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

[ladelfina]

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]

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]

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."



----------
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?

---

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/thinkfast-march-2-2007/

 

[mykidslovedogs]

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]

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/thinkfast-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]

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]

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]

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.

 

[mykidslovedogs]

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

A major medical plan for a healthy child costs about $50-$100/month, so I don't think it would be that hard for middle class to afford that. Why do you think the healthcare should be an entitlement? I bet most people pay more than that for their car insurance.

 

[haha]

I might have misheard some of these details as I was sitting in traffic, but the gist of it is correct.

Here is what a woman named Melissa in Washington State did about her lack of health insurance.

It seems that she had a meth problem, and she was jailed on a short sentence. During her "welcome to jail" physical it was determined that she had cervical cancer. She got a tissue biopsy and staging I think, but her sentence was over before she got definitive treatment, so the state was no longer required to pay her way.

While outside she must have decided that jail was better than dying, so she stole a car and got caught. The judge was compassionate so he told her he could give her a suspended sentence if she attended drug rehab. To his astonishment, she said, "No, I would prefer jail."

In jail and safely the responsibility of the state she will get her hysterectomy and stay alive.

The local AM radio talk jocks are furious that she will get free treatment rather than just go on and die like they apparently think she should.

Only in America!

 

[mykidslovedogs]

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.)

From what I understand, the figures for total health spending include all health premiums plus subsidies.. They include ALL healthcare costs.

Did anyone else read this whitepaper? It is very interesting:

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

 

[mykidslovedogs]

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

Let them eat cake.

I don't understand your mentality on this...so does this mean you think they should just be able to walk into any doctor's office and just get free care? How is it too much to ask that people simply make a few phone calls and get advice about how to enroll in one of these child healthcare programs? Maybe doctors could help by educating their patients about these programs as well. They are great programs. Free preventive care plus extremely low copays for office visits and prescriptions, and they are already available. Plus, they also include dental coverage too.

 

[Martha]

I don't understand your mentality on this...so does this mean you think they should just be able to walk into any doctor's office and just get free care? How is it too much to ask that people simply make a few phone calls and get advice about how to enroll in one of these child healthcare programs? Maybe doctors could help by educating their patients about these programs as well. They are great programs. Free preventive care plus extremely low copays for office visits and prescriptions, and they are already available. Plus, they also include dental coverage too.

Programs programs everywhere. It is confusing and overwhelming, with many holes. The kids program you cite does not cover children who are covered by or eligible for medicaid. Most medicaid programs do not cover preventive dental care or teeth cleaning.

The biggest hole is being over 18, poor, and not disabled.

 

[perinova]

A major medical plan for a healthy child costs about $50-$100/month, so I don't think it would be that hard for middle class to afford that. Why do you think the healthcare should be an entitlement? I bet most people pay more than that for their car insurance.

IMHO Health care should be available to all. A single payer health system available to all is not an entitlement.
A major medical plan is not really health insurance if you have to pay $10,000 deductible. It is more a protection against bankrupcy in my opinion.

The problem I have with the current system is that if the child already has a disability he/she cannot get insured in many states, or the parents will be asked to pay an exhorbitant premium (not $100!).

In NJ, where noone is turned down but the insurance is not (yet) mandatory, family insurance is $12,000 per year for $10,000 deductible.
If you make $34,000 or less there is subsidized insurance. If you make $150,000 it is probably OK to pay $12,000. If you make $40,000 you will go uninsured...

Notice the difference: I am not asking for subsidized health care: I am asking for a portable mandatory health care available to everyone at the same price.
Rich - Poor - High Income - Low Income - Suburb - City - Old - Young - Sick - Healthy...
Actually I would be willing to pay more if I make more or if I would do dangerous activities like skydiving, smoking...

To begin with health care should not be tied to jobs because it forces sick people to work! ANd becasue when you loose your job you loose health care at the same time. Find a new job you might need to find a new doctor, have to deal with preexisting condition issues etc...

 

[mykidslovedogs]

IMHO Health care should be available to all. A single payer health system available to all is not an entitlement.
A major medical plan is not really health insurance if you have to pay $10,000 deductible. It is more a protection against bankrupcy in my opinion.

...And that is exactly what health insurance should be...protection against bankruptcy. Why should it be anything more, and why should we expect big brother to take care of us for day to day medical expenses? For some reason, people think that medical care should be free...That means that we expect doctors who spend years learning their trade to work for minimal income. How is that fair?

So what you are proposing is.... we should all pay income taxes WAYYYYY in excess of what it would cost to buy a guaranteed issue plan so that the minority of people can have guaranteed coverage? ....That doctors only be allowed to earn modest incomes.....And we should ALL have poorer quality of care so that the very very minority of people can have free preventive and major medical care? IMHO, that is how it will end up if we go to a universalized system.

 

[perinova]

...And that is exactly what health insurance should be...protection against bankruptcy. Why should it be anything more, and why should we expect big brother to take care of us for day to day medical expenses? For some reason, people think that medical care should be free...That means that we expect doctors who spend years learning their trade to work for minimal income. How is that fair?

So what you are proposing is.... we should all pay income taxes WAYYYYY in excess of what it would cost to buy a guaranteed issue plan so that the minority of people can have guaranteed coverage? ....That doctors only be allowed to earn modest incomes.....And we should ALL have poorer quality of care so that the very very minority of people can have free preventive and major medical care? IMHO, that is how it will end up if we go to a universalized system.

Woah... Hold on... I didn't come close to say anything like what you added passed your 2nd line... ( You read too much between the lines... )

I didn't say free (I said: premiums paid into it). And it doesn't have to be big brother either just available for all (remember I didn't advocate subsidized). Like you I would choose the high deductible too (most likely since I am really cheap ) but the bankrupcy level (or financial distress I should say) is not at the same level for all families.


I don't think it will end up the way you think (pessimistic view I guess) after all others, not as wealthy countries are doing it better.
I can see creeping a left vs right issue. I personally prefer having healthy neighbors, coworkers, cashiers, maids with all their teeths and limbs...

 

[Rich_by_the_Bay]

I don't understand your mentality on this...

My mentality is from having 32 years of experience caring for both rich and poor. Programs and access are confusing and change often. Precious few physicians want to or can even afford to see patients at the prevaiing rates. Poor folks are often shockingly unable to navigate the complex phone trees. questions relating to means testing, copays, preventive versus active care. Excruciating approval processes crush patients and physicians alike. Consultants frequently don't accept patients you wish to refer to them. I can go on and on with similar stories.

People all over this board (a well-heeled bunch mostly) are struggling with delayed retirement, COBRA, rejected applicatioins, pre-existing condition exclusions, 12K per year family premiums, and all the tribulations of our current excuse for a system. Imagine what the middle income folks are dealing with.

My mentaltiy: you're an American, you get sick, and you get basic care fairly subsidized according to means. Anyone can participate and pay their fair share, but everyone gets care: working, retired, between jobs, poor, rich. Want to pay for the frills? Fine, but it's convenience and perhaps shorter wait times for elective care that you buying. No one dies of a toothache.

No personal offense intended, but you seem to be living in a bubble when it comes to the reality of health care reimbursement. Perhaps in your little world your clients need health insurance, they can pay you, you collect your commision as an insurance agent, and all is well in the world. You are apparently seeing a very small slice of he pie. I hope for your sake that your bubble never bursts, cause there's a whole world of hurt on the other side.

 

[mykidslovedogs]

Perinova - OK - it doesn't have to be left vs. right, as we all agree that something has got to give. But, how would you propose that we get everyone to agree to buy health insurance at the same price unless the government pays for it in the form of taxation? Even if everyone were given the opportunity to buy guaranteed health insurance at community (pooled rates), there would still be a large number of people who would choose to go uninsured. If we decide that it has to come from the government in order to get everyone insured, you can almost bet we will have overutilization which ultimately result in much higher costs...for everyone..

Rich.....Healthcare reimbursement is not as complicated as it seems. Most people are ignorant about their healthplans because they have been spoiled by rich benefits and low copays for so many years. If people would take 1/2 hour to read through their policy summaries and benefit packages, they would understand how their plans work and they would be better equipped to make decisions about their healthcare...When I went in for my physical the other day, the front office administrator tried to tell me I needed to pay 50% upfront because I have a "major medical" plan. I explained to her, because I actually read my contract, that preventive care on my policy is covered at 100% not subject to deductible. She simply said OK, and that was the end of it. Most people would pay the 50% upfront, because they have no clue how their health insurance policy works, and then they would complain that their healthcare plan doesn't pay for anything. I can't tell you how many times we as brokers hold mandatory employee benefit meetings and only 10% of the employees show up. The next thing you know, someone calls us to complain that they went in for Diagnostic Lab Work and it "wasn't covered" (actually it hit the deductible, but the complaint is always, "it wasn't covered"). Had they gone to the meeting, they would have had a better understanding of their plan before going in for diagnostic services. The problem is that people feel they are "entitled" to zero deductibles and $5 prescriptions, because that was how it was in the past. Times are changing, and the fact is, the average person needs to understand that routine medical and dental and prescription drug expenses are going to need to become part of their budget, just like vacations, car insurance and mortgage payments. Health insurance coverage after deductible is for protection against bankruptcy. People can't expect their health insurance premiums to pay for everything anymore.

Programs and access for the poor and indigent are confusing because they are run by the government. Brokers and healthcare administrators can be of great help in informing people about our existing government programs if they would just be willing to take a few minutes extra to give "free" advice.

I agree that it would be best if all people could get basic care according to their means. But even you, Rich, in earlier conversations, stated that "Basic" care cannot be defined. What is "Basic" to one person, might not mean "Basic" to the next. There has to be some kind of limits to subsidies. As soon as limits are enforced, all the sudden, it's "not fair" anymore. But when there are no limits, everyone loses in the LONGRUN.

 

[perinova]

I actually think they found the solution this year to patch the system:
Making it mandatory just as car insurance is (Mass).
Decoupling it from employers (GWBush).
Making it community rated, no-preexisting, portable, guaranteed-renewable (NJ).

Hopefully there will be enough competition to keep premiums low without the insurance companies going under). If the above doesn't work a single payer system will be looming.

 

[Rich_by_the_Bay]

OK - it doesn't have to be left vs. right, as we all agree that something has got to give. But, how would you propose that we get everyone to agree to buy health insurance at the same price unless the government pays for it in the form of taxation? Even if everyone were given the opportunity to buy guaranteed health insurance at community (pooled rates), there would still be a large number of people who would choose to go uninsured. If we decide that it has to come from the government in order to get everyone insured, you can almost bet we will have overutilization which ultimately results in much higher costs...for everyone..

$80 tylenol tablets in the hospital, unpaid ED visits to hospitals that receive Medicare reimbursement, Medicaid and the like are forms of payment that all of us endure under the current system. We are paying it already. If the government (there is one, let's recall) chose to finance it through taxes, it would introduce inefficiencies but remove profit taking and cherry-picking by the private insurers, and no one could take away your right to receive lifesaving care. Yes, right, IMHO.

Unless you are someone who believes that government has no role or responsibility outside the military, it strikes me as a highly legitimate one. Private insurers can cover the aftermarket. Or not. You and other health insurance brokers might have to diversify to maintain your current volume.

Just my opinion from the front lines. As a side note, I have always had an interesting demographic in my practice: typically high end patients with lots of bucks, but often found myself in a minority of primary physicians who would accept both Medicaid and a small number of self-pay (=no pay) patients. The more I saw, the faster my paying patient population would grow. It's almost as if they appreciated my decisions. In either case, I gave the same care. Made a decent if not exorbitant living. It can work.

 

[mykidslovedogs]

I actually think they found the solution this year to patch the system:
Making it mandatory just as car insurance is (Mass).

FYI - According to source: Grace-Marie Turner, "Universal Health Care: Proceed with Caution," National Review, January 31, 2007...The MA plan isn't even in effect yet and already the state says health insurance that meets the minimum requirements for coverage will cost about $380/mo. for an individual, about twice the $200/mo. Gov Mitt Romney had projected. The state has already been forced to create at least 10 new boards and commissions to run the new health system.

As far as your questions about health insurance costs in NJ?...

http://www.nahu.org/legislative/charts/individual health insurance rates june 2005.pdf

Scroll down to NJ and see how the mandates have affected the cost of individual coverage as compared to other states.

 

[perinova]

FYI - According to source: Grace-Marie Turner, "Universal Health Care: Proceed with Caution," National Review, January 31, 2007...The MA plan isn't even in effect yet and already the state says health insurance that meets the minimum requirements for coverage will cost about $380/mo. for an individual, about twice the $200/mo. Gov Mitt Romney had projected. The state has already been forced to create at least 10 new boards and commissions to run the new health system.

As far as your questions about health insurance costs in NJ?...

http://www.nahu.org/legislative/charts/individual health insurance rates june 2005.pdf

Scroll down to NJ and see how the mandates have affected the cost of individual coverage as compared to other states.

Thanks for the link.
I actually live in NJ so I know that the cost is outrageous. I am not sure how they can fix that but making it mandatory - as in Mass - seems a good idea. It is so expensice for a family that it is really unaffordable unless. You'd have to estimate that your family will spend at least $20K-$25K per year on average to make sense financially.
Now the worst is that NJ does not allow short term medical insurance. It also does not have any catastrophic insurance. !!!!!!
The sponsored health-care-for-kids is only available for low income (and it should be).

As for Mass. how is it possible that the cost estimate be off by double?
The $200/mo might be if nobody profits from the system. $380 when everyone is splurging? The market forces are probably not in place and with their boards and commissions....

 

[cute fuzzy bunny]

As for Mass. how is it possible that the cost estimate be off by double?

Apparently you're unfamiliar with "The Big Dig".

A note on that wisconsin health care report, the expert who was consulted to create it heads up a research institute that describes itself as:

"The Independence Institute is established upon the eternal truths of the Declaration of Independence. Founded in 1985, the Independence Institute is a non-partisan, non-profit public policy research organization dedicated to providing timely information to concerned citizens, government officials, and public opinion leaders.

______________________________________________

Our Approach to Public Policy

Because the pursuit of happiness and the enjoyment of life and liberty are matters of individual choice, the Institute addresses a broad variety of public policy issues from a free-market, pro-freedom perspective."

Without reading the rest of the paper, may I presume that the predetermined conclusion they came to is that universal health care driven by a central authority is bad?

Always a good idea when reading a study to see who produced it. For example, if I ask my dogs what they think, they're always going to answer "We want steak!". Doesnt even matter what the question was!

Ask a small government, pro-free market think tank what they think...well...the answers will be pretty predictable.

Free markets not going to work for this "problem", its already out of control and unmanageable. Which is not to say that the government could clear all this bureaucracy up and reduce the costs, since that appears to be what they're specifically NOT good at. But somethings gotta be done.

I'm currently enjoying getting a steady stream of letters from BC/BS telling me that they're rejecting all doctor visit and lab test charges because they're submitted with the wrong "codes". Then apparently that goes back to the doctors, labs and the hospital and they do the onerous paperwork a second time, then it gets paid (mostly), then the health care providers bills me for the six or nine bucks that BC/BS weaseled out of paying, which the HC provider wont just eat.

By the time I'm done writing a check and mailing it, they cash it and the bank manages that small transaction, it seems we've spent an awful lot of time doing paperwork and numerous paper transactions for a 15 minute doctor visit and a simple blood test.

I might feel better about all of this had my former sales territory not included Hartford Conn, where I got to sit in many opulent insurance company offices, trying to sell them stuff.