My look at US healthcare

a reply to: DBCowboy

I agree that we will eventually get single payer universal healthcare in America. Only difference is, I'm in favor of it.

With respect to your comments about buying insurance across state lines and how that's the real solution, I have to disagree.

For starters, there aren't any federal laws prohibiting it right now. It's the individual state's who set insurance standards for their own state.

So, in order for Trump & the GOP to institute mandatory interstate healthcare insurance sales, they would literally be removing the state's right to set it's own minimum standards. Violating state's rights anyone?

But that's not even the big problem. According to a study that I read the other day, there are already several states that have open healthcare insurance markets and they are still unable to attract new carriers because, (according to the insurance carriers) it's too cost prohibitive for them to come in and set up offices throughout the state, much less to build up doctor & pharmacy networks throughout a new state in a questionable market.

In other words, they're not sure it would be "profitable" and therein lies the problem.

Healthcare insurance works best when the pool of beneficiaries is the biggest possible and when profitability is not a consideration.

NOT passing the PPACA replacement was the plan all along.

The corporate mandate is going to kick in for the PPACA. Just wait until 80 million workers that get their healthcare through their employers get the $12,000 family annual deductibles and the $1500 per month costs. You think 30 or 40 million ticked off people was something this November?

You ain't seen nuttin' yet.

This is all about 2018 and the Democrats running to the mikes yesterday and today taking a victory lap on screwing those 80 million about to be newly blown up.

a reply to: DBCowboy

" Lindsey Graham, Senate douche-wad is on record that the Senate will never pass any laws that would allow insurance companies to go across state borders, so we can't look at the most logical and reasonable solutions towards reducing healthcare costs. "



Is that a Fact ? The Douche -Wad Part Yes , but why would the Senate , which is a Republican Majority Right Now , not Pass an Introduced Bill to allow Insurance Companies to sell Insurance over State Lines ? It would Encourage Compittion among them , and Lower the Cost of Health Insurance , would it not ? Maybe President Trump could come up with an Executive Oder to that effect if the Senate Refuses to even consider it for " Whatever " Reasons.....

a reply to: Zanti Misfit

You should read my previous post.

There are no federal laws prohibiting insurance companies from selling across state lines now.

It's the state's right to set minimum standards for their state and any restrictions that may be in place, are put there by the states.

So if congress takes that away, would it not be taking away state's rights?

originally posted by: Flatfish
a reply to: Zanti Misfit

You should read my previous post.

There are no federal laws prohibiting insurance companies from selling across state lines now.

It's the state's right to set minimum standards for their state and any restrictions that may be in place, are put there by the states.

So if congress takes that away, would it not be taking away state's rights?

As I said earlier, there are already some states that allow it, but the insurance companies themselves have not taken the initiative to do so, because the cost is so high.

Not only do they have to create plans that abide by specific state regulations, they have to spend tons of money to build the infrastructure to administer the plans, they have to go out and set in place deals with the hospitals and doctors, and they have to bear the cost of trying to market/sell it to the people in the state.

It's just not profitable in the long run for them to do so.

Many moons ago , a member whose name escapes me (maybe Marg or something) It was maybe a year or not quite after the big 08 recession. She made a post about all of the insurance companies would implode and bust due to the baby boomers all retiring and living longer getting all kinds of special doctoring and services done on em and how there would not be enough younguns to tax to death to cover for all the health expenses for the boomers who are living longer and sicker than before.

This person had inside news on about all insurance companies going belly up when all the boomers started using their services for their extended lives. That is why they pushed that damn bill through so fast.......... you know , you have to pass this bill to see whats in it. What a load. This is one of the reasons they have dumbed us down so much and distracted us with , oooooohhhh shiny.........my prescious phone , tablet . laptop , tv etc.

So they passed Obama care. Premiums go way the feg up and everyone ends up paying a heel of alot more and only with certain doctors not of your choosing. But lo and behold we have 20 some odd million more with health insurance who never had it before. Take from those with more and even sometimes from those who make the same so you can have insurance at our expense.

I think obama crap was to give insurance to the poor to an degree but was more to bail out the insurance companies just like they had done for the banks. I believe we were and still are on a precipice of a magnitude that would do more than merely pucker your rectum. This is the total damn Im eating 3 valiums and a few major shots of vodka at the end of my night just so I can sleep with the addition of ambien. I have savings and a nice sized inheritance and I feel more nervous than I did before. I dreamed of early retirement but dont quite have a pile enough for the house pymnt , insurance and the regular food ,electri internet... We could do it quite nice for about 10 -12 years but then what if I live 16 years more or 20 years more. After paying off a house 550k isnt enough at age 53. This means I will have to work at least 5 -7 years more of 7pm - 7am shifts, Feeling dead tired and listless that many more years. With Trump I hear it would cost me 24k-35k / year just for insurance. That would be what I may get out of my investments in an average year but that is all.

Maybe it is time to go old school and not have insurance and if you get real sick or have a heart attack you just call hospice for some good drugs to eat while you sit around and wait to die. I really am thinking of going that route. Roll the roulette wheel.

a reply to: introvert

Yeah, that's basically what I said in my first post at the top of this page.

For the GOP to stand up there and pretend that they have some magic dust that's gonna force insurance companies to sell their products in every state and act like that's the magic pill that's gonna bring rates down, is totally dishonest.

Just like their three phases of healthcare reform bullsh#t sales pitch. What a friggin joke!

a reply to: Flatfish

Name one large scale government program that has not turned to "snip" due fraud, waste or beauracracy maintaining employment scheme that has met it's goals, budget and has not led to massive deficit increases - did I mention limited access to favored minority classes as well over majority population due political voting blocks, ahem.

You people reccomending single payer are delusional indeed. Don't mean this as an attack - it's more pointing out a wishful pollyannish construct that does not and will not ever fit reality in a constitutional republic such as ours.

The first fallacy is to believe government dictating prices will leave any private provider in business as they volunteer to cut their throat.

Second fallacy is to believe any government run organization can effectively replace private services at similar or lower cost - takes rediculous amount to manage few workers traditionally - truth.

Third when bill comes due fallacy to believe rationing will not become the norm - except single payer leaves no option for normal population to have alternative - but well off could travel.

Fourth, single payer will give congress motivation to pass extremely intrusive and draconian lifestyle rules or forego coverage - huge nanny state will exist.

Fifth, one could make case single payer construed taking under constitutional law for nearly 20% of the economy - might be shot down before it flies causing even more chaos in system.

Why not just cut to chase and prosecute USC15 Chapter 1 laws along with enforcement of Federal and State consumer laws.

I've seen high estimate of an 85% reduction in medical cost were this longstanding laws actually enforced.

Most would not need insurance for routine, preventive or maintenance medications.

Cheap catastrophic policies would cover rest of exposure.

85% cost reduction would then make possible government coverage for chronic or pre-existing conditions as well as adaquate coverage for the poor.

OK if not 85%, imagine 50% which is very doable.

To do this we (USA) needs an honest leader to explain clearly why a recession will undoubtedly occur as result this process but recovery would be quick.

Or do nothing, or effect something like single payer and have more or less permanent recession as healthcare vacuums up more and more GDP due uncontrolled costs or artificially enacted costs outside free market.

Btw, we have no free market now, nor have we had it for most people's lifetime who are alive today. It's rigged, monopolistic and slanted towards those enjoying government protection of markets.

The laws I speak of were effective in breaking up standard oil and rail monopolies, they still apply and medical industry as a whole has no immunities.

All this has same effect of single payer wishful goals but uses market competition to achieve without further legislative action.

This could be done Monday and knock medical industry back to traditional 4% GDP.

I always wonder - why is it impossible to consider a multi- payer system?

Why not have both private and public healthcare facilities that compete with each other? (in cost and quality of care)

Why are there no mutuals ? (non-for-profit insurance)

These are some aspects of the system in France that seem to work well. They scorn the socialized systems of the UK and Canada, and would be just as discouraged to see that start to emerge in their country as many Americans are. But why can't the Americans think of ideas that are neither one extreme or the other, and instead a moderate alternative??

a reply to: Bluesma

Why not have both private and public healthcare facilities that compete with each other? (in cost and quality of care)

That's sort of the way it works in the rest of the world, as I understand it. Except that the public part doesn't really have any reason to compete. Basic coverage for all. Buy whatever increased coverage you can and/or want after that.

a reply to: Phoenix

While there are plenty of examples where universal healthcare has been adopted across the industrialized world and is providing better outcomes at lower prices, how many successful examples of the system you described can you name?

Who's doing what you propose and how is it working out?

originally posted by: Phage
a reply to: Bluesma

Why not have both private and public healthcare facilities that compete with each other? (in cost and quality of care)

That's sort of the way it works in the rest of the world, as I understand it. Except that the public part doesn't really have any reason to compete. Basic coverage for all. Buy whatever increased coverage you can and/or want after that.

What I perceive here is that the public sector has to compete in terms of quality of care. They strive to keep that up, the private sector strives to stay competative in pricing- and the consumer has full freedom of choice (no matter which facility they choose, they are reimbursed by the national insurance the same amount).

When people have foreseeable need for care (like childbirth- I am a woman, so this maybe an example I am just more exposed to, with my female friends and aquaintances), before choosing where they will deliver, they check out both the private and public facilities and compare them for both of these aspects.

It sort of seems like it gives the consumer more power than what I experienced in the US, where my insurance would dictate which facilities and doctors I could go to or not.

a reply to: Bluesma

What I perceive here is that the public sector has to compete in terms of quality of care.

The idea of competition doesn't really fit into the model. I understand your point about competition, but why would a public sector operation (none of which are renowned for efficiency) be able to offer anything at a lower cost (not to be confused with price) than a private sector operation? Is the public sector operation going to give itself a marketplace advantage somehow? If so, how is that a matter of competition?


The reason I separate cost and price, is that presumably the public sector operation would operate at cost, no fees added.

a reply to: Bluesma

My deceased spouse was for years a director of programs and administration for large mental heath facility associated with a county primary care hospital system that was so-called non-profit.

They made a bigger killing (pardon pun) than their for profit competition.

This was due largesse in salary and bonus for executives, pouring money into facilities to out flank for profit competition and worse fiddle books to hide what we would call profits into recruiting programs and far future facilities either overblown cost estimations - all the while playing footie with mass insurance billing negotiations that never reflected actual costs in order to maximize dollar recovery.

My point is, non-profits under current system are just as or more rapacious of consumers as for profit operations.

In this they enjoy monopolistic status with CON for service areas.

They are now getting known for unnecessary $45,000 helicopter rides billed to insurance providers.

Cover under law has to end.

a reply to: Phoenix

Hm. Okay.

I worked for a public hospital here for a few years, and the pressure from the syndicates seemed to really provide a check or balance in most of what they did. I think all that may go with a different cultural mentality.

a reply to: Bluesma

Syndicates. Labor unions?
Because in the US the word has other connotations.

a reply to: Bluesma

Yeah hear you, being more or less exposed to the executive level and witnessing through experience of spouse the corruption on daily basis I have no illusions of altruism by any connected to financial end of the business.

Holier-than-thou to public but devishly focused on fleecing the money.

IMHO public hanging would be a nicety.

I do firmly believe any and every existing law should be enforced right now today to stop financial rape of our population that has been ongoing for decades by providers, insurance and pharmaceutical companies as well as doctor groups like AMA who promote hiding costs.

No amount of legislation will fix until some go to jail and rest get in line.

a reply to: Phoenix

I do firmly believe any and every existing law should be enforced right now today

Be careful what you believe in. There are some pretty peculiar laws out there.

a reply to: Phage

Not very peculiar at all in case of healthcare industry which has paid politicians for protection from applicable laws.

Downside is folks would have to put partisanship aside to a politician who actually had temerity to apply existing law due the recession that would result as to big to fail 20% GDP falls to manageable 4% GDP

I believe that money would quickly redeploy to "productive" endeavors picking economy back up quickly - not to mention massive boost to businesses when that anchor is removed.

Legislation to allow reimportation of drugs would also help foster competition as well as spread costs of research worldwide rather than just or mainly here.

Group insurance legislation allowing membership like credit unions would help break insurance consortium hold on markets by giving normal folks negotiating power they lack and provide portability desired so preexisting clauses become moot.

It's minor tweaking legislation combined with enforcement of long standing laws would go quite far in getting care affordable and insurance for big ticket care within reach.

That done I cannot see how taxpayers could not afford idiginant care we'd all like to see happen without breaking the bank.

a reply to: Phoenix

Name one large scale government program that has not turned to "snip" due fraud, waste or beauracracy maintaining employment scheme that has met it's goals, budget and has not led to massive deficit increases - did I mention limited access to favored minority classes as well over majority population due political voting blocks, ahem.

this describes our military complex better than any other program the gov't has though... and it seems that the republicans are all for sending them more and more money to waste, lose, and screw us with!

medicare fraud and waste is just a speck of dust compared to what's been going on in the military budget!