Wednesday, August 28, 2019

Socialized medicine? We’re already a third of the way there


     Ready for a shock? Because if you aren’t, maybe you should stop reading now ...
     Wait, no, please don’t stop reading. That would defeat my whole purpose .
     Sorry. I’ll begin again.
     Ready for a shock? What percentage of Americans have health insurance? Sixty percent? Seventy? I didn’t have a number in mind before finding the true figure, but probably would have guessed around 80 percent.
     The answer: 91.4 percent of Americans in 2017, according to the U.S. Census Bureau. Or 294 million. Quite a lot.
     Not perfect. Particularly if you are among the uninsured 8.6 percent. But not as bad as I thought. And most surprising, given all the Republican blathering about “socialized medicine” is those insured break down into two-thirds private and one-third public — Medicaid, Medicare. More than a third of insured Americans — 37.7 percent — are protected by the government. So if you’re wondering how socialized health insurance might work, ask grandma.
      When I had my spine surgery last month, I considered myself lucky — “blessed” was the word that got into print. Blessed that I had good insurance, and wasn’t being bankrupted — I hoped — by a single operation. Medical problems are cited as the cause of two-thirds of the bankruptcies in the United States (although the actual cost for health care is only part of that; inability to work is the other).
     Granted, mine was good insurance, provided by a good workplace. When I checked before the operation to see how many sick days I had accrued, the answer was: “26 weeks.” I used two.
     Where am I going with this? I got a letter from a reader — if a note printed in all caps on a 3-by-5 index card shoved into an envelope can be called a “letter” The punctuation is mine:
     “HEY NEIL ... PLEASE FINISH YOUR NORTHWESTERN STORY. LOVE TO SEE ALL OF THE BILLS, DOCTOR INCLUDED. EVERY ITEM FOR THREE DAYS FIND THAT WOULD MAKE A GREAT STORY. TOTAL BILL. LIKE TO SEE IF YOUR NEW SPINE IS WORKING.”
     This falls in to the “double-dog dare” school of reader feedback. The question he poses is legitimate, but the taunting tone so schoolyard — what are you, 14? — reflecting a paranoiac misunderstanding of how newspapers work, at least this one.


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11 comments:

  1. Frank Deford the sports writer once said that he had had huge loyalty to his employer ( Sports Illustrated) because of the outstanding insurance coverage Time-Life provided which he badly needed for his daughters medical care ( she eventually succumbed to Cystic Fibrosis in the days before they could better extend young people’s lives). He said he would get a bill for double his annual salary for which he was responsible for say $50 bucks and let go of any work related aggravation.

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  2. Not to belabor the obvious, or sidetrack the thread, but...affordable health care really shouldn't be contingent on being lucky enough to work for a decent employer.

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    1. No argument here. A column can go a dozen different ways, and setting out, I wanted to point out, Why should I, doing what I do, have access to this, while someone else, doing what he does, doesn't?

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    2. In my opinion, the people who really get screwed are the "independent contractors," who have no insurance, no employer to pay employer portion of taxes, and no contract, or rather no say in the contract they're bound by. I'm pretty sure colleges have bought into that business model; quite likely newspapers are eager to do the same.

      john

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  3. Your bill was $105K and you paid only $1,500., yes you have good insurance. Many insured people would have either not have had insurance that the hospital would accept, or have much higher deductibles or co-pays.

    How much of your bill did BC/BS actually pay though? Hospital billing is a morass, no one can explain hot the amounts charged are actually determined. Typically insurers, and Medicare receive huge "write-downs" from the actual bill. Only those then without insurance, or with bad insurance lacking coverage, end up with gross bills, no write-downs, and then huge debt. Its a great system for those with good insurance, for the rest, not so great.

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  4. For those who don't know why health insurance comes with employment, look to the War Labor Board during WWII.
    Henry Kaiser needed more workers for his shipyards & steel mill on the West Coast. The WLB wouldn't let him pay more, so he asked if adding health insurance for his workers & families counted towards their pay. The answer was no.
    Soon other companies started doing it & it went nationwide.
    Otherwise, we probably would've had a government option decades ago.

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  5. it's well established that the American way of getting health insurance via employment is an accident of history. It works out well for some people. Less so for others. If it wasn't a negotiable issue in labor negotiations and a cost borne by your employer you might have ended up with a higher salary.

    One of the interesting ironies about "socialized medicine" is that the first government insurance scheme was not created by Karl Marx, but the ultra conservative chancellor Otto von Bismarck. And one of the few good things the Nazis did was install the German system in some of the occupied countries.

    Tom

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  6. Dental should be included in that as well. My brother had dental work that lasted a year. While he could afford it, he was on the hook for 11 or 12 thousand dollars. My nephews wife had a baby a couple of months ago. He had a congenital heart problem and needed an operation a few days after his birth. He was in the hospital for two weeks before he was allowed to go home. My nephew is a doctor at the University of Wisconsin Hospital and his wife is a doctor as well. I assume they have great insurance. I am sure the bill was way more than 100,000 for the baby. Just imagine if that was some one who had lousy insurance

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    1. My five dental implants took about eight months each, which I was told is normal. For what I paid, I could easily own three cars, instead of just one. I'm sure I'm helping my dentist maintain his yacht, and maybe even upgrade it very couple of seasons. He's a good dude and does great work, and he's saved a few teeth. But without dental insurance, you're screwed. I wanted to see Europe before I die. I've kissed that dream good-bye.

      As for the doctors who had a child, it survived because they were both doctors. I can easily imagine the outcome if they had been some ordinary Joe and Josephine, civilians with lousy insurance. They would either be in debt for the rest of their ruined lives--or mourning the loss of their baby.

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  7. One of the few good things the Nazis did...?! That's rich.

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    1. It called "giving the Devil his due." But if you prefer, "the only good thing."

      Tom

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