I have been debating health care on several forums like city-data.com/forum for well over a year now. I have vehemently studied the facts and figures to make sure that I understand what the problem is, why it is and how it can be fixed and changed. That having been said, the arguments I usually hear about health care reform, to me, is usually an objection based on a lack of understanding of the issues at hand and the consequences of our current system.
The arguments I hear over and over again are; Why should I pay for someone else's health care? ; If you are sick you can get treated if you go to an ER so everyone has health care. ; People who do not have health insurance can afford it, they just chose not to have insurance. ; I don't want our country to go the way of Socialism; You just want a free lunch; I don't want government making decisions on my health care. Let's tackle each and every one of those objections.
Why should I pay for someone else's health care?
This response shows a lack of knowledge or understanding of how health insurance actually works. The thing is, you and your employer are already paying for someone else's health care. For example, you and your fellow employees are considered a "group". Now, lets take two single individuals who have the same plan with that insurance company in that group. Their premiums are exactly the same. Employee A has a pre-existing condition that requires more regular check ups and prescriptions every month. Employee B is healthy with no pre-existing conditions or medications beyond what may be needed for short illnesses. Employee B, as a result, barely uses the insurance he has and maybe has 1 claim for his yearly physical while Employee A most likely had more claims filed that equaled a higher amount than is actually contributed per employee into the plan. The insurance company, however is not too concerned because Employee B's contribution has offset Employees A's use. In other words Employee B has paid for Employee A. If someone within that group suffers a serious catastrophic illness or medical event that costs a large amount of money (an example would be a fellow employee giving birth to a preemie.. usually dubbed "million dollar babies" in the business). You can bet that when that companies premiums are reviewed at the yearly mark the company, across the board, is going to see an increase in premiums for having had the policy used in such a manner.
But, that is not the only way that you are paying for someone else's health care. Hospital stays are extremely expensive. if someone is uninsured and shows up to an ER they will have to be treated and life saving treatment must be rendered. If that means that the patient requires emergency surgery to save their life at that moment, then they will receive it irregardless of whether they are insured or not. Of course that patient is then responsible for the full bill . If you are not aware of the costs you can simply do a google search on the cost of a hospital stay and you will find that the average cost is approx $3,000 - $5,000 a day depending on the services rendered. This figure includes the cost of nurses, meds, any tests etc. A weeks stay at the hospital could end up costing you $50,000 again depending on what services you required while at the hospital.
Here are some facts you need to know about medical bills and bankruptcy. A 2005 Harvard study found that over 50% of bankruptcies in this country were caused by overwhelming medical bills. A large percentage of those individuals actually HAD insurance. So, while you are paying excessive amounts of money for your premiums you are still not guaranteed protection from financial ruin should a serious illness befall any member of your household. This article, from CNN in June of this year now puts that figure at 60% and 3/4 of those individuals had health insurance. Some more facts and figures; hospitals lose approx 37 billion a year in uncompensated care.
But, when someone fails to pay their bill and files bankruptcy that bill doesn't go "poof". The cost isn't just eaten by the providers of the uncompensated care. Instead that cost is passed on to the rest of us in raised charges for everything down to an aspirin. That results in higher charges to individuals without insurance AND insurance companies who then , obviously, pass that cost on when they raise insurance premium rates yearly. As a result, while income in the U.S has risen at a 2.5% yearly rate , insurance premium rates have risen at an alarming 12% a year. Is it any wonder that a vast majority of the uninsured are middle income working families?
In addition, if someone doesn't have insurance they are least likely to have a primary physician for whom they can see when they are sick or injured. Picking up the yellow pages and calling a physician you have never seen before is not as easy as it may sound and usually new patients can not be seen on the fly. There are no openings for an appointment for weeks (if you've ever changed insurance and needed to change Dr's you have experienced this. I have). So, if something is seriously wrong that uninsured individual will the go the the local ER to be seen. More often times than not the patient puts off care because they didn't have insurance and by doing so their condition , which would have been otherwise treated and nipped in the bud earlier, tends to become a more complicated and costly situation. What could have taken only a couple hundred dollars to address has now become a couple of thousands of dollars.
So, you see how not only are you paying for someone else's health care, but you are paying for it at 2 or 3 times the price. Doesn't it make sense that everyone has access to a physician so that a problem can be tackled at a couple of hundred dollars BEFORE it grows into one that would costs $1,000 of dollars and require more aggressive action?
If you are Sick You can Go to the ER and Get Treated. You Will Not Be Left to Die.
While this statement is true, there is more to it than that. As illustrated in my example above, it makes much more sense for a person to have a regular Dr. to treat a patient before the illness or problem is allowed to fester into something far more costly.
A few months ago, I met a woman in the park. She was a single mom that was raising 2 kids on her own and she worked two jobs. It was obvious to me that looking at her she was undergoing or had just completed some sort of Chemotherapy because she was wearing a scarf on her naked head. I started a conversation with her and I asked her how she was doing. She said fine. She then told me that she had just completed treatment for breast cancer. This led to further conversation. As it turned out, she didn't have health insurance when she discovered a lump under her arm. Instead of going to a Dr. she ignored the lump. A year later she had finally found a job that offered health insurance and after waiting the customary 3 month period she became enrolled in her employer plan. The lump, in the meantime, had grown larger and was now beginning to hurt. She couldn't ignore it anymore nor did she really have to because she was insured. AS it turned out she had breast cancer that had progressed to a later stage. Had she sought treatment when she first noticed that lump her treatments may not have had to be so aggressive and she would have had an increase chance of survival. However, at the same time, had she actually found the breast cancer when she was uninsured, well she wouldn't have been able to afford the treatments without insurance and her insurance would not have covered her condition for 12 months because it was pre-existing.
But let's say that she did end up going to an ER to investigate that lump. Yes, the ER would have treated her, diagnosed her, advised her to see an oncologist and/or her primary physician ( of which she doesn't have one). If the patient required medication the doctor would send the patient home with a script that needs to be filled. The hospital is not under any obligation to start cancer treatment regimens. Their only obligation is to administer emergency life saving treatment that tackles the immediate needs, not the long term care of the diagnosis.
So what does that patient without insurance do? Without money to pay for medications prescribed (which could be a very expensive endeavor on the individual without the negotiating power of an insurance company) they are left, well nowhere. Drug stores are under no obligation to fill prescriptions and they don't take IOU's. The patient most likely does not qualify for medicaid because they make too much money, yet they have not enough to afford monthly insurance premiums and/ or medications. The diagnosis also now puts them in the pre existing condition category, which we all know disqualifies them from enrolling in most plans or subjects them to even higher premiums, deductibles and out of pocket costs beyond the already high priced premium market. A diagnosis of this sort could make a family/ individual lose everything ; their home, their savings and in the end they still wouldn't have enough to cover the very high cost of treatments. Here is the opening line to an article on USA Today from 2006.
Spiraling prices for new cancer therapies — up to $10,000 a month for a single drug — are causing alarm among patients and insurance companies.
As a result many do not get treatment and or they get "spotty" treatment. In other words, they skip doses or half the dose of their meds to stretch it out further so the cost is less. In the end, the person will end up dying of either complications from poor treatment or no treatment at all.
PBS did a special Sick Around America that you can watch online. In it you'll learn the story of a 31 year old woman with Lupus that died because she could not afford her medications, nor could she obtain insurance. Lupus is an otherwise manageable disease one from which she did not have to die from.
People that do not have insurance can afford it, they just chose not to have it.
This one argument made really irks me. While 16M of the 47M uninsured are what they call the "young invicibles" it does not mean that they simply pass it up. While I'm sure some do you have to look at the cost. If you look at the statistics of the uninsured it is obvious that it follows income lines. In other words a much older co-worker in the same position will be making a higher income than their younger co-worker and thereby are more able to afford the high costs.
Alarmingly the highest segment of the uninsured population is the middle income families of this country. The average income in the U.S per household is $56K a year. The average employer cost of covering a family of 4 is $12K a year. That is approx 22% of the average American income. It is practically equal to a mortgage/rent payment. How many middle income families does anyone know that can afford to pay rent or mortgage on a second home? In addition, as I mentioned above, income has risen at only a 2.5% uptick a year while out of pocket medical costs and premiums have risen at almost 4x's that, or 12% a year. It's easy to see how insurance is now out of reach for so many.
Another thing to remember is that if you are unfortunate enough to have a pre-existing condition it may be very difficult or near impossible for you to obtain health insurance. If you do you could end up paying 3x's the rate with a higher out of pocket than your counterparts. In addition, if you have lapsed in coverage for longer than 60 days in most states, the first 12 months of your coverage will not cover anything related to your pre-existing condition. This is the infamous pre-existing condition clause.
I don't want our country to become a Socialistic or Communistic nation.
First I wholeheartedly agree. I'm not a fan of communism, I'm not a fan of Socialism BUT I'm also not in favor of an entirely Capitalistic nation either. I'm about balance and balance is what life is all about.
If adopting socialistic policies is so "evil" then our guess our education system would qualify, as that is a based on socialistic principles. In this country ALL Americans are guaranteed an education regardless of ability to pay. (As an aside, to all those that then say where in the Constitution is health Care a given right, the same can be said for education yet we have had a public education system in place for 100's of years). You might not know this, but the first person to ever propose a public education system was one of our founding fathers Thomas Jefferson.
Here is the link to where the following quote can be found
Jefferson believed that education should be under the control of the government, free from religious biases, and available to all people irrespective of their status in society. Others who vouched for public education around the same time were Benjamin Rush, Noah Webster, Robert Coram and George Washington.
Our founding fathers recognized that an educated population was important to the growth of our nation and that everyone deserved the equal ability to attain such an education and move themselves up in life. By the same token , a healthy population is a productive population. Should not something as important as health care be accessible to all Americans, so that we may be a healthier society (and at this point, a healthier economy).?
Having a socialistic policy in place does not, by itself, make us a socialistic or even communistic country. True socialism in it's purest form is when everyone in society receives everything the same regardless of what they contribute. Socialism means no money and mutual ownership. In other words we'd all be living in the same equal house, driving the same equal automobile etc. America will NEVER, nor should it EVER be such a society. Anything in it's pure form, including Capitalism is never a healthy thing. The fact that we manage to have socialistic type programs amidst our democracy makes us a stronger , smarter more balanced nation. Having our public education has not made us a communist or socialistic nation.
But if you don't want to take my word for it that's fine. So then you must look at countries like France, Switzerland, the U.K and Germany . They are all democratic nations, part of the "free world". They all operate with the same MIXED economy as we do..having a balance between some socialistic policies and capitalistic free market policies. They all managed to have a Universal type health system without becoming what we all fear America would become. So the argument that we will be headed toward Communism or full blown socialism does not really have any evidence to support it. As a matter of fact, more evidence to support the argument that having such a policy does not compromise democracy exists.
I don't want the government making decisions regarding my health care.
Who do you think is in control of your health care now? Do you think you are? Do you think your Dr. is? No, they are not. The insurance companies have complete control of your health care. They can deny claims for such silly things like you having left out a very minor detail on your medical record by claiming that you falsified your application.
But let's say that you do not believe me and that you do not feel that it does happen (denials based on trivial omissions on application). Fine. Let me share my experience with you then.
My doctor had determined that the BEST course of action for me regarding management of my pre-existing condition was for me to have a device that needed approval from the insurance company (back when I actually had insurance). He submitted it to my insurance, and of course they denied it. I appealed and sent them all the literature including my own personal records to show the amazing results I had had that would conclude that this tool was the best to manage my situation. They denied it. I then submitted an outside appeal to a State Government Board that consisted of Dr's. Two of the three doctors on the panel overturned the insurance companies decision. These doctors looked at the evidence and ruled that indeed this was the best medical decision I and my Dr. could make. They had received the same information as was sent on my first internal appeal to the insurance company. The difference was, the insurance company was looking at profit margins. The state panel doesn't care about profit margins and looked at the factual evidence to support the claim.
Ultimately , in a perfect world, all decisions would be in the hands of the patient and the Dr's with no outside interference of any kind. However, this isn't a perfect world. But, at the end of the day who do you want making decisions for you and about you and your life? Do you want someone who is watching the profit margins over the actual medicine ? I'd much rather have my health care in the hands of those without the agenda of profit over everything else.
You want a Free Lunch.
This couldn't be further from the truth. Look, those who you would claim want a free lunch are already getting it. They are the poor receiving medicaid. The rest of us just want to be able to receive treatment when we are sick and know that if and/or when we meet with a medical problem that we would not loose everything we have and then some, or worse, not be able to receive treatment at all. I would be paying a premium right now (at 3x's the price a healthy person would be paying) if I didn't have the issue of a pre-existing condition (I can not afford to pay both for my treatments and the premium out of my pocket for the next year. It has then become a choice between insurance and medications).
I know that in the end, Universal Health Care would probably end up costing me and everyone else slightly more in taxes. But then it comes down to a question of conscience and it's why I feel there is such a deep line of divide in the issue. The taxes saved by NOT having a Universal health Care.. is it really worth it? I mean could I really lay down and sleep at night knowing that I have a few extra bucks in my pocket if those extra bucks came at the expense of peoples lives? I couldn't. I'd rather pay more knowing that I and everyone else can receive the treatment they need when they need it.
I think there is something that many miss or do not think about when they think of Universal Health Care. If you look at the Canadian system, which most American's will refer to and use as an argument against such a policy, you need to keep something into consideration. The Canadian system of health care is the government and only the government. But, if you look at the UK system of health care, which has a co-existing relationship between private insurance AND an underlying government run system you see a difference.
Let's just consider the NHS in the UK the "no frills" policy that every citizen gets ( and it's very extensive in it's coverage, by the way) It is the primary source of health care for most of the citizens of the UK. However, in that country you could buy a private policy to supplement the NHS, so that should something arise that the government would deem as "not covered" your private supplemental insurance (which is cheaper by far than American insurance because most of everyone's needs are already met by the NHS) would then kick in, so to speak. There are Dr's in the UK that take both the NHS and private insurance plans. What I see here is that at least everyone, regardless of financial status or standing, receives some form of health care while the rest that have the ability to purchase more, can always do so. If American's would just look at the Universal type plan as the bottom line entry level of health care, then purchase supplemental to pick up where they feel they may be left short by the government, then I do not see where the objection would lies. I just don't think that people think of it that way and feel it's this way (the government controlled plan) or nothing. As it is now the current legislation that is the subject of such heated debate, does not even propose such a thing. Being a part of the Government option is just that.. an option and is not the forced standard policy.
There are many more arguments that I could cover in this blog, but it could take me days to finish if I went into every one of them. The bottom line simply is this; you need to arm yourself with the information. You need to REALLY understand what the impact of our current health care system is having on you , your family, our economy and ultimately the health and status of our nation. Once you understand these things, the idea of socialized medicine becomes less of a demon and more of a viable solution to a huge and mounting problem, one that will surely lead to our economic fall from grace if we simply can not find a solution to it.
If you take a deep breath and think rationally and thoughtfully do you really really think that the government wants to 'kill granny" and control everything that you do? I understand being weary of government, but there is a point where caution becomes paranoid which leads to fear. Fear just leaves you frozen and unable to move forward. Do we really want to keep our health care system going down the tubes.
If you want to look up some information for yourself you can visit the following site that has a lot of useful detailed information including information on how other countries system of health care operate. If you really care about the issue then you should arm yourself with the knowledge so that you can make an informed intelligent decision based on rational thought and NOT based on fears, distortions and lies.
Sites to visit
Kaiser Family Foundation
National Coalition on Health Care
U.S Census Bureau
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