Why not Universal Healthcare?

[basite]

Hey Dean, Good to see ya.

When my wife had our baby, the hospital billed the insurance company over $98,000. The insurance company paid them $17,000. We ended up paying a little over $5,000. Then we got reimbursed for about $3000 of it. The system is a little strange fo sure.

There went my upgrades

Without insurance, GM would've been on the hook for the entire $98,000 bill. His insurance company paid only $17,000 which was accepted by the health care providers. GM had to pitch in $5,000, some of which was reimbursed to him. Therefore, with health insurance the cost was approximately $20,000. Without health insurance the cost would've been $98,000, i.e., the full amount of the bill. The amount of the bill doesn't change, but the amount the health care provider will accept from a health insurance company is much lower than the actual bill. What was the true cost of the service provided to GM? If you go through the itemized bill, you'll probably find something like a $6 charge for a single Tylenol.

You paid WHAT?
GM, If I might ask you, could you give us an idea of how much you pay for your insurance, monthly, or annual?


Here in belgium (yes, we have healthcare organized by the government, and a pretty good system, I do have to mention that)

well, If you were to have your baby here in Belgium, it'd be free. only thing you would have to pay is if you used your phone in the room, and extra drinks you order apart from the ones you already get (except water - that's always free), or when you insist on having a bigger, more comfortable, maybe a single-bed room.
and on top of that, the mother gets a paid 'parental furlough', and this for a couple of months, and the father gets a paternity leave, for a shorter period, also paid.

If I were to visit a doctor, I'd pay him like, 20 or 25 euro's, but the health insurance refunds most of it, so eventually, I end up paying 2 euro's. Pretty much every medication is refunded to a certain percentage of the original cost (pretty much most of it).

basically every necessary surgery, or visit to the hospital is refunded, and costs us basically nothing. Plastic surgery is almost never refunded, because, let's be honest, even though your your nose can be pretty big, and your breasts might be too small, and that little bit of fat that disturbes you, won't actually kill you.

ok, no, not all this comes free.
here's what my dad, for example pays for himself, my brother and me (parents divorced)

€6 a month for each kid, which makes €12 a month for hospitalization insurance, he has this insurance sponsored by his employer, so he gets it for free.
a small amount (a couple of euro's I don't exactly know how much, but really, it's not much.) for the health insurance, also organized by the government.

and every working citizen here in belgium pays a percentage of taxes on his monthly loan, The government uses this money to pay the pensions for the retired, benefits for the workless and disabled, and the health bills (hospitals are also government sponsored here)

But, and this is a major concern:
As dean martin pointed out, what's the actual cost of the service provided to GM?
Indeed, much less (and very very much less) than that $98.000 bill. Most of it is pure profit, profit to such degree that those who demand such sums of money should be ashamed to ask it.

Universal healthcare is a must, not just in the USA (even though you're basically the only 'rich western country' that doesn't supply it to it's citizens), but everywhere in this world.
but maybe you should start by pointing towards the doctors, specialists, as well as the insurance companies. If they'd ask reasonable fees, you'd be better of already.

Keep them spinning,
Bert.

[kexodusc]

I
I’d be very interested in hearing opinions from someone who's lived with both systems (Kex?).

What do you want to know? I've made good use medicare...concussions, broken hand, herniated disc, muscle tears...I don't have any complaints - had to wait a few hours in the emergency room to get stitches once.

I got a $1700 bill for food poisoning my last year in Bangor (ultrasounds aren't cheap I guess)...they sent me home with some antacids...was glad I had insurance. Other than that eye-opener, I can't say I had any horrible experiences with private health care. I was fortunate to get employment with health insurance though...I kind of took it for granted maybe.

My family has a long military history so my values lean more towards "no man left behind" rather than "every man for himself". But, I guess there isn't a more socialist concept than military so I'm probably not the best person to ask.

[Sir Terrence the Terrible]

I've been following this thread because I knew that, at some point, someone would drag Canada into this.

The Canadian healthcare system is largely misunderstood by Americans from what I can tell. And if you think that you’re going to learn about it by watching a Michael Moore movie, think again.

Dental is not covered by our public healthcare system (with the exception of Quebec, I think). And I seriously doubt that there are any Canadians that “won’t touch Canada’s public healthcare with a ten-foot pole”.

Our system is far from perfect. And there are extreme cases where Canadians may hop the border and pay to have certain tests run or receive certain treatments faster than they can be done here. In fact, I'm even aware of a few situations where Canadians have been sent to the US for treatment and our gov't paid for it (usually it's to receive a drug or treatment not yet approved here...red tape). But, for the most part, our public system works. In 43 years, I have never had to pay for a doctor’s appointment or trip to the emergency room. I can see my doctor as often as I need (currently weekly, while I recover from bronchitis) and never have to worry about how the bill will be paid.

I am free to change jobs and not worry about losing my medical insurance (although we do have employer sponsored insurance that covers prescription medication and other items that our public health care does not cover).

I can see any doctor that I want to. No one tells me where I can and can’t get treatment.

If I need a specialist, I see a specialist. I don’t worry about how to pay the specialist.

If I need surgery, I get surgery. I don’t worry about how to pay for the surgery.

I don’t have to designate any of my income to paying for medical insurance. Yes, I pay taxes but I’m willing to bet that the per cent of my tax going to medical coverage is less than many of you pay for private insurance.

I admit that I don’t know a lot about your private health care system or the proposal being put forward for a public system. And if I've said anything here that is incorrect, I apologize and welcome the correction. But don’t bad mouth the Canadian system with anecdotal bull****. 3LB, if you have specific examples then lets hear them. But so far your post sounds like nothing more than the ignorant fear mongering that I’ve been hearing in your media.

I’d be very interested in hearing opinions from someone who's lived with both systems (Kex?).

P.S. If you have any questions about living with universal health care in Canada, I'm happy to answer them to the best of my knowledge. Also, this post is not intended to be interpreted as an opinion for or against whatever happens in the US. I don't really care what y'all do. I just had to respond to 3LBs post.

Thank you for this FA. I go to Hawaii every year for one of my vacations. Every Canadian that I have spoken to on this issue (very friendly and kind people, and they come to Hawaii by the droves) have said this very thing.

[Sir Terrence the Terrible]

I have a very strong opinion on this issue, because somebody very close to me doe not have very good insurance, and a major illness almost killed him twice.

I am very angry at what I am hearing from the news, and on blog sites as well. One of my buddies company was doing very well financially, but the BOD and stockholders wanted more money to line their already rich pockets. So they decided to make almost everyone in the company part-time so they could kill their benefits package. My friend has a pre-existing condition, so combined with a major cut in salary, and the fact he could not obtain a reasonably priced insurance(or nobody would cover him) he developed a major illness that almost killed him, something that with insurance he was able to afford the meds to control it. After being in the hospital for two weeks, he was promptly sent a bill for over 100k, something he would not have faced when full time employed.

I have seen my health insurance premiums go up about 7% a year for the last 7-8 years. This coincides with the explosion of the salaries of the CEO's of the health insurance companies. Over the last 5 years, one particular insurance company has made $300 million for dropping people when they get ill. I imagine their are other that have had the same result from doing the same thing. Insurance providers raise premiums at will, drop folks at will, sponsor too many expensive employee junkets, line too many politician pockets, and pay their CEO's far too much money with insurance premiums that I pay. They turn around and say they cannot compete with a not for profit government insurance plan, so why are they just not allowed to fail if they cannot? The major cause of bankruptcy in this country comes from medical bills. One county in the bay area where I live has one emergency room in the entire county because the others have all been closed as they were losing too much money.

I was watching television the other day and I heard this gentleman(a rather selfish one at that) say that he does not want to pay for somebody elses insurance. This man lives in tornado alley, and his house has been destroyed several times. I do not want to pay for this man's to rebuild his house after a storm if that is the attitude he is going to take. Things the way they are is going to bankrupt this country, and the free market way of handling insurance is just not working. In this world, everything needs checks and balances and ying and yang. A very strong public option goes a long way to providing a balance, and if the private insurance companies cannot compete, allow them to fail. Isn't that the Republican way? The fact they are afraid of this option, shows that they are not willing to check CEO's salaries, and tackle the waste that permeates throughout their system. If this is the case, they should fail.

What I find ironic about this whole thing, is that the very people who are the most uninsured (the south) are the very people that rile against the public option. How stupid are you to protest against the very thing you need the most? When are people going to stop supporting parties that work against their best interest?

I could go on forever on this, but when fear makes you selfish and paralyzes a process that would actually help millions of Americans, then the country itself deserves to fall from grace into a third world country.

So folks understand. I have a GREAT health insurance plan, and I would gladly pay more in taxes to cover others that are either under-insured, or have none at all.

[nightflier]

When are people going to stop supporting parties that work against their best interest?

...they stop being one-issue voters. Apologies for being crass about this issue, but the formula is very clear: anti-abortion politicians are against the national option. So while it defies logic, those voters will be anti-national-option too. It's what's the matter with Kansas, remember? Free, fair and public education is one generations-long way out of this quagmire, but who's got the time to wait that long? Certainly not the stock market.

I could go on forever on this, but when fear makes you selfish and paralyzes a process that would actually help millions of Americans, then the country itself deserves to fall from grace into a third world country.

I disagree with that sentiment. We should never wish for the sky to fall, because it could fall, and then it won't be health coverage we'll be fighting over anymore.

[Sir Terrence the Terrible]

...they stop being one-issue voters. Apologies for being crass about this issue, but the formula is very clear: anti-abortion politicians are against the national option. So while it defies logic, those voters will be anti-national-option too. It's what's the matter with Kansas, remember? Free, fair and public education is one generations-long way out of this quagmire, but who's got the time to wait that long? Certainly not the stock market.

It's not just Kansas, it's the entire south. The most Ironic thing is I hear people on Medicare and Medicaid saying keep the government out of my health care.

I disagree with that sentiment. We should never wish for the sky to fall, because it could fall, and then it won't be health coverage we'll be fighting over anymore.

Then so be it. It's about time this country pays for its ignorance and backwards thinking. Part of the reason we are in this mess is because we haven't had to pay the price of our bad collective decisions.

[Feanor]

If being trying to keep my mouth shut on this and issues in general. But I have speak out against the gross misrepresentation of the Canadian system I hear from south of the border.

Thank you, FA, for doing your part to rebutt the slander of the Canadian universal, single-payor system. It's not perfect and 3dB is correct that a few Canadians head south for various tests and treatments -- the usual reason is that they too impatient to wait the few weeks it would take to wait for the procedures here. Waiting lists happen but they are not arbitrary: if you case isn't deemed urgrent, you might have to wait. Problem is the "deemed" part: lots of people "deem" that theirs' is a special case and they demand immediate attention. There is no other form of health care rationing beyond the waiting lists for some procedures -- and there are definitely no "death panels".

When William Jefferson Clinton was diagnosed with partial cardiac artery blockage, he got his triple by-pass surgery 3 days later. When I was diagnosed with the same thing, I waited 5 months.

But lets keep a few of things in perspective:

1. My doctors told me that surgery was an option but so was drug treatment and that opting for the latter would only slightly increase my chances of heart attack. In other words, it was basically elective surgery. In fact the medication my cardiologist prescrible totally surpressed my symptoms during normal daily activities.
2. Throughout the interval and for the operation itself and follow up thereafter, I had excellent doctors. My surgeon, a professor at the University of Western Ontario, wanted to do a robotic procedure but decided he couldn't do a good enough job that was so did a standard sternectory (right word?); but he didn't have to stop my heart or use a heart-lung machine or transfused any blood.
3. I recently heard that typical by-pass surgery in the US run $168,000. I have no doubt about the quality of my treatment against the typical US standard so this is the kind of bill I would have got. Instead I was charged $800 for five days in a semi-private room (which my private insurance did pay).

I know Americans resent it when anyone (especially me, I think) criticizes the US. Fine, what you do is up to you. But personally I would be ashamed to lived in the only country in the first world that won't (not can't) offer its citizens quality health care regardless ot their ability to pay.

Look, smarten up. And don't fret about the cost. The Canadian system delivers outcomes every bit as good as the US for about 65% of the cost.

[3LB]

And there are extreme cases where Canadians may hop the border and pay to have certain tests run or receive certain treatments faster than they can be done here.

Specifics? Well, according to sources at three different medical providers in my area, they said Canadian patients account for a quarter of their clients...now maybe these are extreme cases, I dunno, but I have talked to Canadians who weren't pleased with the quality of care they were recieving in Canada, or waiting for care, etc. Maybe they were being picky. One of these places I actually worked for and they were, for the most part, a medical center (not a hospital).

But so far your post sounds like nothing more than the ignorant fear mongering that I’ve been hearing in your media.

I don't know what media outlet you're referring to...these are my own observations based on my own experiences, so there is no one to quote, no links to post, no anecdotes, and no reason to doubt what "people from that country tell me about that country". Perhaps its wrong to quantify or qualify their remarks as consensus, or anyone elses for that matter. All I said was it was telling for me that people who could get free mecial care (there) were eschewing it for care for which they had to pay out of pocket - since these were the only Canadians I met at (then) Madrona Medical, my perception could be ascew.

Again, this was an observation, not an opinion. I've not recieved medical care in any other country but the US, so I can't make direct comparisons to refute what I've heard from those who have.

[3LB]

I've been following this thread because I knew that, at some point, someone would drag Canada into this.

it was inevitable, given Canada's proximity to the US and status as 'developed nation with large land area and population' who also has national healthcare. If Canada's healthcare is the success story you say it is, then a comparison is all the more warranted.

I can't make an assessment of how Canadian gov't is percieved within its own borders regarding its own tax revenue, but we here in the US have every reason to believe that our own gov't could screw up anything, no matter how noble and/or basic it seems. I personally do not like the notion that healthcare is considered a fundimental birthright rather than the financial sacrifice that it seems it going to be...on someone's behalf. Of course, it ain't like we haven't spent the same amount money elsewhere on other uhh, stuff. Just to pile on, our national security is provided by a publically funded gov't entity, and lord knows how efficiently they spend money

[ForeverAutumn]

it was inevitable, given Canada's proximity to the US and status as 'developed nation with large land area and population' who also has national healthcare. If Canada's healthcare is the success story you say it is, then a comparison is all the more warranted.

I can't make an assessment of how Canadian gov't is percieved within its own borders regarding its own tax revenue, but we here in the US have every reason to believe that our own gov't could screw up anything, no matter how noble and/or basic it seems. I personally do not like the notion that healthcare is considered a fundimental birthright rather than the financial sacrifice that it seems it going to be...on someone's behalf. Of course, it ain't like we haven't spent the same amount money elsewhere on other uhh, stuff. Just to pile on, our national security is provided by a publically funded gov't entity, and lord knows how efficiently they spend money

I understand that. And I don't blame you for your suspicion about having the gov't run your health care. But having been raised with public healthcare, I just can't imagine not having it. As I said, our system is not perfect. There can be long waits for treatment sometimes if your need is not critical. Critical needs are always taken care of quickly. But if I was told that I had to wait for a test to confirm an illness, I'd be in Buffalo the next day...for sure. So, is it really that much different than the US system in that respect? Those who can afford it get better treatment...they just don't get it here. I'm not disagreeing with you in that respect. Its the day to day and emergency treatment that I was referring to.

If it makes you feel any better, I've been told by the elders that we had the same resistance here when universal health care was first introduced in the 50s and 60s.

Personally, I think that there can be a happy medium between the two systems. But for now I'll sit back and let you all fight it out in your own country.

[Luzmirr]

To be honest, I don’t really trust the healthcare system either. I think it’s important to take care of yourself. So I bought health insurance from this company american-reia.com a long time ago and don't worry about it. Lately, I've been thinking about getting Ancillary Health Insurance as well. Because I want to make sure that if I go to the hospital, all my expenses will be covered.

[Dilitor]

Hey, I can help you here, osteoartroze is one of the most respected and popular plastic surgery clinics in Riga. The doctors are well-respected surgeons in the industry. For more details about plastic surgery, you can visit their website.

[dean_martin]

props to Smokey for having the guts to pose the question.

My views are very narrowly defined by what I see in my profession and what I've experienced personally. In my profession I constantly see medical bills, particularly hospital bills that vary widely based on whether the patient is insured. Typically, the person who is NOT insured is billed 3X the amount that the hospital accepts from the health insurance carrier of the person who is insured for the same services. This may make sense from a bean counter's perspective based on number of patients insured by the carrier with whom the hospital has a contract (but I can't explain it), but from the consumer's standpoint paying 3 times the amount an insured is billed (the insured doesn't actually pay the one-third bill, but pays a deductible based on a percentage of the reduced bill) is a ticket to bankruptcy. A person working a manual labor job that doesn't offer health insurance (we have a lot of those in my area) could actually afford health services if he or she was billed the same amount that an insured person's health insurance company is billed for the same service, albeit the manual laborer may need to pay off the bill over time. Is the actual value of health services closer to what the health care provider accepts from the insurance company or is the value closer to what the provider bills the uninsured individual? If we address health care costs, I think we need to start with establishing the true costs.

On a personal level, my effin credit report is littered with medical charges for miniascule amounts (after insurance has paid its share) because I get the hospital and related bills from radiologists, doctors groups, etc. (for my kids mostly) many months after the service and I can't remember what the hell they're for so they go in a drawer that rarely sees the light of day. I need a personal bookkeeper, bad.

[GMichael]

props to Smokey for having the guts to pose the question.

My views are very narrowly defined by what I see in my profession and what I've experienced personally. In my profession I constantly see medical bills, particularly hospital bills that vary widely based on whether the patient is insured. Typically, the person who is NOT insured is billed 3X the amount that the hospital accepts from the health insurance carrier of the person who is insured for the same services. This may make sense from a bean counter's perspective based on number of patients insured by the carrier with whom the hospital has a contract (but I can't explain it), but from the consumer's standpoint paying 3 times the amount an insured is billed (the insured doesn't actually pay the one-third bill, but pays a deductible based on a percentage of the reduced bill) is a ticket to bankruptcy. A person working a manual labor job that doesn't offer health insurance (we have a lot of those in my area) could actually afford health services if he or she was billed the same amount that an insured person's health insurance company is billed for the same service, albeit the manual laborer may need to pay off the bill over time. Is the actual value of health services closer to what the health care provider accepts from the insurance company or is the value closer to what the provider bills the uninsured individual? If we address health care costs, I think we need to start with establishing the true costs.

On a personal level, my effin credit report is littered with medical charges for miniascule amounts (after insurance has paid its share) because I get the hospital and related bills from radiologists, doctors groups, etc. (for my kids mostly) many months after the service and I can't remember what the hell they're for so they go in a drawer that rarely sees the light of day. I need a personal bookkeeper, bad.

Hey Dean, Good to see ya.

When my wife had our baby, the hospital billed the insurance company over $98,000. The insurance company paid them $17,000. We ended up paying a little over $5,000. Then we got reimbursed for about $3000 of it. The system is a little strange fo sure.

There went my upgrades

[dean_martin]

Hey Dean, Good to see ya.

When my wife had our baby, the hospital billed the insurance company over $98,000. The insurance company paid them $17,000. We ended up paying a little over $5,000. Then we got reimbursed for about $3000 of it. The system is a little strange fo sure.

There went my upgrades

Yeah, I don't really get it.

I was a gov't employee (clerk for the FBI) when my son was born. All the health insurance plans we could choose from offered maternity coverage even though my (first) wife was pregnant when I signed on. My son had complications at birth, was sent to Virginia Commonwealth University Hosp. and had what was at the time an experimental procedure performed which saved his life. (He's been fine since.) Needless to say, all of that was expensive and my annual salary at the time was $12,500. I was able to set up payments on the balance that I owed after insurance which I paid off when my son was about 3 years old. I have to remind him on occasion that he could've been repo'ed at anytime between birth and 3.

[3LB]

On a personal level, my effin credit report is littered with medical charges for miniascule amounts (after insurance has paid its share) because I get the hospital and related bills from radiologists, doctors groups, etc. (for my kids mostly) many months after the service and I can't remember what the hell they're for so they go in a drawer that rarely sees the light of day. I need a personal bookkeeper, bad.

funny, I spent the better part of my day putting out little medical bill fires - we have a flexible spending account (which is deducted monthly from my wife's paychecks) that we use to suppliment our insurance, i.e., whatever the insurnace doesn't pay, we can use the flexfund to cover. But the company providing the service needs the actual bill to pay out the charges, and the providers won't double bill. Sometimes our flexfund will reject a charge because they didn't get the right info, the right code, the right form, blah blah blah, so I spend a day on the phone trying to fix it...what would we do if I actually worked and didn't have all day to fuss with this stuff?

[dean_martin]

...what would we do if I actually worked and didn't have all day to fuss with this stuff?

get on one of those freecreditreport.com commercials?

I guess the trick is to do what you're doing - get on it before it goes to "collections" because those folks are nasty and either don't know what the bills are for or just won't tell you.

[nightflier]

All this an no one's brought up single-payer health care....

As someone having lived in both socialized-medicine systems and private systems, I can sum it up pretty simply: Under socialized medicine, everyone gets covered but the quality is not as good - in the private system the care is very good, if you can afford it. My guess is that for every household that makes less than 125K a year, this is going to lower expenses, and for the people above that it will be more expensive.

But that is only if (and that's a big IF) the system is well managed, and I also share the skepticism other have since our track record of other socialized programs, the ones we still have (after 40+ years of chipping away at them), is hardly exemplary. There is another factor to consider here: while we pay more in taxes than most other industrialized nations, we also spend more of our tax dollars on military pork than any other nation. Last I read we were spending something like $1.2T a year on the military. Care to guess how much we spend on Medicare/Medicaid? Education? Social Security? All of these combined?

[02audionoob]

The insurance companies have set in advance what they will pay for a given service and it's well below what the doctors, labs, etc. would charge otherwise.

[thekid]

The insurance companies have set in advance what they will pay for a given service and it's well below what the doctors, labs, etc. would charge otherwise.

Lower insurance costs compared to the average Joe is a common practice in other idustries that involve insurance. In the auto collision industry the hourly rate and parts mark-up for the person walking in off the street is considerably higher than the rate of someone going through their insurance company. On the mechanical side of it the "warranty" labor rate at a dealership is also lower than the labor rate for the same operation. There are some legitimate reason's why a gap should exist but those reasons do not justify the large gap that does exist.

This discrepancy is another example of why the system is broken and why at least when it comes to something as important as healthcare we should not let the traditional "market" forces determine cost and availability. Unfortunately the current political debate does not address the cost but on availability which is why both sides are retreating to their tried (tired) and true base positions. Republicans= universal healthcare will cover criminals,the lazy and promote a liberal agenda. Democrats=universal healthcare is the right thing for government to do lets pay for everyone and somehow the cost will figure itself out. What does it say about our current system when out of 100 Senators there are only about 7 (and even less in the 350+ member House) who are willing to sit down in a room together and try and solve a problem rather than run around to the talking heads screaming that the sky is falling. I know Obama wanted to avoid the mistakes of the Clinton's on this issue but to basically say to the Congress you work out the details ignores the totally disfunctionally environment that exists. He is a little late to the table about spending some political capital but he is still not addressing cost containment. If the Administration would just start putting some serious cost cutting proposals on the table such as limiting admin fees or excessive medical testing (because the doctors own the majority of the labs conducting the tests-solution prohibit doctors from owning labs...) they might start to make some headway. Without addressing cost we are just arranging chairs on the Titanic.....

[3LB]

abortion

I'd like to see a gov't sponsored program to provide abortions for anyone who wanted one.

[markw]

I'd like to see a gov't sponsored program to provide abortions for anyone who wanted one.

I'm all for it as long as they tie the breeder's tubes at the same time if they had one before or have kids paid for by the taxpayers.

[basite]

I'd like to see a gov't sponsored program to provide abortions for anyone who wanted one.

we have one.

[ForeverAutumn]

I'd like to see a gov't sponsored program to provide abortions for anyone who wanted one.

we have one.

So do we.

[Rich-n-Texas]

I'd like to see a gov't sponsored program to provide abortions for anyone who wanted one.

It's gonna get ugly!