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| No. 10 | 
Jan 31, 2009, 01:52 AM
 Re: A universal single-payer, not-for-profit healthcare system could help lift tens o
Then again we could just model our health care system on the VA. Superior care at about 2/3 of the cost for our current non-system.
1. Emphasis on primary care
2. Means tested copays
3. Completely based on evidence based practice.
4. Group rates for medications.
5. The option to obtain fee based care from other provders.
 | | Advertisement Sponsored Links | | | | No. 11 |
Jan 31, 2009, 03:49 AM
Updated
Jan 31, 2009 at 03:57 AM by ZASHAGALKA
Re: A universal single-payer, not-for-profit healthcare system could help lift tens o Originally Posted by HM2Viking  Then again we could just model our health care system on the VA. Superior care at about 2/3 of the cost for our current non-system.
1. Emphasis on primary care
2. Means tested copays
3. Completely based on evidence based practice.
4. Group rates for medications.
5. The option to obtain fee based care from other provders.
I've worked for a VA Admin Hospital. I know you work there, now. Nevertheless. Ask a wide range of vets (not just your patients) what they think about the VA.
You won't get an overwhelmingly enthusiastic answer. . .
Thankfully, most of them have a CHOICE. A gov't mandated option is anti-choice. It's not about providing a better product at a superior price. Its about ensuring that Big Health, Inc., does NOT NEED your choice in selling it's product. (These businesses will not go away; they'll just take over - via superior lobbying.) Except now, you no longer have a choice. Halliburton, in charge of YOUR health care. Take it, or leave it.
Gov't rationed health care is about those that would be in charge of the rationing. It has little to do and simply isn't in the best interests of - those that will be rationed from care as a result. (That would be you.)
Not everybody is convinced that the VA is the model of care you suggest. I KNOW. I KNOW. President Bush's Administration vastly improved the care over what it was when I worked there, under Clinton.
Still.
(and WHAT IS THIS with you gaining on me in post counts? I take a little vacation from the computer . . . sheesh!)
~faith,
Timothy.
| | No. 12 |
Jan 31, 2009, 06:20 AM
Re: A universal single-payer, not-for-profit healthcare system could help lift tens o
I actually see that as people know they can get care at doctor's offices and clinics they are going to avoid ERs for simple symptoms.
Or perhaps ERs can get away with what happens at military hospitals "this is not an emergency and here is your appointment time at the clinic accross the the street, or with Dr. so and so, goodbye."
Also, if the laws of supply and demand and private enterprise hold true, investors are going to see an opportunity as more people seek and get health care. It can continue to be the growth industry it is.
I just can't see advocating that health care remain the same just so I don't have to wait in line somewhere.
| | No. 13 |
Jan 31, 2009, 06:36 AM
Updated
Jan 31, 2009 at 06:54 AM by ZASHAGALKA
Re: A universal single-payer, not-for-profit healthcare system could help lift tens o Originally Posted by Tweety I actually see that as people know they can get care at doctor's offices and clinics they are going to avoid ERs for simple symptoms.
Or perhaps ERs can get away with what happens at military hospitals "this is not an emergency and here is your appointment time at the clinic accross the the street, or with Dr. so and so, goodbye."
Also, if the laws of supply and demand and private enterprise hold true, investors are going to see an opportunity as more people seek and get health care. It can continue to be the growth industry it is.
I just can't see advocating that health care remain the same just so I don't have to wait in line somewhere.
1. I think you will see 'pay as you go' (no insurance) clinics in Walmarts, etc., be a standard of care within 10 yrs. It's already starting. Just as $4 generic prescriptions didn't need a huge gov't bureaucracy to become a standard with lots of big-name pharmacies. The free market does the best job of mitigating price while expanding quality and cutting edge.
2. Who wants things to remain the same? I advocate for the government to become LESS intrusive in health care. Gov't restricted health care advocates for MORE restrictive gov't interference. I don't know anybody that wants more of the same.
3. What I specifically advocate is that the gov't end tax breaks for businesses to provide for health care and instead provide those breaks directly to consumers. That would break the back of gov't supported (with lobbiest infested rules for care) tax breaks to businesses and put health care back in the hands of individuals. Combine that with health savings accounts and catastrophic insurance, and you would have a model that would control pricing and bring health care to the masses.
I don't depend on my employer for my car insurance, and I shouldn't need to for my health care. Nobody should be forced to keep a job in order to keep health insurance.
THEN, after the gov't gets out of the business of interfering with care, THEN, the gov't could set up a catch all plan to insure that everybody is covered.
4. Universal health care isn't about universal coverage, at all. There are far cheaper -and less intrusive - ways to accomplish that. It's about controlling YOUR health care. It's about the money - why let YOU decide how to spend YOUR money best, when some bureaucrat in Washington knows YOUR health needs better than you do - and has the actuarial tables to prove it!
5. The only reason why a CT scan costs a thousand dollars is because, get this - YOU DON'T ACTUALLY PAY FOR IT. Remove the middle man and it would be far less. In order to have a market for a product, that market MUST be created at a price that will sustain it.
Nobody advocates leaving things status quo. I advocate a better system that keeps Washington out of your lives and provides par excellent care to everybody - with no rationing lines. Gov't restricted health care advocates want a fair share in a dismal gov't outcome for all.
~~~~
I advocate that we all have the ability/opportunity to have blackberry cell phones. Gov't restricted advocates argue that, out of fairness to everybody, we must all have black box rotary-dial phones. Would you want to bring back Ma Bell and that black rotary-dial box phone for all? For goodness' sakes, then, WHY ON EARTH would you want to do the same to health care?
If you advocate trusting the gov't with your care, then, having put your faith in a bureaucracy for such a personal and important aspect of your life, you cannot then complain that such a bureaucracy ACTS like a - BUREAUCRACY.
~faith,
Timothy.
| | No. 14 |
Jan 31, 2009, 10:15 AM
Re: A universal single-payer, not-for-profit healthcare system could help lift tens o Originally Posted by ZASHAGALKA 1. I think you will see 'pay as you go' (no insurance) clinics in Walmarts, etc., be a standard of care within 10 yrs. It's already starting. Just as $4 generic prescriptions didn't need a huge gov't bureaucracy to become a standard with lots of big-name pharmacies. The free market does the best job of mitigating price while expanding quality and cutting edge.
3. What I specifically advocate is that the gov't end tax breaks for businesses to provide for health care and instead provide those breaks directly to consumers. That would break the back of gov't supported (with lobbiest infested rules for care) tax breaks to businesses and put health care back in the hands of individuals. Combine that with health savings accounts and catastrophic insurance, and you would have a model that would control pricing and bring health care to the masses.
4. Universal health care isn't about universal coverage, at all. There are far cheaper -and less intrusive - ways to accomplish that. It's about controlling YOUR health care. It's about the money - why let YOU decide how to spend YOUR money best, when some bureaucrat in Washington knows YOUR health needs better than you do - and has the actuarial tables to prove it!
5. The only reason why a CT scan costs a thousand dollars is because, get this - YOU DON'T ACTUALLY PAY FOR IT. Remove the middle man and it would be far less. In order to have a market for a product, that market MUST be created at a price that will sustain it.
~~~~
~faith,
Timothy.
Tim, I quoted only a portion of your post ... I hope I haven't distorted your thoughts too much.
Don't let it come as a shock to you all, but I'm with Tim in his concern over gov't-run health care coverage. My reasons are a little different. Having worked in the public sector I can tell you that efficiency, cost controls and ethics are no better than in the private.
I'm just not convinced that it's such an either/or choice between "free" enterprise and government. It's "free" enterprise that gave us the medicare drug "benefit" - overpriced medications - procedures that cost thousands-to-millions - a tort system that compels us to do unnecessary care - middlemen up the wazoo - and publicly traded healthcare providers who are required by law to put their stockholders before their patients.
When I started nursing in 1972, healthcare was mostly non-profit ... costs were out of control then thanks to third party payors. Tim is right, costs were high partly because they were paid by someone else. Medicare instituted drgs in an attempt to control their costs by tying payment to a standard price for a given diagnosis. Private insurers followed the leader with their own reimbursement restrictions.
Then comes the HMO (Harvard was the first) and the for-profit healthcare companies, each, in it's own way, claiming it could control costs. The HMO would do so by concentrating on health maintenance at the level of primary care and restricting access to expensive treatments, tests and specialist care via a gatekeeper.
For-profit companies were going to control costs the old-fashioned way ... the profit motive. But that only works if costs are kept down and prices are kept high. Remember, any company that has stockholders has to put the good of the stockholders ... ie their profit ... above any other consideration.
We've had 25 years or so of these various cost-controlling measures ... they didn't work.
One definition of insanity is doing the same thing over and over again and expecting different results.
So ... I finally get to my point. I, personally can't see a way out of this mess. So, I'd like to hear more about Tim's ideas on the cheaper, less intrusive ways to provide health care/coverage. If it's through a tax break, it would have to be one honkin' break for me to afford even the level of coverage I have now. And how would we get around the fact that prices come down in response to falling demand ... and demand for health care isn't going down anytime soon?
| | No. 15 |
Jan 31, 2009, 01:03 PM
Re: A universal single-payer, not-for-profit healthcare system could help lift tens o Originally Posted by heron So ... I finally get to my point. I, personally can't see a way out of this mess. So, I'd like to hear more about Tim's ideas on the cheaper, less intrusive ways to provide health care/coverage. If it's through a tax break, it would have to be one honkin' break for me to afford even the level of coverage I have now. And how would we get around the fact that prices come down in response to falling demand ... and demand for health care isn't going down anytime soon?
A free market will rise to meet demand. There are billions of cell phones on the market and in use - right now. Nobody had to ration them, and the competition to put them in YOUR hands have made them cheap: cheaper than that black rotary-dial phone was 30 yrs ago.
Here's a four-part plan to make health care affordable. The number one aspect of any such plan is that it must be primary-payor: the user must retain control of the dollars in order to maintain cost-conscience choice.
1. End employer tax breaks for coverage. Employer provided coverage would fall to nothing inside of 3 yrs. Good. You shouldn't be forced to keep a job to keep insurance.
2. Give citizens a 2-fold tax break.
A. - a $5,000/person Health Savings Account (HSA) tax deduction that allows a pool of money to grow tax free for use in health care. Similar to the cafeteria/flex plans many employers use now, but able to "rollover" year to year. When the average person is healthy - in their 20's, this account will build as it's not used much so that, when you're 50-ish, and more prone to chronic problems, you have a relatively big account to pay for care.
B. - Make a catastrophic plan tax deductible as well.
3. Catastrophic Insurance. - Covers only big expenses. Your car insurance doesn't pay for gas and tune-ups, and neither should health INSURANCE. Today's Health Insurance isn't insurance at all; it's pre-paid health care. Make it Insurance: 5k/yr deductible (conveniently the size of your HSA) - when your HSA is depleted, catastrophic coverage kicks in. But. Not before.
4. Gov't pro-rated coverage for anybody in the gap - make it a % of income so that, at about 50k for a family of four, it becomes cheaper to get your own, using the methods above.
That gov't asst would extend to the chronically ill. For example: It's cheaper for society to ensure that a diabetic has access to the right primary care than it is to treat them for non-compliance.
~~~
Right now, Geico, State Farm, Farmer's, All State - they all market heavily to YOU for their business. Why is that? They must compete TO you for YOUR dollars. Why doesn't Blue Cross have a gecko hawking health care to you? You don't count; your employer provides your insurance and YOU have no say. THAT could change.
Give people control over their own dollars and watch health care change. With most routine care being paid "out of pocket", there will be competition for those dollars. "Come to OUR ER, and any CT scans will be free!" LOL.
There are better methods than gov't run care. There are even better methods to universality than gov't run care. Gov't run care isn't about being fair - or universal. It's about lobbyists having more of a say in what kind of care you get than YOU do. Money is power and gov't restricted care is about a few in gov't having access to the power that is 1/7th of the economy. AND. NOT. YOU.
~faith,
Timothy.
| | No. 16 |
Jan 31, 2009, 01:19 PM
Re: A universal single-payer, not-for-profit healthcare system could help lift tens o Originally Posted by HM2Viking Duke University Hospital has more billing clerks than nurses[/url]!
And I will wager a bet that at least half of those billing clerks are needed to obtain payment from government health care programs.
| | No. 17 |
Jan 31, 2009, 01:26 PM
Re: A universal single-payer, not-for-profit healthcare system could help lift tens o Originally Posted by Jolie And I will wager a bet that at least half of those billing clerks are needed to obtain payment from government health care programs.
Don't even get me started on that aspect for our little rural hospital . . . . . . 
I'm with Tim and Jolie and even Heron in some aspects. " Having worked in the public sector I can tell you that efficiency, cost controls and ethics are no better than in the private."
I do not understand WHY people think the government is the panacea, (the Goddess of Healing).
steph
| | No. 18 |
Jan 31, 2009, 03:08 PM
Re: A universal single-payer, not-for-profit healthcare system could help lift tens o Originally Posted by Spidey's mom I do not understand WHY people think the government is the panacea, (the Goddess of Healing).
steph
I'll just quote you but it also addresses Timothy's and Heron's concerns that we're asking the government to take over health care. What some of us are saying is not turning the entire health care system into a system of government run hospitals and clinics, but keep it private. Just have a fair and equal funding source that embraces all of our citizens. Medicare and medicaide make billions of dollars in payments to private hospitals, clinics, and nursing homes throughout the country here and now. Is it such a stretch of the imagination that when all people are covered this can't continue, or is suddenly all capitalist health care going to collapse? I actually see more growth in the industry, this at a time of rising unemployment and other economic concerns, and it might actually be not be doomstay to have all people covered.
| | No. 19 |
Jan 31, 2009, 03:10 PM
Re: A universal single-payer, not-for-profit healthcare system could help lift tens o Originally Posted by Jolie And I will wager a bet that at least half of those billing clerks are needed to obtain payment from government health care programs.
True. But government programs are pretty cut and dry with their criteria, you either meet the criteria to get paid or you don't. In some ways I appreciate it because it's not a free for all with our money. I appreciate they are pretty tightfisted. Unfortunately in these days and times they are pretty low paying in the reimbursement.
Insurance companies do the same thing to the billing clerks. "The person's IV rate was only 100 cc/hr and we only pay if they are at 125 cc/hr....DENIED PAYMENT".
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