Ok. Many of you probably think that MediaMatters is nothing but a bunch of pinko, commie, liberal, lefties. Well, they are a lot of them over there, and I fit right in with 'em! But they also have more than a couple regular posters who lean sharply conservative. I've locked horns with many of them over the past couple years, and some of them have posed some very reasonable questions that deserve answers.
So here goes.
Why should abortion be covered? You say you don't cover other voluntary procedures, why cover abortion? Isn't abortion a 'voluntary procedure'?
First off, let me say that if you feel abortion is IMMORAL, I'm with you! The thing is... so are most liberals and pro-lifers! MORALITY isn't the really key issue here, it's LEGALITY. And the difference between a liberal (like me) and a pro-lifer is that while I BELIEVE (meaning, IN MY OPINION) that abortion is immoral, I DO NOT feel the need to infect my opinion onto anyone else. If you don't like abortions? DON'T HAVE ONE. No one will ever force you to and whatever anyone else does is none of your business to tell them one way or the other.
Second... There is more to excluding voluntary procedures than just the fact that they're voluntary. It's also because they're EXPENSIVE and there's no reason anyone else should have pay for them! The alternative to having a boob-job is NOT having one: Which costs nothing. The alternative to abortion is BIRTH, which always costs MORE. I'm not begrudging those who wish to have children (another voluntary decision, mind you!) BIRTH will always be fully covered, but if a person wants to ASK LESS of the system by terminating the pregnancy early, as long as the procedure remains legal there is no rational reason not to do this! (Fair enough: If you managed to OUTLAW it, it won't be covered. Of course, in theory, it won't be PERFORMED either, so the question of coverage is moot either way.
Which brings me to the next part of the question:
What if I don't want to subsidize someone else getting one?
This is just stupid for many reasons. First of all, if you currently buy private insurance, chances are you're already doing this. You are not paying for anything other than YOUR COVERAGE and YOUR FAMILY'S. So mind your own business and stop worrying about the choices other people make with theirs! And again, we can't have individuals deciding what they do and don't want to cover for themselves, or you lose all the benefits of risk pooling - which is how our CURRENT SYSTEM works! I'm sure 90% of AIDS patients didn't think they'd ever get AIDS, and thus may have been tempted to exclude AIDS coverage if they could save a few bucks a months. And while SOME may have changed their behaviors, most would still eventually get the disease. (And where would THAT leave them now?)You can't have people estimating their own chances of getting something. That's what insurance companies are for and they have thousands of experts crunching reams of data all day long to figure it out. So let THEM figure that out. Just take you gold-star, universal coverage and stop whining about it!
This same line of reasoning, BTW, applies to pharmacists who refuse to fill prescriptions for birth-control pills (for example) for religious reasons. This is BULLSHIT. Anyone pharmacist who refuse to fill a doctors prescription for moral reason should lose their license and business. PERIOD. Why, you ask? What about respecting people's beliefs, you ask? Again, BULLSHIT. If you're Catholic (for example) and you believe the use of birth control is a sin, then YOU can't use, and YOU can't be partners with someone else who does! The Catholic Church's prohibition of contraception DOES NOT (and by the First Ammendment to the Constitution, CAN NOT) APPLY to non-Catholics, and isn't observed by 99% of practicing Catholics anyway! A pharmacist refusing to let SOMEONE ELSE use contraception is nothing more than him or her forcing their religious beliefs onto another person. Someone else's sin is not theirs and don't give me any hogwash about enabling it, either. What's next? Holding gun manufacturer's responsible for every murder that's committed? Not THIS liberal!
Why do we even need this? What wrong with the FREE MARKET setting the price? Wont this lead to RATIONING?
First things last. The 'free market' IS a system of rationing. That what market forces DO. They give resources to those willing (and able) to pay the marker price for a given good or service. Those that aren't willing (or able) to pay DON'T GET the good or service. And the volume available (supply) is only a function of the market price. It is not a function of actual need - the opposite in fact, the more something is needed, the HIGHER the price. In this way the free market serves to ration EVERYTHING.
And that is EXACTLY why it's a lousy way to manage HEALTH CARE: Because the demand curve for health care is essentially flat. Here's what that means in English: Let's say a bag of Doritos cost $100. What would happen? First of all, a WHOLE LOT of people would start making Doritos! But who would pay that much when POTATO CHIPS still cost $1? You see? There a diminished demand for certain goods at higher prices because I have COMPETING CHOICES. And thus the price is kept low, to compete with those alternatives. If I can't afford a Mercedes, I can buy a Chevy. If I can't afford a house, I can rent an apartment. If I can't afford fillet, I can buy chuck.
But if I can't afford chemo... (and I'll give you a clue: nobody can)... then I DIE.
Now, death may be the low-cost alternative to most health care procedures, but it's not one I'm ever likely to choose, is it? It's basically not an acceptable alternative for anyone. So HOW MUCH will your triple-bypass cost? Well... How much do you have?! Since I know that you won't go without, and I know that there's no competing alternatives, there's nothing to reign in my cost. 'Give me all you got and more!' is therefore the only answer one can expect from a free market. (Thankfully, most hospitals are non-profits entities!)
AND not only is the demand curve FLAT, but the SUPPLY curve is unique as well. You see, the supply of oil, potato chips, cars or beef can fluctuate. If demand for something goes UP, we can usually just make more. But the number of DOCTORS we have at any time doesn't really go up with demand, because doctors come from MEDICAL SCHOOLS and med schools take only a very small percentage of applicants. And medical fellowhips (needed for specialties) only take a small percentage of applicants from that pool! And they're not about to lower their standards just because doctors salaries have gone up and more people want to be doctors. So we can't really allow the supply to fluctuate like a regular commodity does, because it takes to long to increase the supply!
What about the unemployed? Or illegals aliens? Why should I pay for them?
First off, you already are. The unemployed already get coverage: Medicaid. And you already pay for that. You still will, but in a less dysfunctional system. You also already subsidize the UNINSURED (which includes illegal aliens) in exactly the way I've already described. SO get over it. Better they get GOOD TREATMENT that costs everyone LESS than get lousy treatment that costs everyone more.
And we REALLY don't want hospitals to put off treatment until they verify legal status, do we? Imagine you've had a stroke or heart attack. Every second counts. Do you really want there to be ANY possibility that your treatment is delayed? That could be fatal! So, just as they are now, hospitals will treat their patients according to medical need, NO QUESTIONS ASKED. They don't have to worry: THEY'LL GET PAID. And is there really any benefit to saying, "Sorry, that guy was an illegal, so we won't pay you for treating him?" NO! Now we're right back to the hospitals baking in unreimbursed expenses, just as they do now, and WE END UP PAYING ANYWAY!!! So get over it. There's no way to avoid it without screwing everything up with red tape and you won't save a single penny anyway!
JUST TAKE YOUR UNIVERSAL COVERAGE AND STOP WHINING!!!
BTW, this is one of my pet peeves with conservatives on a lot of things... They're always more concerned about making sure that the WRONG PEOPLE (whoever they are) don't benefit, than they are are making sure that the RIGHT PEOPLE (whoever they are) don't get hurt. In this case, they'd create a whole system of gov't bureaucracy that will end up killing someone who was entitled to care just to stop someone who isn't from receiving it. Not only is this a senseless trade off, going against the very conservative Principal of limited gov't and making the conservative's fear of a gov't bureaucrat getting between you and your health care a reality, but WHAT IS SO WRONG with saving a life?! Why should the HOSPITAL get punished, by not being paid for services rendered (and costs incurred,) just because they saved the wrong person's life. That's just... psychotic. So get over your xenophobia, conservatives. And besides, there's no reason that the Mexicans would flood over our borders just to get free health care... THEY ALREADY GET PUBLIC HEALTH IN MEXICO!
SO let me knwo if you have any other questions. I'll do my best to satisfy you. I've spent a lot of time thinking about this from many different angles, and I'm confident it's the best way to go. So I'll take all comers!
Now let me have it!
LOL
Who IS this guy?!
Political Talk Show Host and Internet Radio Personality. My show, In My Humble Opinion, aired on RainbowRadio from 2015-2017, and has returned for 2021! Feel free to contact me at niceguy9418@usa.com. You can also friend me on Facebook.
---------------------------------------------------------------------------------------------------------------
Saturday, September 12, 2009
Some Strengths & Benefits of my health care plan
Question: How does giving everyone everything LOWER costs?!
A big way that the cost of any given procedure will be result from the hospital KNOWING that when they treat someone, they WILL get paid. So they won't have to bake-in extra costs assuming a certain percent loss, based on a bunch of patients NOT paying. (Why do YOU think it costs $10 dollars to get an aspirin in the hospital?) Also, the Hospital won't get low-balled anymore for medicaid patients. Since EVERYONE will be in the same plan, the hospital will get paid the same for any given petient they take. Again, this reduces the unreimbursed costs that they currently pass onto everyone else. (And why should it matter WHO the hospital is treating? From their perspective, does a triple bypass cost less to give a poor person than a rich person? They should get paid for the SERVICE not the PATIENT!)
Another way costs are lowered is by providing people with incentives (or at worst removing the disincentives) to make the kinds of decisions that benefit the system, namely: GET TREATMENT EARLY! For example: Right now, if someone gets an earache, and they don't have insurance, they don't go to the doctor; not today, not tomorrow not next week, even when the pain gets worse. A month later, after the infection has spread, they show up in the ER; unconscious and on death's door with 105 degree fever. After spending the night in the ER, they're moved to the ICU. Then they're there for a week, getting exotic, aggressive anti-biotics intravenously, after which they either DIE (and likely don't pay) or LIVE, but declare bankrupcy because they can't pay. Ten's, maybe Hundreds of thousands of dollars worth of unreimbursed costs (and possibly a patient death) now get s passed onto everyone else over something that could have been solved with a single course of simple $10 anti-biotics if it had been treated early.
Because, with health care, sometimes giving MORE in the right place at the right time cost a LOT LESS. This also frees up the ER, ICU and Specialized resources that would otherwise be consumed, thus lowering the cost for THOSE resources. (See? My plan just keeps WORKING!)
Getting people to go to their primary care providers at the first sign of trouble lowers the overall cost of treating any given condition AND improves the likelyhood of a positive outcome. Putting of treatment for lack of coverage ALWAYS costs more, can only INCREASE to chance of a negative outcome, thus leading to more costs being passed onto to those who CAN and DO pay. This is also the answer to the concern (of many Conservatives) that the RICH will SUBSIDIZE the POOR. Well... they may, but no more than they already are, for the very reason I've just laid out. The thing is, under my plan, they'll do a LOT LESS of this. The theory here is NOT to have the RICH subsidize the POOR, but rather to have the HEALTHY subsidize the SICK.
This is the one part of our current system that actually works very well, and it works better the more people you have in a given risk pool. So how about... ALL OF AMERICA?! That should make the cost per person as low as possible.
Question: SO... who pays more and who pays less?
An individual who currently buys insurance, though an employer's benefit program, will pay almost the same as he does now, but get better coverage. Someone who buys insurance ON THEIR OWN will pay a LOT less.
Someone with NO INSURANCE? Yeah, they'll pay more... But they'll get coverage. Let's say your in this group and making OVER median income (about $50,ooo for an individual) but you work for a small company and they don't offer health care. What you'd pay in increased taxes is roughly what your share of the premium would be if your employer DID offer health insurance. If you make LESS than median income, we can cut you some slack. Since you're probably paying NOTHING now (and we're subsidizing you anyway, as I've explained above) ANYTHING would be better than NOTHING. So you'll pay some greatly reduced amount. Below the poverty line? (for example) You'll pay nothing, just as you do today, but you'll get better coverage than medicaid currently offers.
You might ask: Why shouldn't healthy people be allowed to opt out if they choose?
Simple: It doesn't work. First of all: How do you how long you;ll be 'healthy'? Young people all think they'll live forever and we (adults) all know that just ain't true. And besides: a lot of 'healthy' exercise. Which means they can be still be INJURED. So what if they're not sick? If they blow out their knee or rupture a tendon, their will still be COSTS, and that will be more than they can afford. And if they don't pay, THE REST OF US END UP PAYING! So no: EVERYONE puts in who can. Period. It compulsory. Same goes for the whole lower premium / higher deductible argument. It doesn't work our form most in the long run, and if you can't pay the difference, WE end up paying. NO. EVERYONE puts in. DONE. That's the only way it works for EVERYONE.
What about those small companies that can't afford insurance?
Well, if they make a PROFIT, they can always afford a 2% or 3% tax increase. If you make a dollar, after all your employees and other costs are paid, you can afford 3 cents. If you make $100 you can afford $3 and if you make a $Million you can afford $30,000. You see? If you small and don't make enough to afford the HUGE FIXED cost of health insurance, you'll pay a much smaller amount. And if you do make scads of money, then you have no excuse. And below a certain amount (and amount that most all small companies will never meet) you'll still be paying less. But employers pick up about 80% of the tab now, and they'll need to continue to do so. But if it's a TAX, they'll get a break exactly when they need it. (Unlike with private companies who'll want to be paid whether you made a profit or not!)
The other benefit is that the cost of retaining an employee is less, so companies can afford to hire more people, since their health care tab will be a function of the money (profit now, not revenue) they make rather than the number of employees they have. This will increase the number of decent paying jobs, and thus also increase the number of people paying into the system!
SO IT'S SUSTAINABLE! The more you look at it the more you realize that all the right incentives are there!
In my next post I will take on some of the more controversial questions about my Health Care Plan.
A big way that the cost of any given procedure will be result from the hospital KNOWING that when they treat someone, they WILL get paid. So they won't have to bake-in extra costs assuming a certain percent loss, based on a bunch of patients NOT paying. (Why do YOU think it costs $10 dollars to get an aspirin in the hospital?) Also, the Hospital won't get low-balled anymore for medicaid patients. Since EVERYONE will be in the same plan, the hospital will get paid the same for any given petient they take. Again, this reduces the unreimbursed costs that they currently pass onto everyone else. (And why should it matter WHO the hospital is treating? From their perspective, does a triple bypass cost less to give a poor person than a rich person? They should get paid for the SERVICE not the PATIENT!)
Another way costs are lowered is by providing people with incentives (or at worst removing the disincentives) to make the kinds of decisions that benefit the system, namely: GET TREATMENT EARLY! For example: Right now, if someone gets an earache, and they don't have insurance, they don't go to the doctor; not today, not tomorrow not next week, even when the pain gets worse. A month later, after the infection has spread, they show up in the ER; unconscious and on death's door with 105 degree fever. After spending the night in the ER, they're moved to the ICU. Then they're there for a week, getting exotic, aggressive anti-biotics intravenously, after which they either DIE (and likely don't pay) or LIVE, but declare bankrupcy because they can't pay. Ten's, maybe Hundreds of thousands of dollars worth of unreimbursed costs (and possibly a patient death) now get s passed onto everyone else over something that could have been solved with a single course of simple $10 anti-biotics if it had been treated early.
Because, with health care, sometimes giving MORE in the right place at the right time cost a LOT LESS. This also frees up the ER, ICU and Specialized resources that would otherwise be consumed, thus lowering the cost for THOSE resources. (See? My plan just keeps WORKING!)
Getting people to go to their primary care providers at the first sign of trouble lowers the overall cost of treating any given condition AND improves the likelyhood of a positive outcome. Putting of treatment for lack of coverage ALWAYS costs more, can only INCREASE to chance of a negative outcome, thus leading to more costs being passed onto to those who CAN and DO pay. This is also the answer to the concern (of many Conservatives) that the RICH will SUBSIDIZE the POOR. Well... they may, but no more than they already are, for the very reason I've just laid out. The thing is, under my plan, they'll do a LOT LESS of this. The theory here is NOT to have the RICH subsidize the POOR, but rather to have the HEALTHY subsidize the SICK.
This is the one part of our current system that actually works very well, and it works better the more people you have in a given risk pool. So how about... ALL OF AMERICA?! That should make the cost per person as low as possible.
Question: SO... who pays more and who pays less?
An individual who currently buys insurance, though an employer's benefit program, will pay almost the same as he does now, but get better coverage. Someone who buys insurance ON THEIR OWN will pay a LOT less.
Someone with NO INSURANCE? Yeah, they'll pay more... But they'll get coverage. Let's say your in this group and making OVER median income (about $50,ooo for an individual) but you work for a small company and they don't offer health care. What you'd pay in increased taxes is roughly what your share of the premium would be if your employer DID offer health insurance. If you make LESS than median income, we can cut you some slack. Since you're probably paying NOTHING now (and we're subsidizing you anyway, as I've explained above) ANYTHING would be better than NOTHING. So you'll pay some greatly reduced amount. Below the poverty line? (for example) You'll pay nothing, just as you do today, but you'll get better coverage than medicaid currently offers.
You might ask: Why shouldn't healthy people be allowed to opt out if they choose?
Simple: It doesn't work. First of all: How do you how long you;ll be 'healthy'? Young people all think they'll live forever and we (adults) all know that just ain't true. And besides: a lot of 'healthy' exercise. Which means they can be still be INJURED. So what if they're not sick? If they blow out their knee or rupture a tendon, their will still be COSTS, and that will be more than they can afford. And if they don't pay, THE REST OF US END UP PAYING! So no: EVERYONE puts in who can. Period. It compulsory. Same goes for the whole lower premium / higher deductible argument. It doesn't work our form most in the long run, and if you can't pay the difference, WE end up paying. NO. EVERYONE puts in. DONE. That's the only way it works for EVERYONE.
What about those small companies that can't afford insurance?
Well, if they make a PROFIT, they can always afford a 2% or 3% tax increase. If you make a dollar, after all your employees and other costs are paid, you can afford 3 cents. If you make $100 you can afford $3 and if you make a $Million you can afford $30,000. You see? If you small and don't make enough to afford the HUGE FIXED cost of health insurance, you'll pay a much smaller amount. And if you do make scads of money, then you have no excuse. And below a certain amount (and amount that most all small companies will never meet) you'll still be paying less. But employers pick up about 80% of the tab now, and they'll need to continue to do so. But if it's a TAX, they'll get a break exactly when they need it. (Unlike with private companies who'll want to be paid whether you made a profit or not!)
The other benefit is that the cost of retaining an employee is less, so companies can afford to hire more people, since their health care tab will be a function of the money (profit now, not revenue) they make rather than the number of employees they have. This will increase the number of decent paying jobs, and thus also increase the number of people paying into the system!
SO IT'S SUSTAINABLE! The more you look at it the more you realize that all the right incentives are there!
In my next post I will take on some of the more controversial questions about my Health Care Plan.
The Solution to the Health Care Problem
The health care debate rages on. President Obama took yet another opportunity to make his case, and yet all the media can focus on was Representative Wilson's outburst, "YOU LIE!" (Never getting around to letting there audience know that Rep. Wilson (R) was, in fact, LYING.) So Democrats keep trying to compromise, the Republicans keep trying to obstruct and the media remains complicit with the RIGHT WING but still refusing to inform people about the ACTUAL BILL, in favor of repeating RIGHT WING LIES... like those death panels on page 425? Yeah: THEY AIN'T THERE! But you won't get that form the media who would rather report on a fight than actually INFORM people.
So once against the media's forfeiture of credibility, the Republican's lack of brains and the Democrat's lack of balls have doomed us all. And that's not even to say that I LIKE Obama's bill, it's just better than anything ELSE I've seen so far...
Except for MY SOLUTION. Which would solve everything, and satisfy everyone. Over on MediaMatters, even the conservative posters had to concede to it's quality. So here's MY PLAN:
PART ONE: The Government's Role
The primary role of the GOVERNMENT, meaning the LEGISLATURE is to DEFINE the COVERAGE. Put in the simplest terms: Everyone & everything is covered. You could make this 100%, with NO out of pocket expense or could have a SMALL (~$20) co-pay, just to deter some idiot going to the ER for a hangnail.
Now... Just some common sense details: No, I wouldn't cover elective/non-reconstructive cosmetic surgery. I wouldn't cover any 'alternative medicine' (which is all BS anyway!); and I'd also be sorely tempted to exclude lifestyle drugs (Cyalis/Viagra/Levitra?) but I guess I could be persuaded to include those. Abortion would be covered. If you don't like that? Grow up. Seriously. (I'll address why this is the case in another post, "Questions Answered about My Plan, because people have asked.) And mental health would get the same level of coverage as everything else. There's no reason to treat the brain any differently from any other organ that has something go wrong with it. (Currently most Ins.Co shaft mental health drugs big time.) Many things not currently covered, like Speech therapy to treat Autism, would also be covered.
The exact details on every little things can be worked out later, but the GUIDING PRINCIPLE is: If you're sick, and we can heal you, your healed. No fuss, no muss and little to no out of pocket expense! No one dies of anything we can fix, and no one EVER goes bankrupt for getting sick. Period.
PART TWO: So who actually RUNS it?!
Utilizing the enormous network of health care cast negotiators that already exists, the program will be managed by the insurance companies, much in the way they do now. The big difference is that they can't refuse coverage. Everyone gets treated, and the hospital (doctor, etc...) gets paid for everyone they see. DONE.
They will adjust their premiums to figure out what it would cost and then bill the government for that service. What stops them from just GOUGING the government? Simple: COMPETITION. They will have to bid to cover people. And once they get someone they have them for LIFE. SO: Every time a baby is born, they will want to snatch up as many babies as they can since, once born and vaccinated, most babies represent about 30 years of little to no cost. Since they'll be paid to cover them ANYWAY, they'll want as many of those babies as they can get. If their price is to high, their competitors will snatch them up and their current case load just gets older. (Which in the health care world is a disaster! If you can get paid the same for babies as for the over 65's, YOU WANT THEM!)
So they will negotiate prices. The difference between what they negotiate and what the government pays - THEY KEEP. So there's still a profit motive and opportunity. (But for PROVIDING care, not DENYING it!) Going back to PART ONE, to maintain "universal coverage" and to avoid both rationing and robbing people of control over their own care, they will be required to reimburse doctors/hospitals/etc... at a level that (for example) insures that any given person will have a choice of at least three doctors within 50 miles of their home (100 miles in rural areas) that will perform a given test or procedure at no additional cost to the patient. (Save for ~$20 co-pay, if applicable.) Some Doctors can still charge more, if they think the market will bear it, but the difference will have to be paid by the patient. But the standard payment will have to be enough to make sure I have at least three Doctors to choose from with no additional expense. This gives doctors an incentive not to gouge insurance companies because there will be great pressure for them to be among the "free" providers - or at least very close to "free."
Now - I've also thought about how to reimburse at a higher level for specialists. First off, we'll need some way of identifying who the specialists are. It could be years of service, education, experience... whatever. The HOW isn't really important. It would likely been done however it's done now. So let's say someone has a complicated case and needs a specialist. Teh specialist won't be working for the regular rate. So does that mean that the patient now has to pay? NO. Here's how it would work: Specialists get reimbursed at a higher rate, to the point where the "choice of three" doctrine is maintained. So who decides is you get to see the specialist? Not the government (as you may be suspecting, but) YOUR DOCTOR. That's right. You see the regular doctor. When he sees your complicated case, assuming he's not a specialist himself, he'll think "No way am I dealing with THAT, for what they're paying me!" (Since he's only getting the base rate) and he'll refer you to a specialist or three. If a doctor is willing to give up the chance to make a little money (because he judges that what's really needed is beyond what he's getting paid, and thus he'll be at a loss) that's good enough for me. Off to see the specialist!
PART THREE: So how do we PAY for it?
OK, you guessed it: The government will pay the insurance bills with increased taxes. But stay with me now! It's not nearly as bad as you think. In fact, YOU MAY NOT EVEN NOTICE. And corporations may even prefer it!
The increased taxes will be offset by the fact that you're no longer paying premiums. This new tax would be structured such that most people's take home pay would not be affected + or -. This tax would be partially based on income (to give a break to anyone making under median income) but would also vary with martial status and number of children, much the way your premium does now. But the guiding principle here is that your take home pay will be as close as possible, to what you're taking home now.
Corporate taxes increase will increase to, such that the revenue generated will be the same as what is currently being paid in premiums - this is meant to be revenue-neutral. The benefit of this is that in the form of a tax, it will not have to be paid by struggling firms, who would otherwise still have huge, fixed health care costs, and more of the bill will be footed by companies doing really well. Who could just as easily have a tough year next year, and be in the other boat themselves. (Don't believe me? As late as the 1990's it was UNTHINKABLE that GM, still the worlds largest and richest corporation at the time, would EVER declare bankruptcy.) So while ExxonMobil might not like the increased taxes now, 5 years from now (let's say) when they're approaching red ink, rather than BIG FIXED COSTS for health care, their cost will be... NOTHING! And that can easily be the difference between making a profit and taking a loss!
PART FOUR: So what controls costs?
Cost are controlled automatically, through market forces in a more functional manner than they are today: Doctors will charge what the market bears, but will have an incentive to be among those that are "free" to the patient. Insurance companies will be in competition with each other to bid for new babies to cover. Free market principals apply, but will be used to insure coverage, as well as control cost. But rather than let supply and demand drive price, we'll use price to drive supply, and competition to keep Price down.
YOU see a DOCTOR. The DOCTORS deal with the INSURERS. The INSURERS deal with the GOVERNMENT. And the GOVERNMENT bill YOU (and your EMPLOYER.)
That's the basic structure. I'm going to do a separate post on strengths and benefits and also for any questions I get here, and for questions I've gotten from the MediaMatters posters.
So once against the media's forfeiture of credibility, the Republican's lack of brains and the Democrat's lack of balls have doomed us all. And that's not even to say that I LIKE Obama's bill, it's just better than anything ELSE I've seen so far...
Except for MY SOLUTION. Which would solve everything, and satisfy everyone. Over on MediaMatters, even the conservative posters had to concede to it's quality. So here's MY PLAN:
PART ONE: The Government's Role
The primary role of the GOVERNMENT, meaning the LEGISLATURE is to DEFINE the COVERAGE. Put in the simplest terms: Everyone & everything is covered. You could make this 100%, with NO out of pocket expense or could have a SMALL (~$20) co-pay, just to deter some idiot going to the ER for a hangnail.
Now... Just some common sense details: No, I wouldn't cover elective/non-reconstructive cosmetic surgery. I wouldn't cover any 'alternative medicine' (which is all BS anyway!); and I'd also be sorely tempted to exclude lifestyle drugs (Cyalis/Viagra/Levitra?) but I guess I could be persuaded to include those. Abortion would be covered. If you don't like that? Grow up. Seriously. (I'll address why this is the case in another post, "Questions Answered about My Plan, because people have asked.) And mental health would get the same level of coverage as everything else. There's no reason to treat the brain any differently from any other organ that has something go wrong with it. (Currently most Ins.Co shaft mental health drugs big time.) Many things not currently covered, like Speech therapy to treat Autism, would also be covered.
The exact details on every little things can be worked out later, but the GUIDING PRINCIPLE is: If you're sick, and we can heal you, your healed. No fuss, no muss and little to no out of pocket expense! No one dies of anything we can fix, and no one EVER goes bankrupt for getting sick. Period.
PART TWO: So who actually RUNS it?!
Utilizing the enormous network of health care cast negotiators that already exists, the program will be managed by the insurance companies, much in the way they do now. The big difference is that they can't refuse coverage. Everyone gets treated, and the hospital (doctor, etc...) gets paid for everyone they see. DONE.
They will adjust their premiums to figure out what it would cost and then bill the government for that service. What stops them from just GOUGING the government? Simple: COMPETITION. They will have to bid to cover people. And once they get someone they have them for LIFE. SO: Every time a baby is born, they will want to snatch up as many babies as they can since, once born and vaccinated, most babies represent about 30 years of little to no cost. Since they'll be paid to cover them ANYWAY, they'll want as many of those babies as they can get. If their price is to high, their competitors will snatch them up and their current case load just gets older. (Which in the health care world is a disaster! If you can get paid the same for babies as for the over 65's, YOU WANT THEM!)
So they will negotiate prices. The difference between what they negotiate and what the government pays - THEY KEEP. So there's still a profit motive and opportunity. (But for PROVIDING care, not DENYING it!) Going back to PART ONE, to maintain "universal coverage" and to avoid both rationing and robbing people of control over their own care, they will be required to reimburse doctors/hospitals/etc... at a level that (for example) insures that any given person will have a choice of at least three doctors within 50 miles of their home (100 miles in rural areas) that will perform a given test or procedure at no additional cost to the patient. (Save for ~$20 co-pay, if applicable.) Some Doctors can still charge more, if they think the market will bear it, but the difference will have to be paid by the patient. But the standard payment will have to be enough to make sure I have at least three Doctors to choose from with no additional expense. This gives doctors an incentive not to gouge insurance companies because there will be great pressure for them to be among the "free" providers - or at least very close to "free."
Now - I've also thought about how to reimburse at a higher level for specialists. First off, we'll need some way of identifying who the specialists are. It could be years of service, education, experience... whatever. The HOW isn't really important. It would likely been done however it's done now. So let's say someone has a complicated case and needs a specialist. Teh specialist won't be working for the regular rate. So does that mean that the patient now has to pay? NO. Here's how it would work: Specialists get reimbursed at a higher rate, to the point where the "choice of three" doctrine is maintained. So who decides is you get to see the specialist? Not the government (as you may be suspecting, but) YOUR DOCTOR. That's right. You see the regular doctor. When he sees your complicated case, assuming he's not a specialist himself, he'll think "No way am I dealing with THAT, for what they're paying me!" (Since he's only getting the base rate) and he'll refer you to a specialist or three. If a doctor is willing to give up the chance to make a little money (because he judges that what's really needed is beyond what he's getting paid, and thus he'll be at a loss) that's good enough for me. Off to see the specialist!
PART THREE: So how do we PAY for it?
OK, you guessed it: The government will pay the insurance bills with increased taxes. But stay with me now! It's not nearly as bad as you think. In fact, YOU MAY NOT EVEN NOTICE. And corporations may even prefer it!
The increased taxes will be offset by the fact that you're no longer paying premiums. This new tax would be structured such that most people's take home pay would not be affected + or -. This tax would be partially based on income (to give a break to anyone making under median income) but would also vary with martial status and number of children, much the way your premium does now. But the guiding principle here is that your take home pay will be as close as possible, to what you're taking home now.
Corporate taxes increase will increase to, such that the revenue generated will be the same as what is currently being paid in premiums - this is meant to be revenue-neutral. The benefit of this is that in the form of a tax, it will not have to be paid by struggling firms, who would otherwise still have huge, fixed health care costs, and more of the bill will be footed by companies doing really well. Who could just as easily have a tough year next year, and be in the other boat themselves. (Don't believe me? As late as the 1990's it was UNTHINKABLE that GM, still the worlds largest and richest corporation at the time, would EVER declare bankruptcy.) So while ExxonMobil might not like the increased taxes now, 5 years from now (let's say) when they're approaching red ink, rather than BIG FIXED COSTS for health care, their cost will be... NOTHING! And that can easily be the difference between making a profit and taking a loss!
PART FOUR: So what controls costs?
Cost are controlled automatically, through market forces in a more functional manner than they are today: Doctors will charge what the market bears, but will have an incentive to be among those that are "free" to the patient. Insurance companies will be in competition with each other to bid for new babies to cover. Free market principals apply, but will be used to insure coverage, as well as control cost. But rather than let supply and demand drive price, we'll use price to drive supply, and competition to keep Price down.
YOU see a DOCTOR. The DOCTORS deal with the INSURERS. The INSURERS deal with the GOVERNMENT. And the GOVERNMENT bill YOU (and your EMPLOYER.)
That's the basic structure. I'm going to do a separate post on strengths and benefits and also for any questions I get here, and for questions I've gotten from the MediaMatters posters.
Monday, September 7, 2009
First Post: About Me, Da Rulz
Hello all!
My name is "Niceguy Eddie" and I've been active on various political comment boards for awhile now, and have finally gotten around to setting up a blog of my own. My posts will center around my own political positions (most, but not all, of which tend liberal) and personaly philosophy as well as my take on current events. Occasionally I may get into non-political stuff, but that will be the execption. Hopefully the posts will generate some debate - and I completely welcome both liberals, moderates and conservatives to join in. For now, I've very much got a "take on all comers" type attitude, so I welcome all you hard-core right-wingers to come on in and give me your best shot and the be ready for some re-edumacation.
Forum rules? What rules?
JK. For now I really only have two:
1) Stick to the topic. If you do leave an off-topic comment I may take the subject up at a later time, but me saying as much is about the best you'll get from me for an off-topic post. EMAILING ME (at niceguy9418@usa.com) is a much better way to get me to start a new line of discussion.
2) Be respectful TO EACH OTHER. You don't really have to be respectful to me - I can take it - just be warned that I'll respond in kind. If you debate logically, reasonably and respectfully, I sincerely hope that you will find me a worthy opponent. If you mindlessly spout Right wing talking points, treat "liberal" or "progressive" like epithets, or just come on to abuse me and roll around in the mud... Well... I sincerely hope that you will find me a worthy opponent. I am a 'nice guy' but I have absolutely no patience for suffering fools. If you want to tangle with me, you'd better do your homework!
The other obvious rule, that shouldn't really even need to be stated: NO SPAM. (Links are fine, but keep them on-topic.)
You'll notice there's no rule about foul languange. Yeah that's right: FUCK THAT. If you want to let it loose here, go right ahead. SHIT PISS FUCK CUNT COCKSUCKER MOTHERFUCKER TITS, NIGGER... Did I leave anything out? Just realize that areguments littered with expletives are not going be taken as seriously as ones that aren't. (And cutsey little substitutes like "$#!+" get taken even less seriously!) But I'm not uptight about it. It don't bother my ass none.
So let's go!
My name is "Niceguy Eddie" and I've been active on various political comment boards for awhile now, and have finally gotten around to setting up a blog of my own. My posts will center around my own political positions (most, but not all, of which tend liberal) and personaly philosophy as well as my take on current events. Occasionally I may get into non-political stuff, but that will be the execption. Hopefully the posts will generate some debate - and I completely welcome both liberals, moderates and conservatives to join in. For now, I've very much got a "take on all comers" type attitude, so I welcome all you hard-core right-wingers to come on in and give me your best shot and the be ready for some re-edumacation.
Forum rules? What rules?
JK. For now I really only have two:
1) Stick to the topic. If you do leave an off-topic comment I may take the subject up at a later time, but me saying as much is about the best you'll get from me for an off-topic post. EMAILING ME (at niceguy9418@usa.com) is a much better way to get me to start a new line of discussion.
2) Be respectful TO EACH OTHER. You don't really have to be respectful to me - I can take it - just be warned that I'll respond in kind. If you debate logically, reasonably and respectfully, I sincerely hope that you will find me a worthy opponent. If you mindlessly spout Right wing talking points, treat "liberal" or "progressive" like epithets, or just come on to abuse me and roll around in the mud... Well... I sincerely hope that you will find me a worthy opponent. I am a 'nice guy' but I have absolutely no patience for suffering fools. If you want to tangle with me, you'd better do your homework!
The other obvious rule, that shouldn't really even need to be stated: NO SPAM. (Links are fine, but keep them on-topic.)
You'll notice there's no rule about foul languange. Yeah that's right: FUCK THAT. If you want to let it loose here, go right ahead. SHIT PISS FUCK CUNT COCKSUCKER MOTHERFUCKER TITS, NIGGER... Did I leave anything out? Just realize that areguments littered with expletives are not going be taken as seriously as ones that aren't. (And cutsey little substitutes like "$#!+" get taken even less seriously!) But I'm not uptight about it. It don't bother my ass none.
So let's go!
Subscribe to:
Posts (Atom)