I <3 Government Health Care
by Ted Slater on 07/15/2009 at 1:19 PM
The U.S. government runs most things really well, among them the U.S. Postal Service, the Veterans Administration, AMTRAK, the national education system, and Chrysler.
And so it's natural that We The People should invite these bureaucrats and politicians to take over management of our health care. This is the plan proposed by our House of Representatives (click on the image for a larger, more legible version):
The added expense and added bureaucracy and added restrictions are expected to be minor, and will only affect The Rich (including employers, entrepreneurs and businesses; excluding bureaucrats and politicians). Specifically, it will add a mere "31 new federal programs, agencies, commissions, and mandates." Thankfully, to my knowledge, the plan does not include tort reform.
As expected, nay-sayers are already polluting the waters, doing their best to scuttle this marvel of modern nanny-state governance. One such representative complained:
This chart depicts the health care nightmare that House [politicians] have planned for families and small businesses. This isn't reform; it's a recipe for disaster that will lead to higher health care costs, lower quality, rationed care, and bureaucrats making medical decisions instead of doctors and patients. Families shouldn't have to answer to shadowy Washington bureaucrats when they're seeking health care treatments for themselves and their loved ones.
If this isn't bad enough, this new maze of government bureaucracy will be funded by a new small business tax that will cost more American jobs. During a time of economic recession, the last thing Congress should be doing is punishing small businesses that create a majority of the jobs in this country.
Hm. Not sure what to make of this one. On one hand, it'd be awful nice for someone else to take my money and take care of me. An enigmatic collection of government agencies surely is able to care for me with more efficiency and love than I am.
On the other hand, I'm concerned that they might require so much tax money from me (either directly or through taxes and fees on my employer and businesses whose products and services I buy) that I wouldn't be able to keep my satellite TV.
1. P&P said the following at 1:45 PM on Jul 15:
Medical bills are now the number one cause of bankruptcy in this country.
If you can come up with a better solution, be my guest. Until then, I'll support healthcare reform.
2. Ted Slater said the following at 1:54 PM on Jul 15:
P&P -- looking for a better solution?
Two words: tort reform. Malpractice insurance (over $250k per year in some places) is driving prices up, and reducing the supply of medical doctors (e.g., OB/GYNs). If lawyers don't rake in as much money in their malpractice cases, then malpractice insurance will decrease, and then doctors' rates will decrease. Tort reform is working in Texas; it'll work in other states as well.
And three more words: Health Savings Account
Maybe two more: immigration reform.
Yes, P&P, "healthcare reform" is a good thing. I support the concept in general. But, in all honesty, the plan currently in Congress is a terrible thing.
And, no, though many bankruptcies are the result of medical bills, they are in fact not "the number one cause of bankruptcy in this country." Excessive consumption and poor financial planning are the leading causes.
3. Adam said the following at 2:03 PM on Jul 15:
Ahh, I love Canada. We have free healthcare, none of our banks went out of business, our mortgage markets didn't crash, our best universities cost around 5k per year, and our schoolchildren test among the brightest in the world. Some cities in Canada are already calling the recession over. What has America accomplished in the last eight years except for wars?
Time for america to join the rest of the world and get healthcare. Problem is your system is ruled by rich people who will oppose paying taxes to support the poor people who work for minimum wage in their corporations to get health care. Then the rich convince Christians to support their own impoverishment by making lip service to abortion every four years.
4. BDB said the following at 2:11 PM on Jul 15:
As per #1, medical bills are indeed the largest cause of bankruptcy, accounting for about 50% of bankruptcies.
Of course, the way U.S. bankruptcy laws work, the bankrupt party gets to keep their house, cars, and a certain amount of assets. Their credit card companies and the hospitals take the brunt of the bankruptcy as their debts are erased.
The poor and elderly in America already get government health care. Of course, spending on those programs is bankrupting the states and/or the hospitals, depending on how much the government reimbursements are lowered below the cost of providing the service. Hence the rationing we see in Medicaid, where someone needs a whole bunch of "points" to qualify for procedures.
The political calculation being done by health care providers is that even with the below-market reimbursements we see in Medicaid and Medicare, they will make more from a "public option" than they get from the bankruptcy court.
Of course, if the Canadian system is imposed on the U.S., it's a death sentence for my friends with cancer. I will forever be opposed to implementing the Canadian system in the U.S.
The mixed public/private systems in Australia and Germany perhaps offer better ideas. I have a friend in Germany who received prompt care after her cancer diagnosis.
5. Ted Slater said the following at 2:27 PM on Jul 15:
Adam (#3) -- you speak of "free healthcare." What does that mean? Do the health care providers offer their time and services voluntarily? If not, where does the money come from to pay them?
Your use of that term betrays an ignorance about how money moves about -- e.g., from you through government bureaucrats to hospitals -- to be frank. As my dad used to tell me, "You don't get something for nothing unless someone somewhere some time gets nothing for something."
The problems with the Canadian health care system are widespread and well-known.
6. Mike Toreno said the following at 2:31 PM on Jul 15:
Ted, so your solution to excessive healthcare costs is to shield healthcare providers who injure patients from the costs of their mistakes? Please explain why it is the unique responsibility of patients injured by medical mistakes to reduce healthcare costs for the general public.
As to the chart, what I suggest is that you look at it, rather than just listen to what the Boehner says about it.
7. DannieA said the following at 2:35 PM on Jul 15:
well since sometimes universal health care is rationed care, all the more reason to change our lives by:
1. Stop smoking
2. Eat healthy so you're not obese
3. Run/Exercise
4. Practice heathful living limiting sugar/salt intake etc.
You can't complain about health care if you don't go to the doctor more than once a year or every other year.
Not trying to be a pessimist but now that smoking is the great evil, obesity is on the rise, I totally can see people not wanting to spend that much time on you unless you are generally healthy.
8. BDB said the following at 2:40 PM on Jul 15:
To be fair, the Postal Service receives no government subsidies. After hearing stories of people in some countries that must pay a $20 bribe to get their package mailed from the U.S., I'm pretty respectful about how much they do and, statistically, how well they do it. They're well above 99% accuracy.
Government-Sponsored Enterprises like Fannie Mae and Freddie Mac, on the other hand...
9. BDB said the following at 2:43 PM on Jul 15:
I should have rephrased that - I know people in some countries - such as missionaries - that must pay a bribe to pick up their package at the post office in their host country. One in particular related a story about how their parents sent some American things to improve their morale (such as their favorite cold cereal), and the $20 "fee" they had to pay was more than the value of the contents of the package.
Compare that to the fantastic job the postal service and the military do getting packages from the U.S. to troops in the field in Iraq and Afghanistan. It amazes me how quickly things get there. Intact!
10. Ted Slater said the following at 2:44 PM on Jul 15:
Mike Toreno (#6) -- tort reform does not release healthcare providers from responsibility. It simply limits the amount of money that lawyers can make off of cases. Healthcare providers can still be sued for malpractice, and can lose their jobs and lose their income.
Question for you, Mike: Do you think it's right that OB/GYNs in certain parts of the country pay nearly $300,000 per year for malpractice insurance? If so, are you fine with that cost being passed along to the patients? Are you fine with that money being passed along to trial lawyers via the insurance companies? Are you fine with frivolous lawsuits, which also contribute to the high cost of insurance (and therefore medical costs)?
11. JuliaH said the following at 2:47 PM on Jul 15:
I live in Alberta. Right now, all of the income tax taken in each year is not enough money to fund the health care system of this province. In addition, Canadians pay some of the highest taxes in the world. In addition, the wait lists here are insane. I'd far rather pay for private insurance and be able to receive an MRI within 2 months if I needed a cancer diagnosis. Then again, if you never get sick I guess you may never need to wait for service while you are in pain and dying.
12. Amir Larijani said the following at 2:52 PM on Jul 15:
The dirty little secret: this is an attempt to save Medicare, which--at its current level of revenues and expenditures--is going to be insolvent within 5 years.
The Obama plan is being packaged as "comprehensive health care reform", but--in reality--he's trying to save Medicare while avoiding the political disaster that would come from attempting to address Medicare in and of itself.
Wrapping it into an overarching health care plan, makes political sense.
Unfortunately for Obama, he does not have the money to make this--or any of his other grandiose plans--happen.
The reckoning is fast-approaching: the welfare state is not sustainable, nor is the larger government apparatus that relies on tax dollars and IOUs that are owned by creditors foreign and domestic.
The issue is whether Americans will wake up and smell the napalm, and realize that government has written way too many checks that her proverbial body cannot cash.
I'm not banking on the affirmative.
13. JuliaH said the following at 2:58 PM on Jul 15:
Re comment #7. That is a pretty ignorant way of looking at it considering that you can take all the preventative measures you want, but people will still get sick. Seemingly perfectly healthy people still have heart attacks, get cancer, have babies, or get the swine flu and may need medical treatment. Limiting treatment to "unhealthy" people is the same as denying treatment to people who have car accidents because they were exceeding the speed limit.
14. S said the following at 3:05 PM on Jul 15:
Ted,
Recently, Atul Gawande, a general surgeon and the author of "Complications: A Surgeon's Notes on an Imperfect Science" and "Better", two very incredible books, wrote a piece for The New Yorker Here on health care costs. He discusses trends in McAllen, Texas, a town in which health care costs have risen despite tort reform limiting medical malpractice suits.
The basic thrust of the issue is that Americans consume and expect too much healthcare, and that too much healthcare is just as dangerous as too little. It's not about rationing, however.
Some doctors don't worry about the business side: they treat and bill, and hope it all works out. Others use money to better their practices: a nurse dedicated to monitoring diabetic patients, for example. And others see their businesses as a revenue stream: a patient with a query is directed to make an appointment, because insurance won't reimburse for a 5 minute phone call.
This is an amazing read, and has, according to NPR, come to the attention of the White House.
15. Cassandra said the following at 3:05 PM on Jul 15:
and realize that government has written way too many checks that her proverbial body cannot cash.
Not sure if that's a proverb or a Top Gun quote. ; )
16. Dan said the following at 3:18 PM on Jul 15:
Ted, the last sentence of your post really sums up the issue: it would be nice to have a system where those who are less fortunate could have access to care, but 'then you'd have to give up your satellite TV'. As usual, your political positions have more to do with preserving the convenience of the well-off, ingoring the real inequalities in our society and demeaning the value of community responsibility for our brothers and sisters. Jesus did not preach American rugged individualism.
17. Amir Larijani said the following at 3:19 PM on Jul 15:
Cassandra remarks:
Yes.
18. DannieA said the following at 3:19 PM on Jul 15:
re: comment 13
apparently you missed the underlying theme that this is exactly what universal healthcare is...I'm not saying it's right, I'm saying it's probably what will happen.
BTW...if you have speeding tickets or accidents...your insurance goes UP, so basically it's the same thing....you WILL suffer more if you're not healthy. That's the point I was trying to make.
19. Jarod said the following at 3:19 PM on Jul 15:
Ted - must say that Yahoo article seems a little heavy handed in its treatment of the Canadian medical system. An example yes, but not representitive. Sick Kids in Toronto is one of the premier children's hospitals in the world...only an hour from Hamilton. As well, many parts of Southern Ontario are actually closer to Buffalo than to Toronto or another major urban centre that has such facilities.
While the Canadian healthcare system is not perfect, (and I am definitely not the world's biggest fan of it), I do not believe it is still among the best in the world. (for care/treatment/knowledge base)
Although, I have never heard that some Canadian cities are calling the recession over - except perhaps for Dog River...
20. Matt Tucker said the following at 3:30 PM on Jul 15:
I'm not (here) making any argument for or against any proposed changes in the US healthcare system. However, as a Canadian, I have to comment on one thing, because it gets brought up time and again. Ted says:
The U.S. government runs most things really well, among them the U.S. Postal Service
Listen: the US Postal Service is great. In America, you get mail on Saturday! In America, you can put mail in your own personal mailbox - the one on your house and the mail carrier will come to your freakin' house and get it! That's great service, my American friends.
21. hlc said the following at 3:45 PM on Jul 15:
Sometimes I wonder if we Christians truly practiced loving one another as Christ has loved us if some of these political points would be moot. I wonder if the Church did more of what Christ called us to do if we could wipe out the need for welfare and other social programs??? What if we truly treated those in our church family as our own family. E.g. - most of us would give all of the money we had to help our parents, siblings, spouse, child, etc. with medical bills. What we treated others in the church (and out of it!) with the same sacrificial love. I'm not talking about government mandated distribution of the wealth, but simply seeing your neighbor in a hard time and offering to help. Whether it's helping with health care costs, or compassionate care when someone has lost a job or whatever life has handed them. All too often (myself included!) we tend to jump to judgements about how a person got in those situations either through poor financial decisions or lack of foresight, which prevent us from perhaps giving as sacrificially as we should.
I'm not for government sponsored healthcare and see a lot of issues with the government mandated programs. However, perhaps as Christians we need to stop blaming the government and look in the mirror as to why those programs are needed in the first place. (I'm putting myself in this category!!)
22. Mike Toreno said the following at 3:53 PM on Jul 15:
Jarod, that's not an article, it's an editorial. It says something about the weakness of Ted's argument, and his integrity, that he uses editorials rather than real news stories to support his point.
23. Mike Toreno said the following at 4:05 PM on Jul 15:
Ted, tort "reform" does shield health care providers from the harm they cause. Rather than paying the victim the true cost of his or her injuries, the cost to the health care provider is limited to a fixed maximum figure. I shouldn't be able to burn down my neighbor's house, causing $250,000 in damages, have the amount I have to compensate him limited to $50,000, and have someone like you say that because I had to pay something I wasn't shielded from the harm I caused.
I'm going to need something more compelling than just your word to believe that ob/gyns pay $300,000 in some parts of the country. May be true, may not be true, but just you saying something doesn't convince me of anything.
Whatever the cost is, yeah, I'm fine with it being passed along to the patients. A general social problem isn't "solved" by laying the entire burden onto injured people.
Yeah, I'm fine with a portion of the money being passed along to trial lawyers. A general social problem requires services for its resolution, the resolution of the problem requires services, the services require payment, the burden of payment for those services is properly distributed among the general public. The costs would be reduced if insurance companies did not resist paying legitimate claims, but that's a side issue.
How would the burdens caused by frivolous lawsuits be eliminated by placing arbitrary obstacles in the face of well-grounded lawsuits.
Are YOU happy about frivolous defenses to well-grounded lawsuits?
24. doctor horton said the following at 4:19 PM on Jul 15:
Universal health care birthed out of a government that does not recognize the dignity of human life will be a nightmare. When I am taking care of a patient in the ICU I sure as heck don't want a bureaucrat created economic driven protocol making a decision for me.
25. Chris said the following at 4:21 PM on Jul 15:
"Sometimes I wonder if we Christians truly practiced loving one another as Christ has loved us if some of these political points would be moot. "
How is it loving to pass massive debt on to others. Since when is "free" health care a right? Maybe the government should pay for my house etc. and maybe I'll just stop working too. The govt, being the single payer will be able to decide who is able to be the recipient of life saving care.
Have you read what Tom Daschle and others have to say about socialized health care (Read "Critical: What We Can Do About the Health-Care Crisis ")? Essentially, if you're too old you, aren't worth treating anymore and we'll treat you for pain and let you die. This is so loving, Jesus would be proud.
26. Mike said the following at 4:53 PM on Jul 15:
Fundamentally, there are a few very basic problems with the "health care crisis":
1) We have expensive health care because we get a lot for our money. We have a lot of cutting-edge procedures, diagnostics, and medications that most people in the world don't have. You pay more for a lobster dinner than you do for a Happy Meal.
2) We already have extensive government intervention in the health care industry, not only through obvious routes like Medicare and Medicaid, but subtler routes like regulation of pharmaceuticals. It takes 10 years to bring a new drug to market, and the company has to make all their research costs back before the patent runs out and the generics can start making it without having to invest the research and testing costs. So, naturally, it's expensive. 60% of health care dollars are currently government dollars. What makes anyone think that increasing that to 100% will make things better?
3) Even more basically, we have a behavioral problem because we don't pay for our own health care; insurance companies do. Therefore, the cost is hidden from both the provider and from the consumer. If I don't care how much something costs, you bet I'll use as much as I like. On the other hand, if the costs are coming out of my pocket, you better believe I'll be making some serious choices about whether or not I want that drug, or that test, or that procedure. The availability or lack thereof of insurance isn't the problem; it's the fact that I don't pay my own bills.
4) Tort reform matters, not only because of high malpractice costs (we're currently suffering a shortage of high-risk specialties like OB because of it), but because of the self-protective testing doctors order to cover their backsides in case they get sued. To solve it, all you'd have to do is say, "Loser pays." That would eliminate nuisance lawsuits in a heartbeat. Capping damages doesn't help, because they find ways around it, but if I risk coughing up a big chunk of cash myself if I lose, then I'm going to think twice about filing suit unless I have a good case.
Unfortunately, in its proposals to reform the industry, the Obama machine is violating principles 1, 2, 3...and 4. They want to cut costs without any consideration of the value lost; they want to throw more government into the mix; they want to keep the third-party payer in place; and they refuse even to discuss any form of tort reform (probably because a large number of Congresscritters are lawyers themselves). So expect nothing to improve.
27. farmer Tom said the following at 4:57 PM on Jul 15:
I have some quick solutions to the healthcare crisis in the USofA.
First, make all doctors salaries exactly the same. No matter if you are a cancer specialist or a proctologist 75,000 a year total salary.
Second, nurses get 30,000 per year.
This never changes, no increases of inflation, no benefits for length of tenure or quality of work.
Third, no visits to the emergency room unless you are bleeding profusely, or unconscious.
Fourth, no fancy schamcy, high tech equipment, just a stethoscope, a tongue depressor and a hand full of pain killers.
Fifth, make all hospitals government agencies. Take away the ability of the hospitals to set costs, instead set exactly the same fees for every single hospital in the US. $25 dollars per stay.
Sixth, limit of one child per family. This will greatly reduce the cost of all those expensive births. All subsequent pregnancies will result in an abortion and sterilization.
Seventh, and the most cost effective measure, no medical help of any kind for the infirm, mentally disabled, sexually befuddled, and anyone over 72 (they have lived long enough).
WELCOME TO THE BRAVE NEW WORLD, HOPE AND CHANGE, BABY!!!!!
I'm quite certain my plan will save vast quantities of money. Why the heck should we care if a few useless eaters assume room temperature prematurely, after all, cost is what matters, right?
28. Jeremy said the following at 5:00 PM on Jul 15:
I would have to agree with Ted on tort reform. Granted, I've not done the research to know how much lawyers and plaintiffs are being awarded and how many frivolous cases appear, but I do know that litigation can often do a lot more harm than good. Doctors have to do lots of unnecessary tests on patients (something mentioned by Obama), but they do these tests simply because of legal reasons (i.e. to cover their backsides against litigation), not because they can make more money. As already mentioned, litigation drives up the costs of malpractice insurance, and both of these combined make health care quite expensive. I think that dealing with litigation is dealing with the root cause and simply regulating medicine under government (which does such an amazing job with medicare and medicaid) is dealing with the symptom.
Now, to what extent do we move tort reform? I did take a single law class that touched on litigation in college, and I can certainly understand the need for litigation to encourage doctors to do their job well, but there must be a balance where lawyers aren't simply getting rich. As a pilot, I've read about litigation in the aviation industry. In the 1980's, litigation basically killed off small single (and multi) engine piston aircraft. The General Aviation Revitalization Act (GARA) of 1994 put a special Statute of Limitations on aircraft litigation and brought small general aviation back to life. Granted, the litigation insurance paid by companies such as Cessna and Piper for such aircraft still makes them FAR more expensive than they need to be, GARA (tort reform) still saved small general aviation.
As a Canadian (living in the States), I feel compelled to point out one thing about the Canadian system. The Canadian government does keep health costs lower for itself, but it does this by keeping doctor's and nurse's salaries quite low. This has created a new problem: all the doctors and nurses (like my mom) leave and go to the States where the pay is better and wait times in Canada go up more.
29. Emerald said the following at 5:26 PM on Jul 15:
Jarod (19) - nice Corner Gas reference :)
30. Janeile said the following at 5:28 PM on Jul 15:
Doctor Horton hit it right on the head. As Christians we have only one choice here based on the most important reason - LIFE. This administration and the health care bill are anti-life - whether it is the unborn or the terminally ill or the elderly or whoever they deem to be a "drain" on society. While sitting on our fat butts and letting Big Government wipe the tears from our eyes and taking care of our every need seems great, we can ONLY vehemently REJECT this government health care because it is ANTI_LIFE. PERIOD.
I know someone will whine that some people die because they don't have health care now and that having government health care will solve this. But with an anti-life government that person would probably STILL die and even more people on top of that (with government assistance!)
Wake up, folks! The deception and manipulation that is being forced on the masses is unbelievable. The government and the media are both working together to make America a socialist country. Don't be fooled by the airy propaganda or the scare tactics.
31. Ted Slater said the following at 5:57 PM on Jul 15:
Mike Toreno (#22) -- I don't understand your point. The piece that I linked to seemed well-written and supported by facts. Are you dismissing it as irrelevant because it's not "hard news"?
Seriously, Mike Toreno, you've got to cut the attitude. You're free to express your disagreements here, but insulting the editor just isn't cool.
32. adam said the following at 6:08 PM on Jul 15:
Hi, it's me from the top.
Even a homeless person in the poorest city in Canada gets better heealthcare than 40 million americans. Actually, a lot better than most of the other 250 million americans too (re: Sicko).
You can brag all you want about how great your lobster dinners are but it only shows your own narcissism and contempt for your fellow man. Yes, rich people nn the USA can afford to fly around the country and have surgery on solid gold tables. I don't dispute that.
When I was 13 years old I had bad scoliosis. I went through years of treatment, wearing braces, finally I had harrington rods implanted in my back by Mercer Rang (world-famous author of the textbooks on orthopedic surgery) at Sick Kids in Toronto. My mom who is a maid and my dad a salesman bouncing from job to job never paid a cent out of pocket.
If I were living in the USA I'd be in a wheelchair, or worse, today.
Most of the people in this thread betray their very ungodly worldview; the rich should be priveliged.
Arguments that the church should take care of it's own people so the government shouldnt fail on two counts: the church doesn't, and the believers are supposed to care for everyone else too (Mathew 25).
We in Canada believe in voting for our values. We believe that we should take care of each other, so our choice of government and hte kind of society we build reflects that. Christian conservative americans pay lip service to this ideal; they're all for having the government do things for them like fighting wars or toppling democracies (oops) shaping marriages or protecting the unborn: all very "big government" ideas.
Canadian Health Care was the brainchild of Tommy Douglas, a christian pastor who went into politics because of the abject poverty and injustice in his home province. He believed in things like christians taking care of each other, and if we're a christian society then we won't mind doing it as a society.People who believed in that voted for him.
American's style themselves as a Christian nation, then act like it!
33. emma Connor said the following at 6:27 PM on Jul 15:
Please tell me this is tongue in cheek? My home country has government run health care and its a nightmare. BTW, the government does not run the postal service well.
34. Julia said the following at 6:31 PM on Jul 15:
Currently, 40% of health care costs in the US are from preventable conditions caused by smoking, obesity, STDs, etc. etc. Sorry, but I personally do not want to pay for someone else's immorality and irresponsibility, and I know I do not want to impose my health care costs on other people either. If the government is so concerned about the health of its citizens, perhaps it should use taxes to create education programs and to help pay for preventative health care. Even this is pushing it if one feels the government only exists to protect its citizens from outside forces, each other, and themselves.
Also, as a nurse, it is important for me to be an advocate for my patients. Implementing a health care system which would ultimately cause people to be put on waiting lists, not allow them to have choices concerning treatments, and limit how much can be spent, etc. would not be in the best interest of my patients. I really do not think that the government is in the best position to say what is best for its citizens when it comes to health care. This is the job of doctors, specialists, nurses, etc.
Also, if the government were to take on this role of saying what is best, this is where we start heading into dangerous waters. I was in China this past May and toured various health care facilities. In China, if a woman is pregnant with triplets, they are "encouraged" to have a reduction because it is "better" for their health. If they refuse and decide to have the triplets (twins are permitted), they risk losing health care benefits. Is this the direction we want to go?
Lastly, as Christians, we can certainly seek to help those that are having difficulty finding health care services and/or paying for it. For example, there are free clinics which can provide health care to those who are uninsured and/or low income. It also does not hurt to discuss the importance of health promotion within the church and the community. Churches can host free blood pressure screenings to the community, hold blood banks, etc. There is certainly more we should be doing rather than relying solely on the government which will only put our nation further in debt and increase taxes even more.
35. P&P said the following at 6:47 PM on Jul 15:
Ted, a quick Google search revealed a 2005 Harvard Law School study proving that the #1 cause of bankruptcy was medical expenses.
I doubt things have improved.
Speaking as someone who once contemplated bankruptcy because of medical bills that were not covered by insurance (the fact that I needed the surgeries to walk was not considered life-threatening), I don't see tort reform and a meager HSA to be the way to cover bills that run into the thousands.
The reality is that the best care is for the very rich and the very healthy. If you have a genetic condition or just the bad luck of an accident, you're out of luck in our current system.
I'm truly grateful that the government is finally stepping up and forcing insurance companies and what I've come to call the "medical industrial complex" to examine why one of the richest countries in the world can't ensure that every citizen receives good and affordable healthcare.
36. Tee said the following at 6:47 PM on Jul 15:
Doctor Horton makes a very good point. While on my ICU rotation, I was concerned about the effect Canadian health care economics had on care patients in extremis. It was an uncomfortable situation, wrought with many ethical issues.
37. Holly said the following at 6:54 PM on Jul 15:
I'd encourage everyone, but especially those who feel that doctors are ordering unnecessary tests to protect themselves from malpractice suits, to read the article that 'S' (comment 14) linked to.
The article speaks to how doctors and hospitals profit from ordering these extra procedures and how it costs the government and ultimately us end up paying for it.
I found the article extremely interesting!
Thanks for bringing it to our attention 'S'!
38. BDB said the following at 6:55 PM on Jul 15:
Mike (#23) presents an inaccurate picture of Tort Reform limits on awards.
California has a limit of $250,000 on NON-ECONOMIC damages. That's after all the economic costs are paid.
Take Mike's example of someone burning down their neighbors house. The ECONOMIC damages would be the entire replacement cost of the house, plus all the contents, plus alternative housing, lost time for work plus permitting for new construction.
Under the medical limits, not only would the victim get all their economic damages, IN ADDITION, $250,000 for pain-and-suffering.
In medical malpractice, the awards usually cover all medical costs, and all economic costs for lost work - including lost permanent disability. That can be millions of dollars for a truly serious mistake.
The remaining $250,000 is just for the annoyance.
Yes, we as a society should come to an agreement that utilizing medical services involves a (relatively small) risk of permanent mistakes. If we, as a society, insist that an honest mistake is our ticket to lottery winnings, doctors will leave in droves. You see this happening already, with hospitals closing, emergency rooms closing, and doctors leaving states that have unlimited liability.
Do you realize that doctors are leaving the U.S. and setting up shop in Mexico, where there are no such litigation risks? Do you really want a healthcare system that requires you to fly to Mexico because there are no doctors who will do what you need in the U.S.?
39. Carolyn said the following at 7:34 PM on Jul 15:
Ted, I think Mike's point is that while the editorial you cited is well-written, it is undeniably biased in its tone. The quality of a health care system cannot be determined by an exceptional event. Here's an article that's a little more balanced.
We Canadians can't deny that our health care system has problems --long wait-times and doctor shortages among them-- but I do agree with the principles behind our Medicare: regardless of financial or social status, we are guaranteed to some basic level of care. Medicine shouldn't be a business transaction...though perhaps this is just a socialist Utopian daydream.
And if you want a good history read, you should look up our own Canadian controversy when publicly funded universal health care came to be in the 1960s. Just search for Tommy Douglas.
40. Kit said the following at 7:55 PM on Jul 15:
First--#1, well said.
Second--no one is forcing you to change your insurer or move to public insurance if you don't want to. This is not a communist country and despite this board and some of the extremely conservative opinions on it, we do still have the Seante and the House and checks and balances.
Third--We are a military couple and despite paperwork I LOVE our government healthcare. IT's awesome. Is it the best in terms of quality? Some would say, admittedly, no (although I have no major issues wit it) but it's a much better overall package--affordable and efficient. The key is, it's STILL better than anywhere else in the world. Essentially it's an HMO. So, can I pick my doctor? Not at face value, but it's easy to request a specialist.
Four--Medical bankruptcies are HUGE. People are not getting the care they need and they're also going into debt for it for the rest of their lives. There is a flaw in the system.
Five--tort reform is a good idea but only if you can change human nature. People are selfish and will go after all the $$ they can get.
Six--before my hubby joined the military I had a HSA through my employer. Lost money on the deal--it's use it or lose it (my mistake--if I had truly understood how it worked I would never have invested just would have put that taxed money into a high interest account instead.) The catch is, if you don't spend it, and if you don't actually make more than 60 or so K a year, it's not really worth it because you lose it. Sure, it's great for emergencies...but so is a high interest savings account.
So--I do support a national option. It will help many people who can not afford any privatized care, let alone that which is good quality.
41. Kit said the following at 8:02 PM on Jul 15:
Also Ted, although I am not discounting the OPs opinion in any way, I too like to see an article backed by statistics and other sources with MULTIPLE viewpoints and then counter sources to support the op. Pure opinion and one-sided sources are just that...opinion. I have to agree that it makes this article much weaker than it could be.
42. Kellie said the following at 8:48 PM on Jul 15:
Government healthcare will benefit those with no insurance (and no one dies for lack of insurance....they die trying to pay off the bills that come later). For those of us with good insurance, government healthcare is most likely not going to be good.
As someone who works in healthcare, medicare is actually pretty good in my particular sector, but medicaid is a nightmare.
43. JB said the following at 8:56 PM on Jul 15:
I had a patient last fall who came to clinic while having a heart attack. She had been having worsening chest pain for the previous week but didn't see a doctor because her husband had just lost his job and she knew she couldn't afford the tests that she would need. Instead, she hoped the problem would just go away. It didn't, of course, and she needed an immediate catheterization and stenting of a nearly occluded major coronary artery. This woman put her life at risk and could very easily have died in her early 50s because she didn't have access to affordable health care.
I don't like the idea of rationing health care either, but it happens already every day. As a society, we pay for extreme interventions at the end of life but we don't pay for routine care which has a major impact on mortality and morbidity. We pay for new and experimental therapies by denying cheap and proven health interventions to a vastly larger number of people. We can't have both. The question before us isn't whether to ration care but how.
44. Sionel said the following at 9:08 PM on Jul 15:
No one's mentioned the Australian health care system yet, perhaps because we're so far away ;) We do also have 'free' health care (read: taxpayer-funded via a government-administered system) for all citizens and permanent residents, as well as the option to take out private health insurance if you particularly want the wonderful Mr. Smith to do your operation or you're desperate for a private room.
Of course, our system has problems. I'm a doctor in it and I am very aware of many of its issues! However, having had some exposure to those who can't afford basic medical care in the USA because they can't afford health insurance, on balance I think the reforms are the better option - at least as they're planned. Governments are notoriously bad at running things, of course, and here we're having an ongoing battle with our state and federal governments on a host of health-related issues - but everyone can still afford to go to the doctor when they're sick. For me, that's important. I never want to be in the position of telling someone that if they want treatment they need, they'll have to pay money they can't afford - and watching them walk away.
We do have a law here that I think would be quite helpful in America, that being one that allows frivolous lawsuits to be thrown out of court. Litigation is still of course a concern here, but not one that affects our day to day practice to the extent of forcing us to order unnecessary tests or go to extreme and potentially harmful lengths to rule out improbable but serious diagnoses. Perhaps for that reason, our medical indemnity insurance is more reasonably priced, so far as I'm aware. Certainly litigation is much less common.
One concern that's been expressed above is that a socialist health care system will result in the abandonment of some kinds of medical ethics, particularly for the elderly. I don't know the details of how it works in either America or Canada, but it is most definitely possible to work within the system here and provide ethical medical care, in the large majority of cases. Having worked in public hospitals and in general practice, I can say that from experience. Someone mentioned 'when someone gets too old, you just kill their pain and let them die' under this type of medical system, but this is a gross generalisation.
Please note, I am completely opposed to euthanasia or to withholding reasonable treatment. I have never done so and never intend to, God willing. However, there comes a point - and in our medical system it has very little to do with the number in the 'Age' box - where due to the wishes of the patient and/or their family (if they are not able to express their own) AND due to their medical condition and the treatment that would be necessary, it is not in the patient's best interest to go on. Someone who is in a nursing home and largely unaware of his surroundings, who spends all day in bed or in a chair because he can't move, who has to be fed and changed - does not need invasive surgery for his cancer or painful tests for his liver disease. After discussion with him (if possible) and his family, what he needs is to be kept comfortable and allowed to live out what remains of his life in dignity and peace. This is not the same thing as euthanasia or 'helping people die', nor do I feel it is unethical or contrary to the Hippocratic Oath. Our medical system allows for the judgment of clinical practitioners in situations like this; treatment may or may not be pursued depending on all the factors above and on others as well.
Hmmm, that turned into a longer post than I expected. I'm not trying to argue that a socialist health system is perfect - goodness knows ours isn't, and I'm sure whatever reform is eventually brought in in the US won't be. However, I think access to basic health care for everyone, no matter their insurance status or income level, is a goal absolutely worth working toward. Yes, there are significant difficulties and it may not work as intended, certainly not at first, but the end result will hopefully be worth the effort. Of course in today's society health professionals can't usually work for free, but as Christians, I do think our duty is to remember that Jesus didn't ask for income details before he helped anyone ;)
My $0.02...
45. Kelly said the following at 9:37 PM on Jul 15:
Several of the comments prompted the following thoughts. Why are we so afraid of death? If a person is old, or has a severe illness, and if it were 100 years ago would die because there WAS no treatment, why are we prolonging their life?
Why do we fight so hard to stay in this fallen world instead of looking forward to our time with Jesus?
Yes, I'm still young, but I look back at the years of my life and reflect on how good they have been, and if God were to bring me home tomorrow, I couldn't be too upset. And if my life so far had been bad, well, even more of a reason to be joyfully looking forward to heaven!
And sometimes, I think death would be preferable than living with a chronic illness.
46. JB said the following at 9:38 PM on Jul 15:
Doctor Horton,
Your patients' insurance companies don't recognize the dignity of human life. They recognize a fiduciary responsibility to their shareholders. The result is already a nightmare.
47. meg said the following at 10:02 PM on Jul 15:
In a health policy course I took we learned that the Medicare program runs with about a 3% overhead operating cost. In comparison, private insurer Anthem averages about 30% on operating costs- and a recent exec retired with a ridiculous amount of millions, plus additional shares still owned in the company.
That type of corporate greed makes me sick. I understand people have issues with government control and blah blah...but, I would argue that the government is the lesser of two evils here.
Private insurance will always make money from denying care. And their goal is to make money. Unless you are a major shareholder, you are not going to have any say in how the company is run or how much the CEO is paid.
But with the government, we have a voice. Yes it is a flawed system and does not work perfectly, but we have avenues to express our concerns. Unless you've written to your senator and representative, please don't complain.
We are going to pay for health care either way, through insurance premiums or taxes. Personally, I would rather pay through taxes. I would rather my money go towards an unemployed and unhealthy person's health care through my taxes- than contributing to a CEOs millions by paying premiums for insurance that, as a young healthy person, I have never needed much.
During these conversation its also that our money is not really ours, right? Every gift comes from above...
48. Paul said the following at 10:37 PM on Jul 15:
Dr. Horton. You nailed it on the head. As a medical student, I sure as heck don't want to deal with a future where businessmen and politicians make decisions on patient care.
Farmer Tom, I'd caution you against the "slippery slope" fallacy, but you're on the right track. Maybe it's my good ol' fashioned conservativism speaking here, but in my mind the less Government required to successfully run this nation the better!
49. Melissa S. said the following at 10:57 PM on Jul 15:
I hardly ever go see a general practitioner but I regularly visit the chiropractor and he literally keeps me walking. If the government messes with my ability to stay with my long-term chiropractor or my ability to pay for the visits, I'm gonna be seriously upset. I'm an overall healthy person who eats healthily, exercises, and pays for her own medical bills. I'm not going to be happy if I'm forced to pay a lot of money to fund random people and medical bills that I did not incur. It wouldn't make much difference, but I would write to the White House about it. It's wrong.
In about a year, I'll be about ready to find my first full-time career job. Looking at all the taxes we currently have and the cost of living while hearing about all of the president's grandiose plans to tax me some more makes me wonder exactly what percent of my money the government considers my fair share of what I've worked for. What percent does the government think is my very own, safe for me to use as I see fit? Once the government is taking 60% or 70% of my gross income will the rest be safe? Where does it stop? Because honestly, if I'm going to be living on very little of my actual salary, it's like me supporting myself and another family whose salary is the same as the very little I live on, but who gets to sign up for all the "free benefits" that I have to pay for.
My Dad works very hard as a fire captain for L.A. City, one of the best departments in the world. His gross income sounds like more than enough-- but after taxes, he's got less than 50% of it to pay all the bills, tithe, and to fully or partially support 10 people with. If he'd stayed at a lower income bracket, he'd probably end up with about the same amount of money but he went ahead and used his talents anyway. That takes guts and obedience to the Bible. When I hear about new taxes and new bloated programs, it's sure a temptation to worry and panic a little bit. God is still in control, though, and will provide for my needs. But I can't help wondering what it's going to be like raising a family in the next ten to twenty years as the country has us paying off the bills of our parent's generation while saddling us with unfathomable new bills to pay.
Do politicians know anything about economics or history or current world events/conditions? The more I hear them talk, the more uneducated they seem. They are obviously good at politics and getting elected but their plans to create utopias are ignorant.
50. pass the ammunition said the following at 11:06 PM on Jul 15:
Once again, no position is supported unless it maintains the privilege of the privileged.
End of story--why are we even having this discussion? The poor and lower middle class are the biggest drags on the health care system. Americans will never pass a health care plan that favors the poor, and politicians always pander to their wealthy interests. Without a system that benefits the poor, everyone else will continue to subsidize people who can't or don't pay their bills.
When my family first came to America, we had no insurance and NO money. We used emergency rooms as our primary care and could not pay. But guess who did pay--everyone else! Fun fun fun.
51. Cait said the following at 11:22 PM on Jul 15:
We have government assisted healthcare in Australia and I've never had any problems. There are waiting periods but not excessive as far as I have seen. Plus there is the option of private health insurance so if you didn't want to wait you would just go through the private system and even that is covered slightly by the government.
I'm sure there are the cases where the system has failed like any system and I'm sure it has it's downfalls... but from what I hear and read about the US way of healthcare I'd pick this any day.
52. obewan said the following at 11:52 PM on Jul 15:
#2. Ted Slater said the following at 1:54 PM on Jul 15
P&P -- looking for a better solution?
(to personal bankruptcy)
Two words: tort reform. Malpractice insurance (over $250k per year in some places) is driving prices up...
And three more words: Health Savings Account
-------------------------------------
1.) The government "plans" for healthcare "reform" include legislation to limit "malpractice" lawsuit awards do they not?
2.) Do you really think that a HSA is going to take care of a $350K cancer treatment bill? ROFLOLOLOLOLOL!!!! That is for something like a persons $1k a year insurance co-pays. It is of little use to a person without health insurance, and it is a crap shoot too. If you don't use up the money for the plan year, you just lose it anyway. And $350K is exactly what it cost a friend of mine for her cancer fight. Her insurance company denied payment too for the whole bill by claiming some “pre-existing condition” clause which was legal at the time. In her case, the Christian college she was working for stepped up to the plate and “ate the cost” of the whole bill on her behalf!!
As far as bureaucracies go, your chart for private insurance would have to show all the existing providers and all the different claims forms. There are already numerous agencies involved with a great amount of waste.
As for care denial, private insurers already to the same thing you claim the government will do. My insurance company refused payment on a $5k hospital bill because it was for an "emergency" admission that happened on a weekend, and they were not around to answer their own phones and "pre-approve" the treatment. They were in clear violation of the contract, but just rubber stamped "payment denied" on my claim. Their attitude was - "just sue us, if you can afford a lawyer." A co-worker had the exact same thing happen with the same insurance company. He had a heart attack, and they denied payment on a $10K bill. He got a lawyer and sued and won and they paid, but not before he had paid out $3500 in legal expenses out of his own pocket. And still further, that same insurance company CLAIMS to offer 1 colonoscopy a year. Well this year, I had one and they took out 1 pre-cancerous polyp. That was an extra bill of $1000 for surgery, and guess what; they denied payment for that because it was not "pre-approved." What was I supposed to do to "save" them money; go back on a second day with a second prep, and second anesthesiologist (yada, yada), or wait in the O.R. until they said "yes" with the staff's clock running the whole time (assuming they would even answer the phones which are rarely properly manned to answer even basic questions)?
Yes, I would say we already have a major bureaucracy problem as it is.
53. Jethro said the following at 12:07 AM on Jul 16:
You know to people overseas it is simply startling beyond words that anyone could actually oppose universal healthcare.
54. David said the following at 12:40 AM on Jul 16:
The one thing that I am seeing in other news about this and not covered here is the manditory nature of the current democrat plan. There are two things that are mandatory: 1. Health insurance 2. Employers pay, no matter what size.
In states that have mandatory auto insurance, the rates went through the roof as soon as everyone was required to have it. What will keep insurance companies from raising the rates on employers? Nothing. (Keep in mind that the insurance industry is largely unregulated, and gives large chunks of money to politicians). Secondly, if you are a small business, you will be required to provide health insurance. The problem with this will be that most small business will probably have to lay off 10-20% of their workforce and probably delay or cut new hires totally. Most small businesses operate on a very small profit margin, one that cannot sustain additional government mandates. So what will happen? People will lose jobs, and small businesses (the heart of our economy) will fold. The idea of reforming health-care is a good one, however, adding a ridiculous amount of bureaucracy is not the answer. The answer is:
1. Cap punitive damage awards in medical lawsuits. Most states make juries separate out punitive damages from actual damages. Punitive damage claims are whats out of control.
2. Reform the insurance industry, make them adhere to book keeping and accounting standards. Set caps on rate increases, and give each state an appeals/oversight board for insurance.
55. S said the following at 4:40 AM on Jul 16:
So, we shouldn't have bail-outs of banks or auto companies and let the free market play out? However, when it comes to tort reform, we should have the gov't interfere and institute caps? What about the free market?
56. S said the following at 4:48 AM on Jul 16:
Seriously, you're going to rip on the postal service? It is not perfect by any means, but I get mail 6 days a week delivered directly to my house. The price of a stamp is $0.44 compared to $0.64 (converted into US $) in the U.K. Practically a bargain.
57. Frazer said the following at 6:46 AM on Jul 16:
I chimed in on facebook before I read the article but I'll update my view for you. I think if done right government run health care isn't as bad as many Americans are making it out to be. In my case due to a medical condition I am uninsurable. So my medications are partially covered and I wont go bankrupt if I get sick.
There are negatives here in Canada. Currently my local health care system is being revamped and it is not looking like it will be as good as the bureaucrats seem to think it is. So there are negatives but in my case I cannot get medical insurance and my employer isn't likely to take on the cost of group insurance. So at least I'm not paying what would be half my paycheck each month on my medication and I don't have the stress of worrying if I can go to the doctor if I am sick.
Also the counseling I am in after some bad experiences doesn't break my already strained checkbook.
So for the most part if done right it is a good thing, however there are some problems with government health care just as there are some problems with private health care.
58. Frazer said the following at 6:58 AM on Jul 16:
@ Ted in post #5
I agree there are problems with our health care system in Canada. Some wait times are very frustrating. I think part of the reason you see problems like in the yahoo news article you used is that so many people have access to health care, unlike the USA where people who can't afford it and don't have insurance just sit at home sick.
I'll be the first to tell you that there is problems with the Canadian system. For example the closest specialist for my condition (Tourette Syndrome) is 2 hours away and about $40 worth of parking in Toronto. Most days I have to make a day out of seeing my specialist because I would be stuck in the rush hour traffic that could make the trip 4-5 hours just in the car! So I know there are problems, I mean when I was a kid there was a specialist in my area but she only works with kids so now I'm forced to fork over the cash for my truck to be fed with gas, parking (Toronto has impossible/expensive parking) and the fact that I usually have to get a meal in there somewhere. So the Canadian health care system is not perfect but it has it's strengths...like my specialists if it weren't for the government would be about $700 for the hour appointment, that is about a weeks worth pay!
59. Mike said the following at 7:23 AM on Jul 16:
When I see you complain about this complicated proposed health care plan, I have to wonder why you can't embrace something incredibly simple and effective like single-payer. The article you cite to highlight the problems with the Canadian system do not match with what I or the majority of other Canadians have experienced. Our health care is a matter of national pride and the crusader who fought for it, Tommy Douglas, is revered as a hero.
The people I know in my family and church with medical needs have all received quality care. It should be noted that Canadians are on average healthier than Americans (http://www.macleans.ca/science/health/article.jsp?content=20080625_19351_19351) When delays occur, it is for non-urgent treatment. And the cases the Canada-bashing article mentions where mothers had to give birth across the border, their bills were undoubtedly paid for by their provincial health plans.
I also balk at the notion that it is more expensive - Canada's federal government (up until your recession, which has caused our exports to your fair country to drop) has balanced the budget for a decade. I've read that Americans pay more per-capita for health care than Canadians do. Might I remind you again that we're also healthier?
I understand that you have your own vision on what health care in the States should look like, but please, don't mischaracterize my country's health care plan. We truly are doing just fine up north.
60. Chris said the following at 7:39 AM on Jul 16:
Two thoughts:
The CBO did some research a few years back and determined that something like a 30% reduction in malpractice costs would only lead to less than 1% reduction in health care costs. This tort reform argument, as it relates to health care, is a red herring trotted out to achieve another political goal (e.g., tort reform). While I would agree that tort reform is necessary, it should be discussed on its own merits, not as something that will provide almost meaningless benefit to health care reform. For health care, it is a distraction of little benefit.
Second, check out this article. Very interesting, especially the last part about attitudes in "socialized medicine" countries...
http://www.nytimes.com/2009/07/19/magazine/19healthcare-t.html
61. Sarah P. said the following at 7:43 AM on Jul 16:
I think the elegant, simple graphic in Ted's post sums up the situation quite well. Admire the flow, the spaghetti strands connecting box to box. Truly, a marvel of modern ingenuity.
---
Sarcasm aside, I think the problem is clear... the American healthcare system is so stinkin' complicated that the average person cannot possibly understand it! Every geographical area evidences a different combination of hospitals and insurance providers. Which would be possible to learn, except that they are also connected in some ephemeral way to overinflated, bureaucratic, national networks of government agencies and pharmaceutical companies.
The health care providers don't answer to the people they are supposed to be serving. They answer to random people who live elsewhere. So who is going to keep them accountable? I don't even know how to complain if I am badly treated in a hospital. You gotta know that corruption is rampant everywhere in the system. It's human nature. Esp. in Medicare and Medicaid. I did a bunch of research in college, but I don't have these facts on hand; I'm sure I can find some links again if asked.
History has shown over and over again that socialism doesn't work in real life. We humans by nature look out for our own best interest, since we are selfish and fallen -- something the proponents of socialism invariably fail to acknowledge. In the long run, the best government system allows people the freedom to bounce off each other and spur each other on, while limiting those "freedoms" that would cause others to suffer and wither.
Socialism denies the freedom and intelligence of the average human being, saying that others, somewhere else, know better. How can they? They don't live in every area, and so they are not impacted by the results of their decisions on a daily basis. How can Washington, D.C. possess the knowledge or the heart to understand what rural Montana needs?
62. Emily said the following at 7:47 AM on Jul 16:
http://joinpatientsfirst.com/petition
63. S said the following at 8:56 AM on Jul 16:
Holly,
Thanks so much for reading the article I linked to. I was beginning to feel like I had posted into the ether.
This coming Saturday's NY Times Magazine focuses on health care economics as well.
64. faye said the following at 9:04 AM on Jul 16:
Adam post 32: I find your anger towards the American church unfortunate. God's Spirit of brotherly love is active here, just as it is in Canada.
65. Leah W said the following at 9:26 AM on Jul 16:
First the Postal Service - I admire the Postal Service we have in this country, I think the point Ted was trying to make was that our government is having to financially bail them out--while their "Head Honcho" gave himself a big fat bonus for not doing his job so great. (I'm thinkin' there's not much to admire there.)
Second - While I don't have a "suggestion" as to how to solve our healthcare issues, I don't think having the government tell doctors what they can and cannot do is any kind of a solution.
I agree with the previous poster that we shouldn't have to pay for someone else's irresponsibility--ie lung/mouth/etc cancer *directly* related to smoking, health problems raised from morbit obesity that could have been prevented, etc. I would think prevenative measures would be best! But who's to say that people would listen? And what happens if people don't? Would we deny healthcare to people simply because they should know better? (I think there's an oath out there that prevents that.) :)
BTW - I've known people who moved from Canada to the US to "escape" the government-run healthcare, so I highly doubt it's the rosey picture some have been trying to paint it to be.
66. Ted Slater said the following at 9:33 AM on Jul 16:
P&P (#35) and Kit (#40) -- I think we're talking about two different things when we use the term "HSA" or "Health Savings Account."
At work we have an "FSA" or "Flexible Spending Account" -- that sounds a lot like what you're talking about. With an FSA, you put money in each paycheck to cover medical expenses, money that is tax deductible. At the end of the year, the money from your FSA account that you don't spend ... you lose.
An HSA, on the other hand, is a combination of a savings account and high-deductible catastrophic medical insurance. You put money into a "bucket," and your high-deductible insurance is paid for out of that bucket, as are your routine medical expenses. Any money left in the bucket roll over to the next year.
In a way, it's kinda like car insurance -- you are responsible for paying for gas and oil changes and routing repairs, but your car insurance steps in once you reach a certain financial point. Or like homeowners insurance -- you are responsible for cleaning the carpets and replacing broken windows, but your homeowners insurance steps in once you reach a certain financial point.
To better understand what an HSA is, and how it's different from an FSA, please check out the article I linked to above: "Health Insurance Help is Here." I agree with Dave Ramsey that HSAs "could be the answer to the health care crisis we have in America."
67. Adam said the following at 9:40 AM on Jul 16:
I think that there needs to be some kind of balance between providing care regardless of income and paying for designer care.
If someone is in a car wreck, I think the ambulance should give them a ride before checking to see their payment ability.
On the other hand, if a teen wants to go see a doctor because they have 2 pimples on their face, charge the heck out of them!
In order to rein in expenses in the healthcare industry I would suggest 3 things.
#1: Forced simplicity and transparency in pricing. I should be able to pull up any doctor's website and see what a basic visit would cost me. People are scared because they don't know true costs to see a doctor. So they are scared and wind up just letting conditions worsen.
#2: Tort reform. Ted covered this.
#3: Drastically reduce the power of the FDA. Make approval for drugs be much easier and cheaper. Then make waivers for patients.
68. Lia said the following at 10:26 AM on Jul 16:
Something I don't understand-- time and time again in these comments, people have opposed socialised health care because it supposedly means that the elderly and terminally ill won't get the care they need to live longer. That may well be so, but the healthcare system that we have now is already exclusionary-- people who can't afford insurance or visits to the doctor or hospital already won't get care. Surely a system that excludes the poor isn't a Christian system, and if we can include the poor while easing the passing of those who are terminall ill, then we'll be doing a good job.
This is a touchy subject for me, because at the moment, I have all of $6 to my name, no insurance and no job. Thankfully I have no loans, either, and I'm crashing with a friend, but if I were to suddenly become ill, I don't know what I'd do.
69. NathanaelN said the following at 10:35 AM on Jul 16:
Kit(40): You said about HSA that, "Lost money on the deal--it's use it or lose it"
Are you sure that it was an HSA (Health Savings Account)? You should "own" an HSA. Your employer "owns" an FSA (or an HRA for some people). An FSA is flexible because you have all of the allocated money in it from the beginning of the plan period, but you use it or lose it by the end of the plan period (some plans have a grace period). An HSA has only as much money as you have deposited thus far but will never expire at the end of your plan period. It is an interest bearing account that you can even invest in by using CD's.
FSA have money available from day one of the plan period but are a gamble because you might lose money. HSA need to be started ahead of time to have a decent balance but belong to you and can be "cultivated".
For my current employer, I am using an FSA for this year, and I have an HSA on the side that is acculumating interest in a CD.
70. DEH said the following at 10:37 AM on Jul 16:
Kelly (#45)~
My thought on our desire to prolong life is this:
I have people who depend on me, though not necessarily financially, emotionally, psychologically, and otherwise. I depend on my husband financially and in many other ways. In an interdependent relationship, man is not an island.
If one were single with few or no obligations to anyone, or if one were facing living in a vegetative state, then maybe just succumbing to illness would be best. But often those choices cannot be made inside a bubble because we are a society of interrelated beings who depend upon each other to survive. I hope what I'm trying to say makes sense: it's not just about what's best for me. It's about what's best for all of us.
What I don't want is for the government to decide when a life is worth saving and when it isn't.
On a side note, I'm likely spoiled with a PPO plan rather than an HMO plan, but I love being able to make my own choices about my health care. I used to be on an HMO plan, and I hated the "managed care" system. Does it save money? Yes. But at the cost of giving up one's freedom to manage his or her own treatment and care. Government-run health care strikes me as a big HMO, which doesn't appeal to me at all personally. However, managed care is better than no care at all, and that's what I struggle with: if this is the only way to provide care for millions of uninsured, then should my "preferences" matter? Probably not. But I question whether this is really the only way to do it.
71. Ben R said the following at 10:41 AM on Jul 16:
I'm a lowly medical student, but I think this discussion is a lot more complicated than Ted makes it.
First, looking at the diagram Ted posted (made popular yesterday by the Drudge Report), you're astonished at how complicated "government healthcare" can be. What's unwritten in that diagram is that healthcare is already that complicated--that diagram barely adds anything to the complexity. We should be appalled at our current system--not at a system yet to be created.
Second, I know we all fear a poorly-run government healthcare system. It's important to realize that there are some things the VA healthcare system does really well and there are some things private insurance companies do really well; both have their downsides, though. Before Ted criticizes the VA, he needs to realize that the majority of VA patients rate their care better than comparable private patients at other hospitals. Moreover, care at the VA from what I've experienced is much more comprehensive--it treats the whole person and makes sure everything is in line for them to complete their treatment. Just as an example, the medications a patient needs at home are brought to their hospital room prior to discharge and explained to them. I work in a large, private urban hospital and this is impossible, essentially, even if the patient would prefer us to get them for him prior to discharge. In such cases, it's questionable whether the private patient has the means (ie. physically, financially able) to get his medications after discharge; if he isn't able, he won't take the medications he needs.
Third, we spend a lot more for our healthcare for worse results. We spend 16% or more of our GDP on healthcare for a population that's less healthy than countries spending less than half that.
Fourth and most importantly, we all prize our rights of freedom of speech, freedom of religion, and our rights to "life, liberty, and the pursuit of happiness." Sadly, all of these are dependent on health. It's great that Ted and the majority of Americans are wealthy and healthy, but a minority are sick, poor, or both. In reality, any major illness will make any wealthy, insured person in the US poor and uninsured. Most of us are just lucky enough that it hasn't happened yet.
I do believe people have a right to healthcare--it's the right upon which every other right is based. In the interim, though, those of us who have insurance and incomes, should be willing to financially and emotionally support those less fortunate through medical problems. The concept is merely a modern-day translation of the Gospel's request that if one man has two cloaks, he should give the second to a man with none.
72. Amir Larijani said the following at 10:50 AM on Jul 16:
Ted (#67): The HSA is a good start, but we need to have a more portable system, like Medical IRAs (mIRAs).
At my current job, I have an FSA and an HSA, and use a high deductible plan. The problem I see is that (a) there is a limit to how much I can save in my HSA, and (b) the portability of those monies if I move on to another job.
mIRAs would be more portable. Ideally, they would also (a) have unlimited deductibility for tax purposes, (b) be applicable for the individual and/or family members, or even people to whom he or she wishes to designate the monies in his or her estate.
This would put the onus on individuals to stay healthy, make sound choices, save and invest for the future, and use that money to negotiate fees for products and services.
This would also allow an individual to purchase an appropriate supplemental plan, such as a catastrophic care plan.
Would it cover everything? No. Then again, if our car insurance was like our health insurance, we would all have a similar crisis, as we would be relying on our car insurance to pay for oil changes, tuneups, tire changes, etc.
Until the end consumer sees prices that are congruent with the actual costs, you are not going to see any substantive change.
Government efforts--from the advent of Medicare to now--are having the effect of creating demand at a pace that outstrips the supply of services, at every level of production. That has resulted in runaway price inflation.
Get the government out of the business of colluding with the AMA to cap the number of physicians, implement caps on non-economic damages, make the insurance market more national by reforming provisions of the McCarren-Ferguson Act, and provide patients with tax incentives to save and invest for future health care needs. Then we'll see some real reforms.
73. BDB said the following at 10:52 AM on Jul 16:
Lia (#68) wrote:
>>Surely a system that excludes the poor isn't a Christian system,<<
In the U.S., the poor are already covered through Medicaid. The policy argument is about those who don't currently have insurance.
For myself, with an individual Kaiser plan, it costs $130/month. I'm a bit mystified by the people who find it is "impossible" to buy individual insurance. Then again, Kaiser has a very different business model, and as an organization, they do work very hard trying to figure out how to deliver health care efficiently - they are basically a combined insurer and provider. California also has the $250,000 pain-and-suffering cap.
I suspect that buried in the debate is the reality that many young, healthy people simply refuse to by insurance because they are healthy. But the way insurance works is that the healthy people subsidize the unhealthy people. So, when the healthy people refuse to buy, the cost-per-patient for the unhealthy people is through the roof.
One thing about the "insurance mandate" is that people who today choose to buy a new car instead of health insurance will be forced by the government to buy health insurance instead. At least they will be covered in the event of a car accident!
74. P&P said the following at 10:53 AM on Jul 16:
I'm well aware of the differences between HSA's and FSA's. I have also looked at HSA's when I was contracting and responsible for paying my own insurance and there are two major problems:
1. The deductible. As you said, it's high. Sometimes as much as $20,000 to $50,000, before the insurace kicks in. These high-deductible plans basically require you to run through your HSA, your emergency savings and your 401k and IRA before they start to cover your bills.
They also generally cap out at one million dollars. One million sounds like a lot, but if you're in a catastrophic accident, airlifted and then placed in the ICU for three weeks after 22 hours of surgery, that's about a million dollars. I know someone who was in an accident like that and even though he had insurance, his family had to sell their house to cover the other bills from lost income and medication.
Oh, and once you've burned through the money, you don't qualify for insurance. Ever again.
2. Qualifications. If you have what is considered a pre-exisiting condition, e.g. a bad knee that periodically requires surgery (long story, don't ask) or diabeties or even acne, the insurance company has every right to either reject you outright or deny paying to care for the very problem that requires it.
So what am I paying for?
The LA Times ran a painful article about the practice of recission in health insurance claims. Once you read it, you'll see how much regulation the industry needs.
http://www.latimes.com/business/la-fi-rescind17-2009jun17,0,3508020,full.story
75. DEH said the following at 10:56 AM on Jul 16:
One more thing: sometimes I question the idea that people with employer-sponsored health insurance are spoiled, for lack of a better word. I don't necessarily understand this idea. It seems to me that people who live off the government as a lifestyle (some people on welfare and Medicaid) are the spoiled ones because they get something for nothing. My husband works hard at a job he doesn't much care for in order to keep his health insurance. We make decisions in life based on keeping that insurance, such as whether he should get a job he likes better and what other job he could get (hint: it would have to offer health insurance). We make these choices attempting to wisely provide for ourselves and not depend upon others to do it for us. I realize that not all people are in the position we are in to have employer-sponsored health care. But I wonder what makes them different than us? Primarily the choices they make. We chose to pay to put my husband through school. We chose to have him work at abnormal hours to have a job with good benefits. We choose to live on less because his job, while having awesome benefits, doesn't pay that much. We have health care right now because we chose to go in a direction that, while not always easy, would provide for that need. What's to keep others from doing the same?
(I am grateful for the opportunity God has provided for my husband to have this job. But it's not like he doesn't work for his health care, and that's the point I'm trying to make.)
I do believe state programs for uninsured serve a good purpose as bridge programs, such as when a layoff occurs. But I question the people who use Medicaid as a lifestyle. (I believe that Medicare falls into a different category because it serves a unique set of people with unique needs.)
76. Erin Hale said the following at 11:05 AM on Jul 16:
The post office IS great! My mail carrier and all the staff at the local post office are really friendly. Nothing I have ever mailed has gotten lost, even cash (I was a a teenager, I wouldn't mail cash now!). The stamps are gorgeous!
I just love the US Postal Service.
I have some thoughts about the health care reform topic, but once the Postal Service comes up, I just fall into a romantic reverie and can't focus on anything else.
77. Alicia M said the following at 11:11 AM on Jul 16:
My husband and I are the owners of a small business that opened about 3 years ago. I was just finishing school when the business opened, so we ended up being on a state insurance program for low-income families. We were quite fortunate that this was an option at the time, but I am sooo glad I now have health insurance through my job. I now work as a dietitian and work at a large state teaching hospital. This is the only place in our state patients can go to receive health care while on the state insurance program. The care I received, and the care many of my patients now recieve, was subpar at best. I have seen doctors who are rude and condescending to these low-income patients and patients often wait 6 months or more to be seen. If that's government health care, believe me, it's not a solution.
It also makes me very angry that people assume business owners don't provide health insurance because they are greedy. In the three years that we've been open, my husband has yet to take a salary and we have yet to make any money on our business. He works 75+ hours a week for free, so that we can afford to pay our employees a good wage. The point where we may be able to make money is near, but if we are forced to provide health insurance (and nearly all our employees are college students who still could be covered under parents insurance), there is a strong possibility we will have to give up and close.
78. obewan said the following at 11:17 AM on Jul 16:
#73. BDB said the following at 10:52 AM on Jul 16
In the U.S., the poor are already covered through Medicaid. The policy argument is about those who don't currently have insurance.
-----------------------------------
That may be true, but you have to define what poor means. I checked into this when unemployed and uninsured and facing a $30K medical bill. Medicaid told me they would not pay until my net worth hit $2K.
Also, to all those who say that HSA's are our salvation, I have to ask what will be done about "cheap" insurance companies that offer discount high deductable policies only to deny coverage to make up for it. As I posted earlier, I have already had major problems with a leading "premium" insurer in what is not a high deductable policy and they are notorious for payment denials. If they make trouble for a $1000 claim, how much more trouble will they make for a $250,000 claim?
79. Ted Slater said the following at 11:23 AM on Jul 16:
Ben R (#71), you wrote, "Before Ted criticizes the VA, he needs to realize that the majority of VA patients rate their care better than comparable private patients at other hospitals."
The folks who praise the VA's care are probably patients of my dad. My dad's been a VA physician for decades. He was Chief of Medicine at one VA for a while, and is now doing locum tenens work. He's an excellent physician, always placing the patient over the bureaucracy.
I'm not condemning either the VA or the USPS; I'm just saying that they're not run as efficiently as private, for-profit companies.
80. David Petersen said the following at 11:29 AM on Jul 16:
I work in a hospital in Miami,FL- the home of the highest healthcare rates in the country along with some incredible healthcare (notably medicare) fraud.
I really have mixed reactions to Obama's plan...US healthcare desperately needs reform, but I really don't think this is going to fix the problem. While it undoubtedly will help some people, the plan may create more problems than it solves. Most people don't debate the quality of healthcare in the US- it's the price. That all to say, I don't have an issue with the government running a health plan, but their track record in other areas has hardly been stellar. But, I'm not defending the current healthcare system...it really is a mess in many areas.
Using Canada as an example is tricky. Some Canadians proclaim their system works, and if that's the case, I'm happy for them. I also don't doubt that many are healthier than Americans (probably shoveling twenty feet of snow helps). But, looking at the big picture, Canada has about 1/9 of the population of the United States. Putting such a plan into effect in the US would cause a much greater logistical headache. America simply has a much more complex situation with a larger demand for healthcare and a more diverse population. That all means you need a bigger healthcare infrastructure which drives up costs.
81. BDB said the following at 11:31 AM on Jul 16:
A word about insurance-company profits...
You CAN choose to work with nonprofit mutual insurers. I do this for health, life, auto and homeowners insurance. I agree that their interests tend to be more focused on members rather than profits. I really like the fact that I get a refund on my auto insurance every year when there are fewer claims than expected. It means that every other person with insurance has an incentive to NOT file a claim and not get into an accident.
That's why we should support the non-profit health care cooperatives that some of he rural states want to create, rather than Obama's Medicaid-for-all public option.
82. Ted Slater said the following at 11:32 AM on Jul 16:
Ben R, I need to reply to your sweeping comment:
"It's great that Ted and the majority of Americans are wealthy and healthy, but a minority are sick, poor, or both. In reality, any major illness will make any wealthy, insured person in the US poor and uninsured. Most of us are just lucky enough that it hasn't happened yet."
You don't know me, Ben. Don't speak like you do.
I've lived in poverty, and have been both homeless (crashing at friends' homes for months at a time) and lived with another guy in a small trailer home parked in the woods for over a year. I've had to live at times without insurance on either my health or my car. When my wife was pregnant with our second daughter, I had just lost my job; I was unemployed for months, and we had to go on WIC and Medicaid. I understand how difficult it is to find money, stretch the dollars, make difficult decisions about how to spend them.
Would you consider cancer to be a "major illness"? Well, I had cancer, had the surgery, had the years of monthly CT scans and blood tests and X-rays. While I'm not "wealthy" (I work for a Christian ministry, OK?) and wasn't at the time, I'm also not "poor and uninsured." Your sweeping statement that a major illness will ruin your life and keep you from getting insurance is just wrong, as my life shows.
You concluded your comment saying, "I do believe people have a right to healthcare--it's the right upon which every other right is based." I await Farmer Tom's forthcoming comments on that bizarre conviction; I suspect I'll agree wholeheartedly with what he will have to say.
83. Amir Larijani said the following at 11:34 AM on Jul 16:
Ted: Rather than compare government health care with the U.S. Postal Service, it might be more aptly comparable with the IRS.
We'll get the compassion of the IRS, with all the financial solvency of Social Security and Medicare.
When Bernie Madoff scams investors, we call it fraud and send him to jail.
When government does the same thing to us every two weeks, we call it Social Security...
84. Megan said the following at 11:35 AM on Jul 16:
Lia (#68) said, Surely a system that excludes the poor isn't a Christian system, and if we can include the poor while easing the passing of those who are terminall ill, then we'll be doing a good job.
Your basing your argument on a false premise, and that premise is that "the system" is excluding the poor. There is a federally (and state) funded system for "health insurance" for the poor, it's call Medicaid.
When I say a federally funded program is failing, I mean that it is handing more out than it is taking it. Medicaid is failing; why does the current administration believe that something similar to it (nationalized healthcare) would succeed? A lot of federally funded health programs are failing: social security, medicaid, medicare ...
I really believe the picture here is not totally represented fairly. If there was proof that nationalized healthcare was a successful tactic, then there would be little room for argument. The truth is that the basis for a conservative argument is very real: taxing the rich like crazy for "health reform" leads to job loss. Forget not being able to see a doctor within a reasonable amount of time, worry about having a job.
The country's unemployment rate, according to the federal gov't, is at 9.5% (31 million (+) people). Truthfully, unemployment is higher, because that flawed statistic only means THOSE WHO ARE LOOKING FOR A JOB, EXCLUDING THOSE WHO HAVE VOLUNTARILY GONE TO PART-TIME WORK JUST TO HAVE A JOB, THOSE WHO QUIT LOOKING, and may the list go on.
Now, the federal government wants to place the new burden of $1,500,000,000,000 for nationalized health care onto the rich, adding to the $787,000,000,000 already placed on them this year.
Let me clue everyone in on something: tax brackets are like weight classes. The rich who can stomach getting into a lower tax bracket will do so, directly affecting small business.
This is NO TIME to introduce nationalized healthcare.
85. BDB said the following at 11:46 AM on Jul 16:
obewan (#52) wrote:
>>1.) The government "plans" for healthcare "reform" include legislation to limit "malpractice" lawsuit awards do they not?<<
No, they definitely do not.
As pass the ammunition points out, politicans want to reward the privledged. One of the main goals of the Democratic plan is to reward wealthy lawyers who file frivolous lawsuits - making themselves wealtier while bankrupting medical providers.
The government won't allow itself to be sued for denying coverage, but the Democrats will certainly not extend the same protections to providers or private insurance companies. Once their friends the trial lawyers have had their way, it will force the private companies out of business and leave the government as the only one standing.
The best way I heard it described was that the government competes with private industry the way a shark competes with a duck.
86. BDB said the following at 11:47 AM on Jul 16:
And, for the record, the Republican Party showed their complete foolishness when they insisted on talking about Bill Ayers instead of having a good discussion about health care during the election.
87. Ted Slater said the following at 11:51 AM on Jul 16:
P&P (#74), problems you have with HSA include "The deductible. As you said, it's high. Sometimes as much as $20,000 to $50,000, before the insurace kicks in."
I haven't see deductibles that high. Typical deductibles are between $1,100 and $5,600. That's a chunk, but not anywhere near what you identify. Where did you get those numbers from?
88. P&P said the following at 11:51 AM on Jul 16:
"a major illness will ruin your life and keep you from getting insurance is just wrong, as my life shows."
Ted, you've been very, very lucky. One trip to a homeless shelter, a welfare office or even an emergency room will show you that you are the exception, not the rule.
I'm the voluteer coordinator at a shelter twice a month. Part of my standard introductory speech to new volunteers is "once you're out on the floor, you'll see that the only difference between you and the people you're serving is a couple of paychecks and a run of bad luck."
Perhaps a bit of humility is in order. Be thankful for your good luck, but be less judgemental of others who have not been so fortunate.
89. BDB said the following at 11:56 AM on Jul 16:
Ted (#79) wrote:
>>I'm not condemning either the VA or the USPS; I'm just saying that they're not run as efficiently as private, for-profit companies.<<
Hold up there a second. The USPS is under government mandates to provide service that private businesses are not under. UPS and FedEx simply do not servce some rural areas that the USPS is required to serve. Unlike private competitors, the USPS is REQUIRED to charge the same price for a letter no matter how far it goes - a letter to Alaska is required to cost the same as a letter across town.
In one incident, someone building a building in remote Alaska determined that it was actually cheaper to mail the bricks, individually wrapped, to the location as first-class mail. This meant little planes carrying bricks for quite a while instead of other mail. The USPS was legally required to deliver them.
This has now been remedied, but the USPS had to wait until their next round of hearings to get the policy change approved and charge different rates for shipping parcels different distances. Private businesses don't have the requirement to wait for government approval to make logical changes to their pricing.
And that is ultimately what will kill private insurance: government mandating that private insurers cover certain procedures and not letting them charge for it. This has already wiped out many emergency rooms, since emergency-room hospitals are required to treat everyone, but in California are not now even allowed to bill people who don't have insurance. So the hospital simply closes the emergency room as an alternative to shutting down completely.
90. P&P said the following at 12:04 PM on Jul 16:
I based on some research I had to do about four years ago. Most of it was for low-cost catastrophic insurance. The monthly payments were around $100 - $250 per month, and the lowest deductible I found was $20k.
In the northeast, it's hard to find a health insurance plan that accepts individuals with no company affiliation for less than $1,000 a month. I stuck with my previous company's COBRA plan, which was about $600 a month, until I found permanant employment.
91. Sarah P. said the following at 12:05 PM on Jul 16:
Several people have commented that it's not "Christian" for us to let poor people suffer from lack of health care. I had to comment on this point, since this argument is one of my pet peeves. Since when is the civil government the tool by which we are meant to evidence our compassion?
In fact, on the personal level, I feel no compassion and warm fuzzies about paying taxes. That's because I don't trust that my money is being administered particularly well. Nor, I suspect, do poor people who regularly visit the ER for free Medicaid feel love for their neighbor as a result of benefits that are their "due."
Here's a question -- why is it a fundamental right to have medical treatment? No, seriously. Why does somebody owe this to me? I could go on for a while more, but I'm just going to leave it with that question and see what people say.
92. Ted Slater said the following at 12:14 PM on Jul 16:
P&P (#88) -- I'm simply saying that it's incorrect to say that "any major illness will make any wealthy, insured person in the US poor and uninsured."
Sure, sometimes it does. But not necessarily, as my life demonstrates.
And, no, I'm not "lucky."
Regarding your comment #90, again, I'm just not seeing any HSA deductibles that are anywhere *near* $20k. Maybe four years ago, but not today. I'd be interested to see what your research would come up with in 2009.
When I was unemployed, we also went the COBRA route, rather than an HSA.
93. NathanaelN said the following at 12:20 PM on Jul 16:
P&P(74): When you were talking about HSA's, you caught my attention when you referred to HDHP (High Deductable Healthcare Plans)-
"1. The deductible. As you said, it's high. Sometimes as much as $20,000 to $50,000, before the insurace kicks in."
I am thinking that type of crazy deductible has more to do with buying your own insurance than having a HDHP that qualified for HSA. Buying your own insurance versus using an employer's plan is a different beast entirely.
I am under a United Healthcare HDHP and have a deductable of 1200, a max of out of pocket of 3000, and a total coverage of 2 million. Please see the below link for what makes a plan HSA qualified.
While it is possible to get a HDHP that comes with a bundled HSA, it is not necessary. Legally to have an HSA, you just stroll down to a local bank that support HSA's and open up an account. You then ask your employer to direct deposit into the HSA on a pre-tax basis. Even if they refuse to do pre-tax (my employer will not do pre-tax), you could do post-tax and report the difference on your income taxes.
http://www.pathtoinvesting.org/selecttopics/health-savings-accounts/st_hsa_021.htm
94. Julie said the following at 12:21 PM on Jul 16:
I'm coming in late here but with a bit of a new note - I'm kicking against the health care harness I see decending not because I'm against health care reform, but because I want to be able to choose how I select my treatment. I would prefer to use alternative preventative health care for many kinds of potential issues as opposed to the treatments convential medicine uses, and see no reason why my money should be perpetually taxed toward a system I would rather pay for only when I wanted to use it, i.e. if I were in a car accident. I too am suspicious of a system where a shadowy government bureaucracy will have the authority to tell me or my doctor what degree and type of care to give.
Moreover, I do not want to be threatened with arrest or imprisonment if how I choose to treat my disease or my children's disease does not line up with what you would do in my shoes. I've read a few such articles in the past year, and THAT frightens me as much as a local house church recently being threatened with fines and arrests if they did not cease meeting.
95. Dave said the following at 12:23 PM on Jul 16:
If Ted thinks that the USPS is terribly run, what system does he advocate for getting documents and parcels sent around?
Admittedly I don't live in the U.S., but since I get a fair bit of stuff shipped from there I've dealt with USPS and the whole smorgasbord of courier companies.
I've had enough nightmares with courier companies that I adopted a policy of refusing to buy from U.S. companies that ship using a method other than USPS (or DHL being the sole corporate exception).
If the USPS is an example of government operating poorly, then that sounds to me like an argument in favor of moving towards a public system.
96. Ted Slater said the following at 12:32 PM on Jul 16:
Dave (#95) -- now where have I said that "USPS is terribly run"?
Nowhere? Right. Nowhere.
I do admit that it's fun to accuse me of saying that, though.
97. BDB said the following at 12:48 PM on Jul 16:
For the record, my individual Kaiser policy is $130/month, with an up-front deductible of $2700. After that, 100% is covered.
Basically, it's catastrophic coverage. E.G. in a serious car accident, the $2700 pays for the helicopter ride to the hospital. I didn't want to worry about paying 20% of costs myself since it only saved about $20/month on the premium.
My COBRA coverage was $350/month.
I'm a little mystified as to what is missing. What I do know is that Kaiser's customer approval rating is 20 points higher than any other medical insurer. Their method is usually something people love or hate.
In addtion, they don't charge full price for preventative care even on this deductible plan. They made sure to call me and make sure I knew that it only cost a small co-pay for an annual doctor visit physical, for example.
In other words, what I save on the monthly premiums vs. the COBRA plan is equivalent to the deductible, so net-net is the same cost, even if I do get sick.
I'm sure that the threat of government "reform" is part of what motivates Kaiser to be this creative with their plans. There are also a set of HIPAA plans for those with pre-existing conditions.
98. obewan said the following at 1:14 PM on Jul 16:
#85. BDB said the following at 11:46 AM on Jul 16
obewan (#52) wrote:
>>1.) The government "plans" for healthcare "reform" include legislation to limit "malpractice" lawsuit awards do they not?<<
No, they definitely do not.
------------------------------------
It seems like I definitely heard Obama declare that his goal was to eliminate high malpractice awards and frivolous lawsuits though. Whether he makes it a centerpiece of his "healthcare reform" or just another broken campaign promise remains to be seen IMHO. Maybe it is something conservatives will negotiate for if a bill is up for a vote.
I prefer to remain optimistic since it is something I have little control over. Hope for the best as the saying goes...
99. Sara said the following at 1:31 PM on Jul 16:
I am a duel citizen (Canadian/American), and I presently live up in Canada while the rest of my family lives in the US. I never can understand how Christians can be against the idea of free health care. Christian's throughout history have been all about implementing social support programs and helping our brothers and sisters, and yet so many Christians in the US are worried about a government health care system because their taxes will rise. Seems a little selfish to me. I don't think the US should implement a Canadian system... they need a system that works for them! The Swiss have their own, the British of their own, same with the Japanese and the Germans. The US needs one that will work for them, but that still is fair for ALL people, including those who can't presently afford to deal with expensive insurance companies.
I would never, ever say that the Canadian system is perfect. Far from it. I would never say we have the best Doctors (after all, many of our best move down there to get paid more). However, I love the fact that I have never once had to debate about whether a test was worth getting because my insurance wouldn't cover it all, or whether I should get a second opinion from a doctor who wasn't on the "preferred" list.
100. Sara said the following at 1:38 PM on Jul 16:
In response to 91: "Here's a question -- why is it a fundamental right to have medical treatment? No, seriously. Why does somebody owe this to me? I could go on for a while more, but I'm just going to leave it with that question and see what people say."
Is not health more of a right than education? After all, if you are sick it can be very difficult, if not impossible, to learn properly. Yet the US provides public education as a fundamental right.
It is also in Article 25 under the UN Universal Declaration of Human Rights.
Perhaps it is because I have lived in Canada the majority of my life that I find it shocking that people are more concerned about taxes being raised than the welfare of their neighbor.