Health Care Law vs Patient Outcomes - page 2

by cassiemassey | 4,531 Views | 30 Comments

The way I understand our current Third Party Payer system the major decisions are made by a company looking to cut costs and make a profit. Drs are encouraged not to order 'unnessasary tests' (as if they would waste their time or... Read More


  1. 1
    Quote from elkpark
    I always suspect, in these conversations, that the individuals proposing "free market" systems and that people who have a problem with paying for insurance just don't want to be responsible probably don't have any experience as an individual customer in our current free market system. You don't really get how bad the system is until you've tried to buy insurance on your own in our wonderful "free market." The last time I was unemployed for a significant amount of time, I went shopping for health insurance as an individual. At the time, I was in my early 50s and in excellent health except for one minor health issue which is stable on no medication/treatment and has been for a long time. The best offer I could find was $500/month premium with a $5,000 deductible -- that's $11,000 out of my pocket (each year) before the insurance would pay a single penny. Now, if I had been working full-time and making a decent salary, I might have been able to afford that (but, in that case, I would have insurance through my work, at a more affordable group rate).Our system needs serious changes, much more than the ACA (which is basically just minor tweaking of our current dysfunctional system) will provide. I am another of the many advocates of a single-payer system in the US.
    You and many others are missing a big point. That is, what we have now IS NOT a free-market healthcare system. A free market system would be where the consumer controls how their healthcare dollars are spent. Not an insurance company. And not the government.

    Consumers controlling the where, when, and how their healthcare dollars are spent will lead to competition, innovation, lower costs, and better quality of healthcare.
    Last edit by SC_RNDude on Oct 21, '12 : Reason: Typo
    musingmom likes this.
  2. 0
    I don't know. I think there is a reason people come to the US for medical care.
  3. 1
    Quote from Sadala
    I don't know. I think there is a reason people come to the US for medical care.
    *** And millions of Americans going abroad from heath care.
    "A forecast by Deloitte Consulting published in August 2008 projected that medical tourism originating in the US could jump by a factor of ten over the next decade. An estimated 750,000 Americans went abroad for health care in 2007, and the report estimated that a million and a half would seek health care outside the US in 2008. The growth in medical tourism has the potential to cost US health care providers billions of dollars in lost revenue."
    wooh likes this.
  4. 1
    Quote from SC_RNDude
    You and many others are missing a big point. That is, what we have now IS NOT a free-market healthcare system. A free market system would be where the consumer controls how their healthcare dollars are spent. Not an insurance company. And not the government.

    Consumers controlling the where, when, and how their healthcare dollars are spent will lead to competition, innovation, lower costs, and better quality of healthcare.
    I'm not missing any "big point." Our current system is a highly warped, distorted version of free-market capitalism. However, it is still a "free market" system to the extent that employers are free to make decisions about spending on health insurance, and insurance companies are free to seriously screw over individuals attempting to purchase insurance. Individuals are free, in most cases, to opt out of their employers' insurance plans and make their own choices about spending money on healthcare if they choose, although most people would be crazy to do that, considering how the insurance companies and healthcare providers penalize individual consumers.
    JMBnurse likes this.
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    I think you guys are getting off topic, I want to better understand healthcare in relation to patient outcomes, not the budget. It is a NESSESITY, and it if its right, then we will find a way to pay for it just like we find a way to pay for social security. I do not think that healthcare should be tied to someones employment. Im glad to hear that there are so many healthy people out there that can go the few months it takes to find a new job without healthcare, or those that are financially stable enough to afford cobra. I am not among them. I eat right and exercise regularly, I am in my early 20's. I also have a +3 murmur requiring maintencance medication for me to function, hypothyroidism, asthma, a skull base mass that we are 'watching' becouse it may or may not effect my carotid. I recently had my appendix out as well. Im one of those people that insurance companies hate becouse they know they will have to pay out the nose for my care. but if i went without these medications for even a day i would be incapacitated. one of the scaryest things for me is the risk of losing my job, becouse it could risk my life. I hear people saying that healthcare is not a human right issue, it is. I have the right to LIFE liberty and the pursuit of happyness. As a nurse and a patient I want to better understand what we need, then we can find a way to pay for it. lets keep politics out of it and discuss this problem as only nurses can!
    JMBnurse likes this.
  6. 0
    Quote from cassiemassey
    ... lets keep politics out of it and discuss this problem as only nurses can!
    (But, unfortunately, this is an inherently "political" question. Any significant change to our existing system has to be legislated.)
  7. 0
    Quote from elkpark
    I'm not missing any "big point." Our current system is a highly warped, distorted version of free-market capitalism. However, it is still a "free market" system to the extent that employers are free to make decisions about spending on health insurance, and insurance companies are free to seriously screw over individuals attempting to purchase insurance. Individuals are free, in most cases, to opt out of their employers' insurance plans and make their own choices about spending money on healthcare if they choose, although most people would be crazy to do that, considering how the insurance companies and healthcare providers penalize individual consumers.
    You are missing the point. You are dismissing the ideas of a free-market healthcare plan based on the experiences you have had in a healthcare system that you call a free-market, but in reality is nothing of the sort.
  8. 0
    Quote from cassiemassey
    I think you guys are getting off topic, I want to better understand healthcare in relation to patient outcomes, not the budget. It is a NESSESITY, and it if its right, then we will find a way to pay for it just like we find a way to pay for social security. I do not think that healthcare should be tied to someones employment. Im glad to hear that there are so many healthy people out there that can go the few months it takes to find a new job without healthcare, or those that are financially stable enough to afford cobra. I am not among them. I eat right and exercise regularly, I am in my early 20's. I also have a +3 murmur requiring maintencance medication for me to function, hypothyroidism, asthma, a skull base mass that we are 'watching' becouse it may or may not effect my carotid. I recently had my appendix out as well. Im one of those people that insurance companies hate becouse they know they will have to pay out the nose for my care. but if i went without these medications for even a day i would be incapacitated. one of the scaryest things for me is the risk of losing my job, becouse it could risk my life. I hear people saying that healthcare is not a human right issue, it is. I have the right to LIFE liberty and the pursuit of happyness. As a nurse and a patient I want to better understand what we need, then we can find a way to pay for it. lets keep politics out of it and discuss this problem as only nurses can!
    I am in favor of a free-market based healthplan because it will lead to better patient outcomes.

    In a free-market based plan, employers would be getting out of the management of your healthcare. And insurance companies would as well.

    Health insurance would be for emergency care and for lack of a better term, "catastrophic" situations only, much like your car, home, life, etc. insurance. For example, you get a cancer diagnosis, the insurance company would give YOU a payout. You then decide on the treatment. YOU are in control of your care, not the insurance company.

    This insurance would not be tied to your employment. You would buy this as an individual, and and long as you keep paying premiums, they can't drop you. Insurance companies will set rates by your risk factors, again much like car, home, and life insurance. Instead of doing everything they can to keep unhealthy people away like they do now, now they will be competing for all types of customers.

    The consumer will be responsible to pay for routine exams, RX's, diagnostics, etc. They will do this with tax-free Health Savings Accounts. As an employee benefit, employers will contribute to these accounts as well. Your care will be managed by YOU, not your employer and not your insurance company.

    Of course there will be situations in which people still will not be able to afford their healthcare for a variety of reasons. That is when medicaid/medicare, charity, etc. will kick in.

    As the healthcare consumer, you will be managing your own healthcare. You will have the power of choice. Those in the healthcare industry will then have the motivation to keep innovating in order to provide the best options for healthcare at the best values possible.

    Neither political party is promoting such a plan right now, unfortunately. However, Obamacare is a speeding locomotive in the opposite direction, and will take a very, very long time to recover from if ever fully implemented.
  9. 1
    Edited to say: I replied without reading the rest of the new posts. SC_RNDude has made my point about free markets better than I could.

    Quote from elkpark
    I always suspect, in these conversations, that the individuals proposing "free market" systems and that people who have a problem with paying for insurance just don't want to be responsible probably don't have any experience as an individual customer in our current free market system. You don't really get how bad the system is until you've tried to buy insurance on your own in our wonderful "free market."
    Actually, I do not think our current system is a true "Free Market." There are hundreds of health care laws on the books, tax laws that affect health care, a myriad of ways the government and the insurance companies collude to the consumer's detriment. I would suggest that those are some of the reasons we find ourselves in this mire, which I agree with you, is unsustainable.

    Also, if I implied that people who don't want to purchase insurance just don't want to be responsible, I apologize, that was not my intent. I was trying to point out the the current reforms are not worth the panic level they are often assigned.
    Last edit by musingmom on Oct 24, '12 : Reason: additional information
    SC_RNDude likes this.
  10. 0
    Quote from SC_RNDude
    I am in favor of a free-market based healthplan because it will lead to better patient outcomes.

    In a free-market based plan, employers would be getting out of the management of your healthcare. And insurance companies would as well.

    Health insurance would be for emergency care and for lack of a better term, "catastrophic" situations only, much like your car, home, life, etc. insurance. For example, you get a cancer diagnosis, the insurance company would give YOU a payout. You then decide on the treatment. YOU are in control of your care, not the insurance company.

    This insurance would not be tied to your employment. You would buy this as an individual, and and long as you keep paying premiums, they can't drop you. Insurance companies will set rates by your risk factors, again much like car, home, and life insurance. Instead of doing everything they can to keep unhealthy people away like they do now, now they will be competing for all types of customers.

    The consumer will be responsible to pay for routine exams, RX's, diagnostics, etc. They will do this with tax-free Health Savings Accounts. As an employee benefit, employers will contribute to these accounts as well. Your care will be managed by YOU, not your employer and not your insurance company.

    Of course there will be situations in which people still will not be able to afford their healthcare for a variety of reasons. That is when medicaid/medicare, charity, etc. will kick in.

    As the healthcare consumer, you will be managing your own healthcare. You will have the power of choice. Those in the healthcare industry will then have the motivation to keep innovating in order to provide the best options for healthcare at the best values possible.

    Neither political party is promoting such a plan right now, unfortunately. However, Obamacare is a speeding locomotive in the opposite direction, and will take a very, very long time to recover from if
    ever fully implemented.

    This sounds like just a slight revision of our current system. This sounds to me like, again, it would only benefit the wealthy and college graduates with good jobs. The working poor who are not eligible for Medicaid would struggle with this type of system. They would pay higher premiums if they have a medical condition/s? And if they miss a payment, their coverage can be cancelled? I also think this would lead to a decrease in receiving primary care. We desperately need "affordable" health care for all. This will improve our outcomes.


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