You get what you pay for...

[Zeb_Carter]

A questioned was raised by a poster about them not deserving good health care…

I in fact propose that they deserve and get excellent health care, the best in the world as a matter of fact and that they have chronicled that fact right here on this very board. Without the health care they have available to them, a loved one may not be living today. If what had happened to that loved one had occurred…let us say…in Mexico…they would most likely have died. Even if it occurred in Canada they may not have survived.

Now they do have some expenses to pay for obtaining the best health care in the world but, what other kind of insurance allows you to pay premiums and only pay small co-pay amounts for routine maintenance? What other insurance do you have that allows you to have inspections done at almost no charge? What other insurance limits you liability on costs, including those maintenance and inspection items?

When your car breaks down, say a water pump goes out, do you place a claim with your auto insurance? No. If the transmission fails? No. If the engine seizes up? No. The only time you make a claim is for a catastrophic event such as an accident…when your car strikes another or another strikes you or you care strikes something else.

If your roof needs replacing due to normal wear and tear, do you make a claim on your home owners insurance? No. You want to remodel you kitchen? No. You make a claim if a storm blows out all your windows? Yes. And what’s your deductable? $500, $5,000, $10,000?

But with health insurance you expect to have things paid by them for all you health care needs. You expect to be able to see the doctor an unlimited number of times a year. You expect to have visits to the emergency room paid for. You expect those drugs the doctor prescribed for you to be paid for. All for a low monthly premium that you can afford and a low, low co-pay?

I’d love that too! But to be realistic what you get here in America is the best heath care in the world. What you are all looking for is ‘free’ health care, not insured health care.

An old adage once changed my outlook on life…You get what you pay for.

You don’t pay for anything…you get what you pay for…nothing.

Everything has a price…even health care. The price the health provider charges is not what you actually pay anyway. That evil insurer has negotiated a price with the provider. They pay the providers negotiated fee less the co-pay less the deductible. The co-pay is calculated on the negotiated fee not the charged fee.

And as the OP in the original thread stated the providers bills started to roll in soon after discharge and she was shocked at the costs involved. I was too, when I was in the almost the same situation six years ago. My total out of pocket costs for my excellent health care $1,200. Why? The policy I had back then had an upper limit on what I would have to pay in co-pay charges. It was an excellent policy. I also paid a lot, pre-tax, in premium, well my employer paid most of it because they had a stake in keeping me healthy.

Now the policy I currently have does have a higher out of pocket and a different co-pay percentage so my personnel costs will rise for my healthcare.

There is not a policy out there, nor can the government provide, no cost health care. If you think it’s free you’re fooling yourself. If the government says it’s free, they are lying to you. Insurance, real insurance, doesn’t pay for everything. Check all those auto insurance, home owners’ insurance, life insurance policies you have, do they cover everything associated with what they cover?

Does life insurance cover everything pertaining to your life? Nope, only your death.

Does auto insurance cover the health of your vehicle(s)? Of course not.

Does home owners insurance cover the health of your home? Only if you have purchased those options that do cover things like mold, mildew and the like.

You say you want affordable health insurance? What now passes for health insurance is not really insurance. Insurance is purchased to cover catastrophic events, not normal maintenance. Getting a cold and going to see the doctor is not a catastrophic event, yet you want your health insurance to pay for it. How is that insurance? It’s not, it’s a bill payment plan. And that is going to cost you.

You want affordable Health insurance look into an HSA or a plan that doesn’t pay a cent until you have accrued $5,000 or $10,000 out of pocket in a year. Then you’ll see affordable insurance, real insurance.

You want affordable health care? Don’t look to the government. Take care of that yourself. Shop around for the best price for a check up. I know a place that will only charge you $75 for a self pay checkup. Good doctors there too.

If the government truly wanted to make a difference in the health care industry, the only change would be the way the insurers looked at the population of the US.

Change one…

You want health insurance, you first have to apply, then you have a physical. The doctor reports their findings to the insurance company. The insurance company, based on the physical and the questionnaire you filled out and experience propose a premium for the plan and the plan options you selected. If you like it you pay it and your insured. If you don’t you go to another insurance company. The insurance company pays for the physical, it’s a cost of doing business.

Change two…

Would result in change due to change one, there would now be competition and the prices for coverage would now be based on experience. Just like life insurance, auto insurance and annuities. Prices for insurance would most likely go down. But, looking at the health of most Americans they might just go up.

So is it good health care you want? Or is it free health care? There is a difference, a big difference.

You get what you pay for.

Another change is to have the medical industry, and it is an industry, look at preventative instead of curative medicine. Fix it before it becomes a problem, but until Americans take charge of their own health that will never happen, even though it’s easier to fix a problem before it occurs than it is to cure the problem once it’s there.

You get what you pay for.

Yeah, yeah and please don’t quote the old Rolling Stones song…it would just show your lack of intelligence.

 

[rgraham666]

Sigh. Zeb, no one ever said free health care. What people want is affordable, effective health care for every one in the country. Something every other country in the Western World has provided except for the U.S.

The problem with your point of view is that it is predicated on two 'facts'. The first is that government is bad. And the second that business is good.

Neither of these things is true. Government isn't bad nor is business good. Conversely government isn't good nor is business bad. They are simply tools and tools have no ethical qualities whatsoever.

The real question is "What tool do we use to do the job?" So far every Western country seems to have settled on the government. The government's purpose is to provide services for its citizens whether this is national security or health care. It doesn't need to make a profit. And due to the size of a government it can bargain hard with manufacturers for the best prices. This is why drugs are so much cheaper in Canada than the U.S. Plus the administration is much simpler which is also a big cost saving.

A business' purpose is to make money. The best way to make money is to take in as much in payment as possible while delivering as little health care as possible. This is the big problem with U.S. health care. Also none of the health care providers are big enough to bargain effectively with manufacturers. And administrative costs in the U.S. system, administration concerned chiefly with denying benefits, are enormous. Which leads to more cost to the patient.

Your 'suggestions' do nothing for people who are 'uninsurable', those with chronic conditions. A person with a bad heart, cancer, diabetes or any other problem isn't going to get health coverage under your system. Competition won't help because it's simply not profitable to insure these people. Maybe when they were healthy the company could build up an account to cover eventualities but it's still might not be enough to cover their illness.

So it will still be the same as now. People without healthcare will leave off seeing a doctor until they're too sick to ignore it. Then they go to the emergency room which is a lot more expensive than a visit to the doctor.

Sure, taxes are higher in Canada. But we don't pay gigantic medical premiums. So we're ahead of the game.

My $0.02

 

[Zeb_Carter]

Sigh. Zeb, no one ever said free health care. What people want is affordable, effective health care for every one in the country. Something every other country in the Western World has provided except for the U.S.

The problem with your point of view is that it is predicated on two 'facts'. The first is that government is bad. And the second that business is good.

Neither of these things is true. Government isn't bad nor is business good. Conversely government isn't good nor is business bad. They are simply tools and tools have no ethical qualities whatsoever.

The real question is "What tool do we use to do the job?" So far every Western country seems to have settled on the government. The government's purpose is to provide services for its citizens whether this is national security or health care. It doesn't need to make a profit. And due to the size of a government it can bargain hard with manufacturers for the best prices. This is why drugs are so much cheaper in Canada than the U.S. Plus the administration is much simpler which is also a big cost saving.

A business' purpose is to make money. The best way to make money is to take in as much in payment as possible while delivering as little health care as possible. This is the big problem with U.S. health care. Also none of the health care providers are big enough to bargain effectively with manufacturers. And administrative costs in the U.S. system, administration concerned chiefly with denying benefits, are enormous. Which leads to more cost to the patient.

Your 'suggestions' do nothing for people who are 'uninsurable', those with chronic conditions. A person with a bad heart, cancer, diabetes or any other problem isn't going to get health coverage under your system. Competition won't help because it's simply not profitable to insure these people. Maybe when they were healthy the company could build up an account to cover eventualities but it's still might not be enough to cover their illness.

So it will still be the same as now. People without healthcare will leave off seeing a doctor until they're too sick to ignore it. Then they go to the emergency room which is a lot more expensive than a visit to the doctor.

Sure, taxes are higher in Canada. But we don't pay gigantic medical premiums. So we're ahead of the game.

My $0.02

Thanks for your two cents...

But your wrong that you don't pay gigantic medical premiums, what do you think those higher taxes are? Use your noodle Rob.

No matter where the money comes from or goes too it's the same.

From what you have seen of our government would you want them in charge of you health care? Would you want the likes of Bush, Chaney, Obama, Biden, Palin and so on in charge of or making your health care decisions?

Once you let it go, you never get it back except through revolution.

If I pay a premium to a private company and they want to fuck me, I go to a different company. With government running things where do I turn? With government mandated anything where do I turn?

I won't see a dime of all the money I paid into Social Security and I'm only seven years away from retirement and I paid into all my working life. So tell me government, especially US government is good at something. I have abundant proof that it isn't.

 

[Katyusha]

Your 'suggestions' do nothing for people who are 'uninsurable', those with chronic conditions. A person with a bad heart, cancer, diabetes or any other problem isn't going to get health coverage under your system. Competition won't help because it's simply not profitable to insure these people. Maybe when they were healthy the company could build up an account to cover eventualities but it's still might not be enough to cover their illness.

This touches on a huge fallacy in your comparisons, Zeb. If I have high auto insurance premiums due to traffic tickets and at-fault accidents, that's my fault. That's my problem, and I can change it by becoming a better driver. Likewise, with homeowners' insurance, I can do research into houses I'm interested in buying to see how far they're located from local fire stations, have inspections done to see how much of a fire or other risk the house is, and my premium is based on how thoroughly and how intelligently I choose my house.

But suppose my diet's good, my weight is good, I don't smoke, drink to excess, etc., I exercise, in short, I take care of myself, and I still develop a heart condition. Or I develop some type of cancer, or have to deal with lasting damage from an illness, or from an accident caused by someone else's negligence. How is this my problem, and why should I be punished by health insurance companies because of it? Am I bigger risk now? Yes. But is it my fault? No.

Okay, so we can shop around, you say. I can shop around for car insurance if my company decides to drop me or adjusts my premiums to the point where I can't afford them anymore because of my driving record, but I'm likely to get the same thing from every company I go to; some will be higher and some will be lower but I may not be able to afford ANYBODY'S quoted premiums if my record's bad enough. And why should they give me something I can afford? I'm too much of a risk, but I became a risk through my own bad decisions, through my own recklessness. THAT is the difference, and where your comparisons fall apart.

 

[amicus]

Glad someone at least offered our resident Canadian a few of the facts of life, he won't understand, but at least you tried.

Socialized Medicine in every country that has tried it, including Canada and Britain, begins rationing health care an immediately creates huge waiting lists for even simple procedures. Fact! Documented in thousands of web articles for any one with an open mind to see.

Whatever you call them or identify yourself as, socialist, progressive, liberal, left, communist, social democrat...they are all the same, they want something for nothing and Zeb is right beyond question, you get what you pay for in a free society, in a command or controlled society, you don't even get that.

Amicus

 

[Zeb_Carter]

This touches on a huge fallacy in your comparisons, Zeb. If I have high auto insurance premiums due to traffic tickets and at-fault accidents, that's my fault. That's my problem, and I can change it by becoming a better driver. Likewise, with homeowners' insurance, I can do research into houses I'm interested in buying to see how far they're located from local fire stations, have inspections done to see how much of a fire or other risk the house is, and my premium is based on how thoroughly and how intelligently I choose my house.

But suppose my diet's good, my weight is good, I don't smoke, drink to excess, etc., I exercise, in short, I take care of myself, and I still develop a heart condition. Or I develop some type of cancer, or have to deal with lasting damage from an illness, or from an accident caused by someone else's negligence. How is this my problem, and why should I be punished by health insurance companies because of it? Am I bigger risk now? Yes. But is it my fault? No.

Okay, so we can shop around, you say. I can shop around for car insurance if my company decides to drop me or adjusts my premiums to the point where I can't afford them anymore because of my driving record, but I'm likely to get the same thing from every company I go to; some will be higher and some will be lower but I may not be able to afford ANYBODY'S quoted premiums if my record's bad enough. And why should they give me something I can afford? I'm too much of a risk, but I became a risk through my own bad decisions, through my own recklessness. THAT is the difference, and where your comparisons fall apart.

Gee, if it's not your fault then you must have gotten a settlement already on the...which will it be?

Malpractice suit, wrongful harm suit from the accident, workmen's comp claim from the harm done to you in the work place.

Just what caused your health to fail?

Who cause your health to take a turn for the worse?

Do they have liability, malpractice, some type of insurance that will reimburse you for your future costs?

IF not why not?

Did you even think of suing them?

Why should you be responsible for something that wasn't your fault?

Ever hear of subrogation?

 

[Liar]

Gee, if it's not your fault then you must have gotten a settlement already on the...which will it be?

Malpractice suit, wrongful harm suit from the accident, workmen's comp claim from the harm done to you in the work place.

Just what caused your health to fail?

Who cause your health to take a turn for the worse?

Do they have liability, malpractice, some type of insurance that will reimburse you for your future costs?

IF not why not?

Did you even think of suing them?

Why should you be responsible for something that wasn't your fault?

Ever hear of subrogation?

Just curious....

I'm at high risk for certain types of heart diseases. As is my grand-dad and uncle, both who died from it. And my father, who with meticulous preventive health care and monitoring (affordable for him thanks to the evils of socialized medicare, but that's another story) and a bit of luck, have so far been blessed enough to avoid complications.

Is it my fault? Nah. But who do you suggest someone like me should sue?


Also, is an accident always somebody's fault?

 

[amicus]

Katyusha & Liar seem to voice an unspoken assumption that somebody, somewhere, owes them something.

Why is that?

Free people in a free society, exchanging goods and services at a rate mutually agreeable to both, is the only 'honorable' form of society ever tried by mankind.

Every other form of government is, to a greater or lesser degree, slavery; control of the individual.

What I offer is not just a generational difference, or a more modern approach to life, it is a basic tenet of humanity, the individual human freedom is the basis upon which all else rests.

Who do Negroes blame for inherited sickle cell anemia, or women who inherit tendencies towards breast or cervical cancer? Only children believe the world to be fair; reality is otherwise.

If you are born with an IQ of 91, it will determine the rest of your life; to whom do you place blame?

There is no God, there is no 'Big Brother' to whom you can turn to address your complaints about life.

Grow up! Understand and experience Independence! Try it, you might even like it!

Amicus..the truly independent asshole

 

[rgraham666]

Thanks for your two cents...

But your wrong that you don't pay gigantic medical premiums, what do you think those higher taxes are? Use your noodle Rob.

No matter where the money comes from or goes too it's the same.

From what you have seen of our government would you want them in charge of you health care? Would you want the likes of Bush, Chaney, Obama, Biden, Palin and so on in charge of or making your health care decisions?

Once you let it go, you never get it back except through revolution.

If I pay a premium to a private company and they want to fuck me, I go to a different company. With government running things where do I turn? With government mandated anything where do I turn?

I won't see a dime of all the money I paid into Social Security and I'm only seven years away from retirement and I paid into all my working life. So tell me government, especially US government is good at something. I have abundant proof that it isn't.

Zeb, I don't share your prejudice. And it is prejudice.

I know those higher taxes pay for my health care. And the extra taxes I pay are much less than what I would pay in premiums to an insurance company. Unlike you I don't regard taxes as theft. Like Oliver Wendell Holmes I regard them as what I have to pay to live in a civilized society.

One more thing, Zeb. Don't get insulting when you're debating. If you used 'use your noodle' in a face to face debate I'd give you a sock in the mouth. I didn't insult you so I'll kindly ask you not to insult me.

 

[Liar]

Katyusha & Liar seem to voice an unspoken assumption that somebody, somewhere, owes them something.

Nope, as ever so often, you read too fast and add your own ideological presumptions about what you think I say.

That somebody, somewhere, owes them something was Zeb's assumption in the post that I replied to. That one's medical condition is always somebody's fault, and therefore that somebody should be the one paying for the medical expenses.

I just asked the question: Is a medical condition really always somebody's fault?

 

[DesertPirate]

The US government can't do anything efficiently, never have, never will.
Don't believe me?
AMTRAK! constantly flushing money for 30+ years.
File a claim with Social Security and see how many months it takes.

 

[amicus]

]Nope, as ever so often, you read too fast and add your own ideological presumptions about what you think I say.

That somebody, somewhere, owes them something was Zeb's assumption in the post that I replied to. That one's medical condition is always somebody's fault, and therefore that somebody should be the one paying for the medical expenses.

I just asked the question: Is a medical condition really always somebody's fault?[/[/I]QUOTE]

~~~

Liar...you and Edward Teach, if I recall, the English fellow that visited America a few years back and introduced me to an online game a group of us played...always denied everything I posted concerning him, as you do.

Do you not have a philosophy? You say/write things that everyone can and does interpret in the same way and you always deny it. Why?

Amicus

 

[JackLuis]

Katyusha & Liar seem to voice an unspoken assumption that somebody, somewhere, owes them something.


Amicus..the truly independent asshole

You know for once I totally agree with you.

 

[rgraham666]

The truly independent asshole part I'm assuming.

 

[Zeb_Carter]

Just curious....

I'm at high risk for certain types of heart diseases. As is my grand-dad and uncle, both who died from it. And my father, who with meticulous preventive health care and monitoring (affordable for him thanks to the evils of socialized medicare, but that's another story) and a bit of luck, have so far been blessed enough to avoid complications.

Is it my fault? Nah. But who do you suggest someone like me should sue?


Also, is an accident always somebody's fault?

Genetic predisposition I assume will be handled the same way they are for life insurance, annuities and so forth. You might pay a little more or have exclusions for pre-existing conditions for a period of time.

Talk to any lawyer in America and it is.

 

[Liar]

Genetic predisposition I assume will be handled the same way they are for life insurance, annuities and so forth. You might pay a little more or have exclusions for pre-existing conditions for a period of time.

So a genetic predisposition might raise your premiums. In the words of Zeb_Carter: Why should you be responsible for something that wasn't your fault?

 

[Zeb_Carter]

Zeb, I don't share your prejudice. And it is prejudice.

I know those higher taxes pay for my health care. And the extra taxes I pay are much less than what I would pay in premiums to an insurance company. Unlike you I don't regard taxes as theft. Like Oliver Wendell Holmes I regard them as what I have to pay to live in a civilized society.

One more thing, Zeb. Don't get insulting when you're debating. If you used 'use your noodle' in a face to face debate I'd give you a sock in the mouth. I didn't insult you so I'll kindly ask you not to insult me.

I apologize for the noodle comment.

As for civilized society...and taxes. I have never said I was against either.

Taxes on what I make is the complaint I have.

Civilized Society or what passes for one today is a problem in and of it's self. It (society) want's government to protect it and take care of it like a mother. Society should take care of itself while mother protects it from outside interference.

Government should never dictate to society what is moral or ethical. That is up to me as an individual to decide. And as an individual in society I am honor bound to be polite or rude as the situation calls for. Government has no place in society to determine what is and isn't rude or polite.

 

[Zeb_Carter]

So a genetic predisposition might raise your premiums. In the words of Zeb_Carter: Why should you be responsible for something that wasn't your fault?

Because I choose to take that responsibility, never said I wouldn't. It was someone else that was complaining. I guess sarcasm is lost in text.

 

[rgraham666]

Apology accepted, Zeb.

We'll never agree on this. Our system works just fine and I don't mind paying taxes on my income or otherwise. They aren't onerous and I get a lot in return for it.

As far as competition goes I'll quote my favorite author.

COMPETITION An activity in which there are more losers than winners. Otherwise it's not a competition. A society based on competition is therefore a society that consists mostly of losers.

That seems to have been born out by what I've seen to date.

 

[ishtat]

The United States does not have the best health care in the world. I have lived for prolonged periods in the US (non socialised), the UK (most socialised) and Australia (half & half). Health outcomes and care were pretty much the same (all are good) they were merely funded differently.

However I see great danger if the US changes its funding model without changing its cultural attitude to medical services. Generally in the US there are many more referrals to consultants and more expensive diagnostics. If a public funding model is applied to that culture the most likely result is a cost explosion.

Radical change can be very expensive and needs enormous caution. Government administration is always an additional expense

But none of the systems in my experience is superior to the other.

 

[Boota]

I lose my health insurance from my job tomorrow. The ONLY reason I was working there to start with. Currently looking for a job in an extremely depressed job market in this area.

I lived without insurance because I couldn't afford it. I could barely keep all the other plates spinning as it was, so I operated under the Don't Get Sick Don't Get Hurt insurance policy. And it worked for a while. I paid all my bills, never missed work, did everything I was supposed to. But then my insurance policy failed and I got hurt. To top it off I got sick, too. I went back to work, where I made relatively good money, and it was still never enough. I went from having credit good enough for a $250,000 signature loan to filing bankruptcy in less than a year, solely due to medical costs.

As things stand now, I'll go back to doing my own stitches and minor medical stuff like that. If I don't get some sort of affordable coverage and something bad happens I will allow myself to die rather than seek medical help that will bankrupt me again. I absolutely WILL NOT let that happen again.

The plan, as it is being proposed, is flawed. Sure. But it's got to start somewhere. Work the bugs out. I don't believe in the perpetual failure of America. Sure, it's been on the downslide for (oh, about 8) years. But I refuse to believe that we are not capable of doing something that every other Western country seems to be able to succeed at. Every single Canadian that I know personally love their health care system. I'm sure that there are dissenters and the odd disgruntled citizen about something that went wrong, but in general the consensus I get is that they are overjoyed that a heart attack doesn't have to be compounded with a foreclosure. I can relate.

National health coverage will be good for American business. Business can get back to doing what they do - make things and provide services - and not have to worry about the healthcare costs eating all of their profits. Who knows, a few jobs may even decide to remain in the U.S.

The sole reason I had my hours cut at work was to eliminate me from the roll of employees who gets healthcare. I'm in a much better position than one of the people who got laid off, though. She has an existing medical condition that requires that she be on oxygen. It is unlikely that anyone will hire her, especially in this job market. And without something being done to keep her in medical supplies, she's as good as dead in a few months. So, is it better for her to go on Medicaid and have tax dollars spent on her medical care, or have her in a position where she is able to continue working and pay her taxes to chip in on her own medical care? We are already paying for medical care with our tax dollars. How about something that allows us all to benefit from our own money?

 

[Zeb_Carter]

Apology accepted, Zeb.

We'll never agree on this. Our system works just fine and I don't mind paying taxes on my income or otherwise. They aren't onerous and I get a lot in return for it.

As far as competition goes I'll quote my favorite author.



That seems to have been born out by what I've seen to date.

And with big government the only winners are the political class.

As has been said many times...

If it's not good enough for the political class then why is it good enough for you?

(Speaking of the US only, but might apply to Canada and the UK)


ETA: I finished...done...burnt out...bye.

 

[Xelebes]

ETA: I finished...done...burnt out...bye.

See ya t'murrah! *tips hat*

 

[Liar]

As far as competition goes I'll quote my favorite author.

That seems to have been born out by what I've seen to date.

Nah. Competition works. The problem is, there is no real competition in health care. The average consumer have no chance of being competed for, no realistic way to make consumer choices except in some limited cases. Can you choose your own brand of prescription drugs? Do you have a collection of hospitals within range, competing with prices, services and other perks? And in America, do you or your employer choose insurance provider? How easy is it to switch.

In many countries, the US, Canada, Denmark, Sweden , to name a few, the health care providers are private companies (or mostly) on a somewhat free market. There's little to no incentive to compete though, since there are too many degrees of separation between the consumer and the provider.

What I'd like to see, is a system where health care is not free, and not controlled by insurers. But still affordable.

One such system that works pretty well, is the Swedish dental care system. Basic care, from regular check-ups and x-rays to filling and root canals, is subsidized by the government with a percentage of the price. Real expensive work like surgery and replacements are subsidized at a higher percentage. Vanity work like bleaching and straightening (unless medically nessecary) is not subsidized at all. This means the consumer can still compare prices, and in any slightly bigger town, will find a handful of different providers that can price themselves differently, or compete in other ways (outcalls, longer opening hours, compllimentary anesthesia or whatever).

It's not perfect, and it's pretty expensive on the guv budget. But what it does, is make dental care reasonably affordable for everyone, without taking away the direct link between the consumer's wallet and the provider's.