Healthcare

[x88x]

That's great news about the treatment, Kayin. I hope it goes well.

As for health costs, I'm a bit of an oddity...and I feel kinda bad saying this right after Kayin's post, but...well, I don't really get sick...ever. Well, ok, I get one 48-hour flu about once a year. That's it. I've only ever been in an ER because of me once, and that was for a broken arm. Yet, despite all that, I've only ever been without insurance for about 5 months in 2008..during which (surprise) nothing happened. The only health-care related expenses I've had in the last 10 years aside from normal over-the-counter stuff is my yearly eye exam/contacts refill and having my wisdom teeth taken out in 2007.

So..I guess you could say I'm one of the reasons insurance companies actually work.

I did have a friend at work a while ago though, who was in the hospital for chemo..he said the chemicals they were pumping in cost something like $10k/day. Fortunately, it was covered by insurance...though that ended up being irrelevant...

[d_stilgar]

Have you ever been uninsured? Also, it's not a regular rite-aid band-aid we're talking about here, they're generally a bit fancier. Doesn't justify the price, but it's still very easy to believe.

Why is medicine easier to believe than a fancy band-aid? A single pill doesn't cost $10-/+ each, but that's generally what you get charged.

They break-down the costs for you in your billing btw.

If you are saying that it was a very fancy band aid, and not just some little piece of tape and gauze, then don't intentionally deceive by describing it as some $40 band aid. Did the $40 also include application or just materials?

Yes I've been uninsured and I payed full price and it wasn't so bad. I was expecting it to be worse the way everyone complains all the time. Dental doesn't fall under normal health insurance and many more people don't have dental insurance than don't have health insurance, and yet people don't complain about that. Somehow we all think we have a right to just feel good all the time but being able to eat is a luxury. Give me a break.

I've gotten into this subject before on this site and talked about it in depth, but the short of it is that people have come to think of health insurance as some sort of right because the government put wage caps on businesses in during WWII. Because of this businesses would offer other benefits, namely health insurance, to be competitive. After the war it stuck and here we are. So why do we have a right to feel good all the time but not have a right to be able to chew our food, because your employer says so.

I agree that there are big issues with the way that health care is paid for in America. Bad doctors game the insurance system, which drives the price of insurance and health care up. It creates the expectation that people will have their visit paid for by insurance. The result is a price that feels overpriced by the uninsured. What's worse is that there are laws that prohibit giving discounts to those that pay in full on the day of the visit. What it amounts to more or less is the insurance companies setting the price for how much your visit is going to be regardless of whether or not you are insured.

Some of the big problems with health insurance have been that large companies can get big discounts because they have so many employees. This has in part led to increasing costs of self-insuring.

But this isn't the point either. The point really is that it's health insurance and not 'super duper magically free health care.' Insurance is something you don't want to use. Let's compare it to cars, we don't expect our insurance companies to pay for oil changes, tires, wheel alignment, regular tune ups, head lights, etc. But when it comes to health insurance none of us feel like we should pay for anything, even though it costs money. Health insurance should be for that time you get in an accident and have to be life-flighted, for that emergency appendectomy. We should all be paying a couple hundred a month praying that we'll never win the insurance lottery. When you get out more then you pay in it means your health sucks, and nobody should hope for that. And yet so many people expect to get out more than they pay in. Somehow insurance is unfair because we pay in and never see the big payoff.

I've said it before, a good solution would be to create a law that requires people to have health insurance. This would get enough people in the system to bring the costs down. There are laws around health insurance which prohibit certain refusal of payment because of a prior condition, and this is only getting worse under the new national health care plan. Here are some hypothetical examples:

1) My wife and I are young and healthy and the maybe once a year we don't feel well we go to the doctor and pay the $180 to get some work done, but it's cheaper than insurance. We want to have a baby but it's going to cost $15,000. What we do instead is get insured and pay $400 a month, but boy is that cheaper than paying for it ourselves. After the baby is here safe, we drop the insurance.

2) I'm starting to get old but I'm still pretty healthy. I've been having some pains in my chest but I don't want to go to the doctor because social security doesn't pay enough. Instead I buy insurance and lie to the doctor about how good I feel. I'm fit as a fiddle I say. A few months later I go in with these "new" problems. I can't be turned away from insurance due to prior condition and now I can ride the boat for the rest of my life taking out way more than I will ever put in.

These are just a few examples which really show why not mandating insurance is a big problem. It drives the cost up for the responsible people who are trying to do the right thing. I know there are those of you here that will say that mandating car insurance is okay because car ownership is a choice and that life is a right, so there shouldn't be a law that mandates we have health insurance. Well, if you feel that way then never ever complain that the cost of health care is high. Compulsory insurance is a way to drive competition and bring costs down. That's what you were complaining about right? Let compulsory insurance be a possible solution to high health care cost. Anyway, as an architect and urban design major I'll tell you now that unless you are part of the %5 of Americans that live in an area with adequate public transportation, you cannot be a full member of society unless you own and drive a car, so %95 of us are already compelled to own and insure a car whether we like it or not. Compulsory health insurance wouldn't be that much different.

Why compulsory insurance and not a nation wide health plan? Well, our government is good at some things, but they are traditionally bad at innovating (especially when they don't have to) and bad at predicting cost. The competition derived by private insurance brings costs down. Innovations also bring costs down. For instance, one insurance company decided that it would pay for two well checks a year free of charge because people didn't want to pay the $20 co pay. After running the calculations they realized that by paying for preventative medicine completely, they saved a lot of money from emergency room visits and cancer found too late. Now most insurance companies have moved to this sort of system are are continuing to move in that direction. We are moving away from sick care to health care. I doubt any of you would think that our government would be so innovative. We would have one plan for the whole nation that would stay the same until something significant happened, probably in another county.

If the government is going to be involved at all it should be at a state level. State legislature is easier to pass, and with 50 states we could maintain some amount of innovation as well a state wide health plans that can fit the needs of the local people. The needs of Alaskans is not the same as the needs of Californians.

Look, health care has a cost and it has to be paid for or else we are going drive all doctors out of business. Medicare and Medicaid already are a net loss to doctors, a loss that has to be offset by the people who actually pay. If you don't believe me call your primary care doctor and ask him or her. If what the government has already given us comes at a net loss to doctors, I'd rather see someone else paying the doctors when health care reform goes through. If it's the government paying then we're in big trouble.

[x88x]

I've never quite understood employers who offer general health insurance but not dental or vision (or neither). My employer lets us opt out of..well, everything if we want to, but dental and vision individually. My dental and vision monthly payments come to less than $12/mo...not a hugely significant amount in the grand scheme, especially since the only significant 'medical' expenses I usually have is an annual eye exam and contact refill..which would run me about $250 otherwise. So, less than what I pay for everything, but much more than what I pay for vision (iirc, vision is around $8/mo and dental is around $3/mo). For context, my normal health insurance (the cheapest, most basic plan we have) only costs me around $15/mo...so everything put together is still way less than the almost $40/mo that I have to pay for Medicare.. -_^ Compared to my car insurance, it's a bargain.

[dr.walrus]

How much do you pay in taxes? Undoubtedly it's still less than what we end up paying over here in the US, but nothing is truly free.

I can't do a side-by-side comparison, but the NHS accounts for 10% of what the UK raises in taxes, and the American system costs 12% of your total tax bill. And then you pay individual contributions too. I simply don't accept that's a 'good offer'.

My point was simply that I never, ever have to worry about my healthcare not covering me if something happens.

[Kayin]

I would counter that if a country wants to even appear to be civilized, it should provide for its citizens. And currently, the US is a third world country.

I consider it quite a big deal when health care is cheaper, more readily available and light-years better in Cuba than in the US. And that's not just because I'm dying. Nobody will cover me for insurance. You're born with what I have. I was born with a "pre-existing condition." You know what else gets covered as a "pre-existing condition? Rape. Another example? This list shows things like domestic violence to be a precluder for care as well.

The sad fact is, there is no insurance for the people that need it. And statements like yours, while they do have a point about paying doctors who do deserve a check (though not like the ones they get now) also pretty much state if you can't pay you should die. America should get its head from its posterior and realize the only thing they'ere gonna have left is the rich people, and who will do their dirty work for them then?

As to mandating that we buy insurance, doing so for me would be more than I get a month. That doesn't seem to viable a plan. According to the Republicans, I should go wander off in the woods and die. Personally, I would like to stick around a little while longer.

[Luthien]

The people who argue that everybody should have to buy insurance are always the ones who are healthy and don't really need it. I don't wish poor health on any of you, but I think it may truly be a case of not being able to understand what it's like until you've been through it yourself.

I worked until the doctors refused to allow me to work anymore. I mean worked 50-60 hour weeks, on my feet even as the skin, muscles, and nerves in my legs were literally liquefying and soaking through bandaging. I did not want to be disabled, but it happened anyway. So should I just die now because I physically can't work?

[BuzzKillington]

I still don't believe in free healthcare though...

People in the US complain about the waits as it is... Illegals already use the ER for their checkup visits since they can't deny you... I can only imagine how it'd be if it were free for everyone.

Reasonably priced? Sure... They shouldn't be pulling in 10,000% profits on medicines and basic care but I still don't believe anyone should be paying for me nor do I feel I should pay for anyone else.

[Luthien]

So, in other words, yes, I should just die.

[Luthien]

I worked when I could. I paid in while I worked. I never complained about it; it was just part of working. I also never thought I'd have to rely on it so soon (if at all), but I did. I'd say I'm sorry you feel slighted by "paying for others" but I'm not. Here's why: If the roles were reversed, if you were unable to work and I could, I wouldn't resent you. Bad things happen to good people. It's not anything deserved. It's not anything that can be prevented. It just happens sometimes. I hope for your sake you're never in a situation where you'll have to rely on others.

[x88x]

As others have stated, I think the whole thing is just a symptom of the much larger problem of the astronomical costs of health care to begin with. I also don't think there is a simple solution. I forget where, I think on a documentary a while ago, but apparently when the national health care system was implemented in Canada a lot of doctors moved to the US because they didn't want to stop making embarrassing large piles of money. I think it is fair to pay them proportionately to their training and skill, but there does come a point when it gets ridiculous. It's similar to the opposite situation with teachers..if you keep the salary low, nobody will do it just for the money..but if you keep the salaries low, the really good teachers might not be able to afford to stay. If you keep doctors' salaries high, you keep the good ones..but you also draw people who are only in it for the money... On the other end of the system, the medical companies obviously need to recoup the (sometimes honestly massive) costs of developing new medicines, but that again needs to be tempered. It is a hugely lucrative system, and I'll be the last to suggest that someone shouldn't be allowed to make a profit..but as Kayin said, part of the responsibility of the government is to protect their citizens, and when people cannot afford the costs of keeping themselves healthy and productive to society, there is a problem. Like I said, there's no simple solution.