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

[vern_humphrey]

I did not go to med school, I am not at all qualified to determine “oh, I think I need a heart ablation, let’s see who has the best price in town!”

How is that relevant? Do you know better what you need in the way of heart surgery with your current insurance?

Think about this – how did you pick your current doctor? Most people when asked that question will either lie, and tell about all the research they didn’t actually do, or they’ll say, “Oh, my friend Sam recommended him.”

So you go to the doctor Sam recommends and ask him about prices. And if that doctor refers you to a specialist, you ask the specialist about prices. Under the system I recommend, doctors would probably post their prices on the internet.

 

[vern_humphrey]

#1: Determine the actual cost of standard procedures. No more of this nonsense where different insurance carries get different prices, and those prices are all different from what an uninsured person pays. (Ideally, I would get rid of the need for insurance altogether. While it’s helped some people, for the most part it seems to just cause bloated prices by introducing a middleman to the equation)

That’s exactly what my proposal does – only catastrophic insurance would be used. And each person would make his own bargains for treatment.

 

[HopkinsReb]

Especially to help the uninsured and underinsured like peopel who can’t afford co-pays, dedutibles and premiums?

Change Medicare and Medicaid into vouchers for the purchase of insurance. Enable people to shop around.

Reduce the required coverages to things that actually fit the concept of “insurance.” Car insurance doesn’t cover oil changes because they’re predictable, recurring expenses. Likewise, health insurance shouldn’t cover, say, birth control, because it’s a predictable, recurring expense. All insurance does in that case is introduce a markup to pay the middleman to make it a subscription service.

Push HSAs to help pay for those predictable, recurring expenses and for smaller expenses like routine illness – make people have to manage their own money so they’ll be more likely to shop around.

Eliminate employer mandate and tax breaks for employers to provide health insurance, again to encourage people to shop around.

Encourage group policies through non-employer groups. There is power in aggregating risk; this is why Coca Cola has better health benefits than a 20-person company. Imagine if the entire Catholic Church in the US had a group policy. You think 70 million people might have some bargaining power? Plus, it’s so many people that the people who are the really absurdly expensive people to cover will be covered by the sheer size of the pool.

Allow the sale of insurance policies across state lines (this is necessary for the previous point to work).

That’s just off the top of my head.

 

[ProdglArchitect]

And each person would make his own bargains for treatment

I don’t know that I like the idea of each person having to haggle for their treatment. I think there should be an absolute base price, and if a person can’t afford that then they can work with the provider to see what can be done. Bargaining should be the backup, not the norm, imo.

 

[Nihilo]

Especially to help the uninsured and underinsured like peopel who can’t afford co-pays, dedutibles and premiums?

If we’re going to make laws that create a right to health care, then I think we ought to first of all make laws that create a right to legal representation, because a personal attorney is the best way to solve this problem imo, not a government run health care system of some sort, that ppl have to deal with directly. Status quo is that the only ppl guaranteed legal representation are those arrested on suspicion of being a criminal, and if we’re talking about creating a right to health care of some sort, then we ought to first create a right to legal representation so that we are all better defended against bureaucracy’s inherent problems. We are a nation of laws, and I think the right to legal representation will do a whole lot better to improve our society than just a right to health care.

 

[vern_humphrey]

Yes, because everyday laypeople are well versed enough in medicine to best determine what’s medically necessary and what’s not.

How is that different from the situation today? Do you go to the doctor and say, “I need a hip replacement,” or does he tell you what you need?

Ultimately this just puts the boot on middle class families who have members (including children) with special needs

How so? Anyone can apply for help, and the help will be based on needs and income.

Let’s say the deductible is $12,000. I can save that much, so I do – and roll over the unspent money into my IRA each year. Someone else can only save $6,000 – so they get $6,000 a year in assistance, and they roll over the unspent money just like I do.

 

[vern_humphrey]

I don’t know that I like the idea of each person having to haggle for their treatment. I think there should be an absolute base price,

But that means each person will pay the HIGHEST price – because the base price must be set high enough to cover all doctors. If each person strikes his own bargain, he will usually get a lower price.

I would expect to see doctors posting their prices in their waiting rooms, or on the internet – just like other businesses do.

 

[vern_humphrey]

Change Medicare and Medicaid into vouchers for the purchase of insurance. Enable people to shop around.

If you can shop around for insurance, why not shop around for doctors instead? Because the paperwork and bureaucracy of the present system of insurance is a major cost-driver for medicine.

 

[HopkinsReb]

HopkinsReb:

Change Medicare and Medicaid into vouchers for the purchase of insurance. Enable people to shop around.

If you can shop around for insurance, why not shop around for doctors instead? Because the paperwork and bureaucracy of the present system of insurance is a major cost-driver for medicine.

How about both?

As I say later in my post, insurance should be to keep unexpected major expenses from being devastating. Routine office visit shouldn’t need a middleman.

 

[TheLittleLady]

How is that relevant? Do you know better what you need in the way of heart surgery with your current insurance?

Having had more experience with physicians than most people I have met, our physicians are carefully selected. Even for ER visits, we stay in the same health system, so, our selected medical professionals are available.

So you go to the doctor Sam recommends and ask him about prices. And if that doctor refers you to a specialist, you ask the specialist about prices. Under the system I recommend, doctors would probably post their prices on the internet.

Do you know any poor people?

 

[Pattylt]

I don’t totaaly object to your plan but there’s some big holes in it.

There are many working poor that have chronic health conditions that cost large sums of money…even if they are using the lowest prices in town…even if the prices go down due to more competition or regulation.

I know a bit more about the problems in our current system than I do ways to fix it. Eliminating the middle man sounds great but there are often layers of middlemen.

The biggest issue is that healthcare in America is a for profit system. Even the non profit hospitals want to make large profits…ever notice that those non profit hospitals are always building? They don’t have stockholders so they have to spend those profits…ever notice they never lower the costs for anything when they have very profitable years? No, instead, they expand.

Like everyone else, I want medical professionals making my medical decisions. There isn’t any reason the government couldn’t set up medical boards to oversee any plans. We need transparency! This is the first step…what is everyone charging, what profits are they making, where are costs reasonable and where are they ridiculous. The next step would be to decide what to do about it all…one step at a time.

 

[vern_humphrey]

As I say later in my post, insurance should be to keep unexpected major expenses from being devastating. Routine office visit shouldn’t need a middleman.

That is the essence of my proposal – you pay directly for your treatment, and have catastrophic coverage for unexpected major expenses.

 

[HopkinsReb]

HopkinsReb:

As I say later in my post, insurance should be to keep unexpected major expenses from being devastating. Routine office visit shouldn’t need a middleman.

That is the essence of my proposal – you pay directly for your treatment, and have catastrophic coverage for unexpected major expenses.

Mine, too. I said that in my original post…

 

[vern_humphrey]

There are many working poor that have chronic health conditions that cost large sums of money…even if they are using the lowest prices in town…even if the prices go down due to more competition or regulation.

And under this proposal, they would get help. A portion of their medical costs would be picked up by the government, the amount depending on their income.

 

[TheLittleLady]

What about people living paycheck to paycheck?

 

[vern_humphrey]

The biggest issue is that healthcare in America is a for profit system. Even the non profit hospitals want to make large profits…ever notice that those non profit hospitals are always building?

There MUST be a profit in health care, or there will be no health care. What I propose recognizes that, and at the same time eliminates most of the cost drivers.

 

[Nihilo]

vern_humphrey:

And each person would make his own bargains for treatment

I don’t know that I like the idea of each person having to haggle for their treatment. I think there should be an absolute base price, and if a person can’t afford that then they can work with the provider to see what can be done. Bargaining should be the backup, not the norm, imo.

This is one good reason why I suggest that we first create a right to legal representation, so that any bargaining can be done on our behalf through an authorized agent, who is also our legal advisor.

 

[vern_humphrey]

What about people living paycheck to paycheck?

They would get help. They just submit their tax returns and the amount help would be based on their declared income.

 

[RCIAGraduate]

They would get help. They just submit their tax returns and the amount help would be based on their declared income.

And what if they denied? Like what if their situation doesn’t neatly fit into guidelines which leads to a denial?

 

[HopkinsReb]

Also, I want to add that the idea that lack of access to healthcare is because we have a for-profit system just doesn’t bear scrutiny. In every developed country, agriculture and grocery stores are for-profit, and never has good, fresh food been more available than in these places. The problem lies elsewhere.