How do we fix our healthcare system in America?

[bud16415]

Meanwhile, back to healthcare...................

It is about healthcare because healthcare is about money and paying a bunch of people and overhead involved in the Healthcare system. It won’t happen by magic or by the will of the people it will only happen in some kind of an economy that produces things and is growing. If socialism is your thing then that system has to be made to work also and has to turn a profit or at least break even with enough extra to pay for healthcare. So in the perfect world the cardo surgeon would make $15 per hour and the Wal-Mart worker would make $15 and hour. For giving the surgeon more for his skills would be moving him in the direction of the 1%. We all live in the same size house and all go to the same schools. Nothing could be more fair. You would get tested and if you are good for work then you must work and if you like to work there will be none of this working two jobs to make more to get more stuff that would move you in the direction of the 1%.

 

[bud16415]

Bud, @ $10 bucks an hour you are going to live and save money to buy a bus and run it a hundred miles both ways so people can look for work, who pays for the gas?
I like your idea of a wheel barrow but they can be expensive grocery carts are pretty handy. Most people will be looking down at you while you are pushing your cart from town to town.

Good point about the shopping cart I would take one from Wal-Mart. I would take my bike it is faster and I could tell people I’m wealthy and doing a cross country tour.

You are right why would I care about helping my neighbors find work in a different place let the government do that. That’s what they are there for.

 

[nealtw]

Good point about the shopping cart I would take one from Wal-Mart. I would take my bike it is faster and I could tell people I’m wealthy and doing a cross country tour.

You are right why would I care about helping my neighbors find work in a different place let the government do that. That’s what they are there for.

My point is, as long as politicians come up with these kind of fixes, nothing will get better.

Really, people do pull up there socks and move along, they always have and they end up at or near a city and the Walmart job pays the same there.

 

[bud16415]

I have random thoughts driving to work and listening to the radio and this thread is as good as any for venting. We have enough of these threads and I didn’t want to start another on government and such so I hope Chris won’t mind if I ramble here on today’s thoughts. Some are even related to health care.
Rant 1
One thing I was hearing is about the awful struggle people go thru to make their dream come true for a life in America. Some cross our boarders from the south without papers and find a safe home here and some work and start the process of the American dream. Others leave their countries across the ocean for fear of being killed or persecuted and leave family behind to get a taste of freedom in a country they don’t even speak the language of yet. The horrible lives they must have had to risk it all for a chance at something 1000’s of miles away knowing they will never see their home again.
Then I know people that live here that won’t take a chance and move 50 miles to where a company is hiring and say it is too far to drive twice a day and within 200 miles are even better jobs waiting.

Rant 2
Now that we are back to having a Dem governor in Pa Governor Wolf quickly changed and legalized Pot. I don’t have a big problem one way or another about it as he keeps explaining what a source of taxes it will be. We once had one of the largest hardwood paper mills in the country maybe the world in Erie. Hammermill Paper / International Paper that employed 1000’s of people making the finest quality paper there was, until it closed up for all the same reasons everything else did 25 or more years ago. The site is a blight on our waterfront and dozens of businesses have tried to get in there to manufacture something and there is always a reason the community thinks it is too close to home. So now there is this plan to turn the property into a huge self-contained pot growing plant. Everyone thinks this is a wonderful idea and look how much it will help the city.


I just have to get used to this new world I guess.

 

[nealtw]

What new world.
People have been complaining about the other as long as there has been more than one group with in hearing or seeing each other?
Some people use that to develop fear or even better hate and encourage people to freely discuss it in public.

The real question is what can we do to stop it?

 

[zannej]

Bud, fear of being murdered or worse is a pretty good motivator for the people who flee from their home countries. I could tell you some horror stories about the Snakeheads (Chinese human smugglers) but it's pretty gruesome and not really on topic. Most of the ones who came over from China (traveling in the fish-holds of boats) had TB. If they didn't have TB when they started the trip, they almost certainly had it by the time they arrived.

That is one of the facets a lot of people tend to ignore about illegal immigrants. They don't go through health screening and they can bring in diseases that are uncommon in the US and might not be recognized because of the rarity. When people go through legal screening to get in, they get vaccinations and tests done to make sure they are not contagious.

Which brings me to a question for you guys. Whether you are opposed to government provided healthcare or not: Do you think the government should at least provide necessary vaccines for children for free or at low cost to minimize the spread of disease. And for that matter, how do you guys feel about mandatory vaccines for easily communicable things like TB, Mumps, Measels, etc? (I know in some places they do have free vaccines for people-- but do you think they should?)

How do you feel about medical facilities/clinics/hospitals refusing to take certain forms of insurance. Do you think that should be allowed?

Also, since we do have Medicaid/Medicare-- I wish that it would have more allowances for regular checkups and getting tests and stuff done at regular doctors rather than the whole going to the hospital thing. I know that quite a few people end up taking their kids to the hospital instead of a doctor bc Medicare/Medicaid will cover that- and it ends up costing the taxpayers more $. And statistically, if people get regular checkups they are more likely to stay healthier.

I apologize if any of these have been answered already. I confess I did skip some pages to catch up and my memory is not cooperating today on the things that I did read.

 

[mabloodhound]

Do NOT look to Paul Ryan and HIS plan to fix this. It's just more politicians protecting themselves. Remember, Congress has it's own health care program. Nothing like what the citizen has to go through. Before Obamacare it was working like Chris said but once the gov't got their hands on it, healthcare became all FU. Going back will be hard BUT competition is part of it. Sadly, Ryan's bill does not include access across state lines. Supposedly in the 3rd step it may be included but Democrats will never support it and we will be left with Obamacare Light. Rand Paul and Jim Jordan have good ideas but the leadership won't allow them to add amendments.

 

[bud16415]

:agree: What he said. +1

 

[ActuariallySpeaking]

I dont know if I dare chime in here... if you can't tell by my username, I'm a pricing actuarial analyst for a health insurance company... For the people who's insurance increased so drastically... are you buying individual insurance, or is it through the workplace? Did you try to go on the exchange and price out options, rather than stick to your legacy plan? You may have qualified for the tax credit or cost share reduction, or the rates may have been flat out cheaper because legacy plans tend to turn into a death spiral (only high cost members stay in, healthy ones jump ship, since they're rated seperate from ACA, rates rise in a hurry)

 

[68bucks]

OK here's my 2¢. I think we need to remove the profit motivation from the equation, both from insurance and from providers. I also have something of an issue with a hospital CEO or an insurance CEO making tens of millions of dollars, they're not worth it. Reduce it and pay the people that actually do the work more. Transparency in cost is another major issue. If your doctor orders a test for you just try to find out what the cost will be. Its like a snipe hunt. We're told we're bad because we don't check costs but that's bull. My doc ordered a stress test for me 3 weeks ago and I'm still waiting to get approval from the insurance company. One place told me the test was $900 while another within 1 mile told me it was $5600. What's up with that? When I call for a price on a procedure the provider should be required to quote a price instantly within +/- a percentage (10%?). No other industry hides the cost from the consumer like the medical industry. I also have trouble rationalizing that the cost of your health insurance and the cost of your medical treatment is directly linked to the returns that some anonymous shareholder is expecting.

Now on the cost increases since the ACA came about. Insurance cost have been going through the roof for far longer than the ACA has been around. The facts say that the rate of increase has slowed considerably under the ACA, on average. There are locations though where that is far from the truth. Also the policies that are required now are different than before the ACA. No caps on lifetime benefits. Preventative care is paid 100%. Kids can stay on your policy until age 26. No pre-existing condition refusals.

Now to the OP, these are all things that contribute to increasing costs. Now look at the old system. Let's say your business had a really bad year and you dropped insurance for a while to get by and make ends meet. If you or a family member got seriously ill before you signed back up you would never get insurance again period. And this was true for employer plans as well. If you had a pre-existing condition the company would have to fight with the insurance company to get you coverage. I saw it more than once with my employer.

And one last thought. People gripe about paying for people that get free coverage. I look at it this way. What cost more? Person A receives totally free insurance from Medicaid or something. Person B has no insurance at all.
So what cost you more, when person A gets a nasty case of the flu and goes to the doctors office to get checked out and treated, or person B that just goes to the ER (the highest possible cost) for the same thing? You will still pay for either person whether you like it or not.

 

[bud16415]

How much should a hospital CEO or an insurance CEO make? Would one million be too high also. A family can live a nice life on $100k per year I would say the law should say no one in the health care business can make over 100k including doctors. That would be fair.

We should apply the same laws to sports figures and music professionals also as long as we are at it. Oh and actors also. Why stop there no one should make over $100k Warren Buffet and all his buddies 100k.

Sounds logical to me as I make under 100k.

 

[68bucks]

How much should a hospital CEO or an insurance CEO make? Would one million be too high also. A family can live a nice life on $100k per year I would say the law should say no one in the health care business can make over 100k including doctors. That would be fair.

We should apply the same laws to sports figures and music professionals also as long as we are at it. Oh and actors also. Why stop there no one should make over $100k Warren Buffet and all his buddies 100k.

Sounds logical to me as I make under 100k.

Well I wouldn't be in favor of that. I basically don't have a problem with with what people make, more power to them. In the case of human health I tend to feel a little more strongly about top pay. When the top dog makes $20 million a year instead of $5 million that's a lot of medical care that someone isn't getting and the top dog wouldn't suffer too much if they only made $5 million.
I have always said that with any organization there should be a ratio of what the top person makes vs. what the bottom person makes. If we were ever going to regulate pay (a bad idea I believe) that's the way I would do it. Say if your the CEO of McDonald's you can't make more than, for example, 100x the lowest paid person. If you want to make more money, no problem give the person a raise. Never going to happen though.

 

[ActuariallySpeaking]

OK here's my 2¢. I think we need to remove the profit motivation from the equation, both from insurance and from providers. I also have something of an issue with a hospital CEO or an insurance CEO making tens of millions of dollars, they're not worth it. Reduce it and pay the people that actually do the work more. Transparency in cost is another major issue. If your doctor orders a test for you just try to find out what the cost will be. Its like a snipe hunt. We're told we're bad because we don't check costs but that's bull. My doc ordered a stress test for me 3 weeks ago and I'm still waiting to get approval from the insurance company. One place told me the test was $900 while another within 1 mile told me it was $5600. What's up with that? When I call for a price on a procedure the provider should be required to quote a price instantly within +/- a percentage (10%?). No other industry hides the cost from the consumer like the medical industry. I also have trouble rationalizing that the cost of your health insurance and the cost of your medical treatment is directly linked to the returns that some anonymous shareholder is expecting.

Now on the cost increases since the ACA came about. Insurance cost have been going through the roof for far longer than the ACA has been around. The facts say that the rate of increase has slowed considerably under the ACA, on average. There are locations though where that is far from the truth. Also the policies that are required now are different than before the ACA. No caps on lifetime benefits. Preventative care is paid 100%. Kids can stay on your policy until age 26. No pre-existing condition refusals.

Now to the OP, these are all things that contribute to increasing costs. Now look at the old system. Let's say your business had a really bad year and you dropped insurance for a while to get by and make ends meet. If you or a family member got seriously ill before you signed back up you would never get insurance again period. And this was true for employer plans as well. If you had a pre-existing condition the company would have to fight with the insurance company to get you coverage. I saw it more than once with my employer.

And one last thought. People gripe about paying for people that get free coverage. I look at it this way. What cost more? Person A receives totally free insurance from Medicaid or something. Person B has no insurance at all.
So what cost you more, when person A gets a nasty case of the flu and goes to the doctors office to get checked out and treated, or person B that just goes to the ER (the highest possible cost) for the same thing? You will still pay for either person whether you like it or not.

...Just to chime in, profit on insurance is very regulated, and what we price in as profit is probably not as high as one would think. (for individual & SG ACA) Also, most insurance companies lost money on the ACA individual market from 2014 & 2015 (We can't tell for 2016 yet because the reinsurance payout hasn't been figured yet. Group business is, and probably always will be- what insurance companies make money on) The CEO's salary probably isn't considered profit, but more so an admin cost- so yes, that probably could be monitored more, but that probably means my income would suffer, not his- and I feel like I make just enough to make a house & car payment and live comfortably with no student debt- and we want more of those jobs, not less, right? Can we really "cap" someone's income? I'm not defending either way- but I doubt that would fly. Maybe in the long run, since insurance is extremely regulated, but I kind of doubt it in the current political environment.

Transparency in pricing is tricky- and there are programs out there that try to "incent" the consumer to go to lower cost facilities. Whether it be through cash rebates for going to hospital a over hospital b, or a lower copay for lower cost facility (i.e- urgent care over ER for non-life threatening emergencies) Hospitals can't really just announce their pricing because individual vs. insurance company a vs. insurance company b vs. medicare/medicaid are all going to have different rates. Hospitals & care facilities are typically privately owned (unless we're talking VA) and there is not a lot in terms of regulation for pricing going on there that I know of. Not sure if that's a problem or not- however, there are a lot of hospital buyouts going on and I think that is significantly impacting rates. Trust me when I say we pretty much beg hospitals to drop prices to be more competitive in the marketplace.

To the OP... I guess I assumed that you were buying insurance for just your family, not that you owned your business. What the poster above said is correct, if your group is above certain size. If it's a smaller company, you'll be placed in a pool and won't have your experience used for/against you. (If you are a larger group and it is used against you- I would recommend shopping around. Other companies will have less experience to use and will usually use more weight on the average vs. your experience)

 

[French_guy]

I'm French and live in the US.....(legally )
Every time I've to deal with the US health system, I'm SHOCKED !!!
1) it's waaaay too expensive
2) It seems very complicated, even for the providers. I'm the type of person who will ask as many questions as necessary before I clearly understand how it works. And when i have to dig more and more to understand, I realize it's not clear at all, even for them
3) America is the 1st power in the world.....How is that possible there are still people without health insurance??? To me, that's just insane

I'm not saying the French system is perfect...It's not
But I think we should be able to find a compromise between TOO MUCH and NOT ENOUGH

 

[nealtw]

How much should a hospital CEO or an insurance CEO make? Would one million be too high also. A family can live a nice life on $100k per year I would say the law should say no one in the health care business can make over 100k including doctors. That would be fair.

We should apply the same laws to sports figures and music professionals also as long as we are at it. Oh and actors also. Why stop there no one should make over $100k Warren Buffet and all his buddies 100k.

Sounds logical to me as I make under 100k.

There is a problem there. I would bet that many people that are stuck in a min. wage job would agree with that logic. We know it wouldn't work but you have to get people in all stations to understand what fairness is.

 

[nealtw]

I dont know if I dare chime in here..)

In order to do your job, you need facts, yes?
In order to discuss your findings with another person, you both have to agree on the facts, yes?

Can two people ever agree on anything, if one or both people don't agree on the facts?

 

[Chris]

I dont know if I dare chime in here... if you can't tell by my username, I'm a pricing actuarial analyst for a health insurance company... For the people who's insurance increased so drastically... are you buying individual insurance, or is it through the workplace? Did you try to go on the exchange and price out options, rather than stick to your legacy plan? You may have qualified for the tax credit or cost share reduction, or the rates may have been flat out cheaper because legacy plans tend to turn into a death spiral (only high cost members stay in, healthy ones jump ship, since they're rated seperate from ACA, rates rise in a hurry)

I have a private plan because I am self employed. I dropped the plan I had before because it did skyrocket. I have had a few new plans in the last few years and on the aca website they were the same price or more. Because I am self employed on paper it looks like I make money and it is all based off that. It's worse than having another mortgage

 

[frodo]

I TOTTALY disagree about mandating wage caps :downn anyone for anything.
If you want to live in that type of system carry your socialist *** to socialist country

This is America, if you want to get rich work your *** off and do it, It is called the Land Of Opportunity
The opportunity is here to make money if you get off the couch and do it.

 

[frodo]

There is a problem there. I would bet that many people that are stuck in a min. wage job would agree with that logic. We know it wouldn't work but you have to get people in all stations to understand what fairness is.

fairness for who ?

the minimum wage worker ?

 

[nealtw]

fairness for who ?

the minimum wage worker ?

That is my point. Every one will have a different idea of what fair is.