Health Care a Constitutionally Protected Right

[Axxon]

http://apnews.myway.com/article/20040714/D83QSAO00.html

I hadn't seen this discussed here and I was wondering what everyone thought about it?

I'm surprised it passed so overwhelmingly and saying "the cost of providing universal coverage through a variety of public and private means could be made up by eliminating billions of dollars in unnecessary costs currently built into the state's health care system" seems a little vague.

I'm all for the concept mind you but I wonder how this one is going to fly or if the voters are even going to pass it.

[duckman]

I've been through government healthcare systems. It's not pretty. :(

[Axxon]

I've been through government healthcare systems. It's not pretty. :(

Neither is no health care, trust me. :(

We need a system that provides for all it's members ( and lets the emergency rooms be used for what they are meant for, emergencies )but I'm not against people being able to purchase higher levels of additional coverage. That's the american way.

[JonInMiddleGA]

Well, they don't call it The People's Republic of Massachusetts for nothing.

[Axxon]

Well, they don't call it The People's Republic of Massachusetts for nothing.

That's a little to concise of an answer Jon. Want to elaborate just a bit? :)

[SFL Cat]

Why do you think health care is a right?

If I think I have a right to free car repair then I suppose that means the government should take over all car repair facilities in America and provide free car repair and maintenance for everyone.

Also, if I think in-home heat and cooling should be a right that everyone has access to, then maybe the government needs to take over all utilities and see to it that every man, woman and child has indoor heating and cooling. They could also take over all the AC and Heating companies to guarantee that everyone gets free service so they can stay comfortable.

How to pay for this? Simple...the government can cap everyone's salary at $30,000 and use the rest to pay for all these rights we're entitled to. You might not be able to afford some of the luxuries in life like vacation cruises, long road trips, boats, game systems, or big screen TVs...but then, why should only the "rich" enjoy such things. If everyone can't have those things...then no one should have them.

[Desnudo]

That's a little to concise of an answer Jon. Want to elaborate just a bit? :)

As Massachusetts goes so goes the...state of Minnesota?

[Axxon]

Why do you think health care is a right?

If I think I have a right to free car repair then I suppose that means the government should take over all car repair facilities in America and provide free car repair and maintenance for everyone.

Also, if I think in-home heat and cooling should be a right that everyone has access to, then maybe the government needs to take over all utilities and see to it that every man, woman and child has indoor heating and cooling. They could also take over all the AC and Heating companies to guarantee that everyone gets free service so they can stay comfortable.

How to pay for this? Simple...the government can cap everyone's salary at $30,000 and use the rest to pay for all these rights we're entitled to. You might not be able to afford some of the luxuries in life like vacation cruises, long road trips, boats, game systems, or big screen TVs...but then, why should only the "rich" enjoy such things. If everyone can't have those things...then no one should have them.

There's really no point in trying to hold a rational discussion with someone who cannot differentiate between a human life and luxury items so I won't.

It'd take too much work to explain to someone like that how we already pay for this in hidden costs or how the health of people who have insurance is jeopardized daily by those they come in contact with that don't or who have come in contact with those that don't. It would be difficult to convince them that healthcare doesn't exist in a vacuum exclusive to every individual so by denying this "right" they're jeopardizing their own health.

[SFL Cat]

There's really no point in trying to hold a rational discussion with someone who cannot differentiate between a human life and luxury items so I won't.

It'd take too much work to explain to someone like that how we already pay for this in hidden costs or how the health of people who have insurance is jeopardized daily by those they come in contact with that don't or who have come in contact with those that don't. It would be difficult to convince them that healthcare doesn't exist in a vacuum exclusive to every individual so by denying this "right" they're jeopardizing their own health.

Take a look at history. The more the government has stuck its nose into healthcare to try and "fix" it, the higher the prices have gone. If you ask me, some good old fashioned tort reform, especially in the area of malpractice would do wonders for both the costs of insurers and medical professionals

And how you think I'm equating a human life with a luxury item is beyond me. You apparently didn't even bother to read my post. My only point in the previous post was about who was going to pay for this "right" to healthcare.

I'm positive you don't work for free (at least I hope you don't), but you seem to expect the physician and his/her support medical staff to do so when you start clamoring for free healthcare for all. And unless you flunked economics 101, surely you realize that in any socialized system, even when the government is supposedly picking up the tab, the TAXPAYER is still footing the bill.

As I said, if we expect the government to care for us from cradle to grave in every aspect of our lives, then its only fair for every citizen to give the government a majority of his/her earned income to help pay for this to keep the system solvent. Since the average earned income is around $30-$35K, then that seems to me to be a reasonable range to CAP everyone's earnings. The rest can go to the government so it can provide all these "free" services you seem to think we are all entitled to receive.

[sooner333]

If we're losing jobs to Mexico, I don't see why we can't open up trade with Canada on prescription drugs...which they get significantly cheaper. It's time to bust the lobby on prescription drugs and drive down the costs. If we do that, the drugs will actually go down in price and this prescription drug coverage won't be necessary.

[Axxon]

Take a look at history. The more the government has stuck its nose into healthcare to try and "fix" it, the higher the prices have gone. If you ask me, some good old fashioned tort reform, especially in the area of malpractice would do wonders for both the costs of insurers and medical professionals.

I agree with tort reform but that's only part of the equation. The emergency room has become the de facto health care provider for the uninsured and the poor. I've worked in our emergency room and we estimated that approximately 80% of our visits would have been better handled in an outpatient environment and the vast majority of our er bills go unpaid.

Well, this money has to come from somewhere. Guess where it comes from? That's right, you and me, Joe taxpayer that's where. County hospitals cannot refuse anyone treatment regardless of condition or ability to pay. So, you think we're not paying already for the health care of the poor already? Think again.

In our hospital the er staff makes more than staff in any other department, even doing the same jobs. An er doctor earns more than a gp would for the same work. It's crazy but there it is, you prefer to pay more for the illusion that you're paying less.

Now, you need to go to the emergency room but your injury isn't life threatening. Hello, 8 hour wait. Those are normal at our er with 4-6 hrs being the average. Yep, you're sitting in a hospital waiting room sharing god knows what airborne nasties are going around and you're doing it for a long time. Heck, I remember a guy who had TB who forgot to tell anyone and sat for hours in our er. Hope that illusion of saving money comforts you if this guy breathes on you.


And how you think I'm equating a human life with a luxury item is beyond me. You apparently didn't even bother to read my post. My only point in the previous post was about who was going to pay for this "right" to healthcare.


So, your only point is asking who's going to pay but you felt the need to do so in a way that brought up luxuries? I call bullshit and you know it. You were trying to compare human life treatment with such frivolities as car repair and free air conditioning to somehow devalue the argument that health care is a necessity. Your examples were not. Had you used an example like food then maybe you'd have had a point but you didn't, you went for the cheap shot and I called you on it.


I'm positive you don't work for free (at least I hope you don't), but you seem to expect the physician and his/her support medical staff to do so when you start clamoring for free healthcare for all.

Better tell me where I called for free healthcare for anyone much less for all. Simply stating that something is a right doesn't begin to deal with how to implement that right. In fact, the article I cited doesn't discuss this and neither did I.

As for suggesting that doctors and staff work for free, man, give me some of what you're smoking. I suppose the doctors in Canada and England all work for free? You left the realm of reality here brother. Let us know when you come back down. PHEW.


And unless you flunked economics 101, surely you realize that in any socialized system, even when the government is supposedly picking up the tab, the TAXPAYER is still footing the bill.

Well, as I said, we already are. Still, how we pick up the bill is what's the issue. I'm certainly not suggesting that the system forces everyone to use the same health care options. That isn't needed.

What they are saying is needed is a minimum standard that everyone in their state has a right to. The onus can partially be shifted to businesses. Require that they must carry insurance plans that meet or exceed this threshold. The more successful businesses will, and already do, offer plans that are attractive to get the best employees.

Now, before you start on the small businesses, I've owned three small businesses in my time and I know how expensive this would be but so what? If I can't make my business go in a particular place then maybe I shouldn't be in that business. I had one of my businesses that could not offer insurance and believe me we tried. I certainly think that I shouldn't have been in that business and I got out. :)

If we're going to use this argument, which is ludicrous we need to kill workmans comp insurance too because that's a killer. Lets kill social security too, I'd have liked that. Ditto unemployment. Lets remove all the safeguards we have in place. We had that before. Oh yeah, most peoples lives sucked back then too.


As I said, if we expect the government to care for us from cradle to grave in every aspect of our lives, then its only fair for every citizen to give the government a majority of his/her earned income to help pay for this to keep the system solvent. Since the average earned income is around $30-$35K, then that seems to me to be a reasonable range to CAP everyone's earnings. The rest can go to the government so it can provide all these "free" services you seem to think we are all entitled to receive.

Again with labelling me and my thinking. "The rest can go to the government so it can provide all these "free" services you seem to think we are all entitled to receive".

Hey I only mentioned one right, health care. You're the one who is obsessed with your car bills and air conditioning. :)

[Axxon]

dola,

this last post may seem a tad snippy but I can't help it. I lost the calmer post, which said the same points basically, but nicer, to the FOFC 1am lag. Man I hate that shit. It's enough to make anybody snippy. :(

[stkelly52]

My basic problem with guaranteed heath insurance is that I have met very few people who can not afford health insurance. I know that here in Washington State you can get free of very cheap coverage if you are below or around the federal poverty level. If you don't qualify for that then you can afford insurance. The problem is that people choose not to. They decide that it is more important to have cable (or a tv at all for that matter), an internet connection, a car, fast food or any number of other luxuries instead of insurance. That is a choice that people make, so if you choose that then live with the choice you have made.

[Axxon]

My basic problem with guaranteed heath insurance is that I have met very few people who can not afford health insurance. I know that here in Washington State you can get free of very cheap coverage if you are below or around the federal poverty level. If you don't qualify for that then you can afford insurance. The problem is that people choose not to. They decide that it is more important to have cable (or a tv at all for that matter), an internet connection, a car, fast food or any number of other luxuries instead of insurance. That is a choice that people make, so if you choose that then live with the choice you have made.

See, that's all that need be done anywhere. If you don't WANT a right, it shouldn't be forced on you. I don't think anyone wants that. Not all states work like that though. South Carolina doesn't. Free clinics don't count as health insurance and they aren't generally available as illnesses crop up. A 6 week wait for an appointment at the hospital clinics, which aren't free but are cost subsidized, is normal. It's only one place. There aren't enough facilities in the area to meet demand as we're in a high poverty area.

Free health insurance that would be honored at more than one facility in the county is the right idea. If Washington State is like that then I'd say they're doing things right or are at least moving in the right direction.

I do believe all businesses, not just large ones, should be required to offer a group plan though. Individual insurance really isn't an option even to people not under the poverty level. Maybe a little pressure can be put on insurance companies to offer these policies as the price of doing business in the state.

[Fritz]

Well, they don't call it The People's Republic of Massachusetts for nothing.

depends on your point of view....

[randal7]

[QUOTE=Axxon]The onus can partially be shifted to businesses. /QUOTE]

No, it can't. One of two things will happen. The business will simply not be able to function under this burden and will close, or the cost will be passed to the consumer in the form of higher costs.

And before we say "So?" to the second option, consider this: most goods/services are used in equal proportion per person rather than proportionally to income. That is to say, most people eat more or less the same amount, have more or less the same number of TVs, cars, and so on, need the same amount of clothing, and so on. I realize there is some variance according to income, but still most goods/services are consumed in closer proportion to number of people serviced than to amount of income per family. The point of this long ramble being, these increased costs will disproportionately hit the middle class and employed lower class because the more you make the less of your income (proportionately) will be stolen by these increased costs. Anytime you say "make business pay some of the cost" you are really saying "tax the working class and also make some of their jobs go away".

I agree that there SHOULD BE universal health care. I used to pay close to 1/4 my income for health insurance for my family (and could give you a long rant about insurance companies but will spare you). I just don't think there CAN BE universal health care, at least not that improves on what we have.

[Fritz]

"it shall be the obligation and duty of the Legislature and executive officials ... to enact and implement such laws as will ensure that no Massachusetts resident lack comprehensive, affordable and equitably financed health insurance coverage for all medically necessary preventive, acute and chronic health care and mental health care services, prescription drugs and devices."

I am not medical professional or lawmaker, but I would want to know more about what exactly this means. If I were a Mass resident, the inclusion of the word ALL would bother the piss out of me. What does ALL include?

Then again, if I had a job in Mass, I would probably live in New Hampshire.

[Eaglesfan27]

This is an interesting issue. Ideally, I would like to see healthcare for all. However, there are so many practical issues that make this difficult. In New Orleans, we have Charity Hospital which is one of if not the largest Charity Hospital in the United States. It is a shell of it's former self due to years of repetitive cuts (and was only spared another round of cuts by a last minute deal from the state legislature which came under heavy pressure from local grass route groups.)

The fact of the matter is I think healthcare is too expensive as currently constituted to make ANY state be able to afford an efficient well run health system. Why does health care cost so much? I'm not an expert in the economics and I don't know. My educated guesses would be the ability of drug companies to charge exorbitant amount of money for their drugs. I'm not painting all of the blame on drug companies, but I know they overinflate their costs to "cover the cost of research and development." However, like any for profit industry the drug companies want to make money. I don't fault them for that, but that raises the cost of healthcare. It also drives the motivation of companies to make newer, hopefully better drugs. Just like any other free trade industry, the possibility of making a higher profit drives the industry to attempt to make better products.

Another reason for the high costs is the inefficiency in the system. There are several reasons for the inefficiency. The biggest reason is the litiginous society we live in. Doctors order tests that are in many cases unnecessary to prevent a law suit from occuring. For example, every time I order Geodon (a newer antipsychotic) for a patient, I make sure I get an EKG. Why? Because, there was a study in France where 3 people died from a rare cardiac arryhthymia while on this medication. Never mind that the Torsaides de Pointe arrythmia that they had was likely due to a pre-existing condition. We now order EKG's on all patients regardless of age, general fitness level, etc. because we don't want to be sued if our patient has a rare genetic abnormality in their heart and they die on that medication. Is that good medicine? It's debatable I suppose, but I think it is grossly inefficient. There are many examples like this. I think Tort Reform would solve a portion of this problem, however, I don't believe it woudl completely solve the problem.

There are several other reasons the system is too expensive, but I'm VERY tired secondary to being post call right now, and I cannot recall my other reasons.

Also, I think if medicine was going to undergo some sort of socialization process it would require a major restructuring of the medical school system. Right now, medical school on average costs over 150,000 dollars for 4 years (that includes living expenses - my family didn't have the money to help with any of that.) That is after 4 years of college. Now, don't get me wrong. I'm happy with the economics in my life for the first time ever. However, the fact remains that I had a scholarship to USC for undergraduate, but with inflation I still have over 200,000 dollars in debt. I couldn't afford to have a decent quality of life that people who go through 4 years of college and 4 years of medical school (which were the most demanding 4 years of my life without exception) expect to have, if my salary was significantly lowered by a socialized system of care. I think if salaries were driven down significantly which I think would likely be necessary to make a system of healthcare for all work, I think you would see a greater shortage of doctors than what is already starting to exist.

So, Ideally I think a system with healthcare for all is a wonderful idea. However, I think practically there are too many obstacles to make it work.

However, I agree with the idea that the poor and uninsured (actually it's not just this socioeconomic class which does this) are using (abusing?) the ER system as their primary care physicians which causes its own set of problems. Of course, we who pay taxes are helping to subsidize the healthcare system significantly whether it be via medicare or whatever means you want to look at. However, I think the current system of healthcare if made officially open to all would overwhelm the taxpayers financially.

I'm tired from being up all night on call, so I hope I didn't accidently say anything that comes out wrong in this post :)

[gstelmack]

Insurance companies and healthcare providers are partly to blame here. I was glad to see lawsuits finally starting to be filed over the whole "drug costs $40 to the insurance company but $75 to an uninsured person" or "procedure costs $10,000 to the insurance company but $30,000 to an uninsured person" mess. I bet more people would not need prescription drug coverage if they would get the same price as the insurance companies get...

[Mountain]

Tort reform is a dangerous remedy in this field. First of all, the economic realities of bringing a medical malpractice lawsuit prevents the filing of frivolous or low value lawsuits. Since almost all of these cases are brought on a contingency basis, the attorney who files the suit absorbs the costs of the lawsuit whether or not there is any recovery for damages. The costs associated with medical malpratice swuits are enormous, expert fees being the most prohibitve, usually aournd $50,000 to hire an expert in a medical malpractice case. Also, the time the attorney has to spend on the case which, in most jurisdicitons takes eighteen months to two years to reach trial, and thats assuming that the case survives all the pretrial challenges to the case to bring the lawsuit.

At minimum, the costs to a lawfirm for filing a medical malpractice lawsuit is $100,000 which means a jury must award damages of at least roughly $300,000 just to break even in raw dollars, (this does not take into account the present value of the $100,000 up front outlay that you're not getting the benefit from while waiting for the suit to come to trial). As a practical matter, most attorneys will not accept a medical malpractice lawsuit unless the prospective damages are at least one million dollars. In other words the doctor's alleged mistake has to be very serious in order to worry about a lawsuit.

The point of all this is that the perception that these medical malpractice lawuits are frivolous is false. Not to mention that the attorney and his client can face sanctions from the court if the court finds the lawsuit frivolous.

Tort suits operate as a form of safety control over the medical industry. Doctors and hospitals and the companies that insure them are constantly evaluating methods to be safer and eliminate mistakes to avoid the potential laibliity of the lawsuit. It makes our health care system better and less prone to mistakes because there is an awareness of the consequences of not taking precautions.

So what do we lose if we enact tort reform and cap damages at say $250,000 which is a popular figure bandied about by those people who support tort reform? Well you lose the filing of medical malpractice lawsuits altogehter because of the costs associated with bringing the suit. If this happens, then the only check on doctor's competency is the government thorugh licsensing boards and oversight agencies and free market. I think those people who argue for tort reform as a method of controlling costs to avoid a governemnt provided medical system, argue that the government is incompetent to run the medical system. From SFL Cat's earlier post: "Take a look at history. The more the government has stuck its nose into healthcare to try to 'fix it' the higher the prices have gone." It seems strange to distrust the governemnt so much one area, yet have so much trust in the governemnt to do an adequate job in regulating the competency of doctors.

The free market argument goes something like this. Doctors, like any other business, get reputations for good or bad performance. So if a doctor kills their patients then no one will go to them and their incompetency will drive them out of business. Several problems with the market force regulation. One, it assumes consumers have perfect information upon which to base their decision of choosing their doctors. Two, the vey good doctors are going to charge very high prices and be almost impossible to see driving the lower income people towards the most incompetent doctors with only the govenrment to assure the doctors competence. Three, the whole things smacks of "caveat emptor" (let the buyer beware) which this country has rejected for all its products for around one hundred years now. Its one thing to have a caveat emptor theory for your toaster but quite another for a doctor who literally has your life in his hands.

Basically in health care there are varying goals. To provide the best possible care for the lowest price and greatest accessability. To that extent it is a balacing act to accomplish this. I agree that someday we may have to consider a very limited tort reform to cap costs and allow accessabiliy, but I think it should be a last resort and very cautiously implemented. If you want an example of something simple we could do to cut costs is allowing our government, who is probably the largest single purchaser of drugs in the country to negotiatie rates with drug companies. Could you imagine if Wal-Mart didn't use its buying power to negotiate with its suppliers, it's prices wouldn't be as low, that's for sure. I for one would rather subsidize health clinics rather than using my taxpayer dollaras to subsuduze the profits of drug companies.

This post is long enough but if anyone is interested I can provide the details of a very concrete example of the consequences of tort reform. ENRON.

[JonInMiddleGA]

I do believe all businesses, not just large ones, should be required to offer a group plan though.

Okay.

So then my small business simply decides not to hire an employee at all rather than absorb that cost.

And then that person gets to have no job and no health insurance.

Gee, seems like a real bargain you've just given that person (who would have gained valuable experience in an entry-level position, allowing them to move on to bigger & better things in a few years).

Sorry Axxon, but there's already more than enough fees, charges, taxes, et al associated with hiring employees. What you suggest will have either a chilling effect on small business hiring or sound the death knell of small businesses that are hovering on the edge of breaking even, or more likely IMO, both.

[SirFozzie]

What about the people who slip through the cracks.

For example, I happen to know someone who works for $14 or so an hour.. who was out of work for five months last year. A job he loves, a job he does well.. but a job he can't keep after October.

Why?

Because after October he will no longer be covered by even the usurious levels of COBRA health care (Which costs him about a full week of his pay, post taxes each month). He's a contractor, working full time hours, with none of the perks.. (Health, Sick time, Holiday, Vacation). There was NO jobs offering health insurance during the period he was looking for a job last year.. and there are basically no jobs offering that today.)

Oh.. to put a face on this person.

It's me.

Trust me, I've been looking for a "Contractor's" Health Plan. There isn't one.

[clintl]

My basic problem with guaranteed heath insurance is that I have met very few people who can not afford health insurance. I know that here in Washington State you can get free of very cheap coverage if you are below or around the federal poverty level. If you don't qualify for that then you can afford insurance. The problem is that people choose not to. They decide that it is more important to have cable (or a tv at all for that matter), an internet connection, a car, fast food or any number of other luxuries instead of insurance. That is a choice that people make, so if you choose that then live with the choice you have made.

I call bullshit on this argument. I'm paying for my own insurance, and it's killing me. It barely within affordability back when I had a good paying job, and I was nowhere near the poverty level. And I can't do anything about it except become uninsured because I'm in a HIPAA plan, and have a chronic medical condition no insurance company I've found will underwrite a policy if you have. (This condition, by the way, is easily and effectively treated.) You can get an affordable private insurance if you are completely healthy, but as far as I can tell, if you have certain pre-existing conditions, you are completely screwed.

The current health insurance situation is a classic case of market failure. Everybody needs it, but many can't afford it. That is a fact. Part of the reason it is so screwed up is that the system we have in the US depends mostly on employers providing it as a benefit, and many small employers can't afford it, just as many individuals can't afford it.

[clintl]

Dola...

One possible solution might be to require all employers offer all employees (including part-time employees) the opportunity to buy into a group health insurance plan, even if the employer is not contributing to the premiums. I know in California, small businesses can join insurance pools to reduce their insurance rates.

[Desnudo]

My feelings on it are: well gee, they've done such a fantastic job with Medicare, SS, welfare, overregulating our current system to the point that no one wants to be a doctor anymore, and any other public service you care to describe, why not throw more of our tax dollars away on something that I'm sure will fully please no one and will leave the majority of people, who have health insurance, both poorer and with a worse medical plan.

[Cuckoo]

My feelings on it are: well gee, they've done such a fantastic job with Medicare, SS, welfare, overregulating our current system to the point that no one wants to be a doctor anymore, and any other public service you care to describe, why not throw more of our tax dollars away on something that I'm sure will fully please no one and will leave the majority of people, who have health insurance, both poorer and with a worse medical plan.

I knew if I waited long enough, someone would say what I was thinking. :)

[Joe Canadian]

Free health care kicks ass!

[JonInMiddleGA]

Tort reform is a dangerous remedy in this field. ...


I have to say that I've rarely seen a post in a hot-button thread that I've enjoyed more or thought made better points than yours.

I can't think of an industry that requires careful scrutiny, and severe penalties associated with abuses, than this one.

Bravo.

[Mountain]

Thanks.

The odd thing is you and I generally are on opposite sides of issues.

[duckman]

Free health care kicks ass!
Nothing is free, my friend.

[Fritz]

there must be a way to legislate ourselves to a perfect life!

[Arles]

I have to say that I've rarely seen a post in a hot-button thread that I've enjoyed more or thought made better points than yours.

I can't think of an industry that requires careful scrutiny, and severe penalties associated with abuses, than this one.

Bravo.
I agree with both of you in principle. The problem is that, in practice, the high dollar potential suits make getting insurance almost impossible for many doctors.

The best parallel is to imagine a similar situation for car insurance. How many people do you think would be insured if it cost $1000 a month to insure your car with Allstate?

While I agree that the threat needs to still be there to keep the industry in line, penalizing the 95% of doctors that do a good job with an obscene insurance bill doesn't seem like a very good practical solution. The only way around this is to cap the damages at a certain point. Because the current system is just not working.

[Fritz]

my lawn looks like shit and it really bothers me that the doctor down the road can afford a groundskeeper to take keep his looking top notch. Can we tackle this one next?

[Arles]

My feelings on it are: well gee, they've done such a fantastic job with Medicare, SS, welfare, overregulating our current system to the point that no one wants to be a doctor anymore, and any other public service you care to describe, why not throw more of our tax dollars away on something that I'm sure will fully please no one and will leave the majority of people, who have health insurance, both poorer and with a worse medical plan.

I think there is a parallel in concept between the minimum wage argument and health care. While having universal health care (or a higher minimum wage) seems very noble in theory, the truth of the matter is that both would put a very large burden on the working class. Both would increase taxes (or cost for goods) that primarily impacts the middle class. Much like what randal7 said, this activity hurts more than it helps. Instead of having a small percentage uninsured (or making a lower minimum wage), we now have a large percentage of working Americans spending more to get less.

If you go to a nationalized health care systems, there will be lines for everything. Right now, the cost keeps people from running to the doctor everytime they get a sore throat, cough, fever or minor injury. If everything is free, people will abuse it. This means longer waits. Also, there will be without a doubt a lower quality of care. Like Eaglesfan27 said, the government will probably have to cut salaries for doctors and may even need to go as far as making sure certain quotas of medicine study are met. This means smart and capable people that were considering being a doctor will now go into research in the private sector or some other field entirely. It also means longer hours at a lower rate which increases the chance for mistakes and lower qualified people.

The best solution is to get some data on the small number of working Americans that are not insured and try to find a process to target them. Maybe it means raising the salary floor for tax credits on health insurance. Maybe it involves some kind of subsidy if you have a certain condition and make less than X dollars. I don't know the exact formula, but targeting the small number of people that need the help, while keeping the 90+% of the working Americans that have health care with the same level of care and taxes, seems like a better idea than making everyone (including middle class people happy with their health care) pay more in taxes for a lower quality of care.

[clintl]

One thing that might help is if people could deduct the cost of their premium, rather than only the amount over 7.5% of their adjusted gross income. Right now, the only people who can do this are self-employed people who are making enough net income from their business to cover the premium costs.

[JonInMiddleGA]

While I agree that the threat needs to still be there to keep the industry in line, penalizing the 95% of doctors that do a good job with an obscene insurance bill doesn't seem like a very good practical solution.

I think this is kind of like me & Mountain (agreeing infrequently but seeming to be much more in step in this thread), you I & seem to be in agreement frequently but are in different places this time.

If I agreed with you on the underlined part above, I might be more inclined to go along with the notion of some sort of cap.

Instead, believing pretty strongly that a more accurate percentage above is far lower than yours, tends to lean me away from hard caps.

[Mountain]

One thing I don't know is the types of medical malpractice insurance are available to doctors and what type of deductible options they have. However, I do know that for your personal health care coverage you can opt for just catastrophic insurance (hospitalization). Considering the econmic realties involved with bringing the medical malparctice suit, doctors really don't need insurance unless the prospective damages of the suit are very high. Perhaps alternative methods of insuring doctors is the way to go rather than foreclosing suits.

Arles, I'm not sold on the fundamental premise of your argument. If you live in a populous area, how difficult is it for you to find a doctor? Rural areas have accessibility to doctor issues but that has always existed. regardless of the current state of litigiousness. I can see solo practices being hit very hard by this and perhaps the day of the solo practicioner doctor are over. However, doctors can band together and form joint practices to spread out the effects of fixed overhead costs. While doctors may be upset by this, why should you or I as patients care whether our doctor is a solo practicioner or a member of a group pracitce. Also, most doctors who I know who have been practicing are not hurting for money, as alluded to by Fritz's post and his comment about the doctor's groundskeeper.

Like I said, you can certainly see the detrimental impact of the dimishing economic reality of a solo practicioter in rural areas, however, the governments, state and federak,can set up incentives, some of which already exist (loan forgiveness), tax credits, etc.

I think we need to think this all the way through. Lets say I am a patient who goes in for a gall bladder surgery but by a mistake made by the doctor during surgery I suffer brain damage and now function with a four year old mental capacity. I'm forty years old and make forty thousand dollars a year and require medical attention and drugs to function even at this severly diminshed capacity. Probably my damages from pain and suffering, loss of economic earnings capacity, loss of consortium with my wife and other actual damages are conservatively $2,000,000 with the vast bulk of these represented by premanent loss of earning capacity.

If you cap this man's damages at $250,000 its not going to be enough to support him in the future and he's going to have to go on social security disabiity (government pays to support him.). So then the taxpayers in general are paying to subsidize his medical care, just as they would if we had a universal health care system and as ab added bonus you lose the checking effect on the doctors. If you were in a car accident with another person and its his fault, you would expect him to pay the full amount of your medical bills and time lost from work wouldn't you, I don't hear anyone screaming for tort reform in the area of auto accidents. So in essence what you are saying is that people who are injured by doctors don't deserve full compensation for their injuries. Why? What's the principled distinction between the person hurt in the auto accident and the person hurt by the doctor?

[GrantDawg]

Insurance for my family would cost me about 50% of my income. I can pay for health insurance, or we can eat. So, we have decided to eat. :)

[JonInMiddleGA]

What's the principled distinction between the person hurt in the auto accident and the person hurt by the doctor?

1) There are more doctors who are also lawmakers than there are serious-injury-accident victims.

2) The doctors have a much stronger & more organized lobby (which extends to their p.r. machine which has helped invent this particular issue).

[Mountain]

Ironically enough, the easiest way that doctors could achieve tort reform in the field is to consent to a goverment run health care system and become government employees. Then they would be governed by sovreign immunity and could only be sued by the conset of the state. Most states and the federal government have a tort claims act which allows for suits against the governemnt, but have caps on the amount of damages you can recover, and prohibits recovery for damages caused by emotional distress and won't allow punitive damages.

Interesting Catch-22 for the doctors.

[sabotai]

I do believe all businesses, not just large ones, should be required to offer a group plan though.

Which would destroy all small business owners. I make $10 an hour and I don't have health insurance. If my employer was forced to give me health care, one of two things would happen. I'd either make a lot less an hour, or I'd be out of a job (and since I have to work to pay bills, I'd have to go work some shitty job for minimum wage.) So now, because there is a law that says I HAVE to be given health insurance by my employer, who I'm sure is by law not allowed to give me more money if I don't take him up on his health insurance offer because that would be saw as "punishment" to those who do, I don't make enough money to pay for the bills I have.

Sorry, I think I'd rather just pay for my health costs with $10 an hour than not be able to pay for some of my student loans, credit card, car insurance, etc. And yes, I've been to the doctor several time since December, have had a CT scan done, been to the neorologist, had blood tests done, have been given many different prescriptions to take...and guess what!? I'm still here. You want to know something else? In all of that, in all of the stuff I've had to do since December, both of my parents individually have paid more for their insurance than I have in all of my doctor visits, tests, medicine, etc.

Doctors are very understanding of people without insurance (or I'm just lucky with the several I've had...). They will charge less for visits and prescribe generic drugs (or give you a handful of samples) that cost $10 or $15 for a month. General health costs are not as expensive as some people make them out to be.

I know everyone does not have my situation. Some people do need either some kind of insurance or for the cost to be lower. But the way some people act sometimes, they think those who go without health insurance simply can't afford to just go to the doctor when they're sick. That's simply not true.

[Eaglesfan27]

Ironically enough, the easiest way that doctors could achieve tort reform in the field is to consent to a goverment run health care system and become government employees. Then they would be governed by sovreign immunity and could only be sued by the conset of the state. Most states and the federal government have a tort claims act which allows for suits against the governemnt, but have caps on the amount of damages you can recover, and prohibits recovery for damages caused by emotional distress and won't allow punitive damages.

Interesting Catch-22 for the doctors.

This is one of many reasons, all of my contracts are state based contracts. I don't want to have to deal with the hassles of malpractice, and I like serving the populations that I do at the various clinics which are state run.

[Fritz]

perhaps I am the only one who sees things this way, but everything you get from the government comes at a price of individual liberty. IMHO if the state is paying for your health, they should have a lot to say about your lifestyle. No thank you.

[SirFozzie]

perhaps I am the only one who sees things this way, but everything you get from the government comes at a price of individual liberty. IMHO if the state is paying for your health, they should have a lot to say about your lifestyle. No thank you.

Ok.. so what should happen with the folks who can't GET health insurance, because nobody is offering jobs with health insurance>

[Fritz]

I guess you go into debt or worse. Same thing that happens if I need something not covered by healthcare. Sorry guy, nothing in life is free.

[Fritz]

and yes, I have gone through it.

[clintl]

perhaps I am the only one who sees things this way, but everything you get from the government comes at a price of individual liberty. IMHO if the state is paying for your health, they should have a lot to say about your lifestyle. No thank you.

I think that a very, very strong case could be made that state higher education institutions have been a great force for enabling liberty. Most people would still be stuck in dead-end farming jobs if the only choices were private institutions like Harvard and Stanford. And we wouldn't have FOFC at all, because a workforce with the skills to develop the technology wouldn't exist yet.

[SirFozzie]

I guess you go into debt or worse. Same thing that happens if I need something not covered by healthcare. Sorry guy, nothing in life is free.

I don't want free.

I want to pay for my healthcare.

Sadly, either you have it through your job, throuogh your post-job (Cobra), or you just DON'T HAVE IT.

That creates a case of haves and havenots.

The # of contractors/temps are growing quickly (most of the "jobs" created recently are lower paying, contractorish jobs). Maybe there should be a law that states that temp/contractors could by into the company's health care, at full price.

That's what MA is trying to create. Not free healthcare. Healthcare for all.

[sabotai]

I don't want free.

I want to pay for my healthcare.

Sadly, either you have it through your job, throuogh your post-job (Cobra), or you just DON'T HAVE IT.

This is a MA thing? I know it's not the way in NJ. Both my parents pay for their health insurance as individuals.

[SirFozzie]

sab: Maybe I am missing something, but I've been looking.. Insurance companies are very heavily regulated here in MA (just look at the mess of MA Auto Insurance)

[sabotai]

sab: Maybe I am missing something, but I've been looking.. Insurance companies are very heavily regulated here in MA (just look at the mess of MA Auto Insurance)

Hmm. That's kind of wierd.

And I know about regulated auto insurance. In NJ, it's a frickin' nightmare with how much car insurance costs.

[Tekneek]

I'd never vote for it. I've gone through times with no health insurance. I just never thought that the government should force somebody to get it for me. No doubt the people up there will support it. After all, they had a chance to vote down their state income tax and decided to keep it. They love this kind of stuff.

Doctors are probably thinking about finally moving out if it passes. Good job, Mass!

[Tekneek]

I don't want free.

I want to pay for my healthcare.

Sadly, either you have it through your job, throuogh your post-job (Cobra), or you just DON'T HAVE IT.

That's not true. You can buy health insurance directly with many companies. There are websites out there to help individuals get quotes.

[JonInMiddleGA]

Edited to add: Somehow I managed to post this to & with a sabotai quote, instead of SirFozzie, for whom it was intended.

Hmm. That's kind of wierd.

And I know about regulated auto insurance. In NJ, it's a frickin' nightmare with how much car insurance costs.

No idea whether this is
a) legit
b) reasonable
c) useful at all

but just in case ... http://www.nasro-co-op.com/health/ma/index.shtml

[Marc Vaughan]

I'm personally in favour of goverment funded health schemes - but thats not surprising as I'm British and we've got the national health scheme here ... this means in its most basic term that you'll get treated for anything and don't get charged above a standard tax taken from your wages (around 4% until you earn around $50,000 then it rises to around 6% if I remember right).

Any medicine you require is paid for at a standard rate (basically you pay a set fee for it regardless of whether it cost the goverment 50 pence or £500 ..).

In addition to this anyone can get private care if they want (which tends to have posher hospitals with better TV's ;) ) by having their own scheme on top.

Why do I like this - frankly because I don't like the idea of someone dying from something which could have been treated simply because they don't have any money. In the 19th century fire-engines would watch uninsured houses burn down because they didn't have the insurance, today such an act would be considered disgraceful in most societies ... to me someone dying for lack of medical care because they can't afford it is a similar disgrace and something which should be avoided as much as possible.

I do however realise that the system in America is very funamentally different to that in England and could no more U-Turn towards this setup than for the country to change its gun-laws (or indeed vice-versa for England to do so). There is simply too much inertia, not just from the infrastructure and regulations in place, but also from peoples attitudes towards the various systems (in general people will always accept as 'normal' whatever they're used to and be wary of an untried (by them) alternative).

(Realises he's waaaay too far from his fence for comfort and runs for cover ;) )

[SirFozzie]

That's not true. You can buy health insurance directly with many companies. There are websites out there to help individuals get quotes.

Try to find it. I've tried several sites linked through Monster (where I'm doing a major part of my job hunt). NONE of them work in MA

[-Mojo Jojo-]

Axxon posted early on a key point that frequently gets lost in the shuffle of the health insurance debate. We are already paying through the nose for uninsured folks who treat emergency rooms as their primary care provider. The question is not whether we want the state to provide health care for people who can't afford insurance, but rather how do we want to structure it to provide the best care at the lowest price. Getting these folks out of emergency rooms and into more appropriate venues and providing them with inexpensive preventive care could actually save us some money.

Tort reform is (or ought to be) a whole other subject. While I don't have specific sources to cite (maybe someone here can comment), I believe I've read that generally speaking it tends to be a small number of physicians who get hit by a lot of malpractice suits who drive up the insurance costs for everybody. A more vigorous policing by somebody (the government, the AMA?) to root out and unlicense incompetent doctors might make a big difference in reducing malpractice insurance costs, as well as promoting public safety.

[SFL Cat]

Ironically enough, the easiest way that doctors could achieve tort reform in the field is to consent to a goverment run health care system and become government employees. Then they would be governed by sovreign immunity and could only be sued by the conset of the state. Most states and the federal government have a tort claims act which allows for suits against the governemnt, but have caps on the amount of damages you can recover, and prohibits recovery for damages caused by emotional distress and won't allow punitive damages.

Interesting Catch-22 for the doctors.

Yes...that has certainly worked well for the V.A. Sterling example of a "quality" government run system. :rolleyes:

[SFL Cat]

I agree with tort reform but that's only part of the equation. The emergency room has become the de facto health care provider for the uninsured and the poor. I've worked in our emergency room and we estimated that approximately 80% of our visits would have been better handled in an outpatient environment and the vast majority of our er bills go unpaid.

Most don't actually go unpaid. They are either written off as operating expenses or are passed along as higher rates to patients who can pay and/or insurance companies.


Well, this money has to come from somewhere. Guess where it comes from? That's right, you and me, Joe taxpayer that's where.
Can't argue with you there.

County hospitals cannot refuse anyone treatment regardless of condition or ability to pay. So, you think we're not paying already for the health care of the poor already? Think again.
So then...what's your beef? If you're willing to abuse the system, then you obviously do have access to healthcare.


In our hospital the er staff makes more than staff in any other department, even doing the same jobs. An er doctor earns more than a gp would for the same work. It's crazy but there it is, you prefer to pay more for the illusion that you're paying less.

Now, you need to go to the emergency room but your injury isn't life threatening. Hello, 8 hour wait. Those are normal at our er with 4-6 hrs being the average. Yep, you're sitting in a hospital waiting room sharing god knows what airborne nasties are going around and you're doing it for a long time. Heck, I remember a guy who had TB who forgot to tell anyone and sat for hours in our er. Hope that illusion of saving money comforts you if this guy breathes on you.
Then it seems to me that a law should be passed allowing ER doctors and staff to refer non-emergency medical cases to the appropriate outpatient facilities rather than having to process every single person who walks through the door (hoo boy, can you imagine the malpractice suits if something like this happened. F---ing hospital wouldn't treat my condition.)


So, your only point is asking who's going to pay but you felt the need to do so in a way that brought up luxuries? I call bullshit and you know it. You were trying to compare human life treatment with such frivolities as car repair and free air conditioning to somehow devalue the argument that health care is a necessity. Your examples were not.
I say bullshit on your bullshit call. Having dependable transportation IS vital...especially if you don't live within walking distance of where you work or the place isn't readily accessible via public transportation. I've known quite a lot of people in my time who have lost their jobs simply because they didn't have reliable transportation to or from work.

Maybe you live in Shangra-la, but during a hard heatwave in a typical Midwestern city, it isn't unusual to see anywhere from 30-100 people die from heat related stress because they don't have access to AC (malls and libraries don't stay open 24/7 you know). Ditto during harsh cold spells for people (usually the elderly) who can't afford to heat their home.

Had you used an example like food then maybe you'd have had a point but you didn't, you went for the cheap shot and I called you on it.
I'll admit I'm a little envious sometimes when I go to a 24 hour grocery late at night and see someone ring up over $150 worth of items and pay for everything with foodstamps. I think, "damnit, it sure would be nice if I didn't have to write a personal check for my stuff." Now before you go off on your tirade, about how I want poor people to starve, I have no problem with federal assistance for food for the needy, but I do tend to get a little pissed when I see these people purchasing items that I don't consider necessities. In fact I see a lot purchases that I either can't afford (item is too expensive -- with three kids you've gotta stick to your budget) or I wouldn't purchase (I guess they think some of that junk food must be fortified with vitamins or something).


Better tell me where I called for free healthcare for anyone much less for all. Simply stating that something is a right doesn't begin to deal with how to implement that right. In fact, the article I cited doesn't discuss this and neither did I. If I misinterpreted what you meant, I apologize. Usually when I hear about someone having a "right" to something, the "whether I can pay for it or not," part is usually an unspoken condition.

As for suggesting that doctors and staff work for free, man, give me some of what you're smoking. I suppose the doctors in Canada and England all work for free?
Their income is certainly limited unless they have some kind of "private" practice on the side. Doctors in the States couldn't afford to attend med school if they had those kinds of restrictions on what they earned. Say what you want about the quality of socialized healthcare in a country like Canada. However, when someone needs the best-of-the-best in medical care, most folks will look for it here in the States (although you can pick up pharmaceuticals much cheaper from Canada).


Well, as I said, we already are. Still, how we pick up the bill is what's the issue. I'm certainly not suggesting that the system forces everyone to use the same health care options. That isn't needed. What they are saying is needed is a minimum standard that everyone in their state has a right to. The onus can partially be shifted to businesses. Require that they must carry insurance plans that meet or exceed this threshold. The more successful businesses will, and already do, offer plans that are attractive to get the best employees. Why put the onus on the small business owner? Why not promote systems already in place where individuals can pay for their own healthcare (group plans, personal medical savings accounts, low cost HMOs, etc.).

Now, before you start on the small businesses, I've owned three small businesses in my time and I know how expensive this would be but so what? If I can't make my business go in a particular place then maybe I shouldn't be in that business. I had one of my businesses that could not offer insurance and believe me we tried. I certainly think that I shouldn't have been in that business and I got out. :)
If I can't afford to offer benefits then I simply don't hire any employees except on a individual contract basis. They can then take care of their own healthcare like I take care of mine.


If we're going to use this argument, which is ludicrous we need to kill workmans comp insurance too because that's a killer. Lets kill social security too, I'd have liked that. Ditto unemployment. Lets remove all the safeguards we have in place. We had that before. Oh yeah, most peoples lives sucked back then too.
Like we'll ever get back a fraction of all the money we've paid into things like social security and Medicare during our working lives. During the past 20 years, I've been unemployed maybe a grand total of seven months. Just think for a minute if employers didn't have to manage all those government mandated hidden expenses for their employees -- the cost of hiring and "keeping" employees would certainly be much less. In addition, all of these things could be offered as optional pretax benefits. I've done the medical savings accounts and they're a nice little way to help pay unforseen medical costs.

[JonInMiddleGA]

Just think for a minute if employers didn't have to manage all those government mandated hidden expenses for their employees -- the cost of hiring and "keeping" employees would certainly be much less.

I can sure as hell vouch for that. The admin nightmare that is all of the various mandated gimmicks (such as me forced to pay unemployment ... on myself !), between the unproductive hours it costs small businesses and/or the chunk of change our CPA picks up handling some of those things is at least enough to provide a part-time job, perhaps even full-time job, for at least one person.

[Joe Canadian]

Free health care kicks ass!

You're right, but not having to worry about having to pay expensive hospital bills when a loved one gets sick or needs surgery is a hell of a lot better then having to worry about it. It's also nice to know that those who are less fortunate than me don't have to worry about that either...

[Arles]

Arles, I'm not sold on the fundamental premise of your argument. If you live in a populous area, how difficult is it for you to find a doctor? Rural areas have accessibility to doctor issues but that has always existed. regardless of the current state of litigiousness. I can see solo practices being hit very hard by this and perhaps the day of the solo practicioner doctor are over. However, doctors can band together and form joint practices to spread out the effects of fixed overhead costs. While doctors may be upset by this, why should you or I as patients care whether our doctor is a solo practicioner or a member of a group pracitce.

Depending on your medical profession, you will probably still owe a bunch even if in a group. My fear is that good potential doctors are opting for research-type jobs instead of entering the practice of medicine because of the numerous hurdles for people to be doctors. This would be even 10 times worse with a national health care system.

Like I said, you can certainly see the detrimental impact of the dimishing economic reality of a solo practicioter in rural areas, however, the governments, state and federak,can set up incentives, some of which already exist (loan forgiveness), tax credits, etc.
This might be a solution as well. However, then you and me just end up picking up the bill instead of the doctors. I think a limit on punitive damages (maybe even 500K or $1 mil) would go along way to reducing the cost for everyone.

I think we need to think this all the way through. Lets say I am a patient who goes in for a gall bladder surgery but by a mistake made by the doctor during surgery I suffer brain damage and now function with a four year old mental capacity. I'm forty years old and make forty thousand dollars a year and require medical attention and drugs to function even at this severly diminshed capacity. Probably my damages from pain and suffering, loss of economic earnings capacity, loss of consortium with my wife and other actual damages are conservatively $2,000,000 with the vast bulk of these represented by premanent loss of earning capacity.
This is a very good point. Both you and Jon have made many. I could certainly see some flexibility with the punitive limits. Remember, though, that compensatory damages are not capped. I'm not sure how potential earnings work with comp damages, but I'm pretty sure they are factored in for the situation above. Still, having you sue and win $100 million in some lefty court in California doesn't help the situation. And that's the situation right now.

If you cap this man's damages at $250,000 its not going to be enough to support him in the future and he's going to have to go on social security disabiity (government pays to support him.).
Again, the cap is just on punitive damages. If someone loses the ability to function and/or work at their job, I'm pretty sure that the lost revenue is figured by an equation and added to compensatory damages (which are not capped). Punitive is for "additional pain and suffering" that cannot be qualified. This is where the abuse occurs and people have $100-$150 millon lawsuits on mistakes by doctors. And, IMO, that's out of control.

If you were in a car accident with another person and its his fault, you would expect him to pay the full amount of your medical bills and time lost from work wouldn't you, I don't hear anyone screaming for tort reform in the area of auto accidents. So in essence what you are saying is that people who are injured by doctors don't deserve full compensation for their injuries. Why? What's the principled distinction between the person hurt in the auto accident and the person hurt by the doctor?
Again, I think you are forgetting that compensatory damages are not capped. If the same happened in your above auto accident injury, you would get full compensatory damages for medical bills and lost wages in the system I propose. The difference is that maybe your punitive damages would be capped at $1 million. But, you would get fully compensated for all calculated losses.

[clintl]

Just think for a minute if employers didn't have to manage all those government mandated hidden expenses for their employees -- the cost of hiring and "keeping" employees would certainly be much less. In addition, all of these things could be offered as optional pretax benefits. I've done the medical savings accounts and they're a nice little way to help pay unforseen medical costs.

So what? Fair treatment for employees is more important than keeping employers' costs down. Employers have only themselves to blame for this stuff, because they had a long history of treating employees like crap before unions and the government put a stop to it.

[clintl]

This is a very good point. Both you and Jon have made many. I could certainly see some flexibility with the punitive limits. Remember, though, that compensatory damages are not capped. I'm not sure how potential earnings work with comp damages, but I'm pretty sure they are factored in for the situation above. Still, having you sue and win $100 million in some lefty court in California doesn't help the situation. And that's the situation right now.



Do you realize that this cannot happen in California? California has capped pain and suffering damages from medical malpractice since the 1970s (I think the limit is $250K or $500K or something like that - it was in the papers not too long ago.) Compensatory damages should never be capped. That would be horrible public policy.

[Arles]

Do you realize that this cannot happen in California? California has capped pain and suffering damages from medical malpractice since the 1970s (I think the limit is $250K or $500K or something like that - it was in the papers not too long ago.) Compensatory damages should never be capped. That would be horrible public policy.
Sorry, I mixed up California and Florida. You can replace California with Florida or Pennsylvania. Again, no one has ever seriously proposed capping compensatory damages. And, if they did, I would stand out there against it. The caps have been on noneconomic or punitive damages. Right now, 26 states actually have laws that cap punitive damages (Alaska, California, Colorado, Hawaii, Idaho, Indiana, Kansas, Louisiana, Maryland, Massachusetts, Michigan, Mississippi, Missouri, Montana, Nevada, New Mexico, North Dakota, South Dakota, Utah, Virginia, West Virginia, Arkansas, Florida, Ohio, Texas and Wisconsin). And, specifically in Texas and Ohio (who just recently enabled them), caps in punitive damages have already had a big impact on cost (from the AP):

"In Ohio, executives with five insurers that write a total of 72 percent of the state’s medical malpractice liability insurance said that the market was stabilizing and they were poised to make profits for the first time in five years."

"A sharp drop in the number of medical malpractice suits filed in Harris County, Texas, since the passage of legislation putting a cap on pain and suffering awards and punitive damages has been recorded. In 2003, Texas Governor Rick Perry signed a medical malpractice bill that caps noneconomic damages cases at $250,000 per defendant, for a possible total of $750,000."

Both states have also seen a decline in the rates for malpractice insurance as well. Again, when tried, this seems to help the problem without impacting compensatory damages.

[GrantDawg]

Alabama is actually the state with the highest lawsuit payouts. I don't know why, except I have a feeling that most of the incidents start with someone saying "hey, watch this."

[oliegirl]

I have been bouncing between being insured and not insured for a couple of years...I was working as a temp for about 6 months (with no coverage), then a FT job with coverage, then got laid off and poof - no more coverage. My main priority was to make sure my son was covered, luckily in GA we have a program called Peachcare for Kids...he is covered at 100% for about $10 a month and that includes ALL his prescriptions. Thank God I haven't had to use it too much, but I am glad to know it's there.

As for me, I have also been lucky and haven't been sick to the point of needing a doctor since I got laid off. But given the choice, I would rather take my chances until I was able to get coverage (which for me is in October) over being on a state plan where I had to wait for 6 hours to be seen at a state or federal run clinic for strep throat. Like a previous poster said, if you explain your situation, many doctors will charge you less for the visit, which is only about $50-$75 anyway, and give you samples of medication. I would never be in favor of adding a government program to provide healthcare...doing so would take away one less incentive for people who don't want to work to get off their butts and get a job. I am not talking about anyone on this board, I am talking about the people who milk welfare and other similar programs.

There are more jobs and people working today than there were throughout the entire Clinton administration...the jobs are out there. Instead of a Federal/State insurance plan, how about if healthcare companies offer short term plans with low premiums and high deductible for "emergency" use...oh wait, they already do that!!!!

[SFL Cat]

So what? Fair treatment for employees is more important than keeping employers' costs down. Employers have only themselves to blame for this stuff, because they had a long history of treating employees like crap before unions and the government put a stop to it.

I started laughing until I realized you were serious.

What? Do you think "employers" go to some secret "employer school" so they can learn how to tirelessly exploit their employees??

An employer only has two obligations to an employee: 1) to provide as safe a work environment as the job will allow; and 2.) to compensate the employee for services rendered. If you approach benefits like health insurance as part of your compensation package rather than some "right" an employer owes you, you'll do much better for yourself.

[clintl]

I started laughing until I realized you were serious.

What? Do you think "employers" go to some secret "employer school" so they can learn how to tirelessly exploit their employees??

An employer only has two obligations to an employee: 1) to provide as safe a work environment as the job will allow; and 2.) to compensate the employee for services rendered. If you approach benefits like health insurance as part of your compensation package rather than some "right" an employer owes you, you'll do much better for yourself.

Did I say that? No. My comments were regarded toward the more general "cost of employment" remarks, and did not have anything to do with requiring businesses to buy health insurance as a benefit. However, it is a historical fact that prior to the union movement, employers typically treated their employees poorly, and that these "expensive" exployee rights obligations employers have imposed on them now are the result of them at one time not doing your 1 and 2 above very conscienciously. So, as a result, they have minimum standards imposed on them.

However, I do think employers that don't make an effort to create a good work environment that goes well beyond satisfying the minimum standards, and don't care about employee satisfaction and loyalty, are really stupid employers.

Now, if you will go read my posts earlier in this thread, you will see that in a number of places, I have made comments that suggest I don't expect all employers to pick up the cost of health care insurance for their employees. The closest I have come is here:

One possible solution might be to require all employers offer all employees (including part-time employees) the opportunity to buy into a group health insurance plan, even if the employer is not contributing to the premiums. I know in California, small businesses can join insurance pools to reduce their insurance rates.

And by the way, the post just prior to that, I said:

The current health insurance situation is a classic case of market failure. Everybody needs it, but many can't afford it. That is a fact. Part of the reason it is so screwed up is that the system we have in the US depends mostly on employers providing it as a benefit, and many small employers can't afford it, just as many individuals can't afford it.

[Tekneek]

You're right, but not having to worry about having to pay expensive hospital bills when a loved one gets sick or needs surgery is a hell of a lot better then having to worry about it. It's also nice to know that those who are less fortunate than me don't have to worry about that either...

It sure as hell would be nice if somebody else would pay for my transportation to and from work. Oh wait, it would actually be a hell of a lot better to not have to worry about paying for electricity when we need power, water when we need it, etc. How 'less fortunate' do you need to be to qualify for the free stuff?

[JPhillips]

I can go along with tort reform only if there are reforms on the other side as well. Doctors need to be more harshly disciplined for major problems and records of doctor's mistakes need to be made public. We also need to completely reform the drug approval process so that drug companies can not run the entire system. As it stands now most if not all of the doctor's researching the effects of drugs are employees of the drug companies. I know from working on a drug company's behalf that the approval process as it stands is designed to cover up problems and get the drug to market ASAP.

As for national health care, I'm still shocked we haven't seen a push for this from big business. Profits would jump by a few percentage points if they could get out of the helath care business. My prediction is that business will eventually clamor for national health care as costs continue to rise. At that point it's a done deal.

As to whether national health care would be better than I current system I don't know. I have serious doubts though. The folks writing the law would give the medical industry too much say in the bill creating things like the prohibition on Medicare from negotiating bulk discounts. Only if congress was really willing to look at cost reduction plans would it have any chance of working.

Finally, on a sort of side note, it pisses me off that I help subsidize drug purchases for the rest of the world. I want NAFTA and the WTO to apply to US prescription drugs.

[Tekneek]

You think that corporations would rather be forced to pay higher taxes so everyone can get health care from the government than have the current system where it is optional? As it stands right now, businesses only buy health insurance benefits as a way to retain and attract talent.

[GrantDawg]

You think that corporations would rather be forced to pay higher taxes so everyone can get health care from the government than have the current system where it is optional? As it stands right now, businesses only buy health insurance benefits as a way to retain and attract talent.
Or, they are forced to buy extreme health insurance plans by their union workers.

[JPhillips]

Tekneek: Small businesses may object, but big businesses would love to get out of the healthcare business. It costs them a ton of money and they have to have employees specifically to administer the healthplan. I don't know where the breaking point is, but I still believe that big business will eventually demand that the government take over healthcare so they can get out of it.

Keep in mind this would also eliminnate any problems with retiree health benefits, which can become a nightmare for corporations.

[clintl]

Big business is going to care about one thing - is the tax less the cost of providing the benefit? If the answer is yes, they are going to support a national health care plan. And they are not going to care at all how it affects anyone else.