Quote:
Originally Posted by BBQMan
IMHO, we have driven the cost of healthcare too high in the United States by:
1. Making it ‘free’ or nearly so, especially for those on Medicare (that includes me).
2. Needlessly increasing the price of drugs by lawsuits for known side effects.
3. Not having a loser pays to discourage frivolous lawsuits.
4. Failure to have interstate competition for health insurers.
5. Requiring Insurance companies to provide ‘all inclusive’ plans rather than plans meeting the individual customer requirements.
6. Failure to have ‘high risk’ pools in all states that can provide coverage to those with previously existing conditions.
Item 1: Anytime anything is free or inexpensive, more of it is used. This applies to medical care as well as everything else. Today, if you are on Medicare and have a supplement going to the doctor, the ER, the hospital, etc. is essentially free. As a result, people seek care (eg. a visit to the Dr. for a cold and wanting to get antibiotics). Having reasonable copay could discourage this. Some ideas, $25 for a primary care Dr. visit; $50 for a visit to a specialist; $50 for a visit to an urgent care facility; $100 for an ambulance; $100 for an ER visit and $200 for a hospital stay.
This would be applied to households with an income of $35,000 per year or more thereby charging two-thirds of the population and leaving the lower income households untouched. Similar ideas could be applied to insurance plans for those under sixty-five.
Item 2: Drug lawsuits. Any drug that is capable of healing will also have side effects. When you get a drug, you are warned of the possible side effects. Drugs go through extensive testing to determine both the benefits and possible damages from them and are released to the market only when it is determined that the benefits outweigh the risks. If you take a drug and it helps you, so much the better. If you take a drug and encounter one of the identified side effects, then this is risk that you knowingly took and the Pharmaceutical companies should not be liable for your loss anymore than GM should be responsible for your injuries if you get in an accident. You accepted that risk by driving.
Item 3: Frivolous Lawsuits: Today, lawsuits can be brought for virtually any mishap, perceived or real. This is why you see the many ads for law firms saying call us, no cost to you if we lose. Far too often, it is less expensive for the insurance company being sued to provide an out of court settlement than it is to go to court. One example – I was involved in a low-speed accident a few years ago – the speed was so low speed that there was less than $500 in damages. Everyone went away and three weeks later the driver decided he had ‘whiplash’. Final settlement, $18,000 plus legal expenses. I can provide numerous other examples including one by an attorney you see on television virtually every day, but I believe all of you are familiar with the problem.
Item 4: Failure to have interstate competition for insurance plans. Today, insurance providers need to be approved by state regulators who determine which companies can compete and what they may charge. This is a too cozy relationship and invites higher premiums. By opening up to interstate competition, prices will come down.
Item 5: Requiring plans that cover virtually everything – many of those coverages added by special interest groups. Let people choose the coverages they want and are willing to pay for. Some may want Chiropractors, Acupuncture, contraception, fertility treatments, Viagra, zero copays, etc. covered. Others may not. Let those who want these things covered, pay for their plan. Let those who do not, pay for their less expensive plan.
Item 6: Failure to have ‘high risk’ pools in all states. Everyone should be able to purchase health insurance. By creating high-risk pools, everyone will be able to purchase health insurance. Some low-income people may need to be subsidized, but everyone needs to have some skin in the game.
These are just my ideas, anyone wish to comment?
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I do take exception to #1. I, too, am on Medicare for which they take almost $100 per month out of SS for the premium. In addition, I have Part D $45.00 per month + co-pays, and a supplement for $175.00 per month. That is over $300 a month just for me, so please define what I am getting for "free". Eye refractions and glasses and dental are not covered at all. If you have to go somewhere that does not accept Medicare such as Mayo, you are responsible for whatever you do not recover from Medicare and your supplement on your own. I know, because I had to have surgery in 2007 at Mayo...they file the Medicare, but they do not accept assignment. (BTW, my neighbor has some medications for which the co-pay is over $100 a month and ends up in the "donut" hole within 6-8 months.)
This $300+ does not include my husband's care. Just
his anticipated medical expense this year is expected to be some $5,000 out-of-pocket. This is in addition to the drug co-pays through his insurance plan, the drug co-pays at the VA, and the doctor co-pay at the VA based on our income. Free or nearly free? BTW, we do not make unnecessary trips to doctors, hospitals, etc. We do not go to the ER with anything less than life-threatening illness/injury, either. For anything less, but urgent, we go to the urgent care center.
#2 & #3) I do have to agree with you about frivilous lawsuits. Someone here made the remark that we must be "sittin' pretty after our lawsuit" when my husband had his stroke 10 years ago following surgery. (He had surgery so that he wouldn't have a stroke and it caused a stroke.) I just looked at her at said, "I didn't sue anybody. It wasn't anyone's fault...it just happened. We knew the risk going in."
I still say if everyone is forced to "buy" insurance under the proposed plan, who's going to see to it that the insurance companies are transparent (no fine print) and follow through on their part? Seems to me the only winners here will BE the insurance companies.