TCS Daily


Health to Pay

By Josh Hendrickson - April 9, 2007 12:00 AM

As health care costs continue to rise, the calls for a single-payer system have become increasingly vociferous. Recent polls have even suggested that many Americans are receptive to the idea. But the arguments from single-payer advocates are riddled with misconceptions and half-truths. A single-payer system would treat a system of America's health care problem, while leaving the problem itself untreated.

The most frequently cited statistic by those who favor single-payer health insurance is that the United States has similar or even lower life expectancies than other developed nations, despite spending more on health care as a percentage of GDP. But the use of life expectancy in measuring health outcomes is erroneous. Life expectancy, and overall health in general, is determined by a variety of factors, not merely how much one spends on health care. In fact, empirical studies have attempted to measure the effects of health care spending on health status. A study by Robin Sickles and Abdo Yazbeck found that a one-percent increase in health care spending only improved health by 0.03 to 0.05 percent[1]. For comparison sake, an increase in leisure produced improved health by 0.25 to 0.65 percent. Given these findings, it is hardly surprising to observe similar life expectancies despite a wide variance in spending.

Another argument used by single-payer advocates is that the government spends much less money as a percentage of health expenditures on administrative costs than do private insurance companies. While this is factually accurate, it is quite misleading. It should come as no surprise that one organization can spend less than hundreds (even in percentage terms). However, one key fact that is ignored in this analysis is that, in a single-payer system, insurance is funded through income taxes. Associated with income taxes is what economists refer to as a deadweight loss. This concept essentially refers to the fact that taxes distort individuals' behavior and a loss to society is thus created because resources that could have been used to create new goods and services are instead used by bureaucrats to determine the distribution of health services. Estimates of a deadweight loss are not exact, but the consensus seems to be that they are roughly 20 percent of the revenue collected - roughly the same percentage spent on administrative costs by private insurers.

The United States has tried something roughly equivalent to the private insurance version of a single-payer system. Health Maintenance Organizations (HMOs) were designed to keep health care costs down by restricting certain types of treatment. However, it quickly became apparent that HMOs were not the panacea to curbing costs. While HMOs were somewhat successful at controlling costs and maintaining quality, patients routinely objected to having certain treatments restricted by their health insurance companies. In fact, a series of studies by Robert Miller and Harold Luft found that those enrolled in an HMO were less satisfied with the quality of care they received and their interactions with doctors.[2]

The lesson learned from HMOs not only provides evidence that Americans are likely to reject a single-payer system, but also sheds light on why the United States spends more than any other country on health care. Americans spend more because they have a higher demand for health services. This fact should come as no surprise. Americans have generous health care plans and their premiums are predominantly paid by their employer. This insulation from cost gives Americans little incentive to seek cost-effective treatment and thus routinely results in patients receiving a series of high-tech tests and treatments, which economist Arnold Kling refers to as "premium medicine".

A single-payer system is clearly at odds with Kling's "premium medicine" hypothesis. Such systems "solve" the problem of higher health care expenditures not by providing incentives to do so, but rather by restricting treatment. Thus, in a sense, they treat the symptom of the problem rather than the problem itself. Equally important and detrimental is the fact that restricting or delaying treatment may save on monetary costs, but it not without a cost to others. Patients whose treatment is delayed or rejected will incur a cost and, if HMOs were any indication, they will largely become dissatisfied with the system. Similarly, pharmaceutical companies and health equipment researchers and manufacturers will have a disincentive to produce and innovate. One could easily argue that the lack of new innovations and technology would come at a much larger cost in the long run than would be "saved" by a single-payer system.

Reforming the health care system by realigning incentives through free market reforms would do a great deal to reduce health expenditures while having little impact on the quality of care and health itself. By contrast, half-truths and misconceptions make single-payer insurance seem attractive. By any measure, single-payer insurance is not the panacea for our health care problems.

Josh Hendrickson teaches economics at Wayne State University. He maintains the blog entitled The Everyday Economist.





[1] Sickles, Robin C. and Abdo Yazbeck. "On the Dynamics of Demand for Leisure and the Production of Health," Journal of Business and Economic Statistics 16 (1998): 187-197.

[2] "Does Managed Care Lead to Better or Worse Quality of Care," Health Affairs 16 (1997); "HMO Plan Performance Update: An Analysis of the Literature: 1997-2001," Health Affairs 21 (2002); "Managed Care Plan Performance Since 1980: A Literature Analysis," Journal of the American Medical Association 271 (May 18, 1994).


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163 Comments

paying for nothing
Good article giving more evidence on what a crappy health system the US has. But in spite of all the evidence people keep looking for and 'easy' solution instead of the best one. Every place that has single payer systems like Canada, Cuba, North Korea, and the former east block, were EVEN WORSE. But never mind, let's do it anyway because it feels like a free lunch. Why not give an expensive MRI scan to the 80 year old? It feels like it's the humane thing to do even though there's no possibility of effective cure. Newsflash; I just read that in Japan, which has a system that so many people love; just has a Johns Hopkins branch opening up there, where you pay outta pocket, about $25kfor a three day check up; and the place is booked up solid!

anicdotal.
It not far to use such examples.

Compare statistics to statistics.

Sample size dude. Sample Size!

President Hillary Clinton's Plan For American Health Care
If Hillary Clinton is elected President of the United States in 2008- which is probable, a Democratic Congress will pass a law providing universal health care. While many of my fellow neo-cons don't think this can happen, I think Hillary will win the general election in 2008.

The Voters and the Universal Model
Universal Health Care could become enacted in 2009 no matter who the new President is...UNLESS, a comprehensive, market oriented, workable alternative is presented to and favored by a significant plurality of the voters.

I await the health care proposals of the candidates, and believe that once discussion and debate have clarified the benefits and costs of the options available, that the Universal approach will again be deservedly rejected.

A single-payer system would treat a system of America's health care problem, while leaving the probl
How true. If the problem is that it cost too much moving the cost to Gov. will not solve the problem. I think that costs could be reduced be eliminating the excessive licensing requirements. I also think that this would improve quality. Engineers should be designing quality systems in which less trained technicians can operate rather than relying on highly trained professionals (doctors and nurses).


Here's an idea:
Leave it alone!

Why mess with the most innovative, dynamic, and easily accessible healthcare in the world? The life expectancy stat is bogus, which is demonstrated in the article, and has nothing to do with quality of care.

American healthcare is already highly regulated and monitored and yet technological, medical and financial innovations occur rapidly. Leave the markets to adjust without governmental "assistance". One has only to look at the systems in Europe and Canada to see the disaster awaiting us if we move to socialized medicine.

News item: "Medical expenses play leading role in half of U.S. bankruptcies"
http://www.newstarget.com/004318.html

News flash: Your study is idiotic and biased. Rather like yourself...
>"One of the study's authors concludes Bill Gates is about the only American who can afford an extended illness."

Wow. You can the see the scientific objectivity in this statment. The fact that millions of Americans with extended illnesses actual DO afford their care without being Bill Gates should have set off a few alarms but LeMule is quite immune to working of common sense.

But let us just look at the stupidity on display when one just skims over a study and buys it because it fits their predefined notions.

>"A new study says that medical bills cause financial troubles for more than 2.2 million Americans each year, and they account for about half of all U.S. bankruptcy filings."

Again: Wow. Medical bills cause financial trouble for 2.2 million Americans. Stunning. That is 0.7% of the population. Is this a financial epidemic?

Notice that it takes the 2.2 million number and couples it with the "fact" that they account for about half of the bankruptcies. One would believe that the 2.2 million is the number of bankruptcies. However, in 2006 there were 585,000 bankruptcies.

So lets do the math: one-half of 585,000 is 292,500. That would make the percentage of the population that is run into bankruptcy by medical expenses 0.09%. Also note that, according to this study's highly dubious numbers, one-half of that 0.09% actually had health insurance. This would lead a more reasonable mind to question if perhaps other factors were at play.

Again: is 0.09% a financial/healthcare epidemic?

It is not and you really don't have anything to contribute if this is any indicator. This is fluff piece that attempts to create fear that those evil free-market people don't want you to be healthy.

It is a fact that almost any job provides healthcare benefits. It is also a fact that if you went one month without healthcare you become a part of the statistic that is uninsured. While being uninsured sucks, it is something that you can do something about if you wish to. Once again, those hated words "personal responsibility" rear their ugly heads.

The US has the most competent, most accessible, and most innovative healthcare on the planet. Please don't **** with it.

Once again LeMule you are a victim to your own sources. Have a nice day.

Only one of numerous danger lights blinking red
Bankruptcy is an extreme case. Saying there are 'only' 600,000 bankruptcies, and only half of these are from medical bills is whistling past the graveyard: what percentage would you deem acceptable?

>The US has the most competent, most accessible, and most innovative healthcare on the planet.

Most competent and innovative, yes. Most accessible, sure, if you have unlimited money. If you don't, it's severely rationed.

>Please don't **** with it.

Amazingly enough, a large majority of the citizens of this country disagree with you.

Ah yes, responsibility
You don't seem to get out into the workplace much

>It is a fact that almost any job provides healthcare benefits.
No, it's not a fact. Jobs with big companies or institutions, yes. Many other jobs don't, or only provide it at costs out of proportion ot income., Obvioulsy self employed people have to

>It is also a fact that if you went one month without healthcare you become a part of the statistic that is uninsured.

A part, but far, far from the total.

>While being uninsured sucks, it is something that you can do something about if you wish to.
Not if you have a pre-existing condition you can't. Try to buy health insurance on your own if you have diabetes, or a history of almost anything.

>Once again, those hated words "personal responsibility" rear their ugly heads.
Exactly. So how are people uninsurable because of health conditions irresponsible? What's the responsible thing to do if they have givern birth to a kid with a chronic health problem costing $50 or $60K per year to address with the US best medical care in the world?


Why do people accept that costs are so high?
Laser eye surgery costs have dropped and quality has improved dramatically.
Most insurance companies do not pay for it. Could that have something to do with it?

"Highly skilled technologists conduct the painless, non-invasive, ultrasound screenings and the finger-stick blood test screenings. Our inexpensive preventive health screenings are individually priced at $45 or less and are completed in a matter of minutes. We even offer a special package price of $139 (or less, depending on location) when you select our Complete Wellness Package which includes our stroke/carotid artery, abdominal aortic aneurysm, peripheral arterial disease, and osteoporosis screenings. Discounted packages that include blood testing are also available in most states."

http://www.lifelinescreening.com/about.asp


I am still stuck on the concept that Americans spend too much on health care.
Who is to say what is a right or reasonable percentage of GDP to spend on health care? If someone has this information the what is it and how do you compute the numbers?

The fact is that there are millions of reasons why people purchase health care and there are a continium of percentages of peoples income that they spend on health care. There are no averages or right numbers.

The socializers never bring up the worst part of socialized medicine...
The worst part of socialized medicine is that it violates peoples right to LIFE!!!!!

Individuals will be/are forced at gun point with loss of property, imprisionment or violence if they do not pay for health care of all. Of course this means that they have LESS to pay for their own health care.

THIS LEAVES ALL INDIVIDUALS IN A PREDICAMENT: They have less resources to save themselves because they pay resources for caring for others. Kind of like social security ONLY WORSE!!!! The individual is left with a bureaucratic lottery of sorts hoping that their particular illness or injury is "covered".

The percentage of the GDP is an objective number
The value received is subjective, though many would say that the US having low scores on standard public health measures is meaningful.

Superior Goods
The first reason that we spend more on healthcare is that it is a superior good. The more you make, the greater the percentage of income you spend on it. I might also be worth ppointing out that the U.S. still produces a disproprtionate share of medical intervention in the world.

Instead of saying X is the right amount to spend on per capita, we should be working to remove the sources of inefficiency such as unaccountable occupational licensure, tax code induced distortions in compensation preferences, and the general lack of consumer sovereignty that pervades the market.

Correction
U.S. still produces a disproprtionate share of medical intervention in the world.

that should be disproportionate share of medical innovation in the world.

So why don't we have really good public health results?
And why don't we excell at preventive care, instead of desperate people piling up the in ERs?

such examples
Point taken, it could be that North Korea and Cuba do have better systems, and that all those canadians, including their own politicians, go down to the States for proper care.

preventative
Once suggestion would be to ask somebody who smokes, for example, why he does it. Another would be to read all of the mountains of literatures, and studies(and even all the comments on this forum) about why the system is such as it is. But if you don't have any insurance, I suggest you sell one of your cars, or one of the several TVs you have, or eschew that next vacation, and get some friggin insurance.

Do tell, what are the other "danger lights"?
>"Bankruptcy is an extreme case. Saying there are 'only' 600,000 bankruptcies, and only half of these are from medical bills is whistling past the graveyard:"

Do you know what "whistling past the graveyard" is supposed to mean? From the way you use it I don't believe you do.

I imagine that you now want to argue bankruptcy considering the total disintegration of your own source. Fine. Let's throw out the numbers and go with emotion. I guess there will never be a day when you can admit error.

>"what percentage would you deem acceptable?"

Considering that countries with socialized medicine still have bankrupcies I don't really see that you have any connection between the two.

What is unacceptable is to sacrifice our high quality healthcare to cater to 0.09% of the population. That does not require the creation of huge bureaucracies, increased tax burdens, and government intrusion into the healthcare choices of my doctor and I.

>"Most competent and innovative, yes. Most accessible, sure, if you have unlimited money. If you don't, it's severely rationed."

Ah, the highly scientific "Only Bill Gates can afford it" argument. This patently false. There is no healthcare "rationing" going on. Hospitals and healthcare facilities are growing and expanding services. In the city I live in both the University medical center and Catholic hospital are undergoing multi-million dollar expansions. The rationing you speak of occurs in Europe, Canada, and every other country unfortunate enough to have socialized healthcare.

Please give me the evidence of this "rationing".

>"Amazingly enough, a large majority of the citizens of this country disagree with you."

That must be why HillaryCare was so successful.

Responsibility seems to be the hardest word
>"You don't seem to get out into the workplace much"

You don't seem to get out of your Mom's basement much.

Perhaps I know a little more about this subject since my actual workplace is the healthcare industry.

>"No, it's not a fact. Jobs with big companies or institutions, yes. Many other jobs don't, or only provide it at costs out of proportion ot income., Obvioulsy self employed people have to"

Sure. You say it is not a fact but don't provide any facts. I have worked with many a small business that has provided healthcare benefits. Hell, even McDonald's workers can get healthcare benefits.

I don't even know why you bring up the self-employed. Should they not have to provide their own healthcare? What part of self-employed are not familiar with?

This is where the government CAN do something to help out the "little guy". How about allowing businesses and the self-employed to pool their benefits? By allowing this Joe's Pizza could team up with Dan's Auto Body and Marie's Hair Styling to have more bargaining power with healthcare plans and providers.

That is not government interference. That is just removing legal barriers that prevent innovation.

But no. You just want socialized medicine. Yes. That is the solution.

>"A part, but far, far from the total."

Okay. We'll just take your word for it. I am sure you have more wonderful sources that you keep to yourself.

>"Not if you have a pre-existing condition you can't. Try to buy health insurance on your own if you have diabetes, or a history of almost anything."

Sure you can. If you start work for a company that provides healthcare they won't turn you away because you have a pre-existing condition.

In fact, many health plans are starting to see profitability in those sections of the population. The concept is to provide high-levels of maintenance care which cuts down on catastrophic costs. So your diabetes example would be given discounts or cash back by keeping regular doctor's visits, joining a fitness club, etc.

Markets innovate and improve healthcare. Has welfare and entitlements helped aleviate poverty and improve society? Why would you expect it to improve healthcare?

Now let's go back to your emotions.

>"Exactly. So how are people uninsurable because of health conditions irresponsible?"

Emotional and false. Please state the percentage of the population that falls into this category if you wish to continue with the line of "reasoning".

>"What's the responsible thing to do if they have givern birth to a kid with a chronic health problem costing $50 or $60K per year to address with the US best medical care in the world?"

Why you would move to Canada where they would be placed on a waiting list for their treatments! This is if the equipment and/or doctors are located in your area. Or perhaps you could go to Cuba where everyone can have access to their free healthcare. Really LeMule, does free have anything to do with quality? Tell me, where does the world turn to for cutting edge medical care?

Please provide the number of uninsured children who have chronic health problems costing $50-60K per year who go untreated in America.

You pretty much use all the heart-wrenching tactics that all liberals use when they push socialized medicine. I am sure that you, like most liberals, have no issues with using sick children as political props but the fact that remains that government control of healthcare is disasterous.

Take a realistic look at the problems in Europe, Canada, and even the utopian country of Cuba and you will see long waiting lists, lack of preventive care, lack of access, substandard physicians, no recourse to the law in the case of malpractise, and a bevy of other issues.

I have worked with healthcare professionals in the US, Canada, and the UK and I know that even though some fall through the cracks in our country we still have the best healthcare there is. Period.

First things first
>You don't seem to get out of your Mom's basement much

I certainly don't enjoy telling your fat wife that it's not my fault that her gross husband's tiny ***** never gets hard.

Struck a cord?
I guess my response hit a little too close to home for you. You can see in your nonsensical response that you have clearly abandoned rational thought. I will mention this next time you yell at someone for uncivil words or spamming.

Have a nice day LeMule.

Can v. do
Ok, yes, workers in some low paid sectors can get coverage, but the coverage is a) limited, and b) expensive or unaffordable in terms of total income. And so many choose not to. This leads to bad consequesnces not just for them but for the rest of us, because they do not receive regular preventive care (can't afford) it and wind up in the county emergency room being treated at taxpayers expense.

>I don't even know why you bring up the self-employed. Should they not have to provide their own healthcare? What part of self-employed are not familiar with?

The problem is that insurance is either unaffordable or completely unavailable (pre-existing conditions. What this means is that someone who could and would want to start their own business often cannot. I thought you were in favor of entrepreneurship.

>This is where the government CAN do something to help out the "little guy". How about allowing businesses and the self-employed to pool their benefits? By allowing this Joe's Pizza could team up with Dan's Auto Body and Marie's Hair Styling to have more bargaining power with healthcare plans and providers.

At a time when insurance companies are cutting back the access to health insurance even of professional groups like realtors, it's not government that's the problem here.

>>"Not if you have a pre-existing condition you can't. Try to buy health insurance on your own if you have diabetes, or a history of almost anything."

>Sure you can. If you start work for a company that provides healthcare they won't turn you away because you have a pre-existing condition.

And if you don't, you're out of luck. If you get laid off, and can't find another job, after the COBRA (extremely expensive) runs out, you won't be able to. If your not lying your face off claiming to be working in the healthcare industry, you know this. Why are you avoiding the issue?

>>"Exactly. So how are people uninsurable because of health conditions irresponsible?"

>Emotional and false. Please state the percentage of the population that falls into this category if you wish to continue with the line of "reasoning."

Let's say for the sake of argument it's 5 percent, which is almost certainly low. How are these people "irrespnsible."

>>"What's the responsible thing to do if they have givern birth to a kid with a chronic health problem costing $50 or $60K per year to address with the US best medical care in the world?"

>Why you would move to Canada where they would be placed on a waiting list for their treatments!

First you'd have to become a Canadian citizen.

>Please provide the number of uninsured children who have chronic health problems costing $50-60K per year who go untreated in America.

They don't go untreated. They're treated at public expense even though they don't have insurance. Would you prefer we just leave them to die?

Here are some statistics:
http://www.rwjf.org/newsroom/newsreleasesdetail.jsp?id=10360

>ake a realistic look at the problems in Europe, Canada, and even the utopian country of Cuba and you will see long waiting lists, lack of preventive care, lack of access, substandard physicians, no recourse to the law in the case of malpractise, and a bevy of other issues.

Lack of preventative care??? Please document this. See the link poted above.

>I am sure that you, like most liberals, have no issues with using sick children as political props but the fact that remains that government control of healthcare is disasterous.

But having millions and millions of children uninsurance and not receiving prventive care is good policy? As far as 'using sick children' - what's the point here: we have to ignore the problem because it's just children who have it? Maybe we just need more responsible children...

>I know that even though some fall through the cracks in our country we still have the best healthcare there is. Period.

So why are you against taking action to plug the cracks?

It's chord, peawad
And your wife loves you even though she sleeps with everyone else in the neighborhood - she knows it's no your fault.

The other is lack of preventive care
When you have substantial numbers of people without insurance, or with high co-pays, they avoid going to see doctors whenever posssible. The result is conditions that could be easily dealt with preventively become acute crises that have to be dealt with in the emergency room, at much higher cost.

>I imagine that you now want to argue bankruptcy considering the total disintegration of your own source.

The course speaks for itself, and it is a problem. You ignoring or belittling it doesn't change that.

>Ah, the highly scientific "Only Bill Gates can afford it" argument. This patently false. There is no healthcare "rationing" going on. Hospitals and healthcare facilities are growing and expanding services. In the city I live in both the University medical center and Catholic hospital are undergoing multi-million dollar expansions

Sure, in the same way that Mercedes and Lexus are selling well. In the same city, go down to the county hospital and see how well its working out. It's all part of the same pattern: we're spending much more than any other country, and geting worse results. And talking about rationing is silly. In Canada, England or any other country, if you' have money, you can get your own care, either at home or for pay in the US.

Except for people who can't get insurance
If your sick or have been sick, an insurance company won't insure you. Not for any price.

People need to adjust thier budgets to the reality...
...that modern medicince can keep you alive for a long time at a very high cost. People need to do what I do that is even my wife has a policy that covers us, I have a policy apart for work that I pay for each month so that if she got sick and could not work we would be covered. And BTW the policy is cheap about 300/month.

Great points Tlaloc eom
...

Lemuel I have a friend who worked for a company that
Lemuel I have a friend who worked for a company that offered health insurance but to get it he needed to contribute $100/month the deductible was $300 (which he though was high but is in reality very low). I know that he could easily afford the $100/month but he chose to opt out and spend that $100 a month on other things. He was always pushing for government to pay for his healthcare but should the Government provide for his heath insurance it would probably be paying $300/month for something that was worth less than $100/month to him, the government would be better off to give him $100/month in cash.



Defne unaffordable
You wrote: "Ok, yes, workers in some low paid sectors can get coverage, but the coverage is a) limited, and b) expensive or unaffordable in terms of total income. "

'So why don't we have really good public health results?' We do.
...

'If your sick or have been sick, an insurance company won't insure you. Not for any price. '
Mostly they will but will exclude the preexisting condition for some period of time.


And BTW hospitals will work out payment plans. eom
...

There are also charities eom
...

Health to pay--Deadweight loss indeed!
Comment to Josh,
Take a look at the World Health Organization (WHO) data on health care quality indicators. The US ranked 37th when last I checked.

And speaking of "deadweight loss"--how much of our money (including our tax dollars)is being sucked off, feeding the profit and salary lines of parasitic private insurers.

I am astounded that an academic has not done a comparative study of US system versus the plans used in other free-enterprise countries (Canada, France, etc. ) Neither innovation, nor R&D has suffered in those countries. Single payer benefits both the individual and the country's economy.

And before you start parroting the Cato, Fraser, Heritage and Pacific Institute rant about "wait-times," I ask you to remember that a Canadian may wait a few months for a non-urgent hip or knee replacement, but an uninsured American will wait "until the 12th of never!"

Follow-up on "Health to Pay" ( see New republic)
Sorry to post a second time today, but I just read Jonathan Cohn's article in The New Republic (online) and it responds to most issues raised in Josh Hendrickson's "Health to Pay."

Here's the link:

http://www.tnr.com/doc.mhtml?i=w070409&s=cohn041007

So sorry LeMule
And that would be "she knows it's NOT your fault".

So let's state it again. I struck a chord and that is why you are going off the deep end.

You prove my case once again
>"Ok, yes, workers in some low paid sectors can get coverage, but the coverage is a) limited, and b) expensive or unaffordable in terms of total income. And so many choose not to. This leads to bad consequesnces not just for them but for the rest of us, because they do not receive regular preventive care (can't afford) it and wind up in the county emergency room being treated at taxpayers expense."

So the person chooses not to take health insurance. That would be the personal responsibility thing you seem to have troubel understanding. Some people rely on ERs instead of insurance knowing they will not be turned away.

Not to mention that illegals absolutely love ER care.

>"The problem is that insurance is either unaffordable or completely unavailable (pre-existing conditions. What this means is that someone who could and would want to start their own business often cannot. I thought you were in favor of entrepreneurship."

I have never, ever heard of anyone not starting up a business because of health insurance costs. Please tell me where you get this crap from. You are really reaching.

>"At a time when insurance companies are cutting back the access to health insurance even of professional groups like realtors, it's not government that's the problem here."

Wow. What monumental ignorance you show here.

What insurance company is cutting back access to health insurance? Do you have any shred of data on this? If you are not growing access you are dying in this business.

>"And if you don't, you're out of luck. If you get laid off, and can't find another job, after the COBRA (extremely expensive) runs out, you won't be able to. If your not lying your face off claiming to be working in the healthcare industry, you know this."

Not only do I work for the health insurance industry but I have actually paid COBRA and found it quite worthwhile. If you haven't found a new job by the time COBRA runs out you aren't really looking.

>"Why are you avoiding the issue?"

What issue do you believe I am avoiding? The issue of the uninsured is not a problem that should be solved by completely socializing the healthcare industry.

Tell me what issue you are arguing.

>"Let's say for the sake of argument it's 5 percent, which is almost certainly low. How are these people "irrespnsible."

Let's not say 5%. Considering your bankruptcy figures I would definitely NOT say that 5% of the population can't get health insurance because of pre-existing conditions.

By the way if 5% of the population can't get health insurance because of pre-existing conditions that would be 15 million people. That is grossly inflated and unsupported.

>"First you'd have to become a Canadian citizen."

God no!

>"They don't go untreated. They're treated at public expense even though they don't have insurance."

Exactly! So what is the difference? Why should everybody be treated at public expense? Do you know who pays for socialized medicine LeMule? Man, what a disconnect you have from reality.

>"Would you prefer we just leave them to die?"

Oh yes. Let the children die.

Maybe we should also adopt the European model of medicine and have doctors decide if our children would be a drain on society and euthanize them. It sounds unrealistic but this is actually being debated.

Just thought I would throw that in there since you decided to continue down the emotional spiral you are on.

>"Here are some statistics:
http://www.rwjf.org/newsroom/newsreleasesdetail.jsp?id=10360"

Did you even read your source? Once again you rammed that foot right in your mouth!

The point of your source is that many children eligible for free or low-cost, state run healthcare programs are not enrolled because the parents don't know about it or attempt to enroll them. It then goes on to describe the drive to educate people to enroll their children.

This goes against your point that there is no hope for the children. There is tremendous government support for people if they seek it out. Once again it is a person's responsibility to provide for their children. How would the government programs that replace these government programs solve this issue?

Sometimes the level of your stupidity shocks me.

>"Lack of preventative care??? Please document this. See the link poted above."

How do long waiting lists and lack of access to medical testing accommodate prevention? In the US a majority of people can see their doctor, or a doctor, at anytime and usually within a week.

By the way, with your "let's say 5%" statement you have lost your ability to ask for any documentation or sourcing.

>"But having millions and millions of children uninsurance and not receiving prventive care is good policy?"

And you make fun of one mis-spelled word.

Millions and millions of uninsured children who already have access to state and federal programs that provide care if their parents actually enrolled them. Your own source points that out.

Do you consider it good policy to destroy quality and innovation to serve an already served minority of the population?

>"As far as 'using sick children' - what's the point here: we have to ignore the problem because it's just children who have it? Maybe we just need more responsible children..."

No. We just need responsible parents and a government that doesn't believe it needs to be our parents.

>"So why are you against taking action to plug the cracks?"

You would plug the crack and destroy the ****. As you pointed out, state and federal programs already exist and you can't be turned away from an ER.

What I am against destroying the most innovative, accessible, and highest quality healthcare in the world in order to address a problem of perception. You would bring down the quality of care for the majority in order to service a minority.

The chord you struck
Is irritation that you cannot stick to the issues but have to resort to idiotic ad homs like the 3rd hand mothers basement bullsh*t.. F*ck you and the horse you rode in on, and it's a shame you can't f*ck your wife; everyone else does.

here's one example, from Walmart:
"Since the average full-time Wal-Mart employee earned $17,114 in 2005, he or she would have to spend between 7 and 25 percent of his or her income just to cover the premiums and medical deductibles, if electing for single coverage. [Wal-Mart 2006 Associate Guide and UFCW analysis]
The average full-time employee electing for family coverage would have to spend between 22 and 40 percent of his or her income just to cover the premiums and medical deductibles. These costs do not include other health-related expenses such as medical co-pays, prescription coverage, emergency room deductibles, and ambulance deductibles. [Wal-Mart 2006 Associate Guide and UFCW Analysis].
Wal-Mart trumps the affordability of its new health care plan. According to Wal-Mart, “In January [2006], …Coverage will be available for as little as $22 per month for individuals” [www.walmartfacts.com]
What Wal-Mart’s website leaves out: Coverage is affordable, but using it will bankrupt many employees. Wal-Mart’s most affordable plan for 2006 includes a $1,000 deductible for single coverage and a $3,000 deductible for family coverage ($1,000 deductible per person covered up to $3,000). [Wal-Mart 2006 Associate Guide]"

And there's the problem
Do you really not see the problem here??

>So the person chooses not to take health insurance. That would be the personal responsibility thing you seem to have troubel understanding. Some people rely on ERs instead of insurance knowing they will not be turned away.

And this make for much higher public medical costs than a single payer system would be, and much worse public health results because of drastically reduced preventive care. All your handwaving doesn't change this basid fact.

And this isn't just bad for him; it's bad for all of us
Because he'll show up that the ER at the county hospital and what might have cost $200 in preventive care winds up being $50,000 in emergency care.

No, you're incorrect
If you come into a job with a company with good health benefits, yes, you will get coverage after a time period. If you're trying to buy it on your own, in most cases you simply can't. Some states have an assigned risk pool -but it's oversubscribed. Please look at the situaiton before making an unsourced assertion.

Sure they will
Or you can go bankrupt, as noted. The problem is the cost of a serious illness hospitalization easily can go to six or even seven figures. That's not an easy thing to work out a payment plan for. And what happens the second time?

And there's also the Easter bunny
You're still left with the same bottom line. We pay much more for health care than any other advanced country, and have much worse results by most measures of public health.

Compared to Brazil or Botswana, yes
Not compared to Germany, or the Netherlands, or Japan.

And here's a study from the Journal of the American Medical Association
Reverse targeting of preventive care due to lack of health insurance

S. Woolhandler and D. U. Himmelstein
Department of Medicine, Cambridge Hospital, MA 02139.

We analyzed patterns of receipt of preventive services among middle-aged women, with particular attention to health insurance coverage, based on data from the National Health Interview Survey. Lack of insurance was most prevalent among socioeconomically disadvantaged women at high risk for disease and was the strongest predictor of failure to receive screening tests. The relative risk of inadequate screening for uninsured compared with insured women was 1.60 (95% confidence interval [Cl], 1.40 to 1.83) for blood pressure checkups, 1.55 (95% Cl, 1.43 to 1.68) for cervical smears, 1.52 (95% Cl, 1.41 to 1.63) for glaucoma testing, and 1.42 (95% Cl, 1.33 to 1.51) for clinical breast examination. Controlling for demographic and health status variables did not diminish the effect of insurance coverage. We conclude that inadequate insurance coverage leads to "reverse targeting" of preventive care--that is, populations at highest risk are least likely to be screened. This compromises both the effectiveness and the cost-effectiveness of screening.

http://jama.ama-assn.org/cgi/content/abstract/259/19/2872

So question: what happens when these women who aren't screened develop diseases? Who pays? How much does it cost?

*sigh*.
Thanks for considering my point.

If your mind is allready made up, then why post?

Still does not address the individuals rights to Life, Liberty and the Pursuit of Happiness.
Still, I have yet to see an article that addresses the most basic rights of an individual. That is the right to life and its partner the right to preserve and maintain that life. Socialized medicine because it uses the wisdom of a small group and not the individuals themselves can not help in all circumstances. Therefore there is a possibility that individuals will not be able to address their own care because they expended resources to the common care.

All statistics on health, valid or not, are not the issue; Nor is the total health of society; Nor is the desirability of the healthcare mechanism to a majority of citizens, or even a super majority.

What is important is that we respect the rights listed by Thomas Jefferson (who survived fine despite the lack of socialized care): The rights of Life, Liberty and Pursuit of Happiness. Socialized anything destroys all three of these in all instances.

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