[teeituptom]

Originally Posted by clee1

Here's a thought: why wouldn't a system similar to what we use for auto insurance work?

Health insurance would be required, with a certain minimal coverage for preventive, chronic, and catastrophic services established by law. Then, the the private sector would have to compete for customers; based on price per service rendered. If payments from insurance were made to consumers, rather than to providers, then, consumers would be forced to shop for coverage and services, ensuring the best "bang for the buck". Add to this that providers would have to ADVERTISE their prices before service is rendered rather than afterward, enabling people to "vote with their wallets" Include in this legislation punitive fines for insurance companies doing crooked things like denying payment for an "unapproved" medication or a test/procedure deemed necessary by a MD. Now we are starting to get somewhere!

This way, a retired couple with grown children would not have to pay for maternity or substance abuse coverage. Neither would a single man need maternity coverage. You can see where I'm going here. The private sector would have to cultivate individual consumers, rather that the current system whereby a company gets all the business available from an person's employer; and one or two sizes of coverage would have to fit all those employees. Coverage would be portable, and the costs would be reduced for all due to the necessary competition for customers and the efficiency of operation required to remain profitable.

OK.... so what about the indigent, disabled, working poor, "high risks" (d/t chronic conditions) etc.???? EASY! A "high-risk" pool just like the auto insurance industry has, with the payments made to private insurers either via the welfare/medicaid mechanism or with tax credits directly to consumers indexed by income or means-testing.

There may be some bugs in my proposal needing work, but I think this is a far more workable method than "universal healthcare", single-payer, socialized medicine, or our current, inequitable, system.

The free market WILL work, if we allow it to!

The free market WILL NEVER work for anyone but itself

If it would work, it would have worked by now, It hasn't yet, so it never will.

Free market isnt free at all, now is it. Paying for UHC would be a far site cheaper

[jjjoy]

Just a little vent here...

I hate to see such a thought-provoking thread be hijacked by generalizations about "free markets" and "government ineffiency" and the like. In general, free market principles often increase access and affordability and government programs often suffer from ineffiency. Free market principles also often encourage resource exploitation and monopolization. Private companies also often suffer from ineffiency and some government programs are run efficiently.

On a positive note...

I'm enjoying this thread and some of the specific ideas and possibilities for changing the way health care is funded and how health insurance could work. There are pros and cons and potential pitfalls and I appreciate exploring those as opposed to just tossing off this idea or that idea because "free market never works" or "government programs always go wrong" or the like.

[deeDawntee]

Another twist on this issue: the people who need health insurance the most, the disenfranchised, the poor, those in poverty, are the very people who need to be empowered to vote. We would have no problem electing the next president with a good universal health care proposal and other elected officials if we could support voting from all who needs change the most.

What are the statistics on the actual voting turn-out in this country?

We are entrenched in a system that clearly does not work. But there is no will to change it. Without the political will, it will stay the same. I am concerned about my own retirement, if I will be able to afford my medications and long term care, given I am single, with no children and have some chronic illnesses which have made it difficult for me to have a good retirement plan etc. I have a vested interest in seeing things change.

[marvelous_truth]

Originally Posted by teeituptom

The free market WILL NEVER work for anyone but itself

If it would work, it would have worked by now, It hasn't yet, so it never will.

Free market isnt free at all, now is it. Paying for UHC would be a far site cheaper

Sadly many are misinformed and mislead to tyhe historical facts. First anyone who actually believes we have had a free market in recent years is not educated in the history of monetary policy and cartels that have had control over such. That is the purpose of my website which is a resource to Historical Facts and FREE education regarding principles of freedom. Blaming Free markets (which we DO NOT currently have , nor have we had a TRUE FREE MARKET in recent years), is a mistake and deception that many of us have missunderstood. Watch the excellent free video and invite other TRUE PATRIOTS and truth seekers to serve our country and promote Honesty in government and economics.

[June55Baby]

I haven't read all the posts on this thread, so I don't know if this has been mentioned. If we think patient care is tough now with all the Joint Commission and CMS regulations, just wait until the government gets it's hands on healthcare... I am afraid health care providers will be so deep in documentation and inane rules and regulations and sending reports to government agencies, that we won't have time to care for our patients.

[pickledpepperRN]

JCAHO is not a government organization. Hospitals prefer spending &&& to actually providing safe, effective care in a clean hospital.

How much do providers pay for insurance coders?
Does anyone know?

[HM2Viking]

Actually the data says exactly the opposite about single payer. More money will end up going for care rather than less.

Interesting comment from NASI:

Economist Peter Lindert finds that high levels of social spending in European democracies have not slowed economic growth, as long as the benefits and taxes are well designed. Social programs that cover nearly the entire population and are financed by broad-based low-rate taxes, such as payroll taxes or value-added taxes, have almost no
effect on a country’s ability to grow and prosper. Lindert’s research contradicts the oftstated assertion that social welfare spending necessarily slows economic growth because the benefits and taxes discourage recipients and taxpayers from being as productive as
they otherwise would be.
...

Lindert’s study strongly challenges the notion that high spending on health and income security programs results in slower economic growth. His research shows, instead, that universal social insurance programs and broad-based taxes do not harm a nation’s ability to grow and prosper.
...

Another element of the U.S. health care system that should be examined closely is the variations in care and costs within the United States. One recent study divided the country into hospital referral regions and examined Medicare spending in those areas. The researchers found that Medicare costs in the highest quintile of regions was 28 percent higher than in the middle spending quintile, and about 61 percent higher than in the lowest-spending quintile, yet the
quality of care reported across those quintiles is at best flat. What is the cause of these variations? “The key variant in this country appears to be the delivery system—the supply side. It is supply-induced demand,” Ebeler said. It may be possible to match the efficiencies achieved in the lower cost areas of the country—which are comparable to Western European spending levels—while enhancing the quality of care provided. If so, this step would begin to slow the
growth in the cost of health care in the United States.

http://www.nasi.org/usr_doc/Health_a...f_No_10pdf.pdf

[sharona97]

Originally Posted by deeDawntee

Another twist on this issue: the people who need health insurance the most, the disenfranchised, the poor, those in poverty, are the very people who need to be empowered to vote. We would have no problem electing the next president with a good universal health care proposal and other elected officials if we could support voting from all who needs change the most.

What are the statistics on the actual voting turn-out in this country?

We are entrenched in a system that clearly does not work. But there is no will to change it. Without the political will, it will stay the same. I am concerned about my own retirement, if I will be able to afford my medications and long term care, given I am single, with no children and have some chronic illnesses which have made it difficult for me to have a good retirement plan etc. I have a vested interest in seeing things change.

With this said, I hope all children receive insurance. The single payer website was very thought-provoking on this subject (post), don't know how it would influence working nurses, but it very well could improve preventative health issues. We need to refocus on diseases reappearing that were once gone from the U.S.

We need to help our own nation out and start using some of the budgeted monies for programs such as these instead of pouring money into other countries. IMO

[diapason05]

It seems to me that things cannot continue this way. I am thinking SOMETHING major is going to have to change in the next ten (or fifteen?)) years.,. I am concerned about this because I plan to be in the healthcare workforce..
WHat do you guys think? I think we're the only industrialized nation without government healthcare for EVERYONE. I can't imagine this can keep going on. There are too many people uninsured. I was terrified about turning 23, bc I was losing my (kaiser) healthcare... I happened to get married a month before I turned 23, so no worries now. I really feel for all the people my age who might have some sort of condition and no health insurance because their jobs won't cover them.
In Hawaii, employers legally must cover anyone working over 20 hours a month. When I worked at starbucks, they said after only 1 month of work I would qualify. Thats AMAZING. everywhere else I've lived (PA, WA, FL, CA)- you had to work somewhere at least 6 months and work 25-35 hours at least every week to qualify on the 6 months. I've also worked at a variety of places where there was NO option of healthcare no matter how many hours you worked.

Any thoughts on what the future might be looking like..
You guys are on the inside so... have any changes happened lately?

[RNperdiem]

Insurance is not always the savior everyone seems to make it out to be. My insurance recouped the cost of my child's hospitalization; they just took the money back from the hospital. The hospital just sent me the bill for $2,000. This hospitalization was nearly 3 years ago, and I got the bill last week. Now I am caught in the middle between my former insurance company and the hospital.
I see the trend continuing for higher deductibles, more "sorry we don't cover that", higher premiums and more uninsured.
It is easy to talk about universal health insurance, but harder to make work. The US is different from other industrialized countries; we have the third world living conditions in a land of plenty. Americans also have high, often unrealistic expectations of healthcare.