ubertuber

There are two points I wanted to make - maybe to redirect our discussion a little. The first is a perspective quibble:

Cynthetiq - by not buying health insurance in your 20s, you didn't really opt out of the system. What you did was gamble everyone else's money that you wouldn't require urgent care. Thankfully you came out ahead. What would have happened if you had tripped and broken your leg? What if you had gotten meningitis and had to be rushed to the emergency room? What about appendicitis? You would have been treated, because, as so many have pointed out, the emergency department is generally required to provide stabilizing care. Do you really think that they'd turn you away if you couldn't afford an appendectomy, dooming you to near-certain death from sepsis when your appendix burst? Or would you have had the fortitude to say, "no thanks, I can't afford that operation, and it's not fair for others to pay since I opted out of the system. I'll go die now."? So truthfully, you were forgoing preventative care (which could have prevented and lowered the cost of some disastrous medical situations) but not actually removing yourself from the medical ecosystem entirely. Now it is my turn to ask: is it fair for my insurance company to end up footing your bills for emergency treatment when you think that you have opted out of the system?

More importantly, this thread is really missing the important points contained within the movie Sicko, and is therefore sort of missing an opportunity to be different from any other healthcare thread we could have. Sicko wasn't about people who are uninsured, whether through choice or poverty. It's not about the uninsured at all, which I know because Michael Moore told me so at the beginning of the film. It's about the idea that a privatized healthcare system is a fundamentally flawed thing. Here's the synopsis for those of you who haven't had a chance to check the film out:

Healthcare, when tied to economics and profit, doesn't deliver optimal care to the end user - you and me as insured people. Simply put, it is not in the insurance companies' interest to provide care to anyone. Any care at all represents a cut in the profit line that the company could have realized. That's why so many procedures/medications/specialists are run through a gatekeeper system. Managed care organizations put a tremendous amount of resources into strictly defining what "acceptable care" is. Why? Because realizing maximum profit means finding that thin line that causes consumers to think they are getting great/good/adequate care, and minimizing costs (care) enough to salvage profits. Even this small reference to the consumer that I just made is mostly fictional because I don't choose my healthcare plan. My employer does. So what Kaiser or whoever else ought to do is put together a plan and market it to employers such that they'll choose to buy in and enroll their employees. Guess what employers like... Cheap rates. So you've got two entities in the system that are looking outcomes that pressure the system in the same way - limited or cheaper medical care.

Here's a mental exercise for you. Take all of the Managed Care Organizations in this country and picture their annual profit or market capitalization. Now add those numbers up. That huge number represents the extra money that we spend as a population on healthcare to players that don't actually deliver healthcare. Remember, HMOs make money by minimizing health expenditures. And since they are beholden to the stock market, which is a set of pressures that operate in the short term, minimizing expenditures means minimizing care more than it means focusing on preventative care.

Now, I'm not a moonbat or pie-in-the-sky liberal. We wouldn't realize that huge number from the previous paragraph as savings in a socialized system. That's the money that would go into funding the program. And if all of that money went into funding the program and paying salaries at civil servant rates rather than private sector corporate rates, not to mention taking profit out of the equation, we'd be putting more money into care than we do now, without spending another penny!

Lastly, and on a personal note, I'm going back to school to pursue a career in medicine. This has made me more aware of the thoughts of doctors and students on these issues, though I obviously speak only for myself. Yeah, we want to get paid for our work, education, and risk.... But most people, maybe even the vast majority, go into medicine to help people. The idea of curbing treatment or only working with those who can pay exorbitant amounts, the idea of having treatment option limited by a parasitic industry trying to contain costs... Well, those ideas sort of turn my stomach, and I'm not alone.

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Cogito ergo spud -- I think, therefore I yam