I do have a reform package for the disaster that is the ACA. Unfortunately, I won't be elected until 2018. So we're just going to have to deal with an internet post formulating what must be done for the path forward. The ACA is the worst piece of legislation ever passed in the history of the USA.
Originally Posted by Mike12
Furthermore, the assertion that Health Care "is a right", is a blind assumption. To provide for this right, doctors must take long hours out of the day. To provide for this right, nurses must look after their patients. To provide for this right, drug companies must create effective medicines, go through testing and regulations(that I largely support, BTW.)
In short, the cost of health care is very real and to deny these people the right to their financial rewards due to their service in their various sectors is borderline cruel. So, we have to figure out how to afford the cost of health care. There is no 'right' to someone else's property or service.
So, what drives the cost of health care? Quite a few things: Administrative costs, health care usage. Scarcity is the main driver of health care. Not enough drugs, aforementioned usage creates a lack and the demand can't keep up. If you look at the other nations around the world, it's not so much that their health care is cheaper, but that they have less people per capita to actually cover. And thus, their health care is cheaper.
But look at the EU as a whole, and the need for the VAT tax among others, becomes clearly a necessity to the nations of Europe. But high taxation takes dollars out of circulation(guess what also does, mandatory programs like the ACA). Said dollars out of circulation prolongs the recession/decline, whatever you want to call it.
To put it bluntly: The ACA promotes class warfare. From having to force people to buy a product(Insurance), that they may or may not need. At rates they
may or may not be able to afford. The withdrawal from the marketplace now restricting doctor access. The 40 hr work week that forces small businesses to cut hours or outright cut workers. And that's not even the worst offense of the bill. Let's talk about those subsidies.
First off, because the subsidies cover damn near everyone under the sun, you have to have more of them than you do. Thus talk of the subsidies possibly running out in 2017. But this isn't the worst part of it. The worst part of it, is that you only qualify for said subsidies if you're in a certain income bracket(like most government programs). Once you actually raise your income level, you'll be essentially buying health insurance at the expensive prices.
The said expensive prices(along with the taxes for the subsidies) that middle/upper class Americans pay. No one wins, regardless of which sector you're on. Even if you "get insurance" on the lower rungs, that's only as long as you STAY there. This law is absolutely terrible. There's no way around it.
**Throws the ACA in the trash bin**. Let's start reforming the garbage.
One of the ways I suggested to reform this, is to actually give the patient control over his insurance plan. The irony is calling it a "market" and having the insurers themselves dictate the cost of the plan lol. Yeah, no. We're going to give patients/doctors the ability to control the plan, they will be the ones who craft the plan. And all Insurers are, are basically middlemen who approve of the plans. There are those who'd go "Wouldn't the plans be more expensive?" Nope. No more men plans covering tampons, they don't need them. Women plans don't need to cover Viagara.
Already, we addressed a huge reason for costs. But I'll go further. One of the reasons for rising costs were the damn doctor visits for prescriptions.
Create a government-protected server accessed by the patient/doctor, and have your prescriptions loaded on the account in REAL TIME.
There, problem solved. You could just load the prescriptions on the account, the pharmacist would get the prescriptions and you'd get your medicines.
All you'd have to do is attend your daily checkups really, to get the prescription the first time(and/or whenever you need a different prescription.)
And I'm still not done. Another major cost is the lack of access to drugs over the counter. If we make more drugs over the counter, you'll have less need of a prescription. Which additionally leads to less appointments and thus more time for the doctors.
In a nugget to the Left, I concur with Senator Bernie Sanders. It's time for the US to negotiate directly with drug companies. However, this will not be the "US Government"(or a faction thereof). They can't even negotiate a proper budget. My confidence is nil in Washington's negotiating ability. Instead, I would author a "Drug Marketplace Organization"(or DMO. Crappy name, but you guys can help me with a better one.) I'd have pharmaceuticals, insurers and doctors on one big panel with the expressed interest of negotiating with current players in the industry.
With the regulation stipulating that drug prices may not exceed twice their worth(IE: The cancer drug incident isn't happening again.) With those stipulations in mind, and with the vast US market, buyers will eventually cede to a strong US position. It's the one thing Sanders has that I majorly approve of, I just want to give the function to capable players.
Okay, we're getting rid of the mandate. A: It's Anti-American, B: It's not necessary. The reason "the young" had to be brought in, was to de-facto cover the costs for ensuring the Elderly/Terminally Ill. There's much better ways of doing this, such as isolating the Elderly/Terminally Ill from the rest of the pool.
What I want to do is I want to segregate and shorten the pool. You have de-facto three groups: The Youth(0-12), Teenage/young adult(13-40). Adult/terminally Ill(40-). Each group is its own group, and eventually with insurance companies that will only cover that particular group. This will expand the insurer market as they can now selectively choose who they're going to insure.
Now that each group is its own group, the costs of insurance have gone down tremendously. It's the one-size fits all, that's increasing prices. Oh, and I'd have a one-time signup. No more of this annual sign-up crap, or the stupid and I mean absolutely STUPID "sign-up periods". Someone might not have the income to pay for it, in that window. But may have that income at a later date. Get rid of the sign-up periods. No other business does business that way. And I suspect it's in the bill.
Instead, you transfer accounts as you age. Through the transfer system, guess what I did? That's right, everyone has insurance! Without the mandate, I have a much better way of getting people insurance. And through different insurer providers for different age groups, I've even made family plans cheaper.
When you consider that companies already ensure their workers, we have just utterly fixed health care. But there's one problem remaining: The "keep it until your 26" stupidity. This is putting a bandaid on a serious problem: Adults who have yet to stand on their feet. How do we solve it? Make basic health care a collegiate necessity.
And if it sounds far-left, it's actually quite innoative: For these people to get a benefit(health care), they actually have to attend college. In fact, let's extend it to a "Productive Citizen Credit". And the PCC can in effect be insurance for those who are productive in any capacity, but don't necessarily want to pay for it in the form of a costly insurance plan. We'll deduct it from their tax earnings instead.
Oh and finally: Go from Single-Payer, to a Double-tier model like Singapore and other highly developed countries. Thus enabling both choice and expanding coverage capabilities.
Your welcome America.
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