Creativity Challenge: How can we reduce health care costs in America?

[NoPlaceLikeHome]

Does this mean what I think it does?

 

I mean that I would have no problem IMO if the Bill Gates of the world did not get social security even though they paid into it due to a means test:) I think it should be generous since a million dollars is really not a lot of money these days. As to the specifics of a means test to see if one needed social security I am unsure since I would like to see many weigh in on that. I know my dear grandfather truly did not need social security and would not have missed it all if he did not get it and he was not as rich as Bill Gates.

 

As a thought though, I am not even sure if that would be necessary if they took out the social security tax all the way up to the highest incomes instead of capping it at $110,000.

Edited November 6, 2010 by priscilla

[Guest Cheryl in SoCal]

I also don't understand the moral outrage about taxing sodas (and sports drinks and "juice beverages")!

 

I also think we should consider scrapping the whole appointment model.

 

Seriously!

 

Have you ever been to a place where no one makes appointments? It's surprisingly pleasant. You go when you're sick or want to see someone. Including specialists! I went to an OB/GYN while traveling. I just showed up at the office. I waited about 20-30 minutes, and .... I was called in. At other times I've taken my kid(s) and waited up to an hour, maybe a bit more, but there was none of this "sorry, we're all booked" business. I was once having trouble breathing at night and was told I could be seen in 2 weeks. Charming. And one of my kids sees a specialist whose appointments are usually booked 6 mo out for new patients. No, there's no rationing here!

I do not believe this would be practical, especially for those who have chronic health issues and need to see specific specialists (who are often in different offices on different days) regularly. I've waited far longer for treatment at the Urgent Care (no appointments) than I ever have at any of our specialists offices.

[Lovedtodeath]

Exactly, as humans there are no guarantees on our health:( In fact, it is safe to say that the overwhelming majority of us eventually need healthcare IMHO.

Yes but some of us pay an alternative practitioner $200 to find out the same information that Western care would charge $5,000 for.

 

Yep. I have done it both ways, and I prefer the less expensive, less invasive, more effective in the long run alternative care and very very rarely need immediate care from Western Medicine (which is still needed for some things, but a lot less than what most people think).

 

Paying into your system would take away my freedom of choice, because then I wouldn't have the $200 for the alternative test. kwim?

[NoPlaceLikeHome]

Yes but some of us pay an alternative practitioner $200 to find out the same information that Western care would charge $5,000 for.

 

Yep. I have done it both ways, and I prefer the less expensive, less invasive, more effective in the long run alternative care and very very rarely need immediate care from Western Medicine (which is still needed for some things, but a lot less than what most people think).

 

Paying into your system would take away my freedom of choice, because then I wouldn't have the $200 for the alternative test. kwim?

I respect alternative care. OTOH I truly believe most people would go to a hospital if it were a life and death situation such as not being able to breath for example. There are many life threatening conditions that simply cannot be treated with alternative care:(. Another example is gallstones causing acute gallbladder attacks simply cannot be treated with alternative medicine. Therefore, I do not see it as taking away one's choices. Also many people do not have the freedom of good health and truly need medical care:(

[Guest Cheryl in SoCal]

to insure against a catastrophic health episode, a major illness or injury.

 

Individuals and employers should be allowed to purchase major medical policies that DO NOT cover preventative services.

 

One reason we have experienced two decades of incredible medical services inflation is because of the expansion of the subsidy aspect of medical insurance, both private and government.

 

The health saving accounts that were eliminated under the Obama plan should be reinstated and expanded.

 

Free or reduced fee for service clinics should be federally funded for those who need them.

 

Stacy (Who spent 12 years working as a Benefits Analyst to large employers for a consulting firm and who negotiated with various state insurance departments and insurance companies)

What about people who have chronic health issues? If people WANT to be able to purchase a plan that is only for catastrophic illness/injury that is one thing but there are many who have chronic illnesses who would go broke with such a plan.

[Meriwether]

I mean that I would have no problem IMO if the Bill Gates of the world did not get social security even though they paid into it due to a means test:) I think it should be generous since a million dollars is really not a lot of money these days. As to the specifics of a means test to see if one needed social security I am unsure since I would like to see many weigh in on that. I know my dear grandfather truly did not need social security and would not have missed it all if he did not get it and he was not as rich as Bill Gates.

 

As a thought though, I am not even sure if that would be necessary if they took out the social security tax all the way up to the highest incomes instead of capping it at $110,000.

 

Ah, yes. That's what I thought you meant. So people are supposed to pay into SS thousands and thousands - and thousands and thousands of dollars, invest their money, save, and then be told "Sorry, you don't need this money so we are going to keep it."

 

You'll forgive me if you've just lost any credibility for me in this discussion.

 

Meriwether - who grew up in a home that absolutely could not afford health care but is still willing to call stealing, stealing even if it is the government doing it.

[NoPlaceLikeHome]

Ah, yes. That's what I thought you meant. So people are supposed to pay into SS thousands and thousands - and thousands and thousands of dollars, invest their money, save, and then be told "Sorry, you don't need this money so we are going to keep it."

 

You'll forgive me if you've just lost any credibility for me in this discussion.

 

Meriwether - who grew up in a home that absolutely could not afford health care but is still willing to call stealing, stealing even if it is the government doing it.

 

A means test is not stealing IMO since SS is a tax. Also, I honestly do not think it would not be necessary if people paid social security tax up to the highest incomes instead of capping it which I think should be the first measure to shore up social security instead of raising the age of eligibility IMO. Also, many die before ever receiving social security and the government keeps it so to speak and that is not stealing.

 

Honestly, I do not consider myself to ever propose stealing at all. I also strongly favor capitalism for the record. I was just simply thinking of possibilities to shore up social security.

[Snowfall]

Ah, yes. That's what I thought you meant. So people are supposed to pay into SS thousands and thousands - and thousands and thousands of dollars, invest their money, save, and then be told "Sorry, you don't need this money so we are going to keep it."

 

You'll forgive me if you've just lost any credibility for me in this discussion.

 

Meriwether - who grew up in a home that absolutely could not afford health care but is still willing to call stealing, stealing even if it is the government doing it.

 

People already pay taxes for things that do not benefit them. I don't get WIC, Welfare, ADC, Medicaid, etc., etc., but I have paid (and do pay) taxes for them. I also don't use public schools, but have paid (and do pay) taxes for those, too. I've also paid taxes for fire protection, which I have never used. It's not stealing. If there were a means test, should a wealthy person ever become poor, they would get their social security benefits. Kind of like how if my house ever catches on fire, the fire department will come put it out...but if it doesn't, then I've paid for it anyway. That's how taxes for social programs work. This kind of hyperbole (calling it stealing) does nothing to further the discussion.

[Meriwether]

A means test is not stealing IMO since SS is a tax. Also, I honestly do not think it would not be necessary if people paid social security tax up to the highest incomes instead of capping it which I think should be the first measure to shore up social security instead of raising the age of eligibility IMO. Also, many die before ever receiving social security and the government keeps it so to speak and that is not stealing.

 

Honestly, I do not consider myself to ever propose stealing at all. I also strongly favor capitalism for the record. I was just simply thinking of possibilities to shore up social security.

 

Social Security was designed to tax people throughout their working years and then give them payments back throughout retirement. If the government only takes the money and does not give it back, that is stealing. Just because the government has done a poor job managing Social Security does not mean that it is okay to defraud people who have paid into the system -whatever they are worth. Shoring up social security is not a valid reason to take and keep someone else's money. And for those who die young - a more honorable response would be adding that money to their estate.

 

As far as taxing people for social security on all of their income goes, these high income families are the very ones you would deny payment to later in life. Stealing. Just because Congress passes a law....

[MSNative]

Then why not call social security "welfare", rather than a retirement plan? PP was correct - you pay tens to hundreds of thousands into it and the gov't decides if and when and how much you get, if any. If you die before you collect, the gov't keeps it, rather than your family. This system doesn't strike me as fair or wise. (Plus, the gov't is massively in debt and cannot meet its current promised obligations. Not the people I trust with my retirement or my health.)

 

If people need care and can't afford it, there is medicaid. If it needs to be reformed, let's talk about that. Why try to force everyone into a gov't plan as a way to help those who can't afford regular plans? Seems to me if we're trying to address the problem of low income people having access to quality health care, let address that.

[Meriwether]

People already pay taxes for things that do not benefit them. I don't get WIC, Welfare, ADC, Medicaid, etc., etc., but I have paid (and do pay) taxes for them. I also don't use public schools, but have paid (and do pay) taxes for those, too. I've also paid taxes for fire protection, which I have never used. It's not stealing. If there were a means test, should a wealthy person ever become poor, they would get their social security benefits. Kind of like how if my house ever catches on fire, the fire department will come put it out...but if it doesn't, then I've paid for it anyway. That's how taxes for social programs work. This kind of hyperbole (calling it stealing) does nothing to further the discussion.

 

 

People pay a very specific, seperate tax for Social Security. By paying into Social Security, you are making a social contract. Every person who pays into the system should receive the benefits. If they don't, it is stealing.

[NoPlaceLikeHome]

Social Security was designed to tax people throughout their working years and then give them payments back throughout retirement. If the government only takes the money and does not give it back, that is stealing. Just because the government has done a poor job managing Social Security does not mean that it is okay to defraud people who have paid into the system -whatever they are worth. Shoring up social security is not a valid reason to take and keep someone else's money. And for those who die young - a more honorable response would be adding that money to their estate.

 

As far as taxing people for social security on all of their income goes, these high income families are the very ones you would deny payment to later in life. Stealing. Just because Congress passes a law....

 

Again, a means test would not even be my first choice to shore up social security at all. I still do not think it is stealing though since if one dies before receiving social security, then you cannot will it to someone else and it was never meant to be the same as a 401k plan for example. I think instead taxing for social security up to infinity instead of capping at $110,000 will probably solve its problems.

 

My 2 cents:)

[NoPlaceLikeHome]

Then why not call social security "welfare", rather than a retirement plan? PP was correct - you pay tens to hundreds of thousands into it and the gov't decides if and when and how much you get, if any. If you die before you collect, the gov't keeps it, rather than your family. This system doesn't strike me as fair or wise. (Plus, the gov't is massively in debt and cannot meet its current promised obligations. Not the people I trust with my retirement or my health.)

 

If people need care and can't afford it, there is medicaid. If it needs to be reformed, let's talk about that. Why try to force everyone into a gov't plan as a way to help those who can't afford regular plans? Seems to me if we're trying to address the problem of low income people having access to quality health care, let address that.

 

Yes but there are many middle income Americans who are not eligible for Medicaid and cannot afford health insurance premiums or go broke even with health insurance when medical disasters strike:(

[Cera]

I drink soda and I've watched those movies. And again, I wouldn't mind a soda tax. Maybe I'm the exception? :P

 

 

 

One, the military system and the VA system are not the same thing. VA hospitals have a totally different operating budget. That's a different debate. I'm specifically talking about the insurance options we have.

 

1. We can choose Tricare Prime. You choose a network Primary Care Provider. This *can be* the military treatment facility near your location, but it doesn't have to be. My kids had a civilian pediatrician as their PCM at Fort Bragg. I paid *no* fees of any kind for them to see their PCM. My son was referred to a specialist, we chose one in network and therefore paid no fees of any kind to see him. If one chooses to see a doctor without a referral or one outside of the network, then you would pay fees for that, insurance would pay part of the bill, but not all of it.

 

2. We can choose Tricare Standard/Extra. You can see network or non-network providers. You pay 15% of the cost for network providers and 20% for non-network providers. You don't need a PCM, you don't need to go to the MTF, you don't need referrals. There are negotiated rates and allowable charges.

 

There are fairly serious issues when it comes to access to care with Tricare Prime though. We used it in HI and I often found myself having my husband make a phone call (field grade officer) so that the kids could "magically" get an appt. These were routine issues that needed to be seen but didn't warrant emergency room care (for example pink eye on a Thurs. with an appt being offered Monday).

[Rosie_0801]

I'm finding this a bit confusing. You all seem to be obliged to run your kids through health courses in high school, yet people go to the doctor to be told that the best thing to do for a cold is drink plenty of water, pop some vit C and have an early night?

 

I wonder if a large problem is that people don't expect to feel ill when they are? Everyone gets head colds, so somehow that means that the symptoms don't actually count for anything, and we should be able to carry on as usual. Since there is no one to pick up the slack when we are sick, we can't rest up to shrug it off, so we go off to the doctor to ask for a magic pill so we'll be able to recover without feeling any worse than usual?

 

Not requiring a doctor's certificate for every day off would be a money saver. Go to a doctor for a bit of paper saying you have a head cold and will be fine in two days time? What a waste of everyone's time and money. And besides, if one didn't have to go to the doctor, one could be at home sleeping it off.

 

Rosie

Edited November 7, 2010 by Rosie_0801

[Tap]

I think the lowest contracted price for any health care service should be the same for anyone paying cash.

 

Insurance companies routinely have 'contracted prices' that they negotiate for their patients. Then the people who pay cash....get billed the entire amount. :( It is not fair to get a higher profit, off of a person who doesn't have insurance than the same service provided to a person with insurance.

 

I know there is often a discount for cash patients....but it isn't close to what some insurances prices are.

[Meriwether]

I think the lowest contracted price for any health care service should be the same for anyone paying cash.

 

Insurance companies routinely have 'contracted prices' that they negotiate for their patients. Then the people who pay cash....get billed the entire amount. :( It is not fair to get a higher profit, off of a person who doesn't have insurance than the same service provided to a person with insurance.

 

I know there is often a discount for cash patients....but it isn't close to what some insurances prices are.

 

:iagree::iagree:

[Mama Geek]

I think the lowest contracted price for any health care service should be the same for anyone paying cash.

 

Insurance companies routinely have 'contracted prices' that they negotiate for their patients. Then the people who pay cash....get billed the entire amount. :( It is not fair to get a higher profit, off of a person who doesn't have insurance than the same service provided to a person with insurance.

 

I know there is often a discount for cash patients....but it isn't close to what some insurances prices are.

 

That is when you shop around. I have BTDT and gotten better prices.

[Mama Geek]

Since the issue of social security has come up, I think I will throw this in as well. My dh and I were both very discouraged to find out that we were each individually paying more in SS than my IL's combined were taking out. I would much rather have written them a check and and given a check to my family than to pay it to the government where I will likely never see any benefits from it.

 

That really got to both of us. If you haven't read Atlas Shrugged by Ayn Rand it is a good read. It is fiction and there are things that I don't agree with in it, but it discusses one outcome of government taking to much money from high income earners. And please don't say it could never happen, we've thought about it and I am sure we aren't the only ones.

[Snowfall]

People pay a very specific, seperate tax for Social Security. By paying into Social Security, you are making a social contract. Every person who pays into the system should receive the benefits. If they don't, it is stealing.

 

Says you. Me? Nope. And last I checked, there was no final authority on who exactly gets to decide when taxes are "stealing" and when they aren't. You get an opinion, I get to disagree if I think you're wrong. <shrug>

 

I think that at some point a universally accessible health care system of some sort, administered by the government, is inevitable in America. The young people of America will change things, because that's what every generation does. They, as a group, support government getting involved. Sure, there are those who don't, but the majority do. It might take all of us old fogies (ha! I'm only 32!) dying off first, but eventually they'll get it. I comfort myself with this thought - that even if we can't work it out, our kids will. :)

 

The current system is unsustainable. Doing away with insurance companies and forcing people to pay out of pocket is unsustainable. Forcing people to rely on charity is cruel. I know two middle class families, in which both parents work. Both families have decent health insurance, yet both of them must rely on charity to pick up the thousands of dollars per year their health insurance does not cover. Anyone who thinks they like going back every year to ask for more money, to prove they really need it, to open up their lives and finances to strangers who will decide whether or not they're really deserving of charity, has no imagination, since they are clearly unable to put themselves in the shoes of another.

 

Surely those of you recommending we rely on charity understand that charities do NOT pay for everyone who needs help. Surely you recognize that it's not like you just walk in the door and say, "Hey, I need $10,000 for this special wheelchair. My health insurance won't cover it, and after paying our $5000 deductible, plus the drug co-pays for this year, I don't have $10,000 extra. Make the check out to S. Jones. Thanks." That's not how it works, and while my friends are both grateful that they are able to receive this help, don't for one minute kid yourself into believing that they think this is the best America can do for people who work their butts off to support themselves, and have been thrown a curve ball by Mother Nature, who sometimes makes kids with serious congenital defects. I imagine there are some similar people out there who do think this is the best America can do, but my friends don't, and they shouldn't be forced to rely on charity just because we can't find a better way to work this out.

[Guest Cheryl in SoCal]

I'm finding this a bit confusing. You all seem to be obliged to run your kids through health courses in high school, yet people go to the doctor to be told that the best thing to do for a cold is drink plenty of water, pop some vit C and have an early night?

 

I wonder if a large problem is that people don't expect to feel ill when they are? Everyone gets head colds, so somehow that means that the symptoms don't actually count for anything, and we should be able to carry on as usual. Since there is no one to pick up the slack when we are sick, we can't rest up to shrug it off, so we go off to the doctor to ask for a magic pill so we'll be able to recover without feeling any worse than usual?

 

Not requiring a doctor's certificate for every day off would be a money saver. Go to a doctor for a bit of paper saying you have a head cold and will be fine in two days time? What a waste of everyone's time and money. And besides, if one didn't have to go to the doctor, one could be at home sleeping it off.

 

Rosie

Was someone saying to do this? If so, I sure missed it. When I talk about going to the doctor before something is serious I'm talking about seeing the doctor for a significant bacterial respiratory infection before it progresses into pneumonia, not going for a simple cold. I don't know anyone who goes to the doctor for a simple cold. Heck, we didn't go to the doctor when we had H1N1 because I didn't feel that anyone was serious enough to require medical care and we didn't want to expose anyone the myriad of illnesses at the doctor's office.

[Lovedtodeath]

I respect alternative care. OTOH I truly believe most people would go to a hospital if it were a life and death situation such as not being able to breath for example. There are many life threatening conditions that simply cannot be treated with alternative care:(. Another example is gallstones causing acute gallbladder attacks simply cannot be treated with alternative medicine. Therefore, I do not see it as taking away one's choices. Also many people do not have the freedom of good health and truly need medical care:(

Yes, there are life threatening conditions that cannot be treated with alternative care... but they can be prevented. If I kept going to the MDs I would have cancer by now. I was precancerous and they did not change my treatment protocol at all. I am now much healthier overall due to the alternative care.

 

Exactly, as humans there are no guarantees on our health:( In fact, it is safe to say that the overwhelming majority of us eventually need healthcare IMHO.

I have paid cash for my family's health care for 7 years, including surgery for my son and my precancerous autoimmune disease. For the last 3 years we have only used Western Medical care twice. I do not want to be forced into buying insurance so that someone else can decide what gets paid for and what doesn't.

 

What about people who have chronic health issues? If people WANT to be able to purchase a plan that is only for catastrophic illness/injury that is one thing but there are many who have chronic illnesses who would go broke with such a plan.

:iagree::iagree:

[Lovedtodeath]

Was someone saying to do this?

Many employers and schools require doctor's notes to excuse absences due to illness even when that trip to the doctor did nothing to treat or cure it. I assumed she was talking about that.

[goldberry]

People already pay taxes for things that do not benefit them. I don't get WIC, Welfare, ADC, Medicaid, etc., etc., but I have paid (and do pay) taxes for them. I also don't use public schools, but have paid (and do pay) taxes for those, too. I've also paid taxes for fire protection, which I have never used. It's not stealing. If there were a means test, should a wealthy person ever become poor, they would get their social security benefits. Kind of like how if my house ever catches on fire, the fire department will come put it out...but if it doesn't, then I've paid for it anyway. That's how taxes for social programs work. This kind of hyperbole (calling it stealing) does nothing to further the discussion.

 

:iagree:Absolutely, a means test would not be "stealing". We as a society don't want to have old folks who have worked all their life live in poverty when they no longer work. Social Security is not a 401K. You are not putting in your money into an account where it is held only for you. You are putting your money into a general fundthat should go to those that need it.

 

Sorry, but I think failing to recognize that we all contribute to the kind of society we want to live in, is part of what's wrong in the world. I have a niece with alot of money, and when I mentioned the healthcare issue, she says "that's not my problem". She is only worried about higher taxes on her particular income bracket. Who cares if other people don't have healthcare?

 

We all live in this country together. Heaven help people like her if their lot in life happens to change.

 

But it sounds the same to me to hear people say, well if I don't get my money back, whether or not I need it, then it's stealing. We pay money because we want to live in a certain kind of society. It's not always about our own personal return.

[Guest Cheryl in SoCal]

Many employers and schools require doctor's notes to excuse absences due to illness even when that trip to the doctor did nothing to treat or cure it. I assumed she was talking about that.

:001_huh: That is crazy!!! One more reason to homeschool ;) I thought she was describing what she thought people were promoting as preventative care.

[goldberry]

Since the issue of social security has come up, I think I will throw this in as well. My dh and I were both very discouraged to find out that we were each individually paying more in SS than my IL's combined were taking out. I would much rather have written them a check and and given a check to my family than to pay it to the government where I will likely never see any benefits from it.QUOTE]

 

Of course that would be frustrating. But, what about other aging parents whose kids don't make that much money, or are barely taking care of themselves? What about old folks who don't even have any kids or other family to write them a check?

 

That is where your money is going.

[Haiku]

Yes, there are life threatening conditions that cannot be treated with alternative care... but they can be prevented.

 

I find that incredibly insulting. My dd was BORN with her life-threatening illness. To imply that if we somehow did things differently we could have prevented it (and just fyi, she wasn't even born to us, but still, to imply that ANYONE could have done something different/better to have prevented it is bullsh*t) completely discounts the fact that some people simply need "Western" medicine, and that if they do they somehow didn't do what they should have to prevent their illness, is, frankly, assinine, and people who persist in believing this are making it harder for the people who NEED (as in would literally die without) affordable healthcare.

 

Tara

Edited November 7, 2010 by TaraTheLiberator

[Guest Cheryl in SoCal]

Yes, there are life threatening conditions that cannot be treated with alternative care... but they can be prevented. If I kept going to the MDs I would have cancer by now. I was precancerous and they did not change my treatment protocol at all. I am now much healthier overall due to the alternative care.

Are you saying that everything can (and should) be treated or prevented with alternative health care instead of Western medicine? I'd love to know of an alternative medicine that would have repaired my dd's cleft lip/palate or remove my other dd's cataracts and cure her glaucoma. Both were both with these birth defects at no fault of their own or their birth mothers. Without good medical insurance and Western medicine one of my dd's would be disfigured and the other would be blind (and in excruciating pain from the glaucoma, as she was before her first surgery because the pressure was so high)

Edited November 7, 2010 by Cheryl in SoCal

[BethInNH]

People can manage their stress better thus getting sick less. I find Americans to be codependent. People need to take more responsibility for their bodies. I don't think you will convince the government to ignore big business when much of politics has their hands in pharm pockets. Pharm drugs are big money, especially when many people run to a legalized street high when times get tough imo.

 

:iagree: I agree with this totally, especially the part about folks needing to take more responsibility for their bodies. You can't go around abusing your health with poor diet, drugs, alcohol etc. and then go running to the Dr. because you don't feel well. Well, you can, and alot of people do, but it really makes no sense to me.

[Nestof3]

One of the problems I have with saying social security should only go to those who need it is that who gets to determine that? Is it based on how much the person made over his/her lifetime or how much he/she didn't spend.

 

My in-laws just don't spend money. They don't shop, don't have cell phones, don't eat out, the have a small garden, they're very frugal. My MIL worked for the state highway department, and my FIL was a carpenter making about $6.00 when he retired. They saved nearly everything they could and went without much. They have quite a nest egg. They are in the high 80's now.

 

My parents made LOTS more than my inlaws, yet they have very little saved. Oh, he has military retirement at about $40,000 a year, and they both have social security coming in. Oh, and he filed bankruptcy about 20 years ago.

 

Another family might make quite a bit more but spend, spend, spend. They might eat out, make unwise choices. They might be left with very little because they squandered. They might be more needy when they are older because they refused to save.

 

Which couple gets social security? Do you base it on their income level, how much they have leftover, or what?

 

There are programs in place to assist low-income. Social security was designed to be for everyone who pays in, and our gov't screwed that up. Now, people want to take s/s and turn it into another benefit for the low-income.

 

Just remember, if it weren't for the people with the money -- the people owning companies and offering jobs, there would be a lot of people earning nothing. This thread seems to have turned into a thread about class envy.

 

It reminds me of state health insurance plans for lower income families. Some people choose to have far more children than they can afford, so the taxpayers pay for their children's health insurance. A family making the same amount of money with fewer children wouldn't qualify simply because they have fewer children.

 

Personal responsibility has to play into this somehow.

[Lovedtodeath]

I find that incredibly insulting. My dd was BORN with her life-threatening illness. To imply that if we somehow did things differently we could have prevented it (and just fyi, she wasn't even born to us, but still, to imply that ANYONE could have done something different/better to have prevented it is bullsh*t) completely discounts the fact that some people simply need "Western" medicine, and that if they do they somehow didn't do what they should have to prevent their illness, is, frankly, assinine, and people who persist in believing this are making it harder for the people who NEED (as in would literally die without) affordable healthcare.

 

Tara

I am so sorry. That is not what I meant. I do believe that I stated that Western Healthcare is a need in some cases. I just think that it is very overused.

 

Are you saying that everything can (and should) be treated or prevented with alternative health care instead of Western medicine?

I am so sorry that it seemed I was saying everything. I did not mean at all that your children didn't need care.

 

No, not everything... but the vast majority of Western Healthcare expenses are on things that could be prevented or treated before they get that bad.

 

Western Healthcare likely saved my son's and my own life. I developed my disease while pregnant with him and before we discovered the extent of it, we were starving to death. That was definitely a time to let the MDs do their work!

 

One of the problems I have with saying social security should only go to those who need it is that who gets to determine that? Is it based on how much the person made over his/her lifetime or how much he/she didn't spend.

 

My in-laws just don't spend money. They don't shop, don't have cell phones, don't eat out, the have a small garden, they're very frugal. My MIL worked for the state highway department, and my FIL was a carpenter making about $6.00 when he retired. They saved nearly everything they could and went without much. They have quite a nest egg. They are in the high 80's now.

 

My parents made LOTS more than my inlaws, yet they have very little saved. Oh, he has military retirement at about $40,000 a year, and they both have social security coming in. Oh, and he filed bankruptcy about 20 years ago.

 

Another family might make quite a bit more but spend, spend, spend. They might eat out, make unwise choices. They might be left with very little because they squandered. They might be more needy when they are older because they refused to save.

 

Which couple gets social security? Do you base it on their income level, how much they have leftover, or what?

 

There are programs in place to assist low-income. Social security was designed to be for everyone who pays in, and our gov't screwed that up. Now, people want to take s/s and turn it into another benefit for the low-income.

 

Just remember, if it weren't for the people with the money -- the people owning companies and offering jobs, there would be a lot of people earning nothing. This thread seems to have turned into a thread about class envy.

 

It reminds me of state health insurance plans for lower income families. Some people choose to have far more children than they can afford, so the taxpayers pay for their children's health insurance. A family making the same amount of money with fewer children wouldn't qualify simply because they have fewer children.

 

Personal responsibility has to play into this somehow.

:iagree::iagree::iagree::iagree::iagree:

[Nestof3]

Oh, and I just wanted to add that there are self-employed people (like us) who have never had any company pay for our health insurance. We don't get paid vacations, sick time off (if my husband doesn't mow the lawns, he doesn't get the money), etc.

 

We also pay double in social security and medicare. People are suggesting that we should just pay double for someone else?

 

Finally, if you want to turn social security into a welfare system where most cmpany owners would not be eligible to draw, be prepared for job losses and lower incomes for the employees.

[Nestof3]

No, not everything... but the vast majority of Western Healthcare expenses are on things that could be prevented or treated before they get that bad.

 

 

 

You mean like my uncle's diabetes which resulted in dialysis and a toe removal SIMPLY because he didn't take the time to get his prescription refilled? A prescription which was paid for by taxpayers because he is ex-army and on Medicare?

 

Now, he has lung cancer on top of that.

 

It's easy to not consider the expense of something as long as it's not coming out of one's own income.

[Rosie_0801]

Many employers and schools require doctor's notes to excuse absences due to illness even when that trip to the doctor did nothing to treat or cure it. I assumed she was talking about that.

 

I thought she was describing what she thought people were promoting as preventative care.

 

 

If "she" is me, I was griping about requiring doctor's notes for silly things like colds which the doctor can't fix. I wasn't talking about preventative care. Some people really do take themselves or their kids off to the doctor every time they catch a cold. I can't think how anyone could be incapable of diagnosing and treating a cold. (Obviously I'm not talking about situations where Mum knows a cold will trigger off asthma or something in a child in which case she'd probably want to see a doctor or chiropractor or someone to help head it off.)

 

Rosie

[Lovedtodeath]

Oh Rosie, I love your new quote!

[asta]

Stop "grief malpractice" (my word, obviously): Yes, your family member died. People die. All of the time, all over the world. That doesn't necessarily make it someone's "fault". Doctors are not Gods, and they simply can't fix everything, no matter what they do. It may seem like they "should have tried harder"; well, has it occurred to you (general you) that they tried the best they were capable of? Money isn't going to bring your family member back; it isn't going to make your pain go away any sooner.

 

If your family is going to be financially devastated without your family member, what were you planning on doing if said family member had stepped out in front of a bus because they were talking on their cell phone? Sue the phone company? Like nestof3 said, personal responsibility (eg: planning for the future, which in this case would have meant life insurance) needs to come into play.

 

Make doctor visits that aren't for medical need an out of pocket expense. For everyone. Heck, make it sliding scale fee, like county health does for mental health. Believe me, when people have to shell out cash, visits go down. There is no reason someone should be visiting a doctor for a cold (unless, as has already been mentioned, they have a propensity to slide into bronchitis, have asthma, etc.). Medical science hasn't caught up with the common cold; why is the medical industrial complex (that would be all of the people paying into the insurance system + taxpayers paying into medicare) paying for crap like that? For that matter, have a triage nurse/attending at the door to every ER in the country. You're here for Dimetapp? No. We don't do that. We do severed limbs.

 

Give people a choice of tiered health care from whatever company they want. Yes, that means dissolving the whole "you're in New York, you can't buy from Arkansas thing." For some people, a GP is pretty much all they need. A physical once a year, a periodic weird thing, and they're done. They don't even take meds. Let's call that level one, basic care. Next up is maybe a GP plus, I don't know, a psychiatrist. They take some specific meds, either generic or brand - they should have a choice. If they want to pay extra to have those brand names, they should have the option, not have the generics shoved down their throat and the manufacturer (and the country it is manufactured in) changed on a whim. But they're not dealing with a nephrologist or cancer or whatever. Let's call that Level two, Mid care. Then you have complex care: people with multiple issues - diabetes, high blood pressure, lung issues, a merry go round of medications and multiple specialists. It may be genetic or acquired - it doesn't really matter. This would be level three.

 

The way I see it (JMO, remember, this is all theoretical), a person or family would buy what they needed each year. If dad is level one, that's what he buys for his "slot" in the "family plan", and he pays the level one price. If his kid needs level three, he buys level three for the kid "slot". Etc. Not everyone has the same health level, why should everyone pay for the same level?

 

Let's say dad gets cancer. Dad has to start buying level 3. But, but, he has only been paying for level one! That's not FAIR! Yeah, but he also hasn't been using any resources! Dad, with his level 1 policy, has been paying for a policy that has inevitably cost more than he ever got out of it - remember, insurance companies are businesses, not social welfare agencies. And lots of other people are paying into level one policies also - who will never get cancer (which is much rarer than we make it out to be). Besides, now he's paying level 3 coverage, which isn't cheap.

 

Yep, it's a capitalistic shell game. It's like going to Vegas and playing with your life instead of chips. But socialized health care, under the European model that the US is trying to emulate, doesn't work. Trust me, I live under it. It looks good from the outside, but it is rotting from the inside. The only part of it that IS working is the additional insurance (read: PRIVATE) that people are buying to 'bump' themselves up the line above the "masses". Yes, that sounds classist. But it is true. There are overcrowded waiting rooms of people with appointments who wait all day while people with private insurance walk past them. Right? Fair? I'm not going to argue the point. But they've figured out that there are more "options" in the capitalistic model.

 

JM .02

[asta]

One question I do have is under a single payer system (the government) can you go in a pay out of pocket for a procedure?

 

I have been under the assumption that this would not be possible and that is a big reason that I don't like that idea, that, and the government doesn't get much of anything right.

 

Also aren't a lot of Dr's refusing medicare and medicaid patients now? I know more and more Dr's are getting out of medicine or going to other countries to practice and there are fewer students going into medicine. If they have to deal with the government for payment I think that will get much worse.

 

Yes.

 

My insurance is based on Medicare rates. When I'm living in the US (not, currently), I have to find a provider who accepts Medicare in order to find someone who also accepts my insurance. In one (relatively large) city in which I lived, there were exactly TWO general practitioners. One was a fabulous physician's assistant (thank god) and the other was the local welfare clinic. Apparently the city had had a falling out with Medicare a few years prior and decided not to play.

 

Oh, and no specialists, either. People had to drive up to 5 hours to find a specialist.

 

Medicare et al isn't the panacea people think it is.

 

 

a

[Mama Geek]

We pay money because we want to live in a certain kind of society.

 

I thought we paid taxes because if we didn't we'd go to jail. It is pretty obvious that different people want to live in different types of societies.:001_smile:

[Mama Geek]

 

Of course that would be frustrating. But, what about other aging parents whose kids don't make that much money, or are barely taking care of themselves? What about old folks who don't even have any kids or other family to write them a check?

 

That is where your money is going.

 

Why I am forced to take care of other people, instead of being given the option to?

 

I do see people deciding that they don't get to keep enough of the money they earn and deciding to quit trying so hard. I have a friend with a successful small business that is seriously thinking about closing up shop because of all the new mandates in the bills that congress passed. He says it just isn't worth it. He employs approx 20 people and has one of the most successful businesses of that type and size in the country.

[Renee in NC]

Why I am forced to take care of other people, instead of being given the option to?

 

I do see people deciding that they don't get to keep enough of the money they earn and deciding to quit trying so hard. I have a friend with a successful small business that is seriously thinking about closing up shop because of all the new mandates in the bills that congress passed. He says it just isn't worth it. He employs approx 20 people and has one of the most successful businesses of that type and size in the country.

 

I have never known a small business person to really go out of business because taxes were too high. Insurance, yes (as in liability/workers' comp, not health - no employer is required to offer company paid health insurance - yet;).) Taxes, no. I won't say that they don't feel that way, but the other option is to quit being self-employed and get a job. When you do, you still pay the same or almost as much in taxes (personally.) Not only that, but in my experience there are more ways to shelter your income from taxes as a business owner than as an individual. I would reassure your friend that since he only employs 20 people, most mandates do not apply to him or his business.

 

As for why you are forced to take care of people - because your duly elected representatives have made the decision that you are required to pay taxes and they are going to allocate them in certain ways. You don't have to like it, but this is the way our republic works. If enough people vote for people who plan to make changes, then the changes will occur.

[Jane in NC]

I have never known a small business person to really go out of business because taxes were too high. Insurance, yes (as in liability/workers' comp, not health - no employer is required to offer company paid health insurance - yet;).) Taxes, no. I won't say that they don't feel that way, but the other option is to quit being self-employed and get a job. When you do, you still pay the same or almost as much in taxes (personally.) Not only that, but in my experience there are more ways to shelter your income from taxes as a business owner than as an individual. I would reassure your friend that since he only employs 20 people, most mandates do not apply to him or his business.

 

 

 

I suspect that the US will have a single payer system when American corporations demand it. The argument goes that it is becoming more and more difficult for corporations to compete in the global marketplace when companies elsewhere do not have to fund insurance benefits directly.

 

Unfortunately I am a bit cynical with respect to government. Requests from the American people for a single payer system may not be heard, but corporate demands are another issue.

[brehon]

asta, I think I love you. I don't think there is one problem with the health care system, so I don't think one solution will "fix" it. This is a multi-faceted issue.

 

I believe allowing competition across state lines would help bring down costs without necessarily affecting coverage. Changing the health insurance model to more like the auto insurance model would also help. At least in TX one has a choice between types of auto insurance: liability covers the least amount; comprehensive covers a lot more. Health insurance need not be limited to those 2 options; a tiered system would be better.

 

In conjunction with increased competition I think we should do away with employer sponsored health insurance and encourage an increase in the number of private health insurance companies.

 

Right now where I live an increase in the number of free/low cost clinics would NOT necessarily reduce the burdens on the local ERs. People simply don't use the clinics. There are varying reasons given, the most frequent being that "no one except those people uses free clinics". Yes, this is an actual answer I've heard I don't know how many times from people. This doesn't mean I am against free/low cost clinics. I'm not. I'm just realistic about how well they would be utilized. Also in my area many ER docs and quite a number of specialists work pro bono in the clinics; so, patients are receiving the same quality of care they would in the ER.

 

I've not heard anyone in my family nor any of my patients say they were happy with Medicare. Maybe this differs by region, many people where I live have incredible difficulty finding PCPs, let alone specialists, who accept Medicare (and/or Medicaid, for that matter). Because of how the federal gov't pays Medicare claims most doctors (who no longer accept Medicare) find they simply can't afford to treat Medicare patients. This is compounded by the fact that insurance companies generally set their prices using the Medicare rates as a guide, so now doctors find they have to see more patients to make up the difference (financially speaking). Please understand that I'm not talking about doctors making huge amounts of money. This happens, of course, but mainly in the intense specialties. I'm speaking of doctors being able to keep their practices open, pay down their (inevitable) debt, and have a little left over to feed their families.

 

For those who say that the current Health Care law is a good first step toward universal coverage and a way to "stick it" to the insurance companies, did you notice that the big insurance companies weren't exactly howling in protest of the new law? They got what they wanted and won't see their profits diminish all that much even with mandated coverage of pre-existing conditions.

[MotherGoose]

1. Tort reform

2. Competition across state lines for insurance purchase

3. I'm going to be completely politically incorrect here, and make people mad, so I apologize in advance, but I believe this absolutely:

 

If you mistreat your body by being obese (provided you don't have some medical condition that causes it, and those are quite rare), smoke, use drugs-- then you should pay a higher premium than folks who don't do these things. When you buy life insurance, you are penalized, why should health insurance be any different? My husband falls into the obese category, so this would directly affect our finances, but I know he'd be healthier and require less medical care if he lost about 30 lbs.

[NoPlaceLikeHome]

Yes, there are life threatening conditions that cannot be treated with alternative care... but they can be prevented. If I kept going to the MDs I would have cancer by now. I was precancerous and they did not change my treatment protocol at all. I am now much healthier overall due to the alternative care.

 

I have paid cash for my family's health care for 7 years, including surgery for my son and my precancerous autoimmune disease. For the last 3 years we have only used Western Medical care twice. I do not want to be forced into buying insurance so that someone else can decide what gets paid for and what doesn't.

 

:iagree::iagree:

 

Many diseases cannot be prevented at all:( You were also fortunate that you were able to pay cash for surgery and treatments as well. My dfather had open heart surgery to the tune of $100,000. My mother had chemo, radiation, surgery, medications also to the tune of thousands and thousands of dollars.

[Melinda in VT]

:001_huh: That is crazy!!! One more reason to homeschool ;) I thought she was describing what she thought people were promoting as preventative care.

 

Just to offer a different experience, the only doctor's note I have ever had to send in for my kids was when my daughter's surgeon cleared her to return to PE following a bad arm break. The school wanted something in writing.

 

If they are sick, they stay home. We rarely see a doctor for anything other than yearly physicals and broken bones.

[NoPlaceLikeHome]

1. Tort reform

2. Competition across state lines for insurance purchase

3. I'm going to be completely politically incorrect here, and make people mad, so I apologize in advance, but I believe this absolutely:

 

If you mistreat your body by being obese (provided you don't have some medical condition that causes it, and those are quite rare), smoke, use drugs-- then you should pay a higher premium than folks who don't do these things. When you buy life insurance, you are penalized, why should health insurance be any different? My husband falls into the obese category, so this would directly affect our finances, but I know he'd be healthier and require less medical care if he lost about 30 lbs.

 

If we had competition across state lines then I believe it would be a race to the bottom so to speak. With credit cards, they are now located in about only 2 states with the least regulation so that they can fleece customers with usury rates which last time I checked is sinful behavior:glare:. I truly believe the same would happen with insurance companies. They would relocate the to states that allow them to treat customers badly IMHO.

[Mama Geek]

I graduated high school in '93. If a kid missed more than 10 days without a Dr's note, they would be held back, no exceptions. I was notorious about having sinus infections, bronchitus, and stomach problems. Most years I ended up over the 10 days.

[Mama Geek]

I have never known a small business person to really go out of business because taxes were too high. Insurance, yes (as in liability/workers' comp, not health - no employer is required to offer company paid health insurance - yet;).) Taxes, no. I won't say that they don't feel that way, but the other option is to quit being self-employed and get a job. When you do, you still pay the same or almost as much in taxes (personally.) Not only that, but in my experience there are more ways to shelter your income from taxes as a business owner than as an individual. I would reassure your friend that since he only employs 20 people, most mandates do not apply to him or his business.

This was based on the new health care bill among other things. Also there is a third choice, if I were to guess he could probably retire early.

 

 

As for why you are forced to take care of people - because your duly elected representatives have made the decision that you are required to pay taxes and they are going to allocate them in certain ways. You don't have to like it, but this is the way our republic works. If enough people vote for people who plan to make changes, then the changes will occur.

 

I realize that our elected officials make the decisions as to where to spend money and what to tax the people. I also think there is a lot of fraud in elections, that congress is greatly swayed by lobbyist, and that no person truly in their right mind would run for office. :D Just because people are elected does that really give them the right to take the peoples money for things that aren't spelled out in the Constitution?

 

I think the whole system is screwed up and I think both sides are to blame and we as a society are to blame.

[Caroline]

Just to offer a different experience, the only doctor's note I have ever had to send in for my kids was when my daughter's surgeon cleared her to return to PE following a bad arm break. The school wanted something in writing.

 

If they are sick, they stay home. We rarely see a doctor for anything other than yearly physicals and broken bones.

 

I have never had to send in a doctor's note for my kids to miss school. I have never needed one for work and neither has my husband.

[Haiku]

I have never had to send in a doctor's note for my kids to miss school. I have never needed one for work and neither has my husband.

 

Where my dd16 goes to school, you can miss two days per quarter without being penalized. Anything beyond that, for any reason, and you are penalized unless you have a doctor's note. So if you miss two days because you have a cold, and then your grandmother dies and you have to go to the funeral, you will be penalized. So you can bet your hiney that these kids go to the doctor when they have a cold so that they can get those days they miss excused.

 

Lucky for us, my dd's specialist will just fax in a note if we call him because he trusts us not to abuse his willingness to do so.

 

Tara