Ok, Republicans. We give up!!!

[Jenne]

Ippy, really?  You are legislatively coerced to do the right thing ALL DAY LONG.

Roads, taxes, how you get water and electricity, stopping at traffic lights, the list goes on and on...

You're THERE.  You are IN IT.  This isn't the kind of thing (health care for those who need it not just want it and can afford it) that will make society worse.  I can't see it, I really can't.

Because even the people who are afraid that women won't get bc pills or abortions need to realize that if a doctor or pharmacist is committed to doing their jobs, that won't happen, either.  The law's pretty straight on that as-is, and I don't see the doctors and pharm set allowing that to go down without a fight.

Great thread, everyone...we need an Ippy here to give our brains a wriggle.

[Elder Iptuous]

Dunno, but I watched Sjaantze go through bankruptcy because of Medical bills that the hospital had no inclination to lower to a payable amount. In fact, since she lived in the same house as me... they said she didn't qualify for any help at all. Why? Because that's the system I guess. She tried several times to work out some kind of payments, but in the end had to declare bankruptcy.

'just because' is the same unsatisfactory answer i've always gotten at this point of the conversation...

The alter of liberty? What sort of liberty is risked here? The liberty to die with huge bills? The liberty to choose between paying your bills, eating and buying the medicine you need to live?

I love liberty, but that seems like bullshit to me.

I view taxes as an encroachment upon ones liberty.  (a necessary one, to some extent, i admit)  that doesn't seem outlandish to me...

[Jenne]

...and so you live alone, don't drive on the streets, etc.?  Bullshit.  You are not a hermit, and living within society means you adhere to its laws for a common good.  Taxes contribute to that common good.

[Elder Iptuous]

...and so you live alone, don't drive on the streets, etc.?  Bullshit.  You are not a hermit, and living within society means you adhere to its laws for a common good.  Taxes contribute to that common good.

no, man.
that was Kai who said i wanted to be a selfish hermit.... not me.
i realize that there are infrastructure things that are best done publicly.
i realize that laws for the common good are necessary in so far as they protect the individual against fraud and violence, etc.
i don't think that anything that could lead to a smoother functioning society should be centrally enforced, though.
you've read Brave New World, right?  that society functioned efficiently and everyone was happy and healthy, too...

[Triple Zero]

I'm curious... in what way would a gvt run insurance plan be more incompetent than an HMO?

I know the standard line is, "the gvt wouldn't run it right," but no one give any details on what exactly they would fuck up.

HMO is the private insurance company right?

it totally depends. that's why I dont go around shouting you should have basic health insurance just like in the Netherlands.

both insurance corporations and governments can fuck it up, it depends on all sorts of external (cultural/national/economic) factors. I know the Dutch government got it down pretty well, but so do the private companies. I mean, it still could be better, which is why the Dutch national passtime is complaining about shit (it might be annoying but it WORKS, bitches), but compared to the USA, well what I hear in this thread, sorry to say but it sounds like certain demographics are on the level of a fucking third-world country. The very rich in NL might be in the position to buy extra experimental expensive treatment, but they are only marginally better, the difference is not that big. Laser, contacts or glasses (im gonna get laser from my fire insurance money--I have -5 on both my eyes, getting them fixed without needing glasses anymore seems like probably the best investment, one that's valuable even if all economy goes to shit).

[Golden Applesauce]

...and so you live alone, don't drive on the streets, etc.?  Bullshit.  You are not a hermit, and living within society means you adhere to its laws for a common good.  Taxes contribute to that common good.

no, man.
that was Kai who said i wanted to be a selfish hermit.... not me.
i realize that there are infrastructure things that are best done publicly.
i realize that laws for the common good are necessary in so far as they protect the individual against fraud and violence, etc.
i don't think that anything that could lead to a smoother functioning society should be centrally enforced, though.
you've read Brave New World, right?  that society functioned efficiently and everyone was happy and healthy, too...

I don't see a difference between a public health system and public infrastructure.  Both are things that all society benefits from with costs distributed across society, and with a net benefit which would not be profitable for an individual/corporation to tackle it.

[Triple Zero]

000,
you say that this is the crux of the matter.

...but other monkeys, enough to make your entire plan fall to pieces, will help them. either because they think this is the "right thing to do", or because they can't stand to see other monkeys suffering like that, or because the sick monkeys trick them with complicated lies about "human rights" and such.
...
in the end..., everybody ends up involuntarily paying for everybody else.

in order for that to be the case, you are having to define their charity based on some moralistic, empathetic, or philosophic grounds to be 'involuntary'.
is that the way you see it?  (or did i excesively snip your comment and miss the point entirely?)

not quite. what they want (also what I want, because I'm seeing it work over here) is a society where people take care of eachother. because they think the whiners (from the post you quoted) are right, in some sense. even though they are assholes for not contributing, their claim that as human beings they should be entitled to medical help is right (in their opinion, which doesnt need to be your opinion).

so, maybe "involuntary" was too strong a word. they want society to work like that, and the only way to do that (with any degree of efficiency) is to deal out healthcare to everybody. because they dont just want to give healthcare to people that join this game. they also dont want to be the sort of people that have to turn their back to someone in need, regardless. because that requires you to be a cold motherfucker, which may be aokay for a liberain, but if they didnt have any problem with that, they wouldnt want this.

so in that perspective, their desire for society to function that way is just as valid as the one you described.

so hypothetically, that would work if you'd have two separate societies, where one is your liberal fend for yourself type you describe, and the other has healthcare. (pelase ignore the hyperbole)

a problem with this, (apart from that I've never really seen this work with any decent standard of healthcare-- but correct me if im wrong), is that your society requires to be 100% non-monkey. and by that I mean that I believe that this empathy is a fundamental property of human nature. some people might be able to resist it, refuse a man bleeding to death coming to first aid until they show insurance or pay up (this is common in Africa btw, according to a friend who worked there as a doctor), but I believe there will always be a substantial part of the population that cannot stand to see suffering if they can help it.

so, even if from a philosophical perspective, both types of society are equally valid (if they really are, I just followed one line of reasoning), the one that you describe would still have a part of the population paying for healthcare of freeloaders.

[singer]

That, obviously, needs to be addressed.  So, what i'm hearing, is that the costs are rising overall because of uninsured patients not paying at all.  yet they charge a higher rate to the uninsured than they do to the insurance companies because there is no negotiated price point before hand.  it can be assumed that the procedure done at the insured price point is still profitable to some amount, otherwise, they would not do it at all.  So why wouldn't they accept an 'allowed amount' from the uninsured (that is still profitable to some level), rather than receive nothing at all?  i asked this question to someone pushing for the reform, and got no coherent reply....

Oh no... I don't believe this is entirely the case.  I believe that  the un/underinsured pay all right.  They pay as much as they can when they see that astronomical amount mentioned by LMNO.... $500.00 a month, or $50.00 a month.... whatever they can.... because it's their HEALTH at stake here.... and they probably still have follow-up appointments and they don't want to be turned away for non-payment.... so they pay whatever they can... but... they aren't un/underinsured because they are rich bastards... they are un/underinsured because they can't afford insurance in the first place.  

(Someone more inclined than myself can probably check the national median cost for family coverage, I'm just basing my estimate on my experience.  $1,500 per month for family coverage... more than what I could afford monthly if my employer wasn't underwriting the majority of the expense.)

So... when the hospital or clinic billing department gets tired (after 2 or 3.... sometimes even 4 months) of $50.00 per month payments.... because they would like to see 10%... (which we have already ascertained is more than what I am speculating is the average monthly cost of insurance)  ... they turn the account over to a collections agency... who tack on additional fees...

...meanwhile scared patient fearing a future of compromised medical care continues to pay.... whatever they can.... until they can't anymore.

And.... I don't believe we can assume that the negotiated price point is still profitable... I believe we can assume that fat juicy contract with insurance company is enough of a carrot to make hospital administraors agree.... and plan to 'make up the difference' elsewhere... like in the bill of that un/underinsured schmo... just charge them enough more to subsidize the insurance company's discount.  After all... they are sick and scared... they don't have the numbers or the clout to "negotiate a deal"....

...meanwhile scared patient fearing a future of compromised medical care continues to pay.... whatever they can.... until they can't anymore.

And then there's equipment.  Damned expensive... and not everybody will use that shiny new MRI machine.... so we gotta pay for it somehow... oh I know.... how about we start to charge $2.00 for every cotton ball and q'tip used.... everybody uses those... we can charge ALL our patients an artificially inflated price for sterile supplies... and the amount is too small for the insurance watchdogs to waste their time tracking and contesting... for sure we don't need to worry about that un/underinsured schmo kicking about this particular gouge... after all they have neither the numbers or the clout to do anything about it.

...meanwhile scared patient fearing a future of compromised medical care continues to pay.... whatever they can.... until they can't anymore.

I know some tough negotiators who have told their hospitals "I did my research.  You are charging me more than the "normal allowed" amount and I won't pay the difference".... but folks who know what those amounts are... and aren't too sick or scared to risk pissing off the administration/billing department of maybe the only health care facility for miles around... those folks are few and far between.  

The short, (but still unsatisfactory) answer to "why won't hospitals accept a negotiated payment from an individual when they will from a corporation?" is this.... because they don't have to.  They can count on most sick scared recovering patients to pay whatever inflated amount they can afford... damn near in perpetuity... and they always have the ability to "write off" the lingering unpaid amount (once the patient dies... or declares bankruptcy... or whatever.... ) saving a tidy sum on  their corporate taxes

[Triple Zero]

The healthcare situation, I think, is one that betrays the inherent flaws in the 'capitalistic' society. The claim is that the market will provide... yet, we didn't see the market provide here... Any time in the past 20 years the Market could have come up with a solution and pushed for legislation to cover it... Healthcare Co-Ops on a per city basis, Basic healthcarre packages that covered emergencies and only necessary stuff... but instead 'the market' was focused on profit, to the point that the health care industry looked for ways NOT to pay for healthcare, in order to have more profit.

Right.  this has me curious.  if there is a market there (and there certainly is) for better coverage, then why hasn't it emerged?  Although i am ignorant of the answer, i would be willing to wager that it is because of legislative interference bought by the crappy existing system....  That isn't capitalism.  that is fascism.
am i incorrect in my wager?

um, i would assume that given your love of capitalism and the free market, you'd be familiar with the theory behind it? and I dont mean the theory that is obvious at first sight, there are also loads of very counter-intuitive things that happen in a free market. efficiency (the economic term) is one of them. may I suggest you to read the "undercover economist" by Tim Harford. there are a bunch of very solid reasons why the free market doesnt always end up as the most optimal solution (too long to explain in a few sentences though, but it happens often enough). he also gives a bunch of good and interesting ways to support the free market to get to a more optimal solution. taxes, subsidizing, are some of them. also, it's an easy and interesting read

[Triple Zero]

The total cost of treatment was probably close to a million dollars, without health insurance.

what?

I have to say, with my healthcare I'm always surprised how much it actually costs, because I hardly ever get a bill, but sometimes I see it on my insurance reports.

But a million? Wow.

afaik, insurance companies rate the value of a human life at something like 100k-200k or so. (yes of course they do the fight club thing, you bet health insurance companies have a price on a human life)

[Pope Pixie Pickle]

http://news.bbc.co.uk/1/hi/uk_politics/8199615.stm

this debate has made the UK really realise how lucky it is.

Well us brits are tweeting furiously in defence of the nhs, mostly in testimonials. The tory who slagged it off to the US probably wont get his nomination for the next election..

A rash of facebook testimonials from my friends such as "Neil P would have been deaf from childhood without the NHS."

I would probably have died with my mum and the difficult birth I had. My younger sister would have been dead from Meningitis if it wasnt for the NHS, and wuldnt have received the essential after-care and therapies needed to get a 20 year old learning to walk, talk, read, all from scratch because of the resulting brain damage..

My National Insurance only runs at about 10 per cent, from this we get entitlement to unemployment benefits, healthcare, and for the older generation, a pension. (the viability of the nationalised pensions to the X and Y gens looks shaky, but hey... nothings perfect.) as well as other state benefits.

I just don't see how a civilised nation can call itself civilised when many millions cannot get sick without bankruptcy.

America, you are Doing It Wrong.

Love, the Britspags.

[Triple Zero]

I'm gonna come right out and say that I'm a dirty fucking socialist hippy bastard who thinks everyone in my community deserves adequate health care whether they can afford it or not and I am more than willing to front part of that bill via my taxes, knowing that I'll benefit when everyone benefits from good health and education, and that anyone who disagrees with me can go live like a hermit somewhere becoming of the selfish narcissistic antisocial bastards that they are. Or fucking kill me.

I would have said this. I would have if this discussion would have been among Dutch people, however since this discussion is about USA healthcare, I dont think I'm in a position to make such a statement. Glad you think so, Kai.

[Golden Applesauce]

I'd like to disagree with the characterization of people without health care as not being "responsible" for themselves, and to do that I'm going to back up and go over my understanding of capitalism.

Capitalism, like every other economic system, is a system which determines i) what and how goods and services will be produced and ii) who gets those goods and services.

People are rewarded with currency for producing a good or service; the reward is directly related to how much the good is desired and how much of it is already out there, minus a penalty for the other goods consumed in creating the product.  This naturally leads people to make more of the things we don't have enough of, while discouraging people from wasting resources producing things nobody wants.  The genius (and problem) of the system is that the reward is also used to determine who gets what - the reward is a coupon for more goods and services, aka currency.  These coupons, over enough transactions, eventually set the reward for the production of goods and services at reasonable levels (most of the time.)  It's a very democratic system - one coupon is one vote for determining how much of a prize should be awarded for what, and therefore determining what should be produced.

The problem is that the voting is weighted by how many of these coupons an individual or organization has.  Those with few coupons are relatively powerless, only able to exert influence if a great deal of them get together.  The effect of this is that the goods produced are not oriented to serve the public society in general, but rather the portion of the public that holds enough of these coupons.

The current economic system is essentially the same as a democracy which limits suffrage to landowners, just substitute "coupon" for "land" and "production" for "legislation."  The healthcare situation in America is analogous to a democracy in which only landowners can vote determining that the best kind of health care is the system which provides it to the landowners, wasting as little of it as possible on the sharecroppers.

Viewed in this light, the American movement towards a public health care system is an attempt by people who have not enough of the coupon-votes to induce industry to produce more healthcare services to use political votes, which are (somewhat) more evenly distributed, to effect the same end.

Somewhere along the way I meant to show how those without enough coupons weren't being irresponsible, but I guess I got lost in my own reasoning?

[Cainad (dec.)]

After having thought about it all day when I was supposed to be enjoying the aquarium, dammit (fuck you, PD.com!), here is the reason I consider a government-run health care plan to be a good idea:

Every single case of real-world government-run health care I've seen has been adequate to excellent. My own health care and my family's all come courtesy of the US Military (thank you, Iptuous, and everyone else, for paying your $0.002 towards my appendectomy ) and it all runs smoothly and perfectly under the Tricare insurance program. The same is true of all my military brat friends.

So, the Fed pays for the health care of the US Military, and doesn't fuck it up. Score one on our own soil; don't even need to ask them socialist foreigners who don't know any better. Now you can argue "but that's for the military specifically blah blah blah" okay look shut up that's not the point, at all, ever. The point is, the Fed took your money and uses it properly. Motherfucking shocker (I know I'm surprised).

Every single horror story I've ever heard about uncaring government bureaucracies comes from scaremongering speeches from American conservatives; never have I heard anything to suggest that occasional fuckups (which I'm sure happen) are the rule rather than the exception. People who live in countries with government-run health care systems all seem to think that their system is adequate-to-great, as opposed to here, where opinions about health care seem to range from "fuck this shit" to "it's brilliant if you can pay for it, yeah."

And then there's the argument which amounts to "Fuck you, Federal government!" While I'm generally behind this attitude because the Fed is certainly capable of colossal fuckups and commits them like there's no tomorrow, in this case the only thing this argument has going for it is, well, itself. I don't like sticking to principles when they are obstructive to the general health of human beings. Also, there's no point in arguing when people are just bumping opposed principles against each other.

Viewed in this light, the American movement towards a public health care system is an attempt by people who have not enough of the coupon-votes to induce industry to produce more healthcare services to use political votes, which are (somewhat) more evenly distributed, to effect the same end.

Somewhere along the way I meant to show how those without enough coupons weren't being irresponsible, but I guess I got lost in my own reasoning?

I dunno, but you basically illustrated the point that the poor do not have sufficient buying power to make it profitable for the industry to handle their health care.

[Triple Zero]

i realize that there are infrastructure things that are best done publicly.
i realize that laws for the common good are necessary in so far as they protect the individual against fraud and violence, etc.

I don't see a difference between a public health system and public infrastructure.  Both are things that all society benefits from with costs distributed across society, and with a net benefit which would not be profitable for an individual/corporation to tackle it.

yeah that's an interesting quesion, Ip, why do you think infrastructure is necessary to be done publically, but healthcare isn't?

are roads more important than human life? (sorry that sounds like a really loaded question, but I cant find another way to ask it)

cause IMO both are equally important. you dont have proper roads, everything gets bogged down. but if people are sick, same thing, right? except it's even more direct. roads are an indirect way for general happiness, people getting medical aid, are more direct, cause the people getting treated (and their friends/famyily) are more happy.

i just think cause humans are the entities that DO shit, makes them a sort of infrastructure in a way, no?