I am for healthcare reform, but here is what I wanted.

[HumblePie]

To set this straight, I'm all for health care and UHC. I grew up as a military brat, served, lived in Hawaii, lived overseas, and have used the VA. I've been exposed to the good, bad, and ugly of all forms of health care. Things needs to change and I'm glad that they are. However, despite the changes, I'm a little leery about what we are getting. I'm going to list the things I like and list a few things I thought should have happened.

1) I like the can not deny for any reason clause. No lifetime limits, and no pre-existing conditions dumps. I've had friends get screwed over and some die because of this. It was a terrible thing.

2) I thought healthcare insurance should have been separated from employers. While employers started first subsidizing healthcare insurance to gain employees, it went to far with the introduction of unions forcing employers to pay for healthcare. Because of the forced care costs by unions, it caused some major health insurance monopolies in most states and many of the bad practices came about because of this. Make everything for all insurances ala cart and can be offered by any insurance company as long as they follow the rules.

3) Once number 2 is done, do like the French and Japanese and make it so that health insurance is non profit. The insurance companies then compete on their other services like car insurance, and home insurance. This way they still get more money from providing health insurance while competing with the other services.

4) Offer a non profit health insurance government entity. This entity competes with insurance companies and is non profit. It can ONLY offer health insurance though and nothing else. This way people decide if they stay with an insurance company they like, or can choose government run single payer instead. This also helps control costs in the industry.

5) I would like to see implemented more government grants for medical training and higher degree programs for medicine. The more doctors, dentists, nurses, and others out there the cheaper healthcare will be.

6) With number 5, create government run, for non profit hospitals. Anyone receiving a government grant for school, must serve X number of years in one of these hospitals. Again, the hospitals will compete with private hospitals on costs and help drive them down. This also allows people to gain federal employment if they so want these jobs.

7) Tackle Big Pharma and Big bio-engineering companies. These guys are driving costs through the roof for medicine and life saving equipment. Why? Because most of the time they can. There is no competition and most are monopolies. I would like to see government stimulus to create competing companies because truth be told, the bar to enter into this area for a new company is a hard hurdle to overcome. Perhaps a small change to the patent law as it applies to medicine and medical devices? Allow generics or government created items to be sold and near true cost production prices to the government hospitals only. This makes the Big Pharma, and Big Bio have to bring down costs for the private hospitals or else people won't use them because of costs.

8) Oh and I still like the mandate, but I think it must be more. You are either getting insurance through an insurance company or through the government program. There is no opting out. There are no fines. The "fine" for your yearly taxes is you either prove you are paying for health insurance, or you pay for it with your federal income tax return. All of it.

To me, these are the biggest things that would affect and improve our healthcare. It allows private hospitals and insurance to still compete and thrive by competing on better services. It provides options for people that still cannot afford the "best" hospital but can still obtain adequate care. It gets us more health care practitioners. It helps control costs.

 

[highland145]

2) I thought healthcare insurance should have been separated from employers. This came about mostly because of unions and I think it has out lived it's usefulness. It caused some major health insurance monopolies in most states and many of the bad practices came about because of this.

Agree but my understanding was that it came about because of wage controls during the depression. Employers couldn't offer more $$ so they offered benefits. We wouldn't let our boss pick our car/house, they shouldn't be picking our insurance.

 

[HumblePie]

Agree but my understanding was that it came about because of wage controls during the depression. Employers couldn't offer more $$ so they offered benefits. We wouldn't let our boss pick our car/house, they shouldn't be picking our insurance.

Could have been part of the origins. Probably a combination of both. Either how, it doesn't matter as I think the forced entanglement now is a big problem. Your employer doesn't subsidize home or transportation insurance, and you possibly need both to maintain a job as well as being healthy.

Again, I think if employers WANT to subsidize to "compete" in the resource pool of potential job applicants, I say let them. They either pay more $ out, or a little less $ but also some $ into your chosen insurance company. Either way, it's their choice and people can then chose who they work for based on this.

 

[highland145]

Not intending to pull off topic, but I agree. Employers that want the best people should pay for it. Same goes for the employees, the best get the most. Capitalism.

 

[Carmen813]

Not intending to pull off topic, but I agree. Employers that want the best people should pay for it. Same goes for the employees, the best get the most. Capitalism.

I think the employer based system would be perfect if large companies didn't have to compete globally.

 

[lupi]

Health care reform would be great, wake me when that's what they start working on.

Universal government provided is bad, just see numerous programs already run as such for examples.

Employer provided coverage as it exist now started because of cost controls put in place by the previous great progressive era, not due to unions.

Non profit health care wouldn't change things much, with their rather low percent profit margins you could easily hide that into captiol construction and related categories.


The reason we're being killed on R&D cost for medical equipment and drug cost is because so many other countries have UHC methods in place so we pay the cost for the world.


There are already several eduction pay off programs in place, more don't use them because of the conditions applied to using them as it is.

 

[soulcougher73]

I could go for all of what you listed. I think it would bring a lot to the table and satisfy every side of the arguement.

 

[highland145]

I think the employer based system would be perfect if large companies didn't have to compete globally.

As in "employer health care"? Sorry, I got side tracked and want to make sure we're on the same topic.

 

[HumblePie]

Non profit health care wouldn't change things much, with their rather low percent profit margins you could easily hide that into captiol construction and related categories.

Incorrect. The for profit model has been increasing costs, denying services, and creating a maelstrom of problems for years. The requiring by law to force non profit in and of itself could be loopholed around. Which is why the government has to offer an alternative form of bare bones insurance to compete with private insurance.

For example, if Geico wants to start offering healthcare insurance they can along with their car insurance. However, if they think they can sneak a little extra profit in with their health insurance then people are going to chose the cheaper government insurance if they don't do more than the government insurance does. That's not to say they can't charge for more offering more though. Geico can charge more for health insurance if they want to offer more consumer friendly services with their health insurance that the bare bones government program won't do. There is your competition for insurance costs right there with a check and balance system of the government option.

The reason we're being killed on R&D cost for medical equipment and drug cost is because so many other countries have UHC methods in place so we pay the cost for the world.

Incorrect hyperbole here. They charge more here because they CAN. Trust me, if Pharma companies can charge $1 a pill for a product in a country like Malaysia and still turn a profit for something they sell here for $100, they still sell in Malaysia. Why? It is still profit. If the didn't make money selling that pill for $1 in Malaysia, they would never sell there in the first place. They sell what the market can bear, or what they can get away with. Since American consumers are stupid enough to pay for the screwed up healthcare system we have in place now, they rape us for prices for medicine and medical devices here.

Also, a large portion of the medical R&D comes from the government dime, not the companies. They basically get a free ride, or close to it, to create a product to be brought to market. Then they charge through the nose because of loopholes in patent laws granting them monopolies for a very long time. There was a big Dateline and 60 minute special on this a few years back. They followed the making of Clariton as an example of how screwed up big pharma is for America.

Anyhow, the same products being sold here, are being sold everywhere for much cheaper. They sell them cheaper overseas, because it is still a profit for these companies, even if the profit is much smaller. However, money is money and the bigger your market, the more you make.

There are already several eduction pay off programs in place, more don't use them because of the conditions applied to using them as it is.

Some of which needs to be addressed. Part of the problem with the conditions is the strangle hold of how medical practitioners are forced to work in hospitals for tenure. They are limited by the number of hospitals they can work for. Again, creating more hospitals, even government ran ones, and allowing full educational rides for new students in exchange for a few years of service would do wonders to correct this problem. It works well enough for the standard military. Many people get full college education scholarships from the government in exchange of 4 years of service in the military as an officer. It works very well and doesn't create economic problems. Instead you get more well educated people in the common populace WITH years of experience behind them doing a government job.

 

[GroundedSailor]

I have to agree with the OP. in particular I think No's 2 & 3 will be a huge benefit to the whole system. A lot of people seem to use 'Govt health care' as a bogeyman, completely ignoring that Medicare is fully Govt run and owned and is very well managed, in fact much better than any private health care management.

 

[Infohawk]

2) and 5) are key to lowering health care costs.

 

[Danube]

Other countries use mostly American medical innovations and drugs. The private, for profit sector provided for that. Now it will die.

 

[desy]

Yes thats the misconception about UHC in Canada is that its all free.
It isn't, I have health benefits from my employer that made it attractive for me to come work here.
My wife works at an health insurance company and gets great benefits there including money for wellness.

Current problem is too many services are covered by UHC and our province took a braver step and just delisted chiropractic as a subsidized service. My employer will still pick up the tab. People won't go bankrupt or die from lack of subsidized service in this case, and if you need it, maybe thats where your money should go instead of a big screen TV

My dad is taking lots of drugs and under the new plan pays $15 a month, however he brings home more than he can spend in pension and has lots in the bank. Shouldn't his decades of smoking have consequence? Since tobacco is heavily taxed maybe he has payed it forward already .. . . . Also, when he dies half of his estate will go to the gov't and by that token health care . . .

http://www.thespec.com/News/Local/article/742254

Major, who was the report card committee chairperson, has one patient who has maxed out her employer drug plan and her spouse's benefit plan and still had to remortgage her home and count on handouts from family so she can continue to get injections every week that cost $5,000 each.

"You assume it's covered and you only find out when it's too late," he said.

The Canadian Cancer Society estimates cancer drugs cost an average of $65,000 a year per patient. About one in 12 patients is not adequately covered to fund this.

"There is no national standard for how much Canadians should have to pay for cancer drugs," said Aaron Levo, acting director of national public issues. "The Canadian Cancer Society believes Canadians should have equal access to cancer drugs regardless of where you live or your ability to pay."

The report card also raises concerns about employees who get laid off or retire early having inadequate drug coverage. The report suggests there is a gap between the average age of retirement at 62 and when government programs kick in at 65.

"There are gaps definitely," said Susan Eng, vice-president of advocacy for the Canadian Association of Retired Persons, "when you leave a place where you had workplace health benefits coverage and then you are not yet on the public pharmacare system."

 

[Zebo]

Good post my only issue with it is the non-profit clause (#3). Most businesses today are non-profit tax speaking like GS they bonus out all the profit in salaries and fringe only showing 1B in profits to mitigate IRS's levy. What needs to be addressed and I think congress did is margin of dollars in vs. dollars paid out. Setting the bar at say 95% leaving 5% for administrative costs would lower salaries to sane levels. No more 150M dollar a year men like Pfizer CEO.

To address Pharma there would be no more Dr. lobbying and kickbacks allowed. Big time conflict of interest and drives up costs. Also, When the state gives these guys monopoly power with patents the state also have right to regulate how much margin they can run IMO like any other utility. Say 25% gross margin.

 

[HumblePie]

Good post my only issue with it is the non-profit clause (#3). Most businesses today are non-profit tax speaking like GS they bonus out all the profit in salaries and fringe only showing 1B in profits to mitigate IRS's levy. What needs to be addressed and I think congress did is margin of dollars in vs. dollars paid out. Setting the bar at say 95% leaving 5% for administrative costs would lower salaries to sane levels. No more 150M dollar a year men like Pfizer CEO.

To address Pharma there would be no more Dr. lobbying and kickbacks allowed. Big time conflict of interest and drives up costs. Also, When the state gives these guys monopoly power with patents the state also have right to regulate how much margin they can run IMO like any other utility. Say 25% gross margin.

I could float with that. And add in that there is no speculating with money sitting there. I would hope that this doesn't need to be said, but with what banks recently did...

 

[Martin]

4) Offer a non profit health insurance government entity. This entity competes with insurance companies and is non profit. It can ONLY offer health insurance though and nothing else. This way people decide if they stay with an insurance company they like, or can choose government run single payer instead. This also helps control costs in the industry.

This makes you a communist, or at the very least, an America-hating socialist.

 

[jstern01]

Other countries use mostly American medical innovations and drugs. The private, for profit sector provided for that. Now it will die.

Wrong. Most medical innovations are done in universities, along with basic drug research. Then private companies license the research to bring those drugs and technology to market.

 

[HumblePie]

This makes you a communist, or at the very least, an America-hating socialist.

Okay, then lets do away with all social programs and taxes! Who needs government anyhow? I mean seriously, why pay for anything at all? Let's all go back to the "me" mentality and looking after oneself. We don't need anyone telling us what to do!

/sarcasm

Nice troll post. You show real character and class putting labels you know nothing about on ideas and people you know nothing about. What a great American past time.

Now do you you have anything useful to contribute or should I just flag your post for the Moderators? Oh wait, I forgot.. you can't contribute anything. Contributing is communism for you.

 

[Slick5150]

I agree with #4, except that, as Martin points out above, this would somehow be shown as interfering with the free market (despite the fact that if the free market really worked as it's advocates say, they could easily compete with the nonprofit single player entity anyway)

 

[Slick5150]

Okay, then lets do away with all social programs and taxes! Who needs government anyhow? I mean seriously, why pay for anything at all? Let's all go back to the "me" mentality and looking after oneself. We don't need anyone telling us what to do!

/sarcasm

Nice troll post. You show real character and class putting labels you know nothing about on ideas and people you know nothing about. What a great American past time.

Now do you you have anything useful to contribute or should I just flag your post for the Moderators? Oh wait, I forgot.. you can't contribute anything. Contributing is communism for you.

Uh, despite your own /sarcasm, I think you forgot to tap your own sarcasm meter on the post you were replying to there buddy.

 

[GroundedSailor]

Good post my only issue with it is the non-profit clause (#3). Most businesses today are non-profit tax speaking like GS they bonus out all the profit in salaries and fringe only showing 1B in profits to mitigate IRS's levy. What needs to be addressed and I think congress did is margin of dollars in vs. dollars paid out. Setting the bar at say 95% leaving 5% for administrative costs would lower salaries to sane levels. No more 150M dollar a year men like Pfizer CEO.

To address Pharma there would be no more Dr. lobbying and kickbacks allowed. Big time conflict of interest and drives up costs. Also, When the state gives these guys monopoly power with patents the state also have right to regulate how much margin they can run IMO like any other utility. Say 25% gross margin.

I'm not sure how it can be regulated but even setting 95% does leave loopholes for non scrupulous companies. There's costs that can be accounted to cost of goods sold so their overhead will remain below 5% on the books.

As to pharma, there's lots of other things that can be done. One example is they write of billions in samples as 'charity'. This has 2 fold advantages to the pharma co's. They get to claim they are good people because they 'spend' so much on charity & free medicines, and get to influence doctors with free samples.

.

 

[HumblePie]

I agree with #4, except that, as Martin points out above, this would somehow be shown as interfering with the free market (despite the fact that if the free market really worked as it's advocates say, they could easily compete with the nonprofit single player entity anyway)

For number 4, I have a completely separate thread discussing the merits of single payer. Basically, the government is bare bones and collects enough to provide basic coverage and promote health and preventative medicine. This can be done with tax rebates and credits for people getting regular checkups and maintaining a healthy lifestyle. Have a gym membership and use it? get a small tax credit for it's cost. That sort of thing.

Anyhow, we do this for schools for example. I don't have kids but I pay for my neighbor kids to go to school. And some of my neighbors use private schools instead of the public one that they and I already paid for. Again, the purpose is because an educated populace benefits everyone, even if I do not have kids.

 

[Zebo]

I'm not sure how it can be regulated but even setting 95% does leave loopholes for non scrupulous companies. There's costs that can be accounted to cost of goods sold so their overhead will remain below 5% on the books.

As to pharma, there's lots of other things that can be done. One example is they write of billions in samples as 'charity'. This has 2 fold advantages to the pharma co's. They get to claim they are good people because they 'spend' so much on charity & free medicines, and get to influence doctors with free samples.

.

Good point there is always a way to loopholes for the talented. Which is why single payer is done in all other counties who attempt UHC and we will get there too after this monstrosities bills start coming in. And Pharma they negotiate pricing much lower then we pay.

 

[GroundedSailor]

Good point there is always a way to loopholes for the talented. Which is why single payer is done in all other counties who attempt UHC and we will get there too after this monstrosities bills start coming in. And Pharma they negotiate pricing much lower then we pay.

Many countries like Germany, Japan, Switzerland (IIRC), Holland & France have multipayer systems but they're mostly non profit and the country is divided into regions for better administration. But, yes, they're still basically UHC - just a different variation.

 

[Hayabusa Rider]

Incorrect. The for profit model has been increasing costs, denying services, and creating a maelstrom of problems for years. The requiring by law to force non profit in and of itself could be loopholed around. Which is why the government has to offer an alternative form of bare bones insurance to compete with private insurance.

Incorrect. BOTH government and private insurances have had this happen, and guess what? It's still going to.

The only way to bring down costs significantly is to decrease utilization. That's why private AND government agencies have been doing the above, and I'll have you note there is no clause in the current legislation that says otherwise. The difference is that once government is the only game in town, there is no appeal. You do what you are told, and no switching jobs or plans will do a thing.

As has been said, wake me up when someone starts talking health care reform. This is just cost and power shifting.