Willravel

Then I suggest you stop paying sales and income tax. Don't register your car, or ever call the police. Don't use public drinking fountains. Don't drive on public roads. Use your freedom to stop using those social systems. Maybe we can get everyone to stop paying for everything, and then you can be happy when we're in an capitalistic anarchy.

Cynthetiq

I don't have a choice to pay sales tax.

I can opt out of income tax at the risk of possible jail time and fines.

If I chose to not have a car, which some people in Manhattan have never owned on, I don't pay into that system of taxes.

Public roads are still funded when people utilize public transportation like bus systems.

I'm asking you a simple question and you've done nothing but provide mocking replies.

You are stating that it is going to be more money in everyone's pockets, I asked how. I demonstrated that when I opted out of medical insurance it affected my bottom line directly $100/month $1,200/year. If I pay more taxes or have more money withheld from my check, how is that more money in my pocket?

__________________
I don't care if you are black, white, purple, green, Chinese, Japanese, Korean, hippie, cop, bum, admin, user, English, Irish, French, Catholic, Protestant, Jewish, Buddhist, Muslim, indian, cowboy, tall, short, fat, skinny, emo, punk, mod, rocker, straight, gay, lesbian, jock, nerd, geek, Democrat, Republican, Libertarian, Independent, driver, pedestrian, or bicyclist, either you're an asshole or you're not.

Willravel

Overall, it's going to be more money in everyone's pockets. I'm not talking about cynth, the person who didn't have coverage and didn't get hurt, a.k.a. a fluke. I'm talking about everyone, in generalities. You've already made it clear that you're not willing to pay. Do you understand what that means? You're willing to screw over your neighbor for yourself.

Other nations have already shown how this saves money. Look at post #39.

The top 3 countries as far as per capita total expenditure on health:
All socialized.

Cynthetiq

Okay, I don't know what a per capita breaks down into someone's wallet. But again, I don't see how I'm "saving" money by paying into a system that I'm not utilizing.

And I didn't say I wanted to, please stop with the drama. I'm suggesting that where is the freedom to opt out. The basis for all of this country is the freedom to be in or out of the system as one sees fit for themselves.

I have had a number of friends who in their 20s to 30s didn't have any need for major insurance. Maybe Jazz can elaborate on some of those statistics. And, yes it is folly to do so, but it is again a choice.

I'd pay into a system as it stands now but I'm sure it's going to cost me more in this socialized system. Again, how is it that this saving me money?

__________________
I don't care if you are black, white, purple, green, Chinese, Japanese, Korean, hippie, cop, bum, admin, user, English, Irish, French, Catholic, Protestant, Jewish, Buddhist, Muslim, indian, cowboy, tall, short, fat, skinny, emo, punk, mod, rocker, straight, gay, lesbian, jock, nerd, geek, Democrat, Republican, Libertarian, Independent, driver, pedestrian, or bicyclist, either you're an asshole or you're not.

joshbaumgartner

I think that is a mistaken assumption. You don't have the option to opt out of paying for a military that you don't see as serving you. You don't have the option to opt out of paying for police or fire protection even if you are never victimized by crime or fire. You don't have the option to opt out of paying for the infrastructure just because you don't see benefit from it. I could continue the list to cover a good number of other things.

I agree that we ought to hold liberty in high regard. But I just think that you are very mistaken if you think that the freedom to avoid paying for anything you don't think you are getting requisite benefit from is a foundation of this country. If so, we wouldn't have a federal government in the first place. There were founders of this country that argued for such to be the case, and there continue to be Americans that hold that opinion today, but they weren't then and aren't now the foundation or basis of the country.

Willravel

I apologize over getting worked up. I've had allergy related nosebleeds on and off since about 4:00 AM, which resulted in no sleep, being sick to my stomach, and pretty bad headaches, and I'm in a bit of a foul mood. I'm sorry for snapping, and I'll be more conscious of my mood from now on.
I'm trying to figure out why someone would want to opt out of health care. If I remember correctly, you do have insurance now. That's because you're responsible for yourself. Someone who can afford health care but doesn't get it is, as Jazz has pointed out, a fool. They run a massive risk to save a buck. Again, this would be one thing if everyone were an island and no one effected anyone else, but your own experience with the motorcycle came from someone else's buck. When someone without insurance is injured or sick, they become a drain on everyone who does have insurance. So think about this opting out option. You opt out, you get sick. Do you die because you don't pay the hospital and they don't let you in? Or do you get treatment at the expense of those who didn't opt out? Either of those doesn't paint a good picture of opting out.
It's not just folly, it's a likely drain on the responsible payments of others.
You've lost me. Private = more expensive than socialized medicine is my stance. Are you changing your stance? Or have we ben misunderstanding each other?

host

Will & Mike.....I've posted in the past that, just 15 years after FDR died.....the poverty rate when JFK was sworn in was 30 percent.....LBJ did more to effect the halving of the poverty rate than any president before or since......

....and Mike....the top tax rate was levied on annual income above $400k....it was excessive, but it discouraged payment of the obscenely high executive compensation that occurs today.

will.... I can't agree that the working poor can afford to pay more than the FICA withholding that they today. Wealth distribution that relegates 150 million to 1/40th of total assets and 7/10 to 30 million of us is symptomatic if afailed system...

The working poor have a better method now, than under will's proposal....they get sick and they qualify for medicare if they have no assets and are too ill to work.

Your idea for reform will only protect folks with assets to lose, like a house or newer car or significant bank assets or other holdings. Our system cannot squeeze taxes from people one step from lapsing into medicare eligibility....so find another way. Those with assets large enough to preserve will and should pay higher taxes for guaranteed medical coverage.... but not the working poor.

Cynthetiq

Thanks host, that's what I was trying to articulate. The poor that are legal here have means to get some sort of healthcare already. I know because my mother in law goes to them. It's not easy as when she was in UK but she still gets all the care she needs currently.

She makes about <$18,000 collects some social security benefits already. So she'd be paying more for the system that she already gets benefits from.

Josh yes, I already pay for those, just like I pay for the public schools, even though I have no kids and my parents put us in private schools. I understand that you cannot pick and choose but here you are creating a new system. So I ask those kinds of questions because it is new and I'm jaded to paying more for things that I already don't use.

__________________
I don't care if you are black, white, purple, green, Chinese, Japanese, Korean, hippie, cop, bum, admin, user, English, Irish, French, Catholic, Protestant, Jewish, Buddhist, Muslim, indian, cowboy, tall, short, fat, skinny, emo, punk, mod, rocker, straight, gay, lesbian, jock, nerd, geek, Democrat, Republican, Libertarian, Independent, driver, pedestrian, or bicyclist, either you're an asshole or you're not.

Willravel

Medicare is a mess. It's about to run out of money and there's constant fraud. Under a universal system, everyone pays in, not just workers paying Medicare taxes. We create a massive pot. I'm not even necessarily suggesting that we raise taxes for the poor. Those that pay for Medicare are probably paying enough. Those of us that are paying exorbitant amounts for private insurance will instead put our money into the universal system, along with the funds that the less fortunate would have put into Medicare. Actually, I'm under the impression that Medicare taxes are a bit high.

The issue of fraud is an interesting one. I wonder how Canada deals with that. Anyone know?

jorgelito

First, let's be perfectly clear. It's not immigrants that are the problem, it is the illegal immigrants that are the problem. There is a big difference. There are other contributing social ills as well. Will, I did bring up illegal immigrants already. Anyways, no one is saying they should be denied treatment (that's not very humane is it?) but rather, they are one of the causes of stress or burden on a strained system (LA is a fantastic example). It's two different issues.

Secondly, healthcare is a choice and people can make those choices based on risk. I disagree with you Jazz that people are "morons" if the elcet not to have healthcare. Even those that choose healthcare plans have choices of levels of service depending on their risks and needs. That makes sense.

I did not have healthcare for about 12 years. Why? Because I was young and at lower risk for medical problems. However, since I was young, I was at higher risk for accidents etc so I saved money in a separate account for emergencies. In other words, I was responsible.

When I got my job at Starbucks, they gave me health benefits even though I was part time. That is one of the reasons why I CHOSE to work there. It's a great company and fantastic corporate citizen. I could have CHOSEN to work other places but Starbucks had better benefits. I then chose a plan that fit my lifestyle (which was considerably cheaper than the family plan) so of course it makes sense to have CHOICE in selecting benefits that meet your needs and lifestyle.

I then decided to improve myself and went to college and as a result, got a job with even better benefits. We all have CHOICES to make and are responsible for ourselves. I came from a poor, immigrant family. But we worked hard, acted responsibly and deferred gratification. I worked the shit jobs, moved up, kept moving up and made myself better. Everyone should have saved up at a minimum 6 months worth of expenses and put aside funds for emergencies too.

In between school and my job, I had to have have surgery on my hand. No insurance. I had to pay $7500 cash. I used my credit card and some of my savings. That's the way it goes. If I had insurance, they would have billed $25,000. As it was, they we're annoyed that I was a cash patient and had to do all these special things to "bill me correctly".

That right there is illustrative of what's wrong with healthcare. $7500 to $25,000 price difference is pretty significant. The only difference is if you pay or if the insurance company pays. If the insurance company paid, I would have paid $4,000 or more as a copay. Plus all the premiums and stuff I would have paid over the years (couple hundred bucks a month) add up. The difference between having insurance and not having insurance in this case would have been negligible.

host

I need to correct an error in my last post. The working poor and those not working, but who qualify via a means and assets test....when they need medical treatment, they apply for and receive another form of welfare benefits....medicaid....not medicare. Medicare is paid for by those who pay into the system a set aside from the FICA deduction from their paychecks.

You must be retired and receiving SSI, or permanently disabled as SSI defines it, and have that status for a year, before you are eligible to receive medicare insurance coverage, and in addition to the deductions from your income when you were working, medicare deducts a portion of your monthly SSI benefit check, which for newly eligible medicare enrollees, is above $75 per month, and those covered by medicare must also pay a monthly fee of at least $40 to a private insurer for the recently passed presciption coverage, and that $40 or more monthly premium covers "gap" fees for medical treatment that are not fully paid by medicare, and there is a $15.00 or so...."co-pay" required for each treatment "session" received.....vs. medicaid, which costs nothing when received, but is subject to collection efforts if child support of a patient is found to be in arrears, or when a recipient receives a lawsuit settlement or experiences an economic turnaround that results in asset accumulation....equity in a residence or extra income from managing to obtain a well paying job.

I suspect that the majority of medicaid and welfare recipients do not rise economically to a level where they accumulate "on the books" assets great enough to be pursued by state or local welfare benefits administrators, though.....

Ten years ago, I was pursued by a state welfare collections unit because my ex-wife had failed to surrender the weekly child support payments that I had reliably paid to her, for my son's maintenance.....while she also collected welfare. I was able to "head off" the state's attempt to collect more than $20k in child support and interest that it determined I owed....by attending a hearing where I produced several hundred cancelled checks which they examined and made copies of. They also commented that the $5,000 or so that my ex-wife had received in welfare checks had been paid back by her attorney after she won a judgment against the other driver who struck her car and injured her, resulting in her being unable to work while she recovered from the injuries and qualified for welfare benefits....

....all of the collection efforts by public agencies to recover medicaid expenses paid out, and the costs of litigation resulting from attempts to recover medical expenses resulting from accidents and injuries......and the expenses of insurance company administration and marketing, and the cost to the rest of us for M&A as I described in an example I posted a while back....Bill Frist's family's insurance and hospital care company, HCA, going public and then being taken private, generating huge fees for investment bankers and legal firms, during each financial "move"....could all be eliminated if a single payer medical treatment model could eliminate medicare, medicaid, and the mozaic that private insurance "coverage" is today.....

It's all avoidable "churning" of records and eligibility hurdles, fee manipulation, and profits paid to the owners of the private entities that benefit from the status quo. Can't we simply create an ISG, Baker Commission styled panel to study how France, Cuba, Canada, and the UK do payment for medical treatment, adopt the best from the panel's findings, and junk the mess that we "enjoy" today, and that doesn't cover (protect the assets against medical aggravated bankruptcy....and the resources devoted to working out those personal insolvencies that wouldn't happen from major illness or accident, in France or Canada....) of so many of us?

Don't forget that, two years ago, congressional leaders orchestrated the rejection of all proposed amendments to now existing bankruptcy "reform" legislation that coukl have exempted from the "reform" those households who were bankrupted by unexpected medical expenses? The Harvard study used at the time to justify the exemption amendments, persuasively demonstrated that at least half of those forced into medical expense triggered bankruptcy, were insured for at least a portion of their medical expenses, and were bankrupted despite being covered.........

....and .....sigh..... jorgelito....good for you....bettering yourself....but what you did is not a solution for folks with lower IQ's and aptitude than average...somewhere potentially encompassing 40 percent of the working age population. If your personal anecdote could be applied universally, how do you explain the fact that 150 million....half the population, own just 2-1/2 percent of all US assets? Do you dismiss this result as a symptom of laziness, other priorities....or, what? Do you shop for groceries or consumer goods? Do you stay in hotels, or have your garbage collected, your car washed....etc...etc...
Doesn't it occur to you that your anecdotal experience if ludicrous when you attempt to apply it universally? How many low skilled illegal immigrants would it take to replace all of the low paid, low skilled workers who we encounter in our everyday lives, if they all simply "did what you did", tripled their incomes?

How much would a hamburger cost at Mickey Dee's....in that kind of a world that is never gonna happen....and who would cook it, serve it, slaughter, butcher, pack, and deliver the beef that it was made from, and shovel the manure away from the animal that donated the meat for your burger?

Can you not look past your own anecdotal life experience to consider that your solution was beneficial to you, and sooooo much of it was beyond your own control....you didn't choose your parents, your genes, your IQ and other abilities that you found yourself in possession of. Consider that you experienced a fortunate accident of birth, timing, and circumstance. One sixth of the world doesn't have access to clean water, and 38 percent of US children are in households with income below the poverty line. Half of us have lower than average IQ's. Some of us are not fully using all of our given intelligence quotients either.

Translation....your anecdotal experience of how you came to afford and maintain private health insurance coverage speaks more of what I think that you ignore about the situations and potential of those without coverage, than it does about a solution of much practical potential to mitigate the health care distribution problem.

I suspect that you think Michael Moore could better have spent his focus and resources than on making and promoting "Sicko"....don't you consider that Bill Gates and Warren Buffet are giving away so much of their wealth because they regard it as a windfall that they were as fortunate to obtain as they were diligent, hard working, and resourceful to obtain?

Are the folks living in the US with IQ's below mean and other limiting attributes, i.e. with lesser abilities and circumstances than you found yourself with, any less deserving of access to medical treatment that doesn't humiliate them or bankrupt them, than someone living in France....or you.....are able to receive? I'm asking because the main point in your post seems to be that they are less deserving....that you have decided that they just have to put the effort and discipline that you put into getting where you are....in a comparatively short time, too....in your anecdotal example.....and then they would achieve what you have managed.....

What happened to all of the folks who were just as smart and hardworking as Gates and Buffet....not even ten others in the world come close to their material success.....

jorgelito

Yeah, I agree with you there Host. I would definitely be interested in seeing a panel or group study this problem. Also, I am very interested in the UK, Canada, and now the French systems and would like to learn more on how they actually work. Sounds a bit "too good to be true" sometimes.

You made an interesting point too about how the bankruptcy laws changed to omit medical bills from bankruptcy procedures.

Something in the middle just doesn't add up. The reason I shunned health insurance before was because I would still pay a lot even with coverage. I had 2 dental insurance plans from 2 different providers. It should have covered the entire cost of my procedure but instead, I was billed for more than a third. It's not hard to imagine an accident causing a person and their family to go bankrupt over medical bills. It actually happened to my uncle.

There has to be a better way, a good reasonable compromise for all parties involved.

Someone must know.

noodle

I just saw Sicko last night... well, most of it because the end was missing from the copy we got. I recognize that this is a little off topic, but I got so frustrated at my SO's reaction. Maybe this belongs in the other Sicko thread, I honestly didn't read it yet. My SO works for BCBS in the computer part and has no idea what I have to deal with on a daily basis with my kids. He was floored and upset at the stories from France. "We should live there," was one of his first responses after a few days ago having a conversation about taxes and not having access to so many of our "rightfully owned" money. So, here goes....

Okay, I work with dying kids so I'm a little skewed in my views of the insurance companies. But one of the things that I've learned to appreciate about the Un-Great State of Florida is that as long as you are paying something comparable to your income you cannot be sued or sent to collections for medical bills. For example, there was a mother I worked with who spent 9 days on life support in a hospital. She had Medicaid and Social Security... which obviously doesn't like Life-Supportesque treatments... and since her income was less than $1100 for two people, she was only required to pay $5 a month to the hospital after the insurance paid their paltry percentage. Medicaid sucks ass. I refuse to give them any credit because I'm tired of $147 a day to pay for a child on Hospice's services. But, I have to give the industry credit... they knew that they would never get the full close-to-a-million-dollars back that they were unable to choke out of Medicaid and Medicare for a COPD patient. But they took her $5 a month as what she could pay. Her medication copays were almost $500 per month so she didn't take half of them so she could afford her psychotic 10-year-old son's meds. It was one of the saddest situations I'd ever dealt with... and it wasn't in my current field. She worked her ass off in minimum-wage jobs from the time she was 15 until she got sick and actually felt guilty living in Section 8 housing and getting SSDI. And yet, her insurance wouldn't take care of her.

Now, I work with kids who have "potentially life-limiting illnesses". This being cancer, MS, cerebal palsy, every kind on encephalopathy you can imagine, short-gut syndrome... all of it. It makes me ill how the insurance companies suck the life out of these families. And how some of the families who were lucky enough to have the knowledge to get on a list somewhere end up with free diapers while others can't afford medication co-pays. Florida has a piss-poor setup for these chronic kids and one paperwork error can deny them coverage and create a pre-existing condition in a heartbeat. Honestly, I don't know how much better, financially, these chronic families could make it in other countries... the chronic kids didn't end up in the section of the movie that I watched. I have to fight to remind Aetna that chemotherapy can relieve pain and that, yes, the doctor AND the family know that the kid is dying and that the chemo won't save them. Try to get palliative care covered by insurance companies. It would be amusing if it wasn't so sad. They care nothing about trying to keep kids out of the hospital by providing home visits by nurses that will save an ER visit or primary care visit when that nurse can do the exam and consult with a physician. Oh, crap. This is my soapbox and it makes me very angry. To see some of it laid out makes me feel a little vindicated but also annoyed at what was left out. So, I'll jump off my soapbox and just be glad that at least Michael Moore was able to make people question the current situations in healthcare.

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ubertuber

Saw it today - thanks for the recommendation Will...

I'll have more to say when it isn't after midnight (pumpkins don't think fast). It was good, thought provoking, and thoughtful in a way that Fahrenheit wasn't. It's still a giant opinion piece full of cherry-picked anecdotes, but it's also full of content and good ideas.

__________________
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jorgelito

Here's another perspective on "Sicko". It is a well-written article that will help to balance out the discussion a bit.

Cynthetiq

That's just what I mean by having the choice of paying into a system. The cost of premiums is not cheap and can make the difference for someone who is just making enough to make ends meet, and not making it at all.

Also, if someone uses the system more because say they are a higher risk, more active lifestyle and the like, same payments?

will, in the Great State of California who pays for motorists that are uninsured? Everyone else does. There is uninsured motorists insurance. What does that do for you? I've never really understood that. I always thought of it as "double dipping" my premium. It has always explained to me that it helps to cover those that don't have any insurance and do get into an accident. What does that mean too? Jazz? So in your plan why not invoke something along those lines?

Jazz has explained in other threads, higher risk is higher costs to the insurance companies. I do not wish to extend discussion of risk into the realm of fredweena's kids because that's the point of the UHC system right?

__________________
I don't care if you are black, white, purple, green, Chinese, Japanese, Korean, hippie, cop, bum, admin, user, English, Irish, French, Catholic, Protestant, Jewish, Buddhist, Muslim, indian, cowboy, tall, short, fat, skinny, emo, punk, mod, rocker, straight, gay, lesbian, jock, nerd, geek, Democrat, Republican, Libertarian, Independent, driver, pedestrian, or bicyclist, either you're an asshole or you're not.

Willravel

Any time, buddy!
Pumpkins aren't tubers! They're of the genus Cucurbita! I'm so confused!

Watching MM, you have to get used to the fact that some of the information is cherry picked. I still think that all of his overall messages have been totally correct, though.
No one pays for motorists who are uninsured. If they are involved in an accident, you have one of two outcomes: the uninsured are not at fault and the insured pay for damages or the uninsured is at fault and is usually sued. We don't have a system where everyone covers the uninsured necessarily. My dad used to own a landscaping business here in CA, and one of his workers wreaked one of his work trucks. He wasn't insured to be driving the vehicle, so he had to work to pay back the damage.

Cynthetiq

I'm sorry but you have to be flat out wrong, otherwise there wouldn't be a jillion google pages of California lawyers touting Uninsured Motorists Cases.

I recall having to pay a subset premium for it when I was living in California. I understand that it is not required for the minimum financial liabilty laws.

__________________
I don't care if you are black, white, purple, green, Chinese, Japanese, Korean, hippie, cop, bum, admin, user, English, Irish, French, Catholic, Protestant, Jewish, Buddhist, Muslim, indian, cowboy, tall, short, fat, skinny, emo, punk, mod, rocker, straight, gay, lesbian, jock, nerd, geek, Democrat, Republican, Libertarian, Independent, driver, pedestrian, or bicyclist, either you're an asshole or you're not.

Willravel

What I mean is that if they hit you, you don't have to fix their car. If they hit you, your car gets fixed by your company (assuming you have more than liability), and if you hit them, both cars get fixed (again, assuming you have more than liability). They get the short end of the stick, and if you're hit and it's not your fault, you don't have to pay for their car.

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.

__________________
Cogito ergo spud -- I think, therefore I yam

Cynthetiq

If you are not insured are you not outside of the medical ecosystem? ER sends bills, so do the doctors. Is it because they give the "jorgelito" discount that your insurance company is paying some of it?

To answer your question, no it is not fair. I concede that point. But again, I paid for my motorcycle accident on my own. I was eventually reimbursed for it via insurance because of having an attorney. If I did not, if it was solely my fault then I paid for my own injuries, how is that not opting out of the health insurance system?

During the time that I was uninsured, so was my uncle. During that time he had an extreme case of diverticulitis (sp?) and was hospitalized. He had a operation which resulted in colostomy and was on that for way to long for his own stupidity resulting in some sort of complication and was in the hospital again. He paid for all the operations and hospitalization out of his own pocket.

My motorcycle accident resulted in me having a broken collarbone and whatever dressings and checks had to come from the accident. I paid for whatever bills came as a result of that ER visit and doctors follow up. I do recall asking the EMS what the cost of the ambulance was because a few years before my sister had been rushed to the hospital in Singapore due to a car accident. They breakdown for the ambulance service there listed using the siren as an extra charge. The EMS in the township of Englewood, NJ directed me that it was a volunteer service and that I was free to make a donation. I never made a donation afterwards. To my knowledge insurance companies do not fund or pay volunteer EMS services.

Currently in my neighborhood Hatzalah responds almost as fast if not faster than NYFD EMS with "legendary" response time averages between 2 to 4 minutes, NYFD is approximately 11 minutes.

__________________
I don't care if you are black, white, purple, green, Chinese, Japanese, Korean, hippie, cop, bum, admin, user, English, Irish, French, Catholic, Protestant, Jewish, Buddhist, Muslim, indian, cowboy, tall, short, fat, skinny, emo, punk, mod, rocker, straight, gay, lesbian, jock, nerd, geek, Democrat, Republican, Libertarian, Independent, driver, pedestrian, or bicyclist, either you're an asshole or you're not.

ubertuber

The point being, you don't have to pay, and you can get procedures without authorization from your insurance company. Hell, many "patients" in emergency departments give false names and addresses. Again, they can do this because they won't be turned away until their conditions are stabilized.

Your motorcycle accident was traumatic for you, but it doesn't even scratch the surface of how expensive hospital stays and emergency treatment can be. What if you tripped on your shoelaces, fell and hit your head resulting in a subdural hematoma, requiring brain surgery?

What I'm getting at here is that "opting out of the system" is a state of mind. In no way does this "choice" mean that you don't take part in the medical care system. The only difference between them is whether you choose to pay, if you are able...

As I said in my last, overly long, post, the problem isn't uninsured people as much as it is the effect that managed care organizations have on the entire system - driving costs up for all users, insured and uninsured.

Also, regarding your admiration for Hatzalah... They are not able to provide the most advanced portable care options the way the hospital crews and FDNY do. They're not always speedier - that depends on your neighborhood and the "flow" in the city's EMS system that night. Lastly, and most importantly, regardless of what your quoted passage says, Hatzalah can and does refuse care and transport to people based on their medical conditions. I have personal experience with this from my days managing college Residence Halls. I'm talking about conditions that were serious enough that attending physicians in the hospitals would ADMIT the students in question for multi-day treatment. These students were effectively discriminated against by people with vastly inferior medical training. That's not a system I would want to have to rely on.

__________________
Cogito ergo spud -- I think, therefore I yam

host

Less than 2 weeks ago, near the bottom of post #4
http://www.tfproject.org/tfp/showpos...41&postcount=4
...for the second time on this TFP politics forum,I posted this data:


Aetna Net Income Avl to Common (ttm): 1.73B
Humana Inc. Net Income Avl to Common (ttm): 405.93M Total Cash (mrq): 4.42B
Unitedhealth Group, Inc. Net Income Avl to Common (ttm): 3.96B Total Cash (mrq): 9.92B
Cigna CI Net Income 1,133.0
HCA Income From Total Operations (mil) (FYE) 1,424.00


15 percent of $13,620 billion = 2,043

1.73
.405
3.960
1.133
1.424
_______
8.652 ....so, <b>.423 of one percent</b> of US Healthcare expenditures ended up as net income to just five healthcare insurers...although part of HCA $1.424 billion net profit came from European operations and profits from the hospitals that it also operates.....

....add Wellpoint, a Blue Cross, "for profit" franchisee, operating in 14 states, annual profit:
<a href="http://finance.yahoo.com/q/ks?s=WLP">Net Income Avl to Common (ttm): 3.15B</a> and the obscene executive pay and dilutive expense to it's outstanding common stock, caused by creation of new shares exercised by Wellpoint executives:
http://finance.yahoo.com/q/pr?s=WLP

....and the annual net income to just six major "for profit" US insurance providers amounts to $11.8 billion, <b>or .570 of one percent</b> of entire US expeditures on healthcare.

Consider whether there would be savings if the expense of overhead and exorbitant executive compensation, not counted in the net profits of these six for profit companies, (as well as from all of the other insurers...) was also eliminated. What do they spend on advertising, investor relations, perks for executives not counted as income, lavish HQ's, M&A, recruting, travel and other expenses that are unnecessary in non-profit structured entity.....

Picture a funnel where premiums are paid in on the wide end, and profits end up flowing only to a small group of executives and passive investors and the lawyer, accountants, advisors, and ad executives who receive payment expensed from premiums collected, to enhance growth that keeps the stock price rising and throwing off dividends....THEY ARE IN THE BUSINESS OF SELLING STOCK..... their insurance business if just a "model" to act as "bait" to attract investor demand for the stock.....look below at the value of exercised stock options...in just one year....of such a small group of Wellpoint executives: http://finance.yahoo.com/q/pr?s=WLP

<b>Consider that the above "model",,,a system that rewards just a few... is the reason that 150 million own just 2-1/2 percent of total US assets, and ponder why you are soooo resistant to taxing the shit out of folks like the HCA Frist family and the Wellpoint executives.....is it because you hope one day, to be "just like them".....what does that sentiment do for the rest of us?</b>

The $11.8 billion profits of just these 6 companies would provide $6000 annually (or $500 per month) to pay for non-profit monthly insurance <b>premiums for 1,966,666 individuals, or 4.37 percent of the 45 million uninsured.....</b>

EaseUp

It has been necessary to use the scroll wheel quite a bit in this thread. Therefore, I may have missed the part where someone provided an answer to the question of our 800 lb. gorilla, namely, what to do with 13 million or so illegal aliens who feel entitled to US health care.

Michael Moore was on Leno the other night. While I have no respect for him, due to his massive and deliberate distortions in prior films (as well as his tactic of "interviewing" people with Alzheimer's) he came across as almost likeable and unbiased in that interview.

I may just go see this movie, but due to his prior practices, I won't accept any of it as truth until I'm able to research his content.

ubertuber

EaseUp:

Check out jorgelito's post 95. It's an article which did do some fact checking on Moore.

I'm sure (I hope) that we'll see more followup on this issue. To me, his framing of his perspective was less egregious than it was in prior films. Anyway, the only way to know what you think is to check the film out and follow up on the issues yourself.

__________________
Cogito ergo spud -- I think, therefore I yam

jorgelito

Actually, Cyn, the rate I got was not really a "discount" but rather closer to the "true" rate or price. In other words, the inflated rate is billed to insurers to cover the costs of all the uninsured people who cram the ER. So in my case, it's a love hate. They loved that I paid "cash", but hate the fact that they couldn't jack up the bill to an insurance company to cover the deficits from the uninsured.

So in a way, yes, the uninsured (that don't want to pay) do drive up costs whereas those of us that were uninsured (like Cyn and I) were willing to pay if we needed care. SO we were willing to take a calculated risk that we wouldn't need any care during our youth and thus, save on insurance premiums etc. And because I didn't have insurance, I was more responsible with my health. I also put aside money for emergencies. In my case, it appears to have been a well justified strategy.

I have heard that auto repair operates similarly.

Host,

I had a little trouble understanding your last post. Let me try and reiterate:

Is the implication of the "funnel" effect that the few insurance agencies at the top are making enormous profits at the expense of the rest of us? I used to suspect that too but the insurance companies are always crying poor that they can barely make a profit due to malpractice, liability, covering the uninsured (through higher costs). I do agree that is seems "overhead" is rather exorbitant. I can't prove it though.

I think health care is an interesting "product". I'm not so sure it should be treated like a regular service/product in a free market system. Can we really apply liberal economics to health care? I really don't know though.

Do you think creating a higher tax bracket or taxing the highest income bracket group a higher rate is the solution to health care?

This could be a step in the right direction. At the very least, someone is trying to do something about it.

http://news.yahoo.com/s/ap/20070630/...2WW1SOfuxa24cA

Cynthetiq

Lying to get ER care is fraud and a criminal act and should be treated as such. It is a felony to lie on a mortgage application.

My point with Hatzalah is that they are like other volunteer organizations not funded by any government or insurance monies. In my case they will be here faster than NYFD because many of them live in my building. The closest one is just a few floors away. I have no pride of their service since I have never used them. I just know many of them since they are embedded within my building. One of the vehicles is stored in the same garage that I park my car in a couple blocks away.

I cannot imagine the liability or lawyering that would take place had that student died because of the decision.

As far as opting out, again, I'm not opting out of the medical industry. I don't think that is feasible in any manner. I was opting out of the INSURANCE industry. Please note that big difference.

As Jazz explains it is about managing risk. I managed my risk to my knowledge and in my opinion came out ahead. My premiums would have cost me about $100/month and I was not paying into any insurance for 4 years totally about $4800. My medical expenses from my broken collarbone was just over $2,000. I saved a little less than $2,500 by not paying into any insurance plans.

EDIT the above figures are based on my current premiums. I spoke to one of my friends/coworkers from that time period and his premium was $300 if not more since the company was a small <100 employees. Adjusting those figures would have been $14,400 for 4 years. I definitely came out $12,000 ahead.

Fast forward today, and I no longer have that luxury.

I have been to the ER 4 times in the past 8 years, 3 of which netted me being admitted. One admission (thank you Daddy Quadro!) was overnight copay for ER waived, I don't recall the deductible for the room, I imagine it was small. The other 2 were admission for pancreatitis and resulted in stays for 7 days. Insurance paid for 1 of the hospital stays costing me a small deductible, the ER fee $75 was waived because I was admitted. The other not paid due to a paperwork error, I switched coverage from my own to Skogafoss. Insurance company stayed the same, but the coverage number changed. Almost a year later I was served with papers taped to my front door (apparently legal method of serving papers in NYC) to the amount of approximately $15,000 for the hospital stay alone. The doctors were another $2,500. The hospital was the same as the first, I assume the costs were the same.

Had I no insurance, it would have wiped out whatever savings we had and I would not be sitting in my owned apartment in NYC , but still renting in Long Island and in debt with medical bills.

__________________
I don't care if you are black, white, purple, green, Chinese, Japanese, Korean, hippie, cop, bum, admin, user, English, Irish, French, Catholic, Protestant, Jewish, Buddhist, Muslim, indian, cowboy, tall, short, fat, skinny, emo, punk, mod, rocker, straight, gay, lesbian, jock, nerd, geek, Democrat, Republican, Libertarian, Independent, driver, pedestrian, or bicyclist, either you're an asshole or you're not.

host

Does anyone else think that Moore interviewed Charlton Heston, while Heston was impaired by Alzheimers disease, or....that it could have been a "tactic" by Moore....to do that intentionally?

If you agree with EaseUp....do you wonder where he got that idea? It wasn't reported like that in any "news" reporting....but it was an accusation that received great "play" in conservative supported pundit circles. They are "circles", because they are structured in a closed loop,

If Lauer's aggressive, televised for immediate broadcast interview of Heston, at least a year, and maybe 18 months AFTER Moore's interview of Heston was filmed, was not criticized as an ambush of an impaired person, why is Moore's criticized? Why did Heston continue as NRA president for at least 18 months after Moore interviewed him, and for nearly 8 months after Lauer's Sept. 6, 2002 interview?

We know for fact that "Bowling for Columbine" was screened at Cannes before May 15, 2002, and that it contained the Heston interview. We know that Keston did not announce the diagnosis that included "Alzheimer Like" syymptoms untill 3 months after Moore's film was screened at Cannes. We know that movies of a high enough quality to achieve mass US distribution require months in post production and final edit. We know that Heston was the public spokesman for the NRA, a national lobbying organization with a major, and post Columbine in 1999, an even more than usual contentious presence.

It is reasonable, given the facts, to believe that Heston, an elderly man diagnosed with prostate cancer in 1999, and who had a drinking problem serious enough to trigger three weeks of inpatient rehab in June 2001, just a year before Moore interviewed him in 2001, was impaired for several years before Moore arrived to interview him, on a day's notice. Heston was then, and for nearly two years after, president of the NRA, giving in depth, TV interviews as late as 18 months after Moore's interview.

Given these facts, the Alzheimer interview "tactic" EaseUp posts as one of his reasons for his negative opinion of Moore, is not a reasonable objection.

....and that is another example of a major impairment for actual discussion potential on this forum. We "know what we know", and we post accordingly. Then....some of us are challenged by "stuff" that shaped our posted opinion. It is challenged....and then it happens another time, and another...and we lose interest, and we stop participating.....<b>but the forum continues, and there is less discussion, but the "stuff" that "everybody knows....and some people say"....is called out....for what it is. This is a politics forum...it isn't Foxnews:</b>

The following interview of Heston by NBC's Matt Lauer on the Today Show, took place 4 months after "Bowling for Columbine" arrived as a completed film at the Cannes Film Festival. and no one, proabably a year later then Moores's interview of Heston, accused Lauer of "interviewing

reconmike

Oh my, Host with another threadjack, an op about healthcare and Moore film relating to it, has turned into whether Heston was senile while he was interviewed. Complete with interviews raging from Lauer's to a cut and paste of the fact release of him being reelected to another NRA presidents post.

Why Host to you feel the need to pick a one line statement out of a post and run to cut and paste tons of shit? Which actually has nothing to do with the conversation at hand? Let me refresh your memory, this op is about the propumentary sicko, the health care crisis and how things should be dealt with.

__________________
Where is Darwin when ya need him?

ASU2003

I just saw this movie today, and I am too sick to leave my apartment. (figure that one out…) Normally I am a healthy 20-something, but I got a cold (I think) last week. And today my right eyelid is so swollen that it doesn’t open. I have a sore throat and lost my voice too. Add in the coughing and runny nose and I should be quarantined. But have I been to the doctor, no.

Now, I have decent health-care, and ‘should’ get a medical opinion to make sure it isn’t something like mono, flu, pneumonia, bronchitis, sinusitis, etc… that I don’t know enough about to diagnose myself with. Would a pill cure me faster, or would I look stupid and waste the doctors time for having an un-treatable cold virus? But I have to pay $125 anytime I go and see a doctor until I reach my high deductible amount in the HRA plan that I have. My monthly premiums are lower, and it would cover my ass if I got really sick and had bills over $3000, but for simple illnesses I am on my own and paying $1000 to United Health each year for this 'health insurance'. I could pay twice that amount but only have to pay a $20 co-pay to see a doctor anytime. Now it feels just like a fine I have to pay to the police for speeding anytime I see a doctor.

I am the person this movie was talking about. Not the no-income person who can use the services available to the poor, and not the richest people who don’t care about $125 to see someone for 10 minutes and tell them that they have a cold. The people who pay for health insurance but can’t or don’t use it because of the expense they have to pay.

At my job, we get 0 sick days. Sure we can take time off, but it is without pay. We can use vacation days (14 per year) as sick time if we need to. So I make sure if I am physically able to make it to work that I am there like a good American. I went to work last week, and let’s just say that there should be something like manager approved sick time when your fellow employees don’t want you around them. I also went to eat at some fast food places and to the grocery store, so I might have been around you.

As stated previously in this thread, I worry about ‘socialized’ health care for reasons like cost (even though I already pay $721 each year into Medicare that I personally can’t use). Would my taxes go up more than the $1000/year that the for-profit company is charging me? Would I have to pay for all the Americans who drink, smoke, have sex, have risky sex with random people, eat too much, don’t exercise, are older than me, have more kids than am able to support, and make other life choices that I don’t make (I would choose to have sex…).

So, that leaves us with a discriminatory health care system that I would support. Who would pay more; the wealthy, the unhealthy or the unlucky? Or would the costs just get added onto the national debt that nobody cares about? Basically, I would like a health care system run by a small government agency that lists the procedures that are covered and what someone has to pay out of their own pocket if they need them. Most illnesses and accidents would be $0. A standard yearly fee would cover these things that can happen to anyone, and no one wants to have happen to them. It would cost $0 because not seeking treatment causes more harm to society than getting a medical opinion and fixed.

Preventative measures would need to be rewarded and choosing to be more at risk needs to be taxed accordingly.

How you deal with illegal immigrants, trial lawyers, bankrupt poor people and people who have multi-million dollar hospital stays that can’t pay for it are to be discussed some other time. And would it create country-club like hospitals where you have to pay $10000/year to be a ‘member’ and have a personal doctor that really knows you and checks up on you on a weekly basis, but there are never any lines and they have the best equipment?

pai mei

I am from Romania, I broke one arm this year, I went to the hospital, they made some X rays, then put it into a cast, an I paid nothing. I am still a student and I have free health care even if I don't have income and did not pay any taxes until now.
I have seen Sicko it's a good movie, it just showed me what I have known about capitalism.But it also showed me that human nature is usually good until the evil system comes in.
Here we have all the free things that France has, not the same quality yet, but I hope they remain that way. We also have private hospitals and private universities for those who think state owned are not good enough, but I say they are good. And I would not trust a teacher or a medic if he's goal in life is not to teach and cure but to make more money, why is he called a teacher or a medic then ?

flstf

I have not seen the movie yet but watched Michael Moore on Jay Leno last night talking about it. I was surprised to hear that Hillary Clinton is the second largest recipient of health care industry contributions. He said that one of the Executive Producers is a big backer of hers and called him almost every day until the film's release and tried to talk him into removing the segment.

I was impressed that he saw fit to say something negative about a leading Democrat, at least negative as he and his producer interpret it. If she wins it will be interesting to see what influence the health care industry has purchased.

From his website:
http://www.michaelmoore.com/sicko/checkup/

dc_dux

flstf..... not to defend Hillary, but Mitt, Rudy and Barak are right up there with her:

pharmaceuticals: http://opensecrets.org/pres08/select.asp?Ind=H04

health professionals: http://opensecrets.org/pres08/select.asp?Ind=H01

__________________
"The perfect is the enemy of the good."
~ Voltaire

flstf

Thanks for the links. I'm not advocating or defending anyone either, I am just surprised that Hillary who is usually associated with universal health care programs is getting so much money from the industry that is usually against such things.

I read somewhere that she is the only Democrat in the top 5 recipients of health care industry money but I guess this has more to do with her chances of being elected than with her historical positions. Perhaps the industry thinks they can persuade her with money to temper her universal health care position from the 90's.

joshbaumgartner

Or perhaps after how badly she was burned in the 90's for her position, that she'll be tentative to make any bold moves in that direction, unlike a number of other candidates who have much stronger plans to fundamentally change our health care system.