i'm as ignorant as the average american i'm going to guess. i am also lucky enough to live in vermont, where we have amazing and affordable health care.
i've always wondered why health insurance is tied to employment for starters.
i'd want to see all people insured, and leave businesses alone to do their business.
what do you think?
You need healthier people before you can fix the health care system.
THISQuote:
Originally Posted by LexInVA
No junk food in schools
nutrition education
Daily PE and recess
Better access to good food in cities
I would like to see a service like Peapod offer a weekly menu with instructions and preselected food delivered to community centers each saturday. Families could sign up for one or a limited number of options.
To make health care more affordable, you need to limit malpractice suits, and however unpopular ths may be, quit providing free care to people who have no SSN that we can track them with and make sure they pay their bill. Stop letting people get away with free care that they have no intention of paying for
My pet peeve with school lunches is that they are at least 40% carbs, because in many cases, they are the last meal kids will get until their free breakfast the next morning. So we basically put at risk kids ina carb coma so they are unable to pay attention in school in the afternoon, making it harder for them to get good grades and break the cycle they are caught in
Single payer. Government subsidized, low cost medical schools and more residency spots available. We need more doctors.
90% of health-care dollars are spent in the final year of life.
Quit doing "everything possible" to keep frail ailing elderly people alive. Treat the treatable, provide excellent palliative care, and let people die in peace.
Exactly. But what do we do about someone who is brought in after an accident and requires health care? How do we determine if they have insurance or a social security number?Quote:
Originally Posted by rustbreeches
Here's my plan. We dye people a color that corresponds with their access to health care. Green means they have full access, yellow means either crappy insurance or none, but have a social security number and a job. Orange means social security number, no job and no clear way to pay for any medical care. Red...no medical care. Just let them dye in the street. Unfortunately, those of us who are responsible, have jobs and insurance, will have to pay to clear the bodies away. But it's a small price to pay, right?
Single payer/not for profit.
I think this is the huge difference between health care in the US and in Europe. When will Americans be ready for this? My neighbor kept her 80 year old husband alive on a respirator for 10 months. He didn't make it but her theory was that God gave us the technology so it's a sin not to use it...Quote:
Originally Posted by gully's pilot
There are models of healthcare that work much better than the US system (Switzerland is the one I think is the best, but there are others.) They have a much better quality/accessibility/affordability of care than we do, and at a much lower cost.
However, there are aspects of that system that I think would be almost impossible to implement here. For one thing, they have a national health care system (ie, single payer, but also single patient identifier.) Everyone pays the same cost for basic care, which includes preventative care. It is possible to buy supplemental insurance at an additional cost, for "upgrades" - ie, private instead of shared room in the hospital.
Physicians are paid less of a premium than many of our specialists (orthopedists, neurosurgeons etc) BUT they also generally do not have anywhere near the same level of cost to bear for their training. I work in radiology (not in a clinical capacity) and the physicians in my group all have between 13-15 years of medical training; they emerge from that training at an age where many non-physicians have already established careers, families, etc with HUGE amounts of debt. They then have to start paying those student loans back, obviously, and their compensation reflects that reality. Studies have shown that very few physicians (of any specialty) in the US end up liking their jobs, and even fewer would recommend the career to their children. That is not the case elsewhere in the world.
A single payer system along with educational reform (largely removing the for profit aspect of the system) would certainly make it easier to offer quality care at a lower cost, but in our (largely) free market economy, that approach would require really massive change. It would likely also mean that there would be some rationing of care - which we already have, on an economic basis - where many of the "heroic" measures taken at the end of life in our country would become uncommon. This would obviously require both a change in our approach to end of life care, and most likely tort reform.
Healthcare was tied to employment during WWII, I believe. There were limits on wages, so employers started offereing bennies to encourage workers to hire in. It made sense then, not so much now.Quote:
Originally Posted by suz
I would dissolve the link between health insurance and employement. Encourage employers to increase pay when they phase out health insurance by giving a tax break equal to the raise for say, 5 years. Make health insurance on the employee side tax deductible. Repeal/fix HIPPA.
Mandate a co-pay, even if only $5, for every doctor visit. Free care invites abuse. For those on Medicare or Medicaid, send them a 1099 type report annually that shows how much money has been spent on their care. It could also include a line that shows what they paid in.
Let doctors charge fees that reflect their operating expenses, and allow them to cut those expenses where possible. Scrub the Medicare/Medicaid regs for contradictory requirements and plain insanity. Let people buy used, refurbished or non-custom durable medical equipment like wheel chairs.
The junk food issue is separate to me. People have to stop robbing grocery stores. If the stores can go a couple weeks without being held up, they will stay open. If they are open people can buy vegetables etc. There was a grocery store in a not-so-nice part of town growing up that was robbed repeatedly. It eventually closed because the management a) couldn't make money & b) couldn't provide a safe work environment for employees. Periodically a new group would reopen it & try again, but the result was always the same. I have a hard time getting upset about a lack of grocery stores if this is why they close.
I think anyone deserves urgent care regardless of status, whether due to accident/heart attack, etc. Urgent care needs I have zero issues with.Quote:
Originally Posted by LauraKY
But the last few times I've been through the emergency dept. I've been taken aback by the number of people there for non-emergent cases; kids with colds, sore/sprained ankles (that they could easily walk on), and some complaining of the flu.
The best one was the woman who was railing on anyone that appeared to work there in excellent english that they had damn well get a spanish-speaking employee there to assist her (it was her RIGHT!) and she had been waiting with her kids for 3 hours to be seen....for the kid's colds, which she told everyone (loudly!) they had had for days. To hell with those people arriving in ambulances with life-threatening injuries, her kids needed cough medicine dammit!
I understand the idea of not having access to other care and therefore people feeling like the emergency room is their only option for health care, but this area has a decent number of free and income-based clinics that even stay open late and on Saturdays.
The complaints I've heard about these clinics is that you may have a long wait, it's first come/first served for appointments and those with kids "can't get there early enough so they have to occupy the kids", they require more paperwork, and they don't give away as many free sample meds (but do offer great savings on generic prescriptions through local pharmacies).
The clinics try to set things up like a doctor's office and encourage well-child checkups and preventative care (even offer income-based birth control), but they say the response to that has been rather lackluster.
So how do we get people to use options other than the local emergency rooms for their health needs when they won't use the less expensive options that are already available?
To answer yor question how insurace becam tie to emplyotment. You can thank FDR for that. During the depression he passed a law that basically said that employers were not allowed to offer more money to new emplyoees BUT as an incentinv to come to work for them they now can offer some thing called healh insurance. Before that it was never heard of or offered.
This not to say that FDR wanted social med. eventually. No he didnt we was opposed to it. Unlike his cousin Teddy who was a Rep.
My thoughts are that many in FDR's congress who of course made the bill and of course passed it then sent it on to him were in favor of socal med. and they thought this was a way to get a foot in the door so to speak. Then Pearl Harbor happened and other things more important were on the table.
My ideas on how to fix the mess we call health care?
Well no single payor system btdt..and it dosent work.
Regulate the insuance cos. so they cant charge what they are. Face it the same polices in lets say Iowa that run a family of 4 lets say runs 200$ mth shouldnt cost a family of 4 in Calif 2000$ just because they live Calf. It should run the same as in Iowa.
Let the person decide what they want in their policy. Like a male will not use coverage for things like pap, mamograms,child birth etc. why should he have to pay for them? But if/when he get married he can add them.
preexsiting conditions keep that from obabmacare BUT with the state high risk pools make sure they cover ALL of them not just a select few as they do now.
those are my ideas..
malpractice reform.
Someone actually rated this Bad. :lol:Quote:
Originally Posted by LexInVA
Free comprehrensive healthcare for all child under 18. That means yrly physicals, vision and hearing tests, learning disability test, blood work looking for diabetes etc.
Free public health education for the parents of the above.
Return to mandatory PE in our schools and recess almost no matter the weather.
Make the ins cos act like ins cos - the purpose of ins was to take risk and spread it over large nos of people.
If someone chooses not to have health ins and is involved in an accident or sickness, then we treat but using 1950's treatment modalities.
preexisting conditions are covered but must go with mandatory patient education for those conditions that are the result of lifestyle choices.
Lower costs for medical school, waiving of education costs if drs agree to certain stipulations of caring for patient groups.
Preventive care for all groups.
Medical plans that are good in any state.
Yup, http://www.clmagazine.org/article/index/id/MTA5NjE/Quote:
Originally Posted by SerenaGinger
http://www.all.org/nav/index/heading...jA2/id/MjU4Ng/
I agree with most of what you said, except that. There are different costs of living and costs of doing business in different regions. The expenses of a doctor in Iowa are not the same as a doctor in CA. It may take them the same amount of time to diagnose a cold and they may buy bulk Band-Aids at the same price, but the cost of office space and employee wages are not going to be the same. Having the same premiums implies that reimbursement is the same. I doubt that many CA doctors could afford to work on IA rates.Quote:
Originally Posted by bumknees
What does who I work for or which state I live in have any bearing on where I can buy health coverage? I prefer NOT to get plans through work where I have no input, and I would save a lot of time and money and have better choices if I could buy insurance in Indiana and use the doctors and hospitals in South Bend (which is CLOSER than Kalamazoo, where the local hospital has to send anyone with anything more complicated than a broken bone, or we have to wait for the day of the week that specialist is seeing patients here.)
Get rid of Medicaid and Medicare and come up with something cheaper, with less paperwork, and with a much more limited pool of users (only people who actually cannot be cared for in any other way--I do not want to have Medicare when I get old just because some idiot decades before I was born assumed I'd be too stupid to take care of myself.) Overhaul how insurance companies pay out and who can 'participate' so that a doctor can just take whatever pay form they want. A big chunk of medical costs is office overhead--Medicare in particular is a massive hassle which is why many places won't take it, and insurance billing codes can give you a migraine and are easy to make mistakes.
And katarine nailed it--costs will never come down until we have extensive, comprehensive tort reform. Obviously, yes, you should be able to sue over GROSS negligence, but you should NOT be able to sue over every piece of dubious quackery ("The vaccine gave my kid autism!") or just pure human failure (doctors are not psychics or miracle workers, and patients have responsibilities to their own health.) It wastes time and it means doctors are spending a small fortune on malpractice insurance.
this. Plus we pay out bucketloads of money trying to keep all the extremely premature/ born sick babies alive for some reason- if it's born too broke to fix, why? let it go immediately. And some of the other nasty birth defects, while the child is viable, perhaps we should consider euthanising it, in the name of being humane (to parents and child). Would also save a ton of money.Quote:
90% of health-care dollars are spent in the final year of life.
Quit doing "everything possible" to keep frail ailing elderly people alive. Treat the treatable, provide excellent palliative care, and let people die in peace.
Most of our healthcare money is spent in the wrong place- fixing problems. If we spent money on preventing problems we'd spend a lot less. Most of our health problems of today are caused by poor diet, lack of exercise, and smoking. Yes, smoking. Still.
Healthcare should never be operated "for profit". Practitioners should be paid for their ability to keep their patients healthy, not on a per-procedure/visit basis, which encourages the heathcare system to let people get sick.