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The vision of 14,000 physicians.



December 10, 2007 – Comments (4)

As some of you may have noticed, I take the issue of healthcare seriously. Healthcare is a complicated subject, and beyond the quick posting of a blog to address adequately. Kitsapbabe posted a description of its vision and solution to America's healthcare problem. I took it to task for what I considered crap. But like Momma says, unless you have a better idea, shutup. The plan I prefer does not entirely exist. the one I am going to recommend reading about, and consider acceptable, has certain elements that I consider flaws, but it is also workable around those flaws. For example I would like to see all the funding taxed to the individual directly, instead of continuing the existing process of employer sponsored taxation. It amounts to the same expense, but different in where it shows on the books. And so for your reading pleasure, I give you:

The vision of 14000 physicians.


4 Comments – Post Your Own

#1) On December 11, 2007 at 8:57 AM, dwot (29.50) wrote:

I have to agree with and that link is very good.

Seriously, the American economy is disgraceful for its waste.  Certainly health care is probably the best example of the waste of capitalism.  Health care is about treating people, but in the US economy it is about pushing paper from one pile to another, and paying a lot of money for that, and frivolous law suits, more paper pushing.  Health care in the US is parasitic.

I would caution to avoid some of the Canadian problems with health care.  We have universal health care that is free and people expect more and more for it without any sense of the costs or the unreasonableness of the demand.

Universal health care should outline what is covered, and what isn't.  There should also be a cost sharing between the plan and the people, perhaps 75% from the plan and 25% from the people yet some things completely free, such as an annual check up and some routine screening tests, blood work, pap smear, urine tests.  Also perhaps one appointment per quarter 100% covered.

I worked a short time in a doctor's office and I remember her telling me about an immigrant woman who waited until she was covered to make a doctor's appointment.  By the time she saw my friend her blood pressure was over 200 and the time bomb went off before my friend could do anything for her, and here in Canada a $50 appointment the year earlier might have saved her life.

So, you don't want abuse, or increasing demands that can't possibly be funded, but you also don't want people avoiding getting checked out when they know they have a problem for a few dollars.

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#2) On December 11, 2007 at 12:16 PM, devoish (82.19) wrote:

There will never be a perfect system because there is a certain percentage of the population that will say or do anything chasing dollars. Adding or deleting treatments would need to be decided on by the largest group of Dr,s possible because a small panel of twelve can be to easily bought off by the interests of drug companys or equipment suppliers. Having a % of out of pocket expenses IMO would need to start at a cetain income level because  paying 25% of a $100,000 procedure is like not having insurance if you earn $19,000/year. The free or for a small fee, preventative screening is something I would like in the plan, once agin letting the Drs decide what goes in.

I think defense was the biggest waste of capitalism, although now healthcare may be running neck and neck.

A conclusion I reached from your last post/series (and thanks for posting, yours are absolutely among the best) is that inflation is the tool that is going to be used to hide banking/housing losses. This will make any healthcare solution appear more expensive than it actually is. It will also cause us to lose some of the best Dr's we have if they decide to work where their money is going to have value. We are going to have a few less swimming pools built here in the US as we pay the price for our greed and foolishness.

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#3) On December 11, 2007 at 5:39 PM, StockSpreadsheet (64.13) wrote:

One thing stood out to me in the linked page.  It states that 31% of dollars spent on healthcare in the U.S. is consumed by "waste", (administration expenses, marketing expenses, profits for the companies and excessive salaries for the CEO's), and that by recapturing those dollars that we could provide healthcare for the 46 million Americans currently uninsured or underinsured.  I think that these people that state such a thing are smoking something illegal in most U.S. states, or are at least on some kind of drug.  Have they looked at the overhead of a government department, (Social Security, HHS, Medicare, etc.).  There are a lot of "administrative expenses" in each of these departments.  I read somewhere that between 2/3 and 3/4 of the dollars collected by Social Security are consumed by "administrative expenses" and only about 1/4 to 1/3 of the money collected goes to the recipients.  I don't think that Medicare is any more efficient and loses billions in fraud and waste.  So "recapturing monies lost or wasted through administrative expenses, marketing expenses, profits and excessive CEO salaries" is not a plausible arguement nor a source of potential savings.  Those monies will just be transferred from for-profit companies traded on stock markets, owned by shareholders who might have a hope of influencing the board, CEO salary and profit margins, to an unweildy, bloated government bureaucracy with no profit incentive, that will be a dumping ground to employ political cronies and that will waste billions of dollars, just like all the other political bureaucracies.  It might help more people, but there will be no savings from recapturing "waste".  The "waste" will just be transferred from private companies to the government.

I like the idea of a national healthcare system.  Something reasonably small, maybe with a debit card that allows you to pay so much for services with only a minimal copay, (checkups, some doctor visits, most prescription drugs, etc.), and that after a certain dollar amount then maybe the copay becomes a percentage of cost, (which you could get private insurance to pay for, such as the Supplimental Medicare Coverage that can be purchased now).  This could insure universal basic care without breaking the bank by paying unlimited monies for marginal treatments or unnecessary proceedures.  I would not cover most elective surgeries or proceedures, (botox treatments would not be covered, for example), nor any treatments not approved by the NHA, the FDA and the AMA.  Vaccinations would be covered.

The problem I see with a national heathcare plan is the same thing that happened to Social Security.  The government starts out by covering a small group of people for a reasonable amount with plenty of money to cover all expenses.  Then the politicians get involved, cover more people, cut the taxes used to pay for it and spend any surpluses on boondoggle projects that have nothing to do with the program from which they took the money.  Eventually, the trust funds run out of money, (which was wasted on bridges going nowhere or used by very few people, white elephant buildings with the congressman's name on them or any number of worthless projects), and then the congresspeople whine and snivle about how the system is going broke and we must raise taxes so these poor people don't starve and die all while pocketing the money they got as kickbacks for the worthless construction projects that consumed the monies that should have been there to pay for the benefits of the people the program was created for.  Social Security and Medicare are perfect examples of this.

So I like the idea of a national healthcare system, but I don't want Congress to have any control over it, (which as a government program, they would).  It is a great idea in a utopian world.  I am just not so sure it is a good idea in reality.  Which does better to "promote the general welfare"?  A government bureaucracy that wastes money and makes decisions based on votes and not sound medical practices or a private system where people take responsibilty for their own healthcare, probably wastes less money than the government would, but leaves millions uninsured?   I haven't quite figured that out yet.


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#4) On December 11, 2007 at 6:35 PM, devoish (82.19) wrote:

If the shareholders of the USA go to sleep all the abuse you speak about will get in. When the shareholders of UHG went to sleep William Mcguire laughed all the way to the bank. It will not get that bad in the US gv't where every pay raise is publicized and fought over today. There is also the issue of Dr's having to hire paperwork experts to fill out the hundreds of different forms and codings the insurers use to prevent themselves from paying the Dr's. 

This is from the PNHP website.

PNHP Co-founders Drs. Steffie Woolhandler and David Himmelstein published this definitive study of the administrative costs of the U.S. health system in the August 21, 2003 edition of the New England Journal of Medicine. After analyzing the costs of insurers, employers, doctors, hospitals, nursing homes and home-care agencies in both the U.S. and Canada, they found that administration consumes 31.0 percent of U.S. health spending, double the proportion of Canada (16.7 percent). Average overhead among private U.S. insurers was 11.7 percent, compared with 1.3 percent for Canada’s single-payer system and 3.6 percent for Medicare. Streamlined to Canadian levels, enough administrative waste could be saved to provide compressive health insurance to all Americans.

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