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Location: RI, MA, VT, WI, IL, CA, IN (that one sucked), KY
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Quote:
Originally Posted by DC at the Ridge
I think the system was unsustainable before healthcare reform. We have a system that is designed to inflate costs at every level, with no controls on the pricing and very little transparency. We already are devoting too large of a share of our economy to healthcare (which incorporates insurance costs as well as healthcare costs), and when one sector of the economy is using too many resources, those resources aren't available to other segments of the economy. This is one key part of the off-shoring problem. With babyboomers poised to become increasingly dependent on healthcare, which will drive healthcare to consuming an ever-increasing part of our economy, healthcare reform had to be an absolute priority at this time.
While I totally concur with you that the ACA doesn't do much in the way to manage costs, it moves us closer to a single-payer model, where government has the power to manage costs. This may not be a good thing, because how they manage costs can lead to sub-par care, but, frankly, I don't think there's any way to get around government stepping in and slashing healthcare costs brutally in about 2 decades. At that point, it will be necessary in order to save the national economy.
Exactly. And a single payer system would be such an incredible boon to our businesses (it may be the single best economic stimulus ever) and entrepreneurship.
Though, I think the sub par care thing is off base. We should be looking at the results, which is what matters, and many many single payer systems get far better results than our system for much less money.
I think the system was unsustainable before healthcare reform. We have a system that is designed to inflate costs at every level, with no controls on the pricing and very little transparency. We already are devoting too large of a share of our economy to healthcare (which incorporates insurance costs as well as healthcare costs), and when one sector of the economy is using too many resources, those resources aren't available to other segments of the economy. This is one key part of the off-shoring problem. With babyboomers poised to become increasingly dependent on healthcare, which will drive healthcare to consuming an ever-increasing part of our economy, healthcare reform had to be an absolute priority at this time.
While I totally concur with you that the ACA doesn't do much in the way to manage costs, it moves us closer to a single-payer model, where government has the power to manage costs. This may not be a good thing, because how they manage costs can lead to sub-par care, but, frankly, I don't think there's any way to get around government stepping in and slashing healthcare costs brutally in about 2 decades. At that point, it will be necessary in order to save the national economy.
I honestly can't believe my eyes. Did I really just read a post from a liberal who is openly declaring that America has a spending problem and that our national economy is destined to go bust?
Of course it is. But what is being done is compounding the problem, not making it better.
Two hundred years ago the "common man/woman," for the most part, could afford the health care of the time without the aid of insurance companies, governments, etc. And we call what we have "progress"? Bureaucracy most often worsens that which it attempts to improve upon.
I don't think you can compare "healthcare" today with healthcare from the 18th and early 19th century. Healthcare didn't much exist before the 20th century. Yes, there were "bonesetters" and "midwives" and so-called physicians and herbalists and so on, but the rudimentary healthcare of 200 years ago was not comparable.
Healthcare has developed, and by leaps and bounds during the 19th & 20th century, spurred on by the Industrial Revolution which was a technological revolution and also an economic revolution. We could DO things we couldn't do before, and we had the money to FUND research which we couldn't do previously.
However, the United States is unique in the world, for designing a healthcare system which was FOR profit. It invited middlemen into the relationship between patient and doctor who were there to make a profit. It encouraged specialization that connotes an excellence, but it's an excellence at an extreme price. The fact that we treated healthcare as like any other capitalist venture, but at the same time waived conditions that would have actually compelled it to act as capitalism (we squelched competition and transparency), allowed a corrupted system to develop. And yes, other systems of healthcare are also flawed. But the systems in other countries are not in a position to collapse those countries' economies. Our is.
Healthcare reform is an absolute necessity. Because healthcare costs have to be controlled. The ACA does not do this for the most part. But it brings us a step closer to it.
Insurance in other countries is rarely as profitable as it is in the United States.
I think one step to reforming our system that could have been easily taken and was not was to introduce transparency into the system. If medical providers had to submit their prices to a website that was open to the public, and people could compare and shop around, then competition would have leveled prices. More than that, if how providers billed were standardized, so that the bill you get from the Mayo Clinic is broken down the same way that the bill you get from Brigham is broken down, then price inflation would be more easily controlled.
We have at least part of that with the Health Exchanges. People can compare policies side by side. I know in Arizona one Republican lawmakers answer to Medicaid expansion was to require hospitals to post their prices. That was vetoed by Republican Governor Brewer. The insurance companies under the ACA have already done the shopping and squeezed out people who wouldn't lower their prices. A number of high priced expensive hospitals have been cut out of the ACA.
Claiming an oil change on your auto insurance is a profound metaphor that really puts the issue into perspective
Nah, it's actually kind of stupid.
If your auto insurance had to cover the eventual catastrophic costs of not changing your oil, preventative maintenance wouldn't just be covered, it would be encouraged. Just like my health insurance is forever badgering me to get annual checkups and whatnot - early detection is a win/win, in that it may save my life and them a lot of money.
It invited middlemen into the relationship between patient and doctor who were there to make a profit.
And THAT is what I was getting at, not the specific nature of the medical care. I think that's where we (the nation), as related to medical care, ran off the tracks, so to speak.
Our difference, then, is how we believe it can be corrected. You feel it is government meddling. I feel it is a return to direct doctor-patient correspondence in both treatment and billing. I suppose the only thing we might agree upon is the government power being used to implement the "cure." But we are polar opposites on what the cure is. I say it's a legislated direct link between doctor and patient with NOBODY else involved; you say it's a bureaucracy controlling the doctor and patient (I'm assuming).
I honestly can't believe my eyes. Did I really just read a post from a liberal who is openly declaring that America has a spending problem and that our national economy is destined to go bust?
Holy crap!
Actually I think Paul Krugman said the same thing that Medicare needed to be reformed now. If it isn't it will break the country. He suggested either raising taxes or means testing Medicare. With Medicare we subsidize upper income earners. A couple has to earn more than $170,000 before they pay more of their Medicare Part B. Compare that $170,000 and $104 per month to a 60 year old couple paying almost $1,000 per month for a high deductible bronze plan with an income of only $62,000.
I honestly can't believe my eyes. Did I really just read a post from a liberal who is openly declaring that America has a spending problem and that our national economy is destined to go bust?
Holy crap!
Actually, you just read a post that tells you that the American economy is bounded by whatever resources it has at its disposal at that moment. The resources are a pie. A very, very big pie that grows and retracts. And different sectors of the economy get a slice of that pie. Technology gets a slice. Manufacturing gets a slice. Retail gets a slice. Healthcare gets a slice.
The growth of the economy depends on the productive sectors getting the majority of the pie. Healthcare research and development is productive. Healthcare consumption isn't. So from 1900-1970 (my estimate), the fact that healthcare was consuming more and more of the pie was okay, because so much research and development was happening. Healthcare literally became an industry. But from 1970 onward, healthcare consumption has become where the profit is, and the people involved in healthcare have followed the money. They've devoted their resources to expanding healthcare consumption. And that's driven up healthcare costs. Because it's consuming such a large piece of the pie (and we know this by comparing our economy to ALL the economies around the world and how much of their economies are going to healthcare versus how much of our economy is going to healthcare, and we're pretty much 100% over the norm), there's less resources for other sectors of the economy. And those other sectors need resources. Which is one of the reasons for off-shoring.
In an ideal world, we could gradually shift the resources in our economy away from healthcare to other, more productive economic sectors. But in the real world, we've got a demographic catastrophe facing us. Baby boomers. A large population bubble that statistically is known to be major healthcare consumers. And it's started already. They are going to grow the healthcare consumer slice of the economic pie, no matter what we do. So we have to cut the size of that slice by attacking it from the other side, by reducing healthcare costs. That's the challenge that faces Americans. It's not that government spends too much, or the debt limit, or the budget. And those do have an impact on the economy, so they are concerns. But healthcare costs could grow the size of healthcare's slice of the pie so much that there will be no resources for other parts of the economy. Healthcare costs have to be controlled.
-Socialism: You have two cows, the government takes one cow and gives it to your neighbor.
-Communism: You have two cows, the government takes both and gives you part of the milk.
-Fascism: You have two cows, the government takes both, and sells you the milk.
-Nazism: You have two cows, the government takes both and shoots you.
-Bureaucracy: You have two cows, the government takes both, shoot one, milks the other and pours the milk down the drain.
-Capitalism: You have two cows, you sell one, buy a bull, make more babies, then keep selling the offspring and making more money
-Vulture capitalism: You have two cows, corporations buy cows then send both cows to China, China milks cow and sell milk to you
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