Neither party cares about the people's healthcare.

In an ideal world, but reality does not fit your platitude.

 

Actually in your ideal world Government is in charge of your health since you have turned it over to them. In my world, it is in my hands.

 

That's the illusion you hold in your hands.

It's just an illusion.

 

I think it would as well; most likely a change in the first amendment.

 

I tend to agree with you about the political parties. One party claims they want everyone to have health care, but they lack agreement on a viable way to pay for it because everyone thinks "someone else" should pay for it. The other party doesn't want to pay for anything.

Let me show you what I think. I'm going to cut and paste my side of a discussion I had on another thread with another member. He had said in a comment that employer-provided health insurance doesn't exclude for preexisting conditions, and it keeps the premiums down by putting people into large pools, spreading the risk. I highlighted those parts of his comment, and then said this ...

The part I highlighted in red: This is why I have suggested solving this whole problem by making a compromise between those who want a lot of government involvement in our health care choices and those who don't. I have suggested a single government mandate and a few simple requirements.

The mandate is that employers provide family coverage health insurance for their employees. All employers, coast to coast. What this would do would be to cover virtually 100% of the population as follows:

Medicaid for the unemployed and unemployable,
Medicare for the elderly,
Employer-provided for everyone else.

Small employers would be encouraged to create a large national organization that negotiated with the insurance companies. In so doing, they would be on a level playing field with very large employers. Their organization would be representing tens of millions of workers.

Insurance would be allowed to compete across state lines.

There would be no inquiry about health status or preexisting conditions. If a person was well enough to work and get hired, then they qualify to join the company plan. If they aren't well enough to work, then they are unemployable, and that's where Medicaid comes in.

Children may stay on their parents' plan until age 26. (Then they've got to get a job.)

This plan would not cost the government or taxpayers a dime. It would actually save the government and taxpayers a lot of money on Medicaid. Many people receiving Medicaid are also working but with no insurance. That would change, and they would come off the Medicaid rolls. With many people coming off Medicaid, our Medicaid dollars could be better spent because those dollars would be servicing much fewer patients.

Politicians and citizens would not have to fight (and end up in the inevitable gridlock) over how to pay for this - the inevitable tax fight. There would be nothing for government to pay for, other than the things they already pay for - Medicare and Medicaid. Government taxes, penalties, and expenditures for Obamacare would all end. This would also end a lot of the gaming of the system that is going on now, like paying for a Bronze plan until you get sick and then upgrading to a Platinum plan until you're well again.

And, as you pointed out, risk would be spread out over the entire population of working people, in large group plans, lowering the cost of their insurance paid for by their employers.

In exchange for covering the working population with health insurance, I would consider lowering corporate income taxes even more than Trump has proposed, perhaps just eliminating them altogether.

And finally, work would be rewarded, rather than sloth.


He answered me back, and then I replied with this ...


Hey there, young fella ... No, I am not saying the government is completely out of the health business. Medicare would remain the same. Medicaid would be for the unemployed and unemployable. Everybody who is currently receiving health insurance through their employer (both government workers and private business workers) would be largely unaffected by this proposal. I am saying that all of those employers who do not provide health insurance to their employees would be made to do so.

I do not think the cost would be completely offset by the elimination of business and corporate income tax, but it would help offset it to a degree. I think when you weigh the public interest in having everyone covered by health insurance versus the government's interest in collecting tax revenue from business, the trade-off is well worth it. Government's bonus would be in the reduced expenditures for Medicaid because there are a lot of working people on Medicaid. They would no longer need Medicaid because their employer would be providing health insurance.

Granted, this would require an adjustment in the business plan of those affected businesses, but all businesses would be on a level playing field with all the others. I would expect there would be some consumer price increases coming out of certain business sectors to help pay for it. Businesses would have different ways to pay for it - reduced or eliminated business taxes, raising the cost of their goods and services, and/or a portion out of their profits. All businesses would just have to figure out how to make the books balance, but I am certain they would do it. Perhaps it would be wise to phase this in over 5 years, simultaneously phasing out Obamacare, giving the business world, and our economy in general, more time to adjust to the changing system, rather than just dropping a bomb on it, so to speak. But the truth is, this is really not some radical idea pulled out of left field. Employer-paid health insurance has been around a long time. My proposal is just an expansion of it.

So, while there would be this government mandate, the free market system would take over from there.

Currently, 55% of workers are covered by employer-paid health insurance (This percentage includes government workers.) 37% of people are covered by the government directly (Medicare, Medicaid, and military). Medicaid accounts for 19% of the people. Under my proposal, a great many of those would come off of Medicaid and join the 55% who are covered by their employers.

It's a compromise solution to this whole damn mess. Those who want the free market capitalist system out of health care won't like the fact that my idea leaves insurance in the hands of free market for-profit insurance companies. But those folks also believe it is the proper role of government to make sure the population has access to health care, and so they should be happy that there is a mandate that makes that happen. Those who don't like government mandates will chafe at the mandate the proposal contains. But those folks are free market defenders, and they should be happy that this is not government-run UHC and, after the mandate, it runs on the free market insurance system. Nobody gets everything, but everybody gets something, and meanwhile, the whole population is covered, and that is good for all of us.

I've been covered by employer-paid health insurance all my life. For most of that time the employer paid for the premiums. In the early 2000's, my employer paid 90% of the premium, and we paid 10% which wasn't too bad. It has co-pays and deductibles like any insurance, but overall, it took good care of me and my family. With that as being my experience, I would like to see all working people have the same benefit that I have enjoyed all these years because it works.

Seth


What would you think about that?

Everybody is covered by insurance.
There would be no new taxes or a tax fight.
This wouldn't cost government anything. It wouldn't create more deficit spending. Around 35 million people wouldn't need Medicaid anymore.
Preexisting conditions: covered.
Children: covered to age 26
Lose your job? Go to Medicaid until you get another job. Medicaid would be stronger and better because fewer people were on it.
You could put this government mandate on one sheet of paper rather than thousands of pages.
The free market system remains intact.
It's a system that works.

Seth.

 

So you're whining about healthcare that you only pay part OF!

How much do you think Healthcare "should" cost?

Oh and by the way...take out the profit motive in insurance (like Medicare does) and you can save 25%. Let government negotiate drug prices and there are further big savings...

 

That only makes sense to Robert. Oh well....

 

Healthcare was NOT cheap in the 1940s. Look at the time value of money.. The poor and elderly couldn't afford healthcare back then either.

Insurance companies contribute NOTHING to patient care... The just add 30% to the cost of healthcare.

 

You'd think that by now Americans would know that. Last year the National Association of Healthcare insurers spent $86 million to fight universal healthcare and are doubling down on lobbying efforts as we speak.

 

All the right questions.
Only those that avidly support liberty and individual sovereignty have your interests at heart.
Obamacare and most of the current "repeal and replace" plans' primary focus is not healthcare but government control over healthcare. Single payer is the ultimate of that objective. Yes, Obamacare or single payer costs will continue to rise as there is not damping to control costs other than a limit accomplished by rationing. The government will now decide what treatments you are eligible for.
The capitalistic system works because those profit driven entities none-the-less must please the patient and the provider to stay in business. Government run healthcare has no need to make anybody happy. DMV people are friendly and courteous, which is nice, but in the final analysis they could care less if you are really pleased about registering your car.
Virtually all of the Democrats and a big portion of Republicans are greatly in favor of expanded government and more government -- them -- control over people's lives.

 

Did you say that you were an MD?

 

This is an absolute fabrication. I realize that you saw a study that says administrative costs in hospitals is 30%, but that in no manner shape or form equates to insurance costing 30%. Admin costs include everything from building overhead all the way to the salary of the CEO and everything in between. The billing department is but one small part of overall admin costs. To take the statement that admin costs are 30%, and therefore conclude that insurance costs 30%, is nothing short of preposterous.

To make matters worse, I know that you are advocating single payer. Nothing about single payer is going to significantly lower the chunk of admin costs that is attributable to the billing function. If anything, Medicare makes providers jump through more hoops than does private insurance which would just as likely raise the cost of the billing function.

 

Obamacare was never about "the peoples' healthcare".

It was just a federal power grab over 1/6 of the economy, on the way to single-payer and even more federal micromanaging of our lives.

 

I should have been more specific.. I am talking about increase in paperwork that took off in the southern states around 1990.. That added 25% to costs not including rent and power etc.

 

Show me a link to what you are referring. A 25% increase in the billing function, even if 100% true, in no way equates to insurance adding 30% to overall healthcare costs. The correlation just is not there. Its not even close.

 

It was part of my job to check my physican practices twice a year. That's how I know..

Over head went from 49-52% to 75% ..

 

You have made the shockingly bogus claim that insurance adds 30% to overall healthcare costs. You will have to forgive me if I don't take your word for it because you are quoting some type of billing overhead numbers which tells us nothing about billing as a percentage of overhead and much less insurance as a percentage of overall healthcare costs. Ive seen you trumpeting this 30% study, subsequently making the claim that insurance costs 30%, claiming that you really meant 25% increase in paperwork in the south when called on that number, and now some odd recitation of the percentages 49,52, and 75% with absolutely no context. When taken together, you aren't making any sense. You need to post a link, and I will show you how that in no way equates to insurance costing 30% of overall healthcare costs. That claim is utterly preposterous and you will NOT be able to back that up with any type of actual proof.

 

Insurance companies, HMOs, PPOs all have different paperwork and drug schedules.. Both of which eat up a lot of time.

 

That's all well and good, but that in no way equates to 30% of overall healthcare costs. Nothing in this statement supports the 30% claim even a little bit.

I am hesitant to go off on the tangent of billing paperwork, because I don't want to obscure the undeniable reality that insurance doesn't add 30% to overall healthcare costs, but even with that topic..... paperwork for Medicare ALSO eats up a lot of time. You can even argue that Medicare is far more onerous in getting various therapies approved and takes just as much if not more office time. Just because you were to switch to single payer, that in no way magically takes away the billing function. The vast majority of time in getting something approved isn't spent looking up a billing schedule, it is in collecting the medical information necessary to get a therapy approved, and Medicare specifically is a nightmare in that regard for providers.

 

Medicare is far less expensive than private insurance or the VA... and involves LESS paperwork. Insurance companies make money.. They are not about altruism. That's why they are in overdrive to sink Obama care or single payer-private delivery. Medicare has a problem with fraud (reference Rick Scott's Columbia HCA and Tenant Healthcare) but stiff prison sentences would help stop that. In the UK the NHS 's problems with fraud are miniscule.

 

I had a feeling that if responded to your tangent that you would completely refrain from acknowledging the undeniable reality that insurance does NOT add 30% to overall healthcare costs. That is such a gigantic claim, and it is simply absurd. Being someone that keeps reminding everyone that you are a healthcare "executive", you really have a duty to not be spreading such unmitigated misinformation. I do believe that you honestly thought your claim was correct because of the 30% admin cost study that you have cited on this board, but the mere fact that you honestly thought that's what it meant really displays that you don't truly have a very good comprehensive grasp on this subject matter. I have no doubt that you worked in Medical, and probably knew your little area of expertise well, but that in no way means that you have a comprehensive understanding of such a wide and varied industry.

 

Except for some one-off special allowances (changes in the ACA law not made by Congress) companies have to spend 85% for large companies and 80% for others on direct medical care, after taxes and fees. Their overhead is limited to 15% to 20% of their premiums.

 

It seems as if you put a great deal of thought into that plan and I totally respect that. I guess my main concern with it would be it's effect on small business. How would a truly small operation with only a handful of employees be expected to pay for and administrate healthcare for their employees?

Are you suggesting that employers be responsible for 100% of the employees health insurance premiums or a system like is in place now where each pays a percentage?

 

65-70% of the healthcare dollar is spent on the elderly, chronically ill and premature babies... Young working people use a very small share.. and they are paying into the system with their payroll taxes.

 

Why does it matter what portion of my insurance premiums I pay? It does not change the fact that my health care costs have dramatically increases over the last 10 years through zero fault of my own.

Are you suggesting that since I busted my butt in high school and college to put myself in a position to get a good job that I bust my butt at to have a steadily increasing income that I should actually be punished by having the same level of healthcare as someone who didn't bother to put in that effort?

If so shame on you.