Universal Healthcare? YES, we CAN!

a reply to: TheRedneck

The United States of America has had single payer health care system in place since 1930. It is called the Veterans Administration.
It is a shame how that government agency treats veterans, it is an even bigger shame that you want to treat all Americans that way.

An excellent post. Of course we can have universal healthcare. Obamacare was doomed from the start. That was obvious simply because insurance companies stood behind it. It's greatest failure was it did nothing to address why healthcare in America is terribly expensive. The same treatments are typically far less in most countries. Sure, we have a high cost of living here; but that does not explain the disparity. Greed comes to my mind as the most plausible explanation.

a reply to: TheRedneck

Very interesting! I will come back to this with more time because to completely read your proposal, but I like it!

All big things have small beginnings? =]

a reply to: dbarnhart

1. I don't see anything in there about people who choose not to purchase insurance.

This is a complete replacement for Obamacare. It will not work, won't even make sense, as long as Obamacare is in force in any way whatsoever. The entire document specifies insurance as a voluntary commodity; otherwise why would doctors need a collection agency?

2. The fact that insurance companies cannot deny benefits (no pre-existing conditions) means that the insurance companies' financial exposure is unlimited. We'll end up with the same problem we have now: sky-high premiums.

Actually, I am working on putting in a new section about that. Insurers will continue to be responsible for conditions that occur during the time their policy is in effect even after the policy is cancelled for any reason. No insurer will then be responsible for pre-existing conditions.

Of course, present policies which do cover pre-existing conditions will have to remain in effect. The new rule would only cover new policies, except that older policies would still be subject to continuing coverage. That is going to put one heck of a dent in some insurance companies' profits, but they certainly just got through putting a dent in ours.... time about is fair play.

My biggest concern is how to handle insurers which shut down due to bankruptcy... I'm thinking along the lines of specifying that there would have to be an accounting of all assets to establish escrow accounts for those still needing treatment. Corporate officers should not be allowed to receive any bonuses for a period of six months before the bankruptcy either, or should be required to return them through the bankruptcy court.

3. I see nothing in there allowing a doctor to stop accepting new patients when his workload gets too high.

The entirety of II(B):

Paragraph II(A) of this Act shall not be deemed to apply to any person who

1. Is in the act of seeing Regular Patients,

2. Is unable to effectively perform the service(s) requested or required due to inability to access proper medical equipment or facilities.

3. Is engaged in a reasonable period of rest/respite/recreation.

4. Has performed his/her service for a period of time typically reserved for professional service, such as work hours, which was advertised and is typically observed.

If a doctor has appointments, that is seeing a Regular Patient (see the definitions). If there is no appointment, he has to take walk-ins. Period. He does not have to see patients after work, during vacation, etc., but he cannot turn down a patient needing help if he has the time to see them.

If we want everyone to have health care, doctors must be required to provide health care. The days of a doctor just saying "I'm not seeing new patients" with an empty waiting room will be a thing of the past.

TheRedneck

a reply to: TheSemiSkeptic

No, I want all Americans to have good health care. If you would just read the paper, you would see that.

The VA needs to be cleaned up with an acid bath. The way it operates is shameful. I am offended that you made the illogical leap that I was trying to expand the VA to all Americans.

Pundits... *shakes head*

TheRedneck

a reply to: tabularosa

And the greed lies to a large extent in the insurance companies... the very ones Obamacare put in charge of everything.

TheRedneck

OK, I have a new version uploaded: linky.

I made several corrections, from typos to clarifications (including specifying that no insurance requirement to obtain medical care exists). I also made some additions based on suggestions made:

• Clear and open pricing schedules at all medical locations.
  
• Easy access to all medical records.
  
• Clarification of FMRB to prevent conflicts of interest.
  
• Insurers would be required to continue paying on medical issues that occurred during their coverage. Pre-existing conditions would not be mandated to be covered, because the previous insurer would still be liable. (I haven't addressed the possibility of insurers going out of business, but I also haven't outlawed coverage for pre-existing conditions... let the marketplace decide.)
  
• Explicit clarification that no one is required to purchase health insurance, but they are responsible for medical bills (subject to the new FMCS arrangement).

A few things I agree with, but I also don't think they are necessary to the framework. Things like the "orphan drug" policy need to be addressed, but I think too much in a single bill is just asking for trouble. Maybe if I can get this one even discussed, I will be in a position to suggest other things later.

Still looking for input... I have gotten a lot of good ideas thus far.

TheRedneck

na reply to: TheRednecki am for it . damn the insurers they have no business being in healthcare. . i say make s 2 to 5 cent on the dollar sales tax on everything not already federally taxed that way everyone would contribute even illegals. that should be plenty of revenue to pay for it

a reply to: TheRedneck


I like most of your proposal. I would really like to see this go somewhere, but healthcare is a really messy service industry, for lack of a better way to define it.

I work in a hospital where there is a large proportion of older physicians, who could retire, but thankfully have not retired yet. They often limit seeing new patients, and just see their old prior patients who are familiar to them, in the years before they actually retire.

Your idea of this: "If we want everyone to have health care, doctors must be required to provide health care. The days of a doctor just saying "I'm not seeing new patients" with an empty waiting room will be a thing of the past." ... well, where I live, the older doctors would just retire rather than work all the hours a younger doctor might be willing to work, and new younger doctors are really hard to recruit in my dying rust belt town. Nobody wants to come here, and when we lose a doctor these days, their patients lose their local care.

I know what you are trying to accomplish, but in the real world, there are so many variables.

How do you force a doctor to see patients, when they are only working 'for the fun of it', don't need the money anymore, and can just retire?

a reply to: Fowlerstoad

There's nothing in my proposal that says how many hours a doctor has to work. An older doctor can open his office 4 hours a day, three days a week if he wants, as long as he establishes that as his hours.

I see your point, but I am at a loss for how to accomplish both goals. They seem to be at odds with one another.

On second thought, how about an additional caveat that doctors may be exempt from seeing new patients after a certain age (55? 60?), provided they continue to see any established patients that need care regardless of ability to pay?

Thanks for the input. That is a legitimate concern.

TheRedneck

a reply to: TheRedneck

Or maybe this would work ... define however many hours a full time doctor works as 1.0 FTE, and then give the doctor the option to work more or less, say possibly 1.5 FTE for an overachiever, and 0.5 FTE if they want to be part time, and pay them according to that kind of schedule.

FTE = full time employee

Then, within their hours, and / or within their established patient load, they must see whomever they can, regardless of ability to pay.

I completely agree that ability to pay should have zero bearing on who can see a doctor, and who cannot.

The current system is just rife with abuse.

Today for instance, there was a patient supposed to have a biopsy at a nearby private for-profit clinic in my town, but since the patient has no insurance, and cannot pay, they are sending that patient here to my hospital to have the same procedure.

The hospital cannot turn the patient away like a private clinic can, and must do the procedure, even though for the hospital it will eat up the time of 2 technicians for about an hour, and will consume a bunch of medical supplies that will need to be replaced.

The hospital will be forced to eat this as a loss, while the private clinic keeps their 'profit' from all their other paying patients.

How is that in any way fair?

Yes, something must be done.

a reply to: TheRedneck

Based on this bullet-point from your post:

""Insurers would be required to continue paying on medical issues that occurred during their coverage. Pre-existing conditions would not be mandated to be covered, because the previous insurer would still be liable. (I haven't addressed the possibility of insurers going out of business, but I also haven't outlawed coverage for pre-existing conditions... let the marketplace decide.)""


Are you backing away from the Universal HealthCare concept?

a reply to: Fowlerstoad

That's the very issue I am trying to address. Medical service is extremely high-paying, as it should be based on the amount of education required. But with authority comes responsibility. The authority to practice medicine is a lucrative license and should come with it a responsibility to care for people without concern over costs.

Many practices now have split their service into the medical and the financial in an attempt to handle this dilemma. My proposal would make this mandatory... actually would eliminate the financial side and let doctors doctor.

Under my plan, there is no set number of hours a doctor must work. Each doctor sets their office hours, and as long as patients come in during those office hours and there's no appointment, they must be seen.

TheRedneck

a reply to: carewemust

No, I'm not backing away form anything. II(A)-1, the first line after the definitions states clearly that no one may be turned away for inability to pay. Period. I don't want universal "coverage." I want universal healthcare. There's a huge difference. Insurance is a commodity; people should be able to buy it if and how they choose, not have the government mandate that they have to buy this plan at this time form these companies or they're breaking the law and will be fined. That's as un-American, unrealistic, and absolutely economically stoopid in the extreme!

All I am saying is that medical insurance is a contract between the patient and the insurer to pay the medical costs in case a medical issue arises. Medical issues are not always resolved quickly, and can often create a situation where a patient cannot continue the policy for financial reasons (lost work, unable to work, etc.) If an issue happens while someone is covered under a policy, it is just plain old wrong for the insurance company to only pay until the patient runs out of money... but that happens!

Example: you have a medical policy that covers cancer. You're living your life just fine until one day you are getting a checkup and - whoops - the doctor tells you you have skin cancer! No sweat... you're insured. You go to a hospital for chemo... and back in a month for more chemo... and another month for more chemo... all the time your boss is getting tired of having to cover for you, and the next thing you know, he tells you that you haven't been able to make production and he has to let you go. Not totally unexpected because most days you can't work at anything but a snail's pace anyway due to the chemo. The problem is, now you don't have the insurance any more! So you try to buy insurance, but they either don't cover the pre-existing condition, or they charge you more than you make on disability for the policy. You're screwed, glued, and tattoed, royally!

Under my plan, the insurance company would have to continue paying for your cancer treatment because it happened while you were insured. They can cancel the policy, but coverage for your condition continues until you either die or get cured. You can get another policy through another company, and your old insurer is still stuck with the bill. The new policy would cover a heart attack, but they would not have to cover the cancer.

That's all that is about: insurance is a gamble by definition, and the tables are all rigged in today's system so that even if the insurance companies lose the gamble, they can win by forcing the loss onto you. My plan stops some of that.

TheRedneck

originally posted by: TheRedneck
a reply to: Blueracer

Government is already involved. That was the biggest problem with Obamacare.

TheRedneck

Two wrongs don't make a right. Government was wrong to ever interfere with the medical free market. Continuing to do wrong by deepening government's involvement won't magically make things right. The only rational solution is to extract government entirely from the healthcare funding industry (and yes, I also mean Medicaid and Medicare for all not presently on Medicaid or within 5 years of qualifying for Medicare.)

Let the free market fix the mess that was made when the government decided to violate natural law and smart business.

when you look at the surgery centers that only take cash, or private insurance, they say that if they accept govt insurance they are not allowed to post their prices.

So they do not take them and they can publicly list prices for procedures, and give written quotes before the procedure is even done, also if you believe them they undercut the costs charged through the ACA insurers by a lot.

Seems odd, cant say what it will cost on their web sites and without the govt it can be done cheaper. (according to testimonials) Seems like those govt safety nets are part of the health care cost problem.

But that is for smarter more detail oriented people to figure out.

a reply to: burdman30ott6

Two wrongs don't make a right. Government was wrong to ever interfere with the medical free market. Continuing to do wrong by deepening government's involvement won't magically make things right.

I don't see how I am deepening government involvement. I am removing all mandates except the one to force healthcare for all. Everything else is optional. No one has to use the FMCB for collections. Insurance is still available, but no longer mandatory. I am actually eliminating Medicaid, because my plan does what Medicaid is supposed to do, without all the government paperwork.

I am leaving government "intrusion" in collections, and I am forcing insurance companies to provide a fair product. If you consider that undue government influence, then we'll just have to disagree. The Preamble of the United States Constitution itself specifies "establish justice" and "promote the general welfare" as two of the document's intentions. I believe government does have a role in ensuring the marketplace is fair... just not in controlling the marketplace one jot or tittle past that.

The only rational solution is to extract government entirely from the healthcare funding industry

The poor will always be among us. I have no problem with helping them. I consider it an honor to help them. As long as doing so doesn't overly harm others.

TheRedneck

originally posted by: TheRedneck
I have no problem with helping them. I consider it an honor to help them.

Then, by all means use your personal money and help them. Forced charity is neither charity nor altruistic. Tax payers aren't "helping the poor," we're "having money taken by threat of legal action from us to go through a politician's hands and be redistributed to others in exchange for votes." Whichever politician promises the biggest dowry gets the vote for an evening of fun and magic each election night.

a reply to: burdman30ott6

Normally I would agree with you. But we're talking about life or death for quite a few people, and complete financial ruination for others... all because of too much governmental interference.

The optimal solution is for there to be no need for government involvement, but sadly we do not live in an optimal world. The optimal solution for Iraq was for us to wrap it up and walk away, but we all saw how trying to enforce an optimal solution in a non-optimal world doesn't work. We walked away without stabilizing the mess we made. In that case, we got to deal with ISIS and effectively extended our involvement for some more years, at the cost of US treasury and lives. In the case of health care, walking away without trying to stabilize the problem government created will give us many actual deaths from lack of care.

I share your desire for the optimal solution, but I am not willing to turn my back on fellow Americans because I want something that I know cannot exist. Further, I am not willing to allow others to turn their back on their fellow Americans for that reason either. I am willing to work toward a better solution, a more optimal solution, than the absolute disaster we have now.

TheRedneck

a reply to: Irishhaf

Any time government becomes involved in anything, the cost goes up. It's like a law of nature, but nature of course has nothing to do with government. Nature works effectively.

TheRedneck