Health Care/Insurance Reform

Submitted By: Ian from Bostοn

Any opinions on what's going on in the U.S. right now?
Indicate which comments you would like to be able to see

sure have! and would love to see a fair, frank, open discussion on the relevant points expressed in a polite courteous manner. Any takers?
24/Sep/09 10:39 AM
Perhaps an introductory discussion on how the system works at present and how any future proposals would affect the people of the US would be helpful, to me at least. I know little of your system other than visiting your country and the insurance policies I had to take out to cover myself during my stay.
28/Sep/09 9:33 AM
Good idea Genevieve....
28/Sep/09 10:27 AM
There is an artifact of health insurance in the US that probably doesn't exist anywhere else.

During WWII, wages were frozen. In order to entice workers to join them (or stay), employers began offering medical insurance plans, and that became engrained in the American health system. That More...
29/Sep/09 7:36 PM
Interesting - I wasn't aware of the origins of the medical insurance plans.
30/Sep/09 6:02 AM
Thanx Ian, that history is fascinating. As you say, I have never heard of other countries going down that path. The great thing about a site like this is finding out stuff you weren't aware you didn't know.
01/Oct/09 9:18 AM
Ian what entitlement does everyone have to basic health care? Is that governed by insurance also or can one receive a decent standard of care paid for by the government/state? Is dental care available to those without insurance also? It seems to be a very complicated system by all accounts. How on earth can it be resolved in a fair manner.

01/Oct/09 9:40 AM
I guess the conversation must have come to an end then. Are there no more contributors to the discussion?

06/Oct/09 9:39 AM

Gen: There is no entitlement to basic health care in the US, although there are lots of programs which are available to people without money, and people in certain categories like pregnant women.

One peculiarity of US law is that no one can be turned away from an emergency room. So More...
06/Oct/09 7:01 PM

Probably the worst aspect is unnecessary testing. The reason that happens is that, over the past 30 years, nearly all health care and health insurance have become for-profit industries. So the more a doctor bills, the more profit there is, for him and for the company.

But at the very More...
06/Oct/09 7:06 PM

I wonder if the solution might be to allow only health care providers, including hospitals, to offer health insurance. That way, they would have to balance what are now competing interests...spending as little as possible vs. spending as much as possible, with the consumer/patient caught in the middle.

Have to think about that one...

07/Oct/09 2:12 PM
Ian, if you tried that solution wouldn't it make for the hospitals and care providers becoming too self-interested in profit rather than health care, trying to generate extra income and passing on the cost to the patient in an expensive health care plan? On top of creating some kind of exclusivity More...
08/Oct/09 4:06 AM

Yes, I haven't thought it out completely. But a hospital which overbilled a patient, if it were also the insurer, would only be billing itself. The danger might be that the hospital would be sorely tempted to forego treatment which was not covered by its own insurance plan and the patient clearly could not afford.

08/Oct/09 5:14 AM
Why not separate the functions of health care provision and health care insurance?
14/Oct/09 11:42 AM
What are people's thoughts on the initial offering from President Obama? I would like to comment more, but I feel I don't know nearly enough about it to add anything at this stage.

15/Oct/09 9:57 AM
I find that the articles in US sources are either decrying the end of the world if it happens or the end of the world if it doesn't. Its very hard to find a balanced view.
15/Oct/09 5:07 PM
I am left wondering whether the health care system is the same throughout each state? Does any state have the power or control over how a new system could work individually, within said state? It doesn't seem feasible to pare down the system as it is, and enable/enforce everyone to pay for a basic More...
16/Oct/09 9:37 AM

Political options are narrowing as the debate goes on. As it stands now, the US Gov't will not be getting into the health insurance business. But what is likely is that every citizen will be required to have health insurance of some sort, and those who don't will be taxed accordingly.
16/Oct/09 11:01 PM
Ian, you say that 'As it stands now, the US Gov't will not be getting into the health insurance business', but as it will tax those who do not take out health insurance...isn't that 'getting into the health insurance business'? The attitude that many Americans appear to have for their duly elected More...
19/Oct/09 1:01 PM

That's a good point, Mary. It depends on whether funds collected through taxing the uninsured go into the General Treasury or are put into a special account for medical care, presumably for the indigent and/or willfully uninsured. That is not yet clear.

Yes, I think most Americans are More...
20/Oct/09 1:13 AM
May I ask, what happens to the homeless/those suffering from mental illness or a similar circumstance, and/or those who cannot be taxed for lack of money? Do you think they would then be sent to prison for tax evasion or fined or? A very simplistic question but there would be many thousands in that situation no?

21/Oct/09 9:36 AM
That was probably a comment that should be deleted in retrospect. It probably has no bearing on the outcome of the 'reforms'. My apologies.

29/Oct/09 11:53 AM
Late...very late...Saturday night, the legislation passed our House of Representatives by a vote of 220-215. A rocky path awaits in the US Senate, and probably worse during the process of "reconciliation," when the two chambers meet to iron out differences.

The necessary votes in More...
10/Nov/09 1:29 AM
Just saw the thread and decided to dive in. My husband works at a private hospital now, and was a federal employee prior to that for 25 years, so my views vary drastically from Ian's. I don't view the government as suspiciously as Ian, and believe in "the social contract," the view that More...
10/Nov/09 5:44 AM
Hey Terry, thanx for your input.It is a complex issue and extremely confusing to those of us outside the US, and, judging by the rabid response to the mis-information campaigns, many of those inside it.
11/Nov/09 10:42 AM
Rabid is the word. The notion that we're not paying now for the health care costs of the uninsured is simply ill-informed. Medical providers have no choice but to inflate charges to paying care recipients to cover the costs they would otherwise absorb (at least 20% of billables are never paid). More...
11/Nov/09 11:52 AM
I see the issue has been clouded further by the abortion provisions. The story continues.....
14/Nov/09 11:33 PM
Are abortions state-funded in other countries with national health care plans?
15/Nov/09 8:16 AM

I don't know, Terry. I suspect that, in most countries where they are legal and there is public health care, they are state-funded. A few countries still prohibit abortions altogether, of course.

15/Nov/09 10:17 AM


"Countries that totally prohibit abortion, or permit abortion only to save the life of the woman, contain 25% of the world's population, and include Indonesia, Philippines, Chile, Iran, Ireland, Sudan, Kenya and Nigeria."
15/Nov/09 10:20 AM

Maybe I'm missing something, but it looks like the House version of health care reform was written by the insurance companies and the trial lawyers.

Insurance companies still have immunity from anti-trust laws, cannot operate across state lines, and will get about 35 million new More...
15/Nov/09 10:22 AM
The following is what I THINK is the case (Mary's right about it being so confusing). The bill which forced millions to buy private insurance was written by a Dem (!) who is one of the biggest Dem recipients of insurance industry campaign contributions. His is not the version that was voted out of More...
15/Nov/09 11:20 AM
I'll rephrase my question. In countries where elective abortion is legal and where the state funds health care, are abortions ever funded? If not, are the grounds religious or that the procedure is elective/not a "health" issue?
15/Nov/09 11:27 AM
In Australia (except Queensland) they are legal and covered by medicare.
15/Nov/09 1:27 PM
Thanks, Mary. France, Fiona?
15/Nov/09 3:05 PM
17/Nov/09 4:29 PM
Just came across this forum...I'm happy to see that it has engendered interest of those across the pond so to speak, but where are the U.S. voices? We are the ones who should be talking and listening to shared ideas or viewpoints that may help us become more informed.
Ian and Terry have More...
20/Nov/09 8:00 AM
Hey Mamacita, great to see another US input. The more rational debate on the issues the better. We, 'over the pond', mainly get to see the more radical extremes. Sources whipping up hysteria for their own limited agendas are not good anywhere. I think that the 'for the people' bit tends to be too often forgotten.
20/Nov/09 9:11 AM
Welcome, Mamacita, and ditto to all you had to say. Unfortunately, you're probably right about real reform taking a while. It sounds as though the bill that's coming out of the Senate is Hubert Humphrey's "half a loaf." A start that will have to be improved on later. E.g., no public option yet.
20/Nov/09 11:27 AM

It doesn't get much worse that what's going on right now.

Instead of crafting reform that finds broad support, a sliver-thin majority (of elected officials, not of the citizenry) is maneuvering to shove their ambitions down the throats of 49.9% of their partisan opponents...and 90% of More...
21/Nov/09 10:00 AM
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