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RE: Should healthcare be a right or a privilege? - 3/4/2007 6:14:46 PM   
Archer


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In earlier threads on the subject I gave my prefered solution to the problem.
1. Make all not just employer provided insurance pre tax expenses.
   a. this takes many who can not currently afford insurance and puts them in a place where they can afford it
   b. This also moves the insurance field closer to the person paying the bill, fostering real competition for each and every individual customer which will drive down costs further.
   c. It also makes sure the person making the medical payment decissions answerable to the patient who is paying the premiums
  
2. the first round of this will drive down premiums as companies vie for individual customers
   a. This will in turn make the next lower income levels closer to being able to afford health insurance
  
3. Next step provide Insurance vouchers on a sliding scale that people can only use for Insurance premiums.
   a. keeps the government interferance out of the mix as much as posible
   b. keeps the government from ever being in the possition to tell someone "Nope you we can't afford to help."
   c. keeps the government from ever deciding what is and is not covered by a "Universal Healthcare System"

4. Remember sooner or later the other party is going to be in charge of the Universal Healthcare System you pass.
You want them to have the power to determine if
   a. abortion is a covered cost?
   b. Aids is a covered condition?
   c. Birth control covered unless married?
   ( Basicly how wide do you want to make the opposing party's control of the healthcare industry when they eventually come to power, as the pendulem swings back?)

(in reply to Dtesmoac)
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RE: Should healthcare be a right or a privilege? - 3/4/2007 6:27:12 PM   
Dtesmoac


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quote:

ORIGINAL: Archer

In earlier threads on the subject I gave my prefered solution to the problem.
1. Make all not just employer provided insurance pre tax expenses.
  a. this takes many who can not currently afford insurance and puts them in a place where they can afford it
  b. This also moves the insurance field closer to the person paying the bill, fostering real competition for each and every individual customer which will drive down costs further.
  c. It also makes sure the person making the medical payment decissions answerable to the patient who is paying the premiums
 
2. the first round of this will drive down premiums as companies vie for individual customers
  a. This will in turn make the next lower income levels closer to being able to afford health insurance
 
3. Next step provide Insurance vouchers on a sliding scale that people can only use for Insurance premiums.
  a. keeps the government interferance out of the mix as much as posible
  b. keeps the government from ever being in the possition to tell someone "Nope you we can't afford to help."
  c. keeps the government from ever deciding what is and is not covered by a "Universal Healthcare System"

4. Remember sooner or later the other party is going to be in charge of the Universal Healthcare System you pass.
You want them to have the power to determine if
  a. abortion is a covered cost?
  b. Aids is a covered condition?
  c. Birth control covered unless married?
  ( Basicly how wide do you want to make the opposing party's control of the healthcare industry when they eventually come to power, as the pendulem swings back?)



Who makes the decison over what is covered and what is not then? Will this be a private company deciding on profitability, or a medical panel deciding based upon cost effective treatment, or an ethics panel based upon the morally right decision?

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RE: Should healthcare be a right or a privilege? - 3/4/2007 6:59:46 PM   
farglebargle


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From: Albany, NY
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quote:

ORIGINAL: Archer

In earlier threads on the subject I gave my prefered solution to the problem.
1. Make all not just employer provided insurance pre tax expenses.
a. this takes many who can not currently afford insurance and puts them in a place where they can afford it
b. This also moves the insurance field closer to the person paying the bill, fostering real competition for each and every individual customer which will drive down costs further.
c. It also makes sure the person making the medical payment decissions answerable to the patient who is paying the premiums

2. the first round of this will drive down premiums as companies vie for individual customers
a. This will in turn make the next lower income levels closer to being able to afford health insurance

3. Next step provide Insurance vouchers on a sliding scale that people can only use for Insurance premiums.
a. keeps the government interferance out of the mix as much as posible
b. keeps the government from ever being in the possition to tell someone "Nope you we can't afford to help."
c. keeps the government from ever deciding what is and is not covered by a "Universal Healthcare System"

4. Remember sooner or later the other party is going to be in charge of the Universal Healthcare System you pass.
You want them to have the power to determine if
a. abortion is a covered cost?
b. Aids is a covered condition?
c. Birth control covered unless married?
( Basicly how wide do you want to make the opposing party's control of the healthcare industry when they eventually come to power, as the pendulem swings back?)




This raises a salient point: If the Feds can't get their act together W.R.T. abortion, how can anyone expect them to get it together about any other health issue?



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RE: Should healthcare be a right or a privilege? - 3/4/2007 7:51:16 PM   
Archer


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quote:

ORIGINAL: Dtesmoac


Who makes the decison over what is covered and what is not then? Will this be a private company deciding on profitability, or a medical panel deciding based upon cost effective treatment, or an ethics panel based upon the morally right decision?


Well idealy it will be the decission of the patient and their insurer, since they negotiate a contract ahead of time. Which is exactly what insurance is. You buy a service contract either way reguardless of who you negotiate the service with, government or insurance company.

At least the motivating factors with a company are consistent, the motivating factors of the government providing it are open to as much abuse and are far less consitent.


< Message edited by Archer -- 3/4/2007 7:53:15 PM >

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RE: Should healthcare be a right or a privilege? - 3/4/2007 8:11:33 PM   
thompsonx


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quote:

ORIGINAL: Archer

If we set a figure of what is considered a fair profit then what they spend or do not spend becomes less important. Since the figure sets a relationship based on investment and profit.
So again lets take a wild stab at what is a fair profit.
I am convinced from many of your previous posts that you do not feel that anyone may assume what is a fair profit in a free enterprise system. 
If on the other hand we consider state monopolies like the power company then the state determines what is a fair profit.
My statement was in response to your substantiating the profit margins of the drug companies based on what they spend on research as if what they spent on research was a huge number and consequently requiring corresponding profits...I was simply pointing out that the drug companies spend much more on advertising and lobbying than they do on research.  Would you like to justify profit margins based on how much they spend on lobbying?

Three examples of LOCAL government functions by and large.
Police Fire and Education are pretty much local matters so apples and oranges compared to a nationwide healthcare system.
Hardly apples and oranges since police fire and education are nationwide and all local jurisdictions are subject to the federal government.  The local police department the town of Adelanto, California was recently disbanded by the department of justice and replaced by the county sherrif because of its criminal behaviour.

As to the Constitution's General Welfare clause it says Promote the general welfare not provide for it. Removal of obsticles to opportunity is a far cry from giving away someone elses money.
Just how would one  remove the obsticals to access to health care by the poor.
You like to keep using the phrase "giving away someone elses money"  The government does not do anything to earn money.  The government  taxes the citizens in order to get money to do what government does. 
Government funds libraries,education,fire protection,police protection and on and on ...health care would be just one more in a long list of things the government can and should do.  If you feel that government should not do this one need only look at what governments lack of action in this area has accomplished.
If you choose to buy a home the government subsidizes you by allowing you to deduct from your taxable income the amount that you pay in interest on your mortgage.  Why do they do this?  Because it is felt that home ownership is a good thing for our society.  Why does the government provide public education?  Because it is felt the an educated  citizen is good for society.  So also are healthy citizens good for society, consequently it would follow that the government would tax us to pay for it just as they tax us to pay for the other services that are deemed to be in the best interest of our society.
thompson

(in reply to Archer)
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RE: Should healthcare be a right or a privilege? - 3/4/2007 8:23:40 PM   
thompsonx


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quote:

ORIGINAL: Sternhand4

I started this thread as another thread had brought the issue up.

I do not support public health care as it is practiced in europe or as in canada.
Both systems have advantages and flaws. But in the end, they would never work here for a lot of reasons.
Americans expect "cadillac" healthcare. Their is no way they would accept waiting lists, or simple denial of services due to being to old to cost justify the expense.
Most americans will never give up the right to choose their doctor.
The only americans who expect cadillac health care are the rich.  The majority of americans who belong to hmo's, managed care. privete insurance and so forth do not get to choose their doctor, rather they get to choose from a list of approved doctors, and are routinely deniede certain treatments because the providers bean counters say so.

I do think that there should be a national health insurance program. But it would have to be tiered to work. How will the public take it when some " are more equal than others" even though thats essentially the system in place now?
Perhaps that is what we are talking about here...changing the system that is currently in place where the rich are clearly more equal than the not rich.
thompson






< Message edited by thompsonx -- 3/4/2007 8:25:16 PM >

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RE: Should healthcare be a right or a privilege? - 3/4/2007 8:31:02 PM   
thompsonx


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The number one reason for the high cost of health care is the fact that doctors through the AMA artificially limit their numbers to insure high prices.  If you do not believe this try to start a medical school.
thompson

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RE: Should healthcare be a right or a privilege? - 3/4/2007 8:51:07 PM   
Sternhand4


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quote:

ORIGINAL: thompsonx

The number one reason for the high cost of health care is the fact that doctors through the AMA artificially limit their numbers to insure high prices.  If you do not believe this try to start a medical school.
thompson

I would bet its more a function of "defensive"  medicine. Many times tests are run to cover what a doctor already knows. They just want to cover their bases in case they get sued.

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RE: Should healthcare be a right or a privilege? - 3/5/2007 12:25:23 AM   
meatcleaver


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quote:

ORIGINAL: sleazy

quote:

ORIGINAL: edgeofreality
Public Universal Healthcare is not a matter of charity of generosity.


Unless everyone never takes out more than they put in there is an element of charity and generosity from those that are paying in more than they are taking back out. Unless of course the country is just going to print money on demand to cover the costs and then worry about the currency issues that would create




Why would people be wanting to take out more than they put in? 'Oh my god, I haven't been sick enough to get all my share of healthcare I paid for!' There is no charitable element in universal healthcare, it's an insurance that people would on the whole (unless you are a hypochondriac) prefer not to use. People pay according to their means which is how defence, police, education and everything else is paid for. Actually the rich don't pay according to their means, they pay far less, if more in actual money.

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RE: Should healthcare be a right or a privilege? - 3/5/2007 1:04:20 AM   
seeksfemslave


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quote:


Archer said, discussing the content of a Health Insurance contract

Well ideally it will be the decision of the patient and their insurer, since they negotiate a contract ahead of time. Which is exactly what insurance is. You buy a service contract either way regardless of who you negotiate the service with, government or insurance company.


Its seems to me you are overestimating the ability of the insured to have any influence on a Health contract.
What happens in practice is that a contract is offered, as in motor insurance, then the insured finds out "what he has got " or not, as the case may be, when a claim is made.
NO?

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RE: Should healthcare be a right or a privilege? - 3/5/2007 1:16:24 AM   
Zensee


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A lot of good and detailed ideas, Archer. I especially agree with you about health before taxes. It is not impossible to envision real solutions to many of the problems that plague heallthcare access.

I think decisions on what is and what is not covered should be federal in scope, meaning accepted procedures are available everywhere. But I don't think the list should be made by elected politicians or negotiated by individual insurers and clients. A stakeholder's committee of some sort would be preferable. Making those decisions is probably the most difficult aspect and every effort should be made to remove as much politics from it as possible.


Z. 

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RE: Should healthcare be a right or a privilege? - 3/5/2007 5:05:58 AM   
sleazy


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quote:

ORIGINAL: meatcleaver

quote:

ORIGINAL: sleazy

quote:

ORIGINAL: edgeofreality
Public Universal Healthcare is not a matter of charity of generosity.


Unless everyone never takes out more than they put in there is an element of charity and generosity from those that are paying in more than they are taking back out. Unless of course the country is just going to print money on demand to cover the costs and then worry about the currency issues that would create




Why would people be wanting to take out more than they put in? 'Oh my god, I haven't been sick enough to get all my share of healthcare I paid for!' There is no charitable element in universal healthcare, it's an insurance that people would on the whole (unless you are a hypochondriac) prefer not to use. People pay according to their means which is how defence, police, education and everything else is paid for. Actually the rich don't pay according to their means, they pay far less, if more in actual money.


If I pay more into something than I get out of it, then it is charity pure and simple, no matter if it be for famine relief in Africa, flood relief in Bangladesh, the subsidised housing of my neighbour, or for state funded healthcare.


Of course that makes me one of the most charitable people around once you take into account the taxes I pay into the state and slected registered charities compared to how little I take out from the state or my selected charities. For the last 20 years I have worked and paid for the surgery I needed all that time ago, and here I am paying for it again out what I have left after taxes to ensure it was done quickly in a well equipped clean hospital.

As for the rich paying less in real terms, well I would debate that point, but I would also point out that the rich often have their own pension plans that will forbid them taking a state pension, their own health plans that mean public healthcare is there purely for emergency aid, its not just the 40% income tax, but the 17.5% on that plasma tv, the meal out in the fancy restaraunt etc etc. Look how much tax comes from the top n% of earners in just about any country I wouldnt mind betting if I added it all up I would actually be paying well above 50% in taxes on every pound I earn, that sure dont apply to a minum wage family of 4 in a rented house.

Universal healthcare is an admirable goal, if a government can be trusted to run it efficiently and everybody realises that a lot of people will be charitable (even if not by free choice) and put more in to subsidise the healthcare of those less well of or with more severe medical issues than they take back out of the system.

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RE: Should healthcare be a right or a privilege? - 3/5/2007 5:34:13 AM   
farglebargle


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quote:

ORIGINAL: seeksfemslave

quote:


Archer said, discussing the content of a Health Insurance contract

Well ideally it will be the decision of the patient and their insurer, since they negotiate a contract ahead of time. Which is exactly what insurance is. You buy a service contract either way regardless of who you negotiate the service with, government or insurance company.


Its seems to me you are overestimating the ability of the insured to have any influence on a Health contract.
What happens in practice is that a contract is offered, as in motor insurance, then the insured finds out "what he has got " or not, as the case may be, when a claim is made.
NO?



No. At least in my state Auto Insurance is quite tightly regulated. Rates and Coverages are filed with the State Insurance Board, and need to be approved before being offered, and there are required disclosures, etc.

Caveat Emptor still applies, of course, but it's not the wild-west.

_____________________________

It's not every generation that gets to watch a civilization fall. Looks like we're in for a hell of a show.

ברוך אתה, אדוני אלוקינו, ריבון העולמים, מי יוצר צמחים ריחניים

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RE: Should healthcare be a right or a privilege? - 3/5/2007 6:05:29 AM   
meatcleaver


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quote:

ORIGINAL: sleazy


If I pay more into something than I get out of it, then it is charity pure and simple, no matter if it be for famine relief in Africa, flood relief in Bangladesh, the subsidised housing of my neighbour, or for state funded healthcare.


Of course that makes me one of the most charitable people around once you take into account the taxes I pay into the state and slected registered charities compared to how little I take out from the state or my selected charities. For the last 20 years I have worked and paid for the surgery I needed all that time ago, and here I am paying for it again out what I have left after taxes to ensure it was done quickly in a well equipped clean hospital.

As for the rich paying less in real terms, well I would debate that point, but I would also point out that the rich often have their own pension plans that will forbid them taking a state pension, their own health plans that mean public healthcare is there purely for emergency aid, its not just the 40% income tax, but the 17.5% on that plasma tv, the meal out in the fancy restaraunt etc etc. Look how much tax comes from the top n% of earners in just about any country I wouldnt mind betting if I added it all up I would actually be paying well above 50% in taxes on every pound I earn, that sure dont apply to a minum wage family of 4 in a rented house.

Universal healthcare is an admirable goal, if a government can be trusted to run it efficiently and everybody realises that a lot of people will be charitable (even if not by free choice) and put more in to subsidise the healthcare of those less well of or with more severe medical issues than they take back out of the system.


I'm unimpressed with people who cry about paying tax, I'll be paying 50% this year plus all the indirect taxes. Why people whine about paying tax that provides medical care for everyone but don't whine about their car travel and roads and flights being subsidized says more about them than the tax system. I don't use roads or pollute the environment, perhaps I should not have to pay for roads? One can go on and on belly aching about what one puts in and what one takes out.

However you look at the figures, the British NHS is efficient on all levels compared to other countries and the healthcare is cheaper. I've had to use the NHS a before I cam to live in Holland and I never had a problem but you seem to think it isn't up to your standard, that's fine but if it isn't, it is probably because Britain gets healthcare on the cheap. Also, even if I wanted private care, the private sector didn't have the expertise or equipement to treat my condition. That fact alone reinforced what I read, that it is only any good at procedures where it can make a quick profit. The private sector also uses a lot of NHS facilities and expertise so even when you pay for private care, that care is partly paid for by the NHS. Who do you think trains the nurses that work in the private sector? You don't pay for that in your fees but through your taxes. If people think they are getting better by paying private that is up to them but my experience is that is not always true, particularly for life threatening conditions.

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RE: Should healthcare be a right or a privilege? - 3/5/2007 6:30:36 AM   
KatyLied


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I have no answer for this problem, but I hope it's figured out soon.

I am a healthy person and had to undergo surgery last year.  Leading up to it I had blood work, xrays and a ct scan, capped off by a 5 day hospital stay.  I had a good outcome, although it easily could've gone the other way.  The cost to me:  tons of worry and $20.00 (copays to two doctors).  I didn't see the surgeon's or hospital bill, I don't want to think about how much it was.  And I hate to think about the uninsured who have to deal with this sort of stuff every day.  Walking around without health insurance is a huge risk, you never know what time bombs are waiting to go in your body.


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RE: Should healthcare be a right or a privilege? - 3/5/2007 6:44:23 AM   
subrob1967


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Do you really want your health care decided by the same group that runs the VA? I sure as hell don't.

(And I'm a vet of 3 conflict zones)

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RE: Should healthcare be a right or a privilege? - 3/5/2007 8:09:13 AM   
farglebargle


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You have a point. However, I *DO* want the VA's computer system deployed everywhere.

VistA rocks, and the lack of use nationwide borders on the criminal.



_____________________________

It's not every generation that gets to watch a civilization fall. Looks like we're in for a hell of a show.

ברוך אתה, אדוני אלוקינו, ריבון העולמים, מי יוצר צמחים ריחניים

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RE: Should healthcare be a right or a privilege? - 3/5/2007 11:29:32 AM   
Zensee


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quote:

ORIGINAL: sleazy

If I pay more into something than I get out of it, then it is charity pure and simple, no matter if it be for famine relief in Africa, flood relief in Bangladesh, the subsidised housing of my neighbour, or for state funded healthcare.



Why do you insist on repeatedly mislabelling insurance as charity? It seems disingenuous. Charity is a gift - it is giving something to someone in need without expecting anything in return.

Buying into universal healthcare access is risk management. Insurance. Just because you hope you won’t have to use it doesn’t mean it doesn’t have value to you. If you get something of value for your money it’s not charity, it’s commerce.


Z.

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RE: Should healthcare be a right or a privilege? - 3/5/2007 3:07:09 PM   
seeksfemslave


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quote:

ORIGINAL: KatyLied

I have no answer for this problem, but I hope it's figured out soon.

I am a healthy person and had to undergo surgery last year.  Leading up to it I had blood work, xrays and a ct scan, capped off by a 5 day hospital stay.  I had a good outcome, although it easily could've gone the other way.  The cost to me:  tons of worry and $20.00 (copays to two doctors).  I didn't see the surgeon's or hospital bill, I don't want to think about how much it was.  And I hate to think about the uninsured who have to deal with this sort of stuff every day.  Walking around without health insurance is a huge risk, you never know what time bombs are waiting to go in your body.



MsK let us suppose, but hope that it is NOT true , that something untoward had been found that resulted in a chronic, ie long term medical problem. Would your private insurance have dealt with that ?

Assuming someone on the average American FAMILY income had suffered the problems that Christopher Reeve (ie Superman, the name seems wrong as I type it) how would they have dealt with the long term intensive care that he required, and, due to his wealth, got ?

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RE: Should healthcare be a right or a privilege? - 3/5/2007 3:10:34 PM   
Archer


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Take a real look at what Government Provided Healthcare in the US is currently like, seen the Walter Reed Hospital stories?
And that's for the much talked about supported troops. That is the reality of what happens to Hospitals in the US when the government runs them. I was raised in a career military family and I can tell you that I never saw the level of sterility and clean I see in private hospitals at any military hospital while I was growing up.
I have seen what the US government runs healthcare like first hand, it isn't all that great.
That is my number one objection and nobody has said anything to convince me the government would be any better at running an even larger system for 90% more pople than the ones they run now.

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