2 simple fixes for healthcare system

[mattpegher]

I do not pretend that this will fix all of healthcare nor does it address pharmaceuticals but as far as the money spent, the first problems that I see are.

1. Insurance companies are not governed by the forces of a free market economy.

Fix: Make it illegal to sell health insurance to two people of same sex and same age for two different rates. ie no group rates/discounts . And make all plans available to consumers to choose for themselves, not purchased by employer. The "benefit" for employees should be monitary to be used as the employee sees fit.

This should be done in two stages the first is to make law re: the rates. The second would probably happen on its own as companies find that they will save money in man-hours managing health plans.

2. Most healthcare expenditures are not tax deductable untill you exceed 7% of your income.

Fix: Eliminate the standard deduction inclusion of healthcare. Make all legitimate health expenditures deductable. That includes medicine (prescription and over-the-counter), doctors bills, lab etc. Excluding only cosmetic proceedures.

This will keep people from giving extra money to the insurance company for small expenditures. For example for me a PPO plan with 1000 dollar deductable costs 1500/month and a catastrophic only PPO with 5000 dollar deductable cost 1000/month for family.

Thats 6000/ year that I dont give to the insurance company. I am allowed to save 5000/year in a health saving account that does not disappear after one year. If I do so this money is pretax if I donot it is posttax.

 

[JS80]

3. Break the monopoly of the American Medial Association

4. Build more medical schools

5. Offer more medical scholarships

Common theme of 3, 4, 5? Increase the supply of doctors = decreases prices.

6. Legislate the forcing of high deductibles for insurance plans = mitigate moral hazard.

7. Cut government spending on medicine = lower demand by leeches

Of course these are pipe dreams, where we live in a democracy - where you can vote to legally steal from your neighbor.

 

[IronWing]

I agree with #3. The way to break the AMA is to remove doctors' monopoly on prescription writing.

8. Nationalize health insurance, eliminating the private health insurance industry and the incredible inefficiencies it has produced.

9. Ration health care. Stop spending tens to hundreds of thousands of dollars to torture people who are going to die anyway. I never met anyone who said they wanted to spend the last six months of life traveling between a nursing home and ICU. I used to be a member of a small group insurance pool (~1000 members). Twelve members broke the pool before dying. Premiums soared due to the expenses of just twelve members who were at the end of life. Just these twelve accounted for 40% of the benefits paid out by the plan in its last year. Healthier members bailed out and the pool collapsed in a price spiral.

10. Stop pulling drugs off the market as soon as the patent expires and ban drug advertising. Patent cycle = Hard work => discovery of wonder drug => advertise the bejeebers out of it at a cost many time the R&D cost => profit, profit, profit => patent expires => discover all sorts of nasty side effects with drug => pull now generic drug from market => patent new variant that solves problem with old drug => advertise the bejeebers out of it at a cost many time the R&D cos => profit, profit, profit.

 

[Atheus]

Originally posted by: JS80
7. Cut government spending on medicine = lower demand by leeches

Of course these are pipe dreams, where we live in a democracy - where you can vote to legally steal from your neighbor.

Fair enough, but what do you suggest sick children of poor parents do? Die?

 

[ultra laser]

Americans just need to stop being such obese, sickly people.

 

[blackangst1]

Originally posted by: ironwing
I agree with #3. The way to break the AMA is to remove doctors' monopoly on prescription writing.

Who then would you propose writing them? Pharmacists? :laugh:

 

[MovingTarget]

Originally posted by: blackangst1

Originally posted by: ironwing
I agree with #3. The way to break the AMA is to remove doctors' monopoly on prescription writing.

Who then would you propose writing them? Pharmacists? :laugh:

Actually, why not? They are probably more versed on what drugs actually DO than some physicians. Of course, this does have dangers in that Pharmacists aren't properly trained in diagnosis, which is what doctors do. Giving pharmacists the authority to prescribe more types of medications that aren't OTC while only allowing physicians to prescribe the more controlled and/or dangerous stuff may be the answer. The current schedule system needs to be revamped, and can be done so to include this.

 

[JS80]

Originally posted by: Atheus

Originally posted by: JS80
7. Cut government spending on medicine = lower demand by leeches

Of course these are pipe dreams, where we live in a democracy - where you can vote to legally steal from your neighbor.

Fair enough, but what do you suggest sick children of poor parents do? Die?

I and plenty of other children grew up without health insurance and did just fine. Did children just drop dead on the street before the days of socialized medicine?

Terminally ill children have plenty of free options such as St Jude's Hospital.

 

[CADsortaGUY]

Originally posted by: blackangst1

Originally posted by: ironwing
I agree with #3. The way to break the AMA is to remove doctors' monopoly on prescription writing.

Who then would you propose writing them? Pharmacists? :laugh:

Yeah, no conflict of interest there...

 

[MovingTarget]

To answer the OP:

1) Break the AMA to build more medical schools and offer more medical scholarships. The politics of the AMA is producing too harsh a restriction of the supply of doctors/pharmacists in this nation. We need to train more, even if that means that doctors overall earn less.

2) A public/private system would work, provided that #1 is done. I prefer a national health service type system, with the option of utilizing private healthcare and private insurance just as we do now, if a patient opts to not go the public route.

3) BAN ALL DRUG ADVERTISING, but let the pharmaceutical industry to have the time of their patent begin when it is approved for use by the public. They do need to make $$, but we need to stop the bullshit of replacing perfectly good drugs with new ones just because the patent runs out. Ask your doctor about....boot to the head!

4) Allow the gvt to negotiate for bulk prices on medication or allow US citizens to import drugs from abroad. The consumer needs more choice here due to price gouging.

 

[blackangst1]

Originally posted by: MovingTarget

Originally posted by: blackangst1

Originally posted by: ironwing
I agree with #3. The way to break the AMA is to remove doctors' monopoly on prescription writing.

Who then would you propose writing them? Pharmacists? :laugh:

Actually, why not? They are probably more versed on what drugs actually DO than some physicians. Of course, this does have dangers in that Pharmacists aren't properly trained in diagnosis, which is what doctors do. Giving pharmacists the authority to prescribe more types of medications that aren't OTC while only allowing physicians to prescribe the more controlled and/or dangerous stuff may be the answer. The current schedule system needs to be revamped, and can be done so to include this.

Thank you. You just made my point

 

[Atheus]

Originally posted by: JS80

Originally posted by: Atheus

Originally posted by: JS80
7. Cut government spending on medicine = lower demand by leeches

Of course these are pipe dreams, where we live in a democracy - where you can vote to legally steal from your neighbor.

Fair enough, but what do you suggest sick children of poor parents do? Die?

I and plenty of other children grew up without health insurance and did just fine.

Lucky you... many other people are born disabled or have a terminal illness or somehow get horribly injured through no fault of their own...

Did children just drop dead on the street before the days of socialized medicine?

Well, actually yes, go back 80 or 100 years and child mortality was shocking, but it's hard to separate the advance in science and the advance in economics and politics.

Terminally ill children have plenty of free options such as St Jude's Hospital.

But isn't this sort of thing 'legally stealing from your neighbor' according to you?

 

[MovingTarget]

Originally posted by: blackangst1

Originally posted by: MovingTarget

Originally posted by: blackangst1

Originally posted by: ironwing
I agree with #3. The way to break the AMA is to remove doctors' monopoly on prescription writing.

Who then would you propose writing them? Pharmacists? :laugh:

Actually, why not? They are probably more versed on what drugs actually DO than some physicians. Of course, this does have dangers in that Pharmacists aren't properly trained in diagnosis, which is what doctors do. Giving pharmacists the authority to prescribe more types of medications that aren't OTC while only allowing physicians to prescribe the more controlled and/or dangerous stuff may be the answer. The current schedule system needs to be revamped, and can be done so to include this.

Thank you. You just made my point

Ummm....thanks?

All I was trying to say was that the current system has a lot of room for this kind of fine tuning... this is only one possibility...

 

[Ozoned]

Originally posted by: Atheus

Originally posted by: JS80

Originally posted by: Atheus

Originally posted by: JS80
7. Cut government spending on medicine = lower demand by leeches

Of course these are pipe dreams, where we live in a democracy - where you can vote to legally steal from your neighbor.

Fair enough, but what do you suggest sick children of poor parents do? Die?

I and plenty of other children grew up without health insurance and did just fine.

Lucky you... many other people are born disabled or have a terminal illness or somehow get horribly injured through no fault of their own...

Did children just drop dead on the street before the days of socialized medicine?

Well, actually yes, go back 80 or 100 years and child mortality was shocking, but it's hard to separate the advance in science and the advance in economics and politics.

Terminally ill children have plenty of free options such as St Jude's Hospital.

But isn't this sort of thing 'legally stealing from your neighbor' according to you?

As harsh as it seems, It isn't a good idea to fvck with mother nature.

 

[Strk]

Originally posted by: JS80
3. Break the monopoly of the American Medial Association

4. Build more medical schools

5. Offer more medical scholarships

Common theme of 3, 4, 5? Increase the supply of doctors = decreases prices.

6. Legislate the forcing of high deductibles for insurance plans = mitigate moral hazard.

7. Cut government spending on medicine = lower demand by leeches

Of course these are pipe dreams, where we live in a democracy - where you can vote to legally steal from your neighbor.

Why should the government force me to get insurance with a high deductible? That's asinine. If anything, having good insurance will prevent "moral hazard," if that's what you call it. Sadly, there are a lot of people out there who use the emergency room for everything.

 

[GroundedSailor]

Originally posted by: blackangst1

Originally posted by: ironwing
I agree with #3. The way to break the AMA is to remove doctors' monopoly on prescription writing.

Who then would you propose writing them? Pharmacists? :laugh:

Actually I believe clinical pharmacists are permitted to write prescriptions, but cannot not diagnose ailments.

 

[JS80]

Originally posted by: Strk

Originally posted by: JS80
3. Break the monopoly of the American Medial Association

4. Build more medical schools

5. Offer more medical scholarships

Common theme of 3, 4, 5? Increase the supply of doctors = decreases prices.

6. Legislate the forcing of high deductibles for insurance plans = mitigate moral hazard.

7. Cut government spending on medicine = lower demand by leeches

Of course these are pipe dreams, where we live in a democracy - where you can vote to legally steal from your neighbor.

Why should the government force me to get insurance with a high deductible? That's asinine. If anything, having good insurance will prevent "moral hazard," if that's what you call it. Sadly, there are a lot of people out there who use the emergency room for everything.

It's a form of forced rationing to deal with supply shortage.

 

[ScottyB]

From "Life is Beautiful":

"Third grade. Listen to this problem.
I remember it because it shocked me.
A lunatic costs the state four marks a day.
A cripple, four and a half marks.
An epileptic, three marks and a half.
Considering that the average is four marks a day...
and there are 300,000 patients, how much would the state save...
if these individuals were eliminated?
I can't believe this!
That was my exact reaction.
I can't believe a seven-year-old child...
has to solve this kind of equation.
It's a difficult calculation. Proportions, percentages.
They need at least some algebra to do those equations.
That's high school material for us."

 

[alchemize]

1. That's pretty funny. You complain insurance companies aren't free market, then want to fix prices for them. Yeah, let's break the insurance underwriting risk model. Let's make ALL insurance cost the same, home, auto, etc. Doesn't matter if you drive a jaguar or a civic, same cost!

Ask any actuary - what you propose would drive costs up.

2. No problems with that!

 

[Zebo]

No reason to reinvent the wheel. I don't pretend to know anything either so I would just implement the system that insures everyone for half the cost per capita like Taiwan's.

 

[BoberFett]

Originally posted by: ironwing
8. Nationalize health insurance, eliminating the private health insurance industry and the incredible inefficiencies it has produced.

LOL, so in your estimation, government is more efficient than private enterprise?

 

[Hayabusa Rider]

1) Increase the number of medical schools. Lower the standards so we can pay them less. Associate degrees are inexpensive.

2) Let everyone prescribe their own medications. Have the estates of the deceased cover the cost of paying those doctors.

3) Get government involved so they can bring us medicine like they brought us Iraq.

4) Promote euthanasia as a public good.

5) Sterilize the genetically deficient.

6) Eliminate medicaid and medicare. See #4

7) Everyone has a maximum allowed to be spent on them. After that, back to #4

8) Health care needs to be curtailed. It weakens the species, and in the long run is a detriment to it. Therefore only those who are genetically superior ought to breed and get the most spent on keeping them and their progeny alive. I get to decide who that is.

9) Everything on this list is somewhat facetious, but not without a point. See #10

10) Every act has consequences. Be careful of what you ask for because you just might get it.

 

[ElFenix]

Originally posted by: ironwing

9. Ration health care. Stop spending tens to hundreds of thousands of dollars to torture people who are going to die anyway. I never met anyone who said they wanted to spend the last six months of life traveling between a nursing home and ICU. I used to be a member of a small group insurance pool (~1000 members). Twelve members broke the pool before dying. Premiums soared due to the expenses of just twelve members who were at the end of life. Just these twelve accounted for 40% of the benefits paid out by the plan in its last year. Healthier members bailed out and the pool collapsed in a price spiral.

a) it already is rationed

b) can you reliably know who is going to die a year to 6 months in advance?

 

[JohnnyGage]

Originally posted by: ElFenix

Originally posted by: ironwing

9. Ration health care. Stop spending tens to hundreds of thousands of dollars to torture people who are going to die anyway. I never met anyone who said they wanted to spend the last six months of life traveling between a nursing home and ICU. I used to be a member of a small group insurance pool (~1000 members). Twelve members broke the pool before dying. Premiums soared due to the expenses of just twelve members who were at the end of life. Just these twelve accounted for 40% of the benefits paid out by the plan in its last year. Healthier members bailed out and the pool collapsed in a price spiral.

a) it already is rationed

b) can you reliably know who is going to die a year to 6 months in advance?

You could also add a c.

c) What if it was you laying there. "Sorry Iron, you're going to die anyway so we are going to withdraw care". To pile on, someone else will make this decision for you--not you or a loved one. Doesn't that sound wonderful.

Been in this situation too many times.

 

[Elias824]

I'm ok with euthanasia, but not if the doctor just says "ok its to expensive to keep you alive, take these pills and it will clear that problem right up"
Nobody mentioned the cost doctors have to pay for insurance, if they make more then a few mistakes in their whole career they cant get insurance or practice medicine. How about minimize costs they get from lawsuits as well, one thing bush always talked about but never did anything with.