I’m not against doing things in steps, especially, as you say, in this economy. However, we do need to decide on an endpoint, and some people seem opposed to any reform at all. Personally, I have a hard time understanding that viewpoint, partly because I’m from a country with UHC, but mainly because the evidence is that the current system is failing us in damn near every way possible. Healthcare reform is going to need to happen regardless, so while I don’t oppose the idea of doing it in pieces rather than throwing a whole system into place, the sooner we start placing those pieces the sooner we can fix this horribly broken system.
Considering how many countries have UHC programs, I would think that we would want to compare them to decide what direction we’re willing to go in, rather than argue about going in any direction at all as curlcoat and the like seem to be doing.
The thing is, the current system isn’t failing anyone who bothers to live responsibly. I find it incredibly telling that no one has addressed that, even tho I’ve posted it several times. Except for a (comparatively) few cases like Desert Nomad, most people could be insured, they have just made choices that end up making it hard for them to do so. Choices that include things like dropping out of high school - or these days, not getting any education past high school, having children before they can actually afford them, buying more house than they can afford, running up 10’s of thousands of dollars in credit debt. Note that none of that had anything to do with health, other than having children and that is assuming that everything there went fine. How many of these folks being bankrupt by medical costs got that way by having a child that was born ill when they were uninsured or under insured?
People who can be bothered to plan ahead and be responsible for themselves don’t have serious problems with the current healthcare system.
What about it do you think is “horribly broken”? The fact that it costs so much money? Would you rather that we not have the ability to prevent and cure as many diseases as we do now, and stop all research into preventing and curing more? Would you rather that we not have state of the art diagnostic equipment and training? Specialists?
Or is it “horribly broken” to you because so many people are uninsured? Do you think it makes sense to have the rest of the country cover these millions of folks who made choices to spend their money on other things? Who made choices to start out in life lacking education making it impossible for them to earn money to pay for insurance and/or get a job where group coverage exists? What else shall we pay for that you may think is “horribly broken” for these folks? Bigger homes? In better communities? A nicer car? College funds?
As someone said upthread, there is only so much money to go around. The answer is not to keep giving people the idea they “deserve” anything other than what they have worked for themselves. Nobody “deserves” a nice home, unless they can actually afford it, yet we are now in a mortgage crisis because so many people allowed themselves to be convinced just that. The state of California has eight premature and possibly unhealthy children to pay to take care of because Octomom “deserved” to have as many children as she wanted, despite being unemployed and already living on the state & fed with her previous children.
The American dream is life, liberty and the pursuit of happiness. This has been twisted into “you deserve it all, and right now” and that has just got to stop.
Acutally, the Wisconsin plan was to insure everyone in the state under the age of 65, and the argument for the plan was the much touted “administrative savings” everyone in this thread uses as an example of “less expensive”. How’s that not UHC?
There are roughly fifty national health insurance providers in the United States. If we cut the CEO’s salaries down to $1 and generously assume they make an average of $3 million like the Blue Cross CEO does, you can save $150 million a year. In other words, you can save roughly $3.33 per uninsured person. I’m thinking that’s not going to pay for a lot of health care.
Again, the whole Bush Bush Bush thing just aint’ working. Good Christ, CARTER proposed healthcare and Medicare reform. It’s been a political argument since it was expanded to include the disabled in 1972 - more than 30 years! It’s not like fraud and waste are a new thing, and they’re certainly not George Bush’s fault, unless you’d like to propose that he’s been personally running around ripping off Medicare patients in his spare time. I know you don’t like the man, but come on.
As for your last sentence, I’d argue that the government, by its very nature, has very little in common with a “smart business.” That’s why, when I want to order a chair for my office, I have to pay $450.00 for one from the approved vendor, rather than $99.00 for one at say, Office Depot. Because government ISN’T smart business.
Ah, finally something I can agree with you on, though I agree because it supports my argument. Bush hastily implemented a poorly thought out plan that wound up doing more harm than good. That is EXACTLY what is happening today, and that is what I have a problem with. All of the boneheads out there are smugly treating UHC as a given, without thinking for one second about what it could mean to the U.S. economy, health care system, or citizens. Kinda like…Bush. Frankly, I think a lot of you see it more as a matter of revenge against conservatives than as an actual benefit for society.
Exactly my point. A small, specifically targeted government insurance program can’t be run efficiently, thanks in no small part to fraud and waste. Yet for some reason people persist in claiming that it’ll be different under a national plan just because they say so.
And it is just because they say so.This is the outline of the plan that got Obama elected, and outlines further a lot of the “savings.”
The plan claims that already insured Americans can save “as much as $2,500 per year.” For those without calculators, that’s roughly $650,000,000,000 a year in savings! That’s a helluva lot of money. It’s also unrealistic, but we’re not expected to think about that. So where can we get these savings?
Well, says the Bomster, we’ll save it by converting to electronic documents. That’ll bring us $77 billion a year according to some studies. Though we have to get there, and getting there is the hard part. For example, the UK, which already has a UHC system tried the same thing in 2004 (Aug. 30th entry, 1/2way down page). The project has been called the “greatest IT disaster in history” and is projected to ultimately cost £30 billion - more than twice the project budget. Yet, simply because we say so, we’ll do the same thing in no time at all across an industry that supports 10 times as many patients as the UK system. Right.
And even if we do that, and save the $77 billion a year, and ensure that the government gets it, what does that equal? $1700 per uninsured person. Add the three bucks we take from the insurance company executives and you can pay for a little more than a quarter of what their care will cost every year. IF we convert. IF the savings are realized. IF those savings are actually applied to health care.
Let’s look for the rest of the savings…wait, they’re not there. At least not in hard figures. Instead, there’s the same doublespeak about how much we’ll save in preventative care, some beating up of pharmaceutical companies, and nothing of substance. And that’s the same thing we keep getting over and over from the pro-UHC folks. It’ll save money! It’ll save money!
All I ask is, WHERE are these savings coming from? I’ve already done a quarter of the work for you, can you provide the rest? Show me, in dollars and cents, how you are going to add 40 million people to the medical system, and save money at the same time.
How many employers do you think actually offer insurance to their employees? Only one that I have worked for (and they are no longer in business). Even my brother who is a doctor doesn’t have dental or vision insurance.
In 2005, 49% of small group employers offered health insurance while 96% of large group employers offered coverage to their employees. There are few large employers here. IGT is one of the few truly large employers, but the vast majority of businesses are “small groups”.
You do not say where you are, but Nevada currently ranks 46th in the nation in access to health care. In 2004, 22.5% of Nevadans had no access to health insurance. This is more than 1 in 5 BTW. I am quite sure that number is higher now with all the business that have failed recently.
What good is that stuff if we can’t get it to the people who need it? Especially if the reason they can’t get it is the cost? If we’re denying ill people what they need to become healthy, then the healthcare market is not getting goods and services to where it’s needed. Thus, ‘horribly broken’. And yes, cost is a large part of it, as it leads to problem 2–
I think it doesn’t make sense to let people fall by the wayside like that. I mean, isn’t it better for everyone if we attempt to get everyone the healthcare they need?
As far as your last questions, none of those are ‘horribly broken’. Humans need shelter, but I’m not about to say that we should buy everyone a 5-bedroom house just because. A cheap apartment and a mansion are both capable of fulfilling that need, one is just more comfortable than the other. Healthcare doesn’t really work like that though–if you have cancer and can’t afford chemo, you don’t take an aspirin instead. One can’t take the place of the other here.
I suspect that we agree more than is actually coming out here. I don’t think that people shouldn’t be accountable for themselves, but the current healthcare system is not designed to get care to those who need it. If anything, it’s designed to withhold care so the insurance companies can profit.
Finally, as far as ‘life, liberty and the pursuit of happiness’ goes, lack of affordable healthcare can deny people a chance at any of those things.
Employer provided health insurance is not working when employers’ attitudes are along the lines of this quote on a Nevada blog related to this topic:
“Employers pay you to work, don’t they? Why is an employer a medical nanny? He didn’t make you sick, so why is he paying for your medication? If the roof caves in on your house, should the employer pay for it?”
So if it is not the government’s responsibility to provide health insurance, and it is not the employer’s, and it is not available to be sold to an individual… then how the hell do we get insurance?
I’ve rethought my position UHC. The way I see it is there are lots of worse ways we could be spending money. So if we spend a few billion making sure everyone is healthier, it’s money well spent.
You are absolutely right; the Wisconsin plan was a public universal proposal. I overlooked it, assuming it was like the other plans. Thanks for pointing it out.
I don’t know much about the Wisconsin proposal, but the asserted cost of the plan depends on the source. The left leaning sources provide different figures. Support and opposition for the plan was divided between partisans and it was defeated for the same reasons. The general public supported the plan.
I won’t dispute your numbers, but the roughly twenty-five percent of private health insurance expenditures allocated to administrative paper work is well documented. But, eliminating the administrative cost is not enough. Like any group health insurance, the major advantage comes from the large pool of people contributing to one public insurance fund. A large public pool also puts the government in the best position to effectively negotiate pharmaceutical costs which are astronomical. It’s only way it will work.
Okay, I’ll take this as a fair point. Health care is an important issue, and the less partisan division, the more likely it will be resolved. I honestly wasn’t intentionally Bush bashing.
I don’t agree that UHC proposals are necessarily being hastily thrown together. The problems with health care have been part of public policy discussions for years. There has been plenty of time to examine cost, explore ideas and crunch numbers. The President has a specific proposal, but passing any health care reform is hard because of the big money involved. The industries benefiting from the system have the money to aggressively fight any proposal that threatens their existence or cuts into profits. The past campaigns to defeat any suggestion of a public system have been effective. The tactics were intentional misinformation and fear, so it is understandable that some people are genuinely afraid of a universal public system.
Well, thanks for your generosity. I have provided credible sources in this and other threads on this topic. The best information comes from other countries with UHC. It is an indisputable fact that other countries manage health care better than the U.S. They cover everyone, spend less and live longer.
As I said last time you asked this question, I have no idea. Nor do I care. Living responsibly can also mean that if you decide you want to work in a field that doesn’t usually offer group insurance and/or you want to work for yourself, you buy yourself a private policy.
Look, you are either going to have to live in Nevada or overseas, you can’t live in both places. Which “here” are you talking about above? If it is Nevada, I would be surprised if there are any big employers in the state other than the government.
Nevada doesn’t have much for full time employment from what little I know of it. There may not be many doctors there either for all I know - Nevada is a rather special case don’t you think, given that the whole state practically lives on gambling?
Require that the casino owners take care of the healthcare issues in Nevada. Leave the rest of the states alone.
We can get all of that to people who need it, just not to those who either can’t afford it or don’t have insurance. Healthcare isn’t a right. Particularly to those who cannot be bothered to take care of the cost of healthcare themselves. Going to the doctor, getting treatment, drugs - none of that is free and some of it is very expensive. If you spread the cost of taking care of everyone’s healthcare out to all of the folks who can actually afford the additional taxes, you aren’t going to have enough money to get all of your ill people what they need to become healthy, and you will be back to complaining about how broken the healthcare system is. And you’ll have more people taxed into poverty.
No. Weakening the responsible by forcing them to pay out yet more to the irresponsible is not better for everyone. How many examples of that do we need before people figure this out?
Sure they do - a cheap apartment isn’t going to work for a family with five children and we have people who are now being bailed out because they bought a home they couldn’t afford just before the market crashed. A high school education doesn’t get much for a job these days, so how long before people are going to be calling for even more help with college educations than there is now?
And quite frankly, if you have cancer and can’t afford chemo, you die. We don’t have enough people in this country that make a big enough wage to cover every person that needs that level of expense in the way of medical treatment. Those people that decided to gamble with their health and ended up with cancer and no insurance simply have no right to suck other people dry.
That doesn’t make any sense to me. I, my husband, our friends, their families - none of us have any trouble getting healthcare. There is some truth in insurance companies trying to hold costs down but stories of them denying care to someone who should be covered make headlines because those cases are so rare. The insurance industry is highly regulated, both by the fed and by each state.
And really, only the big insurance companies make the profits - the small ones are getting bought up because they are struggling.
Not from the get go. That’s why I talk about personal responsibility and making choices. People who ignore making sure they can get/afford insurance in favor of cars, a house, children or whatever else people seem to think they “deserve” these days have had the option of life, liberty and the pursuit of happiness. Then when they are no longer happy, due to their own choices, they expect someone else to take care of it.
Yes, Nevada. IGT is International Game Technology - they make slot machines and are probably the largest company in the world to do so.
It does live on gambling to a large extent, although there is lots of military here (Navy and Air Force Bases).
The casinos are already heavily taxed and many are being closed and boarded up downtown. 2 or 3 have been converted into condos. Just like Nevada relies on the federal government to pay for our highways (since we have vast distances and low population), health care is something that needs to come from the federal level.
What industry are you in? If and when your company goes under and you have no COBRA option, I would love to see if your views change.
Maybe the government should do nothing at all… no military, no roads, no fire or police departments, and you can just pay for everything yourself (I would not want you to spend a single cent that might help someone else). Do you have kids? You probably shouldn’t be paying for schools either.
FWIW I have no kids… because I would not be able to provide them with insurance, as they would have a 50% chance of inheriting my condition.
My father died of cancer. How was he gambling with his health since developing lymph-node cancer is a quite random event? He did have health insurance, but the company he retired from (a huge company that you have heard of), went into bankruptcy and his insurance was taken over by the government as was his pension. He got lucky in that regard.
I do not think most people without insurance got that way on purpose… sure some dropped out of school which could lead to that in our system, but I know PhDs that have no effective insurance.
I’m not sure why I’m attempting to debate with someone who attempted to claim that they don’t “use” the police, but there’s another huge gap of logic here that needs to be addressed:
The problem is, it’s not fields that have the problem of employers who don’t offer healthcare benefits, it’s entire sectors crossing all manner of fields. You cannot simply say “don’t go into IT” or “don’t go into private consulting” or “don’t become a baker” or “don’t become a zoologist” or “don’t become an artist.”
There are 5,885,784 companies in the U.S. that have employees on the payroll for at least part of the year (that is, companies that aren’t sole proprietorships). 4,980,165 have fewer than 100 employees. Of that number, 3,821,120 businesses have fewer than 10 employees. (Cite In other words, the vast majority of businesses in this country are small businesses. And in most states, especially the states with smaller and less dense populations, the majority of Americans work for a small business.
So when 4% of large employers and 49% of small employers do not offer healthcare coverage to their employees this is not a problem that is only affecting certain fields, nor is it a problem that is only affecting a small portion of American workers, nor is it a problem only affecting low-income earners or the poor. It disproportionately affects workers who earn the least, (and affects non-white workers even more disproportionately, in a way not explained by employment disparity) but they’re not the only ones who have been incredibly affected.
So by the sheer numbers 42% of all employers, do not offer healthcare coverage. These companies have not chosen to forgo offering this benefit because they don’t think that having a healthy staff is important but because they are not able to afford it either.
And if they don’t, and cannot afford private coverage, the same coverage that’s too expensive for entire companies to buy, coverage that is now averaging over $4,000 a year for an individual, over $12,000 for a family of four, increasing every year, outpacing wages, outpacing inflation, with ever-rising deductibles as well, they’re simply irresponsible.
Curlcoat, you talk about people being who “cannot be bothered” to pay this amount of money as if it’s insignificant (1/5th or more of median income levels) as if the cost of all consumer goods and services are not increasing – things that are more pressing on a day to day basis than health insurance, like housing, food, fuel, childcare and utilities – and eating up larger and larger portions of take home pay.
That’s not even touching the numbers who are losing jobs, facing cuts in hours or pay, and fewer and fewer (if any) jobseekers have the luxury of being choosy about taking jobs based on the benefits offered.
Does this argument really pass logical muster with anyone who isn’t curlcoat?
I’m sorry, but this seems self-contradictory to me. If people can’t afford it, then by definition we are not getting it to those who need it. You’re right, healthcare is expensive, but unlike you I don’t take this as a given. Ones of the points to going to a UHC system (and something you and some others seems to keep forgetting is that UHC and government-run healthcare aren’t necessarily synonymous–private companies don’t have to be taken out of the market) is to be able to install measures to help control costs.
It sucks, I know. It isn’t a problem unique to what’s going on at this time, unfortunately–the real estate bust just caused a much more intense problem than is normal, and we’re all going to have to deal with the fallout, whether we like it or not. But the difference between a house and healthcare is that you can save up to buy a house, and wait until the time is right. You can’t save up for medical treatment and tell yourself ‘I’ll get better five years from now’. By then you may well be dead. That’s not touching the fact that being ill can make earning the money to pay pretty difficult sometimes. And if you think a cheap apartment can’t work for a family with five kids, I should show you the house my mother grew up in. I’m pretty sure no one would consider a four-bedroom house big enough for a family with 9 kids these days. But it worked.
I’m not touching the university subject. I have a whole other ream of thoughts on that that are not appropriate for this thread.
Lucky you (and, well, lucky me too).
A bit of a sidetrack, but I’m from an area where the entire economy depends on one industry–an industry that revolves around small businesses. I can’t help but wonder how the economic landscape up there would look if they had to deal with an American-style healthcare system. Especially considering how much physical labour the industry demands.
Which is actually the point some of us are making–insurance benefits from a larger pool of clients.
Normally, I don’t have a problem with this mindset. Health is one area where I don’t, because frankly, shit happens. You get diagnosed with diabetes, or get hit by a car, or that cold doesn’t get better on its own. And when these things happen, you can’t wait until you can better afford treatment–they have to be dealt with immediately.
Rail all you want about people buying bigger houses and cars than they can afford–I won’t argue with you (hell, you sound a bit like my father). But the current system is making it difficult to impossible for a growing number of people to take care of their own health. That is neither good for the individuals affected nor good for society.
Well, the source of lean is always a given. If this passes and is implemented we’ll find out which one was leaning the correct way. The general public supporting it doesn’t mean it’s a good idea.
First, government run doesn’t mean less administration. That’s the point I’ve been trying to make over and over again. We would NEED a program that had less administrative costs, but I think it’s unlikely we’ll get one. And negotiations with the pharmacuetical companies have to work. But as has been found with the UK system, it doesn’t work.
That is why the UK has NICE (pdf), which doesn’t negotiate price, but rather makes a cost/benefit analysis to determine whether a drug will be prescribed. And as I showed in the link in post 255, if the UK system decides that the cost/benefit ratio is inadequate the patients don’t have the option of paying for tratment themselves. If they choose to do so, they lose thier care. As bad as the US system is, I can still pursure a treatment that is outside my plan at my own expense while retaining my current coverage.
Drugs that are too expensive simply aren’t used, no matter the potential beneficial effects for the patient. That’s not price negotiation.
Also, I’d disagree that drug costs are as astronomical as everyone seems to beleive. In fact they only account for 10 percent (PDF) of the U.S. healthcare dollar. Given the benefits we receive by paying high cost for drugs in exchange for excellent research on same, that’s a pretty good deal.
Whew. There IS another person out there.
I think that the partisan slant has obfuscated this issue on both sides. Do we need reform? Sure, and I say that as a guy who’s damn happy with both the amount I pay and the coverage I receive. But the savings that are quoted over and over tend to point to things that can be addressed prior to implementing a big old honking “plan”. Can we reduce the expenses of private insurance through a reduction of overhead? Probably. Let’s try it and let’s find out before rather than after the fact. If only the folks “representing” us could do the same.
True, it’s been being argued for 30 years or more, but the results are the same. The pro-UHC folks have done a little misinforming/fear tactics of thier own. What I’d really like to see is honest discussion, followed by incremental changes with an analysis of the efficacy of the results. THAT is a program I can get behind. However, any program that is touted as a “sweeping change” is, necessarily, not that program.
It’s also indisputable that they’re having to spend more and more with less result, manage costs at the expense of care, are having more trouble funding the programs, and are considering the inclusion of private care options to offset these expenses. They’re worked in the past, but are having trouble working in the present. We might discover that they’re ultimately unsustainable without throwing more money at them, which would affect the “spend less” part of the argument.
I am disabled and can no longer work full time, if at all. My husband is an engineer for medical devices. And no, my views do not change simply because it might affect me personally - I have always been of the opinion that people should be responsible for themselves even when I was living well below the poverty level.
We have already addressed all of this. Just because you are in a unique position doesn’t mean the rest of the world should change to suit you.
What does that have to do with anything? You made an intelligent decision to not pass on whateveritis that you have, as well as to not bring even more people into our over crowded world. Are you saying you did this only because you can’t get insurance?
