[Bryan]

while I do think it is important that everybody have access to quality healthcare and think that the millions of uninsured is a problem. i'm not sure if this is something that should be handled on the state level or the federal level. so what is everybody's thoughts about the topic?

right now i'm leaning towards a state level approach as opposed to a federal approach.

and let's ignore the fact that the constitution doesn't give the federal government any powers of providing medical care for the general populace for the sake of this discussion.

[JerryLove]

I'm leaning towards state-run with federal guidelines mandating it. If nothin else, I think having 50 different governments trying to meet the same goals mean that, rhater than being stuck into what we think will work from the beginning, we'll actually try several approaches and can see what works.

I'm not sure about the ease of portability and the like though at the state level.

[Aquaman]

That's the Canadian model. Federal guidelines in the form of The Canada Health Act sets the conditions that Provincial Health Insurance Plans, and other health care services must meet to receive the full contributions from the Federal government. The delivery of health care is a responsibility of the Province, and I think that's better than having it run from Ottawa.

The dynamics of the population across any nation are regionally circumstantial. The recent transfer of money to the Provinces for improving wait times is targeted on procedures that each province identifies as high priority.

[Ax]

I'm all for private healthcare. These people should get jobs that have healtcare benefits... I'm only 20 but every job I''ve had had some sort of benefits offered, even McDonalds.

[Bryan]

it's not always that easy. a single mom who quit highschool and because she got pregnant and is now the mother of two and working in a diner all the time to provide for her kids probably doesn't get health insurance and may not have the job skills necessary to find another job that does.

[cytorath]

I'm for a mixture of private and state. I don't think that the federal government should be involved except to say how far it should be implemented. In West Virginia they have started a plan where if you are a small business, you can buy into a state sponsored health insurance program for you and your employees. It's not welfare and you have to pay a percentage of your pay towards it, but it's actually been cheaper than most large corporations health plans out there. Programs like this I think would work, but to say that now we have to pay more taxes in order to ensure that everyone has the same level of health care is not right, it's socialism.

[JerryLove]

Originally Posted by AXguitar

I'm all for private healthcare. These people should get jobs that have healtcare benefits... I'm only 20 but every job I''ve had had some sort of benefits offered, even McDonalds.

So people who have had cancer should be disallowed from starting their own business, working as a contractor, or working for a small company? That's interested.

And really pity the person who comes down with a debilitaing disease while unemployed. I assume you weren't undergoing chemotherepy while working at McDonalds?

I personally have to be careful about what jobs I persue because I cannot self-insure, and a small company would not be able to afford insurance wiht me on their payroll.

[normajean777]

Just make insurance tax deductible for everyone. That could very well encourage companies and/or individuals to buy health insurance.

Also a huge amount of people are uninsured simply because they don't think they need, not because they can't afford (they are young and healthy).

[JerryLove]

Originally Posted by normajean777

Just make insurance tax deductible for everyone. That could very well encourage companies and/or individuals to buy health insurance.

It won't. In addition to those who are simply extremely poor, the "pre-existing condition" issue can make healthcare unaffordable (Most insurers would simply refuse to cover me for individual inurance at this point).

Also a huge amount of people are uninsured simply because they don't think they need, not because they can't afford (they are young and healthy).

And they are a huge problem. First, they often get catostrophically ill (I did) and now become a sudden burden without ever having put in their dues (they make healthcare even more expensive because, as a group, they are taking from but not putting into). Then they get old and want coverage, only the costs are high because coverage is only being had by the old and sick.

The only two equitable solutions I can see are to simply refuse them care (unless they have cash up-front), or to switch to a universal coverage that stops me from having to pay for their "all-for-me" style of greed.

[Bryan]

Originally Posted by JerryLove

The only two equitable solutions I can see are to simply refuse them care (unless they have cash up-front), or to switch to a universal coverage that stops me from having to pay for their "all-for-me" style of greed.

or require everybody to have at least major medical insurance.

[JerryLove]

Originally Posted by Bryan

or require everybody to have at least major medical insurance.

That would seem to be "universal coverage", wouldn't it?

Of course, if you mandate it without providing it, I wonder what you would so with someone who did not have it. It's not like car insurance where you can just take away the driver's license / car. You are mandating something as a requirement of existance... which is considered a right in the US.

Jail them? Then how will they get it. I guess the government would have to provide it to inmates... maybe we should just skip that step.

[Epaphras]

I think major medical insurance ("catastrophic coverage") should be mandated by the Federal government and financed/administered by each state individually. Co-pay policies would be on a need-basis (sliding-scale approach already used by many county health departments) with the neediest paying little out-of-pocket and the less-needy paying a small percentage out-of-pocket.

Providing major medical coverage and encouraging health savings accounts empowers people and does not lead to hand-outs.

[BillSPrestonEsq]

Originally Posted by JerryLove

That would seem to be "universal coverage", wouldn't it?

Of course, if you mandate it without providing it, I wonder what you would so with someone who did not have it. It's not like car insurance where you can just take away the driver's license / car. You are mandating something as a requirement of existance... which is considered a right in the US.

Jail them? Then how will they get it. I guess the government would have to provide it to inmates... maybe we should just skip that step.

My guess would be that it would look something akin to the laws that require hospitals to do all they can for a patient who shows up regardless of insurance, and stick the hospital with the bill. (its why the hospitals in downtown LA are down to one, with it in the red.)

In essence, you could almost say there is an unpaid level of insurance that currently screws both hospital and poor individual without insurance as it screws the hospital out of cash, and screws the person's credit which deepens the cycle of poverty.

In my mind we have an unethical universal coverage of sorts already in place. Ultimately though, its basic structure is going to require either federal bailouts of hospitals or universal coverage.

As assinine as this sounds, what happens to an area which bankrupts all its hospitals? Downtown LA could effectively do that in the next 5 years.

[BillSPrestonEsq]

Originally Posted by JerryLove

That would seem to be "universal coverage", wouldn't it?

Of course, if you mandate it without providing it, I wonder what you would so with someone who did not have it. It's not like car insurance where you can just take away the driver's license / car. You are mandating something as a requirement of existance... which is considered a right in the US.

Jail them? Then how will they get it. I guess the government would have to provide it to inmates... maybe we should just skip that step.

My guess would be that it would look something akin to the laws that require hospitals to do all they can for a patient who shows up regardless of insurance, and stick the hospital with the bill. (its why the hospitals in downtown LA are down to one, with it in the red.)

In essence, you could almost say there is an unpaid level of insurance that currently screws both hospital and poor individual without insurance as it screws the hospital out of cash, and screws the person's credit which deepens the cycle of poverty.

In my mind we have an unethical universal coverage of sorts already in place. Ultimately though, its basic structure is going to require either federal bailouts of hospitals or universal coverage.

As assinine as this sounds, what happens to an area which bankrupts all its hospitals? Downtown LA could effectively do that in the next 5 years.

[JerryLove]

In essence, you could almost say there is an unpaid level of insurance that currently screws both hospital and poor individual without insurance as it screws the hospital out of cash, and screws the person's credit which deepens the cycle of poverty.

It also screws the insured who end up with tremendous medical bills to offset the write-offs.

Wouldn't insuring everyone be a better option? Providers would get paid, and the burden would be heaped on everyon collectively, rather than only some.