US Healthcare reform

Post Reply New Topic

No, ed. You make things messier than they are.

With a couple of laws, we could resolve the problem with people being "uninsured." Abolish the "pre-existing condition" factor in insurance (they can't exclude parts of your body/life from coverage). Mandate that insurance companies must take anyone who wants a policy and therefore assess the risk upon the entire pool (this ends super cheap insurance for only the "very healthy" who wind up losing coverage as soon as they get sick).

This reinstates availability and stability in having an insurance policy.

We could (and should) mandate that all insurance carriers use a uniform claim form. The paperwork requirements of all the different companies is killing the health care profession. One uniform standard would simply things for everyone involved.

ALL OF THIS can be done WITHOUT the government running it.

As far as "underinsured" people are concerned (those with insurance but can't afford to see a doctor), we can mandate that the insurance industry needs to come up with "heath care" programs. This would be where you pay every month but get to see a doctor when you need it.

This concept can work hand-in-hand with "health insurance." You have the "health care" program to provide your basic medical needs (based on what you'd like covered) and it's coupled with an "insurance" policy that handles stuff above and beyond basic wellness care (and emergencies, major illness, etc. that may or may never happen).

ALL OF THIS can be done WITHOUT the government running it.

Government should be a leader advocating improvement, not a bully trying to take it over.

^ His plan sounds pretty good.

It is all in how it is done.

I am against forcing people to buy insurance because insurance doesn't mean you get health care, it just means you pay some company some money every month. It is unfair to force people to pay for something they cannot afford, don't need, or is entirely useless. But worst of all, it drives the price of insurance up because of people have to buy it, they can charge more for it and you still have to buy it.

When you are poor, the type of insurance you need, you cannot afford.

The problem really is just in controlling costs and eliminating fraud.

I am not against government run insurance per se, but I think the government is not kind to people and doesn't also do things in an effective and caring manner. Likewise, though, is the same with insurance companies.

I think insurance companies are the reason health care costs so much, because they get hospitals and drug companies to charge outrageous prices.

I very much disagree. His plan will dramatically increase the amount of adverse selection that occurs in insurance policies, as the people who are healthy will have to overpay for insurance, and the people who are unhealthy will initially underpay, and as such, the healthy will leave the pool and the unhealthy will dominate it.

I don't know what is meant by "health care programs" but it will likely make things worse, as if a person doesn't have money except for the amount needed by insurance and insurance also has to pay for additional care at a flat rate, then the poor will generally try to take advantage of insurance policies, while wealthier people will avoid subsidizing the poor.

I generally think that the plan will just worsen health care. The only beneficial program I see him promoting is standardization. In any case, government as a "leader advocating improvement" and as a "bully trying to take it over" really isn't massively different. In both cases, we have government trying to tell other people how to do their jobs, and this can be a terrible idea if the governmental policy is clueless.

Right now, the healthy get cheap insurance ONLY SO LONG as they remain healthy. So, the savings are irrelevant as they go away as soon as that factor changes. One might as well not have any insurance and save even more money, right?

Everyone being in the same pool can IN THEORY raise costs because of averaging out the risk assessment, BUT you must also factor in the elements that would lower costs. Right now, the high cost of a doctor visit reflects people they must treat but who won't be able to pay. Under this system, that is resolved, so prices might come down because everyone can pay. No more padding the expenses to compensate for the work that goes unpaid by some.



Right now, in America, we only have "health insurance." A policy that protects the individual from the liability of medical expenses that exceed what they can afford. This is a broken system that works best when something big happens (major illness or injury). It has failed for ordinary wellness care.

We need to move to "health care" where you get what you are paying for. Insurance, like many other things, is a payment towards something you may need later. If you paid $200 a month for "health care" but never needed to see a doctor, that would be fine because sooner or later, you WILL need to see a doctor, and that visit, any tests and prescriptions could cost a few thousand dollars. Have ONE MAJOR SURGERY and you will have more medical bill than you might pay in premiums your entire life.

THE WHOLE INDUSTRY is based on the idea that if 10,000 people pay $100 each, you have $1,000,000 in liquidity to pay claims. Insurance companies pay only a fraction of what they take in every year in actual claims. So, you pay every month into a plan that will cover your basic medical needs (debate is needed as to how much is covered under this part) WHENEVER you need it. It might seem "wrong" to you to pay when you don't need it, but by everyone doing it, the benefit can extend to everyone.

Couple "health care" with "health insurance" and you can have a policy that covers you when your medical needs exceed what is covered under "health insurance." Since "health care" covers most all the basic stuff you'll likely ever need, the odds of "health insurance" paying out is vastly reduced, lowering premiums on this aspect of coverage. This is a place where the consumer can pick what fits them. Can you afford $500, $1,000, $2,000, $5,000 out of pocket before you need the policy to kick in during a calendar year? That could also lower your "insurance" premium costs.

Well, the issue is that healthy people get insurance in expectation of health catastrophe. This has an expected value, and the expected value is related to the amount paid. The only way that your counter works is if healthy people are rejected to an extreme proportion upon catastrophic injury but less healthy people have better luck with their catastrophic injuries. I don't see much of a reason to say that there would be a real difference though.


No, this isn't resolved. I may have missed a step. However, if you are saying that separating insurance from the additional care provided by doctors will make things cheaper for everyone else, sure, but statements beyond this can be problematic.


Ok, so, you are basically saying that programs should be better fitted to the service actually provided, where insurance and care is separated. I can understand that idea, and I don't see a problem with it. My concern was clearly more about the issue about saying "a poor person", which seems to express a different idea than just covering basic needs, something that many people might want something helping out with.

A problem I see with the idea of health care + health insurance is that what is basic for a healthy person is not the same as what is basic for a sick person. For someone healthy we could be talking about well visits and preventative testing. For a sick person, basic care might include chemo, dialysis, or physical therapy. Chronic conditions require expensive, continual care that would be considered basic to them. The overages sound like the deductible system we have now and I don't like the idea of placing a surcharge on sick people.

How shall we ration health care? What trade-off shall we put on the expected gains in years of a person's life? This is not meant to be an "end of discussion question", but rather I am concerned that the statement "I don't like the idea of placing a surcharge on sick people." might actually be a sign of seeking an emotional way of using the government to reach utopia. That's why I bring forward the question, because part of what is being debated is "who shall control the mechanisms of healthcare?" which is a question based upon efficacy. Another part of the question is "what rationing shall we put on healthcare?" and I just want to make sure that there are two different ideas recognized: 1) that government rationing is still going to be rationing and some people who could have potentially lived will still be selected to die, and 2) that government can be involved in rationing without government controlling the mechanisms of healthcare as the questions are different.

So, take your choice. Who is preferable to tell you to die? The government or somebody who will make a profit from it.

Well, that is one of the issue to work out.

First, if you have a chronic problem, you should expect that every year you will be out of pocket for those needs. That's not fair, but life isn't fair. So, your "insurance" will cover whatever is above the "out of pocket" you are willing to absorb each year. Your premiums will reflect what package you opt for. Since everyone must be insured and placed in the same risk pool to average out the costs, you won't pay any more for X package than someone else who does not have a chronic condition.

Is that a straightforward and equitable solution? I know those who are healthy might not like it, but the fact is that any healthy person could wake up tomorrow and find themselves with a "chronic" health issue. So, again, it really is in the best interest of the whole.

People who do things for profit have competition in the market place. The government is a monopoly.

Or one can make that decision for himself.



ruveyn

When one is sick and broke, the decision is already made for him. Why kick a man when he's down?

Why help him up at your expense?

ruveyn

Because Jesus told us to.

So did Confucious.

That is so lame! There is a better reason. Enlightened self interest.

ruveyn

Just because I'm an Atheist doesn't mean I reject Jesus' teachings. I consider them very relavent in today's world.