Healthcare

Are you in favor of some form of a national healthcare system


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ChristopherASA

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ChristopherPosts​

The below is an Interesting Op Ed from the New York Times (NYT). For instance, I didn't know that "...5 percent of Americans generate more than 50 percent of health care expenses." Do check out the one or two links in the actual article; they are informative

[ I'm taking no particular position on the correctness or lack of in this op ed (at least not now). It is posted here for educational purposes. If we don't know what we're talking about insofar as social policy is concerned, and can't help America make better choices. ]
Article Link: https://www.nytimes.com/2017/05/05/opinion/what-the-republican-health-plan-gets-right.html

"What the Republican Health Plan Gets Right."
by Marc K. Siegel


Now that the Obamacare replacement bill has passed the House and is moving on to the more centrist Senate, the real debate begins. What is the true purpose of health insurance, and what is our government’s goal in ensuring we have it?

I learn from my patients every day about the benefits, limitations and contradictions of their health insurance. One charming 60-year-old with severe seasonal allergies insists on seeing me every few weeks this time of year, even though I tell her she doesn’t need to — her antihistamines and nasal spray treatment rarely changes. But she worries that her allergies could be hiding an infection, so I investigate her sinuses, throat, lungs and ears. I reassure her, and her insurance (which she buys through New York’s Obamacare exchange) covers the bill.

If she was responsible for more than a small co-payment for these visits, I’m sure I would see her less often.

We pride ourselves on being a compassionate society, and insurance companies use this to manipulate us into sharing the costs of other people’s excessive health care. Meanwhile, 5 percent of Americans generate more than 50 percent of health care expenses. Why shouldn’t a patient who continues to see me unnecessarily pay more?

Continue reading the main story
The government’s job is to maintain public health and safety. It should ensure that insurance plans include mandatory benefits like emergency, epidemic, vaccine and addiction coverage. The Republican bill would let states apply for waivers to define these benefits differently; it would be a big mistake to drop such coverage entirely. But Obamacare went well beyond these essentials, by mandating an overstuffed prix fixe meal filled with benefits like maternity and mental health coverage that drove smaller insurers with fewer options out of the market. The few that remain often have a monopoly, and premiums rise.

Speaking of compassion, how about some for the 20-something construction worker who can’t afford to pay his rent because his premiums help subsidize overusers like my allergy sufferer? Why shouldn’t a patient who is risk-averse pay more for coverage she might never need, while that construction worker be allowed to choose a cheaper insurance plan that might cover only the essentials?

In addition to limiting the menu of essential benefits, the House bill would let states create high-risk pools for patients with pre-existing conditions who had let their insurance coverage lapse, and who could then be charged premiums more in keeping with their health care needs. This is the only way to make insurance affordable for most consumers; pre-existing conditions will continue to drive up premiums if everyone is compelled to pay the same price.

These risk-pool premiums can and should be subsidized by the government. A recent report from the Kaiser Family Foundation found that high-risk pools can work, but have been historically underfunded. Trumpcare should change that — though it will cost more than the House bill’s $8 billion in additional funding. Drastic cuts to Medicaid should also be reversed, which could help the bill pass the Senate.

But the bill is on the right track. Americans believe that insurance provides access to care, when in fact it is the gatekeeper that often denies care. Many think Obamacare is generous, and yet I often have to fight for essential care for my patients. We need to be more pragmatic, and less emotional, about this issue.

Jimmy Kimmel’s contention this week that a child like his would not receive lifesaving surgery for his congenital heart problem without Obamacare may tug at the heartstrings, but it is neither fair nor accurate. Employer-based health insurance, which covers 170 million Americans, including, no doubt, Mr. Kimmel, would have paid for this infant’s needs with or without Obamacare. Even if the Republican plan replaced Obamacare, and even if the infant didn’t have employer-provided insurance, the treatment would still be covered, either through a traditional plan or a high-risk pool. And at the end of the day, a federal law, the Emergency Medical Treatment and Labor Act, guarantees this kind of treatment, whether we have Obamacare or Trumpcare.

The final question concerns the skyrocketing costs of innovation, and how one-size-fits-all insurance can possibly continue to pay for it. My 93-year-old father, a retired engineer, just received a $50,000 catheter-inserted aortic valve, which was covered by Medicare. But if all such high-tech devices are covered, it will be practically impossible for any insurance company not to go belly-up. The tax-free savings accounts that the House bill would expand and make more flexible are a far better way to pay for this kind of care. Shouldn’t my father and those like him be asked to save their own money for just this sort of rainy day?

Or should we continue to overload health insurance with all our fears and expectations?

Marc K. Siegel is a contributor for Fox News and a professor of medicine and the medical director of Doctor Radio at NYU Langone Medical Center.​
 
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ChristopherASA

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I'm not sure I will have time to do that; I struggle each day just to get my "daily $" at turking.

I will add that when I ran a rather large travel information center near here (we covered 3 states) I took an un-scientific poll of the Canadians that visited the center, and roughly 80% were pleased or very pleased with the Canadian system.

thanks, Pablo Vanyanka Escobar.

[ tag E @Pablo Escobar ]
 
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El Pablo

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I'm not sure I will have time to do that; I struggle each day just to get my "daily $" at turking.

I will add that when I ran a rather large travel information center near here (we covered 3 states) I took an un-scientific poll of the Canadians that visited the center, and roughly 80% were pleased or very pleased with the Canadian system.

thanks, Pablo Vanyanka Escobar.

[ tag E @Pablo Escobar ]
Healthcare is an evil industry designed to take your money, and lots of it. We have too many government crooks with their hands in the healthcare cookie jar to ever get anything done about it.
 

ChristopherASA

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When I drive away from an doctor's appointment I just had at Kaiser ... for some odd reason I'm not thinking, "Healthcare is an evil industry designed to take my money." Probably because all such wide generalizations carry with them inherent inaccuracies and untruths.

You might want to provide some data or some "learned opinion" to substantiate your point of view so that those who wish to follow this thread might learn something about the issue: that is always more impressive and convincing that specious argument..
 

DareAngel3

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ChristopherPosts​

The below is an Interesting Op Ed from the New York Times (NYT). For instance, I didn't know that "...5 percent of Americans generate more than 50 percent of health care expenses." Do check out the one or two links in the actual article; they are informative

[ I'm taking no particular position on the correctness or lack of in this op ed (at least not now). It is posted here for educational purposes. If we don't know what we're talking about insofar as social policy is concerned, and can't help America make better choices. ]
Article Link: https://www.nytimes.com/2017/05/05/opinion/what-the-republican-health-plan-gets-right.html

"What the Republican Health Plan Gets Right."
by Marc K. Siegel


Now that the Obamacare replacement bill has passed the House and is moving on to the more centrist Senate, the real debate begins. What is the true purpose of health insurance, and what is our government’s goal in ensuring we have it?

I learn from my patients every day about the benefits, limitations and contradictions of their health insurance. One charming 60-year-old with severe seasonal allergies insists on seeing me every few weeks this time of year, even though I tell her she doesn’t need to — her antihistamines and nasal spray treatment rarely changes. But she worries that her allergies could be hiding an infection, so I investigate her sinuses, throat, lungs and ears. I reassure her, and her insurance (which she buys through New York’s Obamacare exchange) covers the bill.

If she was responsible for more than a small co-payment for these visits, I’m sure I would see her less often.

We pride ourselves on being a compassionate society, and insurance companies use this to manipulate us into sharing the costs of other people’s excessive health care. Meanwhile, 5 percent of Americans generate more than 50 percent of health care expenses. Why shouldn’t a patient who continues to see me unnecessarily pay more?

Continue reading the main story
The government’s job is to maintain public health and safety. It should ensure that insurance plans include mandatory benefits like emergency, epidemic, vaccine and addiction coverage. The Republican bill would let states apply for waivers to define these benefits differently; it would be a big mistake to drop such coverage entirely. But Obamacare went well beyond these essentials, by mandating an overstuffed prix fixe meal filled with benefits like maternity and mental health coverage that drove smaller insurers with fewer options out of the market. The few that remain often have a monopoly, and premiums rise.

Speaking of compassion, how about some for the 20-something construction worker who can’t afford to pay his rent because his premiums help subsidize overusers like my allergy sufferer? Why shouldn’t a patient who is risk-averse pay more for coverage she might never need, while that construction worker be allowed to choose a cheaper insurance plan that might cover only the essentials?

In addition to limiting the menu of essential benefits, the House bill would let states create high-risk pools for patients with pre-existing conditions who had let their insurance coverage lapse, and who could then be charged premiums more in keeping with their health care needs. This is the only way to make insurance affordable for most consumers; pre-existing conditions will continue to drive up premiums if everyone is compelled to pay the same price.

These risk-pool premiums can and should be subsidized by the government. A recent report from the Kaiser Family Foundation found that high-risk pools can work, but have been historically underfunded. Trumpcare should change that — though it will cost more than the House bill’s $8 billion in additional funding. Drastic cuts to Medicaid should also be reversed, which could help the bill pass the Senate.

But the bill is on the right track. Americans believe that insurance provides access to care, when in fact it is the gatekeeper that often denies care. Many think Obamacare is generous, and yet I often have to fight for essential care for my patients. We need to be more pragmatic, and less emotional, about this issue.

Jimmy Kimmel’s contention this week that a child like his would not receive lifesaving surgery for his congenital heart problem without Obamacare may tug at the heartstrings, but it is neither fair nor accurate. Employer-based health insurance, which covers 170 million Americans, including, no doubt, Mr. Kimmel, would have paid for this infant’s needs with or without Obamacare. Even if the Republican plan replaced Obamacare, and even if the infant didn’t have employer-provided insurance, the treatment would still be covered, either through a traditional plan or a high-risk pool. And at the end of the day, a federal law, the Emergency Medical Treatment and Labor Act, guarantees this kind of treatment, whether we have Obamacare or Trumpcare.

The final question concerns the skyrocketing costs of innovation, and how one-size-fits-all insurance can possibly continue to pay for it. My 93-year-old father, a retired engineer, just received a $50,000 catheter-inserted aortic valve, which was covered by Medicare. But if all such high-tech devices are covered, it will be practically impossible for any insurance company not to go belly-up. The tax-free savings accounts that the House bill would expand and make more flexible are a far better way to pay for this kind of care. Shouldn’t my father and those like him be asked to save their own money for just this sort of rainy day?

Or should we continue to overload health insurance with all our fears and expectations?

Marc K. Siegel is a contributor for Fox News and a professor of medicine and the medical director of Doctor Radio at NYU Langone Medical Center.​
While definitely interesting to hear a physician's point of view, I have to point out a few things that stood out to me.

I don't think a hypocondriac allergy patient would necessarily stop visiting the doctor if there was a higher copayment, because it seems less of a physical need (unless those meds really aren't doing it for her and he's just ignoring her complaints) and more of a mental issue. If she could not readily see her doctor, I suspect she would find another way to ease her worry or convince herself of more severe symptoms that would prompt repeated ER/clinic visits. I admittedly have a distaste for doctors, and was disheartened how he seemed to dismiss her concern, irrational as it may be. Also not mentioned are the costs of his "comfort" visits and who sets/profits from those price points.

On a more personal note, Kimmel may NOT "no doubt" have employer insurance. I'm not positive how television personalities or actors are handled, but I know that many professional musicians aren't entitled to any kind of employer insurance. I could be wrong, but I don't think WWE even provides insurance for its professional wrestlers (and talk about high-risk pool, there!). It falls under "self-employed" and "independent contractor"... terms that apply to some other group of workers I know :joycat: The number of people receiving employer insurance that the article used accounts for only half of Americans, which I don't think is a real convincing percentage. I've worked for two small businesses who weren't even required to pay the legal minimum wage :flushed:. Who knew THAT still existed? Larger businesses who are currently required (I think?) to offer insurance can still choose an unaffordable plan for most of their workers, with high premiums and deductables, so that their employees cannot afford it and "opt-out", reducing the employer's cost and liability while also making the worker ineligible for medicaid assistance. (One of the qualifying questions is, are you eligible for insurance through an employer?) Other businesses keep workers at an average of hours per week that eliminates their requirement to offer insurance, even if that involves mandatory overtime in one season and then unpaid leave in another season in order to maintain the yearly average. If the overtime amounts to too much money on that years' taxes, they again become ineligible for medicare assistance (and this can happen with a barely-above minimum wage base pay.)

Regardless of the solution, there will always be loopholes to be exploited. I'm just amazed at how MANY of them I've come in contact with that I was unaware of!

My father lives in New Zealand, with paid maternity leave and mostly-free healthcare. I believe children are covered completely up until a certain age. If you look it up, New Zealand has some of the lowest costs per capita, as well. I've met a number of nurses from China who travel here to study, and while they say our hospitals are "immaculate", they cannot believe how many medications we prescribe and the cost of a general check up. The labor and delivery nurses were also horrified at how births are handled here. I can't help but think we're overlooking some really obvious solutions that other countries have already been exploring, and that our culture just creates a continuous loop of ignorance, greed and poverty.
 

TotalBabe

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On a more personal note, Kimmel may NOT "no doubt" have employer insurance. I'm not positive how television personalities or actors are handled, but I know that many professional musicians aren't entitled to any kind of employer insurance. I could be wrong, but I don't think WWE even provides insurance for its professional wrestlers (and talk about high-risk pool, there!)
Actors and TV personalities can get insurance through the Screen Actors Guild (SAG) or the American Federation of Television and Radio Artists (AFTRA). I'm kind of out of the loop about the particulars, but I know you have to make a certain amount in earnings to be eligible for it (which, of course, can be difficult for "struggling" actors).
 

ChristopherASA

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While definitely interesting to hear a physician's point of view, I have to point out a few things that stood out to me.

I don't think a hypocondriac allergy patient would necessarily stop visiting the doctor if there was a higher copayment, because it seems less of a physical need (unless those meds really aren't doing it for her and he's just ignoring her complaints) and more of a mental issue. If she could not readily see her doctor, I suspect she would find another way to ease her worry or convince herself of more severe symptoms that would prompt repeated ER/clinic visits. I admittedly have a distaste for doctors, and was disheartened how he seemed to dismiss her concern, irrational as it may be. Also not mentioned are the costs of his "comfort" visits and who sets/profits from those price points.

On a more personal note, Kimmel may NOT "no doubt" have employer insurance. I'm not positive how television personalities or actors are handled, but I know that many professional musicians aren't entitled to any kind of employer insurance. I could be wrong, but I don't think WWE even provides insurance for its professional wrestlers (and talk about high-risk pool, there!). It falls under "self-employed" and "independent contractor"... terms that apply to some other group of workers I know :joycat: The number of people receiving employer insurance that the article used accounts for only half of Americans, which I don't think is a real convincing percentage. I've worked for two small businesses who weren't even required to pay the legal minimum wage :flushed:. Who knew THAT still existed? Larger businesses who are currently required (I think?) to offer insurance can still choose an unaffordable plan for most of their workers, with high premiums and deductables, so that their employees cannot afford it and "opt-out", reducing the employer's cost and liability while also making the worker ineligible for medicaid assistance. (One of the qualifying questions is, are you eligible for insurance through an employer?) Other businesses keep workers at an average of hours per week that eliminates their requirement to offer insurance, even if that involves mandatory overtime in one season and then unpaid leave in another season in order to maintain the yearly average. If the overtime amounts to too much money on that years' taxes, they again become ineligible for medicare assistance (and this can happen with a barely-above minimum wage base pay.)

Regardless of the solution, there will always be loopholes to be exploited. I'm just amazed at how MANY of them I've come in contact with that I was unaware of!

My father lives in New Zealand, with paid maternity leave and mostly-free healthcare. I believe children are covered completely up until a certain age. If you look it up, New Zealand has some of the lowest costs per capita, as well. I've met a number of nurses from China who travel here to study, and while they say our hospitals are "immaculate", they cannot believe how many medications we prescribe and the cost of a general check up. The labor and delivery nurses were also horrified at how births are handled here. I can't help but think we're overlooking some really obvious solutions that other countries have already been exploring, and that our culture just creates a continuous loop of ignorance, greed and poverty.
Informative and well thought out.
 

ChristopherASA

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Actors and TV personalities can get insurance through the Screen Actors Guild (SAG) or the American Federation of Television and Radio Artists (AFTRA). I'm kind of out of the loop about the particulars, but I know you have to make a certain amount in earnings to be eligible for it (which, of course, can be difficult for "struggling" actors).
thank you, TotalBabe @TotalBabe
 

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My cousin works in Hollywood and has for years. She's not on camera (but has been up for an emmy :).

The problem is that it's feast or famine. When she's working for a great show, she's making good money. But for every HIT (one ran for a decade), there are dozens of short-lived sitcoms that come and go. There have been long periods when she's made no money.

She has to raise her family when she's making good money.........and when she's unemployed.

I don't think on camera folks are the best people to look at.

For me, bring on the socialized medicine!
 

ChristopherASA

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Popping my head in as someone who lived with (and unashamedly loves) the National Health Service. Happy to answer questions/queries/concerns about the actual daily ins-and-outs of living with universal healthcare.
OK, but first, pls give your evaluastion of the NHS. ... :) on a scale of 1 to 10, 1 being it's HORRIBLE and 10 meaning BEST THING EVER ... plus any comments you wish to add. Thanks for being here, kiddo!
 
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jml

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My 93-year-old father, a retired engineer, just received a $50,000 catheter-inserted aortic valve, which was covered by Medicare. But if all such high-tech devices are covered, it will be practically impossible for any insurance company not to go belly-up. The tax-free savings accounts that the House bill would expand and make more flexible are a far better way to pay for this kind of care. Shouldn’t my father and those like him be asked to save their own money for just this sort of rainy day?
This is nuts

I was in my 20s living paycheck to paycheck/turking when I was rushed to the hospital because I was hemorrhaging blood thanks to a genetic disease. I've had expensive surgeries, procedures, tests, prescriptions, etc etc etc. There's no way I would have had $50,000 (or probably more by this point) saved up "for a rainy day". Health Savings Accounts aren't a viable solution for anybody but the rich and it shows a real lack of sympathy for the sick and less fortunate.
 
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DareAngel3

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This is nuts

I was in my 20s living paycheck to paycheck/turking when I was rushed to the hospital because I was hemorrhaging blood thanks to a genetic disease. I've had expensive surgeries, procedures, tests, prescriptions, etc etc etc. There's no way I would have had $50,000 (or probably more by this point) saved up "for a rainy day". Health Savings Accounts aren't a viable solution for anybody but the rich and it shows a real lack of sympathy for the sick and less fortunate.
This was my initial impression, as well. However a friend explained to me that the HSA is meant to be a tax-free way to pay for your insurance deductible, or your co-payment split (80/20 or what have you) in case of emergencies. Maybe even your premium? And that you *should* get a tax break for a designated amount yearly, which you *could* put back for "rainy days" or to pay your premiums. Last I heard, that break was just a blanket break according to age, though. And this of course assumes that you don't have any preexisting conditions that make it impossible for you to get insurance in the first place. I'm still really skeptical. I know private insurance for one of my children alone would cost $412 a month. So I'm not sure how realistic saving ~$2k a month, even pre-tax, is for most families. That would have to be one awesome tax break. :facepalm2:
 

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This was my initial impression, as well. However a friend explained to me that the HSA is meant to be a tax-free way to pay for your insurance deductible, or your co-payment split (80/20 or what have you) in case of emergencies. Maybe even your premium? And that you *should* get a tax break for a designated amount yearly, which you *could* put back for "rainy days" or to pay your premiums. Last I heard, that break was just a blanket break according to age, though. And this of course assumes that you don't have any preexisting conditions that make it impossible for you to get insurance in the first place. I'm still really skeptical. I know private insurance for one of my children alone would cost $412 a month. So I'm not sure how realistic saving ~$2k a month, even pre-tax, is for most families. That would have to be one awesome tax break. :facepalm2:
Yeah, I know the actual approach with the HSAs isn't just "you pay for everything yourself" but I was more replying to the seemingly-crazy way the writer of the article presented it. Regardless, you and I seem to essentially be on the same page. The poor and/or sick won't be able to have much money in those accounts at any given time so HSAs don't do much to help the people who most need the help.
 

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This more recent piece shows he is very good at hiding an agenda of Medicaid work requirements, spotty and less comprehensive coverage for the poor, and increased lack of accountability for doctors and system failures ("tort reform") under the auspices of moderation and compromise.

Also, HSAs are indeed nuts, and a tax money redistribution scam giving money to the rich. 50K in an HSA? The annual limit is currently $6750 for a family (less for a single individual) meaning a family would have to save nearly ten years to afford that fucking valve and that's only if they didn't have any other health expenses in the meantime. I briefly worked in this part of the industry and poor and medium income people are not able to just funnel money into HSAs like it's nothing, esp. when plans redesigned around HSAs can often include a higher deductible as a result. Only rich people are going to reap the benefit of socking away up to $6750/yr tax free (in the highest tax bracket that is a 39.6%, or $2673 savings). And then they will still be able to afford insurance so will just continue to pay lower percentages of their income for healthcare than poor or middle income people. Which is fucking disgusting.

Outdated opinions on a host of issues, including healthcare, are holding this country back and I am fucking sick and tired of it. We have at least a dozen case studies -- industrialized nations successfully caring for their populace w/ centralized medical systems and leaving us behind -- to draw from for guidance in setting up a national health care system, not to mention MEDICARE which works pretty fucking well and don't let anyone tell you any different. I have seen this first hand many times over the past few years, as I am privy to all of my mother's Medicare Advantage bills. At its worst it is like having private insurance, requiring extra phone calls etc. Most of us would certainly rather have that than the big pile of dogshit we are bound to be left with if the AHCA becomes law. Hey doc, if I rub this dogshit on my skin will this rash go away? No?

Right now the [supposedly] most esteemed legislative body in our country is writing a healthcare bill IN SECRET that they refuse to talk about or reveal to anyone but their craven Republican colleagues and probably several of their most reliable patrons/lobbyists. If you are reading this still you probably care a little bit about your own health and future so fucking call your Senators and ask them why they are planning the future of you and your family's health IN SECRET without any hearings or public view of the bill.

edit to add: here is a list of Senators' health care legislative assistants' phone numbers. Ask for this person and ask them how your health care will fare under the new legislation.

Also there's this:

Senate Republicans can't answer simple and critical questions about the health care bill they're crafting in secret.


Some still can't say what it's trying to do — other than garner enough votes to pass the Senate — or how they believe it will improve the American health care system.

With the bill’s text still not released for public view, Vox asked GOP senators to explain their hopes for it. Who will benefit from the legislation? What problems is this bill trying to solve?



To see how we fare next to other countries even though we pay more, World Health Organization statistics
 
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My one concern with a nationalized system is that it might (keyword here) disincentivize innovation. For all the faults of the US system it's designed to drive medical innovation. One of the contributing factors to the success of other nations is they are able to piggy back off of innovations coming out of our companies and universities. If we spent less on healthcare it's very possible that other nations would need to spend more.

Again, I'm not against a universal program, in fact I support it. However, I'd want to see it designed in a way where competition still drives research.
 
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ctraltDel

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Find me a country with socialized healthcare where the people say it is bad.

I'll check back later and see if you had any luck.
I support a socialized system, but just saying, there are people who complain that it can take many months longer for elective surgeries (e.g. hip replacement) or complicated procedures to be scheduled compared to the U.S. A socialized system works great for acute and primary care though.
My one concern with a nationalized system is that it might (keyword here) disincentivize innovation. For all the faults of the US system it's designed to drive medical innovation. One of the contributing factors to the success of other nations is they are able to piggy back off of innovations coming out of our companies and universities. If we spent less on healthcare it's very possible that other nations would need to spend more.

Again, I'm not against a universal program, in fact I support it. However, I'd want to see it designed in a way where competition still drives research.
I think the answer lies somewhere in re-designing how patent life and subsequent pricing will work for new drugs developed in the US. We're forced to shoulder the costs of the research while other countries can get the medications for much cheaper (see: HIV and Hep C meds). Having worked on clinical trials before, I can say there's a huge number of investigative failures/flops, so there is something to be said about them trying to recover from those when they do get a success. Perhaps some combination of cost-sharing among other countries' patients who get the drug would be ideal (but that would probably involve international regulation) so that a) costs go down for American patients, b) they're not trying to order from sketchy online sites which is unsafe and c) for the healthcare business people, they're not losing "customers" to medical tourism. Limitations on the percentage of profits/funds that can go to administrative, ads, and executive overhead vs. R&D would be helpful.
 
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mTurk8705

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Thanks to Chris for starting this discussion!

I'm 67 and just avoided utilizing Obamacare through VA healthcare and Medicare. Through my life I've had insurance and not. From 2006+ into 2010, I personally didn't have any coverage. My wife was unemployed due to health problems but we didn't qualify for Medicaid. We paid $1200+ monthly for COBRA insurance for 18 months (this contributed to our later bankruptcy), until that coverage ceased.

I support a national healthcare program utilizing a single-payer concept, somewhat like Medicare. Research needs to be supported. I haven't researched the details in great depth, but plan to do so soon.

I'm very upset by the Republicans (or the Democrats) trying to shove a bill through with no public disclosure and no public debate.
 
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