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We, along with the country, have talked a lot about healthcare lately: the role of employers, the impact of doctors' salaries, the importance of health promotion and more. Now we're going to take a turn from what the system is providing (or may provide in the future) to what you expect and value. What is most important to you as a patient, client, or customer of the healthcare system — as a consumer of healthcare? Cost? Timely delivery? Quality? Convenience? Does valet parking at hospital mean anything to you? Or do you just care that there is a hospital nearby? Do you prefer low co-pays or smaller premiums?
A moving compilation of emails to Andrew Sullivan includes this personal story from a reader:
As an epileptic I have had a few cases of seizures occurring in public places. While not life threatening, this can often impact strangers intensely. A stranger's first response is usually to call an ambulance and get me to a hospital... The simple act of being picked up off the ground, transported to the hospital and ingesting a Tylenol offered by doctor there would run me over a thousand dollars. When I checked my bill I discovered that the two Tylenols I had ingested alone cost me over 50 dollars... Since I was working a part time minimum wage job, I could not afford to pay those bills and my credit was destroyed for years.
What's your story about using the healthcare system? What do you hope for in the future? Please note, we are really looking for personal experiences from consumers of healthcare in this show, not general thoughts about how the whole system should change (though we understand that one can lead into the next!).
GUESTS:
- John Laird: Editorial Page Editor for The Columbian
- Jenifer Hood: soon to be uninsured after being laid off from her position at the City of Oakridge
- Jason Atkinson: Republican State Senator from Central Point (District 2)
- Phyllis Best: Chief Financial Officer for The Factory Company International and a Trustee of the Group Health Cooperative Board
- Michael Kaplan: HIV positive and the executive director of the Cascade AIDS Project
(Note: For the first ten minutes of today's show we will discuss Washington's Primary election.)
Tagged as: insurance · public health · rx
Photo credit: Catcubed / Creative Commons
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I am a pro-life supporter of a single payer universal health care. I find it hard to not require the one without the other: why protect the unborn life if the mother can’t get pre and post natal care and the child be covered at least until majority? But why claim that protecting someone’s health is important if you are going to kill the innocent and begin trying to force the infirm and old towards a fiscally beneficial assisted suicide. Now before you scream that I’m ill-informed about the latter, please remember that 1) Oregon’s health plan is the image of the Federal run single-payer medicare in many respects and 2) the case of Barbara Wagner shows that at least in Oregon we can not so smugly dismiss the conservative and elderly fears on end-of-life issues the current bills in the House have raised.
I agree with Dr. James Dobson about the responsibility of pro-life proponents to oppose the CURRENT versions of the legislation, but I do believe that providing specific, carefully worded protections against 1) government funded abortion and 2) any body requiring that any doctor who counsels on end-of-life issues have to include assisted suicide/euthanasia would eliminate my opposition. The fiscal conservatives won’t be swayed by the modest changes I suggest, but the pro-life ones should.
My vision of universal care, however, is not what some would want: let’s not pay for Viagra or vanity cosmetic surgery (not talking about burn or trauma victims here); mental health should be covered, beauty or self-serving under the guise of health should not.
My story this year is that my wife got ill and it has cost us well over ten thousand in direct bills and COBRA payments (I had to take 4 months off to take care of her, so it has actually cost us a LOT more). Nothing compared to what some endure, but even this modest a catastrophe destroys one’s personal safety net VERY quickly when you have too high an income to qualify for assistance and yet have very high deductible insurance because that is all you believe you can afford.
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I would take issue with using Barbara Wagner as an example.
The still experimental cancer treatment she was seeking was disapproved by the Oregon plan entirely independently of any other decision she chose to make because the cost vs the potential benefit did not balance out based on the money available and the people in need. In fact there is no other state health plan I know of that WOULD have covered that treatment, and I don't think many insurance plans would either. If we want to cover everyone for everything, that is fine, but we will need to come up with a lot more money first.
Once that decision was made, she was simply informed about the other things she still had available to her under the plan. Granted, it was not done in the most sensitive way possible, but she was never offered assisted suicide as THE alternative to treatment. She was given a range of options which included hospice and assisted suicide, which is legal in this state. And a minor point, assisted suicide and euthanasia are not the same thing. Euthanasis is not legal anywhere in this country, including Oregon.
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I think you might try considering this from the perspective that legal or not, assisted suicide was presented by a public health plan as a responsible and affordable alternative to life. This is the core of the "death panel" concerns seniors and pro-life advocates object to.
No, it was not presented as the only option, but it should not have been presented in that response at all. This is the slippery slope. By the way, I do know the as/e difference, and still think that sits at the end of the slope.
Let me put it in terms most liberal pro-choicers would understand: what is the normal response of NARAL, NOW, and other far left groups when the horrible practice of "partial birth" abortion is even somewhat restricted? It is to scream that such restrictions are steps on the road to making abortion illegal again, isn't it? Of course, when pro-choicers scream, NPR does an excellent job of covering their views well and casting doubt on the pro-life side... in the health care debate, the roles and the coverage are decidedly reversed.
My opinions: Should we cover experimental treatments? no. Should we tell potentially devastated patients that we are glad to pay for them to go kill themselves? no. Should we make sure legislation coming from the federal government protects doctors counseling on end of life issues from ever HAVING to counsel a patient that assisted suicide is a reasonable option? yes. Would just including such protections in the law remove my objections on this section? yup, you bet.
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Every country in the industrialized world is experiencing rising health care costs. This problem manifests itself differently in each country depending on what type of health care system it has. In the US, we see rising costs resulting in the symptom of more and more people finding health insurance priced out of their range. In universal health care countries, we see the symptom of rationed services.
Uninsured Americans are not the problem, they are the symptom, and the problem is therefore NOT the lack of a universal health care system.
The one factor all of these countries have in common is the retention of low retirement ages in the face of longer life expectancies.
We are living longer, but not working longer, and that is creating all kinds of problems, not just in health care.
The American voters obviously feel that people over the age of 65 are capable of working well into their 70s as can be seen by the fact we currently have the oldest Congress in history. Robert Byrd is 91 years old in the Senate.
Don’t you think it is far past time to raise the retirement age and the Medicare eligibility age past 70? Sooner or later, we are going to have to face this reality, no matter how unpopular an idea it may seem.
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In 1935, only 6 percent of the US population was over 65. Today, over 12 percent of the population is over 65. That is a doubling of the proportion of retirees carried on the backs of working people.
To return to a parity of 6 percent of the population, we would have to raise the retirement age to 75.
Life expectancy in 1935 was 60. Our entitlement programs were intended for those who lived BEYOND the norm.
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People like to believe the high cost of health care is due to insurance companies. They couldn't be more wrong. Insurance company profits make up less than one percent of total health care costs. They cover 211 million people and spend only 1/6 of the total on health care spending. The private sector is a model of efficiency.
Take a look at this link which shows the per capita spending on Medicare for each state. It will blow your mind: http://www.workworld.org/wwwebhelp/medicaid_per_capita_average_expenditures.htm
Only three states are below $8000 per capita public spending on health care. Oregon is at $11,813.
Something to think about when talking about adding more people to public health spending.
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The profits of the insurance companies are at least 25% not 1%. All the reports I have ever seen from many sources cite that figure or higher. Medicare, by contrast, has a 2% administrative cost to process the payments to health care providers. The private sector is a model of greed not efficiency.
The per capita cost cited for Medicare says in the link that it is Medicaid, an entirely different population.
Medicare costs can be reduced by permitting the government to negotiate the prices they pay for services. This has been done for most providers but forbidden for prescriptions by the Bush Administration. This has to change.
Luke T's post is just propaganda for private insurance without the correct facts, because the correct facts show that Medicare is more efficient than private insurance.
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If there's a way to salvage a valid statement from Luke's, I haven't seen it.
Perhaps it involves a strict definition of "insurance company profits" to exclude salaries, exhorbitant or not?
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Medicaid is available to people of limited income who are pregnant, disabled, blind, or aged. It is also available to all children of low income families, including immigrant families.
Medicare is available to anyone over 65.
Imagine the savings to taxpayers if instead of drawing on the public treasury at 65, we continued to work and paid INTO the system for another 10 years, instead of drawing OUT of it.
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Then why, in other countries where all health costs are covered by the public system, are surgeries costing 1/10th of what people and insurance companies are being charged here? It is a FOR PROFIT system. It is inherent that there will be exploitation. Also, I am a person of low income who does not qualify for for medicaid although I have a serious health condition that requires surgery. In Oregon people like me are expected to participate in a "lottery" for healthcare in which people who are neither disabled, pregnant etc. are chosen from a vast pool of applicants. Once the person has "won" the lottery, the income level cut- off is around $920 a month. Once that number is exceeded but even a few dollars, the "winner" is disqualified. I have had friends whoare uninsured due to unethical labor practices such as being hired "part-time" at 36 hours a week play this in order to have biopsies for an irregular pap, to check for cervical cancer. These are people in their thirties. Once being selected for the lottery, they must either cut their hours or quit jobs to remain eligible for the health care. Is this some kind of joke?!?!? Oh and p.s. to all who are concerned they may have to wait a week to see a doctor-if you have a shitty insurance policy through your employer in which you pay out evry month and have deductibles, you often have to wait 4-6 weeks to get an appointment and are only allowed 1 dental or eye exam per year. These are the realities that people who are not makingover $30K a year face. Poverty level for a sigle person is $12K.
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Well, if the private insurance companies cherry pick the young and the healthy, and leave the folks with pre-existing conditions and serious illnesses to the Public programs, is it any suprise that the public programs cost more? If the answer is to let sick people die unless they have lots of money, your solution works.
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I prefer to trust the government than a corporation. We need to remember that insurance coops will be run by a board of directors and will be buying their reinsurance from AIG or possibly all of the actual coverage from existing large health insurance companies. Consumers will not necessarily have any more control than they do now. The federal government is the only entity that won't have to buy reinsurance and that will have the largest customer base possible. The "Government Option" is the only plan that would actually compete with insurance companies. Any other plan hugely inflates the profits of insurance companies and the salaries of their CEO's. Don't forget that until a few years ago we were all very pleased with the performance of other quasi-governmental companies such as the Postal Service and Fannie Mae and Freddie Mac. Just as I am sure I don't want the military or my local Police or Fire Dept or my local water system to be run by a huge corporation, I am sure that my government can do a better job of providing my health insurance.
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I am not an anarchist, but I really do not trust the government when it comes to healthcare. The government can set or influence policies to help ensure quality of life, ensure competitiveness in the marketplace (business, healthcare, etc), and so forth. However, the government is generally detached from the day-to-day issues surrounding healthcare.
In addition, the government option may lead to the lowest common denominator to satisfy all. Rarely is the lowest common denominator a happy or satisfying situation.
On the contrary - market competitiveness often leads to the benefit of the consumer. On this point - I agree that government can help. But if there is only one option (i.e. the government option) or a restricted set of options (i.e. co-op), then the consumer is impacted... as well as the health providers.
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The United States already has a singler payer system larger than Canada's. Medicaid provides health coverage to 49 million Americans. The entire population of Canada is 33 million.
The Congressional Budget Office has said, "The federal budget is on an unsustainable path, primarily because of the rising cost of health care." http://www.cbo.gov/publications/collections/health.cfm
The "government option" is already here, and has been for decades, and it is bankrupting us.
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Luke T. is a shill for insurance companies not an honest consumer.
Health care costs are going up, in part because of an aging population, and in large part because of runaway greed by insurance companies. This is why we need to restructure health care in a practical way.
The current bills moving forward in Congress do not do the job, because the protect insurance and drug companies' interests not the rest of us. These bills are a sham brought to us by legislators who have takencampaign contributions of thousands of dollars from the insurance and drug companies.
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I agree with margalo except
the magnitude of campagin contributions (collectively) in the millions.
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211 million people covered by insurance were responsible for about 420 billion dollars of health care spending in 2007.
Less than one hundred million people were responsible for 2 trillion dollars of public taxpayer spending on health care in the same period.
The government does not do a better job.
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Just curious - what is the typical profile of the 100 million which cause 2 trillion dollar public taxpayer spending?
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Due to the lack of a practical health care plan in the US, there are distortions in how health care is paid.
One of the reasons Medicaid is high is that people overuse the emergency rooms for primaray care, which drives up costs. It is also causing many hospitals to close their emergency rooms.
We can solve these problems with the comprehensive public health care bill, HR 676, to put all Americans under Medicare. Medicare is efficiently run, and with all the scare tactics being used seniors are afraid that Medicare will be taken away. None of them are begging to be transferred to private insurance companies!
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Cite sources, please.
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The 100 million you are talking about are primarily on Medicare - therefore over age 65.
It's hardly surprising that those over 65 account for a higher per-capita health expenditure than those who are younger.
The problems are several:
1. Large public commitments to pay for health care in a system without cost controls. (Canada and most other single payer systems have centralized cost controls in place.)
2. A large population of uninsured people whose primary or only means of getting health care is the emergency room. They therefore enter the system sicker, and then get care under a very expensive, silent cross subsidy. The hospitals and doctors who care for all these people who can't pay raise the rates on those who can in order to support their obligation to provide emergency care to all.
3. An incredibly expensive tangle of administration and claims systems.
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First off, THANK YOU BARNEY FRANK for standing up to the horrible unamerican protesters at his town hall.
Yes we need a public option, the opposition is either making big money off of other peoples pain or brainwashed by those who do.
Thom Hartmann suggested letting everyone who wants to buy into Medicare. This is a great idea!
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personal insurance story: I am lucky enough to get decent coverage through my employer and co-pay about $600 a month in premiums for a family of 4.
We had blue cross and hated it. They send daily inexplicable letters with bills often over a year old. You end up getting bills from labs and other affiliate type places that you had no idea you were being treated by. I never knew how much I owed, to whom or for what. I never got a good explanation of why they refused to pay for a tissue biopsy which was $700 out of pocket. Switched to Kaiser and its a million times better. The staff are much happier than the private clinic people were. I asked some practiioners and they always say how much better it is not to have to deal with multiple private insurances. However, I am still waiting to have dental work done because I can't afford the co-pay. By the time I can afford it, it will probably cost a lot more and require additional treatment. Dental is a big problem that needs to be included in the health care relief.
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Since the Congress is refusing to consider HR 676 at this time, the opportunity to buy into Medicare is a good alternative.
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As an owner of 2 small businesses I provide health care for my employees but the costs are staggering - currently around $80,000.00 annually. The problem is that recently those costs have been increasing by 13 to 15% annually and by 2011 the cost of coverage will be well over $100,000 annually. More than I pay in taxes and soon more than I will be able to afford without shifting a disproportionate amount of those costs to my employees. I welcome higher taxes on small business owner because I know those increased taxes cannot possibly be as high as my health care costs and it wil ensure all of my employees have health care coverage - a great social benefit for a small increase in my personal taxes. A fair trade off by any measure.
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Thanks for sharing these details, John. Aside from the cost, what do you think of the healthcare you, and your employees, actually get for that $100,000?
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Can the cost of healthcare be reduced without affecting the quality of care? I'm often surprised at the difference of billed rate vs. negotiated rate when reviewing medical bills, insurance statement, and so forth. Is the billed rate by the health provider a premium to cover losses from other unpaid bills? Are the health providers having to raise their costs due to liability insurance caused by over zealous lawsuits and legal fees? Is there simply too many healthcare needs, or too many situations of urgent care vs. preventative care?
My family has spent a fair amount of time in healthcare facilities. One or my four children has a mild form of spina bifida, and it requires the involvement and coordination of 6 key doctors due to various needs\situations. Other incidents in the family have necessitated coordination of 2-3 medical professionals with different specialities. I have actively chosen to pay for good healthcare in order to ensure we have direct access to preferred doctors. It is expensive, but it provides a quality of life in regards to medical needs. Surgeries, intensive care units, hospital stays, out-patient care, and routine preventative care have become all too familiar. Will healthcare reform impact my family's access and level of treatment received thus far?
The discussion of co-ops raises a number concerns. Many of my friends and family that do utilize co-ops have expressed concerns and frustrations. Medical care is provided, but often they have to fight and struggle with providers, insurers, and so forth. In the healthcare plans I currently pay for, I have rarely had to deal with disputes of payment, service, and so forth.
Is my situation an exception to the general public opinon\experience?
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Thank you for sharing your personal experience.. this is exactly what we are looking for today: real, personal experiences with the healthcare system. Thanks!
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Congress has heard (very loudly) from all the people who seem to be satisfied with the health care system we currently have in this country.
I propose that all of us who support real reform let Congress hear from us during the week that they re-convene.
Send letters, email messages and call not only your own Congressional representatives, but also the leadership of both parties and all the members of the relevant committees.
I'm sorry I don't have that information at my fingertips right now, and I need to leave for work - I'm late already. I will research it tonight and send out a message to all my friends & family. If all of us do that, I think we can make a real difference.
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I can commit to that!
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Great idea Anne. And don't forget to thank Barney Frank.
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You can always find the contact information for your representatives and senators and also all bills in Congress at this Library of Congress site: http://thomas.loc.gov/
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Right on. It is very important that we not get completely drowned out by the anti-reform screamers.
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http://www.reuters.com/article/pressRelease/idUS187049+15-Jul-2008+PRN20080715
Total of $16 billion in profits for the insurance industry for 2007. That is six-tenths of one percent of the total cost of health care for that year, and most of it was made from investments, not from insurance premiums.
The people who blame insurance companies are the ones who are brainwashed and simply parrot what they have heard others say without actually looking for evidence.
http://www.mckinsey.com/mgi/publications/US_healthcare/pdf/US_healthcare_Chapter1.pdf
Read that link and you will discover where we overspend.
We overspend on outpatient care and drugs. And drug overspending didn't happen until 2006 when Part D Medicare kicked in. Then it jumped from 2 percent to 17 percent of total drug expenditures, and all of that jump came at taxpayer expense.
We are living longer but not working longer. We have doubled the load of retirees riding on the backs of working people.
It is time to stop buying into the frame the politicians of both sides are trying to keep you boxed in. It is time to think outside the box and see the actual problem and the actual solution.
The politicians are afraid to talk about the retirement age. Our entire country is being held hostage by 12 percent of the population.
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Retirement age is not connected to health care. People are eligible for Medicare at age 65, retired or not.
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Those of us who are tired of seeing friends rejected from insurance due to pre-existing conditions and those who would like to see small business free from the strangle-hold of health care costs have to make our voices heard. I feel that we are being drowned out by the chorus of t.v. talking heads and their minions.
It is the same feeling I had in 2003 when those same talking heads convinced us that the health and safety of the nation required the invasion of Iraq. It's sadly ironic that the health and safety that inspires the protection and sacrifice of tens of thousands of American troops is apparently not worthy of the protection and sacrifice of the American public.
Thank you, OPB, for having this discussion. I appreciate that I don't have to scream and shout to express myself here.
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You are most welcome!
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Good points - modern media often skews the core issues at hand.
I too am trying to discern what really is the point and effort. I'm very interested to have clear understanding what reform would look like and how it might affect my situation and the general public.
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My wife and I are in our late 50's. We are self-employed and love what we do even though it doesn't pay much. Our health insurance is costing us $800+ per month. Every year the cost goes up as does the deductible. We are now at the point of questioning whether we can continue to afford health insurance. We need a "public option" of some kind while we wait for Medicare or we will have to opt out of health insurance.
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So, folks that dont love what they do but do it becuase it is responsible should pay for your health care. is that what your saying?
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No, TJ, a responsible and just government could possibly tell the big corporations to shove it and relocate a teeny bit of the money from slaughtering people in the middle east/afghanistan to health care.
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The Obama Administration has said that the public option is not the critical issue. Without a public option, there is no real competition to private insurance costs. The co-ops themselves and other reports about them came out yesterday to say that they cannot provide that competition. HR 3200 is another giveaway to big corporations, because it will not provide good health care to us but will guarantee protections to insurance companies. The Senate wants a bill to provide even less for us. We would be better off with no bill than any of the ones proposed this year. Obama never should have taken single payer "off the table," as it is the only cost effective answer to health care.
Rep. John Conyers introduced a bill, HR676, several years ago to put all Americans under Medicare. This bill, which has been reintroduced in the current Congress, has provisions for preventive care and some coverage of alternative care. It would cover every American. Medicare costs only 2% to administer, so if this bill would pass, the cost of healthcare immediately drops by the elimination of the private insurance companies' 25% overhead, including their profits.
Everyone understands Medicare. People choose their own doctors and other providers who are paid by Medicare. The government negotiates with the providers for the payments and should be allowed to negotiate with the drug companies. In other countries, the drug costs are much lower because of their governments negotiated lower prices.
60% of US bankruptcies are due to medical bills, and most of those people have insurance but must pay co-payments or for bills not covered by their insurance. These costs are in the thousands of dollars. If the sick person cannot work or does not have a high paying job, how can they pay these bills?
Medicare should be financed by taxes. These taxes would be lower than insurance premiums, because the cost of health care would be lower.
We are paying trillions of dollars for current wars, past wars, and military readiness without questioning those costs, but we quibble about paying much less for our own health. We need to change our priorities to provide good health care for ourselves first, then pay for other
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The 2 percent figure often quoted by ObamaCare proponents is statistical slight of hand. Since the per capita spending of public health care spending is far, far greater than the per capita spending of private health care spending, then public administrative spending is a small percentage of the TOTAL cost. So, in fact, when you look at the actual dollar figures for administrative costs, Medicare's adminstrative costs were nearly 25 percent higher than private insurers.
http://timerealclearpolitics.files.wordpress.com/2009/06/admincosts1.gif
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I believe Health Care is a basic human right.
Why are there no discussions or pushes to amend the U.S. Constitution to make health care a constitutional right.
This would then require our politicians to find compromises to achieve universal coverage.
As discussed on NPR this morning, this is the approach Spain takes
and seems to be working much better then the U.S. Model.
If health care is not viewed as a human right, what is the justification that allows prisoners to get full access to free healthcare, but not tax paying citizens that are doing there best to be productive members of society.
It seems a bit strange that we have the right to bare arms, but do not have the right to have a gun shoot wound treated without going bankrupt.
Any light you could shed on this topic would be very helpful.
Careless
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Nationalize the current health care system or make the health insurance companies and the for profit hospitals not for profit organizations. Standardize doctor's fees at reasonable rates.
Find the best features of all the health care systems in those countries that provide better health care than we do for less money and copy / improve what they do.
Nationalize the system, but keep as much local control as possible.
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HR676 does this. You can find both a summary of the bill and its entire text at http://thomas.loc.gov/
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Will Healthcare reform cause more paperwork and overhead?
Just this week I'm completing more than 10 documents for my child to receive medical care. The documents cover more than just explaining present healthcare insurer - they cover HIPAA, state mandated disclosures, and so forth.
If reform raises the amount of paperwork and oversight... how does this serve the end goal of cost reductions, burdens on the health provider and the patient, and so forth?
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HR676 would cover every American without all these extra hassles by putting all of us into Medicare.
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margalo - appreciate the reference. I'll do some reading on http://www.hr676.org/
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Real-world.
Several years ago my boyfriend went to the doctor because he had been feeling sick and run-down, almost flu-like symptoms that didn't go away. Blood-work. Told to go straight to ER. Admitted to the hospital. What could it be? Cancer? Aids? Diagnosis: his kidneys had never fully developed. Now that he was an adult his body couldn't handle it, he would either die or go on dialysis and hopefully get a kidney transplant. After months of peritoneal dialysis, which completely interrupts your life, a family member was a donor match and he received a transplant. Transplants (generally) require anti-rejection drugs for the rest of your life. They are at least a thousand dollars a month without insurance. Fortunately he had insurance, but then he lost his job. You can't just get any job in this circumstance, you need a job with good health coverage. You can't get private coverage because you can't get insured.
Something like this effects the rest of your life. You are in fear of getting fired. You can't start a business, because you can't get insured. You can't move unless you are certain you could find a job elsewhere. You become a victim of our system. Not just because of the disease, but because our country and many of our citizens feel health-care is a handout. It shouldn't be provided to people who don't deserve it. Or why should I pay for someone else?
It is amazing what monsters live among us and how they masquerade like saints in our churches and down our streets, so they can feel good about themselves by tearing everyone else apart. What a mighty world they live in with everyone else down-at-heel. If you can't beat them, push them down far enough, so you automatically appear to rise above.
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I've been retired 6 years and in that time I have seen my health care coverage go down (vision coverage dropped, reduced payment for services, increased co-pays, fewer medications covered) while my out-of-pocket premiums have doubled. I want many things from our health care system but the top of my list is affordable access for everybody. I expect to have access to the same doctors and other providers so that they can get to know me and my medical situation.
Beyond that, I want access to what is often call alturnative medicine. The last 5 years that I worked I was in a wheelchair. It was a combination of Acpuncture and herbs that let me recover and no longer need a wheelchair or daily pain medications. I think that if a treatment modality can be proven effective, it should be part of the medical services available to anyone who wants it.
peg
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My Parents also recently retired and they are 1.5 years away from being 65 years old. They are very concerned about being forced to take medicare. Their physicians, who have cared for them for over 20 years, are not going to provide care for them when they start on medicare.
27 years each (54 years total) of public school teaching and this is the "thank you" and care they get for teaching so many children. It is sad that our society cannot take of people during their retirement. At least take care of their health. Medicare system is not working.
My parents have also found relief for their own health concerns and problems through alternative care. They find if they take care of health in a truly preventative way, their health also improved. At this time, conventional "preventative" medicine is MAINLY a disease identification and symptom managment and not proactive. Alternative medicine moves beyond just identifying problems and symptoms and move people to wellness and health!
Hopefully any new healthcare and health insurance reform will include this type of truly preventative medicine. This type of healthcare is severely needed in our country.
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Insurance companies prioritize profits over care if they can - and public companies not only do that, but have a fiduciary obligation to do so. We should not be surprised that these companies protect their turf, vilify alternatives, and do anything they can to protect and increase profits - that is their charter - their 'prime directive'.
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Please leave the Health Care system alone! It is working just fine, we do not need the Government to take charge. I am 41 years old and have NEVER had a problem with my health care. Most of the people that want coverage, are already sucking the system dry and just want more free handouts. If your not a productive person in society, then why should anyone carry you? The welfare system is a joke!
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Hope you never get fired from your job and lose your health care.
"If your not a productive person in society, then why should anyone carry you?" Are you actually advocating that Social Security Disablity and SSI should be taken away from the sick, disabled, and handicapped people???
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Or find out you have a condition then find out that they don't cover it even if you are a "productive" citizen. What's productive mean? Daddy left you 300,000 in a trust fund? Paid for your life? People are blind to such realities when they gethe privileges of the wealthy. Welcome to the USA.
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selfish much?
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If I am not for me, who shall be for me? But if I am only for myself, what am I?
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I want single-payer or at least a public option.
There are over 1,100 health insurance companies in this country and they make over $700 BILLION each year in profits. In the last decade, premiums have more than doubled and insurance company profits have soared by over 420% percent in that same time.
World Health Organization studies consistently rank the United States at the bottom of the 'top 30' countries, as far as health care is concerned because we deliver less care per capita than these countries and spend FAR more to do so. All to line the pockets of insurance companies, drug companies and others.
France spends 6% of its relatively-low GDP to insure every single French citizen, no exceptions. The United States spends over 18% of its huge GDP to profit insurance companies and others while leaving over 50 MILLION Americans with no care whatever.
These drug and insurance companies make these obscene profits by cherry-picking, denying coverage and more. They will do anything, say anything to continue making those profits.They are, unfortunately, aided and abetted by a political party that believes that government by the people is inherently evil, as well as pathological liars like Rush Limbaugh.
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The $700 billion a year in profits is a flat out lie. Insurance company profits are mostly made from investments, and the total industry profit comes out to less than one percent of total spending on US health care.
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And where do you think that those investment dollars come from? And are you aware of accounting and tax-acounting practices? When a dollar of profit made by an insurance company is invested elsewhere as part of doing business it is (guess what?) not reported as net profit. Not to mention the many, many other ways that profits can be buried or sheltered. Companies and individuals do this routinely to avoid paying taxes. There's nothing sinister about this, by the way; it is a normal business practice and is provided for by Congress in the US tax code.
Rather than believing what the insurance companies tell me, I'm inclined to believe non-profits like the Harvard Medical School (hardly a hotbed of liberal thinking) (hms.harvard.edu/) and the American Instutute of Medicine (www.aiom.org).
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I'm listening to your speaker that said she lived in BC and the health care was wonderful. I too lived there--for 5 years. I have to wonder if it's the same BC that I lived in. My neighbor needed triple bypass surgery and twice the night before, it was canceled. It was fine as long as you didn't have anything more serious than bronchitius or if you were in an emergency situation. But other than that it was pretty scary
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Thank you, my sister company is in Vancouver BC. My co workers there work, like I do 50 hrs a week Minimum some times as much as 100 hrs a week, yes a week. And if they go to see a doctor they have to wait in line for 6 hrs behind some single mom with 6 kids that does not work for a living. I don’t want to pay for others bad life choices. But the system does need to be reformed for efficiency.
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My brother lives in Norway. His wife just had a baby and the coverage was outstanding. She gets 1 year off work, and he got 2 months or so. Other social programs are wonderful for folks as well, BUT. Taxes are 50% of their income. My sister in law is a biologist, my brother is in construction and they can’t afford to eat out for dinner. A six pack of beer is $20. This still may be acceptable to some folks but there is one mitigating difference between Norwegians and Americans. There is a huge percent of our population that are completely comfortable with living off the system; this is not the case in Norway. It is shameful to mooch off the welfare system, they don’t brag about it. I work hard and I don’t want to pay for someone bad choices. I think that the majority of folks that want health care have not been around folks that take massive advantage of the system at all of our expense.
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Have you checked your paycheck recently? Most workers are already paying more than 50% of their gross income in various kinds of taxes- what we don't get for it is free education through graduate school as long as you get good grades, free medical care, and a secure retirement. Give me those things and I will gladly pay 50% of my gross income in taxes.
(By the way, a 6 pack costs $20 because of the extremely high rate of alcoholism in Norway- not a factor of the cost of living)
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This is in response to the comment about waiting for coverage in Canada. I have a group of friends from the Vancouver BC area. One had to have surgery and did have to wait. It was not life threatening and she did eventually have a successful surgery but it was not on demand. I was also surprised when I asked my friends how much they paid in taxes they told me it was only something like 35%.
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Access to basic care and universal coverage are important.
In praising the current American health care fiasco, I have heard people boast that anyone can go to an emergency room at any time and get treatment.
Three points regarding this:
In many cases, access to preventative care or a primary care doctor could have prevented it becoming an emergency. Access to urgent intervention does not mean it will be in time to save your life.
The $50. Tylenol cited above occurs to support others who show up at the emergency room and can't pay. Ill people with some money are subsidizing those with none already -- often to the point of bankruptcy.
I have seen friends in dire pain turned away from hospital after hospital, finally getting treatment over 10 hours later. Yes, a dislocated arm is not life-threatening, but without timely intervention, this percussionists drumming ability was impaired (he was a student of national caliber). And the pain was enough to have his eyes keep chaining color. I have heard of others dying after being shunted elsewhere.
- Katja Biesanz
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People always say "oh you can just go to the ER" "the hospital MUST treat you, they cannot turn you away". Yes and they will send you a $600 bill for a 2 mile ambulance ride, $50 tylenol bill etc. Even people with insurance working 40 + often have shitty policies. Friends who make under $30,000 and work full time end up with $2000 surgery bills they didn't know they were going to have. This is with insurance. On $30K that is $2K out of $2.5K a month. The hospital offered my friend a two month payment plan. After that it goes to collections. Real Life.
And what constitutes a "bad life choice"? Deciding to negate creativityand creative lifestyles because you are worried about not having healthcare? For some this is not an option. It would result in mental illness.
Besides, that is not an issue in EU and UK. Believe me, artists are PAID by the state to create because they consider such pursuits an important aspect of culture.
AND, I would much rather skip dining out if I knew I would get a year paid leave from work in order to insure my child's health and well- being. Women in the US get 3 months TOPS if they work for a good company.
Perhaps we need to reconsider our values
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I am lucky because I'm healthy and don't need a lot from my health care, but I know someone currently who had to take out a second mortgage on their house to cover the constant and ongoing costs of ovarian cancer that will NOT be covered by their health insurance. And I remember my father who was an independent contractor, so he was self insured. When he hit 60, his insurance costs trippled and he was given a whole list of things that would be disallowed, if they were to happen, basically, anything that he or my mom could reasonably expect. right up to anything to do with my mothers knee, since she broke her kneecap when she was a teenager.
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I want a public health-care option for everyone. So people don't need to live in fear of getting sick, not from sickness itself but from our response to it. So small-businesses can thrive. So older people don't wipe out their savings trying to survive. So their families don't have to worry about how to care for mom and dad. We treat wounded animals with more decency, at least we end their suffering. We let our humans suffer. Not only do many go untreated, but even those with access to care, have to wonder and worry about how long they can afford it. There is enough fear in the world. We don't need this fear---the fear of getting sick with no way to pay for it.
If you want your employees to be happy and good workers, you treat them well! If you want a country of good citizens you must treat them well!
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So you are saying we should put people to sleep if the cost is to much? good idea..............
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tumpaijohn,
When you have the intelligence to not focus on the absurd: get back to me. Maybe then I will engage in a discussion with you. Till then: take a walk.
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Hey man, I was just being sarcastic. We put down thousands of sick and unwanted dogs & cats a month and it does not seem highly intellectual to me for you to use this as an example. But then again, I am not an intellectual, I work for a living.
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I have some direct experience with the Canadian health care system.
My former girlfriend is Canadian. About 5 years ago she discovered that she had an unburst aneurysm. It's very rare to discover an aneurysm before it has burst, and I think it was found, mostly because of the proactive medical system that exists there, where people are not afraid to visit their doctor if they think they have a problem, and doctors run tests for their clients any time they have a medical complaint. In her case she was feeling dizzy occasionally so an MRI was scheduled.
She did have to wait for surgery because her aneurysm was less than 10mm in size, and that was decided by the specialist not to be an imminent threat. We weren't happy about the wait but we also respect their system, where surgeries are performed, not on a want basis, but by imminent threat of death, allocating medical resources more effectively. She was told that if she felt anything that seemed at all unusual, another MRI would be immediately scheduled.
Her appointment was booked about 60 days out if I remember, and she was operated on at St. Michaels hospital in Toronto by the operating team with the best record in north America for this kind of surgery. The modern method of aneurysm surgery was developed in Canada, just incidentally. The total cost was $0. She fully recovered and has regular follow ups.
From much observation, my impression of the medical system in Canada is that for the average person it is superior to what exists here. People choose their primary care physician, and her doctor gave her several choices of surgeons, while recommending the surgeon she felt would be best.
Meanwhile, here in the u.s., I'm a 55 year old free lance musician and have never had health care insurance.
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One of the most important developments in our country's democratic development was the institution of "universal" basic public education. I've been substituting the phrase "basic public education" when I listen to discussions for and against universal health care. I can't imagine what our country would be like if education was limited to only those whose parents had jobs that provided funds for the only option of private education.
I can't help but think that in the years to come our descendants will wonder why having a healthy population wasn't as important as having an educated electorate.
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Thank you Cheryl! This is what people in the UK think when they hear our absurd debates over this issue.
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Our family has two members with preventive and routine care which covers the majority costs at a fixed monthly rate. Unfortunately these plans are for the dog and cat. When our daughter still lived at home we had major medical/life insurance for a small annual fee.
I am for freeing our businesses from the burden of staffing their Human Resource offices with experts in these areas. Insurers and Employers negotiate with an eye on their bottom lines. The shift to Co=pays is an example of said concerns.
I had hand surgeies where the net paid by insurance company was less than a third of the costs(?) charged. If I were a Self-pay patient would I have been billed for and sent to collectiion for the full amount?
I am for a public option because I can't see any way to rely on family, church, or friends to provide for Primary Health Care.
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I am a Canadian studying here in the US and am dismayed about what I have been hearing about the Canadian heath system, especially about wait times. This is being greatly exaggerated. There is no wait time if something is life threatening or urgent. I have never waited more than 2 hours in a walk-in clinic, or 5 hours in an emergency room, which did not put me at any risk. The difference is that it is free, you never risk financial ruin or the uncertainty of not keeping routine preventative care. If you hear us critiquing our own system, it's because we want it to be as efficient and effective as possible, not because we think it doesn't work.
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Amidst the discussion of government involvement in healthcare reform, it is important to consider the the Veteran's Health Administration (VHA) is a federaly-funded system that utilizes evidence-based medicine, discount/quantity buying from pharmaceutical companies, continuity of care, salaried physicians, and electronic medical records (more than 15 years in use) to provide excellent care--and it has done so for over a quarter of a century. The VHA is a model that warrants consideration as a model for a universal system.
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To get personal:
My best friend of 47 years was a conservative republican who worked as a log truck driver on the Oregon Coast. He was temporarily unemployed, three years ago, when he began experiencing apparent digestive problems and abdominal pain. He couldn't afford to go to a doctor and assumed that this was just some passing digestive problem. He was hired by a log-truck company in the Newport area, but had to work there for six months before he would qualify for health care. With a household to support and a backlog of bills and debts, he put this on the back burner. So he persevered.
Less than a month from qualifying for his employer's health care plan, he was rushed to the hospital in Toledo. They rushed him to Good Samaritan in Corvallis where he was diagnosed with acute diverticulitis. They removed all of his large intestine and 30' of the small intestine. He spent almost all of the next THREE YEARS in the hospital and underwent ten more surgeries. He finally succumbed and died three weeks ago.
Because our screwed up system allowed him no option for health care, he spent about 1,000 days in 24-hour hospital care, when access to an early diagnsosis and treatment would have saved his life and spared the public well over $600,000 in medical expenses that the hospital now has to spread across the rest of us.
Please, people; wake up and recognize that a) not everyone is like you and b) we are all in this together; your lack of perception and compassion for others is, unfortunately, emblematic of a 'conservative' movement that cares nothing about anything but themselves. There's only one problem with allowing the other fellow's 1/2 of the boat to sink.
I'll be scattering my friend's ashes this weekend.
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thank you. we need more REAL LIFE stories like this to illustrate the failing system instead of all these facts and figures that prove this or that. People are DYING or going into bankruptcy and then dying. What sort of quality of life does this lead to in this country?
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The worst way to make public policy for the United States is to base it on anecdotal opinions, such as "MY health care situation is just fine so I don't want the country to change its policy." We need to change practices where there is broad evidence of problems preventing efficient and cost effective health care.
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I completely agree. The 'MY health care is okay so don't mess with it' attitude is emblematic of a so-called 'conservative' movement that thinks that as long as they are okay, everything is fine and if anyone else is having a problem it's their own damned fault. It's also emblematic of people who fear change and avoid it at any cost until a situation reaches absolute crisis proportions.
My friend (cited in the posting above) was a conservative Republican and we had many animated arguments along these lines. In the end, after the benighted health-care system in this country condemned him to three years of suffering and hospitalization and, in the end, death, I wound up spending thousands of dollars and thousands of hours loaning him and his family money, driving them from the coast to Corvallis for doctor's appointments, sitting with him for days at a time in the hospital, etc.
None of his conservative friends, to the best of my knowledge, stepped forward to offer any significant help of any kind during that three year period.
I am specifically NOT saying, here, that all conservatives or all Republicans are heartless or cruel, but I AM pointing out that that philosophy which asserts that we can all make it on our own and that anyone who can't is somehow defective as a person or a member of society breeds the kind of lack of compassion that the 'MY health care is okay so what's the problem?' attitude. And boy, does it cost others dearly. Ask me; I know.
This is a society; that means we are all in this together. We do NOT participate in society because we just wake up and feel like we'd like to be around some other people. We participate because, unless you are willing to find some free land you can call your own, hunt for all your own food, grow all your own vegetables, make all your own cloth, sew all your own clothes, make all your own tools from scratch, build your own house from scratch, etc., you CANNOT SURVIVE WITHOUT EVERYONE ELSE. The idea that you can is a fantasy.
Since we're all in the same societal boat, doesn't it make sense to make sure that the other guy's 1/2 of the boat doesn't sink?
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I grew up in Canada and found the system and care wonderful. My family who still live there have been highly satisfied even with care for major health problems. You don't need to have fundraisers to pay for cancer care there, unlike the USA where even 'good' insurance does not cover the costs. My 88 yr mother was surprised to see the same scare tactics, lies and distortions used to dissuade people from the public option as were used (unsuccessfully) by the insurance and pharmaceutical industry in the 1960's when national health insurance was introduced. Long term care is also covered up there. It is a travesty how many young adults in this country are uninsured or extremely underinsured due to the high costs, 'pre-existing conditions' and the control that corporate America has over health care in this country.
Why can the conservative right control us so easily with scare tactics? For every single case that is cited about the 'Canadian health care nightmare', there are thousands of examples of extraordinary care there.
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Co-ops are the latest scam floated by the corporate health-care industry. What could possibly be more accessible and down-to-earth than a co-operative system, right?
In reality, co-op coverage is usually opaque and unresponsive, limited to a small number of facilities, and certainly not portable if you're traveling outside your home region.
But what the health-care industry really likes about co-ops is that unlike a national public option or Medicare buy-in, co-ops are too small to negotiate lower prices with pharmaceutical companies or medical facilities.
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Tell me how someone accesses an alternative Emergency Provider? All direction signs on the streets and highways are blue Hs with arrows. Remember that some of the ER costs are availability costs and would be there even if the day were prove to be uneventful.
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First, it is pretty frustrating hearing people say to leave the healthcare system alone because THEIR insurance is meeting their needs. Are you not hearing that for many of us, that is not the case? It is for those who are risking bankruptcy or going without, including children that something needs to be done.
Secondly, as a midwife, I see many people who are paying for an out-of-hospital birth themselves to save money, despite having insurance. Most insurance companies do not reimburse Certified Professional Midwives (CPM) attending home and free-standing birth center births, despite the research showing its safety and cost-savings.
A non-surgical birth in the hospital typically costs almost $8500; a free standing birth center is approximately $5000 and homebirth is typically $2500-3000. So many people have huge deductibles that don't cover their maternity care or other medical needs. I would like to see out-of-hospital birth included in any healthcare reform as, not only a major cost saver, but as a means to allow women choices in childbirth - something important to many women who do not want their baby's birth to be an over-medicalized event.
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The idea that the health care system is working in the US is a joke. The world looks at us as Neanderthals when it comes to this issue. I am tired of people with access to insurance ignoring the fact that there are millions of people GOING WITHOUT any sort of healthcare. I am without health care and have been for years now. If you are a part time worker you don't get healthcare. Most companies are adopting the tactic of giving workers hours just under the qualifying amount to get the healthcare benefits. My partner has healthcare that he has to PAY for each month and he has to wait to get an appointment. HERE. Not in the UK or some other "socialist" country. The big corporations are MAKING MONEY from healthcare. That in itself is a joke. I have a serious health condition that I am IGNORING and have been for years bcause I can't go to the doctor. Many people I know have been without healthcare for 10-15 years. I have looked into purchasing a policy myself, but haven't found it affodable. Plus, since I have a "pre- existing" condition I would have to lie to even be able to be eligible. So basically I am just waiting to go tot the ER when the condition gets to be too bad and then end up with a bunch of debt to pay. Wake up people.
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We seem to be trying to find the perfect solution for everyone and that just doesn't exist. What we might be able to find is the best compromise for the most number of people, but there are always going to be those that are not best served by whatever we come up with.
When we talk about other systems, or even our own, people invariable come up with individual, specific accounts that support what they want to say. Those are always going to be there for every possible system.
I would like it if we could step back and look for the system that "the most number of participants" are "the most satisfied" with and start from there. Or list the top 10 health care concerns in the country and address those first. Or something, anything, broader than the minutia of individual needs.
We might not end up with what "I" want, but (selfishly) "I" want what is best for me and mine.
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Good point.
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Yes, that is a good point. And its not my intention to seem bitter or selfish, (I am neither). But as a society we should do no less than provide good health care for all those who need it. That is not being met with the current system.
We can do better and we can afford it.
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Here is a story in how health care does not work in this country.
Years ago I was run over by a car on my bicycle and received substantial but not life-long debilatating injurys. It was clear that the driver of the car was at fault. I had no health insurance so the auto insurance companies were supposed to take care of the costs. Unfortunatly for me I was young and inexperienced and there was no one capable or willing to help me handle it. Do you think the insurance companies held up their end of the deal? They did everything in their power to walk away from the responsibility and I never received a dime or even the cost of replacing my crushed bike. After a brief emergency room visit which consisted mainly of waiting for someone to look at me, I had to pick out the shards of glass imbeded in my body myself once I got home.
Health care in this, still the richest country on the planet, is a joke. Sure it may or may not work for those who can afford it, but there are 45 million of us who can't afford it. I'm a citizen of this country, pay my taxes, and here is what I want. A "PUBLIC OPTION", i.e. single payer universal health care run by my government.
Perhaps it is a crime to be less than rich in this society and that is my problem? But I think we can do much better and personally I think a bit of socialism would do this country some good.
Thank you for hosting this discussion.
Jeffree
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For the past 4 years,I have health insurance through my employer. However, due to premium increases, we have changed providers 4 times in 4 years. Each time I have had to change care providers in the middle of treatment.
I have also had an awful time this past year trying to find out how much out of pocket expenses would result from recommended diagnostic tests. The insurance company says they can't tell me because they have individual contracts with each physician. The physician offices tell me I have to find out about out of pocket expense from the insurance company. AFter going around and around, it's the end of the plan year and we switch insurance companies again.
Bottom line, even with insurance, there is no continuity of care and no feeling of health care security; and there won't be until there is a real alternative to private for profit health insurance model we are stuck with.
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A late posting, but think on it: the four necessary criteria for Healthcare:
+ Security
+ Justice
+ Freedom
+ Efficiency
I heard this years ago, from a leader at Harvard Med School and former head of the AMA, and again on radio, I think it was Marketplace 11/25/2008 -
Comments are now closed.
As an individual, I'd like to see free clinics that would cover basic primary, preventive and wellness care with an nationwide information system. So, I could have a primary doctor at my clinic here that I see on a yearly or regular basis, but I would be able to go in for, say, lyme disease treatment in CT if I am there during an outbreak, which happened to me several years ago.
We would have to decide as a nation is what chronic conditions would be covered under primary care. But beyond that, THEN I'd be willing to go for the co-op or another option to get a high deductible insurance to cover me for the unexpected event, and however that would be managed to control costs and provide coverage.