My republican friend had some questions about Universeal Health Care that I'm not sure how to answer

[CherylK]

She sent me this email...

How much would be taken out of each paycheck (percent or $) if we go to universal health care. I assume it would be listed like social security is on each paycheck, or like when I worked at Menards, they deducted $37 out of my paycheck. But how does someone who doesn't have a job (like me) pay or qualify (does someone else pay)?

I was just thinking if there are people out there who live paycheck to paycheck and dont have health insurance now b/c they cant afford to have anymore money taken out of their check, if it is universal health care, they won't have a choice. It protects everyone else b/c we wont need to cover the cost of uninsured emergency visits but there were plenty of people at Menards who chose not to have health insurance b/c they couldn't afford it and that $37 was the most expensive choice (it went down from there, and that was every 2 weeks). I'm sure there are millions of Americans in this position though.

Also, don't we need to get more doctors, nurses and hospitals? (plan this first, w/ the plan that we will eventually move to UHC) Our Emergency rooms are already full and doctors visits are weeks out, now add 47,000,000 more people to the mix. Do we have the infrastructure?
Won't the price of Elective surgerys go up because the doctors are so busy doing 'life saving' surgerys that in needs to be made worth their while to make time for an elective.

I have more questions but I'll start w/ these. I couldn't figure out why we wouldn't already have UHC but then I started breaking down how it would be implemented and it didn't seem so cut and dry. How much will it cost to insure and allow all needed (plus wanted) surgerys for the already insured(?#) plus 47,000,000.

And I guess the biggest question is....Do we really trust the federal government to take care of something this important? (when have they not fucked up?)

[GreenPartyVoter]

1. All the feds should be doing is paying the bill. The care management shouldn't

involve them in any way.

Has your friend seen "Sicko?" Someone may have a link for watching it online.

[evlbstrd]

2. Start with Medicare.

It's one of the most successful social programs going. It costs less to administer than private insurance plans. And we already pay into that.

[Crunchy Frog]

3. Watch this Frontline program online.

http://www.pbs.org/wgbh/pages/frontline/sickaroundtheworld/

It describes about half a dozen different universal healthcare systems that all work fairly well. I'm sure if this country puts its mind to it, it can figure out how to do what every single other industrialized country manages to do.

Edit: forgot to include link. :blush:

[aquart]

4. They didn't fuck up Social Security. Or Food Stamps.

Which plenty of Americans are surviving on.

Now make your foolish friend watch Sicko and refuse to discuss this until she does.

[Warpy]

5. OK, here goes

"How much would be taken out of each paycheck (percent or $)..." What we do know is that it would be far less than is taken out for profit driven insurance. Administrative costs are nearly 50% of a profit driven premium, but only 3% of a Medicare premium.

How about people who are minimum wage or unemployed? There would be a sliding scale for unemployment check deductions and the destitute would have the premiums forgiven. This would slightly increase the cost to the rest of us, but savings would come when these people were able to see a doctor in a timely manner, not delay until a month in an intensive care unit--still on our dollar--is needed the way it is now. Do the math yourself, a $30/month prescription versus a $500,000 hospital stay.

The lack of medical professionals is a completely different issue and unrelated to how we fund payment to doctors and hospitals. I can speak for the nurses and say that what has driven 50% of licensed nurses out of the profession is the brutality of working conditions in a system where profit is king and cost cutting happens first on the backs of patient care staff.

As for the last, the whole theory behind insurance is spreading risk around so that modest contributions by everybody will cover the catastrophes suffered by the few. That's why any national insurance we have must be universal. The healthy have to buy into it along with the sick to spread the risk. They needn't worry, though. One thing we can all count on is that someday we, ourselves, will get sick and contributions from other people will pay for our care.

[many a good man]

10. Best answer.

Short paraphrase: We can insure everyone at the same cost you pay for insurance now.

With govt as the sole payer, we can negotiate lower prices, thereby providing more services at lower cost.

[harun]

13. Exactly, take the 9 billion of PROFIT out of the profit column and in to the

care column, add in the amount employers and individuals already pay, then add in all the wasted money on administration costs, then add in all the time and money wasted by hospitals and doctors fighting with insurance companies to get them to pay, then add in all the money saved from the for profits that they will no longer have to spend on figuring out how to NOT pay your bill and you wouldn't have to pay much more, may even be less.

[goodgd_yall]

6. This is what I have to say about government fucking up

If the republicans and some DINOs didn't keep trying to undermine social welfare programs as well as agencies by cutting funding, these programs would run much more smoothly. Government can very effectively take charge of our health care, but we have to make sure once it's on board that the Republicans and any other "fiscal conservatives" (conservative only when it comes to regular people) don't start messing with it.

[jpak]

7. Tell her we already have "Universal Health Care" - its called the Emergency Room

and they already take it out of her paycheck

[liberalmuse]

8. Oh for Chrise sakes...

The information is out there. Can your friend fucking google? Why do we always have to spoon feed the twerps who don't know their heads from their asses? They just end up discarding the information and sneering at us anyway. I swear to god, I've yet to meet a single Republican who has bothered to try and educate themselves on the issues. They need blustering pimps like Rush and Hannity to swallow every piece of shit propaganda out there, then regurgitate it as even more toxic, hateful lies, and spit it into their gaping mouths.

Okay. I need to start drinking. The way I'm going, I'm liable to get booted off of DU tonight. I'm having one of those, "I'm mad as hell and I'm not going to take it any more!' moments. :mad:

[Greyhound]

11. You're right, but it is better than letting the other side do it and it isn't really hard.

I know how you feel, but the fact is many (most?) Americans are just too disinterested, and frankly stupid, to do it for themselves. I just hope that eventually they notice that what I've told them holds true and what the reich-wing tells them turns out to be lies.

But most days I feel just like you do today.


:toast:

[ContinentalOp]

9. I'll take a stab at it. Assuming we're talking about Obama's plan...

How much would be taken out of each paycheck (percent or $) if we go to universal health care.

None. Under Obama's plan you're not required to buy anything and you can keep your current health care if you like.

Also, don't we need to get more doctors, nurses and hospitals?

Regardless of what the Republicans would have you believe, this is not socialized medicine. Doctors and hospitals would still be private businesses. The government would have no role in staffing issues or hospital construction issues.

Our Emergency rooms are already full and doctors visits are weeks out,

Emergency rooms are full of people who don't have real emergencies because it's their only option. If more people have access to preventative care, we will ease the burden off of emergency rooms. And maybe you should find a different doctor. My doctor can see me within hours. I used to have a different doctor who made it much harder to get an appointment. These are privately owned businesses and the government has nothing to do with that aspect of their service.

Won't the price of Elective surgerys go up because the doctors are so busy doing 'life saving' surgerys that in needs to be made worth their while to make time for an elective.

I don't know any statistics on this but common sense tells me that the same surgeon is probably not doing a triple bypass and a nose job. I don't see the issue.

And I guess the biggest question is....Do we really trust the federal government to take care of something this important?

No, the biggest question is: is it really ethical to allow private industry to profit off of people's sickness and misery? Should it be legal for insurers to deny treatment or drop patients, simply to increase their bottom line? Because that's how the system works as it stands today.

[The Straight Story]

12. Sounds like a good response to me

good job!

[CherylK]

18. Thanks to everyone who took the time to answer each question!

:grouphug:

[iamjoy]

14. Well, For Starters

Let's not confuse a universal health care system with a single payer system (often called "socialized medicine.")

Universal health care can be reached by government working with private insurers and employers. Hawaii has laws requiring employers to pay a certain portion of their employee's premiums. If a person chooses not to enroll in his/her employer plan, then he/she must submit a form to the state Dept. of Labor.

How universal health coverage would work would depend upon what kind of deal was worked out. Most people who advocate the government taking a role in this through mandates also believe the government should help low income people afford coverage. But, guess what - they are doing this now through funding for Medicare, Medicaid and the Children's Health Insurance Program. A universal plan would just expand this to pick up people falling through the gaps - often because they make too much for medicaid but don't have access to a group plan.

In a single payer system (like Canada) we can expect our taxes to go up, although we wouldn't have those deductions for health insurance. Whether or not it would be broken out (like our Social Security taxes) or bundled in with other taxes is anybody's guess.

Yes, we seem to have a shortage of medical professionals in some fields, but I would ask her who she thinks should be denied care because there aren't enough doctors. Should we triage on need or financial wealth? There are studies that indicate many of us who do have money, or good insurance, have unnecessary treatments and procedures. An example of this is doctors prescribing antibiotics for a virus. Antibiotics only work on bacterial infections, but in our current set up, it is often easier for the doctor to write a prescription than to explain why he/she won't. Speaking of drugs, the pharma companies advertise heavily on television, creating a nation of hypochondriacs running to their doctor to get the latest medicine. Plus, it's easier for the doctor to write the prescription for the newest statin (anti-cholesterol) than to tell the person to exercise and stop eating all the fried crap and sugar. Some healthcare companies do have "wellness" or "lifestyle" programs, but people change jobs and coverages so frequently, they don't always see the benefit. A government run program would see the benefit in wellness incentives.

Our current employer driven health insurance system was established when people worked for a company their whole career. Now, people change jobs every year making the current system a patchwork.

[roamer65]

19. Our "taxes" really won't go up under a single payor system.

Most working Americans now already pay a "tax" for healthcare. It is the deduction from your check for the portion of the premiums your employer won't cover. Plus we pay the 1.5% for Medicare as well.

[canetoad]

15. We pay a levy of 1.5% of taxable income

Here is the Australian Tax Office webpage explaining the Medicare levy http://www.ato.gov.au/individuals/content.asp?doc=/content/17482.htm.

It is included in income tax, there is no seperate bill. Those who have no or very little taxable income pay little or nothing. Administration of the health system and medical care is still in the hands of doctors, hospital administrators etc. The government has absolutely nothing to do with your health care. Some doctors 'bulk bill' - a system whereby you pay nothing and the medical provider is reimbursed by the government, others bill you and you take your account to any Medicare office for a rebate.

Edit to add: This was set up by Gough Whitlam's Labor government in the 70s and no intervening conservative governments have DARED to try to dismantle it.

[tpsbmam]

16. Lots of info for you

For starters, I just want to say I'm happy to see a Republican asking such thoughtful questions. These are legitimate questions and deserve ligitimate answers. Sadly, I can't directly answer much of it but I can suggest you send her some or all of the information below.

She's paying for other people's health care now and she's paying through the nose. She's paying the bill for everyone who isn't insured, shows up in the emergency room and can't pay. That's WAY more expensive than providing someone with regular preventative healthcare. She's paying every time someone is hospitalized and can't pay. That's WAY more expensive than providing regular preventative healthcare and preventing some of those hospitalizations.

Yes, we need more doctors and nurses (though if we had universal health, we wouldn't need them in the ER). Medical school enrollment is going down -- it no longer pays as well to be a doc when they have HUGE malpractice insurance bills and HUGE student loans. Our system is incredibly flawed and this is something that needs to be addressed.

Anyway, this is getting too long -- these are extrapolations from a letter (with references) I sent to a local Dem candidate who supported a very weak version of "universal" (hardly) healthcare. I'm very sorry about the formatting (or lack thereof) -- it's really late for me and my bleary eyes just don't have the strength to go through HTML formatting.

Since 1998, the insurance industry was second only to pharmaceuticals when
it came to pouring money into Washington. I support your view that the oil
lobby is greatly problematic - to provide you with a comparison, oil and gas
money poured into Washington is number 8 on the list.



Reference: Open Secrets --
http://www.opensecrets.org/lobbyists/index.asp?txtindextype=i


Since 1990, the insurance industry has contributed $281,058,830 to
politicians, with Republicans overall taking 64% of those donations. The
shift in donations is easily seen as the insurance industry needs to cater
more to Democrats in 2008, when donations are more evenly split: 51% to
Republicans and 49% to Democrats. These figures don't include contributions
to Levin funds or state/local committees.

Reference: Open Secrets --
http://www.opensecrets.org/industries/indus.asp?Ind=F09



I note that keeping the insurance industry involved in this process has
already negatively affected health care in the form of Medicare bills and
plans. So how does that change if you keep them as a central figure in a
universal system for all Americans? When
<http://www.washingtonpost.com/wp-dyn/content/article/2007/09/17/AR200709170
1576_pf.html> insurance lobbyists become involved,3 Americans get the short
end of the <http://www.cbpp.org/12-5-07health.htm> stick.4


Health insurance industry profits have soared over the past decade. I feel
the need to point out here that the first obligation of for-profit insurance
companies is to their investors, not to the consumer. You said yesterday
you weren't familiar with that information, so here are some data for you:



HMO Profits Jump 21% in the First Quarter of 2005

http://www.weissratings.com/News/Ins_HMO/20051024hmo.htm



Below is from an article dated 10/14/2004 found at Investors.com (excerpts):

<http://investors.com/breakingnews.asp?journalid=23544168&brk=1>
http://investors.com/breakingnews.asp?journalid=23544168&brk=1



Despite a weak economy and soaring medical costs, U.S. health insurers have
raked in earnings at a far greater pace than the rest of corporate America,
with annual profits and margins doubling in the last four years.

Profits for the 17 top U.S. health insurers rose 114 percent to $414 million
from $193 million on average in 2000, according to research by CBS
MarketWatch. Profit margins doubled to 5 percent - the highest level in at
least a decade for the industry's top 10 insurers - and revenue climbed 21
percent to $9.3 billion on average.

By comparison, the S&P 500 saw profits rise a meager 5 percent over the four
years, the CBS MarketWatch study found. Margins fell to 6.8 percent last
year from 8.5 percent in 2000.

Average pay for the five top executives at 16 of the health insurers almost
doubled to $3 million a year from $1.6 million, based on data from insurers'
annual reports and proxy statements. The 17th company, WellChoice (
<illegal codejsfOpenPowerTool(%22WC%22,1,%22%22)> WC), became a public
company in late 2002, and 2000 data were unavailable.

"They're making boatloads of money," said Tom Boldt, senior health-benefits
consultant for Watson Wyatt, a leading human-resources consulting firm.

There's no sign the profit growth will cool. Insurers' premiums jumped 60
percent since 2000, according to the Kaiser Family Foundation, a non-profit
industry researcher.

But their profit of 114 percent was almost twice that rate. Premium
increases will slip this year, Boldt said, but remain close to the
double-digit level.

Investors in health carriers also did well. Stocks for the 17 companies
have, on average, more than doubled since the beginning of 2000 - with
several making huge gains.

(MY NOTE: The above salary reports don't include CEO profit-sharing, which
greatly inflates these incomes. For UnitedHealth's CEO, those profits were
<http://www.post-gazette.com/pg/06108/683054-28.stm> worth $1.6 billion!)

At the same time as health insurance companies were raking in money and
paying their CEO's whopping salaries, health care premiums have skyrocketed:

http://www.nchc.org/facts/cost.shtml

Since 2000, employment-based health insurance premiums have increased 87
percent, compared to cumulative inflation of 18 percent and cumulative wage
growth of 20 percent during the same period (3).

(Their reference: <http://www.kff.org/insurance/7315.cfm> 2006 Kaiser/HRET
Employer Health Benefit Survey.6

A 2003 study published in the New England Journal of Medicine shows that 31%
of American health care dollars are consumed by administrative costs, almost
double that of single-payer Canada (16.7%). Administrative costs for
government-run Medicare (3.6%) and Medicaid (6.8%) are far lower than that
of private insurance (11.7%), yet keeping private insurance companies in our
health care system, at taxpayer expense for universal health care, remains
in far too many Democratic platforms. (Abovementioned study enclosed.)

Finally, if coverage at affordable prices is not mandated for people with
preexisting conditions under the significantly flawed universal
insurance-based coverage plan you propose, you are potentially excluding
almost half the population of persons who currently lack health insurance.
One <http://www.urban.org/uploadedpdf/411161_uninsured_americans.pdf>
survey7 found that almost half of non-elderly adults without health
insurance reported having a chronic medical condition. A
<http://www.medicalnewstoday.com/articles/62945.php> Johns Hopkins study8
also found if the preexisting condition was genetic, people were twice as
likely to be denied coverage. If these findings are reflective of the
general population, you would again be denying coverage to potentially
twenty million or more Americans, citizens who need health coverage the
most. Many of those with chronic conditions can be kept out of hospitals by
receiving regular health care, which is much cheaper than emergency room
visits and hospital stays due to conditions worsening as a result of no
health care at all. Why is it okay to discriminate against this group of
people if we won't accept discrimination against others? Because of money?
What a tragic reflection on our country and the persons who lead it or seek
to be its leaders.

The greatest problem with health care is not technology, as you suggested,
it is our insurance industry. I cannot support any universal health care
plan that maintains the status quo and is insurance industry based. People
are dying because of their lack of access to medical care - we don't have
time to wait for Congress to obstruct progress anymore and to add new
members of Congress who are willing to spend unnecessary taxpayer dollars on
health care. I suggest to you that keeping insurance companies involved
will add to the overwhelming federal deficit, confirm the arguments of those
who say universal health care is too expensive, and may ultimately cause it
to fail.


References not specified above:



1. ABC News/Washington Post Poll:
<http://abcnews.go.com/images/pdf/935a3HealthCare.pdf>
http://abcnews.go.com/images/pdf/935a3Health care.pdf



2. Poll conducted by GOP consultant Fabrizio & his firm as reported in
The Hill:


<http://thehill.com/campaign-2008/poll-shows-many-republicans-favor-universa
l-healthcare-gays-in-military-2007-06-28.html>
http://thehill.com/campaign-2008/poll-shows-many-republicans-favor-universal
-health care-gays-in-military-2007-06-28.html



3. Washington Post article, September 2007: Health Insurance Industry
Looks to Senior Lobbyists.
<http://www.washingtonpost.com/wp-dyn/content/article/2007/09/17/AR200709170
1576_pf.html>
http://www.washingtonpost.com/wp-dyn/content/article/2007/09/17/AR2007091701
576_pf.html

(printed reference enclosed)



4. Center on Budget and Policy Priorities: Curbing Medicare Advantage
Overpayments Would Strengthen Medicare.
<http://www.cbpp.org/12-5-07health.htm>
http://www.cbpp.org/12-5-07health.htm

(printed reference enclosed)



5. The 2006 Kaiser/HRET Employer Health Benefit Survey:

<http://www.kff.org/insurance/7315.cfm>
http://www.kff.org/insurance/7315.cfm



6. Pittsburgh Post-Gazette, UnitedHealth directors strive to please
chief.

<http://www.post-gazette.com/pg/06108/683054-28.stm>
http://www.post-gazette.com/pg/06108/683054-28.stm#

(printed reference enclosed)



7. Uninsured Americans With Chronic Health Conditions: Key Findings From
the National

Health Interview Survey.

http://www.urban.org/uploadedpdf/411161_uninsured_americans.pdf





8. Individuals With Genetic Conditions Twice As Likely To Report
Health Insurance

Denial. <http://www.medicalnewstoday.com/articles/62945.php>
http://www.medicalnewstoday.com/articles/62945.php

(article enclosed)





A few very informative websites:



Physicians for a National Health Plan (single-payer):
<http://www.pnhp.org/> http://www.pnhp.org/



National Coalition on Health care: <http://www.nchc.org/>
http://www.nchc.org/



Health care for All (California):
<http://www.healthcareforall.org/facts.html> http://www.health
careforall.org/facts.html

[LWolf]

17. Here's a link:

http://www2.kucinich.us/issues/universalhealth.php

There's plenty there.

[liberalitch]

20. It's like solar power.... there would be that original investment...

But the premium deduction that's currently in your check (if your company has the ability to have a reasonable insurance plan.... would probably be shifted to taxes. BUT that would insure that EVERYONE get health care.... anyone that you have the remote possibility of employing would be cared for... with out additional cost to you. A healthier workforce... well you do the math.