If Obama Does Not Get Office Again?

[Crabcake Johnny]

Back on target - there is no solution for health care. I haven't found a country that's come up with a solution. The UK system has been on the brink of BK for years. The Canadian system is great for urgent care but primary care is non-existent. The Canadian system is also largely dependent on huge drug discounts per laws instituted that cap RX expenditures. However, if we implemented the exact same caps, likely phama would say "screw it."

Not only that, but health care in Canada is not "free." There are several additional taxes people and businesses pay. Note that people in Canada actually seem to pay taxes as opposed to the 48% of all U.S. households that don't. These are the same U.S. households holding a cup out looking for more and more gov't services.

The main issue at hand is how do we get 95% of the people to cough up 1/4 of their take home pay to cover the medical expense for the 5% who: A) abuse the system. B) To no fault of their own, use an enormous amount of medical resources.

And the answer is? There isn't one. And there may never be an answer.

 

[AndreaSti]

Healthagent hit the nail on the head. If there was a good answer this would have happened years ago. What chaps me is the idiots in DC who act like they have it figured out, and it's gonna save us all money, and save us all from the evil insurance and pharma companies. If any of them had the cojones they would admit they were wrong about the entire thing from the start.

 

[Crabcake Johnny]

You don't get elected touting tough love. You get elected by telling every little girl they get a pony and every little boy gets a scooter.

 

[briko3]

There will never be a good solution as long as people think the only solution is free healthcare. Things have to be paid for. Tort reform is a start. Offering cheap preventive care is clinics is a start (even though poor people won't pay a dime unless it's urgent) Limiting how much hospitals can charge for certain things is a start. (It's like price gouging) I'm fine with charging 2-3 times retail for medicine, but 100x is ridiculous. Releasing "average" cost charts for procedures based on states and comparing that to the nation is a start. Every hospital should have to provide a good faith estimate of the procedure before something is done and have a column next to it showing the state and national average for the same thing. (AND THAT'S BEFORE INSURANCE!)
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In other words, lower the costs as much as possible on the health side and then suck it up and pay what needs to be paid. Nothing in life is free.

 

[Crabcake Johnny]

Part of the solution is transparency and competition. My area is getting very crowded with urgent care choices where the pricing is posted like a fast food joint.

Likewise, ERs should post their charges. Makes a difference. Not everyone hits the ER in an ambulance. I had three hospitals to chose from when I had my kidney stone attack. I would have loved to have know ahead of time what each one charged.

Most procedures are scheduled. Let hospitals compete;

"John, will you be scheduling your surgery with us?"

"Actually no, I'm going with Arundel Medical Center. You quoted me $5,500 but they're coming in at $3,000....so thanks."

....and anything over $3,000 needs to be agreed to: "John, we quoted you 3K but we'd like to have a specialist pop in and spend 20 seconds looking at your chart. He's going to cost $500 extra."

"Actually I'll decline that expense but thanks." Or "everything seems fine but we'd like one more round of testing at $1,200 extra." "That's ok, I'll check out now."

 

[stuy119]

Two comments on this conversation:

1. As a child of a family of educators, I/we would argue that the majority of a schools test scores are not earned in the classroom, but rather at the dinner table or desk with the parents. It's a largely forgotten component in the education debate, and likely the one that matters most.

2. Are consumers likely to care what the cost is, and/or turn down additional services when insurance is likely to pick up a part of the cost? I'm not so sure they are, otherwise we wouldn't see the obesity epidemic. And there needs to be a correlation among the services received and their efficacy, rather than just pure up-front price.

 

[briko3]

Insurance companies pay a certain amount per procedure, so it would help the person's pocketbook to know what is being charged.

As far as education funding, you have to also remember that even if a school gets more money to be equal with "richer" parts of a country/state, that doesn't mean the better teachers will want to move there and teach. (I also agree that parents are the number one correlation to grades/test scores. It's attitude towards learning)

 

[defenderzeta]

What I dont understand is that the free market can easily solve the entire problem.

At the local CVS recently my wife went to a walk in doctor and got a prescription in less than 30 mins, cost us $50 plus cash (not on her plan) and $10 bucks for her pharma plan.

I understand the need to go to a doctor for anything requiring lab work, but there are ALOT of things that can be handled on a walk in basis at these new store clinic things. Its really just a side office they have inside the store... but its pretty cool for the small stuff.

Plus, insurance should only be for major stuff or diagnostics above a certain dollar amount anyhow... and ERs should have the right to siphon folks off to a secondary clinic after a nurse practitioner decides their small stuff can be done by a walk in clinic.

 

[Full Throttle]

Back on target - there is no solution for health care. I haven't found a country that's come up with a solution. The UK system has been on the brink of BK for years. The Canadian system is great for urgent care but primary care is non-existent. The Canadian system is also largely dependent on huge drug discounts per laws instituted that cap RX expenditures. However, if we implemented the exact same caps, likely phama would say "screw it."

Not only that, but health care in Canada is not "free." There are several additional taxes people and businesses pay. Note that people in Canada actually seem to pay taxes as opposed to the 48% of all U.S. households that don't. These are the same U.S. households holding a cup out looking for more and more gov't services.

The main issue at hand is how do we get 95% of the people to cough up 1/4 of their take home pay to cover the medical expense for the 5% who: A) abuse the system. B) To no fault of their own, use an enormous amount of medical resources.

And the answer is? There isn't one. And there may never be an answer.

Good post. There are two big obstacles to any solution: changing people's lifestyle (impossible) and saying no to certain treatments for end stage health care (not popular, nor should it be).

 

[Crabcake Johnny]

We need to take control of our own health care. During my kidney stone episode they recommended 4 meds. I declined 3 and they wrote out a script for one. They wanted me to come back in for a follow up after I passed the stone. I declined.