Who should pay?

doobiedo, RN · Oct 5, 2004

Ok, I'm interested in hearing all your opinions. I had to write a paper on this, and am curious to see what you think.
Who do you think should pay for healthcare? Why?

Hard to say...Businesses pay astronomical health care premiums so they attempt to split the costs by asking the employee to pick up some of the tab...however still difficult especially with average to low income families....It is unreal what I hear my self employed family members have to pay....or others who have to pick up cobra and cannot afford to let it lapse due to preexisting conditions...,

I am lucky and count my blessings to work for large corporation who picks up 90% of my tab however but would not want health care like the UK has as a VP for our company who lives in UK just took her father to an 'urgent visit' with a cardiologist and had to wait for 6 months to get that appt....!

When I see my EOB's and note what the hospital and doctors charge for some services I think it is outrageous and wonder if health care didn't drive us to this dilemma.....

Jolie, BSN · Oct 5, 2004

Without a doubt, I believe the consumer MUST have some financial responsibility for his/her health care, beyond contributing to insurance premiums.

Too often, we have seen examples of abuses of the system by those who perceive that health care costs them nothing out of pocket. In days long gone by, my mother's friend would routinely have 2 eye exams and purchase 2 pairs of glasses per year, "because it doesn't cost anything." My MIL continued to see an MD who she knew was submitting fraudulent bills to her insurance because "the bills get paid anyway." Even HMOs, which were supposed to be cost saving, failed in large part because people could go to the doctor for every little complaint without cost to themselves. If they'd had to pay out of pocket, these same people would probably have not even considered making an MD appointment for a cold or muscle ache.

I have seen my hubby's benefits dwindle over the past 10 years from full coverage at very low cost to us to a plan with a $3000 deductible for which we pay higher premiums than ever. Even with the thousands of dollars that we've contributed to our healthcare this year, I know that we are still paying only a fraction of the actual costs. But because of our financial responsibility, I have made some decisions (to save money) that I probably wouldn't have made in the past. Hubby has switched to an OTC allergy med. (That saves $2/day.) I have opted to join the gym and hire an athletic trainer to devise an exercise plan for me, rather than return to PT for a knee injury which is still healing. (That saves $85 for an orthopedic office visit and $75 per PT session.) Don't misunderstand me, I'm not skimping on anything that I believe could be harmful in the long run, but I am weighing my spending much more carefully than in the past.

Putting healthcare financing solely in the hands of the government would be disastrous, in my opinion. Costs, quality, and access would all suffer, largely because of the "entitlement" mentality that so many people have when they believe that "someone else" is paying the bills.

fergus51 · Oct 5, 2004

I think everyone should pay for healthcare. Why? Because we all use it and we all need it. Unfortunately that isn't the case in the US.

I am Canadian so this is a little biased. But, I can tell you care is just as good in Canada under a taxpayer funded system and people aren't using that care frivolously just because they don't have to pay out of pocket.

jemb · Oct 5, 2004

I actually think that individuals should pay for their , own healthcare (vs. employer paying as many employers do). However, the curent US system has it that individual policies are much more expenseive than group policies that are available to employers.

Also, if the employer pays, you are not taxed n the cost. If you pay for your own health insurance, the costs are not tax deductible unless they are included in other health care costs which equal a certain percentage of your gross income. Even then the total amount over that percentage is all that can be deducted. ( I don't have it in front of me, but I think it is 6 or 7%, which, barring accidents or major illness, is rarely met by the normal working person.)

SmilingBluEyes · Oct 5, 2004

OH my my my. there are many threads heatedly discussing this issue already.

No one wins this one, as most know. I imagine a search here will net you a real varied and interesting reading of many points of view from desires for a completely socialized medical care system to the medical- care -is- a- priveledge- not- right side of things. It gets heated each and every time we discuss it......and no one changes his or her mind.

LydiaGreen · Oct 6, 2004

I think everyone should pay for healthcare. Why? Because we all use it and we all need it. Unfortunately that isn't the case in the US.
I am Canadian so this is a little biased. But, I can tell you care is just as good in Canada under a taxpayer funded system and people aren't using that care frivolously just because they don't have to pay out of pocket.

I completely and entirely agree with you Fergus. In Canada, children and adults can go for their annual check-ups and possibly catch something early instead of waiting until an illness/disease/condition has progressed to a critical point. Children are tracked according to growth charts (height and weight) to attempt interventions before damage is done. There is no copay. Those who can afford it maintain health insurance through their work for medications, dental, optical, and atypical medical treatment (such as artificial insemination, etc). But, there is no need to account for every aspirin that each patient gets in the hospital - they are not charged for it. They are not charged for their hospital stay (as long as they are Canadian citizens, each province has a health system and will pay from province to province). You don't have to pay for an ambulance unless it is deemed unnecessary (not sure HOW that works, how is the average lay person supposed to know if a person can wait for treatment until transported to ER by car rather than ambulance?).

Our universal health care system is paid for by the taxpayers... a portion of your earnings is taxed for health care and those who earn much more, pay more. My family doesn't abuse the healthcare system, we are fairly healthy and do not require much in the way of healthcare or visits to the doctor's office. There are some individuals who need to see their doctor weekly. Odds are, they pay the same amount of health tax that I do but, I don't mind. I am happy to see that anyone who needs healthcare, receives it.

Marie_LPN, RN, LPN, RN · Oct 6, 2004

Each person should be responsible for their own healthcare and its payments, unfortunately it doesn't work that way.

Jo Dirt · Oct 6, 2004

I think everyone should pay for healthcare. Why? Because we all use it and we all need it. Unfortunately that isn't the case in the US.
I am Canadian so this is a little biased. But, I can tell you care is just as good in Canada under a taxpayer funded system and people aren't using that care frivolously just because they don't have to pay out of pocket.

If the healthcare system in Canada is so good why is this country flooded with Canadian doctors?

talaxandra · Oct 6, 2004

Australia has a publically-funded health care system with what used to be an option for going private (the government has, over the last five years, introduced strong incentives for going private and disincentives for not taking out private health insurance). Our ambulance system is different that that in Canada - you can take out ambulance cover ($50/year for singles - paid mine last month!), which pays for all emergency and medically-authorised ambulance transport, including medevac, or you can risk it and pay out of pocket if you need an ambulance.

There's an active thread about this at the moment: two out of three American adults think health care coverage should be a "guarantee" - (thread #921020) which has a fairly thorough coverage of the argument, including US, UK and Australian contributions. SmilingBlueEyes is right - nobody ever seems to change their minds :)

totallytheresa · Oct 6, 2004

I agree that some take advantage, and think "it's free anyway" when they don't have to pay for health care, however there will always be people who can't afford their own healthcare so there will always be this problem. And it's not fair to people who understand the value of healthcare, and don't take advantage but can't afford to pay. There should be some guidelines as to how much of the "free" healthcare people can routinely take advantage of. I know for group dental insurance, for example, they only pay for 2 cleanings a year, same with opthamologists- that's once every 2 years. I just don't think it's feasible for everyone to pay for their own healthcare- so there should be rules governing it and enforcement somehow. (Don't ask me how, our gvnmt has enough trouble enforcing other things!!)

LydiaGreen · Oct 6, 2004

If the healthcare system in Canada is so good why is this country flooded with Canadian doctors?

$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$

There's your answer - isn't that what makes the world go 'round?

Another difficulty with our doctor shortage is that so few med students choose to be general practitioners anymore which is exactly what we are lacking.