Our current patchwork system of private health insurance and government programs is too complex for someone of my small mental ability to comprehend all at once, so I have to break it down into little pieces.
Let’s start with Medicare. (1) Isn’t Medicare, in effect, universal health coverage for everyone who is 65 years old or older? (2) Isn’t some amount taken from everyone’s paycheck to help pay for this program?
1. Correct, Medicare implies that the government provides health care for those 65 or over, or other people who meet special criteria.
2. It is partially funded by payroll taxes, basically meaning from everyone’s paycheck.
But in my opinion the private health insurance is rather simple as your coverage depends on your earnings and what’s in your contract with your employer. But even if you have a health insurance plan there are several “levels” of them. By this I mean that even though many have health insurance some of them may not have one that covers everyone, for example if they get a heart attack they can’t get surgery, but they can get dental. Its all depending on your capital power in other words. More money, better health. God bless capitalism!
Thanks magnus. Please stick around; I have some follow up questions, but first I’d like to get some more comments. I don’t have an agenda, but I am trying to get somewhere or see why I can’t get somewhere with this topic.
Medicare is funded by the American people/our beloved do nothing wrong government. It’s also set to go belly up in 10 years unless “major” tax increases are initiated.
There are three main reasons for that:
1. A large influx of belly buttons coming into the system (baby boomers), thus more recipients and less taxpayers.
2. Gross mis-management of healthcare costs. No disease management programs like you see in private healthcare plans. Why else is Medicare (the best system in the world) shuffling people into private plans at a rapid pace. The private plans are known as Medicare-Advantage plans. I’ll spare the details, but it’s an admission by Medicare that insurance companies can do a lot better job of manageing healthcare costs than the government.
3. Healthcare costs and the Rx program have increased the cost per enrolee per year. I advocated the Rx plan becuase I believe you can manage chronic illness (diabetes, high blodd presure…) with good medication mgt, thus keeping people out of hospitals where costs skyrocket.
Magnus – I haven’t seen a “Major Medical Insurance Plan” that doen’t cover heart surgery. I don’t know whether you were giving a blind example or if you feel this is normal practice among insurance carriers. Our capitolistic ociaty is abotu competition and if Blue Cross quit covering heart surgery, then United, Humana et al… would greatly benefit and Blue Cross would go by the wasteside.
I know insurace carriers don’t cover certain services like gastric bypass and platic surgery to give some examples. Their arguement is these types of services are lifestyle procedures vs. medical procedures. I’m sure every American male over 50 would like the gov’t to pass a bill demanding insurance carriers cover Viagra!
I really cannot understand how anyone that understands the issue would favor a governement run system over provate plans. Look at where Medicare and Medicaid are right now. Do I want to be insured by them? If I were a physician, would I want all my patients to by covered by the gov’t. I truly believe our quality of healthcare would be greatly affected long term. Yes health insurance is expensive. People want to bitch about paying $500 a mont for healthcare, yet will spend that on a car payment in a heart beat.
I’m not so naive that I believe Insurance companies are beacons of light for all to follow. In fact, they are mostly snakes in the grass that have to be watched closely. I think our govt’s role is to police these entities to ensure they provide quality coverage at a reasonable price.
ps – don’t know how the winking sun got in my healthcare rant!
[…] Go to the author’s original blog: Medicare And Universal Health Insurance Coverage […]
So in order for us to have universal health coverage so that everyone is covered, we simply need to expand the Medicare concept to people below the age of 65. I understand there are all kinds of arguments why we should or shouldn’t do this, but, again, I’m taking baby steps. We have universal health care for people over the age of 65. We don’t have it for people under the age of 65.
Thus, it’s being provided for a segment of our population already. It may be crappy. It may on the brink of bankruptcy, etc. I understand that. On the other hand, it’s been around for, what, 42 years? People scream about it going bankrupt, being mismanaged, etc., but I’ve heard no one say let’s do away with the idea — the notion that people over the age of 65 should be covered. Correct?
Yack, you just make things all smiley and sunny. It just pours out from your writing. Anytime you type an ellipsis followed by a parenthesis, it creates a smiley face. I think I can turn that feature off, but I enjoy knowing people are typing serious stuff and once they hit submit, they see a smiling sun and wonder, “WTF??”
The reason people over 65 are on Medicare is becuase they are theoretically “retired” and no longer can receive health insurance through their employer and or can afford it. It’s the same reason they receive social security and you and I don’t.
Brian, please understand and I mean this with all due respect to all Americans:
We have universal health coverage right now:
If you’re old or disabled, you can access Medicare
If you are poor, you can access Medicaid
If you chose not to buy health insurance or come into this country illegally, you go to the emergency room and the hospital HAS to treat you.
So that begs the question:
Who doesn’t recieve healthcare and why? Should taxpayers pay the insurance premiums for every 25 year old bartenders who don’t want to pay $300 a month for medical insurance?
If your answer is yes, then should we pay for their clothing, shelter, legal fees, food and all other basic human needs. I have a friend right now that was screwed by a company out of his life savings (roughly $150,000). He can’t afford to pay legal fees to go after these assholes. Should the gov’t step in and help him? Do you see how insane this whole universal health coverage debate can get?
At some point, we have to demand personal responsibility on our citizens. The democrats and some republicans have created the nanny state among Amercians who now feel “entitled” to everything under the sun.
Give a mouse a glass of milk…….
Back to my original point…we provide healthcare coverage to the poor, elderly, disabled and indirectly to unisured and illegal aliens. What else do we need to do?
Yack, what do I do? Im a PhD student who is a teaching assistant and that amount NEVER changes. Yet I have no healthcare coverage b/c university doesnt provide. SO, where does my 300$ a month come from the 1,100 i get in a stipend? It just seemed that I fall in with your 25yr old bartender analogy and yet, I dont feel like one. Thoughts?
I was hoping to talk about this incrementally because once the term “universal healthcare” is used, people tend to fall into entrenched positions. I’m not saying those entrenched positions are bad, wrong, or misguided, but it does make it harder to see what can be agreed upon b/c we tend to talk in terms of what we don’t want vs. what we can agree on and move from there.
Yack, I hear you about the “where does it end” theme. As you know, I’m very much inclined toward personal responsibility when it comes to making your way in life. I was raised in a lower middle class (some would say poor) family, put myself through college with some help from my mom, and then law school. Now, I’m………….incredibly broke. Damn, this isn’t inspirational at all. I thought I had something here.
Anyway, I believe in self-sufficiency. However, I find it inconceivable that anyone should be denied healthcare because they can’t afford it. Yes, I recognize that there are some people who simply are slackers, but I think they’re the exceptions and certainly not the people around whom we should make policy. Perhaps we make contingencies for such people, but they should not be the focal point. I’ve met far too many people (represented a lot of them) who were hard working, responsible people who simply didn’t make a lot of money and whose employers didn’t offer health insurance or the insurance was lacking.
Bottom line for me is no one should suffer from, say, cancer because they don’t have money. Put another way, money should not be the impediment to proper medical treatment. I understand the ER is always there for emergencies. But you don’t go to the ER for leukemia.
How we get there is another question and it’s the question I was building toward. It’s also the question that I don’t know the answer to. I do know that we’re the only first world country without some type of universal healthcare.
Again, I know the problem I want solved — quality, equal healthcare being a function, at least in part, of money. This is unacceptable to me. Healthcare is too fundamental to be left up to money. I’m not talking about facelifts, tummy tucks, etc. I’m talking about sound healthcare and I’m all ears as to solutions.
Janey,
I’m not an insurance agent, but I would recommend you look into getting an individual policy through Blue Cross or Humana (two carriers I know offer this) and request a high deductible…say $5,000-$10000. You’re premium would be significantly less, but you would have full coverage in case of a serious medical condition. If you can’t afford that, I simply don’t have an answer. Your case is very unique.
My point in all of this is simple: America is a great country that takes care of our elderly, disabled and poor like no other country in the world. We have the best healthcare system in the world. Medicare and Medicaid are good programs philosophically; however, they are grossly mis-managed like most gov’t run programs. The answer to solving issues like the guy Brian referred to or Janey is not have the gov’t become their payer in my view.
One thing that has been proposed and actually Hillary Clinton brought up in the early 90’s was to allow small employers to band together (into associations) to go out and purchase health insurance. This would give that 10 man employer a lot more leverage if he could unite with 20,000 other employers. Premiums would drastically drop and more employers could afford to provide insurance to their employees. The concept is called AHP’s or Association Health Plans. Guess who opposed these? Yep…Insurance Companies! They know if this were to pass it would change the rules of the game for them. They could no longer hold the small employer’s feet to the fire as they do now. Insurance is a game of numbers performed by actuaries (accountants without personalities)! The more covered loves in an insurance plan, the more the risk is spread out, thus lower premiums.
I am clearly a self-admitted conservative; however, I’m not a cruel bastard. It pains me to see hard working people without benefits while lazy do nothings get 100% coverage fromt he gov’t. I think we all agree reform is needed…how we get there is where we are different.
That’s my simple answer and Janey when you get your PHD, please try to remember us little folks!
I suspect that the way our government, or any government, would achieve quality “equal” healthcare is to take away much of the access to healthcare that I have now, to make my healthcare equal to that of the lowest common denominator, then tell me that whatever I have left is “quality.” Those of us with children in public education shoud instantly recognize the model. Going to the doctor would also become every bit as pleasant as going to get your driver’s license renewed. That’s the supercynic in me.
Yack,
the answer is that I have to go and beg for coverage and try to figure out who to pay first…car, phone, rent, grocery,renters ins, car ins, and by the way, it is time for my first mammogram but guess who doesnt get one? Thats right. Thank goodness I dont have any kids or even a pet because I couldnt afford either. Yet, I used to have health insurance for $289 month on one of those “individual policies” you recommended but when a single girl only has 1,100 a month to spread around, guess what goes first?
I appreciate that I am unique case in this process but I am in school with many in this situation. So, when I tripped on Ashley Kremers back porch and hit my head three years ago and had to go to the emergency room, I shouldve lied and told them I had no coverage because I am STILL paying that bill.
I am personally responsible for all I do and for all of my decisions including getting my PhD but because I am an independent 39 3/4 woman, I have no choice but to take a chance and hope that I dont have breast cancer, cervical issues, broken bones, strep throat…..because right now, I choose to eat and pay Honda. and not be homeless.
And I will do my best not to forget the little people because if I am in the early stages of dimentia, I wont be able to pay for a doctor to help diagnose and treat me.
Why are you paying an ER bill that is three years old if you had coverage? Did your insurance not pay it? Just curious.
There are policies you can get that are limited benefit pans that can be as low as $60 a month and they provide some wellness covergae like mamos. If you would like for me to check for you, I will be happy to.
How much longer until you earn your Phd? What is it in?
The Medicare/Mediaid and Universal Health Care Coverage debate both have pros and cons. Yack has made many good points and then there are jobs that simply don’t offer coverage like Janie and supercynic has said. I’m actually curious if the proposed (by the Democratics, right? correct me if I’m wrong) universal health care plan is supposed to be funded by federally or by each state? I honestly think that the universal health care can work. It works in Canada and in Ontario, most health services are provided as long as you have a health card, which covers the cost of the visit and is billed to the government. It just doesn’t cover dentistry, vision, and prescription drugs (which is where insurance comes in). http://www.health.gov.on.ca/english/public/program/ohip/ohip_mn.html
However, I will agree that the the wait time is quite terrible in most hospitals (in Canada). I think there should be a dual — a mixture of both private and public, that people can have the option of basically opting out of the public health care system if they want. That way it sort of pacifies both sides — those for it and against it. That way, at least, there is an option for those who can’t really afford insurance. And then if people think the wait time is too long and they can afford it, then they can go get private health care.
Janie, I’m curious — since you’re a PhD student, shouldn’t there be some type of insurance? It might not be universal, but there must be something that can be purchased. I know there’s medical insurance is a must for international students as I thought about going to the US for university… maybe that’s different if you’re not an undergraduate anymore or not international?
You make some real good points Elizabeth. I’m curious about Janey’s situation as well. It seems for all grad students, their would be some programs to help.
This is a stupid question, but can you get student loans to help pay for medical insurance along with other outside expenses while in college? I know tons of college students make it through college with very little income other than student loans. Obviously they have to be repaid, but anyon earning and Masters and/or PhD has great income potential and can repay the loans.
Just a thought. BTW, I will ask around about limited benefit plans.
For Yack and Elizabeth,
Appreciate that you are so concerned about figuring this out. Really I do. My point in sharing my circumstance is to bring some humanity into the discussion.
Quick answers: loans for insurance…absolutely not. I will take my chances. Insurance companies suck. USM did not provide grad student insurance until THIS YEAR and because I was not enrolled in courses but working on dissertation…well, you fill in the blank. Taking three years to pay: well, the bill was over 5,000, insurance paid part and I was stuck with almost 3,000 dollars.
Enough about my situation yet I appreciate it. THe point of this is to demonstrate that all types fall through the cracks and hope for the best. That doesnt mean that we are uneducated, uninformed or whatever.
I say we keep talking about it and force others to understand it the best “we” can until answers are provided for regular people so that we can make informed decisions instead of having to decide to pay for groceries, gas or power instead of insurance.
janey — you have poignantly made my point, which is we need to make sure there are stop gaps in place to protect people like yourself. No one is saying that we should also buy your books, your pens, notebooks, new shoes, etc. As I said before, healthcare should be a fundamental right in this country — the wealthiest nation on earth (except China, which now owns us).
How we get there is the question that I don’t know the answer to. But it’s achievable. Hell, look at how many billions of dollars we’ve spent on the Iraq war. That money alone would have covered every American multiple times over during the same time period. It’s a matter of priorities and creativity. I’m not against insurance companies continuing to be involved in the process — as long as there are checks and balances. I don’t like the government any more than the next guy/gal. Perhaps the answer lies in some kind of insurance company–government co-operative. But if that’s the case, I sure as hell want real checks and balances.
Fundamental right? That’s opening a can of worms. I love Janey to death and you too Brian, but I respectfully disagree.
Janey can have access to healthcare, but she can’t afford it. Her options are:
1. Pay for it and lose the ability to pay for her car, rent….obviously not a good option.
2. Take out a student loan to pay for the above expenses thus freeing up money to pay for insurance…my recomendation. I took out a loan to pay for college myself….hated it, but I did it. She’s earning a PhD, so she will make more than us!!!!!
3. or role the dice (do what she’s doing now) and basically only have ER coverage. Although I would guess many hospitals, physicians and misc. charities would assist her via a crisis.
In any case, Janey has options. As much as I love all of you, we don’t need a gov’t program to insure her and the like. If insurance is that important to Janey et al…then either get a loan, pay for insurance, pay for a limited benefit policy, get a full-time job and pursue a PhD later.
If you classify health insurance and healthcare as a right, then you are basically saying the gov’t should provide it for all who are uninsured. People are uninsured for many different reasons. We would then have Medicare/Medicaid for all people. Our taxes would go up and the quality of our healthcare would go down.
I don’t see students lining up for medical school to invest eight years of college to work for the gov’t. I don’t want a Neurosurgeon operating on me making 50K per year do y’all???
It’s about personal decisions. If you are 28 years old and are waiting tables making 35K a year, then buy insurance or don’t. If you are 40 years old and are self employed and uninsured, then maybe your best option would be to work for an employer with health benefits. If not, seek coverage and give up something else.
There are people that fall through the cracks in every facet of society whether it’s healthcare coverage, education, food…. At some point, we have to realize that this is America and we were founded as a nation of free thinking capitalists vs. a monarchy or socialist society.
Insurance may “suck”, but we all have to have it just “in case”. What sucks more than insurance is paying 80% of your pay check to insure every person in America for healthcare, food, clothing, shelter et al….
My name is Yack and I approve this message.
Yack, the love is mutual. In fact, I was thinking about calling this The Love Weblog, but that title is already being used by al-Bashir’s Sudanese blog. His latest post is called “Genocide Schmenodice.”
I chose the words “fundamental right” not in the sense of a constitutional right. I’m writing a blog here not a Constitutional amendment. To me, basic health care and the ability to receive treatment for life-threatening illnesses, at this day and age, in this country with so much wealth and resources, is a fundamental right — if only a moral one.
I’ve reached this conclusion because I believe what Jesus said. We are to love our neighbors; we are charged with taking care of “the least of these.” This does not mean that everyone gets the same size house, the same type of car, same quality of clothing, the same vacation spots, etc. But it does mean that no one is going to die because they don’t have enough money to treat an illness.
If this means my taxes have to be raised, then so be it. However, I would then take the opportunity to say let’s look at all the pork-barrel spending going on and see what we can eliminate so that the tax burden on the American people is either not increased at all or only increased as necessary.
Yes, this is a capitalist society. But I know enough about economics to know that there is nothing mutually exclusive about living in a capitalist society and providing health care coverage for everyone. Again, that doesn’t necessarily mean government-sponsored, taxpayer-funded only health care coverage. I stated early on that I don’t know the best way in which to implement a system that does not allow anyone to slip through cracks merely because they don’t have enough money in the bank. But, I know that we can do it.
I share your concern about a nanny state. This is why a necessary element of any solution would be measures to ensure that otherwise able people aren’t just getting a free ride off of the rest of us. I’ve said for years now that if I were a governor or president, one of my biggest agencies would be the department that oversees health and human services. I would expand this department to make sure that caseworkers were not overloaded and simply adding people to the various programs because they did not have time to properly evaluate each claimant’s case, or someone who is eligible for a program was denied because the caseworker is overloaded. In conjunction with this increase in the agency, I would trim, and in some cases severely cut back, other programs.
If you really think about what I’m saying, you’ll see that I am trying to get the government back to what I believe is its single function–being the instrument by which we provide for the common good, e.g., keeping our borders safe, protecting our national interests, providing police and fire protection, maintaining our infrastructure and, yes, making sure no one suffers from or dies from an illness only because they did not have the money to pay for the proper treatment.
My name is supercynic and I’m conducting a poll to see whether I should approve this message or not.
I love Yack as well1 In fact, when all the “money” that you think PhDs make begins to roll in to my coffers, I will phone you for financial planning, insurance purchases and assistance in finding a sugar daddy that will allow me to do whatever I want! Beyond that, I am putting sandbags in front of my house in preparation for TS Faye which is rolling in at almost the same date as HKatrina…wow…a discussion of insurance of ANY type during hurricane season is another irony.
Im glad that Yack has enlightened me to the power of student loans (which I did take out and will begin paying back 6 months after the PHD arrives). I never realized that student loans could pay for other things besides white out and index cards. Also excited to know that I could have put one of my life-long dreams on the back burner so that I could pay for living the life of a single income person and just continue to be unsatisfied in my job. See, all I needed was an Ole Miss fan to straighten me out. God bless you Yack. Until then, I am your number one fan. And am headed to the local BCBS office to get my new insurance policy and then go to my third job that will help me pay for it.
Geaux Tigers.
LOL Janey! You managed to insult me and Ole Miss while making me smile..nice job! You should have gotten a business degree with a 2.1 GPA then you would be living the good life like me. I did manage near perfect grades at Buddy’s.
I hope things turn out for you with your PhD and everything else.
Your friend, Yack
You kill me with “your friend, Yack” like you are signing my yearbook….and thats what PhDs are for…to insult the unwashed masses! I do appreciate your input because I still have to piece together one of those fancy full time jobs.
TB is for Universal Health Care and for getting his goggles all the way down SC’s comments column.
And I did not read any of the first 21 comments, but can see what I missed from Janey’s entry on no. 22.
Janey,
Please e-mail me your contact info if you want to….my e-mail work address is hillj@firstchoicems.com.
Thanks, John
PS – The reason I want your contact information is if I run across or hear about an affordable plan, I want to be able to get in touch with you. I think it stinks you don’t have health insurance and you’ve opened my eyes a little bit. I wish I had an answer for you, but I guess there’s not one. I woudl hope the gov’t can pull together and come up with some alternatives to people that aren’t able to afford insurance.
I thought the “your friend” was a nice comment and I was being serious. I consider you and all my MC friends still good friends. I only wish I had time to see everyone of them.
I’ve enjoyed the discussion and hope I haven’t come across as some uncaring prick.