National Health

[exray]

I thought the other thread was becoming a bit unwieldy.

So what do you folks think about National Health schemes? I have my own thoughts based on what we have here in Puerto Rico. We have a very functional system. Not without problems, of course, but its based on a national INSURANCE rather than a 'guaranteed national everybody's a** is covered' care scheme.

The Plan here is the same for a welfare guy as a senator in the Legislature. The insurance companies bid, I think its every five years, to be the provider for the gubmint. Three different regions here in this small place because they recognize the ethnic/social variations.

But its "insurance", not care. The care providers can take it or leave it. Since about 35% of the population is on the national 'group plan', and thats really all it is - big group plan - , you rarely see any doctors refusing the plan except in very specific instances. Regular Joe can go anywhere and get his doctoring done. He can pay cash, use the gubmint plan, have his own private insurance...they don't really care. There is no stigma about using one or the other and no overwhelming one facility or the other. If theres any stigma it might be walking in wanting to pay cash.

Tex always brings up illegals and I know thats a hot topic up there, especially in TX. Here in PR we have about 10% illegal population too. Haitians and Dominicans. MY United States still has the Statue of Liberty on the other side of the river and until I reject that notion then they are all welcome to come here on rafts or truck trailers or whatever. If I was in one of those Central American shitholes I'd bust balls to come to the US (Oh, I forget...I did that already) The difference between Ellis Island Days and modern days is that they only had to show enough cash for 30 days survival whereas now the application fees can easily cost in excess of a year's pay in the home country so they just sneak in undocumented. That ain't what MY Statue of Liberty was saying.

Reeling back in...the illegals are not our health care problem. The cabal of insurers and providers is what keeps this from becoming viable in the US. Puerto Rico is the most corrupt piece of money-disappearing dirt under the American flag but by golly we have at least pulled off a national insurance scheme by not sending all our tax collections to Washington.

-ex

[Uffda]

Bill, I think it may be workable for a small district like PR, but I am hesitant to support it for the whole US. Of course, I would have to understand the particulars before I could say for sure. When the gov't gets control it soon can't resist changing may to must in the contract language. Then care providers cannot take it or leave it. Price controls go along with it and soon the bureaucrats are dictating what services the docs must or must not provide and whom they must provide it to. Maybe if they made it like my work health insurance - have a number of Authorized National Plans. At the USPS we have something like 8-10 plans to choose from.

It seems that every time I hear that the regular Joe can opt out, it only means he can opt out of using and not out of paying. Fix that and maybe I could buy into the idea. I agree something has to be done and this idea does seem to have potential merit.

[Don Lind]

If it were any good, it would not need to be a law.

[exray]

Uffda Wrote:Maybe if they made it like my work health insurance - have a number of Authorized National Plans. At the USPS we have something like 8-10 plans to choose from.

It seems that every time I hear that the regular Joe can opt out, it only means he can opt out of using and not out of paying. Fix that and maybe I could buy into the idea. I agree something has to be done and this idea does seem to have potential merit.

Thats interesting about the USPS scheme of multiple plans.

Yeah, opting out. I'm doing my taxes at the moment so although I don't use the government plan I don't get any breaks. My wife uses it though so I guess it comes out in the wash. Cost to her is zero, no premiums involved. My private policy only costs around $140/mo and I think that is an end result of having the companies bidding to get the govt contract.

Other than paying the premiums the govt isn't much of an actor. I cannot claim any cases of government interference or coercion although I suspect that happens behind the scenes. I lost my coverage a while back when they changed providers in this area. That was quite a hoopla and something like 200,000 were affected because the 'new' company had restrictions that the previous one did not. That was a case where the govt SHOULD have stepped in and is also an example of how hands-off they are.

[FStephenMasek]

1) Make health insurance mandatory, like car insurance

2) Have a high risk pool, like car insurance, so that those with cancer, birth defects, Etc. can obtain coverage

3) Allow all insurers to sell in all states

4) Require that everyone have a Health Savings Account so that they have money for routine expenditures and deductibles

5) Require that insurers pay the bill, not argue over the amount. This is now their favorite way to avoid providing coverage. You may have a $7,000 medical bill, but they argue that they will only pay $3,000 minus your deductible, leaving you stuck with paying $4,000 plus your deductible.

6) require that there only be a simple deductible, not all kinds of mixtures with co-pays an so forth

7) Eliminate all "benefits," only paying employees for their labor, thus giving employees freedom to obtain the coverage they want from the carrier they want. The same for worker's compensations, unemployments, and so forth.

[Texasrocker]

You bet exray,The state of Texas has a enormous- overwhelming amt of illegal mexicans from Mexico & several other Central American Countries that have been taking-advantage of the entire States hospitals for many,many,many yrs here. Entering into Texas via Mexico, illegals from Hugo Chavez's dictatorship Venezuala has a "expressway" into Texas via crossing the massive length of the Rio Grande river!No prob at all, unless the Border Patrol catches them !!Any Texas Hosp ER you visit in any City, will be 70% illegal US citizens waiting on free healthcare. The illegals have no insurance, no money in their pockets,and live in very small 2-room fully deteriorated very old crackerbox houses in the barrios, and can't seem to speak "englishe", "only",if & when it is to their advantage, and the younger familia members ( unemployed) sell illegal mexican drugs for their entire familys sole-financial support. Even tho old mex grandma & grandpa live with all their kids, grandkids, & great-grandkids under one roof, its easy enough for them to get free healthcare already. No need at all for Washington to intervene further! The Docs are overwhelmed already, & have been for yrs! Yet, if you drive thru the barrios areas in all Texas Cities, most illegals have a nice late model car,( driving un-insured also in most cases) with fancy low-rider wire wheels & tires, and a stereo-system in the vehicles you can hear "La Bamba" playing a mile away.Most likely a new 60" screen TV also. Illegal US citizens have always "expected" free healthcare, and always will, because they have never paid taxes, except ( sales only taxes) on their preferred purchases.
This scenario also really urks all my "legal" US Hispanic friends & their familias also! The legal US (fully insured & responsible) Hispanics taxpaying citizens, that entered the US legally, also despise seeing this happening in the US, and having to "take a number & wait" ticket to see a Doc in the ER. Unless legal US Citizens arrive by ambulance, air med-ambulance, etc bleeding profusely, the Illegals have all the Docs "attention" delivering more "illegals-babies" 24/7 to keep this viscious-cycle going. If the US Govt would quit making it so easy for illegals to get free healthcare, instead of giving it to them "free", ( fed law already existing for any one already living in the US)perhaps we wouldnt have so many more illegals crossing our borders. The US Docs are already overwhelmed, and adding a few thousand more patients to take advantage of Obamas nationalized proposed ER healthcare plan, will most certainly make many US Docs "quit" & walk away, period! It will no longer be worthwhile for them to even care anymore. There simply isnt enough US Docs & Nurses to accomodate such a foolish idea! Nationalized healthcare didnt work in Europe, & it wont work in the US either! We simply dont have enough Universities graduating Docs & Nurses fast enough to keep up with the masses already. It not as simple as Obama & his followers think at all! As I stated on here before, if Obamas nationalized-healthcare plan goes into law, everyone posting here ( insured or not) better bring a tent, snacks, & drinking water with you, for the ER line wrapping around the Hospitals! Texas IS a big State indeed! It is approximately the same distance from Texarkana to Chicago, as it is from Texarkana to El Paso for those that dont know, and Texas' border with Mexico along the Rio Grande is about the same in distance. Easy enough for "wetbacks" illegal entry already!!Once they all hear America has free healthcare, might as well send all "illegals" airplane tickets to get here faster! They will be coming in droves!!

[exray]

From that post it would seem we already have a 'free' health care system in place!

I don't want to drift towards immigration policy but suffice it to say that when the US makes it impossible to do it the legal way then there will be illegals. And with that status they HAVE TO stay under the radar. I think it would be preferable to get these people INTO the system...paying their share. That could go a long way to reduce the problems with not paying taxes, no insurance, no driver's license, etc, etc.

But thats not the reason the US doesn't have a universal type health care/insurance system.

[Uffda]

I listened to an MD on the radio today about the Natasha Richardson accident. If his facts are correct, I'm even more afraid of gov't involvment.

He said she spent 2.5 hours in the ambulance for what in the US would have been a 15 min. helo ride. Quebec has zero medivac helos. In the US
she would have routinely had a cat scan immediately after losing consciousness following a head impact. The scan would have indicated a simple
drilling to drain the blood that would have fixed the problem.Scans in Canada are anything but routine. There are more neuro-surgeons in L.A.
county alone than in all of Canada. Huge disincentives to set up practice there.

I say no thanks to the central committee and its medical commissars.

[exray]

Interesting.
As much as I brag about our system there is something wrong when it comes to the scan and MRI payment arrangement. Neither govt or private insurance will pay more than 50%, sometimes only 25%. I've never heard an explanation for that. There is no shortage of facilities that do the scans.

OTOH, I had to do a set of CAT+MRI about 3-4 years ago when I was walking around uninsured. The combo only cost me $900 out of pocket which was quite expensive to me but apparently was a real bargain compared to what I hear is the going cost in the States. I hear people say that you're better off paying the cash than filing on insurance because your 50% may cost you considerably less.

So whats up with that? Is it to discourage docs from sending patients for scans too routinely? Its amazing technology. You would think they would encourage it?

-Bill

[Arran]

FStephenMasek Wrote:1) Make health insurance mandatory, like car insurance

2) Have a high risk pool, like car insurance, so that those with cancer, birth defects, Etc. can obtain coverage

3) Allow all insurers to sell in all states

4) Require that everyone have a Health Savings Account so that they have money for routine expenditures and deductibles

5) Require that insurers pay the bill, not argue over the amount. This is now their favorite way to avoid providing coverage. You may have a $7,000 medical bill, but they argue that they will only pay $3,000 minus your deductible, leaving you stuck with paying $4,000 plus your deductible.

6) require that there only be a simple deductible, not all kinds of mixtures with co-pays an so forth

7) Eliminate all "benefits," only paying employees for their labor, thus giving employees freedom to obtain the coverage they want from the carrier they want. The same for worker's compensations, unemployments, and so forth.

How are they going to make health insurance mandatory? What about people who prefer to pay the bill themselves? Cars requires licenses to drive that can be revoked, what do you do to pick up on who does not have health insurance? Go around door to door? How about penalties for being uninsured? Jail? Then they get free health care that way? Car insurance is not mandatory everywhere either, some states do not require it, others require a bond in lieu of insurance. It also happens to be a violation of the right to freedom of association, governments are violating enough rights as it is.
Here's a simple, but workable idea, have everyone be the policy holder, and payer, of their own health insurance. No more of this nonsense where someone loses their insurance when they lose their job, make it like home insurance, paid by the year or by the month. Similar to what you said.
As you mentioned, allow all companies with all plans to sell in all states, good idea. The main thing that ties in with so much of this is government interference in the health and insurance industries, telling them who to cover, where they can operate, making them cover elective procedures, limiting competition, or allowing price collusion. etc.
But never, never allow the government to nationalize the health care industry. You only need to look at the public schools, the DMV, the bailout plan, and the post office to get an idea of how it would be run.
Of course tightening up the tort laws would help with the costs as well, bring an end to the "Jackpot Justice" involving malpractice. But this could extent to all forms of civil litigation as well, not just health care. One good thing we have in Canada is that it is difficult and expensive to sue,(perhaps too difficult) lawyers can't work on commission, and cannot advertise on TV. The only exception to this is lawsuits involving motor vehicle accidents in the Province of British Columbia, and that involves the government owned insurance company.
Best Regards
Arran

[Texasrocker]

Having personal health insurance should be the responsibility of each individual citizen,not a Govt sponsored "free-for-all" at taxpayers expense as a whole. The states that dont require mandatory auto-insurance to hold their automobile operators liable for "personal responsibility of financial liability" is another loop-hole in the system. If you can accidentally lose-control of your vehicle while going round a corner on a wet street, and your car crashes into someones living-room while their watching TV and kills somebody, whos "fault" is that? Should the US Govt pick-up the "bar tab" on that mistake also?
In Texas, it has been mandatory to be able to prove "liability insurance coverage" when operating any type motor vehicle for many yrs. Most illegal citizens dont care, dont have insurance of any kind, for their cars, or ANY health coverage either. Never will! The Texas illegal-citizens "do have", "fancy wheels" on their lowriders, and most probably a .44 cal pistolera under the front seat while delivering illegal drugs to their customers. Thats the reason as a law abiding (legal) born US Citizen, I reserve my "right" under the US Constitution to be a licensed- responsible gun owner myself to protect me & my family in the future if Obama Admin doesnt try to take my gun away in the future. As the old saying goes, when the US outlaws guns, only "outlaws" will still have "illegal" guns to shoot with. Thats "not" a option on my clock, period.
As for having personal health insurance (individual-responsibility)coverage, everyone should "arm" themselves also out of their own back-pockets, & not expect a "Obama- taxpayer-national health-plan-for-all-dreamers".... that cant ever be a "reality to work,period"! My Wife also experienced a bad-episode of neuro-surgeons, many MRIs & C-Scans last yr. Luckily , she was cleared of what Docs were looking at closely as possible brain cancer, that scared us frantically as a family. At that time, I had my family covered by 80/20 Blue Cross/Blue Shield. All the specialists- Docs & their Staffs got PAID!! Thats essentual for them being there when we need them in the future, to "stay" in business after also servicing all the Illegals for free-already also!
Our familys final medical-tests- bills ( MRIs-C Scans-Doc visits) equalled approx $ 4800.00 during that scary episode! BCBS covered 80%. I personally paid $ 960. out of my back pocket, with "pride" , that didnt cost the US taxpayers a penny! Thats the way American specialized Docs can stay in business! On Obamas free healthcare plan, these specialized US Docs will simply walk-away from the US Hospitals with hundreds of "illegals" wrapped around the ERs doors, and play golf instead!! At least they will have a "chance" to win on the golf game! As Ive stated here before, "free US healthcare" will not work period! If my family was living in London UK last yr, we would still be standing in line to get her CT reports this yr, ( hopefully)!!
Nationalized Healthcare ideas are nothing more than "socialists ideas at work " at best. Good luck seeing your "free" Docs when you really need them! I regress.

[Music in a bottle]

I've seen a few programs showcasing individuals from this country, traveling to Taiwan, and India for major Surgeries such as cancer treatments, for a fraction of what it costs here, and the level of expertise and technical equipment in most cases rival those of this country. These foreign hospitals are grateful for the American currency, and in exchange, it appears to be a source of decent care for cheap. My lifelong friend for instance, went to Mexico to have all his teeth removed, and get dentures. He said the equipment was every bit as good as here in the US and it cost my friend less than $400! As a builder of airplane hangers for mostly surgeons who own their own private jets, perhaps part of the problem is just plain and simply, paying these experts too much! If other doctors in other places are willing to do it for less, and can deliver the same level of technical know how, why not? I'd be willing to travel. I've seen some slightly third world doctors in this country, who I wouldn't let work on a dead animal, let alone my family! I could really tell you some stories about these Idaho doctors.

[Music in a bottle]

exray Wrote:I thought the other thread was becoming a bit unwieldy.

Sorry exray. Thought the health issue was something that was typically surfacing in Master Obamas informercials. I sort of got of track. My bad.

[FStephenMasek]

Arran Wrote:[ How are they going to make health insurance mandatory? What about people who prefer to pay the bill themselves? Cars requires licenses to drive that can be revoked, what do you do to pick up on who does not have health insurance? Go around door to door? How about penalties for being uninsured? Jail? Then they get free health care that way? Car insurance is not mandatory everywhere either, some states do not require it, others require a bond in lieu of insurance. It also happens to be a violation of the right to freedom of association, governments are violating enough rights as it is.
Here's a simple, but workable idea, have everyone be the policy holder, and payer, of their own health insurance. No more of this nonsense where someone loses their insurance when they lose their job, make it like home insurance, paid by the year or by the month. Similar to what you said.

Arran we agree far more than not. If it is not mandatory, then we need to have laws which make it clear that health care providers are free to deny services to those without insurance, or without sufficient means to pay. Even then, many, such as hsopitals run by religious organizations, might feel compleed to provide free services, even to those who could pay. Do you see the problem?

I think we make it mandatory simply by requiring that everyone with a state-issued id or driver's license provide proof of health insurance.

[Music in a bottle]

I cannot help but feel that when you have administrative mentality running companies intended to skim healthy profits above and beyond actually helping people get well, by their very existence, they contribute to the problem of affordability and reasonable cost. How about a non profit insurance company run by people who either operate on a volunteer basis or receive "sensible pay" like the rest of us bottom feeders, to run the day to day operations and people connections associated with providing medical and insurance. Certainly, this would help reduce cost by side stepping corporate greed or exorbitant profits. I think this would be at least as effective as eliminating crack pot lawsuits in terms of cutting excessive expense. I also think that doctors should be treated like vehicle drivers. Bad drivers, loose their license and are illiminated from the equation and hence, sloppy doctors, loose their license and no longer practice medicine. They could fill their working days by busting up foundations or slaughtering animals and open their position to someone who is competent and willing to do their best to actually help people. Combine that with giving patients from this country the choice to travel to those countries having every bit as able and eager doctors as we have here in America, but who are willing to do the same quality job, for less money, be it outsourcing! Huge corporations do it to us, let's turn it around. Surely, this line of thinking to some degree, could only help to cut cost, and set up fair competition. After all, just about every other industry has been doing it, at our expense, let's trim the fat from these corporate insurance and hospital administrative top feeders! Sure it's not a perfect plan, but within the limited scope of this forum, it makes for some pretty humorous folly and couldn't be any worse than what we already have in place, at least for the uninsured!