Medical - Socialized or Private?

[92bDad]

What are the various views as it relates to socialized medicine?

We have examples of Socialized medicine...in the U.S. via the VA or Military Medical...you also have the Public places that provide services to those without the financial means to choose where they want to be treated.

In Canada and Europe you have examples of Socializes medicine.

On the surface, it's an emotional issue...people want to come off like they care for those in need and believe everyone should have access to care.

Yet, as I have learned from various individuals over the years, appearances can be decieving.

Two examples...I will leave some details out to protect the individuals.

A senior citizen went in for treatment in a country with socialized medicine...tests revealed that they needed a heart transplant to have a chance at a continued healthy life...however, they were a bit older and thus over the age limit to qualify for a transplant. In turn they coordinated for a transplant in the USA, where they paid for the surgery with no insurance. They received the transplant and have had a full recovery and continue to live a good life as a retired individual.

Under the social program, they would most likely be dead.

In this next case...a woman detects what could be breast cancer...she contacts the hospital/doctor to schedule an exam...however she has to wait 4 months before she can get an appointment...once the appointment arrives, they believe she will need additional testing as they have also detected the lumps...but she has to wait another 2 1/2 months...

She told a friend that although in her country they have social medical care provided, she has to wait a rather extensive time frame to get anything accomplished and she commends her U.S. friends who when they want to see a doctor actually are able to schedule and get an appointment as well as obtain results rather quickly.

So again, this is an interesting topic, but one that has no one solution to cover 100% of the population.

Currently we have clinics and hospitals who provide services to those without the means...but we also have places that may provide a little better service because one has the means...I'm okay with this mix of solutions.

I've been treated by both sides and hey when I was broke, I was thankful just to get the treatment...when I've had the money, it was cool to get some of other added touches.

Either way, the responibility fell on me to figure out where I can get medical attention if I needed it.

Obviously we have some serious different views on how Medical care should be provided to the people...but can we find a middle ground that can de-politicize this topic?

[wmbwinn]

catch up on our last big medical discussion first.

http://www.dallas-mavs.com/vb/showth...hlight=wmbwinn

I started in post #4

wade through the discussion and then let me know what else you want to know...

[wmbwinn]

Obama's earlier stated healthcare plan was to give all Americans access to the same plan that the Federal Employees have.

Now, basically, the Federal Employee's healthcare plan is:
1)employee pays 24-26% of the premium
2)Uncle Sam pays 74-76% of the premium
3)the Federal Employee picks whatever insurance plan he/she wants. If he/she wants Blue Cross/Blue Shield, then that becomes the insurance provider. The Federal Employee can search/shop the entire healthcare system for the insurance plan he/she wants

So, that is basically the plan.

Now, no one ever said how Obama intended to provide that plan. He also never said whether Americans would be responsible for roughly 1/4 of the premium monthly.

Medicare in its original form had no financial liability directed towards the covered patient. In other words, the receiver of the coverage had no liability to make premium payments or pay deductions or copayments. Now, in modern Medicare, there are a lot of HMO/PPO managed Medicare contracts. And, some of those plans have deductions and copays.

Having said all the above, my suggestions for a "fix" are the following:
1)kill Medicare. If that never happens, then the system will never improve much. See the above linked thread regarding the problems that Medicare presents.
2)replace Medicare with the Federal Employee's Healthcare plan (which is Obama's idea although he never said he was going to use the plan to replace Medicare). Now, Uncle Sam's financial investment into healthcare is directed to the private insurance world. Uncle Sam is paying the premium (some percentage with some percentage being the liability of the citizen and this would probably have some sort of progressive rate such that the poor pay nothing and the rich pay more). Now, with Medicare dead, the stupid systematic problems I previously described are dead. Now, the private market can right the ship. Now, the money is not wasted in paying for Medicare administration, review, re-writes, endless wasted time in Congress debating its latest form, etc. And, now, the citizen will have better insurance. And, now the hospitals and clinics will have better reimbursement. As a result of a higher percentage reimbursement (insurance pays a contracted percentage of the healthcare bill, not all of it and Medicare pays around 55%), the actual charged cost of healthcare will DECREASE because the healthcare system won't have to over charge knowing that the payment will only be 55%. Private insurance generally funds about 80% of the charged bill.
3)with the tax money that currently leaves your paycheck to pay for Medicare, the money is now used to fund private insurance companies to cover Americans. The cost is actually less and so there will be a surplus of money received. With some of that money, all Americans are now covered for "catastrophic care"; Uncle Sam contracts with private insurance companies to get a massive group benefit deal for all Americans for "catastrophic care" coverage. Catastrophic Care (CC hereafter) covers absolutely nothing EXCEPT for the unexpected serious injury or illness that costs a huge amount of money. The "threshold" trigger is negotiated, at say, 100 thousand dollars, meaning that the CC plan covers absolutely nothing unless your bill costs more than 100K at which point the CC plan covers all of your expenses. CC plans are dirt cheap. I had one for myself and wife and child for about 360 dollars per half year or about 60 dollars per month. If you remove payment for bills exceeding 100K, then the private insurance companies being paid under the Obama "Federal Employees Healthcare Plan" will only have to cover bills under 100K. That will dramatically lower the cost of those premiums.
4)Don't mess with the Pharmacy Industry. Love them or hate them, they are the engine that drives the amazing advances of medicine in our time. And, love them or hate them, they drive the ACCESS and PROVISION of these meds to the world, not just the USA. The Pharmacy Industry has to remain profitable to drive the research and development and marketing and shipping, etc. Punish their profitability and see medicine decline and fail to show advances.
5)Medicaid can be replaced with the same idea of the Federal Employee's Healthcare plan as explained above. Your OB/Gyn and Pediatrician will be so happy because Medicaid is the worst reimbursement plan in America (after TriCare, which is the crappy plan we give our soldiers).

So, Obama has a good idea. But, he needs to incorporate some of these ideas to make it fly.

Now, I am not necessarily in favor of Obama trying to really apply the Federal Employee's Healthcare plan to ALL Americans. But, he should replace Medicare and Medicaid's covered Americans with that cheaper, more effective plan. I don't think we can really afford to have Uncle Sam provide coverage for everyone. If he intends to reach out to persons not currently covered by a Federal plan (Medicare, Medicaid, VA, Tricare, etc.), then the bill will be tremendous. To make it work, the premium would probably have to be paid in large part by the private citizen rather than Uncle Sam.

[chumdawg]

4)Don't mess with the Pharmacy Industry. Love them or hate them, they are the engine that drives the amazing advances of medicine in our time.

What about university scientists?

[wmbwinn]

Originally Posted by chumdawg

What about university scientists?

don't mess with them either. But, the real amazing advances are in the Pharmacy industry.

University scientists are frequently working with those Pharm companies on research projects.