Thread: Reform healthcare now, take on insurance co's later

Last I checked, no one has ever been cured of any malady nor any disease prevented by holding a little plastic card. I have yet to hear of any physician prescribing a little plastic card for the treatment of any disease, illness, or injury. Health insurance does not heal patients, medical professionals do.



These are the facts:



1. At some point in most American lives they will require some sort of health treatment.

2. This care many times is out of reach of the financial warewithall of most Americans to foot the bill on their own.

3. You can afford treatment through health insurance but the insurance itself will not heal you.

4. Some of the affirmities are contageous and may be spread without intent to others.

5. Poor health and affirmities have costs that go beyond actual treatment.



Add them all up and it is clear that quality healthcare is something we need (individually and collectively).



Additional facts:



1. While basic healthcare is necessary, cosmetic surgery and elective procedures are not.

2. Not everyone can go to Johns Hopkins or the Mayo Clinic for medical treatment.

3. Lawsuits drive up the cost of healthcare.

4. Americans are largely unaware of the cost of the procedures they undergo.

5. Physicians spend more time filling out paperwork than treating patients.

6. Doctors are leaving the system, retiring early, refusing to practice certain medical fields of medicine, and new doctors are less attracted to becoming doctors in the first place.

7. Insurance companies look to cut costs anyway they can. These cost cutting measures may be detrimental to the patient, the doctor, or both.



How do we fix the system?



The answer is simple. How we get there is complex.



Simple answer...Reform healthcare first. After we do that, fix the health insurance industry.



My solution will appear in my next post here.

I'm waiting with baited breath. It's a doozy of a pickle.

Reforming healthcare will require that we view healthcare differently. The biggest change will have to come from the consumers of healthcare. Each of us must realize that quality healthcare does not mean that we can go out and get the best treatment facilty, the best doctor, or the best medicines that money can buy. We just cannot afford it. If you can, then by all means pay for the best you can afford.



The first step in healthcare reform should be to open public clinics that are completely free to all Americans. These clinics will provide basic healthcare to all that need it. These clinics can be new facilities or the utilization of existing medical facilities. They can be staffed by doctors who are fed up with the current system, doctors who wish to give up their practices in exchange for fewer hours, otherwise retiring doctors who may wish to continue to practice on a limited basis, and freshly trained doctors who are just starting out. Each will recieve a salary and benefit package for their service. New doctors should have the option to take a reduced pay in exchange for the payment of accumulated tuition debt.



Patients will have the option of anonymus treatment. Patients will have the option to take their medical files with them or stored by the clinic. These files will only be identifiable by a secure, private number that the patient recieves upon entering the clinic.



Doctors at these clinics will be immune from lawsuits. The care is voluntary and free of charge. Patients should not expect to enrich themselves from something they got for free in the first place.



Some critics will call this socialism. Others will call this inferior care. Face it, we are paying for this care anyway. This system will do so more efficiently. It should not be viewed as inferior care. The doctors must recieve proper training and accredidation. It may not be the Mayo Clinic but remember it is free to the patient.



There will still be a place for private insurance. Buy the level of coverage above and beyond basic care that you can afford or that you have negotiated with your employer to provide.



How do we pay for this?



Medicare/medicade will become unecessary. That money will be freed up to pay part of the cost. Health insurance premiums will fall dramatically since the insurance compnies costs will be greatly reduced. Insurance companies will also have to compete more for policies that offer premium care. These premium reductions should be shared with the gov't by the employers providing coverage. For employers who find they are able to eliminate current coverages should also be required to share the savings they receive from the elimination of premiums.



Some health insurance reforms should occur. Insurance companies should be required to pay into a pool to cover pre-existing conditions. As long as someone has maintained coverage over time, they should be exempt from any insurance company denying them coverage for treatments of those conditions. If someone thinks they can just buy insurance coverage when they need it...sorry. The person who has not maintained medical coverage should be required to pay a larger portion of the cost. For example, if you have not maintained coverage you may be required to pay up to $5,000 for each year you did not have coverage. Portability of coverage should be 100%. If you have insurance, you can keep it no matter if you lose or otherwise change jobs.



For those with private insurance, there should be tort reform. This may include caps on settlements but should definitely include a "loser pays" provision. Attorneys that take cases on a contingentcy basis should be required to pay for the court costs and legal fees of the defendant should they lose their case against them.



Please note, I have condensed this plan to a brief overview for this forum. You won't find this plan anywhere else. I have come up with this over a number of years. If you have specific questions, I will be glad to hear them and will answer them as time and space permit.



Thank you.

[quote name='uncommonman' date='08 October 2009 - 02:13 AM' timestamp='1254982421' post='34235']

The first step in healthcare reform should be to open public clinics that are completely free to all Americans. These clinics will provide basic healthcare to all that need it. These clinics can be new facilities or the utilization of existing medical facilities. They can be staffed by doctors who are fed up with the current system, doctors who wish to give up their practices in exchange for fewer hours, otherwise retiring doctors who may wish to continue to practice on a limited basis, and freshly trained doctors who are just starting out. Each will recieve a salary and benefit package for their service. New doctors should have the option to take a reduced pay in exchange for the payment of accumulated tuition debt.

[/quote]



Doctors fed up with the current system aren't going to practice at your free clinic. Many doctors practice on a limited basis, mine is closed on thur and fri every week.



When you are diagnosed with something such as cancer and are facing 50k for treatment can you get that at your clinic for free too?

[quote name='uncommonman' date='08 October 2009 - 02:13 AM' timestamp='1254982421' post='34235']

Medicare/medicade will become unecessary. That money will be freed up to pay part of the cost. Health insurance premiums will fall dramatically since the insurance compnies costs will be greatly reduced. Insurance companies will also have to compete more for policies that offer premium care. These premium reductions should be shared with the gov't by the employers providing coverage. For employers who find they are able to eliminate current coverages should also be required to share the savings they receive from the elimination of premiums.



[/quote]



Insurance co costs will not fall terribly, they don't care about the cost of simple dr visits for your sniffles, they care about the 100k medical bills that one runs up when they are really sick. Your free clinic is not going to be doing bypass surgery and chemotherapy.



I think you have it backwards. Instead of ins companies being relieved from paying the simple cost of dr visits, relieve them from the 100k medical bills, thats why they charge so much, to cover the few that run up exhorbadent bills. If there were a limit that they were responsible for costs would really come down. Now have your UHC kick in to cover only the really sick. Only a small percentage of Americans would need it and it would not be a monumental beaurocratic mess.

[quote name='Pragmatist' date='08 October 2009 - 06:05 AM' timestamp='1254996317' post='34255']

Doctors fed up with the current system aren't going to practice at your free clinic. Many doctors practice on a limited basis, mine is closed on thur and fri every week.



When you are diagnosed with something such as cancer and are facing 50k for treatment can you get that at your clinic for free too?

[/quote]



Actually, there are quite a few doctors who would find this to be an attractive alternative to what we currently have. They will be able to work as many, or as few, hours doing nothing but practicing medicine. The would be relieved of the duties of much of the paperwork and a good deal of expenses that they face these days. Of course it won't be something that all doctors will want to do. They are free to remain in the current system. It will certainly keep a number of doctors from leaving medicine. It will be extremely attractive to new doctors and will help to retain and increase the number of doctors in this country. Doctor shortages are becoming a more and more problematic in this country. Any increase in the number of doctors is something that must be addressed. Current proposals do nothing to address that problem.



As for cases like cancer, you will recieve basic care for the treatment of that disease including drugs. If you are seeking extraordinary treatment you will have to pay for it on your own or to purchase a policy that covers extraordinary treatments. This is far better than the indigent care that the uninsured have access to now. It will also keep the uninsured from using hospital emergency rooms as their family doctor. Remember, this is free care. It is costing you nothing, not even the price of health insurance premiums. Ultimately, we are each responsible for our own health. What you do to protect that health is something you have to decide how much you are willing to pay for it. You will know, however, you will always have basic care to fall back on. This plan will also encourage people to seek care in the early stages of disease when treatment is far less expensive and far more treatable. People will be less likely to ignore symptoms of disease because of the cost of treatment. If you still chose to ignore the signs of disease, it will be your own fault if you wind up with full blown or end stage of that disease.



Preventative services should also be a cornerstone of this plan. A little education and healthy lifestyles can prevent your getting sick in the first place. It is also far less costly.

[quote name='uncommonman' date='08 October 2009 - 06:52 AM' timestamp='1254999127' post='34263']

As for cases like cancer, you will recieve basic care for the treatment of that disease including drugs. If you are seeking extraordinary treatment you will have to pay for it on your own or to purchase a policy that covers extraordinary treatments. [/quote]



Yep, and you just went back to a $1000/per month policy AND you will be paying in some form or fashion by way of taxes to fund that clinic.

[quote name='uncommonman' date='08 October 2009 - 06:52 AM' timestamp='1254999127' post='34263']

If you still chose to ignore the signs of disease, it will be your own fault if you wind up with full blown or end stage of that disease.



[/quote]



I see, and for those that do ignore it there is a dumpster out back for them to pitch your corpse in? Ain't gonna happen.

[quote name='Pragmatist' date='08 October 2009 - 06:21 AM' timestamp='1254997308' post='34259']

Insurance co costs will not fall terribly, they don't care about the cost of simple dr visits for your sniffles, they care about the 100k medical bills that one runs up when they are really sick. Your free clinic is not going to be doing bypass surgery and chemotherapy.



I think you have it backwards. Instead of ins companies being relieved from paying the simple cost of dr visits, relieve them from the 100k medical bills, thats why they charge so much, to cover the few that run up exhorbadent bills. If there were a limit that they were responsible for costs would really come down. Now have your UHC kick in to cover only the really sick. Only a small percentage of Americans would need it and it would not be a monumental beaurocratic mess.

[/quote]



Actually, you are wrong on this. In fact, the percentage of claims for high cost procedures is extremely small. I have handled groups and know this to be the case. The majority of healthcare dollars go to "small claims" and the administration and processing those claims. That's just the facts. At one time, insurance companies covered the cost of administration and processing from using the money held in the lag time through investment of that money. It was not unusual for insurance companies to pay 102% in claims of the dollars they collected from premiums. That began to change aproximately 10 years ago and was hit with an exclamation mark on 9-11. The greatest hits to insurance companies from 9-11 was not for the claims they paid but for the resultant drop in the stock market. Insurance companies now target claims to premiums at about 60-70%.



Why can't public health care facilities handle bypasses and chemotherapy? In fact, they can. As long as it is considered basic care and not elective or extraordinary care, they could provide these services and do so at a lesser cost in most cases. Decisions, of course, should be made by physicians, not bureaucrats.



Covering catastrophic claims is the whole idea behind insurance...all insurance. You usually don't file a claim on your auto insurance when your car gets a little ding from a shopping cart at the grocery store. You file claims for major accidents. That's also why you can cut your premium by opting for higher deductibles.

[quote name='Pragmatist' date='08 October 2009 - 06:58 AM' timestamp='1254999499' post='34264']

Yep, and you just went back to a $1000/per month policy AND you will be paying in some form or fashion by way of taxes to fund that clinic.

[/quote]



Guess what? You are already paying "in some form or fashion" the cost of healthcare for the uninsured...usually through higher premiums. The reduced costs in health insurance should not be a windfall for companies that provide health insurance or for employers who drop their plans because their employees can get free care without it. An equitible sharing of those savings to help fund public healthcare facilities. If you want to call it a "tax," go right ahead. If I, as an employers am saving $100 and sending $75 to fund these facilities, I would be happy to do so. I may actually be able to pay my employees more in their paychecks and still save money over what we now have.