Is Health Care a Right?

Sally_ICURN · Jan 31, 2003

I live in the Silicon Valley and like Deb has shared, I too know people...highly educated people, who were making a killing just a few short years ago but have been laid off or their business failed. Folks have lost homes, savings, and dignity. Most middle of the road employers don't even want to look at a person who is overqualified for a position while thousands of people in this area are underemployed.

It could happen to any one of us.

Q. · Jan 31, 2003

Yes it could.

Which is why I guess my husband and I never assume anything or take anything for granted. The money that we so desperately want to hang on to is put away for things just like this. However, if that bucket keeps getting smaller and smaller by virtue of me paying for everyone else, well, then there will just be even more of us in that situation: overqualified and unemployed.

Then what?

Venti Cappucino · Jan 31, 2003

A couple of folks mentioned Wal-mart and whether or not the employees there could afford insurance.

May I suggest a book called "Nickeled and Dimed: On Not Getting By in America"? Can't recall the author at the moment, but she is a journalist who did an expose on the working poor, working jobs waiting tables in a low-end family restaurant, working as a maid, and at Wal-mart, among a few other jobs. It's a pretty shocking book.

Q. · Jan 31, 2003

Again, it sounds to me like the problem is not solvable by having me pay for it. It sounds like, once again, health insurance needs to be revamped so it's affordable for employers. And employees need to stop utilizing the health care system inappropriately and driving up cost!

SmilingBluEyes · Jan 31, 2003

Originally posted by Susy K
Again, it sounds to me like the problem is not solvable by having me pay for it. It sounds like, once again, health insurance needs to be revamped so it's affordable for employers. And employees need to stop utilizing the health care system inappropriately and driving up cost!

Any suggestions as to how to make this happen? Just curious. Now we are in a direction that interest me, as a responsible,working tax-payer. We have beaten the whole irresponsible, lazy, abusive-health-care user thing to death. How bout addressing those who are NOT at fault, yet find themselves going without? WHO pays One way or the othre, WE ALL DO, that is who, or will be soon. Hell, there are NURSES I know who care BARELY afford the crappy insurance benefit we have to offer where I work. What happens when they can't anymore? Or when the hospitals decide it's not economical to provide it any longer? Sound far off? It's not.

Sally_ICURN · Jan 31, 2003

I wonder how the original poster in this thread, VickyRN, is thinking about how it's going?

SmilingBluEyes · Jan 31, 2003

I dunno but her hopes to avoid flaming were a bit naive. sad to say. there has been some nasty mud-slinging here...shameful.

Sally_ICURN · Jan 31, 2003

"Across the nation, there is a great need for publicly funded psychiatric services. Both the debilitating nature of psychiatric illnesses and the lack of adequate health insurance to cover this illness often thrust individuals into poverty."

Another twist to healthcare of the needy.

San Francisco has the largest population of homeless, as compared to it's general population, in the country. A majority of the homeless population have diseases in mental health.

"Psychiatric treatment must be seen as an integral part of the overall medical system of care, as the root cause of psychiatric illness is brain disease. For too long, individuals with psychiatric disabilities have been isolated, stigmatized and shunned. Psychiatric disabilities are treatable. Treatment must be provided on demand and in a variety of methods and settings that address diverse population needs. Given the advances in psychiatric treatment in the last ten years, it is unconscionable that anyone in this city should suffer, become homeless, and possibly die due to the effects of a treatable condition, simply because they are poor."

http://www.sf-homeless-coalition.org/mentalfacts.html

These folks do not get the care that they need and mental health care in this country is woefully inadequate on the whole--even for those who can pay.

Many many people with a mental health disability are not able to work....ever. It's just a fact.

My question to those who do not think they should pay taxes to support healthcare for the "poor" is what do we do with this population of mental illness? You could even leave out the fact that thousands of homeless have mental illness. Let's say they're not hopmeless (a freudian slip hehe). Let's say they are the ones working at McDonalds or Walmart. Do you propose that they don't deserve our aid?

"Just under a quarter of the population in the United States will experience an episode of mental illness in their lifetime. (Rogier, 1990)"

fergus51 · Jan 31, 2003

How about making health insurance payments a tax rebate for one?

OzNurse69 · Jan 31, 2003

Ok, I'm not saying our system is perfect, but for the information of those on this board, here is how it is run in Australia.....(don't shoot me down if the figures aren't exactly correct, I'm doing this off the top of my head)....

Once your salary reaches a minimum of about $20,000, you pay a 1.5% Medicare levy with your taxes. ALL residents of Australia (permanent, citizens, etc) are then entitled to free health care through the public health system (regardless of whether or not you pay a medicare levy), & a rebate off their pharmaceuticals so that drugs listed on the PBS cost a maximum of about $22.00.

There are waiting lists, & to avoid those you have the option of taking out private insurance. BUT it is much less expensive than in the US -- around the $2,000 mark per family per year, which includes dental, physio, etc.

For those who don't want private insurance, there is an additional medicare levy of 1% (total 2.5% of gross salary) once you make over $50,000/single or $100,000/family. This is to ensure those who can afford to pay more but choose not to, end up paying anyway.

And to get around the fact that some people used to take out private insurance when they reached an age when they would be more likely to use it, the govt has introduced another levy where once you turn 30, it costs 2% more per year to start taking out insurance. So someone who is 36 & just starting out, would pay 12% more than someone who has had health insurance all their life.

Actually, when I think about it, it's pretty fargin' complicated, isn't it?? :confused: But what it boils down to is the fact that everyone who is entitled to be in Australia, who isn't a tourist or temporary resident, is entitled to whatever health care they need, & the govt pays the hospitals for it.

(Oh, and 30% of your private health fund premiums ARE rebatable, fergus, although most people choose to have this cost taken directly off the cost of the premiums, so you don't really notice)....

Nurse Ratched, RN · Jan 31, 2003

Posted without comment.

http://www.nytimes.com/2003/01/31/opinion/31HALS.html?th

To Guarantee Universal Coverage, Require It

By TED HALSTEAD

WASHINGTON-Among President Bush's top priorities, he said in the State of the Union address, is "high quality, affordable health care for all Americans." Yet he offered precious few specifics. With nearly three million Americans losing their health insurance in the last two years alone and health care costs rising at the highest rate in a decade, America needs a bold plan.

The most promising solution to America's health care crisis is mandatory insurance. For the same reasons most states require drivers to carry car insurance, the federal government should require all Americans to purchase basic health insurance. Those who cannot afford the full cost should receive public subsidies. Mandatory self-insurance would provide fully portable coverage to all Americans, while lowering insurance costs, raising the quality of care, maintaining a private insurance market and offering citizens more choice.

The grand bargain underlying compulsory health insurance would be universal coverage in exchange for universal responsibility. Of the 41 million Americans without health insurance, a full two-thirds are below the age of 35. Mandating tens of millions of young and relatively healthy Americans to join the insurance risk pool would drive down the costs for everyone. Insured patients are also less likely to rely on expensive hospital emergency rooms for their basic medical care.

Most of the uninsured are members of the middle class; a third have annual incomes of more than $50,000. Requiring them to devote up to a certain percentage of their income to purchasing basic coverage would be imposing a significant, though not ruinous, financial burden-but they themselves would be the primary beneficiaries. Not only would they receive better care, with its obvious benefits (regular checkups and peace of mind, for example), but their premiums would be significantly lower than those available to them now.

The new system would also be an improvement for Americans who receive health insurance from their employers. They would be able to select their own insurance policy and level of coverage from among private providers, instead of being limited to the one selected by their employer. They would also be able to keep the policy and doctors of their choice as they move from job to job. Employers, meanwhile, would not stop paying for coverage-they would simply contribute to the policy of their employee's choosing. After all, employer-subsidized health insurance is voluntary now, and there is little reason to believe that employers would suddenly stop providing it.

Mandatory self-insurance would also increase the quality of care. Today, most Americans change health insurers when they change jobs: average tenure with any given insurer is a mere couple of years. By enabling citizens to stay with a single insurer for life, mandatory self-insurance would increase insurers' incentives to invest in disease prevention and long-term preventive care.

Making mandatory self-insurance work would require new regulations and changes in our health care framework. For instance, America would no longer need to maintain a separate Medicaid system for the very poor. Insurers would have to accept all comers and be prevented from discriminating on the basis of pre-existing conditions. Ensuring that all citizens self-insure need not be difficult; those unable to prove that they had done so on their annual tax form could be enrolled in a default private plan by the government, and either billed or subsidized accordingly.

A policy of mandatory health insurance defies the usual political spectrum. Its universalist dimension should appeal to the left, while its market-based orientation should appeal to the right. The interesting question is who will be first to lay claim to this idea: President Bush or one of the Democratic presidential candidates.

Ted Halstead, president of the New America Foundation, is co-author of "The Radical Center: The Future of American Politics."

kmchugh · Jan 31, 2003

Sally

You made some good points in response to me, but I think you are missing a subtle, but important difference.

My original point was that recognizing someone has a given right is generally without cost to others. This does not mean that all our freedoms are free. Quite the contrary, protection of freedoms often costs us. I can't at the moment remember the exact quote, but one of our founding fathers (Patrick Henry?) said freedom isn't free. It is paid for with the blood of patriots.

In your example of the pro-life demonstrators, the right of speech is free, but protecting the exercise of that right may not be free. The issue here is not the cost of granting that freedom, but rather the cost of preventing others from denying you that freedom. In fact, the exercise of a right is often not without cost. I have the right to speak freely. I may have a message I want to get out to the general population. I am free to speak on a street corner, but what if I want to reach a larger population? I may need to schedule a speech, or demonstration, on the steps of the courthouse, or even a television show to get my message out. The courts have ruled numerous times that while I have the right to get my message out, that right does not extend to making others pay (i.e. the government, or taxpayers) to get my message out. Whatever costs that are incurred in the exercise of my freedoms must be borne by me.

The subtle difference here is that I must bear the costs of exercising my freedoms. It is not the government's (or taxpayers') responsibility to pay for the exercise or granting of my rights. However, if there are those who would illegally try to deny me my rights, then the government has the responsibility to protect my (and everyone elses') rights. That is the fundamental purpose of government.

As to the issue of courts, of course the dockets are full. Of course the courts are busy. But, they are NOT busy deciding whose right to what is paramount. My point was, anything that must somehow infringe on the lives of others cannot be considered a right. Granting universal health care as a right does infringe on the lives and rights of others. My right of free speech does not infringe on your rights in the least. If you don't want to listen, walk away. My "right" to health care does infringe on your life, if you are forced to pay for my "free" health care.

The argument, therefore, still stands. Universal health care, desireable or not, cannot be a right. Note, I'm not saying that there are not issues that need to be addressed, I have already said there were. I am not saying our system of health care delivery is fine, it isn't. But saying that simply extending health care to all as a right won't really fix any of the problems we all know exist.

Your quote from Justice Marshall is well taken. However, we cannot ever consider something a right if the mere granting of that "right" places a burden on others. I go back to my original point: Your rights end where my nose (or wallet) begins.

Kevin McHugh