Not free to be poor

I can understand where you are coming from, as we have also chosen a lifestyle that's less demanding of our resources.  We have all the insurances one would consider necessary to be secure, but even that doesn't seem like enough.

For many, financial security has a certain amount of risk that can never truly be eliminated.  We can mitigate damages by being insured, but certain unforeseen acts (tornadoes, hurricanes, war, poltical upheaval, disease, etc.) are always going to catch people unprepared.  Often those with the most money are hit the hardest, as certain conditions can leave money without any true "value."

I say live at whatever level you are truly comfortable with, and don't waste your whole life preparing for the unknown.  It's good to be smart about it, but I'd rather not work my fingers to the bone while missing out on all the joys of life simply so that I can be "fully-prepared" for the unpredicable, and often "inevitable."

Great, thought-provoking post (even though it's way too deep for a Monday) !

Right on! The health insurance issue is the ONLY thing that has kept me on the job for lo, these many years. It will keep me on the job until I'm 65, even though in theory I could have retired long before now.

I can attest to the sublime ease of a frugal life. But then I live in Canada and just graduated (with no debt, health care isn't the only thing cheaper here) so frugal living is relatively easy. I certainly don't envy those who don't have the choice of this kind of lifestyle.

Well, I get your point on that. The funny thing is, until you live outside the good old US of A for extended amounts of time, you don't actually realize how much you're being ripped off on hospital fees. In Ireland, for example, any insurer will sell you full benefits insurance for about 500 euro a year. That's everything excluding dental; and if you're prepared to put in a bit more, you can get day-to-day doctor visits and medications added.

Even when you pay as a tourist it's nowhere near as expensive as any operation in the US (hospital care is free here if you're an eu citizen, and the quality of the public hospitals is almost on par with the best private hospitals).

Perhaps what should really be getting done is more protests on the cost of healthcare - this would surely reduce everyone's burdens.

I actually wrote a bit just recently about dental and vision care as things that generally don't need to be insured against.

Still, your greater point is well taken.  You can't just add up your expenses from last year and assume that you'll be able to get by if you can earn that much this year.  You need to do some planning, so that you know you can cover your less-than-annual expenses.  And you need to have a cushion against some small amount of unexpected expenses.

Sometimes, though, the unexpected expenses aren't small--they're huge.  That's when you need insurance. 

Dangerman, I am your nemesis. I have lived without medical insurance intentionally for nine years--not one penny spent on thousands of dollars of premiums for which I would have received zero benefit (and I received zero benefit during the previous 14 years that I did pay for medical insurance). I spend that money instead on ways that promote health. As a result, I have not been in a physician's office in 15 years. A side benefit to my healthy living is that I look 10 years younger--truly, I've been told this many times.

As a young investor myself, this is very disconcerning. I am starting to save for my retirement, and I am living frugally. Unfortunately I do realize that there are unexpected expenses that arise. I say unfortunately because it depresses me to find that there are so many expenses involved with just living out your everyday life. I realize that behind the facade of credit, mortgages, and more you still have payments that will need to be repaid. This is why I try to live by the age old philosophy of "don't spend beyond your means." Even with this philosophy I find it hard to just get by let alone save for future expenses.

Anyways sorry about the rant, I it just helps me realize what kind of problems there are with our society and what to look forward to in the future.

"I am American and live in the UK with my British husband. My husband and I pay a combined average $1000 per month for National Insurance."

This would get you coverage in the US to, wouldn't it? (Guess universal health care is neither cheap nor efficient...another illusion crushed)

@ Post 17 (and 20), I'd just like to point out that the National Insurance contributions you make cover not only health care but disability allowance, state pensions, bereavement and maternity allowances etc.
Also it's not linked to how much you have contributed, so if you were to become a stay at home spouse, your family's combined contribution total would drop but you be entitled to the same treatment- pretty much the point of socialised care.

I think the main problem is that health care is treated as a commodity nowadays, much like college degrees. People are so used to buying things that they expect that health (and education) can be bought too when those things actually comes down to particular behavioral problems and all they're buying is a doctor visit or a "degree". A doctor can fix a broken bone but he can't fix most problems which aside from the unlucky cases of poor genetics basically comes down to crappy lifestyle choices of poor diet, poor exercise routines, bad sleep patterns, etc.

When there is increasingly less connection between price and results, that is, between cost of benefits and actual "benefits"=health, the price can be whatever people are willing to pay. And some people are willing to pay a lot merely because they have a lot of money.

Already I notice that people are increasing their medical tourism, though. Our desire to spend money is driving up global prices, but for now foreign doctors are inexpensive.

John Krumm,

Perhaps 3% of Medicare's budget goes to administrative costs, but it wouldn't matter if it was .05%. The trend is clear, the growth of Medicare is outstriping incoming revenue.

Don't you realize, eventually entitlement programs will make up more than 100% of the budget? Simple Math.

UNSUSTAINABLE.

Kejla asked why she should pay someone else's medical expenses when she works hard to keep her family healthy and other people are careless.

I've often wondered the same thing. My country's government health care covers people who do stupid things -- people who drive drunk, have a poor diet, and smoke (among other things). It's a drain on our system, to be sure.

Yes, I think people need to smarten up and take accountability for their actions, but I don't think that's a good argument for getting rid of (or not having) universal health care. It's good that some people can afford several thousand dollars for their family's insurance, but what about families who aren't as financially advantaged? Are their children worth less than others?

Should a child who is ill suffer and maybe die because they can't afford care? Seems to that shouldn't happen in a developed country. It's in everyone's best interests that the members of a community and country have health care available. It's time to lose the "it's all about me and my family" attitude and see that even people who don't have money deserve care and respect.

I love it when people chime in from all over! (For future reference, the reason I pick on Canadians is that my family is entirely Canadian, and I like getting a rise out of them when they read my blog).

I'm glad that the point about health care not being totally "cheap" in Canada was raised - because taxes are very high there, and jobs, frankly, don't pay as well as they do here. I occasionally consider using my citizenship to move up to BC and work as a tech writer, but the pay is much lower than it is in Seattle - I don't know if I could afford to buy a home in Canada.

There are many reasons why healthcare costs so much in the US, and I don't think that irresponsible people are the main cause. I think doctors make too much money and drug companies spend too much on advertising (and pass the costs along to consumers). Are these the main problems with the system? No. Would changing them drastically reduce the cost of healthcare? I believe so.

Oh please! I am Turkish and here is a tally of our beloved neighbors: Iraq, Iran, Russia, Syria, Greece, Bulgaria, Armenia and a couple others we tend to like so, consider yourselves very very lucky.

Peace at home, Peace on Earth

T'Pol

I'd like to second what Stacey07 said for those who mentioned that the healthcare is one (or the major reason) keeping them from freelancing.

I've been independent for over a year now, and I've paid out over $150.00 a month on a private healthcare plan. It was paid for personally, not by my business. As a result, when I did my personal taxes this past April, by entering the total amount I paid into Turbo Tax, it actually took me from having to pay the gov't to getting a refund!

Now, according to my CPA, this is because it's a private plan, not through my business like I mentioned above. But regardless, it was certainly a nice little surprise when I did my taxes!

@Andrea: I think your comments are hilarious! Part of my family is American.

@Kelja, you raise many good points! I agree that people are careless with things when someone else has to take accountability.

But you still can't convince me that providing universal health care is going to make matters worse. There are a lot of people who work very hard and still can't afford health care if they had to pay for it.

I think it's a fallacy of the middle and wealthy classes that no one works as hard as they do, and that people deserve to be poor because they "don't work hard enough."

It's simply not true. There are people who struggle to make a living. Hard work can't always make up for the lack of money or advantages such as a good education. Sometimes a divorce, job loss or death in the family leaves people in financial straights.

Yes, there are people out there who don't want to work and who take advantage of the system. I'd like to see more done to correct that problem than to cut off people who can't afford care and need it.

Again, you ask why you should have to pay for other people's mistakes. I ask why some should have to suffer for those same people's mistakes.

People in disadvantaged communities and countries find a way to share and provide for others. It's sickening that we can't do the same.

People like Kelja make me really sad for this country. The almighty dollar trumps humanity for way too many people. Don't get me wrong. I think there are plenty of people who contribute nothing to society even though they could and people that are so stupid it is amazing they continue to live. But way too many people put this insane obsession with "their money" ahead of every single thing that involves our country or our society. If it doesn't personally benefit them it must be bad.

I'll attempt to bridge the cultural gap here, as it were. I won't even make a Tim Horton's joke.

There is a difference in the US between health insurance and health care. Health care is what you get when you go to the doctor. Health insurance is what helps you pay for it. Anyone can go see a doctor, but not everyone will have insurance to pay for it. Health insurance is often offered by employers (for all employes - called a 'group plan'), but the cost is very high for the employer. Employees might be required to pay a certain amount to have insurance as well (including fees when they go to see the doctor, or buy medicine, and the insurance company doesn't have to cover everything) - it really depends on the health insurance plan and who is providing it. If you are self-employed, you have to buy your own health insurance, and if you are on a private plan, health insurance companies can refuse to cover you (they can't refuse you if you are getting health insurance through a group plan paid for by your employer).

Health insurance is not a right in this country. However, health care IS (to a point - keep reading). I don't think that there are many instances in the US in which someone will NOT get treated at in any emergency room. I'm sure that there are isolated cases in which people are turned away and die as a result, but generally, doctors cannot, by law, refuse service to someone who is in dire need of medical help, regardless of their insurance coverage (or lack thereof). Many people also see their regular doctor without having health insurance - they simply pay out of pocket for their expenses.

There are two main problems with this system. The first is that seeing a doctor is damn expensive, and you pay through the nose if (1) you don't have insurance or (2) you have insurance, but your insurance refuses to cover your trip tothe  doctor. I've had some pretty lousy insurance during my lifetime (especially as a contractor/freelancer). At one point, I went to see an specialist, because my family doc was oddly clueless about diabetes. My insurance refused to pay for the visit to see the specialist, and a one hour consultation with a doctor cost me $300 in office fees and $700 in lab tests.

Now, at the time, I made enough money to cover the cost, albeit grumpily. However, most people without insurance DON'T make enough money to pay for normal checkups ($300 is a lot of money, and that's WITHOUT any tests), so they avoid the doctor until (you guessed it) they end up in the emergency room with a truly horrible complication.

So, as I've mentioned, the ER can't turn someone away if they are terribly sick. If a very ill person has avoided seeing the doctor for heart palpitations, and then ends up having a heart attack and has to go to the ER, the ER will admit him. He can't pay, but they have to admit him and operate on him. Chances are, he will never pay the hospital, and how could he, anyway? If he can't afford to see a cardiologist about his irregular heart beats, how can he afford the $30-50K that his quadruple bypass is going to cost? He'll have to either declare bankruptcy down the line (or possibly give the hospital fake information when he is admitted).

The result is that the hospital eats the cost of the operation, and then passes the 'savings' along to the average customer. That means that, in order to cover costly ER procedures, my lab fees have to go up, or the cost of seeing an specialist will increase.

It's a lousy situation. The plus side to the American system is that we have some really great care (we have some great doctors, because who DOESN'T want to make at least $100 an hour?), and we get most of our treatments very quickly, regardless of the severity of the situation. I have Canadian relatives who come to the US for treatment, especially for things that require a specialized physician's attention, because it takes too damn long in Canada to see a specialist (up to 9 months to see a neurologist). On the flip side, I sometimes go up to Canada to buy medications - even without any insurance, it's much cheaper to buy inhalers in Canada than to pay the copay on my insurance and buy them here.

So, in summary, health care is not exactly a RIGHT in the United States, but it's pretty unlikely that you would not receive treatment if admitted to the ER. The method for paying for the health care, however, is DEFINITELY not a right, and health care is WAY too expensive here for someone without insurance to indulge in.

@linsey: Sorry for misspelling your name!

Lucille, are you dense or what?

What in any one of my posts gave you any idea I'm obsessed with the almighty dollar?

People like you, Lucile - ignorant in economics - that make me worried for this county.

Hmmm. Joanna's story sounds almost like a mechanic trying to take advantage of a customer who doesn't know anything about cars. When there's a profit to be made at your expense, you have to be informed or you'll get scammed.

I guess the big difference with our "socialized" health care is that dishonest providers are defrauding the government rather than defrauding consumers directly (or through their insurance companies).

In the former case, all tax-paying Canadians bear the brunt of the costs through higher taxes. In the latter case, Americans who are paying for health insurance bear the brunt of higher insurance premiums so the companies can keep making their tidy profits... But they're also getting hit through either higher health care costs because people without insurance can't pay their bills or through taxes as the government fills the gap.

Perhaps I'm missing something, but it sounds like both Americans and Canadians are paying "other people's way". They're just doing it differently.

All humans are more likely to waste any resource they don't see as their own. This is why government programs always grow to gargantuan size and are massively wasteful - there is no personal ownership. This is especially true since the majority of voters do not pay income tax.

It's a let-the-other guy pay or bear the burden mentality.

No skin in the game.

Americans and Canadians are very much alike in this respect.

The point of price transparency in a for profit system really is a major issue. Most people do not have adequate enough insurance that they can simply ignore the initial price of their health care. Many don't have insurance and most programs find ways to dump a large portion of the financial burden back on the patient.

About 50% of those filing for bankruptcy do so because of medical bills, most of those people had insurance.

People in emergency situations simply can't be debating price and many times are not even able to decline procedures. There are very few situations where you can realistically inquire about prices. Even in those situations it is extremely difficult to obtain that information and it frequently sets up a hostile environment with the provider. Doctors and staff get their noses out of joint when people ask about costs or feel it is detracting from competent care.

There are some providers that have almost all procedures and tests including prices online or otherwise easily available to the public. These providers are very much in the minority.

Now add to this the rampant disease mongering by drug companies and some providers, this increases their profits but mostly add to the financial burden of patients. I heard one this morning that said "if your listening to this your at risk for heart disease" and went on to try to sell expensive cardiovascular testing. There was a news piece yesterday, now the drug companies are trying to convince people that young kids need expensive statin drugs for their cholesterol. This is really a seperate issue compared to how broken our for profit medical system is that bankrupts people daily. But at some point either way the lack of transparency and disease mongering has to stop, it is just adding to the financial burden of all of us.

Kelja, I think you're making some very broad generalizations about how Canadians view health care. I get the impression you think everything is handed to us for free and we take it for granted. Let me tell you a little more about what our health care is like.

Resources aren't exactly plentiful up here. There's a significant portion of the population who can't find a family doctor at all, and it really does take 6 - 9 months to get in to see a specialist. Wait times for non-emergency services are ridiculous as well. If you have a family doctor, sometimes it can be weeks before you can get in to see him or her. Emergency room wait times are getting better, but they still aren't ideal. It can take a while to even get booked for a test because of high demand. Private hospital rooms aren't free either.

You're wrong when you say that we're wasteful or careless or don't take personal responsibility because our health care is "free". As you argue, people may be careless with resources they don't take ownership for, but you're forgetting that people are MORE careful with resources that are limited.

In addition, I think people who pay more for something have an inflated sense of what they are entitled to. The whole "I worked hard for it, therefore I deserve" it attitude is part of what got the US into its current financial crisis in the first place.

Maybe what we need to do is think about piecewise solutions.

1) Everyone should be able to afford basic preventive services--it would be great if more people "took advantage" of the system to get their kids immunized, teeth cleaned regularly, etc.

2) Everyone should be able to join negotiation guilds to work out prices for the usual illnesses and so forth.

3) Everyone should be able to spread out the risk of catastrophic illnesses or accidents.

4) We should encourage drug innovation (including basics like immunizations and antibiotics) without putting appropriate pharmacology out of the reach of patients.

To my mind, (1) is a perfect candidate for government universal coverage. I think the uninsured often don't "take advantage" of the system as avoid the system as long as they can; this would be more efficient and save paperwork.

For (2), maybe more like the current system, except set up options that do not rely on being employed by a big company. Make it just like joining Costco or something. Make your coverage as portable as your cell phone number, not just the limited time that COBRA allows. Middle class people can budget and price shop and whatever; the poor are on medicaid anyway. It is my understanding that with a lot of welfare programs it's more expensive to track down a few "abusers" than to just let them draw the check; I would imagine that it would be just as true here, especially since people don't go to the doctor to make money. (Well, unless they're drug reps....)

For (3), the private sector might be able to handle this if they were absolutely forced to cover people for the same price except for maybe smoker/non-smoker and maternity differentials. Even better, to my mind, would be a sliding scale, but that won't happen. The point is to actually pool the risk; it's not much of a pool if you slice it so fine that each pool is just a droplet.

I'm not sure what we can do about (4), but it's worth thinking about how to promote scientific research in general.

I must be getting tired. Joanna, I was answering your question and I put in the wrong name (and spelled doctor wrong too! ha!)

Got to hand it to Philip... I've never paid this much attention to an article and it's comments before. I'm learning so much that I keep coming back!

@Elizabeth

The statement by somebody that "the majority of voters do not pay income tax" seems unlikely. It's probably true that somewhere between 30% and 40% of the potentially tax-paying residents of the U.S. pay zero income tax. But these are mostly poor and young, two categories that are among the least likely to vote. So, without documentation, we should regard the statement as right-wing hyperbole (to put it as gently as possible).

@Edgar A

Yea, should have amended my statement to say approximately 32% don't pay income tax. Or, perhaps this would be more to your liking - 50% pay very, very little income tax. This, by the way Edgar, isn't hyperbole, right-wing or otherwise. I wish you'd keep your obvious prejudices to yourself since you have no idea of my philosophical leanings.

See: http://www.taxfoundation.org/research/show/542.html

Since you seem (I could be wrong here) to be a believer in big government, answer the question I posed here earlier.

Name one government program that is both efficient and effective? Hard one, eh?

It's really common sense, someone who has 'skin' in the game, is much more interested in the outcome than someone who does't. Human Nature. The people who get entitlements from government and pay nothing in, vote to increase entitlements with little regard what it does to the taxpayer. Why is this hard to understand?

I'm a believer that individuals can rise up challenges no matter what. Big Government, in my opinion, stands in the way of creative, smart and motivated people.

First off, let me state that I am thoroughly enjoying this debate/conversation and, as someone (maybe Andrea?) stated earlier, am learning a lot. I particularly appreciate the Canadian perspective. It had been months since I’d been to Wisebread, but I’m so glad I stumbled back. Thank you, Philip! And now to what I missed last night when my computer crashed at home…

@Canada girl:

“As you argue, people may be careless with resources they don't take ownership for, but you're forgetting that people are MORE careful with resources that are limited.”

Excellent point here, and one I had not considered. I’m not sure it makes the case for socialized health care given the lack of resources, but people would value those resources more if they were less plentiful.

“In addition, I think people who pay more for something have an inflated sense of what they are entitled to. The whole "I worked hard for it, therefore I deserve" it attitude is part of what got the US into its current financial crisis in the first place.”

Here, I have to disagree with you, not about the mentality, which I agree is rampant in the US, but about the cause. My best friend is a Legal Aid attorney, whose clients do not pay for their services, and let me tell you, it ain't the paying for it that makes people feel entitled. Her clients are often extremely demanding and resentful of any efforts they must personally make to further their own case, despite the fact that they're receiving a free service (and one with many other clients). I’d actually argue that it is entitlement programs (social security, welfare, etc.) that give people that mentality. Although perhaps we’re both off the mark and it’s a simple matter of plentitude or scarcity of supply. Nothing would humble you like waiting 9 months for a dr.'s appointment.

@Xin Lu:

I agree with you wrt the need for price transparency, but not with the government mandates. As a culture, IMO, we need to look less to the government for our solutions and more to ourselves. Transparency would also be made available if demanded by enough people. Perhaps a not-for-profit advocacy group is in order.

You do make a good point re: monopolies, but socialized health care is exactly that, a monopoly. I guess I should have said government-run programs rather than just government intervention.

@Edgar A.:

“The statement by somebody that "the majority of voters do not pay income tax" seems unlikely. It's probably true that somewhere between 30% and 40% of the potentially tax-paying residents of the U.S. pay zero income tax. But these are mostly poor and young, two categories that are among the least likely to vote. So, without documentation, we should regard the statement as right-wing hyperbole (to put it as gently as possible).”

I absolutely agree that documentation would be needed to support this statement (obviously a moot point now as Velja has backed up her previous statement), however, Velja expressed a mind-set that is not unique to her. Is the correct response an immediate write-off as “right-wing hyperbole”? Or would that be as bad as refusing to listen to a “flaming liberal”?

Perhaps the right response to a statement we initially find overly dramatic or even morally repugnant, is to consider the statement and look for the grain of truth within it, or at a minimum the circumstances and beliefs that have created the mentality, then consider it before we discard it. Believe me, I understand how difficult this is; it’s something I am working on personally. However, I really believe that that’s where we’d have to get to truly get out of “partisan politics”.

Just my two cents,

Jo

Wow, holding up the USPO as the paragon of effeciency!

We have vastly different experiences. As part of a business, I have sent out hundreds of thousands of piece of mail through the U.S. mails. A good of percentage of mail that was either destroyed or never received by recipients was sadly expected. It was, after all the post office.

Maybe your local post office is different, but I've enjoyed lines that would be the envy anywhere in Eastern Europe during the old Soviet era. Haven't you had the experience where one or more of the clerks has simply taken a break when there's a long line of customers?

Inefficiency has always been part of the Post Office. If not, alternative delivery services wouldn't have been born and prospered - UPS, FedEX, etc.

My dad got a job at the post office in the 1940's when he was a teenager. Too many of the men were off fighting the war. First day he delivered the mail, he was too quick. He finished his route early and came back to the post office to find out what else he could do. The supervisor's eyes got real wide and he yelled, 'what are you doing back here so soon?'. When my dad told him he finished delivering the mail, the supervisor told him to go hide somewhere - a poolhall, a friend's house, anywhere, but not to show back at the post office until the end of the day.

Do you think the USPO has changed that much?

And, Kevin ------------ you have to be kidding!

Wasteful, Inefficient companies in the real world get punished by the market and go bankrupt. Anyone who's run a company is acutely aware of that fact! Government programs, no matter how wasteful and stupid, don't ever go away.

You mention the Coast Guard, a branch of the military I have a high regard for. It might do a good job at what they do, but like the rest of the military, it's laughable how wasteful they are.

Anything a federal agency can do, private enterprise could do better.

"Wasteful, Inefficient companies in the real world get punished by the market and go bankrupt."

Halliburton, Exxon, and AT&T are all wasteful yet successful companies.

"Government programs, no matter how wasteful and stupid, don't ever go away."

The Civilian Conservation Corps is the first disbanded government agency that comes to mind. There are others.

"Anything a federal agency can do, private enterprise could do better."

That's one heck of a broad claim and I really doubt it could be defended against every real or hypothetical service. Why were private firefighting services abandoned for municipal ones?

In most cases it's an apples-to-oranges comparison anyway because companies can select their clients while government agencies are beholden to service everyone. FedEx can close unprofitable branches, but USPS is beholden to service practically everywhere. Getting back on topic, Medicare has to cover everyone over a certain age yet private insurers can choose to avoid expensive individuals.

Thanks, everyone, for this great discussion.  I'm pleased to have played a part in kicking it off.

Ever stop and think about how private health insurance works? Successful businesses must make a profit. That profit, for any insurance company, can only be made in a few general ways: increase your ratio of profitable to unprofitable customers, charge more money for the same services, or cut costs. Also consider that a private market economy demands not just profit, but a growing profit... otherwise a company will see dwindiling investment, less available credit/capital, and a shrinking market share.
The ratio of profitable to unprofitable customers remains fairly constant between new and existing customers as long as legal and economic regulation don't change, so that's the industry's base minimum bar for growth. That only leaves two other options: charge more, or cut costs. Charging more shrinks your customer base and hurts your ratio...not a company's first choice. Then, there's cost cutting: reduce overhead or reduce service. There's a point where overhead simply can't be reduced further and the only remaining way to increse profits is to reduce services by denying claims, reducing coverage, etc... More for less becomes the name of the game.
Consider also, anyone in the United States can walk into an emergency room and be guaranteed treatment for serious injuries. You don't have to: have insurance, prove you can pay, or even be a citizen. It is illegal to deny you treatment. For those that don't pay (any reason) the cost is absorbed by the hospital. Hospitals (even public ones) are still bound to economic pressures to break even...or better yet, to turn a profit. So, the losses sustained by providing guaranteed treatment down in the E.R. get spread amongst all the other services in an attempt to stay in the black. The most profitable services provided are those paid for by insurance companies and various governmental institutions.
So far: the under- or un- insured are a loss for hospitals due to laws guaranteeing treatment, that cost is then passed to either the insurance companies or the government by charging more for paid services, and the insurance companies pass it back by charging more for less, or the government passes it back by increasing taxes.
That means anyone that either pays taxes or has health insurance is already paying for a low-grade form of universal healthcare. The differences between this present form of universal healthcare and a social program are: the quality and availability of services, who manages the system, and the fact that profit earning is a factor. The few are still paying for the many, and getting a raw deal to boot.
There are really only two solutions to this problem: change the laws and deny medical treatment to anyone incappable of paying for it, or eliminate profit earning for the equation. Eliminating profit can come in two forms: regulating the industry into non-profit status and watch all things good about free market economics disapear, or create a governmental program providing true universal healthcare.
Wouldn't you rather get a better deal, have an immense weight taken off your shoulders, and help countless people live a happier and healthier life? Do you enjoy providing outrageous salaries to industrial healthcare executives, or would you rather see that money in the smile of your friends and neighbors? Ask yourself this: If every day you were to hear personal accounts of the tragedies this system is responsible for: people affraid to seak treatment for fear of the costs- dispite having debilitating and painful conditions, families reduced to poverty or bankruptcy because their insurance company denied coverage and they chose to save their loved one's life, those that are scarred- crippled- or dead because they avoided treatment until they had no choice and were forced into the E.R. to recieve the bare minimum of care... could you sleep at night?
Remeber that for all, frugality is not a choice but a necessity. Impoverishment is not often a choice, and is seldom able to be laid as blame at the feet of the poor. Living modestly is no sin...it is, in fact, a virtue.

I love your site! I know what you mean, but the phrase, "low standard of living" has negative connotations. When did living w/in ones means, living simply, or being poor, become crime-like. Ho hum. I just don't want to fill my life with junk and I care about people and our lovely planet. I had the opportunity to travel to New Zealand, and stayed in hostels. The transportation and accommodations there were terrific!! Unlike any I've seen in the US. I meant a lot of people from Asian and European countries, and what I noticed, and it stuck with me, was how free they were. They didn't seem to worry about money like the US, and they didn't have to worry about healthcare, and they seemed liberated/free. When my mom was losing her battle w/cancer (She had her own HInsurance problem when my father's company dropped retirees and told them a month later. Try getting affordable supplemental insurance w/pre-existing conditions.), she made pre-arrangements. When she passed and we went to the funeral home, they were trying to sell us all kinds of things for thousands of dollars. We kept saying no. They didn't understand, it wasn't that we couldn't pay, it was, we didn't WANT it.   HInsurance is a joke. I quit my job (when to contracting) to help and be with my mom/hospice.  When I left,  I spoke w/contractors and they said pay out of pocket. I had terrible experiences w/Cobra, catastrophic, and other HInsurance. It was stange being drilled by a salesperson about personal health issues and they weren't happy when there weren't any they could write about. It was a real game to them.  My HInsurance is exercise, eating "right", hopefully keeping my environment safe, and prayers. I just didn't want to participate in what I saw was a losing, corrupt business. A friend, who only had HS diploma, actually had a job approving claims, overriding doctors. I wanted to downsize my home from 1600 sq ft to something smaller because I wanted to - less upkeep, insurance, property taxes. I didn't need much and didn't want much - quality vs quantity. The real estate agents turned their heads, and some subdivisions actually had size limits, large was okay, but not small.  It takes great strength of character in our society - we are inundated with pressures to consume and misinformation -  to simply live and live simply.