What percentage of Americans are without healthcare?
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What percentage of Americans are without healthcare?
Most places say 40-50 million Americans have no health care. But the actual truth is, every American has no health care. We do not have a health care system in the US. What we have is a Symptoms and Disease Care System. There is absolutely no system of helping people become healthy.
The 40-50 million is the figure most often thrown out there, but it includes people who are waiting for insurance to kick in as well as those who choose not to have it. That might sound nutty to some people, but I know several people who don't have health insurace because they don't want it, not because they can't afford it.
Here is the answer to my question.
The percentage of Americans without healthare in the USA is 0%.
Nada.
Zilch.
NOT ONE.
The 40-50 million number that people always refer to is the number of people without HEALTH INSURANCE.
The number of people without actual healthcare is ZERO. By law, hospitals MUST take any emergency patient who needs care, regardless of ability to pay. This includes citizens and non-citizens, rich or poor, balck or white. There is nobody who does not qualify for emergency healthcare in the USA.
Now... are there people without health insurance? Absolutely. But that is a completely different prospect from not having health care.
Furthemore, the 40-50 million figure most often quoted is correct, but doesn't tell the whole story.
Approximately 12 million of those are not legal residents of this country... and they still get quality health care in hospitals all around the country, much bette care than in their countries of origin.
Others are young men and women between the ages of 18-29 who have no health care issues, and have CHOSEN not to pay for health care they don't think they need right now. That is a personal choice, and should not be included in the statistics of people who are "stuck" without health insurance.
There are also a number of people who are able to afford out-of-pocket healthcare, and therefore choose not to buy health insurance. These too should be excluded from the number of people "stuck" without health insurance, but for some reason are not excluded.
And finally, the majority of the remainder have been off healthcare for less than 12 months, and can expect to get back on healthcare as soon as they get their next job.
So in actuallity, we are talking about a very small number of Americans who are "permanently" without health insurance and NONE who are without health care.
Nicespringirl brought up a very good point. She said that in the U.S.A. NOBODY has health care because everyone has "symptom care" and "disease care". Everyone goes to the doctor when they are sick, and nobody uses preventive care to keep from getting sick in the first place. And I agree with that point, at least in concept. This is a question of quality of care.
But I would argue that the quality of care in the USA is much better than that of other countries, especially those with "universal health care", where rationing of healthcare is the norm. In those countries, it truly is symptom and disease care rather than health care. Barring the ability to go outside the universal healthare system, the universal healthcare systems are set up to treat symptoms long enough for the patient to wait on the next health care line and get the next treatment. A cure for the disease in question isn't even taken into consideration.
In the USA, quality of care is higher, access to care is better, and innovation is the norm. Methods of treating disease and get at the root cause of disease are being developed daily. For instance, we are thisclose to finding cures for numeous cancers. No other country is as advanced in cancer research as we are. And the same is true of othe diseases as well.
That said, if you agree that our system is set up for symptom control rather than health care (that is, we only get healthcare when something is bothering us rather than preventive medicine to prevent it from becoming a problem in the first place), imagine how bad it would be if we went to a system of government-controlled universal health care, where lines get long, quality of care becomes poor, access to care is limited, and innovation is rare. How much health care do you think we would get under that system?
Elliot
ETW-
Good post. Eventually someone picks up the financial slack. I suggest in the end it comes out of yours and my pockets. Then by comparison, for sake of discussion, is it that much different of a financial burden from socialized healthcare (or universal)?
Bobby
Hello Elliot:Quote:
Originally Posted by ETWolverine
Very good right wing spin. It's true, if you are the working poor and happen to have lung cancer and no insurance – if YOU go to an emergency room, they'll give you an aspirin and send you home. You will NOT get treatment for your disease, and you will die.
Healthcare, REAL healthcare, is a lot more than emergency room healthcare.
excon
PS> Of course, if you aren’t a member of that class, we have the best health care money can buy.
Excellent points for the discussion. I agree. My wife is pregnant and the doctors know that I have insurance. They use it to maximize every visit as a potential money maker even more so now-in-days. The doctor's clinic, because it is a business, reminds me very much of how car salesmen treat a person when they first come onto the lot.Quote:
Originally Posted by excon
Bobby
And I guess if I start introducing other foreign health care policies to americans, I will be attacked again? :D
Quote:
Originally Posted by excon
I see you can recognize the obvious. :DQuote:
Hello Elliot:
Very good right wing spin
Not necessarily…but you will be questioned and you may win some of us over.Quote:
Originally Posted by nicespringgirl
:)
Excon,
As an EMT who has spent quite a bit of time taking poor people to hospitals, I can tell you definitively that your statement is incorrect. Even poor people who go to a hospital for cancer get ongoing cancer care, including chemo/radio therapy, surgery, etc. Your statement is just false. I don't believe that you are trying to put forth a false statement, I just think you don't have your facts in order.
Bobby, you asked a great question. If the cost is coming out of our pockets anyway, what is the difference whether we are talking about universal/socialized healthcare or a privatized system?
The difference is in several areas.
1) Cost. The cost of socialized healthcare is ALWAYS higher than private healthcare. Even though you and I are covering the cost of millions of people without health insurance, it still costs less than if you and I were covering EVERYONE'S healthcare.
2) Quality of care. We are talking about a government-run program here. This is the same government that can't keep the roads paves, the bridges from collapsing, or the names of illegal aliens that they actually have caught straight. What do you think will be the effect of government run health care will be on the quality of care. If you really want to know, just look at cancer mortality rates in countries with universal healthcare vs. our mortality rates. In the USA, the mortality rate of prostate cancer patients is about 25%. In the Canada, it is over 40% and in the UK, it's a whopping 57%.
3) Accessibility. Currently, even if we have to wait a "long time" for health care, we can generally see the doctor of our choice within a few days or at the worst, a couple of weeks. In Canada, the minimum wait for a procedure is several months. I once had a hair transplant, a voluntary procedure... I made the appointment and saw the doctor within a week. My Canadian friend can't get a hair transplant in Canada. When I was sick with a stomach virus, I saw the doctor the same day. My friend fom Canada waited two weeks.
4) Compensation. The almighty buck talks, bull$h!t walks, as they say. A government system in which the government is the sole arbiter of what doctors will receive as compensation (usually UNDERCOMPENSATION) is not conducive to good practitioners becoming doctors. In the USA, if a doctor doesn't like the compensation being paid by a particular insurance company, he can choose not to accept that insurance anymore. In a government-run system like Canada's, individuals are not allowed to pay doctors, only the government is, and only the government determines the payment structure. So instead of a guy working his a$$ off for 10 years or more to become a doctor (4 years of med school, 2 internship, 3 residency, and multiple years in a fellowship studying a specialty) and incurring debt that he won't be able to cover because of the poor compensation levels paid to him by the government, he'll instead become a lawyer... like we need more of those.
5) Efficiency. The government is a bureaucracy... which is to say that it is wastefull. The government doesn't care if their program is wasting money, because they can always raise taxes (or so they think) to cover the waste. But a private company's sole interest is in the bottom line. They eschew waste in order to maximize profits. They are efficient, and thus lower-cost. Which brings us back to #1. They also manage their coverage to cover as many people as possible, because they want as many customers as possible in order to maximize profits. Thus they are efficient in covering everyone they can. The government doesn't care whether you really get coverage or not... you're just a cog in the system and you really don't have a choice to go elsewhere, so why would they care whether you really get the efficient coverage you need or not.
There are other areas where the systems differ hugely. But this is enough to think about for now.
Great question, Bobby, thanks for asking.
Elliot
And:Quote:
ETWolverine agrees: Sorry, but this answer is incorrect. I know that it is the answer most often given, but it is incorrect.
My post didn't say "health care" it said "health insurance". I mean, thanks for the greenie and all, but I made no mention of "care". :)Quote:
The 40-50 million number that people always refer to is the number of people without HEALTH INSURANCE.
Good points in your post, by the way.
Quote:
Originally Posted by ETWolverine
Elliot, I think Excon has made a valid point, although your correct in that it doesn't apply to all cases. Certainly there are hospitals (my father was president of a hospital board) that make good and don't discriminate based on an financial situation or ability to pay. But none-the-less it is a business.
Quote:
Originally Posted by ETWolverine
I think the raw numbers would confirm, but since we don't actually use a socialized system it's difficult to have anything concrete. I suppose we could use Canada by comparison by scaling up from their population to get an idea. Then again we might improve on that system, by tweaking it. As you have noted it's numbers two and three that are exactly the reasons I'm skeptical of a universal healthcare system.
Bobby
I'm not sure if I can be very helpful here, because I don't know about the details or facts surrounding our healthcare system. I will research the facts though and get back to you.
But I can give my two cents in the form of theory: in order for a nation to improve itself, in, for example, the area of healthcare, it should compare its system to ones that are “better” , and not compare it to ones that are worse.
Elliot, it's interesting that you have mentioned that “By law, hospitals MUST take any emergency patient who needs care, regardless of ability to pay. This includes citizens and non-citizens, rich or poor, black or white. There is nobody who does not qualify for emergency healthcare in the USA”.
I wonder then, what the commotion is about in regards to the American healthcare system? excon (his comment) seems to have filled in a missing gap that answers this question.
This is not to question whether, as Elliot has shown us, that there is a law that requires any emergency patient who needs care, regardless of ability to pay, to be taken in. But I am questioning how this is all following through.
And I am questioning what the hell is going on if this “law” is actually following through properly as Elliot has 'implied'. Have we been wasting time discussing this all these years if the system has been actually helping almost every American (as Elliot implies)? This only implies that there are fifty million idiots here.
Thanks to both of you (excon and Elliot) for the information you've provided.
No but the OP does and that makes you off topic.:cool:Quote:
Originally Posted by jillianleab
Quote:
Originally Posted by nicespringgirl
Nobody should ever attack you for sharing your views. You are a very pleasant person to have conversation with and I always like hearing from you. You often provide a very good international perspective.
Bobby:)
And OP went on to mention both care and insurance, and in fact, point out the exact thing I referenced. Which puts me on topic. :pQuote:
Originally Posted by Dark_crow
This is getting silly.
OK :oQuote:
Originally Posted by jillianleab
Hello again, El:Quote:
Originally Posted by ETWolverine
Frankly, it's you who don't have your facts straight.
I don't disagree with you when you talk about the poor. They're not who I'm talking about. The poor are covered by Medicaid - a damn good plan, I might add. Nope, it's the WORKING poor, who are the subject of my post, and they don't have ANY plan.
IF they happen to have a savings account, or a house, or make more than it takes to support your dog, they aren't eligible for Medicaid. They have to divest themselves of ALL their property and become paupers in order to qualify for the healthcare YOU'RE talking about.
The working poor are estimated to be 40 to 50 million people. I'm one of them. I make a GOOD living and I HAVE assets, yet health insurance for me would cost more than my rent, and I live in a nice house in an expensive city. Fortunately, I'm healthy.
I maintain that if I come down with cancer, I'll have to go broke in order to be taken care of. Frankly, I'd rather leave an estate. Hell of a choice your wonderful system requires of me.
excon
excon, I work for a company that hires the "working poor." They are mostly college students in their early twenties. Anyone working more than 30 hours a week and is here more than 6 months is eligible for the insurance. The company pays 60 %. For young single people, it is cheap.
95% of them don't take advantage of the option (nor the retirement plan.) Their excuse is that they can't afford it. More than half of the group smokes. Most of them have either cable or Direct TV or internet service. Almost every one of them eats lunch out every day. They can afford all that, but not $10 a week to protect their health.
Also, many people with insurance plans have run into instances where congenital defects are considered "pre-existing" and therefore not covered.
It really comes down to your priorities. If my child needed surgery, but I didn't have the insurance, I would work 3 jobs, mortgage my house and beg from family and friends to see to it that he got the proper medical care.
Are you saying that if you went to the hospital today with, say, a stomach virus, you wouldn't e able to see a doctor because you are "working poor"? That you wouldn't be examined by a skilled professional? That he wouldn't proscribe something for you? That he wouldn't give you at least a few days' worth of samples of the drug if you asked? That, if you needed to be admitted you wouldn't get the care you needed? Is that what you are intimating? Because if it is, then I say you are wrong.Quote:
Originally Posted by excon
Please be correct in your words, excon. Not being able to afford health insurance is different from not being able to get health care when you need it. And if you are saying that there are 50-million people in the USA who have no access to health care when they need it, I say prove it.
You keep talking about Medicare vs. affordible health insurance, but that is different from health CARE. Health Insurance is talking about finance. Health care is about medical care.
Just so you know, I happen to be in agreement with you regarding the affordability of health INSURANCE. The cost is way too high. But that is not the same thing as health care. Affordability of health insurance and accessibility to health care are two different animals.
Elliot
I find it amazing that people so often base their conclusions on personal experience. Never mind the seniors, and people with disabilities who apparently your employer does not employ.Quote:
Originally Posted by Emland
While it isn't always this simple in all cases, sometimes it should be. Emland, id kiss you for this quote if your hubby and my wife didn't mind, and then there's the dirty moniter screen...Quote:
Originally Posted by Emland
I have seen a relatives kids go without health insurance, largely in part, because of dumb financial decisions. They were happy to take on a mortgage twice as big as the needed cause it was a dream house... they were able somehow to get that 3000 pool table... etc... but their kids didn't have coverage. Drove me MAD. I had to loan them money on a couple of occasions because they needed care and the cost of the visit was too high... going to pop a vein just thinking about it.
I've lived in a poorer area growing up... I know some people who have had some terrible things happen, and I do not, under any circumstances, take lightly the financial ruin that can come from unexpected things that happen in life. Sometimes just a few setbacks can really make things get ugly... but... there's also a point where you'd better be doing all you can do, or you are just wasting air...
Hello Em:Quote:
Originally Posted by Emland
I don't disagree with your analysis and I'm not complaining. I have a feeling, however, that you don't quite understand the numbers I'm talking about. Yes, it is priorities. And, I choose to eat instead of buy insurance. It would cost me more than $1,500 per month for health insurance, and I'm healthy. Those big numbers are due to my age. I'll be eligible for medicare in 10 months. NO, I am not going to spend $15,000 for 10 months, even if I could afford it.
The only part of your post that I might disagree with is your definition of the working poor. I think you need to expand your universe. There MILLIONS of people like me.
All this goes to belie the original post of the Wolverine who would have you believe that things are all hunky dory in the healthcare world.
excon
I think Emland is falttered.:DQuote:
emland, id kiss you for this quote if your hubby and my wife didn't mind, and then there's the dirty moniter screen...
excon, perhaps I'm missing something because I don't know you personally, but if you are a member of the "working poor" doesn't that imply you work? Doesn't your employer offer coverage? Even if you are self-employed you can get coverage (pre-existing conditions and all).
Seriously, I'm not trying to be a jerk, I just don't follow.
As far as I know,The United States is the only industrialized democracy that allows its citizens to go entirely without health care for lack of funds or to be bankrupted by medical bills.
It seems that you can't really find a perfect way by looking into within the U.S. U can try to look at how other nations have managed to create solutions, what obstacles they faced in doing so, and how they handle all the needs. In other words, your difficulties may not be as unique as you think, but you don't know without learning about other nations' experience.
Sounds like I am off topic, but think about it americans.
Take a look at Sweden, Australia,China, and Japan's health care systems please...
After working over 20 years in management and HR, I truly believe most of the working poor are the working poor because they make poor choices.
Yes, there are those that fall though the cracks. We're talking about the US, not Utopia. My mom was left high and dry when my dad walked out on her at 57 years old. She had to work for the first time in her life outside the home. She got a crappy job that paid diddly, but offered health benefits.
I do believe reform is needed in our health industry. Perhaps some protection for the doctor's from litigation, so they don't have to order every test under the sun to protect themselves.
And, I am not against public health care in the US as long as they don't make it illegal to have private insurance like they do in Canada.
Hello again jillian:Quote:
Originally Posted by jillianleab
I responded too quickly. Yes, I can get coverage - very expensive coverage (see above). The insurers I spoke to are more than happy to take my money.
Again, the rhetoric of the right doesn't make a lot of sense when presented with real life numbers.
excon
PS> I also suspect that NONE of you are self employed.
This discussion has been on the board before about people that say that health insurance is too expensive. If your health insurance is more than your rent you are looking in the wrong place for it even if you were told you were uninsurable before. Part of the problem facing america today about health insurance is that the media tells them that they can't afford it. At one point in time I had health insurance for my wife and I for less than $50 a month. Did the insurance suck, by some standards yes I was responsible for the first $5,000 per person in medical costs and after I spent that in a year my insurance would pay the rest but I was insured and most of my assests protected. Based on what you have said you can afford health insurance you just don't want to and that should be my problem because?Quote:
Originally Posted by excon
America shouldn't be about the government taking money out of my pocket because you don't want to change jobs or live in a not quite so a nice a house.
You have a very obtuse idea of health coverage….you pay the first 5 grand each year per person and then your insurance kicks in. Hell, that is pure robbery by the insurance company and you’re foolish enough to gamble that you will ever receive a dollars worth of coverage.Quote:
Originally Posted by michealb
I saw your post about how much it would cost for you to get coverage, and it sounds outrageous. I guess I'm trying to figure out WHY it's so high for you. There are loopholes in the system, there's lousy coverage (which is better than nothing), so I guess that's what I have trouble understanding.Quote:
Originally Posted by excon
I'm not self employed but I've mostly worked for small businesses, and many of my family members work for small businesses. They've (the employer) decided to join with other small business owners to form a group plan for themselves and their employees in order to get reduced rates. Now maybe that's not an option for you for some reason, but maybe it is.
Of course I could also tell you if you can't afford health coverage you just aren't working hard enough, but that would be a mean and nasty thing to say! :D Kidding, of course!
Health Insurance was originally designed to prevent you from losing your assets. It kicked in to cover major medical issues after a deductible was met.
Now it pays if you have a pimple on your buttocks. HMOs really need to be repaired. In some cases they practice medicine without a license (IMO) and I think are the reason our health care costs have gone up so high (also MO).
I've wandered away from the original question haven't I?
I agree 110%. This is the inherent that most people cannot see or are willing to acknowledge!Quote:
Originally Posted by excon
I didn't receive a dollars worth of coverage, I didn't expect too which is why I got such bad insurance. I did it cause it did what it needed to do at the time protect my assests and keep me from having to use a hand out. If the worst had happened the majority of my assests were covered. I felt with my current assests and future assests it was worth the gamble. You might have made a different choice and could have lost everything or you could have lost nothing, I choose to definitely loose 150 dollars over 3 months and maybe loose 5 grand. I felt I made the right decision.Quote:
Originally Posted by Dark_crow
So find another job, excon, where you can afford the health insurance. Or don't bother. THat's your choice. That's the beauty of the system we live in. You have choices. Under a government-controlled system, you wouldn't.
But no matte what your choice is, why should I have to pay for you choice? If you don't want or can't afford to pay for health insurance, and don't want or can't afford to pay out of pocket for health care, and you choose not to get a better job where health coverage costs less, why is that MY problem. Or for that matter, why is it the government's problem.
Not a very good libertarian position, excon, to say that government should be fixing your health insurance problems or that everyone else has to pay to cover your health care costs. I'm beginning to think you aren't a libertarian at all, just a garden variety liberal. The only libertarian positions you seem take are with regard to legalization of drugs and gun control. The rest of your positions are straight out of the liberal playbook. If you were a real libertarian, you would find the idea of other people or the government paying for your costs to be an anthema to you. Liberals are the ones who believe in wealth distribution and big government.
Elliot
No one disputes the diagnosis: American health care is in lousy shape. As a practicing physician for more than 30 years, I find the pervasiveness of managed care very troubling.
The problems with our health care system are not the result of too little government intervention, but rather too much. Contrary to the claims of many advocates of increased government regulation of health care, rising costs and red tape do not represent market failure. Rather, they represent the failure of government policies that have destroyed the health care market.
It's time to rethink the whole system of HMOs and managed care. This entire unnecessary level of corporatism rakes off profits and worsens the quality of care. But HMOs did not arise in the free market; they are creatures of government interference in health care dating to the 1970s. These non-market institutions have gained control over medical care through collusion between organized medicine, politicians, and drug companies, in an effort to move America toward “free” universal health care.
One big problem arises from the 1974 ERISA law, which grants tax benefits to employers for providing health care, while not allowing similar incentives for individuals. This results in the illogical coupling between employment and health insurance. As such, government removed the market incentive for health insurance companies to cater to the actual health-care consumer. As a greater amount of government and corporate money has been used to pay medical bills, costs have risen artificially out of the range of most individuals.
Only true competition assures that the consumer gets the best deal at the best price possible by putting pressure on the providers. Patients are better served by having options and choices, not new federal bureaucracies and limitations on legal remedies. Such choices and options will arrive only when we unravel the HMO web rooted in old laws, and change the tax code to allow individual Americans to fully deduct all healthcare costs from their taxes, as employers can.
As government bureaucracy continues to give preferences and protections to HMOs and trial lawyers, it will be the patients who lose, despite the glowing rhetoric from the special interests in Washington. Patients will pay ever rising prices and receive declining care while doctors continue to leave the profession in droves.
September 26, 2006
Dr. Ron Paul is a Republican member of Congress from Texas.
Hello again, El:Quote:
Originally Posted by ETWolverine
I understand right wingers have trouble following along, so let me help.
YOU said everybody in this country is doing fine in terms of health care. I said they weren't, and used MYSELF as an example.
Nowhere did I complain about it, and nowhere did I say that YOU should pay for my coverage. This rant is for you too, michealb.
excon
Quote:
Originally Posted by excon
Wouldn't you agree with Tom's Ron Paul Letter.
The reason why healthcare / insurance is so costly is due to gov't /regulatory interference.
I've been self employed. Had catastrophic coverage, $3000 per year deductible, $500 per month for family of 5. - Not cheap - but a plan. Also GW's pushing for HSAs helped sock away the 3000 pre tax.
Why is healthcare / insurance so expensive.
- insurance co / hmo - have to stay solvent to offer a product. Of course as middleman they add to the price.
- this entitlement attitude that healthcare should be free
- ? Does auto insurance purchase one's car
- ? Does home insurance purchase one's home
- ? Does insurance pay for college?
Then why does a third party have to pay for one's healthcare?
- there is no "free market" in healthcare. Medicare sets the rate, Doctor's cannot, legally, accept less than medicare rates from someone who pays directly out of pocket - that is considered fraud. Insurance companies then follow suit with their payment schedules.
For example my wife had an echocardiogram
No insurance cost $1200
Insurance reimbursement [ what they willl pay ] around $900
Medicare reimbursement $ 800
Medicaid reimbursement $ 300
These are approximate numbers from several years ago - I know because I'm on the inside.
Outrageous... right?
- reimbursement determines acess. Do you think a hospital/ doctor is going to want to see an insured or a medicaid patient - look at the numbers above.
If reimbursement is below the cost of business they won't accept or they will limit the amount of medicaid. So in effect the Medicaid program, because of their generally lower reimbursement rates, limits healthcare acess. Call around and see if your local orthopedic or ent doctor accepts medicaid.
The cost of business:
- malpractice
- rent
- staffing and benefits
- supplies
- school loans etc...
- education - funny how there isn't a huge out cry for "free college" because it is a 'right'
In fact college tuition has risen as fast if not faster than the rise in healthcare.
4 years college
4 years medical school
At least 3 years residency
Life begins at 28-30 at the youngest, usually with mortgage size school loan payments.
These are just some factors in why health insurance is unaffordable.
Will a true free market work - no set rates, basic professional standards and certification.
I believe yes.
One example
Walmart $4 per medication per 30 day supply for generic drugs [ the ones that have been on the market for > 7-10 years if not more and proven track records ]. Othe pharmacies in my area have similar programs too compete with this.
Compare this with the red tape and cost of Medicare part D, or a higher price per month for the same generics through the VA system if the medication is not service related or if one is above an income level.
As you espouse - more government is not the answer.
Grace and Peace
Quote:
Originally Posted by nicespringgirl
I agree, but with one disclaimer.
Preventative healthcare is a personal responsibility, not your doctor's or the insurance company's or the government's.
There is internet acess to preventative healthcare information
American Cancer Society
Health Care: U.S. Preventive Services Task Force (USPSTF) Subdirectory Page
For example
It is personal resposibilty to eat healthy, keep up with screening tests, not smoke, wear seatbelts, lose weight if your overweight etc...
Grace and Peace
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