Marc: Your logical error: Because everyone can get ER care when they need it, is not the same as "everyone is entitled to healthcare".  That would mean we could see any doctor anytime for any reason, which is not the case.  Your initial premise is incorrect, so your conclusions are flawed.  We do need to increase the supply of doctors, though.  Returning medical care to the free market, plus removing AMA rules limiting the supply of doctors through unneeded regulation would go a long way toward remedying the problem.  Mandated "health insurance"(another pyramid scheme) is not the answer.

To clarify,

everyone is entitled to health care in the US

All anyone has to do is go to an emergency room in any hospital and they will get care whether they can pay for it or not.  That is the law!  And that is not going to change.  Get used to it!

And who do you think pays for that?  You do. Everyoe who has insurance, pays for it through higher premiums, or in higher health care costs for those who don’t have insurance, but have the means to pay for it themselves.  You also pay for it through higher taxes, and eventually we will all pay for it an inferior health care delivery system.

Health care costs are rising, not because nobody cares how much health care costs, but because the population is aging rapidy, and the supply can’t keep up with the demand. 

You might be able to lower health insurance premiums, in the short run, by adopting more HDHPs, but the cost of health care will continue to rise, at the current rate, and eventually even HDHPs will start rising at the same rate as health care inflation.  Just take the example of managed care, when it was first adopted, way back when, to know that is true.

Costs will continue to increase until supply catches up with demand.  Someone has to pay for it.  All we can hope to do now is spread the cost more evenly among the users of health care, WHICH IS EVERYBODY, by mandating everyone pay for their health care.   

Otherwise, on the extremely wealthy will get high quality care, and everyone else will be left with something less.

 

Puzzlefeet said, Rob, the tired old canard of making people responsible for their own health care is such tripe.

So personal responsibility is a "tired old canard" and is "tripe". Wow!

Bat One,

Chronically hospitalized individuals and the sickest of seniors proportionally use far more healthcare than do the rest of the population combined.  Senior citizens make up approximately 15% of the population, yet account for almost 40% of the spending on medication.  And that is just medication.  They account for almost all of the hospitalization costs.  Their hospital stays last longer and are more costly than younger people.  And the oldest seniors and the unhealthiest seniors account for an even higher porportion.

What part of this do you not believe?  That seniors have more health problems and that their healthcare is far more expensive than younger people?

The point of cost cutting is that our society does not want any limitations on what medications or procedures or tests that an insurance compay is forced to pay for.  To cut costs, insurance companies must cut the frequency, type, or number of proceedures, medications, and hospitalizations that are performed on their patients.  Because of the cost shifting of insurance, people are not directly responsible for the costs associated with their care and everyone if told they could go to any restaurant in town because someone else was picking up the tab would choose filet mignon at Ruth’s Chris over a big mac at McDonalds if the cost to that person was the same–namely zero.

Rob, the tired old canard of making people responsible for their own health care is such tripe.  80% of of health care is used by 20% of the people.  We need to spend more time on disease management such as diabetes, heart issues etc.  People are responsible.  If you look at the data, it is clear that 20% use the vast majority of the health care. HDHP will be useless unless and until, there are ways for consumers to know the quality of the health care they are receiving.  Right now that is sorely lacking.  Most people have no way of finding out the quality of the various health care clinics and hospitals they go to.  Most people simply ask others who they went to see, since there is no other consistent way to monitor health care quality.  So HDHPs will not be the major factor in health care since a major piece of the puzzle is missing.

No likwidshoe, the tired old canard and tripe is that personal responsibilty is the main issue with health care.  My point is that we need to look to the 20% that is responsible for 80% of the health care usage in this country.  The 80% are already doing it right.  We need to look at better disease management where much of the 20% of medical costs are occurring.  Personal Responsibility is already occurring so you won’t squeeze any more saving out of the 80%.  That’s what is tripe about the personal responsiblity canard.

Batone, please feel free to  hit this site:  http://www.kff.org  (the Kaiser family foundation) and search to your little heart’s content for more specific information such that you seek.  They have tons of stats and proof for you.  Happy reading. 

Marc said "everyone needs health care, that is if they are alive, and everybody is entitled to it in this country whether they pay for it or not."

Exactly how much health care is everybody in this country entitled to? Why are they entitled to it? How can you even justify that everyone needs health care?

Also why aren’t Americans entitled to even more health care than whatever arbitrary amount you’d suggest?  Would you not rather we all live an extra year?

What sense does it make to tax corporations that invest in creating new health care technologies (for the purpose of investing in health insurance)?  Wouldn’t they already use that money to invest in public health?  Are they not more efficient than the government than the government in creating technologies that provide for the common health? If they are, are you saying that only the current generation of Americans is entitled to the best in health care technology?  If not, why then do they even exist as a private corporation as opposed to a state owned enterprise.

Would you give these same corporations a tax break because they exist to serve your pet project of public health?  Would I get a tax break for forming a low capitalization attempt at discovering new drugs?  That somewhat seems an inefficient a use of my money.  Would I only get that tax break if I randomly stumbled across a drug that actually worked?  Why would I even deserve a tax break for randomly stumbling across a pharmeceutical solution?  What of my peers who invest the same amount of money into finding new drugs, yet come up empty?

I think I’ve posed enough absurdities to render the statement "everybody is entitled to [state health care] in this country" indefensible.  I’d appreciate some justification to that statement before you use it again in the future.

Finally, to give you some data for that first question, I, as an American, don’t feel particularly entitled to state health care.  If I wanted it, I’d move to Canada…Or Cuba.

But we’re not doing that. We’re not making people responsible for their own health care.  The people that are responsible for health care have health insurance or are extremely rich. 

 That just proves that you don’t get it, Marc.  People who have health insurance are not responsible for their own health care.  They don’t pay their medical bills (or much of them anyway), the collective does.  Thus, they are not held responsible for their health choices.  They don’t shop around to drive down prices through competition and they don’t take care of themselves.

If they can’t afford the high deductible, how can they afford to put money into an HSAs?

Because deductibles are large, one-time payments.  Contributions to a HSA are small, regular payments which amass with interest. 

And as long as the US policy doesn’t mandate health insurance, health care costs to cover the uninsured will continue to rise. 

If the government mandates, or outright subsidizes through a socialized medicine system, health insurance prices will go up even further.  We are not going to solve the health insurance problem by moving the burden away from the individual onto the collective.  If you want to lower the cost of health insurance let’s turn the system into one where free individuals are allowed to freely make persona choices in a free market.

Well already have a partially-subsidized system.  More subsidization isn’t going to fix it.  We can throw all the tax dollars you want at this and the problems aren’t going to go away.

The government needs to get out of the health insurance business, not further entrench itself in it.