6 ms·

Medical debt rankles me like nothing else. The US, supposedly the most advanced nation on Earth has the worst notion of all: health care for profit. Simply evil

by forca 12y ago

Medical debt rankles me like nothing else. The US, supposedly the most advanced nation on Earth has the worst notion of all: health care for profit. Simply evil. Health care is a basic human right. Full stop. Health care should never be based on one's ability to pay. Never. I pray I see socialised medicine in the US in my lifetime. If Hilary Clinton gets elected, the push for this will be stronger than the thin edge of a wedge President Obama has managed. We need a full single-payer tax-based system. I pay the ridiculous sum of $700 US dollars a month for my family's health insurance. If we raise taxes by 10% for every American, we could have awesome health care. I'd gladly take the 10% tax over $8400 a year I pay now. Sick, capitalist theft. I feel I've been politely robbed every pay period.

prostoalex 12y ago
Um, there are more not-for-profit hospitals than there are for-profit hospitals, which doesn't dramatically change the pricing equation. http://www.aha.org/research/rc/stat-studies/fast-facts.shtml http://www.aha.org/research/rc/stat-studies/fast-facts.shtml One man's profit is another man's stash for bonuses and building a new wing of the hospital.
- forca 12y ago
  The goal is zero profit in health care.
  - prostoalex 12y ago
    Where does a dentist then raise money to buy a new XRay machine? Where do you find money if your top doctor wants a raise or threatens to leave for a competitor?
    - snuxoll 12y ago
      Profit != revenue.
      - prostoalex 12y ago
        Ok, but zero profit = zero flexibility on meeting unplanned expenses.
  - refurb 12y ago
    Ridiculous, profit is what drives innovation. You think the billions of dollars a year that go into healthcare R&D comes from the goodness of people's hearts?
- snuxoll 12y ago
  The hospitals aren't the problem, every hospital in the Boise, ID area is non-profit and frequently they work with those without coverage to significantly reduce or completely write off their medical expenses. It's the insurance system that is the problem, since I have insurance the hospitals won't give me a dime off my bill, and my costs are heavily inflated because those of us WITH insurance are subsidizing those without. Now, I'm a software engineer, I make a comfortable income and have a high deductible healthplan and a health savings account, I know I will be able to afford health expenses should they come up, at worst I can make payment arrangements because my annual out-of-pocket max is $5K/10K (individual/family). But many families in my area are just scraping by on barely above minimum wage, and planning for health issues is not high on their priority list. If something happens to them, the $5K debt can be devastating, and it would take them YEARS to pay off what I can in months.
  - prostoalex 12y ago
    Just to clarify: a bunch of people pooling their resources together to negotiate a lower price are a problem, but provider charging high prices to those not able to negotiate a discount is not a problem?
    - snuxoll 12y ago
      Sorry, I may have mis-phrased this, I've edited my original comment. The problem is those pooling their resources into insurance companies are subsidizing those who are NOT. This is what the insurance mandate of the Affordable Care Act is trying to fix, we have yet to see if this will work or not. Ultimately, the simplest solution to the resource pooling problem is to eliminate the insurance industry and go single-payer, then EVERYONE pays with their taxes. However, many insurance companies are for-profit and they'll keep fighting against single-payer until they go out of business.
  - seanmcdirmid 12y ago
    Insurers almost always negotiate huge discounts with hospitals. So the bill you see is not the bill they pay, and what they pay is considered confidential.
kefka 12y ago
>Medical debt rankles me like nothing else. The US, supposedly the most advanced nation on Earth has the worst notion of all: health care for profit. Simply evil. Health care is a basic human right. Full stop. Health care should never be based on one's ability to pay. Never. An injured person has no capitalistic value. They are injured, and can either work limitedly or not at all. Therefore, they are worth little to nothing. Why would a capitalistic government like ours care about someone who will be a drain on the "system"? I's better to send them in the insurance mill or die in the ER. yay usa.
- forca 12y ago
  You sound like a Nazi... I pray you never experience a major medical issue whereby you are "useless" to society.
  - kefka 12y ago
    Actually, I'm much more a socialist. I believe that All people have a right to health. And I also think that introducing large swaths of cash like we do in the USA enables horrible perverse goals.
bequanna 12y ago
I agree, but I think there is too much at stake for too many high net-worth individuals and corporations for the US to make a change to the single-payer system. A 10% rise in taxes? That's a heck of a lot of money. The majority of the rich won't buy into it, they'll fight it tooth and nail. In my opinion, I think it depends on how well appeals for/against a single-payer system resonate with the middle class. Do they generally feel that they will be subsidized, or be subsidizing? Heck, even some poor people (who would be net winners) won't even support it on principle.
- xyzzyz 12y ago
  >A 10% rise in taxes? That's a heck of a lot of money. The majority of the rich won't buy into it, they'll fight it tooth and nail. But now they pay insurance anyway, aren't they?. With a single-payer system, their contribution would actually probably fall.
  - selectodude 12y ago
    Right now, if high net worth individuals pay insurance at all (it's usually an employer provided benefit), it's pre-tax and even the best cadillac plans for the entire family are ~2k/mo. A 10 percent increase in income tax would rankle anybody making over ~150k/yr, and that's assuming the best whole family plans. Someone like myself who pays under 400/mo for really good insurance would get dinged on a 10 percent tax increase at only $50k/yr. Single payer would have to come in at about a 5-7 percent tax increase for it to be even remotely palatable to me, and that's as someone who's all for it and think it's morally bankrupt that we don't have it.
    - jjoonathan 12y ago
      The average person in the US is already paying ~200% as much as a citizen of your typical single-payer country for coverage. Not only are we paying twice as much for coverage, we don't even have universal coverage after paying twice as much. http://healthcarereform.procon.org/view.resource.php?resourceID=005522#V http://healthcarereform.procon.org/view.resource.php?resourc...
refurb 12y ago
Evil! The hyperbole is overflowing! It is true that socialized medicine puts an end to the financial hardship imposed on individuals, but it also brings other problems into the picture, namely rationed healthcare. I've experienced it myself. That's why you have so many Canadians coming to the US when they get really sick.
- mikeyouse 12y ago
  >That's why you have so many Canadians coming to the US when they get really sick. Hardly any Canadians come to the US for medical care, it's a silly rumor that has no grounding in reality. The US has one of the most expensive health care systems in the world for people without insurance, but we're supposed to believe that all these Canadians are rushing over the border with tens or hundreds of thousands of dollars for marginally better care? http://content.healthaffairs.org/content/21/3/19.full http://content.healthaffairs.org/content/21/3/19.full "Results from these sources do not support the widespread perception that Canadian residents seek care extensively in the United States. Indeed, the numbers found are so small as to be barely detectable relative to the use of care by Canadians at home."
  - refurb 12y ago
    The study you reference seems a bit weak. They polled hospitals in Michigan, New York and other border states? The Canadians that I know who have got to the US for care go to places like the Mayo Clinic or Sloan-Kettering. At any rate, rationing of healthcare is a reality in Canada. A few years back the Supreme Court of Canada stated that the ban on private health insurance violated Canadians' right to security as the waiting times for the public system were so high. http://en.wikipedia.org/wiki/Chaoulli_v._Quebec_(Attorney_General) http://en.wikipedia.org/wiki/Chaoulli_v._Quebec_(Attorney_Ge...
    - mikeyouse 12y ago
      > They polled hospitals in Michigan, New York and other border states? The Canadians that I know who have got to the US for care go to places like the Mayo Clinic or Sloan-Kettering. They also polled Canadians directly to approach the question from both sides. > Several sources of evidence from Canada reinforce the notion that Canadians seeking care in the United States were relatively rare during the study period. Only 90 of 18,000 respondents to the 1996 Canadian NPHS indicated that they had received health care in the United States during the previous twelve months, and only twenty indicated that they had gone to the United States expressly for the purpose of getting that care.
gaius 12y ago
My "national insurance" is about that much, £400/mo, at current exchange rates. You would be no better off if the US had an NHS.
wtbob 12y ago
> The US, supposedly the most advanced nation on Earth has the worst notion of all: health care for profit. I presume that in your socialist medical system doctors, nurses, drug chemists, medical feathers and so forth would still get paid, right? Guess what? That's profit. There's plenty wrong with our health care system. Much of it is due to the insurance idea. Much of it is regulatory. Much of it is structural. Single payer wouldn't really address any of that (not even the insurance bit: it'd be insurance writ large). What we need is for everyone to pay for what he receives, with charity/welfare for the indigent. It works for food; it works for medicine.
- lawnchair_larry 12y ago
  No, it doesn't. That's been proven wrong by the entire developed world.
- forca 12y ago
  Easy. Set limits on salaries. All medical schools become government owned and run. Doctors graduate with no debt and they agree to serve the system for 10 years. If you bail before 10, you pay the debt of schooling you. Salaries would be reasonable and capped. You don't become a doctor to become wealthy -- you do so to serve. Have for-profit clinics for stupid things like breast implants and other things that insurance should never be paying for -- like optional stuff.

by forca 12y ago

prostoalex 12y ago

Um, there are more not-for-profit hospitals than there are for-profit hospitals, which doesn't dramatically change the pricing equation. http://www.aha.org/research/rc/stat-studies/fast-facts.shtml http://www.aha.org/research/rc/stat-studies/fast-facts.shtml One man's profit is another man's stash for bonuses and building a new wing of the hospital.

forca 12y ago
The goal is zero profit in health care.
- prostoalex 12y ago
  Where does a dentist then raise money to buy a new XRay machine? Where do you find money if your top doctor wants a raise or threatens to leave for a competitor?
  - snuxoll 12y ago
    Profit != revenue.
    - prostoalex 12y ago
      Ok, but zero profit = zero flexibility on meeting unplanned expenses.
- refurb 12y ago
  Ridiculous, profit is what drives innovation. You think the billions of dollars a year that go into healthcare R&D comes from the goodness of people's hearts?
snuxoll 12y ago
The hospitals aren't the problem, every hospital in the Boise, ID area is non-profit and frequently they work with those without coverage to significantly reduce or completely write off their medical expenses. It's the insurance system that is the problem, since I have insurance the hospitals won't give me a dime off my bill, and my costs are heavily inflated because those of us WITH insurance are subsidizing those without. Now, I'm a software engineer, I make a comfortable income and have a high deductible healthplan and a health savings account, I know I will be able to afford health expenses should they come up, at worst I can make payment arrangements because my annual out-of-pocket max is $5K/10K (individual/family). But many families in my area are just scraping by on barely above minimum wage, and planning for health issues is not high on their priority list. If something happens to them, the $5K debt can be devastating, and it would take them YEARS to pay off what I can in months.
- prostoalex 12y ago
  Just to clarify: a bunch of people pooling their resources together to negotiate a lower price are a problem, but provider charging high prices to those not able to negotiate a discount is not a problem?
  - snuxoll 12y ago
    Sorry, I may have mis-phrased this, I've edited my original comment. The problem is those pooling their resources into insurance companies are subsidizing those who are NOT. This is what the insurance mandate of the Affordable Care Act is trying to fix, we have yet to see if this will work or not. Ultimately, the simplest solution to the resource pooling problem is to eliminate the insurance industry and go single-payer, then EVERYONE pays with their taxes. However, many insurance companies are for-profit and they'll keep fighting against single-payer until they go out of business.
- seanmcdirmid 12y ago
  Insurers almost always negotiate huge discounts with hospitals. So the bill you see is not the bill they pay, and what they pay is considered confidential.

kefka 12y ago

>Medical debt rankles me like nothing else. The US, supposedly the most advanced nation on Earth has the worst notion of all: health care for profit. Simply evil. Health care is a basic human right. Full stop. Health care should never be based on one's ability to pay. Never. An injured person has no capitalistic value. They are injured, and can either work limitedly or not at all. Therefore, they are worth little to nothing. Why would a capitalistic government like ours care about someone who will be a drain on the "system"? I's better to send them in the insurance mill or die in the ER. yay usa.

forca 12y ago
You sound like a Nazi... I pray you never experience a major medical issue whereby you are "useless" to society.
- kefka 12y ago
  Actually, I'm much more a socialist. I believe that All people have a right to health. And I also think that introducing large swaths of cash like we do in the USA enables horrible perverse goals.

bequanna 12y ago

I agree, but I think there is too much at stake for too many high net-worth individuals and corporations for the US to make a change to the single-payer system. A 10% rise in taxes? That's a heck of a lot of money. The majority of the rich won't buy into it, they'll fight it tooth and nail. In my opinion, I think it depends on how well appeals for/against a single-payer system resonate with the middle class. Do they generally feel that they will be subsidized, or be subsidizing? Heck, even some poor people (who would be net winners) won't even support it on principle.

xyzzyz 12y ago
>A 10% rise in taxes? That's a heck of a lot of money. The majority of the rich won't buy into it, they'll fight it tooth and nail. But now they pay insurance anyway, aren't they?. With a single-payer system, their contribution would actually probably fall.
- selectodude 12y ago
  Right now, if high net worth individuals pay insurance at all (it's usually an employer provided benefit), it's pre-tax and even the best cadillac plans for the entire family are ~2k/mo. A 10 percent increase in income tax would rankle anybody making over ~150k/yr, and that's assuming the best whole family plans. Someone like myself who pays under 400/mo for really good insurance would get dinged on a 10 percent tax increase at only $50k/yr. Single payer would have to come in at about a 5-7 percent tax increase for it to be even remotely palatable to me, and that's as someone who's all for it and think it's morally bankrupt that we don't have it.
  - jjoonathan 12y ago
    The average person in the US is already paying ~200% as much as a citizen of your typical single-payer country for coverage. Not only are we paying twice as much for coverage, we don't even have universal coverage after paying twice as much. http://healthcarereform.procon.org/view.resource.php?resourceID=005522#V http://healthcarereform.procon.org/view.resource.php?resourc...

refurb 12y ago

Evil! The hyperbole is overflowing! It is true that socialized medicine puts an end to the financial hardship imposed on individuals, but it also brings other problems into the picture, namely rationed healthcare. I've experienced it myself. That's why you have so many Canadians coming to the US when they get really sick.

mikeyouse 12y ago
>That's why you have so many Canadians coming to the US when they get really sick. Hardly any Canadians come to the US for medical care, it's a silly rumor that has no grounding in reality. The US has one of the most expensive health care systems in the world for people without insurance, but we're supposed to believe that all these Canadians are rushing over the border with tens or hundreds of thousands of dollars for marginally better care? http://content.healthaffairs.org/content/21/3/19.full http://content.healthaffairs.org/content/21/3/19.full "Results from these sources do not support the widespread perception that Canadian residents seek care extensively in the United States. Indeed, the numbers found are so small as to be barely detectable relative to the use of care by Canadians at home."
- refurb 12y ago
  The study you reference seems a bit weak. They polled hospitals in Michigan, New York and other border states? The Canadians that I know who have got to the US for care go to places like the Mayo Clinic or Sloan-Kettering. At any rate, rationing of healthcare is a reality in Canada. A few years back the Supreme Court of Canada stated that the ban on private health insurance violated Canadians' right to security as the waiting times for the public system were so high. http://en.wikipedia.org/wiki/Chaoulli_v._Quebec_(Attorney_General) http://en.wikipedia.org/wiki/Chaoulli_v._Quebec_(Attorney_Ge...
  - mikeyouse 12y ago
    > They polled hospitals in Michigan, New York and other border states? The Canadians that I know who have got to the US for care go to places like the Mayo Clinic or Sloan-Kettering. They also polled Canadians directly to approach the question from both sides. > Several sources of evidence from Canada reinforce the notion that Canadians seeking care in the United States were relatively rare during the study period. Only 90 of 18,000 respondents to the 1996 Canadian NPHS indicated that they had received health care in the United States during the previous twelve months, and only twenty indicated that they had gone to the United States expressly for the purpose of getting that care.

gaius 12y ago

My "national insurance" is about that much, £400/mo, at current exchange rates. You would be no better off if the US had an NHS.

wtbob 12y ago

> The US, supposedly the most advanced nation on Earth has the worst notion of all: health care for profit. I presume that in your socialist medical system doctors, nurses, drug chemists, medical feathers and so forth would still get paid, right? Guess what? That's profit. There's plenty wrong with our health care system. Much of it is due to the insurance idea. Much of it is regulatory. Much of it is structural. Single payer wouldn't really address any of that (not even the insurance bit: it'd be insurance writ large). What we need is for everyone to pay for what he receives, with charity/welfare for the indigent. It works for food; it works for medicine.

lawnchair_larry 12y ago
No, it doesn't. That's been proven wrong by the entire developed world.
forca 12y ago
Easy. Set limits on salaries. All medical schools become government owned and run. Doctors graduate with no debt and they agree to serve the system for 10 years. If you bail before 10, you pay the debt of schooling you. Salaries would be reasonable and capped. You don't become a doctor to become wealthy -- you do so to serve. Have for-profit clinics for stupid things like breast implants and other things that insurance should never be paying for -- like optional stuff.