Your Thoughts on Health Care Reform Possibilities

Updated on September 14, 2011
K.W. asks from Seattle, WA
8 answers

Okay, if we're getting into politics, I have a subject on which I'd like your opinions.

Insurance is something you purchase to protect you from a catastrophic but unlikely event. If things go well, you never use it. Car insurance is insurance. House insurance is insurance. Health insurance is.....something else.

I think if we are to come to a positive solution on health care, we need to back way up and talk about our core beliefs and values in this country around health care. Then, and only then, can we come up with a health care payment system that works for most people. Some questions I have:

What is health care? Are we talking about treating illness and injury? Or are we talking about maximizing everyone's health and well-being? To what extent should structural issues like availability of fresh produce or ability to walk for transportation be considered health care issues? What about environmental pollution? What about social factors? For example, the amount of social support a pregnant woman receives before, during and after delivery has a huge impact on her health and the health of her baby. Friends can impact your health as much or more than medicines. So what exactly is health care?

What are our beliefs about day-to-day health care? Who should pay for it? I'm talking about primary and preventative health care, the kind a family doctor provides. Vaccinations, checkups, minor stitches, strep throat, that sort of thing. Should this just be part of everyone's budget, like food? Or should this be provided for the common good, like roads?

How do we plan to manage contagious illness? Do we manage it differently than injuries? I would personally argue that caring for contagious illness should absolutely be paid for through taxes, for the common good. Sick people are vectors for disease. I would like to see them cared for so that they do not make me and mine ill. What is your opinion? What about paying people to stay home when they are sick (paid medical leave)? How do we respect individual choice and protect the majority against contagious illness?

Do you think that wealthier people deserve a higher standard of health care, since they worked for their money and can pay for it? Or do you believe that the hobo and Bill Gates both deserve the same quality of care? Why?

Where does personal freedom and societal responsibility intersect? Do all people have a responsibility to take all possible precautions against illness and injury? What do we call an acceptable risk? Who decides? What if one of the official standards on preventative care turn out to be wrong?

What are your beliefs about end of life and heroic health care? What is your standard for minimum quality of life? If a person does not meet that standard, should they be allowed to die? If your loved one wanted to end their life now to avoid a painful end, would you support them? What if they wanted to avoid a painless, but deeply expensive end? At what point does the cost (both financial and pain) of extending a life exceed the value of that life? Does your standard change when the individual in question is a elderly person? A newborn? A young adult? On any of these issues, who decides?

What are your thoughts on treatable medical conditions that interfere with productivity but are not fatal? Is it best to require someone with a serious knee injury to remain disabled, possibly for life, if they lack the money for surgery? Or is it best to provide the surgery and get them back into being a more productive member of society?

What are your thoughts on people who wish to opt out of what the majority wants on these issues (type of care, how to pay for it, etc.)? Should they be allowed to do so? How? What if they change their minds?

Should health care be linked to employment? How? Why?

Should there be any profit motive involved in health care? If so, who should benefit? Why? How? If profit motive is involved in health care, how do we help insure that the drive for money assists the goal of superior health care, rather than interferes with it?

The paperwork involved in health care in the US is currently excessive. How can we deal with this?

These are some of my core questions. I'd be interested in your thoughts. I'd also be interested in any additional questions you have. Thanks!

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So What Happened?

Thanks everyone for your thoughts.

Here's my proposal:

Leave private insurers in charge of actual health insurance, that is, payment for catastrophic care. This is the type of care that needs to be rationed by some means. The US culture will not tolerate rationing health care by any standard other than finances. People could choose to purchase insurance or not for this, as they wish.

Change laws to enable groups of people to join together to get health insurance for their members. Right now it is not legal for a church or neighborhood group to purchase health insurance. It is only available to employers or individuals. This seems weird to me, and totally unnecessary.

Create a single-payer system (Canadian-style) for primary and preventative care only. There is absolutely no reason to ration this type of care. This type of care identifies and treats most contagious illnesses, which protects public health. This type of health care also keeps trivial things out of the emergency rooms, thus saving money for us all.

Standardize the paperwork. Every single insurer has a different style of paperwork. This is absurd and drives up administrative costs.

Reform medical litigation to protect doctors who acted in good faith. Gross negligence and/or malice should risk a lawsuit, nothing else. We already have this kind of protection in place for our police officers. We could do the same for our medical personnel.

Create a national government agency which has the responsibility to collect valid information about larger questions of healthy people, and pass that information on to relevant parties. This agency would have absolutely NO power to legislate or compel. Their only purpose would be to collect information and make sure that information got the the people who need/want it. Do communities with sidewalks tend to have a lower rate of heart attacks? Is this correlation significant? Is there evidence that this is a causal relationship? I have no idea, but it seems this information should be made available to cities when planning their building codes.

Whaddya think?

More Answers

T.K.

answers from Dallas on

Wow, will this count for my Masters' Disserataion?
I think that I work a 40 hour work week, in a professional field that requires I be educated and certified. I feel they should offer me the option to purchase health insurance along with the group, as to poole our resources and get the best rates and coverages available. They do not. I think it would benefit the company if I had basic healthcare. I have seen data that wellness programs cut down on emploee absinteeism, as does preventative healthcare. I would prefer my company provide the option to purchase health insurance that includes womens wellness benefits, such as yealry pap. Many companies do not cover pap, birth control or mammogram, but do cover Viagra. I would like my health to be as big a priority as an old man's hard on. However, soft dicked old men make the rules. So I am currently SOL

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G.B.

answers from Oklahoma City on

This is a very thought provoking question. I have no insurance so I am going to be a bit jaded in my answer.

We are grandparents raising grandchildren. We are living on a fixed income due to my husband having had massive open heart surgery several years ago. He receives medicare through his SSDI, the kids medical cards are based on their parents income and they get full coverage through the state. I have no benefits because we make more than $600 per month for the entire family. That's right, if we only made $599 or less I could get free medical care through the free clinic at the hospital. Needless to say if that is all we had for income we'd be living in our van on the street.

I know many other grandparents raising grandchildren who also don't have insurance for health care. The kids come first and if they have a need that need is met the best we can. So I don't even have $20 to go to the low income clinic in the next town. They charge $20 for the office visit, $20 for blood work, $20 for an X-Ray, $20 for each individual thing. It can add up rather quickly. If I am sick I have to do the best I can and usually end up in the ER and get a shot. They usually have to write the bill off because I HAVE NO WAY OF PAYING IT.

So, when there are people in a society that are suffering from illness then that society has an obligation to care for it's members. I am in favor of a more socialized style of medicine where medical care is available to everyone. If they have a serious medical issue then all deserve to be treated.

I have several friends who are Canadian or some other countries and they are emphatic...if they get sick they are going to Canada or their home country to be treated because the medical care is so much better. They all have made sure their children have the duel citizenship too so they can receive the same quality of care. It is sad that America is one of the last countries that care for their people. There are people dying everyday from illnesses that are treatable. That is the saddest thing I can imagine.

I had a friend who died from cancer. She was older but still trying to work. Her insurance wasn''t very good and she could not afford the co-pays. She finally went in from excessive pain, they thought it was her gallbladder so they went in to take it out. She had cancer throughout her body, evidently she had it for several years. If she had the ability to have a yearly physical and have standard medical care she MIGHT have been able to at least fight the cancer instead of living 3 days after gallbladder surgery that was unneeded.

Medical care is a basic need, like food and water. It should be treated as a basic human need and part of a larger program that helps everyone to be as disease free as possible.

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C.B.

answers from Boston on

My 50 year old friend died from cancer last year because she could not afford health insurance while starting her own company and did not get yearly check ups for about 7 years. I think the whole "managed care" formula is wrong, we are paying doctors for the amount of tests they do, and my "primary care physician" has no clue who I am and has not seen me for over 2 years (i get others in the practice when I need urgent care, and for yearly physicals they schedule me with an nurse practitioner, the doctor is too busy dealing with insurance companies and reviewing records to advise the nurse practitioners). But it also ties into the tort system (lawsuits) since doctors can get sued so they pay many times more in malpractice insurance than most people make in several years. Finally, I read somewhere that in America we spend some huge percentage of our LIFETIME health care costs (something like 30%) in the last 1-3 years of life keeping people alive with extreme measures. All three of these facts are making costs go up instead of down. If I just paid for the actual doctor's visits my family of 4 has every year it would cost us WAY less than our toal health insurance, but fortunately we have a group plan through my husband's company or else it would cost about $1,200/month!
I think healthcare should not be linked to employment, I think hospitals are going bankrupt because local landscaping companies hire illegal aliens so they can not pay them much but when they get hurt they dump them in front of the ER and leave them there so the hospitals are not getting paid. I do not have the solutions but I agree our current system is broken.

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D.P.

answers from Pittsburgh on

Well, I'm no expert on healthcare reform, but I have a few thoughts.

I don't think healthcare coverage should be tied to employers.
I DO think we should all be able to purchase SOME sort of plan no matter our physical health.
I know there a re a lot of people WITH coverage screaming about how THEIR coverage is too expensive because of the people who "milk the welfare"system or use the ER as their family doc and "clog" it up for those with true emergencies.
Wouldn't it then make sens to have mandated coverage for all. Make it law that we all need to carry (i.e. pay for) some health care plan & coverage?
Much like the car insurance we MUST have to own and drive a car?
I think the big health care providers could do with a little competition.

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B.C.

answers from Norfolk on

Health care should not be employer based.
Too many people fall through the cracks that way.
Health insurance for all is not the same as health care for all.
A single payer system would be the biggest bargaining group possible and would be better able to negotiate reasonable prices and better prices means getting more bang for the buck.
I've been following Physicians for a National Health Program and what they say makes sense to me.

http://www.pnhp.org

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S.L.

answers from San Francisco on

Lololol to Tracey's answer!!! I cannot believe Viagra is covered, but...why does that not surprise me?

Karen, I love the questions you are asking here. So important for us as a country to think about...

To Gamma G and others who have paid into the system for years and see their benefits shrinking (or nonexistent): I am so sorry! You should not have to go to the ER for a simple antibiotic. Ditto all of the veterans of the armed forces. I would GLADLY pay higher taxes if it meant you all could get the care you deserve. I think veterans especially, and their kids, should have the BEST medical and dental...for life!

I am not in this boat currently, for the simple reason that my employer (a major airline) has one of the most generous benefits packages out there...which is why I initially applied. I have stayed because they just treat us so well.

Anyway, Karen...great questions. I know I could be out of a job tomorrow...and then what would I do???

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A.L.

answers from Austin on

It's imperfect, but here's an idea that I've wondered if it would work.

Socialize preventative medicine, and coverage for congenital conditions. Leave the other stuff to traditional health insurance.

As an example, semi-annual dental cleanings and annual x-rays would be paid for. Orthodontia and dentures? Health insurance. Vaccinations and annual check-ups (with associated tests) would be paid for. Broken bones? Insurance. Prenatal care and birth control? Paid for. True, you would still find health insurance indispensable, but in an ideal world, this would be offset a bit by health insurance being more affordable. Insurance companies would find themselves paying out less - nothing for preventative care, and less in other expenses, because people would be getting the preventative care that would make chronic illnesses less likely and less overwhelming when they did happen. (Regular dental care alone has an effect on reducing incidence of heart disease, for example. Regular testing (paid for) would discover chronic disease before it became more devastating and - not coincidentally - more expensive to treat. ) Theoretically, this would result in cheaper insurance. Let the medical insurance companies compete for our business the way car insurance companies do now.

Think of it this way: car insurance doesn't pay for preventative maintenance on your vehicle. Why does health insurance? However, as I believe that life has value, I also believe that we as a civilization are responsible for assisting our fellow humans in living the best life we can - the only compromise I can see is socializing preventative health care.

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S.S.

answers from Cincinnati on

I know there are alot of people who feel that you should have health insurance no matter what. These people generally don't have to choose between having health insurance and eating. Personally I think health care should be free. Other countries do it? why can't we? I think it should at least be free to children and the elderly (alot of older people almost go bankrupt paying for medications) I don't think that just because someone has more money they should get better health care. Just because you are richer does not mean your life is worth more. A lot of people judge me because my son is on medicade. I have been asked why I don't put him on insurance through my hubby's work. Well that cost 1/3 of his weekly paycheck. That's alot of money. Money I can use to buy almost three weeks worth of groceries. I think that if a lot of people had to spend less on health insurance and health care they might be able to afford things like fresh prodduce and other things that could improve their quality of life.

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