Health Care Reform

Yes someone is paying for it, but what we aren't paying for are insurance company employees, executives and pensions. All those bureaucratic wastes are cut out. Instead, we simply pay for the doctors, nurses and hospital bills, the stuff that needs to be paid.

 

Just some food for thought, I pay $25 per pay check for health, dental and vision insurance.

When I was in college I had a job that paid $9 an hour part time, and offered health insurance for cheaper than that. It is pretty affordable if you have the right job. Fuck, even McDonalds and Wal-Mart offer health insurance to their employees. My brother has private insurance that costs him $60 a month.

There are some affordable options out there. But I do feel really sorry for anyone who works for a small company or is self employed.

 

Actually, I DIDN'T make it up, and we already TOLD YOU...several times on this thread alone, and that it's "pot throw". You're not from our fucking country, you know nothing about it or how it works. I KNOW health care isn't 'free". What it is: something much, much MUCH better than what you have. Period. I love America, and have nothing against it at all. But just ask yourself: how many Canadians do you know that moved to America for the health care?

 

I think what you said in your edit is close to the right line of thinking. The original way I heard the question posed was, "Are other countries free riding off of US pharmaceutical companies drug developments?" As I understand it, the idea is that you going to the pharmacy and paying $100 a bottle for your pills allows Big Pharma to throw the kind of money that they do at R&D and, presumably, continue to innovate new and radical cures for diseases. Because U.S. consumers pay such outrageously high prices for perscriptions medications, they are bearing the brunt of the costs of medical advancement fromw which the whole world benefits. Basically, people who support this point of view believe there's a huge free rider problem going on.

Of course, the people who are actually bearing the brunt of the overprice medication are the insurers, because your $10 or $25 copay probably does not constitute the majority of the cost of whatever it is you are buying. So, the argument goes, if/when healthcare reform comes, and the larger-scale the public option it introduces with it, the less $$$ there will be going to the pharma companies, the less incentive to innovate there will be, and the less medical advancement there will be.

I'm not saying I believe any of this, and I fully realize about 90% of what I said is not hard fact, but that's the way I understand the argument. Off the top of my head, one of the things I'd need to see addressed before I bought in to it would be the benefit of privately funded versus publicly funded research--could universities and research grants take up the slack for big pharma? My initial reaction is to say yes, because so much of what pharma companies do now is just recycling old drugs to keep patents intact, but something tells me this sort of a incentives problem is much more complicated than that. I'm curious as to what others think though.

 

The high cost of health care in the US and how to lower it should obviously be one of the main things to debate. This debate is often had assuming the way things are now arose naturally in the free market (as an example of market failure). Nothing could be further from the truth.

People pay for prescription drugs and routine visits and checkups through their insurance. There are also ridiculous (IMO) mandates for policies in many or all states in the union. The federal government also does not exercise its power to regulate (make regular, not control) interstate commerce in health insurance so states practice protectionism in the insurance market against other states. There are also thousands of regulations on insurance and drug companies which drive up cost. As well as on hospitals and doctors.

I'm sure there are many other things I didn't mention that could be changed back toward a free market system to lower cost. That is, a voluntary system of exchange like we have in food, housing, and whatever else.

Edit: Read Blue Dog's post.

Edit 2: Mandates for health insurance policies, not health insurance coverage.

 

Didn't a guy a few pages back talk about his father going to Panama City to have surgery? I know it isn't moving, but...

 

Deleted.

 

Amen. Insurance is for catastrophes. We're living in a world of unjustified expectations generated from a Post WWII push on employers to provide "insurance" that really is not insurance in the true sense of the concept.

My main problem:

I have a hard time believing there is a need for the government to provide us with 1) healthcare or 2) additional health insurance programs because of the demographics of those people who are already covered:

-In my state and neighboring states there are two forms of health insurance for children 18 years old and younger. One is completely subsidized, while the other is partially subsidized. Kids are taken care of and clearly have access to regular doctors visits, innoculations, etc.

-Everyone retirement age and older qualifies for Medicare (plus additional programs/policies that can be opted in to).

-Jerry's kids and other adults who are younger than retirement age, but older than 18 are typically covered by Medicaid.

-Pregnant women without insurance are covered by Title 19 (Medicaid).

We take care of the young, we take care of the old, and we take care of those who are incapable of taking care of themselves. Who does this leave? Able bodied adults who are able to work who refuse to prioritize health insurance premiums into their budget.*** (I'll acknowledge an exception for pre-exisiting conditions, but in no way should that exception swallow the whole argument.)

***Even when I was poor and starving college student I was able to have access to health care and health insurance by enrolling in programs offered by my state college. Taking into consideration Philalawyer/Carrymehome's post on health insurance expectations, I find it really difficult to believe that even someone in a lower income bracket can't afford a policy with say a $7,500 deductible and/or a health savings account. (I tear up as I say this) So forego purchasing that 52" plasma, rims for your car, etc. and invest that money in yourself/your health.

 

The counterargument here is that the only way to force people to invent in their own health is to tax them for it, which means a de facto public option. Otherwise, you'll still be forced to provide some sort of safety net in case of emergency as you can't leave them bleeding out on the sidewalk outside a hospital because they priotized a TV over health insurance, and tax payers will be paying for them anyway. I just don't see how you could fit people like this into a private insurance scheme, and unfortunately, I think there are a lot of people like this in America today.

 

I think proponents of universal health care are right when they argue that the costs of modern health care are far too expensive for the average American. Most Americans when they hear such phrases as "you might feel a slight pinch", "there'll be a little discomfort", and "this might sting a bit" don't know whether their doctors are talking about the their treatments or the costs associated with them. But why is this so? Was Michael Moore correct when he asserted that our rising health care costs were caused by greedy corporations picking up our sick by their hospital gowns and shaking every last dollar out of them? Hardly.

America's rising health care costs are caused by a myriad of reasons, but greedy corporations isn't one of them. In fact, one of the greatest ironies of our health care system is that a key reason why Americans spend too much on medical care is that for individual consumers, medical care costs too little. For most Americans, upwards to ninety percent of their medical care is paid by insurance companies while over half of us receive some kind of government medical care entitlement whether it be Medicare or Medicaid. So there is little incentive for patients or doctors to restrain their consumption of medical resources. If someone else is paying, we really don't care how much it costs. As patients, we seldom ask how much a medical procedure costs, or turn down suggested tests for treatments. And doctors, for fear of malpractice suits, rarely fail to exhaust any and all alternatives. This particular incentive structure creates staggering inefficiencies that drastically drive up the cost of health care.

Yet another prominent reason for soaring health care costs are the numerous amount of federal regulations and state mandates that come along with it. For instance, it can cost upwards to millions of dollars and take over a decade to get a single new drug approved by the FDA. Moreover, insurance companies are forced to comply with almost a thousand different state medical mandates. These include forcing health insurers to cover toupees, psychiatric services, and teeth-whitening. Although these mandates provide additional revenue for toupee manufacturers, psychiatrists, and dentists, they increase the cost of health insurance enormously for everyone.

As health care markets become more and more distorted, these problems will get worse, not better.

These guys do a decent job of fleshing out this line of argument.

 

The more options for people, the better. I guess I just can't fathom why so many of people in the south are against the public option.

 

I do believe there is something wrong with it. The first thing is lack of tort reform.

With the lottery like earnings from a malpractice suit having no measurable trait (i.e. subject to the whim of the jury, and a little bit of discretion of the judge only) the cost of a doctor goes way up. With the single doctor not actually bearing the brunt of punitive damages (all doctors bear it), there is no point in levying monetary punishment in a malpractice suit. This is a good first step to limiting costs.

Also by limiting this, you also limit something called Defensive Health Care. That is, by not having absurd penalties arbitrarily applied, Doctors no longer have an impetus to order every single unnecessary medical test known to man to cover their own asses. With the current system god forbid a doctor not order the EEFGH test on the extremely extreme remote chance that 1 person on the continent has the affliction without ever showing the symptoms or ill effects.


The next step to take will surprise many people. A problem with the US' system isn't capitalism, but lack of capitalism. Many people (myself included) are guilty of not caring where they get their health coverage, or how much it actually costs when they are sitting pretty on a Health Insurance plan. It seems odd but holds true, because we do not shop around for prices and value, this drives up insurance costs inherently, but also allows Health Care Providers to start charging more.


The next issue is insurance denying claims. This isn't a health care issue, it's a contractual issue. You have to remember that both you and your insurance provider are in the business of benefiting. The insurance provider is in the business of collecting the most dues possible, while paying out as little as possible in claims. It is their right to make a profit in a Free United States because they are taking a business risk. It's one of the riskiest businesses out there, just take a look at Home Insurers post Katrina.

If you were in the insurers seat, you'd be making the very same decisions. There is really nothing you can do but fight it in court. This would be made simpler by making the judicial system a "Loser Pays All" system, but that's another issue entirely.

 

This one's easy. Who has the authority to force me against my own will to pay for someone else's healthcare (or anything else)? Who has the authority to take money from me for his own or other people's use? That's an entirely different question from "Who has the power?" so please don't confuse them.

Maybe I'm a huge asshole and don't care anything about anyone else. Maybe I can't afford to pay for even a small part of someone else's healthcare. Or maybe I think there are better ways than another government program. Or maybe I think the government is bankrupt and will soon default on its debt and destroy its currency and really collapse the economy and that this new government program will simply hasten that.

Those are all reasons to oppose it. And you must answer those 2 key questions before you can support the public option.

 

And as a quick addendum:

With so many congressmen and representatives being Lawyers, and so few being doctors, I hope you can figure out why Tort Reform isn't on the table.

 

See Bluedog's post re: Savage Henry's comments on emergency medical care. If you show up at the ER, you can't be turned away. Which is another aspect of the problem affecting the industry - uninsured people showing up at the ER for non-ER issues. Bottom line - people are not being denied critical healthcare.

One way or another we are being taxed for uncovered individuals, whether it be through income based taxes or increased healthcare expenses from providers or increased health insurance premiums. So in some respects, they already fit into the private scheme.

Our government has already proven its inability to address healthcare and/or health insurance and it's called Medicare. (Or at the very least, the writing is on the wall.) Perhaps it is improper underwriting, but this program is going to bankrupt itself soon.

So, back to the able bodied who are incapable of prioritizing and budgeting for their own healthcare: The able-bodied individual should be accountable for taking care of themselves. Especially since they are (theoretically) subsidizing health care for children under 18, pregnant women, adults without the capacity to care for themselves, and the elderly.

 

The way I see it, an insurance company is a group of people who agree to chip in money in order to have a large pool of money to draw from in the event of shit going wrong. By combining a fraction of the income of everyone in the insurance plan, everyone is able to get better care when they need it.*

The way that a government affords to do things is it takes a fraction of the income of everyone in order to have a large pool of money to draw from for day-to-day operations, wars, and other such expenses. Frankly, I trust the government with my wellbeing more than for-profit corporations. The government has a responsibility to its people, and at least in the case of the USA, if it fails severely in that responsibility, then there is a chance of very bloody revolt. For-profit corporations have a responsibility to their shareholders to maximize profits, and if they fail to maximize profits, may be sued by their shareholders. This forces for-profit insurance companies to make a decision between the wellbeing of their customers and the financial gain of their shareholders.




*This is all just pure theory of course, let's not get into for-profit insurance companies, dropping insured members after they incur serious damage, etc.

EDIT: as for being forced to pay for someone else's health: you already pay for someone else's defense, their road system, their education, their basic food and shelter needs.

I guess the simplest way I can put it is to tell a quick story:
I must have been 8 or 9 or 10, and I went to Alcatraz for a tour. One of the rules Alcatraz had when it was a prison was "you are entitled to food, clothing, shelter, and medical attention. Everything else is a privilege." If we give food, clothing, shelter, and medical attention to hardened criminals, shouldn't we also give that to the citizens who haven't done anything wrong?