Who should pay for our health care?

21

Well, to play the devil’s advocate…if we were to follow that line then I could say that I shouldn’t have to pay money towards social security since I’ll never see it. Let the future retirees work an extra 20-30 hours a week to obtain money for their retirement and let me keep the chunk of money that gets taken out of my paycheck every week and use it as I want. I could also say that my tax dollars shouldn’t go towards anything that I do not benefit from personally - like public schools. Since I don’t have children and have long since graduated myself I should no longer need to pay into the system.

I don’t think that we need to work outselves to death in order to be able to afford healthcare. I’m not for universal and I’m not against it - but I don’t think the current system is set up very well and alternatives should be looked into. Right now I am dependent on employer sponsored healthcare, which goes away (after cobra ends, of course) if I lose my job. Hypothetically if I were to lose my job and then run through cobra …I would be up a creek. I cannot purchase a plan on my own and if I were to go through a lapse in coverage I could feasibly be denied coverage by other insurance companies (employer sponsored or not) in the future. I’m sick of seeing health insurance companies cherry pick the healthiest people. I’m sick of arguing over prescriptions and how often I actually do need insulin or test strips.

I don’t think this issue is about lazy people who want a hand out - and I keep seeing that stimga assigned to it over and over again. To me this issue is about making health care affordable. It’s getting ridiculous. Working yourself to the bone in order to be able to afford the ridiculous price of healthcare is not the answer.

22

I think there are actually a few things that are we are all trying to figure out.

  1. Access to health care should be available…not necessarily paid for by others, but accessible to all. Meaning that if I want to purchase it, I can.

Currently, Medicaid covers the poor. …so the poor are already covered.(government healthcare)
Social Security often covers children… Florida, like many states has a children’s insurance program that picks up many of them, so that is already covered.(government healthcare)
Medicare covers the elderly(government health care)
What is left is 1.the working folks or 2. the people who make just enough money to not qualify for government assistance, or 3. the folks that don’t qualify to buy health insurance.

I think that if you want to reduce the cost of healthcare so that working folks can afford it, stop taxing it, and also pass tort reform. The cost of lawsuits and taxes is staggering.
(Florida got the lawyers out of workers comp about 3 years ago, and my Workers Comp insurance has dropped by 48%!!!That is huge. almost half…

Those with health insurance are already covered. It is expensive but that is a symptom of a costs problem, taxes, legal, etc…Everyone wants health insurance because it is seen as a good deal. Pay $800 in premiums…take out $1000 in supplies or services.
…sounds great. But it has to be sustainable. The reason that extra $200 a month is there is because someone else paid for something they didn’t take out, or the insurance company controlled costs ie…same thing, or the insurance company invested premiums in something that generated income to them…

The problem seems to be to me that Folks who need insurance the most(users who take out more than they put in…I know that I and my family of 5 am one of them!) have a hard time gaining access to the system…or…anyone in need who has either no employer who offers it or married to someone who’s employer doesnt offer it…or…
the folks who are on the financial bubble…can’t qualify for aid but are barely making it.

If you want employers to offer it reasonably, make it very beneficial to the employer to do it, and you will see it happen everywhere. Right now, it is a lot of work, and risk, and is not that much of a benefit to the employer. Instead of taxing healthcare, make it a benefit and spend the money on prebates, or rebates, or benefits instead of going to nationalized healthcare.

We already have government health care as noted above. If you think about it though, those are not typically the most desireable of choices. Go to any hospital Emergency room and they have to take you. Regardless of ability to pay…

I think what I see is that the ability to purchase health insurance is the big one. I think that is the true battle that has to be won, and once you can do that, reduce the costs by getting the government taxes and the lawyers out of it to drop prices.
Please just don’t demand (by the threat of putting me in jail) that I pay more to carry someone else…I am already tired…

Keep going…Peace, Bob

23

I agree with you on a lot of points here. However I think the only point that I’m still hung up on is the “Please just don’t demand…that I pay more to carry someone else I am already tired” comment. I personally feel that is as bad as someone expecting the system to take care of them. It seems like the other extreme.

Because you’re kind of saying “forget about everyone else - it’s all about me”. Or that is what I’m getting from that statement, anyhow. Like I mentioned - I’ve been paying into social security since my first non-babysitting job when I was 16. I’ll never see it, but I don’t seriously moan about how I have to carry others and how those who retire and collect social security are just being living off of my hand outs and expect me to support them through their old age.

If our nation where to go towards universal health care, I’m not sure it would necessarily be a bad thing. I can’t say it would be good either. The thing about it is that we just don’t know for sure because we’ve never had it. We’ve heard horror stories of what it is like in other countries (and the truth of those is debatable) but we don’t have first hand experience of how American would run universal healthcare. Would it really be worse then it is now? Would you really be paying more a month for it? Who knows. Until it happens, there is no point in jumping to conclusions. I’m just going to continue to hope for a change for the better - a change where my husband and I don’t have to take up second jobs just to be able to afford my medication. :slight_smile:

24

But that was my point - we don’t know what kind of impact it is going to make. We simply don’t. If it should happen it is not going to be what Canada or England have. This is a horse of a different color. However. Right now neither candidate is pushing for universal healthcare, so it’s kind of a moot point. (Obama: http://www.barackobama.com/issues/healthcare/ McCain: http://www.johnmccain.com/healthcare/ though I should point out that the pre-existing condition clause will still be in place under the McCain plan) I’m fond of Obama’s plan, personally.

Paying higher taxes is part of the lot you get when you start your own business. I grew up with parents who own their own, so I am aware of the risks and benefits of it. But, that was a choice you made. I chose to get in with a large company and benefit from the insurance plan and other discounts that go along with working in a large company. My taxes aren’t as great. I’m not saying it’s fair by any means - but I am saying that it is part of the package and it was most certainly not a secret.

Some states make it difficult to get insurance after you’ve been off of it. Florida is such a state. If I get dropped then I will always be fighting for my right to coverage because of the ‘lapse’. I believe that everyone deserves the right to good healthcare - and I am willing to fight for it. :slight_smile: It shouldn’t only be available to those who are rich or who have to work two jobs in order to afford it.

25

I agree with you there - I have no desire for universal healthcare, but rather for change. Affordable for all, or at least that is what I thought I have been saying. Perhaps I haven’t been explaining myself very well. I just wanted to point out that we have no idea what universal would have been here in the states. Heh.

My husband does something along those lines - he’s a contractor (3d artist) on the side and we pay quite a bit in taxes from what he makes. I’d love to be able to be self employeed - do design for clients etc. But right now it isn’t reasonable for this newly wed couple. :slight_smile:

26

Haha. Thats funny - my husband and I had considered doing the same exact thing. (On top of freelance he teaches 3d at a local school) I was working for a sinking ship of a company at the time and the constant worry that I’d be jobless was getting to be too much. I held out until December - after we got married and I got added on to his insurance - and have since found gainful employment elsewhere. TMI, I’m sure.

You’re kind of lucky that the state you live in would had insurance policies that you could purchase - even if it was incredibly expensive. Florida won’t write one for me, I looked into it. Maybe not being self employed had something to do with it.

27

I’m going to join this discussion very late in the process (hard to keep track of everything here), because this is one of the central issues for the future (energy and the environment being others, but this one is personal). First, my background – 25 year plus type 1, pumper. I’m a partner at a big lawfirm, which means that, though it is a job, I am treated as self-employed, which means I pay for my own health insurance, at the rate of about 18,000 per year (and that’s after I get my small deduction for health care expenses). I also am fortunate enough to be in the position to pay an enormous amount in income taxes every year as a resident of New York City and New York State.

Now, here’s my take: there is a lot wrong with the health industry today. There is too great a profit motive with the insurance companies. The medical malpractice lawyers make medical errors too costly, driving up the costs of business for doctors across the board, with verdicts and settlements that often are way out of line, but still, paradoxically, often do not compensate many victims enough for the economic costs of the errors. The drug companies would prefer to make medicines that we have to use for the rest of our lives, rather than the treatment that will result in a cure. And we ignore the benefits of education and how health-related education, pre-screening and testing can help save money in the long run. And I am not even going to start on the privacy issue, because in this day and age, I really do not believe that we have any left.

Who should pay: The entire nation should pay. Why? Because those who are healthy right now may suddenly find themselves not healthy, whether it is the result of an accident, diabetes, parkinson’s disease, ms or cancer. Our health rarely changes gradually. Often, it is sudden, and the cost of care is exorbitant. It is not a question of the rich or the high earners paying for the people who are not as fortunate or even do not work as hard. It is a question of all of us, across all income levels, wealth levels, work backgrounds and socio-economic positions being part of a national insurance fund.

It used to be that employers funded generous health benefits for employees. When I first started working, my insurance covered 80% of everything, with a $500 annual deductible. Today, except for prescription coverage, I net about 11% back from my health insurance claims. Employers are trying to cut back on employer-paid insurance plans because of the costs. Some companies try to avoid benefits by having independent contractors.

Paying for all of this health care means a tax. Companies should pay a health insurance tax that is about equal to the cost of a decent insurance plan. They should pay it based on the number of employees (treating independent contractors as employees). Individuals should pay it as some kind of an income or sales tax.

And, the insurance industry should be converted to a non-profit business – businesses should not be making money off health insurance, and insurance company executives should not be making tens of millions of dollars per year for cutting costs. It all results in the wrong decisions being made.

Just one man’s opinion.

28

…Wow, Shannon and Lauren, you guys rock!!!..nice responses…

Shannon did a better job of relating my thoughts I think than I did.
In a nutshell, I think that the ability to purchase health insurance should be available to everyone. What that would mean in dollars and sense, is that everyone would see an increase in their rates. I understand that and think it should be the way to get this done.

As for my stating that I am tired, I guess what I was trying to say was, please don’t ask
me to carry any more. I am already carrying mine plus a lot of others.
Anyone is welcome to do the same…if you think we all need to do more, do it! Just add it to your taxes at the end of the year. Take no deductions and send in 40% of your income…I do. If government healthcare comes to fruition,that number will increase to probably at least 50% plus. Add that amount too, I will.

I did not have health insurance until I was married at 27. I couldn’t get it until I married my wife who had it at BCBS.
I get the starving thing. I would have qualified for food stamps for the first 5 or 6 years of my business while working 80-100hours a week. Often 7 days a week.
I was hospitalized without health insurance, and wound up paying cash monthly over the next 4 years to square up my bills with the doctors and the hospital.
I currently am a foster parent who is raising someone elses child I don’t know along with my own 4.
I pay half of all of my employees health insurance, and I pay half of their Social Security. I pay them for time off from work(vacation). I guess now I will be responsible to do more .
I would like to encourage everyone to do more. To give you an idea, if I work an average of 70 hours a week, and the government takes 40% of my income, that equates to 70 hours x40% = 28 hours for the government, and 42 hours for myself. If they raise my taxes to cover this new (free medical) to 50% plus, where am I gonna find another 7-10 hours a week? I think everyone should have to work another 7-10 hours a week to pay for government healthcare if I have to.

I wonder how many of the folks that say they can’t afford health insurance currently
own 1 or 2 vehicles
a cell phone
cable t.v.
internet
a computer
air conditioning…and if they have it, do they run it at 78 degrees or more
a big screen t.v or multiple t.v.s
a DVD player
an Ipod
Tivo
smoke or use tobacco
eat at restaurants
brown bag their lunch
carpool
children with cell phones
Blockbuster or Netflix
Buy store brands instead of name brands
make their own coffee instead of going to Starbucks
own their own home or have equity in it

I know it’s not popular to point out that these are niceties, and not necessities that add up to hundreds and hundreds and hundreds of dollars a month.
I also know that there are a lot of people who are in need, but I think most of it is covered. The biggest need in my mind is access.

I believe it is all about access to be able to purchase health insurance…not forcing someone else pay for it. I think if we focus on access, then everyone will win and a rising tide will lift all ships.
oh -oh…here come the arrows…Keep going… Peace, Bob

29

Thanks Shannon, I agree, choices define outcomes. Access to be able to buy in to health insurance allows all to participate and then pick and choose the plan they want to pay for… I dont see any other reasonable way.
Thanks for the support…you’re the best…Keep going … Peace, .Bob

30

HAHA :slight_smile: That’s pretty funny!

I’m a newly wed too :slight_smile: We should have thought to get married sooner (in secret) so I could have joined the national health care system earlier!!

One thing that bothered me about the system in the USA is that people with health complications need to find (and consistently) keep a job at a big company that has good insurance. I wasn’t ready to go the traditional road-- and that cost me a lot of money. I always had to find some way to get by…

Maybe that’s just life… and I should have grown up earlier. But young people with no health problems just don’t face that.

About the universal system, actually the national system in Hungary is NOT universal! It is just national (insurance and prices set by a separate government organization). If you do not pay taxes into the system, you do not have insurance. But you can buy it for 10% of minimum monthly income. It does cover children and elderly universally. The MAIN difference is that the premium you paid is based on INCOME, not risk. And eligibility is based on employment or paying (30 dollars per month), NOT health.

It just says that a healthy society is something that we should all pay for. This system needs reform too-- and like Laura said-- i don’t think the USA system should become universal, but we should think how to make the system more efficient and fair!

As Bob pointed out, we waste a lot of money on medical malpractice insurance. Let’s get that down…
Also, the price of providing emergency care to the uninsured might be MORE expensive than insuring them. Perhaps a more fair system does NOT need to be more expensive than the current one!

31

Here is an interesting article comparing diabetes care in the Netherlands and the USA:
NPR article

Though the diabetes care seems much better in the Netherlands, it is partially funded out of income taxes, which has been a controversial debate in this forum, but the amazing thing is how much LESS the government pays per person in the Netherlands compared with the USA. This suggests to me, that a good reform could even DECREASE tax spending on health care…

What’s interesting is that the Dutch reform was modeled after the US system, with one important difference, there is universal coverage!!

Here is an interesting website for comparing health care systems in different countries.

32

Another article offering a different perspective-- comparing the Swiss and American systems.

33

You guys might already know this but NPR is doing a really good ongoing commentary on some of the best European healthcare systems and how they compare to ours. http://www.npr.org/templates/story/story.php?storyId=91972152
Does anyone actually know how much our govt. is currently paying for healthcare per capita? I’d be interested in seeing this statistic beside what some European countries pay per capita.

34

I calculated these figures, using OECD data from this site.

Among the OECD countries (with available data), the USA is the 3rd highest. Higher than most European countries.

This includes ALL public spending, but I’m not sure if that also includes research funding?

But it shows that the USA is in the same range as the European systems, it’s just that the state is providing a lot less, in my opinion!
8572-OECDpublichealthspendingpercapita2006.pdf (34.1 KB)

35

Amen!

36

Here’s the problem I have with a system where everyone puts something in ( through sales taxes, income taxes etc ). Some disease are lifestyle diseases. Some people will abuse their bodies, develop hearts disease, lung disease, renal diseases etc because they make poor choices ( poor diet, no exercise, drug and alcohol abuse, smoking etc ). Then they come crying to the health care system to bail them out.

So I am all for socialized health care so long as smokers, alcoholics, drug users, etc. are excluded from the system.

“The usual argument against sales tax is that is disproportionately taxes the poor because they spend more of their income on consumption than the rich (who save and invest, etc.).” – Kristin

Well … really, if I choose to spend my money on large screen TVs, blinged out cars and other stuff I can’t afford… then I am not being responsible. Why should I now burden someone else with my poor choices? Especially since I most likely will not change my behavior. “Stupid is as stupid does”.

37

Yeah Bob. I agree. Access and choices.

38

The argument here is not about large screen TVs etc (though I do get that argument that many people spend their money on things that they can’t afford…).

The point here is that in many cases BEING POOR IS EXPENSIVE. For example, when you have greater financial assets and more job security, you can get a loan and buy a house. When you don’t, you end up paying rent which in the end makes even a lower quality housing option much more expensive than options that others have. An extreme example of this is people that live in motels, just to get by. They can’t or don’t want to make a one year commitment-- so they live month by month, or week by week. This is more expensive, but perhaps with a lower level of financial security, this is all that they can do(?).

BUT these arguments are more personal thoughts. The more “economic” argument is not about the poor actually BUYING more, but just that it is a larger SHARE OF THEIR INCOME that is spent on consumption (and less money is devoted to savings and investment). Even if both a household with higher income and one with lower income only buy the necessities needed to sustain life, the poorer household would spend a higher percent of their income on consumption than the richer one. If you have no/low income, you don’t pay income tax, but you always pay sales tax. So this tax is “harder” on the poor. Whether it’s in a fair or unfair way is a normative question that can obviously be debated…

I actually am NOT opposed to sales tax as a way of gathering income, as long as necessity items (food, housing, school supplies, … ) are EXCLUDED. Which in many cases they are. That means that we should tax CARS, TVs, ELECTRONICS, GASOLINE, … (I added gasoline as a provocation :slight_smile: … I know gas prices are “insanely” high in the USA, but I live in a country where the average income in one third of the US income level and gasoline prices are 3 times higher than they are in the USA NOW!! Driving is a luxury good. I know that this isn’t possible in the USA because there is not sufficient public transportation… but sometimes i think it is important to imagine how things COULD be different. With out health care system, with our lifestyles…)

39

In response to Khurt’s comment about lifestyle diseases, I think this is just a matter of how you understand life— is it about ‘choice’ or ‘chance’?

I think we all recognize that our lives are determined by BOTH. So which dominates??

Choice-- how hard I work, the decisions I make, the priorities I choose

Chance-- the place and family that I was born into, unavoidable events

I do believe (to a limited degree) in the American dream that ANYONE can do ANYTHING (i.e. that’s it’s all about CHOICES), but when I’m more realistic, I have to realize that SO MUCH OF LIFE IS ABOUT CHANCE.

I did not choose to get type 1 diabetes. I did not choose my genes. I did not choose where and to whom I was born, which shapes SO MUCH of our future (though I do know that you can rise above many things… there is not equality in our society).

But people do choose to smoke. People do choose to drink excessively. People do choose unhealthy eating habits. People do choose not to exercise.

How would I solve this? I would have a universal health care system that serves ALL. This protects the people that were affected by CHANCE. And I would discourage poor choices, without invading on personal freedoms (extremely high tax on cigarettes, education programs, etc.). This could lower the costs of others’ bad CHOICEs.

Would we end up paying for some smoker suffering from lung cancer? Yes.
Would we pay for a child living with type 1 diabetes? Yes.

In my opinion, the benefit of this system OUTWEIGHS the cost. Especially when you see that most countries with universal health care actually spend LESS per person than the USA. So your tax dollars are already being used to pay for others health care. Just the WAY that they are being used is neither efficient, nor fair, in my opinion.

I hope that system will change, but most of all, I’m thankful that we live in a democratic society where we can debate these issues to the point where hopefully we can design a health care system that balances between efficiency and fairness-- a system that realizes that life is decided by both choice and chance!

40

Sleep… it’s overrated :slight_smile: It’s midnight here now, I’m off to bed. May the debate continue while I sleep peacefully :wink: !

By the way, my mom thinks that I brought on my type 1 diabetes by not sleeping!! So maybe it was ACTUALLY a choice :slight_smile: See comment below… :slight_smile: