Single Payer Health Care: Livin the Dream!Follow

So you'd rather pick up the health care costs from uninsured ER visits than force others to pay for their own health care? Never would've pegged you for a secret liberal. So secret you don't even realize it yourself.

Private health insurance in Germany for someone your age will be the same but will cover everything from N₂O over gender reassignment surgery to acupuncture.



On a similar note, gbaji, if you get public health insurance in Germany all that means is you sign up with a company that charges government regulated rates and provides at least the services the government deems necessary. If you get private health insurance, you'll get more services for more money (and no right to get that paid by the government should you find yourself unable to pay it yourself), but you won't have to pay for any public health care whatsoever. The same goes for the Netherlands and in fact half of Europe. The NHS is not the only health care system in Europe and I'll say it again: in many ways it isn't the best.

So you think rising health care costs can in no way be attributed to the uninsured being treated at ERs?

No. I think that has absolutely nothing at all to do with whether or not mandating that someone purchase health insurance represents a reduction of that persons freedom.


Your problem is that you are assuming that I'm arguing in favor of the status quo as well when I'm making my freedom argument. I'm not. When I say we're going in the wrong direction, I don't just mean in the last couple years. We've been going in the wrong direction with health care for at least 40 years.

What we should be doing is going back to a situation where people did not rely on insurance to pay for regular and/or inexpensive care. No one should be using insurance to pay for a checkup, or to get a flu shot or a cut looked at. We should have private general practitioners operating their own practices and people should be able to just walk in and get health care from them directly without going through 5+ layers of middlemen. Those doctors, since they are not part of some larger plan or partnership or insurance co-op or whatever can be as selective with their rates as they want to be, allowing for true competition and keeping prices low. And since these doctors will operate in the community, they'll be more responsive to the needs and funds of their clients and ensure that no one goes without at least some medical care.

Insurance should be kept to paying for things which are expensive and rare. I've made this argument several times in the past. It makes no sense at all to use insurance to pay for anything else. All it does is increase the total cost. If you stop and think about how insurance works, you'll understand why this is (must be!) true.


By breaking those two things apart, we accomplish two results:

1. Regular and minor care is handled directly with no middle man, so it's cheaper. You don't show up at the ER for a scrape or a flu shot. You call your doctor (who might even make house calls!). Absent all those extra layers, the doctor has a vested interest in providing good care at an affordable price. He can also adjust rates based on ability to pay. Right now, a poor person walks into an ER to get care, and the ER charges full price. If they can't pay, some public assistance mechanism steps in to cover that cost (or the owners of the ER pass that full price on to the rest of their customers). The layers make the cost higher. Take them away and the doctor is only dealing with actual cost, not some assumed amount the care is valued at on an actuarial table. Thus, if he chooses to provide care for less money, no one has to make up the full cost of the care. It's much more flexible and affordable and available.

2. Insurance becomes cheaper too. The reason health insurance keeps going up is exactly because we keep insuring more and more things which shouldn't be covered with insurance. As with my example of someone who requires $300/month in medicine, they have to charge at least that much for the insurance for that person just to break even. Worse, as more people use insurance to pay for their health care instead of paying out of pocket, the disconnect between buyer and seller results in price gouging. Why not charge more for that medicine if everyone buying it is just paying a co-pay and their insurance is covering the bill? And when costs rise? The insurance company ups its rate and the employers (or the government) pay more. The people don't notice the costs going up, but it shows up in the form of flat wages or fewer jobs which provide health care as a benefit. Remove that process and everyone is just paying insurance for the rare and expensive care. It becomes far less expensive.



I'll use my standard example to illustrate this:

Imagine what would happen to car insurance rates if car insurance covered regular maintenance of your care instead of just accidents. Then think about what would happen after that. Mechanics would start increasing the cost of a tune up. Why? Because they can. It's covered by the insurance, so the person taking their car to them wont care. And when the rates go up, they wont necessarily connect the two. More to the point, if they raise their rates, people will think they provide better service. I mean, if you're going to get your car tuned up, you going to take it to the guy charging $35 or the guy charging $80? The latter guy must be better right? And if the insurance covers it, you'll pick that one. And even if you are smart enough to realize that this will cause rates to go up, other people will go to the guy charging $80, so you'll end out paying higher rates anyway. May as well get your money's worth, right? And the mechanic who doesn't charge $80 for a tuneup is going to feel stupid when his competitors are making twice what he is.


When you use insurance as a mechanism to pay for regular and affordable services, you create a ton of factors which serve only to make those things more and more expensive. You create a whole industry which serves no purpose other than to act as a middleman for all the money flowing between the customer and the seller. Worse, that industry become yet another factor which will tend to increase costs even more. Insurance should only be used for things which are both rare and expensive. That is what is wrong with our health care system (and is also what's wrong with socialized systems, they just use different terms).

When I talk about private health care in contrast to public health care, I'm not really talking about how the US does things right now. I'm speaking about how private health care should work. Right now, the US has this sort of ******* system that's halfway between the two with none of the benefits of either and most of the negatives of both. But the solution isn't to march forward into socialism. The solution is to remove the socialized aspects we have and move to a more true private health care system. Such systems do work. But you have to actually have it privatized. What we have right now is the result of government meddling so much in the medical insurance industry that it no longer resembles anything which the private market would have created on its own.

You and a lot of people. But the wrong answer is to find a way for government to help us pay for it. The right answer is to figure out why the hell this costs $400/month. And the reason is because that health insurance isn't just paying for people who fall out of a tree, or get hit by a car, or chop their arm off with a chain saw. It's paying for someone to get a check up, and a flu shot, and to get medicine they could buy over the counter for 8-10 bucks (but it's more than the $5 co-pay), and every time someone sprains an ankle, or gets a cold, or has a fever. It costs more because the same health care providers who charge your insurance company deal with an increasing number of people on government pay programs (medicare and medicaid) and see them as bottomless buckets of cash. Your insurance pays $500 for an xray because the hospital knows it can charge that much to someone on medicare and the government will pay it so that has become the market cost (just an example, I have no clue how much xrays cost).

It costs more because the health care provider charges not just for what you got but what you could have gotten if you'd asked. My brother and his wife checked over their bill they got for their last child and noticed a ton of charges for things they didn't get. An example was a nurse to teach his wife how to feed her baby. They declined this since they already knew (not their first kid), but were still charged because the nurse had to be there in case they did need instruction. There were a number of services charged to them like that. Your insurance cost amortizes those costs across all of their paying customers. Every little thing which increases a cost adds up. All the layers of paperwork, the bureaucracy, regulations, and mandates add to the cost.


Imagine how cheap it would be if all you actually paid insurance for was the cost of a hospital stay if a covered person was badly hurt or became seriously ill? It would probably not cost more than $100/month for that family coverage. Do you think you could cover the costs for the normal yearly stuff your family has happen medically out of the $3600/year you'd save? Think about how much it should *really* cost to get a check up, or a bandage put on, or get basic medical diagnosis for normal every day ailments? It just shouldn't cost that much, and if it were you and your doctor face to face with you having to pay him out of your pocket, it *wouldn't* cost that much.

The more we spread the costs out across a bunch of people and for a bunch of different things, the more expensive the whole thing gets. We shouldn't be doing that.

Having read my own itemized bill from our baby being born, I have to say that you're either wrong or else your brother really needs to switch hospitals.

You do realise healthy people in the US pay for health insurance, right? You do also realise that you'd pay a lot less money if you were being taxed to fund public healthcare than if you continued with your current system. Everyone would also be covered, including those who can't afford health insurance under the current system, or those that do not qualify for coverage because they have a pre-existing condition.

If you love paying your health insurance premiums so damn much, you can even go for opt in private healthcare, you don't have to set foot in a NHS style hospital, ever.

Why is this not better again? Does the more socialist aspect of it leave a bad taste in your mouth? Are you so scared of being considered "communist" that you'd just let the poor and the long-term sick die off?

I love how Gbaji's entire method of disputing anything (insurance, education, whatever) relies on some personal anecdote about a person he knows who never had that problem. It doesn't matter the topic, he always has a friend/sibling/cousin and their undocumented story refutes anything you might have to say about the matter.

Echoing this as a fellow Canuck. Ive read stories about people who have had to wait, seen it on the news, but no one that I personally know, has ever had to wait longer than a couple hours in an ER. Heck I think the longest I waited was 5-6 hours and that was me sitting in the ER pumped up on perks with a nail sticking out of my hand.

Thanks to the media however and naivety of most people believing anything on the news is the norm, most health services get a bad rap because the media shows/writes about the 2-3 people a month that had to wait a week or two to get help for a non life threatening injury.

Maybe its the big ol liberal **** up my ***, or maybe its because I have some sense of Morality, but if someone comes to the ER bleeding all over the place and close to death, Ill gladly wait longer so they can get help....more so because of the free meds my hospital hands out like candy FOR FREE, while I wait.

Where I live there is a place where people attempt to process, store, and maintain for the general public all information regarding their license to legally operate machinery, their identification, their deeds and documents of ownership of machinery and other data pertaining to these things called the Department of Motor Vehicles.

I was bring this up to point out in a very cynical fashion that the way that these places operate, Soviet bread-lines, and public health-care are seen as very similar amongst various groups of people in society.
On the other hand I was saying something about the other extreme of privatized organizations running amok if they took over services as well.




Edited, May 22nd 2011 2:06pm by Kelvyquayo

Given the choice between outrageous insurance fees to treat life-threatening injuries and outrageous wait times for non-threatening medical procedures I think that I would gladly take the wait times. In the end I have more money, the same quality of health and all for the low price of not being able to walk into a clinic and get an *** reduction whenever I please.

Too bad I live in America.

Edited, May 23rd 2011 6:10am by decayed

Love thy neighbour and all that, WWJD?!