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TennesseeTuxedo

The Best Healthcare In The World

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Rolltide   
1 minute ago, Justafan said:

So, if I'm understanding you right, this would be a single payer system but managed by state governments instead of the federal government?

Yes. State and local entities manage a lot of federal programs. The federal government does not cook meals for kids the local board of education provides the kitchens, the staff and the food and the management. The federal government then reimburses them for kids who qualify for the school meal program. 

 

Welfare and nutrition programs like SNAP and WIC are managed at the state level. 

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Justafan   
Just now, Rolltide said:

Something that all people need to understand especially conservatives. 30% of the premium cost for your insurance at work is being paid by you! Your employer on average is paying 70%. I'm not talking about deductibles or co pay I'm talking about the premiums for the insurance only!

 

That cost is $.9T a year. 

...and that cost is driving down business innovation, hurting expansion, probably depressing wages, and all kinds of other unknown negative effects.

 

So, in your system of state bids, would a single insurance company win a bid from the state?  Then consumers would be covered based on residency or something to that effect?

 

It's an interesting idea.  I've heard similar plans like this before but everyone tends to gloss over nuanced ideas to either claim socialism or complete free market and never dive into the weeds of what actual solutions might look like. 

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Rolltide   
Just now, Justafan said:

...and that cost is driving down business innovation, hurting expansion, probably depressing wages, and all kinds of other unknown negative effects.

 

So, in your system of state bids, would a single insurance company win a bid from the state?  Then consumers would be covered based on residency or something to that effect?

 

It's an interesting idea.  I've heard similar plans like this before but everyone tends to gloss over nuanced ideas to either claim socialism or complete free market and never dive into the weeds of what actual solutions might look like. 

 

Not sure of the specifics but no there would be several insurance carriers who could win a bid for coverage. Hard to imagine one company would cover an entire state of 5 million people. 

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Justafan   
2 minutes ago, Rolltide said:

Yes. State and local entities manage a lot of federal programs. The federal government does not cook meals for kids the local board of education provides the kitchens, the staff and the food and the management. The federal government then reimburses them for kids who qualify for the school meal program. 

 

Welfare and nutrition programs like SNAP and WIC are managed at the state level. 

Yea, I got it.  Just wanted to make sure I was understanding you correctly.  

 

I like it.  It's not a perfect solution but I think it would be hella better than what we have now.  
 

I'm interested to know what @El Guapo thinks the impact on his end of a system like that would be.  I think it would solve the problem of availability and affordability but I'm curious if it would hurt the medical side and drive down quality or if there are measures that could be instituted along with a system like this that would make it work.

 

There's a ton of smart people in Washington.  It saddens me that we haven't heard more about stuff like this in the media and in political platforms. 

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Justafan   
Just now, Rolltide said:

 

Not sure of the specifics but no there would be several insurance carriers who could win a bid for coverage. Hard to imagine one company would cover an entire state of 5 million people. 

Ah, like a regional thing.  Makes sense.  

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Rolltide   

 

 

Other features of a success program for universal coverage.

 

1. In the system I'm proposing people would be very much encouraged to buy supplemental insurance to cover what the universal coverage does not. Just like Medicare supplement policies now. They could offer significant tax incentives for that coverage. 

 

2. Secondly you have to have an incentive for people to live healthier lives. You voluntarily subject yourself to a basic physical and blood panel every year and if you fulfill certain parameters you get some money back on your payroll taxes you paid that year for coverage. 

 

3. We cannot have 15.8% of our population paying nothing and getting 100% coverage. That is how many people are on Medicaid right now. They pay no premiums, no co pays and no deductibles and get total coverage. We need to pare that number down closer to 10%. 

 

4. Increased incentives for drug and health product companies to offer assistance programs for their products while using the dual power of state and federal government to pressure companies to keep drug costs down. 

 

 

 

 

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5 hours ago, OILERMAN said:

There needs to be a government/public option. The problem is the profit aspect from the insurance companies 

 

People would pile into the public option and the private insurance companies would be forced to lower premiums

 

 

They could make a Medicare buy in be the public option pretty easily. 

 

Honestly though, a public option isn’t enough because you would still have people choosing to go uninsured. I’d just do Medicare for all with an option for anyone under 65 to buy private insurance instead and not be forced to use Medicare. That way, every citizen has to be covered. 

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12 hours ago, titanruss said:

The USA absolutely has the best institutions for research and cutting edge tech and care... but they are unattainable for 90%+ of the country. .. and that doesnt matter what party you support. 

That's not really true though.

My best friend has Marfan's Syndrome, and he's had a stent installed in his descending Aorta, and then later his entire primary vascular system was been replaced piecemeal. (his whole Aorta, from the root to the femoral arteries). 

He's had a bypass, two heart valves replaced, and later a plug put in where one of them leaked. 

 

The get to the surgical hospital when this all started (he suffered an Aortic dissection at work) required a Life-Flight to OHSU at a cost of about $95k.

 

Along the way he had to have all of his teeth removed to prevent any chance of periodontal bacteria in his bloodstream affecting the bonding of the artificial parts, and dentures made. 

He has a total of about 5 linear feel of surgical scars on his upper body and a large one on his thigh.

All this work took place over a period of roughly 2 years.

 

When this all started he was welding in a fab shop that paid him about $19.00/hr + ins.  Now he makes about $23.00/hr +ins.

And all said and done he has a balance owing of less than $10k, and makes monthly payments.

 

He's far from rich, and he had access to some of the best care there is and is alive today because of it.

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5 hours ago, TitanDuckFan said:

That's not really true though.

My best friend has Marfan's Syndrome, and he's had a stent installed in his descending Aorta, and then later his entire primary vascular system was been replaced piecemeal. (his whole Aorta, from the root to the femoral arteries). 

He's had a bypass, two heart valves replaced, and later a plug put in where one of them leaked. 

 

The get to the surgical hospital when this all started (he suffered an Aortic dissection at work) required a Life-Flight to OHSU at a cost of about $95k.

 

Along the way he had to have all of his teeth removed to prevent any chance of periodontal bacteria in his bloodstream affecting the bonding of the artificial parts, and dentures made. 

He has a total of about 5 linear feel of surgical scars on his upper body and a large one on his thigh.

All this work took place over a period of roughly 2 years.

 

When this all started he was welding in a fab shop that paid him about $19.00/hr + ins.  Now he makes about $23.00/hr +ins.

And all said and done he has a balance owing of less than $10k, and makes monthly payments.

 

He's far from rich, and he had access to some of the best care there is and is alive today because of it.

Hugely depends on the state, the hospital, and your employers healthcare...and No offense to your friend and Mick Jagger but discussing individual situation as a representative of a whole is a grossly misleading narrative and a giant logical fallacy. The quality of care for advanced procedures is no doubt one of the best in the world.. the cost is also the highest. 

 

Also so depends on your definition of great. You say great because your friend benefitted. I say we are falling behind because of a myriad of reasons.. most all have to do with average out of pocket payments for treatment compared to the rest of the industrialized world (not even close) and the success of those treatments comparatively. Infant mortality, chance of infection, over treatment (over prescribing pain Meds and antibiotics) mental health, after birth care for mothers, .. the list goes on. 

 

Further, According to the the premise of the OP .. anyone leaving their country for healthcare is going to a better institution. It’s pretty arguable that more people are leaving the US to get their healthcare needs fulfilled than coming in ( just like “Mexican invaders”) .. and that is almost entirely cost based. 

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15 minutes ago, titanruss said:

Hugely depends on the state, the hospital, and your employers healthcare...and No offense to your friend and Mick Jagger but discussing individual situation as a representative of a whole is a grossly misleading narrative and a giant logical fallacy. The quality of care for advanced procedures is no doubt one of the best in the world.. the cost is also the highest. 

 

Also so depends on your definition of great. You say great because your friend benefitted. I say we are falling behind because of a myriad of reasons.. most all have to do with average out of pocket payments for treatment compared to the rest of the industrialized world (not even close) and the success of those treatments comparatively. Infant mortality, chance of infection, over treatment (over prescribing pain Meds and antibiotics) mental health, after birth care for mothers, .. the list goes on. 

 

Further, According to the the premise of the OP .. anyone leaving their country for healthcare is going to a better institution. It’s pretty arguable that more people are leaving the US to get their healthcare needs fulfilled than coming in ( just like “Mexican invaders”) .. and that is almost entirely cost based. 

All I'm saying is with a reasonably priced insurance policy one can have exceptional health care despite catastrophic problems, and not end up owing more than a down payment on a starter house.

He inherited his Marfan's from his mother who died when he was about 12 years old.  The ability to do for him what was done was developed by for-profit doctor working in for profit hospitals in the 30 years or so since she passed.  They had no answer for the problems that plagued her 30 or so years ago.

By standards of the last century he's a walking medical miracle with another 20-30 years ahead of him.  It was not long ago that his condition was an early death sentence.

 

So I have to ask, who would give that up, so that they can get their kids sniffles treated for free?

Look, I agree that most health care costs are way out of line.  But I also believe that insurance companies could be doing things better and cheaper than they are, to the extent that for-profit health care would return to being reasonable. cost wise.

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5 hours ago, TitanDuckFan said:

That's not really true though.

My best friend has Marfan's Syndrome, and he's had a stent installed in his descending Aorta, and then later his entire primary vascular system was been replaced piecemeal. (his whole Aorta, from the root to the femoral arteries). 

He's had a bypass, two heart valves replaced, and later a plug put in where one of them leaked. 

 

The get to the surgical hospital when this all started (he suffered an Aortic dissection at work) required a Life-Flight to OHSU at a cost of about $95k.

 

Along the way he had to have all of his teeth removed to prevent any chance of periodontal bacteria in his bloodstream affecting the bonding of the artificial parts, and dentures made. 

He has a total of about 5 linear feel of surgical scars on his upper body and a large one on his thigh.

All this work took place over a period of roughly 2 years.

 

When this all started he was welding in a fab shop that paid him about $19.00/hr + ins.  Now he makes about $23.00/hr +ins.

And all said and done he has a balance owing of less than $10k, and makes monthly payments.

 

He's far from rich, and he had access to some of the best care there is and is alive today because of it.

A great deal of that was part of the ACA, which ended annual and lifetime caps that insurance companies used to impose. 

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29 minutes ago, TitanDuckFan said:

All I'm saying is with a reasonably priced insurance policy one can have exceptional health care despite catastrophic problems, and not end up owing more than a down payment on a starter house.

He inherited his Marfan's from his mother who died when he was about 12 years old.  The ability to do for him what was done was developed by for-profit doctor working in for profit hospitals in the 30 years or so since she passed.  They had no answer for the problems that plagued her 30 or so years ago.

By standards of the last century he's a walking medical miracle with another 20-30 years ahead of him.  It was not long ago that his condition was an early death sentence.

 

So I have to ask, who would give that up, so that they can get their kids sniffles treated for free?

Look, I agree that most health care costs are way out of line.  But I also believe that insurance companies could be doing things better and cheaper than they are, to the extent that for-profit health care would return to being reasonable. cost wise.

I dont think you'd have to give that up. No one wants to create a new system where top of the top end care is eliminated.. and it never will be eliminated in a capitalist country. Every country still has state and private hospitals and you can still buy insurance for private hospitals if you wish... but there isnt a huge difference when it comes to most commonly needed reasons for going.

 

Reasonably priced insurance here is also exponentially higher than other countries where the rates and quality of care are not that dissimilar to our own. 

 

What needs to be done is cut out the middle man. No one is saying our hospitals are shit.. they are saying our system of healthcare is shit. Cut out the middle man and theres just that much more money for both the patient and hospital. .. which would lead to better care, less money-based regulations, and patients who arent in medical debt their entire lives. 

 

For every one case of your friend... theres many more people paying off amounts that they are incapable of. .. increasing stress... lowering quality of life.. and causing more issues. This is extremely important for young adults who dont have the ability to pay their own insurance and a debt early in life is compounded heavily later in life. a $30,000 debt at 25 turns into a net loss of $250,000 at 60. 

 

 

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8 minutes ago, titanruss said:

I dont think you'd have to give that up. No one wants to create a new system where top of the top end care is eliminated.. and it never will be eliminated in a capitalist country. Every country still has state and private hospitals and you can still buy insurance for private hospitals if you wish... but there isnt a huge difference when it comes to most commonly needed reasons for going.

 

Reasonably priced insurance here is also exponentially higher than other countries where the rates and quality of care are not that dissimilar to our own. 

 

What needs to be done is cut out the middle man. No one is saying our hospitals are shit.. they are saying our system of healthcare is shit. Cut out the middle man and theres just that much more money for both the patient and hospital. .. which would lead to better care, less money-based regulations, and patients who arent in medical debt their entire lives. 

 

For every one case of your friend... theres many more people paying off amounts that they are incapable of. .. increasing stress... lowering quality of life.. and causing more issues. This is extremely important for young adults who dont have the ability to pay their own insurance and a debt early in life is compounded heavily later in life. a $30,000 debt at 25 turns into a net loss of $250,000 at 60.

You will NEVER get me to argue in favor of the way insurance companies conduct business.  I hate them.  But the reason things are as screwed up as they are is their conduct.

If I had my way no insurance company could sell healthcare insurance and malpractice insurance.  One or the other, but not both.  They use malpractice insurance rates to leverage hospitals and doctors.  That shit needs to stop.

The other thing I would do is stop the practice of letting InsCos choose what they will pay.  Let the Doctor or hospital charge their standard rate and tell the insurance they must pay it per their contractual obligation.  No more robbing Peter to pay Paul.

I'll wager healthcare costs would come down by 30% or more overnight if that were implemented.

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El Guapo   

The problem is that people want the best possible healthcare without the costs. It cannot happen. Holding down costs by reducing services and controlling everything is single payer...There is no magic or perfect system. 

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Justafan   
On 4/3/2019 at 11:24 AM, Starkiller said:

They could make a Medicare buy in be the public option pretty easily. 

 

Honestly though, a public option isn’t enough because you would still have people choosing to go uninsured. I’d just do Medicare for all with an option for anyone under 65 to buy private insurance instead and not be forced to use Medicare. That way, every citizen has to be covered. 

A public buy-in option would end up with very poor services because everyone would be forced to move into it because the insurance companies would cater to those who wanted only top notch care.  Then you would have very expensive care for the rich people could afford it, really bad care for everyone else, and the doctors would still be getting screwed.

 

I'm not writing the idea off because I'm making assumptions here and it's certainly better than the system we have now.  I believe we can do better than that though. 

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