Tuesday, February 05, 2008

More Health Care/Politics Stuff

Yeah, I know, this bores a lot of you. However, I started to comment back to the comments in the earlier thread, and ran afoul of the text limits. No fun. So I'll spend this post responding to the very good comments I recieved in that thread, and follow it up very soon with what I really wanted to write about when I logged in.


Wonderful comments. Thank you all. As I hope you know, I'm not doing this to be a polemicist...I really want to know what the attraction is of a national health care system, given the bad things I've heard from people who've lived it.


"sb": You commented (in part) "I don't criticize people who don't want a national insurance system--I just think their perspective is very limited, often to a range of about 200 mi around their own homes."

I answer: This is the heart of federalism, an ideology that is slowly being strangled in the US. To me, the practical effect of federalism is that spending and legislative decisions are brought closer to where you live. This makes the responsibility of those making the decisions much more immediate. I can pick up a phone and call my state rep. I can pick up a phone and get a busy signal for my national rep. It's a bigger problem for a local politician if I get pissed. If the case is bad enough, I can mobilize my town. That's a much bigger problem for him than for a guy whose constituency is much bigger than just my town. If most politicians are facing the people they make decisions about on a personal level, I firmly believe they'll make better, more urgent decisions. I'm new in the neighborhood and don't even know who my state rep is right now, but I damn well knew it was Steve Smith when I lived in Mound, MN. I never had a real reason to call him, but I called him once on general principle. His wife answered, and said he was walking the dog. Then, "oh, wait, I think he just got home. Just a second." I waited. A male voice came on. I asked if this was Mr. Smith. He said yes, and what could he do for me, since his caller ID indicated that I was a constituent? I'm afraid I made a fool of myself, because I had no point in calling other than to see if he was really there if I called. I want that guy making my decisions. What chance to I have to talk personally with my DC rep?

Anonymous: You commented (in part): "Personally, I *can't* get insured, except through a job or through my state's high risk pool. I'm lucky to have found a job that offers insurance, as the high risk pool was way too expensive to join. For people who aren't the poorest of the poor but have pre-existing conditions, I suppose it probably is possible to get health care without insurance, but it might also mean lots of debt that would follow us around for the rest of our lives."

I answer: Welcome to my world. Check my archives. I have cystic fibrosis, as does my sister. Who's going to cover me, EVER (except if they're my employer?) My point stands. Why should other people shoulder my medical costs through government mandate? I've managed to get health insurance and keep it since I was diagnosed. I have full confidence that if I was really in trouble with CF, I'd find a hospital that would help. I'd fight like hell to pay back as much as I could, too...but even if I didn't, people are DECENT. They'll help. Maybe I've got too much faith. But I don't think so.

Second anonymous: You commented (in full, because I REALLY like it): "It is also very discouraging to see family members that are not given medical service. My mother would not go to a doctor because she could not afford the bill it would create. After my father died, she was working three part time jobs, none of which would/could supply insurance options.

Small town America limits the options for jobs, yet how do you move if you have lived your entire life there and raised your family there as well?

My point is that you may know people that do not visit a doctor because they cannot afford insurance, but they do not make a big deal out of it until the situation gets critical."

I wish I could know your mother. She sounds like a woman I could really respect and admire, and hopefully emulate. I also understand your dilemma, and have known people personally that have shared it. However, she makes the choice to deny herself services in this case (from how it sounds). She would not have been denied from treatment from many places, but she values her status as someone who wants to owe nobody anything. I live in small-town America too, though I'm lucky enough to have a college degree, and hold a job where health is included (though expensive anyway). I know many, many people who would die rather than leave the place they were born and lived their whole life. I'm fast becoming one of them. As to your point, that's a pretty personal decision. I still don't think anybody would be forcibly denied around here...though it IS often something that requires persistence.

"Loren": You commented (in full, because it's brief): "I'm a long-time lurker and appreciate your insight on foster care and adoption.

I guess you can get medical care if you don't mind claiming bankruptcy. See this article from early 2005.


I answer: I gave a brief scan of your link, but it's really immaterial in my view. In the US, most credit problems have a horizon of 7 years (or so I've understood from the financial pros I've had the privilege to ask.) Most financial apps have the question "have you declared bankruptcy in the last 7 years?" Let's see...wreck my credit rating for 7 years or save my life....hmmm...

I don't mean to make fun, but DECLARE BANKRUPTCY in that case. That is precisely the kind of situation for which the very concept of bankruptcy was formulated. I'm more concerned about the bankruptcy protection laws that allow someone declaring bankruptcy to keep their half-million-dollar home, their hummer, and all their toys.

mj: You commented (in part): "I too dont support national healthcare. I really think it would downgrade our system without some of the competetive nature of having it private. I do think there maybe more we can do to get more people insurance but we should be leaning on the insurance companies not the government to do this."

Right on, brother/sister. A solution based on private enterprise is ALWAYS better than some sort of government bureaucracy bearing a pretty name.


At 9:56 PM , Anonymous SB said...

You can have federalism and a national health ins scheme (again, see Germany, where that works just fine and the states are a lot smaller than they are in the US but still manage to block federal legislation all the time, which never happens in the US). But the real issue is that if you always believe the best solution is in private enterprise, then some people will never have health care, because there are some people whom it is not profitable or worthwhile to treat. And I really don't see why just because you're poor you should have to forgo health care or beg for it. To me that sounds an awful like your life is only worth protecting if you have a little money. (And what about the people who can't beg and lobby?) As long as you have that attitude, some people will automatically be excluded. That's fine, I guess, but it doesn't square with my understanding of the inherent value of human life. (I find it interesting that the right to life crowd are often the most vehement protesters against comprehensive health care for all).

At 6:11 AM , Blogger Yondalla said...

There are several different ways to assure universal coverage. I favor universal coverage, and I think we need national leadership, I am not quite certain that I want the federal government running it though.

But I want to respond to one thing you said. "Why should other people shoulder my medical costs through government mandate?"

Well, right now other people are shouldering your medical costs through their health care premiums. Only fewer people have to pay the bill because there aren't as many people in the pool. Why should they have to pay a larger portion?

And those people you insist are getting free care? Well, their care is being paid for through higher bills to the rest of us, once again being paid for through our premiums.

And the people who can't get primary care and end up getting more expensive emergency care, and the babies whose mother's didn't have prenatal care, and everyone else who ends up critical and in the hospital and can't pay those bills, the insured are shouldering all those bills. All those expenses get calculated back into the bills paid by the insured which is paid by through our premiums.

Personally, I would pefer for a few more people to help pay for your healthy care, and for all of us to pay for the less expensive care the really poor people need before they end up in the emergency room.


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