How do people envision cutting medical cost?

[edpell]

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

 

[Proton Soup]

"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

 

[WhoWee]

"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?

 

[Proton Soup]

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?

 

[WhoWee]

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

http://www.washingtonpost.com/wp-dyn/content/article/2010/01/15/AR2010011503901.html

 

[WhoWee]

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.

 

[Proton Soup]

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.

 

[WhoWee]

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.

 

[Proton Soup]

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.

 

[mgb_phys]

My question is this, what kind of medical care do you receive for $2,400

The UK or Japan's ?

 

[WhoWee]

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.

 

[WhoWee]

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

Eliminate choice, ration care, and cut fee schedules.

 

[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.

 

[edpell]

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.

 

[edpell]

Surely there are other ways.

We all hope so.

What are some of these?

 

[Proton Soup]

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]

the japanese have a fee schedule. docs may charge X for Y service, and not more.

Your provider doesn't?

 

[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.

 

[Proton Soup]

Your provider doesn't?

nope. doctors don't have to accept your insurance plan.

 

[edpell]

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.

 

[edpell]

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.

 

[edpell]

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.

 

[Proton Soup]

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.
...

 

[Skyhunter]

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

And the difference is, bottom line.

We pay twice as much for our system as the Japanese do for theirs.

Why should healthcare be for profit?

In order to balance the profit motive, you need heavy regulation. Single payer is the most efficient system.

Ours is a government of the people and by the people.

I sometimes wonder if those with an inordinate amount of distrust for the government are projecting.

 

[AverageJoe]

We pay twice as much for our system as the Japanese do for theirs.

Japan only has 127m people as compared to the USA's 308m. I'd say we're not doing half bad as is.


My question is this: Why are we intending on spending $1t to $10t on bureaucracy when we can spend that on research grants and get far more tangible results?

Think of all the lives that could be saved for the entire world instead of just this one country. The whole health care bill as is just seems to me to be extravagantly bloated and selfish.

 

[Nebula815]

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.

I believe that bill is paying for itself, but even if so, I agree it was still a gamble at the time. There was most definitely a conservative outcry, but among the establishment Republican party, they were okay with it.

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 Republicans tried to participate but they were shut out of much of the 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.

The public option was not a substitute for single-payer, it was to make the inroads for conversion to single-payer. It would be impossible to just write a bill to just "convert" the system to a formal single-payer system.

A public option was thus unacceptable to conservatives and moderate Democrats for two reasons:

1) It makes the way for single-payer

2) We already have Medicare and Medicaid bankrupt. It would be utter insanity to think we could fund a brand new program and it too would not hemmorhage money.

Also the idea of using a public option to increase competition and choice is unnecessary, when there are other, much simpler ways to go about doing that.

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.

If the bill passes, the Democrats will likely get a form of single-payer healthcare, but by proxy. The bill is liked by the health insurance companies because, even though they are giving up a lot of control to the government, they are getting guaranteed profits by being turned into a form of utility.

It is a smart move by the Democrats for getting their way, if you can't create single-payer or a public option, then do the next best thing, regulate the insurers to the degree that you have essentially government healthcare through a group of "private" insurers.

The current healthcare system is among the best in the world, but it has a lot of inefficiencies that have been built up over the years that we need to reverse.

 

[jgens]

My question is this: Why are we intending on spending $1t to $10t on bureaucracy when we can spend that on research grants and get far more tangible results?

Think of all the lives that could be saved for the entire world instead of just this one country. The whole health care bill as is just seems to me to be extravagantly bloated and selfish.

You're right! And we should also cut those emergency services provided by the government because that money could be put toward research grants and, after all, we don't want to be selfish. Oh, and while we're at it, we should probably cut the money our state governments use to pave roads, light streets, etc. because in many cases, they aren't even a matter of life and death.

Not to mention the fact that I sincerely doubt people will support a tax hike in order to fund scientific research grants, especially given the number of people that oppose a tax hike in order to provide universal healthcare!

 

[Al68]

Eliminate choice, ration care, and cut fee schedules.

We have that system now.

I don't know what system you're referring to but I'm obviously not a part of it. The actual affect of this health care bill for me and many others (who don't know it yet) is that any medical insurance I would ever be even remotely interested in buying will be outlawed, plus a nice tax penalty.

So what we end up with will not please anyone but the insurance companies.

Who did you think would benefit from a law forcing everyone to buy the most expensive version of their product? The same version that they can't sell now because most people don't want or need it?

It is sad that the Republicans have decided that power is more important than obligation and have refused to participate in an honest debate.

Honest debate would start with recognizing which side is the one seeking power here.

This is a turning point for liberty in the U.S. We are on the verge of giving government more power over people's lives than Caesar (and King George) could have imagined in his wildest fantasies.

As far as the Republican Party, they're finally taking a stand for liberty against the insurance industry and Democrats, but it's probably too little too late.

And finally, my favorite tea party pic:

 

[Al68]

It is a smart move by the Democrats for getting their way, if you can't create single-payer or a public option, then do the next best thing, regulate the insurers to the degree that you have essentially government healthcare through a group of "private" insurers.

This is a good point. They are achieving their main goal of establishing government power over health care. The rest is details that can be tweaked later.

And this isn't just regulation. Government is creating a system and outlawing all insurance policies that aren't part of the system. Private insurers will be nothing more than agents of government, which is what Democrats apparently already consider all private companies to be anyway. This is obvious in everything they say. Why else would they have this bizarre belief that private companies are "supposed" to do the bidding of government?

Or what amounts to the same thing: There is simply no room for private companies in their worldview.

 

[Proton Soup]

if democrats are so anti-corporation, then why did Obama backpedal and throw out the idea of removing the anti-trust exemption from insurance companies?

 

[Al68]

Ours is a government of the people and by the people.

Yes, but private companies are not agents of the government and neither am I. Government is an agent of the people, not the other way around.

 

[AverageJoe]

You're right! And we should also cut those emergency services provided by the government because that money could be put toward research grants and, after all, we don't want to be selfish. Oh, and while we're at it, we should probably cut the money our state governments use to pave roads, light streets, etc. because in many cases, they aren't even a matter of life and death.

That's such a straw man argument it's not even amusing. (This is a federal issue, not state. :P)

Not to mention the fact that I sincerely doubt people will support a tax hike in order to fund scientific research grants, especially given the number of people that oppose a tax hike in order to provide universal healthcare!

It's called investments. They are proven to work and it's something that the layman can understand as useful.

People (myself included) feel that health insurance costs would be greatly reduced if a) technology was faster and more efficient and b) useless pencil pusher bureaucrats and politicians weren't getting a paycheck for a job that wasn't needed in the first place.

Reduce the whole cost of actually getting better (the major multiplier) and all of the cost inherently drops.
At this point when the overall cost is less than the cost to fund the military, universal health care is far, FAR more reasonable to be commonwealth funded and at which point would barely be a major issue as it is now.

The whole deal with this health care thing is that it's really expensive. So just strive to make it less expensive off the bat instead of pushing money around and taking money that people have worked hard for.

Is this not logical?

 

[Al68]

if democrats are so anti-corporation, then why did Obama backpedal and throw out the idea of removing the anti-trust exemption from insurance companies?

Because he obviously thinks trusts are good if they're controlled by government. This whole health care bill is the creation of a giant single trust run by government. And they want to force people to buy their product? Rockefeller would be sooooo jealous.