Fixing Healthcare - Page 3

daThomas · 09/13/2009, 08:15 PM

Quote:

Originally Posted by Technologic 2

I learned about this at a Town Hall meeting by one of the sponsors of the bill. It has some very good features (everyone should check it out) One thing I have not had anyone explain is; if insurance companies have to cover pre-existing conditions, what stops someone from buying the insurance when they get sick and drop it when they get better.

Exactly why it has to be mandatory. And if it's mandatory, there needs to be a non-profit option.

Technologic 2 · 09/13/2009, 08:26 PM

Quote:

Originally Posted by daThomas

So does medicare and so would a publicly run option and they would both do it for nearly 1/10 the costs.

Are you confusing INSURANCE with MEDICAL CARE again?

Medicare can acquire medical care cheaper than medical care paid by insurance companies because Medicare tells the doctors how much they can charge and the doctor is not allowed to bill over that amount. Doctors make up for this by increasing the cost to those of us with insurance. If we were all on a government plan that limited how much a doctor could make we would have fewer doctors and lower standards to try and get more doctors.

When has the government EVER done ANYTHING for 1/10 the cost of the private sector?

1thing2add · 09/13/2009, 08:31 PM

Quote:

Originally Posted by Technologic 2

researchers

Research which is for the advancement of healthcare is primarily funded through NIH, yet another socialist enterprise this country (actually, the planet) cannot do without.

You'll want to make sure you refuse your Swine Flu vaccine since it is being researched by their funding and administration. That also goes for your standard Flu shot as well. Can't be too careful. Who knows? Maybe you turn into a pinko if you get it!

1thing2add · 09/13/2009, 08:37 PM

Quote:

Originally Posted by Technologic 2

Are you confusing INSURANCE with MEDICAL CARE again?

Medicare can acquire medical care cheaper than medical care paid by insurance companies because Medicare tells the doctors how much they can charge and the doctor is not allowed to bill over that amount. Doctors make up for this by increasing the cost to those of us with insurance. If we were all on a government plan that limited how much a doctor could make we would have fewer doctors and lower standards to try and get more doctors.

You think private insurance operates any differently than Medicare? Every insurance plan reimburses a set dollar amount based upon the service rendered or test performed, all encoded in a standardized form that every practice operates under. Where do people come up with this stuff??

Technologic 2 · 09/13/2009, 08:38 PM

Quote:

Originally Posted by daThomas

Exactly why it has to be mandatory. And if it's mandatory, there needs to be a non-profit option.

We have mandatory auto insurance. Guess what 40% of drivers in New Orleans have no auto insurance! They buy it, renew their license and inspection stickers, then drop it.

Do we REALLY want the IRS dictating what we must spend our money on? Should overweight people be forced to lose weight because they are costing us too much? Should we force them to buy healthy food? Where does it stop?

Non-profit? Are you talking about doctors? Hospitals?

Toby · 09/13/2009, 08:42 PM

Quote:

Originally Posted by clemgrad85

[...] Why would palandri want this???? [...]

He's already said it. No risk. When somebody else takes care of all the planning for you, and all you have to do is show up and do some manual labor and collect your authorized salary, you don't have to really take any risks.

Technologic 2 · 09/13/2009, 08:46 PM

Quote:

Originally Posted by 1thing2add

You think private insurance operates any differently than Medicare? Every insurance plan reimburses a set dollar amount based upon the service rendered or test performed, all encoded in a standardized form that every practice operates under. Where do people come up with this stuff??

Yes they do, and I hate that because the doctor still charges his full price. I just have to pay that difference myself. My doctor used to charge $75 for a checkup. Then the government told insurance companies they must cover checkups and allow $50 for that checkup. Now my insurance company covers the $50 and my doctor charges $125. Guess what, I still pay $75. I want a policy that DOES NOT cover checkups. Let me pay that myself, I can shop cost if I want.

What I am saying is that if doctors can't charge their cost we will start losing doctors. With Medicare they CAN'T charge more, with insurance they DO charge more than the allowed charge. We just have to pay that difference.

1thing2add · 09/13/2009, 08:50 PM

Quote:

Originally Posted by Technologic 2

Yes they do, and I hate that because the doctor still charges his full price. I just have to pay that difference myself. My doctor used to charge $75 for a checkup. Then the government told insurance companies they must cover checkups and allow $50 for that checkup. Now my insurance company covers the $50 and my doctor charges $125. Guess what, I still pay $75. I want a policy that DOES NOT cover checkups. Let me pay that myself, I can shop cost if I want.

What I am saying is that if doctors can't charge their cost we will start losing doctors. With Medicare they CAN'T charge more, with insurance they DO charge more than the allowed charge. We just have to pay that difference.

And under reform, you only get more choices through more competition, driving costs downward at the same time.

daThomas · 09/13/2009, 08:51 PM

Quote:

Originally Posted by Technologic 2

We have mandatory auto insurance. Guess what 40% of drivers in New Orleans have no auto insurance! They buy it, renew their license and inspection stickers, then drop it.

Do we REALLY want the IRS dictating what we must spend our money on? Should overweight people be forced to lose weight because they are costing us too much? Should we force them to buy healthy food? Where does it stop?

Non-profit? Are you talking about doctors? Hospitals?

No I'm talking about a non-profit insurer.

Want your mandatory auto liability insurance issue solved in LA? Simple, put it in a gas tax, correlates directly to the time on the road thus the chance of an accident and you have to pay into it to make car go.

But that's more of that intrusive gov't again and it takes money away from the precious private insurance companies. To heck with efficiency and covering everyone.

Technologic 2 · 09/13/2009, 08:59 PM

Quote:

Originally Posted by daThomas

No I'm talking about a non-profit insurer.

How does that work? Who would put up the capital without a chance at profit?

Quote:

Want your mandatory liability insurance issue solved in LA? Simple, put it in a gas tax, correlates directly to the time on the road thus the chance of an accident and you have to pay into it to make car go.

I would not have a problem with this. It is a good idea, because if you decide not to have insurance and run into me, I am the one hurt. I would have a problem with mandatory Comprehensive coverage. If I don't have comprehensive/collision and I get in a wreck it was my choice not to have this coverage and the only one hurt is me.

Toby · 09/13/2009, 09:12 PM

Quote:

Originally Posted by Technologic 2

How does that work? Who would put up the capital without a chance at profit?

Insurance companies where the covered participants are shareholders in the corporation. For example, State Farm at one time used to write a dividend or refund check to participants when the premiums taken in exceeded covered losses paid out. Granted that's not health insurance, but there are also fully funded group plans where the 'insurance company' is more of a provider network/claims processor. They charge premiums based on historical patterns, take a percentage to cover their administrative costs, and any excess remains in the pool and either covers future costs or lowers premiums for the next plan year.

davidra · 09/13/2009, 09:12 PM

Quote:

Originally Posted by Technologic 2

I've gone to both my Senators Townhall Meetings, (D) and (R) and my Congressman's townhall. I've listened to people from both sides express their opinions.

I feel the following is a good solution. Although long, it's a lot shorter than the House Bill (which I have also read most of)

Here goes...let me know your opinions...if you like it forward it to your Representatives!
...........................................

PROBLEM: Right now when someone shows up at an emergency room, we have to treat them. Emergency room treatment is very expensive.
SOLUTION: Have health clinics associated with the hospital. When someone shows up in the emergency room, triage them according to emergency needs. This would lower the cost of treating non-emergency conditions. It would lower cost to insurance companies for people with insurance and the government for people without insurance. This could help lower health insurance premiums.

PROBLEM: Portability of Policies

SOLUTION: No Group Health Insurance. Rates should be the same for individuals regardless of who they work for. Allow insurance to be shopped nationwide and on the internet. Policies should be guaranteed renewable, so you don’t lose your coverage if you change jobs or become ill. Insurance Companies could offer a variety of benefits, so you only pay for what you choose. There should be a standard for comparing policies to make them easy to understand. Employers who want to offer health insurance could put premiums in a tax-deductible flexible spending account.

PROBLEM: PRE-EXISTING CONDITIONS – If pre-existing conditions are covered unconditionally, no one would buy insurance until something happens to them. If you think mandatory insurance works, check out how many people don't have auto insurance where it is mandatory.

SOLUTION: Insurance companies would cover pre-existing conditions after a two year waiting period. There could be a High Risk Pool to help people that insurance companies won’t accept. This would work the same as States High Risk Pools for auto insurance or homeowners insurance. High Risk premiums would be higher, so people would have incentive to buy regular polices before they need it.

PROBLEM: UNAFFORDABLE PREMIUMS

SOLUTION: Premiums could be tax-deductible. The loss of tax revenue would be offset by the cost of paying for uninsured. For low income individuals the credit would work the same as the current unearned income credit.

OTHER PROBLEMS NEEDING ATTENTION
Tort reform – Doctors and Hospitals perform many unneeded test out of extreme caution to avoid lawsuits

Supply and Demand – Universities limit the number of students admitted to medical school to keep the number of doctors down. Fewer doctors  Higher Prices

Cost shifting – Doctors should not be able to charge you more if you have health insurance then if you are on Medicare or paying cash. This is raising the cost of health insurance premiums.

Man, I just can't imagine it's worth getting involved in another thread about this, but when I see someone who's entire knowledge base comes from Town Hall meetings it makes me cringe. I have a better idea. Do away with insurance companies. Wouldn't that be easier?

Many ERs have triage systems that get patients out of the ER, but there is a requirement that patients that come to an ER must be seen. They cannot be turned away. Tinkering with that is dangerous, especially concerning profit motive of private hospitals. Economic assessments of the money saved by having triage doctors and PA's in the ER has not shown any financial improvement over the current system.

Your "plan" will leave many people uninsured for their problems. Does the fact that someone may go bankrupt in two years waiting for their insurance to kick in make a difference to you?

Tort reform is very unlikely to make any significant difference in costs. I think it's fine to implement it, only because republicans seem convinced it's the key to changing MD behavior. I'm pretty convinced it isn't, but I really don't care if they include it.

Do you have a clue as what's involved in training medical students? The costs? The debt of the students? You really think medical schools are trying to limit the number of students they have because they want to keep prices high? That I can answer clearly, and with considerable knowledge. You are 100% wrong. It costs between $55K and $70K to train each doctor. There are no schools that charge that much tuition. As it is, many medical students graduate with $100K to 200K of debt. There is only a physician shortage of some kinds of physicians; there are excesses of others. The problems are career choices and maldistribution, which are based on things like reimbursement incongruities.

There are tons of people that think they have a great plan in mind. Most of them are simplistic and uninformed. These problems do not lend themselves to solutions by people who are unaware, for instance, that Medicare is a health care program for the disabled and people over the age of 65. I keep being called arrogant for my attitude....but that's the way I see it.

Toby · 09/13/2009, 09:17 PM

Quote:

Originally Posted by davidra

Man, I just can't imagine it's worth getting involved in another thread about this, but when I see someone who's entire knowledge base comes from Town Hall meetings it makes me cringe. I have a better idea. Do away with insurance companies. Wouldn't that be easier?

So, Doc... What is your opinion of the Healthy Americans Act?

clemgrad85 · 09/13/2009, 09:19 PM

Quote:

Originally Posted by davidra

Man, I just can't imagine it's worth getting involved in another thread about this, but when I see someone who's entire knowledge base comes from Town Hall meetings it makes me cringe. I have a better idea. Do away with insurance companies. Wouldn't that be easier?

Many ERs have triage systems that get patients out of the ER, but there is a requirement that patients that come to an ER must be seen. They cannot be turned away. Tinkering with that is dangerous, especially concerning profit motive of private hospitals. Economic assessments of the money saved by having triage doctors and PA's in the ER has not shown any financial improvement over the current system.

Your "plan" will leave many people uninsured for their problems. Does the fact that someone may go bankrupt in two years waiting for their insurance to kick in make a difference to you?

Tort reform is very unlikely to make any significant difference in costs. I think it's fine to implement it, only because republicans seem convinced it's the key to changing MD behavior. I'm pretty convinced it isn't, but I really don't care if they include it.

Do you have a clue as what's involved in training medical students? The costs? The debt of the students? You really think medical schools are trying to limit the number of students they have because they want to keep prices high? That I can answer clearly, and with considerable knowledge. You are 100% wrong. It costs between $55K and $70K to train each doctor. There are no schools that charge that much tuition. As it is, many medical students graduate with $100K to 200K of debt. There is only a physician shortage of some kinds of physicians; there are excesses of others. The problems are career choices and maldistribution, which are based on things like reimbursement incongruities.

There are tons of people that think they have a great plan in mind. Most of them are simplistic and uninformed. These problems do not lend themselves to solutions by people who are unaware, for instance, that Medicare is a health care program for the disabled and people over the age of 65. I keep being called arrogant for my attitude....but that's the way I see it.

Techno....you got to realize the doc knows everything about everything

He is working directly with Obama on this whole mess and we just need to trust him. Funny, he gets mad at me when I accuse doctors of ripping off patients, and yet Obama has made it clear what he thinks about doctors....performing unneeded tonsilectomies, cutting off the feet of diabetics for no apparent reason...yes, these are some of the things Obama has accused doctors of doing. Anyway, doc has it under control and we should simply consider ourselves lucky to have found him in here

You da man doc!

daThomas · 09/13/2009, 09:20 PM

Quote:

Originally Posted by Technologic 2

How does that work? Who would put up the capital without a chance at profit?

That is the so called "public option".

Technologic 2 · 09/13/2009, 09:38 PM

Quote:

Originally Posted by davidra

when I see someone who's entire knowledge base comes from Town Hall meetings it makes me cringe.... I keep being called arrogant for my attitude...

Gee, I wonder why? Actually all the Town Hall meetings did was open my eyes to other ideas that others had.

Quote:

Many ERs have triage systems that get patients out of the ER, but there is a requirement that patients that come to an ER must be seen. They cannot be turned away.

Nor should they

Quote:

Your "plan" will leave many people uninsured for their problems. Does the fact that someone may go bankrupt in two years waiting for their insurance to kick in make a difference to you?

Read it again, my plan would create a high risk pool, where these people would be able to get insurance. They would just have to pay a higher premium (which could possibly be subsidized with tax credits similar to the earned income credit)

A friend of mine has been a doctor about 10 years and I think it is ridiculous that through all that work and cost of education by time you deduct their expenses they really don't make that much money.

Quote:

There are tons of people that think they have a great plan in mind. Most of them are simplistic and uninformed. These problems do not lend themselves to solutions by people who are unaware,

When I started this thread, it wasn't to solve the world's problems. It was to start a discussion that wasn't argumentative. Just SOME ideas on how to improve the system and to encourage people to let their representatives know.

KAM1138 · 09/14/2009, 12:33 AM

Quote:

Originally Posted by Technologic 2

and does anyone think my original plan would or wouldn't work? That is, if we can get pass the politics.

I'm not sure if your plans would work or not, but I like your approach. Look at individual problems and think of ideas to address them. They won't all work, they won't automatically be best, but its good to consider them freely.

KAM

KAM1138 · 09/14/2009, 12:39 AM

Quote:

Originally Posted by daThomas

Hospitals already try to do this. They're still passing those costs on to insured patients. So individuals and businesses are still paying for the uninsured and insurance companies sit in the middle siphoning off their huge profits and bringing nothing to health care.

I read a story the other day that said that Insurance companies make an average of 2.2% profit--meaning 2.2 cents on every dollar. That is not anywhere near the top of US companies in terms of profit margin.

Do you have some other number that you think is more valid? If not, then do you agree that 2.2% is "huge".

You've again stated that insurance companies bring nothing to healthcare. Why does anyone use them then? Why would anyone choose to spend their money on something that "brings nothing"--which I understand to mean has no benefit to the consumer.

I asked you in the other thread (I don't believe you answered) a very similar question. I'll ask it a bit differently--why are people paying for nothing? If they are, and you are correct, then shouldn't it be a simple matter to convince them of this. Shouldn't this be easily proven?

KAM

KAM1138 · 09/14/2009, 12:43 AM

Quote:

Originally Posted by clemgrad85

I don't get this arguement....to me....socialism is the transfer of wealth. I don't think paving roads and such is a transfer of wealth. Oh sure, the money is paid to people for these services, but they are working for it. I just don't follow this logic.

Besides, many of these services that are always used as examples of socialism are handled by the states via Amendment 10 of the Constitution.

Anyone who thinks that roads are "socialist" is beyond ignorant. Government spending is not inherently socialistic. It's either a deliberate attempt to present a false idea or the result of gross ignorance.

KAM

windzilla · 09/14/2009, 01:03 AM

I'm not going to get wrapped up in any online healthcare discussions right now, but just wanted to applaud the op (as kam has done) for trying to look at issues and then propose solutions. They may not be viable solutions, but at least they are more fruitful for creating productive discourse than the political blustering blathered about by cardboard liberals/conservatives alike.