You give me fever
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.
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.