Why people are afraid of universal health care

[Swammerdami]

This isn’t going to end with the billionaire class and their lickspittle behaving better. As the GOP eliminates all agencies that do anything to protect public health and corporate accountability, these clowns are going to wall up behind heavily armed and unaccountable private security. In most cases they’ll have government law enforcement and the courts on their side too. Like southern WVA in the late 19th and early 20th centuries.

The  Battle of Blair Mountain in 1921 is called "the largest armed uprising [on American soil] since the American Civil War." It was the culmination of the Coal Wars that scombrid alludes to.

Historical note: It is not known who the town of Blair (in Logan County, WV) nor Blair Mountain is named after. The eponym may or not be related to the J.H. Blair (Sheriff of Harlan County, KY not far from Logan County) who was a key player in the Harlan County War of 1931-1939 which, like the Battle of Blair Mountain, was a war between striking coal miners and both official and (sometimes deputized) private police. This latter Blair was immortalized in this song, here sung by Pete Seeger.

Sadly, in the recent Election 45% of voters in union households voted for Donald Trump.

 

[Emily Lake]

Sure; But they are not grifters, freeloaders, or theives - they are lottery losers.
Nobody chooses to be one of the expensive few; Nobody plans yo be; Nobody expects to be, until suddenly they are.

So in fact, healthcare benefits everyone.

I didn't suggest that the 20% driving the costs are grifters. And none of what you've written counters my point that health care isn't as straightforward of a public good as roads, nor is it forced charity, but something in between and quite expensive.

 

[Emily Lake]

1) You have never addressed the fact that applying your standards to reality produces a very different result than what you're arguing for.

What very different results are produced?

As far as I can see, every complaint against my position is pointing to the negative consequences that happen with a strict no-exceptions ban in place. On the other hand... nobody has come forward with the slews of dead women that happened when RvW was still in place as it had been throughout the vast majority of my life. So... I don't see that there's anything to address.

Depending on exactly how your words are interpreted I get 28, 32 or 36 weeks. Not the 24 of Roe vs Wade.

And this is not situational, that's always the result.

I don't understand what you're trying to say here. Please use more words.

 

[Emily Lake]

It’s true that a disproportionate share of health care costs is driven by a small percentage of the population. However, as you pointed out, most of us are already contributing to these costs through employer-sponsored insurance or other mechanisms. Universal health care simply formalizes and equalizes this process, ensuring that everyone contributes fairly and benefits when they need it. It removes the hidden costs and inefficiencies that exist in the current system, such as emergency room care for the uninsured, which we all ultimately pay for.

You suggest that the ability to opt out of current systems preserves individual choice. While this may seem ideal in theory, in practice, it often leads to gaps in coverage and higher costs for everyone as market-driven approaches often exacerbate inequities and inefficiencies.. Universal systems eliminate these disparities, ensuring a baseline of care for all while potentially allowing for supplemental private insurance for those who want more.

Good post, overall. I'm just picking a snippet to keep the nested quote size down.

I didn't mention opting out to imply that it's a good thing or that individual choice is always the right approach. In the case of health care, I don't actually think it's a good thing... for a large variety of reasons.

That said... universal care isn't my favored approach - but not for the reasons that most people would put forth.

The US has some different existing dynamics that other countries don't have. We have a deeply entrenched fully private and profit-driven delivery system. We ended up with employer sponsored health insurance endemic in our society over a relatively short span of time - where other countries moved to UHC instead. We have a gordian knot in the US and we can't just cut it in half and be done with it, because there are a lot of negative consequences of that.

My preferred approach for the US specifically is to actually start with the delivery system and just nationalize that sucker. All doctors, nurses, clinicians, therapists, etc. would be salaried government employees (complete with federal benefits). Medical training would be government funded based on aptitude and ability to complete the coursework satisfactorily. Facilities would be government owned - and distributed in a way that allows access in less urban areas instead of the current health care deserts that we're dealing with. Drugs pricing would be negotiated federally.

We can talk about Universal Access until we all asphyxiate from lack of air to our brains, but the reality is that the single biggest driver of the disparity in costs between the US and other developed countries is on the delivery side of the equation.

 

[Emily Lake]

It is dangerous that so many people on social media are using this murder as an occasion to air their concerns about the American healthcare system. A man was murdered in cold blood in what was probably a professional hit, and the response in left leaning spaces has mostly been muted. A large proportion of the comments I see are along the lines of "murder is bad, but maybe healthcare will be less expensive for poor people now," etc.

To me this isn't something to politicize or talk out of both sides of my mouth about. "Murder is bad" is not a liberal or conservative idea, it's a human idea. This is completely out of bounds for a civilized society.

I remember calling 911 so many times when my youngest was little. She had severe asthma and it often acted up in the middle of the night. She'd come staggering into my room, barely able to breathe. I'd frantically call 911 and then lay her on the floor and have her hit her inhaler until they got there. Her face, her lips would get so pale. I cannot adequately describe how horrific it was watching my little girl go through this and that this was how she might actually die.

I remember having to follow the ambulance to the ER at 1 or 2 in the morning, terrified for her and feeling so fucking helpless.

I'm sorry that your little girl had such bad asthma. It must have been terrifying for you and her both.

We had Anthem/Blue Shield at the time. The deductible was 5K. It was all that was offered. A gigantic "Fuck You. Take It Or Leave It."

The fear that my child was going to die was coupled with the humiliation of wondering how I was going to pay for her treatment.

So some mega health insurance CEO got gunned down. Boo-motherfucking-hoo. Neither that cocksucker nor any other fucking ghoul like him ever gave two thoughts about people like me or my kids. Why on fucking earth should I feel anything for him or anyone in his family?

Frankly, it's shocking it hasn't happened sooner. And if it happens again? Well, sorry, I'm going to have to deny any requests for sympathy because it won't be in my network.

This is misplaced anger. I guarantee that Anthem had plans available with lower deductibles. The fact that you had only one option, with a very high deductible, is the fault of your employer, not the insurer. Your employer selected a plan with a high deductible, and decided to give you only that as an option.

Why do you think that someone else should die because your employer was a dick?

 

[Elixir]

I guarantee that Anthem had plans available with lower deductibles.

LOLOLOLOL!!!
Your guarantee plus $10,000 would have covered my deductible when I had Anthem.
OF FUCKING COURSE there were lower deductible "plans". At minimum, my monthly $900 premium would have almost doubled, to get the deductible down to a "mere" $2500. I was paying myself $35-45k/yr at the time, so lowering the deductible wasn't a very real option. Even with paying the exorbitant out of pocket "insurance" (haha) costs, I still had major exposure if I had needed any designer drugs or radical interventions... I can TOTALLY understand if someone shot that guy out of misguided blind rage. But all things considered, it sure looks like a professional hit. We will probably learn what kind of skulduggery the guy was into, who would profit from his demise etc... but the idea that someone killed him because they thought the CEO of a conglomerate was personally responsible for their shitty healthcare or tragic outcome, doesn't ring true to me*.

I do love medicare, complain though I might about the healthcare desert in which I live.
Right now I have ZERO deductible (with plan N), negligible drug costs and no fear of catastrophic injury or illness. It's a different life.

* ETA Another possibility is that the killer lost his life savings to a scammer, after United Health Care gave away his personal information. I used United Medicare Advisors for several years, and yeah - they let my info get hacked and scammers were calling, emailing, messaging me about my "account ending in XXXX" for months. That sucked; it was an account that had a lot of activity and kinda freaked me out that the scammers had the last four digits and the bank name.

 

[Emily Lake]

For anyone who cares... I have a very profound problem with health insurance being publicly traded and for profit. I view it as a fundamental conflict of interest - a company cannot act in the best interest of their policyholders while also acting in the best interest of their shareholders.

I have the same objection when it comes to the delivery side. I have a massive ethical objection to for-profit hospitals.

 

[bilby]

Sure; But they are not grifters, freeloaders, or theives - they are lottery losers.
Nobody chooses to be one of the expensive few; Nobody plans yo be; Nobody expects to be, until suddenly they are.

So in fact, healthcare benefits everyone.

I didn't suggest that the 20% driving the costs are grifters. And none of what you've written counters my point that health care isn't as straightforward of a public good as roads, nor is it forced charity, but something in between and quite expensive.

OK, well here you go then:

Health care is as straightforward a public good as roads, and it is not in any way whatsoever charity. It is forced upon us by biologicsl reality, not policy or ideology, and that it is exlensive is irrelevant because it is essential and unavoidable.

That counters your point. Are we done with this libertarian derived foolishness now?

No man is an island.

 

[Emily Lake]

Your guarantee plus $10,000 would have covered my deductible when I had Anthem.
OF FUCKING COURSE there were lower deductible "plans". At minimum, my monthly $900 premium would have almost doubled, to get the deductible down to a "mere" $2500. I was paying myself $35-45k/yr at the time, so lowering the deductible wasn't a very real option. Even with paying the exorbitant out of pocket "insurance" (haha) costs, I still had major exposure if I had needed any designer drugs or radical interventions...

I'm going to take this opportunity to direct you up thread to my prior wall of text.

I 100% get your frustration with the cost of coverage, and I share it. I've got a $7K deductible for me and my husband, and yeah, it's terrifying. And yeah - it's the lowest Ded offered by my employer and my employer is an insurance company. Which brings me back around to the point I was making earlier - the *cost* of *delivery* is a massive problem.

80% of every premium dollar goes to cover direct medical costs. The US health insurance sector is regulatorily profit-capped. There are no caps or limits of any sort on the amount of profit that drug companies, pharmacies, hospitals, surgical centers, rehab facilities, medical device manufacturers, or professionals can make.

 

[Emily Lake]

Sure; But they are not grifters, freeloaders, or theives - they are lottery losers.
Nobody chooses to be one of the expensive few; Nobody plans yo be; Nobody expects to be, until suddenly they are.

So in fact, healthcare benefits everyone.

I didn't suggest that the 20% driving the costs are grifters. And none of what you've written counters my point that health care isn't as straightforward of a public good as roads, nor is it forced charity, but something in between and quite expensive.

OK, well here you go then:

Health care is as straightforward a public good as roads, and it is not in any way whatsoever charity. It is forced upon us by biologicsl reality, not policy or ideology, and that it is exlensive is irrelevany because it is essential and unavoidable.

That counters your point. Are we done with this libertarian derived foolishness now?

No man is an island.

You seriously need to check your fucking reading comprehension.

 

[bilby]

The US has some different existing dynamics that other countries don't have.

It really doesn't. The US is not even vaguely exceptional or unusual except in being many decades behind the rest of the world.

My preferred approach for the US specifically is to actually start with the delivery system and just nationalize that sucker.

You mean, exactly like Clem Atlee did in the UK in the 1940s?

Sounds everso unique and special to me

 

[Emily Lake]

The US has some different existing dynamics that other countries don't have.

It really doesn't. The US is not even vaguely exceptional or unusual except in being many decades behind the rest of the world.

My preferred approach for the US specifically is to actually start with the delivery system and just nationalize that sucker.

You mean, exactly like Clem Atlee did in the UK in the 1940s?

Sounds everso unique and special to me

Why are you so fucking determined to pick a fight with me? If you bothered to actually read and comprehend, you might be able to understand that you're fighting a windmill, bilby, and you're arguing against things I didn't actually say.

 

[Elixir]

Your guarantee plus $10,000 would have covered my deductible when I had Anthem.
OF FUCKING COURSE there were lower deductible "plans". At minimum, my monthly $900 premium would have almost doubled, to get the deductible down to a "mere" $2500. I was paying myself $35-45k/yr at the time, so lowering the deductible wasn't a very real option. Even with paying the exorbitant out of pocket "insurance" (haha) costs, I still had major exposure if I had needed any designer drugs or radical interventions...

I'm going to take this opportunity to direct you up thread to my prior wall of text.

I 100% get your frustration with the cost of coverage, and I share it. I've got a $7K deductible for me and my husband, and yeah, it's terrifying.

Holy shit... I'm truly sorry about that and hope you skate. I absolutely HATED the feeling of exposure to uncontrollable and unpredictable circumstances that could leave me (us) destitute.

And yeah - it's the lowest Ded offered by my employer and my employer is an insurance company.

That's disgraceful.

Which brings me back around to the point I was making earlier - the *cost* of *delivery* is a massive problem.

80% of every premium dollar goes to cover direct medical costs. The US health insurance sector is regulatorily profit-capped. There are no caps or limits of any sort on the amount of profit that drug companies, pharmacies, hospitals, surgical centers, rehab facilities, medical device manufacturers, or professionals can make.

Yay for vertical integration, eh?

 

[laughing dog]

It is dangerous that so many people on social media are using this murder as an occasion to air their concerns about the American healthcare system. A man was murdered in cold blood in what was probably a professional hit, and the response in left leaning spaces has mostly been muted. A large proportion of the comments I see are along the lines of "murder is bad, but maybe healthcare will be less expensive for poor people now," etc.

To me this isn't something to politicize or talk out of both sides of my mouth about. "Murder is bad" is not a liberal or conservative idea, it's a human idea. This is completely out of bounds for a civilized society.

I remember calling 911 so many times when my youngest was little. She had severe asthma and it often acted up in the middle of the night. She'd come staggering into my room, barely able to breathe. I'd frantically call 911 and then lay her on the floor and have her hit her inhaler until they got there. Her face, her lips would get so pale. I cannot adequately describe how horrific it was watching my little girl go through this and that this was how she might actually die.

I remember having to follow the ambulance to the ER at 1 or 2 in the morning, terrified for her and feeling so fucking helpless.

I'm sorry that your little girl had such bad asthma. It must have been terrifying for you and her both.

We had Anthem/Blue Shield at the time. The deductible was 5K. It was all that was offered. A gigantic "Fuck You. Take It Or Leave It."

The fear that my child was going to die was coupled with the humiliation of wondering how I was going to pay for her treatment.

So some mega health insurance CEO got gunned down. Boo-motherfucking-hoo. Neither that cocksucker nor any other fucking ghoul like him ever gave two thoughts about people like me or my kids. Why on fucking earth should I feel anything for him or anyone in his family?

Frankly, it's shocking it hasn't happened sooner. And if it happens again? Well, sorry, I'm going to have to deny any requests for sympathy because it won't be in my network.

This is misplaced anger. I guarantee that Anthem had plans available with lower deductibles. The fact that you had only one option, with a very high deductible, is the fault of your employer, not the insurer. Your employer selected a plan with a high deductible, and decided to give you only that as an option.

Why do you think that someone else should die because your employer was a dick?

Your question is a straw man. Not having sympathy for a victim is not equivalent to thinking the victim had it coming.

And, as a general observation, until the public knows the motivation behind this killing, the speculation is just that. It is possible the motivation for this murder is not related to health care issues.

 

[bilby]

Sure; But they are not grifters, freeloaders, or theives - they are lottery losers.
Nobody chooses to be one of the expensive few; Nobody plans yo be; Nobody expects to be, until suddenly they are.

So in fact, healthcare benefits everyone.

I didn't suggest that the 20% driving the costs are grifters. And none of what you've written counters my point that health care isn't as straightforward of a public good as roads, nor is it forced charity, but something in between and quite expensive.

OK, well here you go then:

Health care is as straightforward a public good as roads, and it is not in any way whatsoever charity. It is forced upon us by biologicsl reality, not policy or ideology, and that it is exlensive is irrelevany because it is essential and unavoidable.

That counters your point. Are we done with this libertarian derived foolishness now?

No man is an island.

You seriously need to check your fucking reading comprehension.

How is directly addressing your own exact words in any way a failure of my reading comprehension?

You said "none of what you've written counters my point that health care isn't as straightforward of a public good as roads, nor is it forced charity, but something in between and quite expensive", so I wrote something that explicitly counters that exact point.

 

[Jimmy Higgins]

Sure; But they are not grifters, freeloaders, or theives - they are lottery losers.
Nobody chooses to be one of the expensive few; Nobody plans yo be; Nobody expects to be, until suddenly they are.

So in fact, healthcare benefits everyone.

I didn't suggest that the 20% driving the costs are grifters. And none of what you've written counters my point that health care isn't as straightforward of a public good as roads, nor is it forced charity, but something in between and quite expensive.

OK, well here you go then:

Health care is as straightforward a public good as roads, and it is not in any way whatsoever charity. It is forced upon us by biologicsl reality, not policy or ideology, and that it is exlensive is irrelevany because it is essential and unavoidable.

That counters your point. Are we done with this libertarian derived foolishness now?

No man is an island.

You seriously need to check your fucking reading comprehension.

You said it isn't as straightforward as roads. He said it is. And it is. EVERYONE needs health care. Our economy in part relies on ti. Being a first world nation depends on it.

Some people need it more than others, but that is a shit biological lottery. Not something that should be the basis to determine who should be able to have a decent standard of living because they spend so much on health care. We should be rushing to help pay for their care, not bitching about how much it costs to help them live.

There are capitalistic, humanitarian, and philosophical justifications for UHC. The only justification against UHC is narcissistic self-interest.

 

[Colonel Sanders]

It is dangerous that so many people on social media are using this murder as an occasion to air their concerns about the American healthcare system. A man was murdered in cold blood in what was probably a professional hit, and the response in left leaning spaces has mostly been muted. A large proportion of the comments I see are along the lines of "murder is bad, but maybe healthcare will be less expensive for poor people now," etc.

To me this isn't something to politicize or talk out of both sides of my mouth about. "Murder is bad" is not a liberal or conservative idea, it's a human idea. This is completely out of bounds for a civilized society.

I remember calling 911 so many times when my youngest was little. She had severe asthma and it often acted up in the middle of the night. She'd come staggering into my room, barely able to breathe. I'd frantically call 911 and then lay her on the floor and have her hit her inhaler until they got there. Her face, her lips would get so pale. I cannot adequately describe how horrific it was watching my little girl go through this and that this was how she might actually die.

I remember having to follow the ambulance to the ER at 1 or 2 in the morning, terrified for her and feeling so fucking helpless.

I'm sorry that your little girl had such bad asthma. It must have been terrifying for you and her both.

We had Anthem/Blue Shield at the time. The deductible was 5K. It was all that was offered. A gigantic "Fuck You. Take It Or Leave It."

The fear that my child was going to die was coupled with the humiliation of wondering how I was going to pay for her treatment.

So some mega health insurance CEO got gunned down. Boo-motherfucking-hoo. Neither that cocksucker nor any other fucking ghoul like him ever gave two thoughts about people like me or my kids. Why on fucking earth should I feel anything for him or anyone in his family?

Frankly, it's shocking it hasn't happened sooner. And if it happens again? Well, sorry, I'm going to have to deny any requests for sympathy because it won't be in my network.

This is misplaced anger. I guarantee that Anthem had plans available with lower deductibles. The fact that you had only one option, with a very high deductible, is the fault of your employer, not the insurer. Your employer selected a plan with a high deductible, and decided to give you only that as an option.

Why do you think that someone else should die because your employer was a dick?

It's a long story, but at the time I didn't have an employer, so I had to take what was available to me on the open market. The employer angle is irrelevant anyway because approval for treatment for other serious illnesses can take months while the patient's condition worsens, and then there's the struggle to get the insurance company to pay what they're supposed to pay. Etc.

 

[Emily Lake]

Your guarantee plus $10,000 would have covered my deductible when I had Anthem.
OF FUCKING COURSE there were lower deductible "plans". At minimum, my monthly $900 premium would have almost doubled, to get the deductible down to a "mere" $2500. I was paying myself $35-45k/yr at the time, so lowering the deductible wasn't a very real option. Even with paying the exorbitant out of pocket "insurance" (haha) costs, I still had major exposure if I had needed any designer drugs or radical interventions...

I'm going to take this opportunity to direct you up thread to my prior wall of text.

I 100% get your frustration with the cost of coverage, and I share it. I've got a $7K deductible for me and my husband, and yeah, it's terrifying.

Holy shit... I'm truly sorry about that and hope you skate. I absolutely HATED the feeling of exposure to uncontrollable and unpredictable circumstances that could leave me (us) destitute.

And yeah - it's the lowest Ded offered by my employer and my employer is an insurance company.

That's disgraceful.

Which brings me back around to the point I was making earlier - the *cost* of *delivery* is a massive problem.

80% of every premium dollar goes to cover direct medical costs. The US health insurance sector is regulatorily profit-capped. There are no caps or limits of any sort on the amount of profit that drug companies, pharmacies, hospitals, surgical centers, rehab facilities, medical device manufacturers, or professionals can make.

Yay for vertical integration, eh?

Oh don't get me started on vertical integration... holy shit.

 

[Elixir]

 

[Gospel]

The US has some different existing dynamics that other countries don't have. We have a deeply entrenched fully private and profit-driven delivery system. We ended up with employer sponsored health insurance endemic in our society over a relatively short span of time - where other countries moved to UHC instead. We have a gordian knot in the US and we can't just cut it in half and be done with it, because there are a lot of negative consequences of that.

My preferred approach for the US specifically is to actually start with the delivery system and just nationalize that sucker. All doctors, nurses, clinicians, therapists, etc. would be salaried government employees (complete with federal benefits). Medical training would be government funded based on aptitude and ability to complete the coursework satisfactorily. Facilities would be government owned - and distributed in a way that allows access in less urban areas instead of the current health care deserts that we're dealing with. Drugs pricing would be negotiated federally.

I agree that nationalizing the entire healthcare delivery system might theoretically solve cost disparities, but achieving that politically is an enormous hurdle. Universal coverage, specifically models like Medicare for All, already have substantial public understanding and some degree of support.

Medicare for All brings all patients into the system, replacing the current patchwork of private insurance, Medicaid, Medicare, and the uninsured who rely on expensive emergency care. By creating one integrated risk pool or regulated set of payers.

So If everyone is covered and there’s a single or harmonized set of rules and fee schedules, then subsequent changes, like altering how care is delivered, reorganizing hospital ownership, or integrating preventative services, become logistically simpler.

However, insurance companies often lobby politicians and use the media to frighten the public with claims of government inefficiency and brand such proposals as “socialist.” Consequently, meaningful reforms are unlikely to occur anytime soon in the land of the free and home of the brave. At least until enough Americans are fed up with being stupid.