Anyone afraid of universal healthcare?

[PrincessFiona]

I don't know...I think it depends on how you define "universal healthcare"....basically, the assumption here in this thread is that it is like some sort of socialist model where doctors go broke and all patients get shitty care. I'm assumig this is Laker's pre-emptive anti-hillary kick-off. :>

There is a middle ground, people and Americans need to get out of the black/white hysteria and start focusing on the gray middle ground.

Here are a few tips to discuss how we can save money in healthcare right now to provide care for younger uninsured people, etc.

1. Allow people to die. Medicare pays more in the last 2 months of someone's life than at any other time because we insist on dialysis, chemo and ICU stays for 93 year old end stage cancer patients with dementia and multi-organ failure. Now....THAT might cut into some doctors salaries, but....is it the wrong thing for the patient?

2. Not every sore muscle/ache/pain needs an MRI/CT. Our hospital ER has instituted a mandatory CT scan for anyone who comes in with abdominal pain. Over labor day weekend we had some physician friends visit us. She was on call and was called into the ER for a 15 year old with left lower quadrant abdominal pain. The kid had been in the ER for 7 hours and had not been examined the entire time. They were waiting for a CT. Basically, this doc examined the kid and said "he's constipated"....but they did a CT anyway and....he was constipated.

MN is one of the top states when it comes to everyone having health care insurance...and our healthcare costs are amongst the lowest in the nation. Doctors here earn a good living, too. Contrast that to TX, one of the states with the highest number of uninsured and nearly the highest healthcare costs in the nation.

In a nation this "great", no working American should be denied healthcare insurance for basic healthcare. There is no excuse and providing it will not break us financially.

Are you afraid of....getting a catastrophic illness and having your private insurer dump you, like my chemo buddy? Are you afraid of your private insurer refusing to pay for expensive medications like my father's wife? They have excellent private insurance but are having to forego medication for her becuase it is over $1000/month. Are you afraid of your private health insurer telling you that you can't see the doc once a year or that you have to pay for it if your doc doens't find something wrong with you?

Re: Universal Auto Insurance. That's a stupid argument. Cars are not alive. Worst case scenario is that you have to scrap your car and buy a junker for a couple thousand dollars to get you to and from work. If you get cancer, who the heck is going to pay for that, Jenn? Your kids can't just scrap you for a junker. When you guys were going through med school, I thought you did get some additional assistance at one time. What if you had gotten sick then and that net hadn't been available?

Most states REQUIRE drivers to have automobile insurance. You can't drive in TX or MN without it and if you're caught or have an accident without it...you are super-screwed. This way if you cause injury to another person or damage their vehicle, you are covered.


kris

I'm baaaaack

:>

[Rapunzel]

It is an interesting analogy but I think one's personal health is different than the functioning of their car. Also, aren't there some easier alternatives to having a car, such as a bike, bus, feet? I can't quickly think of alternatives to health (positive ones, anyway ).

In most places in the US (ie anyplace not a large urban center with a fabulous public transportation system) having a working auto determines if a person has an income!

The analogy fits when you think about how incredibly necessary a car is to the average working person's livlihood (and, thus the ability to have shelter, food, and basic clothing needs met). If one doesn't have a car in most of the nation it is just like being disabled - they cannot work.

Both states I have lived in recently have mandatory insurance coverage laws. I had to put my policy company and number on my car registration application. I don't know if they verify it. Though that is different than a "single payer" system where I suppose I would get car insurance through a government agency? Seeing how well the DMV works...

Yeah, a lot of states require auto insurance coverage (privately bought) by law. I don't know of any government subsidies to cover this expensive, necessary, and legally-required coverage for something that has such an enormous impact on most people's lives.

As Kris said, part of the issue is the definition. If everyone with a car followed the law, wouldn't we have a population of car owners who are universally covered by car insurance?

My SIL lost her license in a not at all urban part of Wisconsin. It sucked (a reasonable consequence in this case and not the same as someone wrecking your car) and she still managed to get to work.

[Vishenka69]

1. Allow people to die. Medicare pays more in the last 2 months of someone's life than at any other time because we insist on dialysis, chemo and ICU stays for 93 year old end stage cancer patients with dementia and multi-organ failure. Now....THAT might cut into some doctors salaries, but....is it the wrong thing for the patient?

2. Not every sore muscle/ache/pain needs an MRI/CT. Our hospital ER has instituted a mandatory CT scan for anyone who comes in with abdominal pain. Over labor day weekend we had some physician friends visit us. She was on call and was called into the ER for a 15 year old with left lower quadrant abdominal pain. The kid had been in the ER for 7 hours and had not been examined the entire time. They were waiting for a CT. Basically, this doc examined the kid and said "he's constipated"....but they did a CT anyway and....he was constipated.

I completely agree with this. DH complains about both almost weekly. The main reason for requiring things like CT is to limit possible lawsuit liability. If a doctor would miss something that a CT/MRI would pick up and the patient sued, both he and the hospital would be majorly screwed.


Oh, and NY doesn't require car insurance.

[Rapunzel]

Re: Universal Auto Insurance. That's a stupid argument. Cars are not alive. Worst case scenario is that you have to scrap your car and buy a junker for a couple thousand dollars to get you to and from work

Welllll, maybe you didn't ever really encounter this situation growing up, but I did. I know very few nonmedical workers who just have a couple thousand dollars lying around to buy a junker. For example, my mother was hit by a drunk driver on her way to work a few years back. Her car was totalled and she was lucky to survive. My parents had exactly ZERO cash on-hand (a very common phenomenon among the working poor) and, the only way they could buy even a junker for my mother to get to work was because they had auto insurance that totalled out the car and gave them a set amount of money. Without auto insurance my mother would have lost her job because she would have been unable to get to work because they could not afford to purchase an automobile on-the-spot (and, like most Americans their credit stinks - so buying one without a down-payment was not an option).

WE can say that we would just "buy a junker for a couple of thousand" should this happen - because we have the monetary ability in our positions in life. However, most people are not in the same position. If it came down to it I could also afford medical procedures that most others could not afford - because I have the monetary ability to do so.



The fact is the two scenarios are highly similar - yet we approach them from radically different angles.

[Rapunzel]

As Kris said, part of the issue is the definition. If everyone with a car followed the law, wouldn't we have a population of car owners who are universally covered by car insurance?

And, this begs the question: WHY is auto insurance required by law in so many states? It is expensive for most people on an average income, after all. WHY do we not require medical coverage by law acquired inidividually as well? Again, it is expensive for most people on an average income.

[Rapunzel]

Oh, and NY doesn't require car insurance.

I :mydoc: NY!

[PrincessFiona]

My brother had gone through periods of time where he didn't have a car....he lives in TX and we all know how spread out things are. He still continued to work by 1. car-pooling, 2. walking and 3. skate-boarding (yes, a grown man on a skate board...but you do what you have to do.)

Twist it as you may, a car is not the same as a human life. Ultimately, it is an object....and people can and do find alternative means of transportation....or they can move to be closer to a bus line or switch jobs to something closer to home. If the transmission goes out on your car, that sucks....and you might have to buy yourself a little piece of junk to get you to work if you're broke (and there are plenty of used car dealers who will work with you to get you a nice junker on a payment plan)...but...if your appendix ruptures, you develop an aneurysm, are diagnosed with cancer, break your neck, develop Lupus or MS....you are pretty much sol without healthcare insurance. Your family will be bankrupted trying to help you/save you and if you die.....you can't be replaced. The VW van? It's replaceable. I'm not. :>

Car insurance is relatively inexpensive in comparison to health care and because we're talking about human lives and not metal/plastic parts it's like comparing apples to oranges. My VW van costs pennies in comparison to my health insurance annually.

If you are ok with the fact that the largest number of uninsured or underinsured are middle class and working americans then so be it....but I think people need to quit bitching about the *universal healthcare* thing and come up with some alternatives then. Few people can afford the cost of health insurance for themselves or their family alone....and the only way the rest of us can really do it is because it is subsidized by our employers as a part of our income.....that's the truth.

My mom has been uninsured for years because she can't afford the huge monthly costs. She's just hoping and praying that nothing happens until she is old enough for medicare...and....my mom is an educated Nurse Practitioner with 2 Master's degrees who has worked her entire life but lost her health insurance after the divorce from my dad.

I'm talking about real life here...not the fantasy that plays out in the minds of our politicians...whom, by the way, WE the taxpayers subsidize with the best healthcare possible until the day that the die. This is another reason healthcare issues will likely not change. If politicians had to live like we do...well....things might be different.

kris

Maybe we should require it! I'm not advocating for everyone to have *subsidized* care but as you said, some people below certain income levels would have an awfully difficult time affording it.

Another difference between car and health insurance -- I think car insurance can be easier to get (for most people). One's driving record is, in some ways, easier to control than one's health. And some of the reasons I mentioned above make this stickier -- problems with the individual market and insurers dropping people for getting ill or retroactively removing coverage for what they characterize as failing to disclose information. Some of the failure to disclose situations are pretty egregious on the part of the insurance company. Oversight of that would probably involve the government in some way but not necessarily through a single payer system.

[PrincessFiona]

Re: Universal Auto Insurance. That's a stupid argument. Cars are not alive. Worst case scenario is that you have to scrap your car and buy a junker for a couple thousand dollars to get you to and from work

Welllll, maybe you didn't ever really encounter this situation growing up, but I did. I know very few nonmedical workers who just have a couple thousand dollars lying around to buy a junker. For example, my mother was hit by a drunk driver on her way to work a few years back. Her car was totalled and she was lucky to survive. My parents had exactly ZERO cash on-hand (a very common phenomenon among the working poor) and, the only way they could buy even a junker for my mother to get to work was because they had auto insurance that totalled out the car and gave them a set amount of money. Without auto insurance my mother would have lost her job because she would have been unable to get to work because they could not afford to purchase an automobile on-the-spot (and, like most Americans their credit stinks - so buying one without a down-payment was not an option).

WE can say that we would just "buy a junker for a couple of thousand" should this happen - because we have the monetary ability in our positions in life. However, most people are not in the same position. If it came down to it I could also afford medical procedures that most others could not afford - because I have the monetary ability to do so.



The fact is the two scenarios are highly similar - yet we approach them from radically different angles.

Sure....your story counts, but what about my chemo buddy who lost his insurance coverage in the middle of a bone marrow transplant? My neighbor who had to sell his house and move because his health insurance would pay for the leukemia treatments for his 4 year old? My neighbor who lost his job and insurance and then his wife was diagnosed with Lou Gherig's disease? These are all just abstract examples, right?

Ultimately, your family survived the car mishap, Jenn....because she had insurance. If she had not had insurance, it would have been catastrophic....just like it is catastrophic for people when they have healthcare issues.

The difference here is that people without a car CAN survive...yes...even the working poor have options. My boss when I was younger and worked at...a fast food restaurant...lived in a trailor and his car died....and I drove him to a bunch of clunker shops until he found a car for $1000 and was able to make a payment plan with them for 18 months to pay it off. He was poor as dirt, but made it work.

When we lived in N. Ireland, we had no money...and Thomas totaled our car in the first 2 weeks we were there. There was no bus or train to take us where we needed to be. We walked more than 2 miles into town for grocery shopping and he had various colleagues take him to the hospital for several months until we could get a clunker.

It's different. Accept it.

kris

[Rapunzel]

Well, yes, when life hands you lemons you make lemonaid.

But, the bottom line is that if you don't have a car in most areas - you cannot work. *If* you can find a way to survive around not having an auto then good for you! Those without medical insurance often do the same. Part of the reason that the "alternative" medicine market has skyrocketed is because people are finding ways to survive around not having medical (as in MD-provided) care.

Yes, a car is not a living thing - however it is a necessity in much of the country in order for the human beings who own them - which are living things - to, well, live.

It's interesting how you are jumping around the question here.

We have two similar situations - and two radically different approaches. And, rather than attempt to tackle this from a logical viewpoint you are choosing to take an emotional tactic implying the analogy doesn't work because a car isn't a living thing - ignoring the fact that it allows so many to maintain their lives.

[poky]

MN is one of the top states when it comes to everyone having health care insurance...and our healthcare costs are amongst the lowest in the nation. Doctors here earn a good living, too. Contrast that to TX, one of the states with the highest number of uninsured and nearly the highest healthcare costs in the nation.

Well, yeah. Because the more uninsured people there are, the more people there are who can't pay their ER bills when they *do* need care (and it's often more expensive care than they would have needed if they were getting preventative checkups), and those costs get passed on to those who *do* have the means to pay....which is a vicious cycle, because as costs go up, more people can't afford it and therefore costs go up again.

At least, that's been my understanding of how it works, from what DH says about his volunteer time at the ER and the county free health clinic.

[PrincessFiona]

If you do not have healthcare insurance you are likely to be sicker and die earlier .... and if you do have a diagnosed catastrophic illness you will financially bankrupt yourself without the ability to file for bankruptcy anymore.

The point that you are jumping past here is that a car, ultimately can be replaced.....but a human life can not.

[Rapunzel]

Maybe we should require it! I'm not advocating for everyone to have *subsidized* care but as you said, some people below certain income levels would have an awfully difficult time affording it.

Another difference between car and health insurance -- I think car insurance can be easier to get (for most people). One's driving record is, in some ways, easier to control than one's health. And some of the reasons I mentioned above make this stickier -- problems with the individual market and insurers dropping people for getting ill or retroactively removing coverage for what they characterize as failing to disclose information. Some of the failure to disclose situations are pretty egregious on the part of the insurance company. Oversight of that would probably involve the government in some way but not necessarily through a single payer system.

This is true.

And, I know of people who have been dropped from their auto insurance coverage - or had their rates raised impossibly high - because they were involved in too many accidents. In that situation it can mean that a person has circumstances beyond their control cause an auto insurance company to cancel the coverage AND make the person a possible pariah for other auto ins. companies. Then you have the conundrum of often being required by law to have this form of insurance - but nobody will cover you - or, at least not at a rate you could reasonably pay (and, afford to eat as well ).

Maybe we should subsidize auto insurance! I don't know! :huh:

But, I am intrigued that our governments (state) have taken an approach to insuring a necessity in life (autos - the ability to ern a living in essence) that is so very different from the approaches our society has taken with insuring another necessity in life (health).

[Rapunzel]

If you do not have healthcare insurance you are likely to be sicker and die earlier .... and if you do have a diagnosed catastrophic illness you will financially bankrupt yourself without the ability to file for bankruptcy anymore.

The point that you are jumping past here is that a car, ultimately can be replaced.....but a human life can not.

And, you are seeing this entirely from the viewpoint of defying death.

MOST medical care is routine. The vast majority of office visits are for coughs, sore throats, etc. that are upper respiratory infections, etc.

Yes, there are lots of major medical cases out there. Just as there are lots of horrible auto wrecks that occur.

But, the majority of medical care needed is small stuff - preventive care - that would greatly reduce overall national healthcare costs by taking care of most problems before they blow up.

Just as most auto insurance claims are for minor incidents where the car can be repaired - fender benders, for example.

Soooo, let's take this more piecemeal: Why approach the routine, minor, often preventative problems in both areas so differently?