Health care: What they're proposing vs. what will pass
McCain and Obama agree we need health care reform, but neither of their plans is likely to pass Congress without drastic changes. What reform do you think we need?
From barbara,tehacahpi calif Iam a small business woman , with untilites and taxes , and prices of goods rising now we have to pay for health care for employees. I know when this passes and its said and done I will quit there no point stressing over staying in business when the government is making it inpossiable. I make less and less every year , I think working for somebody would be easier than being self employed. I think this counrty should brace its self for mass lay offs and small mom and pop business going under . If this country plans to to keep getting there tax monies they need to keep business alive not kill them.
From Ruiz-Perez, MD Galveston, TX What we need to address first is the biggest expense in health care:
Hospital and health insurance costs.
This includes cost of hardware, medications, use of technology (MRI, CT, labs, etc). All these account for 40% of health care costs and their price market is ruled by a greedy profit-avid sector. We need to regulate this expeditiously.
Just to grasp you attention:
Why a typical hospital admission to rule-out MI costs around $5,000 in the US and only $500 or less in other countries? The answer is that in other countries people will not pay $5,000; so the market self-adjusts.
Why is the price of a broad spectrum antibiotic can reach $300 in the US and sells in others for $50 (even from the same lab company)?
And, what is this relationship between health-ware vendors and Insurance companies willing to pay for over priced hardware (say total knee prosthesis- up to $6,000, excluding hospital costs) when in other countries the entire case can be done with the same results for only $4,000-$5,000. By the way these same insurance companies will only pay $1,500 to the Doctor per a 2hr and complex case including some f/u for free; pay $600 for a 2:00 AM ruptured appendix or pay $60 for an office visit (60% of the $60 is absorbed by overhead of which 14%-20% is just the cost of collecting from these insurance companies).
These are the things we need to start regulating in order to bringing costs down to a feasible reality that will allow us to keep health care costs below the National Gross Produce ( you think I'm exaggerating, is almost 40% of the NGP)
Current plans to cut on Medicare/Medicaid reimbursement to providers is not a solution and will only increase shortage of Doctors in already undeserved areas.
Docs can't sustain this any more. Surgeons, Internists, and Primary care providers are closing their offices and running away from rural areas seeking refuge in large metropolitan areas and is because this cuts added to the low volume of patients they see.
What is the repercussion of this shortage of providers,well, people needing to be referred to a larger city hospital either via EMS or helicopter, thus increasing the costs even more.
If we really want o fix this problem we need to regulate more health care industry, you wouldn't let a group of farmer manipulate produce prices to the point that buying an apple will cost you $10, so why we allow these insurance companies and health-care vendors to profit without limits?
Capitalism is not an excuse any more, specially when American don't have elsewhere to purchase health and are obligated to dance to the swing of the puppet master.
From JD, RTP, NC Get rid of the lobbying firm Fierce, Isakowitz, and Blalock. They were profiled in Fortune:The Power Issue several years ago as devoted to keeping profits as high as possible. When the Patient Bill of Rights was floated by John Edwards et al. FIB killed it. I can see profits. I cannot see lobbying firms.
From Christine Janssen, New York, NY Frustrated with the lack of solid information and details provided to the public, I began a personal mission to dig up some political facts to better understand how each of the Presidential candidates might impact me as a small business owner, from health care to tax reform and economic stimulus plans. Realizing that so many other entrepreneurs were just as confused and hungry for information, I turned my personal quest into a research report to share with every other small business owner in this country. I just spent a countless number of hours over the last six weeks scouring through all sorts of websites, reports, and articles – from the Wall Street Journal to The Tax Policy Center to the National Federation of Independent Business. The overall purpose of this project was to find facts using valid and reliable sources and to present my findings in an easy-to-compare format WITHOUT biases. Click here to access the entire article, which is posted on my site within The Library:
http://www.denkenresearch.com/library.html
The article is entitled “How will the next President of the United States impact you as a small business owner?”
Please share this with every entrepreneur you know to make sure they are well educated on these issues and make an intelligent choice on November 4th. And, in addition this blog, I invite you to voice your comments/concerns/opinions on my blog (http://denkenresearch.com/blog/). If you scroll all the way down to the bottom, there's an entry on the lower left under the same title as the article. Let me know if you have any outstanding questions. I’ll do my best to find answers for you. That's what a do for a living…
From raja, Covington, KY to MD Houston, TX,
So, what say you about those folks who were born with deceases. Were they supposed to take responsibility for their actions or the actions of their parents before they were born?
According to your logic, we have a health care problem because americans are fat, and it has nothing to do with the fact that it takes on average 5-6 times more on every dollar to provide health coverage through private health insurance than it does through medicare.
The costs of healthcare are so high because insurance companies deny coverage and hospitals and offices like yours end up with unpaid bills, so that they HAVE to raise prises to recoup their losses. Plus, insurance companies need to pay enormous bonuses to their CEOs and other managers who get them based on the number of claims they deny per month.
Medicare for ALL is the only feasible and humane solution. I do not care if you call it communist, or whatever. I lived in Russia most of my life..and thank you very much it works VERY WELL. I do not need your conservative friends tell me how horrible it is because they never lived and experienced it.
From MD Houston, TX I'm an American doctor working full time caring for American patients,and here's a point I've never seen in print anywhere in American news media. I wonder how/if it will play here…
Americans eat vast quantities of high fat, fast food, though they acknowledge it causes disease. They smoke vast quantities of cigarettes and drink vast quantities of alcohol. Both have warnings from the surgeon general printed directly on the label about the diseases they cause. Sometimes, after having had intoxicating quantities of alcohol, they even choose to go for a drive afterward. As a population, they are probably, on average, the most obese population in the world. And the mountains of cocaine and other illegal drugs they use are so vast that they are impossible to measure.
The diseases that result from these voluntary behaviors are no surprise to anyone, but after volunteering for these diseases, American media responds with shock and indignation at the cost of treatment.
To be sure, the profits of insurance companies and drug companies contribute to the problem. And the performance of government thus far is no great source of hope, either. But as an individual, none of us has much influence over what the government or the insurance and drug companies do, but we each have total control over our diet and lifestyle choices.
I don't know what it would take to persuade Americans to stop abusing themselves as ambitiously as they do. But I know that if they ever do make that choice, this problem will immediately become much, much smaller than it is.
I am equally confident that if Americans continue to volunteer to be sick in these enormous numbers, no medical system can be devised that will withstand it. In closing, I would point out that, if you think medical care is difficult and expensive to get now, wait until it's free.
When you tell this population that it can eat, drink, smoke and snort all they want and have free and unlimited healthcare to address the effects of those choices, what will be the cost of medical care then?
I don't have a perfect solution, but any proposal that does not include individual Americans taking more responsibility for their own health, is probably a waste of time…
From joe, new orleans, la why should it be right for someone with insurance to be billed less by doctors and hospitals than those without? ive seen cases of discounts for insurance of over 50%.
From Bayone, Bayonne, New Jersey Giles, thank you so much for saying it
so correctly!!!!!
Healthcare is a right, period. Don’t agree, fine, but when it is your parent, child, spouse that is critically ill and you have no/insufficient coverage or the health insurance thieves are denying coverage, remind yourself it is not a right.
I have lived in Canada and the UK and both countries provide superior care in my experience than the US does for a fraction of the cost.
Worried about the bloat of government bureaucracy? So am I, but I think the last stat I read was 35% of healthcare expenditure was on administration and billing.
Please raise my taxes by 10% and give me universal healthcare. The current money being spent on health insurance will more than cover it and will put out of business the most evil companies in the world – the health insurers – I have more respect for school playground crack dealers.
From momofonetypeone dallas,TX As someone with a child with a life-threatening, chronic condition who is uninsurable at any price in any state, I am anxious about the future of health care in our country. My coverage is through my employer, and while we both eat healthy, and are active, she is one of those who cannot lose weight, quit smoking, change her diet, exercise, etc. and make her condition go away. If I ever lose my job and don't have anothe large employer with group insurance lined up, she will never be covered anywhere. There has to be a better way.
From Paul Taylor, Westminster, CO Has anyone ever heard of the Fire Department or Police Department. We ALL benefit. The departments have downfalls and could be better but that is another discussion. I do not think we are asked by the 911 dispatcher,
"What is the name of your Fire or Burglar insurance?" "What you do not have one, I am sorry but your house will have to burn!!" We all should pay into an Nation Health Insurance Addministartion. Both Employee and Employer. All would benefit. Neighborhood clinics, located in local hospitals, could be created. People could be seen for minor illnesses at the clinic instead of the ER. There are a lot of details but The Fire Department and Police Department in our major cities and rural counties appear to work. As one of the greatest nations on the planet we have a responsibility as a nation to take care of everyone. No one should ever have to file Bankruptcy due to a medical illness. WOW, could you imagine the savings on Bankruptcy attorneys.
From Donna, US As someone who believes in limited government rather than a government that gives everything to the citizens for "free", I would prefer health care be taken care of in the private sector, which tends to be much more efficient and cost-focused.
When government experiences increased costs, it can just move money around or raise taxes.
During the debates, both candidates were asked about health care. Obama said it was a right, whereas McCain said it was a responsibility.
Assuming it's a right, does that necessarily mean it is the government's job to provide it? I'm not so sure.
As for McCain's response, that's easier. One's health IS one's responsibility, no matter who pays the bill. Far too many people in this country make poor choices regarding their health (diet, exercise, etc) and then cry and whine for someone to save them from the consequences of their poor choices.
Those of us who make good choices regarding our health and reap the benefits should NOT have to pay for those who do not want to take personal responsibility for themselves.
From John Leach, Southport, NC I think that Obama's healthcare ideas are far more helpful to Americans then McCain's. The real problem is greedy Pharma and these "for profit" insurers who look for any reason to deny coverage. The AMA has also shared in the greed. Has anyone seen the movie "Sicko" which is a real eye opener to our healthcare system. Why are some of these healthcare procedures so expensive?? If an automobile mechanic charged by the same standards as doctors and hospitals, it would cost $1000 to have a tire rotation or $1500 for an oil change!! The healthcare industry is begging to be regulated and if we had "real" representation in Washington, something would be done about it. McCains plan is useless as far as I am concerned. There was a bill. H.R.676 which was introduced for national healthcare. There has been no mention of it in the media. What has happened to it?? Cuba takes care of the healthcare of their people better than we do. It's a disgrace that we have been sold out to that point. Vote carefully this election.
From Twyla Dekalb, IL What is missing is "responsibility" for one's self. As a small business owner with 17 employees – paying 50% of Medical Insurance – less than 50 percent enroll. What is the percentage of "uninsured" – have the opportunity to have insurance -but do not like the cost – and decline enrollment. Responsibility – to work and to pay bills – without more government "redistribution".
From will, tulsa OK Personal responsibility is rarely seen by anyone who would use an ER to get healthcare when they could go to a DR and get a much better deal. This country needs to change in the following areas within Healthcare:
Education about nutrition, how to use the coverage they have, and how to use the system we have in place already.
Financial education-how to manage your finances is desperately needed as a required course starting in Junior High
Smoking should be illegal
Group Health Insurance should not disappear but be able to be taken with you to your next job, accross state lines and people should not have a choice to have DR visits covered or cheap meds covered.
Insurance should only be for amounts greater than $5000. Anything under that, we should all pay ourselves from our savings accounts that earn good interest and are flexible enough for other things. They should be emergency funds.
Can you imagine what would happen to our economy if no one could go into debt unless approved by a financial adviser, if we all had emergency funds of at least 1 months income and we all had accountability on our eating and exercise habits. All of this could be done from within each large and even small companies supported and regulated by the government and state orgs.
Anyone disagree with this?
From conoutofconsumer, raleigh,nc Start with doing away with the government employee entitlement of health care. During this benefits season, take a peek at what any governmental employee receives as a choice vs the rest of us. This taxpayer supported handout has to become a thing of the past if we are to listen to any representative talk about how consumers need to have "skin in the game." Undoing can be done much more easily than redoing, and while we're waiting for the reform, the financial benefit of doing away with these governmental handouts will save billions. The time it will take for change once our governmental employees are actually in the same boat as the rest of us will be shorter than the time it took them to pass legislation for the bailout. Enough of government pensions and benefits paid for by consumers who are told that they are unworthy and unentitled to the same.
From Peter Mellis, Richmond, VA What is missing from all these comments regarding the exploding costs of health care is a sense of personal responsibility for taking care of our own health. I am an emergency medicine physician and am confronted on a daily basis with people who have made terrible decisions with their life. Very few people I see truly have accidents or unavoidable medical conditions (although they think this to be the case) – and now want someone (me, you, the government) to fix them so they can go back to the same life choices, preferably at no cost to themselves. There are no near-term consequences for these decisions which actually change behavior! I see this every day occurring in the context of incredible anxiety regarding any life event involving illness – and most want "everything done" to relieve their anxiety. I believe any reform of health care must start very early with real incentives and consequences for making good decisions with respect to health – nutrition, exercise, injury prevention, education, delayed sexual activity until marriage, maintaining health through a primary care provider and especially, planning for end of life care. Until we successfully address these issues, the cost of care will continue to skyrocket regardless of the choices we make as a society how to move pots of money around to pay for it.
From LALeslie, Houston, TX Working in Managed Care most of my life, I believe the government needs to regulate the Insurance Companies. Their premiums are out of control, and they are passing that to the employers. Reimbursment for both the facilities and the physicians are so low, that each entity is struggling to survive. Stop the Insusrance Companies from raping the people, hospitals, and physcians for their huge profits.
From Miles J. Zaremski, Highland Park, Illinois 60035 If anyone has studied how and why Medicare passed into law in 1965, then one would realize that there must be a "perfect storm" of factors that come together to pass major health care reform in the next administration. Except for the economic woes, and assuming Obama wins next week, those same factors are present so that there is a considerable chance that enactment of health care reform will come about in a bipartisan way within the next four years. But such reform should be a partnership of government relief and private sector alternatives – - – why not consider health care for every American at some level (remembering that Obama believes that health care should be a right), with additional levels funded either by the employee, individual, or the employer.
From tenminpay I encourage you to ask a Canadian if you have the opportunity what socialism healthcare is like. I have talked to several. If you need a prescription refilled, you go to THE HOSPITAL and you WAIT. In fact, for anything at all you go to the hospital. Most do not and cannot get a family doctor. Doctor's pay is LIMITED by the socialist government (hello Obama) and so not only is there no incentive for them to take more patients, they just go into dentistry or move to the states and so there is a crucial shortage of docs. Then the socialists regulate what you can have done medically. Those of you who love "choice" will have very little. What I would like to see is some sort of optional, minimal catastrophic only coverage just for small business people like me. Something that would cover in all states and not medically underwritten, where the risk was spread. Such a plan would unleash an explosion of entrepreneurial activity, many are held back from quitting jobs and going solo by the need for health coverage.
From PJ, San Francisco, CA Government run Healthcare is Welfare. What happened to PRIDE? The rest of the world is moving away from socialism, for a reason, and so should we. Americans need to stop pursuing easy government jobs, get to work, slash government, and drop some pounds. Or else we will all be eating chow mein, and cleaning toilets in the new Chinese outpost. Hey, more gov is not the answer. Time to break a sweat you mamby pamby liberal momma boys.
From Rick Crocker, Greenville, NC The real problem is that the american people are willfully ignorant sheep who are not involved in their government.
The medicare drug bill was written by the pharmaceutical companies for maximum profit for themselves …… the Congressmen, like the criminals they are, met in the middle of the night, at the drug companies request, to pass the legislation (no cameras or public viewers at those hours).
Our Congressmen are whores who work for the insurance and pharmaceutical companies. The interests of the public is of no concern to them.
From Randy, Dallas, TX None of the national players mentioned the coverage mandated by the states. In Texas, insurers must cover in-vitro fertizlation, podiatrists, chiropracters, acupuncturists and marriage counseling. Some lobbyst goes to a legislator with a sob story and a check, and every pays. How much would premiums fall if people could opt out of these kinds of elective procedures? Malpractice is only 1/2% of the cost of healthcare; so the story goes. Healthcare is 14% of GDP. How much does that translate into dollars?
Before anyone believes the nonsense about Medicare administrative costs only being 2% of premiums, compare the medical staffs on Medicare vs. the private carriers. Medicare rarely has an oncologist on staff and few of the other specialists to discuss options with private doctors. Did I mention the unfunded liability of Medicare?
Think again about the effiency of Medicare.
From Hunt, Fairfax VA I would like to see a large insurer take the initiative and turn all of their healthcare plans in one state into one or a few large pools. I would envision them trimming their plans down to 3 to 6 and setting up a pool for each one (if not just one big pool), moving all of their corporate customers into these pools. After that had been accomplished, they would move the remaining customers into the pools. This should greatly reduce their administrative cost, the complexity of the system and overall healthcare cost. One negative side I see would be that corporations couldn’t go to an insurer and buy plans specify built for them.
From Beverly Williams Longview, TX Are you an employer or employee? Some businesses can not afford to pay employee's health insurance at anywhere from $250.00 to $850.00 per person and that is if they are young and healthy. Plus, who is to designate the extent of coverage, deductibles, ppo choices, etc. I say give the employee a specified agreed upon pay at begin of employment, then after a certain waiting period of employment, give employee a pay raise. At that point, it could be either restricted or non-restriceted as to the choice the employee makes in whether he/she chooses to spend the amount on health insurance. In other words, instead of government forcing employers to be the provider (and therefore having to deal with all the PROBLEMS the employee will have wilth filing claims etc.) let the employee sign emmployment contract to work for said amount: then,when waiting period is over, the contract will state an additional amount to be paid to employee to purchase his/her own health coverage based on individual wants. This is at least some sort of plan that would require lots of "tweaking" just as all other "health plan ideas" would need. Tough situation to change in short time because of all other variables, such as medical cost, pharmacueticals, and unemployed.
From Edwardo, WIlmington DE Unfortunately, this isn't true; the larger US plans are on the same scale as the national plans in some countries. This means that size alone will not make them cheaper. The real question is what drives the costs, and what are we willing to change. The very fact that there can be debates on what healthcare costs, what it should cover, and the outcomes it should provide, shows how difficult this information is to get and how little consensus there is on what it means. I suspect that until we address these questions, any debate will be futile. The only solution I see is to let each person decide for them selves, but that requires more information and more choice than we currently have.
From Scott, Dallas, TX SOCIALISM NOW! The rest of the civilized world's nations have largely socialized economies and completely socialized systems of health care and education. As for "higher taxes" in those nations? The average American's marginal tax rate is alread above 40%, just like in the rest of the civilized world. If you're a dumb-azz Republican that cannot define "marginal tax rate," you don't belong in the debate! The difference with our tax system is that we get nothing for it other than a bloated military budget that is ineffective at providing the very protection it promises! America's uncontrolled capital-corporatist system is DEAD and pumping $700 billion more of OUR money into Sleaze-E-O's hands won't revive it (not that we want it to be revived!).
From Eileen,, Carmel, CA. I voted for Ralph Nader because he is the only candidate for single payer health care and has spent his life advocating for change. The "other two" are useless puppets of private health insurance industry which is too powerful to bring down and is killing people right and left because it is health care profits, not health care, they really care about. It is one place in our free enterprise system that is not working. Only voters won't find that out until it is their own life in the hands of their insurance company! And then it is too late….
From Songhye Saribudak, Spring, TX The bottom line is that US and the South Afica are the only Contries in developed Countris in the World, which doesn't have nationwide mandatory health insurance.
The first thing is that banning on the discrimination in the health insurance industry due to the health condition. Have the pool whoever wants to get health insurance and pay for it.
From Dwaraka, Potomac, Md Some people eat at McDonalds and Taco Bell while others go to fancy steakhouses. Some people shop at Wal-Mart and Kmart while the rich go to Neiman Marcus and Lord & Taylor. In order to keep inflation low, we allow import of autos and industrial goods from Japan, China, and Mexico, and grocery items from South and Central America. We allow cheap labor to tend to the gardens and yards of the rich and the middle class. But when it comes to healthcare, there is neither a Wal-Mart of doctors nor a cheap drug store. We do not allow healthcare services from cheaper locales even if that means suffering for the poor. We should accept a business model – the reverse of an export promotion zone. The government may designate some geographic areas as health services import promotion zones (HSIPZ) and allow degreed doctors and pharmacists from anywhere in the world to set up cheaper services only within those areas (HSIPZ) with certain minimum standards of care. Such a system will bring affordable care to those who want it. It will relieve pressure on other hospitals and the price of overall healthcare will fall.
From Kellie – Atlanta GA Can we put a few things into perspective. I know people without healthcare coverage. These same people all have cell phones, wear designer clothes, shoes, carry COACH bags, and have flat/big screen TVs. Some of them smoke, go out to eat on a frequent basis, and lead active social lives. What is more important here?
From Michael, Orange, CA Did anyone ever think that maybe it shouldn't be about what will pass, but what we need? This is the reason why things don't get done right in washington. Instead of creating a policy that works and getting popular support for it, they dress a turd up with candy that looks tasty while underneath it is simply a game of handouts to campaign contributors. Not unlike the presidential campaigns themselves.
I am however tired of this "the government cant run anything" argument against nationalized health care. Ever heard of the military. USGS. NOAA. These organizations, the last two tremendously underfunded, have continued to be effective orginazations run by government. Funny. Fanny and Freddie seemed to do just fine until they handed them over to the private sector years back. Oh, and shut up about "from the people who brought you the post office" bit. The post office handles MILLIONS of parcels and letters daily with a less than .01% loss rate. Compare that to private sector health care. There statistics on mistakes happen much more frequently than lost packages by the USPS every year, and I think we can assume that life and death issues should be handled a little more carefully than a letter.
Another bit of sensationalism I am frustrated by is the "I work hard, but anyone who doesn't have a job doesn't". It's called unemployement for a reason, they used to be employed until there were no more jobs. Also, give it a rest with the welfare stuff. I know that most of you in that camp would prefer that they get nothing because you think that they should get a job. When there are no legitimate jobs to be had and they have no where to turn for help, they will get a job. Robbing your house and selling your kids drugs. No one should be feared more than a person with nothing to lose. Plus, there is no one on welfare accumulating wealth. What they get they spend. So I guess we get it back in the end now don't we.
There are several inevitabilities in health care today.
1. Health Care costs will continue to rise as long as health care is a for-profit business because that's what for profit businesses do. So don't cry about the cost of health care when it is run that way. Just like don't cry about the price of oil going up when you've elected an oil tycoon president. Oh wait, we did that.
2. Without health care for everyone, hospital emergency rooms will be forced to provide health care for the uninsured. Higher costs for us paying customers, and eventually the health facilities as we know them will begin to go bankrupt. Who am I kidding, this is already happening.
3. If the costs of health care continue to prevent folks from getting care, more and more of us are exposed to sick people because more and more people can't prevent serious illness. The cost of more people getting sick is expensive to everyone. Your employer, your community, your country and yourself. Ever hear of jumping over dollars to get to dimes.
So what about proposals and what can pass? It should be about a solution. A real solution that puts the argument to rest. Leaving health care private just gets a handful of people very wealthy while we all argue until we die.
From Doug, Weston, FL What's wrong with fully adopting the Obama proposal that everyone have the chance to opt-in the same health insurance that the Senate has. It currently exist today and is known as the Federal Employees Health Benefits Program (FEHB) Provides health insurance benefits to about 8 million Federal enrollees and dependents. It has existed for decades and is one of the best run, most effieient, cost contained programs in existance today. And by the way, the care is not restricted. Check it out at http://www.opm.gov/insure/. Hope this helps you to vote for Obama!!! It is a plan with substance and you don't even have to opt-in if you don't desire.
From Robert Smith Nashville, TN Doug,
First off – do you have a health care plan that would let you fly a child overseas to get specialized treatment? That's what we are talking about here, not how good our doctors are, but how bad our healthcare system is getting.
Second – You are making an assumption that a person would actually have coverage under a private plan. What about those who get caught between plans and get sick, or those with chronic conditions that no plan will cover, or those that just cannot afford the coverage they need because of certain genetic conditions? Yes, this happens under private run conditions. Do we just let these people die?
Healthcare IS a right. And as a country with outstanding resources in healthcare – doctors, medicine, technology, etc – it is imperative that we allow all our citizens to have the health coverage they deserve; regardless of job status, ethnicity, and/or wealth.
From Doug, Allentown PA I agree with most posters here that costs are out of control with our system. I disagree with the almost total abolishment of the free market system by most of them.
When a Japanese government official has a daughter that gets sick with an unknown disease, he doesn't fly her to Canada or Cuba for healthcare. They come to Children's Hospital in Philadelphia. Why do they do this? Because the most advanced healthcare in the world is here.
Here is a suggestion. Have both systems. One government run system and one private one. Let them both operate for 20 years. You tell me where you would rather have the ambulance take you if you are having chest pains.
From Tim, Elk Grove, California Nice job Charley…
Kaiser hospital would be a good model for healthcare from the effective health maintenance and primary healthcare. However, they lack the expertise needed to effectively deal with the really unusual healthcare issues. Any such system should be combined with an organization that can take diagnostic excellence and critical trauma care. An example would be a University Medical center. I would be interested in hearing people's ideas regarding how to inspire American's to be more health conscious without allowing employers to dictate their personal behaviors. There is a distressing trend in this country towards just that. I know people that have to pay higher insurance costs because they will not capitulate to their employers demans that they join a wellness program that requires them to have diagnostic tests whose results are sent to firms contracted by the employer. I also know of healthcare providers that a mandating that their employees take vaccinations designated by the employer. If one cannot or does not take the vaccination, depending upon their positions, they will be banned from the healtcare facilities or have to sign forms stating they are a danger to their co-workers and/or patients. They scary part is the employers get grant money for such actions. It has little to do with healthcare and more to do with money and government sponsorship. Where will is stop?
From Dwaraka, Potomac, Md Healthcare should be seen as investment in the future rather than as an expense. From the time a baby is born, through the years when a child grows, and as a young person matures, healthcare should make a person more productive (less sick leave) and contribute to nation’s wealth creation. As people live longer and healthier, the age limit for social security eligibility may be adjusted upwards. The concept of retirement may be changed so that older people change jobs but not actually retire as in earning no money; this is actually important as the baby boomer demographics are not favorable to the US, Europe, and Japan. Technological advancements may bring work to older people rather than people commuting to a place of work. Emphasis on research into health sciences may give us relief from old age problems like dementia and Alzheimer’s disease. Robotic devices may overcome some physical ailments. The strategy should be to reduce healthcare costs through volume and improving productivity by choosing appropriate management methods.
From Betsy Sheppard, Crozet VA I agree strongly that access to health care services is a basic human right. We do need to change our philosophy in the U.S. from health care as a free market commodity to health care as a social service. It is common knowledge that other free market democracies provide quality health care to their citizens at a fraction of the U.S. cost. The U.S. system is extremely inefficient with administrative costs estimated at 25-30%. Paul Krugman is right to point out that fragmentation of health care services is a root cause of U.S. inefficiency.
We need fundamental reform in the U.S. Unfortunately people are stuck in the "mental rut" that equates universal health care with "the government running health care". We need to learn from other countries and find a model that will work here. Germany and Switzerland for example have a "social insurance model" where both the health care insurers and providers of service are private. We can solve the health care crisis in the U.S. if we ignore the lobbyists and special interests and get to the root cause.
From Charley Charlotte NC Giles in New York:
very well spoken and your ideas have great merit.
From Charley, Charlotte, NC Where to start? There are so many areas that need improvement. here are some thoughts.
1) Health care costs have skyrocketed to the point of being ridiculous. They have increased far more rapidly than inflation over the last 30 years or more. Why? These costs must be controlled. Otherwise, no insurance program will suffice for long.
1a) There must be some entity with the ability to negotiate prices on behalf of the public. This would extend to all health care providers and pharmaceutical companies.
2) A major flaw in the present system is that health insurance is often tied to employment. Lose your job, lose your insurance. Or, work for a business that does not offer health insurance, and you are out of luck. There are 40-50 million people without insurance. This must be addressed. Health care is a right, not a privilege.
3)A larger pool means a reduced risk and costs can be spread across a larger base. Why not have a pool consisting of the entire U.S. population? What if everyone paid the same (reasonable)rate? Sure, some people would use more health care than others, but the cost would be spread across a much larger base. That is the whole purpose of insurance, to spread the risk and make it affordable to all. Everyone would participate without regard to pre-existing conditions.
4)Employers would still contribute, based on some criteria of number of employees, or total size by revenue, etc.
5)Next we start working on improving people's health by providing program and incentives for stopping smoking, regular exercise programs, healthy eating, education, and prevention, etc. (As an aside, all restaurants, and particularly fast food outlets, should be required to prominently post nutritional information at the point of sale.)
6) A system such as this would help to take considerable pressure off of medicare and medicaid, which are rapidly running short of funds. Perhaps most of the funds currently being spent for medicare and medicaid could be spent on subsidizing the costs for the new system.
6a) This would also take a great deal of pressure off of public hospital emergency rooms and the cost of caring for those without insurance.
7. Reasonably priced and predictable health care costs would help businesses of all sizes to better compete in the global marketplace.
Well, these are a few ideas. let me know what you think.
From Tim, Elk Grove, California Charley,
Ordered the book. Thanks for the info. Looks quite interesting.
From Alfer33, Chesapeake VA All aspects of the medical field need to bring down their prices. Everything that we get charged is WAY over priced for what it costs the provider. Why should we, or insurance, have to pay $5 for a syringe that is used for a simple shot when the proiders cost is probably $0.25 for it when buying in bulk. What a rip off. The drug companies are just as guilty. I accept that R&D cost money but their prices and for how long they can hold them that way because of patent laws isn't reasonable. I just had a colonoscopy a while a go and three pollyps were found that the doctor removed. I was glad I went right at the recommended age. But I about dropped when the bill came in. It was $17K! Luckily I have good insurance and a supplemental policy. I just went in for a follow-up screening and nothing was found. This bill comes in around $2,700 for the same procedure minus having to remove the pollyps. You can't tell me that there is that big of a billing difference just because of that. Medical costs have been rising at an average rate of 2-5 times the average rate of inflation for a good 15 years now. Enough is enough.
From Mike, Big Spring, TX The bottom line is that as long as medicine is completely in the hands of private entities, greed will be the controlling factor in health care. I don't pretend to know the perfect solution, if one even believes that a solution that satisfies everyone is even plausible, but without some degree of regulation and protection by the government, people will come second every time.
From Christina, Corvallis, Oregon Tim's statement that a government-run plan would obviously cost more is not supported by the facts. Medicare spends less than 5% on administration, whereas the private insurance companies spend upwards of 20%, which is one reason health care is so expensive now. All these patchwork plans based on the fear that we obviously couldn't afford to insure everyone are bound to fail partly because nothing will be done to reduce the insurance companies' spending on administration, advertising, and such, or the pharmaceutical companies' spending on absurd and annoying television advertising. A single-payer, non-profit national plan is commonly used around the world and would work in this country if all the lies and epithets about it could be exposed for what they are. And don't say that such a plan would force "rationing" of health care. What do we have now in a system where 45 million people have no health coverage? If rationing means that a wealthy person might have to wait six months for cosmetic surgery so a poorer person could receive basic health care, I'm not worried about it.
As far as giving "healthier" people a break or a bonus, how in the world do you expect to administer that? How nosy do you want your employer or an insurance company to be? It's easy to pick out habits like smoking or drinking to excess, or situations such as obesity. But what about many other, not so visible "unhealthy" habits or situations? What about the "healthy" person who often does sky diving, bungee jumping, rock climbing, or more extreme sports? Most people wouldn't want to pay for that risk. That's another reason we need the national-size pool, so everyone can receive health care, without judgment, and without exceptions.
From Jim, Joplin, MO The first thing that has to happen with any plan is to get the liabilities in check. This is one of the main reasons the cost of health care has gone up. There needs to be limits the doctors, hospitals, and manufactures have to pay if something does go wrong. This would maybe the only thing a government controlled program could solve because they would have to put caps on this to control the cost. I am a McCain supporter but I will bet if he sends a check to someone they are not going to run out and get insurance.
From Gail, Bellevue WA Meaningful health care reform will not occur until people change their underlying assumptions about cost v. value. Since most people place an infinite value on their own life (and their loved ones), no cost is too great to preserve that life. This entitlement mentality is the elephant in the corner, and no reform is possible until we address this issue.
From Charley Charlotte, NC There is a book called 'The Undercover Economist' which discusses health care from an economic prspective, written in clear everyday language. Here is a link to the website.
http://www.timharford.com/undercovereconomist/
From Mark A Urbanoski the gvmnt. should supply mandatory insurance only for catastrophic/chronic/mental illness. all other health care should be private/optional.
From Giles, New York, NY Healthcare is a right, period. Don't agree, fine, but when it is your parent, child, spouse that is critically ill and you have no/insufficient coverage or the health insurance thieves are denying coverage, remind yourself it is not a right.
I have lived in Canada and the UK and both countries provide superior care in my experience than the US does for a fraction of the cost.
Worried about the bloat of government bureaucracy? So am I, but I think the last stat I read was 35% of healthcare expenditure was on administration and billing.
Please raise my taxes by 10% and give me universal healthcare. The current money being spent on health insurance will more than cover it and will put out of business the most evil companies in the world – the health insurers – I have more respect for school playground crack dealers.
From Charley. Charlotte NC Frank,
Good Point. I believe health care is a right. This is borne out by the Declaration of Independence: That all men are endowed by their creator with certain inalienable rights; that among these are life, liberty and the pursuit of happiness. Without adequate health care, life and the pursuit of happiness are in jeopardy.
From geoff, kalamazoo, mi We already know the Government can not run health care, just take a look at Medicare. Forcing big business to pay for most of this, will only lead to more big business leaving this country and going elsewhere, which will lead to higher unemployment and costs for small business and individuals who already are feeling the financial strain.
Also, how are those who already have retiree health care going to be brought into this mix? And we have not even got to the medical industry yet, doctors and hospitals, good luck trying to tell them that they can not make what the market will bear. If that were to happen I think you would find the best physicians leaving for greener pastures or trying to work outside of the system for cash. Are hospitals, both profit and non profit going to be taken over by the government?
If you are going to outlaw medical underwriting, how are those who choose unhealthy lifestyles going to cover their fair share. How are the unemployed going to pay? Essentially the idea is nice in a perfect world, but in reality there are just to many questions that for most will be to difficult to answer.
Health insurance is not a right, just like a job, a house, a car, etc…they are a privilege you have to work for it.
From larry,oakland,ca The problem with a tax break – it does nothing to stop the rising cost of health insurance – this year it is raising on the avg. of $2000 a year per couple.
Health care is out of control – just like wall street
From Richard Lam, Pleasanton, CA Why is all the plans being talked about address only side of the equation – paying for medical services? How about doing something to control the escalating cost of medical services and medications? How can anyone expect to solve this problem if all one do is trying to catch up?
From Tim, Elk Grove, California Erin,
Your comment makes me think that you are just like a sheep that can be led by their employers to slaughter. Also it is very short sighted. It is true that weight, smoking and over consumption of alcohol can effect your health. I know businesses are pushing this type of plan. I also know the hidden parts that you have not considered. So let me help you understand something. What you have been told is equivelant to a barker on the street designed to suck you into some club on a strip. But once enough people have ascribed to this type of employer monitored health care, then the ugly side will reveal it's head. There will be no rewards for a low BMI, non smoking, etc.. Under these plans you have given access to parts of your medical information to your employer and you have no control over how it is used. They will dictate that you have certain blood tests for diagnostice procedures with the results going to a firm they hire. They will also dictate that you take vaccines that they mandate. They will find ways to let you go when any health issue become a threat to their profitability. The whole idea is to give them informatin about you that they can use to control your personal life. If you think I don't know what I am talking about, let me tell you now that I am a business intelligence professional that works in healthcare and health insurance. Give me access to your medical information, combined with my access to your income information and your credit history, etc. and I can control you like a robot.
From Charlotte NC Erin,
I agree about smoking, but the BMI chart is outdated and inaccurate. For example, a highly conditioned athlete with large muscles is often labeled obese if you go by the BMI chart. A better measure of obesity is percentage of body fat.
From Nick Loiacano, Freeland, Mi. I think the simplest way to insure working Americans is to require employers to provide health insurance to ALL employees just as they do for social security. At that point there will be no advantage or disadvantage between employers. There would be no government involvement or cost of running the program. It would just be a requirement of employment. The additional numbers of people having insurance should lower premiums due to volume and their health should improve once everyone can be proactive with their health, instead of waiting until they are very, very sick. There will also need to be some sort of pool for all those not working. For every problem there is a solution. We can not be afraid of change.
From Tom Allen, Newington CT I absolutely agree with Mike from TX. The McCain plan would only give money back to people, not dictate how it's spent. It's like trusting people to set up their own Social Security account; it sounds good in theory, but most of us know we won't be that spot-on in saving for anything on our own. Any tax credit put towards personal choice of insurance or not will never work.
But having said that, the idea of a federal-backed program, at least at this time, is ludicrous to suggest. We can't afford to save our own economy from a few bad decisions; how are we supposed to fund millions of Americans for making poor health choices? Yes, I know a lot of things can be outside someone's control, and I work as a Pharmacy Technician handing out medications so I know firsthand. But Erin from CA correctly pointed out that too may people just don't live healthy, and they need to wake up and realize this isn't a one-way deal. If the government is every going to start handing out healthcare plans, the people receiving them had better be healthy enough to be worthy of the plans-and taxpayer money.
From Frank Baxter,Abington Ma The very first step we must take as a country is to answer the basic question on health care, is it a right or a privilege. Until each American takes a position on this question we will go nowhere fast.
From Tim Hoy, Elk Grove, California Hmmm.. what happens to retirees whose health plans are already covered under thier company's retirement systems? I have yet to see a government program that does not cost the American people much more than they deliver. By the time the governemnt tacks on the heavy bureacracy that it injects into every process the costs will outstrip any savings. You can expect healthcare under the government to have about same outcome as their involvement in Fannie Mae, Freddie Mac and the rest of the financial crisis.
From Erin, Los Angeles, CA Employers need the ability to reduce health care costs based on an employees willingness to live healthy. Active, non-smokers whose body weight is something close to the BMI get a discount. Just like giving a break to people making less than $40,000 in taxes you give a break to people with conditions outside of their control –but REALIZE THIS…weight control and not smoking will drastically reduce the number of ailments on this list– All of the people immediately angry at this plan need to go research the fact that being obese (vs BMI chart), drinking too much too often, and smoking are the direct cause for 80% of the health conditions out there.
From Mike, Big Spring, TX I do not share the McCain plan's optimism. A $2500 tax break is just that, a tax break. But it is not coverage, nor does it guarantee coverage. This plan would solve nothing, and would only lead to irresponsible use of the money by those who have other needs more immediate than health care. In addition, there needs to be a deflation of the health care market for any rebate program to be effective, else the costs of adequate care will quickly outstrip such a program, even for those who use it properly.
Anything that helps small business obtain health insurance for less or moves away from the employer sponsored health insurance is a good thing. As an executive in a small business, I have trouble competing for top end employees because our health plan is very costly and mostly employee paid. Moving away from employer sponsored health would level the playing field for small business.