Why the US Makes No Progress with Accessible, Affordable Health Care (fast food, death)
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Portability of insurance is of utmost importance to a economy. If people feel they have to stay working at a place for the health insurance - then new innovations and new businesses are not formed and employees are less likely to innovate and take the risks...that end up making our country great.
I have changed jobs and simply moved from one employer coverage to another employer coverage.
I like my employer coverage, always have. I would not mind an exchange if the options were strictly private sector and unsubsidized, as well as no gov't mandates on anyone, or rules from gov't on coverages required.
Let the consumer decide, and pay.
Most will wisely prefer employer coverage.
You do realize that taxpayers subsidize your employer based coverage. The unisured end up paying more in taxes so those with employer based coverage can get their benefits tax free. The fact is that millions of Americans do not have coverage through their employer. There are not enough jobs with health benefits to go around but those people still need affordable coverage.
Portability of insurance is of utmost importance to a economy. If people feel they have to stay working at a place for the health insurance - then new innovations and new businesses are not formed and employees are less likely to innovate and take the risks...that end up making our country great.
Yup! I wasn't smart enough (in my condition) to navigate COBRA and the world of private insurance circa 2005.
Despite the trouble I had with US healthcare (we have the worst spine care in the civilized world), I emphasized more for my boss. He had a special needs child and that made him a slave to the company.
US healthcare is broken. The ACA was a wobbly first step towards fixing it. And now?
You do realize that taxpayers subsidize your employer based coverage. The unisured end up paying more in taxes so those with employer based coverage can get their benefits tax free. The fact is that millions of Americans do not have coverage through their employer. There are not enough jobs with health benefits to go around but those people still need affordable coverage.
Realize it yes? I liked McCain's 2008 idea. Tax it-give a flat $7,500 deduction to singles with coverage, $15k families with coverage, except I think it should be $7,500 per tax return limit.
That would tax Cadillac plan surplus value, and it would stop providing a tax credit to a non-working spouse.
In reality, I think family coverage cost gap should be subject to a gift tax. The non employee folks covered are not benefitting the employer.
All of the 30+ other OECD countries cover all their citizens, and medical bankruptcy is unheard of. The USA has a patchwork of coverage and millions without access still.
To address point #2, as societies acquire greater wealth, people become less accepting of disease, more aware of health issues and their own health, and more assertive in pursuing good health and living a longer and more enjoyable life.
"As personal income increases, people demand more and better goods and services, including health care. This means that holding other factors constant, as higher personal income increases the quantity and quality of care demanded, overall health care spending increases as well. GDP is a good indicator of the effect of increasing income on health care spending."
Source: United States Government General Accounting Office GAO-13-281 PPACA and the Long-Term Fiscal Outlook, page 33.
To address Point #3, read: Hearing on “Working Families in Financial Crisis: Medical Debt and Bankruptcyâ€
Tuesday July 17, 2007 1:00 pm
Room 2141 Rayburn House Office Building
GOVERNMENT DOCUMENT NO COPYRIGHT RESTRICTIONS
Nor is there any evidence that medical bankruptcies are creating any sort of crisis for the bankruptcy system or that the percentage of medical bankruptcies has been rising over time.
A study by Ian Domowitz and Robert Sartain, for instance, find little correlation of medical debt with other sources of financial distress, such as job loss or income interruption.[1] Fay, Hurst, and White find that health problems by the head of a household or spouse that cause missed work are not a statistically significant factor in bankruptcy filings.[2]
[1] Ian Domowitz & Robert L. Sartain, Determinants of the Consumer Bankruptcy Decision, 54 J. Fin. 403, 413 (1999).
[2] Scott Fay et al., The Household Bankruptcy Decision, 92 Am. Econ. Rev. 706, 714 (2002). https://www.gpo.gov/fdsys/pkg/CHRG-1...83.htm...which debunks the myth of medical bankruptcies.To address Point #4, and specifically infant mortality, you can see what your own CDC has to say:
Source: US Centers for Disease Control
"If the United States had Sweden’s distribution of births by gestational age, nearly 8,000 infant deaths would be averted each year and the U.S. infant mortality rate would be one-third lower."
Note the cause of the "high" infant mortality rate.... "The main cause of the United States' high infant mortality rate when compared with Europe is the very high percentage of preterm births in the United States."
Quote:
Originally Posted by Midpack
So what are ALL the reasons the USA has the highest costs by far, significantly poorer health outcomes, while leaving millions without?
Show us the "significantly poorer health outcomes"...
Source: CONCORD Study funded by the US Centers for Disease Control and the British National Health System.
US outcomes are clearly superior to others, especially to the British and their NHS.
Quote:
Originally Posted by Midpack
Here's what I gather just as a place to start, in no particular order, but please add as you see fit.
lifestyle (obesity, smoking, drugs)
high cost and profit for intermediaries (insurance)
excessive profit for some product and service providers - medical devices, pharma, hospital groups, doctors & other medical professionals
administrative burden (millions of microplans)
high charges for specialized services
forced use of expensive specialized facilities for routine medical needs (emergency room)
multiple regulations around the country
punitive legal awards
diagnostic overuse (expensive tests even for routine matters)
treatment overuse (especially end of life)
excessive unproductive labor vs technology
plus significantly/ironically, excessive usage by patients who have no idea how much the services are actually costing them
almost none of us ever asks "what does it cost?" or makes any attempt to be selective - there is little else we buy without considering the price
You omitted gun violence, automobiles (Americans drive far more miles than their European and Asian counter-parts, placing them at greater risk to injury/death due to accidents), and the fact that the US has a heterogeneous population, unlike the homogeneous populations of the 50-odd countries that have universal care.
I like my employer coverage, always have. I would not mind an exchange if the options were strictly private sector and unsubsidized, as well as no gov't mandates on anyone, or rules from gov't on coverages required.
Let the consumer decide, and pay.
Most will wisely prefer employer coverage.
Not if healthcare is done properly they won't. Employers shouldn't be involved in the healthcare process.
Employers don't want to put out money for healthcare. The money employers save on healthcare could be put to a more attractive benefits package in other areas such as wages and vacation.
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