What did Democrats do wrong?

[jimbob]

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

Of course not. A successful healthcare system is one that guarantees a long life to young multimillionaire cancer patients.

 

[jimbob]

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.

And it's not just cancer. That thread I linked to had multiple examples.

One thing that springs to mind is that millions of Americans will have chronic health conditions that can be almost totally managed by drugs with little extra impact on their lives beyond the need for the drugs.

 

[Silly Green Monkey]

Yeah, I had cancer. Months of chemotherapy, deeply invasive surgery, and weeks of daily radiation, and I'm cured. They had me on a (normally expensive) drug to prevent testosterone from converting to estrogen for ten years, now they're pretty sure all possible remaining seed cells are dead. I will have to be on cholesterol-reducing drugs for the entirety of my life, as my liver believes the level of fat in my blood should be off the charts. Without those, I'd have arteriosclerosis by now, and an early heart attack. With them, I can stay healthy for decades more of likely constant physical labor.

 

[Helen]

To me, the most important argument for universal healthcare is the humanitarian one, and I really think the fact that it alleviates suffering should be enough. But universal healthcare is of course good for society as a whole as well - the whole being able to contribute, if you have prevetative treatment where it is possible, or help to manage a disease, instead of relying on emergency care, when it's too late, etc etc ad infinitum. We all benefit, and it costs less for everyone involved, including taxpayers.

Also, damn you, jimbob, for making me read that old thread. I could have spent that time so much more productively by hitting my head against a wall.

 

[Lukraak_Sisser]

I get that in the US only the aristocracy gets good healthcare, as the US view seems to be that your birth alone determines your worth, fortunately I live in a country that feels that we should all share the burden for healthcare, relative to our income, to ensure we all have at least good healthcare, with the rich still being able to afford extra should they wish to do so.

 

[W.D.Clinger]

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?

I doubt whether the Democrats' opposition to death panels was the main thing they got wrong, but it's invigorating* to see someone thinking out of the box here.
*In this context, invigorating might not be quite the right word.

 

[dirtywick]

how about instead of trying, we give up?

 

[jimbob]

how about instead of trying, we give up?

The US is exceptional. Despite the fact that Canada managed to move from a very similar model of healthcare provision. It would be impossible for the US to emulate

 

[Emily's Cat]

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.

The red bit is the necessary part. And that's what is entirely lacking in proposals for the US. That's how cost gets controlled.

 

[Emily's Cat]

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.

I think a planned step-wise approach is probably the best way to go about it. In part, because the US is heavily fractured in terms of how care gets accessed. In my view, the most reasonable first step is to directly address the cost-side issues - start with either the government setting prices or ranges for prices, or the government being the employer/owner for delivery. I don't know which would be the least disruptive... but either of them is likely to be strongly opposed by AMA and other medical associations that have really big lobbies. But if we can't get a handle on the underlying costs, I really don't think any changes to the insurance/packaging has any chance to be effective.

 

[Emily's Cat]

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.

That's really a sucky experience. I can't speak to your insurer on this, but I will say that this isn't commonplace today. It's entirely true that the other driver's auto insurance is liable for your injuries... but it would be rare for a health insurer today to deny coverage at the outset. Not impossible - just like anything else, some companies are worse than others. The more common approach is that your medical insurance would adjudicate the claims, make the hospital whole, and then would subrogate the claim with the driver's auto insurer.

As a minor item... Short Term Medical plans are a whole different animal, and they are NOT health insurance. It's absurd, but they're actually regulated as a Life insurance product, and they absolutely will deny claims if the injury resulted from an auto accident. Or from parachuting or rock climbing, or anything else they deem "hazardous activities". There are a very few situations where a short term medical plan might make sense, but I would generally recommend against them.

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.

Public Service Announcement: Hospitals can send you to collections, and the collection agency can hound you about it all they want. But they can't use it against your credit score, nor can they garnish your wages or anything like that. They can annoy the crap out of you, mostly. If it's a particularly large amount, they could hypothetically take you to small claims court.

 

[Emily's Cat]

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?

Mmm... with a few exceptions on older "grandfathered" plans, almost all coverage has an out of pocket maximum that is significantly lower than $120K. That said... it's not uncommon for the OOPM to be $10K for an individual, or $20K for a family - and that's far more than most people can handle. At some point, that extra $100K just doesn't make a difference

 

[bruto]

That's really a sucky experience. I can't speak to your insurer on this, but I will say that this isn't commonplace today. It's entirely true that the other driver's auto insurance is liable for your injuries... but it would be rare for a health insurer today to deny coverage at the outset. Not impossible - just like anything else, some companies are worse than others. The more common approach is that your medical insurance would adjudicate the claims, make the hospital whole, and then would subrogate the claim with the driver's auto insurer.

As a minor item... Short Term Medical plans are a whole different animal, and they are NOT health insurance. It's absurd, but they're actually regulated as a Life insurance product, and they absolutely will deny claims if the injury resulted from an auto accident. Or from parachuting or rock climbing, or anything else they deem "hazardous activities". There are a very few situations where a short term medical plan might make sense, but I would generally recommend against them.

Public Service Announcement: Hospitals can send you to collections, and the collection agency can hound you about it all they want. But they can't use it against your credit score, nor can they garnish your wages or anything like that. They can annoy the crap out of you, mostly. If it's a particularly large amount, they could hypothetically take you to small claims court.

That last part may be, but a hospital apparently can garnish wages if it wins a court case, and to suggest that the amount involved in hospitalization for a near-fatal, coma-inducing injury is within the bounds of small claims court is certainly wishful thinking!

I do agree with the first part, that this is how the health insurer should have behaved. What they actually did was initially pay for the first little bit and then take it all back and deny coverage both ongoing and retroactively. Their response was basically "so sue us."

Mind you, this situation would also have been considerably different if Vermont, like some other states had "no fault" auto insurance. I am not entirely sure, but I believe the offending driver's insurance would have paid out then without years of hassle and arbitration. Not the case here, though, anyway.

 

[Emily's Cat]

That last part may be, but a hospital apparently can garnish wages if it wins a court case, and to suggest that the amount involved in hospitalization for a near-fatal, coma-inducing injury is within the bounds of small claims court is certainly wishful thinking!

I didn't intend to imply that the amount was small. Mostly, I just don't think "large claims court" is a thing, is it?

I do agree with the first part, that this is how the health insurer should have behaved. What they actually did was initially pay for the first little bit and then take it all back and deny coverage both ongoing and retroactively. Their response was basically "so sue us."

Mind you, this situation would also have been considerably different if Vermont, like some other states had "no fault" auto insurance. I am not entirely sure, but I believe the offending driver's insurance would have paid out then without years of hassle and arbitration. Not the case here, though, anyway.

That really does suck, bruto.

 

[Brainster]

Of course not. A successful healthcare system is one that guarantees a long life to young multimillionaire cancer patients.

Steve Jobs?

 

[Mongrel]

Steve Jobs?

Not young, he was 56 when he died, and he may have made it if his first choice hadn't been quackery

 

[Brainster]

A bad idea coming out of Texas, that I'm afraid is symptomatic:

Democrats are running for every legislative, statewide and federal race in the Lone Star State:

This is a symbolic win. It’s also structural. Filing someone in every race forces Republicans to defend their turf instead of coasting on uncontested seats. It stretches their resources, exposes their records, and creates opportunities where the pundits swear none exist.

It does those things in some districts in a wave election, and absolutely I'd recommend them running candidates in every congressional race, just because the GOP has diluted its relative strength in quite a few districts. But minor state legislative seats in rural Texas? The Democrats can't win there currently and it is silly to try. Both parties have limited resources and should concentrate their efforts and dollars in districts where they actually have a chance to win.

 

[Random]

A bad idea coming out of Texas, that I'm afraid is symptomatic:

Democrats are running for every legislative, statewide and federal race in the Lone Star State:


It does those things in some districts in a wave election, and absolutely I'd recommend them running candidates in every congressional race, just because the GOP has diluted its relative strength in quite a few districts. But minor state legislative seats in rural Texas? The Democrats can't win there currently and it is silly to try. Both parties have limited resources and should concentrate their efforts and dollars in districts where they actually have a chance to win.

It's not about winning those races, it's about shaving points at the margins, and keeping the Democratic brand visible. In large parts of the country, the only thing Republican voters hear about Democrats is what Republicans tell them. By running for everything, it is far more likely that voters in red states will hear actual Democratic ideas, making them more likely to vote Democrat in the long run.

In the short run, it risks diluting Democratic resources in unwinnable races, but we have been using the "only run in races we might win" strategy for several election cycles now and it just doesn't work in the long run.

Also, state rep and senate seats are important, as they are the guys drawing gerrymandered maps and passing wierd voting laws.

 

[plague311]

It does those things in some districts in a wave election, and absolutely I'd recommend them running candidates in every congressional race, just because the GOP has diluted its relative strength in quite a few districts. But minor state legislative seats in rural Texas? The Democrats can't win there currently and it is silly to try. Both parties have limited resources and should concentrate their efforts and dollars in districts where they actually have a chance to win.

Campaigning is expensive, that's for sure, but is just filing paperwork to run for office really budget busting? I can't imagine it's more than a few hundred bucks and if you don't do any campaigning but just want to make the GOP put forth a bit more effort it honestly seems like an easy win.

The Dem party probably won't spend too much in Texas, but it's worth dropping a few bucks in the jar and shake it up a bit.

 

[plague311]

Also, state rep and senate seats are important, as they are the guys drawing gerrymandered maps and passing wierd voting laws.

Just to add, Trump is alienating A LOT of demographics right now, rural white people included. Issues with medical care, tariffs, etc. It really can't hurt to just test the waters.