Hillarycare part deux

[Jim]

Jim:

 

I presume that when Tim Eyman's referendums secure passage, you raise a glass to to him, and delight in the prospect of legislative solutions to problems requiring the consideration and resolution of an incredibly complex series of conflicting perogatives - by a simple majority of the citizens, whether or not they have any expertise on the matter.

 

"WOULD YOU RATHER PAY A FLAT $30 FEE FOR CAR TABS OR PAY MUCH HIGHER FEES?"

 

Aside from the "wisdom of the crowds" angle at play here, there's also the matter of whether the respondents would respond with equal enthusiasm if the question were phrased differently, and whether enthusiasm for universal health care is synonymous with a model in which all health care is paid for and administered by the government.

 

My main point was to counter FW's assertion that no one wants universal coverage. Certainly some of the 25 million people w/o health care are doing this by choice, but it's fair to say that a good amount of them have no health coverage because it is too expensive. Yes, you can get a cheap policy that covers a major accident, with a major deductable, but that does nothing for any type of preventive, wellness care like taking your kid in for odds and ends.

 

The current private sector model is not working. Given the evidence of how Medicare and the VA can provide a more efficient delivery system compared to the privately run, profit and advertisement driven model, and with ample success stories in all other industralized countries, I have faith that we could work out a good single payer system. So far the only argument against such a system I've heard is that people just don't trust the government to run it well. Given the track record of the private insurers I say it's time to give it a try.

[cj001f]

I'm just posting to say I don't give a shit either fucking way.

 

It's cheaper to fly to Thailand, get four crowns, climb for a week and fly home then it is to pay for the same procedure in the US and thats after insurance covers 60%

[fenderfour]

Hillary is proposing that health care be mandatory, like car insurance -- but not government run. She also supports tax credits to help low income families afford private insurance.

 

This is the worst possible solution. Forcing people to buy somethign from a private company is bullshit. Talk about taking away your freedoms.

 

Tax credits are a boon doggle. EIC is already in place for people who wouldn't be able to afford insurance. The only way for these people to get healthcare is if the tax credits were to pay them significantly more than they paid in the first place. Even then, the financial burden wouldn't be manageable. They wouldn't get that money back until their tax returns were filed.

 

How would being forced to pay for a good from a private company - in a system where aside from satisfying certain minimum coverage requirements - you are free to choose from catastrophic versus comprehensive coverage, you are fee to choose from policies offered by all participants in a competitive health-insurance market, etc...worse than being forced to pay into a unitary system run by the government where you have none of these things? Would you rather buy your car insurance from a government run monopoly, instead of participating in the current system, where the government mandates coverage and certain minimums but otherwise allows insurers to compete for your business and for you to choose who you want to buy your insurance from?

 

If we were discussing private monopolies versus public monopolies I might agree with you, but none of the compulsory insurance models that I'm aware of include the establishment of private monopolies in their plans.

 

There is no real competition at that level. The service is the same where ever you go. All of the rates are inflated and the people at the top are making money hand over fist. The insurance companies all know the rates for certain coverages and they have carved out their little markets. They stay just far enough away from each other tha tthere is no anti trust case.

 

Yes, I would greatly prefer to have the government provide the required liability coverage instead of criminalizing the failure to purchase something from a private company.

 

This would also provide more protection for you and me. Do you carry Uninsured Motorist coverage?

 

Let me be clear on this. I don't think a single payer system is the answer. There is a basic coverage requirement (Car or health) that can be provided by the government. Further coverage can be provided by private companies. Without the huge income from the sale of the required coverage, the providers would actually have to compete to gain customers. They would end up providing a better product. Without you choosing them, they would go under.

[No. 13 Baby]

Did anyone watch that ABC special last night on how utterly horrible Canada's health care system is?

 

Here's a response from one of the people mentioned in Stossel's obtuse demagoguery.

 

My favorite parts, for those too lazy to click links:

In your 'reporting' of this story, you did not contact me, and you did not contact my husband's doctors. [. . .] Instead of calling me up and doing real reporting, all you can do is throw around studies from 1999 about the supposed inefficiency of bone marrow transplants for breast cancer patients - even though Tracy didn't have breasts. He had kidney cancer! [. . .] You are simply carrying water for the for-profit insurance industry that killed my husband. And then you have the nerve to accuse me of "sneering" about it. My husband has only been dead since January 18th, 2006. It is still fresh to me and my family, and comments like this are inhumane.

 

I am surprised Fox "News" hasn't snatched up this "Murrow-with-a-moustache."

 

[cj001f]

Did anyone watch that ABC special last night on how utterly horrible Canada's health care system is?

 

Here's a response from one of the people mentioned in Stossel's obtuse demagoguery.

 

My favorite parts, for those too lazy to click links:

In your 'reporting' of this story, you did not contact me, and you did not contact my husband's doctors. [. . .] Instead of calling me up and doing real reporting, all you can do is throw around studies from 1999 about the supposed inefficiency of bone marrow transplants for breast cancer patients - even though Tracy didn't have breasts. He had kidney cancer! [. . .] You are simply carrying water for the for-profit insurance industry that killed my husband. And then you have the nerve to accuse me of "sneering" about it. My husband has only been dead since January 18th, 2006. It is still fresh to me and my family, and comments like this are inhumane.

 

I am surprised Fox "News" hasn't snatched up this "Murrow-with-a-moustache."

 

 

I've recently become curious what portion of American consumer debt (excluding car and home) is medical expense related. 10% 5%? More

[tomtom]

I've recently become curious what portion of American consumer debt (excluding car and home) is medical expense related. 10% 5%? More

 

May not exactly answer your question, but here's a start.

 

29% of low and middle income households with credit card debt reported that medical expenses contributed to their current balances.

 

Also ...

[murraysovereign]

Long waits and shitty care? I wish I'd seen that program. I've never experienced either long waits or shitty care.

 

OK, more anecdotal evidence. It doesn't prove anything. Even if your portrayel is accurate, it doesn't mean that the program will work in the US. We are not Canada or France - we are a much larger country with much different demographics and structures (business and government), not to mention the cultural differences.

 

I am interested in the history of Canadian health care, however. Do you know when your health care was nationalized, why this was done, and how? I'm assuming of course that at one time you had privatized health care like we do in the states. What precipitated the change up there? Did costs decrease and quality of care go up?

 

I realize my personal experiences are nowhere near representative of the whole. They do, however, conform with the findings of the many Johns Hopkins studies. If my anecdotes were seriously at variance with those studies, you could rightly view them with some suspicion. But from my perspective, the Johns Hpkins studies indicate that my experience is well within the norm, so I take that to indicate the system seems to be working reasonably well.

 

Are there exceptions, cases where people have had to wait far too long, or cases where people have received substandard care? Of course there are, and it sounds like this ABC show went out looking for them, and found them. But is that representative of the Canadian health care system overall? I doubt it. If we were to reciprocate, sending a Canadian tv crew down to travel the States looking for medical horror stories, don't you think they could find some? Hell, it could probably sustain a weekly program that could run for years and never run out of fresh horror stories to report on. But I wouldn't consider it to be an accurate representation of the US health care system.

 

There are problems with both systems, but there is a great deal more that works very well - in both systems. I don't think anyone is suggesting the US should simply implement a carbon-copy of the Canada Health Act. But you also shouldn't dismiss the entire structure simply because some parts are imperfect.

 

As for the history, it's a fairly complicated story, but Wiki seems to have got the major bits about right, although the way it's written makes it a bit hard to follow. You could also google "Tommy Douglas" and find a few fairly evenhanded biographies in amongst the hagiographies from the NDP and various labour organisations (Tommy is the founding father and patron saint of the Canadian social-democratic movement). And I don't know whether overall costs went up or down at the time, but there seems to be no serious debate that the quality of care improved significantly.

 

We're currently involved in a debate of our own, on how to re-structure our system to account for changes in demographics, economics, and medical advances in the four or five decades since the present structure was put in place. And I think it likely that, despite the ideological objections of those on the far left, part of the restructuring will involve some sort of private or semi-private system running in parallel to the public system. There are some concerns that such a "two-tier" system would detract from the public system, but we'll probaly end up moving in that direction provided there are safegaurds to ensure it isn't detrimental to the public system.

[JayB]

Jim:

 

I presume that when Tim Eyman's referendums secure passage, you raise a glass to to him, and delight in the prospect of legislative solutions to problems requiring the consideration and resolution of an incredibly complex series of conflicting perogatives - by a simple majority of the citizens, whether or not they have any expertise on the matter.

 

"WOULD YOU RATHER PAY A FLAT $30 FEE FOR CAR TABS OR PAY MUCH HIGHER FEES?"

 

Aside from the "wisdom of the crowds" angle at play here, there's also the matter of whether the respondents would respond with equal enthusiasm if the question were phrased differently, and whether enthusiasm for universal health care is synonymous with a model in which all health care is paid for and administered by the government.

 

My main point was to counter FW's assertion that no one wants universal coverage. Certainly some of the 25 million people w/o health care are doing this by choice, but it's fair to say that a good amount of them have no health coverage because it is too expensive. Yes, you can get a cheap policy that covers a major accident, with a major deductable, but that does nothing for any type of preventive, wellness care like taking your kid in for odds and ends.

 

The current private sector model is not working. Given the evidence of how Medicare and the VA can provide a more efficient delivery system compared to the privately run, profit and advertisement driven model, and with ample success stories in all other industralized countries, I have faith that we could work out a good single payer system. So far the only argument against such a system I've heard is that people just don't trust the government to run it well. Given the track record of the private insurers I say it's time to give it a try.

 

How do you explain the fact that the premiums for health insurance - and thus affordability - vary dramatically from one state to the next? Does the price of MRI's and scalpel's vary dramatically from one state to the next, or might the manner in which the health-insurance market is regulated have an impact?

 

It's also worth making the point that "affordable" means different things to different people. How many people who claim that they can't afford health insurance have cable TV, elected to purchase homes instead of renting more modest dwellings, eat out instead of preparing their own meals, own multiple cars, etc?

 

If affordability is the primary problem, there are models other than nationalizing the entire sector of the economy. Is the primary goal here transferring control of a massive sector of the economy to the government, or to improve affordability? Seems like the former to me.

[cj001f]

How do you explain the fact that the premiums for health insurance - and thus affordability - vary dramatically from one state to the next?

 

I've found the premiums relatively constant between states of residency.

[Jim]

There may be some minor variations in pricing but no bargins thats for sure. I saw another John Stossel report on how the poor in this country were really not that poor compared to the poor in Africa or Asia because they had refigerators and their apartments had central heating and such.

 

So I guess if they stopped by food they could afford a minmal health insurance policy.

 

Reminds me of the Reagan motto for solving homelessness - "Just get a house"

[KaskadskyjKozak]

It's also worth making the point that "affordable" means different things to different people. How many people who claim that they can't afford health insurance have cable TV, elected to purchase homes instead of renting more modest dwellings, eat out instead of preparing their own meals, own multiple cars, etc?

 

That was a point I made yesterday, and got dog-piled by the typical crowd of assclowns on this site. I know and have known plenty of people who complain about how they don't have enough money while spending wastefully.

 

I'd say that 20-30% of your income is stretching into "unaffordable", and that's where a lot of people seem to be these days. If we address this problem through big-government, I want to make sure the cost is less, and that everyone pays a fair share - everyone. There ain't no such thing as a free lunch. Hiding costs (by passing them on to other taxpayers or through nickle and dime taxation) is bunk. People should pay into this and know how much they are paying - nothing is free.

 

I think some of the more bothersome issues about the fully private system we have actually relate to things like lifetime caps on coverage, denial of coverage, problems with reimbursement for treatment, etc. That's where you can get screwed no matter what your coverage.

 

[cj001f]

I'd say that 20-30% of your income is stretching into "unaffordable", and that's where a lot of people seem to be these days.

 

A serious injury or chronic condition can easily cost, post insurance payment, 10-20% of your pretax income for a moderate earner not counting loss of wages

 

Sure people could buy some crap catastrophic plan that won't cover much if/when you get injured, which is when healthcare gets really expensive.

[KaskadskyjKozak]

I'd say that 20-30% of your income is stretching into "unaffordable", and that's where a lot of people seem to be these days.

 

A serious injury or chronic condition can easily cost, post insurance payment, 10-20% of your pretax income for a moderate earner not counting loss of wages

 

I did say that's where a lot of people seem to be today...

[cj001f]

I'd say that 20-30% of your income is stretching into "unaffordable", and that's where a lot of people seem to be these days.

 

A serious injury or chronic condition can easily cost, post insurance payment, 10-20% of your pretax income for a moderate earner not counting loss of wages

 

I did say that's where a lot of people seem to be today...

 

Oh, I wasn't disagreeing, merely emphasizing.

[KaskadskyjKozak]

I'd say that 20-30% of your income is stretching into "unaffordable", and that's where a lot of people seem to be these days.

 

A serious injury or chronic condition can easily cost, post insurance payment, 10-20% of your pretax income for a moderate earner not counting loss of wages

 

I did say that's where a lot of people seem to be today...

 

Oh, I wasn't disagreeing, merely emphasizing.

 

Also, just consider that group coverage through your employer for a family (if your spouse doesn't work, includes 2 or more kids) is easily 800-1000 bucks per month. Even if your employer pays 80% or more of the premium, it still affects you (lower wage).

[JayB]

I'd say that 20-30% of your income is stretching into "unaffordable", and that's where a lot of people seem to be these days.

 

A serious injury or chronic condition can easily cost, post insurance payment, 10-20% of your pretax income for a moderate earner not counting loss of wages

 

Sure people could buy some crap catastrophic plan that won't cover much if/when you get injured, which is when healthcare gets really expensive.

 

Disability insurance....

[cj001f]

Disability insurance....

 

Is available and costs money. Your point is?

[olyclimber]

is that Insurance is the most wonder business in the world.

[JayB]

Disability insurance....

 

Is available and costs money. Your point is?

 

Ditto for lottery tickets, cigarettes, drugs, alcohol, flat-screen TV's, chrome rims, etc - but people find a way to buy them.

 

If a hypothetical family could afford health insurance, and disability insurance by selling their home and moving into more modest lodgings, then they *can* afford both - but choose not to.

 

Sorry - but there's no right to a house, a car, cable, etc - and unless someone has stripped every non-essential expenditure out of their lifestyle before claiming that they can't afford coverage, then their lack of coverage is a consequence of their choices, not of circumstances beyond their control.

 

 

[cj001f]

Sorry - but there's no right to a house, a car, cable, etc - and unless someone has stripped every non-essential expenditure out of their lifestyle before claiming that they can't afford coverage, then their lack of coverage is a consequence of their choices, not of circumstances beyond their control.

 

Oh for the glorious day when we have a new man! A homo economus!

 

The soviets tried to create a new man (homo sovieticus) to make their system suceed. It didn't work. Mankind will always be irrational - wasting time on internet bulletainboards, overanalyzing their existance and the financia

[Stefan]

more than half of all personal bankruptcies have massive medical bills as a precipitating cause

 

KaskadskyjKozak would sing a different tune if he received an agressive cancer, finding out that his insurance gets cancelled becuase of the excessive cost of treating the cancer and then going into bankruptcy becuase of the ongoing costs. Yeah right. Market conditions will not reduce the cost of this type of health care.

 

This cause of bankruptcy is more common than you think. I know two families this has affected. College education savings were wiped out for both families becuase both families had used all their money.

 

 

[JayB]

Worth asking if the treatments that bankrupted them would have ever come into existence in an economy governed by the incentives determined by the rules governing a single payer scheme.

[cj001f]

If a treatment exists and you can't afford it, it doesn't matter, does it?

 

Except to the Amgen tool spending $5k on the new Trek.

[JayB]

It does matter quite a bit actually, since medical technologies and pharmaceuticals that were once exotic, extremely costly, and rare become far less so over time if they are effective and offer sufficient advantages over the alternatives that pre-dated them.

 

Destroy the mechanisms responsible for bringing new medical technologies and pharmaceuticals to market and you eliminate not only the costly treatments available to the few in the near-term, but more importantly, to everyone else in the long-term.

 

 

 

 

[cj001f]

yeah, whatever, my tiger penis was $3k last month. fuck that shit.

 

market forces seem to work much better with elective cosmetic surgeries than they do with critical services. (note recent botox vs. mole check story). Funny how that is.

 

Bankuptcy court is a poor means of subsidizing care.