Michael Moore's Sicko

[devnull]

Indeed, why pay more than you have to, and give to charity to assuage your conscience, when you can pay less and feel good about helping the less fortunate in one fell swoop?

That's commie speak there mister!

 

[deverett]

There are merits to such a system. I prefer to take responsibility for my own care on my own terms.

But is it really on your own terms? Or what will be provided by an insurance company.

Unless you are mega-rich and can pay for any medical treatment out of your own pocket, then you are in an insurance scheme and that scheme controls what you get, not you.

 

[Giordano]

I recently had a serious medical procedure that would have bankrupted me if I had to pay it myself. Luckily (and I use that word intentionally) my health insurance through my work was very good, and allowed me to have the procedure. It was not my own wonderful sense of responsibility that did it: it was the foresight of the managers at my work, and the willingness of all the other employees to pool their resources (in a very socialistic way) so that a few, very ill people such as myself could draw from a common pot. I could not have afforded this insurance on my own, and I certainly could not have paid the bills on my own. Until I learned that this would be covered by insurance, I considered either denying myself the procedure, or killing myself outright to preserve the finances of my family. I would be dead from the disease by now or my own hand if not for this socialistic concept.

So whatever direction the rest of the discussion may take, please remember that surprises can happen to anyone, and that the price of health care and insurance in the USA can make these surprises financially devastating no matter how responsible one is. I am probably in the top 2% of the USA population in terms of how responsible I am with my savings and money, and earn more than average. Yet this medical "surprise" would have wiped it all out nonetheless, and the fact it didn't was largely due to the pooled resources of others, pooled resources that were not accessible to many other people at that time (or even now).

And I would add that thankfully Obamacare will require any future insurance company to cover my prior condition should I retire or change jobs; in the past I simply would have been out of luck.

 

[Ampulla of Vater]

Regarding these health insurance horror stories, I'd like to know how much the Affordable Care Act has ameliorated this problem. It looks like you can still go bankrupt from hospital bills, but it's somewhat less likely now.

In the mid-Atlantic region, the exchange policies all have tremendously large deductibles. I know Medicaid was expanded, so I suppose those getting that program are in better shape, but the average Joe buying a policy off the exchange will see anywhere from a 2,500 - 10,000 deductible with their policy. Most people do not understand why they are getting billed for their visit, because they "have insurance." What they do not understand is they have a large deductible to meet before it covers their care. IMO, the ACA turned nearly everyone's coverage into catastrophic coverage only. Very few people have little to no copy's and even fewer have $0 deductible.

 

[Swordfishtrombone]

Well, I have to say that I'm glad I live in a country where basic health care is guaranteed, and tax supported.

My father was diagnosed, a little over three years ago, with ALS (Lou Gehrig's Disease). He died about a year ago. As he declined in everything from speech to most muscle control, the help he (and my mom) received from the state would doubtlessly have bankrupted anyone but the richest, or most perfectly insured, in the states.

For the last year or so, he had a personal assistant eight hours a day, and in the end, several health care and social service people were involved with ensuring care for him at home. He got equipment he could use to type words into (he retained enough control over his hands) and it would translate that into speech. He got a tube surgically inserted straight to his stomach, when it became impossible for him to eat.

All this was covered - though my mother had to do a huge amount of paper work and applications to get it all in place. (There's probably improvements to be made in lessening the bureaucracy.)

It was truly a horrible time for all involved, but I can only imagine how much worse it would have been, if financial ruin had accompanied everything else.

So yes, I'll gladly pay my higher taxes. You never know what will befall you, or your loved ones.

I think this sort of thing is the reason socialized medicine works better than having to have everyone insure themselves separately; when you insure yourself, unless you are willing to pay more than most are willing (or able), there will be limits to what you can get. If you get really unlucky, like my dad, you are royally screwed.

In this sort of system that my country (Finland) has, you do pay higher taxes - but not anywhere near what you'd have to pay for private insurance that would cover as much as my father got, I wager. That's because the cost is averaged out, and everyone pays a little to the common pot.

 

[3point14]

So you're happy to pay more money for a service that will actively seek to find ways to not pay for the treatment you need, rather than less money for a service that will treat everyone for whatever illness without extra charge?

I'm guessing yes, is the short answer. It's an ideological stance not driven by observations of outcomes but driven by a belief that the world should operate in this way and by a good dose of luck in never having been in an unfortunate situation that the individual could not drag themselves out of without help.

 

[Ampulla of Vater]

Well, I have to say that I'm glad I live in a country where basic health care is guaranteed, and tax supported.

My father was diagnosed, a little over three years ago, with ALS (Lou Gehrig's Disease). He died about a year ago. As he declined in everything from speech to most muscle control, the help he (and my mom) received from the state would doubtlessly have bankrupted anyone but the richest, or most perfectly insured, in the states.

For the last year or so, he had a personal assistant eight hours a day, and in the end, several health care and social service people were involved with ensuring care for him at home. He got equipment he could use to type words into (he retained enough control over his hands) and it would translate that into speech. He got a tube surgically inserted straight to his stomach, when it became impossible for him to eat.

All this was covered - though my mother had to do a huge amount of paper work and applications to get it all in place. (There's probably improvements to be made in lessening the bureaucracy.)

It was truly a horrible time for all involved, but I can only imagine how much worse it would have been, if financial ruin had accompanied everything else.

So yes, I'll gladly pay my higher taxes. You never know what will befall you, or your loved ones.

I think this sort of thing is the reason socialized medicine works better than having to have everyone insure themselves separately; when you insure yourself, unless you are willing to pay more than most are willing (or able), there will be limits to what you can get. If you get really unlucky, like my dad, you are royally screwed.

In this sort of system that my country (Finland) has, you do pay higher taxes - but not anywhere near what you'd have to pay for private insurance that would cover as much as my father got, I wager. That's because the cost is averaged out, and everyone pays a little to the common pot.

First and most importantly, I am very sorry to hear about your dad. ALS is a terrible disease. I had a similar experience with our "Miss Emily." She watched my children while I worked a few days a week. She was an older woman with no grandchildren and my children became her grandchildren. Even after they were old enough to come home from school alone, we had Miss Emily come over to be with them, as she needed the supplemental income and they certainly benefited from the supervision.

Miss Emily also was diagnosed with ALS. The disease process seems similar to your experience: loss of speech and muscle control, and then the tube for feeding and then being bed ridden towards the end. She ended up in a Hospice facility which, to this day I remember exactly. It was beautiful, like a ski lodge setting. It had a beauty salon where she would get her hair done and her room had expensive, beautiful furniture which actually hid some medical equipment, so it was not obvious it was a medical facility. There was a separate bed for someone to sleep over with her to watch movies and she had a machine she could type in to to talk. This was in the U.S. and she had Medicare. None of this cost her anything. She really didn't have money to speak of anyway.

I relate this story because it is not true the U.S. is some barbaric country often depicted by people with certain political agendas. There are many complicated reasons we cannot have socialized medicine at this point in our history. But just because we don't, doesn't mean someone such as your dad would have received treatment any different than he did in Finland.

 

[paulhutch]

Id like to know if there would ever be any inclination to forgive medical debts in some way.

I mean, let's face it, someone left with $20M medical debt is never going to pay it. You simply arent going to see your money. All that debt will do is act as an anchor around that person's neck.

By filing for personal bankruptcy medical debts are nearly always eliminated completely. A brother and sister of mine both had to go that route and the only downside was that their credit ratings were bad for about 5 years afterwards.

 

[wollery]

First and most importantly, I am very sorry to hear about your dad. ALS is a terrible disease. I had a similar experience with our "Miss Emily." She watched my children while I worked a few days a week. She was an older woman with no grandchildren and my children became her grandchildren. Even after they were old enough to come home from school alone, we had Miss Emily come over to be with them, as she needed the supplemental income and they certainly benefited from the supervision.

Miss Emily also was diagnosed with ALS. The disease process seems similar to your experience: loss of speech and muscle control, and then the tube for feeding and then being bed ridden towards the end. She ended up in a Hospice facility which, to this day I remember exactly. It was beautiful, like a ski lodge setting. It had a beauty salon where she would get her hair done and her room had expensive, beautiful furniture which actually hid some medical equipment, so it was not obvious it was a medical facility. There was a separate bed for someone to sleep over with her to watch movies and she had a machine she could type in to to talk. This was in the U.S. and she had Medicare. None of this cost her anything. She really didn't have money to speak of anyway.

I relate this story because it is not true the U.S. is some barbaric country often depicted by people with certain political agendas. There are many complicated reasons we cannot have socialized medicine at this point in our history. But just because we don't, doesn't mean someone such as your dad would have received treatment any different than he did in Finland.

She was lucky it was ALS and/or she was over 65. There are plenty of diseases that aren't covered by Medicare for under 65s.

To point out that someone with a particular disease got excellent medical care because they were covered by Medicare hardly proves that the US isn't "some barbaric country". It's one disease that's covered, but there are plenty that aren't.

And as you pointed out in an earlier post, even if you have insurance you can still end up paying thousands of dollars for treatment because of high deductibles, and that's assuming your policy even covers the condition you have.

I wouldn't use the term "barbaric" to describe the US medical system, I'd call it perverse.

 

[Swordfishtrombone]

First and most importantly, I am very sorry to hear about your dad. ALS is a terrible disease. I had a similar experience with our "Miss Emily." She watched my children while I worked a few days a week. She was an older woman with no grandchildren and my children became her grandchildren. Even after they were old enough to come home from school alone, we had Miss Emily come over to be with them, as she needed the supplemental income and they certainly benefited from the supervision.

Miss Emily also was diagnosed with ALS. The disease process seems similar to your experience: loss of speech and muscle control, and then the tube for feeding and then being bed ridden towards the end. She ended up in a Hospice facility which, to this day I remember exactly. It was beautiful, like a ski lodge setting. It had a beauty salon where she would get her hair done and her room had expensive, beautiful furniture which actually hid some medical equipment, so it was not obvious it was a medical facility. There was a separate bed for someone to sleep over with her to watch movies and she had a machine she could type in to to talk. This was in the U.S. and she had Medicare. None of this cost her anything. She really didn't have money to speak of anyway.

I relate this story because it is not true the U.S. is some barbaric country often depicted by people with certain political agendas. There are many complicated reasons we cannot have socialized medicine at this point in our history. But just because we don't, doesn't mean someone such as your dad would have received treatment any different than he did in Finland.

I'm glad to hear that someone in the same situation as my father was would be taken care of in the U.S. too - the care given to your Miss Emily sounds truly excellent. It's such a horrible condition that it would indeed be inhumane if it was otherwise - I'm glad to hear it isn't.

What about the points made by wollery though? Is the Medicare coverage disease/disorder/age specific?

To take another example; what about, say, the case of a friend of mine - who had a brain tumor, at the age of about thirty? Got surgical removal of the tumor, and all the medication afterwards, sick leave of 6 months, and periodic check ups for years, all covered. How would that go in the states?

 

[Giordano]

By filing for personal bankruptcy medical debts are nearly always eliminated completely. A brother and sister of mine both had to go that route and the only downside was that their credit ratings were bad for about 5 years afterwards.

In my state at least, you have to convince a judge that you have really gone bankrupt: no savings that could be used to pay creditors, no major property that could be sold for cash, etc. You may be allowed to retain a house, and maybe a cheap car if you need it to go to your job. If you rent, then too bad. I certainly know of abuses by some, but filing for personal bankruptcy is far from a slight inconvenience for most. And remember, if you do you are leaving your creditors in the lurch. Individual creditors pay for the cost of your overwhelming medical expenses, not society as a joint whole.

 

[Giordano]

Long term care is a particular problem at least in the USA. God help you if you or your spouse becomes senile, or otherwise needs to be committed to a nursing facility long term. Even good insurance runs out quickly given the cost (it can easily cost >$50,000 a year). Best solution: die quick.

 

[Giordano]

I would argue that the compassionate and humane aspects of health care in the USA are usually due to the existence of the government-run plans that have been put into place since the 1960s: largely Medicare, the State-run medical plans for the indigent, and the aspects of Obamacare that have been successfully instituted. Many of the anecdotal examples that have been cited here as success stories are, in fact, examples of this government intervention. So is the USA barbaric? Not really, but this is largely because of the deeds of political forces who have provided some form of safety net that will rescue some of the most needly; unfortunately the very poor, the working poor and the middle class continue to struggle to afford and access adequate health care. And the current political trend is to limit or eliminate even these existing government interventions.

Again, I urge people who believe that "they are okay" because they have "taken responsibility" by having private health insurance (often provided not due to their own initiative and which would be too expensive for most, but through a socialistic plan offered by their company) to look carefully at the total costs and the benefits, and to ask if similar care would be available to or affordable by many less fortunate individuals even if they had equally "responsible" views.

Also people should look over their own health insurance policy and ask, "What if I needed a major medical intervention, extended mental health benefits, or long-term nursing care?" My own medical intervention cost approximately $500,000 total; luckily because of my employer-supplied health insurance, and my ability to pay extra for the best plan, I paid only a fraction of that. I sincerely hope that a similar surprise does not happen to you or to those you love, and if it did that somehow you have the premium levels of insurance that will cover these expenses without bankrupting you and your family. Also I hope that your employer will keep your job ready for you when you can return, and that disability (also government run) will help you out during the time you are hospitalized and your salary is missing.

 

[Vic Vega]

To take another example; what about, say, the case of a friend of mine - who had a brain tumor, at the age of about thirty? Got surgical removal of the tumor, and all the medication afterwards, sick leave of 6 months, and periodic check ups for years, all covered. How would that go in the states?

It would depend. I work for very large company (approximately $23 billion in revenue last year), so we have very good options for insurance. I pay lower taxes than your friend, but I have to pay for part of my insurance through direct payroll deduction. My company pays the majority.

If he had my health insurance, the surgery, treatment, and hospital stay would be completely covered. There would be a minimal amount of money that he would have to pay as a co-pay to cover medication he'd need from the pharmacy, but the insurance would pay for most of it. He would also go on short term disability and get paid while he was recovering. All of his checkups would be covered except for the co-pay for a doctor visit, which is $15.

I think, after reading this, you probably realize that people like me aren't really the problem. The issue is with those who are uninsured or under-insured. People are not denied medical treatment. They can go to a public hospital. The problem, of course, that they don't get any preventative treatment and they go to the ER when they are sick. That is very, very expensive because of the nature of an ER and because of how much the hospitals charge to make up for the fact that they have to treat a percentage of their patients who will not be able to pay them. The rest gets covered by the taxpayers anyway.

 

[blutoski]

The rest gets covered by the taxpayers anyway.

This is something my American peers have trouble digesting... they pay more for their system through taxation than I do in Canada. And get less public coverage. And then they pay again out of their paycheques for private insurance on top. And get less coverage. It's massively inefficient.

Their response is that the public subsidization should be eliminated. OK, I admit that's consistent with the 'everybody should take responsibility' stance. The problem that would emerge would be a larger portion of the population dying much earlier, and becoming disabled. In other words: less national productivity.

This is an important reason that Canadians value our public healthcare system: it makes us economically competitive in addition to the improved quality of life.