Scrap Heritage Foundation Mandate, put in public option

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http://www.reuters.com/article/2012/06/ ... 1M20120625

The conservative Heritage Foundation plan - the individual mandate - seems to be unpopular. Scrap it. And, while they're at it, put in a public option. Oh, and remind people where the mandate idea came from.

[youtube]http://www.youtube.com/watch?v=sjefrWJ1SgQ[/youtube]

it is a hopeless quest to enlighten us amuuricans who think we [and only we] already know everything worth knowing. be glad there is canada, a kinder, gentler place.

Most of them don't understand it. Even a broad outline seems to be beyond the average American. So if a new health care plan is debated one day I'd suggest making it as simple as possible. Hillary's employer mandate was sunk by complexity and easy demonizing. The conservative alternative, the individual mandate, suffered in the same way.

The problem is that to get simple you have to be sweeping. In two efforts in twenty years that has not happened. Probably for several reasons.

an ugly, but simpler method of extending effective health coverage to the working class, would be to take the tax credits given to businesses and switch them to individuals instead, with the stipulation that this could only be applied to some kind of officially vetted health coverage with at least a 100% catastrophic care component, in addition to preventative care services which are much cheaper than the mere tertiary care much of the working class has available to them in emergencies. delayed/deferred health care/health care reform acrues a kind of interest, which means the longer you put off fixing a problem the worse that problem will get and the more expensive it will be to fix that problem.

Well, let's see what the Supremes do tomorrow.

If they maintain the individual mandate (and I haven't counted Roberts and Kennedy out, yet), then we're done. Mandatory participation in the private market will be the new normal.

If they scrap the while works then the wonks are going to have to start working overtime to come up with new scripts by September--because there will be a lot of pissed off voters on both sides if the result of this exercise is the status quo ante.

But if they scrap the individual mandate, but leave the balance of the legislation in place, then we are in a very interesting world--one in which the private provision of medical insurance may cease to be a viable business line for any insurer, because of the changed approach on pre-existing conditions, which will allow the freeloaders to wait out their healthy years.

In 24 hours we'll know more, and we can drag out our crystal balls.

I don't support a public option but at least in theory that increases coverage. The individual mandate does nothing but make insurance companies rich, I can't believe anybody supported that corporatist monstrosity.

We already had "free-loaders" with the status quo. Uninsured people using expensive emergency services frequently bankrupt themselves on medical debt which they have absolutely no control over (unless the wish to die on the street). The hospital system charges more to recoup this cost. This is extra cost is then factored back into the cost of insurance premiums. The hospital ER system would bankrupt itself if there were no insured people paying inflated premiums to indirectly cover the uninsured.

So the basic issue is everyone ends up paying for catastrophic care whether they ever intended to or not. It would go against the ethical oaths of the medical profession to refuse treatment to someone who has a severely debilitating injury or illness or may outright die without treatment. This seems to put emergency hospital care in the same category as other types of emergency services, i.e. police and fire. There is a mandatory cost as someone has to pay no matter what. This is one of the main issues that makes health-care so dissimilar to other purely capitalistic markets. Consumption of services is not primarily driven by choice.

Society decides the external costs of letting fires spread uncontrolled and letting criminals run loose is too great, so we pay for these services collectively through taxes on the basis of ability to pay rather than usage of services. The only way to avoid external costs in the healthcare system is to refuse treatment to those who are unable or unwilling to pay for them. If conservatives want to argue we should go that route they can have at it. I believe the majority of Americans would be repulsed by that particular solution leaving only a very small percentage of compassion-less die-hard conservative types in favor. That and a handful with the mistaken belief that charities will be able to pick up the cost. The problem is voluntary charity is simply unreliable as a systemic solution because charitable donors are not clued in on the needed funding. Charity only works for very specific targeted projects.

Well since I cannot afford health insurance, I would hate if it was required I purchase it...I mean what the hell would I purchase it with? I would like actual Universal Healthcare though.

Emergency care is actually pretty cheap, all things considered, and most health care systems are well positioned to deal with the heart attacks and trauma cases. A lot of the chronic stuff turns into palliative care--which is also pretty cheap, unless someone has the coin to pay for the expensive therapies.

The really expensive stuff is ongoing intensive or chronic care: intensive care, kidney dialysis, transplantation, antiretrovirals, some (but not all) cancer treatments. These are the Rolls-Royce therapies--and they are the therapies that private insurers can duck when freeloaders show up to buy health insurance after they get sick. But if the "pre-existing" condition clauses evaporate, then it's open season for the freeloaders to sign up the day that the doctor says the "C" word, and start their chemo on the insurer's dime.

"cheap" for whom? certainly not for me, the last time i had a malignant hypertensive emergency i was billed $3k for my stay in the ER. NOT cheap.

Compare that to $500,000 for a year of kidney dialysis (and that's in this country--in yours it's probably more like $1.5M) and the prices start to take on relative weight.

If someone can't afford to stay alive, why do they deserve to live?

If someone can't afford to stay healthy, why do they deserve to stay healthy?

If someone can't afford to keep working, why do they deserve to work?

You get what you pay for. If you can't afford to pay, well... I suppose it's polite to pretend that it was nice knowing you, but you aren't much use anymore, are you?


And if you disagree with all of the above statements, great! Politics takes money. If someone can't afford a lobbyist, why do they deserve to have an opinion?

who but the dogs wants to live in this dog-eat-dog world, anyways?

couldnt have said it better.