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sactowndog

Is agreement on healthcare possible?

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With the Republicans struggling to gain agreement on a path forward I wonder if agreement is possible.  

Using this forum as a model of Congress can we agree on something?  Here would be my framework?  

Health insurance should be insurance with neither side trying to game the system..... so go with the Republican model of continual coverage means no cancellation for preexisting conditions.  

Costs must be reduced so I would impose the following changes:

1) Life saving drugs and equipment were get a longer patent life but also are price controlled associated with a companies direct R&D costs to develop the drug plus a set return.  No more pricing against a vertical demand curve.

2) insurance can be sold across state lines to further enhance the pools for small states. 

3) Medicare ends as all people are covered under this proposal and insurers can reduce what the offer to cover as people age ( yes we must make cost benefit calculations)

We need to do a better job of personal responsibility and catching items sooner.   

1) we will use the Democratic model of a minimum level of insurance with annual physicals mandated.  

2) companies must also provide low cost clinics staffed by nurses for people to attend.  Cost of a visit can't exceed $20.

3) Government will invest in a National artificial intelligence system to assist with diagnosis.  Said system will me made available to all clinics.  

4) Receiving any government benefit for healthcare would require the receipient have an annual physical.  (This requirement would extend to a complete physical for children entering school)

5) to offer any additional insurance products, insurers must offer the base level plan in all states.   

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2 hours ago, sactowndog said:

With the Republicans struggling to gain agreement on a path forward I wonder if agreement is possible.  

Using this forum as a model of Congress can we agree on something?  Here would be my framework?  

Health insurance should be insurance with neither side trying to game the system..... so go with the Republican model of continual coverage means no cancellation for preexisting conditions.  

Costs must be reduced so I would impose the following changes:

1) Life saving drugs and equipment were get a longer patent life but also are price controlled associated with a companies direct R&D costs to develop the drug plus a set return.  No more pricing against a vertical demand curve.  As with any government attempt to control a market your fix would likely only increase the price of drugs because lobbyists and capitalists are far smarter then any politician.  If it did not increase the price of drugs it would end all innovation and and progress as all socialist programs do if they are effective at lowering price.

2) insurance can be sold across state lines to further enhance the pools for small states.   This is a great idea but requires a constitutional amendment which i would support if it was limited to medical insurance.  Not a small lift.

3) Medicare ends as all people are covered under this proposal and insurers can reduce what the offer to cover as people age ( yes we must make cost benefit calculations)    Putting everyone in the same pool is a good idea so politicians can't play VA recipients off against medicaid or against medicare patients.   If you also relaxed government control of the product and let people pick their plans and coverages this would reduce medical costs more then any other proposal that could be made.   Instead of 80%+ socialist medicine in this country we might end up with a fairly capitalist system which is always the most efficient.

We need to do a better job of personal responsibility and catching items sooner.   

1) we will use the Democratic model of a minimum level of insurance with annual physicals mandated. Mandating coverage is a horrible idea, let the market choose.   Capitalism is always better.

2) companies must also provide low cost clinics staffed by nurses for people to attend.  Cost of a visit can't exceed $20.    This is ridiculous it would destroy the economy.  Probably 70+% of small businesses would be out of business because they can't afford this.  Even business with high labor overhead and small margins like Walmart, Best Buy, Costco.    You would be picking winners and losers in the economy.  Amazon and Google would love you, brick and mortar stores would disappear and so you would see massive unemployment of unskilled workers.  You can't do a $1500 physical for $20, that won't even pay for your time to have someone take your blood pressure.

3) Government will invest in a National artificial intelligence system to assist with diagnosis.  Said system will me made available to all clinics.   This will happen naturally and soon if you let capitalism control the market and end the government's socialist control of the medical economy.

4) Receiving any government benefit for healthcare would require the receipient have an annual physical.  (This requirement would extend to a complete physical for children entering school)   Keep the government out, mandating care is why our costs are out of control.

5) to offer any additional insurance products, insurers must offer the base level plan in all states.   Again keep the government out of it.    

 

I think the government should only have one program for health care at the federal level.  A massive tax credit to everyone who buys insurance.  If you are low income and don't pay taxes then you get a check to buy insurance.  This would immiediatly cut medical costs by at least 20% and over a decade I bet the costs would shock us all as capitalism found ways to make the system more efficient.

 

Now you socialists always forget there are 3+ levels of government in the country.  States like California could spend money like they always do on myriads of programs with varying results.  States like Idaho could spend little and you wouldn't see much difference in the health of the relative citizens.    County hospitals would still be in place for the indigent.  State and county nursing and mental health care systems would still be in place for those programs that make sense.  States and counties do a far better job delivering services then the feds because delivering vaccines to rural Nevada and Idaho is not similar to delivering vaccines in a shithole state like California or Massachusetts.   Inner City medical programs in New York City don't make much sense in Winnemucca Nevada.   

 

Government works better the closer to the people it is.  Only federalize what you absolutely have to.

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6 hours ago, bluerules009 said:

 

I think the government should only have one program for health care at the federal level.  A massive tax credit to everyone who buys insurance.  If you are low income and don't pay taxes then you get a check to buy insurance.  This would immiediatly cut medical costs by at least 20% and over a decade I bet the costs would shock us all as capitalism found ways to make the system more efficient.

 

Now you socialists always forget there are 3+ levels of government in the country.  States like California could spend money like they always do on myriads of programs with varying results.  States like Idaho could spend little and you wouldn't see much difference in the health of the relative citizens.    County hospitals would still be in place for the indigent.  State and county nursing and mental health care systems would still be in place for those programs that make sense.  States and counties do a far better job delivering services then the feds because delivering vaccines to rural Nevada and Idaho is not similar to delivering vaccines in a shithole state like California or Massachusetts.   Inner City medical programs in New York City don't make much sense in Winnemucca Nevada.   

 

Government works better the closer to the people it is.  Only federalize what you absolutely have to.

Access comments response:

So while I said companies, I meant insurance companies providing low cost clinics.

I am not mandating the buy insurance only that they must get an annual physical check up as terms of the subsidy.  No checkup no subsidy because catching items early reduces cost.  Mandating terms is no different then mandating recepients must work but my mandate actually lowers costs.

 

Market comments:   

We agree markets work best if a functioning market exist.  Pretending a functioning market exists when it doesn't is the worst scenario and where we find ourselves today.   The healthcare market fails do to lack of diminishing return for life saving procedures and no immediacy effect for expenses on preventative care.  My proposal addresses those gaps otherwise any subsidy will further blow a hole in the federal budget.   

As to regulating return we do that already with utilities where companies would also face a vertical demand curve and could price at will.   

Too me this provision is a must given the US citizens spends far more per capita on healthcare than other countries.  

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Regulations are like the tax code....ridiculous and in dire need of simplification.  This, and the hospital lobby are the two biggest drivers.

Second, people need to quit treating insurance as a return on investment.   How to change that mindset I have no idea.

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Nothing to really say here.....except GO MWC!!

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36 minutes ago, Chile_Ute said:

Regulations are like the tax code....ridiculous and in dire need of simplification.  This, and the hospital lobby are the two biggest drivers.

Second, people need to quit treating insurance as a return on investment.   How to change that mindset I have no idea.

Not sure how this moves us towards a solution.   Do you have specific proposals?

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I yield the floor to Bauer.?

Seriously, the amount of oversight is stifling and creates so much overhead.  I'm not exactly sure where to start or what to suggest. I was merely pointing out another avenue of expense to our medial system.  Lots of spokes in this wheel.  I need to give it more thought.

Nothing to really say here.....except GO MWC!!

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10 hours ago, bluerules009 said:

 

I think the government should only have one program for health care at the federal level.  A massive tax credit to everyone who buys insurance.  If you are low income and don't pay taxes then you get a check to buy insurance.  This would immiediatly cut medical costs by at least 20% and over a decade I bet the costs would shock us all as capitalism found ways to make the system more efficient.

I like that idea a lot.

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1 hour ago, Jack Bauer said:

I like that idea a lot.

I'm not disagreeing with that either.  But there is lots of white space around that point that would need to be filled in.  Particularly around cost containment.   Why do you think Republican governors are opposed to the Republican Congress shifting the burden to the states.   The states don't have the tools to manage cost containment.  Only the federal government does as they are the ones offering patent protection creating the vertical demand curve.

If healthcare costs continue to grow double digits on a per capita basis you are someone to bankrauptcy.   You will only be transferring personal bankrauptcies to the government level.

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11 hours ago, bluerules009 said:

Q

I think the government should only have one program for health care at the federal level.  A massive tax credit to everyone who buys insurance.  If you are low income and don't pay taxes then you get a check to buy insurance.  This would immiediatly cut medical costs by at least 20% and over a decade I bet the costs would shock us all as capitalism found ways to make the system more efficient.

When facing a vertical demand curve, capitalists will do what they always do which is increase prices way beyond normal returns to maximize short term profit.   

This is true whether it's the Enron energy traders or Milan and the Epi pen.   It's the legitimate role of government to make sure true markets exists or to act as a balance against predatory pricing when they don't.

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1 hour ago, sactowndog said:

When facing a vertical demand curve, capitalists will do what they always do which is increase prices way beyond normal returns to maximize short term profit.   

This is true whether it's the Enron energy traders or Milan and the Epi pen.   It's the legitimate role of government to make sure true markets exists or to act as a balance against predatory pricing when they don't.

It isn't a vertical demand curve and there is all kinds of companies out their ready to compete who are currently just farming the government.    

Your plan would either destroy the economy or really help my medical stocks as they continue to farm your socialist programs.   

You are incapable of even understanding the situation, even when explained to you like a child.

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1 hour ago, sactowndog said:

I'm not disagreeing with that either.  But there is lots of white space around that point that would need to be filled in.  Particularly around cost containment.   Why do you think Republican governors are opposed to the Republican Congress shifting the burden to the states.   The states don't have the tools to manage cost containment.  Only the federal government does as they are the ones offering patent protection creating the vertical demand curve.

If healthcare costs continue to grow double digits on a per capita basis you are someone to bankrauptcy.   You will only be transferring personal bankrauptcies to the government level.

There is no whitespace you fucking socialist idiot.

Capitalism and competition for the money would fuel cost containment and find efficiencies you and I never dreamed of.    No government federal or otherwise has tools for cost containment you ignorant ass.

The only proven tool for cost containment is competition in the market place.  Let it happen.

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I cannot assent to any plan that destroys drug research and developement for the most serious illnesses like this one does. America should not be selling out its kids so that we can pay cheap prices for drugs while at the same time gladly reaping the benefits of the prices paid by those who came before us. 

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We’re all sitting in the dugout. Thinking we should pitch. How you gonna throw a shutout when all you do is bitch.

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14 hours ago, bluerules009 said:

 

I think the government should only have one program for health care at the federal level.  A massive tax credit to everyone who buys insurance.  If you are low income and don't pay taxes then you get a check to buy insurance.  This would immiediatly cut medical costs by at least 20% and over a decade I bet the costs would shock us all as capitalism found ways to make the system more efficient.

 

 

3 hours ago, Jack Bauer said:

I like that idea a lot.

How do we guarantee they're using the tax credit check for insurance?

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16 minutes ago, roswellcoug said:

 

How do we guarantee they're using the tax credit check for insurance?

 

14 minutes ago, bluerules009 said:

Well if they are found committing fraud they go to jail.

You could also have the payments made and applied for by the insurance company.   That would be the easiest way/

What do you think about states being able to require for expanded Medicaid enrollment that able-bodied adults without minor children at home work or volunteer 20 hours a week? 

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5 minutes ago, roswellcoug said:

 

What do you think about states being able to require for expanded Medicaid enrollment that able-bodied adults without minor children at home work or volunteer 20 hours a week? 

I think that medicaid, medicare, obamacare and VA should all be reduced to a tax credit.

 

To answer your question though I think its fine except people with children shouldn't get a break.     There are lots of volunteer opportunities you can bring a kid along.   Maybe you can volunteer to take care of other peoples kids while they volunteer.

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4 hours ago, sactowndog said:

When facing a vertical demand curve, capitalists will do what they always do which is increase prices way beyond normal returns to maximize short term profit.   

This is true whether it's the Enron energy traders or Milan and the Epi pen.   It's the legitimate role of government to make sure true markets exists or to act as a balance against predatory pricing when they don't.

I guess I feel like it's not true competition we see in the medical field.  The government chooses some winners and losers, and that's how you have one company producing epi pen without competition.

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