Americans want universal health coverage

[Martha]

http://www.nationalacademies.org/headlines/20050920.html

The estimate of the National Academy of Sciences is that 18,000 in the US die prematurely each year due to lack of health insurance.

 

[Rich_by_the_Bay]

Total billed to the insurance for the diagnosis/removal/follow up treatment for a oligodendroglioma brain tumor in my area was about $75,000. Insurance paid a lot less than that. I question the hundreds of thousands of dollars for a brain tumor.

Lets,

I agree with your inference that folks tend to throw unfounded numbers around in the heat of discussion.

Alas, in this case probably not too far off: there are glioblastomas which require surgery, follow-up radiation treatment, chemo and more, with costs which can easily top half a million. One of the few situations where one might be "better off" with an oligodendroglioma, at least from a cost perspective. Just FYI.

It is amazing how expensive a serious illness can get.

 

[Craig]

http://www.cato.org/healthcare/dereghealthcare.html

According to a recent Cato study by Duke University professor Christopher J. Conover, health care regulation costs $169.1 billion over and above any benefits it provides.

We can toss studies back and forth, as well as straw man arguments ... I never proposed leaving as is, or removing all regulation.

Insurance was originally designed to cover catastrophic events, not dollar-for-dollar reimbursement of minor expenses, like the average doctor visit.  Martha, you trivialize the auto and life insurance examples, but it isn't the specifics of those industries that matter ... the point is that private companies can and do find ways to create products and services that create value for consumers, while the companies and their shareholders are fairly compensated for their work and investment.  The same concept is possible with health care.

I believe HSA's are an important step forward, and recently we've begun to see more insurance companies embrace the concept.   What a radical idea ... making the patient and his / her family the consumer again.  Who else has a greater stake?

Oh, but the patient doesn't have enough information to make an informed decision.  Why is that?  Because the system discouraged such action, insurance companies were the consumers, and many in the health care profession don't want to see the dissemination of such information.

Every component of the current system is designed to work within the current system ... rather like biological evolution.  Just using the information example, without a patient-centric system, you will not have the demand that would provoke the creation of an efficient informational / rating system.  So, surprise ... we don't have one.

Now the doctors will tell us you can't compare doctors, you can't compare hospitals, or labs, or ad infinitum.  

When one holds an opinion dearly, all options other than the predisposition appear impossible.

Anyone who wishes to honestly consider alternatives to creating the medical version of the U.S. Post Office can begin by looking at http://www.cato.org/healthcare/index.html ... plenty to view on the site, with links to other sites, books and studies.

 

[tomz]

I believe HSA's are an important step forward, and recently we've begun to see more insurance companies embrace the concept.   What a radical idea ... making the patient and his / her family the consumer again.  Who else has a greater stake?

Oh, but the patient doesn't have enough information to make an informed decision.  Why is that?  Because the system discouraged such action, insurance companies were the consumers, and many in the health care profession don't want to see the dissemination of such information.

Here is what getting a colonoscopy might be like if we have market driven healthcare.  http://www.thehealthcareblog.com/the_health_care_blog/2006/03/controlling_hea.html

It's rather long, but worth the read.

 

[Martha]

The confusion and dismay resulting from the medicare drug plan illustrates problems with the "consumer driven" model Charles seems to favor.

http://www.thedoctorwillseeyounow.com/articles/bioethics/consumer_13/

Here is what getting a colonoscopy might be like if we have market driven healthcare. http://www.thehealthcareblog.com/the_health_care_blog/2006/03/controlling_hea.html

It's rather long, but worth the read.

 

[d]

I would leap into this debate with both feet

me too, but i always have one stuck in my mouth

- but I have no freaking idea what to recommend as a solution.

as this discussion suggests, there is no "solution" which will satisfy all aspects/dimensions of the problem -- if nothing else, there must be a trade-off among availability, cost, quality, funding source, etc and herein lies the strong opinions.

 

[cute fuzzy bunny]

Pushing all the other stuff to the side...

Isnt it rather obvious that in a private insurance situation of your choice, or any model remotely close to what we have today, that the unemployed, the old and the chronically ill cannot get health insurance?

Why would the insurers want to cover them, even at a substantial cost? At a substantial cost, could the insurees even afford it or bother with it?

Should employers/government eject health care as a benefit, or put the cost on the employees shoulders, or allow insurers to approve/reject applicants I would expect a lot more support for a universal health care plan.

It seems odd to me that people have no problems footing their part of the insurance bill for bad drivers and careless homeowners, but for a poor sick person? Uh uhhhhh!

 

[d]

It seems odd to me that people have no problems footing their part of the insurance bill for bad drivers and careless homeowners

... not sure what you mean here ... re health ins, everyone in the group foots part of the bill for those group members unlucky enough to be in bad health.  A major difference is that with health insurance is that it is, for the most part, group coverage.

 

[Martha]

Pushing all the other stuff to the side...

Isnt it rather obvious that in a private insurance situation of your choice, or any model remotely close to what we have today, that the unemployed, the old and the chronically ill cannot get health insurance?

Why would the insurers want to cover them, even at a substantial cost?  At a substantial cost, could the insurees even afford it or bother with it?

That's what I said.  And what I said in my review of the the book, The New Health Insurance Solution. And what I have said in maybe 50 different posts on this forum over the past several years.

I find it peculiar that people don't find this obvious. 

That's all she wrote.

 

[Cool Dood]

Well, if the two of you agree on it, then I guess that settles that -- no more questions!

I have to admit, I also find it peculiar when other people don't find my personal beliefs obvious.

 

[Craig]

Well said.

 

[lets-retire]

http://www.nationalacademies.org/headlines/20050920.html

The estimate of the National Academy of Sciences is that 18,000 in the US die prematurely each year due to lack of health insurance.

And over 42,000 died on the streets of America a few years ago so lets out law cars. The point is that number is very small. It would be nice if it were zero, but I don't believe we could afford to pay for it. There is a cost benefit aspect to this.

 

[razztazz]

And over 42,000 died on the streets of America a few years ago so lets out law cars. The point is that number is very small. It would be nice if it were zero, but I don't believe we could afford to pay for it. There is a cost benefit aspect to this

Cant outlaw cars as they ultimately do more good than harm. It's called an acceptble risk. Taking baths has killed people but hygene has saved more. The point is dying due to a systemic unavilabilty of inusrance is a BAD reason to die. And it is reason about which something can be done.
The fact that is it a low number is irrlevent.

Can't afford it? That is merely an assertion. The only people who keep saying we cant afford all manner of things are the same people who have no problem affording whatever they want, let alone what they need. They are also the same people slobbering on all the time about a how great the system is and a "bigger pie". But never a big enough pie.

As far as a cost-benefit aspect: I see no benfit where many are unable to acquire basic necessities in order to maintain ongoing overconcentrations of personal wealth.

 

[Martha]

And over 42,000 died on the streets of America a few years ago so lets out law cars. The point is that number is very small. It would be nice if it were zero, but I don't believe we could afford to pay for it. There is a cost benefit aspect to this.

This is so sad.

I was afraid it might be all about the money for some.

Of course we can afford it. Plenty of countries poorer than us afford it.

Don't repeal the estate tax; use the money for healthcare. Cost--Paris Hilton gets a little less money. Benefit: Somebody lives. Tax my family and families like mine. Last year our income tax bill was in the six figures. I'll pay more. It would be a tax I feel good about.

I know I am starting to sound a bit snide, but I am amazed that for all money our country has and country spends, people might think we can't afford health insurance for all.

 

[Craig]

That's the problem with this kind of debate ... there are those who feel coercion and effective theft, even when grossly inefficient, is justified because of the perceived goodness and fairness of it all.

Used to justify all manner of foolish policy.

From each according to his ability, to each according to his need ... didn't expect to run into it on a retirement forum.

 

[Rich_by_the_Bay]

That's the problem with this kind of debate ... there are those who feel coercion and effective theft, even when grossly inefficient, is justified because of the perceived goodness and fairness of it all.

You're saying that when the able participate in supporting the unfortunate or unable, if it's inefficient (read it might cost the "able" more money), this is "coercion and effective theft?" Wow - harsh words.

Oh, well. I think I get the picture here.

 

[Craig]

Remember that anytime you pass a new tax, or impose a new regulation, that is coercion at its core, plain and simple.  When you do so, it had better be for a very, very good reason.  At the end of the day, you are saying you are willing to use force to impose your view of a better world.

[BTW, "inefficient" means just that ... poor use of resources, gross waste, etc. ... synonymous with "government program".]

If you don't at least see the reality of effectively stealing from many to pay for the few you wish to help, and that is a fact in any government scheme of health care, then I don't know how to help you.  At least recognize the financial reality of what you propose.

You and I may differ on whether your preference is effective or not, but it is clearly a taking of property, and in many cases, rights ... remember that in all of these schemes the patient, and the doctors, lose rights as well.

I'd say we both get the picture here, Rich.

 

[cute fuzzy bunny]

... not sure what you mean here ... re health ins, everyone in the group foots part of the bill for those group members unlucky enough to be in bad health. A major difference is that with health insurance is that it is, for the most part, group coverage.

Easy.

I pay car insurance out the wazoo on three cars, and have since I got my drivers license.

I've never been in a car accident.

But plenty of bad drivers get in them all the time. And part of my payments have gone to fix their cars.

In fact, I have to carry extra insurance in case someone hits me that doesnt have insurance.

I have homeowners insurance; used to be because the mortgage company required it, but now just because its a darn good idea.

Never filed a homeowners claim. But a lot of other boneheads who lit their house on fire by falling asleep with a cigarette burning or who let a pipe freeze and flood their house or who thought barbecuing in the living room might be a great option files claims and the money i paid to the insurance company was used to pay their claims.

So with that in mind, whats the difference if we're all taxed or some common pool is established and paid for through a variety of means, all of which goes to establish basic health insurance for all?

After all, anyone very ill or near death can walk into an emergency room and get taken care of, then walk away without paying the bill. And we pay for that in higher premiums. Even moreso because with basic health care, they may have avoided the problem all together or mitigated it inexpensively. At a minimum, they'd be charged a more reasonable 'insurance rate'.

The really funny part is we're all already paying for universal health care, but the most expensive kind. Full-fare, remedial service at the emergency room sometimes followed by paying for dependent support of the injured or dead person who didnt get proactive treatment. With a huge dollop of bureaucracy laid on top.

Cracks me up that people will run around red in the face over illegal immigrant health care, which might be a percent or two of the total healthcare costs nationwide, but will eagerly pay up to half or more of their insurance premiums to cover the currently uninsured rather than a smaller percentage of that to provide proactive care.

Nuts.

 

[Craig]

So with that in mind, whats the difference if we're all taxed or some common pool is established and paid for through a variety of means, all of which goes to establish basic health insurance for all?

Coercion, to start with. I'm amazed you don't get that.

 

[cute fuzzy bunny]

You must have not fully read what I said.

You're already paying for it, and paying extra!

The only difference is that the insurance company is arbitrating the fees rather than the government.

Wheres this "coercion'?

 

[Craig]

You honestly see no difference between a government program, and insurance you privately contract?

And, I'm not as sanguine about the efficiencies of a government program.

 

[cute fuzzy bunny]

Neither am I. But what we've got now is pretty dang inefficient AND we're still paying for the uninsureds health care, only in the worst and most expensive way.

I guess if your tack at this is that having the government do anything is bad, even if its worse and costs more to do it differently, then theres no point in the discussion.

I cant see that its about cost when you're footing the bill for the last minute care and health care insurance costs are skyrocketing.

I cant see that its about bureaucracy given my first hand experience with the shenanigans that go on between me, my doctor and my insurance company, many of which I've chronicled here. Even I cant shine a cynical enough light on this to say that a govt program would be worse, or even the same. And I hate government programs.

I just got the paperwork for my wifes last doctor visit. Her doctor sent a three page form to the insurance company, billing 25.00. The insurer kicked it back with several other forms stating that they would only pay $24.88. I am not making this up. The doctor had to send another form back okaying and accepting the lower payment. Then the insurer sent us the roll up explaining what was billed, why, what they paid and why, and noting that we would not be responsible for the residual 12c.

Perhaps a standardized government driven program to provide basic health care would produce a situation more stupid than this.

But I doubt it.

 

[Martha]

Oh, well. I think I get the picture here.

Me too.

 

[Craig]

I guess if your tack at this is that having the government do anything is bad, even if its worse and costs more to do it differently, then theres no point in the discussion.

That is not my tack, and I've made that clear.

The choice is not between a dismal current system (itself partly a function of poor existing government policy) and a lousy government system ... we can find a better way than either, and there is current evolution to do so.

 

[cute fuzzy bunny]

I guess I dont see that. Looks like devolution to me.

I see higher costs, more severe filters on who gets acceptance, employers cutting the benefits, and I'm *still* paying for everyone to get taken care of via the worst possible care provider at the highest possible cost: the emergency room.

Enlighten me as to the evolution thats going to solve this in my lifetime.