Rescission and the glories of privatized health care.

[Vekseid]

I never know there was an actual term for this, though I've seen it happen to friends. Considering the issues with the private healthcare system in the US are partly responsible for my current situation, I don't have a lot of respect for its defenders.

http://www.cnn.com/2009/POLITICS/06/19/begala.health.care/index.html

You probably have never heard of Robin Beaton, and that's what's wrong with the debate over health care reform.

Beaton, a retired nurse from Waxahachie, Texas, had health insurance -- or so she thought. She paid her premiums faithfully every month, but when she was diagnosed with aggressive breast cancer, her health insurance company, Blue Cross, dumped her.

The insurance company said the fact that she had seen a dermatologist for acne, who mistakenly entered a notation on her chart that suggested her simple acne was a precancerous condition, allowed Blue Cross to leave her in the lurch.

Beaton testified before a House subcommittee this week. So did other Americans who thought they had insurance but got the shaft. As Karen Tumulty of Time magazine (who has been the journalistic conscience of health care coverage) wrote, other witnesses included:

"Peggy Raddatz, whose brother Otto Raddatz lost his insurance coverage right before he was scheduled to receive an expensive stem-cell transplant to treat his lymphoma. Why? Because Fortis Insurance Company discovered his doctor had found gall stones and an aneurysm on a CT scan -- conditions that had nothing to do with his cancer, that never bothered him and that he wasn't even aware of. And Jennifer Wittney Horton of Los Angeles, California, whose coverage was canceled because she had been taking a drug for irregular menstruation. Now, she can't get coverage anywhere else. 'Since my rescission, I have had to take jobs that I do not want, and put my career goals on hold to ensure that I can find health insurance,' she told the subcommittee."

The subcommittee's chairman, Democrat Bart Stupak of Michigan, called the hearing to highlight the obnoxious and unethical practice called rescission. His researchers produced performance reviews of insurance company bureaucrats who were praised and rewarded for kicking people off their coverage.

Then Stupak asked three health insurance executives the big question: Will your company pledge to end the practice of rescission except in cases of intentional fraud?

All three health insurance executives said no.

...

[Sel Nar]

That is the sort of thing that I feel is So Morally Reprehensible that it's on a level of Murder by Proxy.

<Rant>I may rag on the US. healthcare system simply by merit of me not being American (Plus all the jokes of walking into the ER costs 5000$ or so, just to sniff the air) but when the Medical Insurance companies are cutting insurance for Life-saving measures, just because of various unrelated or 'pre-existing' conditions, well... that makes my blood boil. Insurance is supposed to help Defray the costs of serious incidents such as Car accidents, Fire, or medical Emergencies. It is NOT there to soak you of a pile of money then Kick you to the Curb as soon as you ask for a helping hand.<Rant>

Here's a laugh, and an example at the same time; My dad can't leave Canada as his Hemophilia is a "pre-existing condition" [Duh; it's a genetic Disorder], and no insurance in the US would cover him; the general sentiment from Doctors in Canada is that if My dad had something as minor as a nosebleed in the US. He'd have to sell our home to pay off the bills. And a 70-acre farm rakes in a fair bit more than a half-acre townhouse, so, well... you get the idea.

So, yeah. that's my two cents, be it as rambling and as disjointed as the rest of my thought processes.

[The Overlord]

I will say this much on the matter-


My aunt is going in the late stages of a brain tumor and there’s been plenty of medical care. They put her into good facilities including now a hospice, as she needs help for everything.

Nine years ago my father got plenty of insured treatment for his cancer until he passed. I am glad that my family has gotten as much care as it has.


I can tell you this much, if I get anything serious and companies start dropping me in the future, I’ll move to act decisively while I still can. No one will get proxy murder on me without me taking someone down with me. If society dares to turn its back to me, it will get a blade in it.




And you can take that shit to the bank.

[fossildude181]

Insurance companies can be spotty, but it's considerably better than nationalized health care. What incentive is there to invest in a system where you don't make money? Where's the logic in rationing off health care instead of increasing the supply?

[HairyHeretic]

Insurance companies can be spotty, but it's considerably better than nationalized health care.

That would be a matter of some debate.

What incentive is there to invest in a system where you don't make money? Where's the logic in rationing off health care instead of increasing the supply?

Ask the people that can't afford massive health insurance premiums. They might have an answer or two.

[Jude]

I learned of human nature in a way very different from most, I think.  My cynicism grew out of the most trivial thing, an internet message board.  For many years I played an MMORPG called Asheron's Call by a company called Turbine and read the associated message board that the community of my server used.

Nearly every time a message popped up on the board about someone being banned, it was the same story.  "Turbine took my account away for no reason.  I did nothing wrong.  This is so unfair."  And every time someone wrote something like that, it turned out they had actually done something to lose their account.  I slowly began to realize that people lie a whole lot, especially when authority is involved.  It's almost natural for people to rally against the "big guy" in every situation and suspend any measure of skepticism.  I see it time and time again.

Does this mean I honestly believe that in every situation of someone being screwed by an insurance company that the people claiming such are lying?  Nope.  Does this mean I believe quite often the facts are being misrepresented at least a little?  Yeah.  I bet most of the people forming an opinion based on the nurse aren't scientists, nor do they understand Dermatology enough to actually analyze the insurance company's claim to decide whether or not it's a valid point.

It probably never occurred to most people who read that, that maybe the condition of her skin actually did indicate a cancer problem.  One which she neglected either out of incompetence or carelessness.  I'm not trying to make a point of blaming the victim here, I'm merely arguing that there are shades of gray in all of these stories which people ignore.

You rarely hear anyone arguing the insurance company's side, instead there's this notion that the insurance company should be operating like a charity.  What people fail to realize is that even a system of socialized medicine has its casualties.  In our system its failure to cover certain individuals or people who get screwed by the insurance company.  Under socialized medicine its rationing.  It's not like the government will start running things and the problems will magically go away:  no system is perfect.

To be honest I do think we can improve our health care system.  I think there's a lot we can do to make things better, but I don't think the problem is just the insurance company's fault.  That's a really naive and tritely "anti-authority" point of view, but a common one none the less.  There are a ridiculous amount of problems, but here's a few:

- Faking sick.  I'm sure everyone was guilty of this as a child once or twice, and then your parents made you go to the doctor.  That's wasted money.  It costs your health insurance quite a bit.

- Irresponsible spending because your health insurance provider is footing the bill.  I.E. you probably don't really need that test done, but why not, you're not paying for it.

-  Clinging to life at all costs.  Sometimes it's just time to say goodbye.  Life is an amazing thing, a precious thing.  But you have to be able to put a price tag on it (no matter how much we don't want to) because that's how the system works.  If you're 80 and forcing your health insurance company to pay out in order to keep you alive another 5 years, they're gonna have to work hard to screw someone else over in order to keep their business profitable.  You could be killing someone in their 30s or younger.

You could throw in the fact that we don't take enough preventative steps and many other things into the mix.  I just wish people would realize we're every bit as responsible for the problem as the insurance companies are.  Take what you hear with a grain of salt.

[Serephino]

So you're saying that if an elderly person gets sick they should just give up and die because they're old so that insurance companies can pay for treatment for a younger person and still make a profit?  I bet your opinion on that would change if the elderly person was your loved one. 

I agree that some people waste money on unnecessary things, but no one should put a price tag on a human life.  That's disgusting.  I suppose there are exceptions to every rule.  I don't think it's right to keep someone in a coma alive for years with very little hope of them waking up, or people with diseases that will never be able to take care of themselves and would have a poor quality of life. 

People don't defend big corporations for a reason.  Right now insurance companies are mainly concerned with profit.  Every month people pay them an ungodly amount of money.  The average person can only go to the doctor a few times a year, but end up paying thousands. 

I don't know about your doctor, but a visit to my family physician is $75.  The best insurance plan I've been able to find is $190 with like a $500 deductible.  So even if I do fake being sick one day in a month they still made $115 off me that month. 

I am not a big fan of insurance companies because when I needed gallbladder surgery I was screwed.  It was a pre existing condition so no one would take me.  I could have died, but no one cared, not even the surgeon.  My credit is now ruined because of medical bills.         

[Pumpkin Seeds]

There is some truth in Random’s words.  Medical insurance companies are more a side effect rather than the problem with private healthcare.  Insurance companies will always look for loop holes in their contracts.  They have an entire army of lawyers to do this very thing and have no qualms about doing so.  An example of this would be the home owner’s insurance companies after Hurricane Katrina.  They would refuse to pay for flood damage to a house citing that the wind had pushed the water into the home, meaning that it was wind damage.  Those insurance companies could not afford to pay for all the claims they were now receiving and so had to protect their companies.  So in essence they are being good capitalists.

Unfortunately medicine rests at that unenviable intersection of money and morality.  Nobody wants to put a price on our own lives, yet all have a problem paying for the lives of others.  Therefore the healthcare of the nation is entrusted to people whose main goal is to protect profits and see that their investors are made happy.  Blaming them for doing their job is wrong because it is the government and the people that have given them this task.  Insurance companies have long said that the cost of medicine is rising too fast for them to cover effectively but nobody listened.  Many business owners have said that they cannot afford what insurance companies are charging and what is left for them to cover for their employees.  The government and the people of this country failed to listen, instead believing that only the uninsured were having a problem. 

Someone noted that a private system is better than national because it works and makes a profit.  Looking at the state of insurance companies now and the industries that are going under to give their employees benefits, there is a vast amount of room to disagree.  The simple fact is that a completely privatized system is not working.  Something else has to be tried because the healthcare system is sinking steadily and quickly beneath the weight of rising costs and the inability of people to pay those costs while still demanding care.

Also, eighty year olds can live quite well.  Though that aside, if someone wishes to tell a daughter or son that they are not allowed five more years with their mother because of medical costs they certainly can.  I won’t be the one to do that.  If someone would like to tell a mother or father that they won’t get five years with their child because the treatments are too expensive, be my guest.  As cynical as anyone might profess to be, that is beyond that and passing into the world of callous cruelty.

[Vekseid]

Insurance companies can be spotty, but it's considerably better than nationalized health care.

You make this point like it's a fact, when most of the industrialized world - including the population of the United States - disagrees with you.

Healthy people find jobs easier. Healthy people pay their bills. Healthy people are more productive. Guaranteeing health care coverage through one means or another means people don't fear bills. Over sixty percent of bankruptcies are medically related. Over sixty percent of those went into it with private insurance.

What incentive is there to invest in a system where you don't make money? Where's the logic in rationing off health care instead of increasing the supply?

Because the system makes money even if an individual step doesn't. We don't need Finland's system, we don't want Canada's, but there's obviously a set of solutions that can be tried.

It probably never occurred to most people who read that, that maybe the condition of her skin actually did indicate a cancer problem.  One which she neglected either out of incompetence or carelessness.  I'm not trying to make a point of blaming the victim here, I'm merely arguing that there are shades of gray in all of these stories which people ignore.

Err no, read again:

The insurance company said the fact that she had seen a dermatologist for acne, who mistakenly entered a notation on her chart that suggested her simple acne was a precancerous condition, allowed Blue Cross to leave her in the lurch.

This is congressional testimony, not he-said-she-said. It's not an anecdote, it's a situation where the insurer's practice has actively denied someone coverage due to a mistake.

Above and beyond that, though, incompetence or carelessness? For something as complex as the human body, that's stretching it, especially since only now, in 2009 is the government actually funding programs to check what treatments actually are effective.

No private system has the incentive to do that, apparently.

Nobody wants to put a price on our own lives, yet all have a problem paying for the lives of others.

Most people in the United States actually would be fine with paying more taxes to guarantee coverage.

That number is only going to go up over the next four years.

We have a problem paying for the lifestyles of others, but if my neighbor is more productive they are more likely to be able to want and afford my own services, and that of others.

[Mnemaxa]

Insurance is something you pay in order to have a chance to get help when you need it. 

I would wonder how much of these people money they have taken....and just, not given back? 

Is it not illegal to take money, for a stated purpose, and then tell the people you took the money from to go away?  Is that not fraud?  It's one thing to say, 'no we won't pay for this procedure'.  But that's not what these companies are doing.  It's another thing entirely to say, 'your policy is canceled'. 

Ah well.  The evils of bureaucracy and legal control.

[Jude]

So you're saying that if an elderly person gets sick they should just give up and die because they're old so that insurance companies can pay for treatment for a younger person and still make a profit?  I bet your opinion on that would change if the elderly person was your loved one.

Ad hominid and assumption much?  Not to mention straw man.  In 2000 the man closest to me in the entire world, my grandfather, was diagnosed with liver cancer.  The doctors took a look at his situation and decided that his chances of survival were grim, but there were things they could do in order to prolong his life and possibly cure him.  There was a chance he could've had chemo, undergone everything, and lived another 10 years.

He chose to die with dignity instead of racking up medical bills and delaying the inevitable.  I miss him a ton.  But I have more respect for him than anyone else in the entire world because he knew when it was his time to go, and went down like a brave, honest man instead of struggling and going out screaming and kicking like a lot of people do who absolutely refuse to face their end.

I agree that some people waste money on unnecessary things, but no one should put a price tag on a human life.  That's disgusting.  I suppose there are exceptions to every rule.  I don't think it's right to keep someone in a coma alive for years with very little hope of them waking up, or people with diseases that will never be able to take care of themselves and would have a poor quality of life. 

But you have to put a price on human life, even if your ultimate mission is to save as many people as possible.  It's a basic principle of scarcity that there's not enough to keep everyone going.  Putting a pricetag on things and making hard decisions isn't easy.  It's certainly not something the average person wants to do.  I've known people who worked for insurance companies who got physically ill over going into work at times.  They couldn't handle the work.  I understand that it's a difficult thing to do, but it's a necessary evil.

People don't defend big corporations for a reason.  Right now insurance companies are mainly concerned with profit.  Every month people pay them an ungodly amount of money.  The average person can only go to the doctor a few times a year, but end up paying thousands. 

WOAH, a company is concerned with profit!  IMAGINE THAT.  I wonder why they went into business?  And people attack corporations for almost no reason nowadays.  It's a popular sentiment in our society even if it is baseless a lot of the time.

I don't know about your doctor, but a visit to my family physician is $75.  The best insurance plan I've been able to find is $190 with like a $500 deductible.  So even if I do fake being sick one day in a month they still made $115 off me that month. 

You're using evidence from your personal example in order to refute a broad point.  Which makes your usage of numbers completely irrelevant.  If you want to argue against the fact that people faking sick actually costs them a fair amount of money using statistics, you should actually use statistics are relevant.  Granted the original claim was given by me without statistics and the burden of proof is on the one making the claim.  Which really leaves us at an impasse unless one of us actually digs up the numbers.

I am not a big fan of insurance compa nies because when I needed gallbladder surgery I was screwed.  It was a pre existing condition so no one would take me.  I could have died, but no one cared, not even the surgeon.  My credit is now ruined because of medical bills.         

And it sucks that you've fallen through the cracks.  Some people do.  No matter what system we have, some people will always fall through the cracks.  With a population of over 300 million people in the United States a few cases of anecdotal evidence don't prove anything.

Personally in my life I don't know a single person who's ever had any problems with an insurance company.  Does this mean that such problems don't exist?  No.  Does this mean there isn't a problem?  No.  But I can tell you I don't have the information before me to prove anything.  I was simply applying a bit of healthy skepticism and spreading the blame around in a rational manner instead of making a polarized claim without evidence.

You're free to your opinion, but I won't take it seriously unless you've actually done research on it if you're making a solid claim.

Also, eighty year olds can live quite well.  Though that aside, if someone wishes to tell a daughter or son that they are not allowed five more years with their mother because of medical costs they certainly can.  I won’t be the one to do that.  If someone would like to tell a mother or father that they won’t get five years with their child because the treatments are too expensive, be my guest.  As cynical as anyone might profess to be, that is beyond that and passing into the world of callous cruelty.

The world IS callous and cruel.  It's fun to pretend we like in an idyllic universe, but we don't.  I'm not saying that you turn 80 and bam, we magically stop covering your medicine, but if there's an expensive procedure that you need, you're quite old, and it's only going to extend your life a very small amount of time, I don't think the insurance company should cover it.  Be happy that you've lived a long and full life and say your goodbyes.  Using the most advanced bits of medical technology to keep people alive as long as humanly possible is simply not sustainable in the world we live in to date.  I would like to live in a world where it is, but this isn't it.

It's possible I'm wrong.  I certainly wouldn't mind if I was.  It'd probably take some serious change on behalf of the country to facilitate universal coverage while also keeping the cover for seniors at the current level regardless of the situation.  I'm not really sure if I'm against that either.  I'm just trying to point out that such situations make things difficulty, and questioning if it's really wrong to deny someone expensive procedures if it barely elongates life.

This is congressional testimony, not he-said-she-said. It's not an anecdote, it's a situation where the insurer's practice has actively denied someone coverage due to a mistake.

I like to watch Cspan and I have enough to know that just because it's happening before congress doesn't mean it isn't anecdotal BS.  However, I will grant you that the initial story wasn't simply for the sake of argument.  How many layers of filtration did the story go through to get from its inception to me?  I'm not dumb enough to trust all of the hands it passed.  Furthermore if you'd actually read what I said instead of straw-manning me you'd see the use of the word "maybe" and realize that I was making a general point about the unreliability of first hand accounts.

EDIT:  I also realized that I did misread the original statement you made and your point about me misunderstanding that was valid... I don't know how I got her being a dermatologist out of it.  My reading comprehension apparently failed me.  Apologies for any confusion.

Above and beyond that, though, incompetence or carelessness? For something as complex as the human body, that's stretching it, especially since only now, in 2009 is the government actually funding programs to check what treatments actually are effective.

No private system has the incentive to do that, apparently.

Except scientists have been measuring the effectiveness of treatments for a long time now.  In order to make any medical claim you need hard data to back it up or else the FDA (or is it the FTC, I think they both play a role) can sue your ass.  Maybe we didn't have public funding but it's not entirely necessary in every situation as long as peer review of the scientific community is involved in analyzing the studies done.

When all is said and done I actually support health care reform.  I don't think I'd mind paying slightly higher taxes to do so either.  What bothers me is the "it's all the greedy corporation's fault" mentality.  The system is broken for many reasons, and it's not just the Insurance Industry.   There's a lot of blame to be spread around, scapegoating one party isn't fair.

[consortium11]

I agree that some people waste money on unnecessary things, but no one should put a price tag on a human life.  That's disgusting.  I suppose there are exceptions to every rule.  I don't think it's right to keep someone in a coma alive for years with very little hope of them waking up, or people with diseases that will never be able to take care of themselves and would have a poor quality of life.       

Also, eighty year olds can live quite well.  Though that aside, if someone wishes to tell a daughter or son that they are not allowed five more years with their mother because of medical costs they certainly can.  I won’t be the one to do that.  If someone would like to tell a mother or father that they won’t get five years with their child because the treatments are too expensive, be my guest.  As cynical as anyone might profess to be, that is beyond that and passing into the world of callous cruelty.

I'm not quite sure exactly what these points are doing in a debate about private/public health service... as they are just as (if not more) prevalent in nationalised health systems. In the UK the National Institute for Clinical Excellence (NICE) is quite possibly the single least popular group of people because it is them who decide whether it is cost effective to allows certain treatments and medications on the NHS. Recently they hit the press because they turned down four kidney cancer drugs because their cost wasn't worth it for the extension and quality of life given. Huge media outcry and now one of those drugs is being offered on the NHS after a U-turn by NICE, which was combined with Pfizer offering to pay for the first round of treatments (but drug companies are evil right...)

Great victory right?

Not really.

The reason for NICE's turnaround was officially new rules of determining how "good value" extending someones life was. In reality it was the media pressure from the case... which means public outcry determines the availability of individual drugs and no-one can think that is the best way to determine things like that.

And because of the outcry people started to see what NICE do and look into their system... and realised that there isn't an unlimited budget. So when people were asking for other life-extending treatments and told no, they looked to those with kidney cancer and wondered why they got it and others didn't. Because of the tight purse strings (as they have to be) you have far better access to life extending drugs if you suffer a rare condition than a common one. If the kidney cancer example above had been breast or lung cancer nothing would have changed.

The thing that may surprise you?

The drug in question (Sutent) is pretty widely available in the US... which corresponds with other studies I've seen that access to high cost drugs is far better in the US than the UK.

Of course, the UK isn't the only style of nationalised health service, and we're noticeably worse than most of Continental Europe when it comes to both the speed of approval and provision of cancer drugs. That said the point still remains... the distasteful task of deciding what to spend on someone to extend their life by months is just as prevalent in a national system as a private one... and probably even more so.

[Vekseid]

I like to watch Cspan and I have enough to know that just because it's happening before congress doesn't mean it isn't anecdotal BS.  However, I will grant you that the initial story wasn't simply for the sake of argument.  How many layers of filtration did the story go through to get from its inception to me?  I'm not dumb enough to trust all of the hands it passed.  Furthermore if you'd actually read what I said instead of straw-manning me you'd see the use of the word "maybe" and realize that I was making a general point about the unreliability of first hand accounts.

EDIT:  I also realized that I did misread the original statement you made and your point about me misunderstanding that was valid... I don't know how I got her being a dermatologist out of it.  My reading comprehension apparently failed me.  Apologies for any confusion.

The issue is a bit deeper than that, though. Nearly the entire population of the planet has precancerous skin conditions in the form of moles and so on. This sort of thing becomes a problem in and of itself - people do not generally have the time to keep track of every potential health issue. We only have so much time in a day, there needs to be a healthy balance between prevention and paranoia.

You can say she may not be being entirely honest, but the problem is the amount of lies required to make Blue Cross's actions be reasonable gets to be a bit ludicrous. Hell even talking about it works from accepting the view that denying coverage based on pre-existing issues is at all acceptable.

Except scientists have been measuring the effectiveness of treatments for a long time now.  In order to make any medical claim you need hard data to back it up or else the FDA (or is it the FTC, I think they both play a role) can sue your ass.  Maybe we didn't have public funding but it's not entirely necessary in every situation as long as peer review of the scientific community is involved in analyzing the studies done.

The FDA covers most such things, on an individual device or drug basis. And the FDA does not sue, it terminates your right to sell, which is a bit worse.

I'm talking about evaluating treatments as a whole and comparing drugs, not the approval process which is a completely different beast.

When all is said and done I actually support health care reform.  I don't think I'd mind paying slightly higher taxes to do so either.  What bothers me is the "it's all the greedy corporation's fault" mentality.  The system is broken for many reasons, and it's not just the Insurance Industry.   There's a lot of blame to be spread around, scapegoating one party isn't fair.

Well no. You have malpractice destroying OB/GYN, doctors who are paid per patient visit, unnecessarily high restrictions on medical licenses, pharmaceutical companies advertising and patent trolling... there are a lot of ugly issues in health care beyond insurance issues.

[Revolverman]

Heath Care is a big scam no matter how its payed for.

Its all about treatments, not cures, or more importantly, prevention.

[Jude]

The FDA covers most such things, on an individual device or drug basis. And the FDA does not sue, it terminates your right to sell, which is a bit worse.

I'm talking about evaluating treatments as a whole and comparing drugs, not the approval process which is a completely different beast.

But the approval process requires a burden of proof that the drug be shown safe and affective.  Sure, there isn't anything to measure one drug versus  another other than comparing the two statistics which were developed in the initial approval process, but that is a valid comparison at times, and certainly not worthless.

Also the FTC plays a role because it analyzes medical claims made in advertising.

Well no. You have malpractice destroying OB/GYN, doctors who are paid per patient visit, unnecessarily high restrictions on medical licenses, pharmaceutical companies advertising and patent trolling... there are a lot of ugly issues in health care beyond insurance issues.

Again you miss the point.  Everything you name exonerates individuals, and blames government and/or corporations for the problems.  Individuals play a role too with the various unhealthy lifestyles people live in the United States.

It also doesn't help that some people waste time/money on alternative treatments which have no scientific backing instead of actually getting help from professionals.  Just the populace's tendency to distrust medical authorities is mind boggling and inane at times.  A little skepticism is always healthy but the current anti-vaccination BS circling throughout the country is really unacceptable.  We haven't hit a critical point where it's cost us a lot of money yet, but if things don't change it will (like it has in Europe).

[Vekseid]

But the approval process requires a burden of proof that the drug be shown safe and affective.  Sure, there isn't anything to measure one drug versus  another other than comparing the two statistics which were developed in the initial approval process, but that is a valid comparison at times, and certainly not worthless.

Also the FTC plays a role because it analyzes medical claims made in advertising.

I don't think we're in argument here? I was merely clarifying. The stimulus study covers treatment programs (not just single drugs) and comparing the effectiveness of different programs and drugs.

Again you miss the point.  Everything you name exonerates individuals, and blames government and/or corporations for the problems.  Individuals play a role too with the various unhealthy lifestyles people live in the United States.

When something bad happens there's often an extenuating circumstance, or the belief that they were following authority.

That last point is the evil behind corporations and governments. It is what makes an organization bad and a person good, and why individuals in general deserve exoneration and organizations more scrutiny. We are, as a rule, a species of followers. The Milgram and Stanford experiments demonstrate that rather brutally.

People will gleefully murder if they are convinced it is the right thing to do.

About 4% of the population bucks the trend - about one in fifty seems to genuinely enjoy causing harm or thinks only for themselves - sociopath, whatever. Likewise, about one in fifty by default critically analyzes the situations they are presented with in a moral light.

The other 96%? Followers, by default.

Who is to blame, then? Leaders who are forced to make hasty decisions based on incomplete information? Policymakers who err in writing out the rules and procedures for their organization? Which person, in the lineup, is to blame for the situation?

That there are truly evil people in this world does not help, of course, but in general there really is an organizational rather than a personal issue. Authority is not a simple cut and dry task.

It also doesn't help that some people waste time/money on alternative treatments which have no scientific backing instead of actually getting help from professionals.  Just the populace's tendency to distrust medical authorities is mind boggling and inane at times.  A little skepticism is always healthy but the current anti-vaccination BS circling throughout the country is really unacceptable.  We haven't hit a critical point where it's cost us a lot of money yet, but if things don't change it will (like it has in Europe).

Genuine frauds like homeopathy and such are best placed in their own discussion.

[Jude]

I wrote a lengthy post which I realized in the middle was becoming totally irrelevant to the actual discussion and philosophic in nature.  So instead of posting it here I'll stow my argument on whether or not we are "followers" as a whole.  My response to you is much simpler than writing all of that out and muddying the thread by going off on a tangent anyway.

Let us assume for the sake of argument people are in fact followers.  There seems to be a prevailing notion of anti-government or anti-corporate sentiments whenever a problem occurs (in this case, healthcare).  Never actually blaming the people.  You know those 2% of people who actually cause change, think differently, and try and influence things?  It's going to take them trying to shift the way we think about these problems for people to become empowered enough to do something about them.

I don't care if the average person is empowered enough to do something currently or not.  They are still ultimately responsible for most of the problems in their life (they as a whole) and until enough people start saying, "look at yourself" then the American populace never will.  We need to stop blaming institutions and organizations or we'll never get to the root cause of things.

Granted those institutions and organizations play a role as well, but we're not even-handed at all in our society.  Politicians frequently tell us "the American people are the solution."  They kiss our ass left and right, because if they actually told us the truth to try and wake us up out of our American Idol induced coma we probably wouldn't listen anyway and instead we'd vote them out of office while downloading another episode of "Will and Grace" off of iTunes.

In a Democracy the power lies with the people.  Each and every official in government is there because we put them there either directly or indirectly (by appointment of an elected official).  As much as we'd like to pretend this isn't the case, we still do vote every 2 years nationally.  Let us also not forget that these corporations survive and thrive based on where we choose to spend our dollar.  We are the problem.  For once it'd be nice to see a mainstream voice say that.

[RubySlippers]

I tend to view this in a simple way does a law abiding citizen even if homeless have the same right to health care we give criminals in prison that commit the worst crimes?

I would say focus then if one can say yes to a BASIC safety net access to primary care and treatments that are well known and work for necessary care to spare life and reduce suffering. One doesn't need to give citizens choices just have a medical doctor assigned and specialist care assigned as needed to meet a minimal care standard. The same choice and options an inmate in prisoner gets, maybe a little better. But that could be done cheaply if one has full government control and not provide expensive care options that are experimental to those that need. With modest co-payments on the patiants side based on ability to pay.

[OldSchoolGamer]

Much of the opposition to socialized healthcare stems from the belief the "free market" is invariably the best way to set costs for goods and services.

Yet there are some "services" that we already (at least implicitly) agree are best rendered by means other than the market.  If a house catches on fire, we don't flip through the Yellow Pages to try and find the best deal  on structure fire extinguishing services.  We dial 911.  Likewise, when we hear the downstairs window get broken and a burglar come in, we don't turn to our partner and say, "Gee honey, remember that flyer in the mail last week with 20% off burglar removal services?  Can you find the number?"  We again call 911...or reach for the Smith and Wesson.

Given the dismal inefficiency of the American health care system, I think we have to ask ourselves if the free market is indeed the best approach to providing health care...or if the market should be relegated to a secondary or auxilliary role (i.e., we have a national health system but delegate certain tasks like ordering medical supplies to the market, just like the fire department might put an order for a new engine up for competitive bids.).

But above all, we really need to jettison political ideology here and focus on doing what works.

[Indigo]

....I'm not even addressing whatever proceeded.

What astounds me has always been the fact that

'Republican=smaller government, yet wants 'conservative laws to prevail', that ultimately decide how people make very important life choices...so they seem to want smaller government, yet want huge, blanket laws to rule over the populace.
'Democrat=big government to help the masses,the poor...yet also wants to allow people their 'liberal rights'...so they want government to help everyone, yet want to be able to say 'screw you!' if the laws go against what they consider their 'liberal rights'.

...sighs....

All I can say is...

Unaffiliated Independent ftw.

and no...I'm not arguing the points with anyone.

[fossildude181]

The free market works. As long as there's a demand, the supply will move to accomodate it.
Why do we hear tales of the storages of dentists in Great Britain (such that the Daily Telegraph runs a story every other month of patients pulling their own teeth)? Why does it take a month to get an MRI in Canada when in the U.S. it takes a week or less? Why do some Canadian towns hold lotteries in order to determine who can get medical treatment (see Norwood, Ontario)? Why is it that there are stories about British and Canadian hospitals running out of room to put patients, but we don't hear the same of American hospitals? These are all general anecdotes, yes, but they are telling. You get the health care you pay for, and it may cost a bit but it shows.
I'll end this with one last remark: If the nationalized health care of Canada was so good, why have people flocked to the private practices allowed since 2005?

[Vekseid]

Because Canada's system is horribly flawed.

I think states like Washington are beginning to pioneer what will become the norm - the government guarantees certain minimums (general checkup, guaranteed vaccinations, etc) and limit what insurance providers can't cover in the event of catastrophe.

[Elven Sex Goddess]

Much of the opposition to socialized healthcare stems from the belief the "free market" is invariably the best way to set costs for goods and services.

Yet there are some "services" that we already (at least implicitly) agree are best rendered by means other than the market.  If a house catches on fire, we don't flip through the Yellow Pages to try and find the best deal  on structure fire extinguishing services.  We dial 911.  Likewise, when we hear the downstairs window get broken and a burglar come in, we don't turn to our partner and say, "Gee honey, remember that flyer in the mail last week with 20% off burglar removal services?  Can you find the number?"  We again call 911...or reach for the Smith and Wesson.

Given the dismal inefficiency of the American health care system, I think we have to ask ourselves if the free market is indeed the best approach to providing health care...or if the market should be relegated to a secondary or auxilliary role (i.e., we have a national health system but delegate certain tasks like ordering medical supplies to the market, just like the fire department might put an order for a new engine up for competitive bids.).

But above all, we really need to jettison political ideology here and focus on doing what works.

Just wanted  to say, this of all I read up to this point. Made the most common sense.   

[Rhapsody]

Why does it take a month to get an MRI in Canada when in the U.S. it takes a week or less?

It doesn't.

Why do some Canadian towns hold lotteries in order to determine who can get medical treatment (see Norwood, Ontario)?

They're called fundraisers.  I believe the US also has them for procedures and surgeries your health care plans don't cover.

Why is it that there are stories about British and Canadian hospitals running out of room to put patients, but we don't hear the same of American hospitals?

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.

These are all general anecdotes, yes, but they are telling. You get the health care you pay for, and it may cost a bit but it shows.

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.   

I'll end this with one last remark: If the nationalized health care of Canada was so good, why have people flocked to the private practices allowed since 2005?

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?

[RubySlippers]

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 agree that we need something and health care access comparable to what a criminal in a detention care facility is entitled to under the law and court directive should be what we are looking at. For me the big issue is to cover EVERYONE that has a real medical need at a level everyone can afford and that would include even the homeless and wage-slaves surviving on paycheck to paycheck. Most won't be able to be covered at all if the demands of the insurance costs and using it are too high.

Someone has to say NO to treatments and procedures at some point and limiting choice is vital so treatments offered are ones that are cost effective and work. And I would strongly consider outsourcing expensive cases to India, Thailand and other nations with top ofr profit tourist hospitals where the costs for care would be far lower on say heart treatments, cancer treatments and the like. Use the free market forces to a national health care basic plan and it will work, I'm pretty sure of it.

[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).

[Rhapsody]

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.

[Zakharra]

 

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]

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.

[Elven Sex Goddess]

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]

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:

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;

They 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]

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".

[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]

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.
Report to moderator   Logged

Yes but your also not looking at the other side of the coin. 

Quote

    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]

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

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

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.

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.

[Oniya]

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.

[Vekseid]

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]

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.

Health 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.

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.

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.

[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.)

[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]

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]

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.

[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]

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.

[Dizzied]

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.

Think about how many more people are going to go to the ER when it costs nothing.  I don't know how long your wait at the ER was, but I think it will be higher when nobody is paying a penny out of their pocket for it.

Chances are you could afford insurance or health care if the government wasn't driving medical prices up with medicare or medicaid.  Payment plants should be available for clinics or doctors visits.  I'm interested to hear how you can get out of paying for your ER bill altogether, though.  Nothing except bankruptcy comes to mind.

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.

I'm afraid I can't find the video right now, but Peter Schiff said it was likely to happen.  For those who don't know him, Peter Schiff is an excellent economist who accurately predicted our current crisis years ago when everyone was celebrating under the bubble.  (check him out on youtube.)  However, alot of socialized health care systems do currently cap prices.

Currently, the PPRS(Pharmaceutical Price Regulation Scheme) 'regulates' (caps)  prices in the UK to ensure the NHS can afford them.  In Canada, Patent Medicines Pricing Review Board does the same thing.  It changes nothing, though, if a price cap isn't applied.  Service will be scarce, and demand artificially high.  If the UK can't afford drug prices, I imagine its because most drug companies aren't from England, and therefore not subject to all of their regulations.  It's the US drug companies that are on the frontier of medicine.

[ShrowdedPoet]

I have never seen a payment plan in a clinic. . .they don't allow it.  And the ER will write you off.  I didn't have to wait at all.  I'm for socialized health care.

[Dizzied]

Payment plans should be available; they're available for most other necessary services.  Call up some more clinics.  I don't have dental insurance, but I've never payed up front for a checkup.

I'm glad you didn't have to wait for your care at the ER.  If socialized medicine gets set up, then within a few years you'll probably never see an empty emergency room again.  I don't know what their motivation is for writing off the money you owe them, but it doesn't seem like a sound practice to me.

Again, prices would be lower if the free market was allowed to set a price.  You could afford a regular doctors visit, or health care coverage, if prices weren't so inflated by regulation and intervention from D.C.

[ShrowdedPoet]

Payment plans should be available; they're available for most other necessary services.  Call up some more clinics.  I don't have dental insurance, but I've never payed up front for a checkup.

I'm glad you didn't have to wait for your care at the ER.  If socialized medicine gets set up, then within a few years you'll probably never see an empty emergency room again.  I don't know what their motivation is for writing off the money you owe them, but it doesn't seem like a sound practice to me.

Again, prices would be lower if the free market was allowed to set a price.  You could afford a regular doctors visit, or health care coverage, if prices weren't so inflated by regulation and intervention from D.C.

I don't know about your area but there is nowhere in this area with payment plans availiable and everywhere requires up front payment.

When there is really no possibility of them getting their money from me and if they really wanted to force it and go through the court procedure. . .well that's a lot of trouble. 

[Dizzied]

I don't know about your area but there is nowhere in this area with payment plans availiable and everywhere requires up front payment.

When there is really no possibility of them getting their money from me and if they really wanted to force it and go through the court procedure. . .well that's a lot of trouble. 

I understand your situation.  I guess the ER was your best option, since thats the only place that would take you.  But socialization won't make things better for you.

Health care will only degrade in quality, and increase in price for you (through taxes, most likely) if health care gets socialized.  The answer isn't more government; it never is.  It's less government.  Don't listen to what Washington tells you.  All they want is your vote, and if they can convince you there's a simple solution to your problems, they'll do it. 

[ShrowdedPoet]

I don't listen to what candidates say.  I research and I look into things.  I believe in socialized health care. 

[consortium11]

I'm afraid I can't find the video right now, but Peter Schiff said it was likely to happen.  For those who don't know him, Peter Schiff is an excellent economist who accurately predicted our current crisis years ago when everyone was celebrating under the bubble.  (check him out on youtube.)  However, alot of socialized health care systems do currently cap prices.

Lol at Schiff being an excellent economist. Sure he predicted the crisis... as every single other Austrain theorist does. It gets especially easy when your arguement is "well some time in the future things are going to go wrong..." which is what his pieces amounted to.

What makes it even worse is that Euro Pacific Capital (his investment firm) lost its clients anywhere between 40 and 70% of their investment in 2008... which is far worse than "traditional" firms generally did. Schiff got every aspect of the crises wrong... from hyperinflation to decoupling to commodities (apart from Gold) to foreign currencies (outside the yen) to world interest rates to foreign equities. He got virtually everything wrong.

I like Austrain theory and I liked Ron Paul's presidential campaign (which is where so many people seem to get the idea Schiff is in any way important or knowledgeable) but Schiff is an abject failure. He couldn't capitalise on the boom the way others could, and now that he's in the time he should be doing well (according to his own literature) he is losing his clients money hand over fist and screwing up royally. Every half-specific prediction he made has gone wrong.

So "excellent economist"... not really. He's up there with Jim Cramer on Bear Stearns.

Currently, the PPRS(Pharmaceutical Price Regulation Scheme) 'regulates' (caps)  prices in the UK to ensure the NHS can afford them.  In Canada, Patent Medicines Pricing Review Board does the same thing.  It changes nothing, though, if a price cap isn't applied.  Service will be scarce, and demand artificially high.  If the UK can't afford drug prices, I imagine its because most drug companies aren't from England, and therefore not subject to all of their regulations.  It's the US drug companies that are on the frontier of medicine.

The PPRS is entirely voluntary. The pharma companies signed up and agreed to it. It doesn't force people to sell at low prices, it doesn't prevent things being sold at a higher price. If the PPRS was really capping prices at an unmarketable level then there wouldn't be the need for NICE or any of the other bodies overviewing what drugs the NHS should offer.

And of the top 10 pharma companies in the world 5 are based in Europe and 2 (Glaxo and Astra) are based in the UK... and they're both considered leaders when it comes to R&D. The reason the UK can't afford drugs is exactly as you say... they're expensive and not cost-efficiant to offer under the NHS. As I said earlier in the thread you actually have better access to many top level drugs in the US then you do in the Uk... as in the UK you've already paid for the NHS in taxes (that won't give you the drugs...) and then you have to pay for insurance for access... which has similar problems to the US system. However, at no stage does that mean "no drugs" for those who are able to afford them.

[Rhapsody]

Naturally, with 300 million people in the country with free healthcare (a small chunk of which are non-citzens, I might add),

Do you mean non-citizens, or non-residents?  There is a difference.

Either way, in Canada, you have to be a legal resident of your province in order to be covered by the provincial health plans.  You have a card and everything that you have to present to doctors, to hospitals.  Your drug plans use the same number.  If you have low-income emergency dental, it uses that number.   If you don't have a provincial health card or equivalent proof of insurance, you still have to pay for everything yourself.

[Dizzied]

Lol at Schiff being an excellent economist. Sure he predicted the crisis... as every single other Austrain theorist does. It gets especially easy when your arguement is "well some time in the future things are going to go wrong..." which is what his pieces amounted to.

What makes it even worse is that Euro Pacific Capital (his investment firm) lost its clients anywhere between 40 and 70% of their investment in 2008... which is far worse than "traditional" firms generally did. Schiff got every aspect of the crises wrong... from hyperinflation to decoupling to commodities (apart from Gold) to foreign currencies (outside the yen) to world interest rates to foreign equities. He got virtually everything wrong.

I like Austrain theory and I liked Ron Paul's presidential campaign (which is where so many people seem to get the idea Schiff is in any way important or knowledgeable) but Schiff is an abject failure. He couldn't capitalise on the boom the way others could, and now that he's in the time he should be doing well (according to his own literature) he is losing his clients money hand over fist and screwing up royally. Every half-specific prediction he made has gone wrong.

So "excellent economist"... not really. He's up there with Jim Cramer on Bear Stearns.

The PPRS is entirely voluntary. The pharma companies signed up and agreed to it. It doesn't force people to sell at low prices, it doesn't prevent things being sold at a higher price. If the PPRS was really capping prices at an unmarketable level then there wouldn't be the need for NICE or any of the other bodies overviewing what drugs the NHS should offer.

And of the top 10 pharma companies in the world 5 are based in Europe and 2 (Glaxo and Astra) are based in the UK... and they're both considered leaders when it comes to R&D. The reason the UK can't afford drugs is exactly as you say... they're expensive and not cost-efficiant to offer under the NHS. As I said earlier in the thread you actually have better access to many top level drugs in the US then you do in the Uk... as in the UK you've already paid for the NHS in taxes (that won't give you the drugs...) and then you have to pay for insurance for access... which has similar problems to the US system. However, at no stage does that mean "no drugs" for those who are able to afford them.

The Austrian argument isn't "Something will go wrong eventually."  If you really want to hear their point of view, which accounts for both human nature (it's also called the psychological school) and business cycles, I suggest checking out http://mises.org/

Schiff's company faces some trouble, but I'm not trying to deify him.  Of course he's not some omniscient overseer of the economy.  He simply knows economics; tried and true, real economics, rather than the Keynesian hogwash that is so widespread these days.  You don't have to believe him if you don't want to, and I personally don't care.  But when hyperinflation occurs, just remember he told you so.  :-\

The PPRS and it's kin are 'voluntary' as much as the legal alcohol age in the united states is.  The states are allowed to set whatever age they want, but if they set anything other than 21, they lose massive federal funding for their roads.  Likewise, any company that didn't agree to the PPRS won't have their drugs bought by the NHS.  Essentially, it's a government enforced cartel.  Which, as we all know, doesn't benefit the consumer.

Do you mean non-citizens, or non-residents?  There is a difference.

Either way, in Canada, you have to be a legal resident of your province in order to be covered by the provincial health plans.  You have a card and everything that you have to present to doctors, to hospitals.  Your drug plans use the same number.  If you have low-income emergency dental, it uses that number.   If you don't have a provincial health card or equivalent proof of insurance, you still have to pay for everything yourself.

I mean non-citizens.  If you don't pay US taxes, you shouldn't get the benefits that those who do receive.

From what I've seen, the health care plan we're building doesn't turn anyone down.  It doesn't matter if you're a legal resident of the US or an alien, you still get care. 

I feel a need to illustrate the worst point here, though.  If this monopoly health care system gets set up, we essentially give the government control over our health.  They can decide what drugs to give people, what treatments to administer, etc...

Am I the only one reluctant to give that power to the government?  I'm not really a conspiracy nut, but I see no benefit in removing that power from the private sector and giving it to the government.  If a private hospital lets me down, I'll go somewhere else.  The first hospital will need to make a profit, so they'll strive not to let the customer down.  If the monopoly hospital lets me down...well, too bad for me, right?  I don't' really have any other options for health care.  They don't compete with anyone.  Competition drives prices down, and the quality of service up.  A universal health care system will end up like our post office.  Slow and inefficient. 

[Rhapsody]

I mean non-citizens.  If you don't pay US taxes, you shouldn't get the benefits that those who do receive.

Legal immigrants and those with legal residency are not citizens, but they pay taxes.

[Dizzied]

Legal immigrants and those with legal residency are not citizens, but they pay taxes.

You know who I mean.  The people who don't pay taxes shouldn't get the benefits taxpayers get. I think we can all agree on that. 

[consortium11]

The Austrian argument isn't "Something will go wrong eventually."  If you really want to hear their point of view, which accounts for both human nature (it's also called the psychological school) and business cycles, I suggest checking out http://mises.org/

I know the Austrian Theory isn't based around "something will go wrong eventually". I've read enough Hayek, Mises and Menger to know the basis of the theory and I'm familiar with the Mises Institute. I'm not sure if you missed the part where I said I like Austrian Economics and Theory. It's not the school I'm against... it's Peter Schiff.

Schiff's company faces some trouble, but I'm not trying to deify him.  Of course he's not some omniscient overseer of the economy.  He simply knows economics; tried and true, real economics, rather than the Keynesian hogwash that is so widespread these days.

If he had such a firm grasp on "real" economics shouldn't he have well... got something right while all the other theory based investors (and they're out there) got it wrong. Which is the exact opposite of what occurred... they generally mitigated loss, he continued to encourage it. He got it wrong. It's as simple as that. And when an Austrian Theorist who speaks extensively on the short and long-term effects of current actions gets nearly every single one of the predictions he made on short term effects wrong you really have to step back and say "Damn... maybe this guy isn't everything he was cracked up to be..."

You don't have to believe him if you don't want to, and I personally don't care.

But weren't you using him as your source? If I don't believe him then it pretty much invalidates that...

But when hyperinflation occurs, just remember he told you so.  :-\

You see, this is the problem.

You can't just do that.

You can't say "Oh, there will be hyperinflation sometime in the future..." and then when there is, however far in the future say "I told you so!". Giving that general a prediction doesn't mean anything. I predict that unemployment will rise, but certain banks will recover at some stage... that it will rain in the future... that there will be riots in China... that interest rates will rise... that the markets will fall again.

All of those are near certain to happen at some point in the future... does that make me someone who has a great vision of the future.

It's the equivalent of a conspiracy theorist like Alex Jones going "there will be a terrorist attack somewhere in the world in the next 5 years blamed on Muslims"... and then when there is saying "I told you so, it's a government conspiracy!"

And I'd like to quickly point out that Schiff didn't just predict general hyperinflation. He predicted hyperinflation in 2008 and early 2009... he predicted the world decoupling from the dollar... he predicted a lot of things to happen in 2008 and early 2009... and he got them flat out wrong.

The PPRS and it's kin are 'voluntary' as much as the legal alcohol age in the united states is.  The states are allowed to set whatever age they want, but if they set anything other than 21, they lose massive federal funding for their roads.  Likewise, any company that didn't agree to the PPRS won't have their drugs bought by the NHS. Essentially, it's a government enforced cartel.  Which, as we all know, doesn't benefit the consumer.

Imagine this... there is an Insurance Company... a big one... and it calls up a Pharma company and goes "Listen, we want to offer your drugs... but unless you make them cheaper we won't pay for them for our millions of customers... what ya going to do?"

How is that different other than on one hand you have a government body and the other a private company. Both are in a relative position of strength and both negotiate for the best price they can receive. If the Pharma company isn't getting a price that makes it worthwhile to develop and sell the drugs then they wouldn't... yet they still do. If the NHS was getting such a great price for these drugs, why are they refusing treatment so often due to the cost of the drugs... why does NICE even exist, why are they not avoiding all the bad publicity, all the terminally ill patients appearing on the 6 O'Clock news and asking "why won't the NHS try to save my life"?

If it is a Cartel then it is the single most ineffective cartel I have ever seen in action.

You know who I mean.  The people who don't pay taxes shouldn't get the benefits taxpayers get. I think we can all agree on that.

Are we still talking about just medical/health issues or in general? Because in general is a very big can of worms.

[kylie]

You know who I mean.  The people who don't pay taxes shouldn't get the benefits taxpayers get. I think we can all agree on that.

I'm not so sure.  Non-taxed labor does still contribute to the economy.  Particularly in agriculture and domestic service, many of the laborers live under conditions which their "managers" might prefer to keep hidden.  Maybe there is less chance these will appear at the hospital door.  But in fairness, they are all serving to keep prices artificially low for the rest of us, while suffering great risk themselves.   

[ShrowdedPoet]

I don't care if they pay taxes or are a citizen/resident whatever of the United States.  If they need help I think they should get it.  I still get sick to see people treat other people like this.  A mother with children is the same no matter where they pay taxes.  and I agree with Kylie, they may not contribute taxes but they give other services. 

[RubySlippers]

To demonstrate the real problem for some here. A friend who is working poor and proud can't even afford to see a doctor for a likely genital infection so he resorts to buying FISH ANTIBIOTICS the same capsules humans get without a prescription and is using that because its simple cold math. A doctor would cost $65 a visit plus tests plus the medication, this cost him $15 for 100 250mg capsule pills. And the internet has the dosing instructions and he is going to guess.

This man works hard in day labor and doing odd jobs, pays for his apartment and other needs but has almost nothing left.

I'm sure his case is not special in the United States.

[Zeitgeist]

How about we seriously address fraud, waste and abuse in regards to the current system before we over correct and make matters worse?

Can you even have a discussion about nationalizing health care without addressing illegal immigration? I don't believe you can for any system devised will surely fail under the burden of the influx of people who shouldn't be here.

[Pumpkin Seeds]

Not so certain its realistic to put an entire issue like healthcare on hold until another issue is resolved, such as immigration.  Following that logic our country would chase its tail trying to figure out which issue must be solved first so that the others fall in place.  Illegal immigrants are already using the healthcare system in place now.  So I seriously doubt there will be a crushing weight added ontop of a nationalized one.

[Rhapsody]

Can you even have a discussion about nationalizing health care without addressing illegal immigration? I don't believe you can for any system devised will surely fail under the burden of the influx of people who shouldn't be here.

You missed the point.  Several times. 

[Zeitgeist]

You missed the point.  Several times.

Yeah, the point apparently is an extreme exception to the general rule justifies an over reaching, over arching, over correction, see so-called stimulus package.

For sure you've got to keep several wheels turning at once. Illegal immigrants weigh down the current system and will continue to do so weather it is privatized or nationalized. You cannot address one while not also addressing the other at the same time.

[Pumpkin Seeds]

Illegal immigrants are hardly to blame for the current hardship that medicine is going through.  They make up a very small portion of the population that makes use of medical facilities.  Far more impoverished Americans make use of the healthcare system than do illegal immigrants.  While you can make an argument that they are not helping the system, there is little to no chance that they are the ones who broke the system.  They are not a show stopping problem to healthcare.

[Serephino]

I'm a citizen that can't afford health care.  Private insurance companies want like $200+ for an intial payment, than like $150/per month, and those plans have 1k deductables.  If anyone knows of a company with better plans, please, point me to them.  But we're living paycheck to paycheck.  We can't afford to give a company that kind of money a month, then shell out $1k when something serious pops up. 

So are you going to tell me that even though I was born in this country I must live with being sick until they figure out what to do about illegal immigrants? I'm one of probably millions of American citizens who have poor health and can't afford to do anything about it but function as best I can on a day to day basis. 

Illegal immigrants can go to free clinics.  It's people like me who are stuck in the middle that are the worst off.  We just barely make too much for free clinics and Medicaid, but there's no way in hell we can afford private insurance.   

[kylie]

So are you going to tell me that even though I was born in this country I must live with being sick until they figure out what to do about illegal immigrants? I'm one of probably millions of American citizens who have poor health and can't afford to do anything about it but function as best I can on a day to day basis. 

Illegal immigrants can go to free clinics.  It's people like me who are stuck in the middle that are the worst off.  We just barely make too much for free clinics and Medicaid, but there's no way in hell we can afford private insurance.   

I know what you mean about not being able to afford private insurance as the system is structured now.  I can barely afford student rates, and they're mandatory...  It's generally recognized that the US health care system is vastly overpriced.   

While I would understand (logically, not ethically) if a reformed system had a "Phase One: reform for citizens first," and I do not wish to see conservatives use immigration as a wedge to sabotage a more efficient national health plan:  I also do not believe it is just to deny health benefits to migrant workers. 

If migrants were actually employed under fair practices, perhaps we could tally up about what they actually save citizens collectively on food, domestic labor, and menial work and dedicate that toward clinics for all of them.  Unfortunately, since the amount they produce for the country is hidden by the very conditions they exist here under --and the same conditions limit their access to care-- I don't believe that is a viable alternative.     

I'm not convinced that so many migrants have time, legal status, and freedom of movement to attend clinics even if some are free.  (How many are, and what are their rules, I have to wonder?)  As I understand it, we have plenty of agricultural and domestic workers whose movements are restricted, whose conditions are substandard or outright abusive, plus many of them remain illegal. 

There may be amnesty, but historically speaking: Programs to officially extend official "permission" to migrants have generally meant permission for just a few among many who have already suffered long periods unprotected.  Those few have then been allowed to work in more limited capacities while subject to additional bureaucracy and fees, or else the immediate threat of deportation.  They might also be ineligible for lowest-cost services under the current system; I don't know but that would be consistent with the other historical trends.

[Oniya]

From personal experience, free clinics require proof of residency and proof of income/lack of income.

[Asuras]

There are 300 million Americans and just 12 million illegal immigrants. It's simply silly to suggest that we have to solve illegal immigration before solving health care.

The problem is that the US health care system is simply the most bloated, cost-ineffective health care system on earth. Universal coverage and all that is very nice, but really, I think more importantly, year after year after year health care costs have kept rising, preventative care has withered, and if that continues - if we don't put the kind of controls on this industry that every other developed country has - this will be cancerous to American businesses, which have to bear the cost of health care for their employees, the American government, which has to pay for Medicare/Medicaid, and of course American citizens, who have to pay their HMOs and copays and whatever their insurance doesn't cover.

Would it be better if we had a solution for both illegal immigration and health care at once? Yes. But the political process is notoriously bad at getting even one thing done, let alone two at once. So even if it means letting some free-riders slip through, I think we need to keep our priorities straight and take care of the biggest problems first.

[Zeitgeist]

I think some grossly underestimate the cost to our health care system when you consider illegal immigrants.

http://www.wnd.com/news/article.asp?ARTICLE_ID=43275

Specifically:

In fact, the increasing number of illegal aliens coming into the United States is forcing the closure of hospitals, spreading previously vanquished diseases and threatening to destroy America's prized health-care system, says a report in the spring issue of the Journal of American Physicians and Surgeons.

The article is from 2005. Please tell me how the situation has improved since then...?

[kylie]

There are 300 million Americans and just 12 million illegal immigrants. It's simply silly to suggest that we have to solve illegal immigration before solving health care.

Minority status is not a good reason for putting off an issue.
     The only kind of political expediency that logic backs is called "divide and conquer," and it may be used against anyone and everyone on various issues.  As Fox News has recently pointed out, so many Americans could easily be found "impure" of heritage or faith in some way.  (See separate Politics thread.) 

First. 
If your numbers are right, illegal immigrants are about 4% of the population. 
Under that logic, whose welfare could be put off during any period of change...

Each of these groups among legal citizens counted as less than 4% (as of the 2000 Census):
Laotian-Americans
Hmong-Americans
Pakistani-Americans
Cambodian-Americans
(and presumably numerous others too "small" for the chart). 
http://www.odos.uiuc.edu/aacc/images/demographics.gif

4-5% of the population identifies as Gay or Lesbian. 
http://www.siecus.org/index.cfm?fuseaction=page.viewpage&pageid=605&grandparentID=477&parentID=591#howmany

10% or so are Left-Handed (including the president). 
A larger individual group, but still small. 
And, imagine the savings if all desks were shaped the same way?

Universal coverage and all that is very nice, but really, I think more importantly, year after year after year health care costs have kept rising, preventative care has withered, and if that continues - if we don't put the kind of controls on this industry that every other developed country has - this will be cancerous to American businesses, which have to bear the cost of health care for their employees, the American government, which has to pay for Medicare/Medicaid, and of course American citizens, who have to pay their HMOs and copays and whatever their insurance doesn't cover.

I don't think you've shown definitively that we cannot manage costs sufficiently to cover migrants.
There are a couple problems in there.

1.  You mention that costs have skyrocketed.  That has occurred under existing rules. 
The argument here is about whether to change the rules in various ways.

2.  Granted, I would like to know more about other countries' rules. 
     Are their migrant populations as abused in the same ways as those in agriculture and domestic labor in the US have been historically?  The authors of Global Woman say yes; this is actually common around the developed world.  That leads me to believe there are only limited efforts to address migrant health in general.  Even if so, that would not prove that covering migrants or securing quality of life for a larger portion of them (a small percent of the US population, as you point out) would necessarily be prohibitively expensive. 

Would it be better if we had a solution for both illegal immigration and health care at once? Yes. But the political process is notoriously bad at getting even one thing done, let alone two at once. So even if it means letting some free-riders slip through, I think we need to keep our priorities straight and take care of the biggest problems first.

I know our political system has a good deal of "divide and conquer" combined with heavy doses of (often partisan or pork-motivated) delays and confusion.  However, there are also cases where no action on an issue, or only symbolic action, proves to make other action down the road harder rather than easier.  Compromise when you must, but not sooner. 

     My thinking is, it's better to take a serious stand on issues to begin with and say what would be just.  Not just what "will" get through Congress (how many weeks and news cycles later, during which attack ads and heaven knows what external issue weaken public focus too).  The softer approach can be self-defeating.  We already have a pattern of putting off "minority" interests again and again.  Collectively, they become a majority issue of problems across so many sectors.  Whatever majority forms in the moment can try to stick with baby steps, but this isn't ethical and there will always be scattered protests, riots, and grisly facts surfacing...  So many abuses, in our own backyard.

[kylie]

I think some grossly underestimate the cost to our health care system when you consider illegal immigrants.
http://www.wnd.com/news/article.asp?ARTICLE_ID=43275

Not to throw out the baby with the bath water here, but I'm rather skeptical of the source.  WorldNet Daily seems to have a rather questionable reputation on accuracy. 
(They also appear to have something of a positive reputation for apparent racial prejudice and hate.)

http://en.wikipedia.org/wiki/WorldNetDaily
I don't believe everything I read on Wikipedia either (some of their topical articles flounder especially on nuance and application).  But, there are some live links to follow for verification. 

Specifically:

In fact, the increasing number of illegal aliens coming into the United States is forcing the closure of hospitals, spreading previously vanquished diseases and threatening to destroy America's prized health-care system, says a report in the spring issue of the Journal of American Physicians and Surgeons.

The article is from 2005. Please tell me how the situation has improved since then...?

To answer this briefly, much of the opposition to coverage for migrants here has been based on experience with the existing system.  You're saying under conditions where everyone agrees the entire system is too costly, more people has meant more expense.  Well, of course.  What I'm thinking is, pricing is so ridiculous that a mix of competition and regulation could provide relief for everyone. 

     As an aside...  Even if there are costs specific to migrant care under the current system, have you considered the costs of providing none?  Some particular benefits go to higher economic brackets:  To those who can afford more houses to be maintained and cleaned, more nannies, and more low-cost fresh produce rather than canned or frozen. 

     I think in actuality, we all really have need of so many migrants to cover numerous other low-paying, monotonous jobs like office cleaning and other basic service or labor.  Can we go without 4% of the population when they disproportionately fill these industries?  That is almost 1 in 20 people in a state of utter disregard, limited care, or limbo.  How much would replacing them cost the average taxpayer?  What would the price of strawberries be?  I don't think people wish to pay that.  I actually wonder if it wouldn't cost more than health care under a more universal system.  However, some are afraid to pay a cent more for someone they don't regard as "one of us" even while those people work here with less protection on and on.

[Pumpkin Seeds]

http://www.jpands.org/vol10no1/cosman.pdf

The article cited.

[Asuras]

I think some grossly underestimate the cost to our health care system when you consider illegal immigrants.

http://www.wnd.com/news/article.asp?ARTICLE_ID=43275

Specifically:

In fact, the increasing number of illegal aliens coming into the United States is forcing the closure of hospitals, spreading previously vanquished diseases and threatening to destroy America's prized health-care system, says a report in the spring issue of the Journal of American Physicians and Surgeons.

The article is from 2005. Please tell me how the situation has improved since then...?

Like kylie said, WND is a legendarily bad source.

However, the article provides a wondrous little tidbit. American hospitals are required to provide emergency treatment to anyone, which is how most illegal immigrants end up in a hospital (since virtually none of them are insured). That's just about the only way they become a burden to the US health care system.

But because these people are uninsured, they never encounter preventative care...which is precisely why they end up in the hospital room costing the taxpayer billions to treat their otherwise preventable illnesses.

But even setting that aside - which suggests one little way in which this, with respect to illegal immigrants, will pay for itself - my point remains: only 4% of Americans are illegal aliens, and yet the United States spends 100% more on health care than, for instance, Canada. See this (which demonstrates very vividly how tremendous and catastrophic a problem the US health care system is):



The point of this is that if we had a system like Canada or Germany or the UK or any other civilized country, we'd be able to halve our health care costs because we'd be able to rein in the insurers and all the other waste in the industry. We could reduce our health care costs by as much as 50%. So how could 4% of the population possibly be significant? Other than the odd hospital in Brownsville that WND can point to.

And, for the record, European countries like France and Germany probably have as large illegal alien populations (relative to theirs) as we do.

Minority status is not a good reason for putting off an issue.
     The only kind of political expediency that logic backs is called "divide and conquer," and it may be used against anyone and everyone on various issues.  As Fox News has recently pointed out, so many Americans could easily be found "impure" of heritage or faith in some way.  (See separate Politics thread.)

First.
If your numbers are right, illegal immigrants are about 4% of the population.
Under that logic, whose welfare could be put off during any period of change...

I think you misunderstood me. I wasn't arguing that we should leave them out because there were so few of them. (that's would rightly be ridiculous)

In fact, I was arguing more or less the opposite - I think health care reform is so important that it's worth the cost even if we let along some illegal aliens as free riders. I really don't care if they're covered or not.

However...

The reason I don't care if they're covered or not is that they're citizens of a foreign country here illegally. They're foreign criminals, they're not the same as Laotian-Americans or left-handed Americans or any number of other native or naturalized Americans. At best, they have as much right to the American taxpayer's charity as does a citizen of Darfur or the Philippines. I don't think there's any reason to privilege one group of foreigners just because they happen to be nearby - least of all because they snuck into the country to do it.

So if we were to provide health coverage to these people, essentially, it should be in the very limited context of foreign aid, not in the context of "They're just like us and deserve all the rights and privileges of American citizenship!"

[fossildude181]

As I've argued earlier, those higher costs result in better treatment. Canada's health care may cost far less and result in universal basic coverage, but at the same time, you need to wait. For days, for weeks, for months.
Moreover, I'd like to ask: Would you prefer to pick your own hospital or would you rather have one assigned to you? Are patients entitled to choose their own treatments (provided they can afford them) or should the government ration them out "for the greater good?"
And lastly...
If money was not an issue, where would YOU want to be treated?

[RubySlippers]

For me I would say yes pick my primary care provider. Yes pick my hospital. Yes pick my treatment options and decide if some cost to much for the benefit if that helps cover the most people.

I will add there already is rationing going on my friend who is a citizen and works hard to get by can't even afford after his expenses $65 to see a doctor to get cheap antibiotics and basic care for an infection (suspected one) so bough Fish Mox to treat himself. What if his case gets much worse its going to cost alot more money and at that point everyone will pay much more since the hospital and doctors at that point won't get a dime. People get care rationed by cost, rationed care by the insurance companies who do refuse care and that is a cruel way to do it.

I think having a BASIC safety net is not a bad idea and if I must give up choice for access to affordable care with co-pays everyone can afford so be it.

[Pumpkin Seeds]

Higher costs do not mean better treatment by any stretch of the imagination.  Costs are rising and the treatment is staying near the same in terms of what it is and what is being done.  People in the United States still wait days, weeks and months for treatment.  Emergency rooms are packed and hospitals are struggling to find room for patients.

Also, where did this illusion of choice emerge?  I've seen a couple of people state that a person can choose their hospital.  The employer picks the insurance company, the insurance company picks your doctor or gives you a list to select from and they tell you where to go in order to receive treatment.  Are you going to turn a job down because you don't like the hospital?  I think few Americans have that luxury.

[RubySlippers]

And one forgets how important primary care and chronic condition health management are. Say my friend had the ability on his $40 a month he has left over from his pay to see a doctor for $20, get that $4 antibiotic from Target and cure his UTI before a secondary infection or kidney stones kicks in. That happened his penis is well not nice looking. The system saves money from that simple lower end care. He just went to the hospital with gangrene down there. And now they are pumping him full of very expensive antibiotics as he is bedrests, and may have to amputate his organ. You can guess the Fish Mox he was taking was done to late to matter. Which would have been cheaper?

I can see value of a system that oddly tries to prevent such things from happening at the start, not the thousands of dollars he is racking up he's not going to pay for. Many others and the citizens will one way or another.

[Serephino]

Yes, the state is paying for a 1k bill I got when I went to the ER when I thought I might have pneumonia.  Sadly, I went to the ER because I knew I'd qualify for their financial assistance.  And of course they did chest X rays, gave me medication for nausea as well as fluids, and did a bunch of blood tests. 

It would've been much cheaper for me to go to my family physician.  He would've listened to my chest and told me I had the flu without all those expensive tests.  But I couldn't do that because I didn't have the $75, and they require you to pay at the time of the visit.   

[RubySlippers]

May I ask fossildude181 a question, is a poor human being entitled to the same level of care in a society one would give a dog?

Its sad but say one of us was sick and a dog odds are we would get to see a vet, someone would care for us and we would get better in most cases. From what I see with local animal neglect and care cases. But you don't think a human which I would say has a higher standing to a dog can die for lack of primary care or suffer needlessly.

Libertarians like me are divided but I favor government control in this case the free market fails to control costs and provide care any longer. For example take a free market approach the prices would all have to be known openly for every medical procedure, one would need to shop around, be free to use their insurance in international hospitals since going to India might be one option for a person for tourist medical care and be able to negotiate. Sick people often can't do that.