Health Care: Problems and Common Sense Solutions...

[Solon]

I agreed to start this thread because of the one about what nation has the best health care system, the answer was not the United States obviously.

I think the biggest problem is that we in the United States approach it from the wrong perspective: to control costs at the CARE level.

The problem with this approach is that it doesn't address the biggest cost increase that has occured recently, the cost of administration and the uncertainty of the Stock Market. Insurance companies make money, not in providing care, but in investing in the stock market. All care provided and paid for by insurance companies are ultimately a cost that they have to remedy to increase their profit margins. The snag occurs when the stock market doesn't perform to increase the margins, or even maintaining them, without the need for increased premiums. This is basically true of any for profit service where costs for care cannot be easily controlled.

This is one of those rare circumstances, like public utilities that are properly regulated, where Governments have been shown to be more effecient in providing care AT COST than private companies could ever hope to match. That is probably the biggest thing going for UHC systems is the lack of outside factors in calculating costs. They can be reduced, drastically, without sacrificing care.

This brings up another point, the lack of preventative care in this country, this can reduce the amount of time and money spent for catastrophic care as well. When was the last time any US citizen went to the doctor for a checkup, excluding needed shots or care? For me it has been since I was a child, only since then it was for a car accident and my pinched nerve, thank the Gods those were IT. One of the reasons for this is also cost, because many insurance companies have a 500 dollar or more deduct that doesn't cover such costs. Another could be that Americans don't really like to think about it too much and our lifestyle, being as fast and furious as it is, doesn't allow for that type of caution.(subject for yet ANOTHER thread there.)

One thing that is blamed for these rising costs is litigation, and while lawsuits can be frivolous, I would think that judges would be able to make judgements as to whether they are frivolous or not. The problem is that health care takes up 16% of the GDP a trillion dollars and most judgements in this country for lawsuits are in the thousands of dollars, NOT MILLIONS OR EVEN HUNDREDS OF THOUSANDS. You would have to have half the country win a lawsuit of a 10 thousand dollars each to even make a dent in health care costs. In reality, total costs for litigation is in the single percentage points compared to other costs.

Overhead(Administration, CEO pay) takes up the largest cost in health care in this country bar none. It is up to 40% of total costs, compared to Canada or Medicare at 4-5% and 3% for each one. Also the specialization of Doctors also increase costs, sometimes dramatically. This could be tied in to the lack of preventative care in that a General Practitioner can catch many problems before the need for catastrophic care that many specialists are good in.

As far as drug costs, one question, is it any coincedence that drug costs skyrocketed when the FDA allowed them to advertise perscription drugs on TV?

Here are some of my suggestions that would help solve these solutions and cover ALL Americans. I would take a nod to the Canadians and set up a system similar to their own. But anyways, here are some of my suggestions:

First things first, allow the government to put price controls on prescription drugs, or at the very least, negotiate and have the power to say NO. Revoke the stupid rule I mentioned above about ads.

Second is to eliminate the profit motive of insurance, HMOs, and Private Hospitals by setting up a system of national insurance for the uninsured with no limit on costs for NECCESSARY CARE(Plastic surgery for looks not paid for, reconstructive plastic surgery is allowed). This is actually the beginning of suplicanting all private insurance, and to put strict price controls on costs within even private hospitals for nonessential personnel i.e. Administrators, CEOs get pay cuts of like 90%, doctors and nurses get actual pay they deserve(and are allowed to organize to boot--tentative).

By the end of this transition, we would have a system similar to Canada's, where those who can afford it can get supplemental insurance, and everyone is covered for care neccessary to life the best quality life possible.

Any suggestions or comments are welcome.

[CAcyclist]

1. Agreed

I definitely think the first step is reinstating the controls on advertising and I think the US needs to crack down hard on corporate sponsorship of medical schools, research at public institutions and drug company gifts, kickbacks and bribes to doctors.

Regarding the flu shortage itself, this is a post I started this morning:
http://www.democraticunderground.com/discuss/duboard.php?az=view_all&address=103x81010

[Solon]

4. Definately a problem there too...

One of the reasons I started this thread is to get the great minds a DU to work on all the problems related to health care on the table in an easy format, can't do it all myself, until I'm dictator of the world of course :evilgrin:

[Cleita]

2. Until the private sector, meaning the insurance companies, HMOs

and any others who trade on the stock exchange, get out of health care, we will have this crappy system. I have a proposal. What if the government expands Medicare to cover what it doesn't and offers it to employers and others at a rate that undercuts what the insurance companies offer. It also could cover those who aren't employed or too young or too old to be employed.

I think it would make the insurance companies, who cherry pick who they cover unable to offer competitive insurance and get them out of the business. They could go back to the business of insuring for disasters, instead of ruining our health care system with avarice, which is what is happening.

[Solon]

5. Exactly what I proposed, for the Government to rip the rug out from..

under the insurance companies and HMOs. Just offer the best coverage at a price that literally can't be beat, at cost.

[murphymom]

3. Re health costs and the stock market

Thank you for bringing this up, it's been bothering me for the longest time. I don't understand why more people aren't making a correlation between the stock market tanking and health insurance rates going up but I believe it's got to be responsible for a major part of the increases. The whole trial lawyers hoo-hah is just a big smokescreen. I'd love to read the opinions of any DUers who have knowledge/experience with the insurance industry.

Husband and I are self-employed and our health insurance premiums (Preferred provider plan with prescription coverage, low deductible) have doubled over the last 4 years. And we're among the "lucky" ones, we can still afford it. I don't know how lower income folks or people with large families are managing.

[Cleita]

6. On your preferred provider plan, you'd better find out

if your health care providers accept it. My experience has been that I must pay up front and then get reimbursed for 80% of what the insurer approves. So I find that they pay about 50% of my actual cost after a deductible of a $1,000 of what they approve which can be twice and much. And, 99% of the doctors in my area don't accept any HMO or PPd plan, so it's cash up front and try to get reimbursed from the insurance company. Oh this is after my monthly triple digit premium.

This is not a health plan but highway robbery, yet like you I feel lucky I can pay this.

[murphymom]

8. So far, so good

I have a chronic medical condition so I see my doctor fairly regularly and after a $10 copay, the doctor's office bills the insurance co. Haven't had any problem with the physicians in my area accepting the plan I'm on. (Keeping fingers tightly crossed!)

[sweetheart]

7. A twist on bio-terror security

I think the president should stress and "FORCE" the homeland security
thugs to re-deploy to do something useful, to vaccinate all the
american public against any and all public diseases as a way of
"training" for a bio-terror attack. This would set up a framework
public health service that would seriously spook the private
healthcare profession.

Then president should call the healthcare weenies in to a room
together with drugs companies and all the others and issue a
clear and present threat. "I want you guys to make sure every
american has health care from cradle to grave, or i'm gonna
have homeland healthcare do it, and you'll lose out." "Talk
amongst yourselves."

In effect, force the industry to sort itself out, with a large
cannon aimed at it. If the president is a serious warrior like
John Kerry is, they should feel like Osama Bin laden in the
crosshairs... either they clean up their act, or the wrath of
justice will make them.

This could be backed up with the threat of a highly empowered
anti-trust court prosecuter like say, Eliot Spitzer, charged with
making sure things get sorted for ALL american residents, so that
we can be safe from the spread of infectious diseases and
the potential of bio-terror.

[CAcyclist]

9. Absolutely

We, the public already indemnify corporations against claims for vaccine injuries that the CDC recommends.

We, the public, already provide the research and production of the flu vaccine seed stock and give it to private companies to manufacture.

Chiron is writing off $91 million for their vaccine inventory.We, the public pay for that

If the manufacturers cry poverty and refuse to upgrade their facilities so contamination isn't an issue, then we, the public should nationalize vaccine making. Then we could do it here on American soil.