"I Do Not Have the Money to Pay For This!"


I didn't realize Obama supported a single-payer, universal health care system.
@1 - Really? That's your comment? Ok.
By the way, basic health care is on the governor's budgetary chopping block again.

Her office's number is 360.902.4111
Jesus. That's the saddest story I've read all week.
Oh no. This is awful. I wish there was some way to help him, because if he can't afford a hospitalization, he probably can't afford his medication and the cycle goes on and on...
That reminds me, for some reason, of the WWI soldier jumping and crying and shouting for joy, with a bloody stump where his hand was just blown off, because he knows this means he'll leave the front for good. I know it's seems like kind of the opposite, but they both represent, on some level, normal human reactions to absurd or insane societal circumstances.
That's just awful. I even have health care and I can still relate - just paying my percentage of a serious hospital visit would wipe me out.

@1, I'm pretty sure Obama would support it, actually, but the health care act was literally the very most we could get passed through our broken, leotarded Senate.

What about his bootstraps?

Can't he even sell his bootstraps to pay for it?
I have a friend, works as a security guard, makes $9 n hour no benefits begs for overtime. A few years ago got a cold, went to work. The cold turned into the flu, he went to work. Tried to to treat first the cold then the flu with over the counter drugs. Kept working. I said dude go to the clinic "No I can't they are foreclosing on my house I can't afford it".

The flu turned into pneumonia. He went to work. Finally another friend and his wife went to take him out to dinner, on the drive they said dude you can barely breath, we are taking you to the hospital. "No don't"

The hospital took one look at him and said "your lungs are 3/4 full of fluid your about to die" and checked him in. Three days later he picked up a Mercer infection at the hospital due to his weakened state.

3 months later he and the hospital are staring at a $150,000+ bill he will never be able to pay.

That is your emergency room based health care Mr Romney.

For want of treatment for a cold, the rest of us get saddled with a 6 figure bill.

Fuck Romney and the Republican party.
I can relate. When I was just 22 I fell and hit my head ice-skating. It was a Sunday, and that Friday I had gotten a letter at work saying that my insurance was not in effect because I had not included the $2.00 processing fee with my payment. "I want my two dollars!" I giggled to myself as I told myself to remember to pay it on Monday. I was knocked out when I fell, and when I came to, the paramedics were there, talking about putting me in an ambulance. I was terrified. Even with a head injury I was able to process that that would mean $$$$$ that I didn't have. I was on my third date with a guy who had more money than me, and I was embarrassed to tell him the reason I didn't want them to take me.

After some negotiations, the paramedics agreed to let me leave with him if he promised to take me to the hospital. I said what I needed to say to get them to go away, and once we were in the car, I started begging my date to just take me home, I would be fine, I insisted. I just need to go to sleep ... As a former hockey player, he knew what that meant. I finally fessed up that, no, I can't go because I don't have insurance! He said, "let me worry about it, you're going!" and despite my protests, took me to the ER. Good thing he did, because I had a major concussion - they thought I had a skull fracture because there was blood coming out of my ears. There was neurological damage that left me unable to walk for a week, and I had vision problems when I turned my head for months afterward. And OH MY GOD, THE PAIN. Once it set in, it was just unreal.

That trip to the ER may very well have saved my life, but with a less knowledgable date, or left to my own devices, I would have just gone home.

I think of this every time there is any debate about health insurance. I don't need a personal story to tell me how to feel about it, but it definitely drives the point home. And you want to know the most spectacularly amazing part of the story? The insurance company got their two dollars, and retroactively reinstated my insurance to cover it all.. Can you even imagine?! But I swear, they did. The whole thing still cost me/us $600+, which can still break a person, I know, but that's a hell of a lot better than the many thousands it would have cost, with all the diagnostics they had to do. Brain scans ain't cheap!

And mr and mr.herriman lived happily ever after :)

health insurance for all!!
Awesome story, @10 (so glad it worked out), and heartbreaking, @9 -- but glad I read it. It's good warning. Not just for "personal responsibility" but that things are always a lot more complicated than inimically-intentioned politicians would have us believe. We need to hear more and more of these stories as the election comes up. How many of us are avoiding health care in case it charges us more than we can possibly handle? How much preventive care is put off daily because we're afraid of bad news, are hanging in there hoping things take care of themselves, and vociferous, bean counting bureaucrats?
@11 the stories about American's being crushed by medical costs are legion. Damn fucking shame on us that we can't go there because well that'd be socialist. Never mind Canada has been deemed more pro business then the US by the Heritage foundation and that Canada has a lower corporate tax rate then the US. We can't follow those fucking socialist God would curse us.

Stupid fuck wad Republicans.

Share your stories, tell your neighbors, your friends, your family why this "we aren't in it together" shit is bullshit.
Guess what? Obamacare will not change this. Being given a subsidy to buy high-deductible insurance will not make people suddenly able to afford a $1000 ambulance ride or a $150 appt for a cold. And it won't get better because now people will think everyone has affordable healthcare when they do NOT.
Colds don't turn into the flu. They're different viruses.

If this guy (from the main story) is hospitalized against his wants what, they're going to bill him? And if he does have mental disorder that he cannot maintain with medication, I doubt he has much left in assets for them to go after. The truth is you and I will pay for his hospitalization in the form of increased costs and insurance premiums.

That's the real story behind Obamacare: you who have health insurance or the means to pay your hospital bills already pay for those who don't. It's just hidden from you because you have no idea why the hospital is ordering more tests and why they cost so much.

Now I don't know how true @9's story is, but it's certainly plausible that someone would avoid treatment for something like the flu for lack of abilty to pay and wind up even worse and in the emergency room, and similarly with @10s story. Since we're on the hook for those unreimbursed emergency room visits anyway, it makes sense to me that we would want to pay less for people to be able to seek treatment before it's an emergency.

OTOH, expanding insurance coverage will encourage more frivolous visits and tests, at least until we reform (get rid of) fee-for-service. And don't be surprised if insurance rates go up initially, as a bunch of people with pre-existing conditions get on insurance immediately seeking more than they'll ever pay in- it won't be made up for by new healthy enrollees (especially since there is explicitly no mechanism for the government to enforce the individual mandate penalty). In the long run, though, it'll be cheaper.
Yo madcap:

A weakened immune system from having a cold could easily lead to catching a flu virus and being hit harder than normal by it.

Anthony cares, man.
That guy wasn't being sent to the hospital; he was being sent to the poor-house.

The ride alone is going to set him back $500, and being wheeled into the ER is going to set him back even more.
It would be nice to have a way to link to these stories and force them to read them every time some Republican fucker stubbornly proclaims we have the "BEST HEALTH CARE SYSTEM IN THE WORLD."

Ohhh, wait, sorry, I forgot- this is exactly up their alley. They want this shit to happen. Cull the weak and poor and everything.
@17, we don't actually have poorhouses anymore.

It sucks to be uninsured, but if he doesn't have a phone the collection agencies can't call him. No house with mailbox, no dunning letters. No job, no garnishment of wages. No savings account, no court order to pay.

Obamacare 2014.
@14 'OTOH, expanding insurance coverage will encourage more frivolous visits and tests'
sounds like fear fiction to me. sick people who don't want to go to the hospital because they can't afford it aren't very likely to schedule ' frivolous visits and tests ' if it means they have to take time off from their already low paying jobs. if they have kids it most likely means they either have to drag their kids with them or leave them alone beause they may not be able to get daycare or babysitters.
i have a health insurance because of my husband's job ( or domestic partner , since he works for harborview and our state recognizes our ' civil union' ) a few weeks ago i was struck by what turned out to be kidney stones. i almost called am ambulance because the pain, cramping and nausea had me doubled over barley able to walk. i took a cab instead mindful of not running up insurance costs. i counted myself fortunate because i had money for a cab and the hospital was a ten minute ride away
and because we have insurance i could choose to forgo what promises to be a 4+ hour wait at harborview whose er always seems over burdened with the financially less fortunate sick who can't go anywhere else.
Yeah, this would never happen if Obama were president... wait...
@21 and what is romney going to do for you ?
@ Riz,

To paraphrase my husband who works in health insurance, there is a large enough segment of uninsured individuals that we should expect that our rates will go up. And, it is an unfortunate fact of humanity that fear causes us to seek any service, medication, treatment, or surgery that we think may help us or our loved one, and without fee for service reform this aspect of insurence expansion is also expected to raise rates. In the long run it will be an overall savings, but initially it is going to cost more. The volume of people who have pre-existing conditions or realitively healthy people who have had to neglect aspects of their health care (think mammograms, immunizations, colonoscopies, cholesterol, et cetera) is too large to be absorbed by new healthy enrollees.

Any way, just his $0.02 as someone in the industry and who believes that health care is a basic human right.
@22 Romney is going to broadcast TV ads and send slicks in the mail and lose the election. Then everything will be all better, right? no, wait...
@2, Obama didn't even want Single Payer as an option for congressional Democrats to consider in 2009. Do try to pay attention to the details of what was going on.
@21 - So, your comment seems to be saying that since Obama is in fact president now, this man's predicament is as much Obama's fault as anyone's, and that Obama's policies have nothing to say about whether this kind of situation should continue to happen, or whether we should move toward a health care system where people aren't terrified to get help? Is that it? Or maybe you're saying his policies have actually contributed to this? Or that to be judged a success, he would have had to completely transform the nation's health care system from top to bottom in 3 years? And presumably that Romney would somehow improve this guy's feeling about going to the hospital? Is that it?

It's heartening that people like you and @1 can do no better than these silly, content-free attempts to engage in these discussions. Because there's no argument to be made on that side, it's just anti-conversation hand-waving.
@ 25, would that have passed in 2009?

Also, is this better or worse than no reform at all?

Answer honestly, please.
I should expand and say that fear often causes us to seek things that will not benefit us, and fee for service can make it enticing to run unnecessary tests. The desire to be healthy is not frivolous.
@25 - I didn't say Obama wants single-payer. Obama supports, and has enacted, major health care reform. It's a step in the right direction. Of course it's not enough for all-or-nothing absolutists, but such people are at best irrelevant, and at worst impeding progress toward the goals they claim to seek.
Hey @26 maybe I was just referring to the last line in the article.... "Obama 2012, and fuck the rest." Oh, but wait, you said that... should I say

"It's heartening that people like you can do no better than these silly, content-free attempts to connect an anecdotal incident to the election and pretend it is a discussion. Because there's no argument to be made on that side, it's just anti-conversation hand-waving."

Hmm, no I don't think I will.
@30 - What?
A few years ago as I was putting on my jacket on my way to work, I felt a sharp stab under my right shoulder blade. As soon as the initial pain subsided I chalked it up to a tight muscle and walked to the bus stop. On my way to the bus I started to get a tingling sensation down my right arm and felt my temperature was rising. By the time I got to the stop I was in a significant amount of pain, but was trying to shrug it off. A woman at the stop saw my state and said she was worried I was having a heart attack and was calling the ambulance.
The first thing I said was, "I don't think I can afford that."
She told me it didn't cost anything to call them out to check and make sure I wasn't dying, so she called them.
I wasn't having a heart attack and the paramedics let me get on the bus to go to my doctor's office instead of taking me to the ER, which was luckily right on that line only 5 mins away. My doctor ended up sending me to the ER because of the severity of my pain. Turns out I had a pinched nerve which I had to go to a few sessions of PT for.
I was lucky that I had insurance at the time, but even with that coverage, I was barely getting by month to month with bills and student loan payments. The idea of more bills made my health a secondary concern, even during an emergency.
Anthony Hecht @2: "Kucinich 2004, and fuck the rest."

(But I remember how Kucinich was endlessly mocked by The Stranger back then. Who cares that he supported a single-payer health care system, just get out of the race, little man.)

My point @1, Anthony, is that this sick man won't be able to pay for that ambulance ride under a Romney presidency...or an Obama presidency.

So "fuck the rest"? Yeah, right. Talk about a content-free engagement...
I love Mr. Harriman's story.

I have had heart issues that create stroke like experiences, herniated discs, violent food poisoning and of course the bulk of these happen on a Sunday night when you know it's going to cost extra, because everything is filtered through the ER.

How are you supposed to get better if you're rocking back and forth in the bed trying to figure out what's going to cost more going to the doctor (even with health insurance, you're still screwed) or the days off work that you'll need to get better?

When my back went out I was working from home (luckily) for a month and it cost me over $1,000 because they saw that I was in pain so instead of sitting in the waiting room they "upgraded me" to the ER... I don't see how a herniated disc warrants the ER, but my wallet definitely saw the aftermath. They recommended I go to a physical therapist I thought it was odd that some sessions cost more than others and that payment was NEVER discussed... just the fact that I hadn't paid.

Stress kills and they provide us with a great deal... which must be good for business.
I'd rather be in debt than severely sick, or dead. maybe that makes me the one that's agitated and possibly mentally ill.
@33 - That line was a quick jab at the end, not the overall point of the post which had more content, but yes, things would be/are much better for this kind of situation under Obama then under Romney. It's not immediate, and it's far from perfect, but it's moving in the right direction.

I support Obama because he's the best candidate who can win. Kucinich had many good ideas, and several bad ones. He wasn't going to win, and he's irrelevant now.
I'm reminded of a friend-of-a-friend who was in the reverse situation. He had severe bipolar disorder, but his insurance wouldn't pay for treatment. When he had a severe manic episode that was too much for him to handle, he would deliberately go out and do something that would get him arrested, because it was the only way he could get treated.
@1 (DOUG): The Stranger's staff (and most of its readership) don't understand health-care economics, health-care systems, or the Patient Protection and Affordable Care Act of 2010 beyond what mainstream media and Democratic party-machine PR flacks have told them. It's almost a waste of time to engage with them on it. They will have to find out firsthand, along with the rest of the country, how little protection it provides and how increasingly unaffordable it will become. And later still, they will find out that it's an impediment to, not a step toward, universal single-payer. But if anyone cares to learn what the Manchurian Blue Dog Candidate has helped deliver, here's one of the latest summaries:

Dr. Reginald Clark, Why Obama Health Care Act Should Be Name…,' Black Agenda Report, 24 September 2012. (“Only a small proportion of citizens will end up owning 'affordable' health insurance that will give them reliable access to 'affordable' medical care when they get sick.”)
Please please please vote everyone.
@9: WTF is a Mercer infection? I think you must mean MRSA (methicillin-resistant staphylococcus aureus). It's a bacterium, not a person. Also, like someone else mentioned, the cold and the flu aren't the same thing, but one infection can open the door to many, with increasing severity. Someone with a weakened immune system, for whatever reason, can go from "it's just a cold" to full-blown pneumonia fairly quickly. I hate that our medical system (and the employee benefits system) essentially rewards people for going to work when they're sick, rather than get better. It's a public health (and human rights) nightmare.

To pile on to the "I can't afford this" stories, a few years ago I was hit by a car while crossing the street. The impact banged up my ass and my legs pretty good (the front bumper struck my legs below the knees, knocked me into the air, and I landed on my butt), but I could still sort of walk so I turned down the paramedic's offer to take me to the ER. I also had a dog sitting at home and nobody in town to take care of her, so I didn't want to spend hours in the ER. Yada yada yada, I wound up getting x-rays of the injuries a week or two later, and even though I theoretically had "great" healthcare coverage from my employer (a large hospital), I still had to pay 50% of the radiology bill. Someone with no coverage could have been financially wiped out by something that wasn't even that big of a deal in the grand scheme of things.
Yuck - when I was right out of college (literally, <3 weeks) I cut my hand pretty badly cutting nearly half-way through my left index finger.

I went to the emergency room (I had to call my sister to take me, I was bleeding enough I was near-passing out on the floor).

I got a tetanus shot, and 4 (maybe 5) stitches. The ER wasn't busy at all, I was out of there in less than an hour. Saw an actual doctor for maybe 15 minutes of that time (he did the stitching and nothing else).

No complaints about the care, but I was bracing myself for what I assumed would be a ~$500 bill, based on all the horror stories I always heard about the cost of such things.

The bill came and it was almost $1500! When I called the hospital to see if there was some sort of mistake even the customer service girl seemed to think that was crazy.

When I had them send me the itemized bill (they don't really break it down for you unless you ask apparently) they were charge me $30 for stuff like gauze that I could have bought at Walgreens for <$5.

They were real dicks about being payed too, threatend to turn me into a collection agency, wouldn't do installments. My parents had to end up paying for most of it.

That was like 6 years ago, so I shudder at how much a handful of stitches would cost now. I bet over 2 grand.

Ever since then I'm just terrified of getting sick/hurt.
@ 38, there are as few gutless moves one can make as to assume a superior, I-just-know-better-than-you attitude while linking to someone else's argument in place of your own. ESPECIALLY when that link is without credibility.

But I'm willing to read YOUR case, if you can make it. You hint pretty strongly that you do, in fact, "understand health-care economics, health-care systems, or the Patient Protection and Affordable Care Act of 2010." Can you do that?
For those of you who think that universal health care coverage encourages people to abuse the system and make frivolous appointments, about 50 years of Europeand and Canadian data refute that.
Americans already spend more money on health care as a single nation than all other industrialized nations combined. Fact is, people who have free access to health care are healthier individually and on a national level. The chronically ill, whether physical or mental, are put into cost-saving care mangement programs and because they have routine contact with nurses and other lower cost providers tend to go to doctors much less often than americans with private insurance who have similar diseases.
I had a surgery in mid-August that ended up costing over $40,000.00. It was semi-elective, in that it was to solve a severe chronic pain issue that was doomed to get worse, as opposed to life-saving. It's obvious what a poor and/or uninsured person would do in that situation, isn't it? Live with the pain, and all the misery, interference of life and loss of productivity that it would bring, not just to her but her family.

@#5--and on and on and on and on until he starves to death or dies of exposure.
what a bullshit system!

One ugly, little secret about our health care system is that doctors and hospitals charge non-insured patients so much because they know they can get away with it.

If you'd had insurance, the insurance would have "negotiated down" your bill to $500-$1000. So, even if you had a high deductible plan, you would've gotten a reasonable discount. But, since you were self-pay, the hospital was perfectly happy to rob you blind.

The fact that many of their self-pay patients don't pay one red cent doesn't seem to deter them. I'm sure hospitals are perfectly satisfied taking a "loss" by selling the debt to a collections agency.
@40, was it a hit-and-run? Or somehow not the driver's fault? Because otherwise the driver's insurance should have paid for your medical expenses. Or the driver, if he/she was uninsured.
At some point single-payer will be an obvious preference (even to moderates). Regardless of what improvements the Affordable Care Act will bring, consumers will, in the foreseeable future, be unable to afford even the best market-based insurance policies, whether they originate from exchanges or individual corporations. Why? Because there is no structural enforcement of medical costs. Without single-payer, there is lack of leverage - even the best-intentioned, decentralized, network-based efforts at regulating cost-structures through advisory boards and 'best practices' pale in comparison to the effectiveness of a single administrative body that can establish ceilings and floors (and represent 300 million consumers).

So Andy - we get it. Obama in 2012. Doesn't mean that we have to suspend our critical judgement or a half-century of empirical evidence regarding the effectiveness of single-payer.

@11: "How many of us are avoiding health care in case it charges us more than we can possibly handle?"

As you must know, the real question is: How many of us aren't?

P.S.: We should all shudder every time we eat in a restaurant? How many in the kitchen do you think have health insurance (or medical leave, for that matter)?

*cough, cough, sniff*
medic one is usually a free ride, the case in this story would not be an exception. Medic one is paid for by property taxes.

Other countries have managed to pull off universal health care insurance. Take the Netherlands as an example.

Granted, having insurance companies negotiate down out-of-control charges by doctors and hospitals is an inefficient way to contain costs, but it can work.

And have you noticed how much doctors squawk about how little they get reimbursed by Medicare (even though Medicare's compensation rates are totally reasonable)? Imagine that writ large across the entire system, with the AMA leading the charge. Meanwhile, doctors rarely, if ever, bitch about the low compensation they get from insurance, because they know they can't hire K Street lobbyists to do anything about it. They do business with those insurance companies or they don't do business at all.

Having a single payer entity paying private hospitals and clinics can also be a very inefficient way to deliver health care (measured in money spent), because the single payer has no profit incentive to keep those clinics from fleecing them. Imagine if the University of Washington Medical Center defrauded a private insurance company of $100 million? Do you think that hospital would still be in business today? Because the UW did do that to the federal government and only paid a third of that money back, because the government made the call not to put a major hospital out of business.

Again, imagine that writ large over a nation of 300 million people.
@47: It was a hit-and-run.
Wow, agreed. But more then that. We need to better actively support our most vulnerable populations here in Seattle, and in Washington, where we continue to slash social services while allowing out-of-state banks to walk away with $90 million in tax loopholes.
I'm not proud to admit that I have been this person. Many, many, many years ago. I was suffering from post-partum depression and made a half-hearted suicide attempt (I took a bunch of pills). I was under a lot of pressure on top of the depression (our rental was being sold, we were screwed by a predatory lender when buying our new house and were facing the possibility of homelessness, my husband at the time was laid off and I had to go back to work when my baby was 3 weeks old, etc) and I really just needed a break. My mother, who was visiting from out of state at the time, found the bottles in the trash and called 911. When the ambulance showed up, all I could think of was how much more screwed I was going to be because of the medical bills. I screamed and begged for them not to treat me all the way to the hospital and then some more once I was at the hospital. I told everyone who came into the room that I had no insurance and didn't want the treatment because I couldn't afford it. It didn't matter because in that situation, I didn't have the right to make decisions about my health or finances. I got the bills in the mail just the same. Obamacare doesn't fix this but, like many have said, it does make a step in the right direction of making sure there are resources available to people who need treatment that they cannot afford be reducing the drain on the system by folks who choose not to have coverage. It's not nearly enough but it isn't the evil baby-killer the right tries to tell you it is either.
As a type 1 diabetic, I can sympathize. Just holding on to the health insurance I've got now costs more than rent.
@9 Fuck Romney and the Republican party.


for this and so many other reasons....
I spend a lot of time in the UK. Even as a foreigner, the couple of times that I've needed health care it was efficient, free, professional, etc.
"Obama 2012, and fuck the rest."


"It's heartening that people like you can do no better than these silly, content-free attempts to connect an anecdotal incident to the election and pretend it is a discussion. Because there's no argument to be made on that side, it's just anti-conversation hand-waving."

OH THE INTELLECTUAL IRONY. Did you read your own post? Where is your content-full Obama argument regarding your anecdotal incident?
I had to take a ride in an ambulance a couple of months ago. $800 to get strapped into a backboard and driven a couple of miles to Swedish. After that, the ER bills start.

Can't blame the poor bastard for realizing how his financial situation was about to go into the crapper.

two words- personal responsibility. I aint rich, I'm 20 years old and I pay my own health insurance. Its only about 50 dollars a month. Get your life together and stop asking for handouts!
@60 - you're fucking kidding, right? Do you realize that not everybody is a healthy, 20-year-old male with an extra $50 a month? Do you realize that the vast majority of people are not healthy, 20-year-old males?
@60: Along with #61's point, not everyone has access to the magical unicorn health insurance plan you have found that costs $50 a month.

Either you are lying, or your plan covers nothing.

But hey, welcome to SLOG, since this is the first and only thing you have posted here. I wonder why that would be, you astroturfing liar.
@42 (Matt from Denver): Response, Part 1

Again, I've concluded that it's almost a waste of time to engage with people who are convinced that PPACA is a step in the right direction, especially since the short-term goodies promised to a subset of the pro-reform crowd have effectively divided and conquered what should have been a united front pushing for Improved Medicare For All. If you want a more complete and "credible" (non-black? non-leftist?) autopsy of the Obama health-care reform effort, you can read Hijacked: The Road to Single Payer in the Aftermath of Stolen Health Care Reform by John Geyman, former chair of Family Medicine at the UW Medical School. Or you could watch the PBS Frontline documentary Obama's Deal. If you wanted a lay-oriented survey of foreign health-care systems, TR Reid's The Healing of America: A Global Quest for Better, Cheaper, and Fairer Health Care is pretty good. The PBS Frontline documentaries that Healing was based on, Sick Around The World and Sick Around America, are also worthwhile viewing. (All of the Frontline documentaries I mentioned were viewable free online last I checked.) Michael Moore's Sicko is one-sided counterpropaganda -- the other side being amply represented 24/7/365 in our commercial media and punditry and political rhetoric -- but I haven't been able to fault it on any of the facts it did choose to present. (If it did contain inaccuracies, I'm sure Wendell Potter and his gang would have made us all aware of them back when he was a PR flack for Big Insurance.)

As for me, I've got a background in economics and law and have been a lay member of Physicians for a National Health Program since 2008. I chose that organization because it is by far the most technically knowledgeable of the health-care reform groups I've come across, but it's not my sole source of information on health-care economics and heath-care systems. I also keep an eye out firsthand for reports from the Kaiser Family Foundation, the Commonwealth Fund, and the OECD; and articles in the New England Journal of Medicine, The Lancet, the British Medical Journal, Health Affairs, and New Scientist, among others.

continued ...
@42 (Matt from Denver): Part 2

But that doesn't matter, as the real-world evidence speaks for itself. The health-care systems in our peer countries have all or most of the key elements of single-payer: uniform price and fee schedules (usually monopsonistically bargained), a universal pool of insureds, a universal provider network, a uniform benefits package, a uniform set of rules and procedures, centralized or harmonized claims and payment processing, and a relatively low cap on out-of-pockets. Our current "non-system" and Obamacare have none of these elements. Our peer countries provide coverage ranging from good to excellent to nearly 100% of their populations, have a very low incidence of "medical bankruptcy," spend from around 10% to around 12% of GDP on health care, and get better overall health outcomes than us. We provide coverage ranging from grossly inadequate to excellent to around 85% of our population, have over half a million individuals a year pushed into bankruptcy by medical bills, spend around 18% of GDP on health care, and get close to the worst health outcomes amongst OECD countries in many key measures. Under Obamacare, we will be providing coverage ranging from inadequate to excellent to around 90% of the population, the incidence of medical bankruptcy will likely drop by only around 8% (if Massachussetts' experience under Romneycare is a reliable guide), and we will be spending over 20% of GDP on health care. It's hard to predict how much of an impact it will have on our health outcome statistics. Obamacare contains no cost controls: no monopsonistic bargaining, no capital budgeting, no cost-benefit rationing, no ban on self-referrals, no ban on insurance profit-making -- even Switzerland did that -- no central oversight, and no administrative simplification. Given the weak competition between insurance companies with exclusive or preferred provider networks and local or regional oligopolies, the much-touted 85% and 80% mandatory medical loss ratios will likely tend to function in practice as 17.6% and 25% cost-plus provisions. Health-care costs will almost certainly continue to rise unimpeded; premiums, copays, and deducibles will rise; benefits and subsidies will be cut; and we can expect that the 30 million completely uninsured the CBO now projects will inexorably climb back up to the 48.6 million completely uninsured we have now.

continued ...
@42 (Matt from Denver): Response, Part 3 of 3

But again, I've come to accept that it doesn't matter what I know, what I say, or who I cite. This is something that you and other defenders of Obamacare will have to find out for yourselves, the hard way. In the meantime, the for-profit health sector will continue to skim around a trillion dollars a year in excess costs (compared to per-capita costs in our peer countries), and when Americans cry out once again for reform a decade or two from now, I'm sure the Big Health's PR flacks, media hacks, and politicians will find another cock-and-bull story to sell you.

Final reminder: Obama and the Democrats may have sold it, but the Heritage Foundation designed it and lobbyists and aides on loan from the for-profit health sector wrote it. It's Democratic lipstick on a Big Health pig.
I was just in Italy for two weeks. While I was there, my wife had an extreme histamine reaction to something that got so bad that it required a trip via ambulance to the hostpital, where she was administered IV drugs and heavy duty anthistamines. Total cost to us, non-citizens (and equal to what an Italian citizen would have paid): 22 Euro (less than $30). In the USA, an ambulance, emergency room visit, and drugs, even with the best coverage available to a middle class consumer, would have been anywhere from 10 to 40 times that cost. Without insurance, it would have been 100 times, absolute minimum. If the health insurance industry wants to be for-profit, I'm fine with that, but run your business efficiently; demand accountability, efficiency, and a realistic cost structured from your contractors (hospitals, doctors, and especially medical schools). Clearly, they don't want to do that. So if the government steps in and says 'fuck that' and forces them to live in the real world where people don't have tens of thousands of dollars lying around to pay for artificially inflated medical costs, great. The medical field is not a normal supply-and-demand economic model; when you need medical treatment out of the blue, companies shouldn't be able to just gouge you because you don't have a choice.