• Welcome! The TrekBBS is the number one place to chat about Star Trek with like-minded fans.
    If you are not already a member then please register an account and join in the discussion!

Can you explain the health care thing to a non-american

Are you saying that American women are having preterm babies on purpose (being induced, having early caesareans)?
 
I'm not sure what you mean by "they run out of money". The Obama proposal makes use of private health insurance, not public health insurance. There would be no government run health insurance that everyone would buy into. Rather, there would be a mandate that everyone has to buy private health insurance (and in exchange for getting all these new customers, the health insurance companies would be forced to stop discriminating based on pre-existing conditions).

A couple of problems there.

First, a government mandate to buy something from a private company is unconstitutional (there are no examples of an individual mandate in 220+ years), and lawyers are already lining up to take it to court. So consider that part of the plan dead on arrival.

Second, health insurance companies can't stop discriminating based on pre-existing conditions unless they receive direct compensation for taking on those cases, as they take them on.

Here's a scenario for you.

Everybody goes out and buy's Cutthroat Bob's Catastrophic Coverage, which is dirt cheap and covers almost nothing. Cutthroat Bob makes lots of money. Whenever anyone gets really ill they switch to Cadillac Dan's Platinum Plus coverage, which costs more, but since they'll be drawing out from the first day instead of paying in, they don't care.

Cadillac Dan goes out of business because the only people who buy his insurance are those who are scheduled for heart-lung transplants. To avoid leaving people uninsured, the government is forced to take over Cadillac Dan. Then they hold hearings and blame the problem on Cutthroat Bob, whose unfair undercutting and skimpy service were unfair in the marketplace. So the government takes over Cutthroat Bob, too.

So now you have an unconstitutional mandate for coverage, no insurance companies that still provide coverage, and a complete mess regarding health care. But don't worry. The same people who created these problems will get to work fixing them!
 
Everybody goes out and buy's Cutthroat Bob's Catastrophic Coverage, which is dirt cheap and covers almost nothing. Cutthroat Bob makes lots of money. Whenever anyone gets really ill they switch to Cadillac Dan's Platinum Plus coverage, which costs more, but since they'll be drawing out from the first day instead of paying in, they don't care.

Here's the thing though. I don't think insurance companies will be allowed to offer plans that "cover almost nothing". In fact, I think they're already forbidden from doing so. The government has certain items that have to be covered in any health insurance plan, and I think the list of things that are required will expand with this legislation. But you're right. Because of the very issue that you raise, it's unlikely that there will be many plans that go much beyond what's required by law.

(Of course, it'll still be possible to pay for anything that goes beyond what's covered in your health insurance out of pocket if you have the $.)
 
Miss Chicken, I haven't researched the early births, but it might be related to the higher rate of childbirth in the US, especially among young people.

Chrisspringob, we already have plenty of low coverage catastrophic insurance. It's all many young people need. So already the government will be distorting the market and keeping people from retaining their existing plans. Some people don't even need health insurance. Anyone who can cover their own catastrophic expenses would save money by not carrying any insurance. To take an extreme example, if Bill Gates gets sick he can buy a couple hospital chains.
 
I found this article relating to prem births in the USA.

Among the things said in the article (highlights mine)

The rate of preterm births, which measures the proportion of babies born before 37 weeks' gestation, is a reflection of a number of factors, both biological and cultural. Starting in 2008, the March of Dimes began tracking three of the major contributors to the high preterm birth rate — lack of insurance among women of childbearing age, rates of cigarette smoking and the rate of babies born preterm, but at the tail end of pregnancy, between 34 and 36 weeks.
and

By far the biggest contributor to the high premature birth rate is the rate of so-called late-preterm births. About 70% of babies born too early in the U.S. are born between 34 and 37 weeks. There are many reasons for these early deliveries, making it particularly difficult to target one or even a few factors and address them head-on. The increase in multiples — twins, triplets or more — is one contributor. The rise in assisted reproductive technologies, such as in vitro fertilization, is another; these techniques are associated with both an increased risk of multiples as well as a higher risk of premature delivery, even of singletons. Status of health insurance matters as well. Moms-to-be who are insured have access to proper prenatal care. If a woman sees a doctor regularly, then any problems that arise — pregnancy-related hypertension, for instance, or diabetes — can be picked up early and treated, helping the baby to remain safely in utero for the full 37 weeks.





 
So already the government will be distorting the market and keeping people from retaining their existing plans. Some people don't even need health insurance. Anyone who can cover their own catastrophic expenses would save money by not carrying any insurance. To take an extreme example, if Bill Gates gets sick he can buy a couple hospital chains.

Yep. Any plan for universal health insurance necessarily distorts the market from what it would look like if there was no universal health insurance. Both by forcing people into the pool who may not want to be there and by influencing if not determining what kinds of treatments are covered. This is true regardless of whether it is literally government insurance or (as in the Obama plan) government-regulated private insurance.

Of course, the proponents would say "Yes, but it's worth it because of the social value of getting everyone covered." Really, it's a question of how high a value you place on this. But I'm not really interested in getting into that debate myself, or saying that this is necessarily the right way to go. I just waded into the discussion to explain how the Obama plan would work as I understand it, because it wasn't clear to me that Brent quite got it, based on his curious "what if it runs out of money" comment.
 
Yep. Any plan for universal health insurance necessarily distorts the market from what it would look like if there was no universal health insurance. Both by forcing people into the pool who may not want to be there and by influencing if not determining what kinds of treatments are covered. This is true regardless of whether it is literally government insurance or (as in the Obama plan) government-regulated private insurance.

The "market" should have no place in health care. The "market" by it's very design is set up to extract as much value from the consumer as possible while allowing the purveyor to surrender as little value on HIS end as possible. It is legalized exploitation of the sick by the medical industry.
 
Are their plenty of people who are in favour of UHC but just not Mr Obama's plan?

The way I'm starting to see it, it really does seem to boil down to if you think basic affordable heath care is a right or a privlidge in our society and if you think it is something that people should be forced into, if they don't want to. I can appreciate that people want the right to save money by not covering other people's or their own health if they don't want to - however I question the wisdom of this thought process as a lot of people that are without adequate heath care would seem to be destined to be on social welfare or in the hospital's A&E department when they become critical (which was explained hospitals have to take even if the person doesn't have insurance).

The government forces you to pay for lots of things, it forces you to pay for the police and fire department, even if you never have to use their services. We pay taxes that run transport systems (even though I don't use public transport - it's rubish in my city), my parents paid taxes that run public schools (even though they also chose to pay for me to have a private education), we all pay taxes that are used by the government to fight in wars that we may or may not agree with or build stadiums and host events that you may or may not want to attend.

Almost all government extracts money for things not all people use, some countries think health care should be one some don't. I'm glad mine does but I guess it isn't something I have ever had to think about so I guess it is hard to examine it from the other side.

I reckon this has been quite a facinating topic!
 
Are their plenty of people who are in favour of UHC but just not Mr Obama's plan?

Yes. What happened is that once he got in office, Obama basically caved in on a number of things that he promised on the economic front: UHC, financial re-regulation, criminal and civil prosecutions against the big bankers who led us off the cliff economically with their bad investments, etc.

This occurred after extensive "education" as to the "complexities of the issues" on the part of the K-street Boys (aka the Washington lobbiest corps).

But what else can you expect from a Chicago Machine politician?
 
Its really simple - we Americans are selfish bastards who won't raise a peep about untold billions spent on weapons and "defense", but scream like spoiled children about helping fellow countrymen that need it. I have never been so ashamed to be identified as American as I have over the past year.

I think that this sums it up nicely.
 
I won't get into a huge debate over the assumption that the health care in the US is better than in Canada. I've lived in Canada all my life, and me and mine have always been happy with the health care professionals we have been assisted by. I cannot think of a time that anyone I know has had an excessive wait.

What I will say is this. Everyone in Canada, regardless of their socio-economic status, has access to health care. Plain and simple.

Socio-economic status is the new class system, and Americans, from what I understand, live by, and perpetuate this system.

I think that's wrong. A human being has more worth than how much money they have.
 
Yes. For example, there are a few Democrats in the House who won't vote for it because they favor a more far-reaching overhaul like single payer:
And more than a few Americans think it goes too far in it current form. It does seem that the moderates/mainstream in both parties agree on a lot of the Obamacare bill, if the democratic leadership would consent to breaking up the bill into parts, the agreeable 70 - 80 percent would past with bi-partison support, insert the Stupak amendment, tort reform and open access across state lines to insurance would bring the republicans onboard. The hard right will still vote against it. The hard left wants abortion paid for and access for illegals. Most people I talk to really just want their existing costs to come down, not to have a national system by whatever name you call it.

If the national government can bring into existence a private insurance plan for the poor, I'd be all for it.

My private insurance cost me $81 per month, Blue Cross.
 
There are a few factors going on here:

1. A lot of Americans distrust the government because it is a government. It doesn't matter what government. More centralized power = less personal freedom. They distrust the concept of government and want to limit its power on a philosophical basis, even when doing so might work against their self-interest.

This philosophy cuts across many areas, not just health care. It's a key motivating factor for gun owners, for instance.

2. Some Americans are skeptical about putting health care into one big pot, because they figure they are healthier than average and their share of the pot will be smaller than what they put into it. They don't want to subsidize people who are sicker than they are (often for lifestyle reasons that they can blame on the person, as opposed to bad luck, which they probably also blame on the person).

I doubt that people with this belief are actually healthier than average. I wouldn't be surprised to find that as a whole, they are less healthy than average. But this has more to do with self-image than rationality. They are loathe to admit they are sick, weak or in need of help, especially from the (shudder) government (see point #1).

3. Politicians who are in the pay of the insurance industry are using points #1 and #2 to fight health care tool & nail. But if points #1 and #2 did not already exist in the American psyche, they'd have to find a different strategy.

4. And I'm sure there are some wack-jobs who don't want Obama's socialist witch-doctor medicine because it's a plot to kill old white people. Like that's a bad thing... :rommie:

We have what we call 'Medicare' in Australia, which is the effectivly government paying for a large amount of our heath care.
The government doesn't pay for it. Australians pay for it by being taxed. One way or the other, you are paying for your own health care.

The question then becomes: would you be better off not to be taxed and then pay for your own health care out of the money you set aside for medical bills (knowing that those bills are coming, sooner or later)? That way, you would keep control of your money and you won't be limited by any outside entity in the decisions you make, other than what you can afford. And why shouldn't your decisions be limited by what you can afford? What you can afford is the same as what you deserve.

If you don't trust the government to take your money and handle it for you, or if you think you won't get your money's worth because the government won't give you your fair share, maybe because it shows favoritism towards "those other people" (a fear that is compounded when people you didn't vote for are in power), you'd oppose government health care, too.
 
There are a few factors going on here:

1. A lot of Americans distrust the government because it is a government. It doesn't matter what government. More centralized power = less personal freedom. They distrust the concept of government and want to limit its power on a philosophical basis, even when doing so might work against their self-interest.

This philosophy cuts across many areas, not just health care. It's a key motivating factor for gun owners, for instance.

I'll admit to this to some extent. I dont trust the government, I dont care whos in charge of it. Its not that I think the Government is evil or bad, just inept.
 
Contempt for centralized power in the government has not only been part of our political culture from the first, but also has no doubt protected our own freedom. We look at horrific examples of centralized governmental power over the past couple of centuries (the 20th C being particularly gruesome), and suddenly no health care looks like a minor trade-off by comparison.

Rational or not, this sort of mindset is a factor and might explain some of the Nazi/Commie weird blather. And there's some truth to the connection between contempt for government and preservation of freedom, even if it doesn't mean we have to sacrifice health care in the process.

What Pres. Obama seems to be focused on is the Middle Class of americans, where I personally fall. Do I have health care? yes. Every paycheck (bi-weekly) it costs me $230USD for medical, and an additional $22USD for the dental plan. So, I am paying $500 a month for my coverage.
Wow! I have to pay for my own health care (Kaiser, in California) - $175/month. So what good is national health care going to do me? Just looking narrowly at those two numbers.

But for the average middle class person, the government wouldn't be spending any $ on you anyway. They'd just be forcing you to buy private health insurance, and forcing the insurance company to take you regardless of pre-existing conditions.
There's the problem - why should I support a program where the government is taking my taxes, maybe increasing my taxes, but not spending any money on me? And I get my freedom taken away to boot - being forced to buy insurance even if for whatever reason, I don't want to. If I don't have pre-existing conditions, nothing in this deal is an improvement in my current situation. Hmm, maybe I shouldn't support Obama's plan after all? :rommie:

You don't want to spend a little bit of money to keep them healthy now...you'd rather spend a ton of money later when they get really, really sick. I can't understand that mentality. It's like you're begging to have more money taken away from you.
Think about it this way: the people going to the ER's with no health care are a bunch of scummy drug-addicted bums, welfare queens and illegal aliens. It's worth it to me to pay a little extra to punish them by making sure whatever health care they get comes too late to function as more than a band-aid. If they were worthwhile people, they'd either have health care or would magically not ever get sick.

But seriously, the reason to support Obama's plan is because the irrationality and wasted expense of our health care mess is dragging down our economy. The mess has to be fixed for the health of our nation, regardless of its impact on individual situations. When the dust settles, I doubt my arrangement with Kaiser would be changed very much anyway.
The way I'm starting to see it, it really does seem to boil down to if you think basic affordable heath care is a right or a privlidge in our society and if you think it is something that people should be forced into, if they don't want to.
You're right - it does seem to come down to a philosophical split between those who think that simply by virtue of being born, you deserve certain things, such as food, clothing, shelter and health care, sufficient to safeguard your life, and those who do not make that assumption. You're born, so what? You still have to fight and struggle for everything. A certain minimal level will be provided - you won't starve in the streets - but you won't get the dignity of a sane approach to health care. Go to the overcrowded, chaotic ER with all the other bums.

Interestingly, neither of these viewpoints can be validated by any objective standard. Maybe we don't deserve anything by virtue of being born. Maybe life should be a Darwinian struggle. Maybe the government should start letting people starve in the streets if they can't afford a crust of bread.

But what would stop that is - social chaos due to all those potentially money-earning workers croaking and clogging the gutters. So why not apply that same social utility argument to health care? Forget what's good for you, why not do what's good for the nation? Why do you hate America? :rommie:
 
Last edited:
If you are not already a member then please register an account and join in the discussion!

Sign up / Register


Back
Top