Healthcare/Health Insurance: what is the actual problem?

[ProdigalHorn]

Personally I think that is the part that needs to change. Insurance is viewed more like a "coupon" for much of America. They want to somehow magically consume more than they have contributed. Health insurance should be regarded like other insurance. It should be there for UNEXPECTED care, not recurring anticipated expenses. If we took recurring medication out of the health plan, I bet the ship would right itself.

I'm coming to a similar conclusion. We tend to look at health insurance as a way to save money: we pay as little as we can from month to month, which means we don't have to pay for expenses when they arise. Not only is that unrealistic and a sure way to screw up the health care market, but it would be ridiculous for anyone to offer health insurance coverage based on that model.

Health insurance isn't about paying for things we are normally going to pay for anyway - it can't be if you want a sustainable model. That means regular checkups, vitamins, basic routine stuff. Health insurance should be about not being hit with an unexpected, crippling expense.

It's a lot like the leftist feminists who now are trying to get tampons and razors covered by insurance. That has nothing to do with insurance and everything to do with getting thing for free or at a discount. There's no reason an insurer would ever insure you for something like that at a rate which would save money - nor should they.

 

[mchammer]

Simplest health care policy:

- individual or family pays up to $10,000 per year and up to $100,000 lifetime. That's it.
- individual or family can purchase private healthcare if they choose to reduce risk. Employer sponsored healthcare is taxed as a benefit.
- Medicare pays everything above $10,000 per year or $100,000 lifetime.
- increase Medicare payroll tax to 2% to pay for the above benefit (so everyone pays)
- for those who don't pay the first $10,000, apply wage garnishment. This will incenticize the majority to have some sort of private insurance.

 

[Mr. Deez]

Simplest health care policy:

- individual or family pays up to $10,000 per year and up to $100,000 lifetime. That's it.
- individual or family can purchase private healthcare if they choose to reduce risk. Employer sponsored healthcare is taxed as a benefit.
- Medicare pays everything above $10,000 per year or $100,000 lifetime.
- increase Medicare payroll tax to 2% to pay for the above benefit (so everyone pays)
- for those who don't pay the first $10,000, apply wage garnishment. This will incenticize the majority to have some sort of private insurance.

That's basically a single payer system with a high deductible that you can privately insure yourself against. Surprised to see a conservative propose such a system.

 

[mchammer]

That's basically a single payer system with a high deductible that you can privately insure yourself against. Surprised to see a conservative propose such a system.

What single payer system has wage garnishment? Also, if it is too single-payerish, you can raise the deductibles to $25k per year/$250k lifetime. The conservative part is that people have to spend their own money for the vast majority of expenses (in terms of number). Then only the major health emergencies are covered by government. I would admit that it does allow for single payer creep if deductibles are reduced.

 

[Mr. Deez]

What single payer system has wage garnishment?

Most singe payer systems don't have deductibles, so it's a moot point. The deductible part of your system isn't single payer. The rest of it is, and frankly "the rest" is the biggest part, at least from an economic standpoint.

Also, if it is too single-payerish, you can raise the deductibles to $25k per year/$250k lifetime.

That's fine, but the deductible amount is arbitrary, and how it impacts consumer behavior is going to vary sharply from person to person. Furthermore, whether it's $10k or $25k, most people are going to buy private insurance to cover it. It'll be a lot cheaper than it is now because the carriers won't be assuming anywhere near as much risk, but most people aren't going to pay out of pocket.

The conservative part is that people have to spend their own money for the vast majority of expenses (in terms of number).

Like I said before, they won't. They'll buy private insurance. Wealthy and upper-middle class people will self-insure and pay for things themselves. However, people who are poor, lower middle class, or even middle class don't have $10K or $25K in cash just sitting around to spend on health care. Even if they could scrounge it together, they're not going to. Depending on how cheap it is, they may try to buy insurance, but if they can't afford it, they'll wing it. You can garnish their wages if you want, but there are limits on how far you can go with that. $25K is a lot to garnish from somebody who doesn't make very much. If you take too much, they'll quit their jobs and/or file for bankruptcy. If you take too little, the system won't work.

Then only the major health emergencies are covered by government.

It would end up covering more than that. They'd be on the hook for major emergencies but also for all but the cheapest child births and surgeries. $10K or $25K is a lot for people to pay, but it's chump change when it comes to health care expenditures. Basically, the government would end up covering everything beyond the most routine care.

I would admit that it does allow for single payer creep if deductibles are reduced.

Just looking at political realities, I think you'd see the deductible means-tested. IT'll be higher for some than for others.

Just because your system is single payer-oriented, that doesn't mean I dismiss it as garbage, even if most conservatives would. I live in a country with a quasi-single payer system. It's not the panacea that the Left says it is, but it's also not the dumpster fire that the Right says it is. Furthermore, I think we'll eventually have a single payer system or something like one at some point.

Philosophically I don't want single payer. I want a free market system, but accepting risk is inherent to a free market system. In the healthcare context, that means accepting that some won't get the care they need. We're not willing to accept that, which is why we've created a half-assed government system that covers the highest risk and most vulnerable patients (the poor, disabled, and elderly) and coupled it with private third-party payers for the rest of us. Well, that creates all kinds of opportunities to distort the market, create inefficiencies, inflate costs, and generally screw the system up. We tolerate all that because we're not willing to accept risk but also not willing to entrust the government to finance the entire industry, and this effort to have our cake and eat it too has probably cost us trillions of dollars in waste over the decades. Obamacare sucked and mostly made things worse, but when I hear people suggest that we had a free market system before, I have to chuckle. We had a free market system like WWF wrestling is a competitive sporting event. It wasn't free at all and had all kinds of economic and social problems.

Eventually, I think political and economic realities are going to set it, and we'll scrap what we have, which is basically the worst of both worlds. In other words, Obamacare's true goal (a single payer system) will be realized. It'll take time, but it'll be here in less than 20 years. Since we're moving that way anyway and since a free market system is pretty much off the table, your proposal actually isn't that bad. I'd take it over a British NHS-type system.

 

[Seattle Husker]

Health Care replace is officially dead. The only option appears to be Repeal if the R's can must the Senate votes. Of course, that's no "done" deal as the moderates can't be counted on the support the removal of health insurance for 10's of millions of Americans and the significant increases in costs for millions more (pre-existing conditions plans not subsidized).

 

[Seattle Husker]

Health Care replace is officially dead. The only option appears to be Repeal if the R's can must the Senate votes. Of course, that's no "done" deal as the moderates can't be counted on the support the removal of health insurance for 10's of millions of Americans and the significant increases in costs for millions more (pre-existing conditions plans not subsidized).

The "Repeal" plan died before it ever got started in the Senate. 3 R Senators quickly stated they would not support a vote to repeal the AHCA.

As if on cue...it's the Democrat's fault.



The real news in this saga is that "Repeal and replace" was a slogan all along. There never was a viable plan.

 

[Hollandtx]

As many of you know, my Facebook friends are frenzied liberals who think that Trump is the Devil. I'm not a huge fan of the man myself, but, I am tired of seeing nothing but negative reports day after day.

I have a sincere question for all you smart folks here...why won't a single payer system payer system work in the US. All the Facebook folks think that Canadians and Europeans live in a Shangri-La world with universal healthcare. I think that it could never work due to the vast numbers of US citizens that receive entitlements, our overall poor health, and the fact that, simply put, we are used to picking our own MDs, getting seen by the best, not having long wait times, etc.
It's amusing to me that all the women (p*ssy hat wearers, of course) are wealthy and frequently speak of their wonderful physicians, therapists and psychiatrists.
If things do go to a single payer, I guess they opt out and use their above average income to purchase concierge service?
I would love to have a better understanding of why the single payer system won't wokr here.

 

[mchammer]

As many of you know, my Facebook friends are frenzied liberals who think that Trump is the Devil. I'm not a huge fan of the man myself, but, I am tired of seeing nothing but negative reports day after day.

I have a sincere question for all you smart folks here...why won't a single payer system payer system work in the US. All the Facebook folks think that Canadians and Europeans live in a Shangri-La world with universal healthcare. I think that it could never work due to the vast numbers of US citizens that receive entitlements, our overall poor health, and the fact that, simply put, we are used to picking our own MDs, getting seen by the best, not having long wait times, etc.
It's amusing to me that all the women (p*ssy hat wearers, of course) are wealthy and frequently speak of their wonderful physicians, therapists and psychiatrists.
If things do go to a single payer, I guess they opt out and use their above average income to purchase concierge service?
I would love to have a better understanding of why the single payer system won't wokr here.

Yes, upper middle class will have concierge status. Everyone else will have 2-3 months wait for surgery. The rich will do as they please, as currently done.

As you probably know, your friends are morally grandstanding on issues that will have no impact on them personally.

 

[mchammer]

As many of you know, my Facebook friends are frenzied liberals who think that Trump is the Devil. I'm not a huge fan of the man myself, but, I am tired of seeing nothing but negative reports day after day.

I have a sincere question for all you smart folks here...why won't a single payer system payer system work in the US. All the Facebook folks think that Canadians and Europeans live in a Shangri-La world with universal healthcare. I think that it could never work due to the vast numbers of US citizens that receive entitlements, our overall poor health, and the fact that, simply put, we are used to picking our own MDs, getting seen by the best, not having long wait times, etc.
It's amusing to me that all the women (p*ssy hat wearers, of course) are wealthy and frequently speak of their wonderful physicians, therapists and psychiatrists.
If things do go to a single payer, I guess they opt out and use their above average income to purchase concierge service?
I would love to have a better understanding of why the single payer system won't wokr here.

I had gall bladder surgery a few years ago. In my research I found that people from Canada or U.K. often had wait times of 3-9 months (I looked at various blogs and such). Of course, the wait time for the vast majority of Americans is 3-9 days. Single payer will be 10x worse than Obamacare.

 

[Seattle Husker]

why won't a single payer system payer system work in the US. All the Facebook folks think that Canadians and Europeans live in a Shangri-La world with universal healthcare. I think that it could never work due to the vast numbers of US citizens that receive entitlements, our overall poor health, and the fact that, simply put, we are used to picking our own MDs, getting seen by the best, not having long wait times, etc.
It's amusing to me that all the women (p*ssy hat wearers, of course) are wealthy and frequently speak of their wonderful physicians, therapists and psychiatrists.
If things do go to a single payer, I guess they opt out and use their above average income to purchase concierge service?
I would love to have a better understanding of why the single payer system won't wokr here.

Simple answer. We can easily make it work. It might restrict physician choice and bloat the federal budget a little more. The existing system will easily convert to the "concierge service" for those with means to supplement the single-payer plan.

Of course, this assumes the Insurance company and various health care lobbyists will allow it to happen.

 

[Clean]

All the Facebook folks think that Canadians and Europeans live in a Shangri-La world with universal healthcare

I wonder if they're following the Charlie Gard story? Poor kids parents want to bring him to the U.S., at no cost to U.K., and U.K. says sorry Charlie, we've decided you must die.

That's why we don't want single payer. We're Americans. We want the best health care we can get, not what the government allows us to get.

 

[mchammer]

Simple answer. We can easily make it work. It might restrict physician choice and bloat the federal budget a little more. The existing system will easily convert to the "concierge service" for those with means to supplement the single-payer plan.

Of course, this assumes the Insurance company and various health care lobbyists will allow it to happen.

Single payer healthcare is health care rationing by the government. Think airlines are bad? Imagine if the government ran it.

 

[mchammer]

I wonder if they're following the Charlie Gard story? Poor kids parents want to bring him to the U.S., at no cost to U.K., and U.K. says sorry Charlie, we've decided you must die.

That's why we don't want single payer. We're Americans. We want the best health care we can get, not what the government allows us to get.

Your child must die in the name of government-imposed fairness.

 

[Joe Fan]

 

[Brad Austin]

It's like someone said here in the past, we already have government controlled/rationed (single-payer style) healthcare in the U.S...it's called the VA.

Riddled with corruption, despicable (sometimes deadly) wait times, and vastly inferior care. Even able-bodied freeloaders who 'choose' not to seek employment get better care under Obamacare than many of our vets.

One would think the countless examples of waste, fraud, and corruption of big gov entities/programs under Obama would be enough of a cautionary tale.

IRS, VA, Obamaphone program, Shovel-ready jobs stimulus scam, the list goes on.

Not to mention the marketplace of ideas and innovation takes a big dump on itself when big gov replaces free market competition.

The motivation to make products or offer services that are better, cheaper, and/or more convenient to attract business takes a dive.

I'd prefer to let states run their own healthcare. Roll back to the pre-Obama rules of who qualifies for medicare and medicaid and receive fed funds for that.

Everyone else in Texas would purchase on the free market as our state has a brain. I'm sure lefty states will opt for single payer for their citizens.

Check back in 10 years and see which states have better care. Won't even be close. There'd be even more lefty rift raft piling into Texas seeking superior healthcare.

And as their hypocritical behavior already shows, the invaders will then vote for lefty candidates in Texas who demand single payer like the sh*tshow they just fled.

 

[Crockett]

Must we accept Health Care = Health Insurance? Are there some options besides casting trillions of dollars into the medical industrial complex or casting millions of citizens into indigent emergency/only care? Is single payer/cost control/ rationing is the only way to slow double digit annual growth in health care costs/pricing.

Hell, if I were in Congress I'd try to do something to create a little price transparency like they have in Massachusetts and create mechanisms for health care consumers to benefit from low cost choices ... which if they are a viable and marketed choice might come into vogue.

Neither Democrats nor Republicans seem to side with me. I just want to be able to make good choices mostly spending my own money, but with comfort of knowing that if I'm struck with a medical catastrophe like cancer or a broken back, I've got coverage after the first $2K.

 

[Seattle Husker]

It might be time to finally demand a mental health evaluation of our POTUS. WTF?

 

[mb227]

It might be time to finally demand a mental health evaluation of our POTUS. WTF?

Why? Because he is willing to go on record with what the rational people were stating when the Obummercare plan came into being? It is imploding upon itself and the Democrats absolutely refuse to let anything be done that would FIX (or ATTEMPT to fix) that piece o'crap...

 

[Crockett]

Maybe blowing it up will give everyone an incentive to compromise on a workable replacement. Or maybe with Obamacare out of the way, things will magically go back to that magical marvelous time before Obamacare.

 

[Musburger1]

Maybe blowing it up will give everyone an incentive to compromise on a workable replacement. Or maybe with Obamacare out of the way, things will magically go back to that magical marvelous time before Obamacare.

I read today that social security projects to begin spending more than it takes in five years from now. The US population is generally in pretty bad health. Perhaps the thinking is to deny health care to the old, poor, and sickly in order to save social security.

Ok. I'm just kidding.

 

[Seattle Husker]

Why? Because he is willing to go on record with what the rational people were stating when the Obummercare plan came into being? It is imploding upon itself and the Democrats absolutely refuse to let anything be done that would FIX (or ATTEMPT to fix) that piece o'crap...

Did you write that with a straight face? Just kidding. The ACA is not a perfect system and there are many problems. I believe it was Obama that stated he'd be open to a bi-partisan effort to fix the ACA. Unfortunately, it takes 2 to tango in D.C.

What evidence do you have that the R's have a desire to fix the ACA? 6 times, they've voted to repeal it entirely. Most of the votes, were targeted at gutting and/or delaying the ACA. There were a handful of viable bi-partisan fixes that have passed the house that should be considered. Here is a right-leaning article on the topic.

In order to fix the ACA in a bipartisan way, we need to resolve the fundamental difference in positions: Dems want to get closer to single-payer with coverage for all, R's want something else...an undefined "else".

 

[mb227]

Did you write that with a straight face? Just kidding. The ACA is not a perfect system and there are many problems. I believe it was Obama that stated he'd be open to a bi-partisan effort to fix the ACA. Unfortunately, it takes 2 to tango in D.C.

What evidence do you have that the R's have a desire to fix the ACA? 6 times, they've voted to repeal it entirely. Most of the votes, were targeted at gutting and/or delaying the ACA. There were a handful of viable bi-partisan fixes that have passed the house that should be considered. Here is a right-leaning article on the topic.

In order to fix the ACA in a bipartisan way, we need to resolve the fundamental difference in positions: Dems want to get closer to single-payer with coverage for all, R's want something else...an undefined "else".

The R's want to fix it so people like ME can actually HAVE affordable insurance again. I HAD a plan that I liked and could afford before Obummer lied to the Country. Since that time, I have self-insured, paying the rare medical expense out of pocket.

It NEEDS to be repealed. It needs to be an EX-law, pining for the fjords.

The left wants something that makes it so they pay nothing when they take junior to the doctor because he sneezes or scrapes his knee on the playground. That is NOT what insurance is designed to address. But perhaps more importantly, too many on the left simply want someone to pay their freight via even more handouts. So instead of having a system that actually functioned, the socialist-in-chief forced the POS ACA down our collective throats with even Pelosi admitting to having no clue what was REALLY in the law.

As such, the BEST thing to do is blow it up and start over with something that makes sense. To do anything else means you get something that is more convoluted than the Tax Code.

I can only hope you were not on the pipe by suggesting single-payer makes sense...have you MISSED the giant clusterfk that is the VA? That is a textbook case of how single-payer does NOT work in this Country

 

[Phil Elliott]

Have I already told you this story? I was in Canada about 2 years ago for work. I arrived the day before my colleagues so I was having dinner by myself. To cut to the chase a little, waitress (20-something I guess) said we needed free health care in the US like they have in Canada. I didn't want to have an argument with a child so I just said, "It's not free".

The next morning I was having breakfast with a colleague who was from Canada. I told him what she had said. He did not say much. Then I drove us to work. On the way we passed a Canadian health clinic. This was about 7am and there was already a line at the door that went around the side of the building. I blurted out, "There's your free health care, right there!"

"Free" health care = you can't get any.

How many times in the past 10 years have you heard of an American going to Canada or UK to get some kind of treatment b/c it was better than what we have in the US? Cheaper, maybe, but never b/c it's better.

 

[Crockett]

On the other hand, Medicare is single payer and it works pretty damn well. For all the bitching about low reimbursements, Florida is rife with shiny new hospitals that treat mostly Medicare patients.

 

[OUBubba]

France is a better model. A single payer will allow preventative care to flourish. High deductibles and limited access hinder that.

The problem is that all of those spine surgeons really need to be primary care docs. Capitalism (and medical school costs) has significantly impacted specialty choice.

 

[Mr. Deez]

Capitalism (and medical school costs) has significantly impacted specialty choice.

Barry (I'm going to start calling you that from now on.),

There's nothing capitalistic about the American healthcare system - not the medical schools, not the financing system(s), not the insurance industry, nothing. It's a hodgepodge of government guarantees and protection under a superficial guise of private enterprise.

 

[Phil Elliott]

The plan all along with Obamacare was to let it fail and then blame the free market. I see Barry is on board with that strategy.

 

[OUBubba]

Barry (I'm going to start calling you that from now on.),

There's nothing capitalistic about the American healthcare system - not the medical schools, not the financing system(s), not the insurance industry, nothing. It's a hodgepodge of government guarantees and protection under a superficial guise of private enterprise.

I prefer "slick".

My point was that docs don't want to be family practice docs or rheumatologists. They want to be neurosurgeons and cardiologists and orthopedic surgeons. So, to maximize their income they invest their time and money. We have a primary care shortage these days and a rural physician shortage that is significant while at the same time we have an abundance of some specialties. My take is that in the 1950's a doc made a good living. Since then, school costs have increased significantly. Physician pay (specifically, specialty doc pay) has increased past the point of "a good living".

 

[Phil Elliott]

they invest their time and money

And you want to make that investment null and void.