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Health Care Proposal
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Owl 69/70/75 Offline
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Post: #1
Health Care Proposal
What I don't understand is why the republicans or the blue dogs or some bipartisan group or somebody doesn't drop into the hopper a plan based on the following:

1. Universal coverage based on the French model, which essentially gets the government out of the healthcare business (other than the catastrophic care umbrella, the government is limited to doing what your employer does, deducting money from your paycheck and sending it to an insurance company).
2. Transition rules for medicare and medicaid. My approach would be to fold medicaid into the new system immediately, and to allow medicare recipients a choice: if you're on medicare now, you can keep it; if you are between, say, 50 and 65, you can choose either to go on the new system now and punt medicare, or keep your present coverage until you do go on medicare; if you're younger than 50, you are on the new system. I think those ages would reasonably reflect the costs and benefits associated with the different approaches, and over time medicare would phase out.
3. Tort reform focused specifically on replacing large monetary punitive damages with a mechanism for getting bad docs off the street (what punitives are supposed to accomplish but don't).
4. Bringing significant pressure to bear on other countries to pick up their fair share of R&D costs, so that drug costs could be lowered here. We probably have to streamline FDA to get anyone else to agree, and there's nothing wrong with that.
5. Increased competition for medical insurance, by removing current regulations that function primarily as barriers to entry.
6. Do the kinds of techie things that Newt's group, among others, have recommended to cut costs and improve results.

What we have now might be called a private insurance system but is definitely not a competitive free market system. It is certainly less of a free market system, with more government intervention, than what France has (and I favor).

The French break health care into three components--primary care, elective care, and catastrophic care--and handle each separately. Catastrophic care is the one area where the government is directly involved; you have a cancer or AIDS and run up some threshold amount of cost, after that you're on the government nickel. This is probably a reasonable role for government since they have the deepest pockets, and being relieved of this exposure gives private insurers some freedom to offer more creative and competitive coverages. In particular, it eliminates a lot of pre-existing condition issues.

Primary care is universal, but there is no government agency like National Health Service. As a generally free-market economist, I can justify universal primary care because of the neighborhood effects. If I can afford health care but you can't, and my kid sits next to your kid in school, are my kid and I both better off if your kid has access to basic checkups and vaccinations? I think so, particularly if it can be handled in the private sector like the French do. What they do is to collect enough through their social security system to fund about $3400 per capita per year, which is turned over to a consortium of insurance companies, in exchange for which the insurance companies provide everybody an access card (I think it's green) to what I'll call the "free" system. It's not really free--there are some fairly heavy co-pays to discourage overuse--and it's not really good--somewhere between the VA and a really bad HMO in US terms--but it is universal. Unlike NHS or Canadacare, which try to be comprehensive but inevitably fail, necessitating quotas and queues (and, yes, some of those effectively become death squads), the French free system is intentionally designed to force quotas and queues in order to hit a cost number.

When you get quotaed out and forced to the queue, that's when elective care comes in. You can wait on your quota slot to come up. Or you can go to the "pay" side and pay a private doc to do it today. Or you can buy private insurance that covers access to the pay side when you need it; coverage tends to be cheap, primarily because this is a very competitive market and it's basically supplemental coverage. Or your employer can provide private insurance (and the vast majority do, in order to get injured workers back on the job quicker). Or you can pay extra for a Cadillac version of private insurance that doesn't require you to go through the "free" side gatekeeper. I don't think the French have medical savings accounts, but they would work well with this model. My experience with their "pay" side is that it works like ours, it is as good as ours, and the pay side docs make very good money.

Over 90% of the French have private insurance; they don't want to get stuck in the free system. That's considerably higher than our percentage. And remember, they have universal "free" care, we don't. And their government spends about half as much per capita on health care as ours does. The administrative costs under this system are very low. Because they are a civil law jurisdiction, they simply don't have the same jackpot jury awards and resulting malpractice costs that we do. They are currently experiencing some controversy between those who would like to see the basic coverage expanded to something like NHS or Canadacare and those who want to keep a lid on costs. There is a strong national disdain for "socialized medicine," so the cost controllers will probably win in the end.

Why would this approach not work here?
It's actually less government involvement--and much less government cost--than we have now.
(This post was last modified: 09-05-2009 09:22 PM by Owl 69/70/75.)
09-05-2009 09:18 PM
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SumOfAllFears Offline
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Post: #2
RE: Health Care Proposal
I'll tell you why not, because it could not be considered a WIN for Obama and the Liberal Progressive Democrats if repub drop it in the hopper. They want another bloated big Gov't run program that will help cement gov't in every aspect of our lives and power for them. They want to ring that bell that cannot be un-rung. It's in your face politics like the LGBT A$$whipes. With tort reform you cannot beat around the bush, by limiting people's access to the courts, a logical outcome of reduced awards. Tort reform could save 100-200 billion a year, and you could not achieve that without bearing down on insurance companies, lawyers, judges and even common sense peer reporting for doctors. As far as the French are concerned, How many people are in their system, How many in ours? I sat F the French!!!, 61million to our 350 million. You keep harping this French Fantasy. We need common sense tort reform, secure borders, illegal immigrants paying for their burden on our system, State control of healthcare within their borders, Portability for the insured, Free market competition and regulation for insurance industry, hospitals run programs for fitness training, Real research programs to target obesity. A Mulligan for all the voters to elect new blood in the House, Senate, Oval Office and the Supreme Court because they have all broken their oaths. And while we are at it, real campaign reform with a one term limit. And I don't care if we pull names of patriots out of a hat as long as they are natural born.
09-06-2009 12:44 AM
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WoodlandsOwl Offline
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Post: #3
RE: Health Care Proposal
(09-05-2009 09:18 PM)Owl 69/70/75 Wrote:  What I don't understand is why the republicans or the blue dogs or some bipartisan group or somebody doesn't drop into the hopper a plan based on the following:

Why would this approach not work here?
It's actually less government involvement--and much less government cost--than we have now.

Some good ideas. Besides Newt's people, has anyone run the cost numbers on a plan of this nature?
(This post was last modified: 09-06-2009 11:48 AM by WoodlandsOwl.)
09-06-2009 11:47 AM
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I45owl Offline
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Post: #4
RE: Health Care Proposal
(09-05-2009 09:18 PM)Owl 69/70/75 Wrote:  4. Bringing significant pressure to bear on other countries to pick up their fair share of R&D costs, so that drug costs could be lowered here. We probably have to streamline FDA to get anyone else to agree, and there's nothing wrong with that.

Three questions:

(1) why is price control of pharmaceuticals not covered under NAFTA, etc.?
(2) It seems like that would be a good mechanism for (a) forcing other nations to pay their fair share, and (b) encouraging pharmaceuticals to base operations in the US.
(3) How do we get you elected to Congress?
09-07-2009 12:25 PM
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GGniner Offline
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Post: #5
RE: Health Care Proposal
Don't help your enemy while he's shooting himself in the foot...

Those proposals, can easily be demonized by the Left to scare the all important Senior Vote, like they've always done with Social Security and Medicare in the past against the GOP.

Currently, Obama is losing the Seniors for the Democrats over Obamacare(losing Medicare, imposing Rationing and the real possibility of defacto "Death Panels"). If the GOP jumps in, they will win that vote back by lying/demonizing the effects of Liberating the Healthcare market. The Irony here is that its put the GOP in the position of defending ..... Medicare of all things.

but it takes over 60 Million votes to win elections in this Country, a huge chunk of which are Seniors who depend on Medicare and Social Security.

Just think back to 2005, Bush proposes partial privatization of SS and a GOP congress had it Dead on Arrival all because of how the Democrats(and MSM) and their backed groups like the AARP demonized it running off the Senior voting bloc. Old scare tactics.


aside from that, Obama and the Dems have all the power and their base will not accept anything that isn't Socialized Idiot Medicine.
09-07-2009 12:35 PM
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GGniner Offline
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Post: #6
RE: Health Care Proposal


Quote:BROKAW: "What's been interesting to me is that the Republicans have raised the public option as some kind of Orwellian monster. Half the health care in America is already delivered by the government... Medicare, Medicaid, the Veterans Administration, Federal Employees insurance..."

GIULIANI: "That's part of the problem. Part of the problem is that half of it is already in the hands of one massive monopoly. You make that monopoly greater and you destroy private insurance."
(This post was last modified: 09-07-2009 01:16 PM by GGniner.)
09-07-2009 01:15 PM
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Fo Shizzle Offline
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Post: #7
RE: Health Care Proposal
Sounds fine to me....I particularly agree with removing government regulation of the insurance industry. You are correct...as with ALL regulation it serves as a barrier to competition and thus keeps prices high to meet the overhead associated with those regulations.

Although I abhor any and ALL use of my money to subsidize others....I could live with the government handling "catastrophic" coverages. Removal of this from the marketplace would certainly lead to lowering of premiums that people could afford on their own for basic care by a family physician.
What would constitute "catastrophic" would be something to decide though.

We might as well get ready...This is going to get shoved down our throats regardless of opposition. New proposals need to be looked at closely. I really have not heard very many of the politicians or pundits talking about the French system. Maybe it needs to be looked at closer.
09-07-2009 02:24 PM
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I45owl Offline
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Post: #8
RE: Health Care Proposal
For no particular reason, except that we've talked about similar things before:

Hudson Institute > Life Expectancy Humbug
http://www.hudson.org Wrote:The U.S. spends much more on health care services as a percentage of GDP than other developed countries, and yet in life expectancy it lags most of these others. A specious connection built around these ...
09-07-2009 03:25 PM
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Paul M Offline
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Post: #9
RE: Health Care Proposal
I45owl, your posting facts and we all know facts get in the way of a good lie.
09-07-2009 03:42 PM
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Lord Stanley Offline
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Post: #10
RE: Health Care Proposal
Owl, I see one concern (this coming from a guy who works at a company with seemingly 1000's of "associate marketing managers"

You'd have to drop the connections to the "French. That "French" stuff won't fly in middle America.... If the Dems were smart, they'd call it ReaganCare. ;.)
09-08-2009 10:31 AM
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TheDancinMonarch Offline
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Post: #11
RE: Health Care Proposal
(09-05-2009 09:18 PM)Owl 69/70/75 Wrote:  What I don't understand is why the republicans or the blue dogs or some bipartisan group or somebody doesn't drop into the hopper...

And if they did would the MSM cover it at all much like the Van Jones situation? The story, or should I say their "health care plan", is advanced, from their perspective, by calling the opponents the "party of No" who offer no alternatives. And if no alternatives are mentioned in the NYTimes then, ergo, there are no alternatives.
09-08-2009 11:27 AM
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SumOfAllFears Offline
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Post: #12
RE: Health Care Proposal
Just because the Democrats keep saying that the Republicans or any detractor "have no ideas", does not make it the truth. Tort reform, portability, defensive medicine are three issues taken off the table by the Democrats from jump, and is largely some of the biggest problems that needs to be addressed.
(This post was last modified: 09-08-2009 11:56 AM by SumOfAllFears.)
09-08-2009 11:40 AM
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TheDancinMonarch Offline
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Post: #13
RE: Health Care Proposal
(09-08-2009 11:40 AM)SumOfAllFears Wrote:  Just because the Democrats keep saying that the Republicans or any detractor "have no ideas", does not make it the truth. Tort reform, portability, defensive medicine are three issues taken off the table by the Democrats from jump, and is largely one of the biggest problems that needs to be addressed.

But with no general reporting of this, the average man in the street, who is admittedly an idiot, will not know of any alternatives.
(This post was last modified: 09-08-2009 12:26 PM by TheDancinMonarch.)
09-08-2009 11:47 AM
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SumOfAllFears Offline
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Post: #14
RE: Health Care Proposal
(09-08-2009 11:47 AM)TheDancinMonarch Wrote:  
(09-08-2009 11:40 AM)SumOfAllFears Wrote:  Just because the Democrats keep saying that the Republicans or any detractor "have no ideas", does not make it the truth. Tort reform, portability, defensive medicine are three issues taken off the table by the Democrats from jump, and is largely one of the biggest problems that needs to be addressed.

But with no general reporting of this, the average man in the street, who is admittedly an idiot, will no know of any alternatives.

The American public, those that want to be informed, have to get their news mostly from the Internet or foxnews. The MSM is a total disaster and people see that, IMO.

In my post above add: deficit neutral plan. We cannot spend a trillion dollars on a gov't run plan with the mandate to cover an additional 10 million people. or 15 at the most.
09-08-2009 12:01 PM
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TheDancinMonarch Offline
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Post: #15
RE: Health Care Proposal
(09-08-2009 12:01 PM)SumOfAllFears Wrote:  The American public, those that want to be informed, have to get their news mostly from the Internet or foxnews. The MSM is a total disaster and people see that, IMO.

In my post above add: deficit neutral plan. We cannot spend a trillion dollars on a gov't run plan with the mandate to cover an additional 10 million people. or 15 at the most.

Unfortunately those that want to be informed or even care about being informed are not enough to win an election.

And yes we should stop spending what we don't have and promising what cannot realistically be delivered.
09-08-2009 12:40 PM
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I45owl Offline
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Post: #16
RE: Health Care Proposal
(09-08-2009 11:27 AM)TheDancinMonarch Wrote:  
(09-05-2009 09:18 PM)Owl 69/70/75 Wrote:  What I don't understand is why the republicans or the blue dogs or some bipartisan group or somebody doesn't drop into the hopper...

And if they did would the MSM cover it at all much like the Van Jones situation? The story, or should I say their "health care plan", is advanced, from their perspective, by calling the opponents the "party of No" who offer no alternatives. And if no alternatives are mentioned in the NYTimes then, ergo, there are no alternatives.

If you hadn't already posted that you were a girl, I'd have thought you were Douglass Adams reincarnated.
09-08-2009 02:06 PM
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TheDancinMonarch Offline
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RE: Health Care Proposal
(09-08-2009 02:06 PM)I45owl Wrote:  
(09-08-2009 11:27 AM)TheDancinMonarch Wrote:  
(09-05-2009 09:18 PM)Owl 69/70/75 Wrote:  What I don't understand is why the republicans or the blue dogs or some bipartisan group or somebody doesn't drop into the hopper...

And if they did would the MSM cover it at all much like the Van Jones situation? The story, or should I say their "health care plan", is advanced, from their perspective, by calling the opponents the "party of No" who offer no alternatives. And if no alternatives are mentioned in the NYTimes then, ergo, there are no alternatives.

If you hadn't already posted that you were a girl, I'd have thought you were Douglass Adams reincarnated.

Pardon me but I'm missing the connection. Unless we're talking about a different person.
09-08-2009 02:39 PM
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I45owl Offline
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RE: Health Care Proposal
(09-08-2009 02:39 PM)TheDancinMonarch Wrote:  
(09-08-2009 02:06 PM)I45owl Wrote:  
(09-08-2009 11:27 AM)TheDancinMonarch Wrote:  
(09-05-2009 09:18 PM)Owl 69/70/75 Wrote:  What I don't understand is why the republicans or the blue dogs or some bipartisan group or somebody doesn't drop into the hopper...

And if they did would the MSM cover it at all much like the Van Jones situation? The story, or should I say their "health care plan", is advanced, from their perspective, by calling the opponents the "party of No" who offer no alternatives. And if no alternatives are mentioned in the NYTimes then, ergo, there are no alternatives.

If you hadn't already posted that you were a girl, I'd have thought you were Douglass Adams reincarnated.

Pardon me but I'm missing the connection. Unless we're talking about a different person.

Don't worry. Nobody gets me.

The Hitchhiker's Guide to the Galaxy Wrote:Now it is such a bizarrely improbably coincidence that anything so mindbogglingly useful [the Babel fish] could have evolved by chance that some thinkers have chosen to see it as a final and clinching proof of the non-existence of God.

The argument goes something like this: "I refuse to prove that I exist," says God, "for proof denies faith, and without faith I am nothing."

"But," says Man, "the Babel fish is a dead giveaway isn't it? It could not have evolved by chance. It proves you exist, and so therefore, by your own arguments, you don't. QED"

"Oh dear," says God, "I hadn't thought of that," and promptly vanishes in a puff of logic.

-- Douglas Adams, The Hitch Hiker's Guide to the Galaxy (book one of the Hitch Hiker's Guide to the Galaxy series), p 50
09-08-2009 03:52 PM
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Tripster Offline
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Post: #19
RE: Health Care Proposal
.

ONCE AGAIN ......

This is NOT about helping people, insuring people, or giving people health care ... this garbage has nothing to do with any of that.

In it's present form, all of these Bills are strictly meant to build a Father Barack Legacy and force by usurping, a Totalitarian set of restrictions onto the American Populace that will strangle all of us down and have us kowtow to this Wretch in the White House.

There are at least 1000 OTHER things this guy could do to actually Help and even Fix the Health Care situation without TAKING IT OVER, but he is so stupidly foolish and pig-headedly arrogant to force this monstrosity down our throats at the cost of his own Party's Demise in the the Congress in 2010 and his Own Demise in 2012, that it has become a Fixation of Myopic Proportions to this guy to get it done yesterday.

HE DOESN'T WANT TO "FIX IT", HE WANTS TO "OWN IT" !!!!!!

It is truly horrible, when all is so lost, that the 'Court Jester' has become the King .....

May God be with us all .....

.
09-08-2009 06:04 PM
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TheDancinMonarch Offline
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Post: #20
RE: Health Care Proposal
(09-08-2009 06:04 PM)Tripster Wrote:  .

ONCE AGAIN ......

This is NOT about helping people, insuring people, or giving people health care ... this garbage has nothing to do with any of that.

In it's present form, all of these Bills are strictly meant to build a Father Barack Legacy and force by usurping, a Totalitarian set of restrictions onto the American Populace that will strangle all of us down and have us kowtow to this Wretch in the White House.

There are at least 1000 OTHER things this guy could do to actually Help and even Fix the Health Care situation without TAKING IT OVER, but he is so stupidly foolish and pig-headedly arrogant to force this monstrosity down our throats at the cost of his own Party's Demise in the the Congress in 2010 and his Own Demise in 2012, that it has become a Fixation of Myopic Proportions to this guy to get it done yesterday.

HE DOESN'T WANT TO "FIX IT", HE WANTS TO "OWN IT" !!!!!!

It is truly horrible, when all is so lost, that the 'Court Jester' has become the King .....

May God be with us all .....

.

And we play right into his hands when we refer to it as Obamacare. What we say in a disparaging way he takes as a paean.
09-08-2009 06:26 PM
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