Health Care for Everyone

[Danoff]

Yea it's a terrible system we have tying healthcare to employment. Why on earth would anyone actually want to do that. So you mean if I lose my job I (eventually) lose my healthcare? Perfect!

The reason healthcare is tied to employment in the US is because government incentivize it by enabling employers to offer the perq without charging taxes on it. I've heard the argument that it's because pooling together gives you more power in the market, but if that were the case then my homeowner's insurance and my car insurance would go through my employer as well. The reality is, those things aren't allowed tax benefits through employers, so they're not tied to work.

Which means if I'm laid off I can rest-assured that I have car insurance but not health insurance. Who does this make sense to? We need to stop giving preference for employer healthcare plans. We should be shopping the entire country for the best healthcare (there's another law in the way of that one) and it should be a personal choice.

 

[Joey D]

Or if something happens, they could always contact financial counseling through the hospital the are getting their treatment through. They will work with them and get them in touch with charities to further help them so they don't lose everything. People who go completely bankrupt over medical treatments seem to not explore other avenues. Various cancer charities alone help thousands of people every year (except Susan G. Komen, which is nothing more than a scam).

====

One rather concerning thing I read about healthcare and healthcare bill this week is this: https://www.cbsnews.com/news/coffey...s-is-jailing-people-over-unpaid-medical-debt/

The headline is a little clickbaity since people aren't being jailed over unpaid medical debt, but rather failing to appear in court. Apparently, a judge, who has no law degree and is a cattle rancher, is allowing health systems to file criminal complaints against people who owe them money. How this is remotely legal is beyond me since it's a civil matter, not a criminal one. There should be lawsuit and a civil complaint, no one should end up in jail since debtors imprisonment is highly illegal.

 

[Danoff]

Realistically, universal healthcare seems inevitable in the US. I think that the mess of government interference (including the ACA) has made it all but a foregone conclusion that people will continue to be unhappy enough that universal healthcare will occur. Probably an extension of Medicare. I can only hope that we end up with a two-tier system like Australia and the UK, and no so much like much of Canada. I find it absolutely critical that people at least have the option to buy healthcare. The situation where it is prohibited (because after all, everyone has the same right... right?) is terrifying and horrible.

But make no mistake, it is coming, and I see it as impossible to stop. The only thing that can even slow it down is the degree to which the American government can stifle itself, which is substantial.

 

[HenrySwanson]

Simple question: Which country has the best healthcare model?

 

[Dotini]

Simple question: Which country has the best healthcare model?

Maybe that's not so simple. Maybe it depends upon what that health care system is intended to do. Is it intended to work during a pandemic? Is it intended to work during a natural disaster when the power goes out? In China, the health care seems to be operated by the military for the purpose of national and governmental survival. In the US, clearly giant profits are being reaped and we think we can deal better with anything than anyone. But the smartest people in the world have decided the NHS is best.

 

[HenrySwanson]

Maybe that's not so simple. Maybe it depends upon what that health care system is intended to do. Is it intended to work during a pandemic? Is it intended to work during a natural disaster when the power goes out? In China, the health care seems to be operated by the military for the purpose of national and governmental survival. In the US, clearly giant profits are being reaped and we think we can deal better with anything than anyone. But the smartest people in the world have decided the NHS is best.

Hehe I wouldn't say the NHS is the best - if it were wouldn't other countries have copied its model?

 

[UKMikey]

Hehe I wouldn't say the NHS is the best - if it were wouldn't other countries have copied its model?

https://www.nuffieldtrust.org.uk/news-item/why-has-the-nhs-not-been-copied-spoiler-it-has

 

[Joey D]

@Danoff A look at single payer healthcare in the USA (may contain profanity!):

@PocketZeven this is probably a better place for this discussion, so I'm replying to it here. I didn't watch the whole thing because I can only tolerate very small doses of John Oliver, however, I did see the part about the little girl and the GoFundMe page. My question is, why aren't those parents not looking elsewhere if they've only raised $600 for their daughter? The Shriners, a fraternal organization, raises millions and millions every year to help kids in need of healthcare. In 2019 alone their hospitals treated nearly 150,000 kids and they dumped nearly $40 million into research.

Also, the whole 90% of crowdfunding doesn't work doesn't surprise me. Crowdfunding is stupid because people abuse which leads people no longer caring. Plus, if I'm going to donate money, I'm going to donate it to a proper charity that has what they're doing with every donation outlined on the public record.

Oliver also rambles off a questionable statistic saying the reason our healthcare is so high is due to administrative costs due to private insurance. I've never seen anything concrete that says that is the case and given that a large chunk of health system's money comes from Medicaid and Medicare, I really question it.

 

[Danoff]

I meant to put this post here.

 

[PocketZeven]

@PocketZeven this is probably a better place for this discussion, so I'm replying to it here. I didn't watch the whole thing because I can only tolerate very small doses of John Oliver, however, I did see the part about the little girl and the GoFundMe page. My question is, why aren't those parents not looking elsewhere if they've only raised $600 for their daughter? The Shriners, a fraternal organization, raises millions and millions every year to help kids in need of healthcare. In 2019 alone their hospitals treated nearly 150,000 kids and they dumped nearly $40 million into research.

Also, the whole 90% of crowdfunding doesn't work doesn't surprise me. Crowdfunding is stupid because people abuse which leads people no longer caring. Plus, if I'm going to donate money, I'm going to donate it to a proper charity that has what they're doing with every donation outlined on the public record.

Oliver also rambles off a questionable statistic saying the reason our healthcare is so high is due to administrative costs due to private insurance. I've never seen anything concrete that says that is the case and given that a large chunk of health system's money comes from Medicaid and Medicare, I really question it.

I have one simple answer. In my whole life of almost 40 years, I have never once worried about the burden of the cost of healthcare. I also dont know anyone I know with the same complaint.

The suggestion that those parents should have look for the shriners, maybe a long way from where they live. To me it is so very cruel and alien to me to have to look ways to pay for healthcare bills or a way to pay for it. I cant imagine my child having an illness and having to look for charities to help fund it.

 

[Danoff]

I have one simple answer. In my whole life of almost 40 years, I have never once worried about the burden of the cost of healthcare.

Me neither. I've actually come closer to worrying about the cost of food than healthcare. Although I haven't really faced the prospect of running out of food. The thing is, I don't advocate for a national food service either.

I have spent a lot of money on healthcare though. I burned through over $60,000 trying to have my first kid.

A different daughter of mine has over $30,000 worth of equipment to address her own health issues.

 

[Joey D]

I have one simple answer. In my whole life of almost 40 years, I have never once worried about the burden of the cost of healthcare. I also dont know anyone I know with the same complaint.

The suggestion that those parents should have look for the shriners, maybe a long way from where they live. To me it is so very cruel and alien to me to have to look ways to pay for healthcare bills or a way to pay for it. I cant imagine my child having an illness and having to look for charities to help fund it.

For the most part, you don't really need to worry about it in the US either, or rather you shouldn't have too. For whatever reason, whether its pride, lack of effort, or something else, people refuse to contact charities. The Shriners are a national organization and have 22 hospitals in various areas. Also for pediatric eye diseases, there's also the Retina Foundation that helps with the cost of care as well. Hell, the health system I work for has a hospital dedicated to vision issues and would easily help those parents if they couldn't pay.

Even then, that little girl isn't going to be denied care if her parents can't pay. They're going to get a bill and pay what they can monthly for some extended length of time. It takes something really substantial for a patient to get to the point where a hospital flat out denies them care.

Assuming the parents have even the most basic insurance, they're probably not going to be out more than $10,000 altogether and they'll be able to write those expenses off on their taxes.

And while you think it's cruel for people to have to look to charities, I see it as cruel to force me to pay for through my taxes. While there are many conditions that are beyond people's control, I believe the most prevalent condition in the US is heart disease, which is almost always caused by lifestyle. I shouldn't have to pay up because someone chose not to eat right and exercise.

 

[PocketZeven]

Me neither. I've actually come closer to worrying about the cost of food than healthcare. Although I haven't really faced the prospect of running out of food. The thing is, I don't advocate for a national food service either.

I have spent a lot of money on healthcare though. I burned through over $60,000 trying to have my first kid.

A different daughter of mine has over $30,000 worth of equipment to address her own health issues.

The birth of my 2 children cost me 0 euro out of pocket. And alongside I had 4 weeks additional care at home (chores, feeding and help with baby) for X hours a week.

And while you think it's cruel for people to have to look to charities, I see it as cruel to force me to pay for through my taxes. While there are many conditions that are beyond people's control, I believe the most prevalent condition in the US is heart disease, which is almost always caused by lifestyle. I shouldn't have to pay up because someone chose not to eat right and exercise.

I fully understand that point of view. Heart disease because of bad health is less prevelant here, but in my opinion it is still totally worth it if it saves lives of the ones who dont have the means to pay or look for help.

 

[Danoff]

The birth of my 2 children cost me 0 euro out of pocket. And alongside I had 4 weeks additional care at home (chores, feeding and help with baby) for X hours a week.

The actual birth of my kids didn't cost much. Maybe $500 or so, and my wife and I got leave for care at home. But it cost us $60,000 in failed medical procedures and surgery before we actually made it to the birth. I think it was important that we were paying for those procedures though, because each was unnecessary (strictly speaking) and needed to be evaluated on its own, by us, to ensure that it was actually something that was really worth the resources.

 

[PocketZeven]

The actual birth of my kids didn't cost much. Maybe $500 or so, and my wife and I got leave for care at home. But it cost us $60,000 in failed medical procedures and surgery before we actually made it to the birth. I think it was important that we were paying for those procedures though, because each was unnecessary (strictly speaking) and needed to be evaluated on its own, by us, to ensure that it was actually something that was really worth the resources.

My wife got government funded leave as well. I am a businessowner so could not apply.
What kind of procedures? I am curious if it would be covered if it was in the netherlands.

 

[Danoff]

My wife got government funded leave as well. I am a businessowner so could not apply.
What kind of procedures? I am curious if it would be covered if it was in the netherlands.

Most expensive was in vitro fertilization, which we did 5 times. These days I think insurance has to cover it. Back then it was out of pocket.

 

[PocketZeven]

Most expensive was in vitro fertilization, which we did 5 times. These days I think insurance has to cover it. Back then it was out of pocket.

It differs in my country. Not all insuranceproviders cover fertilization. But it is quite easy to change from 1 insurance to another.

Edit: my insurance and my wifes insurance does cover in vitro, limited to the max age of 43.

 

[Sander 001]

 

[Joey D]

Probably because insurance companies aren't exactly used to dealing with claims for "mauled by a bear". Every claim an insurance company gets needs to be reviewed and the supporting documentation from the healthcare provider needs to be read. While there is an ICD-10 code for a bear attack, it's probably a bit difficult to follow the documentation.

 

[mustafur]

Probably because insurance companies aren't exactly used to dealing with claims for "mauled by a bear". Every claim an insurance company gets needs to be reviewed and the supporting documentation from the healthcare provider needs to be read. While there is an ICD-10 code for a bear attack, it's probably a bit difficult to follow the documentation.

Hence why its a stupid system.

 

[Joey D]

Hence why its a stupid system.

Coding is going to be a thing everywhere though. The ICD system is, if I remember correctly, a Dutch invention that most of the world uses.

I have to imagine no matter where you are, being mailed by a bear isn't going to be something straightforward. It could be more complicated in the US, I'm not sure, but I doubt it's easy to figure out in say Canada.

 

[mustafur]

Coding is going to be a thing everywhere though. The ICD system is, if I remember correctly, a Dutch invention that most of the world uses.

I have to imagine no matter where you are, being mailed by a bear isn't going to be something straightforward. It could be more complicated in the US, I'm not sure, but I doubt it's easy to figure out in say Canada.

It wouldn't matter here, you would just get treated, I don't understand the concept of it being an issue. Anything can happen in this world what kind of primitive system means you are only able to be covered by a set amount of circumstances?

 

[Danoff]

It wouldn't matter here, you would just get treated, I don't understand the concept of it being an issue. Anything can happen in this world what kind of primitive system means you are only able to be covered by a set amount of circumstances?

Universal healthcare does not cover all circumstances either I would imagine. Like, for example, plastic surgery. Actually, and apologies if I have asked this before and even gotten the answer, if you get a boob job (which I would imagine is not covered in AU, CA and UK, at least in purely cosmetic cases where reconstruction is not needed), it will eventually need to be replaced. They only last like 20 years or so. When it does need to be replaced, is that covered in those healthcare systems? Or perhaps they only cover removal.

 

[Joey D]

It wouldn't matter here, you would just get treated, I don't understand the concept of it being an issue. Anything can happen in this world what kind of primitive system means you are only able to be covered by a set amount of circumstances?

You'd just get treated in America too. If you showed up to the ED after being attacked by a bear, you would be treated regardless if you had insurance or even your propensity to pay. The thing is fraud is absolutely rampant in the healthcare system worldwide. Just because you say you were attacked by a bear doesn't mean you were attacked by a bear. This is where coding and documentation comes in and something insurance companies look at. I'm guessing if the person was say attempting to get a selfie with a wild bear while walking in known grizzly country it's slightly different than if they were on a simple hike and a bear jumped out of nowhere to have a bit of a nibble. I can't foresee any health plan, whether its private or state ran, covering stupidity or fraudulent behavior.

In America, we probably have a great amount of fraud then say Australia just because we have more than 10 times that amount of people. As a result, things need to be looked at. I'm guessing bear lady was eventually covered for the most part after all the documentation was complete and all the treatment was coded, which can take many months because medical billing is notoriously slow. It's not like she was being hounded on her way out of the hospital to pay thousands.

 

[mustafur]

Universal healthcare does not cover all circumstances either I would imagine. Like, for example, plastic surgery. Actually, and apologies if I have asked this before and even gotten the answer, if you get a boob job (which I would imagine is not covered in AU, CA and UK, at least in purely cosmetic cases where reconstruction is not needed), it will eventually need to be replaced. They only last like 20 years or so. When it does need to be replaced, is that covered in those healthcare systems? Or perhaps they only cover removal.

Sure but lets be real, needs and wants are different things.

 

[Danoff]

Sure but lets be real, needs and wants are different things.

Seriously though... is it covered? I could look it up myself I suppose but I figured this would be well-known.

 

[TheCracker]

Universal healthcare does not cover all circumstances either I would imagine. Like, for example, plastic surgery. Actually, and apologies if I have asked this before and even gotten the answer, if you get a boob job (which I would imagine is not covered in AU, CA and UK, at least in purely cosmetic cases where reconstruction is not needed), it will eventually need to be replaced. They only last like 20 years or so. When it does need to be replaced, is that covered in those healthcare systems? Or perhaps they only cover removal.

It is covered to an extent on the NHS, and i quote from their own website:

• Breast implants - if you have very uneven breasts or no breasts, and it's causing significant psychological distress.
• Breast reductions - if you're very distressed about the size of your breasts and they're causing problems like backache.
• Male breast reductions - if you've had a condition called gynaecomastia for a long time, other treatments have not worked, and it's causing considerable pain or distress.

Generally, most people who want cosmetic surgery will need to pay for it privately.

Reconstructive or plastic surgery is often available on the NHS. It's different from cosmetic surgery because its main aim is to repair and reconstruct missing or damaged tissue and skin after an illness, accident or birth defect.

If breast implants are implanted in an NHS operation, then the NHS will also replace them when the time comes. I believe.

 

[mustafur]

Seriously though... is it covered? I could look it up myself I suppose but I figured this would be well-known.

Cosmetic surgery. Medicare usually doesn't cover cosmetic surgery unless it's needed because of accidental injury or to improve the function of a malformed body part.

https://www.medicare.gov/coverage/cosmetic-surgery

The answer is depends then, I would assume gender reassignment might go either way, but cosmetic for appearance reasons and nothing else isn't covered.

That is not to say I'm satisfied with how Medicare is in Australia, it still doesn't cover vision and dental.

 

[eran0004]

Coding is going to be a thing everywhere though. The ICD system is, if I remember correctly, a Dutch invention that most of the world uses.

I have to imagine no matter where you are, being mailed by a bear isn't going to be something straightforward. It could be more complicated in the US, I'm not sure, but I doubt it's easy to figure out in say Canada.

The difference is probably in how much you depend on the insurance company. If you get mauled by a bear in Sweden you pay a maximum of 100 sek (~€10) per day you stay at the hospital, so even if you stay a month or two you don’t end up with astronomical bills.

 

[Danoff]

Thanks for that. It comes right up to my question and stops though.

If breast implants are implanted in an NHS operation, then the NHS will also replace them when the time comes. I believe.

And if they're not. Eventually they become a health problem down the line if not replaced. At that point it is a medical need. Are they covered then? So... hypothetical time to make this clear.

- Porn Star gets breast implants to further her career (paid for privately).
- After her career, one implant gets ruptured (or has other complications) requiring it to be removed. At that point it is a health issue resulting in pain or even more serious health complications.
What is covered by the NHS?