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drewkittyI am amused at the heat-light ratio on this important issue. Let's start over with some basic questions:
To what extent should the government _____[BLANK]___ the provision of health care services in this country?
A. "regulate"
B. "set voluntary standards for"
C. "buy and/or pay for with tax money"
D. "compel others to pay for with their money"
A. The government should certainly regulate health care, but not nearly as much as it does. The FDA's over-regulation of drugs and medical devices costs lives in America every year, as proven equipment and medications are denied to American consumers. We spend a lot of money on complying with government regulations which could be better spent providing direct patient care. I am afraid of increased government involvement in health care precisely because of the temptation to over-regulate and under-fund.
B. The government should definitely set voluntary standards for health care. A panel of experts (National Institute of Health?) should establish every few years a reliable definition of "minimal health care," "basic health care" and "comprehensive health care," which can then be relied upon by employers, employees, insurers, hospitals, and all other parties to the health care monstrosity.
"minimal health care" -- that care which must be rendered to prisoners in order to avoid violating their Constitutional rights; the care that is supposed to be provided behind bars, for example the California Department of Corrections. Note that prisoners are not free to choose their own health care providers.
"basic health care" -- quality medical care that addresses major threats to health and provides reasonable quality of life at an acceptable volume cost that may be extended to all
"comprehensive health care" -- high quality medical care that will most effectively provide good health, extend lifespan and enhance quality of life; also, that care which is the maximum that may be provided at public expense to officials of the United States, such as legislators, civil service employees, NIH experts, and others.
This last part is important. I don't want Members of Congress getting better health care than wounded veterans. So establish what "comprehensive health care" means, and then that's what Congress gets. You eat what you make.
I expect that these levels will improve over time as efficiencies go up and costs go down.
It is very important however that people have the right to buy better health care should they wish it and be able to do so.
One thought I have had is a health care lottery. Need very expensive care and cannot hope to pay for it? Buy a ticket. Buy lots of tickets. Some of these people will get care . . . where before they would not have.
C. The government is a volume purchaser of health care through programs such as Medicare and MediCal. Should the government buy health care for the elderly, for all children under 18, for the indigent, for Federal employees and soldiers and their dependents, for the disabled? Only for soldiers who have lost life and limb, or for all veterans?
Whether or not the government _should_ make these purchases is a political question.
Once that has been decided, the next question is, "Why isn't the government getting what it is paying for?!?" This question should be asked loudly and persistently of everyone who makes money from the government until answers are forthcoming.
A related question is the extent to which states or municipalities should be buying healthcare for anyone, and why. They do: both the state of California and the city and county of San Francisco are volume healthcare providers in their own rights, as is every other county of California by law. If so, again and with emphasis -- Why aren't we getting our money's worth?
People are only dimly aware that the health care industry in America is a huge racket. I have no quibble with people making a reasonable profit, but I have little patience for rampant fraud.
D. The government through legislation compels employers to pay a minimum wage. In San Francisco, the government compels employers to pay for minimal healthcare coverage for all of their employees. Business is afraid that the government will require employers to buy minimal healthcare coverage for all their employees -- or worse, their employees and their dependents.
The fact that smart businesses do this now is besides the point; there are always dumb businesses out there who make a quick buck at the expense of not only their own employees, but their competitors and the larger society. Companies with lower healthcare costs have lower prices at the expense of higher costs for the public when their employees are ill or hurt.
To me this is a genuine question to which I have no ready answer. I agree that Federal and local government contracts should require healthcare coverage for all contractors; I am not yet willing to extend this to a society-wide unfunded mandate.
The fact remains that uninsured healthcare costs are a considerable burden on the people of the Untied Snakes. We pay now or we pay later, after unnecessary suffering.
My preference would be to provide the "minimal health care" identified above to all persons in the United States without regard for any other criterion, including ability to pay and legal/immigration status, simply on the grounds of public health and vector control. It would pay for itself in reduced costs elsewhere in the system.
To what extent should the government _____[BLANK]___ the provision of health care services in this country?
A. "regulate"
B. "set voluntary standards for"
C. "buy and/or pay for with tax money"
D. "compel others to pay for with their money"
A. The government should certainly regulate health care, but not nearly as much as it does. The FDA's over-regulation of drugs and medical devices costs lives in America every year, as proven equipment and medications are denied to American consumers. We spend a lot of money on complying with government regulations which could be better spent providing direct patient care. I am afraid of increased government involvement in health care precisely because of the temptation to over-regulate and under-fund.
B. The government should definitely set voluntary standards for health care. A panel of experts (National Institute of Health?) should establish every few years a reliable definition of "minimal health care," "basic health care" and "comprehensive health care," which can then be relied upon by employers, employees, insurers, hospitals, and all other parties to the health care monstrosity.
"minimal health care" -- that care which must be rendered to prisoners in order to avoid violating their Constitutional rights; the care that is supposed to be provided behind bars, for example the California Department of Corrections. Note that prisoners are not free to choose their own health care providers.
"basic health care" -- quality medical care that addresses major threats to health and provides reasonable quality of life at an acceptable volume cost that may be extended to all
"comprehensive health care" -- high quality medical care that will most effectively provide good health, extend lifespan and enhance quality of life; also, that care which is the maximum that may be provided at public expense to officials of the United States, such as legislators, civil service employees, NIH experts, and others.
This last part is important. I don't want Members of Congress getting better health care than wounded veterans. So establish what "comprehensive health care" means, and then that's what Congress gets. You eat what you make.
I expect that these levels will improve over time as efficiencies go up and costs go down.
It is very important however that people have the right to buy better health care should they wish it and be able to do so.
One thought I have had is a health care lottery. Need very expensive care and cannot hope to pay for it? Buy a ticket. Buy lots of tickets. Some of these people will get care . . . where before they would not have.
C. The government is a volume purchaser of health care through programs such as Medicare and MediCal. Should the government buy health care for the elderly, for all children under 18, for the indigent, for Federal employees and soldiers and their dependents, for the disabled? Only for soldiers who have lost life and limb, or for all veterans?
Whether or not the government _should_ make these purchases is a political question.
Once that has been decided, the next question is, "Why isn't the government getting what it is paying for?!?" This question should be asked loudly and persistently of everyone who makes money from the government until answers are forthcoming.
A related question is the extent to which states or municipalities should be buying healthcare for anyone, and why. They do: both the state of California and the city and county of San Francisco are volume healthcare providers in their own rights, as is every other county of California by law. If so, again and with emphasis -- Why aren't we getting our money's worth?
People are only dimly aware that the health care industry in America is a huge racket. I have no quibble with people making a reasonable profit, but I have little patience for rampant fraud.
D. The government through legislation compels employers to pay a minimum wage. In San Francisco, the government compels employers to pay for minimal healthcare coverage for all of their employees. Business is afraid that the government will require employers to buy minimal healthcare coverage for all their employees -- or worse, their employees and their dependents.
The fact that smart businesses do this now is besides the point; there are always dumb businesses out there who make a quick buck at the expense of not only their own employees, but their competitors and the larger society. Companies with lower healthcare costs have lower prices at the expense of higher costs for the public when their employees are ill or hurt.
To me this is a genuine question to which I have no ready answer. I agree that Federal and local government contracts should require healthcare coverage for all contractors; I am not yet willing to extend this to a society-wide unfunded mandate.
The fact remains that uninsured healthcare costs are a considerable burden on the people of the Untied Snakes. We pay now or we pay later, after unnecessary suffering.
My preference would be to provide the "minimal health care" identified above to all persons in the United States without regard for any other criterion, including ability to pay and legal/immigration status, simply on the grounds of public health and vector control. It would pay for itself in reduced costs elsewhere in the system.
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no subject
Date: 2009-08-11 12:38 am (UTC)Preventive Medicine and Lifestyle Changes (http://meowse.livejournal.com/335458.html)
no subject
Date: 2009-08-11 01:23 am (UTC)no subject
Date: 2009-08-11 04:52 am (UTC)Do you know what mass of paperwork it takes to open a new hospital? Or to renovate an existing one?
The number of hospitals in America has been steadily decreasing, despite the need for health care skyrocketing.
Right now there is no competition, we have networks of health care providers who engage in price-fixing. There are gross surcharges because so many bills end up unpaid for one reason or another. It is an open secret that you can often clear a health care bill with a small percentage of the total, cash up front.
no subject
Date: 2009-08-11 06:01 am (UTC)What I am saying is that I don't believe for a minute that our current representatives will do anything to fix it, because they are listening to the wrong people.