Single-Payer Health Care: As Goes Canada, So Goes Vermont

The Something Awful Forums > Discussion > Debate & Discussion > Single-Payer Health Care: As Goes Canada, So Goes Vermont

Mo_Steel: Mar 7, 2008; Let's Clock Into The Sunset Together; Fun Shoe

MattD1zzl3 posted:

I got a medical bill today and went on a rant about how the american system is ridiculous, i was told in response a story of a friend of a friend in canada who had a broken arm in montreal and had to wait "24 hours" or so to receve any kind of car, apparently not getting even painkillers while he waited. Is this actually something that happens there with any regularity? I love the idea of socialized medicine and something that ridiculous actually happening breaks my heart. Thank you for the clarification.

poo poo happens here too, except people "choose" not to go because they can't afford it: (Emphasis mine)

quote:

ACL surgery in San Francisco, USA:
No coverage

cost: USD$10,000.00
wait time: 1 YEAR

I was fencing with a friend, just fooling around, really, when I felt a strange "pop" and an intense pain in my knee. I figured I sprained something, and not having health insurance or a regular doctor, didn't want to go to the emergency room and pay hundreds of dollars to be given some ibuprofen and told to go home and ice it. I limped to a drug store and bought myself a $25 cane. After a week I was still in bad pain and limping and it became clear that it was more serious, so I took myself to our public hospital. The ER doctor, who spent about four minutes with me and gave my leg a cursory glance, gave me ibuprofen, told me to ice it, and referred me to the orthopedic dept, which gave me an appointment for one week later. The orthopedic doctor spent about 3 minutes with me, moved my leg around a bit, told me it was a bad sprain and that I needed to have physical therapy. He did not order an X-ray or any other test. (Total cost including emergency room visit, about $300).

I went to a private physical therapist near my home who was horrified I was walking around with a cane and that I was in so much pain. She said that I needed crutches and an MRI and a "real" orthopedist since the one I saw had clearly misdiagnosed me. ($75)

I made an appt with a private orthopedist, a real sports medical specialist, for the next day. ($350) He examined my leg thoroughly, then told me that he was sure I had snapped my anterior cruciate ligament (ACL) but would need to have an MRI ($250) to confirm that diagnosis. He told me I would need to surgically replace the ACL and it would cost $12,000. I burst into tears and began sobbing. He then said he could do it for $9K at a surgery center if he didn't use an assistant surgeon. I didn't have the money and had to wait almost a year before I could afford it with help from my father. So I got to be disabled for almost a year before surgery, five months on crutches, six months with a cane. After surgery I healed in about 3 weeks.

# ¿ May 3, 2014 22:02

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# ¿ May 22, 2024 08:14

Mo_Steel: Mar 7, 2008; Let's Clock Into The Sunset Together; Fun Shoe

Fat Ogre posted:

It isn't like people don't understand healthcare is expensive in this country.

Which is why it sounds absolutely loving insane to me to go skiing and risk breaking a bone, injuring a limb of some sort or a head injury which happen while skiing quite often. The first thing they think after getting slapped with a 20-30k bill is "poo poo this is so expensive I wish I hadn't gone and done that." See also people that ride mountain bikes, surf, skateboard, etc.

It isn't like I'm being callus to someone who got sick or got cancer. This is someone who got into a dangerous situation, got injured and then is annoyed they have to deal with the consequences of their actions.

I agree our medical system is hosed but people taking risks for no reason doesn't help.

The injury rate for skiing is below 2.5 per 1,000 skiers; in 2012 the injury rate on the roads was 11 per 1,000 licensed drivers. Maybe you should hassle him for being driven to the ER instead, what sort absolutely loving insane person would take that risk without health insurance?

# ¿ May 4, 2014 21:56

Mo_Steel: Mar 7, 2008; Let's Clock Into The Sunset Together; Fun Shoe

Fat Ogre posted:

Yeah like I said car insurance covers that....

Or is there a skiing insurance you can get? Maybe something like health insurance?

Or we could have universal coverage and then people wouldn't have to worry about crippling debt for taking part in generally safe activities and you wouldn't have to blame them for being lunatics. Hence this thread about UHC in Vermont.

# ¿ May 4, 2014 22:01

Mo_Steel: Mar 7, 2008; Let's Clock Into The Sunset Together; Fun Shoe

Fat Ogre posted:

At what point did I say we shouldn't have UHC?

I never said you did, I said you were blaming a victim of our lovely insurance system for being "insane" by taking part in a relatively safe activity. Which you are, and you continue to not comprehend why that's idiotic.

# ¿ May 4, 2014 22:16

Mo_Steel: Mar 7, 2008; Let's Clock Into The Sunset Together; Fun Shoe

Since we're mixing education and healthcare and news about Vermont single-payer hasn't changed much, here's some information about affording either on a minimum wage job from a couple years ago:

quote:

The table below shows the results of a simple exercise. We ask how many hours did a minimum-wage worker have to work to pay for a year of college education (at various kinds of institutions) or a year of health insurance (for an individual or a family). The table compares the experience facing a minimum-wage worker in 1979 � when the minimum wage was $2.90 per hour � with that of a minimum-wage worker in 2010 or 2011 � when the minimum wage was $7.25. (All wages and prices, here and below, are in current dollars � that is the actual dollar value at the time, without any adjustment for inflation. The point is to compare the minimum wage in place in each period with the actual cost of health and education services at the same point in time.)

[...]

Health-insurance premiums have also increased enormously when expressed in terms of the minimum wage. In 1979, one year of individual health insurance coverage cost a minimum-wage worker 130 hours. By 2011, the same coverage cost 749 hours.

The cost of family coverage increased from 329 hours in 1979 to 2,079 hours in 2011. These figures imply that after paying for family health insurance coverage, a minimum-wage worker would have just one hour of work left over to spend on other goods and services after working 40 hours per week for 52 weeks in a year.

[...]

The health insurance costs in the table are based on the premiums for employer-provided health-insurance policies, which are group plans that minimum-wage workers can use only if their employers offer a plan. But, the share of low-wage workers with employer-provided health insurance has fallen from 42.9 percent in 1979 to 25.9 percent in 2010. Only a small share --about 8.1 percent-- of low-wage workers purchase their own individual health-insurance policies. Nor do the health insurance figures here factor in the availability of publicly provided health insurance, such as Medicaid and CHIP (Child Health Insurance Program). Public health-insurance coverage for low-wage workers did increase somewhat, from 8.8 percent of low-wage workers in 1979, to 12.8 percent by 2010.

Some economists emphasize the rapid decline over the last century in the relative price of agricultural products and manufactured goods (such as televisions and air conditioners). These analyses, however, inevitably ignore or downplay the large relative increases in the price of crucial services such as education and healthcare. Minimum-wage workers today may be able to buy DVD players that did not exist in 1979, but at the current level of the minimum wage, they are also far less able to cover college tuition or health-insurance premiums.

This also highlights one of the other benefits behind Single-Payer like what is being proposed in Vermont: your health insurance would no longer be tied to your employment. This means losing your job is not as devastating and quitting your job to pursue another opportunity like education or entrepreneurship is something you can do without risking large financial burdens when hit with unexpected illness or injury.

# ¿ May 8, 2014 21:19

Mo_Steel: Mar 7, 2008; Let's Clock Into The Sunset Together; Fun Shoe

Fat Ogre posted:

It isn't luck finding a job. There are poo poo tons of them out there. By saying it all comes down to luck basically implies no one has any skill whatsoever and everyone is equally qualified for every job. That the people in HR are just pulling resumes out of a hat and are looking at how well a person's attitude, relevant skills and qualifications fit them to that job

In February 2014 there were 4.2 million job openings and 10.5 million unemployed persons. Even if we were to assume that every one of those unemployed people were somehow lucky enough to be geographically and educationally and professionally situated to meet the exact qualifications of those openings and they all tried super really hard, there'd still be over 6 million people unemployed through no fault of their own.

Not even touching other factors like millions who are employed part-time because of economic reasons or who are otherwise underemployed.

Mo_Steel fucked around with this message at 22:52 on May 8, 2014

# ¿ May 8, 2014 22:49

Mo_Steel: Mar 7, 2008; Let's Clock Into The Sunset Together; Fun Shoe

Fat Ogre posted:

So it is impossible for people to create businesses for themselves? And every job out there is over the table and in that list of 4.2 million jobs. How exactly are illegal immigrants finding jobs then?

Again it is unrealistic to assume you'll ever get rid of unemployed people ever. From your link of the 10 million unemployed 3.8 have been unemployed for 27 weeks or longer. That is 6 loving months without a job. Sorry but that is ridiculous.

You said there were "poo poo tons" of jobs out there. You might not like the facts I have presented you that explicitly demonstrate that there are less currently available job openings than there are unemployed persons as of February 2014, but waving your hands and making excuses about illegals and long-term unemployed doesn't change the fact that even if 100% of the unemployed people spent literally every moment of every day applying for and interviewing for any and all job openings 6 million of them wouldn't have jobs as a result.

# ¿ May 8, 2014 23:19

Mo_Steel: Mar 7, 2008; Let's Clock Into The Sunset Together; Fun Shoe

Fat Ogre posted:

There are poo poo tons of jobs out there. 4.2 million of them. You just have to be better suited for that job than 60% of other people in this hypothetical situation.

Again you'll never get unemployment to 0% and you still have the issue of people that are long term unemployed because of reasons like health or taking care of family members etc.

This isn't a hypothetical situation: your "poo poo ton" of jobs only covers 40% of the unemployed no matter how strong the work ethic or how well qualified the other 60% are. Luck absolutely plays a factor in finding a job, and the fact that you continue to not acknowledge that would be astounding if you hadn't already demonstrated how your arguments are insulated from data to the contrary repeatedly now.

There's no issue with the long-term unemployed because of health or taking care of family because that's not included in those 10 million:

quote:

In February, 2.3 million persons were marginally attached to the labor
force, a decline of 285,000 over the year. (The data are not seasonally
adjusted.) These individuals were not in the labor force, wanted and were
available for work, and had looked for a job sometime in the prior 12
months. They were not counted as unemployed because they had not searched
for work in the 4 weeks preceding the survey. (See table A-16.)

Among the marginally attached, there were 755,000 discouraged workers in
February, down by 130,000 from a year earlier. (The data are not seasonally
adjusted.) Discouraged workers are persons not currently looking for work
because they believe no jobs are available for them. The remaining 1.5
million persons marginally attached to the labor force in February had not
searched for work for reasons such as school attendance or family
responsibilities. (See table A-16.)

How does Table A-16 qualify those persons?

quote:

Includes those who did not actively look for work in the prior 4 weeks for such reasons as school or family responsibilities, ill health, and transportation problems, as well as a number for whom reason for nonparticipation was not determined.

Mo_Steel fucked around with this message at 01:49 on May 9, 2014

# ¿ May 9, 2014 01:44

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# ¿ May 22, 2024 08:14

Mo_Steel: Mar 7, 2008; Let's Clock Into The Sunset Together; Fun Shoe

We could look at studies on how price availability impacts healthcare decision-making; I assume Fat Ogre will have some useful sources since he's really insistent on this as something that should be done. I did a little searching and by no means is this the final statement on the topic, but here's a small-scale paper from Taiwan which uses a national insurance system combined with co-pays:

quote:

Decision making when accessing medical facilities

There were a variety of factors considered by participants when accessing different medical facilities. Saturated opinions suggest that the physician�s reputation and friendliness, the medical tier�s
reputation, and convenience are the three key considerations and were repeatedly mentioned by participants. Most notably, those participants visiting hospitals thought that the doctor�s reputation was indicative of extensive knowledge and capability and that more equipped medical facilities equated with high-quality equipment and medicines for most participants.

[...]

Other factors such as the patients� insight into the severity of the diseases, normal visiting habits, information about doctors, and medical facilities were also considered when accessing medical facilities. Of all of them, out-of-pocket payments seem to be the least important consideration and no participant ever proactively mentioned �cost� issue as one of their considerations.

There's some interesting stuff there about how little they knew about the actual difference in cost and how quality and doctors play a big role in decision-making. I'd also like to reiterate how this is a small scale paper about Taiwan and the cost differences are pretty narrow, and not the thousands to tens of thousands that could possibly result in the U.S. instead. Maybe we can move beyond anecdotes about how "prices are good / don't matter in emergencies / well but what about when my back is sore" and onto actual studies? Anybody have something more relatable to U.S. healthcare?

# ¿ May 10, 2014 20:56

The Something Awful Forums > Discussion > Debate & Discussion > Single-Payer Health Care: As Goes Canada, So Goes Vermont