Who are the Uninsured in America?
Filmmaker Stuart Browning has a response to Michael Moore's Sicko explaining who the insured are in America--for those of you who prefer to read a transcript rather than watch the short film, go here.
posted by Helen at 11:05 AM
31 Comments:
My favorite line: "It's 96 dollars a month, but that's twelve hundred dollars a year you're spending on health insurance. And honestly, I feel it's ridiculous that we live in a first world country where I have to pay for basic health care."
Apparently "first world country" means "place where other people are forced to pay for my basic health care".
One of the benefits of insurance is that they can negotiate lower prices with the clinic.
I've been on and off insurance throughout my adult life. When I've been without insurance, I've rarely been in a position to qualify for a government program. On more than one occasion I've had to pay for medical care out-of-pocket. I've gotten exactly one charge (a X-ray of my son's arm) waved due to income levels.
(Last year, when I was laid off, I suppose I could have spent every dime I had paying for insurance under COBRA, but I kind of needed to feed my family.)
The current insurance situation is a joke. It's not insurance, is prepaid medical care with an insurance rider. I don't see why we can't create a more equitable two-tier system. A very basic insurance to cover broken bones, cuts, scrapes, strep, things that can be treated with antibiotics. You see an intern, wait in line and make a small co-pay. You want better care, you get it under the current "insurance" system. (If I'm not mistaken, this is the French solution. Unfortunately, while it makes perfect sense, everyone will start whining about how they are owed the BEST care and all that crap.)
While I'm ranting; the prescription drug system is absurd. Why do I have to constantly call my doctor to get refills for drugs I've been taking forever or drugs that have few harmful side effects? You could make entire classes of drugs purchasable from a pharmacist, but without a prescription (like Birth Control pills, ED drugs, statins, etc.)
(BTW, I already know the answer--it's so the drugs are covered by "insurance" plans. The system is still a joke, though.)
Insurance is something you buy to reduce your risk from low-likelihood, high-consequence events. In effect, you share the risk with a large number of people, of whom a very small number will actually experience the bad thing you're insuring against.
With this definition in mind, it becomes obvious that most health "insurance" isn't insurance at all. Joe is right.
Things like cuts, strep throat, and so on are neither low-likelihood nor high-consequence. You will experience these things in your family but fortunately they are not terribly expensive to treat. Not appropriate for insurance coverage.
Broken bones are rather less likely, especially since kids would rather play video games than climb a tree any more. They can be expensive if orthopedic surgery is required, but it rarely is in kids. Borderline insurable.
Leukemia is unlikely in young people but catastrophic if it happens. Highly insurable.
One unpleasant reality is that we are all going to die of something someday, and it is likely to be expensive. An annuity-like "insurance" scheme for the elderly seems like a reasonable model.
So give me insurance that has a large deductible and large copays. It will be a lot cheaper than the kind of comprehensive coverage my employer gives me. I can use the money saved for my elderly-care annuity, and most likely have some left for other things -- the system will likely be cheaper.
Of course, that won't work until the bizarre tax status of health insurance changes. Nor will it work if deadbeats (there is no gentler description appropriate for first guy interviewed) refuse to chip into the insurance pool, knowing we'll treat them anyway at taxpayer expense. Maybe Romney was on to something when he suggested mandatory catastrophic health insurance.
Wha? Did that first girl say her income wasn't taxed?
Guess I should have done this:
Faye Chao:
On average my monthly income is twenty three hundred. And it's not taxed. Sometimes, you know, it varies. I save almost a thousand dollars a month.
Again . . . "not taxed" ???
anonymous 6:39:
Maybe she collects SSI income? You know, because in "first world countries" like the US, she should be supported without being taxed, of course.
"On average my monthly income is twenty three hundred. And it's not taxed. Sometimes, you know, it varies. I save almost a thousand dollars a month."
--------------------
Some entertainers are paying women $30,000 or more in child support per month (yes, you read that right, I think Puff Daddy and Darryl Strawberry are in that elite group).
That amount is not taxed to the recipient (child support, as opposed to alimony, is not taxable).
My graduate stipend is "not taxed", in that federal income taxes, social security, etc. are not deducted from my monthly checks. It has to do with how the grant money is doled out within the university system. I pay my taxes quarterly, but most of the other students on this grant pretend that they are receiving tax-free money, since we aren't reported to the IRS as university employees.
The downside of not being a university employee is not having health coverage. I've been paying for my own health insurance for two years, and it has never been more than $100/month. And I make a lot less than $2300/month.
People like Faye piss me off. If health insurance is such a low priority for her, how can she argue that it should be a high priority for the government/society?
-Katie
One thing I don't understand about the people who demand state-supported coverage for everyone:
The state-supported medical insurance is covered by their taxes, meaning that they have to pay for it no matter how much they might want to keep the money for some more pleasurable use. However, they seem to be unwilling to pay for it on their own. This is obviously understandable from the people who don't pay taxes, but I've heard it quite often from the people who do.
When I was a kid my parents taught me that the medical insurance is the absolute first thing you pay after taxes, and before you even think whether you can afford food. I've done so for all the time I've lived in the US (I am in Finland now, they have tax-supported coverage, it's a whole different story). But how come the people who obviously don't subscribe to this idea want it forced on themselves by the government?
I am on the premedical advisory committee at my university. We run "mock interviews" for premedical students, to help prepare them for the real thing.
Sadly, the "honchos" on the committee are completely fixated on fully socialized medicine. At every mock interview, I have to listen to how superior Cuba's medical system is, compared to our own. I could go on about that, but I won't.
It goes on and on.
I want to recommend that the students read the book on socialized medicine and possible free market solutions by the author that Dr. Helen and Professor Reynolds interviewed a couple of months ago. But in the Academy of Diverse Ideas, it is best to never, ever mention market forces and instead remember that government funded by taxes always works best.
Sigh.
I do tell the students that there is obviously no perfect solution---or we would all be using it.
The poster writing about problems with COBRA is right on, as I know from personal experience.
Looking at the USSR and China, communism does not work. Unless you are willing to let you gov't murder a couple dozen million to control a couple hundred million - while hoping you are not one of the murdered.
To live like the average Cuban, dirt poor, and drive 1950's and 60's automobiles? Naa.
And screw the spotted owl. The damned thing is a pest. They nest in K-Mart signs, people's attics, etc. You never see that on the six o'clock news either. You'd have to go there and see it for yourself.
Politically correct? Not on your life.
Wow. That was better than a long, hot shower and a glass of port.
To anyone who believes that Cuba's health care is so superior, I would ask: says who?
Cuba has no free press; any information about medical care would come from the state. Of course they're going to say it's great! Meanwhile, anyone with HIV gets put in a concentration camp.
(and wasn't Castro himself treated by a Spanish doctor when he was on his deathbed?)
Dear Knoxwhirled:
I became so tired of my colleague's continual hammering about infant mortality in Cuba that I went and looked things up.
Simple version: Cuba has the highest abortion rate in the Americas. Only a few places in Eastern Europe come close. If there is anything remotely difficult about a pregnancy, their doctors counsel abortion.
Thus infant mortality rates appear favorable.
Faye ticks me off. I have been unemployed for 18 months. One of the first things I did when I found out my job was going away was arrange for health insurance. COBRA was going to cost an arm and a leg, so I got my own policy with a $5,000 deductible -- it costs $120/month. I was not going to have my mother bankrupted -- or myself -- because of a false economy. (Unlike Faye, I am not willing to let the taxpayer pick up my bills.)
"Maybe Romney was on to something when he suggested mandatory catastrophic health insurance." Nope, this is a loser.
Blackwell included mandated purchasing in his 2006 OH Governor campaign. It was one of the final straws that lost him the fiscal conservative vote; leading to a big loss in the general. If memory serves, Blackwell modeled his health plan proposal off the Massachusetts/Romney plan.
In a nutshell,
- The State of MA requires all residents (but not illegal immigrants, heh) to either have employer-provided health insurance or they must personally purchase health insurance. If they don't have insurance, the resident faces legal penalties from the State. The insurance must include coverage at or above minimum state guidelines, so naturally the health care lobbies get those guidelines to be towards cadillac coverage rather than the cheaper coverage of very high deductibles. Supposedly, the premiums to the resident will be low because the resident can buy from a state pool of health care plans; a government parallel to the choices offered by large employers. As the Cobra purchaser above illustrated, high deductibles and high copay plans are unlikely to be among the choices.
While the END RESULT sounds warm-and-fuzzy nice -- health care for all; the MEANS to get to this result are bad.
Some links and excerpts on MA Health Care:
a) The plan about to be passed. Note the first couple paragraphs: "require all residents to purchase health insurance or face legal penalties".
"Their choices would be expanded to include a range of new and inexpensive [to the purchasee] policies ...from private insurers subsidized by the state."
- If the state is subsidizing it, then the state $$ are coming from somewhere.
http://www.washingtonpost.com/wp-dyn/content/article/2006/04/04/AR2006040401937.html
http://www.npr.org/templates/story/story.php?storyId=5330854 . The bottom section has "Key Details of the Bill".
http://www.nytimes.com/2007/04/12/us/12mass.html?ex=1334030400&en=72e83e124a9326e2&ei=5088&partner=rssnyt&emc=rss
Pros and Cons discussion by a think-tank:
http://www.heritage.org/Research/HealthCare/wm1414.cfm
"Notwithstanding the achievement of lower-than-expected health insurance premiums, Massachusetts is still burdened by excessive government control over benefit design. This inhibits flexibility in coverage and increases costs to individuals and families. Other states contemplating the adoption of a health insurance exchange like the Connector would be wise to review and repeal unnecessary insurance rules and outdated regulations as part of their efforts to expand private health insurance coverage and make it more affordable."
c) While the good intentions sounded nice, the latest news ...
"Taxpayers are bearing a larger share of the cost of the expansion of healthcare coverage than expected ..."
http://www.boston.com/news/local/articles/2007/05/10/mass_has_yet_to_collect_fees_from_firms_for_healthcare/
IMHO, it shows that the 'mandated purchasing' approach is just another 'transfer of wealth' method from some taxpayers/voters to other residents/voters. Use taxpayer money to buy some votes, while sounding caring, and with government gaining power by being the middle man.
Of course, I'm a strong libertarian. On principle, I am also offended with the Auto Insurance mandates. But at least having a License Plate and Driver's License are privileges; I can CHOOSE to not own a vehicle. I cannot choose to not be alive; therefore, health insurance mandates take away individual choice from the populace.
eric:
isn't it funny how so many people just unquestioningly accept those statistics, however counter-intuitive they might be...
Let's say you purchase homeowner's insurance for your home. You are concerned about fire and don't wish to lose the value of your home needlessly to fire damage. So you buy the insurance, buy a smoke detector, make sure no one smokes cigarettes in your house and keep a clear path to all exits. Most homeowners do these things so that this makes homeowners insurance a level playing field. Every year a small percentage of home go up in smoke and the insurance company covers the damage.
But this is not the same case in the health insurance arena. Every year thousands of people purchase health insurance. Some of those people take an interest in their health by eating properly and exercising to avoid illness and medical expenses. But at the same time, many other policy holders do NOT take an interest in their health because they figure their insurance(and the other policy holders) will pick up the costs of their poor choices.
So health insurance becomes a way for the constantly ill to get the reasonably healthy to pick up the costs of their excesses. Some people don't wish to become part of this program, rightly so.
Small personal anecdote: Several years ago, I added up my families entire medical expenses (including a premature birth of child 1 and C-Section of child 2, wife's kidney stones and more!)
I was rather stunned to find that my total premiums (including the company paid portions for those employers that offered it) and my total medical expenses were a wash. Granted, I haven't had open heart surgery (yet) and I haven't recalculate since I had my gallbladder removed, but since my current insurance is over $800 a month for my family (employer pays most) it's probably still a wash!
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