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10/25/2016 9:51 am  #11


Re: It's about time to consider medicare for everyone

Just Fred wrote:

...as Micheal Moore said last night on the Chris Hayes show, it was half baked. You either go all the way to single payer universal coverage, or not.

Ok, I'm on board with Micheal Moore on that.  In fact, I believe I said that from day one of it's inception.  I should add that I'm not a fan of employer-based health insurance, either.

We don't have to re-invent the wheel here.  We are the only industrialized country in the world with a system like this.  If our system was so swell, why haven't other countries petitioned their respective governments to switch their healthcare systems to one like we have here in America?

As far as health insurance costs rising every year, we might want to address the costs associated with healthcare from the costs of medicines to the 'non-profit' nature of hospital care.  I could tell you stories about that, but that would be another topic.

I realize I'm somewhat alone here, but when I retired from my teaching career and I had to pick up the cost of health insurance on my own, it hit me like a ton of bricks when I discovered my health insurance premium for my wife and I was going to be $1040.00/month, and that was in 2003.  I can't imagine what it would be today for those retiring in 2016.

Anyway, it's refreshing to be involved in a conversation discussing an issue rather than Donald Trump's latest tweets.

 

Fred, the reason the general public does not automatically get on board is the same reason you and a many, many others who have health care subsidized by their employer. They are sheltered from the TRUE costs of health care. Your premiums are not out of line as absurd as they seemed the way things are structured today. IF and when we can all get on the same page universal health care COULD become a reality. BUT at lot of things (and people) have to change before that happens. 

Last edited by tennyson (10/25/2016 9:52 am)


"Do not confuse motion and progress, A rocking horse keeps moving but does not make any progress"
 
 

10/25/2016 10:13 am  #12


Re: It's about time to consider medicare for everyone

And, how do we address the 15 to 20 million people and those with pre-existing conditions who would lose their health insurance should ACA be repealed?

     Thread Starter
 

10/25/2016 10:51 am  #13


Re: It's about time to consider medicare for everyone

Just Fred wrote:

And, how do we address the 15 to 20 million people and those with pre-existing conditions who would lose their health insurance should ACA be repealed?

I don't have a clue. I am NOT against repealing the ACA. It obviously has flaws, let's fix them. Unfortunately the Trump platform winds up leaving the vast majority who benefitted from the ACA back in the emergency room at least the way I see it. 
 


"Do not confuse motion and progress, A rocking horse keeps moving but does not make any progress"
 
 

10/25/2016 12:24 pm  #14


Re: It's about time to consider medicare for everyone

Lots of questions to be addressed. I do have employer based health insurance, and I like it. They pay about 80% of my premium. It's considered part of my compensation package, but is not subject to income tax.
If we go to Medicare for all, our medicare taxes will have to drastically increase. And what happens to my employer premium contribution? If I get it at all, it will be paid as salary, and subject to tax as earned income.
I see it as negatively affecting my lot in life.

Last edited by Goose (10/25/2016 12:25 pm)


We live in a time in which decent and otherwise sensible people are surrendering too easily to the hectoring of morons or extremists. 
 

10/25/2016 2:05 pm  #15


Re: It's about time to consider medicare for everyone

Just Fred wrote:

And, how do we address the 15 to 20 million people and those with pre-existing conditions who would lose their health insurance should ACA be repealed?

It would be unfair to do that. I would be open to expanding Medicaid to cover those who can't get insurance in any other way.

Of course then you run the risk of having the insurance companies use Medicaid as a dumping ground for all of the insured that they don't want to cover. There would need to be a hard negotiation to work through that.

I also question your number a little bit. If I understand correctly, the ACA on-boarded about 20 million people onto the insurance rolls. I'm quite not all of them didn't have pre-existing conditions, but rather just couldn't afford it pre-ACA.

By the way, I would (were I in a position to do so) show no mercy to those who could afford insurance, but chose not to have it and then ended up in the hospital because of some catastrophic incident. 

The way the Department of Education hounds people til death for their unpaid student loans, I would have the HHS hound those willfully uninsured until they back back every doctor and hospital bill.


I think you're going to see a lot of different United States of America over the next three, four, or eight years. - President Donald J. Trump
 

10/25/2016 5:27 pm  #16


Re: It's about time to consider medicare for everyone

Goose wrote:

Remember, healthcare is very expensive, and Americans love their high tech treatments. You don't get it for nothing.
No bucks, no Buck Rogers.

I've pointed the following out before, but here we go again.

What makes health care so expensive?

First, medical malpractice lawsuits.   It is not just the suits, the cost of the defense, and the payouts, nor the premiums paid by health care providers; but the diagonstic and treatment protocols which are driven by the malpractice insurers.   These protocols for "defensive medicine" require otherwise needless high-tech, intrusive tests just to scratch one off the list.   THERE WILL BE NO MEDICAL COST REFORM WITHOUT TORT REFORM.

Second, designer drugs for anything and everything.   We are the only nation which permits prescription meds to be advertised on TV.  Do you really need a drug for toenail fungus, darker eyebrows, or reduced urge to urinate?  Of course once on a prescription frequent "med checks" are needed, including blood work.  More health care $$$ just for clear toenails.


 


Life is an Orthros.
 

10/25/2016 5:47 pm  #17


Re: It's about time to consider medicare for everyone

I also question your number a little bit. If I understand correctly, the ACA on-boarded about 20 million people onto the insurance rolls. I'm quite not all of them didn't have pre-existing conditions, but rather just couldn't afford it pre-ACA.

My mistake.  I should have used the word 'or' instead of 'and' in the sentence concerning the number of people at risk of losing health insurance.

This whole thing illustrates the dangers of mixing governmental responsibilities with wealthy private-for-profit corporations.  The health insurance industry and the pharmaceutical industry spend wads of cash lobbying for their interests, but who lobbies for the working schmucks like the rest of us?

I'll pose this question one more time:  Why haven't we ever heard about another industrialized country petitioning their government to switch to a healthcare/insurance system like we have here in America?

 

     Thread Starter
 

10/25/2016 5:50 pm  #18


Re: It's about time to consider medicare for everyone

THERE WILL BE NO MEDICAL COST REFORM WITHOUT TORT REFORM.  -  Tarnation

Correct me if I'm wrong here, but I believe Texas tried that and it didn't work.

 

     Thread Starter
 

10/25/2016 7:51 pm  #19


Re: It's about time to consider medicare for everyone

Fred,

No state has enacted serious tort reform because every legislature has an over abundance of trial (read, civil suit) lawyers in its membership.   They're not about to constrict their gravy train.


Life is an Orthros.
 

10/26/2016 6:07 am  #20


Re: It's about time to consider medicare for everyone

Tarnation wrote:

Goose wrote:

Remember, healthcare is very expensive, and Americans love their high tech treatments. You don't get it for nothing.
No bucks, no Buck Rogers.

I've pointed the following out before, but here we go again.

What makes health care so expensive?

First, medical malpractice lawsuits.   It is not just the suits, the cost of the defense, and the payouts, nor the premiums paid by health care providers; but the diagonstic and treatment protocols which are driven by the malpractice insurers.   These protocols for "defensive medicine" require otherwise needless high-tech, intrusive tests just to scratch one off the list.   THERE WILL BE NO MEDICAL COST REFORM WITHOUT TORT REFORM.

Second, designer drugs for anything and everything.   We are the only nation which permits prescription meds to be advertised on TV.  Do you really need a drug for toenail fungus, darker eyebrows, or reduced urge to urinate?  Of course once on a prescription frequent "med checks" are needed, including blood work.  More health care $$$ just for clear toenails.


 

Actually, some would suggest that the costs of medical liability are not the biggest factor.
I think that it lay with technology, drug companies, and unrealistic expectations by consumers.




Medical liability costs in U.S. pegged at 2.4 percent of annual health care spending

Boston, MA – How much do medical liability costs—including the costs of malpractice insurance, claims and legal fees and doctors practicing “defensive medicine” to avoid being sued—add to overall medical costs?

During the recent debates over federal health care reform, considerable attention focused on whether medical liability reform should be included in the package as a means of reducing costs. Proponents offered some very high estimates (as high as 10%) of how much the liability system contributed to health care costs, while opponents trivialized these expenses. In an effort to separate fact from fiction—and to provide the first academic study of medical liability system costs— a comprehensive analysis from Harvard School of Public Health (HSPH) researchers found that medical liability costs totaled about 2.4% of annual health care spending in the United States, or $55.6 billion per year in 2008.

“Medical liability costs have been in the bull’s-eye of efforts to bend the health care cost curve down,” said lead author Michelle Mello, professor of law and public health at HSPH.  “But we can’t have a meaningful debate about the potential effects of liability reform without solid cost estimates. At nearly $56 billion per year, the medical liability system carries heavy costs, and there are good reasons to want to improve it. But we should be realistic about what liability reform can achieve in terms of health care cost control.”

The study appears in the September, 2010, issue of Health Affairs.

According to Mello and her co-authors, other reforms, such as changing the fee-for-service reimbursement system that gives providers incentives to overuse services, probably hold more promise for reducing health care costs. Proponents of liability reform argue that it will address two drivers of health care costs: providers offsetting rising malpractice insurance premiums by charging higher prices and “defensive medicine,” in which liability concerns lead doctors to order more tests, procedures, and other services than are medically necessary.

To come up with their estimate of liability costs, Mello and colleagues analyzed various components of the medical liability system, including payments made to malpractice plaintiffs; defensive medicine costs; administrative costs, such as lawyer fees; and the costs of lost clinician work time. They found that the medical liability system’s annual price tag includes $45.6 billion in defensive medicine costs, $5.7 billion in malpractice claims payments, and more than $4 billion in administrative and other expenses.

While some elements of medical liability costs — such as the high amount spent on legal expenses —represent inefficiencies and could be trimmed, Mello counters claims that money spent on medical liability is waste. “We shouldn’t forget that despite all its dysfunctions and inefficiencies, the medical liability system does produce social benefits,” she said. “It makes injured patients whole by providing compensation; it provides other forms of ‘corrective justice’ for injured persons, producing psychological benefits; and it may deter future injuries by signaling to health care providers that they will suffer sanctions if they practice negligently and cause injury.  The question is, can we reform the system to enhance these benefits and get them at lower cost?”

https://www.hsph.harvard.edu/news/press-releases/medical-liability-costs-us/

Last edited by Goose (10/26/2016 6:10 am)


We live in a time in which decent and otherwise sensible people are surrendering too easily to the hectoring of morons or extremists. 
 

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