Forum Post: Spinoff: Should "free" healthcare have limits?
Posted 12 years ago on Nov. 10, 2011, 9:11 a.m. EST by NotYour99
(226)
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Should there be a max benefit per year? Acceptance requirements like non-smoker? Only available to save life or limb, or to control disease?
Discuss.
There should be no limits, except for plastic surgery. No citizen of a modern rich country should have to worry about getting ailments for his health issues.
Honestly, annual benefits shouldn't be capped because once you do that you wind up leaving a whole class of patients whose illnesses are expensive to cover but no fault of their own out in the cold for no good reason. If you're worried about costs then simply reimburse drug companies at ONLY 10% above cost of manufacture rather than the market price once more than a certain quantity is paid for at market price.
As for acceptance requirements, I'd prefer that you cover everything, but that if you have people with issues like nicotine addiction you should cover (and possibly mandate) addiction treatment services so that you can reduce their risk of cancer early on.
The last idea is an important part of what I believe is driving up healthcare costs in this country today; not covering nor allowing for preventative care and regular screenings. If you only pay out for life-and-death situations but don't offer coverage for mundane things that may prevent these things from occurring you're going to be paying for emergency care left and right. Which is cheaper: a $50 checkup and a short course of antibiotics for minor bronchitis, or a week's hospitalization and lots of broad-spectrum antibiotics to deal with the resulting pneumonia?
A couple of points:
If you reimburse drug companies for 10% above manufacturing cost, that doesn't leave much for research. I don't mind paying more for drugs when these companies plow most (not all) of their profits back into research. If you limit reimbursement this way, you stifle research. It's the new drugs that have helped extend the life of many. Yes, yes, yes I know that the execs all get their nice big fat paychecks too - please no flamers on that one.
Regarding your point about covering preventative care: I couldn't agree more. Unfortunately, Obamacare is on the road to omit preventative care. I know you're not necessarily advocating Obama's vision for "free" healthcare, but people have to know what's going on:
Last month, the United States Preventative Services Task Force (USPSTF), a working group within the HHS recommended against PSA tests for men to detect prostate cancer. Earlier, they recommended against women under 40 getting mammograms. What this all means is that when the government starts making healthcare decisions for us, it may save money, but it may also kill us.
So, I know this isn't necessarily a post about Obamacare, but I think it worth pointing out that it's not the panacea some think it is and it certainly is not the quality of healthcare most currently get under private insurance plans. And YES, I know private insurance companies are no saints - again, no flames please. But, given the choice between "free" healthcare and paying a private insurance company, I'll stick with my insurance company, based on what I've seen so far.
There are issues with Obamacare; in particular the individual mandate creates a captive market and removes the option to simply go naked if none of the health plans in our area meet our needs, and the de-emphasis on preventative care is a problem as well. I would honestly have publicly funded NGOs make personal care recommendations, but I would have these recommendations constitute the bare minimum that every insurance company could be prosecuted for failing to cover and I would have most plans cover far more than that.
As far as 10% above manufacturing, that would only kick in after a preset amount has been spent; it's mostly so people like cancer patients (who require large volumes of extremely expensive treatments) may continue to receive treatment without bankrupting the companies paying for their care(including and most importantly the government). Considering that drug companies generally can make quite healthy profits off the first $500K per year per person there shouldn't be any reason not to curtail additional profits at the expense of the taxpayers.
I'd also like to propose an alternate model for pharmaceutical R&D that comes from a source besides the drug companies: I would set up new NIH labs devoted solely to prescription drug research, with the understanding that drugs developed by these labs would NOT be patented and would be sold at 10-20% above cost to recoup some of the taxpayers' money. At that point we can ensure the continued availability of new treatments and cures at affordable prices for everyone.
People either don't understand or don't consider that one given drug doesn't have to just pay for itself once it gies to market. Many drugs are researched that never make it to market and that research has to be paid for too.
You are greatly underestimating the costs of drug research. 10% above cost would not allow for any research of any significant degree. Paying to set up addition labs for the government to do the research directly is woefully expensive and cost ineffective. The 1% will only tolerate so much of someone else's burden before they simply leave. Then there will be no 1% to pay everyone's way.
Incidentally, developing new drugs may not be cheap but it's hardly as expensive as large pharmaceutical companies make them out to be. There was in fact a fairly strong, comprehensive study done by Light and Warburton on the subject; you can read it here: http://www.pharmamyths.net/files/Biosocieties_2011_Myths_of_High_Drug_Research_Costs.pdf
As far as the 1%, where are they going to go? Europe and Canada, if I'm not mistaken, is largely comprised of democratic socialist states, which means an even higher tax burden for them and even fewer perks. Japan's economy has been struggling quite badly for a while, so there's no reason to go there. They could go to China, where they'll get to live as they choose in one way, but have themselves censored and monitored in a way entirely alien to them. Or they could go to the Third World and live quite well by Third World standards, but again most Third World governments are far more repressive than even China's, and living well by Third World standards would still be a tremendous lifestyle change. I honestly don't see them going anywhere.
I do agree on your point about expensive cancer treatments. These prices need to come down.
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There should be no free healthcare that is run or supported by government.
Yes the limit should be it shouldn't exist in government.