What Is to Be Done about Health Care?

I rarely post here, although I sometimes post in the Lounge and occasionally in LBN. Let's get away from the negativity that's been permeating this space. I want to 'toss out' a positive idea for discussion: How to manage a national healthcare system? This is the sort of topic that I believe we should be discussing on this board as a potential :dem: proposal. This is in contrast to all the negative vibes that have been around lately about religion, lack thereof, etc.

If you or your favorite candidate were elected President in 2004, and wished to bring about a national healthcare plan, how would you do it? Let's say that at least one house of Congress falls to the Dem's, so there is a reasonable chance of getting legislation through.

There are numerous health care possibilities. I'm going to list a few that I can think of, but there are many others. The 'proposals' are all different, and some are 'devils advocate.' I'm sure that some will be liked and others vehemently disliked. I deliberately made some of the ideas either very expensive or kind of like non-proposals, where the problem isn't really solved and the situation remains the same as before. That's the idea - to promote rational discussion of different ideas.

Here they are!

1. -First, reduce the deficit to a certain percentage of the Federal Budget, let's say 5% or 10%. Then, quickly emplace a one-payer system similar to the NHS in Great Britain. Emplace the entire thing at once. Emplace it before the four year term is up, to avoid the possibility of an election year 2000 disaster with a Dem leaving office with a balanced budget and a Repuke entering office bent on running the budget into the ground to destroy domestic programs.

2. -Phase in a one-payer system starting almost immediately, but do it over a period of several years. First phase starts by expanding Medicare coverage to people 55-65 and 0-5 years of age. Second phase covers people 45-55. Third phase covers people 35-45 and all children through age 18. Fourth phase covers everyone e.g. gets the people 18-35 involved as well.

3. -Install a universal health plan that is based on a 'contract' between the individual and the health care provider, which is a version of your friendly local Army hospital, only now there are thousands of such facilities all across the country. In order to qualify for subsidies, the individual has to actively participate in his or her own health maintenance by choosing a healthy diet and by exercising. The universal health care plan is based on the military health care system. Part of the universal health care system is the formation of 'exercise groups' that do all sorts of things from rowing to soccer to running to distance walking to tennis. PT tests are a part of the health care plan, although civilians don't have to do as many pushups, situps or as fast a run as service people do! Basically, people who continue to have high-risk behaviors like smoking will pay more money for things like checkups than would someone who walks 3 miles per day and doesn't smoke. Europeans gasp at the plan and remark about the 'health-care dictatorship' in the U.S. but travelers are amazed at how fit Americans have suddenly become. Many state governers are now built like 'Ahnuld' and have biceps like Jesse Ventura. Stocks of fast food chains plummet while stocks of new firms doing organic gardening skyrocket.

4. -Rather than a one-payer plan, promote universal coverage by pressuring each of the 50 states to enact laws saying that health insurance is 'mandatory' like car insurance. Some states would of course enact such laws more quickly than others. Each state is free to do whatever it wants about people who can't afford to buy the insurance. This is sort of the 'states' rights approach to health care.

5. -First, install relatively universal prescription drug coverage for all persons ages 45 and over and all persons ages 0-10 years of age. Coverage pays 100% of prescription costs up to $4,000/year and 80% thereafter, with no 'gaps.' Second phase covers prescriptions for everybody in the same fashion. Third phase is a Federal law that says everyone needs to have health insurance. Corporations, as well as small businesses, are given tax incentives to insure their employees. Those who are not insured and can afford it can choose which insurance provider to belong to. Those who cannot afford insurance receive vouchers to pay for the insurance.

6. -Merely write into a place a law that says, by 2010, that everyone needs to have health insurance. Don't do anything in the way of incentives for employers or individuals to buy insurance. It's everyone's own responsibility to buy insurance whether they can afford it or not.

7. Dem's should do nothing about health care. It's the individual's own responsibility.

8. -Put Bill Gates in jail on antitrust charges, confiscate all his money, and use the funds to finance universal health care for all children ages 0-18 and for all persons 50 and over.

9. -Keep health care in private hands as it is now, but Bust the Trusts! No pharmaceutical, insurance, or health care company may hold more than 5% of the market for all health insurance combined, all pharmaceuticals, or all health care providing and management. In other words, Pfizer can't make more than 5% of the total pharma sales in the U.S.

edit: added proposal no. 9

is that no one should make a profit from illness or injury. Any system, private or public, that addresses this would be acceptable. Health care providers deserve a wage compensatory to their skills and education but for insurance companies to enrich wealthy shareholders....grr, etc. etc. You've heard it all before.

Your point is the only point. The idea that a sick member of our society is not a social responsibilty is repugnant. To put it in a romantic way. If someone a thousand miles away was sick or injured I could not visit them. But if I send a doctor in my name I am saying "here I am".

The idea that this person should be left to the "Market" is totally reprehensible. And we all know it. Which is why the capitalists make their health-care ads so social in content.

OK. I'm going to gratuitously bump my own thread. I'm going to do this because this health care discussion is:

1. Relevent to any future :dem: agenda
2. A route for GD to turn its discussion away from negativity and too much focus on stuff like sex and religion. <half-joking>Sure, STD's are part of health care, but let's talk about the entire health care system, including the mundane things like broken legs</half-way joking>.

I think most people here basically agree that the pharma and insurance companies are running away with murderously high profits. There may be a few libertarians here, though, who say it's OK to make huge profits off the health care system.

Proposals no.s 6 & 7 basically would allow the insurance and pharma companies to continue making huge profits.

Most of the rest of us want to do something about the problem of these insurers and pharma companies making so much profit. So, what shall we do? We need a plan....which shall it be? Or, shall it be one of yours?

I have my own opinion about which ones of the proposals I like, and which ones I don't like, but I don't want to post my opinion until later, because I really don't want to sway opinions.

system of the future. Insurance companies need to get out of the business altogether. The nature of insurance to pay for the odd disaster, so they are willing to insure healthy young people like car insurers prefer good drivers.

Healthy young people don't need doctors and medicine. Sick and old people do. This has been the major flaw in our system. A single payer system pools all the health care money for the sick to use as well as others when they need a doctor. It also takes the stock market profit motive out of the equation reducing administrative costs and thereby the cost of health care per individual.

For young people, who don't want to pay for pills and doctors for sick and old people, they will in the future need these services when their time comes. To deny a human being available health care because he can't pay can only be called barbaric. A sick person often can't work and won't have health insurance because of this. Health care should be written into the Constitution as a basic human right.

Positive reason for- If we had universal health care it would make it easier for people that want to start their own business to do so? Imagine. I tell you working for yourself isn't that the American dream to have your own business?

I know the above to be true for if I would of had universal health care I would of never stayed at my last (much hated) job for so long. I now have my own business but would of done it waaaay sooner and the only thing that I allowed to hold me back was my fear of not having health insurance. What a waste. BTW I would still be working that job (for the insurance) if I hadn't of gotten canned. :( sad but true

Number 2 and phases I don't like the 18-35 group being phased in last. Reason is related to my above postive thought for universal health care. The 18-35 group is the ideal age group I think, when someone is more apt to try to start their own business also 18-early 20's is when a lot of people are going to College and may not be able to afford health insurance.

I'm for the universal health care for all, take the profit out DK plan, and bring back retirement to age 65 and the way I do it is....I take away the tax cut for the top 2% and go after all American business that opened up offshore accounts in order to avoid paying their fair shair of taxes. I also take away the limit at which the SS tax is cut off at being taxed.

heeee :-) number 8 if your going to put anybody in jail and take their money it ought to be Ken Lay and the Bush crime family!

These are some great points!!!!

The NHS in Britain is not a single-payer plan, it's a government-provider service. The distinction is important because those opposed to health payment reform try to blur the lines and claim that health reform means that 'government bureaucracy' will be providing one's care. Canada has a single-payer system, with a multitude of providers, public and private.

Single-payer was not really on the table in the health reform debate of the early 1990s, although a single-payer plan was on the ballot in California (lost 2-1). Clinton's plan envisioned: continuation of employer-paid insurance, with an employer mandate; government coverage to ensure universal coverage; consolidation of providers into large 'strategic alliances' (seem familiar? it's what the providers have done, but without universal coverage); and a global health budget.

A major problem with the Clinton approach was that a highly-complex plan (as any plan would be)was fashioned and then presented to Congress as a set piece. Congress doesn't react well to such things. A better approach would be to present Congress with a set of objectives, some suggested approaches, and ask them to fashion something -- but an overwhelming majority of Congress would have to want to do it. Remember that Clinton's failed plan was presented to a Congress with a Democratic majority in both houses!

Mandating health coverage by individuals without providing the means to attain it would be a cruel joke on a large proportion of the populace. Under the current nonsystem, those who CAN get coverage (as from employers) generally opt for it, even at considerable extra expense to themselves. It's not that people are unmotivated to enroll, it's that they lack the means.

Disallowing large players in health care would mean a return to the prior fractured nonsystem. That was one the doctors liked because corporate medicine controlled it, rather than big payers. All that might be preferable to what we have today, but it's not a prescription for a good healthcare and health coverage system. There are economies of scale, volume does equal quality (e.g., you want the surgeon who's done a lot of whatever operation you need), size does allow specialization (some of which is needed, if not all that exists), and geographic dispersion can enhance portability. The issue is to not allow corporate greed, HCA and Frist, to control healthcare.

Here's a bump for the nocturnal crowd to talk about health care. Let's make it 'controversial' by using a two-word catch phrase:

'Socialized medicine'....whaddaya think?

no insurance , wife goes in to have her blood pressure chacked , 5 minute tops , got bill for 70 bucks , where and hell is the mercey in life , they no we don't have any health care coverage and can't afford 500 a month to get any , and if we did there is a 2000 dollar spend down befor you have it , this country sucks when it comes to health care , what happened to the old time doc that was happy to get a chicken for supper for his fee ,

Thanks for the replies. Before posting my actual opinions on the issue, I'd like to see the Friday night-weekend crowd give some thoughts about the health care issue.

Health care is a major domestic issue that ranks perhaps no. 2 after employment. Prescription prices are skyrocketing.
Big pharma is trying to make it so USAmericans can't have access to Canadian prescriptions, should they need them.

Let's have more thoughts and opinions on the health care issue. Those that have been posted so far are great!!! ThanX!!