8 ms·

I was in America, in LA, a few years back (I'm British), when the whole Obamacare thing was being debated everywhere. The one thing I noticed, and it was a rul

I was in America, in LA, a few years back (I'm British), when the whole Obamacare thing was being debated everywhere. The one thing I noticed, and it was a rule that didn't have a single exception, was that everyone I talked to could give at least one example of a time when either they or somebody they personally knew had been faced with a ruinous bill for healthcare. People who'd been bankrupted, people who'd fled to another state or even left the country to get away from a hospital bill. And yet even after seeing whole families' lives literally torn apart, first-hand, they still were against any healthcare reform. I tried then, and I've tried in the years since, but I simply cannot understand where they're coming from. How anyone can support a healthcare system in this day & age that can, and does, bankrupt or refuse to treat people.. I just can't understand it.

sultezdukes 14y ago
I tried then, and I've tried in the years since, but I simply cannot understand where they're coming from. How anyone can support a healthcare system in this day & age that can, and does, bankrupt or refuse to treat people.. I just can't understand it. I find it curious and odd that you can't understand another philosophy on the role of government and the individual.
- hcayless 14y ago
  I can't understand it. It seems to me to combine selfishness and short-sightedness in equal measure. "I'm all right, I have insurance" plus "I'll never be faced by a health crisis greater than my plans will handle." You might be right, and good for you if you are, but God help you if you aren't. I guess I understand the philosophical argument, from a purely logical perspective, that an individual must stand or fall on their own. But I don't get how people can seriously hold that opinion without living in a cabin in the woods, or in a bubble.
- wybo 14y ago
  This is not about the role of government and the individual. This is about healthcare, something fundamental that every human being needs. For which it cannot be predicted when one needs it, and where need can vary greatly through (in by far most cases) no fault of people themselves (an unpredictable unelastic good). Such matters - often literally of life and death - are not something that ever could be trumped by philosophies about 'roles'. Yes the market works well in most other spheres, yes economic freedoms are important, but no, economic freedoms (or justice) do not trump human life and death, where avoidable (in a civilized society). Economic freedom is just one of the many things people need for happyness. Health and healthcare are another, that is at least as important. And thus the value of economic freedom needs to be balanced out against healthcare. The government just is the mediator. Taxing one sphere of life (economic activity) to ensure justice and security in another that fares better if guided by other principles than profit extracted from individual patients. (individual GPs do profit in the UK system. They, for example, get a bonus if they can make a patient stop smoking, etc. ...speaking of preventative healthcare. They just have less incentive to exploit individual patients (by having them come back later with lung cancer for example) and then charge them to their limit)
rdouble 14y ago
The system does bankrupt people, but it doesn't refuse to treat people. That is why people go bankrupt - the hospital has to treat everyone, then hands them an immense bill.
- bitcartel 14y ago
  Friend at Google with probably the best insurance plan in the country, broke an ankle, and after seeing doctors and physios, still had to pay out-of-pocket close to ten thousand dollars.
  - rdouble 14y ago
    Cool story, but what does that have to do with my comment?
    - bitcartel 14y ago
      Just clarifying your point about the system bankrupting people. Lots of folk outside the US are under the impression that once a person has healthcare insurance everything is hunky dory. The truth is, the current system can bankrupt anybody, regardless of insurance.
      - rdouble 14y ago
        That is a big problem with even attempting reform. All viable options build off the existing insurance system, which is terrible.
- scarecrowbob 14y ago
  I don't believe that this is true, although admittedly I only have anecdotal evidence. I have known several people who otherwise would possibly be alive if they had access to primary care in the earlier stages of their cancers.
  - rdouble 14y ago
abstractbill 14y ago
Having lived in the uk for the first 27 years of my life, and then in California for the past 10, I have only one word to describe the way American healthcare feels to me: barbaric. Long live the NHS, and yay for Obamacare - it seems like a step in the right direction at least.
- marknutter 14y ago
  Why does it seem like a step in the right direction, specifically?
  - GiraffeNecktie 14y ago
    One reason is that it represents the first acknowledgement that health care is something that every man, woman and child should have. That's not to say there aren't horrible things about Obamacare (i.e. terrible business model) but yes, it's a start.
    - deleted 14y ago
      [deleted]
    - JackFr 14y ago
      Everyone requires food, clothing and shelter, and yet we use other mechanisms to insure that our citizens don't go hungry. While not necessary for survival, education is guaranteed by the states, and we use a different model for its delivery. Neither of those is to say that necessarily Obamacare is the wrong solution but its certainly not the only path.
      - NateDad 14y ago
        6.7 million households went hungry in 2012. How are those "other mechanisms" working out? Source: http://www.worldhunger.org/articles/Learn/us_hunger_facts.htm http://www.worldhunger.org/articles/Learn/us_hunger_facts.ht...
        14y ago
droithomme 14y ago
I'm one of those people. Allow me to respond. I have seen people ruined with medical bills. There are many reasons why the system is dysfunctional, and I'm aware of nearly all of them. Did you know that a round of cancer treatment in the US can cost over $500,000, and even if you are fully insured with a good policy you can have a 20% copay required, meaning that with insurance you still personally have to pay $100,000 or more? That sort of thing is what is bankrupting people and is why most medical bankruptcies involved people who were fully insured. That's assuming your insurance policy wasn't subject to "recission", which is legal retroactive cancellation of the policy as soon as you have any condition like cancer that would cost a lot to treat. We have a for-profit medical industry, and a for-profit insurance industry and both are motivated to increase profits, and reducing care is often a way to do it. Even non-profit hospitals will price gouge. Non-profit status does not mean that the executives working there aren't paid large salaries, it doesn't mean that things are delivered at cost, or with minimal mark up. The "reform" is mandating people buy insurance from for-profit insurance companies, with no cost controls. Thus we end up with policies that can cost a family $20,000 a year in premiums, while still having large co-pays that can bankrupt you. The parts of the law that would have provided socialized care for the poor were gutted by the Supreme Court review, and by the executive office rule directives interpreting the law. The answer to the problem is single-payer. The reform system is a further bailout for industry and is already driving up costs and reducing the number of insured. Your posts presents those of us who support a reasonable working solution of single-payer as a position of hypocrisy, inconsistency, and/or ignorance, because we don't accept a non-working solution that retains and increases out of control costs and profits for industry. Not supporting a specific, bad solution does not mean one does not see there is a serious problem and reform is necessary.
- cpleppert 14y ago
  You do realize that Obamacare makes it a lot more likely any single payer plan will be accepted in the future, right? If people are already forced to buy a private plan and medicaid has been expanded then it isn't a leap to just cover everyone and move to a single payer system. This is more true if the exchanges start covering lots of people, in this case, the government has a direct interest that private care is being provided efficiently. I would briefly point out that the $20,000 a year plans you refer to was an example number that the IRS used to illustrate how the law works and not a projection of the cost of healthcare plans in the exchange.
rmc 14y ago
I tried then, and I've tried in the years since, but I simply cannot understand where they're coming from. How anyone can support a healthcare system in this day & age that can, and does, bankrupt or refuse to treat people.. I just can't understand it. Give it 50 years and they'll never go back. The Tories in the UK were opposed to the NHS (AFAIK).

sultezdukes 14y ago

I tried then, and I've tried in the years since, but I simply cannot understand where they're coming from. How anyone can support a healthcare system in this day & age that can, and does, bankrupt or refuse to treat people.. I just can't understand it. I find it curious and odd that you can't understand another philosophy on the role of government and the individual.

hcayless 14y ago
I can't understand it. It seems to me to combine selfishness and short-sightedness in equal measure. "I'm all right, I have insurance" plus "I'll never be faced by a health crisis greater than my plans will handle." You might be right, and good for you if you are, but God help you if you aren't. I guess I understand the philosophical argument, from a purely logical perspective, that an individual must stand or fall on their own. But I don't get how people can seriously hold that opinion without living in a cabin in the woods, or in a bubble.
wybo 14y ago
This is not about the role of government and the individual. This is about healthcare, something fundamental that every human being needs. For which it cannot be predicted when one needs it, and where need can vary greatly through (in by far most cases) no fault of people themselves (an unpredictable unelastic good). Such matters - often literally of life and death - are not something that ever could be trumped by philosophies about 'roles'. Yes the market works well in most other spheres, yes economic freedoms are important, but no, economic freedoms (or justice) do not trump human life and death, where avoidable (in a civilized society). Economic freedom is just one of the many things people need for happyness. Health and healthcare are another, that is at least as important. And thus the value of economic freedom needs to be balanced out against healthcare. The government just is the mediator. Taxing one sphere of life (economic activity) to ensure justice and security in another that fares better if guided by other principles than profit extracted from individual patients. (individual GPs do profit in the UK system. They, for example, get a bonus if they can make a patient stop smoking, etc. ...speaking of preventative healthcare. They just have less incentive to exploit individual patients (by having them come back later with lung cancer for example) and then charge them to their limit)

rdouble 14y ago

The system does bankrupt people, but it doesn't refuse to treat people. That is why people go bankrupt - the hospital has to treat everyone, then hands them an immense bill.

bitcartel 14y ago
Friend at Google with probably the best insurance plan in the country, broke an ankle, and after seeing doctors and physios, still had to pay out-of-pocket close to ten thousand dollars.
- rdouble 14y ago
  Cool story, but what does that have to do with my comment?
  - bitcartel 14y ago
    Just clarifying your point about the system bankrupting people. Lots of folk outside the US are under the impression that once a person has healthcare insurance everything is hunky dory. The truth is, the current system can bankrupt anybody, regardless of insurance.
    - rdouble 14y ago
      That is a big problem with even attempting reform. All viable options build off the existing insurance system, which is terrible.
scarecrowbob 14y ago
I don't believe that this is true, although admittedly I only have anecdotal evidence. I have known several people who otherwise would possibly be alive if they had access to primary care in the earlier stages of their cancers.
- rdouble 14y ago

abstractbill 14y ago

Having lived in the uk for the first 27 years of my life, and then in California for the past 10, I have only one word to describe the way American healthcare feels to me: barbaric. Long live the NHS, and yay for Obamacare - it seems like a step in the right direction at least.

marknutter 14y ago
Why does it seem like a step in the right direction, specifically?
- GiraffeNecktie 14y ago
  One reason is that it represents the first acknowledgement that health care is something that every man, woman and child should have. That's not to say there aren't horrible things about Obamacare (i.e. terrible business model) but yes, it's a start.
  - deleted 14y ago
    [deleted]
  - JackFr 14y ago
    Everyone requires food, clothing and shelter, and yet we use other mechanisms to insure that our citizens don't go hungry. While not necessary for survival, education is guaranteed by the states, and we use a different model for its delivery. Neither of those is to say that necessarily Obamacare is the wrong solution but its certainly not the only path.
    - NateDad 14y ago
      6.7 million households went hungry in 2012. How are those "other mechanisms" working out? Source: http://www.worldhunger.org/articles/Learn/us_hunger_facts.htm http://www.worldhunger.org/articles/Learn/us_hunger_facts.ht...
      - 14y ago

droithomme 14y ago

I'm one of those people. Allow me to respond. I have seen people ruined with medical bills. There are many reasons why the system is dysfunctional, and I'm aware of nearly all of them. Did you know that a round of cancer treatment in the US can cost over $500,000, and even if you are fully insured with a good policy you can have a 20% copay required, meaning that with insurance you still personally have to pay $100,000 or more? That sort of thing is what is bankrupting people and is why most medical bankruptcies involved people who were fully insured. That's assuming your insurance policy wasn't subject to "recission", which is legal retroactive cancellation of the policy as soon as you have any condition like cancer that would cost a lot to treat. We have a for-profit medical industry, and a for-profit insurance industry and both are motivated to increase profits, and reducing care is often a way to do it. Even non-profit hospitals will price gouge. Non-profit status does not mean that the executives working there aren't paid large salaries, it doesn't mean that things are delivered at cost, or with minimal mark up. The "reform" is mandating people buy insurance from for-profit insurance companies, with no cost controls. Thus we end up with policies that can cost a family $20,000 a year in premiums, while still having large co-pays that can bankrupt you. The parts of the law that would have provided socialized care for the poor were gutted by the Supreme Court review, and by the executive office rule directives interpreting the law. The answer to the problem is single-payer. The reform system is a further bailout for industry and is already driving up costs and reducing the number of insured. Your posts presents those of us who support a reasonable working solution of single-payer as a position of hypocrisy, inconsistency, and/or ignorance, because we don't accept a non-working solution that retains and increases out of control costs and profits for industry. Not supporting a specific, bad solution does not mean one does not see there is a serious problem and reform is necessary.

cpleppert 14y ago
You do realize that Obamacare makes it a lot more likely any single payer plan will be accepted in the future, right? If people are already forced to buy a private plan and medicaid has been expanded then it isn't a leap to just cover everyone and move to a single payer system. This is more true if the exchanges start covering lots of people, in this case, the government has a direct interest that private care is being provided efficiently. I would briefly point out that the $20,000 a year plans you refer to was an example number that the IRS used to illustrate how the law works and not a projection of the cost of healthcare plans in the exchange.

rmc 14y ago

I tried then, and I've tried in the years since, but I simply cannot understand where they're coming from. How anyone can support a healthcare system in this day & age that can, and does, bankrupt or refuse to treat people.. I just can't understand it. Give it 50 years and they'll never go back. The Tories in the UK were opposed to the NHS (AFAIK).