What did Democrats do wrong?

[Emily's Cat]

This is ironic because you just "corrected" me about healthcare vs health insurance, yet you give a prime example of how, previous to the ACA, people couldn't, or wouldn't, go get care because they wouldn't qualify for insurance. So it was either pay out of pocket, which most people couldn't afford, live with undiagnosed illnesses or go to the Emergency room (Which we all know is cheap), not pay that bill which the hospital then recovers by raising prices for everyone else! Brilliant!

Seriously, dude. You're still missing the point I was trying to make. For all intents, you're arguing that some people couldn't get car repairs because they couldn't get affordable car insurance.

Insurance makes repairs more accessible to more people; but nobody was denied repairs just because they didn't have insurance. Lack of insurance does not equate to lack of repairs. Anyone who does repairs will happily repair your car as long as they get paid. And they usually don't much care who pays them. Having insurance lets people who otherwise wouldn't be able to afford the cost of their repairs get those repairs by having other people pay part of the cost of the repairs.

Care in the US is too expensive. That's the end of it, right there. Insurance is just packaging, and it doesn't have a way to materially reduce the cost of care.

 

[plague311]

Seriously, dude. You're still missing the point I was trying to make. For all intents, you're arguing that some people couldn't get car repairs because they couldn't get affordable car insurance.

No, I'm ◊◊◊◊◊◊◊ not because getting your car repaired generally has nothing to do with car insurance. If I blow an alternator I'm not filing a ◊◊◊◊◊◊◊ claim. If I need an oil change I'm not calling my insurance agent. You're terrible at comparisons.

Insurance makes repairs more accessible to more people; but nobody was denied repairs just because they didn't have insurance.

Cool, never said they were so I have no idea why you're telling me this. I merely made a correlation between having health insurance and getting healthcare. Every single visit to a hospital involves insurance, if you have it. Every visit to the mechanic, every issue with my house doesn't involve my ◊◊◊◊◊◊◊ insurance getting involved. For someone with the highest credentials in the land, and most experience I feel like you should already understand this.

Lack of insurance does not equate to lack of repairs.

Yes, it ◊◊◊◊◊◊◊ does. It so does. If people don't have insurance they aren't REFUSED "repairs", but they definitely ignore needed repairs until they're emergencies. That's common sense.

Anyone who does repairs will happily repair your car as long as they get paid.

No ◊◊◊◊.

And they usually don't much care who pays them.

No ◊◊◊◊, as long as they get paid. If people can't afford to go to them because they have no means to pay them, then they don't go to them and the "car" suffers, gets worse, and eventually stops running because the "owner" couldn't afford to repair it.

Having insurance lets people who otherwise wouldn't be able to afford the cost of their repairs get those repairs by having other people pay part of the cost of the repairs.

Sure.

Care in the US is too expensive. That's the end of it, right there. Insurance is just packaging, and it doesn't have a way to materially reduce the cost of care.

That makes no sense, but hey, what do I know? I'm just some dummy with no experience in the medical insurance industry trying to keep my own car running.

 

[Segnosaur]

I have no objection to the state fixing the idiocy of the US health care system. The only thing I object to is the short-sighted proposal that the government should socialize insurance while leaving the delivery system privatized and for-profit. That's a recipe for disaster.

Canada has a system like that.... Government funds basic health care treatments, but doctors offices, MRI clinics, etc. are run as private businesses. Fees for basic services are negotiated between the government and the doctors. It is a flawed system, but it still works (and certainly works better than the US system.)

Sick people don't have to worry about paying for treatment. Doctors are assured they will always get paid, without having to negotiate with a dozen different insurance providers. Government doesn't have the headache of running dozens of health care clinics.

 

[TragicMonkey]

Canada has a system like that.... Government funds basic health care treatments, but doctors offices, MRI clinics, etc. are run as private businesses. Fees for basic services are negotiated between the government and the doctors. It is a flawed system, but it still works (and certainly works better than the US system.)

Sick people don't have to worry about paying for treatment. Doctors are assured they will always get paid, without having to negotiate with a dozen different insurance providers. Government doesn't have the headache of running dozens of health care clinics.

Such a system could at the very least serve as a transition into something better, for the US. I don't know why so many people insist we can't have any change unless and until we can switch on an absolutely perfect system all at once.

 

[bruto]

I think one of the things being missed here is that although it's true that hospitals will give you medical care even if you are utterly and permanently impecunious, this does not mean they won't attempt to charge you. They WILL bill you, and they WILL try to collect their fees, and if you are not utterly bankrupt before your treatment, you might well be after! And the health insurance industry and system is so badly set up that it's quite possible for this to happen even if you are insured, if the insurance provider decides not to pay.

I have an anecdotal note on this. Some years ago I was seriously injured in a bicycle accident, in which a car hit me on the road. The hospital and medical charges ensuing were very large, though not as large as some others I'm sure, but many thousands of dollars. I had health insurance, but because a car was involved, my health insurer claimed the car's insurer should be liable, and simply refused to pay anything, forcing me to sue the driver, whose insurance company of course stalled and balked for years. Now it's also true that what my insurance company did was probably if not illegal at least unethical, but the only way I could have handled this was to sue them! During the couple of years that this dragged on, the hospital relentlessly dunned for its fees, finally sending the bill to a collection agency, even though my lawyer, who knew the law, informed them multiple times that this action was also illegal while the case was under litigation. Eventually a barely-sufficient settlement was negotiated with the driver's insurance (she was quite emphatically at fault here), and after some negotiating by the lawyer to reduce the fees, the bill was paid.

So yeah, it's true that I got treatment without insurance, and had I been already bankrupt I presumably would still have gotten that treatment. But it is also the case that the hospital made continuous effort to recover its fees, and if my resources were equal or less than those fees, they would have taken it all.

Quite a few years ago, when my sister was undergoing extensive and hugely expensive treatment and hospitalization for the leukemia that killed her, she had a fantastically good insurance policy that paid everything. (Such policies, in this case a group policy through the Grange, no longer exist.) But this did not prevent the hospital from presenting her, every time she left, with a bill that, on the day of issue, was labeled "past due." Had the insurance not paid, she would have been instantly liable for all of it.

It's not trivial. People who are poor are threatened with homelessness over medical debt.

 

[jimbob]

Such a system could at the very least serve as a transition into something better, for the US. I don't know why so many people insist we can't have any change unless and until we can switch on an absolutely perfect system all at once.

Remember that Canada and the US had the same type of system until the 1970s

 

[Random]

Such a system could at the very least serve as a transition into something better, for the US. I don't know why so many people insist we can't have any change unless and until we can switch on an absolutely perfect system all at once.

A good number of the people saying we can't have any change without that perfect option are benefitting greatly from the status quo and want it to continue. See the oil company spokespeople who will tell you all about the enviornmental costs of building solar panels...

 

[theprestige]

A good number of the people saying we can't have any change without that perfect option are benefitting greatly from the status quo and want it to continue. See the oil company spokespeople who will tell you all about the enviornmental costs of building solar panels...

It's not like the people who like to agonize over the environmental costs of fossil fuels are going tell you much about the environmental costs of solar panels.

 

[TragicMonkey]

It's not trivial. People who are poor are threatened with homelessness over medical debt.

Not just the poor. I used to work for an oncology clinic. I've seen the bills. Every American who isn't a multi-millionaire is one diagnosis away from destitution.

And for the people who just said "oh, not me, I make good money and I have good insurance* and savings!"....that's exactly what a lot of people said before they cashed in their 401Ks, sold their houses, and pulled their kids out of college. One. Diagnosis. And is that a lump? Has that always been there? LOL sleep well.

*"Good" insurance in the US, the typical employer plan, will cover something like 80% of the costs. Sounds great, huh? Here's your bill. It's $600,000. Your share of that is $120,000. Got that in your pocket?

 

[theprestige]

Keeping people alive past a certain point gets very expensive very quick. Cancer is the end that awaits all of us who dodge or survive the lesser constraints on human longevity.

Death is part of life. If you get diagnosed with cancer, is it really the most ethical thing, to bankrupt yourself and your heirs, in violent rejection of the end that has naturally found you?

 

[TragicMonkey]

Keeping people alive past a certain point gets very expensive very quick. Cancer is the end that awaits all of us who dodge or survive the lesser constraints on human longevity.

Death is part of life. If you get diagnosed with cancer, is it really the most ethical thing, to bankrupt yourself and your heirs, in violent rejection of the end that has naturally found you?

Hate to break it to you, but young people get cancer, too.

 

[theprestige]

Hate to break it to you, but young people get cancer, too.

Nobody is guaranteed a long life.

If your idea is that a successful government healthcare system is one that guarantees a long life to young cancer patients... Cancer doesn't work that way.

But we're not talking about young cancer patients. We're talking about people who have lived sixty years or more, who have amassed wealth, and who are now burning up that wealth trying to buy back a few more days of unearned life at the expense of their heirs.

 

[TragicMonkey]

Nobody is guaranteed a long life.

Well, duh. But please don't tell that to a dying four-year-old, or their parents.

If your idea is that a successful government healthcare system is one that guarantees a long life to young cancer patients... Cancer doesn't work that way.

That wasn't "my idea". It's your strawman. All I've done was point out that it's not just the American poor but also the comfortably middle class who need to worry about medical expenses.

But we're not talking about young cancer patients. We're talking about people who have lived sixty years or more, who have amassed wealth, and who are now burning up that wealth trying to buy back a few more days of unearned life at the expense of their heirs.

You may be talking about that, but I wasn't. You've gone off on a tangent arguing against something nobody's said.

 

[jimbob]

Not just the poor. I used to work for an oncology clinic. I've seen the bills. Every American who isn't a multi-millionaire is one diagnosis away from destitution.

And for the people who just said "oh, not me, I make good money and I have good insurance* and savings!"....that's exactly what a lot of people said before they cashed in their 401Ks, sold their houses, and pulled their kids out of college. One. Diagnosis. And is that a lump? Has that always been there? LOL sleep well.

*"Good" insurance in the US, the typical employer plan, will cover something like 80% of the costs. Sounds great, huh? Here's your bill. It's $600,000. Your share of that is $120,000. Got that in your pocket?

Yup, about 17 years ago I was discussing this with Dr (now professor) Deborah Thorn. At the time 75% of medical bankruptcies had had medical insurance at the start of their illness.

 

[bruto]

Keeping people alive past a certain point gets very expensive very quick. Cancer is the end that awaits all of us who dodge or survive the lesser constraints on human longevity.

Death is part of life. If you get diagnosed with cancer, is it really the most ethical thing, to bankrupt yourself and your heirs, in violent rejection of the end that has naturally found you?

Wow. You do realize, don't you, that cancer has many forms and many levels? Some afflict the young, some can be cured or palliated for a very long and productive time. People have also died from Covid, Flu, appendicitis, compound fractures, and a myriad of other injuries and ailments that afflict young and old, good and bad, poor and wealthy. What you have just said could be easily applied to all medical care of all sorts for all people!

Not all battles can be won, but sometimes we might be excused for trying. You may think that since my sister died at 30 she might just as well have given up at 28 and gone quietly into that good night, and my father too, who made it to 50 and a failed remission, but not all would agree.

Further comment on this best left unsaid!

Posting this after your clarification, I will note that this is not what your original post either said or implied. If you believe it did, you have not thought very carefully about what you wrote, and that is the kindest assessment of it.

 

[TragicMonkey]

Yup, about 17 years ago I was discussing this with Dr (now professor) Deborah Thorn. At the time 75% of medical bankruptcies had had medical insurance at the start of their illness.

What disturbs me the most is that most people's insurance is through their employment. So that's good...unless they get too sick to work. No more job, no more insurance. All the eggs in one basket there.

 

[jimbob]

What disturbs me the most is that most people's insurance is through their employment. So that's good...unless they get too sick to work. No more job, no more insurance. All the eggs in one basket there.

Exactly

 

[Helen]

Someone i loved died recently of cancer. He lived with it for eight years, which was far longer than the one or two, which was what he was told when he was diagnosed. The quality of his life was remarkably good for most of those eight years as well, thanks to a very new (only approved a few months earlier), and wildly expensive drug. Before it became available, the time he had left would have been a nightmare (which it became, once the cancer, after several of those years, had outsmarted the drug). Luckily, he lived in a country with universal healthcare, otherwise the story would have been even darker; we were in touch with others with the same diagnosis in the US. Their insurance did not cover the drug. None of them could afford it. It was heartbreaking. The drug was developed in their country, but they could not get it.

This is shameful, and also wasteful, for society as a whole as well as for the individuals.

 

[jimbob]

Yup, about 17 years ago I was discussing this with Dr (now professor) Deborah Thorn. At the time 75% of medical bankruptcies had had medical insurance at the start of their illness.

It was 2009,

BeAchooser,

I have been in email correspondence with one of the author of the study I was referring to, Deborah Thorn:

http://www.pnhp.org/new_bankruptcy_study/Bankruptcy-2009.pdf

And she states that this is (as of September 2009) is probably the most accurate:



If you look at the figures, you see that the mean medical bills are similar to the mean annual income for the group defined as medical bankruptcies. This is not insignificant.

Unfortunately I don't have access to the median figures, which I would prefer.

 

[Helen]

What made it even more heartbreaking, is that neuroblastoma is extremely rare in adults, but more common in children under seven (it's viewed as a pediatric cancer). They have a far better chance of surviving for longer on this new type of drug, than adults do. If they get it, of course.

Heartbreaking? Enraging. And this is only one small example of how broken the system is in the USA. There are problems with universal healthcare as well, but they are minor in comparison.

Oh, and if anyone thinks it's better for those children, and adults, to get to die more quickly, then first if all, ◊◊◊◊ you, and secondly, that death will be far more nightmarish, for the patient as well as their family.