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Massachusetts Makes Health Insurance Mandatory
Posted by
kdawson
on Wed Jul 04, 2007 03:58 AM
from the no-sickos-here dept.
from the no-sickos-here dept.
Iron Condor writes "Massachusetts is the first state to require its residents to secure health insurance, a plan designed to get as close as practically possible to statewide universal health care. Presidential hopeful and former Massachusetts governor Mitt Romney originally introduced the idea in 2004. Effective July 1, 2007, the law, which uses federal and state tax dollars, is aimed at making health insurance affordable to all residents of the state, including low-income populations. Those who fall below the federal poverty line may be eligible for health care at no cost."
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Socialised Healthcare is the future for the US (Score:5, Insightful)
You know, a few years back I was in San Diego and went to Toorcon (excellent conference by the way - please support it) and I got in to this discussion late at night on socialised health care.
For those that don't know, the United Kingdom spends eighty billion pounds a year on healthcare, funded directly through taxes. His central point was: "Don't you feel like you're being ripped off paying for the health care of jobless people when you're busting a gut earning a living?"
I think it's an important question and one that needs answering if the United States is going to replace their broken healthcare system. My answer is simply that even ignoring the people who don't work, it is still a better deal for you if you have socialised health care.
Free market economies work best when prices are elastic; that is, where changes in price affect the demand for the product. This allows price to signal the level of available supply and prevent shortages of goods. The problem with healthcare is that it is not elastic. If I have cancer, a broken leg or some other ailment I have to get it fixed - regardless of the cost.
In a profit making company, this means raising the price indefinitely sees no reduction in demand. This leads to an ever increasing cost that outstrips inflation. The American system compounds this because a lot of white-collar workers get insurance plans from their companies. Companies have deeper pockets than an individual ever could so the prices increase still further!
Socialised health care delivers better value for money because of the enormous purchasing power of the government. The NHS can purchase millions of shots in one go. That allows you to hammer the drug companies on price and share the proceeds with the population. In the American system, it is you against the drug company and you are needy; you are willing to pay anything to fix yourself. In short you're screwed.
There are also other economic benefits. Heathier and less desperate neighbours translates to less crime and increase productivity. It pays to insure that the daughter of a crack-addict prostitute get first class health care and education - if only to increase their chances of escaping the poverty trap and contribute more to the economy.
It also pays because you can remove the inefficent insurance companies. If everybody is covered then there is no need to have a bureaucracy to decide if a person is covered.
Socialised health care is not evil communism, it is a practical solution to the health care of your nation. I don't see anybody complaining about the socialised road, garabage collection, fire, police and military. When you trust the security of your nation to the government, why do you not trust your healthcare to them too?
I'd I've seen the benefits first hand. When a friend of mine, at the age of 20 developed Lukemia, put his Computer Science course on hold, checked in to the local hospital and began his treatment straight away. He was cured and back in education the following year. I fear that had he born in the United States, he would not have been able to continue with his studies, in fact, he probably would have been bankrupt. Socialised healthcare not only save his life, but his future.
Simon
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When talking about the cost of healthcare, it doesn't help much to know that if you can't quantify it. What's the value of not having a broken leg? Your daughter not having measles? Your other daughter not having bone marrow cancer?
If you love the U.S. like I do, you will... (Score:5, Insightful)
The parent comment, and others, minimize the issue. The issue is fraud by the medical profession. The medical system in the U.S. is broken.
Okay, this is an exaggeration to try to be funny: If you open your window on a quiet night, you can hear the crying of hundreds of people. Film studio executives in Hollywood are crying because they have to spend $20 million to market a movie that cost $20 million to film, but Michael Moore is invited to sell his movie Sicko from the podium in the U.S. federal government's House of Representatives, and the New York Times publishes a photograph, shown in the NYT article For Filmmaker,`Sicko' Is a Jumping-Off Point for Health Care Change [nytimes.com]. Quote from the article: "Even the haters agree this film is genius!"
When I last checked Fandango.com [fandango.com], there were 1651 "must see" ratings, 115 "go" ratings, and only 62 lower ratings. Sicko is the highest rated movie ever, apparently.
Complaining about Michael Moore is evidence of ignorance. He does the best he can. Do not demand that your evidence be sugar-coated and delivered on a silver plate. Get it where you can, and cross-check it carefully, or know you are purposely avoiding being part of the solution to the problems.
For those whose real purpose is having a way to act out their anger, while hiding it from themselves, get help. Work on resolving your anger, rather than listening to anger sellers like Rush Limbaugh.
One last thing: If you had educated yourself about what the U.S. government is doing [wikipedia.org] and has done [krysstal.com], you would have known that Michael Moore's movie Fahrenheit 451, while faulty in presentation, was entirely based on fact. For example, George W. Bush really does hold hands in an affectionate way with Saudis who control the Saudi government. Osama bin Laden's major complaint was that the U.S. government was supporting a Saudi government he thinks should be replaced. I'm against violence from any source, but certainly a Saudi citizen like bin Laden has a right to object to a regime in his own country that many Saudis say is repressive.
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Re:Socialised Healthcare is the future for the US (Score:5, Interesting)
How does one do that again? My wife worked from the age of 13 and continued for 40 years. During that last year she started becoming fatigued and feeling pain. Her attendence at her place of work suffered and so did mine because I would stay to take care of her when she hurt too badly to get out of bed. This was gradual, first it was what seemed an isolated incedent, then it became every other week. She was seeing a doctor and her diagnosis at that point was lupis.
Finally she had an incident where her leg suddenly lost feeling and she dropped on the stairs at work. She suffered no direct injuries. Wendy was already on final notice for attendance and in too much pain to return. After six months Sony stopped paying her disability benefits and claimed there was nothing wrong with her. She applied for social security disability.
Because there was now one income in the home and not two we couldn't afford to keep the house and lost it. We moved to small town IL with my family. I got a job but Wendy could not. While there I paid cash (her old insurance policy was tied to her employer and no new policy would cover her condition) for her doctors and medications. Her diagnosis became MS and then finally settled on Fibromyalgia.
Predictably the only insurance she had left, Social Security, denied her claim. They had sent her to their doctor, who agreed with her fibromyalgia diagnosis but they denied anyway. She appealed and they denied it on review. She went to a hearing, the judge decided she just had arthritis, which while disabilitating is not one of the conditions approved for disability. Oh yes, the judge also decided she smoked and therefore must be evil.
We appealed on the grounds that the judge was reaching her own medical opinions and not ruling based upon the medical opinions of those actually qualified to reach them. Social security denied the appeal upon review (our lawyer told this that they always do before we even filed it). We filed an appeal to the federal level. Wendy quit smoking. She and I moved back to Florida but kept an address in Illinois to avoid the several month delay that a change of jurisdiction would introduce in the process. She began seeing a specialist, this time the specialist actual wrote the exams the specialists take on Fibromyalgia. This doctor evaluated her independently and also diagnosed her with Fibromyalgia. The federal court has a staff that screens cases, the ruling of the Judge exhibited extreme biased and she played doctor so the federal court summarily sent the case back for retrial without seeing Wendy.
We went back to Illinois again. The judge upheld the previous judges ruling and failed to consider her new doctor, despite him being 'imminently qualified' because he hadn't been seeing her long enough (3 months). Naturally we appealed again, social security denied again, we appealed back to the federal courts, and once again the ruling was deemed bad enough that they simply sent it back for retrial. This time social security sent it back to the same judge who ran the first trial.
That saga is coming soon and we expect another cycle of rinse and repeat. We have appealed to a senator in IL and if the federal court doesn't overturn the ruling this time we will move the jurisdiction to Florida in an attempt to get a fair hearing. It is obvious that social security is biased toward rejecting claims and their judges are also biased toward rejecting them.
Wendy filed her claim six years ago. She worked for 40 years without any interruption of more than 30 days. Her diagnosis has been confirmed by 2 general practicioners and two specialists (including SS doctors). Two social security career experts have said that if the limitations specified by her doctors are correct Wendy would be unable to work any job.
Wendy had a good job, insurance, she had a retirement plan in addition to social security (already burned through paying expenses out of pocket. So you tell me, how was she supp
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Re:Socialised Healthcare is the future for the US (Score:5, Insightful)
The significant reduction of fear of failure and the impact that fiscal failure (through no fault of your own) can have on your families ability to obtain health care has no real meaning to greed based individuals, their family is just for show, something that is expected from their peer group and for those greed driven individuals something that can be readily sacrificed for greater personal returns, let alone other peoples families who are just something to be exploited.
For them being able to produce a drug life saving drug for $1.00 and sell it for $1000.00 is fantastic, and preferably the drug should not cure the disease but just limit the symptoms, so they can continue to sell it to the desperately ill. So that is the way they want to run their health care system, lots of desperate people, with life threatening diseases, to keep the health insurance, pharmaceutical industry and private hospitals running at maximum profit.
As for Australia, the current Liberal party ran surveys to see how much the general public would protest if they dropped universal health care, the only thing that stopped them from getting rid of universal health and letting the US health parasites take over was they discovered that the response would be very aggressive mass protests by the majority of Australians and they would end up out of office for at least 3 election cycles.
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Re:Socialised Healthcare is the future for the US (Score:4, Insightful)
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Bludgers vs Battlers (Score:5, Interesting)
Unobtainium is worthless. Next up, a rant....(not aimed at "you" personally).
The Australian system is similar to the UK's NHS, so much so that we look after each others tourists for "free". I was an asthmatic teenager when the "establishment" told us universal health care was a communist plot that was crippling the UK and would bankrupt the country. 30+yrs later and we are far from bankrupt, we have "world class" prevention, care, teaching and research. I belive "the system" saved my son's life and it definitely kept me out of bankruptcy.
As for footing the bill for "non-taxpayers" (depending on political expediency the Australian term for non-taxpayers is either "bludgers" or "battlers").
I spent all of my 20's at the "trailer trash" end of the socio-economic scale. Happily, I am now in the "high income" bracket where I am supposed to "top up" with private cover for stuff such as dentistry and silcone tits - personally I prefer the extra $500 "fine" at tax time and pay for my own dentistry...anyway...When you do the math it turns out I am paying to cover 5-6 non-taxpayers, yet I have only two (grown) kids and I'm no longer married (to the lazy bitch...sorry...that just slipped out, see the "political expediency" comment earlier).
The reason I am not only glad but proud to pay the levy is that I hope the system works for those 5-6 people as well as it did for me in the past. The reason I don't buy "mandatory top up" insurance is because it is medicinal "fluff" that I can afford. Most of all I don't want a return to the partisan politics where one side refuses to acknowledge the inherent "social evil" in a system that can routinely take eveything the patient's family has, and then promptly hang the patient with red tape.
How do my costs compare to the cost of similar cover in the US?
From comparing notes with one or two US slashdotters in the past I belive my 1.5% levy on taxable income is considerably less than HALF of what similar cover (and care) would cost in the US, the exact ratio varies from state to state. Not very scientific I know, but I also know that the death rate from asthma in the US has now overtaken that of Australia, this is despite Australia having one of the highest incidence rates in the world. Make what you will of the facts and figures and competing "-isims", I know first hand it's not me and my five "battlers" who are getting "ripped off" [google.com.au].
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Re:Socialised Healthcare is the future for the US (Score:5, Insightful)
I mostly agree with you, Simon. Isn't it strange that, on one hand, the US spend money on humanitarian goals to help the Third World to fight hunger and desease but, on the other hand, lots of their own people don't even have access to proper medication?
Social, tax funded, insurances for everyone to back anyone who gets unemployed, injured, seriously ill or who gets too old to work, are the prime achievements that make me feel secure here in Europe. In most aspects, European countries imitate concepts coming from the US, but when it comes to healthcare I think the US should have a close look at their friends in the Old World.
Regardsstirz
(please excuse my bad English)
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Re:Socialised Healthcare is the future for the US (Score:4, Insightful)
Are there problems with the system? Sure. But there are problems in the socialized systems as well of people not getting healthcare either due to rationing. Do we say those systems are "broken"?
Second, collective bargaining isn't a panacea to medical issues. Sure if the country buys one million flu shots in one batch to the lowest bidder you're going to get a better price deal. But the reality is that FEWER companies now produce flu shots so the price gets locked down to whatever those one or two companies can give. If THEY collectively join forces and set the price, well that's that for price trade.
The major problem with socialized medicine is that it takes control/responsibility of my medical life out of MY hands and puts it in control of the government. It's amazing that slashdotters will rally about private information being used by credit bureaus and how the government is big brother looking in on internet browsing sessions but when it comes to medical information, oh hey, let the government do it they can be trusted.
To paraphrase Franklin - "Those who would sacrifice liberty for [medical] security deserve neither"
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Yes its broken (Score:5, Insightful)
I got a bill for $3000. I got this bill because I was uninsured. I know the insurance would have paid only $500 but the hospital screws you if you are uninsured. This system would bankrupt me if it was anything more serious. I'm a person too poor for insurance, but still have assets (a car) and thus don't qualify for government help (until I'm broke - i.e. lose my car). I could not fight the bill - I was told that since they did not bill me fraudulently (no double billing basically), the bill was what it was.
I can't go to the doctor for fear of high bills. Even if it would be cheaper in the long run. If I need to get tests done, I can barely afford it, I'm just scraping by. I am young and relatively healthy, but I still have issues time to time. It makes me sick to my stomach when I think of how much I get charged as a private person and what the breaks the health insurance industry gets. It's downright unfair.
Since I have relatives up there, I am moving to Canada soon. I know many Canadians complain about the system, but none would trade it in for the American system. I see the light, I'm moving out of here. I won't miss it. I'll pay the higher taxes if it means that I don't have to worry about rotting in the street or being close to my death before I get help. Fuck all of you blasting Socialized Medicine - it's a safety net for people like me - like the original poster of this thread said: healthcare is a necessity, not a luxury - unless you don't mind dying early or being crippled for life.
(Yeah, I know being a poor
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Re:Yes its broken (Score:5, Informative)
I was drunk one night walking home from the pub and decided to investigate the railway near my house a little more closely. Whilst climbing back over the fence to the road I lost my balance and fell off. On the way down I grabbed the top of the fence and unfortunately put the palm of my hand onto a rusty nail embedded in the fence. The nail ripped a large gash from the palm of my hand to just before the base of my middle fingers.
Since it was around 3AM in the morning I went to the A&E department at the local hospital ( 5mins in a car ). First of all a doctor examined the wound and picked out bits of fence and rust and then a nurse put in 15 or so stitches. I was seen by the doctor immediately and was back at my house around 40mins later. I also had a tetnus injection.
The next day I went back to the hospital where I saw another doctor ( 15min wait for that ) who checked for any nerve damage or other problems with the gash and I think an X-Ray as well and they gave me a load of bandages.
A week later I went to my local doctor to get a sick note for work ( it was my right hand ) and also saw her nurse to check it was all healing and decide when the stitches should come out and a while after that I went back to have the stitches out.
All of this cost me nothing ( except 3 weeks paid holiday from work ) and I think I got a very efficient and effective service. This is the first time I've ever been to hospital and the 2nd time I've ever seen my doctor in 30 years ( the other was for a yellow fever injection before I went on holiday somewhere ) so I really doubt I'd have been bothered to get any medical insurance if I didn't have the NHS to look after me.
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Re:Socialised Healthcare is the future for the US (Score:5, Insightful)
Most unemployed people are not lazy bums who don't want to work. They are people with psychological problems who feel being outcast from society, and don't belong anywhere.
And the poor people are not only the jobless ones, but those that work for minimum pay, because of being unlucky to be born in the lower classes.
It's a shame to even ask that question. It shows a profound lack of understanding of how the world operates. It's that kind of ignorance that politicians exploit in order to get elected.
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Re:Socialised Healthcare is the future for the US (Score:4, Insightful)
Didn't you know? There are no classes in the US.
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Re:Socialised Healthcare is the future for the US (Score:5, Insightful)
Who is going to hire a person who does not have a permanent address, a home to sleep and to take a bath? no one. Once you become homeless, it's very difficult to get back in society.
And being homeless is not as difficult as it sounds, especially as you get older and the company you worked for prefers young people with 1/3 of your wage. The most dangerous range is from 40 to 55 years old, where you are too old to be considered fresh and too young to retire.
But there are also other categories of unemployed people:
1) women who got pregnant early and without a supporting husband.
2) people that were born in areas with high criminal and drug rates (ghettos, etc).
3) immigrants without higher education.
These people will not get hired by anyone. Is it their fault? I very much doubt it. If they were born in rich or middle-class families, they would not have such big a problem, most probably.
Even in the extreme case that unemployed people are lazy bums, it is still correct for us to pay for their health care. If we don't, more problems will arise, as the 'lazy unemployed bums' will get more and more in numbers.
You don't want the French revolution to happen again, do you? because if it does, you will be the one inside Versailles this time...
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Factually dubious (Score:4, Interesting)
Hm, nominal spending is more than that. Now I don't know much about the NHS (other than that it doesn't work) but I do know a bit about government contracts in the UK, and I would be very surprised indeed if more than about 50-60% of that went on anything of even peripheral value to healthcare.
Here, the Times (rapidly becoming a tabloid but never mind) has something on it:
Annoyingly chatty but probably basically correct article. [timesonline.co.uk]
To put it another way, the UK NHS is like the US DoD; they're both ways to funnel money from the taxpayer to those who position themselves to recieve it. The NHS, however, which is regarded almost with veneration by most British people and which doesn't have to fight actual wars, is far more corrupt; buildings built, bought, sold and knocked down within the space of a few years, and so on. But the NHS long ago passed the point where it's powerful enough to keep going forever -- it's quite a political power broker in fact, which is why you *do* get reasonable free healthcare from it in much of Wales and Scotland.
Meanwhile, in England, health care does cost money -- you pay over the counter for even a basic dental checkup. You don't want to? Then take out some private health insurance. It's a fast growing sector in the UK. Good!
I imagine that there are people who find it hard to afford, though, what with all the taxes they're paying. And that's bad. But what can you do?
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Factually bullshit (Score:4, Informative)
It is so interesting hearing conservative whack jobs talk about the bottom line as the ultimate measure of success in an endeavor. Then have them develop selective hearing loss when the bottom line is revealed for a social justice policy like universal health insurance. For example, average life expectancy at birth in the UK is 78.7, in the US its 78. Average spending on health care in the US as a percentage of GDP is 15% in the UK its 9.4%. (And remember for that 15% we don't cover about 15% of the population, while the UK covers 100%.)
So either the British are significantly healthier than us, it is cheaper to provide inexpensive preventative care for all in the long run, or there is a large sucking sound that is coming from the health insurance industry and Pharma taking about 30% off the top of what we spend.
I will tell you the only two thing that is keeping my partner and I from immigrating to Canada is the fact that it would be hard(er) to take his parents with us and I hate cold weather. With global warming and time, Canada looks a whole lot better. And this is a sentiment that I have heard from a lot of my colleagues. Few physicians want to work in a system where 15% of people are uninsured, where people die for lack of simple basic preventative care, where in order to write your patient an rx for an antibiotic, you have to check one of a thousand formularies to determine which they will pay for. For a group of people who, when they started medical school were largely idealistic and wanted to help people, this is a soul-crushing system. However our kids, parents, whatever obligation prevents us from moving. But leave it for a few years, and you may find that the trend of Canadian Physicians emigrating to the US, which slowed and then halted in 2004, may reverse course with US physicians emigrating to Canada.
Nick
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Re:Socialised Healthcare is the future for the US (Score:5, Insightful)
That's the good side of the NHS. The dark side of the NHS is quotas -- because of budget limitations they have very long waiting lists, and Brits have recently taken to travelling to South Africa or India for care that they need urgently. Doctors are less willing to recommend surgery and more willing to tell the patient to wait the problem out.
Another dark side is cost control. Cost control sounds great in theory but in practice means keeping salaries for health workers down, and getting by with inadequate staff. This has led to poorly maintained hospitals in many areas, and the current MRSA scare in the UK.
Finally, because of the pay issue, the best and brightest doctors have emigrated, often to America. The NHS (as I'm sure anyone who's been following the UK carbombers story will know) is quite dependent on foreign doctors because they find they pay scales attractive. (This isn't to say recruiting foreign doctors is bad, just that the pay is better elsewhere.) IMHO this is one reason why a lot of brilliant Brits my age have chosen careers like law or business.
Anyway, some form of universal health care is good to have, but if anyone thinks the NHS is a paragon, please think again (or ask some Brits who're -- unlike the chap in Sicko -- not Labour Party ideologues). And also, consider the Swiss model [civitas.org.uk], which is pretty similar to the Mass. model: it gives a high degree of choice while charging transparently and competitively for health insurance, thus creating market pressure to keep costs down.
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Re:Socialised Healthcare is the future for the US (Score:5, Insightful)
I don't care, in fact I'm happy knowing that people in my country get medical care when they really need it, yes our system could be better and the care could be more extensive but it is there when you really need it. If people get into a car crash and lose a loved one the last thing that they need is the added burden of paying a hospital bill at the end of it. I'm also reasonably sure that stressing over debt doesn't make a ideal recovery environment for a sick person.
I'm not buried in tax to support this system either, how much do I pay? 1.5% of my taxable income, something like $10 a week, if that. I know for a fact this is cheaper then most private health insurance companies offer here, and I have the peace of mind knowing that one day if I get super sick someone is going to take care of me, I know my children will have a full set of vaccinations when they need them and I know that I'm STD free because I got tested for all of them (well the big ones) for free. If I wanted to go to a doctor tomorrow I could call them in the morning and be in that afternoon, no money necessary, I can also choose my doctor.
Oh and before people ask, if you get private health insurance guess which tax you don't have to pay?
The system works, no it isn't perfect but it is a damn sight better then the US system.
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Re:Socialised Healthcare is the future for the US (Score:5, Insightful)
My answer to that is simple - no, I wouldn't feel ripped off. My happiness doesn't depend on the suffering of others. I don't want people having to suffer needlessly because they happen to be poor, lost their jobs, or are too ill to work. I'm a compassionate human being who doesn't mind paying taxes if it supports the common good.
The problem with medical care in this country is everyone is looking out for number one. People are just plan selfish. There's no empathy for fellow Americans. Look at the mess still going on down in New Orleans for just one example. We've lost the compassion we once had for those less fortunate.
Everyone that whines about the possibility of having to pay taxes for medical care better pray hard they never loss their medical insurance. Better yet, hope your insurance company doesn't drop you the second you get a costly, life threatening condition. Imagine being told you had treatable cancer one day and getting a notice that your insurance is being dropped the next. Imaging having to go deep into debt to pay for your care and then being told 'tough luck' by callous, uncaring Americans around you.
If we weren't paying hundreds of billions of dollars to fight a war in Iraq, we could easily pay a two hundred billion medical bill. If we weren't building highways to nowhere we could easily pay for national coverage.
The problem with this country is we have our priorities all screwed up. Instead of trying to solve the problems of the world we should be spending our hard earned tax dollars trying to solve the problems we have right here at home. It's a disgrace we're not number #1 in infant care, education, or elder care for our retirees. We shouldn't even be talking about caring for our people - it should be a given. How can we be an example to the rest of the world if our own country is in such poor condition?
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Re:Socialised Healthcare is the future for the US (Score:5, Interesting)
It's worth noting here that when I worked for a Lloyds of London medical malpractice underwriter, they refused to cover anyone in the US, partly because of the ridiculous culture of litigation, but also because they had determined that the majority of US medical care just wasn't up to the standards they expected in their other markets. The excessive litigation they could have coped with through increased premiums for Americans, but they found that the excessive incompetence made it more profitable to concentrate on selling cover in India and South Africa instead.
Your argument about food is also bogus. Food *is* elastic. If the price of potatoes is too high, I can buy pasta or rice or parsnips or I can grow my own instead. But if I was in the third world and had to buy medical treatment, I would have no choice in the matter. I can't shop around for some other cure when what ails me is brain cancer, nor can I fix it myself. If you really want a food and drink analogy, then you need to compare with water. Water is the one essential (and even then I'm sure there are some crazies who fuck themselves up by only drinking orange juice, or beer). You can pick and choose everything else, but you need water. Additionally, because of the infrastructure (pipes, pumping stations etc) required to deliver water, it is a natural monopoly just like electricity, local phone service, and so on. It is therefore no surprise that the price of water is regulated. If it wasn't, people would have no choice but to pay silly prices just like you poor sods do with medicine.
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Re:Socialised Healthcare is the future for the US (Score:4, Insightful)
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No, it's not. If the socialized care is inadequate -- and it will be (see other countries systems) -- to get decent care you'll have to go private, paying it out of your own pocket.
I'm sorry. Do you know something the rest of the world doesn't? Care is hardly inadequate in other countries. That's not to say that it's perfect and without problems.
How, precisely, would you be hurt by national and guaranteed health insurance for basic services? You know, prescriptions, checkups, urgent care, sports injuries, minor illnesses? The costs for these services are too high in the US, and you can scarcely call the service "inadequate" or that private health insurance is a superior solut
Re:Socialised Healthcare is the future for the US (Score:4, Interesting)
In other words, the free market handles it just fine.
Not quite. There is tremendous variety in the ways people get food - anyone can even grow it themselves. Even without home-growing there are lots of ways to get basic nutrition really cheap (huge bags of rice and beans are pretty cheap).
The medical field, on the other hand, is highly regulated by the government causing a scarcity in the number of people who can practice medicine. Even if I have a lot of money I can't just go open a hospital because I'd have to staff that hospital with qualified doctors, nurses, physicians assistants, surgeons, specialists, and medical assistants. There are only so many people who are already qualified and the schools can only pump them out so fast.
So you have a situation where the supply is not very elastic and most of the elasticity in demand is to simply choose to get care or not. And often the choice to not get care early on means the overall costs, and demands on the system, will be much much higher when situation gets worse.
A friend of mine, for example, got a deep cut on his finger. Instead of going to the doc-in-a-box and get stitches, he decided to take care of it himself. A couple days later he woke up with a high fever and he was unable to move his entire arm. He ended up spending 3 days in intensive care and another 3 days under observation. The cut had gotten infected and the infection went systemic on him. Thankfully for him he had insurance.
Having insurance he should have gotten it treated right away. But so many Americans lack insurance that they couldn't afford the $300 bill to get the finger treated when it would have been simple. Such a person would also be unable to pay the several thousands of dollars the 6 days in the hospital would have cost. "The system" currently buries this cost in overhead.
In Oregon (where I live now), our former governor, who was an E-room doc, has been advocating for universal coverage here in Oregon. The models used by his team demonstrate that the overall cost to the system would be less by helping ensure people get small things taken care of before they become really big.
Mass. probably is hoping they can save on those overhead costs by making sure everyone has the incentive and financial capability to get insured.
furthermore, putting more citizens on the governments teet, eliminating the need for them to take care of themselves, to take resposbility for their actions, will hurt a country in the long run.
That's all fine for those who actually have the resources to divert directly to healthcare. But many don't - and because we as a society have decided that everyone can get emergency care, those people wait until small things become emergencies.
There are really only 3 choices: pay excessive costs for emergency treatment, pay moderate costs for preventive care, or simply turn away the uninsured and let them die in the streets (and have higher secondary costs such as higher threats of epidemics, higher crime, and lost potential as people end up living lives crippled and damaged when they could have been treated).
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Re: (Score:3, Informative)
If people wish to pay for private healthcare to supplement what they can get on the NHS I don't see that as either a problem or a failing of the NHS, it simply means people who can afford to pay for it can get things like hip replacements more quickly and reduces the strain on the NHS allowing those who can't pay to also get their ne
Re: (Score:3, Insightful)
A lot of people argue this is unfair and creates a two tier system for the haves and have nots, which it does, but basically life is unfair and the current system is the most effective way we have for ensuring everyone is looked after.
Beyond that, they fail to examine the American system that has a several tier system. Haves mores, haves, have very little and have nots.
Between letting someone die because they can't afford insurance or making them wait for treatment, even if they might die waiting, at least gives them the hope that the system gives some level of caring. Plus if you take into account preventative health care, those kinds of issues become less and less likely. It may still happen, with a variety of diseases you could be
Re: (Score:3, Informative)
Re:Nope. It's 105 billion pounds. (Score:5, Funny)
Slashdotters make their own luck. Whenever I need a kidney, I spread roofing nails on I-95.
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Re:Nope. It's 105 billion pounds. (Score:5, Insightful)
If you are in Australia and also in a "life threatening" medical situation you are taken the BEST CARE POSSIBLE, even if this means putting the patient in a fucking helicopter to get to a surgeon who can (say) unblock the vien in the patients temple. Note also that the "best care possible" is almost certainly going to be a public hospital and treatment will be "free". The helicopter and the cable-TV above the hospital bed are not "free" but everything else is, including drugs and outpatient care. BTW: Ambulance cover for said helicopter is dirt cheap due to the regulatory absence of middle-men.
"Which is why private insurers still do good business in a market where free health care exists."
The reason "insurers still do good business" in Australia is beacuse the taxman gives those who have it a $500 rebate and "high income earners" who don't have it are "fined" an extra $500 on top of the flat 1.5% levy on taxable income - I pay the $500 corporate walfare contribution and I am still getting a much better deal financially than any US citizen. I say "corporate welfare" because the levy was introduced obstensibly to save what was left of the rapidly shrinking private industry from "totally collapsing".
IMHO: The primary reason why we have such "world class" care at bargain basement prices is that UHC is no longer a partisan issue in this country and it has been that way for at least the last 10yrs. As often displayed by the US military, a bipartisan attitude puts "mission before cost" particularly in a "life threatening situation".
All the predictions of long waiting lists, financial ruin, communist plots, medical brain-drains, ect that we are seeing in the current US debate were also made in Australia during the 70's. In Australia the dire prdictions failed to materialize, what happened instead was the miles of red tape and army of middle men all but evaporated and our national health outcomes have for decades consitently hovered around the top of any serious study you care to mention.
I'm not saying we don't have our own inefficientcies and injustice, I'm just thankfull "bankruptcy to pay for health care" is not one of them.
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Re:Socialised Healthcare is the future for the US (Score:5, Insightful)
If the US is using another country's example of how to improve healthcare systems, perhaps France is a better example than the UK. Our NHS is idealistic and does have problems (high expectations being one of them), sometimes we end up sending patients to France for treatment and politicians here use our EU neighbours as examples of how they could improve the NHS.
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Re:Socialised Healthcare is the future for the US (Score:5, Insightful)
One solution is to make companies make it public what they pay for health insurance for their employees, then give the employees the option of either taking the company health insurance plan or taking the money and going with a different plan. Suddenly, insurance companies would have to compete because they know that it is easy for clients who are sick of paying insane premiums while getting denied service will bolt no matter how many boob jobs they approve.
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Re:Socialised Healthcare is the future for the US (Score:4, Informative)
US employer based health care grew directly from WWII tax and rationing policy. During the war the income tax was extremely high and rationing was in place. But workers needed to be taken care of in order to maintain productivity. Health care and other "benefits" therefore became tax exempt and were excluded from the income tax calculation. That system made sense during wartime and afterwards when much of the US had lifetime employment and society valued life differently than we do today.
Then during the 1970s in a wrongheaded approach to controlling health care costs, government encouraged the establishment of HMOs and other forms of insurance middlemen with the idea that it would be in their interest to control costs and provide the most benefits. But the government still propped up employer based health care primarily as a response to the generous benefits that were lavished on the big unions by GM and Ford and the big industrial companies. The fear amongst many older union workers was that they would lose out on benefits they were soon going to start really needing.
In the US you get to deduct health insurance expenses only if it is provided through an employer (that might change once health insurance is essentially a tax as it is now in Massachusetts), but health insurance that you buy on your own because maybe you found better insurance outside your employers plans (which the employer might have gotten kickbacks from the insurance companies to exclusively provide) doesn't get you a deduction at all. The effect of which is to hand over buying power to your employer even though they might not even be subsidizing the insurance at all, so they will generally offer 3 plans, the least of which is not likely to be chosen by those who decided on the plans, but which is most likely to be chosen by the lowest paid employees. This distortion, putting purchasing decisions in the hands of people that don't have a direct interest in what is being purchased helps to cause the ever increasing medical costs which the employers are more than happy to support with their employees money. There is also a more insidious effect in that the lower cost plans subsidize the actual costs of the higher benefit plans because the lower costs plans provide fewer benefits and charge higher deductibles making it impractical to actually use them. So, you have a system where it is the decision makers that benefit from screwing over the weakest employees in their organizations.
Far from being a system where the free market acts in a healthy and natural way to control costs, the US government has created a system where inequality rules and fear is used as the primary motivating factor in all decisions.
Which brings us to Massachusetts. In Massachusetts, we have chosen to push the current system to its logical conclusion and completely take buying power out of the hands of individuals. Individuals will now have to choose between a dozen health insurance plans which could cost as much as 10-16% of a persons yearly income for those in the middle income range (but much less a percentage for the high income persons). At the low end, the plans are basically worthless because of high co payments ($100 to 150) to discourage doctors and hospital visits and a person will still be forced to pay up to $5000 of the yearly medical bill when they actually get sick. Meaning that the lower income persons likely to choose such a plan will likely be bankrupted by an illness anyway.
The moral theory being applied here is that by at least forcing people to pay into the insurance system now even though they are young and unlikely to get seriously ill, then they will be "prepaying" for when they eventually do get old and more prone to disease. A theory which seems very convenient for the older and richer people that want to get subsidized by the young and healthy, but as we see with social security such a system works well when population is growing and soci
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Re:Socialised Healthcare is the future for the US (Score:4, Insightful)
Yes, except they're not. I imagine a day when this survival of the fattest approach to public economies will be as outdated and useless as nationalism.
For now, it remains a fiction that corporations use as an excuse to raise prices and abuse consumers. Face it, the "law" of supply and demand hasn't been working since the 1980s and the "Free Market" has never been.
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Re:Socialised Healthcare is the future for the US (Score:5, Insightful)
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At least according to Michael Moore (Score:5, Insightful)
Making something illegal doesn't fix it (Score:4, Informative)
They haven't gone a single step forward in fixing the underlying problem of why healthcare costs so much.
(disclaimer: I live in Mass. and my health insurance has not gone down. In fact it went up)
Pre-Existing Conditions, IAALIA (Score:5, Interesting)
Those middle class people in Massachusetts who have pre-existing conditions, will be driven into homelessness. For absolutely certain. No questions asked. Out the door and to the loaves and fishes NOW.
These people will pay $1000 premiums per month - I work with these insurance companies and I see it happening daily in California - and in many cases their contractually agreed upon coverage will get denied.
The raw numbers cannot be denied, and cannot be resisted. The numbers - the the number of people with pre-existing conditions, their income, and their health insurance premiums - all clearly say that a large number of lower and middle-middle class will start paying fines, or going homeless, or leaving Massachusetts.
This is all out war on the middle class, and many will leave, and when they do, the rich will be paying more to support the health care-driven tax increases to support the poor and then the rich will start leaving and badebadebadethatsallfolks!
I hope this law is rigorously enforced. Tie it into SSN's and whichever SSN isn't insured, fine 'em. That'll bring quite a swift end to this law.
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Is No One Denied Insurance in Mass? (Score:4, Interesting)
Will there even be an application process if accepting me is compulsory? Will this give insurance companies less loopholes to try to out of paying for my expensive procedure. For example, as pointed out in "Sicko", insurance companies routinely deny expensive insurance procedures by finding things on the insurance application to invalidate their contract with the patient. If one can argue to a judge that the insurance company had to approve them no matter what, I'd assume that this makes Massachusetts a much safer place to be able to depend on the health care and insurance that you are paying for than anywhere else in the country.
I think these are pretty important questions, but I can't seem to find the answer anywhere.
This is NOT Public Health Care (Score:5, Insightful)
In the first year of this program, residents who elect to defy the mandate and do not purchase coverage will be subject to a paltry $219 lien on their taxes as punishment. Given that this is far less of an economic burden than paying the mandated premiums, anyone who can do math and is healthy would be advised to consider paying the penalty. Anyone who doesn't fit into either of those two categories probably already has health insurance - and those who don't more than likely exist at polar ends of the economic spectrum: they either print their own money and can pay for health-care as needed or they are poor and can't afford the tax penalty or the premium. Of course, for this group (earning 30K or less per year as an individual and 60K per year or less as a family of 4) - the premium costs are gratis under the new Massachusetts law.
Massachusetts has found a way to make public health policy in this country even more ludicrous than it already is. They have taken a system that was a dangerous marriage between public policy and corporate interest and have fully endorsed the idea that health insurance should be the business of private enterprise and that mandating the purchase of that insurance by enacting silly laws and tax penalties is the business of the state. Taken together, the whole thing seems rather sinister at the surface, and that's because it is. It shows either an utter disregard for the concept of insurance or a determined attempt to exploit the public ignorance of personal risk assessment. It's hard in fact to find ANY real benefit for the citizens of Massachsuetts in this mess.
The sales pitch by proponents of the legislation is that it will lower the average premium cost for the entire populace; as healthy individuals are forced to subscribe to an insurance plan, the revenues generated from their participation will offset the increasing costs of paying out benefits to subscribers who are sick. This really is like any other insurance that you can buy: the insurer needs to have as many (if not more) low risk subscribers who pay their premiums such that formerly low risk subscribers who become high risk can be paid the proper benefit when the time comes. But in this instance, the insurance industry won't have to break a sweat to get those low-risk subscribers on board. In fact, they don't even have to get off the couch - the statewide mandate ensures that unless there is some pandemic that makes everyone in Massachusetts sick, there will always be a pool of low-risk subscribers who generate a reliable revenue stream.
People wonder how this is a bad thing? Why would decreasing the average cost of health insurance for all individuals actually be a detrement to people? Well, first of all - because everyone must participate or be penalized financially, this is less of an insurance system and more of a welfare system: everyone is putting their money into the pool, and those who need the money more than others are allowed to take from the pool. In this case however, the twist is that the people responsible for managing this money are actually taking ownership of it and making business decisions on its use. While in a government-regulated welfare program revenues can have no other purpose than to cover expenses, insurance companies have a profit motive - an extra hand that dips into the pool of contributed funds every so often and takes a little something for itself. This isn't in and of itself evil - we deal with big corporations every day. However, there aren't any laws out there that require me to buy $10 of goods at Wal-Mart each day, that is precisely what Massachusetts has done with health insur
Re:This is NOT Public Health Care (Score:5, Insightful)
As a Liberal, I'm frequently shocked by Libertarians utter disdain for public services(I'm looking at you Ron Paul) and blatant misrepresentation of what Government is, or even that it can do a good job(I'm looking at you Penn Jilette). However, as it can be easily shown, no matter how bad Government is and no matter how infinite it can be incompetent, there is no shortage of examples from within the private sector of private businesses and Non Government Organizations screwing up just as badly. The major difference of course, is accountability. We can hold our Government more accountable for it's actions through elections.
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Re:This is NOT Public Health Care (Score:5, Funny)
O_o
Bwahahahahahahahahaha....ooooo....bwahahahahahaha
Oh, that was a good one! I think I blew a kidney on that one.
Um. Oh wait, you must be new here. I'm sorry but we don't do that here anymore.
~X~
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Health has no price ... but value (Score:3, Insightful)
Yes, the ones that need this the most are also the ones that can hardly pay for it. So you, the healthy guy, spend more on your insurance than you'll ever get out of it, most likely. Still, I prefer being healthy and "ripped off" to being sick and "enjoying" my stay in the hospital on someone else's expense.
But that doesn't mean that we have to "level" the field. You can still get "better" plans for more money. Here, the solution is simple: You have a standard insurance. Which covers most of your medication, operations and a stay in the hospital. You want more, you can get more, you just pay more. You want a certain doctor? Pay for it. You want to lie alone in a room in the hospital? Pay for it. You want certain medicaments instead of the standard? Pay for it. You want painkillers where there are usually none required (like in most tooth related issues)? Pay for it.
Yes, the "extras" cost more than they're worth. Most of the time (a shot of painkiller for a simple tooth drilling costs about 15 bucks, a room for yourself in a hospital is a few hundred bucks extra a day). But that's how it works here. You get what you need from your health care. You want comfort? Pay for it.
From an outside perspective (Score:5, Interesting)
I would watch American movies and TV shows, and wouldn't understand when you guys talk about, getting a job with 'health benefits'. Here in Australia, the only thing I worry about getting a job is if it pays right.
If I go to the GP (family doctor in the US), or need to go to the hospital, paying the bills is the last thing on my mind. It's all taken care of. Medicines are also subsidised by the government. You collect virtually any prescription for $3.
Honestly, I was surprised you guys let it get that bad. Then again, I wasn't surprised the reason it went the way it did: through greed and politics.
Wouldn't it be better... (Score:4, Insightful)
...to tax everyone, and have the state provide the healthcare, like in Australia, the UK and most other sensible Western countries?
Compulsory health insurance will just make the insurers raise their prices, because they know that everyone just has to put up with it.
The Biggest Problem With Health Care (Score:4, Insightful)
Other woes of the US system; (Score:4, Interesting)
Essentially, once you're diagnosed with a disease or condition, it's impossible to change to another provider because they won't cover pre-existing conditions. This means that if you leave a job (or are fired), you have to personally keep paying very high rates to your old company's provider in order to keep insurance. Your new employer (if any) will usually not take on those costs, because they have their own provider and plan - which you don't qualify for due to the pre-existing condition. It's a vicious circle.
However, I lived in Massachusetts as well, and I did like some aspects of the co-pay system there. In Canada, anyone can go to the doctor whenever they like, and it's free. So, you get mothers dragging their kids to the doctor every time they sneeze, and all kinds of other useless visits to hospitals and so forth. Having even a token co-pay (exempted for those below poverty) reduces needless visits. I think most visits on my plan in the USA were $10 or something, which is enough.
So - my ideal world would be the Canadian system, plus a small co-pay. Unfortunately most of Canada's best doctors move to the USA so they can get rich instead.
MadCow.
Re:Great. (Score:4, Insightful)
That was my first thought too! Why not start by removing any requirements for Medicaid? Just remove any checks---whoever applies gets it. And if folks ever admitted into hospital, that application is automatic for them. That would ensure everyone is covered. Would need to pump more money into Medicaid, but, eh, there's gotta be costs... But in my view, much better then pumping the same money into a for-profit entity.
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Re:Great. (Score:4, Insightful)
You're going to track down the elected official who appointed the bureaucrat who appointed the bureaucrat who fucked up a huge federal program, and vote for his one opponent up to 4 or 6 years later, for that and that alone, in spite of every other political issue? When are you going to get around to that? After you finish voting out of office the idiots who wrote the federal laws specifically to benefit (even create) Aetna and Kaiser? Shit, if I don't like a company, I just vote against them then and there by not buying their services anymore. And I don't even have to count on 51% of everyone else voting the same way as I do to make an immediate impact in the service I get. Of course, the very same politicians who you haven't gotten around to voting out of office keep passing stupid health care laws that make it difficult for me to do that with health insurance companies...
Good idea. Let's nationalize the farms before everyone dies of starvation.
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