ObamaCare, ACA, ObamaTax, Bad. What is your solution?

We've seen multiple threads on ObamaCare (Affordible Care Act).

We've all taken "sides".

Those against it (heroes of light and wonderment and unicorns) have fought heroically against those that are for it (evil darkness badness nasty badness).


For those that are against it, this thread is for you.

Our healthcare does need reform. It needs work. We have Obama's solution, . . . . . .

What is yours?

Mine is to;
Cap malpractice insurance,
Allow interstate movement for insurance companies to operate.
Cap lawsuit amounts.

If hospitals are paying less, then they can charge less. If doctors are paying less, then they can charge less. Lawyers, DC are the problem.

They are not the solution.

How about you, ATS? What are your thoughts? Let's "think-tank" this and solve the worlds problems.

beez

Some theories have mentioned Medicare.

It needs work too, but many say to simply include all Americans.

I wonder what that would add to existing payroll deductions ?

The contractors are already running that show anyway.

There would be no loss to the "insurance" companies if they just became contracted administrators.

Medicare is using contractors more and more. And we don't hear them complaining.

My solution would never work...

It would be to get rid of insurance ENTIRELY and have flat rates for all medical procedures, established in writing before any procedure takes place, with hospitals and patients directly negotiating terms of payment.

Like I said, would never work, too much money to be made in 'insurance', which is simply another term for gambling.

reply to post by Dreine
If insurance companies were allowed to cross state lines, then smaller companies could compete and effectivelly reduce costs.

Originally posted by xuenchen
Some theories have mentioned Medicare.

It needs work too, but many say to simply include all Americans.

I wonder what that would add to existing payroll deductions ?

The contractors are already running that show anyway.

There would be no loss to the "insurance" companies if they just became contracted administrators.

Medicare is using contractors more and more. And we don't hear them complaining.

Can you expand on "contractors"?

What are they in relation to insurance companies?

Forgive my stupidity.

Originally posted by beezzer

Mine is to;
Cap malpractice insurance,
Allow interstate movement for insurance companies to operate.
Cap lawsuit amounts.

If hospitals are paying less, then they can charge less. If doctors are paying less, then they can charge less. Lawyers, DC are the problem.

Here is the confusion with this thinking...sure all of those things might position doctors and hospitals and insurance companies to charge less...but why would they?

In capitalism price is determined by supply and demand.

SUPPLY
Doctors supply healthcare, Hospitals supply healthcare, Insurance companies supply a scheme of payment where otherwise the costs would be prohibitive as most people don't have the 50k in pocket to pay to get thier appendix removed when it explodes as opposed to dieing painfully.

DEMAND
Healthcare is not an IPad, a new PC, a Car, a home....thier is constant demand that has ZERO Price Elasticity. You get cancer...Your Appendix explodes...You child gets hit by a car...You pay and you pay whatever the Docs, Hospital and Insurance Company determines you pay.

Do you think that Doctors are hurting for money? Do you think they will forgoe that new sports car and simply choose to charge less?

Doctors, Insurance Companies, Hospitals are not doing anything wrong, they are simply playing by the rules of capitalism, but unfortunately for consumers and for better or worse...fortunately for Docs, Hospitals and Insurance Companies....Cancer does not care about Price Elasticity or Supply and Demand...it does not care about Capitalism.

You can cap lawsuits until the cows come home...Gov interventuion by the way...but that will not effect costs, because the costs are determined in a capitalistic equation that is rigged...Cancer does not respond to price.

reply to post by Indigo5
It would open up competition. Competition would lower the price.

The majority of cost when it comes to healthcare comes by government rules,regulation,followed by doctors and hospitals own "insurance" malpractice in other words tort reform.

In this country we have private healthcare "competing" with medicare,and medicaid 3 choices my solution take a look at how ever they are running automobile insurance, and home owners insurance and see why that is cheaper than healthcare insurance.

Wonder how much unions drive up cost the cost of things today is not so much about the products but the labor involved.

Here's what you do.

Firstly, remove the ability of Big Pharma to pay doctors to sell their designer drugs instead of alternative, low cost natural medicines.

2nd, create a two tiered system of heatlhcare, one public, one private.

Force the private companies to provide equal coverage to the public system at lower rates, however allow them to offer premium packages that cover things the public coverage will not, like electives or things of that nature.

Include it as a TAX on all Americans to pay for it, provided EVERY citizen with basic healthcare at no cost and then premium healthcare with either a private plan, or out of pocket expenses for a certain percentage.

We know that countries that have subsidized government healthcare ( france, the netherlands, canada, England etc..) have generally healthier populations, which then leads to less money spent on healthcare because there are less people being treated. I'm not saying they are perfect, plenty of trouble to go around.

However in a hybrid system things would be better IMO.

The problem with America is that you are probably one of the un-healthiest nations on the planet, and so of course, in the first decade or so, the cost would be enormous, but it would eventually decline as people become healthier, without having to break the bank to do so.

So how to you manage the cost?

Cut defense spending and the needless other useless programs that exist.

~Tenth

reply to post by beezzer


My solution? to throw Obama and his obama care out of the white house in November, without legislation to pursue the tax by the IRS it will be not way they can enforced on the people.

Get the crap out of the white house and see which politician will dare to legislate on the tax.

Originally posted by beezzer
reply to post by Indigo5

 

It would open up competition. Competition would lower the price.

edit on 2-7-2012 by beezzer because: (no reason given)

In a model where demand is fixed (need for healthcare) ....increased competition amongst insurance companies would make insurance companies more efficient, but not improve healthcare as they would flee regions and consumers who represent higher medical loss ratios and focus on the most "profitable" customers...wealthy or healthy or both.

You are still treating disease as if it's prevelance responds to capitalistic equations.

Originally posted by tothetenthpower
Here's what you do.

Firstly, remove the ability of Big Pharma to pay doctors to sell their designer drugs instead of alternative, low cost natural medicines.

Wow...am I on board with that one! Here is a question...if Doctors are the ones that are qualified to determine treatment plans and best medications...and the only ones that can legally prescribe those medications...why is every other commercial on television aimed at convincing the consumer they need some new prescription drug to make them happy or horny???

Cuz Big Pharma wants that consumer to go and tell thier doctor what prescription drugs they WANT!!

Big Pharma spends billions advertising drugs to consumers...that only doctors can prescribe....

If you are telling your doctor what drugs you want...he is not your doctor...he is your dealer..

Just sick IMO and Pharma should be banned from advertising prescription drugs to consumers. Let the drugs efficacey be demonstrated through testing and practice...not a marketing campaign to get consumers to bully thier doctors into writing prescriptions.

join a Universal Medicare/Prescription program... cost based on net worth... means testing

if you are well off enough to supplement the Universal Medicare coverage with private insurance
then you have the right to do so...
but everyone will be paying for the basic Medicare plan the government protects the retired with
it will be a universal weekly/monthly Tax on every citizen rich or poor of legal age until death.

a market for medical coverage by private companies is not workable because they will secretly be price fixing under-the-table knowing full well they will not be prosecuted but only fined just like the 'banksters' are now
all sorts of collusion will be going on as to treatments covered/costs etc

reply to post by Indigo5


No, I'm not in favor of banning any particualr industry from being able to advertise.

It's just a matter of them providing the correct information as opposed to promises of treatment that rarely work and require more drugs to combat side effects.

My point isn't to limit the business it's simply to level the playing field.

~Tenth

I wouldn't change anything too much too fast. Lots of small changes over time and keep what works and revert anything that doesn't work back to the original system or a new trail system. It would involve slow trail and error as well as plenty of debate over what is changed and what isn't along the way. My biggest fear is always having too drastic change without properly thinking it though and involving as many people as possible in the planning and debate. This is how I would deal with any policy besides war or disasters where you have to act fast. Though I would want to have contingencies drawn up for these situations and not be entirely acting in the heat of the moment even in these cases. Slow, steady and prepared wins the race

Originally posted by tothetenthpower
reply to post by Indigo5

 

No, I'm not in favor of banning any particualr industry from being able to advertise.

It's just a matter of them providing the correct information as opposed to promises of treatment that rarely work and require more drugs to combat side effects.

My point isn't to limit the business it's simply to level the playing field.

~Tenth

We do not allow tabacco companies to advertise to children, ditto booz.

Prescription drugs are not sold over the counter because those without a medical degree might make bad choices with fatal consequences.

I see no reason why Big Pharma should be allowed to spend billions to drive demand and use of prescription drugs which can't be legally obtained by the consumers they are advertising to.

reply to post by Indigo5


We should not prevent any business from advertising it's products. The pharma advertising is kind of moot point because they need doctor's to prescribe the meds, which is why they pay them everytime to sell a certain drug.

That goes hand in hand with the advertising. If we outlawed this practice, of doctors sellling whatever drug comes out and getting a commission, then there'd be no reason for them to advertise.

~Tenth

Malpractice suits were capped in Texas around 10 years ago. It hasn't reduced the costs. I guess you could presume that it kept costs from rising more than they have, but I don't have anything to back up that claim. No reason to think it would reduce costs anywhere else if it hasn't happened in Texas over 10 years.

Originally posted by beezzerMine is to;
Cap malpractice insurance,
Allow interstate movement for insurance companies to operate.
Cap lawsuit amounts.

If hospitals are paying less, then they can charge less. If doctors are paying less, then they can charge less. Lawyers, DC are the problem.

They are not the solution.

You suffer from the illusion that free markets are necessarily better than imposed solutions, or better than regulated competition. The hard truth is that free markets OFTEN produce undesirable results, and medical care is one of those industries. The problem with the cost of medicine is that there is inelasticity of demand. Bottom line, if you need cancer treatment, you don't care what it costs. That makes the demand curve very steep, meaning price does little to reduce quantity demanded. The result of that is that the industry provides large quantities of expensive care.

The hard fact we have to face is that what needs reform is the rationing mechanism. The current mechanism, price, does a lousy job, so costs are out of control. The only answer is some form of regulation, which at the most efficient level would look like a single payer system. In the U.S. that is probably politically impossible, so we are left with regulated competition, which is, in essence, what Obamacare is. In my opinion, it does not go nearly far enough in encouraging transparency in pricing and in regulating profits, but it is a start, and it will be a success measured against the consumer's nightmare we have now.

Originally posted by beezzer

Originally posted by xuenchen
Some theories have mentioned Medicare.

It needs work too, but many say to simply include all Americans.

I wonder what that would add to existing payroll deductions ?

The contractors are already running that show anyway.

There would be no loss to the "insurance" companies if they just became contracted administrators.

Medicare is using contractors more and more. And we don't hear them complaining.

Can you expand on "contractors"?

What are they in relation to insurance companies?

Forgive my stupidity.

Apparently they are "insurance" companies.

They seem to be running Medicare.

here are some links to see.

I hope someone can give a detailed explanation.

I am looking into the whole deal.

By 2011, new Medicare Administrative Contractors (MACs) will replace Medicare contractors. The Centers for Medicare & Medicaid Services (CMS) contract with insurance companies nationwide to evaluate, process and pay over 1 billion Medicare claims each year. Medicare contractors who operate under insurance companies use national and local coverage regulations and policies to determine what is "reasonable and medically necessary" for paying claims.


Medicare Contractors

There are two types of Medicare contractors. The "fiscal intermediaries" process part A claims for health care facilities. The "carriers" process part B claims for physicians. Here's the problem: Carriers were contracted with one insurance company, and fiscal intermediaries were contracted with a different insurance company. So for one jurisdiction part A claims were submitted to one insurance company and part B claims were submitted to a different insurance company. In 2001 the General Accounting Office identified problems associated with the processing activities of claims and payments. Congress took action to reform Medicares contracting methods.


Medicare Reform Act

In December 2003, Congress passed a law requiring the CMS to reforms its contracting methods for processing Medicare part A and B claims. The CMS is replacing all Medicare Contractors (23 fiscal intermediaries and 17 carriers) with 23 MACs under new insurance companies that will be responsible for processing all Medicare claims for payment.


New Medicare Administrative Contractors (MACs)

By the end of 2011 all of the jurisdictions will be fully transitioned to new MACs. This will provide a one-stop shop to ensure a smoother and more accurate process from claims to payments, and to better serve providers and beneficiaries. The new A/B MAC list by jurisdiction is located in the resource section.

What Is a Medicare Contractor?

Medicare Contractor Jurisdictions Maps