Education payments being based on income.

[imagep]

A large problem with the health care issue in the US is the fact that Insurance companies have no competition in the State they offer insurance due to State mandates which prevent you to buy across State lines.

The largest part of our health care issue is that due to having a system that is based upon a third party payor system (insurance companies), we don't have competition between healthcare providers. I would really think that those on the right, especially libertarians would understand this, but they are so entrenched in todays insurance system that they can't think beyond that, and they can't even begin to imagine a world where these prepaid healthcare plans that most of us call "insurance" doesn't exist.

The problem isn't a lack of insurance, the problem is that we tend to be over-insured, and we hold this concept that our health insurance company should be involved with every little maintenance type healthcare expense that we have, and some people even seem to have this funny idea in their head that you can't purchase healthcare unless you have insurance. I really don't understand why I need to pay an insurance company $800 a month to pay for my $50 doctors visit - it's crazy. And of course that doctor, knowing that I'm not price shopping because I have insurance, is going to charge $150 for that $50 doctors visit, and the insurance companies really don't mind doctors overcharging because the more doctors overcharge, the easier it is for the insurance company to justify high prices for insurance, and this perceived need for insurance.

4 years ago, around the time that our congress was voting on obamacare, I would have gladly voted for any politician who made a proposal to step away from our system that encourages these expensive prepaid medical plans. Simple eliminating the tax deductability for employer provided insurance would have been a great first step. It's actually cheaper for employers to try to attract good employees by offering them expensive insurance in leu of more pay - since the tax deduction goes to the employer. I believe encouraging businesses to to provide health insurance was our first step into todays insurance/medical cost fiasco. Pretty much, most anytime that government gets involved with something, things become worse.

 

[austrianecon]

The largest part of our health care issue is that due to having a system that is based upon a third party payor system (insurance companies), we don't have competition between healthcare providers. I would really think that those on the right, especially libertarians would understand this, but they are so entrenched in todays insurance system that they can't think beyond that, and they can't even begin to imagine a world where these prepaid healthcare plans that most of us call "insurance" doesn't exist.

Okay, this is hogwash. I'd love the idea of paying my family doctor cash for a visit but are you willing to through away Medicare and Medicaid with it?

But the problem isn't the lack of providers as healthcare providers is local and this isn't the issue. For example: I personally have 3 choices of healthcare providers. Ohio State Health system (which includes Nationwide Children's Hospital), Ohio Health, and Mount Carmel. Each have at least two hospitals (some have 3 or more) in the area and then half dozen satellite services (urgent care facilities) and however many doctors offices that are part of their systems.

I am not prevented from going to whatever hospital I want (well except Children's). I can get treatment at any of them. Problem comes along when it comes to Insurance. If your insurance program is through Ohio Health, you'll be recommended to Ohio Health doctors. To go to an OSU doctor you'll have to pay more out of pocket because the Insurance companies have deals (contracts) with each healthcare provider on cost of service and what will be charged. So to see a Cardiologist at Ohio Health might cost you and your insurance company $350 but you (personally) decided to see one at OSU it'll be $500 because your insurance company doesn't have an agreed price with them. You'll pay the difference out of pocket.

So it's an Insurance issue.

The problem isn't a lack of insurance, the problem is that we tend to be over-insured, and we hold this concept that our health insurance company should be involved with every little maintenance type healthcare expense that we have, and some people even seem to have this funny idea in their head that you can't purchase healthcare unless you have insurance. I really don't understand why I need to pay an insurance company $800 a month to pay for my $50 doctors visit - it's crazy. And of course that doctor, knowing that I'm not price shopping because I have insurance, is going to charge $150 for that $50 doctors visit, and the insurance companies really don't mind doctors overcharging because the more doctors overcharge, the easier it is for the insurance company to justify high prices for insurance, and this perceived need for insurance.

And I totally agree but as I said before.. it would require Medicare and Medicaid to go as well. But the idea of insurance is protection. If you are paying $800 a month you aren't paying that to cover a family doctor's visit because that's not the only cost. You have to consider the cost if your family doctor orders blood tests, x-ray, mri, ct or whatever else. A visit to the doc at $50, blood test and an x-ray would be close to $300. Then they might send you to a specialist. A specialist will cost you more then $800 as they'll order tests as well. So in two visits your out $1,100.

4 years ago, around the time that our congress was voting on obamacare, I would have gladly voted for any politician who made a proposal to step away from our system that encourages these expensive prepaid medical plans. Simple eliminating the tax deductability for employer provided insurance would have been a great first step. It's actually cheaper for employers to try to attract good employees by offering them expensive insurance in leu of more pay - since the tax deduction goes to the employer. I believe encouraging businesses to to provide health insurance was our first step into todays insurance/medical cost fiasco. Pretty much, most anytime that government gets involved with something, things become worse.

Umm, I am speechless, I agree with you.

 

[imagep]

Okay, this is hogwash. I'd love the idea of paying my family doctor cash for a visit but are you willing to through away Medicare and Medicaid with it?

But the problem isn't the lack of providers as healthcare providers is local and this isn't the issue. For example: I personally have 3 choices of healthcare providers. Ohio State Health system (which includes Nationwide Children's Hospital), Ohio Health, and Mount Carmel. Each have at least two hospitals (some have 3 or more) in the area and then half dozen satellite services (urgent care facilities) and however many doctors offices that are part of their systems.

I am not prevented from going to whatever hospital I want (well except Children's). I can get treatment at any of them. Problem comes along when it comes to Insurance. If your insurance program is through Ohio Health, you'll be recommended to Ohio Health doctors. To go to an OSU doctor you'll have to pay more out of pocket because the Insurance companies have deals (contracts) with each healthcare provider on cost of service and what will be charged. So to see a Cardiologist at Ohio Health might cost you and your insurance company $350 but you (personally) decided to see one at OSU it'll be $500 because your insurance company doesn't have an agreed price with them. You'll pay the difference out of pocket.

So it's an Insurance issue.

I have no idea what you are talking about. I'm not suggesting that we have a shortage of healthcare providers or options. I think you misread what I wrote, or maybe I didn't do a decent job of wording what I intended. I was saying that insurance is our problem, not the lack of health care providers.

And I totally agree but as I said before.. it would require Medicare and Medicaid to go as well.

Sure. I actually suggested that to my local congressman when I met with him in person in a private meeting. He couldn't seem to understand that, of course I shouldn't have expected him to be able to understand, after all, he was a republican.

But the idea of insurance is protection. If you are paying $800 a month you aren't paying that to cover a family doctor's visit because that's not the only cost. You have to consider the cost if your family doctor orders blood tests, x-ray, mri, ct or whatever else. A visit to the doc at $50, blood test and an x-ray would be close to $300. Then they might send you to a specialist. A specialist will cost you more then $800 as they'll order tests as well. So in two visits your out $1,100.

Insurance drives healthcare prices up because when a third party pays for healthcare, consumers don't bother to shop based upon price, and with insurance companies pick the healthcare providers, consumers don't bother to shop based upon quality. Now imagine if you owned a shop that sold turtles, and most of your customers had turtle insurance, which would purchase the customer a new turtle any time that his old one died or crawled away. You'd probably get rich in no time (assuming that people actually desired turtles), because your customers really wouldn't care how much the turtles cost. You could set whatever price you wanted to, and jack it up more and more each year.

Healthcare should be treated just like most any industry in the US, and this would allow the free market system of competition to keep prices in check. It seems to work well for other industries, I can't see any reason that it wouldn't work for healthcare.

I am speechless, I agree with you.

If you would be speechless more often, and spend that time reading and listening, you would discover that I am one of the more conservative posters on DP. My entire post was about how bad our healthcare payment system is, and most of the bad has been caused by government action. Guberment should get out of the healthcare business totally. Of course they should also get out of the welfare business, and the "policeman/military of the world" business and a lot of other activities that they are involved in.

Often people assume that anyone who disagrees with any of the standard talking points of their "club", the person must belong to the other club. I just don't always agree with the standard conservative talking points, many of which are not actually conservative positions at all. I freqently chastise self proclaimed conservatives when they downgrade the "47%", if they were truly conservative, they would be complaining that the 53% pay too much in taxes. I've never understood why they think that jacking up taxes on those who have the least ability to pay is somehow representative of a "low tax/small government" policy - sounds like just the opposite of that to me.

I'm probably much closer to a true libertarian though (not government hater or anarchists).

 

[austrianecon]

Sure. I actually suggested that to my local congressman when I met with him in person in a private meeting. He couldn't seem to understand that, of course I shouldn't have expected him to be able to understand, after all, he was a republican.

Tell a Democrat that and see the response.

Insurance drives healthcare prices up because when a third party pays for healthcare, consumers don't bother to shop based upon price, and with insurance companies pick the healthcare providers, consumers don't bother to shop based upon quality. Now imagine if you owned a shop that sold turtles, and most of your customers had turtle insurance, which would purchase the customer a new turtle any time that his old one died or crawled away. You'd probably get rich in no time (assuming that people actually desired turtles), because your customers really wouldn't care how much the turtles cost. You could set whatever price you wanted to, and jack it up more and more each year.

Healthcare should be treated just like most any industry in the US, and this would allow the free market system of competition to keep prices in check. It seems to work well for other industries, I can't see any reason that it wouldn't work for healthcare.

I don't disagree with the premise. But Insurance is a safety net. You don't tend to shop around after somethings happen or are happening.

 

[imagep]

Tell a Democrat that and see the response.

Oh, I know the response from both democrats and republicans. It's really just the same. A knee jerk reaction which results from "in the box" thinking. When I proposed the "imagep plan" to my fairly liberal yet republican (RINO?) congressman, his eyes just glazed over, and he kept making excuses why it wouldn't work, rather than trying to understand the concept that the free market keeps prices in check though price and quality competition.

I don't disagree with the premise. But Insurance is a safety net. You don't tend to shop around after somethings happen or are happening.

Yes, insurance should be just a safety net. Thats exactly why we don't need it to cover every $50 or $200 visit to the doc. I spend more than that every weekend when I go to Sams or Walmart, and a tank of gas costs me $75 or so. It's not like that average person can't afford a $100 doctors visit, or a $7 script of medication.

A few weeks ago, I was waiting in line at the pharmacy, this guy pulled out his insurance card, the pharm tech scanned it, then handed it back to him and said "you really don't want to use it, the price it came up with is higher than our price without insurance".

The only health insurance that anyone actually needs, is the safety net type, just like you said. A major medical plan, not a prepaid healthcare plan. The difference being that major medical plans are extremely inexpensive, I pay $150/mth for mine, and it covers two people, however they have large deductables, and don't cover minor health care costs that individuals can afford to pay for out of pocket. NO ONE needs to pay an extra $650/mth ($800 for average "good" insurance minus $150 for the cost of a major medical policy) to cover the occasional doctors visit. Heck, even copays often cost nearly as much as the doctors visit would cost without having insurance. One would literally have to go to the doc three times a week to have enough savings to cover the additional cost of the higher priced insurance.

The plan that I proposed was to eliminate all current government (including local and state) healthcare spending, and replace it with a government paid for, but privately administered, major medical policy for every American. It's not a perfect solution at all, it's a compromise, but one that puts both liberals and conservatives closer to their stated end goal. All levels of guberment combined currently spend $1.2 trillion dollars on healthcare (probably more now, that was a few years ago). Thats nearly half of all healthcare dollars spent in America. Thats enough to purchase a high deductable major medical policy for every single American, and still rebate $2,000/yr back to them (in the form of a HSA). Or, instead of the rebate, we could simply reduce taxes.

Liberals should like the idea because it is universal coverage (even though it doesn't cover every penny of medical care). Republicans should like the idea because it results in smaller government and less government spending, and it in no way socializes healthcare (only health insurance). Insurance companies should like the idea because they get to bid on huge chunks of the policy (everyone who's last 4 digits of their SS are the same would be considered a group, and all groups would be statistically identical, and the insurance companies would bid a specific amount of money to be able to administer the policy for however many groups they chose to bid on).

I like the idea because EVERY CITIZEN then gets this government benefit equally.

 

[Mach]

Doing nothing for fear of screwing up isn't my style.

Big boy's all brave risky other people's money?

And you think that's somehow appropriate?
You do understand that the risk is what keeps people spending money, from spending on non-worthwhile things yes? And by you simply taking that money, and apparently being entirely fearless (i.e. reckless) with that money, how are you going to keep yourself in check in terms of making a sound investment choice? Go ask any investor if it's good to be 100% fearless in investing others money...wow. That doesn't even touch the ethics of taking others money for such emotional gambling.

Every leader ever, has a peanut gallery of wannabe, armchair know-it-alls who want all that power without any of the responsibility. Worse, apparently most of them also want that power simply by demanding it.
Earn the power to pay for education and then pay for their education. Else, you're just wanting to take others money and spend it at your leisure.