sb Loc: Florida's East Coast

All the nonsense about whether - and how - to repeal the ACA ("Obamacare") and yet there seems little discussion about the very important basics:
1) SHOULD our society guarantee healthcare to all of our citizens? Almost all nations do. It would be the Christian thing to do. BUT - most nations do not have the military spending that we do. Over half of our discretionary spending goes to past, present, or future wars (this includes VA costs, nuclear weapons costs, etc. that are not in the official military budget). Even if it is a moral imperative, can we afford to do this? Can we afford NOT to do this? Some studies show that providing basic care costs less - making sure that diabetics can get care, etc., saves a lot of money in the long run. Protagonists argue that even when people get Medicaid they still use the ER - but that is because almost no physicians accept Medicaid. A "Medicare-for-All" program would be widely accepted (for physicians who want to be paid...).

2) There is a lot of talk about premiums but no talk about costs. American health care costs about $9,000 per year per person. NO ONE will ever be able to get cheap health insurance again. People who say they used too get insurance for $200 are confused - their employer was paying much of their premium. Costs for premiums have risen over the years as states have required coverage for things such as mammograms. The ACA required much more coverage - that is one reason the premiums have become so expensive. I was paying $25,000 per year for a family of three. When I had a colonoscopy I paid zero for that service, which otherwise would have cost about $5,000.

Allowing the sale of insurance across state lines would allow people to find cheap insurance that doesn't cover a lot of things. Would I like to buy insurance that doesn't cover cigarette smokers? Sure - I would save a bundle! But states do regulate insurance. If you live in Florida and have insurance from Delaware and have a problem, who is going to care? No one!

Medicare for all would reduce costs. Insurance company overhead adds as much as 25% to our health care costs. Medicare has an overhead of less than 8%. Having a tight prescription formulary, like the VA, would also help cut costs.

Things to consider...

WNC Ralf Loc: Candler NC, in the mountains!

Insurance company's need to make a profit for shareholders huge bonuses for the "bosses", we really need to get to a single payer and face the real problem of the cost of healthcare.

Leica User Loc: Western North Carolina

Like most lefties, you are at the very least being deceptive or lying by omission. You conveniently leave out the FACT that one of the most significant contributors to our high health care cost is the LACK of tort reform. Why do you leave that out? People can come to their on conclusions but I am sure it has something to do with YOUR deceptive agenda. You seem to say that making our system more like the VA healthcare system would solve many problems. That is rich. The VA system is awful. If you like the VA system we have then you will love a single payer government sponsored health care system. I think most would not choose that if given the choice. You imply that the reason we do not have a national health care system for all is because we spend so much on our military and defense. That is rubbish and at the end yet another lie pushed by the left.

You say most countries have healthcare for all their citizens. That for the most part is true. But again, what you conspicuously and probably purposely leave out is that not one of those countries has the gauntlet of lawyers standing just outside the door of the doctor's office waiting for their cut. Not one. You also seem to imply that because another country has national health care that is superior care to ours. Not so, and I know that first hand. If you want to take a quick, albeit unscientific measure of the quality AND availability of other nation's healthcare just go to M.D. Anderson, Sloan Kettering, Emory or the Mayo Clinic and take a poll of the throngs of foreigners that are coming here to get their health care needs. It is stunning.

If you are going to push one of your agenda filled, deceptive and biased opinions at least try and be a little bit intellectually honest. For a change.

Steven Seward Loc: Cleveland, Ohio

I like your thoughtful considerations of this issue. I fully agree that letting people buy insurance across State lines would help enormously. I don't know of any other service that is denied across State lines. Also these insurance mandates that are enacted by Obamacare and also by individual States are getting bloody ridiculous. Requiring senior citizens to pay for maternity insurance and the like is something out of the Twilight Zone. The only reason they do it is to force people who would not use the services to pay for the people who do.

I disagree about the "Christian" thing being to guarantee healthcare to all citizens. If that is true, then it should be Christian to guarantee everything. That would include food, housing, a job, t***sportaion, a mate, and on and on.... I think the trouble with guaranteeing healthcare, or anything, is that people suddenly lose their incentive to work hard to pay for something and expect other people to provide for them, and things just go downhill. All those other countries that you cite having universal healthcare are almost all at lower standards of living and income than here in the U.S. This, despite the fact that many of them spend a pittance on their national defense because the U.S is protecting them. On top of that, most other countries don't do any significant research and development in medicine. They just rely on the research and development work of the U.S. and a small handful of other countries like Israel, South Korea, Japan, maybe a little from France and Germany.

I think it would be "Christian" to take care of the people who are incapacitated or cannot take care of themselves due to an accident of nature, but our welfare system mostly takes care of people who simply choose not to work because they don't feel like it.

Steven Seward Loc: Cleveland, Ohio

I wouldn't level the accusation of being deceptive against sb. He can't cover everything in a couple paragraphs.

To corroborate your observation that there are many foreigners at the Mayo Clinic and elsewhere, I was told by the head of the Cleveland Clinic about 15 years ago that something like 10% of their patients were from foreign countries. I could be off by a little bit but I know it was around 10%. Almost every cardiac-patient in rich oil states seem to come here.

Bazbo Loc: Lisboa, Portugal

As usual. you are off an a rant with partial facts, have t***hs and distortions--probably used on something you heard somewhere. Here is a link to a comprehensive study done by the NIH:

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3048809/

Because its long and complicated and you will probably not be able to get someone to read it to you, here is the conclusion:

"Conclusion

The medical liability system costs the nation more than $55 billion annually. This is less than some imaginative estimates put forward in the health reform debate, and it represents a small fraction of total health care spending. Yet in absolute dollars, the amount is not trivial.

Moreover, to the extent that some of these costs stem from meritless malpractice litigation, 21 they are particularly objectionable to health care providers. The psychological and political value of addressing this grievance could be considerable.

Reforms that offer the prospect of reducing these costs have modest potential to exert downward pressure on overall health spending. Reforms to the health care delivery system, such as alterations to the fee-for-service reimbursement system and the incentives it provides for overuse, probably provide greater opportunities for savings.

Some aspects of federal health reform may reduce medical liability costs. Extending health insurance coverage to the uninsured may reduce their need to file malpractice claims to rec**p medical expenses occasioned by injuries caused by malpractice.

Additionally, in states that have adopted “collateral-source offsets”—meaning that costs covered by health insurance cannot be recovered by malpractice plaintiffs—greater prevalence of health insurance will mean more frequent offsets, lower total indemnity payments, and less “double payment” of medical expenses. A farther-reaching reform that merits discussion would be to impose a federal collateral-source offset in connection with the move to universal coverage. In these respects, health reform and liability reform may have unexpected synergies in bending our cost curve down."

Steven Seward Loc: Cleveland, Ohio

Sounds to me like you more than validated Leica User's post.

Bazbo Loc: Lisboa, Portugal

On the contrary. The study points out that although medical liability costs are real, but are not the primary driving force of the costs of health care which is just the opposite of Leica's argument. The study also points out that there are more direct ways to have an immediate effect on reducing the costs of health care in this country.

As always, simplistic thinking on complex issues only leads to partisan distortion.

Steven Seward Loc: Cleveland, Ohio

He didn't say that litigation was the primary driving force behind healthcare costs. The $55 Billion lost annually to lawyers that you cited is more than I expected. I shouldn't be surprised though, because there are so many television commercials with ambulance-chasing law firms looking for money that they call "compensation.". The latest one that gets me is they are suing over the use of TALCUM POWDER, one of the most benign substances in medicine. If we can't use talcum powder, then everything on Earth must be toxic.

Bazbo Loc: Lisboa, Portugal

It appears to be the only issue he cited. I think it was not unfair of me to equate this as the "primary" cause in his argument.

firtree Loc: Florida, USA

I wish I had coverage as well as the VA offers. I personally know several people who are very pleased with their VA coverage and the minimal co-pays for medications and services. I pay more for my health insurance than that and I receive very little in return for prescriptions and doctor visits. I have heard the horror stories of the VA, but locally it is just not that way. It takes time to get what you need done, but if you are pro-active and in need, it will happen.
What I see as the biggest problem, is that insurance companies run the world. The money they charge, first goes into their pockets. Then they negotiate with doctors as to what the doctor can charge, and what services you will be covered for. I am sure that the doctor also pays them for the 'rights' to treat the folks holding their insurance plans. Add to that the high cost of malpractice insurance, insurance on the building and contents, car insurance, homeowners insurance, and the physicians personal health insurance......well, I don't know about anyone else, but I see a problem here.

Steven Seward Loc: Cleveland, Ohio

The only reason insurance companies "run the World" is because people choose to give them their money. You don't have to do that. If you decide to keep your money, then you can make your own financial decisions. There is some negotiating with doctors by the insurance companies on what will be covered, but it is mostly all idone in writing beforehand and signed by the purchaser of the insurance. Now you can make an argument the the government severely restricts what you are allowed to buy with medical insurance. There they have us over a barrel, but that is not the insurance company's fault, it is the government's. We can no longer buy catastrophic medical insurance if we want to. Instead we are forced to buy all sorts of coverage that most people don't want. No other type of insurance that I know of is restricted and mandated so much as medical insurance. I don't think that doctors pay the insurance companies for the "rights" to treat their customers. If they did, then this would be some kind of fraud.

Screamin Scott Loc: Marshfield Wi, Baltimore Md, now Dallas Ga

There really is no "correct" solution. Neither the Government nor the Insurance companies should be in charge. It should be between the doctors & their patients. Doctors know more about health concerns than either the Government or Insurance companies. If that wasn't the case, why are the review boards populated by medical professionals ?

Bazbo Loc: Lisboa, Portugal

Are you suggesting that we do away with insurance altogether?

bull drink water Loc: pontiac mi.

TORT REFORM, another term for "we can do anything we want to the public, with no worry". over 20,000 people die a year from mishaps in hospetols. I guess we'll just count that as an oops.