How do you think we would fare in a global epidemic, being the only country without Single Payer?

[librechik]

I don't think it will happen with ebola, but I think it would be a cosmic nightmare. People avoiding treatment because they have no insurance. People getting sent home with no insurance. Reporting victims would be hobbled due to the many private options, and poor communications.

God knows what else would happen since we have no national health service.

[Dr Hobbitstein]

1. We're not the only country without single payer...

With that said, however, I think DHHS would probably step up and institute a program. Either that or it's Vegas vs Boulder Free Zone.

[SidDithers]

7. Awesome Stand reference...

Sid

[longship]

53. Hopefully without the religion allusions.

But nevertheless, well played.



Cibola! My life for you!

[workinclasszero]

56. Either that or it's Vegas vs Boulder Free Zone.

There you go Steven

[RKP5637]

2. Being as how the US seems to sink lower and lower to benefit the 1%, we would not fare

very well in this country. The lack of Single Payer is unbelievable. America, collectively, is a very stupid country.

[jberryhill]

3. When did every other country become single payer?

[YarnAddict]

4. People do not get turned away because they have no insurance

Every single ER waiting room has signs (in multiple languages) stating that they will not be refused treatment based on ability to pay.

Besides, now under the ACA, the assumption has to be that everyone has insurance. That was the point of the law.

[JEB]

10. I have insurance. I just can't afford to use it.

$12,000 out of pocket max each year. Flu symptoms, I'm riding it out on my own.

[YarnAddict]

11. If you were sick enough, you would use it

Besides the assumption in the OP was that people would be turned away with no treatment if they didn't have insurance. False.

[JEB]

17. I have no idea if people are turned away.

I think many people, myself included, choose to stay away because of cost and fear of catching disease in hospitals.

[YarnAddict]

21. Take my word for it. They're not turned away.

I think fear of catching something is a great reason to avoid hospitals. The cost is prohibitive, which can be a not-too-bad thing.

Many, many years ago, we had this fantastic health insurance plan. It paid literally everything, with no deductible, no co-pay, and very minimal payments. I think less than $10/paycheck.

During a year in which I had three surgeries, five rounds of chemotherapy, six weeks of radiation, an infinite number of doctor visits, a pregnancy and birth, and well-child exams for my older child, we paid $10, because I had forgotten to bring slippers to the hospital for my surgery and we had to buy the hospital slippers.

BUT--because there was so little out-of-pocket, people abused it. A co-worker took her constipated toddler to the ER once. Someone else had a sliver and went to the ER to have a doc dig it out. No one thought twice about home remedies, or waiting til office hours to see a doc, or anything else that would minimize the cost. Within a very short time, the premiums went up, coverage went down, I believe deductibles may have been instituted, and within a couple of years that coverage ceased to exist. No wonder!

Personally, I believe that everyone should have to pay something to access care, just to make people decide if it is really necessary.

[JEB]

22. Glad to know people are not turned away.

I use the computer to treat myself, but most of my problems even though I am almost 63 are relatively minor. I wish I could find a vet or underground person to fix my hernia.

[YarnAddict]

23. Lucky you

At 29 I thought I was invincible. At 30 I found out I was not.

[JEB]

31. I think I've always known I'm not invincible.

Yes, I am lucky and I try to take care of myself.

[treestar]

14. Go to the exchange

You can do a lot better than that.

[JEB]

16. Been there, here in Oregon. I took the least expensive option

as that is best for us.

[99Forever]

18. Pardon me, BUT...

... I have no idea where your got your "insurance" from, but "$12,000 out of pocket max each year" is about double what the ACA allows by law, so I have to wonder if your "policy" qualifies for the terms of the ACA.

My Bronze level policy is capped at $6200 a year which is very close to the max. Even that is so high that I can't afford to use it, so basically, my premiums are little more than wasted expenses for me. I would be in better shape for a catastrophic illness or accident, but for real life stuff, it hurts more than helps. Hey, but the fucking insurance execs are getting theirs, so I guess it's all good.

[JEB]

19. I don't know the fine points of the law, but

got the insurance through Cover Oregon. For me and my wife it's $7 hundred something a month. Just got a letter saying it will be $8 hundred something per month next year. Money down the insurance rat hole. Kind of like our tax dollars down the Middle East rat hole. I see no pay off from either.

[99Forever]

20. Perhaps the $12,000...

... figure is the deductible of both of you combined. I totally agree about the money going down the insurance rathole. The scam continues.

[Tuesday Afternoon]

48. My bronze level capped at 5K, a little bit better but, still too high to be any good plus I lost my

on my prescription plan so it is actually costing me more per month than before.

I am glad about ACA for those who didn't have it but, the insurance companies really screwed us. I hope we get single payer and soon.

[Recursion]

61. what do you think the deductible for national single payer would be?

People seem to assume it would be zero, without any argument why.

What about the premiums? Medicare premiums right now are about $1k per month.

[UglyGreed]

26. LOL

If I went to the doctor as much as I needed to my family would be homeless, and we have insurance.

[merrily]

33. That was what John McCain stressed. However, the fact that you

are not turned away does not mean you will not get dunned to pay for years to come.

[Paper Roses]

51. My thoughts exactly. Sure they will treat you. THEN

you get the bill in the mail...what a bunch of hogwash. Trillions for war, nothing much for those at home. Have any assets? They will have to be sold if your resources and insurance are not sufficient. Then what? On the streets, that's what.

[jwirr]

37. No they do not get turned away but the poor without insurance do not go into the emergency room

on the first sign of illness. They wait to see if it will get better on its own. During that time more people would be exposed in an epidemic. Not good.

[stevenleser]

5. We would fare quite well.

If you are focusing on the insurance infrastructure, the amount of uninsured has gotten significantly lower with ACA. In terms of the planning, there are emergency contingency plans at the CDC and FEMA that would kick in and provide emergency funding and all other kinds of resources and organization.

http://www.cdc.gov/phpr/documents/Lancet_Article_Sept2011.pdf

http://www.cdc.gov/phpr/pubs-links/2010/download.htm

The national guard would likely be mobilized, various military bases would be set up as expanded hospitals and quarantine areas.

This doesn't worry me so much in terms of health infrastructure and an NHS wouldn't offer much improvement over what we have in terms of an epidemic.

[SickOfTheOnePct]

8. Agree completely on all counts

We would see federalization/mobilization of National Guard across the country, and military bases would become quarantine and treatment centers. Civil aviation would be mobilized via their contracts with the federal government to transport people to available quarantine centers, and anyone exhibiting symptoms would be treated.

Playing devil's advocate, if one discounts the idea of doing the right thing for the greater good,i.e., turning people away because they can't pay, self preservation would still kick in to ensure people are treated.

If you're a nurse, doctor or hospital administrator, do you really want to send people with ebola back into the general population where your family lives, where your children go to school, where you shop for groceries, etc? That's practically a guarantee that eventually, your family will be affected.

And while U.S. treatment protocols are thus far 100% successful in the U.S., that's still a big chance to take, IMO.

[kestrel91316]

25. Republicans would block all that, you do realize?

[SickOfTheOnePct]

32. And how do you believe they could they block it n/t

[kestrel91316]

43. By not funding it. By not passing the necessary legislation to accomplish it.

[SickOfTheOnePct]

47. There is no legislation required to federalize the national guard

As for funding to stand up options on military bases, it would be a matter of O & M money around, which is not something that Congress has a hand in at the base level.

It would be incredibly difficult for Congress to stop these types of operations, both from a legislative and political perspective. It would be political suicide for any Congressman of any party to try to halt operations that are being undertaken to contain an epidemic.

[brooklynite]

6. Except that most people DO have Insurance...

...and always have. One of the challenges of passing ACA was getting people to focus on the needs of others.

[B2G]

9. If ebola becomes an epidemic here

Our insurance system won't make a bit of difference.

That will be the least of our worries.

[FLPanhandle]

12. If there ever is extremely deadly global pandemic, insurance or single payer won't matter

Hospitals and health centers would be overwhelmed. Insurance or not, single payer or not.

In 1918, doctors and nurses were some of the early victims, same for another pandemic.

[librechik]

45. i fear you are right. Even now the early victims in W Africa were caregivers

[Recursion]

13. A lot of countries don't have single payer. Swiss voters just rejected moving to it

Germany doesn't have single payer, nor the Netherlands. The UK doesn't have single payer in the strictest sense. France has something of a hybrid system. Actually Canada is kind of alone in an explicit Medicare-style single payer system; most either have a regulated private insurance system like we're moving to, or government-run providers like the UK (which is single operator, not single payer as it's usually meant).

Honestly I wish activists hadn't gotten fixated on the specific phrase "single payer" 4 years ago. For one, it never polled well. For another thing, it's only one of many ways to get to our goal of universal health care access.

[merrily]

34. Medicare for all would have polled a lot better, esp. if Obama hadn't

totally mischaracterized it (and the Post Office) by scoffingly comparing Medicare to the Post Office.

[Crunchy Frog]

49. They do have universal coverage, though.

[Recursion]

62. True. Though Canada does it by province

And in some provinces you can lose your coverage for not making the premium payments, so even that isn't strictly "universal".

[eridani]

54. Britain has socialized medicine, like our VA system

Germany and the Netherlands have non-profit insurers that are tightly regulated by the government. In France, the health care system is entirely controlled by the government. However, there are 30% co-pays, and strictly regulated private insurers take care of that for those not poor enough to have that cost waived.

[Recursion]

63. Right. My point was those aren't "single payer"

Even in Canada it's not a national single payer system; the provinces are responsible. I wish Baucus's idea of statewide co-ops had gotten more traction.

[eridani]

64. The US is much like Canada in that states have a lot of independent power, just like provinces

That's why I think single payer would work better here, though there are many ways to real universal health care--as in "Everybody in; nobody out."

[treestar]

15. I don't think insurance would matter

there is likely some program the CDC would operate under. The fact it is danger to others would trump the concept of whether the individual can pay for treatment or not.

Interesting, even republicans would have to admit paying for someone else's treatment would be in their own interests.

[kestrel91316]

24. Very poorly. The only possible good to come out of it would be

the likelihood that anti-science folks and Ebola seriousness deniers might be a lot less common in the population when the dust settles.

[Dreamer Tatum]

28. That opinion is highly crazy, in my opinion. nt

[kestrel91316]

41. More's the pity that you can't recognize facetiousness or hyperbole.

[valerief]

27. "Don't worry. We got this." The media would handle it fine.

Actual handling of the problem? "Move along, folks. Nothing to see."

See? That's how it works.

[ZombieHorde]

29. Yeah, those who don't want their communities destroyed by disease

have reason to support some sort of socialized health care system.

[branford]

59. Be careful what you wish for.

Unfortunately, the "socialized medicine" that would result in treating a serious, nationwide outbreak of a terminal disease would be FEMA-like camps run by the CDC where patients are rounded-up and guarded by the National Guard, and quite possibly, regular army troops operating on US soil.

I'm confident that identification, treatment, security and disposal would be organized, efficient and absolutely terrifying, well apart from the disease itself.

On a more positive note, the support for such a draconian and authoritarian (and likely necessary) response would probably be bipartisan and wildy popular.

However, after the dust has settled, just like after 9-11, people will be comfortable giving up certain liberties for security, and the damage to our economy and reduced revenues would make real socialized health care all the more politically difficult to pass and implement.

[librechik]

65. yes, this is because since we have no national health service, we can only mobilize military.

It's long past time we did soothing about that instead of making medicine for profit the law of the land.

[enid602]

30. single payer

The only two countries in the world with single payer are the UK snd Canada. The largest somgle payer in tje eorld is Medicare.

[SickOfTheOnePct]

35. The UK is technically not single payer

It's nationalized healthcare, where providers are employees of the government.

Big difference.

[subterranean]

52. Those are not the only two.

Taiwan and the Scandinavian countries also have single-payer systems. And Australia has single payer supplemented with private insurance.

[ThoughtCriminal]

36. People going to work with a fever

Because they have no sick time, can't afford to miss work and worry that that they may lose their job if they call in sick.

And then there's the whole, "Suck it up", "Work ethic", "No slackers here", "Keeps you going" over-the counter marketing attitude that we are so proud of.

[CullenBohannon]

38. screwed either way

If the gov't doesn't get a handle on this quick it will be like a sci-fi horror movie. What were they doing the last few months when this was starting?

[UglyGreed]

39. No worries

Last edited Sun Oct 5, 2014, 05:24 PM - Edit history (1)

just look how well we handled AIDS in the very beginning.

[SheilaT]

40. In the face of a global epidemic of some

very deadly and easily transmissible disease, what kind of health care system any country has will not matter at all.

Two problems underlie this. One is that Public Health systems everywhere have been systematically underfunded and partially dismantled in the last few decades. Laurie Garrett's excellent book, Betrayal of Trust, which came out in 2000 describes that problem quite well. And things have not improved in the decade and a half since then.

The other is that many hospitals are chronically short-staffed. It's partly a problem of deliberate policy on the part of hospital administration to staff as if it's a retail store and it doesn't really matter if patients then wait an extra fifteen minutes or six hours for treatment. It's also a problem of a very real shortage of nurses. There just aren't enough of them out there in the first place. So for many reasons hospitals are rarely fully staffed, which means among other things a lot of the people there are working overtime to fill in for the missing staff. And even if they had a full complement of nurses and such, they are still staffed at as minimal a level as the hospital can get away with. Right now the one and only hospital here in Santa Fe is engaged in a struggle with the nurses' union over the staffing issue, and it's ugly.

It will be even uglier if some sort of terrible epidemic breaks out, and people don't die quickly but can survive if given the right kind of care. It wouldn't take much to totally overwhelm this -- or any -- hospital's capacity to do so.

[area51]

42. I think perhaps the point is being missed

that with our current patchwork health care system, we have people going to the ER as the doctor of last resort because they can't turn anyone away.

I'm wondering if the fact that the Dallas ER was probably very busy, instead of relatively empty, played a part in not enough time being spent with the patient and him being sent home.

GingrichCare won't solve this.

[librechik]

44. more importantly, Duncan arrived at the ER with symptoms. That means he was contagious.

So i hope they did something about that…

[hughee99]

46. In a global epidemic, the federal governement

would pour hundreds of billions directly into big pharma's hands to make sure everyone gets treatment. When it comes to medicine, the drugs will go to the country that's willing to pay the most and that country will be the US.

[stevenleser]

50. Exactly. I'm more worried about people dying everyday in one-offs. In a big catastrophe, the

government would get involved and everyone would get care. This is the situation where our system and its issues would matter the least.

[workinclasszero]

55. I have no health insurance

Hope I don't come down with any infectious disease. I don't know of any hospital or doctor willing to treat me for free.

Hell I'm a vet and the VA said I make too much money for them to help me....remember that all you vets for future reference.

That was before I lost my job so maybe the VA would do something now, assholes.

With the joke that this country calls a healthcare system I fully expect to see terrible infectious diseases running unchecked and unstoppable throughout the country soon.

I just thank Ayn Rand on my knees that we don't have a dirty socialist healthcare system in Merrca like those godless commies in europe!

Imagine free healthcare for all!? And now free university education as well! Rotten commie bastards!

[Recursion]

66. Well, yes, if you lost your job you should tell the VA to reassess

Though if you're making 0 the exchange plan for you costs 0, so you might not need the VA.

[workinclasszero]

57. What good is your health ins when you cant afford the deducible??

When I had a good job with health insurance the deducible was 4000 dollars a year. Which I could not pay of course.

So I would get check ups and have my damn doctor insist that I go get procedures done that cost thousands out of my pocket that I didn't have. So I didn't get those procedures done and my doc would get pissed.

They have no idea how the average American lives anymore. I tried to educate her on the facts of my life but nope she wouldn't listen.

I worked in a job where you were not allowed to be behind on any debt greater than 5000 bucks or you would be automatically fired.

No bankruptcy allowed either. We cant win people. Capitalists will kill us all in a ditch with no shelter no jobs no food and thanking "jesus" all the way!

[Recursion]

58. You're joking, right? The good is...

... that you end up owing $4000, rather than $175, 000.

[branford]

60. Exactly.

The PPACA certainly does not cure all ills in our healthcare system. However, it certainly is a significant improvement from before, and even then, people seem to forget that it passed with the slimmest possible margins with Democrats in control of the presidency and both houses of Congress and still polls badly today.

I've never understood why the perfect is always the enemy of the good.