An interesting observation on health care systems

[Loren Pechtel]

Nonsense. Under the private insurance scheme, we are demanding that less fortunate people give up their lives in order to maintain profits for insurance companies and access to affordable health care for those who are fortunate enough to be able to afford premiums and deductibles.

That's why we have things like Medicaid and the ACA subsidies.

What is really, truly horrible is that we make more than our children do combined--and have much less expensive, much more comprehensive health care benefits than any of our children.

You're much farther along in your careers, of course you make more!

Every single person should have access to the same level of excellent health care at the same cost we paid out of pocket

The problem is UHC means only the ultra-wealthy get that excellent level of care, everyone else gets a mediocre level of care. You want to improve things but in practice the result is the opposite.

Most Americans do not require transplants. But even with good insurance, it can be extremely difficult to get your insurance carrier to cover the costs of a transplant. A friend recently had a liver transplant and needed to come up with (only) $20K of the cost. That alone would break a lot of Americans. And that keeps a lot of Americans off transplant lists...And that's not counting the cost of follow up care or antirejection drugs that are required for life. The cost of those drugs is extremely high, often not covered by insurance and does also keep some people off of the transplant list.

That's wrong. It's absolutely immoral.

The maximum out of pocket for Obama-era insurance is far less than $20k.

However, you do point out something I would like to see changed--when ongoing expenses are clearly tied to a prior medical cost they should be covered as if they occurred in the year of the initial medical event. Thus chronic problems become a one-time hit rather than a hit every year.

 

[Jimmy Higgins]

Are you out of your mind? Almost All UHC systems have care decisions made primarily by doctors. Not insurance company loss adjusters, as in the US system.

That's not a flaw, it's a vital feature, and the basic flaw in your system. The choice is not "UHC, with 'Death Panels'" vs "Insurance, with no 'Death Panels'". It is "UHC, with life and death decisions made by doctors" vs "Insurance, with life and death decisions made by accountants".

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Doctors may decide what a patient needs, but the government decides the capacity and thus when it will actually happen--and they're the same people that decide whether the system is doing a good job. Thus you end up with big delays for quality of life things (and sometimes with identifying deadly things) being declared acceptable. You end up with unsafe conditions being tolerated. (A US hospital that had feces running down the walls wouldn't be operating! Yet it happened in England.)

The accountants are a greater threat under UHC than here. Yes, we do have problems but when our insurance companies get too far out of line they tend to get smacked down. An example from some time ago comes to mind--the insurance refused to cover HIV treatment as a pre-existing condition. Looking at all the data it was obvious that the "pre-existing" was a human stuck in the past--they wrote the previous year instead of the current year on one critical lab report. The jury hit them for $15 million for that.

My heart goes out to Tom Sawyer and Bilby and all the others who suffer from accountants in their UHC.

Only if Canada, Australia, etc... knew that LP himself could address all these terrible systems with a for profit health care system.

 

[bilby]

Are you out of your mind? ...

Doctors may decide what a patient needs, but the government decides the capacity and thus when it will actually happen--and they're the same people that decide whether the system is doing a good job. Thus you end up with big delays for quality of life things (and sometimes with identifying deadly things) being declared acceptable. You end up with unsafe conditions being tolerated. (A US hospital that had feces running down the walls wouldn't be operating! Yet it happened in England.)

The accountants are a greater threat under UHC than here. Yes, we do have problems but when our insurance companies get too far out of line they tend to get smacked down. An example from some time ago comes to mind--the insurance refused to cover HIV treatment as a pre-existing condition. Looking at all the data it was obvious that the "pre-existing" was a human stuck in the past--they wrote the previous year instead of the current year on one critical lab report. The jury hit them for $15 million for that.

A simple 'yes' would have sufficed.

 

[Toni]

That's why we have things like Medicaid and the ACA subsidies.

And yet none of my kids qualify for Medicaid. They receive health insurance through their employers. The health insurance options they have through their employers or if they decided to do the ACA are far less comprehensive and far more expensive to the insured than what we have.

You're much farther along in your careers, of course you make more!

Well, no shit Sherlock. That wasn't the point. The point is that we make far more than they do--AND PAY FAR LESS for healthcare.

They're young, healthy adults. We're much older and while healthy for our ages, have had cancer in the past. Their health care costs should be less than ours, all things being equal. But that's not how it's working out.

Every single person should have access to the same level of excellent health care at the same cost we paid out of pocket

The problem is UHC means only the ultra-wealthy get that excellent level of care, everyone else gets a mediocre level of care. You want to improve things but in practice the result is the opposite.

Where do you get the information that allows you to make the assertion that the ultra wealthy get excellent health care and everyone else gets mediocre care?

Most Americans do not require transplants. But even with good insurance, it can be extremely difficult to get your insurance carrier to cover the costs of a transplant. A friend recently had a liver transplant and needed to come up with (only) $20K of the cost. That alone would break a lot of Americans. And that keeps a lot of Americans off transplant lists...And that's not counting the cost of follow up care or antirejection drugs that are required for life. The cost of those drugs is extremely high, often not covered by insurance and does also keep some people off of the transplant list.

That's wrong. It's absolutely immoral.

The maximum out of pocket for Obama-era insurance is far less than $20k.

Not for transplants, sweetheart. BTW, friend who received the transplant is recently retired from a long career in the military and in Homeland security. He doesn't need your thanks for his service. They won't compensate for the liver he had to have replaced due to damage incurred while stationed overseas on your behalf. And no, he's never been a drinker or a drug user. Best any doc can tell him is that he likely picked up something while deployed.....

However, you do point out something I would like to see changed--when ongoing expenses are clearly tied to a prior medical cost they should be covered as if they occurred in the year of the initial medical event. Thus chronic problems become a one-time hit rather than a hit every year.

Chronic illnesses should be a zero hit.

Health coverage should not be tied to an employer or employment. Chronic health problems that go untreated keep a lot of people out of the workforce where they'd much prefer to be. Instead, they are stuck subsisting on medicare/medicaid, SS disability and not much else, while their health issues worsen along with their economic condition.

 

[T.G.G. Moogly]

The problem is UHC means only the ultra-wealthy get that excellent level of care, everyone else gets a mediocre level of care. You want to improve things but in practice the result is the opposite.

Don't know what you're smoking.

 

[Loren Pechtel]

The problem is UHC means only the ultra-wealthy get that excellent level of care, everyone else gets a mediocre level of care. You want to improve things but in practice the result is the opposite.

Don't know what you're smoking.

The ultra-wealthy can go anywhere for care and pay out of pocket.

 

[southernhybrid]

The problem is UHC means only the ultra-wealthy get that excellent level of care, everyone else gets a mediocre level of care. You want to improve things but in practice the result is the opposite.

Don't know what you're smoking.

The ultra-wealthy can go anywhere for care and pay out of pocket.

Sure, but that has nothing to do with UHC. I get the same care on Medicare as I did when I had private insurance. In my case, the co pays are higher on Medicare because we had unusually good private insurance from my husband's last job, prior to retirement. The ultra wealthy can get their care from doctors that don't take any type of insurance. They can get any type of elective surgery that they want, but what has that got to do with the vast majority of people in the country.

I'm not against Medicare for all. I just don't see it happening any time soon because there is very little chance of getting enough Congressional support for it, and a lot of people don't understand that they would still have to either pay higher taxes or premiums that are similar to what they have with many private insurance plans.

The ACA has many shortcomings, but it was the only way my husband could even get insurance after he was laid off from his last job and was too young for Medicare. One of my sisters has been getting her care from an ACA policy for years. She just turned 60, but doesn't work. The last two jobs she had didn't provide any insurance coverage. That is the norm if you work for a small business. I hope we can at least make the ACA more affordable for more people. It's not really that affordable for a lot of people, especially if you're over 50.

 

[Loren Pechtel]

The ultra-wealthy can go anywhere for care and pay out of pocket.

Sure, but that has nothing to do with UHC. I get the same care on Medicare as I did when I had private insurance. In my case, the co pays are higher on Medicare because we had unusually good private insurance from my husband's last job, prior to retirement. The ultra wealthy can get their care from doctors that don't take any type of insurance. They can get any type of elective surgery that they want, but what has that got to do with the vast majority of people in the country.

The assertion was that the better off people here that had a better outcome were the ultra-wealthy. I was showing that that's obviously bogus.

I'm not against Medicare for all. I just don't see it happening any time soon because there is very little chance of getting enough Congressional support for it, and a lot of people don't understand that they would still have to either pay higher taxes or premiums that are similar to what they have with many private insurance plans.

I do agree that it would cost similar to what we pay for insurance but I don't see that as a problem. My only objection is a matter of quality.

The ACA has many shortcomings, but it was the only way my husband could even get insurance after he was laid off from his last job and was too young for Medicare. One of my sisters has been getting her care from an ACA policy for years. She just turned 60, but doesn't work. The last two jobs she had didn't provide any insurance coverage. That is the norm if you work for a small business. I hope we can at least make the ACA more affordable for more people. It's not really that affordable for a lot of people, especially if you're over 50.

I've been on the ACA since before it was the ACA.