I Am Not Paying Higher Taxes to Help the Uninsured
"I don't want some government bureaucrats giving my money to someone else."
"I don't want my Medicare cut so that poor people and illegal aliens can have health care."
"I don't want the government death panels deciding what medicines I will get."
"I want what's mine and I want it all."
This is the problem. According to the latest Rasmussen poll, 51% of voters say that passage of the congressional health plan, particularly with the public option, will make the cost of their health care go up, while 21% say it will make costs go down.
The good news is that these numbers were slightly worse for Obama in August; progress is being made, but slowly. The good news is that 54% believe that major changes are needed in health care. Sixty-eight percent say it's important for Congress to pass a bill this year.
Americans know by now that our current system is unfair, odious, and extremely wasteful. They know that the World Health Organization ranks the US 37th. They know that US life expectancy ranks 42nd in the world. (See: Cuba Has Better Health Care than the US.)
Voters know that they are getting fleeced by greedy insurance companies, doctors, pharmaceutical firms, and hospitals. An estimated $700 billion is being squandered annually according to a recent report by Thomson Reuters health care analytics. This amounts to one third of the nation's health care bill.
No wonder insurance payments have doubled in the last decade. Unless major changes are made, Medicare will go bankrupt in 20 years.
Voters want change. They hear the stories about people who don't have insurance and who have died because they did not get early medical treatment. They are afraid of losing their jobs and their health care -- and never getting it back.
They are worried that their insurance will not be enough -- won't cover everything and may have a cap. And they are worried about their pre-existing conditions.
They are worried about their children and grandchildren.
They are crippled with fear mongering from both sides.
But they also hear the stories about how the Obama health reform will cut into their present benefits and raise their taxes. And they are paralyzed with fear. Damned if they do and damned if they don't.
But 68% of voters have health insurance that they rate good or excellent.
It's OK for me now. Don't change anything.
Ninety percent of voters have some health insurance, and they will never support higher taxes to pay for medical care for the uninsured poor. Put this to a vote and it will lose every time.
They will not support any legislation that raises their taxes or lowers their entitlements, unless they are getting a piece of it. This is textbook Prisoner's Dilemma, each voter (prisoner) pursues his own self-interest (by ratting out the other guy) which leads everyone to be worse off than if they acted in interest of each other as a whole, by keeping quiet.
This is Democracy folks.
Voters are nasty, brutish, and selfish.
The question that Obama needs to answer for the large middle class is: What's in it for me? Maybe Obama should include a large, flat screen TV for every middle class family, as part of health care reform.
So far, the middle class voter with health insurance hasn't been given a good enough simple answer.
No social program in American history -- Medicare, social security, rent control, public colleges and universities -- that aims to help the poor, can ever succeed without appealing to, and paying off, a broad middle class. If you are going to build parks in the ghettos, you have to build them in wealthy neighborhoods too.
Bottom line: In order to enact social programs for the poor, you have to buy off the middle class. That's why even the very wealthy are on Medicare and continue to collect social security payments and get unemployment checks -- monies they use for pocket change. And why some hedge fund honchos continue to live in rent-controlled apartments in New York City, while many young and poor pay inflated rental market rates.
This is the price that a democracy has to pay to help the disadvantaged.
Obama must apply game theory to this most complicated conundrum. Game theory assumes that voters are always rational and selfish -- always out to get what is best for themselves.
Game theory is at the heart of the American democratic process. Candidates will inevitably keep shifting their positions -- "gravitational force" -- toward the middle to capture a consensus.
Republicans are playing to the worries of seniors who oppose health reform by a margin of 42% to 32%. Seniors, of course, are already covered by government-supported health care, Medicare.
I got mine, and I am not paying for yours.
Instead of letting this sentiment work against reform, how can Obama make it work to support his reforms? The President must pander to these worries and fears in a blatantly political way. He must fear monger just like the best of the right wingers. He is not going to be able to sell health care reform by pointing to the poor and the dying. Thirty-eight percent of Americans think that cost is the biggest problem with U.S. health care. Only 15% think that the 47 million uninsured is a bigger problem.
The Democrats must warn voters that Medicare will go broke ... that their private insurance rates will double again in the next decade, just as they did in the past decade. The insurance that most of us know, and like, won't be there for us unless urgent changes are made.
Obama must terrify insured workers about the possibility that they will lose their jobs, and their health care, about the real possibility that if they get sick, they will never be able to get insurance again. And that medical care as a percentage of GDP is likely to double again.
He must convince the middle class that the current system is unsustainable if we do nothing at all; that waste, fraud, and greed will mushroom into higher and higher prices. The free enterprise system has failed in protecting the public. It has not been allowed to work.
Often there is little choice. In 40 states the health care markets are effective monopolies, dominated by two or less companies. It's no surprise that our wasteful and unsustainable health care system costs more than twice as much, for worse outcomes, than in the other developed countries.
Insurance companies are particularly obscene in this regard. Instead of competing with lower prices and better service, there is a built-in motivation to make money by not covering the old and sick -- slicing out the young and healthy -- and by denying customer claims on technicalities and fine print.
Health care isn't too expensive; it's the profit and the waste that's too expensive. This is why the public option is so important. It will provide a low cost benchmark for private insurance to emulate.
The answer to the Whats in it for me? question is that what we have now is irrevocably broken. And the faux security some voters now feel will soon be gone. Health reform, with a public option, will bring health care costs in line with the rest of the world.
Ultimately, what's in it for the middle class is long term health care security in a world that has become increasingly scary.
write: jfleetwood@aol.com
Follow Blake Fleetwood on Twitter: www.twitter.com/Blakefleet
Sahil Kapur: So What if a Public Option Leads to Single-Payer?
The conservative indictment against a public option is deeply ironic, and when closely examined, consists of two entirely contradictory cases about the nature of government.
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Skyrocketing medical costs has nothing at all to do with helping to pay for uninsureds. It has everything to do with nurses that make $45 an hour, doctors that make $200k a year, and a layer of beauracracy called the HMO that siphons up to half of every dollar spent on medical costs. People don't pay a nickel to help uninsureds right now, yet their medical costs are already through the roof.. what makes us think subsidizing the ranks of uninsureds will make it any worse than it already is? Do we have any proof whatsoever this will be the ultimate outcome? No, we don't.
Pardon me."People don't pay a nickel to help the uninsured"
Who does ?
A: The insured
B:The taxpayers
-OR-
C Both
When you wake up in the morning ......then you won't be disappoint
Yes ,the medical profession get paid well.If you went to school for 16-20 years and then interned for a couple of more for not much there should be a reward for your efforts , I think.
Years ago a wise old man said to me that when in wakes in the morning he keeps his eyes closed for another moment and thinks to to himself "people are stupid." Then he goes about his day and he is never disappointed.
The taxpayers of America pay now for the uninsured.
In California a number close to 30% of the drivers don't have auto insurance. The Californians who are insured pay for them.
The problem is two fold. One people can opt out and leave the one's that pay with their bill.The other problem is the insurance industry.A
I think we should have mandatory enrollment in auto and medical insurance as the 1rst step.AND then fix the greedy insurance companies.
Did anyone hear the insurance companies offer to "save us" a TRILLION dollars over 10 years if the health bill is scrapped? Where do you think they would get the money?
Everyone needs to pay in or not be included.
Having to pander to - basically having to pay off - those who already "have", especially for something as vital as health insurance/health care is proof of something that I am more and more convinced of every day: Americans are stupid.
Willfully, stubornly ill informed. And they apparently want to stay that way.
Anyone who can read, who can see knows that the health of your neighbor affects you. Directly or indirectly, whether you like it or not, it affects you. Did you shake his hand today? Did you have lunch with her yesterday? Do their kids go to school with yours? Do they go to your church/clu
This is such basic knowledge that denying that it's true and denying the solution amounts to willful, stuborn stupidity.
Regardless of the bills currently headed to reconciliation, I dispair for the country I've served and loved.
COPerez
What is the sole fact which distinguishes life in America from life in any other country?
The simple fact that all Americans are free is what makes us different.
Now, consider how, over time, the argumentation you post can be abused.
The health of your neighbor affects you directly.
Did you shake his hand today?
Did you have lunch with her yesterday?
Do their kids go to school with yours?
Do they go to your church/clu
If not them, how about THEIR friends or family?
If they are not healthy, you will not long be healthy.
When you set out to police the activities of free individuals -- then free individuals become criminals.
Socialism. It's bad for everyone. Don't drink the Kool Aid.
Hey that website you listed for the hospital you went to has an entire section which discusses how lack of health insurance prevents millions of Americans from receiving health care. The hospital you went to is actively lobbying for health care reform and for a public option:
http://www
BTW, when you say "If they do not have insurance and depend on social programs or on the emergency room, who do you suppose covers those costs? You."
My actual real life experience does not support your assertion. Actually it is the donations of churches and other religious institutions, medical professionals, and local business and industry that pays the medical bills of such individuals. The next tier is the doctors agree to drop their fees, and finally the hospital absorbs the cost and applies for a tax credit to cover the cost.
The world is not as one dimensional as you suggest.
Yes, everyone's taxes support municipal emergency services and County Hospitals.
Since when did consolidating anything, let alone medical services, under the government result in cheaper and better service? Name one government program that is under budget, ahead of schedule, and fully delivered in the most efficient manner possible?
Name me one private health insurance that is under budget, ahead of schedule, and fully delivered in the most dfficient manner possible.
"Socialism. It's bad for everyone. Don't drink the Kool Aid."
Code for ' I get all my (dis)information from FOX".. right?
How you could make such an absurd jump to 'police state' and 'socialism' when discussing the poor and uninsured reveals more about you than you probably intended.
As for your other assertion that charities, doctors, businesses and the hospitals themselves eat the costs of the uninsured is just ridiculous and again, reveals your lack of real study on this issue...
"People who are uninsured pay about $30 billion out-of-pocket for health services, the new study found, but another $56 billion in care for them represents “uncompensated care” – doctor and hospital bills that don’t get paid.
Of that, the new study estimated, $43 billion is paid by a variety of federal and state government programs. Most comes from Medicare and Medicaid extra payments to hospitals that treat large numbers of poor people. Some of the government cost includes direct care by agencies such as the Veterans Administration and by government
http://www
But hey, don't let facts get in your way when consigning your fellow citizen to losing their sight due to untreated diabetes or late diagnosed cancers due to a lack of wellness care.
"I got mine, and I am not paying for yours."
Indeed and if the plans go down to worthlessness as soon as revitalizing medicare comes up the republican game will become.
They denied yours why pay for theirs.
And medicare willl probably start down the path to obsolescence as well.
Everyone got so focused on the racial aspects of the last election they ignored the generational. And there was alot of youthful hostility in that vote. Alot of anger at the failure of the baby boomers to accomplish anything meaningful for america in their tenure of power was present in the passion for Obama and even the primary loss of Hillary. It's there to be played under the correct political circumstances.
Seniors being perceived as gutting healthcare reform I think would do it. And it wouldn't be hard to spin that message at the moment.
Conjecturing on what Americans know or don't know is the eternal sport of commentators, but what's sad about it is that usually the conjecture takes the place of actually finding out what Americans know. And what Americans know is more or less some half-remembered factoid or three from out of the nightly newscast. And on the current health care proposals, the nightly newscasts have been unending founts of corporatist misinformation. And then somebody does a poll to see how much misinformation stuck and and which misinformation needs repeating, so as to stick in time for the next poll. Why do news organizations continually ask the opinions of people who have no access to facts, thanks to the efforts of news organizations? Because it looks like consensus-- but it's a consensus of the relentlessly misinformed.
We could have passed a 2% Federal Sales Tax and done away with the penny, allowed the States and Counties to all pass an 8% sales tax or lower their tax to 8%, and wallah Medicare for all..!
See Joe The Nerd Ferraro's Profile
dude, great piece !!!
he makes avery sensible argument. Basic economic theory teaches us the power of incentives. It just makes good sense to say that incentivizing the middle and upper class is a necessity to getting support for a public option.
From the day I filleds for my Social Security Disability, to the day I received my first check, four years elapsed.
As someone who went from being working middle class to being one of the uninsured poor, let me speak for the uninsured poor.
Do you know what happens, Mr. Fleetwood, when you cannot pay your medical bills? Do you?
You are referred to the Financial Assistance Department.
You are not thrown out of the hospital to die in a mud puddle. Your medical care continues. All testing,surgical procedures, and medications continue. You are referred for application to special grant programs (monies donated by those evil big businesses).
I was hospitalized 26 times, I saw a doctor twice a month, and received all of my prescriptions free of charge and never saw a single bill for any of these services. All of this through attending the Heartland
Medical Center a free clinic located at Sheridan and Lawrence, in Uptown Chicago -- the poorest neighborhood on Chicago's North Side.
This is not about medical care for the poor -- thank you very much.
medical care for the uninsured poor
i actually work in in the financial assistance department in a hospital.
I also used to have a chronic health condition myself.
I love that you think money just rains down on the sky for us from corporations. Now I will admit grant programs DO exist, but it typically takes months to access them, and they have very strict rules. Very VERY few people qualify for such grants. As I work in a non profit hospital, we will continue to treat the patient. But guess who's paying for that? Us, the hospital. We lose millions of dollars a year due to insurance denials You didn't see a bill because your hospital ate the cost and then had to spread it out amongs all the other incoming patients, driving up their prices of admission while keeping wages for people like me lower than they should be.
Also, the idea that everyone without medical care continues to get care is, unfortunately, laughable. This happens every day in every hospital in America. Not all hospitals have the ability to just keep treating (continued)
Nothing you have said can change the absolute objective reality that I did continue to receive full medical care.
Weiss Hospital, where I was treated is in Uptown Chicago located at Weiss and Marine Dr. 98% percent of its patient load is uninsured and unemployed.
Uptown Chicago is the poorest neighborhood on Chicago's north side.
Because there is such a concentration of poor and unemployed there is also a concentration of donation run shelters, food and soup kitchens -- run by every brand of church under the sun.
I came to this neighborhood when after 28 years employment at the high end of the commercial printing industry I was diagnosed with an incurable and terminal medical condition and had a four year wait for my Social Security Disability because Chicago Federal Courts were backlogged that far.
Part 2.
We try and continue medical care for patients but sometimes it is simply not feasable. I have seen so many patients who we could no longer continue to treat, though we avoid doing this at all costs. But those grants you laud only affect I would say less than 1% of patients whose insurance won't cover their care.
When I had my own chronic health condition, I absolutely was kicked out of the in patient facility I was staying at when my insurance denied my care. Luckily my parents had enough money that they were able to pay the tens of thousands of dollars necessary for me to continue to receive care, though it was at a not as good but cheaper facility.
The most common thing for insurances to do is not to deny care, but to deny the BEST care (i.e. the most expensive). So for instance we will request the best working drug for a cancer patient. And that drug will be denied...s
Also, if you are a new patient, and we request an authorization, and your insurance will not cover it, we will not cover your care. You have to pay out of pocket or you don't get in the door. And that is the same for every hospital. Again, we DO apply for financial counseling, but the grants that exist are in such small (continued)
It is a federal crime for a hospital to turn turn away a patient needing critical care -- such patients are not tossed out the door to die in a mud puddle, they are taken to County and State Hospitals where they continue to receive care.
Your figure of 1% is only applicable to your personal experience -- not mine.
My experience is that of an individual living below the poverty level with no income and no insurance in a major city.
Weiss Hospitable physicians heavily fund the medical program at Chicago Heartland clinic and volunteer their services there. My medical care continued seamlessly from the first day I was admitted at Weiss through my treatment at Heartland Clinic.
I was sent for some testing and procedures to Cook County Hospital -- and my prescriptions were received there as well.
Mr. Fleetwood here paints Social Security recipients as rich layabouts. You know I never planned to die at my age (I'm 45) but I will before I see 50. Yet I am tarred with this same brush.
You and others claim with absolutely no evidence to support it that people are turned out into the streets -- another lie.
I currently receive Medicare, I go to the finset hospital in the Western Hemisphere and see the best specialists available and I am very happy with my medical care.
Keep your hands off it.
You claim: "Also, if you are a new patient, and we request an authorization, and your insurance will not cover it, we will not cover your care. You have to pay out of pocket or you don't get in the door."
I am sorry but this is not my experience. I was not only admitted with no insurance, but I was treated. There was no turning away. No mythical waiting period., I was treated promptly and my care continued without any delay or gap.
So wen you claim that is the same for every hospital you are wrong. It's not true at Wies Hospital at Marine and Wilson drive in Chicago Illinois.
Also when you claim the Best and most expensive treatment is withhald -- well that also in not my experience either. According to the research I have done I revcieved the best care possible.
Also on Medicare I go to Northwestern University Hospital in Chicago, the best facility in the Western Hemisphere.
I get rock-star treatment: a private room, the cutting edge of treatments, not one, but two nurses along with a full crash cart every time I am moved for testing -- I am never abandoned or left alone to wait no matter how long it takes.
Your stories just do not apply to my real world experiences.
And what guarantee is given that a "public option" will provide "the BEST care", when it too will be under the gun to reduce expenses at all costs? And with the public option, there is no incentive for them to try to retain you as a customer. At least a private insurer will eventually go out of business if enough people shift to a competitor.
I'm not heartless in my lack of support for the public option -- I just think it is designed poorly and is setting a lot of people up for failure. Just because we really want something to work doesn't mean that it will.
The #1 reason for bankrupcy in this country is medical costs. Your story is frankly, an incredible one. It does happen, I have helped patients get exactly the kind of care you describe, free of charge. And for every one patient I am successful with, there are a hundred who we fail to help despite our best interests.
Well, you can't get chemo in the ER. Sure, my surgeon has said he never turns anyone away that actually needs surgery. But after he does his surgery, his office manager gets the paperwork. People get sued for their care all the time. People that need specialized care don't get it in the ER. I am sure an oncologist, most go into the specialty because they want to help people, would willingly help someone needing care. But if you have a house, a car, money in the bank, I can guarantee you that you won't have these items in a few years, after the courts give a judgment against you. Your credit would be shot, your retirement is gone, you'd have to sell your house. Even tho you had insurance, expected it to cover you when you were ill, and found out that it just doesn't take care of you.
It would be similar if you had good house insurance. And had a big hailstorm. And when the insurance adjuster comes to your house, he announces that your insurance is now cancelled, due to the fact that you filed a claim.
by the way, thank you very much for this excellent lesson in the conservative mindset. A mindset that is so supremely self centered that they have an honest belief that because something works one way for them, it must work that way for EVERYONE.
"do you know what happens when you can't pay you medical bills? do you?"
yes, I do. In most instances, you die or go bankrupt. Or both. Again, medical costs are the NUMBER ONE reason for bankrupcy in this country.
Your post is just so uninformed it boggles the mind.
Frankly I did go bankrupt. I spent all of my life's savings, I had to give up my house and all of my property. You obviously didn't read my post below. Typical -- any length to sell your tripe.
What makes you or anyone think that when you are diagnosed with a terminal incurable condition requiring constant medical intervention that your life is going to continue uninterrupted?
It is denial. The bomb goes off. Your world ends. That is going to happen period.
BTW watch your mouth -- you are talking to a dying man, I bet your bedside manner is horrific, where do you get off?
What I did is move to where the very best services could be had -- which meant giving up my life, my friends, everything I owned to live in a poverty stricken sink-hole.
But it was the smart thing to do.
BTW there is a difference between being self centered and acting in ones own Self-Interest.
I know you are so programed that you think it is a dirty thing to have a self, but it is you and not I who is in denial -- The Self : Everybody's Got One.
why refer to your personal anecdotes when there are plenty of peer reviewed studies documenting the reality of health care for the uninsured or under-insured.
The vast majority of people who cannot pay for treatment simply don't get it. Getting help from charities or grants is very hard since demand is huge and resources are extremely limited. What the poor uninsured do is, either they don't go to the doctor or they don't follow treatment, don't buy the medications and progressively get worse until they go to the ER where they get treatment at extremely high cost to the system.
I am a disabled American, I worked for 28 years before being diagnosed with an incurable and terminal illness which will require intensive medical intervention until the day I die.
Having gone through the intensive screening process which prevents fraud I can tell you what it involves.
In order to apply you must have no means of income and have no savings, no stocks, no bonds, no invested monies of any kind.
Then you are denied. You must hire an attorney and file for an appeal.
Now be prepared for the State and Federal Government to comb records for any evidence at all that you have income. This process takes one year.
Then be prepared to see State appointed doctors who prepare a case AGAINST you for the State.
This process takes a year and can go into additional rounds, you know, Round two - a year, Round Three, another year.
Meanwhile you survive on $100 a month in food stamps -- that is the max allowable in Illinois to a single male.
So, you will forgive my laughter at the bald faced assertion: "That's why even the very wealthy are on Medicare and continue to collect social security payments and get unemployment checks -- monies they use for pocket change."
Not in the Real World Mr. Fleetwood. Not in the Real World.
I agree. For a large percentage of this country, if you had a secure home, retirement funds, and a decent job when you get sick, I can guarantee you that you won't have any of this when you're done.
This is a great piece; I am sharing it as widely as possible. The misconception that doing nothing now will let people who are happy with their coverage keep their current health insurance as-is is dangerous. I wish it was being talked about more.
While I certainly don't deny the existance of greedy doctors and hospitals.
please understand that there are good providers out there. And we are not fleecing patients for the fun of it, we're doing so because of the insurance companies.
I work for a non profit hospital. Our hospital as well as several others of the major Boston hospitals have been lobbying for health care reform and a public option for years. 70% of doctors support a public option, according to the New England Journal of Medicine.
I work as a patient advocate in my hosptial, and it can just not be underestimated how much we get screwed by the private insurers. We are a cancer hospital, yet claims are routinely denied as having been "not medically necessary" and the insurance just won't pay us. We lose millions a year this way.
Also almost all insurance companies are now requiring RIDICULOUS amounts of paperwork which previously was unnecessary to get claims processed. In additon, they now require authorizations for practically everything in order to pay them. Which means we have to hire more and more people to process this paperwork and to obtain these authorizations. And of course this cost gets shifted onto the patient.
Again, I'm NOT denying that there are greedy, wasteful hospitals. But even non profits like mine are seeing their costs balloon due to the actions of insurance companies.
In 2004, George W. Bush and the Republican's gave $950 million to Iraq to institute universal health care.
See Blake Fleetwood's Profile
You are perfectly right. Single payer is the way to go.
But it is not in the cards just yet. I am very worried, knowing the ways of Washington, that even the new reforms will by hijacked by the insurance companies.
Medicare is not perfect. Why can't we have the same universal coverage other developed countries have?
Employer based insurance is bogus and bound to fail, but it's a lot better than what we have now.
The only moral, logical, sensible answer is - HR 676. Extended Medicare for ALL. Single payer. Everybody in, nobody out. We all are used to paying for our Social Security and old age Medicare. We're used to FICA deductions from our pay checks. So single payer will make that go up a bit BUT - no more paying out of pocket for insurance, deductibles. No pre-existing conditions surprises. Everyone will have birth to death medical care. No, abortions aren't included. No, illegal aliens won't get it. No, elective surgery like nose jobs, or liposuction don't count. Doesn't that make sense? We're already paying for the uninsured in higher and higher and higher coverage costs. Many people with employers' health plans are also helping to pay for part of their coverage and their share keeps going up. We can stop that escalation with single payer. Medicare was implemented in just a few years. There is no reason universal coverage couldn't also be in place within a couple years. The democratic world didn't end with Medicare. Most old folks like it. So why shouldn't all Americans have it?
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