How would you fix the health care problem in the US?

[Angrycat]

Quote from village trader:

I agree with most of the posts by angrycat. As a doctor with plenty of international experience, I can safely say that the standard of medical care in US is by far the highest in the world. No other country comes close. This can be a proud fact for any US resident, but this is also probably the root cause for rising health costs. So the main problem of limited access to medical care arises.

People want the best and latest treatments for them, including the right to sue a doctor if they don't get the tests and treatments they want, but don't like the price tags on such medical care. If the costs are to be brought down, then some compromises have to be made as to quality of care. And with the current Obama plan, the public healthcare plan would make this compromise. Of course people who want more expensive treatment options would still have the option to go with private plans.
For the record, I am not a supporter of anybody, just making an observation.

I agree with everything you're saying - except for the private plan option.

That DOES exist in Europe but will NOT exist under Obama's proposed plan.

The "healthcare exchange" eliminates private plans in all but name because the government will set the coverage, the terms and the price. That's not what people consider a "private option".

In Europe, private health insurance is unregulated and offers whatever the customers want at a price they are willing to pay. In addition, everyone is taxed to pay into the public system from low to high income

The CURRENT Obmacare plan is much worse.

The other problem is that in Europe, they've gone from really shitty medical care to less shitty - mostly because of innovations in the United States. When Americans think of health care, they imagine the standard we have now. This standard will absolutely fall and Americans will not be as happy with their now reduced health care as their Er.

Of course, the rich will simply pay out of pocket to private doctors. But, given the tax increases on them to pay for this boondoggle and the additional amount they will spend on health care for themselves, there will be less to invest in the new businesses that are required for economic growth and unemployment will skyrocket and remain high.

This plan has the potential to bring down the country - it promises the unattainable to ALL. It relies on 1% of earners to foot the entire bill and since they are the earners with the most options worldwide, that will last for exactly 2 days and taxes will have to be jacked up much more than the additional 5.4% (on top of the 4.9% Bush cut ending) on incomes much lower than $1MM.

In fact, this will be a significant burden for the middle class as high earners who traditionally provide the capital for new businesses and expansion switch to tax avoidance strategies like Muni bonds and reduce their own productive output or leave the country (you are no longer taxed for 10 years after you renounce citizenship). This will mean that the burden of paying for the program falls on the less flexible middle class and the middle class will also pay with higher unemployment due to a lack of investment.

There is no free lunch.

 

[Angrycat]

Quote from Mvic:

While you are correct that the quality of care in the US is the best in the world for a country of any significant size, it is disappointing to see the perpetuation of the myth that cutting costs in our bloated healthcare system necessarily means cutting care and quality of that care, and by a physician no less.

Just fixing the problem of defensive medicine, the cost of which in one mid volume community hospital ED I surveyed for 6 months ran in to the low hundreds of thousands of dollars (did not include the cost of malpractice premiums nor the cost of any litigation that may have been ongoing and was very conservative in ruling in tests and procedures that were done purely for liability protection with no medical justification, if tests done for marginal medical reasons but primarily for liability protection were included the figure would have been 4-6 times higher) we could expand minimal access to everyone without significantly increasing costs. If other cost cutting measures were put in place we would have no problem delivering the high quality of care those with good insurance currently receive to all. But hey, if you want to believe that there is no solution other than to deny older people care or force young people to essentially be taxed at a much higher rate than they need to be to get care then go right ahead, you are right where the politicians want you, divided, factionalized and polarized by your ignorance, and thus easy to control.

Campaign finance reform 1st, then meaningful health care reform which in this country, with what we currently spend, means getting everyone an equally HIGH standard of care, vastly improving access and outcomes, and reducing the burden of health care on businesses.

Mvic,

The system could be improved. I don't think that the doctor or I are arguing that improvements can't be made.

This bill, however, does not do that. ALL it does is put healthcare completely in government control, reduces choice, and puts the burden of paying for it on a very small percentage of the population.

Scrap this bill and work toward actual efficiencies instead of saying "We're the government, and although we've never ever run anything more efficiently in our history, THIS will be a shining success. Just trust us - with your kids' lives."

No thanks.

Why are we only looking at European models? Why not Singapore's - which is much better than Europe's and Canada's and achieves more efficiency and better healthcare outcomes.

Singapore spends 4% of GDP on healthcare with better results.

Canada is close to 10% and rising with worse results. Seems like a no-brainer

 

[Mvic]

Quote from Angrycat:

Mvic,

The system could be improved. I don't think that the doctor or I are arguing that improvements can't be made.

This bill, however, does not do that. ALL it does is put healthcare completely in government control, reduces choice, and puts the burden of paying for it on a very small percentage of the population.

Scrap this bill and work toward actual efficiencies instead of saying "We're the government, and although we've never ever run anything more efficiently in our history, THIS will be a shining success. Just trust us - with your kids' lives."

No thanks.

Why are we only looking at European models? Why not Singapore's - which is much better than Europe's and Canada's and achieves more efficiency and better healthcare outcomes.

Singapore spends 4% of GDP on healthcare with better results.

Canada is close to 10% and rising with worse results. Seems like a no-brainer

Agree completely. The current options reported are terrible and going in exactly the opposite direction. Rather than the private insurers having to compete with a public option (impossible as the public option is subsidized and rations care) the patients should have control of their care regardless of whether they are on medicaid or medicare or have private insurance. In practice that would mean that you would get a voucher and with that voucher you would go to the health care portal, doc groups and other private insurers would compete for your business in a reverse auction and you would pay with your voucher or cash if you are not on medicare or medicaid. Market forces would quickly drive down costs while increasing quality and satisfaction (with the ratings of each provider, be it a doctors group or a HMO, published by patients and aggregated on the portal's website if quality wasn't provided patients would find another provider as they would be free to do each year) and there would be no need for a massive government health care structure. Obama care is going in exactly the wrong direction, taking health care out of the patients and providers hands and putting in that of bureaucrats.

If the above system was implemented along with meaningful tort reform and standardization of medical records and health plans I have no doubt that everyone would have much better access, quality of care would improve, and cost of care as a % of GDP would fall dramatically. No new taxes or premiums would be needed.

 

[options2001]

Quote from Eliot Hosewater:

I see a lot of well deserved criticism of Obama's plan(s), but not a lot of constructive alternatives. Almost everyone agrees that the current system is broken and unsustainable, with insurance costs rising so fast, deductibles increasing, etc.

What would you offer as a solution?

I think allowing states to implement single-payer plans, and/or promoting health care cooperatives might help. There was a doctor in NYC in the news a few months ago who wanted to offer a direct payment plan for his patients, for something like $100 per month he said he could treat most people for most problems. I believe the state health insurance-oriented laws put a stop to that. The health insurance companies couldn't stand the competition. Also, I heard about a coop in the northeast that has been in operation for decades and offers care at a reasonable cost. Why are there not more of those?

As some one who provides care to people on a daily basis, I can tell you if obama care passes people are screwed. I agree american system is not ideal doesnt mean it has to be replaced by shittier system. I work at both VA hospital and private hospital. As most people can guess va system sucks. And thats the system at best what obama health plan can achieve. If inferior care is what you want so everyone has acess to health care so be it. And by the way even though there is no universal health care anyone including illegal immigrants get the same care wheather they have insurence or not all they got to do is go the ER

 

[options2001]

Quote from spinn:

Cut DRs pay by 75% and find a way to pay them bonuses to a) cure people and b) prevent illnesses in the first place. The good DRs will make more, the bad ones will say they deserve it because they went to med school and society owes them, while posting on ET.

Currently, DRs are paid more if their patients are unhealthy and even more than that if the DR prescribes medications which do not work....or make the patient sicker.

You are clueless. I hope you have better insight in trading than you do in fixing healthcare.

Let me tell you Physicians are not the problem with health care. Iam absolutely sure US has the best doctors in the world.
I dont think any other counrty even comes close. Who ranking is a joke. They got thier own agenda. Bottom line is people dont take care of themselves and dont take responsibility for thier
own health.Lots of things statistics cant tell you. If a person decides to smoke, eat junk food all day, doesnt exercise and is obese, on top of that if he smokes crack for fun, Nothing a
physician can do to help them. On top of that a lot of people dont take the pills prescribed to them. People just have very unhealthy habits here compared to rest of the world. Thats why us health care system rankings keep going down.

 

[options2001]

Quote from slacker:

Increase Medical School enrollments

Decrease regulation

Cap Tort Judgements

Will it happen? Not a chance.

Would it improve health care? No doubt in my mind.

The only problem with increasing medical school enrollments is you will get sub-standard physicians. As it is best and the brightest dont go into medicine anymore. They join goldman sachs and other banks and try to come up with schemes to rob the public

 

[swtrader]

"What would you offer as a solution?"

1) Bust the insurance industry owned state insurance commision licensing that keeps competition out. THese insurance companies load their IT shops with H-1bs from India (keeping local workers out), while not allowing YOU to buy insurance from a company in the next state

2) deport the 30 million illegal aliens that get their bills padded to every bill you pay

cant do the above?

then dont do anything

either solve the problem or not

but dont just go out and spend another trillion we dont have, to 'save money'

 

[Scataphagos]

Quote from swtrader:

"... deport the 30 million illegal aliens that get their bills padded to every bill you pay
[/B]

Can't do that. We Libtards are counting on their votes* so we can stay in power.

* We understand they can't vote now, but we're planning to make sure they can in time for the next election... and that they will vote for the Libtards in exchange for all the benefits we've granted them (at the expense of Americans who've paid for them).

 

[Angrycat]

Quote from options2001:

The only problem with increasing medical school enrollments is you will get sub-standard physicians. As it is best and the brightest dont go into medicine anymore. They join goldman sachs and other banks and try to come up with schemes to rob the public

Options2001,

You sound like every doctor in my family (including the WHO doctors) and I make the same point about the WHO rankings earlier in the post myself. I appreciate your point of view.

However, as I an industry insider in Finance, I assure you that you are being rather unfair to the overwhelming majority of professionals in this industry. I don't disagree that we have our share of thieves and low-lifes, but so does every profession including yours.

 

[options2001]

Quote from Angrycat:

Options2001,

You sound like every doctor in my family (including the WHO doctors) and I make the same point about the WHO rankings earlier in the post myself. I appreciate your point of view.

However, as I an industry insider in Finance, I assure you that you are being rather unfair to the overwhelming majority of professionals in this industry. I don't disagree that we have our share of thieves and low-lifes, but so does every profession including yours.

I dont think im being too unfair. Sure there are a few doctors who are crooks, but 98% are not. But then again it goes with the profession. Iam reading financial history of United states right now its about 2000 pages long and bankers and politicians have been robbing the public for only about 350 years in this country now, so its nothing new. Maybe im being too pessimistic but thats just what Iam getting from reading from these history books.