I sure wish we had universal health care.

I don't see how poorer people get by.

Well, they don't. Not exactly. When things get really bad (and much more expensive to treat), they go to the emergency room and everyone else helps to pay for it. That drives up our bills, but insurance companies like that because it makes it easier for them to exclude poor people, who are generally sicker and so more expensive than rich people, from coverage.

I totally agree. My wife is a waitress and I'm a freelancer in film production. Together we make $30,000 a year, have $50,000 in student loan debt, a thirty year mortgage and no health coverage whatsoever. I'm scared to death of an illness or accident. We'd never come back from it financially.

Insurance is one of the problems and why health care is so expensive. It is abused. Not by the people but by the hospitals. Long ago I got ran over by a car. I was mostly ok, my legs were not. When i got to the hospital and they new i didnt have ins, i was mostly ignored. When the driver was caught and the hospital thought they had an ins company to pay, all of a sudden i had more attention than i wanted. They gave me things that were unrelated to my accident. They gave me a thing you blow in and try to raise the ball. I could hold the ball up there all day, and nothing was wrong with my lungs. But that little peace of crap ended up costing my $150 and was worthless. They gave me a hand squeeze to strencthen up my uninjured hands. When the ins turned out not to be comeing in. It was a gst town in my room again. I went from real pain meds to regular tylonal (which costs as much per ill as a whle bttle at the store)
They were caring less about me than gaming the ins system. Mind you this was ages ago, but i dougbt much has changed. My bill turned out to be over 60k, the person that run over me was too poor to sue and my finances were crap for years.

AA exactly, could you imagine 1 billion a month or what ever it is we are spending on health-care... but then who would get rich of the private industry

It is extremely likely that anyone who will have trouble paying next month's rent after missing a mere 8 hours of work, does not have enough money to pay to see a doctor or for health insurance coverage.

Life is always about choices. I actually am spiritually moved by Baseball, and I think that Universal access to Major league Baseball should be paid by the government. Whomever wants to attend a game, they should just be let in, since I am convinced that each attender's life will be better off for having attended (just like some people's view of health care). Oh well, I guess we now have a choice between Universal health care and Universal Baseball game attendance. How about Universal Acura Ownership! Think of the money saved by society on advertising by the other companies (since they are out of business in the US Market) and hey, send all those bus drivers off to grad school - we don't need 'em since we are driving ourselves.

Oh no!! now we have three universal choices. The choice should be determined by elected officials. We are just too stupid to decide for ourselves.!!!

The only reason we might want "Universal Access to Major League Baseball" would be if we wanted to curb overpopulation: We'd simply bore everyone to death.

Dear Poor Person, stop being so poor and things will get better!

P.S. If you can't afford medical care then you don't deserve medical care, perhaps you and those like you should have the decency to admit your personal character flaws and spiritual failings as manifested in your obvious lack of prosperity/free market fitness lead you straight into this bind. Maybe dropping dead will teach your kind the error of your ways - have a nice day.

The social Darwinism of Adam and Mimz is astonishing.

If things are really that bad financially, go to the hospital. An emergency room can not and will not turn anyone away, so even the least of us have access to healthcare.

If things are really that bad financially, go to the hospital. An emergency room can not and will not turn anyone away, so even the least of us have access to healthcare.

Congratulations DBS -- you're an advocate for Socialized Healthcare. How's it feel to be a communist?

Of course spreading out the costs through the hospital emergency room is the least efficient way to do this. It's far more efficient to actually have a centralized method of dispensing preventative care as well. It's fundamentally less expensive to treat Mykola for strep throat (250 mg of Trimox three times daily with food for 14 days) than for an out of control strep infection.

Congratulations DBS -- you're an advocate for Socialized Healthcare. How's it feel to be a communist?

Not exactly, it is a federal law that a hospital must give at least a minimum amount of medical services to treat any disease or injury regardless of the patients ability to pay.

Blake.... how is that refuting the claim? Who do you think ends up footing the bill when people go to hospitals who can't afford to pay?

@Brian White

I don't agree with it at all. I pay for healthcare. I worked my way through school and got a great job. I am blessed to work a company that pays for nearly all of it. I believe in personal responsibility and do not believe that it is the government's job to take care of my health. DBS was simply stating a fact. I don't believe he was advocating for socialized healthcare like Killfile implied. I just wanted to clear up the fact that it was already a law.

I believe in personal responsibility and do not believe that it is the government's job to take care of my health.

Right, but Socialism doesn't necessarily mean that the government has to do it, just that everyone pays for everyone.

If you're going to encourage people to take advantage of the fact that a hospital can't turn you away at the ER you're encouraging those who can not pay for medical care to force that cost on to everyone else. In other words -- if you can't pay do such-and-such and the people who can pay will cover you too.

From each according to his ability to each according to his need. - Karl Marx

That's socialized health care. Now it's horribly inefficient socialized health care that disproportionately screws the middle classes, but it's still socialized. Socialism can exist through market regulation just as easily as through government ownership.

Killfile: Would you agree that under the current system, everyone is already paying for everyone? I was talking with a friend at work today whose wife is a nurse in maternity at a Cape Cod hospital. According to her, no less than 60% of the child births she attends are mothers on public assistance (and that figure may be even higher). We are footing the bill for more than 60% of these mothers and, as if their inability to provide for themselves wasn't enough, they are bringing children into a world in which they have yet to avail themselves of any education or employment that might provide them with the opportunity to escape the welfare trap they are in. Despite abundant employment, education and entrepreneurial opportunities, the rest of us are paying for the care of these women and their newborn children.

Is the world a better place for making these irresponsible choices so easy for people? Should we be perpetuating the continuation of these apathetic, helpless lifestyles, or should we be making it more difficult for people to live off of everyone else?

DBS: How do you know that this second-hand figure of 60% is accurate? Is it because it sounds right when compared to those pre-conceived notions of the lazy poor woman who is unable to keep her legs closed for even a minute? How do you know that those women are unemployed and uneducated? How do you know that these women aren't taxpayers, too: payroll tax, sales tax, property tax as a portion of their rent? They could be working full-time at Wal-Mart or some other minimum wage employer, going to community college or working on their GED at night, and there would be no way they could afford the hospital bills for childbirth or the cost of a health insurance plan. Is it their fault if they went to sub-standard schools? Is it their fault that employers are allowed to pay them a wage which doesn't even bring them up to the poverty level for full-time work? If they are poor, does that mean that they are somehow less human than the rest of us and they shouldn't want to have a family? And what "welfare trap" are you talking about? The one which was all but eliminated by Clinton's welfare reform, providing a lifetime limit on the amount of time a person could receive public assistance, while requiring that able-bodied recipients be working? If tomorrow some horrible catastrophe came down on you and your family, leaving you without money, without a job, perhaps crippled and unable to work, do you think these people would begrudge you society's helping hand?

How do you know that this second-hand figure of 60% is accurate? Is it because it sounds right when compared to those pre-conceived notions of the lazy poor woman who is unable to keep her legs closed for even a minute?

evano: First, regarding your sexual promiscuity reference above, you have chosen to respond according to your preconceived notions of what someone who is opposed to our enabling irresponsible behaviors and lifestyles might think. I think the conversation here would be better served by limiting our commentary to what other contributors have actually said.

I spoke of women who are bringing children into the world without first achieving the self-sufficiency or ability to care for themselves. I am certain that their individual situations are each as different as you and I, but there is an easily identifiable similarity between the majority of them: laziness. I am happy that you were able to discern this common trait from my comment above, but I am unsure how anything else which I have addressed contradicts or argues the rest of your assertions. Had I also mentioned how many of the babies this nurse delivers are born drug addicted, perhaps my feelings about the irresponsible behaviors of these parents would have been better understood?

The 60% figure that this nurse came up with may actually be somewhat lower or even much higher. She can only speak for her experience in this one maternity ward. These figures may, or may not, play themselves out across the country. Regardless, the 60% figure is irrelevant to my question: Is the world a better place for making these irresponsible choices so easy for people?

Fine, let me address what you said: you claim that the common trait among the 60% of women who are on "public assistance" who come into your co-workers' wife's maternity ward is laziness. Since you provide no data for this being a common trait -- neither statistical nor anecdotal -- I can only assume that this supposedly common trait originates in your imagination.

Maybe it's because you assume that anyone on "public assistance" must be lazy. But considering that most forms of "public assistance" nowadays require the recipient to go to school or work 20-30 hours per week, I'm not exactly certain where laziness comes into the picture. Unless, of course, you think that being on "public assistance" at all is living the easy life, sucking at the public teat. Let's take a look at that.

You claim that these women who come into your co-workers' wife's maternity ward are on "public assistance." That's a really vague term which encompasses everything from Medicare to Social Security Disability to housing assistance to food stamps to energy assistance. Your co-worker's wife may be using it to mean the programs that used to be known as Aid to Families with Dependent Children (AFDC) but, since the Clinton-era welfare reforms, are known as Transitional Aid to Families with Dependent Children (TAFDC). The "Transitional" part means that you can only receive the benefits for 24 months out of 5 years. It also means that, unless you are disabled or in the last 4 months of pregnancy you must work 20-30 hours per week or attend school full-time. In Massachusetts, if she is a single mother, she receives a maximum of $428 per month and after the child is born, she receives a total of $531 per month. That maximum is reduced dollar-for-dollar by her net income, so that if before the child was born she was working 30 hours per week at Massachusetts minimum wage of $6.75, her cash assistance would be a maximum of $443 month. Wow! That's living large! It's so easy to make that irresponsible choice. Yep, just working the 30 hours then laying back in a lazy life of ease.

"But, wait!" you say. "These women know how to game the system. They just keep having babies so they can get more money each month." Ancient history. Any kid born after she's been on the TAFDC program for 10 months is ineligible for assistance. Most other public assistance programs have very similar eligibility requirement, work or school requirements and time limits, and their benefits are just as generous.

Of course, all these benefits are subject to availability. Cape Cod, in particular, with a huge influx of retirees, an enormous increase in property values, a lack of public transportation, a median income 10% below the rest of the state, and a real shortage of year-round jobs is at a crisis point right now, where the younger people can't afford to live there anymore, older people can't get around, and aid programs are stretched to the limit. The summer jobs are in the service sector and therefore low-paying, while the cheap houses of the wintertime are filled with vacationers, leaving many of the workers to move away or live in tents.

Still, I wonder, how could the co-worker's wife know whether these lazy women are receiving these forms of public assistance? There's no tattoo or scarlet letter or yellow star or even a barcode which identifies a public assistance recipient. Maybe there's some other outward sign that your co-worker's wife is capable of detecting. Maybe it's hair color or eye color or... who knows?

But maybe, by "public assistance" she means receiving public health-care assistance. That would be the MassHealth program, which "provides comprehensive health insurance - or help in paying for private health insurance - to nearly one million Massachusetts children, families, seniors, and people with disabilities." Massachusetts has a population of about 6.5 million, which means that 1 in 6 Massachusetts residents are receiving some form of health-care assistance from the state. Yet somehow, by a statistical anomaly, 60% of the women having babies in your co-worker's wife's maternity ward are lazy and on public assistance. There are only 2 hospitals on Cape Cod with maternity wards -- Cape Cod Hospital and Falmouth Hospital -- so it would be nice to know which one she works at so I could call and ask why there's such a prevalence of lazy women on public assistance having babies there. It would also be interesting to know what kind of access a maternity ward nurse would have to patient information which would indicate that the new mother was lazy and on public assistance. Maybe I could also find out how many of the 2,010 births in Barnstable County in 2003 were drug addicted and how the county is coping with treatment for so large a population of neonates with the health problems associated with fetal drug addiction. Considering how, Barnstable County had average or lower than average numbers of low birth-weight babies -- a very common consequence of maternal drug addiction during pregnancy -- I don't know how your co-worker's wife could have made the correlation she did.

I could continue, but why should I bother. Your whole statement and your entire point was related to society's making it easy for lazy women to make irresponsible choices in childbirth because of the prevalence of public assistance. Your premise is based on bull@!$%#.

Wow.. Evano, I think you may have just killed the conservative ignorance that feeds their ire over public aid.

Yes, well done Evano, but I am not sure who you are trying to convince. It certainly won't be people who have witnessed the widespread abuses of public assistance in Massachusetts first hand.

Please note that it was you, not I, who brought laziness into the discussion here. However, I did agree that this was a trait common to the majority of people on public assistance here. Perhaps I should have been more specific so as not to seem callous or insensitive. Nearly all of the people who I have come into contact with in my lifetime who were on welfare or housing assistance shared this negative quality. There are definitely exceptions to this, and people who avail themselves of certain programs and assistance, but I believe the vast majority of people who I have personally known to be receiving such assistance could easily have provided for themselves if they had any motivation to do so. You may label this assertion as some figment of my imagination, but I will happily present you with the examples of recent immigrants to this country, the majority of whom have achieved the American dream within a year or two of their coming here. Would you agree that the opportunities available to people willing to work for them in this country are real rather than imagined?

My point regarding the percentage of pregnant women on public assistance having children at one of our local hospitals was to debunk the idea that we are not paying for people's healthcare. Your numbers show that we are already doing this: 1 in 6 Massachusetts residents are receiving some form of health-care assistance from the state. I have yet to read anything that has disputed my original point: Aren't we already paying for everyone?. I also fail to see how you have proven that public assistance is not enabling illegal and irresponsible behaviors. Paint me as the insensitive conservative if you will, but if that means I require some responsibility from people living on our tax dollars and accountability from those who would so freely hand out or money (and just as happily tax it away), I will wear that label without any shame.

evano, nice smackdown.

I have a long track record with strep--I must carry it, but nobody's ever bothered to check into that, so I don't know for sure.

I recently had to withdraw from my summer classes because for two weeks doctors told me that what I was suffering from was a virus. I was running high fevers and had a very sore, lumpy throat. I couldn't speak for three or four days, but there weren't any spots. Doctors said, "it's almost definitely not strep."

After two weeks of worsening conditions, I went back to the clinic and said, "look, brothers, you're drawing blood and checking for mono, and you're doing a throat culture to check for strep." They did a RapidStrep swab first, and when it came back negative, the doctor said "these things are 90% effective. It's probably not strep."

A weekend goes by, and my test results are in. Turns out it was strep after all.

Frustrating moral: no white specks? Strep.

Isn't strep the one that if it manages to get out of your throat and into other parts of your body that it turns into that nasty organ-rotting disease?

Isn't strep the one that if it manages to get out of your throat and into other parts of your body that it turns into that nasty organ-rotting disease?

No, I think that's a staph infection.

The salt water gargle definitely helps. Once when I didn't have health insurance I decided to wait out strep. It took about 4 weeks until it was actually gone. That completely sucked. Plus I probably infected hundreds of people.

strep turns into scarlet fever and then rheumatic fever which will kill you because it is basicly infecting and eating your heart.. this is if it goes untreated.

Well I guess I got lucky then. I didn't have anything but strep as far as I could tell.

I had strep throat once, at least that is what the doctor told me.

I was in the Army and basically ignored it until one day I woke up and I was covered in weird red hives. I decided I would take the @!$%# that comes with going on "Sick Call" and see what was going on.

The doctor told me that it was the most advanced case of Step Throat he had ever seen. He put me on amoxicillin (a banana flavored thick syrup medicine/anti-biotic) and within a day the rash was gone as was the sore throat. I took the meds for 3 (or 7) days as prescribed and have never had a problem again.

The doctor suggested that had I not been in to see him when I did I might have died within a couple more days. Perhaps he was being dramatic (I don't really know). But I do know that if you have Strep, and you can't afford to visit the doctor, you need to do something less it develop as mine did.

So, either go to the Emergency Room (even though it is a horribly inefficient form of socialized medicine; I don't figure you have time to wait for a more efficient form to be introduced). Or try the saltwater and decongestant trick and hope it works. I'd opt for the Emergency Room if I were you at this point and if it is Strep.

As far as surgery and transplants and emergency care go, public health care is the pits.

However, for frustrating bugs, innoculations, and picking up antibiotics to battle strep infections, it is fantastic! Lived in Canada for half my life, and I never had a medical bill. Nothing but money is stopping the good old US of A from expanding Medicare and Medicaid to cover starving students. I think it'd be great.

I'd take the European model. It may be inefficient, but so is the American way which is grossly inefficient for recipients (but very nicely efficient for insurance companies!)

The American system is measurably less efficient. We pay at least twice as much per capita as any other system, without any real benefit. And without universal coverage. Where does that money go? Bureaucratic inefficiency (ie. insurance companies). When people say a single-payer plan would pay for itself, this is the money they're talking about.

My core objection to socialized medicine (and public education) is that people have the right to determine for themselves just what their obligation is to their fellow citizens. So some single mom on welfare has just dropped another kid into this world and I'm expected to accept a higher tax burden? So I'm working alongside another employee who has five kids while I have none, and I'm supposed to ignore that health coverage provides him with much greater compensation when we do the same work? Maybe such things don't bother you at all. Good for you. In an almost completely privatized society nothing would prevent you from acting on your uber-altruistic tendencies by privately subsidizing the disproportionate health and education needs of your fellows, and I would be free to act on what many would call my less highly-evolved sense of obligation to others.

Europe and Canada have their socialized medicine, housing, and who knows what else, but at what cost? Look at the burdens on their anemic economies. Look at how they have for decades neglected their national security responsibilities. No wonder they always argue for more talk and more of the impossibly corrupt UN every time a legitimate international security crisis emerges: they have no choice, for they have utterly neutered their nations by abdicating the most fundamental responsibility, national defense, while giving fiscal priority to remediation of life's chronic difficulties.

When we socialize medicine we remove from citizens the responsibility for their own actions and lifestyles. We tell them they are not responsible for the consequences of the choices they make. And we get the societies we deserve.

There are no perfect solutions, it's true. The question is which is the better approach, to cover everyone (and get the societal inequities you discuss), or to leave it up to the market (and have over 10% of the population with no coverage at all). You feel the latter, I feel the former.

As for economies, I think most Europeans would take their economy over the American economy. They certainly seem to have a better quality of life in any measure you care to employ.

I'm solidly libertarian on every other issue there is.

But on health care I have to come down on the side of universal coverage. I don't know the best way to implement such a program here in practice. And I'd prefer to pay for it by slashing spending on the military and legalizing and taxing drugs than tax increases. But it's my one liberal holdover.

Your paying for other peoples babies and back surgeries already. That's the point of insurance anyway isn't it? I haven't needed medical treatment for nearly three years now. I'm sure my premiums have gone to plenty of babies and surgeries.

Nebulacash,
Good points. I would like to add that public health care has less managerial overhead costs. Cananda's overhead is 1/3 of ours. Medicares overhead is around 2% compared to around 28% for our private insurance. This is due to all the additional paperwork that surrounds the various health care policies.

As for economies, I think most Europeans would take their economy over the American economy. They certainly seem to have a better quality of life in any measure you care to employ.

I don't mean to turn this into a Europe vs. US thing, but you may want to look at the unemployment rates in Europe. And it seems they pay much more for many simple things like new CDs. Plus I think they've benefited tremendously, economically speaking, from being under the much maligned US defense umbrella. Then again, to those who believe US aggressiveness in the Mideast has made the world much more dangerous, that will not seem to be much of a benefit.

pseudon,

I think your philosophical objects just go to show why basing decision making on a philosophy that reduces your choices causes problems.

libertarian ideals are not solving problems, they are creating them and then saying to the people with the problems "work harder". This totally ignores the fact that in such a system there will always be losers since libertarians believe in a competitive market place for LIFE. well winners can not exist with out losers.. telling the losers that they need to work harder solve nothing.

I don't believe I've seen *ANY* system, save communism that puts everyone at the same level...there's always going to be an upper and a lower class. I think the best we can hope for is that lower class at least being able to live a decent, healthy, financially stable life.

@pseudonihilist -

. . . people have the right to determine for themselves just what their obligation is to their fellow citizens.

People derive benefits from living in a society - they therefore owe certain minimal obligations to that society to balance those benefits. We're discussing where the lines should be.

libertarian ideals are not solving problems, they are creating them and then saying to the people with the problems "work harder"

That's an unfair statement. The idea behind libertarianism is that government force should be avoided whenever possible. Government intervention in most situations makes problems worse or causes unintended problems elsewhere.

There are only two libertarian ideals: freedom and personal responsibility.

Your paying for other peoples babies and back surgeries already. That's the point of insurance anyway isn't it? I haven't needed medical treatment for nearly three years now. I'm sure my premiums have gone to plenty of babies and surgeries.

And don't forget the gastric bypass surgeries. That's my favorite. Paying somewhere between 20,000 and 30,000 to make an obese person thin. And then many gain all the weight back because the surgery only corrects a symptom of whatever their real problem was.

Brian,

The end result of a strict stance on the philosophy is big winners and big losers with some folks in the middle. All the personal; responsibility in the world will not help the losers in such a system.

And don't forget the gastric bypass surgeries. That's my favorite. Paying somewhere between 20,000 and 30,000 to make an obese person thin.

That's a little unfair. Gastric Bypass is a fairly risky procedure and isn't undertaken lightly. It's the sort of last-ditch measure which can be used to save a person's life. Not everyone who's over weight is that way because of too many Big-Macs.

Now you may object to a $20,000 surgery to do this -- but you'd be shelling out a hell of a lot more when the same person comes in a few years later with cardiac arrest. An ambulance ride, ER-defib, and an emergency triple bypass later $20,000 sounds like a bargain.

Without exception, preventative care is less expensive than the emergency care it prevents. Ask any doctor.

Further, for every Gastric Bypass you pay for, how many bone marrow transplants, gamma knife surgeries, and brain tumor removals are you paying for? Should those that can't afford those treatments die because you're worried about shelling out for a Gastric Bypass for someone who may or may not need it?

The end result of a strict stance on the philosophy is big winners and big losers with some folks in the middle

Well this seems to be the end result of any system in human history: feudalism, tribes, democracies, communism, etc. If you have something new I'd love to hear it.

The difference of each system is the severity and the support those at the bottom experience.

Tribes really do not have a bottom. Everyone gets fed, everyone works for the betterment of the tribe.

Feudalism is the end result of the kind of unregulated capitalism that the conservative libertarians on Newsvine advocate and is arguably the worst system for everyone but the top tier of society.

Communism (as in marxism) is a search for a way to produce the ideal lifestyle found in tribal situations, only expanded to nation states and industrialization, (Maoism just removes the industrialization part). Such systems have failed miserably on the freedom and safety from tyranny part which results in a stratification of society in most cases. The green movements seem much more likely to succeed than the original marxist ideals. They have at their core democracy and human rights and do not require revolution to achieve their goals because they work as part of a democratic system.

Democracy is not a problem for social stratification. The economic principals that support the democratic society are what creates the social stratification. A system based on green party economics would have very little social stratification compared to The US economic system. Not that I agree with everything the green party has on their platform for economics, but It begins to make my point... more socialism thrown in to protect the people at the bottom and even the middle is a good thing. Too much is detrimental, but not enough is as well... think of it like sodium.. the human body needs it, but it can hurt you if you have too much or too little.

That's a little unfair. Gastric Bypass is a fairly risky procedure and isn't undertaken lightly. It's the sort of last-ditch measure which can be used to save a person's life.

From accounts I've heard (first hand) there are plenty of doctors who rubber stamp patients through the process. Give the right answers to a few questions and you'll get approved. The laparoscopic procedures they're doing these days are quick and the recovery process can usually be measured in days not months.

Not everyone who's over weight is that way because of too many Big-Macs.

Uhhh no... but everyone who becomes overweight has overeaten. They've all consumed more calories than their body could reasonably burn given their activity level. It is a vicious cycle, I won't deny that. The more you weigh, the more difficult it is to exercise. And being obese can contribute to depression, which can contribute to overeating.

Now you may object to a $20,000 surgery to do this -- but you'd be shelling out a hell of a lot more when the same person comes in a few years later with cardiac arrest. An ambulance ride, ER-defib, and an emergency triple bypass later $20,000 sounds like a bargain.

I don't object to the surgery -- I object to doing it for the wrong reasons. Note that they almost exclusively refer to it as "weight-loss surgery" these days. Many people see it as a quick fix for their "problem" -- but their problem is just a symptom of other problems. And those problems aren't fixed with a knife.

Without exception, preventative care is less expensive than the emergency care it prevents. Ask any doctor. Further, for every Gastric Bypass you pay for, how many bone marrow transplants, gamma knife surgeries, and brain tumor removals are you paying for? Should those that can't afford those treatments die because you're worried about shelling out for a Gastric Bypass for someone who may or may not need it?

Who said anything about wanting to deny coverage for other illnesses? Insurance is a good thing - spreads the unexpected costs of a few out to all members. But insurance companies have formulas to decide whether the benefit of a procedure is worth the risk and the cost. They set the thresholds of when to approve or deny coverage based on, among other things, the size of their coffers. So, a better question might be how many bone marrow transplants, gamma knife surgeries, and brain tumors were denied because the risk formulas didn't meet the same risk/benefit threshold that a weight loss surgery does?

Tribes really do not have a bottom. Everyone gets fed, everyone works for the betterment of the tribe.

Feudalism is the end result of the kind of unregulated capitalism that the conservative libertarians on Newsvine advocate and is arguably the worst system for everyone but the top tier of society.

Tribes only work on the very small scale.

Just because you say libertarianism is feudalism over and over and over again does not make it so. You have no proof or historical evidence. In contrast, I at least have quite a bit of historical evidence to show that socialism and communism end on oppressive tyranny, if I wanted to make such a claim.

Adam I never ever ever ever say that Libertarian capitalism is feudalism. Apparently I must be writing too opaquely for you to understand what I am saying.

Libertarian capitalism will RESULT in warlordism just like Marxism results in despotism. neither aim for the outcomes, but those are the inevitable results.

I do not need a proof of concept to make my claim since both your ideology and marxism rely on teh same fallacy...that man will not abuse power.

I may be wrong here, but I believe Libertarianism holds to the belief in personal responsibility. Sadly, as time goes by, I tend to think that is as much of a dream as anything.

Oh My God... OK, I will say this again.

Libertarianism stands for everything they say they do... however, because they rely on the benevolence of those who gain power in th system in order to keep the system operating in their perfect world, it is doomed to fail, just like Marxism was doomed and did fail because of its reliance on benevolence in the power structure.

Behind My Screen, that just shows me that you do not "get" libertarianism. In socialism/marxism/communism there is the abuse of power because everyone is "equal". However to keep everyone equal there are a few select individuals who are granted enormous power ripe for abuse to force everyone to be equal. Because there is so much government intervention, there is so many temptations for abuse in power.

Libertarianism on the other hand, was developed with the purpose of minimizing that very abuse of power, by minimizing the power and protecting individual rights. In libertarianism there is not giant federal government with near infinite power. Instead all the power is extremely limited, and often broken up and placed in local governments. There is really no power to abuse.

But then you may say that evil corporations will come and abuse their power. First off, as I have explained elsewhere, there is no corporations in a libertarian system, for a corporation is as much government regulation and interference as taxes are. Instead all businesses are personally owned by people who are directly responsible for the actions of their businesses. And because everyones' rights are protected equally, there is no possible way for anyone's rights to be abused. In a libertarian system there would be no Wal*Mart using eminent domain to forcibly take land for a store from poor people who rightfully own that land. This is because the rights of those poor people to their own property are equal to the rights of the rich owner of Wal*Mart who has no claim nor right to other people's property.

Libertarianism limits the abuse of power by limiting power.

Here is where libertarianism fails... it does not limit the power of a single wealthy individual.

you yourself have said that resources should be owned by private people... you have also said that roads should be privately owned.. you have also said that you do not see a problem with the police force being owned by a private person.

Tell me... what happens when a single wealthy person gains enough power over a town, or even a state to own all the land, and own the police force, the water and the roads? Who is going to keep him from abusing his power?

Here is my point.. monopolistic companies do not have to be corporations.. Standard oil was not a publicly traded company in the 1890's, it was a trust... a company owned by a small number of individuals.

Power can be gained over the libertarian system and then systematically abused by those who have gained the power. This is where the warlordism will result from.... the power of individuals.

From accounts I've heard (first hand) there are plenty of doctors who rubber stamp patients through the process.

And through accounts I've heard (first hand) no one has ever had an abortion. Anecdotal evidence is worthless. Show me statistically valid surveys.

Get over it Behind My Screen. You are obsessed with warlordism for some bizarre reason. Nothing could be further from libertarian principles than a dictator ruling through force of arms. A person wealthy enough to own all the land in a state is a) impossible and b) no more constrained by our present system.

And tell me.... when was the last time you bitterly complained about Standard Oil or US Steel this year? Monopolies naturally fall apart in changing economic climates unless they can use the government to prop them up (RIAA/MPAA for example).

And tell me.... when was the last time you bitterly complained about Standard Oil or US Steel this year? Monopolies naturally fall apart in changing economic climates unless they can use the government to prop them up (RIAA/MPAA for example).

Yellow Flag - Gross Historical Inaccuracy. 15 Yard Penalty, repeat 1st Down.

Standard Oil and US Steel were the specific targets of US Anti-trust legislation in their time. Government was needed to deal with the overwhelming power of the large corporation. Indeed, the shift from laissez faire economics to a more government regulated system was, in large part, prompted by the abuses of trusts like Standard Oil and US Steel.

Thank you for setting the history straight killfile.

For Brian's sake, this will be my last comment on it because I do not wish to continue offending his idealistic views of his political ideology.

If people cannot see a difference between a political philosophy espousing something and a political philosophy resulting in something, then I cannot help them. The distinction is obvious. I have been arguing the latter rather than the former when I argued against libertarian capitalism. I think there is plenty of historical evidence that supports my concerns as well, but since I am no longer going to argue this point, I will not bother listing off the historical evidence.

not really.

KyleN,
Do you pay for your health insurance without any assistance from your employer? Do you pay for all your own health care costs out of pocket? If not, you should try it sometime. Or call up an insurance company and ask how much it would cost for health insurance comparable to what you have. Dig out your old medical bills and see how high they were before your insurance kicked in.

If you do pay for your own health insurance/health care, add up how much you pay, then subtract that amount from what your income would be if you worked a minimum wage job. Then double the minimum wage and subtract what you pay for health care from that. Then come back and talk to us about reasonably responsible people.

Don't forget the government subsidies paid to his employer in the form of tax deductions for providing health care to the employees. Take away those deductions and see how many employers still can afford to offer health insurance to their workers.

As an employer, I don't profit from tax deductions to my employees. If that is the difference between staying in business and not, then I have bigger problems. While I provide 100% coverage, a wise strategy for a business in trouble is to provide a fixed amount for each of their employees and let them pay marginal increases.

Much bigger than my company health insurance payments are my workers comp and liability insurance.

I didn't claim it was a profit, but an offset to some of the expense. And, you're absolutely right, your business would be in trouble if finances were so tight that little loss would push you over the edge. I was just adding in one more of the ways the public already pays for our healthcare system.

Don't forget the government subsidies paid to his employer in the form of tax deductions for providing health care to the employees.

I was just adding in one more of the ways the public already pays for our healthcare system.

Basically letting people keep their own money is a public subsidy? Whose money is it really? You obviously believe that everything is owned by the government and it "lets" us just keep it.

Take away those deductions and see how many employers still can afford to offer health insurance to their workers.

Maybe this is the problem to start with. If benefits were taxed to start with there would be no employer provided benefits, no huge health insurance firms or HMOs providing those benefits and everyone would be used to providing for their own medical needs rather than looking to others for a handout...

Didn't see that question earlier somehow. Yes I paid for my own health insurance between being a student and being employed. I also am fully aware of how much the company I work for pays for my health insurance and what portion I pay.

I was never completely uncovered because I took steps to prevent that by saving money while I worked and was a full time student. I said all of this elsewhere in this thread I believe.

Right now I think my employer overpays, the combined value of what they pay and what I pay is greater than the plan I bought for myself and the coverage is approximately the same. The difference is likely the group and my company plan includes riders that are useless to me such as maternity care. However my portion of the bill is less than what I could buy independently and my employer will not exclude me from the plan and give me the difference.

No, Adam, I don't believe that the government "owns" everything, (even though the government is "We the people" and therefore does in a sense own everything the collective people owns.) But I do believe that taxes are the cost of living in a modern society. You accrue a tax obligation based on how much you earn, at rates determined by your elected lawmakers. If you offer health insurance to your employees, an activity which is valued by the citizenry and their legislatures, the total tax you owe is reduced by a portion of your expenditures. The public is saying, "You're doing something of benefit, so we will cover the amount of your deduction." You're not keeping your own money; you're receiving money from the rest of us.

Look, I know that we have very different perceptions of the roles and responsibilities of citizens and their governments, but I think that labeling it a "handout" is needlessly disparaging. We're an extraordinarily rich country with a professed belief in the Golden Rule, so why wouldn't we want to help our fellow citizens to a basic level of health?

evano, would you say that homeowners who receive a tax deduction on their mortgage are having their homes paid for by the rest of us?

I can see your point in a way, if you're saying that it isn't fair for KyleN's employer to be able to get a tax break on his insurance now, when he didn't get a tax break when he paid for it himself.

The specialized tax breaks the government offers each seems to have a worthy goal, but they lend themselves too much to abuse (mainly with corporate tax breaks) and are an especially annoying way for the government to try to control peoples' lives. Why does my tax burden change dramatically depending on whether I'm married and living in my own house, or single and living in an apartment? I don't see why it's any of the government's business. I don't believe the federal government should be involved in any of the social engineering oriented tax breaks it has now.

That's not common in my experience. I am an IT manager for a large group of doctors and maintain the EMR for them. Some people are just messy, I'm not super clean but that isn't the same as disorganized.

Surgery scheduling is difficult, I've worked here for close to 3 years now and seen 3 different surgery schedulers just in the office I work out of (out of 9 I manage). The reason is the sheer number of variables they have to make align to get a surgery to work and the people involved all insist on it being their way. I couldn't do that it's terrible but all of those people used various systems to make notes about the 100s of different openings, doctors, assistants, OR suites, and patients to make the most efficient use of the time and to reschedule on the fly over and over as usually happens. In fact my first year here I wrote a web service style program for the intranet to help with surgery scheduling and got to do all the requirements planning is how I know so much about it.

The paper bit frustrates me as well. So many people will not read a computer screen when they can print it out instead, I don't know why but they do. Our offices waste (IMO) tons of paper printing things like schedules that they can look up on any of the 250 computer screens around them easily. The younger people don't do it as much as the older but well over 50% will print first - read later. If it wasn't for the management constantly on their (clinical staff) backs about privacy and cost it would be much worse.

Erin Brown:
If a doctor's office is in disarray with medical records not taken care of, I part of that on the currently too-high level of governmental invasion into health care already. The office is only expected to keep bare minimum records, although a lot of extra useless paperwork that my own physician pegs at 10% of his entire practice's gross income. Second, private evaluation/certification of all professionals (including doctors, teachers) would increase the quality of those services and reduce the number of offices in disarray down to the level that is sustained in a market where patients don't care about such disarray.

But I concur with KyleN that such problems are not common and I have only seen one such office in my MANY doctor visits.

mimiz, those folders and paper work are for INSURANCE companies.

I assume you have never had to deal with an insurance company one on one.. they are a pain in the butt because it is in their best interest to give you the run around and have a monstrous system that is nearly impossible to navigate.

Majority of the paper around here is because of schedule changes, patients not showing up, patients walking-in, patients being worked into late cancel slots, doctors late from surgery, etc. Then all the support staff thinks they need to print a new schedule to see what the up-to-date record of who is coming when is.

The second largest (and very close to the first) paper drag is the patient information forms that we have to have every single person fill out nearly every time they come (unless they have been here very recently). Those are to see what drugs they are on mainly though also any surgeries they have had or other conditions they have contracted.

Insurance companies hate paper, it's waaaay too slow to mail and fax machines are a bottleneck. So all the insurance claims are done online now by a couple of people in an office that go between our billing software, EMR, and insurance websites. Only the most official of correspondence is mail, that would be the real bad disagreements of charges that are escalating to near lawsuit status.

The last big paper drag is the transfer of medical records between doctors. We are a specialist group and so everybody just about is referred here from their primary doctor and they bring all sorts of stuff with them, paperwork or paper charts of their other doctor. Likewise when my docs are finished they have to print something out that goes to the PCP about what they did. We try to fax those where possible but amazingly not always possible.

A smaller but not insignificant source of paper is in lab requisitions. Those are papers printed and given to patients so they can go get their blood/urine/etc taken and studied by reference labs with the results sent back to their doctor. Since very few reference labs maintain staff in a doctors office we can't easily get around that requirement.

So anyway insurance companies are not the primary source of paper in a doctors office.

As far as it being in there interest, I can see that for major claims but most claims are $100-$200 and it would cost them more to fight it or stall it than to pay it. So most claims are fairly well automated, submit get check with periodic audits. Larger claims are pre-approved in most cases like surgeries so after there isn't much left to do and that is done over the phone.

...which can be found in his New Yorker archive. (sidenote: you can't edit comments??? that's rather inane)

Here's the link to the mentioned article.

Not too inactive -- too new. Give it a bit and you'll earn the ability.

As for editing comments -- people have gone back and forth with the pros and cons of that topic since Newsvine was in beta.

The leading cause of personal bankruptcy in the United States is unpaid medical bills.

There's an interesting little tidbit from the article. That's kind of... not good.

especially now since the bankruptcy law was passed.

'The Bankruptcy Law'?

First off, the new bankruptcy laws are designed to prevent people from outfitting their homes with all the latest gadgets, care of Visa, and then getting the court to write off all their debts only to let them go back and do it again later.

The new laws won't even reduce the number of people filing for bankruptcy, but it will force them into a debt restructuring instead of walking off not owing anything.

I believe that the whole concept of bankruptcy exists FOR people that have tremendous amounts of medical debt, or lose their job and go severly into debt while out of work. Those people SHOULD be able to have most or all of their medical related debts written off.

The problem is that 'bankruptcy' has become the way for people to get whatever they want (even if only for a while) without having to pay their bills.

will, I guess you totally lost the fact that the bankruptcy laws were changed and have absolutely NO protections under chapter 7 any longer for people who have legitimate catastrophic losses due to medical bills or natural disasters, or terror attacks.

The fact that most bankruptcies were due to medical bills and the minority were due to credit debit is just a testament to how horrific the restructuring of the system is.

BMS: It is also a testament to how freedom from facts doesn't stop people from spinning lovely rhetorical tales about all those people outfitting their houses with gadgets and then blithely declaring bankruptcy. Those folks probably live next door to all the farmers and small business owners who've had to sell everything in order to pay the "death tax."

Whatever the percentage is for the people who declare bankruptcy due to medical bills -vs- visa bills I don't really know.

However, I only know one person who has declared bankruptcy and he (and his wife) did so from the Visa variety.

Now, granted, my sampling is pretty small (ok, 1 is ridiculously small) but his experience didn't sound all that unusual to the lawyer he used to file bankruptcy. Said lawyer was, supposedly, pushing through a bunch of similar scenario bankruptcies before the Oct deadline last year.

I'm going to look for a resource that actually shows some statistical significance to the number of medical-vs-visa bankruptcies there are. If anyone knows of one before I find it please reply to this thread with a link. Thanks.

Actually, I understood that VA health care was better than most.

Actually, I understood that VA health care was better than most.

Or, rather, it was before we started slashing funding to VA hospitals so that we could use the money to support our troops*.

* May not include actual support such as veterans benefits, body armor, and GI bill funding.

Government controlled health care works in the rest of the First World. No reason it cannot work in the U.S. as well. But as I said, the insurance companies would lose their business, so they propagandize us into thinking it would be a disaster.

scapegoat said: Actually, I understood that VA health care was better than most.

It goes in cycles. VA medical care will really suck, somebody will win a Pulitzer writing about it, there will be reform, and soon as it's forgotten, the system degrades again.

This plan has the added side benefit of back-door right to die ability. How can you possibly prove negligence when there are no restrictions or qualifications on care? :)

I actually kinda like the concept, everybody could get the medical care they can afford instead of many people get no medical care because it is required to be the most expensive kind there is. I think the real answer is in a tiered regulation/qualification instead of no regulation though.

I'm with you 100% on the buying any prescription over the counter. I don't need the government to tell me not to take high blood pressure medicine if I don't have high blood pressure - I'm not that much of an idiot.

Kinda iffy on the 'anybody can be a doctor' idea. If it weren't licensed by the government I hope there'd at least be some reputable private 'guilds' that would ensure quality of training.

One good thing though, the FDA would no longer have authority over cool cyborg implants. Who the heck are they to tell me I can't be as borg as I wanna be?

They are the government. Resistance is futile.

oh yeah.. Mexico is a great place to look to for reforms.. your suggestion is insane by the way.

Try looking at a different method of health care than the monolithic system that Vets and Indians use. No one for universal health care want a system owned by the government.. that is just flat out stupid.

the Medicaid system (outside the paper work that some one on Medicaid must rightfully fill out for qualification requirements) is incredibly well run and the government does not control those people's health care at all. A system that is similar in nature would be cheaper and work better than this stupid system we have now, and would not be an abuse waiting to happen like you Mexican health system reforms.

I'm guessing that "For example, after deregulation, if you shop around, you'll find someone who'll remove your appendix for $50." indicates a certain amount of tongue-in-cheek attitude with this post.

If I'm wrong that, then UB, you'll definitely want to check out the home lasik kit. Why spend so much money on lasik? You can do it yourself at home in minutes.

Brian, you may not be that much of an idiot (to take meds you don't need) but I guarantee there are plenty of them out there.

Of course, I suppose Darwinian Evolution would show up pretty fast to kill of plenty of habitual drug users who love their Morphine and or other pain killers.

Lets not forget all the potential drug interactions. Your doctor (and the Pharmacist) is supposed to be informed about the various drugs and their known interactions. The Doctor has a better chance of knowing all of the various drugs you are currently taking (since you are likely to fill them at more than one pharmacy, while getting them perscribed at the same doctor) so I put more responsibility on the Doctors shoulders.

So even if you are smart enough to not take a drug you don't need - are you equally smart enough to know about the possible interactions with other drugs you are taking that you need when you do end up needing the high-blood pressure med?

I suppose you could look it up online - but can you be sure poorer patients will be able to?

While a Doctor is not perfect; it is a nice fail-safe I like having in the chain before I start taking any medication.

Most universal health care bills that are put to the floor since the 90's have had buy in rates so the people are paying for part of their care. This is similar to what japan does.

The poor are free, Children are free, the elderly are free, vets on disability are free, vets not on disability are reduced because of their service.

People that do not get insurance through work, or want to purchase the government sponsored plan fill out a simple means test form which places them in a payment step.

One way or the other, our country will have universal care. The states have already begun passing universal coverage laws. Mass. has a law (or are they still working on it) that requires everyone to have a health plan. The uninsured due to circumstances get access to a state operated health plan that has a buy in rate which varies based on income level. All children are covered in the state. Anyone who has a job with insurance is required to have a plan. Mass looks at it like auto insurance. You are a liability to the state if you are not covered so it is incumbent upon you to be covered by law.

Hey! Social security isn't a pyramid scam. We just need to grow our population by 300 million in the next couple of years to keep it going is all.

Either that, or raise revenues or decrease expenditures enough to cover the obligations of the General Fund to the Social Security Trust Fund. Or increase the wages of the majority of workers through economic development so that the amount collected by FICA taxes rises. Or peg just the initial benefit amount to wage growth and subsequent COLAs to inflation. Or...

i think the person below who mentions an opt-in system has a better idea. you want 'universal healthcare' (or 'social security' or whatever)? great! you, and anyone else who think it's viable can pay for it.

Sure. As long as anyone who opts out is barred from receiving universal healthcare benefits if they lose their job or have a catastrophic medical emergency.

evano,

Or increase the wages of the majority of workers through economic development so that the amount collected by FICA taxes rises.

Won't raising the amount of money everyone makes result in a raise in the cost of everything (since the providers of the salary will need to recoup the cost of higher wages and their higher employer FICA contribution) and thus the value of the raised wages will, basically, be nullified overall? I mean, isn't this basically just a spur for inflation?

It's a good question, finalcut, and, frankly, I don't know the answer. I know that people who make more money will probably spend more money, so an employer with a suddenly larger payroll might also find that she has a suddenly larger clientele because of the growing number of people who can afford her services, so she may not have to raise prices to cover it. She may not be able to raise prices because her local competitors aren't raising theirs. I know it may be heresy to the science of economics, but in situations like this, there's no hard-fast answer. Ask three different economists and you'll get three different well-argued scenarios.

I have relatives in the UK who have universal healthcare. For routine, scheduled visits they make advanced appointments. For sickness, there is little or not wait whatsoever. Don't believe the propaganda.

As for the cost of coverage, $450 a month is hardly unusual these days. If you don't pay that much yet, you soon will in all likelihood, or else your employer is picking up an unusually generous portion of the bill so far.

If we had universal healthcare, you could make an appointment to see your doctor. Just make sure you have your schedule open a month from now...

I can say the same as NebulaClash for Germany, Spain and Chile. In case of sickness or accident you wait according to your state (from nothing to, I'd say, an hour or two)... If you are too sick to go to the hospital, the on-call medic will go to your place (in Germany and Spain, don't know in Chile). For routine appointments you do have to wait at least 2 weeks. But anyway, in all those countries (not 100% sure about Germany) you can also choose private health, which is usually more expensive, but more comfortable and fast.

About taxes, in Germany I paid about 30% of my paycheck (about 400 €), in Spain as a freelance I pay 200 € a month. All of this is for social security, which also includes pensions, unemployment insurance, and a few more stuff. In Chile I was a student, so I didn't paid for health care.

I have to add that I'm young and single, so, at least in Germany, I paid much less than other people...my uncle for example paid about 50% of his monthly income (divorced, 2 kids, etc). But in Germany you also get free education (I think this changed this year, but the annual fee is very low still), pretty good scholarships (for living expenses), great unemployment insurance and good pensions. Health care is quite uncomfortable, but not bad at all.... in my experience at least.

"As for the person working at a Fortune 100 company and paying $450 a month...I've never paid anywhere near that much, not even covering 2 people."

@tcervo,

Your employer was probably paying a lot of money to your health care. Under my wifes previous plan we were paying less tan 150 bucks a month for health care. However, her previous company was a very traditional ( Socialist ) company. For example they still gave out Christmas cash bonuses and Turkeys along with great health bennefits.

"Monopolistic"? I don't think that word means what you think it means. K-12 education in this country consists of public schools, private schools, hybrids such as charter schools, for-profit schools, home-schooling. Most public schools are run by local school boards, funded by property taxes at varying levels. Cities, counties and states each have their own rules and regulations regarding the administration of schools, subjects taught, qualifications for diplomas, attendance, textbooks. The Federal government adds levels of regulations to all of that, leaving the states to administer the funding. Nothing monopolistic about it.

There is an angle I hadn't considered before. Do duel-citizens have to pay taxes in both countries and do they get benefits if they don't? Maybe I can find a European country that will allow me to be a duel-citizen for the emergency health coverage for free!

Maybe I can find a European country that will allow me to be a duel-citizen

Dueling is illegal in Europe.

actually I'm in a dilemma, as I said I am a french citizen and a US resident (meaning I got a green card, not american citizenship)

Once I request and do become an american citizen, I lose my french citizenship. So that's why I'm all argh about it. Dual citizenships are much more complicated to get ever since 9/11.

You'd better hurry up and get sick Zaki :) You're not going to get your money's worth otherwise.

Dueling is illegal in Europe.

Not really, I am both Chilean and German. I was born in Chile, but my grandmother was born in Germany, so she transferred her German citizenship to my mother, and my mother transferred it to me. As for German laws, I think it was something like... when you are already German, you can't get a 2nd citizenship, but you can get a German citizenship regardless of other citizenships you may previously have (if you apply).... or something like that. I guess many other countries have the same kind of law, Chile doesn't, so I was able to get that 2nd citizenship without loosing the other.

As for the taxes, you pay them wherever you work, and you get the benefits when your request them, if it applies with current laws or something. For instance, I couldn't collect my German unemployment insurance when I went back to Chile for a season (It was still "available" when I came back, but I had to work some time to be able to collect it). On the other hand, when I came to Spain, the money was transferred to the Spanish work department, and I could collect it from here. However, you can't begin to imagine how many forms I had to fill in both countries to be able to do that :P

It all depends on the governments and if they require you give up your previous citizenship to become a citizen of their country.

I think you missed the joke.

dual != duel

Do duel-citizens have to pay taxes in both countries and do they get benefits if they don't?

If you have a US passport, you can read all about it in there. Basically, what it says is dual-citizens that are US citizens still have to report and pay their income taxes even while living in a different country. In terms of benefits, I think it's up to you which country you go with.

Duel: (from merriam-webster.com)

a combat between two persons; specifically : a formal combat with weapons fought between two persons in the presence of witnesses

Maybe the "Dueling is illegal in Europe." comment will make a little more sense now. :-)

LOL. I thought it made sense when I posted it!

lol, sorry about that xDD

A quick search reveals that in Canada, practioners do not work for the government and actually have more flexibility negotiating their fees than US doctors do with private insurance companies.

That's just not how it works in countries that already have universal health care. The real world refutes your scare tactics.

I have a few friends that once lived in Canada and they all say with 100% certainty that the US health care system is super to Canada's.

Sorry I meant to say Superior not super.

Interesting, and my Canadian friends say the opposite. Dueling anecdotes!

Seriously, if you have means, you can get the best health care on Earth in America. The question is what about the other 70/80/90% of the population. For them, a universal solution, on balance, provides better care. For the lowest classes, it provides a far superior solution.

So if you are upper class, you tend to like things as they are. If you are not, there are better solutions out there already, as many countries are already showing.

I think Mr. Right is either lying, or his friends are.

As is it right now the poor people already get free health care. I pay alot of money every week for mine, and I would still rather pay each week than see the government step in and control health care the fact of the matter is that I don't know of any government agency that runs smooth and efficiently. So we would end up paying even more in taxes for a sorry health care system.

we pay a lot more for the poor than what we would under a universal care system.

The federal government will not control anything, they would facilitate and fund plans for different coverage needs.

your fear of government inefficiencies is wrongfully placed... Private health care is far more inefficient than the public systems that the US currently runs.

We would pay fewer out of pocket dollars on a universal care system than we currently do for private care. that is a fact.

You have fallen victim to the right wing propaganda machine.

If you compare the US and Canadian health care system you will find that America has better hospitals,docters, nurses, technology, Specialists, and is just all around a better system. I would love to have free health care but I just can't imagine our government being able to run such a program efficiently. And I know people that where once lived in Canada and they totally agree with me that the American health care system is better. They said that they had to depend on the ER room for their health care because their was such a shortage of doctors. WHY IS THIS?? Because all the good doctors are here in America where they have alot better pay.

Given all the legislation on various drugs, I rather think they do run the health care system in this country.

I would like to see the government get out of the drug regulation industry. Having them pick what is over the counter and what is not is where I see the larger problem. If the government would stop trying to protect people from their own follies, the health care system could be much saner overnight. The last time that I actually needed a doctor was to have a cast put on a fractured arm 17 years ago. But I have payed several thousand dollars out of pocket and more in insurance premiums in order to get antibiotics when I do get ill. I see this as being the largest problem.

If you compare the US and Canadian health care system you will find that America has better hospitals,docters, nurses, technology, Specialists, and is just all around a better system [, if you can pay for it].

There, fixed that for you.

I don't think anyone disagrees that for upper middle class to upper class white color full time workers with no history of chronic health problems - the US health care system is clearly superior. No question about it.

What about everyone else?

What about people that lack the education or skills to hold down full time employment with benefits? I'm all for the capitalist system denying them the means for a 51 inch plasma TV - but should they be unable to afford treatment for serious medical problems?

What about people that have those skills but aren't able to get insurance due to other conditions? I have two college degrees and do fairly well for myself, but can't get private insurance at all due to my medical history. A serious medical problem would ruin me as well as my wife.

There are a lot of people out there who would benefit enormously from a universal health insurance system that would provide a real fall back for those who can't, for financial or other reasons, get traditional health insurance.

That doesn't mean that private insurance has to go away. It doesn't mean that private hospitals or doctors offices can't continue to operate. It just means that the insurance has to compete with the government program and that the doctors offices and hospitals have to deal with the government program as well -- which they already do (we call it Medicare).

Surely, if government run health insurance is as horrifically slow, inefficient, and frustrating as you claim the private corporations will do a booming business from those that can afford them. Everyone else at least gets something, which is a hell of a lot better than the nothing they've got right now.

The insurance companies are just as much a problem. Health care was much more available to the average citizen before that monster gained it's governmental backing.

When was the last time you applied for health insurance?

Should they be unable to afford treatment for serious medical problems?

Should people be unable to afford food? It is not that anyone should be without essential needs. This line of reasoning misses the real point that most people don't try or don't know they can afford health coverage. No one told them how.

They believe the fear that it is unaffordable, unavailable, and only for the rich. If it is not a financial priority for you, why should it be a financial priority for your government?

Most people rent or buy more house than they can afford... why not scale back and make your health your biggest priority???

We the people of the United States, in order to form a more perfect union, establish justice, insure domestic tranquility, provide for the common defense, promote the general welfare, and secure the blessings of liberty to ourselves and our posterity, do ordain and establish this Constitution for the United States of America.
...
Article 1 Section 8
"The Congress shall have Power To lay and collect Taxes, Duties, Imposts and Excises, to pay the Debts and provide for the common Defence and general Welfare of the United States"

There have been arguments ever since about just what exactly that language entails, but I think providing health care to avert an epidemic of communicable disease, for instance, falls plainly under that clause. Mass starvation due to natural or man-made disaster seems to be another case of promoting the general welfare of the country. A quite difficult truth to accept is that no man exists in a state of pure liberty as long as he has neighbors, and that governments are mostly instituted to arbitrate whose liberties get trampled when a conflict occurs.

Now to a more specific case. Through no fault of my own, I was laid off and unemployed for a period of time in the 1990s. During this period of time, I could not afford health care coverage, even with unemployment insurance. I did not lounge around, but in the pre-Internet Bubble days, it was hard work to find work. I ended up moving to another city to find it. When I signed up for my new employer's plan I was warned that they would not cover any "pre-existing condition" as my coverage had lapsed. In fact, I was advised quietly that making any claim in the first six months or so would probably lead to a denial under that clause.

As it turned out, I wasn't sick, so I got through this period OK. But let us consider a plausible variation of that scenario and say that I contracted tuberculosis or something similar and chose to "tough it out" to get through my pre-existing condition period. I ride public transit every day, and there I am, Typhoid Acid, degrading the public welfare all because of circumstances beyond my control. In a universal system, I would have gone to the doctor and received treatment and perhaps even a quarantine for a time at a fraction of the cost to society.

If before you were unemployed you set aside money for emergencies sufficient to pay for temporary health insurance you would still have been covered.

While I was a grad student working at a pet store and doing side jobs fixing computers in homes I set aside enough money that when I graduated and was looking for a job I purchased a open-market policy for myself. I knew in advance that when I graduated I would not be eligible for the health care plan provided to students by the school (or rather subsidized) so I planned it out in advance. I actually made a mistake and should have looked it up sooner because the school subsidized plan was $50/month more expensive than my open-market plan :) I guess students are dangerous people to be in a group with.

Now I keep some money set aside in the case my wife or I lose our job or both lose it. It would hurt but it would take 6+ months to wipe us out entirely and even then I can sell my house and coast for another year at the least if not longer.

The insurance companies are a business designed to make money. So are the drug companies. And the medical establishment. And, often enough, the state. All of these entities have situated themselves between the consumer and the direct care provider, thereby inflating costs for both the provider and the consumer.

More than half a million people die every year from prescription drug problems. Now, the courts have made it more difficult for victims to gain remunerations. And have you actually seen what the baseline coverage is for health insurance? And the costs of treating all of these strange new immuno-deficieny diseases that keep cropping up? And where is the FDA in all of this?

As you can see, there is much more involved in the situation than a lack of financial prioritizing on the part of the consumer.

Yeah Kyle, that would have worked, provided that it wasn't my first job out of college so I had had zero time to build such a reserve. Unfortunately, that didn't exactly happen.

We've seen your libertarian paradise: it's Somalia, and they are now choosing Sharia over lassiez-faire.

We've seen your libertarian paradise: it's Somalia, and they are now choosing Sharia over lassiez-faire.

Libertarians aren't equal to anarchists. One rule/role of government Libertarians support is the protection of private property (the most private property that of your own life). That would be the one that Somalia has not had for awhile now, and the turn to Sharia is an attempt to gain it.

And yes people whose parents kick them out and their first job fires them inside a few months would have a point to make. Being in college however is later than that delicate time period as college itself is done in the place of but not exclusively for a job. Many people work and go to college, even full time college (and some people full time work too).

It's a responsibility issue, however you choose to fund college or work there is a way it just requires planning and desire. In many cases you can take out a government subsidized student loan sufficient to pay for health insurance as a living expense addition above tuition/books.

I would likely support the government undersigning on a note for people aged under 20 as that would account for the parents not willing/able to help their children get on their feet.

@TopJedi - I think you're missing the point here. It's not that people are being forced to choose between Health Care and certain luxuries and are just choosing the short term luxuries - it's that in many cases health coverage is just out of their financial ball park.

The annual premium for a single individual averages $4000 nationwide. Assuming full time employment at minimum wage with no time taken off a single wage earner can expect $10,712 in yearly income before taxes.

Let's assume that health care is a priority for everyone. To make the numbers easier, let's also assume that health insurance can be paid for with pre-tax income. I'm curious -- do you know of anywhere in the United States where a person can reasonably expect to live on $559 a month?

Then there are people like me, for whom health insurance is a priority and who have the means to pay for it -- if only someone would sell it to me. As a childhood cancer survivor it's nearly impossible for me to get insurance. What choice do I have?

KyleN, Libertarian capitalists are in fact in favor of social anarchy. Protecting property rights is great for the people who own the property. In a system that does not regulate any social interactions and allows for private police forces and private resource management, etc it is only a matter of time before the strong take over vast regions using their wealth and the man power that comes from it.

Welcome to warlordism.

I must have missed all those meetings. I just looked again and I can't find the part about warlordism anywhere.

I am no warlord :-) I am not in favor of anarchy, nor have I lived uninsured despite many years of my life earning less than $25,000 annually.

Live your priorities, if you are a regular newsvine member which to me equates to some very bright individuals - I would hope you can earn much more than $25,000 annually to meet your critical needs if for no other reason.

Killfile it sounds like you have a unique situation and I suppose my remarks always need disclaimers that I am not speaking to the exceptions but rather the apparent "majority of Americans" who do not have adequate healthcare.

It's not really that unique a situation, but your point is taken. All I'm saying is that a lack of insurance is a serious and frightening thing. For some people it's a matter of money. They could live their lives differently; but they're not doing that. The rest of us end up picking up the cost for that anyway -- why not do it more efficiently?

For other people it's a matter of health history or any number of other factors. You'll end up picking up the cost for us as well -- though we're at least a little more likely to know what to look out for.

At the end of the day health insurance makes people feel safer. It makes them more likely to seek early care which makes them more likely to live healthy, active, and productive lives. That translates into better jobs, higher incomes, higher tax revenues, and all manner of other benefits.

I'm not saying that health care is the magic bullet. I'm not even saying that socialized medicine would pay for itself. What I am saying is that is the duty of any sovereign nation to protect its citizens from things that will kill them. We protect our citizens (or at least we try) from the militaries of foreign nations and terrorists. We protect our citizens (or at least we try) from natural disasters and help them get back on their feat after the fact.

Why don't we protect our citizens from the diseases that claim far more lives every year than terrorism or natural disasters?

Brian, TJ,

I am not saying the libertarian agenda is to create a warlord state... I am merely saying that the libertarian capitalists are fatally ignoring what Marxist/Leninist ignored in their day... Human propensity to fall into corruption.

Your agenda does not advocate the creation of fiefdoms any more than Marxism called for murdering hundreds of millions of innocents. Your agenda simply creates the perfect environment for such an outcome. No regulations on social interactions means that the powerful can abuse their strength to leverage property from the weak. They can actually own police forces which means that they will enforce their laws, which will certainly be in their best interests. They can own resources such as water and roads which means that they control who comes and goes and who gets food and water and who does not in their lands.. you play by their rules.

Right now in our "highly"regulated economy you already have people who have amassed vast fortunes. the only thing that is keeping them from spending it on things like water systems, roads, private police forces that do their bidding etc. is the government. Remove those restrictions and you create a power vacuum that is filled by these individuals.

As far as Top jedi's policies affect health care, In a Libertarian Capitalist paradise there will always be the poor.. it is an imperative for them to exist. With out the poor there can not be rich. The question then becomes, What to do about all these poor people? They cannot work harder to get a better lot in life because there will always be some one who is at the bottom and can not afford such things. The only solution, if one is to maintain your capitalist paradise, is for Brian's stance.. universal health care.

Behind My Screen, my point was pretty much that in any system in human history there have always been the poor, and there have always been the rich. That's not a very good argument against libertarianism or any other system. It seems to be an eternal part of human nature. My positions, with the exception of health care, are pretty much in line with the Libertarian party's positions, which do not call for private police forces as far as I'm aware of.

Have you ever driven on a toll road Behind My Screen? Did the toll booth operators look at you and decide whether you should be allowed to drive on the road or not, or did they just take your money?

I just found out that the Libertarian Party, the Green Party, and the Populist Party have all agreed on a single candidate for senator in Maryland who's running a unity campaign. The LP said the biggest issue they had with Kevin Zeese's positions was universal health care, but that the parties found enough common ground to work together.

you are certainly not as extreme as Adam Hobson. He has said that private ownership of police and water, and such would be a good thing.

The reason that toll roads today are not as I stated is because there is no incentive for them to act as I stated above They charge too much people will take another road. If however you lived in a system with unregulated social interactions and a capitalist economy at some point you would live on some one else's lands, and access some one else's roads just to get to work. If one person has that much power over the local commerce, then they can make any rule they like about accessing their roads.

Well your opting out is fine, as long as you can sign a legally binding document saying that if you're in a horrible auto accident then no government money will be used to take care of you.

Brian, as long as we are freeing our government from the risk of bmvaughn leaving the program... Why don't we really free up our government risk and all sign legally binding documents that we won't use our neighbors taxes so we can smoke cigarettes, ride motorcycles, bungy-jump, eat fried food, and live without any regular exercise?

I know its all pretty absurd. But if we don't care about how we live why should everyone absorb everyone's lack of care? If we all cared it would be a lot easier to donate to a healthcare cause that didn't have a leaky hole in it.

Or Congress could enact a "Patriot Health Act" to enforce responsibility via additional taxes, fees, or penalties on corporations and industries that damage human health or the environment for the resultant consequential damages of the manufacture and sale of products they sell...

Pipedream, I know. Heh.

Sounds like good fodder for your political career, Aine. You have my vote.

While we're signing these legally-binding documents, let's make each person who wants the government health-care guarantee that they won't drive in a car, will never go outside with any skin uncovered, will totally avoid any stress, and will make sure not to be related to anyone who has any history of cancer, heart disease, stroke, diabetes, or any other genetically linked illness. I know, these restrictions are so rare in the population compared to the huge numbers of lion-tamers, bungee-jumpers and hang-gliders, but I wanted to make sure we were being comprehensive.

Oh, and I almost forgot: soldiers. Between the physical injuries and mental injuries, these people consume so much health care that we have to have an entire cabinet-level department for them. Anyone who is stupid enough to join the military is obviously unqualified to get health-care on my dime.

BMVaughn_
You can be sure that you won't be allowed to opt out, if you think that opting out means also opting out of the taxes to pay for universal care.

Sorry -- can't let you do that. Progressive programs only work because of progressive taxes. Rest assured that if you could opt out it would be an insane choice for everyone making less than, say, $2,000,000 a year. If you're making more than that it's probably a good bet (off the cuff numbers - just a rough estimate).

The average premium in the US is $4,000 a year. The Iraq war costs about half that per tax payer. We can safely assume that a national health care program would be much less expensive.

Why don't we test run this with a universal car insurance program?

Isn't this what most states already have? All car owners are required to hold insurance, and the state runs a program of last resort. I know, at one point in my life I had to resort to Delaware's program while I was unemployed. Required no-fault insurance, like California's program if I recall, also essentially extends insurance to those unable to purchase a policy.

From what I have read, Massachusetts's idea for universal health coverage is somewhat similar although on a larger scale, since everyone owns a body. The state remains the insurer of last resort while mandating that those who can afford to pay for their own.

Incidentally, I have not seen you address the fact that you pay for indigent health care already, through the incredibly inefficient system of hospital emergency rooms and urgent care clinics. Would it not be a more practical* investment to address the poor's health problems before they require expensive interventions through free routine care?

I am not requiring equal outcomes from a universal health care system, which is what I think you fear, only equal opportunities for a baseline of care. You will be able to continue to abuse your body how you wish and pay a fortune for major interventions if you have the ability. Lord knows the French do, and their system is both more efficient and effective than ours.

Adipic, I could be persuaded to accept a program of last resort as you describe. I know you are correct about the indigent care problems as many hospitals are going out of business claiming a basic lack of revenue from "customers."

Poor and indigent require different approaches and again I hope are the great exception to the general topic. I simply struggle with the concept that even the wealthy among us go to the state as a "last resort." The state is also an easy deep-pocket target for the extremely litigious among us, a quality of America that France is far from attaining. If the poor "drain" the program from the bottom the wealthy "drain" the system through endless law suits. Our healthcare program whether private or universal is under attack from a lot of angles that drive up our costs and make it ever more difficult to become an entitlement.

I think all anyone wants is free emergency care, free access to antibiotics, free access to health checkups from your doctor, free immunizations for your children.

After that baseline of care, you can afford to buy catastrophic insurgence plans that cover a hospital stay and surgeries plus the tests/treatments that go along with such illnesses/accidents.

Making it harder (not impossible or capped) to sue a doctor for malpractice would also reduce the cost of medical care because many times doctors spend money on unnecessary tests just to cover their rears.

I don't consider Car insurance to be a close proxy for Universal Health care since you can opt out of owning a car (and insurance), and the wealthy with cars can opt out by posting a bond, but the proposed systems would not allow for any opting out.

I see this issue as the wealthy that do vote, versus the poor that don't vote as much.

Hmm.... maybe that had more to do with Russia than with universal health care.

I agree I don't want our government to run our health care system either.

Brian White, maybe it is just Russia, but what would prevent our health care system for dropping down to that level? Governmental oversight? Lawyers? Something else? What do you think?

Sounds like a government problem, not a universal health care problem

Universal health care does NOT mean Communism.

I don't know if it is hyperbole or if the righties are really this simple when it comes to universal health care.

Mimizhusband, I don't know. Ask Canada. They seem to do a pretty good job with it.

One of the complications of health care is that doctors who make diagnonses also provide the solution. I'm sure we've all felt the skepticism at the auto mechanic that we really need a new gweebo disc or whatever they're recommending that costs so much. Another complication is that doctors admit they routinely order expensive and medically unnecessary tests to avoid any grounds for a malpractice suit later. They're comfortable doing so because the test is covered by a patients' insurance or medicare or something, and the patient doesn't face the sticker shock. It's a complicated issue. I know our current system wastes a huge amount of money nationally. The libertarian approach would be to say that everyone should pay for care themselves, and then they'll make sure the doctor doesn't run an expensive CAT scan when it's not judged medically necessary. The liberal/socialist approach looks at Canada with their much lower per capita spending, slightly longer life spans, and equal cancer survival rates and say "that's how we should do it". JAMA did a study where they concluded that a single-payer system in the US would save so much money (in wasted overhead and paper pushing) that the US would be able to insure the 40 million uninsured with that savings.

It's a complicated issue. And difficult to deal with in the US due to entrenched concerns. In the US doctors are increasinly pushed to specialize, and in increasingly narrow specialties. Often this is to be able to pay off ridiculously high student loans. So we have the best specialists in the world. And trouble finding general practioners. Doctors in the US make about 3 times what doctors in France make. Trying to sell a 2/3 pay cut on an industry, especially one where the young members do have those ridiculous loans to pay off, is basically impossible.

The interesting thing to me, is that I don't believe in requiring prescriptions at all. Mykola's sick, and wishes he could afford to go to the doctor. Maybe it would be better if he could just buy amoxicillin at CVS? When I've gone to the hospital because I really needed to, like after a car accident, or to get my scalp sutured back together, there was clearly a need to go to the doctor. When I decided to wait out the strep I had, or when I needed a steroid to treat really bad poison ivy, there wasn't a clear need to go to the doctor and I resented that.

doctors admit they routinely order expensive and medically unnecessary tests to avoid any grounds for a malpractice suit later. They're comfortable doing so because the test is covered by a patients' insurance or medicare or something

...but if it's on the govenment's tab they'll do that less?

The interesting thing to me, is that I don't believe in requiring prescriptions at all. Mykola's sick, and wishes he could afford to go to the doctor. Maybe it would be better if he could just buy amoxicillin at CVS?

...and if he decided the pain was unbearable from an injury that he got, could he then go and get oxycontin?

...but if it's on the govenment's tab they'll do that less?

I'm not sure how the system works in Canada and France, but it seems to be the case there. Maybe it's much harder to sue for malpractice there.

...and if he decided the pain was unbearable from an injury that he got, could he then go and get oxycontin?

Sure, why not? I don't believe in our country's drug policies.

I don't know how you can disagree with our country's drug policies, Brian. After all, they are doing such an excellent job of keeping oxycontin out of the hands of anyone without a prescription. And, since all other drugs are under such strict control that there is no drug abuse left in the country, how will removing all drug restrictions help? Do you want it to be just as easy to get a hold of amoxycillin as it is to get a hold of marijuana? Why that's absurd!

Brian,

It would be bad for him to go get some Amox for a number of reasons. First, dosage of Amox is weight dependent. Too high a dosage and he'll kill off the bacteria that make his digestive system work. Second, Amox, if taken irregularly, can culture antibiotic resistant bacteria. That's bad. Third, lots of people are allergic to Amox. Brian would be well served by someone who knows his medical history as he's unlikely to know what other drugs an allergy to Amox might predict.

As for the Oxycontin -- while i'm sure whomever makes Oxycontin would love that, some drugs impair a person's ability to make rational choices. We regulate them because they screw with us at the same level of our minds that regulates taking more of them. Feedback loops are bad -- having an outside sanity check helps.

I don't know if it is hyperbole or if the righties are really this simple when it comes to universal health care.

Behind My Screen: I am not sure if you have noticed, but it is not just "righties" who are equating Universal Health Care with the lowered standards of Communist countries. Despite some attempts to make it seem otherwise, this is clearly not a Righty vs. Lefty argument.

I live in a state led by a Republican governor who has at least made an attempt toward addressing this issue (Massachusetts). Mandating that employers provide health insurance is the wrong answer in my opinion, but I have to admire his sincere desire to make progress on an issue that both sides have just paid lip service to thus far. Here, we seem to have an example of a "Righty" who is looking to do more than simply talk about health care.

Pretending that either side (Right or Left) has a monopoly on the "right stuff" to bring health care to the people is just that... a fantasy. It will take bi-partisan cooperation and a concerted effort on our parts at pressuring our representatives to do what is best for everyone concerned so that we might finally see this debate through to some sort of resolution. Any small step forward should be applauded as progress. This may also require accepting that some of our preconceived ideas of what Universal Health Care should be, just may not be the answer right now for this country.

Oh, I group the libertarian capitalists in there as well. They are in fact to the right, they just happen to be socially anarchistic.

BTW DBS... by righties I mean economically conservative. As you point out, Romney is economically moderate.

There are different kinds of righties.. those that are more socially anarchistic and those that are more socially authoritarian.

Pinochet is an example of an authoritarian righty, and Adam Hobson of newsvine is an anarchistic righty.

Brian,

It would be bad for him to go get some Amox for a number of reasons. First, dosage of Amox is weight dependent. Too high a dosage and he'll kill off the bacteria that make his digestive system work. Second, Amox, if taken irregularly, can culture antibiotic resistant bacteria. That's bad. Third, lots of people are allergic to Amox. Brian would be well served by someone who knows his medical history as he's unlikely to know what other drugs an allergy to Amox might predict.

As for the Oxycontin -- while i'm sure whomever makes Oxycontin would love that, some drugs impair a person's ability to make rational choices. We regulate them because they screw with us at the same level of our minds that regulates taking more of them. Feedback loops are bad -- having an outside sanity check helps.

Dosage of amox is weight dependent - fine, put dosage instructions on the package, or put it behind the counter at the pharmacy so he has to talk to a pharmacist to get it.

If taken irregularly it can culture antibiotic resistant bacteria. That's true. That's why it shouldn't be taken irregularly. But it's really up to the people taking it, right? Doctors don't have a good record when it comes to this, they prescribe antibiotics so freely there's no point in requiring the prescription in the first place, and the one environment that has given rise to the most troublesome drug resistant bugs is hospitals. I can't buy this as a reason to restrict this to prescriptions.

Allergies - well since Mykola doesn't have a doctor now I'm assuming he'd be going to a new doctor. The new doctor wouldn't know his medical history. So again I can't see how this would help. Since I grew up I've rarely gone to the same doctor twice, between moves and insurance changes.

Some drugs impair a person's ability to make rational choices. True. So does alcohol. So does love. So does religion. So does the adrenaline rush of bungee jumping. There are more alcoholics than there are oxycontin addicts in this country by far.

put dosage instructions on the package

Your faith in people having intelligence makes me smile.

Well he does have to take it by himself right? The instructions will say take one pill, take two pills, take one teaspoon, take two teaspoons, etc. whether this is provided by prescription or over the counter.