Healthcare Debate in USA

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nutjob

Gym climber
Berkeley, CA
Topic Author's Original Post - Sep 6, 2012 - 06:48pm PT
Maybe it will fail in flaming abuse, but I'd like to see issue-centric threads like this rather than pure politard threads that boil down to democrat vs republican, I'm right you're wrong name-calling fests.



USA HEALTHCARE DEBATE

As a society and as a government we have enshrined the right to "pursuit of happiness," but that is pretty tough if you live in pain or are limited by untreated medical conditions and can't afford to go to the doctor.

I used to think medical care should not be a basic right, but rather an elective thing, something we work hard to purchase (maybe one of the most valuable reasons to earn money). Now I have come to believe that the question about universal healthcare is a defining pillar of civilization.

We are not a civilization if we don't treat our citizens in a civil way. Being left to die or suffer terribly or have a lifetime of financial planning flushed down the toilet because of an accident or a newly diagnosed disease, or for something similar in a loved one....

Yes I fear the bums taking advantage of the system. No it's not fair. But I would rather that the bums are human beings who might be lonely and go to the doctors too much, or people who don't take care of their body and incur excess health costs. These bums are actually cheaper than the corporate bums, such as pharmaceutical companies that bribe FDA executives with future executive employment if they approve questionable drugs sooner, to extract more money from citizens before the patents run out.

And why should for-profit health insurance companies be legal? It seems to be in moral conflict with a basic desire of every country to promote the health of its citizens. Imagine a heart surgeon haggling over price with the family at the moment the patient goes into cardiac arrest. Oooops, market conditions changed, the price for that bypass just went up 10 times. Free-market capitalism is not applicable here, because there is not a free market, no equality of choice between suppliers and demanders both willing to walk away. It is silly to apply notions of free market capitalism to healthcare decisions for this reason. Healthcare "capitalism" amounts to extortion. For-profit insurance companies are just a slow-motion extortion, but no less conceptually gruesome than the heart surgeon haggling with the family in the critical moments. At some point we do have to face limits about healthcare costs and make hard decisions about what an extra amount of life is worth paying for and what the quality of that life should be. But that is a healthy debate to be had on a national setting without the clouds of profit-motives to muck things up.

Why does universal right to healthcare rank below the corporate profit motive in America?

Right now the U.S. national debate about healthcare (and how to pay for it) pits the uninsured against "everyone else". In other words, we have this burden of uninsured people that we have to pay for, where will the money come from? Many other countries face the same dilemma, but frame the argument totally differently. They take it for granted that people will be insured, and the budget problem they face is "we have struggling hospitals, pharmaceutical companies, and doctors are protesting for higher wages and better working conditions, but how will we pay for these things while keeping our guarantee for universal healthcare and reasonable quality and wait times?"

Why do we, in America, give the corporate-right-to-profit a sense of sanctity and exemption, freedom from the political haggling and budget-tightening discussions, while we don't give the same sense of sanctity or exemption to human beings who face death or debilitation or long-term suffering for lack of access to affordable healthcare.

How to pay for it? Eliminate for-profit insurance companies, develop a national fixed price schedule for treatments, mandatory participation by all citizens with government subsidies for poor folks, and no denial of coverage for any reason.

Flame away.
Curt

Boulder climber
Gilbert, AZ
Sep 6, 2012 - 06:51pm PT
No flaming here. I happen to agree with you.

Curt
mountainlion

Trad climber
California
Sep 6, 2012 - 07:27pm PT
My aunt Connie was vaccinated for polio in the 50's and ended up contracting polio (I think this was a government vaccination but I dont know).

I also worked for Farmer's Insurance Group (property insurance). I was a call center employee (through a temp agency while in college). I worked with at least 50 others as the first contact the insured had when filing a claim. It was my job to handle the call, process the claim (so and adjuster would visit).

Our goals were very clear:

Be very polite.

Try to give the insured the "run-around" hoping they drop the claim by forcing them to call back with additional information when filing their claim.

When they do call back with additional information pretend that the previous information they provided isn't showing up on the system.

Disconnect the call if they begin to be agitated.

Be very polite.

We had a supervisor who could monitor our calls and disconnect the insured at will. They insured we did our job how the company wanted us to or
we would be removed (easy to do as we were hired through a temp agency).

At least half of our insured dropped thier claim because of the difficulty in succeeding. I remember one claim particularly vividly. The insured had recieved a check for $300 for his roof. He called in LIVID he said "I have had Farmer's Insurance for 30 years and this is the first time I have filed a claim. I don't have a roof on my house (from a tornado) and you are giving me $300 for a job that costs $10,000?" "I want that adjuster back out here". This insured battled with the insurance company over the phone for several months recieving several small checks as payment. Then he wrote a detailed letter. In the end he did get his roof replaced in full by the insurance company but he was in the minority. His persistence was the only reason he succeeded. Most were not as tenacious.

Given the choice of having the government be the primary contact with the hospital and care providers (doctors, nurses, etc) through a single payer system (similar to Medicare) or having the insurance company be the primary contact (like we have now). I prefer a single payer (medicare)type of program. Not some greedy vultures who want to profit off my misfortune, deny coverage, and profit off of collecting my premium while denying that coverage.
Norton

Social climber
the Wastelands
Sep 6, 2012 - 07:34pm PT
I prefer a single payer (medicare)type of program. Not some greedy vultures who want to profit off my misfortune, deny coverage, and profit off of collecting my premium while denying that coverage.

well said
k-man

Gym climber
SCruz
Sep 6, 2012 - 07:46pm PT
In 2010, the United Healthcare CEO made over $100 Million.

Do the math on how much per day that gentleman was making, it will curl your innards.

Believe me, he didn't make that money by writing checks. Healthcare for profit is a sin.
HighTraverse

Trad climber
Bay Area
Sep 6, 2012 - 07:50pm PT
Single Payer

anything else is failure
And Obamacare is going a long way to prove it.
Unfortunately single payer was DOA when Obama was elected and is probably even more dead now.

By the way, there are a multitude of ways to implement and pay for "single payer", just check out the Euros. I don't believe any two countries do it the same way. Some are better than others.
None have as poor healthcare outcomes as we do.
Jody

climber
35/53k
Sep 6, 2012 - 08:17pm PT
And why aren't you guys jumping on him for another political thread?

Oh, that's right, you agreee with him.

Hypocrites.
Lennox

climber
just southwest of the center of the universe
Sep 6, 2012 - 08:55pm PT
Jody,

You wouldn't know a hypocrite if he was staring you in the mirror.

And just as you don't have the capacity to use logic or discern the difference between a liberal, a socialist or a communist, likewise you can't see the difference between this thread that centers on a real topic of interest, that affects everyone, which is worth discussing, and the purulence you discharge into the forum when you want to stroke yourself.



Who cares where Obama was born?!


Jody

climber

35/53k


Topic Author's Original Post - Sep 3, 2012 - 05:30pm PT

The problem is where he lives now.




Jody

climber
35/53k
Sep 6, 2012 - 08:59pm PT
Thank you. Thank you very much.

I guess certain off-topic posts are okay. And others aren't...I get it now. And Lennox decides which ones. Cool.
nutjob

Gym climber
Berkeley, CA
Topic Author's Reply - Sep 6, 2012 - 09:03pm PT
Hi Jody, I tried to find a pre-existing thread on the topic, so I could deny this coverage. But I just got a bunch of hits on Why Republicans Are Wrong On Everything and didn't want to go there.

Sickness and death don't care which way you vote. I'm not looking for a thread about politicians and their policies and criticisms thereof.

Well, if a very specific policy is advocated by a specific candidate, then fine let's discuss the merits or demerits of that policy. But let's skip the whole labeling of groups of people and politicians part and stick to what is good or bad about different proposals and why.

That's my objective in this thread anyways. I was inspired to this theme by Base104's recommendation of a Frontline episode "Sick Around the World" on the Netflix Gems thread.

The main points I got after looking at a variety of country's approaches (seeing good and bad of it) seem to be:
1. Mandate coverage for everyone (no opt out, no exclusions)
2. Fixed prices for all services to cap costs
3. Instead of insurance profits, if you have money left over you roll it over year-to-year and use it to increase quality and decrease wait time, or reduce premiums.

Some countries have struggled with hospitals at risk of going bankrupt, or doctors protesting in the streets for better pay and working conditions. Frankly I think those are healthier societal problems to be debating, having the budget debates about how to pay for those problems, rather than talking about how we are going to pay for all these people who don't get healthcare today.

Instead of taking it for granted that healthcare and insurance providers are safe thriving businesses, let's take it for granted that EVERYONE will get healthcare coverage and see what problems that presents and try to tackle that.
HighTraverse

Trad climber
Bay Area
Sep 6, 2012 - 09:05pm PT
Jody
It shouldn't really be a PARTISAN political problem.
Our healthcare SUCKS regarding, cost, patient coverage and medical outcomes. ALL of the data supports my claims. It's a national disgrace.

What ideas can you contribute?

<what nutjob said>
Jody

climber
35/53k
Sep 6, 2012 - 09:17pm PT
nutjob, my problem isn't with you starting the thread at all.

I have a lot to say on this subject including touching on a lot of the points in trhe O.P., however, time is of the essence, so I will make one point for now.

Just because someone is uninsured, doesn't mean they have to be.

Personally, I have known uninsured people who live in a way nicer home than me, make more money, drive nicer cars, have boats, motorhomes and motorcycles, fancy entertainment centers with 70" flat screens, smart phones that cost $300/month, satellite and cable TV with all the extras costing $300/month...and the list goes on and on. I for one, am a little miffed that I have to pay for someone's health care COVERAGE(coverage is the issue, not health care itself) when it isn't high enough on their priority list to do without some of the non-essentials I listed.
climbski2

Mountain climber
Anchorage AK, Reno NV
Sep 6, 2012 - 09:20pm PT
To me it comes down to what is the purpose of having a government.

In my mind it is to pool our collective resources to provide basic services that are not best provided by private business. Things like an army or a fair justice system, roadways and basic infrastructure are things we take for granted as basic government functions.

IN order to ensure LIFE LIBERTY and the PURSUIT OF HAPPINESS.

Now for that "in order to ensure the life of it's citizens" thingy. Seems like a pretty good basic priority of any government. What are the best ways to do that. An Army? maybe, probably a good idea. Police, sure Firefighters, yep

How bout medicine!!!!!!!! Seems like the most basic of all concepts when it comes to ensuring our lives.

There are all kinds of reasons to pool resources for economy of scale when it comes to at the very least financing our medical system. There are good reasons for taking the profit motive out of the finance part ie the basic capitalization.

SO yes on the basic finance level it seems to me well proven that a single payer tax system for financing our helthcare is the most efficient way for us to get what we ALL need at some point in our lives.

I suspect it is important to leave the profit motive in to some degree when it comes to who is paid that money for services and actual products. This gives incentive to be a good provider and to develope new and better medical procedures and products.

A lot of nations have various ways to make sure their citizens have healthcare. The USA DOES NOT!

Various mixes from pure socialized medicine (like the VA) to Singlepayer via taxes (like Medicare) but privately owned hospitals and private doctors, to mixes of private and public health insurance.

I just simply cannot understand making any claim to some sort of moral greatness or for that matter any greatness whatsoever if your nation cannot take care of the most basic needs of it's citizens.

multiple private insurance pools are a ridiculous way to get the best effect ..even if you have it it is more expensive than simply paying taxes into a single pool that covers everyone completely .. period. It gives this single pool of finance the clout of monopoly to make sure it gets good rates, it spreads the risk most fully, it does not need to make a profit which raises your cost.
Curt

Boulder climber
Gilbert, AZ
Sep 6, 2012 - 09:30pm PT
Jody,

You wouldn't know a hypocrite if he was staring you in the mirror.

And he is.

Curt
nutjob

Gym climber
Berkeley, CA
Topic Author's Reply - Sep 6, 2012 - 09:38pm PT
Jody, I hear you on being miffed for people scamming the system.

If healthcare was a mandate, then it would reduce people using other discretionary spending to justify not being able to afford health insurance. Point in favor of mandatory coverage.

And as for scammers in general... I finally accepted that yes there will be people ripping off the system. It does get under my skin because I was raised in a very self-reliant and hard-working way and it pisses me off to see people get something for nothing. But. That seems a lesser evil than the alternative of people who really need the coverage and despite their best efforts to live responsibly and plan appropriately, can't afford the coverage and have their life devastated by it.

There will still need to be some sort of oversight/regulation to hunt for individual offenders. In Taiwan, they have automated flags when someone goes to a doctor 4 days in a week or 50 days in 3 months, or something like that. The specifics don't matter as much as the concept of being able to flag over-consumption and then try to address the root cause. Having all this data centralized to make it easier to audit/flag such stuff (abuses of individuals and abuses of doctors who facilitate false claims) would be an advantage of a single-payer system. Point in favor of single payer.



+1 for climbski's post too
Jody

climber
35/53k
Sep 6, 2012 - 09:42pm PT
Just don't look to Canada to be an example(as many here do).

From digitaljournal.com:

The Canadian Medical Association (CMA) says Canada's health care system is failing to meet the needs of Canadians and is in urgent need of reform.

According to a report titled "Health Care Transformation in Canada: Change that Works, Care that Lasts" that was just released by the CMA, Canada's health care is in serious trouble.
The report states that Canadians are not receiving the value they deserve from the health care system, ranking last in 30 countries surveyed in terms of value for money spent.
The Canadian Medical Association says Canadians are "increasingly concerned about the lack of timely access to see their family physician,the long wait times for diagnostic testing, a widespread lack of access to specialists and specialized treatment and the compromised quality of care in overburdened emergency rooms."
The report states that the biggest factor in long wait times for health care is the lack of physicians as Canada's physician supply relative to the population is far below average.
Since Canadian teaching institutions do not produce enough physicians to meet demands, Canada cannot expect to make up the difference without new sources of physicians.
Lack of access to prescription drugs is also an area of concern.
Prescription drugs represent the second largest category in health care expenditures but only 50 percent of drug treatments costs are covered by health care. According to the CMA, the situation is "catastrophic."
Norton

Social climber
the Wastelands
Sep 6, 2012 - 09:46pm PT
I'm with Jody on his being pissed that he and I have to pay a little extra out of our income taxes and increased health insurance premiums for those irresponsible as#@&%es who "choose" to go without health insurance.


When, and I mean WHEN, they "need" healthcare, federal law set decades ago requires
the emergency rooms to treat them.

And there is nothing FREE about that treatment.

The Hospital bills the Federal government and Jody's healthcare company pays a little extra to pay for that healthcare of the freeloaders.

The Affordable Care Act, as Jody knows from reading it, will do away with the freeloaders by requiring them to either fuking "get" healthcare or pay a fine for not having it.

I, like Jody, am sick and tired of people sucking off us taxpayers and getting a free ride.

You damn right I support the President and new ACA, especially for this reason.
mountainlion

Trad climber
California
Sep 6, 2012 - 09:49pm PT
Jody I love your argument that you have "known" someone who has all those luxeries but chooses not to buy health insurance.

I think you made this person up, to create a hypothetical debate.

How did you find out that this person has all of this stuff? Is it your brother, sister, in-law, friend? How did you ask the question or did they just offer the information.

People I know who have those luxury items have enough disposable income to pay for health insurance AND THEY PAY FOR IT!!

When I was 35 (five years ago) my wife and I purchased our own health insurance from blue cross (I was small business owner). We were on seperate policies due to our age being different (she is a little older than I but it put her into a more expensive bracket). Her premium was $275 a month with a $5000 deductible, mine was $200 a month with a $5000 deductible. In two short years our premiums more than doubled. I dropped the insurance when it became $500 a month and $5000 deductible even though nothing had changed but my age (I never used the insurance).

Have you ever wondered why the prices for service aren't listed like other businesses? For example what does putting a cast on a broken leg cost? How much does closing a cut with stitches cost? Have you ever looked at a hospital bill? Why should it be more expensive for someone (without insurance) to pay for a broken arm to be casted than it is for someone with insurance to pay for the same service?

Please respond Jody.
Jody

climber
35/53k
Sep 6, 2012 - 10:00pm PT
Mountainlion, I didn't mean to imply that the SAME person had all those luxuries, but it was darn near.

All I know is that just about every program the government has gotten involved in has been screwed up beyond belief. You REALLY trust them to get it right this time? The most expensive tax increase in history? The biggest government program in history? I don't have all the answers, I just know that government ISN'T the answer.
rottingjohnny

Sport climber
mammoth lakes ca
Sep 6, 2012 - 10:03pm PT
We have the biggest and best military on the planet but what good is it if our citizens cannot afford medical insurance and end up dying , or worse going bankrupt to pay for medical care...?
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