I think those who are covered with medicaid are not being counted as uninsured. So the uninsured are those who are above the poverty line, but still carry no insurance, so we have to pay it for them. Something wrong with this picture.
a) No insurance, no treatment (this is not acceptable in our society)
b) Make minimum health insurance, for at least for catastrophic illnesses, mandatory (the government already carries the insurance for the "destitute" -- medicaid)(People who drive have to carry car insurance in most states, I think -- so why not health insurance?)
c) ????
d) ????
PS. Before someone starts on the "it's all the fault of the illegal aliens" song. Sure, that is a problem and they contribute to the problem, but MOST uninsured people are NOT illegal aliens. Note the numbers: they say 45 million people are uninsured.
Seriously, I do think some drastic measures need to be taken, but not sure what.
So please post any ideas you have.
I personally tend towards b), much as I don't like the government to tell people to have to carry insurance, but I don't see any alternative for more people expecting the rest of us to pick up the tabs for them, because other things are more important for them in their budget, than health insurance.
Cost-shifting, IMO, was an effective way for the medical system to cover the care of paupers. But as medical care costs rise, it will become untenable.
One thing that is tough to face for the resentful public is that their medical care is far better than it used to be--the treatments are much more effective. Just look at survival rates for cancers, and the reduction of the crippling effects of heart disease. More and more surgery is handled by nifty little miniature gadgets that make for smaller incisions and quicker healing times.
In short--it gets better and better, and more and more expensive.
Medical care is unique among consumer goods in that the consumer has no choices as per quality. That is--you can buy an old clunker to drive, or you can choose to buy a sleek upper-end Mercedes. But in medical care, you can only buy the Mercedes. There is only one kind of medical care available--the newest, brightest and best.
You did not mention the huge costs we incur in supporting the lawyer class--not just in legal fees and settlements, but in the defensiveness of hospital administrations. They sure won't risk buying anything but the Mercedes, even when the old clunker would do just fine!! It's a matter of demonstrating "good faith" in court. There are many older treatments that could be used to save costs that would not result in poorer quality, just less sparkle and whizzbang.
In short, provide a legal safe harbor for cost-consciousness.
Vicious circle:
The higher the cost of insurance, the more people who drop it.
And the more people who drop out, the higher the cost of insurance
To stop it, insurance premiums could be indexed to income . . . .
Or an income tax rebate/deduction geared to insurance payments and family income.
That would enable more people to afford it, stop the vicious circle, and possibly even bring the rates down.
Sure people didn't have health insurance back in the 1400's.. but if you were saved.. you were saved.. it didn't matter if you died when you are 40.
Our obsession with living forever is costing alot.. not just in having to work for it.. lost time with family.. degenerating family values.
Of course it's not just healthcare.
To heck with technology!
As much as I don't like to say this, I think the government will need to require people to carry insurance. Obviously the costs of insurance today are way too high for many people to pay, so a "Pay What You Can" system may help to offset rising insurance costs. Here's how:
This will basically create a two tiered health system, one public and one private. The option will be available as to which one you want to participate in.
If you chose private, you are under no obligation to pay taxes into the public system, but each year when you submit your taxes you must also submit that years "Health Insurance Statement" to prove that you are covered.
The public system would be a system in which you pay what you can based upon income that you earn, something like the tax system now. Employers would actually be required to pay the insurance for each of their employees, but they (the employer) would be permitted to withhold that payment from their employees' paycheck in order to recoup that payment (sort of like withholding SS, or FICA). At the end of the year the employee would receive a statement like a 1099, or a W2 that would act as their "Health Insurance Statement" to be submitted with their year end taxes.
I think that this would no doubt create a two tiered system. Those opposed to this idea would call it "second class health care" and "unfair treatment" for those who couldn't afford the private rates, but as it stands right now there is no treatment at all for such people. Which is worse?
To address the illegal immigrant population and its drain on social services like health care, maybe we could tie it into the real estate market. In order to rent an apartment, or buy a house, you must show your "Health Insurance Statement" before being allowed to sign a lease or contract. Should a landlord or lending institution be found violating this rule, then fines are imposed. Those fines would of course be rolled into the public health system. Illegal immigrants would be allowed to pay into the system and receive benefits from the system, so long as they could prove their income. How to prove their income? Require the renters' agreement to see how much rent they pay, cell phone bills, phone bills, cable TV bill and utility bills, and make a reasonable assessment as to how much they are making. If they (the illegal immigrant) are unhappy with the assessment, they could always prove how much they are making by submitting cash declarations and paychecks. Of course if their numbers didn't add up, they wouldn't be able to pay their bills and you would know they were lying.
As I said I'm no genius and I am also NO expert on health care, but I thought I would throw this out there for discussion.