View Poll Results: What should be fixed first?

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  • Cost

    35 70.00%
  • Medical Malpractice

    6 12.00%
  • Medicare Fraud

    7 14.00%
  • Coverage Denial

    9 18.00%
  • Claim Denial

    5 10.00%
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Thread: What should be the first step to fixing healthcare in the US?

  1. #121
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    Re: What should be the first step to fixing healthcare in the US?

    Quote Originally Posted by Redress View Post
    There have been done some studies on how much tort reform would lower cost, and it is pretty small. If I remember right, it would be less than 1 percent. Does not make it not worth doing, but when costs are rising 2 to 3 times the rate of economic growth, there is a major problem and 1 % ain't gonna do it.
    I would look with a jaundiced eye at the claim that the savings would be ~1%. It strikes me as likely that that estimate is a static estimate based solely off of the reduction in lawsuit payouts, rather than the changes in how medicine is practiced. Estimates are that as much as 25% of our healthcare spending is on purely defensive medicine, designed to avoid lawsuit rather than improve health. Slashing into that 25% by reducing the threat of suit would produce pretty significant savings, on top of freeing up medical resources.


    As for the OP, Rising Costs aren't so much "The Problem" as they are the chief symptom of The Problem. The chief problem with our current healthcare system is an abundance of awkward and disruptive interference. This has led to the dominance of a third-party-payment model which discourages cost-awareness and encourages over-consumption among health care consumers. Government pays for roughly half of our healthcare consumption, and of all third-party payment options, government is the one least likely to be capable or willing to nimbly find ways to impose cost awareness on those capable of sending it bills. The result is a healthcare system in which costs rapidly spiral out of control (we have a similar problem in our higher education industry). Any system which does not alter that disruption and incentivize cost-awareness among consumers for the vast majority of medical purchases will not address the chief underlying flaw of our current system, and we will continue to see costs spiral outside of the control of the citizenry and government.


    Reforms which have pushed cost-awareness back onto consumers have demonstrated impressive results at lowering expenditures:

    Indiana offered HSA's, - which have patients save money in tax-free accounts (where it grows and remains theirs forever and ever unless theys pend it) - matched with high deductible plans to it's employees. Employees began to respond to price signals, and medical costs per patient were reduced by 33% and expenditures to the state were reduced by 11%.

    Safeway has instituted a program that gave financial incentives to people who engaged in healthy behavior by allowing price signals in the insurance side of the market to work (Indiana worked on the medical side), and saw it's per-captia health care costs remain flat from 2005-2009; when most companies saw theirs jump by 38%.

    Whole Foods instituted HSA's, and let's the employees choose what they want the company to fund. This institutes price pressure on the medical side (WF covers the high-deductible plan 100%), and their CEO points out that as a result Whole Foods' per-capita costs are much lower than typical insurance programs, while maintaining employee satisfaction.

    Medicare Part D utilized market pressure on the insurance side, and saw expenditures come in at 40% UNDER expectations - the only such government program in history to do so.

    Wendy's instituted HSA's, and saw the number of their employees who got preventative and annual checkup care climb even as they saw claims decrease by 14% (in one year).

    Wal-Mart's low cost clinics and prescriptions save us oodles of cash. Wal-Mart reports that "half of their clinic patients report that they are uninsured" and that "if it were not for [Wal-Marts'] clinics they would haven't gotten care - or they would have gone to an emergency room".

    Dr Robert Berry runs a practice just across the state border from my old hometown called PATMOS (payment at time of service). he doesn't take insurance at all - but simply posts the prices of his services. By removing the cost of dealing with mutliple insurance agencies, medicare, and medicaid, the prices he is able to list are one half to ONE THIRD of industry standard.


    ....And I (again) propose that we build upon the lessons of those successes by building a healthcare system that can ensure universal access to coverage while reducing costs and expenditures.
    Last edited by cpwill; 11-07-13 at 02:14 PM.

  2. #122
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    Re: What should be the first step to fixing healthcare in the US?

    I don't know which answer to pick and here is why. Where I live it's much cheaper to buy junk food and breads, pasta etc that are white that has more sugar in it than whole grain. Vegetables, fruits, etc are very expensive. So, the first thing we need to do is make healthy food affordable. Next, kids should be having gym class every day in school. The healthier we are, the less medical bills we will have. Oh and only natural sugar, get rid of high fructose corn syrup or HFCS.

  3. #123
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    Re: What should be the first step to fixing healthcare in the US?

    Quote Originally Posted by Green Man View Post
    Yes, I mean allow people to purchase health care services from whomever they want.



    Okay, we can keep the FDA, if you wish. I'd just strip them of power to prevent a drug from being put on the market. They could do the studies and publish them so people are informed. But I would still allow people to buy medicine from whomever they want.
    These first 2 could only work if the AMA and FDA were replaced by various private certification companies.

    Suppose 5-10 competing companies existed to certify medical professionals and/or drug safety - the competition is key here, because without it some monolithic and more easily corruptible certification company (like the FDA, really) would form.

    Of course you would need to have some way of preventing a behind-the-scenes agreement between them from forming, and allowing lower standards...

    But I think anti-trust/anti-monopoly laws would work there.

    Quote Originally Posted by Green Man View Post
    Give people more choices. Choices are good.
    To a degree. In this case, though, I completely agree.

    Limiting companies to in-state and disallowing competition across state lines is bad for any service/product, let alone medical.

    Quote Originally Posted by Green Man View Post
    I don't propose ending health insurance at all. If people want insurance, they should be allowed to buy insurance.
    The problem is that some people will NOT buy insurance, and then will still be given medical care when they show up for it. This costs SOMEONE money, and most often it is the hospitals - this then drives up their costs, and thus the costs of the people who DO pay.

    I could actually accept a law that required everyone to have some form of medical care insurance, but the vast number of extra limitations and stipulations in the current law (Obama Care) are what turns me off.

    I mean, if it allowed someone to say "I am setting up a health care savings account", and have that count as medical care insurance.
    Or if it let someone purchase high-deductible health insurance.

    Frankly, that is my main issue with Obama care - it places far too many limits on what care you CAN buy.
    Last edited by The Mark; 11-07-13 at 10:34 PM.
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  4. #124
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    Re: What should be the first step to fixing healthcare in the US?

    Quote Originally Posted by The Mark View Post
    These first 2 could only work if the AMA and FDA were replaced by various private certification companies.
    Why does it even have to be private? Why not allow it to function like the Bar Exam for Lawyers? Has anyone noticed a shortage of lawyers, lately?

  5. #125
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    Re: What should be the first step to fixing healthcare in the US?

    If the FDA really cared about safety, gmos would be illegal, fast food would be illegal, tobacco additives would be illegal and on and on.

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