Sicko *with spoilers*
 

I just saw an 'early screening' of Sicko, the new Michael Moore documentary. Wow. I've been looking into the business of medicine more lately, but I ahd no idea 1) just how bad it is in the USA and 2) how amazing it can be elsewhere. I knew that the WHO had named France as the best health care system in the world, but I really had no idea how good it was. I'm not sure how to go about discussing this without spoilers, so I'm going to add the spoiler tag to the thread name.

The American system is broken, and what's worse is that we (a collective all American 'we') have had to become accustomed to the worst health care in the western world. After watching the movie, I called a friend of mine who also has Kaiser. For every 2.4 dollars he earns, Kaiser gets 1. Why? He has a preexisting condition (some type of heart problem, dissimilar to mine, but serious). He, like me, was grandfathered off a family plan onto an individual plan. He's stuck there because he can't get health care elsewhere because of his preexisting condition, and he can't reapply to Kaiser, because they'd drop him like... well they'd drop him. I happened to be in the hospital at the same time as him when I was getting my coarctation of the aorta repaired. My surgery would have cost me around $100,000 had I not been covered. His would have cost $120,000. The funny part is that if he lives to 80, he will have paid over $370,000 ($515/mo x 12 months x 60 years = 370,800). He could have gone back and had three more surgeries for the amount he will have paid, and he's one of those who has received a lot of care from the hospital. So where does the money go? Insurance is the same in any market or business. There are billionaire CEOs that need the money (thank's, capitalism!).

That's not the worst of it by far. 45 million Americans don't have health coverage because they can't afford to pay the high costs. If you get sick and go to a hospital uninsured, you'll be lucky to be treated. One instance in the film, Kaiser in Los Angeles would put uninsured sick people in a cab, and drive them over to an area nicknamed 'skid row', Union Rescue Mission. In the instance shown in the movie, a woman was dropped off in a hospital gown, confused and disoriented, unable to even care for herself. They didn't even drop her off at the entrance. When she got inside, it was clear that the bracelet provided by the hospital had been removed, so they couldn't find out who had sent her. This is not a singular occurrence. It has happened over 50 times. USC (one of the richest private schools in the country) County had happened to have dropped off an uninsured patient the day before MM started filming at the Union Rescue Mission. This patient had unfinished stitches on her head, she had several broken ribs, a broken collar bone, and was disoriented as she was dropped off. They didn't ask where to take her. They just threw her in the cab and took her over, shoving her out of the cab.

These are American citizens who are being punished for not making enough money by not even being allowed to stay healthy. 45 million Americans are in this group. That's about 15% of out total population. 1 out of every 6.6 people.


In France, things are a bit different. I was born in 1983, long before the time of the house call by doctors. Or so I thought. Apparently, in France, doctors still make house-calls. You can go into a hospital, and not only do you not pay for the health care, but they reimburse you for transport to the hospital. This, to me, is madness. It's like politicians telling the truth or a delicious chocolate bar being free of fat, sugars or preservatives. It's a fairy tale. Well, in the US it may be, but in France it's a reality. So how does the government pay for this, you may ask? Taxes, of course. So the French must pay an unreasonable amount of taxes, right? Here's a link to a simple website, text below:
More info:
http://www.frenchentree.com/fe-legal/
http://www.doingbusiness.org/Explore...x?economyid=70

I'll admit that this is not information included in the movie, but looking at it carefully, it's no exorbitant at all. MM found a local middle class family that took in 8,000 Euros a month. They live in one of the more ritzy flats I've seen in my life. They drove two cars. They had a 4 bedroom flat, which ran about $1575 per month. They owe no money at all. Not just medical, but they had no debt outside of their home. Their biggest expense was fruits and veggies. Oh, and their vacations. They're French, after all.

One thing that surprised me about the movie, is that Americans are marrying Canadians to get their healthcare. And when you get there, there are no lines. There isn't a shortage of doctors. I'm sure my friendly TFP neighbors to the North can elaborate on this quite well.

I'll post more later. Time for dinner. Please, enjoy this movie.

Well, let's see.

I have united healthcare. My doctor is on the ground floor of the building I live in in NYC. I call up and make an appointment. I pay my $10 copay. My doctor will come upstairs if I'm not well enough to go downstairs, something you mentioned as "housecalls." I pay approximately $300/month to cover me and my spouse.

My prexisting condition is asthma. I copay about $600 for my meds.

My father told me some words of wisdom growing up:

"Things cost money, there is no such thing as a free lunch. You'll need to make your own way in life since no one will be there to pick up the slack for you."

I have a friend who's daughter is dying of cancer. She is spending about $4,000 on medical expensives every month. She's sold off her homes and used up all her retirement.

Life sucks sometimes. period.

That seems like a good rate, except when compared to other countries. You definitely pay a lot less than I do, and a lot of people I know, especially considering that you have a preexisting condition.
I wonder if that's the trade off. I get Albuterol (or something else now, it's less effective and it tastes like ass) and Q-var and my copay is $10.
Things do cost money, and under socialized medicine one would pay higher taxes. They pay a lot less in taxes than we pay in insurance, though, and they don't have copay and they get higher rated care.

I'm really sorry your friend's daughter is dying of cancer. My aunt died of cancer (though she smoked her lungs out), and it was very sad to watch her deteriorate and have to spend their saving on her care. My uncle was fortunate that he's talented at stocks and was able to get back on his feet a few years after she passed. Had they lived in Canada, the Uk, France, etc., her care would have been free. There wouldn't have been money woes as she was dying, which I imagine would have given my uncle more time to spend with her.

willravel, while I agree that US healthcare can be unfavorably compared to what is available in France, a country with little foreign debt compared to GDP, almost no trade deficit, and 20 percent less poverty per thousand households, despite nearly a 10 percent unemployment rate, I am unable to separate the "healthcare gap" from the larger problem.....the disparity of wealth distribution in the US, compared to in other ODC's.

You might be able to separate the distribution of healthcare from the "big problem" because you don't seem to recognize that an $8000 euro per month household income (equivalent to $10750 US) is not "middle" income:


<b>IMO, to "do this" discussion in a more realistic way...where the healthcare distribution gap is but a symptom of the larger US wealth distribution problem (crisis....) you run up against the same reluctance that I experienced when I authored these two threads:</b>


My thread dealing with the background of the last true American populist politician, the assassinated Louisiana Senator and former governor, called one of the two "most dangerous men in America by Franklin Roosevelt, and, in his NY Times obituary, a "fascist", <b>Huey Long</b>, did not even garner one reply:

My thread about the re-emergence of the movie "Reds", on DVD, was immediately "modded out".... the TFP owner took it's length personally, I think......

The "Reds" thread contained this quote of Theodore Roosevelt:
<b>willravel, no one wants to talk about the REAL problem....you didn't post in the Huey Long thread....for example......so I'll reemphasize some of my previous sparsely received posts on the disparity problem and on the malignant greed and manipulation that preempts even the small government effort to insure seniors....medicare, and let it go at that.....</b>

....and, finally, if nothing else explains it, maybe this will:

When the bottom 50 percent in the US finally rise up and slit the throats of some of the folks described in the preceding quote box, the sabotuers of medicare and the "churners" who earn fees by taking helath insurers "private", after taking them "public", earning huge fees for themselves and stock options or golden parachute "triggers" for the insurance executives, maybe the knife wielding "rabble" will whisper this into their fucking ears:

Just because I didn't post in a thread doesn't mean I didn't read it. Yes, there is an income gap in this country, and it's one of the biggest problems we face. If we had a health care system funded by taxes, health care would no longer be for the rich. We all pay taxes, and we all get coverage. I know this urks a lot of people who love free markets and capitalism and such, but those have not served us in this case. The insurance companies have done to medicine what we've seen happen to everything from war to news media: profit driven business.

I've always liked to look at it like other life dependent services like firefighters and police. I'm sure no one wants a huge private police force or a firefighter you have to pay insurance premiums for (I'm sorry, you only have the Silver fire plan which covers grease fires and electrical fires. Your house will have to burn to the ground, so we can make more money).

I'm also familiar with the Sinister 18 families, but this is about bypassing them. When a democrat wins in 2008, which will be Hillary, Obama, or Edwards, we're going to be looking at a real shot at bypassing the 18. If Ron Paul wins, the 18 will just pick up and leave. Heh.

Sicko covers a lot about Nixon, Bush and Kaiser. I think you'll enjoy it.

willravel, I don't mean to take out my anger on you...it's just that I wish that we could articulate our vision for the future in a way that truly sets it apart from the anti-government "reform" of the libertarians and the deliberate destruction of the reputation and fiscal stability of the government by the republicans.

I posted about the description of the bi-partisan, "money party" politicians by David Sirota, a few months ago. He's back with this description of the "sell out" by congressional "money party" democrats:
http://www.workingassetsblog.com/200..._21_dem_k.html

I see Clinton and Obama in their ranks, so I don't share your optimism. We face a rapidly deteriorating federal fiscal and foreign policy environment, and a deteriorating maket fundamentals and US currency environment, as well, as baby boomers begin to turn 62 in a wave that will last until 2023 and involve 47 million, aging folks with deteriorating personal health and wealth, if my projections for housing, stocks, bonds, and paper currency valuation are correct.

To avoid mass misery, I see an urgent need for the quick results that a demagogue populist patterned along the lines of a Huey Long, or a Bill Hayward like labor organizer (see the "Reds" thread link) could potentially achieve.

I am more radical than possibly anyone here except roachboy, but I am radicalized by the "achievments" of the money party politicians and the neocon corporatists and their business "patrons". What I see coming can be "bloodless" if a ruthless charasmatic populist emerges, and a majority is persuaded to vote it's best interests.

Small compromises like expansion of health coverage, without radical reform that includes huge tax increases on the top 5 percent and the near elimination of special interest politics, may actually hasten and exacerbate the violence that I see coming, almost inevitably.

lol, I'm a tough kid. I can take it. Hope for the future is a funny thing because it seems so different for everyone... only it's really not. My articulation would start simple: I want my daughter to have more and better opportunities than I. Then we expand on that: those opportunities are education, health, vocational, and fiscal. Then we expand in to each of those subjects: education reform that would best benefit my daughter would be smaller classrooms that are able to focus on growth and improvement, self-directed learning, and such; health can be broken up into several, be they health care (like this thread) or environment, for example.

Often it's this method in which I find the most opportunity for growth and mutuality. That and optimism.
Oh I remember that one.
They're hardly innocent, of course, but I still see their campaigns being health care focused as the best avenue right now towards health care reform. It's not going to be as simple as one is elected and suddenly everything is okay, but the biggest and most difficult part of any change like this is getting the damn ball rolling. I think that they can spark this thing if smart and invested people can spin it right right way to the right people.
I hope that's not true, to be honest, because more appeals to fear and such are what has us in this mess. I would like to think a better strategy would be to inoculate people of their chronic fear though teaching people how to think for themselves. It's things like your ginormous posts that help people get a better grasp of the situation, and the best defense against fear-mongering is knowledge.
It still feels like fighting fire with fire, but I do feel like we're headed towards if we haven't already reached the time for last resorts. It's very possible you're right and the only thing left to do is to produce several leftist talking heads that use the same evil and despicable techniques as the Bill Orly's of the world. Like a Super-Olbermann, only with a much bigger audience and a clearer message.
The idea is that change like this comes either through a slow turn or revolution. I love revolutions as much as the next guy, but they are something that is useful only if all other routes have failed and there is no chance. If social medicine is able to squeak through, that might just be the foot in the door necessary to start the turn-around.

"Of course that's just my opinion, I could be wrong."
- Dennis Miller

US healthcare would be so much better and a hell of a lot cheaper if we would stop regulating the crap out of it. The worst effect of the health insurance industry is allowing them to determine who a doctor can and cannot see as a patient.

In Canada, you can choose your own doctor. And the UK. And France. I suspect that you, dksuddeth, are probably more interested in a capitalist free market system, but I'm not 100% sure. What are your thoughts on social?

I pay $0 for healthcare, get full benefits and $20 co-pay (or was it $10?) thanks to an employer that values my skills and college education (thank you free market system!!). I don't smoke, drink heavily, nor do drugs. I have no preexisting conditions.

If someone decides to smoke and then gets cancer as a result, well then, I am very sorry but you have to take responsibility for your own actions. I would be very pissed if I had to to subsidize someone elses irresponsible choices. I work very hard for my salary and benefits.

So then, would socialized medicine be abused as a fix it all system for irresponsible people? I stay healthy and am careful with my actions because I do not want the expense of health care (especially when before I didn't have any insurance at all. A broken hand cost me $7500 cash). Therefore, I acted responsibly. I think free health care would just open up a wealth of abuse and overburden the system. People abuse the health care system here in LA to the extent that hospitals have to close down and ER centers close too.

Having said that, I do agree that the healthcare system is in need of reform. I'm not sure which part needs fixing: doctors, insurance, hospitals, patients or lawsuits.

Will, you mentioned that you think the insurance companies are to blame. Can you expand on that a little? I used to think the same thing but I'm not so sure. Maybe Jazz can give us some insight. I do know in my case, I paid $7500 cash for surgery on my broken hand. The doctor gave me a steep discount because he knew I just graduated and therefore no longer covered by school insurance and did not have a job yet. The hospital charged the most despite my financial hardship. They told me that if I had insurance, they would have charged around $25,000. I almost had a heart attack. I actually know why they charge so much but that is for another thread.

It's the same with car repair/service too apparently. Different prices depending on whether or not you have insurance.

I am interested in hearing about the Canada and UK systems.

Sigggghhhhhh........I provided plenty of detail that supports the POV that "insurance companies are to blame", in the lower part of post #4, on this thread; and that info was posted separately, here:
http://www.tfproject.org/tfp/showpos...7&postcount=19

....it is all timely, from mainstream sources, and it even details the recent annual profits of major health insurers and the compensation of their executives.... but...it was posted by "host"....so I guess it should be ignored while we all wait for Jazz to "give us some insight"....

I would not really mention Clinton taking care of health care. It is 14 years since she started talking about it, and I have yet to see any results. Her current plan she released was very similiar to the one Edwards released (before she did). And do not forget that she was on the board of directors of Walmart which is known for their employees not having health care (though last year I believe their rate went up to 46%).

I am not a Moore fan but I do agree health care is a huge issue.

I have to think that at least part of the problem is that, culturally, in this country we have a hard time making tough ethical decisions through law.

Can you even imagine setting the basic guidelines for what an appropriate level of care would be for specific illnesses? Of course, when it's my grandmother, nothing but the most expensive treatments taken to the farthest extreme will do. When it's yours, well, we ought to be reasonable. Add to this that you can't REALLY standardize (read: socialize) medical care without dredging up the most unpleasant parts of the illegal alien debate.

host, you obviously are a very smart guy, but you're not an insurance expert. I don't think jorgelito meant any offense towards you when he mentioned me. Then again, maybe I've missed something somewhere and you and I can discuss hammer clauses and short-term nose endorsements. I'm always looking for someone to bounce ideas off of, and someone with your smarts would definitely be a big help to me on a few things.

Just like always, everyone here likes to lump all the blame in one place. Do the health insurance companies share in that blame? Sure. Are they the only ones? Of course not. I don't think they even get the majority of the blame.

We live in a capitalistic society. That's not going to change. There are a couple big problems that I see out there with healthcare and insurance. First, costs are rising. Second, many people cannot get insurance and are forced to self-insure their risk.

Second problem first: in a capitalistic society, you have to allow companies to manage their own risks, including insurance companies. That means that you can't force companies to do things they don't want to do without some sort of trade-off. Ask Florida property owners how making that mistake has been working out for them. The biggest problem here is that individuals and smaller groups actually produce more risk for insurance companies than larger ones. It's a little counterintuitive until you realize that accuaries can predict health care costs for large groups much more accurately than small groups and not at all for individuals. Someone who works for a large company is going to get cheaper insurance than someone who is self-employed, almost regardless of any pre-existing conditions. The risk is going to be factored into the premium charged to the large company from the very outset. There are also a number of things that a company can do to lower their premiums, like taking on some of the risk themselves. It's actually much more complicated than this, so let me know if you want more details. I'm trying to paint with as broad a brush as I can.

Currently, there's no good fix, but I know of several that are being proposed right now. I have a client who is a large benefits agency (health insurance falls under the benefits umbrella). They are current lobbying their state legislature to be allowed to set up what's called a "risk purchasing group" for the self-employed. Their goal is to get several thousand individuals, along with their families, into this pool to allow them to enjoy the benefits of group buying power. This is current illegal in most states (for some very good reasons, actually), but if they can demonstrate the controls that they want to put in place, it could turn into something very interesting.

In a capitalistic system, which again isn't going to change, some people are either going to not be able to afford the coverage or choose not to take it. And that leads me back to my first point, the costs.

There are a whole bunch of reasons why the costs are rising, but I don't think you can really blame the insurance carriers for that one. First, its in their (and your, as the insured) interest to keep costs as low as possible. After all, they will make more money if the costs are lower. Thats why they negotiate the cost of procedures up front with the doctors and hospitals that they work with. You can't even blame the doctors and hospitals since they've already contractually agreed to price things the same way, consistently for all customers of the health care insurer. The variable here are new technologies, which are typically very expensive to bring on line, drugs and the uninsured.

New technologies, especially hardware, are usually exponetially more expensive in medical applications than elsewhere because of the details, whether those be precision, cleanliness or a combination. That exactitude costs more to produce.

Personally, I think that if there's a bad guy it's the drug companies, although I have to admit even they have good reasons to do what they do. Drug companies are moving more and more towards developing long-term drugs rather than ones for short-term use. That means that there aren't nearly as many antibiotics being developed as cholesterol-lowering drugs. After all, you won't take antibiotics for the rest of your life... Another interesting thing to note - whenever you see a drug advertised, you can bet that it will be a long-term drug. You're going to want to pop a woody for the rest of your life, but clearing up that nasty cough is secondary.

The uninsured are the 1000 lb gorilla in the room. Honestly, they force everyone's prices up. In almost any other industry, they'd be ignored because they aren't anyone's customers nor are they necessarily desirable as customers (there are obvious exceptions). Everyone agrees that ignoring them is the wrong thing to do not only from a public health point of view but also from a humanitarian one. There's been talk of "forced placements" with health insurers, where the uninsured sign up with the state and are assigned an insurance company. There's a similar system in place for Workers Compensation insurance, but the fatal flaw here is that most of the uninsured can't afford the premiums for a number of reasons. First, employers typically absorb between 25% and 75% of the cost of the premium, depending on how their plan in set up. The employee contribution typically only pays a portion of the premium, especially if the employer has a large self insured retention and is gambling that there will be little erosion of it. The uninsured, who are mostly poor, can't afford the costs because their underwritten individually, and they are typically in mediocre health at best.

Its my professional opinion that a universal healthcare system will not happen in the US in the next 10 years. Beyond that, it's grows more possible the farther you get away from the present, but the system, as it exists now, is too powerful to overturn easily. It's much more probable that the uninsured will be covered by a quasi-government entity, although I have no idea how that would be funded.

interesting post, mister jazz...objections to it:

capitalism is not one thing: there can be and are any number of institutional arrangements that operate within that general context--there is no contradiction between capitalism and universal health care. capitalism has no "natural logic" to it--there is no normative capitalist system relative to which others can be parsed. the american system follows not from any such natural logic within capitalism: it follows from political choices made by "representatives" from within the ruling oligarchy....

the french model is far more interesting and effective than is the british.
it is a mixed system: the only reason that it is not a part of the debate concerning potential models for a system less barbaric than the present one in the states--which operates according to a logic that (i'll say this again) amounts to the assumption that the lives of the children of the wealthy are worth more than the lives of the children of the poor---seems to me a function of linguistic ignorance/chauvinism (take your pick, they're the same thing from different angles). the french system delivers better health care on a more equitably basis than does the american and than does the british/canadian model. period. it is also a curiously bureaucratic system which profiles in the way the french state does--which is based on a different legal tradition than you have in the states--so if the americans were to come to their collective senses and realise that there is something ethically Wrong about a medical system that is stratified on class lines in terms of access and were to adopt the french model, it would look quite differently than it does in france.

roachboy - I certainly agree with your universal logic arguement, and I have no experience or knowledge of the French system and will defer to those that do.

That said, the health insurance industry works within the free market. Perhaps that is a better term than the overarching "capitalism". The free market allows consumers, whether they be corporate or individual, to chose the plan that best meets their needs and budget. The obvious flaw is the group that can't (or in some cases won't) pay the premiums necessary to offset their risk. Those people end up costing the system billions of dollars and remains one of the biggest reasons that doctors and hospitals agitate for higher prices from the insurers. The insurers, on the other hand, can demonstrate that their clients/insureds do not deserve to pay the higher prices because they are in better health and cost less to treat. They also have the benefit of group negotiations.

I just saw Sicko and I was shocked by seeing how the less fortunate can be treated. I'm seriously going to stop complaining about high taxes here in Sweden. For the first time in my life I'm actually happy we have them (And how fucked up is that?).

Everyone pays taxes, therefore everyone would pay for a great deal of the system. It wouldn't be you funding other people, it would be the whole funding the whole. Irresponsible people... wait, by that do you mean those who purposefully hurt themselves? Or do you mean people who aren't responsible to make a lot of money?
All of it should be examined carefully, I think.
I don't have figures comparing the average cost of health insurance for an individual vs. the average amount the insurance pays out to said individual, but considering the soaring profits from the industry, I can imagine that people pay more than they get. That's how all insurance industries work. They make a profit from the amount they don't have to pay out (which is outlined in Sicko by showing health care professionals who are asked to deny coverage to people, and who even have denial quotas to reach). Between the high cost of insurance with the lower cost in taxes in places like France, the UK, and Canada, a clear picture appears. Their system is a good samaritan system. Our system is an individual supporting themselves system. I imagine, then, it boils down to philosophy. Clearly, most people in the US think that police work and firefighters and the likes shouldn't require you to pay a private corporation. We get fire coverage and police coverage for relatively cheap (if you were to compare it to health coverage, though it might be a case of apples and oranges in people's minds).
That's absolutely true, but I wonder how much less we'd be paying if those companies weren't looking for a continually larger profit.
UK
Canada
She's no where near perfect, but a lot of why she had to shut up was in the film. In the early 90s, as I'm sure most know, she fought veraciously for better health care. She brought it all the way to congressional committees, until George J. Mitchell, the Senate Majority Leader shot it down and took with it a great deal of her political clout. As a result of this defeat and the resulting loss of political power, she lost her ability to fight. Now, she's a Presidential front runner. If she wins, the bought and paid for Senate Majority leader won't be there any more to get in her way. With the Dem congress, they have a good chance of getting something done, if they're not too busy not helping the troops.
I think that's something we all can agree on.
This is an absolutely brilliant point. I imagine this would be a lot easier if we were able to translate ethics through lawmaking. I'm not really sure as to how one would address a broad problem like this. Maybe we have stronger ethics training in schools, so the next generation will have the ethical technologies necessary to make the decisions the leaders of today have trouble with?

Jazz, so you're saying doctors (who are making less than in the 80s and 90s), new technology (something that has always been present in medicine), and drug companies (I COMPLETELY AGREE ON THIS ONE). I have trouble believing that the skyrocketing costs can really be attributed to doctors or technology in any big way. When I was getting my heart surgery in the late 80s, the Catscan machines and EKG machines were very expensive. As I understand it, as a layman who's simply spent a lot of time talking to doctors, a great deal of the money is going into administration, insurance, and prescriptions. I would call those the big three reasons, based on my understanding.

May I ask what you would do to help those 45m who are uninsured in the capitalist system you were describing?

Thank you very much for pointing this out. Canada is no less capitalist for having universal health care just as we are no less capitalist for having socialized fire protection.
I agree. Too often we ironically thumb our noses at France. Yes, yes: cheese, frogs, surrender, coffee. It's all fun and games until you realize just how much easier it is to live under a lot of their social programs, especially their health care which did deserve it's rating of #1 from the WHO. If, by some mericle, we did ever switch to the system the French use, I suspect a lot of people would complain about taxes...until they needed the system. Then, suddenly, they would shut up like Bush not remembering the name of a head of state. "Old Francy!"

It has a lot to do with collective vs. individual, and that's a much more difficult call in a free market. I do have to wonder, though, if a free market is always right, or just usually right. I think we can see that an 'unfree' health care system can flourish when we look at the rest of the Western World. Does that mean it will work here? Not necessarily, but considering how much better they have it there, I keep coming back to the thought, "Well, it can't really get much worse." Also, I'm a bit of a socialist, so my take on this is bound to be different than other people here who are less socialist.
Hahaha...yeah sometimes it's hard to see what you're paying for when it's all you know. Things could be a lot worse in Sweden (the swedest country of them all).

I'm curious to know why Moore took some Americans to Cuba for a doctor's appointment yet Castro had to bring in Spanish doctors for his illness.

Spain > Cuba > US ?

Spain is in the top 10. I'm trying to find my old link to the WHO study.

The_Jazz,
I snipped a couple of paragraphs from your post although I did read it all and I have a couple of questions.

In the first paragraph you say:
What could be a larger group than the whole country? Isn't this a good argument for putting everyone in one group and providing universal healthcare and wouldn't it therefore be less expensive?

In the second paragraph you say:
What are some of the very good reasons for not allowing individuals to pool together to reduce their healthcre costs?

Fire coverage and police coverage only deal with the immediate problem - the fire itself or the actual crime. Insurance, whether it be fire, liability or health, reimburses (theoretically) the insured for their loss from whatever peril they suffered from. Firefighters will not restore your home. Policemen will not fix your car if a thief drives it into a lake. This just isn't apples and oranges - this is apples and the number i. Health coverage pays for your healthcare costs. Homeowners insurance pays for your possessions if they are damaged or stolen. Fire and police departments have nothing to do with this arguement.

Doctors are making less, but the reason for that has to do more with rising malpractice premiums, competition in the medical field and the application of simple economics to the equation (i.e., there's no need for a doctor to pull your ingrown toenail when a physicians assistant can do it for much cheaper) than a nefarious plot by the insurance industry. Whereas I twice had doctors work on my inflamed toe due to a nasty ingrown nail in the 90's, when it happened again 2 years ago, the nurse practioner took care of it and did a great job. My doctor spent 5 minutes checking her work and then went off to do something else. He didn't have a nurse practioner/physicians assistant 10 years ago.

New technologies cost more than I think you realize. The cutting edge machines can run into the millions of dollars now, but I'll conceed the point for the moment since it's not a huge part of my equation. Administration is another large cost, but no more so than in the past, even with HIPPA.

Malpractice insurance varies greatly from doctor to doctor. Some (usually general practicioners) buy it individually. Most buy it through a group or hospital. Malpractice coverage skyrocketed a few years ago for a few reasons, one of the chief ones being that some new models came out showing that claims were beginning to skyrocket. Illinois's largest malpratice carrier is a mutual (meaning it's owned by its insureds), and they had to charge a significant increase in order to stay solvent. The reason for the model changes came from the number of new malpractice claims out there as well as the higher verdict amounts. Many lawyers found some easy targets in the medical community, particularly among doctors with addiction problems. Whether the doctor did anything wrong or not started to become less relevant since a cocaine problem basically demonized the defendant from the start.

will, I'm a liability broker. You're lucky that I know all the big words that I do. I can't fix anything because it's not something I have any hands-on knowledge about; ask me about fixing the 3rd party liability system and I can offer opinions until I'm blue in the face.

That qualifier firmly in place, I will venture to say that some of the uninsured are just dumb. I can't be any nicer than that because if you have the ability to buy health coverage and chose not to, I find that to be a completely selfish and frankly moronic decision. You may be young and healthy today, but that doesn't mean that a Flying Elvis isn't going to come hurtling out of the sky and break your pelvis or that you won't develop drug resistant TB because jackoff thought it was ok to fly internationally on your flight to Buenos Aires.

That's not the position of the majority of uninsureds, however. For those who can't afford the coverage for whatever reason, I think that there needs to be an amalgom of forced placement and public subsidies. I imagine it working where the state pays the majority of the premium with the individual contributing what they can, possibly on a sliding scale. That doesn't work for the truly desititute, and I don't have a quick and easy solution for those.

powerclown's "question" is influenced by a campaign on the anti Michael More blogs on the "internets"....such a closed little circular world they dwell in:

.....and blah, blah, fucking blah....and on it goes, for 2000+ entries....bad rich Michael Moore......sheesh !!!

Nothing about Jeb Bush and his european Cuban south florida political base, and their influence on keeping up the financial and trade embargo on CUba and it's effect on Cuba's healthcare system.....

Instead of wondering why third world Cuba, hobbled by extreme economic conditions and by the US embargo, still manages a lower infant mortality rate, per the CIA Factbook data, compared to the rate in the US, powerclown tows his "party line"....let's cut apart Michael Moore !!!!!!!!!

It's old, powerclown....sheeeesh !!!!!!!!!

Actually it is, assuming that the state is going to pay everyone's cost. It would allow for relatively accurate budgeting (most likely to within a few million dollars out of around several hundred billion). Over the long term - meaning several decades - I have no doubt it would end up being less expensive.

That said, it's not going to happen. For one thing, lots of folks don't want it to, particularly Congressmen who have large healthcare insurers employing people in their jurisdiction. All those folks would either immediately be out of work or become federal employees. Most likely, the group would become a combination of the two. Assuming I live as long as the actuaries say I'm going to (about another 50 years), it's possible that we'll make some great strides in that direction within my lifetime. It won't happen overnight, and it won't happen without the current uninsured being taken care of first. It's the necessary progression, especially given the current legislative climate. I don't see that happening until at least 2010, and as I mentioned in my first post, I have no idea where they're going to raise the money. Maybe they'll take Rod Blagoevich's worst idea ever and put a gross receipts tax on every business in the country. :eek:
First, they don't have what's referred to as "insurable interest". Typically that means some sort of relationship linking them all together, whether it be through family, employer or some other commonality. What's being proposed here would just link the self-employed, with that being the sole link, which is technically illegal. Those laws are in place to prevent consumer fraud, and I can't say that they're necessarily misguided in this case.

Then there's the problem of who ISN'T going to be included in the group. There's the very real problem of discrimination based on real or perceived disadvantages to allowing someone to participate. The issue of pre-existing conditions, etc. would only increase it.

The big question is exactly how it would be set up, whether or not there would be an amount retained by the pool somehow to offset the risk and if people wanted multiple options. I can give you more details if you'd like, but I can't really do it without using some techical terms.

There's also the issue of fraud against the consumer, where the administrator of the purchasing group would take the money and run. My own company was the victim of that about 8 or 9 years of that. Given who's doing this, there's not much chance, but it exists.

Basically, my point was that both sides need to make sure that the other one has all the right legal controls in place

...dealing with the immediate problem, like emergency medical care? Let's say that I get shot in the leg and I have no insurance. The cop gets the bad guy, and I do what? I try to get it out myself and get an infection? I go to a free clinic and compete in line with the 45 million other uninsured people?

What if just emergency care were covered in a social program like fire and police? It's dealing with the immediate problem, which seems more than comparable to fire crime (firemen prevent the fire from getting worse, doctors prevent the wound from getting worse; firemen put out the fire, doctors clean and stitch the wound).

I'm wondering if you could sit down with a man that works two jobs and still can't afford health coverage and tell him, "You're SOL."
Oh comon. Let's leave the 'nefarious' language where it belongs: in threads about Bush.

Do you have statistical information available to you on this? I think it'd be really helpful. I know most doctors are against socialized medicine (and a lot of that has to do with the fact that they believe they'll be making a lot less and seeing a lot more patients, which is a big fat myth).
I'm aware that the cost of these technologies is astronomical, but it was astronomical in the 80s and 90s, too. Expensive technology is hardly something new, and I have no information that tells me that technology now has become more expensive relative to inflation. A million dollar machine in the 80s may have a counterpart ( better replacement replacement) now, but it's basically the same when you adjust for inflation, according to my cardiologist.
I wonder if the better thing might be ceilings on malpractice suits imposed by the government. No one needs $15b because a doctor did his best but still couldn't save someone. I know a lot of doctors make mistakes, and it's important that the victims be taken care of, but what can a million dollars do for someone who's finger was put back on wrong?

I imagine this might be something we agree on. I'll have to check and see how malpractice is handled in France.
I understand what you're saying, but I still can't bring myself to think that 45 million Americans don't buy insurance because they just don't feel like it. As a matter of fact, I'd guess that most of them can't afford it or have been denied. I feel deeply for them because, had it not been for positive circumstance, I would have been one who was not insured because my preexisting condition. If I hadn't been able to get a few scholarships, I'd be dirt poor. It's that small twist of fate that separates me from these 45 million. If you can't think of their situation, think of yours. Imagine if somehow you weren't able to afford medical care and something, god forbid, were to happen to you or your family. I would want a system in place that can deal with anything you can throw at it whether you're Bill Gates or a bum.
Single payer, sorta.

MM was right in Bowling, and that could have prevented the Virginia Tech shootings. MM was right about the Iraq War.

MM is right about this, there is a problem.

NO,,,,,,,,I take no meds, but I've had it with all of the bullshit spin that is intended by CNP/Salem, Bozell, Charles Taylor LGF, Horowitz, Flopping Aces, Clarice, Necons/AIPAC Powerline Blog, ET AL to obscure what actually needs to happen in the US...... a seachange in awareness that influences the 150 million of us that "own" just 2-1/2 percent of US assets...to act and vote in their own interests....no more votes for pols who bring us "bankruptcy reform: or a "fair tax" that replaces a progressive income tax.....no more greedy insurance lobbies defrauding medicare and then telling us that government can't do anything right, and no more "catapulting the propaganda" to attempt a "privatization" of social security from a POTUS who transformed a total US treasury annual deficit increase of just $18 billion from 10/01/99 to 9/30/00, into a $3 trillion increase since 2001.......

No more bullshit, powerclown. Moore has found a way to get people's attention, to make them think and to discuss our real problems, He's only a messenger.....WTF is your purpose......your agenda?????

That's a fine and dandy suggestion. I think it has merit. I also think that it would never happen for the simple reason that you'd have to raise taxes to do so and figure out when coverage gets cut off. I think some emergency ambulances provided by governments are free to the patient, and I agree that's the way it should be. But you can't make emergency rooms into public entities. If you get shot (again), you go to the hospital and worry about how to pay for it later. In the current system, charity would take care of a portion of the bill if you are uninsured.

Again, this isn't what I do. I don't have this kind of information at my fingertips. I'll check my back issues of Business Insurance when I get home to see what I can find with a minimal amount of searching.

I don't think I've been clear. The $1M machine 10 years ago has a new version that costs $2M. The rate of inflation should make it about $1.1-$1.2M. The technology costs more today.

I Actually, we don't even get close to agreeing on this. Malpractice caps have worked very well at keeping insurance costs down for California doctors, but there's a doctor that I know of in N. CA that delivered a number of babies while high on cocaine. He moved from Illinois specifically because of the caps. Many times the doctor didn't make any mistakes and life happened. Some times the doctor plain old fucked up. Those are the times where the cap is a huge disservice to the claimant.

You missed the next paragraph where I conceeded that this isn't the majority of uninsured. The majority are most certainly those who can't afford the coverage. I just went off on a rant against those that can but choose not to.

As far as single payer - no. Not at all. Single payer means that someone pays all of their own bills outside the health insurance system. They are the "single payer". My proposal would have the individual apply through the state, be assigned a health insurer who's already writing business in the state and assigned into a plan with the payment burden being shouldered by the state for the most part.

Charity is hardly reliable. I see your statement "But you can't make emergency rooms into public entities", but you don't give a reason why.
1.1-1.2M today isn't 1m 10 years ago. Based on the general market, it's more like 700-800k = 1.1-1.2m today. I was obviously just throwing out examples not actually based on real prices. Again, according to a source I cannot cite, unfortunately, my Cardiologist said that the cost is basically the same. I can't back that up, but you can always ask someone if you don't have the information.
Then the doctor goes to prison. I somehow doubt that's the norm in malpractice cases.
I respond in order. As I'm typing now, I've not read your last paragraph.

Those who can afford health insurance, have no preexisting conditions and don't get it are dumbfucks. On that we agree.
So you're talking about something not dissimilar to prisons. Government pays, privately run. That hasn't gone too well.

I am admittedly an extremist when it comes to the issue of health care. I believe that allowing citizens to be destroyed by illness is as bad as allowing their homes to be bombed by a foreign country. Lack of access to health care is a weapon of mass destruction that has killed far more Americans than terrorists could dream of. Denying adequate health care on the basis of finances is in my mind akin to levying the death penalty for poverty. But like I said, I'm a wee bit of an extremist on this issue.

I support all efforts that result in more people having better access to comprehensive health care, but the only ultimate goal of my tack is to achieve universal, comprehensive, guaranteed health care for every single citizen regardless of any factor beyond their need for care.

It's not a question of whether we can afford it or not. We can't afford not to.

It's not about addressing the needs of poor people or working people or rich people. It is for all people regardless.

It's not about getting companies to shoulder the burden. Companies should be able to focus on their business, not covering their employees' medical costs.

It's about the fact that American citizens are dying because our health care system is not comprehensive, nor universal. Working parents are unable to cover their children. Elderly have to gamble on which card will cover what they need to stay healthy. Young people around the country are routinely weighing the cost of medical insurance against getting a college education or making other important investments in their future. More bankrupties are due to medical costs than all other factors combined.

Yeah, I'm an extremist; I admit it. I believe that this issue is one of great moral and social importance and if we don't improve matters, our children will have every right to be ashamed of our actions, and look sadly back on us when they read their history books.

Did you know that Moore is as popular in Syria as he is in Beverly Hills? I have to draw the line when Michael Moore and fanatic hezbollah terrorist maniac Hassan Nasrallah espouse the same opinions of America. This is not to say there is nothing in a conversation on the state of the American health system of course, just that Moore is a most unfortunate medium by which to raise peoples awareness on an important issue.

The same can be said of the Pirates of the Caribbean sequel, but it's meaningless either way.

Who cares? The idea is to direct attention towards a problem that many Americans are completely unaware of, not to boost his popularity.

I couldn't agree more. 18,000 people a year die because they don't have health coverage. How many die each year from terrorism?

According to this page, about 20% of the average French gross salary goes into the incredible system they have, which is the most expensive of all social medical programs in the world. Germany is about 13%, according to this site. This lists the average annual rates for people of different ages under the UK's NHS. Note that even at NHS's most expensive, it's only $220 per month, which is probably a lot less than the national average in the US.

will, I'm not talking about anything like prisons in the slightest. Let me elaborate my point and perhaps make it clearer:

An individual, for whatever reason, finds himself without insurance. He applies to the state fund. The state takes the next insurance carrier in the queue (as a part of the benefit of writing health insurance for anyone in the state all carriers join the pool) and assigns that carrier to the individual who then underwrites the individual and assigns them a premium. The state then pays a significant portion of that premium with the individual paying the rest. The individual thereby has healthcare coverage.

There are some big pitfalls that even someone like myself who only knows enough to be dangerous about health insurance can see. Namely, is the individual treated as such or is there a greater plan in place that is accessible? Is there a deductible or retention in place for the state? How do you pay for it? Is there a cap on the coverage? There are others beyond this, but these 3 seem good enough to start. The carrier has to administer everything, make the payments and negotiate the terms with the providers. The state takes the financial burden. The individual has the coverage and, at least theoretically, contributes.

I don't know where your prison analogy came from, will. Honestly, that question disturbs me because I thought up to now that I'd done a decent job describing what I had in mind, but apparently I wasn't even close.

Thats my point. Many people see Moore and want to run away as fast as they can. If I wanted to learn more about the American healthcare system (or avoid the risk of spreading disinformation), I'd choose to get my information from the documentation of serious doctors, administrators, nurses, and journalists in the industry than from an obnoxious blowhard like Moore. Actually, the more I think about it and amidst the poisonous political climate pervading the country, the fact that Michael Moore is commentating on healthcare awareness in America has the effect of trivializing the whole issue in my opinion.

I understand. Uninsured is covered mostly by state, but is treated by private hospital. The state pays for public care to be run privately. Like a prison. That was my comparison. It wasn't intended to be very direct, so far as comparisons go. I'll speak to why I mention it in a second.
Danger is my middle name. The deductible might have to be voluntary or to be put on an extended payment plan, considering the financial problems that an uninsured person may have. I'd even be worried about the payment plan, as they could easily put people into debt. I don't think we need more credit in medicine. Cap on coverage? I don't see why. The idea here is to treat people who need help, despite the fact that they can't afford coverage. My only concern would be proving you are unable to get insurance (to avoid people simply not having insurance because you can get it for free). All of this involves a lot more bureaucracy in addition to that which we already have in medicine, and I'm not sure how much I like that. It will only add on more costs to the whole thing.
Look at the private prison system. They are privately run, but they get funding from the state. This is similar, though not the same, as what you're talking about. I guess my first thought ran to "how will the hospitals try to make a profit off this..." and then I figured they are treating people who aren't able to sue or anything like that. This could lead to cutting corners in order to squeeze profits out of the government funding. This is similar to the prison system in that the prisons cut corners all the time to make a bigger profit. It's a concern.

Understandable. I was definately skeptical when I heard that Micheal Moore was making another film. Yet, after watching it, I have to admit that his argument was pursuasive, informative and well defined. Even his usual bias was subdued.

It certainly doesn't lack in poignancy either.

Well I can tell you that my current premium for a PPO plan for me and my family is a lot more than that. In fact my portion is about $250/mo and my employer covers 100% of my coverage and 50% of the family, so you can figure the total plan cost is probably $600 or so. This is a must-pay cost and I don't exactly have the ability to do a lot of shopping around. This means that I view this expense no differently than if it were taken by the government.

According to the WHO's international health statistics, here are some intersting points:

Per capita total expenditure on health (% of GDP in parenthesis) and the percentage that is paid through government expenditure:
Australia: $3,123 (9.6%) - 67.5% government
Canada: $3,038 (9.8%) - 69.8% government
France: $3,464 (10.5%) - 78.4% government
Germany: $3,521 (10.6%) - 76.9% government
India: $31 (5.0%) - 17.3% government
Italy: $2,580 (8.7%) - 75.1% government
Japan: $2,823 (7.8%) - 81.3% government
New Zealand: $2,040 (8.4%) - 77.4% government
Norway: $5,405 (9.7%) - 83.5% government
Russia: $245 (6.0%) - 61.3% government
Sweden: $3,532 (9.1%) - 84.9% government
United Kingdom: $2,900 (8.1%) - 86.3% government
United States: $6,096 (15.4%) - 44.7% government

Why are we Americans, supposed masters of getting the best deal, so willing to pay so much for so little? 15.4% of our GDP! That's 50% more than most any other developed nation, and even then a huge swathe of people are left with inadequate care. Only one nation in the world (Tuvalu, at 16.6%) spends more. I have no problem spending the money that needs to be spent, but please can we get some better value for our money? One thing I don't know about this statistic is whether it includes only money actually spent on health care, or all the money spent on the organizations that pay for the health care (i.e. does it only count money paid to doctors, or all the cost of premiums)? If the former (which I suspect) then we really pay a lot more on top of our 15.4% to support the insurance industry.

When I hear that we can't afford it, I cringe. France has a fine system of health care, and does it for 2/3 the cost of our system and covers everyone in the country to boot. I know there is not a system in the world that is without issues, but many of these countries routinely are rated as providing better health care across the board than the average care in the United States, and here many people can't even get that.

i cant imagine caring what conservatives think of michael moore.
it seems par for the course that when confronted with problematic information in the context of a film he made, the response is "moore is a blowhard" or some other such. not able to mount a coherent critique of the positions outlined, or anything remotely like a solution to the problems he raises--unwilling to even acknowledge there is a problem (except to say that moore "trivializes" it by being the person who made sicko)--all that remains is ad hominem.

well, moore is not my favorite documentary film-maker--he is not even on the list of the top 10 or 15 i just drew up in my head as i sit here---but he is pretty good at presenting complex problems in a well-researched way to a popular audience across a medium that folk generally view as entertainment. like any documentary film-maker, this presentation comes in the form of arguments, and the arguments are clear--whether you agree with them or not, they ARE clear. there are often problems or holes with the arguments, and personally i sometimes wish that someone else would make these films--but the fact is that moore does what he does and it is good that he does it BECAUSE like the films or not, from whatever political perspective, they generate debates and they also provide a coherent starting point for those debate. this is very different from conservative opinion management tactics, which substitute superficial and crude sloganeering for analysis, which when analysis does happen uses indefensable categories in crude ways to generate conclusions that are of a piece with the political starting point of a piece and which are NOT about fostering the messy process of debate across all positions, but only debate with those who are Other.
and even that's not debate.
it is slogan rehearsal.
you know, shit like "michael moore is a blowhard"...

so powerclown: if you dont like moore, make different, better films.
go for it.
i am sure its easy--if you think michael moore is such a fool, then you must also think that what he does is easy, and so prove how easy it is and do some films yourself.
do it and show the results.
then we'll see what is actually up, yes?

it's like walking around a contemporary art gallery with someone who looks around and says: "well that's stupid: i could have done that"
to which the only response is "why didnt you?"

TY, joshbaumgartner. Those were the stats I was looking for.

RB, yes you're right. Frankly it seems like ad hominem after ad hominem. Judge the film, not the filmmaker.

I actually may have to speak for at least the big pharmacuetical industries, a lot of things they do is bullshit. Ambien CR(wtf) I am looking at the data as we speak and its impossible to tell Ambien from Ambien CR so its just big buisness trying to milk out a few more bucks. The same with Nexium and Prilosec, Celexa and Lexapro both sets of drugs have the same active ingredient but the only difference is that one is a racemate.

To stand up for them, its really expensive to make new drugs and for every drug that comes out about 19 or so fail. So they have to charge extra for the drugs to cover their costs on everything else. And since there is not a perfect drug, because to block a receptor means that something is not going to work and your body is going to compensate i.e Cox-2 blockers. So you have drugs have work really well and because of it are going to increase your cardiovasular risks.

To bash them again, for 1kg of quinapril(powder) in the us it costs 1M and to buy the same drug from spain is around 1,000. That just seems a little crazy

In Sicko, MM walked into a pharmacy in the UK and paid £6.95 ($13.82 US) for all prescription drugs. Unless they were poor. If they're poor they get them for free. In France, they're all free. The tax funded system picks up the tab.

This a great thread and great discussion, really involved.

Host, buddy, you need to relax man. I'm not sure how or why I offended you but you know, Jazz is an insurance professional/expert so it makes sense to seek his opinion. Similarly any doctors, lawyers on the board would contribute greatly to the thread.

This discussion has evolved alot since I last logged in so I don't know if it makes sense to respond to some of the replies to my earlier post. But I will do my best to advance the discussion.

Insurance is a great mystery to alot of us so it helps to get a basic understanding from a proifesisonal on how it works. It's a weird product and almost counter capitalism/consumerism. Ideally, you will be paying for something that hopefully you will never use. I think that screws with most people's economic philosophies.

I want to try and distill the issue further and spread it out a bit.

Some of the reasons people are against "socialized" medicine is because:

1. Fear that the state would be too incompetent or inefficient at administering the service of health care.

2. Raising of taxes.

3. The free rider or sucker principle - people are afaraid that they may pay a lot of taxes for minimal service" or that people who pay less taxes will reap more benefit.

I think somewhere in there, it is very possible that widely available, affordable, and accessible health care would increase the societies' aggregate health and reduce costs over the long run. I also think there would be a huge cost in the beginning but then, in theory, as people access preventive health care and such, then overall costs would start to come down.

Maybe the big hang up is that we are too afraid to give it a shot.

Part of the problem is political. No politician will be in office long enough to gain politically from such a major change and more likely will lose politically because of the long time frame for such an initiative. As a jumpy and impatient society, we need to see "instant results". The very nature of such paradigm shifting initiative implementation runs counter to our politics.

In the Hillary example, it's quite possible that if the Congress had implemented her program back then, then we would be seeing some of the results today, almost 15 years later in the form of better health for our society and lower costs. It's possible but no way to really tell.

Some people here are praising the French model. I would be interested in hearing more about it if anyone is in the know. How much does it cost? How is the quality of care? How is it viable? It sounds too good to be true - cheap/free healthcare for everyone? Surely there has to be a cost somewhere. What do the doctors and hospitals think? Is there insurance in France?

Most of us only hear stories (good or bad) regarding healthcare in other countries such as Canada or UK - it's cheap or free, long lines, poor quality and poor service, cheap or free drugs etc.

I think there has to be a compromise in there somewhere.

Maybe a basic healthcare system for everyone and private healthcare/insurance for those who want it. I think it could be possible to balance an affordable and accessible health care system for everyone. Preventive care goes a long way. EX: filling a cavity today saves you money and pain of a route canal later on. Regular checkups are cheaper (I think) than going to the ER because something you could have prevented got worse.

I think with a good basic healthcare system for everyone, I would still opt to buy a private healthcare plan as I got older, but if someone could not afford it, at least they would get some basic care. 42 million uninsured people having access to health care would go along way in bettering the aggregate health of of our country as a whole. I would guess that it would lead to healthier workers, happier workers and more productive workers.

This is all assuming people would actually use the health care especially for preentive purposes instead of letting things get out of hand or stop taking care of themselves.

Oh yeah, will, thanks for the links, I will look at them.

Also, I wasn't really looking for stats or figures per se, rather I wanted to hear your opinion on the role of the insurance industry in health care more in depth. Despite our differences, I do like to hear your opinion (I wasn't looking for an argument, more of a discussion).

On responsibility, I mean people who "hurt themselves" and thus putting unnecessary strin on the system and/or endangering other people. I realize this is a bit vague and even slippery slopish, but I find it very relevant to the discussion because it implies that extra "unnecessary cost could be placed ona unversal system needlessly. EX: in LA, many ERs were shut down in part because gangbangers keep shooting each other only to get patched up by the ER and then they are back at it again shooting each other only to end back up in the ER only to get patched up and then they are back at it again..... Or drug users that refuse to get help but then end up in the ER. Recover, then end back up in the ER. Or many people who can't afford to have children, do so anyways and go to the ER then keep on having kids and going to the ER. Or smokers who get sick and then end up in the hospital. I am not so sure I like the idea of a smoker getting free (costly) health care to treat something that they caused themselves. In that sense, it would feel like I am paying for someone elses irresponsible behavior. To put another twist on it: imagine free abortions courtesy of the state. So on and so forth.

I couldn't agree more. This thread has been really impressive. Thanks to everyone that has contributed, and I cannot communicate how impressed I am that, despite slightly different methods, we all want the current system improved for the good of people.

I think that in a good universal care situation, you could hope that some of this would even out. Emergency Departments aren't swamped because of people getting shot, giving birth, etc. They are swamped because too many people use them in place of primary care - for sore throats, etc. The ED can't really turn those folks away without doing a workup, or else they'd be exposing themselves to horrible lawsuits - remember the little boy whose toothache became a lethal brain infection?

The good thing about universal care, if it were implemented well, is that people would go to their primary care physician for things and get them taken care of before they developed into costly, acute conditions. Not only that, but since people would have access to preventive care (think about heart monitoring, physicals, weight management, diabetic counseling) you could reduce the incidence of serious problems. I'm not imagining utopia, because I realize that laziness is a significant factor in poor health, just as cost of care is. However, if this hypothetical system were well implemented, it might restore balance to the way the medical system ought to be used.

I'm sympathetic to your feelings about responsibility, jorgelito, but I think that in practical terms you have to realize that we're already treating those people when they show up in the ED with conditions that are vastly more serious and costly than they would have been had the person addressed them at the proper time. Not having universal care doesn't get you out of paying for overnight detox for drug addicts, shot gang members, heart attacks in McDonald's addicts, etc.

Michael Moore's sppech in support of HR 676, which is Kucinich and Conyers' universal health care bill:

http://www.youtube.com/watch?v=DYnad...%2F4652%2Fplay

I've long been pulling for 676, and if this film can raise further support for it, then that is great.

OK, am I the only one here who is just curious as to how you know what "ass" tastes like Will?....lol

I went to college with people who like beer, so I've had someone fart in my face before. It's even less pleasant than one would imagine.

Hippie.

(
http://www.tfproject.org/tfp/showthr...30#post2269630 )

Just remember that Micheal Moore's skills in sophistry are only topped by Rush Limbaugh...

I havent seen the film and I will not pay for it, so does the great MM mention trial lawyers in this masterpiece?

And how come trial lawyers haven't been mentioned in this thread?

I have a very good friend who is an ob-gyn here in Jersey, his malpractice insurance fee is well over 300k a year, thats right 300k.
Great doctor, delievered my first daughter, never had any real lawsuit brought up against him. Why should he have to pay that? So he can cover his
ass becuase some ambulance chaser sees a quick pay day?

Maybe along with the gnp per cost ratio maybe someone who loves the hell out of google could look up the lawsuit per insurance cost per GNP ratio.

reconmike: perhaps you somehow missed posts 22 and 26 in your study of this thread. All of the talk about malpractice is really about trial lawyers.

That's me!!!

Lawyers can be a problem to anyone for any reason. Many are a problem when it comes to health care, of course. There are plenty of frivolous lawsuits out there trying to take advantage of good, honest, hard working doctors who have done nothing wrong. Here's the deal: they can only screw up the system as much as judges allow them. Judges are some of the most important people in a democracy, as the weight of justice sits squarely on their shoulders. It's the judges like the McDonalds coffee judge, who allowed an idiot jury (you heard me, and IDIOT jury) to pay out $2.9 million to a woman who alleged that she didn't know coffee was hot, that really screw up things like health care. Prosecutors are required to do the best for whom they represent, by law. Unfortunately, when some ambulance chaser (that's the first time I've used that term to actually describe an ambulance chaser) sues a doctor who did nothing wrong, they are legally required to do everything within the law to win for their client. It's up to the jury, or if not that the judge to dispense justice.

I did miss the 2 small blips on maybe a possibility for our healthcare woes, it must have happened while I had my scroll wheel's supercharger boost up too much.

They have, now three times. That's 1 out of every 18 or so posts. The 'blips' covered a point you said wasn't covered. End of threadjack. If you want to discuss the point instead of sit outside throwing stones at the beautiful home we're building, go right ahead. This thread is going so well that no drive-bys can shake it, but we'd do even better if everyone came in here with something to add, discuss, or learn.

Will, things like this REALLY irritate me. You've got the facts of the McDonald's case all mixed up, and it's blatant misrepresentation.

The plantiff originally asked for her medical and dry cleaning bills to be paid. McDonald's refused. She filed suit and specified an amount above $50,000 in damages (a requirement to keep it out of small claims court). The jury awarded punitive damages because they felt that McDonald's had ignored evidence that their coffee was served too hot and in containers that did not provide containment.

The plantiff did not allege that she didn't know the coffee was hot. She alleged that she didn't know that the coffee was 200 degrees. It was suposed to be served at 165 degrees but was much hotter, obviously. You'll also notice that McDonald's has redesigned the lid to their coffee cups recently, and that is a direct result of this case. If you remember, McDonald's used to have a flat white lid that peeled up. It didn't stay on very well. The plantiff alleged that the lid wasn't properly fastened by the employee when he handed it to her and that 200 degree coffee spilled all over her, resulting in 2nd and 3rd degree burns.

She tried to settle out of court. McDonald's told her to go pound sand. She took her case to court. The jury felt that McDonald's acted in bad faith. I don't disagree even though the award directly impacted a good friend of mine negatively (he was the underwriter for McDonald's liability coverage).

The judge did nothing wrong. The jury did nothing wrong. They both did their duties. Mentioning prosecutors is a big red herring since there was never a prosecutor in the courtroom unless one stopped by as an audience member. There were no criminal proceedings.

Back on topic, reconmike, I'm sorry that your doctor friend pays so much for insurance, but I suspect that you don't have the full story. The national average for OB/GYN professional insurance premiums (or malpractice) is $100,000. In New Jersey, it's probably $150,000.

So that leads me to believe at least one of these is true: a) the doctor has had a large judgement paid against him, b) he's getting sued a lot but not paying anything out (the most probable), c) he has a substance abuse problem or d) his practice encompasses more than the average OB/GYN's.

That's just bonkers... So, if you want to make any money, you have to earn $100k before you can start earning for your practice overhead before you can start earning for your salary.

When you look at that and think about the fact that OB/Gyn docs go to 4 years of school and do a residency that is 4+2+(1 to 3), it's no wonder doctors want to get paid.

Uber - interestingly (at least to me), the lowest premium is in the undisputed leader of all lawsuits - California. They've put a cap on malpractice payouts there that's been in place for about 25 years (I think) but with mixed results. I've heard that there's some aggitation to remove it from plantiffs and their attorneys, but I can understand that. It's hard to accept when the doctor actually did something wrong that the payment for lifelong care for the injured party won't even get close to making it right.

There are good sides and bad sides to everything.

Sorry Will, what do you mean "no drive-bys" ? I have seen Host do it a couple of times. Slitting throats? Atleast the people with their throats cut will be able to get the finest doctors to sew them up. :eek:

Will, you said the French pay 20% of their salary to the cost of socialized medicine, how is that possible here when the bottom 40% of the people in the US do not pay a dime in income tax? Do you propose that we start taxing these people 20% of their income so they can have health insurance?

Someone earning 30k a year would now be taxed 6k to be covered by the government, or will it be just like everything else in this country, the top 50%
will have to carry the burden for the rest?

My recent visit to the ER a few weeks ago, (while washing a pint glass it broke with my hand in it, ripping my hand open and cutting a tendon), when I got there the place was packed, immigrants for a far as the eye could see.
When I was triaged I asked the nurse if it was always this crowded and she told me it was, because they know no matter what they will be treated.
This hospital has set up a "fast track" section to treat the "true" emergencies,
while leaving the people who use the ER as a doctors office to wait.
I am sure the people using this ER as a doctors office contribute to the high cost of the system. Will this hospital ever recoup the money they spent treating these patients? Or will it be passed on to others with insurance and their carriers?

The system needs something, whether it is socialized or not will be the big debate, but it somehow needs to be reformed.

I meant that you jump in to a thread and post something short and snarky that doesn't add anything to the thread.
Host doesn't do short posts. Also, if people bothered to read his posts, they'd realize that he usually brought all necessary information about the thread subject to the table in one post.
Do you have a link explaining that the bottom 40% of Americans don't pay any income tax? Also, no one is suggesting we use the French system, which is way too expensive. I suspect we're doing something more similar to the UK or Canada systems, which are less expensive.
Oh good, I was hoping someone would bring up 'immigrants' in here. How dare they get medical treatment!!! They're dirty and foreign, and they aren't desperately capitalist like we are!

The current system was screwed up in that it assumes only people with money deserved to get medical treatment. Then people realized that wasn't fair at all and now hospitals are required to treat everyone.

Under socialized medicine everyone pays a little and everyone gets treatment. It's just like the taxes we all pay for fire protection.
Exactly.

Really? I'm curious because EMS services don't work that way.

Then I shouldn't have been given an invoice for a call from NYFD. Also there wouldn't be so many volunteer firemen and EMS services across the country.

Here in NYC I can call 911 and FDNY EMS shows up, they will send me a bill.

I can also call Hatzallah a volunteer Jewish organization. They will show up, and maybe ask for a donation. I say maybe because I don't know for sure.

I do know when I was run over on my motorcycle in Northern NJ, I was picked up by volunteer EMS called by the local city PD, and was told that I didn't have to pay for it.

EMS = paramedics. Firefighters aren't EMS. That's why I said 'fire protection' and not 'EMS'.

Under socialized medicine, usually paramedics would be covered by the program.

So rising up and slicing throats contributes to this discussion or any for that matter?

Here is a link showing 2004 stats, I read that tax year 2006 was 40% but until
I can find the stats I'll amend my statement and say 32% do not pay any income tax. http://www.taxfoundation.org/research/show/1410.html

I never said how dare they get treatment, I said they use the ERs as a normal
doctors visit, why because they know if they have a cold the ER will treat them for it. And bringing up immigrants is a very legitimate topic. If they do not pay into any system or pay for the services they recieve, someone else will have to pay for it.

Now I had to look because I recall being asked to suppor the fire department at one time, but Suffolk County and Nassau County, both very high property taxes all have Volunteer Firemen to cover their territory. It is ALL of Long Island.

So when I lived there I didn't pay for fire protection. The local fire departments had to raise funds to cover their firehouses.

Many fire protection services in the Northeast are volunteer organizations.

I didn't make you drive by. I'm trying to keep this thing going, and I don't want to see a whole bunch of yellow mod messages because people can't contribute.
I wonder how many of those 32% have poor or don't have medical coverage.
Which is why socialized medicine makes sense. Imagine that part of income tax goes to pay for all medicine. That means everyone, citizen or undocumented guest worker, pays for medical.

where did they pay if those 32% did not pay federal taxes? I'll shelve the immigrants since there are a number that "pay" taxes or have them withheld from their wages and do not file for them at the end of the year.

Honestly? Either everyone should pay income taxes of some kind or no one should. Lower income people should pay lower taxes, of course, but they should still pay. OR. No one should pay any income tax, and sales tax should increase. Either way it's about everyone paying into a mutually beneficial system.

Again, sales tax is something everyone pays. It would seem fair that if everyone is going to be given access to a health care system, everyone should pay something.

IMO, sales taxes are akin to abortion restriction. The wealthy have the option to travel outside the jusrisdiction of both the tax, and the restriction. They can opt to make their big ticket purchases or obtain safe clinical abortion where the taxes are low, or where abortion is legally unrestricted.

The only way to collect taxes is on the record of receipt of income. We enjoyed deficit reduction by the end of 1999, that saw only an $18 billion annual treasury debt increase, that year....compared to an average of $412 billion per year, since the Cheney driven, $1.3 billion tax cut was passed by a republican controlled congress and executive branch.

In addtion, the wealthy cease to experience 7-3/4 percent FICA withholding on income above $100K, each year. The poor pay FICA withholding on every dime that they earn. The wealthy have access and influence over elected officials, access to the best legal defense and protections, hedge fund access, etc., etc......and the best tax attorneys and accoutants...and everyone else does not.

I cannot agree with you, Will. Not when half the country owns just 2-1/2 percent of all of the assets, and the top marginal rate on income above $400k per year has been reduced from 90 percent in 1960, to less than 40 percent, today. A progressive tax that is just a bit higher than the certainly reasonable income tax structure that was in place in 1999, would cause no hardship and it would help to lower the deficit. A 7-3/4 percent withholding from folks who make less than ten bucks an hour, is already quite enough, IMO.....

so either way then everyone has less money in their pockets. am I correct in that assessment? either taxes are taken out from everyone or national sales tax. I'm making sure you are in agreement, that people across the board will have less money in their pockets, especially the poor. yes?

Well this thread is about correcting bullshit things like that. The rich don't get a pass. Everyone pays, and if you don't you go to pound me in the ass prison. I don't have a solution to the outside the US tax thing, but that hardly means there is no solution.

This is about planning for progress.
Then we need to hold these elected officials to the fire. If you bribe someone, the government ceases your assets and starts a college fund.
Completely, totally, wholly, and utterly wrong. Everyone will get heath care, and they'll get it dramatically cheaper than it is now. Those who can't afford health care now, when they become sick or need medical assistance, pay through the nose for it. They won't be paying that anymore. Everyone saves a lot of money for health care from the richest of the rich to the poorest of the poor.

I did not note any amounts, especially the poor implies that you are removing their ability to chose to forgo the costs. When I was younger and didn't have as many medical conditions, I saved that money by not paying into any insurance plan. It made the difference of having money to pay all the bills or not.

I'm just making sure that we agree that no one is getting a free ride. Since if it is cheaper for the poor it will also be cheaper for the rich.

so either way then everyone has less money in their pockets.

Choosing for forgo those costs? This isn't bubble-gum or something. While you never had any medical conditions when you were younger, did you ever see the doctor? Ever get a cold, chicken pox, or a flu? Ever need prescription drugs? Everyone gets sick; be they poor or rich. Everyone needs health care available to them.

I, personally, think it would only be fair if everyone paid into the program, but the poor paid less. If you make $300k a year, paying a higher percentage isn't as detrimental as it is if you make $20k a year.

The bottom line is that everyone has more money in their pockets and everyone has health coverage.

Sure, when I was a child. But once I hit 23 and was not in college, I had no medical coverage until I was 27.

No I did not go to the doctor. I did not go to any hospital, I did not get any prescription drugs. Medical insurance does not cover buying Tylenol nor Nyquil. So explain to me how I would have more money in my pocket if I paid into a system that I did not want pay into? I wanted to pay my bills at that time, choosing insurance was $50 out of my paycheck every 2 weeks, $100 each month. When I was making $700 take home a month, how is paying $100 having more money in my pocket?

Again, I CHOOSE to forgo participating in the system. How is that fair to be forced to participate where I don't want to?

Edit: Sorry I forgot when I was 23 and had no insurance I was run over on Route 4 in NJ on my motorcycle. My bills were paid for by the person's insurance that hit me.

Host in 1960 that tax law was crazy, so in 1960 if I earned 400k I would net 40k for the year, while someone earning 60k would net more? No wonder it was changed, not only wasn't it fair but completely asinine.

And the people earning $10 dollars an hour have fica withheld so they have that little safety blanket called social security when the retire or they die trying and their spouses need it.

So because you've been fortunate, you clearly have no need for medical treatment in the future and everyone else gets your middle finger.

Think about that. Does that really make sense to you?

No I made CHOICES. Had I been unfortunate, then it would be my fault. It was my gamble and it paid off for me.

Today I cherish my healthcare coverage because the 3 times I have been hospitalized would have financially ruined me. But I pay for that system, I also CHOOSE my employment based on criteria like health care benefits.

I'm stating that you have stated in other threads about freedom of choice, but here I cannot chose to opt out of a health care system? Think about that for a moment. How is THAT freedom?

As I've stated previously in this thread, going without health insurance is stupid, as you almost found out.

That said, you've (the plural) got a right to be a moron as long as it only affects you.

And just because I said that you're a moron doesn't make it so.

'Freedom of choice'? What the hell does that mean?

You keep pretending like this is a 'freedom to choose' for yourself. It's not. You're making the call for the 45 million Americans who don't have coverage. Maybe you can explain to those who cannot afford it but need it how your decision is about your own 'freedom of choice'.

My own freedom to chose to NOT belong to an encompassing system. What if I don't want to? Just like I chose to not to pay into any health care coverage. I'm not making the call for no 45 Million other people. I'm talking about my own decision for my own life and my money.


You are stating that I'd have to all pay into a system. I've shown you that if I paid into a system back in the day when I chose not to it saved me $100/month. It made the difference between having enough money for all my bills and not having enough money.

Where is my freedom to choose under your socialized medicine? I don't want to participate in it. Can I not participate?

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.

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?

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.

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 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.

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?

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.

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.

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?

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.

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.....

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.

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.

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.

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

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?

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.

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.

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.

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.