Welcome to the Hardcore Husky Forums. Folks who are well-known in Cyberland and not that dumb.
The Club takes on Healthcare - Free Market Style
creepycoug
Member Posts: 24,347
One rare area of common ground between the Centrist Bros and the left wing of @RaceBannon 's Populist Goon Squad is healthcare. We? have generally agreed that it's a BHL Tuff! issue and that is has not been resolved. We? are fearful of state-run health care and death committees; but we agree the current system leaves the vulnerable, vulnerable. It seems in the last years, it is an issue that has been pushed down the list of political priorities. Not discussed at all with the frequency it once was. Did it get resolved and nobody told me?
We? tried to solve this problem for the world in the Tug, but didn't get anywhere. The Club members have the intellectual chops and the even-keeled temperament to give this a go. The Club's wayward son, @UW_Doog_Bot , took a shot at this a couple of years ago. Here's his post. (Seriously), I thought this would be a good discussion for this forum.
https://hardcorehusky.com/discussion/comment/1087413#Comment_1087413
As promised if a bit late. Blame Facebook's ultra shitty search function and my laziness & apathy for convincing people of politics online in general.
Instead of an individual mandate (which is unconstitutional) Congress may pass a tax exemption for every dollar spent on healthcare directly (unlimited, no minimum) or insurance(with a cap) by Citizens. Remove the 10% of income minimum per item on medical expenses etc..
HSA's should be exempt from capital gains and contributions should be tax exempt from income tax. Regular income schedule/capital gains should apply if taken out for other expenditures.
As we already have "Universal Healthcare" although haphazardly and terribly planned through a mandate to treat and a combination of medicaid/unpaid medical bills etc. I actually propose keeping the pre-existing condition clauses of the ACA. I realize this will increase premiums for those of us without pre-existing conditions but it should reduce the amount of money paid to the government to then pay for medicaid expenses and/or help drive down costs for unpaid bills. I also think the concept actually impedes a free market by locking individuals into their current healthcare provider thus not allowing for competition.
One size fits all policies would be eliminated. All young and healthy people should be able to purchase cheap high deductible catastrophic insurance if that's all they want to purchase. Overall, that would bring in more people into the "universal" net and reduce one of our major failures which is catastrophic bills having to be paid by the state or the hospital. This would reduce costs to the rest of us paying normal premiums.
Caps on donations to charities serving high risk pools should be reduced(think St Jude's Children's Hospital) and I actually view federal funding of research hospitals as a good thing as well as prize funds for cures/breakthroughs in research. Pure research(where you might not know what you will get) is a place where the market forces aren't necessarily great without patent or other government protection. We should also stop letting the rest of the world bully our pharma industries as we are essentially subsidizing all medical pharma research for all the "socialized" medical programs of the world. I'd probably also be fine with rolling high risk pools into medicaid but putting them on a voucher system so that they can purchase their own medical care in an open market with competition.
Open up competition across state borders for Health Insurance to help manage costs through competition. Create some standardized rules/best practices around administration etc. through use of the interstate commerce clause. We already do this in plenty of industries. Think DOT or clean air act, mandates are federal, rules are made and enforced at a state level within the guidelines of those federal mandates.
Is this ideal? Fuck no. Would it be an improvement over the current system? I think so. It's full of compromise, doesn't really touch medicaid or medicare, and is *maybe* politically feasible. Probably not in today's hyper-partisan atmosphere though.
Disagree with something? Great! That's what I've got so far. It's a working draft. I'm happy to take feedback and improve it with your help. Policy wonks welcome.
We? tried to solve this problem for the world in the Tug, but didn't get anywhere. The Club members have the intellectual chops and the even-keeled temperament to give this a go. The Club's wayward son, @UW_Doog_Bot , took a shot at this a couple of years ago. Here's his post. (Seriously), I thought this would be a good discussion for this forum.
https://hardcorehusky.com/discussion/comment/1087413#Comment_1087413
As promised if a bit late. Blame Facebook's ultra shitty search function and my laziness & apathy for convincing people of politics online in general.
Instead of an individual mandate (which is unconstitutional) Congress may pass a tax exemption for every dollar spent on healthcare directly (unlimited, no minimum) or insurance(with a cap) by Citizens. Remove the 10% of income minimum per item on medical expenses etc..
HSA's should be exempt from capital gains and contributions should be tax exempt from income tax. Regular income schedule/capital gains should apply if taken out for other expenditures.
As we already have "Universal Healthcare" although haphazardly and terribly planned through a mandate to treat and a combination of medicaid/unpaid medical bills etc. I actually propose keeping the pre-existing condition clauses of the ACA. I realize this will increase premiums for those of us without pre-existing conditions but it should reduce the amount of money paid to the government to then pay for medicaid expenses and/or help drive down costs for unpaid bills. I also think the concept actually impedes a free market by locking individuals into their current healthcare provider thus not allowing for competition.
One size fits all policies would be eliminated. All young and healthy people should be able to purchase cheap high deductible catastrophic insurance if that's all they want to purchase. Overall, that would bring in more people into the "universal" net and reduce one of our major failures which is catastrophic bills having to be paid by the state or the hospital. This would reduce costs to the rest of us paying normal premiums.
Caps on donations to charities serving high risk pools should be reduced(think St Jude's Children's Hospital) and I actually view federal funding of research hospitals as a good thing as well as prize funds for cures/breakthroughs in research. Pure research(where you might not know what you will get) is a place where the market forces aren't necessarily great without patent or other government protection. We should also stop letting the rest of the world bully our pharma industries as we are essentially subsidizing all medical pharma research for all the "socialized" medical programs of the world. I'd probably also be fine with rolling high risk pools into medicaid but putting them on a voucher system so that they can purchase their own medical care in an open market with competition.
Open up competition across state borders for Health Insurance to help manage costs through competition. Create some standardized rules/best practices around administration etc. through use of the interstate commerce clause. We already do this in plenty of industries. Think DOT or clean air act, mandates are federal, rules are made and enforced at a state level within the guidelines of those federal mandates.
Is this ideal? Fuck no. Would it be an improvement over the current system? I think so. It's full of compromise, doesn't really touch medicaid or medicare, and is *maybe* politically feasible. Probably not in today's hyper-partisan atmosphere though.
Disagree with something? Great! That's what I've got so far. It's a working draft. I'm happy to take feedback and improve it with your help. Policy wonks welcome.
Comments
-
-
Not touching
-
Not sure @MikeSeaver would respeck this post. That is, if he cared, and he doesn't btw.RaceBannon said:Not touching
@HoustonHusky and the other economis bros will jump in. I'm sure of it!
Where da fuck is @UW_Doog_Bot anyway? @DerekJohnson said he'd be along momentarily. That was 3 mos. ago. -
This is cool, @creepycoug . I was actually going to suggest his as a topic, but wanted to keep it tug free. By far the best systems I have seen are in countries like Germany, Switzerland, and Netherlands. I also admire what a country like Japan has been able to do. Of course there are tradeoffs. I think there's a lot of room to discuss this topic without tug style insults or team warfare.
-
That's the goal. I've learned to post and be patient. Post it, and they will come.hardhat said:This is cool, @creepycoug . I was actually going to suggest his as a topic, but wanted to keep it tug free. By far the best systems I have seen are in countries like Germany, Switzerland, and Netherlands. I also admire what a country like Japan has been able to do. Of course there are tradeoffs. I think there's a lot of room to discuss this topic without tug style insults or team warfare.
-
https://www.youtube.com/watch?v=h4rg-DJBd34
I think it's difficult to discuss this because so many people refuse to even entertain the idea that the U.S. healthcare system isn't the gold standard in the world. All they hear is how we get the best care in the world, so changing the system would result in a lower standard of care. I don't understand how anybody could look at the data and come to that conclusion, though:
I've really liked this graph since I saw it in 2011, as it really puts things in perspective, comparing per-capita spending, results (in the form of life expectancy at birth), and number of doctor visits per year. So cost, quantity, quality all on one graph:
Not exactly crushing it in infant mortality, either:
-
The CIA is your source?
-
You can trust them when it comes to baby killing.RaceBannon said:The CIA is your source?
-
I think it's best to separate the quality of care vs how we pay for it. I don't think anyone would argue that most hospitals deliver quality outcomes. I don't think it's a secret that when a wealthy person from another country on one of those charts needs emergency heart surgery that they come to the USA for it. There's obviously a problem when someone goes bankrupt due to medical bills though.1to392831weretaken said:https://www.youtube.com/watch?v=h4rg-DJBd34
I think it's difficult to discuss this because so many people refuse to even entertain the idea that the U.S. healthcare system isn't the gold standard in the world. All they hear is how we get the best care in the world, so changing the system would result in a lower standard of care. I don't understand how anybody could look at the data and come to that conclusion, though:
/>
-
I've been down this road too many times to risk my good relationship with @1to392831weretaken
I don't think US health insurance or health delivery is gold standard regardless of other nations which IMHO are irrelevant to this anyway. The US is a big old melting pot of a lot of different people including a lot who left those other countries
I would like a better insurance and delivery system. I would like to keep the standard of care which again IMHO is pretty darn good if you can get it
I think the last attempt got us or me for sure, further from that goal.
I'll take my answer off the air
