Health care rant

[dangermousie]

OK, I don't normally comment on contemporary political stuff but I will now.

You know what drives me crazy in on-line healthcare debates: people, usually college-age (i.e. not paying any taxes) carping on and on about how selfish people are when they are against healthcare reform because it will increase their taxes.

Guess what? Majority of Americans have healthcare insurance already. The majority of them are satisfied enough with it. OK, let me make it more personal - my family has health insurance I am happy with. If the health care reform is passed, I will be indubitably worse off - I will have to pay more taxes (because there is no doubt there will be some sort of tax increase to cover it, whatever the politicians say - income tax, vat-type tax, sales tax whatever). I will have to pay more taxes for something that is of no benefit to me whatsoever. That is the best-case scenario. Worst case scenario is my insurer, who I am very pleased with, will be driven out of business because of its inability to compete with the government-run option - I will end up poorer and with worse insurance. Hooray? I do not think so.

So basically, what health insurance reform means for the majority of people who already have health care is that they have to give up money for other people's benefit - I will have to make my family poorer so a stranger I do not know has better health care. I will have less money to spend on Baby Mousie so some random other family I have never met can take their family members to the dentist for yearly check-ups.

Now, before everyone jumps down my throat - I do support some form of universal health care. I don't mind somewhat higher taxes so my fellow citizens could have access to medicine. But that is the thing - since it's MY money, I am pretty entitled to be picky about where the money comes from (nitty-gritty realistic details) and also want that coverage to be very structured and, frankly, limited. And guess what? I do not hold it against people who do NOT agree with me - who do not want to spend their money on others. Humans are wired this way - we like to take care of our family groups first, strangers later. We prefer the well-being of those near to us to well-being of those we don't know.

After all, a lot of people who are in favor of health-care reform are also doing so on selfish grounds - they have no insurance or insurance they can barely afford and if national health care becomes reality, they will be better off - they are (rightfully) not concerned that it will be at the cost of strangers having to subsidize them. That is how people operate - on selfishness.

I think there would be more of an OK with health care reform if people were told 'because you want to be able to eat out twice a week instead of once, someone else's little Jimmy would die of a heart attack as he would not be admitted into the emergency room' - but because ER is not allowed to discriminate based on your inability to pay, a lot of people believe that worst case scenarios are already covered and anything more is a luxury, not a right.

So yes. I do believe my fellow human beings deserve access to medicine and am OK with paying for it but you can't expect me to blindly agree with whatever the government proposes and also blindly jump for joy I will be losing money for well-being of strangers.

Don't even get me started on rationing - of course it will occur. Whenever there is a scarcity of resources and demand that outweighs them, there will be rationing. Now, national health care is still a good idea despite that, IMO, especially if better private plans are allowed for all those who are willing and able to afford one, but to pretend it won't exist is absurd!

Comments

[valarltd.livejournal.com]

Rationing and wait times are already occuring.

Me, I'm looking down the road 5-10 years. I have two daughters who are mentally ill. I have a son with major ear trouble.

They'll be covered through college on my plan. But what happens when they get out into the work world? Is Bun going to get a job with insurance that covers her meds so she can keep the job and not slit her wrists? Ditto Dollface? Or will my baby end up institutionalized because the monsters got her when she couldn't afford her medicine? Will Jonner be able to get emergency surgery to prevent mastoiditis from infecting his brain?

It took us until 1996 to get jobs that offered insurance. I was almost 30.

Even now, with good insurance, one good infection--like the cellulitis I had in June--can really set our finances back for weeks if not months.

I'm behind the idea of universal health care, not mandatory insurance. It doesn't have to be worse than what we have. Look at France.

[svilleficrecs.livejournal.com]

One thing to remember is that if you happen to have a traditional, big company, salaried job (or a spouse that has one), a) you have your company helping you with the insurance payments and b) your company has the negotiating power to get lower rates from the insurance company.

But these days, those jobs are fewer and further between, and more and more of us move jobs several times during our lives (by choice or by fate) and work freelance. If for some reason you and/or your husband lose your jobs, what happens to your insurance? Can you still get it where you're getting it from at the same rate you're getting it, or do you have to brave the (far, far more expensive) market like the rest of us?

Sure there are people who would rather go to Olive Garden a few more times a week and skip little Jimmy's insurance payments, but for a *whole* lot of us (like me, single, freelancing, self employed), we don't have the privilege of buying into the same big-company-subsidized system that those in traditional jobs do, and for us it's not a choice between no insurance and what you're (likely) paying, it's a choice between no insurance and likely a *lot* more than what you're paying.

Never mind my current (uninsured, for the record) fear of going in for a routine check up. If anything gets found in my right now, while I'm out of the system, I could be utterly fucked in terms of getting insurance. And if I could pay into something reasonably priced, I would. But as a single, non-salary employee forced to buy insurance on the open market, I'm in a very different position, with very different choices than those who are salaried, full time employees (like I assume either you or your spouse are).

And for those who have full time jobs with benefits, yeah, it's possible to have decent insurance. But for those of us whose careers haven't led us that way, plenty of us aren't asking for a bail out, we're asking for reform to an industry that works relatively well - sometimes - for those in traditional jobs who stay with the same jobs for a long time, but for those of us in more 21st century, patchwork careers, we're *seriously* underserved and overcharged by an industry designed to service a 20th century work force. And we? Are gaining in number.

I don't have the answers about health insurance, I don't know if what Obama and congress finally squeeze out will be a turd worth swallowing. But I do know that when I choose not to pay for heath insurance (and it is a gamble, I get that), it's *not* a question of me paying or not paying what your share of your family's insurance happens to be. I'm seriously penalized for not being in a full time salaried job (or being married to someone who is), and what I'm unable to afford is likely way more than what you're lucky enough to pay for the same coverage.

[dancesontrains.livejournal.com]

Isn't it currently 44 million in the US without health insurance, due to unemployment/having rent and food to pay for/ etc?

As a college age non-taxpayer, my opinions are probably moot, but if I may counter your personal argument with a personal one of my own- the NHS saved my life. It is currently keeping several of my friends + relatives, who would not be able to afford insurance if they were in the US, alive whether due to mental or physical issues.

Also, I think your outview on life is rather cynical. I agree that all people, inculding myself, are innately selfish, but I like to think that a part of growing up means at least attempting to move beyond that. Again, perhaps I am naive?

[dangermousie.livejournal.com]

I am cynical - I have grown up in a country (USSR) which was turned into shambles due to a bunch of people having high-minded impractical ideals about people which could not possiby work and failing to take into account that majority of people are not angels. Enlightened self-interest seems to me the best approach - of course, the balance between the enlightened part (regulation) and self-interest (free-enterprise etc) is what is being disputed here.

44mln is a disputed number (as is so much of it on this topic - I have seen both higher and lower figures). Still, even if we take 44lmn as a number, current US population is 307 million, thus under 15% of population is uninsured - my point about overhwelming majority of population having insurance stands.

I am not a product of American privilege - we have immigrated here with no money and with my not speaking any English. Anything I have achieved I did not achieve due to money, connections, or the right heritage - I did it on my own. The same is true for my husband (minus the immigrant part). So while I support some national health care, any money I contribute to it will be MINE, hard-worked-for and the government better convince me it is going to be doing a good job.

[lazypadawan.livejournal.com]

I'm probably the only person who will concur with you on this one ;).

This whole hoohah is about redistribution (money we pay for our health insurance goes to cover those who don't have it) and about giving government greater control over everyday lives, including when it's time to end it. Otherwise, it makes no sense at all instigate reform that inevitably leads to a single-payer system. Just because somebody doesn't have insurance or doesn't want to buy it shouldn't mean I should be deprived of private insurance down the road.

There's no talk at all about tort reform, deregulation, or a real free market solution that would allow more freedom to choose whatever plan works for you. More competition = better services, lower prices, more variety. The free market drives innovation. Government control stifles it.

[shewhohashope.livejournal.com]

This whole hoohah is about redistribution (money we pay for our health insurance goes to cover those who don't have it) and about giving government greater control over everyday lives, including when it's time to end it.

And who has control over it now? Insurance companies?

http://www.dailykos.com/storyonly/2009/7/7/751100/-How-I-lost-my-health-insurance-at-the-hairstylists

[ladysaotome.livejournal.com]

Here, here!!

I don't mind somewhat higher taxes so my fellow citizens could have access to medicine. But that is the thing - since it's MY money, I am pretty entitled to be picky about where the money comes from (nitty-gritty realistic details) and also want that coverage to be very structured and, frankly, limited.

Amen! If someone needs life-saving medications or surgery I would want them to get it & with less hoops & fund-raising than currently required. But if someone gets knocked up due to negligence, my money shouldn't be going to fund abortions I don't morally support & don't want to finacially support either.

[valarltd.livejournal.com]

So you'd be in favor of mandatory sex and birth control then? Or are you into abstinance?

I'm rather a militant about that. More BC=fewer pregnancies. Abstanance=100% failure rate.

[kabutar.livejournal.com]

After all, a lot of people who are in favor of health-care reform are also doing so on selfish grounds - they have no insurance or insurance they can barely afford and if national health care becomes reality, they will be better off - they are (rightfully) not concerned that it will be at the cost of strangers having to subsidize them. That is how people operate - on selfishness.

I don't mean this in a bad way. But isn't that exactly what you're doing here? It's not necessary that you're going to lose quality if the system goes public anyway - but what it sounds like you're saying is you don't want it to go totally public even though others may be denied access to basic needs, so that you can be better off.

I know many people who can't afford health care because they're students, or in trouble, or something. One has a psychological condition so will never see private insurance because it's a pre-existing condition except at exorbitant rates. Another is pregnant and accidentally twisted/cracked a rib and literally could not breathe or move for two days but couldn't go get it checked out because she can't afford the hospital visit. None/neither of these are lowlifes, deadbeats, etc... but they just can't afford it. Yet they have to stay on the outside looking in because of all this worry about going socialist, etc. (not you, just in general)

If the system was entirely public, you wouldn't need an insurer anyway, so the money you pay to the insurer should go to taxes to fund the system. But that's a different story.

So basically, what health insurance reform means for the majority of people who already have health care is that they have to give up money for other people's benefit - I will have to make my family poorer so a stranger I do not know has better health care. I will have less money to spend on Baby Mousie so some random other family I have never met can take their family members to the dentist for yearly check-ups.

That's the essence of a cooperative society. That's exactly what we have up here in Canada, and nobody here would ever want to give it up - to be honest most people up here are a bit boggled that there's so much drama over this. It's not the extreme cases of little Jimmy dying of a heart attack - it's the everyday things: cuts, scrapes, stomach flu, pneumothoraxes, etc. If health taxes are raised, the money should go towards making it better for EVERYONE, not just you and not just the strangers.

We (that is the first world) are already better off than so many other places in the world. I don't know why taking a small decrease in lifestyle or amenities so that everyone HERE can at least have basic needs provided for - while still being ten times better off than people in other places - is so unpalatable. (again: not to you in particular, but just in general.) and that's just for our own people! Totally off topic here, but as other countries develop there are going to be more strains on resources - if the third world is ever to approach a reasonable standard of living we're not going to be able to help taking a cut in our own standard of living - I dread to think what will happen then.

[dangermousie.livejournal.com]

But isn't that exactly what you're doing here?

Oh yes - I thought I stated it upfront, I am being selfish. All I was doing with that paragraph was pointing out that many on the other side of the debate are too.

I do not mean to offend, but I dread the day we get a Canadian health care system. Something like UK might be fine - basic government insurance for everyone but if you feel like something fancier, go ahead and buy private insurance. Canada's ban of any private hospitals and insurance leads to people who can afford it coming to the US for treatment to avoid horrendous wait times for things like MRIs or CATscans or certain types of surgeries - I know, I have Canadian family members who have had to do exactly that. And that can be a form of death sentence in and of itself, especially with conditions like cancer and heart disease where speed is of the essence.

I am not keen on government-run things in general - I grew up in the USSR so anything government run or even with the word 'socialist' makes me wary. This said, I do agree people deserve to have a basic level of health care. But to expect me to unthinkingly agree with any plan proposed by Congress just because it has nice buzzwords is expecting too much.

[shewhohashope.livejournal.com]

I live in the UK, so I'm all covered and more grateful for it than almost anything else that living in this country brings me. I don't have a horse in this race, so to speak, and I actually think that the proposed reforms aren't doing enough (and don't come close to universal health care, btw), but something is better than nothing. Leaving aside the innate selfishness of humanity, the idea of one the richest countries in the world being 'unable to afford' universal health care for it's citizens is disgusting. The provision of health care is not debatable, it's a basic human right.

I've unsuccessfully tried to make this as impersonal as possible because it doesn't affect me (except through the relatives I have in the US who are mostly well off enough that this doesn't affect them).

[ladyaeryn.livejournal.com]

Guess what? Majority of Americans have healthcare insurance already. The majority of them are satisfied enough with it.

A majority of Americans still means there are still, at the most optimistic estimate, tens of millions out there without insurance - hardly a number to be happy about. And like it or not, we are already paying for them.

I don't doubt you if you say you're happy with your insurance. But I would say you're one of the lucky few. In fact, seldom if EVER have I heard anyone in RL or otherwise bring up their health insurance to praise it - if they can afford to have insurance at all. (For the record, I live in one of the most right-wing, Obama-hating states in the nation, so it can't be said I'm only hearing liberal-leaning, pro-reform talk. FAR from it.) One of my coworkers was brought to tears the other day fighting our insurance on a claim they were supposed to pay months ago. I've got the best insurance in my state - insurance I could not remotely afford if I didn't get it through my job. And yet I've still had to put off my own procedures for years because we're looking at five-figure costs even with my "fabulous" insurance. Possibly even heading out of the country to get those procedures done. My mother has federal insurance. It takes her months to get in to see a specialist, and months after that for her surgery. She's been set back thousands for her endless surgeries and medications and will likely be in debt until the day she dies.

As far as "giving money up for others' benefit" - we already do that for roads, for schools, public transportation, police/fire/etc. We're already paying thousands per ER visit for those people who got sent there because they couldn't afford the insurance for those regular checkups to catch that infection before it became life-threatening - we're probably paying far more for these visits than we would be in taxes to fund an optional national healthcare plan.

As far as private industries "being unable to compete with the government" - we have state-run universities and private-run universities. We have a government postal service and private-run delivery services. The existence of a government option does not mean everyone is going to flock to it - if anything, the mistrust of government-run systems seems to point to the opposite. But frankly, if it turned out the government option was better than my current private plan, I would drop my current policy for it in a heartbeat.

[ambergold.livejournal.com]

I totally agree. Whenever I start thinking that I actually might want the government to take over health care so all those poor families can get it - I picture the DMV as an example of a universal "benefit" that is gov't run, and think about whether I want my medical system to be run like that - and immediately it loses all appeal.

also, you're right, of course - it just means higher taxes(again) for the 80% in order to help the 20%

[svilleficrecs.livejournal.com]

There's also an *assload* of stuff like http://www.huffingtonpost.com/2009/08/23/without-reform-health-ins_n_266589.html <- this, in terms of health reform affecting people, like you, who like their current health insurance. Whether or not we get a "everyone can buy into medicare if they want" system, whether or not we get universal coverage (which is looking less and less likely), people who have decent insurance stand to benefit just as much if not more from health care reform as those of us currently without. Premiums have skyrocketed in the last twenty years and are on track to continue doing so, if nothing is done. You like what you have, but how would you like it if it cost double?

And as a lot of people point out, many those who like their insurance *probably* haven't had to use it that much, or bumped up against its limits. I know nothing about your or your family's health, but I assume that you assume that the plan you're paying into is going to be there for you when you need it, and will continue to. There's a lot of really shitty stuff that goes on with health insurance, particularly with people - like you - who assume they're covered for whatever happens, then discover loopholes or denied claims or end up bankrupt even with coverage. I could find you hundreds of stories like this one ->http://karenknowsbest.com/2009/08/19/your-health-care-in-the-usa-tales-from-your-sick-bed-i/#more-4482 where supposedly covered people end up bankrupt. http://money.cnn.com/2009/03/05/news/healthcare_summit/index.htm

Again, I can understand the knee jerk desire to be all "I got mine, why should I pay for yours", but health care reform is about a hell of a lot more than the "good frugal tax paying citizens" subsidizing lazy, selfish uninsured rubes like myself. It's about overhauling a fucked up, broken system for all of us, insured and uninsured and underinsured. It's about making sure that getting sick doesn't mean you have to go broke. Sure I can stroll into an emergency room and get treated in an emergency. But I also get billed for it.

Health care reform is *not* all about those who have insurance paying for those who don't. In fact, as it stands now, unless you're in the very top of wage earners for this country, you're not going to be expected to pay for this. What health care reform is about is making sure that my prexisting conditions or your unexpected job loss don't price us out of the market. It's about making sure that, after paying into your insurance for however many years, your insurance company can't pull any squirrelly tricks.

I understand the concern about us lazy uninsured lowlifes sponging off your American dream success story bank account (I kid, and hyperbolize, I know you don't think that), and if that was *all* that needed to be fixed about the system, I'd be with you. But it's about a *lot* more than insuring the 50 million uninsured in this country. It's about fixing a system that fucks over those who pay into it with alarming regularity, and making sure that *your* insurance works the way it should when you need it. I'm glad your insurance company's never fucked you over, denied claims, and I hope it never does. And I hope you're never in a position where you're booted from the plan or your job because your sickness
is suddenly too expensive for your company to subsidize - but that does happen. And health reform is about stopping that bullshit too.

What it's about is making it so Americans who aren't in poverty, salaried jobs, federal jobs, or one job their whole life have a *choice* that is not tied to their employer and that can't be denied because of a prexisting condition. It's about fixing a system that fucks over the insured - including the president's own mother when she was dying of cancer - with disgusting regularity. Rationing will occur, but it already occurs all the damn time within the private health care system.

Like with this guy http://www.americablog.com/2008/12/carefirst-bluecross-blueshield.html

There are a ton of problem w/ the health care system, and the insurance industry, and whatever comes out won't fix all of them, of course. But reform is about that as much if not more than insuring the uninsured. It's about health care justice for all of us.

[bluehyacinth.livejournal.com]

When I think about this issue it comes down to a numbers game.

We rank 37th (http://www.photius.com/rankings/healthranks.html) in the World Health Organization's 2000 report on 191 health care systems in the world. This is far below most industrialized first world nations with national health care systems.

Further, we already pay more (http://www.who.int/mediacentre/factsheets/fs319/en/) than other countries for health in return for what appears to be less fortuitous results. We have a higher infant mortality and a lower life expectancy than many of our peer nations.

And while many people may indeed be happy with their own local coverage, we are, on average, less happy (http://www.gallup.com/poll/117205/americans-not-feeling-health-benefits-high-spending.aspx) with the status of our health and the quality of coverage nationwide than those in countries with other systems.

All of this seems to really argue for a change.

And I am a post-college tax paying individual with what I hope is good health insurance.

(I won't get in to my discomfort about the fact that insurance companies have a serious financial incentive to find a way to drop you from their coverage should something go wrong)

Finally, as a humanist, I believe that health care in the modern world should be a right, not a privilege. Nothing will prevent people with more money from getting more than the rest, but those with less shouldn't be asked to die because of their financial situation. At the very least, their Baby Mousies or Joeys shouldn't have to bear the health consequences for whatever situation their parents are in.

[kitsune714.livejournal.com]

I like the idea of all my patients being able to have access to insurance and medical care, because there's nothing more frustrating as a physician than to KNOW what needs to be done, but be unable to do it because of something as medically distasteful as finances and insurance. We learn absolutely nothing about the way the insurance system in America works in medical school, and are sort of expected to pick it up as we go -- it's a very rude awakening when you discover just how much all those tests you want cost and how much a simple 5-day course of a third-generation antibiotic (that is apparently only available in brand-name formulation) is going to cost your patient. Most insurance companies are, in general, run by people with no medical training or background. It is the most frustrating thing to have to spend all your time writing letters to insurance companies, trying to convince them to approve X drug or Y test for your patient. I think I spend more time on the phone or filling out paperwork than I do in a room with a patient and her family, which is the most disappointing thing for me. All I ask about healthcare reform is that they cut the red tape, reduce the paperwork, so that I can do my job.

I think I'm sort of personally torn about the idea of these healthcare "reforms" that the president is proposing -- on one hand, access to care is great. There are a lot of kids I see who fall through the cracks of the system (their parents make "too much money" to qualify for Medicaid and safety net programs are being cut left and right), so being able to get them plugged into resources would be a good thing. The downside to all these proposed reforms? From the perspective of a new physician, I'm concerned about how the push on primary care is going to affect my career trajectory -- do I want to end up working for the government? If I want to go into private practice by myself, with the way things are going, I don't know if I could afford to stay open, let alone take care of myself. I went into medicine to help people (anyone who goes into medicine for the money is definitely in the wrong business), but I would also like to be able to afford to pay back my student loans, to afford to send my kids to college, all those good things.

People talk about healthcare in the US being "so bad", with mortality and morbidity numbers through the roof, compared to other nations. From what I've seen? The reason why our numbers are worse is because our patients really are just that much sicker. Our hospitals admit, treat, and sustain patients in far more critical condition than would even be evaluated in hospitals in other countries. We do so much more innovative research and development in surgical and intensive care techniques that carry a great risk. Nearly every major hospital here in the US has, for example, an NICU, where we take care of neonates so ill that doctors in other countries with less resources wouldn't even consider them viable. What works in other countries, then, might not necessarily work for us, in terms of a cost-effective stance, if we're going to continue to offer the same level of care that we offer right now.

The core values of the reform are good: everyone should be able to see a doctor when he or she is sick. However, I agree with you, in that if my money is going to be spent? I'd like to know EXACTLY how it's going to be spent to achieve this goal of making sure other people are insured. I'm all for freedom of choice when it comes to choosing an insurance plan, but I can safely say that I don't know the right answer to covering the uninsured. I'm a libertarian at heart, so I greatly disagree with the idea of the government sticking its nose in where it doesn't belong. It's a confusing issue and I don't know if there's a right answer to it just yet.

[grace-om.livejournal.com]

You're already paying for uninsured people though a surcharge on your insurance premiums (you many not see this personally, if your employer is picking up the tab--for now). Currently this runs about $1000/yr on each insured family. Universal coverage would eliminate this charge, and should bring the costs of covering these people down -- as they would have access to basic care rather than the far more $$$$$$ ER-only care they have now. Yes there would quite possibly be some increase in your taxes, but with the drop in insurance costs, a lower net cost to you.

There is already rationing, and not just of the uninsured who have access to nothing. Try getting seriously ill or injured and see how fast they dump you, after they run out of ways to refuse to cover all manner of charges. I have good insurance through my employer and it's shocking how fast they try to deny payment for charges that they are contractually obligated to cover. I guess enough people don't hang in there and complain and sue, so they think it's worth it to try ripping you off.

Good luck to you if you become so ill that you lose your job. You'll lose your insurance too, and no one will write you a policy for any amount of money.

Premiums are going up an astronomical rate. Projections are that current costs to insure a family of 4 (~$13,000/yr) will almost *double* by 2019. Do you expect your salary to keep pace with that? Do you think your employer will be able to continue picking up the difference?

This isn't just about covering the uninsured, it's about protecting your and your family's own interests.

[dancesontrains.livejournal.com]

I'll (probably) stop spamming your journal after this, but I remembered this project (http://liz-marcs.livejournal.com/453649.html) by liz_marcs, with people giving their experiences about American and non-American healthcare.

[katranna.livejournal.com]

Actually, in that case, you'd be paying for ME to have health care. :-P As I have not really had insurance for the last year, even when I worked. Of course what this did is exactly what people say it does... I have had some medical issues that I did not get attended to because I didn't feel like I could afford to, but now some of them have gotten a lot worse. I will take care if it when I get back onto my TA insurance, but yeah, by that time they will require more care and more money from all the other people paying into that insurance.

That said, I agree that universal health care will make some people relatively worse off. Of course. It's not magic--to provide more insurance will cost more and the money will have to come from somewhere--and obviously not from the people who don't have insurance 'cause they can't afford it in the first place.

The thing is, I do feel decent basic health care should be one of our human rights, something the government just PROVIDES for us by virtue of being, you know, the government. Ie, I feel that's what we have them FOR. As such I would compare it to education and physical sfaety, the way it's seen in most European countries.

By this I mean, we already have public education, provided to every citizen for free (through high school anyway), and heck yeah we're paying taxes for it. We also have a police force that works for us, also all via taxes, and many other public services. If we treated all those things the way we treat healthcare now, well-off family that sends their child to a private school might complain on the same grounds: they're already paying for their kid's education, and they're happy with the school they get! Why should they fund anyone else's schooling via taxes? Another family might feel that even though their kid goes to a good public school now, they'd be able to send them to a private school if all schools were privatized, and that it might cost the same or less than taxes. Or a rich person who can afford their own private security team might resent funding security for others... and so on. But somewhere along the way we've decided that for our society to be functional and decent, we will provide these services to everyone: because it benefits all of us to have an educated workforce (and population), and one that is protected, and now, hopefully, one that is healthy.

[dangermousie.livejournal.com]

Sorry I did not call back btw! Is tonight a good time?

Re: schools. In most big cities, this is already happening. If we stay where we are, I will have to pay ginormous taxes for public schools while not being able to use them due to them being crappy.

I bet any time new taxes get imposed for anything, people are unhappy - am sure was the case with schools police etc. Of course, fewer people could afford private cops than can afford current insurance.

[uisceros.livejournal.com]

This is kind of a difficult issue for me, because I've seen both sides of it. I have siblings who currently live off the system (free state health insurance, food stamps, free housing, the whole deal), and for YEARS I was angry at them. It was so unfair that I had to pay for them through taxes when I did everything I was supposed to do even if I didn't want to (good grades, college, full time job, etc). I too had to work for everything I got (my family is relatively poor), and it hurt that they got things free when I got nothing.

Yes, it angered me, but at the same time I know that if they didn't get these things from the government they would be rather destitute. It's become even clearer since I lost my health insurance. When I quit my job, I was given the option of COBRA, which is to give people without jobs health insurance. I don't know how the government thinks UNEMPLOYED people can afford it, since for me, I'd have to pay $500 a month. I also live in a state where health insurance is mandatory for residents. I do not qualify for state based insurance, and when and if I go back to my job, I will not be full time, and will not receive insurance from them either.

Basically I get your point, it's very valid. But at the same time, I think it helps to consider if you ever found yourself in a position without health insurance. It's a scary place to be, and believe me, it worries me every single day.

[octavia-b.livejournal.com]

We pay an extra 1.5% tax to fund our universal healthcare system (thank god). And in surveys approximately 80% of people here say they would prefer to pay the extra tax than not have universal healthcare. Perhaps people aren't quite as selfish as you think they are.

[wildfirelies.livejournal.com]

If a public option is indeed introduced, there's a good chance YOUR insurance costs will go down. That's more money out of your paycheck that you get to keep instead of paying it to your insurance premimum. It would likely be enough to offset any sort of tax increase (which is not guaranteed to happen). You would likely see absolutely no change in your day to day life from the fact universal health care is now offered. But for those of us who just don't have that kind of access to health insurance, we badly need a way to get health insurance that isn't going to bankrupt us.

My sister is terrified to go to the doctor and is currently living without prescriptions because she just finished law school and is not yet employed and she has no insurance. For me, not having insurance is not an option, I have life threatening illnesses that MUST be treated. I can't just simply hope to be healthy. For a long time I was paying more than half my income for minimal health insurance. It was awful.

Also, a large perecentage of college-age people do pay taxes. Nearly every person I know enrolled in college also works at least part time and thus pays taxes.

I'm sure you're getting a lot of opposition to your statements, and I'm not trying to add to it. Just trying to add a perspective. My sister had the exact same viewpoint as you -- until she lost her health insurance.

[wildtiger7.livejournal.com]

I, too, want health care for selfish reasons (I don't like watching people suffer. And I work for a large company whose health care costs are rising and if the government gets costs under control that'll mean more money for their employees.). I just wish the health care debate was more over the issues you bring up and not the fake stuff that's currently dominating the debate.

[kathputli-girl.livejournal.com]

All I know is that I didn't have any health insurance whatsoever - because I couldn't afford it even working a full time job - until I married my husband, who only has benefits because he has a union job. So I didn't have it until I was 35. Before that if I wanted to see a doctor; too bad, unless I could borrow money from my father. A spider bite that sent me to the ER put me into a serious financial bind and I got turned over to a collections agency because I couldn't pay up.
I work in retail. Most retail jobs, at least here, don't pay for any kind of benefits whatsoever unless they are large retail corporations and you are a long term full-timer. It's really hard to even get a full time job, if any, right now. Alot of people here are surviving on part time or multiple jobs with no benefits. So, I dunno, maybe it would be more accurate to say that most Americans with good paying, permanent full time jobs that are lucky enough to have benefits and/or enough extra money to afford it have healthcare insurance...which, sadly, isn't "most Americans".

[sinclair-furie.livejournal.com]

I have such mixed feelings about this. :/

To me the problem is that the US has decided to be a half-assed welfare state. So now what happens if you're sick and you have no health insurance, or much more commonly, shitty health insurance, is that you don't go to the doctor until it becomes really really bad, and then you go to the ER where they're not allowed to turn you away. Then often, you can't pay the bills, you go bankrupt, can't get a reasonable job b/c of your terrible credit and end up on welfare and Medicaid. Where you continue to waste taxpayer money.

I grew up with the idea that health care is a privilege that you earn, and not a basic human right. All health care. My family was quite poor two generations back in Bangladesh, but through hard work and intelligence got to the point we are now. And a large part of me honestly believes that everybody has to earn this, with the exception of children , who shouldn't be punished for their parents (and already have universal health care under SCHIP).

But people in this country have decided that everybody needs reasonable health care, and I'm not sure exactly how that's going to happen without premiums and copays going up (while simultaneously being capped?). Sure, removing the inefficiencies that come from wasting money on researching why to deny coverage or changing the system so that doctors don't have terrible incentives to endlessly prescribe MRIs that cost thousands of dollars will help, but basically this is asking healthy people to subsidise the lives of sick people.

On some level it bothers me because insurance is what is supposed to protect you from random bad stuff happening- it's not exactly fair when somebody knows for sure they'll get a disease causes my premium to go up. I'm reasonably sure I would feel differently if life had given me some horrible, unmanageable disease. And of course, MOAR TAXES ALL THE TIME, though really, I don't mind my eventual money going towards health care if only the government would stop spending it on dumb things, like the war on drugs... but that's a story for another day, lol.

[kitkat-cat.livejournal.com]

Well, I currently live in the UK and am a receipient of the universal free healthcare provided for by the NHS. I get to see a doctor for free, and contraception is free, although i do pay a set fee for my medication (all of which were very helpful during my poor student days). But, I grew up in a capitalist society in Singapore, and remembered when we didn't have national health insurance. While all national healthcare was subsidised, and there was a relatively cheap option of private doctors (only if you have non-serious conditions), the cost was prohibitive to many people, especially when they had a serious illness and private healthcare was simply far too expensive. My family were lucky enough to be able to afford private healthcare for me when my kidneys kinds packed up when i was about 7. The solution was to have a 'savings account' (Medisave and Medishield) which people automatically paid into out of their salary every month. So, yes, they kinda got a national + private health insurance all rolled in one.

I can see both sides of the argument, for and against a national healthcare insurance scheme. I do think that something has to be done for the vulnerable who feel that they can't go to see a doctor because they can't afford it. Surely that is unacceptable in any society!

And in any case, I don't think that the NHS (currently a punching-bag in the US, i think :) ) is that bad. I've done all right by it, and yes, there are problems with it, what with waiting lists and so on. But at least, everyone, young and old, rich and poor, know that if they really needed it, at least there is a doctor they can see. And hey, if they're rich enough, they'll have private healthcare that can speed things up! It never fails to amuse me that when the BOYFRIEND had to see a specialist for his shoulder, the NHS waiting time was about 3 months, but when he said to his GP that 'I have private health insurance', the same specialist could see him within the week. Yes, we were incredibly frustrated with this, but we did realise that being able to see a specialist was better than not being able to see one at all for certain sections of the community.

I don't know enough about the reforms being proposed in the US, but I would have thought that a combination of private and national healthcare insurance schemes would be the way forward. Most people in my office, across the political spectrum, do love the NHS, and admit that yes, for small to mid-sized health problems, private healthcare is a lot better. But in the case of serious life-threatening things (as in the case of Stephen Hawking and David Cameron's son), the NHS does come through. Problems with access to cancer medication notwithstanding. But that's another argument for another day.

Ok, am done now...kinda rambling cos my head is all fluff at the moment...sigh... these kind of issues, go to far to some and not far enough for others... :(

[ysrith.livejournal.com]

As you will probably tell from my icon, my stance on healthcare is clear

You are entitled to your opinions, which I disagree with, but one thing does annoy me. The concept that a public health service leads to rationing and is therefore inferior to privitised healthcare

All health care systems have a degree of rationing. Resources are finite and choices about how best to use them have to be made. The NHS rations on the basis of cost:benfit/quality of life, with the patient being the central part of the equation.

Rationing already occurs within the privitized US healthcare system, but it is your HMO making the decision on what care to insure or provide or even what procedures they will cover, and their decisions are based on financial incentives and profit margins.

As a medical professional, I believe that provision of basic healthcare to all is part of the state/society's responsbility. In the UK, this comes as part of the taxes you pay. The current basic tax rate is 20%. For that, you get good quality healthcare, dental care, social services, unemployment benefit, education etc.

If you want to go private, you can in the UK. Interestingly, the premiums are significantly lower than the US. Why is that?

My personal opinion having worked there is that the US healthcare system is effectively broken due to the insurance companies. They have driven a culture of high-tech, complicated medicine, that costs a lot to provide, and also a litigation driven system. BTW complicated medical procedures does not always mean better, or even the right procedure. This is an illusion that the US healthcare system has created.

This culture has driven insurance premiums up and up, so that now you are getting to a point where people cannot afford them.

I am not sure whether Obama's solution is the answer. Personally, I believe a NHS style system based on tax is what is needed, which allows people who can afford and want to go private if they wish. However, these systems need to be seperate and distinct.

Personally, I feel that paying a small amount of tax, 1-2% to ensure that I and my fanmily and friends will always be able to get healthcare is a small thing.

I can guarentee that you and your family pay significantly more in insurance premiums per month than the tax for a NHS style service would cost you.

You have an illusion of choice and an illusion of being better off, but in reality instead of being controlled by the government, your healthcare is being controlled by private companies who are far more interested in their profits than your healthcare

Of course, that is my opinion, and this debate will go on and on in the US, and in the UK, as we look at how to continue providing healthcare.