Idea to solve heath-care problems

[Dr. Zaus]

Instead of the government deciding on health care for you and instead of the insurance company getting between you and your doctor, we go a strict single-payer system: That single payer is the individual. This keeps big-evil companies/government out of the health-care decision.

BUT

To make this work we have two major initiatives.

First, every doctor must post what the median cost of curing/performing/seeing you is. Medical services can then be compared based on the price of the offering. This open access to market information would drive prices down.

Second, in-order to avoid the horrible concurrences of having people dieing of diseases that were preventable we require that basic preventative screenings be offered for free and open up a 'student loan' like system for anyone that needs money for medical coverage.

The the medical-loan program would offer a government-backed loan, much like a student loan, that would have loan-amounts capped at what medicare/chips/Medicaid pays now and payments caped at something like 25% of income over 150% of poverty and have years of payment caped at 10 or 20 years.

This brings personal responsibility and an open market back to medicine but at the same time, make sure that everyone has access to medical coverage and no one must die of cancer while perfectly good medicine is left unused, and should allow most people to avoid bankruptcy due to medical debt. (something that, much like student loans, could not be bankrupted)

 

[Matthiasa]

Works well unless you realize how much medical stuff actually costs.

Cancer by itself can cost into the million dollar range easily...

 

[PrinceofWands]

Works well unless you realize how much medical stuff actually costs.

Cancer by itself can cost into the million dollar range easily...

Except that that's in no way the actual 'cost'. The idea that cost is what people will pay has polluted us to the point we can hardly get to the real costs any more. Once you scrape away all the useless middle-men, the exorbitant profits, the IP whoring, inflated real estate values, the frivolous lawsuits, all forms of insurance (which are a pure drain with no benefit), etc you find out that medical care itself really isn't very expensive.

 

[Matthiasa]

Um some of the stuff needed is quite expensive to design and manufacture.(the machines themselves)
Then there are the drugs need.
Take away IP and the companies stop developing new drugs since they can't make enough money on them to even simply pay their employees anymore.
For every drug on the market numerous more fail.
And even taking that away there is still how much doctors gets paid and well you get the idea.

 

[her209]

Still doesn't solve the problem of doctors ordering every test to diagnose a problem. Its how they cover their ass, but its how they make their money. Try telling a doc you're not going to get test x, y, z done because its too expensive. They'd probably show you the door because you're not a profitable patient.

 

[JTsyo]

I think the trouble is insurance is used for everything. It should be only for big ticket items like a hospital stay. If you see the doctor for the flu, why is insurance needed?

 

[MovingTarget]

Some of those reforms can be instituted with the current system, but I believe that a parallel public/private system is inevitable. The consumer often has very limited choices when it comes to medical care even if all the info is posted.

 

[CPA]

I have been advocating single payer for years.

 

[theeedude]

Single payer is the way to go. If USSC strikes down individual mandate, that will become the most likely eventual outcome, IMO.

 

[ShawnD1]

kill all sick people. any other problems you want me to solve?


edit
loaning money to sick people won't work because they'll never pay it back. your average working class joe can't afford to pay back the quarter million dollars spent on his couple months in a coma. they would default on the loan which is government-backed and this would then look astoundingly similar to socialized healthcare

 

[soulcougher73]

Works well unless you realize how much medical stuff actually costs.

Cancer by itself can cost into the million dollar range easily...

That is the current inflated prices for such treatment. Open up the market and prices would drop to be competitive. Cancer could end up only being $10k instead of millions.

 

[soulcougher73]

Um some of the stuff needed is quite expensive to design and manufacture.(the machines themselves)
Then there are the drugs need.
Take away IP and the companies stop developing new drugs since they can't make enough money on them to even simply pay their employees anymore.
For every drug on the market numerous more fail.
And even taking that away there is still how much doctors gets paid and well you get the idea.

That's ok. We dont need more stupid drugs that cure lame crap but in turn add 15 new symptoms which you must take another pill to counter. Its a vicious circle or popping pills. I avoid pills other then asprine.

 

[soulcougher73]

Still doesn't solve the problem of doctors ordering every test to diagnose a problem. Its how they cover their ass, but its how they make their money. Try telling a doc you're not going to get test x, y, z done because its too expensive. They'd probably show you the door because you're not a profitable patient.

That might happen in the beginning but eventually they will be making NO money so they will have to drop pricse of these tests in order for people to accept having them done.

 

[ShawnD1]

That is the current inflated prices for such treatment. Open up the market and prices would drop to be competitive. Cancer could end up only being $10k instead of millions.

Now that I do electrical work and see the electrical requirements for hospital wiring, it surprises me that hospitals are so cheap to build. Not only do they use the best and most expensive wiring (by law), but the best and most expensive wall plugs, breakers, ventilation, air filtration, cleaning, lighting, and varioius other things. Hospitals are brutally expensive. Even in places with "cheap" socialized medicine, you're looking at an absolute minimum of $3,000 per day per bed to stay in a hospital. Cancer treatments might not cost half a million dollars, but you'll blow through $10k in maybe 3 days of random treatment with no surgery. If you include tumor removal, now you gotta pay for the operating room cost, the surgeon, the anesthesiologist, maybe 2 nurses, the cost of the drugs and specialized instruments, etc.

Think of how much it costs to get a contractor to redo your kitchen, now multiply the wage by 10 to account for how many people are involved and their salaries, now multiply the material costs by any random number you want, then multiply how long you need to be treated. Your kitchen might cost $10,000 so a hospital stay very easily gets into the ballpark of $100,000 after a very short period of time. It sucks but that really is what it costs.

 

[piasabird]

The last time my back was hurting I went to see a pay-as-you-go doctor. I payed him about $60.00 and he realligned my back and sent me on my way. It took a few days to get better, but his treatment worked just fine.

There are some maladies that require a fairly expensive test to diagnose. For instance there was a man that just had a problem with his Aeorta. Often you get a bulge in the ascending Aeorta and there is no way to really tell how bad it is unless they do a CAT scan and measure the bulge. Prices vary quite a bit for this kind of test. What the hospital or test center does is they way over-inflate the actual cost to see if the health insurance will pay for it. There is no way a single payer could combat this price inflation without a major hassle. In some ways the insurance companies are the front line in trying to keep the prices down. Hospitals and test centers tend to be very greedy.

 

[rudder]

IN 2008 the average medical school graduate had over $150,000 in student loan debt. going into private practice a doctor has to pay for the building, staff, medical equipment, insurance, student loan payments on top of what he would like to earn for a living.

Can we just enslave all the doctors and force smart kids to go to medical school?

Medicare reimbursements do not pay doctors jack. So they must limit time with patients so they can have as many appointments as humanly possible (which would be difficult with seeing just medicare patients). How much could the average person afford for a doctors visit? With that the average person probably gets about 5 minutes of face time with a doctor. Of course one can see nurses, nurse practitioners, but beyond basic treatments what malpractice company would want them doing any more than that?

 

[ShawnD1]

Medicare reimbursements do not pay doctors jack. So they must limit time with patients so they can have as many appointments as humanly possible

If you ever do get gubment doctors, you should pay them hourly instead of by visit. This is probably Canada's biggest fuck up, and I don't just mean healthcare but including everything Canada has ever done this was the biggest mistake. The problem with paying per visit is that doctors here don't actually do anything. You come in with a real problem, the doctor looks at you for 2 seconds, does absolutely nothing, tells you to come back in 3 days. Why? Because then he gets paid again in 3 days. If it was hourly then maybe he would take the time to figure out wtf is wrong with it.

I get paid hourly at my job and I do a damn good job. I don't rush shit out the door until it's done

edit
People in China are on quotas instead of hourly. Guess what kind of product quality comes out of China...

 

[Darwin333]

Still doesn't solve the problem of doctors ordering every test to diagnose a problem. Its how they cover their ass, but its how they make their money. Try telling a doc you're not going to get test x, y, z done because its too expensive. They'd probably show you the door because you're not a profitable patient.

Just about all of my doctors testing is done by 3rd party companies that are, at least from my point of view, very efficient. I highly doubt he makes anything off of sending me to another place of business to have tests run. The CYA thing is a very real issue though.

 

[Darwin333]

Now that I do electrical work and see the electrical requirements for hospital wiring, it surprises me that hospitals are so cheap to build. Not only do they use the best and most expensive wiring (by law), but the best and most expensive wall plugs, breakers, ventilation, air filtration, cleaning, lighting, and varioius other things. Hospitals are brutally expensive. Even in places with "cheap" socialized medicine, you're looking at an absolute minimum of $3,000 per day per bed to stay in a hospital. Cancer treatments might not cost half a million dollars, but you'll blow through $10k in maybe 3 days of random treatment with no surgery. If you include tumor removal, now you gotta pay for the operating room cost, the surgeon, the anesthesiologist, maybe 2 nurses, the cost of the drugs and specialized instruments, etc.

Think of how much it costs to get a contractor to redo your kitchen, now multiply the wage by 10 to account for how many people are involved and their salaries, now multiply the material costs by any random number you want, then multiply how long you need to be treated. Your kitchen might cost $10,000 so a hospital stay very easily gets into the ballpark of $100,000 after a very short period of time. It sucks but that really is what it costs.

You forgot about the people who don't pay their bills and the .gov underpaying (from what I am told at least, not an expert). They gotta make that money up somewhere...

 

[Darwin333]

Single payer is the way to go. If USSC strikes down individual mandate, that will become the most likely eventual outcome, IMO.

We will never have true single payer in this country. The best you can hope for is a quasi single payer system in which the rich people still get to pay for vastly better care.

 

[her209]

Just about all of my doctors testing is done by 3rd party companies that are, at least from my point of view, very efficient. I highly doubt he makes anything off of sending me to another place of business to have tests run. The CYA thing is a very real issue though.

Seems logical that a doctor would have some financial interest in the place where they send their patients to get testing done whether it be in referral fees or financial stake in the testing facility with other doctors. Don't know if there's any laws where they are required to disclose that information to you beforehand though.

 

[zephyrprime]

Basically your idea is to get rid of insurance? Most medical costs are incurred at end of life. How are you going to get dead people to pay back the loans they took out that have a 10-20 year term?

 

[ViviTheMage]

What happens if people start to shortcut things, because they're trying to undercut other practices, so they can just squeak by.

I could see it working, as long as the quality is regulated somehow...

 

[PrinceofWands]

Um some of the stuff needed is quite expensive to design and manufacture.(the machines themselves)
Then there are the drugs need.
Take away IP and the companies stop developing new drugs since they can't make enough money on them to even simply pay their employees anymore.
For every drug on the market numerous more fail.
And even taking that away there is still how much doctors gets paid and well you get the idea.

Horseshit in nearly every regard.

Yes, big machines are fairly expensive...however their 'cost' can be dealt with over a reasonable time, which comes out to very little once you break it down to 'per person over a 20 year span' (or similar).

The actual COST of most drugs is next to nothing...pennies a pill. Everything else is bullshit greed with no basis in reality whatsoever.

Really? So Penicillin was a cash cow? Smallpox vaccine? Polio vaccine? Aspirin? Newsflash Einstein - drugs have been around in some form since antiquity and MOST are developed at low cost through genius insight or accident, and NOT as a worthless, evil, selfish, corrupted business commodity. In other words, remove 99.99999999999% of the profit in drugs and they'll still be developed, exactly the same as they always have been. The ONLY changes will be that people can suddenly afford them again, and assholes trying to profit from misery will have to find a new source.

When doctors made less, there were still doctors. In short, MOST costs are illusory, and based on greed, and not actual necessity. Nor has the increased capital significantly improved anything because progress is limited by genius and accident, not industry.

 

[matt0611]

The actual COST of most drugs is next to nothing...pennies a pill. Everything else is bullshit greed with no basis in reality whatsoever.

.

If this is true, why doesn't someone go into the business and sell the drugs for less? (I'm seriously asking)