Comments on: Universal Health Insurance

By: Michael

Michael — Thu, 28 Feb 2008 23:12:37 +0000

By: Bryan

Bryan — Thu, 28 Feb 2008 05:50:44 +0000

There will be a good sized initial cost from people who have been putting things off until they can get Medicare, but I still think we need to start with children, because that is where the greatest savings will accrue later. There will be a “bump” in costs as people finally get to see doctors, but early diagnose leads to the cheapest cures.

We are also going to need to look at incentives for doctors to become GPs, instead of specialists, because out current ratio is out of whack with the rest of the world, where half of all doctors are in family medicine.

By: hipparchia

hipparchia — Thu, 28 Feb 2008 05:20:13 +0000

as for doctors making a profit, that’s hard to measure. definitely they should be able to make a decent living.

i paid $28 for my flu shot this year. if after paying all the salries and benefits for employees, taxes and mortgage on the property, utility bills, and the cost of the vaccine, the needle, the syringe, the alcohol, the gauze pad, and the bandaid — if all that only cost them $27, i haven’t got a problem with it.

By: hipparchia

hipparchia — Thu, 28 Feb 2008 05:12:59 +0000

The expense of all this stupid discriminatory health care for those who can afford it is probably greater than the expense of providing health care for all by a significant margin, especially when you factor in all the lost productivity due to lack of medical care.

yep. i agree 100%, michael.i agree with bryan too, except that i think it will cost more than he’s projecting. this country really does need to just go ahead and make the leap to either national health insurance or national health care, no matter which of us is closer on the $$.

By: Michael

Michael — Wed, 27 Feb 2008 10:07:09 +0000

Or maybe I’m just ranting, at this point, because there is what we can achieve and what Bryan is saying is correct. The expense of all this stupid discriminatory health care for those who can afford it is probably greater than the expense of providing health care for all by a significant margin, especially when you factor in all the lost productivity due to lack of medical care.

By: Michael

Michael — Wed, 27 Feb 2008 09:59:27 +0000

I want to be clear that I am not in favor of making doctors reduce their incomes. I am in favor of their incomes being based on something other than a reward for risk. Profits are always balanced by losses somewhere.

By: Michael

Michael — Wed, 27 Feb 2008 09:57:42 +0000

hipparchia, are you saying you think that doctors should make a profit or that they should have income? Because there is a difference. the idea of medicine as a capitalist venture winds up with schwing pills being marketed on the television.

By: Bryan

Bryan — Wed, 27 Feb 2008 07:13:16 +0000

I’ve mentioned before that the uninsured price is twice as high as the insured price, now prices will be leveled with providers being paid for every patient. That eliminates the costs to providers of bill collection agencies and the court costs of suing to collect what’s owed.

The list goes on and on, but the 30% is the direct overhead above Medicare’s that insurance companies spend, without regard to the costs of providers.

We have one of the least efficient systems in the world for providing health care, while having the potential of being the most efficient when you look at the VA system. If we start catching problems early, the problems become cheap to cure. Most of the babies that end up in the neonatal units wouldn’t be there if about $500 had been spent on prenatal care. Canada has very few neonatal units, because they don’t need them. That’s another area of savings.

It is workable, and can be financed through payroll taxes, just like Social Security and Medicare are now.

By: hipparchia

hipparchia — Wed, 27 Feb 2008 06:54:16 +0000

i favor hiring more auditors [or whatever] to track down the ones who should be repaying their loans, because i like the idea of providing a free or low-cost education for doctors, especially in areas where there’s a critical shortage. and definitely hire more auditors and lawyers to go after the fraud.

it’s unfortunate, but the for-profit hospitals really have become nearly as bad as the for-profit insurance companies. i don’t mind in the least if the hospitals, doctors, labs, insurance companies, clinics, etc make a modest profit, but it needs to be a very modest profit indeed and there need to be heavy-duty controls in place to keep a short leash on the predatory and the greedy if we’re going to go that route.

returning to the arithmetic for a moment, we spent something like $7000 per capita last year. ditching the insurance companies would free up 30% and maybe even 40%, but that still leaves us with the task of funding $4000-5000 per person per year.

By: Michael

Michael — Wed, 27 Feb 2008 04:16:58 +0000

It’s not the doctor taking the risk, after all. It’s the patient.