Posted on 10/17/2007 10:34:27 PM PDT by Lorianne
I would differ with you. Business is notably hard hearted when it comes to the bottom line. Your solution would simply deny care to millions who cannot afford it, while profits would continue to rise (because they can).
What I would propose is to allow (in fact encourage)churches to get back into the health care business as it was prior to the '70s when they were taxed out of the game. That is the nexus point for the astronomical cost increases in both insurance and health.
The problem in the US is not “lack of health insurance”, but lack of health. Lack of health is not due to lack of insurance but due to inattention to everything related to one’s health like weight control, diet, exercise, safe lifestyle and even goes to where one lives.
So how does the gubmint legislate health? Let’s say it’s the law that one has to “be healthy” - so it is mandated that everyone have two checkups per year. Everybody in the entire US goes to a doctor twice per year. The doctor tells them to stop doing all the unhealthy stuff the do now. REALLY now, what percentage will actually do so based on their being told by a doctor?
To those who are healthy why do they have to have insurance? I don’t insure my car for full coverage because it is a 1993 Volvo - if it wrecks I either pay to fix it or junk it. I save about 200 bucks per year on car insurance. Similarly with health insurance - if I don’t have it and say I break my arm I pay out of pocket. How much is a broken arm say 2000 bucks? My group plan costs me about 300 per month for a reasonable health policy with a 500 deductible. SO my out of pocket per year is 4100 bucks - if I pay for my broken arm I actually saved 2100 dollars!
Before the gubmint jumps into this they should try an experiement in a state with a smaller population - say we pick North Dakota and pay for two checkups every year for every person and track their health costs for a couple years whether they have insurance or not - and see what shakes out. I would bet that nothing changes - a very small percentage will change their lifestyle but they would anyway. The majority will take what is free and ignore the advice.
We have to stop equating health with health insurance. We should also put more doctors all over the place, more nurse practitioners, flood the market. Then let the doctors advertise their fee structures just like we have let all the personal injury lawyers! Right now there is no competition in the health care market - an MRI costs 1800 bucks? I don’t want to buy the machine, just rent it for about 20 minutes. Yes it is costly to buy (couple million), but at 18000 PER DAY in fees that gets paid for pretty fast.
How about that medicine too - I take Zomig for migraines - 20 bucks PER PILL! Tell me we can’t regulate that - we regulate milk prices, gas prices, fuel prices, but our gubmint can’t regulate drug prices?
We don’t need any national health insurance. What we need is to first figure out how to get people to live a relatively healthy lifestyle, then get the costs under control so they are based on something real, get drug costs under control. That process will take years. Without these controls in place first any single payer health insurance will bankrupt the country while enriching drug companies, doctors, hospitals, lawyers, and lobbyists.
So how does the gubmint legislate health? Let’s say it’s the law that one has to “be healthy” - so it is mandated that everyone have two checkups per year. Everybody in the entire US goes to a doctor twice per year. The doctor tells them to stop doing all the unhealthy stuff the do now. REALLY now, what percentage will actually do so based on their being told by a doctor?
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govt could pay people to be more healthy? If you are very overweight and you lose weight and keep it off, that’s something a doctor could measure. The idea of cold hard cash may be just as tempting as that Hardee’s monster thick burger. It would also be compatible with any effective diet or exercise plan, unlike the junk food tax.
non profit hospitals...don’t they get tax breaks?
My apology. A couple of weeks ago, my granddaughter sat in the ER with my daughter, with a rupturing appendix, a 103 fever, in shock, for two and a half hours as a result of the triage nurse’s inability to take a “bellyache” seriously. As a result, she’s been very ill.
I guess my sense of humor was amputated...again, I’m sorry.
I don't remember the exact reason, but it was said at the time that is would drive churches out of the health care business. Lo and behold, where the predominance of hospitals were once owned by churches, now there are few (at least in midwest, west.. YMMV).
I believe it has to do with being able to shift money from the church to the hospital or back again, as it was functioning as a way for churches to roll up profit and pigeonhole it away.
For whatever advantage it gave them, it is certainly offset by the result in the health industry.
Sorry to hear that. Triage is a tough job. Mistakes a made, particularly when folks use the emergency room as their primary healthcare provider.
how about 2 classes of for profit hospitals:
for profits that have no mandatory requirements
for profits that do but have no tax
Wouldn't one be concerned that a two-tiered system would evolve?
Very well said. Bravo!
End the unfair treatment. Employer-paid health insurance premiums are not taxed.
either:
tax them
or
make self-paid health insurance premiums a deduction from taxable income
Pick one. The current system is unfair.
“The best way to insure prices go down is to eliminate insurance completely and make everyone pay for services out of pocket. I have a orthodontist in my area who refuses to take insurance from any provider. He has the lowest costs of any of them.”
Exactly! The only reason costs are so high is because some people do have corporate health insurance plans. The hospitals and doctors know they can charge more and will get more. I think the only insurance anyone should be required to carry is catastrophic insurance, that would cover a major accident or hospital stay and treatment. All the rest should be paid out of pocket. The costs for doctors’ visits would then have to come down.
We can't have it both ways . . . if we want to have top-quality health care, we're going to have to pay for it. If we want inexpensive health care, we're going to have to lower our expectations.
A word to the wise,
When children are involved call 911 and have
an ambulance bring them in. Unfortunately,
the EMTs have much more experience than the
‘clerk’ sitting at the emergency room window.
That's worked out really well, hasn't it? Yea, right.
Insurance, specifically, employer-paid and government insurance is propping up the industry by paying amounts that consumers would not pay for care.
Brief anecdotal evidence. I fall asleep on a California beach one year without sunscreen on my feet. I get a blister the size of my hand on the top of my foot. I go to the ER in Long Beach and have the blister cut off and some ointment and a bandage put on the open wound. Bill to my insurance for <30 minutes of care and supplies that would have cost <$25 at Walgreens? $2000 (facility fees+physician fees). I would have never paid that for that care. My insurance company did not blink in paying that.
That is one small example that is repeated in a million different ways every day in our system.
So, because claims are paid with free money (to the individual health consumer, and many times to the insurance company as well), there are few market forces brought to bear upon the price of healthcare. The more we implement health-savings account, make people consumers (and not simply utilizers) of healthcare, the lower prices will go, the lower doctors overhead will be, etc. etc.
As I said earlier, many health insurance companies pay the claims with "free money," or IOW, only administer plans. The money is actually coming from the employer to pay the claims. If a company has over 500 employees, they're usually better off with some sort of stoploss insurance and simply paying the claims out of their own account (paying the insurance company a fee to administer their plan, either by capitation or by fee-for-service). As the insurance company is a large bureacratic entity paying claims with other people's money, it becomes less concerned about the efficiency with which it is paying claims correctly. If I get $2.50 to process a claim and I cay pay $20,000 for the claim or $2000 for the claim and it doesn't matter, there will be huge inefficiencies built into the claim-paying process.
Sorry to go on so long, but there's some things to think about. As far as "holding companies" go, it doesn't happen on any sort of scale. I know of no instances where this has been shown to have happened. Healthcare is, by and large, to screwed up and to bureacratically top-heavy (whether pharma, hospital or insurance) to pull off any sort of secret scheme.
Here is the crux of the matter for pharma in the US. Demand is high for pharmaceuticals in the US. There is no clamor for Lexapro (psych drug) or Ambien CR (sleep drug) or Viagra (erectile dysfunction) in Mexico (in the big picture). Those are viewed as luxury items for the wealthy. We view them as part of our Constitutional rights and consume them at high rates (as you point out). That doesn't give us a volume discount. It means our demand is higher. Higher demand --> higher price. And when we have more people privately insured than other companies (where private insurance will pay more to provide customer-sensitive care), the cost will be higher as well.
Secondly, our regulatory system (for all its faults) pretty much guarantees that if you take a script to a Walgreens for Lexapro, you're going to get Lexapro. In Mexico, you might get salt dipped in horse urine covered with a gel coating.
Finally, the average cost to bring ONE drug to market in the US is $1 BILLION (with a "b"). Not counting the 15 drugs that failed in phase 2, the 10 drugs that failed in phase 3, and the 2 that the FDA got skittish about and rejected.
Oh, THAT will make it more affordable! /sarcasm (as if that tag is needed).
companies=countries
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