Jul 29 2009
Finally The Nation Is Having A Serious Debate On Health Care Costs
I was listening to the Grandy & Andy Big Hour (630 AM in DC) this morning and was glad to hear the nation is having its long overdue discussion about health care and the cost of end of life treatment. It is a good debate and it is involving the largest voting block out there – the retiring and aging baby boomers, their parents and their children – who are all facing these tough end of life decisions. I hope Fred Grandy posts all the calls to the show today on their site for everyone to review.
I also listened to Hannity yesterday afternoon and he had a caller who tried to make note of the fact that under Medicare/Medicaid we are going to be taxed into financial ruin by the runaway costs of unlimited care for the elderly, even without the Democrats’ disastrous government take over. Hannity just did not get the point that we as a nation cannot afford unlimited care for everyone. He was babbling about freedom while we face ever increasing taxes to cover Medicare/Medicaid. That was not a good debate but simply the slinging of sound bites. It was really embarrassing. We deserve better.Â
The Dems approach is a non-starter, were bureaucrats are now inserting themselves into the very personal and private family discussions regarding end of life opportunities. They see the problem, their solution sucks. It is government run rationing plain and simple.
A doctor from VA called into the show to note another serious problem with the Democrats’ plan. His take was there are profit incentives in the House plan for doctors to save money on end of life care. This would be a complete disaster if doctors see personal financial reward for convincing challenging cases to forego expensive life sustaining options. Right now this is not the case – as it should be. I want advice based on the merits and down sides of options, not to have dollars get into the mix. Right now too many doctors push for the simple solutions as it is. We don’t need to pay them more for pushing people away from costly options.
However, leaving the system as is no going to work either, because we are beginning to ration, or will need to, anyway. There are too many seniors going into retirement and accessing expensive care for the workforce to cover.Â
So where do we go. I think there are options out there that do not take away access or the opportunity to buy what you want to for end of life treatment. For example, we could cap lifetime Medicare/Medicaid payouts to something that could cover any option. Instead of saying how the money is spent and what is allowed or not allowed, we just allocate a set of affordable limits on each person. Something that allows a couple of shots at this expensive care, but not limitless.
I also think we should promote health insurance coverage for seniors who can afford it to augment the Medicare/Medicaid cap once it is expended. Another option is to allow families to take out tax free loans for the care of their family members. Thus the nation covers some, but people have options to buy more care as their individual situation dictates. These are simply budgets, the decision on how to spend the money stays with the doctors, patients and families.
If you have worked hard and succeeded in life, and have the where with all to pay into insurance and/or qualify for loans to get through these tough times then the government should get in the way. We are a nation that believes in a safety net for those who did not fare as well as the rest of us. But we are also a nation that believes if you work hard you earned the right to spend your rewards as you see fit and not be forced to subsidize others who may have made poor life decisions. I am not interested in providing limitless care to someone who abused drugs their entire life and could never hold a decent job. I will donate to the general fund.
That is the intermediate point we need to reach. A reasonable but not endless safety net, just as was done with welfare.
In addition, we need grouping of small individual plans so small businesses can afford health insurance. We need access to doctors for 2nd opinions when we feel the advice we are getting is more to minimize the doctor’s risk or headaches and not so much about the patient’s situation.
There are lots of ways to fix this, but first we must realize that Dems go too far and the status quo is just a slower path to the same bad end. We need to think outside the box. We need to re-think Medicare and Medicaid to be a life time budget and not a set of allowed services with fixed prices.
Addendum: The more I think about my proposal the more I like it (what a shock!). For one, giving each person a federal budget eliminates a lot of waste and abuse. The money is tied to the patient, not the care giver. It would eliminate a ton of paperwork. And doctors could no longer scam the system with bogus claims, they patient signs off on the expenditure.
Also, I would add the provision for people to donate their budget to others. A healthy spouse could donate their federal safety net budget to their ailing spouse. The well to do could donate to the less off. Between the loans and the donations those who cannot quite afford the next treatment option can have the remainder covered somehow through family or Good Samaritan efforts.
We don’t need the government making these decisions, and we don’t need them deciding what care should be needed. We The People would decide where to help and who to help. We don’t need government to make us a good and proud and selfless people. We need them to get out of our way.
Update: Gateway Pundit has a must see video on how under Obamacare only the strong will survive – it is an incredibly powerful video.
Having the money tied to the patient with a lifetime cap would be a marvelous way to cut out a lot of the waste and fraud associated wtih meaningless medical procedures. One of the best ways to game the medicare system right now is for a care provider to run the gamut of tests and procedures, whether called for or not, and then bill all of it to medicare. The patient currently has no reason to say “no” to any of it. (I could be much more specific about this, but this isn’t the place)
This cap would give every patient an incentive to put a stop to costs that are just tacked on to run up the medicare bill, since unlike now it would affect them personally.
Also I can see a market developing for private insurance that would extend the medical cap; for instance, say you can buy an extra million dollars worth of coverage on top of your cap, if you can afford it.
[…] View original post here:Â Finally The Nation Is Having A Serious Debate On Health Care Costs […]
WWS,
Yes, I agree. It has a ton of benefits, including individual control and removing the government from the decision process.
I say go with it!
Honestly, from what I’ve read today, they ain’t doing any serious debate on the health care reform.
Just read that Obama has deferred the vote to October.
Wizbang said that this is hurting his political capital.
Good.
Funny how the economists are being so positive about the economic numbers….stock market is going back up. housing sales and prices going back up. and all that.
The bottom line point is this bill simply can’t be fixed, tuned ,adjusted or made acceptable.
No matter what efforts you go to to try to compromise on a fix there will still be so much left over that is simply wrong.
Any health care bill that does not address tort reform is just window dressing.
You can basically forget new research to create new treatments and medications.
There are already caps on Medicare. There are lots of things Medicare will not pay for. For instance, Medicare will not pay for long term care beyond a certain point. Medicaid usually ends up paying for a lot of that. Medicare will not pay for home health care beyond a few weeks.
The frustrating thing about this debate is that the government refuses to do what any intelligent person does in addressing a problem, which is analyzing it, then breaking it down into component parts. It is exactly as if, in a bid to end the automobile industry’s problems, transportation access problems, erratic gasoline prices, and foreign oil dependence, the government designed a single car, which would then be bought, subsidized, or given to everyone with a driver’s license, as would the gasoline and maintenance costs.
The most enraging example of this is the problem of uninsured young people. I’m in insurance. To sell a million-dollar term life insurance policy to a healthy young person of 18 is $25/month; a 30-year-old, maybe $40. And even at those prices, insurance companies average someting like an 80% profit on term policies (at some companies, it is over 90%).
Why? Because healthy young people hardly ever die. And when they do, which is rarely, it is not usually because of illness, but rather accidents, murder, or drug overdose. Why? Beause they hardly ever get sick.
A high deductible–and by high, I mean maybe a 2.5K medical policy, for a single catastrophic event–for an under-30 year old, would be, maximum, $30-45 a month. Under 35, $40-50. Simply allow healthy young people to buy a high-deductible policy, and 90% of the problem vanishes. (Poor people get Medicaid; the really rich don’t need it.)
The one exception is pregnancy. All right, so exempt it from covered conditions and put that in a special class and deal with the expense of that. The point is that a major component of the problem, uninsured people under 40, could be solved, so, so, so easily.
And don’t think that they don’t know this; they do, but they won’t do it. They refuse. The problem they want to solve, whatever it is, is not that one.
At the end of paragraph 4, “the problem vanishes,” I mean that aspect of uninsured young people, not the medical insurance challenges as a whole.
AJ; Here is a question I hope you or one of your readers can answer;
Isn’t the current House Bill about Health Care Insurance. In other words, I can still get any treatment I want, as long as I pay for it. Will the Government prevent me from getting treatment or only on what they will pay for or reimburse?
Bobsunshine – of course you will always be able to get what you can pay for personally. But since any serious hospitalization today is going to cost north of $100K, you will need to be fabulously wealthy to consider paying this kind of cost out of pocket. Ask someone who’s had a triple bypass what the total costs for that kind of very common surgery come to. And that’s not one of the higher ones; cancer cases can be far worse in effects, time, and costs.
And, if you ARE wealthy enough to pay this out of your pocket, you are also going to be paying the premiums, through taxes and through your own higher premiums, for a whole lot of people besides yourself.
AJ, you realize that you are talking about a health insurance voucher, don’t you?
It’s a good idea – if your goal is providing moderately good health care to all.
I just don’t think that is the goal of the Left. To them, this is about power and underlining class distinctions. Health care is a minor aside.
WWS:
Thanks and agree they want to eliminate our current insurance plans and replace them with a government plan which will limit us and raise our costs. They play with words to confuse the general public, but in the end, they want to do away with private insurance.
Don’t want the government involved in my health-care decisions. Period. Hopefully, over the next several weeks, the public will get to understand just what Obama wants to take away from all of us to gain control of our lives.
If Obama really wanted to provide health insurance for the uninsured, then the government could just provide it for those people only – or government (free) clinics for the uninsured. It would be a lot cheaper to everyone and we would not lose our current private insurance.
Karl Rove let the cat out of the bag tonight on O’Reilly. He pointed out Obama’s first act upon getting to Congress in 2005.
bobs, a very good article today on how Obamacare will destroy private health insurance for the self-employed. I call this a must-read.
http://www.washingtonexaminer.com/opinion/blogs/beltway-confidential/my-individual-health-coverage-51922707.html
“The bottom line: Under ObamaCare, your individual insurance policy is probably doomed, even if it is grandfathered.”
I have an idea. How about in the spirit of “Cash for Clunkers” that Congress created, we have a “Gold for Geezers” program where youngsters could drag their elder parents in for “End Of Life” counseling and get a bonus if they accept?
Sounds like something the Democrats will jump right on!
Reminds me of the Nazi Youth all over again.
I don’t see any serious debates on this reform at all this week. Sorry!
Even with 4 Blue Dogs capitulating to Waxman, Obama, and Emanuel, they didn’t capitulate much. Only on some of the numbers.
The only way to change their minds is to call them and show up at their townhall meetings and tell them to vote against Obamacare.