Stossel Solves the Health Crisis with Capitalism

[ponderingturtle]

Dan isn't 16.

Do we know this?

 

[Rolfe]

Assuming he's telling the truth. He said his father was able to afford to pay for his health insurance until he was 19, and since then (no idea how long that's been) he's been able to afford it for himself.

He said his health insurance plan is mandated by his employment, and he doesn't get to choose which insurance to buy, which implies he's in employment. And he spoke of an ambition to start his own business.

He's never been inconsistent and I see no reason not to believe him.

I suppose this will offend him to, but I have to say he does come across as being very young. I'd have put him in his mid-teens without the extra information. It's not just the impractical ideology, with ideas most of us have espoused in our extreme youth but recognised as ridiculous with growing maturity, but little things like not knowing anyone who can't afford a car.

Nevertheless, I don't disbelieve him, even if I do feel like giving him a shake and shouting "grow up!" sometimes.

Rolfe.

 

[blutoski]

I think you've essentially nailed it. This reflects my Tennessee friend's attitude, while she was struggling to stay alive and to stay working while suffering from systemic lupus. She was immeasurably worse off than she would have been in Britain, both because she lacked automatic healthcare entitlement, and because of the employment legislation. However, she was quite touchingly grateful that she lived in America, because she was convinced that she would not have got the medication she needed in any other country. Entirely on the grounds, so far as I could tell, that America was self-evidently best at everything, so she must be getting the best.

Dan's repeated references to "soc" healthcare are quite telling. It seems incredible to me that anyone could be quite so naive as to reject anything involving pooling resources for the greater good, on principle, simply because of attitudes formed in the Cold War, but it does seem as if that's what's happening.

Rolfe.

Just one more anecdote that highlights the mindset that has been framed in the US:

There was a basketball player who received a pretty painful and potentially serious game injury while on tour in Toronto, and he was taken to UofT sportsmedicine clinic for x-ray, CT and so on.

When he returned to the US, he described his experience "with socialized medicine" in pretty negative terms. He specifically said that when he was in the CT machine, he expected a bird to pop out and peck the image into a stone slate (a la Flintstones). I emailed my friend who was a student at UofT at the time and asked just how old was their equipment over there? His reply: their CTs were brand new GEs, less than a year old.

This relates to my earlier post about how treating patients like customers distorts the system in unexpected and usually negative ways. This patient was probably used to the appearance of his favourite equipment at his home clinic, and thought that if it was in Canada and a different model, it must be a Soviet-era relic "The People's Scanner". I'm sure he really saw it that way.

So, the lesson for the provider - such as an MD or HMO - is to divert some funds from actual care to the appearance of care, lest the customer think they are receiving inferior value for their policy dollar. Anything from making sure they get brand name Aspirin instead of an ASA tablet to fancying up the CT scanner, and parking the machine that goes "ping!" in the OR. Because it sounds sooo impressive.

 

[DaN K. StAnLeY]

Okay, I must be immature if I don't agree with you about socialized HC. That's fine I guess you can chalk me and half of America up as immature since we don't agree with you.

Bottom line is, your WHO study is crap, you have no idea why our IMR is different from yours, and you haven't proven to me that your HC system is better than mine. You only seem to be able to show that it's cheaper and I'm still suspicious about why that might be. It's insane that someone who sits and clicks refresh on their CPU 24/7 to argue with random avatars would criticize the 20/20 episode as having no merritt. Hey what do I know though, I'm just a 16 year old kid.

 

[Rolfe]

Word! Thanks for you breakdown of the video BTW. Making this thread was easier than referring people to it in the other to get rebutts. That was a pretty thorough trashing of Stossel I'd say, LOL!

It's insane that someone who sits and clicks refresh on their CPU 24/7 to argue with random avatars would criticize the 20/20 episode as having no merritt.

You're entitled to change your mind. However, would you care to mention any specific points where you think my analysis of Stossel was incorrect?

Rolfe.

 

[ponderingturtle]

Okay, I must be immature if I don't agree with you about socialized HC. That's fine I guess you can chalk me and half of America up as immature since we don't agree with you.

Well you also have the problems with your positions and you ignore them and pretend that they don't exist, and then complain when people say that you are for the effects that what you are for will cause to happen.

Bottom line is, your WHO study is crap, you have no idea why our IMR is different from yours, and you haven't proven to me that your HC system is better than mine. You only seem to be able to show that it's cheaper and I'm still suspicious about why that might be. It's insane that someone who sits and clicks refresh on their CPU 24/7 to argue with random avatars would criticize the 20/20 episode as having no merritt. Hey what do I know though, I'm just a 16 year old kid.

You are rejecting reputable statistics. What are you trying to do here?

 

[Rolfe]

Okay, I must be immature if I don't agree with you about socialized HC. That's fine I guess you can chalk me and half of America up as immature since we don't agree with you.

No. Agreement or lack of agreement on any specific point is not what it's about. Quality of debate, addressing of specific points and maturity of outlook are what it's about.

Bottom line is, your WHO study is crap, you have no idea why our IMR is different from yours, and you haven't proven to me that your HC system is better than mine. You only seem to be able to show that it's cheaper and I'm still suspicious about why that might be. It's insane that someone who sits and clicks refresh on their CPU 24/7 to argue with random avatars would criticize the 20/20 episode as having no merritt. Hey what do I know though, I'm just a 16 year old kid.

Personally, I don't recall even mentioning any WHO study, although I do recall one poster agreeing that it didn't seem to be a good measure and that it should not be taken into consideration.

I have a few shrewd suspicions why the US infant mortality rate is so high. You have pooh-poohed the suggestion that lack of insurance might be a contributing factor. I'm waiting for you to produce an alternative hypothesis, or even to explain why on earth you imagine that lack of insurance would not be likely to be a contributing factor.

Our healthcare is cheaper. Why are you suspicious about that? Do you think we're stealing it or something? Does the fact that every country in the developed western world can manage to do a passable job for about the same price, with only the USA as the outlier, not suggest anything to you?

Since statistics seem to mean nothing to you, I'll ask again. What better care could Abigail Hall, or Mark Corrigan, possibly have received if they'd been born in America? Would they have been guaranteed that level of care if they had been born in America, even if their parents had been unemployed or on the minimum wage? How would that care have been delivered to Mark, as he described it, without his parents being in danger of losing their house?

What measure of "better" would you accept as valid?

Rolfe.

 

[DaN K. StAnLeY]

You are rejecting reputable statistics.

So reputable that the WHO stopped ranking countries because they realized how idiotic it was to rank Columbia ahead of the US, huh? Sounds real reputable.

What are you trying to do here?

I was trying to have a civil convo, but since that is becoming impossible I'm just giving Rolfe some reason to keep clicking refresh.

 

[MarkCorrigan]

For a third time of asking, please PLEASE point out a mechanism by which I could have survived and my parents kept their house and stayed off welfare systems under a US style healthcare system.

Your continued avoidance of this is telling.

 

[DaN K. StAnLeY]

For a third time of asking, please PLEASE point out a mechanism by which I could have survived and my parents kept their house and stayed off welfare systems under a US style healthcare system.

There are all kinds of ways you could have survived here.

Here's my own story to share:
My dad has had a best friend since he moved to Texas from a base in Japan in the 70's. His best friends name is Robert. They both graduated from the same highschool, the same year. They both got married and it sounds crazy, but I was born just a day after Roberts son Aaron, so naturally we became best friends. We were inseparable.

Around Thanksgiving when we were 14 or so, me and Aaron went outside to play tackle football and at one point during the game we collided full force. We both got up and shook off the stars we were seeing, but Aaron never quite shook it completely. After two or three more plays it was clear that he wasn't himself so we called the game and before we made it inside Aaron started puking and collapsed. I thought it was a concussion because I'd seen them several times on the field and they usually make you puke. I was wrong.

Aaron was rushed to the hospital after his condition was rapidly getting worse and it was discovered that he was bleeding from a tumor in his brain. I'm not a doctor so I can't tell you exactly the diagnosis, but it required nearly 1/3 of his brain to be removed. He woke up and couldn't talk, write, even swallow his own spit, but he remembered our favorite game to play on long car rides "thumb wars". We must have play a thousand games of thumb wars before he could write his own name again. Maybe a thousand more games before he took his second-first steps and all the while for weeks, then months, he was in a hospital. When he got released he still wasn't ever the same of course. He needed on going care for all kind of things, for the rest of his life, and his father never had to worry about anything. He was struggling with his own business at the time and didn't have insurance to cover Aaron, but Aarons mom has him under her work policy. The never had trouble paying, or lost their house. His dad wasn't ever worried about paying for medical bills and shortly after he was able to get a bigger apartment for him and Aaron to move into (he had been splitting rent with my dad at the time).

Aarons condition seemed to improve as time passed and my dad eventually married but I never went without seeing Aaron for very long. One day, about two years later, we got a call from Robert saying that Aaron had some sort of rupture similar to the one he had while we played football and had passed away. It was the worst feeling ever and sucks to talk about still. The reason I'm sharing is because he recieved awesome care and his family never lost their house or had additional financial tragedies to go along with the lost of their son. Aaron needed all kinds of treatments constantly for years and the insurance always paid the bills. His single mother afforded everything she had before the accident and was able to remarry and continue living her life while this was going on.

So I'm sorry if I can't imagine that this system is as horrible as you people and the WHO say it is. Do you think Aaron would have recieved better care in Columbia??

 

[MarkCorrigan]

There are all kinds of ways you could have survived here. Use you imagination.

HOW?

I needed immediate life saving surgery which I might add was (to the best of my knowledge) less than 6 months old and need continual healthcare for the rest of my life. That kind of healthcare (including multiple heart surgeries, plus exploratory surgery) would leave insurance companies scrambling to get away from me.

I would have no insurance despite my parents being comfortably well off, and if I didn't get the surgery IMMEDIATELY (remember, police escort so I wasn't held up) I was going to die.

What options would have been available to my family. Your glib refusal to provide possible scenarios is not going unnoticed.

ETA: I'm a tiny bit disappointed that I can't find myself online. I made the Liverpool Echo afterall!

 

[Rolfe]

So I'm sorry if I can't imagine that this system is as horrible as you people and the WHO say it is. Do you think Aaron would have recieved better care in Columbia??

(We're not actually talking about Columbia.)

Thank you for that story. I'm so sorry to hear that Aaron died, but glad to hear he got good care.

He was covered by insurance.

I understand (though I think Mark might not) that minor children are covered by their parents' insurance policies, if they have them. Aaron's mother had a policy, so Aaron had entitlement. It's great to hear of a case where there was no attempt by the insurance company to limit its liability. Maybe such cases are rare, and just talked about a lot.

However, the story raises a couple of questions. First, what would have happened if for some reason neither of Aaron's parents had had good insurance? His father didn't - what if his mother hadn't been working at the time?

Second, sadly, it seems from your story that Aaron was still under 18 when he died. So still covered by his mother's insurance policy.

I think one of Mark's questions is, what would happen to someone like him in the USA, who hits the age of majority with a "pre-existing condition" which makes him essentially uninsurable? How does Mark, aged 18, continue to get the ongoing cardiac care he needs?

I think everyone is aware that excellent care is available in the USA. And that coverage of the population is fairly wide. Our concern is that while under a universal system nobody can possibly fall out and find themselves without entitlement to healthcare that they need, this does seem to be possible in the USA. Not having insurance when your problem first manifests is one scenario. Having insurance that expires, leaving you uninsurable with a "pre-existing condition" is another.

Rolfe.

 

[Rolfe]

I'll make it clearer, and more general.

Dan, you said a while back that you already had the best care in the world available in the US. Nobody disputed that at all. You said that the problem was how to deliver that care to everybody.

Not arguing.

So could you be sure that someone like Aaron would be looked after as well as he was, supposing his mother hadn't had that insurance? How would that work? Who would provide the care and who would pay for it?

Suppose Aaron had not only survived until he was 18, suppose he had been like Mark - well enough to have a normal life, but guaranteed to need very expensive continuing care including regular expensive surgery. How would he find an insurance company to take him on? If he couldn't, how would his future care and surgeries be paid for?

And now, still thinking about Aaron, tell us how he'd still be looked after if nobody was obliged to contribute anything towards anyone else's healthcare costs.

Rolfe.

 

[Blue Mountain]

I think one of Mark's questions is, what would happen to someone like him in the USA, who hits the age of majority with a "pre-existing condition" which makes him essentially uninsurable? How does Mark, aged 18, continue to get the ongoing cardiac care he needs?

I think part of the answer is finding a job at a larger company that has a good heath insurance plan. Legally, companies in the US aren't allowed to discriminate against potential hires due to pre-existing and possibly expensive health care requirements.

I see at least two problems with this approach:

• Just because it's illegal doesn't mean it doesn't happen. A company can give any number of plausible sounding excuses for not hiring a given candidate
• A lot of states have "at will" employment, meaning your employment can be terminated at pretty much any time for any reason. I suspect more than a few people find themselves without a job after costing their employer's insurance plan a lot of money.

I'd like to hear Dan's answer, though. In most other countries, you're covered no matter where you work or even if you're not working. Not so in the States.

 

[Rolfe]

This relates to my earlier post about how treating patients like customers distorts the system in unexpected and usually negative ways. This patient was probably used to the appearance of his favourite equipment at his home clinic, and thought that if it was in Canada and a different model, it must be a Soviet-era relic "The People's Scanner". I'm sure he really saw it that way.

So, the lesson for the provider - such as an MD or HMO - is to divert some funds from actual care to the appearance of care, lest the customer think they are receiving inferior value for their policy dollar. Anything from making sure they get brand name Aspirin instead of an ASA tablet to fancying up the CT scanner, and parking the machine that goes "ping!" in the OR. Because it sounds sooo impressive.

[derail]I think you may be being over-complicated here. Even if the basketball player had had previous scans, instrumentation like that is unfamiliar enough that most people wouldn't be in any position to guess the age or the provenance, right or wrong.

It sounds much more like confirmation bias. He'd been pre-indoctrinated with the notion that "socialised medicine" was inevitably substandard, commie trash. He's been shown that the accepted behaviour of his peer group was to mock and belittle such a system. So he just came out with the party line that he knew was received wisdom. Without having any idea at all whether or not the CT machine was a new model.

It's a bit like Jerome last year. He didn't want to examine the standard of care on offer in Britain. All he wanted to do was repeat things like "Face it, your system sucks," and "How are these six-month waits to see a doctor working out for you?" No amount of explaining things like three-year-old girls getting pioneering heart surgery, or the right of patients to a same-day appointment with a doctor, would sway him. He knew what he thought, and he wasn't going to be swayed by facts.

I think your basketball player was out of the same mould.
[/derail]

Rolfe.

 

[Rolfe]

I think part of the answer is finding a job at a larger company that has a good heath insurance plan. Legally, companies in the US aren't allowed to discriminate against potential hires due to pre-existing and possibly expensive health care requirements.

I see at least two problems with this approach:

• Just because it's illegal doesn't mean it doesn't happen. A company can give any number of plausible sounding excuses for not hiring a given candidate
• A lot of states have "at will" employment, meaning your employment can be terminated at pretty much any time for any reason. I suspect more than a few people find themselves without a job after costing their employer's insurance plan a lot of money.

I'd like to hear Dan's answer, though. In most other countries, you're covered no matter where you work or even if you're not working. Not so in the States.

I'd thought of your problems. My main thought though was, doesn't parental coverage run out at 18? Who wants to go permanently into the job market at 18? Who's qualfied to do that? What about college, postgrad work and so on? How are young people with chronic illness covered to bridge the gap between their parents' policies and employment coverage?

Then, you've got to find a secure job with a big company. Suppose you can't? Suppose your health problems are enough that you're always pipped by another candidate? What are you going to do?

Suppose you really, really want to be an artist, or a musician? But you have to go for a job with a big company, because your life depends on it.

Suppose you get that job, and you're OK, but you really, really want to leave and set up your own business. You can't, can you? Isn't this a serious restriction on freedom?

And as you say, suppose you lose that job? It doesn't have to be anything as deliberate as firing someone because they're costing the insurance too much. Lots of businesses are going under at the moment. Here too. But at least here the laid-off employees know where their next heart operation or supply of anti-rejection medication is coming from.

I'd expect many US posters at this point to say, Medicaid. And then we'd be wondering just how reliable that would be when these very US posters repeatedly decry Medicaid as a useless system. But Dan wants to abolish Medicaid too.



Charity?

Maybe I'm running on too far here, but every time it comes down not to whether or not someone in the US will get good care for a serious condition, or even that most people will get it. It's the fact that not everyone is assured of getting it.

Rolfe.

 

[Corsair 115]

Okay, I must be immature if I don't agree with you about socialized HC. That's fine I guess you can chalk me and half of America up as immature since we don't agree with you.

Perhaps immature is not the right word. Maybe you can supply a better one. What would you call it when someone rejects facts because what those facts suggest is not in keeping with the person's ideology?

 

[Lonewulf]

Perhaps immature is not the right word. Maybe you can supply a better one. What would you call it when someone rejects facts because what those facts suggest is not in keeping with the person's ideology?

Idealogue?

Zealot?

 

[ponderingturtle]

I'd thought of your problems. My main thought though was, doesn't parental coverage run out at 18? Who wants to go permanently into the job market at 18? Who's qualfied to do that? What about college, postgrad work and so on? How are young people with chronic illness covered to bridge the gap between their parents' policies and employment coverage?

It depends, you can keep kids on a plan through college is not at all uncommon.

Of course even with a company he might have problem with the insurance paying for any of it as it is a preexisting condition. And insurance does not prevent the sick from bankruptcy.

 

[Darat]

I think part of the answer is finding a job at a larger company that has a good heath insurance plan. Legally, companies in the US aren't allowed to discriminate against potential hires due to pre-existing and possibly expensive health care requirements.

...snip...

Does that mean that insurance companies are forced to accept any new employee onto their plans and cover them for pre-existing conditions? I know, on the whole, company provided policies in the UK don't offer this. You can still join the company's health-care scheme but you will be excluded for anything to do with pre-existing conditions, they are still often popular with employees because they often include private dental treatment, coverage for your partner and children and so on.