How American Health Care Killed My Father

[Wild Cobra]

This is essentially what I favor. A national health insurance model (i.e. Medicare for all) to provide basic coverage to everyone and then private market insurance to provide higher levels of care for those that choose to purchase it. Defining what "basic coverage" is becomes the tricky part.

Of course the right would oppose it as a government takeover and the left would oppose it as unfair.

It is against my the libertarian side of me to have such systems, but we do have enough people in this nation who want some form of universal coverage. At least if the coverage is highly limited, there will be that added incentive for people to provide their own supplemental insurance, or seek employment that offers good insurance.

My understanding of employer provided coverage is that it was a benefit to draw the best workforce to work for them than their compe ion. When you remove such options, we are one step closer to a lowest common denominator society.

[ElNono]

Meh...we can import some more cheap doctors from India and Pakistan.

We already do.

[Yonivore]

We already do.

Hence, the phrase, "...some more..."

[ElNono]

The solution set is not binary. LnGrrrR has made a good point, which I've been trying to make forever. Hybridize the Single Payor model.

Let the Single Payor handle the HMO functions...day to day routine checkups and treatments. The single payor piece will go along way to establishing some serious cost savings as well as increasing the quality of care by simply standardizing the back office processes. Everyone uses the same form. Every form goes into a uniform database. It's a no-brainer.

Then let the insurance companies do what they were designed to do....produce insurance plans that leverage risk across time. Freed of the HMO functions, they should be able to reduce premiums substantially and riding on the standardization from the single payor piece, pick up savings in administrative costs to boot.
.

That's how it works in most places, including most of the so-called "socialized medicine" countries (France, Italy, Germany, etc). You have the state run plan and if you rather have better/different/luxury service, then there's private plans that complement and supplement the standard plan, that you can purchase if you want and you can afford them.

[ElNono]

Hence, the phrase, "...some more..."

missed that, thanks

[ElNono]

Those that cannot afford insurance get their routine/preventative health care needs met at government-run free clinics, indigent hospitals, and every emergency room in the country.

But they don't. Emergency rooms have only to "stabilize" your condition and then they're scott-free to ship your ass home. People with disabilities only qualify for Medicare after 2 years. In the meantime, they have to pony up, and a lot of times it simply bankrupts them. And there's a good gap of people that make enough not to qualify for Medicare or Medicaid, yet personal/family insurance is out of their reach. It's the people that are one diagnosis away from personal bankruptcy (half of which happen to be health-related in this country).

The reasons for this situation are varied and have been discussed plenty, but they exist and for a country that spends as much per capita, it shouldn't be there, IMO.

[ElNono]

This is essentially what I favor. A national health insurance model (i.e. Medicare for all) to provide basic coverage to everyone and then private market insurance to provide higher levels of care for those that choose to purchase it. Defining what "basic coverage" is becomes the tricky part.

Of course the right would oppose it as a government takeover and the left would oppose it as unfair.

I would buy on that, provided that whatever is "basic coverage" is tightly controlled by government cost-wise (much like the VA does). Then you move insurance to "catastrophic coverage" only, and zero management. IMO, that would be substantially better than what we have, and probably cheaper too.

[TeyshaBlue]

Who cares if it's cheaper? That's the wrong metric to use.

Effective is a better one. If we just broke even cost-wise, it would be a win.

[coyotes_geek]

What's the latest delta on medicare shortfalls? $70 trillion? We better care if whatever we end up doing is going to be cheaper.

[ElNono]

Who cares if it's cheaper? That's the wrong metric to use.

Effective is a better one. If we just broke even cost-wise, it would be a win.

While I don't disagree, if you have costs always rising faster than salaries, then you're going to have a system out of control. Obviously, if you brake-even, then it's not a concern, but costs would need to be controlled at least to make sure you break even. Any savings are a plus.

[TeyshaBlue]

Yeah, I got ahead of myself a bit. Of course costs are a concern, but shouldn't be the driver. Universal HMO's likely will not save money. But, they will save lives.

[TeyshaBlue]

What's the latest delta on medicare shortfalls? $70 trillion? We better care if whatever we end up doing is going to be cheaper.

We'll just hit CC up for a loan. He dont need those expensive vacations.

[LnGrrrR]

Do you want control of what you can buy or do you want some authoritarian sitting at a deck deciding for you?

Asking the wrong person WC... you know I'm in the military, so I don't have much of a choice, do I?

Of course, I have the choice to pay for it out of pocket, or buy another insurance... which is the same choice that people would have under a universal health care system.

[LnGrrrR]

I think the producers who would end up paying for both systems, would have something to say about that.

And, besides, you'd end up right back where you are...with the non-producers demanding the same level of health care the producers are receiving.

Well that's a different fight, of a different scale. I think implementing a nation-wide "basic" level of care would go a long way towards fixing our issues.

Edit: If someone were to get into a catastrophic injury, then the gov't could look into either sharing the load (% of costs) or a cap. Sure, it sounds "draconian" but the health care system right now for people without work is a lot more draconian than that solution.

Let's face it, "death panels" are already in existence, with companies covering some operations and not others. If the gov't made the same decisions, it'd just be acting fiscally responsible, which is what conservatives want.

No, the only way Obamacare works (and, even then, "works" is a relative term considering the level of care that will be necessary to keep it afloat) is if he can force everyone to use the same system - except for the elite few, of course.

Right now, the system benefits the elite few, does it not? And isn't that what conservatives want? It benefits those who make the most money... people with more money have more options. That's never changing.

[coyotes_geek]

Sooner or later we're going to have to get around to answering these two questions if we want to be serious about making healthcare more affordable in this country. Until then, we're pretty much just discussing how to take the same healthcare costs, shuffle the deck and make more people feel better on the re-deal.

1. What are we going to do about the illegals?
2. What are we going to do about the self-inflicted costs to the healthcare system created by the uniquely-American fat /couch potato lifestyle?

[boutons_deux]

"basic" level of care

what's that? if you get really UN-basic sick, you aren't covered?

It's the really sick people who cost the most

a Portland managed care organization for Oregon Health Plan, about 25 percent of the adult patients accounted for 83 percent of the spending in 2011.

http://www.politifact.com/oregon/sta...-80-health-ca/

and it's the really sick people who are impoverished by medical catastrophe, who declare bankruptcy, and many them ARE insured.

[LnGrrrR]

Not true.

I have paid as I went out of pocket for a few years, and in doing so paid less than my insurance deductions through my employer. Someone making decent money can s out the costs of periodic visits and pay less than paying for full insurance, also buy a policy that either has a high deductible, like $10k, a catastrophic type policy, etc.

We have choices, and such methods are cheaper, especially when you have to decode if your ailment is worth paying to see a doctor or not. Too many policies have too low of a copay or no copay. People don't care if they do see a doctor or something trivial, and the whole insurance costs are higher for such reasons.

If a person chooses not to buy insurance, then that's on them. They get treated and billed. If they cannot pay, they can be sued. Poor people don't care as they have nothing worth suing for anyway. People with assets or good income care, and will buy insurance or risk losing those assets.

Insurance need not be mandated, and I think those wanting to take my choices away ought to be sent to some other country.

And what happens if something horrific happens and you are hospitalized with a major disease or injury? Could you afford the bills without a significant reduction in your lifestyle?

[LnGrrrR]

This is essentially what I favor. A national health insurance model (i.e. Medicare for all) to provide basic coverage to everyone and then private market insurance to provide higher levels of care for those that choose to purchase it. Defining what "basic coverage" is becomes the tricky part.

Of course the right would oppose it as a government takeover and the left would oppose it as unfair.

I think the above would be a great first step. Too bad the discussion is poisoned by politicians on both sides.

[CosmicCowboy]

Well that's a different fight, of a different scale. I think implementing a nation-wide "basic" level of care would go a long way towards fixing our issues.

Edit: If someone were to get into a catastrophic injury, then the gov't could look into either sharing the load (% of costs) or a cap. Sure, it sounds "draconian" but the health care system right now for people without work is a lot more draconian than that solution.

Let's face it, "death panels" are already in existence, with companies covering some operations and not others. If the gov't made the same decisions, it'd just be acting fiscally responsible, which is what conservatives want.



Right now, the system benefits the elite few, does it not? And isn't that what conservatives want? It benefits those who make the most money... people with more money have more options. That's never changing.

I could live with that. Kind of a "Texas Med clinic" model where you have 24 hour neighborhood walk-in clinics that handle all the basic stuff for a modest co-pay, then you have catastrophic insurance and the normal specialists for the big stuff. We would still have to do something about the drugs, though. That's a HUGE part of insurance health dollars.

[LnGrrrR]

1. What are we going to do about the illegals?

Amnesty them so they can start paying taxes and contributing. Of course, that would mean we should only amnesty those < 30...

2. What are we going to do about the self-inflicted costs to the healthcare system created by the uniquely-American fat /couch potato lifestyle?

That's a biggie. I'd suggest something like a mandated fitness class for continuing benefits, but that would never ever ever get passed.

Then again, I have a different perspective on things since I'm planning on being a "lifer" in the military. We have to do all that stuff anyways, so I don't see what the big deal is.

[coyotes_geek]

We would still have to do something about the drugs, though. That's a HUGE part of insurance health dollars.

We've got to drop the walls when it comes to importing prescriptions from other countries.

[ElNono]

Sooner or later we're going to have to get around to answering these two questions if we want to be serious about making healthcare more affordable in this country. Until then, we're pretty much just discussing how to take the same healthcare costs, shuffle the deck and make more people feel better on the re-deal.

1. What are we going to do about the illegals?
2. What are we going to do about the self-inflicted costs to the healthcare system created by the uniquely-American fat /couch potato lifestyle?

Not so sure it circles around that, IMO. We're already paying for both right now, either through Medicaid or unpaid emergency room visits. If your question is: should they be part of this "basic package" program? then it's debatable. At least in the Medicaid case, they already are. So perhaps it would be a good time to tighten up Medicaid and only provide emergency services. Just a thought.

[ElNono]

I could live with that. Kind of a "Texas Med clinic" model where you have 24 hour neighborhood walk-in clinics that handle all the basic stuff for a modest co-pay, then you have catastrophic insurance and the normal specialists for the big stuff. We would still have to do something about the drugs, though. That's a HUGE part of insurance health dollars.

We've got to drop the walls when it comes to importing prescriptions from other countries.

The biggest problem with that is BigPharma not wanting to close the dollar hose... looking at the ACA, it's quite apparent they have a lot of influence at the top.

[TeyshaBlue]

We've got to drop the walls when it comes to importing prescriptions from other countries.

Or do what I did in college. Get meds from a veterinarian at about 20% the cost.

[Capt Bringdown]

Health care is always rationed, one way or another.

Indeed. Profit-care killed my father.
One week he was getting rationed HMO care, which included such "treatment" as Ben Gay for chronic ankle pain.
The next week, after a medical test that he payed for out of pocket revealed cancer, he was in the hospital getting his leg amputated below the knee and tumors removed from his lungs.