Critics of universal health care who claim that it is too expensive may not realize just how much it costs to have so many uninsured. Preventative care or early care is almost always cheaper than emergency care, where visits average about $1000 a pop. Not to mention the cost to productivity when sick people miss work but can't get better, or when they make others sick because of a communicable problem they can't afford to deal with.
I'll write more on this later, but South Korea's version of universal health care with its relatively high out-of-pocket expenses is being looked at as a model by those who understand the need for health care across the board but don't want to hand over the medical system to a nanny state.
High out-of-pocket costs won't keep people out of emergency rooms, especially undocumented residents. Children often get sick, and families in my school often take their kids to a local emergency room because there is nowhere else they can go to get "free" health care. People bash Wal-mart, but their $4 prescriptions and in-store health clinics provide affordable alternatives.
ReplyDeleteSonagi wrote:
ReplyDeleteHigh out-of-pocket costs won't keep people out of emergency rooms, especially undocumented residents. Children often get sick, and families in my school often take their kids to a local emergency room because there is nowhere else they can go to get "free" health care.
Rest assured, I am not talking about a system where across the board everyone has to pay high out-of-pocket expenses for everything.
South Korea already does means testing which determines how much or how little someone pays to be in the health insurance system (which is now mandatory for everybody), and hospital visits are as cheap as emergency room visits, where the initial visit is nominal (but enough to deter most people from walking in every day).
A key word in what I wrote is "relatively." It's relatively high out-of-pocket, which tends to decrease demand for the frivolous, and when unnecessary demand is deflated, costs don't get run up to much, so in the long run there's a significant cost savings on necessary care, both for the user and for the state.
As long as there are ways for the means-tested poor to receive care without going bankrupt, then it is a good system.
People bash Wal-mart, but their $4 prescriptions and in-store health clinics provide affordable alternatives.
I actually have said this so many times I have it down to a speech. (And it makes contrarian kushibo a tad unpopular among the Ivy Tower liberals who are so far left you can't see them because of the curvature of the Earth.)
Walmart may be bashed for its reliance on cheap workers who don't quite qualify for "fringe benefits" like health care and other necessary goodies, but they are doing a world of good to those on a budget by offering the $4/month alternatives.
When I first heard about them testing this, I thought it might all be a gimmick, but when they expanded from their test locations (mostly in Florida, I believe) to the entire country, I got a hole of one of their lists of $4/month drugs and I was impressed. Of course, it won't cover everybody's problems, but it's a damn good start.
It's good to note that other places have started to follow suit. It's true that it's not so much a gimmick but a hook (to get people into the store), but it is a real savings and no one forces you to buy everything else there.
As far as I know, none of the Oahu stores has a walk-in clinic, but in Hawaii it may not be necessary. Hawaii has, by American standards, a model health care system, so the stop-gap measures provided by Walmart and the like aren't as necessary here.
Sonagi, I have been seriously toying with the idea of creating a medical sociology and public health blog, one that would point out articles and other things related to health from the social side of the equation.
ReplyDeleteYour apparent interest in healthy living (judging from what you write at The Marmot's Hole) makes me think you would be a good addition as a full-time contributor (like you do at MH). Would you be at all interested?
(And by "full-time" I mean with full access to the blog to write whatever you want, even if it contradicts me. I'm not saying you should quit your job or anything.)
I'm flattered by your offer and will consider it. For a short time, I wrote a blog about health issues before abandoning it because I felt I was positioning myself as an expert despite a routine disclaimer. My favorite free access health blog is Mark's Daily Apple. I was a faithful reader of the brilliant yet slightly cranky Art DeVany until he set up a subscription service. If you're not reading Science Daily every day, you must add this website to your rounds. It is a comprehensive collection of news releases describing the latest science research findings from around the world. The single best science news source for lay people on the web and it's free.
ReplyDeleteSomething else to think about, something I'm sure you're aware of:
ReplyDeleteCan the US really afford quality universal health care for everyone? One reason why our health care is so expensive is the increasing prevalance of lifestyle diseases setting in earlier and the lucrative market for treating these diseases. For every dollar spent on health care, I would like to see at least 25 cents spent on making produce more accessible to poor urban residents, making safe public spaces for people to work out, improving public transport which has a dual benefit of increasing physical activity and saving energy. Kudos to Obama for trying to cut wasteful grain agricultural subsidies, but it looks like he won't succeed.
BTW, there is a bill, HR 875, sponsored by the wife of a Monsanto consultant, which seeks to impose new farming and food regulations that threaten small farmers who use sustainable methods. A committed locavore, I have written my representatives in Congress to express my opposition to this bill.
Sonagi wrote:
ReplyDeleteI'm flattered by your offer and will consider it.
I/We don't have to start out big, just a Blogspot or Wordpress repository for news and information we find relevant and useful, plus some commentary.
For a short time, I wrote a blog about health issues before abandoning it because I felt I was positioning myself as an expert despite a routine disclaimer.
Of course, such a thing is necessary, though even the experts often should have such a disclaimer.
My favorite free access health blog is Mark's Daily Apple. I was a faithful reader of the brilliant yet slightly cranky Art DeVany until he set up a subscription service. If you're not reading Science Daily every day, you must add this website to your rounds. It is a comprehensive collection of news releases describing the latest science research findings from around the world. The single best science news source for lay people on the web and it's free.
I've glanced from time to time at all these blogs, though readings from work or school often prevent me from doing so. I'll try to make a point of perusing Science Daily.
Can the US really afford quality universal health care for everyone? One reason why our health care is so expensive is the increasing prevalance of lifestyle diseases setting in earlier and the lucrative market for treating these diseases.
ReplyDeleteYes, the lucrative market for treating them. In my limited study of health economics, I've seen a regular theme of how the market — and especially adherence to supposedly "free" markets in the health industry — actually cause prices to go up and up, without a corresponding increase in overall health care.
One health econ professor I had put it succinctly: Economists believe in free markets but economics is the study of market failures, which are failures of a free market to make things better and cheaper; health economics is a study of why health is a giant market failure.
Many of the Republican plans (like McCain's idea for insurance companies to compete across state lines for better individual insurance deals) actually exacerbate the problem (cherry picking and reducing the pool of average health seekers, leaving the state to pick up the tab for the difficult, expensive, or impossible to insure).
Out-of-pocket expenses are not designed to recoup costs for insurance providers but to prevent moral hazard in health care-seeking. The supplemental insurance policies that the rich can more easily get — essentially covering the deductible and the copay — encourage overuse of medical resources, driving up demand and thus driving up prices for those who cannot afford such luxurious health plans. A lot of that is related to the lifestyle issues you mentioned.
In short, there are dozens if not hundreds of detrimental mechanisms causing health care costs to go up in America, yet we have highly inconsistent health care outcomes.
For every dollar spent on health care, I would like to see at least 25 cents spent on making produce more accessible to poor urban residents, making safe public spaces for people to work out, improving public transport which has a dual benefit of increasing physical activity and saving energy.
Well, I don't disagree on any of that. It's hard, though, based on two things: the massive decentralization of our government structure and, perhaps more importantly, the "rugged individualism" cultural myth (i.e., the self-sufficient frontiersman) which too many politicos bring to the table when it comes time to solving issues that require a high degree of cooperation.
"I didn't need the government building me a park," "Why should I pay for your aunt's hip surgery?" "Your problems are just bad luck and bad genes, so why should I have to pay?"
Collective solutions are seen as socialist or European, or San Francisco liberal crap (and therefore gay). It's like our country has a collective brain disorder.
Kudos to Obama for trying to cut wasteful grain agricultural subsidies, but it looks like he won't succeed.
It would be nice if we returned to subsidies for fresh fruit and vegetables meant to be eaten as such.
BTW, there is a bill, HR 875, sponsored by the wife of a Monsanto consultant, which seeks to impose new farming and food regulations that threaten small farmers who use sustainable methods. A committed locavore, I have written my representatives in Congress to express my opposition to this bill.
Yeah, that's the kind of thing that pisses me off. The big guy squeezing out the little guy, especially when the little guy is trying to do something innovate that bucks the trend.