Volnation Fixes Healthcare

[volinbham]

We've done this before I'm sure and I know this will turn into a shizzshow but have at it.

Address costs in the HC system
Address supply (eg. docs, nurses, devices, and/or pharma)
Address insurance

My quickie:

1. Increase supply of providers by ramping (and giving broader permission) non-MD HC providers.

2. Deregulate forms of care (e.g. buying groups, provider groups, etc.)

3. Create a bare-bones essential benefits service list (akin to catastrophic but perhaps a bit more generous)

4. Subsidize or single payer coverage to all for item #3

5. Utilize non-MD providers where ever possible for #3

6. National, widely varying market for supplemental insurance beyond #3 (either upgrade or buy out of it).

7. Group buying of pharma

I'm sure I'll have more but the goal here is increase the supply at a lower cost per service; provide the HC safety net for serious problems and high costs; create choice on service delivery options and level of care sought.

Flame away

 

[lawgator1]

We've done this before I'm sure and I know this will turn into a shizzshow but have at it.

Address costs in the HC system
Address supply (eg. docs, nurses, devices, and/or pharma)
Address insurance

My quickie:

1. Increase supply of providers by ramping (and giving broader permission) non-MD HC providers.

2. Deregulate forms of care (e.g. buying groups, provider groups, etc.)

3. Create a bare-bones essential benefits service list (akin to catastrophic but perhaps a bit more generous)

4. Subsidize or single payer coverage to all for item #3

5. Utilize non-MD providers where ever possible for #3

6. National, widely varying market for supplemental insurance beyond #3 (either upgrade or buy out of it).

7. Group buying of pharma

I'm sure I'll have more but the goal here is increase the supply at a lower cost per service; provide the HC safety net for serious problems and high costs; create choice on service delivery options and level of care sought.

Flame away

I assume you mean allow people to buy that policy?

The problem is that, once the overall costs are not shared, you have people running to the solutions that fit their needs, and only their needs, at lowest cost. That is natural.

But that is what makes the prices of insurance skyrocket for everyone that cannot just go with the basic, no frills plans.

The healthy people, particularly the young ones, flock to that solution. And pay very little. But then the cost of the larger problems is not spread across a large enough pool. Great for the 25 year olds. Until they turn 40, or have a baby, or anything else that means they can't buy the lowest cost plan.

The solution is single payor, Medicare participation for all. Massive bargaining power with providers and drug companies. Easy to understand universal tax rate, no employer mandate and no obligation for them to pay anything. If you want to add on supplemental policies on top of that, great.

 

[CountVolcula]

Tort reform

 

[IPleadInsanity]

My plan would pay for nothing until you reached $4,000 deductible or were admitted to a hospital for treatment. No drugs, doctors visits, emergency room visits covered. The frequent users of aforementioned services would pay more services of course because they use more services but all would be covered 80% if seriously ill. These services are a huge part of the high cost of care. The most important thing is coverage when we have to go to the hospital. My recent bill was $120,000, first time in hospital, paid premiums for 45 years.

Still, when 5% of customers are using 50% of the products its hard to spread that around fairly in a legislative measure.

 

[lawgator1]

Tort reform

Some effect, but not a solution in and of itself. Plus that is at the state level, and is by definition uneven.

 

[lawgator1]

My plan would pay for nothing until you reached $4,000 deductible or were admitted to a hospital for treatment. No drugs, doctors visits, emergency room visits covered. The frequent users of aforementioned services would pay more services of course because they use more services but all would be covered 80% if seriously ill. These services are a huge part of the high cost of care. The most important thing is coverage when we have to go to the hospital. My recent bill was $120,000, first time in hospital, paid premiums for 45 years.

Still, when 5% of customers are using 50% of the products its hard to spread that around fairly in a legislative measure.

Well, we have to incentivize people to get care early. Not your situation, but where people with chronic breathing problems can be treated for $5,000 a year in palliative and wellness care that is far better than them not doing anything for five years then showing up at the ER, having surgery, and long term rehab for $300,000.

 

[orangeluvr]

Let all the sick people die,that's the GOP fix . :blink:

 

[CountVolcula]

The real problem is reducing the amount people go to the doctor

I mean the ones who take their kids because they get a fever or throw up once

Or the get a headache or sore throat. Instead of letting minor sicknesses run their course, they run up a bill because of a $10 co-pay

Then, you have businesses that require a doctors excuse for being sick one day. Then they complain that insurance cost go up for the company

Insurance should be limited to major issues and preventive care like yearky wellness. It shouldt be used because you are too big of a puss to deal with a tummy ache or a little headache

I hear this too often

"Well, thats why I pay insurance"

No, its not. You pay imsurance in case you get a real sickness. Its not because you have sand in your clit

 

[theFallGuy]

The real problem is reducing the amount people go to the doctor

I mean the ones who take their kids because the get a fever or throw up once

Or the get a headache or sore throat. Instead of letting minor sicknesses run their course, they run up a bill because of a $10 co-pay

Then, you have businesses that require a doctors excuse for being sick one day. Then they complain that insurance cost go up for the company

Insurance should be limited to major issues and preventive care like yearky wellness. It shouldt be used because you are too big of a puss to deal with a tummy ache or a little headache

I hear this too often

"Well, thats why I pay insurance"

No, its not. You pay imsurance in case you get a real sickness. Its not because you have sand in your clit

And how many people in general take every sickness to the emergency room?

 

[lawgator1]

The real problem is reducing the amount people go to the doctor

I mean the ones who take their kids because they get a fever or throw up once

Or the get a headache or sore throat. Instead of letting minor sicknesses run their course, they run up a bill because of a $10 co-pay

Then, you have businesses that require a doctors excuse for being sick one day. Then they complain that insurance cost go up for the company

Insurance should be limited to major issues and preventive care like yearky wellness. It shouldt be used because you are too big of a puss to deal with a tummy ache or a little headache

I hear this too often

"Well, thats why I pay insurance"

No, its not. You pay imsurance in case you get a real sickness. Its not because you have sand in your clit

Wow.

 

[volfanjustin]

The real problem is reducing the amount people go to the doctor

I mean the ones who take their kids because they get a fever or throw up once

Or the get a headache or sore throat. Instead of letting minor sicknesses run their course, they run up a bill because of a $10 co-pay

Then, you have businesses that require a doctors excuse for being sick one day. Then they complain that insurance cost go up for the company

Insurance should be limited to major issues and preventive care like yearky wellness. It shouldt be used because you are too big of a puss to deal with a tummy ache or a little headache

I hear this too often

"Well, thats why I pay insurance"

No, its not. You pay imsurance in case you get a real sickness. Its not because you have sand in your clit

agree

high deductibles
HSAs
insurance for catastrophic illness only
sore throat, cut on your little finger..you pay out of pocket

 

[theFallGuy]

We've done this before I'm sure and I know this will turn into a shizzshow but have at it.

Address costs in the HC system
Address supply (eg. docs, nurses, devices, and/or pharma)
Address insurance

My quickie:

1. Increase supply of providers by ramping (and giving broader permission) non-MD HC providers.

2. Deregulate forms of care (e.g. buying groups, provider groups, etc.)

3. Create a bare-bones essential benefits service list (akin to catastrophic but perhaps a bit more generous)

4. Subsidize or single payer coverage to all for item #3

5. Utilize non-MD providers where ever possible for #3

6. National, widely varying market for supplemental insurance beyond #3 (either upgrade or buy out of it).

7. Group buying of pharma

I'm sure I'll have more but the goal here is increase the supply at a lower cost per service; provide the HC safety net for serious problems and high costs; create choice on service delivery options and level of care sought.

Flame away

I'd like to see greater use of HSA or FSA accounts. This puts control in the consumers hands. Also, increase the total cap on FSA accounts. The $2,600 cap barely makes a dent in medical expenses for a family of 4 over the course of a year. I think the amount should be at least $5,000.

 

[CountVolcula]

And how many people in general take every sickness to the emergency room?

A ton

 

[CountVolcula]

Wow.

So you think its not an issue?

 

[theFallGuy]

and another thing about FSA's, you should be able to spend current money on past expenses. For example, if I have refilled my FSA account January 1, 2017, I should still be able to pay an overdue medical bill owed from 2014 with it. It's my money after all. These kinds of limitations are stupid.

 

[theFallGuy]

A ton

My employer basically held a meeting with employees trying to educate people on not using the emergency room because of how much money it was costing the plan

 

[YorkVol]

We've done this before I'm sure and I know this will turn into a shizzshow but have at it.

Address costs in the HC system
Address supply (eg. docs, nurses, devices, and/or pharma)
Address insurance

My quickie:

1. Increase supply of providers by ramping (and giving broader permission) non-MD HC providers.

2. Deregulate forms of care (e.g. buying groups, provider groups, etc.)

3. Create a bare-bones essential benefits service list (akin to catastrophic but perhaps a bit more generous)

4. Subsidize or single payer coverage to all for item #3

5. Utilize non-MD providers where ever possible for #3

6. National, widely varying market for supplemental insurance beyond #3 (either upgrade or buy out of it).

7. Group buying of pharma

I'm sure I'll have more but the goal here is increase the supply at a lower cost per service; provide the HC safety net for serious problems and high costs; create choice on service delivery options and level of care sought.

Flame away

Replicate auto insurance rules and allow health care insurance providers to cross state borders (while meeting state level laws/regulations). This would:
---Meet the needs of our mobile population
---Effectively remove the pre-existing condition factor since people would generally keep their insurance for life
---reduce the costs by increasing competition among health insurance companies that effectively have a state level monopoly.
---reduce operating expenses for insurance companies by allowing them to centralize overhead staff.

 

[Volsfaninva917]

Let all the sick people die,that's the GOP fix . :blink:

Nice try nancy

 

[volinbham]

I assume you mean allow people to buy that policy?

The problem is that, once the overall costs are not shared, you have people running to the solutions that fit their needs, and only their needs, at lowest cost. That is natural.

But that is what makes the prices of insurance skyrocket for everyone that cannot just go with the basic, no frills plans.

The healthy people, particularly the young ones, flock to that solution. And pay very little. But then the cost of the larger problems is not spread across a large enough pool. Great for the 25 year olds. Until they turn 40, or have a baby, or anything else that means they can't buy the lowest cost plan.

The solution is single payor, Medicare participation for all. Massive bargaining power with providers and drug companies. Easy to understand universal tax rate, no employer mandate and no obligation for them to pay anything. If you want to add on supplemental policies on top of that, great.

ACA currently has an "essential benefits" component - all I'm saying is trim that down to real essentials.

Everyone will be in the pool for this - so the risk sharing is fine.

It would either be provided as single payer or subsidized purchase from private insurers (means tested) as it is in Switzerland.

If anyone wants more coverage, better doctors, etc they add it on.

It doesn't have to be single payer as other countries have demonstrated.

Our problem is some people are suggesting every citizen should have virtually every aspect of their care covered for basically free (paid out of taxes) AND if people who can afford it pay for better care that is some form of wealth discrimination.

 

[YorkVol]

There should be a Ready Care facility co-located to all Emergency Rooms. Currently we have about a half dozen new Ready Care clinics that have popped up in the past few years. You can go in, use your insurance or pay out of pocket $50 or so for a routine issue. This is the place to go when you have a minor illness or injury. But lots of people don't realize their value and take their minor maladies to the ER. So, hospitals should respond by putting a Ready Care type facility near the ER, then use the ER for trauma cases and send everyone else next door.

 

[lawgator1]

So you think its not an issue?

Overutilization is an issue, but its not the $100 general practitioner visits killing us. And while I'm no expert, I would be willing to bet that the huge money saved in early detection and treatment of a lot of medical problems would easily offset the much tinier though more frequent cost of overutilization as described by you.

ACA currently has an "essential benefits" component - all I'm saying is trim that down to real essentials.

Everyone will be in the pool for this - so the risk sharing is fine.

It would either be provided as single payer or subsidized purchase from private insurers (means tested) as it is in Switzerland.

If anyone wants more coverage, better doctors, etc they add it on.

It doesn't have to be single payer as other countries have demonstrated.

Our problem is some people are suggesting every citizen should have virtually every aspect of their care covered for basically free (paid out of taxes) AND if people who can afford it pay for better care that is some form of wealth discrimination.

"Trim it down to the essentials...."

If you are a husband and wife between 22 and 35, do you consider coverages for pregnancy and childbirth to be essential? How about post natal care for serious problems if such develop? People over 50 do not consider that essential, and do not want their premiums to cover it.

If you are a woman between 40 and 65, do you consider mammograms to be essential? Why should men pay for them if they never get them?

If you are a 50 year old male with a history of colon cancer in your family, do you want routine colonoscopies and biopsies covered? 25 year old women don't want them covered because they don't utilize that service.

If you are a black person, do you want sickle cell anemia covered? White folks don't want to pay for that.

If you are a Type I diabetic, from age 8 due to an immune system reaction, do you want insulin and insulin pumps covered? Healthy 35 year olds shouldn't pay for that as they will never be Type I diabetics.

This is the problem. If everyone pays for coverage for only those things they might ever realistically need, it means the cost of other things that others need are shared on an ever-decreasing sized pool, meaning that rates go up and up and up.

The only people who benefit from that are people in the prime of life and otherwise healthy. The ones that never see a doctor. 30 years old and no history of anything.

They win..... until they turn 50. Then what, they find that coverages they need, but did not share when others needed it, is now not included? And cannot be bought?

What do you think the purpose is of the preexisting condition exclusion? It is to keep expensive utilizers out of the system. We may know today who some of them are. But we never know who all of them are. God forbid 10 years from now you find yourself having become one of them in a battle to stay alive.

The solution is to have everyone share the expense. And it doesn't go up based on experience. Its static in that respect. And does not isolate groups based on their misfortune.

 

[InVOLuntary]

The real problem is reducing the amount people go to the doctor

I mean the ones who take their kids because they get a fever or throw up once

Or the get a headache or sore throat. Instead of letting minor sicknesses run their course, they run up a bill because of a $10 co-pay

Then, you have businesses that require a doctors excuse for being sick one day. Then they complain that insurance cost go up for the company

Insurance should be limited to major issues and preventive care like yearky wellness. It shouldt be used because you are too big of a puss to deal with a tummy ache or a little headache

I hear this too often

"Well, thats why I pay insurance"

No, its not. You pay imsurance in case you get a real sickness. Its not because you have sand in your clit

Thanks. I chuckled.

 

[McDad]

My plan would pay for nothing until you reached $4,000 deductible or were admitted to a hospital for treatment. No drugs, doctors visits, emergency room visits covered. The frequent users of aforementioned services would pay more services of course because they use more services but all would be covered 80% if seriously ill. These services are a huge part of the high cost of care. The most important thing is coverage when we have to go to the hospital. My recent bill was $120,000, first time in hospital, paid premiums for 45 years.

Still, when 5% of customers are using 50% of the products its hard to spread that around fairly in a legislative measure.

This would be the single, biggest move to fix the situation. People will shop for services with an eye on the cost. Competition for market share forces prices down.

Example. My MRI of my brain last year was $1,600 at wife's hospital. No discount. Used insurance. I called an Imaging facility in Franklin who would have done identical scan for $295 cash.

 

[McDad]

Its not because you have sand in your clit

Is this where pearls come from?

 

[CABVOL]

The real problem is reducing the amount people go to the doctor

I mean the ones who take their kids because they get a fever or throw up once

Or the get a headache or sore throat. Instead of letting minor sicknesses run their course, they run up a bill because of a $10 co-pay

Then, you have businesses that require a doctors excuse for being sick one day. Then they complain that insurance cost go up for the company

Insurance should be limited to major issues and preventive care like yearky wellness. It shouldt be used because you are too big of a puss to deal with a tummy ache or a little headache

I hear this too often

"Well, thats why I pay insurance"

No, its not. You pay imsurance in case you get a real sickness. Its not because you have sand in your clit

This is way too often true. I have seen it for the last 28 years working in healthcare. Providers complain constantly about people always wanting an antibiotic, when in fact, in many cases, waiting out the illness to run it's course works too. It just may take a couple days longer. Plus, antibiotics do not kill viruses, which is most of time the culprit. There is a reason antibiotics are starting to not work and stronger antibiotics are having to be given.

Plus people overuse the ED like wildfire. Most times they didn't want to take off work to go to the doctor, or they owe money to their doctor and their doctor won't see them, so they go to the ED where they cannot be turned away.

People's overuse of the system is not the main factor for high HC costs, IMO, but it definitely has a big role.