Health Care in the USA

As you know there is a thread going on asking people outside of the USA their opinion on government sponsored or assisted health care. This thread is to give residents of the USA a chance to speak their mind if they have anything to say.

From my point of view the fact that the USA is only country in the industrialized world that does not have a government health care system is scandalous. In infant mortality per capita we are 33rd in the world and behind Cuba.

The pharmaceutical companies, insurance companies and some segments of the medical field are for profit ventures with the bottom line more important than providing adequate health care to all USA citizens.

I doubt if we will see a health care bill get through the congress and signed into law. The opposing forces are spending millions per day to politic against it. Meanwhile if you get become seriously ill in this country chances are you'll be bankrupt and lose all you've got if you're the average working stiff. Not a pretty picture.

It appears that other industrialized countries are doing just fine with a healthier longer living population due to their health care systems and we spend 2 1/2 times more than they do.

Thanks for posting this thread, Jimmy so we can voice our concerns, etc.

If a healthcare system is nationalized to some degree, I don't think any of us have to worry about emergent care. On the non-U.S. post you started initially we're seeing a lot of "I've never really had to use it but for minor things and I have no complaints" which makes sense to me since our membership, although diverse in age is still a bit on the younger side relatively speaking.

I pay a full 20% of my income for my and my family's health insurance in premiums and in deductibles. We have young children so in addition to paying premiums, we are having to pay our deductibles as well. Chimensh said I believe, he pays 50% in taxes. I'm about there with taxes, insurance and deductibles.

My biggest concern with government run health care is this: What exactly would the government decide would be reasonable and necessary care vs. what would be unnecessary and disallowed care in regard to the very sick and the elderly? How realistic could mandated Euthanasia be? What are some other "slippery slope" things that could affect the very lives of U.S. citizens if the government made decisions related to health? If you've got no other options that what the government tells you you can or can't have in regard to healthcare then you darn well better pray that your government is a loving, caring, empathetic, responsible body with the interest of each and every citizen within its borders in mind first and foremost. Oh, and I'll leave it to someone else to put about 10 of the LMAO smiley's after the underlined at the very thought.

Chris L

I don't know what the answer is. If a person has health care through their job and keeps it or if they are wealthy and can afford comprehensive health insurance outside of their employment I am sure they are satisfied with the USA system.

The sad fact is that the largest expenditure for health care here goes to keeping people alive in the last month or so of their life. I don't see a solution to that. Advanced technology comes with it's own set of problems. We can keep people alive longer but it costs more. I don't know what the answer is to that.

I think that people who talk euthanasia are putting up a paper tiger. Scare tactics. If it works in other countries it will work here. If it is true that the USA spends 2 1/2 times what other countries spend and they have as good or better care why wouldn't it work here?

The insurance companies are in business to make money and that is understandable. I don't hold it against them. We all want to get paid for what we do. As I say, I don't know what the answer is but for a large percentage of the population, maybe not the majority, it ain't working too well.

I'm a full time student and older than 25. Thus, I cannot get health insurance without paying ridiculous amounts of money. I'm seriously thinking about applying for AHCCSS (medicaid). If I wasn't young and healthy I would be seriously concerned.

I am sure those of you/us with health insurance from their employer are probably satisfied to some degree, but think of us poor schmucks with no employer to pay our health care costs. The same problem exists for those who are self employed. If I want to open a solo practice, health insurance is going to be a big concern and cost.

And on a purely economical note:
It makes absolutely no sense to not have a national health insurance program. The point of having insurance is to spread the risk around. Otherwise, we might as well just pay our own health care costs without insurance. Without a mandatory health insurance system, the healthy will not be paying their share of the risk. The healthy will opt out of any insurance if they have to pay for it. And with the rising costs of health insurance, more and more healthy, young people are not going to have insurance. And thats bad for us, because if we get into an auto accident or break a bone, or need stitches from a bad razor cut..... I think I painted the picture pretty clearly.

And from an insider's perspective:
When I was working on the billing side of an ambulance company, I remember Medicare paying the bills in a timely manner and with no questions asked. The private insurances always gave the company a hassle. As long as the form was filled out properly, Medicare would pay on time and the agreed upon amount. Same with Medicaid. That said, they would pay less than private insurance because the gov't mandated the prices they paid out. But the point is that the state sponsored health insurance was a better payor than the private insurance companies.
At least thats what I remember, I only worked there for 6 months.

In sum. I think it is shameful that we do not have at least national health insurance. We deserve free health care. It would actually be cheaper per person too. Because everyone would be paying for it through their taxes. However, since employers are the ones who would ultimately be saving, I'm not sure if the employees would actually see any of those benefits. But the mom+pop shops certainly would.

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Originally Posted by JimmyHAD

From my point of view the fact that the USA is only country in the industrialized world that does not have a government health care system is scandalous.

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The USA does have a government health care system.

In fact, it has several, including the Veterans Health Administration, the Older Americans Act, Medicaid, and Medicare. I pay into these every week even though I have never used any of them myself. Nobody asked me if I wanted to contribute, but I am doing so because I am a law-abiding citizen and I think they are generally good ideas even though there is waste, corruption, and lack of choices that is not surprising in either private or public health cares. The difference between private and public is a difference of choice. The law says pay in for these products that the US elected representatives passed or you will be fined, taxed, and/or imprisoned. That's fine, but I would rather these laws not be passed if the end result is anything like what we have been seeing for decades.

The current bill in the house includes a provision to grandfather in current private health care policies, but will only allow for new ones who participate in The Health Insurance Exchange.

I don't think the end result of making sure everyone is covered under a government plan is more valuable than free enterprise in health care.

On a somewhat different line, I am a little unsure how Congress has the authority to pass laws that override state laws.

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The powers not delegated to the United States by the Constitution, nor prohibited by it to the States, are reserved to the States respectively, or to the people.

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I am not a Constitutional lawyer, but this is one of those major bills that seems to get around this somehow. Where in the Constitution was the central government given power to mandate that every citizen must have some kind of government approved health insurance or else be faced with a tax? Usually the government likes to simply tax everyone and then issue a credit for people who perform specific government-approved activities or buy government approved solar panels for example. But now they are finally bold enough to just say if you don't want to buy any of our approved products, we're going to tax you. I do hope the 8% tax is just a tax and not a penalty for breaking the law. Wouldn't it be terrible to be convicted by a court for not buying or signing up for something you don't want? I suppose it is not so strange or surprising, but I still don't like it

And on another note, where is the trillion dollars going to come from? Are there really enough wealthy US citizens to tax a trillion dollars from even over ten years? How long can the US keep incurring more and more debt on top of dept - until the interest on the debt becomes greater than total revenue? Will we just print more dollars to buy off the creditors at that point? Or will we continue to put the squeeze on the wealthy by regulating how much money they can make and how much money they have to put in in order to subsidize health care for the entire nation?

Is there no possible way to make sure that everyone who needs insurance coverage can get it without removing the free choices of citizens to choose whatever insurance they want or to even choose no plan? I am surprised that this bill is the best solution Congress and the President could come up with

Well, a misreading of a Supreme Court decision in the 1800s created a very...interesting precedent. Corporations are persons and they most certainly make over a million dollars a year. I think there are enough of those around to tax. Plus they don't pay their taxes anyway because they can pay really good accountants to find all the loopholes. So, yeah. I think we should tax those faceless *******.

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Originally Posted by Leighton

We deserve free health care. It would actually be cheaper per person too.

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Free is cheaper? You must be a lawyer ;)

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Originally Posted by Leighton

So, yeah. I think we should tax those faceless *******.

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The more we put the squeeze on our employers, the more likely we will be bailing them out with fewer evil companies' monies in the future

PS our corporate tax rates are still the highest in the world

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Originally Posted by Leighton

We deserve free health care.

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We do?? Why?

Do we deserve free legal care too?

How do we "deserve" the professional services of others for free?

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Originally Posted by honedright

We do?? Why?

Do we deserve free legal care too?

How do we "deserve" the professional services of others for free?

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For those old enough to remember Gov Nelson Rockefeller saying,"There is no such thing as a free lunch." you'll undoubtedly agree. Somebody is paying for it.

The question isn't "free" health care as we all know it won't be free. The question is would it be to the advantage of the society as a whole to pay for health care for all rather than the every man for himself deal we have now.

Going back to the contention that in the USA health care costs 2 1/2 times what other countries spend..... if you look at the recent legislation that the last administration pushed through for prescription drugs .... where written into it was the clause that the pharmaceutical companies set the prices the government pays with no option to negotiate lower prices unlike our neighbors in Canada, it is no wonder that our costs are so much higher for the same or less..... makes me wonder whose interests our representatives of both parties are looking out for.

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Originally Posted by honedright

We do?? Why?

Do we deserve free legal care too?

How do we "deserve" the professional services of others for free?

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Someone want to pay for my house and car and gas? Anyone want to pay for my food and the clothing on my back? I mean after all without these things I will get sick easier and likely die sooner. Doesn't it behoove the government to make sure that I stay as healthy as can be? This would be the logical conclusion wouldn't it? Or maybe the truth of the matter is its all about the power of the government over the people. If they manage to pull this rabbit out of their hat they ( our government ) will have gained a significant amount of power over us. Unconstitutional power I might add.

This has nothing to do with our nations health and everything to do with our Governments incessant need to control every facet of our lifes! " Hey fatso, no more hamburgers for you." " Hey there middle aged man. You may no longer have a beer and watch the ball game on sunday. Instead you will run a mile a day." "Hey you, we cant help you with your constant knee pain as you ran 10 miles every other day which is contrary to the state recommended 5 miles every other day"...Ad infinitum

My biggest fear is letting congress into the exam room. There is so much room here for medical decisions to become political ones. There are so many opportunities for government to screw things up.

The observation about most $ being spent late in life (It is actually in the last 6 months) can lead to some unpalatable solutions like having some kind of criteria that marks someone is likely to die and denying services other than palliative ones. (ie, you can't have chemo, but you can have morphine).

When will assisted suicide become a billable procedure?

I can see people who are obese, smokers, alcoholics, or other self damaging behaviors having higher premiums.

Then there is the whole family planning/abortion issue. One group that thinks public money shouldn't pay for the termination of a pregnancy. Another that feels Dr's should be compelled to give the "morning after pill" regardless of personal convictions. This one is sure to be part of the debate once congress is involved. It may not have happened in other countries, but does any one here believe it won't happen in the US?

What about forcing Catholic sponsored hospitals to perform abortions?

What about coverage for chiropractic, homeopathy, therapeutic massage, nutrition supplements, acupuncture, colon cleansing, health club memberships, diet programs, yoga, meditation, etc. They will all be lining up with their hands out and it will not depend on what is proven by investigation or evidence, but on who has the best organized lobby.

Has congress ever done business any other way?

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Originally Posted by Pyment

My biggest fear is letting congress into the exam room. There is so much room here for medical decisions to become political ones.

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With the system we now have it isn't politicians making those decisions it is largely insurance companies whose main object is to maximize their profits. They are primarily interested in stockholders not policy holders. If a person is ill and does have insurance God help them if they don't have an advocate to do battle with the adjusters who are trying by any contrivance to deny care and cancel their policy if and when they suffer a major illness. Cases of hospitals 'dumping' uninsured people who come to their emergency rooms aren't heard of in countries with nationalized health care. Who decides if those poor souls live or die ?

Now, for those of us in the future who don't buy the mandated insurance, will we be turned away at the doors of the emergency room? "What, no proof of insurance?" "Gidouddahere."

Now, say that an unfortunate soul was truly poor and could not afford the mandated insurance and dies right there on the doorstep of the ER, who pays for the funeral? I'm assuming that there will be a "final" expense clause in new omnibus unhealthy bill. Oh, oh, the guy who just croaked didn't have any "cost assumed by all" coverage.

Or will it still be as it is now that the non-covered will still get the ER care they walk in for, and the costs of that care will be properly inflated and re-inflated, and the passed on to whomever pays now: and that's us folks.

Likely not much will change, other than the fact it will cost a lot more because we will have to pay for that new, additional layer of administration, and care will be more rationed and slower, and the government will control your health records and make the info available to all but the insured.

Look at the highway infrastructure and tell yourself that the (any) government does things well and cheaply and promptly. And now transfer that careful scrutiny to the ripe and ready health care system and jump up and down in delightful anticipation that the same institutions will be putting your health care workers into a version of hard hats, steel toed boots, and chartreuse vests. And that those who will control the entire process will be the standers, leaners, pointers, and nodders we have all come to love.

Oh, the joy of it.

Is self-esteem of no importance?

Are we serving the poor by imposing charity upon them? or are they better off being self sufficient? Better to maintain a nation of needy, broken spirited people?

I value, and sleep better at night, paying my own way.

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Originally Posted by honedright

Is self-esteem of no importance?

Are we serving the poor by imposing charity upon them? or are they better off being self sufficient? Better to maintain a nation of needy, broken spirited people?

I value, and sleep better at night, paying my own way.

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People who live in countries with nationalized health care pay for it. It ain't free. They sleep better at night because insurance companies aren't denying coverage for pre-existing conditions or canceling their policies at the slightest excuse when they need them most.

Regarding the argument that we would be allowing government to interfere with health care decisions.

Well, right now your insurance company controls what operations you get and meddles in the affairs of health care providers. So, if the government takes the place of the insurance company, we're trading a group of people we can actually hold accountable, for one that we cannot. We can vote our politicians out of office and influence their decisions. We cannot influence the insurance company unless we own a big chunk of their shares.

Even if government is more bureaucratic, and I'm not convinced it will necessarily be worse, at least we can hold them accountable. The insurance company can drop you at any time, refuse countless procedures, deny any and all experimental procedures, and do all sorts of immoral things in the interests of the bottom line. Government has no bottom line to watch out for, only your/our health.

As for cost. I have no problem paying 2%-5% more in income tax to have free health care.

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Originally Posted by JimmyHAD

People who live in countries with nationalized health care pay for it. It ain't free. They sleep better at night because insurance companies aren't denying coverage for pre-existing conditions or canceling their policies at the slightest excuse when they need them most.

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If they are already paying for it, as you say, then why the need for the government as an intermediary?

Are they incapable of creating a system as good as, or better than what the government can create for them?

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Originally Posted by honedright

If they are already paying for it, as you say, then why the need for the government as an intermediary?

Are they incapable of creating a system as good as, or better than what the government can create for them?

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This is going to sound controversial, and a lot of people are probably going to disagree with me. But I'm going to say it anyway, as I really do believe this.

People suck at making rational/good decisions. And yes, I have an economics background and I don't buy into the rational decision fundamental theory at the heart of classical economic theory.

A lot of people don't have health insurance right now. Plus if everyone was forced to have it, it would drive the cost down. Thus, those already paying for it will see a savings for the same coverage. Assuming everyone who doesn't have health insurance then gets insurance through the same provider.

Being forced to have anything is too high a price already.

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Originally Posted by Leighton

This is going to sound controversial, and a lot of people are probably going to disagree with me. But I'm going to say it anyway, as I really do believe this.

People suck at making rational/good decisions. And yes, I have an economics background and I don't buy into the rational decision fundamental theory at the heart of classical economic theory.

A lot of people don't have health insurance right now. Plus if everyone was forced to have it, it would drive the cost down. Thus, those already paying for it will see a savings for the same coverage. Assuming everyone who doesn't have health insurance then gets insurance through the same provider.

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No competition will bring down the costs? When has a monopoly ever worked this way?

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Originally Posted by honedright

Being forced to have anything is too high a price already.

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....Agreed!

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Originally Posted by honedright

If they are already paying for it, as you say, then why the need for the government as an intermediary?

Are they incapable of creating a system as good as, or better than what the government can create for them?

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well, that is one way to create such system. as we know, a government in a democratic state is elected to represent the interest and work on behalf of those who elect it. now you seem to be saying it's not how it works in practice and it's better if everybody retains as much control as possible for themselves. why is it better for health care and not for other things the government has a constitutional mandate for? private security, private justice... it can all be tiered to one's ability to pay which is more or less tied up to one's importance to society.

there are plenty of doctors who do not accept any insurance - anybody here used that type of health care? even the ones who accept insurance, i'm sure are generally quite happy to charge you directly for the services rendered.

seems that that would be the preferred way to anybody who is concerned with not having an intermediate between themselves and their doctors. Apparently it's only 10% of the americans who do not have health insurance, and the concern seems to be that most of them are not doing it for reasons of being independent, but because they cannot afford it.

So again how many of you getting a health insurance is not a problem at all but choose not to so that they have full control over the medical decisions?

And what about those who don't want or need health coverage?

Here IMO is a book that explains why there are (basically) two opposing views being espoused in this thread. Read the Amazon editorial review for a synopsis.

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Originally Posted by JimmyHAD

Here IMO is a book that explains why there are (basically) two opposing views being espoused in this thread. Read the Amazon editorial review for a synopsis.

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"The largely blue collar citizens of Kansas can be counted upon to be a "red" state in any election, voting solidly Republican and possessing a deep animosity toward the left. This, according to author Thomas Frank, is a pretty self-defeating phenomenon, given that the policies of the Republican Party benefit the wealthy and powerful at the great expense of the average worker."

How? How is someone else's success at my expense.

That insurance companies are in business to make money is not a surprise to many here. What may be a surprise is that most of them think of themselves as acting in the best interests of the people they insure. They try to balance the interests of their customers with those of their investors.

The fact that there are times when things go out of balance for them should be no more surprising than the shortcomings of any other human institution. That includes Doctors that are negligent, lawyers that bring frivolous lawsuits, hospitals that do not see uninsured, etc.

Yet I see nothing in the track record of the congress of the US that would seem to suggest they can run the system any better. If the congress were applying for a job in running the health care system based on their record of indiscriminate spending, gridlock on important issues, tendency to put partisan politics above the common good, would they even deserve a job interview? This is besides the frequent episodes of corruption, self servitude, bad judgment etc that would have them on continuous probation or out of a job where I work.

I recently learned that the clinic (of about 60 physicians) I attend is providing close to $1 million in free care per month to the under served in our area.

Where do we think the expertise to run this health care system is going to come from?

I would expect that they are going to hire people from the same insurance industry that is being so roundly criticized here. Somehow they are going to stop being the predatory money-pinchers that we think they are now and become the altruistic agents of change we envision.

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Originally Posted by honedright

And what about those who don't want or need health coverage?

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Don't need health coverage? yes if your a billionaire and can afford to write a check. Eventually everyone gets sick and eventually just about everyone gets seriously sick. If your not Mr Moneybags what are you going to do when that day comes? Right now people are dying in this country because they can't afford medical care and can't qualify for free care. Also for those who don't want it? When they show up at the emergency room bleeding to death and can't pay we all pay for them.

Also consider though only a "small" number have no insurance a very large number who do have insurance and think they are covered will be in for a rude shock when they need to use it and find out just what they are left to pay for.

HELLO
This is a good subject to talk about. I have known JimmyHAD personally for about 1 month , I met him about 3 weeks after I got the straight razor bug. He is a very wise man and he knows a very lot about straight razor shaving and a lot of other things. Jimmy knows about my current situation and I thought I would share it with all of you. I am a 44 year old male . I was the victim in a drunk driver rear end auto accident back in 2006 while I was living in Las Vegas. The accident caused my L4 and L5 vertebrae in my lower back to fracture. I was luckily working at the time and had very good health insurance. I required a major spinal operation to stabilize my spine so I could walk again. I had this performed in Las Vegas in 2006 and the total bill for the surgery and the hospital was $318,000. Luckily my insurance at the time covered me and my total out of pocket was $250.00. Fast forward to December of 2008 I have moved to Florida in January 0f 2008 and my back was perfect and I started a good job in Florida. In Dec of 2008 the titanium implant in my back has cracked and caused me major problems and I know am unable to work and am walking with a cane and taking major pain killers to cope with the extreme pain. My employer kept me on their insurance for 12 weeks from December 2008 when I was unable to work. They canceled my medical coverage in April and for me to continue with the policy I would have to pay out of pocket $968.00 dollars per month which I cant afford right now. I tried to apply for medicaid but the wait for approval is 6-8 months. I am making a small amount each month from a private disability policy I obtained when I was working it is enough to pay the bills and get by for know but with no medical insurance I cant get my back fixed and get back to a normal life.

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Originally Posted by MARKHOLLADAY

HELLO
This is a good subject to talk about. I have known JimmyHAD personally for about 1 month , I met him about 3 weeks after I got the straight razor bug. He is a very wise man and he knows a very lot about straight razor shaving and a lot of other things. Jimmy knows about my current situation and I thought I would share it with all of you. I am a 44 year old male . I was the victim in a drunk driver rear end auto accident back in 2006 while I was living in Las Vegas. The accident caused my L4 and L5 vertebrae in my lower back to fracture. I was luckily working at the time and had very good health insurance. I required a major spinal operation to stabilize my spine so I could walk again. I had this performed in Las Vegas in 2006 and the total bill for the surgery and the hospital was $318,000. Luckily my insurance at the time covered me and my total out of pocket was $250.00. Fast forward to December of 2008 I have moved to Florida in January 0f 2008 and my back was perfect and I started a good job in Florida. In Dec of 2008 the titanium implant in my back has cracked and caused me major problems and I know am unable to work and am walking with a cane and taking major pain killers to cope with the extreme pain. My employer kept me on their insurance for 12 weeks from December 2008 when I was unable to work. They canceled my medical coverage in April and for me to continue with the policy I would have to pay out of pocket $968.00 dollars per month which I cant afford right now. I tried to apply for medicaid but the wait for approval is 6-8 months. I am making a small amount each month from a private disability policy I obtained when I was working it is enough to pay the bills and get by for know but with no medical insurance I cant get my back fixed and get back to a normal life.

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I am curious what you think a government health care plan would do for you?

Some people are in favor of a Darwinian society. A survival of the fittest sort of thing. I am not one of them.

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Originally Posted by JimmyHAD

Some people are in favor of a Darwinian society. A survival of the fittest sort of thing. I am not one of them.

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That about sums up my position after reading all your comments. And the information below to explain why insurance is cheaper per person if everyone has it is going to be my last post for now. I need to step away from the conversation.

As for monopoly being cheaper. Look at your cable bill. Your gas bill, your electric bill, your water bill. Those are all monopolies and are all cheaper because of economies of scale.

However, insurance is not a business. It is a risk spreading device. Your state requires you to have automobile insurance if you drive a vehicle does it not? Well, they are in essence forcing you to do that. Why? Because not only does it protect the person who you may hit, but it protects you from other uninsured people. AND it lowers the cost of your insurance policy because it forces the good drives to pay insurance rates and thereby spread the risk among a larger group of people.

Insurance is a risk management device. It only works at its best if everyone has to participate. Otherwise, only the very risky will opt for insurance. If they can afford it.

the problem with the US health care system, that I can see, has its roots in the Trial Lawyers. A doctor is sued for anything by them, which leads to increase in malpractice insurance for the doctor. In order to not get sued, the doctor runs test for every possible condition, no matter how remote, because they don't want evidence against them that they dropped the ball and did not run a test to find the 1 in 1,000,000 possibility of an extremely rare disease. this leads to endless tests being run when there is no need for them, and an increase in the cost of basic healthcare.

My vote, instead of creating a new department of the Government, appointment of a new "healthcare czar", and taxing the crap out of us for it, HOW ABOUT SOME TORT REFORM???? Limit the law suits against the doctors, and watch their insurance premiums drop (drastically), and then watch the doctors stop running useless tests just to cover their arses, and then watch the cost of healthcare drop, and then watch the cost of insurance drop.

edit: however, the trial lawyers won't let that happen, and the democrats are so in bed with that lobby group that they are conjoined twins.

Edit #2: also, I know from the doctors that I have spoken to, their insurance premiums are way into the 6 figures per year, and you know that this expense is just getting passed through to us, the consumer.

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Originally Posted by honedright

And what about those who don't want or need health coverage?

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Well in a democratic society it really depends on how many of them there are. All I know so far is that they are less than 10%. That's why I asked the question - how many don't currently buy insurance because they want to pay for all of their health care the same way they pay for say gas and grocery i.e. pay on the spot the cost of what you use.
In the years I have been in US I have paid a little bit more in insurance than I have been billed for medical expenses, so for me it's been more or less a wash. Most people in my socioeconomic and age group that I know seem have only used small fraction 1%-10% of medical services that I have used and few have used few times more than me.

Personally I think having health insurance is the smarter way of doing things than not having one.

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Originally Posted by mhailey

HOW ABOUT SOME TORT REFORM???? Limit the law suits against the doctors, and watch their insurance premiums drop (drastically)

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What you describe seems to suggest that the problem is not in the lawsuits themselves but in the way they are resolved. It seems that the expectations of doctors making no mistakes whatsoever are very unreasonable.
I don't see how the government imposing limits the way you seem to propose is addressing the problem. I have not thought about this at all, but off the top of my head I think restructuring the awards is a much better way to deal with it. If the patient who was not diagnosed for that extremely rare disease and their lawyer don't get most of the money, but it instead goes into funding more research for that disease?


As far as the arguments that the congress is incompetent of running a health care system, I don't think they are supposed to run it. They are supposed to be good at making policy, not running things and that's what this is about.

At the end of the day the overall numbers are pretty clear, us spends more money than similarly developed countries for much worse results in some areas (like children mortality) and much better in others (treatment of extremely rare and difficult diseases). So to some extent it's a matter of values - what are the types of healthcare that the american society values more. For example it seems that to some of you it's better to die independent than get help that you don't think you have earned. (I wonder what would be the case if it's not your life but the one of your wife/husband/child, i.e. would you choose to not insure them and instead be prepared to face the full consequences of any serious disease and injury.)

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Originally Posted by gugi

What you describe seems to suggest that the problem is not in the lawsuits themselves but in the way they are resolved. It seems that the expectations of doctors making no mistakes whatsoever are very unreasonable.
I don't see how the government imposing limits the way you seem to propose is addressing the problem. I have not thought about this at all, but off the top of my head I think restructuring the awards is a much better way to deal with it. If the patient who was not diagnosed for that extremely rare disease and their lawyer don't get most of the money, but it instead goes into funding more research for that disease?

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This is what I mean by Tort Reform. Limit the recovery in most circumstances, decrease the statute of limitations, etc. ... .

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Originally Posted by gugi

there are plenty of doctors who do not accept any insurance - anybody here used that type of health care?

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yep. I buy health insurance... and when I feel like buying better service (or more service) than is provided in my basic plan, I go and buy it, cash in hand.

My health insurance subscription is voluntary. My extra spending on non-essential procedures because I can afford them... is voluntary. I am free to choose.

What if I want to keep buying the insurance that I CHOOSE? seems like the new plan doesn't have room for guys like me. I favor the freest market possible. I favor the most personal choice possible. The fewer decisions the government makes for me, the happier I am.

I'd rather get sick and die then let the government take one more shred of my personal liberty with the excuse that they know what's good for me better than I do.

Some of you feel that no one should have needs that aren't met. You are more than happy to sacrifice liberty for security. There is good news, though... you can get fed, get free health care, and have absolute security in this country. For free. Go rob a bank, and you'll get to go to jail where they feed you and the doctor sees you for free. No liberty, but hey, it was worth it, right?


No thanks. I'd rather keep my liberty and take my chances. A lot of people don't understand that mindset, and I reckon they never will. No amount of talking will every change it. Some people value their liberty more than their lives, and some don't, that's all.

To quote Shakespeare once more, this spirited debate is 'full of sound and fury signifying nothing'. They ain't going to pass health care legislation this time and they probably won't in our lifetimes. I'm going to go hone a razor.

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Originally Posted by jockeys

yep. I buy health insurance... and when I feel like buying better service (or more service) than is provided in my basic plan, I go and buy it, cash in hand.

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yes, but why buy the health insurance in the first place? why not just pay for the health services you use when you use them again cash in hand.

sounds like you are willing to have the third party between you and the provider for some basic services, but not for others. i understand that everybody's 'basic service' level could be different, but why yours is not at zero. That seems like the simplest form of market with the fewer number of parties involved.

For car insurance the government requires everybody to have a minimum coverage and I guess it requires all the car insurers to provide this level. Seems to me that they want to do something similar to the health insurance where everybody would be required to have some minimum coverage but also the government will be providing this coverage along with the other parties who can also provide that or more.

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Originally Posted by jockeys

Some people value their liberty more than their lives, and some don't, that's all.

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I'd say most people value their lives more than their liberty and I think this is normal. In fact I'm not sure that the whole liberty and heroism thing isn't a result of mostly propaganda and brainwashing.
That's why the question that I asked was do you value the life of your children more than their liberty. I mean would you rather have them dead than slaves, in practical terms would you kill them if their freedom is threatened and that's the only thing you can do to avoid it?

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Originally Posted by gugi

1. i understand that everybody's 'basic service' level could be different, but why yours is not at zero. That seems like the simplest form of market with the fewer number of parties involved.

2. For car insurance the government requires everybody to have a minimum coverage

3. I'd say most people value their lives more than their liberty and I think this is normal.

4. I mean would you rather have them dead than slaves

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good questions. please see numbers above.
1. I like the health insurance I choose to buy, which is why I choose to buy it. if I didn't like it, I wouldn't buy it. I'm not opposed to insurance, I'm just opposed to being forced to have it via legislative fiat.
2. red herring. minimum car insurance is not insuring your own car, it's insuring the cars of everyone else against damage you might do to it. you are not required (in my state, anyhow) to insure your own vehicle AT ALL. now, I have a nice truck and I fully insure it. but that's a choice I made on my own, a voluntary investment.
3. it's also "normal" to watch more than 10 hours of tv a week (I watch none), to never use a straight razor, and to listen to Brittney Spears rather than Mozart. Normality isn't necessarily a desirable thing. IMHO, normality is borderline despicable.
4. unhesitatingly yes. It's better to die on your feet than live on your knees. I am fully aware that most people are not so uncompromising. I'm fully aware that faced with such a choice, most people would choose their lives over their principles. I wouldn't.

I spent many years working in the health care system, mostly for health plans. I don't know that there is a solution that will make everyone happy. The big problem we have now - and I don't know that anyone is really focusing on it - is the increasing cost of care. Every year the cost of care -and that includes insurance premiums - goes up three to four times more than inflation. Even if people have insurance, they can't afford it much longer and neither can the employers. Yes, a gov. run system will check costs, but that will reduce provider participation and retard research.

Most of our health care dollars go to treat patients who have chronic conditions (diabetes, COPD, asthma, etc). I do think a certain amount of required participation in disease management programs for them would help. If they don't want to participate, they should have to pay more out of pocket.

End of life decisions are another issue. I've seen a number of cases where say a 90 something year old person goes into a facility. They are on a ventilator, require dialysis, and have other comorbidities. In the jargon, they are referred to as "trainwrecks". They languish for months with no quality of life. Often they have nobody to make decisions for them. This "treatment" costs huge amounts of money for just one person. They slip through the cracks.

Let's also remember that until about 30 years ago, doctors and hospitals had no constraints on what they did and what they got paid for. They played pretty loose with our money. That is why health plans had to begin "interfering" with doctors. The fact is that the people reviewing cases are doctors and nurses who genuinly care about people - I've seen it myself. They are not bureaucrats, and they apply protocols decided on by the various specialty medical societies that represent the treating physicians. The protocols are based on emprical research. If a case requires a unique approach, it can and most likely will be approved.

There's still a lot of waste in the system. I'm rambling so I'll stop now and see if I can be a little more coherent later.

Jordan