Willravel

Remember, this is a solution-centric thread, which means that you answer each of the following questions before elaborating or addressing anyone else. If you can't do that, hit the back button. Once you have answered the questions, you may ask for clarification on points or answers of other posters, but not in an adversarial manner. If you intend to educate, you must provide links to support your position and post in a respectful manner. Here are the questions, along with my particular answers:

1) Is there a problem, and if yes what is the problem? Yes, not only are over 45,000,000 Americans without health coverage, but that number is increasing and shows no sign of changing without serious changes.

If you answered yes:
2) Is it likely to work itself out? I would venture a guess: No. The only way that this problem will fix itself is if it suddenly becomes profitable for everyone to have reasonable coverage, which would take nothing short of a miracle.

If you answered no:
3) What is the best way to fix it? (This will likely be a point of contention based on what you view is the exact cause and your governmental/economic philosophy.) My answer is single payer universal.

4) Why (explain your answer)? Right now the current system in place, which is basically free market, though many of the entities involved in healthcare are active in contributing to government officials for kick backs, is failing overall because about 1 of every 6 people doesn't have healthcare, which I believe is as necessary as many other government provided/funded service (take fire protection, for example). Single payer not only works better elsewhere than our system does here in the US, but it would theoretically maintain quality while costing a lot less because the administrative costs would be so much lower.

5) Who is in a position to enact this change? Congress, then the President.

6) What can I do to make this change? Pressure congress-people so that they see that their seat is in jeopardy if they don't support the vote, which is more important than contributions and kick backs. After that, elect a president capable of complex reasoning and who isn't so partisan that they can't serve the best interest of his or her constituents. Both of these steps aren't just complicated, but are absolutely necessary. Kucinich is currently the only candidate supporting single payer, but he stands virtually no chance of being elected so Obama would be a second choice.

Alright, jump in!

dksuddeth

1) Is there a problem, and if yes what is the problem? Costs for health care are inflated to 4 and 5 times what it should cost because all fields of health care are regulated by companies solely for profit.

2) Is it likely to work itself out?Not as long as political ears are hearing the sound of money dropped in to their campaign funds by health insurance carriers.

3) What is the best way to fix it?totally remove the ability of health insurance companies to regulate, in any way shape or form, the way that doctors dispense health care or how they acquire and deal with patients.

4) Why (explain your answer)?Right now, doctors are required to follow strict guidelines on which patients they can accept, what plans they can work with, what prices they have to charge, what equipment they can use, what specialists they can work with, and what diagnoses they can give, all in the name of profitability to the health insurance carrier. All of these steps, from patient to carrier, require people to process these steps which adds to the cost of medical care as well. Removing all of the impediments to letting a doctor treat his/her patient to the best of their ability will reduce health care costs.

5) Who is in a position to enact this change? Every state legislature and governor that has authority over state medical boards and insurance authority.

6) What can I do to make this change?Support libertarian/free market candidates who will deregulate and weaken the power of the health care insurance industry.

__________________
"no amount of force can control a free man, a man whose mind is free. No, not the rack, not fission bombs, not anything. You cannot conquer a free man; the most you can do is kill him."

james t kirk

As a Canadian, I can tell you that the solution is Universal Health Care. Plain and simple. Anything else is just coming up short. You have to come up with an insurance plan for every citizen, regardless of their rank in society, regardless of their ability to pay and you have to restructure how health care is dispensed from the top down.

Now before everyone goes screaming socialism, and starts spouting off about their mother's brother's cousin's friend who lives in Winnipeg and comes to the states for health care, blah blah blah (I've heard it all before), hear me out.

The United States is the richest country in the world. As such, surely it can afford to have a universal health care plan. There is no reason in the world it can't work and be the best in the world. You can have as good or bad of a system as you want to have.

What will it take?

It will take a politician with guts and determination (An American Tommy Douglas - (Kiefer Sutherland's Grandfather believe it or not) http://www.cbc.ca/greatest/top_ten/n...las-tommy.html ) It will take a man or woman who is not in the pocket of the health care industry. And it will take a populace who is willing to consider fundamental change. I have my doubts that this is even possible in American society to be honest.

If you follow the Canadian example, it would need to start with one state. In Canada, it started with Tommy Douglas in Saskatchewan of all places. But it caught on, and it spread. Now, you'd be very hard pressed to find too many Canadians who would not want Universal Health Care - despite what you might hear on Fox TV.

ratbastid

So.... Can I respond to what somebody's posted here? Is that legal in a SC thread?

Maybe I should be required to answer the OP questions first, then I can respond to others' posts?

Ustwo

I started to answer but it became quickly apparent that the scope of the question is too big to do it justice.

Treating something like 1/5th of the economy or whatever it is and thinking you can come up with a better 'solution' in a couple of sentences would be wishful thinking at best.

The scope of the question must be narrowed.

And while james I'd love to talk about the wonders of the Canadian system, you already violated the format

__________________
Agents of the enemies who hold office in our own government, who attempt to eliminate our "freedoms" and our "right to know" are posting among us, I fear.....on this very forum. - host

Obama - Know a Man by the friends he keeps.

Strange Famous

My govt promised to care for me and my family, from the creadle to the grave, for 10% of my working salary.

If the promise is kept, my feeling is that it is a good one.

The NHS isnt working well.. but this is an agument about use of resource, not about the idea.

Im America middle class jobs give health insurance to the middle class, and the govt gives medi-care to the working class (with exceptions) - the same amount of GDP is spent on health care everywhere.... the point is just which was is efficient

The lesson to learn is to stop arguing about who "owns" what resource, and to realise that society is a collectivism.

By all means go and opt out and live in Iceland or Madagascar if it offends your morals and love of dog eat dog, otherwise - every resource and force of production on this earth belongs to everyone equally.

__________________
"Do not tell lies, and do not do what you hate,
for all things are plain in the sight of Heaven. For nothing
hidden will not become manifest, and nothing covered will remain
without being uncovered."

The Gospel of Thomas

Fotzlid

1) Is there a problem, and if yes what is the problem? yes. like the OP stated, an overabundance of uninsured people. a good portion of them are eligable for free care status at hospitals which is why it costs so much to go to one these days,they pass the cost along to those that can pay.

2) Is it likely to work itself out? no. the numbers are becoming over-whelming and will eventually cripple healthcare.

3) What is the best way to fix it? i think one of the easiest and most far reaching ways is to lower the cost of presciption medications.
there are others, but it will only get me into rant mode.

4) Why (explain your answer)? people are on a ton of medications. you should see some of the lists. alot of these people cant afford all or most of them. they stop taking the meds, their condition worsens and they require often lenghty stays in hospitals and rehabs.

5) Who is in a position to enact this change? congress is probably the only one that can get that done.

6) What can I do to make this change? since congress is useless about the only thing the average person can do is insist on generics and no first generation meds.

flstf

1) Is there a problem, and if yes what is the problem?

Yes, health care costs are out of control and our polititians are reluctant to do anything about it since they are paid off by the industry. Many in the health care industry are profiting nicely and want to keep things as they are. Our polititians don't care all that much since they and their families have great health care coverage (at our expense).

2) Is it likely to work itself out?

No, too many corrupt polititians and many people do not care since they have decent coverage from their employer with low co-pays. After the co-pay many do not care what the overall cost is. Oddly enough it seems that the only ones trying to keep costs down are the insurance companies (which is scary).

3) What is the best way to fix it?

If some way cannot be found to make the industry more competitive then the only alternative is probably to treat health care like national defense and make it universal.

4) Why (explain your answer)?

Because currently I do not see much competition and this results in many middle class families being one illness away from total financial ruin. Hospital charges especially seem to be outragious. Some say it is due to too much government interference and taking a hands off approach may foster more competition but I'm not so sure. Universal health care would be very expensive but like national defense may be necessary and there seems to be some success in other countries with this approach.

5) Who is in a position to enact this change?

Voters, I guess.

6) What can I do to make this change?

A good start may be to refuse to vote for polititians who basically want to maintain the status quo. Which means most of the current politians.

Willravel

Posters 4, 5, and 6, this information, from first sentence of the OP, is pertinent:

DK, I hope Jazz can join us and comment on his take of the "insurance companies". His view is uniquely informed on the subject. While I'm sure you're well read on the subject as it's been covered by media on and off for quite some time, it never hurts to get a professional perspective.

Fotzlid, what should congress do to reduce the price of prescription medications?

flstf, just for clarification, you'd like to see the free market tried and then if that doesn't work universal?

Ustwo

Don't forget poster #3.

Anyways good luck.

__________________
Agents of the enemies who hold office in our own government, who attempt to eliminate our "freedoms" and our "right to know" are posting among us, I fear.....on this very forum. - host

Obama - Know a Man by the friends he keeps.

highthief

1 - As willravel stated, a huge and growing chunk of Americans are without health coverage, which is ridicuous in arguably the richest and most technologically advanced nation in the world.

2 - Work itself out? Not sure what that means - the situation will continue to evolve, but it is people who bring about change.

3 - Universal health coverage paid for by a lessening of the hundreds of billions the US pays for its bloated military and a subsequent increase in health care dollars. Fixed prices for various medical services. Doctors can still get rich on elective procedures but if you need something "normal" like getting a broken leg fixed or dealing with the complications of pregnancy, prices should be fixed to preclude gouging. At the same time, ridiculous malpractice suits have to be limited to fixed dollar amounts.

4 - Are you asking why is this the best way to fix it? Americans simply won't go for increased taxation, so the money needs to come from somewhere and if you stop invading everyone you can easily pay for this.

5 - Enact? Isn't that the job of your congress? If you mean bring about the change I think that as more and more people suffer from insufficient health coverage and more lives are touched by it (or even as people's salaries stop going up in order to pay for increasingly expensive company sponsored health plans) you'll probably see a wave of public pressure for change.

6 - Me? Not much, I'm not American. But the average American can obviously vote for candidates that support such changes and lobby those that don't and use pressure from the media to bring about change.

__________________
Si vis pacem parabellum.

Elphaba

1) Is there a problem, and if yes what is the problem?

The present health care system in the US has a number of serious problems. In addition to the number of uninsured that Will cited, and the ever rising costs from a profit based system mentioned by dk, I wish to add that the current cost of insurance is primarily shouldered by our US companies. It has become clear that this extra burden has negatively impacted our ability to compete in the world market and has driven many of our business sectors to other countries to reduce costs. Current job growth in the US is generally made up of low paying service sector jobs without paid insurance, which grows the number of the uninsured.

3) What is the best way to fix it?

I believe the best solution is Universal Health Care (UHC) with a single payor. We already have UHC for our senior citizens and our veterans so a very effective model exists. The current economic boogy man is "socialism" when discussing UHC, but we have other institutions created for the common good that have not sent our republic into some vaguely defined economic evil.

4) Why

Despite what Big Pharma would have us believe, Medicare and the VA provide health care far more efficiently and less costly than our current for profit system. UHC would also reduce the number of uninsured and the huge cost that this population creates in late treatment in an unpaid emergency room situation. Escalating costs far exceeding inflation would also be reduced because Big Pharma advertising costs ("Do you have ED?") cease to serve the profit goal.

5) Who is in a position to enact this change?

I agree with others that increasing pressure on our elected officials is necessary, BUT not sufficient. Big Pharma finances the campaigns of most of them and that will not change until public financing of elections becomes more than election year "talk."

I believe that a bottom up "war plan" is necessary to combat the expected fight with Big Pharma. They have the money and a clear, factual message is needed to combat the money. If enough people are marching down the road, an important and savvy political figure will jump in front to "lead" the parade.

6) What can I do to make this change?

What I can do other than contacting my congressional representatives, is to garner support from existing political entities that have far greater power to produce the financing of the message to cause effective change. I can also lobby for an improvement in health care in Washingston State, but we are a long way from meeting what Massuchusetts has done. All politics are local may to true to an extent, but this is a national problem and must be solved at that level. I can also encourage my circle of business owners, our employees, and vendors to get active in an issue that greatly effects all of us. Just stop and think for a moment what might happen if business owners are no longer saddled with employee health insurance, and medical costs overall are reduced. The economic boost to the US would be just one of the many benefits.


Edit: Oops. I missed one, but I think it safe to say that I don't think this problem is going to improve on its own. It is already evident that our current free market, for profit system cannot solve our health care problems.

__________________
"You can't ignore politics, no matter how much you'd like to." Molly Ivins - 1944-2007

flstf

I think so. I am not convinced that the free market will work with health care but it would be preferable to government control. Maybe something like basic care (doctor and dentist) could be free market and catastropic care (hospitals,etc..) could be insured by the government.

Regardless of the quality of care, the very poor seem to be protected from financial ruin since they have nothing to sue for to pay the bills, and of course the upper middle class and wealthy are usually covered by good insurance (mostly subsidized by employers). It is the working poor and middle class who have the most to loose from large hospital bills. I think something like half of the bankruptcies are caused by large medical bills.

I don't think basic health care and drug costs can become more competitive as long as people have co-pays and do not care what the final cost is. There must be some incentive for people to shop around like they do for most other consumer goods.

I guess the insurance companies are trying to control costs by limiting what they will pay for certain procedures and denying claims when possible but other than that I don't see much downward pressure of health care costs.

joshbaumgartner

1) Is there a problem, and if yes what is the problem?

A: Yes, a grave and growing problem. We are spending upwards of $6,700 per person for a system that doesn't provide for tens of millions of Americans. Health insurance premiums are rising at 7-8% annually (faster than salaries). Average premium for a family of four was about $11,500 in 2006.

2) Is it likely to work itself out?

A: Not likely, at least not in a way positive to the nation's health and economy. The trends indicate the situation will continue to spiral more rapidly out of control and the idea that it will self-regulate at some point is rapidly becoming a vanishing possibility.

3) What is the best way to fix it?

A: Single-payer universal comprehensive medical service. People can choose their doctors. Excellent hospitals, doctors, medical technology and pharmaceutical companies, all will be able to reap profits for their contributions. Eliminating the yoke of for profit insurance from the equation is the key to cost control.

4) Why (explain your answer)?

A: For all of its challenges, government oversight offers the only way to ensure that the people can continue to exercise power over the system that serves them. A single-payer system will allow for maximum bargaining power on behalf of the American people. Making it universal is the only way to make it fair (I don't mind millionaires taking advantage of the freely provided care, after all, they are as entitled as anyone else in the country to be served by the government.) Comprehensive care is a key to controlling costs and bettering health as a whole. A healthier populace is less expensive to care for.

5) Who is in a position to enact this change?

A: The people, the Congress, and the President, in that order. The people must make clear their desire for a solution, send representatives to Congress with a mandate to enact that solution, and elect a President that will execute that solution effectively and enthusiastically.

6) What can I do to make this change?

Good old political activism. Vote. Challenge candidates to address the issue. Engage in the media to highlight the solution. Share information and the solution with others. Exercise your 1st Amendment rights. Nothing fancy, just good old positive activism. Do it at every level. Local and State politics are a good way to push the Feds if they are slow to act.

ASU2003

[QUOTE=willravel]1) Is there a problem, and if yes what is the problem?
I'll play the other side... I currently do not have any problems with my past health care coverage and benefits I have received. It does cost money, but I shouldn't have to support everyone else.

If you answered yes:
2) Is it likely to work itself out?

If you answered no:
3) What is the best way to fix it?
I support free emergency care for real accidents and free vaccinations to prevent diseases. This is for everyone and would be covered by a state by state sales tax (it wouldn't be that much). Doctors could come up with a list of treatments and procedures that they currently do and would fall in this category, and this would be the tier 1 group.

I support grouping people based on gender, age(0-20, 20-40, 40-60, 60+), # of dependants, smoking level, and body-mass index (a better number needs to be developed) to determine how much of a monthly premium (private or non-profit company) (or gov. tax) they have to pay (their employers should also have to pay a set percentage or all, this isn't optional, it's required for the employee, spouces and children are optional). These would be routine procedures or once in a while stuff. Not everyone will be able to have this, but it should be affordable and available to everyone regardless of previous or current illness. This is the tier two group and would include stuff like visits to the doctor (with no co-pay) because you have a fever, the baby won't keep anything down, having a baby, STD treatment, surgery, other required procedures.

Medicine and bc pills are a different story, they should be available to all that require them, but knowing if Viagra is a recreational drug or a required drug is difficult.

The system needs to encourage people to be healthy and not need to use healthcare (Because they don't need to, not because they are trying to save money or use it because they have paid for it). Maybe even collect too much money and give refunds to people who didn't get sick or hurt that year. There should also be fitness tests done to qualify for discounts.

Mental healthcare is a tough one. It is better to treat people, but I'm afraid that they would flood the system if it was free.

The system needs to support the development of new drugs and treatments. And make sure Doctors are compensated for the quality of treatment, not just the number of patients seen.

The billing system and medical record system needs to be updated to the 21st century and made more efficient.

I think that there should be a large non-profit insurance company (possibly setup by the government) that would handle collecting and distributing money. And instead of profits going to a few big shareholders (your 100 UNH shares mean nothing), the American people would become the shareholders, so any 'profits' would go to improving health care services. And the monthly premiums would go down the next month.

The other tier is the private insurance realm. This would still be run by the private companies. They will provide a high quality of care for the people who can afford it. Or you could get it just to cover anything that the no frills tier 1 & 2 coverage doesn't catch. Maybe it would be more tests or cat scans or better speed of service. If you want to pay to get faster care or what you view as better care, I'm all for it. UPS and FedEx compete with the USPS on package delivery and sometimes they do a better job. Or at least push the USPS to improve.

And they need to limit the number of times a drug can be advertised on TV. Doctors should be telling the patient what drug will help them, not the other way around.

I'm not sure exactly how it would work or how to set it up, but we can do better, or we can do a lot worse.

4) Why (explain your answer)?
Because we shouldn't have to worry about getting financially wiped out by one illness or accident. But at the same time, we shouldn't be getting gouged each month by insurance companies looking to make increasing amounts of profits so their stock price will go up.

I also don't like the universal healthcare approach, because it means that I have to use it since I'm paying for it. I'm afraid that there would be abuse of the system. And the costs would keep going up.

If you break people down into categories, I'm not supporting the couple that decided to have 5 babies because it costs them the same amount as not having any. I don't have any kids; I should be grouped together with other childless people between 20-40.

I included the smoking and body-mass index number, or something better because it reflects how the bdy is being treated.

5) Who is in a position to enact this change?
The government would have to propose it and sell it to the people. They would have to deal with a big backlash from Wall St. and the big insurance companies.

6) What can I do to make this change?
Post about it on an internet forum.

Cynthetiq

1) Is there a problem, and if yes what is the problem?
No, not my problem if you don't have a car, internet, food, new clothes, shoes, cellphone, or "next technology" to stay alive or competitive with the next guy on the block. There is nothing in the US Constitution that states a requirement of Housing, Food, or Healthcare. If you find it somewhere embedded within the Constitution or any of the amendments, particularly the Bill of Rights, please let me know.

If you answered yes:
2) Is it likely to work itself out? I would venture a guess: No. The only way that this problem will fix itself is if it suddenly becomes profitable for everyone to have reasonable coverage, which would take nothing short of a miracle.

If you answered no:
3) What is the best way to fix it? (This will likely be a point of contention based on what you view is the exact cause and your governmental/economic philosophy.)
I don't understand what there is to fix if I said no that there is no problem.

4) Why (explain your answer)? What's there to fix? Since I see no problem.

5) Who is in a position to enact this change? N/A

6) What can I do to make this change? Keep doing what I've been doing.

__________________
I don't care if you are black, white, purple, green, Chinese, Japanese, Korean, hippie, cop, bum, admin, user, English, Irish, French, Catholic, Protestant, Jewish, Buddhist, Muslim, indian, cowboy, tall, short, fat, skinny, emo, punk, mod, rocker, straight, gay, lesbian, jock, nerd, geek, Democrat, Republican, Libertarian, Independent, driver, pedestrian, or bicyclist, either you're an asshole or you're not.

highthief

I'm curious as Americans often speak of something being in (guns) or not in (healthcare) the Constitution - just because something is or is not there does that preclude things changing? You have amended your constitution many times but some people reference the constitution in a biblical manner - i.e., if it's not in the Constitution then it doesn't really matter.

Most of the developed world considers accessible, relatively equitable and affordable healthcare to be a fundamental right or something close to it - perhaps the best way for this to change in the US would be to get the constitution amended and put the matter to bed.

Might that happen one day?

__________________
Si vis pacem parabellum.

n0nsensical

Healthcare may not be a constitutional right, but then neither is free universal education. I wonder if Cyn would oppose that were it under consideration. It doesn't really matter if it's in the constitution because Congress is free to pass a LAW providing for a national health care program at any time. In fact that's exactly what they did in the 60s (for certain groups) with Medicare and Medicaid. Providing universal healthcare would not have been considered within the scope of the federal government until roughly 1950, but it could certainly be done by legislation now. I personally would be all for an amendment making healthcare a constitutional right, but it's such a loaded topic and so difficult to pass an amendment it won't be happening anytime soon.

Fortunately there is better hope for individual states. There are several states currently considering universal health insurance. I have no doubt it will happen within a few years in California at least.

I guess I'm supposed to answer the questions too.

1. Yes, there is clearly a problem. Vast numbers of people have poor healthcare because they don't have enough money to buy into the current system.

2. No. There are too many entrenched interests that benefit from the status quo.

3. All citizens should be guaranteed a basic level of health coverage, essentially national health insurance, financed directly by the federal government or by the states with federal assistance, funded by the progressive federal income tax. Private health coverage could still be applied to care beyond the basic level.

4. Because I believe in a universal human right to life and good healthcare is critical to sustaining it. In this age, in the richest country in the world, no one should be without a decent standard of living.

5. Congress and the states.

6. Contact my representatives and encourage others to do the same.

__________________
"Prohibition will work great injury to the cause of temperance. It is a species of intemperance within itself, for it goes beyond the bounds of reason in that it attempts to control a man's appetite by legislation, and makes a crime out of things that are not crimes. A Prohibition law strikes a blow at the very principles upon which our government was founded." --Abraham Lincoln

Cynthetiq

Free universal education is not a constitutional right, which is why you are not entitled to education at a collegiate level. Up until college, there is subsidized education via the public school systems, set up by each distict and state. Just like the current healthcase system. There is basic healthcare in Calilfornia already, just like in most states. There are many programs that assist the healthcare system from the city, state, and federal levels.

The ideas as to what the federal government should be responsible for is enumerated directly in the constitution. Education and Healthcare are not included in that and should not be.

Congress passing laws have nothing to do with something being a Constitutional right. Congress passing an Airlines Passenger's Bill of Rights does not equate that to the Constitution in any manner.

I think that the states should decide if they wish to create their own universal healthcare systems. That's on them and their ability to deal with their tax base. Many elderly flock to Las Vegas and Florida because it benefits them most, in taxes and in medical care and costs. Why should it be any different for healthcare and other "lifestyle" amenities?

__________________
I don't care if you are black, white, purple, green, Chinese, Japanese, Korean, hippie, cop, bum, admin, user, English, Irish, French, Catholic, Protestant, Jewish, Buddhist, Muslim, indian, cowboy, tall, short, fat, skinny, emo, punk, mod, rocker, straight, gay, lesbian, jock, nerd, geek, Democrat, Republican, Libertarian, Independent, driver, pedestrian, or bicyclist, either you're an asshole or you're not.

n0nsensical

The LAW as a whole is set by both the constitution and legislation (subject to judicial interpretation). The constitution merely provides a framework for what can or cannot be legislated and how. There is no constitutional prohibition against legislation of national health care (at least more than likely according to current judicial interpretation, of course as with any new law the lawyers would probably end up fighting it out). There is also no constitutional prohibition against federal funding for state school systems, nor is it required, but the federal government does it. I respect your opinion that it should be left to the states but I disagree that basic healthcare is somehow an expendable lifestyle amenity.

__________________
"Prohibition will work great injury to the cause of temperance. It is a species of intemperance within itself, for it goes beyond the bounds of reason in that it attempts to control a man's appetite by legislation, and makes a crime out of things that are not crimes. A Prohibition law strikes a blow at the very principles upon which our government was founded." --Abraham Lincoln

Willravel

Just popping in to give a general thank you to everyone who's helped to prevent this thread from becoming adversarial. Respect? In TFPolitics? Maybe this wasn't such a bad idea.

flstf

I don't think so. Most of the health care industry and insurance companies benefit from keeping things the way they are and hire lobbiests to pay off polititians to vote against reform. Also many people (including government employees) have their health care insurance subsidized by their employers and the co-pays are low enough that they do not really care what the final cost is.

The poor and under insured middle class number in the millions but have not organized to hire lobbiests to pay off polititians. Probably the only chance for change will come when employers say enough is enough and require their employees to pay a lot more for insurance.