Brianl made a recent comment that surprised me. Thought I would start a new thread that should keep us off the usual hot button issues. (Man, we've really burned some bits huh?)

To start off, I really want the single pay system. Trimming the fat in regards to billing, codes, and general madness would save a ton of money right outta the gate.

As a sub-topic, where do you all stand on things that we all need? I'm not talking about food, but things that we find necessary, but only obtainable with some assistance.

Power, fuel, healthcare, water, etc...

IMHO, I want to see serious regulation on these things. Their nature more or less demands a monopoly. So, lacking regulation, we end up paying the most we can tolerate. Profit is good, and I'm for profit. However, I'm not ok with excessive profit. The stability of the income should warrant a reasonableness in this regard.

If those with the monopoly really want to make more, they can always take some of their profit and grow it somewhere else...

A solid example of this gone the wrong direction was the recent attempt to price our power here at market value --whatever that meant. It would have raised rates, moved dollars from the region, and hit small business pretty hard.

What say you?

"Power, fuel, healthcare, water, etc...I want to see serious regulation on these things.
Profit is good, and I'm for profit. However, I'm not ok with excessive profit."

One could drive a truck through those statements. How much is excessive? There's research and development to cover, shareholders who expect a return on their investment, plus tons of failed experiments as firms attempt to stay on top of their business, be it a new internet model or hiring people who don't work out.

Remember-If you take away the incentive for business, it will simply go elsewhere. Ever heard of outsourcing?

Another alternative is to have government run everything. Ever been to a UK hospital? No thanks. Our system is not perfect. But the customer is the boss, and if the market doesn't provide what people want, businesses go bankrupt.

Tinker with the system? Maybe. Gut it? No way.
When it comes to health care, I'd recommend another approach: Natural medicine. I like the fact that schools have removed pop machines. Now that makes sense.

Herb

Herb, health care costs in this country are spiraling out of control, even for those of us who DO have insurance. And the customer is hardly "the boss." Most of us are now at the mercy of HMO bureaucrats who are only interested in wringing every last nickel of profit out of their business, not in serving their patients. Even doctors are struggling nowadays due to the crunch of The System.

Because I buy my own insurance being self-employed, I have a plan with $500 deductible. Although I can see a doctor for about $15 for the visit, for the doctor to DO anything everything goes against my deductible. And honestly I am reluctant to go to a doctor anymore unless it's serious, because I've had some very disappointing experiences with them in the last few years. I might be "the boss" but all of my choices for medical care are expensive, and the AMA regulates things so rigidly that there isn't much chance of competition.

Because of the regulation, medical care is far from a capitalistic enterprise where your neighbor down the street can just open up his own medical practice and undersell the guy down the street. It is basically a monopoly, where the procedures and who can practice are regulated but costs are not. This means there is no incentive for companies to serve the patient better or reduce patient costs. The only incentive is profit, for the hospitals, for the insurance companies, for the equipment makers, for the drug companies.

I don't know what the solution is, but the system we have now is so bureaucratic and out of control that a government-controlled system could hardly be worse. And about 45 Million Americans can't even afford health insurance to get anything like affordable medical care even in that system.

We don't need tweaks - we need a major overhaul of the system, whatever that would be. Unfortunately, the companies that stand to lose billions of dollars from reform have deep pockets to fight any changes to the system, so it seems unlikely to happen soon no matter who is running the government.

Andrew

Limit liability.

If a health care worker, takes reasonable precautions, limit liability to actuall costs, eliminate punitive damages.

Military health care is pretty good, and one reason for lower costs, you cant sue the doctors or hospital.

Make the same rule for drug companies.

Also if a doctor, nurse etc donates a day a week at a free clinic, let them deduct the cost of their time from their taxes.

I like it.

Limit liability.

Good call, Nwokie.

And remember, Andrew2. People come from all over the world to America for their health care.

They don't go to socialized countries. We still have the best medical care. It's the cost that is the issue.

Herbert M. the IInd

What is reasonable?

Well, how about 20 percent? That can go to the bank. If R&D and other things come into play, those can be defined as costs of doing business and not be counted as part of profit.

The business will not go elsewhere on these things, because resources are where they are, and the need is where it is. One cannot outsource the local water, nor can they easily outsource the local healthcare professionals.

The nature of these things grants a monopoly. It is possible to eliminate the monopoly on some things (health care), but others are impractical. (water)

The nice thing about defining what is and what is not reasonable, forces some accountability in costs and checks gouging the people.

Everytime I've seen outside ownership of utilities, costs to the people consuming them goes up! That makes some fat cat some additional dollars, but at the expense of entire regions they are not really accountable to.

Use something like the most efficient medical program (Medicare) to fill in the gaps. We need to make sure that poor and middle class people don't lose their shirts with one medical crisis. In addition, the costs will be less with a risk pool that is spread more evenly (gov't-based) than risk pools that are more, well, risky (those with smaller groups of people, like work-based groups).

Or we could just continue to apply the ultra-conservative solution for everything, make the rich richer and shove God on everyone else, right Wayne, Herb?

Sure, if we let them take all they want, they will eventually be come satisfied and begin to take care of us outta the goodness of their little gold hearts!

Here's my $.02 on the medical business here, and I don't know if I surprised Kbbt in a good or bad way with what I said.

I am diametrically opposed to government getting into the health care business. It would drastically raise our taxes, and the quality of care we would get is substandard considerably to what there is in this country now. If you want examples, look at Canada's system, or any European country (most all of them have socialized medicine), or hell look in our own back yard at the VA. I'm not interested in waiting literally months for basic and necessary procedures because the waiting list is so damned long. I'm also not interested in being told who my primary care physician will be, I want to make that decision for myself.

I believe that we SHOULD help those who can't afford medical insurance, but I believe that it should be at the STATE level, like it is now.

Instead of government running and/or regulating the medical part, what government should do is look into what is going on in the INSURANCE end. THOSE are the ones making the excessive $$$, not the medical facilities or doctors. The insurance companies are charging doctors so much for malpractice insurance that it's scaring away our best and brightest, and jacking costs up through the roof. The insurance companies also gouge us, the consumer, knowing that we need to have the coverage ... we pay huge monthly premiums for something most of us don't use more than checkups and the like, but we need so we're not forking out tens of thousands of dollars IF we need something more serious done. The insurance companies and HMOs are getting rich off of both ends, and both ends are getting screwed because of it. If Big Brother wants to really do something about the out-of-control medical costs in this country, IMO, that is where the focus needs to be.

A reasonable limit on liability would also be nice. Part of why insurance companies are charging so much to us and the doctors is because malpractice litigation is out of control in this country. Set reasonable limits, some kind of tort-like reform here, SOMETHING has to be done. Not gonna happen because the insurance companies are in bed with the lawmakers, on BOTH sides of the aisle.

As far as utilities, etc ... I am very much one who likes competition and deregulation here, but in some cases (especially water) it is unrealistic.

I am not a big PUD guy myself personally, it's a level of government bureaucracy I can do without ... that said, living in Vancouver I am MUCH happier with Clark County PUD than I ever was with PGE. PGE has to be one of the worse private utilities I have ever seen.

I wouldn't mind seeing Big Brother stand up to Big Oil, but again it won't happen in our lifetime because Big Oil and Big Brother are a Big Couple.

Brianl: It was simply surprising, given your other comments. I didn't expect your view.

I made a thread because we may all be quite off the mark where we think others are on this, and the finding out would make for some good discussion.

No worries!

I've some questions, but no time at the moment!

Freaking double posts...

Happens on this Mac, I'm running. Anyone else have this problem?

(Love the Mac, BTW)

I'm helping a local company here do high-end 3D MCAD on the Mac finally. They are a complete Apple shop. Amazing really. Never seen one in the product design / manufacturing sector. The only two PC machines in the building are not on the network and are used as part of a highly proprietary measurement solution.

Sorry to digress, I just love the way these guys have found to work.

Snagged a Mac to properly support them in their efforts.

"Brianl: It was simply surprising, given your other comments. I didn't expect your view.

I made a thread because we may all be quite off the mark where we think others are on this, and the finding out would make for some good discussion."

I'm all for good discussion, as long as it doesn't get drug down by certain folks into the dregs.

I know that I may be in the minority here with my view on this, and that is fine. I am willing to listen to reason and logic ...

Ok, so let's say we do this at the state level. I like this because it allows different strategies to compete.

Would you be open to a federal program at some point in the future given the best in class is duly evolved by the various states?

Re: Reason and logic -->me too.

Sweden
Finland
Denmark

Complete health coverage

ANYONE?????
Down sides to that????

Go ahead and fly there.

You'll need to be a citizen, you'll have to deal with their 80% tax structure and deal with their very expensive cost of living.

It gets cold, so you may want to pack extra clothes.

Herb

"Sweden
Finland
Denmark

Complete health coverage

ANYONE?????
Down sides to that????"

Most European countries have complete health coverage.

I know that in England, you are waiting hours, if not days, for something as basic as stitches.

I know that in Canada, scheduling out some major surgeries like open-heart stuff means waiting so long, that many who can afford it come to the States and pay for it out-of-pocket. They also come Stateside because the quality of work is better.

The thought is nice Trix, it really is. You look at the other side of the coin though, those Euros and the Canadians have the highest tax rates in the world, and if I am going to be forced to pay into that kind of Draconian tax system I damn well want good return. Assembly-line medical care run by the central government is NOT good return.

"Ok, so let's say we do this at the state level. I like this because it allows different strategies to compete.

Would you be open to a federal program at some point in the future given the best in class is duly evolved by the various states?"

Allowing competition, even in the medical business, is a GOOD thing IMO. Again, it gives US a choice as to what works best for us.

As far as a federal plan, if we exhaust the options of tort reform, insurance regulation/reform, scrapping this damn confusing medicare issue, things like that ... I would CONSIDER it within these parameters:

-Instead of running the whole show, the feds set guidelines for the states to follow. Much like what happens with the Department of Education now. Give the framework and let the course of action happen on the lower level.

-Make it VOLUNTARY. Those who have medical plans of their own and don't wish to participate (which is a lot of folks I imagine) don't have to. Offer it and utilize it on those who don't have access, but not on EVERYONE.

-Doctor and program choice by the patient. Makes a lot of sense, right? Well in a lot of these countries with existing socialized health care, there is no choice. My son is eight, and he is diabetic. We have established a good relationship with his endochronologist, and I want to keep it as such. Damn it, his life depends on it.

-Allow generic brand prescriptions and drugs from Canada, etc. Right now we have a damn black market of elderly folks who can't afford their medicare drugs here so they smuggle them from Canada. If we're going to help these people, dammit HELP THESE PEOPLE.

Great, the rich people in other countries can afford to come to America and get immediate health care, but the 45 million folks in America who can't even AFFORD health care will wait until they are REALLY sick and if they don't die, go to the emergency room and probably cost 10X or more what their medical condition would originally cost. Of course, the kind of people who can't afford health insurance also won't be able to pay hundreds of thousands of dollars in medical bills. So guess who gets to pay it? You and I do - all the other people who do have insurance. The cost gets passed right along to us.

I'd love to see some substantiation beyond an anecdote that people in England routinely have to wait days for stitches so that their wounds get infected and cost the health care system far more in additional costs. Sounds like either an unusual case or just made up BS to me.

Sure, I have no doubt that people sometimes don't get treatment as quickly as they would like in other countries but the US system is not necessarily better. When my dad was diagnosed with lung cancer a few years ago, his hospital doctor first told him it was final stage, terminal. He wanted a second opinion from a cancer center, but it took months for his insurance to authorize it the required tests. Turned out the hospital had been wrong and his cancer was indeed treatable - meanwhile, the tumor grew for a few more months while he waited. (Treatments were ultimately unsuccessful and he died a few months later.) As I said before, the system we have NOW is full of these same kinds of stories of delayed treatment that you find in all these other countries. Just because the government isn't involved doesn't mean these privately-run HMOS are any more efficient.

By the way, for all the naysayers who claim the Government can only make things worse, Medicare is considered by independent observers to be an extremely efficient program. Just because the "evil government" gets involved in some way doesn't mean the result will be bad.

Andrew

Big problem, medical care is a finate product. There are only so many doctors, nurses etc.

Unless you want to decress standards for medical school, including professors, you cant easily expand that quantity.

Currently doctors, nurses and other medical professionals work very long days. And their seeing patients.

So the only way to give medical coverage to a larger group, is to take away from those currently receiving it.

Right now, those with medical coverage are subsidzing those without, because the medical comunity has to make up for all the care it gives away.

"Unless you want to decress [sic] standards for medical school, including professors, you cant easily expand that quantity."

I strongly disagree.

MANY fine applicants are turned away. All things being equal, I'm fine with a physician holding a 3.8 GPA treating me. He or she may specialize or bring other knowledge to the table.

There are so many applicants to medical and nursing school, that plenty of fine prospective physicians never get a chance. It may keep medical prices up, but the public is the poorer for it.

Herb

Insurance companies are ripping off everyone at every corner.

My belief is that the government should offer a basic no frills health plan for those that can't afford it. For those that already have coverage, or would want more premium coverage, they can get that on their own or through their employer. Treating people early on makes sense, because they cost more down the road, and as Andrew points out, it's US that ends up paying for it anyway. For the money we're spending on Iraq, we could fund healthcare for the 45 million that don't have it.

Herb must be just like Wayner and living off of TAX-PAYERS money???
How did you get your pension Herb???
401K???
Union???
Self-savings???
IRA???

Your rich and can afford helth coverage??? Or am I paying for it like Wayners????

Brianl...
I was throwing a question out there seeing if it would stick. WITHOUT INSULTS!!!
I see Herb wants me to fly there after just asking a QUESTION. Nice Herb!

"I see Herb wants me to fly there after just asking a QUESTION."

Your ignorance on the topic is blinding.

Herb

"You'll need to be a citizen, you'll have to deal with their 80% tax structure and deal with their very expensive cost of living."

While 80% may be overstating it a bit to make a point. It's not so far off that your point is lost on me. And it's a good point. I went to Denmark over the summer - boy - yeah - I mean Copenhagen isn't exactly cheap, I know, but you can see what a heavy tax, like they have, would change our society to the point in which their model would not work in our country. Actually, it MAY work, but people would revolt.

There has to be a better way. I have NO idea what thay way is though. None. I'm am really ignorant about this topic. I have ideas - but none of them are really that good.

>>>"My belief is that the government should offer a basic no frills health plan for those that can't afford it."

I actually almost agree with Rein on this. The difference I would prefer is that some sort of universal health care insurance be available, but through private companies, not the federal government.

If I had any idea how to make this work, I'd send it to someone. I don't.

I do think we need to find a way for everyone to get health care, but it must be workable, not socialist like some other countries. We need our private medical system, and we need it to be based on competition.

http://www.csmonitor.com/2004/0505/p02s01-uspo.html

According to an article in the Christian Science Monitor, Americans spend twice as much on healthcare as other countries, but it turns out that they're not getting twice the quality for the price when they go to the doctor or hospital.

Socialistic health care has proven not to work in most places. Our system is flawed, and it is purposely complex, but still works better than government controlled health care.

One element that has not been discussed here, is the US system encourages people to strive to be healthy...if you try and live a healthy lifestyle, it won't cost you much. Of course, there are always exceptions to this,(accidents, etc.) but the idea of having to pay if you need it, as opposed to paying for everyone else seems to me to be more fair, and more representative of how this country was founded. A very old term, "taxation without representation", comes into play in this debate. Do we, as a country, want to pay more up front to help everyone, or take personal responsibility for ourselves?

Herb IGNORANTLY said>>>
Your ignorance on the topic is blinding.

Your ignorance is unbelievable! Borderline psychotic!

It's cheaper to pay for the $50 medicine rather than $10,000 per day when they're in a coma in the hospital. Preventative care is cheaper. IF the goal is to save money, provide a basic policy for everyone, if they want it, and let other's like myself pay a little more for more deluxe coverage. And personal responsibility doesn't always cause health issues.

"Your ignorance is unbelievable! Borderline psychotic!"

Then please tell us whether or not you have actual experience as a patient inside a foreign hospital, or if you have even worked in ANY hospital for that matter.

We'll be waiting.

Herb

True!
I get my insurance through the business. If I was to pay for it outside work it would be $1400 to cover my wife, myself and the 2 girls. The same coverage...
I would pay it because I can.. But how about the other 296 million in the US???

"Brianl...
I was throwing a question out there seeing if it would stick. WITHOUT INSULTS!!!
I see Herb wants me to fly there after just asking a QUESTION. Nice Herb!"

Sorry if I came across as rude or crass, that was not my intention.

Reinstatepete said:

"My belief is that the government should offer a basic no frills health plan for those that can't afford it. For those that already have coverage, or would want more premium coverage, they can get that on their own or through their employer. Treating people early on makes sense, because they cost more down the road, and as Andrew points out, it's US that ends up paying for it anyway. For the money we're spending on Iraq, we could fund healthcare for the 45 million that don't have it."

Now this is something that I would be willing to deal with. And you're right, for all the $$ spent on Iraq, think about what better use that money could go toward!

"Insurance companies are ripping off everyone at every corner."

Now THIS, ladies and gentlemen, is the TRUE problem here! Both the practicioners and patients are getting hosed!