The DMV.
I believe there is a role for government in the health care system. I’m interested in creative ideas and not the tired old ‘government sucks’ with no ideas.
Don’t get me wrong, I’m not for a ‘takeover’, but I see areas where the government can take over routine, low cost procedures.
A friend told me government healthcare would be horrible...it would take 6 months wait for X procedure. I told him its going to take me 6 months wait to save in order to do X procedure so what is the difference?
Please no flames. If you have an idea, I’m all ears.
One word: CANADA!
Even the man who created the system there admits that it is an abject FAILURE.
We already have a form of socialized medicine for certain groups: Veterans' hospitals, Medicare, Medicaid, and state. Medicare is lousy. They pay my caregivers less than 60% or more of what that actual charges are, and I have a supplement, am looking for a better one even if it costs me more because I don't think it is right shafting my providers plus it may disincentivize them to accept me as a patient. My options are limited already.
One argument I have used was pointing out how it works in Canada, telling my own story of my experience in England and what I've read about Canadians who can afford it crossing the border to obtain urgent health care at their own expense because the wait lines are so long. Some Canadians seem to like it.
Like England, the wealthy won't wait in line; they will have a private physician and pay their own money to avoid wait lines and better options obtaining the best care.
People will flock to emergency rooms with the sniffles worse than now. They won't know until they actually talk to you and/or get a diagnosis, taking time away from more critical patients.
You won't be able to sue your doctors for malpractice. I've never done it, but would like to have that option.
We will have to accept all foreign patients, whether visitors , legal immigrants waiting for citizenship or illegals and pay their total expenses like England, even if they have the ability to pay.
It will cost more to somebody, the taxpayer, may give the illusion of being free but the taxpayers will have to foot the total bill. Once the government gets their hand in anything, it only gets worse.
It will mean making the government larger because more people will be brought on board to manage it.
All the above is assuming you bypass the insurance companies and go government-managed, total UHC, and we're not there yet, but with the economy on the downturn, either McCain's plan or Obama's plan will have an adverse impact on the insurance companies.
It will require one more ID card which will be compulsory, no telling whether a chip (storage of all your records) will be involved, no telling about privacy issues. Those are already looming as a potential threat.
They will make it so complicated (read the new 127-page 2009 Medicare manual), few people will be able to understand it and believe that it is a good idea.
Americans can’t repeal the laws of economics.
The most relevant examples for what American health care would become under a single-payer plan are Canada’s and the UK’s health care systems both of which are nightmarishly dysfunctional and dangerous at this point in time.
The fallacy of of arguments for socialized medicine reside around an exclusive emphasis on incentives for consumers of health care and a complete avoidance of the effects of socialized medicine on incentives for providers of health care. When huge disincentives are erected in the name universal access to health care for consumers, producers do what they always do when the government begins to tax something heavily: they leave.
In 1948, after the UK started up the National health Service (NHS) within a few years a large number of Doctors in their 50s retired from practice. The prospect of a lot more work for less pay was not appealing. Those Doctors who had sufficient financial resources simply quit practicing. On the demand side, once going to the Doctor became a cost free transaction for the patient. UK facilities were inundated with hypchondriacs looking to treat phantom maladies. Demand goes up, supply decreases so prices go up. The NHS reacted to this through an at first implicit and the explicit care rationing scheme. This pattern has continued through to this day. It has become so severe that UK NHS officials are now seriously looking at privatization schemes to address the crisis.
The pattern in Canada followed the UK pattern almost exactly but just a little bit later. It also worth noting that both the UK and Canadian systems are about a least 20 years behind the US in terms of treatment modalities, both drug and and non-drug treatments. It is also worth noting that most notable medical device and drug research happens in the US and not in Canada and the UK. The incentives to innovate have been destroyed in these two countries.
People will not continue to work and to innovate under the threat of a gun. We don’t need or want care rationing schemes here in the US. The forgotten health care producer has to be remembered in any health care reform discussion.
There are far better ways to address health care access problems than to impose a single-payer program. Fewer health care producers, less health care. This elemental economic truth can’t seem to penetrate the obtuseness of liberals on this issue.
The arguement isn’t about socialized anything. Once conservatives understand that the arguement is forcing others to pay for something for other people we will win the arguement.
Whatever the topic is only diverts us from the true issue. And this is done for exactly that reason.
Who can argue against feeding the hungry?
Who can argue against forcing others to give you their earnings to serve their own goals? This is robbery, extortion or whatever term you use it is evil.
The back door to destroying our present system is removal of the pre-existing condition limitation. I’ve heard some commercials here in Carolina from the Obama campaign pushing this line of argument.
How will it destroy the private insurance business?
An analogy that everyone will understand. You choose not to pay auto insurance. You have an accident with your car and it is totaled. The insurance company is forced to insure you regardless of the pre-existing condition of your car. You pay 1 premium payment, they pay to get you a new car. Why ever pay another premium? They go out of business.
bookmarking
By Sheri Porter 3/12/2008
Physician practices across the country are beginning to limit the care they provide for Medicare patients as Medicare physician payments fail to keep pace with the cost of providing health care to seniors. That's according to a study of more than 1,000 physician practices conducted by the Medical Group Management Association, or MGMA.
In a March 6 press release, MGMA said that nearly 24 percent of medical practices that responded to the survey said they had begun limiting or not accepting new Medicare patients as a result of the "financial uncertainty" created by temporary adjustments to Medicare physician payments and a pending 10.6 percent cut scheduled to take effect July 1.
About 46 percent of respondents said that they would have to stop accepting new Medicare patients or limit the number of Medicare patients their practices treat because of the expected payment reduction this summer.
MGMA members participating in the survey reported that they would "suffer further operational damage" as a result of expected double-digit reductions to Medicare physician payments. In addition, more than 50 percent of respondents were considering reducing administrative and clinical staff, nearly 70 percent were postponing purchasing decisions on new clinical equipment and facilities, and about 67 percent were delaying or foregoing investing in health information technology.
MGMA President and CEO William Jessee, M.D., reacted to the survey results by lambasting Congress for its failure to act. In an interview with AAFP News Now, he said, "The inability of Congress to solve the Medicare physician payment problem has reached a level of absurdity. How can physicians be expected to care for a growing number of Medicare patients and invest in e-prescribing and electronic health records when there is absolutely no predictability to their revenues?"
Jessee said that physicians who responded to the MGMA survey were doing what any rational small business would do: "They're restricting the number of Medicare patients they treat, deferring or avoiding investments in new technology, and reducing staff.
"This situation is a very sad commentary on Medicare," said Jessee, adding that the program "is rapidly failing to deliver on its promise of access to health care for America's seniors."
FPs Make Medicare Provider Status Changes
Physicians have options when it comes to Medicare. They can participate fully, become nonparticipating Medicare physicians, or opt out entirely. In these difficult times, family physicians are having to make tough choices in an effort to preserve their practices.
James Molloy, M.D., of Sheridan, Ore., told AAFP News Now that his practice opted out of Medicare in 2008 and instead is offering Medicare patients a 40 percent cash discount on practice fees under individual contracts.
"We made a decision based on what we had to do to make this practice survive," said Molloy.
He said Medicare patients constitute about 12 percent of his patient panel, and that 30 percent to 40 percent of those had signed the private contracts. More than half of his Medicare patients have left the practice, but finding physicians who take new Medicare patients could be a challenge for those patients.
Prior to opting out of Medicare, Molloy said he routinely turned away Medicare patients so desperate to find a physician that they offered to pay for charges out-of-pocket. Medicare, however, prohibits its participating physicians from collecting full charges directly from Medicare patients for otherwise covered services.
Molloy was steadfast and resolute in his Medicare decision. "I refuse to participate in a system that I consider to be a very broken system." He added that he was prepared to "opt out for the long haul" until the Medicare payment system is permanently fixed.
FP Steven Blair, M.D., of Yuba City, Calif., said his small group practice became a nonparticipating Medicare provider as of Jan. 1, 2008. The high cost of living and providing care in northern California already were making managing a practice difficult even before the proposed cuts, he noted. But Blair and his partners got angry enough to take action when the government strung physicians along late in December with the six-month 0.5 percent increase.
Much of the progress made in increasing Medicare physician payment during the past decade would be wiped out by a 10.6 percent reduction, said Blair. "The whole episode left a very sour taste in my mouth. A lot of physicians felt like they were left out to dry."
As a nonparticipating Medicare physician, Blair still sees his Medicare patients, but he can bill them about 9 percent more than what Medicare pays participating providers. The extra cost, which is borne by the patient, would offset most of the anticipated Medicare payment cut in July, said Blair. As much as 10 percent of Blair's Medicare patients have left the practice, however.
Uncertainty Leads to Frustration
"The most frustrating part for family physicians is this uncertainty of not knowing whether we'll have to deal with a 10 percent pay cut," said AAFP President Jim King, M.D., of Selmer, Tenn. "We already have a slim profit margin -- if any at all -- for taking care of our Medicare patients."
King said the Academy has received calls from family physicians seeking advice about their Medicare options.
"It's very frustrating because we like taking care of our senior citizens, and we want to continue to take care of our seniors -- but from a financial standpoint, some family physicians just may not be able to do so any longer if this payment mess with Medicare continues," said King. "The Academy is willing to work with the administration, Congress and CMS to find solutions," he added.
For John Saranko, M.D., of Plant City, Fla., the bottom line is whether or not his practice can afford to continue treating Medicare patients.
Late in December, with the government mired in indecision, Saranko and his partners voted not to accept any new Medicare patients in 2008. They also agreed that if the Medicare pay cut became a reality in July, the practice would opt out of Medicare in 2009.
Medicare patients make up about 57 percent of Saranko's patient panel, he said, and many of those patients are the kinds of old friends that come after 28 years in practice. He agonizes over dropping those patients, but if payments are slashed, Saranko said, he'll have no choice. "It's a business, and if I can't pay the bills, I can't survive," he explained.
Saranko said he's certain his practice would thrive without Medicare; he's consistently turned away younger patients in order to keep treating his Medicare population. "If I stop seeing Medicare patients, within three months, I'd be back up to where I am right now and maybe making more money," he said. That's because he likely could increase his daily patient load with a schedule full of younger patients presenting with simple, easily treated complaints. Older patients suffering from multiple chronic diseases just take more time, said Saranko.
I’m from over there - all my relatives buy their own insurance. WHy would they do that if National Health was so great?
Point out that patients in countries WITH socialized medicine flee to countries WITHOUT socialized medicine for treatment if they can.
To answer the question of a liberal who wants to adopt socialized medicine, you need to get to the issue of why the liberal thinks a transformation of health care is required.
In the United States, which has the closest thing in the world to a free market with respect to health care (note that the U.S. still has government interventionism of Medicare and other government programs), we have the best quality and availability of health care in the world. The problem with health care in the United States is COST.
To find a solution to the COST problem, we need to understand why the problem exists. Of course, the knee-jerk response of the liberal is that the “unbridled free market” has caused this problem. That response does not make any sense. Where the free market exists, prices are competitive, supplies are abundant and quality is good. Where government monopoly exists, prices are fixed by government and thus, supply and quality are negatively impacted. Thus, Europeans receive substandard care and if they have any resources, they come to the United States for medical treatment. In addition, the supply of medical care in European countries is inadequate and therefore, rationed. There’s a joke that you can tell a European from an American by the condition of their teeth. Sadly, this is only too true. In Cuba, Pepto Bismo is available only on the black market. In Canada, children in certain Provinces are entered into a lottery to determine who will get an annual well-baby or well-child check-up. The former leader of the Canadian liberal party came to California to have her breast cancer treated. In sum, the result of “universal health care” is low-quality care and rationing of medicine and medical care.
Thus, we get back to the issue of why the COST of health care in the United States is so high. Under our tax code, employers are permitted to provide health insurance to employees without including those benefits in taxable compensation. The effect is that people get a 100% tax deduction for health insurance premiums if those premiums are paid by their employers. Those same persons, however, are not permitted to deduct DIRECT purchases of health care or insurance unless those costs exceed 7.5% of adjusted gross income. That 7.5% AGI floor deduction is helpful only if an individual incurs massive medical costs. But, in terms of regular insurance premiums, it is far more economic for employers to purchase insurance policies (rather than individuals directly) so that the tax effect is a 100% deduction from AGI.
Thus, we have an employer-based health care system in the United States. And, costs are OUT OF CONTROL. Under our system, the recipient of health care services is NOT the purchaser and so, the provider is unresponsive to the recipient in terms of care, coverage and cost. As a patient, you call your health insurance company with a complaint and their attitude is indifference because you do not have the capacity to “take your business elsewhere.” As the purchaser, the employer has to make bulk purchase decisions on behalf of all employees and is not as price conscious as an individual consumer would be. An employer is unable to make decisions that an individual could make in order to achieve maximum return .... for example, I may not want vision care or fertility services or dental care included in my plan. Or, I might. Imagine if your employer was in charge of purchasing an auto insurance policy on behalf of all employees. Or, even more basic ... Imagine if your employer was in charge of purchasing your shoes. One size doesn’t fit all. The point is that the artificial separation of seller and consumer caused by the internal revenue code has resulted in skyrocketing health care costs and unresponsive insurance companies. In a free market, people could choose to buy a catastrophic health care plan and simply pay their routine doctor visits out of pocket. This would have a huge economic impact on the costs of doctor visits. No longer could a pediatrician get away with charging $300 for a doctor’s visit. This anomaly only exists where insurance comes into play. Everyone knows that an auto shop estimate for body damage is alot higher if the auto shop knows insurance is covering the tab. It’s simple economics. Moreover, people could “shop” the insurance companies, the doctors offices and the hospitals. The companies, doctors and hospitals would be rated for cost, options, customer care, etc... just like any other consumer good. In general, we do more diligent research and review before purchasing an LCD TV than we do before purchasing health care ... precisely because we are NOT the purchasers of our health care.
Thus, the solution to the rising health care costs in the United States is to allow individuals to shop for, negotiate and buy insurance and pay medical costs directly and then, deduct those costs (without the 7.5% AGI floor) in computing federal income tax. This would also alleviate the serious issue of portability that people complain about. The current system necessarily causes people to lose insurance when they lose their job. That is a sickening situation. Do we lose our car insurance when we lose our jobs? Of course not. If people purchased their health care directly, this situation would not exist.
Try this argument with your liberal friends. Or perhaps they want to live in a country where they would have to buy their Pepto Bismo in a brown bag from the local drug dealer….
The people who run the the motor vehicle department being responsible for our chemotherapy
If that doesn’t frighten you, nothing will.
The people who run the the motor vehicle department being responsible for your chemotherapy
If that doesn’t frighten you, nothing will.
Each family, then, provided for their health care, and most people managed, and the cost was not five times as much as the current costs, in real dollars.
“I was trying to think of a parallel that a person could see every day, and not simply disregard.”
too many think that government paid health care will be like BC/BS with some one else paying for it. You need to remind your friend that government paid health care will come with a government budget for all services. That is the reason that long lines and waiting times exist under all forms of government paid health care. Private insurance, OTOH, has to provide the services in the contract regardless of whether they have exceeded their budget. Of course, your friend will counter that ‘American Governement Health Care’ would require the government to provide timely services. But, one cannot compell the government to do anything. The government can break any contract at will since it is Sovereign.
I did some reading on this bill, and it would have been mandatory for every resident, regardless of present coverage. It would have cost our state a minimum of 18.2 billion dollars a year. That represented an 80% increase to our state budget for this one bill.
According to articles in the summer of 2007, by both the Wall Street Journal, and the very left leaning Milwaukee Journal Sentinal, it would have been financed through a payroll tax, structured somewhat like Social Security/Medicare are now funded. It would have added a payroll tax of $510.00 PER WORKER!!!!!
Ask people if they can afford an extra $510.00 a month, again PER WORKER. So for my family, it would have cost us $1,020.00 in payroll taxes a month. That is something I can't afford, I know that for sure.
The bible says “if a man will not work than neither shall he eat”. If this is true for food, how much more for health care?
I've been to the ER (for pneumonia) more times than I've seen my primary care physician because I'm not sick enough, according to their list of symptoms. I guess death's doorstep isn't on the list.
Govt medical care is a disgrace.
i can give you first hand and a few second hand accounts;
but before i start here is a cold fact about healthcare...people die all the time. the question is whos choice should it be, yours of a faceless govt hireling? (more on this later)
background
i live in ireland. for 4 million people we have over 100,000 working in the dept of health with a budget of 15 billion euro per year. now just do that math 15billion divided by 4 million? does that sound free?? add to that it is a complete shambles. let me repeat a complete shambles. about 2 years ago i cut a lump off my finger . i arrived in the hospital at 12.30...i saw a doctor at 6...by accident because i thought he called me( he hadnt i skipped the queue by mistake).. actually that was to join the second queue...i actually saw him at 7pm.. it was bandaged up, told me it was lost and to come back in a week...now let get really real...shall we
first hand experience
my dad
10 years ago my dad had a heart attack. they did great work saving him. one month later he had a second, they left him in a queue for 4 hours whereby he damaged his heart necessitating a triple bypass. the result, he was to go on a queue for 3-5 years taking 10 to 15 tablets a day before he would get the bypass...or we could pay with our private health insurance...did you get that?? yes we have to pay private to get seen which most working people here do. he had a triple bypass which saved his life and he is still going strong today. cost of operation was 15,000 on insurance. so basically here is the reality...go on a public queue...and die off...go private and survive
recent example 3 weeks ago
my uncle had cancer was treated for it (waited about 6 months) was cured of that and got MRSA from the hospital which is rife in public hospitals here. he died 1 week after getting mrsa. he was killed by a health care system spending 15 billion that cant keep a fricken hospital clean.
personal example number 3
our sons innoculation
a few years ago there was panic here about innoculating children with a triple shot called MMR (mumps measles and rubella). we decided for our little prince, why take the risk, lets get 3 seperate ones (it turns out it was total BS by the way). so we goto our doctor (which isnt free by the way (50 euro a visit) and ask for 3 seperate jabs and say we will pay. NO was the answer. huh i say? she says the dept of health have BANNED the 3 seperate ones, you are only allowed to get the MMR. Did you get that? the dept of health BANNED innoculation where people felt there was a risk to their child. they would rather children not be innoculated then give people the option...it was a cost reason, the MMR was cheaper. didnt matter that i wanted to pay, we would have to got a UK private doctor to get it (yes a seperate country). we took the MMR, many children didnt, which is why measles is making a comeback in ireland, something we havent seen since the 60’s. Now think about that— people who are still afraid of MMR will risk those terrible diseases for their kids. Trust me parents in ireland love their kids just as much as you love yours...sit back and imagine that decision?? you are not allowed to get a choice— the dept of health has decided..
recent examples from the uk?
what does public healthcare cover? now does it cover sex changes? Does it?? all of sudden personal choices become mandatory. personally if you want a sex change, knock yourself out, but i dont want to pay for it. that example is from the UK. some doctors were recommending it for patients who were suffering metal issues due to gender identity. it does raise this issue, what will this healthcare cover, will it cover disease a but not disease b?
all socialized medicine will have a medical board that ‘decided’ which drugs can be afforded and which cant. so a govt dept can tell you what you can get to survive. if its too expensive, pay for it yourself or die. if you think i am making this up...go check it out...i am most certainly not. in some countries people are reduced to flying to other countries to get the drugs they need.
socialized medicine doesnt work. in ireland we are trying to get large parts of it private now, but we have unions involved who dont want that to happen. the patient is the last person cared for in the irish health care system. My dad who queues once every 2 months for a blood test has his favourite line ‘the only people stressed in the irish health care system are patients’. Trust me despite what you hear, it is no better in large parts of europe. where it is better (or at least told it is better), the costs are staggering and in some cases is leading to huge holes in budgets filled with borrowing. My better half is swedish and you cannot go private in sweden...trust me if you could there would be a flood of people and the tax rates are huge to pay for it. also the harsh reality is they are failing. it is failing in germany, failing in sweden and failing in france...thats the other fact you dont hear.
the harsh cold reality of healthcare is that it is and should be a personal choice. i dont want a govt minister telling me what i can or cant have to survive. the sirens song of free health for all is an illusion that can never be filled. the cold terrible reality is people die all the time...we are human. quite frankly the closest i came to punching someone was when my dad was in hospital and the way some doctors treated him. there are great people in healthcare here, truly great surgeons, great nurses, great doctors...its just a screwed up system..
anyone who you talk to who thinks it will work is falling for fools gold.
the only way obama is going to get it off the ground is to tax each and every one of ye up the yangers and gut other parts of taxable income as well. trust me you might think you are paying taxes...you have no freacken idea....prepare thyself for a bottomless pit of money run by people who care nothing for your money who will hire other bottomless pitters to fill it...
anyone of your friends that thinks this is a good idea, send them to me for a slap on the face with the cold wet fish of reality...
one final point...where do all the best drugs come from?? ah yes, the US...no drug company is going to deal with a public health system that is going to limit what it will earn to develop drugs. Why would they do that? why cure xyz disease if you can never earn money from it? the dark little secret of socialised healthcare is it sucks and lives because the US doesnt have it. if you do — what we have now drugs wise is as about as good as it will get...
you wont read that last bit in any red tinged obama handout...
there is one way to stop that insanity however...just vote mcpalin...