Conservatives, under what conditions would you allow universal coverage?

[TragicMonkey]

Aha. Makes sense. Thanks for clearing that up. (It's one of my pet peeves having insurance that just barely (and not even that!) covers eye exams.

I'd wager that insurance doesn't bother much with regular eye stuff because there's not much money in it. If most patients spend less than five hundred bucks a year on vision correction, there's not much profit potential. The cost of the paperwork for customers could easily outweigh the income from covering that kind of thing.

 

[sarge]

Ah. I was curious, becuase it seemed to me that Tricare was much better than Blue Cross of Idaho about glasses.

I* don't have need for perscription eyewear coverage, but it is likely that Tricare is superior to many other insurance carriers, especially for the traditionally under-covered items like glasses.




*I am a Tricare beneficiary.

 

[TragicMonkey]

Tricare enjoys some other advantages. I don't know how other providers fare with it, but where I work Tricare has a reputation for simply not paying up everything that's owed, forcing the provider to write off the loss. They also can't be negotiated with, over anything. There's what they're willing to pay for what, and screw you if you want more. At least with commercial insurers you can fight back. Tricare can pass the savings along to its beneficiaries in the form of more benefits if it's not paying fairly for them. The risk, of course, is when the providers get fed up and don't accept Tricare any more.

 

[rustypouch]

I still don't understand how people can be willing to spend substantially more money, with the very real risk of bankruptcy, and no significant difference in outcomes, just to spite others they don't feel are deserving.

 

[Shalamar]

I still don't understand how people can be willing to spend substantially more money, with the very real risk of bankruptcy, and no significant difference in outcomes, just to spite others they don't feel are deserving.

They seem to believe that universal healthcare is socialism, and socialism is evil.

So paying twice as much for the same care is doing your patriotic duty.

 

[Grizzly Adams]

I would be happy to just be able to have any procedure.

I'll pay for your hysterectomy.

To answer your question, I'd get behind a UHC scheme only if an amendment were added to the Constitution that adds provision of health care as one of the powers of the federal government. Until then...

 

[sarge]

Tricare enjoys some other advantages. I don't know how other providers fare with it, but where I work Tricare has a reputation for simply not paying up everything that's owed, forcing the provider to write off the loss.

Does Tricare offer coverage to civilians? I was not aware that they did, and if they do not your objections to their methods are unfounded.

Tricare doesn't set the rate they pay for a procedure - the Goverment does. Once a provider agrees to accept Tricare, they agree to accept Tricares rates.

They also can't be negotiated with, over anything. There's what they're willing to pay for what, and screw you if you want more.

No provider is (yet) compeled to accept a Tricare patient.

At least with commercial insurers you can fight back.

Tricare isn't a comercial insurer. Tricare performs essentially the same role that the goverment would under a universal care system of any flavor - with exactly the same frustrations, of course.

Tricare can pass the savings along to its beneficiaries in the form of more benefits if it's not paying fairly for them. The risk, of course, is when the providers get fed up and don't accept Tricare any more.

Tricare (the company) has no discretion to add or take away covered procedures, nor are there any savings that it can pass to its customers. Its sole customer (if I am correct about the "no civilians" part) is the Goverment.

 

[TragicMonkey]

Does Tricare offer coverage to civilians? I was not aware that they did, and if they do not your objections to their methods are unfounded.

I don't see why. Private doctors can't object to how a program's being run, just because it's government? Guess what--we complain about Medicare and Medicaid as well. That it's government doesn't make it beyond reproach.

Tricare doesn't set the rate they pay for a procedure - the Goverment does.

A government agency runs itself, under the authority of the government. Can you complain about a specific National Park Service policy, or is that "the Government" and only "the Government"'s doing?

Once a provider agrees to accept Tricare, they agree to accept Tricares rates.

True for all insurers, commercial or government.

No provider is (yet) compeled to accept a Tricare patient.

Ah. I forgot, as long as you aren't forced at gunpoint to do something, that thing cannot be criticized. You have the option to send your child to private school, therefore any conditions at public schools are irreproachable in all respects.

Tricare isn't a comercial insurer. Tricare performs essentially the same role that the goverment would under a universal care system of any flavor - with exactly the same frustrations, of course.

I got news for you. Insurance is insurance. They act the same, the differences are who owns the business. Government insurance has some advantages commercial doesn't, but it also has some problems commercial doesn't. Depending on whether you're a patient, a taxpayor, or a provider, you might have different opinions on particular happenings in those entities.

Tricare (the company) has no discretion to add or take away covered procedures, nor are there any savings that it can pass to its customers. Its sole customer (if I am correct about the "no civilians" part) is the Goverment.

Do you think Congress personally runs Tricare? They make the business decisions? Oh wait, it's not a business, it's "government". Just because it's run like a business, the mere fact that it's government-owned means its management, direction, procedures, and policies are completely and utterly different from all the commercial insurers....except they aren't. The difference between government insurance and commercial insurance isn't always very big from the patient's point of view, or the provider's. Mrs Smith and Mrs Jones come in with the same dx and get the same treatments and the same drugs. Mrs Smith's bill goes to a government-run program, Mrs Jones's goes to a private insurer. Huge difference? Maybe to the taxpayers and shareholders. To the patients, not so much. To the providers, well, depends on how much of a fight they have to put up to get reimbursed.

 

[mhaze]

I'm going to lose money for any for profit insurance company. So really only some sort of universal plan would allow me to be covered. And there are lots of other people just like me out there.

So under what conditions would you allow that to happen?

So you like free stuff?

What do I get?

 

[TragicMonkey]

So you like free stuff?

What do I get?

The same thing he does. That's the idea. That healthcare is something worth public expenditure. We all pay in, via taxes, and we're all covered. Instead of some of us paying private companies (who extract a profit, reducing the amount of actual services we're getting for that money) to cover some of us, we all pay and we all get covered. And as a public service there would be no need to generate a profit, it would be cheaper--we'd only need to cover the actual costs. Why not do this? We do it for roads, education, and for having a military. Those things are public goods that benefit all, so we're willing to spend public money on it. Why not healthcare?

 

[sarge]

I don't see why. Private doctors can't object to how a program's being run, just because it's government? Guess what--we complain about Medicare and Medicaid as well. That it's government doesn't make it beyond reproach.



A government agency runs itself, under the authority of the government. Can you complain about a specific National Park Service policy, or is that "the Government" and only "the Government"'s doing?



True for all insurers, commercial or government.



Ah. I forgot, as long as you aren't forced at gunpoint to do something, that thing cannot be criticized. You have the option to send your child to private school, therefore any conditions at public schools are irreproachable in all respects.



I got news for you. Insurance is insurance. They act the same, the differences are who owns the business. Government insurance has some advantages commercial doesn't, but it also has some problems commercial doesn't. Depending on whether you're a patient, a taxpayor, or a provider, you might have different opinions on particular happenings in those entities.



Do you think Congress personally runs Tricare? They make the business decisions? Oh wait, it's not a business, it's "government". Just because it's run like a business, the mere fact that it's government-owned means its management, direction, procedures, and policies are completely and utterly different from all the commercial insurers....except they aren't. The difference between government insurance and commercial insurance isn't always very big from the patient's point of view, or the provider's. Mrs Smith and Mrs Jones come in with the same dx and get the same treatments and the same drugs. Mrs Smith's bill goes to a government-run program, Mrs Jones's goes to a private insurer. Huge difference? Maybe to the taxpayers and shareholders. To the patients, not so much. To the providers, well, depends on how much of a fight they have to put up to get reimbursed.

You object to the way that the goverment manages to pay for health care. That is the sum of your objections to Tricare. You could have just said as much up front.

Tricare does not refuse to pay what it owes - it just sets a rate that it will pay up front, makes that rate well known, and then gives the care provider a "take it or leave it" option. That's simply the way it is with Tricare (and all goverment services).

 

[TragicMonkey]

You object to the way that the goverment manages to pay for health care. That is the sum of your objections to Tricare. You could have just said as much up front.

Not really. My objection is that government healthcare is currently not being run like government healthcare--what we have now is a few programs that are government owned but run themselves like private businesses. It's the worst of both worlds. I don't want government acting like business. I want the healthcare provided but not in the manner of a private insurer, even if the owner is the government.

Universal healthcare can't be implemented simply by using the private insurer methods and businesses but replacing the shareholders with the government.

Tricare does not refuse to pay what it owes - it just sets a rate that it will pay up front, makes that rate well known, and then gives the care provider a "take it or leave it" option. That's simply the way it is with Tricare (and all goverment services).

It's much more complex that that. You really think there's a just one list of procedures with dollar figures next to them? Medicine is every bit as complex as the human body, and so is the business set up to deal with it. ICD-9, HCPCs, visit levels, credentialing, appeals...Jesus Christ, it's never going to work because people outside the system believe they understand how the system works. It's Dunning-Kruger in action.

 

[bikerdruid]

Depends on what you mean by eye care. Glasses, prescriptions, vision correction is usually a separate line of business offered by specialty insurers. I'm not aware of any of the big medical players offering those coverages, just like they don't do dental. But medical-type eye stuff, like retinal detachments, eye diseases, stuff like that is usually covered by regular medical insurance.

this is true for canada.
i have additional insurance through my employer that covers dental, eyecare and prescriptions.
canada's universal care does not cover these, except as you mentioned, medical necessary dental or eye surgery.
all canadians have access to the additional coverage, through private insurers, if they pay for it.

 

[theprestige]

And I want a unicorn, while we're on the subject of pipe dreams.

And Travis wants the government to guarantee him a certain minimum quality of life and a certain minimum lifespan regardless of his medical conditions and regardless of the cost of treatement, and to compel whatever resources are necessary from his fellow citizens to meet those guarantees. And he wants the same guarantees for everybody. While we're on the subject of pipe dreams.

Travis, please feel free to fill me in the details of the minimum quality of life and lifespan you want guaranteed. Please also feel free to correct me if you think there should be limits on the amount of resources the government should compel from your fellow citizens on your behalf.

I'm sure the conditions under which you want universal coverage will be self-evidently reasonable and sustainable.

Me, I'm in favor of death panels. They're inevitable, really.

 

[TragicMonkey]

And Travis wants the government to guarantee him a certain minimum quality of life and a certain minimum lifespan regardless of his medical conditions and regardless of the cost of treatement, and to compel whatever resources are necessary from his fellow citizens to meet those guarantees. And he wants the same guarantees for everybody. While we're on the subject of pipe dreams.

Travis, please feel free to fill me in the details of the minimum quality of life and lifespan you want guaranteed. Please also feel free to correct me if you think there should be limits on the amount of resources the government should compel from your fellow citizens on your behalf.

I'm sure the conditions under which you want universal coverage will be self-evidently reasonable and sustainable.

Me, I'm in favor of death panels. They're inevitable, really.

And you want children to die of easily treated diseases because you would prefer to spend thousands a year on your own potential need for healthcare than risk a dime of your share of taxes go to help someone else.

See how easy it is to hyperbolize? See how little it accomplishes?

And this is to everybody: I don't care how well insured you are, unless you're a millionaire, you're one cancer diagnosis away from poverty. You have no idea what the costs can be. People think "oh, my insurance covers 80%, that's good!" and then are very, very surprised to find that 20% of four million is $800,000 and they don't happen to have that lying around in the sofa cushions.

 

[sarge]

And bingo - we are exactly where these threads ALWAYS go - both sides employing half-truths and outright fabrications to support their prefered "team" in this football game.

 

[rustypouch]

And bingo - we are exactly where these threads ALWAYS go - both sides employing half-truths and outright fabrications to support their prefered "team" in this football game.

Or the fans of universal healthcare point out that countries with a UHC system have similar outcomes to countries without such a system, while paying significantly less and without the risks and resulting unpleasantness of being unable to afford care.

Opponents of UHC point out that socialism is bad.

 

[bikerdruid]

Or the fans of universal healthcare point out that countries with a UHC system have similar outcomes to countries without such a system, while paying significantly less and without the risks and resulting unpleasantness of being unable to afford care.

Opponents of UHC point out that socialism is bad.

right on the nose!

 

[lionking]

Or the fans of universal healthcare point out that countries with a UHC system have similar outcomes to countries without such a system, while paying significantly less and without the risks and resulting unpleasantness of being unable to afford care.

The elephant in the room........

 

[Dr. Keith]

I am a Tricare beneficiary.

Do you carry a sign that reads:

Keep your government out of my healthcare!


No, I'm not trying to pull an ad hom here, just noticing a trend. No doubt you earned your benefits and I have no problem with you getting them. It just seems a bit like people over 55 having no problem with the Ryan plan. Of course not, it screws everyone after them!

Is it a meme yet that those who are already getting government funded healthcare are the loudest to resist the government funding healthcare for others?