Overwhelming Incompetence: a.k.a Government Healthcare

[JWPlatt]

I suspect some element of confirmation bias here. While you mention those who agree with your point of view, the rest are unrepresented although you do implicitly acknowledge them with "not everyone." You say it's also possible your sample is self-selected in your line of work. That's fair. My wife made the same observation you do, but about people who have money to smoke yet live on assistance.

I'm wondering if health care should be like how some countries handle military service so that everyone participates in the greater good of society for some prescribed time. The option would be some requirement to work for the military, medical, or government services - a sort of "New Deal" Civilian Conservation Corps thing. Personally, I'd add space program services to the list. Your position would depend on your level of skill. Robert Heinlein might call it a "franchise." If people had to give same to get same at no cost, would you more approve?

 

[Jedi_Master]

But you have to understand, these are people that are used to being poor. They pay cash for crappy little cars. They have no aspirations of ever owning a home. If they went to the doctor without insurance, they would be totally fine never paying the bill, regardless of the consequences to their credit.

I know plenty of people like that too, and some of them, heck most of them also love that big "refund" check they get in February from the Federal Government, and were super pissed when they found out that they might lose a portion of that if they refused to buy health insurance.

It's crazy thinking, but it does exist.

 

[Robert Maxwell]

I'm curious who all these people are who are poor enough to have never had insurance, but making enough money that they'd have to spend more than a pittance on ACA-compliant insurance. The subsidies have pretty generous income limits and most people who are poor by any reasonable definition of the word would pay little or nothing for their coverage.

Of course, obtaining that subsidy-funded coverage does require some effort on the part of the would-be insured--effort that was not previously required. I guess one could complain about that.

 

[Karzak]

I spent the first half of 2015 out of work. My monthly ACA bill was approximately $0.00.

When I got signed up and ready for my first wellness visit here in California, I was diagnosed with a skin condition -- tinea versicolor. It's nothing serious, and certainly not life threatening or painful. Just a bit of an embarrassment when it would flare up. I was prescribed a special, medicated shampoo to take care of it. Went to my local CVS. How much did this prescription bottle of shampoo cost thanks to the ACA? A whopping $0.00. Within two weeks the tinea versicolor was completely gone.

When I did finally find a job, it wasn't exactly something that rained down the sweet dollar signs from heaven above.

My ACA monthly bill?

Still $0.00.

So, to those who have contributed and done their part embracing the ACA whether they liked it or not, I thank you for doing so because it has helped me while I've been knocked down a bit. I look forward to getting back on my feet professionally and being able to contribute more again and soon so that I can return the favor and pay it forward.

 

[Trekker4747]

For most of them it was just one of those things they wouldn't even consider spending money on. They had lived their whole lives without it, so it wasn't even on their radar.

I've been paying for health insurance my entire adult life, and I have used exactly zero times.

Your entire adult life you've never seen a doctor? Gotten a major illness (even something as simple as strep) that only medication can relieve the symptoms of or cure? Never suffered some kind of injury requiring medical treatment? Never needed your physical health examined to ensure you're not in need of any kind of treatment or have a health condition? Never gotten your teeth cleaned, needed a cavity treated/repaired or other dental need? Your "entire adult life" you've never seen a doctor?

I find that impossible. I don't care who you are, how healthy you are, what your diet is, what your genetic lineage is or any of that. At some point since you turned 18, or were no longer under your parents' insurance, you've needed to see a doctor for one reason or another. You've needed medication for something, you've needed to use a hospital in some form or fashion.

Whether it's a bad cut needing stitches or sprain needing treatment. Whether it's simply wanting your blood and heart condition checked, or whether you've been coughing and have had a bad fever for a few days. Somewhere you've been injured or sick and needed to see a doctor or visited a hospital.

And if you have insurance it likely didn't cost you very much compared to if you hadn't. If you've truly not seen a doctor in however long you've been "an adult" then you're either truly remarkable or have little regard for your personal health.

It's easy to think you'll never get sick or injured but a simple flu can knock you on your ass for days and doctor-prescribed medications can ease the symptoms and hasten recovery. A bad cut can require stitches to stop bleeding, to heal correctly, and in some cases require a shot to prevent getting a bacterial infection related to serious wounds.

You don't have to get cancer or break a limb to "need to see a doctor," seeing a doctor is a common, regular, part of living an adult life to keep yourself healthy or at least aware of your health. Same goes for dental health, keeping your teeth cleaned and cavity free requires doctors.

Insurance makes all of this cheaper, a UHC system would make it virtually free.

 

[FPAlpha]

Of course I'm an anecdote. We're all anecdotes.

My "source" is conversations. My "source" is all the bitching and moaning I heard when they were told that they had to get health insurance or face the penalties.

Of course everyone wants to have medical coverage, but not everyone wants to pay for it. These are the people that I have daily interactions with; these are my coworkers who do not receive insurance from our employer. These are also people who spend so much of their money on alcohol (I work in a bar, btw) that at the end of the month they bitch about how they don't have enough money to pay their rent. It's crazy to me, but I've seen it too much to dismiss it.

There are obviously going to be differing viewpoints on all of this, but I have had these conversation with too many people for it to not have some merit.

Since i live in Germany i grew up with free healthcare(well basically free though people still bitch and moan if they have to pay some 10-20 Euros for drugs that are worth several hundred Euros).

Let them bitch and moan but as soon as these people fall ill seriously and the ACA picks up the tab the money has to come from somewhere and it's from those who pay their monthly fees and never get seriously sick.

This is how the system works but those people don't see that and they don't care which is what drives me nuts because they all want to live ind the land of the free and brave but when it's time to do their share (for the benefit of everybody) then the line has been crossed.

You can't win with such people as they are rarely open for sane and factual arguments so it's best to tell them off and then turn away so they can bitch and moan outside of your perception.

 

[MacLeod]

Well socailsed medical care such as the NHS in the UK isn't really free, it's paid for by taxation. But the various systems of providing medical care have their pros and cons.

 

[FPAlpha]

Well socailsed medical care such as the NHS in the UK isn't really free, it's paid for by taxation. But the various systems of providing medical care have their pros and cons.

Of course it's not free.. in Germany we pay a percentage (around 15% of our monthly paycheck) for it, other nations do it differently.

But if you need surgery or any other major treatment you don't have to fear going bankrupt or paying for it for the rest of your life and that's a whole new quality of life.

 

[MacLeod]

Well socailsed medical care such as the NHS in the UK isn't really free, it's paid for by taxation. But the various systems of providing medical care have their pros and cons.

Of course it's not free.. in Germany we pay a percentage (around 15% of our monthly paycheck) for it, other nations do it differently.

But if you need surgery or any other major treatment you don't have to fear going bankrupt or paying for it for the rest of your life and that's a whole new quality of life.

True, and there is no denying the US provides excelllent Healthcare if you can afford it, but in general terms which systems/countires provide the best value money per amount spend for all of it's population.

And of course having a Universal Health Care system doesn't mean you can't take out private Healthcare if you want to pay for it.

 

[Amaris]

Well socailsed medical care such as the NHS in the UK isn't really free, it's paid for by taxation. But the various systems of providing medical care have their pros and cons.

Of course it's not free.. in Germany we pay a percentage (around 15% of our monthly paycheck) for it, other nations do it differently.

But if you need surgery or any other major treatment you don't have to fear going bankrupt or paying for it for the rest of your life and that's a whole new quality of life.

True, and there is no denying the US provides excelllent Healthcare if you can afford it, but in general terms which systems/countires provide the best value money per amount spend for all of it's population.

And of course having a Universal Health Care system doesn't mean you can't take out private Healthcare if you want to pay for it.

To put it another way: what good is excellent health care if no one can afford it?

 

[JWPlatt]

There are quite a few posts in this thread saying it is in fact affordable with the ACA, myself included with premiums reduced by $1000 per month from what they were - that's no exaggeration.

 

[Amaris]

There are quite a few posts in this thread saying it is in fact affordable with the ACA, myself included with premiums reduced by $1000 per month from what they were - that's no exaggeration.

Indeed, things are more affordable for most now. Before that, we had GOP congressmen complaining that people just didn't want to pay for "the best health care in the world". They wanted to give people $5000 vouchers instead of what the ACA offered, which makes sense if you only got sick once, and that illness only lasted a day or two. Otherwise, you were pretty much screwed.

 

[Squiggy]

There are quite a few posts in this thread saying it is in fact affordable with the ACA, myself included with premiums reduced by $1000 per month from what they were - that's no exaggeration.

Indeed, things are more affordable for most now. Before that, we had GOP congressmen complaining that people just didn't want to pay for "the best health care in the world". They wanted to give people $5000 vouchers instead of what the ACA offered, which makes sense if you only got sick once, and that illness only lasted a day or two. Otherwise, you were pretty much screwed.

And that 5k would pay for no surgery ever.

 

[Relayer1]

What is the perceived advantage to paying for insurance over paying through your taxes ? Both ways are costing you - you are financing your healthcare.

 

[JWPlatt]

What is the perceived advantage to paying for insurance over paying through your taxes? Both ways are costing you - you are financing your healthcare.

Market forces run the industry instead of the government. Whatever you think the corporate abuses are now, government-run and the unbounded grab at money might be worse. Single-payer is still perceived as too radical, socialistic or even communistic for the United States voters to accept presently.

 

[Robert Maxwell]

What is the perceived advantage to paying for insurance over paying through your taxes? Both ways are costing you - you are financing your healthcare.

Market forces run the industry instead of the government.

This is a common belief regarding the American healthcare market, but it's not true. Price transparency is rare to nonexistent. In fact, much of the information required for a consumer of healthcare to make an informed choice isn't available. On top of that, a patient has little negotiating power when it comes to the most expensive healthcare services, as there is no time to shop around in an emergency situation. There is no "free market" on the insurance side, either. Insurers negotiate their rates based on a host of factors, few of which amount to "get the best value for money." A free market requires parties able to negotiate a transaction within a competitive environment and with more or less symmetrical information. The extent to which this characterizes the healthcare industry in the US is laughable.

Whatever you think the corporate abuses are now, government-run and the unbounded grab at money might be worse.

Nonsense. When government has the power to negotiate or even set rates, there is no "money grab." Outside the US, virtually every country with a universal healthcare system has the power to either set or substantially negotiate rates, and this keeps costs down. Even in the US, the extent to which Medicare and Medicaid can set rates has a strong cost control effect among those claims. Notably, when it comes to the prescription drug benefits offered by Medicare--where government doesn't (by law) have the power to negotiate prices--costs are astronomical and abuse and fraud are rampant.

Single-payer is still perceived as too radical, socialistic or even communistic for the United States voters to accept presently.

Americans "perceive" a lot of perfectly reasonable things as "radical." Americans gonna American, I guess.

 

[MacLeod]

^But is single-payer healthcare to radical for American voters, or is it just the ones who find it too radical etc... are just more vocal than the ones who would accept it?

In the case of the US do more Republican leaning voters oppose it than support it, for Democrats do more support it then oppose it? Is there a difference in age groups/gender/ethntincity in opposition/support?

 

[Mr. Laser Beam]

^But is single-payer healthcare to radical for American voters, or is it just the ones who find it too radical etc... are just more vocal than the ones who would accept it?

Probably more of the latter.

 

[Robert Maxwell]

Nope, Americans are just about split on the issue, and it cuts more or less down party lines.

 

[Timby]

There are quite a few posts in this thread saying it is in fact affordable with the ACA, myself included with premiums reduced by $1000 per month from what they were - that's no exaggeration.

Indeed, things are more affordable for most now. Before that, we had GOP congressmen complaining that people just didn't want to pay for "the best health care in the world". They wanted to give people $5000 vouchers instead of what the ACA offered, which makes sense if you only got sick once, and that illness only lasted a day or two. Otherwise, you were pretty much screwed.

And that 5k would pay for no surgery ever.

Hell, not just surgery. Back in the summer of 2013 when I was living in Baltimore, I ate one bad oyster that gave me a severe intestinal infection, and between the CTs, MRIs, lab tests, IV drugs and the motherfucking colonoscopy (that's a hell of a thing to go through when you're 29) and spent four days at Johns Hopkins Bayview, and my bill was somewhere in the neighborhood of $19,000, and I paid $50 out of pocket.