Proposal to help control health care costs:
 

This is bipartisan, so let's not make it political.

The idea is to let the states take the lead in controlling health costs. To curb the growth of health care, states would set their own spending targets. Then states would pocket their share of federal Medicare and Medicaid savings, which could be up to 1 billion or more.

This plan would be called "Accountable Care States", as described in a recent article, and would be voluntary.

How will the states control costs?

What would you do to control costs if you were in charge?

I would try to reduce demand by promoting self reliance through education.
Of course the powerful food industry would be against it so there's little chance of that happening.

The answer to lowering health care is certainly not in going to a state by state list of covered services. You did not link to the article you reference, so I cannot see if you have actually explained what the original writer suggested. The most efficient health care insurance in the US is Medicare, which is Federally run with a single list of covered services uniform for the entire country. Why would someone, knowing that, suggest we go in the exact opposite direction and incentivize states to cut costs and pocket the dollars? I can just see the race to the bottom that would bring.

I really do not understand the new heath care packages. The poor people were already getting free health care (medicaid) and the only ones this has hurt is people trying to stay covered.

Education and healthy lifestyle has never stopped one person from ultimately dying. The majority of healthcare spending for any person is during the last 2 years of their life when they are at the end of the disease process that will eventually end their life. Mortality is still 100% and treatment of the dying is expensive even if it's only palliative. The expense will not be impacted just by switching the burden to the state level. Medicare has been the most efficient health care delivery system in the world. Quick payment for service providers and nearly immediate approval for services for Patients. The problem is private insurance. Take a look at the profit of the 10 largest private insurance providers. WellPoint had a profit of 38%. Anthem was higher! If Medicare received all the premiums that the top 10 insurance providers enjoyed, the system would be the most stable in the world. No one should make profit from administrating insurance coverage. The only profit should be at the provider level. Go to a single payor system with Medicare and wipe out the insurance companies profits and the cost of healthcare would be instantly manageable.

So fun to have thousands dying waiting for treatment. One visit to the VA, IRS, the motor vehicle office/tag… court house, any civic government function… heck, they all require the entire day(s) to just work your way through the system.

If given any choice between private enterprise and govt, I will always choose private enterprise for faster, friendlier, more comprehensive service.

I'm always concerned about the ulterior motives of those pushing for an inferior single-payer system.

Make that "I'm always concerned about the ulterior motives of those pushing for an inferior single-payer system MONOPOLY."

As bad as you might think insurance companies are, they are regulated by the state insurance departments/commissioners and are cited, prosecuted, fined, and sometimes ordered to Cease & Desist if they or their agents commit fraud, do not pass tests of financial solvency and ability to pay all claims, or if they do not pay claims on time or in the amount stated in the policies/contracts.

Also, the consumer or employer can fire them and go with another company and package. With a government single-payer monopoly, do you really think you're going to be able to get them to cite, prosecute, fine or order themselves to cease and desist? And if you could fire them or get them prosecuted and fined, who would you go to for insurance when it's a single-payer monopoly?

Its interesting that the majority of people on Medicare like Medicare.

It would be interesting to hear from some Canadians who are on a single payer system similar to Medicare w/o the requirement to be 65 years old. The Canadians I have talked to would not think of becoming residents in the US because of the their access to that healthcare. It appears that some companies are even moving to Canada so taxes can't be too abhorrent to support such a system.

Our taxes are high, but it's well worth it.
I am extremely happy with the Canadian health care system.


Canuck Bare

It would be interesting to hear from the elderly about how anxious they would be about firing their insurance company and going with another company at age 80, 90, or 100 plus. Any centenarians care to comment?

The VA healthcare delivery system is not comparable to the Medicare system. The VA is a socialized system where every person delivering the care is employed by the government. That is why they are under such scrutiny for long waiting lists for care in some regions. A Single payer system with Medicare in the United States could never be compared to a single payer system in another country. In the United States, the vendors such as Physicians, Hospitals, Clinics, Home Health, DME will always be privatized which gives incentive for more vendors to enter the market. The more eligible Patients, the more vendors eager to provide the care. Regarding regulation of private insurance companies, it's minimal. They are taken to task once in a while over high profile cases ,but, for the most part they have found ways to skirt around the regulations. Some are so reluctant or slow to pay claims that entire hospital systems have stopped accepting their insurance. Medicare always pays. I've been in healthcare delivery for 40 years and I have never witnessed one person FIRE Medicare.

"In the United States, the vendors such as Physicians, Hospitals, Clinics, Home Health, DME will always be privatized which gives incentive for more vendors to enter the market. The more eligible Patients, the more vendors eager to provide the care."

Really?

The Mayo Clinic stopped accepting Medicare at its five-physician practice in Glendale, Ariz., two years ago. Officials said at the time they would analyze financial results of the move early this year.

No results yet. Mayo spokesman James McVeigh said in an e-mail: “Our plan is to continue to study the program, collect data and review the impact on our patients.”

Mayo officials, who were unavailable at deadline, need more time to analyze how the Arizona clinic's decision to drop Medicare affected its finances, patient satisfaction and the overall number of patients, he said.

Mayo officials faulted Medicare for the move when they first announced plans to stop accepting the insurance.

“Mayo Clinic in Arizona loses a substantial amount of money every year due to the reimbursement schedule under Medicare, a loss we cannot continue to sustain,” the health system said on its news blog. “The discrepancy between what Medicare pays and our cost of providing services is particularly acute for our primary-care practices.”

Mayo also told the Bloomberg news service the clinic's finances would be examined under the pilot “to see if it could have implications beyond Arizona.”

Mayo Clinic operates in Arizona, Iowa, Florida, Minnesota and Wisconsin."
http://www.modernhealthcare.com/arti...GS01/301209984

SO. Medicare payments less than the costs of providing the care is going to "incentivize more vendors to enter the market"??

Why? So they can go bankrupt and be unable to pay themselves and their employees who need jobs?

I would be interested in a more detailed response on the Health Care system in Canada.

Interesting. Any updates in the last 2-1/2 years since your cited article about this one clinic?

Really?!?
 

LoriAnn, you wrote: WellPoint had a profit of 38%.

I question the veracity of your informational source. In 2008, WellPoint had an after-tax profit of 4.1% of revenues. That same year the healthcare insurance industry as a whole ranked 35th (out of the 53 identified industries) with a profit of 2.2% of revenue. They were surpassed by both the healthcare facilities industry (34th) and the pharmaceutical industry (ranked 30th) with a meager 3.0% of revenue profit, hardly an enviable number. The before -tax profit of WellPoint in 2013 was 5.4% of revenue, down from 6.2% in 2012. Those numbers seem quite modest to me.

You are proposing a single-payer system. Allow me to offer the following example as one of dozens that could have been chosen: the Department of Energy was formed in 1977, in a large part to reduce our dependence on foreign oil. At that time we imported around 40% of our oil needs. 35 years later, in 2012 we still imported about 35% of those needs and yet, that year, for the first time ever, we produced as much oil as we used. Our oil industry has been able to create those kinds of resources in spite of the government’s contrarian attempts to slow production down.

So I must ask you: do you really want your healthcare needs to be handled by such incompetence? And we must never forget that the efforts driving us to a “single-payer system” are being orchestrated and propagandized by that same inefficient and ineffective bureaucracy.

Remember a few years ago when a politician thought that Exxon’s $40 billion profits were obscene and should be turned over to the government for redistribution? What was never mentioned was that Exxon had paid over 110 billion dollars in taxes that same year or nearly 3 times as much as they made in profit, but that important fact was ignored. That was politics and it was dirty because it misled those who were unaware.

This is not a political statement. Instead it is a statement of facts. It is a statement based on real numbers and it is intended to show that propaganda pieces only sell to those who are unaware.

As Ayn Rand said, “we can ignore reality, but we cannot ignore the consequences of ignoring reality”.