ZERO CARE

[Richard]

FWIW - and MOO - I have problems with having to co-pay for people who suffer the self-induced and often >$$ health effects of smoking, alcoholism, substance abuse, a lack of a reasonable fitness regimen, and the chronic obesity of those w/o a preclusive medical condition.

However - YMMV.

Richard's $.02

[nmap]

Originally Posted by Dad

I am firmly convinced SOMETHING must be done about the price of healthcare in this country.

The solution to that problem (in isolation from all other elements of the problem) is simple. Eliminate all insurance. The patient pays all medical fees immediately and in full, just as with any other consumer product.

Notice that insurance distorts the supply-demand equation. If a patient faces a $10 co-pay for a doctor visit, which also creates a $100 charge to the insurance company, then patient demand will vary according to the cost they see - in this example, the $10.

Likewise, if a surgery has an actual cost of $150,000, but the patient only pays $5,000, then demand will operate at the $5,000 level. Thus, demand is increased.

This propagates through the system. Hospitals obtain more equipment, doctors order more tests, drug companies produce more (and more expensive medications).

Directly couple costs to the patient and you eliminate the distortion and simplify the process. Demand will decline, forcing prices lower.

I'm reasonably certain this will not happen.

Originally Posted by Dad

I am also a huge believer in Medicare. In regards to Medicare, we need to pay the doctors and force the suppliers to bid for their products.

But notice that Medicare is a large and growing fiscal problem. It's very advantage - that it covers everyone for a fixed price - also means that the people covered will use more medical care than they could otherwise afford. And if one supports Medicare for those 65 and older, there is the question of why those 60 and older...or 50 and older...or 20 and older...should not also be covered.

Originally Posted by Richard

FWIW - and MOO - I have problems with having to co-pay for people who suffer the self-induced and often >$$ health effects of smoking, alcoholism, substance abuse, a lack of a reasonable fitness regimen, and the chronic obesity of those w/o a preclusive medical condition.

Of course. The more coverage, the more the cost. We each have areas we think should not be covered. This adds further complexity to the problem - and further emotional loading, I suspect.

Quite simply, the program will (IMO, YMMV) compress the upper-middle class and below down to the level of the working class (middle of the lower-class under a 9 class level scheme). It will provide more options to those at or below the middle of the lower class.

It will also lead to rationing of a sort. Dollars in direct payment is one sort of allocation. Insurance, a sort of indirect dollar-based mechanism, is a somewhat different style of allocation. Dealing with a bureaucracy and various government rules is yet another.

For those in the top 1% (about $6 million net worth), excellent care will be available on a private-pay basis.

If the bill passes, some groups and illnesses will be covered very well. Others will lose quite a lot. Over time, the budgetary realities will assert themselves and the rationing will get more severe. Give the bill 5 years - at that point, those who are old and sick will (IMO, YMMV) be strongly encouraged to drop dead (or, if you prefer, to consider end-of-life options).

[steel71]

When government subsidizes anything, the prices will go up. Then when it subsidizes it over regulates to protect its interest. What would happen if college students decided to stop accepting government assistance and student loans? The tuition fees would drop dramatically. Many times the entity offering their solution usually caused the problem in the first place.

[PR31C]

Others have touched on this problem and here a doctor reports on it directly. Along with what NMAP has pointed out, cost vs demand, when everyone has the right to free medical coverage, who is going to be their to provide it. City EMT workers already tell stories of those with free coverage using 911 to go the ER for a cold, ear ache, etc.

Massachusetts is often held out as a model for national health reform, and the bills being considered in Washington emulate much of that state's 2006 landmark universal coverage law. As a physician in neighboring New Hampshire, I have had the opportunity to observe the effect of the Massachusetts reforms
Today, 97 percent of Massachusetts residents have health insurance, the highest in the country. But less publicized are the unintended consequences that the influx of half a million newly insured patients has had on an unprepared primary care system.

The Massachusetts Medical Society reported that the average wait time for a new patient looking for a primary care doctor ranged from 36 to 50 days, with almost half of internal medicine physicians closing their doors entirely to new patients. And when you consider that Massachusetts already has the highest concentration of doctors nationwide, wait times will likely be worse in other, less physician-abundant parts of the country, should universal coverage be enacted federally.

When patients are forced to wait weeks to obtain medical care, they inevitably find their way into the emergency department for treatment that ordinarily can be handled in a doctor's office. Indeed, since health reform was passed, according to state data provided to the Boston Globe, Massachusetts emergency rooms have reported a 7 percent increase in volume, which markedly inflates costs when you consider that emergency room treatment can be up to 10 times more expensive than an office visit for the same ailment.

Using the ER for Ordinary care means increase cost. Which means increase cost for those with private health insurance and increase to gov for the gov supplied health care. The tax payer will be forced to pay the bill and for those with private health insurance they will pay for it twice, premiums and taxes.

[glebo]

I was just thinking.....( Iknow, I know), with all these social type programs of taking from those who have (money, taxes, etc, etc) and giving to those who don't have. Would this equate somewhat to "reparations" that some have been wanting for years???

Just throwing it out there.

[greenberetTFS]

Originally Posted by swpa19

Lets just hope that the Medicare Budget maintains enough funding to see him through the rest of his years.

Ive dropped my Medicare and have chosen to (for now) go to alternate health care plans. My Medicare options are still open.

My wife is on Medicare $270/month with a AARP supplement which costs $160/month,how ever without it we'd be unable to afford her medical treatment. She is on Cemo (ritauxan) which costs $35,000 a treatment. This cost is covered by both plans. She also has Pulmonary and Cardiac problems which are equally very costly. Without Medicare and the AARP supplement she would probably be dead by now because there is no way we could afford the insurance cost and live on SS like we are doing now..........

Big Teddy