Forum Post: Here is a way to do Obamacare, but better...
Posted 12 years ago on Nov. 28, 2011, 9:35 p.m. EST by newearthorder
(295)
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the 47 million Americans who are not covered under any healthcare right now will soon be forced to buy private insurance. If they can't afford it it may be subsidized. But, instead of throwing all that money down the big black hole on an insurance company why don't we just let people BUY Medicare?
When you get a job and fill out your W4 you would just check a box and it would be taken out of your check, and it would be based on your income.
About 30 million people paying in about $600 each a year is $18 billion dollars....
But no politicians will get any kickbacks for something like that. How can you possibly deny them that money. Who will the insurance companies buy off?
Exactly,...This won't happen until we Occupy the Congress, for real.
You are just too rational.
So where does the rest of the funding come from? Cuz 600/yr aint shit.
Gladiator fight to the death duels between pablum sucking 85 year old O2 sucking lumps of flesh.....If you win you get another year paid for by Obama....It's time to thin out the herd !!
I was in favor of opening Medicare to all too, and I still am, but the premium you mention is much too low. The total health care expenditure for 2009 was about $2.3 trillion dollars, that works out to about $8000 for each person, not family, per person. You can play with the way you get the premiums, but no matter how you look at it, health care is expensive.
Personally if Obama care wins in the supreme court, I'll pay the fine and go without insurance, it's cheaper.
When medicine is practiced on the basis of patient outcome instead of industry / insurer profit, cost will go down dramatically.
When incorporated into a progressive tax structure, the cost of national health insurance (Medicare for all) will be affordable for everyone.
Depends on who is defining affordable. I don't see how you could remove enough profit to get that $2.3 trillion figure down. It's not as simple as just taxing the rich more. Everyone has to pay more. That's the problem no one knows what health care actually costs they just want it for free.
One of the problems is surgeons, and even GPs here make 4 times as much as they do in markets with universal healthcare.
There are a lot of problems, middle men that only add to the cost but treat no one, government regulations, a never ending parade of fees that have to be paid by the doctor. National health care works well for most countries in general, but it too has it's own horror stories of administrative foul ups.
The government has already stepped in to indirectly make medicine unprofitable for doctors with Medicare. To the point where some are retiring and others limiting the number of Medicare patients they see.
Funny in an ironic way that government regulation put us into this trap with health insurance in the first place. During WW2 companies started offering insurance to attract workers when the government prevented them from offering higher pay. Once it became the norm we were set on this path. It's the insured that don't want to risk loosing what they have for a less effective government system.
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Exactly right.
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I was advocating just opening up medicare for the working poor and their dependents. They could buy into it for as little as $10-$20 a week. It would bolster the current system, which is facing cuts.
I would also like to see the government build clinics all over the country, maybe a thousand. they could employ some of the returning military medics. I was a medic in the Air Force. When I was 18 I was cutting people open and suturing them back together. My Dad drove an ambulance in a MASH unit in Korea.
We can do better. Another world is yet to come.
As a group, the poor have more medical problems and they tend to be more complicated. You wouldn't find any savings with a premium that low. If all you are after is more help for the working poor fine, but it wouldn't help Medicare, it would only add to its financial problems.
The CDC counted 956 million doctor visits last year, even at just $100 a visit (an average visit runs $150 to $200 depending on the complexity of the case) that's $95 billion a year, and we haven't looked at needed drugs, surgeries, therapy, just the visits to the office.
We need to understand the cost and accept it as a national necessity. It's not likely to happen when so much of the country gets insurance that is often better then what nationalized plans in Europe are and they think it's "free". Until we get more people elected to office that see providing care as this national necessity we're not going to get anywhere.
The average cost of a new patient visit that runs $150 - $200 depending on the complexity of the case is grossly exacerated by doctors. They don't follow the guidelines set for each level of service and will charge the most that they can regardless of how much time was spent with the patient.
That may be true, but they are also making up for the lower fee the government forces on them with Medicare patients. There are also costs we don't see, it's not like the doctor gets to pocket that $150 as profit.
Doctors are people you'll find good and bad. As a group, considering the education needed and the time required to keep up their skills a doctor deserves that $150 a visit.
As a medical Insurance specialists that delt with insurance companies all day long in particular of what is charged, allowed, and paid is that all the healthcare insurances companies pay just a tiny bit higher then what Medicare allows.
They are not paying so much higher to give doctors the idea that they do not to see Medicare patients. It is quite the opposite in that some practices would go out of business if they didn't get that medicare payment check regularly.
Yes I know, it's the uninsured that get stuck making up the difference.
It didn't used to be that way 15 years ago, in practices that I have worked we would reduce the bill for the uninsured, but nowadays it has become a cutthroat business.
It would need to be a bit more, your right, but this study shows that all uncompensated care for all of the uninsured amounts to about $40 Billion. Seven years later that number could easily be $50 billion. The $600 dollar a year figure I used is for just a little over $10 a week and would be at the low end. The high end might be as much as $40 a week. That would definitely cover those costs, plus, all those people wouldn't be running into emergency room at mercy hospitals every time their kid gets a booboo. Some of the cost of the uninsured not paying for their helath care shows up in the cost of coverage for the rest of us. But, it also shows up in the budget, about $50 billion. This would be nearly eliminated.
http://www.kff.org/uninsured/upload/The-Cost-of-Care-for-the-Uninsured-What-Do-We-Spend-Who-Pays-and-What-Would-Full-Coverage-Add-to-Medical-Spending.pdf
That's why it probably wouldn't even need to be $40 a week, the max could be $30.00 for a family of four. In the beginning the rest of would have to subsidize a little, but not much. The subsidy would disappear when the savings rise.
And, I know this doesn't solve the real problem, I just know if Doctors could ever get used to making half of what they thought they were going to make when they got out of school. It will be hard.
Your total for uncompensated care of $40 billion is not based on reality since with coverage all the healthcare payors combined would never pay $40 billion dollars.
It's a complicated issue. Once you start taking premiums from people there are always going to be questions about what is and isn't covered. Insurance only works when most people don't use the service provided for by their premium. Unfortunately people look at it as getting something for nothing too often.
I think you're being too hard on doctors. A typical family physician is fortunate to earn $140,000 a year, that comes out to be maybe $70 an hour. Most auto shops charge more for labor. Increased regulation is already driving many to an early retirement and causing them to cut back on Medicare patients.
Big Pharms have a hugh expense account in which they peddle their drugs by buying breakfast, lunch plus giving logo pens, pads, etc to the doctors, hospitals plus provde them with free samples so that the medical profession will prescribe those drugs on a routine basis.
They make so much money that they can afford lobbyist in gov to promote legislature that keeps them a powerful giant. You ever wonder why there is no cure for the top 3 disease killers, they don't ever want a cure since this would reduce profit.
Drugs are a major reason why premiums go up with insurance co. and Medicare takes the full brunt of it since most elderly are on a slew of meds (mostly unnecessary) and this should be a #1 problem to fix first.
In it's "infinite wisdom" government regulations have made most of that a thing of the past. Direct to consumer ads have patients coming in demanding a drug by name, wether it's the right drug for them or not. Even when it was done, the drug reps had a difficult time seeing the doctor for more then a few moments. Most doctors resented time lost to a drug rep.
Drug coverage has only been part of Medicare since December of 2003. It's just adding to the financial problems of the system, most of anyone's usage of medical care comes in the last few years of life. Any insurance system needs healthy individuals that pay in but don't utilize the service for it to work. Medicare admits people at the very time they are going to need the system a lot, it's not insurance it's more social welfare.
I feel it is a waste of time to look for villains in the system. We need to decide what we want and be willing to pay for it. Currently no one really knows or cares what something costs. The mood in the country right now though is against government health care.
They maybe the mood of this country but its actions speak otherwise since there are only 5 appeals to stop Obamacare. There are many villains in the healthcare system and if don't address each and every one, the system will eventually not work. This is exactly the same problem we have in our government and big corporations in that we are not addressing the villains so we can stop it.
Obamacare is a long way from the answer. Too bad there wasn't the political will and courage to do it right. Singling out overpaid doctors, or big pharma profits, or any other villain, just gets us a bandaid approach to a complex problem. Often the regulations that get made only make things worse by driving up costs. There has never been a push for national health care however because most of the country gets its insurance through the employer.
There is a very good reason why our government is making it mandatory that everyone pays for health insurance at this point in history. First the baby boomers are now at retirement age and they are living longer. Second, those baby boomers had fewer children so the population will have more elderly then younger generations that normally carry the expense of the elderly.
The court will decide the mandate this summer. Either way I'm disappointed in Obama, he never actually came out with an actual plan himself. When campaigning he was in favor of a single payer, but when it came down to it he played things safe letting congress make the law and allowing it to be watered down.
The fines for not buying insurance are lower then premiums are, that's going to drive up costs, people will wait until they are sick then get insurance mandate or not.
The fines are low the first year you don't obtain health coverage then they double the next year, triple the third year and this now becomes that you will be paying far more then someone that did get coverage.
I know it increases. At some point I'll get coverage, I'll go with what costs me the least. I'm also going to see just how they collect that fine.
I wonder that myself of how they are going to enforce this.
At one point I heard that the IRS would keep any refund to cover the fine. I'll check that out when we get closer to 2014, if that's all it is I'll make sure I don't get any refund. I wonder if federal prison is a good option as a retirement plan?
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