I can't wrap my mind around how we will pay for it. I hope he's got economists working for him who can figure it out. HUGE EDIT: OK... so... I think my short comment may have been taken out of context. I was simply admitting that I don't understand how he is going to pay for it. And my hope for him having economists smart enough to figure out is a genuine hope. I also hope his cabinet and staff will be effective in getting congress to act. I hope people at his rallies will unite and DEMAND this kind of change from their representatives. His message is super empowering. Our system is totally TOTALLY jacked up. I've commented and posted on this before. I hate our healthcare system so much. SO much.
There's lots more where that came from. It isn't hard to figure out where Sanders would "pay for it" so long as you take as a given that he'd tax the fuck out of the wealthy. "Taxing the fuck out of the wealthy" has been the ultimate 3rd rail in American politics since Eisenhower, effectively, so it's borderline unthinkable, but it's an idea whose time has come. Here's another fun game - see if you can deal with the oh-shit-impossible budget crisis we face regularly while also, I dunno, making things suck less for students. It ain't at all hard if you abide by a few simple maxims: (1) raise taxes on the wealthy (2) cut defense spending. Wanna see my mind-breaker? That's a Delta IV Heavy. It's launching from SLC-6 at Vandenberg. It has a spy satellite on it that was put up for the specific purpose of spying on bin Laden's Abbotabad compound ahead of a Delta raid to cap his ass. You'll notice that there's nobody on the beach (there were actually maybe 30 of us) and it didn't make the news. Robert Byrd railed against this launch because... well, take it, Wiki: So the first thing is fuckin' $6.35 BILLION dollars for a satellite we've been launching since 1976. The next thing is that when Congress whined about it, the budget went down by 2 BILLION dollars and 2 YEARS. The next thing is that $6b is a cheap-ass aircraft carrier these days as the one we just built is $13 BILLION DOLLARS. The final thing is why the fuck are we building aircraft carriers? You live in a country where four billion dollar satellites are put into the sky so that government hit squads can execute illegal assassinations and it doesn't even make the news. You live in a country where we're gobsmacked by the notion of providing healthcare for everyone, but bow to the inevitable purchase of $1.5 trillion dollars worth of fighters that nobody wants. We've got a socialist running for president. I say let the fucker kill a few sacred cows.
After the failure of the Boeing led Future Imagery Architecture program in 2005, NRO ordered two additional legacy hardware KH-11s. Critics of the decision voiced concerns that each "exquisite-class" satellite would cost more than the latest Nimitz class aircraft carrier (CVN-77)[2] with its projected procurement cost of US$ 6.35 billion as of May 2005.[3] USA-224 - the first of these two - was completed by Lockheed US $ 2 billion under the initial budget estimate, and two years ahead of schedule.
True dat. Because I felt like it, I can now tell you that the Maginot Line cost $44 billion in 2016 dollars. So - one country-wide series of fortifications and trenches or three modern aircraft carriers. or 22 stealth bombers. I wonder what that is in Albanian mushrooms.
And of the top five countries on those lists, we are first, then two of our allies, then China, then another ally. Of the top 15, all but two are NATO or SEATO countries. $13 Billion for a super aircraft carrier that has no real defense against ballistic missile attack, and the only two global enemies we have, China and Russia, have well developed missile techs.
I still get so.. overwhelmed when I realize how hard obtaining medical treatment it can be for people in USA. Let's say, here in NZ - I damage my knee playing Rugby. It's an accident, no previous history with knee injuries, and I've torn my meniscus. The government funded scheme would cover my Ultrasounds, eventual MRI, surgeon meetings, the surgery itself and all the Physio/rehab required until I am fully fit and back at work. The same scheme will also cover my wages/salary while I'm off work (at 80% of my normal pay). I mean, they'll even cover taxi rides to and from appointments if I live alone or am otherwise unable to get transport for myself. My Dr visits at most cost me $30 (much less for students, children and the elderly), I dunno what the dental care funding is like there but mine was free until I turned 18 - prescriptions are no more than 5$ for 6 months of antidepressants, or things like Omeprazole. Shit if I needed ambulance transport in an emergency the most I would be charged for is bang on $88 dollars. It's scary to think there are people out there who literally have to stay sick or injured so they can afford the rent, and food, and heating.
When this happened: A few months later we were given a $500 bill for the ambulance ride. Luckily with some finagling and a consult with an attorney friend of ours, we were able to get it waived. But this is because we are educated and know attorneys that could help us craft the letter. Imagine being poor and getting that bill. $500 is a lot of money to many people. The system sucks. It makes no sense.
Fuuuuuck me that is nasty. You had to seek legal advice because your child arrived and an ambulance was required. I'm sorry you had to deal with all of that. There are some issues within NZ, like any country, but these stories make me very thankful to be in a country that bends over backwards to make healthcare easier for it's people. I just remembered something - that govt scheme I was talking about? That applies to people who aren't NZ citizens. If you're in NZ, on a working holiday VISA or similar and are earning/paying tax - you're eligible for cover. You can come here to travel, work in a fruit orchard for a bit of cash, get injured and we will patch you up and cover you until you're ready to go back to work/travel. It blow's tourists and immigrants minds alike and it's something I totally take for granted.
Just to be clear - this accidental-injury coverage (it's called ACC) applies to everyone in NZ - including tourists and illegal overstayers. Everyone.
No need to apologise! I became a big fan of ACC when my son broke his neck a few years back. They covered everything including 80% of his salary for the three months or so he was in a halo vest. Without that support, he would have been financially ruined; instead, he didn't even lose his job.
Dang dude... $500 for an ambulance is cheap! I know a guy who got three bills for one ride: $850 for the ambulance ride (less than 3 miles), $280 for the paramedics, and $125 for dispatch service or some such thing. This is a guy in his 70s who is on medicare... it's insane.
You would be surprised how much we pay for healthcare, and things like that. You would also be surprised by how little the highest percent pays in actual taxes. Klein pointed it out to me a few days ago in regards to why there were so few Americans caught up in the Panama Papers debacle. There is money, it's just not being used effectively.
It's not just that. I'm in mobile so I can't dig up links right now, but the US brings in an ass load of money still. We just often make horrible decisions on how to spend it. To make matters worse, there's a lot of grey area on how we spend our money as well, where in some instances it's clearly beneficial to spend money in one situation, but a similar situation is nothing but a money pit.
edit: sorry steve, I got mad. It's not your fault. before Obamacare, when it was "still an Issue", somebody did the math, and you guys actually paid MORE in taxes for healthcare PER PERSON at that time than I did in Canada, and received nothing in return in terms of access or affordability. Do you know what going to a doctor looks like for me if I'm sick? I go to a walk-in clinic, I present my health card, I wait, I see a doctor. If I'm sick enough, I get a script, or a referral to a specialist, or whatever. No money changes hands, because I already paid for it in my taxes, just like you do - Except you don't have the same accessibility that I do. I was just down in OH, and the friend I was staying with was feeling ill. "Go to the doc", I said. "I don't have the money for that", He said. That shit is FUCKED RIGHT UP. you guys live in a country that has incredible wealth not only in resources and money, but in people, and you can't even get your shit together enough to say "if somebody's sick, they should be able to see a doctor without worrying about next month's rent. If somebody's sick, they should be able to take a day off without fear of being fired via 'at will employment'." I mean, if someone is sick and on the job, that shit is a health and safety issue - that's how disease spreads, by some sick dude in a restaurant touching your flatware, which you touch, then touch your face, and then YOU get sick. I have a lot of American friends, and i love them, but your country is so god damn fucked up and your collective consciousness is so broken that it actually makes me upset to think about. My country is not perfect, it is not "the greatest country in the world", it is not even close - but at least it feels like we're trying.
ADVENTURES IN MEDICAID: A TALE IN THREE PARTS 1: The Customer So we know a midwife. She has two kids and a stay-at-home husband since she works about 60 hours a week. She makes enough to provide a middle-class living for her family and pay a mortgage a good hour's commute from where she works. She doesn't make enough to provide insurance for her family of four, however; I don't know what rates they were offered but my Obamacare insurance for a family of 3 was $800/mo for catastrophic with a $10,000 deductible. Her stay-at-home husband recently came down with - wait for it - Stage 2 Lymphoma. Let's assume for the sake of argument he's a mass murderer who doesn't recycle - his presence in her household allows her to work and contribute to the economy so it makes sense to try and keep him alive regardless of his personal merits. Let's also assume for the sake of argument that she pays taxes so keeping her working is beneficial in the long run because she puts money back in the system. But let's also assume for the sake of argument that keeping a father alive and his family solvent is good for the long-term fabric of society so yeah - maybe we oughtta try and treat his cancer despite the fact that the cheapskates didn't protect themselves. Unfortunately she makes too much money to qualify for medicaid, and she doesn't make enough to afford insurance, and her husband has cancer. So the move recommended to her by state-funded social workers was to quit her job, stop seeing patients and drop below the poverty line in order to qualify for state aid. So. How 'bout a couple rounds of chemo with a side of food stamps? Because that's the structure we have right now: if you're earning a living, you're not earning healthcare and we'll take away your healthcare if you try to earn a living. 2: The Provider So we're going to take medicaid at the birth center. Right now, the state program pays approximately 20% of our costs for a birth, and that's assuming the birth happens at the birth center (statistically speaking, about a 75-80% likelihood). If the mom transports, the fees paid by the state cover about 5% of our expenses. It makes zero sense for us to take state money but good of the community, helping out those that can't help themselves, warm fuzzies, whatever. My wife was the only midwife we knew of that successfully navigated California's byzantine medical codes to actually get reimbursed by the state for home births, so why not? Doesn't matter what it costs to cover a home birth. Let's call it a buck. The state right now is paying 20 cents. There are a couple companies negotiating with all the midwives to carry that contract for the state; they're offering a 12% increase over the current rate of 20 cents, bringing things all the way up to a whopping 22 cents! Sign the deal, right? Except we know for a fact that the same companies pay two dollars in Oregon. And we know for a fact they pay eight dollars in New York. And we know for a fact that the cost of delivering a baby in all three states is effectively the same. But we know that calling around to everybody saying "don't take the deal" is collusion and a violation of everyone's contract with Medicaid. But we also know that some of the contracts that have already been signed don't show a 12% increase; they show a 20% DECREASE. 3. The insurer So the government has X money and it's up for bid. For that bid, you provide all the health coverage that all of the state's clients "need." Those "needs" are dictated not by doctors but by elected officials whose decisions are assisted by appointees and lobbyists. The money on the table is there to cover a select population whose boundaries are also determined by elected officials, whose decisions are assisted by appointees and lobbyists. In order to raise money, you need to raise taxes somewhere. And in order to spend money, well - really. Companies like Valeant are taking your generics and making them brand-name again. At a federal level you've been banned from negotiating prices. And your budget is good for a year, and you bid on that year. Yet here you have these fucking midwives who are literally throwing a price increase in your face because for some dumb reason they think they're entitled to some crazy number that some other state legislature saddled you with. And here you have social workers actually advising people who could have bought insurance but didn't to quit their jobs so that their healthcare has to come out of your budget. And you're the bad guy. ________________________________________________________________ I could go on - the pharmaceutical company is jacking prices because it's got shareholders to keep happy and the market is shorting its stock and it's getting killed in Europe where subsidies allow its competitors to crush it. The shareholders are trying to earn enough money to pay for their retirements which is becoming impossible because the HFT firms have arbitraged all the beta out of the market. The HFT firms are trying to eke out a living on the crumbs left over from the giant banks, who do most of their work in dark pools, and the giant banks... well, actually, fuck the giant banks. The real problem is that the closer you get to the human, the easier it is to be human and the further away, the less sympathy you have. The higher your view, the more you see corporations and profits and the less you see the people whose lives matter. All the way through, though, it's money money money money money and it comes from the simple fact that if we value people's health, we shouldn't make them pay to keep it, particularly when the playing field is anything but level. I used to pay $800/mo for $10k deductible catastrophic for my family of 3. No pre-existing conditions, hearty and hale, all of us healthy as fuck. Then I got my hours in the Union and now I pay $600 a year for $0 deductible comprehensive for my family of 3. Should my family grow to four, that number goes up by $50. The lotion for my kid's eczema? Went from $200 a bottle to $4. Same bottle. Same kid. Same pharmacy, same doctor, same prescription. What we got now is marginally better than what we had (I had no insurance between 2004 and 2009 because there was no law requiring insurance companies to sell private-carrier insurance in Washington; you either got it through work or you straight-up didn't get it at all). It's a long damn road from acceptable though. It is so god damn fucked up and our collective consciousness is so broken that it's upsetting to think about. But the thing that people forget is it's fucked up all the way through. By determining that market forces should determine national health, we are forcefully unhealthy. Nationally.
Every time I read this, I think we should open up Medicare/Medicaid for all businesses that have under 20 employees. You don;'t need HR, Don't need to hire anyone, just pay 1% of payroll, done. Maybe offer a better plan with no deductible or something, but keep it as simple as "Oh, you work for us now, here is health insurance." When those small businessmen hit their 21st employee and see how shit the system really is, they will start getting pissed and when the elected criters come by for campaign cash they will get an earful. This is exactly why the medical lobby dropped a half-a-freaking-billion on lobbying efforts to keep this out of the public discourse.
And this is why I'm terrified to graduate from college, where I'm almost positive my mom's health insurance will not cover me anymore. I work as a clerk at a pharmacy, and you really get some insight into how ROYALLY fucked the system is. The pharmaceuticals companies are literally the mafia.
My wife keeps wanting to take Medicaid at her practice and I always have to remind her that we have kids to feed and its wrong to enable a broken system. It would actually make more sense for her to perform the service for free (if it could be written off her taxes) than it would be for her to try to collect from Medicaid. Medicaid reimburses $40/hr and that doesn't include any paperwork time even Medcare reimburses at $120 and that's really low.
I acknowledge your larger point, but this is probably exactly what the social worker should have advised. Our social services are a lot like our legal system, we've arranged for them not to try for desirable outcomes by design but through conflict. Programs are designed and administered by accountants and business school types who prioritize minimizing the amount of money they have to spend, and we depend on caseworkers subverting their efforts in order to actually get people the services they need. I don't know if it's possible to do otherwise in America, since a majority of our legislators think business administration is the ideal model for governing. I know that it means good social workers have to be the most benevolent kind of shady.So the move recommended to her by state-funded social workers was to quit her job, stop seeing patients and drop below the poverty line in order to qualify for state aid
It was exactly the right advice. She took it. My wife is currently covering her practice. The whole family went off and took portraits the day after chemo because hey - it might very well be the healthiest he'll ever be, ever again. They posted that shit on Facebook. F'n heartbreaking. For even more incestuous fun, the social workers that advised them are former coworkers of my ex-girlfriend the social worker at the hospital she used to work at. I probably know a few of 'em. My larger point is that even our non-profit healthcare is run for-profit in a profit-driven environment and you're right - "the most benevolent kind of shady" might as well be the tagline of the entire social welfare industry.
Thank you sp00ns. We Americans have our head so far up our asses we are critiquing the inner folds of our colon, without noticing the stream of shit we are swimming in. And we all know what the problem is... an uninformed electorate, because the media have abdicated their Fourth Estate role and become The Real World, because their corporate backers know this keeps eyeballs on the screen, so advertising can be sold, so people will buy more useless shit. Let's take ONE of those aircraft carriers of cash and ... well fuck. I don't even know who to give it to, who can even begin to address the issue illiteracy of our electorate.
Thanks for the apology - but completely unnecessary... funny how one little comment in the early hours of a saturday morning in bed can cause a ruckus. I think that we agree 100% here. I can't explain enough how done I am with healthcare in this country. I could tell stories... I could give figures... but I think kleinbl00 has put it more eloquently than I could have. US healthcare is so far past broken that it's a miracle that it isn't agreed upon across the aisle. I just know that I pay so much it hurts.... and I get really sub par service... that I'm often afraid to use because I can't afford it. There's a guy at church I'm working with. We literally had this discussion yesterday - except - instead of a cold or flu - it was an INJURED BACK ON THE F&%KING JOB AND WAS FIRED FOR MISSING WORK BECAUSE OF HIS INJURED BACK. It's mind boggling... but legal for a company to jump through the right hoops and fire some one after the company has broken them for life.edit: sorry steve, I got mad. It's not your fault.
If somebody's sick, they should be able to take a day off without fear of being fired via 'at will employment'." I mean, if someone is sick and on the job, that shit is a health and safety issue - that's how disease spreads, by some sick dude in a restaurant touching your flatware, which you touch, then touch your face, and then YOU get sick.
FUN FACT: if you have less than 8 employees you aren't required to abide by really any of the workplace regs that we have anyway. So whatever safety net you might have with a big company, it's entirely f'n absent from a small one. Which makes sense: the regs we got are pretty damn onerous on a small company (you have three employees and they all need to be provided healthcare and 2 weeks paid vacation? Yeah, that's why you have one employee and always will). But also makes no goddamn sense - the regs we got are supposed to allow people to survive, not thrive, and if we're really about backing small business, it probably shouldn't be demonstrably perilous to work for one.