Vote: Best Healthcare Option

[AgentOrange]

You mean single payor?

In a way. Not like the British and French models though. Providers and carriers still compete in the free market.

Do away with everything. Medicare, Medicaid retirement plans etc etc, allow people to choose basic coverage from a number of carriers they can upgrade with private dollars PPOs, private hospitals etc. Everyone is covered at minimum (the poor) and you can upgrade your coverage based on ability to pay.

It's very successful as far as cost benefit and outcome. Its cheaper and has better outcomes. It would also be an easy transition for the healthcare infrastructure we already have in place. Also, it would detach coverage from employment which would benefit workers and employers.

https://en.m.wikipedia.org/wiki/Healthcare_in_Israel

 

[scagnt83]

Singapore type model is what we need.

Basic HDHP for all, with Deductible based on income
HSAs for all, with Gov Subsidies based on income
Supplemental Plans available on Private market
All Providers are required to accept the basic gov plan
Reimbursement rates (prices) are set by a government body... but so are insurance premiums... and your utility bills.

But that is all they have, eliminate group/medicare/medicaid/etc. Although that is very similar to moving to Medicare for all under a HDHP model.

 

[Key2Success]

Singapore type model is what we need.

Basic HDHP for all, with Deductible based on income
HSAs for all, with Gov Subsidies based on income
Supplemental Plans available on Private market
All Providers are required to accept the basic gov plan
Reimbursement rates (prices) are set by a government body... but so are insurance premiums... and your utility bills.

But that is all they have, eliminate group/medicare/medicaid/etc. Although that is very similar to moving to Medicare for all under a HDHP model.

Pipe dream....never happening.

 

[junkman]

You mean single payor?

Doesn't matter who administers. Both medicare and carriers have infrastructure to pay claims. I'd favor HDHP deductible then 100% plans for those with higher incomes starting around $50k. Deductible could rise with incomes. I want the poor out of the ER and would give them HMO with co-pays. Give options to buy up but that introduces some adverse selection. Insurance companies know how to price to minimize adverse selection.

This ain't gonna happen. Dirty groups would get dumped into the public option with clean being cherry picked. Perhaps give everyone core plan and let employers provide buy up.

We need provider price transparency that matters. We currently have none and insurance negates it's usefulness.

 

[Justin Bilyj]

Doesn't matter who administers. Both medicare and carriers have infrastructure to pay claims. I'd favor HDHP deductible then 100% plans for those with higher incomes starting around $50k. Deductible could rise with incomes. I want the poor out of the ER and would give them HMO with co-pays. Give options to buy up but that introduces some adverse selection. Insurance companies know how to price to minimize adverse selection.

This ain't gonna happen. Dirty groups would get dumped into the public option with clean being cherry picked. Perhaps give everyone core plan and let employers provide buy up.

We need provider price transparency that matters. We currently have none and insurance negates it's usefulness.

If we go to single payer it will be like Australia. My exwife's mom had to wait months to find out the diagnosis of her auto-immune disorder, and it took over a month to get on the doctor's schedule for a visit - and she had to drive a couple of hours to see the doctor.

We go to Israeli-care or single payer, we will destroy the quality of healthcare in this country...

 

[TampaHound]

I can see us going to a "Medicare for all option" eventually. Where the costs of procedures are set and regulated and basic care is mostly paid for by the tax payer. You can still buy into a HMO or Supplemental type of plan to cover other expense that are not covered by the "Medicare for all" option.

For me it's a matter of controlling the costs. That's something that none of the current plans do a good job of; and that is what is making healthcare so damn expensive.

 

[Justin Bilyj]

I can see us going to a "Medicare for all option" eventually. Where the costs of procedures are set and regulated and basic care is mostly paid for by the tax payer. You can still buy into a HMO or Supplemental type of plan to cover other expense that are not covered by the "Medicare for all" option.

For me it's a matter of controlling the costs. That's something that none of the current plans do a good job of; and that is what is making healthcare so damn expensive.

Controlling costs is a method that socialist utopians use before they go bust. Free market with less regulation is the key. We go pure medicare for all, and we will be rationing care, doctor's will crank their prices or start only accepting cash...

 

[Chazm]

I can see us going to a "Medicare for all option" eventually. Where the costs of procedures are set and regulated and basic care is mostly paid for by the tax payer. You can still buy into a HMO or Supplemental type of plan to cover other expense that are not covered by the "Medicare for all" option.

For me it's a matter of controlling the costs. That's something that none of the current plans do a good job of; and that is what is making healthcare so damn expensive.

Govt controlling cost? Tell me where govt controlling cost has ever been a benefit?

It amazes me how so many people want to go against what makes America, America. The constitution. It's like we want to go to a socialist country. Go to Venezuela and see how cost control is going there.

 

[somarco]

You can control costs by shifting the responsibility for routine claims from the carrier to the individual.

RK and later optic laser surgery was incredibly expensive when first introduced. Since it wasn't covered by insurance (in most cases) and the patient paid, prices came down.

Most dental work is not covered by insurance and the bulk of what is covered is paid for by the patient directly or indirectly. And most dentists do not discount their fee structure to accommodate insurance. As such, dental care has not increased at the same rate as other medical care including Rx.

Over-utilization drives up health care costs more than any other single factor which in turn drives up premiums.

Government takeover, single payer, Medicare (more precisely, Medicaid) for all isn't needed when you take away the incentive to use health insurance for routine items.

 

[nylife11023]

Over-utilization drives up health care costs more than any other single factor which in turn drives up premiums.

Government takeover, single payer, Medicare (more precisely, Medicaid) for all isn't needed when you take away the incentive to use health insurance for routine items.

I do agree with this. There is no doubt that as a country if we realigned our priorities we could easily provide free healthcare to every citizen via some kind of single payor or mixed payor system. But that would be a drastic change and it would be prudent to see if we could preserve as much of the current system as we could via "opening" the system to "transparency" and real free-market strategies.

I've had the good fortune to travel the world and while our system is very expensive, in most parts of our country we have a way superior delivery system than others... and it would be sinful to abandon it without trying other methods like quoted above.

One item. It is not must over-utilization that drives up the cost... it is also that the rates for so many procedures are simply over-priced. Why does a CAT cost $1300? It is because there is this bottomless pit of money to pay for it... and every other procedure out there... so there is no incentive for prices to go lower... only higher.

If there were NO insurance at all... everything was paid out of pocket, what would a CAT scan cost?

(Actually, the answer is zero... because there would be no such machine as a CAT scanner... no one would invest in development of the technology unless they could make an adequate return on the investment. Of course, we might be able to develop new technology via government grants, etc. There are ways to solve the problems... if only we had the political will to do so and if our government was not bought and paid for by the large carriers, the provider associations, the drug companies, and the financial industry.)