How do we fix our healthcare system in America?

[68bucks]

So what is everybody thinking about the new plan that's on the floor?

I think the republicans are climbing out on a limb and sawing it off behind themselves. Trumpcare is no better than Obamacare, just different. If the CBO is half right on their numbers I think they stand to lose a bunch of seats in 2018 and probably more in 2020. If they would have just put in a little effort in the last 6 years trying to improve the ACA maybe we could have made it into something that was better. But because there is no such thing as a compromise any more we end up where we are.

It's also debatable if we have the best healthcare in the world. From my reading we lead in innovation and availability and that's about it. By availability I mean the ability to see a doctor when you need to. As for other big metrics we lag, like % of people covered, outcomes, cost, etc. Another thing I hate about our system is it's too tied to your employer. Why should your employer control such a vital thing? It has nothing to do with them really and makes changing jobs or career paths way to difficult especially if you have a family to worry about. It's not like most companies get some great deal. I see what our company pays for my healthcare every year and I could buy the same coverage for less. But we are a smaller company, only about 100 employees. I suppose a GM or AT&T might do better with a larger group.

 

[slownsteady]

I think the republicans are climbing out on a limb and sawing it off behind themselves. Trumpcare is no better than Obamacare, just different. If the CBO is half right on their numbers I think they stand to lose a bunch of seats in 2018 and probably more in 2020. If they would have just put in a little effort in the last 6 years trying to improve the ACA maybe we could have made it into something that was better. But because there is no such thing as a compromise any more we end up where we are.

It's also debatable if we have the best healthcare in the world. From my reading we lead in innovation and availability and that's about it. By availability I mean the ability to see a doctor when you need to. As for other big metrics we lag, like % of people covered, outcomes, cost, etc. Another thing I hate about our system is it's too tied to your employer. Why should your employer control such a vital thing? It has nothing to do with them really and makes changing jobs or career paths way to difficult especially if you have a family to worry about. It's not like most companies get some great deal. I see what our company pays for my healthcare every year and I could buy the same coverage for less. But we are a smaller company, only about 100 employees. I suppose a GM or AT&T might do better with a larger group.

I totally agree. Now if the feds want to lower the deficit, why don't they just eliminate the tax write-offs that companies get for healthcare. Let everyone shop retail. That would be a truer form of capitalism.

 

[bud16415]

It goes back to companies wanted a loyal workforce and employees wanted a job for life. unions and companies at one time worked these issues out in labor agreements. They could have asked for just more money but instead asked for benefits. Healthcare was one and pensions another. I’m 61 and about to retire in a year. My choice. I grew up and came into this IMO during the end of the good old days. I will have had healthcare with an employee plan from the age of 17 when I left my parents employee plan. I will have participated in a pension plan for 44 years when I retire and will take home a little less than I make now and factoring in all the costs of working it will be roughly the same. My company will provide my healthcare plan until I switch to Medicare. While I worked there they paid for all my education as long as I wanted to go to school, and many other benefits. They didn’t do it just for me they did it for 15,000 other people at my location when I started. Companies got wealthy, employees got wealthy and the community got wealthy with all the support functions of having 15,000 paychecks getting cashed every week. I never had a desire to jump ship and change jobs going someplace else and I had plenty of offers. It was a nice run and capitalism pure and simple was the driver. It wasn’t a science fiction novel like Atlas Shrugged. It was reality and I had a good and wonderful run under that system. The way it is ending could be a few chapters out of that book though. The company I remember were decent people from the top to the bottom it was made up of men and women, black and white and everything in between all working together. People got hired and some that couldn’t play by the rules got fired. None of it was a free ride for anyone and no one expected a free ride. There were and will always be people that need extra help and they got it. The government had very little to do with any of this and took a healthy cut of my paycheck every week for those 44 years and did what governments do in providing services to people.

There are new ways coming to healthcare and every other aspect of life. I used to wonder if there was a tipping point to this and where and when it would be. I hope I’m not turning into that old guy that’s full of doubt for the future. But watching what republicans had 8 years to think about correcting and doing if they ever got the chance again and these are the best plans they can come up with. I’m going to sound like the old guy and say we passed the tipping point and I never even noticed. SNS is right I will never in my life see a country I lived in thru the 70’s and 80’s again. I don’t think Trump can correct it because I don’t think the people have the will or desire to correct it. If you are on the other side of the coin you feel it is being corrected and moving in a good direction let’s hope you are right. I don’t see it moving any other direction.

 

[Chris]

Priced out healthcare in idaho today for my family and it is almost half of what it is in california.

 

[slownsteady]

...and that's under the ACA.

Politics prevails as usual today with the House putting off the vote.

 

[zannej]

68bucks, I think it depends on the type of treatment and where you go for it. People who can afford higher payments can get in faster, but people who can't have to wait to get in to specialty clinics. I had to wait 4 months for a cardiology appointment. My friend's ex had to wait 6 months for an obgyn appointment and she had to go to a city that was 3 hours away. That brings me to another thing: there aren't always clinics or doctors nearby. I imagine in larger cities there are a plethora of facilities, but you get out to more rural areas and states like Louisiana, and it is harder to find good care. We actually had to take my father to Houston, TX for some of his medical treatment because it wasn't available in Louisiana.

I don't know if any of the healthcare plans could help with that situation.

 

[Chris]

The one quoted to me will cost me 900 a month and have a 7k deductible. No free office visits until deductible is met. So in reality I will pay 900 a month and pay for all my doctor visits because of go maybe once per year. My kids well check will still cost me as if I didn't have insurance. I guess it's 10,800 a year just in case something happens. Seems fair I guess?

 

[zannej]

The one quoted to me will cost me 900 a month and have a 7k deductible. No free office visits until deductible is met. So in reality I will pay 900 a month and pay for all my doctor visits because of go maybe once per year. My kids well check will still cost me as if I didn't have insurance. I guess it's 10,800 a year just in case something happens. Seems fair I guess?

That is still pretty damn high. Most of the people where I live couldn't afford to pay that much.

 

[frodo]

$900. a month ? If I was you, get insurance for the kids but not you and Mrs Chris, pay cash for ya'lls

 

[bud16415]

I’m glad to see that Trump and Ryan have been reading this forum and took my advice.

Now we all can sit back and enjoy the ACA.

For quite a few people we might have to take that first “A” off the name though. Wait for the rest of it to kick in.

 

[bud16415]

That is still pretty damn high. Most of the people where I live couldn't afford to pay that much.

Zannej

You have to understand the basic idea behind ACA. Most of the people where you live wont have to afford that price, because Chris and tens of millions of other people like Chris will be paying more than their share so people that can’t afford it will get it for a low price or for free.

Keep in mind the unintended consequence of such things. In our example this and other such programs are stopping or slowing down the Chris’s of the country and the 10 people he employed will be looking for a job soon. Instead of him continuing to grow his business he is downsizing. Instead of growing from 10 people working for him to 20 and then 30 and then 100, he will be going to zero or one. That’s the potential for 100 people to have a better life because of him and 100 people paying taxes and being able to afford healthcare, to no one moving up. That is what capitalism is all about and what socialism is not about.

Is healthcare more important than food to keep people going? Most people would say both are important equally I think.

So lets take this to the next level and make a law called AFA (A,Food,A) when we fill our shopping cart at the supermarket when we check out we have to show our card. The rich guy pays 10 bucks for a loaf of bread and 30 bucks for a gallon of milk because he can “afford” it. The poor guy in line ahead of him that not working because the rich guy cant afford to hire him gets his bread and milk for a quarter each because that’s what the AFA has done to help everyone have quality food at affordable prices. On the surface this seems wonderful look at that everyone can now afford good food. I think you can see how this type of thinking causes a downward spiral for everyone though.

That where the saying a rising tide raises all ships came from. The new saying in this country is a lowering tide sinks all ships. Or another way to think of it is we want all people to be equal. That’s a noble cause. Just remember all people can be equal when they all hit bottom.

 

[frodo]

Zannej

You have to understand the basic idea behind ACA. Most of the people where you live wont have to afford that price, because Chris and tens of millions of other people like Chris will be paying more than their share so people that can’t afford it will get it for a low price or for free.

Keep in mind the unintended consequence of such things. In our example this and other such programs are stopping or slowing down the Chris’s of the country and the 10 people he employed will be looking for a job soon. Instead of him continuing to grow his business he is downsizing. Instead of growing from 10 people working for him to 20 and then 30 and then 100, he will be going to zero or one. That’s the potential for 100 people to have a better life because of him and 100 people paying taxes and being able to afford healthcare, to no one moving up. That is what capitalism is all about and what socialism is not about.

Is healthcare more important than food to keep people going? Most people would say both are important equally I think.

So lets take this to the next level and make a law called AFA (A,Food,A) when we fill our shopping cart at the supermarket when we check out we have to show our card. The rich guy pays 10 bucks for a loaf of bread and 30 bucks for a gallon of milk because he can “afford” it. The poor guy in line ahead of him that not working because the rich guy cant afford to hire him gets his bread and milk for a quarter each because that’s what the AFA has done to help everyone have quality food at affordable prices. On the surface this seems wonderful look at that everyone can now afford good food. I think you can see how this type of thinking causes a downward spiral for everyone though.

That where the saying a rising tide raises all ships came from. The new saying in this country is a lowering tide sinks all ships. Or another way to think of it is we want all people to be equal. That’s a noble cause. Just remember all people can be equal when they all hit bottom.

nice post Zanne,

 

[zannej]

Bud, yeah. That is why I think it is unfair for Chris to be paying that much. And in my state they really didn't do much to expand the coverage so there are a lot of people who can't get coverage even though there are people like Chris who are paying more.
Taking it out of the middle class is only hurting the economy. That is why I think they will never have a successful plan until they do something about some of the root problems-- such as the absurd amounts that are being charged for medicine and treatment. Nurses get a pittance compared to the administrators of the hospitals. Granted, I get that a doctor's salary is supposed to be decent to make up for the expense of getting a medical degree, but it is expensive for nurses too and they don't make that much. So, where is the money going? It's not all going to cover lawyers or actual expenses-- a lot of it is going to hospital administrators. I know they need the administrators to run things, but I don't think they should be making that much profit off of people's suffering. The question is, how do we do something about it? And can we?
If we could find a reasonable way to bring down what people get charged, then it wouldn't cost as much for insurance and people like Chris wouldn't have it taken out of their hides. I do think it is wrong for people to be charged that much more because of their income. They already get it taken out from the taxes they pay. And a lot of the 1%ers are not even paying taxes or not paying their fair share and their companies are getting government subsidies. But smaller companies like Chris' get screwed.

 

[bud16415]

Bud, yeah. That is why I think it is unfair for Chris to be paying that much. And in my state they really didn't do much to expand the coverage so there are a lot of people who can't get coverage even though there are people like Chris who are paying more.
Taking it out of the middle class is only hurting the economy. That is why I think they will never have a successful plan until they do something about some of the root problems-- such as the absurd amounts that are being charged for medicine and treatment. Nurses get a pittance compared to the administrators of the hospitals. Granted, I get that a doctor's salary is supposed to be decent to make up for the expense of getting a medical degree, but it is expensive for nurses too and they don't make that much. So, where is the money going? It's not all going to cover lawyers or actual expenses-- a lot of it is going to hospital administrators. I know they need the administrators to run things, but I don't think they should be making that much profit off of people's suffering. The question is, how do we do something about it? And can we?
If we could find a reasonable way to bring down what people get charged, then it wouldn't cost as much for insurance and people like Chris wouldn't have it taken out of their hides. I do think it is wrong for people to be charged that much more because of their income. They already get it taken out from the taxes they pay. And a lot of the 1%ers are not even paying taxes or not paying their fair share and their companies are getting government subsidies. But smaller companies like Chris' get screwed.

The way to get cost out of anything is called competition. Chris is reacting to competition he is moving to a new state and look what happened his bill is lower. Ford doesn’t charge you 100k for a car because you will go buy a Chevy for 20k. or a Kia for 15k. That’s free enterprise and what makes jobs and wealth and brings cost down. It also makes products better. It is true of every product and service healthcare included.

We are going to have the opportunity now to watch ACA react to all the market forces and the total plan unfold. No one talked about how it was setup to change each year and work fairly well in the beginning. With a plan that is not sustainable they knew they had to force buy in slowly. It wasn’t a secret it just wasn’t talked about.

Just remember what we heard over and over if you like your doctor you can keep your doctor, if you like your plan you can keep your plan.

In a year or two we can come back and talk about it and see how it is working out. Trust me I hope I’m wrong and everyone has great health care and no one has to pay too much. The opposition to repeal and replace wants to keep ACA so now they can. It was a major win for the left.

We now know exactly the answer to Chris’s question in the first post. More of the same.

 

[Chris]

In reaction to "you can keep your plan" yes you can and I tried. My plan went from 188 bucks for medical and dental for just myself to 322 and then to 417 for the exact same plan, nothing changed except what I pay. Every January I would get a notice stating that I agree to these changes and they are now in affect. I did have to change my doctor when I had to change my plan due to costs and my doctor did not accept the new insurance. Now I am uninsured and saving soo much money, as long as I am healthy its a win. I have always been that guy who is too paranoid to not have insurance but when it comes down to a raping or strong arm robbery why should I sit back and take it. Right now I am trying to see what I can do to get my income lower for this year so I can pay less for my new insurance that we want to get. Stupid that it is based on income. None of my other insurances are based on income, why health? Maybe it should be based on health and lifestyle? Now that would make sense.

 

[slownsteady]

The opposition to repeal and replace wants to keep ACA so now they can. It was a major win for the left.

No, it was a major **** up for the right. They had seven years to compose a better healthcare plan and they did squat. It was never about the health of Americans for them. It was about defeating the other party. Never about the good of the people.

 

[slownsteady]

My biggest gripe about the current healthcare system - and the system prior to the ACA, is I do not want an accountant making decisions about my care. But there they are, trying to scrounge every dollar they can for their own benefit.

 

[zannej]

Bud, I agree that there needs to be more competition with the insurance agencies. They need to be able to try to be better or charge less to get more customers. But, how would you propose they encourage the competition with the healthcare itself? Especially when people don't always have a choice. If someone gets knocked out, they don't get to pick where they go. And it's not like the prices are readily available for people to know how much it will cost them to go to a particular clinic or hospital. Not everyone has the option of just picking up and moving like Chris. Not everyone can afford it.
Chris is fortunate in that he has the guts, knowledge, and finances to be able to move but unfortunate to have had to move in the first place because of an unfair policy.

 

[bud16415]

Bud, I agree that there needs to be more competition with the insurance agencies. They need to be able to try to be better or charge less to get more customers. But, how would you propose they encourage the competition with the healthcare itself? Especially when people don't always have a choice. If someone gets knocked out, they don't get to pick where they go. And it's not like the prices are readily available for people to know how much it will cost them to go to a particular clinic or hospital. Not everyone has the option of just picking up and moving like Chris. Not everyone can afford it.
Chris is fortunate in that he has the guts, knowledge, and finances to be able to move but unfortunate to have had to move in the first place because of an unfair policy.

Regulation is one thing and telling someone and everyone that they must do something in every detail is another. Say we pass a law and say everyone in this country has a right eat healthy food and it is not fair some people get to go to fancy restaurants and others must eat at home or at best go to McDonalds. Because we all know those rich people eat better food at that fancy place that charges $50 for dinner per person. So we make a law we give some people coupons to go get free meals at the fancy restaurants because they have no income. We pay for the coupons by taxing the upper half of the working people a little more. Then the people that are not poor but not rich and wouldn’t be able to eat there normally we tell them we have a plan for you also. We will make the fancy restaurants charge less based on your income and it is ok because we will just tell them they can charge the rich folk that come in more say $100 for dinner because that will be fair they make more anyway. So now the rich guy is paying double taxes on what he makes and if he wants to eat out at the fancy place he gets to pay double there as well. He starts adding things up in his head and says ya know I can’t afford this eating out stuff anymore I’m going on a diet. Then it dawns on him if I make less money I will pay less taxes and I can get in on the voucher system to eat out. So let’s see I’ll down size my company and let my workers go and I won’t make so much and my income will fall in line with lower middle class and now I can go eat out for 25 bucks.

Isn’t America great we brought down the cost of eating out and we now can have everyone eating at a fancy restaurant and we did it with people downsizing and not working as hard. :thbup:

 

[French_guy]

I know you gave this as an example, but you don't have to be reach to eat healthy.....!
As an example, A MacDonald menu is more expensive than the Costco salad ($3.99)
And it doesn't cost more to cook healthy at home than to eat junk food