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ANef_is_Enuf's avatar

Would this approach to universal health care be feasible?

Asked by ANef_is_Enuf (26784points) March 8th, 2017

Note: I’m not asking for opinions on what you think should be done about health care. I just want to know if this would be an unrealistic angle.

If we were to have universal coverage for children and seniors and then have limited, but mandatory coverage for preventaitive medicine, chronic conditions such as diabetes and for life threatening illnesses like cancer. But, that all other insurance would be up to the individual? Broken bones, colds, green toenails, whatever – that coverage would be separate. Would that help to alleviate some of the concern that universal health care erodes the integrity of the care available to everyone? While still ensuring that people aren’t dying because they can’t afford insurance?

What are some of the flaws in this concept and how could it be improved upon?

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23 Answers

funkdaddy's avatar

I believe the concern would be that your listed items that are covered would be 90+ percent of the total costs of healthcare.

The only things I see that would be a major category and not explicitly listed would be pregnancy care for mothers/babies and drug costs.

Everything else is pretty cheap. So you’d be mandating the majority of healthcare. Why not go 100% at that point.

not knocking your ideas, just giving an idea of what the knocks would be

ARE_you_kidding_me's avatar

I like the idea of catastrophic care and it makes sense. Reducing healthcare cost should be paramount to any healthcare reform though. Lawyers, insurance and pharm companies have pretty well got control.

LuckyGuy's avatar

I like the way you approached this. You split things up like car insurance: collision, comprehensive, fire and theft. I don’t have the numbers so I can’t give a good answer.
But I would say that a plan that makes people take some responsibility (cost) for their own health has a better chance of success.
If the condition is something within your control it should always cost something to use medical services. Even if it is only $1. I don’t care if the person is on total disability or begging in the street with zero income. There should be a charge proportional to income.and ability to pay.
That number would then be multiplied by a “responsibility factor” which can be anywhere from zero to 100%. For example, if there is a terrorist act and you happened to be hit with a piece of shrapnel, you have zero responsibility and society will pay 100% of your bills. If you were drinking a driving and hit a light pole, you are 100% responsible and you must pay the charge based upon your ability to pay. If your leg was broken because you were hit by a drunk driver who hopped the curb you would pay nothing. If you broke your leg skateboarding down the banister of a public facility you would pay the full price. Actuaries would work out the chart of responsibility factors – and these factors could be further adjusted depending upon the programs financial state.

gorillapaws's avatar

Broken bones can become life threatening—so can an infected toe nail. Also you don’t want to have lots of people running around with untreated communicable disease spreading infections. What an absurdly perverse healthcare system that would be. Also as @funkdaddy pointed out, you’re including the costs of the most expensive parts of healthcare and making small exclusions that will save negligible money and may even cost the system more if you have lots of untreated sick people spreading diseases to those that are covered.

Most people don’t go to the doctors for the hell of it, they go because they’re having a problem (usually more serious than a cold). Having a healthy population means you have more productive workers which is good for business. This is pennywise/pound foolish thinking.

kritiper's avatar

Health care should be the same for all. Nobody should have to lose their homes, cars, and everything else they own to go live on the street just because they got sick.
And no health care system is going to work without controlling the high costs of insurance, drugs/medicines. hospitals, doctors, etc. If it means socialization, then so be it. Whatever makes it work!

Espiritus_Corvus's avatar

You’ve fallen into the trap of re-inventing the wheel. Single Payer universal healthcare
as practiced in Scandinavia and other western European countries, covers all of this equitably and cuts out the unnecessary and expensive corporate middleman. If you open the link that I gave you, you will see that a very good, working model is already in existence.

What the article doesn’t tell you, and few Americans realize, is that personal liability insurance on cars, businesses, homes and other property is unnecessary when everyone is covered from conception to grave. Think of the discretionary capital you would have left over every month if your auto insurance alone was under $75 per month because your insurance company no longer must fight off and pay out millions because you hit a young motorcyclist who would then require intensive nursing and meds for the rest of their long life due to quadriplegia.

The ACA is a failure because Single Payer was taken off the table in the first days of development and the Republicans are right—what you have is an inefficient, expensive disaster. I haven’t read their new 71-page replacement package yet, but if it doesn’t cut out corporate, for profit, stockholder-held entities and does not involve the incredibly powerful collective bargaining of one nation of 300-odd million healthcare consumers for meds and services—then it is a scam.

Wake up.

ARE_you_kidding_me's avatar

Don’t hold your breath, I think their plan will be shitty too. I took a lot of flak from folks because I did not support the ACA. I would like to see a single payer system over that hands down.

stanleybmanly's avatar

The problem I see with the plan lies of course with that population that isn’t juvenile or elderly. All of us agree that it is better that individuals bear some responsibility for their health, but for a society overall, I think this is the wrong approach, because the issue boils down to just where to draw the line on that responsibility. I mean, we can pass laws making it a felony to not brush your teeth. I think the fundamental flaw with the view of we Americans is in the archaic supposition that since it is the individual who gets sick, it’s up to him to get better. If his immune system or wallet aren’t up to the task, oh well——.

There was a time in this country when it was recognized that certain responsibilities regarding the overall good of the society MUST be assumed by the society at large. To a large extent we do this with healthcare but stupidly, and usually when death is imminent. And the costs are brutal, both financially and statistically. We’ve mastered the art of rushing junkies to the hospital regardless of whether or not they can pay for it. Private health insurance is never going to get the job done. The variability in people and conditions is just too great. There are those with good health habits, and those without. Those predisposed and vulnerable to some things and resistant or immune to others. In an advanced society, the only equitable way to balance out the variables is to distribute the weight over us all.

funkdaddy's avatar

@LuckyGuy – How would you determine responsibility for health related issues? I think that’s impossible in a huge variety of cases. You’ll end up with an even more litigious society.

Let’s say I fall down the stairs. Is that my fault? Is it the same answer if I’ve had a drink? How about 5? If I’m carrying a child? Is it the child’s fault because they knocked me over? Can you imagine giving my health insurance the option to instead defer that?

How about cancer? Is skin cancer my fault? What if I love the sun? How about rectal cancer if I eat red meat? Lung cancer if I’ve smoked?

How about any of the major killers? Are heart attacks the patient’s fault? Diabetes? Stroke? In what percentage?

I don’t believe that will ever work with healthcare. We know far too little.

It works with cars simply because everyone is supposed to be insured and the insurance companies negotiate who is paying what to limit each company’s liability. It works because everyone gets paid and everyone’s premium goes up.

That’s not an improvement for health insurance for anyone but the companies writing the policies.

ANef_is_Enuf's avatar

@funkdaddy it’s fine for anyone to “knock my idea,” because I’m not saying this is what I think should happen, I’m just thinking.
I support universal healthcare and hope to see that happen, but I am also interested in alternatives just because I think it’s good to consider all angles.

Espiritus_Corvus's avatar

Edit, my last post above: “Think of the discretionary capital you would have left over every month if your auto insurance alone was under $75 per year…”

Also, think of this: No longer would “slip and fall” scams be profitable, no longer would there be dangerous two car teams on the highways to force you into an accident for insurance settlements. No longer would scamming insurance companies be an expensive problem for the rest of us.

At my last count, there were 700,000 licensed lawyers in the US. A large portion of these use their noble educations to become “ambulance chasers” who never go to trial in their entire careers. These expensive slimeballs who drive up your monthly insurance costs will finally be eliminated and forced to actually practice American law or GTFO of the profession.

You don’t have to be a whiz at basic arithmetic to see that the money you save on liability insurance will more than pay any increase in taxes for a national universal healthcare single-payer plan. When I lived in Sweden, I had twice as much discretionary capital left over every month than my mother in the US—who owned a business, a home and a car for which she paid through the nose for liability insurance policies—even though I paid nearly 20% more in income taxes on the same annual income. And that 20% extra in taxes paid for much more than national insurance.

Hawaii_Jake's avatar

The voice of doom: As long as there are people getting rich off selling health insurance, we will never have adequate health care coverage in the USA.

Espiritus_Corvus's avatar

@Hawaii_Jake That’s bullshit, pal. If you want to doom this effort toward rational universal heathcare, just keep up that defeatist attitude. When the push for our first universal healthcare program—the ACA—was in development, suddenly you saw certain pharmacies in stores like Safeway, Walmart and Publix offering antibiotics free of cost for low income consumers and previously unknown programs directly from pharmaceutical companies offering expensive, life-saving drug treatments—such as Epoetin which cost over $1,500 per injection per week— free of cost to people who could prove low income upon a rather long application process.

They bent in fear that we would end up with single-payer system. They bend every time the barricade is pushed. We are slowly winning. We can win.

So, it only makes sense to keep pushing on the barricades. What choice do you have? To accept lies and bullshit from these guys and live out your life in humiliation knowing that you never even tried to force change—the humiliation of a person whose job it is to deliver healthcare and who just laid down and let the corporate world fuck your patients?

How do think kingdoms run by governments dependent upon corporations for their wealth under kings with such ridiculous powers as Divine Right were forced to finally take on Social Democratic values in just two generations? They sure as fuck didn’t do that under pressure from citizens with attitudes like yours. Read history. It helps to open you into realms of possibility.

There are more than 300 million of us and only 535 members of the upper and lower houses of Congress. Even without democracy, these are bad odds for our representatives. All it takes is a little education and the fire will take hold. For obvious reasons, that education has be initiated from somewhere else than the media.

If you agree with the statements I made in the posts above—after verification—then spread the word at every opportunity—on the net when the subject comes up, among people in your profession who express curiosity as to alternatives to what we have, to your lovers if they ask your opinion on national healthcare. Don’t force feed. But build the fire. Keep emotion out of it. Do your part. Be a true advocate for your patients.

@LuckyGuy “Even if it is only $1. I don’t care if the person is on total disability or begging in the street with zero income. There should be a charge proportional to income.and ability to pay.”

That is precisely what our present graduated income tax would do if we had single-payer national healthcare.

Hawaii_Jake's avatar

@Espiritus_Corvus I do not understand the extreme response. Your example of the pharmacies suddenly giving away free antibiotics in order to mitigate the type of legislation that eventually became the ACA proves that the entrenched moneyed interests will go to great lengths to protect their money.

I want to see a radical change to the entire system in the USA. I do not like the current system in the least, but I am saying that there are very rich interests who want to keep the system the way it is. It will take a revolution to change it. I have not said a revolution is impossible; I have said a revolution is highly unlikely.

Espiritus_Corvus's avatar

Revolution? Are you talking about .357 magnum revolvers up against choppers bristling with .50 caliber M-60s and flights of aircraft that can vaporize the south side of Chicago in seconds? Don’t be ridiculous, Jake. Just keep educating people. Enough people will eventually see the rationality in a single payer system and force the government to accept it. Maybe not in your lifetime, but sometime in the future.

Remember the statements made before Obama concerning national healthcare in the States? It wasn’t that long ago, Jake. People overwhelmingly said that America would never get universal healthcare—for the exact same reasons you state above. But we did, and a lot sooner than many of us ever believed. And that in itself has been an education.

What we all know now is that there is a such thing as bad universal healthcare, half-assed, bullshit universal healthcare—an obvious compromise forced through by a totally freaked out industry. Now, we must tweak it into single-payer. They bend, Jake. They know they are outnumbered and the programs you saw pop up during ACA development were the sign of an industry shitting their pants in fear.

You think my response is extreme? Is it extreme to insist that a patient advocate fight for patient advocacy? Seriously man. Drop that Gen-X sensitivity and cowardice, and do your job.

ARE_you_kidding_me's avatar

No need for a revolution, just the right reform that takes the commercial interest in health insurance down a notch. We have waay too many Lawyers and accountants in the loop.

Hawaii_Jake's avatar

I feel very exposed right now. I have been told my words are bullshit, and because I choose to be open, my name is now all over the place in an impassioned post telling Jake everything he is doing wrong.

Signing off.

Espiritus_Corvus's avatar

No. Not all your words, Jake. Just the part where you stated falsely that “As long as there are people getting rich off selling health insurance, we will never have adequate health care coverage in the USA.”

Stop taking everything so goddamned personally. You are needed in this fight.

ARE_you_kidding_me's avatar

I’m actually going to take Jakes side on this one but not to that extreme. I think the whole healthcare system has too many hands in the cookie jar.

ANef_is_Enuf's avatar

I don’t disagree with the need for revolution and I don’t think that it will be simple or easy to take the power/money from the top. That’s a big problem, which I think (??) most Americans agree upon, in one regard or another. I could be mistaken.

I don’t think that revolution can’t be lead by education and advocacy. I definitely believe that is the heart of it, if not the whole of it. I like to hope it can be the whole of it, but whether it will go that way remains to be seen.

ragingloli's avatar

“For example, if there is a terrorist act and you happened to be hit with a piece of shrapnel, you have zero responsibility and society will pay 100% of your bills.”
Insurance agent: “I am sorry, but if you had not chosen to be there, you would not have been hit by shrapnel. We will not cover a single cent.”

JLeslie's avatar

I think it’s too complicated, even though it sounds simple.

What happens if the flu turns into intensive care pneumonia? Think about home insurance, if my house floods because a windstorm breaks a window and lifts off part of the roof, my flood insurance doesn’t cover it, because the wind was the culprit, and if I don’t have windstorm insurance I’m screwed.

In Florida for many years there has been state insurance for children, I think there was a minimal fee parents paid, this was way before ACA, and of course the elderly had Medicare. So, we have some models in the country we can look at and see how well they work.

I think if you have minimal insurance, people mostly need catastrophic care, not the basic, preventative care, and will they purchase catastrophic privately to fill the gaps? The catastrophes are what ruin your life financially. True, preventative care can help avoid catastrophes, so there is a cost benefit calculation to be done. Things like childhood vaccination we want for all children, and some diagnostics like Pap smear, colonoscopy at 50, mammogram after 50, all that I agree would be nice as a “free” service paid by taxes. I want single payer altogether, but this Q isn’t about what I want.

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