Is the Obama Honeymoon Over?

[Valmy]

What happens to the 15% who have no health insurance in the US?

That is a really difficult question to answer.  The system is just really complex.  In some circumstances emergency rooms have to treat you insurance or no.  Fans of the Byzantine Empire would love our health care system.

[Valmy]

What is so hard to understand about doctors preferring to work in urban rather then poor rural areas?

That makes perfect sense to me.  But Hans threw out the stat saying it was a result of the faults of the Canadian system instead.

[DGuller]

Canuck, you do realize a pretty small % of Americans are covered by HMOs, right?

No, I dont.  That is why I asking the questions.  My understanding of the US system is limited to the fact that there is a whole spectrum of ways people access health care from not at all to best in the world.

I'm not so sure it's a small percentage.  This 2006 USA Today poll shows 18% HMO, but this 1999 Reason article claims 85%:

http://www.usatoday.com/news/health/2006-10-15-health-poll1.htm
http://www.reason.com/news/show/30907.html

Wiki gives 28% for 1999, and 20% for 2006.  That sounds about right, HMOs have been slowly losing popularity over time.

[Ed Anger]

The funny thing is that abot 15% of Canadians lack a primary physician due to lack of doctors, which is about the same percentage that lack health insurance in the US.

Not sure why you are comparing the two.  Canadians who lack a primary physician (which means they dont have their own family doctor) still have access to free health care provided by clinics and hospitals.  Ineffect the clinic becomes their primary care giver.

What happens to the 15% who have no health insurance in the US?

Emergency room. Back in the day when I was 'po, there was a form you got from billing that got the feds to pay the bill.

[Malthus]

What happens to the 15% who have no health insurance in the US?

That is a really difficult question to answer.  The system is just really complex.  In some circumstances emergency rooms have to treat you insurance or no.  Fans of the Byzantine Empire would love our health care system.

The difference being that, in the US, you have to pay personally to have your eyeballs gouged out. 

[Malthus]

What is so hard to understand about doctors preferring to work in urban rather then poor rural areas?

That makes perfect sense to me.  But Hans threw out the stat saying it was a result of the faults of the Canadian system instead.

Well, to an extent he's right - the Canadian system hasn't developed a workable method of incentivising docs to move to the sticks.

Also, Canada has overall less docs, because being a doc isn't as lucrative here as in the US. But the effect of this is felt most severly in rural areas.

[Valmy]

The difference being that, in the US, you have to pay personally to have your eyeballs gouged out. 

And naturally the bill the Bulgarians got for their 10,000 opticalectomies was way inflated

[Malthus]

The difference being that, in the US, you have to pay personally to have your eyeballs gouged out. 

And naturally the bill the Bulgarians got for their 10,000 opticalectomies was way inflated

... On the taxpayer's dime. 

[fhdz]

The Iran press conference was interesting.  Obama doesn't hold his cool so well when the press is being snarky.

[Ed Anger]

The Iran press conference was interesting.  Obama doesn't hold his cool so well when the press is being snarky.

His teleprompter is cold and logical.

[Berkut]

What happens to the 15% who have no health insurance in the US?

That is a really difficult question to answer.  The system is just really complex.  In some circumstances emergency rooms have to treat you insurance or no.  Fans of the Byzantine Empire would love our health care system.

The answer varies from state to state, actually.

When I was unemployed, for example, the state provided health care for my kids was actually better than the health insurance I had. That is The Socialist Democratic Republic of New York though.

I don't think anyone really simply goes without healthcare - it ends up being provided in some incredibly inefficient manner or another.

[alfred russel]

What happens to the 15% who have no health insurance in the US?

They get treated when they show up with something serious.

The problems of not having health insurance are that:
a) They don't get primary care, so they frequently miss out on health screenings that can detect illnesses early as well as advice from doctors.
b) When they do present with illnesses, they do so in places like ERs that are expensive.
c) Insurance companies negotiate rates, so the rates for uninsured are much higher (which makes sense in a way--as a class, uninsured pay less for their treatments than anyone else, even if those with some means end up getting gouged). This is a huge incentive to avoid treatments as long as possible, and many people end up bankrupt.
d) The uninsured are concentrated in poor communities. Hence inner city hospitals chronically lose money and are in a fight for survival. These hospitals need to receive government support, so in a very backend and inefficient way we are providing universal health coverage.

[Berkut]

Again, in some states the state provides HMO-like health care coverage to the poor. So alfred's response does not really reflect ALL cases.

[alfred russel]

Again, in some states the state provides HMO-like health care coverage to the poor. So alfred's response does not really reflect ALL cases.

If they have coverage, they wouldn't be a part of the uninsured.

[Berkut]

Again, in some states the state provides HMO-like health care coverage to the poor. So alfred's response does not really reflect ALL cases.

If they have coverage, they wouldn't be a part of the uninsured.

They are for the purposes of this conversation about health care coverage, and more importantly, what happens when you cannot afford your own. In some cases, the answer is that the state pays for it.

What is interesting about the New York system is that the state basically pays for your enrollment in the state HMO - you are then free to choose your doctor from those that participate in that MO, which seem to be many (if not most) of them. My kids did not even have to change their PCP when we switched to it and then back.

I had insurance from my previous job however, but the State offered to pay for the kids, so I was not about to say no.