Like us on Facebook


Follow us on Twitter





Page 1 of 21 12311 ... LastLast
Results 1 to 15 of 311
  1. #1
    Join Date
    Sep 2006
    Posts
    15,123

    Healthcare reform

    Didn't see a thread dedicated to it. Figured I'd start one with this little clip.

    http://www.wcpo.com/news/opinion/op-...lace-obamacare

    From Rand Paul
    I agree that we must repeal the current system, but we owe it to the American people to have a replacement plan in place. This is why I have proposed my own plan. My plan brings choice to the health care marketplace, and it legalizes inexpensive insurance.

    On Tuesday, I introduced S. 222, the Obamacare Replacement Act, to provide Congress with a health care plan grounded in broadly supported conservative reforms that is ready for an immediate vote after Obamacare is repealed.

    My proposal would expand access to higher-quality, lower-cost health care for more Americans, regardless of medical history.
    We'll see.
    MacLean's Law: Everywhere you go there will be a jerk. Corrolary: If you go somewhere by yourself you become a jerk.

  2. #2
    Join Date
    Dec 2007
    Location
    Washington
    Posts
    18,316
    Not a fan of Health Savings Accounts as a primary means of medical bill payment. It's tax free up to $5,000 per year. I doubt most middle class and poverty level people will contribute that much per year as its $416 a month which is the amount people were complaining about for Obamacare premiums and it would take years and years before those accounts can cover even routine surgeries or procedures. Imagine someone with $6,000 in their HSA and they get a $26,000 hospital bill. Who pays the rest of it? Do they get $20,000 of debt?

  3. #3
    Join Date
    Sep 2008
    Location
    Central California
    Posts
    6,263
    Quote Originally Posted by valade16 View Post
    Not a fan of Health Savings Accounts as a primary means of medical bill payment. It's tax free up to $5,000 per year. I doubt most middle class and poverty level people will contribute that much per year as its $416 a month which is the amount people were complaining about for Obamacare premiums and it would take years and years before those accounts can cover even routine surgeries or procedures. Imagine someone with $6,000 in their HSA and they get a $26,000 hospital bill. Who pays the rest of it? Do they get $20,000 of debt?
    You are correct, HSAs would not be for everyone but as it stands now they're for no one. FWIW the ACA just tried to funnel too many different needs into a one size fits all thing. People's health care needs are as diverse as the people themselves and the replacement for the ACA will need to be more flexible.

    If the government wants to keep occupying the space between me and my doctor, they're going to have to do a much better job to get my support. This go around I don't want to hear any BS about approving law so that the American people can see what's in it. This means that this time Congress will be tasked with actually producing the text which will become law.

    I doubt seriously that we're capable of getting this done, and done in some fashion that actually repairs some of the defects with health care. I suspect that Congress will do nothing to address the actual costs of health care and just try throwing some more tax dollars at it. If we're serious about letting government manage this they had better get out in front at the root costs of going to the doctor....
    "..When you have great coaches, then after you have great coaches you get great players, you have a great organization, and you tell them one thing-

    Just win baby"

    ~ Al Davis ~

  4. #4
    Join Date
    Apr 2009
    Location
    Central Iowa
    Posts
    3,443
    I am a nurse with around 25 years experience and have seen quite a few changes in healthcare. Here is my proposal:
    What to do?
    First, give medical decisions back to Drs and patients. Keep the government out of these decisions. Insurance companies need to be a bit more flexible when they are giving their recommended stay lengths. If the Dr agrees that the patient needs to stay one more night, they should be able to do that. The recommended stay lengths are pretty rigid.
    Second, force all pharmaceutical companies to bid for their services to hospitals and clinics. This would help keep drug costs down.
    Third, shorten the patent length for new medications and help fund research into new drugs. This would allow drug companies to recoup their R/D costs quicker and decrease costs overall through generics being available more often.
    Forth, teach prescribing Drs to use generics more often. They are identical chemically to the "name-brand" drugs and work as well.
    Fifth, allow insurance companies to offer their products nation-wide rather than being licensed in each state. This would cut down on administrative fees and allow them to do what they do best -- pay for medical procedures.
    All of these will help cut costs and should result in insurance to be available at reasonable rates to everyone.

  5. #5
    Join Date
    Sep 2006
    Posts
    15,123
    My idea ... which I don't think I saw elsewhere:

    Single Payer/HSA plus: Every person with income has pre-tax money withheld from their check on a tiered % of income until $20k (adjustable in the plan as needed) is accrued at which point withholding stops.

    All medical care is purchased by the patient, either paying for it themselves or out of their HSA. There is NO insurance between the patient and the care giver.

    If the patient hits $0 in their HSA the government covers 100% of the expense and no debt is accrued.

    People can pay more for their care if they want to, or they can go cheap if they want to minimize the time money will be withheld from their pay.

    I don't know what to do about the expense of medication. I do think patents should be shortened from the 20 years it is now. Maybe cut it to 10 years on the market from the current 20 years from application. I definitely think it should be legal to buy prescription medication from other countries.
    MacLean's Law: Everywhere you go there will be a jerk. Corrolary: If you go somewhere by yourself you become a jerk.

  6. #6
    Join Date
    Feb 2004
    Location
    Tennessee
    Posts
    43,295
    The problem is healthcare costs. Until they do something about those costs anything they try will be a failure. Good luck changing it when the healthcare industry is dumping huge loads of cash to both sides of the aisle....

    Just some examples to show average costs adjusted to same currency

    Heart Bypass in the United States $75,000 and in Australia $42,000
    MRI in the United States $1,100 and in France $300
    Appendectomy in the United States $13,000 and in Switzerland $4,000
    Cesarean Birth Procedure in the United States $3,000 and in Canada $600
    A bottle of Nexium in the United States $200 and in United Kingdom $30

    I read an article talking about how Forbes releases a list of its most profitable industries. Big Pharma is #3 and Medical Equipment is #4.

    The United Kingdom has the National Healthcare Service which covers all its citizens. It costs their government roughly $2,800 per person.

    In the United States our government currently spends roughly $4,200 per person only covering a percentage of its citizens. Think about that.... As a country we spend nearly $10,000 per person in healthcare.

    So unless you do something about these costs no matter what system we use its either gonna result in us having to pay or the country rolling up massive debt.


    Marcus Mariota

  7. #7
    Join Date
    Sep 2008
    Location
    Central California
    Posts
    6,263
    Quote Originally Posted by steelcityroller View Post
    The problem is healthcare costs. Until they do something about those costs anything they try will be a failure. Good luck changing it when the healthcare industry is dumping huge loads of cash to both sides of the aisle....

    Just some examples to show average costs adjusted to same currency

    Heart Bypass in the United States $75,000 and in Australia $42,000
    MRI in the United States $1,100 and in France $300
    Appendectomy in the United States $13,000 and in Switzerland $4,000
    Cesarean Birth Procedure in the United States $3,000 and in Canada $600
    A bottle of Nexium in the United States $200 and in United Kingdom $30

    I read an article talking about how Forbes releases a list of its most profitable industries. Big Pharma is #3 and Medical Equipment is #4.

    The United Kingdom has the National Healthcare Service which covers all its citizens. It costs their government roughly $2,800 per person.

    In the United States our government currently spends roughly $4,200 per person only covering a percentage of its citizens. Think about that.... As a country we spend nearly $10,000 per person in healthcare.

    So unless you do something about these costs no matter what system we use its either gonna result in us having to pay or the country rolling up massive debt.
    Are you suggesting nationalizing Drs and facilities? Tort reform? Governmental price control?
    Maybe elimination of insurers?

    Any attempt to control the cost of health care by the government seems iffy at best with our track record. Some outside interest will weasel it's way into the process and make balanced success difficult at best.

    I'm not saying not to try but we're going to have to find a solution outside the box...
    "..When you have great coaches, then after you have great coaches you get great players, you have a great organization, and you tell them one thing-

    Just win baby"

    ~ Al Davis ~

  8. #8
    Join Date
    Dec 2006
    Posts
    5,243
    Quote Originally Posted by steelcityroller View Post
    The problem is healthcare costs. Until they do something about those costs anything they try will be a failure. Good luck changing it when the healthcare industry is dumping huge loads of cash to both sides of the aisle....

    Just some examples to show average costs adjusted to same currency

    Heart Bypass in the United States $75,000 and in Australia $42,000
    MRI in the United States $1,100 and in France $300
    Appendectomy in the United States $13,000 and in Switzerland $4,000
    Cesarean Birth Procedure in the United States $3,000 and in Canada $600
    A bottle of Nexium in the United States $200 and in United Kingdom $30

    I read an article talking about how Forbes releases a list of its most profitable industries. Big Pharma is #3 and Medical Equipment is #4.

    The United Kingdom has the National Healthcare Service which covers all its citizens. It costs their government roughly $2,800 per person.

    In the United States our government currently spends roughly $4,200 per person only covering a percentage of its citizens. Think about that.... As a country we spend nearly $10,000 per person in healthcare.

    So unless you do something about these costs no matter what system we use its either gonna result in us having to pay or the country rolling up massive debt.
    Agreed with all of this. Prices need to go down if we're ever going to get control of this thing. I knew that medical equipment was up there in profit. The Brits negotiate much better then our government does. I was reading an article somewhere that when they contract out, they make sure it works and make sure its cheap. Seems our country has missed the mark on cheap when negotiating.

    I think it does come down to the money piling into both sides.

  9. #9
    Join Date
    Dec 2010
    Posts
    4,715
    Quote Originally Posted by Scoots View Post
    My idea ... which I don't think I saw elsewhere:

    Single Payer/HSA plus: Every person with income has pre-tax money withheld from their check on a tiered % of income until $20k (adjustable in the plan as needed) is accrued at which point withholding stops.

    All medical care is purchased by the patient, either paying for it themselves or out of their HSA. There is NO insurance between the patient and the care giver.

    If the patient hits $0 in their HSA the government covers 100% of the expense and no debt is accrued.

    People can pay more for their care if they want to, or they can go cheap if they want to minimize the time money will be withheld from their pay.

    I don't know what to do about the expense of medication. I do think patents should be shortened from the 20 years it is now. Maybe cut it to 10 years on the market from the current 20 years from application. I definitely think it should be legal to buy prescription medication from other countries.
    If I were to go the national healthcare route, there is a lot of merit in what you say, but I would tweak it a little to where 1/2 the tax goes to catastrophic care and half to individual health savings accounts. Then, you would have a fund for the government to pay on the worst cases. (pick a figure between $5 K and $10 K.)

    I would also allow governments to negotiate payments on catastrophic care, including specialized drugs directly with the pharmaceutical companies.

    I would allow individuals to fund an extra amount in their HSA (say $5 K) and to allow them to transfer HSA balances to family members.

    I also allow them to pool money to health savings cooperatives, if they liked (but this could have issues).

    Lastly, there needs to be biomedicine reforms and accelerated entry to market for biomedical and generic drugs.

  10. #10
    Join Date
    Dec 2007
    Location
    Washington
    Posts
    18,316
    I think there is a problem fundamentally with the idea of HSAs being the primary source of funding and coverage. People simply cannot save enough money to pay for the vast majority of procedures and medications.

    There's a reason we allow people to take out loans to buy houses, because if we waited until people had enough cash saved up to buy a house nobody would have houses.

    It is the same principle here

  11. #11
    Join Date
    Sep 2006
    Posts
    15,123
    In my plan there is no need for catastrophic care as anything over your savings is covered by the government.

    We need to get rid of the insurance industry and medicare which are wildly twisting reality and are the major cause of the listed prices of health care. If it costs you real money to get something taken care of you will shop it around or bargain the price down. Right now there is NOTHING to drive prices of health care down at all.

    The cost of health care will go down if people are unwilling to pay the high prices in the US and we facilitate people getting care from other countries (both drugs and procedures).
    MacLean's Law: Everywhere you go there will be a jerk. Corrolary: If you go somewhere by yourself you become a jerk.

  12. #12
    Join Date
    Jan 2006
    Location
    America
    Posts
    73,220
    Quote Originally Posted by valade16 View Post
    I think there is a problem fundamentally with the idea of HSAs being the primary source of funding and coverage. People simply cannot save enough money to pay for the vast majority of procedures and medications.

    There's a reason we allow people to take out loans to buy houses, because if we waited until people had enough cash saved up to buy a house nobody would have houses.

    It is the same principle here
    Agreed. HSA don't solve anything, but make people feel better about themselves who can already afford health insurance and care.

    One thing that I think should be done is an itemized bill provided to every single person admitted to a hospital. Even if insurance is paying the bill, there will be a massive outcry trying to figure out why X costs $XX or why Y costs $YY. You start seeing wide varying costs for identical items and people will force the price down.

  13. #13
    Join Date
    Dec 2010
    Posts
    4,715
    Quote Originally Posted by dbroncos78087 View Post
    Agreed. HSA don't solve anything, but make people feel better about themselves who can already afford health insurance and care.

    One thing that I think should be done is an itemized bill provided to every single person admitted to a hospital. Even if insurance is paying the bill, there will be a massive outcry trying to figure out why X costs $XX or why Y costs $YY. You start seeing wide varying costs for identical items and people will force the price down.
    Disagree on HSAs, but that's typical. Itemized bill is fine, but even better is government negotiating cost of hospital services (other than out of the network luxury facilities not covered by insurance) and prescription drugs, so all costs for standardized care are the same for everyone. As for doctors, they should be allowed to charge whatever they want, since it is a personal service and by law, you can never dictate specific performance on a personal service contract. They can sign up for the going rate and get steady business, but they can't be compelled to do so.

  14. #14
    Join Date
    Sep 2006
    Posts
    15,123
    Quote Originally Posted by dbroncos78087 View Post
    Agreed. HSA don't solve anything, but make people feel better about themselves who can already afford health insurance and care.

    One thing that I think should be done is an itemized bill provided to every single person admitted to a hospital. Even if insurance is paying the bill, there will be a massive outcry trying to figure out why X costs $XX or why Y costs $YY. You start seeing wide varying costs for identical items and people will force the price down.
    I agree on the itemized bill. It took me about 45 minutes at the pharmacy to find out how much a prescription was going to "cost" my insurance. Part of the way the "costs" got jacked up is by keeping them hidden.
    MacLean's Law: Everywhere you go there will be a jerk. Corrolary: If you go somewhere by yourself you become a jerk.

  15. #15
    Join Date
    Sep 2006
    Posts
    15,123
    Quote Originally Posted by johnnyi View Post
    Disagree on HSAs, but that's typical. Itemized bill is fine, but even better is government negotiating cost of hospital services (other than out of the network luxury facilities not covered by insurance) and prescription drugs, so all costs for standardized care are the same for everyone. As for doctors, they should be allowed to charge whatever they want, since it is a personal service and by law, you can never dictate specific performance on a personal service contract. They can sign up for the going rate and get steady business, but they can't be compelled to do so.
    The government negotiated costs is Medicare the result of which is that anybody not on medicare had their prices go up to cover the "losses" to Medicare.

    A big way to reduce prices is to allow patients to cross borders to get care/drugs. State and national borders both.

    The fact is that if people are unwilling to pay the insane prices the prices will go down.
    MacLean's Law: Everywhere you go there will be a jerk. Corrolary: If you go somewhere by yourself you become a jerk.

Page 1 of 21 12311 ... LastLast

Posting Permissions

  • You may not post new threads
  • You may not post replies
  • You may not post attachments
  • You may not edit your posts
  •