10 Excellent Reasons for National Health Care

nicurn001 · Jan 9, 2009

Often when people on these threads compare what they pay for healthcare , against the percieved cost of UHC ,they forget to add what the employer pays for their healthcare to what is deducted from their paycheck .If you don't do that calculation , when you worry about cost of UHC you are comparing apples with oranges . In theory when th eemployer no longer has to pay for your healthcare insurance that money should be released to cover the cost of UHC and any tax consequences to the employer .

Koyaanisqatsi-RN · Jan 10, 2009

Often when people on these threads compare what they pay for healthcare , against the percieved cost of UHC ,they forget to add what the employer pays for their healthcare to what is deducted from their paycheck .If you don't do that calculation , when you worry about cost of UHC you are comparing apples with oranges . In theory when th eemployer no longer has to pay for your healthcare insurance that money should be released to cover the cost of UHC and any tax consequences to the employer .

This is what usually results in the 'sticker shock' that most people receive when they attempt to sign up for COBRA coverage. It's a sad thing, really.

BBFRN, BSN, PhD · Jan 10, 2009

Often when people on these threads compare what they pay for healthcare , against the percieved cost of UHC ,they forget to add what the employer pays for their healthcare to what is deducted from their paycheck .If you don't do that calculation , when you worry about cost of UHC you are comparing apples with oranges . In theory when th eemployer no longer has to pay for your healthcare insurance that money should be released to cover the cost of UHC and any tax consequences to the employer .

Not really. Cost will decrease, because it will be regulated. You can read HR 676 on thomas.gov for the details regarding this.

Jolie, BSN · Jan 10, 2009

Not really. Cost will decrease, because it will be regulated.

Relying on regulation to control costs will work only in the short term.

When you take a commodity (whether it is gas or health care) and limit the amount that can be charged for it, you will control costs initially, but you will ultimately limit the supply of the commodity that is available. Just as Big Oil will quit producing gas when the price they can charge no longer justifies the cost of production, so will health care services become scarce when prices are artificially controlled. When a hospital can no longer recoup the cost of providing a particular service, they will stop offering it. We've already seen this happen with hospitals that have dropped maternity services and physician providers who refuse to accept Medicare and/or Medicaid because of the dismal reimbursement rates.

The ultimate effect is rationing.

BBFRN, BSN, PhD · Jan 10, 2009

Market based health care is also rationed.

loriangel14, RN · Jan 10, 2009

What do you mean the hospital will no longer be able to recoup the cost of providing a service? Under UHC the health care is funded by the government using our tax money. The money for services comes from the governmnet not out of private pockets.

OC85 · Jan 10, 2009

Another thing to note, is that when you have UHC, you largely cut private insurance companies out of the game. Remember that currently, a significant portion of "healthcare costs" does not go toward actual medical expenses, but rather toward the profits of insurance companies. When you establish a not for profit plan, you can pay doctors/nurses/hospitals the same rates for providing service, and still spend less on healthcare.

Koyaanisqatsi-RN · Jan 10, 2009

Relying on regulation to control costs will work only in the short term.
When you take a commodity (whether it is gas or health care) and limit the amount that can be charged for it, you will control costs initially, but you will ultimately limit the supply of the commodity that is available. Just as Big Oil will quit producing gas when the price they can charge no longer justifies the cost of production, so will health care services become scarce when prices are artificially controlled. When a hospital can no longer recoup the cost of providing a particular service, they will stop offering it. We've already seen this happen with hospitals that have dropped maternity services and physician providers who refuse to accept Medicare and/or Medicaid because of the dismal reimbursement rates.
The ultimate effect is rationing.

This example becomes irrelevant when you note that private care is already rationed, and prices are already artificially controlled by insurance companies. That is why (even under your own example) that prices have continued to rise, and the availability of care has continued to drop.

And plus, there is a large difference between buying big-screen tvs(where your example is 100% right) and buying healthcare. (where your example is not right).

Patients or people who need health care are not in a position of choice, as in your example. They are in a position of need. This changes the game entirely, and is a perfect example of why something like national or local defense can NEVER be privatized. It would be a disaster. This is no different. I have not met anyone yet who thinks THAT would be a good idea.

There are a great many more wonderful examples of why healthcare is in no way shape or form a commodity here

http://www.hartford-hwp.com/archives/44/248.html

I would be interested to hear feedback on that article from someone who opposes the idea of UHC.

Jolie, BSN · Jan 10, 2009

What do you mean the hospital will no longer be able to recoup the cost of providing a service? Under UHC the health care is funded by the government using our tax money. The money for services comes from the governmnet not out of private pockets.

Our government already sets reimbursement for certain diagnoses, procedures, etc. via Medicare and Medicaid. What the government pays is sometimes less than the hospital's or physician's cost of providing care to the patient. Hospitals and physicians are able to offset this deficit by passing those un-reimbursed costs on to insured and/or self-pay patients. When the government sets reimbursement rates for all patients with all diagnoses and all procedures (via universal health care) there will be no other source of funding for these providers to recoup their losses. When that happens, they will have to limit their services in order to stay in business.

For example, a number of years ago, I worked in a community hospital in OB. We did several hundred deliveries a month, about half of which were privately insured patients and half Medicaid. For a lady partsl delivery or an uncomplicated C-section, the physician (for prenatal care, delivery and 6-weeks check-up) and the hospital were reimbursed about $2500 each by insurance companies, but only about $800 each by Medicaid. We had about 30 physicians who practiced OB, but only 3 who would accept Medicaid patients because their reimbursement did not cover their expenses to care for these patients for 9 months. Those who accepted Medicaid did so because they felt a moral obligation and because their private pay patients made up the difference so they could stay afloat. If those physicians had not had income from better paying privately insured patients, they couldn't have afforded to care for Medicaid patients at all.

Similarly, the hospital experienced a funding crisis when a nearby hospital opened a new, luxurious OB unit. Suddenly, the number of privately insured OB patients in our facility dropped significantly. The hospital was no longer able to offset the deficit of insufficient payment for Medicaid patients because there were fewer well paying insured patients. There was consideration given to closing OB altogether. Fortunately, that did not happen, but the hospital did post consistent financial losses in OB, which they attempted to offset by developing other well-paying services. Again, that was possible because they were able to attract well paying privately insured patients to other services. If and when we all have the same source of payment (the government), it won't be possible for providers to recoup these losses, and rationing will ensue.

RN4MERCY · Jan 10, 2009

Market based health care is also rationed.

You're right. And therein lies the problem. If health care is treated like a "commodity", like plasma TV's and Cadillacs, only people with money can go shopping for them and purchase them. 47 million people are rationed out of the system already, and that many more are underinsured; they make hard choices everyday about whether to pay for food, pay the rent, or pay for the medicine they need. The commodification of health care is inherently unjust. We are lacking an equal opportunity in this country to get medically necessary health care. If you have money you get it, if you don't, you get sicker and die.

That's why we should provide health care as a social service, paid for by social insurance, like disability insurance or social security insurance; a small tax on individuals based on ability to pay, and on employers, because we all benefit by having a healthy workforce. We already pay for other socialized services like schools, police, and fire protection, and clean water. Why is health care treated differently?

Drug resistant diseases and pandemics don't respect age, gender, dependency and socioeconomic status, state or national borders, so it's foolish to ration care and restrict it only to the wealthy. Based on the principles of justice and equality we should institute a single-payer system of health care. We don't have a two tiered court system and we shouldn't have a two tiered health care system.

loriangel14, RN · Jan 10, 2009

But here they would not spend money on the "luxuries" like artwork and waterfalls in the lobby. Funding is provided for pt care. They don't decorate first first and then ask for money, funding comes first for specific services.

Koyaanisqatsi-RN · Jan 10, 2009

That's why we should provide health care as a social service, paid for by social insurance, like disability insurance or social security insurance; a small tax on individuals based on ability to pay, and on employers, because we all benefit by having a healthy workforce. We already pay for other socialized services like schools, police, and fire protection, and clean water. Why is health care treated differently?

I don't honestly know. I think that is what we're fighting to fix!

Another good point is that doctors may well be paid a little less under UHC. But, with the full force of a VERY large risk pool (everyone in the United States!) many costs can be gotten rid of. This is how insurance works on a very basic level. The more people you have paying in, the less the cost to all. Some of the 'savings' to us can be passed on to these doctors to ensure they have a rewarding enough salary that their education demands.

And anyway, it's not like I'm worried about doctors leaving here to go elsewhere to practice medicine. Once we have UHC, there will be nowhere else to go. :) We are, as said before, literally the last industrialized country on earth trying it this way.