In defense of healthcare reform
I have an opinion on health insurance reform in America now!
Okay, okay I am not going to lie to you, I had an opinion on health insurance reform before. It was just the wrong one. I recognized it right away as the wrong one because, well, I looked around and there were some crasszy (crazy-ass! Ha! That was a typo, but I’ve decided to roll with it.) dudes standing next to me (some of them with guns, all of them with bright red faces and a vein throbbing in their neck) and on the other side, waaayyy over there, were Rachel Maddow and Keith Olbermann and OMG THE PRESIDENT! I LOVE YOU MR. PRESIDENT!!
Must. Get. To. The. Other. Side.
The last time I really even thought about the idea was during the Hillary Clinton universal healthcare debacle. (How much credit does she get for not calling a press conference for the express purpose of saying “Told you healthcare reform was hard! Suckers. Peace out.” And then ripping off her mic and throwing it to the floor? Actually, I’d kinda pay to see that.) Anyway, I spent months and months listening and reading.
Well, trying to listen and read.
I am easily distrac…ooh, a penny! It’s SHINY!
Sorry.
Healthcare.
I should explain where I started.
I grew up poor, not Uganda poor or Appalachia poor, shoes and air-conditioning having poor. (No heat or food. I actually remember when grocery stores didn’t take credit cards!) Anyway, the one thing we had in abundance, was healthcare insurance. And my mom wore that shit OUT!
“Ow, I hit my leg.”
Hospital room.
“My stomach hurts.”
Doctor’s office.
“Sure, I’ll eat this tasty, tasty peanut butter and jelly sandwich”
Intensive care.
I went to the dentist practically every week. And there were no premiums or deductibles or prescription fees. But, the upside, except for when I put poison in my mouth and swallowed, I was a very healthy child.
No braces even!
I don’t know what it cost, um, whoever paid for all of it. But, thanks!
I went to college, still covered under my mother’s plan of freeness, but then hit my first “no money, no service” issue. A year on my own and I needed a root canal when I got home for the summer.
Insurance paid for that.
Oh, but the cap and whatever other stuff you neeed after the root canal? Not covered and cost $1200 and nope, dentist did not take credit cards.
You may laugh, but $1200 at that point in my life, may as well have been $12,000 or heck 12 freaking million. Didn’t have it; had Yale tuition and books to pay for with whatever money I did get.
I lost the tooth completely the next year.
And this experience would color my views on healthcare, in a weird way, for a long time.
Everything costs money. Hello, it’s America, if stuff doesn’t cost money, we can’t make money. My college education cost money. My food, clothes and Ashley’s double cookie dough milkshake costs money. Fixing that tooth cost money.
I had a choice to make and I made sure to get two shakes to drown the sorrows of my lost tooth.
I was never moved by the stories of the people who lost their homes because their cancer treatments bankrupted them.
Dude! THEY CURED YOUR FUCKING CANCER!!!
I didn’t have a house, no one I knew had a house, yet these cured emeffers were now whining that “oh no now I have to live like Dawn Summers and her family. Waaa, I wish I had DIED instead.”
I didn’t believe you “deserved” healthcare. I knew an entire neighborhood of people whose “primary care physician” was Kings County Emergency room.
And when they caught a bullet (or you know, broke an arm) they went to the Emergency room and came out with a cast. We signed it. Done and done.
Caps for root canals were for the rich! Study well, work hard and you too might someday be able to afford caps for your teeth.
And jet packs.
Sweet, sweet jetpacks.
So I did. And the next time I needed a root canal, I put a cap so expensive and beautiful on that tooth, I defy you to tell which one of my teeth is real and which is acrylic. American dream fulfilled!
We don’t need to change anything.
Except things have changed.
Hospitals now tack on the charges for the broken arm casts for the uninsured on the insured. Insurance companies have to pay out grossly inflated charges for various procedures, so they stop covering them, oh and, employers and individuals now pay higher premiums for the privilege. Healthcare is this bizarro world where everyone is paying through the nose and ears, but everyone seems to have their hands stretched out and empty pockets.
What does a broken leg cost to reset and cast?
“Well, how much can you pay?” seems to be the answer. How is it that my insurance company can approve the costs for a medically indicated procedure and then after the fact say “nah, on second thought, good luck with that we’re not paying.” A year and a half, nine angry letters, dozens of bitter phone calls and I’m still facing either paying a lawyer (and likely still losing) or paying the bill. There is absolutely NO other entity IN THE WORLD which could get away with some bullshit like that. Except maybe some Putin backed entity.
Under these circumstances, the government MUST step in. The system is beyond broken, it’s fradulent; it’s criminal; it is breaking the citizenry.
No we don’t “deserve” health care. But we do deserve the benefits of our bargains. If we are paying for insurance, these companies shouldn’t be able to change the rules when we show up with our claims. If a blood test costs $12, hospitals shouldn’t be able to charge Blue Cross/Blue Shield $1200 because medicaid will only pay .12, nevermind the millions who will never pay a dime because they aren’t covered under any system.
The reality is, unless we are willing to stomach actually denying treatment to those who can’t pay, hospitals have to make up the difference somewhere. This problem is so intertwined and self perpetuating that only the federal government can fix it.
And that fix isn’t going to be easy. Dude, the problem isn’t easy. And yes, there is going to need to be a public option, and cost management policies and federal oversight.
And how will we pay for it? Uh, taxes, charges and debt. The same way we’ve paid for everything since the Louisiana purchase. Our government decided to bribe the families of the September 11th victims and their families out of suing the airlines. How did we pay for that? How did we pay for the most retarded “education reform” in the history of mankind? Leaving no child behind wasn’t cheap. Our government decided to liberate Iraq. Did we have town halls? Were people screaming about how we were going to pay for it? Nope. And I posit the liberation of Iraq will turn out to be the most expenditure of American money with the least American gain. I hope I’m wrong and we at least get some oil for that blood.
Yeah, I said it.
Our country needs this reform to happen. What happens when people start declaring bankruptcy and defaulting on their loans because little Timmy needed a bone marrow transplant or mama got skin cancer from her carefree single days on beaches and tanning beds? Foreclosures, property depreciation, underwater mortgages, more bankrupties. Rinse. Repeat.
Health care cost, is like a financial landmine built into an already overleveraged system. You don’t know when or where, but you might step on it and it will blow your leg and your life apart.
Oh, and a word to the critics of reforming the healthcare system: careful. Careful with the way you frame the debate.
Be honest. If you are opposing healthcare reform because you believe the only thing the government should do is cut your taxes, say so. Do not frame this as the government is evil; Barack Obama hates white people. Because when buildings in Oklahoma start getting exploded, I don’t want to hear ye olde “well, we didn’t know saying that ‘the government was fascist and that you needed the blood of tyrants for liberty to grow’ was incendiary” excuse.
Careful about the people you are willing to get into bed with in order to insure that we remain trapped in the worst of all possible systems. If the President catches a bullet, liberal Democrats run this country for the next 50 years. Trust that.
Frankly, critics who scoff at the idea that the federal goverment can successfully tackle this crisis baffle me. The United States government, which everyday, for the last 140 years or so has managed the diverse interests of more than 3000 miles of tens of millions of people without civil war; the United States government, currently engaged in, at least three international conflicts, without a draft or hundreds of thousands of dead soldiers, the government that has managed to rest comfortably between TWO other soverign nations WITHOUT a militarized border on either side — that government can’t figure out how to get dialysis for your grandma without putting down’s syndrome babies to death?
Give me a fucking break.
Well, not literally, not sure that my health insurance will cover it.
August 19th, 2009 at 12:29 pm
Yeah, I’m all about that except for raising my taxes. Why is government the solution? Why does it have to be nationalized healthcare. Why can’t we enact simple reforms like make the stuff the Whole Food CEO talked about? Why must it all or nothing?
Government always equals waste. How will this be different? I agree with you that people are framing this debate the idea of introducing Nazi analogies doesn’t help anyone. Unfortunetely, those voices drown out people such as myself who say a) how do we afford it b) why is health insurance a righ c) there are 3 ways heathcare is being funded, 2 of the 3 are bankrupt while the 3 is making payments on time, why should we eliminate the third and instead for a comparable system to 1 & 2 which is BANKRUPT
P.S. I would pay to see that Hillary conference!
August 19th, 2009 at 12:44 pm
I don’t think health insurance is a right. I think a functioning society where contracts are enforced is a right, but that can’t happen unless the system is reformed. There is only one entity with the power to control all the movings parts and that’s the Fed. As for the taxes, if you add up all I pay for premiums, presecriptions, copays, and maybe this surgery bill — that’s a bigger chunk of my earnings than taxes has ever taken from me — and i live in nyc!
August 19th, 2009 at 12:52 pm
I agree the Fed should reform, I guess I disagree how it should reform it.
August 19th, 2009 at 1:17 pm
“a) how do we afford it”
By diverting the money we currently pay for insurance company profits into a non-profit system. Any free-market libertarian should understand the principle of looking toward where the incentives lie. Insurance companies are for-profit. (Even the “non-profit” ones like Kaiser are run to mazimize the profit of their members in the form of the doctors’ salaries.) They make money by paying out less for claims than they take in in premiums. This doesn’t make them evil, it makes them a business.
The question is, if some percentage of our healthcare dollars must go to a middleman whose function is merely to manage payment for the care, do we want that middleman to be one whose goal is to maximize the amount of that percentage (private business), or one whose goal is to minimize it (the government)? Yes, private businesses are more efficient at many things, but they are (and are supposed to be) primarily efficient at maximizing their own profits. Insurance companies have never been in the business of providing healthcare. There is no reason to assume they would provide healthcare efficiently.
My employer and I currently pay approximately $400/month for my health insurance. If your employer pays all or a large percentage of your health insurance, you probably feel like it’s cheap, or free. But that is actually money your employer could be putting in your paycheck, if it weren’t paying it out in benefits.
Yes, those who are privately insured who choose to hang on to that insurance will probably end up paying twice, once in taxes, and once in private premiums. Eventually, most of them will come to realize that that’s not the most efficent choice for them. (You don’t see too many over 65-ers saying “Yes, I know there’s Medicare, but I prefer the service I get with my full-coverage private insurance plan”) That’s what the insurance companies are afraid of.
August 19th, 2009 at 1:32 pm
Pearatty I don’t like the idea that health insurance is tied to employment, I also agree that I would rather have the money rather than the insurance coverage from my employer. I would rather be able to pick my own insurance without having to be tied to my employer.
Here is where I don’t understand your logic, the US govt has the same incentive as insurance companies, they want costs to be minimized, so they don’t have to raise taxes. However, like ALL govt. programs they don’t know how to minimize costs because there is no incentive to do so. Unless you ration health care, there is no way to minimize the cost, since it is a limited commodity. I rather have the decision to pay for something (with my own money) rather than some bureaucrat deciding through my taxes whether my treatment is worth it or not. Why do I need to give my money to the govt. to decide for me? Also, explain how the government won’t be wasteful as it is with Medicare and Medicaid?
How about health care tax exempt savings accounts? What about all the other things government can do to make the system better without taking it over? I’m not saying I love the insurance companies but I’ll take this system over a nationalized one.
August 19th, 2009 at 1:47 pm
b) why is health insurance a right
I would phrase this as why is healthcare a right. I think it’s a fair question. What we decide are basic human rights change across time and cultures.
100 years ago, most people didn’t think a basic education was a right. Now we, in the US, do. But in a lot of other places it’s still not. The right to basic subsistence for those who can’t provide it for themselves — food and shelter — is one that’s still debated here, if not in most European countries. The right to be free from indentured servitude is pretty much a given almost everywhere now, but wasn’t 200 years ago.
So, how do we decide when to add a new right to the group? I’d suggest one measure is when: (a) we as a society are rich enough to afford to provide the right to those who can’t provide it for themselves, without significant cost to those who can, and (b) where the “right” has become one that the majority of the populace accepts as a necessary component of being able to meaningfully participate in the society in which the right is being considered.
In addition, Dawn’s right. Unless we’re willing to turn away the woman who shows up at the Emergency Room only when the huge tumor in her belly starts causing her unbearable pain, and tell her to go die at home without pain medication or expensive surgery and emergent treatments, we’ll pay less if we just cover her regular pap smears and catch the cancer early.
The question becomes, how much suffering in others are you willing to bear, in order to keep your taxes low? I mean that as a very practical question. If we are willing to turn that woman away, then we as a society probably would save money by not having universal healthcare.
August 19th, 2009 at 1:50 pm
PDov:
You have given me many questions to answer, and I just barely got to the first two. (Sorry, second answer was x-posted.) All right, noone but Dawn is going to like this, but here goes — I’ll do it in separate comments.
August 19th, 2009 at 1:51 pm
yaaayyyy
August 19th, 2009 at 1:52 pm
Where is Eric? Damn lazy californians.
August 19th, 2009 at 1:55 pm
“However, like ALL govt. programs they don’t know how to minimize costs because there is no incentive to do so.”
The beauty of this is that we, as voters, have more control over this than we do over a private system. Our representatives can set the budget. The same way they do with military spending. It’s then up to the bureaucrats to decide how much gets spent on what.
Also, please bear in mind that what’s on the table when we say “public option” is merely a government-run insurance company, not a nationalized health program. If it doesn’t run more efficiently, you have the option of going with whatever does.
August 19th, 2009 at 2:01 pm
“Unless you ration health care, there is no way to minimize the cost, since it is a limited commodity.”
This is true. Insurance companies rathion health care all the time. See Dawn’s story above. There are myriad stories of people who had insurance, and were told their insurer wouldn’t pay for a treatment they needed or wanted. My own insurer only pays for generic drugs, not brand names. That’s rationing of heathcare.
I agree that the proponents of reform need to stop dancing around this issue. No, your 95-year old grandma is probably not going to be able to get that heart bypass. Your beautiful teenage daughter is not going to be able to get a nose job on the government dime. But they will be free to pay for those services on their own dime, if that’s what they want. Which is basically how it works now, with private insurers.
August 19th, 2009 at 2:04 pm
“I rather have the decision to pay for something (with my own money) rather than some bureaucrat deciding through my taxes whether my treatment is worth it or not.”
If you were paying the medical care providers (i.e., the doctors and hospitals) directly, this argument might make sense. But it doesn’t make sense when you’re talking about insurance companies. You’re just trading one set of (more expensive) private bureaucrats for another.
August 19th, 2009 at 2:09 pm
“Also, explain how the government won’t be wasteful as it is with Medicare and Medicaid?”
Medicare and Medicaid spend more on actual healthcare costs, and less on administrative costs, than do private insurers.
This is one thing I don’t get. People on Medicare LOVE Medicare. Have you seen these grayhairs on TV panicked that Medicare is going to be TAKEN AWAY by healthcare reform? As I stated above, I know of no one who has access to Medicare who says, “oh, this sucks, I prefer to pay for private insurance.”
Sure, it could be run better, but it’s run a lot better than the system everyone else has.
August 19th, 2009 at 2:16 pm
“How about health care tax exempt savings accounts? What about all the other things government can do to make the system better without taking it over?”
Tax exempt health care savings accounts are a great idea and I’m all for them. But it’s unrealistic to expect that middle and lower-class people will be able (or willing) to save enough to cover themselves in the event of a major (even if not catastrophic) medical event. Which means we’re back to where we started — do we let these people suffer, or do we all chip in and provide for them?
August 19th, 2009 at 2:18 pm
This problem is so intertwined and self perpetuating that only the federal government can fix it.
I don’t see any evidence this is true. The states are big enough that extending it to the federal level doesn’t buy you any efficiencies of scale. I’d much rather see this handled at the state level.
August 19th, 2009 at 2:21 pm
“I’m not saying I love the insurance companies but I’ll take this system over a nationalized one.”
Why?
Have you participated in a nationalized heathcare system? If you did, I am curious to hear about your experiences that make you prefer the US system. I know many Canadians, and all of them prefer the system they have to the US system. I’ve never actually met someone that had the opportunity to live in a place with nationalized healthcare, that said the US system was better.
August 19th, 2009 at 2:25 pm
Dawn said: “This problem is so intertwined and self perpetuating that only the federal government can fix it.”
Eric said: “I don’t see any evidence this is true. The states are big enough that extending it to the federal level doesn’t buy you any efficiencies of scale. I’d much rather see this handled at the state level.”
Meh. That works so well with education.
August 19th, 2009 at 2:25 pm
Hi Eric!
August 19th, 2009 at 2:26 pm
Ok, Dawn, since you’re the only one reading this at this point, I’m sure, the pearatty show is now over. Great post!
August 19th, 2009 at 2:33 pm
Nono don’t stop! I’m reading too!
August 19th, 2009 at 2:35 pm
Yeah, pearatty, you crazy this is awesome. I actually had no facts, just an instinct. Now I have facts!
August 19th, 2009 at 2:55 pm
It’s pretty amazing that the insurance companies have so many customers, given that they don’t pay out anything; seems like a good business to be in.
August 19th, 2009 at 3:37 pm
As long as the insurance companies are for profit there will be decision made inside the insurance company that means little Suzy lives or dies and as a result my bonus will be larger or smaller. Tying healthcare to profit is bad.
Healthcare is not a right, however by enacting laws that mandate treatment we have made it an unfunded mandate that is paid for by the users of the system.
By relegating healthcare to a freemarket good you by definition: set an equilibrium price and have people that wish to purchase the good unable to afford the good.
Most importantly, healthcare is not a “freemarket” good. Insurers are an Oligopoly at best.
August 19th, 2009 at 3:40 pm
Sorry, meetings all day. I’ll respond to Pearatty one comment at a time:
1. Health insurance in my eyes is not a right. I don’t see our society being rich enough to supplement for people who can’t afford it – in fact, most people who I know who want nationalized healthcare don’t want to pay for the expensive medical bills and they want someone else to pay, yet they live in a lifestyle that they don’t want to sacrifice.
I mean, I’m not all or nothing, I understand there is a need for programs like Medicaid but I believe they should complitely revamped specifically becuase there are going bankrupt.
You can’t afford something – how about appealing to a charity group, why is the govt. always the answer? Also, if health care is a right and there is limited amounts of it how do we decide who gets it?
August 19th, 2009 at 3:56 pm
2. I think your reliance on the influence constituents have on their politicians is overrated. In fact while approval ratings of Congress are low, one’s own congressman is typically seen in a good light. All that Pork that Congress passes is bad for the country, but is seen as good for the locals who get the money.
Look the federal govt. has a lot more resources that one insurance company aka all the taxpayers money. Insurance companies won’t be able to compete and fold up. Thus where will my options be? Or say they stay open. If I use something else, I’m subsidizing other people’s health insurance through taxes and I’m paying for my own. Why would I do that? Why is that fair? How will this reduce the prices the hospital charges? If say I wanted to pay out of pocket for a check up, it will still cost me enormous amount of money.
August 19th, 2009 at 4:07 pm
Medicaid is great because I’m paying for those people on it, that’s why they like it’s not sustainable. I basically subsidize Medicaid in 2 ways: through taxes and through hospitals charging Medicaid less than they charge privately insured. I would love it too if I got those services for free. However, there are drawbacks: many doctors won’t take Medicare, those who do, don’t necessarily have the greatest practices, in fact doctors who can afford it will rather not deal with the bureaucrats. I don’t want the country to be like all those sub par doctors.
August 19th, 2009 at 4:11 pm
Again Pearatty, if someone is unwilling to save and pay for their medical care why should we all (responsible and irresponsible) be forced to pay for them? The saving accounts should be the kind of thing Obama is promoting, self-responsibility – instead we are again counting over and over on people who are the responsible ones, to be the ones to do the right thing and pay for everyone. If you are too selfish and dumb to save for the unexpected than okay you don’t deserve to get treated.
August 19th, 2009 at 4:31 pm
I’ve lived in Scotland and I lived in Russia. As a little girl I remember the doctor coming to our house and it was all very nice and quaint. But I also know that when I needed an operation for my broken nose my parents actually decided not to send me to the hospital overnight because my sister’s experience was so bad when she got her tonsils – my parents couldn’t visit her. When I was born my father couldn’t visit my mother for a week, he was called to tell him his wife gave birth to “something” – seriously.
In Scotland I used the NHS – I hated, instead of getting me the tests I needed I was asked repeatedly if I was pregnant. Which I wasn’t. When I came back to the States I got the necessary tests. For little things NHS is good, for things like cancer not so much. I’m so blessed I was here in America when I got diagnosed with lymphoma – I got amazing care.
August 19th, 2009 at 5:20 pm
Hi Pearatty!
Oh, wait, is it only Pdov now?
August 19th, 2009 at 5:25 pm
And how will we pay for it? Uh, taxes, charges and debt. The same way we’ve paid for everything since the Louisiana purchase.
On that note: Rep. Bachus: “Social Security Could Face Default Within Two Years”. Is this really a good time to add new obligations? And Social Security is the easy system to fix. Medicare will be much harder.
August 19th, 2009 at 5:25 pm
Hey, how come I don’t get a hi? I’m the one who requested your presence. Hmph. Good day to you, Sir. Good day.
August 19th, 2009 at 5:27 pm
This is a big issue. Huge. So big that I can’t wrap my mind around all the pieces of it in one shot.
But I can call bullshit occasionally.
Pdov, you were diagnosed with Lymphoma, and that’s a tragedy. You were in the U.S. and you got amazing care. I’m ecstatic to hear that and sincerely hope you beat it. But given your heartless comment that, “If you are too selfish and dumb to save for the unexpected than okay you don’t deserve to get treated”, I have to ask if you had the considerable money saved up for the treatment you needed. Would you be less deserving of treatment if you had the temerity to spend your savings on a house rather than keep it for the off-chance you’re diagnosed with something disastrous or get hit by a car? The economy would grind to a halt if we all had to save a quarter millions dollars before we could actually go ahead and live our lives.
That’s how insurance companies work, and in fact exactly why they were invented (to protect shipping trade routes). They take premiums from everyone and if you get sick or attacked by pirates, you get some back and if you don’t you get nothing back. Some people get more than they put in and others get much less. It’s the insurance companies job to take in more than they pay out, so they can stay afloat.
I don’t understand how ANY government option or plan that’s been proposed is any different than how insurance companies work right now, except that you’ll be mandated to participate in this system. No one complains that you’re mandated to insure your fucking car, but people? Hell no.
August 19th, 2009 at 5:39 pm
Heh heh. I missed that one.
Hi Dawn!
August 19th, 2009 at 5:52 pm
Um Jamie, I’m not defending nor opposing insurance companies. What I’m saying is that I was grateful to get the amazing care in the US, the level of which I wouldn’t get in the UK or in Russia.
Um, if I had a house to liquidate to pay for my cancer treatment I would do it. Hello, living w/out a house trumps not living at all. I was happy I had insurance through my company, I would be happier if I had the option to pick my own insurance and not rely on being employed. That’s what I was arguing, I’m NOT arguing for abolishing insurance companies #facepalm
I just think there are BETTER ways to reform the system than national health care that is what I was replying to Pearatty about (diff. options), I was just using the saving acct. as an example.
I would rather have insurance that pays for stuff like cancer or broken leg but doesn’t pay for annual check ups, I want things like that to be affordable enough but insurance to used as it is intended in extreme situations. I recognize the system is broken, that insurance can actually be a good thing, I just don’t see Obamacare as a way to fix it.
Thank you for you concerns, I’m doing great.
August 19th, 2009 at 5:53 pm
Hi Eric!
Also, I can always bet on Yaron bringing the funny. hehehe
August 19th, 2009 at 6:07 pm
Pdov, you missed nearly all my points. But you did manage to get in a #facepalm. My internal 11 year old is shivering in fear.
I’m not saying you wouldn’t sell your house to pay for your treatment. I’m saying you shouldn’t have to. I’d prefer my taxes go up a bit than live with the knowledge that my fellow citizens are going homeless to pay for dialysis. You called people selfish and dumb for not saving up enough money for their own health care and a few posts later you’re saying you’re cool with insurance for the really big things.
My head is spinning from the logical inconsistencies of those arguing against health care reform. Don’t worry, it’s not just you.
It’s too bad your side is getting hijacked by nutjobs comparing Obama to Hitler. It’s not like you don’t have viable arguments, they’re just not getting through. Is it too much to ask that the proponents and critics of the administration both come up with competing plans and we can argue them on their merits? It’s kind of an important topic.
August 19th, 2009 at 6:13 pm
Pdov,
yaron was joking? I was so about to respond to that seriously…doh…
August 19th, 2009 at 6:22 pm
Actually it’s not my side, it’s Communist LaRouche supporters who are carrying those signs. But I wouldn’t want you to have the facts in your way.
http://newsbusters.org/blogs/seton-motley/2009/08/12/nbc-cnn-msnbc-all-assign-communist-larouches-obama-hitler-poster-conse
I’m calling people selfish and dumb who want me to pay for their health care because they don’t want to do it themselves. A lot of people who support national health care just don’t want to pay for the premiums, they rather spend on other things – fancy restuarants, nice clothes, vacations, even housing. But they are not willing to deal with the consequences of not paying for insurance when they get sick. So they rather force everyone to pay, than have to take the responsibility and get health insurance.
In this case I was replying to a specific scenario Pearatty and I were talking about. It was one of the solutions, NOT the solution to the crisis.
August 19th, 2009 at 6:59 pm
I didn’t mean those signs, although I have a hard time imagining that there are THAT many Larouche supporters around that the signs are popping up at town halls in every city in the country. I was referring to the rhetoric raised by our boy Rush Limbaugh (he of the very high right wing esteem).
http://mediamatters.org/mmtv/200908060021
http://mediamatters.org/mmtv/200908060023
But you can go on pretending that I’m pulling this out of my ass if it makes you feel better.
Hey, I hear what you’re saying that people don’t want to pay their premiums for health insurance. But again, that’s how insurance works. Even if you pay your premiums, there’s still the possibility of you using more care than you ‘bought’. You yourself are a perfect example. I don’t know how old you are, but I have to believe you haven’t paid enough in premiums to cover your lymphoma treatment.
It’s not a savings account, it’s an insurance policy. If it was nationalized, our ‘premiums’ would be in the form of taxes. Those who didn’t work would claim more in benefits than they put in (nothing), just like you did when you got your own treatment and got more in healthcare than you paid in insurance premiums. How are the two things different? All of us who can have to shoulder the burden here.
Our insurance premiums are now at an elevated rate because of fraud, greed and mismanagement in the private sector. Yes, the same would most likely apply to a National health program, but at least everyone would be covered.
August 19th, 2009 at 7:14 pm
Gawker says it much better than I can:
http://gawker.com/5340961/crazy-woman-repeating-republican-talking-point-was-not-technically-a-republican
August 19th, 2009 at 7:35 pm
No actually, besides the the co-pays, my insurance paid for all of it.
Yes it’s different because I chose to pay for the insurance. I bought the insurance plan, I paid for it each week, so that I can have the health care I needed. That’s how it works you pay for it a little or a lot for a time. Insurance company hopes you don’t get sick, but when you do it pays for you. I bought my insurance in case of an emergency, the emergency arose they paid for it like they were supposed to.
The difference here is that I don’t have a say in what kind of insurance I get (limit of choice) and overall the health care quality will drop.
Gawker can suck it. They are condescending bastards.
August 19th, 2009 at 8:00 pm
Hi Dawn–I hope all is well. Interesting how the current debate is really about health insurance reform, when much should be done with respect to health care reform. Great article in the Atlantic Monthly:
http://www.theatlantic.com/doc/200909/health-care
August 19th, 2009 at 8:21 pm
Actually, pdov I bought my insurance too. Pick the top of the line, can go to whoever I want. I paid for it every two weeks for 7 years, never using it except for rare visits when I had a cold. Then I had the worst two years of my life, they said no problem, we’ve got this and then after the bills came in they refused to pay. My only recourse now is costly litigation. How is this not only acceptable, but evidently routine? I did everything “I was supposed to” I used to be on their side and then they fucked me.
August 19th, 2009 at 10:24 pm
Dawn that sucks, what was their reasoning? Are you going to sue. You know you can threaten them with very public negative exposure on your very well known blog!
August 19th, 2009 at 11:12 pm
I can’t believe I read the post and all these comments. I don’t feel any smarter.
Dawn, I pay 1400 dollars a month for my health insurance. That covers me and my wife. It’s like I pay two rent bills.
But, over the last few weeks I’ve needed thousands of dollars in tests, and they’ve covered it.
Now, you’re saying they screwed you. So what you should be saying is, let the feds step in and enforce the law on the existing insurance companies. I agree with P’dov that you’re going extreme all-or-nothing over here.
Just because Nissan sold me a lemon and refuses to give me a new car (hypothetical, don’t you dare start on my car) doesn’t mean that the feds should be the only ones making cars for now on.
August 19th, 2009 at 11:14 pm
My brother sent this to me minutes ago and I think it’s very apropos:
Like most folks in
this country, I have a job. I work, they pay me. I pay my taxes and the government distributes my taxes as it sees
fit. In order to get that paycheck in my case, I am required
to pass a random urine test (with which I have no problem).
What I do have a problem with is the distribution of my
taxes to people who don’t have to pass a urine
test.
>
> So, here is my
> Question: Shouldn’t one have to pass a urine test
> to get a welfare check because I have to pass one to earn it
> for them?
>
> Please understand,
> I have no problem with helping people get back on their
> feet. I do, on the other hand, have a problem with helping
> someone sitting on their ass – doing drugs, while I work. .
> . . Can you imagine how much money each state would save if
> people had to pass a urine test to get a public assistance
> check?
>
> I guess we could
> title that program, ‘Urine or You’re
> Out’.
August 19th, 2009 at 11:15 pm
Seriously, I drove through east cocoa beach the other day at 2:30 pm on a tuesday, and the place was absolutely hopping. People were shopping, chilling on street corners, it was like the whole fucking neighborhood was on summer vacation.
Why should I slave away and pay taxes so they could live off my taxes and live the life I dream of?
And now we should make it even more that way?
I say no!
August 19th, 2009 at 11:16 pm
P.S. If you drive through Boro Park, it’s the same exact way.
So don’t you dare call me a racist.
August 20th, 2009 at 11:12 am
Seriously, Ugarles and pdov are going to leave me to be the one to explain to the jewish commeter how equating “driving through east coco beach” and “drug testing welfare recipients” is classic racism at its most insidious and further has absolutely NO place in a discussion on healthcare? Really? Dead to me.
August 20th, 2009 at 11:33 am
Maybe they just don’t think it is.
August 20th, 2009 at 11:38 am
uhh, then they are still dead to me, young Jedi.
August 20th, 2009 at 11:42 am
It’s simply me paying for someone else to have services/goods, instead of them working to pay for it themselves. It applies to health care, welfare, and lots of other bleeding-heart liberal ideas.
August 20th, 2009 at 11:45 am
Racism part is equating the people on the street at 2:30 pm in my old neighborhood to welfare recipients. My mom is out on those streets at 2:30 pm and she worked her ass off for 44 years. #sheaintneverbeenonnobodyswelfare #thoughsheisonmedicarenowithinksoyuortaxdollarsarepayingforhermedicalcare #gotaproblemwiththat #suckit
August 20th, 2009 at 11:46 am
Dude, did you even read what I wrote? I was NOT referring to senior citizens. The streets were PACKED with people. I mean PACKED. In the middle of a work day. People mine and your age.
August 20th, 2009 at 11:49 am
Call it racism or whatever you want. But it’s just true. There are whole areas that collect a lot more welfare than others. As I said, Boro Park is also one of them, the Hassidic jews are notorious for it.
But so is East Cocoa Beach.
August 20th, 2009 at 11:50 am
People mine and your age.
Awwwww, see I’m gonna pretend this is all you’ve commented on my blog in two days. Awesome! yay! #untilnextyearwhenyouroldass30yearoldselfisonyourown #truefacts
August 20th, 2009 at 12:00 pm
Um, I like Fisch. I don’t exist so I have no idea what neighborhoods he was talking about.
#absolved
August 20th, 2009 at 12:18 pm
A lot of people who support national health care just don’t want to pay for the premiums, they rather spend on other things – fancy restuarants, nice clothes, vacations, even housing. But they are not willing to deal with the consequences of not paying for insurance when they get sick. So they rather force everyone to pay, than have to take the responsibility and get health insurance.
Welcome back, Cadillac-Driving-Welfare-Queen! It’s been a while!
August 20th, 2009 at 12:24 pm
hahahaah Welcome back, Cadillac-Driving-Welfare-Queen! It’s been a while! he’s allliiiivvveeeeee
@pdov No, you don’t exist. But you should have recognized the phrase “east coco beach” as the poor ghetto where i grew up.
#readingmyblogfail #dontknowwhichisworse #nobodylikesfischheisunlikeable #truefacts
August 20th, 2009 at 12:32 pm
I recognized Coco Beach, just not the other neighborhood. #dudeireadyourblog #imstoppingcommentingrightnowonthispost #toomanycomments
August 20th, 2009 at 12:42 pm
Whew, glad to see someone was holding down the fort while I was attempting not to be the worst employee ever.
Ok, 1st of all, when I was poor, I worked night shifts and weekends. 2:30 pm on *your* weekday might well be my Saturday morning. So the fact that in a working class neighborhood, lots of people are out on the street at 2:30 pm, establishes nothing about their work ethic.
August 20th, 2009 at 12:54 pm
pearatty,
I am and always will be the worst employee ever. Except um…if I ever have or will work for anyone reading this blog. Then I was and am awesome. #noreally #hireme #need400Kayear
August 20th, 2009 at 12:59 pm
What you just said pea, is the epitomy of why we have all these horrible programs in the first place. You assume that all those people were just off-shift? Damn. You’re being had. I don’t want any part of it.
August 20th, 2009 at 1:14 pm
Second of all, when I lived in Pasadena, somehow I never once heard someone cite the presence of all those white ladies wearing Prada pushing thier white babies in zamboni strollers (or whatever you call them) in and out of the Plaza Hotel for brunch at 11 in the morning on a weekday, as evidence of a class of lazy-ass-non-workers who were preparing to suck up my tax dollars to subsidize their lifestyle.
(Little did we know that the bailout would do exactly that, for those that were married to investment bankers.)
August 20th, 2009 at 1:17 pm
So yeah, I’m gonna second the call on racism.
August 20th, 2009 at 1:48 pm
of all those white ladies wearing Prada pushing thier white babies in zamboni strollers (or whatever you call them) in and out of the Plaza Hotel for brunch at 11 in the morning on a weekday, as evidence of a class of lazy-ass-non-workers who were preparing to suck up my tax dollars to subsidize their lifestyle.
HOLY SHIT!! Totally!! I didn’t even think of that! Fisch, go to fricking Midtown or the UES on a weekday ANY weekday at 11 am and you will see the stores all full and they aint tourists.
August 20th, 2009 at 1:59 pm
[...] wins the award this week for the third to last comment on the healthcare post…number 64. Wow. She is a genius and pretty much stands for truth, light, justice and the [...]
August 20th, 2009 at 2:23 pm
PDov:
I’m sorry to hear you were so sick, and very happy that you got well treated. I agree that maintaining a high level of care for serious and complicated diseases has got to be a focus of any health plan we adopt.
I disagree that means that some form of universal healthcare can’t be reached without sacrificing quality.
I will also say that I experienced the (post-communist, but still nationalized) slavic approach to healthcare when I lived in Poland, and I agree that it seemed backward regarding advanced medical issues. But I think that may have had as much to do with the poverty of that country and the culture of corruption and pervaded the entire system, as it did with the fact that the care was universal.
For example, the roads in Poland also sucked–full of potholes, poorly de-iced in the winter. But no one argues here that the government isn’t capable of providing us with decent roads, just because the “nationalized” system of road maintenance didn’t work in Communist countries.
I do believe that nationalizing may mean “rationing” in a way that means some people who are getting a certain level of care won’t get that anymore. I would use the example I used in an earlier discussion with Eric:
When I blew out my knee and had to have ACL reconstruction surgery, I discovered that my workplace had screwed up my insurance paperwork, and I wasn’t covered. I ended up paying for the surgery out of pocket, 10 grand, which was approximately my yearly salary at the time. The doctor scheduled me for an MRI prior to the surgery. I asked the doctor how much that would cost, so I could assess if I could afford it. The doctor said, “oh, in that case, we’ll just go with the X-ray.” Guess what? My surgery went fine, my knee works great now.
I used to take nexium for acid reflux. When I went through a period of unemployment, I discovered that the over-the-counter prilosec works just as well for me. My doctor had never suggested it.
If I’d been insured, I would have had the MRI, and would still be taking nexium, at a cost to society, although not to myself. We, as patients, want the best. Doctors are happy to charge us for the best (my doctor owned his MRI machine, so he would have made the profit off of the MRI). Neither patients nor doctors have an incentive to examine if a little less is just as effective as the best. There’s nothing wrong with a system that does that for society as a whole.
On the basis of my personal experience, I’m happy to reallocate the dollars that currently go to excessive testing and unnecessarily expensive medication, for prenatal care for pregnant mothers, for yearly pap smears for all women, eye exams for kids, for insulin for diabetics, etc. I don’t think that means that we have to take a hit on treating serious conditions with effective and necessary treatments.
August 20th, 2009 at 2:44 pm
PDov:
Since we’re getting into personal experience (and I appreciate you sharing yours), I think I can respond to some of your other questions/suggestions with my experience with my father.
I watched my father, who had worked his ass off working nights and weekends as a professional enter a rapid decline in his mid-50′s. A series of seziures, strokes and clinical depression left him unable mentally to do the work he had been trained to do. (Public service warning kids: don’t smoke, there are worse things that can happen to a bright ambitious person than lung cancer.) He lost his job, and his insurance. He was unable to get new insurance. He ran through his savings, and eventually was unable to pay for the medication that prevented the seziures that caused his strokes. He died of heart attack caused by a seizure.
So:
Personal responsibility: doesn’t mean much when one is, because of one’s illness, unable to provide for oneself. My dad did everything he was supposed to do — he worked, he saved, he paid for insurance. It wasn’t enough.
Charity: too catch-as-catch-can to provide for our social safety net. I called the Pastor of the church where, in better days, my father had donated tens of thousands of dollars, and much of his time, told the Pastor my dad was in a bad way, and asked if he could check in on him or send someone from the church to check in on him. The Pastor made one phone call to my dad. (This is why the term “Presbeterians” will always be preceded for me by the term “f**king”.) If that’s what it’s like for someone who falls on hard times who was actually involved with a charity group, how can we expect that charity will provide for people who are not so affiliated?
August 20th, 2009 at 3:20 pm
So basically presbyterians (sp?)fucked over your dad, so you hate all of them.
But one country doesn’t do national health care correct, but we shouldn’t apply that stereotype to every country.
Hmm, sounds like your arguments are emotion based.
August 20th, 2009 at 3:39 pm
“So basically presbyterians (sp?)fucked over your dad, so you hate all of them.”
Yes, that’s correct. Except for my sister; she’s all right.
August 20th, 2009 at 3:41 pm
hahah fucking presbos.
August 20th, 2009 at 3:43 pm
Ok, let’s separate out the teeny joke/hyperbole about Presbyterians in my post from the rest of it.
I didn’t say: “Presbyterians are fucked, therefore no charity is capable of assisting its members in need.” The Catholic and Mormon churches, I would say, are direct evidence to the contrary, in fact.
I said, “Here is anecdotal evidence of why we can’t count on ad hoc charitable assistance to carry society’s weight on this.” That point still stands.
August 20th, 2009 at 3:46 pm
“But one country doesn’t do national health care correct, but we shouldn’t apply that stereotype to every country.”
When we have evidence of countries who do national health care pretty well, countries where the populations have longer lifespans and express more satisfaction with the level of care they get than do Americans, I think it’s fair to say that national healthcare shouldn’t be rejected out of hand because some other countries do it poorly.
August 20th, 2009 at 3:47 pm
I know, I know. I just don’t have the energy to write back a 4 thousand word comment like you did, so I was just giving you a hard time.
August 20th, 2009 at 3:56 pm
Fisch, what do you think this is? Alarmingnews?
August 20th, 2009 at 3:57 pm
What’s that? Never heard of it.
August 20th, 2009 at 4:05 pm
“Hmm, sounds like your arguments are emotion based.”
My feelings about this issue are emotion based. However, my arguments are rational.
Everyone’s feelings about this issue are emotion based. People who like what they have are *afraid* they will lose it. People who think they may be asked to pay a little extra, to cover people they perceive as lazy, are *angry* at how that seems unfair.
PDov’s stories about national healthcare in Communist Russia are a case in point. She doesn’t actually complain that the healthcare she and her parents received there was faulty, she complains about what are essentially customer service issues: her parents weren’t allowed to visit their children in the hospital, her father wasn’t allowed to attend the birth of his children, and the hospital then wouldn’t tell him if the baby was a girl or boy. Those events made her parents, apparently, and quite naturally, *anxious,* *angry,* and *afraid.* None of them indicates that the medical care was substandard. Based, then, entirely on emotion, her parents elected not to have her stay in the hospital for a tonsilectomy.
PDov then had a difficult time getting a diagnosis under the British NHS. Again, that made her *angry*. She had a good experience getting cured in the US. That experience, I can only imagine, made her *relieved* and *happy*. She then, quite reasonably, used that experience as a basis to decide that the system as it exists in the US is more likely to make one happy than the NHS. That was a rational argument, although based on emotion.
The question for me is, can we keep the things about the system that made PDov happy here, and avoid the things about nationalized healthcare that made her parents unhappy there, while still providing universal healthcare? I look for ways to do that.
Of course, I and all my beloveds are now covered by private insurance through our various employers. Caring about the uninsured is a totally irrational and emotion based position, for me, personally. I know that there are strangers out there right now going through what my dad went through, and it makes me feel bad to think that nothing’s being done for them. So yes, If I were a rational unemotional actor, I would say, hey, screw ‘em.
August 20th, 2009 at 4:07 pm
“”I know, I know. I just don’t have the energy to write back a 4 thousand word comment like you did, so I was just giving you a hard time.”
Wow, I and my employer really wish I had seen that before the last couple of posts.
August 20th, 2009 at 4:26 pm
pearatty mentioned that Medicare spends the least on overhead of any insurance. This is because it is notorious for rejecting every possible claim for every possible reason, pushing the costs back onto the doctor’s offices. Medicare also pays less than any other insurance provider. Between the overhead and the low payments, Medicare is often paying below delivery cost of services. That’s why a lot of providers either won’t take Medicare at all, or limit their number of Medicare patients. This will only get worse soon, as Medicare is due for a 21% reimbursement cut soon.
The current plan was sold as “Medicare for everyone”. I’d rather have heard it sold as “VA care for everyone”; that would have been more honest.
August 20th, 2009 at 5:16 pm
Yay! And that’s 80.
I’m done here folks.
August 20th, 2009 at 5:29 pm
hahaha…nah…you don’t win commenter of the week and then quit. or do you? I dunno, I’ve never been commenter of the week.
August 20th, 2009 at 5:38 pm
See, e.g., Laurels, Resting.
August 20th, 2009 at 6:41 pm
Pearatty I wasn’t going to comment but the reason why my parents didn’t send me to the hospital was because the care was so horrible – because my sister had a bad experience with her care, not because they were afraid. I experienced bad care in Scotland and in Russia. It’s not about my feelings. If you want I can go into graphic details about my parent’s experience in Russian health system. My own experience with NHS was not about customer care, they wouldn’t figure out what was wrong with me. Period. I can’t believe I commented again. #shakesfist
August 20th, 2009 at 6:53 pm
That’s how Dawn gets ya.
August 20th, 2009 at 6:54 pm
C’mon, I bet we can break 100.
August 20th, 2009 at 8:23 pm
I bet we can’t.
August 20th, 2009 at 8:59 pm
I just see the proposed government health care overhaul as the straw that’s breaking the taxpayer’s back. Many people are getting upset at the idea of another government agency being created to meddle in another part of their lives. It’s not that a government health care system doesn’t have plenty of merits. It does–in a vacuum. But pile it on top of all the other government agencies that have been created in the last 50 years and that image starts to make many people a bit uneasy. The ants can only support so many grasshoppers.
August 20th, 2009 at 9:20 pm
But their backs are ALREADY being broken by this system. Or the backs will be broken when illness strikes.
August 20th, 2009 at 9:21 pm
Wanh wanh wanh. Ants are such whiny wusses.
August 20th, 2009 at 9:22 pm
“I bet we can’t.”
What’s that, like, reverse psychology?
August 20th, 2009 at 9:29 pm
Also, to the point about medicaid/care (yeah, all my learnin’ still don’t know which is which) denying claims…so does private insurance AND they overcharge/are wasteful and are not accountable. I don’t understand why people seem so committed to this system just because it’s what we have. (I’m lying, I totally understand that impulse. I kept my ATT cellphone for 7 years even though I could never get service anywhere because it didnt work in downtown manhattan or brooklyn because i wanted to keep my phone number. But then the govt passed a law saying I could take my phone number with me and VOILA I changed to verizon and now I’m on the cellphone all the damn time. Texting, not talking; but still.)
August 20th, 2009 at 9:30 pm
@Pearatty
No, not reverse. It’s the regular kind.
August 20th, 2009 at 9:38 pm
“I don’t understand why people seem so committed to this system just because it’s what we have.”
There was an interesting article in Salon or Slate or something addressing this question in the context of Machiavelli, who apparently said something to the effect of: “a leader who attempts to change the status quo is screwed, because the people who are against change have the most to lose, and will fight most vigorously to keep the status quo, while those who favor change will fight wimpily, because the human mind has a hard time really believing that things can be different as long as the change is just an abstract concept.”
I may be paraphrasing.
August 21st, 2009 at 7:32 am
Machiavelli, so very wise. How’d he end up with such a bad reputation.
August 21st, 2009 at 9:23 am
He really was wise. He got a bad reputation by being straightforward — talking about how things are, instead of how things should be.
August 21st, 2009 at 9:42 am
I feel like that happens to me too.
August 21st, 2009 at 10:34 am
Do you have a bad reputation?
August 21st, 2009 at 10:35 am
Oh man, soooo close to 100.
August 21st, 2009 at 10:45 am
Hey, what’s going on here?
August 23rd, 2009 at 1:49 am
Late to the party. Healthcare is emotional. It is emotional not because I fear losing what I have. To the contrary, I care not about me. I do care about those that I love. This issue directly impacts family.
Having said that, I don’t know how many of the commenters here have had an up close experience with medicaid services. I have. In an earlier life, I was employed in a mental health care facility that provided services to indigent clients. If you think that the services that are being provided in these facilities is even close to those that are being provided to individuals that have a standard insurance plan, you are a sucker.
There will be quality of care issues with the “public” option. This is glibly glossed over in the comments section here as “customer service” issues. Having helped my brother die, I can’t imagine anything in which customer service could be more important.
When I set the shiny pennies aside for the bottom line from those that want a public option, the distilled message is this: Consi, you need to pay for others healthcare, and your loved ones must accept substandard care so that we can stretch the dollars allocated for their care. Forgive me for not feeling the love.