Why can't we fix healthcare?

[John Raabe]

OK, here's my rant (or question).

It astounds me that corporate interests once again seem to have halted an attempt to lay the foundation for a basic American health care system - medicare for all. No other first (or third) world country would give up their less costly systems for our expensive and heartless corporate profit-based system. A medicare for all system would cost no more and probably less than we now spend on our combined health system costs and provide better care to boot. Certainly that is the case in countries that have it such as Canada. They are now as proud of their farsighted health care system as we are of our National Parks system.

Consider:

• The under-employed and under-insured middle class are losing homes and savings when a medical emergency strikes. This should not be happening. The last thing we need in a struggling economy is people being knocked down by avoidable health care costs.
• The truly poor and homeless have no health care insurance at all and have to show up a the emergency room of the hospital. Since by law they have to be treated this cost is shared by all of the rest of us, and emergency room care is far more expensive than treating the problems early with less costly staff and measures.
• At 66 I have recently enrolled in Medicare. The coverage (out patient) is not complete but is quite good. I pay perhaps 20 dollars a month additional for copays and non-covered prescriptions. Hospital care is very good and there is no issue of being dropped or prior conditions. All this for less than $100/ month. Recently, when my wife and I were paying our own insurance it was running over $800/mo. This is for two healthy people - many folks pay much more.

Why can't we extend Medicare coverage to all? We have a proven and tested system using standard doctors, clinics and hospitals. No new scary "socialist" infrastructure needs to be built - the system already works and the people using it generally like it better than their old private insurance. Extending Medicare and including healthy young people, should cost less per person than the current elder population coverage.

What am I missing here? Do most people really think that the high profits and huge CEO salaries of the insurance and drug industry is something we have to preserve?

[Pox Eclipse]

I am confident we will fix health care.  Americans always do the right thing, even if they have to try everything else first.

But in the mean time, there are a lot of powerful forces with a lot to lose if the status quo changes.  I think the current system is so broken, that even Greed isn't strong enough to prevent the change that is needed to keep the wheels from falling off the cart.  In 2007, 16% of the gross domestic product went to health care; the Congressional Budget Office has projected that will rise to 25% by 2025.  Other industrialized nations with universal health care average 8-9%.  Employers cannot continue to absorb the 10% per year increases in health care premiums, and they cannot continue to compete with foreign manufacturers whose employees are covered by government managed health insurance. 

Our current system simply is not sustainable.   The special interest groups that are opposing meaningful health care reform can delay change, but change is inevitable.  It will be less painful if we address it now, but ignoring it will not stave off the day or reckoning forever.  Change is very frightening to some, especially when they have been conditioned by demagogues to believe the lie that private industry is always better than the government.   Our health care is no longer the best in the world; we rank 17% in infant mortality, and worse in life expectancy, well behind other industrial nations with universal health care. 

The free market has failed miserably at providing a system of health care that keeps America healthy and productive enough to compete on the world stage.  The time has come to stop treating health care as a commodity that is sold to the highest bidder, while allowing those at the bottom of the economic ladder to die of neglect.  It is wasteful, and will lead to the ultimate destruction of our country.

[rwanders]

I believe at least one of your statistics is erroneous-----life expectancy rates in the US factor in all deaths, including accidents----the rates for the rest of the world do not count accidental deaths, thus producing a false "apples to oranges" comparison.  I can't cite a specific source for you but, I have seen it.

[rwanders]

   I wish my experience with medicare was as good as yours. The reimbursement rate for primary care doctors in Alaska is so far below their overhead costs there are virtually none who will accept medicare patients----out of over 700 doctors in Anchorage, only 17 will do so and none will accept new patients. I had to agree to not seek medicare coverage with my doctor and thus I pay 100% of his charges.  I do have to pay my medicare monthly charge and my former employers retiree premium (since I am over 65 it is now secondary to medicare and will also not pay since I can't bill medicare). So, I now pay both premiums and 100% of my doctor bills and pay into medicare so you can get your bills paid (don't blame you---just the way it works out) Oh yes--because I had some fairly big capital gains two years ago, my medicare premiums were doubled----I pay over $230 a month now for my non-existent medicare "benefits".  Our congressional delegation is trying to get the reimbursement rates changed, but Obama needs to cut $500 Billion out of medicare so it doesn't look good. Getting Washington's attention is even harder then getting an insurance company's attention----at least I may be able to sue an insurance company for fraud.

[Don_P]

My experience with medicare through helping with my wife's parents has been good. Being self employed my coverage is poor and I do not hire very often due to the costs. I've heard nothing in the proposals so far that made me think the situation for me would get worse than what's in place now.

[StinkerBell]

John R,

I think you said a few things that caught my interest. You ae rare that your experience with medicare has been good.  However the key to the success you are having imo is that you are healthy.

Once you spend 23 hours in a ER or a Rapid Care Unit and you get a bill for the full amount becasue technically you were not admitted to a hospital (depends what medicae plan). I have seen people crumble because they were not aware they were responsible for the bill. They believe they were admitted to a hospital. An ER is affiliated with Hospitals but techinically they are different, because as you noted even the poor who can not pay will be treated at an ER but this does not mean they will get hospital care. ER's and Hospital are two different entity's.

Depending on the state and even the county you live in will depend on your care. I have seen medicare and tricare (each federally runned) and how they work and many docotors will not continue in their practice and will move on if they are mandated to take coverage that cost them out of pocket to treat someone. Now for tax reason there are those doctors who do take on a handful of medicare patients because their practice can absorb the loss and they get a nice write off. However, business is business no once can afford to treat people if there is no money left at the end of the month to pay staff, rent and supplies.

If i were to place it in numbers I think that medicare isgood only 20% of the time and the other 80% is horrible. Now if those numbers where reversed I think there could be an argument made for it.

I am a strong believer in medical reform but it really is a state issue. 

[MountainDon]

.... Do most people really think that the high profits and huge CEO salaries of the insurance and drug industry is something we have to preserve?

Right on!

No other first (or third) world country would give up their less costly systems for our expensive and heartless corporate profit-based system.

If it wasn't for other benefits we found here in the USA (compared to Canada, my birth country and home for 30 years)

The US health care system was not the reason we moved from Canada to the USA. There were many other reasons. However, looking back I have to wonder at times. I have family still in Canada. As I have said in other threads here, they are content with Canada's system. My mother received great care in the last few months of her life. As I also said someplace else, I believe that the greatest asset of any country is the hard working people who make the country work. They should all be taken care of.

My father and mother ilaws received great care here in the NM under Medicare in their last months/year of their lives.

[ScottA]

There are 2 reasons why healthcare cost so much.
1. Lawyers
2. Politicians

[harry51]

A single payer healthcare system would obviously be financed by taxes. Taxes are money collected at the point of a gun. It seems obvious that most people will pay in much more than they get back, in order to make up the difference for those who have huge medical needs. Is it right to force people to do this? And then there's the question of the dismal record of gov't mismanagement of just about anything they've involved themselves in.

I would prefer to take my chances with the profit driven system, purchasing as much or as little healthcare as I think I need, making my own decisions as to when, where, and who from, and donating to Children's Hospital, etc., as I think appropriate to help the less fortunate.

Beyond all that, I just don't want the gov't involved one iota more in my life than they already are, period. Liberty requires taking responsibility for one's life, both the good and the bad, and finding ways to deal with it on our own. We can do that and enjoy liberty, or we can delegate more of our resources and prerogatives to be dispensed according to the infinite wisdom of bureaucrats in exchange for empty promises of security. Thanks, but no thanks.

[Pox Eclipse]

There are no proposals in congress for a single-payer health care system.  The public option proposed in the House is estimated to cover less than 10% of the country.  If you don't want public option coverage, you don't have to pay the premium.  This is not free health care for everyone, paid for by taxes. 

[fishing_guy]

It might not be paid for directly by taxes, but the money has to come from somewhere.  Here in Minnesota, we have MinnCare.  It is a state "pool" which individuals can opt for if they meet certian income requirements.  It is paid for by a 2.5% tax on ALL health procedures.

Until we, as consumers, stop going to the doctors for the little things and use our heads, nothing will change.

5 years ago, I had siatica(sp?) really bad.  I knew what it was, and the doc knew what it was.  I had to go take a battery of tests which told me...drum roll please... that I had a bad back.

Went to a specialist, who gave me 2 options...surgery or physical therapy.  I chose pt as it was the least invasive.  It got me to 90%.  At that level, I can do the things I want to, and the flare ups are few and far between.  I could have elected surgery to get to 100%, but the cost/benefit wasn't there in my eyes.

My brother does not have insurance.  He makes good money, but didn't deem it important.  He pays cash at the docs.  That is and should be his choice.

[MountainDon]

Pox, the question of health care reform is replete with misinformation and misunderstandings. I see nothing wrong with the offering of a public option, to me that is imperative. To make insurance mandatory and not have a public option serves only the large insurance companies and their over compensated CEO's. For my money, under the present system, there is no real competition in the health insurance field.

Many people feel trapped, are trapped, into working at jobs they do not like, only because their employer provides them with health insurance at a rate that is much less costly then what they would pay if they left Corporate America and struck out on their own. I've been there, done that. $900 a month to cover two adults, one of them with catastrophic only type of coverage, is nuts.

[MountainDon]

 He pays cash at the docs.  That is and should be his choice.

I have no problem with people who want to opt out of the health insurance business, as long as they also opt out of accepting any care they can not pay for.

There are few who have the resources to cover their own care is cases such as being the victim of a drunk driver crash with a resultant long term rehabilitation, or worse yet if they are paralyzed. Ditto the costs for the long term care for a child born with some greatly debilitating condition. Ditto for the guy diagnosed with something like colon cancer, who gets treatment, survives only to have a recurrence several years later. There goes another round of treatment. Who can afford to pay for those kinds of expenses out of their own pocket, without bankrupting the family? There are some, but I don't know any personally.

[harry51]

Call me a cynic, but I believe that a "public option", once in place, will crowd out private options over time, simply because gov't run programs don't have to show a profit or break even. After the giveaway prices offered by the public option have driven the private option alternatives out of business, service will become more arbitrary and we'll never really know what the cost is. I would even predict that it will cost more in the aggregate, when all the administrative costs are considered, than we are paying now.

How about instead of using healthcare as an excuse to grab more of our money and force us further under the gov't thumb, a tax credit is developed that gives maybe $1.05 for every $1.00 given for healthcare for patients who seriously need help? Let the tax exempt foundations administer the program, like the ones that make grants to public tv, etc.

There has to be a way to improve things without more taxes and coercion, and without more gov't intrusion into our lives. Relying on my ability to locate and pay for the medical care I need in a free market seems infinitely preferable to relying on my ability to convice bureaucrats to dispense the care I need when I need it.

As long as purchase of insurance is voluntary, providers must maintain an acceptable level of customer service, or they will quickly be out of business. When purchase becomes mandatory, service and prices become more arbitrary because the customer has less leverage. When the insurance is tax financed, the customer is completely at the mercy of the bureaucrats in charge. I am simply not interested in being put in that position. IMO, healthcare is simply not a proper function of gov't. Gov't involvement in healthcare will inevitably make gov't grow, and that's absolutely the worst thing that can happen to us.

[Pox Eclipse]

To make insurance mandatory and not have a public option serves only the large insurance companies and their over compensated CEO's. For my money, under the present system, there is no real competition in the health insurance field.

I agree 100%.  As a lefty liberal, I am going to be very angry if a bill passes with mandatory health insurance, but no public option.

[Pox Eclipse]

Call me a cynic, but I believe that a "public option", once in place, will crowd out private options over time, simply because gov't run programs don't have to show a profit or break even.

This is not true.  The public option plans proposed in both the House and Senate must be self-financing, self-sustaining insurance plans.  The money comes from premiums paid by the insured.  The public option is not free health care.

How about instead of using healthcare as an excuse to grab more of our money and force us further under the gov't thumb, a tax credit is developed that gives maybe $1.05 for every $1.00 given for healthcare for patients who seriously need help?

Of what use is a tax credit to someone who does have to pay taxes?  Nearly 50% of the households in the nation pay no income taxes except Social Security and Medicare, which cannot be reduced by a tax credit.

[emcvay]

There is no reason that we cannot fix our health care system and make it affordable for all who are willing to work.

There is a reason why we cannot create a new socialized system in response to "we need to fix health care".

You see, the problem is viewed one sided.  

One side believes that Government is the answer.

One side believes Government is not the answer.

The first side, the side that believes that uncle Sam should take care of you and all, is not usually willing to hear other side of the coin.  They want their Socialized care and are swayed by those who claim other countries have better care and care for all.  They rarely consider the Constitutional legality of taxing to pay for health care (redistribution of wealth) and really don't seem to care.  Nor will they accept that the problem (aka losing a home) is caused by poor fiscal management as much as the cost of care and to reduce one while improving the other will do as much to solve the problem, if not more, then just putting Government in the mix.

The second side, the free marketeers, aren't willing to listen to the other side either.  They're not interested in Government handouts and socialist programs.  They beleive in the American Way -- the whole idea that if you work hard you can get more stuff, better care etc etc -- and feel that smaller government, less taxes and less regulation is the way to go.

So why can't we fix the problem?  We can't unless the Socialists are willing to accept that their system requires 'fundamentally' changing America and that creating a bigger 'nanny state' is going to cost more (Government does not cost less ever) and reduce wealth while creating a new class of political elites (Study Russia please).

We also can't fix the the problem becuase the Capitalists are not willing to accept big government and it's social elite and their 'cradle to the grave' entitlements all the while accepting welfare, unemployment insurance, social security etc etc.

But I have the answer

For those whom beleive we need Government care I suggest you start a moment in which you voluntarily give up a large enough portion of your salaries to pay for the care and all other social programs desired.  At the same time the Capitalists agree NOT to give up ANY of their income for those reasons and agree to NEVER collect them either.

We get cards, my card will say "No Thanks" and I won't pay the portion of taxes that goes to any social program (Public Ed, Health Care, SS, Medicare/Caid, etc etc) and I won't ever be allowed to collect it either (but you'll have to pay me back too) and you get a card that says "Yes Please" and if they need to take 75% of your income to do that and take away your rights then ok.  You agree and can't opt out once you've used the system.

That would be fair and might just work.

But seriously, the real issue is that you want to force me and others to pay into YOUR system and we don't want it.  What we want is less government, less regulations, less interference, less lawsuits, cheaper care (which it would be) and a true free market system (do away with the dollar while you're at it).

But hey, you know I've been thinking -- maybe we ought to let you take it all and get your Socialist health care (not being mean either, that's just what it is) becuase while Gold hit $1040 today and the dollar continues to tank you won't be able to pay for it anyway and will have to ration care like crazy while canceling all kinds of programs which will tick off American's who will vote out the socialists who put it there and ask for the old system back because at least then if they can get a job and earn a living they can afford care.

By the way, anyone earning $10 today can get care...heck kids making $8.50 an hour can get care and it isn't that expensive.  Most of what you hear is propaganda and you're falling for it like crazy.

[emcvay]

http://www.atimes.com/atimes/Global_Economy/KJ06Dj04.html

If you don't follow economics and you don't read the bills they are trying to pass and you actually believe Government can do something without costing you more then you really aren't intellectually honest are you?

I don't know why I get so passionate about this but perhaps it's every time someone says "public option plans proposed in both the House and Senate must be self-financing, self-sustaining insurance plans" it indicates to me that you either don't really know what goes on in Politics or don't care and aren't willing to be honest about it.

It's kinda like Obama saying he can save billions right now in health care just by improving things...ok so prove it, I'm from Missouri so show me (ok I'm not, but you can still show me).

Where is the proof?  If there are millions or billions of savings just in how business is done today in Medicaid and Medicare then why not just start now and make those savings.

The truth?  It's something different.  For one Medicare and Medicaid are BANKRUPT!!!!  Run by Uncle Sam they are broke.  The writing is on the wall.

Social Security?  broke.  bankrupt.  Kaput.

And you actually think these politicians (who clearly aren't honest) can run a NEW program any better?

Why not fix Fanny Mae and Freddie Mac first?  How about cleaning up the budget now?  Why not get rid of the 1.7 TRILLION dollar deficit first?  There is NO PRIVATE health care money in there after all.

So, the post office has a boss who makes $800,000+ a year (more then they wanted to allow a big CEO of a bank to make remember?) and they are losing millions -- bleeding money -- and they gave him a raise and you actually are so naive to think they can run health care cheaper?  better?  for all?  Without increasing the tax burden?

Please!  Really?

Come on guys and gals, it's a scam.  It's crazy talk, it's nonsense and you know it.

I know you want poor so-and-so to get health care (other then the emergency room care they get now) and I know you want to feed the kids and save the wales but seriously, can't we just first get our finanances in order?

The Obama crowd likes to say "we inherited..." ok so FIX IT!  You cannot be serious.

You inherited a Government that had a deficit of $400 billion and you drove that UP to $1.7 TRILLION.  It's yours now.  So fix it and stop making excuses.

I'm willing to talk about socialized medicine when you're willing to go deficit ZERO and budget SURPLUS with LOWER TAXES and the option to opt out completely,.

The rest is dishonest and not the American way.

By the way, after they ram health care down our throats it will get thrown out by the Supreme Court -- it's unconstitutional.  Though that probably doesn't matter.

Anyway, sorry John, I shoudl stick to cabin building   I need to stay out of politics becuase I don't see there's any willingness to listen to either side.

[MountainDon]

By the way, anyone earning $10 today can get care...heck kids making $8.50 an hour can get care and it isn't that expensive.  Most of what you hear is propaganda and you're falling for it like crazy.

What type of care? Who's paying for it?

I'm not talking about antibiotics for an infected cut. How about finding blood in your stool for months on end, finally going to the doctor and he says we need to do a colonoscopy to see what's wrong. That's after other more simple tests do not resolve anything. The colonoscopy is $5K, not exactly pocket change that the $10/hour laborer is likely to have handy. Or you find a melanoma on your back.... the list goes on....


And that reminds me of another question I have about our health insurance system. Why is it the vast majority of people here in the USA believe their employer should provide subsidized insurance? I have never understood that expectation. I do understand the benefit to the employee of working for a huge corporation and being able to join in one of the many offered plans. Businesses are in business to provide goods and/or services to people in the marketplace. They are not in business to be a conduit or health or any other type of insurance. But I digress.



Also, please note:  the propaganda street is a two way street. The misinformation (lies or exaggerations) is going fast & furious in both directions.

[StinkerBell]

We need health care reform both in the health care system , ie legally treating. We also need to have reform with insurance companies that charge outragoues rates and pays their ceo's incredible amounts of money.

The insurance commissioner in each state needs to be an elective position. Insurance companies do not wake up one day to randomly rise your rates. They need to get state approval first. The people in each state need to make their government wake up and smell the coffee. IMO technically our insurance is run my the government. Without the government they can not operate in your state. 

[MountainDon]

... Medicare and Medicaid are BANKRUPT!!!!  Run by Uncle Sam they are broke.  

Medicare is not quite bankrupt, but is dipping into reserves from what I read. However I believe it is disingenuous to lay the blame solely on Uncle Sam or the managers of Medicare. The fault lies with the proliferate and escalating costs charged by the health care provider industry.

[harry51]

Call me a cynic, but I believe that a "public option", once in place, will crowd out private options over time, simply because gov't run programs don't have to show a profit or break even.


This is not true.  The public option plans proposed in both the House and Senate must be self-financing, self-sustaining insurance plans.  The money comes from premiums paid by the insured.  The public option is not free health care.

Who's going to audit them? We'll never know what any gov't run program really costs.

How about instead of using healthcare as an excuse to grab more of our money and force us further under the gov't thumb, a tax credit is developed that gives maybe $1.05 for every $1.00 given for healthcare for patients who seriously need help?


Of what use is a tax credit to someone who does have to pay taxes?  Nearly 50% of the households in the nation pay no income taxes except Social Security and Medicare, which cannot be reduced by a tax credit.

Pox, maybe I didn't state the idea clearly. The suggestion was that the wealthy, the foundations, and others with heavy tax liability be given a profit incentive (tax credit) to pay healthcare costs on behalf of those who can't afford to pay. Of course, that approach would result in less net revenue to gov't, so that idea couldn't possibly be considered a viable alternative, could it?

[emcvay]

http://www.foxnews.com/politics/2009/10/05/tracking-taxes-medicare-waste/?test=latestnews

Good article on waste in Medicare.

Medicare is bankrupt -- it just doesn't know it yet.

I've read several articles that show the bankruptcy would normally occur in 2011 however bieng run by Uncle Sam means they won't actually ever go bankrupt.  Freddy Mac and Fannie Mae are also bankrupt but Uncle Sam bailed them out...just like GM and Chrysler.

Again, it's not the government that will solve this problem.  They will make it worse.

Mark my words.

Speaking of an earlier comment I made, gold is now at $1042 an ounce.  Seriously, how exactly are you going to pay for socialized care when you're flat broke?  The dollar is sliding and will continue to do so with the Middle East now joining the call to abandon the dollar.

What most I think fail to see is that you cannot monetize the debt by printing billions or trillions of dollars without serious economic consequences.  The Keynesians are wrong, always have been and always will be.

So, while the Austrian Cycle continues and the next major bust approaches i ask:  how will you pay for it?

You won't.

[emcvay]

That the programs will ultimately go bankrupt is clear from the trustees' reports. On pages 201 and 202 of the Medicare report, you will find the conclusive arithmetic: over the next 75 years, Social Security and Medicare will cost an estimated $103.2 trillion, while dedicated taxes and premiums will total only $57.4 trillion. The gap is $45.8 trillion. (All figures are expressed in "present value," a fancy term for "today's dollars.")

http://www.newsweek.com/id/199167

The news report said that instead of increasing by $4.7 billion in fiscal year 1995 and continuing to rise for another year as the administration had predicted, Medicare's trust fund had actually declined by $35.7 million for the fiscal year ending Oct. 1.

This decline suggests that the trust fund's reserves are sliding downward faster than expected and the trust fund might go bankrupt before 2002, the currently predicted insolvency date.

http://tech.mit.edu/V116/N1/medicare.1w.html

What's amazing is the 2nd post was from 1996 (or was the '95?)....

Anyway, the system is failing and has been for a long time -- we all know that right?  So what makes you think that a system that's clearly had major funding issues for the last 13 years or more (more obviously) won't be the same sort of thing we will face in the future?

Come on people, we know these systems don't work.  They are feel good measures at best.

The answer isn't in Government, it's in American's.

I beleive in you and me I do not beleive in Mr. Politician.
Thanks

[emcvay]

"In light of the fact that the Medicare program already faces $38 trillion in
unfunded liabilities according to the most recent trustees' report, and is
predicted to be bankrupt in a few years,

http://www.reuters.com/article/pressRelease/idUS169941+18-Aug-2009+PRN20090818

It's not hard to find these kinds of reports...just search in google for them.

Medcare is bankrupt.  Maybe not filing today, maybe they won't ever file (they can increase taxes to pay for it after all) but it's a clear indicator of what's to come.