Why healthcare is a "Crisis" and how to fix it.

[Scout26]

I cant help but be amused and appalled by the number of people who continue to advocate for Single Payer or Universal healthcare. 

A couple of things they might want to keep in mind:

1.  If wed have had it for the last seven years theyd be complaining about Bushcare or maybe he would have delegated it and it would be known as Cheneycare.
2.  Do you REALLY think that the same government that runs the TSA, CIA, Social Security, Public Education, etc.   Could run healthcare any better then any other task they stick their grubby mitts on???  Puuuhhhhh-leazzzzz.  Come look at the rulings and methods used by the BATFE do you REALLY think that the Healthcare Administration would treat you any better?  Lets get real.  Do you really want your kids treated by the same people who screen you and your baggage at the airport   Because thats what youd get and dont think that you wouldnt.......good and hard.

The major problem with healthcare is the same problem we have with public education, too much government interference/involvement.  The more government gets involved with anything the more it costs.   We already have universal healthcare, its called Medicaid.  Ask anyone whos on it or ever been on it if they prefer it to private health insurance.   Ask a Vet about the VA.

No one talks about the auto insurance crisis, and why is that???  Because you pick your own car insurance, same with your homeowners or renters insurance.

Lets see, theres a lizard that will give me a buttered English Muffin if I have a claim, while saving me 15% in 15 minutes or less.  This apparently causes mental anguish in Cavemen.  My Good Neighbors promise to forgive my accidents.  The Good Hands people reduce my deductible every six months I dont have an accident.  Then theres a progressive company that will cover Vet bills for on my dogs injuries if my idiot brother in law trashes my car when he borrows it to take out to the desert to do donuts.  They will also give me rate quotes from two other companies to compare.  Theres a cartoon super agent that allows me to quote, buy, print my insurance card on-line and reduce my carbon footprint.  Then theres a company that will keep me legal for less by giving me bare minimum coverage.  Im sure Ive missed some others that want to provide me with insurance, but you get the idea.

So how come I have to get my health insurance through my employer?   Glad you asked.  In the later stages of WWII, the work force was maxed out as the Armed Forces approached 16 million people under arms.  The government (and employers) were worried that the demand for labor increased there would be disruptions of necessary war production as employees started job-hopping and driving wages higher, sparking inflation.  Uncle Sam was pretty adamant that that NOT happen.  So what to do???  They didnt want to raise wages, so they came up with a great idea to give the employees benefits.   And to reduce the costs to companies (again to avoid inflationary pressures and increased costs of wartime production) The government made health insurance (benefits) tax deductible to the employers.  It was a win-win-win for everyone.  Employees got a raise, Employers got to give raise without incurring an additional cost, and Uncle Sam got uninterrupted wartime production while avoiding inflation and without increased labor costs of production contracts.   So the war ended and those wartime measures ended, right ?  Now quite, so here we are 60+ years later and we still operating under wartime rules, much like Rent Control in New York and the recently repealed telephone tax to finance the Spanish-American War.  IMHO, every bill passed by congress (or state legislatures) should have a sunset provision of, say 7 years.  If its still a good idea, itll pass again.  Thats one way to bad or stupid laws off the books, but I digress.

Maybe if we took the employer component out and let families and individuals choose their own insurance like we now do with car or homeowners insurance, we wouldnt have the current crisis.    Why should I pay for Pregnancy and well baby care??  Were done having kids.  With care insurance I choose a variety of options, from bare minimum public damage/public liability to rental car re-imbursement coverage.  I should be able to custom tailor my health care coverage just like I custom tailor my car insurance.  The resulting competition will reduce costs just like it has with car insurance, computers, and cell-phones and every other product or service that has to compete in the free-market.   

[Paddy]

A single payer healthcare system has been proven successful for the last 40+ years.  It's called 'Medicare'.  The solution to the 'healthcare crisis' is to simply expand Medicare to cover every U.S. citizen, and get rid of the private insurers.

[Scout26]

A single payer healthcare system has been proven successful for the last 40+ years.  It's called 'Medicare'.

Again part of the reason that health care costs are out of control.  Ask any healthcare provider what they think about Medicare.....

And as far as coverage.....We up to what "Part D" to cover stuff that wasn't covered before and costs continue to spiral upward.

The solution to the 'healthcare crisis' is to simply expand Medicare to cover every U.S. citizen, and get rid of the private insurers.

  It's called Socialism, read "The Road to Serfdom" by Fredrich Hayek.

If you really feel that way, I've spent over $12,000 this year out of pocket on my health care.  Let me know how much you should be "taxed" to pay for my healthcare.  I accept Checks and MO's..

[grampster]

Rileeeeey,

In what alternative universe are you ensconced?  Medicare is rife with fraud, mismanagement, huge paperwork etc etc etc.  They can't even get my wife's name correct, and it's been 7 months since we gave the original documents over to them.  It works, but it would work better if the government is out of it...wait...it is.  You can select from a group of private companies and actually get more benefits.  Still new, so the jury is still out.

Scout has hit the nail on the head.  The employers can pay the employee what they pay in now and still get the tax benefits and the employee must use that money for what he wants for care purchased like he does his auto, home and life insurance.  Competition in the life insurance business in the 90' drove term premiums down drastically and cause all sorts of changes in types of policies and benefits.  Puts competition into the process as well as customizing for your needs.  That truly is the answer, not more statism. 

And this bull pucky about millions not having any health care?   Walk into any emergency room and ask for a show of hands by those who are uninsured.  They get treated.  In Michigan, a no fault auto state, the medical bills for auto injuries are inflated to 180% of the actual cost, admitted to by the medical industry in a court battle a number of years ago, to pay for indigent care for all reasons at the hospitals.  So your car insurance is already the one payer system for the uninsured.

I respect your wisdom Riley, because you're almost as old as me and you do know better.

[Paddy]

Again part of the reason that health care costs are out of control.  Ask any healthcare provider what they think about Medicare.....

I worked for a large hospital system for several years, and can tell you that a majority of healthcare providers, especially hospitals, depend on Medicare for an income stream.  The single largest issue is with different reimbursement rates for different areas.

And as far as coverage.....We up to what "Part D" to cover stuff that wasn't covered before and costs continue to spiral upward.

Part D wasn't about the insured.  Part D is about transferring what will eventually be trillions of dollars of public funds into private hands.

If you really feel that way, I've spent over $12,000 this year out of pocket on my health care.  Let me know how much you should be "taxed" to pay for my healthcare.  I accept Checks and MO's..

Why so much?  I thought 'privatization' and 'competition' were good for consumers.................

[wooderson]

No one talks about the auto insurance crisis, and why is that???  Because you pick your own car insurance, same with your homeowners or renters insurance.

Uh... "auto insurance" only pays in the case of catastrophe. Likewise homeowners and renters' insurance. Relatively small deductibles, but only because it's assumed that the insurer isn't going to be paying out regularly. (Further, I suspect there's about as many people who don't have home or auto insurance as there are without medical insurance. Why isn't this a crisis? Because those people don't own homes or cars.)

"Health insurance," as commonly referred to, is actually 'health service,' covering your preventive care, routine checkups, prescriptions, etc..

It is entirely possible for individuals to purchase affordable 'health insurance' that only covers hospitalization and major health issues - but most people find this useless, given that it's the cost of routine healthcare/specialists and drugs they feel to be prohibitive. Worst case they go to the ER and figure out a way not to pay - why bother with insurance if you're low income and can probably get it mostly covered somehow? (And, as bad a record as for-profit insurance schemes have been in providing care to cancer patients, et al., why pay every month hoping they'll cover you later?)

[Paddy]

Medicare is rife with fraud, mismanagement, huge paperwork etc etc etc.  They can't even get my wife's name correct, and it's been 7 months since we gave the original documents over to them.

Fraud is on the part of the 'healthcare providers'.  You know, those good doctors and hospitals that care so much about their patients?  It has nothing to with the Medicare system. I challenge you to name a system as big as Medicare without any 'fraud or mismanagement'.  As far as 'huge paperwork', that is no longer the case thanks to the DRG system and electronic billing.

  It works, but it would work better if the government is out of it...wait...it is.  You can select from a group of private companies and actually get more benefits.

You damn betcha it works. Thanks to Medicare, money is not the primary issue in the delivery of healthcare to those it covers.  Private companies sell 'supplemental' policies, but the basic Part A, and Part B (hospitals and doctors) are still government operated and funded.

[roo_ster]

I had "single payer" socialized medicine in the Army.  NOT a good experience.

The OP nailed it.  Get the gooberment outta it and give the illegals the boot and the cost of health care 'round here would take a nose dive.

[wooderson]

"Illegals" are why it costs $120+ to see a GP if you don't have a co-pay?

[Paddy]

"Illegals" are why it costs $120+ to see a GP if you don't have a co-pay?

No, they're just a convenient scapegoat.  It costs $120+ to see a GP because the private insurance companies have squeezed that GP so hard (so they can pay their CEO a coupla billion $ while they screw their shareholders) that he has to charge that just to pay his outrageous malpractice premiums to the other insurance co.

Yeah, we need 20-30% of our healthcare dollars being ripped off by private companies.  That's why there's a 'crisis'.

[RadioFreeSeaLab]

A single payer healthcare system has been proven successful for the last 40+ years.  It's called 'Medicare'.  The solution to the 'healthcare crisis' is to simply expand Medicare to cover every U.S. citizen, and get rid of the private insurers.

Uh, no.  What if I don't WANT the government to cover me?  I'd rather find and pay for my own insurance. 

[wooderson]

And I don't want to pay for Dubya's Secret Service contingent or fire protection for the Wal-Mart down the road... but that's not really how our state (or any state) operates. Len's coin-operated utopia aside, of course.

[RadioFreeSeaLab]

I don't want to pay for those things either, but they aren't MY health care.  Your children's health care.  How anyone with two brain cells to rub together could want the United States Government in charge of health care boggles my mind.  I cannot fathom it.

[wooderson]

How anyone with two brain cells to rub together could want the United States Government in charge of health care boggles my mind. 

Very simple: because the profit-centered version we've got now isn't working for a majority of Americans. So they would like to try something different - it could be, at worst, no different than what we've got now.

[RadioFreeSeaLab]

I think at worst, it would be like any other corrupt, wasteful government agency.  Except it's the government, so you've no choice but to get your health care from them.  The hell with that. 

[De Selby]

I think at worst, it would be like any other corrupt, wasteful government agency.  Except it's the government, so you've no choice but to get your health care from them.  The hell with that. 

Wait, would this plan ban all other forms of healthcare?

or are you just presuming that the "free market" solutions wouldn't offer enough incentive to enough consumers to be viable?

[RadioFreeSeaLab]

Riley's idea was to extend medicare to cover all US citizens, and do away with private insurance.  That sounds like a ban to me.  Again, the hell with that.  The last thing I need, or want, is more government in my life.  Anyway who wants to force more government on me, especially in the area of my health can piss directly off.

[De Selby]

Riley's idea was to extend medicare to cover all US citizens, and do away with private insurance.  That sounds like a ban to me.  Again, the hell with that.  The last thing I need, or want, is more government in my life.  Anyway who wants to force more government on me, especially in the area of my health can piss directly off.

I tend to be conservative, but after seeing how much useless bureaucracy and waste our system has compared to the really good government systems in some other countries, I don't buy this line.

I don't know any Aussie, for example, who dreams of having American style healthcare.  No Singaporeans either-indeed, healthcare is at least arguably more accessible (and just as good) in Thailand than in the USA.  It's a third world country that somehow manages to secure and provide medicine as advanced as ours at a fraction of the cost.

We have the most inefficient healthcare system of any developed country I've ever seen, by far.

[BridgeWalker]

Yep, I'm in favor of expanding medicare.  I was covered by medicaid when I was pregnant (gasp, shock, gov't handouts).  I didn't use it much, pretty much just enough to have a relationship with a doctor in case I needed one.  I also paid a midwife $1800 to provide prenatal care and help out with the birth (at home).  But I did use it for a few office visits.  It was so much more efficient that the various private insurances I have used.

Medicaid/medicare is vastly more efficient than private insurance with far less overhead.  

And I'm tired of slowly but inexorably losing more and more of the use of my left arm because no matter what insurance I have, I would have to come up with thousands' of dollars worth of deductibles, copays, "coinsurance", and non-covered services to get the surgery I've needed for five years now.  And I'd have to fight with them for every penny of it.

In another year and a half or so, I'll have my JD, and the decent insurance will probably come with that, and eventually I'll get my shoulder fixed.  But I've been in pain most of the time for five years.  My right arm and hand are subtantially weaker than my right.  I've learned to adapt--I shoot right-handed, even though I'm a lefty.  I shoot a light weight upland gun for trap.  I write with fountain pens, which require no downward pressure like ballpens.  I manage.  But it irks me that I've paid about $20,000 in premiums in the past five years (it would be more, except we've had periods of being uninsured) and in return have received under $500 worth of services because I can't afford the extra money it would cost to get what I need.  Which should, incidentally, cost a whole lot less than $20,000.

Yeah, I'm all for universal coverage.  We have public schools and yet people still have educational choice.  For myself, I'm hoping to homeschool, but it' nice to know that public schools are available as a backup.  I mostly use the law library at my (private) school, but sometimes I need something not law-oriented and I'm more than happy to use the local state university library or the local municipal library.  If I'm interested in a book on women's health, though, I would go to the small private library of books on that subject maintained by a group in the local community.  I sure don't mind driving on public roads.

My first choice of doctor will always be an overtly pro-life/Catholic ob/gyn.  If that mode of practice becomes unavailable through a gov't health plan, then when I can afford it, I will pay privately.  I've got no problem paying privately for what I want, and I don't doubt that it can remain available and a viable option.  After all, almost none of the women I know have had insurance cover their maternity care.  We chose an alternative, and we paid for it.  Fine.  That option is not really available when it comes to orthopaedic surgery though; hospital charges are prohibitive, and utterly ludicrous.  

It is absurd that so very many people, often people who work hard and make a decent living, cannot afford necessary health care, even when they pay 20, or 30, or 40 percent of their pay in insurnce premiums.  It is ludicrous how expensive it is, and it is mostly because of the massive amounts of pencil-pushing at every level.  The only people winning are the insurance companies.  

$20,000 in premiums says I should not be in pain right now, and for the past five years.  
Yeah, I'd give the government a shot at it.  Seems to work for most of the rest of the world.  

[wooderson]

I think at worst, it would be like any other corrupt, wasteful government agency.

Which, in this day and age, is perceived as a lesser evil than corrupt, wasteful bidness.

Humanity is, by and large, practical rather than ideological. American distrust of government is based on experience or received information - not a libertarian/Paulista belief that any use of the state is bad and wrong. The nation isn't going to oppose national healthcare on the principle of capitalism/individualism/whateverism, so that's a brick wall if you're trying to convince people that the current system (or an even further deregulated version) is the best of all possible worlds.

The current mood is that maybe the power of the state can be harnessed to not suck as much as our current healthcare system. Maybe it's right, maybe it's wrong - but it will, within my lifetime, be very much a reality. Now that Wal-Mart/et al. have joined in on calls for a system that shifts all burden off of their books, it will happen.

[GigaBuist]

Has anybody here actually tried just PAYING for their health care?  It's amazing!  It works!

I've had some form of insurance or another through my employers for upwards of 7 years now.  Before that I was still in college, or under 18, therefore covered by my parent's care.  Well, when they did have health insurance that is.  They didn't have any from the time I was 4-12 years old.  Give or take a few years.

I've visited a doctor twice in the past 8 years now.  I came down with strep throat, went into a med clinic, told them I have insurance but I don't have the details on it, they balked, I said I'd just pay for the visit right there, I'm in, doc does his work, sends out for some blood work (said I didn't have strep throat, but I actually did.  The in-house test only looks for the strain usually found in humans -- I had Group D or Type D, usually found in horse and cattle.  No idea how that happened) he still gives me a 'script for antibiotics, I fill it, pay cash money for it.

A few days later I get a call from a local hospital asking about insurance.  I'm confused, thinking this has to do with my car or something, figure out they want money for the blood work, I tell them I'll just PAY the fee and they instantly knock 20% off the bill.

Health care is just plain cheaper if you pay for it.  I can't think of any other industry where the vast majority of all payments are made through a 3rd party.  Can you imagine how jacked up home repair would be if Home Depot had to deal with your home insurance just to buy a new dishwasher?  That's exactly the bullcrap we're engaged in right now with the medical community.

When you delay payment costs will increase.  The doc has to operate on loaned money if they're constantly 90 days away from payment for services rendered.  They have to pay interest on the borrowed money and the client will have to make up for that.  Further, they have to pay more employees to handle all of those documents which also adds to the cost.  This adds up.

[RadioFreeSeaLab]

  The doc has to operate on loaned money if they're constantly 90 days away from payment for services rendered.  They have to pay interest on the borrowed money and the client will have to make up for that.  Further, they have to pay more employees to handle all of those documents which also adds to the cost.  This adds up.

You got that right.  I'm the IT manager for a small health care company.  You should see the paperwork that flows through our offices.  It's unbelievable.  And we're a non-profit, so the regulations we have to comply with are staggering.

[De Selby]

Has anybody here actually tried just PAYING for their health care?  It's amazing!  It works!

I used to work at a place where I watched REAMS and REAMS of letters roll through where insurance companies refused to pay up when their customers needed care.  It happens-frequently.

Sometimes just paying doesn't work-you pay for insurance, and then the enormous bureaucracy that is whatevercompany HMO does everything it can to prevent one single penny flowing out when you need it.

Health care is just plain cheaper if you pay for it.

This is a good point-the insurance setup here is inherently inefficient.

The problem is that because of the way things work, if you have any serious health problems, you will be long bankrupt before you can "just pay for it."  A single round of heart disease or cancer, paid for out of pocket, can bankrupt a good 90 percent of the population.

So we're forced to pay for insurance-and most of the money we pay into the insurance ends up funding endless bureaucracy, instead of more medicine.

[Bogie]

The best solution is to buy insurance for catastrophic stuff... Coughing up a grand in deductible is a LOT easier if you were in a major car wreck, or just got diagnosed with something gnasty... But for common colds? Treat it, and it'll be gone in a week. Suffer, and it takes seven days...
 

[wooderson]

Unless that cold is bronchitis, which becomes pneumonia, which becomes a $3000 ER trip (the basic cost for walking through the door) that gets paid by you, your insurance (if it's the bottom of the barrel kind - and you hope they pick up the tab) or when you can't pay and your insurance can't pay... gets eaten by the hospital. (Now, if the argument then is that the hospital isn't really eating $3, that its actual costs are much lower, that circles around into the wisdom of a profit-oriented health system...)

This is why healthcare eats up less of the GDP throughout the civilized world.