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Originally Posted by willravel
Clearly, most people in the US think that police work and firefighters and the likes shouldn't require you to pay a private corporation. We get fire coverage and police coverage for relatively cheap (if you were to compare it to health coverage, though it might be a case of apples and oranges in people's minds).
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Fire coverage and police coverage only deal with the immediate problem - the fire itself or the actual crime. Insurance, whether it be fire, liability or health, reimburses (theoretically) the insured for their loss from whatever peril they suffered from. Firefighters will not restore your home. Policemen will not fix your car if a thief drives it into a lake. This just isn't apples and oranges - this is apples and the number i. Health coverage pays for your healthcare costs. Homeowners insurance pays for your possessions if they are damaged or stolen. Fire and police departments have nothing to do with this arguement.
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Jazz, so you're saying doctors (who are making less than in the 80s and 90s), new technology (something that has always been present in medicine), and drug companies (I COMPLETELY AGREE ON THIS ONE). I have trouble believing that the skyrocketing costs can really be attributed to doctors or technology in any big way. When I was getting my heart surgery in the late 80s, the Catscan machines and EKG machines were very expensive. As I understand it, as a layman who's simply spent a lot of time talking to doctors, a great deal of the money is going into administration, insurance, and prescriptions. I would call those the big three reasons, based on my understanding.
May I ask what you would do to help those 45m who are uninsured in the capitalist system you were describing?
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Doctors are making less, but the reason for that has to do more with rising malpractice premiums, competition in the medical field and the application of simple economics to the equation (i.e., there's no need for a doctor to pull your ingrown toenail when a physicians assistant can do it for much cheaper) than a nefarious plot by the insurance industry. Whereas I twice had doctors work on my inflamed toe due to a nasty ingrown nail in the 90's, when it happened again 2 years ago, the nurse practioner took care of it and did a great job. My doctor spent 5 minutes checking her work and then went off to do something else. He didn't have a nurse practioner/physicians assistant 10 years ago.
New technologies cost more than I think you realize. The cutting edge machines can run into the millions of dollars now, but I'll conceed the point for the moment since it's not a huge part of my equation. Administration is another large cost, but no more so than in the past, even with HIPPA.
Malpractice insurance varies greatly from doctor to doctor. Some (usually general practicioners) buy it individually. Most buy it through a group or hospital. Malpractice coverage skyrocketed a few years ago for a few reasons, one of the chief ones being that some new models came out showing that claims were beginning to skyrocket. Illinois's largest malpratice carrier is a mutual (meaning it's owned by its insureds), and they had to charge a significant increase in order to stay solvent. The reason for the model changes came from the number of new malpractice claims out there as well as the higher verdict amounts. Many lawyers found some easy targets in the medical community, particularly among doctors with addiction problems. Whether the doctor did anything wrong or not started to become less relevant since a cocaine problem basically demonized the defendant from the start.
will, I'm a liability broker. You're lucky that I know all the big words that I do. I can't fix anything because it's not something I have any hands-on knowledge about; ask me about fixing the 3rd party liability system and I can offer opinions until I'm blue in the face.
That qualifier firmly in place, I will venture to say that some of the uninsured are just dumb. I can't be any nicer than that because if you have the ability to buy health coverage and chose not to, I find that to be a completely selfish and frankly moronic decision. You may be young and healthy today, but that doesn't mean that a Flying Elvis isn't going to come hurtling out of the sky and break your pelvis or that you won't develop drug resistant TB because jackoff thought it was ok to fly internationally on your flight to Buenos Aires.
That's not the position of the majority of uninsureds, however. For those who can't afford the coverage for whatever reason, I think that there needs to be an amalgom of forced placement and public subsidies. I imagine it working where the state pays the majority of the premium with the individual contributing what they can, possibly on a sliding scale. That doesn't work for the truly desititute, and I don't have a quick and easy solution for those.