Universal Health Insurance (2)

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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.
There are several problems with the system we have today. One is the need for health care to feed an industry that is prohibited by law against working in the interests of its “consumers” (a fairly unusual state of affairs) and the problem with over-treatment and unnecessary treatment. They all come back to the same basic reason: a profit-driven system that gets the wrong signals from the health “marketplace”. That marketplace is determined by what insurance companies will and will not pay for.

Respectfully,

Tor
 
**If people can afford to pay for their healthcare they should. Those who cannot (below a certain economic level) should qualify for a government-sponsored healthcare plan.

But don’t we have that already in Medicaid?**
 
There are several problems with the system we have today. One is the need for health care to feed an industry that is prohibited by law against working in the interests of its “consumers” (a fairly unusual state of affairs) and the problem with over-treatment and unnecessary treatment. They all come back to the same basic reason: a profit-driven system that gets the wrong signals from the health “marketplace”. That marketplace is determined by what insurance companies will and will not pay for.

Respectfully,

Tor
There will be problems no matter the system; they may just be different depending on the system. What is causing inflation is multifaceted. The US already has a huge unfunded liability in the future due to social security and medicare. I don’t know what system we will have in place at that time, but the problems today will probably seem minor.
 
**If people can afford to pay for their healthcare they should. Those who cannot (below a certain economic level) should qualify for a government-sponsored healthcare plan.

But don’t we have that already in Medicaid?**
Not everyone qualifies for medicaid/medicare. You have to meet very specific rules to get in,
 
There are several problems with the system we have today. One is the need for health care to feed an industry that is prohibited by law against working in the interests of its “consumers” (a fairly unusual state of affairs) and the problem with over-treatment and unnecessary treatment. They all come back to the same basic reason: a profit-driven system that gets the wrong signals from the health “marketplace”. That marketplace is determined by what insurance companies will and will not pay for.

Respectfully,

Tor
So problems are solved by making that insurance industry completely public? Even if there is a profit motive, there is also the deficit avoidance motive. Companies will tend to go bankrupt if they run up too much of a deficit. Granted a nation will tend to not go bankrupt. The nation can do some major damage to it’s currency though. What happens when it is then the government that doesn’t want to work in the best interest of the health of the nation in order to keep its fiscal system stable? What happens when the government wants to dictate what people can do in the name of the health of it’s people?
 
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
Still on this?

Maybe you simply don’t understand what a marketplace is because your own experience with healthcare is rooted in socialists systems that don’t want people to believe they have any control over their own lives.

Here’s the definition from the meriam webster dictionary:
MARKETPLACE
Main Entry: mar·ket·place
Pronunciation: \ˈmär-kət-ˌplās\
Function: noun
Date: 14th century

2: the world of trade or economic activity : the everyday world

I think what you’re TRYING to say is that some people, due to inadequate finances, are unable to participate in the marketplace of healthcare- but that doesn’t change the nature of the system as market. It simply means that not all people can participate in that market through their own efforts, and they need help from other people to either negotiate services on their behalf (I call this charity on the consumer side) or provide services at below market prices (and this is charity on the provider side).

In the marketplace of healthcare, healthcare providers are offering their set of goods and services in exchange for your goods or services- that is, you are trading them your money for their care. There may be intermediaries, such as insurance companies, who negotiate costs ahead of time, but in the end, one group is providing a service, the other group is paying for that service. That is a marketplace.

So I guess I’m just not able to understand your point of view about this whole “the healthcare is not a marketplace” nonsense.

Let me give you some examples:


  1. *]I occasionally need to go see a dentist. I relocated to a new city several years ago, and needed to find a new one. I didn’t just knock on the door of the first dental office, though. I talked to friends about who they see, I call offices and ask about rates, hours, and services, I checked various websites to see if the dentists I was interested in had any marks on their public records…

    *]When my wife became pregnant, she didn’t just pick the name of an OB at random out of the phonebook. She talked to friends and colleagues, called a couple offices with questions about their services and their approach to care. She made appointments with and met with 3 OB’s before deciding which one she wanted taking care of her while she was pregnant.

    *]We did the same thing to find a pediatrician for my daughter when she was born. We talked to people, called offices, made appointments with a few, and chose the one we thought was best based on their rates, appointment availability, expertise, and other factors.

    *]If any of these doctors fail to meet our needs at some point in the future, we will drop them and find a new doctor who is better suited for me, my wife, or my daugher.

    *]On the other side of the medical marketplace, I can reference my two brothers who are both dentists, and work together in private practice. They advertise their business through the radio, television, billboards, fliers, and other mediums. They have discount plans, they offer coupons, they have partnerships with other professionals in the community to share referrals and cross markets.

    *]I just had a minor surgery yesterday-it went just fine, thanks for asking. Before ever scheduling the procedure witht the surgeon I checked out the references on my anesthesiologists, I checked out the facility where I was going to be treated, and I called a couple of other facilities to compare rates, hours, policies, etc. I didn’t change any of these factors, but I would have if I was at all uncomfortable with any of them.

    These are examples of how people operate as responsible consumers in the healthcare marketplace. It is simply what people do when they are being responsible about their care. I do the same thing when you go to buy a car, or a refridgerator, or shoes. If a healthcare provider is too expensive for my budget, is lacking in experience, has bad hours, or is hard to schedule appointments with, I move on to the next provider.

    You will probably say that I am in a luxurious position that most people aren’t privy to. Or, you might say that if I was in an emergency that I wouldn’t pick and choose who is providing care to me.

    OK, let’s take the first one- I am participating in that portion of the marketplace permitted by my insurance provider. I am limited to medical providers by my private insurance provider. But within that network, I can choose whatever doctor I want, and I do. That is an option available to anyone with private insurance-they may lock you into your choice of primary care provider once you make it, but you can still choose that doctor based on your own criteria- and if you don’t like them, you can drop them at your next enrollment period. Specialists are even more subject to this marketplace environment, as you can pick and drop them any time you want.

    As to your second likely objection, you would be right that I may not be able to choose my on call doctor if I went to the hospital at 3am on a weekend. But I would be able to choose my hospital, and once the emergency was over I would certainly shop the market for the best specialist to meet my needs.
 
If people can afford to pay for their healthcare they should. Those who cannot (below a certain economic level) should qualify for a government-sponsored healthcare plan.

But don’t we have that already in Medicaid?
Haven’t I been trying to say this? In other words keep things as they are and cover more of the uninsurable do to low income through medicare and medicaid.
 
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.
This is possibly the most mind-boggling post I’ve seen yet.

One of the reasons that our politicians act like they own us is because they believe that the money they spend actually belongs to the government, and that they can shift it around however they see fit once they collect it, regardless of what they told us it was being taxed for.

Let me make this perfectly clear-

Say the government declares that 20% of the money they take from us in taxes is going to the military. But it turns out that they actually only spend 10% of that money on the military.
The remaining 10% should come back to us in the form of a refund because that’s our money they’re spending- and they need to spend it the way they said they were, the way we agreed to through our representatives, or not at all.
 
This is possibly the most mind-boggling post I’ve seen yet.

One of the reasons that our politicians act like they own us is because they believe that the money they spend actually belongs to the government, and that they can shift it around however they see fit once they collect it, regardless of what they told us it was being taxed for.

Let me make this perfectly clear-

Say the government declares that 20% of the money they take from us in taxes is going to the military. But it turns out that they actually only spend 10% of that money on the military.
That 10% should come back to us in the form of a refund.
That’s our money they’re spending- and they need to spend it the way they said they were, the way we agreed to through our
representatives, or not at all.
Well I never agreed to have money spent on a war in Iraq.
 
Haven’t I been trying to say this? In other words keep things as they are and cover more of the uninsurable do to low income through medicare and medicaid.
Jim, the government is having trouble covering those on medicare and medicaid already. They’re not going to do any better just because they take on a bigger group of people.

We have to find a better way that doesn’t involve government bureaucrats and juggernaut insurance companies that
work together to manipulate the market for the purpose of keeping individuals from having control over their own lives.
 
Well I never agreed to have money spent on a war in Iraq.
Let’s add that to the list of things we agree on, Jim!

I think we’re up to TWO THINGS!

let’s see…coke or pepsi?

don’t answer that- I don’t want to ruin the good thing we have going
 
Jim, the government is having trouble covering those on medicare and medicaid already. They’re not going to do any better just because they take on a bigger group of people.

We have to find a better way that doesn’t involve government bureaucrats and juggernaut insurance companies that
work together to manipulate the market for the purpose of keeping individuals from having control over their own lives.
Well you can talk all you want about having private insurance cover us, the disabled, but until that happens we are in a Catch22. Unless they are immediately ready to step up to the plate you cannot pull the rug out from under us and expect us to pay our own healthcare costs. My one medication costs 500.00 a month. If I had to pay that out of pocket I could not afford rent and food. And that doesn’t include other health costs. And if I turn to the Church they will not have the money no matter what you do with the taxes.
 
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.
I understand this, Pathia. You fall into the group of people who are unable to participate in the marketplace on their own.
The thing is, when the government and the insurance companies dominate the marketplace to set their own prices and dictate their terms to both providers and consumers, they end up inflating prices to the point that ordinary consumers cannot participate either, and ordinary providers cannot affort to sell their services at reasonable rates.

If the government and the juggernaut insurance providers get out of the healthcare market, then the providers and consumers will be able to work out more beneficial deals with one another directly, instead of having their terms dictated to them,

In this way, prices will come down, providers will be more free to negotiate on an individual basis, and many consumers who think the market is out of their reach will find that they are able to participate.

There will still be those who cannot participate due to insufficient resources- that is why we are called to be charitable toward those in need.
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.
Ok, so…you’re saying that you have to attempt to operate within the market in order to participate in the market…yep, I totally agree with you on that.

The thing is, the market wants to get everyone involved- because the market understands that everybody has something to trade. Let’s take transportation…this is why there are Lexus dealers, Hyundai dealers, and bus companies. People need transportation, and so the market provides it. People who make cars know that there are people who can afford a Lexus and there are those who can afford a Hyundai. And for those people who can afford neither, then there are bus companies who have them pay per ride, rather than buy a car. But what about those people who can’t even afford the bus? Many private charities provide bus vouchers and I hand dollars out all the time to pedestrians who ask for some help with bus fares.

So, the market provides to most, and charity helps the rest.
It works with food, transportation, and just about everything else in our society. It will work with healthcare.
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.
Hmm, maybe I’m not clear on this…The market lowers the price to the point that the best balance is met between the profit per unit and the number of units sold. If customers won’t buy something, then the provider lowers the price until they do. Once this price is met, and the products start moving, then the market will increase supply to meet the demand. If this price can’t be met at a profitable level, then that product is either not desired by the marketplace, or it is too expensive for the marketplace- and in come the entrepreneurs to either find ways to lower the production cost of that product or find new ways to sell it. For example, cellular phones are much more expensive than people realize- I never would have paid the retail price for my cell phone ($400), but I would sign a contract with my cell provider so that they paid for my phone and I paid for their service. In this way, the phone maker found a way to sell their high price item by pairing it to another provider in the marketplace.

So…Not really sure of your point on this one.
In alot of ways, the way healtcare works keeps things stuck in the early adopter method of a product lifecycle.
True, because people always want the newest and best treatment. Similarly, Apple’s business model is weighted heavily on creating hype for early adopters.
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.
Yes, this is my point exactly!!!
That’s right- insurance companies and the government work together to control the exchange of services, and in the process, they sacrifice either the consumer, the provider, or both.

I’m completely with you on this one.

Under the current system, many doctors have no control over what they charge because their rates are dictated to them by third party payers, and most consumers have no idea what they’re actually being charged because they just have their copay to take care of.

You are probably one of the few people who is actually aware of how inflated healthcare costs have actually become, and the cost is so staggering that you have come to believe that the only way to manage it is for the government to monopolize it.

Problem is, the solution can’t be found in the government or the insurance companies, because these two entities are exactly the reason why care has become so expensive.

The solution is to remove the government and the insurance companies from the market, and return control of the market back to the only two groups that have any business being there- the consumers and the providers.
 
I understand this, Pathia. You fall into the group of people who are unable to participate in the marketplace on their own.
The thing is, when the government and the insurance companies dominate the marketplace to set their own prices and dictate their terms to both providers and consumers, they end up inflating prices to the point that ordinary consumers cannot participate either, and ordinary providers cannot affort to sell their services at reasonable rates.

If the government and the juggernaut insurance providers get out of the healthcare market, then the providers and consumers will be able to work out more beneficial deals with one another directly, instead of having their terms dictated to them,

In this way, prices will come down, providers will be more free to negotiate on an individual basis, and many consumers who think the market is out of their reach will find that they are able to participate.

There will still be those who cannot participate due to insufficient resources- that is why we are called to be charitable toward those in need.

Ok, so…you’re saying that you have to attempt to operate within the market in order to participate in the market…yep, I totally agree with you on that.

The thing is, the market wants to get everyone involved- because the market understands that everybody has something to trade. Let’s take transportation…this is why there are Lexus dealers, Hyundai dealers, and bus companies. People need transportation, and so the market provides it. People who make cars know that there are people who can afford a Lexus and there are those who can afford a Hyundai. And for those people who can afford neither, then there are bus companies who have them pay per ride, rather than buy a car. But what about those people who can’t even afford the bus? Many private charities provide bus vouchers and I hand dollars out all the time to pedestrians who ask for some help with bus fares.

So, the market provides to most, and charity helps the rest.
It works with food, transportation, and just about everything else in our society. It will work with healthcare.

Hmm, maybe I’m not clear on this…The market lowers the price to the point that the best balance is met between the profit per unit and the number of units sold. If customers won’t buy something, then the provider lowers the price until they do. Once this price is met, and the products start moving, then the market will increase supply to meet the demand. If this price can’t be met at a profitable level, then that product is either not desired by the marketplace, or it is too expensive for the marketplace- and in come the entrepreneurs to either find ways to lower the production cost of that product or find new ways to sell it. For example, cellular phones are much more expensive than people realize- I never would have paid the retail price for my cell phone ($400), but I would sign a contract with my cell provider so that they paid for my phone and I paid for their service. In this way, the phone maker found a way to sell their high price item by pairing it to another provider in the marketplace.

So…Not really sure of your point on this one.

True, because people always want the newest and best treatment. Similarly, Apple’s business model is weighted heavily on creating hype for early adopters.
Yes, this is my point exactly!!!
That’s right- insurance companies and the government work together to control the exchange of services, and in the process, they sacrifice either the consumer, the provider, or both.

I’m completely with you on this one.

Under the current system, many doctors have no control over what they charge because their rates are dictated to them by third party payers, and most consumers have no idea what they’re actually being charged because they just have their copay to take care of.

You are probably one of the few people who is actually aware of how inflated healthcare costs have actually become, and the cost is so staggering that you have come to believe that the only way to manage it is for the government to monopolize it.

Problem is, the solution can’t be found in the government or the insurance companies, because these two entities are exactly the reason why care has become so expensive.

The solution is to remove the government and the insurance companies from the market, and return control of the market back to the only two groups that have any business being there- the consumers and the providers.

So in your dream world if you removed the insurance companies and the government costs would suddenly drop to where we could all afford them. Keep dreaming.
 
Well you can talk all you want about having private insurance cover us, the disabled, but until that happens we are in a Catch22. Unless they are immediately ready to step up to the plate you cannot pull the rug out from under us and expect us to pay our own healthcare costs. My one medication costs 500.00 a month. If I had to pay that out of pocket I could not afford rent and food. And that doesn’t include other health costs. And if I turn to the Church they will not have the money no matter what you do with the taxes.
Jim, the problem with the current system isn’t simply that people can’t pay, that is only a symptom of the problem.

The real problem is that people can’t compete with the ability of the government and of juggernaut insurance companies to artificially price individuals out of the market.

Our entire healthcare system is built on inflated costs- remove the groups that are inflating those costs, and costs will come back into the reach of the ordinary consumer.
 
Somehow some people think that if you rid the system of government and private health insurance this would miraculously bring costs down to where we could all afford them. Um, what do you think started the idea of insurance to begin with? Costs were already going up and people needed to pool resources through the use of insurance companies to save money. Costs continued to go up and will continue to go up no matter what you do. For the disabled it is ridiculous to think they will ever be able to afford healthcare on their own. This is where the system is a failure from the beginning. My contention is that the only reason universal healthcare is not working is that there is a decreasing population to pay into the system for those who are collecting. Otherwise we could make it work.
 
Jim, the problem with the current system isn’t simply that people can’t pay, that is only a symptom of the problem.

The real problem is that people can’t compete with the ability of the government and of juggernaut insurance companies to artificially price individuals out of the market.

Our entire healthcare system is built on inflated costs- remove the groups that are inflating those costs, and costs will come back into the reach of the ordinary consumer.
Do you really think that if we removed those my meds would drop in price and I could suddenly afford them. Keep dreaming.
 
Somehow some people think that if you rid the system of government and private health insurance this would miraculously bring costs down to where we could all afford them. Um, what do you think started the idea of insurance to begin with? Costs were already going up and people needed to pool resources through the use of insurance companies to save money. Costs continued to go up and will continue to go up no matter what you do. For the disabled it is ridiculous to think they will ever be able to afford healthcare on their own. This is where the system is a failure from the beginning. My contention is that the only reason universal healthcare is not working is that there is a decreasing population to pay into the system for those who are collecting. Otherwise we could make it work.
Jim, you’re right about why the whole idea of health insurance started. And you’re right that insurance companies do have the potential to play a good, helpful role in the marketplace.

The problem is that the insurance companies of today do not resemble in any way the small, community oriented groups they began as, and they certainly don’t serve the same purpose. They used to be non-profit organizations run by people who accepted meager salaries and recognized their work as a community service. Now, generations later, these organizations have merged with one another to become juggernauts that manage gigantic stock portfolios, operate subsidiary companies, employ thousands, negotiate fees, negotiate drug prices, pay lobbyists, and dictate policies and regulations to both providers and consumers. This “success” has resulted in the ability to pay out billions of dollars. The natural response of the market, once flooded with such large sums of money, was to raise prices to the level that the market could bear. Now, we are essentially victims of our own success- we worked so well pooling our resources together that we have created a monster that prohibits us from participating in the healthcare system as indiviudals.

And yet people still defend and cling to insurance companies by asserting that the tendency of insurance companies to grow in this manner is justified because they need to grow larger in order to dilute their risk into an ever growing pool. But this model is ridiculous because it has to continue to grow into larger and larger makets.

Or worse, individuals convince themselves that the government is a better alternative to juggernaut insurance companies.

But soon, you will start to see many UHC countries realizing that their “pooled risk” is too large of a liability, and they will seek out new markets in which to dilute their risk- that is, they will start to merge their healthcare programs with other countries. This is already happenng in the EU.

How long before the UN starts seriously talking about developing a Worldwide Healthcare System, wherein all UN countries will pay according to their ability to participate in such a program? It will be a bigger wealth redistribution scam than the Kyoto Protocol-
 
Do you really think that if we removed those my meds would drop in price and I could suddenly afford them.
Yes, but not suddenly.
The market would have to adjust to what consumers could afford.

If consumers can’t buy drugs, companies can’t sell drugs. Since drug companies want to sell drugs, they would have to find a way to make their products affordable to those who need them.
Keep dreaming.
Ok.
 
Apologies if this has already been posted. I haven’read both threads yet…

Quote:
“How are things going?” The worker replied, “Badly, badly, Your Eminence,” telling Pope John what he earned and how many family members he had to support. “We’ll have to do something about this,” said the Pope, only to be told later that raising the wages would cut the funds available for charity. The Pope’s response: “Then we’ll have to cut them. For & justice comes before charity.”
I like this Pope. Seriously.

Best,

Tor
I can’t believe I let this slip by.

Tor, I’m genuinely surprised that you like what was happening in that quote…maybe you didn’t understand it.

Pope John was confirming that justice demands that the individual’s right to earn a fair wage precedes the call of the governmental body to contribute to social welfare.

That is, the Vatican, as the governmental body of Vatican City, must provide a just wage to its employees prior to attending to the needs of those who depend upon it for charity.

Just as it is unjust for the government to use funds for charity that are, in justice, owed their employees’ just wages, it is also unjust for a government to tax its citizens in the name of a charity, when the very weight of those taxes causes so many to be dependant upon charity.

If anything, you should have complained about that quote as it is clearly in conflict with your values.
 
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