For sure, Elle, plus the enormous cultural reticence to admit that the
free market / rugged individualism isn't hacking this particular issue
and that the govt might offer something worthwhile.
There's a term which I can't remember which theorizes that one problem
with health care in the US stems from the insured consumer's insulation
from the economic consequences of his health care choices. Sounds as
though that's what you're talking about above?
Health services are not a true free market, because the
consumer weighs in not at all on the pricing of the product.
OTOH, plop your typical middle class employee and his/her
family down somewhere in Canada for a couple of years of
experiencing their health care system, and s/he'll come away
saying s/he doesn't want universal health care, because
Canada won't give him/her and his/her family every
conceivable snake oil product offered for a malady. The
person will not believe s/he's getting the best care in
Canada. "More is better" is a way of life in the U.S.
A cultural shift in attitude will be necessary, IMO. It will
take a generation or two.
I don't know the term, but a former neighbor who was president of the local
hospital at the time explained it pretty much that way, and it made a lot of
sense. He said health care at any particular standard costs a certain amount
to deliver. First in line is the gov't, which says you will deliver for the
amount we pay you or you won't do business at all. Next in line are the
large insurance carriers, like Blue Cross, which say you will deliver for
what we pay or you will be left in the cold. The remainder of the cost is
spread among the self-payers at many times the fair price, because the
others just won't pay. A while ago I had to appeal an emergency room visit
that had been denied... my cost was to be $1300 and BCBS eventually picked
it up for $300. That left the $1000 shortfall to end up on somebody else's
It shouldn't be such a goddarned maze. A few weeks ago a
Harvard PhD, a multi-degreed engineer, and a doctor wrote
the NY Times each wrote letters saying they couldn't figure
out how to navigate the new Medicare drug benefit. Add my
father, also multi-degreed, an engineer, from one of those
high-falutin' schools who has mentioned twice in the last
six weeks that he is struggling mightily with it, as well.
If people as educated as this can't figure out how to get
the benefit, what about the roughly 80% of adults in the
U.S. who never even graduated from any college?
I have read that the uninsured are charged a higher fee
(around 30%) because collecting from them is harder. It's
revolting that different fees are charged for the same
service, but there is, in part, a limited method to the
Also, I hear health care services write off the shortfalls
I hate to dismiss it as "a lot of funny money is floating
around," but the stories I'm reading in reputable
publications sure make it seem like there's little order in
the system. Bargaining over fees and haggling over what
exactly was prescribed given by hospitals seems common. If
one doesn't know the ins and outs, one is doomed, ISTM.
Throw in the NY Times piece recently on people with /good
health insurance/ who were driven into bankruptcy because
having to pay "only 10%" of a million dollars of medical
services is still a lot of money.
to bring this back to hondas...
the above reminds me that for every smart internet shopper that gets a
good deal through costco, sams, AAA, etc
there are several that get ripped off, pay "added dealer markup", etc.
I'm not sure that's a fair comparison. It seems to me that
hospitals will not generally haggle over costs with
individuals without health insurance.
I guess that's incentive to at least have catastrophic
health insurance. Even though one may be well below the
(usually several thousand dollars) deductible for, say, a
hospital visit, one is obtaining the discounted rates that
one's insurance company has previously negotiated with the
So if one wants the discount, one is sort of forced into
dealing with insurance companies. But then by being insured
one is forced into subsidizing a lot of people who aren't
careful with their health. Because of the way the
insurance-health care system (monopoly? ponzi scheme?) is
set up, there's little incentive for them to refuse
unnecessary medical services. Hence doctors may prescribe
away, lining their wallets and bringing income to hospitals,
and promoting the "more is better" mentality while
simultaneously claiming it's necessary because they'll be
sued for malpractice if anything goes wrong. Meanwhile, the
added cost is passed along to those who work to stay healthy
and not abuse the insurance system.
I know buying insurance is about buying peace of mind. One
should not expect to ever get back what one pays. Just seems
that in the last 15 years or so, too many expect to get back
from their premiums what they paid and then some, by
excessive use of medical services that benefits them not at
Of course, with uninsured individuals in need of significant
health care services, at some point Medicaid will kick in.
But that also pushes up costs for everone else. Plus, by the
time such people finally get to the hospital, a malady that
might have been easily cured a year ago has exploded into a
very expensive proposition.
Seems to me a Universal Health Care system would solve a lot
of these problems. It wouldn't be perfect, but it would stop
this persistent spiralling of costs that, as I suggest
above, seems more and more like a Ponzi scheme every year.
then theres double-billing.
the time i twisted my ankle i did everything by the book, (listed urgent
care facility, paid my co-pay, etc.) bout a year later i got a bill from
a doctor i NEVER saw that day, for treatment/services i NEVER received.
only 2 people i saw were the receptionist, and a licensed vocational nurse.
went straight into the shredder and havent heard anything since.
the dealer version of that is the:
"you need to come back with a check because..."
1) the car was mica blue metallic, and we forgot metallic paint was extra
2) down payment was too small
3)credit didnt go through
4)numbers didnt add up
5)want another chance to ream ya
... but to a large extent, I /do/ agree with this part of
your analogy. Indeed, from what I'm reading in reputable
publications, the medical-insurance billing process is so
complicated that mistakes are very common. IIRC, and
ballpark, 30% or more of the time there is a significant
billing error by health care/insurance services. Whether
they're intentional, or just gross gross negligence is
I give the current, non-Medicare U.S. health care system 20
years or less. By which time I will be on Medicare. Still,
if all Americans are paying less for health care (while some
are paying a bit more in taxes), that will impact on
Nice tip re garages, water heaters, and leaky car fuel
tanks. Whoa! Glad you're still alive to post here! We need a
top ten list of "Things NOT To Do While Repairing One's
Honda," drawn from real life experiences.
Okay, time to fess up. Sometimes I can do the *dumbest* things, too.
I used to have an early Nissan 300ZX (troublesome beast!). One day it
developed a leak in one injector, so I bought a replacement. I was waiting
for the weekend to undertake the job, but one night the engine started
running rough. I was only a couple blocks form home so I went home and
parked in the driveway. Then I noticed smoke coming from under the hood. I
didn't have an extinguisher or even a plan, but I opened the hood anyway.
"Huh. I wonder what's happening?!" Of course the leak had caught fire, but
it had burned down to where it was only hoses and insulation sedately
flaming, so I bent over and blew them out like a candle on a birthday cake.
Not two seconds later the fuel injector hose that had been burning ruptured
and sprayed about an ounce of gasoline where the flame and my face had been!
Sometimes it is better to be lucky than good.
About a year ago I was working on those nasty rear control
arm bolts etc. I had to be someplace the next day, so I had
to stop mid-job. For a temporary "replacement" of a bolt I
wired up one control arm with some 10 AWG copper wire I had
lying around, several loops. I thought I should take a test
drive. I made it halfway out the driveway at a couple miles
an hour when the car went over a half-inch bump. The
applicable rear strut assembly collapsed, and that rear
quarter of the car crashed to the ground. The wheel bent out
in a totally unseemly way, and I thought, "Oh no... " The
wire was sheared right apart. Jacked it up. Stuck the old
control arm bolt yada in place. Wheel looked okay. The
asphalt of the road where the car quarter landed was kinda
scratched up. Had the wheel balance checked a week later; it
needed no adjustment. The road looks fine, after a year too.
Helluva crash. I got lucky.
snip "thing not to do during Honda repairs"
I was checking under the hood of a Pontiac Tempest and the wind blew the
hood right almost on the windscreen. It was so strong I could not bring it
down to hook in the support rod. So I left it there thinking I will be done
in a second. I got involved with whatever I was doing (I will tell you in a
second why I forgot) and then heard a very loud thud and everything turned
white. The wind had let up and the hood used me as a supporting rod.
I staggered into work and put in a full day. I think my boss was happy with
how quiet I was that time.
which sounds pretty damn good. all our elected representatives get free
health care off our dime, while a lot of people that pay taxes have no
healthcare at all.
if the govt can negotiate for 300+ million people, they should get a
better deal than my employer! and in that case, id give up my
*excellent* healthcare coverage for something mediocre if my employer
wont have to deal with that burden.
or not. you likely didnt even receive $300 worth of service.
Today's NY Times editorial page has fascinating commentary
related to the above discussion as follows:
"Big Labor's Big Secret" (NY Times, Dec. 28, 2005)
As most Americans are aware, our auto industry is in a
Workers' wages are falling, and hundreds of thousands of
jobs are being sent offshore. ...
How did we get here? There are many causes: poor car
designs, high pension costs, increased foreign competition.
But much of it comes down to the overwhelming health
insurance costs borne by the auto makers. This is why the
union's president, Ron Gettelfinger, has urged Congress to
enact sweeping health insurance reforms.
If the government paid everyone's health insurance bills, as
those in Canada and most of Europe do, Detroit's Big Three
could save at least $1,300 per vehicle. Profitability would
return. With deeper pockets, the auto makers could afford to
pay their suppliers. Communities would be spared layoffs.
Most advocates of universal health care focus on the
opposition of Republicans and insurance companies. But
perhaps the most important factor keeping an overhaul off
the national agenda is one that few Democrats acknowledge:
most of Mr. Gettelfinger's fellow labor leaders don't
support a single-payer system either.
The reason comes down to simple self-interest. The United
Auto Workers is one of the few private-sector unions that
doesn't run its own health plan. Rather, most have created
huge companies to administer their workers' plans, giving
them a large and often corrupt stake in the current system.
Opposition to a national health care plan is as much a part
of the American trade union tradition as the picket line. It
goes back to Samuel Gompers, the founder of the American
Federation of Labor, who railed at early Congressional
efforts to pass a law mandating employer coverage as Britain
had done, which he said had "taken much of the virility out
of the British unions."
This line of thinking led to the notorious decision in 1991
by the A.F.L.-C.I.O.'s health care committee to reject a
proposal that the federation support a single-payer plan.
The majority said a national system simply had no chance in
Congress, but others saw a conflict of interest:
government-supplied health care would put union-run plans
out of business.
The deciding vote was cast by Robert Georgine, chief
executive of Ullico, a huge insurance provider created by
the unions. A decade later, Mr. Georgine, who was paid $3
million a year by Ullico, and several other company
directors - all heads of major A.F.L.-C.I.O. unions - were
investigated by a federal panel for insider trading
involving Ullico stock. Mr. Georgine and several directors
resigned, and this year he agreed to pay back $13 million to
Let's face it: union-administered health insurance funds
provide irresistible opportunities for labor leaders. First
there's patronage: hiring friends and relatives. Then there
are the conventions, junkets and retreats provided by the
plans and the providers. And for those willing to cross the
line of legality, there's the chance to take kickbacks from
health care vendors.
Many officials are charged, but few go to prison, even when
money allegedly winds up in Mafia hands. Last month federal
prosecutors lost a criminal case in Brooklyn in which they
charged that the Genovese crime family leaned on two
International Longshoremen's Association local presidents
to, among other things, choose a favored health vendor.
Evidently, the jury was convinced by the defense's argument
that the union leaders were under duress. Even Lawrence
Ricci, the principal accused Genovese figure, was acquitted,
although he disappeared during the trial and never
testified. (His body was found last month in the trunk of a
car in Union, N.J.)
Despite shrinking membership, organized labor still has
enough money and muscle to get behind a campaign for
national health insurance. Last month, public-sector unions
in California came up with tens of millions of dollars in a
successful campaign to defeat a ballot measure that
challenged their right to use union dues for political
The problem is getting American unions to fight for common
concerns as opposed to narrow institutional interests. It
may just be that a broad-scale union overhaul will have to
precede one in American health care.
By Robert Fitch, author of the forthcoming "Solidarity for
Sale: How Corruption Destroyed the Labor Movement and
I suspect that the "savings" of $1,300 would quickly be distributed as
bonuses and other executive perks etc. with little going to reduce
prices or instituting efficiencies...
(Who really like to call "trickle down" something else...)
Motorsforum.com is a website by car enthusiasts for car enthusiasts. It is not affiliated with any of the car or spare part manufacturers or car dealers discussed here.
All logos and trade names are the property of their respective owners.