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.
Yes, let's take this one at a time. IF
Big Pharma and Hartford have a monopoly, and I agree with you that they do, then we MUST ask how that happened. The answer lies in the 1945 McCarran Ferguson Act, which Harry Reid threatened to repeal if the insurance companies didn't stand down.
stockingfull wrote: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.
If portability of health care is a desirable thing, and again, I agree that it is, then why would the current HC proposal seek to eliminate health savings accounts which are in fact portable?
stockingfull wrote: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.
All that end of life care is heavily subsidized by Medicare. What incentive is there to lower costs when the government is picking up a minimum cost? Why do the costs of non subsidized procedures like elective surgeries fall every year?
stockingfull wrote: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.
Why not repeal McCarran Ferguson and allow people to buy insurance across state lines like every other form of insurance? There is a company in Washington state that offers plans from $49 to $89/month. Even someone working at Wal Mart part time can swing that. Except by Federal law, everyone in 49 other states are specifically excluded from buying it.
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.
Total dollars spent doesn't have any bearing on outcomes. Maybe other countries don't eat the poison the Federal government allows into our food supply? And whom are we competing with and for what? That seems like a separate argument.
stockingfull wrote: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.
The problem is the Federal government thinks it can fix problems and create wealth when in reality it causes problems and destroys wealth.
Stocking, your side has had it's chance from the New Deal to the Great Society and beyond. When will you realize you can't multiply wealth by dividing it?
You are killing this country and you're too ignorant or stubborn to see it and admit it.