The health care debate thread.

[CardiacCoug]

Yeah I liked that Time article. I spent 4 years working across the street from MD Anderson in Houston so I liked his description of the Texas Medical Center glass skyscrapers as reminiscent of Dubai. Sure seems like there's something wrong with that when people are getting fabulously wealthy off the backs of people who are sick and dying and paying tens of thousands of dollars in hope of possibly extending their life a few months in the face of cancer.

"Rescue" medical care in this country is awesome. I think people who get in car accidents, have heart attacks, have septic shock, etc. in this country generally get amazing care and have really great outcomes. Cancer care is great in this country as well. And this care is legitimately expensive, although not as expensive as hospital charges obviously.

Why is health care so expensive? Because patients don't ask (and if they ask then nobody knows the answer to the question) "How much is this going to cost?" Patients only ask, "My insurance is going to cover this, right?" Since "somebody else" is paying the costs skyrocket.

Really there are two ways to fix health care: 1. Price transparency with high-deductible insurance and the majority of costs for the majority of patients paid from health savings accounts OR 2. Single payer government health care, extending basic Medicare/Medicaid type coverage to everyone.

Option 1 would work if costs and quality/outcomes for every visit and every procedure test were mandated to be posted on the internet by every health care provider and patients paid out-of-pocket (had "skin in the game") for all this stuff. That would bring back competition and price transparency that is now sorely lacking. But I think eventually this country will work itself to Option 2 because that is where public sentiment seems to be in my experience. That's why Obama won the election. People who have no problem paying $1000 for a car repair bill are outraged if they have to pay $1000 for a medical bill. Most people don't want to take personal responsibility for the cost and quality of their own health care -- people want their taxes to pay for it and the government to regulate it tightly. And I do think that probably at the end of the day single payer government funded health care will be the most efficient and cheapest system that we could have.

[tooblue]

I am a universal health care advocate. The tax burden is heavy but, in my estimation, it is worth it. My family greatly benefits from access to universal health care. The article linked below, however, highlights some of the potential problems with the system, especially in smaller or, rural communities:

A decade of pain: The only foot surgeon in Nova Scotia has waiting list 3,500 names long

http://news.nationalpost.com/2013/02...00-names-long/

“I know you have to wait your turn in Canada,” Ms. Berringer says. “I understand that. But sometimes the system doesn’t seem to work for the people that need it.

“I am kind of back to full circle, back to Dr. Glazebrook, and he has a 3,500-person waiting list. I have waited over 10 years to see him and I’m not getting any younger, you know.”

[#1 Utefan]

I am a universal health care advocate. The tax burden is heavy but, in my estimation, it is worth it. My family greatly benefits from access to universal health care. The article linked below, however, highlights some of the potential problems with the system, especially in smaller or, rural communities:

A decade of pain: The only foot surgeon in Nova Scotia has waiting list 3,500 names long

http://news.nationalpost.com/2013/02...00-names-long/

This is foot surgery. It is also commonplace for those that need serious cardiovascular procedures such as stents, bypasses, etc. to face long waiting lists as well. I have had discussions with many US doctors over the years that have told me it isn't uncommon for them to perform these type of procedures on wealthier Canadians that have been put on 6+ month waiting lists that are concerned about dying before it is their turn. Cancer care in Canada is below US standards as well.

Universal healthcare works great for basic, primary care type of conditions such colds, flu, broken bones, etc. As you get older and need more specialized care, there are a lot of problems such as those mentioned in this article. I'm not sure many of us will be singing the Universal Healthcare model works great for me tune as we get older and find fewer specialists (oncologists, cardiologists, etc.) and need access to newer and potentially lifesaving procedures and technology.

I fear it will only be the very wealthy that will be able to afford access to top notch care in a universal healthcare system. The rest of us will have such a big tax burden, we will not have the income or means to pay for our own private insurance if we prefer.

I don't pretend to have all the answers as to how to fix the spiraling healthcare cost problem. It is a complex, multifaceted issue for which there are no easy answers. Unfortunately, I am pretty sure Obamacare has ironically accelerated the pace of rising costs considerably. I have read articles just in the past few weeks stating that insurers in many states are raising premiums 15-50% this coming year to be able to cover the costs associated with the requirements and regulations in this bill.

I would have preferred an incremental approach implementing some of the ideas already mentioned rather than the huge Obamacare overhaul and associated costs we will now be facing. Obamacare or not, tort reform and caps on punitive damages should have been a part of any healthcare reform bill IMO. While by no means the only problem contributing to out of control healthcare costs, doctors practicing defensive medicine and ordering thousands of unnecessary tests and procedures each year doesn't help the situation.

[LA Ute]

Really there are two ways to fix health care: 1. Price transparency with high-deductible insurance and the majority of costs for the majority of patients paid from health savings accounts OR 2. Single payer government health care, extending basic Medicare/Medicaid type coverage to everyone.

You're right. I think. What's interesting (and frustrating/funny) is that people seem to want the choice that (1) would give them, but they don't want to pay for that choice or take responsibility for their own healthcare. Obamacare will push us towards (2), I think, and we'll be there in 20 years or less. Maybe 10.

[Mormon Red Death]

Here is an interesting tidbit. There are ~10 million people in Michigan. We are expecting that by the end of 2014 roughly 11% of all those in Michigan will be on some sort of individual health plan (IE they don't get their insurance from work). The health care exchanges are going to be a BIG game changer.

To put that in perspective. The Health Plan I work for has about 450k members of which 5k of them are individual plans (1%). If things hold up expectations then ~45k more members will be moved to Individual plans