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Post by pjohns1873 on Feb 18, 2014 17:00:31 GMT
Dr. Ben Carson, in America the Beautiful, has an interesting suggestion as regarding healthcare in America.
His reasoning goes something like this:
(1) Close to half of our healthcare dollars are spent on healthcare provided within the last six months of patients' lives.
(2) It is this enormous expense that has driven up the cost of private healthcare policies.
(3) The problem could be obviated by freeing healthcare-insurance companies from providing any catastrophic coverage.
(4) The government, in turn, would have a "catastrophic health-care fund" to provide for precisely such matters.
(5) This would be funded by "allow[ing] insurance companies a 15 percent annual profit, 5 percent of which would go to the government's national catastrophic health-care fund." (Presumably, this is intended to mean 5 percent of the total, or 33 1/3 percent--not 5 percent of the 15 percent, or 0.75 percent.)
I am somewhat noncommital as concerning this suggestion. On one level, it does make some sense: If insurance companies did not have to spend so much money on paying for catastrophic care (including end-of-life care), private healthcare insurance could be much less expensive--and therefore, much more affordable for many.
On the other hand, I am less than thrilled with the idea of the government's being allowed to dictate the profit margins of private companies. (Dr. Carson sees this as analogous to the government's regulation of utilities.)
Comments?
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Post by iolo on Feb 18, 2014 17:19:28 GMT
Full national insurance is the only answer. Americans are nuts, mostly.
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Post by pjohns1873 on Feb 18, 2014 18:09:31 GMT
Americans are nuts, mostly. That is not a reasoned response; it is merely a smackdown (which is precisely what I try to avoid, in all of my threads). |
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Post by iolo on Feb 18, 2014 18:22:58 GMT
Americans are nuts, mostly. That is not a reasoned response; it is merely a smackdown (which is precisely what I try to avoid, in all of my threads). Well done - keep it up! (The forum, alas, demands verbosity). |
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Post by dangermouse on Feb 18, 2014 21:49:32 GMT
Full national insurance provides the maximum cover for the maximal service funded by spreading the cost among the maximum pool of clients.
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Post by pjohns1873 on Feb 20, 2014 15:36:10 GMT
Full national insurance provides the maximum cover for the maximal service funded by spreading the cost among the maximum pool of clients. Well, that is the theory, anyway. In actual practice, however, I am inclined to believe that government-sponsored healthcare insurance--especially if it is animated, principally, by a desire to rein in costs--is likely to result in the rationing of healthcare; and that the elderly are especially vulnerable in this regard, as they are, statistically, the largest consumers of healthcare. (Besides, it may prove very easy to rationalize that the elderly have "lived their lives already"; so there is no point in "wasting" precious healthcare dollars on expensive treatment for them, when much less expensive palliative care is available as an alternative.) This is what is sometimes referred to, loosely, as "death panels." Although the term strikes me as being a bit crude--and it is simply too inflammatory for my tastes--it is probably correct, essentially, in the point that it is attempting to convey. As Conservative Infidel--admittedly, a right-wing website, as the name implies--puts it: Here is the link: www.conservativeinfidel.com/uncategorized/old-given-cancer-treatment-nhs-writing-patients-75/ Or again: The Daily Mail--which the left simply loves to excoriate--notes the following: Again, the link to the entire article: www.dailymail.co.uk/news/article-2561657/Too-old-lifesaving-drugs-Anger-plan-deny-treatment-youve-fair-innings.html |
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Post by pjohns1873 on Feb 20, 2014 17:12:12 GMT
That is not a reasoned response; it is merely a smackdown (which is precisely what I try to avoid, in all of my threads). Well done - keep it up! (The forum, alas, demands verbosity). So, you believe that my response is a bit too wordy? Or is it possible that you might object to the substance of my words; and that you feel ill-equipped to attack that? |
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Post by iolo on Feb 21, 2014 12:55:10 GMT
So, you believe that my response is a bit too wordy? Or is it possible that you might object to the substance of my words; and that you feel ill-equipped to attack that? Just that I couldn't send my intended message because it was too short, that's all, so I had to fill up. |
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Post by ShivaTD on Mar 12, 2014 9:46:36 GMT
Here is a problem as I see it. We've had an estimated 45,000 people that die annually because they don't have private insurance so they often didn't have routine exams that would provide early detection of a curable desease. By the time the symptoms reach the point that they can't be ignored and are finally diagnosed they patient only has six months or less left to live. Had the desease been detected sooner they won't have died.
Basically this proposal is closing the barn door after the horse is gone. It waits until the person is too sick to be cured and then just funds the costs of the medical expenditures that won't save their lives.
Isn't it better to have early detection where the desease is curable as opposed to funding the "last dying breath" of a person that is beyond any real hope of survival for more than six months?
Additionally while possibly lowering the cost of health insurance is admirable realize that about 40 million Americans don't even earn enough to put all of the food on the table they need based upon the number of households collecting SNAP benefits. Those 40 million Americans won't voluntarily purchase private health insurance even if the cost is dramatically reduced. Even the "individual mandate" for Obamacare is having a hard time in getting those people to enroll when the federal government is subsidizing their health insurance (i.e. reducing the costs dramatically).
BTW From what I understand about 1/2 of all health insurance companies are "not for profit" and don't have any profits to tax and the others really aren't earning over 15% in profits so the "funding" mechanism is rather questionable. |
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Post by newsman on Apr 8, 2014 15:16:44 GMT
Full national insurance is the only answer. Americans are nuts, mostly. Agreed, for-profit health insurance is nothing more than healthcare scalping. They provide no value and only add costs unnecessarily. |
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Post by ShivaTD on Apr 17, 2014 16:57:13 GMT
Agreed, for-profit health insurance is nothing more than healthcare scalping. They provide no value and only add costs unnecessarily.
To my knowledge there is no significant cost difference between "for profit" insurance and "not for profit" insurance so this argument is rendered moot. "For profit" private insurance is basically forced to figure out a means of wrangling out a relatively small profit margin while providing comparable health care benefits at basically the same costs as the "not for profit" insurance companies.
What we also know is that private insurance companies, regardless of whether they are for profit or not for profit, have substantially less fraud associated with them which is why they provide superior health care benefits than government (public) health insurance programs.
In truth many of the costs associated with "public" health insurance are driven by politics where underfunding of the costs of services actually drives up the total cost. By way of example Medicaid/Medicare don't pay enough to cover the actual costs (not profits) of primary care. As a result instead of "treating the patient" a primary care provider refers them to a specialist that charges 4 to 5 times as much to treat the patient. It only takes a few minutes for the primary care provider to refer a patient but much longer to actually treat them.
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Post by fred on Apr 18, 2014 0:47:26 GMT
Americans are nuts, mostly. That is not a reasoned response; it is merely a smackdown (which is precisely what I try to avoid, in all of my threads). The bit of the post you chose to reply to was, but you ignored the rest. Now we have a post to answer and, in my humble opinion, an accurate one. If you intend to have universal health care, you have a national insurance system and take over hospitals so they become care centres, not businesses. Private care will always be more expensive because they are companies, capitalists, so out for profit. I'm naturally a Tory Thatcher lover but, much as I dislike left leaning rubbish, iolo is still correct in his post. If you're going to have universal health care, NI is easily the best way to do it. That's why Americans are mostly nuts. You're trying to fudge a half policy that'll have a million problems and cost far more as you also have to pay the profits. |
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Post by pjohns1873 on Apr 18, 2014 2:28:23 GMT
That is not a reasoned response; it is merely a smackdown (which is precisely what I try to avoid, in all of my threads). The bit of the post you chose to reply to was, but you ignored the rest. Now we have a post to answer and, in my humble opinion, an accurate one. If you intend to have universal health care, you have a national insurance system and take over hospitals so they become care centres, not businesses. Private care will always be more expensive because they are companies, capitalists, so out for profit. I'm naturally a Tory Thatcher lover but, much as I dislike left leaning rubbish, iolo is still correct in his post. If you're going to have universal health care, NI is easily the best way to do it. That's why Americans are mostly nuts. You're trying to fudge a half policy that'll have a million problems and cost far more as you also have to pay the profits. Sometimes there is a disqualifying event (or a disqualifying sentiment). A good example of this is the silly question, "Other than that, Mrs. Lincoln, how did you enjoy the play?" Well, sometimes it is just unreasonable to suppose there is an "other than that." As, for instance, when you festoon your core observation with the comment, "Americans are nuts, mostly." Nonetheless, I will attempt to respond. I believe that UHC would be a bad thing--certainly worse than the system of employer-based healthcare--but that it would represent a substantial improvement over ObamaCare, anyway. |
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Post by ShivaTD on Apr 18, 2014 10:27:48 GMT
I believe that UHC would be a bad thing--certainly worse than the system of employer-based healthcare--but that it would represent a substantial improvement over ObamaCare, anyway.
An interesting statement because it ties into something I proposed.
My proposal would be that all employers should either provide group health insurance for their employees or pay into a fund that would help subsidize the purchase of private insurance purchased by the employee. I estimated that today cost per hour would be roughly $1.50-$2.00/hr/employee regardless of whether the enterprise decided to pay for group insurance or fund the subsidy. This "fixed" one of the huge problems with Obamacare where a person might be holding down two part-time jobs working over 40 hours per week total or for a company with fewer than 50 employees where there was no employer obligation related to their health care needs.
This proposal would put the burden on the employers that are profiting from the labor of the employee and would provide the maximum about of insurance coverage for working Americans.
Of course there would also be those that still couldn't afford the insurance perhaps because they can't work or are limited to how many hours they can work or whatever in which case Medicaid, as originally envisioned, would remain a safety net if properly funded.
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Post by newsman on Apr 18, 2014 12:55:06 GMT
Agreed, for-profit health insurance is nothing more than healthcare scalping. They provide no value and only add costs unnecessarily.
To my knowledge there is no significant cost difference between "for profit" insurance and "not for profit" insurance so this argument is rendered moot. "For profit" private insurance is basically forced to figure out a means of wrangling out a relatively small profit margin while providing comparable health care benefits at basically the same costs as the "not for profit" insurance companies.
What we also know is that private insurance companies, regardless of whether they are for profit or not for profit, have substantially less fraud associated with them which is why they provide superior health care benefits than government (public) health insurance programs.
In truth many of the costs associated with "public" health insurance are driven by politics where underfunding of the costs of services actually drives up the total cost. By way of example Medicaid/Medicare don't pay enough to cover the actual costs (not profits) of primary care. As a result instead of "treating the patient" a primary care provider refers them to a specialist that charges 4 to 5 times as much to treat the patient. It only takes a few minutes for the primary care provider to refer a patient but much longer to actually treat them.
No argument is rendered "moot" just because you are unaware of the facts. For profit insurance companies have some obvious cost factors non-profits do not in the form of profits, enormous executive compensation and dividends for shareholders, all of which add to the cost of doing business. The overhead for operating Medicare is only 3%, but the average overhead of a for-profit insurance company is 19%. www.pnhp.org/PDF_files/ForProfitCare.pdfIn order to compete, for profit insurance companies have to offer inferior services for inflated prices. The simple fact is that there are simple some things that are not better off when subjected to the ravages of the market and are therefore the rightful responsibility of the government to provide. In my opinion those things include, police and fire services, education, military, prisons and health insurance. |
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