How would you fix the U.S health care system?

[DarkLight]

I don’t think most people who are living, like seriously living “paycheck to paycheck” do so out of thier own volition: perhaps they’re stuck at a dead-end career or job, they’re struggling with living costs, especially housing, maybe even going without insurance and they’re people doing what they can, you know your definition of the working class?

Or, you know, they’re spending all their money on medical bills.

There’s a big weakness especially in terms of chronic issues where you get nickel and dimed to death. You can negotiate the big bills. What you typically can’t negotiate is where it’s a big pile of small bills. This medication is $75 a month, that one is $125, the monitoring blood test is $250, and so on. Usually you can’t negotiate bills at that level, and it’s not going to be any one given bill that’s breaking the bank.

I thought I had explained it. Under my proposal, YOU are your own insurer. You make your own decisions and pay with your own money – until you reach the deductible and your catastrophic insurance policy kicks in.

I thought I had explained that, too. When you apply for help, you submit your tax return. The help you receive will be based on your declared income.

I don’t think you’re quite getting the objection here. A significant current problem is people who officially have enough money on paper to cover their expenses, but don’t in practice because the system isn’t calculating all their expenses. It also doesn’t work well for people who take that “catastrophic” hit every year - when I was on a high deductible plan it essentially amounted to just reducing my income by 7.5k a year, every year. While still being ineligible for aid in other areas because on paper my income was just enough at about 30k a year.

Let’s imagine you pay $1,000 a month, and I save $1,000 month. Let’s suppose we both consume $6,000 of medical care during the year. At the end of the year, I put $6,000 in my IRA – and you have nothing.

Context, here. The point was that it’s quite a different matter (as someone who’s coordinating a lot of doctors) to pick out doctors and submit the billing to insurance, than to pick out doctors and spend a few hours with each one trying to negotiate the prices. If you’re someone with a chronic condition, especially something that can cause fatigue or other issues, that may not be doable.

 

[steph03]

How would I do it? Highlight Canada, copy and paste … but that’s just me writting as a Canadian

 

[Thorolfr]

It is the responsibility of the retiring doctor to find doctors for his patients. Not doing so is called Patient Abandonment.

What if there aren’t any doctors to be found within a reasonable distance? A retiring doctor can’t force another doctor to come to town and take over all his old patients or force other doctors in town who already have too many patients to take new ones.

 

[F_Marturana]

Son number 1 since birth has seen:

Pediatric urologist
Pulmonologist
Pediatric neurosurgeon
Pediatric neurologist
Pediatric ENT
Pediatric physiatrist
Physical, speech and occupational therapist
Neuropsychologist

He’s had about 8 surgeries plus many hospitalization. The bill for one if we didn’t have insurance would have been the amount of a nice house in many parts of the country.

I’ve personally known parents of preemies who had to file for bankruptcy because the hospital costs weren’t covered. There’s not much shopping around for a NICU.

 

[vern_humphrey]

What if there aren’t any doctors to be found within a reasonable distance?

How would going to a different insurance system affect the supply of doctors?

What good are these New Developments if nobody can afford them?

What good does it do a company to lay out lots of money on R&D if nobody buys the resulting drug?

 

[vern_humphrey]

What if there aren’t any doctors to be found within a reasonable distance? A retiring doctor can’t force another doctor to come to town and take over all his old patients or force other doctors in town who already have too many patients to take new ones.

How would changing the insurance system cause this?

 

[Thorolfr]

Thorolfr:

What if there aren’t any doctors to be found within a reasonable distance? A retiring doctor can’t force another doctor to come to town and take over all his old patients or force other doctors in town who already have too many patients to take new ones.

How would changing the insurance system cause this?

I was responding to what you said about “patient abandonment”. If some doctor is retiring, he can’t be responsible for making sure that all his patients have another doctor to go to if there aren’t any other local doctors for them to go to.

 

[vern_humphrey]

I was responding to what you said about “patient abandonment”. If some doctor is retiring, he can’t be responsible for making sure that all his patients have another doctor to go to if there aren’t any other local doctors for them to go to.

That’s when you need to get a lawyer.

 

[Thorolfr]

Thorolfr:

I was responding to what you said about “patient abandonment”. If some doctor is retiring, he can’t be responsible for making sure that all his patients have another doctor to go to if there aren’t any other local doctors for them to go to.

That’s when you need to get a lawyer.

What would someone get a lawyer for? What case could anyone make? There’s no law that says a town must have enough doctors for all the people that live there and enough to insure that retiring doctors have someone to send all their patients to.

 

[vern_humphrey]

What would someone get a lawyer for? What case could anyone make. There’s no law that says a town must have enough doctors for all the people that live there.

But there is a law that says a doctor cannot abandon his patients.

Now how is all this relevant to how we should pay for medical care?

 

[Thorolfr]

Thorolfr:

What would someone get a lawyer for? What case could anyone make. There’s no law that says a town must have enough doctors for all the people that live there.

But there is a law that says a doctor cannot abandon his patients.

Now how is all this relevant to how we should pay for medical care?

It’s not, but I’m not the one who brought up the issue of “patient abandonment.”

 

[vern_humphrey]

I pointed out a doctor has a legal obligation to ensure continuity of treatment for his patients.

 

[Thorolfr]

I pointed out a doctor has a legal obligation to ensure continuity of treatment for his patients.

No he doesn’t. He should give his patients reasonable notice so that they can hopefully find someone else to go to, but he’s not obliged to ensure that they have a doctor to go to.

 

[vern_humphrey]

Got a cite for that?

 

[Thorolfr]

Got a cite for that?

Patient abandonment is a form of medical malpractice that occurs when a physician terminates the doctor-patient relationship without reasonable notice or a reasonable excuse, and fails to provide the patient with an opportunity to find a qualified replacement care provider.

https://www.nolo.com/legal-encyclopedia/what-patient-abandonment.html

 

[vern_humphrey]

And this is the key point:

Third, the abandonment must have taken place so abruptly that the patient did not have enough time or resources to find a suitable replacement physician to take over treatment.

 

[John10]

I think by making sure those who cannot pay and are vulnerable receive aid from the government. While at the same time taxing those who have high-income to help pay for those who cannot afford.

Healthcare is not a luxury that only a selected few should be entitled to, but a basic human right.

 

[RoseScented]

No need to nickle and dime me. My current monthly medicine, without insurance, would ring me in at $2300+ a month (it’s improved, it used to be $2500 a couple years ago). That’s not including the rest of my stuff. I make way too much on paper to ever get approved for financial assistance in anything, but my COL even just to keep a roof, bills, and groceries doesn’t leave me with enough to cover that.

 

[DarkLight]

No need to nickle and dime me. My current monthly medicine, without insurance, would ring me in at $2300+ a month (it’s improved, it used to be $2500 a couple years ago). That’s not including the rest of my stuff. I make way too much on paper to ever get approved for financial assistance in anything, but my COL even just to keep a roof, bills, and groceries doesn’t leave me with enough to cover that.

Oh no, not denying that at all! I’m just pointing out that the mode proposed involves people shopping around and bargaining the costs of healthcare. And that doesn’t work well at all with a large number of small bills.

It really doesn’t work with medication in general, honestly, especially if there’s no generic out there.

 

[RoseScented]

RoseScented:

No need to nickle and dime me. My current monthly medicine, without insurance, would ring me in at $2300+ a month (it’s improved, it used to be $2500 a couple years ago). That’s not including the rest of my stuff. I make way too much on paper to ever get approved for financial assistance in anything, but my COL even just to keep a roof, bills, and groceries doesn’t leave me with enough to cover that.

Oh no, not denying that at all! I’m just pointing out that the mode proposed involves people shopping around and bargaining the costs of healthcare. And that doesn’t work well at all with a large number of small bills.

It really doesn’t work with medication in general, honestly, especially if there’s no generic out there.

Sorry, I didn’t convey what I wanted appropriately. I totally agree with what you’re saying, but there was a line about no one single bill breaking the bank. I wanted to chime in with the other side where one bill will do just that even with a salary that pretty much anyone would say is “well off” and wouldn’t allow me to qualify for assistance unless the assistance is not just salary based.