[Micael]

Good discussion....as someone who deals with folks daily on their health insurance (I market plans), here is what I see:

1) As much as I hate folks being told to enroll for anything, this is a must. We must have 100% participation in health care. I see it way too often where a young health person refuses to enroll for their group plan because they don't want to pay $75 for their portion of the premium. But insurance companies need the young healthy participant to offset the unhealthy people.

2) Health insurance needs to be more about catastrophic coverage rather than day to day expenses. Imagine if your homeowners insurance had a co-pay for your toilet to be fixed....or another co-pay for a roof. Instead, most of us keep up our homes and find ways to pay for the new roof....the hole in the floor....the rotted wood....etc. So, you have a higher deductible (maybe $2k or 3k) health plan, with very few co-pay options, and your premium goes down (more money in your pocket for the prescriptions, etc). This at least keeps someone from losing their home or life savings if they have a $50K medical bill and only have $3 - $5,000 in exposure.

3) People must start taking some inititive and watch their expenses. I was told to go in for a $2100 test, after questioning it, I went to a specialist ($350) and turns out the test wasn't needed. Also, rather than taking the $85 prescription (simple BP) I asked for the generic, which is $5.65! People need to ask these questions!

And yes, tort reform could also help....but it's a combination of many things that could help without needing government intervention. Just my 2 cents (well, maybe more than 2 cents).

Agree with the second two, but lets not "force" people to take insurance, if they don't want it.

[Micael]

Here's something to think about:

http://www.nytimes.com/2009/07/19/ma...pagewanted=all

A good article. Thanks. Its not the only debate, though. If all we were worried about was the structure of rationing, we'd already have a government run healthcare. I contend that it will also totally wreck the economy, and will in fact decrease the quality of care by reducing the number of doctors and professionals available for providing care.

[groovy]

I guess in your POV it would be better to let them go bust than get bigger gov. involvement.

I know the question wasn't directed towards me but I'll answer.

Yes.

[clemgrad85]

Agree with the second two, but lets not "force" people to take insurance, if they don't want it.

I normally would agree with you on not "forcing" anyone to take insurance, but it is really no different than forcing car owners to have car insurance (at least they do here in SC). If we want to avoid government run health insurance, we must make sure that insurance remains affordable, that everyone can get it, and the insurance companies are profitable. So, requiring everyone (particularly the young healthy folks that feel they are invincible) to enroll will help accomplish those goals. If we don't require this participation, then we get back to the place where the uninsured person shows up at the hospital, gets treated, and pays the hospital back $50 per month on a $50,000 bill.....which then raises the costs for those of us with insurance. I don't like the requirement, but for the system to be "fixed" with as little government intervention as possible, I think that is mandatory.

Now, I do see some who simply can't afford covering their whole family....which does present a problem. I'm stumped on this part....as much as I hate it, I think it will require some government assistance...gulp...I hate even writing that. If, however, making the suggestions I mentioned in my earlier post does in fact save premium dollars, then I'd be willing to pitch in and help contribute in some way....I don't see how else it would work.

We can accomplish this without another government program that will likely fail.

[blakeb]

Good discussion....as someone who deals with folks daily on their health insurance (I market plans), here is what I see:

1) As much as I hate folks being told to enroll for anything, this is a must. We must have 100% participation in health care. I see it way too often where a young health person refuses to enroll for their group plan because they don't want to pay $75 for their portion of the premium. But insurance companies need the young healthy participant to offset the unhealthy people.

2) Health insurance needs to be more about catastrophic coverage rather than day to day expenses. Imagine if your homeowners insurance had a co-pay for your toilet to be fixed....or another co-pay for a roof. Instead, most of us keep up our homes and find ways to pay for the new roof....the hole in the floor....the rotted wood....etc. So, you have a higher deductible (maybe $2k or 3k) health plan, with very few co-pay options, and your premium goes down (more money in your pocket for the prescriptions, etc). This at least keeps someone from losing their home or life savings if they have a $50K medical bill and only have $3 - $5,000 in exposure.

3) People must start taking some inititive and watch their expenses. I was told to go in for a $2100 test, after questioning it, I went to a specialist ($350) and turns out the test wasn't needed. Also, rather than taking the $85 prescription (simple BP) I asked for the generic, which is $5.65! People need to ask these questions!

And yes, tort reform could also help....but it's a combination of many things that could help without needing government intervention. Just my 2 cents (well, maybe more than 2 cents).

I think you hit a very important point with #2 here. The fundamental reason that healthcare is so costly is that we have prevented capitalism from working. Why? We have failed to allow the general public drive the costs. Insured people are completely disconnected from the costs their insurance companies incur. All they have to worry about is the little copay. In addition, anytime a insurance company tries to control costs (requiring you to see specific doctors, insisting on you using generic drugs), they get battered for denying or limiting care. I have a high deductible plan paired with an HSA account and I think it is a great model. I have an incentive to seek our more affordable healthcare, and I am completely covered for catastrophic cases. In addition, we have a benefit through a company called Compass here in Dallas. It is an amazing healthcare concierge service. You call them and the arrange everything, transfer medical records, send you directions, check the accuracy of your bill, etc. I see a huge opportunity for businesses in this space. These are the things that Obama should be encouraging through policy, these are the things that create jobs and are a win for everyone.

[theog]

Nothing the government has ever touched has ever gotten leaner and more profitable because of it. Only in spite of it.

Not true... the gov't touches much of our society....

Your point would be TOO much gov't intervention.... problem is knowing how much is too much... we won't really know for years. Right now we are living history and ALL are making guesses.

[palandri]

...Nothing the government has ever touched has ever gotten leaner and more profitable because of it. Only in spite of it.

Healthcare shouldn't be profitable.

The argument that unless healthcare is privately owned by one of the good old boys/fat cats reaping in millions, it can't be effective makes no sense to me.

So if one of the good old boy/fat cats was put in charge of a public healthcare system, how would it run?

[groovy]

Healthcare shouldn't be profitable.

The argument that unless healthcare is privately owned by one of the good old boys/fat cats reaping in millions, it can't be effective makes no sense to me.

That's kind of a false dilemma, isn't it? Either healthcare is run by government for no profit or it's run by greedy fat cats for obscene profit. Why does it have to be either? And why is it so bad for healthcare to be profitable? The US generates the vast majority of innovation in healthcare and many other industries so it would seem the market-driven approach is a good thing.

[theog]

A good article. Thanks. Its not the only debate, though. If all we were worried about was the structure of rationing, we'd already have a government run healthcare. I contend that it will also totally wreck the economy, and will in fact decrease the quality of care by reducing the number of doctors and professionals available for providing care.

I don't agree... I work with many doctors... they say decrease the amount of insurance they have to pay malpractice insurance, etc) and reduce the amount of money paid for school, and they can make it.

Obama has already said this will come….

Unfortunately, we don’t know the full plan being proposed, so we are only estimating on what will happen…. making our arguments accordingly.

[theog]

Healthcare shouldn't be profitable.

Yes... it should...

[Toby]

Not true... the gov't touches much of our society....

Non sequitur. To be not true, you'd have to point out an example of somewhere government had made something run more efficiently than otherwise. Tough order considering there are few examples where something competes with government.

[Toby]

I don't agree... I work with many doctors... they say decrease the amount of insurance they have to pay malpractice insurance, etc) and reduce the amount of money paid for school, and they can make it.

Obama has already said this will come….

It may come, but not in the way they imagine. The reason being that if the government 'takes it over', suing for malpractice won't be a realistic option.

[theog]

Non sequitur. To be not true, you'd have to point out an example of somewhere government had made something run more efficiently than otherwise. Tough order considering there are few examples where something competes with government.

Not really... we are simply "used" to gov't in places now... in many the gov't has taken over and it "just is." Gov goes one place, others will move to other places... and it is not like gov't is "taking over." That is not a correct characterization. But I'm sure that does not matter, we could go back and forth for many threads and not get anyplace.... lol

That was the point... nothing to point out or prove...

[theog]

It may come, but not in the way they imagine. The reason being that if the government 'takes it over', suing for malpractice won't be a realistic option.

Should "suing for malpractice" be an option?

If docs stay poor in order to pay for insurance they can't afford, then what is the purpose of getting the higher degree?

Hell, insurance is not getting rich, because they have to payout the nose to judgements....

Of course, what if you have no insurance... what keeps bad docs out? Oh, yea, a governing body, that already exists.... lol

Insurance is a large part of the problem....

All of this has to LOOK different.... change is needed... how we get there is the issue...

[groovy]

Obama has already said this will come….

Obama has said a lot. The problem is, just like all campaign promises, there's no way to pay for it. No way.

[palandri]

Obama has said a lot. The problem is, just like all campaign promises, there's no way to pay for it. No way.

Look at how many nations have socialized medicine and are paying for it.

Here's the problem, Democrats/Liberals think "we". Republicans/conservatives think "me".

[groovy]

Here's the problem, Democrats/Liberals think "we". Republicans/conservatives think "me".

Do you really, honestly believe that?

[bclinger]

He is wrong about the "me." None of the Republican leadership has mumbled anything about "me" paying for it - they have repeatedly asked how we are going to pay for it. It has gotten so bad that the dems have made a few changes and seriously, how is a small minority of people (the "rich") going to pay for this. All of us are going to have to go with the public thing and very few people speak well of any of the public health systems. To say that cuts in Medicare will help - Medicare is so deep in the hole - how will it be able to help?

[Bujin#IM]

All of us are going to have to go with the public thing and very few people speak well of any of the public health systems.

On what do you base your statement that "very few people speak well of any of the public health systems"?

We know that many countries with public or public/private health systems are considered far better than ours, and the cost far less. And we also know that surveys have shown that a majority of Americans (and of doctors) support a public health option.

[clemgrad85]

Look at how many nations have socialized medicine and are paying for it.

Here's the problem, Democrats/Liberals think "we". Republicans/conservatives think "me".

No.....democrats/liberals think "government" to solve any issue and they think "the rich" to pay for it. Republicans/Conservatives should think (I agree, they got off target for a few years) anyone but the government to solve issues.

The only way to pay for ALL of Obama's wish list is to tax the heck out of people (yes, transferring wealth). To say that all they are asking is for the rich to "pay their fair share" would be fine, but when one group pays less than 15% in taxes, and another group is being asked to pay upwards of more than 50% in taxes (Fed, State, and now "surcharges"), I think we have now exceeded ones "fair" share. I always ask liberals where does it stop....what is someone's fair share....and they can never give me an answer because ultimately, they don't want to feel there really is ever a cap on what you can take from the wealthy. As Ross Perot said to Larry King, "It's just sad Larry".