5 responses so far ↓

• 1 Craig // Oct 2, 2009 at 11:38 pm

  I think Obama is being both overly conservative, and overly optimistic. Americans are so afraid of tax increases, Obama has try to find the money to pay for this without raising taxers, which would be the smart, sensible, best thing to do. It wouldn’t have to be much, especially not for those say under $80,000. I agree that the promised money to be found in the current system probably isn’t there in the amounts he needs.

  Raise taxes. Cut “defence” spending. At first it’ll be expensive, but over time the costs will decrease dramatically as the populace becomes healthier because of the availability of much cheaper preventative medicine that has little to no overhead. Get rid of private insurance all together, at least for medical.

  i.e., be Canada, but learn from Canada’s mistakes.

• 2 Jane // Oct 3, 2009 at 8:28 am

  I think you are missing two important factors in your analysis of cost.

  First, the system of lifetime caps, preexisting conditions, co-pays, and coverage limits costs a lot of money. It saves money in the short term for the insurance company, no doubt. And in some cases it may eliminate needless tests and procedures. (Making decisions based on what is best for the patient and cost effective would be better). The system has many disincentives for people to seek preventative care and that costs a lot of money in the long term. For example, when people are afraid of having a pre-exisiting condition, or face a large co-pay, they will delay getting treated. In some cases, it does no harm. In others it becomes very, very costly. Think of a person that does not seek treatment for what they think is high blood pressure when they fear they will be laid off and eventually loose coverage when COBRA runs out. That person does not want to visit the doctor until they have new insurance lined up. Kidney failure or a stroke is much more expensive to treat than high blood pressure. Repeat that for someone with a suspected bladder infection, ovarian cysts, shortness of breath etc by a few million people…and its incredibly wasteful. Keep in mind too, that most healthy people don’t want to waste their time visiting the doctor for a hangnail. Having the odd hypochondriac seeing the doctor about their sniffles is a cost, but its less expensive than someone not being treated for pneumonia in a timely fashion and landing in the ICU.

  Second, the system keeps people from working and paying taxes and that is also costly if a public system of healthcare needs to be funded. The people that did not have preventative care get sicker than they would have and can’t work. Sometimes they become disabled, and sometimes they die. Caps on income for SCHIP, and medicaid for the disabled or poor often prevent them from taking better paying jobs because they will loose coverage (or their children’s coverage) when their income rises but they cannot get health insurance (through their employer, or because a preexisting condition is not covered). Sometimes there is no sliding scale of coverage, only a cutoff. Medicaid can take up to two years to be approved for people with disabilities. Finding a job with insurance can get a person off medicaid but if that person is laid off afterward, it will take two years to get that coverage back. Imagine having chronic health problems and being faced with two years of not seeing a doctor because you wanted to work. Also, people that can’t get individual coverage don’t start or work for small businesses…because they have a preexisting condition.

  So yes, covering everyone would probably lower health care costs and increase the number of taxpayers in the long term. In the short term, someone is going to have to pay for the people that haven’t seen a doctor in a decade.

• 3 Rainey // Oct 3, 2009 at 9:59 am

  Personally, I think any discussion of “can we afford universal health care” must begin with “does anyone think they’re not already paying for it?”.

  Everyone eventually gets health care. They get preventive well care and appropriate intervention from their doctor paid for, in part, by their insurance company; they get intervention into serious illness or injury that is paid for from their own resources, insurance, government programs or passed along to other consumers; they get the most expensive kind of care from hospital Emergency Rooms that gets passed on to other patients; or they die from neglected care and EMTs take care of it on the government’s dime. Therefore, the question, to me, is what is the most efficient and cost effective way of providing people with the well care that prevents more serious disease and contains their contagion while maintaining a healthy, productive population.

  The system we have now is not comprehensive or compassionate. And allowing the insurance companies to determine who gets what kind of care is making the costs to everyone prohibitive while the general population is less and less secure about simple things like flu outbreaks and the catastrophic but far too common things like cancer.

  I have lived in Canada whose much-maligned and (here) misrepresented health care system addresses the needs of citizens head on. It is a far superior approach and lifestyle. And if anyone is unconvinced about that, they should spend a couple weeks in a Canadian community observing the elderly who are still physically and mentally vigorous and living rich lives to their final days. …which happen to be several years later than the average American. And their health costs are far below ours at the same time. Meanwhile, many of the American jobs that have fled our borders are right there across the 49th parallel where educated English-speaking workers do not come with health insurance obligations.

• 4 Craig // Oct 3, 2009 at 10:04 am

  “I have lived in Canada whose much-maligned and (here) misrepresented health care system addresses the needs of citizens head on. It is a far superior approach and lifestyle.”

  Ramen. I so wish I lived there still.

• 5 Rainey // Oct 3, 2009 at 3:34 pm

  Me too, Craig!

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