Do you think the government should take care of people with "pre-existing medical conditions?


#142

Other countries have a program that is largely health-maintenance directed, Canada being a prime example. Numerous Canadians come down to the US to have surgery done, as the Canadian system is backlogged and slow to respond.

Medicine is another example; many countries have much lower costs for medications than the US. That leaves a bit of a Hobson’s choice; pharmaceutical companies in the US have extremely high research costs as there is no guarantee that any medication developed will reach market. Other countries may not have as extensive and as regulated a process for bringing a medication to market.

So we could relax the process of approval of medications, but the counter argument is that it would allow medications not fully vetted to reach market (and you may not be old enough to remember the tragedies over the use of thalidomide, which currently is sued in treatment of some cancers, but when used to treat morning sickness caused major deformities to the child in the womb.

Another argument about the cost of medications are that we have what are termed “boutique drugs”, for medical issues which are not life threatening. Those who benefit from them might have an argument about not allowing research and development of these drugs - I will leave that to others.

I have a friend in my parish who has been stage 4 cancer to well over 2 years. He is currently taking a drug which I believe may still be in final trials, and at this point he is the longest surviving individual in the US. the cost of the drug is basically $40,000 per dose - that is forty thousand dollars each dose.

Doses are weekly. You do the math. And then you can tell me if his life is worth it (he still has a business, sole owner, which he actively runs).

One of the driving forces, among many others, is our tort system, which has allowed multi-million dollar judgments for what patients claim as damages. I say “claim” because often the case is fairly clear that someone or several someones screwed up in the treatment of the patient. We could argue all day and all night into the next century and not come to an agreement as to how that should be handled. Other countries do not have an identical tort system, and may not have as litigious a society as we have. On the other hand, if a doctor, nurse, or combination have either caused the death of someone in your family, what would you do?

The issues go on and on. Much of what occurred with the ACA was and is driven by the inclusion of those with pre-existing conditions, some of whom could not get coverage before they got to that point; and some of whom would not get coverage (called “gaming the system”).

The Socialists are proposing Medicare for all. Only one state has actually attempted that - Vermont; and when they looked at the cost, they had a change of mind and heart. California recently proposed it; their estimate (which any wise person would bet was way too low) was $400,000,000 per year. Their state budget, for perspective, was @ $170,000,000. But they would “find a way to do it”. The estimate nationwide would be about $30,000,000,000,000 in ten years (that is 30 trillion).


#143

The government has been setting prices through Medicare for a long time, Your comment is incorrect. And the result of the complexity ( and some of the insanity of how some things are reimbursed) has caused at least some doctors to stop taking Medicare patients.


#144

This is so true. Isn’t it funny however that if I charge a patient less because they can’t afford to pay I’m guilty of insurance fraud which is an illegal criminal offense in this country. However, if the Insurance chooses to pay me less because the patient can’t afford to pay them the higher premiums this is considered legal and customary.

To me it is pretty easy to see where the problems with healthcare originate.

God Bless


#145

Here is a free market clinic. Without the government and insurance they have consistent prices that you can know ahead of time. And they are cheap.

Hardly. What is ankroe wasteful institution?

Why not if government is so great?


#146

Go look at pictures of ‘fat’ Elvis. He wasn’t really that big. He was a bit puffy, but he was also not a young man anymore.


#147

I don’t know how closely you’ve actually looked at these ministries. But they keep their costs down precisely by excluding coverage for pre-existing conditions. They do good work for some people, but they’re explicitly not equipped to deal with expensive, long-lasting conditions.


#148

I think people with pre-existing conditions should be taken care of. The actual nuts and bolts are not my expertise.


#149

Are you aware of how many hospitals and how many health care insurance companies are nonprofit? I counted 97 insurance companies; and at least the Catholic hospitals have been nonprofit.

As to the government running health care - they already do.

It is called the Veterans Administration, and if you want to see how the government does when in charge of health care, take a look at the critiques of how well they have been doing - or should I say, not doing?


Society acceptance of Homosexuality
#150

Pittsburgh doesn’t have any existing Catholic hospitals, but all of our hospitals are non-profit institutions.


#151

Alexandria Occasio Cortez agrees with you; in fact, she thinks the perfect program is Medicare for all.

About those nuts and bolts: what they really are is dollars and cents.

As in, 30 trillion dollars worth of dollars and cents over a ten year period. That works out to roughly $92,300 per person over 10 years. Is that a bill you can afford? Note: that is an average; as we have a portion of the US unemployed, they are not going to pay that.

As we have a goodly number of people at or below the poverty level, they are not going to pay that either. Estimates which appear to be reasonable is that a bit less than 1/3 of the population is near or at poverty level, so we can’t expect them to pay for it.

Assuming an equal amount of the bill now works out to nearly 13,500 yearly. So, given whatever your paycheck is now after taxes, can you afford that?


#152

As I pointed out in an earlier post, this is a myth. There has only been one estimate of costs, which was by a drug company trade association whose methods included double counting and ignoring tax effects among other glaring faults. No drug company has ever made their costs public. Ever. And they never will. And even if they did, as I said before, there is enough latitude in accounting practices to make the “cost” virtually anything they want.


#153

How do you know? And, to my knowledge, that’s not how it works in Canada or other countries. There is an annual negotiation between the Ministry of Health and the various groups–the doctors’ association, the hospitals, etc. The government doesn’t just come in and say “This is the price. Tough luck.” Fees are mutually agreed upon. (In contrast to the present situation, where insurance companies say “This is what we’re paying you. Be happy.”)


#154

Yes but what is the solution for those who cannot afford to enroll into the cooperative? There does seem to be a need for a wider safety net such as instituting help for working class folks who don’t get coverage through work, what can be done regarding those cases?


#155

According to the most recent statistics from the Insurance Information Institute (who gets their figures from the Nat. Assoc. of Insurance Commissioners), there are 858 health insurance companies in the US. Your number of 97 non-profit companies seems to be accurate.

But what does “non-profit” mean, exactly? Here I am speaking from two years’ experience in dealing with life & health insurance company insolvencies on a national scale. I was involved in analyzing the finances of the failed companies. Now you COULD–in theory–have a non-profit insurance company that devotes itself to the health of its customers, keeps costs low, etc. etc. and I’m sure such companies exist. But the bulk of companies aren’t like that. Their profits are limited by law–state laws require a minimum of 80% of premiums to be paid to customers in claims. The Affordable Care Act raised that to 85%.

So the poor (joke) insurance companies are left with a mere 15-20% of their premiums (and we are ignoring their investment income for the sake of simplicity) to pay for administrative costs. What are “administrative costs”? Well, here are some I’ve seen: ownership of a private island; ownership of private jets; ownership of estates and villas; exclusive country club memberships for executives; the use of mansions in various countries and states for the executives; exorbitant salaries for top executives–into the millions of $$. All these are “administrative costs” and legitimate. And there are a lot more–anything you can imagine, they’ve done.

I’d like to know how any of that improves efficiency or in any way improves the health care of the country. I should add that the administrative costs for Medicare are something like less than 1% of claims. Inefficient? I think not!


#156

I agree. The federal government (and if you add in state governments through Medicaid it’s a lot more) pays for the majority of health care in the country: Medicare, Medicaid, Tricare (armed forces and families). People tend to overlook that when they talk about the government being involved in health care. They already are, and in a big way.

The VA is a different thing altogether. The VA OWNS hospitals and EMPLOYS doctors and staff directly. This is not what anyone means when they talk about single-payer health care.


#157

Well, in theory I’m not against the government running it all. But as a practical matter, that won’t happen in my lifetime.


#158

I don’t think it’s the function of a government to do that. I think that many governments do and can be successful at it without putting a strain on taxpayers, and that’s great of them…but truly, taking care of the sick is OUR job. As the Body of Christ it is up to us to care for others whether it’s financially supporting a charity or even directly giving to sick people who need support for medical bills.

Basically, if the taxpayers agree to, then it’s a good plan for the government to incorporate that service into what they provide. If the taxpayers don’t, no difference. The responsibility falls, ultimately, to us. Personally, I think the fact that many countries rely on governments to meet the needs of the poor rather that the church shows a tremendous failing. shrug


#159

I read the article you linked to. It’s not REALLY a “free market” clinic. Why not? Because, as the article itself points out, it excludes people who can’t pay cash–a guy making $30,000 a year isn’t going to be able to pay $5,000 for an operation, even if the overall cost is cheaper than the cost through some insurance plan. These clinics–again, as the article said–originated as a service to the well to do; now they are trying to get more middle class customers. Is that a good thing? You could argue both ways. It’s a good thing for the people who can afford it and who use it. It’s a bad thing for the rest of us because the people using the cash-only clinics might drop out of the general insurance pool, leaving the rest of us to pick up the cost for the poor folks. In other words, the total risk is not being spread as widely or as fairly.

It’s quite a bit similar to 1-day delivery by Federal Express. They have carved out a little piece of the market, and they serve that. But if you live outside big metropolitan areas, you’re out of luck. Just like the cash-only clinics, they cherry pick their market. Same with railways–remember the days when there was great rail service to small towns? Now if you want to go from Washington to New York, you can do it quite quickly with good service. But if you want to go from Peoria to Kalamazoo…tough luck.

Another issue they didn’t even touch on is equipment. MRI machines, etc. cost a ton of money. Do these clinics have the same equipment a regular hospital would have? I don’t know. I suspect they don’t. So then what happens? They have some arrangement with a local hospital? Great, but again, this is not a solution for everyone; if there were only cash-only clinics, there would be no hospitals to help them out.

Certainly the idea of posting prices is a great idea, and I’m all for it. And, again as the article points out, they would save a lot of money on administration. I think probably every doctor’s office has at least one person devoted to handling billing, relations with insurance companies, etc. Larger offices have entire staffs devoted to that. It’s a huge expense. But of course that would all go away if you had single payer too–you know you will be paid, and you don’t have to negotiate your way through 20 different insurance forms every day to send out bills. Again, as I pointed out, state laws allow health insurance companies up to 20% of premiums for “administrative expenses.” And no company in its right mind would take less than the amount they’re entitled to. If you cut that to 1% or so (Medicare levels), you would automatically save 19% of the entire healthcare cost.

I’m sure there are other problems with the cash-only clinics. How about malpractice insurance? Can they buy it in some sort of large cooperative? Or is each clinic on its own, incurring larger premiums? I don’t know.


#160

I assume you meant “What is another wasteful institution.” Well, first of all “government” in general is not necessarily wasteful by definition. The police are part of the government. So is the fire dept. So is the post office–and you may gripe about it, but it reaches every little out of the way house 100 miles from anywhere. And if you get Christmas cards from overseas, make a note of how much they spent to get that card to you–probably around 50% more than it cost you to send your card to them ($1.15). Is the CDC or NIH an example of inefficiency? Medicare? The list goes on. So exactly what part of government is so inefficient?

And of course we can’t compare government services to private industry because we don’t have the financial information to compare. Yes, public companies issue annual statements, but it’s very difficult to extract information about “efficiency” from them. A great example is Enron–only one group of analysts (I think it was a university) figured out that Enron was playing a shell game and wasn’t really wonderfully profitable. The rest of the financial world couldn’t figure it out. Was Enron “efficient”? Is Amazon? Microsoft? Profitability is not necessarily a sign of efficiency. If I am Standard Oil in 1900, I can be completely inefficient and yet make tremendous profits.


#161

OK. I messed up. I read too quickly and missed the government part. I thought the question was “should people with pre-existing conditions be covered.” I thought it was a question about private insurance companies. My bad.

I think insurance companies should be required to cover pre-existing conditions. It’s my impression that Medicaid takes care of poor people and it covers pre-existing conditions. I may be wrong.

My Canadian and British friends are unhappy with their health systems. They have to wait months if they have a “minor” complaint. I’ll spare you their stories.

I can see the doctor of my choice and have a same-day appointment if I need it.

God bless you!

Note to self: Stay on the prayer forum.


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