Universal Health Insurance (2)

[BamaRider]

I was doing good over on the Family Life threads, but that got kinda boring so I came back over here, and see Oscar trying to fend off crazy libs in all directions so thought I’d help out.

For sure a lot of shady stuff went on in the banking mess. But you know as well as I do, libs want a program to make it easy for every somebody to get house.

Are not some crying out something needs to be done, to keep banks from foreclosing on these folks?

My son didn’t like the job, he said it was hard to go to work and watch people take out loans that if anything went wrong the slightest, they would go under. He often tried to talk them into smaller houses, but most didn’t wanna hear that, and he knew they’d get a approved anyway because the bar was so low.

Anyways, you’ll hafta to call those other boys if your hosue catches fire, I retired in 2005.

 

[SFTor]

I was doing good over on the Family Life threads, but that got kinda boring so I came back over here, and see Oscar trying to fend off crazy libs in all directions so thought I’d help out.

For sure a lot of shady stuff went on in the banking mess. But you know as well as I do, libs want a program to make it easy for every somebody to get house.

Are not some crying out something needs to be done, to keep banks from foreclosing on these folks?

My son didn’t like the job, he said it was hard to go to work and watch people take out loans that if anything went wrong the slightest, they would go under. He often tried to talk them into smaller houses, but most didn’t wanna hear that, and he knew they’d get a approved anyway because the bar was so low.

Anyways, you’ll hafta to call those other boys if your hosue catches fire, I retired in 2005.

Not a chance Guy, I’m calling you personally.

Guy, I just don’t think it makes sense to put this at the doorstep of the liberals. This was done by the real estate industry and the banks.

I can understand how your son felt. Everybody was fed the lie that real estate only goes up, and would continue to go up for ever. A little reading of history and you know that’s not true.

It’s true that some libs are calling for the government to bail out homeowners—mostly because the Feds are bailing out big companies that have a lot to answer for—but I think it’s wrong. Housing prices are still way off what’s real and shouldn’t be supported by taxpayer money. Prices need to come down so we can take the pain and move on.

The other thing you see is that there are a lot of people who saw their house as a way to make quick money. Once the house is underwater they just walk away.

Best,

Tor

P.S, The best that can be said for the people who want the government to intervene is that they want to keep this from turning into a total avalanche: run on the banks, recession or worse, etc. That may be understandable, but it doesn’t fly in my book.

 

[jman507]

jman:

Health care is not about pooling resources, it is about pooling risk. Public health is a public good and an economic good. It is a necessity to provide all other public goods.

Health care is not a market. When we aren’t sick we are not “health care consumers.” jman, I would bet that you don’t know the particulars of your health insurance plan—your copays, what’s covered, what isn’t, etc.

When we are sick, we are not “health care consumers” either. We’re just sick, and we need treatment. I would bet my bottom dollar that if for instance you, jman, came down with a melanoma or some form of liver disease, you wouldn’t go to your doctor and say “I’m considering hiring you for a project, but of course we need to discuss price first.” You say “help me. I’m sick.” If the condition threatened your life, you would say it more than once. If it threatened your child or your sister or your brother, you would move heaven and earth to get them the necessary care. Take a look at my next post to see how that would play out in Harris County, Texas.

No one who is experiencing heart disease, kidney failure or cancer—not even you—is going to act differently in any way because “they don’t feel the real cost of the treatment.” You want to get back to full health, and your loved ones and your community want the same thing because they need you. Your health affects all of us, not just the person who sits next to your bed, reads to you and wipes the sweat off your forehead.

jman, we don’t live in an economy, we live in a society.

Public health, that means the health of all of us, is too important to be left to an industry that is failing patients the way it is happening in this country. We need a system that addresses the need, not the profit opportunity.

I didn’t say if I thought having most people not feel the cost was justified or not. I said, that you risk people demanding too much of the system. I would suppose pooling risk would be worthless unless you tied your resources to that too.

You say the current system is failing. The insurance companies have to deal with the law of economics the same as a huge pool of people sharing risk. The critical aspect is that if the health care “industry” or whatever you want to call it, goes spends more than it can receive as a payment, chances are it’s going to hurt it’s capacity. The payer must still payout for goods and services. If there is too much demanded of the system, then not enough money to cover the cost and the system deteriorates, the prices hyperinflate, or depending on how the system is set up, it may just need a massive bail out. To avoid that situation somebody will have to step in, and say no to what some people want.

 

[jman507]

The problem I see is this, if you want a comprehensive overhaul of the system, short term problems should not be your only major consideration. Long term problems will need to be looked at in order to make sure that the system itself is sustainable.

There are problems with comparison between the US and other nations with UHC. It certainly is worthwhile to understand the advantages and disadvantage in both systems. I see part of the problem is that it doesn’t translate into the US magically turning into the nation you model. I could see a problem where people note that the US at one point has too much and too little coverage depending on the person and the situation. If that is to be equalized then your in a situation where people will not be happy with their coverage and it may also cost too much for the system to sustain. They may lose their options and/or quality in a trade off for an increase of access.

One of the major problems that will face the industrialized nations is the greying of the population, combined with measures that can prolong life. Now I can see people coming up with statistics to show that efficiency gains may be made by UHC. I think the major problem will be how to deal with the demographics change in the future. That is going to greatly effect all industrialized nations regardless of UHC or private insurance.

 

[stevegravy]

Long thread! I am all for universal health insurance as long as the coverage I get is the same one the senators and congress get. I would ask for the exact same policy and coverage as the president but that might be getting greedy.

 

[BamaRider]

I just can’t see UHC being a good thing. What a fiasco it would become. Nothing the govt has done has ever turned out worth a flip. How do you turn over so much of the American economy to the govt? It is mind boggling. Social medicine=mediocrity for everyone! I want no part of it, and neither most Americans.

Just look at Social Security. Libs hold that up as the Holy Grail, of social programs. Its terrible. I paid a lot less into my pension, for a lot less years, and my monthy benefit is 3x social security. I’m still 10 years away from that check. Yet many Americans are content to turn their retirments over to the govt. Sad. They’ll find out when it comes to govt you* never *get what you pay for.

But there is a growing segment of Americans with a sense of entitlement. They think they are entitled to jobs, houses, drugs, and now healthcare. There is portion of society that believes you are entitled to a companies products (drugs) by virture of just having a 65th birthday. No other prerequiste required. Go figure

The Great Society born out of the 60s, has drastically changed the landscape of America. It has single handily destroyed the black family. It did not take long to figure out each baby was a monthly check, have a baby get a govt check. Black men were no longer thought of as father’s but only a means to enhance the monthly take. Now 70% of all black babies are born out of wedlock, it is not unusual to have for a black mother to have 3 babies, 3 different fathers. Their society has totally broken down, and we all suffer for it.

Thirty trillion dollars has been spent by the govt since 1965 on society, and what has changed? Nothing. We are worse off then before we started. Yet so many are still crying out, “we just need a little more money, if we can have this program, it would be solved.” No thanks, I’m tired of hearing it.

Enough has been spend over the year to give each one in the program a* million dollar check*. It is the same mentalilty at work in New Orleans. Officials are calling for another 250 billion dollars to get back up and running. That would give each citizen in the city 519,000 thousand dollars. You’d be better off telling to come on down to city hall and pick up a check, it would be cheaper and more efficent. And the thing is, they’re gonna get the 250 billion. Crazy.

And this is the system you wanna turn health care over to??? :whacky:

Like I said, it ain’t gonna fly anytime soon, too many Americans know it for what it is. Sometimes it makes me wonder why the libs are for open borders and citizenship for illegals,is it to change the dynamics of the country enough so they can pass their ideas on the rest of us? The past playbook has been to do a end run on the laws, and get the courts to write policy from the bench.

 

[pathia]

I just can’t see UHC being a good thing. What a fiasco it would become. Nothing the govt has done has ever turned out worth a flip. How do you turn over so much of the American economy to the govt? It is mind boggling. Social medicine=mediocrity for everyone! I want no part of it, and neither most Americans.

I’d take mediocrity over nothing at all, any day, any time.

 

[SFTor]

The problem I see is this, if you want a comprehensive overhaul of the system, short term problems should not be your only major consideration. Long term problems will need to be looked at in order to make sure that the system itself is sustainable.

There are problems with comparison between the US and other nations with UHC. It certainly is worthwhile to understand the advantages and disadvantage in both systems. I see part of the problem is that it doesn’t translate into the US magically turning into the nation you model. I could see a problem where people note that the US at one point has too much and too little coverage depending on the person and the situation. If that is to be equalized then your in a situation where people will not be happy with their coverage and it may also cost too much for the system to sustain. They may lose their options and/or quality in a trade off for an increase of access.

One of the major problems that will face the industrialized nations is the greying of the population, combined with measures that can prolong life. Now I can see people coming up with statistics to show that efficiency gains may be made by UHC. I think the major problem will be how to deal with the demographics change in the future. That is going to greatly effect all industrialized nations regardless of UHC or private insurance.

What I think we forget sometimes is that a UHC system would not change very much in the system at all. It would replace the insurance companyl with what you’d call a bigger version of Medicare. Medicare demonstrably beats private insurance companies on the efficiency front. They spend far less on their back office operations than them.

We wouldn’t be going to Army docs with a cigar butt between their teeth. It’s the same doctors, the same hospitals, doing the same job they always did. They would simply be paid by a different payer, and that payer would be the government. Take out the 100% pretax markup in the system, and you could see how there would be some savings there.

The biggest efficiency we could get out of it would be a decent information system. Patient data do not travel well today, which is extremely wasteful.

Respectfully,

Tor

 

[jman507]

What I think we forget sometimes is that a UHC system would not change very much in the system at all. It would replace the insurance companyl with what you’d call a bigger version of Medicare. Medicare demonstrably beats private insurance companies on the efficiency front. They spend far less on their back office operations than them.

We wouldn’t be going to Army docs with a cigar butt between their teeth. It’s the same doctors, the same hospitals, doing the same job they always did. They would simply be paid by a different payer, and that payer would be the government. Take out the 100% pretax markup in the system, and you could see how there would be some savings there.

The biggest efficiency we could get out of it would be a decent information system. Patient data do not travel well today, which is extremely wasteful.

Respectfully,

Tor

That still doesn’t solve the problem that will plague industrialized nations, how to deal with the aging of the population. Also we will have a problem if the system itself demands more than the capacity of the system will allow.

It would be like saying we could have averted the problems the from sub prime loans, if the banks had more efficient practices. It may have bought time, but the problem was more or less, the payments couldn’t cover a reasonable expectation of what the loan should yield to whom is supposed to be paid back.

 

[pathia]

That still doesn’t solve the problem that will plague industrialized nations, how to deal with the aging of the population. Also we will have a problem if the system itself demands more than the capacity of the system will allow.

Here’s the thing. People keep saying that with UHC there are wait times, and there aren’t with our current system. Why exactly is that? What does it mean is different in our system? What is the compensation for a supply constraint in our system?

People not getting treatment because they can’t afford it or waiting until it’s an emergency so they can go to the ER. You can see this, because there are constant cries of our ER system being overtaxed. There are also people that go to the ER for things they shouldn’t. Why is that? Some of it is because of entitlement issues, sure, but much of it is because they have no money, and it’s the only way they can be guaranteed treatment. I know this, because it’s what I have to do. I just got over meningitis, I’d felt pretty bad for a few days, but I didn’t have any treatment options. Nothing happened until I was unconscious and my roommates could take me to the hospital.

That is what the relief for capacity problems is, demand rises, prices go up, and people can’t afford it and just simply forgo treatment or they overtax the ER.

Me? I’d rather wait, than not get treated at all.

 

[SFTor]

That still doesn’t solve the problem that will plague industrialized nations, how to deal with the aging of the population. Also we will have a problem if the system itself demands more than the capacity of the system will allow.

It would be like saying we could have averted the problems the from sub prime loans, if the banks had more efficient practices. It may have bought time, but the problem was more or less, the payments couldn’t cover a reasonable expectation of what the loan should yield to whom is supposed to be paid back.

You’re right, jman. The greying of the population poses a major challenge for health care services across the Western world. It needs to be managed. I think one of the things we’ll see is a reduction in futile/end-of-life care for patients, and more use of hospice, in this country and many others.

I’m not vouching for these numbers, but I believe I heard somewhere that a 40% of health care expenditures went to treatment in the last 6 months of patients’ lives.

Elderly people with means may also choose to spend their money on added health care.

Respectfully,

Tor

 

[onetimeposter]

I can’t help but notice the number of people who suggest that charitable organizations pick up the slack for the holes in the American Health Care system. It is a very easy thing to say and entirely unrealistic with what America prizes as a highly coveted value…individualism.

Marcus J. Borg has this to say about that idea:
**
" First, how does one care for victims of the system? Advocates of a politics of individualism commonly answer, ’ Through private charity’ - what a former president called " a thousand points of light." Of course, private charity is important, but this response ignores the fact that in modern American society, with the disappearance of traditional communities, government social policy is the primary way of caring for people we don’t know. Advocates of a politics of compassion thus would ask, " How can we change the structures so that there aren’t as many victims?"**

 

[Oscarthecat]

That is what the relief for capacity problems is, demand rises, prices go up, and people can’t afford it and just simply forgo treatment or they overtax the ER.

Yeah, this is a common fallacy of the “lack mentality,” the erroneous belief that all goods and services are ultimately finite, and so the more popular something becomes, the more expensive it is.

This is true of individual items of worth that cannot be produced- like original pieces of art, or limited natural resources that cannot be synthesized, like gold.

However, in regard to things that are not individual items of worth, their value actually goes DOWN as they become more sought after. That is why plasma tv’s, blu-ray players, computers, and even luxury services become less expensive as they become more sought after. Those providing the services charge a high premium when the service is new and unique, and then lower that cost in exchage for making profits through greater distribution after the product has proven itself in the marketplace.

Healthcare is no different- at least when the providers have to operate within the marketplace, without the interference of government subsidies that artificially raise costs. My contact lenses used to cost 5 times more than they do now- but now everyone wears contacts, and they are cheaper. Porcelain dental fillings used to be prohibitively expensive-and weren’t generally covered by dental insurance. Now, however, they are dropping in price and more people are finding them to be affordable.

Healthcare becomes cheaper and more affordable once people realize that it is a market, and that the consumer does have the ability to shop around. Anyone telling you that healthcare is not a market has no confidence in the ability of individual people to make responsible choices for themselves.

 

[Oscarthecat]

I can’t help but notice the number of people who suggest that charitable organizations pick up the slack for the holes in the American Health Care system. It is a very easy thing to say and entirely unrealistic with what America prizes as a highly coveted value…individualism.

So, tell me exactly how individualism is represented in Universal Healthcare, where the individual has no control over the amount of taxes they pay, the services the government will allow them to recieve, and has no access to a competetive marketplace?

On the other hand, charities cannot pass laws that prohibit other charities from serving the same clients.

Charitable organizations cannot put you in jail for not donating to them.

 

[pathia]

Yeah, this is a common fallacy of the “lack mentality,” the erroneous belief that all goods and services are ultimately finite, and so the more popular something becomes, the more expensive it is.

Healthcare becomes cheaper and more affordable once people realize that it is a market, and that the consumer does have the ability to shop around. Anyone telling you that healthcare is not a market has no confidence in the ability of individual people to make responsible choices for themselves.

That only applies when people have spending money and liquidity to get treatment AT ALL. I do not have that, nor do any of my roommates, nor most of my friends. It is not a matter of prices being cheap. The only way I could afford my treatments are if MRI’s were $10 and drugs were $2 for a month’s supply. Anything more expensive and it adds up, because I’m on like 10 prescriptions.

And I’m well aware of the way a market works, don’t try to tell me I don’t know, I have an economics degree. The market however doesn’t know to compensate and increase production of a thing when people aren’t even standing in line to purchase something (ie: go seek treatment). If people don’t even try to enter the market, the market does not have a way of knowing that the demand is that much higher and that it would be beneficial to ramp production to lower cost, if people don’t seek it, they aren’t counted.

The market only knows to increase supply when the supply becomes constrained. If it never becomes constrained because their customers balk at the price, it can’t make any adjustments. In alot of ways, the way healtcare works keeps things stuck in the early adopter method of a product lifecycle. Since insurance companies will pay the super high premium, then there’s no incentive to lower the cost because their only market is those who have insurance. Those who can’t afford it, can afford only so very little they have no interest in lowering the price to that level, because then the insurance companies would demand that price as well and destroy their profit flow.

 

[soma]

We pay taxes for a government to fight a war that the majority of Americans and Iraqis do not want. If we stop that war those funds should be used to save lives.

 

[jman507]

Here’s the thing. People keep saying that with UHC there are wait times, and there aren’t with our current system. Why exactly is that? What does it mean is different in our system? What is the compensation for a supply constraint in our system?

People not getting treatment because they can’t afford it or waiting until it’s an emergency so they can go to the ER. You can see this, because there are constant cries of our ER system being overtaxed. There are also people that go to the ER for things they shouldn’t. Why is that? Some of it is because of entitlement issues, sure, but much of it is because they have no money, and it’s the only way they can be guaranteed treatment. I know this, because it’s what I have to do. I just got over meningitis, I’d felt pretty bad for a few days, but I didn’t have any treatment options. Nothing happened until I was unconscious and my roommates could take me to the hospital.

That is what the relief for capacity problems is, demand rises, prices go up, and people can’t afford it and just simply forgo treatment or they overtax the ER.

Me? I’d rather wait, than not get treated at all.

Even though I may be making more of an apology for the status quo, I’m not making an apology against UHC. My apology is a bit different. What I’d say is that no matter which system you take, it will have inherent advantages and disadvantages with it. You will no matter have problems, for any given funding those problems may be different. If the demand on the system wasn’t overly stressing the system, the would be no calls for change. The problems we see to day, I don’t think are necesarly systematic, but are going to be there due to the system being overstressed. You can either take money from other areas to place into it (what are you going to take that out of?) or your going to have a strained system.

Before when the system wasn’t as strained, even if people were uninsured you could eat those cost by cost shifting. But if the hospitals and medical practices are demanding more money, the insurance companies will demand that their bills are closer in line with the actual costs. It is hard to do cost shifting in that environment.

Now if all of the inflation is due to insurance companies profits, I could see where making the insurance public would greatly help. The case though is that the inflation is multifaceted, and would be really hard to control without compromising access, options, and/or quality. If UHC can solve that, people will quickly learn to not like UHC. The rich will also be fine, because they could probably buy supplemental insurance, pay out of pocket, and head off to foreign lands.

Even if you have an increase in the medicare program, certain problems will be on a spectrum of being poorly funded to well funded. I having kidney failure am in a pretty sweet situation. There is plenty of us, and plenty of lobbyist. Plus we also have a pretty good case as to why we ought to be well funded. Other less common diseases may well have a harder to justify their funds, due to subject matter, lack of numbers, lack of understanding, or just plain unlucky.

You also need to watch out. Just like Joseph was able to have his family saved by the Egyptians at the end of Genesis, then at the beginning of Exodus, they were then the slaves to Egyptians. You might want to be careful, cause you may just end up losing your freedom to the government. Even with the insurance lobbyist having their ties to the government, they are far more able to regulate ethical guidelines, then if they are footing the bill.

As I’ve said, my apology isn’t exactly against UHC, nor really even a defence of the current system. It is that “the grass is always greener on the other side.” You will basically just trade off problems, and chances are people as a whole (maybe not individuals) will be just as disappointed in the system. Any efficiency will be marginal, because the real problem of the shortcomings will strain the either system. You also run the risk that if you collect all your risk and resources in one pool, you may be some time, but you may be in for a worse problem due to size, once the system does become too strained.

 

[pathia]

As I’ve said, my apology isn’t exactly against UHC, nor really even a defence of the current system. It is that “the grass is always greener on the other side.” You will basically just trade off problems, and chances are people as a whole (maybe not individuals) will be just as disappointed in the system. Any efficiency will be marginal, because the real problem of the shortcomings will strain the either system. You also run the risk that if you collect all your risk and resources in one pool, you may be some time, but you may be in for a worse problem due to size, once the system does become too strained.

It isn’t a case of grass being greener for me, it’s the difference of standing in a dust bowl, and having the option for some grass, any grass. Even brown and dying grass would be nice, I get none, absolutely none right now. You’re talking to someone who cannot get coverage in most states, even if someone just dropped a million bucks into my lap, no insurance company would cover me, and a million bucks would just barely cover my debts.

 

[jman507]

It isn’t a case of grass being greener for me, it’s the difference of standing in a dust bowl, and having the option for some grass, any grass. Even brown and dying grass would be nice, I get none, absolutely none right now. You’re talking to someone who cannot get coverage in most states, even if someone just dropped a million bucks into my lap, no insurance company would cover me, and a million bucks would just barely cover my debts.

As I’ve said, individual situations will always be different from the agragate situations. That will always be subject to the details the policy. Even if you “jump over to the other pasture” there will be some that end up on the brown spots, even if it may be more greener.

You need to be very careful about the plan to which you commit. It may not be sustainable in the long term, or may have other unintended consequences. Then to fix those problems then costs too.

 

[SFTor]

Yeah, this is a common fallacy of the “lack mentality,” the erroneous belief that all goods and services are ultimately finite, and so the more popular something becomes, the more expensive it is.

This is true of individual items of worth that cannot be produced- like original pieces of art, or limited natural resources that cannot be synthesized, like gold.

However, in regard to things that are not individual items of worth, their value actually goes DOWN as they become more sought after. That is why plasma tv’s, blu-ray players, computers, and even luxury services become less expensive as they become more sought after. Those providing the services charge a high premium when the service is new and unique, and then lower that cost in exchage for making profits through greater distribution after the product has proven itself in the marketplace.

Healthcare is no different- at least when the providers have to operate within the marketplace, without the interference of government subsidies that artificially raise costs. My contact lenses used to cost 5 times more than they do now- but now everyone wears contacts, and they are cheaper. Porcelain dental fillings used to be prohibitively expensive-and weren’t generally covered by dental insurance. Now, however, they are dropping in price and more people are finding them to be affordable.

Healthcare becomes cheaper and more affordable once people realize that it is a market, and that the consumer does have the ability to shop around. Anyone telling you that healthcare is not a market has no confidence in the ability of individual people to make responsible choices for themselves.

How do you have a market when the “consumers” don’t know what they are shopping for? They are not shopping for “health”—that makes no sense. What they need eventually is decided by the great lottery of the human gene pool (not to mention an army of bacteria and virus); maybe you’re covered, maybe you’re not. Maybe completely, maybe not. Maybe you go bankrupt, maybe not.

Making responsible choices for many families and individuals today means going broke. The best parallel I can find for the strange behavior needed is gambling addiction.

Respectfully,

Tor