Socialized Healthcare?

potluck wrote:

the welfare of americans lies in the oppurtunities that exist. In the words of EV. your dirt is my food. life is what u make it. I like to give myself and my fellow americans more credit. i think we're capable of providing for ourselve. The "free market" has a way of working itself out.

Clearly this is not the case when not all Americans have the same opportunities to receive the health care they need and the disparity is increasing. The "free market" is not working. Even if it did work itself out eventually, how many people should die while we wait for that to happen?

Americans as a country are capable of using our vast resources to provide for ourselves though - when we all pitch in to ensure that everyone has health care.

Pacomc79 wrote:

I know this, Delivering a baby now even with the new drugs and technology isn't that much more complicated than it was in 1943 and it's about 20 grand to deliver a baby now. I'm pretty sure it wasn't close to that then even adjusted for inflation.

This is in large part because of the outrageously-increasing cost of malpractice insurance for OB care, especially for Family Medicine docs who do deliveries. This will have to be addressed if we are to fix the system.

(I can't help but notice that this is yet another problem involving insurance companies.)

scb wrote:

This is in large part because of the outrageously-increasing cost of malpractice insurance for OB care, especially for Family Medicine docs who do deliveries. This will have to be addressed if we are to fix the system.

(I can't help but notice that this is yet another problem involving insurance companies.)

exactly. Tort reform is a big part of it even in any system. I'd be interested in hearing how malpractice suits work in social systems. I don't really know much about that. I'm guessing it's pretty well controlled or not allowed at all.

Pacomc79 wrote:

exactly. Tort reform is a big part of it even in any system. I'd be interested in hearing how malpractice suits work in social systems. I don't really know much about that. I'm guessing it's pretty well controlled or not allowed at all.

That's actually one of the nice side effects of the Canadian system, it totally cuts down on personal injury lawsuits, and weasely, ambulance chasing personally injury lawyers. I mean if someone causes a traffic accident and you are injured it is pretty difficult to sue for medical expenses when there aren't any.

http://www.counterpunch.com/nader05062008.html

"She and her husband returned with a check for $45,000. After a blood test and biopsy, the hospital oncologist urged admittance quickly. Then the hospital demanded an additional $60,000-$45,000 just for the lab tests and $15,000 for part of the cost of the treatment.

To shorten the story, she received chemotherapy for over a year. Often her appointment was “blocked” until she made another payment.

In a particularly grotesque incident, she was hooked up to a chemotherapy pump, but the nurses were not allowed to change the chemo bag until Mr. Kelly made another payment.

She endured other indignities and overcharges. Reporter Martinez cites $360 for blood tests that insurers pay $20 or less for and up to $120 for saline pouches that cost less than $2 retail.

Imagine anything like Mrs. Kelly’s predicament and pressures occurring in Canada, Belgium, Germany, Italy, France, Switzerland, Holland, England or any other western country. It would never happen."

farfromglorified wrote:

Silly government intervention -- that's where. Insurance companies have long existed in the health market, but they traditionally played a very small roll in that market. Then came WWII. Fearing inflation, the government instituted wage caps for most American workers. As prices increased and labor pools decreased, American employers desperately needed incentives to hire and keep workers. They were prohibited from raising wages, but part of the wage cap allowed for employer payments towards "worker health and welfare" (sounds great, huh?). That's when the concept of employer-sponsored healthcare, one of the dumbest labor missteps in American history, was born. At the time, everyone thought it was wonderful for much the same reason they currently think UHC is wonderful (i.e. "free healthcare"). But that "free" healthcare dramatically increased demand and, coupled with Medicare and Medicaid and other governmental and market forces, played a huge roll in putting healthcare prices at their current levels.

Certainly much blame for the current state of our healthcare system can be placed at the doorstep of insurance companies. But if you think government intervention is the solution to insurance company dominance, please don't forget that governmental intervention gave rise to insurance company dominance in the first place.

Thanks for that interesting bit of history.

For the record, I don't believe I've ever said that the government should completely take over (or that it shouldn't). All I know is that in a country as rich as ours there is no excuse for anyone going without healthcare. We need to make universal healthcare happen. I don't care how it happens as long as it works. The system is obviously broken now.

Regarding insurance companies, I believe "for-profit" and "for the good of the people" are mutually exclusive concepts.

Regarding the government, I understand your point about the government having screwed things up before, but I don't think it follows that they will necessarily screw things up forever more.

RolandTD20Kdrummer wrote:

In a particularly grotesque incident, she was hooked up to a chemotherapy pump, but the nurses were not allowed to change the chemo bag until Mr. Kelly made another payment.

Sad but true. I just now told a patient she couldn't have a single pill she needed until she forked over $105. Then I came back to my office and read this post. How apropos. :(

scb wrote:

Thanks for that interesting bit of history.

For the record, I don't believe I've ever said that the government should completely take over (or that it shouldn't). All I know is that in a country as rich as ours there is no excuse for anyone going without healthcare. We need to make universal healthcare happen. I don't care how it happens as long as it works. The system is obviously broken now.

That's fair -- there's certainly nothing incorrect about saying the system now is broken and saying that we can do much better. However, it's this "I don't care how it happens" attitude that invites very bad solutions. When you have an itch, cutting off your arm is not a very good "solution".

Regarding insurance companies, I believe "for-profit" and "for the good of the people" are mutually exclusive concepts.

That's silly. My homeowner's insurance is "for-profit" and provides me much "good" in the event of a disaster that affects my home. Automobile insurance largely happens "for profit" and provides much "good". Finally, even the much maligned healthcare insurance industry, despite more awful stories than one can count, makes both a "profit" and provides most of its users with low-cost healthcare. There's nothing mutually exclusive about "profit" and "good for the people", particularly considering the fact that philosophically those two things are synonymous. When you get great healthcare at a reasonable cost, you are profitting. Not all "profits" are measured in $$$.

Certainly there is a motive inherent in the market for insurance providers to deny claims, but one needs to think about this more deeply than that. Insurance providers deny claims in order to control costs. The exact same thing happens in UHC systems where people are regularly denied care. In a health insurance market, however, there is also a strong motive not to deny care. That motive extends from revenue. If you were going to buy insurance yourself, would you willingly buy it from a provider that routinely denies care??? Of course not.

The fundamental problem we have is that the people who buy insurance typically are not the people who use it. We have too many employers selecting health insurance plans who don't give a shit whether or not the companies backing the plans deliver on claims. The employers are simply trying to offer insurance for employee retention, attraction, or regulatory reasons. And employers are often going with the cheapest instead of the best option. So now, not only do insurance companies have a motive to deny claims (control costs), their customers (employers) have a similar motive (control costs). Meanwhile, the end user (you) is getting fucked because you're not providing any value into the process because you're getting your healthcare for "free".

Health insurance, once upon a time, used to be relatively cheap (though not so cheap that everyone could afford it) and it used to pay out as regularly as any other type of insurance. Why? Because the people buying it valued the service they got out of it and held the providers to appropriate standards of care. That dynamic is now largely gone thanks to employer-sponsored healthcare. Furthermore, that dynamic can be hard to come by in many nations with UHC where people are denied care due to insufficient taxation and/or supply rationing.

Regarding the government, I understand your point about the government having screwed things up before, but I don't think it follows that they will necessarily screw things up forever more.

Absolutely not! Everyone makes mistakes, not just the government. However, in order to solve economic problems one must take an economic approach. The healthcare "crisis" in America is an economic problem, not a philosophical problem or a emotional problem or even a justice problem. And economic problems always have economic solutions. In terms of pricing, taking any action that increases demand for a product and decreases supply (as UHC would likely do in this country), is to take a step back, not a step forward.

scb wrote:

We don't have universal health care by any stretch of the imagination. We also don't have a free market - hence the quotes in my original post.

I got that part, I'm just saying you could just as well have written "universal health care" isn't working. It's in quotes because we don't have it either.

Why use either term if we have neither?