Question:
What would be YOUR plan to resolve the health care problem in the U.S.??
End The Fed!!!
2008-01-04 07:56:52 UTC
It seems to me that every medical procedure that IS NOT covered under insurance has a price tag that has plummeted. Examples are Lasik, or RK surgery, plastic surgery, implants.... I remember when eye correction surgery was $20,000. Now you can get it for as cheap as $1,000.
With that price drop, and the fact that insurance companies are not involved, should be a VALUABLE LESSON.
Free Market is a beautiful thing.
Fifteen answers:
j-man
2008-01-04 09:36:50 UTC
Free market is the answer.



A majority of US health care is paid for by government (it is slightly over 50%) versus being paid for by private sources. But there are other things to consider. Federal and State regulations require that insurance cover procedures that may not want to be covered. Insurers, Health care providers, and employers are required to fill out mountains of paperwork, and to store it all away.



Back before government got into health care, doctors hired 1 nurse for their office. That nurse not only was trained in her (yeah, I can be politically incorrect here, at the time, male nurses were unheard of) practice, but she also did billing and administrative duties. Nowadays, doctor offices have to hire a billing specialist, an insurance specialist, and at least one person to answer the phone and take appointments. This is on top of a nurse they may hire. If a doctors office must hire all of those extra people, you can be assured that the doctor will pass those expenses on to their patients.



One thing that always crosses my mind is that up until there was Medicare, there were free hospitals. People today seem to think that only a Canadian system can provide free healthcare. Most hospitals with religious names probably offered free health care to those who could not afford it. Under Medicare and Medicaid rules, the cheapest rates a healthcare provider can charge have to be charged to Medicare & Medicaid. That means if you offer free health care to one person, you have to offer it to Medicare/Medicaid.



And back before government got into the healthcare business, healthcare was much more affordable. Getting a bill from the doctor was never fun, but it was more like getting a bill from your mechanic. People did not like to pay their bill, but most could afford it.



Talk to old timers about this. You will see without government handouts, people could more easily afford healthcare, and it was much more accessible than it is today. And a heck of a lot more accessible than it is in countries that offers free healthcare (ie Canada, England)
?
2016-05-29 06:04:14 UTC
The best solution, to me, is to crack down on the frivilous lawsuits, and the medical and pharmaceutical lobbyists, and the insurance company games. There also needs to be some control on the write-offs. Person A goes to the Dr. and is charged 80 dollars. It is submitted to the insurance co, and the insurance co says "we'll give you $50". The Drs. accept that amount. Now, the person who is uninsured has to pay the full $80. But it gets worse. Since the Drs' know they will only get a portion of what they charge, they up the charge to $100, hoping to get $75 from the insurance co. So, the insurance co complies with the higher rate and pays $75 (and ups the subscribers costs the next year to compensate). But now, the uninsured is paying $100 for the visit. Its a little game between the physicians and the insurance companies. The physicians need to make a certain amount to cover their very expensive malpractice insurances (thanks to all of the lawsuits - some legit, some not), and the insurance companies try to be the medical experts and control what the doctors should recieve in payments. What happens is that the insured keep paying more, and the uninsured get completely robbed. It hurts all patients. I think that the plans the candidates have laid out are worthless. They may sound pretty, but they would not solve or address the situation. I think there are other ways to make medical care and insurance affordable again, without putting it in the hands of the government to control and manage.
aaron p
2008-01-04 08:22:33 UTC
How would price effect the demand for blood transfusions or organ replacements? Really.



There is actually a working paper by some folks over at U Chicago that describes why end of life procedures are so expensive. Demand would not decrease because the price is so high. Death is still imminent, making the procedure worth everything they own and more. After death, a person no longer has access to their funds. "Your money or your life" is usually an easy choice for people.



The procedures you mentioned are all voluntary and unnecessary, so they don't have the same mechanics at work as life saving (or life extending) procedures.
I Like Stories
2008-01-04 08:10:12 UTC
cosmetic surgery, including lasik is not part of the health care crisis in the US.



The problem is life threatening illness, like cancer. Look at this way - there is no longer any such thing as a pension. If your under the age of 50, you are expected to save for your retirement which includes you pay for your own medical care out of pocket. 20 years ago, companies provided their employees with a pension and life long health insurance - notice how that policy is about to put GM & Ford out of business.



If you get cancer or have a heart attack etc.. (odds pretty good that will happen) your retirement savings will disappear overnight. Cancer drugs cost up-wards of $1000/pill - my sister had cancer and used to puke up a $800 pill everyday.



I suggest that we have something like Canadian health care for day to day medical care and life threatening illness (cancer).



For the vain, their cosmetic surgery wouldn't be covered under this, you would have to pay for that yourself.



We could also keep the current system for the people who want to deal with the endless bureaucracy that a national health care plan will undoubtedly have. Maybe you get a tax credit if you opt out of the system?
Modus Operandi
2008-01-04 21:05:24 UTC
Or these technologies are becoming cheaper and therefore the savings comes down to you. Wait and see... that iPhone will be under $100 someday.



The main problem is litigation. Which is the answer I'm surprised not to see. If a doctor fails to save a dying patient there's no need to pay the family XX million dollars. They should cap the payments to 100K or make the burden of proof fall on the plaintiffs to prove there was gross negligence on the part of hte physician. Do you think OB/GYN services would cost so much if malpractice insurance weren't $100K annually?
Sue
2008-01-04 17:15:14 UTC
The same plan that Massachusetts now has in place. All residents are now required to have medical insurance. All employers are required to offer it, and those unemployed or self-employed are required to purchase plans. Of course, those that make less than 30k/year will receive help in paying their premium (or may be eligible to have their premium covered in full). Check out this website: www.commonwealthconnector.org

If a resident of MA refuses to obtain insurance, they are subject to penalties. I believe it is a $200 fine, as well as increased rates when they do enroll, but I`m not sure on that.
The_Spaceman
2008-01-04 08:01:43 UTC
The price of "non free market" services (i.e. those that are highly controlled by health insurance companies) also plummet. Actually health care is not "controlled" by the government. The system, by and large, is already free market.



Improving the healthcare system is no easy task. I think the easiest thing to do is to encourage Americans to eat more healthily and to exercise more.
Anonymous
2008-01-04 08:09:33 UTC
Well, surely, I agree with you - if everyone had HSA's combined with a major medical policy with a massive deductible (like $10,000), several very good things would happen:



1. people would stop clogging emergency rooms with colds - and not go to the doctor with colds, either. MANY things are treatable at home, just like mom did with you.



2. frivelous testing would be cut down



3. I think interesting things would happen with pharmaceuticals if insurance companies weren't paying $1,000 a month for medication, and people chose to use those $4 target generics because THEY didn't want to pay $1,000 a month, either,



4. maybe - just maybe - we'd take a bit better care of ourselves. What's the current number, 30% of Americans are overweight, and a healthy chunk of them (pardon the bad pun) are obesely overweight. If someone else isn't picking up the tab for our bad habits, the choice will be either diet, or die. Harsh, though.



HOWEVER. Most of the same people who are uninsured now, won't WANT to pay for their own medical treatment - they don't want to pay for it now! They don't want to save money in an HSA, they'd rather be buying cigarettes and lottery tickets, and eating at McDonalds.



The REAL truth behind all the moaning you see is, MOST people, 85% of Americans, HAVE health insurance. It GETS the job done. But the ones that don't, want someone else to take care of them, and not have any responsibility for themselves. They want someone else to surgically make them lose weight, they want someone to give them a magic pill so they can keep eating rotten foods, they want someone to give them therapies so they can keep smoking, they want . . . you get the picture.



So a pay as you go system is NOT going to fix the "I'm helpless and need someone to take care of me while I make stupid financial and life decisions without taking responsibility for the consequences" mentality. Sorry.
Monte T
2008-01-04 08:01:13 UTC
Medical savings accounts. Actually market driven procedures are wonderful. But since most people don't pay for their own medical care then that is why cost are driven up.
krazykatignatz
2008-01-04 08:04:17 UTC
Personally I think an NHS along the lines of the UK, Belgium or Norway would be the best solution, but phenomenally unpopular politically.
supergirl
2008-01-04 10:48:24 UTC
Free health care like Canada. They pay more taxes but also have a better economy. Our taxes, the way they're going, will be there pretty soon and the middle class will disappear below the poverty line due to this health care crisis.
heyteach
2008-01-04 11:48:09 UTC
You are 100% correct. That is why THE health care changes I believe need to be made are in a book that is NOT getting attention probably because NO special interest COULD make money if the changes were implemented. It creates a true free market--and you correctly pointed out what happens when that occurs.



The author has a LOT of good, documented info on health care, and has changes that could easily be implemented NOW with the BS system we have and improve it.



However, her real strength is her proposal for a new way to do things. She states that the federal government does NOT have the jurisdiction to offer things like Medicare, BUT being a logical woman, recognizes that what is, is and is not going to change overnight. So she has a proposal that could be used either as a transition (she figures about 30 years) from government to private industry OR at least a self-supporting government system.



Because of a recent news article showing the current system is impotent against large insurers (http://www.newsmax.com/medicine_men/medical_insurance/2008/01/03/61543.html) which are robbing us blind, I took the time this morning to sit down to right some politicians AGAIN about this plan and I'm just going to paste down some of what I shared with them because I'm tired of typing, but SOMEONE has to try to do something:



To summarize the sensible plan again, which should be reviewed here (and it is the PDF, NOT the blurb): http://www.booklocker.com/books/3068.html



It offers ALL Americans a catastrophic health care package for an AFFORDABLE price.



Key points:



ALL Americans are eligible (and yes, there would be the traditional breakdowns into categories by age, sex, medical condition so that accurate premiums could be offered).



It is a CHOICE, not mandated with scare tactics and punishment—right now the UNINSURABLE are screwed again with things like “Must have insurance or we’ll fine you.” How about making a legit plan available to all before dumping on the victim again?



Catastrophic health care package is ALL that ANYONE NEEDS. The actual purpose of insurance is to share risk so you avoid bankruptcy. This is NOT done at all these days. First, over half of all bankruptcies are for medical bills and most of those folks were insured. Thus the current system clearly does NOT work. Second, this stupid “if you’ve got a nice policy and a sniffle, stop by the doc’s and others will pay for it” runs up medical costs for NO good reason at all. Resources are wasted every day. IF people had to pay for their tendency towards hypochondria or refusal to follow basic sensible provisions, they’d be more likely to change their behavior.



AFFORDABLE is key. Insurance is NOT now affordable and the UHC story helps shed light on why that is. This plan would use a sliding-scale for the premium AND the co-pays so that those who really are not making much money (be they students or folks just starting out in the work force or the retired or disabled) would not pay more than they can afford. There would be a REAL limit on out-of-pocket NECESSARY medical expenditures as well.



Other key plan points:

There would be one physical with follow-up visit per year as well as one ER visit IF NEEDED (how to prevent ER abuse is covered) for reasonable co-pays.



The point here:

Prevention is ALWAYS cheaper than waiting for a problem to develop. It is also the moral approach to medical care. By getting folks in annually we’d be able to save a lot of lives and improve peoples’ productivity. We could also review meds (or if they’re needed), keep people immunized appropriately, answer questions about nutrition and more, and have a baseline of info should the person be in an accident or fall ill. Again, with a reasonable co-pay, there is now NO good reason for folks not to see the doctor. The follow-up makes sense for anyone who HAS a medical issue. If someone came through with flying colors, he would not even need to use that follow-up. Not everyone needs the ER, but it would be sensible IF needed to not leave people SOL. This logical plan would address ALL the legitimate needs of probably 80% of the population.



Another key plan point:

Necessary medications are covered as well as NO caps on necessary medical treatments.



Right now, we have BS like the “donut hole” of Medicare. This would be eliminated as would all fertility treatments, ED med coverage, and anything else which is not NECESSARY. This does not prevent people from receiving treatment for such things—let them find an insurance plan (this plan doesn’t stop others from being offered) or pay for it themselves, but there is no justification to make the taxpayer help someone have kids or sex. There is a reasonable reason for people on insurance to help those with cancer, strokes, heart disease, diabetes, etc. as this is far beyond a quality of life issue and goes to the heart of life and death. This is the same rationale for ending caps on legitimate procedures, like bone marrow transplants, which are quite expensive. Too often now a plan lies and claims something is covered, but by shunting off $25-250K on the patient to pay, that’s NOT a covered item in a rational person’s book.



Funding then becomes the issue and we’re taken care of here. First, we eliminate all these bogus government offered plans—from Medicare to SCHIP to Medicaid. (IHS is a separate issue and if folks want to keep it, they can. Ditto VA which is also a special deal considering the substantial number of vets who have medical issues the civilian population is NOT used to seeing or dealing with. Funding for both of the programs should be increased and, of course, every Indian and vet who wants this program is more than welcome to be covered by it as well. We’re not going to exclude folks, but two groups get an option for another program.) All the rest of the existing program funds go into the pool. Then every single “charity” designation for every hospital is removed and the taxes those providers now pay will be divided up so that the local taxes go into the local tax pool (got to keep 911 up and running and roads people can get to the hospital on). The state taxes will go into the state’s med pool account and the fed taxes will go into the med pool that helps re-allocate funds to the states, just as they receive things like Medicare block funds now. IF there is a shortfall (and if the other suggestions in the large chapter on health care are followed, there should NOT be), then some funds from the general taxes will have to supplement it because the taxpayer will STILL be better off. How? We’re reducing the number of bankruptcies, which costs the public funds. We’re reducing welfare rolls as people should be more productive when they’re healthier. We should reduce the number of folks on disability as if you can get proper med treatment your whole life you will reduce the number of people who can’t work. We end the issue of free care to illegals (that’s in the immigration chapter of the book). That is NOT a legitimate medical expense to be born under this plan (and how to reduce illegal immigration is dealt with as well as stopping “compassionate entry” at the state taxpayer’s expense. That’s a federal choice and that should come out of FOREIGN AID if people are going to continue to support that stupid policy.) People are paying premiums and co-pays. We are now being logical and negotiating prescription med prices. We are ending the illegal subsidies and protections for the large insurers (they can offer policies, but they’re going to have to start delivering the goods in a cost-effective manner instead of screwing the public, patients, and doctors and skimming off multi-millions for their fat cat lifestyles by abusing contract law principles, not paying their fair share in taxes (see Meidinger’s testimony), and being unfairly gifted with the bogus ERISA shield (see Jamie Cort’s book “HMOs: Making a Killing.”) When people are paid fairly and on-time and paperwork is reduced and a lot of BS regulations are dispensed with, costs will drop.
ak47
2008-01-06 21:38:22 UTC
I donno much about these kinda topics buuut... if we can solve it with money, do it... if we dont have money... how can we pay that much money to stay in Iraq and Afghanistan... bring the troops back and pay that damn money to HEALTH CARE omg...
Sensualbracelet
2008-01-04 08:01:51 UTC
now we all know that those cosmetic surgeries are for the foolish and rich......but seriously......the u.s needs to be like canada.....free basic health coverage for all.....not just some!
Spock (rhp)
2008-01-04 08:37:14 UTC
here's my plan:



1. all medical providers are required to have, adhere to, and make available for public inspection a single price list, by procedure, which shall apply to every patient without exception. public inspection shall mean via an Internet available and searchable database maintained by each state.



2. every insurer and third party payer of every stripe, including Medicare and MediCaid, may determine for itself the level of payment it will provide to each and every provider in similar circumstances [by zip code of location and type of facility], with patient to pay any amount beyond this that provider requires.



These two together set up the needed conditions for successful doctor shopping. your voluntary procedures like LASIK have price competition because people can shop for them. Asking people to shop for price while they have an emergency or urgent medical need is completely stupid -- thus the requirement of all providers that they have one price for all patients.



3. all medical records to be kept in one central database, accessible by all providers. patients who opt out of the database may be assessed by providers for such added costs as the provider believes necessary in the circumstances and insurers need not cover such costs.



this may require that primary care physicians be paid a fee to enter patient's ordinary care data into the database and all other providers to pay a fee for using the database.



item 3 reduces the cost of duplicate care by providing all medical records for patient to each provider. Many, many patients can not recall who they saw for what reason five years ago, nor why drug Z's use was stopped. This is especially prevalent in the elderly, who are our biggest per person users of medical care.





4. Physicians are required to prescribe generic drugs unless there is a medical reason not to and pharmacists shall fill all prescriptions with generics unless physician has indicated the name brand is medically necessary.



5. Continuing prescriptions may be filled by pharmacists for up to 5 years without a new Rx.



6. Prescriptions shall be valid in all 50 states for any drug that is legal in that state as long as physician has a valid license in the state where he is located. [physician license database is already online searchable and should include sample of signature.]



7. narcotics prescriptions shall require validation of Rx by pharmacist by indirect enquiry to physician's office via state database.



items 4 thru 7 are designed to control cost of drugs.



8. all citizens are entitled to have, own and use an HSA [health savings account]. existing legislation is sufficient. Persons who do not have employer provided insurance may purchase such insurance, and contribute to an HSA, with tax deductible funds. such deduction goes on form 1040, not on schedule A. Amount of same to be not less than 2/3rds the average cost for similar age person as provided by all employer plans in same zip code for prior year. Congress may aggregate data further as it sees fit as long as difference in costs does not exceed 15% per person. [Similar to the aggregation used for travel lodging, meals, and incidental expenses.]



purpose -- obvious. levels the playing field between employees with insurance and the self-employed.



9. abusive substances plan.



For every abusive substance as determined by medical research, explicitly including tobacco and alcohol, plus illegal drugs and perhaps calories [obesity and diabetes are fast growing medical problems in America], a separate fund to provide medically needed care shall be established by the industry producing the abusive substances. All sales of the abusive substance shall be taxed at equal rate for all industry participants and the pooled funds used to provide both direct and indirect care as needed. Other specialized taxes on the abusive substance [example: alcohol and tobacco unit taxes but not income taxes] shall be abolished.



when the fund runs low, or is projected to run low, the tax rate on the abusive substance is increased for all industry participants. Tax rate for illegal substances takes the form of fines on all importers, makers, and distributors of the substance. Such fines attach all assets of the criminal of every type, including the right to social welfare payments of all descriptions and retirement benefits, and his civil rights may not be restored until such fines are paid in full with interest.



section 9 relieves the ordinary person of health costs associated with smoking, drinking, drunk driving (an indirect cost), illegal drugs, and excess consumption of calories and saddles them on the industry selling the product.



[note: this may require a "pre-rebate" to all citizens for the "normal" daily calorie intake requirements so that they can purchase their "normal" food free of the calorie tax.]



section 9 will reduce the health insurance costs of nearly everyone, as well as auto insurance costs, by loading the costs of these social ills onto their producers [who will raise prices to their consumers thus making the free market price of the good reflect the externalized costs as it should for the free market to work].





so far, this is all I've come up with.


This content was originally posted on Y! Answers, a Q&A website that shut down in 2021.
Loading...