...for sick people.  

This is an interesting question.  Because it seems that we've pretty much accepted that it can only be handled by some sort of private (insurance) or public collectivism.  

The current business model relies on some form of collectivism.  Is this the only solution?

Thoughts?

I'm torn on the issue. Honestly, most western industrialized nations have single payer and the system isn't all THAT fucked up. I have little faith in our corrupt government implementing anything even resembling an efficient healthcare system however.

I mean look at the VA for fucks sake.

Healthcare costs surge when Government becomes involved.

No one has a Constitutional Right to healthcare.

period.

I don't think the medical inflation is only due to government.  But I agree that's an aggravating factor.  I believe it doesn't respond to normal economic pressures because of third-party payers isolating the consumer from the full financial impact of their choices.

I think if people just paid for health care, like they do other services, the prices would decline.  They'd have to.  

Because healthcare providers are paid by "pooled" payers, they can charge a much higher price then they'd otherwise be able to charge.  

Young healthy people pay for sick older people.   I'm closing in on 50, and I'm healthy.  I've not had any health problems, or needed any major medical procedures, nothing I couldn't have paid for out of pocket at the point of service at fraction of the cost of my annual insurance premium.  

No I realize I might be a little more healthy then many.  But I have to believe most people are still in the same boat.  Especially younger people in their 20 and 30's.  

Most of the really expensive healthcare occurs in the last decades, or years of life ...for most people.  The system depends on most people just paying very expensive premiums, and not costing that much.  So even private insurance is collectivism.  

Single-payer is inevitable in the US. Even on Arf many so-called conservatives want publicly funded healthcare for the 'truly needy', which puts them mere degrees away from the far left on the matter.

We can hope for relatively efficient socialism, but the US .gov is incapable of that, so we'll per-capita spend like Norway and get services like Turkey.

Gov. Housing...top notch.
Gov. retirement..SS..not to worry.
Gov. medical..Medicare..same story.

So what would be success for single payer?

No one knows.

Except charity wouldn't exist in this field anymore.  It would already be enforced.

I think we are going to end up with a dual payer system like Australia, and we are going to be damn glad to have it.

Basically you basic medical costs would be covered by a Medicare/Medicaid type program and higher levels of care are provided through private insurance.

It would also be a good time to start taxing employer health care plans.

Found the Statist!

It is going to be hard to tell which way we finally go.  Government involvement always raises costs.  The main reason healthcare costs in the us have risen is because everything is based of Medicare/Medicaid they pay nothing while higher prices are charged to insurance companies to cover losses.  

Look at car insurance or life insurance to see how competition drives down prices.  I think a free market solution would be the cheapest.  But Insurance companies want to keep their government informed monopolies and government and politicians wants to keep its control to keep power and influence to get votes.  

Look at the VA if you want to see what gov run healthcare looks like.

Taxing something discourages it.  So how would taxing employees health benefits benefit the people? It would be making an incentive for employers to cut benefits.

Please. What do you think is more likely, the repeal of Obamacare or its replacement with something that actually works better?

It would decrease medical spending by moving money from the health care industry to wages, where it could be spent on any number of things.

I say the best way is to outlaw health insurance. Then medicine would have to actually deal with patients over the cost of procedures. Get the gov out any way you can. Insurance is a middleman cost that could be done away with.

I believe in real single payer. Pay for you. Medical savings and loans would be my answer.

It might not be a problem, if we had a real "health" care system, instead of an expensive sickcare system.  

It seems like diagnostic technology, and smart systems, could be the primary healthcare "provider" for people into their 50's or even 60's and beyond.  

Genetic screening, low volume comprehensive blood work, routine diagnostic evaluations, up to and including "if needed" full body scans could possibly help people better avoid needing, or at least provide earlier intervention of major medical protocols.  That, and if people would fucking move more, eat better, and not get fat.  

So how are people going to pay for $1,000,000 in cancer treatment? Just kill themselves?

Insurance was invented by ship owners who new that a certain percentage of their ships would founder in heavy seas, and that by socializing the risk they could survive the otherwise unsurvivable.

Do you have a better idea?

Honestly, I think this is preferable.  But like most free-market "libertarian" solutions it has a snowballs chance in hell of being implemented.  Most people, including conservatives, like some collectivism.  

Why not just start the next great SS Ponzi scheme except instead of it being for your retirement, it's for your medical costs when you're an old fogey

What could possibly go wrong

So taxing my employer on my benefits would cause them increase my wages?  Interesting concept. Except I don't see how that would work.  The market is the most efficient in deciding where money goes not the government.  

You've just described Medicare.

We need to fix a bunch of other issues before we can get cheap health insurance like putting limits on liability and full funding of MD education first. But most of congress is against free education of any kind, and they are all lawyers so they won't be limiting liability anytime soon. The liability insurance is really the kicker probably 75% of the costs are various liability insurances from the doctors and nurses too the equipment they use.

Now, absent a free market?



Probably.

Those things.

Tort reform so you can't sue your doctor for millions if he/she hurts your feelings by saying you're fat and need to lose weight. Less bureaucracy, reduce what insurance pays out, and costs will come down.

Combine with kicking out illegals and preventing them from coming in, and there's a cost savings right there.

It shouldn't cost you as much as a small car when you see the doctor with a broken finger or some relatively minor shit.

The market did not decide to give preferential tax treatment to health insurance. The government did. Do try to keep up.

I do I pay for a building I just plowed thru with my car?  Insurance.  I have the highest liability available through my car insurance and It cost me only $30 a month.  

Outlawing insurance is just as asinine as making it mandatory.

LOL.


I know people who send very basic medicine to old ladies in France, because they can't afford it.

fuck single payer. I call it "Soviet Care", and that's exactly what it is. I don't believe in free care for ANYONE. I might be willing to tolerate a government-funded loan program for the "truly needy", but it would just be a long term payment mechanism......meaning it's still people paying. Fuck illegals or anyone else getting shit for "free"...ever. There has never been anything in the whole history of man more expensive than "free stuff from the government".

If I don't drink water for 3 days I die....and yet I still have a water bill to pay. People should pay for their own medical costs. Would some people have to pay more than others? Yes. Is your life not worth it? If not, why the fuck should I pay your bills?!? Banding together, willingly, to pool/reduce costs is great. Let people do that. No need for the government to be involved. At all. And this is coming from someone that has had about a dozen surgeries in the last 20 years.

If you really want to reduce costs: get rid of government mandates in insurance plans. Get rid of the roadblocks to buying insurance across state (or international) lines. Put a cap on malpractice lawsuits to cut mp insurance costs. Get rid of taxes on anything medical related, on both the business and consumer side. Offer doctors sweet tax benes for volunteering their time at community health clinics. Make price transparency a requirement. Every procedure has a cost. Consumers should know those costs and have the ability to do their own cost analysis so they can "shop" for the best deal for THEM. Disconnect employment from insurance. Right now companies spend BILLIONS every year setting up / offering health insurance for their employees. If you lose your job, you lose your coverage. It's idiotic. Give businesses the same tax benes but only for "healthcare dollars", which they would give to employees with no restrictions other than the money be used for healthcare/insurance-related things. Require that the amount the company offers be public info or provided with job listings. Right now most people don't even know how good/bad their new health plan will be when they apply for a job because you don't get ALL the details until you start. With healthcare dollars you'd know that perspective employer A is offering $5,000/year, while PE B is offering $8,000. It'd be a pure apples to apples comparison. Use the money however you like. Store it in a HSA-type plan, buy insurance with it, or buy actual healthcare with it. Totally up to the individual.

There are more things that could be done...that's just a start. The current system has some issues...but the system we are trending towards is MUCH worse and may collapse the entire economy/country. We need to take a new course, PRONTO, before it's too late.

Also, anyone calling for a ban on insurance needs to look up "freedom" in the dang dictionary. There's nothing wrong with insurance and it's actually a low margin industry compared to a LOT of others that lefties DON'T bitch about all day (Starbucks or Apple anyone?). Insurance for catastrophic care could actually be an excellent way to cut annual costs to consumers. If we lived in a free country you could have a plan that offered minimal coverage for the cheap stuff (check ups, minor tests etc), but if you need a organ transplant or something else REALLY expensive it would kick in and save you from a medical-related bankruptcy. I would looooove a plan in which I paid for my minor care and if I need a kidney stone surgery (again!), the plan would pay most of the cost starting at a relatively low $ amount....while other major care would have a higher cap. In a free country, you could set up a plan like that. It'd be as easy as picking what options you wanted in a bunch of drop-down menus on a web site. With the bullshit we have now, 65 year old men who've been fixed MUST buy a insurance plan that covers pregnancy....which they aren't even physically capable of. It's a classic case of "1 size fits none".

Which ones aren't fucked up?









If you can recognize that government healthcare in the form of the VA is broken, you should be able to realize that expanding on that isn't a particularly good option.



 

As someone who just got some serious sticker shock on new meds, I think I can see whats going on here.  If I couldn't afford it, I'm sure some government program would cover all or a portion or the cost.  My other option is to not buy it.

Which of the two solutions will lower the cost of the medication?

Ah ha!  The typical Lib jab. Good one ol'boy.  

We will see how will that 40% or so tax on "Cadillac" health care plans work out, when they start getting canceled.

Taxing meaning more government intervention only causes problems small, big, or medium but still problems.  

Our healthcare system is huge and massively regulated and no surprise it's a monster. There are many cogs in the wheel that need to be addressed but ultimately any system that mandates or oppressively taxes crushes freedom and the very foundation of liberty.  

Thats the problem the situation is tricky.  Eliminating all patents on medication could lower costs but that would significantly hinder innovation.  The other would be where insurance companies would negotiate with pharm companies to lower costs. The latter is how european countries with single payer systems get their meds and other med tech, mostly.  

There are systems that people smarter than I would conceive of.

True insurance is not bad.
Car insurance, for example.

Pays for catastrophes, not oil changes.




Health 'insurance' in the US  is more like prepaid care for the sick, subsidized by the healthy. And made worse when the recipient doesn't have their own $$$ in the mix.



The West has decided that healthcare, at some level, should be a perk of citizenship, and all are equal in that system.


And that works when you ration care and set a budget.  When the money is gone, it is gone and everything stops until the new fiscal cycle kicks in.


I see the US going to a two tiered system, similar to the UK or Australia.


You can see a public doc in a public hospital for 'free'.


Of course, that is subject to .gov funding and staffing. Break a leg or have appendicitis? You will cared for rather promptly.  Want your tonsils out or your knee replaced?  Get on a list and wait.


But if you don't want to wait, you pay out of pocket for a private doc at a private hospital.


With the dumbing down of medicine, esp primary care, with NPs and PAs, such cheap care will be 'free' and the .gov all to happy to tell you how lucky you are.


Want to see a trained physician or surgeon that does more than give a steroid shot or Z-pak?  Get out your checkbook.




I

Nobody wants to take personal responsibility and save money for potential health issues.

Such much hyperbole. Liberal? I'm a registered Republican. You are the one arguing for tax breaks on certain industries, not me.

If health insurance were taxed as income (which it is) then people would get less health insurance and more income.

When the patient is the one paying for it, the market will quickly discover there is no need for a $1000 per month heart med that is 4% better than a $50 per month med.

 

When there is a deep pocket willing to pay, why would a company sell it on the cheap?

Not at all.  People who pay for their own healthcare, either because they don't have insurance or have insurance with a very large deductible, just skip treatment.  That's one reason why Americans die from things that are easily treated in other countries; people put off care because of the cost.  When HMOs held the line on healthcare costs in the '90s, people hated them and doctors and hospitals banded together into conglomerates to gain market power and force the costs back up again.  Many medical corporations now have effective monopolies in some areas, and monopolies are not much affected by consumer sentiment.  Just look at Comcast.  Anyone see them scrambling to lower prices and improve service?

There's a fundamental flaw in a for-profit medical system; the goals of the provider and customer are diametrically opposed, and with their very lives at stake most people have little option but to pay.  People want to live and be healthy, but doctors and hospitals only make money when they're NOT healthy.  Profit motivates healthcare providers to want a sick population, not a healthy one.  (Just as the security industry benefits from a frightened population.)

And for the 'No one has a Constitutional right to healthcare/water/air' crowd, how is it that socialized healthcare is bad, but socialized police, fire, emergency services, and national defense are good?

In this case it was a long existing medication that was changed slightly to maintain a patent.   I'm currently exploring my options for long term use, and I think I can just take the old stuff instead.  Will ask the doctor next time.

If we all paid out of pocket for it they wouldn't be able to get away with this bullshit.

Damn, nailed it while I was posting my follow up.

I am convinced we are going the way of statism and socialized medicine.

Having said that, I wish we had an insurance system rather than a health care system. I would love to have the "major medical"coverage my parents had--I'd pay for doctor's appointments and prescriptions out of pocket, and insurance would pay for the big stuff, minus deductible. Doctors and drug companies would be forced to have more competitive pricing. There's no reason for insurance to cover all healthcare--do you think there would be $18 oil change places if automotive insurance was designed to cover oil changes as well as wrecks and theft?

Still, I'm sure that's somehow racist or hateful toward the poor, so our long march toward medical mediocrity will continue...

"We want you to have more money to spend on healthcare by taxing it!"

"We want you to have more guns by taxing it!"

"We want you to drive your car more by taxing it!"



You seem to be addressing the symptom not the disease.  Healthcare costs have been on a steady rise due to further restrictions and regulations by the federal government.    No cross state competition, federal healthcare plans that cost hospitals.  

Looking at healthcare one dimensionally though the lens of cost is a not a good way.  

Hyperbole, saying that the iron fist of government dealing with one of the most personal issues a person can have is wrong?  

Also many republicans are liberals but don't know it just like how many democrats are conservative.  Nothing you have posted in this thread has availed your republicanism.

I suppose you think things like tax breaks for solar panels are a great idea too, then.

This stuff is not sustainable over the long run. You have to think about this in terms of decades and centuries, not over the next five years or even in our lifetimes.

The problem is most people are ignorant on most issues, so they have no idea what they're talking about. They think government has to exist, and they don't understand where it comes from, where it gets its power, and its limitations.

Ultimately what you're going to see is a split between charity-based healthcare services and government. There will be no gov involvement because it's not sustainable. You can't force people to pay for others. That's slavery. So you'll have government protecting individual rights (its only real legitimate purpose) and you'll have a secondary tier of "government-sponsored" health care that's funded voluntarily. It'll sorta work like the blood banks where people donate because it's a good thing to do.

Thats a perfect example of why you don't try to manipulate the market with a tax policy that targets individual industries.

NO

The belief that we have a MORAL DUTY to take care of those in need has to be challenged.  Why if I'm healthy do I have a moral obligation to pay for people who are not healthy?  Why if I'm sick do I have the right to force others to pay for my care?

If you want to sign up for a plan that spreads costs around, go right ahead.  But "insurance" companies should not be forced to spread their premiums around among their clients.

Since when did insurance = a shared pool of money?  In order for insurance companies to hedge risk they need to have many clients, but insurance never should have been collectivised.

ETA:  But we're fucked in the end.  There's no reversing course at this point.

Why are you conflating?

I think there should be no corporate taxes. No taxes no "breaks" for pet projects.  And individual income tax should be minimal.

If you want healthcare coverage why discourage its usage?

Costs are being driven up but solving them with the o so gracious hand of big government is not the correct path.

Big government is what says you can keep 70% of your income, but if your employer buys you healthcare instead of paying you, they won't take a cut. But obviously you're in favor of government subsidies for things you think are desirable, I merely wonder what other things you want the government to encourage?

Or the confluence of two industries, like health care and insurance.

Once again, the need to come up with solutions for a serious long-term issue is hampered by absolutists even in a simple web forum.

Some of you should think and not just knee-jerk (either way, conservative or liberal) your way into snarky and useless point and counter point posts.

ETA:  I don't have the answers but I know what causes solutions and common sense to get pushed aside.

libertarian thread





government bad





legalize free pot for everyone





then the "sick" can get all the free medical marijuanna they want, and won't need insurance
edit - or so the don't you love freedom people would think and want


       

 

Health insurance shouldn't be a form of compensation at all, it should just be cash money, then the employee can purchase any extras like that. It was only started due to socialist wage restrictions and has should not exist.

I didn't even realize you were talking about taxing employer provided health insurance when you first started ranting.

I think the government should be severely restricted in what it can tax. The employer is subsidizing what you are paying for income maybe.   Are you going to tax the parking space where you work at? Companies pay for many things to attract an employee.  Oh you used the company counselor taxed, you used the company washing machine taxed, you used the company computer for your Facebook tax. Thats why the power to tax is the power to destroy.

Funny that you agree with me in one line and mock me in the next.

The employers cost to insure you, if they choose to do so, should be income taxed as the same rate as any other wage you are paid.