Universal Health Care: Do We Care Enough?

Is our failure to provide adequate medical care for some segments of the population due to the fact that we don't care enough about them?:

"Want Universal Health Care? The Operative Word Is 'Care'," by Michael L. Millenson, Commentary, Washington Post: ...Here's a cold truth: Despite much media hand-wringing on the subject, most of us give about as much thought to those who lack health coverage as we do to soybean subsidies. The major obstacle to change? Those of us with insurance simply don't care very much about those without it. It's only when health care costs spike sharply, the economy totters or private employers begin to cut back on benefits that the lack of universal health care comes into focus. Noticing the steadily growing ranks of the uninsured, the broad American public -- "us" -- begins to worry that we'll soon be joining the ranks of "them." ...

Two-thirds of those without health insurance are poor or near poor... And there are clear disparities in how different racial and ethnic groups are affected. Only 13 percent of non-Hispanic white Americans is uninsured, compared with 36 percent of Hispanics, 33 percent of Native Americans, 22 percent of blacks and 17 percent of Asians/Pacific Islanders.

Politicians understand what this means in practical terms. If a lack of health insurance were truly a white middle-class crisis, then conservatives and liberals would long ago have joined together, carved out a compromise and done something. Instead, we're served a constantly recycled set of excuses for legislative stalemate. ...

When the general public talks about a health care crisis, what they're generally talking about is rising costs, a constant complaint since the Hoover administration (though Richard M. Nixon was the first president to officially declare a health care "crisis"). In response to this public clamor for cost control, those who advocate for the uninsured have decided to talk not only about the 22,000 of "them" who die annually because of a lack of access to care, but also to emphasize the money that providing coverage to "them" could actually save the rest of "us."

The Commonwealth Fund recently tallied the ways in which universal health care would save hundreds of millions of dollars, most of which were related to lowering the societal costs exacted by the greater burden of illness among the uninsured. The list was an exhaustive and exhausting one that nonetheless had the whiff of desperation, as if civil rights activists had appealed for support against segregation because it was reducing the pool of qualified candidates for the Selma, Ala., police department.

There are glimmers of hope. A growing number of insured families are struggling with higher co-payments and deductibles and skimpier coverage. These uneasy "underinsured" may yet join forces with the uninsured to demand [change]...

A survey last year ... found that more than two thirds of Americans were willing to pay 1 percent more in federal income taxes to make sure that everyone had health insurance. This counts as progress, as does the bipartisan Healthy Americans Act, a significant step toward universal coverage proposed by Sens. Ron Wyden (D-Ore.) and Bob Bennett (R-Utah).

Over the years, our society has gradually provided a medical safety net for the elderly and disabled (Medicare), the poor (Medicaid) and veterans. At one time, these commitments were controversial, and there's no doubt that they're expensive. Yet Americans from all walks of life understand that the true value of these programs must be weighed on a moral scale as well as a financial one. ...

It has been nearly a century since Theodore Roosevelt, a Republican running unsuccessfully on the Bull Moose Party ticket, boldly became the first presidential candidate to promise universal health coverage. That was in 1912. Nearly a century later, we're still waiting for a leader with the courage and skill to break through our fears and successfully lead the charge up that particular hill.

Assuming that people don't care enough currently, we can hope that people suddenly begin to care more about the disadvantaged than they do about soybean subsidies and, because it's the right thing to do, agree to provide universal health care. Maybe that can happen, the author says it is happening to some degree, but even so, I don't see anything wrong with explaining why it's in society's best economic interest to adopt a universal care system and framing the argument along those lines. That seems easier than telling people they don't care enough (or making emotional appeals), though I suppose you could try that too.

However, I'm not so sure that people are indifferent to the health care needs of the disadvantaged. But even if people do care about providing adequate health care for the disadvantaged, and I want to believe they do, even if they do recognize the moral obligation in their evaluation of the benefits of providing universal coverage, that doesn't mean that they will voluntarily step forward to help. For example, there could be a standard free rider problem. It's optimal for me if everyone else except me pays the cost of providing health care for those who cannot afford it. In that case, the poor are helped just as much since my missing contribution makes no practical difference in a large pool of people, and the help costs me nothing (and I get the benefit of being less likely to contract a contagious disease, etc.). So, the mere fact that we do not have universal coverage does not necessarily mean we don't care about the poor (though it might). It could be that we do care, there is net social value in providing coverage, but we haven't yet found a way to fully articulate the net societal benefits of universal care in a way that allows us to overcome the political obstacles that stand in the way of solving the market failure problem(s).

As for the likelihood of change, it's certainly true that the motivation to do something about the problem is greater as the costs begin to fall on the politically powerful parts of the population, and that is driving some of the current movement toward health care reform. And moving forward, as the problem becomes more widespread and the benefits of reform begin to become more evident to middle class (voting) families, the chances for reform should steadily increase. But I hesitate to follow the article's lead and use the term "glimmer of hope" to describe this since it involves things like a "growing number of insured families ... struggling with higher co-payments and deductibles and skimpier coverage" and it's hard to hope for that.

Comments

[Noni Mausa]

Phone a Canadian.

Just phone a number at random and chat for awhile with people whose most likely purchase of health insurance is to protect them if they venture abroad, especially into the USA.

I had to pay for health care this spring. It was the first such payment I have made in 35 years here. (For a niche concern not covered by Health Canada). It felt bizarre, foreign, to shell out the payment at the end of my appointment, as weird as going to Grandma's for Christmas dinner and then paying on the way out the door.

Within five years of changing over the US health system from a maze of toll booths to a common resource (think public libraries) Americans will look back on the current system as an incomprehensible Kafkaesque nightmare.

Noni

[jamzo]

people don't care enough?

the health insurance is dominated by a pact between congress and big employers

this pact does not allow government which spends the most on health care to set the pace in health care

it gives control of health insurance to big employers and their partners - the health insurance companies

this hurts small businesses, the self-employed, and the people of the united states

it also hurts big employers but they would never own up to it

big business gets some marginal economic benefit and an unclear power over the ability of their employees to swtich jobs because they might lose their health insurance

unclear since their employees tend to move to other big employers who give them health insurance

the biggest question in health insurance is what causes big employers to want to continue their control health insurance?

says...

>> Do We Care Enough?

1)america has the highest child poverty in the industrialzed world

2)hundreds of thousand of homeless (maybe millions)

3)soldiers getting royal screwed over after they put their butts on the line(many are homeless)

4)A hate radio industry populated by very rich commentators who make it a point to demonize the weakest members of society

5) Were vicious enough to back the invasion and utter destruction of a country that posed no threat to the US (Iraq)

ect, ect

[me]

Do We Care Enough?

As a diabetic, whose employer took away retiree health care (IBM), if I didn't have to worry about medical expenses I would not worry about retirement at all. I am afraid with the probably retirement of Ted Kennedy and the loss of Clinton to Obama, health care will fall by the wayside. Obama has no real plan and McCain wouldn't even cover himself.

I assume Noni is Canadian. My wife works with people located in Canada so we asked about health care. One guy got a speck of dust in hi eye on the weekend. He was treated at the emergency clinic and had two appointments with eye specialists that SAME WEEK. He certainly has no complaints. It will be interesting what his supplemental insurance will cost for a trip to Disney in December.

[save_the_rustbelt]

This article contributes little to the discussion or debate.

The American people (via their government) pay for about half of the healthcare services in the entire country.

Hardly qualifies are Scrooge.

The American people also elect representatives to fix problems. As of this moment neither party has a really good plan to fix the problem.

[Real Person from the Real World]

Ain't it the truth: the rampant "If I got mine who cares about you" attitude in the US is what is bringing it down. The foreign-born IT employer I work with, will buy himself a new computer keyboard or speakers rather than raise the walmart level pay of someone who has helped build his business for 4 years. His guys over 'there' are cheap but don't know the language soe he needs me, but I am paid the same as them... He has health care and air conditioning. I have neither and a heart problem. Cheap and selfish, sales and lies. That is all I see. I have hard him say to some of the consultants we work with, you get what you negotiate, not what you deserve.

[ECONOMISTA NON GRATA]

Just like guns and attorneys, it's better to have universal healthcare and not need it than to need it and not have it.

It's not that we don't care. Americans care deeply about their fellow Americans. They're just not that well informed and Universal Healthcare is a label that is associated with socialism, big government, liberals spending your hard earned tax dollars, fancy elitist ideas, etc.etc. I even debated an individual recently that associated Universal Healthcare with gay rights. Imagine that.....

We need to change the dialogue and start to talk about Health Care in this country as a basic right, in the same way that we discuss Equal Justice. We are responsible. Our voices will be heard if enough of us care enough to continue this dialogue.

America can afford it....

Best regards,

Econolicious

[anne]

"We need to change the dialogue and start to talk about Health Care in this country as a basic right, in the same way that we discuss Equal Justice."

[Jim]

Ask persons with health insurance to choose one of 3 options.

1) dilute their care so that all are covered without increasing cost.
2) pay more taxes so that all are covered without reducing care.
3) do nothing.

Sounds like a really tough choice to me.

[bakho]

Regular medical checkups is not part of American male culture:

What's the Problem?
In the survey, most men indicated that they have health insurance, have a doctor, and feel comfortable talking to their doctor.

However, more than half of the men -- 58% -- said something keeps them from going to the doctor.

Why the reluctance? The survey included a list of possible reasons; the men could select more than one reason. Here are their responses:

I only go to the doctor if I am extremely sick: 36%
I am healthy, I have no reason to go to a doctor: 23%
I prefer to treat myself naturally: 12%
I don't have time to go to the doctor: 12%
I don't have health insurance: 11%
I don't like doctors: 8%
I am afraid of finding out that something is wrong with me: 7%
I don't know of a good doctor in my area: 4%
Also, 39% of the men said nothing prevented them from going to the doctor

"Many men are unaware that simple screening tests and lifestyle changes can dramatically improve their quality of life," Kellerman says.

The survey shows that 28% of the men had been diagnosed with high blood pressure (hypertension), 13% with arthritis, 10% with diabetes, 8% with cancer, and 8% with heart disease.

The men also noted that, on average, they spend nearly 19 hours per week watching television but less than five hours per week exercising or working out.

Nudge, Nudge
Men may be more likely to see their doctor if their wife or partner encourages them to do so, according to the survey.

Most of the men who completed the survey -- 69% -- said they had a spouse or significant other.

Of those men, nearly 80% said their spouse/significant other influences their decision to go to the doctor.

http://men.webmd.com/news/20070620/why-men-skip-doctor-visits

[Bruce Wilder]

Michael L. Millenson: "If a lack of health insurance were truly a white middle-class crisis, then conservatives and liberals would long ago have joined together, carved out a compromise and done something. Instead, we're served a constantly recycled set of excuses for legislative stalemate."

Michael L. Millenson: "Over the years, our society has gradually provided a medical safety net for the elderly and disabled (Medicare), the poor (Medicaid) and veterans."

str: "As of this moment neither party has a really good plan to fix the problem."

While I certainly agree with str that neither Party has a really good health care plan -- and, no, folks, Hillary's plan was not all that, or even an unambiguously better proposal than Barack's -- it is worth noting how studiously Millenson avoids saying what ought to be obvious, but cannot be written on the nation's leading op-ed pages: the Democrats are in favor of effective health care reforms that provide better, cheaper care for more people, and the Republicans are against.

In every election, amidst the "news" about Obama's bowling scores, analysis of Hillary Clinton's cleavage, and what a war hero maverick John McCain is, we are also treated to a lot of high-minded complaints from "independents" and Broderite reactionaries about partisan bickering and the inability to get things done.

Morons like Millenson cannot acknowledge the most obvious and important political fact in the world: the Parties differ on the issue he's writing about. I suspect that Millenson's op-ed piece would not have been published in the Washington Post if he had, so it is not entirely his fault. Liberals and conservatives are not going to get together and simply "compromise" on some sweeping, good government reform. "Our society" did not "gradually" enact Medicare (or the GI Bill or the Veterans Administration health care system, for that matter). Democrats won a landslide election in 1964, and created Medicare over the (politically) dead bodies of a lot of Republicans. Afterward, Republicans adapted to the reality of an existing institution.

Political Parties are weird conglomerations, formed out of admixtures of attitude, identity, loyalty, material interest and misplaced hope. But, in amongst all of that, there are persistent and real differences on policy; the Parties are the vehicles of political choice in our Democracy.

Fundamentally, the Parties are mutual employment assistance associations -- they function to get member politicians, jobs. And, through most of American history, the Parties, more or less, competed to do the Will of the American People on popular issues. There have always been significant differences in policy approach, reflecting differing bases of support, but over the last 30 years the Parties have become ideologically purer than at any time in American history, and the policy preference differences, today, are stark.

Stark, and, one would think, unmistakeable. But, one would be wrong. Lots of people remain ignorant about the basic policy preferences adopted by the two Parties. If pollsters ask people about iconic Party policies: "Republican voters like the Democrat’s message more than their own party’s message by a large 14% margin when they don’t know which party it comes from."

Denying the reality of choice is the function of our broken Media. Millenson seems to be advocating health care reform. In fact, by not acknowledging or understanding how democratic politics works, he is working against change. Whether from cynicism or a preference for technocratic solutions, he's just another useless, right-wing tool -- better disguised in this case than some others, but there it is.

Politics is a team sport. The two teams are headed toward goals in diametrically opposed directions.

[Jim]

jamzo is correct. Medicare sets payments based on current costs, and corporations set future prices based on what they believe Medicare pricing will be. The U.S. provider/payer system does not function to find the real cost or value of the services provided. Providers once opposed 'socialized medicine', then found out what a bonanza it can be when properly mismanaged. To really find out what the costs and value are, get rid of the money altogether. That of course will never happen.

[robertdfeinman]

The problem is said to be unfixable, or too expensive, or there are no viable plans, but as Noni has pointed there are countries which have solved the health care problem. In addition to Canada there is the UK, France, Germany, Japan and Scandinavia. What's the difference?

1. They allow the government to regulate (or manage) health care.
2. They don't permit Pharma to advertise to individuals, or bribe doctors or legislators.
3. They review treatments for efficacy and allow comparisons to other options. In the US a drug only has to prove it works, not that it is better than an alternative.
4. They don't spend 54% of the federal budget on militarism.

Health care is only too "expensive" when you ignore the elephant in the room. How often does this need to be stated?

It's not only health care that is being sacrificed, we have broken levees, falling bridges, decaying schools, a high imprisonment rate and many other indicators of a civil society being sacrificed to the god of war.

If people are really interested in the US being competitive in the world then good health, education and infrastructure should be priorities. Sick, ignorant people don't make good workers.

[Alex Tolley]

Real Person from the Real World; What would happen to your employer's business if you got sick and couldn't work? Are you just 'plug and play' and immediately replaceable, or would the business suffer?

Jim:
1) dilute their care so that all are covered without increasing cost.
2) pay more taxes so that all are covered without reducing care.
3) do nothing.

False choices.

How about:
1) Pay higher taxes but get all your salary H/C deductions back.
2) Know that you have the freedom to change jobs without worrying about getting an inferior H/C plan (or none) in your next job.
3) Know that with even with a catastrophe, you will be fully covered and not have to pay the balance exceeding the cap.

The last time universal H/C was promoted, the vested interests struck with FUD messages, and successfully got voters to stop thinking rationally. 15 years later, a lot more voters are seeing that they are the ones vulnerable to the system.

Interestingly enough, the system is now so broken that physicians find Medicare working better for them than many large private insurers. Think of that, the one traditional scrooge of H/C payments now being a better "carrier" than private business for the provider.

I recall that when Paul Wellstone ran a week long H/C teach-in for a panel of citizens c.1990, the panel changed it's collective mind and embraced universal H/C when presented evidence by pro and con representatives. What we need is a collective national teach-in. In this, I think Krugman is right, we need to make H/C insurance a major issue in this election and have a real debate about the issue so that people cannot be ostriches in this matter.

[save_the_rustbelt]

The "average American" is busy working and raising a family, and doesn't have time to read economics papers, do blogging or whatever else us policy eggheads do.

i just returned from services in my medium sized rural middle class Methodist Church, and in my head counted up ministries, about 36, ranging from prisons to Native Americans to NOLA reconstruction to health care to poverty relief to etc.

The idea that the "general public" hates the poor, or is indifferent, or whatever, is just crap.

[save_the_rustbelt]

Regular medical checkups is not part of American male culture:

bakho:

Have you been talking to my wife?

[jamzo]

if big employers said that they wanted to get out of the health insurance purchasing business the health insurance discussion would be very different

this is not an outlandish idea

there is support in the business community for this

the health insurance companies see this happening

they propose a new market structure

they want to get rid of the group (employer-based)market that they have fought so long to protect

they want to create an individual based market tied into high deductible insurance policies, tax incentives, health savings accounts, and medicare funding

they call it consumer-directed health insurance

bush has been salesman-in-chief for this idea, the bush administration has done everything it could to move the idea forward

mccain is hoping to assume that role

[cm]

Real Person: "the rampant "If I got mine who cares about you" attitude in the US"

This attitude is present in any society with a degree of geographical and social mobility that breaks up stable local mini-societies where people are "stuck" and in each other's face for a long time, and hence are accountable to each other.

The mechanism of mitigating the lack of voluntary, or otherwise peer pressure induced, cooperation is "regulation".

[cm]

To repeat what I have pointed out many times before, in Germany health insurance for employees is about 14-15% of gross wages (up to a cap), with a 50% employer match (no match for the self-employed). That's family insurance, but every wage receiver in the family has to pay. Healthcare is also provided by the unemployment and welfare systems, financed with transfer payments from non-welfare healthcare carriers and tax funds.

The healthcare premiums are (in part) income tax deductible according to a complicated enough degressive formula to not go into that here.

Back in Germany, as a single with an OK professional salary, my total income tax plus FICA plus healthcare would amount to about 45% of my gross (effective not marginal) - 25% taxes and 20% various social insurance.

As of today, Germany has a sales tax (VAT) of 19% if memory serves, and 7% for food items and books.

That's nominally more than in the US, but overall living standards are not below the US in my judgement, but ever so slowly declining as social insurance is "reformed" and business "deregulated" in deference to US-style "prosperity".

[Cost Matters]

"When the general public talks about a health care crisis, what they're generally talking about is rising costs."

The problem of cost is the primary reason we don't have universal coverage. The US already spends as much per capita on public health care as other advanced nations. Unfortunately, health care is twice as expensive here, so only half as many people can be covered by what is spent.

The general public understands the real problem very well. Cost. You simply can't keep driving costs up without regard to ability to pay, and still expect things to work out.

[cm]

Cost Matters: Costs are only what they are in the current system, where a lot of money is siphoned off by activities, and agents, that have little to do with actual healthcare delivery.

Cost apparently does not matter a lot for hegemonic ventures like the Iraq war, or supporting a debt-based finance system.

[jfb2252]

About a sixth of US health care spending is overhead in private health plans and providers, versus ~2% for Medicare or single payer plans in other countries. This is why Jim's choices are inappropriate. The real choices are:

1. create a single payer universal health care plan with a four year career redirection plan for all the health care paper-pushers who would be thrown out of work. No new dollars needed except for the four year redirection plan.

2. continue to see US employers lose competitiveness to all other first and second world economies. Continue to have a sixth of Americans uninsured.

[Cost Matters]

"Cost apparently does not matter a lot for hegemonic ventures like the Iraq war, or supporting a debt-based finance system."

I'm with you. We spend almost as much on defense as the whole rest of the world put together. Neither Canada nor Mexico shows any inclination to invade us. What on earth are we doing this for?

The debt based finance system is out of control. During the emergency of the Great Depression, a bit of credit stimulus was called for. However, the stimulus has gone on for so long that debt is now completely unbalanced. Once started, programs almost never seem to end.

[donna]

As I keep trying to point out, we're already paying for it. Just because you don't see those payments doesn't mean they aren't there.

One reason Medicare costs are skyrocketing is because that's where hospitals are making up for those patients who can't pay -- my mom's final hospital bill was 350K just in Medicare costs alone. If she hadn't had Medicare and private insurance as well from my dad's previous employer Motorola, there would have been nothing left of her estate to provide for the trust my disabled sister and nephew, not to mention pay off my brother's house and leave my family a tidy sum.

I am insanely grateful for Medicare. Everyone in this country is one healthcare crisis away from supporting universal healthcare. It's time, we all need it, employers need it to even begin to compete globally and still be able to provide jobs in this country, and why we are still fighting against it at all is simply beyond me to understand.

WE ARE ALREADY PAYING THE COSTS. DOn't people get this yet?

[ddt]

I use the Canadian system, and I find it great. I wish that it covered dental too, but oh well. The hospitals do get crowded and there have been problems with some wait times, but overall it is dependable and more importantly, very cheap for what you get. even the conservatives overwhelmingly favor public healthcare.

That's actually something that American progressives might want to study: how to sell public healthcare to conservative voters - because you are going to have to at some point. I think that implementing it directly at a federal level without first establishing widespread support would be very difficult. Fortunately, it is such a good win-win idea that I think it is possible to get most people behind it, from all over the political spectrum, even in red states.

If you look at how Canadian medicare came about, it wasn't something set up by policy wonks in Ottawa, but a product of rural populism and a common sense approach to pragmatically solving the problem of doctor shortages, excessive cost and poor access to medicine in Saskatchewan. It started in the rural prairie provinces (midwest) and then spread from there by example and sound argument. It only became federalized later on.

The interesting thing is that the founding provinces aren't even the most left-leaning in Canada, and one of them is the most right wing. That's really the reason that we still have the system, and that is why Americans need to get at least a portion of the conservatives on board if they don't want whatever progress they make to be reversed 4 or 8 years later. Establishing the system is only half the battle. Saving it from destruction or "subtle strangulation" over the course of multiple administrations is the hard part, and if conservative voters in Canada did not support medicare it would probably have been gutted already.

[Blissex]

«how to sell public healthcare to conservative voters»

Dixie voters chose to die in their hundreds of thousands to defend the "States rights" of their elites to keep them poor and to enslave their dark skinned compatriots. Anything to keep that vile rabble down.

As someone suggested you ain't gonna sell voters on the need to pay more taxes so that welfare queens with Cadillacs and strapping young bucks eating t-bone steaks can also get laugh their way to the doctor and hospital knowing that the victims of their parasitism and exploitation are footing the bill. As Lee Atwater said in not so many words.

Look, as someone said, if Unions, Health Care, Nice Neighbourhoods, Decent Schools and Good Jobs were reserved to those who matter and their blue eyed blonde kids, the USA would be the most social democratic country in the world (and it was pretty social democratic as long as unions, good jobs, neighbourhoods, etc. were segregated).

But they would rather not have any of those things themselves than share them with the undeserving muggist and rapist exploitative parasites of a different color who want to live large looting and mooching their betters...

Or as refined economists say "welfare provision tends to correlate synchronically with tribal uniformity" :-)

Way to go americans :-)

[Cost Matters]

"About a sixth of US health care spending is overhead in private health plans and providers, versus ~2% for Medicare or single payer plans in other countries."

Private insurance isn't even a significant factor with regard to Medicare/Medicaid, and costs are still twice as high as other nations. Far more fundamental changes are needed than just eliminating private insurance. We should be able to cover everyone with just what we spend now on public health care, and completely eliminate employer based costs on top of it (allowing higher wages).

[Cost Matters]

That is, 15% of GDP devoted to health care is not necessary. Other nations do it for about half that, and most of the difference is not just the administrative cost of private insurance.

[anne]

Ever more sickening, keep on though.

[anne]

Complaining reference to: "As someone suggested you ain't gonna sell voters on the need to pay more taxes........................................."

[anne]

Cost Matters:

"Private insurance isn't even a significant factor with regard to Medicare/Medicaid, and costs are still twice as high as other nations."

Please reference.

[TJ]

Man, I love to hear you liberals whine and place blame on everyone except yourselves. You sissys need to be more optimistic.

I love this line the best from the post: If a lack of health insurance were truly a white middle-class crisis, then conservatives and liberals would long ago have joined together, carved out a compromise and done something.

Sure, that's it, blame it on racism. Why not? On average, white males tend to live longer than black males. Is that a vast government conspiracy too? Or perhaps you believe FDR and his fellow racist fascists instituted the Social Security program to ensure black men would be working to finance white men in their retirement. You guys have it all figured out.

[Blissex]

«FDR and his fellow racist fascists instituted the Social Security program to ensure black men would be working to finance white men in their retirement»

Now that you mention Social Security, it was created when most black men (never mind women) could not get a proper job except as menials or sharecroppers, that is self-employed. Some parts of the New Deal though were supposed to help those categories, but Social Security was not quite there.

Anyhow, a quick search yields some interesting links (not that I agree with them, just found them randomly notable:

http://www.cato.org/pub_display.php?pub_id=3329
"Why Did FDR's New Deal Harm Blacks?"

http://au.answers.yahoo.com/question/index?qid=20080606110230AAlLFwk
"How did the new deal help black americans?"

http://encarta.msn.com/encyclopedia_761595158_7/african_american_history.html
«The Social Security Act brought assistance to many workers, but it excluded farmers and domestics—65 percent of all African American workers. Similarly, the bulk of black workers were not covered by National Recovery Administration codes (see National Industrial Recovery Act).»
«One of the most dramatic developments that took place during the 1930s was the realignment of black voters. Blacks in large numbers switched their votes to the Democratic Party, deserting the Republican Party, the party of Lincoln that blacks had supported since Reconstruction. This shift took place partly as a result of blacks’ involvement in labor unions that generally supported the Democrats, and partly in response to Republican efforts to attract Southern segregationists.»

Workers of irish and italian etc. workers mattered electorally rather more (they were not as disenfranchised as the dark skinned ones).

[mrrunangun]

Another reason the public has not supported such schemes in the past is that our political system has not recently shown that it can be trusted to put the interests of the whole above the interests of special pleaders. Medicare pays for chairs that stand a person up, motorized chairs costing several thousand dollars each to help folks get around, and other luxuries that other countries' socialized systems would probably not consider worthy of public support. The manufacturers of a device with a medical application lobby for its incorporation into the medicare program and then roll the cost of lobbying for it into the item and, once it is in, can bill medicare. As long as the system works that way, immense expenditures of dubious value for the dollar become part of the system. An honest efficient federalized system could in theory be the best obtainable system, but nothing else in the government is run honestly and efficiently and the citizenry may suspect that the flood of money rushing into a medicare-for-everyone plan would enrich the few at the expense of the many on an even greater scale than it does now.

[Blissex]

Even more entertaining:

http://www.duboislc.org/MissouriBlacks/p06_1914-1939.html

«When the United States declared war on Germany in 1917, some 20,000 Negro-fighting men volunteered, many of who were from Missouri. The Negro soldier had double purpose in fighting; the first was to save the world for democracy and the second was his belief that victory by the allies would gain him the full citizenship so long promised, but so long denied.
The post-war years, however, held out small hope for improvement for the Missouri Negro. Negro soldiers were beaten and lynched when they returned home.»

«Moreover, unions organized opposition to the introduction of black workers into northern industries and urban centers.»

«Adding to the racial conflict resulting from job competition was friction caused by Negroes trying to move into formerly all-while neighborhoods.
In 1925, Samuel R. Hopkins, president of Square Deal Realty and Loan Company, was the victim of the first bombing of homes occupied or about to be occupied by Negroes in Kansas City.»

«The Negro still had very little political influence at this time. At best, all the Negro could hope for was a small political job from the Republicans. Out of gratitude, the Negro largely supported the Republican Party. The Republicans did little for the black man. The Democrats did eve less. In fact, Missouri Democrats were even opposed to blacks filling stereotyped janitor roles.»

«Health care was still a problem for Negroes. In March, 1925, during Negro Health Week, the Secretary of Missouri’s Negro Industrial Commission, Robert S. Cobb, estimated 13,000Missouri Negroes were ill all of the time and their annual loss in earnings was approximately $1,350,000. Cobb said Missouri Negroes had an excessive death rate caused by ignorance of health laws, poverty, environment, migration to urban areas. Furthermore most white doctors refused to treat them and white hospitals refused to admit them.»

«In the 1930’s, Missouri and the nation were in the midst of the greatest depression ever experienced. The depression hit Negroes hardest of all. They were the last to be hired and the first to be fired.
Whites began taking what were once regarded as “nigger” jobs—waiters, porters, and other menial work.
When the state government changed administration in January, 1933, white girls even replaced Negro elevator operators at the state capitol as well as in major state offices. Blacks had been “expected” that positions vacated by Negroes would be “filled with Negroes.”
The battle for employment continued to be uphill for the Negro. In 1934, Negro workers had no share in the construction of Kansas City’s new municipal auditorium. Race exclusiveness among local labor unions was the excuse given.»

«It was fitting this litigation should have been started by a Missouri black, because Negro parents had appealed to the courts to permit their children to attend white schools which had better facilities and, except in the larger cities, better trained teachers.»

«Probably of greatest permanent benefit to black and white Americans was the Social Security Act of 1935, providing for old age pensions and unemployment insurance. While the benefits were meager, they held out promise to persons who before had been dependent upon charity, relatives or poor houses.»

Except that most blacks could not join the system...

[TJ]

Growing up in a mobile home park, I promised myself I'd leave it and never return as an adult. I did. My brother, however, still lives there. This is an important fact given that we both grew up in the same environment with the same culture, opportunties and values.

I went on to earn my BS and MS. I sacrificed my youth to make sure I would have a good future; my brother did not.

I now have a well-paid job and a relatively high net worth. Since getting my degrees ten years ago, I've never taken a sick day (although I've been very sick), and I've only taken six vacation days. My brother, however, does not even work.

I sacrificed my youth and I still sacrifice so that I never have to rely on anyone else. Now that I'm doing well, you liberal nutjobs want me to sacrifice more--in taxes--to support your lazy, incompetent butts.

If you want health insurance, get a job. If you still can't afford it, get two or three jobs. Just don't ask me to work harder and longer to support those people like my brother who don't feel like making sacrifices themselves.

Incidentally, I've been without health insurance briefly, too. Because of my frictional unemployment, which accounts for nearly half of the uninsured, I had no health insurance. But I soon found employment again, and I once again had health insurance.

People do care about helping others, but not those who are not willing to sacrifice to help themselves.

[anne]

Blissex:

Thank you for the references and tempered tone.

[save_the_rustbelt]

"I've never taken a sick day (although I've been very sick),"

Do your coworkers a favor and stay home when you are sick - spreading your crud around the work force is not some great act of heroism.

[We (almost) universally care]

We, i.e. society, will not let your brother die of some common disease that can easily be prevented with medical care. We don't care how poor his choices have been, he doesn't deserve to die for them. The only question is the cheapest way to provide that care. Universal care is the answer.

[Lee A. Arnold]

TJ, the idea behind universal health care is not to help the free-riders. The free-rider problem will exist under any system and it already exists in this one. Taxpayers are already picking up the bill for free-riders at county hospitals and so on. But taxpayers are also picking up the bill for people with jobs who can't afford the insurance. Universal basic health coverage (not for all medical demands, but just basic coverage) will lower the cost of the entire system, be cheaper than private insurance, and is likely to raise worker productivity in addition -- because low-paid workers won't have to worry about the health of their families. Most people are not bums -- even the poor.

[robertdfeinman]

From TJ the standard "I'm superman" libertarian rant. Get back to us on how that self sufficiency works out for you in the unfortunate event that you ever get really sick or too old to work.

Why libertarians feel so superior to others and are so resentful of anyone who needs help never ceases to amaze me. They are especially contemptuous of loafers, of course the definition of loafer changes over time. At one time it as assumed to be Irish and Italian immigrants, during the Jim Crow period it was blacks, now it is "illegal" immigrants.

I tell you an ugly truth, if the wealth in this country was more even distributed we could even afford to pay for the care of a few actual deadbeats. Why aren't you equally resentful of Bill Gates? He amassed his fortune by overcharging millions of people using monopolistic tactics.

As I've said before there are only two classes in the world, those who have to work to eat and those who don't. If you don't realize that you are in the same boat as every other worker then you have been blinded by the rich.

The spiteful would rather penalize the unfortunate in vast numbers rather than see a few loafers getting a free ride. Surprisingly when these "loafers" are asked if they would prefer to work the bulk of them say yes. There is little pride in being a parasite and most people want to feel they are doing something with their lives. So I don't want to hear about the onslaught of deadbeats that will happen if social services are made more equitable.

[TJ]

A few points:

We (almost) universally care says--"We don't care how poor his choices have been...[we want to give everyone handouts]."

I do care about personal choices. Economic incentives matter!!! Persons must be accountable for their actions. Tell me, do you hold murders and theives accountable for their poor choices? I hope so. Read an economics book. Even the liberal Paul Samuelson admits personal behavior and incentives matter (I've read his econ book several times, in fact).

If you want to provide handouts to anyone regardless of his actions, you will encourage poor behavior, not good. Funny thing, rewarding the needy only encourages neediness. It's basic behavioralism we learn as college freshmen. Reward good behavior, punish bad.

Lee Arnold says: "Most people are not bums -- even the poor." I agree, Lee. I was poor for much of my life; now I'm in the top 10% of wage earners. But some poor people, such as my brother, are bums. He spends hundreds of dollars each month on booze, tobacco, and weed, but he is on a state-provided medical plan, which I'm paying for. He could afford it if he would get a steady job and stop making all the bad choices like booze and tobacco.

Robert says: "Bill Gates? He amassed his fortune by overcharging millions of people using monopolistic tactics."

That's just funny, Robert. Bill Gates helped improve productivity across the world, which generated economic growth and likely made the world trillions of dollars richer. He has directly and indirectly produced millions of jobs, and he even made several thousand people into millionaires. Bill Gates is a hero to be praised, not condemned. And, by the way, Microsoft is no monopoly, Robert. In fact, follow the news to see just how Bill Gates and Mr. Ballmer are frightened about Google and the resurgence of Apple. It is a company that might not survive 10 to 20 years from now, and it may falter sooner. Monopoly? Balderdash!!!

[Icarus]

TJ,

I don't envy your uphill battle amongst these bloggers.

The general tone here is that the poor have done no wrong. They make no mistakes, and hence should not be held accountable for their actions. If a child is born into a poor family, it's not the parent's fault - it is societies. If a child is hungry at school, they blame the school for not being a proper soup kitchen.

This is the cavernous pit that these quasi-socialists have devolved into. Tax the rich, and give it away to the poor. It's shallow robinhoodism.

The truth is that no one really wants to pay for healthcare, but assumes they deserve it. Many live obese, smoking, not exercising, and somehow it's the health care industry's fault they're not healthy. It's just insane.

I too, like you, sacrificed my youth, in a way. No dating, no watching hours of tv, no lingering on street corners. I had to suffer through studying at times, and didn't get caught up in a monied economy. The result was a great education, and now a high paying job. And, like you, my individualistic sensibilities are offended when I'm told the 40% or so I pay in taxes is insufficient.

Poverty is structural, no doubt. But, breaking that cycle has to involve changing behaviors, and not begging for handouts (which is what the left is reduced to now).

There should be a level of healthcare for even $50/month, which covers basics. There will always be expensive treatments which some cannot afford...we can't manage against this. Science and Technology will lead to many medical developments, some very expensive.

A first step in developing a healthy lifestyle for americans (which moves beyond just getting them healthcare) would be to set expectations about personal responsibility. You are responsible for your choices...this is the underbelly of the freedoms we cherish. Have children before being financialy stable...well, don't be surprised when you're living paycheck to paycheck. Don't exercise for a couple of decades...well, don't be alarmed at the arthritis and cardiovascular disease you develop. Smoke cigarettes for years and years...don't be alarmed at the odds of lung cancer.

Instead of speaking in a practical tone, the left (on this blog) usually speak in the language of handouts. Corporations should pay, the wealthy should pay, everyone else should pay.

At some point, does a person's choices in life ever matter?

[rowen]

"Far more fundamental changes are needed than just eliminating private insurance."

"That is, 15% of GDP devoted to health care is not necessary. Other nations do it for about half that, and most of the difference is not just the administrative cost of private insurance."

Blue Cross/Blue Shield once did a Pareto study, and found that 80% of the costs were beginning/end of life situations. Because of our unique "costs be damned" philosophy towards life, health care costs in this country will always be astronomical. How much are the last 6 months worth? Some cancer drugs are 30k/month; if everyone gets that kind of coverage, we're royally screwed. Obama says that everyone gets the same care that he gets; does that mean I get the world's foremost brain surgeon, a la Ted Kennedy, if I have a brain tumor?

The usual "preventative care" justification for universal health care benefits may help for individual maladies, but we'll always have beginning/end of life scenarios. Unless you can prove demonstrate that universal health care is a capital investment (derivative monetary benefits offsets costs), then right now, given our current economic environment, there are much better uses for government expenditures (e.g. renewables, mass transit, etc).

[Icarus]

Rowen,

You've hit the issue right on its head. What are the politics of death and birth?

We spend much to much of our precious dollars on extending life...and, we simply can't afford it. Emergency rooms are financially strapped, and often closing.

The so called progressives will shriek in alarm...they expect that society spends every dollar it has to, to keep someone alive one more day. It's just silly...

[robertdfeinman]

TJ:
If you are going to persist in making the libertarian arguments, you have to at least get the facts straight. Microsoft was found guilty in the US and the EU of monopolistic behavior. A quick search will turn up the wikipedia article about the US trial as well as the (continuing) issues in the EU.

A monopoly (Microsoft) extracts excess payments from customers who have no alternative. Bill Gates made his fortune by engaging in illegal activities. The fact that our legal system is broken and the firm got away with a slap on the wrist doesn't change the findings of fact.

One of the characteristics of monopolies is that they get complacent. The money comes in too easily and they, eventually, get overtaken by events. It happened to US Steel, the big three automakers, AT&T (with some help from the government), IBM and Kodak. Some survive in a reduced form, some adapt. Microsoft is now trying to buy into new technology. They may be successful, or not, but they still have a monopoly on operating systems.

I'll skip remarking on the rest of your reply, since I covered the points in the first place and suggested you not repeat yourself, but you did anyway...

[Andrew]

The Farmer and Universal Health Care

Imagine you’re a farmer out in the country. You know what type of crops to plant and when to plant them. You take pride every year when you see your goods being sold to market and fell good about providing nutrition for both youth and adults. You know very well that some of your crop will spoil before they make it to the shelves. However, there is nothing you can do to prevent this, once it leaves your farm, someone else has the responsibility of delivering or storing your crop.

Now imagine that about half of the population in the big cities has a great idea to stop crops from spoiling. They protest that the government should be the ones to grow and ship the crops. These idea holders have little knowledge of farming, but have heard that in some countries, government run farms appear to be just as efficient as ours. This is the basis of their argument. The government should run all farms and see that the shipment is delivered in a timely fashion, to ensure there are no spoiled products.

As a farmer you know that spoiled crops are inevitable, unless you grow them right next to the store. But there are many who hold you responsible, for what is really the nature of produce. Although it’s clear to you and all other farmers, that it's just the reality of farming, but to try and change the opinions of those in the far away cities would be impossible.

Those who cling to this new idea are happy to consume your crops. However, they haven't a clue as to what it takes to make them grow and to ship. They just want fresh produce and don't care to educate themselves about what farming is about.

The following year’s political season is filled with promises of government collectivization of farms. “Fresh produce” for all they say. This appeals to many, and the polls indicate that most people are in favor.

With dust in their eyes, they cannot recognize the benefits of the current system. They can pick and choose which ever store they wish to shop at and always have a variety of produce to choose from. They can complain to the store management if the tomatoes are never fresh. Management, in turn, will probably call a new produce vendor to keep his customers happy.

Shortly after the elections, an agricultural collectivization act is past. All farms are now government run. The harvest is expensive, but the government does its best and it turns out to be a great season. The Gov. then ships the harvest to the cities and the inevitable occurs. There are some spoiled goods. Now the city folk find themselves in a tight spot. Who can they complain to, and who would listen? Now they are stuck.

I know the idea of Free Health care for all seems great, but it is a trap. You will be stuck with what ever the government says. What if you really needed a surgery and the Gov. deems it unnecessary or what if a preventable mistake occurs during a procedure? Maybe you feel your doctor is incompetent but he’s going to be your surgeon, who do you turn too?

The reality is that your grievances will be ignored, you may be denied a life saving treatment or possibly a therapy that would improve your life. Today we have choices upon choices, and doctors are fully aware that you may drop them at any time. They save lives and alleviate pain, but at the end of the day, they still need to feed their families. So long they compete for our $, Dr.’s will always be at the mercy of the consumer. If you place your health in the hands of the government, you will no longer have control of your health, it will belong to the Feds.

Less Gov. is Better Gov. So Long It’s a Fair Gov.

www.InsureMeDFW.com

[reason]

Andrew...
That is probably the stupidist post on a complicated issue I have ever read. This is not kindergarten.

[cm]

Andrew: When attacking strawmen, make them at least resemble the original. Nobody exhorted other nation's healthcare systems as merely "as efficient as ours". They are in enough cases more efficient and more effective. If you look at the US system, those in the HMO or "network" system cannot choose and pick where to go. Well, they can, and pay "list price" out of their pocket and/or have their coverage substantially reduced.

And neither are other countries' systems "collectivized", they are in many cases private but regulated. But maybe you consider that to be the same?

says...

«So long they compete for our $, Dr.’s will always be at the mercy of the consumer.»

That's one of the most incredibly stupid things that I have read in a long while.

[german_reader]

Some of the posters above have mentioned the German health care system as one among many other examples how health care could organized more efficiently than currently in the U.S.. One integral element of the German health care system is the division between a public system ( gesetzliche Krankenversicherungen ) which covers around 90% of the population and a privately run system which insures around 10% of the population, mainly younger and higher income people or in other words the "better" risks.

The dual nature of the German health care system has been a constant reason for discussions, because it's seen as an unnecessary waste of resources ( administration costs ) and private insurance companies tend to concentrate only on the most lucrative customers, leaving the "bad" risks to the public system.

The surprising thing is now that even some of the largest insurance companies in Germany such as Allianz or Axa have started to advocate for a single public controlled health insurance system. It would insure all major risks at a unified charge and leave only the coverage of additional luxury treatments to free arrangements between insurance companies and their customers. The background is that many private insurance have run into serious trouble because unexpected costs from an aging client base are damaging their calculations and they obviously want to spread the risks. The German edition of the "financial times" had on article on it ( in German ):

http://www.ftd.de/unternehmen/versicherungen/:Krieg%20Krankenversicherer/369877.html

What might be interesting of this story for Americans is not only that the business models of private health insurers seem to work primarily under "good weather conditions", but the differences in calculations and costs between the private and the public insurance sector in general.

While public insurance companies charge on average 2210 euros per year from their customers ( employees and employers contributions combined ) and spend 2069 euros per capita on health care costs, privat insurers demand 3209 euros per year and pay 2116 euros per capita for health care. The difference is enormous.

At least here in Germany private insurers are much more expensive than public insurers - despite a more advantageous customer structure - while the health care coverage is not necessarily better. Most of the difference can be explained by higher administration costs and additional profits in the private sector.

Perhaps the German example reflects on a lower level what's a major reason behind the cost explosion in the American health care sector: Inefficient organization structures and monopoly profits of private health insurance companies.

[Andrew]

Less Gov. is Better Gov. So Long It’s a Fair Gov.

www.InsureMeDFW.com Health and Life Insurance for Texans

"Straw Man"? Don’t think so.

The Farmer and Universal Health Care was just a parable I wrote. My intent was to help those who don't think very much. I guess I failed.

Yes, with most HMO's you must first see your PCP for a referral. There are a few exceptions.

No, on a PPO plan or Network plan, you need no referral. You simply pick the doctor of you choice and so long they are part of your network, you will face no penalties or extra charges. You have many choices.

You can pay for your health care up front. (It’s cheaper, you have better choices, and there is competition for your dollar.) Or you may pay for it, with taxes extracted from your rear. (You will sign off all rights to your health, you will be stuck with what ever they say you need, and Dr.'s and hospitals will not care if you’re satisfied with their services because they know you’re not picking up the tab, and then you’re helpless)

The Gov. doesn’t budge.

Have you ever heard of the "Down Winders"? All of the evidence was in their favor but when they tried to sue the fed's they lost. You can’t win against the fed’s.

Do you really want to give up the rights to your Health?

I doubt it, but there are a few who do. Therefore I must ask.

What other rights do you wish to give up?
I am sure Washington will gladly take them away, just ask.

[Andrew]

-Says...

Have you ever heard of competition? If so, how can you disagree with Dr.'s competing for your $. After all, they are in business. If you don't like em, don't use em. They depend on your $ to eat.

That’s what our current system afforded us.

Do you have your kids in one of those soccer leagues where no score is kept, so both teams can win?

You are a fool to want the Gov. to have more control over your daily affairs.

I assure you, our Founding Fathers were not puta's, nor did they want anyone to be forced to pay for your mishaps.

[Patricia Shannon]

Anne,
How come you can't recognize when someone else is making obviously ironic remarks, when you do the same?

[Patricia Shannon]

Anne, I'm referring to Blissex's obviously sarcastic remarks. Why is it ok for you to make such remarks, and assume other people will see your intent, when you don't do that for others?

[Patricia Shannon]

TJ

Most of us have been around long enough to know that the children in a family do not have the same environment, a fact which has been borne out by recent studies. Parents do not treat their childen alike. I'm not saying that everybody is alike. There are certainly individual differences. I am the only one in my immediate family with a college degree. Much of that is due to the fact that I am lucky to be more capable educationally. It wasn't my hard work that caused my genes to have their particular combination.

The fact that you would be ok with your brother dying from lack of health care, when the worst thing you can say about him is that he is lazy, indicates to me that both of you were injured by your early environment, with different results.

[Patricia Shannon]

http://news.yahoo.com/s/ap/20080610/ap_on_re_eu/italy_ancient_laborers;_ylt=ArRj6w2tu6iHndAp9lFfpNVvieAA

Ancient laborer burial ground excavated near Rome

By FRANCES D'EMILIO, Associated Press Writer Mon Jun 9, 8:41 PM ET

ROME - First-century burial grounds near Rome's main airport are yielding a rare look into how ancient longshoremen and other manual workers did backbreaking jobs, archaeologists said Monday.
...
Also excavated was a skeleton of a man whose lower jaw was fused to his upper jaw.

Study indicated "how for all of his life this individual was fed, likely through the care of his family" with liquids or semisolids "introduced through a hole made through his teeth," the archaeology statement said.

The man lived into his 30s, a decent age at the time. Experts took that as evidence that the lower classes cared for the disabled.

At least some ancient Roman laborers were more civilized than some people today.

[ken melvin]

Good enough for it's time, the old testament was written thousands of years ago.

[Patricia Shannon]

TJ says If you want to provide handouts to anyone regardless of his actions, you will encourage poor behavior, not good. Funny thing, rewarding the needy only encourages neediness. It's basic behavioralism we learn as college freshmen. Reward good behavior, punish bad.

If that worked so well, we would have no needy people.

[Patricia Shannon]

TJ
It sounds like your brother is depressed. This is not something one chooses.

[Patricia Shannon]

ken melvin,

Typical ignorance of religion by those in this suppposedly so religious county.
Jesus, in the new, stressed caring about others. In Matthew 25, He said that how we treat the unfortunate determines whether or not we go to heaven.

[Patricia Shannon]

Welfare Religion
copyright Patricia M. Shannon 1996

What would Jesus think if He came to earth today?
Do you think He would be happy with all the folks who say:
"I am saved, alleluia, and I'll live forever more".
But they would never think of giving comfort to the poor.

They say they believe in Jesus and the Bible is all true,
but they ignore what He did say in Chapter 25 of Matthew:
What you do for the less fortunate, you've done it unto Me,
and where you go after you're dead depends upon your deeds.

They say "I feel so good because I have been born again.
And what's that got to do with how I treat my fellow men?
Jesus loves me, this I know, He loves only myself;
it's true, because He doesn't care how I treat anybody else.

I believe in Jesus, no need to change my ways,
just massage His ego once or twice a day.
I believe in Jesus, that is all it takes,
to get me into heaven, the perfect welfare state.

[Patricia Shannon]

http://www.eurekalert.org/pub_releases/2008-06/cf-ibp060608.php

Public release date: 10-Jun-2008
Contact: Mary Mahon Commonwealth Fund

Insured but poorly protected: 25 million adults are underinsured

Number up 60 percent in 4 years; rate of underinsured triples for middle and higher income families; underinsured go without needed care and face medical debt

New York, NY, June 10th, 2008—The number of underinsured adults—those with health insurance all year, but also very high medical expenses relative to their incomes—rose by 60 percent between 2003 and 2007, from 16 million to more than 25 million, according to a new Commonwealth Fund study released today as a Health Affairs Web Exclusive. Middle and higher income families were hit the hardest by the steep increase: underinsured rates nearly tripled for those with incomes above 200 percent of the federal poverty level, which is an annual income of $40,000 or higher for a family.
...
ncluding those who had any time without insurance during the year, the study estimates that more than two of five (42%) adults ages 19-64, or 75 million people, were either uninsured during the year or underinsured during the year as of 2007, up from one-third in 2003. The study identified the underinsured using medical cost exposure relative to income. The underinsured included those insured all year who spent 10 percent or more of their income on out-of-pocket medical expenses or 5 percent of income if low-income (under 200% of federal poverty level), or who had per person deductibles equal to 5 percent or more of family annual income.

The study found that despite the fact that the underinsured have health insurance all year long, they are at high risk of access problems and financial stress—with experiences often similar to the uninsured. Both underinsured and uninsured adults were significantly more likely to go without needed health care and to struggle with medical bills than people with adequate health insurance.

* Half of the underinsured (53%) and two thirds of the uninsured (68%) went without needed care because of cost, including not seeing a doctor when sick, not filling prescriptions, and not getting recommended diagnostic tests or treatments. By contrast, only 31 percent of the insured report going without such care.
* The underinsured were almost as likely as the uninsured to face financial stress related to medical bills. Nearly half (45%) of the underinsured reported difficulty paying bills, being contacted by collection agencies for unpaid bills or changing their way of life to pay their medical bills as did half of the uninsured (51%). By contrast only 21 percent of the insured reported financial stress related to medical bills.

Insurance Characteristics

Underinsured adults were more likely than adults with more adequate insurance to have insurance plans with limits on the amount a plan would pay or on visits. And, underinsured adults were much more likely to have high deductibles—one quarter had annual deductibles of $1,000 or more.

Despite these limited benefits, the underinsured faced premium levels that were similar to those paid by adults with more adequate health insurance. Premiums were often very high relative to incomes, adding to financial stress.

[Patricia Shannon]

http://www.eurekalert.org/pub_releases/2008-06/jotn-coc060508.php

Public release date: 10-Jun-2008
Contact: Liz Savage
Journal of the National Cancer Institute

Cost of cancer care climbed between 1991 and 2002, as radiation and chemotherapy increased

The cost of cancer care incurred during the period two months prior to cancer diagnosis and 12 months following diagnosis increased substantially between 1991 and 2002 for elderly patients in the United States, according to a study published online June 10 in the Journal of the National Cancer Institute. The increases in costs for breast, lung, and colorectal cancer were due in large part to increases in the percentage of patients receiving radiation therapy and chemotherapy and the rising costs for those therapies.

[Patricia Shannon]

Even with perfect conditions, some people are not going to do as well in a particular environment because survival of the species requires variability.

http://www.eurekalert.org/pub_releases/2008-06/bc-aaa060608.php

Public release date: 9-Jun-2008
Contact: Graeme Baldwin
BioMed Central

ADHD an advantage for nomadic tribesmen?

A propensity for attention deficit hyperactivity disorder (ADHD) might be beneficial to a group of Kenyan nomads, according to new research published in the open access journal BMC Evolutionary Biology. Scientists have shown that an ADHD-associated version of the gene DRD4 is associated with better health in nomadic tribesmen, and yet may cause malnourishment in their settled cousins.

[Icarus]

So, Patricia, are you now saying that I can be lazy, contribute little to nothing to society, blame others, sit at home watching tv...and, because I am a human, I deserve public handouts? Should I get a basic human wage for doing nothing? Should I get medical coverage? How about a car? Where do my 'rights' take me to, in terms of the goods/services I can demand from my working co-citizens.

I love this plan...

[Matt]

Did you see the Bunk study stating 2/3 of doctors in America want National Health Care. The doctors who did this study also conducted one in 2002 and found that the majority of doctors did not want national health care, the problem with this is that the 2 question surveys drastically differ in there 2nd question. I found this article, 60% of Physicians Surveyed Oppose Switching to a National Health Care Plan, It's worth a read.

[Real Person from the Real World]

Icky, where are you finding all these lazy types? Everyone I know is employed, even if it is unofficially, under the table and not counted on taxes. There are some wealthy types who live on the rents and investment income they never earned, but some distant ancestor did. These cannot be those of whom you speak, can they? Oh, but their income buys them the health care they need, doesn't it.

[Andrew]

Universal Health Care Euthanize:
If it’s free, it gets used, A lot.
Countries with socialized medicine are familiar with the “Take as much as you want so long that it’s free” mentality. Americans took on the same attitude in the 1990’s when they were given something new. These were the “Unlimited co-pay days”. Insurance companies were hit hard by there overuse and reacted by limiting or raising co-pays while preserving preventative care benefits. Why is this great? Because, the fact that private insurers can make the changes to balance things out. They can re-act to current circumstances, but best of all, they bear all the risk, not the public, and what’s even better? If rates increase or there are unfavorable changes in coverage, the consumer is free to leave and purchase coverage from a long line of competitors.
Socialized medicine has approached the problem of overuse by rationing care and raising taxes. Rationing care does not mean that some people will go without treatment, except in the cases where one dies while on a list or when one is discriminated because of his or her old age. Rationing care also means that the amounts of procedures to be preformed in a certain area are pre-determined. It is a system of action not re-action. Simply put, a person might be placed on a waiting list if they aren’t first in line for an unanticipated need for a certain type of care or procedure. You may be placed on a list for something as simple as MRI, mammogram, or in many cases, surgery. (It is important to note that most emergencies, i.e. car accidents, are treated immediately)
However, what’s most worrisome about rationing out health care, are the treatments withheld because of poor foresight or lack of resources. There are countless examples of Canadians paying out of pocket for their surgery in the U.S., rather than wait several months at home. I met a Canadian couple whose relative was placed on a six month waiting list for his bypass operation. He spent $30,000 for his surgery in Seattle. Not all Canadians are as fortunate.
The U.K. has a mature socialized medical system. It’s sometimes referred to as a “Two Tier” system. The first tier includes everybody. The second tier is reserved for those who can afford private insurance. (Mexico’s system is similar.) The second tier are the fortunate and do not want to deal with the shortcomings of their public system. (Last I heard was, approximately 15% of the population in the U.K. held private insurance and this number was expected to increase.) Ask yourself, why anyone who has free health care purchase a Private Health Plan?
Canada does not currently allow its citizens to purchase private health insurance, however, if their system does last as long as the UK’s. You will find plenty of Canadians with private insurance. (This is a Two Tier System)
Now ask your self this. Is a two-tier system fair?
“A patriot will give their life for their country, only a fool will give their health to their country.”

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