Healthcare for everyone!

[Darwin333]

uh wrong. people who do not contribute to society do not deserve the benefits of society. this goes for EVERYONE top to bottom. I refuse for my tax dollars to pay for assholes who won't take care of themselves. People who CAN'T(very very very very very very few can't) I have no problem with, but way to many won't and we should just let them starve to death.

They generally don't starve to death. Truly hungry people usually they wait for you to leave the grocery store and shoot you in the back of the head before you even know the threat is there. Hunger is the best motivator known to man but the problem is it can and often does motivate people to do bad things instead of good. Hungry people are extremely bad for a modern and decent society.

 

[glenn1]

We really do need basic healthcare for everyone. Free for all citizens. Yes, the rest of us really do need to pay for it. Its good for society. Its good for humanity.

What do you mean, the "rest of us"? You can't honestly say this with a straight face knowing how much of the overall income tax base is paid by the wealthy. What those who are clamoring for "universal healthcare" would pay towards it would be a tiny fraction probably barely above their own costs (if even that). So at least be honest enough to say that you want healthcare for all with the rich paying for it. And besides, there's lots of options for those who are charitably minded to help pay for the healthcare of the less fortunate if you so desire.

 

[bfdd]

They generally don't starve to death. Truly hungry people usually they wait for you to leave the grocery store and shoot you in the back of the head before you even know the threat is there. Hunger is the best motivator known to man but the problem is it can and often does motivate people to do bad things instead of good. Hungry people are extremely bad for a modern and decent society.

I don't disagree, but that doesn't mean we should feed them for nothing. If they want to be dredges on society they should be treated as dredges on society, not coddled for their own shitty personal choices. Do you expect to be coddled for your terrible choices? We've all made bad ones, we've all made mistakes, how many people REALLY want someone else to pick up all the pieces for them? Not a whole lot, but to many of us feel we should do it for others regardless of what they do for themselves. IMO that's immoral.

 

[Hayabusa Rider]

I'm not following your math. If we spend 22% of our healthcare dollars on Physicians salaries compared to other OECD countries and we reduce that to 15% that's a savings of 7%. This is only one of the reasons that health care costs more here. As I said in my first post it's a few different things.

I see now. I was looking at gdp figures. Salaries could be cut which would kill supply since they would be below income for like education and physicians have to wait longer before they realize that pay. I think that encouraging the kind of resources we'll need at the right place at the right time without needless duplication of resources would be most beneficial, but that involves commitment to something that might be best implemented by means not to the greatest political advantage.

 

[the DRIZZLE]

I see now. I was looking at gdp figures. Salaries could be cut which would kill supply since they would be below income for like education and physicians have to wait longer before they realize that pay. I think that encouraging the kind of resources we'll need at the right place at the right time without needless duplication of resources would be most beneficial, but that involves commitment to something that might be best implemented by means not to the greatest political advantage.

I'm not advocating forcing cuts in doctors' salaries, I'm arguing that the higher levels of those salaries in the US is evidence of restrictions in the supply of doctors created by the AMA and state medical boards. We need more med schools and we also need to move some of the work to lower cost workers like PA's and nurses. This is only one of the reasons that our medical costs are so high so it won't be a magic bullet.

 

[werepossum]

Completely false. Even the Democratic Senate that produced the healthcare bill found that only 15-20% of healthcare costs related to the overhead and profit of the insurance companies.

There are three major reasons that health care is more expensive in the US than other places. We receive more and higher quality healthcare, we live a less healthy lifestyle, and doctors here make far more money than in countries with single payer systems.

It feels better to go after the insurance companies than the doctors but if you put your feelings aside and look at the numbers it's clear where the money is going.

This is all true, and until we accept that these things are true, and thus that there are no easy answers, any change we make is likely to make our health care worse. More strictly rationing health care means more people die of unlikely causes diagnosed only by defensive medicine. Mandating a healthier lifestyle means less freedom to make unhealthy choices. Less well paid doctors means we no longer have our best and brightest going into health care and thus worse care. There are no easy answers; there is no free lunch.

The vast majority of money consumed by insurance companies will be at least matched by any government program. Right now government has the luxury of passing some of its costs onto non-government payers by mandating lower than market payments, but once we shift to a single payer system that apparent cost savings vanishes and care must inevitably get worse. To some extent that's acceptable to cover more people, but without accepting that fact (and the fact that when something desirable is "free" people consume more of it) we're stuck demanding a free lunch that does not and cannot exist.

 

[WhipperSnapper]

Simple, important, correct. The only real issue here is how 'change' is hard for people.

If the public does finally decide that it wants socialized medicine, perhaps after the costs of our current system have skyrocketed to 20% of GDP, making the change will be akin to the effort needed to put a man on the Moon or more likely, to fight World War II.

Give the American populace another 20 or 30 years for the effects of a dwindling middle class to change the populist Republican-types' and free-marketers' economic mindset and it could happen.

 

[WhipperSnapper]

Who is going to collect the funds and make the needed payments for the health care providers?

That's a very legitimate question. Paying for health care could simply become part of the income tax. (Instead of spending 17% of our GDP on health insurance and health insurance-related industries, people would instead spend a smaller percentage of GDP in the form of taxes. Does it really make a difference what pocket your money goes into for the same service?)

What is the determination of basic?

Any health care that is required to either save a person's life or to increase the quality of it other than frivolous cosmetic surgery (unnecessary breast enlargements, etc.) or expensive and futile attempts to extend bedridden dying elderly people's lives for another 3 or 6 months.

Not saying that we need the insurance companies; but otherwise; who will step in.

Here's a worthwhile PBS documentary about how other first world (and predominantly free market) nations do it:

Sick Around the World: Can the U.S. learn anything from the rest of the world about how to run a health care system?

 

[WhipperSnapper]

Completely false. Even the Democratic Senate that produced the healthcare bill found that only 15-20% of healthcare costs related to the overhead and profit of the insurance companies.

Note that just because those politicians are Democrats, that doesn't mean that they aren't in the pocket of Big Pharma, Big Insurance, and Big Healthcare and that they thus weren't motivated to try to make the numbers look more favorable for them. (Our politicians know where their bread is buttered.)

There are three major reasons that health care is more expensive in the US than other places. We receive more and higher quality healthcare, we live a less healthy lifestyle, and doctors here make far more money than in countries with single payer systems.

It feels better to go after the insurance companies than the doctors but if you put your feelings aside and look at the numbers it's clear where the money is going.

Do you really think it's the doctors, many of whom only make around $150,000-200,000/year while having to pay off large student loans (with mostly after-tax money), who are the problem? My wife had some major surgery a couple years ago and the total cost was about $21,000. The surgeon's portion was only about $1500 of that.

Also, the administrative costs are not just in the form of insurance companies, but in all of the other people who don't have anything to do with the actual provision of health care (all non-nurses, non-doctors, and non-technicians, etc.). The people who handle the billing and the front-line screeners who make sure that you have the proper health insurance, etc., are a part of the cost. Health insurance brokers are part of the cost. Company benefits plan managers in HR are part of the cost. Hospital and (prescription-based) pharmaceutical advertising is part of that cost.

I wouldn't be at all surprised if 40-50% of all the people whose income comes from providing health care have nothing at all to do with the actual provision of health care.

 

[airdata]

With $1800 in medical bills in front of me from when I had the flu... i'd have to agree to some extent.

Or maybe I just need to get a better job where my insurance actually covers things other than major injuries w\ $5k deductible.

 

[WhipperSnapper]

The Washington Post had a good article on this today. Republicans are really good at screaming "Kill Obamacare! Kill Obamacare!" And that wonderful, amazingly better alternative they've been promising? Details later. Much, much, much, much later. (Don't hold your breath.)

http://www.washingtonpost.com/polit...lth-care-law/2011/12/14/gIQApUB8FP_story.html

And there you have it, folks, the whole Republican strategy wrapped up into and small, easy-to-understand package: demagogue Obamacare, but never, ever put forth a specific plan for an alternative. Because any specific alternative that substantively addresses the "volcanic issues" listed above is going to be at least as bad as Republicans claim Obamacare is.

Awesome post! You win my coveted Post of the Week award. That article totally pwns the loud-mouth Republicans. The Republicans' real plan for the lower classes is, "Don't get sick, and if you get sick, die quickly."

 

[WhipperSnapper]

They generally don't starve to death. Truly hungry people usually they wait for you to leave the grocery store and shoot you in the back of the head before you even know the threat is there. Hunger is the best motivator known to man but the problem is it can and often does motivate people to do bad things instead of good. Hungry people are extremely bad for a modern and decent society.

In South America, or at least in parts of Brazil, it's gotten to the point where those people form organized gangs and then kidnap members of wealthy families and hold them for ransom. There have been stories about the mothers of professional soccer players being kidnapped, etc.

There's a Brazilian documentary called Manda Bala (Send a Bullet) all about this. It features the daughter of a wealthy family who had her ears cut off, a plastic surgeon who specializes in reconstructing ears for such people, and a businessman who purchases an expensive bulletproof ("kidnap proof") car who goes on to take anti-kidnap driving classes and who considers having a radio transmitter tracking device inserted into his body. (I saw this film on a cable channel.) There's another documentary out there called Ransom City where the filmmaker actually interviews such kidnappers, which I'd like to see but haven't seen.

Consequently, the wealthy in many third world countries live behind walls topped with barbed wire and have security guards. Some even travel back and forth to the office by helicopter to avoid having to go into the streets.

 

[WhipperSnapper]

What do you mean, the "rest of us"? You can't honestly say this with a straight face knowing how much of the overall income tax base is paid by the wealthy. What those who are clamoring for "universal healthcare" would pay towards it would be a tiny fraction probably barely above their own costs (if even that). So at least be honest enough to say that you want healthcare for all with the rich paying for it. And besides, there's lots of options for those who are charitably minded to help pay for the healthcare of the less fortunate if you so desire.

But how did the rich become rich? Could part of how they become rich come from paying workers less money than they deserve, money that those working poor workers could use to purchase health insurance? Do rich people actually produce all of the wealth they consume--do they actually go out and do the labor that's required to make them rich? Does a rich man work 200 factory jobs at once to earn the income he consumes? Does pushing paper around and telling other people to work constitute actual productivity?

I'm not saying that intellectual contributions are not productive and don't have value and that many wealthy people don't deserve much of the money they have, I'm just trying to encourage you to question the free market, capitalist dogma. Have many of these rich people actually put in the human effort needed to consume the value of the wealth that they get to consume?

You know, Atlas Shrugged-loving capitalists aren't the only ones who believe that people should get what they deserve or consume the amount they produce. Free marketers don't have a monopoly on that belief nor on the concept of "justice". I'm not an expert on socialist and communist ideology, but I'm under the impression that that exact same belief is also part of those ideologies. (The slogan is "WORKERS of the world unite", not "Drug addicts and lazy bums of the world unite.")

 

[ccbadd]

I would fix heathcare by:
1. Pass a law that requires medical providers to have a single set of rates for everyone rather than one for each insurers and one (usually huge) price for the uninsured.
2. Make HSA's as easy to set up as a 401K and allow anyone who wants to, to self insure through an HSA. Add catistropic coverage and start young with the HSA, and you will never be a burden.
3. Put people who hire illeagal aliens in jail and take there personal wealth to pay for the burden they place on the health care system.
4. Require anyone who is capable to work off the cost of healthcare if they do not have the financial means.
5. Most important, do not allow ANYONE to work in a government job more than 10 years! Politicians and bureaucrats alike all the way down to the county clerks. I would, of coarse, exempt police, fire and rescue, and teachers, maybe a few more too. This would help with a lot more than healthcare.

This is just a framework, but this is how I would start.

 

[glenn1]

You know, Atlas Shrugged-loving capitalists aren't the only ones who believe that people should get what they deserve or consume the amount they produce. Free marketers don't have a monopoly on that belief nor on the concept of "justice". I'm not an expert on socialist and communist ideology, but I'm under the impression that that exact same belief is also part of those ideologies. (The slogan is "WORKERS of the world unite", not "Drug addicts and lazy bums of the world unite.")

Well, "universal" healthcare means exactly that those with greater healthcare "needs" are going to be the ones who soak up most of the resources, and those will predominantly be those who make those bad decisions like drug addicts. So instead of having to pay only for your own healthcare, you'll essentially need to pay for your own plus additional taxes to cover their healthcare as well. For progressives, it means that every time you read a story about some redneck moron's antics on Fark.com ("hey y'all, watch this!"), that you're asking to pay for his treatment. Personally, I'd rather progressives donate to charity to handle this if that's what you want to do.

 

[the DRIZZLE]

This is all true, and until we accept that these things are true, and thus that there are no easy answers, any change we make is likely to make our health care worse. More strictly rationing health care means more people die of unlikely causes diagnosed only by defensive medicine. Mandating a healthier lifestyle means less freedom to make unhealthy choices. Less well paid doctors means we no longer have our best and brightest going into health care and thus worse care. There are no easy answers; there is no free lunch.

The vast majority of money consumed by insurance companies will be at least matched by any government program. Right now government has the luxury of passing some of its costs onto non-government payers by mandating lower than market payments, but once we shift to a single payer system that apparent cost savings vanishes and care must inevitably get worse. To some extent that's acceptable to cover more people, but without accepting that fact (and the fact that when something desirable is "free" people consume more of it) we're stuck demanding a free lunch that does not and cannot exist.

Very well said. It's impossible to have an honest discussion about the trade offs that are inherent in getting costs down.

 

[child of wonder]

Very well said. It's impossible to have an honest discussion about the trade offs that are inherent in getting costs down.

Seconded.

It feels great to think about a world where everyone is provided free healthcare. However, there are two realities that don't make it work:

1. When people are handed things rather than earning them, they take them for granted. Evidence of this is everywhere. Free healthcare would be abused to the point of implosion and we'd be left with a worse situation than we're in now.

2. Someone has to pay for all this free healthcare. Unfortunately, there are many people out there who will not or cannot contribute which leaves others with a higher burden to pay. Part of the reason free healthcare is appealing is because of the inequality it corrects -- however, solving one inequality by creating another isn't fair.

There are no easy solutions whatsoever. Every idea I come up with also has at least 2 negatives that make me discard it.