At this point 35% of my income would be a deal.

I didn't say that this was the big one. Just that it seems that they are finally starting to get the message that they are in a cycle that can't last forever. It may go up another $25 a barrel before they start to truly believe it, but just that they recognize that they are headed for a bubble is a good start.





Julie,

I'm not Canadian, but I remember reading about the emerging "secondary" healthcare system in Canada. Those who can afford to pay, do. Otherwise, you wait extended periods of time to get to a Dr. So, if you don't want to waith 6 months to find out why your toe hurts, you pay a private Dr. to see you (if you can afford it). This isn't the norm, but it was starting to show up in Canada in the last few years. Eugenio can clarify if it's still going on and to what extend as well as how long wait times are for care. I can only share what I've read, but it could have been "spun" by an "anti-national healthcare" news agency for US consumption. Sadly the self employed take a beating in this country. If you don't run a business with 1,000 employees (thus making money and having enough clout to get some kind of healthcare setup through the business for the employees), you're pretty well stuck. And that's a pretty bad situation to be in.

Maybe Eugenio can correct me if I'm wrong (and as usual, I very well could be). I don't think we want to go to a national healthcare system. And, the lucrative jobs in medicine will likely get less lucrative. That will likely reduce the quality and quantity of those who are going into healthcare. Less available and less skilled Dr's could be a result. I think it will upset the apple cart in this country, but I won't claim to be smart enough to predict the extent of the fallout.

I think Julie (and others here who are self-employed) are going to bear the brunt of this, if they can afford it. Personnel is typically the number one overhead item in any company, and small companies typically get caught (and go under) in "raise the tax" mantra.

Howdy,



Last I checked, universal health care won't replace air travel. If you've got money, you can still go get whatever (overpriced) care you want.



I work at a healthcare company. I think something needs to be done to provide healthcare for everyone as well.

"Too expensive" is a cop out. Figure out a way.

You think its really surprising that everyone you know in the healthcare industry doesn't want to change anything? Really? Gee, I wonder why that might be... I don't think its because they're raking in the dough (there's been enough of a crunch that that's slowing down), but there sure as heck is a ton of "fear of change" going on.

The "system" we have right now forces folks without healthcare to wait until they can't stand it anymore, then go to an emergency room. No preventive care. No scheduling of care. Instead, they rely on a system where any type of care can be provided at any moment... Even if its not needed that way, and worse even if much cheaper care a little earlier would have prevented the visit altogether. And you're right, we all pay for it.

Since we're going to pay for it either way, how about we all pay a lower price, by getting people care appropriate for their needs and in time to prevent big claims later?

Mark

Howdy,



Julie, the only people that bitch about universal health care are people in the US that either don't want to change because it'll hurt them personally or sheep who do whatever the conservatives spout off about next.

Mark

(A friend of mine in Switzerland has no issues with their universal health care... Reports that the whole system is much smoother than the US)

Agreed. I don't care who figures it out as long as someone does!

Howdy,



Self employed, retired, unemployed, work for a small company, can't afford the premium even if the health care is offered, the health care offered is a "mini-med" type product that still leaves you bankrupt if you actually get sick, etc. etc. etc.

The system is f*cked up, people.

Mark

Indeed, hubby is retired, 55 and has major depression, he does not qualify for regular plans. I am self-employed with one part time employee, at one time Costco had a business plan for me then recently changed that to having a full-time employee which I cannot afford. I'm as healthy as a horse and not near the 55 age cutoff, I'd hate to think what it would be if I was and I was also a persona-non-grata like hubby is.

Howdy,

To be fair... My level of knowledge about universal health care is probably similar to Kevin's... I.e. I've seen a few tv shows (there was one on PBS I think it was a month or two back during the democratic primary race that examined various universal health care systems in other countries) and thought some about it, but I'm far from an expert.

That said... I don't see any way our system can be anything but one of the most expensive ways possible for folks to get healthcare.

Look, I want healthcare for me & my family for all our lives. I'm not an idiot, I know there are costs involved with that, but also that those costs are going to exist (hopefully, if I make it that far) after I stop working. A system that only provides reasonable health care to folks that are currently employed by companies that can afford to provide healthcare seems completely broken to me.

Currently my parents, both retired teachers in Maine, pay _significantly_ more than I do for health care (our cost per month for healthcare for our family is on the order of $300/month, my parents is well over double that), despite our income being about three to four times their income.

These are people that "did all the right things"... They worked their entire lives. They had retirement plans. They planned for retirement. They haven't had abnormal medical histories or issues. All the right stuff. And they're still struggling to pay for healthcare costs.

Now I realize that nobody gives a shit about anyone other than themselves, but here's the issue... That's going to be you and me, and sooner than you think.

Why don't we at least _try_ to fix the problem?

Mark

Mark - you've hit the nail on the head in a few posts. First, the healthcare industry IS resistant to change. From top-to-bottom, any change is viewed with skepticism. Look at our health care records - most are still on a paper system, with little or no computer backups.

Also, the current system is geared towards caring for people having catastrophic events, rather than preventing them in the first place. However, I'm not so sure that the system is to blame here. As a community-based health system, it is in our charter that we must provide healthcare to the citizens of our county (actually, they're parishes down here). Therefore, we must take Medicaid and Medicare when a patient comes to see us at a clinic for a checkup. The problem is that, as a percentage, those with health insurance make up the vast majority of those that receieve preventative care. This is despite the fact that they make up a smaller percentage of the population.

The conclusion is that those who pay for health coverage are more apt to take advantage of preventative medicine and are more involved. Conversely, those to whom coverage is given do not appreciate it, don't worry about the costs of it, and therefore don't use it wisely.

The answer is not universal healthcare - the answer is mandatory healthcare insurance!

We know that the minority of people with health insurance pay such high premiums because they are paying some of the costs of the majority of people with Medicare, Medicaid, or nothing. But, if everyone were forced to have health insurance, then the prices for that insurance would go down. Basically, instead of you paying for your share plus some, you'd just pay for your share.

At that point, private business people, those that fall in the gaps - everyone - would be able to afford it. As for thsoe who absolutely would not be able to afford it (unemployed, disabled, etc.), the premiums would be paid by the government, which is where their monthly checks come from anyway. But, this pool of people would be vastly reduced than it is today.

Here's another scenario about univeral government healthcare. We all know that preventative care is cheaper than reactive care. So, now that the government is controlling your healthcare, they can tell you when and where to go for a checkup. Not only that, but once the doctor prescribes a drug or course of action, they can require you to do that. And, if you don't, they may inforce criminal penalties.

I'm not being melodramatic, either. Look at Japan. Every year all men and women must participate in a physical exam. If the men's waists measure more than 36 inches, they must follow a diet and exercise program. During a follow-up visit later that year, they get re-measured. If they fail again, they are fined!

I don't think that kind of system is what America is all about. If people want to eat fast-food, not exercise and die young, that's their American right. I'm not saying I won't try to encourage them not to do so. But, I don't think that forcing people, by law, to adhere to a 2000 calorie-per-day diet is what America stands for.

BTW - for Julie, Mark and whoever else. If you have to go to the hospital for some reason, and you don't have insurance, these things can help you out. First of all, review the bill meticulously - there are often errors. Secondly, talk with the billing dept about getting the rates discounted. You'll read stories about how insurance companies don't pay the same rates for services that individuals are charged. Well, that's true - they buy in bulk, so they get discounts. But, you can ask for some discounts too. All they can say is no. Thirdly, ask what kind of "forgiveness" program they have. Hosptials often provide free care as part of their tax-exempt or charity status. Ask them if you qualify for any of that. Finally, they will set you up on some payment system to pay the bill over time.

The simple fact that you are willing to work with them to pay tells them that they may expect some money from you. And, they'd rather have some than none - which is what they usually get.

Right now, the problem is that there is not enough care and what is there is too expensive. Ultimately, government run care has one of two solutions to this. Each of those solutions has a problem, based on the fact that it costs money to provide healthcare. So, let's analyse the two problems:

1) MORE HEALTHCARE - to provide more care will cost more money. More people will be covered, and more people will be getting services. The problem is that the government gets its money from taxpayers. So, taxpayers will be paying more, which is part of the same problem we have now.

2) LOWER COST - to lower costs, less care will be provided. Providing the "right" kind of care (preventative medicine) will help, but no more Viagara, Prevacid, hip replacements (it's an elective surgery) or heart transplants for 70 year olds. The problem here is that people are not going to accept being told that there is a remedy, but the government will not provide it.

As a side note, someone mentioned that things the government refuses to pay for will still be available if you pay yourself. This is true, to a degree. Currently, every single bill introduced at the Federal or State level that would have set up a universal government coverage has also made it illegal to provide parallel services in the private sector. In English, this means that it's illegal to sell health insurance. Therefore, people would have to pay out-of-pocket the entire costs of these things. Instead of pills costing a co-pay of $70, they'd be $400. This would mean that the uber-rich (not you or me!) could afford these things, while everyone from the upper-middle class downward would have to do without.

Howdy,



Ok, stop.

:-) I'm probably using some stupid political buzzword without meaning to. I don't see any difference between "universal healthcare" and "mandatory healthcare", if the government is going to pickup the tab for those that can't afford the premiums anyway. Call it a tax, call it a premium, may paycheck doesn't care.



This reminds me of something Obama said during a debate with Clinton (I support Obama, btw, despite this)... Talking about healthcare reform, he pointed out that one big difference between clinton's plan and his was that clinton's plan would require people to pay for insurance and his plan wouldn't. Which I was all for at first, until he went on to say that if someone that had opted out came to the emergency room, they could pay up their premiums and receive care... That's not insurance then, is it?

Anyway... If you and I are paying some of the freight for some fast-food eating non-exercising dying young person when they need healthcare, then I _do_ think the government has a right to say that they need to shape up.



The simple fact that the above stuff should be useful advice (and I agree it is) should tell you just how badly the system is currently broken.

Mark

Big business runs the country, it has for a long time and will for a long time. We'll never get universal health care because those that get rich off of the insane costs won't allow it.

Let me enlighten those of you that think private health insurance is the answer than that those of us who have our own businesses relating to what we enjoy (cars in my case) live a dream. My health insurance costs were... $1453 *a month* for 3 people, on a business plan. There are cheaper plans, but none that would have covered the costs involved in my Mom's troubles. We didn't get the cheapest plan, we got the best plan we could afford. That's right, I pay $17k+ a year in just health insurance costs. Since Mom passed away that's dropped to a cheap(?) $1000 a month, so only $12k a year for 3 folks who have no record of health issues, serious ones at least.

Do you know how many parts I have to sell just to cover those costs, let alone the cost of parts (going up as most are made of metal and need shipped), fuel, natural gas, electricity?

We need universal health care, we need a lot of things fixed. I'm lucky I can keep my head above water. I don't have a second job or a spouse with insurance. This business is my life (which is why I get annoyed when folks just buy whatever from whoever when I could have helped them out) and it pays my bills.

The whole system is F*cked up. Business rules, and Bush only made it worse. I'm not saying a Democrat can fix it, I don't think anyone can fix it, or will try, until it's too late. But I know how we got in this mess, and when it's all been since 2000. Somehow that'll be everyone's fault but the "Decider" who lives in the White House is is supposed to watch over this country. But nay, that's not as much fun as killing thousands of kids, wasting billions of dollars, leaving "no child behind" by making education so poor any moron can pass, the fact it costs of hundreds of dollars to fill up our cars, which need to get from A to B--like work.

Gas costs? Sure not as much as Europe, but then we also don't carry nearly the taxes on fuel they do. And last I checked they don't have to cover nearly as much ground (it's not nearly as large as the US). And while they are higher in costs there are places that are cheaper too. It's a nice thought the oil companies have that "we have it good" and they can't do anything. They make BILLIONS of dollars in profits, record profits in fact and then say they feel for those who can't barely get by. Give me a break. And oil is being helped by speculators because it's a safe investment to defend the weak-ass dollar that our supposedly "fiscially responsible" Republican President has gotten us. Yeah, right. Last I checked the the "spend it all and more" Democratic President had a surplus and balance budgets. But let's ignore that little fact because less taxes sound good to everyone. Hell I'm paying more of those too, on top of everthing else.

I am working on this one! It's my day job.



Hold on now!!! You can't be serious! The government making sure you are taking your medicine! This does not describe a free state. That is stepping way over the line and infriging on my presonal liberty, freedom.

Not Eugenio but anyway .... our system kind of works, except we all get the same mostly lousy service unless it's serious ...

Example ... I had torn cartilage in my knee. The initial schedule was 3 months to get the MRI and then another 3 for surgery. Luckily, I told the doctor I'd pay myself to get the MRI in the U.S. if necessary, which prompted him to get an appointment for me at a hospital 3 hours from home and the surgeon turned out to be a fellow autocrosser that plugged me in to a cancellation. That shortened the whole process to about 2 months. My understanding is if you have good coverage you'd get the whole deal done within a couple of days.

Essentially, costs are controlled by rationing services. We also still need private coverage for dental, optometry, drugs, etc as it's not covered by our "universal" health care.

The lobbying here is to allow "private" for profit clinics and hospitals to allow those who can afford it to jump the queue, so far with little success. Desperate rich folks go out of the country for quicker service.

Sorry - I may have muddied the waters. There's a huge difference between the government requiring that everyone HAVE insurance, and the government BEING that insurance. If the government IS that insurance, then they get to tell you what to do (because the government has the force of law). If the government is just telling you that you have to have insurance, they it's no different than the choices we have now (if I go to the doctor, I pay $10 co-pay, if I go to the ER, its more expensive).

Sam - you pay so much in health insurance because you're paying for yourself and your dependents, PLUS a few people who don't have insurance. If they had insurance, you wouldn't have to pay for them.

Let me put it into #s. I'm going to use my hospital payer mix (the mix of patients based on who pays their bills).

(IMG:http://i119.photobucket.com/albums/o145/mpatterson1410/Reimbursement.jpg)

I made it easy by assuming that, for each patient we saw it cost us $1000 to provide care. This assumes a lot of things (people with different payers are equally as healthy, they receive equal care, etc.) that aren't quite true. But, for an example, it's a valid method. Those are the actual Payer Mix and Patient counts from our facility. You'll also note that Medicare and Medicaid pay us 85% of our costs (not our charges, but what it costs us to provide care). That's like you buying shocks from Bilstein for $200 apiece and selling it to everyone here on the board for $170 apiece. If you do that, which you may do, then you're going to have to sell the corresponding springs at a much inflated price.

That's where you see the 208% figure. To make up for all the money we lose on Medicare, Medicaid, and Uninsured patients, and to make a paltry 3% profit, we have to charge insurance companies 208% of our costs. If we don't we'd lose money and close our doors. BTW, the break-even-point for us is somewhere between 191% and 192%.

So, now let's assume that everyone has insurance. Instead of us having to charge 208% to make a 3% profit, we only have to charge 103% of our costs. That is a 49.5% reduction in charges to the insurance company. So, now the insurance company paying us 50% of what they used to, so (assuming they keep the same profit margin that they are now) they will pass those savings on to you.

Now your payments are $500 per month for health insurance. Is that too much? I don't know. One thing that I do know is that I pay about $150 per month in auto insurance. For our family of 2, it's about $250 per month. So, I'm paying $250 per month to replace my car if it gets damaged, and twice that to replace my body if that gets damaged. Knowing the relative importance of my car vs my body, $500 doesn't seem like too much. (and, that's my car insurance for 2 people and 2 cheap cars - 02 Santa Fe and 06 Saturn)

Art - I may PM you one day for more details. Would that be OK? This issue will likely come up either in the fall or next spring, and it'd be good to have some first-hand testimonials.

Hold on now!!! You can't be serious! The government making sure you are taking your medicine! This does not describe a free state. That is stepping way over the line and infriging on my presonal liberty, freedom.

We lost that a long time ago.

I am going to piss some people off now.

I was raised in Janesville, WI. Home to Tahoes and Suburbans, besides Texas and Mexico.
This plant which started as a tractor plant in 1909, will be closing by 2010.
Janesville's economy is based on the GM plant and other manufacturing and supply lines in and around Janesville.
This closing affects my brother who works for Lear Seating Corp on the assembly line making $ 18.00 p/hr., and his wife who works on the assembly line at GM who makes $ 22.00 p/hr. The economy here is going to implode like a blackhole.
My Grandfather was one of the original "Sit-Downers" in the late 1940's, and he and my father both retired from GM.
I have a couple of Uncles that have worked and retired. Even my Uncle Harold " Vernel" (he developed the rigging to install the windshields for the 55 Chevy Belairs and became Plant Manager for the Cadillac Plant in Michigan- he retired in the late 70's)
Especially in my Grandfather's time and even during my Fathers time (he retired in 1996 after 31 years) Unions were needed.
Now days, the Unions are bad as the "FatCats". The are not about protection of GOOD employess, but lining their pockets. The Bigger the pay, the Bigger the Union Dues.
I use to be a Union Steward at Alcoa, so I know, I have been there and seen it, and been in Union Negotiations. What a Nightmare.

The Salaried Paycuts are going to be at the expense of the Middle Management and on down employees. Supervisors, Engineers, Customer Service Reps, etc.
Do you think Wagoneer or Lutz are going to take a pay cut, or give away their "Golden Parachutes"? I think not.

There are so many things that can be fixed and changed overall, it is mind boggling, but as a culture I do not see any of us taking a paycut, can't afford to.

Small Business owners pay taxes for earnings for their business, and pay taxes for their personal earnings. Isn't that a load of bull.

Free Trade agreements have killed us. Thanks Clinton.
Very few people take pride in American things, or even being American. Just look at all of the Political Correctness bull pucky.
African American, Mexican American, Irish American, etc. etc..
Last I knew, if you were born here, you are an American.Period.
I am probably preaching to the choir, but damn, we need Reganomics again.
The Economy was great during Regans second term, Bush Sr.'s term and Clinton's first term. Then the Democrats had to screw it up. And I come from a traditionally Democratic Party Family.
Now the Dems want to tax the Oil Companies more, who is going to pay for it in the end? Us, John and Jane Q. Public.
It just seems as of late it has been spiraling deeper and deeper into an economic abyss.

I am just thankful I have a new 40 hr job in Madison in the Medical Industry, and able to still have this small business of mine to let it grow and nurture. I am thankful to be able to provide for my family, and be able to do some of the things we like. We do not own nice shiny new vehicles, but the are mine lock, stock and barrel. I am glad I can say I am debt free so I can weather this economic turn.
I wish my younger brother's family could say the same.

Sorry for letting some frustrations out on here.

This post has been edited by T.O.Dillinder: Jul 15 2008, 10:01 PM

Howdy,



Who's paying for your current uninsured and Medicare/caid folks with this new "everyone has insurance" system? You can't ignore that, and keep it apples to apples.

Mark

Well... the thing with our health care system, it's far from the best...
Yeah it's free... If I get a heart attack, get into an accident and end up in a coma for 9 months, and need several surgeries... it all costs 0$.

kinda...

our taxes are higher than yours, though.
Nonetheless, we have too many idiots going to hospitals, emergencies for light headaches that minor rest or a tylenol will take care of.
Instead, the engorge the system.
Lineups are long, although it's free.

To speed up or get a bit of better service, ie a private room @ the hopital... that is charged to you or insurance... but nothing compared to your prices.
Now, given the lack of professionalism of the entire health community, since the end-user ain't paying, service sucks, and waiting lists are long for any intervention... unless you are a celebrity, and you bump my friend from getting its Chimio (damm @#$%^er Saku Koivu bumped my friends appointment so he could get treatment when he was diagnosed)

Anyways... private sector is developing, and i'm a believer that Canada is getting into a good path of getting away from too much socialistic programs.
The health care needs a good kick in the ass, employees need to realize no matter if the client, insurance, government is paying the bill... they should offer A1 service... something that would never happen in the US, where ppl are very service oriented and making sure customers are treated well.

Anyway, that's my rant of the day... but at least, it's good to know that no matter my financial situation, my health will always be dealt with.
I dunno how you guys can live knowing that from one day, a health bad luck can ruin your whole life, not only physically, but financially as well.

Also, In some case where critical, and ppl can't get care in fast enough time, the government allows ppl to get the care in the US and they fork the bill... but needs to be approved before hand.

Note that the following isn't included in the freebies:
medication (unless you part of a gov program, elderly, etc)
dental care
eye care (prescription glasses, laser surgery) ... but if you need an eye surgery for medical reasons, it's free

For these 3 items, there are insurances.


Just to finish the argument,

here is what one pays when buying a product for sale.
5% federal tax (used to be 7% 2 years ago, 6% 1 year ago)
7.5% state tax (compounded over the federal one)

ie. 1.05 x1.075 = 1.12875 = 12.875% on purchase of service/goods.

Income tax... well, what about 55% of your income being held and gone... you keeping 45% of your income.
Yet, high % of population with low salaries pay 0 income tax... government doesn't encourage success much there.
Unemployment last ~1yr
Welfare is a joke and abused.
interest paid on mortgage is NOT tax-refundable
property/school taxes are outrageous

car/bikes yearly registrations are outrageous.

ex. me having a perfect driving record (points/accidents), just for the plates, I pay ~$260 / car / yr... ~$420 / yr for camaro because they passed a law on extra $ for cars with more than 4.0l of displacement.
motorcycles are over 1k$ on registrations alone.
This does not include insurance, gas, etc, where you are always charged the famous 13%

You do the math on what is needed to live in a place where it's safe, good freedom, good healthcare, no guns, etc... there is no perfect place.
Canadians dream of the States, Americans dream of Canada... lol


And FWIW, 87 octane regular gasoline is ~$6/gallon here... so gas is cheap in the US.