Health insurance bill passes the house

[Berkut]

How would I go about paying this for instance?  Full time student, unemployed, no real income.  I don't like it, I never go to the doctor, but if they were making me pay I'd be getting every little ailment checked out, may as well.

That's how its worked out hre in Mass. Now that everyone has to have insurance everyone is running to the Doctor whenever something comes up.

Of course, why not? It doesn't cost you anything, or very little, so you might as well use it!

The joys of disconnecting the consumer of a service from the person paying for it - what could possibly go wrong???

Trouble with that idea is, going to the doctor is no great fun... actually, it's more like a pain in the ass, you do it only because you have to. Yes, with 'socialized health care' you go to the doctor 'whenever something comes up', he sees you and you don't pay a cent... in money. But you spend at least two hours making the appointment, going to the health center, waiting, seeing the doctor and afterwards you have to buy medicines if necessary (at a discount, but they aren't 100% free). Not my idea of a well spent afternoon unless I'm ill, and not totally free... besides, that 'whenever something comes up' part avoids persons going to the doctor only when their little ailments have developed into something really serious.

You are basically arguing that there is enough dis-incentive to visit the docotr that the cost of the visist somehow doesn't matter?

That is just silly - not everyone is as terrified of visiting a physician as perhaps you or the people you know are - I certainly see all the time people going to the doctors for all kinds of stupid crap. My sister is an ER nurse in NYC - and she sees this all the time - people coming to the ER (who of course have no insurance of any kind) for the most minor of ailments.

And you really really want people to use doctors, if only because so many ailments are infectious illnesses.

Very few infectious illnessnes that are commonly seen are going to be less infectuous because someone goes to the doctor AFTER they are already sick. We aren't talkng about ebola, we are talking about the common cold.

You really should spend all of five minutes examining how this kind of thing works in Europe. Not that the system is perfect, far from it, but some things you fear simply don't happen.

I don't need to go to Europe, this is already happening right here in the good old United States. It is, IMO, the primary reason that health care costs in the US have skyrocketed in the last decade or two.

You bumped your head? Hey, order up an MRI! Why not, it is FREE!!!!

Fearing consumers will visit the doctors every day without any valid reason is a bit like fearing mandatory car insurances will make the number of car crashes skyrocket right trough the roof.

I don't think I said I was afraid consumers would visit doctors every day, I said I think consumers will consume a lot more services if they do not have to pay for those services themselves. You can argue that if you want, I guess, but I don't think you will have much luck, since that is a pretty basic assumption of human nature.

And really, comparing consuming health services with getting in a car accident? You are making Marty analogies look good.

To the extent the analogy works, it works for my point - you don't think people don't insist when they get in an accident that their car be fixed with only brand new parts, and go to the best shop for body work, and they want a nice rental car while the repair is being done, etc. etc., etc. - all because someone else will be paying for it?

[Berkut]

You really should spend all of five minutes examining how this kind of thing works in Europe. Not that the system is perfect, far from it, but some things you fear simply don't happen. Fearing consumers will visit the doctors every day without any valid reason is a bit like fearing mandatory car insurances will make the number of car crashes skyrocket right trough the roof.

He's probably going by personal anecdotal experience here... I can tell you anecdotally that Princesca's former boss in Massachusetts was going to the doctor nonstop for both her and her two kids, and all three were on an absurd amount of medication.  Seriously, she was at doctors' appointments like 3-5 times a week on average.  She had her eight year old son on Prozac, Xanax, some acid reflux shit, etc. and had him going to a psychiatrist.  The thinking is that this kind of behavior is what killed HMOs.

I don't know for sure, of course, but I wouldn't be surprised if Berkut has seen this kind of nonsense himself.

Indeed. I don't even need to look at other people, I see it myself. Why not go to the doctor if the cost is very little? It takes me 5 minutes to make an appointment, and maybe an hour for the appointment itself. The cost to me is $20, and that is the cost no matter what the doctor decides I might need, "just in case".

I most *certainly* go to the doctor more often than I would if I had to bear the real cost myself - and by real cost I mean the actual fair market value if we had a fair market - it is pretty much impossible to know what that actually is though. A lot more than my co-pay, almost certainly a lot less than what the doctors bills my HMO.

[Iormlund]

Alatriste is right. Unless you are one of the first for the day, going to the doctor basically kills an entire morning (I have to do it often, sadly). And getting an MRI or similar in a non-emergency situation will take you another morning, and so on ... I don't know of anybody who does that for "fun". In fact most of my roommates at the hospital took too long in going to the doctor (just as I did).

What really clogs our system is simply the amount of old people out there.

Also, I suspect most of those who flood the doctors with silly stuff do it already, just like addicts get their fix by whatever means possible. The rest of you are indeed supposed to go to get checked if you have a problem.

[Caliga]

What really clogs our system is simply the amount of old people out there.

I've said it before and I'm sure I'll say it again, but we need a mandatory execution age.

[Razgovory]

http://www.myleftnutmeg.com/diary/11757/support-for-public-option-in-connecticut-by-district

That must be the only poll showing a majority supporting the "public option" because virtually every serious poll I've seen shows between a majority and a plurality against it.  This particular poll shows not only a large majority in Connecticut, but also large majorities nationwides supporting it, which is a laughable.  Of course you would have to look at the internals of the poll and the way the question was phrased by the left-wing group that did this poll to get to the bottom of it.

I have seen other polls that show that large majorities nationwide are supporting.  In fact the polls I know that are showing that people don't support it are done by the same types who showed that John McCain would actually win in November.

[Faeelin]

Incidentally, I've seen a couple of people claiming the Stupak Amendment is unconstitional. Am I missing something, or is that a pile of horse shit?

[DontSayBanana]

Incidentally, I've seen a couple of people claiming the Stupak Amendment is unconstitional. Am I missing something, or is that a pile of horse shit?

Not sure about blatantly unconstitutional, but here's the text of the amendment itself:
http://documents.nytimes.com/the-stupak-amendment#p=1

I think I see where the issue is- the amendment claims that it in no way prohibits the purchase of supplemental coverage to include nonessential abortions, but it's unreasonable to assume that those using the subsidy to purchase insurance would be able to afford supplemental insurance; even though it says it doesn't prohibit coverage for abortions, it attacks the indigents' right to select their coverage through their pockets.

[Iormlund]

Based on the research that I've been doing here in Europe, I'd venture that Americans tend to care a lot less about the state and its money that Europeans.  Patients talk here about not wanting to be on very expensive medications as they understand that it costs the government a lot of money.  I think, us Americans, are more likely to be give what you got, I want the best and I don't care how much it costs the state.

I don't know if that's the biggest divide between us. For me the idea of deserving or not medical treatment because you can or cannot pay for it is much more alien. It just doesn't sound right. That everyone should have access to decent health care is for me a basic requirement of a working society, just like education or security.

[DGuller]

Trouble with that idea is, going to the doctor is no great fun... actually, it's more like a pain in the ass, you do it only because you have to. Yes, with 'socialized health care' you go to the doctor 'whenever something comes up', he sees you and you don't pay a cent... in money. But you spend at least two hours making the appointment, going to the health center, waiting, seeing the doctor and afterwards you have to buy medicines if necessary (at a discount, but they aren't 100% free). Not my idea of a well spent afternoon unless I'm ill, and not totally free... besides, that 'whenever something comes up' part avoids persons going to the doctor only when their little ailments have developed into something really serious.

And you really really want people to use doctors, if only because so many ailments are infectious illnesses.

You really should spend all of five minutes examining how this kind of thing works in Europe. Not that the system is perfect, far from it, but some things you fear simply don't happen. Fearing consumers will visit the doctors every day without any valid reason is a bit like fearing mandatory car insurances will make the number of car crashes skyrocket right trough the roof.

I was going to make the same point, but you said it better.  Everyone in my family has insurance, but no one sees doctors themselves (although my sister does see them regularly for her three children, of course).  Why?  Just foolish stubborness, and the fact that it's not a fun experience.

I would make an exception for the old folk.  I think a lot of them do like seeing doctors, for them it seems like a social event, and unfortunately the doctors frequently oblige.  However, that falls under Medicare, not the new coverage we're talking about.

[Berkut]

Based on the research that I've been doing here in Europe, I'd venture that Americans tend to care a lot less about the state and its money that Europeans.  Patients talk here about not wanting to be on very expensive medications as they understand that it costs the government a lot of money.  I think, us Americans, are more likely to be give what you got, I want the best and I don't care how much it costs the state.

I don't know if that's the biggest divide between us. For me the idea of deserving or not medical treatment because you can or cannot pay for it is much more alien. It just doesn't sound right. That everyone should have access to decent health care is for me a basic requirement of a working society, just like education or security.

But you don't need socialized health care to provide that, and in fact, the US already fulfills that "basic requirement" of a working society.

The debate is not whether or not everyone should have access to health care - that debate was settled decades ago - it is whether or not everyone should have the SAME access to health care, convenience, and who should pay for it all.

[DGuller]

But you don't need socialized health care to provide that, and in fact, the US already fulfills that "basic requirement" of a working society.

It doesn't always.  It does when you get into a car accident, it doesn't when you get cancer.

[Berkut]

I was going to make the same point, but you said it better.  Everyone in my family has insurance, but no one sees doctors themselves (although my sister does see them regularly for her three children, of course).  Why?  Just foolish stubborness, and the fact that it's not a fun experience.

So we should base the entire countries health care plan on the assumption that everyone is like your family?

I can assure you that there are lots of people out there who do not think like that.

And what is more, no matter how reluctant your family is to go see a doctor, obviously they would be MORE reluctant if they had to pay for it themselves - or rather, if their payment to go see a doctor was more clearly tied to their decision to go see one.

I would make an exception for the old folk.  I think a lot of them do like seeing doctors, for them it seems like a social event, and unfortunately the doctors frequently oblige.  However, that falls under Medicare, not the new coverage we're talking about.

How is the new coverage different such that it will prevent people from seeing the doctor whenever they have a tummy ache, if in fact they are inclined to do so?

What is different about this 'new coverage' that solves the fundamental problem I am talking about? And remember, this problem is not health care specific - it is a basic tenet of economic theory, that people will consume a service base din large extent on the cost of that service.

Is the plan to make the service so unpleasant and difficult to obtain that people won't want to get it, even if they really do need it?

BTW - I am not arguing that this would actually be any worse than what we have now, which seems to combine the worst aspects of private healthcare with the worst aspects of public servicing, so we get this current reality of ever increasing costs for the same levels of service, with the lions share of the increased money simply making the health care industry consume more and more and more of our actual income.

[Strix]

The debate is not whether or not everyone should have access to health care - that debate was settled decades ago - it is whether or not everyone should have the SAME access to health care, convenience, and who should pay for it all.

Don't confuse the debate with reality like that Berkut. It makes the GOP look much worse if people are allowed to scaremonger by suggesting that poor people are being denied medical care.

[DGuller]

What is different about this 'new coverage' that solves the fundamental problem I am talking about? And remember, this problem is not health care specific - it is a basic tenet of economic theory, that people will consume a service base din large extent on the cost of that service.

The difference is that it affects people who don't actually like seeing doctors, and/or have something better to do with their time.  The old folks don't see doctors frequently because they have Medicare, it's because they're old folks.  In Soviet Union, where everyone had coverage, it was the same.  They just don't have much to do with their time.

The problem you describe most certainly is there, but I think you're focusing on the wrong part.  It's severity, not frequency, that takes a hit.  It's not that people choose to go to the doctors willy-nilly, but rather that they go along with very expensive treatmennt that no cost-benefit analysis would come close to justifying, when a treatment 50 times cheaper would work almost as well.

[Iormlund]

But you don't need socialized health care to provide that, and in fact, the US already fulfills that "basic requirement" of a working society.

I think you and I have different ideas of what access entails. Having to go into bankruptcy to try to save someone close from cancer (to follow DGuller's example) doesn't sound to me like access at all. That that is an actual possibility at all is simply incomprehensible to me.