Health Insurance
 

There have been a number of interesting discussions in the past, but they're all buried in other threads where I can't find them...

This guy makes some interesting points, though I'm not sure I buy into his claim of speaking from a "conservative" viewpoint. Merely claiming to be a conservative does not make you a conservative any more than claiming to be a woman makes you a woman. That having been said, I did make a conscious decision not to call 911 yesterday morning when I though I might be having a heart attack, as I'm in-between employer-sponsored insurance policies at the moment, so I'm not unsympathetic. (Turns out I'm still alive, though still in moderate pain when I breathe in deeply.)


A conservative case for single-payer health care

Matthew Walther May 3, 2017

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The GOP's latest health-care push is a magic show featuring the same malnourished rabbit being pulled from the same shabby top hat Republicans have been reaching their fingers into for years before pronouncing their now-familiar incantations.

Abracadabra! they always say. Allowing companies to sell insurance across state lines! Alakazam! Block-granting — is there an uglier formulation in the English language? — Medicare to the states! Presto-chango! Medical malpractice reform! Hocus-pocus! Health savings accounts! And for my last trick, keeping the expansion of Medicaid but not paying for it!

For Republican members of Congress and the kinds of people with whom they tend to be well acquainted — defense contractors, up-and-coming fracking magnates, lawyers, purple-tied megachurch pastors — all of that sounds very convenient. For millions of other Americans, the reality is very different.

What is a 25-year-old making burritos at Chipotle for Heritage Foundation bros at $12 an hour supposed to do with the chance to funnel an unlimited amount of his meager wages into a tax-free health-savings account? Pay the rent with catheters? If he saved diligently for two or three years, he might be able to buy himself half a blood test. A colleague whose friend recently decided to open a health-savings account was forced to upgrade to a premium version of TurboTax in order to fill out the proper forms, which cost her $25 more than she had managed to put away during the previous year.

In the grand sweepstakes that is America's health-care system, I am one of the winners. My family is covered by a premium plan for which my employer pays every month without deducting so much as a penny, pre-tax or otherwise, from my paycheck. We have negligible co-pays and a whopping $500 deductible. Having two children at one of the best midwiferies in the D.C. metro area cost us virtually nothing out of pocket. If, like most Americans of my age and class, I went in for yearly check-ups, I could actually get the insurance company to pay me!

But even we have had our fair share of hang-ups. When my wife was pregnant with our first daughter, she went in for a routine ultrasound. Months later a bill arrived for something like $1,000. When I called the insurance company, they told me to disregard it because there was no out-of-pocket charge. Copies of the erroneous bill continued to pour in every few weeks regardless. Eventually they crossed paths with a much smaller bill for a second ultrasound that we were supposed to pay, but who could tell the difference? Somehow it escaped our attention and ended up with a debt collector, another black mark on a young family's credit score. This sort of thing happens to responsible people every day.

Nearly everyone agrees that our semi-private insurance-driven system is mad. It makes all the logistical sense of having the clerk at the Shell station file a claim with Geico every time you put gas in your car. The Affordable Care Act exacerbated everything wrong with the present arrangement by creating a permanent carve-out for insurance companies. Millions of Americans were left feeling the way villagers would have if the Magnificent Seven had shown up at the last minute and thrown in their lot with the bandits.

Meanwhile, conservatives insist on getting rid of the only good part of the legislation: the expansion of Medicaid. This is not because it hasn't worked but because it conflicts with Republicans' increasingly ethereal principles. Put aside for a moment the question of whether it would be desirable to return to those halcyon days when simple country doctors gave big bills to the rich, smaller ones to ordinary people, and treated the poor gratis. Is it even possible, much less feasible? No one, not even Tea Party members during the movement's heyday, has been clamoring at the door to get rid of Medicare. Even if their wildest dreams came true and they managed to get government out of health care altogether, what would happen to people in the meantime while their hypothetical army of altruist medicos mustered its forces?

The solution should be obvious. Single payer is the only way forward. The U.S. government should provide health insurance for every one of its citizens.

Already I hear the chorus of well-rehearsed objections from the right. Who's going to pay for it? Please. Every other wealthy country in the world ensures universal health-care coverage, and we are spending far more than any of them to let people above the bottom and well into what remains of the middle fall through the cracks. What about innovation? they say, as if Costa Rica, with a GDP smaller than New Hampshire's, were not a leader in the treatment of diseases such as pancreatic cancer and a destination for innovation-seeking medical tourists from around the world. (It is curious how this objection never seems to spring up in the case of the military. Should we privatize that too, lest we fall behind the denizens of the SeaOrbiter in the quest for better fighter jets?)

Single payer just isn't "conservative." Of course it is, at least if the word still means anything. Conservatism is about stability and solidarity across class boundaries, not a fideistic attachment to classical liberal dogma. When Winston Churchill's Conservative Party returned to power in the U.K. in 1951, they did not attempt to dismantle the National Health Service established six years earlier by the post-war Labour government. They tried to do a better job of running it. Conservatives in this country should get used to the idea of being prudent stewards of the welfare state, not its would-be destroyers.

Then there is the old concern about "rationing," with which I must admit to very little patience, probably because, like the claret-soaked Tories of old, I am not myself terribly interested in health. I have no doubt that if America were to adopt a single-payer system, those with sprained ankles or runny noses would indeed face longer lines. This is a good thing. Health is not the be-all end-all of human existence, and half the reason care costs what it does is that providers across the country know that they can charge BlueCross whatever they want when wealthy suburban mothers bring Dylan in after soccer practice for X-rays, MRIs, CT scans, and goodness knows what other radiological marvels, when what he really needs is a $1 ice pack.

Putting the government in charge of health care would restore it to its proper place in our lives. If conservatives' worst fears turn out to be justified, then visiting the doctor will become a very occasional half-day-long exercise in mandatory tedium, like going to the DMV or having your passport renewed. I do not visit the clinic down the street for aches or minor ailments, much less stop in to see my non-existent family physician to engage in morbid speculations concerning the potential diseases to which I might one day succumb — and neither should you.

"In the long run we are all dead," Lord Keynes said. To quote a marginally more cheerful writer, "There is nothing better for a man, than that he should eat and drink, and that he should make his soul enjoy good in his labor." There are a thousand more important things in life than fussing about health. Exercise if you want — or don't. Have a nice lunch; order a drink or two; smoke; relax with a ball game or a good book. If you're sick, go wait in line. You'll be glad not to get a bill four months later.

A conservative case for single-payer health care

That article is written from the perspective of a liberal, not a conservative. Being conservative means fiscal self-responsibility, not whatever this guy is espousing.
Health care is NOT a right. It is a service, for which one should pay.

But the whole system is messed up. There are taxes and fees and unfair pricing all over the place.

i stopped believing it was a conservative view-point from here.

a 25yo working at chiptole doesn't need/want health care. he should have thought about the life choices made between 18-25yo while still living at home covered under their parents, getting paid to protest trump and filling burritos for a living.


the only person benefiting from a 25yo paying into the system, is the 90yo that needs assistance paying for unnecessary operations.

https://ourworldindata.org/wp-conten...ion-titled.png



http://2.bp.blogspot.com/-LTx66OcW9A...1006154933.jpg


this is quite literally taking form the poor (50% of workforce is 25-44yo), and giving to the wealthy.

I completely disagree. USA is the only 1st world country that DOESNT have free health care. There was something like 1 million medical bankruptcies last year alone, while literally every other 1st world country had, you guessed it ZERO.

Health care is (in most of the world), and should be provided to all people

Discredit all of the above, since I really don't know what I'm talking about!

thumpetto00, nothing is free.


Rob, The fact that healthcare is a government-funded social service which is provided to all citizens as a basic entitlement in most other countries, and the fact that healthcare is a service, are not mutually-exclusive.



Road-building is a service, and yet the majority of roads and bridges in the US are publicly-funded.

Fire-fighting is also a service, and also ditto.

Same goes for air traffic control, war-fighting, 911 phone service, running the courts, and so on.


We, as a society, have come to accept that all of the individuals employed to provide all of those services can be paid out of public tax revenue and deficit-spending, and that's ok.
But healthcare is different. (?)

The United States was also the first country with a Constitution which gave power directly to the people and established explicit rules for the government to follow...

Ask anyone in the military how they like the VA.

Sick people costs the state in lost tax revenue.
Universal healthcare gets things done early, gets people meds for their chronic illnesses that in time will cause a high level of morbidity / death and need for more expensive treatments.
Universal healthcare costs the state, however, it also gets the citizens healthier and happier.

Universal health care does put extra load on the system, time to surgery gets longer for instance. In the country I work this applies to benign cases and the malignant ones still gets treated very fast (of course one would be able to find sad examples of the opposite, as always).

Universal health care would probably increase the tax load on the individual. But knowing that if you, a relative or friend, would get a child with a chronic and expensive disease, it will be handled, is a good thing.
Making the choice Joe had to make in the top post is absolutely alien for me, according to his description, its probably only a strain in the intercostals, tietzes or something similarily benign, but a pulmonary embolus can also hurt and of course a myocardial infarction tends to be noticeable. Not a single person over here would hesitate to see the ER for something like this. Of course that results in a lot of negatives, but they are pretty quick to handle.

I appreciate that it is a big question. But just once, the US might have to fall in line? Come on, you have the child survival of a third world country.

// Swedish surgeon.

sick people still have to pay taxes. there is no "sick" loophole in the US tax code.

wrong.

healthcare costs the few remaining taxpayers. this is not even remotely close to necessarily true.

oh, but i thought people got things done early and everyone was happy!

Canada's health care wait times in 2016 longest-ever recorded: Fraser Institute report | CTV News

you swedes should understand this:

https://scontent-iad3-1.xx.fbcdn.net...40&oe=5A4CEC8B


BWHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHA HAHAHAHAHAHAHAHAHAAHAHAHAHAHAHAHAHAHAHAHAAHAHAAHHA AHAHAHAAHAHA.



Think of all the children!


next you're going to tell us it was a good idea to let all the terrorists in your country... and that living in constant fear is just a small price to pay in order to make Mohammad feel good about himself.

I suppose I should follow up with that.

I had pain and shortness of breath all weekend. On Monday, I decided to visit a private clinic. They ran an EKG and confirmed no heart attack. They took some chest x-rays, and both the doc and the radiologist appreciated an opacity deep within the right lung, which they diagnosed as an infection. The doc sent me out with a prescription for antibiotics.

A few hours later, the doc called back, said she'd consulted with another radiologist, and asked me which hospital I wanted to go to. I said "What?" and she replied "You need to go to the ER right now. I'll call ahead to alert them, just tell me where you're going."

Long story short: spontaneous pneumothorax.

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Spent 5 days in the hospital with a chest tube. Wound up meeting a nurse who was recently divorced. We're still dating.

Managed to reinstate my prior employer-sponsored insurance plan via COBRA, at $623 per month. So that covered nearly all my expenses, which were not inconsiderable.

Did they need a radiology consult for that, seriously, that xray? its clear as day.

Well, you wouldn't want to do timed runs with that.

Brain >> not sure if you are trolling, but if you are not, then I appreciate that I won't get you to see the light. As far as your diagram goes, yep, I'd make more in the states, in fact, a lot more. But I'd have to pay a load in malpractice insurance and such as well. End point, probably around 30-40% more money, it's not like I'm starving nowadays though.

Your side of the pond is yours to run, as long as you accept global warming (oh, did I say that now) :)

As an example btw, what Joe would have paid for all that in Sweden: 300sek (er admission) + 70sek*5 (days in hospital bed) = 650sek, with todays exchange rate, thats 81.43$
Real costs: 3k sek for ER, then something like 300sek for the tube and me putting it in (a bit bundled with the ER cost), local analgetics would be something like 50sek, analgetics the rest of the stay, if needed, would be around 100-200sek, suction device for the tube, 500-1500sek. 500sek * 2 or 3 for xray and follow up xray. Labs would come in at around 200 sek. if we'd test him for alfa1-atitrypsin deficiency we'd have to add 70sek to that.

Joe would pay about 10% of that. still though, If he (sorry joe, just as an example) would be found to have lung cancer, he'd still pay only that. I assume that Joe is a productive fellow, so he would have paid at least part of that with taxes before. Luckily, not everyone gets sick.

I still find it fascinating that a simple bag of iv saline, that costs something like 4$ over here can be a couple of hundred dollars on your side. And terrorists? well, last I checked, you where the ones having trouble with that. Sure we got some IS dudes coming back, some of them even gets jailed due to evidence of them actually being IS "warriors". The refugees? they cost a lot, but they don't cause much trouble.

To be fair, that was an image taken at the hospital during my admission, not the same one the doc at the clinic was looking at. But yeah, it's pretty clear to me that the left side of the chest is filled with, well... a lung, and the right side isn't.



Haha. I did, in fact, mow the lawn with that. But I had to stop and come inside to catch my breath several times. Figured it was just due to the heat (July in the southern US is brutal.)




I've heard arguments that absence of single-payer system = higher pay = more competent doctors. Given my recent experience, I'm not convinced that's universally true. What was really hilarious is that the doc who originally misdiagnosed me called me several times while I was in the hospital to check in on my progress, and to implead that I should see her as my regular (primary care) doc after I got out.

Needless to say, I declined.

(I also don't live in North Carolina any more.)


To Brainey's point, I'm torn...


My sister has cystic fibrosis. She received a bilateral lung transplant about 8 years ago. She's unable to work, and therefore cannot access private health insurance. Over the course of her lifetime, her medical bills have easily exceeded $1m, nearly all of which has been covered by Medicaid.

By the measure of any reasonable economic calculation, she should not be alive. She is a *massive* drain on the publicly-funded healthcare system, and contributes no direct economic value to my sociecty.

On the other hand, I very much appreciate her being alive, as do her daughter, her husband, our mother, etc.

So I don't have an entirely unbiased perspective here.

To start off we must remember that Brain has no heart. So that has some effect on his beliefs.

In a single payer system your sisters healthcare would have cost the government a lot less money.

People in the military don't have to use the V.A. as they have TRICARE (which was CHAMPUS in my time). As to how this disabled veteran likes the V.A., I love the V.A. I've gotten better care in Tampa, Los Angeles, NOLA, Tulsa and Denver by my V.A. providers, than with my employer provided health insruance. To the point, that I generally go to the V.A. hospital/clinics, and let the V.A. get reimbursed by my employer provided health insurance.

Could the V.A. better? Yes, so does my dating life, yet they are both pretty good...

http://vignette3.wikia.nocookie.net/...20100912122700


I dunno what heart has anything to do with beliefs. spending other people's money with our hearts is how we got in this mess...


so that all are kept low so not one can be high is morally bankrupt.

The free market does almost everything better. Part of the high cost of US healthcare is that lots of stuff costs more in the US because we can afford the better stuff.

Part of the reason that healthcare is expensive and cumbersome in the US is the already existing Federal controls. That is typical government modus operandi. Pass laws that make some bad. Try to fix it with more laws and more $$. Rinse and Repeat. The free market kills bad ideas. Central government supports bad ideas with more money.

until it inevitably runs out. source: history.

The problem with healthcare is that it has gone beyond either health or care.

Average American: I want to eat all the full of preservatives, synthetic coloring and flavors enhancers foods, I can buy, and pretend that eating that junk won't affect my health. Average doctor/health practicioner: You should probably eat a low fat diet (bad for most people, but better than the frozen section at Wal Mart or Trader Joes), but here is a pill, for your problems!

Average American: Doctor, that pill give me XYZ, what else can you give me? Average Doctor: let's reduce dose of pill A, and give you pill B and C...

When I first moved to Denver, I saw this bumper sticker: "Healtcare, starts in your yard, and your kitchen"..

we should really get the US government to do more things:


https://slns93t2j3c4h0o42gaac81d-wpe...ance-Table.jpg
https://resources.ehealthinsurance.c...care-cost-2017

Affordable Care Act


you want more and more people in a shitty system that's less and less free-market.

.

^ Since insurance companies job, is to keep their premiums, while providing the least amount of care for most people, I don't know if the U.S. Government is doing so bad.

Nowadays, even after major surgery, most patients are sent home, right after surgery. So, if there are complications, and there usually are, patients have to go back to the E.R. Why? To save costs.

Yeah buddy, that private sector sure has it right!