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We Need to Design Health Care Reform That Puts Patients Before Profits

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Re: We Need to Design Health Care Reform That Puts Patients Before Profits

#21

Post by bduerst »

refurb wrote: post #14
claudeganon wrote: post #2

> We can and must design the next round of insurance reforms with patients as a priority. With low deductibles that actually facilitate the consumption of care, our health care system can directly benefit the well-being of low- and middle-income people—not just the holders of for-profit hospital stock. No, we need to get rid of private insurance with Medicare for All. The amount of money, corruption, and lobbying ins…

Umm.. a good part of Medicare is run by private insurers. Medicare Part C and D. Are you saying get rid of those too?

And why do you think that is?

Part C and D have privatized options because it offers gap coverage from Part A and B, so yes, privatized Part C and D would disappear if the gaps are closed.

Re: We Need to Design Health Care Reform That Puts Patients Before Profits

#22

Post by dragonwriter »

bduerst wrote: post #15
kapuasuite wrote: post #4

Earlier quoted context omitted.

Other countries, yes even in Europe, have better healthcare than us with multi-payer systems. Medicare for All is a joke.

Medicare for all doesn't eliminate other payers, and is more similar to the European system than what we have now.

> Medicare for all doesn't eliminate other payers

The Sanders bill does eliminate most other payers (except for the VA).

Other candidates with plans (or vague descriptions of plans) borrowing the name sometimes do, and sometimes do not, and sometimes are not entirely clear (or consistent over time) as to which category they fall into.

Re: We Need to Design Health Care Reform That Puts Patients Before Profits

#23

Post by 4ntonius8lock »

I'm really not sure why this isn't mentioned:

USA should commission a study of health care systems in other countries. Include costs, challenges, issues of bringing it to scale in US, etc.

Then we can implement something based on real world experience and data.

It seems that these highly complex topics are dealt at the ideological level only. Which is absurd, as details can make anything from any ideology horrible. It makes me think of times when other common sense issues that should be data driven were treated in such a way. In the end, the curvature of the world is really independent of any ideological constructs that were created, but the ideological constructs made discussing the data virtually impossible at the time.

Re: We Need to Design Health Care Reform That Puts Patients Before Profits

#24

Post by soup10 »

Zelphyr wrote: post #16

I know a medical provider who works for a small family medicine practice recently purchased by a large hospital group in our area. They're being told, "You guys need to be sending more people to our hospitals." So for these organizations, patients who are sick and suffering are seen as a product. A day of reckoning is coming for these organizations because the sick and suffering are getting fed up with being treated…

Not holding my breath on that one. The current health care system is institutionalized and is going resist reform every step of the way.

Re: We Need to Design Health Care Reform That Puts Patients Before Profits

#25

Post by kerkeslager »

dsfyu404ed wrote: post #5
claudeganon wrote: post #2

> We can and must design the next round of insurance reforms with patients as a priority. With low deductibles that actually facilitate the consumption of care, our health care system can directly benefit the well-being of low- and middle-income people—not just the holders of for-profit hospital stock. No, we need to get rid of private insurance with Medicare for All. The amount of money, corruption, and lobbying ins…

>No, we need to get rid of private insurance Insurance works well for rare events. Using insurance for an annual physical (or any other routine thing) is just pissing money away. Cutting insurance out of routine and preventative care will require far less political capital and should have a massive impact on costs. No need to go all the way to eliminating private insurance. A government option would have benefits but…

In a larger sense, insurance only makes sense to cover events that are both expensive and rare.

1. If an event is not expensive, you can just pay for it yourself.

2. If an event is not rare, then pooling resources doesn't increase your ability to pay for it.

Annual physicals are neither expensive nor rare. But the larger problem is, illness isn't rare. People get sick, and we need to stop pretending that this is some unusual thing.

I really don't see myself staying in the US if we haven't switched to single-payer healthcare by the end of the next presidency. I probably want kids, and I'm simply not going to bring them up in a country where the government and increasingly, the culture itself, cares more about corporate profits than people. We work really hard in this country just to achieve the same standard of living that people in countries with fewer resources have. Healthcare is, in my opinion, the most egregious example of that. It's stupid, and I don't want to inflict it on my kids.

Re: We Need to Design Health Care Reform That Puts Patients Before Profits

#26

Post by claudeganon »

balls187 wrote: post #17
claudeganon wrote: post #2

> We can and must design the next round of insurance reforms with patients as a priority. With low deductibles that actually facilitate the consumption of care, our health care system can directly benefit the well-being of low- and middle-income people—not just the holders of for-profit hospital stock. No, we need to get rid of private insurance with Medicare for All. The amount of money, corruption, and lobbying ins…

We do need Health Care reform, but I'm not convinced single payer government is going to lead to better outcomes. > No, we need to get rid of private insurance with Medicare for All. That would shift the incentivization from maximizing profits, to instead solely minimizing tax payer dollars. Lobbying would still exist (see defense industry). Denying care wouldn't be based on health reasons (dubious), but shift to cla…

>And, our healthcare will instead be subject to the whims of the politics, rather than the profits for Shareholders. Medicare works because it's beneficiaries are a strong voting block. There are population segments in America who aren't.

The point of Medicare for All is also to instantiate this new voting block across as much of the population as possible, to imbue them with this political power and free them from control by their employers and the profit-seeking of healthcare companies.

You have the causation backwards: government provided healthcare among the elderly is what has created their defense of the system. Medicare for All extends the possibility of this defense to everyone.

Re: We Need to Design Health Care Reform That Puts Patients Before Profits

#27

Post by analog31 »

helpPeople wrote: post #6

Until Americans find Physicians (and Pharmacists) as the enemy, it will never happen. They(AMA and APA) are top lobbyists that entrench themselves using monopolistic practices. Sure school can cost 500k, but with 200 to 300k+ per year salaries, they can kill that debt. (This is their common defense)

Make med school free in return for doctors working for the government, for a decent professional salary. This would also potentially change the mix of people who want to become doctors -- more middle class.

I don't believe that salaries tell the whole story of doctor income. Doctors are well positioned as insiders to make investments in the medical industry, ranging from ownership of clinics and diagnostic equipment, to owning entire provider networks.

An effect of the cost of doctor education is that it favors students from wealthy families, who are also positioned as investors.

Meanwhile, every interest group in the system will cry poor, and claim that someone else is gouging us, which is an almost certain sign that they're all gouging us. I've got a lot of doctors as friends, and I don't pity them.

Re: We Need to Design Health Care Reform That Puts Patients Before Profits

#28

Post by kerkeslager »

balls187 wrote: post #19
headcanon wrote: post #12

Earlier quoted context omitted.

Seems like a reasonable ask. Gov't pays for preventative care like physicals, flu shots, and STI testing (sort of already happening on the last bit through Planned Parenthood), insurance takes care of traumatic events. Seems to me though the greatest cost in healthcare, and thus causing the greatest amount of contention, are chronic ailments that can't really be classified as preventative or traumatic, and require co…

What if we pay for affordable preventative care, and the government covers the cost of traumatic events?

What about chronic diseases that require frequent treatment?

Re: We Need to Design Health Care Reform That Puts Patients Before Profits

#29

Post by snowwrestler »

jostmey wrote: post #9
helpPeople wrote: post #6

Until Americans find Physicians (and Pharmacists) as the enemy, it will never happen. They(AMA and APA) are top lobbyists that entrench themselves using monopolistic practices. Sure school can cost 500k, but with 200 to 300k+ per year salaries, they can kill that debt. (This is their common defense)

I think you're stumbling on a root cause of America's healthcare crisis. I think most American's don't understand just how much physicians make--and where did you get those figures because clinicians I know make a good deal more than 200-300k

It's an uncomfortable subject because the vast majority of front-line medical professionals like doctors, specialists, surgeons, nurses etc. are doing that job with passion and honesty to help people.

But it's also true, and I think well-known at least in a vague sense, that one can make a pretty good living in the medical field.

For-profit insurance companies come in for the most hate since they are in the position to deny care. But their profit margins are not sky-high. Whether or not one believes that private health insurance is a terrible idea, the facts are pretty clear that there is a lot more to the high cost of U.S. healthcare than just private insurance.

There is a lot of cost everywhere in the medical system... that's the other side of those professionals making a good living.

I'm not going to pretend I have a good answer to this.

Re: We Need to Design Health Care Reform That Puts Patients Before Profits

#30

Post by breck »

One of the key steps that needs to happen is to ditch Intellectual Monopoly laws. If you have a system that provides 100x+ the financial incentive to sell patented drugs, regardless of efficacy, then you will have many more people out hawking harmful drugs than the boring mainstream alternatives. See Purdue for a great case study on this.

Anyone who talks about "drug development cost is expensive" yadada has no clue what they are talking about. The only reason it's expensive is because people are on a fishing expedition for novelties that have at least some contrived way of demonstrating efficacy (you only need to hoodwink the public with your drug long enough for you and your reps(dealers?) to make short run monopoly profits). In the age of big pharma Americans have gotten less healthy. Time for Intellectual Monopoly laws to go.

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