Old People aren't Cost Effective

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If you're paying for care for a serious medical condition out of pocket, yes. If you're just talking preventative care and checkups, not really. And you don't have to be rich to afford good health insurance, either. I know, I'm not rich and I'm paying for my own at the moment.

 

I was just making a snarky comment NOG, and it was at least partially tongue-in-cheek. I largely agree with what you are saying. Most middle class Americans who are working in some professional career can afford health insurance.

The problem, it seems, is that it costs about the same amount of money to insure someone within a company regardless of the age of the people invovled. I know that's true of my company. The plan I have doesn't take into account any of the people's ages or health conditions. This sets up an interesting dynamic - the people who make the most money are generally the oldest who require the most care, and yet, they are paying the smallest percentage of their total income for their insurance. The younger people who need less health care are paying a higher percentage of their total income for their insurance. And people like janitors, regardless of their age, will frequently not get the insurance because it is a significant percentage of their total income.

 

Well, that's a function of group policies through an employer, which may be problematic, but hardly the "health care crisis" everyone is talking about.

Additionally, your janitor friend can probably afford something, at least something minimal, for him and his wife as long as he budgets properly. I was earning a low wage working only 1/2 time at my job, and I could afford it. Now, I've been out of work since November, and I still pay my own. Sure, it takes some careful budgeting, and recently I've had to ask for some help from my parents, but that's after 7 months of complete unemployment. If I can manage, a janitor working 40 hours a week should be able to manage, too. Maybe not if he has kids and they need to be covered, but if his wife works, then they should be coverable as well.

My point is, affordable health insurance in the US isn't all that rare of a breed. Looking at what I've seen paying for my own health insurance, I can only question the budgeting skills of the people who can't afford it.

That being said, I find it a great sham that basic economics aren't a required course in high schools everywhere.

 

NOG - While it is a good thing that your parents are willing to help you through a rough period, many are reluctant to ask other family members for help, for a variety of reasons; while some others have no family who is in a position to help them. Here are some rough numbers on the cost of health insurance premiums. Also, medical bills are one of the leading causes of bankruptcy and high credit card debt:

http://healthinsurance.about.com/b/...urance-premium-out-of-reach-for-uninsured.htm

http://www.pnhp.org/new_bankruptcy_study/Bankruptcy-2009.pdf

 

Chandos, my point is that I've only even had to turn to support systems like family after months of unemployment. This is because I saved and managed my limited income wisely. Additionally, the second section you quoted there tells me that a lack of insurance isn't even reliably the problem. 75% of those filing for bankruptcy due to medical reasons had health insurance, and "Most medical debtors were well educated, owned homes, and had middle-class occupations." These aren't exactly the poor and destitute. This tells me the problem is either with insurance companies not paying or with excessive costs of medical procedures.

 

I understand that 7 months is not very long to be unemployed, even though you managed your income well. But my point was that some people are not lucky enough to have the kind of support, even though, as you point out you only made it 7 months.

That was, of course, the major reason I posted this data. The health care system is broken, atm, at least for those who are underinsured, or worse, have no insurance. It could also be that some were underinsured. Placing Silvery's heartrending and dire situation in this context, where the illness is this major, the cost could be hundreds of thousands of dollars, with about 20-30 percent of that to be paid out-of-pocket. That's enough to drive the average household into bankruptcy. A very tragic situation. But how can you put a dollar value on a human life? It seems the health care providers do just that every day.

 

I don't get why there's this objection about the US having an NHS system like we do. Sure there are some horror stories but it's like plane crashes. You only ever hear about the planes that crash, you never hear about the thousands that land safely everyday.

I should point out that while my nan was being told that she was no longer an asset to society, my son was in another hospital and the staff there saved his life every day for 8 weeks and were absolutely amazing

 

Chandos, actually, for most people, 7 months is a long time to be unemployed. Unless your entire industry collapsed from under you (such as home construction or something), 7 months is definitely a long time to be unemployed.

Silvery, I think the problem is that Americans don't like other people making decisions for them. If a doctor told me my wife was going to die because I couldn't afford the surgory, I'd be heartbroken, but I'd look to myself for blame. If the doctor told me my wife was going to die because the higher-ups just don't care that much about her, though, I'd want to go on a killing spree. This may be a weakness in the US, but when both systems automatically fail someone, when neither system is necessarily better, why should we change?

 

Well, "any time" is a long time to be unemployed. But most people are able to draw benefits for 6 months. After the benefits run out is when things start to get tough for a lot of people. There are people who are unemployed for a year or longer, and it has nothing to do with an "industry collapsing." Much of it depends on the local economy; there are often ripple effects that run through local areas that create chronic unemployment, regardless of the industry. 7 months is really not long at all, COMPARED to what a lot of other people experience. Right now the average national unemployment rate is nearly 10 percent, so the job market is especially tight.

 

Well, for one thing, I was wage, so I had no benefits period, just pay. Nothing carried over after the job was gone. For another thing, yes, things are especially bad right now, which seems to be a large part of why I'm still unemployed. A lot of people want my resume, it's just that none of them are hiring at the moment. I don't consider right now to be an accurate picture of the long-term condition, which is what is being addressed by legislature.

 

We still have private healthcare here and health insurance to pay for it. To me it just seems a bit more sensible. You have the option of going private if you want to jump the queue or the NHS won't pay for treatment but you can still use the NHS for the majority of stuff

 

Silvery, that system sounds good, but what impact on doctors did having a public system have? Here in the US, one of the major fears is that the public system will have enough negotiating power to bully prices down to ridiculously low rates, like, the doctors taking a serious loss on anything that system pays for. That would mean either loosing a substantial number of doctors, or most doctors not accepting the public insurance, which renders it kind of useless.

 

NOG,

I just did a search on doctor salaries on google, and a little hunting allowed me to find how much doctors are paid in the US, UK, and Canada (all those countries speak English, so I had the easiest time navigating through those links).

What I found is that doctors on average do make more in the US than in the UK and Canada, but not remarkably so.

I just looked up general/family practice salaries in each case, so this is just your run of the mill doctor. Specialists in all the countries probably make significantly more than this, but here's the totals:

Average salary for general/family practice doctor:

United States: $135,000
Canada: $116,000
United Kingdom: 67,000 pounds (how to you do the pound sign with the keyboard?)

With the current exchange rate of 1 pound = 1.63 dollars, that works out to about $109,000.

So doctors do make less in other countries, but not remarkably less, and I wouldn't consider any of those salaries to be low. None of them are hurting financially.

 

Yeah but surely when the US system is the worst in the world by a mile on a value for money basis that must bother you? The US spends way more than Britain for results a bit better. It spends way more than any other country as far I know but life expectancy is still worse than Japan, France, Germany, etc. (obviously lifestyle and diet play a part here).

On an individual basis there's a lot to be said for saying the US is the best in the world as long as you have the right insurance. I'm fairly sure I'd be better looked after in the US as long as I didn't get a permanent disability. But looking at the national stats the US is clearly failing a lot more people than most other systems and doing an expensive job of it too.

 

Deise, the thing is, the US isn't really one system. You're generalizing a nation when the nation doesn't exist as one coherant entity in this factor, while the UK, by and large at least, does.

Aldeth, those numbers are good to see, but I'd wonder how they're generated. Are they actual total money made, on average? Are they an average of the costs for procedures, weighted by the commonness of procedures? Are they an average of the salaries for salary doctors, because most in the US aren't salary? How those numbers are generated may raise or lower the actual income of doctors substantially.

 

That is far and away the most likely option you listed, since we're talking about general and family practice doctors.

Almost certainly not - the vast amount of money for any medical procedure would not go to a family practice doctor - you'd go to a specialist for most procedures, or at least have a specialist read the results, not to mention the salary paid to the technician performing the procedure, and the hospital or clinic in which the procedure is performed.

That I will agree with - most general/family practice doctors are privately employed - specialists work at hospitals.

Also keep in mind that I picked a common type of doctor, but I also picked what I would imagine are the worst paid doctors overall. In fact, I was surprised at how LITTLE general and family practice doctors make. My younger brother is an ER doc, working at an average hospital in Harrisburg, PA, and even though he's only been a doctor for a few years he already makes way more than what the average general or family practice doctor makes. I'm sure the same is true in UK and Canada as well - that the specialists make way more than the listed figures.

 

Oh certainly, and I'd imagine the non-emergency specialists, the hand surgeons, the cancer doctors, etc make even more.

 

I know but surely it's possible to talk about the overall US system when you're comparing countries? I know the US system is broken down into subsystems that individuals fit into but surely that's merely America's choice to do it that way? Ye could have a universal NHS type system if ye wanted to (not suggesting Obama could do it with a click of his fingers but it could be brought in gradually). To me it seems the majority of Americans get excellent medical care but pay way over the odds for it. Then there's an awful lot of people who get very poor care.

 

The UK has similar difficulties though: Scotland has different rules for allowing new drugs to be paid for by the NHS. English patients (excuse the pun) must wait 5 years for new drugs to be tested and approved. If they want to try new drugs, they must pay themselves, or just be 'patient'. Which is a lot to ask for if you're ill.

 

I think that these posts would be better off in the universal health care thread, I'll PM Tal and ask him to merge them

[Can't really do that, as the other one is in AoLS and primarily political due to political nature of the issue in the US. Also, merging two threads this late would just make it into one big jumble as all the posts would get mixed; rearranged by the post time. -Tal]