AMERICAblog: Making a little headway in understanding healthcare reform
belili
· 1 year ago
Oh my god - don't do this. You are giving the same talking points Republicans give. Do you seriously think no one will want a free ride on the universal health care train? If we don't mandate coverage, why should people buy the plan? They can just wait until they're sick, then purchase it, and get coverage. The problem there is that the rest of us have to pick up the slack. If someone can afford health care and still they chose not to buy it - what recourse do we have if we don't mandate coverage?
Please, employ logic and not rhetoric. This isn't an attack against the poor who can't afford it. This is a legitimate complaint against the rich or well off who will want to take advantage of the system. Hell - if social security taxes were voluntary I wouldn't pay them. Would you?
sput
· 1 year ago
Actually, I kind of *do* want to pay social security taxes because I recognize a universal net benefit in doing so.
That aside, let me say that I otherwise agree with belili on this one. Without a mandate, you're running a serious risk of a lot of us wanting to just play the system when it becomes necessary or convenient to do so. Obama's plan creates a very, very serious risk of a premium deficit that forces premiums up for those who do have coverage. Mandating coverage is going to be the only way that we can take these first small steps towards fixing a system that is undeniably broke.
I'm not disillusioned at this point. I was a supporter of Senator Clinton, but I recognize that we're going to have a fine (at at this point, it's inevitable) candidate in Senator Obama. I do though have very, very serious problems with the lack of a mandate in Senator Obama's proposed health care plan.
belili
· 1 year ago
This is coming from an Obama supporter by the way...
slappymagoo
· 1 year ago
I'll halfway agree with Clinton. Yeah, there ARE young people who have problem prioritizing, think that health issues are a lifetime away, and don't think of health insurance as a necessity as a result. They'll use money they could spend on healthcare and use it for going out and lifestyle items.
But Jacki is MORE right, in that we have a crisis where most people have to choose between healthcare or healthy foods, or healthcare and living in a safer neighborhood, or healthcare versus a decent education for their child, and no one should have to make these kinds of choices. I'd rather have healthcare everyone can afford, and everyone can get, and worry about the cheaters on a case by case basis, then deny what's so necessary to so many while cheaters will find ways to cheat regardless.
jr
· 1 year ago
if someone suggests medicare for all the media and the beltwayists act like you're speaking Klingon
belili
· 1 year ago
It's not just young people - it's everyone. Anyone who wants to save a few $ would simply not buy insurance until they're sick.
I don't understand why some Obama supporters and Obama himself keeps reverting back to "they can't afford it!" as if it's a counter to the mandate argument. DUH! Supporters of mandates know that! That's why we also support subsidies for people who cannot afford it. If the subsidies work correctly (which I hope our administration would make them work correctly) then EVERYONE can afford health care. If that is true - what's the excuse? You can't choose not to be sick. You can't choose not to have an emergency. It's inevitable for many people. Given that fact - the only reason you have to not buy insurance at THAT point (not now, this isn't an argument about now but about the new plan) is to save money even though the insurance is affordable. It's, in effect, stealing money from those that actually pay the premiums. Do you really want that to happen?
Cheaters may be good at finding ways to cheat, but that doesn't mean we have to facilitate their cheating.
Ksue
· 1 year ago
I am 100% with you on this one, Jacki. Especially that next-to-last paragraph. Not all of us have regular jobs with our employers providing part of our health care premiums. Has anyone looked into how expensive health insurance premiums are when you're self-employed? It was certainly beyond our means when our kids were little and we were self-employed.
We've just never fit into any tidy little employment category. And probably never will.
Andrew A. Gill
· 1 year ago
If I'm reading Clinton's and Obama's plans correctly, Obama would allow you to choose between a private plan and a new federal plan (like the NHS, I guess).
Hillary would force you to buy private health insurance.
My question would be--how would buying current, private health care alleviate any of the issues facing people like those mentioned in Sicko?
The other thing is that Obama seems to have more room to compromise and get a really good bill through.
Hillary has locked herself into universal health care for all, and anything short of that would be considered a failure for her administration. When Republicans try to block the bill, Clinton has no room to move, but Obama can offer deals, and possibly even put obligatory health care on the table without taking too much of a hit.
JMOHR
· 1 year ago
Yes, there are those who are young and healthy who eschew insurance. However, that is not the real issue. They would contribute to the private insurance companies with very, very low rates. It would not offset the cost of the older and less healthy individuals who will be charged at excessive rates. Of course, your tax dollars will go to pay this.
Now, we will also see a system that will be just as confusing to those attempting to obtain coverage as all those wonderful options under the Medicare drug program. Think of the advertising dollars and additional overhead expense that will be incurred going after all of the new people who must make a choice. Indeed, why would employers want to cover anyone. Ever more people will find themselves fending for themselves against very, very rich and powerful insurance corporations.
TheOriginalLiz
· 1 year ago
Please let me know what insurance I can wait until I'm sick to buy, or until I break a leg, or whatever...I was under the impression that health insurance companies didn't feel obliged to cover "pre-existing conditions". If people don't buy insurance when they can afford it, it's not because they're "cheaters (what a republican mind-set) but because they don't believe anything they can't handle will ever happen to them.
nicho
· 1 year ago
Well, if coverage is mandated and is linked to income, why not just take it out of people's salaries, as we do with Social Security and Medicare. Then, you can create a single-payer system, which will result in low administrative costs, leaving more for health care.
Hillary's plan, however, will benefit the insurance companies, who will create a welter of confusing policies with indecipherable terms and imponderable differences among them. Most people will fall victim to insurance company hucksters and many will just stick a finger in the phone book to pick a plan, which may or may not be right for them.
This mess will be sold using the scam word "choice." When you can't understand your alternatives, you have no real choice.
A good example is the current Medicare prescription plan. There are hundreds of plans. Not all plans cover all drugs, so you have to pick a plan that covers the drugs you're on. However, you don't know what drugs your doctor may prescribe tomorrow -- and the insurers can drop drugs at any time. You can only change your plan once a year.
At the end of the day, because we will still have a multi-payer system, premiums and costs will be much higher than they need be.
Hillary's plan is designed to benefit one group only -- the insurance companies and the pharmaceutical companies that have been so generous to her campaign.
Andrew A. Gill
· 1 year ago
Well, if coverage is mandated and is linked to income, why not just take it out of people's salaries, as we do with Social Security and Medicare. Then, you can create a single-payer system, which will result in low administrative costs, leaving more for health care.
Hillary's plan, however, will benefit the insurance companies [...] At the end of the day, because we will still have a multi-payer system, premiums and costs will be much higher than they need be.
Hillary's plan is designed to benefit one group only -- the insurance companies and the pharmaceutical companies that have been so generous to her campaign.
I'm catching up, but I gotta say,
THIS.
Gary SF
· 1 year ago
We seem to be aligned on this issue. Why is it so difficult for people to understand that the insurance companies are the enemy of health care? They exists for profits, PERIOD.
When was the last time we went a month without one of these bloodsuckers being sued for something?
TheOriginalLiz
· 1 year ago
As long as health insurance is handled by insurance companies (i.e. companies who make money by taking in premiums and not paying out benefits) it will have problems. The whole paradigm needs to shift, not just the payment method.
belili
· 1 year ago
I agree the only perfect plan is single-payer. But any attempt at getting that through Congress will surely fail.
TheOrigialLiz - Republican mindset? You know what is a republican mindset? Ignoring and twisting facts. Neither Clinton nor Obama's plan allow for insurance companies to ban people for pre-existing conditions. So your argument in effect proves my point (if you plug in actual facts).
As to the issue of compromise - the first rule in compromising is to ask for more than you are willing to accept. You don't start out with a compromise and work from there. You start out with the ideal and THEN compromise. If we go into negotiations with Obama's already compromised bill - Republicans will want even more concessions and the entire system will be corrupted.
Andrew A. Gill
· 1 year ago
You start out with the ideal and THEN compromise.
I think Obama's ideal is what he's proposing.
But it also allows him to use mandatory health care as a bargaining chip and not look like a loser. e.g. ``OK, so you'll vote for it if we give tax breaks to the insurance companies. If we're going to give them all the people's money, they should be obligated to cover all the people. It's not what I want, but I'll take it, and it will appease the Hillary bloc.''
shell
· 1 year ago
There is one (read: ONE) way to solve the health care problem. UNIVERSAL CARE. And I mean universal, not the non-universal pundits and politicians CALL "universal" now. That means everyone. 100% of Americans.
And it's simple -- single payer. Like Medicare. NO HEALTH INSURANCE. If everyone is covered, there is no need for insurance. And if some goofy really rich folks want more (oh, like botox, plastic surgery, waiting 2 days for elective surgery, etc.), they can buy insurance. Leave me out of it, though.
I have worked IN health insurance, or around it, for 20 years. I know of what I speak.
It is so simple -- why can't Americans see this?
Andrew A. Gill
· 1 year ago
And it's simple -- single payer. Like Medicare. NO HEALTH INSURANCE. If everyone is covered, there is no need for insurance. And if some goofy really rich folks want more (oh, like botox, plastic surgery, waiting 2 days for elective surgery, etc.), they can buy insurance. Leave me out of it, though.
Yup. This is what the NHS is, right?
I want doctors who dedicate themselves to the health and well-being of their patients, not those who want the house in the Hamptons and the Maserati.
I know doctors. Trust me, all they want is the well-being of their patients. They're trying to keep their heads above water just like the rest of us. No, the health care money is going to bureaucrats.
Also, some people may remember that I'm a Libertarian.
A Libertarian who is supporting government health care? I oppose large government because it encroaches on my personal rights. But right now, private health care is encroaching more on my rights than government health care ever could.
TheOriginalLiz
· 1 year ago
belili - a little defensive, aren't we?
Since we can't know the motivation for "cheaters" in the future, I was talking abut the current state of health insurance.
belili
· 1 year ago
Because Republicans have had their cocks up the free markets ass for decades, and they're not willing to pull out for any reason, including people's health and lives. The result is that they fuck us all.
OlderAndWiser
· 1 year ago
This sounds very much (with the exception of "mandatory") like the Medicare prescription plan. And the doctor's plan under that isn't the most generous, either; it assumes you have the money to pay the deductible every year, as well as that portion of the doctor's fees that aren't covered. While many can pay those things, a large number of SS recipients cannot, since SS is their only form of income.
And I see nothing in her plan that would provide a sliding scale based on income, and the thought of retaining insurance companies to administer her plan is abominable. Right now, the cost of administering SS itself costs the taxpayers about 1/2%. Imagine how much it's costing for Medicare at this point. And how much it would cost to administer universal health care.
Totally unacceptable. Get rid of the profit motive and ensure health care for all. I want doctors who dedicate themselves to the health and well-being of their patients, not those who want the house in the Hamptons and the Maserati.
belili
· 1 year ago
Liz - why talk about the current state of health insurance? We're talking about which plan is best right? Under both plans they don't allow pre-existing conditions to be banned. Thus we have to ask ourselves are mandates necessary under THOSE plans. Of course mandates would be a horrible idea under the current system... we'd all be broke. But Obama and Clinton's plans will be drastically different.
nicho
· 1 year ago
Don't be too hard on young people or others who don't buy insurance, especially those who have to make very difficult financial choices.
When my Cobra ran out, I looked for private health insurance. I was turned down for a low-cost plan because I had the dreaded disease of hay fever -- automatic disqualification.
So, I was offered a plan that would have cost me a total out of pocket expense of $16,000 a year. I was working free-lance at the time and my income was (a) unpredictable and (b) not high enough to pay that and keep a roof over my head and buy food.
Most people are subject to what has been called many nasty things -- free-riders (by the way, Hillary's use of "free rider" is wrong), instant gratification -- but what really is in play is a phenomenon called "bias toward the near." We all are subject to it in varying degrees. You really will want to get into that two-piece bathing suit come July, but you still ate two donuts this morning. You get the point.
Young people are more inclined to this. If it weren't for bias toward the near, no one would smoke, no one would overeat, no one would watch TV instead of studying, no one would put any chore off until tomorrow so they could do something pleasurable today.
Young people, for the most part, feel pretty good and don't understand what happens to them when they get older. When you're 22, 40 is the other side of the moon. I never could figure out why my parents went to bed at 9:30, when the night was still young. I remember that these days as I start thinking about bed sometime around 8:30.
People predictably will choose a near benefit over a distant future benefit. This is the whole idea behind Social Security, Left to their own devices, most people wouldn't, in fact, save the money necessary for retirement -- not with kids to feed and clothe, etc. Social Security is probably the best social service plan in all of history -- or it was until the corporatists started using it as an ATM.
shell
· 1 year ago
At one health insurance job I worked, I found out many of their tricks. One that they did was denying 100% of claims, over about $200. Even if they were obviously legitimate. Why? With all of them, just the several months it took for re-applying the claim, etc., the insurance company got tons of money, just in interest (on the money they had). In addition to US, I don't see why all doctors aren't up in arms.
belili
· 1 year ago
But the young people aren't going to harm themselves, they are going to harm others. Under both plans - no matter if they grow up to be 45 and have never paid into the system - they can still buy insurance after they get sick. That's like getting social security after never paying taxes.
If young people would just be harming themselves, I'd agree (by the way, the focus on young people is disturbing. This would involve much more than just younglings). However, they're harming people who actually pay into the system.
nicho
· 1 year ago
belili 4 minutes ago But the young people aren't going to harm themselves, they are going to harm others. Under both plans - no matter if they grow up to be 45 and have never paid into the system - they can still buy insurance after they get sick. That's like getting social security after never paying taxes.
No, that's not how it works. If we had a single-payer, cradle-to-grave system -- say like Holland -- your argument would make sense. You would have to look at money paid in and money taken out over a person's lifetime.
However, with a multi-payer system, you can only look at in-year costs for the pool any insurance company insures during that year. You can't look at what someone contributes or consumes over their lifetime, because there is no "system" to pay into. I might be with Blue Cross this year, Aetna next year, and someone else the year after. So, Blue Cross doesn't care what I spend two years from now or 10 years in the past. All they look at is how much they take in this year and how much they pay out this year.
This is what keeps premiums high and makes insurance companies find way to "cherry pick" in order to keep high consumers out of the system.
BeccaMorn
· 1 year ago
As long as there is an incentive for a parasitic health insurance company to maximize profits by denying care, they will do so. If there is any way they can get out of paying claims or to avoid covering those who have ANY health issue whatsoever, they will do that, too.
There's a reason why 'single-payer healthcare' works. Because it exists primarily to deliver medical care to those who need it. The people working in the system get salaries, but NOBODY gets obscene profits by denying treatment to those who need it.
The insurance biz has become a scam, and any candidate involving private insurance companies in an essential public service (namely, the delivery of medical care) is on a fool's errand.
Worse, they're scamming the public.
nicho
· 1 year ago
The real issue is that as long as Big Insurance, Big Pharma, and Big Medicine are major players in our political process -- and as long as candidates need buckets of corporate money to run for office -- we will never have meaningful health care reform.
We will end up with some kind of hybrid system that will, in the end, screw the workers and ensure corporate profits.
And you can take that to the bank.
So, all this talk about Hillary's plan, Obama's plan, McCain's plan (truly truly scary) is just talk. Nothing will be done.
The most important issue -- and in fact the only issue -- is getting corporate money out of politics. Until we do, everything else is just bullshit and distraction.
nicho
· 1 year ago
If ever you've tried to untangle a knotted necklace, you've got a good sense of how I feel trying to make sense of the specifics of the healthcare reform debate. It's infinitely frustrating, and you start to rely on small victories to keep you going.
The problem, Jacki, is that we've got a system that is fundamentally flawed and unworkable. So, trying to "untangle" it is a futile task. All the tinkering in the world is only going to make it worse. It's like putting a cup of salt, instead of a cup of sugar, into your cake batter. There is really nothing you can do to make it better. You just need to toss it and start over.
met00
· 1 year ago
What a load of crap.
1) compute the percentage that smoking taxes have increased against all other taxes. So we will continue to tax a decreasing base for a greater percentage. Makes no sense. 2) What are the "other" things that damage health? Well there is sugars. Look at the percentage of the population that has diabities type 1 and 2 against the same percentage in say 1960. If you are going to go after a bad guy, sugars are a very bad guy. 3) Look at the percentage of tax increase on alcohol and bring it up to match the same level of tax increase that tobacco has had over the 50 years. This attacks both sugars (that are in alcohol) and things like liver damage. 4) Let's increase the cost of that Starbucks coffee that is all so bad for you by 10% or so. There are known links between health costs and coffee. 5) a fat tax sounds good too. If it has transfat it has a tax.
So right there, without attacking the ever shrinking demographic of tobacco users we have been able to tax things that we KNOW are bad for personal health to use the taxes from those that are doing bad things to themselves to offset the costs of the care that they will be requiring.
Of course Joe Average (read Chris in Paris) would bitch and complain because we aren't going after smokers. But the reality is that taxing a shrinking demographic even more is going to cause that demographic to shrink further and will potentially reduce tax revenue. While, on the other hand, going after BIG demographic groups who are still doing very bad things to their health with a lower tax bite will get some small percent to choose a healthier lifestyle, but will generate a far larger revenue stream to fund universal care.
Now, why can I see that, but our pandering politicos can't seem to understand the same thing?
MorgaineSwann
· 1 year ago
Find a group of people who don't have health insurance. Now, ask them how many of them can give up 10% of their income. Let me save you the trouble - the answer will be NONE of them. People simply don't have this money they're expected to spend in Clinton's plan. People spend money on health insurance before they have disposable income. What should they give up? Food? Rent? Heat? Sell a couple of kids? This is why we have to switch to public campaign financing. There need to be a few poor people in the room when these issues are discussed. Rich people don't understand the concept of not going to the doctor because you don't have the 1 dollar co-pay, let alone 10% of your income that you don't desperately need. These rich people haven't got a clue about what real life is like for the rest of us.
LeftCoastOracle
· 1 year ago
You don't get it. The only way we'll ever have reasonable health care is if we adopt single payer such as Medicare for everyone. For profit health care schemes have priced themselves out of the market and should be outlawed. If people want more than could be provided by Medicare then let them buy a supplemental plan offered by a non-profit HMO.
Let's face it, we're never going to get this unless we demand it from Congress. And I mean DEMAND it! Throw the bums out of office if they don't make it happen - Republicans and Democrats. Their health care is fully paid for so they don't have an incentive to solve this problem except to stay in office.
Get a clue! Demand non-profit, single payer health care for every legal resident of the U.S. - something like Sweden offers. Just imagine what it would mean to your budget if you didn't have to worry about health care. I'd bet that millions of Americans could handsomely support themselves and their families if they didn't have to worry about this one issue.
Andrew A. Gill
· 1 year ago
OK.
I just got this from Obama's site:
Subsidies. Individuals and families who do not qualify for Medicaid or SCHIP but still need financial assistance will receive an income-related federal subsidy to buy into the new public plan or purchase a private health care plan.
So it sounds a lot like Obama is pushing for a non-profit solution.
Mycelium72
· 1 year ago
But does Hillary's use of subsidies mean that although her plan requires everyone to have health care that it will be affordable for all?
I agree more with your earlier post of Krugman's article about how the take of mandatory health care is more of a scare tactic.
Gary SF
· 1 year ago
This plan will bring of more of the same - government mandates to fund private industry. The only successful plan is one that eliminates insurance companies. They add ZERO value to the health care dollars being spent in the US. Nothing.
This plan forces all of us to pay insurance companies to 'administer' our health care. It is little more than more of the Bush administration's philosophy of enriching corporations - many of which have been sued over and over for illegal and unethical activities.
The other issue I have with plan is its tacit approval of the idea that most of us want to 'shop around' in the health care 'marketplace' for the best plan. Nope, not me. First, the coverage can change within any plan at any time. Second, when you are really sick, you don't have the energy to shop around or fight for you basic needs.
Clinton has sold out to the insurance industry. I read someplace that 25% of the health care 'dollars' in the world are spent buy us in the US. And yet we rank at the bottom of the list of industrialized nations in most health outcomes. Why would we create a system that is more of the same? It is a bad system.
All Comments
Please, employ logic and not rhetoric. This isn't an attack against the poor who can't afford it. This is a legitimate complaint against the rich or well off who will want to take advantage of the system. Hell - if social security taxes were voluntary I wouldn't pay them. Would you?
That aside, let me say that I otherwise agree with belili on this one. Without a mandate, you're running a serious risk of a lot of us wanting to just play the system when it becomes necessary or convenient to do so. Obama's plan creates a very, very serious risk of a premium deficit that forces premiums up for those who do have coverage. Mandating coverage is going to be the only way that we can take these first small steps towards fixing a system that is undeniably broke.
I'm not disillusioned at this point. I was a supporter of Senator Clinton, but I recognize that we're going to have a fine (at at this point, it's inevitable) candidate in Senator Obama. I do though have very, very serious problems with the lack of a mandate in Senator Obama's proposed health care plan.
But Jacki is MORE right, in that we have a crisis where most people have to choose between healthcare or healthy foods, or healthcare and living in a safer neighborhood, or healthcare versus a decent education for their child, and no one should have to make these kinds of choices. I'd rather have healthcare everyone can afford, and everyone can get, and worry about the cheaters on a case by case basis, then deny what's so necessary to so many while cheaters will find ways to cheat regardless.
I don't understand why some Obama supporters and Obama himself keeps reverting back to "they can't afford it!" as if it's a counter to the mandate argument. DUH! Supporters of mandates know that! That's why we also support subsidies for people who cannot afford it. If the subsidies work correctly (which I hope our administration would make them work correctly) then EVERYONE can afford health care. If that is true - what's the excuse? You can't choose not to be sick. You can't choose not to have an emergency. It's inevitable for many people. Given that fact - the only reason you have to not buy insurance at THAT point (not now, this isn't an argument about now but about the new plan) is to save money even though the insurance is affordable. It's, in effect, stealing money from those that actually pay the premiums. Do you really want that to happen?
Cheaters may be good at finding ways to cheat, but that doesn't mean we have to facilitate their cheating.
We've just never fit into any tidy little employment category. And probably never will.
Hillary would force you to buy private health insurance.
My question would be--how would buying current, private health care alleviate any of the issues facing people like those mentioned in Sicko?
The other thing is that Obama seems to have more room to compromise and get a really good bill through.
Hillary has locked herself into universal health care for all, and anything short of that would be considered a failure for her administration. When Republicans try to block the bill, Clinton has no room to move, but Obama can offer deals, and possibly even put obligatory health care on the table without taking too much of a hit.
Now, we will also see a system that will be just as confusing to those attempting to obtain coverage as all those wonderful options under the Medicare drug program. Think of the advertising dollars and additional overhead expense that will be incurred going after all of the new people who must make a choice. Indeed, why would employers want to cover anyone. Ever more people will find themselves fending for themselves against very, very rich and powerful insurance corporations.
Hillary's plan, however, will benefit the insurance companies, who will create a welter of confusing policies with indecipherable terms and imponderable differences among them. Most people will fall victim to insurance company hucksters and many will just stick a finger in the phone book to pick a plan, which may or may not be right for them.
This mess will be sold using the scam word "choice." When you can't understand your alternatives, you have no real choice.
A good example is the current Medicare prescription plan. There are hundreds of plans. Not all plans cover all drugs, so you have to pick a plan that covers the drugs you're on. However, you don't know what drugs your doctor may prescribe tomorrow -- and the insurers can drop drugs at any time. You can only change your plan once a year.
At the end of the day, because we will still have a multi-payer system, premiums and costs will be much higher than they need be.
Hillary's plan is designed to benefit one group only -- the insurance companies and the pharmaceutical companies that have been so generous to her campaign.
Hillary's plan, however, will benefit the insurance companies
[...]
At the end of the day, because we will still have a multi-payer system, premiums and costs will be much higher than they need be.
Hillary's plan is designed to benefit one group only -- the insurance companies and the pharmaceutical companies that have been so generous to her campaign.
I'm catching up, but I gotta say,
THIS.
When was the last time we went a month without one of these bloodsuckers being sued for something?
TheOrigialLiz - Republican mindset? You know what is a republican mindset? Ignoring and twisting facts. Neither Clinton nor Obama's plan allow for insurance companies to ban people for pre-existing conditions. So your argument in effect proves my point (if you plug in actual facts).
As to the issue of compromise - the first rule in compromising is to ask for more than you are willing to accept. You don't start out with a compromise and work from there. You start out with the ideal and THEN compromise. If we go into negotiations with Obama's already compromised bill - Republicans will want even more concessions and the entire system will be corrupted.
I think Obama's ideal is what he's proposing.
But it also allows him to use mandatory health care as a bargaining chip and not look like a loser. e.g. ``OK, so you'll vote for it if we give tax breaks to the insurance companies. If we're going to give them all the people's money, they should be obligated to cover all the people. It's not what I want, but I'll take it, and it will appease the Hillary bloc.''
And it's simple -- single payer. Like Medicare. NO HEALTH INSURANCE. If everyone is covered, there is no need for insurance. And if some goofy really rich folks want more (oh, like botox, plastic surgery, waiting 2 days for elective surgery, etc.), they can buy insurance. Leave me out of it, though.
I have worked IN health insurance, or around it, for 20 years. I know of what I speak.
It is so simple -- why can't Americans see this?
Yup. This is what the NHS is, right?
I want doctors who dedicate themselves to the health and well-being of their patients, not those who want the house in the Hamptons and the Maserati.
I know doctors. Trust me, all they want is the well-being of their patients. They're trying to keep their heads above water just like the rest of us. No, the health care money is going to bureaucrats.
Also, some people may remember that I'm a Libertarian.
A Libertarian who is supporting government health care? I oppose large government because it encroaches on my personal rights. But right now, private health care is encroaching more on my rights than government health care ever could.
Since we can't know the motivation for "cheaters" in the future, I was talking abut the current state of health insurance.
And I see nothing in her plan that would provide a sliding scale based on income, and the thought of retaining insurance companies to administer her plan is abominable. Right now, the cost of administering SS itself costs the taxpayers about 1/2%. Imagine how much it's costing for Medicare at this point. And how much it would cost to administer universal health care.
Totally unacceptable. Get rid of the profit motive and ensure health care for all. I want doctors who dedicate themselves to the health and well-being of their patients, not those who want the house in the Hamptons and the Maserati.
When my Cobra ran out, I looked for private health insurance. I was turned down for a low-cost plan because I had the dreaded disease of hay fever -- automatic disqualification.
So, I was offered a plan that would have cost me a total out of pocket expense of $16,000 a year. I was working free-lance at the time and my income was (a) unpredictable and (b) not high enough to pay that and keep a roof over my head and buy food.
Most people are subject to what has been called many nasty things -- free-riders (by the way, Hillary's use of "free rider" is wrong), instant gratification -- but what really is in play is a phenomenon called "bias toward the near." We all are subject to it in varying degrees. You really will want to get into that two-piece bathing suit come July, but you still ate two donuts this morning. You get the point.
Young people are more inclined to this. If it weren't for bias toward the near, no one would smoke, no one would overeat, no one would watch TV instead of studying, no one would put any chore off until tomorrow so they could do something pleasurable today.
Young people, for the most part, feel pretty good and don't understand what happens to them when they get older. When you're 22, 40 is the other side of the moon. I never could figure out why my parents went to bed at 9:30, when the night was still young. I remember that these days as I start thinking about bed sometime around 8:30.
People predictably will choose a near benefit over a distant future benefit. This is the whole idea behind Social Security, Left to their own devices, most people wouldn't, in fact, save the money necessary for retirement -- not with kids to feed and clothe, etc. Social Security is probably the best social service plan in all of history -- or it was until the corporatists started using it as an ATM.
If young people would just be harming themselves, I'd agree (by the way, the focus on young people is disturbing. This would involve much more than just younglings). However, they're harming people who actually pay into the system.
But the young people aren't going to harm themselves, they are going to harm others. Under both plans - no matter if they grow up to be 45 and have never paid into the system - they can still buy insurance after they get sick. That's like getting social security after never paying taxes.
No, that's not how it works. If we had a single-payer, cradle-to-grave system -- say like Holland -- your argument would make sense. You would have to look at money paid in and money taken out over a person's lifetime.
However, with a multi-payer system, you can only look at in-year costs for the pool any insurance company insures during that year. You can't look at what someone contributes or consumes over their lifetime, because there is no "system" to pay into. I might be with Blue Cross this year, Aetna next year, and someone else the year after. So, Blue Cross doesn't care what I spend two years from now or 10 years in the past. All they look at is how much they take in this year and how much they pay out this year.
This is what keeps premiums high and makes insurance companies find way to "cherry pick" in order to keep high consumers out of the system.
There's a reason why 'single-payer healthcare' works. Because it exists primarily to deliver medical care to those who need it. The people working in the system get salaries, but NOBODY gets obscene profits by denying treatment to those who need it.
The insurance biz has become a scam, and any candidate involving private insurance companies in an essential public service (namely, the delivery of medical care) is on a fool's errand.
Worse, they're scamming the public.
We will end up with some kind of hybrid system that will, in the end, screw the workers and ensure corporate profits.
And you can take that to the bank.
So, all this talk about Hillary's plan, Obama's plan, McCain's plan (truly truly scary) is just talk. Nothing will be done.
The most important issue -- and in fact the only issue -- is getting corporate money out of politics. Until we do, everything else is just bullshit and distraction.
The problem, Jacki, is that we've got a system that is fundamentally flawed and unworkable. So, trying to "untangle" it is a futile task. All the tinkering in the world is only going to make it worse. It's like putting a cup of salt, instead of a cup of sugar, into your cake batter. There is really nothing you can do to make it better. You just need to toss it and start over.
1) compute the percentage that smoking taxes have increased against all other taxes. So we will continue to tax a decreasing base for a greater percentage. Makes no sense.
2) What are the "other" things that damage health? Well there is sugars. Look at the percentage of the population that has diabities type 1 and 2 against the same percentage in say 1960. If you are going to go after a bad guy, sugars are a very bad guy.
3) Look at the percentage of tax increase on alcohol and bring it up to match the same level of tax increase that tobacco has had over the 50 years. This attacks both sugars (that are in alcohol) and things like liver damage.
4) Let's increase the cost of that Starbucks coffee that is all so bad for you by 10% or so. There are known links between health costs and coffee.
5) a fat tax sounds good too. If it has transfat it has a tax.
So right there, without attacking the ever shrinking demographic of tobacco users we have been able to tax things that we KNOW are bad for personal health to use the taxes from those that are doing bad things to themselves to offset the costs of the care that they will be requiring.
Of course Joe Average (read Chris in Paris) would bitch and complain because we aren't going after smokers. But the reality is that taxing a shrinking demographic even more is going to cause that demographic to shrink further and will potentially reduce tax revenue. While, on the other hand, going after BIG demographic groups who are still doing very bad things to their health with a lower tax bite will get some small percent to choose a healthier lifestyle, but will generate a far larger revenue stream to fund universal care.
Now, why can I see that, but our pandering politicos can't seem to understand the same thing?
Let's face it, we're never going to get this unless we demand it from Congress. And I mean DEMAND it! Throw the bums out of office if they don't make it happen - Republicans and Democrats. Their health care is fully paid for so they don't have an incentive to solve this problem except to stay in office.
Get a clue! Demand non-profit, single payer health care for every legal resident of the U.S. - something like Sweden offers. Just imagine what it would mean to your budget if you didn't have to worry about health care. I'd bet that millions of Americans could handsomely support themselves and their families if they didn't have to worry about this one issue.
I just got this from Obama's site:
Subsidies. Individuals and families who do not qualify for Medicaid or SCHIP but still need financial assistance will receive an income-related federal subsidy to buy into the new public plan or purchase a private health care plan.
So it sounds a lot like Obama is pushing for a non-profit solution.
I agree more with your earlier post of Krugman's article about how the take of mandatory health care is more of a scare tactic.
This plan forces all of us to pay insurance companies to 'administer' our health care. It is little more than more of the Bush administration's philosophy of enriching corporations - many of which have been sued over and over for illegal and unethical activities.
The other issue I have with plan is its tacit approval of the idea that most of us want to 'shop around' in the health care 'marketplace' for the best plan. Nope, not me. First, the coverage can change within any plan at any time. Second, when you are really sick, you don't have the energy to shop around or fight for you basic needs.
Clinton has sold out to the insurance industry. I read someplace that 25% of the health care 'dollars' in the world are spent buy us in the US. And yet we rank at the bottom of the list of industrialized nations in most health outcomes. Why would we create a system that is more of the same? It is a bad system.