Replacing Obamacare

[Acim]

The other Obamacare thread here in conservative only is prompting me to start this thread that I thought of starting months ago. And rather discuss among conservatives because I'm thinking non-conservatives think Obamacare is peaches and cream or if they don't, they are wanting to make push for universal, government run health care system.

*I bolded parts in this post that are main point

I've seen a little bit, not much, on what some politicians actually mean by replace Obamacare. I wonder if there's a plan out there for replace that another has seen that you truly think will work. I personally think it could, but would face uphill battle by LW/MSM media with stories galore of how whatever is replacing it is far worse than how things were (for them) under Obamacare. And like all things LW bias, that would be pushed while denying the fact that Obamacare was arguably worse than what the replacement offers.

I have 2 thoughts on this, in terms of what to do differently from Obamacare. One is unacceptable I think to most people and the other is I think unacceptable to conservatives. I think of both as being in the vein of conservative ideology, but realize it is debatable.

My first idea is to get rid of insurance and let free market determine rates for everything in the healthcare industry. I therefore identify insurance companies as the problem, or what is consistently being utilized to manipulate pricing/costs in the market with seemingly nothing that can re-align the ship (cost efficiency). From the consumer perspective (people desiring healthcare services), insurance provides a wonderful safety net, but is unlike I believe all other aspects of the market. There seems to be no way for a healthcare provider (doctor) to tell you the cost/price of a service until after it occurs. So, as long as that's in play and insurance is in the picture, consumers will be in the dark as to what it cost to get any service done for them. While insurance company will know and will be doing the job of negotiating rates/costs, primarily for their benefit, not the consumers. If there were such a middle man in other aspects of the market, and that middle man was deemed best to only option, I doubt we'd be talking much about a "free market." The drawback that I recognize to getting rid of insurance is that anything costing over say $5000 would impact vast majority of budgets, and if it is $50,000 or more, it would possibly wipe out a whole lot of people. What replaces that, I admittedly am not sure, and so something in vein of catastrophic insurance is currently only thing that makes sense to me, while all other (routine type) services, IMO could be handled by free market, and make it so doctors are negotiating with clients. Helps (consumers) they have an oath to do their best by patients, but I do imagine there would be 2 classes of doctors: those for the rich, and those who deal with the middle class and poor, knowing they may not get paid in some instances with treating the poor.

My second idea is government run healthcare. Yep, you heard me. If somehow the free market, by getting rid of insurance companies from healthcare market except for catastrophic needs is unacceptable (to conservatives), then I would make a push for this. And would try to use founding documents of the country to say it is in our best interest to have this backed by the government. Yet, I definitely hesitate to go in this direction as a transition from what we have now. I think it could bankrupt the country (more so than it is now) and would plausibly lead to substantial loss in the quality of care. So, I would kind of hope we'd have a good 3 to 10 years of trying the first idea (allowing free market) and if somehow that is truly identified as working poorly (rather than constant liberal spin of - this is not working), we'd then transition from that to government run healthcare.

Can easily say more about each of my ideas, but already have a wall of text and right now I'm wondering what other conservatives mean by "replace Obamacare?" Are there plans that you know of that will work, and that after say 5 years wouldn't have vast majority of progressive types (constantly) crying foul. As a conservative, I recognize there is almost no way around that last point, they'll whine about anything non-government run until it occurs (the government take over).

I frankly don't see a winning approach going forward, and am not enamored by current (or even say 20 years ago) quality of healthcare. I think/know true health/healing to be spiritual rather than physical, but that type of debate is not what I'm seeking in this thread. So, rather discuss what are the practical, conservative steps, that can be taken to try and effectively manage the healthcare industry in America.

 

[Twilight Hue]

I'd probably would like to see a revamping of Medicare and Medicaid for better individual accessibility based on a persons ability to pay and the medical condition they face.

As far as Goverment, something which is structured like public and private education system could be playable including vouchers, but the costs involved could increase taxation substantially. Maybe a deduction or savings program could provide a venue by which money is pooled and drawn as needed.

 

[Acim]

I'd probably would like to see a revamping of Medicare and Medicaid for better individual accessibility based on a persons ability to pay and the medical condition they face.

As far as Goverment, something which is structured like public and private education system could be playable including vouchers, but the costs involved could increase taxation substantially. Maybe a deduction or savings program could provide a venue by which money is pooled and drawn as needed.

Much of what you're conveying is favoring government run healthcare, no?

 

[buddhist]

Non-corporate free market. Everyone should be able to purchase whatever they wish to purchase from other individuals (not corporations), and not be forced to purchase what they don't want or need.

 

[Twilight Hue]

Much of what you're conveying is favoring government run healthcare, no?

I'm not against the idea in general. My major contention was the personal healthcare mandate by which penalties incurred for noncompliance were not representative the same way general taxiation is imo.. I still think people should still be able to make choices similarly like person can with education for instance through a voucher system.

Ironically the Canadian healthcare system seems plausable and worth consideration, but its not perfect though. Quality of care over there took a fair hit and dental medicine is not even considered a part of the healthcare system over there. It's still not a bed of roses but still it's better structured than the hideous healthcare mess the Democrats created for people everywhere now. If it wasn't for the insistence on a personal mandate and corrupt way if implementing it, I think ACA would / could garner more bipartisan support and with intelligent careful planning, might of had a modicum of success.

Then again were not Canada. What "works" for them may still not fare as well in the U.S. Compatibility would need to be looked at.

Maybe healthcare would be better instituted at the state level than going the way of federalism for healthcare. It would be more managable , as well as give people choices as to what system would best suit them.

 

[Acim]

Non-corporate free market. Everyone should be able to purchase whatever they wish to purchase from other individuals (not corporations), and not be forced to purchase what they don't want or need.

Could you provide a few specifics on how you see this working in the healthcare industry, from consumer perspective?

 

[Valjean]

Why are we being so insular? This isn't new territory. We have dozens of examples of working healthcare systems from all over the world as exemplars. There's no need to re-invent the wheel.

There are four basic models for healthcare systems: http://www.pbs.org/wgbh/pages/frontline/sickaroundtheworld/countries/models.html

The US is currently using three of these. The Veterans hospitals use a socialized, Beveridge model. Medicare is a single-payer, NHI model. Many pay out-of-pocket, but a price controlled, regulated Bismark-style insurance system is nowhere to be seen.

We already have a socialized and single-payer systems in place, which could be extended to cover the entire populating at perhaps a third the cost of our current, for-profit insurance + out-of-pocket model.

The problem is, any politician who tries to bar the insurance industry or big pharma from the trough is going to find himself with a pretty scanty re-election fund.
This is the problem with Obamacare -- which essentially gives the insurance industry millions of new customers to price gouge. Obamacare dosen't regulate either insurance or drug prices -- Uncle Sam picks up the tab for any unaffordable charges.

 

[Valjean]

Much of what you're conveying is favoring government run healthcare, no?

Neither Medicare nor Medicaid is government run, they're single-payer, NHI systems.
The VA is government run, with the hospitals being owned by the government and the Drs and nurses salaried, government employees.

 

[Acim]

Neither Medicare nor Medicaid is government run, they're single-payer, NHI systems.

From the link you provided:

This system (NHI) has elements of both Beveridge and Bismarck. It uses private-sector providers, but payment comes from a government-run insurance program that every citizen pays into.

*Bold emphasis, mine

 

[Valjean]

From the link you provided:
*Bold emphasis, mine

The government is only the payer. It doesn't regulate or run anything.
Private hospitals, private Drs, private treatment plans -- the only difference is the government, not the patient or a private insurance co, picks up the tab.

Go to the link and watch the video. It's very informative.

 

[buddhist]

Could you provide a few specifics on how you see this working in the healthcare industry, from consumer perspective?

IMO the following scenario applies not only to healthcare, but similarly for any other profession, as a result of the elimination of corporations, and the promotion of free markets:

• Since there would be no corporations (and no corresponding corporate protections to hide behind), very few individuals would personally take on the risk to insure others, so there would be no "insurance companies" or "insurance".
  
• With no insurance, individuals would have far greater incentive to live more healthy and self-responsibly, and to avoid conflict (and what comes along with it, e.g. mental illness, sickness, and death).
  
• With no insurance, patients must work directly with the healers of their choice, and pay them directly.
• With no corporate laws to hide behind, healers would be far more judicious and careful with their treatments, preferring to work only with patients whom they are personally familiar with.
• Since healers are careful about whom they treat, patients also have far more incentive to maintain excellent social ties with their healers and their local community (lest they be treated as irresponsible outcasts and refused service).
  
• The local community is enhanced with these strong ties: every member of the community finds it is in his or her self-interest to be a good, upstanding citizen, and are collectively individuals who trusts and takes care of one another as a personal and community obligation.
• Conflict, crime, wars, and competition are inherently curtailed; ethical and moral behavior, peace, and cooperation are inherently enhanced. Costs are kept down (greedy swindlers easily become outcasts), local communities are strengthened, natural limits are observed. Physical, mental, and social health becomes a natural consequence.

 

[Twilight Hue]

Why are we being so insular? This isn't new territory. We have dozens of examples of working healthcare systems from all over the world as exemplars. There's no need to re-invent the wheel.

There are four basic models for healthcare systems: http://www.pbs.org/wgbh/pages/frontline/sickaroundtheworld/countries/models.html

The US is currently using three of these. The Veterans hospitals use a socialized, Beveridge model. Medicare is a single-payer, NHI model. Many pay out-of-pocket, but a price controlled, regulated Bismark-style insurance system is nowhere to be seen.

We already have a socialized and single-payer systems in place, which could be extended to cover the entire populating at perhaps a third the cost of our current, for-profit insurance + out-of-pocket model.

The problem is, any politician who tries to bar the insurance industry or big pharma from the trough is going to find himself with a pretty scanty re-election fund.
This is the problem with Obamacare -- which essentially gives the insurance industry millions of new customers to price gouge. Obamacare dosen't regulate either insurance or drug prices -- Uncle Sam picks up the tab for any unaffordable charges.

How do you address the mandate? No American should ever be forced to buy private services.

 

[Valjean]

How do you address the mandate? No American should ever be forced to buy private services.

Not sure what you're getting at, here. Are you asking about Obama's mandatory insurance?
OK, no mandatory private services, but what about public services like police, fire, education and the military? Most countries include healthcare as a public service.

 

[Valjean]

IMO the following scenario applies not only to healthcare, but similarly for any other profession, as a result of the elimination of corporations, and the promotion of free markets:

• Since there would be no corporations (and no corresponding corporate protections to hide behind), very few individuals would personally take on the risk to insure others, so there would be no "insurance companies" or "insurance".

• Freetrade promotes corporations, corporate mergers and monopoly.
  

• With no insurance, individuals would have far greater incentive to live more healthy and self-responsibly, and to avoid conflict (and what comes along with it, e.g. mental illness, sickness, and death).

  Historically, people did not take better care of themselves when medical care was unregulated and payment strictly out-of-pocket.
  

• With no insurance, patients must work directly with the healers of their choice, and pay them directly.

  And historically this resulted in charlatans and snake-oil salesmen dominating the industry, and no way to distinguish between a legitimate healer and a quack.
  

• With no corporate laws to hide behind, healers would be far more judicious and careful with their treatments, preferring to work only with patients whom they are personally familiar with.

  See above. Unregulated, business -- including healthcare -- selects for predators and sociopaths. Just look at history.
  

• Since healers are careful about whom they treat, patients also have far more incentive to maintain excellent social ties with their healers and their local community (lest they be treated as irresponsible outcasts and refused service).

  Again, this has not been the case, historically.
  

• The local community is enhanced with these strong ties: every member of the community finds it is in his or her self-interest to be a good, upstanding citizen, and are collectively individuals who trusts and takes care of one another as a personal and community obligation.

  Seriously -- when has this ever happened?
  

• Conflict, crime, wars, and competition are inherently curtailed; ethical and moral behavior, peace, and cooperation are inherently enhanced. Costs are kept down (greedy swindlers easily become outcasts), local communities are strengthened, natural limits are observed. Physical, mental, and social health becomes a natural consequence.

  Can I get a toke of whatever your smoking?

 

[gerobbins]

I'm not against the idea in general. My major contention was the personal healthcare mandate by which penalties incurred for noncompliance were not representative the same way general taxiation is imo.. I still think people should still be able to make choices similarly like person can with education for instance through a voucher system.

Ironically the Canadian healthcare system seems plausable and worth consideration, but its not perfect though. Quality of care over there took a fair hit and dental medicine is not even considered a part of the healthcare system over there. It's still not a bed of roses but still it's better structured than the hideous healthcare mess the Democrats created for people everywhere now. If it wasn't for the insistence on a personal mandate and corrupt way if implementing it, I think ACA would / could garner more bipartisan support and with intelligent careful planning, might of had a modicum of success.

Then again were not Canada. What "works" for them may still not fare as well in the U.S. Compatibility would need to be looked at.

Maybe healthcare would be better instituted at the state level than going the way of federalism for healthcare. It would be more managable , as well as give people choices as to what system would best suit them.

I am Canadian, and while our Health care system is not perfect. I will take it over the U.S. system everyday. We will never have to worry about Medical bills and we will never get turned down for surgery
We need to see a specialist, we go, there is no 2 tier system here...

My daughter was born 6 weeks premature and had to spend 10 days in the ICU and the total cost me was nothing.

I had 3 MRIs this year and the total cost to me was nothing. (Although my appointments were at 5 am and 11:30 pm) It still did not cost me one cent.

Health care is just not an issue up here. I feel sorry for my American friends when it comes to Health care.

 

[buddhist]

Freetrade promotes corporations, corporate mergers and monopoly.

I speak from a conservative-libertarian perspective. A libertarian state only recognizes and protects Men and Women. There is no provision for corporations. With no laws protecting corporations or shielding Men and Women who create those corporations, there is no incentive to create those "corporations" in the first place. Free trade would only happen between Men and Women.

Historically, people did not take better care of themselves when medical care was unregulated and payment strictly out-of-pocket.

I disagree from personal experience. When I had no insurance, I consciously knew that I had to avoid reckless behavior, and take better care of myself.

And historically this resulted in charlatans and snake-oil salesmen dominating the industry, and no way to distinguish between a legitimate healer and a quack.

I would not trust a stranger who wandered into my local community. A legitimate healer would establish and build a reputation for himself in the community as an upstanding, honest, effective citizen.

Even then, if I wanted to personally try snake-oil, it's my responsibility, and my money, and consequences are for me to experience. It's attempting to bypass the Law of Kamma which brings us into many of the messes we have today.

See above. Unregulated, business -- including healthcare -- selects for predators and sociopaths. Just look at history. Again, this has not been the case, historically.

See above.

Seriously -- when has this ever happened?

IMO before the evil invention of the corporation.

Can I get a toke of whatever your smoking?

No need for personal attacks.

 

[Twilight Hue]

I am Canadian, and while our Health care system is not perfect. I will take it over the U.S. system everyday. We will never have to worry about Medical bills and we will never get turned down for surgery
We need to see a specialist, we go, there is no 2 tier system here...

My daughter was born 6 weeks premature and had to spend 10 days in the ICU and the total cost me was nothing.

I had 3 MRIs this year and the total cost to me was nothing. (Although my appointments were at 5 am and 11:30 pm) It still did not cost me one cent.

Health care is just not an issue up here. I feel sorry for my American friends when it comes to Health care.

How do you deal with your dental care?

I'm not Canadian , yet my work day usually is spent up here in Ontario and surrounding areas.

I do like your health system though your taxed to hell imo. ;0)

Anyways it seems dental has no coverage although it should be, far as I know.

CBC awhile back were discussing the issue and that aspect quite suprised me.

Unless it was This and That. *grin*

 

[Valjean]

I speak from a conservative-libertarian perspective. A libertarian state only recognizes and protects Men and Women. There is no provision for corporations. With no laws protecting corporations or shielding Men and Women who create those corporations, there is no incentive to create those "corporations" in the first place. Free trade would only happen between Men and Women.

But the incentive is pecuniary. Back in the unregulated Gilded Age there was violent business competition leading to predatory monopolies dominating industry. It took Teddy Roosevelt and government intervention to bring them to heel.

I disagree from personal experience. When I had no insurance, I consciously knew that I had to avoid reckless behavior, and take better care of myself.

You are the exception, my friend.
Health insurance is a new thing in human history. It wasn't till post WWII that personal health insurance policies became common. I don't see any indication that people were any less reckless with their personal safety before insurance became the norm.

I would not trust a stranger who wandered into my local community. A legitimate healer would establish and build a reputation for himself in the community as an upstanding, honest, effective citizen.

Yet before government regulation charlatans managed to thrive. Anyone could hang up a shingle and open a Dr or dentist's office. Sans regulation, quacks, shysters and all manner of scoundrels run rampant.

Even then, if I wanted to personally try snake-oil, it's my responsibility, and my money, and consequences are for me to experience. It's attempting to bypass the Law of Kamma which brings us into many of the messes we have today.

Are you talking about a Karmic meritocracy? If so, I can see where you're coming from. The strong/competent will thrive. The weak, lazy or incompetent are lift behind; law of the jungle, the natural order of things.
As a libertarian I'm assuming you don't see government's role as much more than enforcement of contracts and national defense. Me, I see it more as an extended family; a large mutual aid co-operative; one for all and all for one.

IMO before the evil invention of the corporation.

That being before the founding of the East India Company in 1600? Wasn't life back then "solitary, poor, nasty, brutish and short?"

No need for personal attacks.

My apologies -- I get carried away, sometimes.

 

[gerobbins]

How do you deal with your dental care?

I'm not Canadian , yet my work day usually is spent up here in Ontario and surrounding areas.

I do like your health system though your taxed to hell imo. ;0)

Anyways it seems dental has no coverage although it should be, far as I know.

CBC awhile back were discussing the issue and that aspect quite suprised me.

Unless it was This and That. *grin*

Dental care has never been part of our Health care. Most of us have benefits through our jobs which covers that cost... Yea, we are taxed to hell. However, that being said, my lifestyle is just as good as my American friends who earn the same money has I do...

 

[GoodbyeDave]

How do you address the mandate? No American should ever be forced to buy private services.

So you're against forcing people to have motor-vehicle insurance, as every state does?

My observations on health insurance:
Public health insurance works, as in France.
Private health insurance regulated by the government works, as in Germany.

Running health care as a nationalised industry, as in the UK or Italy, is a bureaucratic mess, unless in a small country like Sweden.

The free market doesn't exist. I recently read of a New Yorker who needed a new knee joint, and that knee was excluded from his current insurance. He got his knee replaced in Belgium: the total cost, including air fares, was less than the cost of the joint alone in the US! It just so happens that all US joint manufacturers charge the same prices — what a surprise! Or consider the epipen: $300 in the USA, about $50 in the UK and France.