Heathcare Reform

"Ding Dong, the Witch is Dead, the Witch is Really, Really Dead"

In case you haven’t heard, the White House is now talking about an insurance company sponsored Co-Op program to provide coverage to those that currently don’t have it.

In other words, despite the President’s world class communication skills and the disappointing level of understanding on the part of so many Americans, the idea that we’ll receive better care at a lower cost by replacing free market competition with governmental bureaucracy is swiftly being laughed off the table.

Ronald Ragan 1961:

Now back in 1927 an American socialist, Norman Thomas, six times candidate for president on the Socialist Party ticket, said the American people would never vote for socialism. But he said under the name of liberalism the American people will adopt every fragment of the socialist program. One of the traditional methods of imposing statism or socialism on a people has been by way of medicine. It's very easy to disguise a medical program as a humanitarian project. Most people are a little reluctant to oppose anything that suggests medical care for people who possibly can't afford it.

I'm still pissed a stupid ct scan for a kidney stone cost 3200 bucks. Something needs to change to make that a little more affordable for guys like me, who have a combined household income of less than 35000.

No, I don't want all you rich republicans paying for it, and i don't want all you bleeding heart democrats giving it to me for free, but something needs to be done to help keep cost reasonable.

Joey

I would like to see some form of healthcare for all people. When I was younger there was a time when my job did not provide healthcare and I was shelling out 400+ a month to buy it myself and that is when I was a fit healthy young thing too.

1 - Make plans available across state lines. Most health care plans are state-specific, which increases administrative costs for insurance companies. This would lower costs.

2 - Eliminate preexisting conditions clauses. Insurance is for hardship, and there's no greater hardship than knowing you're going to die because your insurance company won't cover your treatment. Incurable is one thing, lack of coverage for a procedure is another.

3 - Require health insurance providers to publish the details of their plans, then allow anyone to buy into any of those plans. There's no reason why an employee of Company X can't use Company Y's health plan. (No, Company Y would not be expected to pay for a portion of a non-employee's coverage. Non-employees would not get that perk and would have to pay the complete cost of the plan.)

4 - Unemployed or self-employed? You should still be able to buy into any published plan. And since every plan is required to be published, you have 100% choice no matter what state you lived in.

The result: Available coverage goes through the roof, competition is increased among health insurance companies (just like with car insurance companies, this would bring costs down because they'd all want to be the cheapest to get your business), and the number of uninsured Americans would drop enormously, bringing costs down further because it's spread out more. This would also fully bring health care into the free market, which the political right is all hung-ho about. This solution should please both sides of the political aisle.

Am I missing something?

Well said Joey….in just a few sentences, you covered the essence of the situation.

Notice there’s no mention of Tort Reform in the Healthcare proposal.

Somewhere around six percent of all procedures are defensive. In other words, they’re not indicated by the patient’s situation but are performed just to protect the physician from getting sued. My wife had a C-Section with our second daughter and my brother in-law who is a doctor said there was no need for it and in fact, we would have been better off with a conventional delivery but the procedure was performed just for liability reasons.

Although more challenging to quantify…fraudulent, frivolous, & excessive settlements add a very significant cost as well.

As a Process Engineer that teaches / practices Lean, I can assure you that very significant cost reductions could quickly be achieved by just streamlining the system.

Bottom line, I’m sure we could take fifteen to twenty percent out of the cost of healthcare care quickly, with little risk, & without taking more freedoms away from Americans by just addressing the above issues but as has been said: never let a good crises go to waste.

Longer term, I’d create a highly advanced diagnostic application that represented the cumulative knowledge of medicine. Along with this, I’d create an intermediate position between nurse and physician similar to the nurse practitioners we have now that would be very highly trained on making observations (IE: is this blemish a mole or skin cancer) but not an expert on biology, chemistry, etc. The idea being that you could have something like a four training program followed by a two year internship that would produce someone that could (in conjunction with the diagnostic application) out perform physicians at a significantly reduced cost.

RX Reven' wrote: Somewhere around six percent of all procedures are defensive.

No I'd say that's Offensive. They are done mostly to pad the doctor's pockets.

The current methodology of insurance payment is responsible for most of the rise in medical costs. They bill an astronomical amount to see how much the insurance company will pay. That way they always get the most money for any procedure.

It's kinda like car insurance. Get a quote from a body shop with insurance and then tell them you don't have insurance and see how much lower the cost goes. I've saved over 2/3rds several times that way.

No, carguy123, they are not done to pad the doctor's pockets. You have a fundimental lack of knowledge and understanding in this area. You must be a Democrat or Republican politician.

Most "defensive" medicine is extra tests for the one in a million chance. The doctor gets nothing from that. Mrs. Reven' got a C section because there is an entire legal industry that does nothing but sue doctors that didn't do a C section. Mommies think their babies are perfect, and if it comes out and isn't perfect, it must be someone else's fault. Lawyers step up and say, sure it's someone else's fault, and we'll go sue them and "make" you money.

As for the prices and insurance companies, the insurance industry captured the political system a long time ago. They passed laws saying it is illegal for a doctor to have two fee sheets, one for insurance and one for none. That way, your office visit (which used to cost $25) gets billed $200 to "everyone" and the insurance company pays the doctor $25 on a "negotiated discount." If you go in and have no insurance, the doctor is forced, by law, to bill you $200.

Last study I saw said physicians get about ten cents on the medical dollar. It's probably less than that today. What portion of that do you want to cut? I'm sure there are plenty of people who want to work for free. Lets start with you.

hate to say it, but i mostly agree w/ the doc here.

(besides, lawyers are the only profession that has unethical ripoff artists in it. ;) )

not to mention that hospitals, etc. need to overcharge the insureds in order to cover the costs of the uninsureds that they can't turn away. people don't get that we're ALREADY PAYING for care for uninsured people.

it's funny (and sad) that those who claim to espouse the free market so dearly are the ones arguing most loudly against competition for the health insurance companies.

despite what those companies would like you to believe, no one has proposed eliminating consumer choice and "replacing" our system w/ a gub'ment run one. the "public option" would be an additional choice for consumers. like your current plan? stick w/ it. think the public plan would be a better value? go ahead and join. if that plan would be as terrible as opponents seem to think, then it will not survive in the market b/c no one will want it.

Actually I do get a different rate sheet when I go to the doc and pay for it myself than when it's billed to my insurance. My last visit to the doc was $100 cheaper for me to pay in cash. They already had the bill prepared for insurance purposes and when I told the lady I was paying cash she changed the bill.

Thank you.

As a Federal employee I have no choice but to use the ObamaCare System.

BTW, I have a door stop that looks just like your picture, Ruby Slippers are metalflake.

There are several problems with Healthcare that are driving up costs.

Tort reform.

Health insurance (several aspects)

Self inflicted poor health of the population.

The "A pill can fix all of my problems" mentality.

Political corruption of all legislation relating to the healthcare and pharmaceutical industries.

The solution is complex and it isn't "Tax us and buy us Health insurance"

Why not have the public option be a catastrophic type coverage? For example you will be provided with fully 'covered' care after paying a certain amount, say ten percent of your yearly income, yourself? That would leave me and the wife on the hook for 3500 a year. No small amount. It enough incentive for me to stay healthy. Then, employers could offer as part of the benifits package to pay some or all of the yearly deductible as incentive to work for them. The deductible amount could change for different income levels. Then, relatively healthy folks like myself would subsidize less healthy folks who cost more. This plan could also include discounts (lower deductible for example) for people who get routine screenings (mamogram, prostate) done.

Just my idea.

Joey

Joey, I buy catastrophic at $37 a month.

MrJoshua wrote: Joey, I buy catastrophic at $37 a month.

really??? That's awesome! Where are you, and how old are you? I'm thirty in mi, and it costs me 75 with a 5000 deductible.

Joey

Buzz Killington wrote: it's funny (and sad) that those who claim to espouse the free market so dearly are the ones arguing most loudly against competition for the health insurance companies.

If the government is involved, it ain't competition. Not if they are spending tax dollars to play, and don't need to turn a profit to survive.

Buzz Killington wrote: despite what those companies would like you to believe, no one has proposed eliminating consumer choice and "replacing" our system w/ a gub'ment run one. the "public option" would be an additional choice for consumers. like your current plan? stick w/ it. think the public plan would be a better value? go ahead and join. if that plan would be as terrible as opponents seem to think, then it will not survive in the market b/c no one will want it.

See above. Everyone who can't afford health insurance will want it because it is subsidized by those who can afford health insurance, and it will not be required to turn a profit for those unwilling "investors".

Social Security was promised to be a "public option" for a simple alternative to private retirement plans.

We all know how well that's turned out, and just how "optional" it is.

Should everything we do have to earn a profit? Should some industries be for the good of everyone?

Doctors should be paid very well for what they do. Same with nurses.

Should we all have the same healthcare options as say...Congressmen? Senators? Dick Cheney?

Xceler8x wrote: Should everything we do have to earn a profit? Should some industries be for the good of everyone?

Only if people voluntarily choose to work in those industries at no profit.

Xceler8x wrote: Doctors should be paid very well for what they do. Same with nurses.

Agreed.

Xceler8x wrote: Should we all have the same healthcare options as say...Congressmen? Senators? Dick Cheney?

Only if we can all afford to pay for those options ourselves... including Congress and Dick Cheney.

joey48442 wrote:

MrJoshua wrote: Joey, I buy catastrophic at $37 a month.

really??? That's awesome! Where are you, and how old are you? I'm thirty in mi, and it costs me 75 with a 5000 deductible. Joey

Catastrophic just covers death and LONG time period illnesses.

Healthcare "insurance", this it is not.

What's really ironic about this "socialism" thing is that you are ok being a socalist if you pay your money into a great big pool that you can share among all the others in the pool as long as that pool is privately owned. But if that pool were the entire country- you scream socialism. It's a pool of money one way or another, how it changes when you pay more for the honor of giving someone profit for "managing" your money vs. not paying a proft to the govenment is beyond me. In the end, it's money you don't take home one way or another.

Also, for those of you who really dispise the govenment taxing for healthcare, or giving some kind of benefits- I do hope you are willing to shell out the money to pay for that benefit you are getting from your company. For that $Xk per year that is paid FOR you, the company does not pay taxes, nor do you. Which isn't like the income you get. So, YOUR corporate paid heath insurance IS being subsidized by the govenment. For the smaller companies who can not afford to pay this, they do NOT benefit from this arragement- so by the current system, the smaller companies are being screwed out of a way to give benefits. If you scream socialism, please pay your taxes on that income that is called heathcare.

And I'm with Xccler8x- why do we pay extra to companies who basically launder my money. Why can't we pool all of it, and use it as needed- skimming off enough to pay for real processing, but not profit. The healthare insurance companies do not provide a real serivice for thier profits- they just handle the money. The serivce is with the doctors and hospitals.

Just my humble opinion.

Eric

It becomes "socialism" as soon as you don't have a choice about paying into it or not, and when what you pay into it is not related to the costs of your service or what you get out of it.

If I'm a fat middle age guy who drinks and smokes an doesn't exercise I damn well should pay more, because statistics say I'm likely to need a lot of health care (which I am, minus the smoking). Likewise if I'm a young mother who has a history of problem pregnancies. People at higher risk for payout should pay more for coverage, period.

People who are healthy should not be required pay more just to "even out" the burden for those of us who are not as healthy, and people who can afford more should not be required to pay more just because they can.

Say you're a 20-something in good shape who doesn't smoke and who hits the gym 3-4 times a week. Would you expect (or be happy) about paying part of my insurance costs to cover an overweight, 40-something couch jockey like me?

Duke wrote: It becomes "socialism" as soon as you don't have a choice about paying into it or not, and when what you pay into it is not related to the costs of your service or what you get out of it.

Sort of like national defence (sic)?

(and before you say that it's in the consitution, so is welfare- it's 3 words later when defence (sic) is specifcially mentioned twice)

Right now, I'm certain the amount that my employer pays is not nearly what I get out of it, so that's half of your definition.

The other problem is that we want to deny the fact that everyone does get some kind of healthcare, be it rather poor from ER rooms, so we ALREADY pay for eveyrone w/o a choice. But you want to deny a better system and ignore what you already pay PLUS pay a separate company profit to "manage" your money. Interesting.

If I'm a fat middle age guy who drinks and smokes an doesn't exercise I damn well should pay more, because statistics say I'm likely to need a lot of health care (which I am, minus the smoking). Likewise if I'm a young mother who has a history of problem pregnancies. People at higher risk for payout should pay more for coverage, period. People who are healthy should not be required pay more just to "even out" the burden for those of us who are not as healthy, and people who can afford more should not be required to pay more just because they can. Say you're a 20-something in good shape who doesn't smoke and who hits the gym 3-4 times a week. Would you expect (or be happy) about paying part of my insurance costs to cover an overweight, 40-something couch jockey like me?

Thing is, even under the current system, I'm quite sure that I pay more for your bad health than my good health. So what you are suggesting that we need some kind of reform to help the good health people like me (am training to run a 1/2 marathon, and have lost 30 lb since most GRMers have last seen me) from people like you?

Eric

Messy business that has a lot of people freaked - so scare tactics all around - 40 million uninsured, 18% of GDP, socialism... Follow the cash. For most people - they live about 73 or 74 years with very minimal usage of healthcare. In the last year or two of life people seem to hit healthcare superuser status as their bodies start to fail them. I'm not saying soylent green is the answer, but we have a system and society where it's ok to spend millions on one 4th stage cancer patient with no real expectation or hope (other than the family's) of altering the trajectory or outcome. You get to pay for it through higher insurance premiums or through medicare taxes. The medical community will oblige because they think they can help improve a life and someone will pick up the tab. Choosing hospice or comfort over heroics is probably best for overall - right up to the point it's your mother, brother, wife or child, then it's the right to life, liberty, and pursuit of happiness baby. OTOH, the medical advances are out there on the fringe rather than what we know today. If you never treat the tough stuff, you'll never get better at it.

Don't really have an answer - the U.S. seems to be in this weird middle ground - we have socialism for the very wealthy and the very poor, and the middle pays as long as they feel they have a shot at getting out of the middle. I am impressed at the level of irony though - got a neighbor (on medicare) railing about the horrors of socialized medicine.

One thing that tends to get overlooked, as far as I can tell, it that people how have Health Ins. are already paying for those who do not. Hospitals have to charge more to those that can pay to cover those who can not. Insurance companies have to raise rates to cover the increased costs from the Hospital. There have been plenty of studies that have found it to be cheaper, in the long run, to get people coverage now than have to pay for their emergency care later.

Have you ever had to have the Police, Fire Department or the Army (just an example) come over to your house for something? For the jast majority of us the answer is no but we all pay for them just the same. Socialism?

alfadriver wrote: Sort of like national defence (sic)? (and before you say that it's in the consitution, so is welfare- it's 3 words later when defence (sic) is specifcially mentioned twice) Right now, I'm certain the amount that my employer pays is not nearly what I get out of it, so that's half of your definition.

No, I'm not talking about the dollars you get paid in benefit. I'm talking about the actuary costs of insuring you as a person - given your risks and lifestyle, you (or your employer on your behalf) should not pay more or less than what it costs to insure you.

I'm all for efficient commonalization of some infrastructure like defense, roads, libraries, and emergency services that are really not efficient to provide on a subscription basis. At a $/person number it does not cost any more for the military to defend a rich person's house than it does a poor person's, and besides, national defense is the way the government does its duty of protecting the rights of every citizen, it is not an entitlement program that is available to some at the expense of others.

alfadriver wrote: The other problem is that we want to deny the fact that everyone does get some kind of healthcare, be it rather poor from ER rooms, so we ALREADY pay for eveyrone w/o a choice. But you want to deny a better system and ignore what you already pay PLUS pay a separate company profit to "manage" your money. Interesting.

No, I want to stop paying what I already pay without a choice, and pay for what I choose to buy for myself and my family.

alfadriver wrote: So what you are suggesting that we need some kind of reform to help the good health people like me (am training to run a 1/2 marathon, and have lost 30 lb since most GRMers have last seen me) from people like you?

Yes, exactly. I am living a less-healthy lifestyle than you are. There is absolutely no reason that you should be required to subsidize that for me. I should pay more for health insurance than you do, based on the actuary difference in our chances of needing medical care.

Duke wrote: Only if people voluntarily choose to work in those industries at no profit.

No one is forcing anyone to work. Should healthcare be a for profit industry? Or should it be for the good of society?

Duke wrote:

Xceler8x wrote: Should we all have the same healthcare options as say...Congressmen? Senators? Dick Cheney?

Only if we can all afford to pay for those options ourselves... including Congress and Dick Cheney.

They don't pay for it. Also, the care that many of them receive would be denied to us even if we have private insurance. Check out Cheneycare. Also, keep in mind, all government employees including the people arguing against a public option benefit from a public option that you and I already pay for. Hypocrites? Not if they choose to get private healthcare AND publish what it costs them to be insured to the level they are comfortable with.

Duke wrote: It becomes "socialism" as soon as you don't have a choice about paying into it or not, and when what you pay into it is not related to the costs of your service or what you get out of it. .... People who are healthy should not be required pay more just to "even out" the burden for those of us who are not as healthy, and people who can afford more should not be required to pay more just because they can.

Again, back to my suggestion that some social entities should be there for the good of the people and not for profit. You could argue that public schools are much like what you've defined above. We all pay into it and get a mixed bag of results. The benefit we all see is an educated society. A society that has a group identity based in the education we receive and it's quality. I've heard some selfish folks argue that they don't have kids. Why should they pay? Everyone who is a citizen should pay is my response. You benefit from this bit of socialism indirectly at least. Same with healthcare. Everyone benefits even if you are not sick or in need of care.

Every industrialized nation has healthcare for everyone. Why are we behind the rest of the world? By the way, The French, Canadians, and English all like their national healthcare just fine. The U.S is the only nation dissatisfied with it's healthcare.

Butch_86 wrote: I would like to see some form of healthcare for all people. When I was younger there was a time when my job did not provide healthcare and I was shelling out 400+ a month to buy it myself and that is when I was a fit healthy young thing too.

at 23 and 3 I'd say you were still fairly young.... can't comment on the healthy part