Comments on: A simple fix for healthcare? Thu, 21 Jul 2016 07:57:19 +0000 hourly 1 By: Jeff McQuinn Fri, 28 Aug 2009 17:20:56 +0000 The problem with healthcare is the cost. We have 50 years of experience proving that insurance does NOT lower the costs. In fact, the more insurance introduced into the system, the faster healthcare costs seem to rise.

People receive a service that someone else (insurance) pays for. Most don’t even pay directly for the insurance, their employers do. They do pay, just through lost raises in their pay.

Insurance has no desire to lower the cost of healthcare. They pass the costs on. Higher costs mean more people must have insurance.

The healthcare industry has no desire to lower cost. They don’t compete based on cost. They don’t advertize. People rarely know what services cost before they receive them.

This is already a socialist system. Putting the Government in charge will not improve it. It will just replace the insurance company with Congress (who will ultimately legislate savings through lower quality or rationing).

The solution is to return the healthcare industry to free market controls. Rather than having 100% insured, better to have 0% insured (albeit perhaps for catastrophic insurance). Simple fee for service. You get surgery, you pay for it. Doctors/hospitals would then have to compete based on price. They would learn to become more efficient. They certainly won’t stay in business if they charge more than most people can afford to pay.

Insurance is about spreading risk. It assumes that only a small number of the insured will need healthcare service and that the cost can be spread over a large body of people who won’t need any service. But everyone needs healthcare services. When you spread a 100% risk, you are really just morgaging the cost over time. People can do that without the added overhead of an insurance company.

By: Paul Tue, 18 Aug 2009 20:17:32 +0000 What do we do with those who do not file tax returns and pay no taxes, hence don’t contribute to the fund? We don’t have guts to deny them coverage and throw them out — we know that.
Once the tax is instituted, it’ll be prone to be increased gradually over years because of the rising costs. Government rarely decreases in size. Why don’t we create Government pension plan for everyone by imposing a pension tax? What about Government-run supermarkets, dealerships, restaurants, etc? It’ll decrease overhead, will streamline the process and should decrease costs, right? It looks great on paper and in books.Utopias do not work.
I am for required individual coverage just like it is mandatory to have car insurance in Mass, but not through the Government. No insurance — no service in the hospital. It should persuade people to buy health coverage for themselves and problem with everyone participating is solved. We all know: not going to happen. United Soviet States of America…

By: Joseph R Fri, 14 Aug 2009 20:45:48 +0000 The proposed approach, as well as covering all U.S. residents, would help to contain costs, and maintain quality of care that is at least as good as the current system. Costs would be contained by reducing overhead such as by streamlining the collection of premiums. Quality would be maintained as the major change proposed is one involving payment and not provision of health care and may, in fact, be improved by giving providers to join together in more in more integrated, better coordinated organziations such as Group Health of Puget Sound and Cleveland Clinic. And the government is quite capable of doing this and doing it well as is demonstrated by Medicare, an enormously successful and popular government program for almost half a century.

By: Dave Thu, 13 Aug 2009 22:08:38 +0000 The approach proposed in this article is similar to what the federal government currently does as an “employer” for all federal employees and members of Congress; negotiates rates with private insurers and offers employees a cafeteria plan from which to choose. Sounds like a winner to me!

By: Sally Thu, 06 Aug 2009 18:31:55 +0000 Shelby you nailed it!
I would add the easiest fix is to make healthcare tax deductible for all and get the government out of the way.
The government beauracracy is too big to succeed as evidenced by Medicaid and Medicare and the USPS, Amtrak ,etc.
Where are all the journalists who should be picking apart this proposal. All i ever read is how congress is working it out . How about the media do it’s job of investigative reporting on the plan?

By: Shelby Thu, 06 Aug 2009 01:31:45 +0000 As soon as the President, Congress, the Senate and all other government officials agree to put themselves and their families on the same healthcare they propose for the American people, then I think alternative healthcare to what we have now can be considered. Until the powers that be realize that what is not good enough for their families is not good enough for ours, we will remain in a stalemate on healthcare reform. Healthcare reform would have happened decades ago if the President, Congress, Senate and all government were in the same situation for healthcare as are the American people. Who could trust anyone who would put a healthcare in place and plan to administer it but will not put themselves or their own families on it?

By: Matt Wed, 05 Aug 2009 18:31:30 +0000 Why not just outlaw insurance for healthcare? Force healthcare facilities to charge for their own services.

By: Steve Davidson Wed, 05 Aug 2009 15:18:20 +0000 CMnurse doesn’t understand how my proposal would differ from the present. Here are some of the ways: everyone would be covered; with their vouchers, all would choose plans not on the basis of their cost, but the available providers and quality of the plans’ service; all plans would cover the same comprehensive set of services; plans would be paid risk-adjusted amounts; insurers’ income would be determined by the numbers of people who choose them and the risk-adjusted amounts associated with those people; in order to attract and then, retain subscribers, they would have incentives to negotiate arrangements that ensure good quality care and contain expenditures; the amount spent by the health care system would be the fund determined by the HIF to be needed for that year (not the sum of all the bills for all the services provided). Yet, to achieve all these good results would be simple administratively even though providers of care would still receive their payments from private insurers.

By: The Bell Wed, 05 Aug 2009 03:53:38 +0000 It was written:

“[People] fear that quality of care would decline, their out-of-pocket costs and taxes would increase, and they would not be able to choose their own doctor. The fact that there is little reason for these worries is beside the point.”

Sorry to disagree, but that *is* the point. Many people’s attitudes – or enough to make a newsblip on some hot-button survey – are driven by the utterly unfounded fear that the American corporate healthcare system could get even worse than it already is without provoking widespread riots.

And of course they’re completely mistaken about that, not because American people are stupid by nature, but because they have been systematically deceived into imagining any worse alternative to that which they already endure and thus assume they couldn’t have it any better, anyhow, ever, than the way things are now.

It is the perpetrators of such legends who should be locked up in a lunatic asylum; and the people who pay them to utter such falsehoods, well, expropriated and then locked up too.

I’m from a medical family, having been in many hundreds of hospitals here in the U.S. and elsewhere and traveled with medical people in quite a few countries of the first, second and third world persuasion but never yet having seen anything as lamentable as the widespread state of medical malaise in the United States, coupled with grossly inflated distortions about its alleged prowess.

That having been said, my elderly uncle is currently in Critical Care at an extraordinarily good medical facility in Northern California, next to which every other American hospital I have ever seen comes across as a mediaeval dungeon. I would give out its name publicly but fear that, by doing so, the anticipated long-term “cure” for this situation would amount to its being marginalized and shut down by the appalling mass of third-rate pollster-addicted so-called medical competition which dominates the ailing American commercial health marketplace, instead of rising to the occasion and operating per sworn oath to Do No Harm, not even for profit.

The survey I expect to see next will show that the profit motive in post-Reagan, post-Thatcher Western healthcare has claimed more victims in this country, this century than the Black Plague ever did. And, more’s the pity, it will be absolutely on the money.

By: CM nurse Tue, 04 Aug 2009 23:54:54 +0000 I don’t see how this is much different that what we have except to add another level of administrative cost. What about the selfemployed, unemployed and off the books employed? How does this address the quality/cost savings problem?
Speaking of easy fixes. There has been much reference to an article in The New Yorker by Dr. Atul Gawande about a hospitals in Texas that spends more Medicare money per patient than any place in the country and about hospitals like Bassett Hospital in Cooperstown that spend the least. The difference between the two being at Bassett the doctors are paid only by the hospital and in Texas (and a vast majority of hosptials in the US) private practice physicians admit their own patients and bill insurance companies for every time they see the patient and they refer every little problem to a buddy specialist who also charges the insurance company for every test and time they see the patient. What evolves from this is groups of physicians in colusion with the hosptials that depend on admissions creating a whole practice culture based on abusing the system. Maggie Mahar calls it “Money Driven Healthcare” in her book.
The starkly simple solution to this is outlaw private practice internal medicine physicans from attending to hospitalized patients. Hospitals would hire salaried hospitalists to treat patients eliminating any motive to over or under treat.