The Government of Distributism

[Theo520]

You ignored what I said and continue proposing that the govt fix it all.

Having a strong economy is the best thing a govt can do for the poor and middle class. On healthcare, I wish they would focus on reducing the cost, not redistributing who pays for it.

 

[Socrates92]

Again though, if they are go getters then let them work more than 40 hrs.

So you basically agree with my solution?

 

[Socrates92]

Sorry, I just don’t think the poor should to work more than 40 hrs unless they want to.

They don’t have to. They don’t even have to work 30 hours, if they can survive on less than that. Chances are they will remain poor though, at least what we 21st-century people consider poor.

 

[LeafByNiggle]

On healthcare, I wish they would focus on reducing the cost, not redistributing who pays for it.

They could do both.

 

[Theo520]

They could do both.

If we reduced the cost, our medicaid $ would go much further. As would medicair.

 

[LeafByNiggle]

LeafByNiggle:

They could do both.

If we reduced the cost, our medicaid $ would go much further. As would medicair.

All true. But we could still do both.

 

[Elizabeth3]

On healthcare, I wish they would focus on reducing the cost, not redistributing who pays for it.

I agree with you on this. However, I’ve also read that the reason the costs are so high is because of research and development for new treatments and prescription drugs, not to mention development of more sophisticated equipment. Other countries have reduced costs but they also have very little in the way of bringing anything new to the table. The high profit margin is supposedly used to fund the cost of research and bringing a new drug or treatment to the market. I would hate for us to lose the pace of advances we are making in treating disease.

 

[Theo520]

I agree with you on this. However, I’ve also read that the reason the costs are so high is because of research and development for new treatments and prescription drugs, not to mention development of more sophisticated equipment.

That’s a big pharma talking point, not reality.
They spend far more on Marketing than R&D (Merck is the exception). They bribe doctors to push their non-generic pills and ‘influence’ DC to keep the regulations in their favor.

They will continue to do R&D, but US consumers won’t be the ignorant cash cow as in the past. Why should only american consumers be the ones to pad their bottom line, we shouldn’t pay more for the same drugs as our lower volume neighbors (Canada). Maybe the price in Canada will increase to compensate for dropping the high US prices, that’s how normal markets should operate.

Since we can’t afford the cost of the present healthcare we would be far better off reducing it’s cost, even if the pace of innovation slows a bit (on treatments and equipment most can’t afford).

 

[Elizabeth3]

That’s a big pharma talking point, not reality.
They spend far more on Marketing than R&D (Merck is the exception). They bribe doctors to push their non-generic pills and ‘influence’ DC to keep the regulations in their favor.

Thank you. You are more well read about this than I am and that all makes sense.

Why should only american consumers be the ones to pad their bottom line, we shouldn’t pay more for the same drugs as our lower volume neighbors (Canada). Maybe the price in Canada will increase to compensate for dropping the high US prices, that’s how normal markets should operate.

Do you know…Are the lower prices other countries pay tied to what their single-payer systems are willing to pay and have worked out with the drug companies? Would those countries health care systems collapse if they had to pay more to compensate for the US paying less?

 

[Theo520]

Do you know…Are the lower prices other countries pay tied to what their single-payer systems are willing to pay and have worked out with the drug companies?

They’ve negotiated lower prices just as you might haggle from a vendor. The vendor will sell at the price that still works for them. There is no moral reason why the US must pay ‘list price’ when everyone else gets a discount.

Would those countries health care systems collapse if they had to pay more to compensate for the US paying less?

The scenario you described means the US has been subsidizing their healthcare systems. If we can’t afford it for our people, we can’t afford to subsidize their universal care

 

[Elizabeth3]

This seem to be the basis for how Medi share and other type of health cost sharing works. You negotiate a good price with your dr.'s as a cash customer and get a reimbursement check from Medi share as a paying member.

Edited to add: I wonder if this private cost sharing model would work on a larger scale as a better model than our current private health insurance. It’s kind of the same concept only it takes the employer out of the equation, makes everyone a cash customer where dr.'s would be price competitive to keep costs down, and the health share company would reimburse your negotiated costs. Seems as if these models became the primary model it would solve a lot of the problems and premiums would come down if much, much more people were paying in. Anyone know of any big issues with the cost sharing model that would make it NOT a viable primary model?

 

[Hume]

Elizabeth3:

Do you know…Are the lower prices other countries pay tied to what their single-payer systems are willing to pay and have worked out with the drug companies?

They’ve negotiated lower prices just as you might haggle from a vendor. The vendor will sell at the price that still works for them. There is no moral reason why the US must pay ‘list price’ when everyone else gets a discount.

Would those countries health care systems collapse if they had to pay more to compensate for the US paying less?

The scenario you described means the US has been subsidizing their healthcare systems. If we can’t afford it for our people, we can’t afford to subsidize their universal care

The fundamental difference is that those other systems are single payer.

They negotiate for essentially the entire country, giving them true negotiating parity with a typically monopolistic supplier. And if the supplier doesn’t make money, the answer is “no”.

You or your insurance company must do the haggling here. No parity.

To the OP, the only way I could see it done would be a 100% tax on wealth and income after a certain point. It would disincentivize growth beyond a certain point and the market would distribute the opportunity to the next-best.

On government, people would naturally form socio-industrial blocs so a parliamentary system would probably be required since they function with multiple parties and no one entity needs 50% control to form a government

 

[Socrates92]

veryone a cash customer where dr.'s would be price competitive to keep costs down, and the health share company would reimburse your negotiated costs. Seems as if these models became the primary model it would solve a lot of the problems and premiums would come down if much, much more people were paying in. Anyone know of any big issues with the cost sharing model that would make it NOT a viable primary model?

I’m not sure. Trying to understand it first. Would these health share companies reimburse 100%? If so, what incentive is there for individuals to negotiate the best price? (I guess cash flow could be an issue) What type of fees would these companies charge their members, and how would these be calculated?

 

[Hume]

The reason it doesn’t take off is the same one explaining why stated prices are so high -
The Arab Sheik Problem.

When that billionaire comes in, you want full harvest. That’s the motivating theory, anyway.

 

[Theo520]

The fundamental difference is that those other systems are single payer.

So it’s no different than our high volume medicare or medicaid (govt) negotiating a price.

I never suggested they would also negotiate for private insurers, you introduced that stipulation. However, I do think it would lower prices for all, as it has in Canada when people not in their system buy without coverage. That’s why US citizens go North and pay cash…

 

[Peeps]

I have worked in healthcare (Medical Technologist, ASCP, microbiology) since 1980 (took 6 years off in the 1980s when my daughters were babies/toddlers).

I don’t understand why we don’t attempt to reduce the cost of healthcare by doing the things that any business would do-

(1) cut costs by eliminating or reducing duplication of testing and treatments

(2) cut advertising/PR costs by eliminating competition between health care systems

(3) eliminate using the ER as a “clinic” for routine health care and illnesses

(4) cut costs by eliminating or reducing a maze of regulations and “certifying” agencies that basically do nothing but inspect facilities and cite violations that often have nothing to do with the quality of the health care, but don’t cite obvious deficiencies like “INADEQUATE STAFFING!!!” Also, many of the regulations for senior care make it necessary for the seniors to enter rehab centers where they are not allowed to do the exercises unless a professional is with them in the room.

(5) cut cost by eliminating higher education requirements for ancillary health care professional like laboratory professionals, etc. and hire more lab, Xray, respiratory, etc. professionals who have a lesser degrees (for example, Physical Therapy assistants, who do the same treatments but don’t have the Doctoral degree).

(6) cut costs by hiring more staff which would eliminate overtime (often time and a half plus a bonus), burnout, and employee attrition, which requires a search for replacements and the time spent training new hires.

(7) cut costs by embarking on a massive PR campaign that would involve the public and private schools starting with middle schools (not high school) and the ENTERTAINMENT INDUSTRY, especially television, to inform young people and their families of the existence of the many and varied careers in health care, NOT JUST doctors and nurses!!!

(continued next post)

 

[Peeps]

(continued from last post)

(8) Reign in lawyers–reduce the number of lawsuits, especially frivolous lawsuits, and educate people that everyone dies eventually and it’s not always someone’s fault and therefore good for 20 million dollars in pain and suffering monies.

(9) Un-deify doctors–re-educate all of the U.S., especially the doctors themselves so that they will recognize that they are not mini-Gods. Bring back the “general practitioner” and the “family doctor” who actually knows his/her patients. It’s costly to have to keep seeking out a good doctor that can be trusted.

(10) instead of the government paying for ALL of health care, let’s have government-paid health care for wellness, including a yearly physical, all vaccinations (and financial penalties for those who are able to comply but choose not to), all screens (mammograms, prostate exams, colonscopies), annual dental exam and basic care, annual hearing and vision screening and one pair of glasses/one hearing aid, mental health screens, regular blood pressure screens.

(11) government (taxpayer) funding of the antibiotic research, and immediate escalation of this issue to TOP PRIORITY!! This issue should be at the top of the list, way over “climate change.” Climate change won’t matter two hoots if we all die due to infection by antibiotic-resistant bacteria!! I see this almost every day, and it’s getting worse and worse, and all of us who work in microbiology know it–and yet, Greta Thunberg wins Person of the Year, while the poor microbiology professor doing research has to jump through political hoops to get any funding. THIS NEEDS TO CHANGE, or health care will be unnecessary because we will all be dead.

There are probably lots of other changes that could and should be made that would reduce the cost of health care. I can guarantee that if the government takes charge of healthcare, in the U.S. the costs will skyrocket to astronomical costs–doctors will be paid millions, not hundreds of thousands, and staffing requirements will INCREASE to the point where an R.N. has to have a doctoral degree, and other ancillary health care professionals like me will need a Master’s Degree, and even a janitor will have to have a Bachelors Degree and a two-year internship in “floors and countertops.”

One of the biggest reasons for the increase in the costs of health care is government regulations–that alone should give us great pause when it comes to putting the government in full charge of it. And if they are paying the bill, believe me, they WILL take full charge and they will expect to be paid well for their “work”.

 

[Crocus]

So…how does the Government of Distributism deal with this?

You and your husband and your brother are doing well. Others are not, and you express frustration that those people are not thriving on the opportunities provided to them. I think symptoms show that policies are lacking in substance and/or scale. It has taken a long time to get this point. Even with a committed set of policy makers, it will take time to turn around to improve educational outcomes and reduce poverty.

Distributism is just a name for getting more money into the hands of more people so that they can participate more in the economy. This in itself grows the economy and everyone benefits, especially low income workers.

Can you get behind this, knowing that the actual tax cuts to the wealthy over the last 40 years has exacerbated the problem?

A practical, easy move could be an increase to the EITC.

Having a strong economy is the best thing a govt can do for the poor and middle class.

The best way to grow an economy is to motivate people to get and keep a job, i.e. motivate them to work 40 hours through EITC.

I can guarantee that if the government takes charge of healthcare, in the U.S. the costs will skyrocket

It is a terrible idea, to have the government take charge of healthcare (also insurance companies and pharmaceutical companies). Governments should pay though, for those basic health services you mentioned, under a negotiated agreement with doctors.

Doctors should take care of healthcare, self governing themselves through an association dedicated to the health of their patients.

Lawsuits and advertising are also over represented in healthcare costs.

 

[Peeps]

The best way to grow an economy is to motivate people to get and keep a job, i.e. motivate them to work 40 hours through EITC.

I try to have charitable thoughts towards everyone, and think the best of all people.

But…no. I can’t deny what I see and know.

I’ve seen it over and over, in my own family! And in my son-in-law’s family! And among acquaintances that I’ve tried and tried to help.

We simply have to accept that there is a group of people who are unwilling to work, even if given every opportunity and every help.

They aren’t mentally ill or emotionally-bankrupt. They were raised well by two parents (a man and woman), and grew up with enough money to provide them with plenty of food, clothing, shelter, and other necessities. They went to church, or at least had godly relatives who taught them about God. They lived in safe neighborhoods, went to decent schools, and didn’t experience any kind of trauma (e.g., a rape) that would cause them to lose confidence in themselves and others.

They simply don’t want to work. They enjoy sitting on the sofa watching a TV that they didn’t pay for, eating food that they didn’t earn, and keeping a schedule that includes a lot of sleep whenever they wish.

Honestly, why put money and resources and energy and heart into trying to help these people? Why not just leave them alone and out of decent charity and Godly concern, make sure that they have enough to eat, a warm place to live, and health care that will give them a chance at a pain-free and reasonably long life?

You can bring in psychiatrists and psychologists and counselors, set up training centers, utilize peer groups, offer relaxation and yoga classes, job training, GED help (although many of these people have their high school diploma and some even have higher degrees or certification). You can give them a job and train them–and within two weeks, I guarantee that they will get injured, or sick, or their old back trouble will act up again–and they’ll call in sick and when they return, they’ll have to leave early, and they’ll cry and everyone will try to comfort and encourage them, and in the end, they will resign from their job with great regrets…and go home to watch more TV, eat more free food, and sleep whenever they want.

Do you honestly not know anyone like this?

Have you tried to help them and had any success?

Best, IMO, to put our resources, energy, time, and MONEY into helping those who truly demonstrate that they not only want to work, but they want to KEEP working for 30 years or more–not just quit in a few months when the weather gets too cold (or too hot), or their legs swell up or they just get sooooo tired and stressed.

Yes, give them their basic needs with no expectation of a change in their lifestyle. It’s our Christian duty. But don’t waste time designing programs that will end up failing. Just accept that some people will never work.

 

[Crocus]

We simply have to accept that there is a group of people who are unwilling to work, even if given every opportunity and every help.

Not fair to withhold incentives to the many for the possible persistent work avoidance of the few.

Just because of some, is no excuse to not extend help to those who are working but not making an income on which they can actually live. Not a new program EITC.

Best, IMO, to put our resources, energy, time, and MONEY into helping those who truly demonstrate that they not only want to work, but they want to KEEP working for 30 years or more–not just quit in a few months when the weather gets too cold (or too hot), or their legs swell up or they just get sooooo tired and stressed.

Good idea. Now how to get EITC for example, to commit the resources that actually provide that incentive!

Do you honestly not know anyone like this?

Yeah, my nephew. At one point, someone paid him a good amount of money for what he did and he realized: “Hey, that’s how it works. I can do this and get more.” He is now a supervisor in a successful trade.