Wow, what do people do who don't have health insurance?!

[Martha]

Quote:

Originally Posted by ziggy29 So let's consider ways to keep health care costs from spiraling out of control in the future. Do any of them avoid restricting the availability ("rationed care") or reducing the quality and technology available? There is the crux of the problem.

Depends on what you think "rationing" means.

I have read a number of articles on reducing health care costs, but the folder with all my info is not easily assessable right now. A few things come to mind. One is finding a way for insurance companies (if we are going to keep them) to compete more on price and less by way of underwriting. On the delivery end, our primary care system is weak as compared to some other countries. Doctors see too many patients and spend too much time on paperwork. If we could strengthen that system, higher cost specialists may not be needed as often and patient comliance may be better, ending up in reducing costs. Health promotion at work (see a recent Business Week article) seems to result in savings. Carrots and sticks for compliance make a difference. Chronic diseases use up a lot of money; education in self management can result in savings. There are many many more things we can do to reduce costs. I am just tossing out a few.

Besides chronic diseases, end of life care is very expensive. Tough nut to crack. One thing that seems to reduce end of life care cost is simply having discussions about end of life care with everyone involved and not have families close their eyes to what is going on. Rich_in_tampa could speak more to this than I ever could.

[eridanus]

Financial Times has an new article on US Healthcare. Interesting read.

----------
Symptoms of an unsustainable system

By Jacob Weisberg

Viewed as a whole, the American system is inefficient, expensive and
possibly unsustainable. It consumes 16 per cent of gross domestic
product and is growing 6.4 per cent a year. Europe provides
universal, high-quality care for half as much per capita.
Employer-based coverage is a drag on the economy, tethering workers
to jobs they would otherwise leave and adding to the cost of goods.
Healthcare spending is everywhere a budget wrecker. Yet, for all that
the US spends, 16 per cent of the population, including 8m children,
must make do at the system's charitable margins.

[ziggy29]

Quote:

Originally Posted by Martha Besides chronic diseases, end of life care is very expensive. Tough nut to crack. One thing that seems to reduce end of life care cost is simply having discussions about end of life care with everyone involved and not have families close their eyes to what is going on. Rich_in_tampa could speak more to this than I ever could.

Very true. Dealing with end-of-life care is a medical hot potato, a real ethical dilemma. On one hand, we are loathe to give up our loved ones to a death sentence, but for some situations the cost of trying to cure *one* almost certainly hopeless situation and maybe add a couple of low-quality months to someone's life could probably pay for routine and preventative care for hundreds of uninsured and underinsured individuals.

My dad succumbed to cancer in November 2005. He basically learned he was terminal a couple months prior to his passing. He specifically opted for home hospice care with strict medical directives in place, including a DNR and a signed document stating that the ONLY medications he was to be given were to keep him comfortable and feeling as well and pain-free as possible -- not for any attempts at life-prolonging "miracle cures".

Not to say this makes my dad a hero over other people, but I have to imagine a LOT of health care dollars would be saved if a lot more people made these end-of-life choices (preferably voluntarily). I guess some end-of-life situations have more "hope" than others, so that would be another factor to consider.

[mykidslovedogs]

Quote:

Originally Posted by eridanus Financial Times has an new article on US Healthcare. Interesting read. ---------- Symptoms of an unsustainable system By Jacob Weisberg Viewed as a whole, the American system is inefficient, expensive and possibly unsustainable. It consumes 16 per cent of gross domestic product and is growing 6.4 per cent a year. Europe provides universal, high-quality care for half as much per capita. Employer-based coverage is a drag on the economy, tethering workers to jobs they would otherwise leave and adding to the cost of goods. Healthcare spending is everywhere a budget wrecker. Yet, for all that the US spends, 16 per cent of the population, including 8m children, must make do at the system's charitable margins.

This is one of the arguments I always hear for universalized care, but one thing that is never explained is that our "total healthcare spending" includes the cost of coverage that we pay for people from other nations who come to the USA for care because they can't get it in their countries, yet, those people are not counted in the population when determining the "per capita" figuers. Also, those figures are skewed because of cost-shifting to the American people for prescription drugs (poor countries purchase their prescriptions at much lower prices than America does, because the pharmaceutical firms are able to make up for it by charging higher prices to the American people since our markets can sustain the higher prices).

Also, did you know that Immigrants accounted for a third of the increase in the uninsured population from 1994 to 1998 and from 1998-2003 immigrants accounted for 86% of the growth of the uninsured according to a report by the Employee Benefit Research Institute?

[mykidslovedogs]

Quote:

Originally Posted by Martha I've been "on break" from the healthcare discussions, but I would hesitate to assume that a 12 year old's tooth abscess was caused by failure to brush and floss. And no matter what, a 12 year old shouldn't be dying because of a tooth abscess.

You are right! If the mother or father had been paying close attention to the child and had taken him/her into the ER in a timely manner, the death could have been prevented. If the mother or the father had taken the child to the dentist for preventive care, and worked out a financial arrangement, the death could have been prevented. I am sure that no dentist would turn down a child in excrutiating pain just because the parents can't pay the bill in full at the time of service.

Just because someone else wasn't there to pay for the child's dental care is no excuse. There are plenty of charitable organizations that could have advised the parents where to go to take care of the problem had they just taken the initiative to ask. My guess is that there is more to the story than what is being told. Perhaps the parents were neglectful, resulting in the child's demise. The USA healthcare system should not be blamed for such a tragedy.

[Rich_by_the_Bay]

Quote:

Originally Posted by mykidslovedogs This is one of the arguments I always hear for universalized care, but one thing that is never explained is that our "total healthcare spending" includes the cost of coverage that we pay for people from other nations who come to the USA for care because they can't get it in their countries, yet, those people are not counted in the population when determining the "per capita" figuers.

No doubt that occurs, but I've never seen anything to suggest that it's anything more than a minor contributor to the gigantic overall problem. Lots of uninsured immigrants, but also lots of insured immigrants and tons of others to dilute the effect.

I'd have guessed it's a trivial factor (in the relative sense) but if you have something to the contrary, I'm educable.

[mykidslovedogs]

Read through this paper. Page 14 has some interesting information on Healthcare Spending in the USA, and gives another picture than what we typically see from proponents of universal coverage.

http://www.wpri.org/Reports/Volume19/Vol19no10.pdf

[Empty Pockets]

Back to the original question, what do people do who don't have health insurance ?

I don't mean this as a smart answer, but it used to be - they died.

My parents tell of people who didn't have any money in the 30's and when they got sick, they stayed home and fought it with home remedies the best they could and they either lived or died.

I realize times have changed and this wouldn't happen today. But it does keep things in perspective, I don't like paying these high prices for medical care and I think something has to change, but I am glad that there is care available if my family or I need it.

[unclemick]

I really hesitate to remind the old timers here but I went 12 years without health insurance - that or go back to work.

I was in the 'get well or die camp' given the prices availible to me when I lived in LA. 10k deductible BCBS outta Kansas City and 12 yrs of portfolio growth post Katrina.

I DO NOT RECOMMEND THIS!!!!

heh heh heh - everyone depending on me had insurance and finances were arranged should sickness bust my portfolio to zero.

[eridanus]

Quote:

Originally Posted by mykidslovedogs Read through this paper. Page 14 has some interesting information on Healthcare Spending in the USA, and gives another picture than what we typically see from proponents of universal coverage. http://www.wpri.org/Reports/Volume19/Vol19no10.pdf

Do those US numbers include government subsidies for employer-bought insurance?

If you're getting a government subsidy, you're a socialist!

(Only 10m Americans have completely non-subsidized health insurance.)

[ladelfina]

Quote:

If you're getting a government subsidy, you're a socialist!

Hands up anyone who gets NO government subsidy of any kind!


--
Why is it that when we talk about a tooth extraction or antibiotics for some poor shmoe, it's "A Government Subsidy", but if it's a business tax break or building a sports stadium or bailing out Chrysler.. it's an "incentive" or a "stimulus"? :

A 12-year-old in a potential working life of, let's say, 40 years, generates how much economic "value" to the US, even at minimum wage..? Eighty dollars worth? I'd say so.

I have seen in Italy the worst aspects of centralized social planning.... I have also seen the best. Don't tell me the most powerful nation on earth can't come up with an acceptable hybrid. We have hybrid solutions for a lot of other stuff; the die-hards just won't acknowledge the extent of their existence.

[eridanus]

Quote:

Originally Posted by mykidslovedogs You are right! If the mother or father had been paying close attention to the child and had taken him/her into the ER in a timely manner, the death could have been prevented. If the mother or the father had taken the child to the dentist for preventive care, and worked out a financial arrangement, the death could have been prevented. I am sure that no dentist would turn down a child in excrutiating pain just because the parents can't pay the bill in full at the time of service. Just because someone else wasn't there to pay for the child's dental care is no excuse. There are plenty of charitable organizations that could have advised the parents where to go to take care of the problem had they just taken the initiative to ask. My guess is that there is more to the story than what is being told. Perhaps the parents were neglectful, resulting in the child's demise. The USA healthcare system should not be blamed for such a tragedy.

Admit it, you didn't read the entire article.

The lack of empathy on this board sometimes astounds me.

[shiny]

Quote:

Originally Posted by eridanus The lack of empathy on this board sometimes astounds me.

Its not the board, just a few posters.


"I'm made of atoms, you're made of atoms and we're all in this together" Ben Lee

[ladelfina]

eridanus.. I find certain expressions of a "lack of empathy" refreshing (in a negative way).  They give me a wake-up call.

I think that, on the whole, "the board" is surprisingly forgiving of the shortcomings of the human race. Those that are less tolerant of such just show us how far we need to come, and therein lies the value of having these views aired.

This allusion is going to be seen, by somone I'm sure, as despicable.. but here goes..
Look at the outpouring of support on the board for Laurence and his daughter Tori, which I wholly share.
Then read this:
"There are plenty of charitable organizations that could have advised the parents where to go to take care of the problem, had they just taken the initiative to ask."

:P :P :P

----------
Edit: Sorry for getting carried away. I know this is not what mykidslovedogs means!!!!!!
But I want to leave it here as a caution: there but for the Grace of God go I...!
Things are not always as easy as they seem!
------------

The difference is.. what? Laurence is white, middle-/upper-middle-class and, I assume, has insurance!!
D'oh!  What's WRONG with "these people"!? That at $5/ or $7/ or $8/hour they don't run out and buy health insurance that could cost 1/2 their salary, or more!?

As a (bad) Catholic.. I just find the privileged WASP Calvinist line repugnant.

Get well or die, indeed.

The "problem" is PEOPLE. Us. PEOPLE. People that are too fat or too thin or too sick or too young or too old or with too many genes or too many allergens or too much arthritis or too many broken bones or TOO MUCH HUMANITY. It's just "too much" for an insurance company to deal with!

Christ!!

They have hearts and spleens and stomachs and teeth and joints and intestines and brains and skin and GOD KNOWS what else!!! Why can't they just Go Away?

---

Quote:

56 percent: Number of Americans who believe the federal government has a responsibility to provide health care for all. Eighty-four percent said they support expanding the Childrens’ Health Insurance Program to cover all uninsured children, even though President Bush has proposed cutting funding for the program.

http://thinkprogress.org/2007/03/02/...-march-2-2007/

[mykidslovedogs]

Quote:

Originally Posted by eridanus Admit it, you didn't read the entire article. The lack of empathy on this board sometimes astounds me.

I can see how that sounds like lack of empathy, but it isn't so. I just don't think the government should be heavily involved in or heavily responsible for people's healthcare. Sure some subsidy is necessary, but I am amazed that so many people feel like we need big brother to take care of everyone. I read the whole story. OK - maybe there aren't enough dentists who take Medicaid. Hmmm... I wonder if that's because the government simply doesn't pay them enough. What makes anyone think that socializing the entire system would make it better? Then, maybe there wouldn't be any dentists left, so we can all suffer with lack of good dentistry. Would that be better than just a minority of people having difficulty finding a good dentist?

For the minority that don't have good dental care, what is wrong with putting the responsibility on THEM to work out a financial arrangement with a dentist that doesn't take Medicaid instead of just expecting an entitlement and allowing their child to die because they didn't have an entitlement. That's what really bothers me. No, I do not lack empathy. In fact, if the mother or father had come to me begging for help, I personally would surely have donated the money to them, just as I am sure there are plenty of empathetic dentists out there in the private system that would have been willing to accept a payment arrangement.

It angers me that any parent, regardless of financial status, would allow a rotten tooth to lead to a brain infection, and then play victim because they didn't get an entitlement from the government. For God's sake, do whatever it takes to fix the problem. Ask your church for help. Contact social services to find out if there are any other alternatives. Call a local dentist or two or three, explain the situation, and ask if a financial arrangement can be made. Don't give up until the issue is resolved. Worst case, utilize the local Emergency Room and get it fixed there on the taxpayer's dime.

[mykidslovedogs]

Quote:

Originally Posted by ladelfina 56 percent: Number of Americans who believe the federal government has a responsibility to provide health care for all. Eighty-four percent said they support expanding the Childrens’ Health Insurance Program to cover all uninsured children, even though President Bush has proposed cutting funding for the program. http://thinkprogress.org/2007/03/02/...-march-2-2007/

We already have programs in every state for children. The problem is, many of the uninsured don't know about these programs, and that's why they remain uninsured:

http://www.insurekidsnow.gov/ - Now, you may have one less thing to worry about. Your state, and every state in the nation, has a health insurance program for infants, children and teens.

[Lazarus]

Government provided health care could hardly be worse than what we have overall. Even though I am a conservative I can see the benefit of some government services. We have public education, public roads, ect. They are not perfect by any means but they are better than nothing for most people. People in the greatest country on Earth should not be worried that they cannot get treatment for life threatening problems. If we cannot afford this as a society then we have a lot of questions to answer. Life, Liberty, and the pursuit of happiness. How are we the best if we cannot take care of out own at a basic level.

[perinova]

Quote:

Originally Posted by mykidslovedogs We already have programs in every state for children. The problem is, many of the uninsured don't know about these programs, and that's why they remain uninsured: http://www.insurekidsnow.gov/ - Now, you may have one less thing to worry about. Your state, and every state in the nation, has a health insurance program for infants, children and teens.

Unfortunatelly all those programs are for families with incomes under $34K. Which cuts out the middle class out and most on this board...

[perinova]

Quote:

Originally Posted by Lazarus Government provided health care could hardly be worse than what we have overall. Even though I am a conservative I can see the benefit of some government services. We have public education, public roads, ect. They are not perfect by any means but they are better than nothing for most people. People in the greatest country on Earth should not be worried that they cannot get treatment for life threatening problems. If we cannot afford this as a society then we have a lot of questions to answer. Life, Liberty, and the pursuit of happiness. How are we the best if we cannot take care of out own at a basic level.

Well said.
I might add that it is OUR government and OUR money. We also pay for this health care one way or another so the argument that it will cost too much is not a valid one.

[Rich_by_the_Bay]

Quote:

Originally Posted by mykidslovedogs We already have programs in every state for children. The problem is, many of the uninsured don't know about these programs, and that's why they remain uninsured

Those silly poor people, not understanding the U.S. health care reimbursement system.

Let them eat cake.