August 26, 2005
Health Care Reform Free Market Style
The create a statistic crowd just loves to harp on health insurance. We have heard the numbers, 15, 20, 28.4, 45 million people without health care. The numbers fly off the mouths of the talking heads so freely you can almost believe some of them. Why is all this spouted? Universal health care of course. A young man knocked on my door last week and asked me to sign a petition to lower health care costs. How would signing a petition lower health care costs, I inquired? Simple, we could create a single payer, and I cut him off there. I asked the young man if he had heard of a proposal from John Shadegg to lower health care cost by increasing competition? A blank stare is all I got in return.
I wonder how many of you know about this?
John Shadegg is a Congressman from Arizona who has some revolutionary ideas in regards to health care reform. The Congressman has proposed The Health Care Choice Act which is designed to let the free market act with all its might to reduce health insurance cost across the Nation.
One of the major costs in Health Care Insurance is something called mandatory coverage. Each State has its own Insurance Commissioner, these Commissioners have great power in determining how insurance companies that do business in their states must operate. The number of mandates has grown increasingly over the years with such things as hair replacements, aromatherapy, acupuncture, etc adding extensively to the cost of coverage. In some States as many as 1,800 mandatory coverage items are listed.
The effect of this mandatory coverage is to force consumers in certain markets to get nothing less than Cadillac coverage in the States in which they live. Many people and many businesses can not afford to offer this type of coverage.
So how do you fix it? Congressman Shadeggs Health Care Choice Act will allow insurance products licensed in one State to be sold in another.
Here is how it works. Let us say Idaho has 300 mandates and can offer a family policy at $400 a month. New Jersey has 1,500 mandates and insurance coverage is a minimum of $2,400 a month. An insurance company licensed in Idaho could apply with the Insurance Commissioner in New Jersey to sell the Idaho product.
Think about this. Now many private business owners who could never afford basic coverage for their employees now could because it costs 84% less than the previously mandated cost in New Jersey. Additionally, the self employed would have many more options available to them.
Increasing competition in this fashion could go a long way towards getting more people covered in our Country. I understand The Speaker and the President are supportive of this plan and it could be brought up in the House in September. The plan did pass the House Energy and Commerce Committee on July 21, 2005 on a party-line 24-23 vote.
It would appear that the Democrats on the committee like to talk about the number of people without health care, but want little to do with helping get more people covered. As this legislation moves forward expect to hear the loudest screaming from the Insurance Commissioners across the Country. While increasing competition, the bill would also decrease their power base. Nothing screams louder than a beaurocrat who is having their power taken away.
Posted by RealDebate at August 26, 2005 12:26 PMThis is a horrible idea!!
Mind boggling paperwork and cross-state regulations etc. come to mind.
Posted by: womanmarine at August 26, 2005 12:58 PMReal Debate: “While increasing competition, the bill would also decrease their [Insurance Commissioners] power base.”
Decreasing their power base because of the extra, new layer of beaurocracy needed to administrate such a scheme while simultaneously increasing the possible spigots from which to siphon tax payer funds into designated private pockets.
Posted by: jo at August 26, 2005 01:20 PMFor once, a post that makes sense. Nice job. And thank you for bringing this to our attention, as skyrocketing health care costs have yet to be adressed intelligently and equitably by either party.
Posted by: Mister Magoo at August 26, 2005 01:41 PMWe need to rethink heath care in general. We have developed a mistaken idea that it is not only a right, but also an unquestioned benefit.
All sickness is not equal and people’s responses to it are different. Some people run to the doctor when they get a headache and demand some kind of treatment. Doctors always can find some treatment, but is doing nothing an equally good one? We also are protecting against very low probability events too often. The headache might signal a brain tumor, but probably not.
We have to bring the market in at all levels. If I am buying a car and the price is too high, I complain to the dealer and don’t accept it. When the price of medical care is too high, we complain to the government to give the provider more money.
A good innovation has been the health savings plans where you set aside pre-tax funds to pay health expenses. The user can choose to spend these where he thinks is best.
There is also the question of how much is too much. Let’s face the fact that we can’t spend a million dollars on each ninety year old man so that he can live to be ninety-one. As painful as it is, modern medical technologies is forcing us to make decisions previously left to chance, nature or God.
One more point. Health care should not be free anymore than food and water (even more immediately necessary to life) are not free. People need to expect to pay a percentage of their income for health care and not think of each expenditure as some sort of unjust anomaly. This in another reason to like the health savings plans. You plan to put away a certain amount of money to take care of your routine needs. Your insurance is left to take care of the truly catastrophic or truly unforeseen.
Is it just me, or have the Republicans completely abandoned the whole “state’s rights” thing?
Every state has different priorities, and different reasons for making their laws. Those laws have the effect of making people want to live there or not, or changing the laws with their votes. The laws will benefit the states or not.
For example, infertility coverage is mandated in Illinois, Maryland, and Massachusets. It is expensive and people in those states may pay higher rates or taxes because of it. However, if they don’t like it,they are free to vote out the politicians who made the laws, or move. However, for someone like me, those laws are very appealing, and I have put those 3 states at the top of my list to move to, and therefore add my taxes to their coffers.
This law would prevent me from having that choice, and negate the wishes and priorities of the populations of each state.
RealDebate,
Since you did not offer the answer to these questions, I have to ask: What about providers? Are these insurance companies going to have to come up with a list of accepted providers for each state, or are people going to have to travel to the state where the accepted providers are? Or are providers not going to matter any more, and what’s covered would be determined by the service provided, not who provided it?
Posted by: Stephanie at August 26, 2005 03:39 PMjack,
I agree. Besides what you mentioned, I think we should also look at mandatory testing. I have two children diagnosed with developmental disabilities on the Autistic Spectrum. My third child is going through that process now. With my first two children the diagnostic process was relatively simple. Autism was suspected, so autism was tested for and the results were conclusive.
Now, with my third child (only two years time difference), for some reason that is no longer sufficient. Blood tests were taken. A CAT scan was performed. Other possibilities checked into. It was a lengthy process taking two months, and the originally specified concern (again autism) hasn’t even been checked into yet. But everything else has been eliminated as a possibility.
The doctor who performed all these unnecessary tests called them mandatory. Whether it was mandated by the state or the hospital, I don’t know. But thinking of the thousands of dollars that was wasted gives me a headache. Maybe I should see a doctor? :-)
Posted by: Stephanie at August 26, 2005 03:48 PMWithout question, the level of technology in medical testing equipment and procedures is much better today than when many of us were younger. (I am 62). This obviously adds to health costs.
I can remember the day when I went to the doctor (actually I can remember the day when he would come to the house)and he asked me a bunch of questions, asked my Mom a bunch of questions, maybe took blood or urine, gave me an exam then, diagnosed what was wrong and prescribed some medication. Many times there was no medication but, rest and diet.
I can also remember the recent times when you go to the doctor, he asks questions then sends you for tests, takes blood, does an EKG, takes two X-Rays, sends everything somewhere else for analysis and then prescribes something. The “cure” always involves prescription drugs.
The difference is that today IMO, people have been brainwashed to be more health conscious and, there is a health care system (private or government sponsored) that is willing to pay the majority of the cost of diagnosis and treatment.
Many people (including the doctors) abuse the system. People go to the emergency room rather than sit in their doctor’s waiting room. This cost is much greater than an office visit. Doctors know exactly how and what Medicare and private health plans will pay for.
Doctors over-prescribe medications. There are “designer” medications. By the time people even get to the doctor’s office, they are convinced that they need Medication X that they saw on TV or in a magazine.
I think being a doctor is an admirable and much needed profession. I have a high level of respect for most doctors. I also am inclined to say that there are people who can be doctors today that could not have been yesterday. Machines are asking all the questions and providing the diagnosis.
Drug advertisements make it seem that it’s OK to abuse yourself because “one simple pill a day” is all that’ needed to feel good.
Posted by: steve smith at August 26, 2005 04:05 PMjack,
I definitely agree that:
All sickness is not equal and people?s responses to it are different. Some people run to the doctor when they get a headache and demand some kind of treatment.
I am not sure exactly what you were getting at with:
Doctors always can find some treatment,…
…so I will not draw any conclusions.
As you know I am a social worker in West Virginia. I am Director of Social Services at JCE School of Medicine at Marshall University, Pediatrics. I recently heard a tv commercial saying dr’s and hospitals routinely perform unnecessary tests, because they know the insurance will cover it without question.
I am sure there are many unscrupulous doctors and hospitals that do so, but, I can assure you that NONE of the some 35 Pediatric doctors, including sub-specialists here where I work, prescribe unnecessary Rx, nor do they do order un-necessary tests because an insurance will pay for it. In fact, quite the opposite. I am constantly on the phone with insurance companies trying (many times in vain)to get prior approval of a test, procedure or medication that is crucial to diagnosis or treatment of our patients. Insurance companies can simply say “no,” and deny approval.
Let?s face the fact that we can’t spend a million dollars on each ninety year old man so that he can live to be ninety-one.
How about ten thousand? What about spending the money on an 80 year old so he can live to be 91? IMO, to deny ANYONE the medical treatment their doctor recommends IS
forcing us to make decisions previously left to chance, nature or God.
also,
A good innovation has been the health savings. plans where you set aside pre-tax funds to pay health expenses. The user can choose to spend these where he thinks is best.
Many times, NOT SO GOOD. While I am lucky and have several plans to choose from, (NONE are free either) one of those choices is this exact “good innovation” plan you mentioned. What the fine print said, was, this plan alone, WITHOUT an additional plan such as Blue cross/Blue shield, means the patient (me) becomes a “private payer.” You lose the bargaining power that other policies offer to negotiate prices. For example, I recently had a minor out-patient surgical procedure, my bill was aproximately 3500 dollars. After my insurance paid 589 dollars, the provider (as agreed by negotiations) “adjusted” the bill so that my share came to only 100 dollars. If I had no insurance at all or ONLY the “innovative” health savings plan, my total bill would have been the original 3500 dollars in full. Not quite fair huh? Also another little point hidden in the fine print is that I must estimate how much I will need to spend in medical costs each year and have that amount taken from my check and put into a “private / personal” account. The hidden part was that ANY MONEY IN THE ACCOUNT THAT I DID NOT HAVE TO USE IS NOT REFUNDED! and NOT rolled over for the next year. I JUST LOSE THE MONEY The administrator said it was to deter over-estimation. HUH?
I’m not sure what other options are available, but I SAY BE CAREFUL! These plans are just like Social Security Reform, another Individual / personal account fiasco. And just like with the social security “individual personal accounts”, (IE: PRIVATIZED ACCOUNTS) they will soon become the ONLY means of obtaining health care. (just like social security would have been eliminated)
thanks,
sassyliberal
Realdebate,
Good article, about a good idea.
For those worried about traveling to another state to sign-up, or states rights ect;
It sounds no different than going to an IND. Ins. agent for auto or house ins. They scan the net to find the best price for what you want from every ins. company that offers ins. coverage in your state.
If someone can only afford coverage for energency care, hosp. costs, and needed tests, let them get the basics.
If NJ wants a primo plan that pays for “peckerectomys” and shit like that for $2500 a mo., fine, offer that plan too for those that wish to pay for it. But they should also allow the Iowa plan that covers the basics for $375 a mo.
The people that will fight this bill are those that want the silly stuff, but want everyone to share the costs for it.
Can everyone spell socialism ?
RealDebate,
I’ve got to admit feeling extremely weary as I read your post. It is yet another “free market” solution to the world’s most free-market healthcare system in the developed world. It is, of course, yet another symptom of ideology creep.
Now, before I’m castigated as a know-nothing communist, let me proclaim my undying love of free markets. I think that in most circumstances, they are absolutely the best way of allocating scarce resources, just as classic macroeconomic theory insists. The U.S. health care system, however, is a colossal failure: astonishingly expensive by global standards, appallingly bad considering the money spent, and alarmingly ineffective at helping the national population.
I ask my fellow free-marketers to just consider, even if for only smallest of fractions of time, that our system is poor largely because of free markets rather than because of government. Oh, sure, government deserves some blame, but the vast majority of it should be reserved for the fact that our politicians are utterly terrified of two words: “socialized medicine.”
Now, I’m not advocating any particular system of health care: single payer, managed competition, or whatever. I’m only saying that we should be much more practical and much less ideological about the health care crisis in the U.S. For good free market reasons (that is, economies of scale), governments can do much to lower the costs of medical insurance coverage. This basic principle is why so many other nations have better and yet much less costly systems than we do. We could learn from those systems even while crafting one to suit our own nation, if only we could shake lose the extremely well-financed special interest groups and the legalized corruption inherent in our political system.
We can do much better, but only after we’ve stopped wrapping ourselves in the snuggly comfort of our own soporific ideologies.
Posted by: Reed Sanders at August 26, 2005 04:54 PMMaybe doctors are ordering all the un-necessary tests to protect themselves from malpractice suits. And maybe a big part of the high cost of medical care is malpractice suits. I’m not advocating the elimination of lawsuits if a doctor or hospital screws up, just some common sense in the awards. $250 million for a death caused by
vioxx is just WRONG and drives up the cost to everybody.
For the free market to work to reduce costs, the consumer has to have the ability to evaluate the benefits of the product. In healthcare, this may not operate. I estimate that roughly half of the costs we expend for healthcare in this country go for worthless or harmful therapies (whoa, Jack and I may agree here), and I’m not talking about “alternative” therapies (they tend to be ineffective, but they’re cheap). I’m talking transplants, angioplasty and bypass surgery, antiarrhythmic drug therapy, many cancer chemotherapies: big ticket items. Our system is profligate in supporting whatever therapies the drug companies or surgeons dream up without demanding clear evidence of efficacy. That’s why our medical care is so expensive.
And I think that we should guarantee our citizens enough food and water to live as well as adequate healthcare to preserve their functioning in society. That doesn’t mean providing it free to everyone, but it does mean universal coverage via some mechanism and I haven’t seen any good arguments that single-payer systems are more expensive than fee-for-service.
For the free-marketers, note that healthcare isn’t a classic market. There are non-economic barriers to entry (medical licensure and hospital accreditation) and there is limited information about cost/benefit. The former is necessary and the latter insurmountable.
Posted by: Mental Wimp at August 26, 2005 05:32 PMOkey Dokey, where to start. Consumer choice is a good thing. A great question was asked about State rights. I think any good conservative will tell you they are more for individual consumer rights over any Federal vs. State issue.
Brian, if there is a call for infertility treatments the market will have a solution. I am married with no kids, we are not going to have any either. However, in my home state of Wisconsin by law I have to be on a family plan and pay the same as a family with 6 kids, how is that right? Additionally should non-child producing persons be forced to cover infertility coverage that increases their costs? They do now, this program would change all of that as choice would be introduced into the market.
In answer to what provider, that would be up to each individual consumer. I see a whole cottage industry starting up with this. Health Insurance Brokers who would compare and contrast plans for the consumer, lay out your priorities and let them do the work.
Posted by: RealDebate at August 26, 2005 05:40 PMSassyliberal:
Well said. My experience with the accounts parallels yours. You LOSE the money!!
This can’t be a good idea.
Posted by: womanmarine at August 26, 2005 05:54 PMSassy
I have both Blue Cross and the savings plan. The saving plan has been very good for my kids, who need glasses, dentist etc. not covered or not covered completely by insurance. I get some tax savings, but I have found it just makes me feel better (for completely illogical reasons) to put it aside. If there is any money left over, we can always use it on dental care. My kids have perfect teeth, since they grew up in the era of flouride and good toothpastes, but my wife and I could spend the whole GDP to repair ours.
The God choice is thrust upon us whether we like it or not. Medical technology can keep people alive for a long time beyond when they would have normally shuffled off the mortal coil. The quality of life may be gone, but it is very hard to decide when. My mother in law dies on cancer. At first it was good that she could be kept alive a bit longer. But as the months went on and she got worse and worse, it was a really hard decision to decide when to stop the heroics. As I look back, it would have been better a couple of months before it actually happened.
The question then is how much to pay. Let me be really cruel sounding, but if a 91-year-old man came to me and asked for $10,000 to keep him alive another, I wouldn’t give it to him. Nor should he, in all morality ask for it. Everyone dies, some sooner than others. We could do the appeal to emotion and yes I would have a very hard time telling him to his face, but the decision would be valid.
BTW – when I say doctors always can find treatment that is just what I mean. Not all doctors do, but people who want treatment shop for doctors. We all know people who are on all kinds of medications that don’t seem to do anything for them. Sometimes it is best to just do no harm.
Finally, I didn’t say that a lot of doctors do tests just because the insurance pays, but it does make the choice much easier. And doctors are justifiably afraid of being sued on the off chance they are wrong.
$2500 a mounth for health insurance? That would require a wage of about $15.65 an hour just to pay for the insurance. Never mind the little things like food, a place to live, and clothes.
I’m not one that likes government regulations, but of ALL the industries, the insurance industary is THE ONE that needs to be regulated, and hopfully RIGHT OUT OF BUSINESS. It is the most corupt business there is.
I’ll bet the insurance commisoners of the states that have all those mandates are in the pockets of the insurance companies. I mean, how many people are going to have plastic surgary in their lives? But the insurance companies are charging the many that won’t for it and making a killing.
I have a total of 37 employees (counting me) and their families covered on my company’s heath plan.
I recently changed insurance companies because the one I had raiised the premiums. When I inquired why, after wading through the bs their answer was basicly “Because we can”. Now there’s a good reason to raise rates.
When I inquired why, after wading through the bs their answer was basicly “Because we can”. Now there’s a good reason to raise rates.
Ah yes, the free market at work.
Let me be really cruel sounding, but if a 91-year-old man came to me and asked for $10,000 to keep him alive another, I wouldn?t give it to him. Nor should he, in all morality ask for it.
Sounds so simple, doesn’t it? But the old man loves his life and family. He thoroughly enjoys teaching the great grand kids. Perhaps he’s in the middle of a book about being a soldier in WWII, and he’s paid into Social Security all his life. But you say, “Nope, no Medicare coverage for you, old man. So maybe you could squeeze out an extra year or two, or may just six months, but we’ve decided that ain’t worth 10 grand, whatever your sacrifices and contributions have been. Let me help you onto that the iceberg.”
Look, common sense should be used. Some other nations manage to make these kind of decisions better than we do. But let’s not blame the insane costs of our horrible system on the aged or the ill. First let’s look hard in the mirror.
Posted by: Reed Sanders at August 26, 2005 07:58 PMThis is hilarious. This bill hasn’t a prayer in current form.
First, Jack says its good because someone with a headache should just learn to get along with the headache. I would suggest that Jack would change his mind if his heart surgeon was just about to cut into his chest for a quad bypass with a splitting headache. Jack also says in so many words, those children who can’t afford their parent’s premiums should just up and die and make more room in the affordable health care system for the wealthier folks. That is hilarious logic that ain’t gonna fly.
Second, here go the Republicans again, trying to outdo Democrats on increasing the size of government. The state’s rights issues aside, this bill would give free rein to insurance companies to race to the bottom for least coverage for maximum premium profits, all legally sanctioned by the Republicans. The massive fraud and accountability issues would require another branch of federal government to oversee it all. Another hilarity.
Third, it is truly appreciated by me the UTTER Hypocrisy of Republicans to deny competitive pricing for the Medicaid Rx drug plan passed by Bush and the Republican Congress while touting competitive pricing in this bill. Keep your eyes on the bait and switch that is coming folks. Republicans will say anything to increase the profitability of their corporate buddies which in turn increases Republican campaign bribes at election time.
At a time when most other democracies in the world are providing or wrestling to provide universal health care coverage to its citizens, Republicans take the position, those who can afford it can have it and the rest should leave the US or die for lack of health care access. What a heartless party.
There is no question America’s health care needs reform. There is no question that those who can afford to pay should pay. There is no question that there is a tremendous amount of waste, fraud and abuse in our current system, much of it coming from insurers and health care providers, and the medical technology industries. There is no question we need to halt and even reverse the inflationary pressures on health care costs. But this bill either doesn’t address these issues or does so in a way that will be cruel and counterproductive in the long run.
Stop the illegal immigration is one of the most important things we can do to help make health care more affordable. The resulting increases in worker wages will significantly increase premium payers into the health care insurance markets.
It is a national problem. Therefore, we need enforceable laws that will eliminate elective procedures in a fair way from being funded by federal tax dollars.
American health care coverage needs to get into preventative coverage (smoking cessation clinics and weight control regimens) which will reduce the demand for immensely costly medical care later in people’s lives.
It was the height of idiocy and folly for politicians to have taken the tobacco suit money and NOT fund affordable smoking cessation hosptials, clinics, and programs with that money. Absolute lunacy. We will pay for that lunacy for another couple generations.
We need practical pragmatic heavy lifting to reform health care in a fair and responsive way to the needs of Americans. Republicans will have none of it, for them ideology of free markets and caveat emptor, and laissez faire blind them to the realities of possibilities for practical and responsible solutions. The evidence of that is in this bill which would grow government bureacracy, pander to corporate interests, and leave vast numbers of Americans with less health care and less assitance in living healthier lives, and leaving some Americans to just die for lack of funds, including children who bless their hearts, just can’t earn the big Republican bucks yet.
Ron Brown. Absolutely Right. Insurance makes money on you betting against yourself. That’s right, their profits come from you paying premiums for not living your life in a careful and responsible manner.
Earth bermed homes can’t burn down. Who stands as the biggest obstacle to the earth bermed home industry taking off, you guessed it, Insurance companies and their state commissions who say there are no standards for insuring such structures so builder’s loans which require builder’s insurance become a huge hurdle in almost every state in the union.
How much more carefully would we all drive if we didn’t have car insurance and medical insurance? Millions would drive far more carefully if they weren’t insured. Don’t get me wrong, I am not against insurance. But, we have to understand that insurance companies thrive on increased risk, and as a lobby group, this makes them very, very dangerous to Americans and our economy.
How much more would we save, if we could not buy a life insurance policy. Savings in America is a huge, huge economic problem, and insurance companies are one of the biggest obstacles to savings. Instead of the money being saved for your family, all 100% of it, a large percentage of it goes into profit margins of your insurance premiums.
What America needs is self-insurance incentives by the Federal Government. But, of course, the insurance lobbyists would throw their entire might behind defeating any candidate that ran on that platform. Money, and the power it buys, corrupts, and man, is our nation becoming corrupt in the Ancient Greek definition of the term.
Posted by: David R. Remer at August 26, 2005 08:22 PMI know what I say about the health care is unpopular. We all want to say that we will save everyone, or at least move heaven and earth to try. It sounds noble to say that every life is as precious as all others. Yet we have to make choices and we do make choices every day. How many lives lowering the speed limits on all the highways to 25 mph could save? Aren’t we trading lives – often young lives – for convenience?
Beyond that, some people don’t value their own lives very much. Anyone who is significantly overweight, smokes, drinks to excess, uses illegal drugs, doesn’t exercise or refuses to wear a seatbelt is telling us that he values his life less than he values momentary pleasures or conveniences, or at least he is willing to trade five or six years of life in order to eat all those bacon-cheeseburgers or smoke those cigarettes. A large percentage of health care dollars could be saved if people just had better habits. We could cut lung cancers by 80%. We could virtually eliminate adult onset diabetes. Heart disease could be postponed by ten or twenty years. You want to spend a million dollars to give a 91-year-old man six months. How about some of these younger guys? Break the fat-boy of his bad eating habits and your looking at decades more of healthy living.
David,
Finally you and I agree on something
“Ron Brown. Absolutely Right. Insurance makes money on you betting against yourself. That’s right, their profits come from you paying premiums for not living your life in a careful and responsible manner.”
very true. You are betting something happens to you and the insurance company is betting it won’t.
“Earth bermed homes can’t burn down. Who stands as the biggest obstacle to the earth bermed home industry taking off, you guessed it, Insurance companies and their state commissions who say there are no standards for insuring such structures so builder’s loans which require builder’s insurance become a huge hurdle in almost every state in the union.”
I believe this is true too. The insurance company is trying to make as much money as they can. That is what they are supposed to do. The insurance company will cite government regulations to justify making money. The regulations need to go. The same in most other businesses. Government regulations in a lot of cases only serve to provide income for the Government.
“How much more carefully would we all drive if we didn’t have car insurance and medical insurance? Millions would drive far more carefully if they weren’t insured. Don’t get me wrong, I am not against insurance. But, we have to understand that insurance companies thrive on increased risk, and as a lobby group, this makes them very, very dangerous to Americans and our economy.”
Personal responsibility….I couldn’t agree more.
“How much more would we save, if we could not buy a life insurance policy. Savings in America is a huge, huge economic problem, and insurance companies are one of the biggest obstacles to savings. Instead of the money being saved for your family, all 100% of it, a large percentage of it goes into profit margins of your insurance premiums.”
I have my doubts as to how much additional savings people would have because of this, I wouldn’t want to take away anybody’s right to buy insurance and now it is still an option. It should stay that way.
“What America needs is self-insurance incentives by the Federal Government. But, of course, the insurance lobbyists would throw their entire might behind defeating any candidate that ran on that platform. Money, and the power it buys, corrupts, and man, is our nation becoming corrupt in the Ancient Greek definition of the term.”
The only part I really disagree with. What the Government needs to do is get out of it as much as possible.
Let’s start with the most important fact: according to the World Health Organization in its its World Health Report 2000, the United States doesn’t have the best healthcare system in the world. It isn’t in the top 10, or the top 20, or even the top 30. We ranked 37th, right between Costa Rica and Slovenia.
What we have instead is the most expensive healthcare system in the world. According to the Organization for Economic Cooperation and Development, in 2001 on a per capita basis we spent nearly 50% more than the Swiss, who have the second most expensive healthcare system in the world. We spent 75% more than the Canadians and 145% more than the English.
And who has the best healthcare system in the world? France! Yes, France. They may not know how to vote in the UN when it comes to discretionary warfare, but they sure can take care of their people. In 2001, we spent $4,887 per person, every American man woman and child, on healthcare. And how much did the French spend? They spent $2,561
At the risk of sounding like a total moron, why don’t we simply do what they do? After all, it can’t be any worse than spending nearly twice as much as they do in order to get appreciably inferior results.
Obviously, our healthcare system is broken, and it’s broken because it’s based upon a flawed premise: that the marketplace is an efficient mechanism to hold down medical costs. Why isn’t it? Because the marketplace is predicated upon supply and demand.
When it comes to medical treatment, demand is illusive. People don’t shop for healthcare like they shop for cars and TVs. When you get a prescription or require a medical treatment, demand increase from mere desire to necessity. The dynamics of the marketplace become superfluous. Medical necessity eliminates demand from the pricing equation, thereby making private enterprise an inherently inefficient and expensive method of distributing healthcare goods and services throughout a society. When demand is fixed at absolutely necessary for any good or service, prices become excessive intrinsically. A hungry person will pay more for a sandwich than a sated one, but a starving person will pay anything. As Benjamin Franklin said,
“Necessity never made a good bargin.”My favorite analogy is to compare medicine to the police. Entrusting the provision for palliative goods and services to pharmaceutical drug pushers and samurai surgeons who sell their goods and services only to those who are willing or able to pay their prices is like relying on roving bands of hired gunslingers to protect us from criminals.
Imagine that somone’s trying to break into your house in the middle of the night. You dial 911 and the operator asks you if you have crime insurance, and if you don’t have it, you’re on your own. How much would you pay for police protection under those circumstance? How much would you pay for crime insurance? “Well, let’s see. It’ll take two cops and a squad car. How much extra is it if they bring their guns?” That is the healthcare system we have in this country today.
Those of us who are willing or able to purchase private detectives or bodyguards or home security systems should be free to do so, but elementary police protection, just like elementary medical protection, must be provided on the basis of need, not financial wherewithal, in a civilized society. After all, we have three unalienable right in this country: life, liberty and the pursuit of happiness. The police protect and defend our liberty; healthcare professionals protect and defend our lives. Why is the “free” market a wholly inappropriate method of providing the former, but defended by right wing ideologues as appropriate for the latter.
Disparities in the ownership of property are not some form of secular Calvinist election; affluent Americans are not God’s chosen people, thereby entitled to a greater degree of physical salvation than indigent Americans. While government neither can nor should provide its constituents with a guarantee for the material quality of their lives beyond mere subsistence, it can and must guarantee them access to those goods and services that will preserve their inalienable right of life. If the protection and preservation of human life is the ultimate objective of medical science, then it is incumbent upon any modern democracy to ensure that those medical products and treatments that are necessary to sustain and prolong life are available to each of its citizens as a birthright. The preservation of human life is the highest priority of any civilized society. It is the ultimate human entitlement.
Posted by: Chuck Hanrahan at August 26, 2005 10:13 PMWe spent 75% more than the Canadians and 145% more than the English.
Nice post, Chuck, but I doubt you’ll convince any ideologues by citing facts.
You want to spend a million dollars to give a 91-year-old man six months.
First it was 10 grand and now it’s millions. Make up your mind, jack. Talk to us when you’re 91.
Posted by: Reed Sanders at August 26, 2005 10:43 PMChuck, excellent comments, and I couldn’t agree more.
Posted by: David R. Remer at August 26, 2005 10:45 PMReed
I fear that if I reach the age of 91, I will be willing to spend any amount to hang onto my life for a few more years. That is why you can’t let me.
Those better health care systems you all love so much give doctors and health services a lot more power to ration health care. We often spend as much in the last year of a person life as we all the other years. Does this make any sense?
You guys are taking a position you know is not tenable in the real world.
Take the case of Terri Schivo. Most of you (and I agreed) thought that we should just let her die. What if she had expressed a clear wish not to die – no matter what? Suddenly you change your minds?
Or let’s really jump on the other side. A baby can be helped to survive at a very young age. Abortions are allowed past the time when a baby can be viable. Should we save each of these babies?
Don’t try to take the high road if you can’t stand on it.
Posted by: jack at August 26, 2005 11:14 PMtomd, where we disagree diametrically in the faith that a regulation free enterprise system would make anything better. You believe it would, I know from history it would not.
I say you believe it would, because the only unregulated almost truly free enterprise period in our nation’s history ended in the worst economic depression of modern times. History does not substantiate your belief.
It was after during and after FDR and WWII production elevating the consuming power of the masses that our economy became the greatest in the world, and that means that prosperity came with the accouterments of regulation, unions, federal oversight, and wealth redistribution.
The truth is, regulation is a tool. Wield it too heavy handedly or crookedly and the nail bends or splits the wood. Try pushing the nail in with one’s hand and one only impales oneself. Balance and synergistic regulation is what is needed, not its elimination.
Posted by: David R. Remer at August 26, 2005 11:15 PMDavid and Chuck:
Thanks. You have both spoken what I feel so much better than I can.
Wondering where Terry Schiavo fits into the ideas expressed by Jack?
Posted by: womanmarine at August 26, 2005 11:22 PMWhat say you all who oppose this to out of control mandated coverage that increases cost? That is the crux of this thing. More choice in the market can not be a bad thing.
Posted by: RealDebate at August 26, 2005 11:32 PMDavid,
Your arguement comparing health care to police service is convincing. What would you consider basic health care?
Posted by: Stephanie at August 27, 2005 12:07 AMWomanmarine
Read what I wrote a couple of posts above yours to see how Terri Schiavo fits in.
Posted by: jack at August 27, 2005 12:41 AMJack:
Yes, I see we cross posted. I find your thoughts confusing, probably just me.
Posted by: womanmarine at August 27, 2005 12:55 AMDavid,
I never said we don’t need SOME regulations. We do have to use common sense though. Using your analogy, we are trying to drive a finishing nail with a sledge hammer.
If I get a splinter in my hand and ask you to remove it you can do so without a problem…unless I hand you a dollar for doing it, then you are practicing medicene without a license.
Our system is so broken that one simple fix won’t work any more, more regulations certainly won’t help.
womanmarine, thank you for your words. That is the only compensation I and many others who spend time here trying to get it right, receive, and it is very much appreciated.
Posted by: David R. Remer at August 27, 2005 03:54 AMStephanie, I don’t think comparing health care to police service was my argument. Some other thinking person came up with that one.
But in answer to your question let me say something that few people understand. HMO’s, Health Maintenance Organizations, began with the brilliant concept that a healthy person is cheaper to maintain than an unhealthy person, both personally, for the family, for the health industry, and for the society as a whole. I enrolled in an early HMO and my doctor was fantastick. He took the time to talk and explain how I could avoid coming back to him. His goal was to help insure that the only time he saw me was for my annual physical. He complimented my diet, weight, and cholesterol levels and physical exercise. He chastised my smoking and alcohol consumption explaining with words and pictures what they were doing to my insides and what they were going to cost me if I didn’t quit.
That is where health care in America should have gone. Enter the managers of HMO’s and insurance companies. The Managers of HMO’s quickly realized their idealistic doctors were losing them business. It was unethical for them to tell doctors to NOT to keep their patients healthy, so they began setting quotas on doctor’s time, eventually requiring doctors to see twice as many patients in an hour to reap the same compensation.
That put an end to the doctors spending time praising healthy behavior and pulling out pictures of diseased lungs and case histories. The insurance companies took a look at the actuarial data after the HMO’s became dominant early in the movement, and realized that healthy people don’t buy as much health insurance, if any at all. So, insurance companies put their lobbyists out front and hammered home the concept of not paying for preventative medicine saying it was driving up health care costs and putting insurers out of business.
Some HMO doctors wanted to create smoking cessation check in clinics, where those who had tried and wanted to quit, could check in for 5 days, couldn’t check out without a prearranged family member or friend giving consent (emergencies excepted of course). The HMO managers wouldn’t hear of it, and the insurance companies would not cover it, and went further to provide attorneys for some who wanted to sue for being illegally detained.
So, ended in just 1 year, the whole concept of smoking cessation check in clinics. I don’t remember what the price was, but it was within reach of the average working smoker who would recover the cost in 24 months of not smoking if they had early CPD or emphysema requiring doctor visits.
The ounce of prevention was sold out in favor of multi-millions of dollars of cure. Lipposuction replaced healthy eating habits and prescriptions for nutritionist coverage. Inhalers, and oxygen carts and tubing replaced exercise and smoking cessation clinics. Contraceptive pills for a lifetime replaced coverage for vasectomies.
This is how we got to this health care crisis where spending twice as much on health care buys us twice as unhealthy lifestyles. To fix it, we need to retrace our steps.
We need HMO’s which are truly prevention oriented again, stockholder greed be damned. We need protections for doctors wanting to set up small health oriented clinics not attached to large corporate health care where a good but lesser income is offset by lifelong friendships and relationships with their patients. We need price controls on new doctors coming out of college, insuring the public is not paying top dollar for bottom rung experience, and we need much more control over the costs of educating nurses and doctors.
We need insurance commissioners who are not appointed by the insurance companies but by doctors or citizens focused on preventative health. And we need regulations that force oversight of insurance company actuarials who deliberately attend short term gains and losses when lobbying Congress and State Insurance Comssioners and hide the longer term preventive health data that shows they could still be very profitable, but, not as profitable on annualized basis by covering preventative medicine.We need to install competitive bidding for medical health care covered by Medicaid/Medicare saving tax payers billions.
That’s what we need. But money is power, and power corrupts, and absolute power corrupts the medical system absolutely just as it does the political system.
Posted by: David R. Remer at August 27, 2005 04:26 AMMarket Driven Health Care = We got it, you pay
for it, or else go somewhere and die quietly.
Look at History people.
“Market Driven Health Care = We got it, you pay
for it, or else go somewhere and die quietly.
Look at History people.”
To spark debate and play the devil’s advocate, What is wrong with that? Seems like it would make us a lot more responsible for ourselves.
Posted by: tomd at August 27, 2005 10:42 AMtomd, well some. Others who simply get an infection or are injured, would simply have to die. Civilized has a meaning… There are a great number of maladies for which responsible living is no defense. Especially for children.
Posted by: David R. Remer at August 27, 2005 12:58 PMDavid,
“I don’t think comparing health care to police service was my argument. Some other thinking person came up with that one.”
You’re right. That was Chuck’s (sorry, Chuck!!!).
As per your other statements… I agree completely, wholeheartedly and enthusiastically.
I’m a smoker. I’ve tried to quit countless times. My doctor’s advice (and he’s a great doctor) is that my efforts to quit won’t work if I can’t relax…well, to relax I need to get away from my kids (my children are special needs and trying to manage their care is very stressful), but when I get away from my kids and my husband (who has to stay behind to care for the kids) I also get away from my incentive to quit and the support system helping me do so. It’s a catch-22. Now, I’ve often wondered why they don’t have affordable rehab centers for smokers, since it can work so well for other addicts. Now I know why. Thank you for that.
So, how do we take the greed out of health care? You know, other than voting out all incumbents, of which I’m already convinced there’s plenty reason to do! ;-)
Posted by: Stephanie at August 27, 2005 01:39 PMStephanie,
Boy oh boy. I do my research, I come up with what I think is a well-reasoned argument, I agonize over each word, I type my fingers to the bone, I check for typos and grammar, I post my comments, and what thanks do I get? You think I’m David Remer! Geez, it’s enough to make a grown pundit cry.
:^)
Posted by: Chuck Hanrahan at August 27, 2005 01:55 PMStepahnie,
Just saw your most recent comments. Apology absolutely unnecessary. I’m pleased you thought I was David. We all make mistakes. (For example, I should’ve looked for updates before I posted my preceding comments.) So apology appreciated but, again, unnecessary.
One final thought. I guess the idea of emulating the French went over like a lead balloon. (Too many Francophobes out there, I guess.) So I checked to see who had the second best healthcare system in the world. It was Italy, and their 2001 per captia spending was even less than the French. (US - $4,887; France - $2,561; Italy - $2,212)
Maybe we can rip off their healthcare system. If somebody else has a better and cheaper way of doing something, I’m not above a little creative borrowing. And I don’t think that President Bush should be above it either. After all, how do you think he got through Yale?
Posted by: Chuck Hanrahan at August 27, 2005 02:04 PMjack,
What if she had expressed a clear wish not to die? no matter what? Suddenly you change your minds?
She should then live, especially if the family members with legal responsibility agree. But such extreme cases mostly cloud the discussion even while making for enticing moral drama. Our healthcare system is not ill due to Terri Schivo or 91 year olds. It’s ill because it’s super inefficient, doesn’t serve the whole population well, and yet is protected by the political status quo. We could do much, much better if our politicians didn’t require corporate hand outs to stay in office.
I agree with Chuck we should be looking at other systems and customizing their best practices in an effort to overhaul of our own unique system.
I find your thoughts confusing, probably just me.
Well, it is confusing on one hand to seemingly be advocating extreme rationing of health care (let the old people die without treatment) while at the same time apparently criticizing “those better health care systems you all love so much [that] give doctors and health services a lot more power to ration health care.”
Seems like it would make us a lot more responsible for ourselves.
Truth is, we live in the most individual-focused (many would say narcissistic) culture in the world. Compared to most societies, we already tend to be thrown back on our own resources. The thing about health care is that you can do best by individuals but doing the right thing by the larger community. There’s a business case that can be made, as well as a biological one, not to mention an evolutionary one.
But those are all utilitarian arguments. There’s also the moral one. “Am I my brother’s keeper?” No? Why not? Would it be better if we all hung separately?
Posted by: Reed Sanders at August 27, 2005 03:20 PMC’mon Chuck, you’ve been called worse, and better, I suspect. :-)
Posted by: David R. Remer at August 27, 2005 05:03 PMJust don’t call me late for dinner.
Posted by: Chuck Hanrahan at August 27, 2005 05:06 PMHave you ever thought about the millions of people that work in the medical insurance business ?
Do you think they’re really providing you a necessary service?
Think again. Why pay all of these people unnecessarily?
Why not pay medical providers directly?
____________________
PROBLEM:
Government and insurance companies set up a system with themselves as middlemen, resulting in:
[X] skyrocketing costs;
[X] increasing medical insurance premiums;
[X] increasing malpractice insurance for health providers;
[X] increased taxes;
[X] institutionalized medical fraud;
[X] proliferation of fraud, and ridiculously high, multi-million dollar judgements (making the ambulence chasing lawyers rich mostly);
[X] an over-complicated system, confused by too many parties with conflicts of interest;
[X] insurance companies making medical decisions instead of your doctors;
[X] medical care quality becoming increasingly unreliable and expensive;
[X] complicated billing
[X] ALL attempts to control costs have failed, since government or insurance companies are the guarantors of final payment.
SOLUTION:
Direct pay medcial FUND PLAN:
(1) administered by the healthcare providers themselves,
(2) that eliminates all reliance on either the government or insurance companies (middlemen) between health providers and patients,
(3) and eliminates insurance company bean-counters from making medical decisions;
(4) will help control costs, since government and insurance companies not the guarantors of final payment,
(5) simplified billing
(6) will reduce fraud because there will no longer be an ignorant and indifferent middleman that doesn’t care about fraud, and merely raise insurance premiums or raise taxes;
CONCLUSION:
(1) Get rid of the middlemen (government and insurance companies).
(2) People pay directly into a medical fund that must be managed by the medical providers themselves, by people with medical knowledge and backgrounds (instead of being hired away by an insurance company to validate services and costs).
(3) It won’t solve everything, but it would be a big step in the right direction. What we’re doing now isn’t working.
________________
I have group medical insurance at the moment through an employer, but was checking around the other day, and the costs per month (just for me: age 47) were ridiculous. Most offered what I have now for about $600 per month. The cheapest was about $300 per month with $7500 deductible and riders. Ouch! It would be better to just self insure; open an account, start with as much as possible, and then put $250 per month into that personal account. And, invest portions of it into CDs and other interest bearing instruments. In five years, it would grow to more than $30K (over $45K in 10 years). Then, if an illness occurs, the money will be there. Medical Insurance companies are about to price themselves right out of business, because few will be able to afford it, and those that can, should just self insure. That’s what’s happening anyway already. Many self insure or go without, since many can’t (or won’t) save money for self-insurance. Many just stiff the health providers, who pass the cost on to others.
Chuck,
“Boy oh boy. I do my research, I come up with what I think is a well-reasoned argument, I agonize over each word, I type my fingers to the bone, I check for typos and grammar, I post my comments, and what thanks do I get? You think I’m David Remer! Geez, it’s enough to make a grown pundit cry.”
LOL! It was a definitely a well-reasoned arguement! I like the analogy, it makes your point very well. So….what would you consider basic health care?
“One final thought. I guess the idea of emulating the French went over like a lead balloon. (Too many Francophobes out there, I guess.)”
Francophobia aside, I don’t think ripping off some other country’s health care system would be practical. We have far too many laws in place to help determine why our system is the way it is. I know it’s possible to repeal all those laws, but is it probable? Do you honestly think our government could do that if they wanted to? (I’m not be facetious here, I honestly don’t know the answer if we could.)
Posted by: Stephanie at August 27, 2005 06:44 PMStephanie,
I used to smoke (quit in 1992).
Here’s what helped me quit.
I bet my brother (who also smoked) $1000 that we’d both quit.
If either, for 1 year, smoked, they had to pay the other $1000. We both quit.
I’ll be damned if I was going to lose that bet, and so was he.
d.a.n.,
Thanks. I’m not much of a gambler, but it might work. I’ve tried just about everything else. I’ll give it a try if I can find someone to join me (and my husband thinks it’s worth risking $1000).
Posted by: Stephanie at August 27, 2005 07:24 PMStephanie,
What do I consider to be “basic health care”?
Well, that’s a little too complicated to get into in depth here, so let me lay out the bare bones.
Have you ever heard of Community Health Centers (CHCs)? There are about 3,500 of them throughout the US, and they served about 13 million people in 2003. A nice start, but imagine if there were 15,000 of them, one each in the 15,000 least affluent zip codes. We cap income for those who could use their services at $100K per year, and (here’s where I agree with OttO - increased supply lowers costs) increase the number of practioners by creating Associate MDs. The AMDs would require less training than MDs and be much more limited in the procedures they could perform and drugs they could dispense. (Things like setting broken bones and dispensing flu shots and asthma inhalors.) They would also be trained to treat the most common and prevalent maladies in areas such as pediatrics, geriatrics, nutritional services, obesity, smoking cessation, drug and alcohol addictions, and preventative medicine. Perfect? No, but at least it’s a start.
But they would be a no-cost/low-cost entre’ into the medical system for people who need more sophisticated interventions. Specialists and hospitals would be required to accept their referrals.
How would we pay for it? I’d require every pharmaceutical company that recieves a US patent for a particular drug to sell that drug to the government at the cost of production (including reseach and development). We have a federal law called the Invention Secrecy Act, which stipulates that if you invent something that could be valuable to our national security, the goverment will pay you a fair price for it and deny you a patent. In 2002, ten years after the Cold War ended, 4,800 inventions fell within the provisions of this law.
I don’t propose anything as drastic as that. Instead, I propose a Medical Necessity Act. The MNA would permit patented products that are medically necessary to be sold at monopolistic prices in the open market, as they are today, but instead of the taxpayers having to pay those prices via Medicare & Medicaid, the manufacturers would have to sell them to the American taxpayers at cost. The savings in Medicare & Medicaid would pay for the creation and maintenence of the CHCs.
If you want more details, send me an email & I’d be happy to forward them to you.
To answer you question about could we do it, the answer is an emphatic yes! Would we do it is another matter entirely.
Posted by: Chuck Hanrahan at August 27, 2005 08:18 PMChuck,
“Have you ever heard of Community Health Centers (CHCs)?”
No. They’re news to me.
“If you want more details, send me an email & I’d be happy to forward them to you.”
I’d like to hear more. So, I guess you’ll be hearing from me.
“To answer you question about could we do it, the answer is an emphatic yes! Would we do it is another matter entirely.”
I don’t know which is more scary, federal law canceling out state and local laws that deal with medical care, or the fact that we can’t get enough concensus to do anything remotely productive.
I have one last question (sorry, no, I don’t actually promise this will be the last question. ;-) ). Have you considered the impact this kind of program will have on families with special needs? Katie-Beckett? SSI & Medicare (or Medicaid, I can never remember which is which)? You’re going to get a LOT of resistence if individuals with disabilities (who have outrageously high medical expenses as per the current system) are going to get severe cuts. And not just from people with disabilities and their families.
Posted by: Stephanie at August 27, 2005 08:48 PMStephanie,
As I envision it, this access to nomial healthcare should treat common maladies before they become acute or chronic. I don’t presume that it will affect persons with severe maladies one way or the other (except, perhaps, that they night be diagnosed before they become severe, and hence easier and less expensive to treat). Short answer: this wouldn’t affect your kids one way or the other, except to say that you wouldn’t have to pay for their “common” procedures (check-ups and vacinations, etc.)
Posted by: Chuck Hanrahan at August 27, 2005 10:53 PMChuck:
” increase the number of practioners by creating Associate MDs. The AMDs would require less training than MDs and be much more limited in the procedures they could perform and drugs they could dispense. (Things like setting broken bones and dispensing flu shots and asthma inhalors.) They would also be trained to treat the most common and prevalent maladies in areas such as pediatrics, geriatrics, nutritional services, obesity, smoking cessation, drug and alcohol addictions, and preventative medicine.”
Don’t we already have these? Physician Assistants, and there’s one for nurses, Nurse Practitioners (my sister is one). Maybe this program needs to be expanded and changed?
While it is a simplification I know, on the face I like your idea.
Posted by: womanmarine at August 27, 2005 11:03 PMThere seems to be some confusion here with terminology. There are Medical Reimbursement Accounts (MRA) and Medical Savings Accounts (MSA). MRA have to be used in the year they are set up for or you lose it. Congress is looking at extending it into the following year at this time. (March 15 deadline instead of year-end) This is an older plan.
The MSA is set up to be there permanently and are not forfeited EVER. This is a very good plan. It puts people in charge of their money to spend as they see fit. It enables companies to use a high deductible plan ($1,000 and up, the higher the cheaper the policy) with 100% coverage after deductible.
This is a much better plan AND it lets the consumer and the market work together. It also enables companies the affordability to attain insurance for their employees. (Some companies are even matching contributions into the plan, because of the money they are saving over conventional plans. The consumer chooses when he/she wants to spend their pre-tax dollars. Whatever is left can be used in their retirement years and is transferable to their heirs upon death, just like any other asset (similar to what privatization would do in Social Security - had to throw that in ;-)
Health care costs and quality will continue to spiral out of control until we eliminate one huge and obvious drain on the system:
the middlemen (health insurance companies and government) that are unnecessarily driving up the costs and decreasing the quality of health care.
Unfortunately, health care is not a right. It’s a service that is purchased (excluding those on Medicare/Medicaid; and even then, they paid into the system; the only problem is that it’s been plundered and it’s already bankrupt).
If health providers set up their own HEALTH FUNDs, and members pay directly into the HEALTH FUND (voluntarily each month; but not forced to do so; not forced to be a member), and they are managed by health care providers (not bean counters or people ignorant about medicine), then health care costs could obviously be much lower (i.e. without the middlemen taking their huge cuts and incurring huge waste and fraud and inefficiencies).
The HEALTH FUNDs would be transparent and all accounting would be made public for all to see.
The only downside, which is a downside in any business, is the potential for gouging and monopolies. The common way to minimize that is to have more than one competing HEALTH FUND.
The alternatives are to continue along the same path, where more and more people can not afford health insurance, or institutionalize it and let the government manage it; but can the government manage anything correctly? look at Social Security, Medicare, Medicaid, GPBC & pensions, the national debt, inflation, etc.
Do you really want the government to be the middleman for your health care? Do you want to give the government another huge entitlement system to screw up, like all the other systems they’ve screwed up? Just look at the government’s track record.
Chuck,
“Short answer: this wouldn’t affect your kids one way or the other, except to say that you wouldn’t have to pay for their “common” procedures (check-ups and vacinations, etc.)”
Believe it or not, it wasn’t a completely selfish question. There are many individuals with special needs who get seemingly minor ailments that turn rapidly (in a matter of hours) to serious ailments that require hospitalization. My children are not like that; however, like my children, many of these individuals rely on Katie-Beckett or Medicare through SSI to provide for most if not all of their medical needs, including routine care.
The system you suggest MIGHT be used to make meeting such individual’s medical needs even more complex, when it is usually already confusing as hell.
I know for Wisconsin at least, medical assistance because of poverty and medical assistance because of special needs are two separate issues. If your program would allow for that to stay the same, then I’m sure finding support would be much easier. At least, it would be one less group of staunch opposers you’d have to face! ;-) And, it just might make screening for special needs in the poor more practical.
To describe what I mean: My mom works for a small business and has no health coverage. She makes too much for state funded MA, but too little to afford it on her own. So, she’s very limited in what she can get as a pay-as-you-go patient. With your 100K plan, she’d be covered, which would be a great boon for her. However, while she’d support it for her own benefit (as would I), you’d lose both of us as supporters if it would screw over the special needs community, because we both have worked with various different “needs” and know that a “basic” coverage wouldn’t cover their needs, even the basic ones.
I often use my children as examples of my interest in the special needs community, because I know the details of their experiences very intimately, and thus can easily back up what I say. However, my interest in the special needs community pre-dates my knowledge that my children were part of this community and expands far beyond them.
Posted by: Stephanie at August 28, 2005 01:49 PMwomanmarine,
Nurse Practitioners go through just as much schooling as a regular MD. My mother-in-law is one and she’s qualified to handle almost everything a pediatrician is, the specialization is just from a different angle.
Posted by: Stephanie at August 28, 2005 01:52 PMThe fastest way to lower health care cost is to do away with insurance altogether.
If everyone had to pay out of their own pocket they would start shopping for the least expensive doctors and hospitals.
When the doctors and hospitals (who jack up the fees bcause insurance companies are paying) findout they have to compete for the bargin driven patients that demand good care with a reasonible price then they’ll start lowering their fees to get these patiants in their care.
I personally try to practice responsibility for myself in regards to health insurance, but because government interferes with that process, I cannot create a medical savings account because I chose Medicare as the least expensive care as I had a special need (which I recently was told no longer exists by my health care practitioner) that made acceptance (or elimination of care for it-pointless) by insurance providers impossible.
I would like to see that regulation, put in place in 2002, REMOVED IN THIS COMMENDABLE BILL, for I do healing and know well what combinations of treatments work well, many effective, not just inexpensive, and naturally I would chose them rather than western medicine, except for structural realignment/surgery for lnjuries.
Posted by: Judyth at August 28, 2005 04:22 PMThe fastest way to lower health care cost is to do away with insurance altogether.
Ron Brown,
Yes, that sounds harsh, but it’s the truth.
And, that’s the way it will soon be whether we like it or not, since few can currently afford insurance or health care.
It’s not easy for everyone to live at the expense of everyone else.
Therefore, we should remove the middlemen (insurance and government) from the health care system, because they simply create higher costs for everyone. And it’s highly likely that they provide no net benefit anyway. Obviously costs are higher when a big portion of insurance premiums also have to pay for the many unneccesary jobs for all those working for insurance companies and within government.
And those insurance employees and government workers aren’t doctors, despite their continuous attempts to make medical decesions.
So, what good are the health insurance companies?
People (if possible) should consider paying that huge insurance premium into savings/investing accounts instead. And, if they don’t get sick, they’ll still have the money later.
Besides, it’s becoming the only option anyway, since insurance is either unattainable or unaffordable.
I know many people now with mid-level incomes that can no longer get health insurance.
Many are waiting until they’re old enough to qualify for Medicare and Social Security (which will also go bust, or be bust when their turn comes to draw benefits).
I’ve tried to buy health insurance, and it’s ridiculous.
Sure, insurance is a business, but their hypocrisy knows no bounds, as they advertise like they have a plan to fit your needs and pretend to care, when they don’t.
And then I’ve know lots of people who had an operation or something (remove kidney stone, remove malignant prostate, etc.), and the insurance company should have paid, but didn’t, always claiming some reason or another why that wasn’t covered.
And, we can’t look to government to give it to us either, or solve this problem (a problem that government helped create with perpetual meddling), because they’ll just mismanage it like everything else they’ve mismanaged for many decades.
Health Care is just another symptom of many symptoms of a much more serious core problem. And none of the many problems (below) will ever be resolved without first addressing the core problem: irresponsible and unaccountable government
- Social Security
- Medicare and Medicaid
- aging population
- health care crisis; unaffordable and increasingly unreliable
- insolvent pensions systems
- energy vulnerability (and Katrina will greatly exacerbate this problem, and oil just reached $68 per barrel)
- unsecured borders, illegal aliens
- Iraq, Iran, N.Korea, Afghanistan, etc.
- terrorism
- corporate/investor fraud
- election fraud, and main parties restricting access to ballots for third and independent parties
- Identity Theft (fastest growing crime), false Identities
- $8 trillion national debt and a looming potential financial meltdown due to the combination of massive annual budget deficits (which really represents $50 trillion in interest payments (in 2005 dollars) over the many decades to come )
- campaign finance, buying elections, influence for sale
- pollution and global warming
- globalization and outsourcing, global pillage, falling incomes, declined manufacturing (will we forget how to make things?)
- looming bankruptcy of the Government Pension Benefit Guaranty Group
- increasingly stupid, costly, and abused tax system
- foreign policy that alienates allies
- declining quality of public education
- the 40 hour work week is more like 50 hours (and 2 workers per household)
- a crumbling infrastructure (roads, bridges, etc.)
- urban sprawl, 40+ hours per month (540 per year) commuting, traffic grid-lock
- world over-population in areas that can’t sustain those populations, resulting in poverty, starvation, disease, crime, dissaffection, etc.
- A very corrupt and impoverished neighbor: Mexico
- insufficient law enforcement; perversion of the law and legal plunder to do the very thing the law is supposed to prevent;
- a dysfunctional legal system full of greedy parasitic ambulance chasers and idiotic juries ruining everything for everyone else;
- legal plunder, property theft via abuse of eminent domain laws, plundered entitlement systems, government fraud, etc.
- an arrogant, irresponsible, unaccountable, incompetent government that can’t seem to solve anything, or do anything quickly except vote themselves raises;
Ron Brown said: “The fastest way to lower health care cost is to do away with insurance altogether.”
You are right, Ron. And the most complete way to remove health care costs altogether is to detonate 45 nukes in various places across the US to insure the death of every American. With everyone dead, there is not health care costs at all.
Such nonsense. Sounds like Bush speaking. The reason doing away with insurance altogether would reduce health care costs is by removing half the population for access to health care in the first place starting with Medicare/Medicaid. If folks would just die instead of going to doctors, the price would drop real fast because supply would exceed demand.
C’mon, be reasonable. The goal is to provide everyone who needs health care access to it afforably. Increasing the supply of providers would help. Reintroducing competitive bidding for Bush’s Rx Medicaid program would help. Lowering the costs of education for health care professionals would help, and incentivizing healthy lifestyles would help, setting up smoking cessation clinics would help, requiring physical exams on an annual basis as a condition for employment by any and every government would help by catching health problems early when treatment is cheaper.
There are a host of things that can be done. Eliminating the means by which modest income folks can pay for medical emergencies IS NOT one of them. Though ending the practice of insurance companies electing insurance commissioners would be a great start.
Posted by: David R. Remer at August 28, 2005 10:04 PMCan we find solutions to this problem that DON’T involve government interference and more tax dollars?
Posted by: tomd at August 29, 2005 03:52 AMtomd,
Yes, we can. Remove the middlemen (insurance and government) as guarantors of payment.
The health care crisis is just one of the top ten serious problems facing the U.S.
Our generation (baby boomers) are ruining this country.
The next generation is getting screwed and it’s going to get worse.
This country soon will no longer be the greatest country on the planet, because of rampant selfishness, greed, dependency on government, and government that promises everything, but on the backs of our children.
Bush should not have expanded Medicare to include prescription drugs.
All of this is going to lead to government pitting the elderly against the younger working Americans. We have heaped $8 trillion of debt (representing over $50 trillion in interest payments) onto the next generations. The burden is too large for 5 workers per 4 recipients. Taxes will have to be raised, and benefits decreased drastically.
One day, the young people are going to begin to resent it. They’re going to leave the U.S. or revolt, and who could blame them? Why stay here and pay high taxes when taxes are lower in Austrailia, New Zealand, and numerous other countries.
What this generation is doing to the next generations is very selfish, and it’s ruining this country.
Posted by: d.a.n at August 29, 2005 05:28 AMTell your children they’re getting screwed.
Inform them that the baby boomer generation is screwing them royally.
The baby boomer generation is guilty of awful parenting, and selfishly voting themselves what ever they want from the National treasury (which is already deep in debt).
Spread the word, and educate your children so that they may speak up now and demand an end to the insanity, and the theft of their future.
We can’t keep selfishly and greedily heaping astronomical debt onto our children.
Inform your children now, and maybe the problem can be resolved; maybe they can helf force change.
The only resolution is a major reform of entitlements, which currently amount to $1 trillion per year (for Medicare, Social Security, and Medicaid), and $50 trillion in interest.
But, what ever younger Americans do, they’d better do it fast, because time is running out.
The treasury is already overflowing with I.O.U.s that the baby boomers have so selfishly left for to their children.
