Just as long as that out of the box thinking doesn't involve government and stays safely in the private, for-profit insurance box, right?
wrong. I support alot of government involvement, I just do not support getting rid of the insurance industry. I want it to be reformed. your genius solution of adopting single payer UHC is not even close to thinking outside of the box. its riddled with potential problems. but please go on telling us all how it should be. you can do no wrong.
I have acknowledged that it can, if we do not take steps to ensure that it does not. But rather than even considering that such steps might be possible, you latch onto the possibility that government could end up in control and refuse to entertain another thought. It's not a lack of enthusiasm, which is justified, it's a complete unwillingness to consider it as an even remotely viable option under any circumstances.
are you describing yourself? you think there is no other possible solution other then to get rid of the insurance industry. sounds like you are the one with complete unwillingness to consider other viable options under any circumstances
#1) I was joking about getting you to buy a TV for me, it was all just a joke, I thought you would see that. When you didn't, I added a winky. Since that didn't work, I'll add this text. Done now?
#2) For my out-of-the box comment, if you read back, jlew used "out-of-the-box" in a post and I agree with him that we need more change then just covering evryone and letting the gov't run it while taking more and more tax $.
#3) I hope you have health care, because you need to be seen for your bi-polar disorder. You can be one of the best posters on the board, with some really interesting points and certainly well-thoughtout...and then you do stuff like this..
"Of course, out of the box for you is whatever delusion you can sell yourself that profiting off people's sickness is a good thing and an American tradition... anything that threatens private profit is too outside the box for your liking... you want people safely inside that profit-dominating box"
And then your attacks on Jlew. Relax.
1. Missed that, figured you were trying to lure me into some classic "lazy welfare abuser" statement. My apologies.
2. The entire point I and others have been making, which you and jlew continue to willfully ignore is that government funding does not inevitably mean government control. While you talk about out of the box thinking, you refuse to step out of the "anything government does is bad" box and consider any solution that does not protect the possibility of a private, for-profit insurance industry. We have proposed a number of ideas involving little to no government involvement in health care at all, other than writing checks, and others have addressed the cost issues endlessly.
3. Otherwise reasonable people responding to "really interesting points and certainly well-thought out" ideas with dismissive regurgitations of "I will not consider or respond to any suggestion that involves the government because it is inherently wrong" causes a lot of frustration. And my attack was on you, not jlew, for the absurdity of dismissing out of the box solutions without a thought while saying you want to hear them and giving props to someone who has offered no out of the box solutions yet.
2) I've seen your point. And it's a fair statement to say I'm having a hard time seeing the governemnt being more involved as a good thing. But I'd be more in favor of a system mentined by know1 and you in another thread where you remove the insurance for basic health care and have the patients deal directly with the medical care providers, paying them (except for catastophic care).
3) I meant your attacks on Jlew that came later. read back, you attacked me for sure and I pointed that out and then attacked jlew. One thing though, you use a direct quote from me (with quotation marks) and then make up a statement that you are saying I said using quotes...a bit misleading. I'd like it stricken from the record.
I guess it can be confusing, I don't type, respond to everything and not everything I'm thinking. I'm reading the posts and then when I want to ask a question or add a concern I post it. It doesn't mean that I don't agree with other things or other points that I'm not addressing. I've not completely dismissed any ideas on this one. I'm leary of more gov't control. I've said that the system now isn't working and needs changed. As for solutions, I'm still trying to form my opinion. What made you think I was dismissing your solutions completely? Just because I raised my concern over part of it?
but it can, can it not? typically the person paying the bills gets to the call the shots. with UHC, thats the US government. excuse our utter ignorance for not having such enthusiasm trusting the government to run things how we expect them
neither cincy or myself are claiming to be the know all out of the box thinkers. all I said is we NEED out of the box thinking for the best solution. cincy agreed. calm the fuck down with this already.
This is exactly what I was trying to say.
I don't want to just look at another country's UHC and try to reapply. Certainly we should look at what's working elsewhere and take the best for what will work in our situation.
Just as long as that out of the box thinking doesn't involve government and stays safely in the private, for-profit insurance box, right?
wrong. I support alot of government involvement, I just do not support getting rid of the health care industry. I want it to be reformed. your genius solution of adopting single payer UHC is not even close to thinking outside of the box. its riddled with potential problems. but please go on telling us all how it should be. you can do no wrong.
I have acknowledged that it can, if we do not take steps to ensure that it does not. But rather than even considering that such steps might be possible, you latch onto the possibility that government could end up in control and refuse to entertain another thought. It's not a lack of enthusiasm, which is justified, it's a complete unwillingness to consider it as an even remotely viable option under any circumstances.
are you describing yourself? you think there is no other possible solution other then to get rid of the insurance industry. sounds like you are the one with complete unwillingness to consider other viable options under any circumstances
I assume you meant you don't support getting rid of the health insurance industry, which is my point... you want to protect private, for-profit insurance above all else. That is hardly out of the box thinking to my mind. Any solution that upsets that apple cart too much is out the window instantly.
And I am open to other solutions, but none of the anti uhc/single-payer people have offered any other than small band-aid regulations on health insurance practices... all of which I agree with but none of which address the underlying problems that you and cincy mentioned as requiring out of the box thinking... thinking which you both say you don't possess.
2) I've seen your point. And it's a fair statement to say I'm having a hard time seeing the governemnt being more involved as a good thing. But I'd be more in favor of a system mentined by know1 and you in another thread where you remove the insurance for basic health care and have the patients deal directly with the medical care providers, paying them (except for catastophic care).
that you and cincy mentioned as requiring out of the box thinking... thinking which you both say you don't possess.
I certainly never said I don't posses outside-the-box thinking, don't think jlew did either. I've said I don't have the answer...because I'm still thinking about it.
[I have acknowledged that it can, if we do not take steps to ensure that it does not.
Forgive me if you posted it already, but what are those steps?
For the government to take over the healthcare delivery system, wouldn't there have to be some group that actually wants this to happen? Is there such a group? Not that I know of.
2) I've seen your point. And it's a fair statement to say I'm having a hard time seeing the governemnt being more involved as a good thing. But I'd be more in favor of a system mentined by know1 and you in another thread where you remove the insurance for basic health care and have the patients deal directly with the medical care providers, paying them (except for catastophic care).
How would people without money get care?
It's a good question. I've just recently been reading the arguments made by know1 so I don't have a fully formulated opinion on everything. But, I'd assume that it be part of the welfare program. Food stamps and medical stamps maybe, this is where it's appropriate for the government to play a part. Anyhow, haven't thought enough about it yet and I'm sure someone will try and use my words against me.
that you and cincy mentioned as requiring out of the box thinking... thinking which you both say you don't possess.
I certainly never said I don't posses outside-the-box thinking, don't think jlew did either. I've said I don't have the answer...because I'm still thinking about it.
You really have quite the ego.
unbelievable. this reminds me of Ahimus from the old board. he just snapped one day and told everyone to fuck off. I'm done with this, its pointless.
2) I've seen your point. And it's a fair statement to say I'm having a hard time seeing the governemnt being more involved as a good thing. But I'd be more in favor of a system mentined by know1 and you in another thread where you remove the insurance for basic health care and have the patients deal directly with the medical care providers, paying them (except for catastophic care).
How would people without money get care?
It's a good question. I've just recently been reading the arguments made by know1 so I don't have a fully formulated opinion on everything. But, I'd assume that it be part of the welfare program. Food stamps and medical stamps maybe, this is where it's appropriate for the government to play a part. Anyhow, haven't thought enough about it yet and I'm sure someone will try and use my words against me.
my concern isn't solely those without money, it is ALL of us. yes, i think the first step is making certin those completely without care get some.....but also, what about the rest of us?
we have a few threads discussing bankrupcy due to medical expenses, healthcare costs continuing to rise, out of pocket costs on the rise, how tenuous our coverage really is, lack of choice, etc. most of us are a layoff or serious illness away from no health insurance, being under-insured, etc, not being able to afford care, getting in debt for our own health and so on. it's not just the poor or unemployed, it's all of us - including those of us well-educated, who save for a rainy day and all else to do things 'right'. to me, that's the big picture - what do we do, for us ALL, to ensure healthCARE for everyone, for life?
(and no cincy, not singling you out.....just using your post as a stepping-off point)
my concern isn't solely those without money, it is ALL of us. yes, i think the first step is making certin those completely without care get some.....but also, what about the rest of us?
we have a few threads discussing bankrupcy due to medical expenses, healthcare costs continuing to rise, out of pocket costs on the rise, how tenuous our coverage really is, lack of choice, etc. most of us are a layoff or serious illness away from no health insurance, being under-insured, etc, not being able to afford care, getting in debt for our own health and so on. it's not just the poor or unemployed, it's all of us - including those of us well-educated, who save for a rainy day and all else to do things 'right'. to me, that's the big picture - what do we do, for us ALL, to ensure healthCARE for everyone, for life?
(and no cincy, not singling you out.....just using your post as a stepping-off point)
I agree. Plus, when people have to pay out-of-pocket for every doctor's visit, test, or whatever, even middle-class people will inevitably make many of their healthcare decisions based on financial considerations instead of just doing what's best for their health. I think we need a system where healthcare decisions are not based on personal finances.
my concern isn't solely those without money, it is ALL of us. yes, i think the first step is making certin those completely without care get some.....but also, what about the rest of us?
we have a few threads discussing bankrupcy due to medical expenses, healthcare costs continuing to rise, out of pocket costs on the rise, how tenuous our coverage really is, lack of choice, etc. most of us are a layoff or serious illness away from no health insurance, being under-insured, etc, not being able to afford care, getting in debt for our own health and so on. it's not just the poor or unemployed, it's all of us - including those of us well-educated, who save for a rainy day and all else to do things 'right'. to me, that's the big picture - what do we do, for us ALL, to ensure healthCARE for everyone, for life?
(and no cincy, not singling you out.....just using your post as a stepping-off point)
I agree. Plus, when people have to pay out-of-pocket for every doctor's visit, test, or whatever, even middle-class people will inevitably make many of their healthcare decisions based on financial considerations instead of just doing what's best for their health. I think we need a system where healthcare decisions are not based on personal finances.
exactly.
as it is right now, our entire healthcare IS tied directly to personal finances....and i think that is insane. i've brought up the public/private school thing, the idea of education for all citizens, etc......b/c in many ways, i DO think education and healthcare are similar. (and no, i don't want to get into a debate about the state of our public schools :P) my main point is, i think both education and healthcare should be available to ALL citizens. period. i don't even have children, i was privately educated, and i STILL believe this. too many people don't have the OPTION of choosing to pay for education, or for healthcare......and they still deserve it and need it, and it benefits us ALL to have a poplace that at LEAST receives a basic education, and basic healthcare. it SAVES us $$$, overall, to have a healthy community, long-term...financially and in regards to life happiness.
and that's the thing.....ACCESS to ALL....we ALL support it and can use it...but we also can choose other, private options if we so desire, have the inclination and means to do so. and i know public schools have many faults, there is no one perfect system....but having public schools, education for all, is a far better compromise than leaving a good deal of our children with no education. i think very similarly to healthcare.
my concern isn't solely those without money, it is ALL of us. yes, i think the first step is making certin those completely without care get some.....but also, what about the rest of us?
we have a few threads discussing bankrupcy due to medical expenses, healthcare costs continuing to rise, out of pocket costs on the rise, how tenuous our coverage really is, lack of choice, etc. most of us are a layoff or serious illness away from no health insurance, being under-insured, etc, not being able to afford care, getting in debt for our own health and so on. it's not just the poor or unemployed, it's all of us - including those of us well-educated, who save for a rainy day and all else to do things 'right'. to me, that's the big picture - what do we do, for us ALL, to ensure healthCARE for everyone, for life?
(and no cincy, not singling you out.....just using your post as a stepping-off point)
I agree. Plus, when people have to pay out-of-pocket for every doctor's visit, test, or whatever, even middle-class people will inevitably make many of their healthcare decisions based on financial considerations instead of just doing what's best for their health. I think we need a system where healthcare decisions are not based on personal finances.
And there's danger the other way. When people see it as "free" and don't have to have any investment in it...what will they run to the dr's for....every snifle?
One example given was Car insurance. You don't use car insurance to buy new tires, or change your oil, or headlights, etc. but you use it for a catastophic unforseen event. Can medical insurance be the same?
[I have acknowledged that it can, if we do not take steps to ensure that it does not.
Forgive me if you posted it already, but what are those steps?
Step one is removing all private entities from the political process. Make it illegal for any corporation, compan,y bank, etc to contribute to political campaigns of PAC's. The bill of rights was designed to protect citizens, and the idea of granting personhood to business entities is an absurd legal fiction that is frightening and dangerous. It gives pooled wealth and interests the ability to control the legislative process and political discourse through lobbying and financing elections.
Step two is ensuring that any legislation does not grant the administering agency any power to set prices or cap payouts so that they cannot improperly influence costs or choices of care. Leave this to doctor discretion. This raises the problem of fraud or overbilling, which I am open to solutions on. My initial thought is to vest power in the AMA to set pricing schedules that are not subject to government review or dispute and provide some uniformity. They can be enforced via the AMA's already unquestioned licensing power. It allows doctors themselves to set reasonable pricing standards that both they and the government would be bound by. Hell, at this point I'd be willing to cut government single-payer out, provided that there is a safety net... say a fund set up similar to what is used in the legal system. If you are indigent and cannot afford the services needed, it is paid out of that fund. Or if the costs exceed your means, you can get reimbursed by the fund... kind of a hybrid of single-payer and know1's idea of keeping things between doctors and patients.
There would be market pressures to encourage conformity... doctors only have so much time and thus cannot order unnecessary procedures or take on infinite patients; and payouts to doctors would follow how desirable or reputable a given doctor is, allowing them to operate without an eye to making sure they overcharge enough to compensate for people that don't pay because everyone is guaranteed to be paid for. Patients can balance their desire to always have the best doctor against how long they're willing to wait to get in. It's more freedom than they have under private plans that pick doctors for them regardless of their thoughs. Doctors still have incentive to excel because if they're terrible no one will want to see them and if they're great they'll always have a full list of patients. And if you go a hybrid route they can undercut competitors to attract people that can pay if they want via regular market pressures. Impose stiff criminal penalties for fraud. I'm sure there are systems in place to discover problems wrt to fraud and overbilling in the defense/arms industry and education system. Adapt them.
In addition, I would push for a medical court system similar to the drug court system we have set up in an effort to weed out meritless tort claims and reign in astronomical damage claims and reduce the ancillary problem of profit-seeking litigation in the medical field. Lawyers have it pretty easy for legal malpractice, doctors should too.
As to funding, depending on whether you use a safety net approach for indigence or a pure single-payer model, roll over current payroll taxes directly into this fund. Phase out social security (most of its cost goes to health care, disability, and prescription drugs anyway), and abolish medicare and medicaid and roll them all into the payer system. That's a pretty hefty startup fund right there. If there are still problems, we start cutting programs like the dept of education and other things that ought to be handled locally anyway. I'd also suggest that the military budget could stand a little trimming. There is room to fund this with minimal concern over tax increases.
I had other thoughts in the shower, but they've deserted me now. This is a start though.
And there's danger the other way. When people see it as "free" and don't have to have any investment in it...what will they run to the dr's for....every snifle?
One example given was Car insurance. You don't use car insurance to buy new tires, or change your oil, or headlights, etc. but you use it for a catastophic unforseen event. Can medical insurance be the same?
It should be, but the problem is that it's a little easier to distinguish between routine car maintenance and a catastrophic accident. In health care, it's not quite the same. You go in for a check up, something is anomalous, you're referred for tests, you get a diagnosis, you get treated. At what point did your health become a catastrophe?
In addition, a car is a self limiting cost ceiling, and it's not a necessity. If you can't pay to fix your car, you can bum rides or do without it and the cost of fixing the car doesn't dramatically increase due to your ignoring the problem to wait until it's more financially feasible. If you can't afford preventive care, the long term cost can skyrocket when a routine problem you hoped would go away escalates into a full blown medical emergency. You can postpone car maintenance to fit your budget with no risk. You can't do that with health care.
that you and cincy mentioned as requiring out of the box thinking... thinking which you both say you don't possess.
I certainly never said I don't posses outside-the-box thinking, don't think jlew did either. I've said I don't have the answer...because I'm still thinking about it.
You really have quite the ego.
unbelievable. this reminds me of Ahimus from the old board. he just snapped one day and told everyone to fuck off. I'm done with this, its pointless.
I don't think I told anyone to fuck off. But I did grossly misstate the be-all end-all of outta the box thinking remark, for which I apologize. It came off far more demeaning and condescending than I intended it to and I should have proofread that one.
What I was trying to say is that, while acknowledging one's lack of expertise is a good thing, there is also a danger of using it as a cop out to avoid having to put any of your own ideas on the line for debate and just sitting back to take potshots at everyone else's instead. It's easy to do and I know I have fallen prey to it many times myself. There's a certain poster here who I believe got a degree in it in China. Even throwing out bad ideas gets the brainstorms going. You all may think my ideas are terrible, but it did lead to know1 throwing out the idea of no insurance AND private payers, which sounds promising the more I think about it.
Step one is removing all private entities from the political process. Make it illegal for any corporation, compan,y bank, etc to contribute to political campaigns of PAC's. The bill of rights was designed to protect citizens, and the idea of granting personhood to business entities is an absurd legal fiction that is frightening and dangerous. It gives pooled wealth and interests the ability to control the legislative process and political discourse through lobbying and financing elections.
Step two is ensuring that any legislation does not grant the administering agency any power to set prices or cap payouts so that they cannot improperly influence costs or choices of care. Leave this to doctor discretion. This raises the problem of fraud or overbilling, which I am open to solutions on. My initial thought is to vest power in the AMA to set pricing schedules that are not subject to government review or dispute and provide some uniformity. They can be enforced via the AMA's already unquestioned licensing power. It allows doctors themselves to set reasonable pricing standards that both they and the government would be bound by. Hell, at this point I'd be willing to cut government single-payer out, provided that there is a safety net... say a fund set up similar to what is used in the legal system. If you are indigent and cannot afford the services needed, it is paid out of that fund. Or if the costs exceed your means, you can get reimbursed by the fund... kind of a hybrid of single-payer and know1's idea of keeping things between doctors and patients.
There would be market pressures to encourage conformity... doctors only have so much time and thus cannot order unnecessary procedures or take on infinite patients; and payouts to doctors would follow how desirable or reputable a given doctor is, allowing them to operate without an eye to making sure they overcharge enough to compensate for people that don't pay because everyone is guaranteed to be paid for. Patients can balance their desire to always have the best doctor against how long they're willing to wait to get in. It's more freedom than they have under private plans that pick doctors for them regardless of their thoughs. Doctors still have incentive to excel because if they're terrible no one will want to see them and if they're great they'll always have a full list of patients. And if you go a hybrid route they can undercut competitors to attract people that can pay if they want via regular market pressures. Impose stiff criminal penalties for fraud. I'm sure there are systems in place to discover problems wrt to fraud and overbilling in the defense/arms industry and education system. Adapt them.
In addition, I would push for a medical court system similar to the drug court system we have set up in an effort to weed out meritless tort claims and reign in astronomical damage claims and reduce the ancillary problem of profit-seeking litigation in the medical field. Lawyers have it pretty easy for legal malpractice, doctors should too.
As to funding, depending on whether you use a safety net approach for indigence or a pure single-payer model, roll over current payroll taxes directly into this fund. Phase out social security (most of its cost goes to health care, disability, and prescription drugs anyway), and abolish medicare and medicaid and roll them all into the payer system. That's a pretty hefty startup fund right there. If there are still problems, we start cutting programs like the dept of education and other things that ought to be handled locally anyway. I'd also suggest that the military budget could stand a little trimming. There is room to fund this with minimal concern over tax increases.
I had other thoughts in the shower, but they've deserted me now. This is a start though.
And there's danger the other way. When people see it as "free" and don't have to have any investment in it...what will they run to the dr's for....every snifle?
One example given was Car insurance. You don't use car insurance to buy new tires, or change your oil, or headlights, etc. but you use it for a catastophic unforseen event. Can medical insurance be the same?
It should be, but the problem is that it's a little easier to distinguish between routine car maintenance and a catastrophic accident. In health care, it's not quite the same. You go in for a check up, something is anomalous, you're referred for tests, you get a diagnosis, you get treated. At what point did your health become a catastrophe?
In addition, a car is a self limiting cost ceiling, and it's not a necessity. If you can't pay to fix your car, you can bum rides or do without it and the cost of fixing the car doesn't dramatically increase due to your ignoring the problem to wait until it's more financially feasible. If you can't afford preventive care, the long term cost can skyrocket when a routine problem you hoped would go away escalates into a full blown medical emergency. You can postpone car maintenance to fit your budget with no risk. You can't do that with health care.
i think the car insurance model is interesting...we could lower medical costs across the board so that it would be affordable to pay for routine "maintenance" and have insurance for the big things...but don't ask me how to change things
And there's danger the other way. When people see it as "free" and don't have to have any investment in it...what will they run to the dr's for....every snifle?
One example given was Car insurance. You don't use car insurance to buy new tires, or change your oil, or headlights, etc. but you use it for a catastophic unforseen event. Can medical insurance be the same?
So on one hand we're in danger of people not receiving enough health care (which could result in death) and on the other hand we're in danger of people receiving too much healthcare (which could cost us more money). I would err on the side of caution and prefer for people to have too much healthcare, if those are our options. Plus, although it may be more costly for people to receive too much healthcare, it is also financially costly to not have a workforce at optimum health or to have people skip preventative care and put off being seen until their conditions have worsened. Also, in theory (and this is the theory that many anti-UHC people are afraid of), medical care would be prioritized in order of importance, which would limit the number of unnecessary visits and tests. Finally, money isn't the only thing that keeps people from over-running the doctors' offices. It's not like people go there for fun. It's still a hassle to get off work, wait around for the doc to see you, get poked and prodded, etc. Those factors will still keep people thinking twice before running to the Dr. for every little unnecessary thing.
Here's why I don't think car insurance is a good analogy: 1. Our cars are not as important as our bodies/lives. We can replace our cars, or do without them, if we need to. We cannot replace or do without our bodies, so we need to take better care of them. 2. Car insurance doesn't pay for routine maintenance, but it also doesn't pay for major repairs. The health care system in question would pay for major repairs. We're all in agreement that we need coverage for such things as cancer, not just such things as being hit by a bus or struck by lightening, right? So it's not the same model. And it's more cost-effective, when paying for major events, to avoid those events by paying for the little things up front.
scb, I gotta say, I agree with you on the car analogy. I mean, its comparing cars and people is it not? that just doesnt feel right. lemme ax you a question, what do you think a fair decidable is if the government controlled healthcare? is it zero? how about $500?
scb, I gotta say, I agree with you on the car analogy. I mean, its comparing cars and people is it not? that just doesnt feel right. lemme ax you a question, what do you think a fair decidable is if the government controlled healthcare? is it zero? how about $500?
Do you mean deductible? Celebrating the perfect game a bit tonight?
And there's danger the other way. When people see it as "free" and don't have to have any investment in it...what will they run to the dr's for....every snifle?
One example given was Car insurance. You don't use car insurance to buy new tires, or change your oil, or headlights, etc. but you use it for a catastophic unforseen event. Can medical insurance be the same?
So on one hand we're in danger of people not receiving enough health care (which could result in death) and on the other hand we're in danger of people receiving too much healthcare (which could cost us more money). I would err on the side of caution and prefer for people to have too much healthcare, if those are our options. Plus, although it may be more costly for people to receive too much healthcare, it is also financially costly to not have a workforce at optimum health or to have people skip preventative care and put off being seen until their conditions have worsened. Also, in theory (and this is the theory that many anti-UHC people are afraid of), medical care would be prioritized in order of importance, which would limit the number of unnecessary visits and tests. Finally, money isn't the only thing that keeps people from over-running the doctors' offices. It's not like people go there for fun. It's still a hassle to get off work, wait around for the doc to see you, get poked and prodded, etc. Those factors will still keep people thinking twice before running to the Dr. for every little unnecessary thing.
Here's why I don't think car insurance is a good analogy: 1. Our cars are not as important as our bodies/lives. We can replace our cars, or do without them, if we need to. We cannot replace or do without our bodies, so we need to take better care of them. 2. Car insurance doesn't pay for routine maintenance, but it also doesn't pay for major repairs. The health care system in question would pay for major repairs. We're all in agreement that we need coverage for such things as cancer, not just such things as being hit by a bus or struck by lightening, right? So it's not the same model. And it's more cost-effective, when paying for major events, to avoid those events by paying for the little things up front.
also consider...going to the doctor for a sniffle, as suggested earlier...while sure, it costs $$$ and time......it doesn't cost NEARLY as much, long-term, as those who neglect their health and preventative care. i still think, in the long-run, providing for preventative care is wise. as i said, i just went thru my annual 'preventative care'...witjh a total cost of 2k! now imagine a family...or a single mom with a couple kids...will she or the parents skimp on their own, or their children's preventative care? everyone wants to do what's best for their family, but if they or their kids 'appear healthy'....and the choice is, annual check=up or pay the rent, or buy groceries...i think we all can see which would appear the more pressing need, and be taken care of.
preventative care is the most cost-effective way of increasing longevity, preventing/forestalling disease.....thus it makes far more sense to fund it. if we're going to come up with a bnad-new model of healthcare..well why not aim for what truly would be the BESt for us all?
also consider...going to the doctor for a sniffle, as suggested earlier...while sure, it costs $$$ and time......it doesn't cost NEARLY as much, long-term, as those who neglect their health and preventative care. i still think, in the long-run, providing for preventative care is wise. as i said, i just went thru my annual 'preventative care'...witjh a total cost of 2k! now imagine a family...or a single mom with a couple kids...will she or the parents skimp on their own, or their children's preventative care? everyone wants to do what's best for their family, but if they or their kids 'appear healthy'....and the choice is, annual check=up or pay the rent, or buy groceries...i think we all can see which would appear the more pressing need, and be taken care of.
preventative care is the most cost-effective way of increasing longevity, preventing/forestalling disease.....thus it makes far more sense to fund it. if we're going to come up with a bnad-new model of healthcare..well why not aim for what truly would be the BESt for us all?
I totally agree. And I'll add something else to consider: Birth control is part of preventative care. So I would think all those people in the abortion threads who say the woman should have used birth control should be in support of this idea.
also consider...going to the doctor for a sniffle, as suggested earlier...while sure, it costs $$$ and time......it doesn't cost NEARLY as much, long-term, as those who neglect their health and preventative care. i still think, in the long-run, providing for preventative care is wise. as i said, i just went thru my annual 'preventative care'...witjh a total cost of 2k! now imagine a family...or a single mom with a couple kids...will she or the parents skimp on their own, or their children's preventative care? everyone wants to do what's best for their family, but if they or their kids 'appear healthy'....and the choice is, annual check=up or pay the rent, or buy groceries...i think we all can see which would appear the more pressing need, and be taken care of.
preventative care is the most cost-effective way of increasing longevity, preventing/forestalling disease.....thus it makes far more sense to fund it. if we're going to come up with a bnad-new model of healthcare..well why not aim for what truly would be the BESt for us all?
I totally agree. And I'll add something else to consider: Birth control is part of preventative care. So I would think all those people in the abortion threads who say the woman should have used birth control should be in support of this idea.
absolutely!
(and we'll just leave how the truly religious/anti-BC crowds would fight this even more b/c of that b/c no one wants their tax dollars paying for things they don't agree with)
And there's danger the other way. When people see it as "free" and don't have to have any investment in it...what will they run to the dr's for....every snifle?
One example given was Car insurance. You don't use car insurance to buy new tires, or change your oil, or headlights, etc. but you use it for a catastophic unforseen event. Can medical insurance be the same?
It should be, but the problem is that it's a little easier to distinguish between routine car maintenance and a catastrophic accident. In health care, it's not quite the same. You go in for a check up, something is anomalous, you're referred for tests, you get a diagnosis, you get treated. At what point did your health become a catastrophe?
In addition, a car is a self limiting cost ceiling, and it's not a necessity. If you can't pay to fix your car, you can bum rides or do without it and the cost of fixing the car doesn't dramatically increase due to your ignoring the problem to wait until it's more financially feasible. If you can't afford preventive care, the long term cost can skyrocket when a routine problem you hoped would go away escalates into a full blown medical emergency. You can postpone car maintenance to fit your budget with no risk. You can't do that with health care.
@ the diagnosis, maybe?
True about not having to fix your car. But overall, I like the concept. Would need some work as you point out. What other insurance do you use for routine mainteance of anything?
scb, I gotta say, I agree with you on the car analogy. I mean, its comparing cars and people is it not? that just doesnt feel right. lemme ax you a question, what do you think a fair decidable is if the government controlled healthcare? is it zero? how about $500?
It is not comparing cars to people, that is a way too simplistic look. It's comparing coverages.
Many good critiques pointed out, but I think the overall concept is still a decent one. Is insurance really needed to pay for an annual checkup? Or, if you get a fairly routine issue (ear infection, allergies, etc.)?
Anyhow, it was just a thought posted by someone else that I found intriguing.
also consider...going to the doctor for a sniffle, as suggested earlier...while sure, it costs $$$ and time......it doesn't cost NEARLY as much, long-term, as those who neglect their health and preventative care. i still think, in the long-run, providing for preventative care is wise. as i said, i just went thru my annual 'preventative care'...witjh a total cost of 2k! now imagine a family...or a single mom with a couple kids...will she or the parents skimp on their own, or their children's preventative care? everyone wants to do what's best for their family, but if they or their kids 'appear healthy'....and the choice is, annual check=up or pay the rent, or buy groceries...i think we all can see which would appear the more pressing need, and be taken care of.
preventative care is the most cost-effective way of increasing longevity, preventing/forestalling disease.....thus it makes far more sense to fund it. if we're going to come up with a bnad-new model of healthcare..well why not aim for what truly would be the BESt for us all?
But it isn't just the cost of th evisit itself...it's the opportunity cost of the lost time of the medical field. That Dr. could have been seeing someone else that really needed to be seen. Where do you draw the line? That's tough, and a decent arguement for not even trying. But, that mentality certainly will lead to overcrowded Dr offices (moreseo than now) and delay in treatment.
Preventitive care is certainly better for the patient and whoever is paying the bill...but not all preventitive care. Because sometimes, you don't need to see a dr....that's not preventitive care unless you mean preventing someone else from seeing the Doc that really needed too.
Comments
wrong. I support alot of government involvement, I just do not support getting rid of the insurance industry. I want it to be reformed. your genius solution of adopting single payer UHC is not even close to thinking outside of the box. its riddled with potential problems. but please go on telling us all how it should be. you can do no wrong.
are you describing yourself? you think there is no other possible solution other then to get rid of the insurance industry. sounds like you are the one with complete unwillingness to consider other viable options under any circumstances
2) I've seen your point. And it's a fair statement to say I'm having a hard time seeing the governemnt being more involved as a good thing. But I'd be more in favor of a system mentined by know1 and you in another thread where you remove the insurance for basic health care and have the patients deal directly with the medical care providers, paying them (except for catastophic care).
3) I meant your attacks on Jlew that came later. read back, you attacked me for sure and I pointed that out and then attacked jlew. One thing though, you use a direct quote from me (with quotation marks) and then make up a statement that you are saying I said using quotes...a bit misleading. I'd like it stricken from the record.
I guess it can be confusing, I don't type, respond to everything and not everything I'm thinking. I'm reading the posts and then when I want to ask a question or add a concern I post it. It doesn't mean that I don't agree with other things or other points that I'm not addressing. I've not completely dismissed any ideas on this one. I'm leary of more gov't control. I've said that the system now isn't working and needs changed. As for solutions, I'm still trying to form my opinion. What made you think I was dismissing your solutions completely? Just because I raised my concern over part of it?
This is exactly what I was trying to say.
I don't want to just look at another country's UHC and try to reapply. Certainly we should look at what's working elsewhere and take the best for what will work in our situation.
I assume you meant you don't support getting rid of the health insurance industry, which is my point... you want to protect private, for-profit insurance above all else. That is hardly out of the box thinking to my mind. Any solution that upsets that apple cart too much is out the window instantly.
And I am open to other solutions, but none of the anti uhc/single-payer people have offered any other than small band-aid regulations on health insurance practices... all of which I agree with but none of which address the underlying problems that you and cincy mentioned as requiring out of the box thinking... thinking which you both say you don't possess.
Forgive me if you posted it already, but what are those steps?
How would people without money get care?
I certainly never said I don't posses outside-the-box thinking, don't think jlew did either. I've said I don't have the answer...because I'm still thinking about it.
You really have quite the ego.
For the government to take over the healthcare delivery system, wouldn't there have to be some group that actually wants this to happen? Is there such a group? Not that I know of.
It's a good question. I've just recently been reading the arguments made by know1 so I don't have a fully formulated opinion on everything. But, I'd assume that it be part of the welfare program. Food stamps and medical stamps maybe, this is where it's appropriate for the government to play a part. Anyhow, haven't thought enough about it yet and I'm sure someone will try and use my words against me.
unbelievable. this reminds me of Ahimus from the old board. he just snapped one day and told everyone to fuck off. I'm done with this, its pointless.
I respect that.
my concern isn't solely those without money, it is ALL of us. yes, i think the first step is making certin those completely without care get some.....but also, what about the rest of us?
we have a few threads discussing bankrupcy due to medical expenses, healthcare costs continuing to rise, out of pocket costs on the rise, how tenuous our coverage really is, lack of choice, etc. most of us are a layoff or serious illness away from no health insurance, being under-insured, etc, not being able to afford care, getting in debt for our own health and so on. it's not just the poor or unemployed, it's all of us - including those of us well-educated, who save for a rainy day and all else to do things 'right'. to me, that's the big picture - what do we do, for us ALL, to ensure healthCARE for everyone, for life?
(and no cincy, not singling you out.....just using your post as a stepping-off point)
Let's just breathe...
I am myself like you somehow
I agree. Plus, when people have to pay out-of-pocket for every doctor's visit, test, or whatever, even middle-class people will inevitably make many of their healthcare decisions based on financial considerations instead of just doing what's best for their health. I think we need a system where healthcare decisions are not based on personal finances.
exactly.
as it is right now, our entire healthcare IS tied directly to personal finances....and i think that is insane. i've brought up the public/private school thing, the idea of education for all citizens, etc......b/c in many ways, i DO think education and healthcare are similar. (and no, i don't want to get into a debate about the state of our public schools :P) my main point is, i think both education and healthcare should be available to ALL citizens. period. i don't even have children, i was privately educated, and i STILL believe this. too many people don't have the OPTION of choosing to pay for education, or for healthcare......and they still deserve it and need it, and it benefits us ALL to have a poplace that at LEAST receives a basic education, and basic healthcare. it SAVES us $$$, overall, to have a healthy community, long-term...financially and in regards to life happiness.
and that's the thing.....ACCESS to ALL....we ALL support it and can use it...but we also can choose other, private options if we so desire, have the inclination and means to do so. and i know public schools have many faults, there is no one perfect system....but having public schools, education for all, is a far better compromise than leaving a good deal of our children with no education. i think very similarly to healthcare.
Let's just breathe...
I am myself like you somehow
And there's danger the other way. When people see it as "free" and don't have to have any investment in it...what will they run to the dr's for....every snifle?
One example given was Car insurance. You don't use car insurance to buy new tires, or change your oil, or headlights, etc. but you use it for a catastophic unforseen event. Can medical insurance be the same?
Step one is removing all private entities from the political process. Make it illegal for any corporation, compan,y bank, etc to contribute to political campaigns of PAC's. The bill of rights was designed to protect citizens, and the idea of granting personhood to business entities is an absurd legal fiction that is frightening and dangerous. It gives pooled wealth and interests the ability to control the legislative process and political discourse through lobbying and financing elections.
Step two is ensuring that any legislation does not grant the administering agency any power to set prices or cap payouts so that they cannot improperly influence costs or choices of care. Leave this to doctor discretion. This raises the problem of fraud or overbilling, which I am open to solutions on. My initial thought is to vest power in the AMA to set pricing schedules that are not subject to government review or dispute and provide some uniformity. They can be enforced via the AMA's already unquestioned licensing power. It allows doctors themselves to set reasonable pricing standards that both they and the government would be bound by. Hell, at this point I'd be willing to cut government single-payer out, provided that there is a safety net... say a fund set up similar to what is used in the legal system. If you are indigent and cannot afford the services needed, it is paid out of that fund. Or if the costs exceed your means, you can get reimbursed by the fund... kind of a hybrid of single-payer and know1's idea of keeping things between doctors and patients.
There would be market pressures to encourage conformity... doctors only have so much time and thus cannot order unnecessary procedures or take on infinite patients; and payouts to doctors would follow how desirable or reputable a given doctor is, allowing them to operate without an eye to making sure they overcharge enough to compensate for people that don't pay because everyone is guaranteed to be paid for. Patients can balance their desire to always have the best doctor against how long they're willing to wait to get in. It's more freedom than they have under private plans that pick doctors for them regardless of their thoughs. Doctors still have incentive to excel because if they're terrible no one will want to see them and if they're great they'll always have a full list of patients. And if you go a hybrid route they can undercut competitors to attract people that can pay if they want via regular market pressures. Impose stiff criminal penalties for fraud. I'm sure there are systems in place to discover problems wrt to fraud and overbilling in the defense/arms industry and education system. Adapt them.
In addition, I would push for a medical court system similar to the drug court system we have set up in an effort to weed out meritless tort claims and reign in astronomical damage claims and reduce the ancillary problem of profit-seeking litigation in the medical field. Lawyers have it pretty easy for legal malpractice, doctors should too.
As to funding, depending on whether you use a safety net approach for indigence or a pure single-payer model, roll over current payroll taxes directly into this fund. Phase out social security (most of its cost goes to health care, disability, and prescription drugs anyway), and abolish medicare and medicaid and roll them all into the payer system. That's a pretty hefty startup fund right there. If there are still problems, we start cutting programs like the dept of education and other things that ought to be handled locally anyway. I'd also suggest that the military budget could stand a little trimming. There is room to fund this with minimal concern over tax increases.
I had other thoughts in the shower, but they've deserted me now. This is a start though.
It should be, but the problem is that it's a little easier to distinguish between routine car maintenance and a catastrophic accident. In health care, it's not quite the same. You go in for a check up, something is anomalous, you're referred for tests, you get a diagnosis, you get treated. At what point did your health become a catastrophe?
In addition, a car is a self limiting cost ceiling, and it's not a necessity. If you can't pay to fix your car, you can bum rides or do without it and the cost of fixing the car doesn't dramatically increase due to your ignoring the problem to wait until it's more financially feasible. If you can't afford preventive care, the long term cost can skyrocket when a routine problem you hoped would go away escalates into a full blown medical emergency. You can postpone car maintenance to fit your budget with no risk. You can't do that with health care.
I don't think I told anyone to fuck off. But I did grossly misstate the be-all end-all of outta the box thinking remark, for which I apologize. It came off far more demeaning and condescending than I intended it to and I should have proofread that one.
What I was trying to say is that, while acknowledging one's lack of expertise is a good thing, there is also a danger of using it as a cop out to avoid having to put any of your own ideas on the line for debate and just sitting back to take potshots at everyone else's instead. It's easy to do and I know I have fallen prey to it many times myself. There's a certain poster here who I believe got a degree in it in China. Even throwing out bad ideas gets the brainstorms going. You all may think my ideas are terrible, but it did lead to know1 throwing out the idea of no insurance AND private payers, which sounds promising the more I think about it.
i like this
i think the car insurance model is interesting...we could lower medical costs across the board so that it would be affordable to pay for routine "maintenance" and have insurance for the big things...but don't ask me how to change things
So on one hand we're in danger of people not receiving enough health care (which could result in death) and on the other hand we're in danger of people receiving too much healthcare (which could cost us more money). I would err on the side of caution and prefer for people to have too much healthcare, if those are our options. Plus, although it may be more costly for people to receive too much healthcare, it is also financially costly to not have a workforce at optimum health or to have people skip preventative care and put off being seen until their conditions have worsened. Also, in theory (and this is the theory that many anti-UHC people are afraid of), medical care would be prioritized in order of importance, which would limit the number of unnecessary visits and tests. Finally, money isn't the only thing that keeps people from over-running the doctors' offices. It's not like people go there for fun. It's still a hassle to get off work, wait around for the doc to see you, get poked and prodded, etc. Those factors will still keep people thinking twice before running to the Dr. for every little unnecessary thing.
Here's why I don't think car insurance is a good analogy: 1. Our cars are not as important as our bodies/lives. We can replace our cars, or do without them, if we need to. We cannot replace or do without our bodies, so we need to take better care of them. 2. Car insurance doesn't pay for routine maintenance, but it also doesn't pay for major repairs. The health care system in question would pay for major repairs. We're all in agreement that we need coverage for such things as cancer, not just such things as being hit by a bus or struck by lightening, right? So it's not the same model. And it's more cost-effective, when paying for major events, to avoid those events by paying for the little things up front.
Do you mean deductible? Celebrating the perfect game a bit tonight?
I knew it was bound to happen some day! And now, my work here is done.
When the government pays for healthcare, I think the deductible has to be zero. Otherwise you always run the risk of it being prohibitive.
also consider...going to the doctor for a sniffle, as suggested earlier...while sure, it costs $$$ and time......it doesn't cost NEARLY as much, long-term, as those who neglect their health and preventative care. i still think, in the long-run, providing for preventative care is wise. as i said, i just went thru my annual 'preventative care'...witjh a total cost of 2k! now imagine a family...or a single mom with a couple kids...will she or the parents skimp on their own, or their children's preventative care? everyone wants to do what's best for their family, but if they or their kids 'appear healthy'....and the choice is, annual check=up or pay the rent, or buy groceries...i think we all can see which would appear the more pressing need, and be taken care of.
preventative care is the most cost-effective way of increasing longevity, preventing/forestalling disease.....thus it makes far more sense to fund it. if we're going to come up with a bnad-new model of healthcare..well why not aim for what truly would be the BESt for us all?
Let's just breathe...
I am myself like you somehow
I totally agree. And I'll add something else to consider: Birth control is part of preventative care. So I would think all those people in the abortion threads who say the woman should have used birth control should be in support of this idea.
absolutely!
(and we'll just leave how the truly religious/anti-BC crowds would fight this even more b/c of that b/c no one wants their tax dollars paying for things they don't agree with)
Let's just breathe...
I am myself like you somehow
@ the diagnosis, maybe?
True about not having to fix your car. But overall, I like the concept. Would need some work as you point out. What other insurance do you use for routine mainteance of anything?
It is not comparing cars to people, that is a way too simplistic look. It's comparing coverages.
Many good critiques pointed out, but I think the overall concept is still a decent one. Is insurance really needed to pay for an annual checkup? Or, if you get a fairly routine issue (ear infection, allergies, etc.)?
Anyhow, it was just a thought posted by someone else that I found intriguing.
But it isn't just the cost of th evisit itself...it's the opportunity cost of the lost time of the medical field. That Dr. could have been seeing someone else that really needed to be seen. Where do you draw the line? That's tough, and a decent arguement for not even trying. But, that mentality certainly will lead to overcrowded Dr offices (moreseo than now) and delay in treatment.
Preventitive care is certainly better for the patient and whoever is paying the bill...but not all preventitive care. Because sometimes, you don't need to see a dr....that's not preventitive care unless you mean preventing someone else from seeing the Doc that really needed too.
I'm glad you put "pays for" in italics.