National Healthcare - Questions
 

If virtually everyone who owns a car has insurance on their car, without government, why don't people buy health insurance the same way?

If virtually every building in this country has fire insurance without government, why don't people buy health insurance?

If a person is willing to pay for insurance on an auto, why won't they pay for health insurance on their children?

If every worker in this country is covered by workers' compensation (most states its run through private insurance companies) why isn't there health coverage for the non-working hours and for those who don't work?

If a 20-ish year-old is willing to send $xxx.xx on whatever they spend money on, why aren't they willing to buy health insurance?

If there is a crisis in this country with uninsured people, I generally wonder why people have not taken initiative on their own to protect the most important thing they have, their health? Perhaps some of you can help me understand.

a) people insure cars because the law requires them to (in the UK at least)

b) people insure their houses because the mortgage lenders make it a condition of the loan

c) 20 year olds don't buy health insureance because they KNOW that illness is a character flaw suffered by old people who just didn't try hard enough

Because at age 23, I can pay $60/mo. for comprehensive coverage on my car, but it will cost me $90/mo. for health insurance--and that health insurance STILL doesn't cover everything. It has a deductible that has to be met, and a $20 copay every time I do go to a preferred provider as well as copays for my prescription drugs. My car insurance also has a deductible, but I'm less likely to have to pay that, versus one for health insurance.

Quite frankly, I can't afford that. If I DID have the money every month for health insurance, trust me--I'd have it. But as is, I have student loans to pay, car insurance to pay, rent, food, and other basic bills. I don't go out often and I don't waste my money--but I still can't afford health insurance.

Car payments are optional, mortgage payments are optional, health is one of these things I haven't worked out how to live without yet.

:lol: :lol: :lol:

In most areas you need a car to get to work.

Health insurance with their deductibles, what they will cover and co-pays. The product isn't worth the money for people in their 20's. Even as I close into 40 I wonder what benefits insurance would help me with. If I had had insurance and gone into the ER when I thought I had had bronchitis, would the company have covered the x-rays and the Sarcoidosis tests and such? I seriously doubt it.

What is insurance?

Insurance is a way of paying someone a small amount consistently to avoid a very large amount in an unlikely event.

Car insurance? $60 a month, but I don't have to pay $20,000 when someone smashes my car.

House insurance? $40 a month, but I don't have to pay $200,000 when my house catches fire, or a tornado rips it apart.

Health insurance? $X a month, but I don't have to pay $X when my health goes.


Hold on.

Notice that I can put a price on the value of the car, the house, and everything else that is normally insured. Hell, you can buy mail insurance.

And these things that I have insured, they are for UNLIKELY events, not routine maintenance. If your car breaks down because you didn't change the oil, your insurance doesn't cover it. Insurance won't cover the replacement of your roof in 25 years when it starts to leak.

Let us put health insurance into the normal insurance category;

1. What is your life worth? I argue that it is infinitely priceless. You are willing to spend any amount of money you have to stay alive. All things staying the same (Ceteris Paribus), money is worthless if you are not here to spend it. Lets keep your kids and your legacy out of this for brevity sake.
How do I put a value on you feeling good? If you are in pain, how much money would you be willing to spend to have the pain go away? I would argue that it is a lot of money, but not EVERYTHING YOU OWN. Thus, we are now in an argument of relativity.

2. What are the chances that you will die? I argue that it is 100%. Did you know that if every person lived long enough, everyone would get cataracts? Those who don't just died before their cataracts came. Using this logic, it is a certainty that we will need healthcare, and it is no longer an unlikely event, as in fire and accident insurance.

With normal insurance, I can take the EXPECTED VALUE of the cost of repair or replacement of the insured item, and then multiply that by the LIKELIHOOD of a bad event occuring. I factor in inflation rates, types of vehicles and types of homes, and using statistical models I can come very close to predicting what my costs are going to be in the future; Statistics being what it is, I can only do this when large number of people are involved. Thus, if I want to take my risk away, I need large numbers of insured people. I won't go into the mathmatics here, you can research the statistical principles of insurance elsewhere.

But health... it is different. It is a state of being. Your body is the only one you have. Look at yourself in the mirror. Count the scars. What is your health worth?

What about that scary story you read about here (and elsewhere) about that healthy guy that got cancer, or that funky rare disease? The media is always sure to tell the public the costs of treatment in the private sector. Why? People want to avoid that, and they are interested in reading about someone else's misfortune. "Boy, am I glad that wasn't me!". Think of it like mental rubber-necking at a car accident.

How do you insure against that? The costs of my cancer treatment may very well be different than yours. You may live through your bout of prostate cancer, and I may die. I can't go back to the dealership and ask for a new prostate. I can't phone the real estate agent and ask to move to a different body. I can't (as a Canadian) comparison shop for my cancer surgery. How in the hell would I? I am not the expert...

So what do you do with private health insurance? You cover people for a list of very uncommon, yet very expensive medical procedures. You put people into groups (smoker/non-smoker, male/female, over 35 yrs old/under 60 yrs old) and you run a very complex algorithm to see what their monthly payments should be. Then you need large numbers of people in each category to round out the statistical model, and you make money as an insurance agency.

If you want more common procedures covered, then the expected value of your insurance will go up, because the odds are changing.

But what if you got a rebate on your insurance for putting in sprinklers in your home to prevent fires, and you went to a defensive driving course to be a better driver? You are changing the odds of very bad things happening, and you should be compensated for that... Is health the same way?

Should your insurer pay you to eat healthy, work out, get a good nights sleep, quit smoking, and have regular health check-ups? Some people say yes. Others argue that free will is more valuable than that.

Still reading? I would like to take this opportunity to thank you. I will finish by saying that comparing normal insurance with health insurance is a straw-man argument. They are not the same, and are so fundamentally different at the basic statistical level that comparing them only confuses matters.

Your final question is an Economic one, and one that frankly fascinates me; Why would you choose to spend your money on X instead of Y? You obviously see the benefit in health insurance, and cannot understand why someone would spend their money instead on cigarettes and alcohol, spinning rims and subwoofers... That is why people started studying human economic behaviour hundreds of years ago.

All I can tell you is that people get more personal good (utility) with their consumption set than they would by replacing some of their purchases with insurance. People are risk-adverse, that is true. They also try not to think about getting sick, old or dying.

In one respect you are correct comparing auto insurance to health insurance is an apples to oranges comparison. They are different. However, there are similarities. If your resources are limited you can make a choice between an apple and an orange for nurishment.

The probing question like you state, is how one goes about making that choice. How do people come to the conclusion to buy auto insurance and not buy health insurance.

"Auto insurance is mandated by law", but owning a car is not. I find the "by law" point to be somewhat superficial.

My gut tells me that people do not value health insurance because if they don't get it from government or work they won't make a sacrifice to pay for it.

My gut also tells me that there is no healthcare crisis in this country. People are generally satified with the level of healthcare they receive in this country. And, they generally choose the level of health insurance they want if they want it at all. I know there are exceptions and personally I think we have an obligation as a sosciety to care for the old, children, and the mentally disabled.

O.k. you might have to make me re-think my entire outlook. If people are so short-sighted that they don't do what is in their best interest over the long-run, perhaps we do need government to make their decisions and therefore require by law everyone to buy health insurance or provide it. I always thought that people wanted to be free to make their own choices, but if we conclude that most can't or don't understand the consequences of the choices they make, I guess we may have no choice but to make decisions for them. I would of course have to be one of those making the decisions for everyone else.

Free healthcare and manditory military service, does that sound fair?

Probably because young people find it to be too expensive and not justified on a risk/reward basis. The chances of a major illness at that age is probably very remote and approaches lottery winning odds. I'm just guessing here and don't have any data to back this up.

Because I can go to the ER at a not-for-profit hospital in town if something happens to me, conveniently forget my SSN and accidentally write down the wrong name. See, we have universal healthcare.

Peoples resources are always limited. Yours may be more or less limited than mine, or Bill Gates, but limited nonetheless. Hence my statement about relativism.


My gut tells me to look at health insurance expenditures across the entire economy, and make an informed decision. Americans are paying a large amount of money on healthcare insurance. I leave it up to the reader to find the evidence.

I agree with this statement entirely. It is often media sensation that produces the "Oh My God WE ARE ALL GOING TO DIE IN THE STREETS!" news story.

Granted, those exceptional circumstances make for good television, but the public is misinformed to think that those exceptions are the norm.

That's what I am here for. I cannot think of a better compliment in a debate. I appreciate that. Thank you.
Well, this is where Democrats and Republicans differ fundamentally in their ideology. Democrats would provide government programs to ensure societies best interests in the long run, and Republicans would educate the public to make good decisions on thier own. Alas, I think both ideas are good, and would prescribe to a third option of fairness and balance if given the oportunity.

I would agree that all citizens who have served their country in the Armed Forces should be given universal healthcare coverage. I also think that the term "Free Healthcare" is wrong, and it is my personal mission to have people stop using that terminology.

Everyone knows it is not free. It is paid by tax dollars. Taxes are high. Let us instead use the term "Universal Health Care", which represents the idea that every citizen is entitled to the same level of healthcare as every other citizen.

Don't get me started on healthcare....

I am 33 years old, have paid into private health insurance since I was 18. My family and I have made very few claims against health insurance....until this past year.

My son was born with multiple birth defects that have left him on a ventilator. It is likely that he will wean off of the vent within 2 or 3 years. I make too much for Medicaid, but due to my son's handicaps, have been placed on a waiver waiting list to receive some sort of government care. It is likely that we will receive aid within 2 years of the date of application.

IN THE MEANTIME...

My private health insurance company has thrown up roadblocks at every juncture when asked to provide the care necessary for my son. We get 30 nights of nursing a year, yet my son needs 24 hour supervision (read as, a competently trained adult awake with him) per his doctors' orders. At the end of the 30 days, they took the following stand:

1) We won't pay for more nursing, because our contract doesn't cover it.
2) We won't pay for your son to go into the hospital, because he's well enough to be cared for at home.
3) We won't pay for Durable Medical Equipment (his vent & supplies) beyond your contract...and by the way, you'll be at your yearly limit at the end of the 30 days.

If I were home every night, we MIGHT be able to make the supervision thing work. Problem is, I travel 80% of weekdays as a condition of my job. My wife can't stay up with him all the time, and care for him and our 4 year old daughter.

You want to talk about a rock and a hard place? They were basically leaving my son without ANY of the care he needed! (This has since been resolved - the terms of that resolution are confidential, but we're satisfied - but it took an act of GOD, signed in triplicate, sent in, sent back, queried, lost, found, subjected to public enquiry, lost again, and finally buried in soft peat for three months and recycled as firelighters. That and media intervention. ;-) )

Personally, I don't believe that we need more universal healthcare. I DO believe that better management of the current system will result in better care. I DO believe that care should be provided that has the best outcome for the patient, and at the best cost. In many cases, this means care at home...even when the contract doesn't specifically cover it. I DO believe that the legal shield of protection enjoyed by these companies when faced with bad consequences to their decisions should be lowered.

and I DO believe I'm done for now - my blood pressure is going up again....

The only insurance I will ever have is car, and that is because it is legally mandated. House insurance I may accept, simply because its often a condition of the loan.

Insurance companies calculate MY risk based on the risk of people SIMILAR to me. And by similar, its usually age. I know that I'm not like most people my age, and have a much smaller risk of car accidents and dehabilating health problems. I've never been ill enough to go to the hospital, and I'm rarely sick to the point of perfect attendance.

I know my risk far better than the insurance company, simply because they're basing it on my bracket and not me. Therefore, I budget for MY risk and save accordingly. I still insure myself from risk, without being subject to an inherently flawed probability model and accompanying outrageous prices.

I also believe both sides have merit but really wish the Republican philosophy was viable. Unfortunately it seems like healthcare especially hospitals are becoming less and less competitive.

Unless we can figure out how to instill free market competition we may be forced to adopt universal healthcare.

ScottKuma's example is a good one for the differences between auto and home insurance and health insurance. How do to plan for something like that?

If it was a car or a home you would write it off and get a new one. With a child, this is just a little impractical.


By the way, I don't have a problem with demanding public service in exchange for Universal Healthcare. I actaully think it would be a very good thing to mandate one or two years of service for everyone once they turn 18. This could be military service but it could also be community service or foreign service (like a peace corps type of thing).

The unconscious elitism expressed in the OP is simply staggering.

Here's an idea. How about if the people who own cars get to have their health care taken care of, and those who don't--say, the 27 million Americans below the poverty line--be permitted to crawl into gutters and die?

The crisis isn't people unwilling to pay for health insurance. The crisis is people unable to.

Jesus Christ. I've never seen such a "let them eat cake" sort of argument.

Exactly. I am sitting in this position right now. I need a car to get to my job and make money--therefore car insurance is one of those bills that has to be paid. But I don't make enough money to pay an additional bill such as health insurance. Consider this--I am a 23 year old non-smoking healthy female. Yet my health insurance will cost me $90/mo--and that STILL doesn't cover everything. That is coverage for a single female. Imagine what it would be if I had a family.

I wish there was a more affordable solution for everyone.

If health insurance were so affordable to the masses, companies would offer it.

I find it sad that supposedly the best healthcare system in the world is not a viable option for many.

You pay an outrageous sum for what? To be told what doctor tot see, to have to have referrals, second opinions, what THEY will pay for what they won't, high deductibles, easily reached lifetime maximums, co-pays on expensive and ever growing more expensive meds (if you are lucky).

So the service is not there for the people. The choices are limited and if you don't believe you'll get sick you weigh the negatives described above to the benefits and the negatives far outweigh the positives.

I suggest changing the system and making the industry more responsive to the needs of the people... not the other way around.

A few weeks back, i was half paying attention to one of hte talking heads on one of the sunday news programs - they were pontificating about the state of healthcare in the US...

they raised an interesting point...

Why should healthcare be tied to employment - so that when/if you lose your job for whatever reason - you are basically insuranceless...

Interesting perpective... but where else is insurance going to come from? Taxes? you can only pay taxes if you are working- but if you aren't working- you don't pay taxes..... but in some scenario where taxes pay for healthcare -- do even non working people get the same healthcare as those that do work? I'd ask the question is that fair... because I don't think it is - -but I'm sure someone would point out to me all the stay at home mothers and children that are entitled to get healthcare.

If taxes were to pay for healthcare, what about the person who has 6 kids - that's their choice... they should pay more than I do... but it seldom would work out that way because some bleeding heart would make the argument that 6 kids cost more money.

My employer allows me several choices of healthcare- and some cost more than others - I prefer to go to my own doctors rather than a 'managed care' type program -- I pay more for that... I'm not sure I'd want to lose that option. So would i have to pay more taxes for that? Already - -I tend to pay more than my share for insurance because 1. I rarely go to the doctor.. .and 2, as a single person, I don't pay half of what married people pay for insurance.. .they are covering two people (one of which is not working)

eh - i'm rambling...

Insurance is a very broken situation right now, and I'm not sure if it's even possible to right it...

You have said this over and over. I sure wish you'd post the basis for your opinion, because it couldn't be further from the truth.

It originated as a way to increase the compensation of employees without getting them taxed to death. Everything has grown from that original premise.


The question I want answered is "Why can't a self-employed (non-incorporated) person write off his health insurance premiums?"

Exactly. At my previous employer it cost $660/month to insure myself, my wife and our daughter. It was pre-tax but the fact is that most people don't have 8 grand per year to spend on insurance.

Bigben,
Those are some really interesting posts with a lot of useful ways of framing this issue. Lots of food for thought - thank you.

There are some people who truly need a car for work, but in my opinion, the vast majority WANT a car. Because it's faster, more convenient, and less plebeian than riding a bus.

I would maintain that for almost anyone whose work does not require him or her to drive a personal vehicle, they have CHOSEN the convenience of a car instead of choosing health insurance. Or, if you prefer, some have chosen cableTV/broadband for $90 a month instead of health insurance. Or, they've chosen to spend their time surfing the internet instead of working 4 hours a week at $7 an hour, which would net them the same $90. And yes, some people choose to have children they really can't afford. I'm not talking about children with health problems--I'm talking about people with minimum wage jobs and no plans for an education who decide to have kids, and then, once again, expect everyone else to pay for their choice.

I would further maintain that most supporters of government health insurance are just the same old group of people who want "everyone else" to pay their expenses. Except for politicians, who are happy to stir up class envy if it will get them re-elected.

If having health insurance were a condition of using an X-Box, we'd see a dramatic drop in the number of uninsured, without a new government program.

Thanks to Bush's HSA's you can. Too bad they need to be tied to an insurance plan and you can't just have a HSA without insurance if you wanted to DIY.

edit...oh, that was the deductibles. yeah sorry. Why can't you write off your premiums? damn.

A wise man (not me) once said "A tax is a tax is a tax". If you are paying part of your wage to your employer for health insurance, what is the difference than paying that money to the government in tax, and having a government run healthcare system? In my mind, there is no difference, other than taking out the middle-man (read private insurers)

So you want a tax break? How about this: "A tax-cut is a tax-cut is a tax-cut..."

Would you feel better knowing that your tax dollars went to provide ScottKuma's son with top of the line medical care?

Sorry to offend anyone with that statement, but I truly believe that it helps my side of the argument. The reality: Someone has to pay, or people are put between rocks and hard places.

That's a really short-sighted comment. Half of the country clears less than 30k. Most of those people can't afford kids but they still do. If they stopped having kids our population would shirnk and the system would collapse. Maybe CEO's need to take a pay cut so that people can be paid fair wages. There is no excuse for someone to make 10,000 times that the lowest person on the ladder makes.

I think it's the nature of the business. When you are taken to the emergency room after a serious illness/injury you are in no position to negotiate price. It's not like deciding whether you wish to buy their life saving service or not or have time to shop around. It does not seem to be competitive like other consumer goods and services.

Sorry if I have repeated myself, these topics come up from time to time and I just write whats on my mind at the moment and do not take the time reference the links of previous discussions.

It's interesting to me, the tradeoffs between private and public run systems.

On the one hand, government run stuff is generally considered innefficient. There is no direct competition driving performance increases - and at least in AU, we seem to have a proliferation of forms, procedures and stuff in government departments that look silly to an outsider.

However.... there is a flipside.

In AU, the only country that I have direct experience of, government is such as big buyer (or subsidiser... to me more accurate) that they have a strong influence on prices. The two examples that I can think of are general practice billing costs and drug costs.

Looking at general practice. Doctors can charge whatever they like, but in effect they are a bit of a club. The AMA (medical association) sets fees in a way that would not be acceptable in some other industries (petrol sales for example).

Ok then. The government here gives us a rebate on GP visits. Now - if the doc charges no more than this amount, then we can see a GP without paying a cent and there are arrangements for the bill to be settled directly between Medicare (govt) and the doc/centre. On the other hand - if the GP charges more, the patient pays it all upfront, then partially recoups the cost from the government later.

In effect, there's a strong pressure on GPs to charge no more than the govt set fee, at least in poorer areas.

Looking at drugs, we have a different situation with some similar outcomes. We pay a set fee for most drugs, now about AU $20 I think, regardless of their actual cost. The government rules on which drugs are eligable for support. For new drugs, my understanding of the process is something along the lines of

1) Drug company offers drug. Price per pack $500 say.
2) Govt agency says, no. Too expensive. Not effective enough.
Not enough need to get on the supported list
3) Drug company says, if approved, we can sell in volume for $450
4) Negotiation
5) Sale price, $400. Government pays $380. Patient pays $20. Volume
sales occur.

Obviously there are pros and cons. I'm not a policy expert. I'm just hoping that some of this is interesting/useful. I'm not saying that this is the best method or anything.

Private insurance is paid by individuals in AU. It's not tied to employers/employees in any way...

The fact that it is tied to work in the US seems somewhat of a quirk. No doubt there's an explanation and some advantages to your system.

That's extreme.

I was just checking some prices here. The top cover (family) with a local insurer costs AU $6200 per year.

At the same time, basic hospital cover with excess (some out pocket, no physio/dental etc) costs $35 / month for a single person. This probably excludes procedures relevant to older people though.

Most youngsters here (say 18-25) would just rely on the public hostpitals to patch them up, if they get into a scrape.

I think the key difference might be drug costs. Drug costs are covered seperately in AU - these are subsidized by govt (with the exception of the very new stuff). Otherwise, there must be something else you have which pushes costs higher.

Now THAT is helpful healthcare debate.

I want to give you a little kiss right now.

Hmmm. I studied the New Zealand healthcare system, because it tried and failed miserably.

I think you and I are on the same page. Tell me, what is the procedure to see a specialist (orthopedic surgeon) where you are? What if Diagnostic Imagery is required?

I wait, with bated breath.

Finally, someone who is not arguing, but contributing. God bless the TFP.

Why stop at CEO's? Why not entertainers, athletes, lawyers, doctors, commissioned sales people, pilots, trades people, middle managers, engineers, architects, politicians, investment bankers, or anyone else who might make an above average salary? Who do you want to decide the value of someone's labor, the market or a central committee somewhere?

Getting back to the point of healthcare, if everyone purchased health care especially healthy young people, premiums would generally be lower, assuming generally the same cost spread over a bigger pool of people.

If people got activly invovled in shopping and buying their own health coverage, the market would respond, service and product options would improve. Generally we have a small group of executives at major companies buying health insurance. So health insurance companies target their products and services to make those executives happy. It is ironic, but most working people with health coverage delegate that important decision to an "over-paid" executive. Perhaps they should take that responsibility, cut that executive, split the money and buy their own coverage direct.

The OP asks 6 questions. Asking questions is elitism? How do you go from questions being asked to having people "crawl into gutters and die"? Questions don't form arguments, stating a position with support does. I am actually seeking support or contrary points for an argument.

You state that it is not true that people are unwilling but that they are unable, do you really think this is true of 27 million Americans? Do you have any support for this?

Ace, you lost me on that one...

If everybody bought healthcare insurance, that does not necessarily mean that the average cost will be lower. Profits could easily increase, and the increased demand for insured services would cause the price to go up as well, negating any savings...

Executives are forcing insurance plans down their employees throats? They are choosing the wrong plans? I don't buy that, as a blanket statement.

I was wondering the same thing. It would seem like the gov would want to encourage folks to get insurance by making the premiums deductible for those not covered by an employer's plan.

When I was downsized/retired a few years ago the cost to maintain my employer's insurance plan was over $800 per month for my wife and I. Instead we signed up for $10,000 deductible catastrophic insurance for around $300 per month and even that is not tax deductible. At least the money put into our HSA is deductible.

If we have an insurance pool of 50 people who generate $1,000 in health care costs (keeping it as simple as possible). The average cost or premium for this insuance pool would be $20. If we added another 50 who generate $500 in healthcare costs, the new total is $1500, and the new premium for each in the pool would be $15. Insurance company profits are often based on investment income or managing the "float" more than it is on underwriting profit. If the insurance company has a bigger pool of money to manage, their profits will be higher, but that normally won't effect the underlying costs. So in this case if the insurer got advance premiums of $1500 rather tha $1000 and earned 5%, they would make $75 rather than $50. And, actually with a bigger pool of money the insurance company is less likely to want underwring profits and would use less risky investments to meet their profit objectives.

Who is the customer? The employer is writing the check for the plan, the employer picking the plan, the employer defines the specs for the insurers being considered to bid on. So I would say the employer is the customer. Therefore the insurance company want to serve the employer much more so than the employee. I think this is true even when the employee is paying part or all the premium costs when it is being done through the employer. If the employer says cost is more important than choice - the employees won't get to make choices, if the employer picks a plan that has $1 million cap - the employees get a plan with a $1 million cap, ettc, etc.

I am not suggesting that the insurance company doesn't care about the employee. It just seems clear to me that there is a hirerarcy, and the employee isn't at the top.

Okay, but what I am saying is

What if the 50 new people in the insurance plan consume the same amount as the last 50? Instead of them consuming half, they consume an equal portion?

Your example has them consuming half as much. What do the numbers look like if they consumed MORE?

What if we insured the people that had higher risk factors? They consume double?! Uh oh, those numbers don't look so good anymore.

Insuring everyone (even the really, really sick and 'expensive' ones) means that the rich people who can afford lots of bells and whistles in their coverage will actually get WORSE care. We don't allow them to buy their way to the front of the line, and we make them wait with the dregs.

Now, this is kind of the classic trade off, and Vilfredo Pareto talked about the optimisation process. Take one dollar away from Bill Gates, and give it to a starving guy so he can buy a meal. Bill doesn't miss one dollar, and the starving guy is infinitely more happy, because he got fed... Keep doing that, across the board, until people's marginal utility rates are equal.

If me taking something away from you does not make you unhappy, but makes someone else happy, I have created happiness by re-distributing the wealth between the participants, in a closed system. Hmmmm. This is a lot easier to say this than it is to tell you "You have to wait for your hip surgery because a small boy needs the funds so he can breathe. You will get your hip fixed, just not right now."

Who wants the job to tell rich people that theydon't get to buy healthcare anymore?
That is almost Un-American!

I think we have young healthy adults who avoid health insurance because they don't think they need it or would rather spend the money on other things. Then you have the people who really need it now and if it is available they will make sure they have it. Then there are the people you know they are close to really needing it and they make sure they have it if it is available. There is a tendancy for adverse selection when it comes to insurance. Perhaps, that is one of the bigger problems with premiums in this country.

Very theoretical. What if Bill Gate values his dollar more than his time, and you take his dollar, he wastes his time, and the guy you feed values wine more than food. It is possible that marginal utility rates don't change or actually worsen. Where on the otherhand Bill Gates would have happily given his time to train the individual who would have been happier receiving the training and then be in a situation where he could buy his own food and wine. I don't think you can manage marginal utility, I think each person has to be free to make choice, both the giver and reciever. I think any time you "take" it is a net bad thing.

Why not look at it on an individual level. If I stop doing X and it doesn't make me unhappy, and therefore I can do Y, which does make me happy, I have created happiness. You do this without taking from another. Would this be the most effecient way to generate increased happiness? I say yes, otherwise how do you determine what will make someone happy or unhappy. I don't think you can, you can only do that for yourself. It begs the question do we want a central committee somewhere deciding on what makes people happy and unhappy? I think those kinds of systems have always failed.

it seems to me that the entire logic of this thread is geared around an inability to think in social-system terms--which is of a piece with the refusal to take class stratification seriously--which leans on the assumption that an uneven distribution of wealth is a simple fact of nature and not a social problem---which enables a reductio ad absurdum of the question of health care coverage to an abstract matter of isolated, unqualified individuals and choices that are equivalent across all class positions.

there is nowhere to go with this way of thinking.

Not going to offend me... but I might point out: one of the problems is that I AM paying for the insurance...and I'm still being put between that proverbial rock & a hard place! (Please excuse me if this continuing real world example of the short-comings of private insurance is out of place.)

The irony of the situation is that if I weren't paying for the insurance, and if I weren't working - or even if I were working minimum wage - my son's care would be fully covered on the public's dime. Not only that, but he would be getting a higher level of care than he is currently receiving under the private plan. (I'm hearing that less-severe cases routinely receive 15 - 16 hours of nursing a day, compared with the 8 hours a day that he currently receives.)

What really cheeses me off is that the private plan is essentially waiting for the government to start picking up the bill, so that my son no longer skews their actuary tables.

After thinking about the above statement, the fundemental difference between my view of the world as compared to my soscially liberal freinds becomes clear.

Wealth can be defined in nature in different ways, for example in a pack of wolves - stronger, faster, smarter, more aggressives wolves (wealthier) rise to lead the pack. I see this as a fact of nature. I see this as social order. I do not see it as a problem. In fact I see it as effiecient. It is up to the stronger, faster, smarter, more aggressive to make sure the rest are taken care of. I think refusal to accept this order of nature leads to chaos and to the detriment of everyone.

So, you are correct in your observation. When you say there is no where to go with this way of thinking - it is also correct because it is like saying there needs to be a change in the way we look at gravity. There needs to be a reason to take us to a different level of thought. I have not seen one. If I have missed it, please let me know.

But your thread here blatantly ignores those unable to take care of themselves. You've said nothing that even acknowledges the existence of those unable to afford health insurance. You've attempted to pin the "insurance crisis" on teenagers who would rather buy new rims than pay an insurance premium. As far as I can tell, your interest in "taking care of the rest" is nothing but lip service.

You obviously have wolves on the brain...

No, I do not accept the "Wealth is like the natural abilities of a wolf..." argument.

Not to get into the "What is wealth" or "What is value" arguments of classical, neo-classical, marxist and keynsian economists, the wealth that you speak of is not wealth. Ability does not equal wealth.

Some economists say that certain birds can acquire wealth, through the building and maintenance of their ornate nests; I still think the argument is a poor one.

Strength, speed, intelligence, and agression have nothing to do with wealth.

I agree that the wealthy members of society have a moral obligation to provide support to those less fortunate. Nothing can change that belief. I think that it comes down to my belief in a perfect society:

Create a society where you define all roles and responsibilities and all allocations of wealth and privledge before any one person is assigned to a position. You must assume that you have the same chance of being Bill Gates the billionaire or John Doe the homeless guy.
You would see a dramatic increase in social spending, if people had the risk of changing places with those who they decry as loafers and beggars. That is the society in which I want to live.

Re-read my posts because what you state is not correct. I think we have an obilgation to care for the young, the old, and the mentally disabled. I also think healthcare can be made more affordable if everyone actively participated. In our current system "we" take a very passive approach to heath insurance. Ironically, we take auto insurance more important than health insurance. The basis of my OP is to understand why. I don't understand and I still don't.

I really thought that I had cleared things up a bit;

Ace, please don't worry. There are people that are smarter than me working on it. American healthcare is like a duck in the water. On the surface, everything is calm and serene. It seems that the duck magically floats from place to place.

Then you see under the surface, and see those little duck feet paddling like mad...

What does it take to aquire "wealth"? It is either luck or ability. I think luck is insignificant, so I see a clear connection between ability and wealth.

So, you have bees on your mind. The above is exaclty the way a bee hive operates. You are correct "social spending" is at its maximum. However, individuality is at its minimum. I would prefer to live in a pack of wolves.

that is a perfectly ludicrous idea.

Okay, they help ACQUIRE WEALTH, but they are NOT WEALTH, DEFINED.

Sheesh.

Bolding mine.

And here we are, discussing wealth and value.

edit: Calling my ideas ludicrous does nothing to contribute the free exchange of ideas. Please refrain from posts like that in the future.

How about hard work, vision, and goal setting?

Define less fortunate. If you are a lazy slug are you 'less fortunate'?


Life is not a lottery, we rise and fall based on our own merits. If you create a fantasy land like the above, what do you think would happen? Those with the skills and abilities and drive would figure out how to get where they wanted to be, and your lazy slug ceo would fail. The only way your society would make me a homeless guy is at gun point. Take away everything accademic of mine, I'd still find something to do to keep me off the streets.

I think that most people require transportation in order to work and many especially the young do not think they will need a doctor anytime soon.

Those without many assets probably figure they are safe to do without insurance as well since their emergency care will be taken care of with little fear of a hospital collection agency taking much from them to pay the bills.

Those who have assets and are uninsured or under-insured though are very much at risk of losing everything if they get injured or seriously ill. As one poster in this thread pointed out even those with what they thought was good insurance can find themslves in financial trouble after a major illness or injury.

Those are also ways of achieving success, but the term "Wealth" applies to an abundance of something, not just money.

You may create lots of money if you have a good work ethic. Some may even call you "Wealthy". I say that one does not need these magical skills you posess to be wealthy. You may be born into a privledged class and location.

In my opinion, yes. In my definition, I would leave out the terms 'lazy' and 'slug'. That's just me.



I think you and I are much closer than you originally propose; I am not talking communism here, but rather a set of rules that society follows that allows the rising and falling based on our merits. You do not want privledge to be passed on to the incompetent, do you? You don't want the meritous homeless child to be without any chance of improvement, do you?

I think I got this idea from Friedman, but any philosophy majors out there should correct me promptly. This is not a new concept, and I fear I am doing it a disservice by butchering the definition so badly. It is just this:

I want everyone to have the same chance, whether you are in a position of extreme wealth or poverty.

And I would beg to disagree about the whole lottery thing, Ustwo. I think you and I won the baby lottery, and are living in our repsective locations instead of Bangladesh, the Ivory Coast, Somalia, and 100 other countries. Do you catch what I'm throwing?

I get it on an individual level assuming many uninsured simply value other things higher than they do health insurance. However, I still don't understand the liberal point of view when it comes to healthcare insurance.

I live in the state of California, some consider it the most liberal state in the country. In my state, mandated by law, every worker is covered by workers compensation insurance, Except for The State Fund the system is done with private insurance companies providing the coverage. But there are children in the state without healthcare insurance. Why not mandate coverage for every child and have a safety net health insurer like the State Fund is for work comp.?

The city of San Francisco passes a law against gun ownership, clearly unconstitutional, and will end-up spending millions trying to either enforce this law or defend it in court, but won't spend a dime to make sure every child has health insurance in the city. Why?

PETA will spend millions on protecting endagered owls, but won't spend a dime on making sure children get proper healthcare. Why?

Barbara Striesand could do 4 performances a year, and raise enough money to insure every child in the state, but she doesn't. Instead she spends time complaining about Bush. Why?

Deadbeat dads will blow thousands on a few trips to Vegas every year, but won't buy heath insurance on their children, and are not forced to by law. Why?

You can not drive a car off of a dealer lot without proof of auto insurance, but you can take a baby home from the hospital without proof of insurance on the baby? Why? I could go on but hopefully you understand what I am trying to say.

Is insuring everyone important, or not? It clearly is not, so why pretend that it is? This is what I don't understand.

I can answer this one. Because according to PETA humans are the enemy.

Ben I think the problem is, what you are advocating is as against human nature as communism. I have a son myself, 16 months, obnoxiously cute. I will see to it that he has EVERY advantage I can give him, I will work harder myself to do so, I will give him extra schooling if needed. He will not be spoiled, he will learn the value of hard work, and earning your own keep. This is what most parents want for their kids, trying to make it all equal would only work if we were all raised in a creche instead of families.

Why expand beyond your minium if you can't give it to your family when you die?

I see this in a lot of parents, not just wealthy ones. I know a waitresses who put her kids in private schools, its a prime motivator to give to our children. For every Paris 'spoiled rotten whore' Hilton there are tens of thousands of kids who enter the family bussiness or whatever and succeed on their own merit.

Life can NEVER be fair to everyone, its just not possible and when you try to make it fair it tends to make it far more funfair to a majority of the people than fairer to others. We already give out free educations, and have societies that allow upward mobility, something that is often lacking in those other countries you speak of. At some point you have to let people do their thing.

BigBen,

i accidentally hit the "post quick reply" button instead of the "go advanced" button. my interest was in the thread was already waining, just didn't have the motivation to go edit the darn thing. you were right to call me out, my apologies.

i think your heart is in the right place here (everyone should be given a fair shot at advancement in life), but you're going about it in all the wrong ways. what you're advocating are essentially marxist ideas that any student of human nature and/or history will tell you are misguided at best.

think of all the thread topics on this board... how many contain glowing praise for a major government program? and yet, some people think giving the same entity responsibility for our bodily health and well-being is a great idea.

the moral argument for national healthcare is even weaker. healthcare isn't a right. you have no "right" to go to the doctor. if a person's kid is sick... they have absolutely no right to take money from another person to pay the bills.

nationalized healthcare is essentially forcing one person to pay for another's responsibilities under threat of imprisonment.

can anyone make a serious case for justifying this? i'm not saying people shouldn't help one another out... but is it a proper function of goverment to force people to do it?

Great point.

I think that's a very legitamate question a person has to ask themselves. Would you be willing to put a gun to someone's head or throw them in prison to make them pay for your healthcare or the healthcare of a loved one. It sounds crazy, but that's essentially what you are doing by having government enforce a national healthcare policy or enforcing any policy for that matter.

For me, the answer is no. I cannot support a national healthcare program.

Another question, does anyone who supports a national healthcare program deny that you are basically forcing someone else to pay you by using the threat of imprisonment?

interesting to read the moralizing commentary above, particularly given that, if you actually think about what is being said, it amounts to the usual conservative claptrap about poverty----you get the petit bourgeois mythos of the Heroic Individual which stages individual financial prosperity as a function of one's gumption level, glossed with tedious robert ardrey terminology---that amounts to the adventures of the Entrepreneur overdubbed with duran duran lyrics about being a predator--very sleek, very flattering, wholly arbitrary....

those not enjoying the same access to opportunity (a factor bracketed like everything else concerning the social system by the duran duran school) should get nothing because they deserve nothing (their situation being a function of moral failing)
they should not have access to basic medical care.
they should simply die.
or convert.
why?
because these sleek predator types dont like taxes.
that is all there is to the posts from ustwo and irate above: moralizing nonsense wrapped around a dislike of taxes.
the logic, such as it is, in their posts would apply equally to any and all taxes.
curious that they do not pitch the same kind of claims in conversations about defense spending.
but apparently it is ok to squander enormous sums on systems designed to kill with great mechanical efficiency--but keeping folk alive and/or enabling them to enjoy some minimal quality of life--that is a problem.
go figure.


measures that enabled universal access to health care (and note that no particular plan is being discussed here..this thread is about swatting at imaginary flies) would function to increase system stability over the longer term
(this longer term is obviously hard for the duran duran school to think about, since for them the universe revolves around each and every one, and there is no timeframe not as short as their attention span)
to see arguments for such a system of health care,you would have to be capable of thinking about capitalism as a system, of looking at the long-term history of actually existing capitalism and not flee into the reassuring world of econ 101 diagrams and neoliberal ideology so as to avoid that history--if you looked at this history of capitalist systems, you would see--is is obvious---that capitalism has and continues to function at cross purposes with its own requirements for social reproduction. universal health care would be among the measures that could be implemented in the interest of compensating for the consequences of capitalism (as a mode of production).

this would entail the view that the distribution of wealth and opportunity is a political function---nothing about the views from the right above would allow you to get to this space because everything about these views is geared toward depoliticizing economic activity.
so maybe we should take this depoliticization seriously.
not only do i fail to see the analytic value of conservative economic ideology, so also i do not understand why conservative posts about economic activities are proper to a politics thread--perhaps another forum on rightwing fairy tales would suit them better.

The existance of a state run police force is essentially forcing one person to pay for another's responsibilities under threat of imprisonment. Really, why should rich people pay for the police protection for poor people?

My point is that we already have numerous systems that operate and provide services without your taxpaying ability effecting your reciept of those services. Whether or not you pay taxes, your roads are maintained, is having usable roads a right defined in the constitution? How about education, are you willing to cut off education from families that aren't able to pay for it? What kind of a country do you want to live in?

Funny you should mention that;

Is there such a thing as "Gated Communities" down in the states? Let us ask for a moment what that is...

Rich people subsidizing their police protection with private providers. These guards keep out the riff-raff, and the rich people get to feel safer than the general public.

Instead of spending the money for better policing in general, the rich folks want tax cuts so that they can spend their social dollars to benefit them specifically! Rise up, my fellow poor, and refuse to allow this anymore!

Gated communities are so lame. I think they are just another false sense of security. What's really funny is when a community has a gate and then there are a few really nice houses guarded by a second gate.

Do you like taxes?

I love taxes.

Sounds weird, doesn't it?

I can look at the situation reasonably. I would much rather have taxes than have the government go into deficit spending. That pushes the tax burden (with interest) onto the next generation, or the next...

I can see what my taxes give me. I take very little for granted. I feel privleged to be able to contribute to the well-being of others. Does that make me weird?

Why do you feel that taxes are bad? You don't want to pay to help others?

I don't want to be forced to pay to help others...

Saying you love taxes is pretty weird considering the current tax system is basically a huge pyramid scheme. You want to pay more money to the top of the pyramid while currently very little of that money ever makes it back down to the working class anyhow. Our corrupt leaders just loot it. I'd say it's foolish to want more taxes with the idea that it's going to help out people who need it.

Of course taxes really don't have that much to do with deficit spending. We have a group in power who has no regard for your money or using it wisely, and you want to give them more. Do you really think that if they increased taxes another 20-30% they wouldn't just spend over that amount too? Moreover would they spend it to 'help others' like you say, or would that money just go into the general slush fund to spend however they like as with social security currently.

whether i personally enjoy taxes or not is irrelevant, ace---unless you imagine that one's affection or lack thereof of taxes constitutes an analytic postion on their function. try to make the argument that your emotional response to taxation allows you to say anything about their function socially...lay it out. i dont think you can do it coherently. but let's see

As taxes would relate to this thread, taxation is not needed. People have the opportunity to voluntarily purchase health insurance. Given a choice I would rather retain the choice than to have a healthcare insurance system funded through taxation. Some government services are not condusive to individual choice, like national defense. So I think taxation is the best way to fund national defense. I would also prefer a system where those who are not able to purchase health insurance, i.e. children of irresponsible parents, have it provided through local taxation, as close to the source as possible. If handled on a more local level there can be increased accountability.

I hate giving others control over my money. It seems the liberal assumption is that if people control their own money they won't help the needy. This assumption is wrong. You saying you like taxes is important because it is like you are saying that if not through taxation that you would not do the right thing in terms of helping others. I hope I misunderstand your point. Why do you trust "government" to do what is right more than you would trust yourself?

While not the MOST elitist thing I've ever seen posted here, this comes pretty close.
First, lets talk about the bus versus a car.
In order to get into downtown LA from the 'burbs it takes 4.5 hours, and 3 transfers. (Thats 9 hours in transit, BTW.)
Live near your work, you say.
No. (I hate crime.)
For most americans a car is directly related to your ability to find a good job. If you think i'm kidding, try being late to your job 3 times a week because the buses don't run as predicted. (ALL temp agencies ask if you have RELIABLE PERSONAL transportation. No car, no job.)
Second, some of us don't work 4 hours @ $7 because we have kids that need our time and attention.
I am middle-class, and cannot afford unsubsidised health care.

Consider also that the uninsured rate for any proceedure is often twice the rate hospitals charge insurance companies. So the people that are least likely to be able to afford it are charged higher prices. How fair is that? (Not that anyone said life was supposed to be fair, but still...)

"The irony of the situation is that if I weren't paying for the insurance, and if I weren't working - or even if I were working minimum wage - my son's care would be fully covered on the public's dime. Not only that, but he would be getting a higher level of care than he is currently receiving under the private plan. (I'm hearing that less-severe cases routinely receive 15 - 16 hours of nursing a day, compared with the 8 hours a day that he currently receives.)"-ScottKuma

I was in exactly the same spot when my son got diagnosed with craniosinostosis. I had to get denied Healthy Families, (Middle class-ish sub'd ins.) then apply for medical. (They would cover the proceedure but were going to charge us more than if we just paid it all out of pocket!) So we then had to take all of our paperwork and re-apply to healthy families. (approved!)

"those not enjoying the same access to opportunity"-roachboy
This is the reason i called marvin elitist. It is also why i think Us2 is a little deluded. He talks about hard work, and merit, but (as far as i can tell) does not recognize the fact that it is his birth, quality of education, his whiteness, his gender, and his general health, (IE, His Socio-Economic Status) that has made it possible for him to have something to hand down.

Also, being in favor of taxes does not mean that i trust the government to spend my money more responsibly than I myself would. I simply trust the government to spend your money more responsibly than you would.

you're right, its not the most elitest thing. This is...

I used to believe in Santa Claus.

Give it time, you will grow out of this.

:eek: Wow. Just...wow.

It seems like you trust the government to tax us to pay for things that many do not believe in like national defense, R&D, highway construction, bridges to nowhere, education, etc... What an original concept. :)

I'm glad it helps. It's an interesting area actually.

Ok re specialists. Look I've not used them much... so I'm unclear on this.

Generally, we have to see a GP first if we want any rebate etc. The GP gives us a referral letter then we head off to see the specialist.

At that point I think that we can go private or public. The GP will probably have asked also whether it's a work injury or transport injury. The former is covered by a seperate (employer funded) scheme, while the latter is covered by our annual car registrations.

In the one case that I can remember, I had a suspected ganglion in the wrist. I was probably about $40 out of pocket (after medicare reimbursement) for two visits to the sports medicine oriented GP.

I had Xrays, free through medicare but carried out at the private sports-med facility. I also opted to have an MRI, which wasn't covered (private or public schemes) in this case. Cost about $100.

Then I visited a specialist surgeon, in an exclusive clinic, who charged me about $100 for a short visit. About 5min only. He advised against surgery actually, at this time. Not worth it apparently. I recovered some of this fee but I'm not sure the percentage. All prices are in AU dollars.

I just did a check. Here's a quote...

My interpretation is that the medicare schedule... is the government decreed fee. My guess is that the AMA sets a higher standard fee. Insurers however have agreements with some hospitals though... if you go to these designated centres on specific schemes then my understanding is that you are gauranteed no out-of-pocket expense. This effectively promotes both the insurer and the hospital I guess - the doc probably gets less than usual and the scheme probably pays more than usual.

This is all just outpatient stuff. Hospital procedures are still free in the public system (as best I know) - but there are waiting lists, depending. Waiting lists for "elective" surgery (which I understand to mean things like hip replacements etc) are one of the key measurement criteria for the hospitals and are usually discussed come election time.

As I said though... message me if you really want to know more. It's probably much easier for me to find out these things. Both medibank and medicare have shopfronts nearby that I can visit for example.

Links, if you are interested
www.phaa.net.au/links.html (from AMA Victoria)
www.medicare.gov.au
www.medibank.com.au

Others have already covered the "trusting the government" section, so I'll leave that one twisting in the wind.

Would you like to know what's quite a bit more elitist than my post? YOURS!!

Unlike literally millions of illegals who come here with basically the shirts on their backs, you're too good to live where they do. You're too good to work at the jobs they do. You're too good to ride the bus like they do. Your kids are more important than their kids are to them. Why is that? Are you better than they because you were born here?

And, because of the above, many of them are likelier to be happier, and more successful, than you. I've seen illegal Mexican and Filipino immigrants carve out quite nice lives for themselves, but none that I have observed did it by complaining, or "trusting the government" to take care of them.

And by the way, I specifically excluded kids with health problems in my post. I guess you missed that.