[BlueRidgeHomeRN]

Originally Posted by HM2Viking

. If anything I think that the most likely reform is along the lines of the french model.

Is that having another glass of red wine and a Gauloise?

[HM2Viking]

http://www.censusscope.org/us/chart_popl.html

The US Population has nearly doubled since LBJ's presidency. Increases in public spending tend to follow population trends.

What is more worrisome is the trend in health care inflation as a percentage of GDP.

[HM2Viking]

A very brief discussion about the French model:

France's system is further prized for its high level of choice and responsiveness -- attributes that led the World Health Organization to rank it the finest in the world (America's system came in at No. 37, between Costa Rica and Slovenia). The French can see any doctor or specialist they want, at any time they want, as many times as they want, no referrals or permissions needed. The French hospital system is similarly open. About 65 percent of the nation's hospital beds are public, but individuals can seek care at any hospital they want, public or private, and receive the same reimbursement rate no matter its status. Given all this, the French utilize more care than Americans do, averaging six physician visits a year to our 2.8, and they spend more time in the hospital as well. Yet they still manage to spend half per capita than we do, largely due to lower prices and a focus on preventive care.
...
A wiser approach is to seek to separate cost-effective care from unproven treatments, and align the financial incentives to encourage the former and discourage the latter. The French have addressed this by creating what amounts to a tiered system for treatment reimbursement. As Jonathan Cohn explains in his new book, Sick:

In order to prevent cost sharing from penalizing people with serious medical problems -- the way Health Savings Accounts threaten to do -- the [French] government limits every individual's out-of-pocket expenses. In addition, the government has identified thirty chronic conditions, such as diabetes and hypertension, for which there is usually no cost sharing, in order to make sure people don't skimp on preventive care that might head off future complications.

The French do the same for pharmaceuticals, which are grouped into one of three classes and reimbursed at 35 percent, 65 percent, or 100 percent of cost, depending on whether data show their use to be cost effective. It's a wise straddle of a tricky problem, and one that other nations would do well to emulate.

http://prospect.org/cs/articles?arti...lth_of_nations

Greater access to care
Lower overall cost
emphasis on evidence based care.

[HM2Viking]

Here is a snapshot of the premium structure as envisioned by Jacob Hacker and confirmed by independent analysis.

Premiums for workers above 200 percent of FPL would be as follows, and would be phased-in based on family income between 200-300 percent of FPL.

Family Type Premium

Individual $70 per month

Couple $140 per month

Single Parent $130 per month

Two-Parent Family $200 per month.

...

Families with incomes

over 400 percent of the FPL would pay the full cost of the premium.

http://www.sharedprosperity.org/hcfa/lewin.pdf

In other words between 200-400% of poverty premiums would be assessed on a sliding scale basis. A single parent family would be 460$/month at 400% of poverty and above. At 400% of Poverty and above the maximum premium for a 2 parent family would be 670$/month. Given that current family coverage for EPDTA standards is approximately 1000/month this would net to a substantial savings for ALL plan participants. Whats not to love about this plan!

http://www.sharedprosperity.org/hcfa/lewin.pdf

[ZASHAGALKA]

Originally Posted by HM2Viking

There's never been a law yet that didn't have a ridiculous consequence in some unusual situation; there's probably never been a government program that didn't accidentally benefit someone it wasn't intended to. Most people who work in government understand that what you do about it is fix the problem -- you don't just attack the whole government. Molly Ivins

You're right. There's NEVER been a gov't program that didn't have ridiculous consequences. All the more reason not to trust the gov't.

The best fix is to eliminate gov't. In most instances, the gov't IS THE PROBLEM. The solution? Remove the problem.

~faith,
Timothy.

[ZASHAGALKA]

Originally Posted by Mschrisco

How would we fund the vouchers? Tax monies?

Yes.

But, by giving parents DIRECT control of how those dollars are spent, schools would compete for those dollars.

Competition will yield the best combination of price and quality.

As a result, the States could fund education for half of what they currently spend.

The trick is to get the Federal gov't completely out of the equation. Education is a State issue. The vast majority of school dollars come from property and sales tax, at least here in Texas. If the funding is mostly local, then why on earth is the control in Federal hands?

As IF the Feds know better the needs of my community than my community.

Vouchers would lead to superior education at less cost. What it WOULDN'T do is give liberals a venue to indoctrinate my children. THAT is why moving away from the public school system is such a heated idea.

It's the same with health care: it comes down to choice. Advocating for gov't control means DEPRIVING the ultimate consumer from choice. I advocate choice: let the parents choose.

I trust parents to choose better for THEIR children than I do ANYBODY ELSE. Washington does NOT have a more vested interest in children than parents.

I trust MY ability to choose my own health care much more than I do Washington's ability choose for me a 'black rotary phone' health care plan.

~faith,
Timothy.

[jjjoy]

Originally Posted by BlueRidgeHomeRN

When people stopped paying with their own real money, the spiral upward of medical care costs began..because "someone else" was paying.[/color][/size][/font]

That factors in to an extent. But also health care simply costs a lot more. There are a lot more options and those options are expensive to develop, implement, etc ... MRIs & CTs not just x-rays, by-pass and PCI instead of death by MI, long term chronic care, etc. Providers tried bilking the insurance companies (and this includes Medicare) by padding costs. Then insurance companies got serious about what they would and wouldn't pay. And through that all, procedures, supplies, tests and drugs multiplied in number and complexity... and cost. So health insurance becomes less profitable and companies have to squeeze more and more to keep costs down. They use bulk negotiation powers to induce provides to accept reduced payments for services and then providers struggle to recoup their costs. For profit organizations have no incentive to provide care for those who won't help their bottom line. And non-profits struggle to cover their costs, which tend to be heavier since they usually end up taking care of those who couldn't get help from the for-profits.

Removing third party payors from the equation would help reduce costs but there would still be tough decisions to make. I just want to acknowledge that because sometimes proponents of either side of an argument tend to come across as ignoring the pitfalls of the system they advocate and dismissing the concerns of those who resist that system. There are no perfect answers. In any solution, someone somewhere will end up getting the short end of the stick. So we can't use the argument that if anyone loses ever that the system has totally failed and needs to be scrapped. It may be obvious to some but I find it useful to remind myself of that.

[jjjoy]

In regard to the private/public school topic... yes many parochial schools do a better job than public schools at a lower price. Sometimes the school tuition is subsidized by the affiliated religious organization. I know of many small parochial schools that aren't considered to be strong academically and the local public schools offer more opportunities for their students. So there are no guarantees that private always provides better education than public.

Also, private schools have the option of turning away students who don't behave, who don't do well on entry exams, or if all of their seats are full. Public schools don't have any of these options. And usually, if a parent is motivated and concerned enough to look for and make the extra effort to send their child to parochial school, then they are also more likely to be supportive of the students.

What about choice? I choose to help provide public education for all children in this country through the taxes that I pay. Even if I don't have kids. I'm not going to ask for my money back even though I'm not directly benefiting public education. So we're all paying for that. Parents have the option of sending their kids to the public school that they help pay for, or they can send their kids to a private school and pay for that extra service.

Does the public school system need an overhaul? Yes! But the same problems that plague the public schools can just as easily come about in with private schools as they compete for voucher dollars. Sure some schools would get a great reputation and everyone would want to go there... like the public schools in affluent neighborhoods.

The great schools would fill up quick but there would still be lots of students needing to find a school. If the only schools left available are low quality, what *choice* is there now? It's back to square one.

[ingelein]

Originally Posted by jjjoy

. So there are no guarantees that private always provides better education than public.

Does the public school system need an overhaul? Yes! But the same problems that plague the public schools can just as easily come about in with private schools as they compete for voucher dollars. Sure some schools would get a great reputation and everyone would want to go there... like the public schools in affluent neighborhoods.

The great schools would fill up quick but there would still be lots of students needing to find a school. If the only schools left available are low quality, what *choice* is there now? It's back to square one.

Milwaukee, 2008 Voucher Brief, Did Compromise Voucher Law Achieve Intended Purpose?

http://www.publicpolicyforum.org/pdf...ucherBrief.pdf

[ZASHAGALKA]

Originally Posted by jjjoy

The great schools would fill up quick but there would still be lots of students needing to find a school. If the only schools left available are low quality, what *choice* is there now? It's back to square one.

I disagree. You are projecting current availability of private schools onto the VAST amount of choice you'd have if parents could direct their children's education dollars.

Competition will expand to fill the need.

For example. Are all the good cell phone plans 'filled up' now? All the good restaurants in your town?

There may be SOME competition for limited space in better places. True. But to say that it would be a game of musical chairs and some kids would be left out isn't exactly true.

It comes down to choice. The gov't plan removes all choice: your children must be education in a humanist 'feel good' environment. What if I don't WANT my child being taught outright lies, such as evolution and global warming? Sorry, that's the law - it's on the secular humanist agenda.

See, at issue is that some of you simply don't think I should have a say in what my children are taught. The whole issue of denying choice is to veto my say, as a parent.

It's about choice.

Health care will be no different.

~faith,
Timothy