CDZ OK, I'll Try Again, How Can We Save Obamacare and Make it Actually Work for ALL of Us?

[Mac1958]

Take-the-partisan-political-motives-out-of-the-process,-work-together-achive-a-workable-solution.-nothing-will-ever-be-perfect.

I don't we have that ability any more. Like a muscle, it's use it or lose it.

Seriously.
.

 

[Votto]

True. And I've always found trusting others more lucrative than fearing them

If you want to put all your trust in either party at the federal level then have at it.

Most don't, however.

 

[Grumblenuts]

Didn't say all my trust. Reasonable caution, always.

eta: The ongoing funding is always a legitimate concern. The bureaucracy far as actually running Medicare is concerned has only proven remarkable.

 

[Votto]

Didn't say all my trust. Reasonable caution, always.

eta: The ongoing funding is always a legitimate concern. The bureaucracy far as actually running Medicare is concerned has only proven remarkable.

After watching the circus in DC, I would not feel comfortable with any of them dog sitting for me.

 

[Markle]

Here is a much simpler solution with far less verbiage than the original post. It has been around for quite a while.

The Cure: How Capitalism Can Save American Health Care
December 18, 2006 38 min read Download Report
David Gratzer

Delivered October 18, 2006
[...]
First of all, we need to make health insurance more like every other type of insurance. As I've alluded to before, Americans are overinsured because, in a sense, many insurances don't discriminate between small items and large items. Imagine if we did that for car insurance. It wouldn't just cover you if you were in an accident, but it would cover you if you had a fender bender or your tank of gas was running low or your wife couldn't believe you bought a blue car and thought you should get a paint job to make it a red car. Car insurance would be feverishly expensive were we to adopt that approach. American health care is so very expensive because we violated basic rules of insurance.

What does that mean? I think Congress took a good first step with health savings accounts. I think they are overly rigid in their structure: something that made sense for a tax committee of Congress and not so much on Main Street of America. I think we ought to expand HSAs; we ought to build in more flexibility. I also think we ought to level the playing field so that if you're an individual, you can get the same tax preferences as an employer.

Idea number two: Government policy needs to foster competition. It seems absurd to say that in America, but so much of our philosophy has been "regulate first, ask questions later" for the last 60 years. Let me just give you one example.

As you know, I'm affiliated with the Manhattan Institute. Sitting in my office in New York, if I tried to buy myself health insurance, I would pay four times more than I would pay for the exact same insurance policy from the exact same company if I lived in Connecticut. That's because New York State has thrown in so many mandates--44 in all-- as well as guaranteed issue and community rating, meaning you can buy health insurance in New York State after you get sick, which is like buying home insurance after your house has caught fire. We need to deregulate that and, in lieu of that, allow out-of-state purchases.

Many federal and state laws also undermine competition: EMTLA,[1] certification of need laws, and so on. We need to reconsider that if you want competition in the quality of innovation.

My third idea: We need to reform Medicaid. Medicaid has become the great sleeper issue. We spent $5 billion in 1970; today, we spend over $300 billion a year, in part because it is owned by neither the state government nor the federal government and, as a result, is probably the worst government-run program in America.

How to reform Medicaid? Turn it over to the states. I favor block funding, much in the way we reformed welfare a decade ago. Let the states experiment and innovate. Let's look forward to one day having a Wisconsin for Medicaid the way we had a Wisconsin for welfare reform.

Idea number four: We have to revisit Medicare. We've had a lengthy and feverish discussion about a prescription drug benefit, but we really haven't seriously reformed it in any way, shape, or form. As Bob likes to point out, when the foundation of the house is weak, we've built a gazebo and gotten a second mortgage for it. I thought this debate was further ahead a decade ago when we were talking about a menu of private insurance options modeled after the Federal Employees Health Benefits Program. I don't think this is a cure-all, but I don't think we can even look at solving our Medicare crisis until we get away from wage and price controls, which has been among the reform efforts of this Administration and every other Administration since Medicare was created and Nixon refurbished it.

Finally, my fifth idea is we have to look at prescription drug prices, which I think everyone can appreciate are too high. The way to do that is to go back and reconsider the role of the Food and Drug Administration. That's my plan.

For 30 years, we've dealt with rising health costs, and there are two titans who have come out of this era. There is Wilbur Mills, who championed Medicare and Medicaid and I think more than anyone else got that through Congress, and Richard Nixon. Wilbur Mills said expand government, and that will solve your problems, and Democrats have dutifully followed. Richard Nixon said we need to do something, and he preached a corporatization of American health care, particularly like managed care, HMOs, which before then were just a West Coast idea.
[...]
The Cure: How Capitalism Can Save American Health Care

 

[Grumblenuts]

I talked with a guy who immigrated from the UK because his kids were not being treated well in the socialized system there.

To Get Perspective on America's Broken Health Care System, Talk to a British Doctor

 

[Markle]

Price controls.

Yeah, how has that worked in the past?

 

[dblack]

I think having both administer different aspects of healthcare is good.

Nope. Government should never be used to control access to health care. The power will be abused and we will regret it.

 

[dblack]

I think having both administer different aspects of healthcare is good. Allow the States to continue catering to the specific needs of their inhabitants while the Feds ensure all are covered at some basic level and handle the non-State citizenry.

If you had states run things, you would have 50 laboratories going to see what works well and what does not in actual time, instead of listening to some spin troll insist we all put our eggs in one basket and how much worse things would have been had we not done so.

If we the people ran things, instead of government, we'd have 300 million laboratories.

 

[Care4all]

Does that sound like the foundation of a smart, efficient health care system to you?
.

Answer, "Fuck no."
Want more?

Grumble, please stop grumbling, and tell us what you mean? I'd like to know more on it....

 

[Markle]

I talked with a guy who immigrated from the UK because his kids were not being treated well in the socialized system there.

To Get Perspective on America's Broken Health Care System, Talk to a British Doctor

Yeah, they had a great solution until they were caught and they had to cease and desist. Or...what can go wrong by turning our healthcare over to the government?

60,000 patients put on death pathway without being told but minister still says controversial end-of-life plan is 'fantastic'

• Pathway involves the sick being sedated and usually denied nutrition and fluids
• Families kept in the dark when doctors withdraw lifesaving treatment
• Health Secretary Jeremy Hunt said pathway was a 'fantastic step forward'
• Anti-euthanasia group said: ‘The Pathway is designed to finish people off double quick'

By JASON GROVES FOR THE DAILY MAIL and DANIEL MARTIN FOR THE DAILY MAIL and
22 January 2013 Last updated at 13:43

60,000 patients put on death pathway without being told but minister still says controversial end-of-life plan is 'fantastic' | Daily Mail Online

 

[Votto]

I think having both administer different aspects of healthcare is good. Allow the States to continue catering to the specific needs of their inhabitants while the Feds ensure all are covered at some basic level and handle the non-State citizenry.

If you had states run things, you would have 50 laboratories going to see what works well and what does not in actual time, instead of listening to some spin troll insist we all put our eggs in one basket and how much worse things would have been had we not done so.

If we the people ran things, instead of government, we'd have 300 million laboratories.

What is wrong with letting conservatives states have a conservative government and liberal states having a liberal government, or do you like half the country wanting to secede from the union every Presidential election?

Those that wish to limit the power of a federal Congress that can't manage to attain a public opinion poll that is above 20% approval, yet we still call ourselves a democracy, I suggest you begin to support the movement for state rights, which is called the Article V movement.

The Founding Fathers correctly were concerned about a Federal government that would become too powerful and corrupt, which we see today, so that is why they included in the Article V amendment in the Constitution the power of the states to amend the Constitution. It has never been done before, but currently about a dozen have joined and all that is needed is 2/3 of the states to agree.

Once they do, they can implement amendments such as term limits for Congress and a balanced budget amendment of some sort for Congress to have to go by. This is the ONLY way to limit the power and corruption that exists in the US Congress. There is no other legal way to go about it because they won't impose term limits on themselves nor will they restrict their own spending in any way willfully.

About 80% of Americans favor doing this yet the will of the people will continue to be ignored until we rise up.

 

[Markle]

Didn't say all my trust. Reasonable caution, always.

eta: The ongoing funding is always a legitimate concern. The bureaucracy far as actually running Medicare is concerned has only proven remarkable.

The failure of Medicare:

 

[2aguy]

OK, Trump could take the wind out of a lot of Democrat sails if whe would do two things:
1) Adopt this Personalized Health Care proposal; Personalized Healthcare - Healthcare for You

Putting patients in charge by removing barriers that separate them from their doctors.

• We must remove unnecessary red tape that separates doctors and patients. Under Obamacare’s electronic health record (EHR) regulation, doctors are required to spend about half of their time on paperwork and data entry instead of patient care. Regulations like that have put a literal and figurative screen between doctors and patients.
• Red tape and regulations are driving physicians out of private practice; we need more independent doctors, not fewer. 53 percent of doctors are now payroll physicians employed by hospitals. Those doctors are beholden to the hospital and not their patients.
• The doctor-patient relationship is intimate and personal; no one knows better what kind of treatment a patient needs than that patient’s doctor.

Reform: Eliminate unnecessary government red tape that create hours of unnecessary paperwork and strangle the patient-doctor relationship.

Personal Health Management Accounts to give patients more control over their healthcare dollars.

• Personal Health Management accounts allow patients to purchase insurance plans that are customized to their needs and portable—similar to life and auto insurance—so individuals can take it with them from job to job. This eliminates the fear of losing health insurance when you change jobs or move.
• Employers can opt to contribute directly to these accounts, getting them out of the insurance business which puts healthcare decisions in the hands of their employees, not employers and their third-party administrators.
• This allows employees to use pre-tax dollars to pay for healthcare and gives them the same tax benefits enjoyed by employers.
• Allows patients to only pay for what they need, not a one size fits all government plan like Medicare For All.

Reform: Change current rules around Health Savings Accounts by a) increasing the maximum HSA contribution, b) allowing people to pay for insurance premiums from an HSA account so individuals have the same tax advantage currently enjoyed by corporate employees, c) repeal the requirement that exclusively links HSAs to certain high deductible plans and d) allow people to contribute to an HSA and use it to fund a Medical Cost Sharing plan or a Direct Medical Care arrangement.

Expanding Direct Medical Care to increase choices and lower costs.

• Putting patients back in charge of their healthcare spending through expanded pre-tax accounts will vastly increase direct medical care, which cuts out middlemen to lower costs and gives patients more choice.
• For family care needs, direct medical care is known as direct primary care, which offers families all their primary medical care needs for one low monthly membership fee – no insurance or middlemen necessary. Patients can get access to their regular doctors at any time through call, text, or telemedicine.
• For other procedures – at surgery centers, for instance – direct medical care means transparent cash prices, which will allow patients to price shop, lowering prices.
• Cash prices are often cheaper than what insurers can offer. According to Vanderbilt economist Larry Van Horn, cash healthcare prices are 40 percent lower than insurers’ negotiated rates.
• Whether it’s a monthly membership fee for Direct Primary Care, posted pricing at a surgical center, or fee for service from a specialist, patients will be able to get healthcare at a lower price and have more choice.

Reform: Eliminate rules that restrict the use of direct medical care and encourage patients to take advantage of alternative avenues to receiving health services.

Lowering insurance premiums through increased choice and price transparency.

• In every industry where we have more choice and price transparency, we see lower prices and more innovation; healthcare is not an exception to this economic fact.
• End inefficient federal rules and requirements on private insurance plans and allow states to expand and regulate their private insurance markets to offer more choice and better options.
• Let patients purchase plans that are customized to their needs like they do with auto and life insurance
• Rather than another centralized federal experiment, we should remove federal regulations on this private market and let the state insurance departments and lawmakers tackle problems or concerns. What works best in New York may not work for Kansas. You should not be required to pay for features that you don’t want.
• End federal restrictions on modern healthcare advances like telemedicine, which allows patients to access their physicians via text, email and SKYPE, decreasing time spent waiting in doctors’ offices to be seen for minor issues.

Reform: End rules that regulate what should be included in a healthcare plan, how you can access it and when you can keep it.

Lowering drug prices.

• Return savings back to the patients instead of medicine middlemen; right now $250 billion per year goes to middlemen.
• Nearly all the recent increases in drug list prices can be chalked up to rising rebates.

Reform: Repeal the legislation that exempts these middlemen from penalty for violating the federal anti-kickback law.

Protecting against pre-existing conditions.

• Patients will be covered even if they have a pre-existing condition.
• Allow employees to use Personal Health Management Accounts to buy their own health insurance which prevents any lapse in coverage when changing jobs. This change helps address some of the problems of pre-existing conditions.

Reform: Give states the autonomy to guarantee a health insurance policy that cannot raise people’s rates or drop them from coverage due to health conditions. Many states have these laws in place, but they are moot under the ACA. Others can amend their laws to include it, or they can set up risk pools.​

And ...
2) Reform MedicAID into a government run health insurance system that is pro-rated for income level and the premium based on national averages - 20%.

I think if you do that, most moderates thinking about a Democrat will jump over to Trump because we get national health care coverage for everyone, and keep our private insurance too.

You can't, it was never designed to work, it was designed to slowly kill off private medical insurance.

 

[Markle]

Providing affordable healthcare for all does work

Provided by who paid for by who?

 

[Markle]

So why not save MedicAID by converting it to a government run insurance program?

And why do you think that the MedicAID low reimbursement rates wont become the norm for a universalized Medicare system?

That is all you will do, turn Medicare which does work into a MedicAID 2 that does not work.

 

[Markle]

And it's not an even comparison anyway. Socializing health insurance is not the same as socializing healthcare.

 

[dblack]

I think having both administer different aspects of healthcare is good. Allow the States to continue catering to the specific needs of their inhabitants while the Feds ensure all are covered at some basic level and handle the non-State citizenry.

If you had states run things, you would have 50 laboratories going to see what works well and what does not in actual time, instead of listening to some spin troll insist we all put our eggs in one basket and how much worse things would have been had we not done so.

If we the people ran things, instead of government, we'd have 300 million laboratories.

What is wrong with letting conservatives states have a conservative government and liberal states having a liberal government, or do you like half the country wanting to secede from the union every Presidential election?

Those that wish to limit the power of a federal Congress that can't manage to attain a public opinion poll that is above 20% approval, yet we still call ourselves a democracy, I suggest you begin to support the movement for state rights, which is called the Article V movement.

The Founding Fathers correctly were concerned about a Federal government that would become too powerful and corrupt, which we see today, so that is why they included in the Article V amendment in the Constitution the power of the states to amend the Constitution. It has never been done before, but currently about a dozen have joined and all that is needed is 2/3 of the states to agree.

Once they do, they can implement amendments such as term limits for Congress and a balanced budget amendment of some sort for Congress to have to go by. This is the ONLY way to limit the power and corruption that exists in the US Congress. There is no other legal way to go about it because they won't impose term limits on themselves nor will they restrict their own spending in any way willfully.

About 80% of Americans favor doing this yet the will of the people will continue to be ignored until we rise up.

State level would be a little better than federal, but government shouldn't control access to health care - at any level.

 

[dblack]

Does that sound like the foundation of a smart, efficient health care system to you?
.

Answer, "Fuck no."
Want more?

Grumble, please stop grumbling, and tell us what you mean? I'd like to know more on it....

Enquiring minds want to know.

 

[kiwiman127]

Being as Little Trumpsters think it's OK to let the current healthcare system continue to bankrupt huge swaths of the American public, while letting the healthcare industry raise their prices unfettered, things will never get better, only worse.
With Medical Bills Skyrocketing, More Hospitals Are Suing for Payment

Do Medical Bills Really Bankrupt America's Families?

Nothing gets done about controlling the cost of healthcare in America. At least 99% of other countries, have their government control the cost of healthcare. But here in the US, we let the cost of healthcare increase faster than the GDP and faster than wage growth.
I'm all for Public Option, leave it to the consumer to decide what kind of healthcare insurance they can afford, including a government plan as an option.
Healthcare costs are going to bring down the US economy.
Rising health-care costs a 'huge threat' to US economy: Cleveland Clinic's Toby Cosgrove
And Little Trumpsters want us to sit on our hands addressing healthcare cost, even at the cost of a failed US economy. Pathetic.