So, how will healthcare impact the economy and why should it be included in the stimulus package? If we are going to attract and retain businesses, we need to have a healthy workforce and access to health insurance that doesn’t break the bank, either for the individual or the employer.
The problem with throwing out some ideas and solutions is that this one issue is probably the most complex and intertwined with other aspects of the economy.
There are those who believe that illegals, medicaide and frivolous lawsuits are placing such a burden on the system that it is driving up costs for all of us. And they have a point but when dealing with these issues we must also consider the illegal immigration problem in general, welfare and entitlements and legal reforms.
Finding ways to encourage illegals to stay home, work for welfare programs and some sort of tort reform may go a long way to easing these burdens. So, what else could we do?
Of course we have people who don’t want more government involvement and given the federal government’s dismal track record, I can understand their reluctance. But, in being realistic, I do not see how we can bring about any meaningful changes without SOME government oversight and intervention.
There are people who really understand the working of healthcare and advocate some sort of personal account system which, on the surface, sounds like it could be a workable plan in that is promotes consumer responsibility by rewarding them for saving money.
Another interesting plan was commented on by TAO at another blog which is the Swiss model. All Swiss citizens must purchase a government sponsored minimum health insurance plan. It can be deducted from your paycheck like any other deduction. If you want more coverage and can afford it, you are free to purchase it. The one thing this system allows for is the right of a medical facility to refuse treatment to anyone without insurance. While this does relieve the burden currently borne by facilities compelled to treat the noninsured, it also means we would be at greater risk of illegals in this country developing and spreading communicable diseases so how to solve the burgeoning population can’t be ignored.
The cost of medications is another thorny issue that must be addressed as more of the poor and elderly have to decide between the electric bill and their pills. Why do we pay so much more for medications than even our closest neighbors in Canada? I’ve heard many explanations but the one that seems most plausible is this; while drug company medications enjoy a protected patent period in the US, no such agreements exist in other countries. If they want to sell their wares abroad, they must negotiate the pricing or the other countries simply threaten to produce a generic. The drug companies claim that the higher prices they can get here and not in other countries go toward funding research. Seems like we can find a way to help fund some research, let the drug companies pony up a little and stop this protection racket that has broken our backs. I don’t mind paying for medication and even a little more to go toward research but we have carried the whole load for far too long.
So, what would YOU like to see happen in healthcare reform?
Rocky, this is my comment on my post regarding health care. I don't take credit for the ideas, but I think they all have advantages.
ReplyDelete"Will all your suggestions and ideas, this is what I came up with....
1. We need to get the illegals out of the country and keep new ones out. This will eventually help our health care of it's own accord.
2. We need to have stricter laws and regulations regarding malpractice. If someone is truly hurt, then they need and deserve it, but we need to weed out those that are just using the system. They only hurt those that really have been hurt.
3. Establishing a review board that is separate from both doctors and insurance. No special treatment for either side.
4. Changing so that we are only responsible for immediate treatment and the patient becomes responsible for seeking extended treatment.
5. Follow the Swiss.....
The Swiss have enacted healthcare reform that would please most Americans. It does not nationalize anything but provides a basic package of health insurance that everyone must buy. It gives flexibility and options, if you can afford more coverage then you can buy more insurance. If you cannot afford insurance then the government offsets your premiums.
6. Ultimately control of your health care should be up to you...how much you want, how much you need, etc.
Anything needed to be added or taken off the list? Why or why not?"
I don't want total government control but I think the government being involved would be okay if it was limited to something only they could provide. Just to get you started.........
The United States spends over 14% of our GDP on healthcare and we spend more than any other nation.
ReplyDeleteThe average american spends $7,500 a year for healthcare and healthcare costs are the number reason for personal bankruptcies in the USA, even for those individuals with insurance.
On top of that Americans are the least likely to visit a doctor.
We also have to acknowledge that our healthcare system is so large and so disorganized that there is no way the private sector can provide adequate solutions.
We also have to acknowledge that between funding research and research institutions, and medicad and medicare, that the US government is the largest player in our healthcare industry already.
Of course, depending our your perspective and where you sit in our healthcare system you will "see" solutions that others won't see. Doctors will always point to malpractice insurance costs, but even if we banned all lawsuits, that cost savings will not be passed on to patients and it wouldn't amount to much savings overall.
Drug companies point to research and development and FDA processes as adding to costs. but again, we could go back to the days of selling snake oil as a medical cure all for everything and still drug prices would be high because the drug companies do not acknowledge that prices are set on what the market can bear...not on costs.
People want free markets, as if patients, with the information that is available today, could direct their own treatment. If Obama can get his healthcare database up and running the way it should we can access information on most common treatments for diagnosis, which will also help doctors because most of them are not as up to date as all of us would like to believe.
Then we need to figure out how to get Americans to go to the doctor on a regular basis so we are dealing with problems before they get out of hand....and we are going to have to examine our food supply and agriculture policies.
We just might have to quit turning all our foods into "twinkies" and accept the fact that the chemicals we use might be safe by themselves but it is obvious that with all the chemicals used in foods is having some detrimental overall effect on the health of this country.
We also might have to acknowledge that all of us work too hard and too long. Days off can do wonders for ones health.
But most of all we might want to focus our healthcare dollars a little more wisely and put more of them in preventative treatments rather than cosmetic.
Oh, and then the big one, we just might have to accept the fact that all life ends in death....and if we could accept that we just might quit spending so much money on prolonging life and focus on the quality of life issues.
TAO, you raise a lot of great points. I particularly think your comment about the food we eat is important. It doesn't seem like there has been enough of an acknowledgment that constantly eating processed food, filled with high fructose corn syrup and the like, has an ENORMOUSLY deleterious effect on our health.
ReplyDeleteAnother thing to keep in mind is not just the chemicals in food, but in the air and in the products we use. Many people in my family are very allergic to things like fabric softeners, asphalt, Teflon, etc. They can get very sick being around the chemicals in these types of things. I may not have the problems they do when I'm exposed to those chemicals, but it is stupid to think that they aren't causing me any harm.
There is a reason, for example, that cancer rates have been increasing so dramatically in recent years, and I would not be at all surprised to learn that a major reason for this is a combination of constant exposure to chemicals our bodies weren't designed to handle and poor diet that leads to a generally lessened ability for our bodies to handle those chemicals.
I'm certainly not a doctor, but this just seems like common sense.
Brian,
ReplyDeleteI am no doctor either, and while I acknowledge that illegal immigrants and tort reform are issues that must be dealt with WE REALLY need to focus on the overall system and ALL the facts...in the case of healthcare to be successful we need to acknowledge that comprehensive means exactly that!
Many good ideas and points have been raised here. And, as I posted, the issue is not so easily managed due to the many facets of healthcare, delivery systems and the symbionic relationship with other areas such as agriculture and industry.
ReplyDeleteAgriculture is a BIG one on my list. I never had daughters and at any rate, the timing would be off if I did. But in recent years I've become aware of a trend that seems to be largely ignored and/or supressed. Pre-pubescent girls are being put on hormone supression therapy because they are developing too fast. What I question is whether all those hormones given to animals in our food chain might not have some bearing on this syndrome. Food for thought, no?
The problem with illegal immigration is that for years these people were allowed to cross with little interference because they provided cheap labor, especially for agriculture but also for industry. With threats of INS it was easy to abuse these desparate people. Then, there were those who advocated ensuring they had some sort of health treatment which benefits us all by preventing the spread of communicable diseases. The children also suffered and advocates arose to push for education. Still, no one addressed the illegal status problem. With education and healthcare and little border resistence many more came and we have what we have now.
I still think that a positive approach will do more in the long run than a reactionary approach.
And Jenn, I think the two most promising ideas that have come out of these posts is the health accounts and the Swiss model which, although it involves some government oversight, could be the least ainless, most cost effective way of ensuring basic coverage for all while at the same time discouraging illegal border crossings.
Another that strikes me about Europeans is they spend a lot of time outdoors, hiking, walking, etc. We have so many park areas both federal and local that it might be good to include some sort of increased activity in our parks as part of preventative healthcare.
I think way to much time is spent on comprehensive programs that ultimately become so overwhelming nothing gets done. People become paralyzed at the size and scope of the problem that the problem never gets dealt with.
ReplyDeleteAll these issues are good and valid but success is going to come from doing one thing at a time in a systematic approach. You can't eat the elephant in one bite. This is more like a jigsaw puzzle and we have to decide where to start.
Everyone has identified illegals as the #1 issue, but getting any traction with the elected elite seems impossible.
Everyone seems to realize that putting government in control of healthcare is a bad idea. Yet our current elected leaders are heading in this direction right now.
If we want results we better pick an item at a time and really push to get a solution that will improve healthcare.
ablur - what you are saying makes sense. Start in one corner and build off of there.
ReplyDeleteI think the problem is, which item can be worked without peripheral issues getting wound into it thus creating another comprehensive morass?
Maybe it would make more sense if a few problems were worked on simultaneously by diffrent groups until they all meet in the middle.
At my old site, a Speak I had on national health care generated the most hits it ever had. Quincy loves it's blogs. Don't let yourself think I was some great guru.
ReplyDeleteI believe a single payer national health insurance system is the only way to go. It takes the burden off businesses that provide health insurance benefits. I offered a 4% income tax we all pay. I also added copays to keep the idiots with sniffles and the hypochondriacs from abusing the system.
But I see no other way. The ones that demand the private sector stay in control are simply parrots for the big insurance companies. There will always be plenty of business for the AFLACS anyway.
" Of course we have people who don’t want more government involvement and given the federal government’s dismal track record, I can understand their reluctance"
I think we're on the same page here Rocky. You're just a much nicer person than I am. I look at Medicare and Social Security. Two government programs that millions every day thank God FDR and LBJ started. The interstate highway system under IKE. I liked Ike.
OSHA which protects our Country's workers. I hope it starts again anyway now that Bush is gone.
The greedy try and portray government as the boogieman. Good government makes all our lives better.
There will always be opportunities to make money. But the first priority is the good of the American People. National Health Insurance is good for Workers, Good for Business. And good for America.
Truth - I'm not really nicer, but since I'm sort of the moderator on this one, I thought I'd keep it as civil as possible.
ReplyDeleteRegardless of how each person feels about government involvement, I really don't see how we can go forward with a national system of any kind without some involvement. I just want effective, responsible involvement - not a program laden down with as much shit as Congress can pile on for special interests they're beholden to.
As a political hack, I should be offended. But at the risk of offending those I hack for, I agree with you Rocky.
ReplyDeleteTruth- I respectfully disagree in a single payer/government system working. What you get is a one size fits all approach that either becomes cost prohibitive because you have to have everything or becomes cost selective where you essentially have nothing.
ReplyDeleteThe private sector can create multitudes of unique plans that fit individuals and there tendencies toward certain diseases of lifestyles.
example: some states require ob/gyn policy coverage in all cases increasing the cost of the package but maybe you only have men in your work force (not an act of segregation or prejudice) or only employees over the age of 55. They are then buying coverage that will never be used.
Cafateria plans are great but under current systems they are a pain to administer.
Selection and fit are key components to successful care and ultimately a successful healthcare system.
Interesting reading that may further some of the conversation:
ReplyDeleteShocker! Uninsured not jamming emergency rooms
The government systems already show a tendency to drive healthcare to the lowest level. Is this what we want?
Thank you for the opportunity to respong Ablur.
ReplyDeleteAll who pay premiums pay for all the health care whether it's in our group or not.
The one size fits all approach is the easiest and most effective. You pay your premium through the 4% income tax. You go to the doctor or emergency room when you need to. No nonsense about if you're in the network. If this or that is covered. You get treated and the system gets paid. HMO's are a nightmare.
The tailoring of policies is a gimmick to make money for the insurance company by not paying for certain treatment. Insurance is to mitigate risk. If we all knew we would never get sick or break a bone, we wouldn't need insurance.
I do have some experience in this field. And I don't remember too many people actually understand the difference between the Gold, Silver and Bronze plan. Just that one cost more. It sucked telling them the Bronze plan had a yearly deductible of $2,500 dollars that restarted every June 1st when they got sick the middle of May.
I too hated trying to deal with multi-level plans and their subtle differences that made little sense to the buyer.
ReplyDeleteLook at how policies are built. The more coverage you add in the more cost must be spread over the consumers.
The fall in the scheme is how do you know what you don't need? Most people have a fair idea of their propensity to curtain conditions by looking at family and environment, but fluke cases come up.
I have yet to see the government do anything that doesn't cost more and yield less for the same money. Perhaps a tax deduction system would be advisable but putting my health or someone I care about in the hands of government is unacceptable.
Your health right now is in the hands of a company bureacrat Ablur. I don't know about you, but I don't take much comfort from knowing the guy that decides whether or not to pay my claim's main concern is profit.
ReplyDeleteDang. Forgot to sign in.
I think the key issue is profit. The government has no motivation to do anything better for any reason.
ReplyDeletePrivate industry has every motivation to do better and cheaper. Competition is the great equalizer that keeps fairness and satisfaction in the game.
A government system takes all the natural controls and tosses them out the window. This is the true failing of government and large bureaucracy.
Wait a minute - whee the hell did anyone establish that "illegals" are our number one problem? That's just irresponsible and without any statistical support.
ReplyDeleteI'm afraid health care is just a big whetstone that everyone grinds his own axe on.Somehow the axe never gets sharper.
I don't know about this argument ablur. Private industry has been running healthcare for profit and look at the mess it is in.
ReplyDeleteThere are no natural controls on greed. Stockholders will demand their cut and then the corporate bureaucracy will want their's.
I've worked in medical facilities that were non-profit and those that were not. Guess where I got paid better, had better benefits and patient care was optimized?
And if you guessed the for profit facility, you guessed wrong.
I'll second that Fogg.
ReplyDeleteIllegal immigrants may place some burden on the system, but let's be careful to not jump all over them. It's easy to make immigrants into scapegoats, but that doesn't mean blaming them necessarily makes sense.
Ablur,
ReplyDeleteBusiness is about profitability. If to be profitable requires improvement and efficiencies then business will improve and be efficient.
If profitability can be achieved without improvement and or efficienies then business will not improve or be efficient.
It should be obvious nowadays to just about everyone that quite a few of the basic economic theories of capitalism no longer work.
A lot of the assumptions that all of us believed for so long were only correct in theory and have no basis in reality.
After the last three months I have had I can state factually that reality seems to be more unreal everyday.
Market forces work very well in some areas of life, but providing access to health care isn't one of them. Health care itself is a deeply ethical concern, and capitalism as a system is amoral. (I refer not to the individuals who take up a position within the system, but rather to the system itself. Many good and kind people work within private enterprise.)
ReplyDeletePrivate insurers have some interest in delivering a product (i.e. access to health care, which must be kept distinct from the care itself) at least to a degree that won't drive consumers away in droves. But beyond that, these companies couldn't care less what happens to the individual client. Anyone who believes they do, or who is comfortable entrusting his or her access to vital health care to a private, profit-hungry concern, is mistaken. I will trust such concerns "as I will an adder fanged." There are examples of how insurance companies go out of their way to cancel the policies of individual subscribers (vulnerable ones who pay as single subscribers because they aren't part of a job-based group plan) once they become ill. Government may be high-handed and confused sometimes, but they won't cancel your policy the minute you are stricken with anything worse than the flu or a minor broken bone. It is in the interest of insurers to "cover" only healthy people; those who are known to be ill before applying they simply refuse to cover if they can get away with it, or attach "pre-existing condition" riders to the contract. From the standpoint of communal ethics, the absurdity of this model should be obvious. From the standpoint of pure capitalism, its "wisdom" is perfectly—and fiendishly--obvious.
We need to grapple with our priorities as a community. The purpose of life is living, and short of this there's nothing more important than being cared for when you or those you love are ill. Therefore, I see no problem with spending an impressive amount of our tax dollars to fulfill this obligation that we have towards one another. It's a matter of establishing priorities about what is most important in life. Health care is vital, so spending on it should be treated in the spirit of generosity. Let's be rational about it, sure--but not so "rational" that we end up grousing and begrudging others what they need to live.
While healthcare for illegals and medicaide may put a burden on the system, you gentlemen are correct in pointing out that they are not the number 1 problem.
ReplyDeleteI see illegal immigration impacting our healthcare system already but denying them access to treatment would be irresponsible and dangerous to the health of the general public.
Too many years, a blind eye was turned toward illegals because industry was profiting from having them here. But, we must not forget that these ARE human beings, most of whom want all of us want; a better life.
I think it far more constructive to work cooperatively with Mexico to improve conditions and work prospects in their own country to induce them to return home, thus relieving the problem with the minimum of pain.
Dino - nice to see you. Thoughtful, intelligent analysis. Thank you for your input.
Very well said rocky. And I agree completely about working with Mexico.
ReplyDeleteI am still immersed in “the project” but wanted to take time out to comment on this subject (and thank Rockync for sponsoring this thread).
ReplyDeleteAbout immigration, I affirm Captain Fogg’s skepticism about illegals being a number one problem. Our country has a nasty habit of seeking out and blaming defenseless people as causes of all our problems. Find a scapegoat, slime and smear the scapegoat, just like the Nazis did to the Jews and Gypsies and others whom they persecuted.
There is another term for it: Victim Blame. Those who risk death in the desert and deportation do so because they are poor, and it is all too easy to blame the poor for their own poverty. Like blaming women for allowing themselves to be raped or abused. Like blaming workers for losses in American competitiveness (although the same workers are the most productive in the world). But how did illegal immigration grow in size and scope? For 30 years, the trend has been to cave to the demands of American business for cheap labor without conscience or forethought. Greed is good. Poverty becomes your problem.
Downsizing, outsourcing, union-busting, theft of pension funds, chicanery and corruption … wage earners have been under constant siege from their American employers since the 1970s. Meanwhile, our government casts a blind eye, rewards power and privilege, deregulates ... as the fascists among us seek scapegoats.
Like immigration, the healthcare debate is tainted with greed and propaganda. On one side of the debate are pigs, gouging us for years, who refuse to give up their greedy franchises … the HMOs, the pharmaceutical companies, the hospitals, and the bureaucrats (who account for 50% of all costs but contribute zero in actual healthcare). Having lived in London in the 1980s and Paris in the 1990s, I have some experience with nationalized healthcare systems. How do these rate? Better and far less expensive on every measure ... contrary to claims from entrenched stakeholders.
Now, back to "my project."
I was in Rochestor NY for a family reunion last summer. I didn't see one Canadian there looking for health care because it was better here.
ReplyDeleteTAO & Dino - The key to control is competition. Pure greed without competition will result much as you suggest. Competition is the key to any capitalistic market working. If you remove all competition (monopoly) the market has no control or checks and balance. If the customer was free to move without being locked in for a year to the competition this would naturally place controls. Pre-existing conditions would have to be waved if going from coverage to coverage. In fact, pre-existing needs to be reviewed and perhaps tossed. If everyone is required to have coverage then many of these rules would become void by law.
ReplyDeleteYou see insurance is not regulated nationally. It is state to state causing irregularities and specific implimintation standards that further muddle the system. As a licensed agent I have to qualify and be licensed in every state I wish to do business. This becomes a constitutional issue at this point because this was left to the states. Perhaps it needs to be controlled at a federal level to deal with many of these issues.
Once again competition could then be more direct because state by state variations would be eliminated. (Some state restrictions only allow a certain numbers of carriers of certain policies. This further eliminates competition.)
Illegals as a cause- I posted an article above that addressed this issue. It seems our government being a horrible payer, has caused a great deal of this as well. Illegals do have a hand in this but other factors are also tearing down our system.
Fixing Mexico - Mexico is in the midst of this right now. They have to either get control of their nation or fall to lawlessness. The horrible part is it is spilling over into our nation.
The citizens of Mexico need to stand up and take their country. They need there own group of patriots who will sign their Declaration of Independence and risk it all to make it free. We can back and support them, but we can't do it for them unless you would like to do another Iraq or Japan? Until the lawless corruption is dealt with, the problem will remain.
What is Your Citizenship to the USA Worth?
ablur - I checked out your post and it sounded strangley familiar. In fact, I came across this same bit of history, nearly verbatim while researching a post I did on our founding fathers.
ReplyDeleteWhat you have posted has made the rounds of the internet under the heading "The Price They Paid." It is not completely accurate.
Snopes has done a cover of this article here:
http://www.snopes.com/history/american/pricepaid.asp
Do not misunderstand; I have much admiration for the courageous, perhaps somewhat reckless, radical
colonists who put their lives on the line for independence. But, as with most tales of daring deeds, it is sometimes embellished and stretched.
I found Benjamin Franklin's autobiography to be most enlightening and educational as he had a way with words that could transport you through time. While Jefferson and Adams were prolific writers, they just can't match Franklin for his handling of the written word.
There is indeed some embellishment but snopes does not do justice to the issue. These were well off to rich men who by inciting the revolution that made this nation risked it all. If they would have left well enough alone, they would have most likely stayed rich.
ReplyDeleteLet's us look past the embellishment and see the true risk and udder destruction that they invited to their lives.
I need to pick up Ben's Auto. I keep hearing about it. I have seen several stage performances of the life and times. He was a truly remarkable man.
Most were wealthy men and businessmen and they took great risk with the promise of astounding returns if they were successful. They would be creating a country! They would write it's laws.
ReplyDeleteIf you ask successful men the secret of their success;Carnegie, Ford, Gates, Buffett, to a man they will cite taking risks.
Our founders had radical ideas, they wanted to turn the status quo on its ear. Not everyone was on board - many wealthy men wanted to remain under British rule because they feared what would happen to their livelihoods.
Basically, they were arguing and debating what to do and how to do it...sound familiar?
These guys were ordinary fellows from different walks of life, with different beliefs and different ideas. Their desires were not unlike our own today. They wanted to live well, raise their families and enjoy their personal pursuits. All these orinary folks were caught up in extraordinary events because of their own audacity of hope.
Rockync- looking back at your need to help Mexico, how can we unless they desire to help themselves? Who is going to sign their Declaration and take back their country? We already know how hard it is to do it for someone. They have got to want it and do it for themselves. We can help but it has to be them.
ReplyDeleteMost choose to ignore their nations problems and seek alternative answers to solve their problem. They choose to break the laws of another nation instead of challenging the failed system of their own.
Shouldn't we promote courage of the people of Mexico and push them to make a difference in their own country?
My thoughts on Mexico and how best to deal with them began in part 1.
ReplyDeleteIF we can stabilize and increase our economic output to a point where we would be able to dangle an economic carrot under Mexico's nose to give them incentive to clean up their own act.
At the same time making it more difficult for illegals to obtain goods or services. Both must happen simultaneously so that living conditions improve in Mexico while they become more difficult in the US giving Mexican nationals more incentive to stay home or go through proper channels to apply for entrance into the US.
I would prefer a cooperative relationship as opposed to a "Berlin wall" approach.