Affordable and Quality Health Care

[Winstonm]

What is the cost of enforcing Empire with troops stationed around the world, paid mercenaries to bolster the numbers, and warfare to maintain hegemony?

 

Isn't this the Roman blueprint that failed?

 

As a nation we seem to always be able to afford the costs of deathcare, but find healthcare too expensive.

 

Perhaps healthcare cost is not even the issue - maybe it is only a matter of priorities.

[helene_t]

Maybe a stupid question from an ignorant non-American, but: why don't individual states set up their own health care? Why do they need to wait for the federal government? Are they afraid that all their good tax payers would move to other states if they implemented a policy that would require a drastic raise of the income tax?

[finally17]

Maybe a stupid question from an ignorant non-American, but: why don't individual states set up their own health care? Why do they need to wait for the federal government? Are they afraid that all their good tax payers would move to other states if they implemented a policy that would require a drastic raise of the income tax?

A few have. And I believe more are moving towards it. However, I think Federal input is very necessary for it to be effective, and as such it's my understanding that the results have not been stellar. I really don't know any details to share.

 

More states are moving towards guaranteed health care for children anyway. Seems to me that only the most cold-hearted of people would be opposed to this; they can't be blamed for the world they were born into and as of yet have no power to affect.

[DrTodd13]

Maybe a stupid question from an ignorant non-American, but: why don't individual states set up their own health care? Why do they need to wait for the federal government? Are they afraid that all their good tax payers would move to other states if they implemented a policy that would require a drastic raise of the income tax?

I seem to recall hearing that some states had already tried what you suggested. I could be wrong but I think they've all subsequently abandoned those plans for the reasons you suggested. These plans inevitably end up costing 3 or 4x what the original estimates are. I was reading Obama's webpage and he shares this delusion. There's all this stuff on there about reforming government and making it more efficient, reducing waste, getting more done with less. Are there any examples of this ever being done? Huge government efficiency seems to be an oxymoron. No amount of good wishes and empassioned speaches are going to make it otherwise.

[RedSpawn]

The simple fact is that if you hide the cost of something and make it appear free then the inevitable result is increased demand, which will result in higher prices and/or rationing or long waits (if prices are not allowed to move). In the US or in a country with nationalized health care, there is very little downward pressure on prices because people don't shop around for the lowest prices since the costs are hidden. The insurance companies would like to pay less but all they can do is negotiate after the fact. If you want to control health care costs then only have health insurance for catastrophic events (> $10,000 deductible) and otherwise have health savings accounts and have people compete based on price for those health savings account dollars.

 

The fundamental presumption of health care as a right is totally ridiculous. What if no one was willing to be a doctor at the prices the government was willing to pay. Would the government then have an obligation to force smart people into medical schools under point of gun? Stop existing doctors from retiring? The whole concept is offensive. Nobody has a right to the productive efforts of anyone else and the only way to guarantee the "right" to health care is the partial enslavement of others.

I want to resurrect this topic in light of the Trumpcare health care plan. Is affordable and quality healthcare a right for American citizens or should it be a choice?

 

Should the government be authorized to levy tax penalties against its citizens for failure to enroll in any health care plan?

 

Do American citizens have the right to self-insure for medical services?

[RedSpawn]

What is the cost of enforcing Empire with troops stationed around the world, paid mercenaries to bolster the numbers, and warfare to maintain hegemony?

 

Isn't this the Roman blueprint that failed?

 

As a nation we seem to always be able to afford the costs of deathcare, but find healthcare too expensive.

 

Perhaps healthcare cost is not even the issue - maybe it is only a matter of priorities.

My comrade.....well said! And you even threw in the monetary hegemony angle into the equation.

 

We can spend $600-$800 billion ANNUALLY on deathcare but to preserve the health of we the people, domestically, we are all of a sudden broke and wanting in political will.

 

War always results in 4 D's:

• Death
  
• Disease & Disability
  
• Destruction
  
• Debt

Is war good for the economy? http://www.huffingtonpost.com/michael-s-lofgren/is-war-good-for-the-econo_1_b_3185569.html

 

We have money for unnecessary extended war campaigns but can't feed the poor or provide a tenable, sustainable form of universal health care....amazing priorities.

[RedSpawn]

Because I didn't see it. :)

 

I agree an advanced civilized society has many benefits. What I reject is that civilization is equivalent to government. I would prefer civilization without government but that isn't available to me. Just because I prefer civilization with government to lack of civilization with no government does not mean that I lose my right to lobby for what I think would be a better system. It's like a guy given a choice between getting beaten with a tire iron or a baseball bat and then told to stop complaining during the beating because he was given his choice of form of torture.

 

Flag on the play....logical fallacy afoot...False analogy...though I know where your heart is.

http://lovinglogicalfallacies.weebly.com/uploads/2/5/9/8/25985536/5060311_orig.jpg

[Winstonm]

Is affordable and quality healthcare a right for American citizens or should it be a choice?

(The question is whether some basic level of healthcare should be considered a right.)

 

Should the government be authorized to levy tax penalties against its citizens for failure to enroll in any health care plan?

(This has been resolved by the SC and the answer is yes. The question is not legality but whether the quasi-market solution is better or worse than a true universal government provided plan.)

Do American citizens have the right to self-insure for medical services?

(This is a red herring. There is no reason why both basic universal care and extra-cost exceptional care cannot be offered within the same country.)

[RedSpawn]

https://obamacarefacts.com/costof-obamacare/

 

Never did look up this web site. It answers a lot of questions about Obamacare. Says the average plan after subsidies is $82 a month for all plans but that sounds very low. Hmmm.

[RedSpawn]

And here's Trumpcare facts...

 

https://trumpcare.com

 

Interesting....

[barmar]

https://obamacarefacts.com/costof-obamacare/

 

Never did look up this web site. It answers a lot of questions about Obamacare. Says the average plan after subsidies is $82 a month for all plans but that sounds very low. Hmmm.

Isn't that the point of government-subsidized health insurance? It needs to be very low so that poor people can afford it.

 

But I wonder if that's just the regular monthly costs, and doesn't include other out-of-pocket costs like deductibles and co-pays.

[shyams]

https://obamacarefacts.com/costof-obamacare/

 

Never did look up this web site. It answers a lot of questions about Obamacare. Says the average plan after subsidies is $82 a month for all plans but that sounds very low. Hmmm.

 

From the website above, "The US healthcare system is expensive, the most expensive in the world. That is due to many factors including the quality of our care, the general cost of things in America, the sheer amount of folks employed by healthcare system, and general fraud, waste, and abuse."

 

IMO, the idea of a wasteful industry which resists efforts to streamline itself may be the crux of the problem. It's not only about the US Govt subsidised cost of insurance, but the idea that insurance is expensive because the healthcare system is profligate.

 

Perhaps this shouldn't be something that the Federal Govt alone needs to tackle. The State Govts, regulatory authorities, citizen groups etc can also help.

[RedSpawn]

From the website above, "The US healthcare system is expensive, the most expensive in the world. That is due to many factors including the quality of our care, the general cost of things in America, the sheer amount of folks employed by healthcare system, and general fraud, waste, and abuse."

 

IMO, the idea of a wasteful industry which resists efforts to streamline itself may be the crux of the problem. It's not only about the US Govt subsidised cost of insurance, but the idea that insurance is expensive because the healthcare system is profligate.

 

Perhaps this shouldn't be something that the Federal Govt alone needs to tackle. The State Govts, regulatory authorities, citizen groups etc can also help.

http://www.foxnews.com/us/2017/06/26/disability-lawyer-in-center-600m-fraud-case-reportedly-says-fled-country.html

 

Agreed.

 

This is social security disability which is not medical health care per se; however, if one lawyer can pimp the system for a whopping $600 million, one wonders what savings abound in the health care industry with even bigger players and a cottage industry of ambulance chasing lawyers.

[RedSpawn]

Isn't that the point of government-subsidized health insurance? It needs to be very low so that poor people can afford it.

 

But I wonder if that's just the regular monthly costs, and doesn't include other out-of-pocket costs like deductibles and co-pays.

It probably excludes any and all out-of-pocket costs.

 

Did you see that Trumpcare includes workfare provisions for states that offer Medicaid? We can't create jobs with livable wages, but we can mandate that Medicaid recipients work for extremely low-paying, unskilled jobs that have no viable career path. This should be a plus for the retail and fast food industry who will then have a semi-permanent underclass labor pool from which to choose and exploit. Imagine the possibilities.

[barmar]

Perhaps this shouldn't be something that the Federal Govt alone needs to tackle. The State Govts, regulatory authorities, citizen groups etc can also help.

Unfortunately, this flies in the face of our general reluctance to control any industry in this way. We already have price controls on Medicaid (or is it Medicare, I can never remember?) coverage, but extending that to the entire healthcare industry is a political non-starter.

 

The theory behind Obamacare was that if we force everyone to buy health insurance (via the individual mandate), the costs will be spread sufficiently that insurance companies will be able to afford everything. In addition, there will be economies of scale and negotiations between the insurance companies and the healthcare providers to bring costs down, so the government wouldn't have to mandate price controls.

[mike777]

https://en.wikipedia.org/wiki/CRISPR

 

Just as innovations over the next ten years with nanotechnology will bring huge changes to the cost structure in the energy/climate change discussions so will nanotech bring changes in Health care costs.

 

One example is CRISPR.

 

The potential with CRISPR is to alter evolution itself.

[RedSpawn]

Good answers.

 

http://www.msn.com/en-us/news/politics/facing-gop-opposition-senate-leaders-postpone-vote-to-overhaul-obamacare/ar-BBDmhlx?OCID=ansmsnnews11

 

The GOP is postponing the vote on TrumpCare after the Congressional Budget Office had some bad things to say.

 

Meanwhile, progressive groups began laying the groundwork to attend senators’ public events, while medical providers and groups representing Americans with chronic illnesses predicted that the bill could leave millions without access to adequate medical care. The Congressional Budget Office concluded Monday that the measure would cause an estimated 22 million more Americans to be uninsured by the end of the coming decade while reducing federal spending by $321 billion.

 

Atul Grover, executive vice president of the Association of American Medical Colleges, told reporters that he and other doctors “take it personally” that the bill would lock people out of insurance for six months if they go for 63 days without a health plan and try to sign up for one the next year.

 

“We’re there at the bedside,” Grover said, adding that none of his members would be willing to tell a patient: “I’m sorry about your stage-four cancer. Come back in six months, when your insurance kicks in.”

[y66]

Part of our system of government appears to still be functioning:

 

WASHINGTON — A once-quiet effort by governors to block the full repeal of the Affordable Care Act reached its climax in Washington on Tuesday, as state executives from both parties — who have conspired privately for months — mounted an all-out attack on the Senate’s embattled health care legislation hours before Republicans postponed a vote.

 

At the center of the effort has been a pair of low-key moderates: Gov. John R. Kasich, Republican of Ohio, and Gov. John W. Hickenlooper, Democrat of Colorado, who on Tuesday morning called on the Senate to reject the Republican bill and to negotiate a bipartisan alternative.

 

Just before Senate Republicans delayed a vote on the bill, Mr. Kasich denounced his own party’s legislation in biting terms, saying it would victimize the poor and mentally ill, and redirect tax money “to people who are already very wealthy.”

 

“This bill,” Mr. Kasich said, “is unacceptable.”

From How Governors From Both Parties Plotted to Derail the Senate Health Bill

[ldrews]

From http://www.zerohedge.com/news/2017-06-27/2-out-3-patients-cant-afford-their-hospital-bills-thanks-obamacares-soaring-deductib

 

 

- 63% of hospital bills were $500 or less; of those hospital bills, 68% were not paid in full in 2016.

 

 

 

- 14% of hospital bills were $3,000 or more; of those hospital bills, 99% were not paid in full in 2016.

 

 

 

- 10% of hospital bills were $500 to $1,000; of those bills 85% were not paid in full in 2016.

 

Apparently Obamacare enrolles cannot afford the deductibles.

[Zelandakh]

A quick overview of what is coming for those who don't want to trawl through partisan news, whether Left or Right.

[RedSpawn]

From http://www.zerohedge.com/news/2017-06-27/2-out-3-patients-cant-afford-their-hospital-bills-thanks-obamacares-soaring-deductib

 

 

- 63% of hospital bills were $500 or less; of those hospital bills, 68% were not paid in full in 2016.

 

 

 

- 14% of hospital bills were $3,000 or more; of those hospital bills, 99% were not paid in full in 2016.

 

 

 

- 10% of hospital bills were $500 to $1,000; of those bills 85% were not paid in full in 2016.

 

Apparently Obamacare enrolles cannot afford the deductibles.

The underlying problem is at least twofold. People can't afford the hospital bill because they are poor. Also, patients can't afford hospital bills padded with an obscene amount of overhead. We in the industry call this ridiculous bidding. Hospitals have not been required to clean up their cost accounting structure--this is the true root cause; therefore, they have no earthly idea how much services should cost in an allegedly competitive marketplace.

 

This is why the average patient must vehemently negotiate against the hospital's FIRST BILLING OFFER. Treat it like a buying a car from a car dealer...everything is negotiable. The hospital bill is just a starting point.

 

For example, if I stay at a hospital and am not attached to any expensive equipment, I should not be billed $550/night for a room. I have stayed at the Ritz Carlton with 24/7 room service cheaper! Toothbrushes do not cost $10.00. In general, hospitals have not been required to have TRUTH IN BILLING PRACTICES; thus, they don't know how much their services really cost the patient so they apply all of their costs to overhead and are not compelled to track down inefficiency, waste, fraud, abuse, and poor inventory control.

 

Any hospital worth its weight should be on activity based cost accounting structures. Anything less is simply uncivilized and undisciplined.

 

See http://www.beckershospitalreview.com/lists/average-cost-per-inpatient-day-across-50-states-in-2010.html for crazy inpatient rates!

[barmar]

I heard that Trump is saying that when they finish the negotiations, the new health care bill will be special. Isn't "special" the euphemism often used for children who used to be called "retarded"?

[Winstonm]

I heard that Trump is saying that when they finish the negotiations, the new health care bill will be special. Isn't "special" the euphemism often used for children who used to be called "retarded"?

 

I thought it was the church lady: Well, isn't that special.

[Zelandakh]

I thought it was the church lady: Well, isn't that special.

Or drugs - mummy's special cookies...

[RedSpawn]

I thought it was the church lady: Well, isn't that special.

You are too much....you took us way back

http://s3.amazonaws.com/rapgenius/snl-church-lady.jpg