Here comes your socialized health care...sort of...

[justin]

Guaranteed issue high-deductible health insurance for all. You pay a premium unless you can't (a la medicaid - income limitations maybe higher, maybe lower, dunno).

When you go to the doc, you pay the insaurance company negotiated rate.

Maybe throw basic preventative care in there with a copay.

I'm not happy about the current system, but feel it would be pretty fair if everyone paid the negotiated rates that insurance companies. Indigent folks could pay for a $5000 triple bypass surgery much easier than they could pay for a $30000 triple bypass surgery.

 

[sgeeeee]

The way I look at it is that yes we can trade downward in quality and immediate access to get much better universal coverage.

. . .

I think this may be very misguided. Some of the analysis I've seen indicates that much of the cost and effort in our current system goes to heroic medical attempts to save the lives of people who are going to die within the next few months regardless of how the procedures turn out. I'm willing to give that up.

I think we have far too many medical administrators who look at a patient's records and say, "The important thing to remember is that the patient is fully insured." They then procede to run up astonomical bills. The motivation is clear. A medical system based on capitalism will find ways to produce profit -- not health.

 

[Brat]

I think this may be very misguided.  Some of the analysis I've seen indicates that much of the cost and effort in our current system goes to heroic medical attempts to save the lives of people who are going to die within the next few months regardless of how the procedures turn out.  I'm willing to give that up.

I couldn't agree more. We need to make the 'basic care' standard clear, if you want heroic measures you need to buy additional coverage.

 

[farmerEd]

To suggest that there will not be trade-offs is not realistic.

As far as Massachusetts attempting to extend health-insurance to almost everyone in the state, I just don't see where that makes it "socialized" health-care. I live in Mass, I have a BC/BS policy that I pay for...more state money may go to subsidize private policies for poor folks, but it changes ZERO about my plan...I still have BC/BS...I still go to the doctors that I want. Even the folks that may end up getting it for free, also choose their doctors, and in some cases the insurance company they want to use.

Nobody is being forced to see a doctor that is on the payroll of the state...where is the "socialized healthcare"? I don't see it.

Both the highway system and the military are a lot more "socialized" than the plan being proposed in Massachusetts will ever be.

 

[tomz]

I think this may be very misguided. Some of the analysis I've seen indicates that much of the cost and effort in our current system goes to heroic medical attempts to save the lives of people who are going to die within the next few months regardless of how the procedures turn out. I'm willing to give that up.

According to many studies of healthcare costs in this country, 20-30% of the patients account for 70-80% of the cost.  Also, most of a person's healthcare costs come in the last year or 2 of one's life.  There are 46 million uninsured people under 65 in this country.  Hospitals can't refuse to treat someone without insurance.  Cost shifting to patients with commerical insurance is a common practice in hospitals to pay for care for the uninsured.  One of the reasons the MA plan got off the ground is that the costs for providing this care have gotten way out of hand.

Did anyone see the recent episode of the Sopranos where the ambulance driver who took Tony to the hospital was accused of doing a "wallet biopsy?"  He checked Tony's wallet to see if he had an insurance card.  Since Tony had one, he was taken to a decent hospital.  If he hadn't had one, he would have been taken to the county hospital and would have probably died.

If you are interested in understanding more about healthcare in this country, check out http://www.thehealthcareblog.com/the_health_care_blog/.  It has a lot of good info.  Just for the record, I worked in hospital information systems for almost 20 years so I've seen what's behind the curtain.....It's not something to be proud of.

 

[lets-retire]

!--The socialization protion comes in when the poor people think they are entitled to the same procedures responsible people receive. First it's life saving procedures (no problems), then it slowly becomes I need Viagra. Eventually it morphs into I need these breast implants. My insurance pays for all of these. I also have a full time job that required several years of education after high school. The poor who are working at entry level jobs, because they choose not to grow up and become a responsible citizens of the country, are not entitled to the same benefits I am. If they want the same procedures then go to school, grow up, and work your butt off, otherwise shut up and enjoy your poverty. You chose to live that life.

The military has seen that providing medical for everyone for everything is too expensive and has started to farm some of that benefit out. There are few military emergnecy rooms open 24/7. A lot of bases have gone to a clinic and refer patients to civilian doctors for operations.

As shown in the Soviet Union, if everyone receives the same benefits no matter how hard they work nobody has an incentive to work hard. Why work hard if your not going to get ahead?

 

[kramer]

For a lot of detailed information on health care policy and economics from a free market point of view, two economics professors from George Mason university keep up a blog at:

http://cafehayek.typepad.com/hayek/health/index.html

They allow anyone to comment and there are lots of interesting comments pro and con on each entry.

I thought this was an interesting factoid from an OECD study:

the percentage of the respondents in need of elective coronary bypass who had been waiting for more than three months was 0% in U.S., 18.2% in Sweden, 46.7% in Canada, and 88.9% in the United Kingdom.

I think many people do not realize that in a country like Britain, you still would want health insurance as an early retiree, since few want to be at the whim of such a system where care is rationed by forced waiting for even necessary procedures. My company employs many people in Britain and it offers them all health insurance as a benefit, just like in the US (although the employees pay much higher taxes in Great Britain according to the employee I transferred from there -- he and his family have decided to live here now).

I am assuming that someone posted on this board the recent NY Times article on how the Canadian health care system is coming apart at the seams? On the blog, there is a pointer to a 24 minute video on the Canadian system:

http://www.onthefencefilms.com/video/deadmeat/

I have not seen it (hey, I still work for a living), and obviously it is strongly opposed to their system. Maybe someone could comment.

Kramer

 

[sgeeeee]

. . . The poor who are working at entry level jobs, because they choose not to grow up and become a responsible citizens of the country, are not entitled to the same benefits I am.  If they want the same procedures then go to school, grow up, and work your butt off, otherwise shut up and enjoy your poverty.  . . .

If that's the criteria for good health care, then I'm entitled to better health care than you. Why do I have to pay more to get less than you?

 

[tomz]

Here's a funny take on how the free marketplace and consumer choice might work when it comes to getting a colonscopy.

http://www.thehealthcareblog.com/the_health_care_blog/2006/03/controlling_hea.html

 

[farmerEd]

I also have a full time job that required several years of education after high school.  The poor who are working at entry level jobs, because they choose not to grow up and become a responsible citizens of the country, are not entitled to the same benefits I am.  If they want the same procedures then go to school, grow up, and work your butt off, otherwise shut up and enjoy your poverty.  You chose to live that life. 

In that case, since you are still working, and I am FIRE'd already, I would assume I'm worth a lot more money than you...so I should get better care than you do, and my kids should get better care than you kids, correct?

Where are the highways that the riff-raff like you (the poor working slobs) can't use, and only the FIRE'd elite like me get to use? What makes you think you should be able to drive on the same highways as people like me?...Geez, talk about socialist..next your going to tell me that poor folks should be able to sit in front of the bus to with us upper crust folks.

 

[tryan]

I just don't see where that makes it "socialized" health-care. I live in Mass, I have a BC/BS policy that I pay for...more state money may go to subsidize private policies for poor folks, but it changes ZERO about my plan...I still have BC/BS...

Your rate is regulated to allow the smokers and aids patients to pay the same rate you pay - one for all and all for one (socialism). For example, a BC/BS family plan (4 people) in NH is $580/month. Bet you pay nearly twice that in MA.

Ironically the NH residents can use the same MA doctors for 1/2 the cost because BC/BS is a nation wide network. MA residents will catch onto this very quickly ... I can already hear the sucking sound as people/businesses leave the state.

 

[lets-retire]

If you can't afford the same care as a poor working slob then are you really FI? It sounds to me like you chose to take a little less in health care in return for an early retirement. If you want the same healthcare then maybe you should have worked longer and saved a few thousand more to pay for the insurance. I wouldn't. I'll be out the door as soon as possible.

Where are the highways that the riff-raff like you (the poor working slobs) can't use, and only the FIRE'd elite like me get to use? What makes you think you should be able to drive on the same highways as people like me?

Uh, the highways were built by the government for the use of everybody. If you want your own private highway, then build it.

 

[astromeria]

Yeah, it sux that People Like Me--got Lyme Disease on a hike, never saw the tick bite, and went undiagnosed for years while they repeatedly ruled out brain & endocrine tumors, heart failure, lupus, MS, leukemia, rheumatoid arthritis, hysteria...--get to pay the same low, low group insurance rates as More Virtuous People such as yourself. But don't worry--I'll get What I Got Comin' when I have to buy individual insurance when DH retires...if anyone will sell me a policy, that is. Don't worry, I'll try not to fall down in your path 

=astro, hoping I like the good folks at Dadgumbumrap Hospital in Bangkok <where's the sardonic smile smilie...none of them seem quite right for this!>as I may need to go "bare"

 

[tryan]

if anyone will sell me a policy, that is. Don't worry, I'll try not to fall down in your path

... or move to MA. You're welcomed here! One for all and all for one ... comrade!

 

[Maximillion]

I live in a Country with Socialised Medecine,I don't feel like a communist, I just feel that the key word is "Society"

Visit a Cancer Hospital look at the little 4 and 5 year olds, bald from Chemo, then tell me that ALL should not have the same access to Health Care.

Pierre Trudeau called Canada, a kinder, gentler society, not perfect, but no one should be denied access to being cared for.

 

[laurence]

I'm all for capitalism, but sometimes the arguments of the "free market" health care proponents make me think if they could monopolize air and sell it back to us, they would (they already got there with water).

 

[Cool Dood]

I'm all for capitalism, but sometimes the arguments of the "free market" health care proponents make me think if they could monopolize air and sell it back to us, they would (they already got there with water).

And back in reality, the government does monopolize healthcare under the social system while private companies don't and can't monopolize healthcare -- yet you blame capitalists...

That's what I mean, it's easy to feel good about some things and bad about others, but it often doesn't lead to a very realistic policy...

 

[laurence]

You know, after I hit post, I thought, "eh, I didn't express myself very well there."

So monopolize was a poor choice, but I believe there are a few things a society should not deny some one because they can't afford market price.

And yes, I need look no further than Medicare prescription drug fiasco to see how the govt. can mess things up, too.

 

[Martha]

The poor who are working at entry level jobs, because they choose not to grow up and become a responsible citizens of the country, are not entitled to the same benefits I am. If they want the same procedures then go to school, grow up, and work your butt off, otherwise shut up and enjoy your poverty. You chose to live that life.

I assume you are trolling me.

 

[unclemick]

Nope

I've heard a reasonable range of similar opinions from people.

 

[cute fuzzy bunny]

Replace the words "health care" with "education". Yep, everyone gets to pay more for better education if they want it, but everyone also gets a basic education. Doesnt it seem a little silly to argue that poor or dumb people shouldnt get an education? Yet poor people and sick people shouldnt get health care? At least not as good as what people with money get?

 

[lets-retire]

Martha--I wouldn't think of trolling you. I'm sure you'd beat me up with half your brain. My point is I shouldn't have to pay for the insurance to conver non-essential procedures for people who don't have the will or desire to earn what is needed to provide for themselves. Everyone should receive lifesaving procedures if they want it, nothing more. Similar to what we already have. The people you listed in the other insurance post are exceptions that the government should pay without hesitation.

CFB--Education and medical care are two very different things. A good education can lead to better health care. The education is provided by the governement, but it is up to the parents and the student to put forth the effort to learn the material and force the unwilling student to try to learn the material. If a parent wants te student to receive a better education they must either get them into a better school or make sure the student puts forth an earnest effort. The basic education is just that a basic education, similar to life saving medical care nothing more. No viagra on my dime, unless it's for me.

 

[Cool Dood]

Replace the words "health care" with "education". Yep, everyone gets to pay more for better education if they want it, but everyone also gets a basic education. Doesnt it seem a little silly to argue that poor or dumb people shouldnt get an education? Yet poor people and sick people shouldnt get health care? At least not as good as what people with money get?

Yeah, exactly, everyone should have a right to go to Harvard. And Harvard should be obligated to provide free money to anyone who can't afford it. And if they can't do that, then nobody should be allowed to go to Harvard, and all private schools should be banned in favor of universal public education.

Tax-funded public schools*, sure -- but as with healthcare or food or anything else, just because a caring society provides the basics to the poor, that doesn't entail that it should communize the whole damn thing. What's wrong with people spending more to get a better service?

*I'm not sure if the meaning of "public school" varies by place, but I mean all levels of education, not just primary/elementary/grade school.

 

[Maximillion]

I spent over 30 years in Health Care at the most Senior level with one of the largest companies in the World, and All people should have access to Health Care, regardless of income, anyone who disagrees is [edited by moderator].

I have been in Hospitals where Babies were dying of dehydration due to the lack of IV Solutions, where people were dying from infected Bed Sores due to lack of staff, where doctors assign a death list, dealing with those first who may ahve a better chance of surviving, watching Parents being told their Baby will die because a certain Drug was not available in that Country.

There is NO EXCUSE for the US not having Universal Health Care, NO, I am wrong, there is an excuse but there is no REASON..

it is Politic NOT money, Money there is plenty of, just decide Boeing or Bayer, Iraq or Indiana, part of the solution or part fo the problem?.

In the 60's you guys marched and changed a Nation, you guys just need to remember why you marched and get out your walking shoes.

It is a Revolutionary Idea, accessible and Equal Health Care, where is Joan Baez and Pete Seeger when you need them??

 

[youbet]

Maximillion:

I'm just wondering, not to be argumentative but just curious, if you urgently needed a medical procedure you could obtain more quickly in the US than in Canada, would you come to the US to receive it?  This assumes you could easily afford it and the amount of time saved is very meaningful.  And if you would come to the US to save significant time, would it matter to you if you knew you were bumping a less financially endowed US citizen out of line due to your ability to pay?