Enlighten Me on Health Care Reform?

One thing I had worried about was that the purveyors of woo would see this as a golden opportunity to guarantee themselves lots of extra paying customers.

Last week, Tulsa’s fundie chiropractor radio talk show host – “Doctor” Howard Boos – was exhorting his listeners to go to http://www.adjustthevote.org to make sure that fundie chiropractic would be covered under Obama’s plan.

I’m afraid that with Obama’s plan, sooner or later, we’ll end up being forced into giving even greater funds to quacks than we do now.

Reform of health care in this country is certainly needed, and a noble goal, but I am personally adamantly opposed to the bill in Congress. As a libertarian, the thought of the federal government getting its claws into this huge portion of our economy is not only anathema, but downright frightening.

But perhaps even worse is the fact that our elected representatives don’t even bother reading the bills they vote for any more. John Conyers has ridiculed his fellow members of Congress calling for them all to actually read the bill, while he says it’s no use unless you have two days and two lawyers to tell you what it means. And after they pass these bills and the (supposedly) “unintended consequences” come back to bite them (or actually, US) on the butt, they utter variations on the refrain “Well, that’s not what we thought it would do.”

I wouldn’t feel bad that you can’t make sense of it, since the people we elect to make sense of it have thrown their hands up and decided just to vote to nationalize everything in this country. One can’t expect much else than rabid obfuscation on both sides of the issue when the proposed laws are so far-reaching and so dense as to defy understanding. And that’s not even taking into consideration the track record of most government programs.

The same people on the hill that will debate endlessly over banal trivia, try to pass trillion-dollar socialist agendas with minimal analysis and debate.

Business as usual.

It’s nice to know I’m not the only one confused about the health care kerfuffle. Part of the problem is GOP people who’ve made it their stated goal to prevent it from passing just to make Obama look bad. You might find something useful on Politifact.com. They’re pretty good about separating myth from reality.

I’m glad you had such a good experience with medicine abroad, Hemant, but my anecdote is a bit different. When I lived in Paris, I remember visiting a health center in the 13th for what I suspected was the flu. I waited five hours to see a doctor, only to be told that I had to come back the next day. I think the incentive was for me to just visit the pharmacie, and only come to a doctor if I was on the verge of death.

Conversely, on a trip to the much smaller city of Troyes, I caught the same bug and had little wait to see a doctor (maybe twenty minutes).

If we implemented a public health care program, I wonder what the disparity of coverage would be between urban and rural areas. That’s something I never hear anyone talking about.

In Germany I had them removed for free. All I had to pay for was the ibuprofen that I took during recovery.

“Free” is not entirely correct. Nothing is free, as I’m sure you know. Cost isn’t just measured in currency. All actions involve cost, and surgery has costs in effort, in time, in materials. Someone is incurring this cost. The doctor of course is getting paid, but it’s not by you. That is the tricky part, because the people who are getting hit with the cost are not immediately involved. Theoretically, everyone in Germany paid for your operation. Don’t forget they do that for an entire system.

I see the health care debate in moral terms. Do we want to have society where all members have access to proper health care or do we want to be a society where large numbers of our population do not have access to proper health care? I for one think the answer is obvious. Of course, there is the question of how best to provide everyone with access to the health care system. I support many parts of the plans being tossed around by congress, but would be happier if the progressives in congress would push through a single payer system. Unfortunately, they don’t have the guts and many of them have been bought by the pharma. and health insurance companies.

The argument I always hear against single payer is that health care will be rationed or there will be long waiting periods. Guess what – both these things already exist. It is rationed so only people who can afford it or who qualify for Medicaid can access it without going into horrible debt. A system where everyone has health coverage just means that those who don’t have it now will have it. Even if they have to wait an extra week, at least they will be able to get it. Rich people will still be able to buy better care and jump the line, but at least the rest of us can get care too.

The other big argument I always hear is the fear of government bureaucracy. Again, the current system is already a bureaucracy. I would much rather deal with a government one because then I can hold my congressman and senators accountable at the ballot box. With the private insurance I have now, I have to deal with awful bureaucracy and I have no way of holding them accountable. I know many people who have beneftied from Medicare/medicaid and their stories of dealing with bureaucrats don’t hold a candle to mine.

This is my big issue because I know what it is like to be comfortable and happy with your insurance and I know what it is like to make the decision to not go to the doctor when you probably should because you don’t have insurance or the money to pay. Not having access to health care can kill you. Thousands of people die in this country every year because they do not have health insurance and cannot afford to access the system. No one should go bankrupt because they are sick. As I said in the beginning, it is a moral issue for me. Health care is a right, not something that should be reserved for the wealthy.

Great article about this and other things

http://www.huffingtonpost.com/bill-maher/new-rule-not-everything-i_b_244050.html

As a resident in a European nation, I find the whole health care debate confusing for a whole different set of reasons.

First of all, decades of insurance industry funded propaganda have given many Americans a very very skewed vision of what Universal Healthcare is.

I hear things like you don’t choose your doctor. This is simply false. I have a GP assigned to me based on the nearest GP clinic to my home and the relative workloads of each doctor. However I can change it any time I wish, no questions asked.

I hear that public healthcare would lead to rationing, with some treatments not being covered, and the decisions not being made by doctors. All of this is true, but I am amazed that people don’t realize this is ALWAYS true. Your insurance also chooses to cover or not cover certain treatments and quite often the decisions on what is covered or not covered is not made by your doctor but someone in an office. The only difference is that in public care, turning a profit is not a priority.
Another thing I hear is that everyone will be forced into the public system. Again, totally absurd. Every single European nation has Universal Healthcare and every single one has a thriving private healthcare industry, where people who have the money can go to get care (usually identical to private care, just with less waiting). I also find it strange that people can simultaneously think that public care is this awful third-world terrible medicine that on the other hand will completely wipe out private care if it is allowed to compete.

I don’t understand it. Education is considered a fundamental right in the US but health isn’t? Yes I’m aware that public school isn’t wonderful, but would anyone argue that it should be eliminated because it’s bound to force every child in and put private schools out of business?

It’s always argued that the US has the “best healthcare in the world”. This is laughable. Oh don’t get me wrong, if you have the money, it’s absolutely the best in the world. THE best hospitals are in the US. When the very rich in Spain get cancer, they go to a hospital in Houston. However I would argue that the best healthcare should be a measure of how it serves thoe whole population. By that standard the US has a system that is more expensive and less effective than almost any other nation in the industrialized world.

To understand the issue better, download the latest episodes of Democracy Now and Counterspin.

Rachel, your comparison between the taxes you pay and those paid by your friend in Manhattan is a bit of a red herring. A person living in Toronto pays more taxes than you as well. And someone living in Idaho pays less than your friend in Manhattan, too. However, I agree with you regarding your assessment of the Canadian health care system. We have it pretty good up here.

Here’s the problem with the current debate: a lot of the right-wingers in the USA are trying to set the tone as forcing a Canadian, English, or French-style health care system on the United States, when that isn’t the question at all. What the President has suggested is something rather different.

To the best of my knowledge, the President has suggested a public-held insurance option, with the purpose of providing competition in the health insurance market, and a decent price that is affordable. Indeed, from what I understand, they want to use the full faith and credit of the United States of America to back this insurance plan, allowing them to set rates based on what people can afford.

The biggest GOP thought is to provide tax cuts for those who need to buy health care. Of course, this has ignored the simple fact that most people who don’t have health care don’t pay any taxes. Beyond that, they seem to want a status quo.

Either of these plans, of course, are completely different to the Canadian system, which is a “single payer” health care system in which the government uses taxes to pay for everyone’s health care. The USA isn’t suggesting that at all. They are suggesting creating a new insurance provider that is maintained by the government. The overall hope is to lower everyone’s costs by providing competition.

I can’t say whether or not this is a good idea – it isn’t to me to decide. But I can tell you that this new option will allow Americans who do not have health care to get it at a reasonable rate, and hopefully without concern to pre-existing conditions. These proposals are being slowly neutered, unfortunately.

Hemant, here is the thing to remember. Nobody is suggesting a Canadian-style system in the USA. I can’t tell you whether or not a single-payer system would work in the USA. But I can tell you that they are trying to find ways to extend the current system to cover more people, more efficiently.

Let’s be honest here, no one has ever died from a lack of health care. They have died from disease, accidents, and poor health. Thinking that the lack of health care kills is an easy way to confuse the issue from providing something to taking away what we already have. Health care IS indeed PROVIDED, not enforced or sanctioned

People do die from lack of access to health care. People put off seeing a doctor until it is too late because they cannot afford to go to the doctor. Emergency rooms do not cure cancer, but early detection does. Preventative health care is avaliable to those who can afford it out of pocket or access it through health insurance. There are thousands who fall through the cracks.

For example, you may not have coverage for a mammogram so you have to skip it because you can’t afford it out of pocket. Your breast cancer is discovered too late and you die from it. Other people may elect to not treat their chronic diseases because they have to put food on the table. There are people who need to take meds for diseases, but can’t afford to pay for these meds. All these things lead to early death but could be prevented if a person has adequate health insurance. These are situations that happen everyday to people who are uninsured. Yes, we have great hospitals and doctors in America, but the fact is many people cannot afford to access these resources because they do not have health insurance.

Google “Care without Coverage: Too Little, Too Late” to see the impact not having health insurance has on people’s lives.

As a Brit, the whole American healthcare debate is farcical. And for one very good reason. If congress passes decent, single payer healthcare for everyone, the GOP will be guaranteed out of power for at least a decade.

They’ve been ranting so long about the evils of “Socialised medicine” that when the american people actually see how much better every other first world nation has it compared to them there will be a backlash.

My girlfriend is disabled. She has a condition called fibromyalgia. It leaves her with constant pain and constant fatigue. She cannot work, she is on 6 different pills and takes about 17 pills a day, more when her condition flares up.
She sees her doctor every fortnight or so, never waiting more than a day from when she calls them. She attends physiotherapy, goes to swimming for the chronically ill sessions and has had MRI scans, x-rays and cat scans.

This costs her £10 a month for the drugs and the rest is free.

Now as a working man, i pay taxes which go towards our national health service (NHS), my actual take home pay at the end of the month is about 76% of my salary, after national insurance, tax and pension deductions. I consider this bloody good value for money. How much would my girlfriend and I pay per month in the states for such care? I’d guess quite a bit more.

When i threw the disc in my back a year or so ago, i saw my doctor the day after i called, got an MRI the next month (i wasn’t in much pain, just mild discomfort) then physio sessions. At no point did i hand over any cash.

Watching the healthcare debate in the states really pains me. When you see how badly screwed the american people have been, just so some rich scumbags can make even more money off them. Its sick.

And Dusty, thinking of the healthcare industry as part of the economy is wrong. The healthcare providers have no inherent right to exist or enjoy record profits. People however deserve better care than they are getting.

All this warnings of dire outcomes strike me as very hypocritical too. The GOP say that government can’t provide good healthcare, then let them start campaigning to take away the Veterns administration, medicaid and medicare. See how the public feel when wounded vets and their poorly grannies get their government provided healthcare taken away.

What I don’t understand from christians is why they wouldn’t want every person to have access to good medical care. Would there god have acted like that? Was not jesus the ultimate socialist, urging everyone to give up their possisions for the greater good of society?

Not to be the militant atheist and all (not like thats awfully hard to do), but what would the christians have to feel good about when they gave their money to the church? Many of them are under the delusion that church uses all that money to help heal and save people.

While driving down the highway near my home, I notice the churches have perfectly green lawns, satelite dishes on the roof, huge LED video screens… And two blocks away homeless are living under a overpass begging passer-bys for money.

Guess where the money they collected went to?

On to my own views…

As someone is on SSD and Medicare, and when I was back east on Charity Care in NJ, I can speak on quite a bit about how those who don’t have insurance are handled.

I had an ear infection – one of those lovely ones that was bad enough they were worried it would do perm damage. Doctor prescribed me an antibiotic, but the pharmacy at the hospital wouldn’t dispense it because I was a Charity Care case (ie: funded by the state), and they were ordered to not dispsense ‘expensive’ medications to charity cases. It took me going back and forth with my doctor in the clinic like three times before they managed to find a medication that was cheap enough that the hospital had no problem dispensing.

Or, how about being told to come back in 30 days for your appointment because all of the appointments for the charity cases are booked?

These days, yeah, I have Medicare which covers alot of my medical care, but I still don’t have reasonable script coverage. I have to pay out of pocket for medications so I can eat without throwing up, hormones to replace what my body can’t produce, and hypertension pills so I don’t pass out from dangerously high blood pressure. It gets expensive, and there are times where I need to ration what I take.

People may bash Obama for not being perfect, but at least he’s trying to make this country a better place, which is more then I can say about Bush. Change takes time, and this is just a first step.

While I admit that, as a college student, I have almost no personal experience with either serious illness or health insurance, what prickles me is the constant assertion by conservatives that we don’t have a healthcare crisis in this country. Here, for instance, see Rush Limbaugh claim that anyone can get emergency room care and pay for it later. What’s sickening about these claims is that they completely ignore the necessity of regular, preventative medical care for the millions of the uninsured.

Also, you might want to check out this New Yorker article that profiles the costliest city for healthcare in the nation. The conclusion: the major reason for a difference in costs is not at all who pays, but rather a system that augments profits in underhanded, medically valueless ways.

I may be opening the floodgates here, but would you share your thoughts on health care and whether you support or oppose the current health care bill in Congress? What needs to be changed? Yes, that’s a very broad question. I know it.

I’m not very confident in the system being debated in Congress.

Personally, I favor a system where only people who currently pay or would have to pay over X% of their income for private insurance can get into. This public health insurance would cover the poor and those with extremely high health care costs.

Covering fewer people would make the program more affordable, less likely to run private insurers out of business (not that I really care about that) and, if people get sick of long waiting times, (assuming that would be a problem) they could opt out of the system and pay more for private but speedier care.

I believe that healthcare reform is needed; Americans pay more for the level of treatment than anywhere else in the world, but I disagree with the way it is being implemented.

The primary reform being mentioned is having the government pay for healthcare, as if that would magically fix everything. Medicare/Medicaid costs have risen faster than private insurance costs, so I fail to see how government can control costs.

What is needed is addressing of the fundamental causes of costs.
1) Frivolous lawsuits – Doctors spend more money on Malpractice insurance than any other single expense. Doctors will often order tests that are not needed so that they can cover themselves in a lawsuit (my mother got a CT scan ordered for a foot sprain last month for instance). Remove or reduce malpractice suits to manageable levels and costs will fall dramatically.

2) Pay by treatment – Many doctors get paid by the prescription, causing many to write unneeded prescriptions or by the patient, causing them to rush through patients and outsource the diagnosis through scans. Simply changing the payment model to a simple salary will change things for the better.

3) Lack of communication(Doctor level) – I had my wisdom teeth out two weeks ago. I had an X-ray done by my dentist. I took it to the oral surgeon who insisted on taking his own to get the exact same X-ray. That needs to change.

4) Lack of communication(Bureaucratic level)- This one comes from my father being CFO for 5 hospital branches. Insurance companies(private and Medicare) both try to avoid paying anything. The hospital will bill the insurance company and the company will then make the hospital jump through hoops to prove the patient was actually there. My dad once actually got so sick of a company trying to dodge a 1.5 million charge(his hospitals specialize in long-term care), he copied every single chart, prescription, and related things, took a picture of the patient with his insurance card on the pillow next to him, did some other things, crated it all, and hired a moving company to ship three and a half big-rigs(18 wheelers) full of papers to the insurance company. The insurance company then tried to pretend they lost it. He had to send someone over to help them “find” the boxes (they were right were they were supposed to be and clearly marked). Obviously, such shenanigans raise expenses.

Address those issues and costs will fall to manageable levels(you will need to nudge the insurance companies a little to make them lower the rates), eliminating the need for a public option.

As far as I can see the main difference between our Canadian system and the American system is this:
Our health care system is based on providing health care to Canadians.
The American system is based on providing health care for profit.
Now I wonder which systems focus is better centered with the patients concerns in mind.
It is easy to see that both have legitimate arguments. However in my experience focusing on profits causes people to easily lose focus on the true objective.
I realize that our system has faults. But I have never been turned away from a hospital because I could not afford it. I have never been given a prescription I could not afford. If I did not like my doctor, I went to a different one. I had surgery on my knee, when I was done in the hospital and arrived home I did not have any costs that weren’t covered except my taxi ride home.
I personally can not understand why there are not riots in your streets demanding demanding regulated health care. It seems to me that the True American god is not Jesus but The Dollar, and if there is no profit in it, it is not worth doing.

The one thing I worry about with government being the primary payer source for healthcare is the effect that will have on the overall QUALITY of healthcare.

This may be completely unfounded, but I suspect that physician reimbursement will decline rather steeply if the new “public option” follows the course of Medicare and Medicaid.

As it stands now, Medicare/Medicaid reimburse pennies on the dollar. For example, if a visit to my office costs $100, I get about $30-40 if the patient is insured by Medicare/Medicaid.

In the current system, one of two things happens:
1. Doctors schedule more and more patients b/c if you don’t get paid much for seeing them, you have to see more. Nurses don’t work for free, and the rent on the building isn’t free either… This results in the patient having less time with the doctor who is overbooked.

2. Doctors limit the number of Medicaid/Medicare patients in their practice, effectively shutting out a large portion of the poor. It’s a financial decision.

If the public option reimburses like Medicare/Medicaid, then I predict you will see fewer and fewer young people choosing medicine as a career. The best and brightest will choose other options. It doesn’t make sense to accrue $100,000 + in student debt knowing that when you come out you’ll be making about $40-50 k per year. I know that doctors don’t primarily go into medicine for “the money,” but you do expect to make more than a public school teacher (no offense, Hemant) when you finish 12+ years of post high school education.

The current system is broken, no doubt, what’s worse, I haven’t a clue of how to fix it.

I know that a majority of practice surgeons are opposed to nationalized medicine because it will cut down their profit margins. My father is in the orthopaedic field and he’s a staunch advocate of keeping medicine a private enterprise.

For a long time, the medical profession was a lure because it was a good way to earn a solid living. Over long decades of reform with Medicare, HMOs, etc., doctors’ profit margins have decreased exponentially. This, coupled with the cost of medical malpractice insurance, is driving competent doctors out of full time practice, and the only people getting into the medical field are people who want to do research or only practice part time.

Becoming a doctor in the U.S. is getting to be similar to becoming a public school teacher: no one wants to do it because the job is demanding and the compensation isn’t adequate. I have a fear that nationalized medicine will exacerbate this problem, and there will be a shortage of doctors even though the demand for care is rising. Many doctors today refuse to accept Medicare payments because it’s usually several months before they are paid for their services.

And before anyone goes railing about how doctors are paid too much, I don’t think that six figures is unreasonable given the amount of post-graduate education that’s required to practice – as well as the debt that prospective doctors frequently accrue.

One more thing:

Although the principles behind the current reform bill are, for the most part solid, there is one gaping hole as I see it.

As a physician (which I am), we often order unnecessary or redundant tests for the express purpose of CYA (covering your ass). There is a real fear of being sued. One lawsuit can ruin your professional reputation and destroy your practice finanically.

Most of us practice with a “how would I defend myself in front of a jury” mentality. This is bad for the docs and the patients, not to mention the excess costs to the system.

The current plan does not address the serious problem that is medical malpractice litigation.

Talley: you went to the doctor because you thought you had the flu? If you weren’t elderly, immunocompromised, or some other high-risk group, why did you go? And what exactly did you expect a doctor to do? (Say, yes, you have the flu, now go home and rest? You need a doctor to tell you this?)

This hardly sounds like telling you to see the doctor only when you’re on the verge of death. How about, only see the doctor when 1) it’s a problem that is at least somewhat serious, and won’t just go away on its own and 2) the doctor can actually do something about it. (I don’t know how recent this incident was, but antiviral medication is a fairly recent invention, and not necessary for normal people with the flu anyway.)

I think one of the most important issues is simply defining what single payer means.

What we are talking about is not government run health care, but rather government run insurance.

The theory behind insurance is that spreading loss is a good idea. It started with a bunch of ship owners deciding to lower risk. So instead of each of 6 owners owning 1 ship each, each one owned 1/6 of each of 6 ships.
That way, when a ship sinks it doesn’t completely ruin the owner, it just gives a smaller hit to 6 owners. The bigger the number of owners, the smaller the significance of the loss per owner.

Each party got the same loss, so there was no question of profiting off of another’s loss.

That has changed. Insurance companies are run for quarterly profits and so they get up to all sorts of weaselly things to avoid paying out to cover loss. Instead of the elegant system of people collectively putting into the money pit and then taking out in a reasonable way, we now have people collectively putting money into the pot, and then the CEO’s and members of the board taking out the bulk.

A single payer option would mean that people would have an alternative system not run for profit.

I recently wrote a blog post on the topic for Homosecular Gaytheist which you can read here

In addition those who are able to afford it are entitled to pay for additional private health care. The benefits of this, at least in England, are those of luxury. Instead of sharing a ward you might have a private room. Instead of having tests over a period of a whole day you might have a scheduled time slot.

There’s nothing saying you can’t pay for better treatment with a univeral health care system. You still can use your own health insurance.

The point is, that the playing field would be leveled quite a bit for those who can’t afford such luxury as antibiotics and life saving treatments without having to sell their house, take out a loan, go into massive debt, etc.

I shouldn’t have to keep going back to my doctor to play medication roulette because a hospital is saving its medications for those who will make it a profit.

Here’s my little story.

I was working on a co-gen power plant in southern Ontario ( I am Canadian btw). I scraped my leg on one of the I-beams while on the job and promptly suffered an infection either from the paint (zinc type coating) or perhaps some dried bird shit, who knows.

Anyways, I go to the emergency room, get checked-out, which cost me nothing, got set up with a IV pump, antibiotics, VON nurse to make house calls and all it cost me was $2 for transportation of the medicine and a week off of work, which was really nice.

Also I have dislocated my right shoulder 3 damn times and each time it cost me nothing to get fixed up.

Yeah, so what, we have to wait in line for a little while and sometimes in severe pain. But lifes friggin painful at times anyways. Your repubs hate the idea because it smacks of socialism blah, blah, blah you know what I am saying. Mostly, I wonder if they feel it is a blow to their pride that someone has to take care of them. tell them to shut up and not use it if they don’t want to.

It’s my personal opinion that health care should be a right, that every American deserves to have. Along with an education, and all the rights in our Constitution. Our current system sucks, and we need some form of affordable, public health care for everyone. Maybe like Canada’s health care system, or like some of the countries in Europe, but just as long as it works for all Americans I’m fine with it. If we have to pay higher taxes for it, so be it. It’d be worth it, in my opinion.

Disclaimer:
Sorry that this turned out longer than intended… I think that it will be worth the read however 🙂

The American Civil War ended 144 years ago and Reconstruction ended 12 years after that. In the grand scheme of things, that’s a really really really really really short time so it should come as no surprise that feelings and sentiments of those engagements and time periods have managed to make their way to our time but have different social symptoms… Memetic mutation.

One of the reasons why people are STRONGLY opposing healthcare reform in a general sense is because of bigotry, racism and prejudice that comes along with the general political position (I say STRONGLY because those shock ads are aimed at scaring those people and not playing to the minds of those people that genuinely want to give critical thought to the process). One would expect that good moral behavior would implore you to want to help your fellow man, but in this day and age ruled by religion it’s so-called morality is all about ‘morality is for me and my fellow religious members and not for you; you’re on your own!’. I feel that religion is the basis of justifying one’s prejudice and hate because they feel “God made us this way”, this is what I’ve seen and heard from people who think segregation is Ok and from many others when talkin about their dislike and hatred over other races and religions. The reason I bring up religion is because it’s something I’ve taught about recently and I’d be willing to bet that people that are non-theistic are more willing to favor healthcare reform (in whatever form it is; whether single payer, public option, co-op, simply something that provides for close to all, to all) than people who are staunchly theistic. More often than not, people justify their racism through religion and God because if someone would truly understand the process of evolution and science then they would understand why we are the way we are and why we look the way we look and not have the belief that God made us out of sand and claydoh when he was bored 6000-12000 years ago and obviously made some people more special than others.

Some people have bought into this idea that their ability to make profits will be taken away from them with ANY type of government involvement and therefore go against it blindly without thinking. The reality is that within our current economic system people do not realize that as of right now, the likelihood of you becoming wildly rich is not probable. Simply put, everybody CAN’T be rich in Capitalism and therefore some sort of regulation by government is needed and who else would do it anyhow? One can’t or shouldn’t expect children to mind themselves, now would you? This is why you need authorities to regulate their behavior” And for those who cry that a public option would make the private companies go belly up and would result in completely socialized medicine, then I wonder how UPS, FEDEX and other couriers are still in business.

Another issue here is that the Republican party is primarily a Southern party and the Southerners are the outcome of the Confederacy and the “public option” and what is being called “government run healthcare” by propagandists scares them so much because the Southern states since Reconstruction have always felt that ‘big government’ means that they are being controlled by the ‘Union’. The Confederacy rebelled because of the decision to stop slavery from being implemented in other states and to ultimately end it. In some ways the War never ended, it’s just that there aren’t battles with guns anymore, but battles of ideas have continued on for the last 150 years.

Republicans today say:
1. Vote Republican and we will give you good government
2. Big government is bad and we need small government UNLESS ‘1’ is in effect then forget this.(see above)

Today’s Republican party is not the same as Lincoln’s Republicans and I’d be willing to bet that if the exact personage that we know as Lincoln was alive today he’d be a Democrat.

These names are just that… names… allegiances switch and sway and change all together all the time with political parties and reminds me of the Ship of Theseus and other paradoxes that address identity.

All in all… healthcare reform is about some measure of equity and the modification or creation of a system to help those that are disenfranchised by creating checks and balances to keep people honest. These changes are to provide benefits for all or close to all as quickly as possible, and there are some people who simply do not want that because racism and prejudice still exist today in sizable numbers, but it’s just more latent and is not acted upon in public as it used to be 50 years ago. Racism and prejudice are mental afflictions that are hard to measure unless they are converted to something physical that can be quantified, qualified and examined. Some people want some things to remain special for them alone and in a way they want a segregation of health services. “If you (the people we don’t really like read: the blacks, immigrants, foreigners) will be getting healthcare, well I don’t want that” (EVEN if it will actually benefit THEM!)

They rather cut of their noses to spite their faces.

I am British, and live in the UK. I have health insurance provided as part of the compensation package from my company. The terms of my insurance are that I must see my GP before any treatment will be approved, so the only real difference is that I have the choice as to whether I should wait for treatment on the NHS, or have earlier treatment paid for by my insurance. In one case (my cataract operation) my doctor suggested that I “go private”, not to have faster treatment, but so that he could choose the doctor that he trusted.

When I had a detached retina, the NHS treatment was quick, because delaying treatment leads to blindness. My total expenditure was probably £100 for train fares to London so that I could go to the eye hospital there. I had no medical costs.

laterose, I was really hoping that it was an ill informed caricature. 🙁

Bo does have a point. In England the National Health Service demand far exceeded the initial expectations and so costs were considerably higher than first planned for. 95% of patients went NHS rather than private in the first year. Even today the NHS is considered by many to be underfunded. Much of this is to do with the huge drug prices that pharmaceutical companies now charge but much of it is political in nature.

Once you start funding a health service you cannot simply withdraw it. The funding must come from central government rather than local taxes. Imagine if neighbouring states funded their health services differently. People would cross state lines for better treatment which would burden some states with higher costs and allow the poorly funded states to benefit. Even if this didn’t actually happen the states would claim it did and make funding a health service a political football.

If funding comes from a central tax scheme then it is a political discussion point. Who will better fund health? Democrats or Republicans? I can imagine that Republicans would take the same stance as the English Tory party and claim that lower costs come about through efficiency so lower funding is necessary while Democrats would follow our Labour party and insist that it is a service that we all benefit from. Whatever the details the nationally funded health service becomes a key point in politics once you have it. There will always be stories where something went wrong due to inefficiency or cost cutting that will keep the tabloids entertained just as there will be stories of wastage and abuse of funding. Ammunition for both sides.

Be cost benefits are that the healthy majority of people pay for the sick few so the costs of expensive procedures are spread. If 100,000 people pay for $1million of medical procedures for 1,000 people then they pay $10 each rather than the 1,000 paying $1,000 each. It’s fairer for all even though 900,000 people are paying for something that they don’t directly benefit from. Of course they might benefit from it next year or in a decade or two. I’d rather pay now and have that safety net if I need it. If I don’t then I’m sure my money will have helped someone that I know eventually.

My response is here:
Intellectual Dishonesty and HR 3200

My parents have been bankrupted by medical costs.

My father is now disabled due to heart failure that could have been prevented with early intervention, which he couldn’t get because when you’re working-class, your bosses have zero sympathy for your needing a day off to visit the doctor for preventative care. Oh, they were all hugs and sympathy when he had repeated heart attacks, though. He is also diabetic, which is very expensive.

My mother is a breast cancer survivor. Luckily, the bloodsucking insurance companies did not refuse her coverage, but there are still quite a few costs involved. Copay is one thing, but insurance didn’t really cover her reconstructive surgeries (she had a radical mastectomy). Plus, the meds she’s on are sapping her bone density, which means more meds, which means more money. I moved 2 hours away to work 2 years ago, and only once have they been able to afford the gas money to come visit me, because their combined medications cost so much.

My aunt had to be put in a home a few years ago, and when her Alzheimer’s became too advanced, insurance wouldn’t pay for her to be properly taken care of. We had to put her in a hospital psych ward.

My brother is in desperate need of mental health care that he can not hope to get on a maintenance guy’s wages. His best option is to get back into college so he can get free therapy, but he’s already swamped with student loans. When he needs urgent medical care he drives 50 miles to the outreach clinic my mom works at, so that he can get healthcare on a sliding scale.

I am lucky. I work for the state (Mississippi) and they actually have fantastic insurance. I walk into the clinic, I get seen, I give a lady a piece of paper, I walk out. I have some copay on labwork, but I haven’t yet paid over $100 for this (having a uterus is expensive). I have the option to purchase additional cancer, dental, and vision insurance (all of which suck, but all of which I kinda need).

Why in (insert deity’s) name should the rest of my family not be able to do what I can do? I support single payer, period. I will settle for a good public option, or “improved Medicare,” but I don’t think we’re getting a good public option.

I want single-payer with excellent provisions for childcare and eldercare. I don’t mind purchasing dental or vision insurance–although they are essential parts of health and I think they should be included in any health plan. Holler “socialism” all you like. Feel free to go Galt and pay for your own health care. But I support single-payer and I won’t shut up until I get it.

On this topic, there was a good article in the LA Times about how and why private insurance is such a sacred cow that any government system can’t be allowed to ‘threaten’ (ie compete with) it.

Also, don’t miss Keith Olbermann’s piece called “Legislators for sale” wherein he takes both Republicans and Democrats to task, for selling themselves to the insurance companies.

Government bureaucrats in charge of my health care? Better them a thousand times over than the insurance bureaucrats currently occupying that slot.

Wow. I got to be 70.

Just coming back from a little trip with no internet…

It seems, from a perspective of a Country “in development” (nice and polite way of saying Third World), that one of the memes, or virus-like ideas that many think tanks and media are promoting for the good of their business is that what each earns is theirs to spend, and to hell with the rest of the people. That means, less money for social needs is more money to spend in useless, superfluous, or luxurious COMMERCIAL items.

Many people don’t get it that if everyone lives better and longer, they’ll get more customers on the long run.

Why they don’t promote the concept of the helping neighbour? that is, if it were your neighbour, you’d help them even if it costs you some because you expect the same from them.

Somebody said that before me: People care for the health of others mostly if it doesn’t cost them. And so long this idea supersedes the concept of the helping neighbour, there won’t be a single-payer system.