US Health Care Reform

[Jae Onasi]

I received a link to this Obama page to RSVP for the health care reform web address on Thursday at 2:30 pm Eastern daylight time. Being a provider and a future recipient/participant in whatever version of health care reform does pass, I of course signed up.

 

I asked the President these things:

1. Can we not just extend Medicare to every American citizen? It's a system that would work for both providers and participants--provided it's properly funded, of course.

2. Tort reform--we desperately need it. Yes, we need to hold bad doctors accountable, but too often it turns into the 'Million-dollar Medical lottery' that makes a lot of money for the lawyers. It's driving doctors out of some states like IL where liability insurance is just too expensive to afford, and driving some of them out of business.

3. Insurance reform--I want streamlined claim submission, on-time insurance payments. Right now, when we file claims, we have to file a different set of paperwork for every single one of the hundreds of insurance companies we deal with. We need one form that everyone can accept. Also, when claims are rejected, neither my patients nor I want to receive an 'explanation' from the insurance companty that would win the Pulitzer for "Most Creative Obfuscation." We want a clear explanation of why a claim has been rejected and what to do about it.

4. What will be done to ensure that the US remains on the cutting edge of medical research? We have some of the finest researchers and research institutions in the world, and I'd like to continue living in a country that has some of the best medical minds in the world.

 

I think health care reform is necessary and almost a certainty in this administration. What do you all think should be done to improve health care? What can be done to address the valid concerns of dissenters (note--this does not include the stupid things that loonies on both the left and right are spouting), such as problems with delays in health care in those countries with universal systems?

[Totenkopf]

I agree that changes are necessary, but would rather not see a "public option" in any form. I'd say that the govt can provide guidelines and enforce regulation, but that healthcare should remain in the private sector. More competition between insurance companies (hell, among cable companies and utilities would be nice too, but I digress), such as allowing them to sell policies across state borders, would help force business to lower costs in order to compete. Frankly, govt ownership would only make the situation worse. We've already seen how responsible the govt is in too many other areas to seriously contemplate handing over 14-16% of the US economy to its "care". I strongly agree that tort reform is an essential part of the mix, and must be part of any bill seeking to "reform" healthcare in the US. Also, remove pre-existing conditions as an automatic means of refusal for coverage and allow greater portability of health-plans so that loss of employment doesn't put you out on your ass while you look for a new job. Greater streamlining of insurance practices would likely lead to better efficiencies due to the lack of an office needing several employees just to process med claims, as well as hopefully less confusion. Also, and this probably spills over into education, but a greater effort should be made to encourage people to lead a fitter lifestyle. You may not be able to help your genetics/unforseen accidents, but healthier people would likely put less strain on the system. just a few ideas...

[Bimmerman]

I have the rather unique perspective of an American who has used the universal health care system in Germany.

 

 

And I don't like it. The doctors here work maybe four hours a day four days a week. There is no such thing as walk ins, and I literally was told I would have to wait three months to get a nasty infection looked at by the dermatologist I was recommended. The long wait times that people throw around to disparage the system are in fact quite real. Whether that's a function of the system or the incredibly lazy doctors, I don't know, but I tried multiple different dermatologists and they all had similar multiple month waits. I was not amused.

 

Also, the claim that universal health care of the European variety brings costs down....eh not so much. While it's true that it cost me all of 10 euro for a doctor appointment, and 10 euro for surgery, that isn't the whole cost. About 25% of my paycheck goes directly to the insurance company, and I am in the "lowest" bracket for taxes (student intern). The difference is that rather than writing a check yourself, it is simply garnished from your wages so you never see it. It is anything but "free." Medicines are subsidized, yes, but not free.

 

Where I'm going with this is that I fully agree the US system needs to be overhauled if not started over. I strongly disagree that we should use the European system as a model.

[jrrtoken]

It's somewhat... funny, to see that every time the public gov't-funded option is brought up, people yell "UNIVERSAL HEALTHCARE SOCIALISM BAAAHHHH!!!", when it only creates a separate healthcare firm like every other insurance company. It's hilarious to see that it's also being touted as some ultra-restrictive bureaucracy. Seriously, my current private health provider tells me which hospitals I can or can't visit, which doctors I can or can't see, and where and how much I can or can't buy my medications from. If the government can attempt try better, then I'd gladly see what they can do over my current health provider.

[JediAthos]

I definitely agree that changes need to be made, but I think the president needs to slow down a bit. It almost seems like the legislation is being forced and I don't think it's the best way to go about it.

 

Having been the recipient of a form of government health care(military) I don't know that some form of public option would be horrible. At the same time Jae's suggestion of extending medicare to all could possibly be an option too. I'm not sure how that would work but something definitely needs to be done to help keep the big insurance companies honest with their pricing.

 

The doctor's liability insurance thing definitely needs to be addressed as well. My wife's uncle was a surgeon until the cost of insurance forced him to stop practicing and settle for an administrative position at his hospital. He was never sued, and had a clean record, but his insurance costs continued to rise. There needs to be some sort of regulation there for sure.

 

I'd also like to see insurance companies regulated as far as what treatment they will and won't pay for. I read stories all the time about how someone died because insurance refused to pay for an expensive treatment, or an experimental treatment, or a drug that wasn't FDA approved. It all seems very random to me, and I'd like to see something done...granted I don't have a solution, but that's why I do my job, and I'm not in Washington.

[ForeverNight]

It's somewhat... funny, to see that every time the public gov't-funded option is brought up, people yell "UNIVERSAL HEALTHCARE SOCIALISM BAAAHHHH!!!", when it only creates a separate healthcare firm like every other insurance company. It's hilarious to see that it's also being touted as some ultra-restrictive bureaucracy. Seriously, my current private health provider tells me which hospitals I can or can't visit, which doctors I can or can't see, and where and how much I can or can't buy my medications from. If the government can attempt try better, then I'd gladly see what they can do over my current health provider.

 

Private companies can't compete with government. You know why? Because government doesn't have to turn a profit in order to spend money whereas if a private company runs out of money, it has to file for chapter 11 and reorganize within a set period -that the courts decide- or file for chapter 7 and liquidate their assets.

 

So, the public option will create inexpensive health care that you're going to be paying for already. With Taxes. So, you'll pay for health insurance TWICE if you get it though a private company.

 

And, government doing better? They couldn't pour water out of a boot with instructions on the heel.

[JediAthos]

well...I'll say this...private insurance companies aren't hurting for money that's for darn sure. If having the government or medicare, or whatever can keep them honest and keep them from robbing the public blind then it might not be a bad idea.

[jrrtoken]

Private companies can't compete with government. You know why? Because government doesn't have to turn a profit in order to spend money whereas if a private company runs out of money, it has to file for chapter 11 and reorganize within a set period -that the courts decide- or file for chapter 7 and liquidate their assets.

I doubt it; they already turn in massive amounts of profit from being the middlemen in a system. People will always be willing to pay for more than the government standard, therefore, people shall always seek out private healthcare firms. It's not much different than deciding to ship a package via FedEx than the USPS.

And, government doing better? They couldn't pour water out of a boot with instructions on the heel.

Seeing as there's not much regulation when it comes to insurance rates and hospital bills in the private sector, which allows insurance firms to restrict consumers to their own whim, then I can't really see the harm of the government attempting to provide an alternative.

[Mandalore The Shadow]

Here's my view: *Insert title of thread here* is a bad idea. i dont agree with ObamaCare and if it ain't broke don't fix it

[Det. Bart Lasiter]

Here's my view: *Insert title of thread here* is a bad idea. i dont agree with ObamaCare and if it ain't broke don't fix it

 

i don't think anyone has said the american healthcare system isn't broken, congrats you've outdone even rush limbaugh

[Mandalore The Shadow]

I dont think that we need a complete overhaul of the healthcare system it isn't that "Damaged"

[jrrtoken]

I dont think that we need a complete overhaul of the healthcare system it isn't that "Damaged"

Considering that America is probably one of the few, if not the only, industrialized nation(s) to not have their entire population on some sort healthcare plan, I believe that's quite shameless, if not entirely inexcusable. Especially when America is the last bastion of Freedom™ and Democracy™.

[Mandalore The Shadow]

Well then we should have Freedom from a GOVERMENT RUN health care program

[jrrtoken]

Well then we should have Freedom from a GOVERMENT RUN health care program

...and you would under the current proposal. It would operate and function like any other healthcare firm, and it would be entirely optional for those who wish to pay for private life insurance. So, yes, I can't really see your point of how a government-operated healthcare firm is analogous to a universal healthcare system...

[Mandalore The Shadow]

I don't feel like explaining my point so I won't it will take too long any you'll just pick it apart anyways

[Darth InSidious]

I dont think that we need a complete overhaul of the healthcare system it isn't that "Damaged"

You're right - "damaged" doesn't quite do your health system justice. "Barbaric", "insane", "inhumane", "plutocratic" and "corrupt" are all much better words for it.

 

Well then we should have Freedom from a GOVERMENT RUN health care program

Why? The practical upshot for the end-user is the same, but with the added advantage that health services are working for your well-being rather than the profit motive.

 

But please, don't let me interrupt ranting about the red peril.

[Q]

[whitetrash]What the hell are you all complaining about? Here in the US the poor have the best health insurance on Earth. It's called Chapter 7 Bankruptcy Protection.

 

Hospitals can't legally refuse me care and while they can bill me, that doesn't mean that I can pay.[/whitetrash]

[Jae Onasi]

well...I'll say this...private insurance companies aren't hurting for money that's for darn sure. If having the government or medicare, or whatever can keep them honest and keep them from robbing the public blind then it might not be a bad idea.

I knew someone who was on the state insurance board in another state. He related a story he'd heard from a VP of an insurance company (from a different state, or he would have had to report this company to the Attorney General for fraud). Insurance companies reject all claims with incomplete information, information in the wrong boxes, wrong codes, wrong diagnoses for the treatment codes, etc. Well, this insurance took all the claims that should have been paid ("clean claims") and just randomly didn't pay 50% of them to see how many people would resubmit the claim. Only 20% of people did. The company made a lot of money that day committing fraud. There definitely needs to be more accountability for insurance companies, and streamlined claims filing so that the companies can't abuse it creating so much paperwork it's almost not worth it to file the claim in the first place.

 

I doubt it; they already turn in massive amounts of profit from being the middlemen in a system. People will always be willing to pay for more than the government standard, therefore, people shall always seek out private healthcare firms. It's not much different than deciding to ship a package via FedEx than the USPS.Seeing as there's not much regulation when it comes to insurance rates and hospital bills in the private sector, which allows insurance firms to restrict consumers to their own whim, then I can't really see the harm of the government attempting to provide an alternative.

The hospital bills are high because they have to charge a high amount for things like simple tylenol to cover the costs of people who will never pay, or late state Medicaid payments by states like IL who are 6 months or more behind. People with insurance or adequate funds pay the high rates to subsidize people who don't or can't pay. Having every person covered would possibly lower costs in that department. Once hospitals and providers were assured that they'd get paid for everyone they see, they'd be able to lower some of the more ridiculous costs.

 

I agree that insurance companies restrict consumers to their contracted providers/hospitals. My insurance company will only pay for certain medications and I have to go through some hoops to get certain procedures approved. There is far less of that problem with Medicare, though I believe Medicare works of a formulary (specific approved list) of drugs as well now.

 

Interestingly, the "$4 bucks a month" program that Wal-Mart started, and Walgreen's and other major pharmacies picked up, has made it easier and harder for me as a provider in some ways. It makes it very easy to prescribe something affordable for my patients. It makes it a lot harder for me to prescribe something that's not on the list--I have to explain why I have to prescribe a $80 bottle of an antibiotic drop instead of the $4 one, and that takes time. With my schedule (over)booked, it means I get behind with the next patients in line, which drives me and them crazy.

 

I dont think that we need a complete overhaul of the healthcare system it isn't that "Damaged"

I suspect you don't work in the medical system at all and that your family has adequate medical insurance. This is an opinion based on lack of information about the extreme problems in American health care. May I ask what you think the problems in health care are (or are not), and what criteria you're using to determine that it's 'not that damaged'?

 

Considering that America is probably one of the few, if not the only, industrialized nation(s) to not have their entire population on some sort healthcare plan, I believe that's quite shameless, if not entirely inexcusable. Especially when America is the last bastion of Freedom™ and Democracy™.

Shameless, inexcusable, barbaric, backwards, selfish, and assorted other negative sentiments, yes.

 

Well then we should have Freedom from a GOVERMENT RUN health care program

Should we get rid of public schooling too, because it's not part of the right to 'life, liberty, and the pursuit of happiness'? We have zero constitutional right to public schooling. We have public schooling through 12th grade because society has deemed it to be a direct benefit to have educated adults. We should have universal health care because it's a direct benefit to society to have healthy members. Do you have any idea how much it costs society to care for one person who's gone blind from glaucoma? The monthly disability check could cover a year's worth of medication and optometric/ophthalmologic care alone. It costs society a lot less for eye drops and appropriate medical care required for that person to keep their sight in the first place.

 

I don't feel like explaining my point so I won't it will take too long any you'll just pick it apart anyways

The point of discussing controversial or more serious topics is to learn how different people from different backgrounds, countries, cultures, etc. view it, and perhaps learn from that. Yes, sometimes arguments are going to be picked apart. That's because sometimes they really need to be picked apart because they're wrong. Sometimes it's because the other person has a radically different viewpoint and sees the situation entirely differently. Maybe they're wrong, too, but hold strong opinions on something anyway. Your argument may get picked apart, but that doesn't mean you're an awful person--it just means there's perhaps a problem with that particular argument.

[Q]

I knew someone who was on the state insurance board in another state. He related a story he'd heard from a VP of an insurance company (from a different state, or he would have had to report this company to the Attorney General for fraud). Insurance companies reject all claims with incomplete information, information in the wrong boxes, wrong codes, wrong diagnoses for the treatment codes, etc. Well, this insurance took all the claims that should have been paid ("clean claims") and just randomly didn't pay 50% of them to see how many people would resubmit the claim. Only 20% of people did. The company made a lot of money that day committing fraud. There definitely needs to be more accountability for insurance companies, and streamlined claims filing so that the companies can't abuse it creating so much paperwork it's almost not worth it to file the claim in the first place.

So what happened in The Rainmaker wasn't an exaggeration, huh?

[Jae Onasi]

So what happened in The Rainmaker wasn't an exaggeration, huh?

 

Well, rejecting all the claims 100% of the time would get the attention of the state insurance commission very quickly. More likely they'd randomly reject a small percentage of them so they wouldn't attract so much attention. At least, that's what I'd do if I were a disreputable, greedy insurance company.

 

From an article on Medscape:

 

From Medscape Family Medicine > Physicians Are Talking About...

Physicians Are Talking About: What to Do to Reform Healthcare

 

Nancy R. Terry

 

Authors and Disclosures

 

Published: 08/07/2009

 

As the healthcare debate heats up, the only point on which all parties agree is that the present healthcare system does not work.

 

An estimated 50 million Americans are uninsured, and the number continues to rise as more people lose both their jobs and their health insurance. Americans spend more than $2 trillion a year on healthcare, which is, by some estimates, 40% more per person than the next most costly country. President Barack Obama and Congress are mobilizing to reform healthcare. Yet, change alone does not guarantee improvement.

 

In a flurry of postings on Medscape's Physician Connect (MPC), a physician-only discussion board, doctors debate what reform measures would salvage US healthcare. Many physicians are as wary of increased government intervention as they are frustrated by the bureaucratic, profit-driven excesses of private insurance companies.

 

"As someone who has lived with illness (a congenital immune deficiency) for longer than I have been a doctor, I know first hand how broken our system is," says a dermatologist. "I live in fear of losing my health insurance since I know I am uninsurable through any private program. A public option is the only way to go."

 

"What would a greatly expanded role for the federal government mean for healthcare in this country?" asks an anesthesiologist. "Rationing for patients, with fewer treatment options and increased difficulty visiting a physician." An infectious disease physician agrees, "Obama's thrust to mandate a Medicare-for-all, single-payer [program] will ultimately lead to healthcare rationing of services -- not for the young and healthy but rather for the elderly, who are the sickest and most vulnerable among us."

 

The rationing of medical services is frequently cited by a number of physicians as an alarming but predictable component of a national healthcare plan. Yet, other physicians contend that rationing of services already exists. "The private, for-profit insurance carriers have contributed to the healthcare crisis by cherry picking the insureds," says an orthopedic surgeon. "To have a different premium price for those with preexisting illness denies insurance to those who need it most," adds an emergency medicine physician. Another MPC contributor comments, "Instead of making people wait, we just deny elective procedures altogether to people who don't have insurance. That's American rationing."

 

Advocates of free enterprise favor maintaining a system of multiple insurance providers because, they argue, free enterprise ensures maximum efficiency. In contrast, other physicians claim the exorbitant cost of healthcare can be largely attributed to profit-maximizing insurance companies. "Insurance companies are responsible for the high cost of healthcare," says an MPC contributor. "THEY set the premiums, and the reimbursement and the schemes that are squeezing everyone. All in the interest of profit -- not healthcare."

 

A national healthcare plan, according to other physicians, would afford no greater efficiency than the current system. "Already doctors aren't accepting Medicaid because of dwindling payments, hassling paper work, confounding delays, long waits, impersonal attention -- medicine DMV [department of motor vehicles] style," quips a pediatrician. "So, everyone will have insurance. Just not that many will have doctors."

 

Still others see little difference between the options of private and public insurance plans. "The schism between private health insurers and government is a ruse," says a general surgeon. "Medicare is already outsourced to private health insurers. Medicare-for-all will be a big boon for health insurers. Their volume will go up as will their profit margins as government-sponsored cost-effectiveness research demonstrates how much of the expensive medical treatments are "ineffective." Another win-win for government and health insurers. It's all a numbers game -- shift to preventative healthcare and the healthy are happy and the sick are shoved under the carpet."

 

Obviously, there is no easy solution. The best option, according to some MPC physicians, is to keep open as many options as possible. "Most of the primary care societies and academies favor a one-payer system," comments an MPC contributor. "If we are to give at least basic healthcare benefits to our citizens, we need it [a public plan]. It is not the perfect system, but at present it is the best option available. If a person wants concierge care, he should buy it."

 

"Will someone please explain what is wrong with a 2-tiered system?" asks an MPC contributor. "A basic plan with some basic coverage for those who cannot contribute and the premier plan for those who do contribute. The water analogy...everyone can drink tap water, but if you want bottled water, you gotta pay."

 

"Sounds OK to me," responds another contributor. "Coverage for treatments for which there is good efficacy data (not just statistical significance but clinical significance) and everything else, well, if you want it, feel free to buy it."

 

Few physicians are comfortable with a proposal favored by Congress that participation in a public plan be mandatory for all physicians who accept Medicare patients, although a nephrologist is "okay with mandatory participation for 1 to 2 years to support the government effort, but the mandatory participation should expire automatically afterwards."

 

Healthcare reform, however, is not simply a question of the number of insurance plans available. Recognizing that any insurance option must coexist with a reform agenda, physicians offer a range of proposals how a more equitable, efficient healthcare system might be achieved.

 

* Hold the insurance companies accountable to insure patients who have a preexisting illness.

 

* Set one premium level for all insurance participants, with varying deductible and copayment amounts.

 

* Establish a fund, patterned after Alaska's Permanent Fund, to cover the cost of insurance for those who cannot afford it. The fund could be built up by taxing commodities and activities that increase the risk for illness, such as tobacco and alcohol use.

 

* Incentivize preventive medicine, especially in the management of lifestyle diseases, such as diabetes and hypertension.

 

* Reduce redundant and defensive testing.

 

* Reform the tort system and eliminate malpractice insurance.

 

* Initiate a national campaign to promote fitness programs, improved nutrition, self-care programs, and disease prevention.

 

* Establish national licensure for nurses and doctors to decrease the costs of multistate practice.

 

* Eliminate state-by-state variations in insurance laws to unify the method of determining eligibility for healthcare insurance.

 

* Eliminate the fee-for-service model, and put doctors on salary.

 

Physicians, according to an MPC contributor, are in the best position to offer practical, constructive solutions for healthcare reform. "We need to stop coming to the table primarily motivated by protecting our incomes," said an emergency medicine physician. "Instead we should come to the table as citizens who have insight into why our healthcare system is so sick."

[Totenkopf]

Well, at least you can sue the insurance company. Rather difficult to do that to Uncle Sam, especially when you need "his" permission. Frankly, a govt run plan is not even remotely morally superior to a private one. Perhaps a few other ways to help fund things like FICA is to remove the salary cap and then make it illegal for Congress or the President (whoever they happen to be) to touch that money for anything other than its original purpose. I see no reason for the govt to be anything other than a side player, a safety net basically, for the people who may fall through the cracks. While the current system isn't perfect, it's not tragically flawed beyond tweaking either. Another consideration is for people who refuse to buy insurance, but can afford it, to have to get a policy, thus infusing $$ into the system.

 

As to the competitiveness angle, if the "public option" appears more affordable b/c its financed by tax money, most private firms will not be able to compete and will lose customers. $$ talks and BS walks. If the USPS were completely private, they'd have gone out of business long ago or postage would be much higher than it currently is. If the "public option" is even remotely analagous to the USPS, that is a very poor argument for adopting it.

[Tommycat]

Some of my biggest concerns are the "public" option. Who pays for it? What I would like to see is something like a tax credit for those that choose to pay for their own health insurance. This would help make private insurance companies less likely to deny claims as if you deny a claim, they drop you and go with the public option.

 

I'm with Jae on the one standardized form. It's bad enough working through one of those forms(had a friend show me the billing forms she had to work with... the sample was hard enough to work with)... I can only imagine what doctors have to go through... bleah....

 

Sometimes an insurance company can surprise you. My girlfriend is a cancer survivor. She needed a gene test. She was told that the insurance company would not cover it. She got the test done anyway(as it needed to be done). Insurance covered everything but the deductible.

 

Not all insurance companies are like that though. I think a public option with a tax credit to those that fund their own insurance would be the best choice.

 

Jae, I think the Public school analogy is a pretty scary one... Think about teacher pay. Chronically underfunded. Overworked in some areas.

 

USPS isn't a great example either.

 

Then we have the VA hospitals... Yeah... they are run just tip top(note: some areas are run quite well... others... not so much "Prescription strength Tylenol for all").

 

I'm always skeptical of any plan that you don't have to do anything to get. I have a fear that much like when I needed financial assistance the time when I need it, I'll be denied. I'll pay into it and never be able to make use of it.

 

Also, from what I understand Canada has somewhere near 700,000 waiting for medical treatment. That number doesn't include the number of people who have come to the US for treatment(though in many cases that treatment is also paid by the Canadian government) or those who have just decided to go with separate health insurance. It's still significantly lower than our 15%

[jrrtoken]

Not all insurance companies are like that though. I think a public option with a tax credit to those that fund their own insurance would be the best choice.

Yes.

Jae, I think the Public school analogy is a pretty scary one... Think about teacher pay. Chronically underfunded. Overworked in some areas.

Public education isn't federally-operated. Funded, yes, but it's the fact that every state can make their own standards with very little oversight and regulation is what has made public education a joke, full of bureaucracy.

Then we have the VA hospitals... Yeah... they are run just tip top(note: some areas are run quite well... others... not so much "Prescription strength Tylenol for all").

Yes. That's more or less a failing of the staff and the administrative process itself. Which is why I think it needs to be overhauled along with general healthcare.

I'm always skeptical of any plan that you don't have to do anything to get. I have a fear that much like when I needed financial assistance the time when I need it, I'll be denied. I'll pay into it and never be able to make use of it.

Why? As long as it's crafted to forgo any bureaucratic errors, then what would be the problem with it? You say you don't want to really pay taxes for other citizens' healthcare; well, you probably already pay taxes for thousands of unknown childrens' educations, so I can't see how this would be any different.

Also, from what I understand Canada has somewhere near 700,000 waiting for medical treatment. That number doesn't include the number of people who have come to the US for treatment(though in many cases that treatment is also paid by the Canadian government) or those who have just decided to go with separate health insurance. It's still significantly lower than our 15%

You're forgetting the key thing: the current proposal is not a universal system. There always still be private insurance firms. You have the freedom to choose who you want to pay your bills; knock yourself out.

[Tommycat]

Why? As long as it's crafted to forgo any bureaucratic errors, then what would be the problem with it? You say you don't want to really pay taxes for other citizens' healthcare; well, you probably already pay taxes for thousands of unknown childrens' educations, so I can't see how this would be any different.

 

That's just it. We have no way of knowing if it will be. Or if it won't morph into some insanely bureaucratic monster in the future. Keep in mind that even if you trust the current administration and congress to do it right, who's to say what nonsense the next admin will add. or the one after that...

 

And it's not about paying taxes for other people's healthcare. It's about the same kind of situation as with Welfare. If it ends up that I can be denied because I had healthcare in the past month, or that I made too much money the previous year, or that I don't fit some narrow scope that gets more and more narrow each year, that is what I worry about.

 

Though from what I can gather, the new proposal is essentially Gubmint Health Insurance which you can choose between that and a private insurance company. Strange as it really does nothing for the unemployed.... a currently growing demographic.

[Jae Onasi]

Well, you're already paying for those without insurance through your state taxes. When someone develops a catastrophic illness and are uninsured, the expenses end up eating through whatever assets they do have (maybe a small house) and forcing them into bankruptcy and then onto Medicaid. Your state taxes pay for their resultant welfare, food stamps, and so on. You pay for the uninsured who don't pay through higher medical costs that are charged to offset that.

 

The main reason I brought up the public school example was to show that yes, we do indeed pay for certain programs that aren't limited to just what's in the constitution, and in fact we view this as necessary to society. I view health care coverage the same way--necessary to society. Any of us could be struck down with an illness or injury at any time that disables us and makes us unable to work. That issue is bad enough. Having to deal with a loss of a home on top of that to try to pay for medical care creates a horrendous burden not only for the individual but also for the rest of us who pay taxes to indirectly cover those costs.