An issue - Health care?

[Guest]

The issue of having the federal government (meaning all taxpayers) become responsible for guaranteeing the availability and delivery of health care services (the quality of which is also 'to be determined') has mushroomed as fast as the costs for health care services. The U.S. Public Health Service, the Veterans Administration, Tri-Care, Medicare and Medicaid are examples of government involvement in health care. Many people question the administration, costs and effectivity of these government-run services, and use them as examples of the government's lack of business acumen in the delivery of consumer services. The National Health Care programs of various countries are often raised as examples (good and bad) of the types and quality of care which can be expected if adopted within the United States.

As one who does not believe that "government" must be mommy and daddy to the general public, but the general public often needs to fix things in spite of the government's "help," I'm curious on the ideas any/all of us have on the issue of government involvement in and delivery of health care services.

We've all "been around the block" several times, so one would think we'd have some ideas. I'm not really interested in what either campaign has speechwriters working to impress, but would be more in the line of - if I had ten minutes with each candidate, this is what I'd say and have them listen, not the other way around. Maybe they might even listen!

As a start - recognizing that "insurance" is simply the pooling of resources by many in order to cover the potential of need by some at any time, and that the Medicare salary deduction is just that (an insurance premium), the Medicare salary deduction can be increased to fund "catastrophic" circumstances (e.g., annual deductible of $ _,000) in the same manner that similar commercial policies operate. The schedule of payments for types of services could be matched to Tri-Care's (the only comparable schedule I can think of. This type of catastrophic coverage would not provide for preventive or 'routine' care costs, but only kick in to cover the extreme.

What are your ideas?

[Guest]

Maybe I missed it and maybe I'm mean spirited but can someone please point out to me where this RIGHT to free medical service is? I cant seem to find it.

It just grinds me that our generation thinks someone else should take care of us. No offense but our parents and grand parents would be rolling in their graves. They would have done anything to not take government welfare, and would at the very least be ashamed of themselves if they did. Benj

[Guest]

I debated on whether to wade into this, but the balanced way the questions were phrased by SteveZ sort of reeled me in.
Let me start by saying in no way do I think I have the answers, but I do have some observations, which are only my opinion based on my experiences.
First I do believe that our present healthcare delivery system is irrevocably broken. It is not sustainable from a financial or "personell" standpoint. While we do have government/taxpayer sponsored programs, some of them are so pitiful that a large majority of physicians are now not participating, and this does include Medicare(watch the news on this issue, it's coming). It is not about getting rich for the physicians in these cases, it is about survival. In many instances it either costs money to see these patients, or at best is break even. No business can be expected to survive that. Bear in mind, I am speaking primarily of Primary Care Physicians here.
The problem is so bad now that it is becoming extremely hard to find medical students willing to even go into these fields. Couple a rapidly aging population with a massive expected shortfall in primary care physicians and realize we have already mixed all of the ingredients for a disaster.
Is a "government run" single payer system the answer? I certainly am not confident in their ability to run something this important based on past history. What other entity could do it?
Do we have a responsibility to provide healthcare for everyone? On some levels I think yes. Healthcare as a commodity is a little different than a lot of things. There truly is a bit of an ethical question involved. Should people with more money and resources get more or better healthcare? I do recognize that the sense of entitlement in today's society is beyond absurd though, and that there are multiple abuses within the present system.
My personal humble opinion is that we likely do need, and at some point will have some type of single payer system. Astoundingly enough, physicians that fought it for years are now on board due to the pending collapse of what we have now. My great fear is that it will happen to late and with little planning....reactive rather than proactive action.
Alot of providers involved in the present system know that without a major paradigm shift any action is likely doomed to failure.
As massive an undertaking as it will be, the government is the default "head" of the system I think. Grand steps need to be taken to remove bureaucratic costs, multiple levels of midmanagement, antiquated forms, and ridiculously cumbersome standards. Steps to take special interests out of the picture and disincentivize dishonesty and profiteering from the system would need to be intelligently implemented. I think taking the insurance companies, HMO's, PPO's etc, with their large profits out the equation will give us some wiggle room financially.
As important as ANY of these is the involvement of people Representative of the general population and representative of real world physicians that have to work within the system. A big part of the horrible mess we have now is bureaucrats with little or no real world knowledge setting up a system with inane and arcane rules. Congress passes and approves these pitiful rules while they have the best health care in the country. Parity?
Realize also that like it or not we DO have a single provider system...any patient can go to an E.R. any time for any condition and they will be seen and treated regardless of ability or intent to pay. I would estimate that fully 70-80 % of these visits are non-emergent.
More money is not really so much the solution as better utilization of the resources we have. Can we achieve such a major change in how things have been done for so long? I don't know but it will likely require some sacrifice and adjustment from everyone. It will not be what we are used to, nor will it be painless. The fact is we have to do something..we are in serious trouble at this point.

[Guest]

You know I dont want people to suffer or not get the medical care they need, But you havent shown me the RIGHT to healthcare.
I'm not sure how serious trouble we are in. Anyone can go to most any hospital and get treated money or not. We have disability benefits, We have Medicare. We cant take care of everyones needs if they have not planned and saved enough to cover their bills.
You think we have an obligation to provide health care for everyone. Do we have an obligation to provide adequate housing, or adequate Satellite TV?

Is personal responsibility a thing of the past? This line of thought looks like to me you have given up on our capitalist society and want everyone to be equal. The answer to your question " should people with more resources and more money get more or better healthcare" is , if they can afford it YES they should. Or would you take away the incentives that capitalism provides the entrepreneurs and hard workers who have built this country? If so where does it stop? Benj

[Guest]

I hesitated in replying, I probably should have listened to myself. Please at least be accurate when you refer to my comments.
I stated that on some levels I felt we have a responsibility to provide healthcare, I did not make the sweeping generalization you refer to.

"Anyone can go to most any hospital and get treated money or not." Is this not providing healthcare, is it not done out of a sense of responsibility on some level?

"We cant take care of everyones needs if they have not planned and saved enough to cover their bills." Even the hardest working, kindest, giving people often are the ones saddled with medical bills that financially devastate them. This is not always because they didn't "plan" well. It may be that their job doesn't afford them benefits, or that taking care of a sick parent or child has pushed them over the edge.

"Do we have an obligation to provide adequate housing, or adequate Satellite TV?" Come on benj, do u really equate satellite TV with healthcare in terms of importance?

"This line of thought looks like to me you have given up on our capitalist society and want everyone to be equal." This is really a ridiculous an unfair extrapolation of what I said. I don't need to defend my self but I will tell you that I am greatly in favor of a capitalist society. That does not have to be mutually exclusive of open minded thoughts on this subject, nor of simple compassion.

"The answer to your question " should people with more resources and more money get more or better healthcare" is , if they can afford it YES they should." I respectfully disagree with that to some extent, and I genuinely pray that you are never in the position to see how it feels to be on the "poor" end of that equation. It is heartbreaking to see.

"Or would you take away the incentives that capitalism provides the entrepreneurs and hard workers who have built this country? If so where does it stop?" Again, throwing the socialist type accusations are not only innaccurate, they serve no purpose. I am just not sure that the capitalist end of medicine is on a par with other capitalist enterprises in every facet. I am one of those hard workers, entrepreneurs if you will. I am also open to at least considering that since our system is not working we should be willing to openly entertain and discuss alternatives.

Out of all I said you chose these things to focus on. There was a lot of meat left on that bone, but this is open discussion and we all have our preferences.

You are not sure we are in trouble? I respectfully encourage you to do some research into some of the things I refer to above if you are so inclined. I have spent thousands of hours not only researching this, but living within it every day.

Anyway, thanks for the input. As you may be able to tell, the situation of our healthcare system in general is of great interest to me, and I honestly believe that an exchange of ideas like this is at least a beginning of finding some solution.

But who knows...I could be wrong. ;)

[Guest]

Serenityseeker'

My thoughts on this matter are as open minded as yours.

Ok you said on some level you felt a responsibility to provide healthcare. On what level?Going to the ER and being cared for with or without money, Isn't that providing healthcare on some level?
I don't equate TV, or housing, or healthcare as being guaranteed for being an American citizen. Just the opportunity to succeed is all I want. My question is the same WHERE DOES IT STOP?
To what extent do you disagree that people with more money may be able to buy better healthcare? They buy better cars too. Do you expect them to not spend their own money the way they see fit. Come on, You think thats not fair?
Could we discuss any remedies that don't cost the taxpayers or the govt more money?
I agree we are in trouble but it's because nowdays people expect others to be responsible for their needs.
We have many safety nets in America for people down on their luck. WHERE DOES IT STOP???
My wife recently died of cancer. With tier 4 and 5 drugs that were not covered and a stem cell transplant and all the other things that we not covered by the two policies we had , you don't have to tell me about the costs of healthcare, but I don't expect to see anyone else paying the bills for me. There is no guarantee in life.. Benj

[Guest]

u missed the whole point.

[Guest]

Serenityseeker'

Ok whats the point???

It sounds like a Obama campaign slogan:::EVERYTHING FOR EVERYBODY. Benj

[Guest]

Benj, you're absolute right! The entitlement mentality is way too prevalent in our society and is not only dividing us ideologically, but is essentially bankrupting our country. No society can ever afford to pay for all of the care of all of its citizens (and some non-citizens) other than the safety net (for those that can't meet their basic needs for good reasons)- even with the entitlements we have today, not even considering the outlandish extention of entitlements that Obama (and his supporters) has in mind. Its not just healthcare. The best economic system ever devised in the history of mankind (free-market capitalism) is in serious jeopardy of failing in our country and the free-world because of the rapid encroachment of Socialism (meaning entitlements for all). Not only will the citizens of the U.S.A suffer if the U.S.A declines economically and/or politically, but so will the whole world. Most of the improvements in the human condition and contributions to the improvement in human standards of living historically have originated via the incentives offered by free-market capitalism. The encroachment of Socialism will greatly retard such future advancements. Tyrants will have control and humanity will suffer for years to come. The history of the world for many centuries is littered with the sad example of tyrannical ruled societies. Only since the rise of democracy and free-market capitalism has the human condition improved to any significant degree. An Obama Presidency will lead us farther and faster into a Socialist society to the detriment of all of us in the US and the free world. Unfortunately, there will be no way back, because the tyrants and totalitarians will have complete control and the people will only be subjects - not of Islamic Fascists, but of Socialist totalitarians (formerly known as Communists). Yes, when the liberal establishment is touting the elimination of the right to free speech of the conservative (i.e. free-market capitalist) talk shows, it is a strong move toward radical totalitarianism. Unfortunately, the liberal left is Socialistic and is leading the country, and basically the whole world, down the path to declining standards of living for all. Its not an attractive vision for our children and grandchildren, but it is clearly the direction in which we are rapidly being led. That is why I am opposed to Obama and the liberal Congress.

Sorry, I know this is a downer reply, but that is the mood I was put in by reading the posts. Liberals always do that to me.

[Guest]

SHNEAL..you are so absolutely correct...your post is PERFECTLY said and so correct.

Now, we face the election of the most radical, most far left President in history with a Democratic controlled congress. No wonder the Communist Party of America so strongly endorsed him !

[Guest]

Glen Beck had a comment today about Obana being the # 1 liberal in the US Senate, Biden is # 3, and the # 4 guy is an admitted socialist. That means Obama and Biden are both to the left of a socialist. Benj

[Guest]

I will tell you...I began with Sen Obama as a real fine alternative as I was not happy with the performance in the WH (or the last congress) and thought he could be a nice fresh breath of fresh air and a great change.

That lasted until I researched him....then watched the antics during the primary...if someone would in any way dispute his training to me...well, different story but nobody has nor can they and that past leads me to believe he is "conning" everyone right now and the largest "give away" in history will begin in Jan 09.

[Guest]

OK benj, I'll give it one last shot. I thought the point of the thread was to express ideas or thoughts about the healthcare system. To somehow steer this to slamming liberals and talking about fascists, totalitarians and any number of other inflammatory remarks really robs any chance of intelligent exchange about healthcare. Heck, I'm not even considered a liberal by people I know on both sides of that fence.
The fact is we spend TONS of money in the most innefficient delivery of healthcare of almost any advanced country....with the exception interestingly enough of the V.A. system which excels in many areas both fiscal and regarding patient care. If we are wasting all of this money on all of this free care you seem to think we bandy about, why not restructure what we have/do into a more efficient system? How exploring that notion and its' alternatives ends up bringing some conservative or liberal diatribe that really addresses nothing about the problem is beyond me. You guys have commandeered the thread and I happily leave it too you.
If anyone else wants to talk about some of the specific problems in health care I would love to hear from you.

take care all

[Guest]

Those of you who are reading this and saying "I'm not going there" are pretty smart. I've never been accused of that, so here goes...

I feel bad for you benj because in this country, your wife should have had better care when she needed care. I don't mean going on the dole or shamelessly living off of others, I just mean we could be a lot smarter and in touch with people's needs than we are now. We spend billions on the most inane things.

When you live in a really good community that provides quality services and facilities for it's citizens, we don't scream that we've all "gone to hell in a socialist handbasket". We appreciate what hard work, vision and cooperation can do, and we say that's the way it should be in America. (TV's as a pretty good example).

It's not about THOSE people with an ENTITLEMENT mentality. We ALL have increasing expectations from what our great country has already provided. If our ancestors roll in their graves, it's not because of the lazy poor folks, it's from shock at all the fine things the spoiled folks have.

It's not about the RIGHT to healthcare. The RIGHT to healthcare is the same as the RIGHT to carry AK-47s. Argue forever about RIGHTS. And for those of you made crazy by that filthiest word of all: 'LIBERAL', you get too easily distracted as well.

We can do better. If we can accomplish the overall standard of living we have now, we can do even greater things. For the poor we can provide the kind of start our immigrant ancestors got all the way from Ellis Island to the towns and cities that took them in.

What's wrong with more and better healthcare? If we do improve it and, unlike benj's wife, people get access to and live better with the best medicines, does that mean we will become inexorably mired in the depths of some radically liberal socialistic society headed for destruction? Not a chance.

So don't think John McCain will be the answer just because he's the opponent of some crazy liberal who is determined to tap into the pocketbooks of billionaires then throw that money away on people who aren't worth a damn. The last guy who said he was conservative has left us a legacy worse than any socialist handbasket and will almost certainly be regarded as the worst leader we've ever had.

[Guest]

Serenityseeker,

Please dont put words in my mouth. I never mentioned Fascists or totalitarians You did.

If your point is to spend the "TONS" of money efficiently , I AGREE.
If your point is take the same amount of money (no more) and restructure how it's spent, I AGREE WHOLEHEARTEDLY.
I didnt say we were wasting money on healthcare , Just that there is a limit. Benj

[Guest]

ljusluvit,

Thank you for a very thoughtful post.
Man do I agree that we could be alot smarter and in touch with peoples needs than we are now.
I think our relatives are rolling in their graves not because of lazy poor people but because us spoiled folks expect more and more on someone else's money, our relatives called that welfare and had to much pride for that.
I love that you say we can do better, again I agree we are Americans. And I would love to have more and better healthcare.
Your point about the billions we spend on the stupidest things is so true. Like my earlier post said, I wish we would back he tankers up to Iraq and suck oil till the bill for the war was paid in full. I also would support a moratorium for ALL foreign aid for a couple of years they don't like us? I'll bet that would change their mind. Also it would give us many billions of dollars to pay down the debt and maybe have enough leftover to fund other programs including healthcare.
But no matter what there is a limit, so where does it stop?? Benj

[Guest]

Hey, do any of you know anybody who wants or needs to retire but is hanging onto a job for health insurance coverage because once they retire, all they will have is COBRA, and they don't call it COBRA for nuthin'?

Do any of you know anybody who owns a small business or a practice of some sort, you know, The American Dream, but who finds that once they decide to sell it and retire, they will have no access to a plan where they can BUY decent coverage at a reasonable cost?

Do any of you know anybody who has worked for a government entity within a state or local where retiree health plans used to cover spouses at a reasonable cost? But now ready to live the dream, said potential retiree finds that the job must continue because the cost of spousal coverage has become prohibitive. So the only real choice is to just keep on working and slouching toward Medicare?

Does anybody know anybody with a pre-existing condition that makes it darned near impossible to find any decent private plan that will cover them when they retire if their employer, like so many, drops retiree coverage? No matter what the retiree thought was supposed to happen.

Does anybody know anybody who retired, good health, found a plan, got sick, and found rates raised to crush them?

Does anybody know anybody who one day found that their health insurance company, through their employer, was going public? An IPO. Offering the covered cash or stock. Those who took the stock were pretty happy. The CEO was happier. Rolling around in more and more millions while claims were too often turned down and premiums skyrocketed. All those stockholders owning a piece of every body insured by the company. (And yes I meant to put that space between every and body.) Stockholders must be kept happy you know.

Probably everybody knows somebody who is trying to sell a house so they can move to their retirement dream but find that it's not happening, (Yet another lift of Congress' hindleg on the American people. I digress.) But I think more of you than realize it know somebody who cannot move to their retirement dream because even though they could come right in, slap down cash for a house, and still have a few bucks left, because they did it all right, they find that they cannot access a decent affordable healthcare plan for early retirees.

Does anybody know anybody who is the spouse of a retiree from a big company who is now covered but who lies awake nights wondering what will happen to that coverage if something happens to the spouse? COBRA. Yep, it's a COBRA all right. Better than nothing. Really expensive. And it runs out.

Does anybody know anybody who remembers having to pay for prescriptions up front, saving the receipts in a shoebox, and then mailing them in for reimbursement? And did that person find that once the drug card and co-pay concept hit, it was just soooo much easier?

And does anybody know anybody at all who figured out long ago that drug cards were just like that old Trojan Horse? Roll that baby right in here. Hey, this is great. Let's celebrate. We do not have to worry about those pesky mail ins anymore. And inside that drug card, there hid the enemy. Big Pharma could raise prices and raise prices without anybody even noticing. Too busy celebrating the convenience of the drug card. (And yeah, I get pipelines.)

Does anybody know anybody with a young doctor in the family? In practice for only a couple of years. Already wondering why.

There is so much to this issue that I could type all night. Even though I swore I would chew my fingers to bloody stumps before trying to even get into this again.

I tend to focus on what happens to people in our age group. The people who thought they had it all planned. All figured out. Who did it right. According to the American Dream.

And you might also be surprised to know that for now, we have it covered. But I also know that this is not just about me. It is about a huge economic picture.

But before I am dismissed or worse, accused of being some commie pinko old broad, let me tell you that I am not talking about socialized medicine. And I have never voted for a Democrat candidate in my whole long voting life. (yet) And that I hate taxes. But what I hate worse is the ignoring of this huge problem that will go on to hamstring our economy if not addressed.

And before I leave, I really do have an offering of what seems to be a relatively easy to figure out solution for the early retirees at least. An early Medicare BUY IN. Did you see that? I said BUY IN. At the beginning of this thread SteveZ brings up pools and catastrophic coverage. Big, big pools and catastophic coverage is what those who did it the old Amercan Way really need. Not to be shut out at the point of no return.

And that old "No Socialized Medicine!" is nothing more than a battle cry guaranteed to whip up a knee-jerk block vote while offering no solutions. Off the hook. And on to power. (I know I said that somewhere else on the board, but I wanted to say it here, too.)

I have a favorite quote that I have used on this board before when I ranted about the bad lending practices that are hurting so many. I do not know who said this, but I wish I had. "Unrestrained greed is not only bad morals, it's bad economics."

Boomer

Whew! Well, I don't know if anybody read it, but I do know I feel much better.

[Guest]

Boomer love your posts.
Sadly I have been at least two of your scenarios. Buy in's and pools are good ideas, many more are needed. But maybe you will answer me. Is there a point where we cant afford to spend more?? Is there a percentage or dollar amount?? Is there a burden to high??where does it stop??
I hope to live to 95 and die in bed...with my lover, but sadly that may not happen. At what point do I stop being responsible for myself and become the responsibility of others??
I dont begrudge anyone healthcare or the best life has to offer, but when do other people become my caretakers?? Please I dont mean this an any way to be against anyone else or their best interests or mean spirited but God or the US govt doesn't guarantee us free healthcare. Benj

[Guest]

Hi Benj,

I just wrote a really nice answer back to your last response. It took me a little while. I tend to cover ground I guess.

But when I hit "send" a quite hateful red note appeared and said that I was not allowed to post on this board without registering.

And I said, "Helloooooo, my name is Boomer. And I never shut up. So I think I am registered."

So then I logged in again. And it let me. But then a hateful red note said, "Naa-naa-naa-naa-naa, your post box is empty."

So I guess they are not trying to throw me out. Well, I don't think so anyway. But I have no idea where my well thought out post to you went. And although I did not keep my promise to myself to chew my fingers to bloody stumps before posting anything political again, I really have to keep the promise I made to myself to never type again after midnight. I just am not a stay up late kind of girl.

And besides, now I am afraid the system is going a little haywire. And I could type it all and lose it once again.

Although, John McCain's picture keeps doing the Google crawl across the bottom of my screen. Maybe he is trying to get in here to say, "Boomer, Boomer, please come back."

Oh see what I mean. I should never type after midnight. I just sound crazy. (crazier)

So anyway.

Goodnight.

And it really was a nice answer.

Boomer

[Guest]

In most developed countries and many developing countries health care is provided to everyone regardless of their ability to pay. The National Health Service, established in 1948 by Clement Atlee's Labour government in the United Kingdom, were the world's first universal health care system provided by government and paid for from general taxation. Alternatively, compulsory government funded health insurance with nominal fees can be provided, as in Italy. Other examples are Medicare in Australia, established in the 1970s by the Labor government, and by the same name Medicare was established in Canada between 1966 and 1984. Universal health care contrasts to the systems like health care in the United States or South Africa, though South Africa is one of the many countries attempting health care reform. The United States is the only wealthy, industrialized nation that does not provide universal health care.

Maybe it would help to study or listen to another developed country?

[Guest]

Great insight into other countries actions.
What we have working against any progress...even studying others hat are at least DOING something....is our non representative representatives.
All they have to do is provide for all the coverage THEY already have....then trash all the rest.
But that ain't gonna happen. They may...the next administration...MAY...get something started....MAY!!!
And if they do it will take years of study...some more years of partisan bickering...then there will be a new election....the next administration....ditto....ditto....ditto.
It just is not going to happen. I don't care who wins the election.
Wanna bet?

BTK

[Guest]

...from Boomer,"And before I leave, I really do have an offering of what seems to be a relatively easy to figure out solution for the early retirees at least. An early Medicare BUY IN. Did you see that? I said BUY IN. "

:agree: :agree: :agree:

I am not looking for something for nothing. I pay my expensive HMO premiums monthly. I also have pre-existing conditions that keep me tied in to my NY health insurance for the next three years. An early Medicare BUY-IN would free me up for TV.

Thanks Boomer,

Shirleevee

[Guest]

This has bee interesting.

Just to add one more thing into the mix, an old boos of mine used to have a sign behind his desk which read, "There is no such thing as a fully funded problem."

All programs come with a price tag, and the question is always, does every taxpayer subsidize it, or is it funded only by the users of the program?