freecounterpoint: The joys

Wednesday, August 13, 2008

The joys

Two years ago, Ms. Moulton looked into buying more comprehensive coverage through the Washington State Health Insurance Pool, a state-financed program for high-risk patients. She found the premiums unaffordable, but noticed that the state offered subsidies to those with low incomes. As their debts and desperation multiplied, it occurred to Ms. Moulton that divorcing her husband of 17 years would make her eligible for the subsidized coverage.

“I felt like I had done this to us,” she said. “We had worked hard our entire lives, and if this was all the insurance we had, we could become homeless. I just said, ‘You know, we really need to sit down and talk about divorce.’ ”

18 comments:

My Frontier Thesis said...: Here's some respectful counterpoints: I see where this is going, but one can divorce for monetary reason, and still remain married even though it's not sanctified by the State or Feds. For example, Friend A, an American, is thinking about wedding his non-American girlfriend (they are husband and wife) of 6 years so she can get a passport and perhaps dual citizenship to finally travel freely between her country and the States -- with her son, too.

It's a bit irritating to a Libertarian to see individuals put so much emphasis on what the Feds or Church or State says is Sacrosanct: can't we, humans, start thinking on our own? Is society going to fly out of order if the Feds or State doesn't tell us what to do? Society has been flying out of order since time immemorial.

Anyhow, just getting a bit of dialog going here. Let me know what you think (as though you wouldn't).; 8/13/2008 9:08 AM
Pepe le Pew said...: mft - I think the point is simply that the healthcare system as it is is pushing people into absurd situations in order to simply remain healthy.

White I appreciate the emphasis on individual responsibility that is strangely diminishing in western europe, I do believe at the same time access to quality healthcare ought to be a right, not a privilege in a civilized society. It is unfortunate that this position is misconstrued by vocal ideologues as amounting to communism.; 8/13/2008 11:45 AM
Tecumseh said...: the emphasis on individual responsibility that is strangely diminishing in western europe: "Strangely"? After decades of addiction to the dole from the Nanny State, and the concerted attack by the left on anything to do with individual responsibility (as opposed to dependence on the all-knowing State), is this in any way strange?

access to quality healthcare ought to be a right, not a privilege: Well, yes -- but the crucial thing there is to have qualified doctors and nurses, cutting-edge research and technology (in both methods of treatment and pharmaceuticals, as well as foundational research in all the sciences on which medicine draws), well-equipped hospitals, and also a well run insurance and health management bureaucracy.

Unfortunately, when Socialist ideologues think about this (to the extent that Marxist philosophy and its pidgin variants allows for coherent thought processes), they almost exclusively focus on the payment issues, and how to gain control of the whole enterprise through their usual statist schemes. Rather trite, if you ask me.; 8/13/2008 12:47 PM
Pepe le Pew said...: but the crucial thing there is to have qualified doctors and nurses,

Of course, but training qualified healthcare providers is a separate issue from that of access. The way I see it, having an MD remove the left frontal lobe of a guy with a broken leg isn't a healthcare system issue: it's an issue wit that particular MD, unless you can establish that there is a generalized frontal-lobe-for-cast issue.; 8/13/2008 2:41 PM
Pepe le Pew said...: strangely / a euphemism for unfortunately.; 8/13/2008 2:41 PM
Tecumseh said...: That business about "access" is a figment of the lurid imagination of the left -- an urban legend that doesn't stand up to rational analysis. You can jump and down screaming "the poor are dying in the streets 'cause the big bad kkkapitalists don't let them get into hospitals when they need it" till you go blue in the face -- it still will not make it true. And you can invoke "free" health care in the quasi-socialist states of Western Europe -- and still it wont make it true: the price to pay is (1) higher taxes, (2) rationing through long waiting lines [which can be extremely painful if you are in pain], and (3) worse care, since doctors and nurses are overworked and under-payed as a result of the "free care" conceit (same thing with profs teaching in a "free education" setup).; 8/13/2008 4:02 PM
Tecumseh said...: By the way, why should "free health care" and "free education" be God-given rights? (Are they enumerated in the Constitution?) Maybe we should have free photos taken, and photographs be state employees, payed on a civil-servant scale? While at it, why should there be a free market and a free economy, if health care and education are socialized? This is the thin wedge of the slippery slope towards Socialism (or, Communism, if you wish -- what's the difference?) As usual, the Left plays on people's fears and anxieties (and one's health is certainly one of those issues) to advance their agenda -- which, since at least the French Revolution has consistently been greater control of the individual, and his subordination to the Greater Good. Le Culte de la Raison, and all that Robespierrean crap, as jazzed up by Marx in 1848 -- you try to portray it as something new and fresh, but it's still the same old, same old, autrement coifée.; 8/13/2008 4:11 PM
Pepe le Pew said...: It's not a matter of having free healthcare. It's a matter of having access to healthcare. It's really not a political left/right issue, ai. it's about fundamental rights, like the right not to be shot at. It's all bad.

Central issues:
with a pre-existing condition, no access unless you have a company plan (which many small businesses don't have).
you are maxed out and still have assets: these have to be liquidated before medicare kicks in.

What do you make of the story of the woman considering divorce ?; 8/13/2008 4:24 PM
Pepe le Pew said...: ai - I certainly do not advocate free anything. Access is NOT synonymous with free. Even in France (which has a pretty god system fro the perspective of the patient), it's far from free.; 8/13/2008 4:26 PM
Pepe le Pew said...: This is the thin wedge of the slippery slope towards Socialism

there you go again. Help people stay healthy and the next thing you know, the reds are walking down main street.; 8/13/2008 4:27 PM
Tecumseh said...: Pepe -- you seem to have a problem with the word "access". Of course anyone has access to medical care -- anyone can walk in a hospital, there are no brownshirts at the entrance turning people away, unless they show proper ID. It's just a question of making the payments afterwards -- and that's everyone's business, like you have to pay for groceries, or whatnot. And, in a medical emergency, any hospital is obligated by law to treat you. Just brush up on definitions of words, and the basics of the health-care system in the US, before hyperventilating.

And, yes, there is such thing as a slippery slope. I could give you zillions of examples from history, but why waste my breath?; 8/13/2008 7:43 PM
Pepe le Pew said...: it'd be great if you would discuss specifics instead of theory, ai. I don't give a shit about discussing how access to healthcare really philosophically, on some abstract algebraic level, amounts to a second serving of stalinism because it is bullshit (unless you want to make a case for it, with convincing arguments, examples, all the stuff that people mired in theory have no time for).

Since this isn't about conservative vs liberal/commie/whatever theory but about how people's lives are affected, I'd like to stick to the specifics of the problem and hear what you have to say about the very material issues in my last post. Or am I just talking to a bunch of math/philosophy geeks who are so pathologically unable to stick their necks out of their books that this request is hopeless ?; 8/13/2008 9:18 PM
Tecumseh said...: You need to get off your meds, Pepe -- looks like you don't have access to proper medical advice. A nice little tisane will do you good.

Now, as I was saying, very precisely and very to the point -- we all do have access to medical care -- just go to a doctor,or to a hospital, and tell them what your problem is. It's got nothing to do with Stalinism or whatnot -- just being able to perceive reality.; 8/13/2008 9:45 PM
Pepe le Pew said...: well sure, they can't refuse to see you, but that is not what this argument is about.; 8/13/2008 9:50 PM
Pepe le Pew said...: I mean, sure you can see any doctor and run for the door as soon as you have your prescription and treat the pharmacy the same way.
But assuming you are not planning on defrauding other members of the community and paying your bills, what do you do once your coverage has maxed out and you still have assets ?
and what do you do when your health condition precludes access to private coverage ?
I can't believe you are beating around the bush like this and still refuse to answer.; 8/13/2008 9:56 PM
Tecumseh said...: Why, you effing pay for it. Like you pay for everything else. Doctor, plumber, photographer, professor, waiter, what's the difference? You ask them to do something for you, they do it, and you cough up the dough. Even a 3-year old can grasp the concept. What's so difficult to comprehend?; 8/13/2008 10:37 PM
My Frontier Thesis said...: You ask them to do something for you, they do it, and you cough up the dough.

I agree with you AI, but most M.D.s are glorified technicians posing as superheros (with superhero bank accounts). I get a bit sick and tired of doctors getting shit wrong, too. A close family member passed away not long ago (within the past couple weeks), and the night prior was in visiting the doctor. This guy casually changed medication prescriptions, told her to call him in the morning, and sent her home. She passed away that next morning, in her own bed (there is universal agreement in my family that it is better to pass away quickly in your own bed then have a protracted clinical illness in a hospital). Was there something the MD could've done? I don't know. I don't care for this doctor's casual (another word for Lazy) diagnosis, especially with the bank he's pulling in.

Another recent example: a friend of mine was hurled over his mountain bike handlebars, and he thought he dislocated his shoulder. For two weeks the two doctors he visited assured him he pulled ligaments, and that his shoulder was in its socket. By the end of the second week, he got a third opinion: this doc did an MRI, and said, "Your shoulder is way dislocated, and has been for some time..." He's on the mend, now. Who is going to hold the doctors who misdiagnosed my buddy accountable? Should they refund his bank account? Shit, the doctors' checking accounts won't even be affected by this. I'm not suggesting a socialist revolution, or any kind of revolution, but I'm tired of doctors (or anyone in our democracy) being regarded as fucking demigods.

Checks and balances are healthy for any discipline or profession. There's a serious lack of it within the medical profession. If I fucked up like that at my job, I'd resign just before getting canned. How about doctors?; 8/13/2008 10:55 PM
Tecumseh said...: MFT: No disagreement on that. I profoundly distrust doctors and their diagnostics. In fact, I think by and large doctors are getting worse than in the old days in their ability to identify what's wrong with someone -- as you say, they are nowadays more like dignified technicians, depending on high tech gadgets (which were developed by engineers applying basic science), but with very little feel for the body left.

At any rate, this is a long story, and I think a more interesting one than going around and around in circles about how to pay for the damn health care -- though big statist tax schemes, insurance, or whatnot. More important is how to bring the cost down, and the quality up -- let the green eyeshades and the politicos argue about payment schemes.

In this respect, yes, doctors are way overpaid. But that's not the whole story: a huge chunck of medical costs comes from malpractice insurance. That is, paying huge amount of money to ambulance chasers like Edwards. Now, I think it's good that doctors can be sued -- unlike in Europe, where they can do all sorts of terrible things to you, and you have little or no recourse. (Again, a byproduct of the "free" system there.) Someone needs to keep them honest, and they need to pay the price for fuck-ups. But why should the damn shysters make zillions on this?; 8/14/2008 5:01 AM