Health care - administrative incompetence

In my opinion, private health insurance in the US will only be with us a few years longer. The premium increases we are seeing every year are simply not sustainable. My feeling is that Medicare will eventually be expanded to cover everyone, with a corresponding increase in payroll taxes to cover the cost, to maybe 3% from 1.45% now. I would be willing to bet this will happen by 2020.
 
jhunter1163 said:
In my opinion, private health insurance in the US will only be with us a few years longer. The premium increases we are seeing every year are simply not sustainable. My feeling is that Medicare will eventually be expanded to cover everyone, with a corresponding increase in payroll taxes to cover the cost, to maybe 3% from 1.45% now. I would be willing to bet this will happen by 2020.
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That's already (kind of, since it isn't Medicare) happening on a few state levels. Vermont with it's single payer system they're crafting. It's simply become too expensive in VT maintaining the private insurance system, hence the reform happening there. Only a matter of time before the profit based system collapses on it's self, the vast increases in GDP spending pretty much guarantee this.

About damn time too.
 
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I sort of working on an idea I believe would work. Basically most funding would be in bulk based on the demographics of the register of the practice and its previous years requirements. To determine the amount, you'd would work out what the average patient costs add a % above that due to age, fiscal, or racial needs, plus a little on top to allow a profit. This would cover all primary health care needs from accidents, to saving lives, to making well, to end-of-life care, so excluding life style things like elective gastric by-pass, elective cosmetic surgery, Lasick, etc. As such there would be no at point-of-use payments required (or minimal ones.)

Above that funding you'd have incentives to meet certain goals such as preventive medicine targets. This target would be a double win as money saved by not having to do later more expensive procedures means less of the bulk amount used up, and a bonus from the incentives would add to that bulk amount, and thus more profit in the end.

In cases where it's clear that there is going to be a major blow out, grants can be applied for, things like Ducky's cancer, a plane crash, or natural disaster. These would be checked by a panel of MDs and approved, or suggestions on modifications made and a compromise found so that the final decision would be for the patient's best interest and not the profit line. (note this could go both ways, the committee could recommend to fund a more expensive option if they believed it was in the patient's best interest.)

The whole thing would be run via a singler payer system that would be non-profit and Govt funded. It would be run by Medical Care Professionals for Medical Care Professionals. They would decide the funding numbers, make best practice recommendations based on current international medicine practices, and negotiatate drug prices for all FDA approved medicines, which providers could then use to buy what they required. If a provider or patient decided that they want something not on the price list then an the provider, insurer, a donator, or the patient themselves could pay for it.

I'm sure there are tweeks that would need making, but I can't see why it wouldn't work as a starting place.
 
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TFian said:
Since when do the poor produce the wealth of the rich? Maybe you should pick up a copy of "Atlus Shrugged".

If you already paid for it, you'll get the treatment. Simple as that.
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Ayn Rand, the Right Wing Elitists Ideological Hero :rolleyes::rolleyes: . 'Nuff said.

Hope you like living in a Feudal society. That's how the Rich get Rich, by sucking up the wealth created by everyone else.

GB
 
TFian said:
Yup. It's why we're in the mess we're in now.

Democracy simply doesn't work. The weak can never govern the strong. It must be the other way around.
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Yup, exactly why Ayn Rand's brand of "Libertarianism" is a recipe for Feudalism or Totalitarianism. Survival of the ones with the biggest bank accounts and the biggest guns to defend their bank accounts. :rolleyes:

I love how the health care debate brings the fascists out of the closet so we can get a real good look at how ugly their ideas are.

GB
 
PhantomWolf said:
I'm sure there are tweeks that would need making, but I can't see why it wouldn't work as a starting place.
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Sounds interesting, but I have a few questions.

What do you mean by "grants for blowouts"? As in grants for the patients to pay for such expensive care, or grants for the providers?

Also, how would the patient be interacting in such a system? You say single payer, I guess an single payer insurance system of sorts?
 
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Garrison0fMars said:
Sounds interesting, but I have a few questions.

What do you mean by "grants for blowouts"? As in grants for the patients to pay for such expensive care, or grants for the providers?
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Grant to the Provider. So the Provider would send an application that would basically say, this is a special case above and beyond what we'd usually get and we aren't funded for it because..... and this is what we want to do.

The panel could then determine things like, should the provider actually be doing it? For instance if the case is a cancer case and the provider is a family clinic, they might suggest passing the case on to an oncology department. Is the treatment best for the patient? If not, what might be better. Once they have checked it, basically a peer review or moderation, they would yah it or seek modification of the application explaining why so it can be done, if the applicant disputes the modification then it'd be resolved by a panel member speaking with the applying doctor to see where the disagreement is and getting it resolved in the patient's best interest so the application can be yahed.

Also, how would the patient be interacting in such a system? You say single payer, I guess an single payer insurance system of sorts?
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Not quite sure what you mean here, the patient would interact with his/her doctor(s) to determine what they consider the best treatment for the patient.

If you are meaning in the above application process, then again they'd interact with the doctor and the doctor would act as their advocate to the panel.

If you mean financially, it'd be financed through the already current tax take with the Govt passing that over to the National Health Board who would proceed to directly fund each provider.
 
PhantomWolf said:
Not quite sure what you mean here, the patient would interact with his/her doctor(s) to determine what they consider the best treatment for the patient.

If you are meaning in the above application process, then again they'd interact with the doctor and the doctor would act as their advocate to the panel.

If you mean financially, it'd be financed through the already current tax take with the Govt passing that over to the National Health Board who would proceed to directly fund each provider.
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Pretty much that's what I'm asking. Was wondering how the patient would navigate the system. Would they have an insurance card that pays for it through the private non profit providers for example, or would they receive cash subsidies from the facilities paid for the by the gov, etc. That was what I was wondering.
 
Garrison0fMars said:
Pretty much that's what I'm asking. Was wondering how the patient would navigate the system. Would they have an insurance card that pays for it through the private non profit providers for example, or would they receive cash subsidies from the facilities paid for the by the gov, etc. That was what I was wondering.
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You'd have to register with a primary health care provider who would enter them in a national healthcare database system that all providers have access to. Once done you could just have to turn up and have Photo ID because payment would be fully via tax take if possible, if not then a small fee might be charged for things like doctors visits, perhaps on a tier based system so those on welfare don't pay as much ($10 compared to $25.)

Visits to providers outside of your primary provider's network (eg, if you are out of state and need treatment) would trigger a small one off quarterly payment for the provider that saw you.

The system would keep track of all medical records etc, so not only would the doctors at the non-primary provider have access to your entire medical history for your appointment there, when you returned home their notes would be available to your regular doctors. This would also pick up providers attempting to rip off the system by registering patients one place and sending them elsewhere to get double payments.
 
PhantomWolf said:
The panel could then determine things like, should the provider actually be doing it? For instance if the case is a cancer case and the provider is a family clinic, they might suggest passing the case on to an oncology department. Is the treatment best for the patient? If not, what might be better. Once they have checked it, basically a peer review or moderation, they would yah it or seek modification of the application explaining why so it can be done, if the applicant disputes the modification then it'd be resolved by a panel member speaking with the applying doctor to see where the disagreement is and getting it resolved in the patient's best interest so the application can be yahed.
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Sounds like government run death panels to me. In this country we don't put up with that kind of crap.
 
jhunter1163 said:
In my opinion, private health insurance in the US will only be with us a few years longer. The premium increases we are seeing every year are simply not sustainable. My feeling is that Medicare will eventually be expanded to cover everyone, with a corresponding increase in payroll taxes to cover the cost, to maybe 3% from 1.45% now. I would be willing to bet this will happen by 2020.
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I hope you'll stick by that bet.

It's likely that the far more expensive insurance options (Medicare, Medicaid, SCHIP systems) will be dismantled, and the more efficient insurance companies will be able to bring their costs down with government out of the picture.
 
So, TF, did you ever manage to explain why our UHC systems provide at least comparable results to yours, but for half to two-thirds the cost? I think I must have missed your reply on that.
 
Architect said:
So, TF, did you ever manage to explain why our UHC systems provide at least comparable results to yours, but for half to two-thirds the cost? I think I must have missed your reply on that.
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Comparable results in what exactly?
 
TFian said:
Comparable results in what exactly?
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Lower infant mortality, higher life expectancy. They're rough and ready measures but you'll find that not one of the opponents of UHC here have managed to come with another set of indicators they prefer - feel free to flag up some of your own, however.

Be cautions if you're going to mention pancreatic cancer survival rates, I think we've done that one to death (no pun intended) already. Different in diagnosis techniques in the US, higher initial diagnosis but broadly comparable survival rates.
 
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Architect said:
Lower infant mortality, higher life expectancy. They're rough and ready measures but you'll find that not one of the opponents of UHC here have managed to come with another set of indicators they prefer - feel free to flag up some of your own, however.
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Run the cost between another measure of success, how much freedom do you have? How much freedom have you lost to take care of your own body? How much is your NHS financed by theft? (Taxation by gunpoint). How many die by government fiat?
 
xjx388 said:
You didn't quote him correctly. He said "best healthcare system in the world." Big difference. No one actually thinks our system is the best but we definitely have some of the best healthcare in the world -well-trained docs, state-of-the-art tech, etc.
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No-one denies that there are excellent doctors and treatments available. What we're saying is:

1. Your overall clinical outcomes are no better (and often worse) than other comparable nations.

2. You're spending somewhere between a third and a half more than the rest of us.

3. A large part of your population does not have access to affordable coverage, leading to your own suggestion the other day that one poster should just go bakrupt.
 
xjx388 said:
You didn't quote him correctly. He said "best healthcare system in the world." Big difference. No one actually thinks our system is the best but we definitely have some of the best healthcare in the world -well-trained docs, state-of-the-art tech, etc.
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Pretty meaningless nuance.

Can you prove our doctors are better trained than other developed nations with UHC, or that we have access to more advanced technology than they do?

Who cares anyway if we have "well trained docs, state of the art tech" if an increasing amount of Americans can't even access them? Means little to me (and the 50 million uninsured and even more so underinsured)
 
TFian said:
Run the cost between another measure of success, how much freedom do you have? How much freedom have you lost to take care of your own body? How much is your NHS financed by theft? (Taxation by gunpoint). How many die by government fiat?
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I can choose which GP I go to.

I can choose which hospital I am referred to for treatment.

If I do not like the conultant surgeon, then I am entitled to ask for another.

I am legally entitled to seek second opinions.

If I do not like the NHS, I am able to procure private healthcare insurance.

People with no income are legally entitled to exactly the same healthcare as people who do not.

I do not have to worry about declaring pre-existing conditions.

I do not have to worry about insurance companies restricting my treatment regime, or worming out of paying.

I have freedom from co-pay, deductibles, and excesses (teminology depending on country).

As of next year, I don't even have to pay prescription charges here in Scotland.

Against this, let me stress again that we live longer than you and pay less.


Now, which point are you claiming the US trumps us on? Or are you telling me that none of this matters because "taxation is theft", in which case I have to ask how you drove to work today? On public roads, perhaps?

Incidentally:

How many die by government fiat?
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If you have evidence that it's significant, including comparison with those denied treatment by private healthcare insurers in the US, then bring it forward for discussion. XJX could do with the help, and BaC would be very grateful.
 
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