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Old 07-04-2013, 11:58 AM   #76
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My thought was more along the line - if we have a nationalized system (no state-to-state differences), what is the base line level of healthcare that should be made available to everyone. Should base line care include every new drug and procedure created by the medical industry? Do we include drugs that help conditions that could otherwise be addressed by diet & exercise? Do we include things like Viagra?
Right, and I get all that. They are not uncomplicated questions. But they are questions that every other western democracy has answered so it is not an impossible task, necessarily. For example, you can dictate a baseline and then set up a system of secondary/top-up insurance as we have in Canada. Our prescription medications are NOT covered unless you are on a social assistance or social security of some sort (though they are infinitely cheaper than in the US because our government is able to take advantage of bulk purchases). For the rest of us, workplaces typically offer top up prescription insurance (for example, I get 90% coverage for prescription medication), and those who are self-employed or independent contractors can purchase such additional insurance at a very reasonable cost. So it is not necessarily an all-or-nothing approach.

To me, there are both tangible and intangible benefits of having a healthier society. And a healthier society is easier to achieve when people seek medical intervention early or who have access to free preventative care.
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Old 07-04-2013, 12:22 PM   #77
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I think the problem is that people have such a high level of anxiety living in a nation with little to no safety net and decreasing economic mobility and increasing wealth inequality.
That's a real bedrock of right-wing ideas in general in the US. It's a belief in fundamental scarcity: the notion that there really isn't enough good in the world to go around, so we must each be sure to get our own. It tends to imagine each interaction or problem as a zero sum game. In order to some to gain, someone has to lose. And of course, everyone must have someone in authority over them to control the inevitable cheating, violence and chaos that this reality creates.

And I just don't think that's the case. I believe in a world in which we can literally create more good-- that things can get better for everybody, probably indefinitely. But if you believe a universe-- in fact a God and a theology of scarcity, and you see scarcity occurring around you, then yes, the urge to grip at all that you can is very strong.
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Old 07-04-2013, 12:29 PM   #78
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My thought was more along the line - if we have a nationalized system (no state-to-state differences), what is the base line level of healthcare that should be made available to everyone. Should base line care include every new drug and procedure created by the medical industry? Do we include drugs that help conditions that could otherwise be addressed by diet & exercise? Do we include things like Viagra?
here in Europe we have governing bodies which decide on the therapeutic benefit of drugs, whether new or existing, say every 5 years, to verify whether they should still be eligible for reimbursement by the health insurance system or not - there is a list of drugs which are eligible/ineligible for reimbursement by the state system, based on their effectiveness, safety, public need, cost, etc. - and there are protocols/consensus/recommendations for the treatment of certain disorders, for instance diabetes, where doctors opt for lifestyle/diet changes first of all, then adjust treatment as necessary, always opting for the most cost/effective/safe option first of all, and then moving onto more costly treatments when other measures have failed... it's really not that complicated...

not all drugs are reimbursed, and sometimes, for instance in the UK, it can be a postcode lottery - for example, recently a new cancer drug was only available in certain NHS trusts and not others...

also, reimbursement levels vary - here in France, for instance, drugs which are reimbursed by the state, are only up to 65% reimbursed, and if you want/need full reimbursement you need to have a top-up health insurance to cover the remainder - a whole range of policies are available, from minimal reimbursement to full coverage... for instance, my top-up health insurance is about 155 euros a month and provides pretty much max. cover including ophthalmology and dental care/orthodontics, for a family of 4 - it has been worth every penny (although that is much MUCH less than my monthly state health insurance contributions which are incredibly expensive - around 6.5% of business profit for self-employed people, but that one contribution covers the whole family again, and i wouldn't want to be without it because it gives me a real sense of security for my family, but i do still complain like hell about the amount i have to pay because it really does hurt lol - it is worth it though when you see the break-down of the charges that have been covered)
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Old 07-04-2013, 01:26 PM   #79
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The sad thing is that the extreme right has such a stranglehold on religious dialogue in this country that I had literally never heard the view that AEON expresses until just a couple of years ago, and then not by an American. American fundamentalists have completely branded Christianity with their own "by the bootstraps" image. When I heard that Christians in other developed nations consider it a spiritual duty to extend care to the poor-- well, my mind was boggled.
Jeevey, it is my hope and prayer that the extreme right is not only losing it's voice, but it's influence. Like you, I'm curious and confused how Christianity and Capitalism became such bedfellows. I can see how this confuses other countries.

I am seeing more and more Christian posts here than I remember - and most of them are expressing love and compassion more than the Fox News talking points. While some of my views can still be labeled "conservative" - I'm finally sensing that most American Christians are finally moving out of the Falwell/Robertson camp.
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Old 07-04-2013, 06:36 PM   #80
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I'd like to see them get a lot more vocal about it. I'm not a believer but it's disgusting that these views own the public discourse on Jesus just because they're louder. I'd like to see a lot more Christians speak out publicly and call out Tea Party-Christian nut jobs, saying "This is not of Christ." Because in the public mind, that's really the image that Christianity has.
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Old 07-04-2013, 11:39 PM   #81
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The current big-government system allows too many to profit and too few to receive care.
This statement just seems completely wrong to me. First, I'm not sure that we actually have a big government system right now, other than Medicare and Medicaid. And how are those programs allowing too many to profit and too few to receive care?

To me, it is our privatized health care system that allows too many to profit and too few to receive care!

Did anyone read that big investigative piece in Time magazine about how hospital charges are calculated?
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Old 07-04-2013, 11:43 PM   #82
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This statement just seems completely wrong to me. First, I'm not sure that we actually have a big government system right now, other than Medicare and Medicaid. And how are those programs allowing too many to profit and too few to receive care?

These are wildly popular programs, too. Which is the real danger of the ACA -- that it's a step in a direction that many Americans are going to like, and it's going to be popular.
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Old 07-04-2013, 11:47 PM   #83
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[Note: just trying to explain concepts here]

The best way to understand a pure health care insurance system is to look at automobile insurance. When you purchase a new car, you purchase a policy that will cover costly repairs to the car (you are still responsible for gas, oil, maintenance, etc. on your own). If you get in an accident, insurance steps in to cover the repair bills - that way you can manage your overall cost of maintaining the car with regular monthly payments and avoid getting nailed by the one-time spike in costs. Insurance allows us to manage risk.
I agree that the way we do health insurance makes no sense. In fact, I've used the very same analogy about auto insurance.

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Now, let's say the government steps in and tells the insurance company that the policy must cover damage to the car that doesn't occur during the policy period (let's say you buy a car with a dent and then look to insurance to fix the dent).
When did the government begin these mandates? Are you talking about ObamaCare or are you saying that mandates have been added by government fiat over many years? I've always been under the impression that the insurance companies were the ones that made the decisions about what they would and wouldn't cover. At least until ObamaCare came along and demanded that they not deny coverage for pre-existing conditions etc (which from an insurance point of view is kind of crazy, really. They only went along because of the mandate that everyone must have coverage).

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The individual is no longer managing their own risk, but must help cover additional risks taken by others.
But that's the nature of how insurance works any way. It's not like Geico is taking my premiums and putting them aside for me specifically in case I need them down the road. The premiums of all pay the for the needs of a few (and also help Geico's bottom line).
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Old 07-04-2013, 11:48 PM   #84
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These are wildly popular programs, too. Which is the real danger of the ACA -- that it's a step in a direction that many Americans are going to like, and it's going to be popular.
What do you mean by dangerous?
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Old 07-05-2013, 12:23 AM   #85
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What do you mean by dangerous?

Political danger. For the GOP.
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Old 07-05-2013, 01:42 AM   #86
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My thought was more along the line - if we have a nationalized system (no state-to-state differences), what is the base line level of healthcare that should be made available to everyone.
Wow, that goes against most of your fellow supporters that thought "making insurance available over state lines" was one of the answers.

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Today, we discover that healthcare coverage is rationed by a group of actuaries (i.e., sorry, your test won't be covered until you turn 50, your procedure is only available to people who are in worse heath than you), a top down type of limitation. My idea of "tough questions" would entail building healthcare from the bottom up. This would increase certainty regarding coverages and costs, while reducing the opportunity of businesses to profit from vague mandates.
This would entail completely destroying the current healthcare model previous to the Affordable Care Act, how do you see that going?
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Old 07-05-2013, 10:55 AM   #87
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I'd like to see them get a lot more vocal about it. I'm not a believer but it's disgusting that these views own the public discourse on Jesus just because they're louder. I'd like to see a lot more Christians speak out publicly and call out Tea Party-Christian nut jobs, saying "This is not of Christ." Because in the public mind, that's really the image that Christianity has.

Some "Christians" defend their refusal to help the poor, whether in their country or in other countries, by using the Biblical quote "charity starts at home" - which is totally taken out of context.
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Old 07-05-2013, 12:32 PM   #88
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To be fair, Christians are generous. They do give a lot to charity, although many times the charities are selective. They are very firm that individuals and churches need to help the poor. They just don't want the government to do it. What I don't understand is making a false distinction about what we do as individuals and what we do as a government-- as though in a democracy the acts of the government were something other than expression of the will of the people. This is especially puzzling considering how that same branch of Christianity is very concerned that the government express Christian values in other ways.
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Old 07-05-2013, 12:39 PM   #89
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To be fair, Christians are generous. They do give a lot to charity, although many times the charities are selective. They are very firm that individuals and churches need to help the poor. They just don't want the government to do it. What I don't understand is making a false distinction about what we do as individuals and what we do as a government-- as though in a democracy the acts of the government were something other than expression of the will of the people. This is especially puzzling considering how that same branch of Christianity is very concerned that the government express Christian values in other ways.
I am not saying Christians in general aren't generous. I consider myself a Christian too, though I'm not affiliated with any church. If you notice in my previous post, I put quotations around that word, indicating that those who say they're Christian but yet do act like one, really aren't Christian.

But I agree that it is puzzling that some Americans don't want the government to get involved in helping fellow citizens. Some say it is because the government will be forcing you to give money, rather than choosing to give. That still doesn't make much sense to me. We should all have a moral obligation as citizens to help those in need, no matter what our theological beliefs are.
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Old 07-05-2013, 02:53 PM   #90
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I believe in a world in which we can literally create more good-- that things can get better for everybody, probably indefinitely.
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