Help me to understand McCains health care plan.

[shira]

Originally posted by: CADsortaGUY

Originally posted by: shira

Originally posted by: CADsortaGUY

Originally posted by: shira

Originally posted by: CADsortaGUY

Originally posted by: shira

Originally posted by: JS80
Why should I subsidize your disease?

For the same reason that I -non-parent - pay property-tax dollars to subsidize your kids' public schools.

Everybody deserves decent health care. Every kid deserves decent schooling.

Wrong. Taxes(and Education for that matter) are different than INSURANCE. Why do these discussions always devolve into people trying to make stupid comparisons?

Yes, everyone deserves health care. However, INSURANCE is not healthcare. Those who choose to not have INSURANCE can still gain healthcare, they just pay for their actual costs instead of pooling their risk with others.
However, just because someone does not have INSURANCE does not mean that I(the gov't) should subsidize all their care.

Your argument is specious. You state that "everyone deserves decent health care." Unstated by you is that tens of millions of Americans can't afford health insurance. CAN'T AFFORD HEALTH INSURANCE, get it?

Now, we all know those uninsured WILL receive health care one way or another. The costs of health care delivery to uninsured people are paid for with/factored-into the insurance rates of those who ARE insured, into the rates charged by health providers (to cover costs they won't be able to recover when they treat uninsured), and tax dollars.

In other words, the health costs of the sick and un-insured are already subsidized by the rest of us, but in a haphazard way that ends up delivering sub-optimal care to the un- and under-insured and randomly bankrupts individuals that get hit with huge costs they can't afford.

In other words, our current system is grossly unjust. The question is: What's the best way to improve it. As far as I can see McCain's plan will only make the problem worse. Obama's plan will cost more, but it will do a lot to address the problem.

By the way, one issue addressed by neither McCain nor Obama is tranportability of insurance. If you leave a company that offered health insurance and strike out on your own, there's a good chance you won't be able to obtain insurance at any price (if you have pre-existing conditions). Why not pass a law that that says that if you're currently insured under a group plan, your existing health-insurance provider is required to offer you the same group plan at the same price (paid for by you) if you decide to change employment? I can't see how the insurance companies could object - they'd still be insuring someone they already insured, and would be receiving the same premiums (plus, perhaps, a small administrative fee).

What part of health care != INSURANCE do you not understand. Please educate yourself before posting more foolishness.

Just because someone "CAN'T AFFORD HEALTH INSURANCE" doesn't mean they can't get healthcare. "get it?"

Again, everyone gets health care, even the uninsured. The rest of us already pay for it. You can object and turn red in the face, but facts are facts.

The problem is that the current system is grossly inefficient and unjust. We can do better.

When are you going to stop with the ignorance? No, everyone does not get "health care", they get emergency care.

The problem with the current system is that it's based on an antiquated system of employer based insurance, the under utilization of preventative care, and over use of drugs. It has nothing to do with how "unjust" you think it is.

You're playing word games. Yes, the poor use emergency care as their primary care. That's grossly inefficient. And the lack of preventive care for the uninsured guarantees that inexpensive-to-prevent conditions become expensive conditions.

But if a poor person presents with cancer, they don't get turned away. They get treated. If they need surgery, they get surgery. If they need critical care, they get critical care. Hospitals eat the cost of these services, and build the losses into their rate structure.

I stand by my original statement: Everyone gets health care, but our system sucks.

 

[ElFenix]

employer based insurance is due to government manipulation of the jobs market

and it's frickin' medical care.


oh, and nested quotes suck.

 

[shira]

Originally posted by: Mursilis

Originally posted by: shira
As I wrote, we're already paying for health care for everyone. Why deny it? And once you stop the denial, it just becomes a question of what's the most efficient/just system we can construct.

While you may be correct, it amuses me that any realistic person would think the most efficient system would involve the gov't.

I never wrote that a single-payer, government-controlled system was best. If you're reading that into what I've written, then maybe I'm not being clear.

For the record, I think we need some sort of combined approach in which the elements are:

If someone wants good medical insurance (including drug coverage, dental coverage, point of service delivery, reasonable co-pays, etc), then every insurance company should be required to offer that coverage to everyone at their best group price, plus a reasonable administrative fee to account for individual rather than group delivery. Employers could offer premium credits as part of their benefits package, and could provide information on plans the company thought were particularly attractive, but employees and everyone else would shop around themselves for the best deal they could find. Requiring this of every insurance company would prevent cherry-picking, would take care of the issue of pre-existing conditions, and would foster competition.

For people that can't afford such coverage, all insurance providers should also be required to offer some sort of lower-level plan with defined minimum benefits. The government would issue means-tested premium credits that cover all or most of the cost of these plans, and insurance companies would compete to attract customers.

I think we also need more expansion of health-care savings accounts, so that people can pay out-of-pocket expenses with pre-tax dollars.

Maybe there would need to be some component of a comprehensive plan where the government was a payer, but I don't envision government-as-payer for most people.

 

[soulcougher73]

Originally posted by: Xavier434

Originally posted by: soulcougher73

Originally posted by: Red Dawn

Originally posted by: soulcougher73
My question is if we had UHC of some sort and were taxed to support it. Would it cost me more monthly then the $90/month i currently pay for insurance? Simple question, but i dont know the answer.

$90 a month? Nice, I pay $600 a month.

Single healthy male with no preconditions. employer pays other half or 2/3's Cant remember. Its not bad. I was just curious what the taxes may end up being ina UHC system vs. what we already pay for insurance. Although if i paid $600/month id think id definatly favor UHC.

If I put my entire family on my insurance then it would cost me almost $1000 a month. (family of 3)

They are not all insured for that reason.

Ouch. Sorry to hear. Something needs to be done about this.

 

[HeroOfPellinor]

Originally posted by: cKGunslinger

Originally posted by: Genx87
btw the more I read about healthcare in this country the less I am of the opinion an ounce of prevention saves a pound of cure. The majority of a persons healthcare costs happen in the last 24 months of their life. Those last 24 months cant be prevented because they are dying. And we are spending through the nose to prevent something the happens to every human at one point in their lifetime(death). I suppose if you want to make an argument the quality of care can go up or we can extend a viable enjoyable lifestyle that is one thing. But we all die, and we all seem to spend a shitload of money preventing it when the time comes.

That's a point, but what is the solution? Mandatory euthanasia for the elderly?

Let's do this in a manner that makes both sides happy.

Government-run and paid-for healthcare for children under 12 and adults over 68. They would be separate entities. I imagine something like Kaiser with their own hospitals. Basically all pedicatricians become government employees and elder care becomes a specialization. The elderly, like with Kaiser, get care that's a little worse. They look at the books before authorizing procedures which means needing to wait longer sometimes. I imagine this entity would also, like Kaiser, actively reach out to it's base to proactively advance their health level. This elder care system would get drugs and equipment at cost......one of the compromises for NOT bringing in drugs from other countries like Obama wants. It's paid for by a tax on businesses.......of course, businesses no longer need to pay for dependent children or elderly employees which should partially offset the cost. Private healthcare for those between 12 and 68 remains the same as now except premiums drop drastically........also saving the businesses money as well as those who pay out of pocket.

So we've got the kids covered. The elderly aren't as much of a drag on the system and might benefit potentially from specialized healthcare system and facilities. Health insurance costs go way down.

 

[CADsortaGUY]

Originally posted by: shira
You're playing word games. Yes, the poor use emergency care as their primary care. That's grossly inefficient. And the lack of preventive care for the uninsured guarantees that inexpensive-to-prevent conditions become expensive conditions.

But if a poor person presents with cancer, they don't get turned away. They get treated. If they need surgery, they get surgery. If they need critical care, they get critical care. Hospitals eat the cost of these services, and build the losses into their rate structure.

I stand by my original statement: Everyone gets health care, but our system sucks.

No, words have meaning. "emergency care" is not the same as "Health care" and ElFenix probably used a better word than "emergency care" with "medical care". I'd say it's more "emergency medical care" but whatever it is - it's not "healthcare". "healthcare" is too broad for you to suggest that emergency room visits are "healthcare".

Actually yes, a poor person with cancer would get immediate treatment and then released to a specialist. If they can't pay, they may or may not get the treatment they need.


*sigh* - preventative care is available to EVERYONE regardless of INSURANCE status. Sure, you might have to pay for the full office visit but really - how much is your health worth? But alas.... people don't go...or expect other people to pick up the tab for their basic care. It's f'n ridiculous. My home owners insurance doesn't pay for window cleaning or other maintenence. My car insurance doesn't pay for routine maintence. Why do people think health INSURANCE should pay for routine visits? If INSURANCE didn't cover these visits and people paid cash - it would be a level playing field and likely a lower cost per visit as well as quicker/better service as it would be relatively competitive since where you go wouldn't be dictated/restricted by your insurer.

 

[CADsortaGUY]

Originally posted by: Xavier434

Originally posted by: soulcougher73

Originally posted by: Red Dawn

Originally posted by: soulcougher73
My question is if we had UHC of some sort and were taxed to support it. Would it cost me more monthly then the $90/month i currently pay for insurance? Simple question, but i dont know the answer.

$90 a month? Nice, I pay $600 a month.

Single healthy male with no preconditions. employer pays other half or 2/3's Cant remember. Its not bad. I was just curious what the taxes may end up being ina UHC system vs. what we already pay for insurance. Although if i paid $600/month id think id definatly favor UHC.

If I put my entire family on my insurance then it would cost me almost $1000 a month. (family of 3)

They are not all insured for that reason.

You don't have HSA's in your area? There is no reason you shouldn't have atleast major med with an HSA. It'll likely get you better "rates" for routine visits since you are part of a policy even though your particular policy may not cover routine visits.

 

[quest55720]

Originally posted by: CADsortaGUY

Originally posted by: shira
You're playing word games. Yes, the poor use emergency care as their primary care. That's grossly inefficient. And the lack of preventive care for the uninsured guarantees that inexpensive-to-prevent conditions become expensive conditions.

But if a poor person presents with cancer, they don't get turned away. They get treated. If they need surgery, they get surgery. If they need critical care, they get critical care. Hospitals eat the cost of these services, and build the losses into their rate structure.

I stand by my original statement: Everyone gets health care, but our system sucks.

No, words have meaning. "emergency care" is not the same as "Health care" and ElFenix probably used a better word than "emergency care" with "medical care". I'd say it's more "emergency medical care" but whatever it is - it's not "healthcare". "healthcare" is too broad for you to suggest that emergency room visits are "healthcare".

Actually yes, a poor person with cancer would get immediate treatment and then released to a specialist. If they can't pay, they may or may not get the treatment they need.


*sigh* - preventative care is available to EVERYONE regardless of INSURANCE status. Sure, you might have to pay for the full office visit but really - how much is your health worth? But alas.... people don't go...or expect other people to pick up the tab for their basic care. It's f'n ridiculous. My home owners insurance doesn't pay for window cleaning or other maintenence. My car insurance doesn't pay for routine maintence. Why do people think health INSURANCE should pay for routine visits? If INSURANCE didn't cover these visits and people paid cash - it would be a level playing field and likely a lower cost per visit as well as quicker/better service as it would be relatively competitive since where you go wouldn't be dictated/restricted by your insurer.

That is were we disagree those routine prevenative visists would lower costs. It would catch disease at an ealier stages making it easier and cheaper to treat. A 100 dollar doctor visist could save them a million dollars in the future.

UHC just can not work in this country. This country is unique because of the unhealthy population and illegal problem. Add 10 million illegals to france any other EU country and see their UHC bankrupt them in record time. The second we pass UHC everyone from south america with a health issue sneaks across the boarder to a sanctuary city for treatment. It would just drain the tax payers dry. Now if you want to seal up the boarder and send illegals home. Then we can talk but the democrats will not do that and you all know that.

 

[Excelsior]

No matter who is elected...I'd settle for a large reduction in administrative costs if nothing else.

 

[quest55720]

Originally posted by: Excelsior
No matter who is elected...I'd settle for a large reduction in administrative costs if nothing else.

To bring the costs down it will take everyone to do their part. First the people must get in better shape. They have to make better life style choices. Insurance companies must push preventative care. They should go as raising rates on people who don't go in for that preventative care and screenings. Those visits should be free besides the standard office visist copay. The health care providers must adapt and change. They need to move away from the big expensive clinics. They need to open more places that use physician assistance and nurses to treat minor things like colds and strep throat ect. Then the government needs to do its part by sealing up the boarder and deporting illegals.

 

[CADsortaGUY]

Originally posted by: quest55720
That is were we disagree those routine prevenative visists would lower costs. It would catch disease at an ealier stages making it easier and cheaper to treat. A 100 dollar doctor visist could save them a million dollars in the future.

UHC just can not work in this country. This country is unique because of the unhealthy population and illegal problem. Add 10 million illegals to france any other EU country and see their UHC bankrupt them in record time. The second we pass UHC everyone from south america with a health issue sneaks across the boarder to a sanctuary city for treatment. It would just drain the tax payers dry. Now if you want to seal up the boarder and send illegals home. Then we can talk but the democrats will not do that and you all know that.

No, we don't disagree to a large extent. You already pay for those visits as they are built into your premiums so if everyone paid for their own doc visits, the cost of those visits would likely be reduced - or at minimum everyone would be paying the same regardless of INSURANCE status. Also, you'd see much better service as it'd be competitive as to quality. The problem would obviously be med records but that is minor in today's world.

But I suppose I could see a "routine" visit type insurance that people could buy and add to their INSURANCE. Sort of like a maintenance agreement on other items we buy. I wouldn't be opposed to that at all but when you start using INSURANCE for maintenance it no longer is INSURANCE - it becomes managed care and the like.

 

[daishi5]

Originally posted by: GTKeeper

Originally posted by: Mursilis

Originally posted by: shira
As I wrote, we're already paying for health care for everyone. Why deny it? And once you stop the denial, it just becomes a question of what's the most efficient/just system we can construct.

While you may be correct, it amuses me that any realistic person would think the most efficent system would involve the gov't.

I guess it depends on what how you define efficiency.

One thing is for certain, that, if government were to step in I think we would/could have some kind of price control.

I don't want to get into a massive debate, but things like energy/food/healthcare/gas are not affected by free markets as much as we think they are.

Interesting, you want price controls on health care, and mention food in the exact same post. It is a very interesting little tidbit, the two items that I know of that have had the most price controls instituted on them were housing, and food. Please feel free to examine the history of price controls on food. From the time of the roman empire we have historical accounts of price controls being instituted to stop the "evil profits" and to make food "affordable." In every single instance that I know of off the top of my head, they have all resulted in food shortages.

Strangely many countries with UHC also suffer from shortages we see them in the form of a waiting period.

The problem with healthcare and UHC is, that if UHC does indeed cause a shortage, it takes a long time before we see the shortage. If we impose price controls, and I guarantee you a single payer system is a price control, many of the people and facilities that provide health care will continue to provide health care. Therefore we do not see an immediate shortage. A doctor cannot just go start work as an engineer, he may not make as much as he did, but he still makes more than he would anywhere else, therefore he stays. However, you may start to see fewer students studying medicine, and eventually a doctor shortage. An MRI machine lasts a long time, and we cannot use it for anything else, so we still have all the MRI machines we used to have. However, hospitals may not buy new ones because they will not make their money back on them, so we stop getting new machines and are stuck with old technology.

This all depends on the government underpaying the healthcare system, it may be possible that the government will pay at a fair wage, and that all will be good. I doubt it though. For the record, I work for a hospital in Illinois, and the government often does not pay us enough to recover the costs of the procedures we perform. In fact, they try very very hard to not pay us at all. One of the systems I administer is dedicated to making sure we get payed by the state. This system cost us over 200,000, and costs us at least 20% of that every year. We are a small (<100) bed hospital, so that amount is not a trivial one to us. I also know that I am understating the cost by a large amount, I do know it is over that amount, but I do not know how much over. But surely you see the waste of 4 servers, 6 people, and hours a day spent just trying to make the state pay us for the work we do.

And finally, I find it very amusing that someone said health care and health insurance are not like cars. First, there is a huge push to learn how to be more efficient from comapnies like toyota. And second, because health care and health insurance are like cars.

1. A person makes a car, a person makes each and every health care device.
2. A person designs cars, a person designs health care instruments.
3. There are safety tests and standards to meet for cars, there are safety tests and standards to meet for cars.
4. Cars require resources, and people, health care requires resources and people.

Resources and people are not infinite, and those people need to be adaquetly compensated for the work they do, or they will not do it. It is not possible to give everyone quality health care at a low cost. You cannot have all 3, quality quantity and price because this is the real world and we must work within the constraints of the fact that we do not have the ability to do everything we want.