Sorry I don't remember everything I read yesterday. My bad... What about people that cannot afford to cover the premiums? You cover people who cannot get it because of pre-existing conditions but not those that cannot afford it. Also, you've said several times that it is stupid to cover people with pre-existing conditions but now you are for it?
Cost is still going to be outrageous because when people go to the doctor they just see the $15 copay. Not the $100 that goes to pay the doctor so they go for everything. Along with other problems. Just curious: What do you think would happen if we got rid of insurance all together? Prices would have to come down because otherwise no one will be able to afford anything. (I am not advocating for this. I just want to know what people think will happen?)
Those are pretty good questions, I think. As far as people being able to afford the premiums, I have seen high deductible plans with pretty low premiums. If lower income people didn't have to be so concerned about meeting the deductible, the premiums would not be such a hardship. Sure, there are people with no income, or with incomes so low that they legitamately could not pay the premiums regularly enough to maintain the insurance. But I believe these are the exceptions to the rule, once you start looking at each person individually and determining WHY they are so impoverished. For those who are disabled or over 65, there is already a system for that. Medicare. I would be for extending that benefit also to people with pre-existing conditions that prohibit them from private coverage. That way, it truly is a public option, paid for by CMS, rather than burdening private insurers and causing across the board premium increases for healthy people due to the increased costs of having to insure the uninsurable.
As far as your comment regarding overutilization of healthcare services due to low copays- this would not be burdensome. This is how insurance works. The insurance companies would get their monthly premiums for each covered person, and would pay everything but the copay and co-insurance (if any- and it would be preferable for a lower income person to choose a higher deductible plan with limited or no co-insurance). The taxpayers would pay for the deductible, but that limits the taxpayer's costs to a maximum of 10-12k per capita per year, and that only for those people under the "deductible assistance" program. (Again, that would be no one over 65, and no one who is disabled- because there are other programs that take care of those people, and no one who has enough money to afford better insurance. So the pool of eligible people would be really small.)
The way we would fund this would be to take what the money currently allocated for Medicaid (which is a federal/state match) and reallocate it to the new program. Doing it this way, no one would be uninsured, and the private insurance companies would be taking care of most of the big bills- everything but the deductibles and the people with pre-existing conditions.
As far as eliminating insurance, you have to remember that enterprise and pricing are based on supply and demand. The demand would not go down, because people will always need the health care services- it would actually go up, as I'll explain in a minute. Supply would go down- meaning lots of people needing care, and not enough people providing it.
The big deal is the research. Coming up with state of the art equipment and innovative medications is extremely expensive, and those cost are built in to the price consumers and insurers pay at point of service. When a hospital buys a new MRI machine for millions of dollars, they are going to charge a lot of money for each MRI procedure in order to cover the costs and turn a profit.
What would happen is that costs would remain at current levels at first, and people would still utilize the services- but they wouldn't be doing the preventative care, so when they did end up having to go to the hospital, the costs would be even higher. They wouldn't be able to pay it, so they would be in debt to the hospital- who would be required to provide the service anyway under federal law. When hundreds of thousands defaulted on their debts to the hospital, the hospitals would start to go under, meaning decreasing supply and decreasing access to health care services. As the hospitals went under, they would default on their debt to their vendors, who would default on the equipment and pharmaceutical manufactures, who would default on the R&D companies, preventing them from funding cutting edge research and design.
Increased demand and decreased supply results in increased cost to the consumer. That is just the way things work. Getting rid of insurance without having something to replace it would completely destroy our system of healthcare.
Kamikaze: how will your plan lower healthcare costs? Also why should a public option be available to those who can't get private coverage?
I would love to see your reasoning behind these two questions
The reduction in healthcare costs would be twofold. There would be a reduction in terms of actual treatment costs as well as healthcare cost savings to taxpayers.
By making sure everyone has some type of insurance, there would be no need for the Indigent Health Care and Treatment Act. Right now, uninsured people who get sick go to the hospital. The hospital treats them as required by law. But the hospital doesn't get paid. So those losses are passed on to consumers and insurers in the form of increased costs for services. These embedded costs to the providers would disappear because everyone would have the opportunity to have insurance. This would cause not only the eventual (within a year or two) reduction in costs, but it would increase supply of health care services. The services would be more profitable, the healthcare marketplace would become even more competitive, and increased supply, without an increase in demand, results in lower prices.
Secondly, it would save taxpayer money- simply because the government would be paying less money for less people. The taxpayer's bet would be hedged because most people would have private health plans.
Secondly, the only reason the public option would be made availabe is to SAVE taxpayer money. It would be a way to limit the taxpayer's burden per capita by having everyone insured. That way, private insurance markets handle the bulk of the risk. But they are in the risk business, whereas the federal government is not- or at least it shouldn't be. And that public option would replace the following:
A) Obamacare
B) Medicaid
C) The Indigent Health Care and Treatment Act of 1985
D) The Emergency Medical Treatment Act of 1985
The total cost savings to taxpayers would be unbelieveable and it would go a long way toward the solving the high health care cost problem. The catch it this: no one would be required to participate in any program. But the programs would be available to everyone. So if people chose not to participate and did not have health insurance of any kind, hospitals would not be required to provide them with services. It places some onus on individual responsibility, while at the same time helping those who can't get insurance or can't afford it.
Then the only battle we'd be fighting is how to reform Medicare to make it sustainable- but then again we would have all this extra money.
