I think the solution is one that is quite simple, but politically difficult. To me it comes down to one word.....accountability. People have to know that when they go to the doctor there will be a cost and the cost will not be just nominal, but enough to make sure they only go when they really need to. For the doctors there needs to be accountability also. If you charge for services that you didn't render you lose your license to practice. For the lawyers who specialize in medical malpractice, a penalty for friivlous lawsuits. For the insurance companies, a mandatory cap on executive compensation and a refund for policy holders on excessive profits. For the government, enforce your own rules. For the drug companies, I would go with the Canadian solution. Drug prices are negotiated at the beginning of the year and you will stick with those prices. How's that for a solution? Most of the pro Obamacare arguments that have been placed have been along the lines of it is the "right" thing to do to take care of those who can't take care of themselves. I have no issue with those who can't take care of themselves. My issue is with those who won't take care of themselves. Many social programs are wonderful in theory, but the downside gets ignored. Medicare is the perfect example. Most people over 65 are on tons of medication, much of which is not needed. Why? Because someone else, the taxpayers, pay for it.
That is the single biggest problem I would have with a private health care system. If people are afraid to go to the doctor because they are making a judgment call on whether or not they can afford it they could end up costing a lot more. How many cases of cancer or heart problems come from people feeling 'a little run down' or feel like they have a nasty cold? Some people do take advantage of socialized systems, as a Canadian I acknowledge that. But the vast majority don't abuse the system so I don't think excessive use should be used as an argument against a system similar to Canada's or the U.K.'s
The argument is not just one of excessive use, but of overload. We have a system in place right now that can barely handle the load placed upon it. Added 30-40million people into the demand side of that equation is not going to make health care better but make it worse for everyone. That is my point. I agree that our current system is not ideal, but rather than just coming up with some massive social program, there were better solutions out there. I would have much rather seen a subsidy for medical education than this program. The political logic that is in place is that this will generate votes, while the proper solution, increase the supply of medical providers will not generate votes.
Many of your ideas have merit, and some may run counter to good medical care. I'll make a brief comment on them, from my point of view. Logical. By whom, for whom? Insurance companies, I suppose, could negotiate with large pharmaceutical chains for discounts, then limit their insured to using one of these chains. The national, state and local governments would take bids for drugs for any programs they sponsor. Some insurance companies may already be doing this: the federal government had a perfect opportunity to start doing this when the medicare drug benefit law was passed, but powerful drug lobbies got in the way, I suppose.... Control of insurance companies' profits is a corner stone of Japan's system, which requires everyone to have insurance, either private or through the employer. (See video) Insurance companies in America are out of control and have massive leverage with medical providers, controlling as they do access to medical care for their insureds: they negotiate with hospitals a rate of reimbursement many times lower than the official hospital charges (the ones the public sees). I had a hospital bill of $25,000, with the rate of reimbursement being just $1,000: owing to contract provisions with the insurance company, the hospital had to eat the difference. Good idea, but more than 100,000 patients die in the U.S. from officially certified acts of malpractice- with more than 1,000,000 additionally suffering malpractice, but without dying. Those who've worked in understaffed American hospitals, with surgeries performed by doctors stretched thin by the demands placed upon them, know how easy it is to happen. The process of suing in response is a poor substitute for curing the problems that exist- preventing acts of malpractice, in the first place. Without looking, I suspect every state has provisions for license revocation of any physician convicted of a crime involving moral turpitude, such as fraud. This one is problematic when the goal is keeping people healthy, and avoiding much greater expense in the long run. Preventing disease is the first step in holding down costs: the U.S. does not do a good job in this area, but it is the starting point of health care delivery in the U.K. (See video). When there is a health problem, early diagnosis and treatment is important if you want to hold costs down. Taking responsibility for tough decisions when it comes to what the government is going to try to do is a hard one for Americans to swallow: they love to talk of cutting government spending until the program in question is one they receive a benefit from personally. Take medicare, for example: no one is ready to willingly make any sacrifices in terms of reducing benefits- not the doctors, not the hospitals, not the patients- yet, at some point, there must be a denial of benefits to hold total costs down. Governments which provide broad medical coverage for their citizens do this when necessary to preserve the integrity of the system; but, Americans opposed to government sponsored health care use this very fact to criticize such programs in other countries, while they, more often than not, are the same people who say government spends too much money. As for the question, on what terms would you prefer to see medical care offered the American people, I still don't know if you prefer the mixed provision of services which exists, with some tinkering around the edges such as you suggested or, if you had the chance, you'd start over again with something different.
Clearly we have two camps: One that puts their faith in government, believes government must be compassionate, government has the responsibility to care for the people regardless of financial impact, and government is the solution to all problems. On the other side we have those that believe in fiscal responsibility, government has a limited role, that personal liberty, accountability, and responsibility are highly valued & the correct path. I choose the latter and it has occurred to me that we have good examples of the former. By posting in another thread, I've found British Parliament Member Daniel Hannan who makes a lot of sense and he warns Americans of things to come. [ame=""] [ame="&feature=related"]YouTube - Daniel Hannan - Universal Health Care in the UK
Zackman, dividing us into camps probably isn't a good place to start. How would you answer the question I asked Twinimini? On what terms would you prefer to see health care offered the American people for their real health care needs, the mixed provision of services which exists, with some tinkering around the edges or, if you had the chance, start over again with something different?
Please consider the following wikipedia article I found on national debt of countires. List of countries by external debt - Wikipedia, the free encyclopedia There are some interesting rankings if you sort it by per capita debt. Canada: $23,325 U.S.A.: $43,646 U.K: $150,673 All I am saying is that if a country like Canada can have half the per capita debt of the USA and provide a publicly administered health care system so can the USA. Sure we have higher taxes to pay for it but the money I don't spend on health care ends up in other sectors of our economy, which is quite strong by all accounts. I put my health care system in the same category as the Fire Department, or Police. Which are very socialist agencies if funding and guidance by the government are prerequisites.
My focus was not the division, but to bring more clarity. Sometimes a clear definition of where one stands is more important than agreement upon a single issue (which I doubt will ever happen). As for your question on what terms would I prefer to see health care offered the American people? My preference is relatively inexpensive phased free market reforms for healthcare, rather than a wholesale & vastly too expensive government takeover. These would include: • The ability for individuals to buy their own health insurance policies across state lines thereby increasing competition (i.e., open the state insurance market up to interstate commerce) • Tax-free income exclusions for Americans without employer-based coverage and Tax-free Health Savings Accounts. This would create a powerful incentive for more Americans to own their private health insurance -- making it portable instead of dependent on an employer. • Financial Incentives and a focus on availability of preventive care for individuals instead of ER visits. • End lawsuit abuse by trial lawyers thereby decreasing costs Doctors must pay for Malpractice insurance. • Enacting sensible government laws & regulations for health insurance portability in case one looses their job and reasonable regulations against denial of insurance for pre-existing conditions. A free-market cure for US healthcare system http://www.boston.com/news/nation/articles/2007/08/03/a_free_market_cure_for_us_healthcare_system/ The Whole Foods Alternative to ObamaCare: http://online.wsj.com/article/SB10001424052970204251404574342170072865070.html • Equalize the tax laws so that employer-provided health insurance and individually owned health insurance have the same tax benefits. Now employer health insurance benefits are fully tax deductible, but individual health insurance is not. This is unfair. • Repeal all state laws which prevent insurance companies from competing across state lines. We should all have the legal right to purchase health insurance from any insurance company in any state and we should be able use that insurance wherever we live. Health insurance should be portable. • Repeal government mandates regarding what insurance companies must cover. These mandates have increased the cost of health insurance by billions of dollars. What is insured and what is not insured should be determined by individual customer preferences and not through special-interest lobbying. • Enact tort reform to end the ruinous lawsuits that force doctors to pay insurance costs of hundreds of thousands of dollars per year. These costs are passed back to us through much higher prices for health care. • Make costs transparent so that consumers understand what health-care treatments cost. How many people know the total cost of their last doctor's visit and how that total breaks down? What other goods or services do we buy without knowing how much they will cost us? • Enact Medicare reform. We need to face up to the actuarial fact that Medicare is heading towards bankruptcy and enact reforms that create greater patient empowerment, choice and responsibility. • Finally, revise tax forms to make it easier for individuals to make a voluntary, tax-deductible donation to help the millions of people who have no insurance and aren't covered by Medicare, Medicaid or the State Children's Health Insurance Program.
Bottom line... This bill was forced through with 65% of Americans agaisnt it. This was forced through with not 1 Republican vote, This was forced through with not 1 member congress or senator reading the entire bill, This was forced through by bribing members of congress and senate. Let's say this bill would save the world, but last time I checked Gov't worked for us, and if the majority of the people didn't want it, then it should have not passed. Nothing is for free. This is not Free Healthcare. This is a gov't forced legislation which forces every American by law to purchase, not receive healthcare. Unless your low income or don't want to work, or already on gov't assistance, on drugs, etc... Let's say all right great... Now 47 million unisured Americans now have insruance... HURRAYYYY... Now how are we going to handle this? With Doctors so busy now they barely have time to take lunch breaks. And let's this bill truly would help every American. But why try to pass a trillion + bill during one of one of the worst ecomonic times in history? When putting the American people back to work should be the focus right now.. and Saving our economy. Our current Gov't also said they would let the American people know exactly what was in the healthcare bill. They would be transparent. " No one knows everything in this bill." And don't even get me started about this bill's take over of Student loan programs.
Fire Departments, Police officers, FBI, CIA, Army, Navy, AirForce, is all part of what this country was founded on. To protect the American people from Terrany, Terrorism, attacks from abroad, being safe in our home... This is what we pay taxes for. Not for the Govt to take over our lives. What happened to controlling our own destiny, taking ownership of our lives, working hard for your family, being able to start a business and live well enough to have the dreams you worked so hard for? Instead of having a hand out and try to get everything you can from other people's hard work.
