Thanks for the civil reply. I apologize that my response is rather long.
HSAs work fairly well once you are firmly financially established. My wife and I currently make about $27,000 a year, and both of us are cancer survivors. Since she requires ongoing pain medication (to the tune of about $600 a month if we don't have insurance) our health costs are quite high. HSAs are rather poor options for the chronically ill, the out of pocket costs are simply too high. When I was getting 2-4 pet scans a year there was just no way I could afford that with an HSA.
I think part of what you said depends on what you mean by "accepting a lower level of care." Many other countries do pretty well in terms of overall quality and spend a lot less money doing it. They might not be better necessarily, but certainly comparable considering what they pay. If "accepting a lower level of care" means that we can't get unnecessary tests (which are primarily due to defensive medicine costs), than I am all for it. I agree that we need to re-couple health care costs with the individuals receiving the care.
Part of the reason doctors salaries need to be so high is the cost of education and malpractice insurance. This reform effort makes substantial steps at reducing the cost of education through loan elimination programs.
My dad ran a small business so I know how badly health care costs can hurt them. It's a major problem.
I think you made a good point about the U.S. starting at a lower baseline, obesity in particular simply must be addressed. It costs us hundreds of billions a year not only in health care costs, but lost productivity.
In political terms I end up being a liberal-libertarian, or a
libertarian democrat. In general I agree that government can sometimes end up doing more harm than good, but I also think government can do "good." That said, I also think government has the responsibility to step in when private or non-profit industry fails.
That is my belief regarding the health care. We've got a major national problem, and I believe it needs a national solution. I think piecemeal solutions will simply drag out the process and we will end up doing more damage in the short-term without addressing the real long-term problems.
I don't really agree that it is the federal government taking over, because the private industry will still exist. Despite cries from the right, this bill isn't socialism. We won't have state owned hospitals, drug companies, or doctors/nurses won't becoming state employees. It's an attempt to fix a broken system. I think this legislation is flawed, but not utterly apocalyptic. I imagine there will be some rough patches that need to get fixed, but overall I think it will end up being a "good" direction for health care in the U.S. Then again, I'm not an expert, just a consumer
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I think Hayabusa makes very strong points regarding the fact that the fix should be designed by the people who have the most experience with its flaws. I'm just not sure there is a realistic way to accomplish that...which is why I've been prodding him for more information
🙂 I really want to know how he thinks reform should be done...as well as a description of how it could be implemented.