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John Mackey’s Health Care Plan
Wednesday, August 12th, 2009The Whole Foods CEO lays out his plan for improving health care coverage and quality in the U.S.
It’s spot-on.
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So seven relatively minor tweaks (that are mostly good ideas), then;
•?Finally, revise tax forms to make it easier for individuals to make a voluntary, tax-deductible donation to help the millions of people who have no insurance and aren’t covered by Medicare, Medicaid or the State Children’s Health Insurance Program.
Where are we going to get the money to cover the uninsured? Magic!
Wonder why Obama hasn’t asked him what to do?
oh, yeah, cause he’s a Marxist!
but then some of us knew that before the election.
Unfortunately, wishing really, really hard isn’t going to help us.
You see, the crushing deficit isn’t a bug, it’s a feature. It means the politicians today can act as though they’ve got a personal checking account without limit. It means the politicians tomorrow can seize yet more power to “solve” the crisis when it happens.
It is a decent idea. What worries me though is the readers comments. There are those who support the idea and those few who make a logical argument against it. However, it is mainly those who either relate Whole Foods business practices to healthcare or those who believe that healthcare reform is not about providing healthcare, but to level the social playing field.
Loveable opposition logic like:
Whole Foods isn’t union, therefore this plan is bogus
Whole Foods charges outlandish prices, therefore this plan won’t work
Status quo, status quo, status quo! (which, evidently, means that, regardless of the drastic changes recommended, the healthcare system will still be as broken)
I cannot tell if the comments are from a representative group or just some trolls trolling. Either way…not good.
I’m pretty dissappointed here, Radley. This plan seems to have the same old take on the standard plan that says we need to increase competition, and give consumers more freedom. We can all get behind that,and this adds nothing too new to that idea.
It does list a few problems and mistakes though.
First, “Enact tort reform to end the ruinous lawsuits that force doctors to pay insurance costs of hundreds of thousands of dollars per year. ”
This is just wrong. Insurance companies have admitted themselves that Tort awards have nothing to do with premiums, and a world class panel of doctors have determined that Medical malpractice Victims are actually *under-served* by the legal system. This is just ignorant.
Second, “two-thirds of Americans are now overweight and one-third are obese.” Well yes because we have clinically defined these words in such a way as to have no meaning AND these conditions are not particularly a) unhealthy or b) costly for our health system.
“heart disease, cancer, stroke, diabetes and obesity—are mostly preventable through proper diet, exercise, not smoking, minimal alcohol consumption” Is this guy fucking serious!? How does someone die of obesity?
Do you really want to endorse this article as “spot on” Radley?
#1, Jack:
The other one is:
•?Repeal government mandates regarding what insurance companies must cover. These mandates have increased the cost of health insurance by billions of dollars. What is insured and what is not insured should be determined by individual customer preferences and not through special-interest lobbying.
Most people will pick the lower cost insurance that DOESN’T cover the rare, but big ticket items. Then poof! They get MS and are relegated to dying in a gutter. Awesome!
Other than that, though… most of those ideas are pretty good, but Just bows and arrows against the lightning. The lightning being our demand to be kept alive at all cost without being willing to pay for it.
Speaking of healthcare reform has anyone noticed that when pressed the loud and obnoxious anti-reform protestors seems to fall back to “We’re afraid of Obama! He’s a socialist!”, or “Glen Beck says . . . “. LOL.
Great starting point for reforms. Mackey’s plan is what we ought to be working toward; if even half of the suggestions were implemented, we would be moving in the right direction. Of course, government’s primary objective is not to truly improve the lot of the citizenry, but first and foremost to gain greater control and surveillance over them, so I’m not holding my breath.
#5…
Morbid obesity does shorten your lifespan.
But more broadly, Mackey isn’t endorsing government definitions of overweight and obesity, and he and I may disagree about what is and isn’t healthy (I think he’s wrong about “minimal” alcohol consumption, for example), but he’s simply stating that collectivist medicine (which would be an apt description of the current system, BTW) removes any financial incentive to lead a healthy lifestyle.
I disagree with Mackey about his specific lifestyle recommendations, but in terms of policy he’s absolutely correct. Your own health ought to be your own responsibility. That rather common sense is going to disappear as we increasingly start paying for one another’s health care.
Many promoters of health-care reform believe that people have an intrinsic ethical right to health care—to equal access to doctors, medicines and hospitals.
People think you should have an intrinsic right to a lot of stuff. And the more they get, the more they want. And nothin’ pisses them off more than when that fact is pointed out to them. It’s only called greed when corporate CEOs do it.
While all of us empathize with those who are sick, how can we say that all people have more of an intrinsic right to health care than they have to food or shelter?
People do believe that everyone has a right to food and shelter only it’s in the form of a “living wage” which is defined as whatever it takes to get food and shelter.
#6
Most people will pick the lower cost insurance that DOESN’T cover the rare, but big ticket items.
Lower cost insurance is the insurance that does only cover the rarer, big ticket illnesses.
Think about car insurance. Poorer people buy policies with high deductibles that only cover serious accidents, because those policies are cheaper.
John Mackey is clearly just another free market nut case.
The combination of high-deductible health insurance and HSAs is one solution that could solve many of our health-care problems. For example, Whole Foods Market pays 100% of the premiums for all our team members who work 30 hours or more per week (about 89% of all team members) for our high-deductible health-insurance plan. We also provide up to $1,800 per year in additional health-care dollars through deposits into employees’ Personal Wellness Accounts to spend as they choose on their own health and wellness.
Money not spent in one year rolls over to the next and grows over time. Our team members therefore spend their own health-care dollars until the annual deductible is covered (about $2,500) and the insurance plan kicks in. This creates incentives to spend the first $2,500 more carefully. Our plan’s costs are much lower than typical health insurance, while providing a very high degree of worker satisfaction.
I guess I don’t get how that works.
I have a similar plan and as best I can tell there’s no incentive for me to shop around for care because the only thing I can spend that money on is medical expenses, and since it’s already rolled over a couple times in my case I’m pretty sure my deductible is covered anyway.
And he touches on cost transparency but frankly that’s a big issue and I don’t see a lot of ideas there. Most of his proposals are about encouraging development of an effective market in health care but how do you do that unless people can actually know what a thing is and what it costs? I would imagine, for instance, that if my insurance company negotiates specific rates w/ various providers that neither they nor the providers are going to be eager to publish those rates.
Fair enough, Radley,
I do think that point was sloppily made and it adds fuel to the fire for those who want to regulate health decisions and will cut and paste the snippets they like from the CEO of Health Foods. He may not be endorsing government definitions of weight classes but he’s using them and he’s throwing them out there as if they mean something simply by pointing out these “facts.”
Like I said, I think the plan is almost entirely very wise, but i can’t stand behind something that is so careless – in a potentially reckless way – with important facts about decisions and health.
One thing this site has taught me and makes clear is that misinformation always plays a central role in limiting personal liberty.
#13…
Once your HSA exceeds your premium, you can roll the excess over into an IRA.
Radley’s right about the big ticket items but that’s not what the debate is really about.Peple expect their insurance to cover every doctor visit and most of their drugs.They don’t want up front costs period.It’s the only industry where people think they (or their employer mostly) can pay one flat fee and get all the service and product the want.It’s not sustainable.
So how do I get an HSA like that?
The shitbirds that run mine – I dumped them after a one-year experiment – have a use-it or lose-it clause that allows them to confiscate any unused money at the end of the policy year.
Consumers will never care what a things costs if they’re not paying for it directly.
High deductible insurance that gives people an incentive to shop around for routine care sounds like a step in the right direction.
Also, instead of dictating what insurance companies should cover, maybe they should be issuing policies for a maximum amount of coverage like car insurance. That would give people an incentive to shop around for health care providers to cover major and emergency treatments (most likely before a crisis actually strikes).
Agree with Nick T – that article is awful.
Tort reform is a red herring. I’d be embarrassed to associate with the article on that basis alone. He also seems completely confused as to what people mean by “a right to health care” (he conflates a right to basic health care with a right to anything you want, randomly asserts that is supercedes a right to food and shelter, and completely misunderstands the concept of rights as developed in the enlightenment and understood by the founders) and doesn’t seem to have the foggiest idea how the systems in other countries work (the additional paid coverage is a feature, not a bug). Who is going to “make” costs transparent, if not the government? His solution to lowering costs is to make it easier for insurance companies to deny coverage? How is that going to improve health care at all? His “solution” appears to be the status quo, tax breaks, increasing the number of uninsured, and making anyone who can’t afford coverage dependent on charity. This isn’t a solution to anything.
Most baffling of all are his unsupported, and frankly crazy, statements about health. We can prevent cancer? Since when? What does it mean for people to take responsiblity for their own health? If thats not the beginnings of a justification for letting “irresponsible” people die on the streets, then what does it mean? And his statements about health and obesity run directly contrary the opinions offered on this site.
You need to stop rushing to praise libertarians. He doesn’t even agree with you, let alone make any sense.
Eat salads, drink water and live forever! At least it will seem like forever.
I think it is amusing that the largest group against socialized medicine in this country is the group that is currently on socialized medicine. The elderly. The greatest generation. Damn.
It is a god damn mess and I don’t see a solution.
A few days ago the consensus (at least, by karma points) here seemed to be we need to decouple health care from employers. Doesn’t his suggestion pretty much continue the current system of employer based?
Also, the HSA is a good idea, and I have one, but I can’t say it actually makes a much differance in my health care choices. Besides, when you get sick, just a couple of tests can easily wipe that out.
We need govt OUT of health care completely.
We need the AMA kept out of govt.
We need to eliminate all artificial limitations on the numbers of people entering the healthcare profession. Limits are placed so those in healthcare can make mo’ money.
Eliminate insurance and pay as you go.
No tax breaks for nothing.
From 86 to 01, I had my own business. I opted for no insurance for my family of 5. I saved minimally $500/mo for those years. I paid all medical costs from my savings. Total expenses including MRIs, etc for the 15 yr period – maybe $3k.
We have thousands of people running to emergency rooms for freaking coughs and colds. We have people going in for every ache and pain BECAUSE they have insurance.
IF we want to have a program, everyone should pay according to use. “I” should not be forced to pay for “you”.
That CEO is so full of it he has brown eyes.
Tiocfaidh ar la!
IRA – sounds like you had an HRA instead of an HSA. An HSA is your money in a special account, nobody can take it from you. An HRA, on the other hand, is funny money that the insurance company spends on your behalf.
We had an HRA before an HSA, and it just felt like a complete scam.
“The problem with socialism is that eventually you run out
of other people’s money.”
—Margaret Thatcher
She should have said democracy, not socialism. Anyway, she’s a party pooper. We can spend as much as we want as long as China believes future generations in the U.S. will be able to pay it back.
All people want is the best possible health care at an affordable cost. Anyone who proposes a plan that doesn’t guarantee that is a loser. Free market proposals sound nice, but they’re naive and don’t come with a guarantee like government proposals.
On another point:
IF the number is 47 million, that is approximately 17% of the population. According to studies I’ve read it’s more like 8 million since many of the millions counted don’t have insurance by choice or just aren’t signed up for coverage they are “entitled” to but no one is really entitled but the govt gets to control you through entitlements.
83+% of us are fine. So the contrived crisis is not major for the majority.
Why fix a problem that doesn’t exist? Because that is all govts have ever been good for.
You want lower costs. Drop the insurance, save the money, and pay your way when you really need care. Worried about the major illness that could take everything you have to pay for? Worrying will not change one hair on your head except to make it grey. Plan for it. Set up your OWN savings and leave the money until it’s really needed.
Dominus providebit!
“Your own health ought to be your own responsibility.”
Not anymore.
@ #5: Yes, obesity can kill you (in that it parties with with any of a dozen real killers). And, squirrels like nuts.
For those interested (who haven’t seen it yet…I hope this isn’t a redundant post), here’s where you can find an abridged, understandable breakdown of the new health care bill: http://blog.flecksoflife.com/2009/07/19/the-hc-monstrosity/
I have to say that Mackey’s plan makes a lot more sense and is a lot less oppressive than what’s being pushed through government, atm. The more I read about Obamacare, the more worried I become…
Radley,
I’m all for high deductible policies. I think we can ALL agree on that.
That’s not his point. His point was to allow the consumer greater leverage is choosing an even LOWER cost policy by allowing insurers to eliminate rare but high cost coverage. Insurers would LOVE this because it provides cost stability.
Do you think, for a heartbeat… that a majority of people would NOT choose the cheaper alternative, even though it doesn’t cover conditions they will likely never be a victim of? If so, then your faith in the human race is greatly misplaced.
Off the top of my head: Child’s Leukemia. Those without children, those with older children, or just those WITH children but really broke… will propably opt out of this, leaving a TINY pool of ‘insured’ paying inhuman premiums because of the tiny pool.
The car insurance example? Not even Apples and Oranges. More like Cumquats and Steel I-Beams. Noone EVER took their Honda to a mechanic and was told “Well, it’s got Overdrive Spinitis. It’s going to cost 400 grand to repair.” No, you’d just put a bullet in it’s radiator and bury it out back before heading off the nearest car lot.
Actually, yeah, I do have an HRA rather than an HSA.
They already got theirs. They’re probably thinking that adding that many more people to the welfare rolls might compromise the government’s ability to meet commitments its already made (to them).
“Lower cost insurance is the insurance that does only cover the rarer, big ticket illnesses. ”
I think it would be more apt to say it “should be” rather than “is”. Certainly the cheap dental Insurance offered by my employer through DeltaDental is horrible and covers the exact opposite of what I would like for them to cover. They have an annual cap on benefits of $1000 dollars. So the 2K Root Canal + 2K crown and I was out of luck.
Another thing that has bothered me is congressmen and the president complaining about ‘fee for service’.It seems they’d like doctors to get a set income per year.To do this all doctors would have to work for someone,either government or a insurance company.Most of the docs I know are self employed.Only socialism can do this .
I thought this was a decent article with thought provoking points though I didn’t agree with all of them, most of them I would like to hear how implementation would work. I have had HSA’s in the past and NONE of them rolled over. In fact, due to a lose or use policy at the end of the year, a lot of people underwent unnecessary treatments and exams so as not to lose the money they put in. I would like to hear how these HSA’s would become rollover when it is not in their interests to do so.
Also, I basically agree (philosophically) with the section on our health care being our business and that lifestyle choices can effect our long term health. What does he want insurance companies or your employer do with that information? Higher premiums? Higher deductibles? Denial of coverage if I let me weight get too high or buy too many cigarettes or don’t eat the type of diet he proscribes (which just so happens to be the type of diet his stores cater to, coincidence that.) I don’t want the government to force lifestyle choices on me any more than I want corporations or my employer to do so.
But my biggest problem with this way of thinking is that it is a huge red herring. Even assuming all his stats are right about the dangers of poor life choice on our health and choosing to live his way will extend our lives into our 90′s or 100′s, so what? Everyone will still eventually die of something and if it isn’t cancer or diabetes or some other lifestyle choice related disease in our 50′s or 60′s it will be something else in our 90′s and 100′s. And unless someone can show some evidence otherwise, I presume that the majority of us will die slow lingering deaths as our bodies grow old and fail, even if from no cause at all. I suspect there would be an increase Alzheimer’s and other forms of dementia for example, which would cost just as much, if not more, than treatments for lung cancer.
I think dangers lie down this road for little or no gain.
#22, fwb:
That’s awesome! And if… say… one of your kids came down with Leukemia you would have… what? taken them out back and shot them? Or watched as they died slowly knowing it could have been treated?
What about traffic accidents?
Or would you have gone bankrupt trying to treat these conditions? Way to roll the dice!
#30 Mike-
You forgot about the other aspect of what Radley was saying, that the cheap insurance would have a high deductible. Your Dental Dental example looks like it had a low deductible (and a cap). So, it isn’t comparable.
No. But they get in an accident and find themselves suddenly responsible for hundreds of thousands of dollars in medical bills. Happens everyday to ordinary people and that’s what they get insurance to protect themselves from.
Sorry if my post was unclear. My reference to car repairs was a metaphor for routine medical expenses that aren’t (and shouldn’t be) covered by the insurance.
ok, #31 Mike. Sorry. It was #30 when I commented.
“People expect their insurance to cover every doctor visit and most of their drugs.”
Interesting point. It’s sort of a similar logic as the people who overpay their taxes and are excited when they get their refund. I suspect most people would pay less in doctor fees and prescription costs compared to what they pay in insurance costs now.
Dave, I was responding to Radley. His reference to car repair was an attempt to support high deductible insurance, which specifically does not cover routine expenses.
Haha, he gets some of his information on other healthcare systems from the Investor’s Business Daily. Same claptrap responsible for this quote:
“The controlling of medical costs in countries such as Britain through rationing, and the health consequences thereof, are legendary. The stories of people dying on a waiting list or being denied altogether read like a horror script … People such as scientist Stephen Hawking wouldn’t have a chance in the UK, where the National Health Service would say the life of this brilliant man, because of his physical handicaps, is essentially worthless.”
Hawking, of course, was born and has lived in Britain his whole life. Also recently quoted as saying he wouldn’t be alive today if not for the NHS.
Is it possible for America to have a discussion about our embarrassing healthcare system without spewing misinformation about every other system in the developed world?
Well I’m not sure I forgot, I was comparing the currently available dental insurance products offered to me. I talked to my HR department and they chose this one as it was the cheapest plan available.
So the cheapest available plan was a low deductable but also a low total cap. I have never seen a dental plan offered that has a maximum out of pocket cost (to the patient). I certainly would have liked a high deductable plan but it didn’t/doesn’t exist.
My basic problem w/ a lot of these proposals is that I think health insurance itself tends to cause a lot of distortion in the market. And I think, even after all these supposed market-based reforms take place, we’ll end up more or less back where we are now.
For instance, it makes sense for people to pool their risk by purchasing insurance. But it also makes sense for insurance companies to mitigate risk by screening customers for preexisting conditions, genetic disposition to certain ailments, etc. So while most of the population will have insurance some percentage won’t and basically never will. As a society, I don’t think we can, will, or should just let these people go without care, so that burden is still likely to fall on the government or the providers or charities, etc. This is the state of things today, and I’ve not seen any serious market-based proposals to deal with it.
At the same time, it makes sense for insurance companies to negotiate rates w/ service providers. The insurance company directs business to the providers and in return the providers offer the insurance company a discount. It’s good business for both parties, but serves to undermine competition in the marketplace. As I mentioned up-thread, how are you to shop around when you can only choose from 3 or 4 providers and most of them aren’t going to give you an accurate picture of what you’ll be paying.
Likewise, once insurance is detached from employment, I think insurers are going to take a greater interest in preventative care, simply because there’s a greater chance that they will be on the hook for your coverage 5 or 6 years down the line. So while it’s nice to say that high deductible plans will encourage competition, it’s not clear that those high deductible plans will be structured in the same way they are today. If insurers decide that it makes sense for them to cover preventative care outside of the deductible, then you’re still back in the same boat where competition is undermined by their agreements w/ providers.
I’m also unclear on how high deductible plans work in conjunction w/ those negotiated rates; if my insurance company has a set rate for services through a specific provider and I get those rates even for services under my deductible, then it probably makes the most sense for me to stick w/ the providers my insurance company approves of.
If big government is truly inevitable as many people on this site argue, then the best solution is to abolish the Pentagon and its trillion-dollar budget and reallocate that money to universal health coverage where every person gets whatever health care they need no questions asked and no matter the cost.
If the money is to be stolen by government and spent on something no matter what, at least the victim of armed robbery (the taxpayer) gets SOMETHING in return.
So basically, you’re ok with the idea of healthier people subsidizing people who decide to practice a risky life style?
Or is it a privacy issue where it’s ok for everyone who sees you everyday to know that you’re obese or that you smoke, but the people covering the potential or resulting medical costs should be kept in the dark?
Seems like that would be a bit like telling a landlord he can’t control whether tenants are allowed to smoke or own pets in one of his apartments.
So basically, you’re ok with the idea of healthier people subsidizing people who decide to practice a risky life style?
I think it’s more that he’s not okay w/ attempting to eliminate subsidy through questionable definitions of health.
They already got theirs
Oh yeah. I understand that. What I would like to see is the hundreds of divisions of wheelchairs and hoverounds that would storm the White House if suddenly they no longer had their socialized medicine.
All of ‘em shaking grocery sacks full of pill bottles and wearing $250.00 per pair shoes for diabetics. Screaming with one unified voice, “Liberty! Don’t Tread On Me!”
The Greatest Generation. Damn.
Mackey has all sorts of interesting things to say. But it seems to me that he fails to get at some of the most politically touchy factors tending to drive prices up. An earlier commenter mentioned expanding the ability of NPs and other health care professionals to deliver services currently provided by physicians; but I think we need to be more forthright: professional licensing schemes and hospital accreditation schemes can significantly increase health-care costs, and need to be abandoned. Ditto for pharmaceutical and medical-device patents.
http://liberalaw.blogspot.com/2009/08/state-socialism-and-anarchism.html
My mistake. It turns out my comment equating car repairs (which aren’t covered by insurance) to routine medical care wasn’t even in this thread. It was in Equality, Health Care, Religion, Sex.
You don’t die from it, but it can be the major cause of things that do kill you, such as heart attacks and diabetes. Don’t be obese, and you’ll greatly reduce your risk of heart attacks and diabetes. It’s just semantics to state that you can’t die from being obese. It’s the same as saying “you can’t die from smoking”, but it’s the major cause of lung cancer, which will kill you.
You can’t save everyone, and sometimes shit happens in life. No one has a RIGHT to be saved from the trials and tribulations of life. Focusing on the exceptions in life which affect a minuscule percentage of people isn’t an intelligent method to employ when searching for a solution. You focus on what can be done for most people, and accept that there will ALWAYS be an exception.
The idea that insurers and hmo’s would compete better if only they were allowed to compete ignores the fact they they have consolidate into regional markets on purpose.
Further, these companies are too big for small players to force them to compete, and if they threaten competition, they simply acquire them.
Its especially rich that Mackey, the king of non-competition, demands the ability to compete. He avoid competition at all costs by buying and eliminating competitors to avoid what he calls “price wars”, which to the rest of us is called “cost savings via lower prices”.
And HSA’s arent going to solve anything (except maybe where should I put my money tax free) since only people who can afford insurance can afford to contribute to them.
Once money is in an HSA it makes zero sense to take it out given its rate of return and tax status. So it is effectively a retirement account and puts no pressure on current health care spending or cost. When catastrophe does strike, the $2.5k or so you socked away each year in your HSA isnt going to cover your $100k heart attack anyway.
While I think providing health care for members of our society is absolutely a moral obligation (as does the rest of the industrialized world), it doesn’t take altruism to see that having healthy neighbors, coworkers and customers is a good thing.
Here’s an interesting article about why healthcare is so expensive. It doesn’t have a thing to do with malpractice lawsuits, it has everything to do with doctors trying to be businesspeople. Doctors realize that they make money off expensive tests, procedures and home equipment.
The problem with ‘healthcare reform’ is that they’re not reforming healthcare, they’re changing who pays for it. It’ll still be extrememly expensive unless we fix the culture of doctors who are out to make a buck on sick people.
“Tort reform is a red herring. I’d be embarrassed to associate with the article on that basis alone.”
Tort reform is not a red herring. I know personally doctors who have moved out of Philly and right across the county line into the burbs b/c it halves their malpractice premiums. It’s specifically about avoiding that corrupt jury pool with a “soak the rich” attitude. That’s why OB/GYNs are fleeing cities and high-risk pregnancies. Tell a woman trying to find an OB appointment in Philly that it’s a red herring.
Frankly, if we’re talking about deregulating the health care industry, then it seems like tort reform is the last thing we should be looking at.
Referencing the article I linked above,
Tort reform is not a red herring. I know personally doctors who have moved out of Philly and right across the county line into the burbs b/c it halves their malpractice premiums.
Why does McAllen TX (texas has a limit of $250k for malpractice suits) have the highest cost of care anywhere in the US?
Dave Kruegger@44
Matt D. is close.
Two things to keep in mind. Lifestyle choices rarely DIRECTLY cause bad health long term. They create increased likelihoods, lower odds, cause complications, etc. Not all smokers get lung cancer and not all lung cancer sufferers were smokers. There is no one-to-one relationship. It is a matter of percentages and sliding scales and odds based upon a host of factors, many of which we are not aware of yet. Sure if someone who smokes two packs a day for 40 years gets lung cancer, we think we can narrow down the cause, but what if that same person worked for a steel mill, or was a coal miner, or even a clown (yes there is such a thing as clown lung)? Do the insurance companies cover only 10% of the care because some actuary has determined a 90% chance his cancer was caused by smoking. And to be honest if I got lung cancer tomorrow, what would I need to do to prove I never smoked if my insurance company or government panel (pick your poison) chooses to believe I did? Would I be registered somewhere? Would I need to submit 20 years of grocery receipts?
Second, all science is provisional. There are few definite, immutable, eternal conclusions. Every study leads to another study to refute or refine. Just think how back and forth the various studies have been on various issues like second hand smoke, obesity, excercise, weight control, BMI, nutrition (is a pyramid this week or a ziggurat?) etc. There was a time when reputable doctors were claiming smoking was good for you and had studies to back them up. When we learned otherwise would smokers have to retroactively pay more for premiums? There was a time, and still are believers, that second-hand smoke increases cancer risks. Since I lived with two parents who smoked like chimneys for 25 years would my premiums be higher. (no this isn’t MY lifestyle choice, but then I did choose to live with them for 7 years past my majority and my parents did pay for my health insurance before that. I have no doubt the insurance companies would make them pay for THEIR lifestyle choices even though I was the insured) Once we learned from new studies that second hand smoke is maybe not so bad, could I get my money back? Could someone get reimbursed for a procedure that wasn’t covered because at the time it was thought to be caused by a poor lifestyle choice but subsequent research shows it wasn’t?
So put those two together and now we have bureaucrats (government, insurance, employer, I don’t care) making decision by balancing odds, percentages, unknowable causation and likelihoods based upon provisional and contested science. Yeah, nothing could go wrong there.
The obvious examples of the 800 pound guy who needs to be weighed at the horse track and the three pack a day smoker are extreme examples. Put a gun to my head and force an answer and no, I wouldn’t want to subsidize them either. But the vast majority of us don’t fall into those categories. We exist in the twilight land of ebbing and flowing BMI charts, changing nutrition metaphors, and scientific tests that are frequently controlled by the very people who can benefit from the correct finding and that is aside from the bias towards positive results found in most peer reviewed journals. (That means if you have 5 studies on the connection between widgets and cancer, the one that shows a connection will get published and the four that show no connection won’t)
I’d like to hear more about how implementation would work on this, as I said in my original post, but I just don’t see how it could be implemented without letting insurance, my employer, or the government (probably all three) intrude into my life for little overall gain.
And your simile about the apartment complex needs more explaining. A landlord owns the apartment complex and should be allowed to rent to whomever they want. What is the property in this example and who is the property owner? I’m not sure I see an insurance transaction as being about property so much, but I could be corrected.
Once money is in an HSA it makes zero sense to take it out given its rate of return and tax status. So it is effectively a retirement account and puts no pressure on current health care spending or cost. When catastrophe does strike, the $2.5k or so you socked away each year in your HSA isnt going to cover your $100k heart attack anyway.
Right. And to reiterate a point I made up-thread, if you’re dealing with an expense that you know is going to exceed your deductible anyway, then what’s the incentive to shop around? I have a $1k deductible on my current plan, and while $1k is still a lot to me, I know that it’s still way, way less than any hospital bill I’m likely to receive.
Likewise, inasmuch as it creates an incentive to shop around for routine care, it also creates a disincentive to shop at all. And I’m not sure how helpful that is–if anything, I think we’d want to encourage people to seek preventative care, screenings, etc. But they’re less likely to do that if they can’t afford to pay into their HSA to begin with, or need to preserve it to cover their deductible for emergencies, etc.
#26 Why don’t you read the portion of the article I quoted, Boyd.
The guy lists a bunch of “real killers” like heart disease and cancer and in among them he says obesity. That seems to me to be clearly saying that obesity can kill you just like cancer. That the cause of death would be “obesity” or whatever (I’m not sure how technical causes of death actual work and how specific they get, but you understand my point). You are basically supporting my point that the author was sloppy with his info in listing obesity as a real killer.
I stopped by to point out the error of the tort reform. But it looks like many have beaten me to it. (I live in Texas and it has done nothing to decrease our cost of healthcare).
Otherwise some pretty good recommendations. I really like the idea of HSA and high deductibles made easier. I tried to start an HSA with my company and the requirements seemed a bit onerous (yes it was an HSA not an HRA).
He should have left out the section about Canada and the U.K.. Since all that amounts to is more hand waving.
It’ll still be extrememly expensive unless we fix the culture of doctors who are out to make a buck on sick people.
Good luck with that. What are you gonna do when the sale of lake houses and beach front condo’s crash?
Don’t be silly. Everyone knows licensing is government’s way of protecting innocent consumers from blood thirsty practitioners who would just as soon kill you for your organs as look at you.
To quote myself:
1. Allow the dispensing of health care by people with less than the educational requirements of an MD. (increases supply)
Also:
3. Reduce state control over who can dispense health care. (increases supply)
I worked for a fairly large company last year and had an HSA. The company put $1500 in and I put $750 in to cover the $2200 deductible. It rolled over and I still using it to pay for health care this year. The prior year I also had the HSA, but exceeded the deductible during the year.
This year I work for a small company and they do not offer either the HSA or the FSA (pre-tax flexible spending account). I miss them both and wish I could take the dollars my company is spending and buy into an HSA. But, I cannot due to the rules and regulations covering insurance. In my opinion, I think allowing that, and having doctors/dentists post their fees, would go a long way to improving “health care”.
Oh, I had Delta Dental for several years. I finally tracked my costs one year and taking into account the per pay check costs for the insurance, I paid $1800 that year for $1500 of dental care. Delta Dental sucks!
In response to #61, Dave Krueger. My family normally visits the nurse practitioner in the clinics we go to. Both the Internal medical clinic my wife and I use, and the pediatric clinic for the kids, have one. I find they are great value for the money and it’s normally very easy to get an appointment.
re: Tort Reform
I always wonder in sheer astonishment when people advocate tort reform.
Look, it is this simple. If a Doctor makes a mistake and the patient is injured what should happen? Ex. Doctor cuts off wrong leg.
1st question who should bear the loss.
1. the doctor
2. the patient
3. the govt/society
What of the loss/harm to the patient?
1. Tell the patient to deal with it
2. Let the legislature define the loss. – A bad idea b/c then once the risk is defined there is no incentive not to err.
3. Let the jury decide.
4.Then we know that a per
3. Let the jury define the loss Say your losses are x
Most people will pick the lower cost insurance that DOESN’T cover the rare, but big ticket items. Then poof! They get MS and are relegated to dying in a gutter. Awesome!
I missed the part where he advocated getting rid of Medicaid.
That would be in MY reform package, but it’s not in his.
So if you get MS and can’t work, once your assets are gone you can go on Medicaid.
The gall demonstrated by some health care reform advocate arguments astounds me. “Middle class people shouldn’t have to declare bankruptcy if they get sick!” Um…why not? You can appeal to altruistic impulses and pity if you want to argue for government health care for the poor, but it’s not really a demand of any altruistic moral system that I know of that I preserve someone’s middle class lifestyle if they suffer a misfortune. I especially don’t see the “altruistic” logic of taxing the poor to pay for the health care of middle-class people who don’t think they should have to choose between their assets and their health when bills come due. Libertarians get accused of “making money more important than people’s health” all the time, but it seems like middle-class health care reform advocates are the ones disparaging the dollar value of health here: they don’t think their health is worth their savings. As far as they’re concerned, their health is only worth MY savings.
Also why are doctors so special that they should be protected? Do we feel that way about cops, businessmen, garbage collectors? or is everyone equal?
You also need to think two steps down the road…i.e. what happens to the “energy” that causes one to sue…if limited severely, the energy will take another form…aggressive criminal prosecutions for doctors?
Also why are doctors so special that they should be protected? Do we feel that way about cops, businessmen, garbage collectors? or is everyone equal?
You also need to think two steps down the road…i.e. what happens to the “energy” that causes one to sue…if limited severely, the energy will take another form…aggressive criminal prosecutions for doctors?
The civil courts should be about restorative justice and the criminal courts should be about punishment for crimes.
That means that, YES, the ability to impose “punitive” damages should be taken away from the civil courts, and YES, if there are actions by private actors that we want courts to punish, we should do it in criminal court.
“In my opinion, I think allowing that, and having doctors/dentists post their fees, would go a long way to improving “health care”.”
Not going to happen without laws forcing them to do so. The problem is the fees you pay depends on if you have insurance or not and even what kind of insurance you have. An uninsured person could pay 180 bucks for something that insurance A pays 100 while insurance B pays 120. That’s just how the billing process works..
the gall demonstrated by some health care reform advocate arguments astounds me. “Middle class people shouldn’t have to declare bankruptcy if they get sick!” Um…why not? You can appeal to altruistic impulses and pity if you want to argue for government health care for the poor, but it’s not really a demand of any altruistic moral system that I know of that I preserve someone’s middle class lifestyle if they suffer a misfortune.
Well, speaking only for myself here, I would say that “people shouldn’t have to declare bankruptcy if they get sick” is a pretty good description of the sort of outcomes I’d expect to see from a functioning health care system.
The usual angle for tort reform is wrong. Setting caps on damages is exactly the wrong way to fix the problem.
When a doctor makes a mistake that’s clearly gross negligence, such as chopping off the wrong leg, suing him into bankruptcy is probably a net benefit to the health care industry.
But I get the impression (note no actual research here – I don’t care that much) that the real problem isn’t suing doctors for negligence, it’s suing doctors for bad outcomes, which are rather more common, but not the fault of the doctor. Well meaning people (mostly) get convinced that X shouldn’t have happened, it must have been somebody’s fault, and the most logical target is the doctor, whether X is a miscarriage, a fatal infection, or whatever. Well meaning juries weigh a sympathetic and grieving family on one side versus a faceless insurance company that will have to pay.
The solution would be to properly filter cases of doctor negligence vs cases of unfortunate outcomes, and not set arbitrary caps on those cases. I don’t know how that could be done.
“Loveable opposition logic like:
Whole Foods isn’t union, therefore this plan is bogus
Whole Foods charges outlandish prices, therefore this plan won’t work”
Simple to defeat
-They pay their employees significantly more than their union competition…then again, these people probably consider treating your employees well as union-busting
-Prices aren’t that bad on most items. Prices are actually better than your local supermarket, often significantly better, on organic and “health foods”. They’ve expanded their 365 brand and lowered prices to remain competitive in the current economy and to compete with the expanded organic selections available at other markets. Go figure, Mackey understands how the market works. I’m out of work and still frequently shop there.
Slightly off-topic, but I felt this needed to be pointed out. The whining on Daily Kos about “OMG! UNION BUSTING! OMG!” that Whole Foods engages in was gut busting hilarity for me.
A friend of mine briefly worked at Shoprite, a local grocery store chain in Philly & NYC metro areas; I’m almost certain his store was unionized. I have a few acquaintances who have worked at Whole Foods and have applied there several times.
The starting rates for cart people (about the crappiest job you can get in a grocery store) at the Whole Foods at 10th & South (in Philly) range from $10/hour to $13/hour, IIRC. The starting rates for check-out clerks at the Brooklawn, NJ Shoprite are $7.50 for someone with retail experience and a Bachelors degree.
Man, oh man, Whole Foods is just run by a bunch of blood thirsty bastards, I tell you!
You know, I just heard on NPR today that the population of Detroit is less than half what it was at its peak and is suffering huge unemployment. They seem to be having trouble bringing back the kind of labor intensive industry that would put all those unemployed union workers back to work. That seems difficult to believe given the fact that they’ve spent the last half century proving that they are completely willing, with their high school education, to do unskilled labor in exchange for a salary, benefits, and pension only slightly better than the average college grad gets in a white collar job after five years or so.
I can’t imagine why greedy corporations aren’t falling all over themselves to get up there and take advantage of the now plentiful supply of labor…
//But it also makes sense for insurance companies to mitigate risk by screening customers for preexisting conditions, genetic disposition to certain ailments, etc.//
There needs to be some clarification on when exactly losses occur, and the duration for which insurers must cover them. If I am insured by auto insurance company X, get in an accident, and then cancel my policy the next day (e.g. because I’m not likely to be driving any time soon) company X will still cover me for future harm or liability I may suffer from the accident. The insurance company may want to jack up my rates, but if I cancel the policy they can’t get another dime from me even though they’ll still have to pay out for the accident that already occurred.
Conversely, if I don’t buy insurance until after the accident occurs, I can’t expect it to cover me for anything that happened before I bought it. If I had a $50,000 liability policy from company X before the accident, bought a $500,000 policy from company Y immediately after the accident, and I subsequently got sued for the accident, my liability coverage would be $50,000 from company X and nothing from company Y.
A major problem with health “insurance” is that many of the bad things that can happen to a person will result in many years of foreseeable expenses, but the “insurance” will only cover the costs of the first year. I’m not sure how one could best ensure that people would be covered for on-going expenses resulting from problems that developed while they were insured, but perhaps requiring companies to post annuity bonds in such cases would be a good start.
I work at a company that is self insured, using Blue Cross to administer the program. We have a nurse practitioner on hand during the day. Very nice. Easy to schedule a same day visit and no waiting line. It saves the company money. I think it’s a great idea.
“While I think providing health care for members of our society is absolutely a moral obligation (as does the rest of the industrialized world), ”
It would be nice if health care could be provided for free, but it cannot. There are real expenses that must be paid for. Obama Care means taking at gun point from one person and giving it to another. And you dare speak of morality? You sure have a lot of ideas about how to spend my money.
#58 Nick
If that’s your point, you need to quickly get a sharpening stone.
WOT.
Even in countries like Canada and the U.K., there is no intrinsic right to health care. Rather, citizens in these countries are told by government bureaucrats what health-care treatments they are eligible to receive and when they can receive them. All countries with socialized medicine ration health care by forcing their citizens to wait in lines to receive scarce treatments.
Hrmm, this sounds just like what insurance companies do for a profit.
#9 | Radley Balko | August 12th, 2009 at 11:11 am
…
I disagree with Mackey about his specific lifestyle recommendations, but in terms of policy he’s absolutely correct. Your own health ought to be your own responsibility. That rather common sense is going to disappear as we increasingly start paying for one another’s health care.
Care to share even some anecdotal evidence of this?
“It’s spot-on.”
That’s utterly ridiculous, Radley. Look: nobody who can write with a straight face, “Enact Medicare reform,” has anything serious to say to this entire subject. Stop being foolish.
#77: “Obama Care means taking at gun point from one person and giving it to another. And you dare speak of morality? You sure have a lot of ideas about how to spend my money.”
And this is different from Defense and HUD and Agricultural and FBI and FCC and PBS and CIA and OSHA and NASA spending how?
Get off your morality pony and STFU.
@80. You can have your HUD, Agri, FCC, PBS, and OSHA. The rest of the stuff is covered by the constitution and is part of the already agreed-upon social contract that binds the country.
…and discussion works particularly well when you DON’T tell people to STFU.
So…in honor of you…suck it.
So, health care cost reduction is going to cost us a trillion dollars over the next ten years. Once we have this success behind us, I think we can look forward to similar cost reduction programs in all social welfare programs.
It’s no different at all. And most of the programs you name are unnecessary expansion of government exactly the way social welfare programs are.
But, by that logic, as soon as government takes on one unnecessary responsibility, then nothing is off limits.
This is precisely the kind of argument you often get when you accuse one party with doing something stupid. Their immediate response is to point out that the other party has done the same thing, as if that justifies it.
In general, libertarians tend to believe that government should provide for national defense, law enforcement, and a court system. That’s what differentiates them from the other two parties who believe that government should be strictly and narrowly limited to providing only those services that reward their biggest campaign donors.
“And this is different from Defense and HUD and Agricultural and FBI and FCC and PBS and CIA and OSHA and NASA spending how?”
I would say that all citizens benefit or don’t benefit equally from most of those items. This is the key difference. Having the FBI look for criminals has an equal chance of preventing me from being murdered as it does you. Harsh as it may be, paying for your the healthcare of the uninsured does not provide the same benefits to those that are already insured. That said I suspect most people here don’t support a lot of those funding efforts.
Even if they were the same your argument is then two wrongs make a right.
What tort reform will do is to reduce “defensive medicine”. Several months ago, I cut my right leg and needed stitches. Since it was on a Saturday, I had to go to the Emergency Room at the local hospital. I won’t pull any punches, I’m a big guy (6′-4″, 295 lbs). Once I got back to see the Doctor, he slapped a gauze pad on my leg and said that he wanted to run some tests, before putting the stitches in. I asked what type of tests and was told an EKG, a heart sonogram and a sonogram on both legs to see if I had any blood clots. I told him that I had just had these very tests done less than two weeks ago at this same hospital. I was told that the privacy laws didn’t allow him access to those results and that it was hospital policy to run these tests on someone of my size. I was also told not to worry about it, that I had good insurance and that the insurance company would pay for it, no questions asked. A few weeks later I got my benefits statement listing the costs for the trip to the Emergency Room. It was $300 just to show up at the ER, another $250 for the stitches and $4000 for the tests. If this would have happened during the week I would have seen my Doctor and the whole thing would have been about $350. The hospital has their policy in place, so that if I collapsed in the parking lot with a heat attack after getting my leg stiched, they had ammunition to fight a lawsuit.
I actually have some sympathy for the Doctor and the hospital. I used to work as an aircraft mechanic. I spent several years and quite a bit of money aquiring a Federal A&P license, to allow me to
work as a mechanic. These days I don’t touch a plane, except to volunteer at a local air museum to keep my license current. I can’t afford the liability insurance needed to protect myself. If I change the oil on a plane and two months later the wing falls off, you can be sure that I will be a defendent in a lawsuit over the crash.
81, 83 & 84
My argument is this: I don’t want to pay for that other shit but I do. You don’t want to pay for healthcare, tough shit. That’s part of being a contributing member of society.
Don’t like it, work to change it but don’t whine about being forced to pay for stuff you don’t like at the point of a gun.
Elections have consequences and if the Dems have any sense they’ll ram this down the GOPs throat and be done with it.
You sound like someone playing the victim card and since I really hate that I say STFU.
first post should’ve been to 76 not 77 but you all can figure that out, right?
I don’t think the people on this blog (being a libertarian blog) want to pay for that shit either. So this isn’t a quid pro quo situation where you make us happy by paying for our shit and we will make you happy by paying for your shit. That argument may work at rightwingnutjob.com or leftwingnutjob.com but here I think we need to evaluate all programs individually.
It is just more stuff that we don’t currently have the money to pay for. Adding new programs prior to figuring out how we are going to pay for existing ones is not a good idea.
“You can appeal to altruistic impulses and pity if you want to argue for government health care for the poor, but it’s not really a demand of any altruistic moral system that I know of that I preserve someone’s middle class lifestyle if they suffer a misfortune.”
So you would rather people get sick, lose their house, and then pay for their care, because somehow that is more fair? My father in law has been disabled for 20 years now – not the “I don’t think I can work anymore” disabled, the “I haven’t walked in 20 years and can’t hold a pen” disabled. My husband was 2 when this happened. Even with medicaid they almost lost the house and things were pretty tough growing up.
Or, my cousin had a c-section with her last child. Not an expected outcome. $20k to have a baby with no complications other than the c-section itself? Guess we’re not having any babies in this country under your plan.
The problem we are currently facing is the uninsured/underinsured can’t pay for health savings accounts, etc, and the cost of their waiting for procedures drives up overall costs. I waited to see my regular doctor after a mishap around the house, and while it cost me much less than the ER, they had to perform a different, more expensive procedure and my time to heal is greater than if I had been seen by a doc right away. I lost my insurance when I was laid off (been working continuously since I was 15 other than this) and my husbands company is too small to offer insurance.
You might not want to spend ‘your money’ on other people’s health insurance, but that is pretty much what is happening now anyway. We will all equally benefit, because something like what happened to my father in law can happen to any of us at any time.
Mike,
Been reading this blog for well over a year now and I’ve seen Balko blast the Libs and the Cons, Dems and GOP. What I haven’t seen him or other’s do is play victim like the pony riding indignant pansy I originally responded to did.
If you and the rest think OSHA etc is BS and oppose it, fine.
That POS is a GOP pansy in disguise crying about having to pay for shit he doesn’t like.
Just because folks agree with you on a specific subject does not make them your friend or political ally. Hell, I agree with about 50% of what I read here but while you true Libertarians may drink a beer with me, you’d never side with me ideologically – and that’s fine.
Providing cover for neanderthal GOP pussies makes you weaker and makes me believe your Libertarian ideals are for sale, IMO.
Heh, I certainly don’t agree with any regular poster on this blog 100% of the time, however I do feel compelled to say it is a bullshit argument that since we agreed to pay for X, then we should pay for Y.
Every item in the budget should stand as useful by itself. As for healthcare I personally doubt the ability of the government to run an efficient healthcare system more than what the giant costs of it would be. Decent affordable healthcare for all is certainly a goal worth striving for but I disagree that a government run system would provide that.
#89 posts that she lost her healthcare when she lost her job and her husband’s company is too small to provide health insurance. This to me screams out that subsidizing employer provided healthcare more than individual policies is unfair. If the government hadn’t somewhat forced health insurance to be linked to employment they might not have been in the current situation they are now.
Hey, Ira: “You don’t want to pay for healthcare, tough shit.”
Oh, yeah? Well, why don’t you get up on your hind-legs and come get what you think you can take from me?
He doesn’t need to. He has goons for that. Some people refer to them as government.
“I lost my insurance when I was laid off (been working continuously since I was 15 other than this) and my husbands company is too small to offer insurance.”
This still does not create an obligation on my part.
92 & 93 – Yep. If I had my way, the gov’t would take your money to pay for Healthcare.
I hope it happens really soon so I can read your lamentations and cries for “Revolution!” and “Watering the tree of liberty!” and all that BS. I really hope it happens soon as I could use the laughs.
Enjoy stewing in your hatred and bile!
“Enjoy stewing in your hatred and bile!”
It’s no big deal: animals like you have always existed, and I can hate you without even thinking about you. You don’t count, and you can keep this in mind: I will not be paying for your medical needs, punk. I haven’t paid income taxes in thirty-two years, because I always saw you coming, and I’m not going to start now.
Tough shit, loser.
Boyd, If I die after some expensive accident, where I linger for months in an intensive care unit until I die, and I have no assets or insurance to take as payment GUESS WHAT? There’s your obligation, because someone is going to have to pay for my care. Society as a whole has to pay for my care. So making a cost effective system where everyone has some sort of catastrophic care is in everyone’s best interest.
It is also our obligation, as a society, to make it so I can enter the individual market without having to worry about fraud. All I really want is one physical a year, one well woman visit a year, and catastrophic care (anything over $3,000). My biggest fear right now is getting pregnant, because I have no way of paying for pre-natal care or birth. But because I am uninsured, I can’t pay for birth control pills anymore, so my chance of getting pregnant has gone up at the moment I can’t pay for it.
Life didn’t crawl out on to land, evolve into man, and suddenly become obligated to pay for everyone’s health care. What happened is that politicians, wanting to get reelected, said to themselves, “wouldn’t I sound compassionate and wonderful if only I crusaded for the idea (or something similar) that no hospital could turn away a patient at the door if they were in critical need of care?” And presto! Suddenly hospitals were saddled with the responsibility to treat people who couldn’t pay for it. And that strategy has been going strong ever since.
Giving other people’s money away is the number one job of any politician. You can call it something lofty like “society as a whole” if you want to, but it’s really just a politician making promises to give voters something “for free”. Mr. Voter get’s sucked in because it makes him feel noble to be charitable, but he only really wants to be charitable if he can make everyone else be charitable, too, whether they like it or not (which, of course, is the definition of robbery).
“There’s your obligation, because someone is going to have to pay for my care.”
That’s what you think.
“All I really want is one physical a year, one well woman visit …”
Yeah, yeah, sure. All I want is a new Harley, five grand to finish my airplane, and a big rock-candy mountain.
The difference between you and me is that I’m not interested in making you a slave in order to pay for it.
Go fuck yourself until you get your ethics squared away. Until then, you can drop fuckin’ dead on the spot, with my earnest compliments.
“No justice? No Peace.”
You can bet on it.
I think you’re confused. The reason you can’t pay for birth control pills isn’t because you’re uninsured. It’s because you’re unemployed.
Wow, I didn’t think my post was worthy of a “go fuck yourself” attitude.
My point is that I can’t get the very thing that would control my costs in the INDIVIDUAL MARKET. I’m not making you a slave to pay for anything – I would be happy to pay for it myself. But I can’t even get coverage in the individual market, because that is so riddled with fraud. See Karen Tumulty’s story in Time Magazine about people who have paid for coverage for years in the individual market and were rejected as soon as some condition was diagnosed.
Dave, I can’t get birth control pills not because I am unemployed, it is because health care is tied to your employer (and incentives given to employers and employees to keep it that way, because health benefits are tax deductible, except in the individual market).
It isn’t a free market system if there are so many barriers to entry. It isn’t a free market when no one will tell you up front what any costs will be, from the hospital to the lab to the doctor themselves. It isn’t a free market when you can’t negotiate.
So, if I did have a baby, who would pay for it? I have no assets. I have no cash. Society – someone else – would pay for it. Anyone who walks into a hospital has to be treated – that’s worldwide medical ethics, not politicians. If we say that anyone who comes in has to be treated, then that cost has to be borne by someone. You can stick your fingers in your ears chanting “na-na, not my obligation” but this is happening now, in reality. If you think it isn’t driving up the costs of your care when you need it, I guess you have your ethics to make you feel all better.
Muffy, your argument that, because you’ve been laid off you’re now forced to get pregnant isn’t very convincing. In fact, it sounds lazy. There probably isn’t a single medical service in this country that is more widely available than birth control. Pills cost $20-50 a month. There are fee clinics, Planned Parenthood, etc.
If you don’t have a job and can’t afford birth control pills, how could you possibly afford health insurance premiums. Even if the government offered low cost subsidized health insurance, it’s going to cost more than The Pill.
Free health care for the unemployed has nothing to do with the free market. What you’re talking about is welfare.
But, I appreciate your willingness to define “our obligation as a society” toward you, the unemployed. I’m just not sympathetic to the concept that, because you don’t have a job, society is now responsible for your bills.
‘Wow, I didn’t think my post was worthy of a ‘go fuck yourself’ attitude.”
Yeah, I know you didn’t, but guess what: I don’t think my money is yours to be claiming that way you do. I get pissed-off about that.
So, go fuck yourself.
Try to understand, Muffy: I don’t care. You can drop dead and I don’t care.
This government has priced me completely out of that market.
I NEVER SAID FREE.
I said I would like to purchase in the individual market. There is fraud. I would like the government to list non-fraudlent options I could purchase.
Try reading, fuckers.