A Thought On Healthcare

[Behind The Mask]

I'm still quite young (17) and still in High School but my Govt. Teacher, whom I respect immensily seems to have formulated his own way to reform healthcare, and I thought it would be nice to at least post this method for some critique; it seems quite sensible.

The basic idea is that National Healthcare is a great idea, everyone deserves healthcare, but the bills and methods being suggested are rather, 'lackluster.'

The idea is that every year, a person will be given $5000 into a sorta, 'health account', whenever anything comes up, the person dips into this account to cover their expenses. However, if a person wants to add into this account they are free too (with a possible cap); the idea is that at the end of the year, the account will be restored to $5000 and the difference is given back to the person.

The method above gives the consumer the option of, perhaps paying for Health Insurance, or for shopping for their medical care, with this ammount in mind it would hopefully stimulate the consumer to shop smart for their healthcare, and be mindful of the options.

However, then their is the question of a big ailment, say cancer. If a person is diagnosed with cancer, and the payments are clearly more then they can sustain with their $5000, then the govt. will cover between 80-90% of the medicine or treatment, with the rest payed for by the consumer. This method carries on at the turn of the year, the account is still restocked to $5000 and the govt. pays that 80-90% for the cancer, though other things are covered by the consumer if not connected to the cancer.

The idea of the plan is to give the consumer options. They will still be able to spend their money on health insurance, however for the less fortunant they will have $5000 to cover their expenses.

This probably doesnt belong in the mudpit; but at least I'm not off in some rant. What do you all think? Any suggestions?

I don't know if I recalled everything right, but this is the basic idea.

[The Devil's Sergeant]

Oh where oh where does the money come from? It is quite easy to come up with a plan to fix anything when such a pesty details such as cost are ignored.

[Behind The Mask]

Oh where oh where does the money come from?

Taxes of course, however, at least compared to other methods and bills proposed, this is more sensible, reasonable and allows the consumer a say in how they spend the money given to them; they are free to spend it on insurance, pay it as they become sick (in the case of flus or such), or perhaps whether it through. Its far from socialism if thats what you're saying; giving money to people may sound socialist to you, but once in the hands of the person, it promotes capitalism; if people shop smarter, it will boost competition amongst doctors or clinics and perhaps give rise to more efficent procedures or such.

Taxation isn't the scourge of the earth some believe; the idea is painful, but for the welfare of the nation, just as with the maintaining of an army for defence, the health of the people is much needed.

[justicar5]

Oh where oh where does the money come from? It is quite easy to come up with a plan to fix anything when such a pesty details such as cost are ignored.

If you had a universal health care system modeled on, say the NHS (just because I can find that organisations budget) it would cost you $700 billion US dollars a year. (assuming same cost per head of population) you could ofc scrap medicare and medicaid, saving you: $332 billion for medicaid, and $454 for medicare, providing NHS level of care for your entire population would actually be financed by scrapping medicare and medicaid, as they would have become unneccesary. Hell you could reduce taxes, freeing up more money (give or take $80 billion) into your economy, and leaving more people with the option of going to the private insurers if they so wished, reducing costs to businesses as private health insurance for employees would be a real benefit rather than a requirement. Looking at that and unless I have suffered horrible maths fail at some point in my calculations, Universal health care would save america billions, lower the tax burden and give everyone a good level of coverage with the option of going for a higher level.

(calculations based on the NHS budget for 2008, the population clock to give US and uk populations, the Congressional budget office for medicare and medicaid expenses for 2008 and an exchange rate calculator found on google)

[Martin N]

If you had a universal health care system modeled on, say the NHS (just because I can find that organisations budget) it would cost you $700 billion US dollars a year. (assuming same cost per head of population) you could ofc scrap medicare and medicaid, saving you: $332 billion for medicaid, and $454 for medicare, providing NHS level of care for your entire population would actually be financed by scrapping medicare and medicaid, as they would have become unneccesary. Hell you could reduce taxes, freeing up more money (give or take $80 billion) into your economy, and leaving more people with the option of going to the private insurers if they so wished, reducing costs to businesses as private health insurance for employees would be a real benefit rather than a requirement. Looking at that and unless I have suffered horrible maths fail at some point in my calculations, Universal health care would save america billions, lower the tax burden and give everyone a good level of coverage with the option of going for a higher level.

(calculations based on the NHS budget for 2008, the population clock to give US and uk populations, the Congressional budget office for medicare and medicaid expenses for 2008 and an exchange rate calculator found on google)

Ya but you see, america is bought by private health insurers and the health industry, why think about logic when money talks ?

Why not make the exact same health indutry we have now, force everyone to buy the same junk were used to but make it enforcable with a tax for punishment of not having insurance, oh what a fantastic idea!

[The Devil's Sergeant]

If you had a universal health care system modeled on, say the NHS (just because I can find that organisations budget) it would cost you $700 billion US dollars a year. (assuming same cost per head of population) you could ofc scrap medicare and medicaid, saving you: $332 billion for medicaid, and $454 for medicare, providing NHS level of care for your entire population would actually be financed by scrapping medicare and medicaid, as they would have become unneccesary. Hell you could reduce taxes, freeing up more money (give or take $80 billion) into your economy, and leaving more people with the option of going to the private insurers if they so wished, reducing costs to businesses as private health insurance for employees would be a real benefit rather than a requirement. Looking at that and unless I have suffered horrible maths fail at some point in my calculations, Universal health care would save america billions, lower the tax burden and give everyone a good level of coverage with the option of going for a higher level.

(calculations based on the NHS budget for 2008, the population clock to give US and uk populations, the Congressional budget office for medicare and medicaid expenses for 2008 and an exchange rate calculator found on google)

Youi are forget the fundamental fact that the NHS intentionally rations care, even to the point killing people by denying proven life extending medicines and treatments and for the healthy it is designed to be so inaccessaible so that many people have to leave the system entirely to receive even routine care.

In any case this thread isn't about your factory of death "medical" system. Nuff said. And back on topic.

To the OP:

I want to make sure I understand you corrently,

Person A on Jan 1. 2010 both have $5000 to spend on any and all health care needs for the entire year. (I'm imagining a special government issued debit card?) If person A spends $1000 during the year what happens to the remaining $4000? Does he keep the money to spend any why he wants in 2011? That would be the only way such a system would incentivize a person to shop wisely. If the money is lost to them on Dec 31, (which is what I think you intend) then a rational person would see that all money is spent by the end of the year, when a new $5000 card is made available to them. Or does the $4000 roll over so that on Jan 1, 2011, so he has $9000 for medical expenses?

And what if a person goes over? You say a person could load additional money onto this account, but with limits? First of all, why would you even want to limit what a person can set aside for medical care? That make zero sense. And second why would a person even want to place money into this account, given that you propose government covering 80% to 90% of catastrophic care payments.

Even that is ass backwards. I know when I had that type of catastrophic medical insurance it paid for 100% of care after meeting a high deductible, which happened to be about $5000.

As FF points out, there are currently allowed under law health savings account, which allow people to save tax free money to be used for medical expenses, of course that is your own money you put in, you can earn interest, or get capital gains which is also tax free. And the money can be saved for years, money saved in 2010 can be used in 2020 for example.

[Behind The Mask]

Person A on Jan 1. 2010 both have $5000 to spend on any and all health care needs for the entire year. (I'm imagining a special government issued debit card?) If person A spends $1000 during the year what happens to the remaining $4000? Does he keep the money to spend any why he wants in 2011? That would be the only way such a system would incentivize a person to shop wisely. If the money is lost to them on Dec 31, (which is what I think you intend) then a rational person would see that all money is spent by the end of the year, when a new $5000 card is made available to them..

You got that wrong. If $4000 is left in the account at the end of the year, then $1000 is put into the account to return it to its $5000 minimum at the start of the year.

Not rly; I don't think people (and you may disagree if you wish) would intentionally squandor money meant for their health, just for the sake of squandary.

The only way to get money out of this account to spend on yourself is if you invest an excess.

Account Start: $5000

Over the year the person puts money into the account, not only keeping it at $5000 but raising it.

Account at End of Year: $5500 (ex.)

From that account, the $500 excess is transferred from the medical account to the persons other account and he can spend the difference as he wishes; the $5000 however is maintained and he can repeat such a process.

And what if a person goes over? You say a person could load additional money onto this account, but with limits? First of all, why would you even want to limit what a person can set aside for medical care? That make zero sense. And second why would a person even want to place money into this account, given that you propose government covering 80% to 90% of catastrophic care payments..

As mentioned above the account will be maintained at $5000 at the start of the year; the difference is theres should they add over the original ammount. It is reasonable.

Because not every emergency is a catastrophic one; cancer is quite different from busting your arm in a skating accident and the expenses that goes with it. The cancer patient could use help (considering many believe the cost of some of the medicines is a bit high; this allows the medicines to get payed for and the person to live) but that skater must pay for his own misfortunes.

Even that is ass backwards. I know when I had that type of catastrophic medical insurance it paid for 100% of care after meeting a high deductible, which happened to be about $5000..

Because the system is still meant to force some form of responsibility on the consumer when dealing with their money and health. Shop around, find the most efficent forms, decided what you want. You disagree, I disagree with you - bah.

[justicar5]

Youi are forget the fundamental fact that the NHS intentionally rations care, even to the point killing people by denying proven life extending medicines and treatments and for the healthy it is designed to be so inaccessaible so that many people have to leave the system entirely to receive even routine care.

In any case this thread isn't about your factory of death "medical" system. Nuff said. And back on topic.

.

Oh no working to a budget, the NHS provides care, if you can afford better, then buy it. The insurance companies are all about profits, the less people they treat, the more money they make, letting people die is in their best financial interest, in their shareholders interest, recision of care should be treated as premeditated homicide, but no it is standard business practice, take someones premiums for 10 years then when they need treatment drop them because they scuffed their knee at the age of 2. You support that system and DARE complain about the NHS, well I hope when you get sick your cover is rescinded, maybe then you will see how monsterous your system is.


The thread is about the private murder industry that you call insurance, call it was it is extortion folloowed by murder.

[The Devil's Sergeant]

Oh no working to a budget, the NHS provides care, if you can afford better, then buy it. The insurance companies are all about profits, the less people they treat, the more money they make, letting people die is in their best financial interest, in their shareholders interest, recision of care should be treated as premeditated homicide, but no it is standard business practice, take someones premiums for 10 years then when they need treatment drop them because they scuffed their knee at the age of 2. You support that system and DARE complain about the NHS, well I hope when you get sick your cover is rescinded, maybe then you will see how monsterous your system is.


The thread is about the private murder industry that you call insurance, call it was it is extortion folloowed by murder.

Yes I dare.

We have been over this ground before justicar5, with me giving you step by step details on how the NHS deliberately limits people's ability to access the system. I cite your own newspapers and even the NHS itself on how it place values on the lives of different people and grants or denies care as though people are livestock. Yet you never remember any of it. It always escapes your attention that the NHS is a mandatory system, taking from people their livelihoods just to later kill them off when a panel of bureaucrats calculate that treating them would cost too much. Private insurance is a contract entered into voluntarily, with benefits defined and enforced by law. Both parties are equal before the law. If there is a dispute over the contract it can be settled by a judge. With the NHS there is no equality before the law. There is no contract. There is only political and economic expedience. The NHS is the arbiter of live and death.

[Justinian]

$5,000 x 307,212,123 = $1,536,060,615,000

So this would cost $1.5 trillion a year just to put the money in people's accounts, never mind the other costs?

[The Devil's Sergeant]

By giving people a pile of money, you are incentizing people to spend, not save. If I gave you $20 to go to the movies and only to the movies, you are going to go to the movies and spend it all. You have no other choices. The money you have has no other utility to which it might be better used. December of every year would be a boom time for plastic surgeons as people rush to expend unused dollars. Indeed, decembers are a very busy time for elective surgeries even now, as people who have met an insurance deductible rush to exploit their polcies.

[Behind The Mask]

By giving people a pile of money, you are incentizing people to spend, not save. If I gave you $20 to go to the movies and only to the movies, you are going to go to the movies and spend it all. You have no other choices. The money you have has no other utility to which it might be better used. December of every year would be a boom time for plastic surgeons as people rush to expend unused dollars. Indeed, decembers are a very busy time for elective surgeries even now, as people who have met an insurance deductible rush to exploit their polcies.

If you give people a limited amount of money, they will either learn that after they spend that they're outta luck, or that they'll need to think if they want to take advantage of what is given them.

Thats why its a health account, its limited only to be spent on health related things. (I didn't properly explain that - I apologize) it would be refined to simple medical related inceidents.

The point is, for those who need it, they are given the ability to cover themselves. For those who are foolish with their money; they will either need to learn to conserve, or are out of luck. For those who are smart, pay into the account, and have a surplus about $5000 by the end of that year (up until the set cap, whatever it would be) they will be rewarded for being responsible with their money.

It wont be 1.5 trillion dollars a year either; it would be if every account was empty by the end of the year; but with it restricted to $5000, it will only be restored from whatever point it is at; they cant go on a spending spree with this money.

It is an incentive to save; smart shop. This is you're money for you're health; you're health may not be covered by an insurance company, when people get the point that this money is their coverage, they will look for prices, become more efficent, take some responsibilty. Those who don't, well, pay outta their own wallet when the account runs dry.

[scarybandit]

Good idea that national healthcare idea... oh wait the entire Western world apart from the US already has it.

By the way, the reason we have it is because we can't afford to pay health insurance middle men the kind of money the US can, so we go with the cheaper and fairer system to save taxes.

[Admiral Piett]

What his proposal is basically a federally provided health savings account. Such things exist its just they are private and you pay into them.

The problem with that is that such a fixed figure is problematic at best. Plus all of the requirements, bureacracies made by it and the doctors having to go through paperwork to find out how much you've spent. And it does nothing to solved the almost total control insurers have over prices and coverage terms. Plus how criminally high drug prices are. (Which foreign trade could easily remedy) I am more and more of the opinion that the FDA is the source for a lot of our problems and it needs to be significantly loosened over its regulatory power. Just keep it there for basic safety and precautions in drug development and testing. It should not charge a lot of money and enforce a copyright-like patent which allows a single drug company to charge whatever it wants and prevents generic forms of the drug from being produced for much cheaper.

The easiest solution is simply to implement a style of universal healthcare that is simply provided on the local and state level, while funded federally as well as by the states. We already have the revenue if we repeal most of the functions of Social Security - which are mostly healthcare related.

[Musthavename]

Problem is, you can't just blanket introduce a system the equivalent of the NHS to America. Firstly, you'd have to build a bunch of new hospitals or buy out ones from the private sector. Then you have the issue of staffing them, due to the fact that any existing doctors/nurses/whatever are already in the private sector, and won't want to take a pay cut to go to the public sector. Then you've got the problem of the public's perception. For people that actually are insured, many are going to want to stick with a private sector, so you wouldn't have as many people switching over to a state run system as you'd originally assume.

[The Devil's Sergeant]

I did interpret you correctly then, and "saved" money is lost to the consumer. Don't you see the problem? You are expecting people to be niggardly when there is absolutely no reason for them to be.

Since it is christmas, lets use the a gift card as an example. Say I give you a $100 gift card to a particular store. You take that card to the store and pick out something you really want, but it only cost $50. What are you going to do with the other $50 on the card? Would you throw it in the trash? Almost certainly not. You would find something to spend it on. You however are expecting people to just throw the left over money away! That is a rediculous expectation.

The only way to get money out of this account to spend on yourself is if you invest an excess.

Account Start: $5000

Over the year the person puts money into the account, not only keeping it at $5000 but raising it.

Account at End of Year: $5500 (ex.)

From that account, the $500 excess is transferred from the medical account to the persons other account and he can spend the difference as he wishes; the $5000 however is maintained and he can repeat such a process.

Again why would a person put money into this account? What is the incentive? I certainly don't see any. Why is this account better than a simple savings account? Does it earn it interest? Is it tax deductible?

Because not every emergency is a catastrophic one; cancer is quite different from busting your arm in a skating accident and the expenses that goes with it. The cancer patient could use help (considering many believe the cost of some of the medicines is a bit high; this allows the medicines to get payed for and the person to live) but that skater must pay for his own misfortunes.

I certainly understand that there is a big difference between breaking an arm and cancer. I've broke an arm, and my wife who is a doctor, had, and maybe still has, cancer.

You believe you are making a point, but trust me you are not. You keep saying people would be responsible for their own care, but your system doesn't do that. It divorces them from that responsiblity, since they know every year there is a new $5000 waiting for them. It isn't their money in the way a person who earns a paycheck regards it as his money. Its a gift card that can only be used to buy one thing. There is nothing that promotes responsiblity at all.

[Behind The Mask]

Again why would a person put money into this account? What is the incentive? I certainly don't see any. Why is this account better than a simple savings account? Does it earn it interest? Is it tax deductible?

Perhaps because they would like to have some spare funds in case anything actually happends? Make sure that have a full account? Caution?

Its not a difficult concept but you act like it is... Its not.

You believe you are making a point, but trust me you are not. You keep saying people would be responsible for their own care, but your system doesn't do that. It divorces them from that responsiblity, since they know every year there is a new $5000 waiting for them. It isn't their money in the way a person who earns a paycheck regards it as his money. Its a gift card that can only be used to buy one thing. There is nothing that promotes responsiblity at all.

You believe you are making a point, but you are not.

Every year, they will have $5000 in their account maintained. It doesnt divorce from responsibility, you give people too little credit. Every year you have $5000 at minimum, or thats just an example, perhaps $2500, the point is, unless they invest into that, thats it... If they waste it, they will be left with the responsibility of their poor choices.

You say there is nothing that promotes responsibility. I disagree. You act like you're absolutely correct; you blanket term this over all people.

National Healthcare is a good thing. There are those people who need coverage; others who don't need it so much. This gives those the ability to cover themselves; and should they drain it, be left with the responsibility of their choices.

[The Devil's Sergeant]

Perhaps because they would like to have some spare funds in case anything actually happends? Make sure that have a full account? Caution?

Its not a difficult concept but you act like it is... Its not.

You are completely and utterly failing to appreciate the incentive for waste you are setting up. There is an incentive to save money some of the year yes, but as the end of the year approaches people beome less cautious of risk (because in fact there is less) and more concerned that about the cost of doing nothing. As I mentioned earlier this is a real phenonemon you can observe in any doctor's office. Decembers are very busy.
Generally a person's deductible cycles ever January, meaning that the first dollars one spends comes out of pocket ($1500 in my case) so people try to stay away from spending their own money. But as soon as the deductible is meet, its a free for all since most everything after the deductible is on the insurers' dime. My wife who is a surgeon, has had a surgeries scheduled almost every day this month. Come january she does back to her normal schedule, surgery only one day a week.

And I will give you a personal example. As I said before my wife had cancer. Well a recent test has indicated it might have returned and she needs a biopsy and radioactive exam. She also recently tore some tendons in her arm playing squash and needs surgery to repair it. But since we have not come close to meeting our deductible this year we are putting everything off until next year. There is no point in meeting our deductible in 2009 and 2010, when we can condense everything into 2010, meeting one deductible of 1500 instead of two. Aslo I plan on having surgery on my nose for a deviated septum. I'm gaming the system. I am acting rationally with respect to my dollar costs.

If I had your hypothetical $5000, I would do everything that $5000 could do right now. I would spend it all before the end of the year, Because in 9 days I lose the utility of that money. And I can be pretty secure that nothing else bad will happen in that 9 days. If I waited until January, the new $5000
would have to cover all those proceedures, plus it would have to stand for the risk of the next 365 days.

You believe you are making a point, but you are not.

I know what the hell I'm talking about, you don't.

Every year, they will have $5000 in their account maintained. It doesnt divorce from responsibility, you give people too little credit. Every year you have $5000 at minimum, or thats just an example, perhaps $2500, the point is, unless they invest into that, thats it... If they waste it, they will be left with the responsibility of their poor choices.

You say there is nothing that promotes responsibility. I disagree. You act like you're absolutely correct; you blanket term this over all people.

All I am doing is assuming people will act rationally. And there is a ton of evidence that they do, its called economics.

National Healthcare is a good thing. There are those people who need coverage; others who don't need it so much. This gives those the ability to cover themselves; and should they drain it, be left with the responsibility of their choices.

I've given you several examples now of how your system incentives people to spend it all every year.

[Behind The Mask]

You are completely and utterly failing to appreciate the incentive for waste you are setting up. There is an incentive to save money some of the year yes, but as the end of the year approaches people beome less cautious of risk (because in fact there is less) and more concerned that about the cost of doing nothing. As I mentioned earlier this is a real phenonemon you can observe in any doctor's office. Decembers are very busy.
Generally a person's deductible cycles ever January, meaning that the first dollars one spends comes out of pocket ($1500 in my case) so people try to stay away from spending their own money. But as soon as the deductible is meet, its a free for all since most everything after the deductible is on the insurers' dime. My wife who is a surgeon, has had a surgeries scheduled almost every day this month. Come january she does back to her normal schedule, surgery only one day a week..

You claim your wife is a surgeon. I don't know this... Honestly anyone can say such things, and I'm right in doubting it. Unless given proper proof I can not take it on faith alone that you are married to a surgeon, and even then, theres still reason to doubt that you dont know what your talking about.

You say I'm making an incentive for waste- so is the system in place, the system suggested, they all have waste. Yet I'm suppose to believe everything you say as fact when I dont...

And I will give you a personal example. As I said before my wife had cancer. Well a recent test has indicated it might have returned and she needs a biopsy and radioactive exam. She also recently tore some tendons in her arm playing squash and needs surgery to repair it. But since we have not come close to meeting our deductible this year we are putting everything off until next year. There is no point in meeting our deductible in 2009 and 2010, when we can condense everything into 2010, meeting one deductible of 1500 instead of two. Aslo I plan on having surgery on my nose for a deviated septum. I'm gaming the system. I am acting rationally with respect to my dollar costs..

Again, how can I be sure of this personal example. I'm not saying its untrue, but you cant just expect me to take everything at said as fact.

Besides, this is a personal example, as you said yourself... for others not in your position we give them an alt. and covers those who otherwise have little ability to pay for it otherwise.

If I had your hypothetical $5000, I would do everything that $5000 could do right now. I would spend it all before the end of the year, Because in 9 days I lose the utility of that money. And I can be pretty secure that nothing else bad will happen in that 9 days. If I waited until January, the new $5000
would have to cover all those proceedures, plus it would have to stand for the risk of the next 365 days. .

If you're gonna go catch the flu, break an arm or leg, stick your pecker in a pencil sharpener or whatever just to spend all that $5000; then you are incredibly petty and most likely not so smart.

If you want to spend 9 days wasting whatever money is left in your account just so you can and just because its theres, then shame on you- and if you expect everyone else to do so, then once more shame on you.

I know what the hell I'm talking about, you don't..

You claim to know what you're talking about. I claim to know what I'm talking about...

You say I dont.

I can say you dont.

Then we can quote this same statement time and time again but it will not change that fact... You feel your right if you wish and disagree with me, and I can do so to you. Fair enough, Comrade?

All I am doing is assuming people will act rationally. And there is a ton of evidence that they do, its called economics. .

Rationally? Injuring yourself or getting yourself sick, or just wasting time in a clinic is a far shot from rationality. Opposite in fact, imagine, if they have all the surplus time to squander and they squander on this, not quite rational.

I've given you several examples now of how your system incentives people to spend it all every year.

And I give rational regions why a person may actually give a damn, come to a realization, take responsibility and have the incentive to shop around due to this system.

The problem with our arguement is regardless of the arguement; we both have our minds made up and regardless the others point, both side finds their own points founded solidly.

[The Devil's Sergeant]

You are entitle to your opinions, but you are not entitled to your own facts.

Everything I've said about myself is true. Of course you dan't have to beleive that. That's your problem. But I am not stating my opinions. Everything I've said about insurance, medicine and economic behavior is logical, reasonable and factual.

I recognize that there are many wasteful aspects to our current system and can suggest many reforms, but I won't do that here as I have done it many times in other threads.