Massachusetts Makes Health Insurance Mandatory 779
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."
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
At least according to Michael Moore (Score:5, Insightful)
Re:Socialised Healthcare is the future for the US (Score:3, Insightful)
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.
Re:Socialised Healthcare is the future for the US (Score:3, Insightful)
Re:Socialised Healthcare is the future for the US (Score:3, Insightful)
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?
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)
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
Fines for those who cannot afford insurance! (Score:1, Insightful)
When all you have is a hammer, everything looks like a nail.
And all we have are lawyers.
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.
You can't shop around for ERs (Score:1, Insightful)
The truth is though that you can't apply capitalism to medicine because if you're dying of a heart attack or some other emergency you can't choose between Macy's prices and Walmart's prices in ERs. You go where the ambulance will take you.
You can almost never pin doctors or hospitals down much with "What will this cost?"
You are at the mercy of the bill they will send and if you are uninsured you can be sure it will be approaching if not beyond what you can earn in a year to stay in the hospital a few days.
It's an unconscionable system in America.
Look at the effort to discredit Michael Moore's "Sicko".
The rich bastards running HMOs are stooping to outrageous levels to stop and discredit Moore. And they might succeed again with the FOX Noise crowd.
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"
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.
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.
Socialised healthcare has been rejected (Score:2, Insightful)
http://news.bbc.co.uk/1/hi/scotland/6700685.stm [bbc.co.uk]
http://society.guardian.co.uk/nhsperformance/stor
http://news.bbc.co.uk/1/hi/health/6266124.stm [bbc.co.uk]
etc etc etc etc etc ad nauseam.
The UK has been throwing tens of billions of pounds at the system in order to try to reduce the waiting but you know that's temporary while the lists are in the news. At some point reality will kick in (again) and they'll rediscover they really can't afford £105 billion (even more next year) every year. The people of course blame immigration for the spiralling costs and waiting lists, because it's simple to do so, but in reality it's just the wrong model.
In the majority of EU countries some form of compulsory health insurance is in use. There's no particular need for the state to own and operate hospitals.
We're talking about the cost of healthcare insurance which is an entirely different thing. Where it's too expensive people simply don't get it, as is evidenced by the fact that millions of Americans don't have insurance. What drives up healthcare insurance costs is the legal requirement to treat people without insurance. Who bears that cost? The people paying for insurance. This is the wrong model as well.
Re:Socialised Healthcare is the future for the US (Score:3, Insightful)
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 carrying that might just suddenly pop up, but chronic illnesses do get treated.
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.
Re:Making something illegal doesn't fix it (Score:3, Insightful)
It's fairly analogous - companies having a legal right to your money mandated by the government. Competition doesn't help much.. there are lots of insurance companies but they all charge the same fees, so unless someone breaks ranks and starts offering really cheap insurance then the price will stay the same, more or less.
Can't imagine mandatory health insurance.. I had that through my employer once and turned it down as it wasn't worth the paper it was written on. It did't cover preexisting conditions, chronic conditions, accidents, anything to do with sport or 'dangerous' hobbies, basically pretty much anything you'd possibly need a hospital for. I think they specialise in breast enlargement or something... can't think of what their niche is. All the private health insurance in this country is the same - god help you if it's the same in the US.
Re:Socialised Healthcare is the future for the US (Score:2, Insightful)
MRI's must be selling like hotcakes in the USA, I imagine their proliferation is assisting health care costs to rise in the USA by large amounts.
People are living longer; Why ?
More expensive drugs and procedures and hi-tech equipment.
I reject the notion that people are living FAR healthier lifestyles nowadays and propose that this corrolates to the higher cost of health insurance.
Re:Socialised Healthcare is the future for the US (Score:4, Insightful)
Didn't you know? There are no classes in the US.
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.
Re:Socialised Healthcare is the future for the US (Score:3, Insightful)
Government is best used to take care of things that are not well served by a free market, usually either because a goal is incompatible with a profit motive or because something else requires top down oversight. Services like the military are necessarily in the government's control because they require a cohesiveness and a strict chain of command that would be impossible with private militias. The police are there because of similar reasons, plus the simple fact that any body enforcing laws should absolutely never be in the position of weighing shareholders' financial desires versus the appropriate application of law. Fire stations are provided because it is in your best interest to extinguish a fire at a neighbor's house whether or not your neighbor has any ability to pay for this service. Can you really believe that any of these things would function at all, let alone better, if they were privately controlled?
Health care is another matter. Some argue that the free market is working just fine - they are usually those that are provided good health care packages by their employers and have not had their providers turn against them on matters of care. Others argue that the current system is not working very well - typically these are people who at some time or another have not been able to get health insurance for whatever reason. I'm on the line. To me, the main problem with the current system is that if your employer does not provide health insurance (or you're self-employed), there is essentially no way to get it at a reasonable price. This means that most people who don't have a serious condition already just don't get the insurance, because the likelihood of needing expensive care is just not high enough to justify spending the large amount of money on the insurance. That's not to say that I can entirely fault the insurance companies here, either, though - the only reason they raise rates for people independently purchasing health insurance is that their statistics have shown that people who buy it independently are much more likely to actually use it than those that get it through their employer. The idea being that if you didn't already know that you'd need to make a large number of claims, there's no chance in hell that you'd actually pay the outrageous rates to buy the insurance. Hence essentially, unless you're getting your insurance through an employer, if you want insurance at all you're assumed to be using it not as catastrophe insurance, but to cover a large set of expected health expenses (which kind of defeats the purpose of insurance).
The Massachusetts law in TFA is actually a good way to combat this problem because it removes the stigma (in the insurance company's eyes) associated with wanting to actually buy health care for yourself. Now it doesn't necessarily mean that you're sick and need a lot of medicine, it only means that you don't have health insurance elsewhere. So in that respect I think it's actually a step in the direction of making the product a little less expensive, though I still don't know if I think it's ultimately the "right" solution. The main problem is that mandating coverage means that should the prices go too high, consumers have no choice not to purchase, so there is quite a bit of potential for gouging here. Still, this is true of any essential service, and in theory a free market would behave quite well in this situation assuming no collusion between the insurance companies on price.
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.
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
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.
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.
Re:Socialised Healthcare is the future for the US (Score:2, Insightful)
Psychological problems such as, for instance, being lazy bums who don't want to work? You're essentially saying, "most unemployed people don't have a defective personality. They have a defective personality." Except the first time, you make a "defective personality" sound like a moral failing, and the second time, you make it sound like something beyond their control. It would have been more direct to say, "being a lazy bum who doesn't want to work is a psychological problem and not a moral failing".
The Biggest Problem With Health Care (Score:4, Insightful)
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.
Re:Socialised Healthcare is the future for the US (Score:2, Insightful)
As long as there are people who work that are not eligible for health insurance, then the people who don't work are irrelevant. A health system shouldn't ignore large groups of people because they cannot pay for themselves. Aren't homeless people worth saving? Are they somehow worth less than the rest?
The question itself is flawed, because it assumes that the only people who benefit from socialized health care are the people who don't work, when in fact, there is a vast ammount of people who do work, and who have a fairly good income, but who just don't have health insurance. Say for example that you have a wife who's not eligible for health insurance because a previous run-in with a serious ailment. Would you then be opposed to her getting "free" health care, because a hobo down the street would also get free health care?
The fear and scepticism american politicians have towards socialized health care is completely unfounded, and an unfortunate result of this is that millions don't get the help they need and deserve.
GB isn't a communist state and they still make the NHS work for everyone.
Mandatory prostate checks next? (Score:3, Insightful)
Yeah, I know it's way out there... but have you seen Gattaca? The rate the US is going, I'm... disturbed.
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.
Re:Socialised Healthcare is the future for the US (Score:2, Insightful)
Re:Socialised Healthcare is the future for the US (Score:4, Insightful)
Re:Socialised Healthcare is the future for the US (Score:2, Insightful)
Furthermore, do you really think, a withdrawal of US-troops could have any persistent and remarkable impact on the European economy? You know these are hollow threats because, firstly, US have been reducing their forces in Europe for years and, secondly, US simply need NATO-airbases and military hospitals to pursue their hegemonial strategy.
Regards,
Stirz
Re:Health has no price ... but value (Score:3, Insightful)
You're the closest I've seen to bringing home a point I see about national health care. Thing is that national health care is the ultimate HMO. Difference is that your monthly premium is a percentage of your income, not "how sick/old/risky are you". In the US, it doesn't matter how much you pay per month, if you ever have a claim, you're a freeloader. Just like the homeless bum who it'd be oh-so-horrible if he got treated on your dime. Because any (serious) claim in the US medical industry costs more than you'll likely ever pay out in premiums. So you're taking other people's money. That's how insurance works. Those with claims ride the coattails of those who don't have claims.
So. Why is it so hard to embrace the idea that everyone - even the deliberately lazy - deserve to live? It's just a tiny step further from where you are. Only a "national non-profit HMO" will be cheaper per-person despite the freeloaders because... it's NON-PROFIT. Yes, I know that's evil and alien, but maybe, just maybe, some essential services shouldn't make a few dozen people rich.
Disclosure: I'm Canadian. I get sick... I get fixed. I will do anything within my power to prevent my government from ever dismantling our system, including introducing any sort of two-tier health care.
Socialized healthcare is like democracy: (Score:3, Insightful)
Re:Socialised Healthcare is the future for the US (Score:1, Insightful)
Is he a trash hauler? Pull the plug, he's replaceable.
Simple as that.
Re:Socialised Healthcare is the future for the US (Score:1, Insightful)
Re:Socialised Healthcare is the future for the US (Score:3, Insightful)
Preventative medicine is in the public interest, without it you would see more epidemics, more disease in the population and as a result a less productive population, and quite possibly a smaller one. So the country as a whole benefits from public healthcare projects such as vaccination (and public education campaigns as well I guess.). Realistically you can't force people to have vaccines and then make them pay for it (unless you also mandate a price) because providers will simply charge massively over the odds for the treatments, after all they have a guaranteed customer base.
Moving on to elective healthcare, this is where the private sector could be not only profitable but also efficient and reduce the burden on any national healthcare system, it does depend largely on the definition of elective. I would include all cosmetic surgery as elective except where it is re-constructive work, say post trauma, but I am unsure about things like vision corrections where the benefit is only minor. It would mean that the private health providers could compete on cost, and quality and customers would have a real freedom of choice, not only between providers, but also the choice not to have treatment at all.
Re:Yes its broken (Score:3, Insightful)
He also said he only went twice to the doctor in 30 years. Contrast this to America where you do pay. Without knowing much about him, I would wager he has likely paid more into the system than he has taken out.
People do stupid things. Stupid things also happen. This is the case in any type of system. Unless statistics are procured, we cannot say if this is more common in a system like the U.S. or a socialist system. I doubt it is much different either way.
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...
Re:Yes its broken (Score:3, Insightful)
Re:Yes its broken (Score:2, Insightful)
Accidents don't happen in you country then? Nice, I want to move there where I can drive a car in perfect safety.
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?
Where do you stop with this? (Score:3, Insightful)
This is the problem when you start thinking like you do. The moment you start qualifying who should and shouldn't get medical care, then you have to start making HARD decisions -- like who gets it and who doesn't.
So, in this case -- the guy goes out, gets drunk, and cuts his hand. You complain about footing the bill because he was drunk and did something stupid. All I am saying is that if you are going to do this, you'd better be prepared to start drawing lines in cases where it isn't so clear. How about a car accident that wasn't their fault? Would you be comfortable paying for that? Is that wasted money? After all, maybe they were stupid and pulled out in front of someone. What about an accident where someone fell off a ladder? That's pretty dumb if you ask me. So is that money any more or less wasted than the guy who cut his hand while drunk?
My point is this: the moment you start qualifying *why* someone should or shouldn't get care, it forces you to clearly define those lines. And by doing that -- you have to leave someone out. Lines get drawn for a reason, otherwise, your answer would simply be "healthcare for all people, regardless of why". So how do you draw those lines and determine what is "wasted" vs. "well spent???
Re:Socialised Healthcare is the future for the US (Score:5, Insightful)
Re:Socialised Healthcare is the future for the US (Score:3, Insightful)
"Conversation at lunch revealed that the neighbor, who had a history of heart trouble, suffered severe chest pains a few weeks ago. He wisely went to the hospital seeking treatment. He was told that there was no space available for him. He was advised to go home and call back later to see if a room might have become available. He did so, but was told repeatedly that the hospital remained full to capacity. Several days later this man died at home, never having received hospital treatment."
Going to government-paid health care does not mean that healthcare is "universal." It just means that it's no longer ability-to-pay that determines who gets it.
Re:Socialised Healthcare is the future for the US (Score:1, Insightful)
And being homeless is not as difficult as it sounds
In the US the vast majority of people are just 2 paychecks away from eviction or foreclosure. Imagine living in that situation, no wonder most people are unhappy wage slaves.
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.
Re:Yes its broken (Score:2, Insightful)
Re:Nope. It's 105 billion pounds. (Score:3, Insightful)
And finally, since MDs in Britain are on fixed salaries rather than per hour or per visit fees, treating you once and leaving you cured suites them better than having you come back twice a week for the next 3 years.
Strangely enough, that is what actually happens when it is within the skill of the British doctor.
Socialized healthcare (Score:2, Insightful)
If you can start with the assumption that you think everybody should have healthcare available to them, anyway.
It simply costs less to run - consider every single person/advert in the chain between you signing up with healthcare, going to hospital and coming back after an operation.
Socialized healthcare at a stroke allows you to remove huge layers of management and cost from the system. You still go to hospital, but less people get paid along the way - and as all those salaries/adverts etc are ultimately coming out of your pocket...
Re:Socialised Healthcare is the future for the US (Score:3, Insightful)
There's no difference between healthcare insurance and anything else. The only difference is that you want someone else to pay for the results of your lifestyle.
Re:Socialised Healthcare is the future for the US (Score:3, Insightful)
All I see from these /. blue-sky socialists is talk of tacit social cast systems and some sort of agoraphobia being the biggest reasons for poverty.
But maybe I've got it all wrong. Actually, I take it all back. I can't wait to foot the medical bills of all the chain smokers and the burgeoning diabetic population who can't stop cramming their mouthes full of big macs. Personal responsibility is just so passe.
The generosity of some people around here with other people's money is just heart-warming, isn't it?
Re:Is No One Denied Insurance in Mass? (Score:3, Insightful)
The idea behind insurance is to spread the risk of a venture around a group of people. The cost of driving a car, the cost of owning a home, and the cost of living. It's not unlike the Amish coming together and helping out a family who has a sick member -- the cost of care is shouldered by the community.
However, insurance companies have taken that 'community support' -- the money people pay in -- and then *excluded* people from the insurance pool. So they've just taken they money, but have failed to provide the support. It's become a money-making scheme instead of an insurance scheme.
That goes against the whole idea of insurance. We want as many people as possible in the pool, to lessen the burden of each disease. Ideally, you would insure the whole population in a single pool. But what insurance companies have done is made two pools -- one for healthy people who pay in, but don't take as much out, which makes more money for the insurance company, and another for the unhealthy people. For the unhealthy people, they each individually might take out more on average than a healthy person -- driving the second pool bankrupt. We need both the healthy and the unhealthy people in the pool to make it work properly.
Re:Socialised Healthcare is the future for the US (Score:3, Insightful)
Further, few people actually value their lives infinitely. If you go up to most people and offer them a hypothetical procedure which would grant them a hundred years of healthy life, but requires the sacrifice of a hundred schoolkids, how many would take it?
So yes, we do ascribe finite value to our health. So what? That finite value is still very large in relation to the average person's earnings, to the point where it equals anything they are capable of paying (and often more). Health care providers are in the same enviable position as the oil industry: demand for their product is very inelastic, so they can charge a premium. People will simply cut back on everything else in their lives until they can afford little Suzie's cancer treatment.
Rationally, people should buy health insurance, even if the price is wildly inflated. But people aren't rational, and your plan is hopelessly naive because it assumes people will be. Individuals are notoriously bad at estimating the value of mitigating future risk. They tend to either assume that the future event will be worse than it actually would be (in which case they overpay) or believe that it can't possibly happen to them (in which case they're unwilling to pay). So we have this situation where the "peace of mind" being advertised by insurance providers on TV is just another product, jockeying for position against home ownership, cars, video rentals, sugary cereal, and advertisements for the latest generation of reality TV. Health insurance a fundamentally different product, and I believe socializing health care is the best way to deal with its fundamentally different nature.
Lastly, your glib advice about "mitigating risk" ignores the fact that health insurance providers cherry-pick the lowest-risk customers. If you get cancer, your insurer is going to look high and low for any excuse to deny you coverage (as aptly documented in Sicko), and once you've had cancer, no company is going to be willing to take you on as a customer. These people need to be taken care of as well, and the free market isn't getting it done.
People should not be allowed to go without coverage, regardless of their own personal conception of the risks and rewards of opting out. Insurers should be required to make a basic plan available to anybody who signs up, regardless of the risk a given customer represents. The government should step in and pay for the insurance of those who are deemed unable to afford it. Given those three constraints, I think the free market will do a fine job of providing a health care system that serves the needs of every American. Drop any of those, and we get the dysfunctional system we have today.
The real problem (Score:2, Insightful)
I was trying to think of something that has not been approached as insurable by these predators and the only thing I could think of that insurance has not exploited YET (insert drum roll)... is a Fart. Of course I am sure that if, some representative of this heavily marketed seemingly so necessary non-product producing industry reads this, they are probably thinking about having Britney Spears or Paris Hilton fart in a bottle and cap it so they can insure it for a million bucks. Our health care is fine folks, the problem is all the greedy government lobbied and sanctioned profiteering hands holding the door closed between the people and their health care. Imagine a world where one simply pays for whatever product or service that is offered. It's a slippery slope and Massachusetts has one foot on the downhill with the insurance industries lobbies hands on their back.
Re:This is NOT Public Health Care (Score:3, Insightful)
When was the last time you voted a CEO out of his job because the company provided poor service? That power is usually reserved for the shareholder class, who are frequently not even the company's customers or are ever affected by poor customer service.
When was the last time you, personally, had a hand in holding any corporate executive responsible for ANYTHING bad they did? "Not buying their product" doesn't count. We're talking about monopolies (health care).
On the other hand, much of Congress was just held accountable last election by the people it failed.
Re:Socialised Healthcare is the future for the US (Score:2, Insightful)
Re:Health has no price ... but value (Score:3, Insightful)
You as joe blow are FORCED to go and buy health insurance or you will be FINED by the state.
anyone that finds that a step in the right direction is completely and utterly nuts.
The law is insurance lobbying at it's finest and disgusting at every step of the way.
if you are rich you already have health insurance, if you are poor you get to suckle off the government teat for free health insurance, everyone in between is screwed HARD.
when you make $2000.00 (take home) a month an added $150->$350 a month to buy your own insurance will break you. Oops, you cant live in that rental house in a decent school district, get your ass and your kids to the slums where you belong.
Step in the right direction? maybe for the rich people trying to get those icky almost poor people who rent out of their neighborhoods, how dare they rent the nicer homes.
Most families in america live with $20.00 in play money a week. Everything else is spoken for in rent,utilities,food,clothing and transportation. Those that like to booze it up or smoke simply live in lower quality housing or dont bother with buying new clothes or good food (hamburger helper and ramen goes best with bush beer and marlboro!) That stained wife beater that says harley is their sunday best.
forcing a family to spend an insane amount a month on health insurance is redicilous and criminal. Want to fix the system? flat tax based on Gross income before any and all deductions. that goes to fund health insurance that is given free to all state residents. THAT is a step in the right direction.
Re:Note to self: don't move there. (Score:2, Insightful)
I also believe that many who have posted here underestimate the cost of health insurance. For my family, it would cost us around $700 a month for health insurance. That's more than some of you pay thru your employer because your employer has the power of buying in bulk, which you do not have. My last employer to offer insurance had a policy costing a little over $500 a month.
How is a low-paid worker going to afford health insurance if he's over the poverty line? If you make $30k, and have to pay $8400 a year in insurance costs, you will soon be homeless and on the dole!
Re:Socialised Healthcare is the future for the US (Score:3, Insightful)
Well, apart from the fact that people's food, accommodation & travel costs are largely decided by themselves and considerably less variable - at least when comparing people of similar status (or whatever the PC term for class is). Not many minimum-wage earners drive new BMWs and sit in their mansions eating foie gras. Hence these type of expenses are somewhat predictable, and people can at least attempt to live within their means.
On the other hand medical costs can vary widely - several orders of magnitude - and often due to reasons entirely beyond the indivudual's control.
That's the risk part. That's why there's the concept of spreading it.
Re:Yes its broken (Score:3, Insightful)
What is equally astounding are the US citizen's who think the they aren't paying for the poor
The poor AC gp is exactly the kind of person for why we need socialized health care. He (assuming its a he) can't go do a doctor to get basic preventative care. If he develops some kind of disease or illness, he won't go to the doctor to get treatment at the early stage, where treatment is cheaper & more effective. He has to wait until it becomes an urgent situation, and then he goes to the expensive ER where they have to address the immediate concern, but don't have the time / staff to do any long-term care. And more often than not, he won't be able to afford the ER visit, which means the hospital eats those costs & passes them on to all of those who can afford to pay (via insurance or government subsidies).
So just like socialized health care, the people who are working are the ones paying. The only variable is how effectively your working dollar is used to subsidize care for those who can't afford it.
Re:Socialised Healthcare is the future for the US (Score:2, Insightful)
I think the big hurdle in the US is simply to convince our people that there is a better way of doing things. We have a tendency to always think our way of doing things is the best, and doesn't need changing. But statistics show that many other countries have public healthcare systems that function well, and even better than our system does.
Re:Socialised Healthcare is the future for the US (Score:3, Insightful)
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.
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.
Re:Socialized healthcare (Score:3, Insightful)
That's just the thing - socialized medicine doesn't remove all of those layers. While the advertisements and marketing goes away - the (private) insurance company people are merely transformed in the (public) bureaucracy. The paperwork doesn't go away - just the forms change. The decisionmaking over what care you get when doesn't go away - just the entity that writes the paychecks of the decisionmakers changes.
It gets cheaper because the goverment can now force you to use cheaper generics. And because the goverment limits who gets what treatment and when. And because the goverment can mandate the salary paid to health care workers...
It always utterly astonishes me that Slashdot - home of the most stalwart dyed-in-the-wool get-the-goverment-out-of-my-life crowd I know of... Rolls over and begs the goverment to come in and take control of this aspect of their lives.
Re:Socialised Healthcare is the future for the US (Score:4, Insightful)
That's stupid. (Score:3, Insightful)
My company pays about $900/month to insure myself and my wife. We could be similarly insured for about $250/month in the private market, since we're young and healthy.
The problem is, since we're young and healthy, it costs far less to provide us with healthcare than the people I work with who are, say, 45 years old. So what happens when you let people just take the money instead of the insurance? People like me leave the employer insurance pool and get private insurance, and then the company ends up spending $1600/month to insure the people who are left. Except now at $1600/month, even more people would pay less with private insurance, so now THEY leavue the employer pool, and you're left with a company that is now paying $5,000 a month for the diabetics and others with chronic diseases and the rest of us are all on private insurance.
Of course, this doesn't really happen. Because once isnrance starts costing $1,600, $5,000 month, and the company is BOTH paying that for the people who actually take the insurance, and giving it ot the people who don't take the insurance, the company just decides to stop offering insurance at all. Now nobody is insured.
Employer-provided health insurance works the way it does because it's the only way it can work.
Re:Great. (Score:3, Insightful)
However, in the US, a significant minority of the population does not have access to preventative and basic primary care medicine necessary for survival. So yes, just like I would expect the government to get involved if 8% of American children and almost a quarter of non-elderly adults were starving to death, I would expect the government to get involved if 8% of the American children and almost a quarter of non-elderly adults are unable to get basic health care.
But hey, nice demo of a great slippery slope fallacy!
Nick
Re:Nope. It's 105 billion pounds. (Score:2, Insightful)
Sorry, but that's essentially bullshit. My mom works in public health, and has her master's degree in Health Services Administration.
Here in Canada, we're getting the same story pushed by people who want a US-style system (one difference between Canada and the US: US doctors make dramatically more money, on average) that our health-care system is in crisis, and the bogeyman of "waiting lists" comes up all the time.
What conditions have waiting lists? Slow, progressive, conditions like knee replacements or cataract surgery. A condition that's been developing for years (if not decades), I don't care if that person waits 6 months or a year for surgery. It's often suggested that the long wait for MRI's is indicative of a need for private health-care.
Well, actually, if the reason for an MRI is potentially life-threatening, you get in in 24 hours or less.
The argument that long waiting lists mean the single-payer, socialized medical care is flawed has no more validity than Microsoft's "235 patents are infringed by linux".
Pure, simple, FUD.
Re:Socialised Healthcare is the future for the US (Score:3, Insightful)
Re:Socialised Healthcare is the future for the US (Score:2, Insightful)
If you want to equate healthcare insurance with "anything else" then I'd like to protest every penny spent on public roads and infrastructure that does nothing but allow yuppies to go skiing. My taxes shouldn't fund their lifestyle.
In any event, I'm not sure you understand how insurance works. By definition, when it comes into play someone else is paying for what happened to you.
Re:If you love the U.S. like I do, you will... (Score:3, Insightful)
Can you afford a cancer treatment now? Can your parents? Can your friends, if you have any?
You get the same mediocre crap every time from a doctor who is far less worried about malpractice complaints.
Mediocre, but in vast majority of cases good enough. You may pull up an example of a $EXOTIC_CONDITION treatable only at an elite university clinic in $US_CITY but for every such case there are literally millions of others where what you consider mediocre is entirely adequate.
How many people die in the US because they can't afford an expensive procedure (including unaffordable expenses of preventive care or getting treatment early enough while the symptoms are minor but the doc visit is too expensive in comparison), in comparison with the number of people elsewhere who die because of a botched doc's work? I dare to assume that the risk of the latter is significantly lower than the risk of the former, for sufficiently developed values of "elsewhere" (let's say EU).