From Feministe I learned that the New York Times reads: “Massachusetts is poised to become the first state to provide nearly universal health care coverage.”
Nearly universal health care? You mean almost everyone won’t die because they don’t have enough money. That’s just swell. Massachusetts must be so proud of itself.
Why on earth is nearly universal coverage an accomplishment? Why is the possibility that anyone could be without medical care OK in one of the richest countries in the world? Why is it OK to make money from other people’s illness
I don’t understand American politics (although it’s possible, just possible that the fact that both parties take money from health insurers has something to do with this).
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Last semester, I had a student write her final paper on how Universal Healthcare is really quite a bad thing – citing all the typical argument – socialized medicine takes competition out of the game, and so it’s not as good as our medical system. Why else would people from Canada with enough money come here for care? Yadda Yadda Yadda. My dad makes the same arguments – (he’s in the healthcare industry, not a Doc, but worked at two of the most prestigious medical institutions in the country – Mayo Clinic and Cleveland Clinic), we’re the best and that’s the way you get to be the best and the price you pay for being the best. I think it’s total BS, but that’s just me. Anyway, back to the student. Of all the things she wrote the most alarming and distrubing that she wrote over and over again was this, “Healthcare is a PRIVILEGE NOT A RIGHT.” She believes this and AGREES with it – and get this – she’s a nursing major. I just don’t know what to do with that. In my PERSONAL opinion, anyone who believes that access to basic and decent medical care is not a basic human right doesn’t have very good morals. It still shocks me. And angers me because I know first hand what it is to have to fight for insurance. My husband was laid off and our coverage was through his work. We paid $800 a month for cobra until we finally got MassHealth (the MA “universal” coverage). People say to me, why not just go without insurance for a few months until you could get covered somewhere else – $800/month is a lot of money when you are down the major income your household was receiving. All in all, we paid $4000 in PREMIUMS – not copays or anything else while I was the only one working – in part time, sporadic work. Well, I have a medical condition, and if ever I go without coverage, the next time I am covered the insurance company can claim “pre- existing condition” and then never cover ANYTHING related to it ever again. So, I was in a difficult position. Anyway, my point is the entire insurance industry is a total and complete rip off in my book – and I live in MA!
Why is it OK to make money from other people’s illness?How otherwise will the people providing the health care support themselves?
Maia:
Not just from insurers, but from Pharmaceutical corporations as well. Of course, the American taxpayer essentially pays for the health coverage of Senators and Congresspeople, who already make plenty of money. I wonder why “Socialized” medicine would somehow denigrate my character while it seems to be a-okay for them to get it ? Fuckwits.
Kate L:
I hope little ms. PRIVILEGE and her idelogical buddies develop lots of nasty chronic conditions soon, so they can enjoy all the wonder of our system at its best. Gevalt. That’s the kind of crap that just makes me want to shake people until their pea-sized brains rattle.
Yeah, it’s an easy thing to “just go without” for a few months. Any condition you’ve been treated for magically becomes “pre-existing” when your new insurer shows up. Nearsighted ? They don’t pay. Bad feet ? They don’t pay ? Antidepressent meds ? They don’t pay. Any chronic, treatable condition at all ? If you had it before you got Insurer B and have let Insurer A’s coverage lapse, Insurer B does not pay. That’s why I got married, so I wouldn’t be stuck with COBRA, which I couldn’t afford– when I left my former job. I haven’t actually been back to any physician for any treatments or checkups since I left, because it’s hard coming up with co-pays when you don’t get Unemployment. Essentially then, I’ve gotten (thanks to my husband’s generosity) a glorified form of Major Medical for myself. If I fall down a flight of stairs or suddenly develop problems related to any old/current medical conditions, I’m covered. I guess I’m supposed to bow and scrape before our wonderful, perfect, fabulous system now. Funny that I don’t feel like it. >:
Here here to alsis, but I’ll also add on this quote:
Wrong Maia – you exactly understand American politics. You just don’t understand the logic behind stuff like this. But that’s only because there isn’t logic, only cash.
How do the people building our roads support themselves? In case you’ve never noticed, road-building (and maintenance) is not a for-profit enterprise.
Health care is also a public good.
Is it wrong to agree that health care is a privilege (for believing that only negative rights exist), but should be universally given to citizens?
Personally I favor a mixed-market solution, with quite good, but affordable health-care for everyone, and top-notch for those who can afford it.. Completely socialized medicine can have quite horrendous outcomes (due to simple fact that resources are limited, and thus utilitarian min-maxing must take place), as can completely privatized (because some people are left out).
The “near universal” healthcare isn’t even single-payer. It’s basically a big handout to health insurance companies, the same way mandating car insurance is.
If the state decides you can afford insurance but don’t have it (I haven’t seen the income guidelines, but most Americans are already stretched to their budgetary limits and don’t have a few hundred dollars extra every month), they will impose tax penalties on you. So basically, it’s a way of forcing people to buy insurance, perhaps even insurance they are affording instead of, say, good childcare or reliable transportation, and mandating that people pay the insurance companies (which will undoubtedly raise rates when people are required to pay them).
For people whining about socialized medicine, this is corporate welfare. If you don’t hate corporate welfare at least as much as socialized medicine, you’re a hypocrite and an idiot.
Why is it OK to make money from other people’s illness
Same reason it’s okay to make money from other people’s ignorance (teachers), hunger (farmers), and homelessness (landlords and homebuilders). These problems don’t fix themselves.
Great – Maia writes one ambiguous phrase, and this, and nothing else is what Brandon and RonF latch onto. Nice.
Allow me to explain, there’s a difference between a doctor or surgeon earning a living doing what they do, and the CEO of Blue Cross/Blue Shield earning millions of dollars by making decisions to cut people’s coverage and raise rates. This isn’t about the doctors, the doctors are the ones who have to jump through hoops to be insurance providers so they can charge what a bunch of executives hundreds of miles away decide is a “reasonable price” for their services.
It’s basically a big handout to health insurance companies, the same way mandating car insurance is.
And what is your alternative to mandating auto insurance?
it’s true that the only way to pay doctors, nurses, and other health care workers is to have someone pay for health care, and it has to be the consumer somehow even if it’s through taxes.
but the phrase “make money off of” is ambiguous. it’s okay that people have to pay for health care (possibly collectively), but it’s morally very sketchy if someone is making a profit by turning the provision of a right into a business.
if we took away the financial incentive for insuance companies (by mandating strict non-profit accounting, with profits returned to policy-holders, for example), then no one is making money off of denial of care.
You sound bitter, Raznor. One would think that you wearied of nailing jello blocks to the wall. Or are you merely running short of nails ? Here. Borrow some of mine. Mal-Wart had a sale. :/
Maia -isn’t “nearly universal” a big improvement over “nowhere near universal”? The MA plan may be a bad idea for other reasons, but it’s not to be disdained merely for being non-universal, just as the U.S. 1964 Civil Rights Act should be condemned because it didn’t also ban sexual orientation and gender identity discrimination.
ct: shouldn’t be condemned.
I know that universal health care sounds good but it needs to a workable system. What may work in Massachusetts might not be a good idea for the entire country or in other places such as TX (that has more than double the number of uninsured people as Mass) whose healthcare costs need to be supported.
I, for one, don’t want to end up paying 50% of my paycheck to the government to take care of everyone’s needs. I hope I’m not the only one that feels this way…..
In my PERSONAL opinion, anyone who believes that access to basic and decent medical care is not a basic human right doesn’t have very good morals.
In my personal opinion, anybody who doesn’t understand the troubling implications of positive rights – at least to a degree sufficient to cause them to be ambivalent in their declarations of same – doesn’t have very good sense. Morals can be upgraded, but stupid is forever.
Now if we’re done trading insults with one another, perhaps Maia’s substantive point can be addressed:
Why is the possibility that anyone could be without medical care OK in one of the richest countries in the world?
Because not everybody agrees that security is the ultimate value. A plurality of Americans – a plurality that legitimately controls, at least for now, the political machine – believes that individual freedom and choice are the ultimate values, which trump the desire of the state to control and provide security for its citizens.
You live in a country whose government will put you in jail if you speak out for justice in a voice loud enough to be meaningfully heard – just for reporting a true fact about the identity of a vicious criminal. That’s a predictable outcome of the value set that your society (or at least a big chunk of it) has selected.
There is no perfect value set. All of them involve costs and benefits. You have “free” adequate health care. We can tell our judiciary to bugger off if it would rather we be quiet about its misdeeds. Life is full of trade-offs.
Alsis- I may take you up on that. One can never have too many nails.
SBW: would you rather be forced to pay, say, 70% of your paycheck to take care of your own needs? Needs like healthcare, that a responsible government in a country as rich as ours should be providing?
Taxes aren’t the only drain on your wallet.
Raznor, the nice thing about freedom is that you aren’t forced to pay the 70%. You can adjust your needs. You can spend 80% if you like. You can work more and get more. YOU get to decide, instead of Bill Frist getting to decide.
How many of the decisions of your life are you comfortable with Bill Frist deciding?
SBW: would you rather be forced to pay, say, 70% of your paycheck to take care of your own needs? Needs like healthcare, that a responsible government in a country as rich as ours should be providing?
The answer to this question is a resounding yes. It’s my money, isn’t it? Who better for it to be spent on than me and in any way that I see fit?
I like the idea of universal healthcare. It sounds nice; what it requires to put it into practice is what I have a problem with.
I don’t think this is nearly as good as it sounds – individuals will be penalized for not buying coverage – my daughter and I are not included on my husbands plan because it costs $526 extra a month. Who decides that we “can afford” to be paying that? If this encourages his employer to cover family benefits, then great but somehow I doubt that will be the result. This is a way of letting businesses off the hook, and letting Medicaid continue to shrink as well – between 1999 and 2003 Medicaid dropped coverage for services until it was down to nearly nothing then it dumped me as an insuree because I had a child. Having a child “proved” I had a man to support me though we weren’t married then. The system is completely forked up.
Polymath:
Housing is at least as important as medical care, isn’t it? Food certainly is. I assume you consider them rights, too—do you also believe that it’s wrong to run a grocery store or home-building company for profit?
Also, when you say health care is a right, how much healthcare are we talking about?
And if you think that for-profit health care is demonstrably inferior to the non-profit variety, why not get together with some like-minded people and start up a non-profit organization to provide health care? Since you don’t have to worry about making a profit, you’ll be able to offer superior service at a lower price, and you’ll put all those nasty for-profit providers out of business in no time!
What a silly idea Brandon! Non-profit health care? What, you mean like every Catholic Hospital in the country? Or like Blue Cross Blue Shield insurance, or USAA insurance?
No, no, obviously if such a silly idea is going to get off the ground, it is only going to be because you incite polymath to go out and do it themselves.
Oh, and on the silly question of non-profit vs for-profit health insurance quality: a press release for a AJM published study finding non-profit health insurance to be better on several criteria.
But non-profit and for-profit both still fall far short of universal, and no new non-profit that polymath sets up will provide universal coverage. For that we need a functional government. Sadly…
Arrrrggghhh! I hate arguments like this. Why should you pay 50% of your paycheck so all can have adequate healthcare? Because I believe healthcare costs will diminish if people don’t wait until they are half-dead to see a doctor because they don’t have insurance. If they know they can go to the doctor, they won’t clog up the very costly emergency rooms with their colds. If they get the drugs they need without paying an arm and a leg, maybe they won’t stroke out and need nursing home care. It’s economical!!!! Arguments about rights and priviliges gets into the muck. Argue cost/benefit ratios instead.
Just from what I’ve read of the Massachusettes plan, I despise it. Folks who are already strapped for cash now will have an extra expense, either insurance premiums or a tax. I didn’t see anywhere that they are planning on expanding Medicaid or other low-income insurance plans. With car insurance, if you have a beater car, you can just carry liability. Just carrying catastrophic health insurance might make sense for healthy 20-somethings. Once you get to be forty, you need to start having screening exams to stay healthy. I think it would be cheaper for us to pay for the screening exams and catch things early than later.
My neighbor lady is dying of colon cancer. They didn’t catch it until she had a bowel obstruction. The chemo that made her miserable gave her maybe an extra six months. My Dad had ulcerative colitis for many years, and was closely screened for colon cancer because of it. My dad had a colostomy five years ago that cured the small cancerous polyps he had. I am screened more frequently than people my age because of his history. I won’t die like my neighbor lady. That’s why we should have universal health coverage with a strong emphasis on prevention.
The really sad thing is this bill, if it passes, will remove any state requirement that employers cover infertility treatments (second on the list after abortion on the right-wing agenda).
M
No – the really sad thing is that unlike car insurance, you can’t choose to avoid being a living person to avoid paying for health insurance. Cars, while a necessity in some places, are not a necessity everywhere. You can give them up (although it severely limits employment choices, and in many places can make it difficult to access necessities like groceries) without dying.
Having access for everyone to basic medical services is a noble and good mission. Doing so by forcing everyone to pay for it, because laws are generally rather black and white and hard to apply circumstancially, is not noble and good. It will create a system in which those who are trying to get ahead – by working overtime, 2nd or 3rd jobs, or choosing to put all their money into education, will be penalized for making just slightly too much.
Honestly, that’s what happens now with medicaid – you don’t work, you can go to the doctor. You try and support yourself with whatever crappy temp job you can manage to get, and suddenly no more medicaid for you. What the hell kind of system is that???
Robert, I often enjoy hearing your contributions to threads, because you have a nice tendency to sometimes bring in pragmatic or libertarian arguments that are relevant. (That said, you sometimes bring in arguments that are complete crap, in my opinion. But that’s neither here nor there.)
Your assessment that Americans don’t have a universal health care system
Because not everybody agrees that security is the ultimate value. A plurality of Americans – a plurality that legitimately controls, at least for now, the political machine – believes that individual freedom and choice are the ultimate values, which trump the desire of the state to control and provide security for its citizens.
is a prime example of letting ideology cloud what might otherwise be a nice point. I think a review of the actual history of how health care came to be delivered primarily through employers in the U.S. would show that (like a lot of policy) it happened because an enterprising company took advantage of a loophole in IRS regulations that allowed it to offer a fringe benefit without being taxed as it would have if it had offered a commensurate salary increase. Able to offer $X amount of health insurance gave it a competitive advantage–the IRS gave its blessing–and other companies followed suit.
50 or some odd years later, we’re now faced with a system that is thoroughly entrenched, and like many entrenched systems, it’s a hell of a lot easier for a highly-motivated minority voice in the system (read: the people who benefit from the current arrangement, including health care providers and the companies they serve) to be able to keep it in place when the more diffuse majority doesn’t particularly feel one way or the other about it, even if a better alternative exists. (I’m not sure that I consider a single-payer system better–particularly when in my opinion the political will does not exist to impose a realistic way of rationing benefits–but I think my point still stands.) There are undoubtedly many people screwed by the current system, but a huge number of people probably just don’t think that hard about it–they get insurance through work, it’s not so expensive as to prod them to demand a better system, and most people don’t actively think about things like “but what will happen if I lose my job or try to start my own business or become poor?” because, realistically, who has the time?
I just have a hard time believing that most Americans have seriously sat down and thought about the inherent trade-offs of universal health care through a single-payer system vs. the current flavor we have now.
Personally, I wouldn’t have a problem with single-payer auto insurance, either — “when companies compete, you win” is a good slogan for lending companies, but the truth is, they’re the ones winning. Over, and over, and over. Mandatory car insurance also generates extensive amounts of “faux insurance” companies, the same way mandatory health insurance will. For that matter, the state minimums don’t even come CLOSE to paying any real hospital stays (and, of course, if we had single-payer healthcare, we wouldn’t need to go after people in accidents to pay our hospital bills), or close to the full amount of damage on any new car. The minimums make very little sense, in context. But they’re required anyway.
No no, I’m convinced it’s all about freedom of choice. Like do you choose to die of a treatable disease or starvation. Thank you Robert and SBM for showing me the error of my ways.
And let me add, how much you pay for healthcare is not a choice. You either pay for it, or you don’t get it. It’s that simple. There’s no, “Do I decide to do this” with your money. If you have appendicitis, and you need $10,000 for the surgery, you’re paying that $10,000 or you die.
And one more:
Indeed, what novel and absurd concepts. Food as a right. Pshaw. Why, what are you suggesting? That the government should issue some sort of credit that people could use to buy food? What would you call them? “Food stamps”? Pshaw, like that would ever work.
Raznor, are you honestly contending that the appendicitis scenario – pay or die – is the only scenario present in medicine? That this adequately represents the health care decision space?
I have a rheumatoid inflammatory disease. We don’t know exactly what it is – mainly because I have chosen not to spend thousands of dollars on bloodwork. I won’t die because I haven’t chosen this option. I won’t even suffer more because of it. The only thing that spending the thousands of dollars would do is give us a name for something that doesn’t have a cure – just treatment options, which don’t vary from a fairly standard regimen of care for rheumatoid conditions.
I don’t find it worth spending $5000 to know that for absolute optimum pain reduction I should be taking medication X instead of medication Y which does 95% of the job. If the pain was fifty times worse, though, I certainly would spend the money in the hopes of even a minor improvement in my condition.
If I lived under a system like Britain’s NHS, the decision would be made for me. Perhaps the system would decide it’s really best that we nail down what this is; perhaps the system would decide that there are higher priorities. Either way, it wouldn’t be my call – it would be someone else’s call.
And that’s unacceptable to me.
AB, you raise a fair point. I shall have to give that some consideration. Thanks.
Charles:
And yet for-profit care persists. If it’s unambiguously inferior to non-profit care, all the for-profit providers should have gone out of business. If non-profit care just works better, fine. But there’s no reason to mandate that all health care providers be non-profit. If it’s better, people will choose to use it on their own. But historically, allowing people to make money doing something has been a pretty good way of making sure it gets done.
The study is interesting, but somewhat limited in scope, in that it examined only four factors and dealt only with Medicare patients. Also, I’m not sure what the methodology was.
Michelle:
Why should insurers be forced to cover elective procedures like infertility treatment? If insurance companies want to offer it to attract customers, that’s fine. But I see no reason why the state should step in and force insurers (and ultimately consumers) to subsidize this sort of thing. Let them adopt if they can’t pay for it themselves.
I was objecting to people making profit from illness, not to people earning a living providing health care.
New Zealand has socialised health system (not as good as it used to be, but it does exist) and our top tax rate isn’t 50%. America spends far more on healthcare than any other OECD countries as a percentage of GDP and per capita, but it’s outcomes aren’t that good. It’s just that the way you spend your money is extremely inefficient.
I was objecting to people making profit from illness, not to people earning a living providing health care.
But people making a profit are people earning a living; I am not comprehending the distinction you’re drawing.
It’s just that the way you spend your money is extremely inefficient.
Depends on what you mean by efficiency.
Looking at general numbers, the US spends $4631 per cap on health care, total, while New Zealand spends $1623. But if you look at private spending on health per cap, the US is dropping $2580 compared to your $357. The actual public spending is $2051 vs. $1266.
So what are we paying for with our $2580? One of the single biggest components is that our elderly are free to spend their life savings buying a couple more years of life, and generally do. Its this type of private expense, based on individual choice, that accounts for the differences in our health care expense ratios.
That expense is “inefficient” – from the point of view of someone running a state enterprise. If I owned all the economic product of the nation, it would indeed be unacceptable to drop 200 grand to keep one elder alive for a year, when instead I could give pre-natal care to 500 young mothers.
But from the point of view of individual utility, it’s a very efficient use of the money. The old person uses the resources that they accumulated over their life to spend another year with the great-grandkids – from their point of view, priceless, and an outstanding use of the privately-held resource.
It seems that your objections to our health care system are actually objections to a private economy, where people make their own choices about how to use their resources, instead of the state overriding those individual desires.
Bully for you, Robert. I have a chronic disease in which I have already had the tests to determine its presence. Millions of others could be incubating the very same illness without any financial means to determine its presence and to prepare themselves accordingly. Others either receive compromised treatment for their illness, or none at all. They are disabled and die from something that is treatable and curable. A system that allows this and the people who crow about how it’s not their problem to worry about it if the sufferer isn’t in their own family are short-sighted and inhumane.
I have gone into my issues with our current system numerous times on this board, so I’ll just cut to the chase today. Your idea of “freedom” is a joke. You can keep it.
Your idea of “freedom” is a joke. You can keep it.
Thanks, I will.
A system that allows this [avoidable suffering is] short-sighted and inhumane.
I quite agree.
Our national health care system ought to make lavish provision for the well-being of those who are too poor to pay for their own care.
That does not require taking away choice from those who aren’t that poor.
No, you’re right. It makes perfect sense to force those who are not yet impoverished to choose between no healthcare, crappy healthcare, and impoverishment. Once you create more impoverished people (assuming they survive the distinct drawbacks of zero or lousy care), why, then you’ll break out the barrow full of money and lavish your Godly love on them !!
[snort.] Thanks for reminding me why I don’t take folks like you seriously when you go on and on about how much you despise waste and worship efficiency. Creating more poor, sick, people before you deem them worthy of care is not efficient by any stretch of the imagination.
I’m not following you, Alsis. If you have resources, should you not be expected to expend them on your own health care, before asking others for assistance?
It isn’t a question of being “worthy of care”. It’s a question of being a proper recipient of charity.
I just can’t believe there are no Canadians here
pointing out the clear pitfalls of an inevitable Orwellian social health system.
Any predictions on the rate of outright frauds that accompany
ALL such legislated socialism?
Raznor:
You’re missing the point. While I do disagree that anyone has a right to food, since such a right would necessarily entail the right to force someone else to provide that food, the idea that there is a right to food is at least somewhat tenable.
What I am objecting to here is the idea that it’s wrong to make a business out of providing things to which people have a “right.” So, again, if it’s wrong to make a business out of providing health care, isn’t it at least as wrong to make a business out of providing food, or shelter, or clothing, since those things are arguably even more important?
As a child, I had a chronic disease that would have left me deaf without treatment. If my mother had not been insured, and me through her, the diagnosis would have been “put off” in the same way Roberts was, because only intense scrutiny would have showed me as having nothing more than a minor recuring bacterial infection in my ear canals.
As for those who think there should be no public funding of health care, I have a few words for you – polio, smallpox, german measles, mumps, and rubella. And a whole lot more.
I’m really not interested in getting into the nuts and bolts of what you might consider “impoverished” enough to deserve free or discounted medical care, Robert. I remember all too well your casual dismissal of Jake Squid’s five-figure medical debt as being not very important. I’ll forgo any further trips to your little moral house of mirrors, since I always end up feeling headachey and nauseous by the time I manage to find the door and stagger out.
Suffice it to say that I had a family medical history that indicated a 1 in 2 chance of having a chronic medical condition. I asked for the test. Because I had decent insurance and a good wage, I got the test. I didn’t have to hock my furniture or live on only beans and rice for a month to do it.
So far as I’m concerned, everyone and anyone has that same right. Not merely folks living in mansions and folks living in cardboard boxes, but everyone. Indeed, society is both more humane and more efficient when this happens. Otherwise, you have people suffering dangerous symptoms that nobody has tried to find a cause for. You have people being treated for a symptom with drugs that may aggravate their undiagnosed condition further. At the very worst, you have a treatable, curable ailment disabling and killing people because they can only afford substandard care, or had to sacrifice most/all of their material possessions and assets to afford care. Or worst of all, they can’t afford treatment at all.
That’s acceptable to you. It’s not acceptable to me.
That does not require taking away choice from those who aren’t that poor.
Thanks for the red herring, strawman argument. Single payer/nationalized/socialized healthcare doesn’t take away choice from those who are not poor. If you have the money, you will still be able to buy your own private, supplemental insurance or pay a doctor from your very own bank account for whatever it is that you want done. Works that way in Canada, the UK, France, etc. afaik.