Health Care Reform: The Good, the Bad, the Ugly

[mijan]

The Good: 
- Private health insurance can't deny you for a pre-existing condition under this bill.
- You can't be dropped from a policy because you get sick.
- If you have insurance, they can't "cap" your coverage and say "you've been sick enough now, so we're not paying any more."

The Bad:
- It's not REAL universal health care.  YES, I am "one of those" who fully wants this backwards country to switch to a single-payer system like Canada's system.  I think anything less is a travesty - humiliating and ludicrous.  Time to join the modern world, people.
- Because it's not real UHC, this will do nothing to help the over-complicated network of insurers and the grossly high overhead costs of the health care system.
- Private insurance still rules our health care system.  I'm sorry, but for-profit health "insurance" is a crime against humanity, as far as I'm concerned.
- Nothing to attenuate costs of malpractice insurance, which is putting even GOOD doctors out of business, even if they've never been sued for malpractice.

The Ugly:
- Fining people for not having health insurance.  WTF?!?  I'm sorry, but for the self-employed to have to afford policies on their own when they're BARELY making ends meet... this is going to bankrupt many individuals.  That's STUPID.


Want to chime in with your thoughts?  Go for it, but no flaming.  Civil discourse, please.  Actual facts, please.  Insight from those who live in countries with UHC are welcomed and encouraged to share their experiences.

Comments

[affreca.livejournal.com]

Addressing the fining people angle - it is the stick to get healthy people to buy into the system, i.e. get everyone covered by some health insurance. Insurance works by having people without need of health care pay for those who do. The trick is that people change between those states, and often without warning. Those barely making ends meets are supposed to get subsidies to help them afford coverage, and it should protect them from going into bankruptcy when shit hits the fan.

Another way to think of it is that it would be the taxes you'd pay for a single payer system.

Downside is, I'm not sure there will be a self pay insurance option that will be affordable enough. Non employer insurance costs are highly variable (Lawnchair and I had a high dectuctable plan in KS at $120 a month for the two of us, but that was the perfect storm of KS low regulations and young people with apparently good health, vs. the thousands a month for COBRA I've known people to pay).

So, I don't know. There were some stabs at making the system better (using MA as the template). I'm afraid it was the best plan that could be passed. We'll see if it works.

[gmonkey42.livejournal.com]

The logical way to force everyone to participate in the system is single-payer, not this mess. It's infuriating that the government is so in the thrall of corporations that not allowing them to continue making obscene profits off human suffering is out of the question.

[mijan.livejournal.com]

I still think that forcing people to buy the product of a private business should be illegal, even with subsidies. I don't want my tax dollars subsidizing private health insurance companies. I want private health insurance to die a fast, painful death. It's a scam, even if everyone participates, because it's a for-profit system that makes money by denying coverage as often as possible.

Right now, an employed adult making $40K per year who can't get health insurance (which was me four years ago) STILL pays more for health care in this country than most people pay for health care in most countries with a universal system, whether directly or indirectly. Now, add to that the FORCED purchase of an insurance plan that the person can barely afford (who determines who gets subsidies?), and the fact that some insurance plans barely cover anything, and this is doomed to fail.

The single-payer system is more fair, more efficient, and not for-profit. So no, it's not "the taxes I'd pay for a single payer system." The overhead costs are still hideous. And while they can't deny people with pre-existing conditions under the terms of this new bill, they can sure as hell charge more! That's making me EXTREMELY nervous right now.

The ONLY logical solution is UHC, in the manner of a single-payer system.

[gmonkey42.livejournal.com]

I still think that forcing people to buy the product of a private business should be illegal

YES. Exactly.

[gasphemer.livejournal.com]

Agreed. I make about $10k on my own, my mother recently got a job and was required to get insurance through her employer- for me, her,and my brother.

Her job pays $26k a year.

The insurance premium is $550 a month.

It's fucking robbery, and I still copay out the ass for something as simple as a doc visit.

[ias.livejournal.com]

still think that forcing people to buy the product of a private business should be illegal

As I said to someone above, don't you have to have car insurance in order to drive?

That's exactly the same, a requirement by the State to buy a product from a private company.

[mijan.livejournal.com]

Negative. It's not exactly the same. Not even close. Owning a car isn't required by the government. Driving a car is a choice that many people make, but are not required to make. Many people choose not to have cars.

Additionally, car insurance is a STATE requirement, not a federal requirement. I lived in New Hampshire, which did NOT require drivers to purchase car insurance. So no, you don't necessarily have to have car insurance.

In contrast, if the government requires all people to get health insurance, there is NO "out." You can't "not buy the car" to avoid buying health insurance. According to this new bill, you EXIST, therefore you must buy health insurance.

[ias.livejournal.com]

But in most civilised countries, you are required to have car insurance to drive a car, it is not an unusual requirement. And in all cases the car insurance is bought from private, usually for-profit, companies. Failure to have at least third-party car insurance will result in a fine. Afterall those drivers who do not have car insurance and are involved in accidents only make the premiums more expensive for everyone else. You could call it socialist - making everyone buy into a scheme in order to reduce the cost to individuals.

Also in most civilised countries citizens are required to have health insurance. Here in the UK we all *have* to pay national insurance through our taxes, there is no opt out even if you also pay for private health insurance, just as you don't get a rebate on your taxes if you choose to pay for a private education for your children rather than use the state system. As I said elsewhere in many western European countries, all citizens are required to buy health insurance, frequently from private companies (although many are not-for-profit).

I exist and I have to earn money to survive, therefore I have to pay taxes on my income above a certain level. The necessity to have health insurance is just another form of tax, albeit one that has been mangled in the process of getting the bill through.

[mijan.livejournal.com]

I have no argument with socialism. I have an argument against being forced to buy a product from a private company.

AGAIN, there is NO COUNTRY ON EARTH where you are forced to have a car. Driving a car is a privilege, not a fundamental human right. So if you WANT to have a car, you must then insure it in most places. Nobody is FORCING you to buy a car; therefore nobody is FORCING you to buy car insurance. In contrast, merely by EXISTING, you would be forced to buy health insurance from a private, for-profit company. Additionally, if you have a super-cheap car, your car insurance costs less than if you have a high-end sports car; and a cheap car will still get you from point-A to point-B. However, if you are diagnosed with cancer, you really can't opt for cheaper forms of care without putting your actual life at risk. Do you see the difference?

I WANT socialized medical care. I want a single payer system of FUNDING for health care that is administrated by the government, with the actual clinics and hospitals being run privately, as they are in Canada. I don't think the organization that handles funding for medical care should be skimming profits off the top. That money should exist for the people who get sick, spent on the actual health care, with as little overhead cost as possible.

A system that is funded by taxes is public, by the people, for the people. A private health insurance company is not owned by the people. I have no problem with being taxed to fund a public system. I have a problem being forced to spend money on a private company where the CEO can make insane salaries and the stockholders skim off the top while the worker-bees continue to rubber-stamp claims forms with "denied."

So no, the requirement to have private health insurance is NOT just another form of tax. Not as long as CEO's and shareholders continue to skim off the top for private profit. There is a fundamental and intrinsic difference.

[ias.livejournal.com]

You are never going to get healthcare paid for through taxes in the States, it's just not going to hapen in a country where a significant proportion of Republicans still think the Preisdent is ineligible to hold that position.

As I said before, governments requiring citizens to buy insurance of whatever kind from a private company is nothing new and in several European countries that is the model they use for their UHC provision. There are not-for-profit insurers out there, even in the US, maybe if there is a critical mass of people needing to buy insurance then the not-for-profits can gain a larger market share and help drive down the prfliate waste and inefficiences in parts of the healthcare system in the US which vary widely.

[mijan.livejournal.com]

Also, you said that by forcing healthy people to participate, you make the insurance plans more viable to keep coverage for sick people. I say that's false, because at the moment, insurance companies KEEP healthy people and DROP unhealthy people from policies.

[gmonkey42.livejournal.com]

And they will continue to do it by increasing premiums for people who have the audacity to require the insurance company's services.