Health insurance debate

Discussion in 'Politics, Religion, Social Issues' started by FatTony, Mar 2, 2006.

  1. FatTony macrumors regular

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    Jul 17, 2002
    #1
    What's wrong with this idea?

    Expand medicare, medicaid and the VA system to cover everyone with a SSN. Completely take the burden off of business and individuals for health insurance.

    The business get to keep and reinvest the money they had been spendng on employee health insurance. The employee get to keep their contributions to insurance. The uninsured finally get insurance.

    The government gets to tax all the new money that was previously in the insurance tax shelter. This can go to offsetting the increased cost.

    Everyone who has insurance through their job would get a nice raise from not having to pay for insurance anymore. the business get relieved of an ever increasing burden and can invest that saved money back into their business. Everybody wins...except the private insurance sector.

    Why isn't this on the table? What am I mssing? Is this feasible?
     
  2. WildCowboy Administrator/Editor

    WildCowboy

    Staff Member

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    #2
    Well, say businesses and people save X number of dollars through this move. Then the government gets to tax that money at, say 30% on average. So they'll running a program on a budget that's 30% of what is being spent today...right.

    Obviously there are a lot of other complicating factors, but that's the most obvious one right there.
     
  3. pseudobrit macrumors 68040

    pseudobrit

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    #3
    It's also a program with 2% overhead instead of 30%.

    No one's claiming it's going to be a tax-free transition.
     
  4. zimv20 macrumors 601

    zimv20

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    #4
    what's standing in the way are principally:
    1. healthcare lobbyists
    2. politicians who decry the "nanny state"
    3. pro-privatists

    in the past year, princeton economist and nyt op/ed contributor paul krugman has written a number of pieces describing why national healthcare is a crucial plan and who's against it and why. dig up the columns, well worth a read.

    now excuse me while i go write another monthly $500 check for my health insurance...
     
  5. mactastic macrumors 68040

    mactastic

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    #5
    Why should I have to pay for some lazy slob of a smoker's health care with my hard earned money? That's just the government stealing from me at the point of a gun and redistributing the wealth. The black UN helicopters will be right behind them.

    I'd much rather pay for some lazy slob of a smoker to get on an ambulance and catch a free ride to the emergency room for a cold, then get soaked for it the next time I pay my private insurer. I'd rather a private company steal from me than the BadNasty gummint anyday.

    Work or die mother*******! A setback like a major illness or death is God's way of telling you that I'm better than you!

    :rolleyes:
     
  6. mactastic macrumors 68040

    mactastic

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    #6
    Why should I have to pay for some lazy slob of a smoker's health care with my hard earned money? That's just the government stealing from me at the point of a gun and redistributing the wealth. The black UN helicopters will be right behind them.

    I'd much rather pay for some lazy slob of a smoker to get on an ambulance and catch a free ride to the emergency room for a cold, then get soaked for it the next time I pay my private insurer. I'd rather a private company steal from me than the BadNasty gummint anyday.

    Work or die mother*******! A setback like a major illness or death is God's way of telling you that I'm better than you!

    :rolleyes:
     
  7. leekohler macrumors G5

    leekohler

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    #7
    The healthcare industry will have to completely collapse before anything gets done. And trust me, that day is coming. These are the perils of unchecked capitalism.
     
  8. stubeeef macrumors 68030

    stubeeef

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    #8
    There is nothing "unchecked" about our healthcare system. Infact there are far too many checks.

    For our company to bundle a different set of product (product that is already approved and sold) it must go through a ton of paperwork, to the point that it has not been done. FDA is unbelievable.

    Between the TPA's, insurance companies and lawyers, it is amazing it still exists. It will collapse. And the leftovers will become another poorly managed govt program that will be a momument to stupidity.
     
  9. Agathon macrumors 6502a

    Agathon

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    #9
    The reason why is really boring.

    Insurance markets are particularly prone to market failure. That means the private market will tend to produce inefficient levels of supply. The state corrects for this by forcing everyone to pay for it (i.e. using a non-market mechanism).

    The market has tried to correct for this by instituting HMOs which don't suffer from some of the obvious failures of classic fee for service health insurance (the HMO can exercise adequate oversight of costs because it is vertically integrated).

    But it still isn't particularly efficient. Canadians pay far less as a percentage of GDP than Americans do on healthcare, yet every single Canadian is covered, and Canadians are on average healthier than Americans.

    It's no argument to complain that public health care is redistributive, because private insurance is as well (everyone else pays for the unlucky). In countries with public systems, the "evil smokers" actually pay for your healthcare through the cigarette tax. As a whole smokers pay a lot more than they get back (not least because they tend to die younger, before they can soak up the vast amounts of healthcare dollars that elderly people do).

    Public healthcare, like most of the welfare system, actually doesn't have much to do with egalitarianism. It's simply the most efficient way of providing a number of social goods that the market won't provide. Even if everyone had an equal income, we would still be better off having public healthcare.

    And the state is uniquely positioned to provide us with all sorts of other goods.

    For example: in New Zealand, where I am from, there is basically no homelessness (I saw one homeless guy in the 25 years I lived there). New Zealanders who leave the country for the first time are often shocked and horrified to discover that there are actually real homeless people in developed countries like Canada, the UK and the USA.

    Now there aren't many things that make a city worse than a load of homeless people. Nobody likes having to step through hordes of bearded lunatics to get to their job, and the spectacle of human degradation makes everyone feel bad. If everyone paid a small amount (less than a dollar a week) it would be possible to eliminate homelessness and everyone would be better off (including the formerly homeless people), but if we leave it up to private charity almost nothing gets done. The reason is that everyone is stuck in a collective action problem - it is rational to wait for someone else to pay for it since you will get the benefit of other people's charity (since one less homeless person on the street is a boon to everyone). So hardly anyone pays and we are left with streets full of homeless people, which nobody likes. This is a classic market failure. If you asked most people whether they would be prepared to pay 50 cents a week to end homelessness, most people would say yes. But even though most people are prepared to pay for it, nothing happens, because they are stuck in a collective action problem.

    In some countries the government corrects for the failure by forcing everyone to contribute a small amount. The result is that everyone is better off. One of the great secrets of the welfare state is that the people who pay for the benefits of others actually receive something worthwhile in return (in this case a society without homelessness).

    Healthcare, education and policing are all things that suffer from market failure. That's why it is better if the state compels us to pay for them. That's not to say that what the state provides is perfectly efficient, it is just more efficient than the market.
     
  10. solvs macrumors 603

    solvs

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    #10
    Healthcare needs a major overhaul, and judging by the current administrations opinions on Health Savings Accounts and other ideas that don't actually fix the problems (and can actually create more... privatizing SS anyone), I don't see anything good happening anytime soon. I wouldn't mind paying more taxes instead of the several thousand it cost me for my last trip to the ER for a couple of hours. And that's with insurance!

    Hate to generalize, but I suppose unlike NZ, Americans in general don't really think about the big picture as much as the day to day.
     
  11. stubeeef macrumors 68030

    stubeeef

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    #11
    While a model for NZ (pop approx 4 million) and a model for the US (pop approx 300 million) would be vastly different. I don't see a national plan as the answer. I don't know of much the gov't is better at (other than taxing, starting wars, other non likeable things).

    I would rather laws that help shape the field rather than elimination of it. I have family in the UK that come to the US to sked their healthcare, for 2 reasons. Quality and Quantity. While I don't think this administration has done anything good for HC, and don't know much the Govt or anyother admin has done good for it either.

    The system is broke, my daughters broken arm the week before Christmas is now north of 10 grand. She did have pins inserted and 3 nights in the hosp. It was particularly nasty, but 10k+! Insurance has us paying 1250 of that which happened in 2005, but a new deductable for 2006 and the follow on treatment will take another $1,000 out of me this spring.
     
  12. mactastic macrumors 68040

    mactastic

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    #12
    I'm sorry to have made you write a novel rebutting my sarcastic comments. :eek:
     
  13. iGary Guest

    iGary

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    #13
    My surgery and precription medications for my back, along with MRI's, tests etc. ran about 30 grand in 2005. :eek:

    I was on anti-depressants at one time in my life without insurance. How about 300 bucks a month for 90 pills (3 daily)?

    End of the day, there is no easy answer. We probably have one of the best health care systems in terms of technology and new procedures, etc. Probably the worst in terms of cost, due to these "wonderful" procedures.

    I have no idea what I am going to do when my COBRA runs out in a year.
     
  14. Desertrat macrumors newbie

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    #14
    Agathon, the question you haven't asked is, "Why are the U.S. homeless people without homes?" There are quite a few disparate reasons, but lack of health insurance has little to do with it. Lack of available jobs has little to do with it. One facet here is that the courts have held that if a person is not a danger to the community, he is free to come and go as he pleases--even if he is unemployable due to mental condition.

    As to medical care and health insurance, it seems that the more the government has gotten involved, the higher the costs have become. MediCare covers us old farts. It's a complex system, with an incredible amount of paperwork. Were it extended across society, it seems to me that the total costs would become greater than we can afford. I'm vague on the numbers, a bit, but I think some 65 million people are now covered by MediCare. If you add 230 million people...

    Just guessing and playing with numbers, a bit: The MediCare insurance premium is a joke; way below $100 a month. $500 for private coverage was mentioned above. Split the difference: Say $250 a month as the premium cost, overall. That's $3,000 per year per person, for 300 million people. That's right at a trillion $$$ per year. Right at 40% of the national budget. Add to that the extension of the Old Farts' free pills' cost to all of society.

    The money comes out of the economy, one way or another...

    'Rat
     
  15. IJ Reilly macrumors P6

    IJ Reilly

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    #15
    According to my insurance company, my recent week in the hospital and surgery resulted in an $81,000 hospital bill -- of which the insurance company paid $17,000. The balance, they are calling on the "explanation of benefits" statement, "patient savings." Right. Tell me they aren't playing games with numbers. Oh, and my insurance company raised my rates by 30% this month, and lowered my benefits. I'd like to look for another policy, but given my recent health history, I can forget about that. I'm trapped.

    I would like to have the option to buy into Medicare. I suspect it would cost me a lot less than my current policy. But I know the insurance industry will never allow it. Medicare may be "a poorly-run government program," but the insurance industry, for some reason, doesn't want to compete against it in the marketplace.
     
  16. zimv20 macrumors 601

    zimv20

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    #16
    paul krugman has written a number of columns about health care. here is one of them:

     
  17. zimv20 macrumors 601

    zimv20

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    #17
    and, from here:

     
  18. tristan macrumors 6502a

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    #18
    Good editorial. Economics most important lesson is that "incentives matter". In every area of our health care system, people have incentives to do the wrong thing. Insurance have incentives to deny coverage or claims. Doctors have incentives to focus on cosmetic surgery rather than life-saving treatments. Patients have incentives to not get health care coverage until it's too late. Drug companies have incentives to treat acid reflux or erectile dysfunction rather than cancer or AIDS. Hospitals have incentives to run fifty needless tests to make sure that they pad their fees and don't get sued.

    And who's responsible for our system having all of these incentives that push people in the wrong directions? The guys running the show - the President & Congress. And the voters of course, for not demanding that they fix the problem.
     
  19. mactastic macrumors 68040

    mactastic

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    #19
    But in this analysis you (conviently) ignore the fact that if all that you predict comes to pass there will be trillions pumped back into the economy from people like IJ and Zim who no longer have to write $500 checks each month to their insurers, as well as the money paid out be private employers to their employees. How much of GM's budget goes to health care? As you say, take $250/month average, multiply it by 300 million... No small chunk of change there.

    Do you think that money will sit in a bank? How much more 'consumer spending' would happen if people weren't paying through the nose for health insurance?

    And what of the money saved by not having to treat non-emergencies at the emergency room because the uninsured know they can't be turned away if they have an 'emergency'?

    Besides, you can't seriously be arguing that government-funded health care will be any less efficient than the system we've got going now. $30 for a 'pirin tablet? Puhleeze!

    This isn't as simple as you make it out to be...
     
  20. iGary Guest

    iGary

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    #20
    I know this has always been a debatable item, but what happens when being in the medical business isn't profitable anymore? What is the incentive to companies to develop new procedures, equipment, supplies, etc. (I won't even start the prescription drug debate).

    I'm pretty luck; I am covered by COBRA from my last employer @ 269.00 a month, but it will get interesting if I am still self employed in a year when it runs out.
     
  21. mactastic macrumors 68040

    mactastic

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    #21
    I'm not sure that's a 'when' question. More of an 'if'.

    But I'd look at it the same way as police or fire. What happens when it's not profitable to operate a fire station? Shut it down? Or does the community pitch in and pay out a little to keep it going?

    The benefits of a healthy nation are worth some government involvement.

    Let's just pass a law saying Americans should have the same health benefits members of Congress get. Or that members of Congress should have to buy their own insurance like regular Americans. That would fix the problem within a short time.
     
  22. IJ Reilly macrumors P6

    IJ Reilly

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    #22
    It'll be expensive, intrusive and scary. First, the insurers will demand access to all of your medical records. Why? So better to cherry-pick the healthiest customers. Then, assuming anybody wants to insure you at a price you can afford, the premiums will start going up immediately, at a clip that will look like Germany in the 1920s. Then, your insurance company will start sending you notices, altering and reducing your coverage in ways that you can hardly understand. Finally, if you ever make the mistake of having a major illness, you can forget about going back into the market for better coverage. Now your insurance company has really got you by the short-and-curlies.

    Hey, but if it ain't broke...
     
  23. zimv20 macrumors 601

    zimv20

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    #23
    i went from about $150/mo to being dropped when mine expired. were it not for an IL program to insure the uninsurable, i'd be w/o coverage at all. and every year, that program has to be saved from being cut.

    i'm very interested in a national program.
     
  24. solvs macrumors 603

    solvs

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    #24
    It's almost darwinian isn't it? Only the strong and healthy survive. Everyone else suffers. Very un-Christian. I don't remember "I was sick, and you called me lazy and told me to get a better job" being in the Bible.
     
  25. leekohler macrumors G5

    leekohler

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    #25
    Me too. My insurance is good at the moment, but who knows how long that will last? My employer could yank it away at any second.
     

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