Health care problems and solutions in politics

[Occams Barber]

We've talked a bit about getting things paid for and coverages, but I think we've missed the lager elephant in the room which is the cost of medical care. It appears our costs outstrip the costs of care elsewhere. Some of that I think is due to universal healthcare.

If you look at the graph below you'll see two things:
1. The US has the highest healthcare cost in the OECD (actually the highest in the world)
2. Most of the extra cost comes out of your (private) pocket (the red section of the bar chart)
Considering the standard of US healthcare is generally rated below that of comparable countries it appears the extra cost is not achieving anything useful.

List of countries by total health expenditure per capita - Wikipedia

OB

 

[GodLovesCats]

What is OECD?

 

[Occams Barber]

What is OECD?

About the OECD - OECD

The Organisation for Economic Co-operation and Development (OECD) is an international organisation that works to build better policies for better lives. Our goal is to shape policies that foster prosperity, equality, opportunity and well-being for all. We draw on almost 60 years of experience and insights to better prepare the world of tomorrow.​

Broadly speaking OECD membership incudes most of the worlds economically developed countries.
OB

 

[comana]

That's not unreasonable. But I'm not sure why you need insurance companies as managers. Seems to me that middlemen just add to the premium. It has to be cheaper if non-profit regional insurance funds directly handle claims and pay providers. Do providers bill Tricare, or do they bill the contracted insurance carrier? As a provider myself, I know it would be much easier if every patient's bill was sent to a single payer, rather than having to deal with multiple different insurers.

Tricare claims are sent to the regional contractor similar to how Medicare claims are billed.

I agree that claim billing would be greatly simplified if the multitude of insurers were not billed individually but unless we move to single payer this issue will remain.

 

[jayem]

I agree that claim billing would be greatly simplified if the multitude of insurers were not billed individually but unless we move to single payer this issue will remain.

Some variety of single payer is coming. I predict it will happen before 2050. The way we currently finance our health care is an antiquated relic that's destined for extinction. It's an absolute certainty. And the pressure to replace it will come from the business community. They will not tolerate being health insurance providers for 50+% of the population forever. A single payer system of some type is only viable alternative.

 

[GodLovesCats]

The for-profit insurance companies will do everything they can to stop the single-payer health care efforts because they know any plan would put them out of business. Thousands of living wage jobs will be lost to the very same thing they exist for. That is a legitimate concern with switching to a single-payer system. I don't know how we can totally eliminate the private health insurance industry.

 

[stevil]

I clearly stated I oppose letting health insurance companies cover elective abortions,

I understand this is your position. I was referring to that position.
I am supportive of elective abortions and opposed to govt putting in laws to take those choices away.

 

[GodLovesCats]

I understand this is your position. I was referring to that position.

I am supportive of elective abortions and opposed to govt putting in laws to take those choices away.

Keep that opinion out of this thread. Elective abortions are not health care unless a mother is forced to choose between her baby and taking certain medications.

 

[MorkandMindy]

The for-profit insurance companies will do everything they can to stop the single-payer health care efforts because they know any plan would put them out of business. Thousands of living wage jobs will be lost to the very same thing they exist for. That is a legitimate concern with switching to a single-payer system. I don't know how we can totally eliminate the private health insurance industry.

Is it wrong to try to improve efficiency?

You are the first person to point out the core issue, that the US health system could run more efficiently but there would be a lot of job losses.

And my personal big problem is keeping a whole bunch of people employed at salaries between 3 and 30 times my own, is something I cannot afford to do, nor indeed can the country afford it. The main driver harming US industry is the high health care costs.

It could even be a moral issue as due to high costs and low efficiency many cases of cancer are not found until they are stage 4 which could have been easily found long before.

 

[MorkandMindy]

I have no healthcare at present owing to the enormous cost

 

[GodLovesCats]

Ideally America would have a single payer system. My concern is it will hurt the economy when insurance companies are forced to go out of business. How do we find a balance? Where do we draw the line? That's why I struggle with the idea to let the government take over 100% of our health care.

 

[GreatLakes4Ever]

Ideally America would have a single payer system. My concern is it will hurt the economy when insurance companies are forced to go out of business. How do we find a balance? Where do we draw the line? That's why I struggle with the idea to let the government take over 100% of our health care.

I’d personally rather have people without a job than people dying from easily preventable diseases. Also, I think the economy would expand with people able to leave their employer who has their health insurance and set up their own business.

 

[stevil]

Keep that opinion out of this thread. Elective abortions are not health care unless a mother is forced to choose between her baby and taking certain medications.

I disagree. I think it is a fundamental healthcare concern for women.

If a country like USA has a super expensive health system, then it may make it financially out of reach for those people that may need it(want it) the most.

I think if USA fails to provide affordable abortions (regardless of if they are "elective") then I think your country is failing women and especially the poor (for no reason other than to appease one group of your society).

 

[stevil]

Ideally America would have a single payer system. My concern is it will hurt the economy when insurance companies are forced to go out of business. How do we find a balance? Where do we draw the line? That's why I struggle with the idea to let the government take over 100% of our health care.

Even with "a single payer system" you can still allow healthcare insurers to persist. It's kinda like having public schooling and yet you also have private schools too.

If your goal is to get affordable healthcare and to ensure all people are covered then I think that is a great goal for all of society.
If your goal is to have lots of profitable healthcare insurers/providers, then that would be a great goal for people who own or invest in healthcare insurance companies.

 

[GodLovesCats]

I disagree. I think it is a fundamental healthcare concern for women.

If a country like USA has a super expensive health system, then it may make it financially out of reach for those people that may need it(want it) the most.

I think if USA fails to provide affordable abortions (regardless of if they are "elective") then I think your country is failing women and especially the poor (for no reason other than to appease one group of your society).

Abortion is "fundamental health care" if the mom is taking a drug that is known to kill embryos or fetuses and has no safe alternatives. But if she can live without a medication that would risk the embryo's life she can simply quit taking it for nine months and restart. The patient and doctor share this responsibily so an abortion can happen early in the first trimester, before the fetal stage begins. Once the bones harden too much for a fetus to be removed without being crushed, abortion is a HUGE no-no under ALL circumstances except to save the mom's life.

 

[MorkandMindy]

Ideally America would have a single payer system. My concern is it will hurt the economy when insurance companies are forced to go out of business. How do we find a balance? Where do we draw the line? That's why I struggle with the idea to let the government take over 100% of our health care.

The simple fact is working class jobs get eliminated all the time, complete car factories close and get moved to Mexico, the job losses are so extensive there is no one to buy the houses left behind so the workers lose both incomes and capital.

The banks nearly lost money but bundled up the mortgages as top rated mortgage backed securities, and sold them on.

The rich were bailed out both by the Republican government of G W B and the following Democrat one of B O B, but the car workers just had to do whatever they did (does anyone care?)

But insurance workers are middle class so we have to somehow look after them.

 

[MorkandMindy]

There's nothing humane about keeping people working in the the health insurance industry behind a computer or phone which does nothing useful for society. Sounds like a recipe for heart trouble and mental health issues.

There's also no point in us paying for a 'service' nobody wants. A neighbor had both Medicare and supplementary Medicare and his wife went in for a scan and removal of a tumor. After Medicare and the supplemental had paid their bits his payment was still 30,000 dollars.

The Medicare supplemental covered a lot less than the brochure made it sound like, the whole scam is just a rip off and only exists because lobbyists pay some election expenses for those in Congress.

 

[GodLovesCats]

Medicare is a scam? I would say HUMANA Medicare is, but not Medicare by itself.

Maybe a gradual change - placing stricter rules that drastically decrease drug prices and deductibles while setting up the single payer plans - would work to soften the blow to health insurance company employees as they trickle out. Then Americans would get used to the change before it sudenly hits them that they're only insured through the government, not their jobs.

 

[stevil]

Abortion is "fundamental health care" if the mom is taking a drug that is known to kill embryos or fetuses and has no safe alternatives. But if she can live without a medication that would risk the embryo's life she can simply quit taking it for nine months and restart. The patient and doctor share this responsibily so an abortion can happen early in the first trimester, before the fetal stage begins. Once the bones harden too much for a fetus to be removed without being crushed, abortion is a HUGE no-no under ALL circumstances except to save the mom's life.

I agree with you that we shouldn't have a pro-life vs abortion debate in this thread.

But I was talking about the situation where the intent is specifically to end the pregnancy (for whatever reason)
Being pregnant is a health condition. Terminating a pregnancy is a part of health care.

If you live in a society that doesn't provide a safe, regulated and affordable means for women to get an abortion AND you also exclude this from healthcare plans/insurance then I personally think that you are not adequately providing healthcare.
Personally I think private healthcare companies should be allowed to provide this service/insurance if they decide that they want to provide this.
However, if you have a system where the Employer gets to choose which Healthcare services/packages they offer their staff, then their staff may miss out on what I would deem to be even the bare necessities for an adequate healthcare package.
I can completely understand why many employers don't want to be forced to pay for this type of healthcare plan for their employees. This is one of the significant reasons why I think the government should be catering to this rather than forcing that obligation onto employers.

 

[GodLovesCats]

Stevil, I brought this up in the Abortion Dabates section and got this message for everyone else: It would be the same as killing a two-year old because you don't have insurance.

A good question would be how early in life should "childcare" begin? Neonatal care absolutely needs to be covered in any children's health insurance plan. But then you come across the ethical questions about the age of viability. Should babies be born and taken to the NICU (neonatal intensive care unit) or stay in the uterus until their due date while the mom pays for pregnancy-related issues? This is why I suggested the government could create a plan for women who think they may be, definitely are, or just were, pregnant. My fear is that many women have abortions because they lack the necessary health care coverage for the next several months (up to nine) so I want to see what the govenrment can do to give pregnant women a full range of health services that will drastically decrease the costs out of her pocket to deliver a baby.