How do people envision cutting medical cost?

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242
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Main Question or Discussion Point

How do you think the U.S. will cut medical cost?
 

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107
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"cadillac" tax seems to be one plan on the table. encourage people to buy less coverage by making additional coverage progressively expensive.

http://www.nypost.com/p/news/national/unions_get_pecial_treatment_in_health_AB053CwqPIJlIxXAm37DOM
About 2 weeks ago, estimates of costs of $2,400 per year for a 4 person family were being discussed. Now, last week, Obama raised the "Cadillac tax" base to begin at $24,000 per year (not counting dental and vision) for union members.

My question is this, what kind of medical care do you receive for $2,400 versus a $24,000 union plan?
 
About 2 weeks ago, estimates of costs of $2,400 per year for a 4 person family were being discussed. Now, last week, Obama raised the "Cadillac tax" base to begin at $24,000 per year (not counting dental and vision) for union members.

My question is this, what kind of medical care do you receive for $2,400 versus a $24,000 union plan?
are you comparing a base individual plan to a family cadillac plan?
 
107
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About 2 weeks ago, estimates of costs of $2,400 per year for a 4 person family were being discussed. Now, last week, Obama raised the "Cadillac tax" base to begin at $24,000 per year (not counting dental and vision) for union members.

My question is this, what kind of medical care do you receive for $2,400 versus a $24,000 union plan?
Links:

http://healthcare.change.org/blog/view/does_the_new_senate_health_care_bill_get_the_job_done_pt_1 [Broken]

http://www.washingtonpost.com/wp-dyn/content/article/2010/01/15/AR2010011503901.html
 
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107
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are you comparing a base individual plan to a family cadillac plan?
They're both tax payer subsidized - so yes - except the $2,400 is for a family of 4 under the Senate plan.
 
They're both tax payer subsidized - so yes.
that's not the point. one plan has more people in it, so it makes the discrepancy in cost wider. if you don't compare an individual to an individual plan, the comparison is invalid.
 
107
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that's not the point. one plan has more people in it, so it makes the discrepancy in cost wider. if you don't compare an individual to an individual plan, the comparison is invalid.
Our posts have over-lapped. Both plans cover a family of 4 persons.
 
They're both tax payer subsidized - so yes - except the $2,400 is for a family of 4 under the Senate plan.
oooohhh, OK. yeah, from what i understand, the Senate has a MAJOR cadillac plan and are ridiculously well-covered.

fwiw, i think it's a bit silly that they're doing this. all it does really is highlight that government workers are the worst "offenders" when it comes to spending "too much" on healthcare. so... let's ration healthcare not by government fiat, but by using a sin tax (like we do with cigarettes and alcohol) and while we're at it, let's exempt all our political friends. it's just a big disaster in the making, IMO.
 
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107
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oooohhh, OK. yeah, from what i understand, the Senate has a MAJOR cadillac plan and are ridiculously well-covered.

fwiw, i think it's a bit silly that they're doing this. all it does really is highlight that government workers are the worst "offenders" when it comes to spending "too much" on healthcare. so... let's ration healthcare not by government fiat, but by using a sin tax (like we do with cigarettes and alcohol) and while we're at it, let's exempt all our political friends. it's just a big disaster in the making, IMO.
Actually, the $24,000 per year plans I'm referring to are the UAW plans that Obama has agreed not to tax. The $2,400 per year plans are the ones being offered to families making less than $88,000 per year and subsidized under pending Senate legislation.

As for the plans the Senators enjoy - I don't know their cost - has to be VERY high.
 
107
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Argentum Vulpes
How about asking for prof of insurance or citizenship to provide anything over stabilization care (they do this in Europe). Also changing HIPA rules so first responders all the way up to specialists can report fraud in any government health assistance program. And the last big one tort reform.
 
Skyhunter
Eliminate choice, ration care, and cut fee schedules.
We have that system now. I think they have a new plan.

Individual mandates, salaried doctors, digital records, focus on regular healthcare and maintenance instead of reacting to health crisis', etc.
 
242
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Eliminate choice, ration care, and cut fee schedules.
It seem obvious to me that this is the one and only way to lower cost.

And then there would be the free system that you pay for yourself in parallel. That is beggars have no choice.

So the question is how low do we want to lower government medical cost? 5% of GPD? Higher? Lower?
 
Skyhunter
Japan spends ~8% of GDP on healthcare. And they have a much higher life expectancy than the US, which spends ~16%

If we can get it to 12% GDP, which is closer to average, that would be a $500 billion a year reduction.

It is quite telling that when the prescription drug bill was passed by the Republicans, I don't recall much of a conservative outcry. Not only did they not pay for it, they didn't tell us the true cost until after it became law.

So after giving a trillion dollars away to the drug companies, now they argue that the only way to save money is to:
Eliminate choice, ration care, and cut fee schedules.
Surely there are other ways.

It is sad that the Republicans have decided that power is more important than obligation and have refused to participate in an honest debate. The true conservatives are moderate Democrats, and IMO they are getting their way. The progressive Democrats made the initial compromise, substituting a public option for single payer. Then the Senate moderates eliminated the public option.

So what we end up with will not please anyone but the insurance companies. But it will cover more people and should help, but it is IMO a minor retrofit, when what is required is a major overhaul.
 
242
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We all hope so.

What are some of these?
the japanese have a fee schedule. docs may charge X for Y service, and not more.
 
Skyhunter
Skyhunter
We all hope so.

What are some of these?
We have that system now. I think they have a new plan.

Individual mandates, salaried doctors, digital records, focus on regular healthcare and maintenance instead of reacting to health crisis', etc.
I hate having to repeat myself in a thread.
 
242
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the japanese have a fee schedule. docs may charge X for Y service, and not more.
So does medicaid, medicare, and most employer health insurances.
 
242
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Skyhunter, yes salaried doctors. What is the point of digit records? Is it just fraud detection? Personally I like the federal government having as little information as possible (need to know basis). And since I get no government money for health care I see no reason that they need any information on my health or health spending.
 
242
3
How about a free market for medical services? Regulated in the sense that you must honestly state your qualifications (and the truthfulness of these claims is monitored and checked by a government agency). Free in the sense any with any qualification or in fact with zero qualification my enter the market.

For example if I cut my arm and need stitches I would like to have the option to go to a low cost nurse at $40 who knows how to clean a wound and knows how to sew rather than a Harvard med school grad at $400 for showing his/her face plus nurses fees and facility fees.
 
So does medicaid, medicare, and most employer health insurances.
doctors can choose to accept that, or not. japan is different, because there is only one system, and only one fee that can be charged. here, the government or insurance company either has to adapt to the realities of the market, or fail to provide the services. so you've got two different systems, each with its own dynamics.

http://www.nytimes.com/2009/04/02/business/retirementspecial/02health.html

...Many people, just as they become eligible for Medicare, discover that the insurance rug has been pulled out from under them. Some doctors — often internists but also gastroenterologists, gynecologists, psychiatrists and other specialists — are no longer accepting Medicare, either because they have opted out of the insurance system or they are not accepting new patients with Medicare coverage. The doctors’ reasons: reimbursement rates are too low and paperwork too much of a hassle.
...
 

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