Health Care for Everyone

[Joey D]

I challenge anyone who thinks this plan is a good and honest plan for improving healthcare to explain to me why it involves taxing all the things we use to actually have good healthcare.

It won't improve healthcare but do you really think most of the stuff politicians come up with isn't riddled with hidden fees? I don't care who was running the show, you better believe there would be hidden fees in anything that was passed. There's always a bunch of crap tacked onto any bill that passes some inane law or tax. I mean they tried to sneak the "I want to spy on the Internet bill" onto some other bill.

And before anyone mentions something about how it is just 2.3%, it is on even things like sutures and gloves. That means 2.3% on scalpels, plastic tubing, face masks, surgical scrubs, gauze, surgical bandages, etc. Anything that can't be made one time and sanitized repeatedly will be 2.3% more expensive. Your treatments won't just have a higher price if you get a hip replacement, but every treatment will cost more. You know that paper they roll out on the exam table? Taxed.

The good thing that will come out of this is that it will reduce medical waste in hospitals and probably physician offices too. You know how much crap is wasted in hospitals because inventory isn't accounted for correctly or a clinician just grabs a handful of whatever and then has to throw it away at the end of the day because it went unused? At the last hospital I was at we lost thousands of dollars worth of scrubs every month because they weren't properly accounted for and some of the supply guys looked the other way when people wanted a set to lay around the house in (who would want to lay around in surgical scrubs is beyond me because that's gross).

Having a tax on medical equipment will ultimately reduce the use of it and make hospitals actually be accountable for the stuff being used and the stuff that they are charging you or your insurance for. It's not the best way to go about it, and I'm not suggesting that it is, but a result of it is that a part of healthcare that is really out of control will get slightly more under control.

Question - with healthcare (not talking about insurance) being privately owned and a free market to make profit, isn't everything working as intended right now? How do you make healthcare cheaper without it still being a free market? Or, is healthcare something that shouldn't be a free market?

Short answer no it isn't working currently. The healthcare system needs reform in America and that's where the debate comes in as to what needs to be done. Anyone who thinks our current healthcare system prior to the healthcare reform by President Obama was good is delusional.

Having a free market healthcare system doesn't work, neither does a healthcare system fully funded by the government. You need some regulations and you need higher organizations to hold health organizations accountable, but there needs to be a line. Things like the CMS do major audits on all hospitals to make sure they meet a certain standard of care, if they fail to meet that standard the hospital is typically cut off from Medicade/Medicare reimbursement which means they are now out of business pretty much immediately, that's a good thing. But as pointed out by Foolkiller when you have too much involvement you start getting weird taxes on things, that's a bad thing.

There also needs to be some sort of regulation on how much it costs because unlike most other industries you need healthcare to survive. If hospitals could refuse to treat people because they didn't have the money to pay for their service, they'd end up with a lot of dead customers. When you get rushed to the ER, typically you don't have time to decide which hospital you want to go to which means you wouldn't have time to figure out which one would give you the best price. Having people pick their hospitals like they pick their auto mechanics isn't the way to go. I don't think Obama's plan is perfect by any means but if you don't focus on the tax and actually look at some of the other features it has, you'll see there is some good with it.

I don't think that really answered your question much on second though, sorry about that .

=====

Having changed organization that I work for it's interesting to see how another healthcare system is tackling the healthcare reform. The current organization I'm at has a way better plan to conform and get the most amount of reimbursement possible, while developing new ways to lower readmission rates. They also own and operate a health insurance company which is providing me with some pretty awesome coverage and seems to be more on top of their game then previous plans I've had.

One thing that won't survive with the reform are independent hospitals. If an organization isn't part of a larger system they will be closing their doors in the next few years because they won't be able to provide the level of care needed to get adequate reimbursement. In a way this is a good thing for the patient since being part of a large healthcare system means you get better care. You have more doctors to choose from, medical records are easily accessible at more institutions and the hospitals operate with typically a larger budget meaning they can hire the staff they need. Independent hospitals (and not ones linked with universities) are, as an observation by people in the medical field, under staffed.

There's always negative sides to everything too so I'm not saying it's all rosy, but just merely pointing out that it won't be all doom and gloom.

 

[FoolKiller]

Question - with healthcare (not talking about insurance) being privately owned and a free market to make profit, isn't everything working as intended right now? How do you make healthcare cheaper without it still being a free market? Or, is healthcare something that shouldn't be a free market?

If you consider heavily regulated a free market then it is, but that isn't the definition.

And you can't discuss the current issues in the system without discussing insurance, as that is a major part of the issue.

See health insurance is not insurance by definition, a plan to insure against financial ruin in the event of tragedy. For instance, car insurance covers you in the event of an accident. It does not cover inspections and routine maintenance. Home insurance protects against damage or theft, but doesn't fix an old floor or a broken air unit. Life insurance provides a financial safety net for your dependents if you die. It does not make sure you have a good life.

But health insurance covers inspections (check ups) routine maintenance (vaccinations) and small damages (bumps and bruises). So when you might get price estimates for a new muffler or a plumber because it comes out of your pocket you go straight to the doctor for an annual checkup without asking about cost.

What this has done is alter how the healthcare industry works. Mechanics have to compete and keep their prices in check with the rest of their industry. A doctor has no need to. They charge as much as the insurance plans they sign on to work with will allow, or in many cases charge more and then let the insurance pay what their agreement says.

Now, if you listen to the politicians you will be led to believe this is evidence that the insurance companies are the problem, which would make the new healthcare act seem like a good idea. But what they fail to tell you is insurance has been heavily regulated to do exactly what it is doing. Insurance is primarily tied to your employment due to unions backed by politicians. Insurance can not be sold across state lines (more people on a single plan = cheaper plans) because it is forbidden by regulations, and President Obama said allowing it would be unreasonable. The much hated HMOs were the shipping boy of the late Senator Ted Kennedy. The same Ted Kennedy that authored the bill that created HMOs through regulation.

From just those few examples you can see how regulations play a role and it isn't a free market. This doesn't get into the effects created by systems like Medicaid and Medicare. A quick example I have personal experience with is that certain medical supplies are superior and/or easier for the patient. Because they are fairly new they are more expensive. But Medicare won't cover them because they don't care about patient comfort. If these products got mass use they would lower in price, but since Medicare won't pay for it patients who use a facility that accepts Medicare don't get a choice on what equipment they get. Government assistance is designed in a way to basically dictate the market. So, even when you don't use government assistance for your medicine they effectively limit your choices.

 

[arora]

I posted some links and an outline of all the taxes involved in the other thread, I'll link it in case you guys wondering about the tax and cost of the bill...

https://www.gtplanet.net/forum/showthread.php?p=7843255#post7843255

It's post 106 if it doesn't directly link. The cost is going to be huge, it's going to impact the economy in a bad way not even considering how the care is going to go.

 

[arora]

Dion from Australia just told me his health care was free, he says he pays for it because he makes enough money that they tax him for it, yet he is still happy it's free.

 

[Small_Fryz]

No Erik,

I merely asked why would I pay extra to see a Doctor then some X-ray clinic when I can go to the hospital for no extra charge and get it all done at once (though with a half decent wait) as it would all be covered under my "medicare plan" which is not free, but is paid for by my taxes (of which I contribute more than enough..).

In fact, I do struggle to see the point of "private health" in Australia as to me it just seems like you pay more on top of what you already get charged for, then have to pay when you need work done anyway. I don't understand....

 

[arora]

👍

But I have to ask, why pay extra when you can clog up an emergency room? For those who may not know, I'm poking at the man because he has experience.

 

[Shaun]

In fact, I do struggle to see the point of "private health" in Australia as to me it just seems like you pay more on top of what you already get charged for, then have to pay when you need work done anyway. I don't understand....

It's all about elective surgery and choosing the hospital/surgeons of your choice Dion.

Your absolutely correct in saying if your current prediciment is bad enough you will be in under the public system pretty promptly.
Having a heart attack?
Good chance if you dial 000 the ambulance will pick you up and you'll be in a public hospital pretty quickly. At the end of it all you normally pay for is the ambulance.
As you point out there is no such this as free health care as we all pay for medicare, well put aside people who are long term dole recipients.

For the other side of the story though.
We have private health insurance, costs us around 3K a year for the family. Main reason being is my wife's MS. Sure if we wait long enough (sometimes years) we would in the end be looked after by the public system.
As some of the procedures aren't due to a life threatening situation you simply go to the back of the cue and wait your turn in the public system.
Many of the procedures my wife has aren't life saving but make her alot more comfortable within herself, I won't go into details as she would be embarressed if I did.
With private cover the most we normally wait is around 2 weeks and we get to choose the hospital and doctors involved.

For some reason the out of pocket expenses we have even after Medicare and Private cover is for the anesthetist .


Edit: Sorry I should point out that not every elective procedure is covered by Medicare and Private cover, just that all of my wife's electives have been.

Cheers Shaun.

 

[Small_Fryz]

👍

But I have to ask, why pay extra when you can clog up an emergency room? For those who may not know, I'm poking at the man because he has experience.

Funnily enough a few years back almost all GP Doctors (the kind you see when you have a cold or get sick etc) were what we called "bulk billed" which meant it was covered under the medicare plan. Recently though quite a few have shifted away from that and are now "subsidized" however you still required to pay an out of pocket fee. On top of that some places are over worked or not accepting new patients so if you need service you have no choice but to go to the ER in hospital. But you are right, things are not right when kids with runny noses are clogging up our ER..

To be honest I'm still figuring out how to do things best when you need extra attention or specialist appointments like X-Ray etc (hence why I was in the ER with a non life threatening condition). I've also had a few broken bones over time and have always gone to the hospital to get them sorted, never tried the Doctors then X-Ray route.


@Shaun,
I see, that helps clear up the situation 👍

I guess you really need to figure out what is best for the individual and go with that. On one hand I'm lucky with my condition (full govt support) and on the other I'm not (the fact I have it)

 

[arora]

Thanks for input son

 

[Johnnypenso]

No Erik,

I merely asked why would I pay extra to see a Doctor then some X-ray clinic when I can go to the hospital for no extra charge and get it all done at once (though with a half decent wait) as it would all be covered under my "medicare plan" which is not free, but is paid for by my taxes (of which I contribute more than enough..).

In fact, I do struggle to see the point of "private health" in Australia as to me it just seems like you pay more on top of what you already get charged for, then have to pay when you need work done anyway. I don't understand....

Choices, options, free market competitiion would be a good reason.

Many years ago, after much suffering followed by testing, it was determined by a physician under the public health system that my Dad needed a hemorrhoidectomy for the constant irritation,bleeding and other symptoms he had. Not really keen on getting his rectum cut open needlessly, he got a second opinion and the same answer. Surgery was scheduled and everything was a go when someone suggested he try the Rudd Clinic in Toronto.

At the time I believe the Rudd Clinic was completely outside our public medical system and was and is known worldwide as experts on colo-rectal health. My Dad was seen by Dr. Rudd himself and was told he didn't need Hemorrhoidectomy, that it was completely unnecessary and the wrong diagnosis. In fact he had a combination of benign polyps and a poor diet, both of which led to irritation, swelling and bleeding and very similar symptoms to hemerrhoids. $200 later the polyps were removed and my Dad began a journey back to health through diet that he continues on today.

My Dad swears that without seeing Dr. Rudd in that private clinic, he would be dead today and I believe him. Dr. Rudd was also the first medical professional he had ever encountered that told him of the role that food plays in our overall health, especially bowel health. As far as I know, to this day, most doctors are given little or no training in the role that diet plays in overall health, when in fact, it's probably the most important component of lifelong health that there is.

Free market competition, even if it's private health care alongside public health care, will produce better care for everyone, and better outcomes for patients.

 

[FoolKiller]

Somehow I missed this.

The good thing that will come out of this is that it will reduce medical waste in hospitals and probably physician offices too. You know how much crap is wasted in hospitals because inventory isn't accounted for correctly or a clinician just grabs a handful of whatever and then has to throw it away at the end of the day because it went unused? At the last hospital I was at we lost thousands of dollars worth of scrubs every month because they weren't properly accounted for and some of the supply guys looked the other way when people wanted a set to lay around the house in (who would want to lay around in surgical scrubs is beyond me because that's gross).

Having a tax on medical equipment will ultimately reduce the use of it and make hospitals actually be accountable for the stuff being used and the stuff that they are charging you or your insurance for. It's not the best way to go about it, and I'm not suggesting that it is, but a result of it is that a part of healthcare that is really out of control will get slightly more under control.

Depending on the situation, it may it may not help with the waste. Will it reduce wastes in clinic check ups and routine non-invasive procedures? Sure. Although in most of those the supplies are stocked in the room, so it rarely makes a difference. No one grabs too many bandages when they are in a cabinet or drawer two steps away.

But when I am in an invasive procedure I want too many gauzes, bandages, saline packs, and so forth. The last thing I want if I suddenly have a weak vein wall rupture is just enough supplies for the procedure. In fact, I am comforted when I see them hang a couple of extra saline bags nearby and wheel in a crash cart off to the side and check it's inventory and charge. It lets me know they are prepared for worst case scenarios. I actually make note of the bag connected to my IV before getting drugs and check it after regaining conciousness. For a less than two hour procedure I expect to see the same bag hanging up mostly full. If it is mostly drained or replaced I know something went wrong.

Sometimes waste is a result of "just in case" and I would hate to discourage that.

The other aspect, and the far more harmful one in my opinion are the durable medical equipment (DME) for home use. Between my personal use and working with a voluntary starewide prescription assistance program and voluntary physician access program at work I know for some people that is their most expensive bills are their DME. I get calls from people all the time having trouble covering diabetic supplies. Those test strips are hundreds of dollars. For me, my home INR (blood thinner) test kit is $200 for 12 tests worth of supplies. And that is just a 15% deductible.

Fact is, people are more frequently encouraged to do this stuff at home when possible. People are often healthier when at home than in a hospital. This will hurt those people the most.



And this isn't the only tax coming this year.
http://www.nytimes.com/2012/12/09/us/politics/new-taxes-to-take-effect-to-fund-health-care-law.html

New Taxes to Take Effect to Fund Health Care Law
By ROBERT PEAR
WASHINGTON — For more than a year, politicians have been fighting over whether to raise taxes on high-income people. They rarely mention that affluent Americans will soon be hit with new taxes adopted as part of the 2010 health care law.

The new levies, which take effect in January, include an increase in the payroll tax on wages and a tax on investment income, including interest, dividends and capital gains. The Obama administration proposed rules to enforce both last week.

Affluent people are much more likely than low-income people to have health insurance, and now they will, in effect, help pay for coverage for many lower-income families. Among the most affluent fifth of households, those affected will see tax increases averaging $6,000 next year, economists estimate.

To help finance Medicare, employees and employers each now pay a hospital insurance tax equal to 1.45 percent on all wages. Starting in January, the health care law will require workers to pay an additional tax equal to 0.9 percent of any wages over $200,000 for single taxpayers and $250,000 for married couples filing jointly.

The new taxes on wages and investment income are expected to raise $318 billion over 10 years, or about half of all the new revenue collected under the health care law.

Ruth M. Wimer, a tax lawyer at McDermott Will & Emery, said the taxes came with “a shockingly inequitable marriage penalty.” If a single man and a single woman each earn $200,000, she said, neither would owe any additional Medicare payroll tax. But, she said, if they are married, they would owe $1,350. The extra tax is 0.9 percent of their earnings over the $250,000 threshold.

Since the creation of Social Security in the 1930s, payroll taxes have been levied on the wages of each worker as an individual. The new Medicare payroll is different. It will be imposed on the combined earnings of a married couple.

Employers are required to withhold Social Security and Medicare payroll taxes from wages paid to employees. But employers do not necessarily know how much a worker’s spouse earns and may not withhold enough to cover a couple’s Medicare tax liability. Indeed, the new rules say employers may disregard a spouse’s earnings in calculating how much to withhold.

Workers may thus owe more than the amounts withheld by their employers and may have to make up the difference when they file tax returns in April 2014. If they expect to owe additional tax, the government says, they should make estimated tax payments, starting in April 2013, or ask their employers to increase the amount withheld from each paycheck.

In the Affordable Care Act, the new tax on investment income is called an “unearned income Medicare contribution.” However, the law does not provide for the money to be deposited in a specific trust fund. It is added to the government’s general tax revenues and can be used for education, law enforcement, farm subsidies or other purposes.

Donald B. Marron Jr., the director of the Tax Policy Center, a joint venture of the Urban Institute and the Brookings Institution, said the burden of this tax would be borne by the most affluent taxpayers, with about 85 percent of the revenue coming from 1 percent of taxpayers. By contrast, the biggest potential beneficiaries of the law include people with modest incomes who will receive Medicaid coverage or federal subsidies to buy private insurance.

Wealthy people and their tax advisers are already looking for ways to minimize the impact of the investment tax — for example, by selling stocks and bonds this year to avoid the higher tax rates in 2013.

The new 3.8 percent tax applies to the net investment income of certain high-income taxpayers, those with modified adjusted gross incomes above $200,000 for single taxpayers and $250,000 for couples filing jointly.

David J. Kautter, the director of the Kogod Tax Center at American University, offered this example. In 2013, John earns $160,000, and his wife, Jane, earns $200,000. They have some investments, earn $5,000 in dividends and sell some long-held stock for a gain of $40,000, so their investment income is $45,000. They owe 3.8 percent of that amount, or $1,710, in the new investment tax. And they owe $990 in additional payroll tax.

The new tax on unearned income would come on top of other tax increases that might occur automatically next year if President Obama and Congress cannot reach an agreement in talks on the federal deficit and debt. If Congress does nothing, the tax rate on long-term capital gains, now 15 percent, will rise to 20 percent in January. Dividends will be treated as ordinary income and taxed at a maximum rate of 39.6 percent, up from the current 15 percent rate for most dividends.

Under another provision of the health care law, consumers may find it more difficult to obtain a tax break for medical expenses.

Taxpayers now can take an itemized deduction for unreimbursed medical expenses, to the extent that they exceed 7.5 percent of adjusted gross income. The health care law will increase the threshold for most taxpayers to 10 percent next year. The increase is delayed to 2017 for people 65 and older.

In addition, workers face a new $2,500 limit on the amount they can contribute to flexible spending accounts used to pay medical expenses. Such accounts can benefit workers by allowing them to pay out-of-pocket expenses with pretax money.

Taken together, this provision and the change in the medical expense deduction are expected to raise more than $40 billion of revenue over 10 years.

Suddenly I am curious what Obama is on about with all this talk of taxing the rich. He already got his tax increases on them. He's going to double or triple dip their tax increases if he gets his way.

But they don't pay their "fair share" right?

 

[Johnnypenso]

And this isn't the only tax coming this year.

Suddenly I am curious what Obama is on about with all this talk of taxing the rich. He already got his tax increases on them. He's going to double or triple dip their tax increases if he gets his way.

But they don't pay their "fair share" right?

This is how it works with Liberals/Democrats/Socialists, it's always more, more, more when it comes to taxes and spending. People who are so called 99%'ers will look at that and say, "Oh poor 1%'ers paying an extra thousand or two in tax, big deal, big deal they can afford it". That's always the liberal fallback position, when all else fails, just point the finger and say they can afford it, they're rich, you're not, they "should" be paying more.

And it won't end there. I think the country is at a tipping point already, divided now between the "haves" and so called "have nots" and taxes and government spending will keep going up and up and up until something breaks.

 

[FoolKiller]

This is how it works with Liberals/Democrats/Socialists,

I try more to avoid the labels, as attacking one group requires creating stereotypes. Not all Democrats or liberals think we need more taxes, but would rather we just rework how the funding we have is spent.

And then, a similar argument can be said for Republicans/Conservatives. Some of them aren't content with just saying forcing religious hospitals to perform abortions or pay for their employee's birth control is wrong. Some want to go so far as banning them or forcing patients to go through shameful, and unnecessary, tests first.

Both sides can be stereotyped as forcing their form of morality on people, at the cost of liberty, but not everyone who identifies with one side is that extreme.

But I will say President Obama has definitely tried moving his agenda by stirring up class warfare. Unless class warfare is the agenda and he is choosing issues to ignite it. But I don't see the endgame there. I can see an endgame in using class warfare to move his agenda forward.
In healthcare, I think the endgame is single-payer. It feels as if parts of this plan are designed to raise costs, reduce the abilities of businesses, and generally make private insurance a pain. I tried convincing myself I'm wrong, but I can't look at the stuff this plan does without thinking it is designed to cause more anger among citizens, leading them to support more government control. It wouldn't be the first time government regulations and interference have screwed the average citizen over and later the government came back to punish the evil corporations and save the day. And part of me is more afraid that the stuff that appears to do more harm than good is not some long game plot, but just the result of ignorance due to politicians creating policy in a field they do not understand. Or even worse, just sheer oversight due to rushing to move the party agenda along.

 

[hogger129]

Free health care is all fine and dandy until you decide who is going to pay for it. Why do I need to pay into it to support people who won't do the same?

 

[ScouserInExile]

Free health care is all fine and dandy until you decide who is going to pay for it. Why do I need to pay into it to support people who won't do the same?

This is just the nature of tax, really. You get a lot less out than you put in and there will always be people who pay in less than you but get the same, if not more, benefit.

 

[Johnnypenso]

Free health care is all fine and dandy until you decide who is going to pay for it. Why do I need to pay into it to support people who won't do the same?

It's not free, it's never free, someone has to pay for it.

Another thing to consider is this. When you have private health care, you can do whatever you like with your personal actitivies so long as they are legal, it's up to your insurance provider to assess your risk to their system and charge you accordingly. When you fall into a publicly funded system, your insurer, the government, then earns the right to pass laws and by-laws that mitigate their risk. So while in some areas of the US you can still ride a motorcycle without a helmet, here you cannot. Kids need to wear approved helmets while bicycling here as well. There's a movement afoot now to get kids to wear helmets while tobagganing.

There's also no allowance made for those that take care of themselves vs. those that abuse their bodies with drugs, alcohol, excessive eating, sedentary lifestyles etc. In a private system, again, it's up to the insurer to determine your risk to their pool and charge you accordingly, but I as the healthy person, can opt out of insurance altogether or pay a reduced premium because I take care of myself. Not so in a publicly funded system. Regardless of how much people abuse their health, everyone gets the same treatment, so in essence the healthy people are forever subsidizing the unhealthy.

While many of these make common sense to a lot of people, others might resent this intrusion into their lives, but this is a small part of what comes with publicly funded healthcare.

 

[ScouserInExile]

It's not free, it's never free, someone has to pay for it.

Another thing to consider is this. When you have private health care, you can do whatever you like with your personal actitivies so long as they are legal, it's up to your insurance provider to assess your risk to their system and charge you accordingly. When you fall into a publicly funded system, your insurer, the government, then earns the right to pass laws and by-laws that mitigate their risk. So while in some areas of the US you can still ride a motorcycle without a helmet, here you cannot. Kids need to wear approved helmets while bicycling here as well. There's a movement afoot now to get kids to wear helmets while tobagganing.

There's also no allowance made for those that take care of themselves vs. those that abuse their bodies with drugs, alcohol, excessive eating, sedentary lifestyles etc. In a private system, again, it's up to the insurer to determine your risk to their pool and charge you accordingly, but I as the healthy person, can opt out of insurance altogether or pay a reduced premium because I take care of myself. Not so in a publicly funded system. Regardless of how much people abuse their health, everyone gets the same treatment, so in essence the healthy people are forever subsidizing the unhealthy.

While many of these make common sense to a lot of people, others might resent this intrusion into their lives, but this is a small part of what comes with publicly funded healthcare.

When people say "free" they mean "free at the point of care" which is how the nhs operates.

Funny thing about the "do as you like" thing. A friend of mine moved to the USA for work. His company provided health insurance as standard. Which is a good job, because he'd only been there a few weeks when he got falling down drunk and fell down, breaking his wrist in the process. As it turned out, his insurance wouldn't pay for any of his care because he was drunk when he got hurt. In the UK, the nhs would have picked up the tab no matter what state he was in. In fact, in the hospital I used to work in, they reckoned about 80% of people they saw in a&e were drunk when they hurt themselves.

For some time now, the nhs has been pouring money into preventitive medicine. Doctors are incentivised to get people to give up smoking, cut down on the booze, get some exercise etc. All because it's much cheaper to get people to take care of themselves than it is to treat them for the effects of poor lifestyle choices.

One of the big objections to universal healthcare seems to be subsidising others, but you do this if you pay for private insurance. If you never get ill, your premiums are used to treat people who do. It's just that you don't really have a choice in what you pay in with universal healthcare.

 

[FoolKiller]

When people say "free" they mean "free at the point of care" which is how the nhs operates.

By that rationale, my cell service is free. I pay a fee in advance and then every call is free.

Funny thing about the "do as you like" thing. A friend of mine moved to the USA for work. His company provided health insurance as standard. Which is a good job, because he'd only been there a few weeks when he got falling down drunk and fell down, breaking his wrist in the process. As it turned out, his insurance wouldn't pay for any of his care because he was drunk when he got hurt. In the UK, the nhs would have picked up the tab no matter what state he was in. In fact, in the hospital I used to work in, they reckoned about 80% of people they saw in a&e were drunk when they hurt themselves.

I have a feeling there is more to this story, even if it is just that he didn't read his policy properly before agreeing to it.

One of the big objections to universal healthcare seems to be subsidising others, but you do this if you pay for private insurance. If you never get ill, your premiums are used to treat people who do. It's just that you don't really have a choice in what you pay in with universal healthcare.

Choice! There it is. We can choose our plans, pay more for better coverage, less for less coverage. We can weigh it against our personal finances.

Unfortunately, the system is prevented from allowing us too wide of a range of choices by law.

 

[ScouserInExile]

By that rationale, my cell service is free. I pay a fee in advance and then every call is free.

Well no. Free at the point of care is the term that actually describes how the nhs operates. It's not something I've made up, it's what it does. Your comparison is closer to private insurance: you pay an agreed amount, you get an agreed service. A better comparison would be the police: if you get robbed and call the police, you don't pay for anything they do. It's free at the point of service.

I have a feeling there is more to this story, even if it is just that he didn't read his policy properly before agreeing to it.

To be honest, I'm going off what he posted on facebook. But yeah, I imagine he didn't have a clue about the terms of his insurance.

Choice! There it is. We can choose our plans, pay more for better coverage, less for less coverage. We can weigh it against our personal finances.

Unfortunately, the system is prevented from allowing us too wide of a range of choices by law.

Choice is the advantage we have as well, we can pay for private insurance or we can rely on the "free" service, which might not be as good or as quick as if we went private but it is, for all intents an purposes, a free service.

 

[FoolKiller]

Choice is the advantage we have as well, we can pay for private insurance or we can rely on the "free" service, which might not be as good or as quick as if we went private but it is, for all intents an purposes, a free service.

You have a choice to add on. You do not have a choice to keep your money and not pay into any system, or adjust coverage and cost.

In private insurance I know they only people being aided by my money are those who are paying in as well. There are no free loaders.

You have to participate. I do not. I have a choice of if I want coverage or not.

 

[ScouserInExile]

You have a choice to add on. You do not have a choice to keep your money and not pay into any system, or adjust coverage and cost.

In private insurance I know they only people being aided by my money are those who are paying in as well. There are no free loaders.

You have to participate. I do not. I have a choice of if I want coverage or not.

Well yeah, but, again, that's the nature of tax, isn't it? There's plenty of stuff my tax money gets spent on that I'll get no benefits from. Benefits, for example.

 

[Sam48]

Well yeah, but, again, that's the nature of tax, isn't it? There's plenty of stuff my tax money gets spent on that I'll get no benefits from. Benefits, for example.

The difference is that healthcare is a good or service. And like all goods or services, we have the choice to buy them, or to not buy them (e.i. use or refuse). However, that's no longer going to be the case with healthcare. Regardless, that doesn't change the fact that it is a good or service.

 

[ScouserInExile]

The difference is that healthcare is a good or service. And like all goods or services, we have the choice to buy them, or to not buy them (e.i. use or refuse). However, that's no longer going to be the case with healthcare. Regardless, that doesn't change the fact that it is a good or service.

But again, there are lots of services your tax money pays for that you may or may not use, but you would be up in arms if they stopped being free at the point of service. Like schools, the police, the fire service, child protection services, the road network, street lighting and so on. These are all things tax money pays for and are, in my opinion at least, essential in a civilised nation. As is, in my opinion at least, universal healthcare.

Especially since you can't chose whether you get sick or get involved in an accident. In times of trouble, the government should at least make an attempt at helping you out.

 

[FoolKiller]

But again, there are lots of services your tax money pays for that you may or may not use, but you would be up in arms if they stopped being free at the point of service. Like schools,

I think schools should be private or local only at most.

the police,

Protecting the rights of citizens is a job of government. We all benefit from their simple presence. And low income people should pay for them in their taxes too.

the fire service,

I grew up in a small town with a volunteer fire department. Guys in my high school were part of it, and they also had EMS training as we had no nearby hospitals.
And in places where fire services are paid with taxes, everyone benefits, seeing as how fire does not have a tendency to only burn one building and then go out. Just ask Chicago. And low income people should pay for them in their taxes too.

child protection services,

Protecting the rights of citizens is the job of government. We all benefit from them in one way or another. And low income people should pay for them in their taxes too.

the road network,

Paid for with gas tax, aka you pay for what you use.

street lighting

I live in a rural area. What street lights?
And in urban areas lighting is best in places where it is easy to be attacked without many witnesses, like parking lots, which is the responsibility of the property owner to light.

These are all things tax money pays for and are, in my opinion at least, essential in a civilised nation.

All? Street lights, really?

As is, in my opinion at least, universal healthcare.

Especially since you can't chose whether you get sick or get involved in an accident. In times of trouble, the government should at least make an attempt at helping you out.

Why not start with the bare essentials of survival? Universal food. Universal shelter. Universal clothing. These are things you will die without. Why not give everyone a government provided source of these things? I mean, you can't help being alive and being sensitive to malnutrition and exposure.

Universal healthcare forces you to pay for a service whether you use it or not.

Also, you may want to realize who you are talking to before suggesting I would be upset if those things were taken from being government provided to private. If I had street lights I would rather pay extra on my electric bill to cover just the street lights in my neighborhood than pay for it in a tax where I even pay for street lights in places I never go.

 

[Danoff]

But again, there are lots of services your tax money pays for that you may or may not use, but you would be up in arms if they stopped being free at the point of service. Like schools, the police, the fire service, child protection services, the road network, street lighting and so on. These are all things tax money pays for and are, in my opinion at least, essential in a civilised nation. As is, in my opinion at least, universal healthcare.

I agree with everything FK said except his apparent hatred of street lights (which I love). But I'll take his argument a step further and claim that your argument about healthcare being free at the point of service is entirely limited to emergency care. No other healthcare in the US is free at the point of service, and that doesn't generally bother people. Lasik surgery is a wonderful example of something often not even covered by insurance (which is still not free at the point of service), where the purchaser has to pay 100% of the cost, and they are perfectly willing to do so without being offended at the notion that they might have to pay for their eye surgery.

Nobody is arguing that emergency rooms should be closed down or not free at the point of service (though we can have that as a separate discussion if you like). We're talking about routine health care including physicals, getting anti-biotics when you get an infection, having your skin tag or wart removed with liquid nitrogen, having your tonsils out, getting knee surgery when you tear something while playing in your local soccer league, having tubes put in your kids ears, getting glasses, contacts, or lasik surgery, getting an asthma inhaler, getting a pace maker, getting your arrhythmia treated, eye surgery to fix your retinal detachment, having a prosthetic hip implant, on and on and on....

All things that you schedule (sometimes on a short timeline, but scheduled anyway), some of which are covered by some types of insurance, but all of which require up front payment from almost all insurance plans.

The raucous that you hear in the US over health care is not about whether you have to pull out your checkbook at the doctor's office. People are generally willing to do that. The argument is over the price of insurance and the ridiculous way in which your insurance is tied to your employer. So that if you work at wal mart, you have trouble being able to find and afford insurance. That is the argument.

The solution of course is to divorce insurance from your employer, and the natural way to do that is to either make health insurance from any source tax deductible, or to make employer sponsored insurance taxed. Also allow it to be purchased across state lines. These are things that have essentially zero downside, steps that our government could take at zero cost tomorrow and which would benefit everyone. Why they haven't done so is beyond me.

 

[FoolKiller]

I agree with everything FK said except his apparent hatred of street lights (which I love).

I grew up where I could walk outside and it be very dark. I find comfort in the darkness surrounding me and a sky full of more stars than I can count, laying on the roof to watch meteor showers and seeing random, stray meteorites on a semi-regular basis. That does not exist where street lights are.

Street lights, and privately owned security lights, are a symptom of a problem you don't want in your area. I like seeing my motion sensor light (installed because we forget to turn it off too often) come on, only to find an animal walking by.

 

[ScouserInExile]

Protecting the rights of citizens is a job of government. We all benefit from their simple presence. And low income people should pay for them in their taxes too.

See, this is how I see universal healthcare. It's the job of the government to look after it's citizens. When you strip away all the outer layers of foreign policy and so on, the government is just there to serve the people. Part of that should be making sure they are healthy.

Why not start with the bare essentials of survival? Universal food. Universal shelter. Universal clothing. These are things you will die without. Why not give everyone a government provided source of these things? I mean, you can't help being alive and being sensitive to malnutrition and exposure.

Not sure how social security (wellfare?) works in the US, but they do supply that here in the UK. My wife's step sister is a good example of this. Neither she or her boyfriend have jobs and haven't had them for as long as I can remember but the have a house that is heated and lit, they clothe and feed themselves and the two kids and it's all paid for by the government. Granted, despite what certain tabloids would have you believe, they have very little in the way of luxuries but they have those essentials of life that you mentioned.

Universal healthcare forces you to pay for a service whether you use it or not.
.

Yes, but essentially everyone uses it, that's why it's universal. Most of us use it from before the day we were born and will continue to use it until the day we die. So, while some benefit more than others, we all get something out of the nhs, even if it's just a trip to the doctors and some prescription medication every once in a while.

 

[ScouserInExile]

I agree with everything FK said except his apparent hatred of street lights (which I love). But I'll take his argument a step further and claim that your argument about healthcare being free at the point of service is entirely limited to emergency care. No other healthcare in the US is free at the point of service, and that doesn't generally bother people. Lasik surgery is a wonderful example of something often not even covered by insurance (which is still not free at the point of service), where the purchaser has to pay 100% of the cost, and they are perfectly willing to do so without being offended at the notion that they might have to pay for their eye surgery.

The raucous that you hear in the US over health care is not about whether you have to pull out your checkbook at the doctor's office. People are generally willing to do that.

This is the big difference here and is why this argument isn't really going to go anywhere. Healthcare have been free at the point of care in the UK since 1948, which means a good portion of the population can't remember a time when you had to pay for it and it's now just part of life. We find the concept of not having "free" healthcare as alien as an American must find erm... our gun laws, I guess.

Nobody is arguing that emergency rooms should be closed down or not free at the point of service (though we can have that as a separate discussion if you like). We're talking about routine health care including physicals, getting anti-biotics when you get an infection, having your skin tag or wart removed with liquid nitrogen, having your tonsils out, getting knee surgery when you tear something while playing in your local soccer league, having tubes put in your kids ears, getting glasses, contacts, or lasik surgery, getting an asthma inhaler, getting a pace maker, getting your arrhythmia treated, eye surgery to fix your retinal detachment, having a prosthetic hip implant, on and on and on....

All things that you schedule (sometimes on a short timeline, but scheduled anyway), some of which are covered by some types of insurance, but all of which require up front payment from almost all insurance plans.

Of all the things you've listed, the only one you would have to pay for over here would be the laser eye surgery. Unless your eyesight was seriously affecting your quality of life. A lot of those I would say I would find it slightly immoral to ask the patient to pay for, but again, that's because the treatment has always been free here.

Oh, hang on, you wouldn't get contacts either. Or glasses (unless it was seriously affecting your life, or under 16)

 

[Famine]

Of all the things you've listed, the only one you would have to pay for over here would be the laser eye surgery. Unless your eyesight was seriously affecting your quality of life. A lot of those I would say I would find it slightly immoral to ask the patient to pay for, but again, that's because the treatment has always been free here.

Oh, hang on, you wouldn't get contacts either. Or glasses (unless it was seriously affecting your life, or under 16)

And the antibiotics - you pay a prescription charge (unless you're unemployed, pregnant or a child). It wasn't on the list but don't forget dental either.

See, this is how I see universal healthcare. It's the job of the government to look after it's citizens. When you strip away all the outer layers of foreign policy and so on, the government is just there to serve the people. Part of that should be making sure they are healthy.

The job of government is to look after its citizens rights. There is no right to good health or continued existence.

 

[ScouserInExile]

And the antibiotics - you pay a prescription charge (unless you're unemployed, pregnant or a child). It wasn't on the list but don't forget dental either

Which is free to under 16s, pregnant women, the unemployed and (I think) over 65s

The job of government is to look after its citizens rights. There is no right to good health or continued existence.

Are there not? Do we not have the right to life? If the government passes laws around access to healthcare, does that not become a right?

As mentioned, I've never known there not to be "free" healthcare, so I, like a lot of people, see it as a right.