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Old 08-19-2015, 10:06 PM   #41
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No US politician is advocating for single-payer.

Even then, the US infrastructure seems to tend towards higher costs than other countries with single-payer.

You'd have to overcome ideological opposition not only to government paying for everyone's health care, there would have to be acceptance of the govt. pressing providers (hospitals, pharmaceutical companies, etc.) to take lower and transparent, consistent pricing for health care.
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Old 08-20-2015, 12:05 AM   #42
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Who here has car insurance provided thru an employer… where the employer selects the companies and policy coverage options… what a mess… imagine how much worse if they made health insurance coverage something to be provided by employment…
And then when you lost your job you'd lose your car insurance, too! Either type of insurance tied to employment is an illogical concept.
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Old 08-20-2015, 06:57 AM   #43
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Allowing insurance to cross state lines is a no brainer that should apply to Obamacare or any alternative. Also, allowing Medicare to negotiate drug prices with the manufacturers or insurers is another obvious one. Not getting dinged for pre-existing conditions is probably a must have provision as there are too many people in that situation.
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Old 08-20-2015, 10:02 AM   #44
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Allowing insurance to cross state lines is a no brainer that should apply to Obamacare or any alternative.............
While it seems like a no brainer, I think that Katsmeow brings up a critical point, below. There really has to be some Federal level guidelines to ensure it is not a race to the bottom.

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.............
If insurers could sell across state lines, don't you think that they would want to go to to the states that regulated premiums and consumer protection the least? Be careful what you wish for.....
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Old 08-20-2015, 11:08 AM   #45
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Allowing insurance to cross state lines is a no brainer that should apply to Obamacare or any alternative.
It might work but it wouldn't be an easy over night change.

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The failure of Georgia’s Interstate Experiment
Within the health-wonk community, a recent article from the Atlanta Journal-Constitution has made waves, in which Carrie Teegardin reports that an experiment in interstate insurance competition doesn’t appear to be working.


In 2011, Georgia passed a law allowing people to buy insurance from out-of-state carriers. But not one out-of-state insurer has sought to do so. “Nobody has even asked to be approved to sell across state lines,” Georgia Insurance Commissioner Ralph Hudgens told Teegardin. “We’re dumbfounded. We’re absolutely dumbfounded.”

http://www.forbes.com/sites/theapoth...-reduce-costs/
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Old 08-20-2015, 12:02 PM   #46
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I am not holding my breath for the day when all states agree on a common set of regulations regarding health care.

Look at Canada for example. Each province has a different set of rules and regulations. I talked to an RV park owner in Nova Scotia who maintained a residence in Alberta because he liked the coverage there better. In fact, his wife had just flown back there for medical treatment for a serious illness when I was talking to him.
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Old 08-20-2015, 02:31 PM   #47
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No US politician is advocating for single-payer. Even then, the US infrastructure seems to tend towards higher costs than other countries with single-payer. You'd have to overcome ideological opposition not only to government paying for everyone's health care, there would have to be acceptance of the govt. pressing providers (hospitals, pharmaceutical companies, etc.) to take lower and transparent, consistent pricing for health care.
Bernie Sanders wants a single payer system. He wants to expand Medicate to cover everyone.
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Old 08-20-2015, 02:39 PM   #48
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It is time to stop "tinkering" with the U.S. healthcare system and in fact reform it once & for all. The U.S. does not need a "GOP" plan or a "Democrat" health plan but rather universal access to quality healthcare.
Unfortunately the US legislature consists of Reps and Dems.....and a few independents.....so any solution will necessarily involve the political parties. The ACA is a very flawed attempt at some middle ground, but costs are the real problem and I see the US as very I'll equipped to come up with a solution.

It will take a health care crisis of similar scale to the 2008 banking crisis for anything to change. The vast majority of other countries have found solutions ranging from single payer to regulated private insurers and a US solution exists. But ideological stances in the US work against actual solutions.
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Old 08-20-2015, 03:46 PM   #49
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.......It will take a health care crisis of similar scale to the 2008 banking crisis for anything to change. ........
With health care costs outstripping inflation for years now, eventually it will create its own crisis. It is a mathematical certainty.
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Old 08-20-2015, 04:09 PM   #50
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And then when you lost your job you'd lose your car insurance, too! Either type of insurance tied to employment is an illogical concept.
+1 A critical first step for healthcare reform would be to divorce health insurance and employment. IMO, the resulting larger pool of insureds would make individual health insurance more affordable, there would be more competition.... I think it would be a very good thing albeit difficult politically. Employers could subsidize health insurance by contributing to a HSA on an employee's behalf.

I also think there needs to be more mandated transparency about the cost of procedures so consumers can price and comparison shop if they want to.... if they decide not to then fine, but they should be provided the information to make that choice.
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Old 08-20-2015, 04:13 PM   #51
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+1 A critical first step for healthcare reform would be to divorce health insurance and employment. IMO, the resulting larger pool of insureds would make individual health insurance more affordable, there would be more competition.... I think it would be a very good thing albeit difficult politically. Employers could subsidize health insurance by contributing to a HSA on an employee's behalf.

I also think there needs to be more mandated transparency about the cost of procedures so consumers can price and comparison shop if they want to.... if they decide not to then fine, but they should be provided the information to make that choice.
Totally agree, and the two ideas are tied together. With the insured oblivious to both the premiums and the charges for services it was easy for costs to balloon.
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Beginning of a GOP alternative to Obamacare?
Old 08-20-2015, 04:20 PM   #52
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Beginning of a GOP alternative to Obamacare?

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+1 A critical first step for healthcare reform would be to divorce health insurance and employment. IMO, the resulting larger pool of insureds would make individual health insurance more affordable, there would be more competition.... I think it would be a very good thing albeit difficult politically. Employers could subsidize health insurance by contributing to a HSA on an employee's behalf.

I also think there needs to be more mandated transparency about the cost of procedures so consumers can price and comparison shop if they want to.... if they decide not to then fine, but they should be provided the information to make that choice.

No disagreement with you at all, but if this ever happened you know the workers currently receiving this benefit would get the royal shaft without a preparatory greasing. They probably would get half of it added to their salary and the other half would mysteriously disappear into the monthly company cashflow statement!


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Old 08-20-2015, 04:22 PM   #53
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While it seems like a no brainer, I think that Katsmeow brings up a critical point, below. There really has to be some Federal level guidelines to ensure it is not a race to the bottom.
I am not sure I follow this concern. Its all about creating unfettered competition across all state lines, and no states should be able to regulate more or less than any other.
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Old 08-20-2015, 04:26 PM   #54
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No disagreement with you at all, but if this ever happened you know the workers currently receiving this benefit would get the royal shaft without a preparatory greasing. They probably would get half of it added to their salary and the other half would mysteriously disappear into the monthly company cashflow statementour quarterly dividends!
FIFY. Just kidding. No, you are right, that is a potential issue but if you implemented it during a time of high demand/low supply of human capital then employers would have an incentive to try to be fair. I wouldn't even mind mandating that employer's provide an explanation of their expected health care subsidy costs before and after enactment.... mind you, not mandating that they have to make employees whole but rather that they have to disclose what they did so employees and investors can see whether employees were made whole or not. It would be sort of fun to watch. I actually think that many employers would play fair.
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Old 08-20-2015, 04:30 PM   #55
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I also think there needs to be more mandated transparency about the cost of procedures so consumers can price and comparison shop if they want to.... if they decide not to then fine, but they should be provided the information to make that choice.
+1

35 years ago, my employer then, a large engineering and aerospace corporation, already saw that medical costs were spiraling out of control. Along with other private employers, it pushed for health care reform in the state via a proposition. I remember that pricing transparency was one of the desired changes. I was young and did not even have my 1st born yet, so did not think much about this subject, nor had any life experience with healthcare to have much of an opinion. Hence, I did not follow it closely to see how the proposition failed, but I recalled people saying that local hospitals and clinics used scare tactics for voters to put their thumbs down on the change.

I do not believe that one price can fit all, when you talk about hospital costs or much else. I do not know exactly how it works in other countries, but an upscale clinic should be allowed to charge more, and they should not be shy to post their prices. If your insurer only allows so much for an operation, but you want to stay in a place that serves filet mignon cooked by the bedside covered by 1000-thread-count sheets and do not mind to pay extra, you should be free to do so. It is no different than some employers allowing a certain per diem for business travel, and if you want to pay extra to stay in a 5-star hotel you are welcome to do so.
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Old 08-20-2015, 04:36 PM   #56
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[QUOTE=pb4uski;1625997]FIFY. Just kidding. No, you are right, that is a potential issue but if you implemented it during a time of high demand/low supply of human capital then employers would have an incentive to try to be fair. I wouldn't even mind mandating that employer's provide an explanation of their expected health care subsidy costs before and after enactment.... mind you, not mandating that they have to make employees whole but rather that they have to disclose what they did so employees and investors can see whether employees were made whole or not. It would be sort of fun to watch. I actually think that many employers would play fair.

My GF works for a large Fortune 500 company with paid for premium with $150 yearly deductible. She has NO CLUE how much she would have to pay monthly for a gold plated plan like that. And she even complains about the deductible!


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Old 08-20-2015, 05:08 PM   #57
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No disagreement with you at all, but if this ever happened you know the workers currently receiving this benefit would get the royal shaft without a preparatory greasing. They probably would get half of it added to their salary and the other half would mysteriously disappear into the monthly company cashflow statement!
It would also be an interesting discussion when the old health care premium was added to the base wage and the young single guy realizes that the old family man got a much larger raise simply for having more dependents.
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Old 08-20-2015, 05:08 PM   #58
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I am not sure I follow this concern. Its all about creating unfettered competition across all state lines, and no states should be able to regulate more or less than any other.
That would be great if that was so. But, it isn't so... at least it hasn't been in most of the across state lines proposals that have been made.

Sure, if every state had to regulate insurance companies the same as others then competition across state lines would be fine (in my opinion).

But, in the actual real world, they don't have to do so. States actually do vary tremendously in their regulations of insurers and in how they handle things like rate increases or other consumer protections. Simply allowing insurers to compete across state lines does not change that.

So, in the actual real world, it would be like what happened with credit card companies. A race by some states to regulate the least so as to bring more insurers to that state.

I agree this could be fixed by having minimum standards that would have to be met...but that isn't what is being proposed.
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Old 08-20-2015, 05:14 PM   #59
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It would also be an interesting discussion when the old health care premium was added to the base wage and the young single guy realizes that the old family man got a much larger raise simply for having more dependents.

That would be another hornets nest wouldnt it...Equitable distribution of the monies...And no doubt many companies give that kind of bene for family fertility success...


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Old 08-20-2015, 05:21 PM   #60
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But ideological stances in the US work against actual solutions.
The problem is that healthcare in the U.S. is treated like any other commodity. We are witnessing the same approach now in public education and to varying degrees, other municipal services like water & public safety.
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