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Author Topic: My solution to funding health care  (Read 1111 times)

Online kathyp

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My solution to funding health care
« on: July 01, 2017, 04:21:07 pm »

1. Give every man, woman, and child citizen and legal resident 1 million dollars to put in an HSA. They can either use it for insurance or pay cash for care. If they die, it can roll over to their spouse, children, or another family member. If there is no family, it goes back to the treasury. If they leave the country, they forfeit the money.
2. get rid of Medicaid except for the very ill and very poor who might go through even the million dollars.
3. Exempt seniors from the plan and allow them to keep Medicare.
4. Regulate insurance companies as we regulate public utilities so they don't jack up rates knowing everyone has a million dollars to spend.
It's not a perfect free market plan, but it gets the government out of healthcare, saves money, and gives people choice.
?Every record has been destroyed or falsified, every book rewritten, every picture has been repainted, every statue and street building has been renamed, every date has been altered. And the process is continuing day by day and minute by minute. History has stopped. Nothing exists except an endless present in which the Party is always right.?


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Offline cidersabuzzin

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Re: My solution to funding health care
« Reply #1 on: July 01, 2017, 05:47:44 pm »
"keeps the government out of the health care business" who regulates the insurance companies? do you seriously believe the insurance / health care companies would not find a way to raise prices?
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Online kathyp

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Re: My solution to funding health care
« Reply #2 on: July 01, 2017, 06:29:15 pm »
Quote
do you seriously believe the insurance / health care companies would not find a way to raise prices?

That was brought up to me and that is why I added to the plan that the insurance companies be regulated as we regulate PUCs.  Different places fo this in different ways, but my favorite is to have a citizen commission that has to approve all rate increases.  That means the company has to go before the commission and justify the rate increase. 

As a practical matter, there isn't much difference between insurance companies taking more or government taking more.  Your NHS is very expensive.  You pay for that if you are paying taxes.
This plan would also allow people who are healthy to pay out of pocket for what they use.  For those who chose insurance of any kind, it gives them the negotiating power to shop for the best price and forces insurance companies to compete for those dollars.  That's something many don't do now because they are paid by way of employer policies or government pools.  Being forced to compete for dollars would cause them to offer multiple types of plans at better prices...just a auto insurers do. 

?Every record has been destroyed or falsified, every book rewritten, every picture has been repainted, every statue and street building has been renamed, every date has been altered. And the process is continuing day by day and minute by minute. History has stopped. Nothing exists except an endless present in which the Party is always right.?


― George Orwell, 1984

Offline beecanbee

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Re: My solution to funding health care
« Reply #3 on: July 01, 2017, 08:01:21 pm »
Health care, much like national defense, IMO - should to be truly national, single payer, and paid for thru general tax revenues.  With the fiasco for Republicans of non-support that has unfolded on the Senate bill, it is time for moderate Republicans to work with Democrats to fix the ACA. 

My suggestions would to expand Medicare/Medicaid for all states, limit insurance companies by law - to free market Premium policies which top-up coverage for cosmetic procedures, private hospital use, etc., where charges might be greater than the negotiated rates covered by the national program.   The new national coverage should apply for all non-cosmetic medical services which are FDA approved.  Single payer of course, and no identifiable premiums, but rather paid for thru increased progressive taxes on incomes, investment returns, and estates ? bringing back the old 75% tax rate for those at the highest income levels.   Once universal health care, national defense, social security, and the national debt have all been fully covered, then the tax rate can be lowered to match expenditures in these and the other important areas such as climate change, clean air and water, etc.
"I come from a state that raises corn and cotton and cockleburs and Democrats, and frothy eloquence neither convinces nor satisfies me. I am from Missouri. You have got to show me."  Duncan Vandiver

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Offline Dallasbeek

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Re: My solution to funding health care
« Reply #4 on: July 01, 2017, 08:27:39 pm »
On the surface your plan looks pretty good, Kathy, but ...

1. Have you not noticed how some regulatory agencies overseing public utilities seem to be in the pockets of those PUCs?

2.  What happens when an individual has spent their million?  Do we let them die?  I just started on an oral chemotherapy medication that I was told had a monthly co-pay of $2,783.  I said no thank you and the drug company is giving it to me free for now.  In six months, it will be reviewed and we'll see if I stay on it.  But $2,783 a month would eat into that million pretty quickly.
"Liberty lives in the hearts of men and women; when it dies there, no constitution, no laws, no court can save it." - Judge Learned Hand, 1944

Offline Dallasbeek

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Re: My solution to funding health care
« Reply #5 on: July 01, 2017, 08:32:41 pm »
I should clarify that I have a type of cancer that's treatable long-term.  I've been living with it for 16 years already.  I wasn't aware this med was chemo until it arrived today.  Very weird stuff.  I guess I might be part of a study or something, but they do have to have informed consent for a study, right?
"Liberty lives in the hearts of men and women; when it dies there, no constitution, no laws, no court can save it." - Judge Learned Hand, 1944

Offline gww

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Re: My solution to funding health care
« Reply #6 on: July 01, 2017, 08:45:51 pm »
I like single pay and getting rid of health insurers.  Supposedly a four hundred billion savings per year in health care cost. 
dallas
Hope it stays long term illness (meaning I can keep reading your post for a long time) and that you are not put at any risk due to cost.
Good luck
gww

Offline Acebird

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Re: My solution to funding health care
« Reply #7 on: July 01, 2017, 10:44:56 pm »
3. Exempt seniors from the plan and allow them to keep Medicare.

If you make exceptions it is not a sound plan.  I am very close to being a senior.

I think your plan is not that bad.

According to Warren Buffet we should have elected one of his sisters and then elected them to office.  It certainly would have raised the IQ in the White House by 100 points.
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Offline beecanbee

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Re: My solution to funding health care
« Reply #8 on: July 02, 2017, 03:39:24 am »

1. ... If they leave the country, they forfeit the money. 

Several millions of Americans work overseas for years at a time.  Most return, but they do pay US taxes while overseas, even if they don`t ever return.  But return they might if they were insured and faced a life changing disease.

-----

Also - $1m doesn`t cover many diseases, particularly if contracted while young.

On the other hand ? with single payer hospitals shed very significant billing and even treatment burdens, since they don`t need to seek preapprovals, check for insurance status, or manage different billing procedures.  One form fits all.  Plus, the doctors call the shots on treatments and just follow the standard treatment guidelines in most cases, and make informed decisions when necessary to step outside of those.
"I come from a state that raises corn and cotton and cockleburs and Democrats, and frothy eloquence neither convinces nor satisfies me. I am from Missouri. You have got to show me."  Duncan Vandiver

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Offline Acebird

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Re: My solution to funding health care
« Reply #9 on: July 02, 2017, 09:28:54 am »
I guess I might be part of a study or something, but they do have to have informed consent for a study, right?

Not if the drug / treatment is approved.
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Offline Psparr

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Re: My solution to funding health care
« Reply #10 on: July 02, 2017, 12:13:42 pm »
Single payer would look no different than the post office.  An utter mess and never on budget. Are health insurance companies the best answer? No.
However if you want to see the future of single payer just google Charlie Gard.

Offline beecanbee

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Re: My solution to funding health care
« Reply #11 on: July 02, 2017, 01:58:30 pm »
Single payer would look no different than the post office.  An utter mess and never on budget. Are health insurance companies the best answer? No.
However if you want to see the future of single payer just google Charlie Gard.

Single payer would look more closely like SS or even Medicare - once enrolled, the patient loses sight of it since only the hospital blling department has an ongoing relationship with one, and only one, insurance company.  Of course top-up private insurance would complicate the billing for some patients, but then again - not for the patient nor for the doctor, and in any event it would be far simpler and far cheaper than what exists today.  
"I come from a state that raises corn and cotton and cockleburs and Democrats, and frothy eloquence neither convinces nor satisfies me. I am from Missouri. You have got to show me."  Duncan Vandiver

A boy can do half the work of a man, but two boys do less, and three boys get nothing done at all. :)

(False) Patriotism is the last refuge of a scoundrel.  - Samuel Johnson

Online kathyp

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Re: My solution to funding health care
« Reply #12 on: July 02, 2017, 02:02:38 pm »
Valid points and some that we have been going over on FB.  I want this simple, so let's try to keep it to one page.

Leaving country was directed at those who are legal residents, but perhaps citizens of other countries.  If they choose to leave, they forfeit dollars.  If you choose to be an expat, you should also forfeit in my opinion.  Working in another country is not really leaving. 

Long term expensive treatment would be covered by a simple process of applying for a top-up.  Even if you had to do that for many people, it would still be less expensive than the current or proposed plans.  We have 350ish million people and under 4 million births per year.

Congress would have to address the insurance company bit because it would have to have to be applied nationally.  this part is the part that is the least free market, but as someone pointed out to me elsewhere, if they are not more regulated they will see the money as something they need to get at.  To that end, a PUC type process would probably work, but it would have to be one that is not IN government even if the rules are set by the government.  Maybe something like the FCC, which works pretty well most of the time and if kept balanced keeps ideologues from screwing it up. 

There are a couple of problems that are at the top of my list with single payer.  1 is cost.  The government never controls cost until things are out of hand.  It can't do any program without a monstrous bureaucracy (NHS 5th largest employer in the world for 65 million people) When they do finally figure out that a program is out of hand, they usually just print money to cover it, rather than do something to reduce cost AND the people throw a hissy fit if anyone tries to limit "free" stuff.  True in England and true here.
Another big problem is availability of or limiting of services.

Expanding Medicaid makes it worse.  Already Medicaid users use more services than anyone else and much of that use is abuse.  England has the same problem.  Faster to go the the ER for stuff than wait for an appointment.  Easy to go for every sniffle and cough that wait for something to pass.  The result is that people who need cancer surgery wait weeks.   People who need heart surgery wait months.  Never mind things like joint transplants, etc. that are certainly not emergencies but go to the quality of life.

Quote
I just started on an oral chemotherapy medication that I was told had a monthly co-pay of $2,783.

One of the biggest ways single payer in other countries limits cost is by limiting drugs.  If the drug is not standard of care, then it probably is not available.  There was a drug for MS that became available in the US as soon as it was shown to work.  It was not cheap, but most insurance covered it.  It was not available in the UK on the NHS for many year.  If people wanted it they had to find a private doc and pay all expenses out of pocket. 

No plan is going to be perfect.  The most simple plan that does the most good for the most people, controls cost, and keeps the inept government out of it, is the plan I want.


?Every record has been destroyed or falsified, every book rewritten, every picture has been repainted, every statue and street building has been renamed, every date has been altered. And the process is continuing day by day and minute by minute. History has stopped. Nothing exists except an endless present in which the Party is always right.?


― George Orwell, 1984

Offline Psparr

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Re: My solution to funding health care
« Reply #13 on: July 02, 2017, 02:03:55 pm »
You mean like when Obama said maybe you could just take a pill instead of having a hip replacement? That kind of government run health care?

Offline beecanbee

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Re: My solution to funding health care
« Reply #14 on: July 02, 2017, 02:17:37 pm »
... if you want to see the future of single payer just google Charlie Gard. 

I did google and read.  Sad story for sure, but hardly an aspect of single payer or even national healthcare insurance.  Compare to the thousands who die every year in the US for lack of insurance, or worse - for having insurance that simply decides to no longer pay.  That is the system the US has now - with many patients and doctors at wits end.  In the end, they contact their state insurance commissioners or their congressmen in a last ditch effort to remain on treatment.  But for those without insurance - still over 10% now, and for many with very high co-pays, they simply must avoid treatment and thus die many years sooner than the might if they had coverage.
"I come from a state that raises corn and cotton and cockleburs and Democrats, and frothy eloquence neither convinces nor satisfies me. I am from Missouri. You have got to show me."  Duncan Vandiver

A boy can do half the work of a man, but two boys do less, and three boys get nothing done at all. :)

(False) Patriotism is the last refuge of a scoundrel.  - Samuel Johnson

Offline beecanbee

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Re: My solution to funding health care
« Reply #15 on: July 02, 2017, 02:21:00 pm »
You mean like when Obama said maybe you could just take a pill instead of having a hip replacement? That kind of government run health care?

Trump - Repeal and replace - I will not touch SS or Medicare.  It will be so much better than the ACH.  Huhhh?  How many millions will lose insurance?  Better for whom?
"I come from a state that raises corn and cotton and cockleburs and Democrats, and frothy eloquence neither convinces nor satisfies me. I am from Missouri. You have got to show me."  Duncan Vandiver

A boy can do half the work of a man, but two boys do less, and three boys get nothing done at all. :)

(False) Patriotism is the last refuge of a scoundrel.  - Samuel Johnson

Offline Psparr

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Re: My solution to funding health care
« Reply #16 on: July 02, 2017, 02:42:50 pm »
... if you want to see the future of single payer just google Charlie Gard. 

I did google and read.  Sad story for sure, but hardly an aspect of single payer or even national healthcare insurance.
If there is only the government offering insurance, they can dictate what care you may or may not receive.
Remember the "death panels"?
It was a group set up by the government to look at certain forms of treatment and to decide wether they were worth it or not. Sounds exactly like Charlie Gard.
Many places in the ACA it says "shall be determined by the HHS secretary". Medicare and Medicade are going bankrupt and you want more of it?

Offline sawdstmakr

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Re: My solution to funding health care
« Reply #17 on: July 02, 2017, 02:43:40 pm »
Bruce,
I think you will find many many millions more will be able to afford health care when it is repealed. Very few people, compared to what it was supposed be for ever even got Obamas unaffordable health care. The main reason for it was more control and to bankrupt the US.
"If you don't read the newspaper you are uninformed.  If you do read the newspaper you are misinformed."--Mark Twain

Offline beecanbee

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Re: My solution to funding health care
« Reply #18 on: July 02, 2017, 03:00:46 pm »
Valid points and some that we have been going over on FB.  I want this simple, so let's try to keep it to one page.

A few quibbles...

Quote
Leaving country was directed at those who are legal residents, but perhaps citizens of other countries.  If they choose to leave, they forfeit dollars.  If you choose to be an expat, you should also forfeit in my opinion.  Working in another country is not really leaving. 

Being an expat - is working overseas.  That is, unless you are military (assigned overseas) or maybe a company employee who is posted overseas for a short term - measured in weeks or months instead of years.  Many people are dual citizens too and move back and forth throughout their lives to follow jobs, education, and care for older family members.

Quote
Long term expensive treatment would be covered by a simple process of applying for a top-up.

That could work well for healthy adults, but not so well for children or for those with genetic or familial histories that might make them top-up ineligible.   

Quote
There are a couple of problems that are at the top of my list with single payer.  1 is cost.  The government never controls cost until things are out of hand. ... Another big problem is availability of or limiting of services.

Single payer reduces cost of the multiple billing departments, the claims adjusters, and by allowing uniform negotiated cost of services and medications.

The UK does limit the pipe-line, and I agree that is a real problem which both doctors and patients face there - but it still does a better job for their society at large than does the US, where would-be patients don`t even present for care, except to the emergency room when it is too late.

Quote
Expanding Medicaid makes it worse.  Already Medicaid users use more services than anyone else and much of that use is abuse.

Many more on Medicare/Medicaid today, and thus insured, under the ACA, so naturally they use more services than in the past.  If there is abuse it needs to be addressed, just as it needs to be addressed when private insurance refuses to pay.

Quote
One of the biggest ways single payer in other countries limits cost is by limiting drugs.  If the drug is not standard of care, then it probably is not available.  There was a drug for MS that became available in the US as soon as it was shown to work.  It was not cheap, but most insurance covered it.  It was not available in the UK on the NHS for many year.  If people wanted it they had to find a private doc and pay all expenses out of pocket. 

That is exactly the same as in the US today with private insurance, with refusals to pay.  Many patients get around this by participating in trials, and by begging for mercy to the drug companies who may be willing to give it away in order to build doctor relationships, but this is not the case for most.


Quote
No plan is going to be perfect.  The most simple plan that does the most good for the most people, controls cost, and keeps the inept government out of it, is the plan I want. 

The most good for the most people is national healthcare for all, and single payer.  The government needs to get involved to solve the distorted system the US has today - for would-be patients, patients, and doctors.


"I come from a state that raises corn and cotton and cockleburs and Democrats, and frothy eloquence neither convinces nor satisfies me. I am from Missouri. You have got to show me."  Duncan Vandiver

A boy can do half the work of a man, but two boys do less, and three boys get nothing done at all. :)

(False) Patriotism is the last refuge of a scoundrel.  - Samuel Johnson

Offline beecanbee

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Re: My solution to funding health care
« Reply #19 on: July 02, 2017, 03:11:00 pm »
  If there is only the government offering insurance, they can dictate what care you may or may not receive.
Remember the "death panels"?

...  Medicare and Medicade are going bankrupt and you want more of it? 

Insurance companies do that today - even for those with insurance.  But for those without, they do it in a blanket way.  Death Panel - is exactly the right term for the Republican cabal that is pushing repeal. 

Medicare/Medicaid only goes bankrupt if it isn`t funded.  Compare to military defence - is it going bankrupt?
"I come from a state that raises corn and cotton and cockleburs and Democrats, and frothy eloquence neither convinces nor satisfies me. I am from Missouri. You have got to show me."  Duncan Vandiver

A boy can do half the work of a man, but two boys do less, and three boys get nothing done at all. :)

(False) Patriotism is the last refuge of a scoundrel.  - Samuel Johnson