Health Care Costs - Who is Responsible?

Yeah, I know, rhetorical question.

I just found it interesting, that the costs of health care continue to rise while my actual quality of health care hasn't really improved all that much.

We just went through our annual benefits enrollment at my place of employment, and unsurprisingly, the "new and improved" plans this year both feature less coverage than last year's, as well as higher cost. So I'm paying more for a plan that has doubled my up-front out-of-pocket costs before coverage kicks in. Yay!

I'm sure that I'm part of the reason that my company's health care plan costs are changing in this way. My medication, which keeps me functional and able to work (and thus not living unemployed on disability/welfare) costs $1600/month for two 50mg shots. My coverage plan for prescription meds makes that $40 out of pocket for me. So that leaves $1560 monthly covered by my insurance plan.

My rheumatologist visit costs are rising as well. I don't even know what the charge for an office visit is now, since I pay a $15 copayment, but last time I was uninsured and paying with cash (about three years ago), they were running around $75/visit (for a 15-minute appointment).

This isn't including fees for blood tests and x-rays that they periodically need done of my joints, nor costs for regular health care issues.

These costs keep rising, we keep paying more... who exactly is responsible? Health care costs are advancing MUCH faster than either the rate of inflation or the average wage growth (or decline, depending on how you do the math...) of the American workforce. But the line I'm fed when I inquire as to the rising cost of my healthcare is that we, the victims, are the cause of it. We cost the system more money, so the system charges us more. But the system is what's charging us more in the first place, costing the system more money, which then causes them to charge us more.

What?

ok...

This is more a rant than anything I suppose, but I'm wearying of the circular logic behind rampant health care cost increases, and my annual benefits enrollment is like an annual reminder of everything I hate about our health care system in the US.

Linking profit to people's health just sounds irresponsible to me.

People should be able to pay for health care if they can afford it, maybe even forced to. But those that can't pay shouldn't have to find the money. This is where capitalism really does fail - how do you gain profit from ill (i.e. unproductive) people with no money? It just can't happen. And people can be poor through no damn fault of their own.

I'd like to be on my British high horse about this one, but our health care system is gradually being privatised by the back door as I type.

Man, I gotta move to Canada.

Farscry wrote:

We just went through our annual benefits enrollment at my place of employment, and unsurprisingly, the "new and improved" plans this year both feature less coverage than last year's, as well as higher cost. So I'm paying more for a plan that has doubled my up-front out-of-pocket costs before coverage kicks in. Yay!

Your thread reminded me that I needed to do my annual enrollment. I just finished it and my costs only increased 2.5%. My plan hasn't changed its benefit amounts, they still cover pretty much everything. Maybe your employer needs a better benefits team.

Baggz wrote:

People should be able to pay for health care if they can afford it, maybe even forced to. But those that can't pay shouldn't have to find the money.

Those who can afford often choose not to. They'd rather have a newer car than have insurance premiums deducted from their pay. Those who can't pay are covered under Medicaid, they just have to get off their butts and apply.

Baggz wrote:

This is where capitalism really does fail - how do you gain profit from ill (i.e. unproductive) people with no money? It just can't happen.

How can one expect innovations and progress to be made when there's no profit to be made; but still plenty of risks? It just won't happen. Instead, one makes profit from the ill who have money and everyone helps support those who are truly both ill and poor.

Baggz wrote:

And people can be poor through no damn fault of their own.

Those very few are the exception rather than the rule.

If you want to control health-care costs, the solution is to provide tort reform to lower the costs of malpractice insurance and to make the patient responsible for more of their costs, not less. Catastrophic events should be covered, but part of the problem is that the true costs of medical care are masked from the consumer, leading to increased demand and higher prices. If your co-pay was $100, people wouldn't run to the doctor every time they got a splinter.

Edit: Fixed it, thanks for the spot PurEvil

JohnnyMoJo wrote:

If your co-pay was $100, people would run to the doctor every time they got a splinter.

I'm assuming you mistyped this, and it should read "wouldn't". And honestly, it's the truth. Working in a military ER, where my patients didn't have any medical bills or co-pays really taught me this. Child has a 99F temp? Run to the ER and claim it's an emergency. Have a headache but don't have a car to get to the ER? Call 911 (happened way too frequently, it was rare we had an EMS come in that was even urgent). And don't get me started on the chronic migraine fakers... there's no damn reason a patient should be taking over 190 percocets within a 30 day time span, and it happens pretty often.

I don't know what to tell ya though Farscry. I've been lucky in that I haven't had to worry about this kind of stuff since I've been married. Since my wife is AD Navy, and I'm covered under her health plan, I've declined every health insurance offer I've gotten from an employer. Good thing too... nothing's worse than the insurance they offer to contract civilians who work for the Navy... I remember the rate was about $600/mo for family coverage, then you had a co-pay. They gave us a $2.36/hr raise to help pay for it, but since I turned it down, it was just a raise to me.

To be fair CC, I don't really understand the US health care system - so you can consider me talking out of my ass

CannibalCrowley wrote:

How can one expect innovations and progress to be made when there's no profit to be made

Why do we need prgress or innovation. I'm talking about fixing people with whatever is available today.

CannibalCrowley wrote:
Baggz wrote:

And people can be poor through no damn fault of their own.

Those very few are the exception rather than the rule.

I have to take eception here. How about all poor kids? Sure you can blame the parents - but not the kids themselves. Plus there are still problems (worldwide) with various sub-groups not having the equal access to opportunities as other's. People born with disabilities. People hit by natural disasters. Victims of crime. Etc. etc.

There are just too many factors with regards to a persons economic status they have purley to do with the location, timing, and conditions of their birth. Those that do start at a dis-advantage can of course work their way up, as it were, but they are still dis-advantaged.

Whereas someone born with the proverbial silver spoon in the mouth will very rarley even have to try to get ahead. They're already there from the start. And it takes a lot less effort to stay on top than it does to get there.

Now for most factors in life I'd say tough. We all just have to play the hand we're dealt and try to make the best of it.
But when it comes to people's health and well being I firmly believe that we should all act as a society and, you know, look out for each other - preferably without assigning each of us with a cash value.
I tend to think it's this kind of meta-familial sentiment that's helpped the human race get to where we are today.

Health care insurance is the #1 reason for health care costs, and high costs leads to more people getting insurance which leads to higher costs, on and on and on. Malpractice insurance (that dirty word again) is another contributor.

I have a firm belief that if people actually had to pay out of pocket for their own health expenses, the expenses would be much much cheaper.

Just a note for Farscry, the number of benefits eligible participants at your employer has a big impact on your employer's benefit plan costs. Benefit carriers like Aetna, BCBS, etc... have tiers of participants, the more participants your company has, the better rate they can negotiate with the insurer. Size of deductibles, co-pays and out of pocket maximums also play a part in the negotiations. After that your company decides how much of that rate they will pay on your behalf, some companies pay nothing, but most range anywhere from 50-80%, the remainder is what get's taken out of your paycheck.

EDIT: Baggz - I'm against "universal" health care, but then again I can pay my own bills. I guess if I wasn't willing or capable of earning money to pay my bills I might feel different. However I feel very few people fall into this criteria, in my opinion most of the people that won't improve their lot in life simply don't have the self-motivation, initiative or ambition to do so.

I don't think tort reform would honestly lower costs in the long run, but the companies that stand to profit from that the most certainly want us to believe that.

I also haven't seen in my experience that people go to the doctor too much for things that don't require medical attention, though it certainly does happen. In the times I've assisted in the ER, all but one patient legitimately needed medical attention. Unfortunately, yes, there were those who went to the ER because they had no medical coverage and couldn't go elsewhere. The only person who came in and didn't need treatment was a drunk who claimed he had a migraine, but really he was just dealing with a hangover. Guy was a real pain in the ass, too.

If my co-pay was $100, then I would question the need to pay much for my insurance, and how affordable that would keep healthcare for families in particular. Heck, I had a running tab at my rheumatologist when I couldn't afford it, took me several months to finish paying that off even after I finally had insurance.

[edit]Interesting point, Leaping. My company employs several thousand people altogether across multiple divisions, I haven't heard a ballpark figure recently though.

Baggz wrote:

Why do we need prgress or innovation. I'm talking about fixing people with whatever is available today.

You can't be serious. If everyone thought like that we'd still using bloodletting for everything from colds to migraines.

Baggz wrote:

How about all poor kids? Sure you can blame the parents - but not the kids themselves.

In that case the state should pay for the care of the children, after taking them away from their parents. Medical care is a part of giving one's children a good environment, parents who abuse their children by not providing them with medical care shouldn't be allowed to have custody of their children.

Baggz wrote:

People born with disabilities.

Some have disabilities bad enough that they can't work and some can't. Those who can work should be treated like anyone else.

Baggz wrote:

People hit by natural disasters.

Where you live is a choice. If you choose to live in a soupbowl, you shouldn't complain when the inevitable flood happens. Especially when you have plenty of time to leave and choose not to do so until it's too late.

Baggz wrote:

Victims of crime.

That's pushing it. I don't see how being a victim of a crime means that someone besides the criminal should pay for your medical care.

Baggz wrote:

There are just too many factors with regards to a persons economic status they have purley to do with the location, timing, and conditions of their birth. Those that do start at a dis-advantage can of course work their way up, as it were, but they are still dis-advantaged.

Oh, not this "we're oppressed for life" tripe. Please explain to me how Larry Elder is dis-advantaged today because he used to be poor.

CannibalCrowley wrote:

Oh, not this "we're oppressed for life" tripe. Please explain to me how Larry Elder is dis-advantaged today because he used to be poor.

So we get to listen to the "everyone can just pull themselves up by their bootstraps" tripe instead? Please explain to me how, for example, millions of Americans are supposed to get higher-paying jobs when those jobs are finite in number?

Baggz's other examples are solid examples of cases where people may need medical care and be unable to afford it and may not have coverage. No, it doesn't apply to every case in those examples, but a fair number of them.

Baggz wrote:

I'd like to be on my British high horse about this one, but our health care system is gradually being privatised by the back door as I type.

Man, I gotta move to Canada.

Sorry, Baggz, privatisation is becoming a big fight here too.

Farscry wrote:

Unfortunately, yes, there were those who went to the ER because they had no medical coverage and couldn't go elsewhere.

It's not that they couldn't go elsewhere, they simply chose not to do so.

Farscry wrote:

So we get to listen to the "everyone can just pull themselves up by their bootstraps" tripe instead? Please explain to me how, for example, millions of Americans are supposed to get higher-paying jobs when those jobs are finite in number?

Those who want high paying jobs badly enough will either get them or become self-employed. The jobs are out there, you just have to be willing to do more than the next guy. Many Americans have limits to the amount of work they'll do or what they'll sacrifice for a certain job. This is what holds them back and thus makes them unable to get those higher paying jobs.

There will always be people who want to be in a low paying job or simply don't have the drive to do anything else. As for those finite number of high paying jobs, they'll go to those who are willing to work for them.

Farscry wrote:

Baggz's other examples are solid examples of cases where people may need medical care and be unable to afford it and may not have coverage. No, it doesn't apply to every case in those examples, but a fair number of them.

The only example he gave where state medical coverage should be given was the case of extreme disability. In all the other cases people still have the ability to work. Improper preparation on their part doesn't make an emergency on the part of anyone else. The same goes for those who make bad choices (which goes double for those who continue to make those same choices).

Baggz wrote:

I'd like to be on my British high horse about this one, but our health care system is gradually being privatised by the back door as I type.

That's because the public system is failing, as per my earlier argument. When you hide the actual costs, all it does is overload the system.

JohnnyMoJo wrote:

If you want to control health-care costs, the solution is to provide tort reform to lower the costs of malpractice insurance and to make the patient responsible for more of their costs, not less. Catastrophic events should be covered, but part of the problem is that the true costs of medical care are masked from the consumer, leading to increased demand and higher prices. If your co-pay was $100, people wouldn't run to the doctor every time they got a splinter.

I agree that tort reform needs to be part of the solution, but I disagree about the patient paying much more of the costs directly. What you're talking about there is a system that risks leaving the poor and elderly without adequate health care, and I don't think anyone wants that. I don't believe there is a pure market-driven solution for this.

As for tort reform, my father-in-law is a surgeon who pays $60k - yes SIXTY THOUSAND dollars - a year in malpractice premiums, and he has never been found liable for a malpractice settlement in 35 years of practice. If that ain't a broken system, I don't know what is.

If you want to control health-care costs, the solution is to provide tort reform to lower the costs of malpractice insurance and to make the patient responsible for more of their costs, not less.

This makes about as much sense as the notion that the current problems of UA automotive industry are rooted primarily in the lawsuits filed by the accidents victims.

Last time I read about it, the leading cause of rising healthcare costs was were the increasing prices of medications, and not litigation costs and payouts in tort cases. Costs are galloping in all states across the board, including those that have passed the tort case reforms.

A simple way to check "where the legs are growing from" is to corellate the growth rates of overall healthcase costs to the growth pace of liability insurace premiums which doctors and the hospitals have to pay to their insurance carriers to hedge against the malpractice suits.

Last time I read about it, the leading cause of rising healthcare costs was were [sic] the increasing prices of medications

And the medication costs will keep rising because insurance companies are paying them and they negotiate the rates down. So say you're a pharma out there and know that your typical negotiation with Aetna is to get gastro medicines at 60% of "retail" price, but you still want to clear X percent in profit. No one except uninsured people not eligible for medicare/caid pay retail price (a very small market) so why not just mark the drug up to ensure the profit percentage even after the insurance negotiated rate? Then of course a few years later a newer drug comes out that does the same thing but slightly better, well it's gotta cost more than the old one. And uninsured people get screwed again with a newer higher "retail" price, which no insurance company actually pays this inflated price, it's just to make the "discounts" the pharma give to big insurers look better.

Same thing with doctor's rates. Go into any dentist or doctor office and get treatment X as an uninsured person and as a person with UHC or BCBS insurance. I can guarantee you in over 90% of treatments the insurance company pays less than the person without insurance. Which encourages people to get insurance. Which encourages higher prices and deeper insurance "negotiated rates", which encourages people to get insurance, on and on in a circle. Sound fair?

The healthcare industry at all levels really needs to be shaken up in my opinion.

CannibalCrowley wrote:
Farscry wrote:

So we get to listen to the "everyone can just pull themselves up by their bootstraps" tripe instead? Please explain to me how, for example, millions of Americans are supposed to get higher-paying jobs when those jobs are finite in number?

Those who want high paying jobs badly enough will either get them or become self-employed. The jobs are out there, you just have to be willing to do more than the next guy. Many Americans have limits to the amount of work they'll do or what they'll sacrifice for a certain job. This is what holds them back and thus makes them unable to get those higher paying jobs.

Emphasis mine. This is not an example that answers Farscry's question. It is an example of one person climbing over another on the economic ladder, leaving the "next guy" behind to fill the role of too poor for health care.

JohnnyMoJo wrote:

If your co-pay was $100, people wouldn't run to the doctor every time they got a splinter.

How would you respond to the argument that co-pays not only discourage the healthy from seeking treatment, but also those that need it, thus compounding the problem in the long run?

Emphasis mine. This is not an example that answers Farscry's question. It is an example of one person climbing over another on the economic ladder, leaving the "next guy" behind to fill the role of too poor for health care.

As long as we don't have a total socialist society, not everyone is equal. If everyone is not equal then someone has to be on the bottom. What do you want to happen?

Danjo Olivaw wrote:

This is not an example that answers Farscry's question. It is an example of one person climbing over another on the economic ladder, leaving the "next guy" behind to fill the role of too poor for health care.

The "one person climbing another" is what happens at the upper levels. At the middle class level there's plenty of jobs to go around. Barring some serious disability, anyone who can't make it into the middle class simply lacks the ambition to do so.

I grew up poor and I watched it happen. Those who actually wanted to climb out of poverty did so, the rest stayed where they were. Out of those who stayed poor, some will admit that they enjoy their life since sucking off the public teat makes for a relatively easy life. Others blame everything on society keeping them down when it's clear that they haven't put forth any effort of their own. They expect some company to knock on their door and offer them a 100k salary even though they didn't finish high school and refuse to learn any additional skills.

CannibalCrowley wrote:
Baggz wrote:

Why do we need prgress or innovation. I'm talking about fixing people with whatever is available today.

You can't be serious. If everyone thought like that we'd still using bloodletting for everything from colds to migraines.

Sorry CC, didn't make my self clear. We obviously need to progress and innovate - I was just saying that if I cut my hand, I put a plaster on it. I don't agonise over what benefit this action means for the future of all treatments - how much 'progression' I'm making in tha art of plaster application or anything. I just what a plaster on my cut because that's what's available to me now.
I was just talking about the need to treat those who may not be able to afford it, in the here and now.
Whatever health care system you use, it needs to be funded in some mannor, and some of the funding will naturally go into R+D.

CannibalCrowley wrote:
Baggz wrote:

How about all poor kids? Sure you can blame the parents - but not the kids themselves.

In that case the state should pay for the care of the children, after taking them away from their parents. Medical care is a part of giving one's children a good environment, parents who abuse their children by not providing them with medical care shouldn't be allowed to have custody of their children.

Very sensible. In order to avoid paying for the healthcare of the children, you propose that the state pay for the heathcare of the children and pay to raise them/re-home them.
Plus your still punishing the children born into a poor family by removing them from that family. Double whammy.

CannibalCrowley wrote:
Baggz wrote:

People born with disabilities.

Some have disabilities bad enough that they can't work and some can't. Those who can work should be treated like anyone else.

But those that can work my be only able to do so at a reduced capacity and therefor income - which reduces their access to healthcare. e.g. someone with a severe mental impairment maybe able to hold down a steady low wage job, but they are never going to be able to climb the career ladder or stand any real chance of increasing their income. Thus reduced access to healthcare.

CannibalCrowley wrote:
Baggz wrote:

People hit by natural disasters.

Where you live is a choice. If you choose to live in a soupbowl, you shouldn't complain when the inevitable flood happens. Especially when you have plenty of time to leave and choose not to do so until it's too late.

Okaaaay - where are the prescribed 'safe' places to live? Natural disasters can strike anywhere at anytime. I agree there are obviously more vunerable areas than others - but look at the boxing day tsunami. Nobody could've expected the massive scale, just in terms of area affected, of damage it caused.
And can you really expect the entire population of the planet to huddle together in the few islands of comparitive safety the planet affords us?

CannibalCrowley wrote:
Baggz wrote:

Victims of crime.

That's pushing it. I don't see how being a victim of a crime means that someone besides the criminal should pay for your medical care.

What if someone mugs you, and in the process slices up your face with a blade. He gets away and is never caught.
You can't claim off an individual on the run, but you still have to live with the consequences. And because you now have a facial disfigurement you're going to find it a lot harder to get those high paying top jobs, because of the prevailant disposition that good looks get hired.
So again you're earning potential has been damaged through no fault of your own, and consequently the income you're able to invest in healthcare is dimished.

CannibalCrowley wrote:
Baggz wrote:

There are just too many factors with regards to a persons economic status they have purley to do with the location, timing, and conditions of their birth. Those that do start at a dis-advantage can of course work their way up, as it were, but they are still dis-advantaged.

Oh, not this "we're oppressed for life" tripe. Please explain to me how Larry Elder is dis-advantaged today because he used to be poor.

I'm not familiar with Larry Elder. As for the "we're opressed for life" I do undestand, and in cases, agree with your sentiment. But the truth is, as much as there are many people who seem more than happy to make little effort with their lives, there are plenty of people who are willing to do whatever it takes to change their situation but find it impossible to do so.
I've known people working several jobs, studying, and raising a family - desperatly trying to improve their lot so that their kids don't have to put the same effort in. And while these people I know have improved their situation, it has not been to the extent that their effort and actions should have.
The reasons vary, but a lot of the time it comes down to issues of class and background.

You seem to make the argument that every person on the planet is where they are because of their own actions or inaction. Full responsibility I guess you're advocating. But can you really blame the thousands who starved in Etheopia for not sorting their life out, or for being born and then not leaving an arid country.
Can you blame the victims in Rwanda for suffering a genocide. Or do you think of it as more of a mass suicide kind of thing - "oh well, we could leave to avoid geting shot, but I'd rather hang around to see what happens?"

With the welfare state we have in the UK there a lot of people not just taking advantage of it, but activly milking it for all it's worth. This does anger me, especially as I'm paying for it. But the problem lies within the system that allows them to get away with it. I don't think you should tar all people with the same brush. There are a lot of lazy poor people, it doesn't mean that all poor people are lazy.

The philosophy you're holding to is an over simplistic method of anaylising the vast complexity of factors that govern an individuals station in life. I'm proud of who I am and where I'm at - but I know it's a combination of external and internal factors. You can't put complete emphasis on either condition.
You're just saying that [i]everyone[\i] who is doing better than you in life actually deserves to do so. e.g. Paris Hilton

I would rather help those who don't need it, on the condition that I'm also helping those who do. If there's two child killers and one inocent man lost at sea, and I have the chance of saving or condeming all three - I'd rather save the child killers to make sure I'd save the innocent man, rather than watch the innocent man drown just to avoid helping someone who doesn't deserve it.

In the case of healthcare there are obviously financial factors that have to be considered. If you only have the resources to help one person out of every ten, then any way you chose who gets to be that one is not going to be really fair. In those cases you may as well let market forces decide.

But if you have the resources available (and I'm looking at you, USA; number one largest economy on the planet) then maybe there is a moral obligation to function as a whole society, and not exclude those from it's wealth whom you find distasteful.

So you want communism Baggz? That's really what it sounds like. And I think we've seen in numerous examples despite all the high-minded ideals and tugging on the heart strings for poor african starving children, that in the real world it doesn't work.

LeapingGnome wrote:

So you want communism Baggz? That's really what it sounds like.

Not Communism, but Social Cohesion.

An acceptence that if your foot is rotton it's detrimental to the whole body; the symtoms aren't just confined to the foot.

If you let the lowest echelons of your society rot and fester, it actually serves as a detriment to the whole of your society.

I understand that you can never fully eradicate all the problems of society, but that's not an excuse to do nothing.
I still believe that individuals should be able reap the benefits, or suffer the consequences, of their own actions - but those are just quality of life issues. I'm talking about life issues. We should try and keep each other alive and well when it's in our power to do so.

LeapingGnome wrote:

And I think we've seen in numerous examples despite all the high-minded ideals and tugging on the heart strings for poor african starving children, that in the real world it doesn't work.

I don't understand what you mean here: What doesn't work?
If you mean aid doesn't work, that's probably beacause the media loves bad new's. You get swamped with images of horror and abhoration, but when it's all sorted and people are happy again very few camera's revisit an area. Some aid does work, if it's managed properly.
If you mean it doesn't stop the problems, then you're right. But that's kinda the point - there will always be a draught, famine, war, disease, insert large scale tragedy of your choice, to deal with. Just because they will keep happening doesn't mean we should just give up.

You help them, then when the time comes, they help you. It's one of the contributing reasons why the human race has been so successful.

If my neigbours' house burns down and I try to rescue him, I put my self at risk. But if I succeed there are still two of us.
When my house burns down, he reciprocates. There are still two of us.
OR
When my neighbours house burns down, I think "screw that, not my problem!" he dies. There is now only me.
When my house burns down I die. There are none of us. Extinct!

I'm just tryng to express the need to include our natural altruism (that to help with any justifiable resources you have available is long-term good practice) within a governments intention and practice.

I just don't like the "if you get shot, you should've ducked" line of argument.

It may all to be to do with our different cultures; since my Grandad's time we've had the concept of minimum 'cradle to grave' care. The idea that there is a bottom line which it unacceptable to see human life exist below. In practice this is ideal is not always achieved, but I still feel in needs to worked towards.

I don't want to come across as all "I'm right and you all are wrong!", because there is no way any one can know that with certainty. I have to concede that any system I advocate brings its faults and problems, and at some point will always create an issue of 'loss' for some individuals somewhere.
This is just an emotive issue for me.

Baggz wrote:

Very sensible. In order to avoid paying for the healthcare of the children, you propose that the state pay for the heathcare of the children and pay to raise them/re-home them.

We have 2 likely situations here.

A: The parents really are poor and decided to have children who they couldn't afford. They've probably been on public assistance since at least the time she got pregnant and they'll likely stay on it until their children move out. They shouldn't have decided to have children unless they had the ability to raise them.

The state should take the children and adopt them out while they're still in infancy. This early cost will be more than offset because the child's new parents won't require public assistance programs to raise the child. Thus saving 18 years of payouts to the original family.

B: The parents can afford healthcare for their children; but don't care enough. A clear case of neglect.

Baggz wrote:

Plus your still punishing the children born into a poor family by removing them from that family. Double whammy.

If beginning status really matters that much then the children in situation A are being rewarded. They are going from a very poor family to one that's at least middle class. The children in situation B are being rescued from an environment that's neglectful at the very least.

Baggz wrote:

But those that can work my be only able to do so at a reduced capacity and therefor income - which reduces their access to healthcare. e.g. someone with a severe mental impairment maybe able to hold down a steady low wage job, but they are never going to be able to climb the career ladder or stand any real chance of increasing their income. Thus reduced access to healthcare.

As long as they make enough to be able to afford healthcare then their access is not reduced.

Baggz wrote:

Okaaaay - where are the prescribed 'safe' places to live? Natural disasters can strike anywhere at anytime.

No, natural disasters generally strike in the same places repeatedly. I can't recall ever hearing of any serious mudslides in Wisconsin or hurricanes in North Dakota.

Baggz wrote:

I agree there are obviously more vunerable areas than others - but look at the boxing day tsunami. Nobody could've expected the massive scale, just in terms of area affected, of damage it caused.
And can you really expect the entire population of the planet to huddle together in the few islands of comparitive safety the planet affords us?

I'm saying that those who choose to live in obviously dangerous areas accept the risk of doing so. If Joe Blow decides that he wants to continue living in an area even though his house is destroyed every other year by a hurricane, then that's his decision and others shouldn't be forced to pay for his bad judgment.

Baggz wrote:

What if someone mugs you, and in the process slices up your face with a blade. He gets away and is never caught.
You can't claim off an individual on the run, but you still have to live with the consequences. And because you now have a facial disfigurement you're going to find it a lot harder to get those high paying top jobs, because of the prevailant disposition that good looks get hired.
So again you're earning potential has been damaged through no fault of your own, and consequently the income you're able to invest in healthcare is dimished.

You still have the job you started with. You can also have your face fixed if you choose to do so. Maybe in the future the person in question will also take more of an interest in defending himself as well.

Baggz wrote:

I've known people working several jobs, studying, and raising a family - desperatly trying to improve their lot so that their kids don't have to put the same effort in. And while these people I know have improved their situation, it has not been to the extent that their effort and actions should have.

I can spot their first mistake. They decided to have children before taking care of their schooling and getting a good job. They set themselves back when that choice was made.

Baggz wrote:

You seem to make the argument that every person on the planet is where they are because of their own actions or inaction. Full responsibility I guess you're advocating. But can you really blame the thousands who starved in Etheopia for not sorting their life out, or for being born and then not leaving an arid country.

Your statement about Ethiopia is evidence that you don't really know what you're talking about. The country is far from being completely arid. In fact, most of their exports are agricultural. Their government is to blame for many of the problems that have happened through the years.

Baggz wrote:

Can you blame the victims in Rwanda for suffering a genocide. Or do you think of it as more of a mass suicide kind of thing - "oh well, we could leave to avoid geting shot, but I'd rather hang around to see what happens?"

No, I tend to blame the actual people who did the killing. As for the prevention issues, people tend to die when UN Peacekeepers are on the ground, that's basically a fat of life.

Baggz wrote:

With the welfare state we have in the UK there a lot of people not just taking advantage of it, but activly milking it for all it's worth. This does anger me, especially as I'm paying for it. But the problem lies within the system that allows them to get away with it. I don't think you should tar all people with the same brush. There are a lot of lazy poor people, it doesn't mean that all poor people are lazy.

The temporarily poor aren't lazy. Those who remain poor for their entire life usually are lazy or just unambitious. That's why I'm such a strong proponent of term and life limits on public assistance programs for those who aren't disabled. People tend to work harder towards their goal when they know that they'll be cut off on a specific date. Without that date the worker types often put things off and the lazy ones see no reason to change at all.

Baggz wrote:

The philosophy you're holding to is an over simplistic method of anaylising the vast complexity of factors that govern an individuals station in life. I'm proud of who I am and where I'm at - but I know it's a combination of external and internal factors. You can't put complete emphasis on either condition.

One doesn't legislate to the exception and for the most part a person's drive to succeed (or lack thereof) will overcome life's obstacles. If you suddenly made Bill Gates or Warren Buffet poor, they sure wouldn't stay that way. They would work to overcome their obstacles and bring themselves to the top again. On the other hand, give a bum a few million bucks and he'll be living on the streets again in a few years. We see it all the time with lottery winners.

Baggz wrote:

You're just saying that [i]everyone[i] who is doing better than you in life actually deserves to do so. e.g. Paris Hilton

No, I'm saying that those who truly want to rise do so and those who don't want to rise will sink. As much as I dislike Paris Hilton I have to admit that she's actually done quite well for herself in the business world. TV shows, designer clothing line, well known public image, modeling career, acting roles, and a fragrance line. Was some of this aided by her parents' wealth, of course. But she certainly put in her share of work. Not even a rich girl can just wake up one morning and decide to be a fashion model for top designers.

Baggz wrote:

I would rather help those who don't need it, on the condition that I'm also helping those who do. If there's two child killers and one inocent man lost at sea, and I have the chance of saving or condeming all three - I'd rather save the child killers to make sure I'd save the innocent man, rather than watch the innocent man drown just to avoid helping someone who doesn't deserve it.

But in your situation there's no cost for helping any of them, in real life there is. If you knew who the murderers were and you only had time to safely save one, I bet you'd save the innocent man.

Baggz wrote:

But if you have the resources available (and I'm looking at you, USA; number one largest economy on the planet) then maybe there is a moral obligation to function as a whole society, and not exclude those from it's wealth whom you find distasteful.

One of the reasons that the U.S. has a large economy is because it was founded on letting people swim, sink, or tread water instead of forcing the swimmers to drag everyone along. Furthermore, people aren't excluded because they're "distasteful," they exclude themselves by not working for their own wealth. People here are guaranteed "the pursuit of happiness" and it's up to them to work for that happiness, others shouldn't be expected to give it to them.

LeapingGnome wrote:

So you want communism Baggz? That's really what it sounds like. And I think we've seen in numerous examples despite all the high-minded ideals and tugging on the heart strings for poor african starving children, that in the real world it doesn't work.

Especially since socialism has caused many of those poor African children to starve in the first place.

Baggz wrote:

Not Communism, but Social Cohesion.

Healthcare for everyone is not a requirement for Social Cohesion.

Baggz wrote:

An acceptence that if your foot is rotton it's detrimental to the whole body; the symtoms aren't just confined to the foot.

Not a good argument for your side since in this case the best thing to do would be to amputate the foot.

Baggz wrote:

If you let the lowest echelons of your society rot and fester, it actually serves as a detriment to the whole of your society.

Keeping them on as leeches both harms society and creates more leeches. It's better to help the ones who can't help themselves and give the others a shot at making it on their own.

Baggz wrote:

I understand that you can never fully eradicate all the problems of society, but that's not an excuse to do nothing.

It's not an excuse to use the government as a nanny either.

Baggz wrote:

I still believe that individuals should be able reap the benefits, or suffer the consequences, of their own actions - but those are just quality of life issues. I'm talking about life issues.

Nobody is going to die just because they can't afford health insurance, so it is a quality of life issue.

Baggz wrote:

We should try and keep each other alive and well when it's in our power to do so.

Nobody here is talking about letting people die. You may not know it; but hospitals here can't refuse an emergency case even if the person has no means to pay.

Baggz wrote:

If you mean aid doesn't work, that's probably beacause the media loves bad new's. You get swamped with images of horror and abhoration, but when it's all sorted and people are happy again very few camera's revisit an area. Some aid does work, if it's managed properly.

Wherever there's aid, corruption follows. If aid really worked, then all of Africa would be thriving. A quick peek at Liberia, Nigeria, and Somalia shows us that aid alone doesn't work. Aid can't save a single life if the problem goes much deeper than supplies (which it almost always does).

Baggz wrote:

You help them, then when the time comes, they help you. It's one of the contributing reasons why the human race has been so successful.

Which is perfectly fine until you get in a situation where you're doing all the helping and the people on the receiving end refuse to help themselves because they can depend on you always helping them.

Baggz wrote:

If my neigbours' house burns down and I try to rescue him, I put my self at risk. But if I succeed there are still two of us.
When my house burns down, he reciprocates. There are still two of us.
OR
When my neighbours house burns down, I think "screw that, not my problem!" he dies. There is now only me.
When my house burns down I die. There are none of us. Extinct!

Or your neighbor has a house-fire on almost a monthly basis. You save him every time and since you keep saving him and let him know that you'll continue doing so, he doesn't bother doing anything to prevent the fires.

Eventually you die trying to save him from one of his many fires. Extinct! Or you have a fire and he doesn't bother to save you (why would he save you if he can't even bothered to stop the fires in his own house). So you die and then he dies in his next fire. Extinct!

Baggz wrote:

I just don't like the "if you get shot, you should've ducked" line of argument.

I don't like the "if you're being shot at, don't bother to duck (because somebody else will be along to patch you up)" line of argument.

Baggz wrote:

It may all to be to do with our different cultures; since my Grandad's time we've had the concept of minimum 'cradle to grave' care. The idea that there is a bottom line which it unacceptable to see human life exist below. In practice this is ideal is not always achieved, but I still feel in needs to worked towards.

Ugh. That concept tends to make people feel entitled to a certain standard of living just because they were born. It's known to them that the state will use violence to force others to provide them with a comfortable life even if they don't want to work for it.

Baggz wrote:

I have to concede that any system I advocate brings its faults and problems, and at some point will always create an issue of 'loss' for some individuals somewhere.

I'd rather have "you get what you work for" instead of "the harder you work the more we're going to steal from you so that we can give it to those who don't want to work."

I don't know. When I turn on my TV and see a dozen ads in two hours for Cialis, toe fungus pills, Lapband weight loss surgery, Nexium, Ambien, Lunesta, etc. I just can't figure out what's going on. I have this theory, that drug companies are possibly publicly traded on the stock market. And as such they have to keep coming up with blockbuster drugs to cure diseases. Especially important ones like erectile dysfunction and toe fungus. And then I think that when they spend all that R & D money, they have to spend billions more to advertise in order to sell lots of expensive drugs to make up for the money they spent on R & D and thus make their shareholders happy.

But that's where the theory ends. I can't figure out why drugs cost so much. All I know is that above part. After that I guess it's because of taxes being too high or something.

CannibalCrowley wrote:

I'd rather have "you get what you work for"

Why, what a coincidence, so would I!

But yet, so many people who work very hard for long hours receive less in every way than, say, high end business execs who don't really work that hard for what they get. My parents, for instance, both work above and beyond in their jobs as public school teachers doing a necessary and important service, but get sh*t for health coverage (much less other benefits and income).

Our system doesn't work. We need a better one.

DSGamer wrote:

But that's where the theory ends. I can't figure out why drugs cost so much.

Considering how much of that R&D money for pharmaceutical research comes from government funds (i.e. our money we pay to the government in the form of taxes), not from private funds, I have the same problem.

Farscry wrote:

But yet, so many people who work very hard for long hours receive less in every way than, say, high end business execs who don't really work that hard for what they get.

It's all about skills, knowledge, and being able to perform a job that others cannot. Just because a person spends less actual time at his job doesn't mean that he does less work. Pretty much anyone can be a janitor, mopping floors isn't exactly a job that takes a lot of processing power. Even if he works 16 hour days he still isn't worth as much to a company as the broker who can bring in a few hundred thousand in profits each day or the realtor who closes on a house or two every week.

Farscry wrote:

My parents, for instance, both work above and beyond in their jobs as public school teachers doing a necessary and important service, but get sh*t for health coverage (much less other benefits and income).

They're the ones who chose to work in that public school. They have the choice of working in a different public school, a private school or at a University; but they choose not to. They're getting paid what they are because that's what they're worth to the school. If they don't like it then they're free to go elsewhere.

Farscry wrote:

Our system doesn't work. We need a better one.

Our system works just fine. The market dictates what a person's worth is as a worker based on their skills and the number of other people who have those skills. If anyone can do your job after reading a 2 page pamphlet and your quality of work doesn't really matter, then you're going to get paid a lot less than the person whose job can only be performed by 4 other people in the country and what you do could earn or cost the company millions every day.

Since you think we need a better system, what system would you like to see in place?

The CEO provides $400 million of value to his company. The janitor only provides $20,000 of value to his company. I agree. I <3 this style of capitalism.

CannibalCrowley wrote:
Farscry wrote:

My parents, for instance, both work above and beyond in their jobs as public school teachers doing a necessary and important service, but get sh*t for health coverage (much less other benefits and income).

They're the ones who chose to work in that public school. They have the choice of working in a different public school, a private school or at a University; but they choose not to. They're getting paid what they are because that's what they're worth to the school. If they don't like it then they're free to go elsewhere.

You're not getting the point I was trying to make. This thread is about the health care system and the increasing costs associated with it. My parents each individually decided that what they do with their lives is more important than how much arbitrary wealth they accumulate. Thank God there are people like them in the world or society would be in serious trouble. But though they are ok with not making a lot of money, the thing that's really hard on them is the lack of decent health care coverage.

What I contest is that the health of my parents, for instance, is somehow less important than the health of, say, one of the top executives at the company I work for. If you were to equate that to their pay differential, well, you could say something to the effect of "we'll sacrifice the lives of 30 of these teachers to save the life of this business executive!"

There are certain things that a civilization as advanced as we claim to be should provide on an as-needed basis for anyone in need. I contend that one of those is health care (and no, not strictly life-threatening emergencies). If you don't, well, we'll simply never see eye to eye and there's no point in any further discussion.