What ONE thing is most important in a new health care system?

country mom · Jul 6, 2009

Myself, I believe keeping insurance as an employer-based benefit really limits people in going into business on their own, hiring new employees and keeps people from going into new jobs. I think it's part of the economic collapse that we've seen. People are afraid to go into business for themselves or to hire employees because they cannot afford to insure their health. It's also a major factor in businesses taking their manufacturing overseas.

elkpark · Jul 6, 2009

Myself, I believe keeping insurance as an employer-based benefit really limits people in going into business on their own, hiring new employees and keeps people from going into new jobs. I think it's part of the economic collapse that we've seen. People are afraid to go into business for themselves or to hire employees because they cannot afford to insure their health. It's also a major factor in businesses taking their manufacturing overseas.

I agree one of the best things we could do is break the current link between employment and health insurance. It made sense when it was first initiated, under the conditions that existed at that particular point in time, but, for a long time, it has just handicapped individuals and employers/businesses.

canigraduate · Jul 6, 2009

I think the most important thing would be to make healthcare affordable, however it can be done. I'm all for practical solutions. Right now, I want to pay for health care but I just can't afford to keep paying at current levels.

To illustrate:

I am a healthy 32 year old woman with no medical conditions (other than being female) who does not plan to have children, yet I am paying out the nose for insurance. I can't get it from my employer without a pregnancy rider and I can't afford to get private insurance, which would cost me more even without the pregnancy rider.

Also, I had to go the emergency room for a wisdom tooth that went bad. I wouldn't have gone to the ER except it was at night, the pain was incredibly bad, and the left side of my face was swelling. My insurance was supposed to cover the visit with a $150 co-pay. I ended up paying the hospital nearly $400 on top of the co-pay, and almost $400 to another company that paid the doctor (who saw me for a grand total of 3.5 minutes). Over $900 for a prescription for oxycodone and a referral to a dentist. Not worth it!!!! :angryfire(BTW - I am not a pain pill freak - I only used them until the tooth was extracted and got rid of the rest.)

Hopefully, there will be an analysis done to find out where these ridiculous charges come from and reform that will bring them down to a range where I can afford to pay for them. The problem, as I see it, is not who pays what, but how *******' much!!!

MedSurgeMess · Jul 6, 2009

Everyone has excellent suggestions and I think that a single payer system that is a private entity that sends bids to the govt for providing the service, just like other services that the govt provides that they don't directly run. The govt should gather a list of "basic services" with some possible extras, maybe, and send out a list of what it would cost the govt--to bid they would have to respond with a payment of each service, and a grand total, so the govt would know what the charges would be each year.

Who should put together a list? Providers: nurses, docs, PTs, OTs, STs, RTs, lab persons, etc. The actual people who provide the services. After that list refined, then administrators from insurances, hospital boards etc, can weigh in to add, or even make alternative suggestions.

This may be a fairyland dream, and realistically would take a lot of time to initiate, but it would be nice.

And employers could always have insurance benefits for things that aren't covered if they wanted to have that as part of an incentive. If not, they could save tons of money and actually employ people that would pay taxes that would fund our system. I know what my DH and I each pay in a year has got to be more than what we would be taxed for healthcare.....sorry for the rambling

lamazeteacher · Jul 6, 2009

Allow only legitimate litigation against institutions/providers.

Actually that is how it's done, now. There's a hearing to see if the claim by a plaintiff is valid, before any case goes to trial. The Judge decides that, and only iof he/she approves that actual damage to the plaintiff has occurred, does it go ahead. The damages can be any or all of psychological, physical and financial states that is/are worse than the original one. Hurt feelings don't count, unless suicide is attempted. If the family sues over premature death due to mistreatment, then the defense will go after records of previous psychiatric conditions/hx of such behavior previously.

The problem is the amount of money plaintiffs recover upon winning their case. Juries have gone all out, due to the "it could have been me" thinking that lawyers elicit in their arguments. Hospitals and corporations just don't have that appeal. The winning "purse" isn't from the defendant, but from their insurance companies, so the punishment for damage done hasn't the sting it was intended to have (other than the $1,000,000 ++++ premium/year the insurance costs, the most expensive premiums are for OBs, anaesthesiologists and surgeons). Does the affordableness of that give you a clue regarding hospital and doctor profits, that makes that fee affordable. Of course it's a "business expense" that is partially or all tax deductable, but you have to pay it, before you can deduct it........ :uhoh3:

lamazeteacher · Jul 6, 2009

Medsurgemess: Your post shows that you've put a lot of thought into the betterment of our health care system. What I don't get, is why you think that a middleperson/agency is needed (at extra expense) to submit bids, when the single payer (the government - in your example) will approve, or disapprove it anyway......

What has actually been planned by a large body of doctors, is a group of medical professionals of backgrounds matching the service providers, who will publish guidelines for physicians, hospitals, labs, OT, PT, pharmacy, etc. They'll also follow trends of care, and when they see something out of line of current acceptable care, dispute that.

That will not be what government has done with Medicare, Medicaid, etc. to date, as they contract with profit making insurers (mainly BCBS/Wellpoint/Anthem - all the same company, and yes, it is a monopoly, which is illegal) for that, at great expense to taxpayers. However, since political opposition to that plan is quite voluble (to wit the use of TV commercials against any government involvement in the delivery of health care), the use of (possibly corrupt) but more intensely government monitored insurance companies that exist now, might continue to be used.

I believe that will put us right back where we began, after consuming a lot of taxpayer monies in the process. It would be better to do a complete overhaul with regulators, guidelines, etc. Standardization is not necessarily a bad thing. Where I've been the past 2 years, practically all the doctors hale from the same med school, and residency programs in the state of VA.

They are extremely opposed to government involvement in their domain, even refusing to see any Medicare patients (who hadn't already been their patients before) 6 years ago. Only recently have those doctors accepted patients on Medicare, but I've experienced that they greatly restrict the time (and effort) they provide for their appointments with me severely.

I've also not been treated for extremely aberant lab results for weeks. Over last Christmas, my anemia wasn't discovered for 2 weeks (Hgb 9.4), which indicated that I was having a GI bleed, again. The last goof was hypokalemia, discovered in April while I was hospitalized for a GI hemorrhage, and only now a "critical" value was brought to my attention by a new doctor of whom I requested blood tests, to assure that I could drive safely across the country to the west coast. The etiology of both conditions hasn't been found due to negligence when the nuclear bleeding scan wasn't done while I was bleeding! So they say, "It could be your medications".

I really believe that with enhanced use of technology and consultation with professionals at universities and teaching hoispitals, better health care will be provided. Universal health care provides that.