> This is why talking only about the uninsured (of which I am one, by the way)
> is such a terrible strategy to win national health insurance. Most people
> have insurance. It is crappy, insecure, job-dependent and getting
> more expensive
> every day. It has co-pays, deductibles, denials, and massive, unfathomable
> paperwork. It is the threat of uninsurance, and the reality of crappy,
> overpriced insurance which should be examined.
>
> Focusing on the uninsured also leads to the conclusion that if only those
> people were covered, everything would be fine. Hence, cover people
> at 150% of the poverty level, etc., leaving the insurance co.
> vampires responsible for the disaster untouched.
This is a good point and I definitely agree that getting insurance is an important but secondary part of any health care solution. This has important political consequences as well. The presumption among most liberal people has consistently been that getting health insurance is "solving most of the problem". Currently there is a concerted effort amongst a wide coalition here in Massachusetts to get a referendum to pass "universal insurance". Many good people and organizations are involved in the effort. When I tell supporters (who include single-payer advocates) that I have reservations, including the fact that the Heritage Foundation approved position of "individually mandating" insurance are on the table as "possible" ways of making insurance universal, they are surprised (actually, some have pulled support because of me!).
It is a question of priorties and these referendum supporters see the primary problem as lack of insurance. This set of priorities is even more bizarre in Massachusetts as they are the only state to have a "Free Care Pool" (in which the uninsured get hospital based care).
I suspect from your tone ("insurance co. vampires") that you do think that insurance companies are a (the?) main problem. I admit my perception is clouded by the fact that insurance companies and even large purchasers of insurance are relatively weak where I live. It is also hard not to listen to stories like Doug's mom's $21,000 broken arm and not see that as the major problem.
Insurance companies do add largely unnecessary complexity and are the cruel bearer of "harsh realities" to many people. However, a major cause of problems in the US and probably the most important one to tackle, is the health delivery system as well as the industries that supply it.
To relate back to Jordan's point there are many problems related to health care delivery and government cost control in Canada. Politically speaking, creating single-payer in the United States may solve many problems but there will be trade-offs between benefits and taxes. Inherently socializing insurance without strong formal controls over the strength of drug companies, hospitals, doctors is guaranteed to have problems. Solving the average families horrors over co-pays, coinsurance, exclusions, high deductibles, and massive premiums are worthwhile benefits of single-payer but I doubt it would be politically sustainable at the the tax rates necessary to fund it if the current health care delivery system and drug co. propaganda remain in place.
In my experience, health care reform supporters are usually well versed in discussing the waste/inefficiency around insurance. However, they seem to be pretty naive about the scope of medical care inefficiency and the scope of death/dollars that go into unnecessary care (and I'm not talking about "alternative" medicine here in case someone was wondering--I am simply about applying evidence based, quality, patient centered care to the population).
Jim
"A thought that never changes Remains a stupid lie It's never been quite the same."
--New Order