Those are compound words (if I have the correct term here but you’ll catch the meaning). The best way to explain this would be by saying that compound words would be written in German like: compoundwords. So you’re actually saving space by reducing spaces!
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That would be fitting, since Jill Stein is a joke candidate. 
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I don’t know, in the Netherlands it takes something like 10 years after you get your citizenship as a immigrant before you’re eligible for (unemployment) benefits. Still you’ll hear a lot of scare stories about immigrants coming here and getting benefits (not doing their part and obviously also stealing our jobs)
So I don’t think reality will get in the way of that mindset/scare story.
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The theory of why for-profit insurance companies make sense is that there are ways an insurance company can profit that have nothing to do with denying people treatment. They can profit by negotiating lower healthcare rates with providers, by pushing more efficient medicine and by getting their members to be healthier by pushing things like preventative care.
The healthcare market just seems broken. Medicare reimbursement rates seem to be the floor insurance companies negotiate from and even they are too high, we choose incredibly expensive medical treatment options rather than their cost-effective alternatives and people don’t visit their physicians frequently enough for preventative care.
Even the nonprofit health insurance options aren’t any more affordable and there are over 100 million Americans on a nonprofit plan.
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Actually, countries with universal healthcare systems do this far more aggressively than the US. It is a major cost control mechanism and bigger factors for why our healthcare is more expensive than theirs.
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OMG, that’s been sitting there all this time and you’re the first person I’ve heard put it together!
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To be fair, @Archon [practically handed me the opening] (Al Franken sending Jeff Sessions letter "to have him explain himself").
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Private health care insurers are very skilled at limiting how much they’ll pay for testing, prescriptions, surgeries, etc. They end up being, in effect, corporate death panels for patients of all ages, not just the elderly.
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This is a true and valid argument, however I think at this stage with them and me it’s less me having a valid argument and more about… me?
I dunno. I’m not good with people, family least of all.
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They just had a historian on Here and Now talking about the problems with health insurance. Here is the conversation, in case you’re intrested in a historical view of the problem:
Honestly, I don’t think it’s a numbers issue (though it might be a contributing factor). It’s a problem of rising costs that we can’t control (how more complicated care just flat out costs more, no matter who you happen to be), but that insurance also causes cost to rise, because you have something between you and the doctor now. I see a major part of the problem being that we’re treating healthcare as a luxury rather than as a right.
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I think that a certain basic level of healthcare really should be a right and many countries have shown this is feasible. At the same time, there are certain aspects to healthcare that should also be treated as luxuries.
-Want to go to the doctor for a checkup or because that thing hurts / oh-no I have cancer (covered for everyone)
-Want medically unnecessary plastic surgery (out of pocket / private insurance)
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Well, did I say anything about plastic surgery? And some people define things like birth control as “luxuries” no matter what the circumstances, and it’s actually not. Birth control is common enough that, frankly, they should be OTC at this point, but they aren’t. As such, given the various reasons women might use them (and assuming we all deserve privacy), birth control SHOULD be covered.
Also note that some plastic surgery, such as implants after a mastectomy or reconstructive surgery after an accident, fire, or some such, SHOULD be covered, I think, as they stem from physical changes to the body due to an accident or a medical condition. Gender reassignment should also be covered and that can include plastic surgery.
But neither insurance companies nor the government should not be making that decision. An individual with their doctors SHOULD be making those decisions. Certainly not some random busy body who happened to have won re-election and not some CEO looking to take an extra overseas vacation with the bonus he got denying people life-saving medical coverage.
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I agree with you 100% that contraception and medically necessary plastic surgery (such as the examples you cite) should always be covered. I also mostly agree on who should make those distinctions. There will always be a set of ground rules about things that should and should not be covered. In my experience (in Canada) it is generally the bureaucracy (always somewhat influenced by politics) who makes these decisions rather than the politicians themselves. I think that this makes the system at least somewhat responsive to public pressure to include new treatments or drugs or to cover new categories of procedures (because of changing societal norms). Perhaps a bit slower than if individual patients and their doctors were the only ones making the decision.
There are always pressures to keep a lid on the rising costs of these programs but I would much rather have the decisions being made in public rather than the boardroom.
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Reading your post again I am floored at how far away our views on the utility / benefit of government seem to be.
I think the idea of denial of life saving treatment is very interesting. In Canada we are discussing how opioid users are being denied life saving treatment because the health care system will not supply prescription heroin to treat their chronic condition of Opioid addiction. This is especially urgent with the epidemic of overdoses from fentanyl and carfentanil. Where do you draw the line?
I personally am in favour of harm reduction treatments for addiction but not everyone is. This may be a situation where the courts will force a different decision on the government than they would otherwise take on their own.
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What about the greater good?
We only have so much money to spend on healthcare. Every dollar spent on one patient is a dollar that isn’t spent on another.
Is it right for a doctor and patient to decide to spend $100,000 to extend a person’s life for 6 months when that same money could have been used to extend a half-dozen people’s lives by decades?
These kinds of decisions governments with universal healthcare make. They’re focused on improving the quality of life for as many people as possible for as many years as possible. That requires making trade-offs that negative affect the minority for the benefit of the majority. That’s not something a doctor or patient is focused on.
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How so? I just don’t think insurance companies or the government should be making health decisions for individuals, deciding on individual care, such as a woman isn’t allowed
I agree, but that wasn’t part of the above discussion, so I’m not sure how you got the idea that I would disagree. I also believe in legalization of at least some drugs and robust care for addiction as part of health care.
But we spend too much NOW when we don’t have to do so.
Single payer cuts costs. Allowing the government to negotiate cuts costs. Promoting wellness visits and preventative care, and FUNDING that for everyone cuts costs. Not making sure everyone is covered, means lots of people will not go to the doctor when they feel ill, because they can’t afford to, and then their health problems spiral out of control.
Insurance companies are making them now. Would you rather that a for-profit company make these decisions, or the people we elect and can more effectively can hold accountable? [quote=“Aloisius, post:96, topic:97721”]
That’s not something a doctor or patient is focused on.
[/quote]
No, but I’d argue that the insurance company makes these decisions now and overrides the doctor’s decisions quite often.
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Often times those end of life treatments are experimental, with accrued results over time leading to the extension of many lives. More to the point, this is why such direct cost comparisons aren’t always appropriate for healthcare decisions.
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Ideally? An agency of civil servants that are as politically isolated as possible with input from a national board of medicine, international organizations like WHO and ideally, other national medical boards.
Absolutely not elected officials given lobbying of the health sector (half a billion dollars last year) and the difficulty in explaining to the average constituent that “death panels” save lives.
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I think that might be workable and I can certainly agree with that. But I do think that elected officials have more public accountability than for-profit insurance cos. I do think looking at programs that already provide the public with insurance are good to look at for how they actually function (especially in states where they are not artificially constrained by politics). People with medicare, for example tend to be satisfied with it.
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That was just an easy to understand example. The cost-savings measures that countries do aren’t just end-of-life scenarios. They’re things like cutting way back on MRIs, not performing mammograms on 80 year olds, not covering a name-brand prescription that is only moderately better than a generic alternative, limiting colonoscopies to one every decade, etc.
Effectively, it is health treatment options by actuary.
A doctor simply has far less leeway than in the US. Though some of that comes from simply offering up best practices and recommended treatment pathways that promote the more cost-effective options, but sometimes it means simply not covering more expensive options or being fined for using too much medicine deemed unnecessary.
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