How do we fix our healthcare system in America?

slownsteady said:

Have you noticed that you're not allowed to drive around in an uninsured car? Why? Because it's the law that you must be insured. And what happens if you're caught without car insurance? You pay a fine.

Hey everybody! Let's abolish car insurance!!!

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There is a big difference between car insurance and ACA. The government does not tell you that you have to own a car. Owning and driving a car is a privilege not a right. The government does not go to people that do not own a car and say you have to pay for car insurance even though you don’t own a car, because if spreading the burden of car insurance over everyone will lower the cost for all. Government does not say when you go to get your car insured tell us your income because the more you make the more you should have to pay so that people that make less can better afford car insurance. Instead they ask you what kind of car what year and how much do you drive. They also look at your driving record. Then they ask you how much coverage do you want.

No one that does not own a car and does not drive a car has ever been made to pay a fine for not having car insurance. People that do not want health insurance and do not have health insurance are being fined for not signing up.

It is our right to live our life free. We are free to work or not work and work as hard as we like. If we are blessed with a skill or intelligence it is our right to use it or squander it as we best, see fit. If we think the money we earn would better be spent on something else we should be free to do that.

I just had stone chip in my windshield that turned to a crack and I called my car insurance company. They reminded me I had $500 deductible and told me the cost was just under 500 and I was SOL. I could have had glass breakage on my insurance but I chose to keep my money and take the chance I didn’t have glass breakage and I lost.

Having any kind of insurance has never been a right in this country.

nealtw said:

Let's talk about car insurance, we have had gov. insurance since the late sixties, I still don't pay a much for insurance as I did in 1967, the only people complaining are those that get caught skiing when they are suing for a broken neck or something.

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I’m a little confused. Are you saying your car insurance in Canada is also thru government? And that you pay the same or less now as you did in 1967? If so how do you explain where the money comes from to pay out claims?

zannej said:

Bud, I think comparing car insurance and restaurant meals to health insurance is like comparing apples to oranges.
Having a car is very helpful and there are times when it can be a life-saver to be able to drive away, but there are other people who can drive someone (not always, but most of the time) if need be.
A person can still get some less expensive food at grocery stores and such (if they don't live in a "food desert") and still survive.
But medical care is not something that can really be compromised.
Medical treatment requires very specific care, medicines, and procedures. People can and do die from lack of treatment. People don't die because they can't eat at a fancy restaurant and ones who are very desperate for food will pick through the trash (I've seen people doing that). But you can't pick through the trash for medical care.

I'm not saying we should bring all the medical prices down to an unfair level so they would need to make up for it in other ways. I'm saying we should bring it down to a reasonable level so that they are able to make a little bit of profit over breaking even as an incentive. When they have a test that costs maybe $5 to run and they charge $800 or even $8,000 for it, that is absurd. They can charge maybe $20 to $50 or even $80 if they need to make up for the cost of the equipment. And the more people that can afford it, the more likely they are to get $ from doing those tests.

As for the cheap/free clinics-- they aren't available in some areas. People might have to get a lift to places 2 to 3 hours away. And some people aren't able to get there. And places like Walmart (at least where I live) won't always let people have days off when they need to go to appointments or even when they have medical emergencies. The local Walmart here has fired at least 5 employees (that I know of) because they needed medical treatment. (Which is why I think they need to enforce the rules for the Family Medical Leave Act more strictly).

I'm not sure how I feel about a Walmart run clinic. Maybe they can pull it off in Canada, but not where I live. I know they sometimes have eye clinics at Walmarts, but actual regular medical.... I wouldn't trust them. I think I'd trust Costco more, but there is no Costco in my area.

I'm not suggesting that people just straight up get a free ride, but people should not be dying because they can't get medical treatment- and I do know that some hospitals will refuse to treat children because the parents can't afford it. I've had friends who couldn't get their kids treated for painful injuries/medical issues because they couldn't afford to pay the full amount up front and the doctor's refused to do the treatment without said payment. And if they were charging reasonable amounts or allowing payment plans, my friends would have been able to afford it. I get they don't trust payment plans because people don't always pay, but necessary treatment should not be withheld because of money.

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Of course you are right comparing anything that is not exactly the same is comparing apples to oranges. Even when going grocery shopping for fruit.

Basically the discussion comes down to two or three things. The first being is healthcare a commodity like apples and oranges or a car, to be bought and used to make our life better and more enjoyable, or is it a right all men are entitled to give to us from God. Secondly is compassion to our fellow man that we should all have. The third item is cost and how far we should go with our compassion and then what happens when we hit the cost prohibited point and our compassion persists.

All people are different in their beliefs. Where I live we have a large Amish population. Their belief is they take care of their own. If they get sick they doctor themselves as best they can and when they can’t they go see a doctor and insist on paying cash. If a kid gets a tooth ache they go to the dentist and tell him to pull the tooth out. It is their way and it is their right. They drive their buggies down the public roads without the inspections I have to pay for every year and without car insurance.

So let’s assume health care is a right given to us from God. I think you will agree we need to put limits on it. I have needed reading glasses for the last 10 years and I would love to go get eye surgery and have 20/20 vision again. The thing that’s stopping me is my very good insurance says go for it and pay for it yourself because all they think I need is a 10 dollar pair of glasses from Walmart. I could make a case that’s not very compassionate. Or should we only be compassionate when it is life or death. Well that is a hard one also because most of the cost of health care is at the end of life. And who makes the call when someone is very old and wants a procedure that costs 100 grand and will keep them alive another 6 months.

No matter how much money is available and how low we lower costs there will never be enough and sadly people won’t get treatment with or without insurance. The goal of ACA was to insure everyone. All we heard about was the 14 million that didn’t have insurance. Then lately if Trump had his way it would be 20 million. It would be easy to insure everyone if we lower our compassion for our fellow man to the point the funding will cover. We are all covered now. Granddad who is retired needs a knee replacement we take a look at his knee and we tell him you don’t work anymore you are on social security here is a cane (next). Grandma needs a bypass she is 88 here are some nitro pills (next).

What level of quality do we expect and at what level of compassion do we show. We have a ER doc in our family and he tells me most of his 12 hour shift is telling people they don’t need painkillers they are asking for or bringing back to life OD’s with some expensive drug and then seeing them come back in a week later OD again. Do we lower costs and toss these drug users out the door and help some sick people.

We do agree on one thing if I’m having chest pain I would much rather go to Costco than Sam’s Club.

bud16415 said:

I’m a little confused. Are you saying your car insurance in Canada is also thru government? And that you pay the same or less now as you did in 1967? If so how do you explain where the money comes from to pay out claims?

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I think BC is one of three Provences with gov. insurance.
https://www.biv.com/article/2016/6/icbc-slips-out-bad-news-balance-sheet/

All a little different.
http://www.bcuc.com/Documents/Proceedings/2014/DOC_42062_C4-2_McCandless_Letter-of-Comment.pdf

The gov. uses it has a cash cow and then complains it is always losing money.

Bud, you make some very good points.

I don't think giving everyone insurance will fix things. I also don't think that lowering the costs of medical treatment alone will fix things. There need to be multiple things done and I am not naive enough to ever think we will have a perfect system.

However, just because we may never have a perfect system does not mean we can't try to have a better system-- and while lowering medical prices may not fix everything, it could actually save a great number of lives.

The question of how far to go and so forth is a good one. That is something that will have to be decided upon.

I do certainly think that children should not be made to suffer. Anything that causes debilitating pain or is life-threatening should be treated. If a kid breaks his/her arm, they should not be told they can't get a cast because their parents can't pay for it up front.

zannej said:

Bud, you make some very good points.

I don't think giving everyone insurance will fix things. I also don't think that lowering the costs of medical treatment alone will fix things. There need to be multiple things done and I am not naive enough to ever think we will have a perfect system.

However, just because we may never have a perfect system does not mean we can't try to have a better system-- and while lowering medical prices may not fix everything, it could actually save a great number of lives.

The question of how far to go and so forth is a good one. That is something that will have to be decided upon.

I do certainly think that children should not be made to suffer. Anything that causes debilitating pain or is life-threatening should be treated. If a kid breaks his/her arm, they should not be told they can't get a cast because their parents can't pay for it up front.

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I don’t know what it is like where you live but here I’m very sure before and after ACA no little kid with a broken arm hasn’t been treated in our hospitals with or without insurance. If there have been some I would love to read more about it. I know homeless people often get treatment both before and after ACA.

This is pretty much what I see around here.

http://law.freeadvice.com/malpractice_law/hospital_malpractice/hospital-patients.htm

bud16415 said:

I don’t know what it is like where you live but here I’m very sure before and after ACA no little kid with a broken arm hasn’t been treated in our hospitals with or without insurance. If there have been some I would love to read more about it. I know homeless people often get treatment both before and after ACA.

This is pretty much what I see around here.

http://law.freeadvice.com/malpractice_law/hospital_malpractice/hospital-patients.htm

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Then of course, there is the argument that the ACA has lowered losses for hospitals enabling them (in some cases) to stay open. There was a report on this recently which I can't exactly recall to memory. The whole concept of preventative care combined with the reality that taxpayers are already paying for ER care (very expensive and often not necessary) means a net lowering of costs, which (either by ignorance or intent) is not calculated into the argument by Congress.

I don't know of any ER in America that is allowed to refuse treatment to anyone? I am still trying to figure out how it cost me 12k to have my wife deliver a baby. The baby was born within minutes of getting there. She stayed their two day minimum, no surgeries or anything special and 12k for that. There is no way they are not making a profit off that.

Profits from you may be covering losses at the ER. I'm not offering excuses for the prices they charge, just saying that might be the case.
I guess the rest of that argument could start with: why did you choose that hospital? Did you price other hospitals? Did you consider a mid-wife? Etc.

Chris said:

I don't know of any ER in America that is allowed to refuse treatment to anyone? I am still trying to figure out how it cost me 12k to have my wife deliver a baby. The baby was born within minutes of getting there. She stayed their two day minimum, no surgeries or anything special and 12k for that. There is no way they are not making a profit off that.

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It is the same argument you use when you dig a hole for someone and it takes you 15 minutes. And they want to give you 25 bucks after all that’s $100 per hour in their mind. They don’t take into account you have a million dollars in equipment waiting to be used. Tell them to dig it by hand with a shovel and a month later they will have the same hole. I get it plowing snow all the time. They figure it takes 2 swipes total of 3 minutes for a 100 foot long driveway with 2 foot of snow. So they hand me 5 bucks for my 3 minutes work. I tell them buy a 30 grand truck and a 10 grand plow and come back and we will talk then I loan them my shovel.

You had healthy babies that’s great but part of the cost was all the pediatric doctors waiting around in case your baby needed heart surgery or something.

I also am not defending them as there is loads of waste it is just putting the government in charge never reduces waste.

slownsteady said:

Then of course, there is the argument that the ACA has lowered losses for hospitals enabling them (in some cases) to stay open. There was a report on this recently which I can't exactly recall to memory. The whole concept of preventative care combined with the reality that taxpayers are already paying for ER care (very expensive and often not necessary) means a net lowering of costs, which (either by ignorance or intent) is not calculated into the argument by Congress.

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I agree. And that is the argument I hear a lot. If it is true ER’s should be freed up by now and laying people off. I haven’t seen that as the case yet. Once we give ACA a couple more years we should be seeing everything improving. We will know as time goes on.

As to money / cost not calculated in by the Congress keep in mind all the money they are using to keep afloat these programs is also coming out of nowhere. If they print money or quantitative ease money where did that new money come from. And who is going to pay it back. Neal gets his for free why can’t we do the same thing? Money is free if you can make it whenever you want.

bud16415 said:

I agree. And that is the argument I hear a lot. If it is true ER’s should be freed up by now and laying people off. I haven’t seen that as the case yet. Once we give ACA a couple more years we should be seeing everything improving. We will know as time goes on.

As to money / cost not calculated in by the Congress keep in mind all the money they are using to keep afloat these programs is also coming out of nowhere. If they print money or quantitative ease money where did that new money come from. And who is going to pay it back. Neal gets his for free why can’t we do the same thing? Money is free if you can make it whenever you want.

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You heard free, perhaps you should pay attention. You can't have a discussion unless you want to understand the facts and build on them until everyone understand the facts so that solutions can be found.

Governments all over the world subsidize the healthcare system, many pay less than your government does. If the free market works so well in this industry, what was the problem.
No body ever ran over the limit.
Nobody ever lost their house..

As to money / cost not calculated in by the Congress keep in mind all the money they are using to keep afloat these programs is also coming out of nowhere. If they print money or quantitative ease money where did that new money come from. And who is going to pay it back. Neal gets his for free why can’t we do the same thing? Money is free if you can make it whenever you want.

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That argument goes astray of this discussion. I know your reply is it all comes down to money - you've said that before. But that argument could be made about anything the govt touches (yes, everything), even to "keep afloat" the navy.
Money is the key issue, granted, but my point is more about how the political parties use or disregard facts and figures as it suits them. I haven't heard about a CBO report based on if we went backwards to the previous system.

I am not complaining about my 12k bill. Just pointing out that with the amount of people that go to the hospital that pay should far out weigh those who don't. 800 bucks for a bag of water for an iv seems steep. I think hospitals are probably doing better than they lead on to be.

Speaking of government waste this amphibious forklift cost the government more than 500k to buy. My buddy bought two from the marine base both with less than 75 hours on them for 3k.

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slownsteady said:

That argument goes astray of this discussion. I know your reply is it all comes down to money - you've said that before. But that argument could be made about anything the govt touches (yes, everything), even to "keep afloat" the navy.
Money is the key issue, granted, but my point is more about how the political parties use or disregard facts and figures as it suits them. I haven't heard about a CBO report based on if we went backwards to the previous system.

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I wont disagree with that political parties are government and as Regan said…

[ame]https://www.youtube.com/watch?v=XObcP69dhCg[/ame]

Chris said:

I am not complaining about my 12k bill. Just pointing out that with the amount of people that go to the hospital that pay should far out weigh those who don't. 800 bucks for a bag of water for an iv seems steep. I think hospitals are probably doing better than they lead on to be.

Speaking of government waste this amphibious forklift cost the government more than 500k to buy. My buddy bought two from the marine base both with less than 75 hours on them for 3k.

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That’s your tax dollars at work. Don’t forget who bought those two forklifts for a million dollars and didn’t use them. The government bought them but you paid for them. The government with all its million employees doesn’t make any money. It takes your money and spends it for you.

nealtw said:

You heard free, perhaps you should pay attention. You can't have a discussion unless you want to understand the facts and build on them until everyone understand the facts so that solutions can be found.

Governments all over the world subsidize the healthcare system, many pay less than your government does. If the free market works so well in this industry, what was the problem.
No body ever ran over the limit.
Nobody ever lost their house..

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When you say a government subsidizes the health care system it sounds like governments are some big pile of money that will never run out. Ours is 20 trillion in debt and growing.

Watch the clock and the dollars coming in and going out. Who owes the debt? Not the government the people that live here do. Who’s paying it? The tax payers.

I just went another million in debt as I typed this.

http://www.usdebtclock.org/

You don't think there was a problem in 2009 when your taxes were already paying the same as mine but you had all that other stuff going on.

bud16415 said:

When you say a government subsidizes the health care system it sounds like governments are some big pile of money that will never run out. Ours is 20 trillion in debt and growing.

Watch the clock and the dollars coming in and going out. Who owes the debt? Not the government the people that live here do. Who’s paying it? The tax payers.

I just went another million in debt as I typed this.

http://www.usdebtclock.org/

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$61,145 per person. If it would cancel out our debt and we would not accrue any more I would come up with the money to pay my share. Heck thats less than I paid in taxes last year.

bud16415 said:

I don’t know what it is like where you live but here I’m very sure before and after ACA no little kid with a broken arm hasn’t been treated in our hospitals with or without insurance. If there have been some I would love to read more about it. I know homeless people often get treatment both before and after ACA.

This is pretty much what I see around here.

http://law.freeadvice.com/malpractice_law/hospital_malpractice/hospital-patients.htm

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Bud, a friend of mine had doctors refuse to put a cast on her daughter's broken arm until she could cough up the money up front. They did splint her arm, but they wouldn't give her a cast.
Another friend of mine who had insurance but a high deductible couldn't get the doctors to treat her daughter for some sort of severe nerve pain that required surgery. They insisted that she pay up front before they would treat the child and she had to save up for two months and then take her child back in. Those were both prior to the ACA. First incident was in Texas and second was in North Carolina.

Chris said:

I am not complaining about my 12k bill. Just pointing out that with the amount of people that go to the hospital that pay should far out weigh those who don't. 800 bucks for a bag of water for an iv seems steep. I think hospitals are probably doing better than they lead on to be.

Speaking of government waste this amphibious forklift cost the government more than 500k to buy. My buddy bought two from the marine base both with less than 75 hours on them for 3k.

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Chris, I agree that the amount people pay is obscene. And there is proof that the prices are arbitrary.
I can't find the initial article I'd been reading, but I googled and found a few:
https://thinkprogress.org/new-gover...ical-bills-are-completely-random-221492d89900

http://www.arbiternews.com/2014/03/...harge-19-for-an-aspirin-and-get-away-with-it/

Last one is more relevant to your wife's situation-- they charged $40 to hold the newborn baby.
https://qz.com/805664/arbitrary-hos...rn-and-other-hidden-charges-new-parents-face/

Also, hospitals can and do bill people again for stuff that was already paid by their insurance or that the people already paid. They double bill. That is why you always have to look at the itemized bill. We've had that happen numerous times and had to call them and say "This was already paid". But they do it because some people don't check and just pay it. And they will even charge for services they did not tender. Like the time they charged me for two injections (plus the medicine) that I never received. And this is not just some clerical error, one of the articles I read before (I don't think I found it again) had hospital staff admitting that they deliberately charge for things that they think patients won't notice so they can get more $. They really LOVE to charge Medicare and insurance for things they didn't actually give to patients.

I forgot to quote it, but I completely agree that if a person doesn't want to have health insurance, they shouldn't be forced to pay for it and they shouldn't be fined for not having it.