Health Care in the United States

Started by RubySlippers, June 12, 2006, 02:09:54 PM

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Zakharra

Quote from: RubySlippers on June 14, 2006, 08:32:43 PM
Simply put we spend more than any other country on health care and 40 million plus are not insured and a good portion are underinsured perhaps another 40 million or more at least. Bankruptcy for medical debt is climbing and the main reason for doing so. The sstem we have doesn't work that's the fact here.

Part of that 40 million uninsured are people who change health care plans and are uninsured for one day. And children who could be covered by their parents health care plans.

RubySlippers

Why is it a personal issue? Health care affects community health (like controling communicable diseases), community economics (sick and ill people are poor workers plus it burdens business to provide this and many can't) and community needs since everyone NEEDS health care at some point.

Like I pointed out the cost of not covering preventative and maintenance care far outweighs the cost of people getting it. And Zakharra the 40 million uninsured and larger UNDER-insured are adults who don't have it long term.

All I said was take the money we already spend on health care, add a modest health care payroll tax and pool that and give a share based on population to each state. Then let them figure out how to spend it to cover everyone with some kind of serious blanket coverage, that will focus on prevantative care and the essentials. Among this a certain number of free doctors visits per year based on need and a certain number of drugs provided by the plan leaning hard to generics maybe 4 per month and a fair fee for other times and more drugs. Its pretty sad when Cuba has better overall access to health care for its citizens than we in the United States.

What good is all our advanced and best medical technology when many can't get the care done?








Zakharra

 Many of the uninsured are young people who don't need it or do not think they need it. Health care does NOT affect the community, unless ity is a communical disease. Then it affects others outside of immediate family.

QuoteAll I said was take the money we already spend on health care, add a modest health care payroll tax and pool that and give a share based on population to each state

It would not be a moderate tax. It would be a ever rising tax that would be spent on other things besides health care. Look at what was done with the money states got from the tabaccoo companies. It was supposed to be spent on smoking related problems. Hardly any of it was spent on that. most was taken for other projects.

QuoteAmong this a certain number of free doctors visits per year based on need and a certain number of drugs provided by the plan leaning hard to generics maybe 4 per month and a fair fee for other times and more drugs. Its pretty sad when Cuba has better overall access to health care for its citizens than we in the United States.

Part of the reason drugs cost so much in  the US is because nearly everywhere else it is a regulated price. The companies that develope and produce the drugs spend hundreds of millions, if not billions, in making it for a drug they can have exclusive protectiojn in making for what? 20 years? Then it becomes generic and avalible for other companies to copy. They have to be able to make the money back that they put into developing it. And that's just for the drugs that do pan out. The drugs that don't become a drain on the company coffers.

If Cuba has such good health care, then why are so many Cubans trying to leave the nation? And why aren't people here going to Cuba for health care? Health care by a dictator is a good thing?

Elvi

Can we remember to read what others have said before we jump to conclusions please?
Heated discussions yes, but I don't want this to start becoming a flame war.
It's been fun, but Elvi has now left the building

National Acrobat

QuoteIt would not be a moderate tax. It would be a ever rising tax that would be spent on other things besides health care. Look at what was done with the money states got from the tabaccoo companies. It was supposed to be spent on smoking related problems. Hardly any of it was spent on that. most was taken for other projects.

I agree with this statement 100% because it is true, and has been proven true here in Virginia numerous times when they decide to create special taxes to solve problems.

The money never goes where it is supposed to go, and the gasoline tax and the tobacco settlement are but two of the examples I can give here in Virginia. Politicians see the extra income and totally forgo placing the funds where they need to be used.

The same goes with the Lottery Funds here. They were supposed to be used only for education, but increasingly, they are using them for everything but education.

I just don't trust any government program (state, Federal or local) that wants to propose a 'tax' or some other settlement like a Tobacco Settlement to fund something, because it's been proven that they can't keep themselves from raiding the funds for other, mainly pork, projects.

Another problem with the institution of the tax idea is that you are projecting revenues for a year or more, and problems arise when the projections fall short. Then you have to figure out where to make up the revenue, which usually means raiding another program for the money.

RubySlippers

That's why the money has to go to either an Individual Health Care Account supplimented by existing funds to let people get Health Care through private companies who would be required to take everyone that applied OR an agency like the Federal Reserve INDEPENDANT of the Federal and State Governemnts that can use that money strictly for Health Care costs to cover everyone with a basic plan. Both work. The former might work better. The theory here is you put people in at a young age at a fairly set amount and since they are unlikely to need the medical care for many years in the long run the costs even out. Everyone would be required to carry health insurance and it would keep it out of company hands save to take the payroll tax for it out which they already do for Social Security and the like.

My view is make people pay out around $3000 a year starting at age 18 adjusted for inflation until they die and Humana would take that money to cover a good HMO plan as an example, children would be required to be covered by their parents and extra policies could cover gaps or they could pay extra for a PPO or other options. The remaining money would go to a Health Savings Account that could cover treatment in the USA or outside at any hospital or clinic licensed in their home country. Existing funds for Medicaid and Medicare would go into the main fund to suppliment the program. I would also expect employers with a certain number of employees to pay something towards their employees since this system is good for business and makes the workers more productive and healthier.

This way the government would only have to take the money it has and collect taxes on earnings (this would be like Social Security taking out though JUST enough to meet the minimum amount for the health care plan a year no more and the person could voluntarily add extra for a Health Savings Account administered by any bank- could treat it like a CD).

My view is simple here and plain to understand keep the free market in place as it is now just make the money work better and make people take responsibility for their care by keeping choice in the system. But carry that to employers and the governement as well. This system would take the best ideas from other nations and apply it to the United States in our own way.




Purple

Who would keep Humana honest?  And that still doesn't stop the problem of rising prices...medical costs surge much faster than inflation.  Medical accounts for individuals are a good idea.  But I take strong exception to something you said.  Something that should grate against every American thankful for their freedom.  You said they should 'make' everybody pay $3000/year.  First of all, please consider what that would do to my household.  So that I can be a college student and finish my degree we currently make only $15000/year.  You would take 1/5 of the money we make, money that pays our mortgage, feeds my kids, pays for our vehicles so my husband can get to and from work and me to and from school...please, be reasonable.  And 'making' people do anything goes against every tenet of our society unless it is absolutely necessary or voted in by the people.  And again...it's not the government's responsibility.  I can't afford to pay your medical bills.  I've got my own problems to take care of.  If I wasn't taxed so heavily then I could help others in capacities I agree with, but I'm not because they take my money and put it where they think it should go.  In an ideal world, I believe they call it Utopia, we could all get along and share everything and everybody would be happy, but we don't.  We have to do what we can, and that means I take care of my children first and then help others when and where I can, and I do.  People are going to think that I'm horrible because I'm not willing to share my money.  But I do.  There is a local children's home (an orphanage basically) near here.  I volunteer my time to raise money for them and spend time with the children there.  I buy food, cleaning supplies, personal supplies, and toys whenever I have a spare dime for the children there.  I'm not as heartless as I sound, but what you're suggesting won't work and isn't right.
There's something very sexy about being submissive. Because your guard is down, you have to totally surrender to something like that. --Eva Longoria

RubySlippers

The $3000 would come from the existing money spent on health care from existing government programs, a payroll tax and an employer contribution and its a ball park estimate you could easily reduce this to $2000 a year or even to $1500. The goal is to fix this so when people are young they use it less but when they are older and need more care the price stays where it is. Like Hurricane coverage you might not need it for ten years but when you do it overall saves your money. And working people this can be adjusted we can base the deduction on income off the paycheck I would see that as practical. So those working at that level might pay less and a lawyer earning $100,000 a year pays more.

My overall consideration is doing this does help your family we would all benefit.

Must I add we already require drivers in Florida have auto insurance, we require others to carry coverage what's wrong with requiring health coverage.

Another option Bush suggested might work offering a tax break and/or voucher for health care with a Health Savings Account. Still the gobvernment would have to mandate companies take anyone that applied at the same rate as anyone else for that to work. But for even $2000 a year a family can get a basic policy. Of course to do this we would have to rework how the government hands out money from existing sources and still have some sort of Health Care payroll contribution. Doing this I would apply a payroll contribution matched by the employer to a few percentage points of ones income plus an optional additional amount. This placed in a interest account at a bank for the express use to pay medical bills. We could even have it all direct depositied directly from the employer since it common to do that with paychecks. Most employers want health care for their employees so asking them to match lets say 3% of ones salary is not that much to ask. They do that with 401k accounts in many companies. And one could choose to add more themselves and the accounts would be untaxable and could only be used for health care expenses.

But we have to do something- as for medical costs we must decide to focus on treatment that works, focus on the least costly options first like diet and working out for a high blood pressure then try drugs and be willing to refuse care if its not likely to be successful. The last can be hard I know but is treating a cancer patiant for $100,000 with a under 10% chance of curing them worth the money? The choices are hard but someone will make them either by people not having health care and they get so ill they qualify for Medicaid or buy all paying out something to have some decent plan for everyone to prevent major problems later on.

Let me as you Purple if ,the Higher Power forbid, you had an aggressive cancer and needed care that if it was detectable and treatable early would have a 80% cure rate would that be worth the $3000 a year to stay alive for your family? I'm talking her I help pay for you and your help pay for me and we all benefit by paying for others that are in the United States. And that's the point you and other that aren't covered play Russian Roulette that you won't get seriously ill, are in an accident or other event that when it comes will break you financially. I for one would prefer to have that one bullet not there at all than take the chance it is my turn. And I will pay to protect you and your family.

Purple and my other critics those are the stakes human LIVES and if you take all the money we spend on health care now in this patchwork system and the money all the businesses pay and what would be fair to ask be contributed we can get a good system. Its called sacrificing a little now for a greater good just like we all came together in WWII we can have the same commitment now for this.

Purple

I think we all know that lives can very well be at stake here.  Certainly.  States CAN require citizens to carry auto insurance as they are in charge of the roads and nowhere in the Constitution does it say that states can't.  You do realize that they won't take money from any existing government programs to pay for something like that even if it would work.  One of the ills of government.  They will take it out in the form of taxes, which still comes out of my pocket.

Bush's plan is the best bet so far.  So much better than Hillary's farcical attempt.  Yes, we do have to do something.  I find it interesting, though, that you won't even consider my stance on the issue.  Why are you so convinced that your way is the only way without even checking it out?  I've looked into this and researched this for years, I know why my stance is the way it is, and I've supported it.

I have no problems sacrificing for the greater good as long as it is done within the law, for the right reasons, and voluntarily so that I am giving to issues that matter to me.  Healthcare would be one of them.  Children's rights and protection is another, etc.  We need to get rid of the monopoly, look at other systems that work good as well to get some ideas, and really work at finding ways at helping people that need it.

Another concern I have, you mention a lawyer, for example, having to pay more.  Why?  Should we penalize the lawyer for making more money than I do?  He went to law school, he passed the bar, his time is clearly worth what he's paid or else he wouldn't get paid.  If the lawyer pays the same as everyone else, which is fair, then he has more money to feed into the economy which helps everybody in the long run.  This is economically sound and proven.  And a strong economy that helps everyone will help everyone pay their medical bills.
There's something very sexy about being submissive. Because your guard is down, you have to totally surrender to something like that. --Eva Longoria

RubySlippers

Well how an be worked out, lets says you had a fixed amount for health care to get into an HMO or PPO once we get to that we can make some good ideas on HOW to do the system. I like the free market generally I just think if its something people need like their health making a huge profit on sick people is ghoulish.

Now one fast fix would be to ban any health insurance and make the establishment charge what people could afford, after all the costs rose because the insurance covered the bills not the patiant.

I do agree personal accountability is important here, one must avoid getting sick if one can with being fit and doing what must be done that is less expensive. In my case I need treatment its not optional I take five drugs including insulin that cost me around $350 a month, need testing strips that run me around $100 a month if I do not I could easily lose the use of my Kidneys, go blind, have amputations or other conditions that will cost everyone a great deal more. Then I'm on lifetime government care and you and others will pay alot more than the $350 a month. I'm not alone in this.

But a free market economy cannot work no insurer even through a company will cover me (my company will after one year- Humana covers their employees)  but on my own I can't get any insurance. So for my case to work a company must not be able to refuse enrollees or have waiting periods for coverage to kick in. So the reason I said $3000 a ear that would be to absorb the costs this would incur to everyone. You can make companies compete here but not let them refuse patiants or cherry pick the healthy ones. But I would say if you can get coverage for less than that amount it should be legal. I for one would give up doctor choice in not a PCP for a lower rate as long as I get to see needed doctors.

Lets start with a premise here- everyone must be covered by a health care plan by law. Now what is the the best way to get there? Lets talk about it.

Zakharra

QuoteLets start with a premise here- everyone must be covered by a health care plan by law.

I don't accept that premise. It is not the government's responsibility to do that. It's bad enough that car insurance is required (the costs keep rising), but to add yet another requirement that will result in a tax increase is hard.

The $3000 you say as a basis is about 9-10% of my yearly takehome pay. I make $34,000 a year. I'm a private contractor so taxes are not taken out of my paycheck. I get the entire amount in one shot. So any taxes I have to pay myself. I can't afford another tax.

Nothing

Just to throw my 2 cents in, sorry..

It isn't the governments job to pay for car insurance though...It's required by law that you have it (which I currently don't, way, way to expensive for my budget), but you have to provide it yourself. And, the amount you pay varies on the amount of coverage you have and what your deductable is. Unisured moterist is an option on your insurance, so the government doesn't pay for that, either...
at least, to the best of my knowledge, I could be wrong...

Zakharra

 True, but it is required. I have been caught twice without car insurance and twice lost my licence. I need my car to do my job and I need car insurance. I keep it paid for now. It's not easy, my job is not covered by most car insurance plans, so finding one that will cover me for the level I need and be inexpensive enough that I can actually pay for it is difficult.

If I had to pay into a health care plan, that's yet more money taken out of my paycheck. Another tax, since it would be required that I do this and give it to a governmental agency.

RubySlippers

What I want to point out is health coverage everyone at some point needs- unless your some kind of superbeing or lucky. We spend more than any other country per person yet don't insure everyone. Now assuming we want free market functions we should look at how best to do that not shoot down a real issue because some people are too cheap.

Now $34,000 a year. ok that's your income. Now lets say the government using already existing money paid a third of that into the system that would leave $2000 to be paid. And I would not make that a mandatory amount but would require everyone have insurance be it with an employer or privately paid. The government using existing money from Medicaid and Medicare would pay part of the cost and leave the rest for you. Could be a simple fixed voucher of lets say $800 a year. Surely you could dig up maybe $1000 and get some decent policy with that added in. [Would be more for a family with children so the government share would be adjusted likely for that, businesses would get that portion applied if they paid the cost based on the percentage they cover i.e. if they pay half the cost they could get 50% of that money.]

One thing the government can do right now get rid of exclusions for existing conditions make insurance companies take everyone at the same price- right now an individual in most states cannot get covered even if they have a minor health condition. By including everyone it spreads the risk pool and would allow more people to get coverage and right now the companies can cherry pick people. We must end that first before we can look at another option. If Humana or Blue Cross want to offer health insurance make it blind to applicants health histories.

Elvi

UK have the National insurance stamp.
It is a payment made by anyone who has a taxable income.
The amount that is paid by the employee must be matched by the employer.
If your contributions are up to date, you qualify for unemployemnt benefit, sickness benefit, a small retirement pension and a proportion goes towards the national health service.

Quick clean and simple. 
It's been fun, but Elvi has now left the building

RubySlippers

Elvi nothing personal it sounds great but people in the United States when it comes to such common sense things like public health and health care seem to be pretty selfish. Hell you ask any American in the main most will not want to pay taxes more for anything important like in my home state even for Schools. And special interests run the hen house- look at that HIDEOUS Medicare Pard D plan they are making seniors take. You think doctors and pharmacists did that?

No any plan will be lightly government influenced, be more expensive and unwieldy than it has to be and likely to be far from egalitarian.

Purple

No drug companies did it.  More monopolies.  And thank you for calling me selfish, I appreciate that.
There's something very sexy about being submissive. Because your guard is down, you have to totally surrender to something like that. --Eva Longoria

Elvi

Purple,
Ruby was calling people selfish in general terms.
Please do not begin to take offence where there is none intended.
It's been fun, but Elvi has now left the building

National Acrobat

I pay more than my fair share of taxes, thanks.

Again, any plan that involves the government, the word taxes, and universal is neither going to be realistically feasible, nor will it deliver the value that people seem to think that it will.

Purple

Well I do kind of think that saying Americans who don't wish to pay any more taxes selfish would certainly apply to me.  I wasn't taking offense so much as reminding her that those nameless Americans do, in fact, have names and families and perfectly legimitate reasons that have nothing to do with selfishness.  Although I didn't put my customary smiley or hug at the end I wasn't angry.  Hurt, but not angry.

Acrobat, I think you're correct.  And even if it would, before we just start taking out more taxes, problems with previous systems, departments, etc., etc., should be cleaned up and fixed first.  Maybe then something could, although I do not at this time endorse it, be easily afforded without even raising taxes.  Fix the problems we've already got before adding more fuel to the fire and all that.
There's something very sexy about being submissive. Because your guard is down, you have to totally surrender to something like that. --Eva Longoria

Elvi

I think, in reality, the American Government have spent just a little too long looking at what other countries are doing and have neglected what they should be doing and that is looking after the American people.

I'm desperately trying to find a report on a speach made by a senator about health care.
He compares the American system with the British system and says that there are great similarities between the two and three main things wrong with the systems in general.

He goes on to say that the British will be the first to solves these problems because of two reasons.
The first is that the British Government take the issue seriously and do keep it on the agenda.
The second reason is that the National Health service belongs to all of the British people and every single one of them has the right to voice their opinion on it and actually do keep the issue in the public view.

The point I am making is that if everyone pays the same, then everyone has the right to say they are paying too much, too little or that they are not getting the service they expect to get.
If everyone pays into various schemes then I complain that the bill is too high or that the cover was inadequate for my needs and I am told 'tough, change your insurer.'

In effect, this country has a huge pressure group, all of us.

It's been fun, but Elvi has now left the building

RubySlippers

Well I'm an American and in general we do hate taxes. I for one point out we can't wait to do something about health care more and more people are losing access. As for cleaning up the system its not that easy until our elected repreentatives stand up to the special interests of the health monopoly. But we have to do something? To Purple I understand but do you like your family and in the future your children when they are adults have to go without health coverage? Your grandchildren?

Fact is I for a time saw a relative go through the local health department for care they treated her like a criminal checking her bank statements and keeping on her back when she had cancer- yet a felon can get covered no questions asked that is better than my sister a law abiding citizen who had as her only crime was not having a good time trying to get work. And her jobs never provided health care. And they oly covered her for her lifetime 3 years of care now she has none. And is too ill to work at good jobs that offer health coverage.

We can do better. We have to do better.

Lets just look at the simple plan Bush has offered we have money in Medicare, Medicaid (Federal matching) and other programs if we take that and lump it together. We can give government backed grants for health care. If the states impose a modest tax on income and require all businesses or individuals have to have insurance- and make the companies take everyone OR have default plans we can at least have something decent. And something not tied to an employer if its designed that way.

For example I would give up doctor choice for referals to specialists for lower cost, a limit of drugs leaning to generics first and pay fair co-pays as long as I get coverage.

Its not a government plan it would be taking money we all already pay in and that is there channeled to help states arrange for some sort of health care plan system. But take Health Care companies I see no problem with requiring for the privalege of offering health insurance in the country they be rquired to take all applicants they could limit the plans but saying we have lets say altogether a year $1500 for Purple so you must enroll her in a plan that covers these areas at this fee schedule. Even a basic but nicely designed HMO operated out of one local hospital.

Purple

Look, I'm a Bush supporter which I'm sure will get me shot for saying that in public anymore.  I like his idea.  No, I don't WANT my family to not have health care.  And that's why I'm doing what I can by going back to school and making a better life for my family the American way.  Now, change the freaking Constitution to make it legal for the federal government to implement such a system and I would be happy to talk about one then.  Until then, I'm out.
There's something very sexy about being submissive. Because your guard is down, you have to totally surrender to something like that. --Eva Longoria

Elvi

#73
And I think, after that posting it will be better if you do take a break from this thread Purple.....

And Ruby please keep your comments general, it is not best practice to site peoples names when talking about things like this.
It's been fun, but Elvi has now left the building

RubySlippers

Sorry nothing personal Purple.  :-[

As for the Constitution it doesn't require an amendment just a simple set of laws. The government can collect personal income tax it doesn't say how such a tax can be used or that health care cannot be included. Its already included Medicare, Medicaid and other spending like the VA system could all be pooled and used for it. Hell if we add in what businesses. private individuals, states and local people put into the system there is plenty of money.

All we have to do is channel all this into ONE system, my proposal would work. Have people have to have health coverage, tax businesses around what they spend now and through a payroll tax to meet that portion which mean large businesses might save money, small businesses would pay something and people working would contribute something. Take that money add it to a Federal base amount and that should be enough for a decent HMO plan. Cover the basics and hospital care. Then have voluntary supplemental options that are better just like Medicare has now. Make companies in the system and most would have no choice have to take people if they offer health plans, let new ones form and bring in proper competition.

I did rough math if the Federal Government took all the health care funds they could put toward every citizen of all ages $500 per year, State funds at all levels should be required to put in $250 and payroll taxes maybe $500 a year thats enough for basic coverage if the HMO is tightly run. Of course there would be a Health Saving Account option I would make it just like an IRA and co-pays but maybe basic Primary Care could be cheaper than hospital stays and generics cheaper to encourage taking them.

And if someone wanted a better plan that would be $1250 already to put into it so if you wanted a $3000 a year plan one could put the extra in themselves.

As for the American Way I love being an American and enjoy a Capitalist system but we are not a free market one and never were- and since businesses don't have to provide health coverage and if a person changes jobs they can lose coverage if they have it- COBRA is very expensive. We need coverage neutral of employment that stays with the person at a fair cost. Sometimes the government has to act for the common good through regulation and taxes and this is one such case.