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Zoethe

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You give me fever [May. 10th, 2010|10:32 am]
Zoethe
When I moved to Fairbanks, Alaska, the firefighting services for all homes outside the incorporated city limits were by subscription. It was an all-volunteer force, and there were no property taxes to cover it. So in order to have firemen fight a fire at your property, you had to subscribe to the service, which was optional.

Because it was optional, many people decided to take their chances and not sign up. If you were one of those people, and your house caught on fire, the fire trucks would respond to your 911 call. The firemen would ensure that all people (and pets, if possible) were safely out of the house.

And then they would stand and watch your house burn to the ground.

No amount of crying, begging, or offering to pay double, triple, quadruple the cost of the annual subscription would induce the fire fighters to lift a finger to protect your personal property. They remained onsite to assure that your fire did not spread to other residences, but the gamble you had lost, you lost completely. The police generally sent a squad car so that officers could intervene if the homeowner threatened the fire fighters, but watching a non-subscription property burn was strictly a spectator sport.

And if didn't matter if you didn't know. In one particularly tragic case, a really charming log home burned to cinders because it happened to be on a narrow appendix of unincorporated land almost completely surrounded by city land. The owners claimed they had no idea - but hadn't checked into the fact that their property taxes were exceptionally low, either. The reports read that fire fighters wept at the loss of that house, but they still couldn't make an exception. Because once you made an exception, why would anyone pay for the annual fire subscription? If coverage can be bought at the time of the fire, why pay any sooner?

That shortsighted thinking would have bankrupted the volunteer fire department. Because most of the people subscribing to the service were not going to have fires, and their funds were paying for the equipment that made it possible to fight fires at other people's houses. By buying the fire subscription, those homeowners were making a bet that they hoped to lose, year after year. They hoped that the only value they got for their money was the assurance that if something bad happened, they would have at least a fighting chance of salvaging their home. And they were goaded into that investment by the sure and certain knowledge that not buying the subscription would mean no one would lift a finger to save their property.

Many people are up in arms because the new health care plan mandates that everyone in this country have health insurance. But the reality is that unless health insurance is mandatory, we will have to make a policy of not treating the uninsured who cannot afford to pay the real cost of care themselves. You were in a horrible car accident and are bleeding out on the side of the road? Sorry, dude; we'll get you a pillow and a shot of morphine. Your baby has meningitis, but you figured you were all young and healthy and didn't need insurance? That's a shame, but you'll have to go home now. Lung cancer? We'll sell you the painkillers to keep you comfortable as it metastisizes throughout your body, but at some point you probably aren't going to be able to afford those.

Sort of turns the stomach to imagine it. We just don't DO that in this country. And that's part of the reason the system is broken - a good and humane reason, part of what makes us the people that we are, but still one that's driving our healthcare costs through the roof. Right now Jill Insured's hospital bill has to absorb part of Joe Uninsured's treatment costs. If we aren't going to leave Joe lying outside the emergency room door, we have to do something to bring him into the system.

A big part of that solution is bringing premiums from healthy people into the insurance pool. Again, buying insurance is placing a bet that you hope you lose. The insurance company hopes you lose, too, because it knows that a certain number of people are going to "win" the terrible prize of becoming very sick and, just like Las Vegas, it needs your dollars in order to pay out to those unfortunate winners. For years health insurance companies have received applications from uninsured people who want a policy now that they've learned they have cancer. Allowing people to buy in only when they're actually sick would bankrupt insurance companies. Even if the companies were non-profit, they would need more healthy dollars coming in than sick dollars going out. So in order to make the system work and treat everyone, everyone has to be within the system.

Yes, there are cost control measures and other problems that need addressing. And if any of my Republican friends try for the "this just lines the pockets of all those rich insurance companies who donated to Obama," you can just think back to when you were up in arms over the notion of a public option and congratulate yourselves on getting us this version. It's not perfect, but it's the best we could get under the circumstances.

By the way, up in Fairbanks? They eventually did away with the subscription service, and everyone has to pay for fire service through their taxes - that's right, universal fire protection. Because even Alaskans couldn't stomach the harsh cruelty of standing by and letting houses burn.
LinkReply

Comments:
[User Picture]From: aiela
2010-05-10 02:48 pm (UTC)
Thank you for this. I may print it out for a few coworkers. :P
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[User Picture]From: zoethe
2010-05-10 03:03 pm (UTC)
It's been banging around in my head for a while. Had to get it out.
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[User Picture]From: trianakvetch
2010-05-10 03:02 pm (UTC)
May I link on livejournal/facebook/twitter?
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[User Picture]From: zoethe
2010-05-10 03:04 pm (UTC)
Always, but please don't identify me by the name I use on facebook/twitter, just link (family and all).
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[User Picture]From: pierceheart
2010-05-10 03:02 pm (UTC)
How do you argue against the morons who come back with "this is an unconstitutional taking of my property, nowhere in the Constitution is that government allowed to make me buy something I don't want."
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[User Picture]From: meyerweb.com
2010-05-10 03:06 pm (UTC)
As long as they support the same right of non-being-bought for people who oppose military spending of tax dollars, then I'd be cool with their objections. Doesn't really change anything, but at least they're consistent.

Alternatively, you could propose that the mandate be done away with in exchange for a tax raise that funds a truly socialized medical system. I bet they'd love that one.
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[User Picture]From: mplsindygirl
2010-05-10 03:11 pm (UTC)
Nice to read something sane about this topic. It puts things in perspective very well.
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[User Picture]From: zoethe
2010-05-10 03:16 pm (UTC)
Thanks.
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[User Picture]From: littlebuhnee
2010-05-10 03:22 pm (UTC)
Excellent way of looking at things. Thank you for writing this.
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[User Picture]From: zoethe
2010-05-10 03:44 pm (UTC)
Thanks
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[User Picture]From: dana3
2010-05-10 03:40 pm (UTC)
I'm horribly sad that this attempt to actually FIX health care descended into 'health insurance reform'. As a survivor of the last round of health insurance reform -- the stuff that gave us HIPAA, so that the people involved in trying to provide you care cannot collaborate or tell your family your condition or a thousand other niceties that used to be much easier -- I have huge concerns about this. Further to the issue, the big companies have found (not surprisingly) that it's going to be cheaper for them just to not cover their employees. See http://money.cnn.com/2010/05/05/news/companies/dropping_benefits.fortune/ for details on that one. Universal fire protection is looking better and better ...
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[User Picture]From: zoethe
2010-05-10 03:45 pm (UTC)
Believe me, I was not in favor of this version of health care reform. Every time we received calls from the DNC asking for money to support the effort we said no because we didn't like the way it was going.

Unfortunately, it's what we have to work with for now.
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[User Picture]From: walkertxkitty
2010-05-10 03:57 pm (UTC)
It's an apt comparison but...

The problem is, it applies to those of us who have insurance too. I've been refused treatment and put on comfort measures only because a doctor determined my life wasn't worth living (I'm 38, still fairly active, and have a family that loves me --- just how do you determine that?). I've had the devil's own time getting simple things like physical therapy, referral to a surgeon so we can see if anything can even be done about my condition, or for useful things like a motorized chair (try pushing a big manual one around for a day, loading and unloading it off a truck, when you have so many crushed discs in your back that the doctor himself winced).

And this is with a service I pay for.

Now, there are regulations in most places about the closeness of the brush to your home and about storage of incendiaries like oily rags. Just suppose that it's one of those homes which catches fire. I wonder, would they still put it out or would they decide that the person in question deserved to have the house burn?

With health care, it's a lot more clean cut. The prevailing attitude --- with all the doctors I've seen going back into my mid-teens --- is that if you're sick, you did something wrong. Fresh air, good exercise, and food will cure it. If it doesn't, you're doing something wrong. If you say you're doing those things you're a liar. I've dragged nutritionist and dietitian verified food logs to a doctor in an effort to prove that I AM sick, not merely fat (none of my health care issues have anything to do with my weight; they caused the weight gain because I can't move around) and had them dismiss them out of hand. One took my wheelchair and made me crawl into his office because he was so certain I was just too lazy to walk.

When I am assured that it will be truly universal health care --- everyone treated without the doctors playing God and no one deciding that this one or that one is more or less expendable --- I'll be behind it.

Until then, I trim my bushes and keep the hose handy.
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[User Picture]From: zoethe
2010-05-10 06:56 pm (UTC)
That's another HUGE set of issues, and they need to be addressed. The mistreatment you've received is appalling.

As I said elsewhere, I am not a fan of this resolution, I'm just explaining why this version requires these measures.

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[User Picture]From: gythiawulfie
2010-05-10 04:21 pm (UTC)

Love this... very well written

And a great explanation.

What I would love to see, is that all insurance companies (auto, home, health, life, etc) be non-profit period.

Also, I know from first hand experience, that the more people that pay into the system, the more the cost spreads, and the more affordable it becomes. The fewer people that pay in, the more expensive it becomes, especially if someone in the system has a cataclysmic event, (ie cancer). The entire cost of insuring the group goes up, but if EVERYONE pays for it, then the cost is minimized.

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[User Picture]From: zoethe
2010-05-10 06:58 pm (UTC)

Re: Love this... very well written

Exactly.
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[User Picture]From: sacramentalist
2010-05-10 04:37 pm (UTC)
What kind of pinko commie sos'shlist libtard nonsense is this??? I mean, it makes sense and shit. And puts things in perspective of something that all Americans care about -- property ownership.


Good work.

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[User Picture]From: zoethe
2010-05-10 07:01 pm (UTC)
Thanks.
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[User Picture]From: phillipalden
2010-05-10 05:10 pm (UTC)
As far as I'm concerned, the "Republicans" have no right to criticize anyone about anything.

They caused the "Sub-Prime Economic Crime Wave" of 2008 through their blind devotion to Reagan's deregulation fervor, and they led the cheer-leading for the invasion of Iraq.

They had little credibility with me before all this. Now they have none. If they had any sense of shame they would sit down and shut up. (Not that the "Democrats" are blameless in all this, either.)
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[User Picture]From: zoethe
2010-05-10 07:07 pm (UTC)
And they STILL sing the deregulation tune. It astounds me.
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[User Picture]From: pkthunder
2010-05-10 09:26 pm (UTC)
Did those homeowners have the option to take out their credit cards or check books and pay outright for fire extinguishing services?
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[User Picture]From: zoethe
2010-05-10 09:43 pm (UTC)
No. There was no way of showing guaranteed funds in time, and no method for volunteer fire fighters to take those funds onsite. And believe me, people offered.
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[User Picture]From: hippie_mamabear
2010-05-10 10:02 pm (UTC)
Just a matter of curiosity: did their homeowners insurance refuse payment too, since they had been negligent by not subscribing to the fire service?
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[User Picture]From: zoethe
2010-05-10 10:21 pm (UTC)
I do not know the answer to that. Sorry.
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[User Picture]From: zoethe
2010-05-10 11:38 pm (UTC)
Yes, Fairbanks still has a volunteer fire department. But the coverage is via taxes, not optional subscription. They are two entirely different things.
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[User Picture]From: therinth
2010-05-12 04:51 am (UTC)
This is a perfect metaphor. Thank you!
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[User Picture]From: zoethe
2010-05-12 04:09 pm (UTC)
Thanks!
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[User Picture]From: lunarennui
2010-05-13 09:11 pm (UTC)
i have never been able to get insurance, with i believe exactly one six-month exception, and i paid through the nose for it. (naturally i did not get sick during that time.) i now have state insurance, which is worse than having NO insurance, because doctors are quite pleasant until i say 'and i'm on basic health' and then they get very, very rude before hanging up on me. i cannot get help no matter how i try. i have applied for insurance; i am turned down for pre-existing conditions. i last had minimal insurance (other than that six months) when i was under 18 and could still get on my mother's insurance.

so i'm all for mandatory health insurance, because i need medical care a lot more than most of the people i know who have really good insurance and maybe get a cold sometimes. i have no idea how i'll pay for it, because i haven't been employed for ten years, but i'm still for it. because it would be really, really nice to go into a hospital and be treated like a human being instead of a steaming pile of shit. i've broken both ankles repeatedly, i've suffered through six months of whooping cough, i paid cash for my tubal ligation, paid in full for my ER trip from my first seizure--didn't go to the hospital at ALL for my second, because what would be the point? they could charge me for a second MRI and tack on a few thousand for the visit itself. mandatory health insurance? i'll beg my family and maybe take up prostitution, but i'll pay the damned fee somehow, because GREAT STARING GODS it would be amazing to have my fibromyalgia treated, my pinched nerves treated, my crippling anxiety treated, and heaven forbid, get antibiotics when i'm desperately ill and coughing blood and neon yellow alien snot babies.
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[User Picture]From: zoethe
2010-05-13 11:44 pm (UTC)
And your health is probably compromised by the care you didn't get. It's a horrible cycle and one we have to break.
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[User Picture]From: spreadsothin
2010-05-14 06:20 pm (UTC)
Mandatory health insurance does not save our healthcare problem. Health insurers aren't crying when beautiful people don't get care, but they are pocketing the profits of a system that benefits corporations over individuals.
With the elimination of the public option, the premiums are out of reach for many people.
And this new healthcare does not sufficiently cover people who live differently: trans people, people who have religious objections to certain services, people who have personal objections to certain services.
That is my big complaint.
After years without insurance, I finally received premium insurance through my heterosexual marriage. This is a premium HMO through a nationally known provider. It pays 53$ every other year for vision benefits. That small amount is designed to cover an eye exam and a pair of lenses. That's not enough for the doctor to make a living on. And this is what I pay for.

The system is fundamentally flawed. I don't think supporting it with mandatory insurance is the answer.
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[User Picture]From: zoethe
2010-05-14 10:53 pm (UTC)
Trust me, I think this plan is horribly flawed. I'm just explaining why if we're going to do this damned silly thing we have to do it this damned silly way.

I still pray for actual reform.
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[User Picture]From: dana3
2010-05-16 05:45 pm (UTC)
May I please have your permission to use extensive quotes from this article, with link-backs, in an academic paper on universal health care? It's only BSN level stuff so it'll never see print, I don't think, but still would like your official permission to use it. Please? Thanks!
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[User Picture]From: zoethe
2010-05-16 05:53 pm (UTC)
With credit, certainly. I am flattered!
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[User Picture]From: ex_sorormys
2010-05-27 10:24 am (UTC)
Insightful, thanks! My goodly hunbun (hubby who is not on LJ) grew up in Anchorage, he said there was something like that for those that lived outside the city limits then (late 70's/early 80's) also.
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[User Picture]From: zoethe
2010-05-27 11:51 am (UTC)
I'm sure they did. We lived in the Hillside area for a number of years, but by the time we were there, regular fire departments had been established.
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