Clarifications of your words, by my summary, are in bold
, one step at a time.
Clarification: So we need to reform the rules under which insurance companies operate in order to increase competition, cover pre-existing conditions, eliminate cancellations, and to limit health care to "those who don't need it."
stockingfull wrote:Let's take this one step at a time.
1. There's no gun at anybody's head now, right? Yet costs are skyrocketing. Why? IMO, there are several major reasons. Big pharma and Hartford have a virtual monopoly, state-by-state. That monopoly is allowed to cherry pick the healthiest insureds, to deny coverage to anybody with a PEC, and to cancel people who have the temerity to get sick. Meanwhile, the problem is magnified as the population ages and requires/demands more and more expensive health care.
Clarification:So we need to reform the rules under which insurance companies operate in order to increase the portability of coverage.
As it stands now, if you contract an illness which requires ongoing treatment, you simply cannot change jobs. You become indentured to your employer. (Why? Because healthcare as an employee benefit was thought to be a good thing once upon a time, and this tether happens to attach to that concept.) If you're lucky, your insurer won't find some "benefit cap" or "program limitation" or ancient unrelated undisclosed PEC, or other horsecrap on the basis of which to rescind your coverage.
Clarification:So we need to educate the people to understand that their life will end at some point and at that point they become a financial burden to the health care system because all of the tech heavy life prolonging techniques are very costly without much benefit if you are going to die anyway. Thus, an agreement must be made between the care givers and the patient as to when your life will end.
Plus costs simply are out of control because it's all become a tech-heavy, on-demand system, where gigantic amounts are spent for end-of-life treatments, many of which do virtually nothing but burn money. Medical advances in the last generation have been so rapid that people in this country have come to believe that they never have to face death. And insurers have stopped fighting and become content to just pay, keep score, charge higher premiums and take their profit, which is what insurers do best. If your health insurance costs haven't risen much faster than your income, that says a lot for your income. But anybody who doesn't think that the cost of the end of life in this country has become a significant problem is already under some strong medication. Finding a way to deal gracefully with death is a challenge we must confront, without resorting to the irresponsible and inflammatory "death panel" lingo of the Betsy McCaugheys and Sarah Palins of the world.
Clarification: Those without means have health problems that grow large because they delay treatment and become more costly to treat thus they need preventative care to reduce overall system costs.
2. Apart from the niceties outlined above for people who actually have insurance, the growing uninsured population is going without sometimes inexpensive early detection and treatment, which results in (1) them becoming acutely sick, and (2) getting treatment for their sickness in ER's, (3) at the highest possible cost for that treatment (even ignoring that it might have been completely avoided with cheap preventative care), (4) which stratospheric costs either bankrupt them or us, or BOTH them and us.
Clarification:The inefficiency of capitalism has left holes in the health care system that need filling by government because the magnitude of the problem has reached a critical mass. The injection of government regulation will foster competition.
3. The above risk and cost structure isn't really much different in character from that which required Social Security, or Medicare, or even carrying insurance on your car when you drive. When a problem reaches a breadth and/or scale which significantly affects the taxpayer, then it's the function of government to intervene in some way. We're by far the most expensive healthcare system in the world, yet we're 37th in outcomes. It's not just a matter of national embarrassment, it's sealing our economic fate in the world marketplace. If we don't reform, we'll never compete again; it's that simple.
Clarification: Health care reform is an imperative national security and welfare issue. Politicians cannot ignore it because of the implied moral imperative. There are many ways to reform the system but all require the force of government in some form.
4. So the question becomes how best to do it. It's clearly a national problem, so it's not something which can be "optional." That said, there still is a wide range of possible solutions, from minimum guidelines for state programs, to universal Medicare, and lots of possibilities in between. Scott Brown participated in doing it in MA; let's see what he thinks about how it should be started in DC. As I said yesterday, I think it can be started with a list of simple minimum standards, which few in either party would want to answer for voting against.
1. There is no moral imperative to reform health care. The economics of your proposal is as much of a moral dilemma as the current system. It will provide only basic health care to the elderly because the high-tech costs aren't "worth it" for someone with a short life expectancy. That life expectancy must be determined by someone besides the patient. You are swapping one moral dilemma for another.
2. Insurance regulations can be changed to do what you want with regard to coverage holes but there is no guarantee that companies will survive to provide the service. Regulation rarely spurs competition. Government involvement usually stops all competition and creates a regulated monopoly. Don't fool yourself, or the people, with regard to competition.
3. All of your proposals limit LIBERTY, for the sake of charity, at the expense of the taxpayer. The taxpayer may
be willing to provide some charity but that amount should be determined by the people. That is what Brown's election was about. The people have a responsibility to provide for themselves and the government must leave incentives in place. Food, clothing, shelter (a.k.a basic sustenance, which includes health care) should always be the responsibility of the individual except in extreme
cases. Any health care reform that focuses on universal coverage MUST require a flat tax on the earnings of everyone
for the purpose of equity. The poor must have "skin in the game" to understand that health care isn't free.
4. The system of torts must be addressed to limit awards in the case of medical malpractice. Defensive medicine costs as much as preventative medicine will save.
This article outlines some places to start the reform before abandoning our system to socialism:http://www.foxnews.com/opinion/2010/01/ ... achusetts/
The article is by CL Gray, president of Physicians for Reform.