Okay, let’s just all agree to agree on this. We all need medical care during our lifetimes. And, maybe we can agree on this too. Healthcare/medical care is pretty expensive. Expensive compared to the average person’s wage at least.
Maybe some disagree with one of the two above statements, but generally I think we can agree. The key is how to pay for our individual healthcare. Or maybe, the key is how to try to encourage our society to come to some sort of agreement on how to pay for the healthcare of those that don’t have the means to pay for it themselves. I’m not sure what the real issue is. All I know is that we, as a country, are wealthy enough that we “deserve”, and should demand, healthcare for all our citizens.
I’ve been thinking about this since I did rotator cuff surgery in February. Actually, since I tore up my shoulder at Cyclocross Nationals in Madison in January. Participating in the system, as many of you already might know, is a challenge. It is so unbelievable broken that even those working in the field don’t understand how the system works. I’m not sure anyone does.
Yesterday out riding, we had a problem. My friend, Ian, crashed and hit his face pretty hard. He has a history of seizures, but none of us saw him go down. We came back and he was laying on the edge of a gravel road, pretty much unconscious, blood pouring down his face and out of his nose. Little Jack, was already on the phone with 911, trying to explain to them where exactly we were. Bill was holding Ian’s head, trying to keep him still. I called Ian’s wife, Katlin, to see if she could give me some information on his condition. She got into her car and started driving out to where we were immediately.
Long story short, the ambulance arrived, they put Ian inside to get him out of the cold. Ian “came back” after about 15 minutes in the back of the ambulance. He had health insurance, he works at Rebound Physical Therapy, where I did PT on my shoulder, but it was going to cost him a “fortune” to take an ambulance ride to the hospital and do all the necessary tests. Something maybe like 2 to 4 months salary, depending on what they did to him once he showed up. He decided to deny care and get a ride with his wife. The ambulance guys said since Ian was aware, he could decline treatment. I wasn’t so good with the decision at the time. Ian ended up going to minor-med and getting his face stitched up. He decided to take the risk on the concussion and broken nose.
I was talking to Bill while riding and wondering what he would have done. He told me pretty much exactly what Ian did. I think that it is so wrong that we have to make financial decisions that may, and many times do, risk our lives and health. I’m not sure what the answer is, but it needs to be fixed. I don’t understand why no one wants to address the cost issue. No one can ever tell me what it is going to cost to do any test before they actually do the test. CAT scans, MRI’s, tests that cost a few thousand dollars, they have no idea how much.
My brother broke his wrist falling off a ladder a couple months ago. He didn’t go to the hospital. I finally got him to go get it x-rayed and then sent them off to Stacie in Louisville. She said he needed a CAT scan of his wrist. I called around Topeka and no answers on cost. I eventually got some quotes of between $1800 and $2200. I went onto the internet and found a place from California that scheduled them all over the country. It cost $395. He drove the 60 miles and went to a regular imaging place and it was done. The charge less than 20% of the higher cost in Topeka. I don’t understand it.
Catherine had really great insurance when she crashed in Madison at Nationals and punctured her lung. But when all was said and done, she owed nearly $8000 out of pocket because they said she used an out of network hospital. I thought if it was an emergency, your insurance paid for any immediate medical care? Guess not.
We’ve already decided as a society that we take care of really hurt people. It is a law that hospitals can’t turn down patients that need immediate medical attention. When I come upon someone hurt or really sick, I want to be able to call the proper authorities, an ambulance and have the person taken to the hospital and taken care of. I really don’t care if the person was a drug dealer who was shot selling crack, an old lady that slipped on the ice or a police officer that had a heart attack. Or Ian, who crashed on his bike and hit his face onto the ground. I want them taken care of. We are a society of people. All of us don’t necessarily approve of what many of the others do or how they choose to live their lives, but that being said, it is the society that we choose to live in. No one is forcing anyone to live here, so we need to put aside the “I don’t want to pay for the other people’s insurance” argument.
And it’s a law that we do take care of them. So, our society has agreed, by law, that these people get medical treatment. No matter if they can pay for it or not. So we pay for the treatment whether they have insurance or not. Society pays for the treatment. We all pay for the treatment. But, people like Ian can’t afford insurance that pays for anything but a disaster.
Ian is in a very high risk group, as his wife, Katlin is. He has had seizures since he was a teenager and she was just diagnosed with Type 1 diabetes. They are both going to be turning 26 pretty soon, so have to buy their own insurance. Can you imagine how much that would be? Through no fault of their own, they are nearly uninsurable in today’s system. It’s bullshit. It’s wrong.
I heard a radio interview on NPR about a woman in Florida that was trying to get people down there to sign up for the Affordable Care Act, Obama Care. The NPR segment said that Florida was a state that would really benefit from the legislation. But they are having a hard time getting people to look at the information, let alone sign up. I heard interview after interview from people that said that it was horrible legislation and it was just going to cost everyone money, but then admitted that they no nothing about it, but were sure that it would not be any good for them, even thought they had no health insurance now.
Nearly everyone I talk to has some view about Obama Care. And I really haven’t met any one person that could tell me more than one or two things about it. I’ll be the first to admit that I know very little about it too. I know that you can get insurance without having to disclose pre-existing conditions, which is a very big deal. That would apply to my brother, whose wrist is still broken, Ian and Katlin. Other than that, I don’t know much.
I can’t tell you if the Affordable Health Act is going to be a great thing in the long run. I do know that our health care system is really screwed up currently and I’m willing to try just about anything different to see if it helps some. I wish we could all have a more open mind and put themselves into other people’s positions. When it comes down to it, our health is the most important part of life. If we are unhealthy, then the rest of life is an uphill battle.
Let all try to figure this out. At least keep an open mind and recognize that we have a big problem that needs to be addressed. This might not, and most likely won’t fix the whole problem, but in my opinion, something is better than nothing. If you want to check out the Affordable Care Act and it’s offerings, click here. If this post just gets one uninsured person to go out and explore the options of getting insurance, then it was a success.
We had to wait here over 15 minutes before an ambulance arrived. We complained about how long it took, but really? We are very fortunate to live in a country that has such good emergency services.
Ian taking a rest until Katlin showed up.
Katlin showed up with some medicine.
Kansas aren’t so inclined to look into the ACA either. This headline of the Topeka paper says that only 1855 people have signed up for it so far. That is out of an estimated 363,000 people that don’t currently have health insurance now. That is about 0.5% of the unisured people here. Wow is all I can say.
I think the NY Times had a big article last weekend on the very subject of “wtf is up with medical costs and pricing?”
Steve,
Thanks for writing what needs to be said. Too many people are out there without healthcare. Whether or not people like the healthcare act isn’t as important as getting at least some type of catastrophic coverage so that someone doesn’t go deep in debt in the case of a very serious crash. I know a pro rider who quit riding because he racked up $150k in medical bills. You can get cheap plans with $20k deductibles. Not great to owe $20k, but for a few bucks a month that beats a life changing debt of $150k….right. I’m a workers’ compensation attorney in Georgia, and I see serious medical bills put people in worse debt than almost anything else you can imagine.
Beth Gearhart
Sadly, a root cause of insurance woes has something to do with the fact that many of our young people aren’t finding jobs with health coverage. Twentysomethings get jobs where they get 32 hours a week so their employer doesn’t have to pay for insurance. Traditional insurance depended on healthy younger people contributing to the system, which in turn helped cover older people. But the wealthy, such as the billionaires who own WalMart, have no interest in helping the bigger picture. Apple, for all their talk about making peoples’ lives better, export most jobs to China to avoid such costs. The insurance companies themselves seem mainly devoted to enriching their top management.
I read that 20% of college grads from the last few years are unemployed – these are all people, then, who can’t contribute to the system, but use it when needed. I heard that one reason so few young people are enrolling in Obamacare is they’ve come to understand they’re mainly needed to pay in more than they will likely need – although any one of us can find ourselves in a serious medical trouble. BTW, I’m writing this from a surgical waiting room where my wife is having minor hand surgery . Even though I have good insurance through my workplace, I still have to cough up $800 out-of-pocket. Sorry for the rant.
hope ian is going to be ok..
8k because she didnt go to a hospital that was on her plan.. the guy that made this rule up needs his ass beat…
Man I’m glad to hear Ian is alright! I guess pending a concussion that hopefully he can get checked out under his insurance plan. Scary stuff.
Great post Steve. In my perfect world, we would have a single payer system and do away with insurance companies. I think that is where a ton of the problem lies; the difference between the pricing for Kris’ MRI and such, pre-negotiated deals between hospitals and insurance companies. That being said, I don’t think my single payer utopia will never happen in the U.S. and we have to hope we can afford what isn’t covered in our plans, or pick the right hospital to go to when we suffer a punctured lung. Unbelievable!
I agree that the ACA is good in many ways such as the coverage of pre-existing conditions and like you I really don’t know anything about it, which also makes me wonder. Seems like we should understand it more by now? I hope it is a good deal for everyone but it seems to be off to a bad start.
Wow! These comments are actually fairly insightful and reasoned. Where are the reactionary anti-Obama fools that I often ride with? Come on, speak up!
Quick suggestion – USA cycling used to have insurance for costs over and above those covered by insurance. It saved me thousands of dollars. Not sure what they have now – but check it out.
As an Insurance agent in the State of Texas the out of network issue is something that I am always reminding my clients that travel a lot to make sure that they look at. The friends of mine that are cyclists and clients are told too go online and make sure that they print out a list of Hospitals / Docs that are in-network when they go out of State to race, yes sometimes they forget but if you will do that it can save you a lot of money.
Q for Ken are you in a Hospital for the surgery or a Surgery Center for just in and out surgery? And would you really expect to pay less than $800 for a hand surgery if you didn’t have insurance? If you didn’t you would pay much more correct?
To the Pro Rider that had the enormous med bills – should have spent some of that contract money on Insurance. And if someone that has insight into this could help me – Steve? DO Pro level or even high level Teams offer their employees / riders Health Insurance as part of a Contract if not – why NOT? Tried talking to a Team about it at one point and they didn’t even want to think about it.
ANd yes the amount of racers that I know as well that do not carry Health Insurance is very scary. They seem too believe that the Health Insurance that is provided by or Organization will be good enough when the time comes for them to use it. Most find it is not.
Ironic that you praise the “insightful and reasoned” comments then in the next sentence pre-name call opposing viewpoints that aren’t even present.
It’s funny (read: not funny at all) that Steve and others admit that they don’t know much about Obamacare, just like Pelosi (“Let’s pass it and then we’ll find out what’s in it!”).
Unfortunately, the things that most people know about Obamacare are the things that Obama told them…off the top of my head:
1. “If you like your plan you can keep it. Period.”
2. “If you like your doctor you can keep them.”
3. “Obamacare will decrease the budget.”
4. “The website will work by Nov. 30.”
Of course, these are just a few of the blatant lies told by the POTUS, to get the law passed. If it’s so great, why did POTUS have to lie to sell it?
Hey RogerH, why don’t you ask Canadians how much they like their “single-payer utopia”? Just hope you don’t get cancer, because you have to go to the US to get treated:
http://economix.blogs.nytimes.com/2009/07/08/how-canadians-feel-about-their-health-care-wait-times-and-spending/?_r=0
Seriously RogerH, if the US Govt. can’t even handle a single website, what makes you think they can handle the entire system of healthcare?
Best wishes to Ian, but emotion isn’t the greatest foundation for a discussion about healthcare.
Steve,
I don’t get over and check your website very often but I sure love the way you “put it out there” and the comments can be pretty entertaining. I think the last time I commented here it was about one of your articles on “2nd Amendment” and views on guns.
I am retired now but when I was working my employer paid most of the cost for my health insurance. My wife is still working and her employer also pays her a stipend to purchase her health insurance. I shopped for insurance after retirement and currently have a policy with the highest possible deductible that I feel comfortable we can afford. In the past 5 years I have suffered a concussion and self diagnosed tail bone fracture from a crash and put a chainsaw in a foot. I didn’t go to the doctor for any of those accidents. I don’t take any medication of any sort so no prescriptions needed. I have what they call the “healthy life style” discount but the cost of my insurance continues to rise each year for the typical reasoning that I get in the yearly “rate increase’ letter. Cost of this, that, everything, increasing so we have to pass on to you. Some point at liability-malpractice suites, etc…
I’m pretty much sick of it, pun intended. I am 5’7”, weigh 140ish, body fat at about 10%, resting HR around 40. I don’t smoke or drink, etc… yet I continue to pay increasing health care costs. I know that I can shop for insurance each year and look for a “better rate” but they pretty much have me by my “man parts” regardless of the fact that they allow me to participate in free enterprise and competition. Why do I have to tell someone how old I am? I may be 60 but my physiological statistics are not typical of my age, but my age is one of the reasons I pay higher premiums. Am I being rewarded for my healthy lifestyle? I’d like to find X amount of people that live and think like I do and be a part of a “self insured” group that would use insurance the way I do.
I have friends that have full benefit insurance through their employers and they go to the doctor for everything and many take pills for everything.
You want to know why insurance costs so much in the USA, follow the money train. Why do you think health insurance companies are paying lobbyists and are such vocal contributors to congressional members? The concept of free enterprise does not work when the industry that is suppose to be competing continues to draw a line in the sand as far as profit is concerned.
One just has to reflect on Maslow’s “hierarchy of needs” to understand that we first take care of the physiological needs first (food, water, sleep, sex), safety is the next step and we can not function when we are sick, injured, or responsible for a family member dealing with injury or illness. It’s one thing if I chose to go out and pay for carbon bikes, wheel sets, etc… new cars, etc… but it is another when we are talking about food, shelter, and health. It’s all about money and as long as we have people that are representing us not having to “walk in the shoes” of the rest of the citizens, why will it change?
Just to help stir things up, check out how the USA fairs with the rest of the developed countries of the world when it comes to cost of health insurance and percentage of GDP (Gross Domestic Product) that goes to health care. I think you will also be a little surprised by the fact that we may spend the largest % of GDP for health insurance but check out our life expectancy, obesity, etc… and we are not doing that great for what we pay for.
http://www.theguardian.com/news/datablog/2012/jun/30/healthcare-spending-world-country
http://www.washingtonpost.com/blogs/wonkblog/wp/2013/03/26/21-graphs-that-show-americas-health-care-prices-are-ludicrous/
http://www.huffingtonpost.com/2013/10/03/health-care-costs-_n_3998425.html
I live in a small town in the “Mid Waist” and when I go to Wal Mart or the local Hy Vee it is always depressing watching people on electric carts buzzing all over the store. Please don’t misinterpret my comment as being unsympathetic to people with handicaps. I just feel many of these people have created their handicaps through their lifestyle choices and thus continue to be part of the problem with rising health care costs.
I am all for health care reform. I’m would also be up for a third party called the “Common Sense” party but that would be a topic for another day.
I think we can all agree on this-that the ACA took the most complicated health-care system in the history of civilization and managed to make it MORE COMPLICATED !
great post! and, btw, every canadian i’ve ever asked was ok with their healthcare.
Please tell me what is the Republican Plan is for providing health care to the 40 plus million Americans who do not currently have it. I think the GOP has a “hope and prayer plan” for these uninsured people. These folks should hope that they don’t get sick and pray if they do. The ACA is a complicated law, and will be difficult to implement, but I do not see anyone putting forward alternative plans. This law will ultimately help millions of Americans. Ask someone with a preexisting condition who was unable to obtain health insurance previously what they think of the ACA Law.
I love racing bikes but after after a crash in Canada I realized the risk/reward was not worth it anymore.The crash cost me alot. You can really mess yourself up . I mainly commute and do charity rides . If I were in my twenties again I would still be out there. At 47 I am glad to be where I am at
Dan
Jeff Burnett,
I totally agree I’d pay more for my wife’s surgery if we had no insurance. But then again, with no insurance I wouldn’t have paid in the thousands upon thousands (upon thousands) of dollars of premiums over the last three decades that we haven’t largely used, as we’re both pretty healthy. I guess I just figure when a person (via their company, but here we all took pay cuts from last year because of rising insurance costs to the company), I wouldn’t also fork out another $800.
When I took my wife to the emergency room when she damaged her hand (after our primary sent us there), it was filled with endless uninsured people who used the emergency room as their primary-care facility. They came as families, drank the coffee, crowded in front of the TVs and clogged up the system with injuries or complaints best sent to a family-practice doc. And in the end, they won’t pay their bills; I’ll pay it via my premiums. So that’s now three ways I’m paying in.
(1) the costs are messed up BECAUSE of the govt interference. Why can’t a person get a competitive price quote for a procedure? Even an emergency procedure should be price-competitive, but it’s not, because of all the layers of red tape involved that are supposed to protect us but all they truly do is add cost to the system.
(2) there needs to be a link to personal responsibility. People abuse things that are “free” and the utopian universal health care vision is basically “free” because “everyone” pays for it. But we all know that’s a bunch of BS – taxpayers pay for it, in fact a minority of the people pay for it, less than 40% as of the most recent stats. Your friend who crashed took a known risk and now he gets to suffer the consequences. If I go out and crash my car, do I come to the taxpayers to help my buy a new one? No, because it’s my car, my problem.
(3) there’s already a law that hospitals must treat everyone for emergencies. Obamacare adds to that making it Federal Law that you must have health insurance. Great concepts, but again, the result is a few people end up paying for everyone else, and, the quality and price of care sucks. So, “more of the same” is not a viable strategy.
Let’s ask a few questions:
– why are hospitals exempt from anti-trust law? Did you know that’s the case? They don’t have to compete on price, they are exempt, they are allowed to price-fix.
– why is there an employer tax deduction for health insurance? Answer: it’s a leftover from WW2 when Roosevelt (illegally) enforced price and wage controls; so employers who needed workers were unable to raise salaries, so instead they offered health insurance. So the whole basis of our modern health insurance system is an accidental leftover of a temporary problem from the last century. Crazy.
– who benefits from the current arrangement? Follow the money: it goes to the insurance companies and the “nonprofit” hospitals. Those are the people who are in bed with Obama on ACA, they negotiated the terms of the law way back before Obama was even inaugurated. “The fix is in” and it has been for years. “More of the same” is not going to fix the problem.
Health insurance is both an extremely important and controversial issue. Is there going to be a perfect fix? I would say probably never. Unfortunately too much money and politics is tied into health insurance. Sad but true. I have also noticed that whenever I hear somebody say Obamacare, their voice just drips with sarcasm. I refuse to use that term as there is no such thing as Obamacare – it is the Patient Protection and Affordable Care Act. Also remember that CONGRESS was repsonsible for it, not just the President. They are repsonsible for the wording of whatever is sent up to his desk. If they didn’t like it, they should have never passed it.
I often take healthcare for granted. I have both insurance provided through my employer (being a federal employee, we have many very decent options) and Tricare as a military retiree. Yes, I pay premiums for both. However, in 2009 I had a surgery with a one night stay in the hospital that totalled over $42,000. My share was $15. Period. That one episode of care may have taken care of most of my premiums for life. Last year my insurance purchased a hearing aid for me. That one purchase was more than my premiums for the year. However, before I had this job, I worked for a contractor for the state that had horrible health insurance and I hated using it.
Is there a solution? I don’t know. I doubt that politicians will ever find it though.
A menu of services with pricing would be a good start. The fact that you can’t get a cost for a service prior to going does not make sense.
The other part of this is that it will create competition, if prices have to be posted. Competition will “legitimize” the pricing. I don’t want to say bring down the pricing because that opens up the argument to talk about the level of care we would get for the “price”.
Ultimately, as a person who runs a small business that does pay for a portion of our employees health care, it seems to me, based upon the premiums that an employee of ours that has a wife and two kids and makes $50,000 per year would likely decline coverage due to the costs. The least expensive I have found for that family of 4 is more than $500 per month. If paid after taxes, that is a huge chunk out of a $50k salary.
A menu of services with pricing would be a good start. The fact that you can’t get a cost for a service prior to going does not make sense
Step back and look at it this way without any emotion involved. Have you had any car body repair work done? If so they give you an estimate on what they can see as far as visible damage but once they start taking this apart they may find something else that was broke in the crash. Gotta use the same logic here, there is absolutely NO way that a Doc or Surgeon could tell you what the total cost will until they can see all of your internal damage, and lets use Tilfords rotator cuff as an example. That was supposed to have been a fairly straight forward procedure, but here almost a year later he is still having to spend money for treatments on it. If the doc would have told him just the set price that figure would have been way off.
The government handles Medicare/Medicaid/Veteran’s Affairs and Social Security pretty well. Nothing’s perfect. That is why I believe it only happens in my own little idea of a perfect world. All the revenue funding Medicare and Medicaid could fund a Single-payer system. We wouldn’t need Medicare, Medicaid, the VA, or any other program funded from the Dept. of Health and Human Services. Need medical service? Go to the Doctor. Whomever you are, where ever you are.
Again, it’s my own little Utopian dream. One which would surely be destroyed by the insurance industry lobbying congressional representatives with all sorts of fear mongering propaganda. Like, “Canada is scary. People have to wait for services.” I have noticed that sometimes there seems to be no better way to scare Americans than to mention a foreign country.
Our system sucks and I’m not sure the ACA will make it any better, but it’s damn sure worth a try. Like Steve said, there really is no excuse for everyone in this country to not have access to healthcare. Despite the website failures and false statements by the POTUS, it doesn’t justify any one not having healthcare in this country.
Dennis C is on the right track.
The current rhetoric from the anti-ACA folks has no plan to lower costs or increase access.
Previously, “free market” health care advocates have mostly had their way for the last 20 years and what did we get? Decreased availability, increased costs, increased complexity, and for total rhetorical excess, Death Panels buried inside insurance companies.
All the way around, conservative/free market advocates utterly failed to address the issue.
And yet the anti-ACA knuckleheads demand that one of the highest cost health care system in the world with the least access is somehow the better choice.
Please stop kicking yourself in the nuts long enough to see the error of your ways. It’s costing me a fortune every year.
the costs are messed up BECAUSE of the govt interference.
Okay, stop and think about this for a minute. Because of “government interference” you can get your car repaired with relatively simplicity and cost confidence.
there needs to be a link to personal responsibility.
This is nonsense. Am I quantizing my level of “personal responsibility” with insurance fees? Is this like the greens fee contest golfers play to rank fellow players? I pay for optical insurance, do you?
Hospitals are exempt from anti-trust laws because THEY CANNOT BE RUN AT A PROFIT Yet, somehow, you will wave a magic wand and make them profitable when there isn’t enough population density in 80% of the U.S. for it to ever work.
You really, really don’t understand the nonsense you’ve chosen to believe and defend. Not even a little.
Have you had any car body repair work done? If so they give you an estimate on what they can see as far as visible damage but once they start taking this apart they may find something else that was broke in the crash.
This is a fundamentally broken analogy. Why? Because medical intervention is not 100% effective in all cases as Steve’s shoulder. Car repairs on the other hand are.
I’d like to add you are going to a bad mechanic if they are grinding you for “hidden damage.” Cars aren’t that complicated.
Good post. Lots of good points to think about. I think we all agree something needs to be done but the nuts and bolts are where the problems are. Health Insurance companies typically operate at a 4-5% margin, what incentive to they have to control cost when the margin across a greater amount results in a greater profit amount.
After trying to price hernia surgery at our local non-profit hospital, the Sisters of Perpetual Billing, I flew to Oklahoma City and had the procedure done at the Surgery Center of Oklahoma. All costs for the procedures they do are labeled in advance. My all in cash costs, including travel, were lower than what my share of “insured” costs would have been ($1,000 deductible and 20% copay). Pricing can be done in advance.
http://www.surgerycenterok.com
“Hospitals are exempt from anti-trust laws because THEY CANNOT BE RUN AT A PROFIT ”
You are incorrect.
http://www.beckershospitalreview.com/lists/13-largest-for-profit-hospital-operators.html
Even the US DOJ thinks the antitrust exemption should be ended:
http://www.justice.gov/atr/public/comments/271584.htm
The ACA is an 11,000 page document that people had no idea what was in it. A lot of positives were touted and come to find out they were not true.
I know for me I have okay health insurance but it seems my monthly premiums will double and my coverage will go down. How is that right. I can’t handle the increase in cost but make to much for the vouchers. So what am I to do? The ACA is not the answer for the typical middle class. It puts more taxes on the middle class that already is taxed heavy. Slam me if you want you can’t argue with the facts of my circumstances.
Steve I agree something needs to change. But for me the ACA will not work. A bunch of people will get free or reduced rates for health care. But it still has to be paid for by someone. That someone is the middle class. If the ACA is so great why did the people in charge pass laws to opt then out of the ACA?
I for one do not want to pay for health coverage for for drug dealers, sex offenders, or derelicts that do not contribute to or society. However we should help the truly needy, elderly, handicapped, Vets, or those that fall on hard times at no fault of there own.
I am very fortunate to live a decent life. But I made choices in my life that got me here. I paid my own way and supported my family myself.
For those that think I am a jerk that’s fine because you have no idea what I have done or what I have done for others. Or what I have done to provide a good life for my family.
Those that are responsible for it are exempt from it. Why? If it is so great I think they would want it. Obama coined the term Obomacare. He stoned using it after it blew up in his face.
OK boys, some food for thought: You are right, our current health care system does not do a good job…not as good as some other places. However, there are a few blips with ours i bet a lot of you have not thought about: As a Doctor, i send people all the time to get expensive test they really don’t need. If they are paying the extra $2,000 out of pocket or if there insurance co is paying it, irrelevant to my point. We are then paying for waste one way or the other. Why you might ask would i be sending people purposely off to waste money? Cuz i have to or risk loosing my license and getting sued out the ying-yang. Because of all the ambulance chasing, greedy souls about, politically correct nonsense…my hands are tied. In the olden medical days, if you went to your doctor and described system that would only have a .05% chance of having a tumor, he told you to go home and let him know if this or this occurs. Now days, you get sent off for $10K worth of scans and test. Why??? Because if you are the one in a million who does have the tumor and the Doc did not tell you to go get the test/scans…….you can now sue him for his pants and his bikes. results: tons of unnecessary tests being done everyday.
Second note: for all you who question just why some of us question Obama: I have found there are two basic indicators to reality: 1. History. If Bob has always shown late to the ride….I am not surprised he is late today. 2. Common sense. If I jump off of a tall building onto concert…will mostly likely break up my legs.
History: come on folks facts are facts. Historically the government does a piss poor job of running anything. How does UPS and Fed-x come along later to the game and beat the pants off of the postal system. Why is the government putting in millions of prop up money into postal annually and they still cant’ compete. We don’t even want to get into the waste and fraud in Medicare and SS. How come every year we see all the statistics on most all of the government programs that somehow “lost” x millions again this year? “Hey Bob, you know what happened to this 10 million this year?….Nope, but since we don’t have accountability necessity to our job…..I guess it don’t matter anyway, pass the Ketchup.”
So just what is the History and common sense flags suggest about Obama and his program:
1. If I have to race Steve on a 40 lb. Huffy from 1966, just tell me this ahead of time. Don’t repeatedly tell me you are letting me ride my Scott rocket when you know dam good and well you are lying.
A lot of you pointed out to some of us who did not trust Obama and gang. Why, why would we “flinch” when told about obama care?? Don’t we want a better system…are we just haters?? History/Common sense: “So, he is going to get MORE people covered, with BETTER coverage, and it will cost us all LESS. keep Doc…Keep current plan….period” 1. History: Politicians lie. Some lie more than others. Sorry to offend but, Obama has a history of proven lying (don’t’ shoot the messenger). 2. Common sense: “Hey wait a minute, how are we going to feed 20% more people at McDonalds today, order a larger burger for each than previously, and yet it is going to cost me less???
If I question you on such things and you then prove me wrong….you are correct, i will eat my crow and apologize. However, we all now now, us unbelievers had good reason for unbelieving. So then you have Mr. Harry Reed explain the situation this way: “OK, so we had to fib a bit. If we did not, we would have never got it passed.” As the vote was so close, i am sure you are correct Mr. Reed it would have not passed. Hmmm, I think i will try this method on some of you and see if it works: “Charlie, you told me this bike weighed 15 lbs, full red components, and has a rock for a BB. It weighs 24 lbs, has a cheap low end groupo on it, and I am bending the frame all over the place when I crank at all.” “Well, ya boys, I knew that before i sold it to ya. But, if i had told you that, You would not have bought the bike from me would ya?”
Does our Health system need a new Bottom Bracket…Oh ya. Does history and common sense suggest Obama and gang will get it done right…….Yikes!!
Good piece Steve.
Several things:
– Medical expenses are the number one cause of personal bankruptcies in the US. Even people who make good money can go bankrupt this way if they get a very serious illness
– US medical expenses are among the highest in the developed world, with low performance
– ACA is a big improvement – many people who are currently buying insurance directly find lower prices.
– ACA is nowhere near enough – the lower price plans have big deductibles. Single payer, as is the case in many countries, is clearly cheaper overall, but the healthcare industry nd the people that work for them (Republicans in particular, but also leading national Democrats such as President Obama) have taken that off the table in our national debate.
– The Obama administration has been guilty of happy talk and misleading optimism about how good the ACA is, but it is undoubtedly a good thing – big improvement. Maybe not a great thing, but good. Obama’s “lies” have helped get something good to happen.
In contrast, national and state-level Republican leaders have been guilty of huge amounts of lies – lies that are going to result in more people going bankrupt, being permanently disabled due to not getting care, and in some cases even dying. Huge difference there.
Also people like SB here are talking total nonsense. More universal health care such as in many many other countries reduces total costs – it doesn’t raise it. His claims about “responsibility” are BS not born out by the facts. And greater government involvement in health care generally lowers costs.
Here is some info on costs in the US compared to other part of the world
http://www.washingtonpost.com/blogs/wonkblog/wp/2013/03/26/21-graphs-that-show-americas-health-care-prices-are-ludicrous/
http://www.pbs.org/newshour/rundown/2012/10/health-costs-how-the-us-compares-with-other-countries.html
“Health Insurance companies typically operate at a 4-5% margin”
Get rid of them. Or at least, make them an optional part of getting health care. Have the government fund health care directly. If someone want to buy insurance in addition to the good care provided by the single payer, they can, but having health insurance should not be a vital part of getting health care.
That will free up that money mentioned above, plus the huge amount of waste in our systems due to different entities fighting over who should pay.
Single payer systems (with the government paying) work great at lowering overall costs as has been demonstrated all over the world.
The big question is, what were all of you doing riding in the middle of the work day? I must be doing it wrong
Phrasing –
Healthcare – Everyone has it for free
Health Insurance – I think this is what you are referring
Careful with these two words, Its like calling the ‘abortion’ thing ‘women’s healthcare!’
They are both two VERY different things.
Well written piece. USA needs to offer emergency care to their citizens and visitors. Many countries around the world offer free care! About the pricing of MRI /cat scans etc, USA seems to be over-priced for sure; even $395 for an MRI as the cheapest one is still expensive. I had an MRI done on my shoulder after dislocating it at the Mongolia Bike Challenge as it was not healing up. I got this done in a Chinese hospital and they use the same equipment the American hospitals use, the price was 500 RMB, about $80 USD for my two MRI scans of every possible angle.
Good post, Steve. My wife and I pay 1250 bucks a month for a plan with a 2000 dollar deductable. Will we benefit from the new healthcare law? Well,we will be able to get the same plan but the new monthly fee is 1325 dollars. Yes,when compared 1250 to 1325 is not that much more UNTIL you have it drawn from your bank account. The key to all this you summarized well: who knows why it costs so much?
Spinner
Businesses have paid staff to negotiate these systems; they’re called HR departments. Expecting each individual to understand the nuances of various coverage and/or the plans they are applying for is ridiculous expectation. Kind of like 401(K)’s – a vast majority of people, including me, have no idea what their money is actually invested in or if it’s invested in the best possible way. I just know it’s invested.
Healthcare should be like education- something that’s available to everyone on (relatively) equal footing that we all pay for because it’s for the common good. If people don’t like whats’ funded by the public, then they can choose to by their own private coverage- like people do with private schools.
President Obama did not “coin” this phrase. It came about before he was president. Per the Atlantic magazine:
“The Atlantic has done some digging and now reports that it’s found the answer. In March 2007, lobbyist Jeanne Schulte Scott, in her analysis of the 2008 presidential campaign, wrote this in the trade magazine Healthcare Financial Management:
The many would-be candidates for president in 2008 are falling over themselves offering their own proposals. We will soon see a “Giuliani-care” and “Obama-care” to go along with “McCain-care,” “Edwards-care,” and a totally revamped and remodeled “Hillary-care” from the 1990s.”
I’m a veterinarian. We use many of the same drugs, equipment, and techniques as do human doctors do but at a fraction of the cost. Of course sitting in a cage after ACL surgery is nothing like the expense of a hospital stay, but the technology, training and expertise of the procedure is. We can spay a dog for several hundred dollars and it really is the same procedure as a hysterectomy which would cost tens of thousands. I think one of the big reasons that our costs are lower is that without insurance and a deductible, the true cost is apparent to the client at the time of service. For every sick patient I have, I have to justify each test/ or procedure and quaote the owner the cost before we do it like a car mechanic would. We don’t even give a rabies vaccine without going over the cost first with the owner. This makes the client a smarter shopper and natural competition with the practice down the street keeps costs as low as the market (and the business) will bear. And like Steve’s vet in Kansas, I don’t know a vet that don’t do some pro bono work for clients that can’t afford it.
The other big issue is legal. OBGYNs for example I’ve heard pay hundreds of thousands for their mal practice insurance, mine is $600/year. Drs often find themselves in the trap of running unnecessary tests because they’re worried about getting sued which of course drives up costs. Surely our current legal system has a big affect on all this. Nobody wants to talk about tort reform, but surley that’s a big part of the answer.
Most first world countries have some sort of government sanctioned universal health care system. The U.S. is behind the curve relative to most of the rest of the advanced countries of the world. The ACA is a step in the right direction. We currently subsidize “free health care” now by paying extra for hospital bills to cover the costs the hospital must incur to treat the uninsured. Going to the emergency room for every possible ailment doesn’t make sense, just so you can get treated when you are uninsured. The tradition of getting your health insurance through your employer has only been around since perhaps about WWII. It’s not really a system that works all that well, especially for unemployed, part-timers and those whose employers opt out of providing it. Besides, why should employers have to have that responsiblity? People should be able to get health insurance through the goverment or at least through the private market at a competitive rate. And, I don’t think the private market will provide reasonable rates unless there is government regulation. Current health care costs are outrageously billed. At least with things like Medicare, the reimbursement rates are set at a fairly low level (maybe too low), but the government enforced system keeps costs reasonable. But, people can get charged vastly different sums for the same treatment depending on who you are — Medicaid or Medicare recipient, other health insurance or uninsured. How about a little compassion for those folks who need the care but cannot afford it? As I said before, we already, in part, pay for that now in the context of hospital bills for which we pay an extra fee to cover all the uninsured treatment hospitals must provide. I’m not a great believing in the old Adam Smith adage about the “invisible hand” of the free market to solve the health insurance based on market necessity.
Evidently the $42,000 for your operation was produced by magic instead of being extorted from taxpayers with the threat of incarceration. By the way, the PPAC was passed on a strictly party-line vote, it’s a completely Democrat invention. What’s up with the insurance obsession anyway? How about enabling the free market to supply medical care in a competitive environment? If a patient wasn’t paying $5 for a tongue depressor he might not need insurance.
“I don’t think the private market will provide reasonable rates unless there is government regulation. ”
Well, that settles it, let’s have government regulation.
“As a Doctor, i send people all the time to get expensive test they really don’t need. If they are paying the extra $2,000 out of pocket or if there insurance co is paying it, irrelevant to my point. ” How many people would want to be treated by this guy ?
Funny how he stopped using the phrase after it blew up in his face. But why should he care none of them have to sign up for Obamacare. That’s the Elite Class for you.
I would let him treat me anytime! Charlie is a doctor so he has a bit more insight to these things. I have a few doctor friends and we have been talking a lot about Obamacare on rides this year. It is very insightful. I think the doctors should be able to make a good living and the insurance companies should make a lot less. After all it’s the doctor that could save your life, and spent hundreds of thousands of dollars to become a doctor. Not to mention the amount of years it took to become a doctor.
“You really, really don’t understand the nonsense you’ve chosen to believe and defend. Not even a little. ”
I suggest your last statement applies to your beliefs on this topic.
I agree that doctors should be compensated well. I just don’t want top go to a doctor who will send me for thousands of dollars of unnecessary tests just to cover his ass. Sorry, I like to deal with ethical people especially when my health and life are at stake.
Very few people actually shop for medical services, largely because about 80% of them have
insurance that largely dictates where they will be treated and what they will pay. Anytime you
separate the buyer from the seller this way, prices will go up unreasonably.
Tilford mentions getting an MRI for a fifth what the local people wanted, simply by going to the
trouble to shop- on the Internet of all places. ONE FIFTH.
I had a similar experience with a hernia repair. I got it for half what the locals charge by going
to a small hospital in a rural area.
I have gone bare most of my adult life despite bike and skate racing. Been fairly fortunate.
Odds caught up with me a few years ago when I ignored warning signs and had a kidney-stone
experience. Cost me seven thou for pain meds, anti-nausea drug, quick MRI and the advice
“drink more water”
With this personal reminder about how fast you can run up a big bill, I went for the ACA a couple
weeks ago. I don’t make alot of money, and the ACA offered to pay about 80% of a high-
deductable plan (in tax credits), which brought my premium to just under a hundred a month.
Worth the peace of mind at that price.
Swell. BUT, if there are twenty million people like me who sign up, that’s another hundred
billion a year… that the Federal Government already doesn’t have. AND we perpetuate
the above-mentioned disconnect of the buyer from the seller of medical service.
I bought, but I don’t think it’s a good plan. Hope for the best…
All this reminds me of an article in the Onion about a man with a 5% understanding of the ACA, arguing with a man with a 7% understanding of the ACA.
I’m one of those lucky people who has crazy good insurance from work. In the last 7 years, my wife has incurred over $400,000 in medical bills. I’ve paid less that $1000 out of pocket.
As for the ACA, you can look at it from different viewpoints.
From the Left, you could claim that Americans deserve to have universal healthcare, and it’s the “Right” thing to do.
From the Right, some could say….”Make those deadbeats buy insurance, so that I don’t get stuck with those bills that they can’t pay, dammit.”
It’s about time for America to start looking after Americans.
.
.
My takeaway from this whole thread is that it is nearly impossible to have a debate if both sides can’t agree on the basic issue at hand. There are so many facts, partial facts, and misunderstandings produced from both sides that even intelligent people fail to find any common ground. As a result, this debate will not be solved anytime soon…
SB, I 100% agree with you about the (maybe) 40% pays for everyone else. However here is the question: So, now with Obama Care, everyone is supposed to have insurance. Which should bring the insurance paying people to way over 90% right ?
Here is the question: If Obama Care makes the insurance paying group to over 90%, why is insurance still so expensive ? If, 40% paid for everyone else, that makes sense, but since we are changing that ratio to over 90% … What’s going on with insurance cost ?
Many will agree there is something majorly wrong with heath care cost in the USA. How can an MRI cost $2000 in one place, and the same machine few miles away do same service for $500 ? There is something very very wrong.
Bill K,
Perfectly worded. I think the most annoying thing about the debate is people not being upfront with their positions. If you are a liberal, be honest and explain that you don’t mind a little socialism and sharing the cost of healthcare for those who can’t afford it. If you are conservative, be equally honest and explain that you don’t think it’s fair to have higher premiums to cover the cost of those who decide not to buy insurance or don’t have a job. Each side clouds their position rather than being upfront about their position because they don’t want people to know the actual reason for their position. This may be one of the issues with a politically correct world where we try to disguise our true beliefs by claiming the other side is an idiot for their last sound bite.
Beth said:
“My takeaway from this whole thread is that it is nearly impossible to have a debate if both sides can’t agree on the basic issue at hand.”
There is one thing which all sides can agree on, but how come and why Democrats and Republicans did nothing about medical cost ? Why an X-ray or MRI will cost so much ? Why Hospitals call themselves non-profit when every service is so expensive ?
How come health care cost in Canada is way less ? If, so why can’t the US copy their system ?
I’m no expert, but we all agree heath cost in US is way out of hand, way too expensive and unfair. I feel there is a lot of corruption, Lobbying, power, money and politics ahead of public interest. I wish people in the US would get together and send a real message to Republicans and Democrats that the people won’t take any more BS from these Non-for-profit Hospitals charging $2000.00 for an MRI.
Let’s look at the pre-Obama Care health care landscape:
Medicare: works fairly well – government run – could be funded better
VA – works fairly well – government run
Medicaid – terribly underfunded (its for poor people after all) – government run
Group Insurance offered by large corporations – works well and privately run – BUT heavy government regulation and tax subsidized
Individual insurance – a dysfunctional mess that left 40 million uncovered and included many ‘cheap’ policies run by flim flam operations that rescind the coverage for anyone who racks up claims.
Great post. Many people in their 20’s can ‘skate’ for a few years without health insurance and get away with it and are lucky (and avoid pregnancy if female). Competitive cyclists aren’t among those who can really afford to ‘skate’ – even if 25 and healthy. Obamacare is aimed at fixing the dysfunctional mess that was once called the individual insurance market place. I personally have good private insurance but that is because I work for a large corporation and this sort of group insurance is (and always has been) heavily regulated by the government and tax subsidized.
Guess it is my GOOD Fortune that i have lived in Australia , England & Austria and am still a very active 68yo , using the bike daily .
Each of these countries has the Public Health system , paid out of General Taxation . In Australia i chose to pay for ” Top Cover Personal Insurance ” , just about never used , but would have given private room if required . Guess i got more rebate on my Dental bills and choice of Dentist . England saw me pay National Insurance Premiums at Salary source , went towards Health & Pension provisions at a guess . There was also Private Health Plans available that i could have chosen to pay hefty premiums to ensure Private Facilities and going to the head of the queue for Specialists7Consultants .
Most of the time in Austria , when not employed i had to pay Eu90 pm and this covered half Dental , Hospital except Eu10pd and Eu5 per prescription , so my life has been fairly secure throughout .
Whilst visiting in Italy , my host told me of his Brother’s visit from Canada that cost Eu50k for a Heart Attack , he had forgotten he was no longer a EU Citizen . That reminded me to make sure that my Austrian cover was always in place .
During ALL of my life , i have come across people that , THROUGH NO FAULT of their OWN , or their family , have arrived in Hospital as a result of accident or sickness . Normal people who would prefer NOT TO USE the Health Facilities required .
In each of these countries the Health professionals have a Good Income , they have World Standard Qualifications but i doubt the bulk of them would be getting excessive incomes ?
Couple of quotes that i saw in earlier comments :
” Healthcare should be like education- something that’s available to everyone on (relatively) equal footing that we all pay for because it’s for the common good. If people don’t like whats’ funded by the public, then they can choose to by their own private coverage- like people do with private schools.”
” Nobody wants to talk about tort reform, but surley that’s a big part of the answer.”
” Most first world countries have some sort of government sanctioned universal health care system. The U.S. is behind the curve relative to most of the rest of the advanced countries of the world. The ACA is a step in the right direction
In the USA , the wheel is BROKEN ! There is NO WILL TO ATTEMPT to fix the system ! Lobbists seem to have the ability to thwart whatever the President or Congress propose ?
Watching the TV Show ” House of Cards ” , tells me ALL i want to know about how crazy the US way of doing business has become !
Those visiting the good ole USA , make sure that your TRAVEL Insurances are GOOD for $US10M , as YOU will be the TARGET of ” Health Professionals ” , as pointed out by an earlier commenter , with his $US2k battery of tests !
Today being the 1st Ann. of Newtown , it is clear that the US Government has more problems that needs FIXING than the Current Admin. has the Courage OR Ability to fix !
“There are so many facts, partial facts, and misunderstandings produced from both sides”
Can you give an example of the misunderstandings from those of us who say that single-payer health care produces good results for less money. Or misunderstandings about saying ACA is going provide people with health insurance that don’t otherwise have it.
The problem with comments like yours, that try to blame “both sides” is that one side is actually working to keep people from getting health care, for political reasons and also due to the interests of their donors. The other side is not perfect, but is not lying to the same extent, is actually trying to help people get health care. And has actually compromised a ton in ideology – the ACA is based on ideas that came out the conservative Heritage Foundation and put into practice by a Republican governor. The anti-ACA crowd is a bunch of liars and frauds.
Actually, that is not the case. The exchanges bring transparency to pricing and to coverage. Minimum standards are set. People can’t be denied due to a pre-ex condition. How is that more complicated? Once the transition is made over the next couple of years, there won’t be any noise. Go back and read about the beginning of Medicare, because you’ll read the same kind of nonsense the GOP is pumping out every day without an alternative.
The hospital statement may be incorrect, but the rest is spot on. Every time I here the phrase “personal responsibility,” it makes me ill. Did you read Steve’s story? The guy bashed his head against the concrete and won’t go to the hospital because of the cost? What kind of fked up morality thinks that’s a good decision? The lack of compassion and care about fellow human beings expressed by some people in this forum and elsewhere is just depressing.
We all can agree it’s a very complex problem. The problem comes down to one thing.. How much money anyone have to pay for health care !!
This is from the NY Times site, which explains a lot of what is going on.
“The arsenal of medicines in the Hayeses’ kitchen helps explain why. Pulmicort, a steroid inhaler, generally retails for over $175 in the United States, while pharmacists in Britain buy the identical product for about $20 and dispense it free of charge to asthma patients. Albuterol, one of the oldest asthma medicines, typically costs $50 to $100 per inhaler in the United States, but it was less than $15 a decade ago, before it was repatented. ”
What makes my head spin is, why REPUBLICANS and DEMOCRATS can’t fix this issue where the heath industry is all about making the most it can. To me it sounds a lot like a lot of corruption, lobbying and dirty politics. The heath care industry ( drug companies and heath insurance ) are out there to make money. We the people are getting screwed and the Gov. have done NOTHING to fix a broken corrupt system where money is king.
Why can’t we the people have fair prices like in UK, Canada or Mexico ? Don’t we pay already enough taxes ? — To me Obama Care was a big broken promise.
Mr. Dennis C. “How many people would want to be treated by this guy ? “
Ahh Dennis you do indeed have a problem then Chief. As you will find (just go ask your Doc about what I just told you) all the Medical providers in this old USA are stuck in my same boat. Dennis, don’t go acing like a politician on me here. You took part of my phrase stating how I know I order test for people I really don’t think they need (waste) and then forgot to mention the explanation for same I gave. My whole point of what I was trying to point out was: Yes, it is indeed very wasteful. Yes it is indeed a shame all these procedures/test/etc are wasting money and such. The point you failed to grasp was: This is not done because the Docs in this country are stupid. It is your government that has made the rules here, not your Doctor.
Great piece. The system is broken, plain and simple. People suffer, and it’s not right.
Available, affordable, high-quality health care is a human right. We have failed at that in this country.
There is not any one villain — providers, hospitals, for-profits, non-profits, insurers, Big Pharma, government, employers, individuals … The system is broken.
The ACA will extend coverage to many, but having insurance is only one part of the problem.
The lack of transparency in the system, we think, is one place where change can happen. If people had an idea that the system allows providers and insurers to charge and pay as little as $395 for a common procedure like an MRI or as much as $6,000, they’d be shocked.
We’ve been working to make change happen at our small NYC startup, http://clearhealthcosts.com/ ,where we’re revealing cash or self-pay prices for common procedures.
That’s one reform that hasn’t yet been tried; putting real, actionable information into the hands of people so they can have some control over billing/charges, and a clearer understanding of the random nature of pricing.
JT Way to try and stay Mature, unbiased, contructive, and Honest
. “The anti-ACA crowd is a bunch of liars and frauds.” .
I am Ian’s Dad. First, thank you all for being there for Ian!!! He is an outstanding person and I think more than just his Father would say this.
Steve I agree with your post. Get along and lets get moving in the right direction.
I would add that let’s fix what is broken and not fix the things that do work well otherwise we are wasting attention in the wrong areas. We can do this. We as a society have an obligation to help each other out. Period.
I am one of those people whose insurance was cancelled do to the ACA(I just got an extension however for 11 month or there about). And I loved my health care plan. I was told that I can sign up for a comparable plan that costs me about $50 more each month but my deductible goes from $2500 a year to $6300 a year. Not a good deal by any comparison. After taking it to a high level with BCBS they in a nut shell told me that I was too healthy for a 49 year old male to be able to keep the premiums that I was used to paying. Rates were being equalized. My View……..There are many benefits to taking care of your health during your life on Earth but I do not like that the incentives to do so through health care premiums is no longer offered for the ACA. The people that have made good choices in life should not have to pay for other peoples poor choices. Items like genetics and non controllable forces should be dealt with as a society. Health/Life choices should be expensed out by the people making those choices.
Thanks again for being there for Ian.
Please tell me this is performance art.
Noticeably missing from your post: substantive criticism of the law and a serious proposal for an alternative that works at least as well.
I also don’t get the argument that if health care is “free” it would be abused on any significant scale. You don’t get an immediate reward from a preventative care office visit. It is in fact an inconvenience, and sometimes quite literally a pain in the ass. People – normal people – do not want to visit the emergency room for treatment. people – normal people – do not want to go under the knife for frivolous reasons. If anything, this unpleasantness and immediate pain, combined with financial pain, would result in pretty substantial under-utilization, and you can see exactly that in measures of health and longevity for this country versus First World countries.