universal health care

[LivingAlmostLarge]

Let's talk about universal health care. Are you for or against? Have you or are you on medicare or medicaid? Also for parents have you kept your child on your healthcare plan past age 22-24 to age 26? Why? What do you think will happen when your child hits 26 and has to go on their own? What do you think should happen if you are supporting your child on health insurance to age 26 and they have children? Are you allowed to provide insurance for your grandchildren? When is enough enough? I mean we went from 18-22 to 24 to 26. Is the next number that we allow people to have their kids on plans to age 30? What happens if you ever want to retire and jobs because so few are offering health insurance instead you no longer can provide for your children?

I used to dislike HDHP because I think people get the shaft versus normal HMO. I still think it's more shifting it to people who are healthy get ahead instead of properly balancing risk. But now I'm like sure I"m healthy and young and wish I had a HDHP. We have PPO that is good.

I'd also like a universal coverage in case we lose our job we aren't scrambling for work. I hope that this recession with all these people unemployed i Wonder if this is the push to universal coverage? Enroll everyone now and then everyone under 18 and over age 50? And everyone unemployed gets medicaid and can buy into public option. Then we'll have only 26-50 year olds covered by work and if they lose their jobs they transition fast to a public option?

[disneysteve]

Yes, I'm in favor of universal health care. This has come up in a few other threads recently so I won't repeat everything I've already posted, but yes, everyone should have basic coverage. If you want to pay for more bells and whistles, that should also be allowed.

If UHC becomes a thing, your question about coverage until age 26 becomes moot. Until then, as I said in another thread, extending coverage to 26 was one of the big wins of the ACA. Prior to that, young adults had the highest rate of being uninsured at about 30% because they typically had jobs that didn't offer coverage.

Again, if UHC becomes a thing, coverage for your grandchildren won't be an issue either. Everyone will be covered.

HDHP sounds like a good idea on paper but in reality it's an awful plan. The more costs you shift to the patient, the more likely they are to delay routine and low level care. That just leads to conditions progressing and worsening before they finally have to break down and seek treatment, which ends up being more expensive.

Hopefully, the high unemployment rate and the high uninsured rate that goes along with it will help move the ball forward on UHC, though that depends entirely on who wins in November.

[kork13]

I'm not violently opposed to universal healthcare, as long as the program is managed smartly. (of course, putting "smart" & "federal program" in the same sentence generally constitutes a contradiction in terms... But I can dream, right?) I think what really has to happen is divorcing health insurance from employment. Whether that's done through a single-payer/universal healthcare program, or some modification of mandatory health insurance like ACA attempted, or whatever else...

Realistically, I'm arguably already part of a quasi-socialized medicine program through the military's Tricare. Really, it's just a very broad, low-/no-cost (to the patient) health insurance plan. While owned/controlled by the government, right now it's being administered by United Health (at least in the western half of the US...don't know about the East or Overseas regions). A few years ago, it was Humana. Realistically, it's not awful, though there is definitely plenty of room for improvement. I could totally see expanding a Tricare-like system to cover everyone, especially as a half-step to a 100% public UHC system. You replace the company with, and the government becomes the sole controlling authority of whatever regional insurance companies are going to administer the program. You still have insurance companies (conglomerates?) managing the system, but it's all centralized by region, then controlled and paid for by the feds. Coverage is based not upon employment, but citizenship/permanent residency. others could probably buy into it as well in some form.

The danger of systems like this is wait time & priority. When it's free for everyone, people are much more willing to go to see the doc about any random little illness or infirmity. That's notionally good for overall public health, but only if the health system can support it -- enough docs to see patients, support staff, etc. For example, the military system is EXTREMELY short on dentists. I recently had a filling on a molar partially chip off, taking a chunk of my tooth with it (bit a popcorn kernel... oops). The tooth had jagged edges, and was cutting into my tongue. Went to get in with dental, and they told me to come back in a week (!!!) when they could fit me in for a quickie 30min procedure to tide me over until they could do a proper fix. A week of blood & pain later (I couldn't even swallow without a flash of pain), they filed down the sharp edges, slapped some temp sealant on there, and scheduled me for a proper appointment 6 weeks later. Almost everyone I know has had dozens of appointments, surgeries, and other procedures delayed repeatedly due to higher priority patients bumping their procedures down the road.

Any solution will have to be holistic and far-reaching. The healthcare industry needs (has long needed) an infusion of trained manpower. Doctors, PA's, nurses, techs, and on down. Without it, elective procedures will face 2-3 month (or longer) delays, and even more important procedures will struggle with being prioritized sufficiently to take place in a timely manner.

[riverwed070707]

Agree with kork. It's a scam that the only way to have affordable health insurance is through an employer. It's a way of keeping people tied to corporations. In a country that supposedly supports small business and entrepreneurship, we sure to make it hard to raise a family with those kinds of work. I don't really have an opinion about keeping kids on insurance until 26... but I can tell you that won't be the case for mine because I'm leaving my corporate job when she turns 18 lol. Hopefully there is something in place for her by then.

[Like2Plan]

Let's talk about universal health care. Are you for or against? Have you or are you on medicare or medicaid? Also for parents have you kept your child on your healthcare plan past age 22-24 to age 26? Why? What do you think will happen when your child hits 26 and has to go on their own? What do you think should happen if you are supporting your child on health insurance to age 26 and they have children? Are you allowed to provide insurance for your grandchildren? When is enough enough? I mean we went from 18-22 to 24 to 26. Is the next number that we allow people to have their kids on plans to age 30? What happens if you ever want to retire and jobs because so few are offering health insurance instead you no longer can provide for your children?

I used to dislike HDHP because I think people get the shaft versus normal HMO. I still think it's more shifting it to people who are healthy get ahead instead of properly balancing risk. But now I'm like sure I"m healthy and young and wish I had a HDHP. We have PPO that is good.

I'd also like a universal coverage in case we lose our job we aren't scrambling for work. I hope that this recession with all these people unemployed i Wonder if this is the push to universal coverage? Enroll everyone now and then everyone under 18 and over age 50? And everyone unemployed gets medicaid and can buy into public option. Then we'll have only 26-50 year olds covered by work and if they lose their jobs they transition fast to a public option?

I think everyone thinks universal health care is a good idea. But, no one has figured out how to pay for it. If it was easy, we would have already been doing it. Simply transitioning people over to Medicare doesn't magically pay for the costs. And, Medicare doesn't cover all the costs. (It seems like the co-pay costs are creeping up to what medical care use to cost a person without any insurance.) Finally, Medicare is confusing and is not just one medical coverage as it currently exists. There is part A (hospital). Part B (medical care) Part D (prescription coverage) and so on. Plus, a whole bunch of private insurances which cover the co-pays etc.

I mentioned in another thread that DH has recently started Medicare. It's a long story, but basically because he continues to work and our primary medical insurance is through me (and I am retired)--DH has to pay a higher premium than the $144.60 that most folks have to pay for part B. The higher premium for higher incomes (because DH is still working full time) is because congress has to pitch in for the cost of part B medicare as it would not be affordable for pensioners to pay the entire cost. So, right now part B Medicare is not self sustaining on the premiums that people pay. The part B payment we pay is in addition to the health insurance that we will continue because Medicare does not cover everything--not by a long shot.

When I turn 65, our Medicare expenses will double because the cost is per person.

We kept our DS on our insurance until he was 26, but he didn't use it after he graduated from college. (But, he could have if he needed it, so it seemed like a no-brainer). He was also covered by his employer.

[disneysteve]

I think everyone thinks universal health care is a good idea. But, no one has figured out how to pay for it.

We all know how to pay for it: taxes. Look at any country that has universal coverage. Their tax rate is much higher than ours. I will happily pay higher taxes if it gets me and everyone else health coverage. However, I'm a liberal Democrat. I believe in silly stuff like that. Half the country disagrees.

[Like2Plan]

The danger of systems like this is wait time & priority. When it's free for everyone, people are much more willing to go to see the doc about any random little illness or infirmity. That's notionally good for overall public health, but only if the health system can support it -- enough docs to see patients, support staff, etc. For example, the military system is EXTREMELY short on dentists. I recently had a filling on a molar partially chip off, taking a chunk of my tooth with it (bit a popcorn kernel... oops). The tooth had jagged edges, and was cutting into my tongue. Went to get in with dental, and they told me to come back in a week (!!!) when they could fit me in for a quickie 30min procedure to tide me over until they could do a proper fix. A week of blood & pain later (I couldn't even swallow without a flash of pain), they filed down the sharp edges, slapped some temp sealant on there, and scheduled me for a proper appointment 6 weeks later. Almost everyone I know has had dozens of appointments, surgeries, and other procedures delayed repeatedly due to higher priority patients bumping their procedures down the road.

In the case of your dental care--isn't that for active duty only? I would think the problem isn't that it is "free", but rather they don't have enough providers for the number of patients they must take care of. This touches on another problem that I have with socialized medicine- shortages. Maybe on the whole they have enough dentists, but maybe they are not in the right places...

[disneysteve]

In the case of your dental care--isn't that for active duty only? I would think the problem isn't that it is "free", but rather they don't have enough providers for the number of patients they must take care of. This touches on another problem that I have with socialized medicine- shortages. Maybe on the whole they have enough dentists, but maybe they are not in the right places...

I worked for 17 years in one of the poorest cities in America. A high percentage of my patients had Medicaid. There was essentially ONE dentist in the area who accepted Medicaid. And you couldn't make an appointment. You had to get there in the morning and get in line and it was first come, first served.

Having insurance and having access to care are two very different things.

[Like2Plan]

We all know how to pay for it: taxes. Look at any country that has universal coverage. Their tax rate is much higher than ours. I will happily pay higher taxes if it gets me and everyone else health coverage. However, I'm a liberal Democrat. I believe in silly stuff like that. Half the country disagrees.

It all sounds good on paper. But, there are a couple of things that gives me pause. When I think about it. I would say some of the current leadership would be a classic reason as to why you wouldn't want socialized medicine. Would you like some of the folks who are currently in leadership positions having total control about your health care decisions? You can fill in the blank for some of the likely candidates that I wouldn't want making these decisions. But, here's one example--how about the UK's initial decision to go with "herd immunity" for the current covid-19? The thing of it is you don't even have to be a doctor to be making funding decisions in congress.

The other problem is the ever expanding budget and inexhaustible appetite for expansion. Also, I'm dubious that this would streamline anything.

Still, there should be health care insurance that is available to everyone. I think the affordable health care act while not perfect at least tried to solve that problem.

[disneysteve]

Still, there should be health care insurance that is available to everyone. I think the affordable health care act while not perfect at least tried to solve that problem.

Definitely. The ACA made great strides. Of course, then the current administration came in determined to undo as much of it as possible. That's a big part of the problem with a national plan, as you pointed out. It would be an endless system of one party improving coverage and the other tearing it down.

[LivingAlmostLarge]

How will we pay for it? I don't know maybe instead of paying THOUSANDS of dollars a month for MEDICAL INSURANCE premiums we pay for it that way? I KNOW Personally and do taxes for families who pay on Average $18k-25k/year for medical insurance. Some are families and some are a couple of 50 year old contractors. EVERYONE above 50 pays through the NOSE for medical insurance of any kind because it will prevent bankruptcy. Even those getting subsidies will tell you it is VERY expensive.

It's been proven and shown through lots of data that the US pays the most for medical insurance, care, and outcomes and the worse patient outcomes. We spend too much at End of Life. We spend too much on risky procedures. We also pay a premium to dr more than most countries. The AMA is good at keeping the number of Dr down.

Also I live by and do taxes for dentist. Where i live there is an overabundance of dentists so salaries are lower. But dentists and likely dr don't want to live in rural or underserved areas. I can say that because one of my neighbors moved from Michigan and couldn't give his practice away there an he was making about 50% more but half the COL. Sooo.....how do you deal with people not wanting to live and work in places like that? If it's all universal insurance and pricing then dr would accept everyone and there might not be the same waits.

[disneysteve]

How will we pay for it? I don't know maybe instead of paying THOUSANDS of dollars a month for MEDICAL INSURANCE premiums we pay for it that way? I KNOW Personally and do taxes for families who pay on Average $18k-25k/year for medical insurance.

Exactly. Instead, raised taxes on EVERYBODY to provide universal coverage. Then nobody will have to spend 25K/year to cover their family. And even if they do pay that in taxes instead of premiums, they'd be no worse off than they are now and everybody would be covered.

[Snicks]

I would support it if there was a real effort to COOPERATE and do it right.

[disneysteve]

I would support it if there was a real effort to COOPERATE and do it right.

I guess the question is how do you get both parties to cooperate on something - anything really, not just this - when one party is fundamentally opposed to what the other party is trying to accomplish?

[Like2Plan]

How will we pay for it? I don't know maybe instead of paying THOUSANDS of dollars a month for MEDICAL INSURANCE premiums we pay for it that way? I KNOW Personally and do taxes for families who pay on Average $18k-25k/year for medical insurance. Some are families and some are a couple of 50 year old contractors. EVERYONE above 50 pays through the NOSE for medical insurance of any kind because it will prevent bankruptcy. Even those getting subsidies will tell you it is VERY expensive.

But, one of the proposals I have seen on this board is to move everyone over to Medicare. Would you be willing to pay about $500 per month per person in your household for coverage that does not include prescription drug coverage (that is an additional cost)--and then on top of that, pay for supplemental insurance for coverage that medicare does not cover?