National Health Care
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integra_gsr98;283189 wrote:
tl;drTrafik Jamz;283136 wrote:
I recently posted the following on my FB blog:I am writing this to gather my thoughts on how to create a more perfect and efficient health care system in the USA. First I will start by creating a list of things that I think cause health care/health insurance to be expensive:
1 Reactionary treatment rather than preventive maintenance
2 Drug costs
3 Malpractice Insurance/Frivolous lawsuits
4 AMA/Universities limiting the number of healthcare providers in this country
5 Greed
6 Abuse of the ER system
7 Patients telling Doctors what to prescribe for them
8 Advertising of Prescription medication to the public
9 Doctors prescribing name brand drugs
10 Lifestyle Choices
11 Canned policies
12 Life Support
Now let’s look at each of the above and see what can be done to prevent/lessen these expenses:
1: There is an old adage that says an ounce of prevention is worth a pound of cure. Detecting diseases early is the #1 most effective means to both stop the disease and lessen the amount spent on curing the problem. The obvious choice is to have an annual checkup to better get a grasp on what is going on in your body. I for one think that EVERYONE (legal US Citizen) should be allowed a tax rebate (to be filed at any time in the year…or even filed electronically by the Dr’s office for immediate refund/payment to the clinic) for providing proof of 1 annual examination for themselves and each of their dependants….regardless of tax bracket. Obviously those that have Medicaid/Medicare are already being covered under this and would be the exception to my “regardless of tax bracket” rule, but there are a bunch of people who are not currently covered by any health plan that would benefit from this.
2: Drug costs are substantially higher in the US vs. other industrialized countries. Change the laws to allow for the importation of drugs from other countries so long as they are still in their original certified packages from the drug companies in those countries.
3: Lawsuits cost time and money for the Dr’s….and even if they win them, they may still suffer huge credibility hits. Do some lawsuits have merit? Absolutely! Should they be prevented entirely? Hell no! But how about we put forward a litmus test of sorts in that** if the plaintiff AND THEIR LAWYERS in the case is found to have brought about charges that are completely unfounded, they are financially held accountable up to 50% of the amount they were suing for. **Obviously this would be subject to interpreting what is unfounded and what is not, but it would (hopefully) stop/slow the sue-crazy world in which we live in.
4: Why, oh why does the AMA and Universities turn away qualified applicants from their programs? If we TRULY live in a free society then why are not ALL qualified applicants allowed to pursue the career of their choosing? Get rid of the affirmative action nonsense for a while and let those who qualify study what they choose to. This seems entirely like price fixing to me (limiting supply to increase demand) and should be made illegal. Period.
5: Not sure what can be done on this end. I am all for fair market values on things….perhaps if #4 were allowed to be changed then we wouldn’t have as much greed as it would be competitive.
6: Right now, just about anyone who walks into an ER is guaranteed to be treated…which is a good thing if they have an actual emergency. Sorry, but your little kids runny nose can wait until tomorrow. I’m even ok with covering every child that is a US citizen with health insurance because I honestly don’t think that they have a whole lot of choice in what home they were born into and what social class they fall. But back on topic, broken bones, high fevers, heart attacks, etc… are emergencies. No one should be denied help when they truly need it, but it’s not right that the ER gets bogged down with non-emergencies by people who otherwise couldn’t get healthcare…and worse, ER visits cost at least 4x as much as regular clinic visits and if the uninsured default on their payments guess who gets stuck with the bill? You and I do. So in a way we already have subsidized health care in this country, we just don’t call it that.
7: If I have a problem going to the bathroom too much, it is my responsibility to tell my doctor about my PROBLEM not to tell him that I need Flomax
. There could be a LARGE number of things causing this problem, and yes, Flomax may be the right drug, but unless I am a practicing physician myself, there is no way on God’s green Earth that I should be the one doing the diagnosis and telling him what to prescribe me.
8: Continuing with what is typed above, there is ZERO reason that I need to know about every new drug on the market. We are breeding a nation of hypochondriacs with all this crap. Let the drug manufacturers advertise in trade magazines and send out their reps to hospitals and clinics. Those are the people who need to know. Not me. Not you. I am ok with them having websites that talk generally about what their drugs do…at least then someone is searching for a way to cure an ailment that they already have and not one that they think they have.
9: Once there is a generic drug on the market, I think Dr’s AND pharmacists should be required to mention that to their patients along with any differences between the two (dosage amounts, frequency of use, etc… can be slightly different). If there is a generic drug available that is equivalent to the name brand, then I think insurance should ONLY pay the cost of the lesser priced option unless the name brand is directed by the Dr in writing due to special circumstances.
**10: We, as a nation, are fat, lazy, people. This ties into preventive medicine as well, how about health insurance providers covering a membership to a gym/fitness facility? Don’t people who are in shape tend to live longer and be in generally better health? Maybe require an annual physical as well. Those that are at a high fitness level should get preferred discounts. Those who aren’t, but are making strides towards improving their health should get a standard rate and those whose physical health is in decline (aside from illness caused) should pay a higher rate for their insurance coverage.
11: Choices are good. For example: A post-menopausal woman does not have the same needs as a woman in her mid 20’s who is trying to conceive a child…and her rates should reflect that. In fact, I think that should be an opt-out of coverage for any woman (or man for that matter as child birth sometimes comes from the males policy as well….at least for the child). Cafeteria style coverage would be best. Everyone gets the same “main course” but you get to choose which “side dishes” you’d like with it.
12: Life support. I’m sorry, but there are far too many people that stay on life support for far too long of time. If 2 Doctors state that a patient has no chance of recovery and machines are needed to keep you alive, there is no reason to keep the machine on. I’d say that everyone should be allowed to be on life support for 30 to 45 days but that if there are no signs of recovery in that time, support should be cut. **Sorry to be so cruel, but everyone has to die some time. And yes, I know that it would be EXTREMELY hard to do that with my own family (especially my child) but as I think about it now, with no emotional baggage weighing in on my decision I firmly believe that this is the right thing to do.I’m not a healthcare expert by any means, and the thoughts put forth may or may not provide huge cost savings, but I honestly feel that they would all be the start of something bigger/better for this whole country if they were implemented.
Please feel free to comment/add to this discussion. I do NOT want to see a nationalized healthcare system, but I fully realize that things need to change.Cliffs are highlighted
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thrash;283138 wrote:
You can safely assume that I understand exactly how insurance works. I'm not convinced you do. While risk pooling plays a part in setting premiums, an insurer could still make money on a risk pool of size=1. Insurance, in general, is not modelled on the assumption that the lucky pay for the unlucky. A lot of people think this is the case, but it isn't.Insurance is based on odds. Period. The more people in a rate pool, the more predictable the odds become as a whole. IOW if you have 5 people in your risk pool and you know that the overall odds of getting cancer are about 1 in 3, you cannot cover those 5 people at the same rates as if you have 50,000 people in your risk pool. What if the 5 people you have insured all end up with cancer? Answer: Your company goes out of business. The odds of 5 random people all getting cancer are a LOT higher than the odds of >16,500 (33%) of 50,000 people getting cancer.
I have the ND Insurance Handbook sitting right beside me that clearly states that for a company to be allowed to conduct insurance business in ND, it must show that it's insurable (pure) risk is not greater than than published statistics and in order to do that it needs to have a large number of people in it's risk pool.
Insurance is 100% about playing the odds, it's really not all that much different than professional gambling (although less instant gratification) in that you look at your own health metrics, assess your risks, determine how much risk you (and your family) are willing to take and then put down your ante and let it ride every hand until you hit the jackpot (or rather, end up in the hospital).
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24valvenotak;283192 wrote:
on another note, my aunt recently breached the 1.1mil mark in claims to her insurance for three transplants/complications/diabetes over the years and they dropped her. guess you only get insurance until your actually sick and they stop making money. good thing we dont need any reform or anything.Uh, why shouldn't they drop her? She's cost them 1 million dollars, less whatever her premiums have been in her lifetime.
It'd be one thing if they weren't honoring a contract they had signed -- that's illegal and they should be reamed for doing so.
But if their previous agreement had a sunset date, and they're choosing not renew her, how can you blame them?
How is it that people understand that some drivers are uninsurable, but somehow don't think that should apply to health insurance?
I already stated at the beginning of this thread that people that can't pay their own way don't **deserve **to continue living at the expense of others. If they can convince people to help them out, that is awesome, and that would be one of the nice things about human compassion.
That doesn't change whether we're talking about your aunt or my kid or whomever.
I sure hope I never have to come crawling back to Fargostreet saying "my kid is about to die and I don't have any money left, please help", but I don't beleive that I have any right to *force *YOU to pay for his medical costs.
I have a medical condition that my insurer will only cover up to a certain amount on, and that coverage was completely used up years ago. I've spent at least one nice car's worth of money out of pocket on treatments, and am contemplating another nice car's worth of future treatments.
It's not my fault that I have this problem [as near as anyone in the medical community can tell], but it certainly isn't anyone elses fault. Why should they have to pay? [In some states, they do, but not here].
Luckliy for me it isn't life threatening; it's "only" a quality of life issue.
I know it can be hard to see through the hurt and anger of personal situations, but you have to ask yourself: when will it stop? In order to keep your aunt alive, how much are you willing to steal from others? And from which "others"? If somehow I am taxed so much that I cannot afford future out-of-pocket treatments for my condition, so that your aunt can pay for hers, is that a just system? By what standard or rational basis? Who should decide that your aunt gets treatment and that I do not?
The point you are trying to make about me already being in a shared risk pool where others affect my premiums is perhaps interesting, but here's where it breaks down: today, I can choose not to be a part of any risk pool. And today, I can choose which risk pool I'd like to be a part of. That's what private enterprise allows.
Put uncle sam in that picture and I have no choice left. Make it compulsory and suddenly its an issue of basic rights, the role of government, the appropriateness of taxation, stealing from Peter to pay Paul, and so on.
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Trafik Jamz;283197 wrote:
Insurance is based on odds.I cannot tell if you think you are disagreeing with me or not. In either case, I'll point out that Lloyd's [while not technically an insurer] underwrites policies for irreplacable, singular items as a matter of routine course, i.e. the pool size is 1.
You should also not assume that insurance regulators are brighter than the actuaries designing products.
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If we step back and look at the big picture, the problem with "healthcare" all started when employers started paying for peoples insurance. It's been a downhill slide since then, because it took all the responsibility from the individual. People no longer cared what a doc visit or treatment cost, because "they" were no longer paying for it. Most people don't know or care what it actually costs to go to the doc, because "the insurance company" is paying for it. Without costs being held in check by the individual, doc visits/treatments are expensive enough that people "feel" like they can't afford it. IMO any type of govt program is just adding to the problem. The accountability for paying for your own stuff has to be brought back.
DaveH
'94 Supra- 7.77 @ 176mph -
Isn't the whole point of insurance to cover your ass when you get really sick? Why would they drop someone after they've spent that much? That is why you have insurance, is it not? I understand it's a business, but that is the risk they take going into the insurance industry. You win some, you lose some. Otherwise, what is the point of having insurance? Granted, if she signed a contract that says we will pay x amount of money for you, then yeah that is her fault. If not, isn't that the companies fault? Don't insure someone if you can't take the heat once they do get sick, especially after they approved the policy.
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DaveH;283220 wrote:
If we step back and look at the big picture, the problem with "healthcare" all started when employers started paying for peoples insurance. It's been a downhill slide since then, because it took all the responsibility from the individual. **People no longer cared what a doc visit or treatment cost, because "they" were no longer paying for it. Most people don't know or care what it actually costs to go to the doc, because "the insurance company" is paying for it. **Without costs being held in check by the individual, doc visits/treatments are expensive enough that people "feel" like they can't afford it. IMO any type of govt program is just adding to the problem. The accountability for paying for your own stuff has to be brought back.Which is the reason insurance companies should not be paying for your little "i have a cold" visits to the doctor. I believe that insurance companies should be there to assist in the costs of the more expensive vists. Say.. anything over $500.
Now.. I don't know the cost of medical care as the last time I saw the doc for something was to get my yearly shots. Aside from that, it's been a few years.
Maybe insurance companies should be looking at medical records and setting guidlines on what the value is that the bill has to reach before insurance will step in.
This would eliminate all the pointless visits to the doc. If you still want to go for your "cough", you can foot the bill.
Summary: Insurance companies need to stop covering the pointless "I have had a cough for 2 days" visits. That would grealy help in the cost of insurance.
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PSiedTSi;283221 wrote:
Isn't the whole point of insurance to cover your ass when you get really sick? Why would they drop someone after they've spent that much? That is why you have insurance, is it not? I understand it's a business, but that is the risk they take going into the insurance industry. You win some, you lose some. Otherwise, what is the point of having insurance? Granted, if she signed a contract that says we will pay x amount of money for you, then yeah that is her fault. If not, isn't that the companies fault? Don't insure someone if you can't take the heat once they do get sick, especially after they approved the policy.Most policies have a maximum $ of benefits they will pay. It is stated clearly within the policy (by law). Once you have exceeded the lifetime maximum benefit there becomes no coverage for (all or part) of the policy going forward.
Thrash - Lloyds is a surplus line insurer, insuring things that don't meet the normal risk patterns. To do this, they have to charge more than if you had a larger group of people to spread this risk around, hence the larger premiums. (I'm sure you understand this, I'm just trying to get everyone up to speed on this)
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DaveH;283220 wrote:
If we step back and look at the big picture, the problem with "healthcare" all started when employers started paying for peoples insurance. It's been a downhill slide since then, because it took all the responsibility from the individual. People no longer cared what a doc visit or treatment cost, because "they" were no longer paying for it. Most people don't know or care what it actually costs to go to the doc, because "the insurance company" is paying for it. Without costs being held in check by the individual, doc visits/treatments are expensive enough that people "feel" like they can't afford it. IMO any type of govt program is just adding to the problem. The accountability for paying for your own stuff has to be brought back.Remember when/why employers started doing this?
It was because the government put salary caps in place in the WW2 timeframe. Companies had to find a way to attract talent in a competitive labor market place.
You're right: when the end user doesn't know what things cost and doesn't pay for it, they have no incentive to economize. When the end user has no incentive to economize, the provider has no incentive to compete on price. When both the end user and the provider don't care what something costs, the price continues to go up, until the people stuck footing the bills -- insurers -- start breaking.
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thrash;283228 wrote:
Remember when/why employers started doing this?It was because the government put salary caps in place in the WW2 timeframe. Companies had to find a way to attract talent in a competitive labor market place.
You're right: when the end user doesn't know what things cost and doesn't pay for it, they have no incentive to economize. When the end user has no incentive to economize, the provider has no incentive to compete on price. When both the end user and the provider don't care what something costs, the price continues to go up, until the people stuck footing the bills -- insurers -- start breaking.
24valvenotak;283107 wrote:
take a bottle of 170 dollar brand name pills and then a generic version for 40. i have insurance so guess which ones get prescribed to me... is that the market doing its job?apparently i need another 30 years under my belt before anything i say is actually comprehended
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Ok...I think we can all agree that IF something catastrophic happens (cancer, heart disease, etc....) you will be best off if you have insurance. I'm really surprised more people don't go the route of no major medical insurance but just bulk up on supplemental policies. 2/3 of the expense with cancer happens outside of the hospital (missed work, travel, drugs that aren't covered, etc...) and supplemental pays YOU if you get sick and miss work or need drugs/chemo. Aflac/Conseco and a host of others have really good cancer policies and they are extremely inexpensive vs major medical insurance. I'm not suggesting people drop major medical by any means, just throwing the thought out there.
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24valvenotak;283272 wrote:
apparently i need another 30 years under my belt before anything i say is actually comprehendedI hate to be so condecending, but by reading your posts you just sound like a piece of shit welfare case to me. If your aunt has had that many problems to rack up $1mil+, sorry but she should be dead by now, and big fucking deal if you have to take the cheap pills? Can you afford the difference to buy the good ones? If not, tough shit you should be thankful that someone else is paying the $40 that THEY cost. boo hoo i want everything on someone elses dime, fuck you and pay for your own shit
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Grr;283283 wrote:
I hate to be so condecending, but by reading your posts you just sound like a piece of shit welfare case to me. If your aunt has had that many problems to rack up $1mil+, sorry but she should be dead by now, and big fucking deal if you have to take the cheap pills? Can you afford the difference to buy the good ones? If not, tough shit you should be thankful that someone else is paying the $40 that THEY cost. boo hoo i want everything on someone elses dime, fuck you and pay for your own shitHis point was not that he feels slighted by having to get the generics...
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Grr;283283 wrote:
I hate to be so condecending, but by reading your posts you just sound like a piece of shit welfare case to me. If your aunt has had that many problems to rack up $1mil+, sorry but she should be dead by now, and big fucking deal if you have to take the cheap pills? Can you afford the difference to buy the good ones? If not, tough shit you should be thankful that someone else is paying the $40 that THEY cost. boo hoo i want everything on someone elses dime, fuck you and pay for your own shitAre you retarded?
For example.. A guy I used to work with (a good friend of my dad's), as a grand-daughter that need a life saving brain surgery at the age of 8. Yes, EIGHT. Just the surgery alone was over $200,000.
By time you figure in ALL of the medical bills for this 8 year old, the final tally was over $800,000.
So what your saying is she should be dead because it cost so much to save a life?
Go fuck yourself you ignorant bitch.
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yeah...a million isn't that hard to accumulate in bills anymore at a hospital.
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listen guy, that has nothing to do with any of it, and like i said i carry my own policy and dont use the VA except for the mandatory stuff. I think people get shit for a reason and die for a reason, its natures way. If you dont like it fuck you, i dont need your acceptance, sorry im not some soft cored little bitch
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I can't wait until you or one of you close friends/family has cancer or brain surgery and dies. I'm going to go to the funeral and LAUGH MY ASS OFF and say "They deserved to die, insurance should not cover any of it."
Your ignorance is absurd.
Go talk to the dude who just had his leg amputated. Ask him if he could have afforded the bill without insurance. Willing to bet he couldn't have.
Insurance saves lives. It's the babies who get checked for everything that causes the cost of insurance to go up.
If you don't believe in insurance, what the fuck do you have a policy for? So when you get sick and almost die, that other people's money can save your life? Or will you run like a bitch to the VA and get ur free medical care?
Fuck off and die you worthless pile of white trash. End your life now before you humiliate yourself any more.
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