My ideas for health care reform

[zsdersw]

While I'm sure these ideas are not original, I do believe in them and have not heard them floated during this debate, so here they are:

1. Eliminate health insurance. Why do we need a middleman? Why can't we deal with and pay doctors/hospitals directly? We are then free to spend our money (or whatever benefit system offered by our employer) on whichever doctor/hospital we believe delivers the best care at the lowest cost.

2. For immediate life-or-death emergencies, all hospitals must have an Emergency Room or section of rooms that is administered by the government (or some other independent third party) and paid for, on an as-needed basis, through the individual's income tax on whatever payment terms are reasonable. This is exclusively limited to true life-or-death emergencies and situations where the patient is not able to make hospital decisions.

These things would lower costs and would force people to be more accountable for their own health, which is never a bad thing.

 

[Tristicus]

I'm sure nobody else has ever thought of this, and we should put this into place right now.

 

[Zebo]

1. HI serves a purpose. I had a MRI a while back. When I got the bill docs claim it was worth $5300, insurance said FU and paid ~$900. If I were paying cash I'd assume I'd have to pay $5300.

2. Already covered, EMTALA 1986.

 

[zsdersw]

1. HI serves a purpose. I had a MRI a while back. When I got the bill docs claim it was worth $5300, insurance said FU and paid ~$900. If I were paying cash I'd assume I'd have to pay $5300.

Wouldn't the free market determine a similarly low price on its own?

2. Already covered, EMTALA 1986.

Not exactly. It's paid for out of government funds (HHS, CMS, Medicaid/Medicare) not just the specific people who use the services.

 

[werepossum]

While I'm sure these ideas are not original, I do believe in them and have not heard them floated during this debate, so here they are:

1. Eliminate health insurance. Why do we need a middleman? Why can't we deal with and pay doctors/hospitals directly? We are then free to spend our money (or whatever benefit system offered by our employer) on whichever doctor/hospital we believe delivers the best care at the lowest cost.

2. For immediate life-or-death emergencies, all hospitals must have an Emergency Room or section of rooms that is administered by the government (or some other independent third party) and paid for, on an as-needed basis, through the individual's income tax on whatever payment terms are reasonable. This is exclusively limited to true life-or-death emergencies and situations where the patient is not able to make hospital decisions.

These things would lower costs and would force people to be more accountable for their own health, which is never a bad thing.

The idea behind insurance is that there are certain risks that are unlikely to occur to any one person or company, but certain to be devastating where they do occur. (This practice goes back at least to early medieval times, by the way, as ships and caravans were commonly insured.) This is even more likely today; as Carmen can attest, diagnosis and treatment can be terribly expensive. I certainly agree that people need to be responsible for our own day-to-day care, but we absolutely need catastrophic insurance. Unfortunately too many people today view health insurance as someone else paying all their medical expenses, leaving themselves free to buy luxuries.

 

[zsdersw]

I'm sure nobody else has ever thought of this, and we should put this into place right now.

Thanks. Your highly useful input is always appreciated.

 

[Zebo]

Wouldn't the free market determine a similarly low price on its own?



Not exactly. It's paid for out of government funds (HHS, CMS, Medicaid/Medicare) not just the specific people who use the services.

Well medicine is the only biz I know of they list prices after the fact so no I think. In other words I think insurance serves a good cost modifier/bargaining power unlike one man would have.

 

[zsdersw]

The idea behind insurance is that there are certain risks that are unlikely to occur to any one person or company, but certain to be devastating where they do occur. (This practice goes back at least to early medieval times, by the way, as ships and caravans were commonly insured.) This is even more likely today; as Carmen can attest, diagnosis and treatment can be terribly expensive. I certainly agree that people need to be responsible for our own day-to-day care, but we absolutely need catastrophic insurance. Unfortunately too many people today view health insurance as someone else paying all their medical expenses, leaving themselves free to buy luxuries.

I wouldn't mind catastrophic insurance, if it was restricted to only those maladys.. and eliminate insurance for everything else.

 

[Tristicus]

Thanks. Your highly useful input is always appreciated.

I thought you were leaving. I was looking forward to it.

 

[zsdersw]

I thought you were leaving. I was looking forward to it.

Nope. I've decided to remain and call out useless demagogues and useless demagoguery. I suspect I'll be quoting a lot of your comments in future threads.

 

[zsdersw]

Well medicine is the only biz I know of they list prices after the fact so no I think. In other words I think insurance serves a good cost modifier/bargaining power unlike one man would have.

Perhaps prices for elective, non-emergency items shouldn't be listed after the fact.

 

[Tristicus]

Nope. I've decided to remain and call out useless demagogues and useless demagoguery. I suspect I'll be quoting a lot of your comments in future threads.

Talking to yourself is not a good sign.

 

[nonlnear]

Wouldn't the free market determine a similarly low price on its own?

Not exactly. It's paid for out of government funds (HHS, CMS, Medicaid/Medicare) not just the specific people who use the services.

Just because there is a market doesn't mean it's "free" (which, as a piece of economic jargon really should be clarified as "freely competitive" due to the widespread misunderstanding and willful misapplication of the term). The only kind of markets that determine efficient prices in a systematic way ore those markets with low or no barriers to entry, total information (i.e. price) transparency, a large pool of buyers and sellers, no price discrimination, and no unpriced externalities.

This is definitely NOT the case for the health care market (and many other markets actually). It could be and that's the kind of Change I Hope for, but it's not going to happen in the next couple decades.

 

[zsdersw]

Just because there is a market doesn't mean it's "free" (which, as a piece of economic jargon really should be clarified as "freely competitive" due to the widespread misunderstanding and willful misapplication of the term). The only kind of markets that determine efficient prices in a systematic way ore those markets with low or no barriers to entry, total information (i.e. price) transparency, a large pool of buyers and sellers, no price discrimination, and no unpriced externalities.

This is definitely NOT the case for the health care market (and many other markets actually). It could be and that's the kind of Change I Hope for, but it's not going to happen in the next couple decades.

Of course, but the length of the span of time between now and when those changes occur isn't reason to disregard the idea.

 

[nonlnear]

Of course, but the length of the span of time between now and when those changes occur isn't reason to disregard the idea.

GWB actually tried to make a respectable, if small, start. One of the (arguably few!) bright points of his legacy. Too bad Obama killed many of the HDHP plans by requiring all sorts of goodies be covered...

Insurance is one of the great impediments to market transparencies because it hides costs, and also entrenches rampant price discrimination. Also "conventional" insurance products are really three different services in one: risk diversification for unexpected expenses, amortization of expected expenses, and price negotiation. If price discrimination were simply disallowed at the provider level we would see such a dramatic transformation of the medical service price landscape it would make Ronald Reagan rise up out of the grave and plant a big wet one on zombie FDR's face. It would take a lot of pressure off of providers to take losses (or near losses) from big providers. There would still be room for negotiation, but whatever the lowest price a provider approved would be available to all. For example, if a service is provided at price x, that service may not be billed more than 10% higher in the next 6 months. That way everybody would benefit from the negotiating power of the big group insurers. Conversely, the big group plans wouldn't be able to negotiate overly peachy prices at the expense of smaller group plans and the individual purchasers.

This is the kind of insurance reform you will NEVER see out of either party.

 

[GaryJohnson]

Perhaps prices for elective, non-emergency items shouldn't be listed after the fact.

You need to find a new medical provider. All the ones I've been to will tell you how much something is going to cost if you ask.

 

[yllus]

Why does insurance of any kind exist? It's a hedge - purchasers buy it and pay a fairly low recurring rate in the hopes that if it's ever needed, the amount they've paid over the years is lower than the amount needed to do the actual medical procedure. If customers are okay with this and insurers are happy to offer the service, what's the problem? It's a win-win.

The free market for medical services still exists, it's just hedged against by the end user. If anything you (through the insurer) are ideally getting a better price from medical practitioners if you went to them on your own: The insurer can use the weight of thousands of patients to negotiate lower prices than you can alone.

 

[GroundedSailor]

While I'm sure these ideas are not original, I do believe in them and have not heard them floated during this debate, so here they are:

1. Eliminate health insurance. Why do we need a middleman? Why can't we deal with and pay doctors/hospitals directly? We are then free to spend our money (or whatever benefit system offered by our employer) on whichever doctor/hospital we believe delivers the best care at the lowest cost.

2. For immediate life-or-death emergencies, all hospitals must have an Emergency Room or section of rooms that is administered by the government (or some other independent third party) and paid for, on an as-needed basis, through the individual's income tax on whatever payment terms are reasonable. This is exclusively limited to true life-or-death emergencies and situations where the patient is not able to make hospital decisions.

These things would lower costs and would force people to be more accountable for their own health, which is never a bad thing.

You want to eliminate middleman. They why do we have to go through our employers. We could cut them out too.

Actually your arguments are best served by a single payer system which includes a copay for both doctor/hospital visits and prescriptions.

 

[zsdersw]

You want to eliminate middleman. They why do we have to go through our employers. We could cut them out too.

Don't have to go through our employers, either. Just a suggestion.

 

[IndyColtsFan]

The idea behind insurance is that there are certain risks that are unlikely to occur to any one person or company, but certain to be devastating where they do occur. (This practice goes back at least to early medieval times, by the way, as ships and caravans were commonly insured.) This is even more likely today; as Carmen can attest, diagnosis and treatment can be terribly expensive. I certainly agree that people need to be responsible for our own day-to-day care, but we absolutely need catastrophic insurance. Unfortunately too many people today view health insurance as someone else paying all their medical expenses, leaving themselves free to buy luxuries.

Truer words have never been spoken. I am afraid that when people think health care is "free," they will over-utilize it, causing costs to go up. That's why people need to be responsible for their own day-to-day stuff.

 

[Hayabusa Rider]

You need to find a new medical provider. All the ones I've been to will tell you how much something is going to cost if you ask.

They can to a point. People aren't cars to put up on a rack and say "that muffler has a hole, and I can fix it for X"

There are potential complications to any procedure or treatment. You might not recover as quickly as hoped and need a few days more in the hospital. You might need some other treatment in addition to what was first thought necessary. It's not really possible in a great many cases, however for something like removing a wart, sure.

 

[cubeless]

this is a strawman for single payer... just have the gov't take over all hospitals and put politically appointed bureaucrat like ray lahood in charge to ensure competent administration... everybody then goes on medicare... just add taxes to pay for it all and sam's your uncle...

 

[her209]

Truer words have never been spoken. I am afraid that when people think health care is "free," they will over-utilize it, causing costs to go up. That's why people need to be responsible for their own day-to-day stuff.

Maybe its because people think "I'm paying thousands for this. I'm going to use it when I please."

 

[cubeless]

Maybe its because people think "I'm paying thousands for this. I'm going to use it when I please."

no, it's more the people who say 'bo bucks paid for this so it's free to me...'

 

[her209]

no, it's more the people who say 'bo bucks paid for this so it's free to me...'

Do "'bo bucks" also pay for the co-pay?