Might as well misogynyFollow

Exactly. Just because it's available doesn't mean people are going to take it. I for one (stupidly I know) do not see any regular doctor and I've had insurance for about 10 years straight through employers. Does it make me an idiot? Yes.
Now I have used it on occasion for as needed dental work (wisdom teeth) and one infection on my leg that put me in the hospital for 3 days.. That's like 3 times in 10 years. Not to mention that there is nothing stopping anyone from NOT signing up and then just waiting until something is wrong to sign up eventually is there?


All I'm saying is anything less than free universal health care is a complete failure of governing.
I should be able to go into a medical facility, give my ID (actually why would I even need an ID?), and get seen and get whatever treatment I need. It doesn't matter if I have chronic problems that require thousands of dollars a week or if I go in once a year for a checkup... It really shouldn't matter. Let the government sort out how it gets paid for. That's their job. Instead people are so stuck on how to profit off of sickness.. THAT is the bottom line.
We can invade countries and spend billions of dollars bailing out bankers. I don't see the American public getting nickel and dimed over that cost of that individually. Do I see on my income tax statement how many A-10s I paid for to be refurbished for the service of protecting my life? Do I get sent a Christmas card from Goldman Sachs every year with a receipt for exactly how much of my earning when to grease the gears for the economy?

Pfehh

Now calculate the lifetime cost to the health care industry if those things are diagnosed as a result of routine exams versus not. Remember, this is about cost. What percentage of the total times you go on a routine exam are you going to be diagnosed with one of those illnesses? So to get 100% diagnosis, we have to have 100% of the population get regular routine exams. But only a tiny fraction of them are going to contract one of those illnesses in any given year. But we have to pay for every single one of them.

Then you have to factor in how many total health care dollars are saved if you catch those illnesses early versus late. How much do we decrease the total number of people who show up at the ER with a heart attack by making sure every single person gets a heart disease screening regularly? Same thing with all of those illnesses. You can diagnose them, but for many of them treatment is about lifestyle choices, and many people aren't going to change their diet and whatnot, no matter how many times you pay them to go to a doctor to tell them "You need to quit smoking, exercise, eat better, etc" until they suffer a real negative consequence. Which often means "end out in the ER".



Again though, you are chasing the wrong end of the issue. You're starting out with the assumption that we save total health care dollars by making sure everyone gets regular exams. That's the assumption I'm challenging here, so simply restating it isn't a valid response. I think you'd be surprised how many things aren't caught in routine exams, and how many which are don't result in lower total lifetime costs because the patient doesn't act to prevent the risk factors until he ends out in the ER or because the illness itself is of a type that by the time it can be detected in any sort off regular screening, it's likely to be too late to offset total costs. Some forms of cancer can be effectively treated if caught early enough, but many cant. And how soon is "early enough". Cancer spreads quickly. Even if you get a full screening every single year, that still leaves you with a roughly 50% chance of a cancer going 6 months past the point at which it could have been detected and the point at which it *is* detected. Which is often already too late.


I just think that people have been sold this myth of preventative care, when the reality is that it's something worth doing on a quality of life basis (I'd never argue that someone *shouldn't* get regular checkups), but you can't really make the "save us money" argument. If you argue that it's worth increasing the total health care bill by 20% or so nationwide in order to help people live longer more healthy lives, that's a perfectly good argument to make. Arguing that it'll somehow cost less money to do this? Wrong.

Edited, Jun 23rd 2014 3:44pm by gbaji

I'm repeating the reports from the hospital.


That's nice. No one gives a shit about your guesses. Funny that you whine about me "making an assumption" though while your whole argument is based on "My guess is my evidence".

What reports? You only said that they had a lot of visits to the emergency room. What you suspiciously didn't say was whether the number of visits would have changed if those people were insured versus uninsured.

Let's not forget that the argument you're supporting is that those of us paying for insurance would be better off cost wise footing the bill for the insurance of all of those currently uninsured because the cost of those uninsured people visiting the ERs, which ultimately gets paid by us anyway, is higher than the cost to insure them all. I don't believe that's remotely true. Right now, I'm only paying for when someone actually gets sick and has to go to the hospital. The alternative is paying for that person and everyone who doesn't get sick. It's a direct cost assessment. How much does it cost to insure someone (comprehensive insurance)? Let's lowball it at $4k/year. What percentage of people will require the ER if they don't get regular doctor visits? 1 or 2 percent (maybe?). So unless the ER bill exceeds like $200k each and every freaking time, I'm better off paying the ER bills than the insurance.

Like I said earlier, the math just isn't that hard to do. And it doesn't come remotely close to equivalent. I know this sounds mean and what not, but it really is vastly cheaper to pay for the small percentage of uninsured people who will actually get sick enough to require emergency treatment, than to fully insure every single currently uninsured person. That does not preclude making an argument that we should be willing to pay more to improve the quality of life for those who can't afford insurance, but do *not* make the argument that it'll cost less. Because that's a laughably false claim.

That's nice. Look, I don't give enough of a **** to argue with your changing ideas or asinine demands of evidence or whatever. I'm just saying that the hospital reported losing shitloads of money on uninsured people using the emergency room as general care. If you don't want to accept that or want to demand that I quantify exactly how much or yammer on about the "deltas" or whatever, I can't say I care. Rock on with your bad self.

And? Was there a relevant point in there somewhere? How does this support the claim that the total cost for ER visits by the uninsured is more than the total cost to insure everyone currently uninsured? Because that's the claim I'm countering. So your little example is interesting, but doesn't actually shed any light on the issue at all.

I'd say it's an unfortunate fact of living in a world with limited resources. We always make choices between money and people. Hell. You do. Unless you give every single penny you earn to charity, then you make that choice yourself every single day. So how about we drop the pointless emotional rhetoric? The issue isn't over whether we choose money over people, but where the dividing line should be. At what point does someone else's needs exceed our own wants? At what point does it become "evil" to *not* provide for someone else? That's a far trickier question IMO.


I'll also point out that this still requires getting people to even acknowledge that this issue is about cost versus care, and not the unicorn and rainbow filled fantasy that we can provide a bunch of people with free health insurance and it'll somehow cost us less money to do it. If you want to make the argument that we should be willing to pay more to provide comprehensive health insurance to everyone, then make it. But I get really annoyed when people insist on lying about the cost to do this. It's not "free". It will cost a hell of a lot of money. If people want to make the moral argument, then have the guts to actually make it. Don't pretend that there isn't any conflict at all by insisting that it wont actually cost anything. That just sidesteps the whole issue IMO.

Excluded middle much? (I thought you hated the "excluded middle" thing?)

Thanks for not reading. I said you love money more than people and that's a pretty straight definition of evil. Quit changing the subject, Screwtape.

Exactly as much as the statement made by you. That was, in fact, the entire point of my response. You're free to look up reductio ad absurdum if you're unclear what I was doing and why.





Um... Is this where I point out that that's actually not what you said? And even if you had, it doesn't make my response invalid. You made an absolute claim. That "caring about money more than people" is the definition of evil. But you failed to provide any guideline about when this point is reached. Assuming that we're allowed to care about money at all and accepting that there is scarcity in the world (meaning someone somewhere is doing without something they need), then we're either all "evil", or there must be some point at which we care for money "more than people". I think it's quite fair and reasonable to ask you where you think that point is.

Otherwise, you're just making a pointless statement.

Do you understand how what you posted doesn't actually counter what I've been saying all along at all? I'll give you a hint: Those countries don't use insurance as a means of delivering health care. You and I certainly disagree on what we should be doing with regard to health care, but can we please agree that using insurance to provide health care (comprehensive health care specifically) is the dumbest possible way of doing it?

You want single payer. Why not just be honest and say "We should have single payer"? Why be dishonest and say something like "paying for health insurance for everyone would be cheaper than simply treating the sick in the ER"? It's this bizarre disconnect that I'm addressing. It's like people want one thing, but instead of arguing for it, they argue for something else, but then lie about that other thing in order to get people to think it's a good idea. You don't even want health insurance coverage as the norm for our health care system. Right? I mean, I'm going out on a limb here, but I'm assuming that most of you dislike the whole part where private companies make oodles of money by being the middleman in the system. But you know that single payer and universal health care is unpopular in the US, so you argue for something you don't want and know wont work, and then actually lie to try to convince people that this thing you don't really want will work and will be less expensive, when you damn well know it'll accomplish the exact opposite.


I get it. I really do. If you make the private health care system so expensive and so horrifically bad, maybe you'll make enough people so miserable and unhappy that they'll accept single payer. That is the plan, right? So can we at least be honest about this and stop pretending that you guys actually think that mandating that everyone be covered via private health insurance is remotely workable as a health care system? Because it's an absurd claim. I get why you feel like you have to make it, but it does kinda go back to that point I keep making about how if you have to trick people into adopting your agenda, maybe that's a good sign that you should rethink that agenda. How bad must your solution be if you have to make the existing condition so much worse in order to make people think that yours is "good" in comparison? Doesn't the dishonesty ever make you stop and question your methods?

Well, the guesses an IT guy makes on the cost of medical care are certainly something we should consider.

You mean like I have a bajillion times before? Well, you got me there.

We should have a universal single payer system. Since we don't, we should have a universal system to cover as many people as possible. Due to unfortunate political dynamics, a near-universal system based on private insurance is the best we can get at the moment. We should have single payer but the system now is still better than the system five years ago.

Doing some basic math (cause premiums are only 45% of the total amount collected for insurance per person) it costs roughly $3000-3250 to insure someone in the Netherlands for a year with children under 18 being insured free of charge under their parents insurance. This being in a system that is roughly equivalent to what Obamacare tried/tries to achieve.

Of course it doesn't translate literally to the US but taking it as a somewhat reasonable estimate Gbaji is pretty far off with his guess.

We're not great long-term thinkers, is what you're saying.