The Public Healthcare Debate

[Kelt]

Thank you for posting this video Theo, my thinking is in line with what they are saying. There are many hurdles to getting anything resembling universal health care in the states and I believe one of the biggest obstacles will be the American concepts of "freedom" to do whatever we want with our own lives free from restrictions and regulations. "Individuals" will want to continue to behave in ways that undermine personal and public health while expecting care for no additional expense. I think some of the Euro examples of accountability would be a good step, but in the states?

We saw how the conversation began during the primaries where everybody though Medicare for all was a great idea as long as the loudest voices just kept shouting about FREE everything. Then when Warren got her feet held to the fire and tried to start explaining costs, it quickly started to lose its shine.

I believe that our medical services for pay system is horribly broken and has no business calling itself "Health care". I see no health or care involved, what I see is an industry build on the promotion of disease and the patching up of symptoms and no regard for prevention or responsibility. That said I have no solutions or even good ideas, we have a three tier system that is broken and needs a complete reboot. I keep asking myself who is going to pay and how?

I do think taking the profit motive out would create an opportunity to change priorities but then we have the same question of "who runs it?" I look forward to seeing what others here have to say because I'm stumped.

[Gráinne]

For starters, I believe all ads for pharmaceuticals should be banned. A tremendous amount of money is spent on TV and magazine ads, and guess where that comes from?

All health care providers should be required to openly state their prices, just like a fast-food menu board. Let competition do its work; if hospital A costs $$ and hospital B costs $$$$ for equal services, hospital B is going out of business. None of this "in network" and "out of network" stuff. One reason costs are so out of control is it's impossible to get a straight answer on how much anything costs. Medical providers shouldn't be able to charge some astronomical sum simply because insurance will cover it.

I believe in theory in interstate insurance, but to make that work and prevent massive fraud, I've little idea. Ultimately, the entire insurance business is hugely bloated and inefficient, but I have too little knowledge on how to possibly reform it.

[theoddz]

I hear what you all are saying about how the expense of such a nationwide single payer system would almost be just plain out impractical and, in the end, disastrous. I do think, however, that removing some of the profit incentive would drive overall costs down.

Even in traditional business models, costs always go up when you have middlemen (insurance companies) involved. Could that be where the first slice of a type of precision "trimming down" could begin?? At least, in theory?? Insurance companies seem to be the base cause of a lot of costs going up. They are, by and large, public companies, so they have shareholders to appease, therefore, they are in it to make as much money as they possibly can. In this case, it's at the expense of another person's health and/or well being. That's where the profit motive lies, in large part. I think everyone would agree that every living organism on this planet has the drive to live, and we humans also feel that the quality of our health determines a lot of the quality of our lives. What person wouldn't do everything and anything to just live?? What would YOU sell, bargain, beg, steal, lie or cheat for, if for nothing else, life?? Just to keep taking one breath after another without screaming in pain?? C'mon, be honest. This FOR PROFIT health "system" that we have, here in the US, has a sincerely captive audience. It isn't hard to understand. Yet we will give anything, ANYTHING to anyone who will help us live to see another sunrise, even if we are flat broke, living in a cardboard box under a bridge with nothing to eat but dirt.

Leveling the economic playing field in the health care industry is going to mean taking the huge profits away from the insurance companies, and they might just have to reinvent another business model that they can survive under. Maybe get rid of the shareholders and replace them with folks who really do have some skin in the game....like maybe the patients they are charged to take care of/insure?? I don't know what the answer is, but this much I do know: Something is going to have to give if our entire democracy is going to survive. We ALL do better when the interests of the public good is served, so we've got to start with one measure of common sense and make sure that ALL of our citizenry, not just the ones with $$, can just stay alive.

I've gotten a bit jaded, over the years, because I've worked in the US health care industry (both private and public sectors), and one of the big reasons I switched to the public sector (VA - US gov't) is because I saw what the real conditions were in the private/for profit systems, back when they brought in the concept of "Managed Care". We providers used to cynically call it "mangled care". I loved the VA system, overall, because it didn't require that a patient have enough $$ to get care. All that mattered was that that person served our country and put his/her life on the line for his/her countrymen/women. We treated all Veteran patients equally, no matter what. They are ALL precious lives to us. Oh, and something like 40% of us are Veterans, ourselves, so that helped. I once heard someone comment that, "if you want to see what socialized (I assume they were meaning government run) medicine would look like in this country, take a look at the VA." I thought that was kind of interesting, because it's widely recognized, according to consistent polling, that the VA Health Care System has held the top rating in patient satisfaction (of all US health systems) for many years now. The VA was one of just a few systems that brought about using computerized patient records/charting that streamlined VA care and reduced costs, nationwide. It also served to improve the quality and timeliness of care, also. Overall, it is a very impressive system, and I'm very proud to have worked in it, serving my fellow Vets.

I am so thankful to you all who have shared your thoughts here. I'd also like to extend a hand out to every and anyone else here to throw out your ideas and thoughts about this here, too. BFP is, admittedly, a microcosm of our LGBTQ communities, I think, and we all come from various walks of life, occupations and arenas. Something someone says here, or other places, might end up reaching the right ears and create constructive conversations in other places, with other ears. An idea is an idea, you know!! I've gotten a lot more to think about now, thanks, again, to those who have shared. I tip my hat to ya'll!!!

~Theo~

[GeorgiaMa'am]

This will be controversial, I know, but please read my entire post if you care to respond to my post.

I do not believe that every person has the right to medical care. People have the right to what they can afford in this country, everything from shoes to food to justice. We may not like it, but that is the capitalist system we have set up in the U.S.

That said, I believe every person deserves medical care. We cannot call ourselves decent human beings if we don't provide basic health care to everyone that we can afford to. Somebody has to pay for it - but if we are good, humanitarian folk, then we should be willing to pay for it.

Even if we're not all good, humanitarian folk, we should recognize that it is in our own self interest to provide health care for everyone. This is one of the things that Americans will have to be convinced of in order to provide universal health care. I used to work with an otherwise perfectly reasonable, decent woman who felt, "I had to work hard to get a job where I get good healthcare. Why shouldn't everyone else have to do the same?" (I'll just mention that the numbers don't work out with this reasoning - there will always be people who slide to the bottom of the economy, and no matter how hard they work, or don't work, they will never get a job with great medical benefits.) What I said to her instead was, "You have to think of it from the point of enlightened self-interest." If only some of us have health care and others don't, the unhealthy ones will make the rest of us unhealthy. We want ALL people to be vaccinated against transmissible diseases so they don't spread. Likewise, we should want all people with the flu to be treated, so they don't spread it around. Consider the plight of a grocery store worker, with no health care and no sick days. They go to work even when they're sick, because if they don't work, they don't get paid - and these low-paid workers can't afford health care with no insurance. Yet, they are handling your and my fresh produce, trimming our meat, cutting slices of cheese in the deli and all the while transferring their germs to everyone who shops at that store.

Re: Insurance Companies - they are EVIL. They will do anything at all to avoid having to pay a claim. It doesn't matter if they are in the right or not, what matters to them is: can they wiggle their way out of paying? I have worked for insurance companies and I know how deceptive and underhanded they are, on a regular everyday basis. Anyway, this is probably best discussed in a new thread, if anyone cares to. But insurance in its current form, for all of the reasons stated previously in this thread and others, is a huge impediment to getting affordable health care in this country.

[Vincent]

Originally Posted by GeorgiaMa'am

This will be controversial, I know, but please read my entire post if you care to respond to my post.

I do not believe that every person has the right to medical care. People have the right to what they can afford in this country, everything from shoes to food to justice. We may not like it, but that is the capitalist system we have set up in the U.S.

That said, I believe every person deserves medical care. We cannot call ourselves decent human beings if we don't provide basic health care to everyone that we can afford to. Somebody has to pay for it - but if we are good, humanitarian folk, then we should be willing to pay for it.

Even if we're not all good, humanitarian folk, we should recognize that it is in our own self interest to provide health care for everyone. This is one of the things that Americans will have to be convinced of in order to provide universal health care. I used to work with an otherwise perfectly reasonable, decent woman who felt, "I had to work hard to get a job where I get good healthcare. Why shouldn't everyone else have to do the same?" (I'll just mention that the numbers don't work out with this reasoning - there will always be people who slide to the bottom of the economy, and no matter how hard they work, or don't work, they will never get a job with great medical benefits.) What I said to her instead was, "You have to think of it from the point of enlightened self-interest." If only some of us have health care and others don't, the unhealthy ones will make the rest of us unhealthy. We want ALL people to be vaccinated against transmissible diseases so they don't spread. Likewise, we should want all people with the flu to be treated, so they don't spread it around. Consider the plight of a grocery store worker, with no health care and no sick days. They go to work even when they're sick, because if they don't work, they don't get paid - and these low-paid workers can't afford health care with no insurance. Yet, they are handling your and my fresh produce, trimming our meat, cutting slices of cheese in the deli and all the while transferring their germs to everyone who shops at that store.

Re: Insurance Companies - they are EVIL. They will do anything at all to avoid having to pay a claim. It doesn't matter if they are in the right or not, what matters to them is: can they wiggle their way out of paying? I have worked for insurance companies and I know how deceptive and underhanded they are, on a regular everyday basis. Anyway, this is probably best discussed in a new thread, if anyone cares to. But insurance in its current form, for all of the reasons stated previously in this thread and others, is a huge impediment to getting affordable health care in this country.

I just want to add,Aust does have private health insurance as well as universal healthcare,although my cousin who is very well off gay man they both had top private health cober,his partner got prostate cancer,out of pocket was $16,000,he now is an avid advocate for free health care.
I am poor,I had ovarian cancer,I got the cadilac of treatment in the best cancer clinic in the country 100% free.But I have paid my taxes all my life from working,so its not actually free,but who misses 1.5 % of tax,it is morphed into tax you pay.without it,I would be dead now,I was told I would have died within 6 mths.should I be dead,because I got sick?
If so,I do not believe we are so called civilised.

BUT medecare will not cover my trans surgeries at all,which means we are dicrimated as Transgender treatment for those wanting it is surgery.
Medecare also will not cover cosmetic surgery,all of that is in private sector of our health system.

[Kätzchen]

Nice subject topic to discuss, Theo. I watched your video and found myself listening intently. Not sure I could add much to your discussion here, but I can say that for most of my own adult life, I've never had health insurance coverage. Ever. My parents both had union jobs; so growing up I had the best of health care one could get. My dad was a vet, so between both my parents' work related health coverage for our very big family, plus his VA benefits, we pretty much had the best health coverage one could get during the 60s and 70s. Seems like a life time ago. Especially since my dad died in February and my mother turns 81 this summer.

The only time I ever had health coverage, was when my employer was responsible for my health coverage after I was hurt on the job (near death car wreck in my employer's car). I'm sure the bills for my health coverage were in the high thousands, if not cresting past a million in fees.

Other than that, I am still without health coverage. I could always elect to have my current employer's health coverage, but it covers nothing. I'd still have to cough up money for an office visit or heaven forbid if I caught the COVID 19 virus. I am sure I would die, if that happened.

I hope to find myself employed by a union back employer, later this year. If I am lucky to find myself hired by them, and if I stayed with them for 5 years or more? Then I'd have health insurance benefits for the rest of my life.

I agree though. Health insurance is a proverbial money pit. I'm lucky that I have been in fairly good health all my life, up until I was hurt on the job. I was in my late 50s when that happened. Injuries in your latter years can cause significant impacts. I know it did for me.

I look forward to following your forum discussion. Thanks, Theo.

[GeorgiaMa'am]

Originally Posted by Kätzchen

The only time I ever had health coverage, was when my employer was responsible for my health coverage after I was hurt on the job (near death car wreck in my employer's car). I'm sure the bills for my health coverage were in the high thousands, if not cresting past a million in fees. . . . Health insurance is a proverbial money pit. I'm lucky that I have been in fairly good health all my life, up until I was hurt on the job. I was in my late 50s when that happened. Injuries in your latter years can cause significant impacts. I know it did for me.

Lucky is right.

I have had good health insurance most of my life, except for a few years in my 20s when I was self-employed. Like most 20 year olds, I thought nothing really bad would ever happen to me. Luckily for me, nothing really did until recently in my 50s - in the past six months I have been hospitalized three times, for multiple days each time - once for pneumonia, once for a pulmonary embolism and once for gout. I have no idea how much the bills that I have to pay are going to be for the most recent rounds of hospital stay, although the one from six months ago ended up only costing me about $1500, plus the payments that come out of my paycheck (which are pretty low) due to my excellent health insurance. It would have been about $60,000 otherwise.

Somehow, we are going to have to convince young, healthy adults that healthcare is a lifetime investment.

[Gráinne]

Originally Posted by GeorgiaMa'am

This will be controversial, I know, but please read my entire post if you care to respond to my post.

I do not believe that every person has the right to medical care. People have the right to what they can afford in this country, everything from shoes to food to justice. We may not like it, but that is the capitalist system we have set up in the U.S.

That said, I believe every person deserves medical care. We cannot call ourselves decent human beings if we don't provide basic health care to everyone that we can afford to. Somebody has to pay for it - but if we are good, humanitarian folk, then we should be willing to pay for it.

Even if we're not all good, humanitarian folk, we should recognize that it is in our own self interest to provide health care for everyone. This is one of the things that Americans will have to be convinced of in order to provide universal health care. I used to work with an otherwise perfectly reasonable, decent woman who felt, "I had to work hard to get a job where I get good healthcare. Why shouldn't everyone else have to do the same?" (I'll just mention that the numbers don't work out with this reasoning - there will always be people who slide to the bottom of the economy, and no matter how hard they work, or don't work, they will never get a job with great medical benefits.) What I said to her instead was, "You have to think of it from the point of enlightened self-interest." If only some of us have health care and others don't, the unhealthy ones will make the rest of us unhealthy. We want ALL people to be vaccinated against transmissible diseases so they don't spread. Likewise, we should want all people with the flu to be treated, so they don't spread it around. Consider the plight of a grocery store worker, with no health care and no sick days. They go to work even when they're sick, because if they don't work, they don't get paid - and these low-paid workers can't afford health care with no insurance. Yet, they are handling your and my fresh produce, trimming our meat, cutting slices of cheese in the deli and all the while transferring their germs to everyone who shops at that store.

Re: Insurance Companies - they are EVIL. They will do anything at all to avoid having to pay a claim. It doesn't matter if they are in the right or not, what matters to them is: can they wiggle their way out of paying? I have worked for insurance companies and I know how deceptive and underhanded they are, on a regular everyday basis. Anyway, this is probably best discussed in a new thread, if anyone cares to. But insurance in its current form, for all of the reasons stated previously in this thread and others, is a huge impediment to getting affordable health care in this country.

*clapping*

The bolded is exactly the scenario I fear at work. Although these days we have to get our temperature taken before we can clock in, I have seen many coworkers come in with non-contagious things that make them feel miserable, simply because they can't afford to miss a day (and/or can't afford the doctor). One was a woman undergoing chemotherapy who developed severe edema because she came back to work too soon after surgery.
(Our boss tried to screw around with her FEMA benefits; a little bird told her about a local attorney used by said bird who made Jaws look like a tuna. Friend must have name-dropped the attorney to our boss, as it got fixed right quick.)
In my own life, I have had to go to the free clinic, and I have also had the best care available. My feeling is that free clinics and the like are crucial. I am not saying staff them with quacks and give substandard care; in fact, I believe in a massive push for universal preventative care, especially for children. It may sound cold, but I think resources should go firstly for prevention. If you choose to smoke or drink yourself to death, that's on you and I don't want to pay for your choices.