Looking forward to Hillary Care?

[Tallpine]

get people to quit smoking, moderate their drinking, and lose weight

I frustrate doctors to no end, because I've never smoked, hardly ever drink alcohol anymore, and am 5-10/160#.  Basically, there is nothing that they can do for me. 

[roo_ster]

What The Rabbi wrote, with one exception.

Do not limit what localities wish to require for local insurers.  Let them write mandates that cover everything form Viagra for headaches to acupuncture to psychic readings if they so desire.

Instead, LIFT the limits on where the consumers can buy.  If you live in NYC with all those local restrictions stated above, local NYC insurance is going to cost a buttload.  Allow folks in NYC to purchase insurance from a company in Montana that, say, covers just the basics or some such.

How long of a skidmark would local NYC insurers leave out of NYC and into Montana?

[RocketMan]

Interesting possibilities in that, Jfruser.  There are some bureaucratic difficulties that would need to be overcome.  How would providers keep track of what is covered in the many different flavors of coverage presented by consumers?  I'm sure something could be done, just don't know offhand what it might be.

[mountainclmbr]

Sure, it'll be free.  But you'll get exactly what you pay for.

Well, not exactly free.

Privately owned health care companies will probably be seized by the government. Health care workers will be forced to become government employees and will be paid uniform rates regardless of performance. Patients will lose the freedom to choose their health provider. Taxes will be raised by more than health insurance used to cost, and all this for poor service. And you will have nowhere else to go.

And other industry will be reluctant to invest and take risks because their industry may be the next to be nationalised.

[Firethorn]

I've thought about this before.  I really like the idea of the high-deductible insurance plan coupled with a tax-advantaged health care savings account.

That way, on average, each individual sees what their health care costs, and has an incentive to limit it.  That's savings number 1.  Savings number 2 would be that young people who, on average, don't need much health care will be able to invest against higher health care needs further down the road.  This has the added benefit that the individual retains the ability to get whatever care he or she needs up to their account balance - Which at $5k/year could be a half million, without the need to dicker with insurance companies.

Now, unlike most other forms of insurance, health care does delve into the realm of predictable increased risk that's not the fault of the person.  Live on the coast, but are finding that hurricane/flood insurance is too expensive?  You can always move, even if that does carry costs of it's own.  Own a dangerous car?  Sell or scrap it and buy another.  You can't divest yourself of your DNA though*.

So my personal philosophy would be to set a limit - don't allow companies to discriminate based upon genetic or hereditary illnesses**.  By the same token, set an upper limit, much like house and car insurance have maximums.  My personal car insurance is $250k per person, $500k per incident, for example.

We already have a government system in place for truly disabled people.  If you're so badly off that you honestly rack up more than $500k in medical bills in a year, I think that it'd be reasonable to have the government pick up the rest of the tab, essentially declaring you disabled.

By allowing more open competition as well as simplified billing(billing is often 50% of the cost of the treatment), we'd see a lot of savings.  By having the high deductible, we return our health care plans to being insurance plans.  By having the limit on overall coverage, we keep them affordable.  By removing them from the benefits list, we return choice to people, who are now free to find a plan that fits them, not their employer.

*Future medical advances and experimental treatments aside.
**And I'm not talking about being fat because your parents taught you a poor diet.

[The Rabbi]

What The Rabbi wrote, with one exception.

Do not limit what localities wish to require for local insurers.  Let them write mandates that cover everything form Viagra for headaches to acupuncture to psychic readings if they so desire.

Instead, LIFT the limits on where the consumers can buy.  If you live in NYC with all those local restrictions stated above, local NYC insurance is going to cost a buttload.  Allow folks in NYC to purchase insurance from a company in Montana that, say, covers just the basics or some such.

How long of a skidmark would local NYC insurers leave out of NYC and into Montana?

That works out to the same thing since the mandates won't be meaningful anymore.

I will add that there is some flexibility on the part of consumers.  When we had a $10 office visit option and one of the kids complained his ear hurt, we would go off to the doctor first thing.  After we dropped that and it cost $50 we might wait a day to see if it actually developed into something.  Often it wouldn't.

[De Selby]

Nonetheless, that doesn't change the fact that our current health care system works pretty well, better than most anywhere else.  Even the free clinics and free emergency rooms here in the States provide care that's on par with the state-funded universal health care that citizens receive in the socialist countries. 

The two places I spent a significant amount of time in with socialist systems for healthcare, Australia and Singapore, have monumentally better care than the United States.  I don't think it can be said that this is the best healthcare in the world-in my experience, most Americans pay 10 to 100 times the price, and get either the same or substandard levels of care.

The regs here protect the industry, not the patients.  I shudder to think of what a "national health plan" would look like in the US when the private system we have now is so grossly gamed towards limiting consumer choice and protecting health provider price fixing and liability. 

When people in America start talking national healthcare, they need to be reminded of what the government already did to the system.  I'm not one of the "big pharm and hmo's love us and wouldn't ever rip us off and leave us in poor health for a profit!" people, but it's just ridiculous to think that the government which consistently protects those industries from lawsuits, from price competition, and from antitrust actions would ever make a patient-friendly national system.

[De Selby]

.

[mountainclmbr]

http://www.city-journal.org/html/17_3_canadian_healthcare.html

The Ugly Truth About Canadian Health Care
Socialized medicine has meant rationed care and lack of innovation. Small wonder Canadians are looking to the market.
David Gratzer
Summer 2007
Mountain-bike enthusiast Suzanne Aucoin had to fight more than her Stage IV colon cancer. Her doctor suggested Erbituxa proven cancer drug that targets cancer cells exclusively, unlike conventional chemotherapies that more crudely kill all fast-growing cells in the bodyand Aucoin went to a clinic to begin treatment. But if Erbitux offered hope, Aucoins insurance didnt: she received one inscrutable form letter after another, rejecting her claim for reimbursement. Yet another example of the callous hand of managed care, depriving someone of needed medical help, right? Guess again. Erbitux is standard treatment, covered by insurance companiesin the United States. Aucoin lives in Ontario, Canada.

When Aucoin appealed to an official ombudsman, the Ontario government claimed that her treatment was unproven and that she had gone to an unaccredited clinic. But the FDA in the U.S. had approved Erbitux, and her clinic was a cancer center affiliated with a prominent Catholic hospital in Buffalo. This January, the ombudsman ruled in Aucoins favor, awarding her the cost of treatment. She represents a dramatic new trend in Canadian health-care advocacy: finding the treatment you need in another country, and then fighting Canadian bureaucrats (and often suing) to get them to pick up the tab.

But if Canadians are looking to the United States for the care they need, Americans, ironically, are increasingly looking north for a viable health-care model. Theres no question that American health care, a mixture of private insurance and public programs, is a mess. Over the last five years, health-insurance premiums have more than doubled, leaving firms like General Motors on the brink of bankruptcy. Expensive health care has also hit workers in the pocketbook: its one of the reasons that median family income fell between 2000 and 2005 (despite a rise in overall labor costs). Health spending has surged past 16 percent of GDP. The number of uninsured Americans has risen, and even the insured seem dissatisfied. So its not surprising that some Americans think that solving the nations health-care woes may require adopting a Canadian-style single-payer system, in which the government finances and provides the care. Canadians, the seductive single-payer tune goes, not only spend less on health care; their health outcomes are better, toolife expectancy is longer, infant mortality lower.

Thus, Paul Krugman in the New York Times: Does this mean that the American way is wrong, and that we should switch to a Canadian-style single-payer system? Well, yes. Politicians like Hillary Clinton are on board; Michael Moores new documentary Sicko celebrates the virtues of Canadas socialized health care; the National Coalition on Health Care, which includes big businesses like AT&T, recently endorsed a scheme to centralize major health decisions to a government committee; and big unions are questioning the tenets of employer-sponsored health insurance. Some are tempted. Not me.

I was once a believer in socialized medicine. I dont want to overstate my case: growing up in Canada, I didnt spend much time contemplating the nuances of health economics. I wanted to get into medical schoolmy mind brimmed with statistics on MCAT scores and admissions rates, not health spending. But as a Canadian, I had soaked up three things from my environment: a love of ice hockey; an ability to convert Celsius into Fahrenheit in my head; and the belief that government-run health care was truly compassionate. What I knew about American health care was unappealing: high expenses and lots of uninsured people. When HillaryCare shook Washington, I remember thinking that the Clintonistas were right.

[The Rabbi]

Schip of Fools.
We are already sliding towards socialized medicine, and here is the vehicle for it.  What congressperson is going to want to be against health care for children, even if that child is 18 years old and lives in a middle class family?

The State Children's Health Insurance Program sounds like the epitome of good government: Who could be against health care for children? The answer is anyone who worries about one more middle-class taxpayer entitlement and a further slide to a government takeover of health care. Yet Schip is sailing toward a major expansion with almost no media scrutiny, and with Republicans in Congress running for cover.

Schip was enacted in 1997 to help insure children from working-poor families who make too much to qualify for Medicaid. In the intervening years, the program reduced the rate of uninsured kids by about 25% ...