wait a minute lulz are you arguing for abortion now?

well put lul

Trim - I'm entirely for abortion, more or less until the fetus is capable of fighting back with its fists.

fair enough just this confused me thats all innocent babies are murdered by evil, murderous liberals

Okay listen before I get into this I want to be very honest.


I'm 18 years old. I barely have any health problems. I don't really know how healthcare in the US works (I live in the US, though). As far as I know there is your normal doctor (GP) for when you feel sick, and if its really specialized he'll reccomend a specialist (cardiologist, neurologist) and you go to his office. If you are like, dying, you go the to ER and they take care of you. Somewhere along the way you have to pay for it all, sometimes insurance covers some, but maybe not everything. But my parents, in all honesty, do all of that. So what is the deal, really? I know my dad gets our health insurance through his job. So.... what actually happens?

Equally, the bill, I know nothing about. I don't want to hear any more about the over hyped clauses in the bill. What does it actually do, overall? What are they changing, what is going on here, and how much will it really cost? Try to keep as much politics out as possible, just so I can actually understand.

@Thucydides - I don't claim to be an expert on the subject, but I've tried to follow the debates in the news and by talking with people who really know what is going on (public health professors). If anyone who is more closely involved knows more than this, they are probably right, but this should hopefully help at least give an introduction to the topic.

"What actually happens?" As I understand it, there are two major issues here. First is the huge cost of the uninsured. The process you described above is true only for people who do have insurance. Those who don't go through a different system. Hospitals (specifically ERs) are required to treat anyone who walks in, with or without insurance. As a result, if uninsured people ever reach a really bad state, they typically go to a hospital's ER to seek help. This creates two problems - at a smaller level, it puts incredible strain on the ER (it's much harder for them to keep down lines and still respond to real emergencies when the waiting room is full of Joe Flus who would have gone to their GP if they had insurance); at a larger level, it creates huge costs for individuals and taxpayers - once discharged, uninsured patients are billed directly for all the hospital's costs. These can be astronomically high, and probably unaffordable for someone who couldn't afford health insurance in the first place. If the individual can't pay, then the government, which mandates that the hospital treat everyone, is supposed to step in to keep the hospital from hemorrhaging cash, and the government ends up paying a lot (much more than it would pay for simple preventive care).

The second major issue of "what actually happens" is the insurance industry. Since it is a for-profit and largely unregulated industry, insurers do their best to make sure they don't lose money. This means that they often refuse to cover people because of (sometimes very minor) preexisting conditions, contributing to the uninsured problem above - for example, if Fred can't get insurance because he has diabetes, and then breaks his arm in a horrific Diplomacy negotiating accident, he will have to pay out of pocket to get his arm fixed, even though it had nothing to do with diabetes. This problem is compounded by the fact that the health industry isn't perfectly competitive - there are usually fewer than 10 insurance providers in any given state, and a few smaller states may only have a single provider option - so if that provider refuses to cover you, you're basically out of luck. Additionally, insurers will often try to wiggle their way around having to pay for treatments. For example, cancer treatment may be covered, but only as chemotherapy or surgery, rather than a more effective targeted therapy; or, your depression medications might be covered, but only for one prescription every four months, even though you need to buy it monthly. This effectively means that many people with insurance are only "partially insured," and this too contributes to the uninsured problem.

There are other issues with the current system, but as I understand it, this is the core part of the system that needs fixing. Insured or not, medical bills cause more than half of the bankruptcies in the US, and it is this problem, of rising and unaffordable costs, that the bill is trying to fix.

The bill - There are a few in consideration, but "the plan" that everyone is hyping right now is the Affordable Health Choices Act, the only one that really got moving in Congress before the recess. The Wikipedia page for it (http://en.wikipedia.org/wiki/Affordable_Health_Choices_Act) is surprisingly concis, especially compared to the Wikipedia pages on other health topics, but if you don't want to read it there, some of the main provisions, by category, are:
-Regulating the industry: Prohibiting exclusions for preexisting conditions, prohibiting variable costs (i.e., 26-year old Mike from LA pays the same as 26-year old Steve from LA, even though Mike's current plan actually charges him twice Steve's premiums for the same care because Mike's employer is much smaller), limiting the maximum out-of-pocket (deductible) amount a person can pay before the insurance company must step in, and establishing a Health Insurance Exchange which lets small providers or individual policyholders pool their coverage groups to reduce overall costs.
-Expanding coverage: taxing corporations that do not provide insurance and individuals who do not buy it, providing a health insurance tax credit for low income individuals to avoid punishing the poor through the above provision, incentivizing preventive care and long-term solutions (rather than temporary fixes) by reducing payments to hospitals with high readmission rates, and taxing people making over $350k to help pay for the plan.

Cost: The Congressional Budget Office puts it at about $100 billion per year, or about $25 billion per year in net costs when accounting for the taxes it builds in.

Hopefully that helps answer some of the basic questions of the insurance debate in a non-political way. Now you can throw in the politics and go nuts with the debate! Enjoy!

nice liberal spew thread obiwan...

It's not liberal spew. Jacob. Although that thread was incredibly biased.

@jacob: it felt like I was watching network news for a second

Sounds like something Hannity would say.

grncton wrote in part:
>[…] the insurance industry. Since it is a for-profit and largely unregulated industry, […]

I wouldn't call it largely unregulated at all. It is pretty thoroughly regulated, and regulation can cause problems as well as alleviate them. The AHC Act doesn't change that; the question is whether it produces better regulations or worse ones (and the taxes, spending, and bureaucracy that it increases).

For example, why can't Fred get insurance for bone injuries that doesn't cover his diabetes? Partly it's because the industry is, as you say, rather uncompetative, so he doesn't have many plans to choose from, certainly not something unusual like that. But also, I wouldn't be at all surprised if that's simply illegal. I don't know about that case, but I do know that (for example) it's illegal to cover diabetes but not depression.

The simple fact that there are many regulations to comply with also helps explain why the industry is uncompetitive. A small start-up business has to comply with all of the regulations, making their options less flexible and increasing their adminstrative costs. So if you and Fred decide to start a company that just covers broken bones, not only do you have to hire lawyers to make sure that your business plan is legal; even if it is, you still need a bunch of lawyers checking all of the other regulations and adminstration to make sure that you comply with it. So probably, you're not going to make it in this business.

(On the other hand, insurance is inherently collective, so there are market reasons why it will be uncompetitive. Ultimately, this gives an argument in favour of guaranteed government-provided coverage.)

I also don't think that it's relevant that some insurance companies are for-profit. First, not all are; Kaiser Permanente, the largest HMO in the U.S., is non-profit, but it still excludes people (for example, me) for preexisting conditions. Just like for-profit corporations, non-profit corporations are legally required (by common law, not regulation) by ‘fiduciary duty’ to maximise their income and minimise their costs, subject to the organisation's mission. So unless an organisation is dedicated to covering everybody, it's going to start excluding people.

I forgot to say that I mostly agree with what grcton wrote; I just wanted to address that one bit.

Are you kidding me!?

Just wrote this long thing and it didn't even take, damn...

Well, I'll summarize in bullet form:

-Yes, I'm liberal and have a liberal slant; nearly all non-Cronkite news distributors and news personalites and "journalists" have a slant, so sorry- left-wing is mine
-Yes, I mean pro life and anti abortion to mean mostly the same; I used pro life seperately to extend it to encompass Palin's opposition to end-of-life Wills and potential requested euthanasia.
-Yes, I support euthanasia conditionally (ie the patient must be confirmed sane and must have an affirmed and decent rationale for wanting to end their life) as well as (here it comes) abortion; I think abortion should be the very last resort and should not be widely practiced, but I am a firm believer that, religious backers or not, NO ONE, besides the woman should have control over her body, and to force such restrictions on such a basic liberty as what one is allowed to do with one's own body is an extremely dangerous precedent and a can of worms waiting to explode
-I am for base coverage for all Americans healthcare-wise, as healthcare is becoming a such vital part in determining the length and quality of one's life that to deny it would seem to deny one the equal opportunity to long life, good health, and happiness. I believe that above that base there may still be more options for the rest of America (namely those who are currently with a healthcare plan that would include treatments above the base of the proposed "regular" healthcare.)
-I hold a very low opinion of Ms. Palin and an even lower one of Mr. Cheney, whom I would dub the most dangerous man in America, and while I do have a high opinion of Obama, ven with it being tempered with his failings so far, I also have a high opinion of McCain, whom I view as a wholy honest man with some good ideas and some ideas I would not agree with, but nevertheless truly honest, patriotic, inspirational, and an American hero.

That's a nice summary of your beliefs, but what about the reason you started this thread? Your point, I think, was in this cute little couplet of sorts.

"If these mobs DO, as they seem destined to, lead to deaths and assaults, may we count the inciting forces of the said mob as culpable?"

Or was it something else? I don't know what you're trying to say beyond Sarah Palin is wrong. Really, I have trouble understanding what you want to talk about.

I saw that you wanted the opinion of people from countries with state-run health care. I'm Swedish, and most of the health care system here is in the public sector. All pharmacies belong to the state, although this may be changed in a while since we now have a more liberal government instead of the social democrats that have been in power for most of the last 50 years, and most hospitals are run by the state or are at least heavily regularized.

What has this meant to me? Well, I come from a family without much money. My mother is in a wheelchair due to polio as a kid, and my father had a stroke at the age of 45, neither has been able to work for 20 years. They have always received care and help though. My father spent months in hospital free of charge, and my mother recieves wheelchairs and whatever else she might need. The government even sponsored rebulding a car since she can't use her feet, free of charge.

Me? I was hospitalized for a month due to a severe depression. I was unemployed at the time, but since we don't need insurance through our workplace, we're covered by a universal health insurance to a certain degree. A month in hospital and my bill for it, without private insurance, was €6, administrative fees. I now take SSRIs to keep from falling back into depression. 100 mg of Sertraline a day. This costs me approximately €10 for three months of medicine, and if I in some way spend more than €150 a year (which the pharmacies themselves keep track of in their computer system which also allows me to collect my medicine anywhere in the country without any written prescriptions, the hospitals are also connected to it for ease of information transfer) everything else is covered. No doughnut hole, no hidden agreements. In the only other country I lived in, Ireland, the same medicine cost me €70 for one single month. A doctor's appointment there would be around €40, where it is limited to a maximum of €10 here.

Of course there are problems. The health care can be ineffective and slow, there are other problems as well, but I'm not going to go into that since I haven't read enough about it and don't feel like getting into a discussion that seems very American. But I wanted to share my own experience from a social democratic health care system ;)

not to turn this into an abortion thread or anything, but this comment drives me crazy:

"NO ONE, besides the woman should have control over her body, and to force such restrictions on such a basic liberty as what one is allowed to do with one's own body is an extremely dangerous precedent and a can of worms waiting to explode"

go do some DNA testing on that "fetus" and then tell me it's the woman's body.....

obiwan, you made alot of large sweeping statements against pailn in your fisrt few posts, granted, I didn't erad through the entire thread just because of how long it's getting, but I didn't see you provide any proof at all for your accusations against her. infact, I don't even think you posted the entire facebook status.

could you please provide more evidence?

and I would just like to throw out the idea that the world is not a fair and equal place. to say everyone is equal as human beings is completely correct. However, to say that each human being deserves a certain thing (in this case free health care) is erroneous. It is a common rule of nature that he who works hard and well at what he does will gain, and he who is lazy will not gain. So it messes with a basic natural principal. There's never a free lunch, if you know what I mean.

Yes, it is a basic natural principle that people get sick and die. Physicians should stop messing with that!

@jman777: "It is a common rule of nature that he who works hard and well at what he does will gain, and he who is lazy will not gain."

Are you saying that everyone who is poor or disadvantaged is in that position due to their own laziness?

no I'm not, but it isn't fair to give lazy people the same benefits as hard working ones.

that was my point, I don't think I did a very good job expressing it at first. but basically, people should be rewarded according to their merit.

Do you think the current system does that?

I would rather that the government just give people benefits rather than get (further) into the business of judging who is good (hard-working but unlucky) and bad (lazy bum).

Also, a particularly interesting question for health care: What if a lazy person seeks psychiatric care for depression? Laziness (they call it ‘Loss of interest in normal daily activities’ officially) is one of the most common symptoms of major depression, which can often be successfully treated with counselling and/or medication.

To clarify my first paragraph: I don't want the government making those decisions on an individual basis. I agree that, overall, you have to make decisions like this to decide which procedures and programmes to fund. And it's true that not having government benefits at all solves this problem; I just mean that, given that the government is going to get into providing some sort of benefit, I would rather that it be done uniformly rather than through individually judged cases. That may or may not have any bearing on what you want the government to do, jman777.

@Tony Bartels: Yes, it's one of the most common symptoms, but you can't get the diagnosis of clinical depression just from lack of motivation. Believe me, I've had several depressions. There are loads of other symptoms, hurting yourself, recurrent thoughts of death and suicide, fear of being physically ill, fear of going crazy, sudden weight changes, sleep disruption, decreased motor skills, physical weakness... Several symptoms should be confirmed before a physician can give you that diagnosis, and believe me, it would take one hell of an actor.

Actually, Vaftrudner, I was thinking the other way. Of course laziness alone doesn't qualify as depression; but many lazy people *are* lazy *because* they're depressed. (I was, once. I'm still kind of lazy, but not like that.) So it would be bad if the government refused to cover medical treatment on grounds of laziness if this kept people from curing their laziness by getting treatment for depression.

Oh, sorry, I misunderstood completely :) I'm with you.

And spelled your name wrong... Sorry.

Obama's healthcare plan is not evil. Stupid, sure, but not evil.