Healthcare reform

[StrangeSox]

Great, so mark down another against governmental health care!

 

I don't expect the government option to be fantastically better. I also have no ideological opposition to its existence.

[StrangeSox]

Because it will be cheaper for them, result in higher stock prices and bigger profits. Its the same reason companies dump superior American workers and send jobs out of the country.

 

So this would tend to indicate a deeper flaw within that economic structure, no?

[Y2HH]

Because it will be cheaper for them, result in higher stock prices and bigger profits. Its the same reason companies dump superior American workers and send jobs out of the country.

 

I don't know why others can't seem to understand this.

 

I've seen a mass exodus of IT jobs to crappy Indian alternatives, regardless of inferior support or products, the bottom line is it saves money.

 

For example:

 

Designed by Apple in Cupertino California -- Assembled in China.

 

Gee, I wonder why they assemble their stuff in China.

 

Oh, that's right, they don't have to offer healthcare, high wages, or any other benefit.

[BigSqwert]

I've seen a mass exodus of IT jobs to crappy Indian alternatives, regardless of inferior support or products, the bottom line is it saves money.

And all this happened without universal health insurance?

[southsider2k5]

So this would tend to indicate a deeper flaw within that economic structure, no?

 

You can call it a flaw if you like. I call it the freedom of choice. Not all freedoms result in ideal situations.

[BigSqwert]

You can call it a flaw if you like. I call it the freedom of choice. Not all freedoms result in ideal situations.

What exactly is the choice you're referring to?

[NorthSideSox72]

OK, here goes. Here it is, in all its glory, the NSS health care plan. This is the framework for what I'd like to see, eventually, though I am fairly certain it won't happen for any number of reasons (mostly political)...

 

--Government should not be running any health care plans, at all.

 

--Employers should not be the ones to provide health coverage either.

 

--Health insurance should be a private market product, just like car insurance.

 

--Health insurance should be REQUIRED for all US citizens and residents.

 

--Health insurance providers would continue offering various plans, but to the public generally.

 

--Health insurance plans need to reflect cost of care - in other words, you shouldn't be paying $25 for any doctor visit. You should be paying $20 for tier 3 doctors, $30 for tier 2, $50 for tier 1, etc. - to reflect actual cost AND allow for real competition to occur (prescriptions are going this way now anyway). Insurance plans should still have a personal spending cap, under some plans. (this one is probably the hardest to make work)

 

--Those who cannot afford regular insurance would need to prove why (income, loss of job, etc.) in some fashion, and then be eligible for a pool, which is covered by all insurance providers on a persons-parallel-with-market-share model (like the utilities do with infrastucture costs in deregulating). The pool costs should be supplemented by the federal government to lower cost, but the plans available should essentially be low-end plans that are truly only a safety net, providing just protection from huge costs (kind of like we made the welfare system less appealing in the Clinton years).

 

--Tax incentives should be large to encourage not-for-profits in all areas of health care - insurance, hospitals, etc. Having NFP's present will help keep overall costs down in the sector.

 

--Insurance providers need to be federally licensed, not state, and be required to clearly publish the number of providers in their systems in each region/city/state/whatever, so that people can make educated decisions about making their plans.

 

--All insurance providers required to provide emergency care at ANY licensed facility in the country at any time, at their given rates, period.

 

--No pre-existing condition restrictions allowed under any plan.

 

--HSA rules need to change to NOT have a use it or lose it policy, and additionally, allow for all health claims to go through that account and be eligible for being non-taxable dollars.

 

--All medical providers required to pre-clear all tests and procedures performed (except in situ for emergency medical), and show actual cost to the patient before performing.

 

--All medical records need to be housed in a database, medical ID cards issued, no more forms and s*** that just take time and cost needless money.

 

--All EMS providers and emergency rooms need to handle emergency medicine for anyone coming in the door - the rest can be sorted out when the person is stable (this is mostly the case anyway, but not always)

 

--No person in the country illegally should be provided insurance, under penalty of fines. If hospitals want to treat patients not properly ID'd, that is their risk to take (emergency med may need to be an exception here).

 

--If any minor (

 

ETA: --College students currently in school full time should be eligible for government-supported access to the pool plan.

 

-----

 

That's what I have for now. Not perfect to be sure, and probably not possible, but the best thing I can come up with.

[Y2HH]

And all this happened without universal health insurance?

 

Yes, because it has nothing to do with Chinese workers assembling iPhones for 2$ a day + free cokes and moonpies.

[Y2HH]

--Health insurance should be REQUIRED for all US citizens and residents.

 

I'll have to read the rest of your post more carefully, because it sounds like something we can actually begin to agree on, but to your above point, I'm not sure that's constitutionally legal.

[southsider2k5]

What exactly is the choice you're referring to?

 

The same type of choice that allows Klan speech to be freely flowing, and for them to assemble in public. It isn't ideal, but it is a freedom none the less.

[NorthSideSox72]

I'll have to read the rest of your post more carefully, because it sounds like something we can actually begin to agree on, but to your above point, I'm not sure that's constitutionally legal.

Car insurance is required. Is that constitutionally legal?

 

Health care, like driving, is a legal privilege, not a legal right.

 

[southsider2k5]

Car insurance is required. Is that constitutionally legal?

 

Health care, like driving, is a legal privilege, not a legal right.

 

I'm not really convinced it is, but that is neither here nor there.

[NorthSideSox72]

I'm not really convinced it is, but that is neither here nor there.

Not convinced that what is not what?

 

[StrangeSox]

You can call it a flaw if you like. I call it the freedom of choice. Not all freedoms result in ideal situations.

 

Where's my choice in whether my job gets shipped to India? Where's my choice if all companies decide to drop health care because it costs too much?

[StrangeSox]

Car insurance is required. Is that constitutionally legal?

 

Health care, like driving, is a legal privilege, not a legal right.

 

It's done on a state-by-state level, not a federal mandate.

[Y2HH]

Car insurance is required. Is that constitutionally legal?

 

Health care, like driving, is a legal privilege, not a legal right.

 

No, car insurance is not required unless you want to drive. I don't HAVE to drive, so I don't HAVE to have car insurance. What you are proposing is that even if I don't want health insurance, I have to buy it...that's like saying even though you don't drive you have to have car insurance...

 

I've heard this being discussed by constitution lawyers, and from what I've heard, it's not legal. I haven't read up enough to know one way or the other, but even I have to say, it's iffy sounding.

[southsider2k5]

Not convinced that what is not what?

 

Constitutionally legal.

[NorthSideSox72]

No, car insurance is not required unless you want to drive. I don't HAVE to drive, so I don't HAVE to have car insurance. What you are proposing is that even if I don't want health insurance, I have to buy it...that's like saying even though you don't drive you have to have car insurance...

 

I've heard this being discussed by constitution lawyers, and from what I've heard, it's not legal. I haven't read up enough to know one way or the other, but even I have to say, it's iffy sounding.

Interesting.

 

I looked over my plan again, and it still flies without the out and out requirement for insurance. And I've seen states require health coverage for minors in some fashion, so I think that can still fly, in some way.

 

[StrangeSox]

Interesting.

 

I looked over my plan again, and it still flies without the out and out requirement for insurance. And I've seen states require health coverage for minors in some fashion, so I think that can still fly, in some way.

 

States can mandate it, but its questionable whether the federal government can.

[EvilMonkey]

OK, here goes. Here it is, in all its glory, the NSS health care plan. This is the framework for what I'd like to see, eventually, though I am fairly certain it won't happen for any number of reasons (mostly political)...

 

--Government should not be running any health care plans, at all.

 

--Employers should not be the ones to provide health coverage either.

 

--Health insurance should be a private market product, just like car insurance.

 

--Health insurance should be REQUIRED for all US citizens and residents.

 

--Health insurance providers would continue offering various plans, but to the public generally.

 

--Health insurance plans need to reflect cost of care - in other words, you shouldn't be paying $25 for any doctor visit. You should be paying $20 for tier 3 doctors, $30 for tier 2, $50 for tier 1, etc. - to reflect actual cost AND allow for real competition to occur (prescriptions are going this way now anyway). Insurance plans should still have a personal spending cap, under some plans. (this one is probably the hardest to make work)

 

--Those who cannot afford regular insurance would need to prove why (income, loss of job, etc.) in some fashion, and then be eligible for a pool, which is covered by all insurance providers on a persons-parallel-with-market-share model (like the utilities do with infrastucture costs in deregulating). The pool costs should be supplemented by the federal government to lower cost, but the plans available should essentially be low-end plans that are truly only a safety net, providing just protection from huge costs (kind of like we made the welfare system less appealing in the Clinton years).

 

--Tax incentives should be large to encourage not-for-profits in all areas of health care - insurance, hospitals, etc. Having NFP's present will help keep overall costs down in the sector.

 

--Insurance providers need to be federally licensed, not state, and be required to clearly publish the number of providers in their systems in each region/city/state/whatever, so that people can make educated decisions about making their plans.

 

--All insurance providers required to provide emergency care at ANY licensed facility in the country at any time, at their given rates, period.

 

--No pre-existing condition restrictions allowed under any plan.

 

--HSA rules need to change to NOT have a use it or lose it policy, and additionally, allow for all health claims to go through that account and be eligible for being non-taxable dollars.

 

--All medical providers required to pre-clear all tests and procedures performed (except in situ for emergency medical), and show actual cost to the patient before performing.

 

--All medical records need to be housed in a database, medical ID cards issued, no more forms and s*** that just take time and cost needless money.

 

--All EMS providers and emergency rooms need to handle emergency medicine for anyone coming in the door - the rest can be sorted out when the person is stable (this is mostly the case anyway, but not always)

 

--No person in the country illegally should be provided insurance, under penalty of fines. If hospitals want to treat patients not properly ID'd, that is their risk to take (emergency med may need to be an exception here).

 

--If any minor (

 

ETA: --College students currently in school full time should be eligible for government-supported access to the pool plan.

 

-----

 

That's what I have for now. Not perfect to be sure, and probably not possible, but the best thing I can come up with.

By being Federally liscensed can they now compete across state lines and have those restrictions removed? What about tort reform? Your basic structure looks interesting, I'll give you that. You would also need to create some sort of standard for the electronic files, otherwise you will have systems that can't talk with each other, as we have now.

[kapkomet]

The being able to sell across state lines is a huge one and something I had forgotten to say.

 

[StrangeSox]

Should they be able to cross state lines if a plan in IN doesn't meet IL standards?

[mr_genius]

OK, here goes. Here it is, in all its glory, the NSS health care plan. This is the framework for what I'd like to see, eventually, though I am fairly certain it won't happen for any number of reasons (mostly political)...

 

--Government should not be running any health care plans, at all.

 

--Employers should not be the ones to provide health coverage either.

 

--Health insurance should be a private market product, just like car insurance.

 

--Health insurance should be REQUIRED for all US citizens and residents.

 

--Health insurance providers would continue offering various plans, but to the public generally.

 

--Health insurance plans need to reflect cost of care - in other words, you shouldn't be paying $25 for any doctor visit. You should be paying $20 for tier 3 doctors, $30 for tier 2, $50 for tier 1, etc. - to reflect actual cost AND allow for real competition to occur (prescriptions are going this way now anyway). Insurance plans should still have a personal spending cap, under some plans. (this one is probably the hardest to make work)

 

--Those who cannot afford regular insurance would need to prove why (income, loss of job, etc.) in some fashion, and then be eligible for a pool, which is covered by all insurance providers on a persons-parallel-with-market-share model (like the utilities do with infrastucture costs in deregulating). The pool costs should be supplemented by the federal government to lower cost, but the plans available should essentially be low-end plans that are truly only a safety net, providing just protection from huge costs (kind of like we made the welfare system less appealing in the Clinton years).

 

--Tax incentives should be large to encourage not-for-profits in all areas of health care - insurance, hospitals, etc. Having NFP's present will help keep overall costs down in the sector.

 

--Insurance providers need to be federally licensed, not state, and be required to clearly publish the number of providers in their systems in each region/city/state/whatever, so that people can make educated decisions about making their plans.

 

--All insurance providers required to provide emergency care at ANY licensed facility in the country at any time, at their given rates, period.

 

--No pre-existing condition restrictions allowed under any plan.

 

--HSA rules need to change to NOT have a use it or lose it policy, and additionally, allow for all health claims to go through that account and be eligible for being non-taxable dollars.

 

--All medical providers required to pre-clear all tests and procedures performed (except in situ for emergency medical), and show actual cost to the patient before performing.

 

--All medical records need to be housed in a database, medical ID cards issued, no more forms and s*** that just take time and cost needless money.

 

--All EMS providers and emergency rooms need to handle emergency medicine for anyone coming in the door - the rest can be sorted out when the person is stable (this is mostly the case anyway, but not always)

 

--No person in the country illegally should be provided insurance, under penalty of fines. If hospitals want to treat patients not properly ID'd, that is their risk to take (emergency med may need to be an exception here).

 

--If any minor (

 

ETA: --College students currently in school full time should be eligible for government-supported access to the pool plan.

 

-----

 

That's what I have for now. Not perfect to be sure, and probably not possible, but the best thing I can come up with.

 

That's pretty good list. I salute you.

 

--No person in the country illegally should be provided insurance, under penalty of fines. If hospitals want to treat patients not properly ID'd, that is their risk to take (emergency med may need to be an exception here).

 

but this should be US citizens only. people here on visas need to be covered by their employer.

Edited August 31, 2009 by mr_genius

[StrangeSox]

why not people here on visas and greencards?

[mr_genius]

why not people here on visas and greencards?

 

Because they are not US citizens, their employer needs to cover them. Way too much room for abuse otherwise. They should be getting market pay rates anyways, so them being in the program would be visa fraud as they wouldn't meet a hardship requirement if actually paid market rates. We already have over 20% fraud rates in the visa programs, no need to encourage even more.

Edited August 31, 2009 by mr_genius