Health Care Reform

Post by **yovargas** » Sat Sep 15, 2012 9:27 pm

So a good friend of mine - who works a minimum wage, part-time job with no benefits - has been having very bad sharp pains in his abdomen for the past three days. Naturally I really really insist that he should go see a doctor. But he stubbornly says that he has no money to see a doctor and he can't afford to miss any time off work (where he's at right now). Soooooooooo...this is why American health care sucks.

Post by **Impenitent** » Mon Sep 17, 2012 3:25 am

I hope it's not serious. But even if it isn't serious, he's still hurting and it's just wrong that, in one of the wealthiest nations on earth and in the 21st century, he has to put up with it because the social contract doesn't provide him with a realistic option of having it seen to.

Post by **Primula Baggins** » Mon Sep 17, 2012 5:52 am

So we're losing our COBRA insurance at the end of September. We applied for family insurance on the private market. Yesterday I was told that I cannot be covered (as I expected)—not for anything, not for any price.

So the others will get that insurance, and I'll buy from the state high-risk pool. My insurance will cost more than the insurance for the other four put together, but we will all be covered.

So, no problem, right? This is going to cost somewhat less than COBRA did—for lousy insurance, but, it's insurance and will eventually cover any medical disaster once we've paid out, oh, $15,000 or so. Which we could pull out of our retirement fund. No problem—what's working an extra year or two?

Unless I stop to think that if I weren't lucky enough to live in a state with a high-risk pool, I would be uninsured for six months until I qualified for the federal high-risk plan. And one third of U.S. states don't have such pools this year. The federal pool would not exist except for Obamacare. Without Obamacare, in a state without a pool, if I got sick I would bankrupt my family.

Greatest healthcare system on the planet . . . right?

Post by **Impenitent** » Mon Sep 17, 2012 6:12 am

I'm sorry Prim.

Move to Oz. We could be neighbours.

Post by **Primula Baggins** » Mon Sep 17, 2012 3:58 pm

Post by **vison** » Mon Sep 17, 2012 4:35 pm

Mt. Lehman is closer.

Post by **Primula Baggins** » Mon Sep 17, 2012 5:05 pm

Post by **nerdanel** » Mon Sep 17, 2012 7:44 pm

yovargas wrote:So a good friend of mine - who works a minimum wage, part-time job with no benefits - has been having very bad sharp pains in his abdomen for the past three days. Naturally I really really insist that he should go see a doctor. But he stubbornly says that he has no money to see a doctor and he can't afford to miss any time off work (where he's at right now). Soooooooooo...this is why American health care sucks.

One of my friends struggled with abdominal pain a few years ago. At the time, she was also partially employed without benefits. She could not afford to see a doctor. Fortunately for her, our city - tired of waiting for the state or federal governments to provide the basic human right that is access to health care - took it upon itself to universalize health care, regardless of income or immigration status (to the extent a local government can accomplish this - i.e., participants do not receive "insurance" that is valid anywhere in the country, but have access to medical care within city limits.) After my friend was able to see a doctor, she was quickly diagnosed with a large malignant ovarian tumor; her cancer had progressed due to the years that she was without health care. It is no exaggeration to say that the city's giving her access to health care probably saved her life.

I have a lot of reservations about "socializing" health care to mean that everyone receives the exact same health care. I think it should be possible to purchase a higher standard of health care beyond the minimum, although that probably makes me a conservative in these parts.

(Although, Brits correct me if I'm wrong - I think the UK operates like this - everyone has access to the NHS, and there are still additional private options for people who want them.) But I firmly believe that, in a country that has the resources to provide each of its residents with health care, no reasonable person can support denying access to a basic level of medical treatment (especially treatment necessary to preserve life) to any resident on any ground. It infuriates me that this stance is remotely controversial.

Post by **Erunáme** » Mon Sep 17, 2012 8:01 pm

nerdanel wrote:(Although, Brits correct me if I'm wrong - I think the UK operates like this - everyone has access to the NHS, and there are still additional private options for people who want them.)

This is correct.

Post by **vison** » Mon Sep 17, 2012 9:22 pm

I don't understand your objection, nerdanel. Do you think some people should have better bridges or highways?

In Canada everyone is covered. Some provinces require premiums and some don't. I don't think prescriptions or glasses or dentists are covered here but they are in England.

Everyone is covered, as I say, but not everything is covered. We can buy extra insurance and many people do. But that extra insurance will not get you into a hospital any quicker. You CAN pay privately, though, and some rich people do.

One local billionaire paid his own way. He soon found out he got no different care than anyone else and was so impressed he built a high-tech diagnostic centre across the street from the hospital.

Post by **Nin** » Mon Sep 17, 2012 9:29 pm

It's a bit like this here too: there is a basic insurance (which is not free nor state sponsored by the way) which everybody has to have and who have to accept everybody without health-exam or age restriction. Different companies (dozens, in fact) offer this basic insurance. The prices vary, but the minimal cover is the same for all companies and defined by law. All those companies are private insurances who make benefits, and every company which wants to offer health-insurance in general has to offer this basic version.

Then you can choose to have complementary insurances to be covered (privat room in hospital, for instance). Those have restrictions, like health exams or age limits.

I have always had only the basic insurance (including during both of my pregnancies) as has my sister and her radiotherapy was fully covered while her insurance has not risen because of it - the price for the basic insurance is the same for all clients of one company, but it varies according to the region and the company. You get covered for all necessary medical acts, free choice of doctor (or you choose it otherwise, you pay less), public university hospital with top equipment. I got covered for delivery (of course), the ambulance last year, hospital stay in emergency but also physiotherapie, glasses (for the children only!), preventive cancer tests like mammographie, physiotherapy, X.rays, echograpy and psychotherapie prescribed by your doctor.

Yet, it is not a national health insurance. It's private and profitable.

I pay 330 Swiss francs per month for my health insurance. Geneva is the most expensive region of the country. Every year, I have to pay the first 400 francs of health costs myself. The kids are a lot cheaper. Persons with low incoms get state help in order to pay their insurance.

Could an alike system (as it is private and profitable) work in the US?

edited for typos

Post by **Holbytla** » Mon Sep 17, 2012 10:07 pm

I'm not sure we will ever have health care for all without extracting some of the profits put of the system, and that is going to cost jobs. The national debt is over $16 trillion and counting, the deficit is over $900 billion, and the unemployment rate is at 8.3%.

I know a guy who drove this kid to a clinic, because he wasn't feeling well and had no insurance. Because the kid lived in the town and had no health care, they treated him. The kid had strep throat, so that meant cultures, lab work and a prescription for medicine. The cost (which the guy paid for the kid) was $50.

The guy was impressed at how little it cost and talked to one of the people at the clinic. He asked what would have happened if he had gone in there with the same symptoms, but with insurance. He was told his insurance would have been billed for over $400, and he would have had to pay the usual co-pay and to have the prescription filled.

Now I am sure the clinic is funded and has to make up the difference between that $50 and what the actual costs were, but it isn't $400 in difference.

I think that is the real issue. There is a giant pile of money earmarked for the health care industry, and there are lots of hands out trying to benefit from it. Doctors, nurses, providers, labs, tech companies, pharmaceutical companies all gain from the industry, and also provide jobs.

All people should have access to health care. Period.
There is however, no quick and easy cure all without ramifications.

We don't manufacture much in this country anymore, because it is far cheaper to manufacture in other countries. Heck you can't even call a customer support number without talking to someone overseas.
Health care isn't something you can outsource though, and the cost of living here dictates higher wages, and the vicious cycle goes on and on.

We are going to get health care for all, I believe, but I'm not sure we are going to be able survive the cost without figuring out some way to create meaningful jobs.

Post by **nerdanel** » Mon Sep 17, 2012 10:19 pm

vison wrote:I don't understand your objection, nerdanel. Do you think some people should have better bridges or highways?

Think of it this way: my city has also chosen to make a minimum standard of housing available to all residents including the homeless, via SROs (single room occupancy units). The objective has been to create enough SRO capacity that every homeless person in the city can be offered non-shelter accommodation. This makes perfect sense to me - in addition to being a good, compassionate practice, having fewer people on the streets improves the overall quality of life for us all and benefits the businesses and real estate owners on whose doorsteps the homeless would otherwise dwell. However, even though I support the existence of this minimum housing standard for all our residents, that does not mean that I think we should all be living in SROs. I prefer to pay for nicer housing for myself; most of us do.

I support the existence of the best public school systems possible, but I feel strongly that there should also be private school options available for those who wish to use more of their own funds, or loans, to pay (speaking as someone who has attended both types of schools, both at the grade school and university levels.)

Even a well-funded public health system is going to have to make difficult decisions about when additional treatment cannot be made available to a particular person or can only be made available after delay. You have spoken candidly about this in the Canadian context, referring waiting lists for some treatment (that people can circumvent if they are willing to pay) and talking about what is usually done or not done for patients of a particular age (and the fact that that might vary based on factors like dependents). I'm sure that we all agree that in an ideal, resource-abundant world, everyone would get equal and unlimited treatment. But given that this is not that world, I definitely feel that people should be able to supplement the minimum universally-available treatment with their own private resources. I don't think my point is really that controversial except to the very far left; based on your earlier posts and Eru's confirmation in this thread, I seem to be describing the system in both Canada and the UK.

Post by **vison** » Mon Sep 17, 2012 10:51 pm

I can't think of any country where money won't buy you extras, whether it's health care or private schooling. We have plenty of private schools in Canada and the poshest of them do exactly what they do elsewhere: educate the ruling class.

Public housing is a whole different thing. We have public housing here but not on a grand scale and it's mostly a mess. Vancouver gets the poorest of the poor from all over the country because our climate is so mild and you can live on the street most of the year. People get all het up, demanding that we house them, but the truth is that a significant percentage of these people live on the street because they want to.

The kind of public housing that we provide for single mums on wlefare, hard-up seniors, etc., is a not managed very well. The 2010 Olympics were supposed to leave us with hundreds of nice, affordable units but like all the other Olympic promises, it never happened.

Post by **axordil** » Mon Sep 17, 2012 11:11 pm

vison wrote:I can't think of any country where money won't buy you extras, whether it's health care or private schooling. We have plenty of private schools in Canada and the poshest of them do exactly what they do elsewhere: educate the ruling class.

Public housing is a whole different thing. We have public housing here but not on a grand scale and it's mostly a mess. Vancouver gets the poorest of the poor from all over the country because our climate is so mild and you can live on the street most of the year. People get all het up, demanding that we house them, but the truth is that a significant percentage of these people live on the street because they want to.

The kind of public housing that we provide for single mums on wlefare, hard-up seniors, etc., is a not managed very well. The 2010 Olympics were supposed to leave us with hundreds of nice, affordable units but like all the other Olympic promises, it never happened.

Out of curiosity, what did happen to the Olympic housing?

Post by **vison** » Tue Sep 18, 2012 3:24 am

Mostly the usual: not much.

The units are supposed to be divided between "social housiing" and for-profit, but there's not enough money and the city is interfering over zoning, etc. The Olympic village was in a very prime part of the city and it seems as though it's too good for poor people.

Post by **axordil** » Tue Sep 18, 2012 6:11 am

Yeah, that's what I was afraid of.

Post by **anthriel** » Tue Sep 18, 2012 1:33 pm

vison wrote:I can't think of any country where money won't buy you extras, whether it's health care or private schooling.

True story.

I have a friend who grew up in Vietnam, and was there during several years of communism, as well. She is not a fan of communism.

She feels like "free" health care is not quite as straightforward as it sounds. Her own sister went on vacation to Canada two years ago, and while there, she badly cut her hand. She went to the ER, and waited for an hour, bleeding.

She was taken back to see the doctor, who told her that if she paid him $100 American ('cause he had kids going to school in America), she could be seen right away. Otherwise, she could go back to the waiting room for another 6 - 8 hours, and wait. Bleeding.

I was shocked beyond words. I have read so many things (mainly on this messageboard

) about how wonderful Canada's healthcare system is, that I think I thought everyone and everything there is perfect. Corruption seeps in everywhere, it seems. Ugly stuff.

She paid her 100 bucks, of course, rather than bleed for so many hours. My friend is so... scared of the "free" healthcare stuff, and I am sure that goes back to her Communist days. But that experience didn't help her confidence in the idea elsewhere at all.

Post by **axordil** » Tue Sep 18, 2012 1:38 pm

Don't start a "horrors of the ER" competition. Just don't.

Post by **Primula Baggins** » Tue Sep 18, 2012 2:19 pm

I am a fan of socialized medicine, having seen it up close and personal while helping my parents with their health care needs. Medicare makes it so simple. Mom and Dad are eventually billed for any balance, but once they were "in the system" at the various hospitals and clinics here, there was never any hassle up front. I hope it's still around in some form when we turn 65. I have no idea what we'll do if it isn't.