“Consumer-driven” health care no better than “consumer-driven” fire dept.

[maryf]

http://www.socialmedicine.org/2010/10/06/us-health-care/from-consumer-driven-health-care-to-consumer-driven-fire-department/

From “consumer-driven” health care to “consumer-driven” fire department.

October 6th, 2010 by Claudia Chaufan

While “consumer-driven fire department” sounds decidedly weird, for some reason some have been brainwashed to believe that “consumer-driven health care” makes sense. But it does not. It makes no more sense to let people’s house burn down because they cannot pay their fire-department fees — maybe they chose the wrong “plan”? or a plan with a deductible they cannot afford? – than to let them die because they cannot afford their health care.

Now, why the new federal law, the Patient Protection and Affordable Care Act P-PACA), will fail to keep its two key promises (protecting patients and making health care affordable), is not the topic of this posting, because I and many others have commented on it extensively elsewhere.

Rather, it is to point out that if we continue turning health care more and and more into a “consumer good” that those who have the ear (and pockets) of Congress and the White House can make a profit off of (and P-PACA reinforces the trend ), we are up to extremely unpleasant experiences.

<snip>

As Dr. Bill Skeen, executive direction of Physicians for a National Health Program-California, wrote:

Sadly, those of us who believe healthcare is a right know that this country has never assumed the mantle of providing healthcare to all its residents. Currently we leave 50 million of our brothers and sisters uninsured; 45,000 of them die each year because of it. It is time for us to stand up and demand that our nation return to the real American values of empathy and compassion and caring about our neighbors’ wellbeing.

Last night we as a nation let a family’s house burn to the ground while those who could save it watched and did nothing. Everyday we let more than a hundred people die who have no health insurance. Are we willing to standby and do nothing to stop it?

(the new healthcare bill will only take care of less than half these people, by the way! maryf) also at pnhp.org

[Cant trust em]

1. This is what happens when policy is dominated by economic/market based thinking. nt

[maryf]

2. In other words: profit before people...

capitalism is killing too many...

[aquart]

3. Because the free market regulates by death.

It has no other way to brake or change course.

[MrsCorleone]

25. What is so tragic is that even those with health insurance are tragically harmed by a for profit

healthcare system.

Little known site that summarizes our twisted "healthcare" system.
http://www.patient-safety.com/index.html

Speaking from personal experience, healthcare in this country is sick, disturbingly so. The root of this rot is money.

[maryf]

35. "The root of this rot is money." right on

and the best way to get at the root rot is with grassroots...thanks for the link, sharing. Profit in any aspect of health care, outside vanity surgery maybe, is wrong, wrong, wrong.

[stray cat]

4. So everyone should be required to be insured -no opting out of a mandate

If you allow opting out you get the same situation as the firefighters

[TBF]

5. Agreed, and the way we do that is medicare for all. nt

[maryf]

7. but stray cat is implying

that everyone should be following the mandate to buy health care from private insurers ...unlike Medicare for all...

[TBF]

26. I know - and Stray Cat is wrong about the private insurers.

We do need coverage for all, but it's got to be medicare. It is the only humane choice.

[maryf]

29. absolutely!!!

I knew where your mind and heart were on this, so sorry everybody's aren't...Everybody in, Nobody out!! :fistbump:

[bobbolink]

42. The list of errors would be too long to post.

:evilgrin:

[maryf]

48. are you being

naughty again? :hi:

[maryf]

6. So you are saying everyone should be paying for the firefighters

and if they don't, they'll let the house burn down, or let them go without health care, or pay a fine....the true parallel is fire protection for all, health care for all as in Medicare for all, hr. 676

[BzaDem]

14. Except the problem with HR 676 is that it wouldn't get 10 votes in the Senate.

Just because you can talk ad nausium about something doesn't mean it will ever happen, or has any chance of happening. I would have thought that were obvious before the whole healthcare debate, which was why I was surprised to find so many deluded people talking as if single payer were a possibility.

[maryf]

17. And people will still talk as if it were a possiblity,

because when the realities of the health insurance profit mongering plans are plain, millions more will be calling for human needs to be met, for the deaths directly attributable to lack of health to be stopped! Don't lie down and take it! Fight for what you know is right, and don't give up the courage of your convictions! The Senate are supposed to represent the people's wishes, not the corporations, make them!

[BzaDem]

18. 80-90% of the people are satisfied with the healthcare they receive.

The whole

"when the realities of health insurance profit mongering plans"

argument has been argued incessantly for a hundred years, yet we still have 80-90% of the country satisfied with their healthcare. Until that number changes, you are spinning your wheels. There is a large difference between what one wants, and what one is going to get. Most people learn this difference as a general matter (or at least the potential for this difference) at the age of five. Comparing PPACA to a magical plan that would never get enacted is not productive.

[TBF]

27. Any link for that claim? nt

[maryf]

34. What about the 50 million without any, I guess they are happy?

I guess that's the 10 to 20 not happy?? 5 people die every hour directly related to not being able to get the necessary health care, MAYBE down to 3 an hour with your plan. Can you be happy with that?? People die from abscessed teeth because they don't have coverage? Are you happy about that?? Your plan will cover some, but not all, with Medicare for All, Everybody is in, Nobody out. I can't be happy until everybody gets health care. It's not only a human right but a human need...

Article 25 of the Universal Declaration of Human Rights (hey, we signed onto this!).

* (1) Everyone has the right to a standard of living adequate for the health and well-being of himself and of his family, including food, clothing, housing and medical care and necessary social services, and the right to security in the event of unemployment, sickness, disability, widowhood, old age or other lack of livelihood in circumstances beyond his control.
* (2) Motherhood and childhood are entitled to special care and assistance. All children, whether born in or out of wedlock, shall enjoy the same social protection.

[CTyankee]

37. That figure might have been a bit more realistic years ago but today, with our growing

umemployment, I doubt it. Layoffs have resulted in thousands and thousands of people without health insurance and no eligible for Medicare. Even the employed have seen their once "wonderful" health care rise in costs even as pay increases are nonexistent.

I think it is more accurate to say that people are afraid that any changes would leave them worse than they previously were, so they cling to what they have. Fear of the unknown can be very potent.

What needs to be done is to re-educate the American public about how univeral health care works to the benefit of all people in every other industrialized nation on the planet. The right wing has done a good job at brainwashing America that socialized medicine is some kind of horror. When average Americans find out the truth, they start asking questions about why we don't have that kind of health care...it's a start...

[maryf]

45. a good start, thanks!

:)

[bluethruandthru]

55. I would imagine that's because either they haven't really had to test their insurance coverage or

they don't know that it's possible to have something better.

[eridani]

22. It was passed 3 times in CA. In PA, 40% of state legislators

--who support single payer are Republicans. In the Vermont primary, gubernatorial candidates argued over who supported single payer the most. No, on a national level it won't happen any time soon, but let a couple of states implement it successfully, and dominoes will fall.

[BzaDem]

24. I'm not sure how successful it will be if only a few states do it.

Single payer will impose much lower prices on hospitals and other providers. This provides a HUGE incentive for them to just get up and leave the state, and go to other states where they can earn much more.

But even if it could possibly be passed by both state houses, signed into law, and then successfully implemented within a few states and avoiding the above problem (a huge if), I don't think that means it becomes politically feasible to enact it nationally. You run into basically the same political problems we have today -- most people being very satisfied with what they have, scared by any hint of change, and a Republican party that realizes that single payer would essentially end the purpose of its existence.

The status quo is so entrenched that you will need a HUGE majority that bases their vote SOLELY on single payer to get anyone in the Senate to vote for it. And that is unlikely. It is probably more likely that anti-single-payer candidates will win en masse than pro-single-payer candidates.

[maryf]

30. Not sure why you fight what's right?

If everybody was in on this, we'd be able to move all the houses in all the states, and DC as well...the grass roots hold the ground on which they are all built...if all the grass roots withdraw their support the houses will fall....

[Dragonfli]

43. That is how it happened in Canada, but it couldn't possibly work, so

Canada is one big illusion or work of fiction I guess.

[eridani]

51. When Saskatchewan implemented single payer, provider incomes went UP by 30%

That was because of a lot of postponed care. Also, overhead went down dramatically, and providers generally care more about their net than their gross. The other provinces fell into line because they saw how it worked and wanted some of that good stuff.

Here is would be necessary to impose very strict residential requirements, so that potential in-movers would get motivated to get the same thing in their states.

[leftstreet]

8. Capitalism's death throes: they're down to helping some of us die off

anything to scrape the last pennies from our pockets before we impale Capitalism's head on a stick

K&R

[maryf]

9. and then the pennies will do no good!

:fistbump:

[leftstreet]

10. hehe The RDA for Copper is like 2 mg. Let them choke on 'em!

:fistbump:

[maryf]

11. and copper's a natural contraceptive!!

aahhh, the end of the family dynasties! :D

[leftstreet]

12. LOLOL!!

:spray: :rofl:

[maryf]

32. good morning!

glad to have made you laugh, and me again now! :D

[BzaDem]

13. I think you made an error. PPACA does not entrench "consumer-driven" healthcare.

PPACA limits exchange insurance policies to approximately 4, that cover basically everything (with different deductibles/cost-sharing depending on which of the 4).

Consumer-driven health care is where you are given x thousand dollars and have to pay everything out of pocket (up to a certain amount like 5 or 10 thousand per person, after which catastrophic care covers it). It involves health savings accounts and catastrophic plans for everyone (like in Singapore). This is a Republican idea, but it is the exact opposite of what was enacted in the PPACA.

[maryf]

15. Any health care plan that has people buying their plans from for profit

insurance companies sure as heck fits under my definition of consumer driven healthcare ...

We are the only country in the industrialized world that does not provide for a not for profit health care system for it's people, (except for Medicare for the disabled and elderly and the VA for our vets.)

And with Medicare for all there are no deductibles, no co-pays, full dental, full vision...PPACA compares pretty poorly to that and costs a lot more and won't cover everyone, in fact millions won't be covered and millions will pay a fine as it will be cheaper...

[BzaDem]

16. The problem is that you are comparing PPACA to Single Payer, which assumes that the latter actually

has a chance of ever happening in our lifetimes. If you correct for this error, and instead compare PPACA to the previous status quo, it starts to look much better.

"Any health care plan that has people buying their plans from for profit insurance companies sure as heck fits under my definition of consumer driven healthcare"

That just means your definition is wrong. It doesn't mean that PPACA has anything to do with "consumer-driven" healthcare.

[maryf]

19. Nope, considering how the insurance rates are exponentially rising...

more and more people will opt to pay the fine when it comes to that so, except for supposed pre-existing condition codicils (and I read something recently that spoke to that and how the deceitful insurance industries are trying to beat that too), it's not much better at all...PPACA is based on for profit insurance being bought, how you can try to spin that to not be consumer driven is beyond me...(consumers are buyers by the way)

[BzaDem]

20. Insurance rates may exponentially rise, but that means the subsidies exponentially rise as well.

Anyone below 400% of the poverty line will pay no more than 10% of their income. Eventually, they will need price controls, and that will likely happen at some point.

Single payer, on the other hand, will not happen. Anyone who knows even the slightest bit about politics and political history would find that obvious.

"how you can try to spin that to not be consumer driven is beyond me"

Consumer-driven is a defined term with respect to healthcare, so I am not trying to "spin" anything. I am simply articulating the definition. If you have some other definition, then your other definition is not accurate.

[maryf]

31. 10% of someone making 20,000 is 2,000 a year...

too much, far too much. Watch your math. Who defined the way you use the term? The insurance companies who wrote the bill, the people who are benefiting from the profit off of other people's health or lack thereof. It's wrong, as wrong as letting a house burn down because people can't pay.

[BzaDem]

54. Single adults making 20k would pay more like 5%. 10% is a maximum, not a minimum. n/t

[maryf]

57. OK, 5% of 20k is $1,000

Way too much just for premiums...especially considering deductibles...how much would the fine, opt out, or whatever euphemism they are calling it, be?

[Bluenorthwest]

36. No you are not 'simply' articulating a definition at all

You are also egagning in claims of prognostication, seeing the future, knowing what can and can not happen in 'our lifetimes' as if anyone on the planet has ever been able to make any sort of accurate predictions of any nature.
Anyone, and I mean anyone, whose argument involves having to accept a seer like vision of future events is selling soap and has a reason to do so. Magical thinking is not used by those who are 'simply being accurate'. Rational people do not claim to know the future. Period. It is an irrational mindset, not based on reality, but on presumptions. Anyone who disagrees should look up blogs for the week before Obama won Iowa, which was 'not possible' and 'too soon' and they muttered about 'white America' and the 'Bradley Effect'(another phrase made to sound like science when it was just bullshards) and on and on. They knew, for sure, what could and could not happen. Look at history, they said.
What does the Amazing Kresin think about it? At least he can find his paycheck under any form of health care.

[maryf]

47. +1

thanks!

[BzaDem]

53. Yawn. Same thing was said 100 years ago. n/t

[grantcart]

21. Optional health care is no better than optional fire protection

Single payer systems like the Canadian system are very consumer driven. Comsumers have the freedom to go to any doctor without the insurance company in the middle.

I would love that.

[maryf]

50. me too!

:)

[tavalon]

23. This cannot be stressed enough

The concept must get legs.

[maryf]

33. It's got roots...

and each root can spread! :)

[lonestarnot]

28. K & R

Privatization is another word for skim the cream.

[maryf]

38. which is why the fat cats are fat...

pretty soon all the skim milk cats are going to return to their feral state...300 million feral cats against 3 million fat cats, who's placing odds?

[RB TexLa]

39. Consumer driven health care allows me to give much less of my money to the insurance company

instead the funds that would be sent to them are invested in both fdic insured savings and in mutual funds. I have had $0 spending from my HSA or from the insurance company for health care this year. I may have an annual exam which would be paid from the insurance policy (ie my and other insureds money) we tend to forget when the doctor says "oh your insurance is paying for it don't worry about the cost," that means we are paying for it. Remember doctors want to take and steal as much money as they can from you. They don't care if they steal it from your pocket or from your pocket through the insurance company.

The best thing about the HSA is the tax free growth in it and after age 65 you can withdraw it for whatever you want and not pay a penalty, just normal income tax on it. When I have had some medical costs I have paid them out of pocket instead of out of the HSA to keep from reducing it and it's tax free growth.

I know they aren't for everyone, if you have a condition or maintenance drugs you are better off on a traditional compressive plan but if you are in good health, it is the best way to go. You keep so much more of you money.

[maryf]

40. A lot more would be kept with Medicare for all...

and it is for everyone.

[Dragonfli]

41. That is true, we will pay more and receive less even than before now that it is mandated

Democrats will be hated for the new poor tax on those that can't afford the premiums AND deductibles and co-pays. Some will pay the poor tax/fine out of money they can ill afford to lose, others will try to make it work, cut back to subsistence levels just to make the mandated protection payment/premium only to find that there will be no more money left to pay the deductable and co-pay vigs and will not be able to receive care anyway.

We are well and truly fucked.

There is a reason the I.C.'s stocks went up after this betrayal passed.

[maryf]

49. Thank you, this is an excellent synopsis!

:yourock:

[LWolf]

44. And no better than consumer-driven education. nt

[maryf]

46. Yes! or housing, water, or food!

:fistbump:

[DailyGrind51]

52. Alowing the "free" market to govern human services is anaolous to letting a lynch mob to govern

our justice system!

[maryf]

58. Or terrorists to run our military...

Or bank robbers to guard our banks....ooops guess that is kind of what's happening anyway...thanks! :)

[blindpig]

56. kick