Victim of Crime Healthcare Compensation

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[Philly]

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[Philly]

Phosphide, I have to question the thoroughness of your claim about medical bankruptcy. I don't doubt that people who go bankrupt due to health problems often lose their jobs. But you also aren't likely to permanently leave your job because you needed a day or two in the hospital. Losing your job means long term health issues, which in turn means lots of medical care and/or procedures. So even if your job is cool with you being out on medical leave for months at a time, you have another issue here. You're absolutely right that people with insurance go broke paying the out of pocket costs, but that brings us to another huge flaw in our current insurance system...

Note the term I've been using to describe people who are going to have trouble paying their medical bills is "under-insured". I am using that as a catch all for people who have no insurance at all as well as people who have the plans on the most basic end of the ACA mandate. The reason I am using them interchangeably is because we are having a discussion about people needing major attention and lots of work, in which case these basic plans are only a small notch better than having no insurance at all. Obamacare has expanded coverage access to many people, which is a good deal for them if they only need to go for basic checkups with a family doctor and occasionally get some antibiotics for a mild sinus infection. But if you find yourself in need of extensive care from hospital staff and specialists and surgeons, that basic ACA plan is total shit. One really good thing about the ACA is that it makes preventative care a lot easier for people who previously just couldn't go to any doctor until they needed the ER, but in the case of being seriously injured, it leaves you in the same bind.

So unless you're affluent and bought a premium plan, or you're lucky enough to have an employer that offers good coverage, your insurance is gonna let you down when you need it the most. Democrats keep saying that Obamacare is almost where it needs to be and that they just need to apply a couple fixes to expand access to the small percent who aren't yet able to get on a plan. What we're eventually going to have to acknowledge as a country is that Obamacare focused on access instead of cost, meaning that lots of people still can't afford their hospital bills because the affordable, accessible plans that they made available are too cheap to cover serious medical expenses. This leaves us with much of the same dilemma we had before Obamacare: if you're not rich and your employer doesn't voluntarily offer you good insurance, a medical emergency could be financially ruinous to you.

What we need is single payer that provides universal coverage for what is truly reasonable and a medical necessity. Then allow for supplemental plans to cover things that most Americans would want included but could live without. So if you get into a car crash and need surgery plus a 2 weeks recovery time in the hospital, you're not paying your life savings in the out of pocket. If you got a scar on your forehead from the crash and you want a plastic surgeon to put 150 stitches in to make it less noticeable, that's for the supplemental plan. To make this work we also need to try some of the approaches other countries have with regards to things like pharmaceuticals and let's face it, hospitals have legit high overhead costs, but some of the things they charge people for are just gouging, which we'll have to put a stop to if we're serious about this as well.

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[Philly]

But ex, getting back to the main topic...

Seeing as you're such a strong proponent of universal single payer, I really do question why you'd want to introduce yet another piecemeal government program to alleviate healthcare expenses for a limited class of people in a very limited scope. The unwashed masses would have probably already taken to the streets and forced something like single payer long ago except we've sliced and diced this thing so many ways that there's no cohesive, self-interested, consensus demanding it.

We have Medicare for olds. Medicaid for poors and disabled. The VA for Veterans. SCHIP for children. Obamacare for young adults under 26. Now you want to add Exploitedcare for victims of violent crime. Each thing we do like this is just more people saying "I got mine" and walking away from the table so we can't get a coherent system that actually makes sense for everyone. You know why young people loved Bernie's single payer proposal while olds said they didn't wanna pay more taxes for it? Because Medicare IS single payer and olds can already get that, so why are they worried? And then there was fearmongering that Bernie's single payer would rob people of their Medicare coverage, obscuring the fact that Bernie's plan would offer them the same thing anyway. So we do your plan and whenever we make a real push for single payer, the health insurance lobby is gonna shove some domestic violence and rape victim with a horrific story on the airwaves who will tearfully plead America not to let the commies with their single payer plan take away her Violent Crime Victims Benefits.

With most issues, I'm usually open to small steps that could be helpful as we wait for a real comprehensive solutions to come about. But with healthcare in America, every little patchwork program we implement just makes it more and more difficult to envision the real overhaul we need.

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[Philly]

Single payer will save money but only if done right and in conjunction with other things.

1. Rationing is going to have to be real, but let's be clear: the same rationing we have in our current system. No one will be told they can't seek a treatment. You just can't use up excessive resources from the system and not have to throw in more of your own money or have supplemental insurance to cover it. Death panels, I know, but we shouldn't cover an expensive and complicated surgery on an 88 year old that will extend his life expectancy from 3 months to 6 months. If his family wants to pay for that surgery, go right ahead.

2. We also need to ask those whose behavior will lead to them burdening the system to pay for that up front. I'm talking about what you do to your own body. A tax on cigarettes. A tax on big macs. A tax on soda. I'm not talking about making things prohibitively expensive. I'm talking about paying $1.50 for that $1.25 bottle of coke. Go a little heavier on the cigs since people are addicted to that shit and could use the incentive to quit. The money is designated to help offset rising healthcare costs due to the higher rates of obesity, heart disease, and cancer that these products inevitably cause.

3. Need to get serious about negotiating with pharma industry on drug prices. Other countries do this and save a ton. Hospital Industry really won't like this either, but let's get real. They are ripping us off. I know it's not a flophouse hostel and they have costs to run the place, but some of their shit is outrageous. Need to have regulation there.

4. This is just an idea I'm spitballing, but just as we tax things that will increase burden on the system, perhaps we can incentivize things that would have the opposite effect. A modest credit to people who diligently keep up with their preventative care and screenings for things their demographic need to be watchful for. This may sound like it's encouraging people to actually use the system more, but if we can catch things early and detect problems before the advance and complicate, we end up using less resources.

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