Medicare reform...

steveinaz

My brothers latest article:

http://www.csmonitor.com/Commentary/Opinion/2011/0629/How-to-reform-Medicare-with-faith-in-market-principles-including-vouchers

Joe08867

I think I'll leave this topic alone.

But I will make some popcorn.

steveinaz

Nothing wrong with spirited debate. All opinions are welcome.

tonyb

I'm a big fan of vouchers, for education. The basic principles of any voucher system is to give the control, power,decision, back to the consumer....which goes against the grain of unions and politicians. That goes back to many statements I have made before that neither one has your best interest at heart.

If you take just one percent more out of paychecks for medicare, that would solve alot of the problems. Also you have to tackle the fraud aspect of it or your just spinning your wheels. If anyone deserves free medical, it's our seniors and vets. We could do it if we wanted to, the will is just not there though.

steveinaz

IMO, vouchers are a very simple, transparent system---the last thing politicians want. They want us confused and blind---and makes for easier pocket-lining.

rooftop59

That was a pretty balanced article, and I find many of the arguments persuasive. The main part that I find extremely problematic is the whole "faith in the markets" approach. And the funny thing is, I couldn't articulate it until the end when he decided to push the envelope and compare health care to food and claim that we do not have a food crisis in America because of the free market so why do we have a health care crisis. The point is misleading. While we do not have a food shortage in America (because we consume, throw away, or us as fuel almost 35% of the WORLD'S food supply), we have FAR too many people (especially children) going hungry everyday. My mom was a teacher in Southern AZ for almost 40 years, and one story always stood out to me. A young boy who was usually well-behaved was misbehaving on a Monday morning. They had to remove him from class and asked him what was wrong, He admitted that he had not eaten since his Friday lunch at school. They feed him and he was fine after that. Anyone who thinks that we do not have a food-crisis in this country is either blind or ignorant, and that author is obviously neither. So the comparison fails horribly.

I will say that vouches seem like a reasonable solution, but even then it will require regulation and oversight, and it won't succeed purely because the markets saved it.

kevhed72

steveinaz wrote: »

IMO, vouchers are a very simple, transparent system---the last thing politicians want. They want us confused and blind---and makes for easier pocket-lining.

Amen, brother.
It also seems the whole making healthcare more affordable/efficient idea has gone out the window lately. Making the healthcare system more efficient is hard / cutting benefits and raising taxes is easy :frown:

cnh

The idea of 'vouchers' is an age old favorite of those who favor 'free market' solutions to everything and assume that there is no poverty--no poverty that is not 'correctable' by the free hand of Market Capitalism.

Let's just leave it at that because no one I know who favors this idea has 'ever' given the other side even a few seconds to present it's counter. And those who don't believe vouchers will work for anyone but those who already 'have' enough resources will ever be convinced of the opposite either. This is a political 'hot tamale', a hornet's nest, a Gordian Knot!

And we know what Alexander's response to the Knot was?

In my experience as a teacher I have found that most of my students who favor vouchers come from families whose income levels are several times the average for Americans, and that's really all I have to say here. And I'll leave it to Alexander to cut the Gordian Knot! lol

cnh

steveinaz

I'm financially comfortable, have good health insurance, and am in good health---but I'd be willing to pay a federal sales tax to ensure everyone who isn't as fortunate as I was covered, and the country had a system in place that wasn't blindly wrapped in red tape, and full of corruption/abuses as the current system. Not to mention a system that wouldn't have my grand children "crippled" with debt.

What does that say about me?

rooftop59

This is certainly not about your compassion or willingness to contribute to the greater good. Its about the best way of solving the problem. The issue at hand is not about "compassionate conservatism" vs "bleeding-heart liberalism" but whether or not the free market can ensure that the least of these among us will have their basic needs met (which I think includes food, basic health care and education among other things). I for one am very skeptical about the viability of any hard-core free market approach, but agree that something needs to radically change.

Outfitter03

The US health care system is significantly different than other developed countries. It has always been interesting to me that in a country that since the beginning of the 21st century has had Capitalism as the dominant form of economic thought has largely left Health Care out of the Frey, much to the detriment of the consumer. What do I mean by that? Let me illustrate.

For capitalism to work there needs to be competition. Generally defined as having at least 12-15 significant competitors in the marketplace. Once the competition drops below this to 3-6 you have an Oligopoly where collusion runs rampant, and real competition doesn't exist.

Health care systems were largely run during the 40s, 50s into the 60s by Universities or through religious institutions. Back in the day when doctors made house calls, physicans were largely generalists and made a fair living. Very, very few made in present dollars the equivalent salary over $1,000,000 a year.

Business then stepped in, Physicians migrated to specialty areas and technology took a huge leap forward. The costs skyrocketed as well as the compensation packages for anyone involved in these fields.

Many of us, such as myself that believe in the power of a competitive market place would love to make wise choices in health care. Ever try to cost compare services and outcomes? Good Luck.:frown:

Having crossed the 50 age thresh hold recently I needed to have a Colonoscopy. As this is a very standard procedure and there are multiple facilities in my area to have it done 30-50 although most are only tied to 2:eek: heathcare systems to service 1, 500,000 people. I called and could not even get basic pricing out of 5 providers. They would say things like $2000-$3000 but it will depend on your insurance. I ended up going with the facility that my primary care physician recommended. In the pre-approval process I learned from my insurance company they would cover all the costs if they found no items of interest or polyps, but if the Proctologist performed even one biopsy it was now a surgical procedure and I would have to satisfy my $500 deductible and pay 20% of the remaining balance of all costs.

The procedure lasted less than 45 minutes. I spoke with the physician about 3 minutes prior to the procedure and about 3 minutes after while still looped from the propofol anesthesia.

Doctor bill $1,800.
Facility bill including nursing support, anesthesia etc. $1,750. Cost to me after insurance, about $1100.

$1,800 for an hour and a half of work, even if it is shoving a probe up someones butt ain't too bad of pay. Imaging if you do about 10 of these a day, 4 days a week!

My point is this whole debate is Smoke and Mirrors and lobbyist funded crap. When you can find fixed procedure costs online as well as outcome statistics that physicians and healthcare all secretly keep, you can argue that Capitalism has come to Healthcare and real competition is in place. In the meantime our entire economy is being drained with excessive costs and much lower overall health outcomes than exist in some of the European Countries that have a more centralized approach to Health Care and pay their primary care physicians better incentives to due Preventative Medicine instead of Specialist to due high cost restorative procedures.

steveinaz

Tough love is sometimes exactly what the doctor ordered. This country has lived irresponsibly long enough--and it's pay-back time. That's a FACT. Now, people can either roll their sleeves up, get ready to get a little scuffed up and dirty---or they can continue to bury their head in the sand and take solace in knowing they'll be long gone before the floor drops out, so "who cares." At the same time parading around like they are the only one who cares.

strict parent vs. permissive parent OR do what's gonna benefit my kid vs. do what makes ME feel good. The same general rules apply.

Those who would balk at a federal sales tax...get real. You're paying, one way or another. One way creates an effective system that leverages competition (thereby creating more jobs), and has far more transparency; the other way bullshits you into a false sense of security, is full of excess and corruption, but your still payin. Me, I like getting REAL results from my hard-earned tax dollar, and I don't mind paying a little more for a better "product.".

These are simply my opinions on the topic.

aviator

My next door neighbor doesn't owe me health care, a meal, a roof over my head, a car, a boat, a living, an education for my kids or anything else, I don't owe him/her any of that either.

The only thing my neighbor owes me is to pay his/her own way, that is all I owe him/her - to pay my own way.

I'm a old fashioned liberal, my life and property are my own, not the crown's to do with as it pleases.

steveinaz

Well, with all due respect, you sound pretty conservative to me. My Dad is an "old school" democrat (the party was quite different in the 50's & 60's than it is today), and me and my brothers constantly bust his balls telling him "Dad, you're a closet conservative, you just don't want to admit it." He is very conservative, we were taught from day 1 that the country owes you nothing. We paid room & board from the age of 16 (20% of our paycheck went to Mom & Dad) to teach us that nothing is free, and to motivate us to want to move on to bigger better things. What he didn't tell us was that he was saving the money for us (secretly), and presented it to us upon leaving the house. He wanted us to think it was gone--that he'd used it for food, gas, etc. He was instilling in us a source of pride for feeling like we somehow "helped" the family. It worked.

rooftop59

So you guys don't want roads, police officers, firemen and women, military defense, prisons, public education and the host of other things that we pay for collectively and that have helped us all at some point when we were down or couldn't afford those benefits on our own?

We must remember that there is a fine-line between hardcore libertarianism and all out anarchy. I for one like the benefits of society. YMMV.

aviator

rooftop59 wrote: »

So you guys don't want roads, police officers, firemen and women, military defense, prisons, public education and the host of other things that we pay for collectively and that have helped us all at some point when we were down or couldn't afford those benefits on our own?

We must remember that there is a fine-line between hardcore libertarianism and all out anarchy. I for one like the benefits of society. YMMV.

I have an idea your post was aimed at me -- I said my neighbor doesn't owe me health care, a meal, a roof over my head, a car, a boat, a living or an education for my kids.

You will note I didn't mention the few legitimate functions the government has such as fire, police, courts and national defense -- and what is commonly called a free public education is neither free nor is it an education.

tonyb

The problem on the otherside of vouchers is what about the people who don't pay anything. In other words, a voucher can be your money you pay in taxes,given back to you to put towards the school of your choice, healthcare of your choice,etc. Now those that don't pay anything to begin with will say it's class warfare. If you can't take money from someone else to pay for these things,where are you going to get the money for the poor, or lower class ? Problem is then applified when the economy shrinks,such as now, and the lower class grows,and the upper middle class tax payers shrink. Thus the tax the rich more mentality that we've had for awhile. Now play that scenario out to the end,and you have a tens of thousand rich people supporting a country. Then benefits get slashed to stretch it out even more. Like we have said before,sooner or later you run out of other peoples money. We are just about there.

TECHNOKID

I have to admit as a Canadian that this thread and content is hard for me to read and understand. As Canadian, I paid since my first day of work for our healthcare system and this too me was just a natural thing. I did on few occasions have to use the system and thank God it was not runned as a business but rather existed for the welfare of all.

I have to admit our system is far from perfect, is costly and we have serious issues to deal with however, I thank God that our country sees healthcare in a much bigger and serious way than just a business/market. IMHO, healthcare should NOT be seen as a competing market but rather as a mandatory high quality service for ALL of its cityzens regardless of race, color or wealth.

To me, the life of the poor and the rich have the same value therefore when comes time for medical attention one's shouldn't have to worry if he/she can afford it or not. When sickess hits, one has greater concerns than to look if the wallet can provide. I honestly hope our cousins in the US can find a fair way for ALL US citizens be poor or rich to have access to the medical attention they ALL deserve.

God Bless!
TK

tonyb

Techno- Why is the care of one's health someone else's problem ? I get you like what you have up there, that's cool, roll with it, but down here,we like people to pay their way in the world. Why healthcare costs what it does has never been adressed, just how to keep paying for the rising costs. Most put forth the idea of having to cut benefits to bring costs in line, but never why a hospital room costs what it does,or medical gear, insurance, drugs,etc. Until we are able to have a serious discussion about it, costs will continue to rise no matter who is paying for it.

TECHNOKID

tonyb wrote: »

Techno- Why is the care of one's health someone else's problem ? I get you like what you have up there, that's cool, roll with it, but down here,we like people to pay their way in the world. Why healthcare costs what it does has never been adressed, just how to keep paying for the rising costs. Most put forth the idea of having to cut benefits to bring costs in line, but never why a hospital room costs what it does,or medical gear, insurance, drugs,etc. Until we are able to have a serious discussion about it, costs will continue to rise no matter who is paying for it.

Why would have home insurance, life insurance, car insurance and so on? I see healthcare insurance in the same way, happens suddenly and can bring you down financially pretty quickly.

As an example, my dad got stabbed in 1956 when coming out of his busness, someone wanted to steal his business mony. He was in hospital between life and death, 1 chance over a 1000 to survive. There was no such health care system at the time, he lost his restaurant and everything he had to survive. He then carried on in life miserably financially and healthwise. Of course his missfortune brought down with him an entire family, wife and six children. If healthcare were available then maybe, just maybe he could have kept his wealth and would have definitely been easier on his healtth and family and he definitely could have made a better contribution to his community (don't forget other people lost their jobs due to his downfall).

I am not seeing has owing the other one anything but rather as some form of "group insurance". Costly but protects each and everyone when bad times hits and you are not able to do much about it. Protects both the rich and the poor. Face it, you are rich, badly ill and looses everything you have in order to save your life. Wouldn't be better that "society group funding" provide you with the necessary insurance to get you back on your feet so can contribute again to society? Humans need a good balance of personal responsibilities and society responsibilities. IMHO, a society that takes care of their own has much to gain from it. I'm not saying it is easy and all black and white but it does have benifits.

I personally was sick and hospitalized in 2010. I spent a month in hospital and 4 extra months on sick leave. I was allowed to unemployment for most of my sick leave period, I did not have to pay for hospital bills, medication and once out of hospital my group insurance took care of most of my medication. My job and seniority were secure up to a certain point during that time. Of course my employer made sure I was still fit for the job but I took my position back and still am of great service to the company (matter of fact they fired my co-worker which also covered for me while I was away). IMHO, it is often worthwhile to spend money on people as a society as eventually there is benefits to be reaped.

What if our system was not there to protect me while I was vulnerable? More likely would have lost my house and not even sure if I would have been nurture back to health. I am convinced (Humbly I KNOW) my employer benifits from my recovery (I guess I should go over the revenues I generated since I've been back, hummm).

tonyb

TECHNOKID wrote: »

Why would have home insurance, life insurance, car insurance and so on? I see healthcare insurance in the same way, happens suddenly and can bring you down financially pretty quickly.

Because home/life/auto/ insurance benefits the individual paying for it. Why would I want to pay for your homeowners insurance if you couldn't afford it ? Am I also expected to pick up the tab for your car insurance because your a high risk driver ? Why should I pay for your healthcare then ? Is it or not your responsibility to take care of yourself ? You say the cost are too high ? Can't afford it ? Then deal with the reasons of why they are high, not just spreading out the cost to the masses. We have to start demanding our elected officials tackle this. Granted some will have to pay more because of the risk factor involved with current health problems or occupation.

There are alot of curve balls life can throw at you to "bring you down financially". So what...thats part of living, and making the choices to limit your liability is too. Government programs is not your nanny,mommy or daddy. Take responsibility for your life is all I'm saying and if your own choices in life bring you to finacial ruin,so be it.

In our country anyway, the whole healthcare discussion started with the rising cost of HC. So the wise decision our elected boneheads decided on was to not look into why HC cost what it does, but to spread it out, cap benefits,raise taxes. So in the end, what we asked for was to do something about the fast rising cost of HC, and we got legislation that will make it cost even more for most or reduced benefits.

Along the same lines, on a different note, as high as HC costs have risen over the past decade, college tuition has doubled the rise of HC over the same period. Something else that is subsidized in a big way.

You want to get the average americans hair to stand up ? We pay for others HC, college, free phones, condoms,foodstamps, subsidize housing, subsidized child care, free job training, and we will pay you as a single person up to 400 bucks a week to stay home for up to 2 years. Man, I'm motivated to go out and get a job.:rolleyes: The nanny state is out of control, stand up or fall on your own, and I'll bet if given those two choices,you'll stand.

Airplay355

It's a tough situation. I don't want to live in a place where I have to pay for dead beats who are lazy and or stupid. I also don't want to live in a state where good hard working people, who might get caught in bad situations, will fall into financial ruin with their families and never recover. I'd give money out of my paycheck for the hard working people, the elderly (does anyone really want to see grandma poor and starving?), the vets who have come by hard times because of curve balls life throws at you. I'm only 23 and I have a nice steady job with great health insurance so I can't imagine not being able to see a doctor because I have to choose between medical bills and feeding the kids. Know what happens when that situation presents itself? The medical problem gets worse and worse and worse until they end up in the ER, rack up a huge bill that they will have to walk away from. The hospital isn't going to eat that cost, they are going to pass it on to other people who can pay, by raising costs of procedures.

Like I said, I don't want to pay for other people's crap, but I also don't want to be in a place where good people can lose everything in a heartbeat. Where does one draw the line? It's a tough situation for sure.

tonyb

I always said I thought the elderly and vets were first inline if a freebie for hc was to be given out. Even with a job, and HC benefits, your still capped. A medical crisis can still ruin you financialy, then what ? The rest of us suppose to pick up your losses ? Nobody, and I mean nobody, not any insurance carrier, the government itself, will protect you from everything in life that can ruin you. Healthcare, housing, a job, and the other endless list of freebies is not a right, if it is, who granted it to you ? Heck, we are still battling the right to life itself in this country. How on earth did we ever build this country without all the freebies we have today ? Yeah, that was sarcastic. Not meant directly at you Airplay, just venting is all.

Airplay355

No no I completely understand. I can't even figure out which side I'd stand on because it feels like there's so much gray area.

I'm not sure we built this country without freebies. I'd like to think that when the world was a smaller place if someone in your community had come on rough times people would band together to help them out. I'd consider those freebies. Hell, that even happens here on CP. I've read posts where something bad has happened to someone and a line instantly forms with people ready to donate paypal money, raffle off gear, do whatever. I think I'd rather live in a country where people act like that instead of one where everyone just shrugs and says tough luck. I suppose the real issue though is should the government FORCE you to be a good human and help people when they deserve it or can society do that on their own. I definitely don't have the answer for that one.

I definitely agree with you on the elderly and vets getting free health care though. Should I pay for someone's rehab after they have their arm blown off in Iraq or for a program that makes sure elderly have something to eat? Absolutely, who do I send the check to...

decal

Correct me if I'm wrong on this, but aren't political topics taboo on CP? Yes, this discussion is political, no matter how you spin it.

tonyb

decal wrote: »

Correct me if I'm wrong on this, but aren't political topics taboo on CP? Yes, this discussion is political, no matter how you spin it.

You could stretch politics into anything these days if you spin it the right way. For instance, we could say audio is political because of the energy usage on those big tube amps. You could also say the use of cheap asian parts in speakers are supporting slave labor. See....not so far a stretch.

We have been doing very well keeping politics to a minimum in this thread. Lets keep it that way. Unfortunately the subject matter of medicare is a government run program and politics of coarse is part of it. Nobody as been blaming any party for it's woes, so lets just talk about how to fix it without dragging the donkeys and elephants into it.

cfrizz

ROTFLMAO! Thanks for the chuckle Tony.

rooftop59

I think that *almost* anything is allowed as long as it remains civil. Yes, I have pointed out in the past the firearms and religion and other hot-button political issues are not allowed because Polk does not want a potential consumer offended, which makes sense from a business standpoint. However, if we can keep a discussion civil and no one takes issue with it, then I don't see why we can't continue. However, if you or anyone else says that have a problem with it I for one will stop participating.

tonyb

Always at your service Cathy.:biggrin:

markmarc

As a private (parochial) school teacher, I can testify that vouchers can come with a double-edged sword. On one hand, vouchers would be a terrific boom to private school education allowing many, quality, serious students to consider private education. Not to mention allowing many faith-filled but financially strained families the opportunity to send their children to their parish school.

The downside to vouchers is the fear of many educators in private schools that with the voucher comes the endless gov't regulations that could very well kill what makes private schools work so well. As it is in the 17 years that I have spent teaching in private schools our regulations/requirements have doubled. It is still a third the size of public schools but it still causes us time that could be better spent instructing students.

steveinaz

Airplay355 wrote: »

It's a tough situation. I don't want to live in a place where I have to pay for dead beats who are lazy and or stupid.

Welcome to free society. You're already paying for others in countless ways--it's the nature of the beast. The key is to minimize it as much as possible, and to come up with programs that are built from the ground up to minimize potential abuse. Unfortunately there is an "element" that has no integrity or pride, and will take advantage of any opportunity. Stricter standards are needed to shut these freeloading morons out.