How can the profit driven , private insurance funded healthcare system be fixed ?

HM2VikingRN, RN · Jul 25, 2008

Thats because our market driven system has failed miserably...

Katie82, RN · Jul 27, 2008

This thread is for those opposed to Universal Health Care .

I don't think it's a matter of being opposed to UHC, but some of us question the ability of the government to deliver quality, efficient health care to every one in the country without doubling our taxes. Imagine a bureaucracy ten times the size of CMS trying to keep everyone happy. CMS does not even manage this on its own, they outsource like crazy. BCBS does their billing, several large insurance companies are piloting a program for Disease management and Case Management. UHC would be more of the same.I would love to see UHC in place, but I just don't see it working as smoothly as proponents think it will. Someone will have to manage this monster and I guarantee HHS will turn to the same people who are doing it now. Someone will have to pay for it, and I guarantee it will be us, and many people who do not have health insurance now because they say the premiums are too high will be screaming because their taxes have doubled. There is no easy solution here, or we would have it already.

Mijourney · Jul 27, 2008

I don't think it's a matter of being opposed to UHC, but some of us question the ability of the government to deliver quality, efficient health care to every one in the country without doubling our taxes. Imagine a bureaucracy ten times the size of CMS trying to keep everyone happy. CMS does not even manage this on its own, they outsource like crazy. BCBS does their billing, several large insurance companies are piloting a program for Disease management and Case Management. UHC would be more of the same.I would love to see UHC in place, but I just don't see it working as smoothly as proponents think it will. Someone will have to manage this monster and I guarantee HHS will turn to the same people who are doing it now. Someone will have to pay for it, and I guarantee it will be us, and many people who do not have health insurance now because they say the premiums are too high will be screaming because their taxes have doubled. There is no easy solution here, or we would have it already.

My question is how well are those people in other countries who are doubly taxed for services making it? We hear so much about the tax aspect of UHC, what about the quality of life in those countries? Is the quality of life as good or better in Holland, Finland, or the other UHC countries than the U.S.? If so, how? If the quality of life is as good or better in the countries that supposedly have UHC, then what is our fear? Of course, I'm not clear on whether it's best for employers to determine what coverage and benefits we should have in the U.S. or the government. Maybe a more well-developed hybrid system will do. I may change my mind as time passes and as I learn more from you all about UHC and capitalism.

nicurn001 · Jul 27, 2008

and many people who do not have health insurance now because they say the premiums are too high will be screaming because their taxes have doubled. There is no easy solution here, or we would have it already.

At present the Middle Class are the ones who are being doubly taxed to provide private healthcare insurance .

1) to pay for the uninsured , made up of the poor who simply cannot afford premiums d/t low income and those who chose not to pay premiums because they feel they are a low risk group and it is too big a chunk of their income, so they shift the risk to the taxpayer to meet their need.

2)The middle class by paying their premiums to a private insurance company ( effectively a corporate tax , in which they have no representation), to obtain similar care they could recieve if their premiums were paid to the single payor , rather than being used to creat profit for the insurance industry .

The present system was created to ensure profits for the insurance industry , by removing from the risk pool the most expensive patients to care for ( chronically sick and aged ) and placing the responsibility for them on the tax payor .

So this thread was set up to hear from those who feel the profit driven ,private insurance funded healthcare system , to have them explain how it would provide healthcare for all without tax payer support .

Surely if the private system cannot provide healthcare care for all , as its proponents say it is the most efficient provider system , it cannot be viewed as anything but a failure .If the present system continues the tax payer will always have to pick up the tab for those the private insurance industry does not cover .

nicurn001 · Jul 27, 2008

My question is how well are those people in other countries who are doubly taxed for services making it? We hear so much about the tax aspect of UHC, what about the quality of life in those countries? .

Having lived in one of these countries prior to coming to the USA ( I am now a US citizen ),I did not feel doubly taxed when I lived in Europe . Actually I feel doubly taxed here because I have to pay taxes for a healthcare system I have no access to ( Medicare) . I then have to pay a "tax" (mine and my employers premiums to private insurance to obtain healthcare for myself and my dependents ) to the Insurance Companies for healtcare that is similar to what the uninsured have access to .

As to quality of life , your view is dependent upon what you view as important to your quality of life .Europeans may not have some of the trinkets we have in the USA ,but they do have the peace of mind to know that an illness is not going to bankrupt them and place them at risk of losing all they have worked so hard to obtain .They can change employers and even have breaks in employment and not lose healthcare coverage , so they are much less indentured to there employers than Americans.

Before any one comes up with the usual retort , if you don't like it go back to where you came from . As I said quality of life is what the individual values , On balance I believe that the quality of life I have here at present is better than I had in Europe .

UKRNinUSA, RN · Jul 30, 2008

the only way to fix it is to make it NOT FOR PROFIT -Switzerland does it - the private insurance companies (required to be not for profit) compete against each other in terms of quality:

"Swiss insurance companies and providers each year negotiate health care prices, which then are reviewed and approved by local Swiss governments, the Morning News reports. The government sets price controls, according to the Morning News. An average family of four pays about $680 a month in premiums. Swiss insurers charge a premium for each family member, with children having a lower premium than adults. The government subsidizes premiums for lower-income individuals. Deductibles and copayments for the Swiss are comparable to those in the U.S., the Morning News reports. Besides selling other plans, Swiss health care insurers must offer a basic health care plan priced without regard to risk, and they cannot make a profit from it. The companies compete with each other by offering various deductibles and supplemental benefits, according to the Morning News. Average annual premiums for family coverage under the basic plan are about $8,167. U.S. families with employer-based health coverage contribute an average of $2,713 in yearly premiums for family coverage, according to a survey by the Kaiser Family Foundation and Health Research and Educational Trust. U.S. employers contribute an average of $8,167 for family coverage, for a total of $10,880 a year, the survey says. Health care spending in Switzerland averaged $3,781 per person in 2003, compared with $5,635 per person in the U.S. Switzerland spends a larger percentage (11.5%) of its national income on health care than any other country besides the U.S., which spends 16%. "People in Switzerland realize what [health care] costs do to American business, and they don't want to add to the anti-competitive burden of Swiss businesses in the global economy," Felix Gutzwiller, a doctor who heads the University of Zurich Institute for Social and Preventive Medicine, said. He added that Swiss citizens "do not want employers to get so much into their private life and lifestyle." While many Swiss believe the quality of medical care in their country "is among the best in the world," others say the health system has to high of prices and encourages people to remain in hospitals longer than necessary, and insurers offer too many "bewildering choices," the Morning News reports. Gaudenz Silberschmidt, head of the international affairs division of the Swiss Federal Office of Public Health, said, "Theoretically, it's consumer-driven. But practically, no," adding that insurers "offer thousands of different premium plans, and when it's that many, it means it's not transparent"

http://www.medicalnewstoday.com/articles/37544.php

nicurn001 · Jul 30, 2008

Thank you UKRNinUSA , for your interesting post . I think I could accept the swiss type of healthcare provision , or UHC . One of the things that irritates me about the present system of healthcare provision in the USA , is that I am obliged to pay for healthcare twice , once thru government taxes , for Medicare ( a system I cannot access ) , then through corporate taxes ( my/ my employers premiums ) to an insurance company , to produce profit .

nursesforchange · Jul 30, 2008

I think there is a way to incorporate the private insurance system into health care reform that includes government sponsored insurance accessible to all, but not without significant regulation of the industry.

Regulation is required to prevent people who have purchased private insurance being dropped from their plan when they get sick, monitors the mechanism of denying people coverage, and monitors premium increases.

This is somewhat the basis of Obama's plan for reform, though his plan is sketchy on the details of containing the costs of care.

RN4MERCY · Jul 31, 2008

I don't think it's a matter of being opposed to UHC, but some of us question the ability of the government to deliver quality, efficient health care to every one in the country without doubling our taxes. Imagine a bureaucracy ten times the size of CMS trying to keep everyone happy. CMS does not even manage this on its own, they outsource like crazy. BCBS does their billing, several large insurance companies are piloting a program for Disease management and Case Management. UHC would be more of the same.I would love to see UHC in place, but I just don't see it working as smoothly as proponents think it will. Someone will have to manage this monster and I guarantee HHS will turn to the same people who are doing it now. Someone will have to pay for it, and I guarantee it will be us, and many people who do not have health insurance now because they say the premiums are too high will be screaming because their taxes have doubled. There is no easy solution here, or we would have it already.

Have you ever travelled in Canada, the UK, or the Netherlands? I have, and it seems to me the people living there have a quite decent standard of living, and as many shoppers in any mall or store that I've seen here. So, their taxes aren't killing them or impairing their quality of life. They also have Single-payer health systems, each a bit different, but everyone has access. By comparison, our lives are shorter, and our babies have a higher infant mortality rate; we are ranked 37th by the World Health Organization.

Speaking of terrifying monsters, what about the insurance company bureaucracy with multiple rules, plans, premiums, co-pays, deductibles, delays, and denials that are killing us: 21,000 deaths per year here are attributable to lack of health insurance, 101,000 deaths due to preventable conditions. For that, we spend twice as much per capita, so we're clearly not "the best in the world." USA ranked dead last among the top 19 industrialized nations and we are the only nation without a universal health system. "No easy solution here, or else we'd have it?" Insurers and big PhRMA are spending a lot of money to convince you of that--the system works for them, but not the rest of us. Hey, if Canada can do it, we can do it too.

Watch this, just out by the Communications Workers of America::typing

http://www.healthcarevoices.org/content/canada

RN4MERCY · Jul 31, 2008

I think there is a way to incorporate the private insurance system into health care reform that includes government sponsored insurance accessible to all, but not without significant regulation of the industry.
Regulation is required to prevent people who have purchased private insurance being dropped from their plan when they get sick, monitors the mechanism of denying people coverage, and monitors premium increases.
This is somewhat the basis of Obama's plan for reform, though his plan is sketchy on the details of containing the costs of care.

This is an industry that is all but impossible to regulate. You can't pick up a paper without reading about insurers being fined for fraud and deception, dropping coverage, refusing treatments and claims. Patients are dying, families are going bankrupt. Obama is not going to lead, however he is on record as saying that he would sign the single payer health care bill if Congress can get it to his desk. With 91 Congressional co-sponsors, we're on our way.

You tell me, how successful do you think you'd be "incorporating" a convicted child molestor or rapist who's been parolled into your home? Even with "significant regulations" don't believe for a minute your family will be protected from harm. Historically, insurers haven't behaved despite regulation and punishment. They have a shamefully high recidivism rate.