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The Best Health Care In The World? — Why Now?
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The Best Health Care In The World?

The BBC reports on one state’s attempt to deal with the uninsured: Oregon’s healthcare lottery

In what is believed to be the first such move, a US state is running a lottery in which the prize is health insurance.

With some 45 million Americans uninsured, how to pay for medical treatment is a big issue in this year’s presidential election.

Now officials in Oregon say they have come up with a fair way of providing coverage for some of those who cannot afford it.

Gives new meaning to the expression “your number is up”.

This is how we deal with life and death in the United States, by luck of the draw? If you win you live; if you lose you die after going bankrupt. Why is this acceptable?


1 Michael { 03.30.08 at 11:55 pm }

It is not acceptable.

2 LadyMin { 03.30.08 at 11:57 pm }

It appears that some would like to outsource healthcare. The tribune had an article on the booming business of medical tourism.

Several Fortune 500 companies and the West Virginia Legislature are among those considering bonuses — including first-class airfare and four-star hotel stays—for employees willing to undergo medical treatment abroad. And several major insurers already cover treatment programs in Mexico and Thailand, the AMA said.

Disturbing trends.

3 Bryan { 03.31.08 at 12:20 am }

This is what people are willing to do rather than fixing the damn system that all sentient beings realize is badly broken.

Single payer is the quick and obvious answer to the problem – Medicare for all, and I do mean all.

4 Steve Bates { 03.31.08 at 2:33 am }

The whole notion of a lottery as a substitute for reliable universal public healthcare is obscene. Aren’t the GOPers supposed to be opposed to public obscenity? Well, here it is, right out in front of Dog ‘n’ everybody.

A single-payer universal system… Medicare for all, if you like… is demonstrably the best and least costly system. We don’t even have to alpha-test it; any number of nations have already done that for us. But it does require that our government work for us, not for the insurance lobby, and I’m not at all sure it does.

5 Jack K., the Grumpy Forester { 03.31.08 at 10:43 am }

Out here in the All Gambling All The Time State, we have a program called the Oregon Health Plan, which was created a number of years ago under special waivers from the Fed’s to use Medicaid and other state and federal health care money in an effort to approach something like universal coverage. Part of the plan included basic health care for the uninsured who didn’t qualify for Medicaid or Medicare. It was actually working pretty well until that booming Bush economy came along a few years ago (you know, the one that resulted in Orygun schools having to close for several days, much to the delight of Gary Trudeau), when the state basically when broke and there wasn’t enough funding to keep people on the list…

The state now has enough funding to expand the list of covered citizens, but nowhere near the amount necessary to provide basic coverage for all the uninsured people who qualify for the plan. The lottery to get on the list sucks, it’s totally unacceptable and, yes, even obscene, and I’m sure that the Orygun Dept. of Human Services would happily entertain any and all suggestions on how to establish fair, objective criteria for deciding who gets on the list and who doesn’t…

What’s truly obscene is that Oregon has been getting some media play the last couple of weeks for a cold heartless system of offering health care coverage, but that hasn’t led to any sudden increase in the discussion about what other states and the Fed’s are doing – or could be doing – for the tens of millions of citizens who don’t qualify for Medicaid and are otherwise uninsured. Our embarrassing situation out here in Oregon shines a bright light on the need for national single-payer health care coverage, but all we really know right now is whether every pundit in the Western Hemisphere thinks Hillary Clinton is hurting the party by staying in the race…

6 Bryan { 03.31.08 at 12:57 pm }

Jack, I’m not picking on Oregon, because there is no “fair” way of determining who will live and who will die that would be acceptable in modern times. Florida is in even worse straits and the government makes no real attempt to do anything about the problem.

As the only solution the GOP has is to cut taxes to invoke a “market solution”, when the “market” has already said it is not interested in providing a solution, and, in fact, doesn’t actually want to be in the insurance business if it involves any risk to profits.

The sooner people accept that the private sector won’t provide the solution, and single payer is the only reasonable, economically feasible, course, the better off we will all be.

Medicare for all, and to hell with the millionaires that run insurance companies and other Ponzi schemes.

7 Michael { 03.31.08 at 2:49 pm }

Medicare for all is the best solution, in my opinion. There can be no market in human suffering.

8 WereBear { 03.31.08 at 5:20 pm }

It reminds me of the Richard Bachman (Stephen King) novel The Long Walk.

Young men, who have no prospects, set out on an endurance marathon. The last one walking gets a life.

Everyone else loses theirs.

If I’m going to be in a science fiction novel, can’t it be one of those Heinlein ones where everyone sleeps with everyone else?

9 cookie jill { 03.31.08 at 6:53 pm }

Social Darwinism at it’s worst. You’ll also NEED to win the Lotto to pay for any healthcare you may be “entitled” to….

10 Bryan { 03.31.08 at 8:03 pm }

It’s a sad commentary that this probably is as good a solution as can be devised for the reality that the system hasn’t got the funding to cover everyone.

Medicare for all – everyone pays, everyone is covered, and the only profits are for people who actually provide health care. It’s simple; it’s efficient; it’s economical; it’s the right thing to do.

11 Michael { 03.31.08 at 10:54 pm }

Profits isn’t the right word, health care providers deserve to have good incomes, but it should not be a return on risk.

12 Michael { 03.31.08 at 10:59 pm }

Frankly, we’d get a lot more people going into the medical professions if they knew they had a guaranteed good income at the end of their education, as long as they demonstrate competence. We don’t need medicine for profit, at least as to necessary care. Elective care, go for it.

13 Michael { 03.31.08 at 11:04 pm }

Socialized medicine, fine. Horrors. You want to buy a private plan, they should still be available and maybe they can cover more of the elective stuff and so forth. Supplemental.

14 Bryan { 03.31.08 at 11:33 pm }

Michael, a paycheck is the “profit” a worker receives for doing a job. There is nothing wrong with profiting from a job well done. The majority of health care providers are small businesses, not corporations, and they actually have to do something to earn a living.

In general, the actual health care providers are also being screwed in the current system. They provide services based on the assumption that the health insurance companies will pay them, and then, all too often, the insurers later decide that what was done wasn’t covered.

I see no reason to start a fight with doctors when the problem is insurance companies. The health care providers should be allies in this battle, as they are also victims of the system.

15 Michael { 04.01.08 at 12:58 am }

You use that word profit in a way that is not quite what the word means in economics, though. Wages are not profits, they are return on labor. You may risk losing your job if you do it badly, but you don’t risk a financial loss on your job, you expect to be paid regularly and on time.

16 Michael { 04.01.08 at 12:59 am }

I agree about not starting unnecessary fights, we do not need to go further than we can achieve consensus.

17 Badtux { 04.01.08 at 1:51 pm }

Oregon has the money to pay for health care for all Oregonians. The deal is, they don’t want to pay for health care for all Oregonians. Because that would require (gasp) A TAX. So hundreds of Oregonians die each year due to lack of health care, part of an American Holocaust that kills 20,000+ Americans every year due to lack of health care, and, well, we can’t have a sales tax on durable goods to pay for health care because, well, just because, okay?!

As for “Medicare for All”, remember, this is America. Profits for millionaires are more important than the lives of 20,000 Americans killed by the health care mafia every year. I mean, c’mon. We’re talking about our God here — the almighty Dollar — which of course is worth more than the lives of those 20,000 Americans who are killed each year by the health insurance mafia. Too bad for those 20,000 Americans, they shoulda been born millionaires like Bill Frist, eh?!

— Badtux the Snarky Penguin

18 Bryan { 04.01.08 at 3:13 pm }

Michael, I view capital as anything of value, and work has value. Profit is the condition where the capital invested is less than the capital returned. Gamblers aren’t the only people who can make a profit; a gambler being anyone who risks only money in the hopes of making more.

That’s the real issue, Badtux: are we ready to do what is necessary, or do more people have to die? The only thing lacking is the will to fix the problem.

19 Kryten42 { 04.01.08 at 10:54 pm }

It is obscene, and it isn’t at all right.

Nothing to add to what has already been said. Just letting you know how I feel about it also.

It’s broken here also, thanks to Bushmoron’s #1 asskisser, Howard. Not as bad as in the USA, but it will take time and pain to fix our system also. At least Rudd has said his new Gov will work on it. Problem here is, people want it all fixed *NOW DAMMIT!* of course! 🙂 But there is a lot to fix. I guess we’ll just have to wait and see.


20 Bryan { 04.02.08 at 12:12 am }

You at least have a general agreement that it’s necessary, Kryten, we’re still dealing with people who can’t see the problem because they haven’t been affected yet.

21 Michael { 04.02.08 at 12:34 am }

Bryan, with respect, I view returns to capital as interest, returns to labor as wages, returns to privilege as rent, returns to risk as profit. I don’t want to sidetrack the conversation overmuch but I thought it would be helpful that we at least understand how we are each using these terms. The more simplified model of treating all resources as capital and all returns as profit has the benefit of being easier to work with because it is often very difficult to separate the factors of production, and more efficient to treat them as a unity — income from whatever source derived.

22 Bryan { 04.02.08 at 1:08 am }

The only reason for separating profit into different categories is to permit them to be taxed differently, which enables the establishment of economic privilege. The arithmetic, it isn’t involved enough to be called mathematics, and set up in a computer program are identical.

It is the artificial classifications that allow hedge fund mangers to pay a lower tax rate than a plumber. Capitalism requires a level playing field to work, and the laws are preventing it.

Capitalism is a great economic system. I wish we would try it.