But states can opt out.
So now what?
We grow the federal deficit even larger?
or maybe our premiums go down because we don’t have to pay for the health care needs of the uninsured?
I wonder if health care will be triaged, and if so, then can you “jump” the helath care gatekeeper by buying a premium insurance or some gap insurance…
It is about time the United States joined the rest of the developed world in providing health care to all.
I also like that my kids will be covered under our insurace until age 26, very smart, now they won’t have to struggle with that cost as they try to make it after graduating college.
Other than the possibility of increased taxation or changes in insurance premiums, what do we get from this package?
Anyone have thoughts on states being able to opt out? Any disadvantages?
Ohh that’s funny!
We don’t have to pay… because the money will magically shoot out of a unicorn’s posterior?
Mmm hmm. Go on. 
Can someone explain to me what the downside of this particular plan is?
Also, what would be the downside of single payer (socialized) healthcare? I really hate that there is an entire industry out there that gets between me and my healthcare. As far as I can tell, all insurance does is add cost; the insurance industry doesn’t provide a product, or a service of any real value.
Serious questions. Thanks for answering.
Insurance is a good thing. What we have in the US is not really typical insurance anymore. Government destroyed it long ago which caused the problems that made people request government to do more of the same thinking it would fix the problems. If it were really insurance, people would buy it to cover the unforeseen higher cost cases, and pay out of pocket for the routine care, but now it is mostly expensive all-inclusive health care plans that people have. If people paid out of pocket, they would price shop around and cause downward price pressure on health care costs, and they would question if certain tests or medications are really needed.
So now we have people who have an unhealthy diet (probably since they follow the upside down food pyramid) that go to their doctor for that quick fix (the latest expensive designer medications), instad of looking for the lower cost solution to their ills (eating right and exercising).
Meanwhile, Nurse Ben is excited because his pill pushing industry is being subsidized.
The downside is that you’ll be forced to pay for health insurance to help pay for the health care costs of all the unhealthy people. You know those grossly obese people you see in the grocery store driving around in the electric carts with their cart filled with stacks of red meat and junk food? Those people.
While I agree with most of what you say, here is where I have trouble: where the rubber meets the road if you will. Where theory meets practice.
When one is quite ill, time is of the essence. Heck even when he isn’t quite ill… time lost from work costs money. Who would have the time to shop around? Especially given the fact that a call to a doctor’s office rarely gets one in touch with a doctor or nurse?
How would one even shop around if they don’t know their diagnosis? You’re wasting a lot of time by going to the doc just to get diagnosed, then going to another doc to get treated… that second doc would likely want to re-diagnose you first to be sure you’re getting the right treatment. This could be more expensive than if you just got treated at the first visit.
And who has sufficient knowledge to override a doctor’s decision to question if a test or medicine is needed? Here is one place where insurance companies sometimes benefit patients… they can take statistical looks at remission / survival rates given particular diagnoses and treatments and sometimes make better decisions than doctors.
Yes, in theory, shopping around benefits the consumer. But I can’t see how it plays out in practice in this situation. Sure, for elective procedures, in cases where treatment can be delayed, etc. But I don’t think this will encompass enough of the medical market to make a big enough impact on pricing…
Edit: Food for thought: would you REALLY want a surgery done by “the lowest bidder?” At some point, price competition creates bottom-of-the-barrel providers. Mobile tonsillectomies? No thanks…
The number of people in the US with health insurance will decrease.
When your car breaks down, you often need a repair done on the car ASAP if it’s your daily driver. You will often go to a mechanic whom you trust and have had prior experience with. Why should it be much different with doctors and hospitals? You go to a doctor or hospital whom you like where they have not charged you exorbitant fees in the past.
A lot of times you can just ask the doctor. They may give you a recommendation, and if you then tell you are paying out of pocket they will tell you a test is not necessary, or that there is a cheaper medicine that is just as good.
Even if you do not have the time to shop around, you have the benefit of downward price pressure caused by those who do and can shop around. If you have an insurance policy, one of the benefits they may provide is to limit your out of pocket costs, even if you are under the deductible amount, to equal their predefined pricelist assuming you meet the conditions they lay out (ie. you are incapable of decision making, and/or they are notified asap to manage your care).
Explain please…
Hey Maestro we agree on that one!
Globally the economics of health care is something extremely complex and not understood even by economics spin doctors.
Every country where universal Health care is provided has to fight money leaks and fixing that depends much on local conditions. Two important (cultural?) points:
- one is social solidarity: yes I pay for those who may have poor health compared to mine. So where is the problem? For sure you can pinpoint problems with some people with irresponsible behaviours but do people that have big health problems suffer because some are irresponsible? no way!
- the other is personnal responsiblity from persons delivering health cares.
(I don’t mean hunting doctors with lawyers!)
Oops yes I forgot the personnal responsibiliy of insurance companies when they prefer to fleece their customeers instead of offering a service (that merits a just retribution).
Given a choice between a health care plan paid for out of pocket that is more expensive than the penalty (tax) charged for the uninsured, people will abandon their private insurance programs and let the state care for them instead. Maybe I was unclear; the number of people on out-of-pocket health care programs will decrease as they move into the inferior state-supported program. Health care as a whole will necessarily deteriorate.
I have $10K left from the bet that nobody took about the impeachment date of Bush that I am willing to wager on this. This is another sure-thing bet. Charles Murray’s book, Losing Ground, from the 1980s describes the historical record of government programs like this, what they try to accomplish, and how and why they always produce exactly the opposite of what was intended. There was a weak apology written to this book that Billy or Raphael will chime in with eventually. What they won’t chime in with is the $10K to cover the wager.
by “governement” you mean just the US governement … or just any “government” ?
Figuring out who exactly is going to pay the extra $, or what the government will stop paying for, takes more time than I’ve got. The Budget Office Report isn’t exactly light reading.
Exact opposite:D
What a silly concept:D
The USA has now joined other industrialized nations in providing health care for its people.
As someone who lives a fairly healthy lifestyle, I (obviously) do not want to be paying for the medical costs of those who totally disregard their own health (obesity, drug use, poor life choices in general). On the other hand, I’m sure the guy who sits in front of a television for 8 hours a day doesn’t want to be paying my health care costs for when I break a leg due to a climbing fall, or end up paralyzed after a bad skiing accident. How do you balance those two things out?
Should we have socialized health care that does not cover self inflicted problems?
Are there genetic tests that can be done to show if someone is obese due to a medical condition (bad genes), or lack of exercise and poor nutrition (bad habits)?
How do you determine if someone’s broken arm is from a slip and fall in a supermarket parking lot (bad luck), or if it was because they were riding a shopping cart down a steep hill behind the lot (bad choice)?
I think it would be great to have socialized medicine cover everything. And tax certain things to pay for the medical costs they may contribute to (sugar would be a great one to start with). Other changes could be made as well.
It would be good to limit “end of life care”, or at least stop people from saying “death panel” so that American’s can at least talk about the subject seriously.
Stop allowing pharmaceuticals to be marketed directly to the consumer. While we’re at it, increase government funding for academic medical research, and stop allowing drug companies to patent medicines for so long.
Legalize (nearly all) drugs, tax the drugs that cause problems (alcohol, cigarettes, crack, etc) to pay for counseling and medical costs.
Increase funding for school lunch and head start programs. Get rid of the junk food in schools.
Probably some other things too.
Cut out the middleman, for most people. Get rid of the insurance companies.
almost agree
but
Well again a balance: drug companies should have financial incentives but in some cases there should be a way to get much needed medications without losing your shirt.