The National Health
I wasn’t going to mention Melissa Mia Hall’s death here—this is economics and politics, not sf—but now it is clear that, as usual, there is an overlap:
If she had seen the doctor, most likely he would have suspected more than a pulled muscle and would have ordered a life-saving EKG.
As Texas lawyer, writer and Melissa’s friend, Laurie Moore, wrote to me, “She would’ve had a huge doctor bill she couldn’t pay, and would probably have lost her house over it, but she would be alive instead of taking pain pills and dying in the night. “
In the end, Melissa didn’t die from an overdose, not even an accidental one; Melissa died of the very heart attack she feared….
Melissa worked hard. She owned a home. She paid her taxes. She was trying to live a dream – the American Dream – that supposedly we as citizens are promised – the right to pursue life, liberty and happiness. For her, that couldn’t be achieved in a traditional job that came with the perks of health care.
This is the quintessential “hard-working American” who gets talked about by The Teabaggers as if nothing ever goes wrong and they never need “government help.” (link h/t Dr. Black) This is the woman of whom Peter Cannon (via Rose Fox)* said:
Melissa contributed hundreds of reviews to PW, in all different genres, as well as dozens of Q&As. In recent years, ever reliable and diligent, she was reviewing three books a week for me…
This isn’t someone who was getting “fails to perform” ratings or “stealing” a house. This is someone whose every effort was aimed at making money and paying bills to keep what little she had gained. She used her skills—human capital, painfully developed—and made rational decisions.
And the rational ex ante decision not to use the medicines she needed or to have to pay out of pocket for an exam that may well lead to more expenses that are beyond her liquidity constraints are, well, exactly what we teach as “correct” in Ph.D. micro- and macro- Economics courses.
So this isn’t a science fiction post, because no one who reads and writes science fiction would believe that a hard-working, conscientious person with great skills, a positive personality, and diligent attention to opportunities would die because they couldn’t afford to live.
It’s an economics and politics post, one I wish I hadn’t had to write.
*Full disclosure: I’ve known Peter Cannon for years; he edited both myself and my wife at PW. (Full, full disclosure: he fired me, after having previously turned down my request to quit for a while. Both were good decisions on his part.) I’ve met Rose Fox several times and she edited my wife for a while when PW still paid something resembling minimum wage for the effort required.
Ken,
I read the link. It’s very tragic and was very preventable.
Why the heck did she not get to a clinic at least? Where were her friends? Family?
——
As for the economics of it. Well, I will throw the first stone and with it garentee a 50+ set of comments.
First, she was single and owned a home. Though it didn’t state it, I assume she had some kind of job but that it didn’t have any medical benefits (or else she would lose her home anyway). Yet, she did not have enough $ to go to the doctor/ER to get a check-up? The post clearly stated that she was worried that if she went to the doctor and they found something serious then she couldn’t afford the resulting medical bills and could lose here house. So she decided to gamble her life on the bet that it wasn’t serious, even after at least a few days of intense pain (enough to call a doctor and get pain meds stronger than Advil).
Not to be blunt, but she gambled her life over, at most, a $500 check-up. It would have been tight for awhile, but a payment plan could have been worked out if all it was was a bad pulled muscle. On the down side, if it was a bad situation (which happened) her life would have been saved and she, at worst, could have declared bankruptcy. (And if she lived in Texas kept the house).
My question is how did she afford the mortgage, homeowners insurance plus the electrical, water, gas, phone, and internet bill?
You can live really, really cheap by yourself if need be. When she decided to keep frills that she didn’t need and scimp on the necessities (healthcare) she made another bet she would not need healthcare. Then when she lost that bet she doubled down and gambled Advil would be enough.
Yes, I know, pretty cold-hearted. And I bet she was a great person. Just made a series of bad decisions that tragically cost her her life. Sounds like the last accident I read in the AF. You don’t make policy over anedotes…
Flame away…
Islam will change
buff,
I do not use insurance unless 1. required: auto insurance, 2. it is awesomely cheap that being TRICARE and my federal employee health insurance, I am retired from both.
I do not have survivors’ benefit (easily done, divorced at a good time) or life insurnace I do not want to pay an ante each month betting I am going to die.
Insurance is a bet, you lose if the thing you insure against, a hazard or peril harming you, does not happen.
Given other things in the life expressed I suspect the bet on health coverage was not a good one for that person.
In all things, it is up to the three Norns……………………
Moral hazards………………
I recently read a post at a blog I visit concerning the moral hazards presented by “deductibles” in health delivery.
Growing evidence that cash strapped beneficiaries are not filling prescriptions, taking half doses and doing other things to reduce out of pocket cost impacts of “deductibles”.
The result is the Norns tend to cut the cloth more readily for folk who do not take needed medications.
The economic impact is “deductibles” reduce the efficacy of treatment, causing more expensive treatment options because today the Norns’ cut is sometimes fixed and the Norns don’t cut the cloth again soon.
The insurers then raise rates……………..
The health outcomes then put the US behind 37 other nations.
Good thing the insurers get to pay dividends, otherwise there is no use for them.
What Buffpilot said.
She could have bought health insurance; she wanted to buy other things. She could have worked for a company that provided insurance.
And all O-care would do would is force her to buy the insurance; all single-payer formulations would simply take it out in taxes, both “a luxury she simply couldn’t afford.”
She could have died in the queue waiting for an appointment at a rationed government run hospital.
What are you going to do?
We have become a cruel and heartless people.
I am a middle manager, a professional who manages pink collar paraprofessionals. The PTB have arranged my department such that I have two benefit eligible employees and six non benefit eligible employees. Last year I had to sit and watch a long time employee– my hardest worker– suffer with tears in her eyes for almost two weeks with what turned out to be pancreatitis. She came to work each day, since has no sick time, sat at her desk as best she could and just suffered. With no health insurance and a huge fear that having to file bankruptcy would make it impossible for her to help her son through medical school, she just sat there until she had to be taken out by ambulance. She is good woman, a hard worker, and I hate myself and my employer for what have done.
What Buffpilot said.
She could have bought health insurance; she wanted to buy other things. She could have worked for a company that provided insurance. She could have gone to an emergency room, where she would have been treated.
And all O-care would do would is force her to buy the insurance; all single-payer formulations would simply take it out in taxes, both “a luxury she simply couldn’t afford.”
Furthermore, if in a fully government run health care system (think Canada, Britain) she very probably would have died in the queue waiting for an appointment at the government run hospital. (Do you really think she would get to see a doctor, within the few days or so, at the government clinic, complaining of a pulled muscle in her back and chest from lifting her dog Daisy)?
What are you going to do?
My business was to save people like Ms. Hall. It wasn’t hard. I just ran my SS office in such a way that anyone like her got sent to where they needed to go. The hospital. The DSS or the DCFS. When they showed up in my shop, we took care of them. The Norns count on us not to pay attention to their call. Insurance doesn’t do it. Even if all they did was call us. We took care of them. I don’t understand how it is that no one in y’all’s world gets sick and dies because they can’t afford to go to the doctor. Plenty of people did in mine for lack of medical care.
Buff, peope end up alone with no one to help them for many reasons. One is that when they get sick, they can’t think of how to get help. Another is that children and family have their own problems and can’t manage to help their family members. No phones, you know. People in this country who are poor die on account of it. C’est ca. NO
Two things:
Given the current labor market to blame her for her lack of insured employment seems a bit sadistic.
And in your world is it really OK, morally speaking, for someone to suffer and die because they felt they could not afford insurance? Does that not strike you as morally repugnant? Would you have people like her and people otherwise unable to afford insurance either die for it or be forced to put themselves in debt to live?
No flame, Buff. She didn’t have $500.00. And that was that. Don’t worry about it. It happens. NO
Tell Buff. People make decisions about what to do when they get sick. Most of those decisions depend on what they can afford and what they are doing to help other members of their families. As Miss Sarah explains. Here, people die. In Canada or elsewhere, they live. Bad decisions. Well, maybe. If you live here. NO
Oh and also Canada and Britain both do better overall than we do http://theincidentaleconomist.com/wordpress/health-outcomes-report-cards-by-country/. Nice strawman though.
Lollipop,
If she was that poor, she could have signed up for Medicaid.
Hmmmm…which provinces? Let’s ask Stormy and Noni about Canada since you appear to suggest stories are okay.
Hard to explain how deeply angry this makes me.
We have a system that may have possibly saved Sara – Medicare. Assuming she was aware that she had a serious health problem, she probably could have seen a doctor within a week, and the Dr. could have ordered an EKG and she would have been able to get the proper treatment.
The only question would be how much that would cost us. So let’s look at Medicare. It covers 45 million people at a cost of $452 billion (12.5% of the Budget) so to extend that to all 300 million Americans it would cost $3 Trillion (88% of Budget). Using an estimate that the under 65 population has an average cost half of that of current recipients, that equals $1.3T or 40% of the budget.
If we were to just add the $1.3T onto the Budget that would make total spending $4.7T compared to tax revenues of $2.2 T. This means that current taxes would have to more than double to balance the budget. Or you can cut government spending on the rest of the budget by 50%, (or much more if you leave out interest and SS) and leave taxes the same. Or some combination.
And, oh yes, assume that quality and innovation won’t deteriorate under government control.
So, yes, it is possible, with that one big last assumption.
Quality and innovation haven’t deteriorated in France, Norway, Taiwan, Australia, Israel, Italy and most of the other countries that have universal healthcare. So why do you presume it would here, under a system in which medicine remains in the private sector. Doctors won’t be government employees and hospitals won’t be operated by the government.
Of course, there isn’t much quality now for the 50 million people who have no insurance. And not much innovation either.
So why do you presume it would here,
Because what drives quality and innovation is competition and the profit motive. When the government sets reimbursement rates it effectively caps profits from quality and innovation. The only way to increase profits is to cut costs, which is usually quality. Furthermore, it is inevitable that government will seek to squeeze reimbursements due to budget pressures. The only way out for providers is to reduce quality. Have you been to a Post Office recently?
Beverly,
So why do you presume it would here,
Because these countries overwhelmingly use equipment, drugs, procedures, and training developed in the US.
What drives quality and innovation is competition and the profit motive. When the government sets reimbursement rates it effectively caps profits from quality and innovation. The only way to increase profits is to cut costs, which is usually quality. Furthermore, it is inevitable that government will seek to squeeze reimbursements due to budget pressures. The only way out for providers is to reduce quality. Have you been to a Post Office recently?
Sadly, I see this way too often. There is no better illustration of the utter failure of our current disjointed healthcare system than cases like this.
Working in Emergency Medicine….I see too much of it….too much..
“Have you been to a Post Office recently?”
Yes. It works remarkably well, and does so more cheaply than FedEx.
NO,
I do understand. I have a good friend who’s a Doc and my mom was a ER nurse for, well forever. (She is 70+ AND still works part time as a triage/train the newbies nurse in the ER).
Maybe I’m just from a differnet group. I grew up in a small town (less than 300) surronded by farm country. You kept track of the old and single, especially during times like the current blizzard. My parents made me shovel out this one guys driveway once. I complained until I was told that the healthy 40 year old had a broke leg (his wife was very petite and probably couldn’t even pick up the shovel). My wife’s family had someone live with her grandmaother EVERY day from when she was 96 to 103. She came to Texas on a covered wagon.
Even now I call my one grandparent daily to talk about the current storm…this was tragic story but like any aircrat accident report it was a series of bad decisions that ended up in her death.
Anyway hope your weather is getting better!
Islam will change
To continue my cold-heartedness.
Your employee basically decided to gamble her life in paying for her son’s education. Medical school ain’t cheap, so once again she decided, on her own free will to skip medical for herself to use her money elsewhere. You can just as much complain about the huge cost of Medical school as the cost of health care.
And I would bet it would have been cheaper for her to go to the hospital on day 1 than wait 14 days until she had to call a ambulance to roll her out. Probably far cheaper.
I hate to say this since both stories are tragic, but this applies,”Life is tough, its tougher if your stupid.”
Cold, but true.
Islam will change
NO,
BTW you can get an EKG and a clinic I use at times (they are convenient and take Tricare) for $230. That would have saved her life, and she could have worked out a payment plan. Plus there are free clinics around here.
Islam will change
I understand. Your point of view is morally reprehensible and not one that leads people to build the kind of society that is worthy of our great nation. People make mistakes, they are poor, some of them are stupid. The rest of us pick them up and together we all make it to the finish line.
When you are old or injured or have a run of bad luck you will see that not everything can be prepared for and sometimes we all need help. If you are blessed to need less than others be grateful for your luck. And use your good fotune to help others. That is what a functioning human society does. The world you describe is a world of sociopaths and alienation. I reject your vision.
I recall reading a complaint that most investigations of aircraft incidents resulted in a finding of “pilot error”.
I suppose we have here a similar finding of death due to “individual error”.
Sammy provides a link to a study done by the Fraser Institute. That “think tank” is described as follows by Wikipedia:
“
The Fraser Institute is a fiscally conservative think tank based in Canada that espouses free market principles. Its stated mandate is to advocate for freedom and competitive markets. It generally opposes public policy solutions based on government spending, taxes, deficits, and regulation. Some of the public policy stands taken by the Institute include: greater free trade throughout the world, privatization of various government services, marijuana legalization, competition in primary schooling, and greater private sector involvement in the delivery of healthcare insurance and services.”
Smells a bit like the Peterson Institute, that bastion of non-partisan rgith wing ideology.
No surpise that the Fraser Institute would find the results it was looking for, a well known research phenomenon. Have the findings of that syudy been replicated and published? No single study proves a point.
What is your evidence for this assertion? None of course but the necessity that your free market ideology must be right. I lived in Europe from 1988 to 2006. It is not perfect, and their are cost and practice issue there as well as here. But as far as relative advantage, it seem that Europe was quicker to innovate and develop best practices. And since they smoked like fools compared to Americans, I am not sure that it is just Americans bad behavoir that accounts for Europe’s superior health statistics.
Ah! That’s it! Adding many millions more people to the ranks of the insured would reduce profits for pharmaceutical and medical-device companies, hospitals (which now are obligated to treat uninsured people without expectation that they will be paid), and doctors, whose incomes will be reduced if they have more insured patients.
Good grace. What the hell does this healthcare law have to do with profits, quality and innovation? Why do so many wingnuts just blather irrationally? Can’t you folks ever deviate from the talk-radio talking points and actually think about whether what you’re about to say makes sense?
A typical Canadian seeking surgical or other therapeutic treatment had to wait 18.3 weeks in 2007, an all-time high? And how long did a typical American without health insurance have to wait for surgical or other therapeutic treatment? In 2007?
And how long did a typical Frenchman, Norwegian, German, Italian, Japanese, Dane, Swede, Austalian, Austrian, or Taiwanese have to wait?
Anyone points out that Melissa Hall first felt symptoms one week before she died but did not see a doctor because she had no insurance, although she badly wanted to see one, and uses that as proof that she would have died anyway because some people who have health insurance die of heart attacks too, is an idiot.
A typical Canadian seeking surgical or other therapeutic treatment had to wait 18.3 weeks in 2007, an all-time high? And how long did a typical American without health insurance have to wait for surgical or other therapeutic treatment? In 2007.
And how long did a typical Frenchman, Norwegian, German, Italian, Japanese, Dane, Swede, Austalian, Austrian, or Taiwanese have to wait?
Anyone points out that Melissa Hall first felt symptoms one week before she died but did not see a doctor because she had no insurance, although she badly wanted to see one, and uses that as proof that she would have died anyway because some people who have health insurance die of heart attacks too, is an idiot.
A typical Canadian seeking surgical or other therapeutic treatment had to wait 18.3 weeks in 2007, an all-time high? And how long did a typical American without health insurance have to wait for surgical or other therapeutic treatment? In 2007.
AA typical Canadian seeking surgical or other therapeutic treatment had to wait 18.3 weeks in 2007, an all-time high? And how long did a typical American without health insurance have to wait for surgical or other therapeutic treatment? In 2007.
And how long did a typical Frenchman, Norwegian, German, Italian, Japanese, Dane, Swede, Austalian, Austrian, or Taiwanese have to wait?
Anyone points out that Melissa Hall first felt symptoms one week before she died but did not see a doctor because she had no insurance, although she badly wanted to see one, and then says she would have died anyway because some people who have health insurance die of heart attacks too, is an idiot.
Or were you saying that since some people who have health insurance die of heart attacks, medical treatment should not be sought when experiencing possible heart attack symptoms? Truly, you are an idiot.
No, sammy. This woman was too young for Medicare. She was earning too much money for Medicaid and couldn’t afford to go to the doctor whether she had insurance or not. Copays are steep for physical exams and tests if you have no history for the doctor to go on and expensive even if you do. It’s quite common for middle income earners to die and never make it to the ER. Just is.
What government clinic, sammy? We have for-profit medicine in this country, remember?
Buff, I don’t think you’ve ever been as sick as this woman was. I have. I was so sick I couldn’t grasp how sick I was. I narrowly avoided another heart attack when I got dragged into the ER by my husband and sister. Right atrial fibrillation will sure kill you if you don’t do something about it but I hadn’t been diagnosed until then. Too sick to make the right decision? You bet it happens.
No free clinics here, Buff. This is the South, remember?
Buff, she didn’t know she needed an EKG. That’s the point. If she had health insurance, she wouldn’t have been the one making that call.
And to those of you who say she could have got Medicaid–how do you know that? I live in a state where the only people who can get Medicaid are 1. Pregnant 2. Parents of minor children living in the home 3. On SS disability. Period. It doesn’t matter how poor you are.
Make that “Anyone WHO points out that …” in my last post.
Depending upon where she lived there are free clinics as well as lower priced clinics. Its possible for example that a nurse practicioner at a drug store clinic would have seen that the problem was serious for $50 and called 911. There are so many variables to this that its hard to speculate. Of course in the old days when physicians really could not do much for you it really did not matter if you went the same result occured. I recall hearing that 100 years ago a lot of folks died of acute indigestion (really a heart attack).
I suspect that waiting period is for non emergency cases. I have read that in the UK if you present with a heart attack you get treated right now. Rules I have seen for Canadian MRI read the same way if its life threating immediate treatment, if not you will wait.
If you search for Texas free clinic there is a list by cities. If you live in a larger city there are several. Many are associated with various charities. So it now depends on where she lived if free or reduced fee services could have detected the problem. Anyway if all you have is a house and a 401k then bk would not be that bad, as all home equity is protected along with 401ks in Tx.
NO – I live in the DFW metroplex, so yep plenty of ways to get healthcare. And plenty of ERs.
And Lyle is correct. IN texas at least your house and 401k would survive BK (along with your horse, saddle, a set of guns and spurs).
Islam will change
Lollipop,
Sorry your employee made a series of bad decisions. Any one of which would have saved her.
1) She could have gotten a job with medical coverage (she didn’t)
2) She elected to spend her money on a luxery good (funding her sons’ school) vs getting health insurance
3) She elected not to go to a free clinic on day 1.
4) She elected to slowly have her condition get worse, in the midst of her supervisor and co-workers (none of which raised a hand to help), without seeking help until she collapsed.
Sorry I can’t do much to help people who make a series of bad decisions.
But where were you while one of your employees was literally dieing in front of you???? Why did you, her boss, not step in with your good fortune and take her to a clinic? You watched this go on for 2 weeks – 80 hours!!!! And you call me morally reprensible????
Get a grip.
Islam will change
NO,
If your that sick there is no decision – get to the ER if no where else. And I have been that sick before. I was just lucky I didn’t kill anyone driving to the ER…could barely control my shaking – teeth chattering so hard it blurred my vision.
And she sat in a office, with plenty of her suppossed collegues, who basically saw no problem sitting there and watching her die. She picked a really crummy place to work.
Islam will change
Julie,
She knew she needed medical care, if not the first day, definitely the second. And as I pointed out below she elected to take the gamble with her life. She lost. She made a chain of bad decisions that cost her her life.
I live in Texas and their are plenty of free clinics around (remember we have large immagrant pop). The pay clinic I know of would have charged her $230 for the exam with an EKG (I make the assumption here that the Doc would recognize the issue enough to accomplish the EKG or call the ambulance to take her to the hospital).
And she elected to spend her money on things other than health care. Even after losing that gamble she could have gone to the ER, run up HUGE medical bills and just declared BK. She would have saved her house and all retirement saveings and could start afresh.
Or she could do nothing and die.
It would have been nice if family or friends would have grabbed her and taken her to the ER, found the cash for the exam etc. BUt obviously she had no support system. I wish it had turned out better. But that doesn’t make the leap Ken makes that we need Federal Government run and operated single payer medicine in this country.
She had plenty of options and should have planned ahead in case she lost her gamble oon good health. But as many here have said, your health goes sometime…
Islam will change
Yes, people make decisions that have consequences. In a society as rich as ours it is a moral abomination that death should be the consequence. This is the fundamental point of disagreement. It is not ok for some people to have access to medical care and some not.
As to your other points:
1. We have no jobs where I live. Our recession started in the 70s and continues. You take what you can get and you grow a garden and pray.
2. I’d risk death for my kids too. A just society would not make this a trade off.
3. We have no free clinics. None.
4. I have no right to force her to a doctor. She was afraid of getting into debt because she takes her financial obligations seriously. She is an adult whose judgement I have to respect.
Should read death or debt
You are ignoring the underlying issue: It is not morally acceptable, it is not good or just, for some to have poor access to healthcare because they are poor.
I do not want to live in a society that fails to provide for the sick, the poor, and the disabled. Everyone deserves a safety net because human dignity too sacred and too valuable to leave to the free market.
If an old lady resists a purse snatcher – whether because of how much money is in it, or how many irreplaceable photos are in it, or just because she is incapable of assessing the danger – and she is seriously injured or killed, who is at fault? It’s easy to say the old lady was foolish, but rare is the person who would say that the purse snatcher had nothing to do with it.
“some people die of heart attacks with national health care”.
True, but far far fewer.
http://www.reuters.com/article/2008/01/08/us-deaths-rankings-idUSN0765165020080108
“some people die of heart attacks with national health care”.
True, but far far fewer.
http://www.reuters.com/article/2008/01/08/us-deaths-rankings-idUSN0765165020080108
“she elected to take the gamble with her life. She lost. She made a chain of bad decisions that cost her her life.”
You could have said something like, “She took a chance and it turned out to be a mistake that led to her death.” Instead, we have the words “gamble” “lost” “bad.” All judgmental, pejorative, and dismissive.
The point is that both the decision itself and the factors that led to it might have been different. I know that’s ambiguous. Every moment of every day she was in pain, she could have done something different. Even before she was in pain, she could have done something different. We don’t know what the outcome of any one of those possible decisions might have been. Had she lived, she could have spent years on coulda woulda shoulda.
We cannot second guess what a stranger does, and we should not necessarily reject or criticize what a friend does. In this case, whether as friends, or sympathetic strangers, we may be saddened and/or angry with a system that exacerbated the dilemma, but I think it’s treading on dangerous ground to try to second guess Melissa Hall’s decision or to say with any certainty what would have happened if she’d had insurance.
On the other hand, what we can, and in my opinion should, do is continue to press for solutions to the prohibitive cost of health care. It’s not enough to say that health care is a choice. I don’t believe that anyone should be forced to accept unwanted medical treatment (except perhaps in cases of dangerous contagion), but I do believe that those who need and want it should be able to get it without destroying the very future that prolonging their life will give them.
Yeah, getting to the ER is the tricky part. Luckily, the EMS guys here come in about 5 minutes average response time. Small town and they’re just up the road. Sorry you were sick and sorry I made the wrong assumption. Just glad you’re still Gruff Buff. 🙂
Buff–I for one wouldn’t know what to do without my horse, saddle, guns and spurs. And of course my trusty bull dog, a creature of eternal vigilance. Which is as we know the price of liberty. 😀
Buff:
You weren’t doing bad until you said :
“ERs are free.” In fact they are not free and in many cases, the hospital pursues you for payment and they are brutal.
Buff:
Go back and read the story again:
“Melissa worked hard. She owned a home. She paid her taxes. She was trying to live a dream – the American Dream – that supposedly we as citizens are promised – the right to pursue life, liberty and happiness. For her, that couldn’t be achieved in a traditional job that came with the perks of health care.”
This is one of your own . . .
Sammy, to pay that extra $1.3 T in taxes, taxpayers would have over $1.5 T that they would no longer give to health insurance companies and out-of-pocket health care expenses. (Actually, I think both numbers probably are a bit higher.) And everyone would be covered. And Medicare would have greater leverage over industry prices that keep climbing much faster than inflation–people who look at long-term deficit projections know how important this is. Of course, if you blindly oppose taxes, then let the taxpayer suffer the consequences.
PJR
Sammy, to pay that extra $1.3 T in taxes, taxpayers would have over $1.5 T that they would no longer give to health insurance companies and out-of-pocket health care expenses.
This is a good point. However, Ms. Hall wasn’t paying any premiums. None the less, a good point.
Lollipop and the others: I would be willing to stipulate that you are A Great Person, more compassionate than thee and thou, in order to skip the platitudes about caring for the poor. What would this cost and how would it be paid for?
Let’s see, an insurance policy that would allow a appointment w/in one week and cover the majority of Ms. Hall’s expenses might cost $500/mo. I guess you are proposing that this be virtually free to those making at or below Ms. Hall’s income level (educated guess = $40K)
You come up with a plan, not bromides, and I would be willing to listen. I don’t particularly like paying for health insurance or watching people suffer any more than you do.
You must remember that buff doesn’t live in the real USA. He lives in the GOPUSA, where there is no unemployment that isn’t the fault of the lazy bums who don’t want to work. In the GOPUSA everyone can get any job they want and they can pick and choose and everyone can find a job that offers health insurance and that pays enough to avoid having to make tough choices. All hail the GOPUSA and its official state church, the First Church of Free Market.
My plan is that we implement a single payer system like that in Canada and Europe.
It isn’t so easy to know if you are “gambling with your life” or being financially prudent. Once my husband got very sick with vomiting over a couple of days and I persuaded him to go to an urgent care center because he seemed to be getting very weak. The visit to the UC was only about $80, but they were not sure what was wrong and urged him to go to the ER. After sitting in an empty waiting room for about 4 hours vomiting in a wastebasket, he saw doctors who gave him a CBC (common blood test) and one IV bag of fluids for dehydration. They diagnosed a bad stomach flu and gave him a prescription for an expensive antinausea medicine that we decided not to fill. The total bill ended up being $1300, which we paid in installments. We obviously regretted having sought care, since the bill was a burden that turned out to be unnecessary.
Months later I thought back on that episode when I was stricken with severe abdominal pain. I made an appt with a doctor instead of going to the ER, even though the pain was so severe I thought I might be dying. The doctor recommended I go to the hospital for an ultrasound, but since a few days had passed and I felt a little better by then (although I couldn’t eat solid food), I called to find out the charges first. It would be around $1800 for the test, plus radiologist’s fees. We were still paying off my husband’s bill, so I decided to wait it out. Obviously, I didn’t die, though I lost about 25 pounds in a 2-week period. I have no doubt that what ever was wrong with me, it was worse than what my husband had, and that I did not make a wise decision from a health standpoint. But from a financial standpoint, I did the right thing.
The point of all of this is that the decision to seek medical help should not be so hard to make. Even minor illness can be very expensive, and no one should have to decide whether they should try to tough it out, or risk bankruptcy by seeking care.
And before you tell me it’s too expensive, I can promise you with the return of 90% marginal rates on earners over 1 mil we will be able to afford it.
(As long as I’m queen of the world)
And before you tell me it’s too expensive, I can promise you with the return of 90% marginal rates on earners over 1 mil we will be able to afford it.
Ah, now we find the wellspring of Lollipop’s overweening humanitarism: SOMEONE ELSE PAYS FOR IT. How very magnanimous of you!
In 2008, about 160.000 taxpayers reported income of over $1.5 million http://www.irs.gov/taxstats/indtaxstats/article/0,,id=133521,00.html
So Lollipop proposes that those 160,000 taxpayers are to pay for the health insurance of 300 million citizens ($3T). Even if this were mathmatically possible, that revenue stream would dry up faster than you could say “Grand Cayman Islands.”
Lollipop is a typical lib: grandstanding moralism ->namecalling->someone else pays -> poor research -> idiotic policy. Rinse and repeat.
Ah, now we find the wellspring of Lollipop’s overweening humanitarism:
And before you tell me it’s too expensive, I can promise you with the return of 90% marginal rates on earners over 1 mil we will be able to afford it.
SOMEONE ELSE PAYS FOR IT.
Does Lollipops’ taxes go up even .01? That would be a negative. How very magnanimous of Lollipop!
In addition, about 160.000 taxpayers reported income of over $1.5 million http://www.irs.gov/taxstats/indtaxstats/article/0,,id=133521,00.html
So Lollipop proposes that those 160,000 taxpayers are to pay for the health insurance of 300 million citizens ($3T). Even if this were mathmatically possible, that revenue stream would dry up faster than you could say “Grand Cayman Islands.”
Lollipop is a typical lib: grandstanding moralism ->namecalling->”someone else” pays -> poor research -> idiotic policy. Rinse and repeat
Of course sammy. Happens daily.
Sammy sez:
“If we were to just add the $1.3T onto the Budget that would make total spending $4.7T compared to tax revenues of $2.2 T. This means that current taxes would have to more than double to balance the budget. Or you can cut government spending on the rest of the budget by 50%, (or much more if you leave out interest and SS) and leave taxes the same. Or some combination.”
Intarwebs sez:
http://www.newdeal20.org/2010/02/10/the-federal-budget-is-not-like-a-household-budget-heres-why-8230/?author=83
the common thread i’m seeing among most teabag “objectivists” is that they all seem to think we still have gold standard currency. there are any number of ways they exibit their willful disregard for reality (and humanity), but this is where most of their economic mistakes originate. i think.
though i may be conflating different issues here.
i think this:
“let’s look at Medicare. It covers 45 million people at a cost of $452 billion (12.5% of the Budget) so to extend that to all 300 million Americans it would cost $3 Trillion (88% of Budget).”
is more relevant to the gold standard misunderstanding. like the idea that “the government can only spend a dollar it takes from its citizens”, this comparison of budgetary percentages seems to rely on an understanding that the governmen’ts budget is constrained by the fixed amount of “money” in the american economy (“fixed” by some arbitrary means like gold standardization).
my previous quotation of sammy has much more to do with the false equivalence of “government budget” with “personal budget” than it does the false imposition of a gold-like standard for US currency.
perhaps the two are related, but they’re not the same. just thought i’d refine my sentiment a bit.
Sammy, I think you slightly missed at least a part of my point by responding that Mrs. Hall doesn’t pay premiums. Let me say it differently. I ask you to give me 85-90 percent of what you spend on health insurance and out-of-pocket health care, and you keep the balance; in return, I cover all your health care costs and those of Mrs. Hall. Do you reject the deal because Mrs. Hall is getting a free ride? No, you don’t. You might reject it for other reasons, but Mrs. Hall’s free ride should not be among them.
I think you also are worried that we would raise the money for Medicare-for-all (or another single-payer system) through a progressive tax, in which case wealthy people would pay more in taxes than they currently spend for health care, and poorer people would pay less in taxes than they currently spend for health care. BUT it might not be nearly as progressive as many would suspect, depending on how the taxes are raised. A starting point is that a large chunk of the needed money currently is spent by firms for insurance on behalf of employees–one notion is that none of that money has to reach employees’ paychecks, so firms can instead pay it as taxes on behalf of their employees. This alone would bring us closer to a flat-tax for a single-payer system.