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Posted by Samprimary (Member # 8561) on :
 
This is a pretty broad topic.

With so much crazy stuff floating around on the subject of American healthcare's pathetic bottom-rung performance in the fully industrialized world, and its predicted inevitable insolvency, what do you think about it, and where do you think we should go from here?
 
Posted by Samprimary (Member # 8561) on :
 
Corollary to first point, since it seems like I'm trying to frame the issue in a biased fashion:

The strong negative wording is not my own assessment, though it's starting to rub off on me pretty strongly. It's essentially the wording of medical industry experts and hospital operators who largely are operating on the measured assumption that the current healthcare system will collapse or be replaced.
 
Posted by Tante Shvester (Member # 8202) on :
 
I'm a nurse, and I see first hand how our system is broken. The band-aid patches aren't up to addressing the critical condition of the patient. The country needs universal healthcare, and it needs it now. Or 10 years ago. It is a scandal and a crime.

We are endowed by our creator with certain inalienable rights, including those of life, liberty, and the pursuit of happiness. I consider a national healthcare system to be congruent with promoting the right to life for our citizens.

I feel strongly about this. You can disagree with me, but you'd be wrong.
 
Posted by Princess Leah (Member # 6026) on :
 
I'm a patient, and I too see firsthand how our system is broken. *nods to Tante* She's right. I might add something about ensuring that more is done to promote quality of life (for example, that more health insurance companies cover insulin pumps rather than shots if that's what the patient chooses).

Incidentally, just a few hours ago I finished a book that in part adresses this subject, and I'm angry, dangit! Our current healthcare system, coupled with our current litigious society, practically guarantees that a huge percentage of patients will get substandard treatment, and whether that means overtreating, undertreating, or not being able to afford whatever treatment is prescribed, it's unacceptable.
 
Posted by Lyrhawn (Member # 7039) on :
 
I snagged this from the Big Three thread, it's what I jotted down real quick when someone asked me for my healthcare plan. Certainly there's room for fixes.

First thing's first, make all records electrionic and secure. It will save us billions in administrative overhead, and will cut down on a lot of errors made by physicians. Records will be easily portable, and easily accessible no matter where in the country you are.

Second, fix the legal system when it comes to medical malpractice suits. There needs to be a cap on punitive damages. People makes mistakes. I know those mistakes hurt real people, but there's a ripple effect. A doctor in a difficult surgery does the best he can, but the patient still comes out a quadriplegic. In response, the family sues the doctor for millions of dollars. His insurnace, and the hospital insurance pay for the suit, but his premium is jacked up so high that he can no longer afford to practice medicine. The end result is that his collective knowledge is lost from the medical profession.

The medical profession is full of open jobs. GPs are in high demand, as are nurses. Nurses require the same amount of schooling as a regular 4 year degree, and command more than 50K right out of the classroom, with huge signing bonuses. There needs to be more support for these professions, despite huge salary opportunities, there are still massive shortages, and it is in the national interest to fill those spots. Wages will rise to meet demand yes, and supply will rise as well, but at what cost to hospitals?

Cap punitive damages, overhaul the whole system. It's ridiculous as it stands. Consider giving general practitioners and general surgeons, and nursing students some sort of tax break, or zero-interest loans, or tax deductible schooling if they go into the profession we (The US Gov) choose, and agree to work at the the hospital the US Gov decides to send them to for two years (maybe four, but the benefit would have to go up).

Allow the government to negotiate with drug companies for reduced prices, and increased production of generics. Drugs in this company, lifesaving drugs (of which most of them are), should be available and affordable for everyone. Keeping everyone healthy without bankrupting them is good for EVERYONE, even the drug companies that are crying bloody murder about what they perceive is an attack on their industry. Get used to it guys. Your multibillion dollar profit margin still isn't going anywhere.

Put more emphasis on personal responsibility. Auto Insurance companies offer to reduce your rates for every year you go without an accident. Health insurance, corporations, and yes, for the time being, government, should get in the game with health. Preventative healthcare will save the industry billions. People who live and lead healthy lives should get a reward. Why? Because they make the healthcare system cheaper as a whole to operate.

If no one in America smoked, or was obese, that would erase billions from the cost of healthcare every year. I know that infringes on personal choice, so fine, I don't advocate outlawing smoking, or criminalizing fatness (despite the advantages), but I'm all for positive reinforcement. Were we to offer a type of national healthcare, there should be greatly reduced rates for healthy Americans. And I think the corporations with the healthiest workers should get tax breaks as well, as a benefit to encouraging a healthy work force.

And really, it only helps the corporations. Companies that offer rewards for healthy employees enable a win/win situation. Healthier workers means a vastly lower cost of healthcare that they have to pay out of company coffers, and also gives them a happier, more loyal workforce. With lower healthcare costs, they can either pay the workers more, or lower their prices, making them more competitive. If the whole US does it, we sharpen our global competitive edge.
 
Posted by Allegra (Member # 6773) on :
 
quote:
If no one in America smoked, or was obese, that would erase billions from the cost of healthcare every year. I know that infringes on personal choice, so fine, I don't advocate outlawing smoking, or criminalizing fatness (despite the advantages), but I'm all for positive reinforcement. Were we to offer a type of national healthcare, there should be greatly reduced rates for healthy Americans. And I think the corporations with the healthiest workers should get tax breaks as well, as a benefit to encouraging a healthy work force.
I could see this getting out of hand. If you give businesses bonuses for having a healthier work force, I bet you will see more unemployed obese and cronicly ill people. Even if no one is fired, I bet it would be a lot harder to get a job if they could tell you were "unhealthy". Also, I am not sure it is fair to have to pay more taxes because you are not healthy. If someone is having health problems it is likely that they will have to miss more work anyway.
 
Posted by Jhai (Member # 5633) on :
 
While I don't really have a position on this issue (not enough research done on my part yet), I'd like to point out that our health care system is not without its positive points.

I disagree with Tante that everyone has a right to insurance. And no, I'm not one of those people sitting up high with insurance passing down judgement on the poor saps who can't get it - at least, I'm not going to be in a little while. I'll most likely be uninsured come Decemeber, and I will continue to be uninsured until the summer or the fall of next year. I could get insurance through COBRA, but, despite my chronic illness, I don't think the cost is worth the benefit. Yes, it's a risk, but so are a million other things in this world, and I don't expect the US government to protect me from them all so that I can continue to exercise my right to life.
 
Posted by MightyCow (Member # 9253) on :
 
I wish I could get good health insurance as a self-employeed writer without paying through the ear. I also wish insurers would see more value in preventative medicine, rather than discouraging it. Because my doctor visit co-pay is so high, I'm encouraged to wait until I'm sure I have a real problem, rather than going to see my primary care doctor when I am feeling unwell, only to be told that it's a virus, have some soup and thanks for the $70.
 
Posted by Lyrhawn (Member # 7039) on :
 
quote:
Originally posted by Allegra:
quote:
If no one in America smoked, or was obese, that would erase billions from the cost of healthcare every year. I know that infringes on personal choice, so fine, I don't advocate outlawing smoking, or criminalizing fatness (despite the advantages), but I'm all for positive reinforcement. Were we to offer a type of national healthcare, there should be greatly reduced rates for healthy Americans. And I think the corporations with the healthiest workers should get tax breaks as well, as a benefit to encouraging a healthy work force.
I could see this getting out of hand. If you give businesses bonuses for having a healthier work force, I bet you will see more unemployed obese and cronicly ill people. Even if no one is fired, I bet it would be a lot harder to get a job if they could tell you were "unhealthy". Also, I am not sure it is fair to have to pay more taxes because you are not healthy. If someone is having health problems it is likely that they will have to miss more work anyway.
The only way it isn't fair is if you were paying an extra tax for being fat. I'd agree that a Fat Tax isn't fair, but giving a tax break to someone who does what you like is totally fair. It's positive reinforcement. If there is never any real push to get healthy, people never will. Obviously fear of death isn't doing a very good job at convincing them, because they are dying in droves.

Besides, YOU aren't paying more taxes, the company you work for is. If you have to pay more for healthcare, then I'm sorry, but life choices can have consequences. Unless someone has a medical reason for being overweight, then it's a choice, just like anything else in life. The health factor here focuses on controlled aspects of your health, such as obesity, or smoking. You can't control if you get cancer or not, so that shouldn't be a factor in how healthy you are. But obesity, and smoking related illnesses are two of the (if not the two biggest, I believe) killers in this country, and they drive up the cost of health care monumentally.

I'd be okay with making a law that says you can't use obesity as part of your hiring practices. The idea is for companies to offer gym memberships, or other company incentives to employers to get them healthy, so they can enjoy the tax break, not to keep obese people out of work. Maybe we'll really see if Americans are more interested in money than living.
 
Posted by Jhai (Member # 5633) on :
 
quote:
Originally posted by Lyrhawn:
The only way it isn't fair is if you were paying an extra tax for being fat. I'd agree that a Fat Tax isn't fair, but giving a tax break to someone who does what you like is totally fair.
This is pretty fine line to draw. It's the same thing as telling criminals "you're not being punished for committing crimes, everyone else is just being reward for not committing crimes." If you're breaking the population into two groups (and how are you going to do that, by the way, considering that there are atheletes who are considered obese by BMI standards?), then giving a reward to one group is nearly the same as giving a punishment to the other group - it's really just a question of semantics. And since the majority of the population will be getting the reward, it will really seem as if you are punishing the minority.
 
Posted by Princess Leah (Member # 6026) on :
 
quote:
giving a tax break to someone who does what you like is totally fair.
Yeah, but you're not proposing that. You're proposing giving a tax break to a company who gets results, or, individually, to someone who does what you like and gets results. I hope this doesn't spark an argument about the simplicity of weight loss, because I'd hate to have to flame you ( [Wink] ), but just because someone excercises and eats healthily doesn't necessarily mean they're going to lose weight. Rewarding weightloss on an individual level is unfair in many ways. It's hard to lose weight. Certian populations are more disposed to medical conditions that make it even mroe difficult; conditions that often go undiagnosed for a long time (due in part to racism/classism within the hospital system). It's much more expensive to eat healthy. Many of the resources that make healthy weightloss more achievable are prohibitivly expensive. I think if a policy that rewards individual weightloss is put into place, what you'd see is an increase in eating disordered behaviour, which causes its own special problems, including psychological--an expensive branch of medicine.

Incidnetally, Lyrhawn, why don't you advocate outlawing smoking? We outlaw other drugs, and smoking takes a huge toll on our healthcare system. Tobacco takes up space that could be used for food production. And smoking in public directly harms others. You've been talking about a complicated system punishing those people whose choices (if we assume that all obesity is a result of choice) indirectly make them more at risk for medical conditions. You've had little to say about smoking, which is CLEARLY a choice and directly affects health.
 
Posted by Lyrhawn (Member # 7039) on :
 
quote:
Originally posted by Jhai:
quote:
Originally posted by Lyrhawn:
The only way it isn't fair is if you were paying an extra tax for being fat. I'd agree that a Fat Tax isn't fair, but giving a tax break to someone who does what you like is totally fair.
This is pretty fine line to draw. It's the same thing as telling criminals "you're not being punished for committing crimes, everyone else is just being reward for not committing crimes." If you're breaking the population into two groups (and how are you going to do that, by the way, considering that there are atheletes who are considered obese by BMI standards?), then giving a reward to one group is nearly the same as giving a punishment to the other group - it's really just a question of semantics. And since the majority of the population will be getting the reward, it will really seem as if you are punishing the minority.
So,

Tax breaks for students in college is a punishment to the uneducated?

Tax breaks to families with children is a punishment for the childless?

Tax breaks for home owners is a punishment to renters?

etc...

BMI is not a good indicator of how healthy you are. But a doctor at a physical CAN tell you how healthy you are. BMIs are a quick, clean little mathamatical formula to tell you who is obese and who isn't, it's not something a health insurance company is going to make a decision on.

And it isn't a punishment, everyone else gets the status quo. Do you feel punished now? I mean under the current status quo do you feel like you are being punished for something? According to your take on tax breaks, every tax break that is out there is a punishment to you. The NIH can come up with a reasonable zone of what is and isn't healthy. From " " to " " is a healthy weight, depending on your body fat and muscle ratio, and your blood pressure, cholesterol, etc. Doctors KNOW what is healthy. Furthermore, these aren't TAXES ON PEOPLE. Again, I never suggested that PEOPLE be taxed for being obese, I said that corporations should get breaks for actively parterning with their employees to make them healthier. What is unfair about a voluntary system?

Also I seriously wonder if the majority of the population is getting the reward here. First of all, the rewards go to business, so actually, EVERYONE gets that reward, in the sense that business doing well is good for the nation, but the health epidemic in this country, for those that suffer from a side effect of poor personal choices, is more than 50%.

If you're referring to charging more for obese people for health insurance, well, it really already is that way for other health issues. Smokers pay more. It should be the same.
 
Posted by mackillian (Member # 586) on :
 
I work for a health insurance company. The health insurance they offer us as employees is absolutely awful.

We also don't have an on-site gym.

There used to be. Now it's part of the cube-farm.
 
Posted by Lyrhawn (Member # 7039) on :
 
Leah -

quote:
Yeah, but you're not proposing that. You're proposing giving a tax break to a company who gets results, or, individually, to someone who does what you like and gets results.
It isn't as simple as weight loss, I can appreciate that. But for millions of people, eating responsibly, and getting a moderate amount of exercise every week will result in weight loss. And even if it doesn't, for millions more than that, it will result in increased cardiovascular health, and since heart disease is the number one killer in this country, that can only help the nation as a whole. For a lot of people it IS difficult to lose weight, and our system needs to be overhauled as a whole. Preventative health care means they never should have grown overweight to begin with. It may well cost millions or billions to get everyone to a perfectly healthy state, but we'll realize billions in savings once we get there, and those will last forever. It's going to be a painful switchover, but it needs to be done sooner rather than later, for the health of the nation, and for the future of the nation.

My generation is the first generation that will see a DROP in their life expectancy in America, EVER. And that drop is entirely blamed on obesity related health problems.

quote:
I hope this doesn't spark an argument about the simplicity of weight loss, because I'd hate to have to flame you ( [Wink] ), but just because someone excercises and eats healthily doesn't necessarily mean they're going to lose weight. Rewarding weightloss on an individual level is unfair in many ways. It's hard to lose weight. Certian populations are more disposed to medical conditions that make it even mroe difficult; conditions that often go undiagnosed for a long time (due in part to racism/classism within the hospital system). It's much more expensive to eat healthy. Many of the resources that make healthy weightloss more achievable are prohibitivly expensive. I think if a policy that rewards individual weightloss is put into place, what you'd see is an increase in eating disordered behaviour, which causes its own special problems, including psychological--an expensive branch of medicine.
See above for the answer to the first part of this quote.

To cover the part in bold first, you won't see that at all. Why? Because anorexia is extremely unhealthy, as is bulemia. It does no good at all for people to lose weight, if at the end of their weight loss they're going to be twice as unhealthy as when they were obese. This isn't solely a war on fatness at any cost. It's a war on unhealthy habits, it's a crusade to make the nation healthy. That means HEALTHY weight loss. There is a lot of healthy weight loss medication out there, that in concert with responsible eating habits and exercise can result in a healthy weight. Such medications should be covered under insurance, at least partially.

As for problems with detecting weight loss difficulties, it's time to change that part of the medical system too. Our goal is healthy Americans, regardless of race, or class.

quote:
Incidnetally, Lyrhawn, why don't you advocate outlawing smoking? We outlaw other drugs, and smoking takes a huge toll on our healthcare system. Tobacco takes up space that could be used for food production. And smoking in public directly harms others. You've been talking about a complicated system punishing those people whose choices (if we assume that all obesity is a result of choice) indirectly make them more at risk for medical conditions. You've had little to say about smoking, which is CLEARLY a choice and directly affects health.
I'm morally split on outlawing smoking. Personally, I say outlaw it. Either outlaw it, or legalize all narcotics. Opponents to outlawing it would say that infringes on personal choice, though I'd say too bad, the government outlaws tons of stuff that are bad for you. We aren't allowed to use a lot of narcotics, or have chemical weapons or nuclear material, etc. And I'd make the argument that smoking is on the level of weapons of mass destruction. It kills more people in one year in America than WMDs have in the 21st century. I'm interested to hear other people's opinions on the outlawing of smoking. I doubt it'll ever happen. Too many millions of dollars flow from tobacco farmers, too many millions come in from taxes on cigarettes. And yet they add billions in damages to our society.

Also I reject that my system is complicated. On the contrary, I think much of it is designed to make things easier, especially in the long run. And I reject that the system is based on punishing ANYONE. Punishment implies something new that will directly punish unhealthy people.

Vice taxes are negative reinforcement. Taxes on cigarettes are in a sense a punishment. Offering a tax break to someone in order to entice them to better themselves, and provide for the betterment of America as a whole isn't a punishment to anyone. It's a benefit for everyone.
 
Posted by Tante Shvester (Member # 8202) on :
 
I was working for a very large home care agency that provides nursing, therapy, and home health aides to patients at home. My husband requires home care nursing. When the policies were set to be renewed, guess what benefit got cut from the policy? Yup. Home care is not a covered expense.

I had to resign and find a job with better benefits.

On-site gym? Never in my career have I had such a thing.
 
Posted by Princess Leah (Member # 6026) on :
 
quote:
Because anorexia is extremely unhealthy, as is bulemia. It does no good at all for people to lose weight, if at the end of their weight loss they're going to be twice as unhealthy as when they were obese. This isn't solely a war on fatness at any cost. It's a war on unhealthy habits, it's a crusade to make the nation healthy.
I don't argue that we need to focus on the health of the nation. I'm arguing that implementing the methods you propose will be at best essentially ineffective, and at worst, harmful, exploitative/exploited, discriminatory, and will only increase the health gap between the educated well-off and the uneducated poor.
 
Posted by Flaming Toad on a Stick (Member # 9302) on :
 
All right, here's my perspective.
To give you some background, I live in Canada, just across the border from Detroit. I've had way too many health problems/surgeries in my life to not have familiarized myself with Canadian healthcare.

First off: Free (well, tax covered) health care is defiitely worth it, when run properly. When I had to undergo surgery on my eyes (they had swollen up to the literal size and weight of tennis balls), I was transferred to London, two hours away. The service was fast and competent, and my surgery was executed with no complication (It felt good to be able to open my eyes without using my hands).

On the flip side however, (and this was a major issue in the last few elections) Canada suffers from a widespread shortage in medical personnel. When my toe was sliced open my a broken bottle of tabasco sauce(which is exactly as painful as it sounds), I waited six hours in the emergency waiting room after being triaged. It has now gotten to a point where people are calling ambulances over very minor injuries, simply because they get faster service. A major issue in Canada is whether or not private health care should be government-funded. If the current decline continues, I migh even start to support that initiative.

Sorry if I grossed anyone out.
 
Posted by Lyrhawn (Member # 7039) on :
 
quote:
Originally posted by Princess Leah:
quote:
Because anorexia is extremely unhealthy, as is bulemia. It does no good at all for people to lose weight, if at the end of their weight loss they're going to be twice as unhealthy as when they were obese. This isn't solely a war on fatness at any cost. It's a war on unhealthy habits, it's a crusade to make the nation healthy.
I don't argue that we need to focus on the health of the nation. I'm arguing that implementing the methods you propose will be at best essentially ineffective, and at worst, harmful, exploitative/exploited, discriminatory, and will only increase the health gap between the educated well-off and the uneducated poor.
Specifics please.

Which methods?

How?

Blanket statements that disapprove of an idea aren't very helpful to the discussion without providing details.
 
Posted by rivka (Member # 4859) on :
 
I agree with the Princess. And you've been providing at least as many blanket statements in support of your plan as she has against it.

There are plenty of people who are rail-thin, and still have shockingly high cholesterol. And accompanying health risks. Weight is far from the only measure of health, and claiming that it is shows a serious lack of knowledge on the issue.
 
Posted by Lyrhawn (Member # 7039) on :
 
quote:
Originally posted by rivka:
I agree with the Princess. And you've been providing at least as many blanket statements in support of your plan as she has against it.

There are plenty of people who are rail-thin, and still have shockingly high cholesterol. And accompanying health risks. Weight is far from the only measure of health, and claiming that it is shows a serious lack of knowledge on the issue.
How many times do I have to say that weight isn't the only measure of health? I didn't even say it was the best measure. It's just the most visible. I even specifically enumerated other important measures of health, and the benefits of a healthy lifestyle that don't have to do with weight.

As far as I can tell, Leah, and you, are only taking issue with one piece of a larger plan to fix the system. And I can't really even tell what you're disapproving of.

Your objections and hers are to something I really can't find in my posts. You're either reading something into my posts, or just plain misunderstanding me, but either way you have it wrong. I never said that it would depend entirely on weight, I've stated the contrary in fact. I don't know how else to say that I don't think weight is the only measure involved. If you read my posts, you'll see me speaking in favor of a "healthy" lifestyle, of which reduced fat, and lack of smoking, are usually automatically implied.

I really don't understand what you're taking issue with, which is why I asked for specifics. What is your problem with that?

[Edited for clarity]

[ November 19, 2006, 03:26 PM: Message edited by: Lyrhawn ]
 
Posted by Sterling (Member # 8096) on :
 
Gee, it would be nice if the uninsured didn't end up going to emergency rooms when their conditions become urgent and end up costing ten times as much.

And if doctors didn't get the same fifteen to twenty minutes to deal with patients with the flu as with ones with five or six more serious conditions.
 
Posted by Lyrhawn (Member # 7039) on :
 
quote:
Originally posted by Sterling:
Gee, it would be nice if the uninsured didn't end up going to emergency rooms when their conditions become urgent and end up costing ten times as much.
Best way to fix that is to make sure everyone is covered, and to keep a focus on preventative healthcare.
 
Posted by Princess Leah (Member # 6026) on :
 
Lyrhawn, I don't have a lot of time to spare today so I can't respond in detail now. I'm copy&pasting this from my journal and I hope it will clarify a bit:

"Pay-for-performance is a stupid idea. That's a policy that's guarenteed to make the care of patients that are already having difficulties with control, getting ignored, and being referred away to other areas/doctors even more difficult to get. Why? Because patients that are challenges and need more help and tools are the ones whose statistics are least likely to reflect well on their care provider, and if that care provider is getting a financial reward for every patient with an A1c under x, then the patients who are doing well (ie do not need help) will be the most desired patients. And the good doctors (ie the ones who care enough about the PEOPLE they are treating to stick with the difficult ones despite the work, potential legal/professional risks [and this, my friends, is where the lawsuit economy is screwing us all over], etc.), will be NOT be financially rewarded.

"Pay-for performance is an ESPECIALLY bad and prejudiced idea if applied to patients themselves. Why? Because the most of the people with the money to get decent care, medication, and technology are the people who don't *need* the financial reward that the improved control that is much more achieveable with that c, m, and t that absolutely is not an option for many."

This rant was mainly addressed to proposing a pay-for-performance system for diabetes care practitioners, but it can be applied more generally.

quote:
What do you want to hear, exactly?
I'd like to hear how you would evaluate someone's health. I'd like to hear how rewarding companies for something as arbitrary, chance-based, and unmesurable as the health of their workers could possibly work in practice.
 
Posted by Samprimary (Member # 8561) on :
 
Also demographic based. If you make it easier to employ the healthy, it's just one more hurdle for low-wage workers and offers the potential for discrimination that will be acted upon.
 
Posted by Lyrhawn (Member # 7039) on :
 
Health is unmeasurable? Bull.

I'm not a doctor, but I'm pretty sure that at some point during medical school, doctors learn what "healthy" means for human beings.

If it is your position that a doctor can't tell you when you are and aren't healthy, then we're REALLY at an impasse. But really, since your position seems to be that it's impossible for someone to know if they are healthy or not, I'm extremely curious to hear how you'd solve the healthcare problems in this country.

I assume what is, and isn't healthy, as some sort of national goal or standard would be for the AMA/NIH etc, the professionals to decide.

Doctors know what is, and isn't a healthy level of the "good" and "bad" varieties of cholesterol. Doctors can tell you if you are at risk for, or have, diabetes, congestive heart failure, a pulmonary embolism, hernia, types of cancer, gout, osteoarthritis, back pain, stroke, carpal tunnel, sleep apnea, asthma, depression, and many, many more problems that all have a direct link to obesity.

Is it your claim then, that medical science is arbitrary? That when doctors say "hey, your cholesterol is above such and such, keep it down," that they are just picking arbitrary numbers? Are you aware of the fact that there is an entire profession dedicated to figuring these things out, diagnosing problems, discovering their source, and fixing them? You'll note a healthy degree of sarcasm there, because I don't feel my ideas are being treated fairly, and I think you are misrepresenting them in your attacks.

Doctors know when you are, and aren't healthy. And maybe at the end of the day, it'll come down to a report card from your doctor to know where you stand. You leave me a bit shocked, that you're disputing a lot of what I'm saying, as it's fairly widely accepted medical science.

You seem to be operating under the assumption that my idea is to find all the fat people, and punish them for being fat, and force them to either lose weight at any cost, or suffer the consequences. Is that an accurate assesment of your perception? If it is, where did you come up with it?

Maybe it'll turn out that this one piece of my plan won't work, so be it. I'll fix it and move on. But I know that preventative healthcare, and reducing obesity are two big ways to help Americans live longer, and to trim tens of billions of dollars from our healthcare costs. If you know a better way to do it, I'm all ears. But instead of offering alternative ideas, you're going beyond just attacking my plan and seem to be attacking fundamental medical science itself. This, I get from your scoffing at the idea that health can be evaluated fairly.

When you have more time, I'd like to hear your ideas. And I'd like to hear your specific criticisms of this specific part of my idea. If it is impossible for us to create a national standard of what is healthy, how are we ever going to have a healthy nation? Recognizing the fact that we are all different, there's still a recognized level of where test results should be. If there wasn't, there'd really be no point in ever having tests done in hospitals.

To get to the specifics of your question:

Health isn't immeasurable, and therefore isn't arbitrary, and isn't chance based. It's a science, with thouands of professionals around the country whose job it is, to decide who is, and isn't healthy, and how to turn the latter into the former.

I admit to not having the kinks worked out, hell, I'm not in Congress, and I'm not a medical health professional. Are you? Having a goal is step one, and you leave me flabbergasted when you dispute the aims of my goal. Having a plan is step two, and there's where I'm at. I'm open to suggestions.
 
Posted by MightyCow (Member # 9253) on :
 
An interesting Catch 22 with giving bonuses to the healthy is that the healthy don't need the bonuses. You don't want to reward people for being unhealthy, yet the unhealthy are the ones who need the most help. It makes sense to reward people for healthy behavior, as it would lower overall health costs, but the healthier you are, the less rewarding you need.

On a related topic, I think it would be great if health plans covered diet and exercise programs. I currently jog and use a few weights I have around the house, but if I had an insurance covered gym membership, I'd be able to exercise more often and with greater results, due to the better equipment and professional trainers who could help me. Certainly a much better deal for the insurance company than if I don't exercise, and get type 2 diabetes, joint injuries, and other weight related problems later.
 
Posted by Lyrhawn (Member # 7039) on :
 
Who suggested giving monetary bonuses to healthy individuals?
 
Posted by MightyCow (Member # 9253) on :
 
quote:
Originally posted by Lyrhawn:
Who suggested giving monetary bonuses to healthy individuals?
It's been suggested that healthy people should get a tax cut, or that businesses who hire healthy people should, in order to encourage unhealthy people to lose weight and get in better shape.

My point is that helping people who need less help is rather counter productive.
 
Posted by Lyrhawn (Member # 7039) on :
 
With my plan, the idea was that businesses would work in partnership with employees to make them healthier. In other words, If McDonalds were to take up this idea, and offered coverage of weight loss and/or health plans and gym memberships to their employees, who I think we'd all agree are the people who would need the help, and their workers take advantage of the plan (which the company could offer their own incentives for), and their people become healthier, then the company gets a bonus for it.

This isn't just a plan to cater to the rich, I'd argue that the point is to cover people across the board, regardless of economic standing, but that it's most likely going to benefit the less abled, as these are benefits that would be provided to them that they can't afford themselves. Giving healthy people a tax cut was never suggested by me. Giving businesses a tax cut was a plan to spur partnerships with their employees to improve their overall health.
 
Posted by Sharpie (Member # 482) on :
 
"Doctors know when you are, and aren't healthy. And maybe at the end of the day, it'll come down to a report card from your doctor to know where you stand. You leave me a bit shocked, that you're disputing a lot of what I'm saying, as it's fairly widely accepted medical science."

I don't think it is anywhere near as clearcut as you seem to think it is. In the last two decades, the offical guidelines for whether you should place your infant on his/her back or front to sleep have changed three times. The nutrition pyramid has changed at least once in that time period (and I think it has been twice). Vaccine schedules continue to change. Wine was healthy, then it wasn't, now it is -- unless it changed again while I was in the kitchen.

Yes, we continue to gain knowledge. Yep. But there is a LOT we don't know, and one of those things is: what is causing the obesity epidemic? We have some ideas. More TV time, less "walking to school" time. There's growing evidence that there is at least a link to high fructose corn syrup and other "new" food additives/sweeteners/sources. Genetics are a factor, for sure. Depression -- which you mention -- is a factor... but is it cause or effect? Or is it, as is suspected, more complicated than that?

And all of these causative possibilities have slightly different ethical nuances. Does a person who gains weight purely because of genetic factors have different responsibilities from a guy who just hasn't "gotten into" healthy lifestyle choices? Yes, and no, right? What about the gal who is skinnier partly because of her smoking habit? She eats crappily, but doesn't pay as much of a price. Do her bad habits cancel each other out? Of course not.

The obesity epidemic is a problem. We have to be smart and purposeful about how to solve it. Saying "people have to exercise more and eat less" is true... and nowhere near the whole picture.
 
Posted by Lyrhawn (Member # 7039) on :
 
Good point. Let's just not do anything.

Maybe we'll have it figured out in fifty years. We can solve it then.
 
Posted by mackillian (Member # 586) on :
 
quote:
On a related topic, I think it would be great if health plans covered diet and exercise programs. I currently jog and use a few weights I have around the house, but if I had an insurance covered gym membership, I'd be able to exercise more often and with greater results, due to the better equipment and professional trainers who could help me. Certainly a much better deal for the insurance company than if I don't exercise, and get type 2 diabetes, joint injuries, and other weight related problems later.
Actually, you should check to see if your health insurance policy has a gym reimbursement rider. Some actually do. Most of the plans administered by the company I work for offer gym reimbursement, and one insurance policy I had myself had gym reimbursement as well. Something to look into.
 
Posted by Jhai (Member # 5633) on :
 
quote:
Originally posted by Lyrhawn:
Good point. Let's just not do anything.

Maybe we'll have it figured out in fifty years. We can solve it then.
No one is suggesting that we do nothing. But if you're going to be giving out incentives to get healthy or rewards for being healthy, then you need a clear idea of what is healthy and what is not healthy, and who is to blame for the current situation. Most people think it's wrong to punish the blameless, and also wrong (often to a lesser extent) to give rewards to those who did not really earn them through proactive measures.

If your plan were to pass, I can imagine a lot of people claiming that it's not their fault that they (or their employees) are unhealthy, as well as a lot of shady doctors taking kickbacks to pronouce someone healthy. It's nice to be able to say "let's reward the healthy," just like it's nice to say "let's reward good people." But in the real world, identifying those deserving of a reward or punishment, particularly in the case of the extremely complex and personal issue of health, is not so simple as waving a hand.
 
Posted by Samprimary (Member # 8561) on :
 
I think that looking at this issue in terms of "Our health care is the most expensive because we are the least healthy people in the high income nations" is really only scratching the surface, especially considering that it also manages to muddle cause and effect.

One reason why we have such epidemic health issues is because we have entire socioeconomic tiers which will reliably go without any preventative care and consequently end up with more expensive and chronic issues which turn them into wards of the state and drive increasingly larger numbers to insolvency.

More than half of all bankruptcies in the U.S. are on account of medical issues, and hospitals are starting to only receive 40-50 cents back on every dollar of medical charges they deliver. Uninsured patients routinely get half of their charges lopped off by hospitals after an emergency. Patients who are obviously incapable of paying anything are given charity care. The ensured folks pick up the tab, which raises premiums. More people go uninsured as a result.

Rinse and repeat.

Really, any poor health trends which aren't a fault of the profit-motive system and our lack of universal coverage are merely an unhelpful exacerbation of an already serious issue. We'd be attacking peripheral issues if we only focus on Healthy People Bonus™ ideas.
 
Posted by BaoQingTian (Member # 8775) on :
 
quote:
Originally posted by Jhai:
quote:
Originally posted by Lyrhawn:
Good point. Let's just not do anything.

Maybe we'll have it figured out in fifty years. We can solve it then.
No one is suggesting that we do nothing.
A lot of people are kind of piling on Lyrhawn right now. There's a lot of attacks made on his hastily put together system, without a lot of good alternative solutions being presented. If you're going to tell him why a certain portion of his plan sucks, then at least do him the courtesy of presenting something better. It's much easier to tear down than to build.

P.S. Lyrhawn- I like a lot of things in your plan. I saw it in the other thread, and am still mulling over some things. Don't get to discouraged by all the criticism. If you hadn't put that stuff about the overweight people in there, most of the people probably wouldn't have bothered responding. It's a pretty touchy subject here.
 
Posted by Princess Leah (Member # 6026) on :
 
quote:
But really, since your position seems to be that it's impossible for someone to know if they are healthy or not, I'm extremely curious to hear how you'd solve the healthcare problems in this country.
I was unclear. Obviously there are standards and measurements that can determine whether your cholesterol or blood pressures is high, etc etc. What I mean to say is in the context of setting national standards of health for the workforce, and then rewarding or not rewarding a company based on how many of thier workers meet those standards, any measurement of health is meaningless because of the infinate number of variables. It's unfair to the companies and it's unfair to the people who work there to make their personal lives into something that affects the company's profit. Do you not see how risky that is?

quote:
Doctors know what is, and isn't a healthy level of the "good" and "bad" varieties of cholesterol. Doctors can tell you if you are at risk for, or have, diabetes, congestive heart failure, a pulmonary embolism, hernia, types of cancer, gout, osteoarthritis, back pain, stroke, carpal tunnel, sleep apnea, asthma, depression, and many, many more problems that all have a direct link to obesity.
Right. What are you trying to say here?

quote:
Is it your claim then, that medical science is arbitrary? That when doctors say "hey, your cholesterol is above such and such, keep it down," that they are just picking arbitrary numbers? Are you aware of the fact that there is an entire profession dedicated to figuring these things out, diagnosing problems, discovering their source, and fixing them? You'll note a healthy degree of sarcasm there, because I don't feel my ideas are being treated fairly, and I think you are misrepresenting them in your attacks.
Yes, I'm aware of the fact. Are you aware that fixing problems takes work, money, and effort? Not just willpower. Not just desire. Not just a quick and simple dose of medication. Health isn't simple. You can't just rate a person on a general health scale of 1 to 10, and base rewards on those ratings. A measurment of health is arbitrary because there are so many things that affect it. Depending on which factors you pick to measure it by will put people on different sides of the healthy-unhealthy line.

quote:
Doctors know when you are, and aren't healthy. And maybe at the end of the day, it'll come down to a report card from your doctor to know where you stand.
We're discussing health care reform and you're suggesting another generalized, oversimplified form? Just to satisfy my own curiosity, have you ever had any medical problems? If you're not comfortable answering on the forum, you can email me, and if you're not comfortable answering at all then please don't feel obligated.

quote:
You seem to be operating under the assumption that my idea is to find all the fat people, and punish them for being fat, and force them to either lose weight at any cost, or suffer the consequences. Is that an accurate assesment of your perception?
I'm operating under the assumption that your idea is to find all the workplaces that for one reason or another, some of which are based purely on chance, hire people that are found unhealhty based on some impersonal survey of certain factors, and then punish those workplaces. Since your first post you've made it perfectly clear that you're not trying to target fat people. I understand that. I still think, based on my understanding of what you're proposing, that it's a bad idea.

quote:
When you have more time, I'd like to hear your ideas. And I'd like to hear your specific criticisms of this specific part of my idea. If it is impossible for us to create a national standard of what is healthy, how are we ever going to have a healthy nation?[/QUOTE

We're never going to have a healthy nation. Get over it.

[QUOTERecognizing the fact that we are all different, there's still a recognized level of where test results should be. If there wasn't, there'd really be no point in ever having tests done in hospitals.
And those test values are useful in treating an individual, not basing government funding to companies on.

quote:
To get to the specifics of your question:

Health isn't immeasurable, and therefore isn't arbitrary, and isn't chance based. It's a science, with thouands of professionals around the country whose job it is, to decide who is, and isn't healthy, and how to turn the latter into the former.
Perhaps we're actually in agreement, but getting bogged down in semantics.

Here is how health is measurable: You can test my pancreas function and see that I'm diabetic (Type 1). You can test my cholesterol levels and see that they're fine. You can test my Hemoglobin A1c and see that my average bloodsugar is over the recommended level. Basically, you can take an individual and find what is wrong with them.

Here's where health is not measureable: when you're trying to compare health. My friend is also diabetic (type 1). Her cholesterol is not fine. But her Hemoglobin A1c shows that her bloodsugar levels are excellent. Her BMI shows her to be obese, but she's an internationally known athlete. Who's healthier, her or me? Would we both be labeled "unhealthy" based on your national standards? Probably. Are we? It's hard to say. For diabetics, we're both doing reasonably well. For a "normal" person, we're not doing so hot. What do you do here? How would the system you propose deal with this?


quote:
I admit to not having the kinks worked out, hell, I'm not in Congress, and I'm not a medical health professional. Are you? Having a goal is step one, and you leave me flabbergasted when you dispute the aims of my goal.
I don't think I'm disputing the aims of your goal at all. We absolutely need to have preventative healthy care and we absolutely need to encourage health. I just vehemently disagree with the method you proposed that we've been arguing about forever.

Here's what I think: I think money needs to get out of the picture. I think that the income disparity between surgeons and high-demand specialists, and general practitioners and professionals in non-lucrative specialties needs to dissapear. I think that health insurance coverage needs to be more comprehensive. I think that we need more health care professionals. I think we need to have much more regulation on malpractice suits. I think drug companies should be forced to lower thier prices. I think patients need to be treated as individuals, without doctors and hospitals having to worry about wasting time on cases that won't get them out of the red.

And I admit that I don't know how to make it happen. I have some ideas that I hate because they involve government regulation, and that means more bureaucracy and probably more efforts to standardize things. Which I'm against, as you may have noticed.
 
Posted by pH (Member # 1350) on :
 
quote:
What I mean to say is in the context of setting national standards of health for the workforce, and then rewarding or not rewarding a company based on how many of thier workers meet those standards, any measurement of health is meaningless because of the infinate number of variables. It's unfair to the companies and it's unfair to the people who work there to make their personal lives into something that affects the company's profit.
That's the part that was confusing me. I wasn't sure if Lyr's plan was to reward companies that OFFER gym memberships and such or to reward companies based on the percentage of employees that met X health criteria. If it's the latter, that scares me to death.

-pH
 
Posted by mackillian (Member # 586) on :
 
quote:
ospitals are starting to only receive 40-50 cents back on every dollar of medical charges they deliver
Have you ever seen what a hospital actually charges insurance companies?

Here's an interesting thing. Providers either participate with a health insurance plan or they don't. If they're participating, then they agree to a contacted rate and are paid that contracted rate. They can bill whatever they want, but it's the fee that they agreed to that's given as payment.

Now, if a provider is non-participating and an insurance plan has benefits that will pay for non-participating provider services, then the non-participating provider is paid the UCR (usual and customary rate) for their geographic location. The insured is responsible for the difference.

However, if it's emergency care, then the company will pick up the tab (even if it's out of network and the insured as no out of network benefits, like in an HMO or EPO).

...if you have any questions about how health insurance works, I'll be happy to answer them. I just won't tell you what company I work for. [Wink]

There's a lot going on on both sides. Health insurance is incredibly complicated. The system is very broken. I say this as a person with a chronic illness that requires daily maintenance medication, a person who can never, ever have her insurance have a gap in coverage, a person who has to consider the health insurance plans of jobs, and the first panic at the thought of losing a job is losing healthcare coverage. If I can't pay for my medications, I become a much less productive member of society.

And the current trend of moving away from managed-care networks (HMOs, EPOs, PPOs) and towards HSAs isn't a good trend at all, especially if you have a chronic illness.
 
Posted by pH (Member # 1350) on :
 
quote:
However, if it's emergency care, then the company will pick up the tab (even if it's out of network and the insured as no out of network benefits, like in an HMO or EPO).
You go tell that to my student health insurance. Go!

-pH
 
Posted by BaoQingTian (Member # 8775) on :
 
I think I've hit on why you're having problems your plan. National health care is almost by definition a socialist institution. Your plan is all about personal responsibility. Getting the two to work together is rough.

I think that's why I have such a hard time thinking of a good plan too. I'm all about personal responsibility, but also don't want money to be a barrier to those who need health. I suspect you're the same way.

Flaming Toad on a Stick spelled out a few of my worries about a national health care system. Whenever I try to think about implementation of a national health care plan, I always try to think of a way to avoid the pitfalls of other plans. It's hard though. [Smile]
 
Posted by Sterling (Member # 8096) on :
 
quote:
Originally posted by Lyrhawn:
quote:
Originally posted by Sterling:
Gee, it would be nice if the uninsured didn't end up going to emergency rooms when their conditions become urgent and end up costing ten times as much.
Best way to fix that is to make sure everyone is covered, and to keep a focus on preventative healthcare.
Oh, I quite agree. And a lot of the latter issue (doctors having the same visit time to deal with simple and complex issues) could be dealt with if so many patients were able to see doctors more than once a year or less.

The most significant difficulty I see (well, once you get past the pharma and insurance lobbies, of course) is that some people will always try to game the system. Narcotics seekers, questionable disability claims, and the like. Still, I don't doubt that even with such problems, we could get more out of the system with universal coverage than we do now... Paying more for health care than anyone, and getting less for it.
 
Posted by Lyrhawn (Member # 7039) on :
 
quote:
Originally posted by Samprimary:
Really, any poor health trends which aren't a fault of the profit-motive system and our lack of universal coverage are merely an unhelpful exacerbation of an already serious issue. We'd be attacking peripheral issues if we only focus on Healthy People Bonus™ ideas.
Good thing no one is suggesting we do that then.
 
Posted by mackillian (Member # 586) on :
 
quote:
You go tell that to my student health insurance. Go!
I can't tell 'em, but you can. I can tell you how to tell them.

You gotta speak their language. And I now know their language.
 
Posted by pH (Member # 1350) on :
 
quote:
Originally posted by mackillian:
quote:
You go tell that to my student health insurance. Go!
I can't tell 'em, but you can. I can tell you how to tell them.

You gotta speak their language. And I now know their language.
They don't listen! They send forms! I DON'T UNDERSTAND FORMS! And then they send the forms AFTER they say oh, too late for you to send in the forms now.

And I WENT TO THE ER. I don't understand why they're even asking for a referral form. If I could have gotten a referral at the time, I probably wouldn't have gone to the emergency room. GAH!

-pH
 
Posted by mackillian (Member # 586) on :
 
IM me [Razz]
 
Posted by Lyrhawn (Member # 7039) on :
 
BQT -

Thanks [Smile]

Leah -

I'm going to answer your post as honestly as I can, and then at the end, I'm done discussing the tax incentive part of the plan. At this point I'm willing to kill it entirely, because I think the other parts of my plan are more important really. It was really just a random idea that I tossed into the mix, but I'm very, very stubborn by nature. [Smile] Anyway, the goal I'm shooting for is personal responsibility, preventative care, and ending obesity related illnesses, for this SPECIFIC part of the plan, and this is the first thing that jumped to mind as a possibility. I'm open to any and all alternatives. With that in mind, and almost just for fun:

quote:
I was unclear. Obviously there are standards and measurements that can determine whether your cholesterol or blood pressures is high, etc etc. What I mean to say is in the context of setting national standards of health for the workforce, and then rewarding or not rewarding a company based on how many of thier workers meet those standards, any measurement of health is meaningless because of the infinate number of variables. It's unfair to the companies and it's unfair to the people who work there to make their personal lives into something that affects the company's profit. Do you not see how risky that is?
So we change it to make it work. Base the system on individual improvement, and not a national standard, or a combination of the two. Some things work pretty much across the board, such as cholesterol levels, others are person specific. So you check someone's health every year, if they got better, there you go. No comparisons to other people, and really, people NEED to be getting yearly checkups, too many people (especially us stubborn men) don't, and problems result. If they have to go anyway, and their doctor will know them better than anyone else's, that doctor is the best peson to make that judgement call. Keeping in mind that some things are incurable, and that you can't really control them, there'd have to be some give on what you can do to change your own health, and those will be the factors. People wouldn't be punished for things beyond their control.

I think there is potential for risk there, but I'd like to fully explore the problems, and see if a fix can be made before just dismissing an idea. The tax break isn't going to be millions upon millions of dollars. The point isn't to give a windfall of money to companies, it's to encourage, and help offset the cost of, companies offering extra benefits to their workers, and encouraging them to lead healthy lifestyles. If they CAN'T, then there's no backlash. No one is going to get fired. Safeguards can be put in place to make sure of that.

quote:
Right. What are you trying to say here?
My point, was that doctors can tell you when your weight is a major cause of your health problems, what you are at risk for, and what you already have, and how reducing your weight can either eliminate or decrease the likelihood of getting, these problems. That was in response to some of your earlier statements about the arbitrariness of the whole thing, and what looked like you disputing the drive to end obesity in general.

quote:
Yes, I'm aware of the fact. Are you aware that fixing problems takes work, money, and effort? Not just willpower. Not just desire. Not just a quick and simple dose of medication. Health isn't simple. You can't just rate a person on a general health scale of 1 to 10, and base rewards on those ratings. A measurment of health is arbitrary because there are so many things that affect it. Depending on which factors you pick to measure it by will put people on different sides of the healthy-unhealthy line.
This paragraph makes me thing you haven't REALLY read the rest of what I've said. The focus of this part of the plan is entirely on a combination of personal effort, government encouragement and private companies to spend money, time and effort to try and solve the problem without government stepping in to say "Hey, you're fat, fix it or suffer the consequences." I'm going to take your comment as sarcasm and move on.

quote:
We're discussing health care reform and you're suggesting another generalized, oversimplified form? Just to satisfy my own curiosity, have you ever had any medical problems? If you're not comfortable answering on the forum, you can email me, and if you're not comfortable answering at all then please don't feel obligated.
I was being flippant. But just for the sake of curiousity, if your doctor doesn't know how to make you healthier, and he/she is unable to tell you when you've become more or less healthy, then how do you ever hope to keep yourself healthy?

I have asthma, and when I was younger (haven't heard anything about it since) I had a heart murmur.

quote:
I'm operating under the assumption that your idea is to find all the workplaces that for one reason or another, some of which are based purely on chance, hire people that are found unhealhty based on some impersonal survey of certain factors, and then punish those workplaces. Since your first post you've made it perfectly clear that you're not trying to target fat people. I understand that. I still think, based on my understanding of what you're proposing, that it's a bad idea.
Yeah, I'd call that a mischaracterization of the plan being discussed, which is why this post will be my last response to it.

quote:
And those test values are useful in treating an individual, not basing government funding to companies on.
The two don't automatically cancel each other out. So you're againt any sort of national healthcare in general?

quote:
Here's what I think: I think money needs to get out of the picture. I think that the income disparity between surgeons and high-demand specialists, and general practitioners and professionals in non-lucrative specialties needs to dissapear. I think that health insurance coverage needs to be more comprehensive. I think that we need more health care professionals. I think we need to have much more regulation on malpractice suits. I think drug companies should be forced to lower thier prices. I think patients need to be treated as individuals, without doctors and hospitals having to worry about wasting time on cases that won't get them out of the red.

And I admit that I don't know how to make it happen. I have some ideas that I hate because they involve government regulation, and that means more bureaucracy and probably more efforts to standardize things. Which I'm against, as you may have noticed.
From what you've said there, it looks like we agree on pretty much everything. But I'd still like to hear your ideas.
 
Posted by MightyCow (Member # 9253) on :
 
I think one thing that would fix a lot of problems is if insurance companies weren't allowed to refuse coverage to "pre-existing conditions." That seems like such a horrible way to work the system. Why is it that a new company is required to cover you, as long as you have insurance covering your condition, but if you ever lose the insurance, a new company can refuse to cover your condition?

To me, it just looks like a loophole made to allow health insurance companies a way to deny expensive patients. Sure, they're a business, they don't want to cover an expensive patient, but those patients are the ones who need the insurance the most.

In fact, I think that's the crux of the problem with private insurance companies. It is in the companies' best interests to try to help its customers as little as possible, try to make its service as complex and difficult to use as possible, and try to serve only the customers who need the least amount of help.

The system needs to be changed so that health insurance companies have a strong financial incentive to make their service BETTER, help patients MORE, and work with patients, instead of against them.

I want my insurance company to call me up and ask how they can help me fill my claim, rather than forcing me to call them begging them to pay even some of it.
 
Posted by pH (Member # 1350) on :
 
You don't think the problem would be exactly the same with public healthcare as well? In terms of trying to get by spending the least amount of money possible, I mean.

-pH
 
Posted by Lyrhawn (Member # 7039) on :
 
I think it'd be a little different at the very least. They have different aims.

Private insurance companies are trying to get money, and answer to shareholders.

Public insurance would be trying to keep people healthy, realizing that keeping everyone healthy as best as possible is what lowers the cost of healthcare. And they answer to the public at large.

Private companies don't need to worry about keeping EVERYONE healthy, they don't care if another company has healthy people being covered or not, it's all competitive. There's a different focus I believe. I think a public, national healthcare system (with the option for better private care, whatever that might be), would in the long run end up much cheaper than a hundred different private companies.
 
Posted by pH (Member # 1350) on :
 
They also answer to the public at large concerning how much they spend, though.

-pH
 
Posted by Tresopax (Member # 1063) on :
 
I think one issue largely ignored in the health care debate is the negative effect that a employer-based system has on innovation in general in our country. Employer-based health care places a double-whammy on entrepreneurs who want to go out on their own, or operate independently. For one thing, it would mean losing the health care benefits of being a part of a larger company, and needing to provide your own health care. For another thing, it typically means going through the expense of setting up a health care plan for any employees you may want to hire. End result: people are less likely to develop new enterprises, and more likely to stick with established organizations. I think this is one of the hidden benefits of universal health care - if we can detach health care from employment, it will promote innovation as a whole across the economy. Small business owners will be freed of a significant cost that could prevent them from getting of the ground to start out with.
 
Posted by scholar (Member # 9232) on :
 
On the preexisting coverage, insurances making things difficult issue, I have had the same insurance for almost 2 years now. Right now, they are being throwing a fit about paying for my drs bill because it is a "preexisting condition". My condition- pregnancy. Apparantly, I am now an elephant.
 
Posted by twinky (Member # 693) on :
 
I noticed something back on page one that went unchallenged, and I think it needs to be addressed:
quote:
Originally posted by Jhai:
While the US spends more on health care than other nations, it seems that most of this extra cost is due to our poor general health (lack of exercise & diet). The US health care system is more productive than nationalized systems in getting us well - that is, better output of health given the cost.
There's some evidence to suggest that this may not actually be the case.
quote:
Now an article published in the Journal of the American Medical Association casts that assumption into doubt. Comparing the health of middle aged Americans and their counterparts in England, the authors make the startling discovery that across the board, the Americans are less healthy. It's a sad fact that minorities have worse health outcomes than non-hispanic whites, so the study only looks at that population group, but despite this the English still come out on top.

Worse yet, these findings held true regardless of socioeconomic status or education level. Poorer English patients might be expected to have better health than their US counterparts due to their National Health Service, but well-off Americans only fared as well as working class English. The differences can't easily be explained away by risk factors either, which are broadly similar between the two nations.

I must admit I'm a little fazed by this study myself. Not so much at the lower end of the socioeconomic ladder, where the NHS would be expected to help out, but the findings that the richest portions of society in the US are worse off despite the almost limitless medical technology and facilities at their disposal is quite shocking.
Added: Also, my employer subsidizes gym memberships as a taxable benefit for up to CDN$400 annually, which basically covers my YMCA membership. I've noticed this kind of thing in my industry before (I'm a fairly recent chemical engineering graduate, but have a variety of internship experience), and think it's a very positive way to promote employee health.
 
Posted by Lyrhawn (Member # 7039) on :
 
Twinky -

I'm confused. Doesn't your second quote back up the first one?

pH -

Yeah, that's true, but you can't ignore the other benefits, they are tied to cost. If it's cheaper in the end, the people have less to complain about.
 
Posted by TheHumanTarget (Member # 7129) on :
 
I thought that you couldn't be denied medical coverage under an employers benefits for pre-existing conditions (because of HIPPA laws). I know that there are usually waiting periods before certain coverages begin, but I've never heard of anyone being outright denied.

quote:
There needs to be a cap on punitive damages. People makes mistakes. I know those mistakes hurt real people, but there's a ripple effect. A doctor in a difficult surgery does the best he can, but the patient still comes out a quadriplegic. In response, the family sues the doctor for millions of dollars. His insurnace, and the hospital insurance pay for the suit, but his premium is jacked up so high that he can no longer afford to practice medicine. The end result is that his collective knowledge is lost from the medical profession.
Spoken like someone who's never been involved in a serious medical malpractice situation. A cap would do more damage than good. A better solution (which is gaining ground in many states) is to have patients sign an agreement indicating that in the event of something happening, a mediator (paid for by the state, I believe) will attempt to reach a reconciliation prior to any lawyers being involved. This allows both parties to reach an equitable arrangement without bogging down courts.
 
Posted by Lyrhawn (Member # 7039) on :
 
I used to work for people that did this sort of thing for a living.

You can still be awarded the money necessary to pay for any damages done to you, separate from punitive damage. Punitive damage, which includes pain and suffering, shouldn't be millions upon millions of dollars. I've seen some pretty ridiculous cases over the years.
 
Posted by TheHumanTarget (Member # 7129) on :
 
quote:
Punitive damage, which includes pain and suffering, shouldn't be millions upon millions of dollars.
I disagree. Punitive damages should absolutely be whatever the court feels like awarding, especially in situations where gross negligence or incompetence is involved. I still prefer the mediator method of resolving these kinds of issues, but in situations where it cannot be settled amicably, then it's up the courts.

quote:
I used to work for people that did this sort of thing for a living.
Trust me when I tell you that things look entirely different when you're actually involved.
 
Posted by twinky (Member # 693) on :
 
quote:
Originally posted by Lyrhawn:
Doesn't your second quote back up the first one?
Only if the "starting" level of health is so staggeringly low that there is actually some proportionality between the differences in health outcomes and expenditures. You would expect such a difference in pre-treatment health to show up in the risk factors, but my snippet above notes that they're "broadly similar." As an example, say the risk of an American having a heart attack is comparable to that of a Brit having one (I don't know if this is the case, but it's the sort of thing I would expect to be covered by "broadly similar" risk factors); what the study suggests in such a context would be that after treatment, American heart attack victims have worse health outcomes despite the fact that more money is being spent on them, per capita, than on the Brits. Since they had the same risk of having a heart attack in the first place, this can't simply be attributed to the American having been less healthy to start with.

Obviously that's a completely hypothetical example; I'm just using it to help make my point clear. The basic sentiment I'm suggesting has gone unchallenged is that the vast sums of money spent in the U.S. health care system buy Americans better care -- that is, that the average may be low, but the peaks are high. The study described in my snippet above suggests that this is not the case.

In terms of expenditures, here's some OECD data to chew on. Check out the linked Excel spreadsheet, there's lots of useful and interesting data there. I've compiled two datasets from 2004 here, health care expenditures as a % of GDP and health care expenditures per capita, in USD:
code:
2004	        % GDP	Per Capita	
Australia	9.6	3120	
Austria	        9.6	3124	
Canada	        9.9	3165	e
Czech Republic	7.3	1361	e
Denmark	        8.9	2881	e
Finland	        7.5	2235	
France	        10.5	3159	e
Germany	        10.6	3043	
Greece	        10	2162	e
Hungary	        8	1276	
Iceland	        10.2	3331	e
Ireland	        7.1	2596	
Italy	        8.7	2467	
Korea	        5.6	1149	
Luxembourg	8	5089	e
Mexico	        6.5	662	
Netherlands	9.2	3041	e
New Zealand	8.4	2083	
Norway	        9.7	3966	
Poland	        6.5	805	
Portugal	10.1	1824	e
Spain	        8.1	2094	e
Sweden	        9.1	2825	e
Switzerland	11.6	4077	e
Turkey	        7.7	580	
United Kingdom	8.1	2508	d
United States	15.3	6102	


e: Estimate
d: Differences in methodology
The extent of the "differences in methodology" isn't clear, though, so we have to take the U.K. figures with a grain of salt. However, the U.S. tops the list in both per capita and % GDP expenditures. Again from my first link above:
quote:
The US currently:
Historically, this sort of thing has been addressed by noting the high number of uninsured Americans, or by suggesting (as Jhai did) that Americans are less healthy to start with. But the study in my first link controlled for these things, and still found that even wealthy Americans fared no better than working-class British.

This suggests strongly, to me at least, that something is wrong with your system.

However, all of this is not to say that our system here in Canada is without problems, nor that the U.K. system is the embodiment of perfection.
 
Posted by Samprimary (Member # 8561) on :
 
quote:
This suggests strongly, to me at least, that something is wrong with your system.

However, all of this is not to say that our system here in Canada is without problems, nor that the U.K. system is the embodiment of perfection.
If anything's wrong with our system, it's the 'moral hazard myth.'

quote:
Americans spend $5,267 per capita on health care every year, almost two and half times the industrialized world's median of $2,193; the extra spending comes to hundreds of billions of dollars a year. What does that extra spending buy us? Americans have fewer doctors per capita than most Western countries. We go to the doctor less than people in other Western countries. We get admitted to the hospital less frequently than people in other Western countries. We are less satisfied with our health care than our counterparts in other countries. American life expectancy is lower than the Western average. Childhood-immunization rates in the United States are lower than average. Infant-mortality rates are in the nineteenth percentile of industrialized nations. Doctors here perform more high-end medical procedures, such as coronary angioplasties, than in other countries, but most of the wealthier Western countries have more CT scanners than the United States does, and Switzerland, Japan, Austria, and Finland all have more MRI machines per capita. Nor is our system more efficient. The United States spends more than a thousand dollars per capita per year—or close to four hundred billion dollars—on health-care-related paperwork and administration, whereas Canada, for example, spends only about three hundred dollars per capita. And, of course, every other country in the industrialized world insures all its citizens; despite those extra hundreds of billions of dollars we spend each year, we leave forty-five million people without any insurance. A country that displays an almost ruthless commitment to efficiency and performance in every aspect of its economy—a country that switched to Japanese cars the moment they were more reliable, and to Chinese T-shirts the moment they were five cents cheaper—has loyally stuck with a health-care system that leaves its citizenry pulling out their teeth with pliers.
Moral hazards and profit motives. I could open up a diabetic preventative care center in Boston, to coach and treat people diagnosed with diabetes so that they could manage their condition and not end up with costly, reactive surgeries.

Of course, insurance would not pay for this sort of preventative care, so I'd simply go out of business. But if I got into the business of lopping off the limbs of all the untreated diabetics in America that we consequently have, I'd be making money hand over foot.

Our system has bad prioritization that leaves us stuck playing catch-up with poorer nations. We have an infant mortality rate higher than some developing nations. It's no good.
 
Posted by ClaudiaTherese (Member # 923) on :
 
Great article, Samprimary.
 
Posted by Lyrhawn (Member # 7039) on :
 
quote:
Originally posted by TheHumanTarget:
quote:
Punitive damage, which includes pain and suffering, shouldn't be millions upon millions of dollars.
I disagree. Punitive damages should absolutely be whatever the court feels like awarding, especially in situations where gross negligence or incompetence is involved. I still prefer the mediator method of resolving these kinds of issues, but in situations where it cannot be settled amicably, then it's up the courts.

quote:
I used to work for people that did this sort of thing for a living.
Trust me when I tell you that things look entirely different when you're actually involved.
People shouldn't get rich off accidents. I've seen some RIDICULOUS cases where people won millions and millions of dollars, over and above what they got for medical care, etc, stuff they would need to live their life with the impairment.

If there's negligence or incompetence, I have less of a problem with it, but if it was literally an accident, or if it just didn't go as planned, and nothing was done wrong by the doctor and the results still weren't as planned, those aren't a reason to sue for millions.

It doesn't just go for malpractice suits, which are always the largest. At least one dog bite case would come in a week. Some kid, or adult, would get bit by a dog, and regardless of the damage done, they'd sue. Now if the kid has some major damage of some sort, alright, compensation is due. But even if the bite just broke the skin a little bit, parents still sue for forty or fifty grand, and usually they get it.

I got bit by a dog when I was about 12 and I was on my paper route. It broke the skin, I went to the hospital, I got my tetanus updated, and I went home. I found out a couple years later at my job that I probably could have gotten fifteen or twenty grand for suing the guy's homeowners insurance. Does anyone really think that's fair?
 
Posted by Mrs.M (Member # 2943) on :
 
quote:
Infant-mortality rates are in the nineteenth percentile of industrialized nations.
This means absolutely nothing. Every industrialized country has a different way of counting infant mortality. In some of those countries, a stillborn baby that is less than 38 weeks gestation is counted as a miscarriage. In other countries, it's not an infant death unless the infant has taken a certain amount of breaths. This is a misleading statistic that is thrown around and it drives me crazy.

Additionally, the US has a huge number of women who use fertility treatments and the number of pregnancy complications among them is high. This has nothing to do with poor health care or insurance. Also, maternal age is rising and I'm sure that is a factor, though I can't speculate as to the degree.

I also want to add that every single preemie born in this country is covered by Medicaid. They'll even take over if your insurance tops out, which it frequently does with micropreemies. We have the most amazing neonatal technological advances and every year it gets better and better. All of the neonatologists and neonatal nurses I've ever spoken to are confident that we're very close to having 20-weekers survive in the near future (we're at about 22-weekers now).

quote:
Trust me when I tell you that things look entirely different when you're actually involved.
I have been involved and they don't look different to me at all.

75% of all OB/Gyns are sued. 75%! I very much doubt that 3/4ths of all OB/Gyns are guilty of gross negligence or malpractice. Even an unsuccessful lawsuit can raise insurance premiums and those costs are passed onto the patients. Not only that, but lawsuits have changed the way that medicine is practiced. Due to a wave of lawsuits in the late 80s or early 90s (I always forget), medical students are now taught, "When in doubt, do a C-Section." The suits alleged that doctors waited too long to do Sections, thereby causing complications and harm to the babies.

Lastly, I also think that requiring employers to provide insurance hurts both the employers and the employees. Dagonee summed it up beautifully in another thread, but I'm just too tired to look it up.
 
Posted by Sterling (Member # 8096) on :
 
quote:
Originally posted by Samprimary:
Of course, insurance would not pay for this sort of preventative care, so I'd simply go out of business. But if I got into the business of lopping off the limbs of all the untreated diabetics in America that we consequently have, I'd be making money hand over foot.
Don't hear a lot of free market economists admitting the "Invisible Hand" may be bearing a bone saw, do you... [Angst]
 
Posted by El JT de Spang (Member # 7742) on :
 
quote:
This suggests strongly, to me at least, that something is wrong with your system.
I wonder what the other possible explanations could be. The one that jumps out at me is lifestyle differences.
 
Posted by twinky (Member # 693) on :
 
quote:
Originally posted by El JT de Spang:
quote:
This suggests strongly, to me at least, that something is wrong with your system.
I wonder what the other possible explanations could be. The one that jumps out at me is lifestyle differences.
Again, these were controlled for. As I've already noted, medically significant lifestyle differences would show up in risk factors.
 
Posted by El JT de Spang (Member # 7742) on :
 
That's not entirely true. From the AMA summary:
quote:
This conclusion is generally robust to control for a standard set of behavioral risk factors, including smoking, overweight, obesity, and alcohol drinking...
Those are great, but I was specifically thinking about stress as a risk factor, which, as far as I can see wasn't controlled for. I'm not sure there is a reliable way to control for it. I read something years ago correlating workweek length and lifespan in first world nations, and it's been percolating ever since. I don't think that that is a primary or even secondary cause of our general poor health, but I wonder what effect our being a 'high octane' society does have.

Are Americans significantly more stressed than, say, Brits or Canadians? I have no idea. But I think it's possible.

The other risk factor that I didn't see controlled for is diet*. I think, no, I know, that Americans eat a lot more junk food and fast food than almost every other nation. That's not something that will be fully represented by the risk factor assessment, because (I'd guess) a substantial percentage of those who eat fast food regularly are not obese.

*Obesity was controlled for, but I'm mainly concerned about the skinny people who aren't as healthy as they appear. I'd guess America has more of that demo than anywhere else.
 
Posted by twinky (Member # 693) on :
 
I'm not sure you're considering that the British diet consists primarily of fish and chips. And beer. [Wink]

I'm extremely skeptical that differences of this magnitude can be explained away by "lifestyle differences." We're talking almost 50% more in expenditures as a percentage of GDP than the next largest spender. Surely Americans aren't 50% less healthy in ways that can't be controlled for.
 
Posted by El JT de Spang (Member # 7742) on :
 
I am considering that. I don't think we fully realize what the various food additives in processed foods do to our bodies yet.
quote:
I'm extremely skeptical that differences of this magnitude can be explained away by "lifestyle differences." We're talking almost 50% more in expenditures as a percentage of GDP than the next largest spender. Surely Americans aren't 50% less healthy in ways that can't be controlled for.
As well you should be. I didn't say that the entire difference could be explained by the other variables I brought up, because I don't think it could be. But I wonder if there aren't serious contributing factors beyond America's shoddy healthcare system; factors that were outside the bounds of those studies. And I wonder what percentage, if any, those outside factors account for.

I'm just following the direction of the thread title and ruminating.
 
Posted by twinky (Member # 693) on :
 
Ah, okay. I took your phrasing to imply that you were looking for alternative explanations to use in place of "something is wrong with the healthcare system," rather than in addition to it.
 
Posted by El JT de Spang (Member # 7742) on :
 
Oh. I didn't even touch on the healthcare system because I take it as a given that it's screwed up beyond repair. So, yeah, in addition to that.
 
Posted by BaoQingTian (Member # 8775) on :
 
El JT is on the right track. Fixing America's healthcare system would only do so much if other contributing factors are not fully considered. On the contrary, considering those factors would probably yield a better healthcare system with more emphasis and spending in smarter areas.

A tradeoff with national healthcare that I think people fail to consider is the varying amounts of freedom they would lose, depending on the nature of the system.

Economic freedom is one. Also, you may have the government influcing everything from your exercise habits to the foods you eat. By placing the burden of your health on society, you become subject to society's rules regarding your health.

It does need to be fixed, but it needs to be considered in far greater depth than I usually see it done. Heck, I've spent about 8 hours in the last few days researching a computer I'm building, trying to get the best gaming system for under $1000. Most people I discuss healthcare with haven't done much beyond read a Time magazine article, and this is for a multi-billion dollar system that would effect 1/3 of a million people.
 
Posted by Lyrhawn (Member # 7039) on :
 
quote:
Originally posted by BaoQingTian:
A tradeoff with national healthcare that I think people fail to consider is the varying amounts of freedom they would lose, depending on the nature of the system.

Economic freedom is one. Also, you may have the government influcing everything from your exercise habits to the foods you eat. By placing the burden of your health on society, you become subject to society's rules regarding your health.
I don't automatically agree, mostly because I don't think national healthcare will ever been the ONLY choice. There will always be private companies that offer a different kind of, or better service, with different rules, and you'll always have the choice to use them instead.

As far as exercise habits and foods you eat, you'll always have personal choice when it comes to those. If you make a poor choice and have to pay for it, monetarily or when you die from making those poor choices, that's your choice. The amount of exercise and good food needed to be healthy is different for everyone, so there'll never be more than federal guidelines for how much you need. We're not Soviet Russia.
 
Posted by Samprimary (Member # 8561) on :
 
quote:
I didn't say that the entire difference could be explained by the other variables I brought up, because I don't think it could be. But I wonder if there aren't serious contributing factors beyond America's shoddy healthcare system; factors that were outside the bounds of those studies.
Well, if you cut out what health issues are the product of a lack of preventative care, you get left with stuff like obesity and smoking and other clear and macro health issues.

We got examples of nations with greater obesity than the U.S. -- we also have a couple of very westernized, postindustrial gems with health habits which border on being worse than the United States -- the UK and Australia.

I'll go and see what comparable and contrastable data exists, see if I can't evidence anything for or against your claim.
 
Posted by BaoQingTian (Member # 8775) on :
 
Are you saying that in your plan people would have an option whether or not to 'pay into' national healthcare? Because if not, then you'll pay for national healthcare as well as private if you want that.

In regards to the second paragraph, there is a current sin tax on cigarettes. We're still free to use them, however, there is ~50% tax against them. There is data that shows that this tax is responsible for decreasing smoking.

Remember the fast-food tax thread awhile back? I don't think it's too far of a leap to think of the government levying extra taxes against junk food/fast food in order to partially recoup associated healthcare costs. In the case of cigarettes, the tax collected offsets something like 10% of the associated healthcare costs. It would make sense to either drastically raise prices on cigarettes to make the offset closer to tax collected.

If the price is increased to make the products reflect their true cost to healthcare, then they'd probably be unaffordable. And in reality, that's about as bad as making it illegal.
 
Posted by Lyrhawn (Member # 7039) on :
 
You already pay into national healthcare and for private, ever see the medicare tax on your paystub?

You still have the choice to use them. Sin taxes aren't new, and I don't think they are unfair. Smoking is bad for you, and it's bad for people around you, and the financial and physical well being of the nation. You have the choice to do it if you want, but if you do, you have to pay a lot for it, and you suffer the ill health consequences. That's exactly what I said.
 
Posted by Samprimary (Member # 8561) on :
 
The comparable data shows minimal comparisons to the American system's particular weaknesses. Australia has an issue with getting modern healthcare over amazingly rural areas, but they've got nothing compared to the non-universalized healthcare woes of this country.

There's an interesting thing that actually happened to me after I made this thread, and I didn't really want to bring it up before now. I was driving home from out of town when I was struck with chest pains which were so terrible that I could not breathe right or drive, and I ended up managing to pull up beside a policeman and ask for a ride to the hospital.

Once there, they ran a battery of tests on me, including a "less than stellar" EKG, followed by chest X-ray and blood checks and the whole gamut, to rule out any immediate health concerns. They found a heavy dose of enzymes in my blood corresponding to heart tissue damage, but eventually ruled out any heart issues (the first EKG had been an echo misprint, or something) -- at least I managed to worry them for a while!

After spending a night in excruciating pain (they got a urine sample to make sure that I wasn't a drug addict on a hideous crash) I ended up transferred to my PCP, who found out on subsequent days in subsequent visits that I had 1. GERD, 2. Ridiculously bad GERD, and 3. IBS. I'm now on an intense regimen to restore a malfunctioning, acid-burned stomach valve which I have apparently been blessed with via genetics.

Three perscriptions, three PCP visits, one ambulance trip, one night in the ER. Total cost for me was $85, all co-pay. I'm insured by my family. If I had not been insured by my family, I would not be insured. If I was not insured, then I would quite objectively have been financially wrecked by this, at least to the extent of having to quit college.

Colors my view of the subject matter a bit, methinks. Oh, by the way, GERD hurts so bad. So, so bad.

[ November 23, 2006, 03:37 AM: Message edited by: Samprimary ]
 
Posted by pH (Member # 1350) on :
 
quote:
Originally posted by BaoQingTian:
A tradeoff with national healthcare that I think people fail to consider is the varying amounts of freedom they would lose, depending on the nature of the system.

Economic freedom is one. Also, you may have the government influcing everything from your exercise habits to the foods you eat. By placing the burden of your health on society, you become subject to society's rules regarding your health.
I really, really worry about this, BQT.

-pH
 
Posted by Lyrhawn (Member # 7039) on :
 
I'm not entirely convinced that's a bad thing, to varying degrees.

It's a curious thing to defend the right of the individual to put a harmful burden on society, but to attack any measure of responsibility or burden that society might try and place back on the individual to balance the equation.

Making poor choices about your health often adds a negative burden to society, regardless of what insurance you have. Everyone still foots the bill.
 
Posted by rivka (Member # 4859) on :
 
So you won't mind the new soylent green diet?

Excellent. You can have my share. [Razz]
 
Posted by AvidReader (Member # 6007) on :
 
"Making poor choices about your health often adds a negative burden to society, regardless of what insurance you have."

I'm with you, Lyr. One of my big complaints with accross the board national coverage is the number of people who treat their bodies terribly and then go to the doctor for a magic pill. People eating McDonald's twice a day. People staying stressed all the time. People getting antibiotics for the flu cause they don't want to take a day off. My 300 some odd pound friend who smokes, won't eat a vegetable, and won't exercise is going to end up with diabetes or a heart attack.

I like the idea of refunding the health departments to be primary care providers for the poor. They used to do it. I'm sure they could do it again. (They also offer free and low cost child vaccines, so our low vaccine numbers should have nothing to do with cost. It might still be related to the perceived autism link.)

I like the idea of coverage for people who have things go catastrophically wrong. I watched a show on TLC about a girl born with Treacher-Collins Plus who basically had no face. I have no problem with my tax dollars going to help build her one. I don't remember how many millions of dollars they said she had required by age two, but she was only about 5% done. No one can plan for that.

I remember it really hitting me on Little People, Big World when Matt mentioned he, his wife, and their son Zach couldn't get insurance because they're little. It's pre-existing, and all their surgeries have to be paid for out of pocket. That's not right.

Those are the kinds of things we as a nation should provide. Not so every hypochondriac with the sniffles can take a pill and ignore the stresses they put on their bodies.
 
Posted by mackillian (Member # 586) on :
 
A lot of folks can't plan for chronic illnesses, either.
 
Posted by BaoQingTian (Member # 8775) on :
 
quote:
Originally posted by Lyrhawn:
I'm not entirely convinced that's a bad thing, to varying degrees.

It's a curious thing to defend the right of the individual to put a harmful burden on society, but to attack any measure of responsibility or burden that society might try and place back on the individual to balance the equation.

Making poor choices about your health often adds a negative burden to society, regardless of what insurance you have. Everyone still foots the bill.
I hope you don't think I'm defending the right of the individual to put the burden on society. That's not my point at all.

My point is simply that if we want a national healthcare program, we better be prepared to give up some freedoms for it. If you've considered it, and don't think it's a bad thing, fine. I just think a lot of people don't think about it that way.

I'm really not too keen on paying for someone's bypass surgery cause they loved those big macs, or paying for cancer treatments for those who smoked their whole lives. A lot of the same people that really push for national healthcare would cry bloody murder if you made their big mac cost $9.
 
Posted by pH (Member # 1350) on :
 
quote:
Originally posted by mackillian:
A lot of folks can't plan for chronic illnesses, either.
Or mental illnesses. I mean, I can see so much potential for abuse. The state-run mental facilities are bad enough already though. People get lost in the shuffle a lot. I'd be really, REALLY uncomfortable with the government having ANYTHING to do with my care.

-pH
 
Posted by mackillian (Member # 586) on :
 
I think chronic illness also has the component of making sure to always, always, always be covered by health insurance. No gaps in coverage ever or you're screwed. At least with government insurance, that problem would be alleviated.
 
Posted by AvidReader (Member # 6007) on :
 
I wouldn't consider chronic illness to be a poor choice. It's one of those things that just happens. You can't plan for it, why should we as a society mind picking up the tab?
 


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