Subject:
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Re: A question for my Canadian pals
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Newsgroups:
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lugnet.off-topic.debate
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Date:
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Wed, 6 Oct 2004 23:23:27 GMT
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Viewed:
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1317 times
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In lugnet.off-topic.debate, Dave Schuler wrote:
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I’d rather have my routine medical costs covered, even if it means that
an uncommon procedure is made less accessible to me.
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That seems counterintuitive to me.
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Yeah, I’m not sure that I can support my view. I’m looking for a good
analogy to articulate it, but I haven’t found it yet.
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Part of the problem might be in saying that an uncommon procedure is necessarily
less accessible to you. In the US health insurance system, expensive procedures
usually come with expensive deductables, so while the line in front of you may
be very short, and you might have good health insurance, you still might not be
able to afford every possible procedure. In the end, any changes to the
existing health care system are going to benefit one group at the expense of
another. The Canadian model showed that straight national healthcare benefits
the poor (by providing them with full coverage where they had none) while
hurting the rich (by reducing the quality/immediacy of care that they receive).
They appear to have improved it for the rich by providing access to fully
privatized health care on the side (so the rich can still receive the quality of
care that they were used to while also helping to finance healthcare for the
poor). Of course, there’s still probably some group in the middle that could
afford to pay the deductables for expensive immediate services under our system,
but couldn’t afford to go to fully privatized Canadian providers, so they’re
stuck with getting both reduced cost and care levels, where they might be
perfectly happy to pay higher costs to get better service.
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Hmm... If routine costs are (relatively) small but unavoidable, but a
catastrophic cost is huge but only (insert percentage here) likely to occur,
then circumstances might incline a person of limited resources to wager that
he’d be better off in getting help with his small but unavoidable costs than
in waiting for help with a cost that might never come. I expect that this
kind of gamble goes on all the time, in healthcare as well as in other
arenas.
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The entire insurance system is just such a gamble. Those who get insurance
(where not required to do so by law) are gambling that they’ll end up needing
higher paybacks than what they’ll need to put into the system. Those who don’t
get insurance are gambling that they won’t need catastrophic coverage, and so
the cost of premiums would therefore be higher than what they’d need to pay
out-of-pocket. I worked for a boatbuilder who refused to get insurance on his
19’ sailboat on the grounds that a single year of insurance was roughly 1/3 the
amount that it cost him to build the boat in the first place...and even the best
insurance isn’t going alert anyone that your boat just sank and left you
treading water in the middle of nowhere. He felt it made much more economic
sense to hope that the boat wouldn’t sink in the first three years (at which
point he’s saved enough money to completely replace it) and instead buy an
EPIRB (Emergency Position
Indicating Radio Beacon) that would automatically activate when the boat sinks
and will notify all nearby Coast Guard vessels and airplanes of both your
location and your need for assistance (at the time, the 406MHz
satellite-detectable EPIRBs might not have been available, or he might have
figured the 243MHz locally-detectable style was good enough for near-shore
recreational boating).
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Message is in Reply To:
 | | Re: A question for my Canadian pals
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| (...) Sure, but today my access to certain procedures is limited by my income and my insurance, so I don't know that it's any better in practice. (...) Well, then we're back to the brain surgeon vs. hole-digger, aren't we? (...) Yeah, I'm not sure (...) (20 years ago, 6-Oct-04, to lugnet.off-topic.debate)
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