DallasDave's Blog

This may be an old saying, but it remains true:

Think healthcare is expensive now? Wait until it becomes "free"...

Obviously there is no such thing as "free," the questions are how we pay for it and how people get it. What's the difference between requiring everyone to carry health insurance and paying for it through taxes? Main answer: overhead.

Despite all the libertarian hand-wringing (which used to include me, say 15 years ago), Canada ain't doing all that bad vis-a-vis health care. Time tells, and time has told. The nation does not collapse with tax-paid health care, quality of care really does not suffer, and medical advances still occur.

Middlin' coverage for my family runs above $1000/month (full price). Part of the reason it's so high is all the people who aren't covered, who get their health care in emergency rooms, which cost a lot more than doctor office visits, and then walk away from the bills. Another big factor is the complexity of the administrative overhead handling all the paperwork for private insurance; it's a huge amount of crap, 'way more than it was 20-30 years ago.

The math here is not all that hard. I think it's time we considered it seriously.

Holy cow Grim, "Overhead...all the paperwork?" Your position implies this will disappear, or at least diminish, if (God forbid) the government takes over.

How long was Hilary's Communist Manifesto errrr, health care plan? And that was just the first run.

If I had all the answers, I'd be a very rich man. I know what the answer isn't: employer-sponsored insurance; and, in the name of all that is holy, keep the federal government out of it!

Here's a democrat's definition of "free": someone else pays for it.

Blu, yes there are cheaper private plans available, with high deductibles and higher copays. When I said "middlin'," it's typical for group coverage that employers provide -- the full premium, not just an employee's monthly share (which for the same coverage was under $200). Employers usually don't go for the cheapest possible, because they want to encourage preventive care and early intervention, thus modest copays (plus it's an untaxed benefit, so a partial substitute for payroll). The figure I quoted is a very recent data point. There are more expensive plans, too; the carrier in question is one that many providers cringe at for sometimes being difficult to get payment out of without a fight -- which of course adds to administrative overhead.

Herman, I've not spoken with Canadian nurses, but I have with Canadian patients. Those I've spoken with generally think their system works fairly well. I do know a few US nurses, though, and in general, RNs here are given too high a load of patients with too few LVNs and aids to help out. But this is about all health care, not just hospitals: most of us (with insurance) see a GP for care far more often than we go to a hospital.

Eddie, with single payer, much of the accounting overhead WOULD go away because there's one clearing house, and coverage is standardized. I'm not at all saying Hillary got it right in the early 90s, but that it's high time we revisited single-payer ideas. In essence we're already paying for a bunch of uninsured people now, but with expensive care like ERs when they finally do get treatment. Getting th

I shudder to think that HMO might become Government HMO. Imagine your court options then?

Something needs to be done - there's our point of consensus. Mark's right. If a government agency runs it, there will be an appeal process; but it will go through bureaucracy; hearings; and eventually through the courts: administrative law judges; hearings and more bureaucracy.

My daughter had surgery a couple of weeks ago. Earlier this summer, my HMO denied the surgery. I put together an appeal letter and worked the customer service lines. After a couple of weeks, common sense prevailed and we were back on track.

In the context of this conversation, I would hate to think what would have happened - and would still be happening - if we were working through the federal government.

I still don't believe the HMO/employer sponsored system is best. However, in my personal case, the private HMO had a stake in keeping a customer, and a pretty darn big national account happy. The federal government wouldn't have cared less.

Eddie, I agree that something other than what we have now would be nice, but it certainly seems as if the starting and ending point of this debate for some powerful polititians is single-payer. The sheer scale and breadth of instituting such a thing is scary, not to mention that it nationalizes a private system in direct contravention of Constitutional government limitations.

I'm willing to listen to ideas, but single-payer is a dead horse to me.

Hope your daughter is doing well.

Gimpeur can argue all he wants, if National Healthcare becomes a reality it will not only be hospitals that suffer it will be privtae offices as well. There is already a nursing shortage that is the reason you will find less qualified health care employees than you would perfer. I am not a political guru but I do know about health care and I can tell you some of the people I work with now don't meet the standards they should.
Let me put it very simply, If national health care does happen the standards will drop faster than Bill Clinton's pants at a college girls dormitory.

Nice to hear your daughter is well, Eddie.

I just had a thought (it happens sometimes, and often is not pretty). We have our places of employment pay a portion of our health costs. Why not get rid of that? The company hands the worker the money, and we in turn can seek our own plan. Since the government will never reform their tax code to a flat tax, and will always have tax credits and tax deductions and such, the government can allow us to claim the $$$ spent on insurance as a tax deduction. That way, if an individual elects not to obtain insurance, they are penalized.

Obviously a rough draft, but I offer it up for consideration.

"The main problem with subsidizing through tax deductibility is that it's regressive: the higher your tax bracket, the more the fed subsidizes you. But the problem here is general affordability, so if there's to be government subsidy, it should skew from the bottom up, not from the top down."

The government should not be subsidizing anything, period! If the government is subsidizing, the market is not free and that means we (the consumer) are getting screwed.

"to a very large degree health issues strike randomly, regardless of how one lives or what care one can afford."

Not at all. Most every health issue is preventable, but that is a topic for a different blog...