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POLICY: Why covering the uninsured matters

So there’s been lots of back and forth in both THCB and Don Johnson’s BusinessWord about the uninsurance issue. Take a look at my comments alone to understand some of the issues involved.  And randomly enough it’s "Cover the Uninsured Week".  The irony of Orrin Hatch, a crypto-fascist from the wonderful state of Utah, being one of the Senators kicking off the week is just too delicious to forgo a mention. But the real issue and the reason to care is that, if you don’t have access to health insurance, your care and your health will be worse. In fact CDC data show that millions of uninsured adults forgo needed treatment for chronic health conditions. And of course who pays when they do show up for the treatment they need when these conditions have got worse? They do with their pain and those of us who are taxpayers or insured pay with our money.

Meanwhile Don fails to answer my question about what’s the difference between subsidies for the uninsured and more taxation, other than saying that universal insurance would not answer the question for the poor and the uninsured!!  That’s just ridiculous and is patently untrue.  If health care was free at the point of use, people wouldn’t not get it for cost reasons nor would they be beholden to huge debts because of it — those are by far the two worst symptoms of uninsurance. But he does raise the real politik situation when he says that:

What is the greater good here, take care of the 93% of Americans who
are insured today or the 7% who are uninsured for a year or more? I
think I know how the insured and their representatives in Congress will
vote.

And that’s the problem. So long as the majority (actually only 80%)
perceive their plight to be divorced from the minority, and no one
gives a tinkers cuss about the poorer 20%, we end up with what we
have.  Of course in reality we’re all mostly getting a worse deal than
we perceive and we’d be better off financially in a universal system that had built in cost constraints. So we are not seeing a "greater good". But then again hiding information from us is what the system’s all
about.

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AngelaJCDMCLinkmeistergadfly Recent comment authors
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Angela
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Angela

I live in a country that has cover for every man, woman and child. I have also lived in the USA under the system you have there.I can tell you that a socialised system works better.Our tax payers all pay 1.5% of their income toward mediare.A lot of people also choose to have private cover so that they can choose to have there own doctor and the hospital of their choice. My husband recently got cancer. He is getting the best of care and its all free.He is American and I know that if we were still in The USA… Read more »

Ron Greiner
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Sure Rick,
State your “clear” and valid question.
Hillary said, “No, No, NO tax free HSAs put to much money in the private sector.”
Senator Ted Kennedy said, “I’m the HSAs biggest opponent.”
President Bush said, “Get low cost HSA health insurance and combine that with a tax free HSA and you have yourself affordable healthcare.”
No wonder President Bush has a mandate.

Rick
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Rick

Ron, You certainly are right about not understanding me. So much so, you dodged answering clear and valid questions by going after the minutiae. I’ll refrain from challenging what you’ve already accepted as gospel. It wastes both of our time. Single-payor, universal coverage isn’t Socialism as long as the delivery mechanism stays in the private sector. And it’s just common sense. It’s a scientific reality that the broadest pool is the cheapest solution, your lectures about realpolitik notwithstanding. I know you think you’ve found a bargain, but the potential is there for it to cost even less. If you really… Read more »

Ron Greiner
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Rick, You ask, “When you are getting $10,000 worth of medical care for $5,000 that the government didn’t collect any taxes on, where’d all that unspent money go?” You are deep thinker Rick. Then you continue, “You know as well as I do, it didn’t disappear. It’s a zero sum game….blah blah blah.” Sorry Rick I don’t understand your rantings. I do understand FSAs and MSAs. The FSA is an account that what you don’t spend by the end of the year you lose and it is illegal to get interest on your balance. The MSA is the original name… Read more »

gadfly
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gadfly

//system that tries to squeeze on the costs, or dodge the events. // I think I mentioned here before that a few months ago the CA legislature rejected reforms that would have improved access to retirement homes. The argument was that people would “come out of the woodwork” to claim the benefit. What astounds me is that “woodwork” is an argument *for* reform, not *against* it. Those people in the “woodwork” are the ones who are living who-knows-how while they are being denied affordable housing and help with their disabilities. It seems self-evident to me that aging is a universal… Read more »

Rick
Guest
Rick

Ron, Lighten up. You’re a little too full of yourself. The fact that gadfly has worked in the insurance industry and doesn’t understand HSAs just goes to prove they aren’t the panacea you’re trying to sell everyone on. All you’re doing is proving HER point by poking fun at her ignorance. HSAs are, after all, just the latest spin on MSAs and FSAs, which have been around for a decade or more. By now, if people don’t understand them, or trust them, or have the time/energy/inclination to try, the whole concept is a loser, no matter how well it works.… Read more »

gadfly
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gadfly

//don’t know anything about HSAs.// I do now know *something* about HSAs since you have been kind enough to explain them to me. I also welcome corrections of fact. //You have made many incorrect statements about HSAs.// Which I’ve corrected in response to your remarks. Feel free to correct further instead of just discounting me as a know-nothing. //43% of HSAs had no previous insurance. You call these uninsured people rich, you’re a hoot.// You said people had to buy insurance to qualify for an HSA, and those people needed money to do that. This makes it sound like those… Read more »

Ron Greiner
Guest

Remember Gadfly you don’t know anything about HSAs.
You have made many incorrect statements about HSAs.
43% of HSAs had no previous insurance. You call these uninsured people rich, you’re a hoot.

gadfly
Guest
gadfly

//cost less after it become part of the Government domain? // Universal doesn’t mean run by government, though it would probably have to be in some respect. Universal means the health plan covers everyone. Non-universal health plans are cheaper because people are excluded. If this country continues to deny universal health care, my hope is that those excluded people, suffering and in pain, will go stand in front of the house of the privileged covered person and make them watch the atrocities they’ve shrugged off. Another thing to consider is that when health care will only be offered to some,… Read more »

JC
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JC

I can’t understand why someone would support universal coverage on the basis that health insurance costs too much (or doesn’t cover dental). Do you honestly believe through some sort of magical economic theory that it will cost less after it become part of the Government domain? Look at my earlier analogy, that’s like thinking a Mercedes Benz will cost less if the government buys than if I buy it. The universal coverage theory is flawed because of this. It will simply shift label of cost from “premiums” to “taxes”. Why do you think no career-minded politician supports this idea. If… Read more »

gadfly
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gadfly

DMC – Matt also floated someone else’s proposal that the VA eventually be extended in the same way.
I’m pulling this out of thin air, but I think part of the political problem is that everyone thinks of Medicare as a bloated moneysuck, so extending it might be perceived as fostering an even bigger bloated moneysuck…
Or, someone could get Medicare a better press agent. 🙂

DMC
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DMC

I’d like to address a point NOT about HSAs… Matthew wrote …And that’s the problem. So long as the majority (actually only 80%) perceive their plight to be divorced from the minority, and no one gives a tinkers cuss about the poorer 20%, we end up with what we have… Anecdotally, I think this may be changing. My politically-conservative parents are rethinking their political philosophies _because_ of their health insurance woes. My mom’s employer, a medical practice, provides the insurance, which is very expensive. I’ve often argued to my parents about the need for single-payor system in this country, including… Read more »

gadfly
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gadfly

//you are a blogger at the Health Care Blog// I’m a big fan of Matthew’s, but I consider myself an interested learner at the Health Care Blog. I’m not a fellow blogger as far as the analysis of the health care system is concerned. I’m glad I’m starting to understand the issues around HSAs. It sounds like public awareness should be raised on this topic. Abby – with the amount of people being furloughed from the workforce in school, you’d think there would be some sort of transitional health care plan to cover any gap between school and work. Also,… Read more »

Abby
Guest

Let me be clear, that I’m talking about a chronic condition. Group is the only thing that works.

Abby
Guest

Ron,
My health insurance came from my school. Once you leave school, it’s gone.