To those who oppose mandatory health coverage

[woot]

You haven't yet made an argument other than...I don't agree with you and, the ever popular, you suck and are immoral.

Now you're just lying. Please explain how it is moral to expect other people to pay entirely for your care in the event of a major accident/illness.

[KillerDog]

How do you not see that emergency heathcare treatment is analogous to the military? Both provide an 'umbrella' of protection. One protects from enemies, the other protects you from dying in the street or your home.

By opting-out of basic healthcare coverage, you are placing the burden of maintaining this emergency coverage on those who pay for healthcare. The cost to keep Emergency Rooms open and staffed has to be paid in advance, BEFORE service is needed.

You are a Free Rider if you don't have healthcare.

Military spending provides coverage that protects all people behind its lines. It generally protects against invasion and being part of the 50% of our population that doesn't pay federal income tax still is protected by it.

Union membership provides wage and break protection for all people within a class of workers. Actual membership is not a prerequisite to get the benefit.

Emergency care provides a service to the individual. Each individual who uses the services is asked to pay. Those who have insurance pay for those who do not. Everyone who USES the services benefits from the service. Everyone who doesn't pay but uses the service is a free-rider. What you are saying is that a non-user is a free rider. That is analogous to saying a person in another country is a free rider on our military or an electrician is a free rider on the plumber's union.

The fact that they will give me free service if I can't pay for it does not make me a free rider unless I use the free service. The difference in the cases mentioned is the nature of the service. In the military and union examples, there is no way to protect the borders or negotiate in a collective bargaining environment without benefiting everyone behind the border or in the shop. In the ER example, the system is based on services to the individual as needed and therefore does not create a free-rider problem in the classic sense. Even stretching it, you only have free-riders if they use the system.

[KillerDog]

Now you're just lying. Please explain how it is moral to expect other people to pay entirely for your care in the event of a major accident/illness.

Spectacular. Please explain how it is moral for you to beat your wife.

[woot]

Spectacular. Please explain how it is moral for you to beat your wife.

So... you actually do plan to pay for your own care if you have a major accident/illness? How exactly will you go about doing that? How will all the others like you do the same? Feel free to go ahead and state your position instead of making childish retorts.

[KillerDog]

So... you actually do plan to pay for your own care if you have a major accident/illness? How exactly will you go about doing that? How will all the others like you do the same? Feel free to go ahead and state your position instead of making childish retorts.

I've already stated it in my original story. I paid for medical care over time and was charged interest for it. That was how I paid for my medical care and how I intended to pay for any of it that was required.

Of course, now that I am older, I make different allocation decisions with my money.

BTW, it wasn't a retort, I was demonstrating to you the invalid argument form you were using.

[woot]

I've already stated it in my original story. I paid for medical care over time and was charged interest for it. That was how I paid for my medical care and how I intended to pay for any of it that was required.

Of course, now that I am older, I make different allocation decisions with my money.

BTW, it wasn't a retort, I was demonstrating to you the invalid argument form you were using.

Really? You're going to just go into 500k debt and pay it off over time with interest? That's your solution? You also think that everyone else that doesn't have health insurance will do that too? The reality is that unless you are wealthy, and probably even if you are, you won't do that and you know it. Neither will 99% of those who don't have insurance. You have offered no credible reasoning whatsoever for your position.

[KillerDog]

Really? You're going to just go into 500k debt and pay it off over time with interest? That's your solution? You also think that everyone else that doesn't have health insurance will do that too? The reality is that unless you are wealthy, and probably even if you are, you won't do that and you know it. Neither will 99% of those who don't have insurance. You have offered no credible reasoning whatsoever for your position.

You know what woot? Fuck you too. Seriously, that's what your argument amounts to. For a second there I thought you were actually making arguments but now I see that you weren't. For some reason, you can't believe that there is a difference between taking a risk and gaming the system. You have no problem believing that a person will pay back a home purchase of $500k with interest but you don't believe that someone will pay for their life the same way. Ultimately, you keep reverting to arguments that are premised on your belief that I'm a liar, your belief that I'm a thief, and your belief that there must be something fundamentally wrong with someone allocating their own income...so I say FUCK YOU!

[woot]

You know what woot? Fuck you too. Seriously, that's what your argument amounts to. For a second there I thought you were actually making arguments but now I see that you weren't. For some reason, you can't believe that there is a difference between taking a risk and gaming the system. You have no problem believing that a person will pay back a home purchase of $500k with interest but you don't believe that someone will pay for their life the same way. Ultimately, you keep reverting to arguments that are premised on your belief that I'm a liar, your belief that I'm a thief, and your belief that there must be something fundamentally wrong with someone allocating their own income...so I say FUCK YOU!

Um. You might have some anger issues in addition to your reading comprehension problems. Good luck with those.

[SloanHater]

Military spending provides coverage that protects all people behind its lines. It generally protects against invasion and being part of the 50% of our population that doesn't pay federal income tax still is protected by it.

Union membership provides wage and break protection for all people within a class of workers. Actual membership is not a prerequisite to get the benefit.

Emergency care provides a service to the individual. Each individual who uses the services is asked to pay. Those who have insurance pay for those who do not. Everyone who USES the services benefits from the service. Everyone who doesn't pay but uses the service is a free-rider. What you are saying is that a non-user is a free rider. That is analogous to saying a person in another country is a free rider on our military or an electrician is a free rider on the plumber's union.

The fact that they will give me free service if I can't pay for it does not make me a free rider unless I use the free service. The difference in the cases mentioned is the nature of the service. In the military and union examples, there is no way to protect the borders or negotiate in a collective bargaining environment without benefiting everyone behind the border or in the shop. In the ER example, the system is based on services to the individual as needed and therefore does not create a free-rider problem in the classic sense. Even stretching it, you only have free-riders if they use the system.

You are combining and confusing services. The military exists in the time of peace and there is an additional cost to fight a war. The same is true of emergency medical services. There is a access/maintenance cost and a SEPARATE service cost.

How do Emergency Rooms afford to stay open? Insurance premiums and user fees. If you never visit the ER and don't pay an insurance premium, you are receiving free emergency medical coverage. Thus you are a free rider.

The only way to eliminate free riders is fund healthcare with taxes or mandate coverage.

[statman]

[QUOTE=KillerDog;176470]Military spending provides coverage that protects all people behind its lines. QUOTE]

that's just it, our medical system does too. Get in a car accident, go into a coma for a couple weeks, and rack-up $500K in medical bills? Our system covers you, whether you pay into it or not. And let's not pretend you're prepared to cover $500K in medical bills. Lets leave fantasies to <other> websites...

[statman]

What you are saying is that a non-user is a free rider.

No - what he's saying is that there's no such thing as a 'non-user.'

If you live in the US, in a life-or-death situation, you have access to most our medical system, regardless of your ability to pay. That safety net is there for EVERYONE. There are no 'non-users.' Those who aren't contributing to the upkeep of the system are freeloading.

And it's more than that.

Cash payers also are generally given lower prices than the insurance companies. Cash payers are typically just required to pay for the Direct Costs of their care. Insurance companies get stuck with DCs plus add-ons for allocated overhead costs - someone has to pay foroverhead, and since the system is based in insurance carriers paying the bulk of the costs, it's generally they who end up carrying the water for everyone else...

[KillerDog]

No - what he's saying is that there's no such thing as a 'non-user.'

If you live in the US, in a life-or-death situation, you have access to most our medical system, regardless of your ability to pay. That safety net is there for EVERYONE. There are no 'non-users.' Those who aren't contributing to the upkeep of the system are freeloading.

And it's more than that.

Cash payers also are generally given lower prices than the insurance companies. Cash payers are typically just required to pay for the Direct Costs of their care. Insurance companies get stuck with DCs plus add-ons for allocated overhead costs - someone has to pay foroverhead, and since the system is based in insurance carriers paying the bulk of the costs, it's generally they who end up carrying the water for everyone else...

I see how you can think that they are the same. I understand what the argument is, I just don't agree. I think the two are inapposite.

[Uncle Ted]

The doctors on this board are going to love this... They saved the best for last.

[CardiacCoug]

I agree with the importance of price transparency and cutting administrative costs, but the rest of that chart doesn't make much sense. Payments to physicians are such a small part of the overall health care crisis. Physicians in the US generally spend more years in training and work longer hours than physicians in other countries (not to mention the $150K+ in debt often incurred) so that may justify the fact that they make more money..

When my son was hospitalized and there were $80K of charges, I think maybe $1500 was payments to physicians. My patients have similar ratios for their inpatient care. And you factor in things like prescription drugs and long-term and rehabilitation care and the physician piece of the pie gets even more insignificant.

And some of the stuff in that chart is just stupid. Like the line "In the UK, 60% of hernias are treated as inpatient, in the US that number is just 11%."

Uhhh... Outpatient treatment is cheaper than inpatient treatment (even if the profit margin is higher). Are they arguing that the US should keep patients in the hospital unnecessarily for more days so we can be more like the UK? That's something the US is doing right.

[wuapinmon]

I agree with the importance of price transparency and cutting administrative costs, but the rest of that chart doesn't make much sense. Payments to physicians are such a small part of the overall health care crisis. Physicians in the US generally spend more years in training and work longer hours than physicians in other countries (not to mention the $150K+ in debt often incurred) so that may justify the fact that they make more money..

When my son was hospitalized and there were $80K of charges, I think maybe $1500 was payments to physicians. My patients have similar ratios for their inpatient care. And you factor in things like prescription drugs and long-term and rehabilitation care and the physician piece of the pie gets even more insignificant.

And some of the stuff in that chart is just stupid. Like the line "In the UK, 60% of hernias are treated as inpatient, in the US that number is just 11%."

Uhhh... Outpatient treatment is cheaper than inpatient treatment (even if the profit margin is higher). Are they arguing that the US should keep patients in the hospital unnecessarily for more days so we can be more like the UK? That's something the US is doing right.

I think a program where all MDs and DOs get free med school tuition, in exchange for working for a modest salary for a few years (the military model) could do a lot of good, and probably save everyone some money.