Heath care and Hillary

[Wayout]

I look at it like this. If they want to raise my taxes to fund a national health care program, that's fine AS LONG as I still retain the option of providing my own insurance and still get to pick what doctor I go and see, AND my insurance premiums are tax deductable.

Be careful whay you wish for. To fund national health care your taxes would be so high you might not be able to afford your own insurance. 
Remember the Dems moto.  "From each according to his ability, to each according to his needs."

[myelo]

Healthcare costs were low until the government got involved.

It's a little more complicated than that. Healthcare costs have skyrocketed for several reasons:

1. Better care. The typical patient in ICU today would, 50 years ago, be in the morgue. Some morphine and a hearty handshake were pretty cheap. But CT, MRI, chemotherapy, radiation therapy, organ transplants ... that crap's expensive.

2. Third party payers. Back then, it was fee for service and the fee came out of your pocket. But every insurance scheme, whether public or private, insulates the patient from the true cost of health care so there's no incentive for patients to make good economic decisions. Also not all the insurance premium goes to health care -- the shareholders, sales people, and bureaucratic staff get their cut first.

3. Out of control legal environment. Back in the day, a drunk went to the police station. Now he comes through the ED because of fears he might aspirate on his own vomit and die in police custody leading to an expensive lawsuit. Or god forbid a patient might develop a complication, in which case they scurry to the local ambulance chaser like they buy lottery tickets, but with a much better chance of hitting the jackpot. Modern doctors spend an incredible amount of time documenting and ruling out unlikely diagnoses not because it improves care, but because they prefer to not loose their house.

4. Futile care. Keeping your demented 90-year old granny with 8 comorbidities alive another 2 months sucking life through plastic tubes costs big money. 50 years ago, or today in any other country, this patient would have died 15 years earlier.

5. Patients are not encouraged to take responsibility for their own health. We smoke, drink too much, eat too much, don't exercise enough, ride motorcycles without helments and engage in all sorts of other foolish behavior ... but when the heart says "See ya", the liver shrinks up or the head splats on the concrete we expect somebody to fix it.

[lazs2]

I guess we need to define "health care" and even "free health care"...

They are very broad subjects.   It seems that some of you feel that it is your gawd given right that...  any new procedure.. so long as it keeps you alive or.. you simply want it.. that it is your birthright that someone pay to give you that procedure.   

Say a drug came out that would cure cancer but it costs oh...  10 million bucks for the treatment..  90% success rate.

Would everyone be entitled to it under your "free health care"  or is it even considered "health care" by you guys?

lazs

[Kaw1000]

myelo,
 You for got one.
People and Illegals with out health insurance....Drives up cost big time!

[myelo]

Actually uninsured patients don't drive up costs as much as everyone seems to think, at least directly. (whether they're immigrants or not doesn't matter and 47 million US citizens aren't insured)

Let's say the typical gun-and-knife club member goes to the local ED to have his face put back together because he was standing on the corner, minding his own business when two dudes (it's always at least two) jumped him for absolutely no reason at all. He doesn't have insurance and isn't going to pay out of his own pocket (that would cut into his cell phone, cigarette, and tattoo budget). So the hospital doesn't get paid and has to eat the bill. That means they have to jack up their fees for folks with insurance. The insurance companies in turn jack up their premiums to pay for the increased fees.

But ...

Let's say this same dude is Laz's buddy and has gotten some of that $75/month health insurance. So the hospital gets paid by the insurance company. But guess what? The insurance company now jacks up their premiums so everyone else who has health insurance pays higher premiums. Same result.

Indirectly though, this behavior probably does increase costs to some degree for another reason. The folks with no health insurance are more likely to go to the ED with minor complaints instead of a primary care doc or an urgent care place. The ED by law has to evaluate them even if they can't pay, while the first thing the primary care place does is see if the patient can pay. If not, they won't see them.

And for several reasons, getting your earache treated in an ED is a lot more expensive than getting it treated at primary care. But the problem here is more the stupid EMTALA law (which I did leave out).

[Toad]

My 23 year old son got a Blue Cross Preferred Care policy for $100/month. This policy is his alone. I'm on a different system at work.

He has a $2500 deductible. After that he pays 20% in network. Covers prescriptions and some dental too.

So it can be done.

[Joker]

That is true, Toad, rates are cheaper for the young and healthy. But if he were 50+, or had a chronic illness, the rates would be much higher if available at all.

And Myelo, many good points made there. The ED is rapidly becoming the primary care provider for the uninsured, and for the most part this is unreimbursed care. Our hospital ends up writing a lot of that off.

and EMTALA....causes no end of problems for our small rural hospitals

Joker

[Toad]

When the politicians spit out the numbers on how many Americans have no health insurance do they break it down by age?

Don't think they do.

Point is that health insurance IS available to many of the currently uninsured for the price of the all-in-one cable/internet package as Laz said.

As for older, chronically ill people, there should be high risk pools like there are for car insurance.

Where did this idea come from that everyone should be entitled to the same health care at a standard price? There are very high risk behaviors that are linked to serious illness. Should smokers pay the same as non-smokers?

[Kaw1000]

"Point is that health insurance IS available to many of the currently uninsured for the price of the all-in-one cable/internet package as Laz said."

Point IS that those people you are talking about, will not pay a penny because they don't have to. So great, heath Insurance is available
to every one.....even if you tried to make people pay for it....They will not.Why should they?? Ahh the Democratic way!

Lets watch, tonight, and here Obamma how hes going to fix heath care...can't wait to get a good chuckle.

[midnight Target]

medicare works about as well as social security works...  a bunch of people some years down the line are gonna get royally screwed.

I never could understand how these poor people who can afford a $100 a month for cable and $50 a month for cell phones can't afford maybe $75 a month for health care insurance.

lazs

What kind of health care insurance costs $75 a month?

[Toad]

MT, my son could have gone ~$75, maybe a bit less if he had not chosen the "Preferred Plan". They had cheaper plans available.

[myelo]

If you're young and healthy, you can get relatively cheap health insurance if you're willing to have a decent-sized deductable and copay. You do have to pay attention to the maximum reimbursement (both yearly and total).

And that's really the way health insurance was originally intended to work -- protect you against catastrophic losses. The problem is a lot of people want their health insurance to pay for every little minor thing. That gets really expensive. Think of homeowners insurance. If you want to get reimbursed if your house burns down, that's relatively cheap, because it's a rare occurrence. But if you wanted to to reimbursed for things like getting the heat pump fixed, the walls repainted or the toilet repaired it's going to be expensive. In fact it's always cheaper just to pay for that yourself because for the insurance company to cover that they're going to first take out their overhead costs and profit.

So if you're young and healthy and willing to pay for the small stuff yourself, you can get pretty cheap insurance.

On the other hand, if you're older and/or already have a serious health problem or two, it's going to get expensive. After all, if your house is already on fire, how much do you think you would have to pay for homeowners insurance?

[Toad]

All true, Myelo.

I think that it needs to be pointed out however that when our teary-eyed politicians decry the lack of a national free health care system for the millions of Americans that have no insurance they are including the young, healthy people that could get insurance from providers like Blue Cross for less than $100 like my son did.

So in any event, their numbers are really skewed. Many of the millions could get health insurance for less than their cable/internet package but would rather have cable/internet instead.

Again, where did this idea come from that everyone should be entitled to the same health care at a standard price or even free from the government?

There are very high risk behaviors that are linked to serious illness. Should smokers pay the same as non-smokers? Should smokers be entitled to free health care even though it's proven that they are voluntarily increasing their health risks enormously and that they will require far more national healthcare resources (as a group) than non-smokers?

Lastly, I don't believe there is an existing national health care system in any country where that healthcare isn't rationed. The example being the Canadians that come to the US for treatment because they can't wait a year for a CAT scan and surgery in Canada.

Is there anyone foolish enough to think that health care will not be similarly rationed here?

We'll probably be joining the Canadians on the way down to Mexico to get prompt medical services and treatment.

[lazs2]

The guy I know who gets insurance for $75 a month is almost 50 years old and has had back surgery and a few other things.   He has a $4000 deductible and he pays $50 for a doctor visit.

I would love to hear what "right" to what kind of "health insurance" you have.

myelo proves my point I think..  my buddy doesn't go to the doctor every day cause he pays for the visits.  myelo admits that when people use the system it all goes up for everyone.   with "free" health care.. unless it is a really bad system.. one you hate to use.. worthless aholes will be parked in doctors offices around the country with every little ache and pain hoping to get some kind of good drugs or a disabillity pension.

lazs

[AKIron]

Think of the Canadians. Where will they go for quality health care if we governmentalize ours?