Its "Universal," not Joseph Stalin coming for your babies
11:27 AM
by Chris Johnson of Drawnlines Politics.
I was recently asked a question about Universal Healthcare. I was dismayed by the level of public education on the subject. Here is the question I got... and my answer:
"Um, doesn't everyone in Canada HATE their universal healthcare plan b/c they have such a hard time getting into see a dr and they don't really have a choice in who they see? Women from Canada come to the States during pregnancy just to get a sonogram b/c they can't get one at home until they're already 6 or so months pregnant. People don't like HMO's b/c it's people who don't know anything about healthcare making decisions about others' healthcare, how on earth would this be any better?"
Good questions and good points. My comments are these: I know there are many satisfied people in Canada regarding their healthcare. That is not to say that their system is not without a few faults. Their system is called “socialized medicine”. What we are talking about is a little different. Universal Healthcare does not preclude private providers from participating. In this system, all you need to have insurance customers is a good product for a competitive price. Under the first step (currently being debated in congress), There would be a government backed insurance plan that will end up serving as a benchmark for the private companies. If companies can provide better service, great. If they can provide it at a better price, even better.
Our current system is not sustainable. Prices will continue to rise as Dr.s and pharmaceuticals continue to raise prices. It is just that simple. Insurance costs will continue to go up because they will continue to pay what the medical companies bill. Add to that insurance profit margins- anyone who works in insurance can tell you that the insurance companies never lose. Benefits will continue to shrink while premiums continue to rise. This is exacerbated by the number of people retiring every year continuing to increase for the next ten years. The risk pool is becoming more concentrated (more claimants per premium in a given time period).
People in the workforce today pay for retirees today. Medicare and Social Security taxes go to the people that need it NOW. In ten years, there will only be two people in the workforce for every beneficiary of these programs. Retirees who participate in Medicare Part B (doctoral care) only pay $100 per month into the system… these are the people that use doctors the MOST! If we do nothing now, then our out of pocket Medicare taxes will go through the roof (five to ten times what we pay now) within the next decade. Universal healthcare will reduce our burden to pay for healthcare costs by taking a lot of exorbitant pricing out of the equation while also reducing superfluous testing and procedures. Doctors should be well paid- but they should not be paid by the job. This only allows them to bill for busy work and inflate the costs for everyone. Good medicine- the right medicine- when it counts… Just remove the incentive to do bill more and that particular part of the problem will go away. When we do this across the board, not only do working people’s coverages get cheaper, but so do old folks (thus defraying a lot of Medicare increases).
As far as managed care is concerned- I am not familiar with Canadian obstetric and prenatal care guidelines for their socialized program. Their rulebook does not apply to our proposed system. Our guidelines will continue to be established by market demand under a universal system. If expectant mothers keep asking for early sonograms, then the insurance companies will keep finding a way to provide them.
We have to keep in mind that we are a society. We cannot afford to act as individuals on this issue. We will lose. Even the wealthy will lose. If we do not act: care will become too expensive for most people. Insurance will become a luxury. Employers will discontinue benefit programs. Doctors will continue to cater to those that can pay- and as that pool gets smaller and smaller- the prices will go higher and higher. Care options will shrink, and quality will suffer. If we can work together, even a little bit- and see Universal Healthcare as a potential solution, and not a socialist bogeyman, then we might have a chance of having a decent private system that we can all use.
The basic misunderstanding about the whole thing that I keep running into is that some people confuse “universal” with “government run” (sidebar: this isn’t accidental. There are propaganda machines out there intentionally confusing facts). Our economy is based on the free market. And so it should stay. But having a “corporate run” system isn’t working as well as it should. Prices keep going up above inflation, care is confusing, billing is confusing, fingers are pointed… it’s a mess. Let’s give a "consumer run/market run" system a chance and try to clean it up, shall we?
I was recently asked a question about Universal Healthcare. I was dismayed by the level of public education on the subject. Here is the question I got... and my answer:
"Um, doesn't everyone in Canada HATE their universal healthcare plan b/c they have such a hard time getting into see a dr and they don't really have a choice in who they see? Women from Canada come to the States during pregnancy just to get a sonogram b/c they can't get one at home until they're already 6 or so months pregnant. People don't like HMO's b/c it's people who don't know anything about healthcare making decisions about others' healthcare, how on earth would this be any better?"
Good questions and good points. My comments are these: I know there are many satisfied people in Canada regarding their healthcare. That is not to say that their system is not without a few faults. Their system is called “socialized medicine”. What we are talking about is a little different. Universal Healthcare does not preclude private providers from participating. In this system, all you need to have insurance customers is a good product for a competitive price. Under the first step (currently being debated in congress), There would be a government backed insurance plan that will end up serving as a benchmark for the private companies. If companies can provide better service, great. If they can provide it at a better price, even better.
Our current system is not sustainable. Prices will continue to rise as Dr.s and pharmaceuticals continue to raise prices. It is just that simple. Insurance costs will continue to go up because they will continue to pay what the medical companies bill. Add to that insurance profit margins- anyone who works in insurance can tell you that the insurance companies never lose. Benefits will continue to shrink while premiums continue to rise. This is exacerbated by the number of people retiring every year continuing to increase for the next ten years. The risk pool is becoming more concentrated (more claimants per premium in a given time period).
People in the workforce today pay for retirees today. Medicare and Social Security taxes go to the people that need it NOW. In ten years, there will only be two people in the workforce for every beneficiary of these programs. Retirees who participate in Medicare Part B (doctoral care) only pay $100 per month into the system… these are the people that use doctors the MOST! If we do nothing now, then our out of pocket Medicare taxes will go through the roof (five to ten times what we pay now) within the next decade. Universal healthcare will reduce our burden to pay for healthcare costs by taking a lot of exorbitant pricing out of the equation while also reducing superfluous testing and procedures. Doctors should be well paid- but they should not be paid by the job. This only allows them to bill for busy work and inflate the costs for everyone. Good medicine- the right medicine- when it counts… Just remove the incentive to do bill more and that particular part of the problem will go away. When we do this across the board, not only do working people’s coverages get cheaper, but so do old folks (thus defraying a lot of Medicare increases).
As far as managed care is concerned- I am not familiar with Canadian obstetric and prenatal care guidelines for their socialized program. Their rulebook does not apply to our proposed system. Our guidelines will continue to be established by market demand under a universal system. If expectant mothers keep asking for early sonograms, then the insurance companies will keep finding a way to provide them.
We have to keep in mind that we are a society. We cannot afford to act as individuals on this issue. We will lose. Even the wealthy will lose. If we do not act: care will become too expensive for most people. Insurance will become a luxury. Employers will discontinue benefit programs. Doctors will continue to cater to those that can pay- and as that pool gets smaller and smaller- the prices will go higher and higher. Care options will shrink, and quality will suffer. If we can work together, even a little bit- and see Universal Healthcare as a potential solution, and not a socialist bogeyman, then we might have a chance of having a decent private system that we can all use.
The basic misunderstanding about the whole thing that I keep running into is that some people confuse “universal” with “government run” (sidebar: this isn’t accidental. There are propaganda machines out there intentionally confusing facts). Our economy is based on the free market. And so it should stay. But having a “corporate run” system isn’t working as well as it should. Prices keep going up above inflation, care is confusing, billing is confusing, fingers are pointed… it’s a mess. Let’s give a "consumer run/market run" system a chance and try to clean it up, shall we?
Posted by chris
on 11:27 AM.
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"Our economy is based on the free market. And so it should stay."
Stay? Free market? What country do you live in? It's not that now. We already have Medicaid and Medicare. We should get rid of them. Health insurance at a minimum needs to be opened up to inter-state purchase. Any company wishing to offer health insurance should offer a catastrophic policy and build further levels of policy on its backbone. Employer health insurance benefits should be taxed as long as every other benefit is, but I'd prefer that we remove the tax on all of them. Employers really shouldn't be our source of health insurance. The more we remove the cost from the consumer, the more willing the consumer is to overuse and abuse the system. Why wouldn't they when they're not directly paying? Make costs visible to consumers and they'll shop around for their best overall value, including factors of price, quality, and convenience.
You're correct in that universal and government-run are not the same thing, but they might as well be. If you don't force people to do something, there will be those that don't do it. And good for them! I'm not for universal care when it comes by way of liberty-stripping mandates.
The mis-information is alarming. A lot of people include in their arguments the supposed fact that some people don't want health care reform, usually when attacking Republicans. I don't know anyone who doesn't want to reform the system in some way, Republicans included.
We should focus on minimizing our need to seek medical consultation. Some of us can't avoid it, but the bad health habits that we have, such as the obesity rates, indicate that we could do a lot more on our own to better our health. Put the burden in the hands of individuals and you might get some results.
When people say that we have the best health care in the world, they are right. But that's not to say that we can't do it better. Certainly, the number of uninsured is a problem and not just for the uninsured themselves but for the other taxpayers that shoulder the burden when that patient goes to the emergency room and receives care without ability to pay.
On that overarching theme, I actually think Chris gets the point. Universal coverage so that every person receives periodic care and has a financial backstop against catastrophe is essential (again not just for them but for the rest of us that would shoulder the burden for their indigent care). But how do we cover them and who is going to pay for it?
K, you're spot on about a few points. One, NOBODY is against reforming health care. That's exactly the type of propaganda Chris talked about (though this time lobbed at us from the Left). Also, the employer-based health insurance system is a mess with a ton of unintended consequences.
Finally, preventative care is key. Maybe it shouldn't be about reducing total visits, but rather reducing overall risk. It's much cheaper for me to see the doctor twice yearly for checkups and catch a cancer early than to go without a checkup for years and receive care when I'm in a late stage. The cost comparisons are staggering, not to mention my probability of survival. The same goes with HIV, diabetes, you name it.
Preventive care is tricky. It's possible that the person who never goes to the doctor still won't when very sick. In this circumstance, health care costs are not high (actually nonexistent) and going to the doctor for routine check-ups would make it more expensive. I don't know how many such people exist, but I know at least two like this.
What are we trying to prevent? Costs or disease? It always starts with you, at home. If you're not living a healthy lifestyle, you're likely raising my costs. As you said, it's about risk. If you're more likely to get sick, you should pay more. People with pre-existing conditions should be covered, but they should pay based on their risk. Do people with cars more likely to be stolen pay more for car insurance? New drivers? Houses in high crime areas cost more to insure? A lot of the hard-to-insure say that they either can't get insurance or it's prohibitively expensive, but isn't that, the high prices, how a market-based system is supposed to work? Putting the currently uninsured in your insurance pool really isn't any different than paying for them through taxes -- you still pay the cost.
The insurance system we have now is in some ways "pre pay". I pay premiums and the insurance company pays my doctor or other health care provider when they render services. There's little incentive to work to lower my costs because I don't pay them directly.
I'm not sure we have the best health care in the world. As others have said before, we have the best disease care, but doctors are largely ignorant of nutrition and exercise information. They know much better how to treat disease than how to prescribe health.
Take out requirements that health insurance have to include anything other than catastrophic coverage. There's no need to require plans that offer all the letters of the alphabet when not everyone needs them. Some of us only want a few things covered. It's de facto socialized medicine. You want coverage? You pay for it. Cafeteria plans a la "you choose the options you want" seem much better.
We don't have the best healthcare in the world. We're 38th. 50th in life expectancy. Sorry but you right wingers who believe this country is "the best there is," about any number of issues are sorely mistaken. It's a a great country, but we certainly have room for improvement.
How do you suggest we improve it, afucfguy18?
I'm waiting to hear an answer to that one myself.