How would you fix the US health care system?

[Penumbra]

I voted, "socialized insurance".

I support a universal single payer system.

 

[Crystallas]

I voted other, because saying that a "capitalistic free market" is current, would be terribly wrong. We are very very far from having a free market, and merely refer our controlled market as "free" out of political convenience.

 

[Trey of Diamonds]

I Trey: This sounds like the Bismark System, used in Germany, France, Japan, &al. Everyone is required to carry insurance, but the insurance is non-profit. The hospitals are generally private. (Sort of like a non-profit "Obama-Care).
The specifics vary widely.

Personally, I still lean toward the National Health Insurance (NHI) system, used in Taiwan, the US Medicare system, and Canada. Here the government is the single insurer/payer, but the medical facilities and personnel remain private.

Actually, I was referring to a failed bill to make Medicare the single payee insurance system rather than a Non-Profit. The bill has fallen to the wayside for now. Looks like we lean the same way.

 

[Darkness]

Why are socialised insurance and medicine mutually exclusive? I want a system of universal socialised insurance (with allowed private competition, such as in the UK) and socialised prescription drugs.

 

[9-10ths_Penguin]

Personally, I still lean toward the National Health Insurance (NHI) system, used in Taiwan, the US Medicare system, and Canada. Here the government is the single insurer/payer, but the medical facilities and personnel remain private.

Canada's a bit more complicated than that. The vast majority of hospitals (i.e. all but a very small number of private facilities that were grandfathered in) are publicly owned, though they're generally run independently at arms-length from the government. Most doctors' offices and non-hospital clinics are private, but paid for by government health insurance on a fee-for-service basis according to a set fee schedule.

 

[T-Dawg]

I think "socialized medicine" is being used somewhat indiscriminately here. I'm not always sure what system's being referred to.

T-Dawg: Are you referring to the Beveridge System, used in Britain and the US Veteran's Administration, where Hospitals are government owned and run and healthcare personnel are government employees? (this is the only true "socialized medicine" system).

Trey: This sounds like the Bismark System, used in Germany, France, Japan, &al. Everyone is required to carry insurance, but the insurance is non-profit. The hospitals are generally private. (Sort of like a non-profit "Obama-Care).
The specifics vary widely.

Personally, I still lean toward the National Health Insurance (NHI) system, used in Taiwan, the US Medicare system, and Canada. Here the government is the single insurer/payer, but the medical facilities and personnel remain private.

To be honest, I'm not exactly sure what the difference between the socialist medicine and socialist insurance is. I was under the impression that the distinction was in that in socialist medicine, the government produced and distributed healthcare as well as paying for it.

Either system will work, but why have pay for private healthcare providers when you can pay for government healthcare?

 

[9-10ths_Penguin]

I know I'm responding to a post that's a few years old, but I think t raises an interesting point:

Socialism removes the incentive to work. If all your basic needs are met, why get out of bed and go to work?

When people abuse the system, it is just as bad as slavery. One person works hard and does not recieve the fruits of their labor while the other person does nothing and eats the fruits.

OTOH, a capitalist system only values things to the extent that they can be monetized. I think very negative effects can occur when we try to use a purely capitalist model with systems where life and death are in the balance, because I don't think that market forces can ever truly reflect the real value of human life.

 

[Terrywoodenpic]

No. It's a little more complicated than that. Socialized medicine is where the health care system is like a government department. The government owns and runs the hospitals. Physicians are like civil servants, on a government payroll.
The UK, for example, has socialized medicine. The US Veteran's Administration is socialized medicine.

A single-payer system is not necessarially socialized. Canada and the US Medicare system are single-payer, but not socialized medicine. Drs and hospitals are private, independent entities.

UK system is socialised and insured... we pay national insurance.
Doctors are contracted practicioners. Not many senior doctors are contracted full time. they also do private medecine. General practicioners usualy own their own buildings and pay their staff the going rate. They are contracted to the health service for a certain number of "sessions" They get extra payments for non contracted work. and for the work of their staff.
One month my son in law's practice manager got the accounts and claims wrong , so he had no money to pay himself that month.

 

[Trey of Diamonds]

Why an MRI costs $1,080 in America and $280 in France

Selected quotes

There is a simple reason health care in the United States costs more than it does anywhere else: The prices are higher.

That may sound obvious. But it is, in fact, key to understanding one of the most pressing problems facing our economy. In 2009, Americans spent $7,960 per person on health care. Our neighbors in Canada spent $4,808. The Germans spent $4,218. The French, $3,978. If we had the per-person costs of any of those countries, America’s deficits would vanish. Workers would have much more money in their pockets. Our economy would grow more quickly, as our exports would be more competitive.

The result is that, unlike in other countries, sellers of health-care services in America have considerable power to set prices, and so they set them quite high. Two of the five most profitable industries in the United States — the pharmaceuticals industry and the medical device industry — sell health care. With margins of almost 20 percent, they beat out even the financial sector for sheer profitability.

This is a good deal for residents of other countries, as our high spending makes medical innovations more profitable. “We end up with the benefits of your investment,” Sackville says. “You’re subsidizing the rest of the world by doing the front-end research.”

But many researchers are skeptical that this is an effective way to fund medical innovation. “We pay twice as much for brand-name drugs as most other industrialized countries,” Anderson says. “But the drug companies spend only 12 percent of their revenues on innovation. So yes, some of that money goes to innovation, but only 12 percent of it.”

And others point out that you also need to account for the innovations and investments that our spending on health care is squeezing out. “There are opportunity costs,” says Reinhardt, an economist at Princeton. “The money we spend on health care is money we don’t spend educating our children, or investing in infrastructure, scientific research and defense spending. So if what this means is we ultimately have overmedicalized, poorly educated Americans competing with China, that’s not a very good investment.”

But as simple an explanation as “the prices are higher” is, it is a devilishly difficult problem to fix. Those prices, for one thing, mean profits for a large number of powerful — and popular — industries. For another, centralized bargaining cuts across the grain of America’s skepticism of government solutions. In the Medicare Prescription Drug Benefit, for instance, Congress expressly barred Medicare from negotiating the prices of drugs that it was paying for.

 

[Reverend Rick]

There is no pure capitalist option. Our current system is car from capitalist.

I get charged 10K for a MRI because insurance companies will subsidize this crazy amount.

Sure, when a new technology starts out, you have to cover start up expenses.

MRI's have continually became more expensive when this technology is not new any more and supply and demand should have dropped the charges for this service.

Insurance has kept these prices high. If no one had insurance, the price would be around 500 bucks.

 

[Trey of Diamonds]

Insurance has kept these prices high. If no one had insurance, the price would be around 500 bucks.

So how do you feel about a single payee system to replace the insurance system we have today?

 

[Mathematician]

Eliminate the middle-man except for catastrophic care coverage.

I think it's amusing when someone posts a status update about their insurance reducing a prescription cost from $200 to $25. First of all, that drug shouldn't cost anywhere near that amount. We're gauged of money every day by the pharmaceutical industry. Secondly, either you or your employer has been paying at least $150 a month to boot.

There should still be public programs in place to help the poor and elderly, but it can be greatly simplified.

 

[Reverend Rick]

Let me put it this way. I think everyone should buy electrical insurance.

This way I can charge your insurance thousands for a service call instead of hundreds.

No one will complain a out my charges because the insurance company will pay for it.

In my industry, people shop around for the best deal.

When has anyone shopped a hospitals prices?

I'm not even sure it is possible.

There are no checks and balances with health care costs.

Facilities charge just about what ever they like and insurance companies deal with them.

This is why medical expenses are so high.

Think about it, if there was no health insurance of any kind, hospitals would only charge what folks could afford to pay.

I go to the BMW dealer and they charge me 500 dollars for an oil change.

The guy down the street uses the same oil and filter and charges less than half.

Now if my auto insurance covered oil changes, I would go to the dealer and not worry about the expense.

 

[Trey of Diamonds]

Let me put it this way. I think everyone should buy electrical insurance.

This way I can charge your insurance thousands for a service call instead of hundreds.

No one will complain a out my charges because the insurance company will pay for it.

In my industry, people shop around for the best deal.

When has anyone shopped a hospitals prices?

I'm not even sure it is possible.

There are no checks and balances with health care costs.

Facilities charge just about what ever they like and insurance companies deal with them.

This is why medical expenses are so high.

Think about it, if there was no health insurance of any kind, hospitals would only charge what folks could afford to pay.

I go to the BMW dealer and they charge me 500 dollars for an oil change.

The guy down the street uses the same oil and filter and charges less than half.

Now if my auto insurance covered oil changes, I would go to the dealer and not worry about the expense.

If all this is correct, then why are medical costs in countrys with socialised medicine so much lower than in the US? :sarcastic

 

[Reverend Rick]

If all this is correct, then why are medical costs in countrys with socialised medicine so much lower than in the US? :sarcastic

Because their doctors live in smaller homes?

 

[Trey of Diamonds]

Because their doctors live in smaller homes?

As good an answer as any I suppose.

 

[Mathematician]

Our medical training system is inefficient, too. In most other countries someone starts to learn medicine as soon as they turn 18 or 19. Here we have them study "biology" or "pre-medicine" first.

 

[Reverend Rick]

As good an answer as any I suppose.

Seriously, we have the worst system possible right now.

Of course other countries are cheaper.

If we had no health insurance at all, our prices would be competitive.

 

[Trey of Diamonds]

Seriously, we have the worst system possible right now.

Of course other countries are cheaper.

If we had no health insurance at all, our prices would be competitive.

I disagree. You are suggesting the competition would drive prices down without insurance companys in the way to keep prices up. But I think that the medical profession would keep prices high just because they could. If all doctors charge $200 for a $20 procedure and your life depended on the procedure then you have to pay it. You can't simply stop using doctors because they charge to much. Your system would rely on doctors having a much higher state of ethics and morals than the average human being does.

 

[Sunstone]

The most efficient way to lower health care costs in the US is to shoot the sick. So, if efficiency is our only concern, then murder is our friend.