Enlighten Me on Health Care Reform? August 2, 2009

Enlighten Me on Health Care Reform?

I’ve been following the health-care debate as best I can… but a lot of the information I’ve come across is either too broad or too irrelevant or even contradictory. I really want to support a public plan — I know something needs to change and it sickens me that so many people don’t have any coverage.

I recently read many of the comments on my Christian friend Anne’s website when she asked her readers’ thoughts on health care. Many of them are opposed to Obama’s plan, but most of their reasons are ridiculous. (Things like it’ll determine whether old people should die, it’ll take away choice, it’ll lead to Communism, etc.)

A few years ago, I was in London and had to get something checked out. I was seen by a doctor and treated wonderfully, and all it cost me was a couple pounds worth of medicine from a drugstore. That’s it. Last year (in Chicago), I had to go to the hospital for a non-emergency situation, and it ended up costing me over $1,000; they didn’t even fix the problem. My anecdote is just that; it doesn’t prove anything one way or the other. But I know plenty of people who have similar stories.

What I would like to hear are some rational arguments for or against the Obama plan. Right now, I don’t know if I could hold my own in a conversation about this issue, and that bothers me. People I tend to listen to and read are going both ways on the issue (though leaning toward the Obama side).

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.

Commenters on this site are usually clear and helpful with their words, so I’m hoping I can learn something from you all.

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  • mdcurler

    I grew up in Canada and moved to Maryland in 2000. All the arguments I hear from republicans (christians) is that health care will deteriorate. The examples they give are all anecdotal. This is what I saw and lived.
    1. Never had to wait to see my primary care physician
    2. When I had to go to the emergency room, I felt that I waited an appropriate time. Maybe 5 mins when I had a 104 fever, maybe 3 hours with a broken hand.
    3. My friends/family had similar experiences.
    4. My father had many health problems never had to wait an inordinate amount of time for any service. Cataract surgery was withing 2 weeks.
    5. Everyone gets service.

    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?

    Bottom line, socialized medicine is good.

  • Jesse

    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.

  • ErinM

    Jesse, that’s the kind of comment I want to know more about: Why do you think Obama’s plan will force us to fund quacks? I don’t see how that’s a risk — or at least any more of a risk than it is with Medicare.

    I do know the rumor that Obama’s plan would kill senior citizens was started by one woman (Betsy McCaughey – a member of a conservative think tank with ties to the pharmaceutical industry, and a proven shill willing to lie for her cause in the past) on a conservative radio show — twisting the provision that the government support efforts to get senior citizen to write living wills (which has been the federal government’s policy for about 20 years) by having Medicare provide counseling in that regard into … the government counseling senior citizens on how to end their lives sooner. As a favor to society, I think she added.

    This was picked up as a conservative talking point, of course, and she’s been repeating it herself on every available outlet.

    So that’s the history of that outrageous lie. Next commenter?

  • Dusty

    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.

  • How can private insurance companies help people when their incentive is to make money by denying as much coverage as they can?

    Living in both the U.S. and Germany I have experienced both types. In the U.S. I was denied coverage for wisdom tooth removal when my teeth were impacted, infected, and causing me a great deal of pain on the grounds that it was “unncessary”. In Germany I had them removed for free. All I had to pay for was the ibuprofen that I took during recovery.

    I have not experienced long lines or a lack of choices significantly different here than I did in the U.S.

    It is my opinion that misinformation is being spread to protect peoples’ pockets and not with any regard for my health or yours.

    I really enjoyed this interview of a former CIGNA executive on youtube http://www.youtube.com/watch?v=FmEwhakknkk

    Looking forward to reading the other comments.

  • 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.

  • Tom

    Some questions to form the debate:

    Is life a privilege or a right?
    Are you entitled to live as long as medicine can make you?
    Should pain always be avoided?

    The last question is a strange one, because most everyone would say “Yes!” But I am really asking about pain on an individual level, not a general, societal/group level. To offer care for someone takes effort, a type of pain/suffering. Consider the trade off between caregiver and the patient.

    I believe the caregiver doesn’t always have to save you from pain, or even death

  • Talley

    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.

  • Cindy

    I’m concerned about the background discussion of whether abortion would be covered under a public plan. I say, as long as abortion is a legal medical procedure in this country, it should be covered…but, of course, the religionists are getting their panties in a wad over the idea.

  • Tom

    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.

  • Rachel

    I’m Canadian and don’t understand why the US does not have a similar system. I have excellent care my entire life, through several serious illnesses, and all the arguments against the canadian system by americans are generally FUD. I strongly encourage reading this:
    “Debunking Canadian health care myths”

    Right now overall I pay less taxes in Nova Scotia Canada overall than my best freind in Manhatten and have free health care.

  • beckster

    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.

  • Luther

    Last Thursday I was in Washington at a rally for single payer with 1000-1500 others. (Note: Hardly covered by the Media which benefits by political ads). For one day we countered the 1.3 million per day lobbying by the health-industrial-insurance complex. After the rally we went and called on our congressional delegation. Also my wife and I are both retired insurance company IT employees that spent part of our careers working in aspects of health insurance. We are and have been customers of several companies and also know many people who have or continue to work in health insurance.

    We support single payer and would a accept if necessary a bill with a reasonable public option.

    – Single payer works. It works in every other industrialized country. It costs about 1/2 of what our current system costs. They are healthier and live longer. All systems have have some problems and horror stories – but they survey as more satisfied than we do. Half of my wife’s family is from Canada, they are all pleased with their system.

    – The Insurance Companies are, like all business driven by profit. They make money by not paying claims, by not insuring those who are or might get sick. United Health Care and CIGNA reported increased profits last week – on less people insured, they did it by raising rates, cutting staff, and reducing the number of risky people insured. Aetna’s profits went down, somehow they had more people insured, so they probably got “stuck” with more people who needed health care or managed to deny less.

    – A good public option would be like Medicare, as some call it “Improved Medicare”. It sets the rates, Doctors are free to join or not, people are free to choose it or private plans. Like Medicare it would have an overhead of about 3% vs around 30% for private insurance.

    – There are a lot of ways to game the system and cripple the public option. One can never be sure but on Tuesday the house bill H.R. 3200 was OK, but on Wednesday it seems to have been gutted in the compromise with the Blue Dogs.

    LBJ covered 41 million Americans with Medicare 11 months after it was passed. 3200 will cover perhaps 10 million and won’t even start until 2013 and in its current form cost us $ without the savings possible with a good public option let alone single payer.

    People like Medicare. People like single payer in other countries. The government already pays 60% of health care costs in the U.S. so single payer can be a wash in costs but a huge benefit financially for the country.

    As Bernie Saunders says, it is Progressive and Conservative – it covers everyone and it gives the most bang for each health care dollar.

    For More:

    Anyone who loves having business executives determining our health care should watch or read this former CIGNA executive and his realization that our system is not working for the public good: http://www.pbs.org/moyers/journal/07102009/profile.html

    Here is one from Paul Krugman which summarizes the economics. http://www.nytimes.com/2009/01/30/opinion/30krugman.html?partner=permalink&exprod=permalink

    Another good way to get a view of the rest of the world is to watch Sick Around The World http://www.pbs.org/wgbh/pages/frontline/sickaroundtheworld/

    And for a taste of what each of us or our friends and relatives may confront: Sick Around America


  • TJ
  • Jeff

    Search YouTube for John Stossels special on health care, it’s called Sick In America, there are six parts. Government run health care is not the solution, and Stossel does a superb job of explaing why and offering alternatives.

  • Claudia

    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.

  • capt’n john

    I will start out by stating that I know almost nothing about the US system of health care, but I do know the Canadian system. About 35 years ago I was diagnosed with intractable hypertension, of unknown cause, and extreme in nature. Since that time I have had literally thousands of visits to doctors and specialists. These visits have resulted in innumerable tests and hospital stays of up to three weeks at a time. These have all been at no direct cost to me. I do pay through my taxes for these services. I understand that I am paying taxes at a higher level than my income would suggest if I were a US resident. My drugs cost me $800.00 a year, even though I am taking drugs valued at more than $5000.00 a year. My family doctor is available to me by appointment 4 days a week with less than 4 hours notice. Emergency service is available as required, also at no charge. I do not know whether this is of any help to you , but I am very happy with the Canadian system.

  • ChameleonDave

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

  • Tom

    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.

    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

    *to make it clear, I am largely in support of Obama’s health care initiatives.

  • 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.

  • Rachel


    5 years living in the annex, then 5 years living in etobicoke. I moved to NS 2 years ago, and we did the calculations back then. I still ended up paying less taxes than my NY freind when living in the GTA, note we are both renters.

  • 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.

  • Dave Lemen

    As someone who was laid off during both of my wife’s pregnancies, I’ve seen first-hand how messed up our current system is. In the first pregnancy, my former employer was going out of business and failed to submit paperwork in-time to give their employees COBRA (the right to keep existing coverage — if, despite being jobless, you can pay the full premiums). We looked in to getting an individual plan, but the premiums were much higher, and wouldn’t cover any pregnancy related expenses for the first 10 months of the policy.

    The system we have now, which ties insurance to your employer, is really broken.

    Based on what I’ve read, I think that the best option, by far, is a single payer system. For some reason, that option was taken off the table immediately. The next best option is to provide a robust, public health insurance option that provides a safety net for people who are between jobs, or for various reasons can’t get group coverage elsewhere.

  • beckster

    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.

  • Sven

    Years ago, my Dad came down with a VERY rare type of Histeocytosis, a disease that nearly took his life. It’s so rare that ALL of the treatments for it were deemed “experimental” by his insurance ‘provider’, and the family had to pay out-of-pocket. It came to about $100,000 over several years. Fortunately, both he and his wife (my step-mom) work and we’re upper-middle-class, so we were barely able to afford it. Finances were TIGHT.

    If we were not lucky enough to be in our income bracket, my dad would be gone. I recognize that the MAJORITY of Americans don’t have that luxury, and they should NEVER be given an impossible dollar amount needed to save their loved one’s lives.

    The government is under a constitutional mandate to “provide for the common welfare” of the governed. Common sense says that if deaths can be prevented through financial assistance, then any government that cares for its people will provide such assistance.

  • gribblethemunchkin

    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.

  • jemand

    The only good argument against Obama’s plan is the insurance lobby is too noisy in Washington and is somehow going to grab a piece of the pie.

    But right now they are gobbling the entire pie so tossing them only a piece would be great improvement.

  • 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.

  • Barrett

    I second Jeff’s recommendation to watch Stossel’s Sick in America (http://www.youtube.com/watch?v=aEXFUbSbg1I). This is not conservative christian right vs everyone else. There are many legitimate reasons to be against government run health care.

  • Jon

    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.

  • Mark

    Despite all the “facts” being thrown around by both sides of the debate, public health care really comes down to how you would answer the following question:

    You and your friends are walking down the street. You encounter a man who is clearly dying. He also clearly does not have the means to help himself, to prevent his own death. Do you and your friends help?

    1) Yes, you will do whatever it takes.
    2) Yes, you will do as much as you can afford to do.
    3) Yes, as long as it doesn’t cost too much.
    4) Yes, as long as it doesn’t cost anything.
    5) No, not my problem.

    Proponents of public health care hold up #1 as the ideal, but public health care systems in the real world are implemented based on #2, leaning more toward #3.

    If you ask this to a large number of people (preferably in a forum where you are likely to find a diversity of opinion,) you will find supporters for each of the answers above. I would argue that the spread of the choice of answers to questions such as this says a lot about the kind of society we choose to build for ourselves.

    The health care debate is being framed in terms of people who can’t afford health insurance, or in terms of you much you will pay in taxes. The more important question, though, is what kind of society do you want to live in?

  • Justin jm

    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.

  • zazazoom

    I think that if we are living in a country where the government is allowed to tell us what to do at every turn and make laws for our “own good” the least they should be required is to offer free healthcare to everyone. In that way I don’t think this plan is nearly enough. It would only make insurance available to more people. There would still be people who are uninsured, and just because you have insurance doesn’t mean you can afford the deductible much less your percentage of the extortionate bill. I guess a public plan may be a step in the right direction, but without that option it would be government mandated support of sleazy insurance companies. I do not believe it is the purpose of healthcare to profit off of suffering.

  • Matthew

    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.

  • Another Atheist

    Ok, you asked for it . . .

    John Stossell is full of crap and his so-called “documentary” is full of outright lies. First of all, “government run health care” is not and has never been on the table. Nobody is proposing that the government own hospitals or employ doctors, such as is done in Britain. Second of all, if you want some perspective on alternative methods of providing universal (NOT government run) health care, check out Sick around the World (http://www.pbs.org/wgbh/pages/frontline/sickaroundtheworld/). If you want to see horror stories of people dying due to lack of medical care, watch Michael Moore’s movie Sicko.

    If you think the government doesn’t belong in the health care industry, think again. Our tax dollars already pay for the majority of medical care consumed in this country through VA, medicare, and medicaid. The private insurance companies cherry pick the healthy customers, and gain massive, obscene profits NOT providing care for them when they do get sick.

    BASIC medical care is a right, not a privilege. The same way every child in America has the RIGHT to a free k-12 education, the same way every person in America has the RIGHT to clean drinking water, and the same way every person in America has to the RIGHT to drive on public roadways, every person should also have the RIGHT to receive basic medical care regardless of their ability to pay.

    As an earlier commenter pointed out, medical care is severely rationed under the current system by ability to pay. This is a moral travesty. If you believe that children do not choose which family to be born into, if you believe that we have not yet achieved equality of opportunity in this country, and if you believe that you ARE your brother’s keeper, then rationing medical care based on ability to pay is morally equivalent to rationing food, clean drinking water, and k-12 education based on ability to pay. Is it okay to let your neighbor starve to death just because he got laid off? If not, then why is it okay to let him die due to lack of medical care just because he got laid off?

    I was laid off 2 months ago with no warning. My family now has no access to medical care except through the emergency room. I can barely pay the rent with my unemployment money, and I am not eligible for COBRA. I am desperately seeking a job, any job, but haven’t been able to find anything yet. Now look me in the eye and tell me that my children don’t deserve to be able to go to the doctor.

    My son just had a birthday and is due for his yearly checkup, but I can’t take him because to go to the doctor without insurance requires a payment of $225. That is for a basic checkup, you know, about 10 minutes with a nurse, and 3 and a half minutes with the doctor. He seems healthy, so hopefully delaying this checkup until I get another job will be okay . . .

    Am I thrilled with the current plan on the table? No, but I still support the passage of this imperfect reform because you have to start somewhere. There was a great article in the New Yorker about how reform is path dependent, i.e., you have to start from where you are. http://www.newyorker.com/reporting/2009/01/26/090126fa_fact_gawande
    I highly recommend reading it.

    And to end my rant, let me just say that there are many economic arguments for a greater government role in the health care industry. But to me, the economic arguments are secondary. This is an issue of moral responsibility. You pay for what you NEED before you buy what you WANT. The people of this country NEED access to medical care. Therefore, we must provide it. It is a moral imperative.

  • Richard P

    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.

  • I really hate to use Jon Stewart as an example (yes, i’m well aware that his show is satire), but he made a great point in his show not to long ago against Bill Kristol.

    Kristol’s argument was that a government run health care system would be sub par.

    Stewart, however, countered with the idea that the health care system our troops receive is one of, if not the best in the country (And possibly the world). So if a government run health care system is so doomed for failure, why is our military’s system so good?

    I’m personally for the Obama plan. There are PLENTY of other countries in the world with government run health care, and they all seem to be very good.

  • ATL-Apostate

    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.

  • bh

    I’m not intimate with the details of the bill in Congress, so I don’t feel I qualify to comment on that in specific. But one thing it has going for it is that it opens up health care to the democratic process. It’s not a perfect system, but as with political power, it’s much more ethical than any oligarchic distribution of access or decision-making.

  • Simon

    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.

  • But one thing it has going for it is that it opens up health care to the democratic process. It’s not a perfect system, but as with political power, it’s much more ethical than any oligarchic distribution of access or decision-making.

    The organ transplant system is in need of an overhaul. Nothing aggrivates me more then seeing some smoking rich snob get a heart/lung transplant while a young child dies because he’s way at the bottom of the list of ‘important people who needs transplants’.

  • 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.

  • Bo

    The current U.S. healthcare system is objectively awful. However, I oppose pretty much every suggestion the Obama administration and the houses of Congress have proposed so far.

    The main problem with healthcare in the U.S. is that it costs too much. There are several reasons for this:
    (1) The U.S. leads the world in pioneering new procedures, drugs, and protocols, which are expensive to develop and test.
    (2) Healthcare providers, doctors especially, have, for better or for worse, made becoming a healthcare provider very difficult. Many years of expensive medical school are required to perform even basic functions, due to licensing restrictions.
    (3) As an artifact of wage controls in World War II, most U.S. citizens with private healthcare get it from their employer. They have little say in what plans are available.
    (4) Failure to limit damages in malpractice suits has led to a spiraling of insurance costs for doctors.
    (5) As a result of (4), doctors are encouraged to prescribe lots of unnecessary procedures “just in case.”
    (6) The tax code gives hospitals perverse incentives to encourage prices too high to be reasonably paid.
    (7) State and federal laws mandate that insurance companies cover a host of illnesses and procedures that apply to only a small fraction of the population, driving up costs for everyone.

    The proposals by the Obama administration and Congress do nothing to address most of these causes, at least without destroying (1).

    To fix (2), we could make nurse practitioner and physician assistant licenses much easier to get. Basic functions should not require years of med school. There’s no reason why you anesthesiologist needs to belong to be paid a steep sum for having an assistant attend your surgery.

    To fix (3) and (6), we need to fix the tax code and get people to stop expecting someone else to take care of their health insurance.

    To fix (4) and (5), we need comprehensive tort reform.

    To fix (7), state and federal laws need to be changed. People need to be able to buy insurance policies that correspond to the types of care they might need. A 60 year old couple should not have to pay premiums on a policy that covers maternal care.

    The current proposals, and what we’ll end up getting, will do little to contain costs (I’m willing to bet on this). They’ll reward the insurance and drug companies that pay lip service to the plan.

    I’m very glad to be rid of Bush, but the debacle that this will bring will be a huge stain on Obama’s reputation.

  • Charon

    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.)

  • Charon

    Simon: “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.”

    Wow, I had no idea. The students I’m prepping for the MCAT will all be overjoyed to hear this. They were all under the impression that it was harder than ever to get into med school, because the number of spots available didn’t increase as fast as the pool of premeds.

    Good news in my field (astrophysics), too. It’s demanding and doesn’t have high compensation, so I figure it must be a snap to get a tenured faculty position!

  • DavidWillB

    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.

  • Charon

    Bo: I won’t address all your points, not being an expert in everything you mention, but
    2) Doctors in Canada, the UK, France, etc. don’t have to go to years of med school? WTF?
    3) Yes… that’s what single-payer would resolve (and a public option would be at least a step towards resolving).
    7) You haven’t been paying attention, have you? Universal health care drives down the cost precisely because it completely levels the field. Everyone pays for everything. Your elderly couple contributes to a plan that covers maternal care, and the young couple contributes to the same plan, which also covers arthritis treatment and bypass surgery. This has been proven to reduce costs overall, and reduce extreme costs on everyone.

    Tort reform may well be sensible, but it’s a term used almost exclusively by people (generally Republicans) trying to protect corporate profits. It thus makes my spidey sense tingle. (I’m not arguing that malpractice insurance rates aren’t crazy. That’s true.)

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

  • I’m unsure how the proposed system would work as I’m from England but isn’t the existing US health care system a matter of paying for the service and treatment that you receive? If you have an in growing toenail you pay a doctor or practice nurse to fix it, if you break your neck and need 20 or more years of care, you pay for it. You can buy insurance to cover you but this is often inadequate. If insurance doesn’t cover you and you don’t have the money then you don’t get treated. Is that right?

    If it is then it is one of the most barbaric systems that I can imagine, only slightly better than no health care at all. At the very least it denies health care to the poor and needy. The very people most vulnerable to unexpected emergencies and least able to pay for it. I understand that there is a basic free service but this is quite restricted.

    If this is the case, and I admit that I may have it completely wrong, then any alternative is better. Isn’t it? The question then becomes how much are you willing to pay to provide a health care system for the people? Like any form of taxation the wealthier will pay more and so benefit less. On the face of it this seems unfair but proportionally the wealthy will still pay less that the poor.

    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.

  • 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.

  • GullWatcher

    What I find puzzling about the scare tactics the right is using is that they are threatening us with things that already happen, things that are part of the broken system we are trying to fix, and for some reason that is actually working to scare people. Maybe it’s time the left started doing an effective job of scaring those same people with what it will be like if we don’t fix the system.

    Insurance is the root cause of the problems with our system as it is now. Before insurance, doctors and hospitals could only charge what people could afford to pay. Once employer-sponsored insurance became the norm, the cost of medical care exploded. Suddenly a doctor (hospital, pharmacy, etc) could charge five times what a person could afford to pay, since the 20% copay was all the patient was on the hook for, and the insurance company’s deep pockets were good for the rest. Who cares what anything costs? The insurance company will pay! Having the government involved won’t fix that, but there’s nothing else that can even begin to control it.

    Not every single thing on earth should be about making as big a profit as possible, and as long as that is the primary driver of health care in this country, we will have a hugely expensive system that no one, not even the richest nation on earth, can afford. Taking control of it out of the hands of the profit-driven corporations who now have it is the first step to fixing the system. The only way to do this is to offer an alternative – a government funded insurance plan with cost controls.

    My favorite part of the whole debate is the cognitive dissonance at the bottom of it – we can’t have a government plan, because it will be a terrible plan, and it will drive insurance companies out of business because they won’t be able to compete with it. Yup -the plan will be simultaneously awful, fail to work, and be so popular that it that it will destroy the competition – all at the same time.

  • Ryan Hill

    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.

  • christian doesn’t always = republican 🙂

    and i think i’m moving to europe.


  • Dan W

    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.

  • laterose

    hoverFrog, that’s the best description of the US health care system that I’ve read. I really can’t understand why so many of my own countrymen can’t see it for what it is.

  • 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.

  • gribblethemunchkin

    ATL apostate and Simon, fear not for the doctors paychecks. Over here in the UK doctors are exceptionally well paid. My parents both work with doctors (one orks reception and another drives for an emergency doctor service) and they know plenty of doctors. All loaded. Salaries of £100,000 aren’t unusual. And thats pounds sterling. Being a doctor over here is a very prestigious job with very good compensation.

    And frankly if other first world nations can do it successfully, why do you naysayers have so little confidence in the ability of your own nation to manage the same?

  • Mark Browne

    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.

  • keddaw

    You either view healthcare like roads or like cars.

    If you think it should be available to everyone as a necessary public service (and, btw. wwjd?) to help the sick and injured regardless of their financial situation.

    Or it is a luxury, like a car, and only people who own one should be able to drive it.

    1. If socialised healthcare is so bad why do you give it to veteransn (and politicians)?

    2. If it is so bad why do virtually all western democracies do it?

    Private health insurance ties workers (and their families) to companies and gives a ridiculous amount of power to employers.

    Private healthcare should be an option but there should be a basic but good safety net for everyone in society. If you want better care then by all means pay for it.

    But, as I said before, how can a wannabe Christian nation NOT have universal healthcare?

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

  • Bo

    Charon: Thanks for your comments.
    (Q) Doctors in Canada, the UK, France, etc. don’t have to go to years of med school? WTF?
    (A) Of course they do. They also have ever-escalating costs, just like we do.

    (Q) Yes… that’s what single-payer would resolve (and a public option would be at least a step towards resolving).
    (A) No, it wouldn’t. People would then have little say in what public plans were available.

    (Q) You haven’t been paying attention, have you? Universal health care drives down the cost precisely because it completely levels the field. Everyone pays for everything. Your elderly couple contributes to a plan that covers maternal care, and the young couple contributes to the same plan, which also covers arthritis treatment and bypass surgery. This has been proven to reduce costs overall, and reduce extreme costs on everyone.
    (A) This will increase the average cost for everyone. If everyone pays for everything, then everyone pays for the new very expensive procedure.

    Don’t confuse me with a righty; I can’t stand either side of the aisle.

    Please note my comments are meant to address the question of ever-rising costs, not goodness or fairness or usefulness (and if you oppose tort reform because Republicans usually like it, don’t.).

    Whatever the virtues of a public plan or single payer system will be, we won’t get them with what Congress passes and the Obama administration signs. Corporate profits of those who play ball will be enshrined, and we’ll be left to fix the whole mess again in less than a generation.

  • 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.

  • ATL-Apostate

    gribblethemunchkin –

    Honestly, I don’t know what docs in the UK make, but 100k pounds sounds like a lot. I’ll say this about doctors salaries:

    1. Most people GROSSLY overestimate what they think their doctor is getting paid. This even goes for people that work IN the hospital, and relatives of said doctors. I have family members who think I make over half a million, when in reality, I make less than 100k (USD, not pounds).

    a. I work in pediatrics, which is grossly undercompensated compared to other fields of medicine – so maybe I’m the outlier. I know there are MD’s who make BANK – but I’m not one of them. The healthcare system in America values the heathcare of senior citizens moreso than that of its kids. Politicians give lip service to “caring for the kids” because it sounds nice, but when the annual budget comes around, they cut Medicaid and Medicare repeatedly. As they say, put your money where your mouth is.

    b. Part of the reason we pediatricians are so poorly compensated is because of our patient mix, and lack of lucrative procedures to perform on the kiddos. 5 year olds don’t need colonoscopies, but every bloody 50year old in America “has” to have one per the new guidelines. Those rack up about $2k each for the doc.

    c. The current system does not reimburse well for people who perform “primary care.” For example, an internist who takes care of one patient with heart disease, diabetes and hypertension gets the same paltry reimbursement as he does for seeing someone with a cold. Now, if you can devise some procedure to perform on either of these patients, then there’s money to be made (whether the patient actually NEEDS the procedure or not).

    d. Any healthcare reform MUST address the completely skewed reimbursement scheme that is presently in place.


  • Ceryle

    Just thought I would add an Aussie perspective.
    Here, everyone who works pays a 1.5% Medicare levy. (if you earn over a certain amount, it is increased by 1%, unless you have private health insurance.) In an emergency, everything is covered (ironically, the only exclusion is an ambulance ride). Many other services, including cancer treatments (which my dad had recently) and pregnancy (I am doing this atm) can be either public (all paid for, your doctor is assigned) or private (you pay extra, but choose your own doctors etc).
    Whether private or public, you can choose your own GP, who can either ‘bulk-bill’ (ie they only charge the price Medicare gives them) or they can charge a higher fee, where you need to pay the gap between the two fees.
    Unfortunately, there is no Medicare on dental, so private health cover is needed for that.

  • 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.

  • Brooke

    What I’m getting from reading these comments is that so many of us are talking about a single-payer system – most comments are positive and some are negative, but we’re discussing it.

    What pisses me off so much is that our elected leaders aren’t even considering it!

    If Congress wants to play nice and pretend they’re compromising on a bill, that’s all well and good; however, why take the seemingly “liberal” option of single payer off the table if the other side isn’t taking off the “conservative” option of not doing a damn thing?!

    You can probably tell this whole debacle is getting on my nerves. There is no compromise in Washington, and I’m still waiting for change.

  • GullWatcher

    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.

  • Heidi

    I think it’s horrific that the righties don’t want everyone to have health coverage. Do they really want people like eruvande’s family and Another Atheist’s kids going without needed health care? Is that what their argument is? That it’s like Scrooge said and people who cannot afford to take care of themselves should die “and decrease the surplus population.” That is so sick and twisted.

    WTF are our taxes for if they aren’t to take care of each other when we need it? That’s certainly what I want to have first priority on any tax money the government gets from me. As opposed to, say, invading other countries and bankrolling Halliburton.

  • 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.

  • Jerad

    I love when people use the dmv analogy, I wouldn’t mind that, and for those that don’t like it they can join AAA and visit them instead, that’s what the public option is all about, giving those that can’t afford it a place to go.

    Of course I’d prefer single payer, but that was never on the table.

    As for my story, I haven’t had insurance for about 3 years, couldn’t afford it and my employer wasn’t required to provide for it. Last week I was quite horribly sick, still recovering actually. And each day I’d say to myself, well, there’s not too much blood in my vomit, if it gets worse I’ll break down and put myself in crippling debt to see if it’s anything worth worrying about.

    The bloody vomit varied day to day for about 4 days before it started lessening. And I should have seen a doctor, but that would have put me several thousand dollars into debt most likely.

    In this the richest country in the world, should someone on unemployment have to set a mark on what level of blood is worth crippling debt?

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