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Part I: Healthcare System Problem Identification

NaughtyGeek

Golden Member
So, after reading through numerous HC reform threads, what is abundantly clear is that there seems to be no rational approach to solving our healthcare crisis being pursued or the approaches being taken are missing key points so lets start with the first thing you need to do to solve a problem, identify it.

1) Rising Costs
2) 18% Uninsured rate (or therabouts)
3) Lack of coverage or loss of coverage for individuals with preexisting conditions
a.)Claim denial for seemingly unrelated clerical or informational errors.
4) Health care being tied to employment
5) Lack of uniformity in pricing
6) Excessive litigation
7) Unnecessary and/or excessive/redendant proceedures.
8) Hospitals forced to care for non-citizens who don't pay.
9) Doctors motivated by money (more procedures = more money).
a) increases costs by doing unnecessary things.
b) decreases "with patient" time (less thorough than they should be) due to
rushing through many patients.
10) lack of medical record accessibility / transferrability / online-y goodness
11) billing by the item/procedure (surgery, bandaids, single tylenol, splint, etc) and not by
the outcomes.
12) not enough doctors, too many devices (MRI machines for example)
13) don't need full-on doctors for "simple" things (strep throat, etc.)
14) rare/non-existent after-hours care for things such as Xrays / labs / etc... (outside of
the emergency room, which should be reserved for people who are severely injured).
15) corruption.
a) collusion between Doctors and Medical Supply/Pharmaceutical companies.
16) pharmaceutical advertising to the public.
17) If you sell "insurance" to anyone in a given state, you must accept all persons in that state on the same terms and at the same price. (I don't believe this to be true but have added it as the poster may know something I do not.)
18) The denial of treatments, or removal from a plan altogether, at times when such treatments are critical to the survival of a patient -- this is simply unacceptable.
19) There should be no lifetime maximums for anyone -- catastrophic protection should be mandatory for all plans.
20) People using the ER for routine medical care
21) Old people


Please add your views of our current problem as line items as above so they can be easily cut/pasted into later posts for resolution discussions. Please leave name calling and partisan BS at the door and just state for now what you feel are the shortcomings of the system that is currently in place in the USA.
 
If you sell "insurance" to anyone in a given state, you must accept all persons in that state on the same terms and at the same price.

Borrowed from Karl Denninger
 
Originally posted by: Darwin333
If you sell "insurance" to anyone in a given state, you must accept all persons in that state on the same terms and at the same price.

Borrowed from Karl Denninger

And now that the insurances companies have been driven out of business we all get to join the government health care monopoly plan.
 
Originally posted by: RedChief
Originally posted by: Darwin333
If you sell "insurance" to anyone in a given state, you must accept all persons in that state on the same terms and at the same price.

Borrowed from Karl Denninger

And now that the insurances companies have been driven out of business we all get to join the government health care monopoly plan.

How does that drive the insurance companies out of business?
 
Originally posted by: Darwin333
Originally posted by: RedChief
Originally posted by: Darwin333
If you sell "insurance" to anyone in a given state, you must accept all persons in that state on the same terms and at the same price.

Borrowed from Karl Denninger

And now that the insurances companies have been driven out of business we all get to join the government health care monopoly plan.

How does that drive the insurance companies out of business?

Does that statement say anything about implying compelled coverage for pre-existing conditions?
 
Originally posted by: Darwin333
Originally posted by: RedChief
Originally posted by: Darwin333
If you sell "insurance" to anyone in a given state, you must accept all persons in that state on the same terms and at the same price.

Borrowed from Karl Denninger

And now that the insurances companies have been driven out of business we all get to join the government health care monopoly plan.

How does that drive the insurance companies out of business?

Let's see. The fact that government insurance is paid for by taxpayers. Whether or not you are going to be in it or not, you pay into the system. The people who pay for BCBS or Aetna or whatever use it. The people who don't, do not. Simple. UHC is backed by a semi-unlimited supply of funds.
 
Originally posted by: DLeRium
Originally posted by: Darwin333
Originally posted by: RedChief
Originally posted by: Darwin333
If you sell "insurance" to anyone in a given state, you must accept all persons in that state on the same terms and at the same price.

Borrowed from Karl Denninger

And now that the insurances companies have been driven out of business we all get to join the government health care monopoly plan.

How does that drive the insurance companies out of business?

Let's see. The fact that government insurance is paid for by taxpayers. Whether or not you are going to be in it or not, you pay into the system. The people who pay for BCBS or Aetna or whatever use it. The people who don't, do not. Simple. UHC is backed by a semi-unlimited supply of funds.

I didn't realize I stepped on board the "UHC bus". I thought we where talking about specific problems and potential solutions for health care reform. Health care being tied to employment is a problem, in my opinion. Instead of selling a specific insurance product to only people that work for a specific company it would be offered to everyone in that state.
 
Problem:

1. Different prices for exact same service provided by any one service provider (or lack of uniformity in pricing). What I mean is, if you are on medicaid/medicare you get one price from doctor Joe. If you are on HI, you get billed a different amount. If you are unisured, you get yet another price.

IMO, everyone getting the same thing from the same doctor should pay the same price.

2. Excessive litigation (which likely leads to next problem)

3. Unnecessary and/or excessive/redendant proceedures.

4. Hospitals forced to care for non-citizens who don't pay. I'm thinking oif the case in FL where the guy finally whisked away by chartered jet (paid for by hospital) after incurring $100Ks in bills. I also belive there some illegal in CA who wnet through millions with a bunch of liver transplants etc. IMO, US taxpayers shouldn't have to pay for the care of non-citizens here illegally. However, I do agree that hospitals should provide them care for urgent life-threatening needs even if they cannot pay; I suppose it's the limit on, or abuse of that, I take exception to.

Fern
 
Originally posted by: NaughtyGeek
So, after reading through numerous HC reform threads, what is abundantly clear is that there seems to be no rational approach to solving our healthcare crisis being pursued or the approaches being taken are missing key points so lets start with the first thing you need to do to solve a problem, identify it.

1) Rising Costs
2) 18% Uninsured rate (or therabouts)
3) Lack of coverage or loss of coverage for individuals with preexisting conditions
a.)Claim denial for seemingly unrelated clerical or informational errors.

Please add your views of our current problem as line items as above so they can be easily cut/pasted into later posts for resolution discussions. Please leave name calling and partisan BS at the door and just state for now what you feel are the shortcomings of the system that is currently in place in the USA.

Those are symptoms, not problems.

Ask yourself what is the cause of those problems.

1. Consumers dont care about price as someone else is paying the bill.
2. health insurance is tied to employment(most people are only uninsured for a short period)
3. preexisting conditions are not insurable as they have fixed regular costs associated with them.
 
Solution:

1. create a list of each major problem with our current system.
2. author one, small, well-written bill for each of those problems.
3. debate and pass said bills one at a time.
 
Originally posted by: TheSkinsFan
Solution:

1. create a list of each major problem with our current system.
2. author one, small, well-written bill for each of those problems.
3. debate and pass said bills one at a time.

Stop being reasonable.
 
Originally posted by: Darwin333
Originally posted by: DLeRium
Originally posted by: Darwin333
Originally posted by: RedChief
Originally posted by: Darwin333
If you sell "insurance" to anyone in a given state, you must accept all persons in that state on the same terms and at the same price.

Borrowed from Karl Denninger

And now that the insurances companies have been driven out of business we all get to join the government health care monopoly plan.

How does that drive the insurance companies out of business?

Let's see. The fact that government insurance is paid for by taxpayers. Whether or not you are going to be in it or not, you pay into the system. The people who pay for BCBS or Aetna or whatever use it. The people who don't, do not. Simple. UHC is backed by a semi-unlimited supply of funds.

I didn't realize I stepped on board the "UHC bus". I thought we where talking about specific problems and potential solutions for health care reform. Health care being tied to employment is a problem, in my opinion. Instead of selling a specific insurance product to only people that work for a specific company it would be offered to everyone in that state.

Ok, you offer it to everyone, but then can they afford it? Premiums can be very expensive. Maybe impose a cap on insurance rates?
 
Originally posted by: Uhtrinity
Originally posted by: Darwin333
Originally posted by: DLeRium
Originally posted by: Darwin333
Originally posted by: RedChief
Originally posted by: Darwin333
If you sell "insurance" to anyone in a given state, you must accept all persons in that state on the same terms and at the same price.

Borrowed from Karl Denninger

And now that the insurances companies have been driven out of business we all get to join the government health care monopoly plan.

How does that drive the insurance companies out of business?

Let's see. The fact that government insurance is paid for by taxpayers. Whether or not you are going to be in it or not, you pay into the system. The people who pay for BCBS or Aetna or whatever use it. The people who don't, do not. Simple. UHC is backed by a semi-unlimited supply of funds.

I didn't realize I stepped on board the "UHC bus". I thought we where talking about specific problems and potential solutions for health care reform. Health care being tied to employment is a problem, in my opinion. Instead of selling a specific insurance product to only people that work for a specific company it would be offered to everyone in that state.

Ok, you offer it to everyone, but then can they afford it? Premiums can be very expensive. Maybe impose a cap on insurance rates?

Wouldn't it the plan get cheaper the more people are enrolled in it? Isn't that the idea behind insurance? If not, why doesn't a single person get a better price than a large business plan? How do you disconnect insurance from employment if the vast majority of affordable insurance can only be found through employers?
 
Originally posted by: NaughtyGeek
So, after reading through numerous HC reform threads, what is abundantly clear is that there seems to be no rational approach to solving our healthcare crisis being pursued or the approaches being taken are missing key points so lets start with the first thing you need to do to solve a problem, identify it.

1) Rising Costs
2) 18% Uninsured rate (or therabouts)
3) Lack of coverage or loss of coverage for individuals with preexisting conditions
a.)Claim denial for seemingly unrelated clerical or informational errors.

Please add your views of our current problem as line items as above so they can be easily cut/pasted into later posts for resolution discussions. Please leave name calling and partisan BS at the door and just state for now what you feel are the shortcomings of the system that is currently in place in the USA.

Back to the OP's intent with this thread, IDENTIFYING THE PROBLEM:

1) Doctors motivated by money (more procedures = more money).
1a) increases costs by doing unnecessary things.
1b) decreases "with patient" time (less thorough than they should be) due to rushing through many patients.

2) lack of medical record accessibility / transferrability / online-y goodness

3) billing by the item/procedure (surgery, bandaids, single tylenol, splint, etc) and not by the outcomes.

4) not enough doctors, too many devices (MRI machines for example)

5) don't need full-on doctors for "simple" things (strep throat, etc.)

6) rare/non-existent after-hours care for things such as Xrays / labs / etc... (outside of the emergency room, which should be reserved for people who are severely injured).

7) corruption.
7a) collusion between Doctors and Medical Supply/Pharmaceutical companies.

8) pharmaceutical advertising to the public.

 
Originally posted by: Darwin333
Originally posted by: Uhtrinity
Originally posted by: Darwin333
Originally posted by: DLeRium
Originally posted by: Darwin333
Originally posted by: RedChief
Originally posted by: Darwin333
If you sell "insurance" to anyone in a given state, you must accept all persons in that state on the same terms and at the same price.

Borrowed from Karl Denninger

And now that the insurances companies have been driven out of business we all get to join the government health care monopoly plan.

How does that drive the insurance companies out of business?

Let's see. The fact that government insurance is paid for by taxpayers. Whether or not you are going to be in it or not, you pay into the system. The people who pay for BCBS or Aetna or whatever use it. The people who don't, do not. Simple. UHC is backed by a semi-unlimited supply of funds.

I didn't realize I stepped on board the "UHC bus". I thought we where talking about specific problems and potential solutions for health care reform. Health care being tied to employment is a problem, in my opinion. Instead of selling a specific insurance product to only people that work for a specific company it would be offered to everyone in that state.

Ok, you offer it to everyone, but then can they afford it? Premiums can be very expensive. Maybe impose a cap on insurance rates?

Wouldn't it the plan get cheaper the more people are enrolled in it? Isn't that the idea behind insurance? If not, why doesn't a single person get a better price than a large business plan? How do you disconnect insurance from employment if the vast majority of affordable insurance can only be found through employers?

Affordable insurance is available now, however the general population has been conditioned into insuring the affordable. So every simple healthcare transaction has a 3rd party involved to pay the bill. When you insure the affordable you drive up cost. Get a high deductable plan and pay for the routine and affordable out of pocket.
 
Originally posted by: charrison
Originally posted by: Darwin333
Originally posted by: Uhtrinity
Originally posted by: Darwin333
Originally posted by: DLeRium
Originally posted by: Darwin333
Originally posted by: RedChief
Originally posted by: Darwin333
If you sell "insurance" to anyone in a given state, you must accept all persons in that state on the same terms and at the same price.

Borrowed from Karl Denninger

And now that the insurances companies have been driven out of business we all get to join the government health care monopoly plan.

How does that drive the insurance companies out of business?

Let's see. The fact that government insurance is paid for by taxpayers. Whether or not you are going to be in it or not, you pay into the system. The people who pay for BCBS or Aetna or whatever use it. The people who don't, do not. Simple. UHC is backed by a semi-unlimited supply of funds.

I didn't realize I stepped on board the "UHC bus". I thought we where talking about specific problems and potential solutions for health care reform. Health care being tied to employment is a problem, in my opinion. Instead of selling a specific insurance product to only people that work for a specific company it would be offered to everyone in that state.

Ok, you offer it to everyone, but then can they afford it? Premiums can be very expensive. Maybe impose a cap on insurance rates?

Wouldn't it the plan get cheaper the more people are enrolled in it? Isn't that the idea behind insurance? If not, why doesn't a single person get a better price than a large business plan? How do you disconnect insurance from employment if the vast majority of affordable insurance can only be found through employers?

Affordable insurance is available now, however the general population has been conditioned into insuring the affordable. So every simple healthcare transaction has a 3rd party involved to pay the bill. When you insure the affordable you drive up cost. Get a high deductable plan and pay for the routine and affordable out of pocket.

I agree but unfortunately my employer doesn't offer a plan like that. It would be nice if I could enroll into plans like that that are already being sold in my state.
 
Originally posted by: Darwin333
Originally posted by: RedChief
Originally posted by: Darwin333
If you sell "insurance" to anyone in a given state, you must accept all persons in that state on the same terms and at the same price.

Borrowed from Karl Denninger

And now that the insurances companies have been driven out of business we all get to join the government health care monopoly plan.

How does that drive the insurance companies out of business?

Because alongside the inevitable "pre-existing condition" clause that will come up in this thread NOBODY will buy insurance until they have an expensive procedure to pay for.

Why buy insurance until I get cancer, if the rates are exactly the same as everyone else and they can't deny me coverage?
 
Originally posted by: Darwin333
Originally posted by: charrison

Affordable insurance is available now, however the general population has been conditioned into insuring the affordable. So every simple healthcare transaction has a 3rd party involved to pay the bill. When you insure the affordable you drive up cost. Get a high deductable plan and pay for the routine and affordable out of pocket.

I agree but unfortunately my employer doesn't offer a plan like that. It would be nice if I could enroll into plans like that that are already being sold in my state.

Not to mention the fact that there are a LOT of people that DO end up needing insurance for the "routine and affordable".

I had a simple sinus infection a couple months back. Got a prescription for antibiotics (nothing really exotic). Looked on the bill, would have cost me over $300 for 2 weeks worth if I didn't have insurance. and that's on top of the doctor's fee of at least $100 (more likely $200). That's $400-500 for a simple, very routine thing. There are many who could not afford this.

 
Picked out most of the points relating to my OP and added them to the list whether I agreed with them or not. Please save your philosophical debates for the gazillion other UHC threads and stick to the point please. Lets work together to identify the problems with the current system.
 
Originally posted by: ebaycj
I had a simple sinus infection a couple months back. Got a prescription for antibiotics (nothing really exotic). Looked on the bill, would have cost me over $300 for 2 weeks worth if I didn't have insurance. and that's on top of the doctor's fee of at least $100 (more likely $200). That's $400-500 for a simple, very routine thing. There are many who could not afford this.
That's not as uncommon as most of us would like to believe. A friend of mine developed a skin infection on her leg last month and ended up being hospitalized. It turned out that she had one a "used to be rare but more prevalent now" MRS infection. Upon release from the hospital, she was given a prescription for a 3-week course of antibiotics. When she picked up the prescription, the pharmacist warned her that her insurance company would not pay for a replacement or refill -- if she lost the pills she would have to pay the full $80/capsule price.
 
Originally posted by: charrison
Affordable insurance is available now, however the general population has been conditioned into insuring the affordable. So every simple healthcare transaction has a 3rd party involved to pay the bill. When you insure the affordable you drive up cost. Get a high deductable plan and pay for the routine and affordable out of pocket.
"Affordable" is of course, a relative term. In today's labor market, most people are not making enough to afford even routine care. For one thing, employer-paid insurance has distorted the market such that those who pay out of pocket are charged many times more than insured patients for the same services.

Also, many of the high deductible "affordable" policies of which you seem so enamored are the very ones that end up precipitating personal bankruptcies. By and large, they are so full of loopholes that they end up paying only a small percentage of actual costs . Like the "maternity" insurance that covered only $3000 of pregnancy related charges or "hospital" insurance that covers only the room and no actual services, they end up being nothing more than a bonanza for insurance companies.

 
Notes:
4) Health being a benefit of employment is between me & my employer. I earned this job and the benefits I have aren't for you, congress, or anybody but me and my employer to be concerned with. Why is this an issue?

11) Outcomes are going to vary. People aren't cars. There has to be a middle ground reached on this one. The economics simply won't bear it.

12) There aren't too many devices. There are just not enough doctors.

15a) Do you have any idea how highly regulated pharmacuetical sales and advertising is? I say enforce existing laws and punish those breaking them rather than the entire industry.

16) Pharma advertising is highly regulated. I don't understand the issue. Awareness of disease is one of the single greatest factors of early detection, treatment, and positive outcomes.

The rest of your list, I'm cool with. nice job.

EDIT: 17) That's a half step away from a government run insurance system. How about we try to fix what we have before we start discussing trashing it all and starting over.
 
Originally posted by: Darwin333
Originally posted by: DLeRium
Originally posted by: Darwin333
Originally posted by: RedChief
Originally posted by: Darwin333
If you sell "insurance" to anyone in a given state, you must accept all persons in that state on the same terms and at the same price.

Borrowed from Karl Denninger

And now that the insurances companies have been driven out of business we all get to join the government health care monopoly plan.

How does that drive the insurance companies out of business?

Let's see. The fact that government insurance is paid for by taxpayers. Whether or not you are going to be in it or not, you pay into the system. The people who pay for BCBS or Aetna or whatever use it. The people who don't, do not. Simple. UHC is backed by a semi-unlimited supply of funds.

I didn't realize I stepped on board the "UHC bus". I thought we where talking about specific problems and potential solutions for health care reform. Health care being tied to employment is a problem, in my opinion. Instead of selling a specific insurance product to only people that work for a specific company it would be offered to everyone in that state.


It's not a problem - it's just something you and everybody wants. It's okay to be jealous, but call a spade a spade.
 
Originally posted by: TheSkinsFan
Solution:

1. create a list of each major problem with our current system.
2. author one, small, well-written bill for each of those problems.
3. debate and pass said bills one at a time.

This. :thumbsup:
 
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