Coping with "Medicare for all"

Coping with "Medicare for all"
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#61

The problem I see with the current mess is that it’s often cheaper to pay high insurance rates because healthcare costs are astronomical, largely because they are subsidized by the high insurance rates. A perfect storm.

Many people (especially those covered 100% by the government, and even those only paying a copay) visit doctors and get prescriptive medicine when they wouldn’t otherwise if they had to pay for it OOP. This attributes a great cost that everyone ends up paying for with higher rate insurance coverage and overinflated care. Entitlements aside, if there is no extra cost or only a small cost for medical care, the ‘I’ll get mine’ attitude is predominant.

I’ll be the first to admit that I took a much harder look at the necessity of taking my son in to the doctor when we were covered under a $15k OOP HDHP than now, where we pay a higher premium plan but only pay co-insurance and very small OOP. I believe most all of society looks at things this way when they don’t have to front the entire bill. This mentality is largely what has lead us to our current crisis.

Obviously there are many in our country with bad health that need better coverage but if medical bills weren’t inflated as they are due to the above, they actually might be more affordable for everyone. Though I’m sure doctors, providers and drug companies would not be fond of this idea.

Clearly though, a one size fits all is not going to cover it. There are really no good answers for everyone. Someone will foot the bill for those that can’t afford their catastrophic care, even in a purely capitalistic situation. We obviously can’t leave those who can’t pay cash upfront or get a loan for their $50k bill to die in the streets.


#62

Well if capitalism can’t fix it then I guess we’ll all just have to go to a totally socialist system then eh?

I don’t believe that capitalism is helpless against peoples desire for free stuff. Plenty examples of capitalism working perfectly fine along side / against / in spite of entitlements.

One might argue that our healthcare system is not truely a free market. OK thats fine.

Back to the question… what are the republicans doing to fix anything other than just opposing democrat ideas?? Claiming that free markets can’t help isn’t really a solution in any way whatsoever nor is it a valid excuse for lack of solutions.


#63

You are putting way too many words in my mouth.

And that wasnt “the question”.


#64

OK then.

What was your point? Why did you say free markets can’t work in opposition to entitlements?? I thought we were talking about the republican plans…

Here is a question:

What are the republicans doing to fix our healthcare system other than oppose the dems?

anything?


#65

I sure hope one would argue it’s not a free market. I don’t know anybody that would argue that it is a truly free market with a straight face.

They aren’t even opposing the dems anymore. I’m old enough to remember when I (a republican voter) was supposedly going to get a shutdown over obamacare funding that would have hopefully resulted in some cuts. Nope, that never happened. But I got a long shutdown over funding for the wall. And for that I ended up with…


#66

LOL, crickets


#67

Really? I was supporting your comment.


#68

I don’t think glitch was saying they couldn’t “work” together. All glitch said was that capitalism is not a solution for a situation where there are entitlements. I think that’s the same as what you’re saying - they can both work at the same time, in spite of each other. But capitalism won’t create the entitlements.


#69

I was saying ‘crickets’ in response to the comment asking what the R’s plan was to actually fix the system. In other words, there isn’t one and everybody knows it by now. All there is is knee-jerk rejection of anything the D’s propose.


#70

See the thread on the Trump Administration requiring that medical providers post prices. With today’s high deductible policies there is a yuuge incentive for people to price shop. Once they can do this it would have a yuuge effect on medical costs once the President gets it through the Resistance of the medical industry and the Obama judges. The market does not require everyone to use it to discipline providers if a substantial part of their profits are affected.


#71

Its a good change.

sadly as much as we’d like … It won’t even move the needle on healthcare pricing.

Democrats don’t oppose it.


#72

Of course there is no official plan. The plan was repeal and they didn’t have the votes. I think after the repeal failed, the unofficial plan has mostly been just “give up.” Kinda like same-sex marriage. At some point, there’s really nothing you can do anymore and you move on to the next fight. Republicans were able to get rid of the penalty for not having insurance, so maybe somewhere down the line when a bunch of healthy people leave the exchange plans, people on both sides will wake up and see the current system is unsustainable. But whether anyone does anything about that… I’m not holding my breath.


#73

The problem is that politicians are not willing to look at real solutions. Here are a few ways we could actually achieve meaning impacts:

  1. Take lawyers out of healthcare: tort reform, limit damage awards, prevent frivolous lawsuits, institute a “loser pays rules”, etc. Sadly we have a conflict of interest with many of our politicians having made their fortunes at law firms.

  2. Take the government out of healthcare: repeal laws and rating restrictions preventing consumers from buying any health insurance policy they want, regardless of which state they live in, without mandates on what is included in that policy.

  3. Take the employer out of healthcare: I think it is fine that employers want to help with the costs, but lets let them contribute to the insurer consumers choose and not choose for the consumer. This allows anyone to change jobs without losing insurance benefits.

  4. Encourage personal responsibility: car insurance does not cover oil/tire changes or other minor car repairs and neither should health insurance. Increase contribution limits of HSA accounts and allow contributions regardless of healthplan. High deductible plans will pay for the big stuff and the minor stuff will be easily covered by HSA contributions.

  5. This one is optional, but for those that like to pick winners/losers you could give tax breaks to motivate good behavior: tax breaks for healthcare costs of healthcare premiums (first dollar), gym memberships, home gym purchaes, vitamins, supplements, It might save money long-term to encourage that consumers make healthy choices, thereby reducing the need for expensive doctor visits, medical procedures, or prescription drugs.


#74

IMHO, high deductible plans need to die. I’ve seen good HMO/PPO style plans that cost no more than high deductible plans with a small HSA contribution. At a time when many Americans can’t afford a basic car repair, what makes you think they would voluntarily contribute to an HSA?

I know myself that if I have a medical condition, and I am going to have to pay for treatment directly from my pocket, I am going to wait until the last possible moment to go. This can make the condition worse and treatment costs to rise. Furthermore, people that are relatively unhealthy and the least able to work would be forced to contribute more to their own healthcare which exacerbates the problems we have now.


#75

@storm Then you are basically saying that things are great the way they are, because a large majority of the current plans are HMO/PPO type plans. High deductible plans make up a small percentage (~10%) of current plans.


#76

I’ve seen statistics that malpractice insurance and malpractice costs are ~2% of our total spending on healthcare.

Medical errors amount to ~1% direct costs.

Of course you can also find estimates that so called defensive medicines total cost is $700 billion. That is ludicrous and such exaggerations are just conjecture and speculation. Some people seem to want to grossly exaggerate the cost of lawsuits. Some doctors especially seem to like to blame the lawyers. Blaming lawyers is easier than admitting that you aren’t 150% perfect.


#77

Medicare fraud is at least 10% (that they found), and more like 20% of the budget if you include the stuff they didn’t but speculate is going on. That’s an obvious place to start.


#78

I’m saying a high deductible plan is nearly as bad as having no insurance at all. What is the point of paying for healthcare insurance if you have to be out of pocket several thousand dollars before it covers anything? I worked for a S&P 500 company that only offered high deductible plans, and it was a big reason why I left.

https://www.bloomberg.com/news/features/2018-06-26/sky-high-deductibles-broke-the-u-s-health-insurance-system


#79

That’s what I did when I had a high deductible plan in 2007. I injured my hand, but I didn’t want to go in and spend hundreds of dollars if it wasn’t broken. I decided it didn’t hurt THAT bad, so maybe it was fine. Flash forward to a month later and it still didn’t look right, so I went to the walk-in clinic. It turns out it was badly broken and the bone was fused together in the wrong place. It’s still slightly deformed.

Thankfully, my most expensive health care costs occurred after implementation of the ACA, which has saved me over $30,000 thus far. Thanks, Obama!


#80

Most plans have some kind of deductible, so you are faced with the same decision regardless. I wish I could lower my premiums further with an even higher deductible. I’m not going to go to the doctor with every cough just so that he can tell me “yup, you’re sick”, so I don’t want to pay extra for “better” insurance I will not use anyways.

I want insurance for what it’s intended to be - a backstop against life-changing medical costs. Covering the day-to-day stuff is a big part of why it’s so expensive.