To "Utefan60" if Canada's system is so great, why do they have wait
list insurance?Why is it that, prior to the ACA, you were more
likely to die in Canada waiting for care than you were to die in the US because
of a lack of insurance?I think you should do some research on those
countries, and how they limit medications, limit procedures, and limit what care
you get. It isn't a limit on what they will pay for, but nationwide they do
not allow certain procedures.As for bankruptcies, in Canada, they
are due primarily to tax debt. If that isn't enough for you, their
bankruptcy rate is about the same as the US. So, do you want to declare
bankruptcy because of medical debt or tax debt. In the US few people file
bankruptcy for taxes, so does that mean Canada pays too much in taxes?If socialism is so great, tell us what nation has declared itself socialist
and has the same standard of living as the US.
Redshirt1701 - Deep Space 9, Ut, Canada has amazing universal socialized
health care. And it is working amazingly well contrary to the Fox like snippets
about it that are easy and honestly disproved. Universal health care
is a standard in almost every developed country in the world. And it works.
Germany, Denmark, Canada, Thailand, etc.I want you to research just
one question. How many Canadiens filed for bankrupsey last year due to medical
costs? There is an answer. While you are at it, tell us how many people in the
US filed for bankrupsey last year for medical reasons? Hint, it's in the
hundreds of thousands. Look it up. Universal Health care even covers
those who for a "short time were unemployed" . There are many people
who lose their job related insurance who are left high and dry when they lose
their jobs. It's a reality that the GOP just doesn't care about.
But keep using the "socialialism' arguments. They are
fasle fronts to deny millions of US citizens health care by the GOP.
To "countryvoice3" the data came from the Kaiser Health Foundation,
Census Data, and a couple of other government sites.They also state
that the numbers thrown around about the uninsured numbers are exaggerated
because they include people who were without insurance for part of the year.
That means if you lost your job and didn't have insurance for a month or
two you were considered uninsured.But lets look at what the
government did. We gave insurance to the poor, but the poor can't use it.
The government spent a lot of money to just appear to take care of a problem.
See "Even the Insured Often Can't Afford Their Medical Bills" in
@countryvoice3:You didn't really respond to any of my points,
and instead are attacking a proposition I did not make.I want to
separate "helping the poor" from "buying routine care."Because I understand one thing: The middle class ultimately ends up paying
their own way. It might come in the form of lower salary or wages, or higher
prices, or lower earnings in a retirement plan, but it does come.And
the middle class is *BIG*.So, I want to make it possible for the
middle class to pay for their own care in a way that makes the most economic
sense.You oppose this.That's understandable. Many
people would rather pay $300/month instead of a surprise $1800 expense on
average of once per year.I'm not one of those people.So, I have no objection to YOU buying whatever insurance YOU like, even if it
doubles your cost. You simply have the objection to ME buying the
type of insurance I like. Now do you understand my objection?
First of all Redshirt..your claim of less than 10% of pre ACA uninsured
couldn't afford insurance is impossible to source, and of course you
don't provide any sources so I guess you rely on some virtually dark web
connection. Of course common sense revolts at the thought that 36
million of 40 million simply refuse to cover themselves either because they want
someone else to pay or they just refuse.The closest one can come to
sourcing causes is Kaiser..the premier authority and they say.."Poor and
low-income adults were particularly likely to lack coverage, and the main reason
that most people said they lacked coverage was inability to afford the
cost."Once again you are trading in conspiratorial nonsense and
that's not with any churlish intent, just fact.
To "countryvoice3" that is nice, but it doesn't change the fact
that less than 10% of the uninsured were unable to afford it. That means 90%
either could buy insurance on their own or else qualified for a government
program.All the ACA did was make us pay twice for most of them, and
made insurance more expense for the rest of us.
Redshirt, without arguing your assertions, it's a fact from all credible
sources that non elderly citizens without health insurance decreased from 16.7 %
(where it had been since 1998) to 10.3%. A lot of the gain was in states that
expanded Medicaid. If that happened because they were now aware so be it.S C Matt.."Do you want health care to be cheaper for everybody, or
only some people?Because there are ways in which we can help people
who truly need help, but also allow a rational system for those of us who accept
that it is our job to provide for ourselves."First of all the
uninsured are generally not uninsured because they are waiting for you to pay
for them. In addition how do you determine those who "truly" need help.
Basically you've made the assumption that life and death is for sale
(market solutions) and that there are those who "deserve" your help and
those who don't. The gigantic fact you ignore is that
universal health care systems are available to all and cheaper for all..and btw
contain better outcomes as a society.
@pragmatistferlife:"but what happens when a person shows up at
the hospital you describe and can't pay at all"Do you want
health care to be cheaper for everybody, or only some people?Because
there are ways in which we can help people who truly need help, but also allow a
rational system for those of us who accept that it is our job to provide for
ourselves.And it is not rational to use insurance to pay for a
routine annual physical. Nor for a simple sinus infection, or even "Bobby
fell and needs a few stiches." And there's no reason
insurance *can't* be part of providing for ourselves. It's a great
way to cover things like double-bypass open heart surgery. And if
you read closely, the surgery center I mentioned, even though they don't
"take" insurance, has people going there with 100% of the cost paid by
their insurance company. Read the Time Magazine article.What I find amazing is that people oppose a method the provides quality health
care for a lower price.
To "pragmatistferlife" that is a lie. If you look at the pre-ACA numbers
there was a large portion of the uninsured that could afford insurance but chose
not to buy it. There was also a large number of people that qualified for
Medicare/Medicaid but chose not to sign up for it. In reality the number of
people that were uninsured, didn't qualify for any government program, and
couldn't afford insurance was less than 10% of the total uninsured.What is worse is now that we have the ACA, the poor that couldn't
afford insurance before still can't afford care because they have high
deductible plans and they can't afford to meet their deductibles. Now we
pay for them twice, instead of once.
SC Matt..for the record I'm not being snarky here, but what happens when a
person shows up at the hospital you describe and can't pay at all? You have to remember that before the ACA there were 40 million Americans
without any health insurance. I'm sure some of them were there out of
choice and could participate in your system. However the vast majority
weren't and aren't. They are there because of poverty. Our core argument here is that health care is a necessity for all in order to
have a moral and civil society. Having health care available for "all"
benefits all. If one spends any time at all in the countries with universal
health care it is obvious they have a civility we don't. A cooperation we
don't. In fact they are more democratic than we are and health care is
fundamental to that.NoNames.. keeps telling us to move because we
see a benefit in civility and a democratization of life and death..our
answer..no. We aren't going anywhere. We see a chance to engage our
better angles, and we will to continue to fight for that.
"Eds and Meds" are the only businesses left in many local economies.School teachers. community colleges, hospitals and clinics bring in all
the payroll in some towns.But that business model is not
sustainable. Neither industry creates wealth.One day we will see
that problem. For now, the blinders are firmly in place.
Those who claim that tax policy, being shielded from the cost of care, who claim
that most care is emergent or can't be shopped around, or otherwise dismiss
any analysis of health care costs beyond an overly simplistic view of what other
nations do remind me of the old saw about socialism. "When it comes to
socialism, there are two kinds of people. There are those who advocate for
socialism and then there are those who actually understand socialism."Tax policy encourages us to have insurance pay for everything possible
because a 5% profit margin on insurance is a lot cheaper than a 25% tax bill.
Insurance insulates us from the true costs so we don't make
"rational" (as that term is used by economists) decisions for the 90%+
of healthcare that is not emergent. Insurance negotiations with providers also
discourages providers from posting their rates making it difficult for consumers
to make "rational" decisions.Bottom line, I respect
others' rights to form socialist societies to handle their various needs. I
simply demand the right not to join, not to help fund, not to participate in
their folly.If the rest of the world is so much better for
healthcare and guns, please move.
@SMcloud:"The free market isn't working."The free market isn't given a real chance. And as for
shopping around, it's easy. You do it in advance.There is
enough care out there that's delivered day by day in ways that don't
involve an ambulance that you could easily weed out all of the places you'd
*never* want to go for care. They simply need to post prices.
People would see that they're the outlier and they would then lose every
bit of business *except* for ambulance cases, and then they'd lose them too
because they'd shut down due to having lost 85% of their business. This can work even with an insurance model. There's no reason that
you can't have insurance to buy your life-saving drug if it's out of
your price range. That's called risk-pooling, and it works.But
using insurance to cover routine medical care? That's like buying auto
insurance that covers oil changes. And there's a really good
reason auto insurance doesn't cover oil changes. Because if it did, oil
changes would cost $150.
To "SMcloud" but health insurance isn't like a normal market. It is
a government micromanaged system that is just a hair away from socialized
medicine. The problems that you see with insurance are due to government
"action", not the market working.People shop around for a
heart attack like you do when your car breaks down, house floods, or any number
of non-medical emergencies. People won't spend any amount for life saving
drugs. They will pay whatever they can afford, meaning if a company wants to
sell a pill for $1000 per dose that people will only do so as long as they have
money. If that pill costs the company $50 to make, it won't take long for
them to realize that they can make more money selling the same pill for $60.
Treating healthcare like it fits into a normal market isn't working.It works great with non essential procedures: think Lasik or breast
implants.But how is someone supposed to shop around during a heart
attack? How does one even know how much anything costs? What am I to do if I
can't afford a lifesaving drug -- these hospitals and pharmaceutical
companies know that we will spend any amount to save our own lives and price
accordingly. The free market isn't working.
@Unrepentant Progressive: "Problems are from excessive
administrative costs and inflated pricing from the Corporate Medical Industrial
Complex."Inflated pricing is *exactly* what you get when you pay
for every little thing with insurance, instead of a free market. I've seen this. Shortly after moving to a new area, one of my kids got
injured at a fast-food restaurant. When I took him to the emergency room, I
wasn't sure if we were going to be able to get the fast-food place to pay,
so I didn't present my insurance card. Since we were new to the area, it
was also our first visit, so they didn't already have our insurance
information.The first bill I saw was the "uninsured patient"
rate. It was half of what they eventually got after we figured out that the
fast-food place wasn't going to pay, and I presented my insurance
information. Every insurance company overpays. Every doctor bills
enough to get all that every insurance company is willing to pay. I'd love to have a real free market system. It would be far cheaper than
what we currently have.
@Pragmatist:"There is no market solution."I
would disagree. There's a surgical center in Oklahoma that
doesn't participate in insurance at all. We're talking about real
problems, like total knee replacement, not a simple hangnail.Some
*employers* are beginning to notice that these guys are far cheaper than
traditional hospitals. Search for a Time article titled "what
happens when doctors only take cash."What happens is this: The
Oklahoma State Public Employees insurance fund tells people that if they use
these guys (or others that meet the criteria) then the employee pays nothing.
No copay. No deductible. Nothing. Because paying cash is *that
much cheaper* than routing payments for medical care through 3 layers of
administrivia. I'd be interested in knowing why you think it
isn't, and that market solutions can't work.
To "unrepentant progressive" how did people get snookered by Trump, when
the problems that we currently have with the cost of insurance have been around
for nearly 40 years, and were made much worse when Obama signed the ACA into
law.You do realize that Obamacare raised costs by 40%, and has
failed to do any of the good it promised.Why would we want social
medicine? That is like saying you are tired of having a Ferrari, and want to
trade it in for a used Ford Pinto.To "Dart Thrower " if you
want healthcare to be like electric utilities, look at California. You know, the
state that has rolling brownouts, high prices, and are getting rid of effective
means of production just to look politically correct.To "marxist "
and how do things change when you replace insurance premiums with taxes?To "one old man" you have the leeches mislabeled. The leeches
are the politicians that keep burdening the insurance companies with more and
more regulation and mandates. The politicians then use their position to entice
insurance companies to contribute to their campaign funds.To
"Freiheit" look at the mismanagement in the military, do you want that
for healthcare too?
@SMcloud "When is America going to figure out what the rest of the
established world already has...."Most of the health care
systems you point to are hybrids. They tried it with all-out socialism and found
themselves going broke, so they brought back enough free market to stay
viable.We don't need to follow their course. They are swinging
back our way.@SMcloud "That's America's healthcare
system. It's a laughingstock."America's current
healthcare system is still too much governed by Obamacare, and yes, it is a
laughingstock.Now the same advocates for Obamacare want to design
our next health care system. They wrecked it once, and somehow think we will
trust them. We don't.
"Why would any rational person believe that the same government that cannot
balance the budget could possibly manage to run a health care system? The very
thought is astounding. "And yet we trust that same incompetent
government to defend our very existence with a very expensive military whose
budget no one seems able to question. We also trust our water supply,
transportation, air travel safety, law enforcement, and other vital functions to
government entities. This mindless, irrational hatred of anything government is
insanity in action, and it's costing us dearly.Single payer on
a national level would eliminate the costly middle men in our present
Health care is not free market. It is run by the AMA; there is no competition
if no one advertises prices or makes detailed comparisons between individual
doctors and hospitals; where there are no consumer reports and for a long time
insurance has not been portable. On top of that there are no
guarantees of any kind (you will be asked to sign escape clauses not holding
anyone liable) , no contract prices, and products are advertised fraudulently
in many cases. Obamacare was much much worse - but we are not free
market either, our 'private' system is not by any means completely
free of government control. Both systems ('public' and
'private') are awful. Let us try making health care truly
free market and let voluntary charitable assistance also thrive. Above all let
us live in a much more healthy way and avoid doctors etc as we would a plague.
Healthcare does not work well in the "free market"Imagine
going into a store and there are no prices on anything until you get to the end
and you can't take anything out of your cart. And they don't tell you
that the tomatoes are actually from an out of network farm so today they are ten
thousand dollars. Surprise! That's America's healthcare
system. It's a laughingstock.
The system we have now stinks. My family pays a huge premium and still have to
pay a high deductible even to start getting any coverage.My friends
from the UK can walk into an ER anywhere in the country and never be afraid that
they will get run over by crazy bills. Their taxes are not that different - add
what you currently pay to your insurance and it's about the same.
We Americans spend more on healthcare and get worse outcomes.When is
America going to figure out what the rest of the established world already has:
Universal Healthcare works.
I really don't think that it is simple to prove that health care is subject
to market forces. The analogy of emergency care is a poor one. And how many of
us go shopping for costs on treatment when it is somewhat elective or an
emergency? Or can chose one medication over another on price. The MD has
prescribed what she/he thinks best. Are we going to argue that?Furthermore, all this messenging about tax deductibility and insurance and pre
tax wages is nonsense. Problems are not from tax policy. Problems are from
excessive administrative costs and inflated pricing from the Corporate Medical
Industrial Complex.Healthcare is like clean water. We need it
universally to maintain the general welfare of our family. Indeed, not just our
immediate family, but the family of every person in the country. It should be
treated like any other utility for the betterment of each of us, rich or poor.
No Names you make a couple of very serious mistakes.First of all
just because a condition is not "emergent" does not mean it is not
serious and will not morph into a costly procedure to correct. A situation
way beyond the ability of any "free market to make personal payment
possible. Take prostate cancer as an example. In the end the costs of office
visits and tests all non emergent, will pail in comparison to the surgeries and
follow up procedures necessary because of the disease . To compare
vision correction, and cosmetic surgeries to progressive mortal diseases is
just plain ignorant. Even if costs "come down" let's
say 50% prostate surgeries and follow ups can put you on the line (with a 50%
reduction) for 40 to 50 K. Now let your wife go through breast cancer and your
gone.There is only one solution socialism..either medicare for all
or govt. regulation of health care costs. There is no market solution.
NoNames, the answer my friend is socialism. Socialism like the electrical power
to your house and the water at your kitchen tap. We need to make healthcare a
utility. Every other first world country has socialized medicine.
They spend about half of what the US does on healthcare and they get better
results. The International Insurance website has a nice chart if you want to
look it up. According to that site, the US ranks 11th in overall healthcare and
our cost per capita is about double of what everyone else pays.I
have lived overseas on several occasions and used socialized medicine. My care
was every bit as good as my experience in the US and my treatments were all
successful, including surgery in Europe.This is another example of
where the rest of the world is right and the US is wrong. The model exists, it
is well proven and it delivers good results. The only people that are you
telling you otherwise are those that are making a killing off the bloated
"freedom" model in the US.
Health insurance companies have annual profits of about 5%. This is not
surprising as the profits are all but guaranteed; Actuary tables don't
lie.Since government takes some 25% or more of our wages, paying 5%
to our employer provided health insurance is a great deal in the short run. The
long term problem is that by laundering all of our medical spending through
employer provided insurance so as to use pre- rather than post-tax dollars, we
are insulated from the costs of our medical decisions. This drives up costs.Notice that costs in vision correction and cosmetic procedures (not
covered by insurance) have come down dramatically. Dental (less covered by
insurance than many other medical procedures) costs have stayed reasonable while
outcomes have improved.The answer is not socialism. We simply need
to let individuals deduct 100% of all medical expenses: use pre tax money for
all medical costs. In that case, we have no incentive to pay 5% to the insurance
companies and we'd pay out-of-pocket for most routine care, reserving
insurance for unexpected expenses. Being exposed to the true costs of our
decisions, we'd make better choices and costs would come down.Free market.
@unrepentant progressive: "Healthcare is not subject to normal economic
rules like supply/demand."Actually, in the vast majority of
cases, healthcare is subject to supply-demand curves. In fact, every time we
bemoan that too many people, too frequently use the ER, we are admitting that
most of healthcare is not emergent, it can and should be fully subject to
supply-demand curves.Only a small fraction of health care cases are
truly emergent. The vast majority are not emergencies and so are properly
handled with regular doctor visits or a trip to a non-emergency extended hours
clinic.Vision correction surgery, cosmetic surgery, and (to a lessor
extent) dentistry & orthodontia demonstrate the power of subjecting medical
care to the free market: Lower prices and far better service and outcomes than
even 20 years ago, drastically better outcomes than 40 or 60 years ago.The problem is that both private insurance and government welfare insulate the
consumer too much from our medical choices. And, most medical providers are
loath to provide up front pricing.We don't need more socialism.
We need more free market forces.
"The irrefutable fact is that the Founding Fathers never intended for health
care to be considered an inalienable right of any kind."The real
irrefutable fact is that the Founding Fathers lived in a time when there was no
such thing as health care of any kind.That was the time when people
like George Washington -- suffering from a severe sore throat -- was treated by
applying leaches to his arms and legs to suck blood from his body because at
that time the fever accompanying infection was believed to be a result of too
much blood in the body. Washington's physician's leaches sucked out
so much blood that it killed him.Now, however, we still have leaches
in our health care industry.They are called "executives."Could it be that the irrefutable fact of our modern time is that
Americans are still being killed by having our DOLLARS sucked from us by
leaches? That, I believe, is where our modern government needs to
step in. That's probably the only chance we have. Other nations have
figured it out. Should we follow their examples?
The lead sentence in this article is " It's wages vs. health
benefits."It sure is.But the truth is that one of
the driving forces of American health benefits is the wages paid to those who
REALLY benefit from our health benefits.I challenge all readers here
to simply Google something like "Pay packages of health care industry
executives" and see what you find. You will find that top execs
in virtually every pharmaceutical company, hospital chain, or health insurance
company are taking home multimillion dollar checks every year. The average of
their pay packages run about $66,000 PER DAY.It takes a lot of
premiums, prescriptions, and hospital bills paid by those of us who need their
"services" to cover the costs of their obscene profiteering.When will we wake up and demand that our legislators do something to end this
"High private insurance premiums condemn millions of workers to stagnant or
falling incomes. "Medicare for all. Go Bernie!
Why would any rational person believe that the same government that cannot
balance the budget could possibly manage to run a health care system? The very
thought is astounding. The Founding Fathers established this Country
on the principle that the government is beholden to the people and that it has
no other source of power except the people. The great question of our time is
whether we will stay true to this principle. Will we believe in our capacity for
self-government, or will we abandon the American Revolution and accept the
left-wing claim that a tiny group of intellectuals in a far off capital can plan
our lives for us better than we can plan them ourselves?The
irrefutable fact is that the Founding Fathers never intended for health care to
be considered an inalienable right of any kind. Society disregards that wisdom
to its peril.
I like ..progressives idea that health care is a public utility. I've
always said it wasn't necessarily a "right" but a necessity. That the right is willing to treat it as a commodity is in the first
place just plain dumb, and Mr. Samuelson is very clear as to why. We may have started this path decades ago innocently but to continue the way
the right wants us to is absolutely destructive for families and America in
Samuelson again hits all the right notes.How/why American labor got
snookered by trump, and continue to be is still beyond me.I am not
at all vexed by the bite that health insurance takes out of our pay envelope
each week. And I am not vexed by the millions still under/uninsured to meet a
health care crisis. The great American health care industry eats up the
national treasury and into the pocketbooks of most every citizen of this
country. Yet, we have done little or nothing to staunch the outpouring of
billions upon billions of dollars for very poor results.It is not
the fault of Medicare, Medicaid nor Obamacare that our system is too expensive
with too little results. It is the fault of bad assumptions. Healthcare is a
utility like water and power, yet we treat it like selling cars, cereal and
widgets. Healthcare is not subject to normal economic rules like supply/demand.
Nor is it necessarily a factor of human choices.The country must
adopt almost any other system used by other western style democratic countries
(the do it cheaper with better results) to get this under control. But under
the control of the party of trump, nee GOP this will never happen.