Quote:
Originally Posted by Villages Kahuna
No disagreement here, Cabo. As much as anything, I was putting some information out there for many of the people who post here whose analysis of the current situation regarding healthcare is hasn't gone beyond what we have is OK with them and whatever we do, any form of government involvement is a bad thing.
If I had my 'druthers, the Congress would take a good long time considering all the reforms that should be included in their legislation. And definitely, whatever bill they pass should not add to the deficit and national debt. My greatest fear is that the various members of the 435, responding to their own interests and special interests will cobble together a bill which creates a system as confusing, ineffective, inefficient and expensive as the one based on a myriad of private insurance companies that we have now.
Some of the things that I wouldn't resist if they were included in the proposed reform legislation would include... - Significant tort reform
- Some sort of single payment system the could be designed and regulated by the government. I don't mean a system where the government makes the payments. Rather, I mean the establishment of a system or procedure with the objective of simplifying and standardizing the claim payment process, thereby reducing the overhead costs of healthcare insurance.
- The creation of some sort of "healthcare claims appeals" court or central adjudication process. Americans shouldn't be subjected to the whim and/or profit motivation of an army of privately-employed claims adjusters making the decision of what gets paid for and what doesn't. Whatever system we have should be consistent for everyone.
- Means testing for Medicare and VA benefits
- Healthcare insurance for all American citizens, whether they can afford to pay for it or not. That means that if someone can't produce citizenship or insurance documentation at a hospital emergency room they don't get treatment. More specifically, after the first illegal immigrants die on the stairs to hospitals, there will be be lot more of of those who entered the country illegally heading home. Note that I said "or insurance documentation". I mean that if employers want to hire illegal immigrants because they work hard and cheap, if they want to keep them here they should provide them with healthcare insurance. Of course, another alternative would be to secure our borders--but that's another whole different debate.
- A tax on the richest Americans to help pay for the program(s)
- Some serious regulation on what medical research gets paid for by the government or by individuals thru their insurance premiums. We shouldn't be paying for rocket science when a fast train will do. If medical research beyond that is desired, it should be funded privately. (If you want a pattern of what I mean, consider stem cell research. Stem cell research can be deemed to have significant potential--it's just that the government won't pay for it. If the potential of the research is so great, let private money pay for it.)
- Negotiation, probably by the government, of more reasonable prices for prescription drugs. Why should Americans be required to pay substantially more for the same drug that companies sell elsewhere in the world for far less? We all know the stories of our neighbors going to Canada or Mexico or Europe to buy drugs made here in the U.S. for deep discounts. Why? Along with that, some serious reductions of the period for which drug companies can prevent the introduction of generic drugs with their patents and copyrights.
- A hard look at whatever legislation further reduces payments to doctors. Medicare payments authorized by Congress have already been reduced to the point that about 40% of the doctors in the U.S. refuse to treat Medicare patients--and that number is growing! Maybe even take a long look at paying doctors who practice in the areas of greatest need more than those in areas where the doctor-patient ratio is already too high.
- Government regulation of the coverages, benefits and co-pays on company-provided health insurance. Just because a group of employees are represented by a particularly powerful union or work for a generous employer, shouldn't mean that they get "Cadillac" healthcare coverage at little or no cost while other U.S. citizens have no insurance or coverage that is less than "basic". The healthcare insurance playing field should be leveled--or at least the "tilt" reduced somewhat. If employers want to provide better than standard coverage for competitive purposes or because it is the result of a union contract, those benefits over and above a standard package should result in a tax on the employer.
- If after all the other stuff I like has been done, if the government wants to offer Medicare coverage to citizens instead of private insurance that may be available to them, that would be OK with me. There is a caveat however. The premiums of Medicare to those of less than "senior" age would have to be increased to cover the actual cost of healthcare treatment for those that choose the that option. Premiums for seniors should remain low, as they have paid into the funding for both Social Security and Medicare thru payroll taxes during their working years.
- Finally, whatever national healthcare insurance or standards that are created should apply to all members of the Congress and all government employees. The Congress and government employees should not be permitted a different, better or cheaper plan than that available to the citizens they represent or work for.
That's certainly not a complete list of stuff that I wouldn't mind seeing in reform legislation, just a few that I though of on a warm Sunday morning here in The Villages. |
The list is impressive, but in general indicates
the government is the only solution. So far, there has been nothing concrete, proven workable, presented in HR 3200 - just a bunch of theoretical concepts with none having any record of trial or success.
I agree that immigration, border security and all that involves is worth a debate, as the predominate group filling this "uninsured" population are illegal aliens (yeah, "undocumented" is a lousy descriptive), followed closely by foreign long-term visitors who get rolled into most statistics. Fix this problem and the largest argument for changes to the health care system goes away, as this population impacts costs to a disparate degree.
When the economy is booming, competition for employees (recruiting and retention) solves the health care insurance issue. When domestic employers find themselves behind the business 8-ball due to government-directed business advantages given to foreign providers/suppliers of almost everything, to increase the domestic employers' cost-of-doing business will have only two results: 1) the employer goes under; or 2) wages are decreased to equalize the cost of government-directed employee compensation. There is no free lunch here.
It's always easy to tax the richest, but it's always only a starting point. This is one place where "trickle down" really happens.
The only "significant tort reform" that may reduce "defensive medicine" is blanket immunity from damages. There is no partial or cap that works, as already found where in place. Is that what folk really want?
So, for the most part, the problem is not the health care industry - it's everything which impacts the health care industry and every other industry in this country. Until the externals which impact the industry (and all others) are fixed, we are just applying an unproven and untested and highly expensive action (not even a solution) just for the sake of "change."
Don't get me wrong. I have no problem fixing anything that is broken. What I do have a problem with is saying we'll buy an expensive "fix" when we have no proof that these "fixes" have worked anywhere or will work on any scale or magnitude. It's like saying I don't like my car, so give me a new way to get around (Beam me up, Scotty) that has never been tried and charge me 100 times what the car costs to get it.