Health Care In America: How Do We Fix It?

brucelewis.com ^ | 2008.05.29 | Bruce Lewis

[CottonBall]

Bring back traditional indemnity plans, and get them away from the employer provided concept where premium costs are hidden. Allow people to band together to form small groups to purchase insurance. Make ALL health care related spending a TAX CREDIT. Provide incentives to faith communities to help the indigent. Establish means testing for Medicare eligibility, and create means-tested free clinics in low income communities.

I agree with all except the means-testing for Medicare. If all are forced to pay into it their entire lives, it should be given to all. This sounds too close to what the Dems will try to do: means testing for SS.

[DManA]

It might not be fair, but it is simply a fact of life. There isn’t enough money in the country to pay for everyone’s SS and Medicare.

[Leisler]

He was and is describe as personally being a bitter, mean spirited little man. Decades long columnist, Robert Novak said that in almost fifty years of covering Washington politics, Carter was the most lying(est) person he ever met, which is saying a lot.

[socialismisinsidious]

Time and sweat are worth something. Germany many have more doctors per capita it's the quality that I'm worried about. The best and brightest wouldn't be the brightest if they didn't think about making a living long term. And no thanks on the loan forgiveness. I don't want to pay for my neighbor's health care so I sure don't want to pay for his education. I don't want to pay more than I already do, via higher taxes, for someone else to get an education.

How about this: you pay for your education and the market decides what you can make when you get done. Brain surgeons are going to and SHOULD make more than a store clerk or school teacher. Get government and 3rd party payers out of it. Have insurance for catastrophic and personal responsibility for the rest. Government messed up the system in the first place (info that is glaringly missing from this article) why turn to them to "fix" it?!

[ccmay]

2. how can illegals affect the stats of legals?

The statistics are not broken down by nationality, only by residency (legal or illegal.)

3. Europeans take lots of drugs too.

Not nearly so much, in general, although a few European countries may beat us in selected categories of drug abuse. Even Holland, where marijuana is legal and hard drugs are mostly ignored, has lower rates of drug abuse than the US.

4. interesting. I never heard that one.

Here's more: Infant Mortality Myths.

-ccm

[CottonBall]

It might not be fair, but it is simply a fact of life. There isn’t enough money in the country to pay for everyone’s SS and Medicare.

But means-testing is not the way to go. That's the liberal ploy of punishing those that managed to save some money vs those that spent it all. IF there is going to be a means test, it should be based on income earned over a lifetime. Those that were irresponsible should suffer the consequences. Punishing success and rewarding stupidity is the liberal way.

[Einigkeit_Recht_Freiheit]

Funny. I always thought he was “nice” guy. A fool who is hell-bent of ruining is country and his legacy, but in a “nice” kind of way. I though my opinion of Jimmah could not get any lower. Surprise, surprise.

[Lancey Howard]

Therefore, to stay on a "going concern" basis, each civilization must implement some way of forcing those with the means to pay for health care services to cover the costs of those without those means.

Horse manure.

[Leisler]

Carter, and the family were often described as peanut farmers. Kind of gives them earthy, farm type halo.

The real story. Back in the Depression in the 1930’s a bunch of laws were passed to protect farmer incomes. Naturally this raised food prices in a time of labor income depression, so yet another set of laws were needed to raise more taxes to subsidize urban food prices from the raised costs of food. So in a typical lefty way it was a three-fer of bad laws.

Anyways, one of them was that it was A. Illegal to import peanuts. B. You could not grow or sell them as a grower without a federal permit.

These laws are still on the books and the Carters have had a federal permit since the 1930’s. It's a license to print money and thus even a idiots like the Carters could not go broke. In a way the family has been on welfare since the 1930s.

[PoliticsAndSausages]

That’s an ugly story. I have a hard time believing that you are not allowed to simply buy services in the Netherlands...but I am German and don’t know the NL system that well. When did the story with your friend’s mother happen?

[PoliticsAndSausages]

A lot of the points you adress are actually answered in the opening post. And here's my argument: One of the main reasons for health care is that most governments, also that of the US, will not leave people to die in the street. They will offer an emergency service. But it is pretty easy to calculate that if you only offer help in the direst of circumstances, people who can not pay will all come in these circumstances, and treating them wll be much, much more expensive.

Also, the market will decide what you can earn. How do you think that is not the case in Germany?

[AndyJackson]

The US spends more of GDP than any country (16%..)

This is 1 in 7 dollars in GDP. Whatever the solution, it isn't more money because there isn't any more.

[socialismisinsidious]

It sounds as if Germany has socialized the insurance industry....health insurance is not health care. As you have said everyone will become someone in the direst of circumstances and will "need" government insurance (what % of Germans actually buy private insurance?) The end result for the US is the same...high cost,via taxes, for small number of people and "fair" care for all.

The only way the market can decide what a worker (this case = doctor) can make is if the worker is paid directly (not by a third party of insurance or government) by the consumer. Is that the case in Germany?

[PoliticsAndSausages]

Around 10% of Germans buy private insurance, due to faster treatment and more options covered. The Government does only set the socialized health care rates and a base list of services, which still produces some competition between the providers.

It is far more expensive to treat someone as soon as he needs stationary treatment. Prevention is usually cheaper.

Yes, the market can not decide exclusively, but he can still decide. And how does it matter who pays, as long as the doctor can set the price himself (and government/insurances just won't pay it)?

[socialismisinsidious]

And how does it matter who pays, as long as the doctor can set the price himself (and government/insurances just won't pay it)?

It actually matters a lot here in the US b/c the doctor sets the prices knowing he won't get paid what he asks so he/she sets the prices high and then begins negotiations with insurers who tell him what he will be paid....the government doesn't negotiate. It becomes a problem b/c it is insurance fraud to charge insurance one price and an individual another. For example: Let's say a doctor charges $15 to do a procedure hoping that insurance will give him his true costs of $10 and knowing Medicare/Medicaid will only give $8. He charges more than the procedure costs b/c he is playing a game, he knows if he really charges the true costs of $10 then insurance will negotiate to pay him $7 so he charges a high cost of $15. Then patient Joe comes into the office and wants to pay out of pocket. The doctor is not allowed, by law, to charge Joe the true cost of $10! He has to charge the same that he charges insurance (Hillary Clinton was instrumental in getting that law passed). He has to charge the patient the inflated cost of $15, so you see the costs of health care go up b/c the doctor plays money games with insurance in order to get paid and b/c the individual does not feel the sting unless they are paying out of pocket. Also health insurance here in the US is paid for by employers so the individual does NOT feel the costs directly and often believes (wrongly) that he/she doesn't to pay for health insurance.

10% is what I've read too. That's not very high. So most Germans are covered under Socialized Medicine...they may have the "choice" to pay for their own health insurance but they choose to have someone else do it instead. Socialism is insidious. I hate socialism b/c I am the one who ends up paying and most importantly I like my freedom. Being allowed by government to buy private insurance is not what I consider freedom. Being forced to pay for 90% of my countryman's health insurance via high taxes is not what I consider freedom either.

[Ditter]

My Dutch friends mother died at least 10 years ago. The system may have changed since then. I certainly hope so.

[PoliticsAndSausages]

The way you describe the American health system, I'm getting the impression that the problem rather lies with the fact that relations between insurances and doctors are not regulated enough :) yes I know, that view will be insanely popular with you.

I actually like socialized medicine out of a number of reasons. The one that you might accept are the favourable economies of scale. I admit that I barely know anything about the US health care system, but it seems to me that the main profiteer from upholding the status quo are the insurance companies, and also that a lot of the problems the US health market has to deal with are related to the intransparencies on the health insurance market.

Another argument for a more socialized system (or at least a base tarif or something) are the problems with asymmetric information and adverse selection. As long as insurers will systematically filter out those people with a high risk of illness by demanding insanely high rates, these people will mostly not be able to afford insurance. Ignoring the samaritan view it may still be said that these people with tendency to chronic or genetic illnesses will without help often develop very expensive problems which will then periodically be fought at emergency hospitals (which will normally be more expensive than constant treatment and prevention running on a lower scale, with prescribed medication or therapy for example) and they will possibly also become unable to work, drawing yet more money from your taxes.

[WheresMyBailout]

This sounds pretty similar to RomneyCare, which of all of the universal health care systems, I would like the best. In fact, Mitt Romney is the only American official to have sucessfully implemented universal health care in the United States. I wonder when Michael Moore will do a documentary on that.

[Chickensoup]

I understand that the Swiss model of healthcare is responsible, and comprehensive. Everyone buys insurance and the monies are split by the insurers according to the weights of the cases of the insurers.

It is transparent to the user

[B-Chan]

Thanks for replying to such an old post. In the current economic and political climate, the whole question seems rather quaint now.

I myself have no health insurance and no prospect of ever having any. (Few professional writers have health insurance!) Even if I could afford $1200 per month in premiums for a basic private policy, no insurance company will accept me; I’m 43, fat, and a diagnosed depressive (depression = pre-existing condition = no way). Thank God I’m in fine health — my blood pressure, blood sugar, cholesterol levels, and so forth are all at healthy levels, I rarely catch colds or other diseases, and I’m too old and doughy to skydive or play hockey.

I pay cash for care. Happily, I have a doctor who is liberal with pharmaceutical samples and who offers steep discounts in exchange for cash payment at the time of service. If not for him, I would have no drugs to control my asthma and mood disorder. His generosity with the samples he receives means my asthma and depression are fully controlled — but I’d be in deep, deep trouble without him. I could probably scrape up enough for a bottle of generic Paxil every month, but my asthma inhaler (that lasts one month) costs over $300 without an RX card!

Should an accident or catastrophic illness occur, however, I’m boned. The county hospital ER would be my only health care option.

I suppose the Ayn Rand fans would argue that if I can’t afford medical care I should just go off somewhere and die. I doubt my 2-year-old son would agree, however.

And when I get old? I must admit, the prospects of having a comfortable final decade are looking pretty dim. If current trends continue, by the time I’m too old to clean myself they’ll probably have drop-off euthanasia centers for useless eaters like me.

Although I don’t know much about the Swiss system, I know a former Swiss citizen who had nothing but good to say about it. She and her family plan on moving back to CH at some point in the future, which (I assume) she wouldn’t be doing if the health care delivery system in Switzerland wasn’t up to scratch.

For the record, I think the French system is probably the one that works best.