Can We Agree On This Healthcare Reform?

[ArtDeco]

Just curious. There's alot of common ground, I believe, among Americans regarding healthcare. I personally just think the politicians have used the issue as a crowbar to divide us and pit us against each other.
So let's see how many of us agree:
Would you support a plan to provide a basic level national health plan, perhaps attached to your SSN, that provided government-paid coverage for catastrophic events (not office visits) that required hospitalization, at rates TBD by an office like Medicare, to be funded by a national sales tax or other similar tax? It would be understood that bells and whistles like immunizations, birth control, doctors visits, colds, ankle sprains, and all other non-emergent conditions would have to be paid out of pocket or covered by traditional private insurers or Medicaid/Medicare.
Could you support this?

[gatordowneast]

Not through the government. Government cannot do anything or provide any service as efficiently and as economically than a for profit entity. Exception is the military.

These type policies are available now through insurers. Trouble is, you have a significant % of the population that will not pay the money to buy the policy as they are accustomed to showing up at the emergency room and being treated for free.

And if you force those of us who are willing to pay and want better and more timely care into the same pot as those that want freebies, who suffers?

[gatorman_07732]

Not through the government. Government cannot do anything or provide any service as efficiently and as economically than a for profit entity. Exception is the military.
These type policies are available now through insurers. Trouble is, you have a significant % of the population that will not pay the money to buy the policy as they are accustomed to showing up at the emergency room and being treated for free.

And if you force those of us who are willing to pay and want better and more timely care into the same pot as those that want freebies, who suffers?

^^^^^^^^^^^This this this

[ArtDeco]

Exception is the military.


Wrong. As a provider for 3,000 military families, I can tell you Tricare/VA is the most wasteful and bureaucratic of all organizations. There is a tremendous amount of waste in Tricare and the VA system, but that's another thread.

[QGator2414]

It is not the "Federal" governments job. If the staes want to take on the issue I would be open to it.

I have a hard time giving up more freedom to the federal government after SS, Medicare and soon to be obamacare...

So based on the premise the Feds would run this I would say no...

[ArtDeco]

These type policies are available now through insurers.

I do not see patients with catastrophic private plans. Know why? They always show up with card in hand thinking they have great insurance, and when I tell them they haven't met their deductible, they piss and moan about paying me $77 for a doctor visit. People with private catastrophic plans are less likely to get needed tests and as a result, no doctor wants the liability of treating them.
By scrapping Obamacare and retooling Medicare and Medicaid, we could have a system that takes the biggest legitimate expense that people worry about- going bankrupt over medical costs- out of the equation. You're telling me you wouldn't want your taxes to go to that instead of a Medicare system that won't be there when you need it? You don't also think your Blue Cross policy will come down when they no longer have to pay for hospitalizations and critical care?

[QGator2414]

I do not see patients with catastrophic private plans. Know why? They always show up with card in hand thinking they have great insurance, and when I tell them they haven't met their deductible, they piss and moan about paying me $77 for a doctor visit. People with private catastrophic plans are less likely to get needed tests and as a result, no doctor wants the liability of treating them.
By scrapping Obamacare and retooling Medicare and Medicaid, we could have a system that takes the biggest legitimate expense that people worry about- going bankrupt over medical costs- out of the equation. You're telling me you wouldn't want your taxes to go to that instead of a Medicare system that won't be there when you need it? You don't also think your Blue Cross policy will come down when they no longer have to pay for hospitalizations and critical care?

I am the rare exception...and agree this is a problem.

I have a $10K/$20K in/out-network plan. I get a Boston Heart blood test every 6 months and have no problems paying for the service. Last time I was in it was for my follow up on my results but my checkup as well. I was ready to pay for the checkup as I forgot that I get one "free" (I send Florida Blue $70 through the year so they can then send my doctor $60 or so) mandated regular checkup. It is ridiculous we mandate insurance companies be a middle man for things like this!

[Gatorrick22]

I said no, because the Pubs tried to get together with the Dems at the end or GW's last term only to have the Dems change the narrative completely from lowering the premiums and reducing to cost of healthcare to socializing it in a complete government takeover.

I will never again trust the Dems when it comes to national policies that affect all Americans.

In the end, I can't trust one word a Dem politician says about healthcare.

[ArtDeco]

I guess this is why nothing gets done. I can't believe all my right wing friends on here disagreeing with the premise. You wouldn't pay an extra 3 cents or so on the dollar for items you buy if it meant being free of the threat of foreclosure, bankruptcy, or failure secondary to medical debts?
I compare it to home insurance. In Florida, the private sector is already out of the riskier areas (flood, hurricane, etc.). Nowadays, your private homeowners plan covers the low-risk stuff, the improtant stuff is through FEMA anyway. I believe the government could handle the critical care issues that most of us are scared of (ICU care, ventilators, heart attacks) as long as they pay at current Medicare rates. I wouldn't ask them to ration or criticize said care, just simply pay the bill when the check arrives. Believe it or not, there's not many people freeloading a ventilator needlessly. That would free up the private plans to coexist for those of us that want office visits, labs, or other extra coverage. And their rates would plummet. It would be like buying an umbrella policy, which nowadays are like $200 a year.

[QGator2414]

I guess this is why nothing gets done. I can't believe all my right wing friends on here disagreeing with the premise. You wouldn't pay an extra 3 cents or so on the dollar for items you buy if it meant being free of the threat of foreclosure, bankruptcy, or failure secondary to medical debts?
I compare it to home insurance. In Florida, the private sector is already out of the riskier areas (flood, hurricane, etc.). Nowadays, your private homeowners plan covers the low-risk stuff, the improtant stuff is through FEMA anyway. I believe the government could handle the critical care issues that most of us are scared of (ICU care, ventilators, heart attacks) as long as they pay at current Medicare rates. I wouldn't ask them to ration or criticize said care, just simply pay the bill when the check arrives. Believe it or not, there's not many people freeloading a ventilator needlessly. That would free up the private plans to coexist for those of us that want office visits, labs, or other extra coverage. And their rates would plummet. It would be like buying an umbrella policy, which nowadays are like $200 a year.

I am all for the premise of insuring only catastrophic procedures. Hence my HSA policy. But I am not for government being the one running the insurance...

Yes I know some will not purchase insurance but that is the liberty and freedom they should be afforded. If the states want to set up some catastrophic subsidy I would possibly be game if the idea was good...

[gatorev12]

I guess this is why nothing gets done. I can't believe all my right wing friends on here disagreeing with the premise. You wouldn't pay an extra 3 cents or so on the dollar for items you buy if it meant being free of the threat of foreclosure, bankruptcy, or failure secondary to medical debts?
I compare it to home insurance. In Florida, the private sector is already out of the riskier areas (flood, hurricane, etc.). Nowadays, your private homeowners plan covers the low-risk stuff, the improtant stuff is through FEMA anyway. I believe the government could handle the critical care issues that most of us are scared of (ICU care, ventilators, heart attacks) as long as they pay at current Medicare rates. I wouldn't ask them to ration or criticize said care, just simply pay the bill when the check arrives. Believe it or not, there's not many people freeloading a ventilator needlessly. That would free up the private plans to coexist for those of us that want office visits, labs, or other extra coverage. And their rates would plummet. It would be like buying an umbrella policy, which nowadays are like $200 a year.

After some consideration, I can admit there's a lot of merit to the idea. As you said, the big "fear" in driving the "need for something to be done" is the threat of some catastrophic event occurring and an individual going bankrupt over medical costs. Removing that fear would, in theory, drive down healthcare premiums (since individuals could opt for a basic coverage plan to cover routine checkups and regular testing while the govt covers the higher-risk stuff) and also remove the liberal drive to "fit in" with the rest of the world and implement single-payer.

I think the real reason conservatives are skeptical though isn't because it isn't a sound idea...its because they don't trust Democrats/ big government types to "stop" at catastrophic coverage. And, you have to admit, it's a valid skepticism to have given that SS, Medicare, and Medicaid all started off as small programs and weren't intended as originally conceived to be the bloated federal programs they are today.

[QGator2414]

After some consideration, I can admit there's a lot of merit to the idea. As you said, the big "fear" in driving the "need for something to be done" is the threat of some catastrophic event occurring and an individual going bankrupt over medical costs. Removing that fear would, in theory, drive down healthcare premiums (since individuals could opt for a basic coverage plan to cover routine checkups and regular testing while the govt covers the higher-risk stuff) and also remove the liberal drive to "fit in" with the rest of the world and implement single-payer.

I think the real reason conservatives are skeptical though isn't because it isn't a sound idea...its because they don't trust Democrats/ big government types to "stop" at catastrophic coverage. And, you have to admit, it's a valid skepticism to have given that SS, Medicare, and Medicaid all started off as small programs and weren't intended as originally conceived to be the bloated federal programs they are today.

This! And it is not just dems IMO...

[QGator2414]

Another concern I have on top of gatorev...

The doctor that runs procedures on volume to get paid. While this is not the norm IMO I worry that limiting the free market more than it already is in healthcare could create an ethical issue as it is expensive to run medical practices as I am sure you are aware art...

For example how does this catastrophic coverage cover an anesthesiologists services who are slammed by medicare and a low fee schedule?

[austingtr]

The problem started when guvmint (when they capped wages, and industry started providing health insurance as a way to create higher pay) got in between doctors and patients. The problem is so insidious now, that medical ethics has changed from doctors being patients advocates, to doctors worrying about costs for the society. This change came through coercion and fear of incarceration (doctors being afraid of committing Medicare fraud- which is a federal offense, that can land you in jail). So IMO only going back to individuals deciding directly, and being directly responsible for paying for their own healthcare is the only way to fix this. Sure, there can be guvmint assistance for the needy, but to think that society is responsible to pay for Mercedes Benz care for everyone is simply ludicrous and false. And isn't happening now, because there is covert rationing, and nobody wants to expose the reality to the masses, because we are just too stupid to understand, or our leaders are afraid of losing their power.

Coding for Medicare/medicaid (which is usually done by clerks in offices or hospitals) is impossible to do without breaking the law. Studies have shown that there is only a 20% agreement in coders. This is by design. The coding laws are contradictory so that all docs break the law. Yes, even when is the hospital doing the billing, and even when a doctor works for a hospital, if there is "Medicare fraud", it is only the doctor who gets fined, loses his practice, or gets put in jail.

Hence the doctor's decisions are by necessity now dependent on federal mandates and the "good of the collective". The guvmint is in the middle now, because healthcare is a "right", and has to be provided by the guvmint. So now the guvmint is the agent of covert rationing, a role that used to be of the insurance companies. All because the doctor patient relationship was intruded by insurance and the guvmint. None of us has a true advocate any longer. That is only if you are among those privileged few who went back to paying their doctors directly and are out of the system.

So no I cannot get behind the ACA. I repudiate it as an an awful assault on my God given right to be free.

[g8orbill]

supposedly there are about 36 million uninsured Americans- certainly if the goal was to provide for them it could have been done without this monster ACA aka prezbocare

[mastoidbone]

LOL---I remember a patient complaining about $800 anesthesia bill for a 3 hour emergency colectomy at 3 AM.
I asked him how much would he pay a plumber to come to his house at 3 AM for 3 hours?
How much would he pay for a new transmission?
And did either of those guys have $250,000 school debt?
Did either of those guys get 9 years of training AFTER college to do their job?

He still refused to pay because he said it was too much.
I then laughed when he pulled out his Ipad to make notes of the meeting.
I told him he WOULD be getting a collection letter.

[QGator2414]

The problem started when guvmint (when they capped wages, and industry started providing health insurance as a way to create higher pay) got in between doctors and patients. The problem is so insidious now, that medical ethics has changed from doctors being patients advocates, to doctors worrying about costs for the society. This change came through coercion and fear of incarceration (doctors being afraid of committing Medicare fraud- which is a federal offense, that can land you in jail). So IMO only going back to individuals deciding directly, and being directly responsible for paying for their own healthcare is the only way to fix this. Sure, there can be guvmint assistance for the needy, but to think that society is responsible to pay for Mercedes Benz care for everyone is simply ludicrous and false. And isn't happening now, because there is covert rationing, and nobody wants to expose the reality to the masses, because we are just too stupid to understand, or our leaders are afraid of losing their power.

Coding for Medicare/medicaid (which is usually done by clerks in offices or hospitals) is impossible to do without breaking the law. Studies have shown that there is only a 20% agreement in coders. This is by design. The coding laws are contradictory so that all docs break the law. Yes, even when is the hospital doing the billing, and even when a doctor works for a hospital, if there is "Medicare fraud", it is only the doctor who gets fined, loses his practice, or gets put in jail.

Hence the doctor's decisions are by necessity now dependent on federal mandates and the "good of the collective". The guvmint is in the middle now, because healthcare is a "right", and has to be provided by the guvmint. So now the guvmint is the agent of covert rationing, a role that used to be of the insurance companies. All because the doctor patient relationship was intruded by insurance and the guvmint. None of us has a true advocate any longer. That is only if you are among those privileged few who went back to paying their doctors directly and are out of the system.

So no I cannot get behind the ACA. I repudiate it as an an awful assault on my God given right to be free.

Repped!