the first would be a system where the insurance companies will be required to give reasonably-priced coverage to all the way they do with car insurance.

The first problem I see here, is that you’re trying to force business to do something that will hurt their bottom line. Good luck getting a law like this passed! Here’s a good title for the law: ”OK, we know you’re a for-profit company, but we’re going to force you to take a loss. WE’RE the government! Do what we say!”

There will be a minimum standard that meets the basic care someone would need, with some provisions for catastrophic situations. If you want to and/or can afford it, you may buy more coverage.

That’s the point of health coverage, catastrophes! The idea that a low-cost plan would have provisions for catastrophes is ludicrous! Who would buy the expensive plan, if emergencies were covered by the cheap plan? Unless you have a different definition of a medical catastrophe than I do. You’re not talking hurricanes are you?

The first problem I see here, is that you’re trying to force business to do something that will hurt their bottom line. Good luck getting a law like this passed! Here’s a good title for the law: ”OK, we know you’re a for-profit company, but we’re going to force you to take a loss. WE’RE the government! Do what we say!”

We already do it for car insurance.  It’s not unprecedented.  Government restricts what business can and cannot due to obtain profits all the time.  Your argument is meaningless.

That’s the point of health coverage, catastrophes!

Really?  Colds are catastrophes?  An ear infection is a catastrophe?  Physicals and annual gyno exams are catastrophes?  Preventative care is a catastrophe now?

Think before you type.

Who would buy the expensive plan, if emergencies were covered by the cheap plan?

Because they would have complete freedom to choose a doctor, hospital or treatment facility, based on the “tier” of service they purchase.  The more you spend, the more expensive the place you can go and still be covered.

It’s really quite simple.

Oops, there’s more…

I envision it something like this: HMOs negotiate with clinics, big pharma and publicly-owned hospitals to get the rock-bottom lowest rates.  Everyone in the basic pool goes to these places for almost everything.  If you buy a higher tier, you get to choose your doctor, hospital, etc.

So you want HMOs to be able to choose your doctor/hospital for you? Isn’t that what most people who are anti-universal health care say is the biggest problem with socialized health care? With your plan, you PAY for that privilege? Don’t you think that’s a little selfish? Don’t you see the problem with saying “only people with money can choose”? Don’t you think that’s only going to make the problem worse?

Of course this would also have to accompany reforms in the industry so that an insurance company would be forced to abide by the contract they signed if you go into a higher tier.  No more of this “looking for a reason to dump you” crap.  In fact I would propose that if they take more than six months of premiums from you, even if they find out that you had seventeen STDs between the ages of 12 and 20 that you never told them about - tough luck.  You tooks the money nows ya takes yer chances.

I really like this idea, but it’ll never happen. The only thing would change is it would make the screening process more thorough, and consequently premiums would increase. Also, “they” would find loopholes. The easiest would be to raise the rates to the point that the customer (you know, the sick/dying/injured person) cannot pay any more. Forcing non-payment is an easy fix to that pesky pre-existing condition problem.

Also, obviously, the initial “assigned risk” tier that everyone can buy is issued to all, at any time, pre-existing conditions do not apply.  Suck it up, HMOs. :)

Again, why would anyone go with anything more expensive? “Hi! I have HIV/AIDS, cancer, hepatitis, diabetes, and am a chronic alcoholic. Which coverage should I choose, the ’cheap one for everyone, regardless of pre-existing conditions, that can never be canceled’ or the one that I cannot get in the first place and would not be able to afford?”

So you want HMOs to be able to choose your doctor/hospital for you?

HMOs already do that RIGHT NOW. As does the government’s Medicaid/Medicare programs. It’s only PPOs and rare HMO plans that let you choose from *anyone*, anywhere. Do you really not know that?

Don’t you think that’s a little selfish? Don’t you see the problem with saying “only people with money can choose”? Don’t you think that’s only going to make the problem worse?

How do you think we can keep costs down?  Do you have any suggestions?

Again, why would anyone go with anything more expensive?

Asked and already answered. TWICE.

We already do it for car insurance.  It’s not unprecedented.  Government restricts what business can and cannot due to obtain profits all the time.  Your argument is meaningless.

I hope you’re not saying that auto insurance is the system we should emulate for health coverage! I drive a car that might be worth $1800, if I’m lucky! I pay $700 a year for insurance on that car. I’ve never had a ticked, never had an accident, never had a DUI, and have a perfect driving record. I have the absolute cheapest insurance I could find. Yet, Geico makes the value of my car in profit every 3 years! IF I were to be in an accident, my premiums would skyrocket, even if that accident wasn’t my fault (I wouldn’t even have to be present when the accident occurred). Yeah, the government is really putting huge burdens on the auto insurance companies! My argument IS meaningless!

Really?  Colds are catastrophes?  An ear infection is a catastrophe?  Physicals and annual gyno exams are catastrophes?  Preventative care is a catastrophe now?

Got a cold? Chicken soup and rest.
Ear infection: yes, this is a catastrophe
Physicals, OB-GYN visits; you got me, they’re not a catastrophe
Wouldn’t these relatively minor concerns be covered, even in the lowest tier? If not, what possibly would be covered? My main, thought-out, argument is still perfectly valid: Who would get tier-2 if tier-1 covers everything? Who would pay for tier-1 if it does virtually nothing?

they would have complete freedom to choose a doctor, hospital or treatment facility, based on the “tier” of service they purchase.
...
It’s really quite simple.

I didn’t see the simplicity before!
No money = no choice.

I’ve got an idea! Lets apply this simple philosophy to all facets of society!

Oh for the love of fuck. We can’t even have a hypothetical discussion on different *possible* theories without this level of crap, misstatement and deliberate goading?

Wouldn’t these relatively minor concerns be covered, even in the lowest tier?

Yeah. I frigging said that already. Twice.

Who would get tier-2 if tier-1 covers everything?

Asked.  and.  Answered.

Lets apply this simple philosophy to all facets of society!

Or you could just be a smarmy prick and not actually discuss anything that isn’t your perfect idea of socialized medicine.  That’ll really help move the debate forward.

HMOs already do that RIGHT NOW. As does the government’s Medicaid/Medicare programs. It’s only PPOs and rare HMO plans that let you choose from *anyone*, anywhere. Do you really not know that?

The question isn’t ”IS it the case” the question is “do you WANT it to be the case”. So much of what I’ve seen here is “I agree, there’s something wrong” and later “well that’s the way it is”. Well, don’t you see the correlation between “the way it is” and “there’s something wrong”?

How do you think we can keep costs down? Do you have any suggestions?

There are 2 sets of costs. #1 what the hospitals/doctors charge and #2 what the health insurers charge to pay for the doctors/hospitals.
#1 I do agree that if a limit is placed on how much doctors earn the care the doctors provide will also be limited. At the moment, this cost is very high, but it seems to be necessary.
#2 is what needs to be changed. I’m sure you’ve heard of “middle men”, right? If not, here’s what a “middle man” is: A middle man is a person or company who provides a service between 2 other entities for a fee. Some middle men are necessary (shipping companies, grocery stores, etc.). Some are not. Insurance companies are unnecessary middle men. I think we can agree that the actual “cost” of #2 would be reduced by removing the profit concerns from the equation. #1 would likely increase, but #2 would decrease. Am I saying it would balance out? No, it’s almost surely going to increase. I’m only saying it would be better for more people.

Am I thrilled that I’m paying for firefighters that I’ve never relied upon? No. But if my apartment catches fire I’m going to be glad they’re there. Am I glad I’m paying for a police force, of which I’ve never received any direct services? No, but when if I get robbed they’re the first people I’m going to call. Will I be happy when I’m paying much higher taxes to pay for the medical care of homeless people? No, but if I ever get a… Cold (what an idiotic example you came up with) I’ll be more than happy to take advantage of the “free” medical service provided to me.

Or you could just be a smarmy prick and not actually discuss…

Sorry, ad hominem attacks don’t work on me.

Here’s just a thought for what Hirudin is saying, which is basically why would anyone get Tier 2 health insurance if theres the lowest teir. Right now I’m in Australia, which has a national health care system. The family I’m staying with has private health care as well, on top of the national health care. Its not an unknown thing. So clearly, people will opt for more than the bare minimum.

Lowbacca wrote:

Right now I’m in Australia, which has a national health care system. The family I’m staying with has private health care as well, on top of the national health care. Its not an unknown thing. So clearly, people will opt for more than the bare minimum.

That statement got me thinking about the 1st idea. What if the first and second tier were separate companies.

The phone industry used to be where you had a the the local phone company that you paid for your local calling and then you picked another vendor (AT&T;, Sprint, etc.) for your long distance carrier.

What if you had the Teir one in each region of the country that everyone bought from. And then if you wanted to, you could by Tier 2 insurance from a different company that just handled more coverage.

That way the companies that supply the coverage for each tier are separate. Tier one companies would not have to worry about anything but the basic coverage the supply. Tier two companies could concentrate on higher level support and not worry about the basics.

Each company would just worry about their teir of service. This may prevent the senario of a company, if they controlled selling teir one and two insurance, of dumping a client from teir two because of a pre-existing condition.

Of course, one downside would be possibly more paperwork. However, the idea of the 2 tiers being separate companies could ensure that people are covered by the basics.

The family I’m staying with has private health care as well, on top of the national health care. Its not an unknown thing.

And this brings up an interesting point . . . while Moore is discussing socialized medicine for Americans, the countries practicing socialized medicine are creeping toward privatization, at least to some degree. 10% of Germans have opted out of their “free” system which is legal as long as you meet certain income level requirements. In another European country, once you reach a given income level, you’re on your own . . . no choice, you much have private insurance.

What if there was more than one tier of doctor rather than one tier of insurance? Up here in Northern Maine, a lot of people see a N.P. rather tnan a doctor. What if we expanded N.P. programs in lots of schools and gave people incentives to pursue that profession? A lot of the basic health care stuff could be handled by them, leaving the serious stuff to the doctors. You could have little N.P. clinics where people could go for basic care. Maybe there could be a limit on malpractice against them because of their limited scope. Mini-Clinics might help reduce the demand by freeing up doctors for more serious conditions.

And, maybe fourth-year med students could work part-time in these clinics, helping them reduce the debts they are saddled with when they finally graduate.

Well, that’s my contribution. Feel free to destroy it.

Another angle that larger employers are exploring is CDHP, or Consumer-Driven Health Plans (I’m sure they have various names).

Basically, it works like this:
- employees have a base level of coverage (60/40, 80/20, whatever)
- the employer covers the first portion of the copay/deductible (e.g. 500 ind/1000 family)
- beyond that first portion, the employee covers the remainder of the deductible (e.g. 700 ind/1400 family)
- once that two-level deductible is exhausted (1200 ind/2400 family), then the insurance kicks in at whatever percentage (say, 90), depending on the level of service.

In short, you have a higher overall deductible, but the first part is covered by the employer.  So it’s possible that individuals who have fewer doctor’s visits/prescriptions will end up not paying a single dime beyond their premiums, and those with more bills will at least get some relief provided by the employer.

Incidentally, we are quite content to hit the local Urgent Care rather than schedule an appointment with our PCP, so we have only the $10 copay and the cost of the prescription whenever there’s bronchitis or a UTI or other minor illness in the family.  I don’t know if that helps a bit with Belcatar’s analysis.

I like the first idea presented. The second one, I’m not entirely clear how that would lead to extending affordable health coverage to more people.

The first idea actually puts me in mind of the Canadian system. We do still have private insurance, but its only needed to cover routine trips to the dentist, eyeglasses, and prescription drugs. The government handles doctor and hospital visits. So in a sense, Canadians are covered by two separate, non-overlapping insurance providers: one is public, the other private.

I don’t see any reason why a similar non-profit (or low-profit) system couldn’t be put in place, relying entirely on private insurance. And it would make sense if each insurance policy was handled by a different agency, that way they could specialize in dealing with specific kinds of health care, which may cut costs to some extent. But I’m no financial analyst.

I do think, though, that it would be very hard to make a change like that. The insurance companies wouldn’t be happy, and they’d lobby for all they were worth to keep the status quo.

With your plan, you PAY for that privilege? Don’t you think that’s a little selfish? Don’t you see the problem with saying “only people with money can choose”? Don’t you think that’s only going to make the problem worse?

And you PAY with socialized Healthcare. It’s called higher taxes.

And also sometimes “pay” because you need the care now and don’t get it for a few weeks or longer.

I didn’t read all the responses, so forgive me if this was mentioned, but the 2nd idea would be a complete disaster.

In the public school system, the government mandates certain standardized tests that measure what kids are learning. The better your kids score on the tests, the better you look to the government - the people that write your checks. Schools/teachers have a financial incentive to focus on teaching only a few things, instead of the overall education of their students. They’re “teaching to the test.”

This 2nd idea reminds me a lot of those standardized tests - hospitals/doctors have a financial incentive to focus on treating only a few things, instead of the overall health of their patients. There won’t be any way around this flaw - if you give them rewards for specific things, they will make sure that those things happen, and it’ll be at the expense of other problems not being treated.

Jim, I can’t help but think that socialized medicine is going to come eventually no matter what we do.

Our next, best hope is to do our best at limiting the shortages that would ensue.  We can try to limit the shortage of doctors by giving tax incentives.  For instance, doctors and nurses only pay a quarter of the federal taxes that other people earning the same amount of money pay.  Something to that effect.

OMG J00 WANT TAX BREAKS FOR THE RICHEST X PER CENT!

/leftist “enlightened” response to your suggestion

I think that sometimes the point of the socialised healthcare debate is over-complicated. (not least by Moore!)

It’s not about whether or not you pay, or if it’s cheap - its about being socialised. To me (as a Brit) I’m fine with the fact that I pay more into the pot so that those who can’t afford it still have access to healthcare. Yes its a very socialist ideal, but on this point I think its worth it.

Now this is obviously not the view of the majority of Americans - call it rugged individualism or what you will - which is absolutely fine - it’s not what you guys do.

So you guys concentrate on fixing the system to make it as fair as possible whilst still keeping it as capitalist as possible, and we’ll concentrate on making our socialised system as efficient as possible.

Sniping about who is better is pointless.

IMHO

Tell that to the people DEMANDING that we “join the civilized world” and “treat people humanely” and “stop leaving our children to die” and so forth.  Those of us arguing against Moore are, by and large, quite content to do exactly as you say: work to fix the system in place.  Those arguing FOR socialized medicine are the ones trying to deconstruct things.  “Sniping” from this side of the debate typically comes in the form of a response, e.g., if socialized health care is so much better, then how come Example X still happens over there?  The point being that the “system” is neither the problem nor the solution.

And to dissolve the meme (again), those who cannot afford health care in America still have access to health care.  We have Medicaid and SSDI.  The part that needs to be fixed is managing the costs for those of us who (ostensibly) ARE able to afford health care.

W0rf, that is exactly what I am doing - trying to tell those Mooreons and trolls to leave it alone.

But I’m not sure you can call it a response when Lee or JimK post an article about some failing of the NHS to ‘prove’ that socialised systems suck. It’s exactly the same tactic of attacking the other system.

**repeat ad infinitum re: Gun Control**

I still claim that it is intended only to show that social systems are not the messiah that these other people are making them out to be.

Moore’s portrayal in the film is that private companies destroy people’s lives in their quest for the almighty dollar, and the answer is to make it more like this other system over here, and look how awesome it is!  (He even went so far as to say that certain aspects of scandanavian health care are not mentioned in the film because they are so mind-blowingly amazing and awesome that Americans would not even believe it was true!  Irony nothwithstanding...)

When an argument is unequivocally presented as “our system sucks, and their system does all this stuff better than we do and it’s great”, why would it NOT make sense to demonstrate the shortcomings of such a system?

By contrast, there has been NO ARGUMENT from the authors that our system is not without problems and does not need improvement.  I would say the articles demonstrate a sense of fairness to both sides of the argument, while Moore explicitly states that he is NOT treating the argument fairly.  ON PURPOSE.

W0rf - I realise the irony of me posting this in a thread where JimK specifically gave his idea for improving the current system!!!

All I am trying to say is that as someone who comes from a country that has a socialised system, I do hear my fair share of “those dumb europeans and their commie system” comments as well as those clueless trolls who call you guys ‘heartless’ and whatnot.

And by the way - I wasn’t trying to assert that those who do not have healthcare don’t have access. I’ve been around here and RTFTLC for too long for that!

Although, I do have a question out of curiosity. If you’re going to get the healthcare you need whether you have insurance or not, why bother getting insurance in the first place?

or is this one of the problems with the system?

Could it be argued that socialised healthcare is just a way of forcing the irresponsible f*cks to pay for ‘health insurance’?

If you’re going to get the healthcare you need whether you have insurance or not, why bother getting insurance in the first place?

Well, that wasn’t anything that I ever said, but the obvious answer is that insurance subscribers pay into a pool, and those who need the money pull it out.  All the benefits of a social system without any of that pesky government intervention on individual liberties.  It’s supposed to be protection against catastrophe, but it balloons into something far more inclusive at far more cost.

Could it be argued that socialised healthcare is just a way of forcing the irresponsible f*cks to pay for ‘health insurance’?

It could.  Which of course is exactly the problem, the government forcing people to spend their money the way the government says you should, on a matter that is not critical to the nation as a whole.  It is not the government’s job to *make* other people do things that you think they should be doing.  Especially when we’re talking about no more than 10% of American households: not exactly an epidemic of “irresponsible f***s” given that maybe half of those can’t afford traditional insurance.

Improvements can be made within the private system.  Localities can institute their own system of care in a way that more efficiently addresses their needs, hitting a better target at a lower cost with more accountability.

... the point being that the presence of problems does not mandate a federal answer, and certainly not in a forcible manner, an apt desriptor that I thank you for providing.

W0rf mate, I’m not attacking you at all, just trying to ask some questions about the American system! (and maybe playing devils advocate a little ;-) - you’re sounding really defensive! I never said there was an epidemic - if anything I’m speaking in the abstract.

Could it be said that in effect you do kind of have a socialized system, its just not administered by the government. In a way you are ‘forced’ to pay for the healthcare for people who don’t have the personal responsibility to get care for themselves (through higher premiums) - the pool you pay into is the same as the pool I pay into, except for the fact the money rests in an insurance companies bank account rather than in the treasury? The argument seems to then boil down to one of ‘who is best at running this sort of thing’ - and I think we can pretty much guess everyones opinions on this one!

W0rf mate, I’m not attacking you at all, just trying to ask some questions about the American system

I didn’t accuse you of attacking me, I only said that “having health care with or without insurance” was never an argument that I made.  I even gave a measure of grace in responding to the extent that I accept the argument as correct (which is only in part).

I never said there was an epidemic - if anything I’m speaking in the abstract.

Nonetheless, the fact remains that the percentage of uninsured Americans is relatively small, and the number of people who cannot afford insurance removes them from the pool of people who could be labeled as shirking their social responsibility.  Based on that, I don’t see the benefit in creating a system that mandates compliance from 100% of the people to correct the behavior of 5%.

Could it be said that in effect you do kind of have a socialized system, its just not administered by the government.

That could be said of any organized system: either it’s publicly managed or it’s privately managed.  To say that they are the same in that they are organized systems seems redundant.

In a way you are ‘forced’ to pay for the healthcare for people who don’t have the personal responsibility to get care for themselves (through higher premiums)

I have several problems with this portion of your statement:

1). I am not “forced” to pay for anything when I voluntarily enroll in an insurance plan.  There is no comparison between this and the mandated appropriation of monies under force of law.

2). I only pay into my risk pool.  Insurance companies typically do not pay out to uninsured persons, so I don’t know who would be the “irresponsible parties” here.

3). For that matter, I do not know what you mean by people who are “not getting care for themselves”.  Do you mean people who do not seek medical attention?  People who are not part of my particular plan?  People who have no insurance at all?

4). Higher premiums are generally assigned to those who present a higher risk to the pool.  Smokers pay higher premiums than non-smokers.  So do people with higher risk factors for certain diseases (particularly those who incur those risk factors through personal choices such as drinking or smoking).  As someone in generally good health who doesn’t drink or smoke or seek a great deal of medical attention, my premiums are actually quite nice for my level of coverage.

5). The relative “pools” of each system are also not comparable, as premiums are calculated through rather complex “risk tables”, whereas your pool is whatever share of the budget is marked for NHS (or whatever), and personal income tax is not based on health or risk factors.

And if ever it is, I think you should grow very concerned at the ramifications of such a thing.

2). I only pay into my risk pool. Insurance companies typically do not pay out to uninsured persons, so I don’t know who would be the “irresponsible parties” here.

On this point, I think you may be a little off. While insurance companies do not pay for the uninsured, hospitals need to recoup the costs of the services they provide to those people who do not in fact have health insurance and can not/do not pay for services. So if a given procedure costs $500 and I go in there with insurance I pay a $20 copay and the hospital bills the insurance company for the remaining $480. If I walk in there with no insurance however I am expected to shell out the full $500 for the service. Seems simple right? The trouble is that typically the person who does not have health insurance also does not have $500 lying around to pay for the procedure so they skip out on the bill. After this happens a couple of hundred times, the hospital is faced with a pretty big shortfall so what do they do? That’s right, they raise the price of the procedure to make up the deficit. As the procedure increases in cost, the health insurance companies pass that increase onto people paying insurance.  So in a round about way, you/insurance companies do pay for the uninsured. The sad part about this is that as the cycle repeats itself, you start to see more and more people thrust under the line where they can afford health insurance and thus we have more and more people skipping out on the bill…

The answer is fairly simple of course. No payment, no service. It’s draconian and in no way would it ever come to pass, but it would certainly clear up the problem really quick wouldn’t it?

While insurance companies do not pay for the uninsured, hospitals need to recoup the costs of the services they provide to those people who do not in fact have health insurance and can not/do not pay for services.

They have to do that without regard for whether the person is insured or pays out of pocket.  If I have no insurance, walk into the doctor’s office, have an $80 consult and get a $35 prescription, I still pay $115 out of pocket.  Being insured or not does not change the cost, and the uninsured cover the default bills every bit as much as the insured.  I am the one paying for the uninsured, the insurance company is only a proxy.

Moreover, this relates to people who cannot afford the insurance, and as I said before, people too poor to afford insurance would not fall under the label of “irresponsible”.  The argument was that socialization would force enrollment from people who otherwise would shirk their “civic responsibility” of joining a plan, and this does not fit that description.

Could it be said that in effect you do kind of have a socialized system, its just not administered by the government. In a way you are ‘forced’ to pay for the healthcare for people who don’t have the personal responsibility to get care for themselves (through higher premiums) - the pool you pay into is the same as the pool I pay into, except for the fact the money rests in an insurance companies bank account rather than in the treasury? The argument seems to then boil down to one of ‘who is best at running this sort of thing’ - and I think we can pretty much guess everyones opinions on this one!

ilovecress,

While there are similarities between the two systems, their differences define two different animals. And remember this because it’s very important to understand . . . we do have socialized health care in this country. It’s called Medicare although it might be better defined as a quasi-socialized system since there is a co-pay on some things.

There is one big difference between the two systems. Since a socialized system depends on tax revenue, rising prices cause government deficit spending, cutting services, or raising taxes. I’m sure you are aware of all the discussions in the UK concerning treatment for obesity, smoking and alcohol consumption. To cut costs, denial of some services is being considered. Meanwhile, France’s system is in the red by $10 billion a year. In 3 years it will be $29 billion. 10 years later it will be $66 billion a year. Our Medicare system is facing the same problems . . . all the baby boomers who will be enrolled over the next 2 decades will overwhelm the system. Germany has the same problem, maybe worse.

On the other hand, a privatized system doesn’t face the problem of deficits since premiums can be readily increased. Of course, that means health insurance gets more expensive, but it does so without becoming a trillion dollar national debt that soaks up an ever-increasing percentage of tax revenue paying interest on that debt.

In the end some people may be left behind, but isn’t that really the case with all systems? How much longer can France delay the inevitable? In my opinion their taxes are . . . well, to use Moore’s word . . . simply obscene.

The discussions going on in the UK today involve serious considerations. Does an alcoholic with cirrhosis of the liver deserve a liver transplant? Does a clinically obese person get a heart by-pass operation? Does a smoker deserve a lung transplant? All these considerations stem from a lack of funding.

The reality is no government can be everything to everyone. Medical cost are going to keep on rising, and since no country’s GDP can keep pace, something has got to give. I don’t point this out to discredit Europe. I point it out to discredit Michael Moore. When he says if Europe (or whoever) can do it, so can we, I have to question his agenda. He isn’t giving the American public the whole picture. All systems have their share of faults. It’s just that our system is getting more than it’s fair share of abuse.

If we take Moore’s advice and opt for a socialized system, is he going to be around to make the same tough choices the UK is making now? . . . the same choices other countries have to make with wait times and denials? . . . the same choices we will soon have to make with Medicare?

They have to do that without regard for whether the person is insured or pays out of pocket.  If I have no insurance, walk into the doctor’s office, have an $80 consult and get a $35 prescription, I still pay $115 out of pocket.  Being insured or not does not change the cost, and the uninsured cover the default bills every bit as much as the insured.  I am the one paying for the uninsured, the insurance company is only a proxy.

Not sure I completely follow what you were saying here.  With insurance, I walk into the doctors office and pay my co-pay...get a Rx and go to the pharmacy of my choice..pay the co-pay and go home with my medication.  Without insurance, I instead of going to the doctors office...go to the local Emergancy Room...walk out with an Rx....then have to worry about paying to fill it. 

Problem comes in with the fact that those without insurance use the ER as their primary healthcare provider.  Hospitals are required by law to take any and all people who come regardless of their ability to pay.  They are NOT required to provide more than basic care.  Which is why in SICKO we see the cab dropping off the homeless woman at a shelter.  Hospitals add the cost of those that can not pay to the price paid by those that are insured.  The insurance companies pass that cost on to those that pay the for coverage. 

While we may or may not agree with what Michael Moore has said in his movie....or while we may or may not agree about a single payer system...we have to agree that Michael Moore has done what he intended to do...get a conversation started about health care in the USA and maybe...just maybe...we can fix what is wrong with the system...and keep what is good about it.

On the other hand, a privatized system doesn’t face the problem of deficits since premiums can be readily increased. Of course, that means health insurance gets more expensive, but it does so without becoming a trillion dollar national debt that soaks up an ever-increasing percentage of tax revenue paying interest on that debt.

A major part of the reason the cost of health care keeps going up is the fact that there are around 45 million people who do not have insurance in the USA. 
While hospitals are required to treat everyone regardless of ability to pay...it is the people who can not pay that add to the cost of others.  If everyone was covered...then the cost should even out and not keep growing.

Hospitals add the cost of those that can not pay to the price paid by those that are insured.

This is not a wholly accurate statement, and it was the very point of the paragraph you said you didn’t understand.

Hospitals do not ONLY pass costs on to the insured.  A $500 operation costs EVERYONE $500, whether they have insurance, pay cash, or default because they’re broke.  If the number of non-payers drives the cost up to $600, the hospital will charge $600 to the insured, the self-sufficient, and the financially strapped alike.

Price increases are universal, they do not target the insured.

we have to agree that Michael Moore has done what he intended to do

What Moore intended was for us to fill the streets of Washington, demanding universal, single-payer health care every day until the government enacts it.  He has said as much.  “Starting a conversation” as a stated intent is disingenuous because he did not stop at that.  Neither did he intend to “start a conversation” about gun control; he has openly proclaimed his campaign to have guns banned.  Neither did he intend to “start a conversation” about Bush or 9/11, he actively campaigned to oust him in the 2004 election.

Make no mistake: Moore’s aim is not to foster discussion, else he would not manipulate reality or use incendiary tactics to press his point.  He wants to convince his viewers not only that his view of the world should be adopted, but that it’s so painfully obvious a choice that there’s no intelligent reason not to see things his way, the truth be damned.

If everyone was covered...then the cost should even out and not keep growing.

If the 90% of insured peoples cover the cost of the 10% who can’t afford it, and we move to a socialized system (where the people who can afford it cover the cost of the people who can’t), how do you figure the costs will even out?

If the 90% of insured peoples cover the cost of the 10% who can’t afford it, and we move to a socialized system (where the people who can afford it cover the cost of the people who can’t), how do you figure the costs will even out?

I am not sure where you are getting the figure that 90% of the population of the USA is covered by insurance.  I can not give a exact quote of where the info came from because I was channel surfing and did not catch the whole news cast but I remember hearing just in the last week or 2 that there are roughly 45 million Americans without health insurance.  According to the US Census there are roughly 281 Million people in the USA. Using your 10% figure..that would mean there are only 28.1 million people without health insurance instead of the 45 million I heard.  Even if your figure is correct...that is still a lot of people who use the ER’s in this country as their primary health care giver instead of a GP. 

How would it even out if we went to a single payer system? If you like most people have coverage provided thru your employer..you have an amount deducted from your paycheck...what difference who that money went to as long as you received the same coverage as you have now.  If it was going to the government then the other people ( who are working but their job does not offer the insurance option, would also be paying into the system just the same as you do.  That would mean that there would be at least, using your figures, 28 million more people paying into the system.  The more people who are insured..the more people who will go to a GP for their general health care.  A GP is cheaper to visit than your local ER.  That in it’s self would be a savings...Plus...the more people who go to the GP the less likely those people would wait till a small problem became a major medical emergancy.  It is cheaper to treat a sore throat at home than it is to wait till it turns into pneumonia.

JimK started this thread with a couple of ideas and I would like to comment on one of them.  He said

..the first would be a system where the insurance companies will be required to give reasonably-priced coverage to all, the way they do with car insurance.  There will be a minimum standard that meets the basic care someone would need, with some provisions for catastrophic situations.  If you want to and/or can afford it, you may buy more coverage.

That would be a good idea if and only if there was a way to make sure that everyone participated.  With mandatory auto insurance laws on the books here in my state...there are still many people who can not afford the minimum required amount of coverage.  I would assume that some if not all of these people are part of the same group that does not have health coverage.  They are also the same people who because they do NOT have coverage, cause the rest of us to pay more for our coverage.

MgmLneWolf said:

That would be a good idea if and only if there was a way to make sure that everyone participated.  With mandatory auto insurance laws on the books here in my state...there are still many people who can not afford the minimum required amount of coverage.  I would assume that some if not all of these people are part of the same group that does not have health coverage.  They are also the same people who because they do NOT have coverage, cause the rest of us to pay more for our coverage.

True enough.  In my defense, I don’t really have a fully fleshed out plan here.  Just kicking around some ideas!

I am not sure where you are getting the figure that 90% of the population of the USA is covered by insurance.

The population is closer to 300 million and the 45 million figure is exaggerated; it seems to increase every time someone brings up the number (38, no 40, no 42, 45, 60!).  At worst, it’s like 12% and not 10%.  Or you could look at it in terms of 100 million households, and about 90% of households are covered.  If you want to get into it over a couple of percentage points, I recommend you find someone else with whom to wage that battle.  A couple points are not worth that much to me.  It was only a rough number to make a point which is not impacted by exactitude.

That would mean that there would be at least, using your figures, 28 million more people paying into the system.

They are not “my figures”, so you can abandon that line of commenting right now.  See the above paragraph.

However, that might not be far off the mark, since not all of the 40-ish million uninsured are working adults, therefore, you will not HAVE 40-ish million people paying into the system.

You are also working under assumptions that require faulty math in order to work.  The system only “evens out” if you assume that all of the uninsured will be paying in, and at the same rate as everyone else.  But we have a tiered system based on income.  That leaves two possibilities: either the health care will be part of the General Funds like nearly everything else, and therefore people will pay different amounts based solely on their income level, or it will be in a “separate” fund like Social Security… except that the government plunders Social Security to offset deficits in the General Funds every.  single.  year.  Including the years of the Clinton “surpluses”.  Social Security pay-in is proportional to your income anyway, so in truth the same argument used for General Funds would apply to a separate health fund as well.

Not only that, but a number of the lowest income earners pay little to no tax at all.  The bottom 20% of the population bears only 1% of the federal tax burden.

So what you would be doing is adding millions of people to the health care rolls, but many will not pay taxes into that system, and many who are unemployed will not be paying into the system AT ALL.  I don’t see any conceivable way that the costs would “even out” if people are enrolled into your plan BY DEFAULT and you are REQUIRED BY FORCE OF LAW to pay their bills.

And even if we threw away 150 years of history on income tax and just assumed for the sake of argument that everyone would magically be taxed the same for enrollment in this health care plan, just think about what you’re proposing to be the case.  If these people had the kind of money to be taxed for enrollment, don’t you think they would already BE enrolled in a private plan?  I thought the whole point here was that they could not AFFORD insurance and/or medical treatment, and now you are claiming money that they are not supposed to even HAVE as evidence that my financial burden will be lessened?  That makes zero sense.

And if the problem is only that people visit more expensive ERs rather than less expensive GPs, couldn’t we just address the problem by sending them all to GPs anyway?  Where does restructuring the entire health care system of the nation figure into that?  Just have them go to the GPs and that money is saved anyway.

JimK said

True enough.  In my defense, I don’t really have a fully fleshed out plan here.  Just kicking around some ideas!

I understood from your original post that these were not fully fleshed out ideas.  At least you presented something for us to discuss.  That is where the solution lies in this issue...as in all other issues of national importance.  We each come into this discussion with some sort of idea.  With each of us contributing to the conversation then we might be able to formulate a solution.

Problem I see is most people are willing to admit that the system is flawed… but the same people are scared to change it.  I do not claim to know if the single payer system used elsewhere is the better way to go or if it is best to keep the insurance companies.  What I do know is that it is a shame that the richest country in the world has as many people as we do in the USA who can not afford to go see a doctor

wOrf wrote:

At worst, it’s like 12% and not 10%.

I am not here to quibble over what percentage of the population is not covered by insurance.  it does not matter if the total figure is 10 million or 100 million un-insured people in this country.... both figures are too high for a country like ours.  And btw...I used the term “your figures” only because I was discussing something you said...I did not mean to imply anything by that. 

Not only that, but a number of the lowest income earners pay little to no tax at all.  The bottom 20% of the population bears only 1% of the federal tax burden.

All tax payers have a certian percentage deducted from their pay for Medicare.  No matter how much that person makes each year the total amount deducted can not exceed a set dollar amount.  Granted a person that makes $10,000 per year would never have the maximum amount deducted where someone making $100,000 would...Medicare tax is NOT refundable ...that would be the way to go. 

If these people had the kind of money to be taxed for enrollment, don’t you think they would already BE enrolled in a private plan?  I thought the whole point here was that they could not AFFORD insurance and/or medical treatment, and now you are claiming money that they are not supposed to even HAVE as evidence that my financial burden will be lessened?  That makes zero sense.

I don’t know about you ...but the only way I can afford what I pay for health coverage is because I work for a company that offers the coverage and as part of my compensation they pay the larger part of the policy.  People who are not offered company paid insurance usually can not afford to pay the amount that the employer pays as well as what would be deducted.

And if the problem is only that people visit more expensive ERs rather than less expensive GPs, couldn’t we just address the problem by sending them all to GPs anyway?  Where does restructuring the entire health care system of the nation figure into that?  Just have them go to the GPs and that money is saved anyway.

That would be the purpose of a single payer system.  ALL persons could afford to go visit the GP.  Personally I can afford to spend the $20 co-pay to visit my GP...but I could not afford to go see him if he was to charge me say $80 to visit him.  How would you make someone go to the GP without insurance anyway.  They only go to the ER because the hospitals are required by law to treat them regardless of ability to pay. 
A friend of my son does not have insurance.  In the past year he has been to the ER at least once a month because of a sore throat.  Each time he goes he is charged around $300.  Each time they tell him that he has mononucleousis (sp) and send him home without treatment or a shot to ease the pain.  He can not afford to get insurance on his own...his job does not offer it...so he goes to the ER instead of a GP who would most likely find the true cause and treat it properly.  Since he can not afford to pay the roughly $4000 in hospital bills he has accumulated in the past year..the hospital is going to have to recup that money by rasing the cost of everything they do and passing that cost on to you and me ...the insured.

it does not matter if the total figure is 10 million or 100 million un-insured people in this country.... both figures are too high for a country like ours.

Whatever.  You were the one that raised the question.  But a high number of uninsured people (apparently disregarding people who CHOOSE no insurance, are between insuring jobs as I have been from time to time, or are destitute and therefore ALREADY covered by the government) does not mandate a change from a private system to a social system unto itself.

All tax payers have a certian percentage deducted from their pay for Medicare.  No matter how much that person makes each year the total amount deducted can not exceed a set dollar amount.

So you agree that a person making 10k a year is going to pay less into the system than a person making 100k a year.

People who are not offered company paid insurance usually can not afford to pay the amount that the employer pays as well as what would be deducted.

And therefore it’s logical to assume that they also could not afford the level of taxation required to offset the costs the way you claim they would.

That would be the purpose of a single payer system.

Thank you for admitting that a single-payer system would force people to do their health care the way the government tells them to do it.

the hospital is going to have to recup that money by rasing the cost of everything they do and passing that cost on to you and me ...the insured.

THE COST GOES UP FOR EVERYBODY.  NOT ONLY THE INSURED.  IT IS NOT A TIERED SYSTEM.

but I could not afford to go see him if he was to charge me say $80 to visit him.

$80 would be easier to scrape together than $300.  And if he doesn’t have $80 to spend on a doctor’s visit, what makes you think his budget will endure additional taxation?

But a high number of uninsured people (apparently disregarding people who CHOOSE no insurance, are between insuring jobs as I have been from time to time, or are destitute and therefore ALREADY covered by the government) does not mandate a change from a private system to a social system unto itself.

I really wonder if you have a real sense of what it is like to be without insurance or in a low income situation.  Yes there are some people who “chose” to be without insurance.  Most of them are making the choice between paying for their homes or paying for insurance.  Trust me...there is NO choice there… The destitute...are you talking about the un counted people who have no home commonly called homeless?  they can not get into the govt system unless they have a perm address.

So you agree that a person making 10k a year is going to pay less into the system than a person making 100k a year.

Of course I do.  At least that is the way it is for Medicare Tax.  and the way it is for the income tax.  would assume that it would be that way for any other tax we can come up with.  Of course...if every person in this country was in the same risk pool...then I am sure that there would be a fair way to establish what an individual’s portion would be. 

And therefore it’s logical to assume that they also could not afford the level of taxation required to offset the costs the way you claim they would.

Do YOU pay for your entire health insurance costs?  or does your employer pay part?  Could YOU afford to pay the entire amount?  I know that the answers for me would be NO...I can not afford the entire cost of health insurance that is paid on my behalf. 

Thank you for admitting that a single-payer system would force people to do their health care the way the government tells them to do it.

I admit nothing of the sort...but you have your ideas...I have mine...Maybe here is an idea that would work better in your mind...instead of the government taxing each person ...how about the government require that each and every business provide it’s employees a basic health insurance policy that would provide the same benefits that we provide for our members of the House and Senate.  If all working persons in this country were offered a chance to have an affordable policy and that person decided NOT to take the policy ...then they would be on their own…

THE COST GOES UP FOR EVERYBODY.  NOT ONLY THE INSURED.  IT IS NOT A TIERED SYSTEM.

True...very true...as the cost of health care goes up ....it goes up for both the un-insured as well as the insured.  Problem is...it is only the insured that are paying...the un-insured usually just toss the bill from the hospital in the trash.  Wait...I take that back...I should never say anything at all that indicates all members of a group does something...most of the un-insured toss the bill in the trash and never make any payment...hummmm lets see....one million people un-insured make a visit to the hospital.  Average cost of each visit is say $300 ....that means that the hospitals in this country are out $300,000,000.... and there are how many people uninsured in this country??? You pick a figure and do the math...that is what is added on to the cost of insurance that you and I are paying right now...why not try and figure out a way to get them to pay something...even if it is not the same as you pay?

$80 would be easier to scrape together than $300.

if the $300 were deducted from your weekly paycheck it would be easier to pay than trying to get it all at once…

I really wonder if you have a real sense of what it is like to be without insurance or in a low income situation.

Yes.  Guess you should give up on assuming things about other people.  ESPECIALLY WHEN THEY SAY EXACTLY THE OPPOSITE IN THEIR PREVIOUS POST.

Yes there are some people who “chose” to be without insurance.  Most of them are making the choice between paying for their homes or paying for insurance.

Those are not the people I am talking about AND YOU KNOW IT.

The destitute...are you talking about the un counted people who have no home commonly called homeless?

If I meant homeless, I would have said homeless.  By destitute, I meant those whose incomes are low enough that they qualify for Medicaid.  WHICH IS WHY I SAID THEY WERE ALREADY COVERED BY THE GOVERNMENT.

This will go a lot smoother if you respond to the things I say rather than taking something completely different and substituting that for my actual words.

Of course I do.  At least that is the way it is for Medicare Tax.

Therefore their contributions to the paid system will be minimal.  Therefore their contributions will not offset the additional costs the way you claim that they will.  Exactly as I said at the very beginning.

Do YOU pay for your entire health insurance costs?  or does your employer pay part?

Would we pay for the entire socialized system?  Or would the employer pay part?  If the employer pays part, then the cost to the person would logically be no different than the private insurance than they ALREADY cannot afford.  If they have to pay for all of it, then the cost to EVERYONE, including the people you are trying to cover, will be significantly higher, double or triple or more.  Now you are looking at a system that NOBODY can afford to maintain, much less the people who you already acknowledge cannot afford the private coverage.

I admit nothing of the sort…

When I pointed out that we could just send people to the GP instead of the ER, you said that was THE PURPOSE OF a single-payer system.  Behavior modification by force of law.

I should never say anything at all that indicates all members of a group does something...most of the un-insured toss the bill in the trash and never make any payment…

That is still a very callous assumption on your part.

You pick a figure and do the math…

Okay.  I pick yours.  $300 million.  Divided by 250 million insured persons.  $1.20.  Go ahead and multiply it by the full 45 million.  $54.  Four bucks a month to absorb the costs that you are estimating, out of some $250 a month that I pay.  JimK pays like a thousand a month, what do you think four dollars savings means to him?

You’re going to have to look elsewhere for your “rising costs” argument, apparently, as this doesn’t seem to match up.

if the $300 were deducted from your weekly paycheck it would be easier to pay than trying to get it all at once…

If $300 were all one had to pay, of course it would.  What insurance plan do you have that only charges you premiums as a pro-rated amount of the bills you incurred this year?  Do you or do you not have a certain amount due regardless of the level of service you require?

And also, many hospitals AND PRIVATE DOCTORS are very happy to work out payment plans.  I have done it many times myself.

And there’s also this little gem called the State Children’s Health Insurance Program which Congress enacted to provide coverage for children of families making too much to qualify for Medicaid but not enough to afford health insurance.  The point being, there are lots of resources out there that can be expanded, improved, or for those without the proper knowledge, just plain educated, to rein in the system without giving it all over to the federal government.

By destitute, I meant those whose incomes are low enough that they qualify for Medicaid.  WHICH IS WHY I SAID THEY WERE ALREADY COVERED BY THE GOVERNMENT.

but....those people who are covered by Medicaid and Medicare are NOT included in the ranks of the uninsured...they have coverage.  At least that is the way I understand things.  The people who do NOT have insurance coverage in this country are for the most part lower middle class people who are NOT offered insurance as part of their employment benefits.  The rest of the uninsured are unemployed and the homeless. 

you said that was THE PURPOSE OF a single-payer system.  Behavior modification by force of law.

The purpose of a single payer system...as I understand it...is so that everyone can afford to go see the GP when they first get sick...so that people will use the lower priced alternative to the ER.  If everyone had insurance then they could do that..

Okay.  I pick yours.  $300 million.  Divided by 250 million insured persons.  $1.20.  Go ahead and multiply it by the full 45 million.  $54.  Four bucks a month to absorb the costs that you are estimating, out of some $250 a month that I pay.  JimK pays like a thousand a month, what do you think four dollars savings means to him?

You’re going to have to look elsewhere for your “rising costs” argument, apparently, as this doesn’t seem to match up.

Ok...we know there are more than 1 million people in the USA without health insurance...and the argument is about the total number...I will use a different figure of 20 million uninsured which is lower than the 10% you mentioned in an earlier post… 20 million people times $300 is $6,000,000,000 (six billion dollars).  Divided by the 250 million insured equals 24 per month… so you are subsidizing the uninsured thru your premiums… Insurance premiums or tax payments...in the end we still end up paying for those without insurance

And there’s also this little gem called the State Children’s Health Insurance Program which Congress enacted to provide coverage for children of families making too much to qualify for Medicaid but not enough to afford health insurance.  The point being, there are lots of resources out there that can be expanded, improved, or for those without the proper knowledge, just plain educated, to rein in the system without giving it all over to the federal government.

This paragraph I decided needed it’s own post to respond to as I believe based on it that we are actually closer in thought than it might appear. 

CHIP is a wonderful program for the children.  At least for those who’s parents know about it.  Education is key to parents finding out that even though they can not afford to be covered...they can cover their children cheaply.

As far as the rest of the paragraph...for the most part we have a good system...it just needs some tweeking to get it to the point where every citizen of this country can access the system.  I am not sure if the single payer system is what this country needs....what I do know is that discussions like this are a way of pointing out what is wrong with the system and maybe someone of us out there will come up with a way to fix the problems while keeping what is best about things.  It is a shame when a country as rich as ours allows anyone to be denied medical care for any reason.

but....those people who are covered by Medicaid and Medicare are NOT included in the ranks of the uninsured...they have coverage.

That has been my argument from the beginning.  The people who are genuinely impoverished already have a state system of support in place.

Also, since Medicare covers the elderly and disabled, that has no relation to my point about the poor and their ability to afford insurance.

The rest of the uninsured are unemployed and the homeless.

This is simply not accurate.  There is a percentage of people who pay their own way in health care and despite my telling you so repeatedly, you fail to acknowledge this simple fact.  Why?!?

so that people will use the lower priced alternative to the ER.

People can do that without the need to institute a state-sponsored system.  The mere fact that it is priced lower should be enough to drive them towards such an alternative in the first place.  And that says nothing of the Urgent Care facilities or free clinics that polka-dot the nation, or programs like CHIP the government is utilizing to try and cover the gap.

Either way, this notion floating around that people either MUST have a total health care package (public or private) or MUST be left to rot in their homes is a rather grotesque case of a false dichotomy, when there are so many other options and alternatives available.

If everyone had insurance then they could do that..

People already can do that.  A part of my post that you did not bother to quote explains that.

Ok...we know there are more than 1 million people in the USA without health insurance…

Really?  There ARE?!?  Is it even remotely conceivable that might be the reason why I MULTIPLIED IT TIMES FOURTY-FIVE IN MY PREVIOUS POST?!?  JUST MAYBE?!?

I am aghast that you could quote my entire paragraph without paying any attention to it whatsoever.  Meanwhile, you artificially inflate the numbers by swapping out single visits for monthly visits.  It’s bad enough that you give no attention to what I’m trying to say to you, but to be disingenuous in response is beyond the pale.

so you are subsidizing the uninsured thru your premiums… Insurance premiums or tax payments...in the end we still end up paying for those without insurance

For the last time, this is neither an accurate reflection of reality nor is it a 1:1 comparison.  EVERYONE is billed the same amount REGARDLESS OF WHETHER THEY ARE INSURED OR NOT.  I DO NOT GET CHARGED A HIGHER AMOUNT THAN AN UNINSURED PERSON IN ORDER TO COVER THEIR COSTS.

Moreover, assimilating a PORTION OF the costs of a person’s treatment is NOT THE SAME AS assimilating the TOTAL COST of their TOTAL COVERAGE for the year.  Covering the costs of your friend’s ER visit’s IN FULL is still less than it would cost to cover the costs of a health plan equivalent to my own.

Your arguments waver between costs evening out and costs going down, depending on how you want to spin things, but I cannot conceive a single scenario where your theory intersects with reality.

Did Londoner change his name?

EVERYONE is billed the same amount REGARDLESS OF WHETHER THEY ARE INSURED OR NOT.  I DO NOT GET CHARGED A HIGHER AMOUNT THAN AN UNINSURED PERSON IN ORDER TO COVER THEIR COSTS.

I think I get Mgmlnewolfs point here w0rf. Yes the prices go up for everyone, but that only affects those who are actually planning on paying.

Say you and Buzz are insured, and I am not and broke. I go to the hospital, and they charge me a grand. I don’t pay, so the hospital has to up their prices. Now in order to cover these higher prices, the insurance premiums go up. This doesn’t affect me, however, as I don’t pay insurance premiums - and you and Buzz are left paying more.

Serious question - what are the repercussions for someone refusing to pay their medical costs? A day in court?

I do agree that the health care systems needs to be improved.  The on thing that no one has mentioned is that there is free health care in the U.S. its called medicade (I think I spelled it right).  I think that before starting a whole new system, we should try to fix what is already in place.

This is a system that if you know how to work it, you can live off it, but if you are working and trying to make a living, but still need help you cannot get the help if you make say $40 to much a year. 

I personally think the private health care should be left alone right now and the public health care should be fixed.

I think I get Mgmlnewolfs point here w0rf. Yes the prices go up for everyone, but that only affects those who are actually planning on paying.

It also separates people into a false dichotomy of those who have insurance and those who do not pay anything at all for treatment.  There are insured persons who are late or even default on their co-insurance.  There are people without insurance who set up payment plans with doctors to pay the bill over time.  There are people who are financially secure to the point where they elect to pay all of their bills out of pocket.  To say that insurance premiums go up to cover the cost of the uninsured is simply not an accurate statement.  There is a measure of truth to it, if you drill down two or three levels, but INSURANCE only covers the INSURED.  The issue lies at the COST OF CARE, not the cost of coverage, and the cost of care impacts EVERYBODY.  Unless you want to claim that if the cost of a GP visit dropped to $20 tomorrow, the uninsured still would not pay the $20 just because they are uninsured.

Rosh:
The on thing that no one has mentioned is that there is free health care in the U.S. its called medicade

No one has mentioned Medicaid?  Are you absolutely certain of that?