Universal Insurance

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  #1  
Old 05-13-09, 04:07 PM
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Universal Insurance

It appears that universal health insurance will ultimately become a reality at some point. The question is only who will pay for it.

Its either going to be the individual, business or all of us.

I for one can't help but wonder why our geniuses in Washington, don't take the opportunity to incentivise individuals to purchase heath insurance by providing a 100% tax deduction on every dollar spent on health care and heath insurance and for business perhaps a 150% tax deduction. Maybe more business would opt to keep their employees healthy, and individuals would not be put in a position to deplete their income.

My guess is enrollment would skyrocket ,revenues would
explode and costs borne to supply and demand would moderate, having the net effect of lowering overall costs.

The added effect would be, that tax payers would have fewer people to support. Just saying...
 
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  #2  
Old 05-13-09, 05:24 PM
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Originally Posted by merlesdad View Post
I for one can't help but wonder why our geniuses in Washington, don't take the opportunity to incentivise individuals to purchase heath insurance by providing a 100% tax deduction on every dollar spent on health care.
How would the gov't earn any money? The cost of health care probably is a big chunk of what the gov't takes in in revenue? I thought I heard once that medical costs are like $2 trillion a year.

Since middle income and low income wage earners do not have to pay all that much tax after all the excemptions and deductions are subtracted. Would it be fair that they pay no tax?, by subtracting their yearly health care costs? One little stay in the hospital for the slightest thing can cost thousands. Just one CT scan or MRI can cost $1-3,000. My neighbor was in the hospital for 11 days with infection and his bill was $40,000 +. The neighbor on the otherside of me has a bill for about $150,000 for his colon cancer. The stories are endless. A local girl hit a deer on her motorcycle and the hospital bills are now $150,000 and counting. They are holding a benefit for her. (Who in their rightmind would ride a motorcycle in deer country, where they breed here like rabbits, and other stories are out there about motorcyclists being killed by deer? Look at what her lack of judgement is doing to make us all pay more!)

Health care costs just cost too much. I think it is because the field is not competive enough because I doubt you can easily start your own clinic or hospital without a complete bureaucratic nightmare. So they charge through the roof for every single thing. I think if a nurse gives you an aspirin, it's about $8. The hospital wants to make big buck, and so does the insurance companies. A double whammy.

Our 2 big local hospitals have spent bookoo bucks on major additions and renovations thanks to their big bills.

Should the industry be regulated more? Well, something needs to be done. You can't have insurance companies sending out notices every year that they have to raise your premium another 20%, and this goes on every year! After a while it mathematically cannot work for a working or retired person to pay.

It will take a think tank institute to iron out this current mess(actually it's a serious crises) and carefully design a better plan that both allows capitalistic principles, without unnecesary procedures and waste.
 
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Old 05-13-09, 06:37 PM
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It's a good theory, but that's about it.

I heard on our local news that a doctor was charging a flat flee of $45 for anyone who needed a checkup. The insurance companies threatened to end his practice, so he had to stop.

That is the mentality and greed these companies have.

Another example:

My wife is pregnant, and we didn't realise our medical insurance (Blue Cross) did not have "maternity" coverage. So we are paying for all appointments and the birth out of pocket. A ultrasound WITH insurance would have costed us $300, but since we didn't have covereage and paying cash, it was $100. I'm not arguing, but it's no wonder no one can afford health insurance.
 
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Old 05-13-09, 08:11 PM
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Just my $.02 worth, but I get a little tired of the idiots in Washington spouting the numbers like 40 million people don't have health insurance or some such. What they never see is how many of them would rather have a new SUV, big screen TV, vacation home in the mountains, and house with a pool than pay premiums.
 
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Old 05-14-09, 03:28 AM
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TG, that may be true of a few but I'm sure there are many uninsured that can't afford health insurance. What gets me is, they say this nation pays more for health services but has poorer health than a lot of other countries. I agree that corporate greed pays a big part in this.

Pharmaceutical companies also pay a big part in health care's high cost. Before medicare part D, I bought over half of my meds overseas. My local pharmasist said what I paid for zocor was = to his wholesale cost.

Last fall I cut the tip of my thumb off. The ER visit would have been over $1000 but after medicare cut the price, my 20% was only $54. The 20 yr old hospital is constantly being remodeled since it was about 5 yrs old. The hospital is non profit - guess they have to spend the excess money somewhere.

my 3 cents
TG, does that trump your 2 cents
 
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Old 05-14-09, 04:41 AM
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Nah, I agree; I wasn't suggeesting that everyone falls into that category, but I would say there are a fair number and also a fair number who can afford all the mentioned luxuries AND health insurance premiums, but choose not to.

The media and many politicians also tend to slur the difference between health insurance and health care; just because one doesn't have insurance doesn't mean they can't get medical attention [again, of course, if they can afford it].

Wasn't the whole HMO idea supposed to keep these problems from happening? Can't remember who came up with that system originally.
 
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Old 05-14-09, 06:29 AM
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Tg,

I think many people think that more people could really afford health insurance if they had their priorities straight. Yes, I see more and more people with those big flat-screen tv's --even in dilapidated trailers!! I know one lady who is a single mom, living in a tiny ramshackle trailer, who has a ginormous one with surround sound, like you are in the theater. I doubt she has insurance. But -

The tv cost her a one-time cost -say a couple to a few thousand. But that will not buy even one year of premiums! Health insurance premiums are every month to the tune of thousands a year per person! That is why people can't afford it. And this is why they need to do something to make health care costs lower, by streamlining and other methods.

But I would like the idea that poor people can qualify for care if they pay towards it in the way moderately poor people make a least a gesture payment towards income taxes. At least it would show some form of responsibility.

But - I am open to new ideas on all this, and am even willing to change my mind and attitude. For example, I even have mixed feelings regarding the poor. They (not all) make their bed and sleep in what they sowed years ago. Because of their possible lack of initative in life to further themselves, they perehaps are satisfied with their lot in life (as long as they can have a junk car, cell phone, place to live no matter how junky, buy cigarettes and beer, and have a flat screen tv and a dvd collection, and enough gas to drive to the next town to get a McDonalds sometimes) by staying at the bottom of the totem pole and simply rely on price breaks on everything, and they are satisfied with that -as the cost burdened is then divided out amongst those people who are paying for them. So in a way, I really don't like the idea of necessarily blindly giving out handouts either. That is why I mentioned about "think tanks" debating all this. This is all very complex andd deep.

No easy answers here. Working on plumbing and furnaces and the like is way easier to solve than this nightmare.
 
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Old 05-14-09, 11:17 AM
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Amen. My biggest beef with anyone in Washington trying to "fix" the problem is that it will not only be made worse, but the beaurocracy will become entranched so deep that any chance of fixing it will be lost until sometime in the next century.
 
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Old 05-14-09, 03:05 PM
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I highly doubt that universal health care could work in the US because as has been said it is too entrenched in big business.
In Canada the system is not perfect but it is nice to know that a health problem will not break you financially and that people who could not afford health insurance will be well looked after.

In our system the hospitals are run on a cost recovery basis, not for profit and we do not have the insurance companies raking in a profit acting as a middleman as they would be if your scheme was insurance based.

Although we do have long wait times for some services who seems to be doing the most complaining here are the rich who are not allowed to jump the que by paying for their health care.
Private hospitals are not allowed.

This is also the reason that many US citizens are trying to buy "cheap Canadian drugs"!
The government run hospital and drug programs keep the prices down.
Why do you think the US drug lobby is vigorously trying to stop this.
 
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Old 05-14-09, 06:03 PM
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Originally Posted by GregH View Post
Private hospitals are not allowed.
Hmmmm. A government that becomes to much of some sort of poling agency sort of scares me.

I believe in freedom too much. This is what actually scares me about where our own gov't seems to be heading.

I thought our country was founded on principles in which we, the people, allowed certain appointed individuals ( a relatively small number at one time) to run our affairs, because we are too busy to. But the problem that started to occur, and will occur in all gov'ts, is that those who gain control start to control more and more, and control the ones who hired them in the first place. Then with the fear of their hired police and military, there is actually nothing much the masses can even do about their power anymore! And then the gov't gets bigger and bigger, and it almost sounds silly to refer to the gov't as our employees. No -they start dictating to us. And here we hired them in the first place.

I'm just not sure right now what the answr is. I just do not like more and more of our freedoms being taken away because "they" determined it is in all of our best interest -which maybe could be. But there is no end to that reasoning, actually -until you become totally controlled to the point they could actually insist on what we all eat, because it be for our own good, and could keep health care costs down. It sounds ludicrous right now perhaps -but give it time. After all, we have seat belt laws and no smoking (ban) laws, and you can't burn leaves anymore -just a lot of stuff - where no longer are personal decisions on matters solely at the discretion of the individual.
 
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Old 05-15-09, 09:50 AM
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Part of the real problem is brilliantly illustrated in gunguy's lawyer post. People are so friggin' sue happy, malpractice insurance costs an arm and a leg. Also I imagine that the HMO's have a trillion lawyers working for them. I once had Anthem, which cost me one paycheck per month. Those idiots would not cover extracting an infected tooth, but would cover me if the infection spread. I paid for the extraction myself because I didn't want to play that game. By the way, gas to go back and forth to work and groceries aren't free so I had to drop the health insurance due to the fact I couldn't afford it.

However, with the way the government is running the war on drugs, the idea of them doing health insurance for me scares the you know what out of me.
 
  #12  
Old 05-15-09, 10:42 AM
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Estimates are that this will cost 2 trillion dollars. Where do you think that money is going to come from? Taxes, taxes and more taxes!!!!!!!
 
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Old 05-15-09, 10:56 AM
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Ya, but you know what 'Joe the plumber' was told. They want to redistribute the wealth. You take from the rich [some of which have worked very hard for what they have] and give it to the bums

What will they do when the rich deside this is no longer the great country they want to live or invest in.
 
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Old 05-15-09, 12:38 PM
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Originally Posted by the_tow_guy View Post
Just my $.02 worth, but I get a little tired of the idiots in Washington spouting the numbers like 40 million people don't have health insurance or some such. What they never see is how many of them would rather have a new SUV, big screen TV, vacation home in the mountains, and house with a pool than pay premiums.
And then, you get people like my wife.: 62, extremely healthy lifestyle, non-smoker, at age 58 she had breast cancer - it's what they call "sporadic", there no predisposing environmental factors, that's just the card she drew.

Fortunately she has a corporate job an excellent health insurance, but if she lost a job tomorrow, she would be uninsurable once COBRA ran out... we could afford to pay the $12,000 a year so that make up her contribution the employer's contribution, but the insurance simply wouldn't be available.

She could be sitting at her desk today, insured, and she could be laid off tomorrow, and uninsured once COBRA ran out - the only difference is that one day she would have a job, and the next day through no fault of her own she wouldn't.

IMO two things that are very clear here: 1) a system that ties the availability of insurance to employment is crazy. 2) The only way that insurance can possibly be affordable to someone like my wife is either 2a) you have private insurers and mandatory coverage based on "community rating" - the insurance company is required to cover everyone and premiums are averaged out across was groups or 2b, you accomplish the same through government insurance program, which is essentially the situation with Medicare.

------

As someone with some actual knowledge of how the rest of the world provides medical care, one of the things it's very clear to me( sorry if I offend anyone, but it's just the truth) is that most Americans are abysmally ignorant about both the pros and cons of other arrangements.

I give you two examples:

It's often pointed out to me how longer people have to wait in Canada than in the US for things like hip replacements. Who do you think pays for all those hip replacement for the elderly in this country? Private insurance? No way. The vast majority of hip replacements in this country are received by elderly citizens, and paid for by Medicare - what matters is not the mode of insurance, what matters is the kinds of decisions society makes about how it's going allocate medical resources.

The second is the assumption that Europe is the land of "socialized medicine".

In fact in Europe you have systems that range from the UK (probably the closest thing to pure socialized medicine in Europe, though even in the UK you can buy supplemental private insurance) to places like Germany and Holland, where the government subsidizes the purchase of insurance through private providers (this is probably the sort of system we are going to end up with here).

My wife's cousin is an American who's lived in Holland for 40 years and is married to a Dutch citizen - she's probably about as close to the Dutch equivalent of the average "salt of the earth" American worker as you can find - she was a secretary, her husband is a truck driver - and she just laughs her head off when she hears Americans tell her how horrible her medical care must be: she developed congestive heart failure in her late 50s and was unable to work, in this country that would bankrupt all but the very affluent once they lost their job and their insurance, however since she paid into the Dutch system for entire working life her medical care is covered for a very reasonable premium.

My suspicion is once Americans who hate "the goberment" have been subjected to the "indignity" of actually having affordable healthcare available to their family if they happen to get laid off for a few years, they too will be laughing their heads off at anyone who tries to convince them to go back to the good old days when they when once they got cancer if they happened to be uninsured they had (like the woman sitting next to my wife in the hospital) to choose between terminating the radiation treatments early, losing their home, or pulling their kids out of college.

Just my $.02 worth... for a "second opinion" take a look here: "Going Dutch"
 

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Old 05-15-09, 01:36 PM
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I do not know aboout the rest of the world, but it seems like in this country the joke below is scarily true

How many politicians does it take to change a light bulb? Two, one to screw it in and one to screw it up
 
  #16  
Old 05-15-09, 06:56 PM
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It is more political than helping all citizens have insurance.
It's about securing the re-election of a political party and uncle sam taking over more of the private sector.
Anytime the federal govt gets their sticky hands on anything they allways muff all it up.

Keep it private, fix the system not throw it away it's still the best healthcare system in world.

Do you realy want some Washington bueraucrat telling you when and where and if you're worth having medical treatment?
 
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Old 05-16-09, 07:39 AM
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I have heard of Canadians coming to the US for operations due to the long wait and have heard of people who didn't come here and died waiting. So it sounds like universal insurance is as about as beneficial as flatulence in a hurricane.
 
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Old 05-16-09, 03:47 PM
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Originally Posted by Michael Thomas View Post
My suspicion is once Americans who hate "the goberment" have been subjected to the "indignity" of actually having affordable healthcare available to their family if they happen to get laid off for a few years, they too will be laughing their heads off at anyone who tries to convince them to go back to the good old days when they when once they got cancer if they happened to be uninsured
Naturally. Hence why there is getting to be more of a consensus opinion that the more people that are poor in this country, the more likely they will vote Democrat, so they can receive things, even if they do not have to pay for it -because they want it, or feel that by breathing in air, it is their right to have it - based on some law of humanity.

The money has to come from somewhere, no matter from what source. It is simply a game of shuffling cards and picking which card out of the deck. Only this is not a magic trick and money just does not freely appear.

Is it the right of poor people to get full coverage, even if they do not work or work at low paying jobs and may have minimal coverage or no coverage at all? Who is to pay for them? Steal money from the rich, who do the employing, to get it?

I think a big approach to this dilema has to be addressed on the medical and insurance costs front. These cost increases have got to be fairly curbed -and soon. The charges are outlandish. As long as these charges continue to escalate at ungodly yearly rates, there is no way a gov't or individual can afford the coverage. It just will not work after a while.

BTW -sorry to hear what the wife has had to through. My sister went through it.
 
  #19  
Old 05-17-09, 10:15 AM
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Originally Posted by HotinOKC View Post
.......An ultrasound WITH insurance would have costed us $300, but since we didn't have covereage and paying cash, it was $100.

Are you sure you don't have the numbers back wards? If not, be glad you don't live in Minnesota.

1) My daughter had a baby a little over a year ago. The hospital bill was ~$14,000. Normal birth, no problems. Because she works for a big company with good insurance the co-pay was $100 and insurance paid ~$5,000. In other words, if you DON'T have insurance you pay around 3 times MORE.

2) Brother-in-law slipped on ice and broke a couple ribs. Left emergency room owing $4,500......."well, we should do a CAT scan." They have Blue Cross so the bill was reduced $1,000. I would think it'd be the other way around.

And don't even think of calling an ambulance. I read the other day it costs $1,000 (Cloquet, MN) just to go out the door, plus mileage.

Yikes.

Baldwin
 
  #20  
Old 05-17-09, 12:21 PM
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Health care prices vary around here. If you have insurance, you and the ins co are usually charged a negotiated price although some are charged full price. Those without insurance are often charged full price although some health care providers will cut the uninsured a break.

The public ambulances here used to only charge the insurance companies [and not the patient] but the ins co's had a fit because the patients weren't getting billed. They are now required by law to bill the patient. I don't know how hard they work at collecting....and hope I don't have to find out
 
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Old 05-17-09, 12:47 PM
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Well, with ours (retired military basic coverage) the provider bills full price..for instance wifes last Dr visit for blood work was about $120 plus lab fees. Some things were disallowed by insurance (like "handing of medical samples" ie..the blood) and since Dr is "in the network", we weren't charged. So we wound up paying something like $.55 to the Dr and $5.00 of the $95 lab work fee.

I asked the billing clerk if they reduced prices for people without insurance who payed immediately and she said they normally did, but I'm sure not down to $.55 on a $120 bill. They also reduce it for people who are on various forms of public support.
 
  #22  
Old 05-18-09, 11:40 AM
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Don't be fooled into thinking that the wealthy will pay for the poor unisured. It will be the middle class as always that will have that privilege. Make no mistake about it, we will all pay for it. We will pay for our own, and for many that don't care to pay for their own. The Obama administration cannot do magic, the money must come from somewhere.
 
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Old 05-18-09, 12:06 PM
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It's a common thought that the middle class pays the most taxes..

Do a search for "who pays the most taxes" and almost every souce disputes that fact.

I guess a lot depends on what you consider "middle class". A few years ago, I heard some people talking about their son (IIRC) and they said he was "just doing ok, not great". Turned out he was making almost $100K a year as chief fundraiser for William and Mary in VA.
 
  #24  
Old 05-18-09, 12:43 PM
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Gunguy

Hate to say it, but if you make "almost $100,000 a year" in northern NJ, you cannot even afford to buy a house. Middle class is certainly defined differently depending on location. The thing is though that housing eats up of much of the money you make in my area. We are no better off here, we just make more money to pay for housing, that is pretty much it.

As to the middle class paying the brunt of taxes, I cannot imagine that is not the case. 42% of the people pay no federal income tax, and with the Obama stimulus package, that will go to 50% this year. So who is paying for the multi trillion dollar budget we have. I can't believe it is only the wealthy.
 
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Old 05-18-09, 01:27 PM
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Johnny
I completely understand..and wasn't trying to argue. I know the costs are ridiculous in some areas. That's why I qualified my post a bit. Saw something a while back about a couple in NYC, he was a cop making $80 or so, she was a teacher making $50-60, living in a 2 bedroom apartment for some also ridiculous price. Couldn't afford a house within 40 miles and had one old car they rarely drove.

That's why when they include people making over $100k or so in the upper 30% income earners it can be confusing to some.

Wifey and I took that into consideration when we were looking for a new place to live. We looked at a town in NM where we would have been in the top 1% of income, but it was 300 mi from anywhere, so we found here, still top 10% but much more affordable and closer to large cities. We just deal with not having a big theater or lots of choices for eating out. Or any sort of nightlife...lol

Still when you look at the figures, people earning upwards of $300K (1% of income earners) pay almost 40% of all income taxes. And all people earning above around $150K (5% of income earners) pay about 60% of all taxes. These numbers are approximate, since some info is older and they compute it differently, but it's about right. I know theres a lot of people in NYC, LA, Chitown, etc...but thats not where the majority of folks live.

I think most people would be happy to take home half of either one of those numbers.

I'm 51, shes 42, and with our military retirement (45 yrs total service between us), we live within our means, and "just do ok", but we don't want for anything. When the economy picks back up, might go find some work, but right now, its better to just lay low and conserve (gotta get some money set aside...I REALLY want that STAR motorcycle).
 
  #26  
Old 05-18-09, 01:37 PM
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Only point I'm trying to make here is that while the wealthy may pay a lot of tax, the middle class pays a lot of tax as well. If Obama needs 2 million more to pay for health care, it won't all come from the wealthy.
 
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Old 05-18-09, 01:48 PM
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Absolutely...and didn't mean to take away from that point..sorry.


Hey one last thing....in all sorts of surveys..you know who says they pay too much in taxes? The people who make less than $25K a year...because it impacts them the most.

$5 to some one who only gets $200 a paycheck is huge..but $50 to someone with a $2000 paycheck isn't as big a perceived deal.
 
  #28  
Old 05-18-09, 06:46 PM
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I don't think this discussion is about who makes more money or who pays more in taxes; either total amount or percent of income. I will state that at the height of my earning years I was in the low six figures and had few deductions as a result of paying off my mortgage. When I retired I was earning mid-to-high five figures.

Honestly, the discussion is about medical coverage and NOT medical insurance. Insurance requires risk assessment and premiums based on that assessment. I have zero chance of ever getting pregnant yet part of my "medical insurance" premiums is for pregnancy and birth-related medical coverage. Is that fair? I have never had any children in public schools yet all my life I have been paying taxes that support public schools. Is that fair? My car insurance premiums, in part, pay for accidents caused by drunk drivers yet I do not drink alcoholic beverages. Is that fair?

Fairness cannot be used as any kind of measure because it is not universally applied. Some people do not want to work at anything more than an entry-level job and even then for only the minimum of hours. Is it fair to penalize the person that learns more skills and works more hours to receive more pay?

Life isn't fair, get used to it.

The figure that is often tossed out these days is that forty million people do not have health insurance or have minimal health insurance. That sounds like a huge number and I'll admit that it IS a huge number until you look at it in regards to the total population. Our current population in this country is in excess of three hundred million people, that means that less than fifteen percent of the total population is being used as a reason/excuse to overturn our current system.

Who are the uninsured/underinsured? Quite often they are also the young and mostly healthy members of society. Think back to when you were in your late teens and up to about mid thirties. How often did you or anyone you know have any serious health problems? That segment of the population is notorious for NOT wanting to pay for health "insurance" when they could be using that money for some other purpose.

Think also about who uses the greatest amount of medical services. Heck, I have probably used more medical services in the last ten years of my life than I did during the first forty. If the cost of medical coverage could be shared straight across the board in most cases those under forty would pay almost nothing and those over forty would pay more than they could earn.

So while it will never be "fair" universal health coverage could be a bargain for all.
 
  #29  
Old 05-19-09, 06:13 AM
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Originally Posted by furd View Post
If the cost of medical coverage could be shared straight across the board in most cases those under forty would pay almost nothing and those over forty would pay more than they could earn.
But that is the very thing some insurance companies must pull. When I was younger, my health insurance was relatively cheap. But year by year as my "group" aged, my insurance premiums skyrocketed, yearly -dadgum it.

Insurance by it's very nature is a system intended to level out a given playing field. If it's structure was based on likelihood of use of services, then it more closely resemble a pay as you go, user-fee plan, rather than insurance.

I gladly pay my car insurance everyyear even though I have never been in an accident, since in case I DO one day need the coverage, it will be there for me.
 
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Old 05-19-09, 08:41 AM
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Oddly, I've never seen a young, uninsured person arrive in the emergency room after a serious accident, regain consciousness, and demand to be dumped back out on the curb and allowed to bleed out in the name of "fairness" - it seems that in such circumstances some sort of temporary insanity takes hold of them, they abandon their libertarian principles, and for some reason expect the rest of us to try and keep them alive absent insurance.

-------------------

IMO a lot of people are in pretty deep denial about the necessity of rationing healthcare, and some of the people who are the most angry about the prospect of such rationing are the same people who feel very strongly that society ought to be paying enormous costs to keep particular individuals alive irrespective of their circumstances.

To give you a practical example, a while back I met someone who it recently changed jobs because they had maxed out the $1,000,000 lifetime benefit limit of the insurance at their previous job!

The reason for these enormous costs was a child who'd been born extremely prematurely and as a result had many different kinds of severe medical problems, was, constantly in and out of hospitals, required extensive ongoing care, and had severe physical and mental developmental disabilities which would require lifetime institutional care once his parents were no longer there.

This man was extremely proud of the fact that he and his wife disregarded medical advice to consider the option of not opting for exceptional measures to keep this premature infant alive - a suggestion made because the consequences above were predictable.

And while I understood his reasoning, at the same time as I was listening to him I was looking out across an office with perhaps 50 cubicles, and considering the fact that it was likely that the entire insurance premium being paid by every man and woman sitting at those desks, along with the entire employer's contribution, was being spent to preserve the life of this one child - and that the same amount of money more "rationally" spent (for example, on providing healthcare to low income pregnant mothers and the follow-up needed to ensure that they used) it would likely produce a much greater aggregate improvement in the quality of children's lives.

If we want to talk fairness, was this man's act "fair", or "selfish"?

----------------

I've never been much impressed by arguments that it's "fair" to allocate access to non-discretionary medical care by economic condition or employment status, to me it smacks of the assumption that a "low income" workers are a sort of serf, and entitled to the concern of their betters at at level somewhere between that given pets and upper-caste humans.

This notion of "fairnes" produces all kinds of absurd situations, for example one in which it's "fair" for a trust fund baby who's never worked a day in her life to have access to unlimited cosmetic dentistry, while the woman who works 50 to 60 hours a week caring for her children has to go sit at the dental clinic on her day off to deal with a toothache.

Or, where the man who's made a fortune as the CEO of a business that failed on his watch, costing tens of thousands of jobs and billions of dollars in financial losses for stockholders, gets to sit in a private room at an expensive clinic after he breaks his leg on the slopes, but a member of the crew who spent three hours getting them off the mountain has to pay cash at a "Prompt Care Clinic" to get her wrist set after she the broke it getting him down.

Or, as in the case of the woman seated next to my wife at the hospital, having lost her insurance when she lost her job, having to decide whether she should forgo the full course of treatment recommended by the doctor, lose her house, or pull her child out of college - while my wife, who is no more or less deserving - has her care paid for in full by the insurance she's lucky enough to have because she still has a job... knowing that the rules could easily have been reversed.

The situations are "fair" only if you assume that income or net worth - no matter how obtained - reflects legitimate entitlement to access to scarce resources which are needed on unpredictable basis. And the problem is that you then find yourself deciding that it's "fair" that a sociopathic Mafia Don who accumulated his wealth via extortion, drug dealing and homicide should be able to obtain medical care without financial risk or difficulty, while the woman who works 46 hours a week as the uninsured employee of the vendor with the contract to make the beds at the hospital must bankrupt her family to receive the same care.

You can certainly argue about what constitutes "non-discretionary care", or about how best to allocate the finite public resources available to pay for it, but in my experience once you start trying to justify denying such care on the basis of economic success, you've got yourself a morally untenable position if you really bother to think it through.
 
  #31  
Old 05-19-09, 09:31 AM
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I work for a small company (4 employees) so health insurance isn't offered. Paying for it out of my pocket now would be a very good trick. I am thinking about changing to a job with health insurance provided, but in this economy the chances of that are not going to easily be fulfilled
 
  #32  
Old 05-19-09, 10:57 AM
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For those of us who have health insurance, we know that it does not come cheap. As a self employed person, my health insurance in NJ for a family plan is a little over $18,000 per year. It is the single largest expense that I have, but I have no choice, if I want coverage for my family this is what I have to pay. I realize that it may be less costly in other parts of the country.

Here is what I know, it doesnt take a genious to figure this out. Obama says he needs 2 trillion dollars to fund his plan. That money has to come from somewhere, and I'm pretty confident that it will not come from the 40 million uninsureds. I'll put 2 + 2 together and conclude that I will get the privilege of paying more taxes in some shape or form.

Enough is enough, people have to start to be responsible for themselves and stop expecting everyone else to do for them what they will not do for themselves. Times are hard now, nobody can disagree with that, but in the past, when times have been good there have been plenty of opportunities out there for everyone that seeks to make something of themselves.
 
  #33  
Old 05-19-09, 02:33 PM
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If social and corporate welfare recipients were forced to get their money through private charities instead of getting handouts from the government, would that pay for it?
 
  #34  
Old 05-20-09, 06:18 AM
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Originally Posted by HeresJohnny View Post
Here is what I know, it doesnt take a genious to figure this out. Obama says he needs 2 trillion dollars to fund his plan. That money has to come from somewhere, and I'm pretty confident that it will not come from the 40 million uninsureds.
How do you suppose we pay for it now?

Take the uninsured woman woman next to my wife in hospital as an example: either the hospital and the other providers will absorb the cost of her treatment (largely through indirect subsidies provided via state or federal taxation), or she won't receive the treatment all, in which case we all pay in the long run via reduced economic growth, productivity, and tax revenues.

(It's important to realize that these are real costs - something people often find it easier to understand when looking at the benefit end. For example if we had a 100% default rate on student loans taxpayers would still come out ahead because the productivity, incomes, and eventually the tax remittances of college graduates are so much higher than their peers with only high school educations.)

----------------

The dirty little secret about medical insurance is this: as people age, on the average is almost impossible for them to pay the costs of current medical care out of investments of income earned in the much less productive economy of their younger years.

There are two consequences of this:

1) The government - via taxation of younger, more productive workers - has to subsidize the medical care of older citizens, it just isn't possible for most of them to have earned from investment of previous income enough to pay these costs.


2) Anything that reduces the productivity of younger workers - for example children who are not receiving appropriate preventative medical care or adults deferring education to cover medical expenses - makes it harder to do 1).

(One interesting aspect of this is that lots of people complain about the inheritance tax - which is paid by very few Americans - while far fewer complain about the real "death tax" - which is assessed on many more Americans in the form of medical and extended care costs incurred late in life - THAT'S the "tax" that really guts the inheritance of wealth for average American families).


Originally Posted by HeresJohnny View Post
Enough is enough, people have to start to be responsible for themselves and stop expecting everyone else to do for them what they will not do for themselves. Times are hard now, nobody can disagree with that, but in the past, when times have been good there have been plenty of opportunities out there for everyone that seeks to make something of themselves.
My wife, has "been responsible" for her entire life: she is at her ideal weight, eats a healthy diet, exercises regularly, engages in no unnecessarily hazardous activities, and gets all the recommended preventative care and testing.

At 58, she got cancer anyway.

At 62, if she loses her job tomorrow, she will be inelligible for private insurance due to her pre-existing condition.

We are able, and would be willing, to pay both the employee and employer's cost of her current health insurance if she became unemployed, but the insurance industry won't let us.

So how exactly are you proposing that we "be responsible for ourselves"?

I don't mean platitudes or talking points, I mean exactly and in detail how and what what we should be doing differently.... IMO, if you don't have the answer that question, you don't have an understanding of the problem.
 

Last edited by the_tow_guy; 05-20-09 at 12:40 PM. Reason: Fixed a typo
  #35  
Old 05-20-09, 06:33 AM
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Originally Posted by nightowlpunk View Post
If social and corporate welfare recipients were forced to get their money through private charities instead of getting handouts from the government, would that pay for it?
Well run private charities have much lower administrative overhead than private health insurers (the same is true of some government programs such as Medicare), so you would pick up considerable cost savings there.

OTOH badly run private charities have outrageous administrative costs, as a result IMO if private charities were actually responsible for providing a substantial portion of the medical care in this country they would soon - in response to financial scandals - become a heavily regulated industry (as for example is currently the case for not-for-profit hospitals), and would start working on ratcheting their administrative costs up to the levels of existing private insurers.
 
  #36  
Old 05-20-09, 04:08 PM
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Misunderstanding. I was wondering if the government got out of the habit of corporate and social welfare and forced those who collect social welfare to go to private charities. Would that kind of spending cut pay for the horror known as universal health care. There are times when I had to use the ER without insurance, so I set up a payment plan with the hospital instead of skipping the bill. When I showed them a pay stub at the time, they did lower the bill by quite a bit, disremember by how much.
 
  #37  
Old 05-21-09, 06:00 AM
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Originally Posted by nightowlpunk View Post
Misunderstanding. I was wondering if the government got out of the habit of corporate and social welfare and forced those who collect social welfare to go to private charities. Would that kind of spending cut pay for the horror known as universal health care. There are times when I had to use the ER without insurance, so I set up a payment plan with the hospital instead of skipping the bill. When I showed them a pay stub at the time, they did lower the bill by quite a bit, disremember by how much.
When the hospital agreed to to reduce your bill, you became a recipient of "publicly funded universal healthcare" - the hospital absorbed a portion of your costs, and was in turn reimbursed at least in part with federal (and likely state) dollars from other taxpayers.

So we do have a form of "universal health" care in this country, it's just an often arbitrary and inefficient system... and a lot of the people who are its beneficiaries don't even realize they receive such benefits.

For example if you live in a rural area federal dollars are absolutely essential to keeping the local healthcare system running, and those dollars are flowing in from taxpayers in other areas faster than they are flowing out in taxes paid by recipients of such care, and yet the people receiving it are often angry that "guberment programs" funded with their taxes are handing out such benefits.

-----------------------

There's a lot of belief in this country that the way to control medical costs is to allow "market forces" control "demand for services", and there's certainly some truth in this. However the other side of the coin - rarely mentioned - is it ultimately this requires some form of "rationing

For example many of the elderly (and many younger people as well) cannot afford to pay out-of-pocket - or even out of savings or future earnings - for such care, and since in these cases the "purchaser" of care in this "market" is ultimately the taxpayer, only way that you can reduce "demand" for such services is by rationing them, for example (to take an example of a policy that would be effective, but not politically palatable) by deciding that as a matter of public policy we are going to refuse to pay for anything but palliative care once there is less than a 90% chance of 24 month survival.

And this is the dilemma for taxpayers and policymakers: there is no way to radically reduce the cost of medical care in this country without making decisions that make sense in the abstract, but are extremely difficult to make when you get down individual cases.

You can see this problem as actual fact that the state level, attempts a been made to ration Medicad spending on the basis of the set of priorities and rules; you set up committees of taxpayers and insurers and medical professionals, they start with the amount of money available, and create a prioritized list of what public funding will pay for, and what it will not.

But when push comes to shove the regulations never get enforced, because to do so is politically impossible impossible - just try to cut off Grandpaws pointless and expensive chemotherapy for his terminal cancer, and watch the media firestorm burn its way through your career once it hits the five o'clock news.

-----------------------------

These problem are as bad or worse if you presume that you're going to fund medical care entirely through public charity.

As bad because the "demand" for "medically necessary services" is not going to go away, and worse because in many cases locally managed and private charity programs in a position to dispense large amounts of money can and do become hotbeds of corruption, nepotism racism and a whole bunch of other unpleasant "isms" -it is just a fact of life that when local organizations (public or private) are dispensing such services the chances of every kind of abuse increase, and to the extent that what is being distributed is important and unobtainable elsewhere the discrepancy in power between the giver and the recipient increases, as does the likelihood of abuse.

This of course is contra the casual belief of most Americans that local organizations are invariably more honest, humane and efficient than distant Washington bureaucrats.

But if you follow news reports with an open mind you quickly discover that it's a lot easier (and safer) to bribe the local official inspected your building than the IRS agent who is doing your audit, or that state and local legislators are caught taking envelopes full cash a lot more frequently than their national counterparts. And say what you will about Medicare, but it's worlds easier to deal with their paperwork and bureaucracy than with private insurers, and often a lot more efficient and less frustrating to deal with ever private insurers that the deal with the local public works department.

And at least in the first case you can at least be reasonably certain that the rules will be enforced in an evenhanded manner, because the people administering them are essentially impossible to influence with regard to individual cases . You may not like the rules, but they're not likely to be bent because they're being enforced by your sister-in-law, or because you slipped the enforcer five Benjamins, or talked to your friend at the college admissions office on behalf of his grandson.

that's how it looks to me, anyway.
 
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