I am watching a brilliant TV show. This man who is relatively new to politics (but very promising) has a great idea to tackle the US' healthcare debackle.

He noted how Canada has universal healthcare for its citizens and wanted to model his model on Canada's program, but knowing the US is very different politically and much more populous, he came up with a brilliant solution: fake Canadian ID's for all US citizens! Below is the ad with his proposal.

http://vimeo.com/9514207

The novice politician's name behind this plan is Mr. Dave Chappelle.





I apologize if you find this obnoxious, but with all the depressing topics in nonav lately, I figured the best thing to fix this is Dave Cheppelle.

Here's another option: Go to Denmark, Finland, Norway or Sweden. Bring a xerox copier, borrow the text, copy, implement, raise taxes to pay for it. Job jobbed.

Even single payer system is not going to fix unless cost side of the issue is addressed. Hospitals are gouging.

May be medical insurance companies should offer off-shore option to patients for major procedures. I suppose EK can offer round trip airfare, procedure and accommodation in Dubai/India for 1/10 of what hospitals charge here.

TWA772LR wrote:

I apologize if you find this obnoxious, but with all the depressing topics in nonav lately, I figured the best thing to fix this is Dave Cheppelle.

No apology required. That has to rank extremely high among all videos posted here.

Funny.

BobPatterson wrote:

TWA772LR wrote:

I apologize if you find this obnoxious, but with all the depressing topics in nonav lately, I figured the best thing to fix this is Dave Cheppelle.

No apology required. That has to rank extremely high among all videos posted here.

Funny.

Thanks Bob!

Better would be a transition over the next 10 years to a hybrid health care and insurance plan, modeled in part by Medicare and the current ACA. My concept would be an expanded Medicaid, people paying premiums, co-pays and deductibles based on their income and place of residence. For those above certain incomes, like with Medicare, one could buy a private insurer policy for co-pays and deductibles. To fund the expanded Medicaid a fixed tax for employee and employer, as used with Social Security and for Medicaid as well as non-employment income would be assessed. Ban all TV/Radio ads and most marketing for prescription drugs. All doctors, hospitals and other medical service providers would have participate in the new program. There would be fair pricing of drugs and services. Government programs to fund medical education including for doctors, nurses, technical specialists to make it so no or manageable debt from school loans. I would also have comprehensive health and sexual responsibility education, discourage the marketing of 'bad' foods and encourage 'good' foods as well as encourage exercise.

ltbewr wrote:

Better would be a transition over the next 10 years to a hybrid health care and insurance plan, modeled in part by Medicare and the current ACA. My concept would be an expanded Medicaid, people paying premiums, co-pays and deductibles based on their income and place of residence. For those above certain incomes, like with Medicare, one could buy a private insurer policy for co-pays and deductibles. To fund the expanded Medicaid a fixed tax for employee and employer, as used with Social Security and for Medicaid as well as non-employment income would be assessed. Ban all TV/Radio ads and most marketing for prescription drugs. All doctors, hospitals and other medical service providers would have participate in the new program. There would be fair pricing of drugs and services. Government programs to fund medical education including for doctors, nurses, technical specialists to make it so no or manageable debt from school loans. I would also have comprehensive health and sexual responsibility education, discourage the marketing of 'bad' foods and encourage 'good' foods as well as encourage exercise.

You have packed an awful lot into your proposal for National Health Care. I'm all for National Health Care and a single-payer system (with optional extra plans for those who can afford "amenities").

But hybrids usually don't do well, and your hybrid plan is overly complex. Why not just have a National Health Plan that covers everyone, and pay for it out of the public purse?

That, of course, means taxing everyone, individuals and businesses, sufficiently to pay the costs.

I don't want to nit-pick everything in a single post, but effectively banning competition among drug manufacturers is unwise.

And you seem to have overlooked the matter of how new drugs and treatments will be developed and brought to market, especially since you seem bent of wringing profit out of drugs.

How will we ever get new drugs and maintain supplies of less-profitable ones such as antibiotics?

BobPatterson wrote:

That, of course, means taxing everyone, individuals and businesses, sufficiently to pay the costs.

I did the math a few months ago for a different discussion elsewhere, and surprisingly enough the US *already* pays more for Medicare and Medicaid per head of population in the US (so, everyone in the US, not just those covered by those two plans) than the UK pays for its NHS per head of UK population.

So the UK pays $x per-head-of-population and everyone is covered by the NHS. The US pays > $x per-head-of-population and only a portion of that population is covered by Medicare and Medicaid.

Very eye opening!

I'm at a conference atm, but I will find the figures if you are interested.

"Who knew the US health care issue was so complicated?"

No Tax On Rotax

This brief story may not link due to subscription restrictions but anyone that is interested in the topic should read it. It easily dispels the silly knee jerk names most GOP operatives attach to Canadian or Euro healthcare schemes and shows the many options we have in fixing our broken, bloated and costly US system. Bottom line, the healthcare itself need not be "socialized", just the insurance for those that need or qualify for it. In most countries in our "league", private doctors and private insurance exist side by side with government-mandated programs. And in each of these countries, every single last one, people pay less and live longer, healthier lives. They pay less for more, and I can't think of a more capitalist, republican, American or freedom fries-loving outcome than that. It ain't socialism, it's just smarter and better.

http://www.economist.com/news/united-st ... n-be-found

wingman wrote:

This brief story may not link due to subscription restrictions but anyone that is interested in the topic should read it. It easily dispels the silly knee jerk names most GOP operatives attach to Canadian or Euro healthcare schemes and shows the many options we have in fixing our broken, bloated and costly US system. Bottom line, the healthcare itself need not be "socialized", just the insurance for those that need or qualify for it. In most countries in our "league", private doctors and private insurance exist side by side with government-mandated programs. And in each of these countries, every single last one, people pay less and live longer, healthier lives. They pay less for more, and I can't think of a more capitalist, republican, American or freedom fries-loving outcome than that. It ain't socialism, it's just smarter and better.

http://www.economist.com/news/united-st ... n-be-found

Sometimes an article like that contains info that just leaps out at you:

"America spends vastly more on administration: 8% of health spending, versus 2.5% in Britain. As of 2013, Duke University hospital had 400 more billing clerks (1,300) than hospital beds (900)."

Of course, much of their work does not involve patients who occupied beds but received outpatient services.

B777LRF wrote:

Here's another option: Go to Denmark, Finland, Norway or Sweden. Bring a xerox copier, borrow the text, copy, implement, raise taxes to pay for it. Job jobbed.

As a Scandinavian, I would never wish that system upon any body.

Not only is it extremely expensive for society (they are trying to figure out ways how to cut it down), it leads to nothing more than government rationing and making health care decisions for you. One experience long waits, and the government decides what procedures and pharmaceuticals you can access. Most well to do Swedes as result now purchase supplemental private health care to ensure they have access to what they might need.

I happily opt for the open market system in US where on chooses and pays for benefits and services you desire.

moo wrote:

BobPatterson wrote:

That, of course, means taxing everyone, individuals and businesses, sufficiently to pay the costs.

I did the math a few months ago for a different discussion elsewhere, and surprisingly enough the US *already* pays more for Medicare and Medicaid per head of population in the US (so, everyone in the US, not just those covered by those two plans) than the UK pays for its NHS per head of UK population.

So the UK pays $x per-head-of-population and everyone is covered by the NHS. The US pays > $x per-head-of-population and only a portion of that population is covered by Medicare and Medicaid.

Very eye opening!

I'm at a conference atm, but I will find the figures if you are interested.

This is exactly right. The difference is the US does not make health care providers take care of the population in order to get money. We could, for example burn healthcare executives and hospital administrators at the stake for refusing to allocate the budget in the way that it is done in Germany or Canada. Or we could burn legislators (if the law allowed that). Using a punitive system including burning of resistors I think the healthcare system could be improved greatly.

But until then, people will continue to die without access to care. Oh - and millions of people make lots of money by keeping the system exactly the way it is. It is incredibly entrenched in every way. This is why I talk about drastic measures. I am talking about what it would actually take to change the system we have. It is NOT a money issue. It is a misappropriation issue. As you correctly pointed out.

ltbewr wrote:

Better would be a transition over the next 10 years to a hybrid health care and insurance plan, modeled in part by Medicare and the current ACA. My concept would be an expanded Medicaid, people paying premiums, co-pays and deductibles based on their income and place of residence. For those above certain incomes, like with Medicare, one could buy a private insurer policy for co-pays and deductibles. To fund the expanded Medicaid a fixed tax for employee and employer, as used with Social Security and for Medicaid as well as non-employment income would be assessed. Ban all TV/Radio ads and most marketing for prescription drugs. All doctors, hospitals and other medical service providers would have participate in the new program. There would be fair pricing of drugs and services. Government programs to fund medical education including for doctors, nurses, technical specialists to make it so no or manageable debt from school loans. I would also have comprehensive health and sexual responsibility education, discourage the marketing of 'bad' foods and encourage 'good' foods as well as encourage exercise.

I keep going back to to the Aussie system because I lived there AND also purchased private health insurance there when I was visiting 5 or 6 times a year.

At the core of that system is the elimination of cost shifting - and cost shifting is a major cost driving factor in our system. Probably well over half of premiums.

For the US there is no need to take 10 years. We have computer systems in place for Medicaid and Medicare, but these systems would need to be upgraded to larger, more powerful systems to handle more than doubling the users.

I do agree that the cheapest approach is an addition to FICA contributions. A Medicaid approach is ideal because people on lower incomes can be excluded from paying unaffordable premiums, but can still contribute a small amount and automatically move up as their incomes increase. Medicaid may need another name to avoid the stigma and it shouldn't be Medicare. Medicare should be held stable because it is designed for people who pay "premiums" during their working years, with their FICA contributions closing out. Changing that will get politicians voted out of office and they would deserve it.

In terms of costs, look for some cuts to be dramatic and some discounts about the same as private insurance. I had a EOB the other day for some CPAP supplies. The amount submitted to Medicare by the DME was $287.85 and the amount approved was $102.52. Before you get too upset you need to remember that the DME placed bids to get that business and is therefore doing OK. The $287.85 is simply the inflated number that goes to the uninsured and the private insured patients. It does, however, give an indication of the types of overcharging that is causing premium inflation, Government options can kill that cost shifting, and a chunk of the greed.

Another factor I believe in is that this needs to be a National program, not state run. I am a very strong believer in the concepts of equal protection under the law. Every patient should given the same access to care, and especially preventive testing & exams. That requires major increases in medical education for all professionals as well as investments in physical infrastructures. It also means bringing back the funding that was lost in many rural areas, with resulting closing of local health care.

On the employer side I believe in the paying their share based on profits. That puts employers in a position of not having to consider the high costs of today's health care when having to reduce employee counts (which might lower the number of employees laid off ) or when looking at increasing employee counts - which might result in more employees brought on. When the numbers for moving production overseas is close enough it might also help keep production in the US as the cost of health care is taken out of the equation. Lastly it opens up funds traditionally spent on health care to be applied to R&D, new plant and/or equipment. In other words, growth. That should be a conservative's dream.

Ken777 wrote:

On the employer side I believe in the paying their share based on profits. That puts employers in a position of not having to consider the high costs of today's health care when having to reduce employee counts (which might lower the number of employees laid off ) or when looking at increasing employee counts - which might result in more employees brought on. When the numbers for moving production overseas is close enough it might also help keep production in the US as the cost of health care is taken out of the equation. Lastly it opens up funds traditionally spent on health care to be applied to R&D, new plant and/or equipment. In other words, growth. That should be a conservative's dream.

If employer funds traditionally spent for health care are redirected to R&D and capital outlays, then those funds are not available for health care benefits.

Employer share of health care should be considered a cost of employing people just as is employer share of FICA, Worker's Compensation Insurance, Unemployment Compensation Insurance and any other per capita employee cost.

Expecting employers to pay such costs only IF a business is profitable is nonsense. No other cost of production/operation is treated in that manner. A business pays its suppliers or it goes out of business. Employees are suppliers of labor. Pay them or go out of business.

It is possible, based on the experience of many countries, for the USA to reduce health care costs very substantially. THAT is the way to grant relief to businesses.

My idea to fix the healthcare system is for a fantasy congress (one that actually gets things done) appoint a commission of a dozen or less, experienced, successful businesspersons who have no conflicts of interest ie: no doctors, hospital administration types, drug industry executives, lawyers who have experience working in the healthcare industry or anyone else presently connected with the American healthcare industries. Then provide this commission whatever resources it needs, and a few years to do research, which might include looking at other countries experience. Then have them draw up a detailed plan to structure the future healthcare of the nation and write the laws to enact it. From the beginning, laws should be enacted to prevent persons, organizations or politicians from attempting to lobby this commission or its representatives. The commission should have subpoena powers to get access to accurate financial data of the current system.

Diddling with how the current system is financed is a fools errand IMO. Creating something that is an amalgamation of the desires of special interest groups would also be a fools errand IMO.

Oh, Come on BMI727. Come on in here and tell us about how you want to pay for your own chemo but nobody else's

BobPatterson wrote:

If employer funds traditionally spent for health care are redirected to R&D and capital outlays, then those funds are not available for health care benefits..

A Medicaid for all system pulls in taxes to fund the program. My preference is to eliminate the excessive costs business now faces, opening up funds for spending that can increase profits and then develop a small Medicaid tax on those profits. That approach gives relief to companies who are struggling in tough times without killing the health care system. Funds available for health care benefits are in Medicaid because of taxes on income and profits.

BobPatterson wrote:

Employer share of health care should be considered a cost of employing people just as is employer share of FICA, Worker's Compensation Insurance, Unemployment Compensation Insurance and any other per capita employee cost..

That approach is one reason why we have the grossly overpriced system that only serves a select group of Americans. Move it to a national system and corporate management is freed from that overpriced cost of doing business. Cut costs per employee dramatically and you open up some positive avenues for growth. Might also help US companies in competing on the international markets.

BobPatterson wrote:

Expecting employers to pay such costs only IF a business is profitable is nonsense. No other cost of production/operation is treated in that manner. A business pays its suppliers or it goes out of business. Employees are suppliers of labor. Pay them or go out of business..

I believe in pulling health care costs OUT of the cost of production. It simply doesn't need to be there, and makes products generated under our current system overpriced. I can remember in the early '90's a report that GM pays out $1,250 in health care expense for every car they produced. That got my attention. Overpriced health care policies are an unnecessary albatross on corporate necks. There is no good reason for continuing that failed system.

BobPatterson wrote:

It is possible, based on the experience of many countries, for the USA to reduce health care costs very substantially. THAT is the way to grant relief to businesses.

Reducing costs first requires ending cost shifting. Go stand around a city hospital ER for a while, guessing how many properties there do not have insurance, The costs of taking care of them is going to be shifted to insurance premiums through cost increases. Universal health care funded by a profit/income tax system is the only approach to killing cost shifting and failure to eliminate cost shifting guarantees continuation of our over priced system. That is the key lesson learned from more sophisticated countries.

BTW, in the early 2000's my limited US policy was costing me $550 a month per person - $1,100 per month total. My Aussie policy was $88 per month and was far superior to the US policy, starting with the inclusion of a dental policy. Companies that want to continue paying for part or all of the health care under a sane system will be looking at a very small cost that can easily be shared with employees.

LAXintl wrote:

Not only is it extremely expensive for society (they are trying to figure out ways how to cut it down), it leads to nothing more than government rationing and making health care decisions for you. One experience long waits, and the government decides what procedures and pharmaceuticals you can access. Most well to do Swedes as result now purchase supplemental private health care to ensure they have access to what they might need.

I happily opt for the open market system in US where on chooses and pays for benefits and services you desire.

Well, I see nothing there that isn't true of the US system except it's private bureaucrats instead of the government deciding what procedures and pharmaceuticals you can access. It's also a bit of a nightmare because this patient's insurance wants them to get atorvastatin for their cholesterol, while the next patient's insurance want simvastatin. Often, this information isn't plainly laid out anywhere so you're left scratching your head and taking guesses as a physician. It's really annoying.

So I like your system better still.

Ronald Reagan weighs in on Socialized Medicine in America (From 1961, *not* from the grave...)

https://www.youtube.com/watch?v=AYrlDlrLDSQ

DIRECTFLT wrote:

Ronald Reagan weighs in on Socialized Medicine in America (From 1961, *not* from the grave...)

That was interesting as it was made a year before I graduated from high school 55 years ago. IIRC (and my brain is aged) the cost of a family medical plan. was under $80 a month and various hospitals would care for the indigent without complaint. I remember talking to a retired surgeon in the mid 70's who said that half his surgeries were done without compensation as the patients could not afford medical care.

Things are a bit different these days. Medical insurance keeps exploding in costs - to the point where a lot of people can only afford a policy with a $10K or $20K deduction. And if you can'y pay those "non-profit" hospitals toss you over to the debt collector. or fix you up with a credit card. The grand world of US medicine that Reagan talked about did not include the very poor or the people of color. And today's medical systems are basically a money grabber, with many patients placed down the list. Not the same as in Reagan's day.

Today the main issue is exploding costs and Medicaid For All is the only option for ending that.

Ken777 wrote:

DIRECTFLT wrote:

Ronald Reagan weighs in on Socialized Medicine in America (From 1961, *not* from the grave...)

That was interesting as it was made a year before I graduated from high school 55 years ago. IIRC (and my brain is aged) the cost of a family medical plan. was under $80 a month and various hospitals would care for the indigent without complaint. I remember talking to a retired surgeon in the mid 70's who said that half his surgeries were done without compensation as the patients could not afford medical care.

Things are a bit different these days. Medical insurance keeps exploding in costs - to the point where a lot of people can only afford a policy with a $10K or $20K deduction. And if you can'y pay those "non-profit" hospitals toss you over to the debt collector. or fix you up with a credit card. The grand world of US medicine that Reagan talked about did not include the very poor or the people of color. And today's medical systems are basically a money grabber, with many patients placed down the list. Not the same as in Reagan's day.

Today the main issue is exploding costs and Medicaid For All is the only option for ending that.

In a nutshell, greed and corruption now rule the day. I ask Ken, who are these people on here who defend this greed and corporate corruption of our medical industry? Independently wealthy are they? I rather doubt it, but possible. My Children both had braces on their teeth. 5 hundred bucks in total each. My grandsons, 5000 bucks each now. My daughter is 50 now. so in less than 40 years that is where we are these days. I guess that wire is more expensive than it was, but really????. I guess it must have be Obamas fault.

salttee wrote:

My idea to fix the healthcare system is for a fantasy congress (one that actually gets things done) appoint a commission of a dozen or less, experienced, successful businesspersons who have no conflicts of interest ie: no doctors, hospital administration types, drug industry executives, lawyers who have experience working in the healthcare industry or anyone else presently connected with the American healthcare industries.

So your plan is to take anyone who might actually know anything about the industry and the challenges it faces and...axe them?

Glad you aren't in charge.

DocLightning wrote:

salttee wrote:

My idea to fix the healthcare system is for a fantasy congress (one that actually gets things done) appoint a commission of a dozen or less, experienced, successful businesspersons who have no conflicts of interest ie: no doctors, hospital administration types, drug industry executives, lawyers who have experience working in the healthcare industry or anyone else presently connected with the American healthcare industries.

So your plan is to take anyone who might actually know anything about the industry and the challenges it faces and...axe them?

Glad you aren't in charge.

How is the nation's healthcare doing now that it's under the control of those "who might actually know anything about the industry and the challenges it faces" aka embedded special interest groups.

Let me offer the first answer: we have the (by far) the most expensive healthcare system on the planet, yet our healthcare system provides second rate service to the bulk of the people who are served by that system.

Maybe we need an excess profits tax on the healthcare industry. I know the Republicans would love that one. I take that back, all of congress would not touch it. A corrupt congress after all.

LAXintl wrote:

B777LRF wrote:

Here's another option: Go to Denmark, Finland, Norway or Sweden. Bring a xerox copier, borrow the text, copy, implement, raise taxes to pay for it. Job jobbed.

As a Scandinavian, I would never wish that system upon any body.

Not only is it extremely expensive for society (they are trying to figure out ways how to cut it down), it leads to nothing more than government rationing and making health care decisions for you. One experience long waits, and the government decides what procedures and pharmaceuticals you can access. Most well to do Swedes as result now purchase supplemental private health care to ensure they have access to what they might need.

I happily opt for the open market system in US where on chooses and pays for benefits and services you desire.

What makes you thing that the US health insurers do not ration health care? Procedures must be pre-approved, drug must be on the accepted formulary...the only difference is that private insurers have higher "overhead/admin"...aka profits....then Government health insurance...I think they premiums that we are paying now could go straight into a Medicare for all and we would get MUCH more for our money....possible some research done to boot!! Make no mistake, we are caught in the middle...Big Pharma does not wont you healthy, healthy folks do not need drugs, and Health insurance companies do not want you sick!!

We are screwed either way as long as your well being is..or not...profit driven!

Can you imagine if there were major problems with the internet - the costs were skyrocketing and many people couldn't even get their service to work, businesses were going bankrupt, yet the industry mandated a cutback on the number of slots available for schools that train internet technicians?

That's the situation we have now with medical care. The AMA is opposed to new med school openings. This policy is obviously meant to make sure that the current MDs can always find a high paying job no matter how bad they are. This is definitely not mandated to stimulate better care for the public.

This is just one of many examples of how the current system of healthcare management by special interest groups works against the public good. But woe is the politician who would ever challenge the current system; instead, the politicians spend their time and energy manipulating the way to pay for the current wasteful system.

I consider this whole "Obamacare" debate laughable.

Going off at a tangent....for a moment

One aspect of US healthcare I keep encountering as a diabetic who is active on social media (and usenet before that) is that my US friends pay a huge markup on drugs thanks to some chicanery over patents and importation of generics. US Pharma companies guard their brand name drugs like the gold they are, and fiercely oppose attempts to import generic drugs from outside the country.

The example I always point at is Glucophage. A US branded drug, costs about a dollar a tablet retail. In the UK, the generic Metformin is prescribed instead and the wholesale cost is 2.5p or about three cents at current exchange rates. Same tablet, same active ingredient.

Big Pharma is also banned from advertising prescription drugs to the public. That's another story. They sell into the supply chain and that's it.

Drug companies in the USA are screwing the patient, insurers and also Medicaid/Medicare thanks to high dollar lobbying in Washington and fighting imports from safe third party countries like Israel or the EU. Until this price-gouging is dealt with there can be no effective move towards sorting out US healthcare.

salttee wrote:

...the current system of healthcare management by special interest groups works against the public good. But woe is the politician who would ever challenge the current system; instead, the politicians spend their time and energy manipulating the way to pay for the current wasteful system.

How True!

It would take a Dictator to "fix" the Healthcare "System" in America.

Don't know what to do..

LAXintl wrote:

B777LRF wrote:

Here's another option: Go to Denmark, Finland, Norway or Sweden. Bring a xerox copier, borrow the text, copy, implement, raise taxes to pay for it. Job jobbed.

As a Scandinavian, I would never wish that system upon any body.

Not only is it extremely expensive for society (they are trying to figure out ways how to cut it down), it leads to nothing more than government rationing and making
health care decisions for you. One experience long waits, and the government decides what procedures and pharmaceuticals you can access.
Most well to do Swedes as result now purchase supplemental private health care to ensure they have access to what they might need.

I happily opt for the open market system in US where on chooses and pays for benefits and services you desire.

You couldn't be more wrong. The US System is about twice as expensive (relative to the BNP of respective country) as the Swedish system.
The US health care system costs about 17.5 % of the USA bnp.
The Swedish health care system costs about 9 % of the Swedish BNP.
source.

Various health care rankings:
http://nordic.businessinsider.com/the-1 ... ms-2017-1/
http://edition.cnn.com/2017/03/17/healt ... index.html
https://www.theguardian.com/society/201 ... is-the-nhs

http://www.who.int/whr/2000/media_centr ... elease/en/

The U.S. health system spends a higher portion of its gross domestic product than any other country
but ranks 37 out of 191 countries according to its performance, the report finds.

If you are a rich man/woman then the US health might work well but for the rest of the population it is a really poor system.

The Swedish (and British they are very similar) ensures that every man or women will get a good care regardless of how much
money they have/earn. It also means that if you have heredity for a certain decease the health care will work pro-active with screening
of you/other family members to prevent the decease from developing. (mainly) Tax financed health care does not have fine print.
In a insurance based system like the US, the insurance companies will do everything to prevent you from using/getting an insurance.
If you have a know heredity for a certain decease, then good luck finding an insurance.

A healthy population -> a productive population ->will provide towards the BNP (better productive for companies/employers) ->more tax income -
>investments into better health care/schools/infrastructure -> a productive population -> (and the circle continues).

Thunderboltdrgn wrote:

If you have a know heredity for a certain decease, then good luck finding an insurance.

This is what was so important and critical with the ACA (Obamacare), the insurers cannot exclude anyone. That is why the "mandate" was also so critical, pretty much everyone must pay in for their whole life or it does not work. But since sooner or later everyone needs healthcare it is a proper solution, it was just poorly implemented. Had the Republican's actually participated in crafting the legislation I truly think the program would be much better.

Thunderboltdrgn wrote:

A healthy population -> a productive population ->will provide towards the BNP (better productive for companies/employers) ->more tax income -
>investments into better health care/schools/infrastructure -> a productive population -> (and the circle continues).

This is the part that I don't understand why fellow Republican's don't get, this is why I support healthcare as a universal need. I also support some limits to it and involvement/inclusion of the private sector but over all feel that as you note a healthy population leads to more people working leads to more productivity. It has just become impossible to have the conversation on how best to do it since people have made it an identity that they feel they must live and die by, must protect at the expense of all else with no compromise or effort to meet i somewhere in the middle.

Tugg

Unfortunately, health care is not a profession here in the States. It is the business. For-profit entities, not much different from airlines.

Whats wrong with going back to the way it was before Obama Care? You want health care? Go out, work hard, and get a job the provides health care benefits. I would go one step further and repeal the 1980's law that Reagan passed that requires hospitals to provide care for those who do not have insurance, thats is the cost side that needs to be addressed.

AA747123 wrote:

Whats wrong with going back to the way it was before Obama Care? You want health care? Go out, work hard, and get a job the provides health care benefits. I would go one step further and repeal the 1980's law that Reagan passed that requires hospitals to provide care for those who do not have insurance, thats is the cost side that needs to be addressed.

So if you, a family member or a neighbor was ever between jobs and had a heart attack you'd be content to go bankrupt? That's what it means to work hard for 20 years, have your company go under and then in the 6-12 months until you find work again the stress makes your heart give out...you have no coverage.

Then I need to ask you to consider this scenario..you're a out jogging one evening and get hit by a car that drives off. A passing motorist stops and calls 911. You're taken to emergency care but have no ID and no insurance card on you. In your world the doctors let you bleed out in the lobby because they have no way of verifying insurance.

Any of those two scenarios could happen to you, and they happens to millions of Americans every year. Wouldn't it be much easier to just copy a proven healthcare solution from Germany, Japan, Switzerland, Britain, Canada, France, Spain or Sweden where they pay half our costs and provide care to 99% or their populations..and they live longer, healthier lives? I'm astonished that so many Americans are so insistent on having the shittiest healthcare system in the Tier 1 nation group. What's the attraction?

I was reading that there is a proposal being floated that would give each state a block grant and would require the states to use that block grant to set up their own healthcare system. In this way it is covered at a more local level, which makes the health plans easier to manage. If you look at the European plans, a good majority of the European countries are actually similar in size and population to US States, which is one reason it is easier to make it work over there. In Canada, the health care system is managed at the provincial level. I like the idea of this being run at the state level on a couple of fronts. One is that if a single payer system was run at the federal level, I do not trust the politicians to manage the program well, and I also believe that given the way lobbying works in this country and the amount of political donations at stake, special interests would successfully lobby congress to allow healthcare firms to price gouge taxpayers, and that would cause huge long term issues.

I have actually thought something like this is the way to go. Think about it. With a block grant, progressive states like California and Vermont can actually use the block grant money to set up a single payer system without risk to their own taxpayers as the money would come from Federal, not State Sources. Other states could go the MA route with healthcare, or could set up something like Badger Care in WI. The states that expanded Medicaid or set up state exchanges could keep them. The only issue I see with this might be that some real conservative people on the far right, mainly Ted Cruz, might balk at any new spending and appropriating money for this seeing this as an easy way to balance the budget. But I think this idea has more positives than negatives, and it puts heathcare at the state level, which I still believe is the appropriate place that healthcare should be handled. Mitt Romney said this in defense of Romneycare.

AA747123 wrote:

Whats wrong with going back to the way it was before Obama Care? You want health care? Go out, work hard, and get a job the provides health care benefits. I would go one step further and repeal the 1980's law that Reagan passed that requires hospitals to provide care for those who do not have insurance, thats is the cost side that needs to be addressed.

You do remember that insurance rates were going at double digits prior to the ACA, don't you? So what problem are you actually solving?
Also I take it you support wheeling people outside to die? Or are you willing to a least allow these people to come into your home to die so we can keep our streets clean? Don't forget that you will get to support your family members directly (or I guess maybe at least you will be willing not let them be in your house if they need to recover or if its bad die?) and you will get sick more often and be less productive at work since people will go to work and be in public sick more often and any outbreaks won't be attended to quickly....

And final question, what if you cannot afford the cost of the healthcare at your work?

Tugg

The British system is national while the Swedish system is a regional system (landsting or regions as some have started to call themselves).

https://en.wikipedia.org/wiki/County_councils_of_Sweden

apodino wrote:

I have actually thought something like this is the way to go.

One of the other important things I like about this versus a national system is that you have more ability to test and try new or different things and see what works best in different situations. It reduces the "one size fits all" and monopoly effect of a notional system.

I agree that getting the more extreme members of either party on board will be a major obstacle but maybe it can be done. There will have to be some national standards that will need to match up with any state based solution but it could work very well.

Tugg

Thunderboltdrgn wrote:

The British system is national while the Swedish system is a regional system (landsting or regions as some have started to call themselves).

https://en.wikipedia.org/wiki/County_councils_of_Sweden

Except that the British NHS is broken up into localised Primary Care Trusts, so its a regional system as well - each trust buys its own supplies in, sets its own approaches on certain procedures and treatments etc etc. You might get 5 attempts at IVF in one PCT, and none in another etc etc.

There is no one single body called the NHS which has overreaching control over the entire aspect of the NHS across the entirety of the UK.

AA747123 wrote:

Whats wrong with going back to the way it was before Obama Care? You want health care? Go out, work hard, and get a job the provides health care benefits. I would go one step further and repeal the 1980's law that Reagan passed that requires hospitals to provide care for those who do not have insurance, thats is the cost side that needs to be addressed.

Well, let's see:
1) I have to question your moral constitution if you're content to literally have people dying in the streets. My response to you is: "you go first."

2) What are people to do if they are self-employed? If they lose their jobs during an economic downturn? If they get sick and can't keep their jobs? Moreover, your idea would kill entrepreneurship because entrepreneurs don't technically have "jobs."

3) There are elements of public health, like vaccination, that don't work unless everyone has access to them. I won't go into the details of how vaccination works and herd immunity, but suffice to say that without high levels of coverage, we will have outbreaks, even among some vaccinated individuals.

4) Are you honestly suggesting that children "go out, work hard, and get a job"? That's just messed up, dude.

AA747123 wrote:

Whats wrong with going back to the way it was before Obama Care? You want health care? Go out, work hard, and get a job the provides health care benefits. I would go one step further and repeal the 1980's law that Reagan passed that requires hospitals to provide care for those who do not have insurance, thats is the cost side that needs to be addressed.

1. Many jobs supply no health care benefits.

2. Many jobs that do supply some benefits are inadequate in coverage and/or contain huge deductibles and exclusions.

3. A significant percentage of the population cannot find a job.

4. A significant percentage of those who are employed (but without health insurance) are not paid enough to be able to purchase health insurance without subsidies.

What provision would you make to assist the uninsured and under-insured? Is there any room in your heart for your fellow man?

dtw2hyd wrote:

Even single payer system is not going to fix unless cost side of the issue is addressed. Hospitals are gouging.

May be medical insurance companies should offer off-shore option to patients for major procedures. I suppose EK can offer round trip airfare, procedure and accommodation in Dubai/India for 1/10 of what hospitals charge here.

Some US insurances are already doing this. Some French hospitals are earning good money that way. US patients are billed 30% more than French ones (until recently we didn't even have bills but now we do, so we know how much money was spent, even though we don't pay it directly). Including the plane and hotel bill it still ends up cheaper for the US company.

A few of our most famous hospitals have expanded to provide service for foreigners, not US citizens usually but rather wealthy middle easterners, the idea being to pay for pro bono procedures, for example fixing the hearts of African children.

Tugger wrote:

One of the other important things I like about this versus a national system is that you have more ability to test and try new or different things and see what works best in different situations. It reduces the "one size fits all" and monopoly effect of a notional system.

I agree that getting the more extreme members of either party on board will be a major obstacle but maybe it can be done. There will have to be some national standards that will need to match up with any state based solution but it could work very well.

Tugg

The problem with state level grants is the it will fail to reach one simple standard: equal protection under the law. I live in Tulsa and believe in the idea that God blessed Oklahoma with Mississippi so we wouldn't be last in such areas as health care and education. With the dumb broad we have in the Governor's Mansion we tend to be pretty low on any list that is important and we simply cannot trust our politicians to properly manage health care funded by the Federal Government.

The other issue of national systems is that people can move when they want without concerns for health care. Some move because of a job transfer, others move for a long list of business or personal reasons. There is simply no reason to allow various states to move away from consistent standards of health care.

BobPatterson wrote:

AA747123 wrote:

Whats wrong with going back to the way it was before Obama Care? You want health care? Go out, work hard, and get a job the provides health care benefits. I would go one step further and repeal the 1980's law that Reagan passed that requires hospitals to provide care for those who do not have insurance, thats is the cost side that needs to be addressed.

1. Many jobs supply no health care benefits.

2. Many jobs that do supply some benefits are inadequate in coverage and/or contain huge deductibles and exclusions.

3. A significant percentage of the population cannot find a job.

4. A significant percentage of those who are employed (but without health insurance) are not paid enough to be able to purchase health insurance without subsidies.

What provision would you make to assist the uninsured and under-insured? Is there any room in your heart for your fellow man?

Much better presented than my comment to AA747123, thanks.

I do hope that AA747123 returns explain his reasoning.

Tugg

Back then, the Emergency rooms were getting overrun on a major scale, they were the healthcare provider of default.
ER's all across the US became very busy; wait times became extreme in more than a few places. ER's cost a lot of money to operate. Hospitals were closing them down on an increasing scale, and some communities were facing 45 minute drives to get to the nearest ER. ER's are still under pressure, but before Obamacare it was a real time crisis.