I'm having some conflicting views on health care reform...

Boo Radley said:

I think a single payer system is a better system, not perfect but better. In this country, it would have to be two teired though, so those who can afford more can buy more.

Click to expand...

I assume you are talking about socialized medicine when you say "single payer". I don't understand that term, if it is socialized, then we all pay for it. To me, "single payer" would mean the consumer pays and no one else.

Regardless, I think that there is a better solution to socialized medicine, and thats socialized high deductable insurance.

imagep said:

I assume you are talking about socialized medicine when you say "single payer". I don't understand that term, if it is socialized, then we all pay for it. To me, "single payer" would mean the consumer pays and no one else.

Regardless, I think that there is a better solution to socialized medicine, and thats socialized high deductable insurance.

Click to expand...

Single-payer is a term used to describe a type of financing system. It refers to one entity acting as administrator, or “payer.” In the case of health care, a single-payer system would be setup such that one entity—a government run organization—would collect all health care fees, and pay out all health care costs.

What is Single Payer? | Physicians for a National Health Program

In this country, it would be two tiered. So if you want to and can afford more, you'd be able to do that.

ksu_aviator said:

I'm going to catch hell for this, I always do, but the only real solution is to put the cost factor back into the pockets of the consumer.

As it stands with most insurance, someone else pays the majority of the bills. So people go to the doctor for EVERYTHING.

Without going into all the why's, this is what I would do:

Ban (yes ban) Comprehensive Health Insurance, but still allow Major Medical Insurance.
Allow Health Savings Accounts to roll over into IRA's at the end of the year.

Just the initial ban of Comprehensive Health Insurance would save so much money that we'd be one of countries that spends the least on health care...and not because people quit going to the doctor.

Click to expand...

No hell from me - I think you are on the right track.

Taking your suggesting one step further, the government ALREADY spends enough on health care, that it could provide at no additional cost to the taxpayer, a high deductable policy purchased from private insurance companies, for EVERY citizen. At that point, no one is taking anything from anyone (that isn't already being taken), and every citizen automatically has a reasonable health care insurance policy.

This solves the mandate delima. Like has been brought up so many times, a sytem of health insurance doesn't really work well unless everyone is insured, and while it may be wrong or unconstitutional for our gov to require everyone to purchase insurance, there is nothing wrong with the government using it's unique ability to bargin (bid out) with insurance companies to purchase insurance for every american (using money that is already spend on health care). As long as we offer identical policies to all citizens, with no means testing or other bullcrap, it would just be another service that we get from the gov, similar to police protection and roads.

The answer is sooo simple, yet most of us ignore it as if it were not even an option.

imagep said:

No hell from me - I think you are on the right track.

Taking your suggesting one step further, the government ALREADY spends enough on health care, that it could provide at no additional cost to the taxpayer, a high deductable policy purchased from private insurance companies, for EVERY citizen. At that point, no one is taking anything from anyone (that isn't already being taken), and every citizen automatically has a reasonable health care insurance policy.

This solves the mandate delima. Like has been brought up so many times, a sytem of health insurance doesn't really work well unless everyone is insured, and while it may be wrong or unconstitutional for our gov to require everyone to purchase insurance, there is nothing wrong with the government using it's unique ability to bargin (bid out) with insurance companies to purchase insurance for every american (using money that is already spend on health care). As long as we offer identical policies to all citizens, with no means testing or other bullcrap, it would just be another service that we get from the gov, similar to police protection and roads.

The answer is sooo simple, yet most of us ignore it as if it were not even an option.

Click to expand...

Well, while it is good for everyone to have insurance...it is not good for the government to provide it. Just the very fact that the government provides what you can buy for yourself means it will cost more.

ksu_aviator said:

Well, while it is good for everyone to have insurance...it is not good for the government to provide it. Just the very fact that the government provides what you can buy for yourself means it will cost more.

Click to expand...

We pay a lot for very little now.Is it really possible to do worse? Certainly countries with a single payer are not paying waht we are and are getting more.

winston53660 said:

The problem I have with that is preventive care. eg catching things like cancer early from my understanding can greatly improve outcomes medically and financially.

Click to expand...

Actually, that is a myth. It has been proven over and over again that the types of things your are talking about is not cost effective.

The studies that prove that preventitive health care is cost effective includes preventative care such as exercise, not smoking, not drinking, healthy eating, etc. No insurance company pays for those things. You can't even buy them at the pharmacy. They are lifestyle choices, not insurance company choices.

Random screenings and such have been proven to not be cost effective. Now sure they may be beneficial to the individual, but the cost of screening everyone is far more expensive than treating the few who would benefit by the screening (the rare individual who would be found to have an early stage of cancer or whatever).

Regardless, nothing about banning comprehensive health insurance would prevent people from being screened, and nothing about having comprehensive health insurance insures that people get screened. You are under the misbelief that you can't purchase health care unless the insurance company pays for it. I purchase health care several times a year, without even mentioning my insurance companies name. I just pay for it, and it is cheaper than a tank of gasoline or a weeks worth of groceries. I don't bother my insurance company to fill up my car or my pantry.

Boo Radley said:

We pay a lot for very little now.Is it really possible to do worse? Certainly countries with a single payer are not paying waht we are and are getting more.

Click to expand...

You pay for a product that is a scam. You can't possibly use all of the "preventative" visits that are included in a comprehensive policy.

ElijahGalt said:

I agree with you in some respect, especially in regards to why care has become so expensive. However, this thread is specifically about the individual insurance mandate being debated today and its relationship to a similar mandate on individual auto insurance (albeit one is state-wide consensus while the other is being debated federally). The thread is also about using that insurance mandate to pay for the unfunded liability known as the EMTLA.

Two straight-forward questions I would like to pose to you are:

Would you repeal the EMTLA?

Are you opposed to mandated auto insurance coverage for the same reason you oppose the individual healthcare insurance mandate being legislated and debated today?

Click to expand...

Under my plan EMTLA could be repeals as there would be no need for it. I do not opposed mandated auto insurance, but that's an entirely different situation.

My plan eleminates the issue of whether insurance should be mandated. Under my plan, there would be no need to be mandated, as it would be automatic for every citizen. My plan simply moves "health insurance" into the list of benefits that we recieve from government - might as well because that is effectively what happens anyway (in an indirect sort of way).

ksu_aviator said:

You pay for a product that is a scam. You can't possibly use all of the "preventative" visits that are included in a comprehensive policy.

Click to expand...

Did you mean to answer me or someone else? I said we pay a lot today. We do. More than countries with single payer systems. And in terms of access, we get very little.

ksu_aviator said:

Well, while it is good for everyone to have insurance...it is not good for the government to provide it. Just the very fact that the government provides what you can buy for yourself means it will cost more.

Click to expand...

Do you really think that it is cheaper to build your on interstate highway than for the goverment to build one? Do you really think that you can raise your own private army cheaper than the goverment can? There are many services which can and are done more cost effectively by the goverment. I can send a letter for just 44¢ using the government mail service, Fed Ex would cost me $8.

Also note that I suggested the goverment not being the insurance company, but purchasing insurance from private companies. It wouldn't be that hard to work out the details.

The last 3 digits of Social security numbers are random. We could divide up our population fairly equally if we grouped everone who's ss ended with "000" into one group, "001" into another group, so on and so forth. That would give us 1,000 different groups (of about 3 million people per group). The gov would pre-write the standard insurance policy and would allow insurance companies to competitively bid on the opportunity to be a provider for each group. Insurance companies know insurance, and they know exactly what they could do the job for and how much over cost they would need to charge to make a decent profit. The competitive bidding process would keep prices low, and each insurance company could bid on as many groups as they choose. The lowest bidder would get the first groups, the next lowest would get the next groups, on and on until all the groups have an insurance provider. Every X number of years (I'm thinking maybe 2 years to start out with and then extending that lenth later), the groups would be rebid.

Boo Radley said:

Did you mean to answer me or someone else? I said we pay a lot today. We do. More than countries with single payer systems. And in terms of access, we get very little.

Click to expand...

Maybe you missed my post above. If we eliminated comprehensive health insurance we could cut about $648 billion in health care costs. That would bring our health care system from the 15% of GDP it is right now to closer to 10%...which is right in line with every other nations. In addition, we would see savings as people see the real cost of health care and only visit the doctor for those items that require a doctor. It is a guess, but we might see as much as 1% or 2% drop in spending in relation to GDP which would put us below other nations. Then, I proposed allowing individuals to keep the tax free HSA savings as an IRA if they don't use the funds rather than losing them as they do now. Imagine this, if you took all the money you spent on health insurance and got nothing for and put it into savings, do you think you could retire without SS?? Yes, yes you could.

ksu_aviator said:

Maybe you missed my post above. If we eliminated comprehensive health insurance we could cut about $648 billion in health care costs. That would bring our health care system from the 15% of GDP it is right now to closer to 10%...which is right in line with every other nations. In addition, we would see savings as people see the real cost of health care and only visit the doctor for those items that require a doctor. It is a guess, but we might see as much as 1% or 2% drop in spending in relation to GDP which would put us below other nations. Then, I proposed allowing individuals to keep the tax free HSA savings as an IRA if they don't use the funds rather than losing them as they do now. Imagine this, if you took all the money you spent on health insurance and got nothing for and put it into savings, do you think you could retire without SS?? Yes, yes you could.

Click to expand...

The trouble is it wouldn't work that way. It was the inability of most people to pay for health care, as it moved from the home to the professional ranks that created the need for insurance. At one time, many went without, trading fruits and vegitables for minimal care. Home treatment was more common, and they didn't get MRI's.

And the trouble we have with savings is we spend it. No matter what we think someone could do or should do, at the end of the day, someone won't have enough, a lot of folks won't have enough, and not enough to even pay on time in any reasonable way. So, we either treat them and pass on the costs, or we say to treating them. Either way, we're worseand not better than we'd be with a single payer.

ksu_aviator said:

Maybe you missed my post above. If we eliminated comprehensive health insurance we could cut about $648 billion in health care costs. That would bring our health care system from the 15% of GDP it is right now to closer to 10%...which is right in line with every other nations. In addition, we would see savings as people see the real cost of health care and only visit the doctor for those items that require a doctor. It is a guess, but we might see as much as 1% or 2% drop in spending in relation to GDP which would put us below other nations. Then, I proposed allowing individuals to keep the tax free HSA savings as an IRA if they don't use the funds rather than losing them as they do now. Imagine this, if you took all the money you spent on health insurance and got nothing for and put it into savings, do you think you could retire without SS?? Yes, yes you could.

Click to expand...

The bad thing is that our gov already allows us to do so, but most people just don't understand the concept. I actually have more money in my HSA than I do in my IRA. The added bonus of everyone doing this would be the savings that you mention, plus a drop in the cost of medical care due to the fact that this would convert our health care industry from a non-price-competitive industry to a price competitive industry.

Boo Radley said:

The trouble is it wouldn't work that way. It was the inability of most people to pay for health care, as it moved from the home to the professional ranks that created the need for insurance. At one time, many went without, trading fruits and vegitables for minimal care. Home treatment was more common, and they didn't get MRI's.

And the trouble we have with savings is we spend it. No matter what we think someone could do or should do, at the end of the day, someone won't have enough, a lot of folks won't have enough, and not enough to even pay on time in any reasonable way. So, we either treat them and pass on the costs, or we say to treating them. Either way, we're worseand not better than we'd be with a single payer.

Click to expand...

Actually, you are not allowed to spend your HSA money on anything other than health care (without a huge penalty). I have NEVER spent a dime of my HSA money on anything other than health care, although I empty out my piggy bank quite frequently to go on vacation.

If the best arguement that you have against high deductable policies and HSA's is that "it just won't work like that", then obviously the high deductable policy and HSA combo is the best option. It keeps the gov out of my health care decisions, keeps gov small, keeps my doct from having to report to the gov, saves me a mountain of money, provides me with security, allows a truely free market to set prices and allocate goods and services, and doesn't cost the gov a dime. Sweet deal, and sooo simple.

imagep said:

Do you really think that it is cheaper to build your on interstate highway than for the goverment to build one?

Click to expand...

Well, yes. Here's why. The government has to collect taxes or borrow money to build/maintain the roads. Either way, they have to pay for the collection of the taxes/bonds. Then, they pay contractors to bid on the roads. Everything from there on is the same. But you have the added cost of the government laying and collecting taxes or the interest on the borrowed money that you would not have with privately owned roads.

Do you really think that you can raise your own private army cheaper than the goverment can?

Click to expand...

The government does. They have been hiring security companies because they offer a service that is analogous to troop deployment and the government doesn't have to make long term financial investments.

There are many services which can and are done more cost effectively by the goverment. I can send a letter for just 44¢ using the government mail service, Fed Ex would cost me $8.

Click to expand...

Ya, but what are the chances the letter will get there? I never send anything that has to get there via USPS. I always use FedEx (never UPS...oh God, never UPS).

Also note that I suggested the goverment not being the insurance company, but purchasing insurance from private companies. It wouldn't be that hard to work out the details.

The last 3 digits of Social security numbers are random. We could divide up our population fairly equally if we grouped everone who's ss ended with "000" into one group, "001" into another group, so on and so forth. That would give us 1,000 different groups (of about 3 million people per group). The gov would pre-write the standard insurance policy and would allow insurance companies to competitively bid on the opportunity to be a provider for each group. Insurance companies know insurance, and they know exactly what they could do the job for and how much over cost they would need to charge to make a decent profit. The competitive bidding process would keep prices low, and each insurance company could bid on as many groups as they choose. The lowest bidder would get the first groups, the next lowest would get the next groups, on and on until all the groups have an insurance provider. Every X number of years (I'm thinking maybe 2 years to start out with and then extending that lenth later), the groups would be rebid.

Click to expand...

Really and truly, this is a creative solution. But, I'm a Constitutionalist first and a Conservative second. If you want to implement this solution, it can only be done on the local level. If you take a closer look at Medicare et. al. you'll find that Medicare is actually state run and funded by the federal government. The federal government cannot administer programs like Medicare. They can send funds to states earmarked for certain uses and they can refuse to send the funds unless the states follow certain rules, which gives the federal government real control over Medicare...but it is structured to be a state fun program.

Besides the objection to federal run programs, I have a philosophical objection to the government maintaining practical control over my health care. If the government controls the funds to the insurance (and the implementation of the insurance) they, for all practical purposes, control my right to life.

I don't mind regulations that prevent the insured from being dropped. I don't mind allowing insurance to be sold a crossed state lines. I don't mind regulations that raise life time maximums. I just mind having the government provide to me the means to which I can extend or better my life and health.

imagep said:

The bad thing is that our gov already allows us to do so, but most people just don't understand the concept. I actually have more money in my HSA than I do in my IRA. The added bonus of everyone doing this would be the savings that you mention, plus a drop in the cost of medical care due to the fact that this would convert our health care industry from a non-price-competitive industry to a price competitive industry.

Click to expand...

But you lose your HSA at the end of the year, unless the rules have changed.

Boo Radley said:

The trouble is it wouldn't work that way. It was the inability of most people to pay for health care, as it moved from the home to the professional ranks that created the need for insurance. At one time, many went without, trading fruits and vegitables for minimal care. Home treatment was more common, and they didn't get MRI's.

And the trouble we have with savings is we spend it. No matter what we think someone could do or should do, at the end of the day, someone won't have enough, a lot of folks won't have enough, and not enough to even pay on time in any reasonable way. So, we either treat them and pass on the costs, or we say to treating them. Either way, we're worseand not better than we'd be with a single payer.

Click to expand...

So? Other people are going to screw up. Why should the government guarantee that their bad decisions are going to work out? Why should others have to pay from someone else's bad decisions?

imagep said:

Actually, you are not allowed to spend your HSA money on anything other than health care (without a huge penalty). I have NEVER spent a dime of my HSA money on anything other than health care, although I empty out my piggy bank quite frequently to go on vacation.

If the best arguement that you have against high deductable policies and HSA's is that "it just won't work like that", then obviously the high deductable policy and HSA combo is the best option. It keeps the gov out of my health care decisions, keeps gov small, keeps my doct from having to report to the gov, saves me a mountain of money, provides me with security, allows a truely free market to set prices and allocate goods and services, and doesn't cost the gov a dime. Sweet deal, and sooo simple.

Click to expand...

I know. And it wouldn'twork for me as you lose it at the end of the year, thus forcing me to spend when a Iwouldn't have to. Tried it once, no more.

ksu_aviator said:

So? Other people are going to screw up. Why should the government guarantee that their bad decisions are going to work out? Why should others have to pay from someone else's bad decisions?

Click to expand...

Because we're left with what to do. We say we have to treat them, so what now? And it isn't the government, it is us. One way or another, we have to figure out how to address this, and one way or another we will pay for this type of thing.

Well, yes. Here's why. The government has to collect taxes or borrow money to build/maintain the roads. Either way, they have to pay for the collection of the taxes/bonds. Then, they pay contractors to bid on the roads. Everything from there on is the same. But you have the added cost of the government laying and collecting taxes or the interest on the borrowed money that you would not have with privately owned roads.

Click to expand...

The cost of the collecting taxes is far less than having to have a toll booth at every street corner. Can you imagine what it would cost to do that? Not to mention the inconvienance to the driver, and legal issues that would arise (like who would patrol private streets, and would abulances be allow to drive on those roads toll free)

The government does. They have been hiring security companies because they offer a service that is analogous to troop deployment and the government doesn't have to make long term financial investments.

Click to expand...

The gov hires private armies because private armies can do jobs that we have for some reason prohibited our own military from doing. It's not cheaper to hire a mercinary at $250k/yr plus expenses than it is to hire a marine at $32k/yr plus expenses. there also may be some corruption in those decisions.

Ya, but what are the chances the letter will get there? I never send anything that has to get there via USPS. I always use FedEx (never UPS...oh God, never UPS).

Click to expand...

Near 100%. Thats the reason that the USPS delivers more than UPS and FedEx combined.

Besides the objection to federal run programs, I have a philosophical objection to the government maintaining practical control over my health care. If the government controls the funds to the insurance (and the implementation of the insurance) they, for all practical purposes, control my right to life.

Click to expand...

Yes, thats exactly why you should support my plan. Under my plan, you will pay for the bulk of your own medical care at your own expense. Gov would have virtually no control over what care you purchased. They wouldn't even have to know what care you purchased and wouldn't neccesarally have access to it since the doctors would be private and since the insurance companies would be private. The private insurance companies would implement the insurance plans by whatever methods they found to be most cost effective, the only control over the insurance companies would be that they are required to make payments in a prompt manner, and of course the % and deductable that they would be responsible for. This is a plan to get goverment out of our personal business.

I don't mind regulations that prevent the insured from being dropped. I don't mind allowing insurance to be sold a crossed state lines. I don't mind regulations that raise life time maximums. .

Click to expand...

It seems that you don't mind a lot of government intervention into your financial transactions. My plan eleminates the need for all those laws.

I just mind having the government provide to me the means to which I can extend or better my life and health

Click to expand...

Thats exactly why we need to eleminate government paid for health care. The VA, Medicare, Medicaid, SCHIP, etc. My plan eleminates the need for all that government control and puts the individual in charge of his own health care decisions. The only the the gov would do is to pay a thousand or a couple thousand dollars a year per citizen to the insurance companies - outside of that, my plan gets gov out of our personal health care decisions.

ksu_aviator said:

But you lose your HSA at the end of the year, unless the rules have changed.

Click to expand...

Absolutely not.

I set up my HSA account with my bank. It is my money, that I deposit, and it is my money to spend as I choose. I have incentive to deposit money into that account because I know that from time to time I have health care expenses and because it is fully tax deductable. The gov has nothing to do with my HSA other than the fact that they allow it to be a tax deduction. My insurance company has nothing to do with my HSA. It is my money, I can spend it how I choose. If I want to have a botox injection with my money, I can do that and not the government and not the insurance company can tell me that I cant. If i don't use all the money that I deposit into my HSA this year, then it is still mine next year, and the next and the next.

i think that people tend to reject the idea because they don't know what it is. Insurance companies may be the villians here - they don't let people know that the high deductable policy is available and they don't want individuals to know about HSA's as it is more profitable for insurance companies for you to purchase an expensive insurance policy.

Boo Radley said:

I know. And it wouldn'twork for me as you lose it at the end of the year, thus forcing me to spend when a Iwouldn't have to. Tried it once, no more.

Click to expand...

I don't think you realize the type of HSA that we are talking about here. Thats part of the problem. The HSA is not controled by the gov and is not controlled by the insurance company. It's your money until you spend it.

If you had a Health Care Savings Account with a bank, and you didn't use up all the money, then you either still have that money in the account, or you need to sue the bank for your money back.

Boo Radley said:

Because we're left with what to do. We say we have to treat them, so what now? And it isn't the government, it is us. One way or another, we have to figure out how to address this, and one way or another we will pay for this type of thing.

Click to expand...

yes. Like my plan.

Health savings account - Wikipedia, the free encyclopedia

You may want to look this up.

imagep said:

The cost of the collecting taxes is far less than having to have a toll booth at every street corner. Can you imagine what it would cost to do that? Not to mention the inconvienance to the driver, and legal issues that would arise (like who would patrol private streets, and would abulances be allow to drive on those roads toll free)

Click to expand...

I don't know what a toll booth is. We don't have those here. We have toll roads that use cameras to determine your fees. But that is beside the point. The point is that, with health care, you have have to collect taxes and then pay for the insurance. That means added expenses. Regardless of how you run the equation when you add one to another it will always be more.

Near 100%. Thats the reason that the USPS delivers more than UPS and FedEx combined.

Click to expand...

Well, I was in shipping when I flew cargo. I flew UPS and USPS. I know UPS loses 0.55% of packages and the USPS loses 3.4%. FedEx I believe loses 0.8%.

Yes, thats exactly why you should support my plan. Under my plan, you will pay for the bulk of your own medical care at your own expense. Gov would have virtually no control over what care you purchased. They wouldn't even have to know what care you purchased and wouldn't neccesarally have access to it since the doctors would be private and since the insurance companies would be private. The private insurance companies would implement the insurance plans by whatever methods they found to be most cost effective, the only control over the insurance companies would be that they are required to make payments in a prompt manner, and of course the % and deductable that they would be responsible for. This is a plan to get goverment out of our personal business.

It seems that you don't mind a lot of government intervention into your financial transactions. My plan eleminates the need for all those laws.

Click to expand...

No, you make an assumption that is not true. I don't mind the government setting rules that we all live by. There is a difference.

As for your plan, it would still require those rules. In addition, the government could buy insurance of less value if they felt it was in their best interest. So yes, they would have a say in the catastrophic care side of things, which I don't want. I think it is a violation of my rights.

Thats exactly why we need to eleminate government paid for health care. The VA, Medicare, Medicaid, SCHIP, etc. My plan eleminates the need for all that government control and puts the individual in charge of his own health care decisions. The only the the gov would do is to pay a thousand or a couple thousand dollars a year per citizen to the insurance companies - outside of that, my plan gets gov out of our personal health care decisions.

Click to expand...

It really doesn't. It just adds those that aren't on the government doles.