Walter Jones, a professor of health policy and health economics at the Medical University of South Carolina, said there are a number of reasons South Carolina is on the high end of the wrong list:
”¢ A number of people are employed by small businesses that can’t afford to provide insurance.
Ӣ Many people work in the tourism industry, which tends to pay less and not offer health insurance benefits.
”¢ The state’s requirements to qualify for Medicaid are overly strict.
Kendall, thanks for keeping this issue in the forefront. Until it really starts to affect folks in corporate and government jobs, we will not see the outcry from conservatives. Again, the big three are getting rich at my expense and will not provide a market solution.
Of course, 1/3 of the oft-touted number of 45 million uninsured are illegal immigrants. So it’s a pity that the 1/5 that is touted in this article isn’t broken down further so that we can actually have a number for 1) citizens of the US, 2) folks who actually want health insurance [a large chunk of the 45 million are people who are well able to afford health insurance but simply choose not to have it], and 3) citizens of the US who really really want health insurance and cannot buy it.
That latter number — far far far smaller than the 1/5 — is what I am interested in.
And then one has to divide it further down into 1) folks who are full-time employed and cannot acquire it and 2) folks who are unemployed and cannot acquire it.
The former have every reason to be frustrated . . . and just as soon as we have tort reform and allowance for *individual policies at the same Federal benefit as corporate policies* along with individual pooling [currently regulated], along with de-regulations on insurance companies to allow policies to be distributed for further niches [ie, those with healthy lifestyles, etc] which then would bring further market forces to bear on the monopolized insurance industry . . .
Only then can we turn our eyes to the by then much much smaller slice of the US citizens who are employed who desire health insurance.
My bet is that by the time we enacted those minor reforms, the cost of acquiring health insurance would plummet and many many more employed US citizens could acquire health insurance.
Of course . . . that would mean that individuals would be left in control of their health care and health insurance . . . which would really cramp the style of those members of the Centralized Planning Politburo who desire the State to have control of indiviuals health care and health insurance.
let’s not forget those who have pre-existing conditions that aren’t covered even if they have a policy. we need change, the sooner the better.
Great post Sarah1 and very true. Sarah1 and Magnolia, let’s get started.
I actually surprised the number in SC is that [i]low[/i]. Outside of the major metro areas, much of the employment in the rural south is what I would term “subsistance jobs”. Farm work, chicken processing plants, fast food, discount retail, hospitality (meaning motel housekeper) and the like. None of which offer any health insurance options. If you haven’t lived here, it’s hard to realize just how poor vast areas are.
Sarah, are you saying that illegal immigrants shouldn’t get health care?
Scott, first of all they in the country illegally. They should actually be deported to their native country. Are you suggesting that the tax payers pay for their health care?
I find it curious that there are many MSM reports about those lacking health care insurance, and few reports about how well the federal government has managed medicare, medicaid, and the VA. In both cases, there is no breaking news.
🙄
Scott K, I can’t help but think she’s pointing out that American tax payers should not be obligated to furnish medical care for non-citizens, particularly at the cost of lowering the quality of existing care, with seems satisfactory to the majority of citizens of this country, in spite of its faults.
# 9 Just curious, who pays for your health care and how satisfactory is your plan?
[blockquote]Sarah, are you saying that illegal immigrants shouldn’t get health care? [/blockquote]
I think they should get every bit they can pay for.
Even under existing laws, illegal immigrants and THOSE WHO IMMIGRATED LEGALLY WITHIN THE LAST 5 YEARS (meaning those who have been here longer are eligible), are not eligible for government health benefits. Don’t know about employer-sponsored benefits. One would assume they were eligible. Adding this group to the count of “uninsured Americans” is only used to inflate the number of “uninsured”, and add to the fire of their arguments.
In other countries, the NHS isn’t quite like a Politburo.
But the economics is a bit messy.
Is going to a doctor to treat cancer like going to the store to buy a pair of shoes?
Should doctors be like salesmen?
Should patients be considered a source of profit?
Should insurance companies be permitted to cut off people with preexisting conditions? Or required to take them? If not, should the government?
How does the government subsidies of medicare and medicaid allow private insurers to make a profit?
Does licensing of doctors inhibit the competitive nature of the market? Allowing more people into medical school might diminish the cost.
Tort reform hasn’t really cut down costs – at least not in the states where there is tort reform. Nor has technology made us healthier.
Is going to a doctor to treat cancer like going to the DMV to get a new set of plates?
Should doctors be like bureaucrats?
Should patients be considered a source of political power?
Should home insurance companies be permitted to cut off people whose houses are on fire? Or required to take them? If not, should the government?
How does the government underpayment of medicare and medicaid force providers to shift costs onto private insurers?
#14
Its interesting how you decided not to answer the questions I asked.
“Is going to a doctor to treat cancer like going to the DMV to get a new set of plates?” Would someone with no insurance know if they have cancer or not?
“Should doctors be like bureaucrats?” Nope. Which is why single payer would be better.
“Should patients be considered a source of political power?” You mean, should patients have the right to set policy, as patients? Yep. It’s called democracy.
“Should home insurance companies be permitted to cut off people whose houses are on fire? Or required to take them? If not, should the government?”
So, you think that a home insurance company should cut off people whose houses are on fire? That is exactly what private insurance companies do. For people who are dying. I understand that this is not a problem for you.
“How does the government underpayment of medicare and medicaid force providers to shift costs onto private insurers?” It doesn’t. By taking away the pool of old and poor people, insurance companies get the pool of healthy people. Without medicaid, medicare, and the VA the system would be far more broken than it already is.
The problem is the “fee-for-service” incentives; not the principle of social insurance. Doctors are incentivized to offer more tests and charge the government.
Your questions are loaded nonsense, John, the reason for my parody of them (though they come close themselves).
[blockquote]Would someone with no insurance know if they have cancer or not?[/blockquote]
My insurance company doesn’t provide diagnoses, and even the uninsured have access to care so it’s entirely possible, yes.
[blockquote]Nope. Which is why single payer would be better. [/blockquote]
Which puts the bureaucrats in charge of the doctor’s livlihood, thus making the doctor an extension of the government bureaucracy if he knows what side his bread is buttered on. Monopsony power, monopsony control.
[blockquote]You mean, should patients have the right to set policy, as patients? Yep. It’s called democracy.[/blockquote]
Patients won’t even remotely “set policy,” John. The aforementioned bureaucrats will. Patients will get to take whatever the government monopsony dishes out. When election time comes, they’ll have to decide between Candidate A and Candidate B on issues like defense, terrorism, education, ag policy, transportation, treaties, energy, the environment, and a thousand other issues. That’s a pretty low signal to noise ratio. Isn’t dealing with healthcare insurers and providers a much more direct, informative way?
[blockquote]For people who are dying. I understand that this is not a problem for you. [/blockquote]
[url=http://www.standfirminfaith.com/?/sf/page/24463]The State is my Shepherd[/url], I shall not want…it won’t do any good anyway. Maybe Obama could tell her to take a pain pill.
[blockquote]It doesn’t.[/blockquote]
[url=http://www.managedcaremag.com/archives/0612/0612.costshift.html]It does[/url].
Your assumption is that insurers wouldn’t charge rates for oldsters commensurate with their risk, a foolish assumption. Of course, meddling politicians might well compel such bone-headed cost shifting in the insurance side of things if they weren’t doing it on the provider side.
Medical care isn’t fundamentally different from other forms of hedged products like auto or home insurance. The mess we’re in today is largely because some people think that’s not the case and attempt to enforce this blinkered idea by force.
[blockquote]Would someone with no insurance know if they have cancer or not? [/blockquote]
[blockquote]My insurance company doesn’t provide diagnoses, and even the uninsured have access to care so it’s entirely possible, yes.[/blockquote]
Here’s a little illustrative example of how this really works. The sister of a friend of ours was out of work for a year, not uncommon these days. Shortly after losing her job, she felt a lump in her breast. Now, she knew that if she went to a doctor anything resulting from that lump would not be covered even when she did get a job and insurance. She also knew, since her sister our friend work in insurance, that people without heath insurance can’t get effective cancer treatment. So, she waited. Finally, she did get a job and went in to get the lump checked. The verdict: “Sorry, you’ve got 6 motnths to live. If you had come in a year ago it might have been different”.
Jeffersonian you have outdone yourself with #16! #17, she should have been eligible for COBRA if it was “shortly after losing her job.”
These are all good posts. Basically, responsible folks have become the victims in many cases. I must tell you that I rarely visit my doctor. I simply can not afford “bad news.” The other side of this is that I hear my friend (state employee) complaining about a $15 copay for medication. We haven’t even discussd that it is rare for folks who run small businesses to have dental insurance as well.
What you must know is that I am a moderate conservative and generally support the right side of the equation as to free markets etc. It is a hard pill to swallow when I see an insurance executive purchasing the most expensive real estate in the state of SC but his company will not provide me insurance based upon a condition existing a decade ago. Again, the reason we are not having a private solution to this problem is because the big three in general are getting rich off of the system.
[blockquote]Jeffersonian you have outdone yourself with #16! #17, she should have been eligible for COBRA if it was “shortly after losing her job.†[/blockquote]
Unfortunately, COBRA is hideously expensive. For the unemployed it can be out of reach. COBRA does have it’s uses. For someone with an ongoing condition, COBRA can be cheaper than the drugs or treatments. However, if you think you are healthy, it’s hard to decide to lay out a payment bigger than your house payment “just in case”.
If the unemployed would have saved a few bucks while they while they were employed, they could afford COBRA. It doesn’t get any cheaper when I’m forced to pay it for the unemployed.
Jefferson,
Everything you say the gov’t would be doing is being done by insurance companies. So what’s the practical difference between gov’t beauracrats and insurance company beauracrats making those decisions for us? Are our rights and freedoms any less threatened by a corporation than from a government? I’m reminded of the last paragraph of Animal Farm: “No question, now, what had happened to the faces of the pigs. The creatures looked from pig to man, and from man to pig, and from pig to man again; but already it was impossible to say which was which.”
Isaac, the difference is that, unless you’re willing to emigrate, there’s no getting off Napoleon Obama’s farm.
Jefferson, perhaps, but where do I go to escape consumerism/corporatism? Fleeing Napolean for Mr. Pilkington doesn’t seem to be any sort of real move. I just don’t see any difference. Either way, when health care became an ‘industry’ instead of ‘care,’ when it became a consumable good, I think we invited this sort of problem. At least with the gov’t, we have a right to a voice, a hearing, a vote, etc. I don’t get that with Aetna.
If you don’t see a difference, then why the enthusiasm for government-run, mandatory collectivism? I mean, what does government have private industry doesn’t? (Hint: It goes “bang!”)
As for your right to a hearing, I suppose…you and 300 million others. And, as I pointed out before, your vote (which is what really matters) will be bound up with hundreds of millions of others cast on every topic from Pentagon procurement to gay marriage. Think they’ll be able to get the message through the noise? Me either.
Well, I suppose you and like-minded individuals could put together a healthcare co-op, Isaac. You have that freedom, you know. Exercise it instead of taking everyone else’s away.
There is a question here that Jeffersionian has nicely exposed which to my knowledge has not been subject to a decent debate in any forum. Although it is a root question, it’s gotten lost in the clamor over this plan or that plan. Lots of folks on both sides seem to think the answer is self evident but that certainly does not seem to be the case.
To wit:
1) Should all American citizens be entitled to health care, regardless of ability to pay?
2) If 1) is Yes, then what are the minimum and maximum levels of health care included in that entitlement?
3) If 2) has a maximum, should those able to pay have access to health care beyond that maximum?
4) If 1) is No, what about children or the elderly?
5) If 1) is Yes, who pays and are there limits to how much?
Most other industrialized nations have had this debate and have come to differing answers to these questions. To my knowledge, we in the US have never really discused this; not directly at least.
Note: I carefully posed it as “US citizens”. Outside of that bound, is a whole other question. True, it’s related, but another question.
Jefferson,
You leaped into a conclusion I’ve not offered; taht I’m in favor of a public health insurance option, or any other gov’t plan or anything like that. I simply asked what the difference was between corporate tyranny and gov’t tyranny, because no one’s given me any significant reason to think there is one. Everything you fear from the gov’t option is already happening through the private sector. And the only thing seperating the two is guns? So what are the armed guards at the Bechtel-Jacobs site in Oak Ridge, TN doing? Or Blackwater? I just want someone to explain the practical difference between a corporation and a gov’t, because I can’t really tell the difference anymore.
As far as my right to a hearing… Yes, abut at least it exists as a right. I have no right to a hearing from Aetna, no voting rights nothing of the sort unless I decide to purchase said right in the form of stock… Again, one out of 300 million or shares. I’m not offering a plan, or an alternative. I’m just asking a question. It just hasn’t been answered yet.
A company’s power reaches only to the extent of its property, Isaac. If you choose not to interact with it, it has no more power over you than the man on the moon. If they don’t offer what you like and don’t want to bargain with you, you can just go elsewhere, or nowhere for that matter. Even better, if they fail to uphold their end of the bargain, you can go to the government and have them compel your insurer to comply with the terms of your agreement.
I don’t know of any other tyranny you can avoid just by withholding payment, nor do I know of any that can be compelled to uphold terms of an agreement. If your definition of “tyranny” is that they won’t give you what you want at the price you’re willing to pay, well, then we all live in abject tyranny insofar as human desires are infinite while resources are limited. It’s axiomatic that everyone wants everything for nothing, but it’s not a good idea to base a political economy on it.
Contrast the free-market (and I know we have anything but in medical care, a legacy of destructive government involvement) a government system: Medical insurance will be mandatory – no deciding you’re young and healthy and don’t need it. That the $5k you were going to use to set up an internet business?…poof, it’s going to the government to buy insurance you don’t want or need. Resist, and you may be fined or jailed.
Prefer to do business on a fee basis with your doc? Sorry, not permitted. Want a service that isn’t on the government list? Sorry, not permitted. You’re 100 years old and need a pacemaker? Sorry, take a pain pill. Willing to shell out your own money for it? Try Mexico.
Like I said, there’s no escaping federal healthcare unless you, like Canadians do, leave the country. That’s tyranny. And any freedom-loving man, woman or child should run like hell from it.
Oh, and I didn’t address the Oak Ridge/Blackwater red herring. I’m quite sure the Oak Ridge folks are guarding government nuclear facilities there, no? They aren’t out forcing people to do business with Oak Ridge.
i used to administer COBRA for a TPA and it doesn’t benefit the companies to provide coverage for ex employees so they will do everything they can to discourage participation. coverage for family cost 4-5 hundred per month and that was 15 years ago, cannot imagine what it must be now. try paying that on no salary.