Rescission and the glories of privatized health care.

Started by Vekseid, June 30, 2009, 05:02:26 AM

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Oniya

Just to point something out, since it keeps getting brought up:

Health care - and indeed, room and board - for people in American prisons and jails are paid for by the taxpayers, and the average taxpayer isn't too thrilled about it.  Law enforcement budgets are suffering just as much as other public services (like schools and libraries).
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Rhapsody

Quote from: RubySlippers on July 03, 2009, 09:41:56 AM
I hate to say this being a Libertarian but how many people in Canada are afraid they will have to go bankrupt over a health care bill, or in other countries with basic national health care?

I'm in a low-income family. My eldest son has been recently diagnosed with autism, and is in need of child development specialists, pediatricians and speech therapists.  My youngest is looking like he might require specialized developmental intervention as well. 

My grandparents are on a strict income.  My grandfather just had a colonectomy (his bowel removed) back in April because his colitis polyps were turning precancerous.  He was in hospital for a week and a half, and still requires weekly visits from a home nurse and (to my best knowledge) biweekly or monthly visits to his internalist to make sure everything's healed properly and colostomy system is working alright.   

All we have to worry about paying out of pocket for are whatever prescription drugs come our way, and I have a drug plan and my grandparents a privatized health plan for that.
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Zakharra

#27
 
Quote
I'll end this way: There are 1.8 million Canadians without a family doctor.  There are 45 million Americans without health care.   Which would you rather be?

And the Canadian population compared to  the US one is..? 33 million compared to 300+ million. Big difference in size and expenses, as well as living style.

the 45 millon americans also includes, I believe, those who can pay for their own healthcare, those who do not think they need it and those who are between plans, even if for only a few days to a few weeks.

Rhapsody

Quote from: Zakharra on July 03, 2009, 12:30:20 PM

And the Canadian population compared to  the US one is..? 33 million compared to 300+ million. Big difference in size and expenses, as well as living style.

If you really want to get down to numbers, let's just call it 5.5% of Canada's population and 15% of America's.
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Elven Sex Goddess

Quote from: Zakharra on July 03, 2009, 12:30:20 PM

And the Canadian population compared to  the US one is..? 33 million compared to 300+ million. Big difference in size and expenses, as well as living style.

the 45 millon americans also includes, I believe, those who can pay for their own healthcare, those who do not think they need it and those who are between plans, even if for only a few days to a few weeks.

I have to ask show me the hard proof of your claim.   Of those only a few days without are on the lists of uninsured.  I seem to remember Brian Williams saying on NBC that it is six months without health coverage before a person is listed as one of the uninsured.  I may be wrong, so is not listing it as a claim.

Never the less, either way if anyone has hard data.   Not supposed and implied please list it. 

consortium11

Quote from: Asherah on July 03, 2009, 02:05:08 PM
I have to ask show me the hard proof of your claim.   Of those only a few days without are on the lists of uninsured.  I seem to remember Brian Williams saying on NBC that it is six months without health coverage before a person is listed as one of the uninsured.  I may be wrong, so is not listing it as a claim.

Never the less, either way if anyone has hard data.   Not supposed and implied please list it.

Read the US Census Report on "Income, Poverty, and Health Insurance Coverage in the United States: 2007", which is where the 47 million uninsured figure comes from and freely avaliable on their site.

Here's where the confusion comes in. On Page 19 it states:

QuotePeople were considered “insured” if they were covered by any type of health insurance for part or all of the previous calendar year

So that seems clear. If someone had insurance for a single day during the previous year they would be classified as "insured".

However, directly below that first quote;

QuoteThey were considered “uninsured” if they were not covered by any type of health insurance at any time in that year.

So if we use that definition then someone who had no insurance for a week between jobs would be classified as uninsured.

It's a horrific definition and one that clouds debate on the issue.

Vekseid

It takes six months for your insurance coverage to expire after losing employment, at least it did for me.

consortium11

Quote from: Vekseid on July 03, 2009, 02:36:05 PM
It takes six months for your insurance coverage to expire after losing employment, at least it did for me.

Didn't know that... thanks for the info.

On the other hand, if we take the second definition (uninsured for any period = uninsured) that would still cover someone who say cancelled an existing private insurance contract before starting a new one with a days gap between any expiration period/notice on the first and the second starting.

As I said, it's a horrific definition and one I did a double take for when I first read it.

Vekseid

A part of it though is the reason for this very thread - one day of lost coverage runs a very high risk of getting it canceled due to a 'pre-existing condition' later.

Rhapsody

Honestly, Vek, even without losing a day of coverage, benefits can be waived because of "pre-existing conditions".
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RubySlippers

Oddly I did some digging an in at least my area people without health care of low income have several benefits. State law bans hospitals from charging people considered poor under the Charity Care Laws a group I fall into even though I work. Free clinics are well supported and I go to the one in my area paying $5 a visit and I get good care. The other bills for example if in the hospital I can usually bargain down to payments I can afford.

Oddly the people with insurance get shafted they can't tell the hospital to go fuck itself and I can do that legally. I just need to make sure I stay in the right parameters to stay a charity case which I do on purpose now. I turned down a job just to stay under the income cap because at this point its the best way to assure my health care is affordable. Even if not very good.

As for prison care as an example I just pointed out I'm a law abiding citizen and I can't get the level of health care as a criminal convicted of say serial rape gets, something is wrong with that picture.

Elven Sex Goddess

QuoteSo if we use that definition then someone who had no insurance for a week between jobs would be classified as uninsured.

It's a horrific definition and one that clouds debate on the issue.
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Yes but your also not looking at the other side of the coin. 

QuoteQuote

    People were considered “insured” if they were covered by any type of health insurance for part or all of the previous calendar year


So that seems clear. If someone had insurance for a single day during the previous year they would be classified as "insured".

However, directly below that first quote;

Quote

All I am pointing out is the illusion is being given that the uninsured is being pumped up as if some diabolical scheme.  That lets assume is a left wing liberal plot.  To bring about socialized health care.   

Yet with how it reads and  as you have pointed out.  A person with one day of insurance, can end up for that year as one of the insured. 

Anyways thanks for the response. 

fossildude181

Quote from: Rhapsody on July 03, 2009, 05:33:37 AM
It doesn't.
You're right, it's actually ten weeks to get an MRI. http://www.cbc.ca/health/story/2007/10/15/waittimes-fraser.html
Quote from: Rhapsody on July 03, 2009, 05:33:37 AM
They're called fundraisers.  I believe the US also has them for procedures and surgeries your health care plans don't cover.
Not a fundraiser. That's how they determine who sees the town's doctor. http://abcnews.go.com/2020/Stossel/story?id=3580676&page=1
Quote from: Rhapsody on July 03, 2009, 05:33:37 AM
There are stories about that because people like to whip them out to prove that socialized health care is an evil, pointless thing that's only going to extend your wait times and suck away all your money.
We can’t prove that either way.
Quote from: Rhapsody on July 03, 2009, 05:33:37 AM
No, they are not telling.  I've been under the US health care system as well as the Canadian, and I can tell you right now that there is no hugely discernable difference in wait times or bed spaces available.   I once spent 18 hours in an American ER for a kidney infection because there wasn't enough bed space, for example, and I had to delay having my first pregnancy induced twice because the beds in the Canadian maternity ward were full.   

Because our basic health care doesn't cover everything.  It doesn't cover dental, it doesn't cover vision, and it doesn't cover drugs.  It's why it's called "basic".  Private health insurance has been around a lot longer in Canada since 2005.   "Nationalized" health care is also a misnomer.  The federal government has little to do with our health care plans.  The word you're looking for is "provincial".

Is it a perfect system?  No.  Is it a better system than what I witnessed and experienced in the United States?  I believe so.

I'll end this way: There are 1.8 million Canadians without a family doctor.  There are 45 million Americans without health care.   Which would you rather be?
I’ll accept your personal experience as an indicator, but the veracity of the statistics remain the same. Health care is harder to get in Canada.
I’ll concede the point on private health care. It still existed after the national coverage began, but the Canada Health Act of 1984 made it financially unwise to use such coverage. Private health care didn’t start taking off again until Chaoulli v. Quebec in 2005.
Your last point is inaccurate. Forty-five million Americans don’t lack health care, they lack insurance. If they want health care, all they need to do is pay.
Civis Americanus sum

Oniya

Quote from: fossildude181 on July 03, 2009, 06:21:14 PM
Your last point is inaccurate. Forty-five million Americans don’t lack health care, they lack insurance. If they want health care, all they need to do is pay.

Might want to look into the reason that they lack the insurance.  There is a fair percentage of people out there, especially now, who don't have health insurance because a) their employer doesn't offer it (either at all, or only to the full time employees that the employer isn't hiring because part-timers are cheaper) or b) they can't afford to knock the substantial chunk of cash out of their monthly budget, what with the cost of food, housing, gas and utilities going up.
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Vekseid

Quote from: fossildude181 on July 03, 2009, 06:21:14 PM
If they want health care, all they need to do is pay.

No, all we need to do is make you pay. You're paying already, in several ways.

Rhapsody

#40
Quote from: fossildude181 on July 03, 2009, 06:21:14 PM
You're right, it's actually ten weeks to get an MRI. http://www.cbc.ca/health/story/2007/10/15/waittimes-fraser.html

I've never had an issue getting the procedures I needed done when I needed them.  It also to my best knowledge (as I am not a medical professional and cannot speak with absolute certainty, only my personal experience) that such cases are taken by priority... For some things, yes, appointments can take months -- my son's speech therapy, for instance.  We've been on the waiting list since November, and his first appointment is in two weeks -- but he's not as severely affected as some kids, and has been lucky enough to become involved in programs that aid in developing his speech.  On the other, faster side of things... Requiem, my husband, was hospitalized up here in Canada with health problems for nearly two weeks almost three years ago.  He had a multitude of ultrasounds, radiology and MRI scans done within days of his being admitted, and had a cardiologist at his bedside the following day to explain the results.

QuoteHealth care is harder to get in Canada.

I'd argue that's because everyone has free basic coverage, and it's more about preventative medicine than reactive medicine.  I lived two years in the United States, and almost all of my friends would have needed to be on their death beds to go to the hospital, because they either didn't have coverage through their works or couldn't afford their premiums to increase.   One of them was born with CP, and was insured out the ass as a disabled person, but she still pressed her coverage as little as possible.

Up here as a Canadian citizen, if you're feeling crappy, you can go to the doctor without worrying about how you're going to feed your family for the next week, and a stay in the hospital generally doesn't automatically lead to stress over how much out of pocket this is going to cost you, or how it impacts your credit rating when you can't pay.   This logically leads to more people going to the doctor when they feel they have to, instead of just sucking it up and hoping whatever they have won't kill them.

QuoteYour last point is inaccurate. Forty-five million Americans don’t lack health care, they lack insurance. If they want health care, all they need to do is pay.

I use the terms "health care" and "health insurance" interchangeably; perhaps that's inaccurate of me, but it's the habit I've fallen into, since I've mostly just dropped the "plan" off "health care" in speech.

I think what I'm trying to get at in a very roundabout sort of way is that you really can't define a health care system by the dry facts and sometimes biased reporting that's done on the issue.  It's not a perfect system, and I've never claimed it was.  But I see the argument that "wait times will increase" and "why should I have to pay for Joe Blow's gallstone surgery" from people who oftentimes don't have the slightest clue what they're talking about.   They parrot articles they've read and speeches they've heard, often enough from people who represent companies whose sole purpose that I can discern seems to be draining every drop of cash they can from your pocket and trying to find ways to weasel out of the agreement they made with you at the initiation of your plan's coverage.

One final fact: when my stepdaughter was born in the States, her mother racked up well over ten grand in hospital bills which her insurance, fortunately, covered.  When my first son was born, I was in the hospital for nearly a week, and would have, had I lived in the States or wasn't a Canadian citizen, owed nearly fifteen thousand in bills for bedspace, medications, meals and medical supplies.  Perhaps the argument can be made that you shouldn't have a child if you can't afford health care coverage for them, but I think a stronger argument should be: why shouldn't you be afforded free, basic coverage so no one, no matter how well-off they are, has to deal with thousands of dollars of extra debt when they're starting or adding to their family?

Edit: Rereading this post, I stated something inaccurately.  You do not have to be a citizen of Canada to qualify for provincial health insurance.  You just have to be a legal resident, either through immigration, citizenship or permanent residency.
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RubySlippers

There is another side to this the Underinsured. Those that have insurance at some level but can't afford the co-pays and deductibles so still end up going into debt and bankrupt. Take COBRA its true an employee can keep insurance if they pay the full cost but that is often at or more then their unemployment check so they don't keep the insurance.

Like I said if your well off you can get health care, if your low income you can get help (free clinics, charity care laws at hospitals and the like) and the fact most write off a debt if they have no hope of collecting. If your even incarcerated in jail in our county they have a county health facility for the prisoners that is rather good. But if your middle class insured you tend to get the short end of the stick it seems to me.


Dizzied

I don't know if this has been said before, but has anyone looked at other things the government owns?  Amtrak, or the post office, for instance.  Neither of these things is profitable.  The government covers their losses with tax dollars, and it doesn't matter if you use UPS for your mail, or if you've never ridden a train in your life, everyone ends up paying for them.  Nationalized health care doesn't stand a chance to be any different.  Making health care free will create an artificially high demand for health care.  Doctor visits increase when you don't have to pay for them.  Emergency room costs don't exist anymore.  Got a bad cough?  It's probably allergies, but why not march down to the ER just in case.  It won't cost you anything.

Naturally, with 300 million people in the country with free healthcare (a small chunk of which are non-citzens, I might add), the spike in demand will be more than the system can handle.  It won't be profitable, like all government owned businesses, so doctor's wages and benefits won't be rising.  There's less incentive to become a healthcare worker, so the shortage becomes even worse. 

To make matters worse, it's likely that the government will price cap pharmaceutical companies so that the government can afford to distribute the drugs to those who need it.  Unfortunately, pharmaceuticals are highly priced because thats what it costs to finance research and development of new drugs and treatments.  If they can't charge what they need, then we don't get any new drugs.  The future won't be any better than today.  You can bet the pharmaceutical companies will outsource to China, India, or somewhere else where the government doesn't screw things up.  (Less jobs for us, I'm sure you all know)

I'd like to say that I wish everyone could get health care.  I don't want to see anyone dying or broke because of health costs.  But the fact is that nationalized health care doesn't work.  It makes things worse.  This isn't a slippery slope argument; its economics 101.  An artificially low cost to something (health care) creates higher demand, and a shortage of supply.  Health care would be cheaper if government wasn't involved at all.  Medicare and medicaid help to drive prices up; as a doctor, you can charge more from your patients knowing that they won't have to pay for it, the government will.  You won't drive your customer away, and you'll make more money.  Why not increase profit?

I'm not gonna argue these points with anyone, mostly because of a lack of time, but I felt obligated to say something. 

Oniya

Actually, the USPS is not government-owned, and was showing a profit until quite recently.  (My maid of honor worked/might still work for the post office.)
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Pumpkin Seeds

People already do go to the local ER for a bad cough because they can't afford the doctor visit.  Also, drug companies from the United States sell those drugs to Canada at such a reduced cost that they are sold back to the United States for cheaper.

Zakharra

Quote from: Oniya on July 08, 2009, 03:18:34 PM
Actually, the USPS is not government-owned, and was showing a profit until quite recently.  (My maid of honor worked/might still work for the post office.)

Not true. It IS owned by the US government, It just isn't funded by it. It's mandate was that it had to make a profit and stand on it's own revenues, but it is a federal run bureuacracy. It's now failaing due to fewer people using the mail, a bad economy and more stuff going over the net.

Dizzied

Quote from: Askie on July 08, 2009, 03:24:37 PM
People already do go to the local ER for a bad cough because they can't afford the doctor visit.  Also, drug companies from the United States sell those drugs to Canada at such a reduced cost that they are sold back to the United States for cheaper.

The ER costs way more than a simple doctor's visit, with or without an insurance co-pay.

Regarding what you said about drug companies, please elaborate.  I'm interested to hear about this. 

ShrowdedPoet

The point is they don't have to pay up front, they can make payments, and often times they end up not paying.  I have gone to the ER before because I could not afford a simple doctors visit myself.  No doctor would see myself or my daughter for less than 100 dollars.  We were both running high fevers and finally I decided that we had to be seen so I went to the ER.  We don't have insurance.  Can't afford it.
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RubySlippers

There is a difference between a Basic Safety Net and full health care like we have now. I would point out my idea would be to have people see whatever doctor or nurse practitioner is available or they are assigned to. Limit health care to treatments that are well known and work to meet needs such as preventative care and treating medical conditions in standard ways. And forcing the use of only generic drugs likely older ones unless absolutely necessary. And refusing care for expensive care that has a lower than a certain percentage chance of success for say cancer. Perhaps a cutoff at say under 30% of success on the estimation of physicians handling the case.

With low co-pays and this can be funded with existing funds Medicaid, county and state indigent care funds and I would add in Medicare funds since seniors would get the care they need this way with limits.

Supplemental insurance can be available for seniors.

consortium11

Quote from: Dizzied on July 08, 2009, 03:02:28 PM
I don't know if this has been said before, but has anyone looked at other things the government owns?  Amtrak, or the post office, for instance.  Neither of these things is profitable.  The government covers their losses with tax dollars, and it doesn't matter if you use UPS for your mail, or if you've never ridden a train in your life, everyone ends up paying for them.  Nationalized health care doesn't stand a chance to be any different.  Making health care free will create an artificially high demand for health care.  Doctor visits increase when you don't have to pay for them.  Emergency room costs don't exist anymore.  Got a bad cough?  It's probably allergies, but why not march down to the ER just in case.  It won't cost you anything.

Naturally, with 300 million people in the country with free healthcare (a small chunk of which are non-citzens, I might add), the spike in demand will be more than the system can handle.  It won't be profitable, like all government owned businesses, so doctor's wages and benefits won't be rising.  There's less incentive to become a healthcare worker, so the shortage becomes even worse. 

To make matters worse, it's likely that the government will price cap pharmaceutical companies so that the government can afford to distribute the drugs to those who need it.  Unfortunately, pharmaceuticals are highly priced because thats what it costs to finance research and development of new drugs and treatments.  If they can't charge what they need, then we don't get any new drugs.  The future won't be any better than today.  You can bet the pharmaceutical companies will outsource to China, India, or somewhere else where the government doesn't screw things up.  (Less jobs for us, I'm sure you all know)

I'd like to say that I wish everyone could get health care.  I don't want to see anyone dying or broke because of health costs.  But the fact is that nationalized health care doesn't work.  It makes things worse.  This isn't a slippery slope argument; its economics 101.  An artificially low cost to something (health care) creates higher demand, and a shortage of supply.  Health care would be cheaper if government wasn't involved at all.  Medicare and medicaid help to drive prices up; as a doctor, you can charge more from your patients knowing that they won't have to pay for it, the government will.  You won't drive your customer away, and you'll make more money.  Why not increase profit?

I'm not gonna argue these points with anyone, mostly because of a lack of time, but I felt obligated to say something.

Is there a source or evidence of this?

Half the negative press the NHS gets in the UK is because it can't afford to pay for drugs for people... and off the top of my head I can't think of a single country with a universal health care type system that's stuck a price cap on drugs.