I had a doctor’s appointment today. It was a follow up to a follow up from my general practitioner. If you all remember, in mid-December, a month after my dad was in the hospital with a broken hip and Lily died, and just a few weeks after Tammy, I had covid and the flu. On a follow up checkup in early January, my blood pressure was through the fucking roof and had anxiety and depression, so we took some steps to work on that. Went back in the first week of March, and had a follow up today.
Long story short my bp is now back down to a respectable 120/66, and my resting heart beat is about 58. Both of which are pretty good for someone as fat and old as me. Combined with the lifestyle changes I am making this year which will hopefully lead to some significant weight loss, I might be able to get off blood pressure meds altogether by the end of the year and be healthier than I was a decade ago. That would be nice, and I feel like it is something I owe to Joelle. Can’t show up to a wedding half dead with one foot in the grave and the other on a banana peel.
All of which is to say that the only reason this is happening is because I am lucky enough to have health care through my employer, and not only that, have had it long enough that I am not afraid to use it and understand the importance of checkups and follow up appointments. And that it is still fucking crazy to me that we do not have some sort of universal health care so that everyone in this country could have the same sort of health outcomes. It would be cheaper, the country would be stronger, people would live longer and happier. Health insurance needs to just be abolished.
Jackie
I’m glad you’re taking care of yourself and treating your health seriously ♥️
Joy in FL
You are absolutely right.
You had a series of awful things to deal with. I’m really glad you’re doing better and will probably be even better when we say goodbye to 2023.
mvr
I’m wishing you the best in our uncertain times and giving you credit for knowing that not all of us even have access to this kind of help you and I have.
Pete Downunder
Here downunder we have “universal” health care which is chronically underfunded. It is fine for emergencies but wait times for things like hip replacements are months to years. Private insurance is also available and much cheaper than US. I have gold coverage for about AUD $5000 a year (USD about $3800). Two years ago I had heart surgery at a private hospital with outstanding care and my out of pocket was under $500. It can be done, but it requires huge government investment and a much diminished role for private insurers. I frankly doubt the US will ever get there – too many vested interests.
Jim Appleton
My best friend is an actuary who makes a very good living crunching healthcare numbers for Fortune 500 clients.
She is the one person in my life who instantly, aggressively advocates for single payer.
eclare
So glad that you are feeling better and taking care of yourself. How did you get covid?
Villago Delenda Est
Cole, you really, really need to think about Joe Manchin’s Ferrari. It’s more important than your health.
Amir Khalid
@Pete Downunder:
The bill for my most recent hospital stay (11 days in a government hospital for hypovolemic shock) listed both the itemised total cost of my care — RM 8,316 — and the amount billed to me — RM250. I’d say I got a pretty good deal.
mrmoshpotato
P-R-E-A-C-H!
My parents (and us kids) were insured through my mom’s work when they were still working. The hospital she worked for was “self-insured” (I have no idea what that means.) But I always wonder if our combined time in the hospital would’ve ever hit the lifetime max on a traditional health insurance plan. And, of course, this was decades before the ACA threw out lifetime maximums, etc.
“Your money or your life,” said the
mafiahealth insurance company.mrmoshpotato
@Pete Downunder:
Those “vested interested” are called lobbyists and corrupt Rethuglicans here.
eclare
@Amir Khalid:
I am so happy you were treated and got better. A lot of us were worried!
NotMax
Depends on the prenup.
:) //
Ruckus
If what I get for healthcare could be done for the entire country, I imagine that a hell of a lot of people would be a hell of a lot better off.
I am a vet and qualify for VA healthcare. And it has been one of the best healthcare systems I’ve been in.
And I once worked for a company that paid very, very well for our insurance, with a copay twice a month of $10. That is it did. But around the turn of the century the insurance companies, all of the ones the VP of finance tried to purchase a comparable plan for said no, they would no longer provide that level of coverage. So no matter that the company was willing to pay, they wouldn’t provide it.
We need to do like other countries do, provide universal health care. Of course it will never happen here because someone gets to make a pile somehow NOT providing it. And too many of our voters hate some group that would greatly benefit. I feel like the fucking money grubbers are screwing us massively, collecting their billions while we have a massive percentage of citizens that have zero healthcare, or places to live, or often even food. And that is first class bullshit. Doubt me? Read the Forbes 400 every year. Billionaires – every fucking one of them.
David 🌈 ☘The Establishment☘🌈 Koch
AlaskaReader
Ronald Reagan is your reminder that Republican voters are every bit as corrupt and depraved as are the people they elect.
David 🌈 ☘The Establishment☘🌈 Koch
mrmoshpotato
@David 🌈 ☘The Establishment☘🌈 Koch: Is there record of that asshole comparing universal healthcare to communism (as I’ve heard)?
David 🌈 ☘The Establishment☘🌈 Koch
@mrmoshpotato: The link in the above comment takes you to the record he recorded
AJ of the Mustard Search and Rescue Team
I’m really wrestling with the depression hard these days, but this site (and TPM & The Great Orange Satan and Hullabaloo) all help me from completely giving up on people.
I somehow missed the marriage origin story but I’m so happy to hear you taking care of yourself and I hope it just keeps getting better.
NotMax
@mrmoshpotato
You’re likely referring to Reagan railing against Medicare before its passage. Really don’t care to look it up just now but there’s verifiable footage from back then.
ColoradoGuy
In the early decades of the 20th Century, the Nordic countries came to the realization the greatest asset the countries had were the population itself … not natural resources or farmland, none of which are abundant in that part of the world, but the skills, talents, and resourcefulness of the people as a whole.
So naturally, you want a healthy and productive population, educated to their fullest potential, in order to maximize national wealth. Sure, it’s good from a moral perspective, but what matters is growing the national economy in a sustainable way over many generations.
This was also FDR’s vision. A healthy and well-educated nation is a prosperous nation, no matter what challenges are thrown at it, because the economic potential of the entire population is maximized.
This is the inverse of Ayn Rand’s continual competition of all against all, the low-functioning economic feudalism of Russia, or the fascist military machine. Each of those not only degrades the individual, but the entire society. The wealth of those at the top of a kleptocracy are stolen from the entire nation.
2liberal
ask your doctor for Mounjaro if it’s covered by your plan. It helps reduce appetite.
prostratedragon
Some really late Schubert for a really late hour: String Quintet in C, op. post. 163.
Maxim
@AJ of the Mustard Search and Rescue Team: Sorry to hear that. Do you have medical care? Have you talked to anyone?
Nancy
The insanity of the health care industry is evident in the name. Those of us who have coverage do not somehow “deserve” it because we are virtuous or special. We’re lucky we’re able to hold a job that provides some form of decent coverage. (I won’t try to say veterans are lucky. You were promised this and other things that somehow didn’t happen. That’s another comment that I’m not qualified to write).
Anyway, I’m happy for you, John Cole. I hope your quest for health and, dare I say, happiness continues to go well.
raven
We’re very lucky having medicare and a stipend from my work that pays for the supplemental policy. Now if they could just figure out why I my left quad hurts constantly and surgery and spinal and hip injections have done anything. I’ve had MRI’s on my entire spine and they have found nothing that would warrant surgery. If the thunder don’t get ya the lightinin will.
Princess
Americans who want changes to the way health care is paid for in this country need to really do some research into how other countries successfully deliver universal health care (which is NOT usually the same as single payer health care though it can be). Each system has pluses and minuses. I’m going to say that about 80% of the Americans I know (that is, liberals with decent care provided from work) would HATE a single payer system. Americans who want single payer seem to think it means “the same care I get now but someone else gets the bill.” It’s not. Care gets delivered in a very different way that I think most Americans who have insurance would find hard to get used to. There are countries that blend cheap very regulated insurance, high subsidies for the poor, and good outcomes in a way that more Americans would find palatable in my view.
lowtechcyclist
@mrmoshpotato:
Nah, the vested interests are the people and corporations that hire the lobbyists. The lobbyists are middlemen, really.
But they’re also a symptom of how our system favors wealthy interests. Joe and Jane Sixpack may occasionally call or write their Congressperson, but a big corporation can hire lobbyists to buttonhole your Congressperson and everyone else’s, day in and day out.
Free speech is a good thing, but when one person or entity can buy an all but unlimited quantity of speech, it severely tilts the playing field. And the one recent attempt we made to do something about one form of that was killed by the Supreme Court in
CitizensCorporations United.lowtechcyclist
@Princess:
Here’s a quick primer that Ezra Klein put together back in 2007: The Health of Nations
He explains the separate ways that Canada, Britain, France, and Germany have taken to achieve affordable universal coverage. (He also brings in the example of our own VA health care system.) Some of it may be out of date since this is 16 years later, but like you say, there are a number of different ways to get there, and single payer is just one of them. It’s a good overview.
Maxim
@Princess: Good points. I read a book several years ago that compared health systems from several countries (France, Germany, Japan, and a few more). There are a lot of ways we could go about improving how things are done here.
ETA: what I read was not Klein’s thing.
Barry
@Pete Downunder: “…emergencies but wait times for things like hip replacements are months to years.”
I had gold-plated coverage when I had a hip replacement. I was authorized in Feb, got the surgery in Aug.
If you know a country with faster non-emergency hip replacements, I would like to know it.
AJ of the Mustard Search and Rescue Team
@Maxim: thanks Maxim, I have health insurance, a strong 12-step fellowship and family support. I appreciate your checking.
Tony Jay
A universal healthcare system that is free at the point of use and supports the medical needs of the population from the cradle to the grave is one of the finest achievements of British Socialism and an essential keystone of our society.
But it’s major flaw is that, when it’s run well, especially in tandem with a universal educational system that makes it possible for new recruits to receive high quality medical training without crippling tuition fees, it provides zero opportunities for private capital to make huge profits on the never-ending misery of sick people, so Britain’s conservatives, of all Parties, have been determined to run it into the ground and replace it with a US style model for decades, freeing up all of that lovely, lovely public money to flow into bonuses and dividends and, eventually, into their own pockets.
When the NHS finally goes under, and it’s very close to happening, the UK will have lost one of the greatest achievements of any civilised society in history, and people will be looking around asking how was this allowed to happen? Who is to blame?
I’d suggest they might look to the ‘moderate’ politicians who trouser huge donations from private Healthcare groups, the Party leaderships who install lobbyists for the likes of Palantir at the top of their executive bodies, the newspaper and media bosses who have spent decades whitewashing enforced privatisation and underfunding as ‘modernisation’ and ‘reform’, and maybe at themselves. Because it’s not like those smelly Lefties haven’t been warning about this for generations, but the voters still insisted on rewarding the bastards who were clearly lying to them.
But this is Britain, so chances are when it all goes ‘Mega-Health Inc is here to help, please insert your National Health Ration Card and press 1’ and we’re paying thousands for a basic check-up most people will be blaming ‘bloody immigrants’ and dulling their pain with Victory Gin.
Mousebumples
@mrmoshpotato: I work for a PBM, and “self-insured” means that they need to cover all claims and costs on their own. (we have some self-funded school districts as clients, as an example) Some (most?) of our clients are “fully-funded” on the medical side, which impacts how some drugs are covered or approved.
For example, hemophilia Factor replacement products are usually “cheaper” for clients to cover on the medical benefit vs pharmacy benefit.
Chris T.
@2liberal:
NARRATOR: It was not covered by his plan.
Seriously, even Ozempic coverage, even with full blown diabetes, is pretty rare. Someone I know is on it and is on the special Microsoft coverage (the extra-good one that you have to know exists before they acknowledge that it exists) and is covered due to T2 diabetes, but it still required months of approval paperwork.
Meanwhile there’s an estimate out there (I think I read this in The Guardian) that Ozempic and Mounjaro, which currently cost roughly $1000/mo if you pay full retail price, could be produced and sold profitably for about a tenth of that. So it’s mostly price-gouging here.
All that said, these drugs are not a panacea: they can cause a bunch of negative side effects (mostly digestion issues), and apparently it’s easy to lose a lot of lean body mass, which tends to be bad for future health. Still, it would be nice to have these much more widely available, for non-insane prices.
Nukular Biskits
Why does John hate Murka?
HeartlandLiberal
Here in Indiana, IU Health (Indiana University Health) has grown and metastasized like a cancer, taking over hospitals, and independent doctors right and left. It has become a giant, lumbering bureaucracy. My wife had to go to ER three times in a week, and she swore she would not go back. ER docs referred her to GI specialists. I tried to get appt with the GI docs, and despite fact she was experience pain still, the earliest appt I could get was JULY F*CKING 30th. And that with a PA. Fortunately she returned to the GP yesterday that she had seen before, and explained everything in detail, and laid out a plan for her to get better. She had had a CT scan while in ER, and he studied it and told her she had no evidence of disease of or blockage. We could not get an appt with our normal family GP, because he is so popular. We are thinking about switching to the doctor we saw. That is my most recent experience with healthcare in America. And Dentists? Don’t get me started. Neither Medicare or Anthem supplemental covers anything but an annual cleaning. I just spent over past two months $10,000 for my wife to have two dental implants and to caps. ARRGGGGHHHHHHHHHHHHHHHH!!
lowtechcyclist
@Villago Delenda Est:
And there goes his blood pressure!
Good luck with the weight loss, Cole! One good side effect of losing weight is that it becomes easier to exercise, even for simple things like walking, once it doesn’t involve lugging quite so many pounds of your own flesh around.
Ramalama
I already planned on formally applying to be a permanent resident in Canada, not just a commuter, but the event that made me finally go through a very complex and involved process was being with my parents in their final year of life, doing battle with insurance and doctors re: coverage. What a fckin shite show. You pay in to a great plan and it works…….until it bloody doesn’t. Health insurance will gaslight you to death.
Ramalama
@Chris T.: My wife tried this weird thing that helped her stop vaping, which she’d started to get off cigarettes. ” Try fum” deals with”habits” which I’d assumed meant smoking-vaping. She was dismissive about it at first but something about the feel of it and the gamification of the emails and progress bars online hooked her in. Something about your post make a me wonder if I should try it for weight loss. Chocolate, mostly.
Butch
Just got a bill for $944 for my supposedly “completely covered” annual physical.
davecb
Ontario bootstrapped their system by providing emergency-room coverage as the first part of the “Ontario Health Insurance Plan”. They hired an insurer to run it while building them a system and staffing it. My dad said it looked rather like they were going to build a parallel system and wait for the insurers to abandon health when it stopped being a near-monopoly with monopoly profits (;-)) Canada as a whole did the single-payer approach a little later and Ontario adopted it, so we didn’t get to see if that approach would have worked.
Mousebumples
If I remember right, insulin (very expensive until recent price cuts) was very highly rebated, with a lot of that price going to the PBM or employer. I think GLP1s (eg Ozempic, Mounjaro, etc.) are similar. My employer is a PBM that gives those rebates back to the “client” (employer or health plan group), but a lot of the big PBMs (eg United Healthcare, CVS/Caremark, etc.) keep all/most of that rebate for themselves.
I’m hoping the public pressure over insulin price gouging moves to other highly priced products in the near future…
Nukular Biskits
Just did my open enrollment (my employer’s benefit year runs from 01JUL-30JUN).
High deductible ($6500/yr) plan that runs approx $15K/year total in premium in which my employer picks up approx $13K and I pay the rest.
It sucks having a high deductible plan BUT this does allow me to divert pre-tax to an HSA.
sdhays
@HeartlandLiberal: This is one of the things that I find interesting about the discussions of single payer. People will need to wait and they won’t be used to it.
Well, people have to wait for stuff a lot in the US healthcare system despite paying ridiculous amounts of money for the privilege. This idea that at least you get your healthcare fast here is not the reality a lot of the time.
Jager
I’m a California Kaiser Permanente member. My Medi-Care Advantage cost is $5.98 a month. I’m getting a cataract/cornea transplant next month, my out of pocket? $400 because I’m opting for the lens upgrade. f I had to pay retail for the operation, it would cost me between 27-28k.
I take Pradaxa, a 3 month supply cost me 78 bucks through Kaiser. A pal of mine on Medicare plus an expensive supplement, in Massachusetts takes Pradxa, $146 a month.
Our Health insurance system is insane.
Ohio Mom
@Barry: Yeah, Ohio Family experiences wait times for our various medical needs too. I’ve come to find it reassuring in a way.
We’ve had some command partformances — “Your test results came back, they aren’t what we want to see so we’ve made a appointment for you to see Dr. Specialist this Thursday at four” — and that is never a good feeling.
sab
@lowtechcyclist: TR Reid wrote a good book about his experiences with healthcare around the world. “The Healing of America.” It covers healthcare in UK, Japan, France, Switzerland, Japan, Taiwan, Canada, India amd the US. All sorts of different models that combine government subsidies and insurance.
Deputinize Eurasia from the Kuriles to St Petersburg
@raven:
Have you had an mri of the quad itself? As the veteran of quad ruptures and repairs in both legs (one partial and one total), I can say that the partial hurt all the time prior to the surgery. An mri will pick up the damage.
twbrandt
John, it is fabulous you got your blood pressure and heart rate under control. Losing weight and keeping it off is absolutely possible – I dropped 40 pounds after I had a heart attack 9 years ago and I’ve kept it off through lifestyle changes.
And yes, it’s nuts we don’t have universal health care.
Ohio Mom
@Mousebumples: Some self-insured companies do buy catastrophic coverage for their employees. The way that works is, Acme Safe company contracts with Big insurance company, which sets up the plan.
So let’s say the first $10,000 of health care per employee is paid by Acme — Acme has given Big insurance company that money to dole out (after deductibles and co-pays of course, which are all calculated by Big insurance company per their contract with Acme).
But if something very awful and expensive happens to the employee,costing much more than the money Acme has given Big insurance company, the catastrophic plan kicks in.
Now if employee is marvelously healthy and doesn’t use all of the $10k, that’s part of the plan too. I don’t know if Acme and Big split that or what, but someone makes money off of denying care.
Mousebumples
@Ohio Mom: Makes sense. I think that might be stop-loss insurance? I’m not on the financial side of my work (well, client financials, anyhow), but I’ve heard that word thrown around. I think that’s good for one-time/short-term high costs, but if you have a new member with yearly high costs (eg hemophilia), you may be SOL
Eta –
Definitely does happen in some cases, but part of my job is to figure out what lower cost alternatives might be. For example, Repatha is a great drug for lowering cholesterol, but statins (eg Lipitor or atorvastatin) are pennies by comparison. We have a bunch of members on Repatha, but we require them to try statins first in most cases. (some genetic cholesterol diseases can bypass that)
Sure, Repatha will lower cholesterol, but if a healthy level can be reached for a few bucks a month vs a few hundred, that helps save money for everyone.
Deputinize Eurasia from the Kuriles to St Petersburg
@Tony Jay:
But they have their blue passports back and will joyfully sing “Rule Britannia”, secure in the knowledge the the rump state of England will remain sovereign and unsullied by any multilateral arrangement.
That should be comfort aplenty for those midlands voters as they face budget crises and food scarcity, a hard Scottish border, deal with calls for Welsh and Cornish autonomy and contemplate what the now nuclear armed and EU member Celtic Union (on both sides of the Irish Sea) means for them….
SFAW
@Villago Delenda Est:
Were I better at PhotoShop [Translation: if’n I knew how to use it], I would post a picture of a Ferrari “rolling coal,” with a caption like “you mean this one?”
NB: It appears that Manchin drives a Maserati, not a Ferrari, but either way …
SFAW
John –
Glad to hear your health is better. Looking forward to wedding pics of the slim, trim you. Maybe it will give me that push to turn me from a tenpin to a candlepin.
Maxim
@AJ of the Mustard Search and Rescue Team: Glad to hear it. Hang in there.
@sab: That’s the one I read.
@Tony Jay: But socialism is communism is godlessness is Evil, and we here in Murka are too pure for that.
Sorry about your ghoulish conservatives.
2liberal
Im a T2 and I just had to ask , it got approved no problemo. It has dramatically reduced my sugars. I’m just getting going with the weight loss. I’m having a body composition body scan next week and am doing some weight lifting designed to add muscle.
kalakal
The most chilling words I’ve ever heard* where when put me in the ambulance and before the epinephrin was kicked in and they asked me
“What hospital do you want to go to?”
In any sane country the answer is “the nearest that can treat me/ save my life” not ” here’s my insurance card, which is the nearest I have coverage for**”
People die in overly long ambulance rides because they can’t afford to go to the nearest place that can treat them. That’s horrifying
* and I was close to coma/death with anaphylactic cardio vascular collapse at the time
** hard to answer when you’re semi conscious. When the epinephrine kicked ( that stuff is great!) I was tempted to ask which hospital had the best WiFi and could I go to that one please?
Baud
@kalakal:
Must…juice…. despite…. intense…pain.
RevRick
@Pete Downunder: Too many vested interests!
That includes people who already have decent health insurance coverage and don’t want to risk screwing it up.
Those who say we should just enact universal government-funded healthcare need to think long and hard about how we get from here to there. Because there’s a real possibility it leads to disaster.
We can’t just conjure up a system out of thin air, and even Medicare needs constant tweaking to keep things running. The assumption that people who work for private health insurance companies will happily toddle over to become G-6 federal employees doesn’t pass the sniff test. It would take a significant effort to recruit and train the necessary staff. It took three years to roll out the ACA.
And what happens in the meantime?
Well, the second the President signs into law is the second all private health insurance companies collapse. Everyone involved will see the handwriting on the wall and will seek an exit ASAP. The owner of the office building will not renew leases and seek new tenants. Banks will refuse to lend to dead-companies walking. Employees will update their Linked-in profiles. Investors will dump their shares. Within days the private health insurers will become hollowed out shells, and whoever is left will have to assume greater responsibility and workloads, which will only add to the incentive to leave. And these husks of corporations will have neither the ability or the desire to train replacements.
In fact, all their incentives would be to let things collapse in expectation that a furious voter pool would throw out all those responsible for this disaster, and they would be resurrected.
Chris T.
@SFAW:
Generally speaking, a Maserati is more expensive and exclusive. They were different companies originally but now Ferrari own Maserati, and F consider M their “luxury division”, a la Toyota and Lexus.
In other words, it’s even more FYIGM. 😀
(Not that I should talk as I have a Jaguar…)
kalakal
@Baud: lol! when you have that much adrenaline slammed into you You. Feel. No. Pain.
The weirdest part is you get random muscular twitches for hours, I kicked the Dr at least twice.
I can’t even begin to imagine what it feels like if you’re starting from a good place rather than near flatline
Chris T.
@2liberal:
Hm, maybe it’s getting better now.
This is a good idea when you’re dropping massive amounts of body weight. It tells your body to keep more of the lean mass. (Bodybuilders use bulk-and-cut—a period of weight gain to add muscle, and then a period of weight loss while still working out to cut non-muscle—because it’s so difficult to add lean mass during weight loss. I’ve done the bodybuilder thing myself, it works, it’s just kind of weird.)
Sherparick
@mrmoshpotato: The lobbyists & Rethuglicans work for the suits in the C-suites, the Hedge Fund managers, & private equity offices. But the emotional energy that prevents us from having nice things is the majority of white people loathe the idea of sharing anything in this country with non-white people & like to blame all their problems on same & mysterious conspiracy theories usually made up of Jews & Gay people.
Barry
@Deputinize Eurasia from the Kuriles to St Petersburg: “But they have their blue passports back and will joyfully sing “Rule Britannia”, secure in the knowledge the the rump state of England will remain sovereign and unsullied by any multilateral arrangement.”
They will be unilateral agreements, where the UK Govt will bend the knee.
Chris T.
@Barry: You mean bilateral? Unilateral seems awfully submissive…
oatler
There are Botox ads offering migraine relief; oddly it’s the same way I’m getting migraine relief-the dispensary.
RevRick
If we designing a health insurance scheme from scratch, a government funded one would likely be the best. But we aren’t. We have 80 years of choices to contend with. And I believe we’re stuck with this bloated, dysfunctional, Rube Goldberg system.
Why?
Because there’s no way to get from where we presently are to a 100% government-funded system without creating chaos. How does one get from here to there? How do we build up the new infrastructure we’d need faster than the old one collapsed in a smoldering heap?
Because the second the President inked his signature on the bill, every single element of private insurance would be destroyed. In fact, the collapse would start even as soon as the likelihood that this new system would be enacted.
How could it end any other way?
Investors would dump the stocks. Banks would cease lending. Employees would start looking for new jobs, and the most capable would be first to go.
Could we just nationalize the existing companies? Well, to get around the “Takings clause” we’d probably have to buyout the current stockholders with a super generous offer to ward off lawsuits. And would the newly minted government employees be happy taking a pay cut from their well-compensated private sector jobs?
I see no way out of this predicament.
kalakal
@Sherparick:
Fun fact: The British company that had been making UK passports lost the contract for the new blue ones to a Franco-Dutch firm and had to close it’s factory
“British” passports?
TriassicSands
Yes, John, we would be far better off with a good (not Medicare-for-All)* universal health care system.
However, what we gained in health, we would lose is Freedumb! And nothing is more sacred to the America of 2023 than the ability to make really stupid, short-sighted policy because we fear “sochulism.”
*An 80-20 health care plan that requires supplemental insurance to ensure against medical bankruptsy is not an adequate plan.
TriassicSands
Yes, but. And the but is that the U.S. today wouldn’t adopt a universal heath care system — even a mediocre one — even if the only votes that counted were Democratic votes.
TriassicSands
@2liberal:
Side effects. John should avoid resorting to medications unless he has no other choice. Since every person is different and responds differently to medication, taking a medication for something that might be accomplished without it should not be a first choice.
Eolirin
@RevRick: You very slowly and gradually expand the VA and Medicaid, never promising universal coverage but increasing out how many people can be covered by those programs. Eventually they’ll be at near the funding they need to take on more and more of the population and you can just roll in the last groups.
And at the same time you add more regulation to both the insurer and provider end to squeeze profits so that the gap is smaller.
You couple this with even more subsidization for higher education and med school if you work for the gov programs. I don’t think you actually have a hard time getting the administrative staff you need. Only the high level execs (and specialty doctors) are going to see major pay cuts if these programs are funded correctly.
This will take many decades of work to accomplish, but it doesn’t collapse the system.
It’s going to be very difficult to do while the Republican party is a going concern and while white supremacy is a dominating force for a large chunk of our electorate though. It’s too hard to preserve incremental improvement and keep things moving forward when you need to fight tooth and nail just to stop them from tearing it all down every time you make progress.
BellyCat
9 out of 10 health insurance companies recommend this improvement: abolish payments from them while still requiring payments to them.
Capri
@Chris T.: I’m on Ozemic, it got approved easily by my insurance co. They have a program where they help with out of pocket charges if it costs more than $25.00 a month. My cost? $24.99 a month – no joke.
A few years ago I switched over to a direct service provider for my doctor. I did it to get away from the siloed care that comes with going to a regular doctor. It means traveling from Lafayette to Noblesville Indiana and paying $1000 a year, but it’s worth it for a doctor who takes everything into account and treats things holistically.
RevRick
@Eolirin: Decades? That sounds like it would be easier to just keep expanding the ACA.
Tony G
@AlaskaReader: In a debate in October of 1980, Jimmy Carter tried to remind the public of Reagan’s opposition to Medicare less than 20 years earlier. Reagan sidestepped the issue by saying “There you go again”, and then changing the subject. The corporate news media and the majority of voters ignored Reagan’s extremism and dishonesty. Not much has changed in more than 40 years. The news media sides with the far right, and the majority of voters are too dumb to think for themselves.
Ramalama
@SFAW: What does “rolling coal” mean? Is there a photo you can point to to illustrate it?
C Stars
I think about this a lot WRT pregnancy care in red states that are outlawing or severely restricting abortion. In CA there are affordable prenatal care options through the state but in places where it is harder to access healthcare, people will die because of this lack of access in combination with pregnancies. Human gestation comes with some massive and scary side-effects and risks.
Tony Jay
@Deputinize Eurasia from the Kuriles to St Petersburg:
I have a LOT of Celtic blood. Tons of it. I basically bleed green and get maudlin at the drop of a hat. I guess what I’m saying is that ‘sympathetic Fifth Column’ is what I would be in that situation.
But no whiskey or whisky. Deal breaker.
Freemark
@Tony Jay: I believe the UK spends the nearly the least amount of money per capita of all the G20 nations (only Japan might be less) and gets pretty damn good results. I can’t imagine how good it would be if funded at even the average G20 per capita rate much less what Germany spends. With that it could probably have healthcare workers on street corners begging to help people. If they spent what we spend in the US everyone could practically have there own doctor…lol.
Tony Jay
@Maxim:
We’ve all got them. They’re like haemorrhoids or the Fast n’ Furious* films, hard to get rid of and they just get worse over time.
* Now, I went to a Catholic boys school and have been known to enjoy the music of Elton John, George Michael and Boy George, but those films? Vaseline to the elbow Super-Gay. I’ve seen less homoeroticism in a Derek Jarman retrospective.
Tony Jay
@Freemark:
Yup. The amount of effort the conservatives have had to put into choking the NHS into submission over the last 40 years has been staggering. In US terms they’ve basically treated the NHS like Cuba while pretending to treat it like Israel.
But a LOT of very rich people have got a little bit richer out of it, and the people paying for it have come to expect a shit service provided by increasingly despairing staff, so it’s a win-win for the forces of evil.
Ruckus
@ColoradoGuy:
THIS!!!!
Conservative “wisdom” is that “He that makes the most is the best.”
What this does is create the SFB’s of the world. Now sure they are going to be there regardless but it elevates the shitheads to a status that shitheads should never, ever get. (I can’t remember, is his last name spelled trump or dump, as in being one?)
Ruckus
@Nancy:
My experience with VA care is quite positive. Sure it’s not perfect, what involving humans is? And I do see, have seen, other patients that have issues that I’m not sure any healthcare can fix. I once sat across from a man in group, my age, and we had to sit there in silence for 2 minutes looking at each other. This man is in a constant rage, mostly caused by his experience in a war zone during a war. I’m a pretty strong person, have been a mental health counselor and dealt with a fair number of people with problems and this man will likely never get better. He seemed like he wanted to respect life and he’d had to take life from others. His anger will likely be with him till his death. So yes VA care can have to be different than regular health care. But my experience is that it is very good, and better than a lot of our current public health care and especially far better than getting none.
Chris Johnson
I’m a physician. And I can say without fear of contradiction that health insurance adds NOTHING to health care. It’s cost without benefit.
Ruckus
@Jager:
Our Health insurance system is insane.
First, it’s a series of systems for most people. And as it is a series and we are a for profit country/system, everyone has to get a cut.
Second, because it is a private system rather than a government one we end up having to pay the costs, the upkeep, and THE PROFITS.
Healthcare should be an inalienable right of every person. Now of course when this country was founded it was founded on the principle that money was the most important, and yet not discussed part of the system. (Also, living was a bit different than now.) Sure we had doctors, but healthcare as anyone knows it today is a hell of a lot different than 75 yrs or even 50 yrs ago. A big part of that is knowledge about science. Of course for us it is also about profitability. Isn’t that word in our constitution?
Ruckus
@Ohio Mom:
Having owned businesses and paid healthcare insurance for employees I can say unequivocally that Acme will not get a dime back. They just figure it in as the cost of doing business, as I did. It’s paid, it’s gone.
gene108
Approximately 90% of people in the U.S. have health insurance. Even then healthcare can be unaffordable with deductibles and coinsurance.
Insuring everyone is a step in the right direction, along with elimination of lifetime maximums, and having annual maximum out-of-pocket costs.
Despite this it won’t make the dent some hope, because at its core healthcare in America is about squeezing money out of consumers at every level from doctors, hospitals, insurance companies, pharma, to medical device makers, and anyone else providing services of any kind.
Nancy
@Ruckus: Thanks for your perspective. I’ve known some vets with PTSD and rage. It pains and angers me.
wmd
Having high value health insurance in 2017 meant I did not have any financial stress when I had cancer in 2017. I’d hit my $2000 out of pocket maximum while still getting diagnosed. That meant the over $1 million billed by Stanford, and the $500,000 or so that was the negotiated rate the insurance company ended up paying wasn’t even on my radar. I filed my explanation of benefits letters, then looked at them about a year after my diagnosis, 6 months after I was done with treatment and cancer free.
If finances had been on my mind during treatment I suspect the anxiety would render the treatment less effective. Universal health care would remove that anxiety for everyone if the quality of the plan was good enough.
Ruckus
@gene108:
Despite this it won’t make the dent some hope, because at its core healthcare in America is about squeezing money out of consumers at every level from doctors, hospitals, insurance companies, pharma, to medical device makers, and anyone else providing services of any kind.
This needs to be repeated and as often as possible.
It is a lot of the basis of life in current day USA, Profits. Above all else.
Now this is important – profits are a necessary part of business life in a free country. Without profits, businesses fail. And rapidly. It’s extreme profits that are an extreme problem.
Barry
@Chris T.:
“@Barry: You mean bilateral? Unilateral seems awfully submissive…”
From everything that I’ve seen, Post-Brexit Britain holds no cards.
When dealing with the USA and its megacorps, the UK is now in the position of a colony.
Barry
@Ramalama: “@SFAW: What does “rolling coal” mean? Is there a photo you can point to to illustrate it?”
https://letmegooglethat.com/?q=rolling+coal
Ruckus
@Nancy:
PTSD is I think far more common in combat vets than is often realized. Many of them can work and exist but the underlying angst of having to kill and high risk of being killed can really change a human, even the best humans. If you are in the military and on a duty station with those risks day to day I’d bet the risk of having PTSD is dramatically high. I was lucky in the service. Many are not even close to that lucky. I wrote on BJ today that yesterday a buddy of mine – ex Marine, went to Fleet Week. I’ve know him for 50 yrs and he has a hair trigger that has gotten a lot slower over the decades and he never chambered a round in 13 months in Vietnam. He could type, his dad was a reporter, and they made him a company clerk. But many vets have PTSD from warfare. Having someone shoot at you really makes the concept of life a different experience. I know, I got shot at once. Thankfully they missed. And thank adrenaline which allowed me to set a world record 1/2 mile run. At least it felt like my feet didn’t touch the ground.
Ramalama
@Barry: Ha ha fair but I’m the type of person who is trying to get away from googling my day away…one thing leading to another…and whoops, three hours, gonzo. #toomuchchoice
VFX Lurker
The biggest obstacle to change is that the majority of voters are happy with the status quo.
In 2010, an insured person asked me how he could flaunt his wealthier status if everyone had the same insurance. He wanted to make sure he had better insurance than the next person.
Around the same time, an uninsured person objected to mandating coverage, claiming that he could use the savings from not paying health insurance premiums to better deal with his family’s medical needs on a cash-only basis.
In 2011, an insured person voiced her concerns about allowing previously uninsured to have insurance, because it might prevent her from scheduling her children’s appointments with her favorite pediatrician. She didn’t object to me having insurance — she just didn’t want to give up her access to her preferred pediatrician.
In early 2016, a co-worker expressed her preference for single-payer for everyone. I agreed, suggesting that the easiest path to single-payer in California was to make Kaiser Permanente universal for everyone. She recoiled, recalling a relative’s bad experience with Kaiser. She wanted single-payer…but not through Kaiser, somehow.
I think we’re on the right path. The ACA got more people insured through parent’s coverage, Medicaid and the marketplace. We just need to keep going with whatever the majority of voters will accept.
Joelle
I should solicit a kickback from your insurer.
XXOO,
The Missus