What should we do with the uninsured?

Let them eat cake!

A better question is 'How do we de-industrialize the medical and pharmaceutical industries?'

Probably more important is what's wrong with the system when Health Insurance is beyond the cost of so many?

Col

I think you're right that health care companies put profit over people. There is no caring anymore. What happened to us as a people that we don't care about one another anymore? Its now all big business. Maybe there are too many of us where if a few get sick and die off it doesn't matter.

I think the fear of death has always driven most people to try to plan for health issues in some way. Everyone thinks about that sometime, but why isn't there an affordable option for the masses to have health care that would give you some security? Maybe health care companies should reconsider why they are in business. They can make a profit, but they have to be about people first.

AV

Once your eyes have cleared of them, isn't that how married life proceeds?
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If the choice is between feeding the young and putting money into a non-refundable savings towards potential harm, then it's a matter of instinct of the bonus pater familias to do the former.

Insurance is a racket, you all know that - too many hands getting a cut of the pie - that makes it OK for "optional" or "frivolous" expenses, but not for basic need expenses.
A more honest approach would be to make it a tax, then let people choose their service provider - best of both worlds.

Bring on the flames, but you know I'm right :p

Re: Necessary x Sufficient -> Doctors get sick and die too. :p

THAT is what the crowd applauded, not a suggestion to let the hypothetical guy die. Wolf Blitzer made the assertion of letting the guy die, not Ron Paul. And Ron Paul, with his answer, dismissed Blitzer's assertion that under a system of individual freedom and responsibility - versus welfareism and socialism - that the guy would go uncared for. He recalled the days in the early 1960s - before government got into the medical delivery business - when hospitals did not turn people away, but local churches, friends, other people, etc. took care of it.

And just look at how the whole vocabulary regarding the insurance product has changed. Today, what's being sold is called [i]"health care"[/i] insurance. A decade or two ago, it was called [i]"medical insurance"[/i]. In the 1960s and earlier, it was called [i]"hospitalization insurance"[/i], and absolutely everything else (outside of being hospitalized) was paid for out-of-pocket by the medical consumer. When my mother took me to the doctor when I was a kid, the first question that was asked was, [i]"What seems to be the problem?"[/i] Today it's, [i]"Who's your insurance carrier and what's your policy number?"[/i] That's crazy!

And after the doctor treated whatever ailed me, she paid the bill. If she was a bit short in the cash department, the doctor would work with her, perhaps offering a discount or even a waived bill for one of his best customers (we had a lot of kids in our family). I actually know another such large family, who, upon having their 13th kid, had both the doctor and the hospital tell them, [i]"We offer a Baker's Dozen. The 13th one is free."[/i] This kind of thing is unheard of today, because everybody expects somebody else - either insurance or government - to pay for it.

Why do you think so many hospitals are named [i]Saint Something or Other[/i]? Because they were created and supported by local churches and charities to help those who could not afford it. People got cared for, and no one was turned away and left to die on the street. This notion that people will be dropping dead all over the place if government got out of the medical delivery business is ludicrous. And in my opinion, something just as ludicrous is any suggestion that government and medical delivery should even be used in the same sentence.

People do not NEED insurance. They never NEED insurance. What they NEED, from time to time, is medical care; insurance is only a broker that pays for it. But the insurance industry and government have taken over the medical delivery business, and together have forced their product - and their will - onto the American consumer. People pay upwards of $500 per month for medical insurance (called health care insurance today). But I would guess that 95 percent of the people, 95 percent of time, NEVER consume $6,000 per year in medical goods or services. Not even close.

When, and under what system of government, did the medical delivery system work best? I have to think it was in the early 1960s, late 1950s - the era Ron Paul illustrated - when people willingly took responsibility for their own healthy (or unhealthy) lives and paid for the majority of their medical care out of their own pocket, not even thinking about insurance until some catastrophic event occurred. When the business of government was governing, not minding everybody else's business; when the business of the medical care industry was delivering medical care, not managing insurance payments while being dictated to by insurance companies; when the individual consumer was the customer of medical goods and services, not insurance companies (or government); when the individual consumer dictated, not the insurance companies (or government); and when the business of insurance companies was to make their product available to the individual consumer for those things that might turn catastrophic. And at that time, the best and most affordable medical care in all the world could be found in North America, not behind the Iron Curtain or in the People's Republic of [i]Wherever[/i], where the business of government was minding the business of every business and every person in their domain.

So to answer your initial question, [i]"What should we[/i] (assuming you mean the collective "we" by way of some federal government meddling program) [i]do with the uninsured?"[/i] The answer: Nothing; absolutely nothing.

Disclaimer: While I support and agree with many of Ron Paul's policy positions, I am not a Ron Paul supporter. (Although I would be if hell froze over and he won the Republican Party nomination, becoming the candidate running against the absolute disaster we call Barack Obama.)

But the Radical Far out Comments that I am currently hearing from some in the US are exactly the same thing that allowed the Father to rise to power in Germany prior to the early 1930's.

The more scared and insecure that people get the more they tend to accept extreme political Ideals which they otherwise wouldn???t have a bar of. If nothing else it just goes to show how wrong Democracy actually is where out of Fear and Insecurity the Masses will Vote for the one who tries to [b]Out Extreme the Other.[/b]

Could be why I don't like Politicians at all as they sink to the lowest common dominator well actually race to it when times get tough and then it takes a lot to repair all of the damage that they did when in power.

However on the Up Side after 9-11 it now appears that GWB is unable to do any international Travel without running the risk of being arrested as a War Criminal. While he stays in the US he can not be touched as the US is not a signatory to the International War Crimes Tribunal but the moment that he moves to visit any country who is he's surspectacle to arrest.

Very much reminds me of a person I found in the Philippines who had suffered a Burst Appendix and when i took them to the Local Hospital they where asked who was going to pay for the treatment to fix them. When they replied that they or their family didn't have enough money they where asked to leave the meat works so that they didn't cause a mess there which had to be paid to be cleaned up. In other words they where told to go home and die in agony and it's not our problem.

Being a Good Catholic they where not willing to practice any form of Birth Control but found it perfectly acceptable to die for the want of a lousy $500.00 AU because they didn't have the money to pay for the treatment. Even then that $500.00 was for treatment that I would expect in AU not what they where expecting there. I personally find that Offensive and just plain Wrong.

When any country devalues any human life they can not be considered as Civilized or an Advanced Country.

Col

Deleted

The republicans are the ones claiming charities can do it, but they ought to show that it's liable before expecting people to go along with it.

"The post-iron age but pre-1960's eras aren't coming back..."
We can do total regression. Just vote Not-the-Michael into the Oral Orifice.

You've changed your tune, perhaps. Can't be that you care what other people might think, can it? Or is Rick someone you know? If the latter, that's your problem, not mine. Either way, it is interesting, nothing more.

Medical treatment without which you'll certainly die? Priceless... but that doesn't mean you should accept hospitals set the price tag much higher than cost plus shareholder dividend (in this climate 5% is good enough for shareholders).

After all Insurance is a protection racket dressed up as a savings account.
The insurance companies get their own back, first by the statistical overpricing on the policies, and then by stock ownership in hospitals.
They can squeeze money out of a rock, and you know it.

It's what happens when a crucial service is allowed to remain without public competition. Like toll road pricing if there were no public roads.
Crucial services cannot be cast to the wolves. It will always backfire.

By all means allow private competition, but keep basic public interests covered via public means. Monopolistic profiteering strangles the economy.

Kill me now. Without the benefit of any damn socialist death panel. :^0

Not that I've ever asked for any sort of publicly supported healthcare, though. Nor will I. Can't afford it, and I don't expect anyone to afford it for me. But there are plenty of people who need services, and I'm not averse to a small portion of my taxes going towards healthcare in the social contract of which I am a member by being a citizen of this country. You have your own private insurance? You're paying for other people's healthcare anyway, or they are paying for yours. This is how insurance works.

Now, if you stop letting the greater healthcare industry charge whatever the hell they want for products and services, insurance wouldn't be a big deal. But we don't interfere with oligopoly/monopoly industries in our fair capitalist system, because that would be evil.

To take a different angle, if we stopped supporting the ridiculous expeditions and toy-collecting of our war-machine and security theater operations and horrifically bad intelligence outfits, we wouldn't have such budget issues and strains on our economy.

Or, if corporate America would give jobs to Americans and pay their damn taxes, and if people would stop thinking for half a second that the only kind of economy is a growth economy, things wouldn't be so bad either.

But on just the healthcare angle, even in present conditions, insurance for preventative medicine or maintaining wellness is by far cheaper than addressing life-threatening emergency issues that could have been easily avoided.

I couldn't find in a few minutes anything more recent but this study goes into some very high level of detail about administration costs in Healthcare:
http://www.pnhp.org/publications/nejmadmin.pdf

In 1999, Health administration costs in the US were $1059 per capita versus $307 per capita in Canada, or 31% of the total healthcare costs in the US versus 16.7% in Canada.

Much of that difference is about billing - in Canada a doctor bills the government, in the US a doctor bills any number of insurance companies. Canada also doesn't have much to spend in the way of healthcare marketing(we do have supplemental insurance for things like dental etc, so the number isn't zero).

The gap in the doctor's labour cost could be about his overhead, the amount of administration required to get his bills paid, plus the cost of malpractise insurance is surely higher in the US than here.

When we had an MRI gap in my province, I had an interesting discussion with some policymakers about why private clinics would be cheaper(though the government resisted them). In a private clinic, with no unions, you can run an MRI 24 hours a day and pay the same wage to the all technicians. In a hospital, you will pay more labor costs for running the MRI 24 hours a day because the healthcare workers union demands shift premiums for the night shift workers.

I'm sure we are just scratching the tip of the iceburg.

Your question, [i]"What should we do with the uninsured?"[/i] makes the assumption (whether you intended to or not) that the collective [i]"we"[/i] are somehow responsible for the collective [i]"uninsured"[/i]

But the first question that should be asked is this: Is receiving medical care an individual responsibility or a collective one?

Moreover, the debate has shifted from one of providing medical care to people who need it but can't afford it, to one of providing insurance coverage to those who need it (or not) and can't (or maybe can) afford it. Those are two different products: medical and insurance.

There are those who might say that receiving medical care is necessary for life itself (or something like that), and should therefore be a collective effort. Well, so is food. Food is also necessary to sustain life. We should therefore all have food insurance.

Imagine, just for a moment, if we had this debate about food insurance and food purchases instead of medical insurance and medical purchases. What if all our food purchases were made like our current medical purchases are made? What would that look like? And what would it look like after about 70 years of the food insurance industry creeping deeper and deeper into individual food choices to the point of controlling many aspects of it?

But we need food insurance, people would say, because food is so expensive. Heck, a simple load of bread costs fifty dollars! That's crazy! And my food insurance premiums keep going up. Food insurance now costs upwards of $500 per month for a family of three! And there are deductibles and co-pays on top of that! We need someone to do something about this.

Then the question would be, [i]"What should we do with those who don't have food insurance?"[/i]

You know, that guy who was baron of La Brède and Montesquieu

It's a stamp which reads "In God we trust".
First of all... talk about a crutch.
Second of all, it is implied, "Only ... "

So you're only interested in telling conservatives how to spend their money. That explains everything.

Is it really so hard to read that sentence?
They claim that charities could and should do what tax money is now paying for.
They - need - to - back - up - that - pathetic - see-through - lie - before - expecting - anyone - to -believe - that.
Like hell the corporate goons will pay to charities that help the poor live a reasonably dignified life.
They'll pay to for-profit "charities" run by the wives of business partners, just so they can mingle with fellow lizards, support institutions that spread their vile propaganda, and get a tax cut out of it as well. And then spout the statistics about how they give more to "charity".

Charity my ass.

You probably wring your hands over them more than they do over themselves.

I wonder why.

they have better things to do than wring their hands.

Sometimes those better things turn out to be rather detrimental to the wellbeing of those with more than they. A revolution is simply the realization by the many, that they are in fact many, and the few are not.
Doesn't take a lot of maths, that.

And revolutions are wasteful, especially since no better plan has been developed, it will just be more of the same.

But I am not wringing my hands, just calling BS where I see it.
And I do. I see BS everywhere.

God didn't write the Bible, after all.
And certainly didn't instigate the church.
Nor tell the church to start kowtowing to the powerful and sell out the meek, who being destined to "inherit" should be thankful for the indignities heaped upon them by their betters and the pharisees blessing them.

:D

Now that you've verified that that was exactly what you meant, lets talk taxes. The liberals want higher taxes. Using your logic, they should put their money where their blab is and pay more taxes.

Let's start with the Obama supporters. They should start paying 50% of their gross income to the Government. After all, it's the only way to pay down the debt and provide all those great Government services.

Naturally, there will be some of those supporters who don't work. They will be given 50% less of their Government assistance. This won't help with increasing the tax income but will take some of the burden off of the Government's obligation to the poor and needy.

And they needn't worry, I'm sure the Government will return them back to their current tax rate as soon as this crisis is over. Who knows, maybe they'll even get a refund for being such responsible citizens.

If someone can afford to insurance (and that's the key part) and makes the decision to not purchase it, why should anyone else be stuck paying his bills? Liquidate the assets he chose to leave unprotected until there's nothing left. If that means that the plug gets pulled should no one else choose to accept the financial obligations, so be it. (Note that Paul did NOT say that.) I'm tired of being charged to cover those who will not (not those who cannot) accept the responsibility for their own financial responsibility, in this and many other areas.

None of this applies to those who cannot afford health care or insurance coverage. I have no solution to that problem. But dropping concerns about those who can afford it certainly reduces the number of people society should be working toward a solution for.

I remember a TV Show recently [i]like this week[/i] where one of the Firemen that did duty on the World Trade Centre Site after 9-11 was saying that they had to have a Bone Marrow Transplant and they where unsure if their Insurance Covered the 200K of the procedure.

Seems that there is something dramatically wrong when any place can run up a bill of that much and then wonder if they will get paid.

Maybe more importantly who is responsible for that Medical Bill the person who got Cancer or the people who caused him to get cancer by demanding that he work on a Contaminated Site to clean up the mess after the event.

To me at least there is something fundamentally wrong where any Emergency Service Worker should be in a position of dying years after they do work for the Public Good and are let wondering if their treatment will be covered.

Or why after so many of these people have got severely sick and been forced to retire years before they otherwise would have why the Insurance Companies who where supposed to cover these people have a gapping hole in their available money to pay for these treatments.

In True Free Enterprise Environment, Trading while Insolvent is the Worst Possible thing that any company can do but in the US we have Chapter 12 Bankruptcy Protection [i]I believe it called[/I] which allows Insolvent Companies to continue to trade and run up even bigger debts.

And then I suppose who is responsible for these people when the Companies that where chosen for them, to cover them go broke and they are left Uncovered? Is it right that they should suffer and Die because the Free Enterprise System that seems so Impotent to the US Citizens here is a failure?

Maybe I'm just Insane but to me at least any Insurance is just a [b]Ponzi Scheme[/b] that has to fail when the Wrong Circumstances are reached. You can not continue to pump money into any system with the promise of Coverage and honour that Coverage when the Incomes are dropping and the number of new members all but dries up. Even if it's legislated as in Public Health that requires a constant increase on any Countries Numbers so that the coming Generations pay for the past Generations eventually.

In the West with Dropping Birth Rates and lower Immigration all Health Services are exposed for the jokes that they actually are. ;)

So in the case of the Fireman above who required a Bone Marrow Transplant who should pay the Medical Bill? Him or the Community that he worked for and demanded he do that work?

Col

The automobile driver, of course - unless it's the pedestrian who's at fault.

In the case of a hit and run? Well, walking across the street might pose just as big a risk as skiing down a Colorado ski slope. The same rules would apply. The pedestrian's major medical would pay, or in the absence of such a policy, apply for medical financial aid and let the chips fall where they may.

We can't address or eliminate all risks in life.

Re: [i]Your clearing house proposal is interesting, but how does that differ from what the insurance companies basically do now? Who's on this decision making board of this organization, and how did they get there? [/i]

No, it's not what insurance companies currently do. Who's on the board and such? Details to be decided.

Sorry to disappoint you, Max, but the new era of man has arrived, and everybody in a first-world economy expects medical care as a human right. Except for some libertarians, and apparently you, who believe that freedom is crucially offended by a system mutual assistance. I'm not sure what bothers you more: paying for somebody else, being dependent on somebody else's care system, or just being required to do something as part of a government program. Well, the world has changed, and for better or worse we are on a path that treats health care much like national defense: something that shelters everyone, and that everyone pays for.

Decent health care is something that costs way too much, which is one reason why it has to be supported by insurance. However, the biggest reason it costs so much is our insurance design itself. Insurance separates the payers from payees from the beneficiaries; your employer pays the insuror, patients choose who receives the money, the doctors design a treatment program and bill for whatever they deliver. Nobody is making decisions based on cost and buyer preference, the kind of decisions that in the rest of the economy give you a variety of choices and hold down prices. What we have now is a system that pays for services limited only by the medical industry's capacity to provide them. No surprise that we've turned a sixth of our economy over to the medical industry, and that it is expected to grow more.

Just turning off insurance would not solve the problem. Treatment is more technological and expensive than it was in the comfortable 1960s, when setting your bones and giving you a morphine drip was the peak of patient care. Charitable hospitals can't afford to pick up what is a much more detailed and costly mission, like they did 100 years ago. Also, hospitals are designed to handle expensive crisis care, not routine care of mildly ill people, like diabetics. Universal health care has to address everything, so that little problems don't become big expensive ones, and so that quality of life is actually improved by health care (something that happens less than 100% of the time even among people currently insured.)

The Obama plan probably slows the growth in cost somewhat, but it doesn't fix what's at the middle of the problem: our system of payments just guarantees that the bills will forever become bigger. We need a system that covers everyone, yet uses consumer choice to put a cap on costs. I have not heard any proposals for how to do that when Obamacare was being debated and voted on.

Of course, you're the one who'll have to make them pay it, since I'm sitting over here in a different country. But it sounds good. If everybody pays for the things what are coming out of their mouthes, I'm sure you'll get a much quieter political space very soon. Which might leave room for deliberation, rather than knee-jerky.

until Monday, I'm swamped right now. ;-)

Since it's the weekend for you, go have a beer at the fortress for me.

This thread will not take off. Everyone is being entirely too reasonable.

Like the situation of healthcare, groupthink isn't working any better than the problem it purports to solve.

Maybe it's the reasoning process itself. Maybe what we need is to have someone or something wade in with an unreasoning sword.
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Does ANYONE think insurance is an appropriate tool for handling healthcare? Doesn't sound like it.
So I guess insurance is what is taken for granted in the political status quo, because they cannot agree on what's to replace it.

Another topic in this discussion is how people can receive emergency treatment even if they can't pay... I think there are two aspects to add to this : Think back on the last ten times you've had medical treatment - how many of those constituted medical emergencies? If a treatment was not for a medical emergency - would you have wanted to be without it?
The second aspect is, what if a person can pay, but it means screwing over their own economy, for example creating a choice between food and mortgage payments in the near future? What does "can afford it" really mean in this debate?

Just kidding, I'll make that a w00t beer.
Weekends are nice.

Not that I would ever expect such an idea ever see any daylight outside of my own mind. Like I said, it was an idea that's been bouncing around in there for a while, and I just decided to let it out to go for a walk through the TR threads.

But I do think that such a system (as fully described) has merit.

they rig the odds.
That's why they're called Actuaries, rather than bookies.
They're like special forces infantry where the bookies are like local pub bouncers.
When they rig the odds, they don't fluck around.

They do file for bankruptcy from time to time, but that's not because they don't have the money... it's because they don't want to PAY the money.
Better to go bankrupt and shuffle the money around until it doesn't exist anymore.
Same with delayed payments, or policies which turn out in fact not to cover anything... all just ways to make sure too much of their money doesn't fall into the wrong hands... i.e. the consumers'. ;)

because everything that breathes, shits.

Ron Paul's solution might have worked years ago, but not now. Maybe the time when people die in the streets hasn't happened yet, but that doesn't mean it can't happen in the future.

I think Wolf Blitzer painted a worst case scenario, but things like that do happen, so it is a valid question. Ron Paul's message is, if you can't pay for health insurance and charity and family can't sustain you, you're a goner. I get it.

AV

..... well, never mind.

the kind that comes out the rectum of a male bovine...
and the one that accompanies that aforementioned breathing of a certain species of monkey.

Or have some posts disappeared from this thread?

I know I'm crazy but even I seem to remember some more posts here. :(

Please tell me its not another Undocumented Feature of the Platform that TR is running on. ;)

Col

for the observant, it's "fun" to find this reference to Roger Rabbit and the disappearing-reappearing ink.

was "indirectly" flouting the imposed wage freeze...