5 Votes
How Would You Implement Health Care
So I’m going to keep this ridiculously simple. Everybody likes to armchair quarterback the government and yell about how stupid they are and whatnot. Well … given the task of national healthcare, what would an OmniNerd create/want?
I’ll seed some parent comments to get your thoughts organized into various lanes.
Similarly tagged OmniNerd content:
- Surrogate Mother and Abortions, by VnutZ 3 months ago
- Why a Health Nut Is Against a Soda Tax, by Brandon about 3 years ago
- 5 freedoms you'd lose in health care reform, by smcbride almost 4 years ago
- Statist health care, by the numbers, by LordDilly almost 4 years ago
This article was edited after publication by the author on 08 Sep 2009.
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Illegal Aliens by VnutZ
I’ll make it interesting … a nine year old Mexican boy is lying on the side of the road having been hit by a car with a compound fracture, some internal bleeding and maybe more issues.
- Does he get ambulatory care?
- Does he get X-Rays?
- Does he get surgery?
Prescription Medication by VnutZ
The twelve year old child of a meth dealer is exhibiting signs of paranoia, visual and auditory hallucinations.
A seventy year old grandmother living on nothing but social security is suffering severe alzheimers.
- Do either qualify for prescription meds au gratis?
Unemployed by VnutZ
You were just laid off from your job and have spent the past two months seeking employment to no avail. You’ve come down with swine flu (but don’t realize it yet) and are burning up a fever in bed completely incapable of doing anything but barely making it to the bathroom to vomit.
- Should you get ambulatory care?
- ER time?
- Medications?
It has been done in America by Occams
This article covers the issues rather well I think.
A few years ago, the State of Massachusetts passed legislation that facilitated almost universal health insurance coverage for its citizens. Massachusetts also now enjoys health outcomes comparable to those of other industrial countries and generally superior to the rest of the United States. Despite these achievements, the level of health spending, as well as the rate of health care inflation, remain so stubbornly high (at about the national average) that many citizens of the Bay State regard the experiment as a failure.
Health care reform is not simply a technical problem, but also a moral and political one.
It can be done, but like all insurance schemes there will be winners and losers and the losers will be those who pay but don’t claim on it. Even so, they will have gained from it because their premiums mitigated a significant risk and they did enjoy that protection.
The main thing here is to keep it from becoming a profitable vehicle for any service providers. If business can be kept out of it it might have a chance.
Let them choose by MateFrio
Everyone gets a tax rebate earmarked to pay for health care insurance of their choice picked from government or private plans.
Illegals are given emergency health care and a one way ticket home.
After six years all drugs are produced generically.
Cort reform where the lawyers do not get a % of punitive damages.
Better privacy laws to protect patient’s personal data.
A Healthcare fund that continues once a person is retired.
Run like a business by marcus
Rather than marketing around the country with stories about how hard your grandma had it without health care, why not
1) Have a plan where you show costs lower than revenue
2) Hire an executive team whose pay structure is structured to encourage keeping costs lower than revenue
3) Have fairly accurate details of what tax payers are providing the revenue and where the costs are coming from – make sure the data can show outliers so we understand the plan and who is paying way over their share and who is getting way more than their share, if there are too many outliers, something is wrong
Re: Run like a business by Anonymous
Occams, I think you are simplifying this too much
I would assume that there is going to be some standard pricing based on a standard deviation. The outliers are probably where
1) People are high risk because of certain factors
2) People are abusing the system
3) People are lower risk because of certain factors
Do you really believe someone who works out, stays in shape, doesn’t smoke, and drinks socially should have to pay the same health insurance as someone obese or a chain smoker? The kind of system that guarantees the same health care cost to everyone or based on income level will not take into account the factors I am listing above.
This will not help American’s behavior to prevent health issues by living a healthy life, as you can chain smoke and eat yourself into cancer at the same cost of health insurance as someone who exercises and eats well.
Health care should consider both prevention and protection.
I really believe the government needs to take some of the emotion out of their plan, gather facts and data, and make some informed decisions that include prevention of health issues and to insure that costs remain below revenue.
RE: Run like a business by scottb
I think you are simplifying this too much
And I think you’re ignoring his point.
You’re saying, “It’s not fair that I have to pay someone else’s costs”. Under that way of thinking nobody should have insurance at all. Everyone should pay their own costs.
The point of a national health care plan is that everybody should get access to health care, regardless of their financial status. “Nobody should die because they can’t afford health care and nobody should go broke because they got sick”, as the recent Facebook campaign put it.
Somebody still has to cover those costs — coming up with a system that demands that those who are more likely to get sick are required to bear a higher level of the costs just throws the goal of universal coverage out the window.
Zombies by VnutZ
… as the recent Facebook campaign put it …
I much preferred the “Nobody should have to die from a zombie attack, but if they get infected, the right thing to do is shoot them” campaign.
RE: Run like a business by Occams
Do you really believe someone who works out, stays in shape, doesn’t smoke, and drinks socially should have to pay the same health insurance as someone obese or a chain smoker?
Yes. That’s how it must work. It is working fine that way in many other countries. It is a compulsory insurance scheme. This is good public policy not communism. A universal health scheme is funded by a percent of income and there are no exceptions, either to the tax or the access. It is administratively efficient and fair to treat everyone the same. Make concessions there and the bureaucracy required to manage it will expand enormously and so will the cost and there will most likely be no benefit to the country or you.
The ones who have good health are lucky, but they don’t know what will happen to them in the near future. Looking forward they get the same benefit as everyone else, protection. Looking back and saying I never needed it after all is irrelevant. You pay to mitigate risk.
OK, now you will say you should pay in proportion to your risk. I addressed that in para 1 on the basis of administrative efficiency, but let’s think about it in another way.
The fit guy enjoys better health. That is a big reward, but paying less for insurance would be another reward and I agree that it might encourage more people to become fit. Out Fit guy might be grateful for his access later when fit girl walks out on him, he turns to Jack Daniels, and fast food for comfort and becomes a lounge lizard. At least his bypass surgery won’t force him into bankruptcy, and fit kid with diabetes has had good treatment all her life. So he cross subsidised himself later by his fitness earlier.
You no doubt will still feel that fit guy has fewer risks because of his good health, so he deserves a lower premium. That is true in terms of some afflictions but he and his family are still vulnerable to many other problems as well as infections and injury by accident. And his fitness probably only covers him for his young adulthood. As a baby, child, teen, and in middle and old age his risk is not different. There are also his dependants to consider. So childless couples will subsidise families. What a pity, never mind. They will reap the benefits of those children later paying taxes and supporting the economy and them in their old age.
The people who are born with health problems, have car accidents or who get infected do not deserve to pay higher premiums either. No one does. People don’t get sick in order to abuse the health system.
I suggest that you stop worrying about being forced to pay for someone else’s problems and consider all the benefits for yourself. You won’t lose on this deal unless you have an interest in a HMO.
RE: Run like a business by scubasteve
It is administratively efficient and fair to treat everyone the same.
So it’s fair for the fit individual who never has to see a doctor (due to better health) to pay the same as an obese individual who is always sick (due to poor health)?
The ones who have good health are lucky
Are you serious? So a person who is obese from eating crap all-day-every-day for years is unlucky? So much for personal accountability for one’s actions.
I suggest that you stop worrying about being forced to pay for someone else’s problems and consider all the benefits for yourself.
Maybe you need to start considering it. When in the hell did it become my responsibility to pay for someone else’s problems? This is typical liberal crap. Your fairness reasoning always works when you apply it to the unfortunate, but never works when you apply it to the fortunate. So fair is never truly fair. You’ll say that it’s for the betterment of all mankind. I would like the option to pay for someone else’s problems. That said, you’re now going to accuse me of being a typical conservative that hates everyone, nature, animals, etc. because I won’t willingly allow you to force me to pay for someone else’s problems. It’s about choice. (and yes, I already know that I am paying through Medicare, Medicaid, etc.)
RE: Run like a business by Brandon
I wonder how peer pressure might come into play in a public system. With so many insurance plans out there, you don’t feel a connection to the people around you. So, you can watch your neighbor make poor health choices and not easily see an impact on your taxes.
Once everyone is on the same system, though, everyone is paying for everyone else. So, when someone lights up, everyone that sees it knows they will likely end up paying for that person’s cancer treatments later. And, the smoker knows, too.
I’m not buying into the public option, but this is one aspect I hadn’t considered before.
RE: Run like a business by Occams
New Yorkers are paying for the Defense of Hawaii. Americans already pay for many things that don’t benefit them personally. Under a public health system, you would simply be paying for protection and that is what you would receive in full. Whether or not you or your neighbor make claims in any period is ex post and irrelevant to you.
RE: Run like a business by Brandon
I don’t think you understood what I was saying.
My thought isn’t about whether or not it’s proper to pay for someone else. My thought is realizing when everyone is on the same plan, they might feel a sort of group responsibility to be healthy. If they can keep each other healthy, their costs go down.
RE: Run like a business by Occams
If they can keep each other healthy, their costs go down.
That’s true, but I think it would be a weak force. More likely would be the attitude that we should use the system more because we are paying for it and everyone else is.
There would be a big incentive for the government to try to keep us all healthy, so It might be more inclined to pay for immunization programs, community sports facilities, public pools, etc
RE: Run like a business by Brandon
And also more likely to tax tobacco, alcohol … and maybe soda?
I wonder if it would make it more difficult for food industries to get a sympathetic ear. All of the sudden the push to create a market for milk and high fructose corn syrup has a downside the government cares about.
RE: Run like a business by ldsudduth
You won’t lose on this deal unless you have an interest in a HMO.
Take a close look at your own 401K/IRA/other investments. I recall reading somewhere that somewhere around half of US stock market is health care and related stocks.
Another thought on alians by MateFrio
Send them back and bill the country of origin ….
Universal Health Care by ldsudduth
Just like this.
Shocked? One of the board conservatives (more libertarian/conservative) types actually agrees with Universal Health Care—isn’t life amazing.
Moot Question by GreatWhiteDork
Healthcare is not in the Constitution. It is also not a logical extension or result of something in the Constitution. (And no, you can dredge up the preamble and “promote the general wellfare”)
Healthcare is therefore, by the 10th Amendment, reserved for the states respectively, and the people.
Implement away at the state level, but it is unconstitutional at the federal level. Yes, I know we already have some federal level medical programs, but they are bankrupt and unconstitutional as well.
And no: I don’t believe that a need on one person’s part is a claim upon another. My need is not your moral, ethical, or legal responsiblity. If you are able to and choose to help me with my medical bills, thanks. But federally forced charity is not moral virtue, it is merely compliance.
If I don’t save for a rainy day and am too poor to pay for my medicine, I can ask for help from my Family, Friends, Church (If I have one), Community, or State.
But not at the Federal level.
sigh by AnonBCA
I’m disappointed…not ONE answer to the actual question…just a bunch of pseudo-intellectual bickering…shame…