Universal health care.

[mrw]

You're the one that chose to bring up illegal immigration, not me. Watch any of the Republican debates and when answering most questions on problems in the US at least one Republican will bring up illegal immigration. Listen to O'Reilly talk about the guy who shot and killed two men robbing his neighbor's house. He focuses on the robbers legal status.
It really doesn't matter what the issue is, illegal immigrants alway deserve some if not all of the blame. This is a permanent talking point for Republicans.

The illegal alien dilemma is indeed burdening an already eroded health care system. Forcing hospitals to treat these people not only raises the costs for those that pay for health care but clogs the emergency care system putting American Citizens at risk.

The options available are to green card all of them or send them back.

My choice would be to send them back and install a proper border that stops the influx permanently.

Illegal immigration is nothing less than an a State supported invasion of our country. If you follow the logic that this is ok, we as a country should be encouraging our poor and homeless to migrate to Canada to access their socialized services.

But the response to this has already been given in a post above. An American married to a Canadian and living as a full time resident is not allowed to access their health care system.

If they don't stand for it, why should we?

[philippeR]

I meant to say 30% of immigrants, but that is probably a low number. Unemployment is over 8%, and that is pretty close to the number of foreign born citizens (google fact).

30% of immigrants ?! WTF ?


What does it look like for the future though? From what I know, many of the Muslim immigrants are riding the wave, having a lot of children, and not participating in the French "culture". They can't become acclimated to French culture, mostly due to their religious beliefs. Am I wrong here? This is mostly coming from my brother in-law, and his mostly middle class French family. They are scientists and teachers in Paris.

Let's say your in-law, his family and I do not share the same outlook on french society and immigration.
ie, while there are issues with some muslims, immigrants or citizens, those broad generalizations are basicaly horseshit. Studies show that immigrant's birth rate lowers to average with the second generation (from 2.6 children/woman to 2.1). in other words, the idea that muslims and/or africans (what you meant by "immigrants" ?) reproduce like rabbits is a myth. The second generation is french in every sense.
(For the record, I'm middle class, live in Paris and work in a poor suburb.)


Where do gas prices figure in? You guys pay for your services in much more ways than we do. My brother in-law used to have to pay 13 months of rent, just cause he could afford it.

Yes, we pay. We also got real services. Do you ? Hell, you don't even get an army : you need to hire contractors to screw the job in Iraq.
I don't get what you mean with the rent.
Now, don't get me started on the price of gas... But, as positive side effect, it pushes for more fuel efficient cars.

The rates are the same for everyone, except the poor. The benefits are not the same for everyone. Not everyone can go to the best schools in France. Not everyone can get the best care. It has become a bit of a caste system, as I see it. Maybe Sarkozy will change some of that?

Caste system is a good comparison, and a real issue. Everyone can go to the best schools (they're public and real cheap), but it does not happen.
The french model is fucked in many ways and that's a genuine concern. But I fail to see how school issues are related to the tax pressure or the health care system.

12345678

[PNWbrit]

send them back.

How's that going to work? Round up 10s of millions of people? Send them where? What if they resist? What if their country of origin refuses to take them back? Do we go as far as concentration camps and ovens or just refugee camps in the desert?

Presumably you'd be giving the contract to a private contractor?

[Burrrr]

Grange: Sorry about the red quotes. I need to figure out how to work the quote options.

"By using the word clogged your leading the reader to believe ER's have more non-insured patients that are illegal immigrants than US citizens."

In my orginal post I lumped together indigents and illegals. But, depending on the geographical location, it is a true stmt. When was the last time you went to the ER at St. Anthony Hospital in Denver, CO?


"You single out illegal immigrants, when plenty of US citizens do the same damn thing."

I haven't singled out illegals. See above response.

"Again you're leading the reader to believe all US citizens without health insurance are covered under Medicade and primary care physicians. If that's the case then we already have Universal Health Care. Why do I pay for my health insurance when I could just use Medicade. Also please inform my insurance company when they raise my rates again."

Literally, primary care physicians do not "cover patients", they treat them. You are correct about already having an Universal Health care system of sorts, but it is only available to the poor and elderly. The rest of us need to pay for our insurance coverage one way or the other. So if you want to quit your job and file for medicaid coverage, good luck. Plus medicaid's reimbursement is pathetic. It is one of the reasons why our insurance is so expensive. Hospital administrators spend alot of money on lobbyist to capture larger reimbursements from private and commercial carriers to make up for the indigent care and terrible medicaid and medicare reimbursement.

"How are they directly affecting our quality of care?"

Because they are causing congestion in our ER which are suppose to be dedicated serious trauma and very sick patients.

I am not a fan of O'Reilly. Immigration is a huge buzz word, obviously. Their effect on Health Care is one of the reasons why. The single biggest compliant about our healthcare system is the cost. The illegals and indigents are just one of many reasons why our coverage is so expensive.

Universial/Nationalized health care is not an option in America. We are too demanding and expect immediate attention when we are sick/injured and it doesn't necessarly make it less expensive.

[mrw]

How's that going to work? Round up 10s of millions of people? Send them where? What if they resist? What if their country of origin refuses to take them back? Do we go as far as concentration camps and ovens or just refugee camps in the desert?

Presumably you'd be giving the contract to a private contractor?

Yep, round them up and ship them back. Once we pull the welcome mat from under their feet and make it an inhospitable place to live, they will think twice about trying to stay here.

Ovens and concentration camps? Why is it when someone wants to uphold the boundaries of his country, he is lumped into that category? If someone immigrates here legally, welcome aboard if not, toodles.

And yes, a private contractor would be the best way to go.

You do have a green card don't you?

[powder11]

An American married to a Canadian and living as a full time resident is not allowed to access their health care system.

If they don't stand for it, why should we?

to clarify my point, I wasn't feeling any sense of entitlement to Canadian health care, only that the Canadian health care system recognize private health insurance for people living here who aren't covered or for Canadian residents who want to pay more for better service.

[PNWbrit]

Yep, round them up and ship them back. Once we pull the welcome mat from under their feet and make it an inhospitable place to live, they will think twice about trying to stay here.

Ovens and concentration camps? Why is it when someone wants to uphold the boundaries of his country, he is lumped into that category? If someone immigrates here legally, welcome aboard if not, toodles.

And yes, a private contractor would be the best way to go.

You do have a green card don't you?

So we have teams of Black Wateresque storm troopers picking up the even faintly latino looking, raiding businesses and snatching people from their homes. Since the 14th amendment gives automatic citizenship to lot's of the detainee's children we'll need some kind of adoption program and orhpanage for them (anyone got a number for Halliburton?).

Mexico immediately closes it's border and refuses to accept our delivery of so many into their already broken economy. What are we going to do invade? That's when we get the camps and nut jobs like you saying they're still a drain on the hard working US tax avoider. It's only a small step from there to gas chambers.

[MeatPuppet]

The rest of us need to pay for our insurance coverage one way or the other.

We pay for insurance or we(gasp) pay for medical care. I have not had medical insurance for over a decade. For reasons that aren't relevant to the discussion I have decided not to have it. I have been to the ER a half a dozen times in the last ten years. I have never once been turned away. In the private hospitals I had to sign a note promising to pay whatever cost's I incurred and then I was off to see the doctor. In the public hospitals there was even less paperwork.

After all was said and done, then the subject of payment came up. Every time, I was able to set up a payment plan and pay for the services rendered to me. All this talk about all the people who don't have access to health care in this country has very little correlation with reality.

[mrw]

Mexico immediately closes it's border

If they would really do that, I would be willing to swallow the ones that are here now happy in the knowledge that the invasion is over.

As far as gas chambers, come on... really. I draw the line at waterboarding.

[MeatPuppet]

So we have teams of Black Wateresque storm troopers picking up the even faintly latino looking, raiding businesses and snatching people from their homes. Since the 14th amendment gives automatic citizenship to lot's of the detainee's children we'll need some kind of adoption program and orhpanage for them (anyone got a number for Halliburton?).

Your talents would be more appreciated here.

[Hugh Conway]

We pay for insurance or we(gasp) pay for medical care. I have not had medical insurance for over a decade. For reasons that aren't relevant to the discussion I have decided not to have it. I have been to the ER a half a dozen times in the last ten years. I have never once been turned away. In the private hospitals I had to sign a note promising to pay whatever cost's I incurred and then I was off to see the doctor. In the public hospitals there was even less paperwork.

After all was said and done, then the subject of payment came up. Every time, I was able to set up a payment plan and pay for the services rendered to me. All this talk about all the people who don't have access to health care in this country has very little correlation with reality.

Since by law they can't turn you away, I'm not sure what your point is.

As for your last assertion:

In 2001, 1.458 million American families filed for bankruptcy. To investigate medical contributors to bankruptcy, we surveyed 1,771 personal bankruptcy filers in five federal courts and subsequently completed in-depth interviews with 931 of them. About half cited medical causes, which indicates that 1.9–2.2 million Americans (filers plus dependents) experienced medical bankruptcy. Among those whose illnesses led to bankruptcy, out-of-pocket costs averaged $11,854 since the start of illness; 75.7 percent had insurance at the onset of illness.

http://content.healthaffairs.org/cgi...haff.w5.63/DC1

Correlation with reality? TGR?

[mrw]

We pay for insurance or we(gasp) pay for medical care. I have not had medical insurance for over a decade. For reasons that aren't relevant to the discussion I have decided not to have it. I have been to the ER a half a dozen times in the last ten years. I have never once been turned away. In the private hospitals I had to sign a note promising to pay whatever cost's I incurred and then I was off to see the doctor. In the public hospitals there was even less paperwork.

After all was said and done, then the subject of payment came up. Every time, I was able to set up a payment plan and pay for the services rendered to me. All this talk about all the people who don't have access to health care in this country has very little correlation with reality.

Yeah but oddly, you probably ended up paying more than an insurance company would have for the same service. They simply adjust the bill sent by the provider and mail off what they feel the service was worth. Nine times out of ten, The provider accepts it and that's that.

As the fine print reads don't try this at home

[Burrrr]

We pay for insurance or we(gasp) pay for medical care. I have not had medical insurance for over a decade. For reasons that aren't relevant to the discussion I have decided not to have it. I have been to the ER a half a dozen times in the last ten years. I have never once been turned away. In the private hospitals I had to sign a note promising to pay whatever cost's I incurred and then I was off to see the doctor. In the public hospitals there was even less paperwork.

After all was said and done, then the subject of payment came up. Every time, I was able to set up a payment plan and pay for the services rendered to me. All this talk about all the people who don't have access to health care in this country has very little correlation with reality.

Meatpuppet, you have big balls! You must have very good negotiation skills.

If I didn't have health insurance I would possible be bankrupt.

The amazing thing is that people who elect not to carry coverage are charged the full amount for what ever procedure you receive.

Insurance carriers pay a negotiated rate, which varies from insurance company to insurance company and is based on thing like patient volume and in-network/out of network facilities. This payment is usually 50-65% of the actual charge amount. Sometimes its even less, such as BCBS whom make up the difference through a yearly capital passthrough program.

But the hospitals will agressively come after uninsured patients for the full amount, as if the can affored it. Why are most people unisured to begin with, b/c the can't afford it. This to me is outragous and should be criminal.

[MeatPuppet]

Since by law they can't turn you away, I'm not sure what your point is.

My point is that arguments like these:

People, lots of people, die and/or suffer simply because they don't have enough money,

The notion that some people cannot afford heath care is madness in my eyes and every person has the right to be treated if injured or ill.

are not arguments for government funded health care, nor are they arguments against what we have right now. Yet they keep appearing in threads like this one. So many people seem to think that no insurance=no health care. That notion is simply false.

As for your last assertion:

http://content.healthaffairs.org/cgi...haff.w5.63/DC1

That might be an argument for price regulation; something that has some precedent in industries deemed necessary for the public good. But it isn't an argument for government funded health care.

Yeah but oddly, you probably ended up paying more than an insurance company would have for the same service.

Yeah, I probably did.

[mrw]

to clarify my point, I wasn't feeling any sense of entitlement to Canadian health care, only that the Canadian health care system recognize private health insurance for people living here who aren't covered or for Canadian residents who want to pay more for better service.

Nor did I think you were. I was pointing out that other countries rightfully limit their services to their citizens. For some reason, there is an ongoing sentiment here that we should feed, clothe and treat who ever wanders over our borders free of charge.

[Tourette Dude]

We pay for insurance or we(gasp) pay for medical care. I have not had medical insurance for over a decade. For reasons that aren't relevant to the discussion I have decided not to have it. I have been to the ER a half a dozen times in the last ten years. I have never once been turned away. In the private hospitals I had to sign a note promising to pay whatever cost's I incurred and then I was off to see the doctor. In the public hospitals there was even less paperwork.

After all was said and done, then the subject of payment came up. Every time, I was able to set up a payment plan and pay for the services rendered to me. All this talk about all the people who don't have access to health care in this country has very little correlation with reality.

It is true you will get treatment for acute events, however.....

The main issue with uninsured/underinsured is health maintence/chronic disease prevention.

A pt. on beta blockers for hypertension suddenly stops taking his/her meds and has a stroke, ends up an invalid on chronic ventilaltory support.
Diabetic doesn't properly control blodd sugars ends up loosing a leg and/or blind and/or in chronic renal failure dependent on dialyisis 3-5 time a week.
A kid doesn't get proper asthma managemnet and ends up in status asthmaticus and on the vent for a few days, disharged and repeat in a year or two .
The epileptic doesn't get his/her antisiezure meds end up in status epileticus on the vent and with possible brain damage.
All of those things happen EVERY day in this country multiple times. Each one of those hospitaliztion costs tens of thousands, sometimes hundreds of thousads of dollars. And the cost of one of those hospitalizations is sometimes equal to what it would cost to insure multiple pts. for a lifetime.
Most could be prevented with proper medical management but that depends on insurance to pay for th long term costs of the medication. Instead we end up paying much more for the acute hospital events and mangement of the more serious consequences of untreated chronic illness. That is where the main financial burden comes to the medical system.

There are issues with pt. compliance not related to insurance access but that is a different topic......

[Adolf Allerbush]

Nor did I think you were. I was pointing out that other countries rightfully limit their services to their citizens. For some reason, there is an ongoing sentiment here that we should feed, clothe and treat who ever wanders over our borders free of charge.

What do you think about legal non-citzen (yet) immigrants that are working for minimum wage and are uninsured. Are you suggesting that if they get sick that they should die instead of get healthcare?

[Burrrr]

Nor did I think you were. I was pointing out that other countries rightfully limit their services to their citizens. For some reason, there is an ongoing sentiment here that we should feed, clothe and treat who ever wanders over our borders free of charge.

and don't forget educate! With full rides to our state colleges, yet our tuition is rising as fast as our health insurance. Then they have the opportunity to work in our country. Laughing all the way to the bank.

Can't blame the immigrants, who wouldn't take advantage of that.

[PNWbrit]

Have TGR been advertising on the Lou Dobbs show?

[MeatPuppet]

Meatpuppet, you have big balls!

No, just very pragmatic. I am (relatively)young, healthy, keep myself in shape, come from a family with several centenarians in it and have no family history of non-lifestyle related diseases. I also live in a country where I knew that if I were mangled in a car accident I wasn't going to die because I didn't have insurance, or a trust fund. It was a calculated risk.

Why are most people unisured to begin with, b/c the can't afford it. This to me is outragous and should be criminal.

If you look at the average lifestyle of the "poor" in America I would say that most people who don't have insurance, don't have insurance because they would rather have a cell phone, satellite, eat out often, etc.
IMO, the government shouldn't subsidies lifestyle choices.

There are those who truly cannot afford insurance. For them we already have a (state) government funded health care system in place. If that system is broken and needs to be reworked, then lets do it. Layering a federal system on top of what we have right now is just ridiculous, and totally unnecessary.

[MassLiberal]

MassLiberal & Grange, perhaps you should read my entire post. I did not single out illegal immigrants as the root to all of the worlds problems, far from it. But it is a fact that our ERs are clogged with illegals whom have a cold or the flu instead of taking the appropriate channels, b/c they have learned that it is law in the states that health care cannot be denied at a public institution. Hence, limting the access of well insured patients whom are seriously sick or injured. If they were citizens they would have access to federally funded programs such as medicade. They would then have access to primary care physicians. Illegals are taking advantage of our health care system, receiving free health care at our expense not only financially but directly effecting our quality of care.

I stated very specifically that this was one of many problems with our current system.

If your statement wasn't a sad attempt to bash conservatives, then please enlighten me.

Dude, I wasn't attacking any point that you made, only that you were resorting to tired talking points which hold no water. There is an argument against universal healthcare which does hold some merit. Sure, I don't agree with it, but making statements about a liberal media conspiracy certainly doesn't help individuals see what you are talking about. We are all pretty intelligent here, why don't we debate the issue based on its merits rather than resorting to tired platitudes.

[MeatPuppet]

It is true you will get treatment for acute events, however.....

The main issue with uninsured/underinsured is health maintence/chronic disease prevention.


There are issues with pt. compliance not related to insurance access but that is a different topic......

I agree, and this is one of the few good arguments than can be made where a government funded health care system would be better than what we have right now. But again, the state run systems already in place can/should address these things. Not the federal government.

[Tourette Dude]

I agree, and this is one of the few good arguments than can be made where a government funded health care system would be better than what we have right now. But again, the state run systems already in place can/should address these things. Not the federal government.

The question is how to expand access to those that are under/uninsured. I don't have the exact stats but I believe that adminstrative overhead for medicaid and the VA is somewhere around 2% while private insurance and the problems with billing, treatment approvals and of course profit is somewhere around 20%. The government system has its problems but it is by no means completely inefficient.

MediCare part D is also a huge pharma scam that gets little coverage and makes it illegal for government programs (other that the VA) to negotiate large scale buying contacts to lower drug cost.

[Adolf Allerbush]

No, just very pragmatic. I am (relatively)young, healthy, keep myself in shape, come from a family with several centenarians in it and have no family history of non-lifestyle related diseases. I also live in a country where I knew that if I were mangled in a car accident I wasn't going to die because I didn't have insurance, or a trust fund. It was a calculated risk.

I hope you don't get into a car accident, I hope you aren't in a location where an earthquake or other natural disaster occurs, or live in an area where unbeknownst to you has some environmental hazards, etc that end up seriously fucking up your health.

Just because I've never been in a car accident doesn't mean I drive around without insurance. A similar case can be made about health insurance.

Just because no one in your family has died cancer, diabetes, been in the ICU for extended periods of time, etc doesn't mean that it couldn't happen to you. Similarly just because others in your family tend to live a long time doesn't mean you will. The fact is that if you get into an accident or something tragic happens to you that lands you in the hospital for extended periods of time there's a good chance you will become bankrupt because of it and this could in turn bankrupt your family by them trying to support you. Basically you will be that strain on the healthcare system that bothers you so much.

[Tourette Dude]

All of the following are components that need to be incororated into policy descions.....


western concept of life, dying and death

quality vs quantity of life

family emotion based descions at end of life

pt compliance

lifestyle choices

incentives for positive choices

disincentives for negative choices

influence of pharma industry,health insurance indusrty on policy formation

liability issues with phys,nursing, pharmasists, respiratory care, rad techs, PT/OT , med equip manufactures

technological development and coming online is the potential nightmare of gene therapy/life extension

systems/practice management inconsistencies