Bartender Geek

Crappy doctors who follow the letter of the law would stay in business with greater frequency than currently. This is the observation of people who come from countries with socialized health care; care becomes universally crappy. Newer ways of measuring health care performance may ameliorate this.

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holzman.livejournal.com

This is the observation of people who come from countries with socialized health care; care becomes universally crappy.

It's not the observation of people who've told me about the socialized health care they recieve. Nor has "crappy doctors who follow the letter of the law" been notably absent from the tale fodder from people who've told me about their health care in the U.S. unless they've had serious dollars to drop -- and sometimes even then.

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It was the observation of a friend of mine living in Russia in the 80s, and another who lived in the UK in the 90s. I didn't mean to imply it was the observation of *everyone* in that situation; YMMV.

Their point, jointly, was that yes, even *with* money, you couldn't really buy local health care -- there was no incentive to perform functions that weren't authorized by the government, and those wheels turned slowly. So you went abroad (i.e. to the US) for new or unusual conditions.

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papersky.livejournal.com

I think your first point may be valid. (I'll even add to it that good but mercenary doctors may leave for other countries where they can make much more money.)

However, the corrollary isn't. There are bad doctors in countries with socialised medicine. This doesn't mean all doctors are bad, and it doesn't mean all care is crap. And I say this with experience of medicine from the patient end in Britain and Canada. (I'll also say that I had a US friend with me once when my son had an accident and we went to Emergency in Britain and she was very impressed at how good and fast the treatment was... and how little admin there was.)

Also, I've heard in the US if you want a "top surgeon" you can get one if you can pay for it -- and that's wonderful, except if you can't pay for it. In Britain or Canada, you get a random surgeon, who might be the best in the country or who might be the worst, according to what's available and how sick you are. It's random chance and need, not whether or not you can pay for it, even if you are paying for it. So if you imagine the life of a British or Canadian "top surgeon" they'd be assigned to the hardest cases, and a US one, to the richest.

It seems so much more fair to me, but I suppose if you're looking at it from the POV of a rich person, that wouldn't seem fair.

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British or Canadian "top surgeon" they'd be assigned to the hardest cases

How so? Should socialized medicine have a mechanism for this? (I've never heard of such a thing.) It sounds nifty, but it also sounds pretty much impossible to implement.

It's very true -- capitalist medicine means the rich stay healthy and the sick stay poor. Believe me, I've been both. But socialist medicine needs to be implemented very, very carefully, because it's a system with no strong balancing force toward "right", and (like all socialist approaches I've seen so far) a strong force toward "what we have now, only cheaper and receiving less effort".

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Not in New Zealand it doesn't. Health care here is not "universally crappy" -- it's universally pretty bloody good, actually. The thought of being in the USA with no medical insurance (or the wrong kind) scares me half to death.

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Awesome. Maybe you can share some of your secrets to convincing HMO-funded politicians how to implement some of that -- I'm getting tired of Managed Care (as in, "It's amazing you Managed to get any Care at all!")

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hobbitblue.livejournal.com

I love the way "socialised" medicine carries such a negative undertone. Imagine getting sick and being able to see the doctor the next day and be treated and get your meds on a prescription you pay just 12 bucks for. Or imagine cutting yourself and calling for an ambulance and being treated in your home by trained paramedics who strap you up, check you out, give you oxygen, take you to the hospital, get you seen by a doctor and given medical advice or treatment and then sent home, without wondering if you'll go bankrupt paying for it all?

Nah, would never catch on in a civilised country...

*sigh*

*hugs the NHS despite its faults*

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The thing is -- we could do that back on the health care plan we had from Lis's employer two employers ago. But we can't do that now.

Tying health care to employment, the way we do in the United States, means that you CAN get that level of health care -- SOMETIMES. But then, if you change jobs, you can lose that level of health care.

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solipsistnation.livejournal.com

You could be a commie. Grar socialism.

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amberdine.livejournal.com

Silly. Insurance companies and hospitals couldn't make nearly as much much money!

What are you thinking?

From: (Anonymous)

How about having to wait for necessary but elective surgery for several years, such as for back pain, gall bladder, or bunions. How about not having a choice of hospital or doctor for certain surgeries or illnesses.

From:

kiya

How about not having a choice of hospital or doctor for certain surgeries or illnesses.

"I'm sorry, you can't see that doctor on this insurance plan."

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bradhicks.livejournal.com

I don't have a choice of doctor or hospital for those illnesses, either. I don't get one. Which means that I have, of course, also been waiting substantially longer than a couple of years for some medical procedures that won't kill me any time soon, but do cause substantial problems.

Oh, you mean upper middle class and wealthy people having to wait a tiny fraction of the time that the rest of us have to wait? Oh, well. Can't have that, can we?

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We've got both those problems with our current health care system, and you can get around those problems in socialized medicine by paying cash -- just the way that we do now.

Socialized health care wouldn't make either of those problems significantly worse than they are now.

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cheshyre

Malcolm Gladwell's been writing about Canadian v. US health care systems (bolded parts mine):

In the comments on my about-face on health care, a number of people make the familiar criticisms of the Canadian system. Care is rationed. You wait a lot longer for certain elective procedures than in the United States. Technology is not as up to date, etc. etc. These arguments are, to some extent, entirely accurate. But I'm not sure they are relevant. They aren't criticisms of the system, after all. They are reflections of the how well the system is funded--and that's an important distinction. On a per capita basis, Canadians now spend on health care--and I"m not sure of the exact figure here--something like 60 percent of what Americans spend. If that were increased to, say, 65 percent, many of the rationing and wait-time problems would be alleviated. The problem with American health care, by contrast, is systemic. No simple increase in funding fixes the problem. In fact, we already spend far and more the most on health care than anyone else in the world. This was the mistake I made in my original debate with Adam Gopnik. I confused funding problems with structural problems.

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navrins

"Socialized medicine" is an underdefined phrase. Tell me what it is, how it works, how it's paid for, and how the amount paid for it is kept from growing infinitely, and I'll answer your question.

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cellio

Choice, both at the doctor level and at the plan level.

At least in theory, if I don't like the coverage I'm getting I can go buy a different plan. Now, because insurance is tied to employment (a bad thing), that's not always true in practice without spending huge piles of money, but the system does not preclude it. With socialized medicine, on the other hand, there is one plan, one standard of care, and if you don't like it that's too bad unless you're rich enough to go to another country for treatment (like some Canadians do in the US -- I wonder if they're lobbying against socialized medicine here 'cause it'll screw them up?).

My Canadian in-laws tell me that the waits for anything deemed "elective", no matter how severe, can be quite long. In a system where providers compete at least some, that time goes down.

I'd love it if we could reform health care in this country, kicking out the huge middlemen and letting people pay reasonable fees to doctors they choose. I don't think a one-size-fits-all plan is going to work, though.

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I would like a socialized system with a private system beside it. Your taxes pay for one standard of care; you can choose to pay more, either for an insurance plan, or just out-of-pocket, for anything else.

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papersky.livejournal.com

Exactly like in Britain.

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warren8472.livejournal.com

If people could be given the choice to pay more for other services, why should people be obligated to pay taxes on any of it? Shouldn't they just pay into a private "system" on their own... and wouldn't allowing (or endorsing) a system other that the public system essentially be-- or inevitably lead to-- what we have now anyway?

Or am I missing the issue entirely here? My comparative health care policy knowledge is a bit rusty.

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Because you want to ensure a minimum standard of health care for everybody in the society.

Now, what that minimum standard IS is, properly, subject to a great deal of debate and discussion. But the argument is that a society has a moral obligation to make sure that every member of its society has a reasonable chance to live a healthy, productive life.

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warren8472.livejournal.com

And this hinges on the argument over what constitutes "making sure" and "reasonable chance", i.e., is giving everyone equal protection and an equal opportunity to succeed under the law enough, or do we go all Robin Hood and give services away, hoping people won't abuse it?

I'm not a big fan of legislating morality; some people's self-described moral obligation to do what's best for society is what gives us legislative gems like anti-flag-burning laws and the Defense of Marriage Act.

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shmuelisms.livejournal.com

Here it is actually three-tiered in a sense. All of the "HMO" here MUST supply a basic "basket" of health-services, including thousands of common prescription-medicine for real-cheap (~3$ a prescription). The cost of insurance is salary-dependent in the form of a health-tax (stepped percentages, highest being 5% with a max-cap), so everybody has coverage. Additionally the HMO compete with each other offering additional services as part of the basic package, or additional coverage-plans. Beyond that you have private medicine, in which you can pay full price for whatever you want.

Most of the hospitals (first tier) are government run, and paid for their services by the HMO, which supply the common day to day services themselves (second tier), and finally the third, entirely private tier. So while our hospitals are somewhat over-crowded (and this is mostly infrastructure falling behind growth rates), we have one of the best health-systems in the world.

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Just like in New Zealand.

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bikergeek.livejournal.com

well, there's the small problem that the people who administer it would have the same attitude as the people at the RMV. It'd be Yet Another government bureaucracy run for the benefit of its employees rather than the benefit of its customers.

As a libertarian, I've noticed that government tends to screw up whatever it puts its hand to. However, private insurance is so screwed up at this point it's tough to see how government could make it any *worse*.

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warren8472.livejournal.com

Although I am also libertarian, I recognize that my distaste for socialized medicine comes from the fact that health care has never been public, so the idea of public health care is strange to me. I don't object to my tax dollars going toward a police force, or firefighting, or even to the ostensible security of the future of the ongoing national conversation that we succinctly call "education"... so why do I feel icky about the public funding of health care, a service that I could suddenly need at any moment, like police or firefighting? Is it because it something that's really better paid privately... or because I'm just not used to the idea that it could be public?

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felis-sidus.livejournal.com

Maybe it's because you instinctually realize that whoever pays for your medical care gets to know the details of your medical record, in order to verify correct billing and payments. Do you really want the government to be able to poke around in your medical details, including psychiatric issues? Granted folks on Medicare have this going on now, but would you want the government to have this access life-long?

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I come from a country with socialised medicine and _that doesn't happen here_. It's against the law.

The laws defining who can have access to medical records are very strongly worded and very strongly enforced. No government agent or agency may have access to a medical record without the patient's permission. Full stop. End of story.

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I do have sympathy for

felis_sidus's point here, though. In the United States, we've discovered that our government is perfectly willing to ignore its own laws protecting privacy.

I was an area lead in the 2000 US Census. We all had to take oaths that we would not misuse any information we discovered. There were laws in place that made certain that, for instance, Immigration couldn't use the raw data gathered to find illegal immigrants.

It was decided that the importance of the census was such that this was worthwhile. Getting an honest and accurate picture of who was in the United States was important; therefore, we could agree to NOT use the gathered information for law enforcement, so that the people we talked to would be able to trust us.

This trust was backed up by law, and by our personal oaths. I stressed in training what a personal oath meant -- that this was putting our own personal honor, and even our immortal souls, on the line saying that we would never use this information to harm the people we were talking to. Ever. Everyone who worked for the census had to take these oaths. (Or affirmations, if you didn't believe in taking oaths -- an affirmation is taken on your own honor.)

As soon as the census data was compiled, it was turned over to Immigration, the way that we had all taken oaths that it would not be. I told people that I PERSONALLY had pledged my own honor to protect their information -- and the government broke my pledge.

So

felis_sidus is right. We cannot trust our government with any information. Our goverment -- at least, the Bush administration -- has already proven taht they aren't worthy of our trust.

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That has to suck. In fact, that has to suck asteroids through nanotubes. I'm very sorry you are all in this situation, and I hope you get a trustworthy administration soon.

(Please note, it would be easy to read the above as sarcasm. It isn't. I really, genuinely mean it.)

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I hope you'll forgive a longish post.

If you think options are limited now, under a government monopoly they'd be even more limited. Even the most limited healthcare insurance provides multiple choices over a wide geographic area. You may not be able to choose any doctor you want, but you can choose from a set number. For example, my current plan, and it is nothing spectacular, gives me a choice of about ten different doctors in the town where I live. Another four in the city where I work. This ignores the dozens more that are all within 15 minutes drive from both my work and my home. It's maybe half of the total doctors in the area, but that's still dozens. I can, of course, go 'out of system' for a higher co-pay to any doctor I choose.

Compare to a system run the way we run another government monopoly; public schools. You get assigned a clinic by geographic area. You might be able to choose a handful of doctors from that clinic, but you can't go to another clinic. If your local one doesn't offer a service? Too bad. Of course, my taxes have gone up to pay for this, so I have even less money to try and go outside the system if I want to do so. That's presuming it is even legal to do so without going outside the country.

The way to solve this problem is simple:

Currently, employers spend an average of 3965.00 per employee for single employees on health insurance premiums. Of that, 500 and some odd dollars is provided by the employee. This doesn't include the cost of copays and the like, but we'll leave that out.

There are however, HSA. Healthcare Savings Accounts. These are highly regulated and almost impossible for most people to use effectively. But lets say that you and your employer could choose to put those premiums into a savings account. Let's say further that the accounts roll over from year to year and they are in -your- name. So even if you lose your job, that account is still yours. You can still use it for any doctor or procedure or medicine you want. There would also be no cap on how much you could put into that account tax free.

The two requirements would be this: if you use an HSA you must A) buy catastrophic health insurance and B) Pay taxes on the money if you use it for anything except healthcare *twitch*. A is in case you come down with cancer or other major disease. Such policies are relatively inexpensive. Around 80 dollars a year for several hundred thousand dollars coverage, with a 500.00 premium. Of course, part of that price is due to the low numbers of people that purchase such coverage.

Now, how does this help poor people? Well, here's how. It brings down the overall cost of health care. Much of the cost that drives healthcare upward is the increasingly byzantine nature of insurance/HMOs/etc. A local doctor's office that accepts only cash/check/credit cards charges half of what his competitors that accept insurance charge. Now, that won't hold true across the board, but if there's even a 25% reduction in such costs instead of 50% it makes it more affordable for everyone. And for those who are completely without recourse, we already have medicade and medicare.

From:

cheshyre

Compare to a system run the way we run another government monopoly; public schools. You get assigned a clinic by geographic area. You might be able to choose a handful of doctors from that clinic, but you can't go to another clinic. If your local one doesn't offer a service? Too bad.

Why do you think that would be the case?

I'm not heavily versed in comparative health care, but is that true anyplace else, or are you making up that idea out of whole cloth based upon notions of public schools?

Unless there's a history of this concept in practice, two reasons why that wouldn't work and thus probably wouldn't be implemented.

(1) America is an extremely mobile society, I think moreso than Europe (where DNA testing found Cheshire man's descendant living within a few miles of the ruins). Even within the same metropolitan area, I've lived in at least four cities, and I know many people whose residences have been even more transient. If part of the point of this is continuous coverage with doctors who can get to know a patient longterm, than this kind of geographical limitation would be counterproductive and makes no sense.

(2) Furthermore, even public schools are no longer as monolithic as you describe, what with magnet programs and school choice... Even though my parents house is across the street from the high school I attended, my younger brother went to a magnet high school at the opposite end of the county. He had trouble with the program academically, so after freshman year returned to our "local" HS. But because he preferred the other school so much, he suddenly developed a burning need for a particular class only offered at that school. And the district let him transfer back.

I may come back to dissect the rest of your comment later, but this point stood out for me like a sore thumb and I couldn't let it stand.

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Because public schools are the only major government monopoly we have other than police, to which there is very little analogy. Minor government monopolies like the USPS, Amtrak, or perhaps the DMV don't offer much more hope.

As for 'making it up whole cloth'. No, I'm not. Many socialized systems of medicines assing you a health care provider. They assign what services are available. In many, you can't even opt to pay for additional services. That wouldn't, after all, be fair to let the rich jump in line. And even when you can go see another doctor, you've got a long wait ahead of you. So, I think the analogy of decreasing choice even further is legit. Is it partly theoretical? Yes. But I don't think it's farfetched either. Unless you've got a specific plan you want to present, it's a bit hard to refute something as nebulous as the original post.

As for your points 1 and 2, mobility has nothing to do with it, nor the example of 'school choice' you give. I'm pointing out that your choices get even further narrowed by government intervention. It is -always- what happens, both with socialized systems abroad and with other fields where we have tried it at home. Show me one system of socialized medicine where people have shorter waits, more treatment options, and more choice in providers than we do here.

America offers the highest quality health care in the world. It isn't perfect, and I'd like to see some changes to make it better. But socializing it isn't going to do that. It will make it worse.

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Show me one system of socialized medicine where people have shorter waits, more treatment options, and more choice in providers than we do here.

Who do you mean by "we"?

Lis and I had exactly one choice in health care provider for our psych meds. And it wasn't the doctor we wanted to see, it wasn't someone we'd ever heard of.

In what way do Lis and I have choice, when our insurance company directed us to see Dr. Bayard, with no other options?

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By 'we' I mean the U.S. in general.

As for choice in your specific instance? I don't know. Can you choose different insurance provider? You also have the choice to pay out-of-pocket. Under a socialized system, there's no evidence to indicate you'd have more choices. And the OOP option would be diminished as the increase in taxes would eat up some of the income that could make it possible to use that OOP option.

I agree the current system is less than ideal. What do you think of the HSA idea? It would definitely provide you with more options than the current one w/o socializing things.

From:

cheshyre

HSAs were first devised by people who thought the problem with healthcare costs was that Americans were overinsured. This is neither hyperbole nor exaggeration, and that faulty premise makes me distrustful of any solutions based off of it.

The notion appears to be if individuals are paying out-of-pocket they'll economize and that individual consumers can negotiate better prices than collective groups. [This cartoon is one of the more cynical criticisms I've seen...]

Group insurance balances out costs among a large patient pool. In the last several years, for-profit insurance has been trying to cherry-pick their clientele, to only attract the healthiest so they can avoid paying for the people who truly need the health insurance. My gut reaction is that this kind of plan appeals most to the young and healthy, who anticipate few health expenses. [What *does* happen if something major happens and the account gets overdrawn? SOL? Or will there be a safety net? Too cruel without the safety net, and if there is an adequate safety net, why do we need the HSAs?]

Ian, if you want to do more reading on this, I've got a mess of links for you, though I haven't sifted them for quality or authority, but we've got some further reading if you're interested.

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This is only a part of the notion. It also provides for flexibility. In Ian's case, he'd have almost 4K (or more if he and Liz opted to put more money into the account)to spend on whatever mental healthcare provider he'd like, as well as medicine that's prescribed. To give an example, I'll use my own life path. I'm going to use some estimates, so take the numbers with a small grain of salt:

My first job with medical insurance came when I was 24. Now, I don't think it would meet the average I sited above so I'm going to assume it was only paying 2k a year in ins. premiums. I was on that job for a year, but I didn't go to the doctor except for a routine check up. The cost billed to the insurance company was 60.00 + my 15.00 co-pay. That's 75.00. There's also the premium for catastrophic health insurance. Let's say around 400.00 a year.

So let's say I had an HSA. I'd have had 2000.00 in the bank because I was young and didn't contribute. I had to take out 75.00 (we're going to assume no price drop due to HSAs) and that left me with 1925.00. I went to the dentist twice at 60.00 per visit. So that's another 120.00 deducted. That leaves me with 1805.00. Take out the catastrophic and we're down to 1405 At this point, I could take the money out and pay normal income tax on it. Or just leave there. I'm going to leave it there.

The next year, I changed jobs. Now, it took 3 mo. for my ins. to kick in. But with an HSA, I'd have been able to keep that 1405.00 and use it if something happened. Nothing did, and at my new job my healthcare contribution was probably higher than average. But I'm going to use the average number of 4K a year. Now, I only got 9 mo. of coverage that year, so that's 75%. That means 3k. My HSA now has 4405.00 in it. Less the same 195.00 for physical and teeth cleanings. That leaves us with 3810.00 after the catastrophic.

I stay in the same position for another year. I get the full 4K and I haven't used any of that money again that year, save for the same check up and teeth cleanings. So I'm at 8005.00. Then, disaster strikes. I lose my job. Fortunately, that 8005.00 is mine. I start doing contract work, so my real dollar income is up, even if my benefits are down. I don't add more to it, reasoning I don't know if this contract thing is going to work out and I need to pay my bills. I forego one teeth cleaning and the checkup, so I'm still at 7910.00. Maybe not too smart, but I'm 27 and healthy and in reasonably good shape so I take the gamble.

(More coming in an additional reply)

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I find a new job with UPS. Benefits are better than average so I'm going to say 5K a year on this one, and that they pay the catastrophic for me. Benefits also start after three months though. And oh, shit. I got a kidney stone and have to go to the ER to take care of it. I racked up like 4500.00 in bills. Now, i've got a choice. I can pay my catastrophic premium of 1000.00 and let the catastrophic cover the rest. Or I can pay all 4500.00 out of my HSA. I decide to do that. the Catastrophic has a lifetime limit of 1 million and I want to make sure if I get cancer or gangrene or something fucked up I don't have to work. So that leaves me with 3410.00. I have no more health problems during the year though, and I'm back to my regular check-up and teeth cleanings of 195.00 a year. So I'm down to 3215.00. UPS kicks in though, and I get my 3750.00 from them which brings me up to 6965.00.

My next year at UPS, I go to the doctor once for a sore throat. So that's an extra 80.00 visit added to my normal 195.00. So I'm down to 6690.00. Add in my annual 5k and I'm up to 11,690.00. That's a pretty good little hedge.

I change jobs again. My insurance is about the same as UPS and kicks in after 30 days. That was almost a year ago so I'm going to assume the year is finished for purposes of this example (and because this is getting long). This year I've been to the doc. twice besides a checkup. That's 375.00. I spent another 300.00 on a chiropractor. So that's 675.00. I only get 4583.00 this year due to losing a month. That leaves me with 15,990.00 sitting in HSA.

Now, I've not bothered figuring interest. Or taking out costs of meds as I didn't really spend that much on meds. I think, once since I started working 7 years ago I got a prescription medication, so I'm going to call that even. Regardless, I'd be sitting with almost 16K in an account and should I start having medical problems I can use that, and if it gets near the bottom, I can use my catastrophic insurance, say if I get cancer or have a heart attack or something like that. This ignores my wife's income and insurance. My point though is this: if people have it, they have their 20s which are typically low health-care expenditures to build up a cushion so that as later in life problems get more serious/expensive/likely, they are better prepared to handle it.

Now, I don't know Ian's finances or medical expenses. But his major complaint seems to be choice. And HSA would undeniably give him more choice than he currently has, at no additional expense to himself or to anyone else. It's just removing some of the blocks on money that's already there, freeing it up to go where it is treated best, as defined by Ian instead of a pencil-pusher in the gov't or at some insurance company.

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You're making a number of assumptions here.

First is that "young equals healthy."

There has never been a year of my life in which I've consumed less than a thousand dollars of health care. And most years have been significantly more. My medications are over $200/month alone. And have been for most of my life.

In addition, I've never earned more than $10,000 in a single year.

Under your plan, I'd be dead.

Now, this may or may not be a downside of your plan from your point of view, but I assure you that, from my point of view, it is. I'm afraid that I cannot support any plan under which I'm dead.

Another assumption that you are making is that I have the ability to make better decisions about my own health care than a pencil pusher in the government or at some insurance agency.

Why? Actual assignment of health care risk is a significantly complex technical specialty. Why would I be better at it than someone trained in it?

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I'd say you being dead is a downside, yes.

Why would you be better at it than a pencil pusher? Precisely because it would be your life on the line. I think you're perfectly capable of picking a doctor or other health care provider that will meet your needs.

I did make a presumption though, that if someone has insurance of some kind from their work, they'd be able to use that money for an HSA. Or to choose their own healthcare instead of having to go with what their employer provides.

Another point I didn't make is that if someone with an HSA takes money out for non-medical purposes, they'd have to pay an income tax on it. As benefits of this kind are currently taxed, that additional revenue could be channeled into helping people who are having trouble. You well know I'm not fond of taxes, but I'd find that tolerable as a) the subsidy is self-selecting b) the self-selectors are people taking risks of their own choosing.

I'd also presume that necessary medical treatment would be provided as it is now. The problem with socializing systems like this is that it doesn't bring the people at the 'bottom' up, it just drags the people in the middle down and makes it even worse for the people at the 'bottom' and I don't think that helps anyone.

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cheshyre

Quality only for those who can afford it.

One of Gladwell's commenters made an excellent point:

I have a question. What would happen to the lines for health care in this country if the 40 million people currently uninsured were suddenly insured and got in line (and remember that many of these people are poor and perhaps in greater need of health care than the average person)? Wouldn't the lines for health care provision get a lot longer? So in that sense, maybe the quickness with which Americans can access care has something to do with the large portion of the population that has no access.

So which is preferable: everybody gets (say) 70% of what they want, or the top 1% gets 100% of what they want because they have the money for it, most people get (say) 60-80% of what they want, and 20% of the population gets nothing

Mind you, the richest of the rich will always be able to get what they want. That's true in medicine, that's true in other aspects of life. Even when abortion was illegal, wealthy women could fly abroad to get abortions, while poor women without those opportunites couldn't, regardless of who had the more meritorious case.

Also, the costs of insurance in this country, private and company-provided, are rising faster than inflation. Just to break even, companies are increasing the amount the employee pays anad reducing the benefits. We're all paying more for less. And why? One of the reasons is because insurance is a for-profit industry. Their primary goal is making money, not public health. Another reason healthcare costs are so high is because of all the uninsured people, who can't afford preventative maintenance so only get care when matters become acute enough to require a (much more expensive) emergency room visit. And since they can't afford that either, those costs are distributed to the rest of the patient population.

One last point: employer-provided healthcare puts us at an economic disadvantage with foreign competition. Domestic manufacturers must pay for their workers' insurance, which invariably means they have to charge more than foreign companies whose healthcare costs are absorbed by the government...

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