabama for instance, won’t consider anyone for Medicaid if they make more than _$111_ a month. That’s exceeded if someone works even 4 hours a week at minimum wage, even less if they earn more, and most fast food establishments and gas stations are paying more than minimum wage these days, if only by 25-50 cents an hour. And? > [@](#): > > Remember, the average cost of a private policy for a single individual (who has no pre-existing conditions) is $4,000 a year, or, after taxes, roughly 2 weeks income for someone working _full time_ at minimum wage, or the entirety of someone’s earnings if they part-time at minimum wage. But it’s also a full week’s wages, or so, for someone making $10 an hour. And? > [@](#): > > It’s extremely _easy_ to earn more than Medicaid allows and still not have enough to buy private insurance. And? Actually, I assume you mean for me to be sorry for these folks that are working in gas stations and fast food who make too much to qualify for Medicaid but can’t afford a private insurance policy. Nope - bed, made, lie. Anyone over 18 who is living like that shouldn’t be expecting anyone else to take care of them. > [@](#): > > No, they wouldn’t. A family of four wishing to get Medicaid coverage can have an earned income (that is, money made from working rather than any public benefits) in my state of no more than **$514** which wouldn’t pay for a _room_ for them to live in let alone food, fuel or utilities. A family of four that is making that little is getting food stamps and government housing, and in my state they are also getting MediCal and DentiCal. Of course, if the adults had not had two kids they couldn’t afford, it is quite possible that they wouldn’t be so poor. > [@](#): > > Since your entire argument is based on presumption and wild guessing, and assumptions about who can and cannot afford insurance and who does and does not qualify for Medicaid, and you can’t take any time to educate yourself whatsoever, you need to do the honorable thing and stop trying to debate. Snort. Your whole argument is I don’t know the exact income levels that qualify for Medicaid? I don’t _care_ what they are, because _it is supposed to be for folks who have nothing else_. Not for people with jobs, assets, family. A stop gap to cover people who are suddenly, severely down on their luck - not a lifestyle. Unfortunately, over the years far too many people seem to think that “the government” (i.e. the taxpayers) should be supporting anyone and everyone who can’t afford their 2.4 kids and house with a white picket fence. Like you using the example of working at a gas station or a fast food place - those are not the sorts of jobs one should be building a future on, and so do not offer group insurance, nor pay enough to buy a private policy. Nor should the taxpayer be covering their healthcare. If you want to cover healthcare for a poor family yourself, go for it and more power to you. But I can’t afford it - I’m disabled and can’t work, and the husband will retire in about seven years. We have to take care of ourselves, make sure we have enough to live on when he is no longer bringing in a paycheck. It’s enough that we are responsible for ourselves - we cannot afford to pay for those who can’t be bothered to do so for themselves. ---
**Author:** ![curlcoat](https://avatars.discourse-cdn.com/v4/letter/c/ea5d25/32.png) [@curlcoat](https://boards.straightdope.com/u/curlcoat)\ **Post date:** [March 11, 2009, 3:18am UTC](https://boards.straightdope.com/t/would-universal-healthcare-be-more-expensive-or-less-than-the-current-us-system/487175/310 "2009-03-11T03:18:56Z")
> [@Jayn\_Newell](#): > > Actually, no. My husband’s job offers group coverage. That still left us paying ~$800 (or over a month’s rent) out of pocket for a couple hours in the ER to treat a migraine. My co-pays on medication are also now higher than the full price of the same drugs were in Canada. Why did you go to the ER and pay $800 to treat a migraine?? As for the price of drugs in Canada, the reason they are lower has been beaten to death already in this thread. If you live near either border, you can get cheaper drugs north or south of the US. When our COBRA wouldn’t cover my Celebrex, I got it in Mexico and I frequently get codiene from Canada. ---
**Author:** ![Desert\_Nomad](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/desert_nomad/32/177_2.png) [@Desert\_Nomad](https://boards.straightdope.com/u/Desert_Nomad)\ **Post date:** [March 11, 2009, 4:09am UTC](https://boards.straightdope.com/t/would-universal-healthcare-be-more-expensive-or-less-than-the-current-us-system/487175/311 "2009-03-11T04:09:17Z")
You kinda have to leave your job when it goes out of business and they close the office. > [@curlcoat](#): > > True. However, this doesn’t answer either of my questions. Sure it does. You said: Apparently the mother of the child left her job before it was born? And they just assumed that everything was going to go just fine with the pregnancy and birth? Yes - this person left their job because the job went away when the company folded. Because of this no COBRA was available and a short while later the baby was born into a household with no insurance. ---
**Author:** ![curlcoat](https://avatars.discourse-cdn.com/v4/letter/c/ea5d25/32.png) [@curlcoat](https://boards.straightdope.com/u/curlcoat)\ **Post date:** [March 11, 2009, 5:30am UTC](https://boards.straightdope.com/t/would-universal-healthcare-be-more-expensive-or-less-than-the-current-us-system/487175/312 "2009-03-11T05:30:41Z")
> [@Desert\_Nomad](#): > > Yes - this person left their job because the job went away when the company folded. Because of this no COBRA was available and a short while later the baby was born into a household with no insurance. What, you want me to guess? OK. Both people worked for the same place? They assumed that everything was going to go fine with both the pregnancy and the birth? They had no clue that their company was going to fold? ---
**Author:** ![Desert\_Nomad](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/desert_nomad/32/177_2.png) [@Desert\_Nomad](https://boards.straightdope.com/u/Desert_Nomad)\ **Post date:** [March 11, 2009, 5:36am UTC](https://boards.straightdope.com/t/would-universal-healthcare-be-more-expensive-or-less-than-the-current-us-system/487175/313 "2009-03-11T05:36:12Z")
> [@curlcoat](#): > > What, you want me to guess? OK. Both people worked for the same place? They assumed that everything was going to go fine with both the pregnancy and the birth? They had no clue that their company was going to fold? One person worked for a place that offered no insurance and the other business closed unexpectedly. I wasn’t there, but I gather that employees showed up one morning and the doors were locked for good. Shit happens… but I am sure you are prepared for absolutely anything. ---
**Author:** ![curlcoat](https://avatars.discourse-cdn.com/v4/letter/c/ea5d25/32.png) [@curlcoat](https://boards.straightdope.com/u/curlcoat)\ **Post date:** [March 11, 2009, 6:13am UTC](https://boards.straightdope.com/t/would-universal-healthcare-be-more-expensive-or-less-than-the-current-us-system/487175/314 "2009-03-11T06:13:45Z")
> [@Desert\_Nomad](#): > > One person worked for a place that offered no insurance and the other business closed unexpectedly. I wasn’t there, but I gather that employees showed up one morning and the doors were locked for good. Shit happens… but I am sure you are prepared for absolutely anything. The story seems to be changing. In this version only one person lost their job when the business closed, in the previous version you made it sound like both are unemployed. For some reason, you are skating around giving out the real story, probably because you know these friends of yours could have planned better. It rather sounds like they bought a house, perhaps had other debt and decided to have a baby pretty much all at once, and now with only one (?) income, they can’t afford their mortgage payments along with everything else. I also note that you have ignored the “didn’t they have any clue there might be problems with the pregnancy/child” question twice now. Oh if only the baby hadn’t been born sick! Oh if only the company hadn’t closed it’s doors! There is no way we could have been ready for this! The economy has been in the crapper for a year but we couldn’t wait! No one can be prepared for absolutely anything, but when the two of us were both unemployed for most of last year, we didn’t even come close to losing the house, and $200,000 in medical bills would have meant we would have had to rack up debt, not end up on the street. We don’t gamble with our finances - which is probably why we are being “rewarded” by being expected to bail everyone else out. ---
**Author:** ![tumbleddown](https://avatars.discourse-cdn.com/v4/letter/t/e9bcb4/32.png) [@tumbleddown](https://boards.straightdope.com/u/tumbleddown)\ **Post date:** [March 11, 2009, 6:32am UTC](https://boards.straightdope.com/t/would-universal-healthcare-be-more-expensive-or-less-than-the-current-us-system/487175/315 "2009-03-11T06:32:10Z")
> [@curlcoat](#): > > There is a difference between having never used a thing and not planning to ever use it. That still shows a fundamental lack of understanding of living in a society. You drive on roads. Those roads are safer because police apprehend drunk and reckless drivers. You walk down the sidewalk at night, it’s safer to do so because police apprehend muggers. Your property values are higher because the police patrol your community and keep people from doing mischief. That you’ve never picked up 911 and called police for yourself is irrelevant. The fact that you live somewhere with an active police body means that your safety and life are enhanced by both the crime-solving and crime-preventing roles played by your local police. It’s not necessarily something which can be quantified, but to pretend that you don’t use the police is naive approaching flat falsehood. > [@](#): > > It doesn’t? So, you expect that when a teenager gets a job at McD’s, he should be offered insurance? No, I expect that someone, regardless of age, regardless of where they work, should be able to access healthcare without being financially devastated. You keep talking about fast food workers and gas station employees as if they’re some subclass or different species. But they are real people, and i can promise you this – if a McDonald’s worker or gas station clerk gets seriously sick and ends up tens of thousands of dollars in debt from an ER visit ([or from getting shot on the job and being denied workers compensation](http://www.fox16.com/news/local/story/McDonalds-shooting-victim-wants-workers/k_fXwac27EGO8yvkhUPQog.cspx)) and still unable to afford the follow-up care necessary to return to full health, their chances of ever becoming something other than a McDonald’s worker or gas station clerk become smaller and smaller with every passing day. Untreated or undertreated chronic illness presents a barrier to work. It presents a barrier to further education. It presents a barrier to progress. > [@](#): > > Oh lord. So, to you, it is OK for someone to just wander into adult life working at a low paying job, but somehow they “deserve” healthcare? That I will have to pay for? And that they are paying for too, through _their_ tax contributions. Just like you’re currently paying for the healthcare of the people covered by your plan, and all of their spouses and children, through your premiums. (And they in turn are paying for yours.) You’re very caught up in this “I don’t want to pay for other people” but you already are, both private insured and public insured (Medicaid, Medicare, government employees, military members) _and_ you’re funding the inadequate and inefficient care given to the uninsured who end up in ERs in May (where you don’t get out without at least a $500 bill) rather than a neighborhood doctor’s office in April (where treatment could have been had for a fifth of that or less). > [@](#): > > The argument is the same as the one when the liberals want to raise the minimum wage because “noone can live on it”. No one is supposed to live on minimum wage and those who blither into life expecting to shouldn’t be surprised when they can’t afford things like healthcare and/or insurance. And the argument against that is always “no one is supposed to” which ignores the fact that some people don’t have any other options. And that some people are _not_ “blithering” but actively working to make things better for themselves and in the meanwhile, working themselves to death at more than one job and still barely able to make ends meet. It ignores that things happen to people beyond their control – companies closing, parents or spouses dying, accidents, illnesses, pregnancies and complications thereof – and that it doesn’t serve anyone over the long run to **assume** that anyone who is in that position put themselves there by their own “poor decisions” or inaction and deserves a system which treats lack of opportunity and misfortune punitively. > [@](#): > > And? And **you** were the one who said that anyone who wasn’t earning enough money to pay for private insurance was either wasting their money or was earning so little that they qualified for Medicaid. This has now been demonstrated to be false, by virtue of the fact that there is a significantly wide gulf between “earning \<$200 monthly” and “able to afford $335 monthly.” > [@](#): > > Actually, I assume you mean for me to be sorry for these folks that are working in gas stations and fast food who make too much to qualify for Medicaid but can’t afford a private insurance policy. Nope - bed, made, lie. Anyone over 18 who is living like that shouldn’t be expecting anyone else to take care of them. I expect you to realize that anyone “over 18” living “like that” may well be attempting to pay their own way through school. They may well be trying to support a household that is in dire straits and has been through their entire lives. I expect you to realize that having a healthy workforce benefits _you_ by lowering labor costs which lowers the costs of everything you purchase. It benefits you by keeping the teachers in school teaching your kids, the police on the streets protecting your community, the pharmacist at work distributing your pills, the mechanic on the job fixing your car, and the clerk at the till in the grocery so that you’re not in line for 45 minutes to buy a loaf of bread. And when your grocery clerk can get a flu shot, and can go to the doctor without spending their own grocery money for the week, they’re not going to be at work, blowing their noses into soggy tissues and coughing into their hands while weighing your apples and handing you back your change. When the nurses’ aide at the care facility where your 90 year old father lives can get a flu shot and see a doctor without having to short the electric company this month, they’re not going to be at work, spreading their bronchitis to your father, which in a low-mobility elderly person turns into pneumonia which kills. > [@](#): > > A family of four that is making that little is getting food stamps and government housing, and in my state they are also getting MediCal and DentiCal. Of course, if the adults had not had two kids they couldn’t afford, it is quite possible that they wouldn’t be so poor. And when you face a job layoff and a house fire, your fortunes change. But more to the point, again, there’s a big gulf between eligible for Medicaid/government services and able to afford, in the case of a family of four, $1,000 a month to pay for private insurance. > [@](#): > > Snort. Your whole argument is I don’t know the exact income levels that qualify for Medicaid? I don’t _care_ what they are, because _it is supposed to be for folks who have nothing else_. Not for people with jobs, assets, family. A stop gap to cover people who are suddenly, severely down on their luck - not a lifestyle. Exactly, and that’s what it is. However, your argument suggested that if someone was earning more than made them Medicaid eligible, they should be able to get private insurance and that’s a falsehood. You are the one who continues to posture that the continually climbing cost of private insurance is only a problem for the irresponsible, the “blitherers” the people too lazy or too stupid to find “better” work or to get a job with a “good company.” None of these positions is true. Your entire argument is based on a truckload of assumptions, labels, stereotypes and LIES. You need to face the fact that until you can come up with a better reason than political catchphrases like “healthcare isn’t a right” and a bunch of utter nonsense about who uninsured people are and why they’re beneath you, oh benighted, privately insured curlcoat, your arguments on the matter hold no water. ---
**Author:** ![Broomstick](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/broomstick/32/246_2.png) [@Broomstick](https://boards.straightdope.com/u/Broomstick)\ **Post date:** [March 11, 2009, 6:40am UTC](https://boards.straightdope.com/t/would-universal-healthcare-be-more-expensive-or-less-than-the-current-us-system/487175/316 "2009-03-11T06:40:10Z")
> [@curlcoat](#): > > No, you save up ahead of time, before you get sick. You know - plan ahead? Or even better, you make sure you are insured before you get sick instead of just blithering along and not worrying about it until OMG I’m sick and someone needs to pay these bills! My husband was born with spina bifida. That is a condition that manifests approximately 8 weeks after conception, or 7 months before birth. I am trying to figure out how in the hell he could “make sure” he was insured _before he was even born_. But before you start whining - yes, we do have health insurance. However, you are vastly underestimating the difficulties involved in getting it when one is down on one’s luck. We are both college-educated people who, until I was laid off in November of 2007 (NOT my choice, by the way) had a very nice income, no debt other than a car payment (that’s right, zero on the credit cards), and very much lived within our means. We get health insurance for my husband through a high-risk pool in our state because, without it, we couldn’t afford it. Private insurers quote monthly premiums for him of $1,200 and up. That’s $14,400 a year or more for just one person because of birth defect he had absolutely no control over. But, of course, it’s all his fault, right? He should have planned ahead if he wanted to be born disabled, right? ---
**Author:** ![Desert\_Nomad](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/desert_nomad/32/177_2.png) [@Desert\_Nomad](https://boards.straightdope.com/u/Desert_Nomad)\ **Post date:** [March 11, 2009, 7:00am UTC](https://boards.straightdope.com/t/would-universal-healthcare-be-more-expensive-or-less-than-the-current-us-system/487175/317 "2009-03-11T07:00:49Z")
> [@curlcoat](#): > > For some reason, you are skating around giving out the real story, probably because you know these friends of yours could have planned better. > > No one can be prepared for absolutely anything, but when the two of us were both unemployed for most of last year, we didn’t even come close to losing the house, and $200,000 in medical bills would have meant we would have had to rack up debt, not end up on the street. We don’t gamble with our finances - which is probably why we are being “rewarded” by being expected to bail everyone else out. I am not going to go into all the details, and yes, they could have planned better, but things happen that are sometimes beyond even your ability to plan. I think I have planned rather well… I have no debt and enough savings to last for a decade if I needed it to… but it could all be wiped out with medical bills. ---
**Author:** ![curlcoat](https://avatars.discourse-cdn.com/v4/letter/c/ea5d25/32.png) [@curlcoat](https://boards.straightdope.com/u/curlcoat)\ **Post date:** [March 11, 2009, 7:28am UTC](https://boards.straightdope.com/t/would-universal-healthcare-be-more-expensive-or-less-than-the-current-us-system/487175/318 "2009-03-11T07:28:05Z")
> [@tumbleddown](#): > > That still shows a fundamental lack of understanding of living in a society. Oh please. You wander into the middle of an exchange between myself and **Desert Nomad** and then lecture me on the police? Which has nothing to do with the subject? > [@](#): > > No, I expect that someone, regardless of age, regardless of where they work, should be able to access healthcare without being financially devastated. And? You really think that our shrinking middle class can afford to pay for all of these folks that expect to make a living working at McD? Why are you making me responsible for their choices? > [@](#): > > And that they are paying for too, through _their_ tax contributions. Anyone who cannot now afford to pay an insurance premium is not going to be paying near as much as I would. This is one of the big things that UHC proponents choose to ignore, that it would end up covering hundreds of thousands of people who will take much much more out of it than are paying in. And who would make up for that shortfall? > [@](#): > > You’re very caught up in this “I don’t want to pay for other people” but you already are, both private insured and public insured (Medicaid, Medicare, government employees, military members) _and_ you’re funding the inadequate and inefficient care given to the uninsured who end up in ERs in May (where you don’t get out without at least a $500 bill) rather than a neighborhood doctor’s office in April (where treatment could have been had for a fifth of that or less). You think pointing out all of the ways I am paying taxes to support other people makes me want to pay even more? And as for that $500 in an ER - if we give everyone easy access to healthcare, they are going to rack up _much_ more in medical expenses than that each year. > [@](#): > > And the argument against that is always “no one is supposed to” which ignores the fact that some people don’t have any other options. Yes, they do - they always do. > [@](#): > > And that some people are _not_ “blithering” but actively working to make things better for themselves and in the meanwhile, working themselves to death at more than one job and still barely able to make ends meet. Yup, been there done that. > [@](#): > > It ignores that things happen to people beyond their control – companies closing, parents or spouses dying, accidents, illnesses, pregnancies and complications thereof – and that it doesn’t serve anyone over the long run to **assume** that anyone who is in that position put themselves there by their own “poor decisions” or inaction and deserves a system which treats lack of opportunity and misfortune punitively. Of course there are folks that end up in trouble thru absolutely no fault of their own but those cases are far rarer than you appear to want to believe. Pregnancies for one - how can that be anything other than a choice? Illnesses, losing a job, even losing a spouse - these things happen in the real world and should be planned for. So many people in this country just jump into “being a grown-up”, start racking up debt, popping out children, buying a house and then, wham! Life hits and they cannot handle it because they have no savings, no fall back plan, nothing. This is why there are so many people out there in trouble these days, because they feel they “deserve” whatever it is they want, and so they go get it whether or not they can afford it. It isn’t just the mortgage lenders that lead people on - any credit card company is happy to give you piles of credit you’ll never pay off, and people buy cars, big screen TVs, vacations until there is no way they could deal with even a minor set back. > [@](#): > > And **you** were the one who said that anyone who wasn’t earning enough money to pay for private insurance was either wasting their money or was earning so little that they qualified for Medicaid. This has now been demonstrated to be false, by virtue of the fact that there is a significantly wide gulf between “earning \<$200 monthly” and “able to afford $335 monthly.” I said “what” are they spending their money on. Do you have any idea how many people are actually out there who make more than $200 but less than $500? > [@](#): > > I expect you to realize that anyone “over 18” living “like that” may well be attempting to pay their own way through school. They may well be trying to support a household that is in dire straits and has been through their entire lives. How is this my responsibility, or that of any of the rest of the weakening middle class? Why is someone working at McDs and going to school at the same time? Or supporting a household? You never have any answers to these sorts of questions. > [@](#): > > I expect you to realize that having a healthy workforce benefits _you_ by lowering labor costs which lowers the costs of everything you purchase. It benefits you by keeping the teachers in school teaching your kids, the police on the streets protecting your community, the pharmacist at work distributing your pills, the mechanic on the job fixing your car, and the clerk at the till in the grocery so that you’re not in line for 45 minutes to buy a loaf of bread. Say what? We have a healthy workforce already, and I believe that most of those jobs you just listed have insurance anyway. > [@](#): > > And when your grocery clerk can get a flu shot, and can go to the doctor without spending their own grocery money for the week, they’re not going to be at work, blowing their noses into soggy tissues and coughing into their hands while weighing your apples and handing you back your change. Uh, right. I don’t know where you live, but the clerks here do not take time off of work to go to the doctor when they get a cold. > [@](#): > > When the nurses’ aide at the care facility where your 90 year old father lives can get a flu shot and see a doctor without having to short the electric company this month, they’re not going to be at work, spreading their bronchitis to your father, which in a low-mobility elderly person turns into pneumonia which kills. Oh come on. > [@](#): > > Exactly, and that’s what it is. However, your argument suggested that if someone was earning more than made them Medicaid eligible, they should be able to get private insurance and that’s a falsehood. You are the one who continues to posture that the continually climbing cost of private insurance is only a problem for the irresponsible, the “blitherers” the people too lazy or too stupid to find “better” work or to get a job with a “good company.” None of these positions is true. Your entire argument is based on a truckload of assumptions, labels, stereotypes and LIES. Then prove it wrong. Prove that there are hundreds of thousands of people out there who don’t make enough to afford insurance and too much to qualify for Medicaid, and they are in that situation _thru no fault of their own_. I’ve said that at least once before and yet still see nothing. > [@](#): > > You need to face the fact that until you can come up with a better reason than political catchphrases like “healthcare isn’t a right” and a bunch of utter nonsense about who uninsured people are and why they’re beneath you, oh benighted, privately insured curlcoat, your arguments on the matter hold no water. I am not privately insured, I have group insurance thru my husbands employer. Prior to that we were group insured thru my employer. I have been insured thru one or another employer group insurance for the past 30 years (only been married for 15), yet I started out with only a high school education and worked my way up from McDs and other fast food. And at no time was healthcare a right - until I got a job with Seattle First National Bank and thru them, insurance, I just didn’t go to the doctor or dentist. Yet, I still managed to go to work - fancy that - even after I had a car accident while delivering newspapers. And the thing is? Nothing special about me, other than I have always felt that adults are supposed to be responsible for themselves, not whining because their lives aren’t perfect and trying to find someone else to fix it. Somehow, with all the folks living on welfare and sueing everyone in sight, we have lost that concept. And the US is going in the crapper because of it. ---
**Author:** ![curlcoat](https://avatars.discourse-cdn.com/v4/letter/c/ea5d25/32.png) [@curlcoat](https://boards.straightdope.com/u/curlcoat)\ **Post date:** [March 11, 2009, 7:32am UTC](https://boards.straightdope.com/t/would-universal-healthcare-be-more-expensive-or-less-than-the-current-us-system/487175/319 "2009-03-11T07:32:34Z")
> [@Broomstick](#): > > My husband was born with spina bifida. That is a condition that manifests approximately 8 weeks after conception, or 7 months before birth. I am trying to figure out how in the hell he could “make sure” he was insured _before he was even born_. He doesn’t - that is the responsibility of his parents. > [@](#): > > But before you start whining I’m not the one doing the whining here. > [@](#): > > We get health insurance for my husband through a high-risk pool in our state because, without it, we couldn’t afford it. Private insurers quote monthly premiums for him of $1,200 and up. That’s $14,400 a year or more for just one person because of birth defect he had absolutely no control over. But, of course, it’s all his fault, right? He should have planned ahead if he wanted to be born disabled, right? His parents didn’t prepare him for this? They sent him out in the world without group insurance? And since then, he/you have done what? You have insurance, what are you on about? How would a UHC make anything any different for you? ---
**Author:** ![tumbleddown](https://avatars.discourse-cdn.com/v4/letter/t/e9bcb4/32.png) [@tumbleddown](https://boards.straightdope.com/u/tumbleddown)\ **Post date:** [March 11, 2009, 8:02am UTC](https://boards.straightdope.com/t/would-universal-healthcare-be-more-expensive-or-less-than-the-current-us-system/487175/320 "2009-03-11T08:02:25Z")
> [@curlcoat](#): > > Oh please. You wander into the middle of an exchange between myself and **Desert Nomad** and then lecture me on the police? Which has nothing to do with the subject? Like I said, it shows a fundamental lack of understanding on your part. One that you still cannot address meaningfully, I see. You’re very good at deflection. > [@](#): > > And? You really think that our shrinking middle class can afford to pay for all of these folks that expect to make a living working at McD? Why are you making me responsible for their choices? You’re back to this making a living thing. And honestly, everyone cannot go from zero to median national income without any intermediary steps. Do you really think that there are that many people who are trying to make a career out of working at a low income job as opposed to people who are working there while they’re in school, or until they have enough money to go to college or into some sort of training program? Or until their spouse finishes college/training? Or working there to supplement the household income and are _not_ the primary breadwinner? > [@](#): > > Anyone who cannot now afford to pay an insurance premium is not going to be paying near as much as I would. This is one of the big things that UHC proponents choose to ignore, that it would end up covering hundreds of thousands of people who will take much much more out of it than are paying in. And who would make up for that shortfall? You’re already doing that. You’ve got private insurance, and there are thousands of people insured by your company who make much higher use of their coverage than many others, many who use their coverage more than you. That’s the nature of insurance. In the years that I had private insurance I never used it for anything more than annual checkups, a single case of strep throat and a sprained ankle. Meanwhile, the son of one of the women on my plan was on medication that cost $550 a month (this was 15 years ago, that was a _lot_ at that point) and had over $700,000 in hospital bills in a single year. _That’s how insurance works._ > [@](#): > > And as for that $500 in an ER - if we give everyone easy access to healthcare, they are going to rack up _much_ more in medical expenses than that each year. That’s been addressed earlier in the thread, and frankly, if you’re going to assert that, I’m going to demand a cite. > [@](#): > > Of course there are folks that end up in trouble thru absolutely no fault of their own but those cases are far rarer than you appear to want to believe. Pregnancies for one - how can that be anything other than a choice? Have you ever heard of rape? Does that exist in libertopia? > [@](#): > > Illnesses, losing a job, even losing a spouse - these things happen in the real world and should be planned for. Sure, they should be planned for, but that presumes time. You can’t put a year’s worth of salary in the bank in a year. You can’t replace a $35,000 a year salary when you’re not eligible for that sort of employment for yourself. How do you plan for a child born with multiple unforeseen challenges that progress to the point that one of the parents loses their job because of the time they’re forced to spend at the hospital? How do you plan for your 23 year old husband of seven months to be mugged on the street right outside your house and knifed to death, leaving you in the middle of a complicated pregnancy? How do you plan for your mother, your only parent, to be gunned down walking home from the grocery store with Thanksgiving dinner? (These are all cases of people I know.) > [@](#): > > So many people in this country just jump into “being a grown-up”, start racking up debt, popping out children, buying a house and then, wham! Life hits and they cannot handle it because they have no savings, no fall back plan, nothing. You’re right, and it doesn’t help anyone to get to a point of having a savings, having life insurance, having a big down payment for a house when they’re paying premiums for private health insurance that are rising at twice the rate of inflation every year with deductibles that are doubling every four years. > [@](#): > > I said “what” are they spending their money on. Do you have any idea how many people are actually out there who make more than $200 but less than $500? Does it matter? Are people making $201 - $499 a month somehow more or less able to access health care? It’s a red herring. > [@](#): > > How is this my responsibility, or that of any of the rest of the weakening middle class? Why is someone working at McDs and going to school at the same time? Because school isn’t free. Because people going to college still have to have a place to live and food to eat and that requires a job. Why are you asking ridiculous questions that are answered on their face? > [@](#): > > Say what? We have a healthy workforce already, and I believe that most of those jobs you just listed have insurance anyway. Do you have any idea how many manhours of work are lost to illness every year in this country? I’m not doing your homework on this one. And no, grocery clerks and nurses’ aides and mechanics often don’t have insurance, at all. > [@](#): > > Uh, right. I don’t know where you live, but the clerks here do not take time off of work to go to the doctor when they get a cold. And that would be why? Because they can’t afford to. Mmm, which is… exactly my point. > [@](#): > > Then prove it wrong. Prove that there are hundreds of thousands of people out there who don’t make enough to afford insurance and too much to qualify for Medicaid, and they are in that situation _thru no fault of their own_. I’ve said that at least once before and yet still see nothing. Because it’s irrelevant why someone is in the gap between Medicaid and private insurance. There are 48 million Americans in that position. Are you actually suggesting that if enough of them prove to your satisfaction that they’re upstanding, hardworking people who live like ascetics that you’re going to change your position? I doubt it completely because you don’t seem to understand that these people will be paying for insurance right alongside you. You want to brand them all freeloaders and can’t be bothered to research what you’re arguing against in the most basic of ways, so why would more facts change your mind? > [@](#): > > I am not privately insured, I have group insurance thru my husbands employer. Which is private insurance. It’s not a public program, it’s not Medicaid, Medicare, etc. [Previous page](https://boards.straightdope.com/t/would-universal-healthcare-be-more-expensive-or-less-than-the-current-us-system/487175.md?page=15) [Next page](https://boards.straightdope.com/t/would-universal-healthcare-be-more-expensive-or-less-than-the-current-us-system/487175.md?page=17)