Health Care for Everyone

[Biggles]

And that assumes that those healths which can afford it are more valuable to society than others.

The only way to decide this would be to implement a single-payer option. Of course, the collective bargaining of tens of millions of people using the single-payer system would send private option prices through the stratosphere but gotta pay to play right?

I'm not sure that's true. A private system within a larger single-payer system has to be competitive to prove that it's worth the extra money. There are already examples of how it works in various countries around the world. The UK & Germany for example have private health care operating alongside the public option. My mother (living in London) has private health insurance & was treated for cancer in a state-of-the-art Harley St. clinic. It was a very nice place to be sick ... but in the end she died from the cancer in spite of the best efforts of the specialists. The palliative care she received from the NHS (public system) staff in her last months was (in my opinion) very good.

Canada (more or less) does not allow private health care options as many Canadian are opposed to the idea of a "two tier" healthcare system. However, dentistry, optometry, some areas of physiotherapy, psychology & other areas of health are not publicly funded. It's pretty clear there are pluses & minuses to every system. If you can afford it, the US probably has among the best healthcare options in the world, however, in delivering healthcare to the population as a whole it ranks pretty low, especially on an overall cost basis.

 

[FuriousDemon]

I'm not sure that's true. A private system within a larger single-payer system has to be competitive to prove that it's worth the extra money. There are already examples of how it works in various countries around the world. The UK & Germany for example have private health care operating alongside the public option. My mother (living in London) has private health insurance & was treated for cancer in a state-of-the-art Harley St. clinic. It was a very nice place to be sick ... but in the end she died from the cancer in spite of the best efforts of the specialists. The palliative care she received from the NHS (public system) staff in her last months was (in my opinion) very good.

Canada (more or less) does not allow private health care options as many Canadian are opposed to the idea of a "two tier" healthcare system. However, dentistry, optometry, some areas of physiotherapy, psychology & other areas of health are not publicly funded. It's pretty clear there are pluses & minuses to every system. If you can afford it, the US probably has among the best healthcare options in the world, however, in delivering healthcare to the population as a whole it ranks pretty low, especially on an overall cost basis.

I’m not super impressed with the care here. You have to convince your doctor to pay attention to your concerns and sometimes they will not even prescribe additional tests if you ask for it. Not a specific doctor either. There are a few exceptions that go above and beyond, but it’s rare. It’s probably similar to other places in this regard, but for the amount it costs I expect much better service. Maybe we should implement tipping system for doctors?

 

[Biggles]

I’m not super impressed with the care here. You have to convince your doctor to pay attention to your concerns and sometimes they will not even prescribe additional tests if you ask for it. Not a specific doctor either. There are a few exceptions that go above and beyond, but it’s rare. It’s probably similar to other places in this regard, but for the amount it costs I expect much better service. Maybe we should implement tipping system for doctors?

You're talking about the US? I think as with everything in life, it's going depend somewhat on the individual you're dealing with. It also depends on your own ability to act as an advocate. My wife is awesome at this, having had a lot of experience with her sick parents. I am terrible at it. I suspect, in general, women may be better as they are more likely to be the primary healthcare liaison dealing with sick parents, or sick children.

 

[Joey D]

When you're self-pay and the cardiologist office says, "Actually, the doctor has openings this afternoon..."

Doesn't matter that I'm a 100% financial aid write-off, when they're expecting cash they'll get you an appointment in a right hurry lmao.

If this was at a major healthcare system, I strongly suggest you call the main number found on their website and ask for the compliance office. I don't know every health system in Ohio, but I know for a fact the Mount Carmel system in Columbus, which is part of the larger Trinity CHS system, has a policy against this. I worked for the parent company for a number of years and even worked on the go-live for the whole Mount Carmel system.

Also, if you do struggle to pay or are un or underinsured, please ask for a financial counselor.

I’m not super impressed with the care here. You have to convince your doctor to pay attention to your concerns and sometimes they will not even prescribe additional tests if you ask for it. Not a specific doctor either. There are a few exceptions that go above and beyond, but it’s rare. It’s probably similar to other places in this regard, but for the amount it costs I expect much better service. Maybe we should implement tipping system for doctors?

In the US, the reason doctors won't order additional tests is due to part of the Affordable Care Act that was enacted under Obama. It's called Meaningful Use which forces efficiency in a really anti-patient sort of a way. In theory, it should drive down costs, but all it did was make it so people couldn't get what they needed.

Also, Medicaid and Medicare have absolutely asinine rules regarding what they will and will not pay for. Most healthcare systems just have a blanket policy to follow those rules for everyone since many insurance companies do something similar.

 

[Keef]

If this was at a major healthcare system, I strongly suggest you call the main number found on their website and ask for the compliance office. I don't know every health system in Ohio, but I know for a fact the Mount Carmel system in Columbus, which is part of the larger Trinity CHS system, has a policy against this. I worked for the parent company for a number of years and even worked on the go-live for the whole Mount Carmel system.

Also, if you do struggle to pay or are un or underinsured, please ask for a financial counselor.

I use Kettering Health Network here in Dayton, and I already qualify for their 100% financial aid tier, which is why it's funny that they're so eager to offer self-pay appointment rushing. They've written off like $30k of this FAA-requested nonsense I have to keep doing.

 

[Danoff]

My stance is definitely built around hoping for the best, but preparing for the worst. Realistically the chances of a healthy child reaching self sufficiency is good in places with modern healthcare and rights protections, but I think it's always worth asking yourself what you would do if you or your child end up unlucky and stuck in a tough situation. Agreed that anything further is better suited for a different thread.

I was trying to figure out where is the best place for this discussion. It seemed like it made sense in the abortion thread, or maybe even a new thread about adoption and family custody. But I suppose this is also a pretty decent place given that it touches so much on the cost of healthcare.

Personal responsibility is a big soap box of mine, and you and I are largely aligned on that point. When pregnancy is something that can happen to you, even against your will, personal responsibility exits the stage. It's definitely not appropriate to think of pregnancy automatically as something someone is responsible for and must take responsibility for. So the idea that a mother can be saddled with a lifetime of healthcare needs from a child that was forced upon her is... perverse. For this scenario I need only imagine a rape victim in Texas (or similar state) who is pregnant with a child who has some kind of severe medical need. To anyone who is thinking "but adoption", keep in mind that the mother must be willing to select an adoptive family, and for a child with severe medical needs, the options may be limited or in some cases even not exist.

The burden of a parent (of all kinds) is only part of the reason, of course, why abortion must remain legal. And why adoption must remain legal. But beyond this, who can possibly afford to take the risk of having a child?

Generally people who are ready to start a family are young, maybe in their 30s or late 20s. They have jobs, but are not assumed to be wildly wealthy. They might be able to be assumed to have access to some kind of medical insurance, but of course layoffs and unemployment is a thing. Who are we expecting to be prepared to take the risk that they'll be essentially a servant to a child with severe needs for the rest of their lives? With the alternative being hoping that someone else will take your burden?

If anything, this argues, and I would suggest there are many good reasons for this, that children should have their own minimum healthcare standard which the state is willing to assume. In China, orphanages exist where children with needs can be cared for and educated for the rest of their lives. The only catch to that is that to get your kid in you either need to die or be a criminal (because you cannot legally give up your child).

Choosing to be pregnant is choosing to take on a great responsibility and service for another individual (the child). Compounding it with so much financial and personal loss risks people being unwilling to take on this role, and it is an important role.

Here's my recommendation for this issue:
1) Abortion must be legal
2) Adoption must be legal
3) Institutionalization options for children with severe needs should exist (also for the elderly, different thread I suppose)
4) Some kind of partial institutionalization for children with severe needs probably also makes sense. I'm imagining parents retaining custody while children receive institutional services like health and education.

 

[Exorcet]

But beyond this, who can possibly afford to take the risk of having a child?

Going back to my original statement in the other thread for a moment, highlighting that there is risk in every case of childbearing was the goal. Risk is unfortunately messy because it inherently involves things beyond our control or knowledge. As a result risk can never be completely eliminated. This also makes choosing an acceptable level of risk that isn't subjective impossible. Given that, it's probably most important to focus on making sure risk is acknowledged and planned for above anything else. The wording of my original statement might have implied otherwise, so I just wanted to make sure that my intention was clear to any readers in general.

Generally people who are ready to start a family are young, maybe in their 30s or late 20s. They have jobs, but are not assumed to be wildly wealthy. They might be able to be assumed to have access to some kind of medical insurance, but of course layoffs and unemployment is a thing. Who are we expecting to be prepared to take the risk that they'll be essentially a servant to a child with severe needs for the rest of their lives? With the alternative being hoping that someone else will take your burden?


...


Here's my recommendation for this issue:
1) Abortion must be legal
2) Adoption must be legal
3) Institutionalization options for children with severe needs should exist (also for the elderly, different thread I suppose)
4) Some kind of partial institutionalization for children with severe needs probably also makes sense. I'm imagining parents retaining custody while children receive institutional services like health and education.

Your solution is a sensible one. Pooling the resources of all parents (and possibly of others not in that category) to minimize the risk to any individuals and also efficiently distribute those resources should go a long way to creating a safety net for people who are less fortunate. I think another component to consider is family planning. Families, especially when it comes to children, may commonly be thought of in terms of a nuclear family. However, a family can extend much further than that. Looking back at the previously provided example of a new family, one consisting of a younger couple that has not had time to build wealth, the risk they take in having children could be considered greatly reduced if the wealth and availability of their relatives is factored in. Specifics will always vary on a case by case basis but anyone desiring children should seriously consider how much aid their extended family may be willing and able to provide. The same goes for elderly or medical care in general. In a way this is a smaller scale and less formally defined instance of what you suggested above.

 

[Danoff]

Going back to my original statement in the other thread for a moment, highlighting that there is risk in every case of childbearing was the goal. Risk is unfortunately messy because it inherently involves things beyond our control or knowledge. As a result risk can never be completely eliminated. This also makes choosing an acceptable level of risk that isn't subjective impossible. Given that, it's probably most important to focus on making sure risk is acknowledged and planned for above anything else. The wording of my original statement might have implied otherwise, so I just wanted to make sure that my intention was clear to any readers in general.



Your solution is a sensible one. Pooling the resources of all parents (and possibly of others not in that category) to minimize the risk to any individuals and also efficiently distribute those resources should go a long way to creating a safety net for people who are less fortunate. I think another component to consider is family planning. Families, especially when it comes to children, may commonly be thought of in terms of a nuclear family. However, a family can extend much further than that. Looking back at the previously provided example of a new family, one consisting of a younger couple that has not had time to build wealth, the risk they take in having children could be considered greatly reduced if the wealth and availability of their relatives is factored in. Specifics will always vary on a case by case basis but anyone desiring children should seriously consider how much aid their extended family may be willing and able to provide. The same goes for elderly or medical care in general. In a way this is a smaller scale and less formally defined instance of what you suggested above.

I would generally agree that the wealth to support the child should come from the parents and their social network except that the child does not belong to them, and is fundamentally not their resource. If we're talking about taking a risk when buying a home, that's their property and their resource and so any risk taken should come from their financial pool. But a child is not property, and it's not a resource, and it's not ultimately for the benefit of the parents. In fact, children can be seen as a great burden for parents that the rest of society ultimately benefits from.

I love my kids, and I'd sacrifice so much for them (and do). But my kids are ultimately not mine, they're individuals and members of society in their own right. It might look like the whole thing is for my benefit, but it's really something I wanted to give to someone else, my kids.

Parenting is weird. It's basically a job that people want to do so much that they do it for free. Your social structure can either view children as a part of society which society is responsible for, or you can view them as essentially property belonging to parents and wipe your hands of it. The more you view children as the responsibility of parents, the harder you make the job of parenting. And the harder that job is, the less people will opt to do it for free.

I think it's easier to look at other people's kids and say "they chose to have kids, that's their problem". But if you consider yourself for a moment, you're probably less likely to consider yourself as belonging to your parents and be "their problem". I know that's partly true automatically if you're an adult, but even when I was a kid with crap parents, I didn't think of myself as tied to them in this way. I thought of myself as an individual in my own right.

If kids were grown in a lab, we'd be talking about hiring parents.

 

[Exorcet]

I would generally agree that the wealth to support the child should come from the parents and their social network except that the child does not belong to them, and is fundamentally not their resource. If we're talking about taking a risk when buying a home, that's their property and their resource and so any risk taken should come from their financial pool. But a child is not property, and it's not a resource, and it's not ultimately for the benefit of the parents. In fact, children can be seen as a great burden for parents that the rest of society ultimately benefits from.

Absolutely, children are not and cannot be classified as property. They are individuals. The resources that I was referring to would be money, time [of the care providers], etc.

It's also true that children can benefit society more than parents, although parents may also receive some benefits. Risk is mostly on the parents though.

I love my kids, and I'd sacrifice so much for them (and do). But my kids are ultimately not mine, they're individuals and members of society in their own right. It might look like the whole thing is for my benefit, but it's really something I wanted to give to someone else, my kids.

Parenting is weird. It's basically a job that people want to do so much that they do it for free. Your social structure can either view children as a part of society which society is responsible for, or you can view them as essentially property belonging to parents and wipe your hands of it. The more you view children as the responsibility of parents, the harder you make the job of parenting. And the harder that job is, the less people will opt to do it for free.

True and this extends to a lot of things. Humanity's current success has depended on quite a few things. Intelligence is an obvious one. Really though, being social is probably the most important. Groups can do more than individuals. Collaboration is a solution to many, many problems.

However, collaboration still relies on the sum of the actions of individuals, so it remains important for people to take their specific situations into account. When it comes to parenting, it is without a doubt better to involve more people and work together. Working on a societal level will bring the best outcomes, but individual planning and preparation is also required to make the most of the larger cooperative effort.

I think it's easier to look at other people's kids and say "they chose to have kids, that's their problem". But if you consider yourself for a moment, you're probably less likely to consider yourself as belonging to your parents and be "their problem". I know that's partly true automatically if you're an adult, but even when I was a kid with crap parents, I didn't think of myself as tied to them in this way. I thought of myself as an individual in my own right.

Yeah, I'd be surprised if a child did consider themselves as belonging to their parents in the same sense as property unless it was drilled into them from very early on. I know that growing up it did not take me long to disagree with my parents on somethings and I would definitely try to defend my own individual wants in those disagreements.

If kids were grown in a lab, we'd be talking about hiring parents.

Very likely, a job to raise future generations that could take over when the current one ages. Similar to now, but willingly unpaid as you said before.