As soon as you start handing out something for "free", even if it isn't truly free, sooner or later even ordinarily hardworking people are going to say "why should I pay for it?" when some get it for nothing. Any candidate that preaches that they can mix and match government and private health care has one thing in mind. I'm glad the Governor of Hawaii saw what was happening and put a stop to it. If you are truly needy then yes there should be help for you. But if you can afford it, then leave the plasma tv on the shelf and buy the health insurance.

http://news.yahoo.com/s/ap/20081017/ap_on_he_me/child_health_hawaii

"People who were already able to afford health care began to stop paying for it so they could get it for free," said Dr. Kenny Fink, the administrator for Med-QUEST at the Department of Human Services. "I don't believe that was the intent of the program."

Unfortunately when this is tried at the federal level, and it will be, instead of scrapping it the program will just continually expand until it is nothing more than a bloated carcass that all the parasites are feeding off of. Why be responsible for yourself when you can let the government be responsible for you?

While I believe basic and preventive health care should be available to all childred I think the state of Hawaii implimented the program wrong.

Why would a family pay for coverage through their employer when they could qualify for the other insurance? Maybe instead of scrapping the program they should charge you for it if you have it available through your employer? Or maybe an income cap. If you make more then $XX you're not eligible?

Just a thought.

Quoting ADXMatt (Reply 1): Or maybe an income cap. If you make more then $XX you're not eligible? Just a thought.

That is EXACTLY what Oregon does. If a single person makes less than (I think) 300% of poverty level, they can qualify for the state health care. I don't know what the family income level is, but there is one. Unfortunatly, there is nothing for those who are earning more than poverty level but still do not qualify for OHP because of income. Those are the people that can not afford health care because they have to pay for food, rent, and utilities.

Before everyone starts screaming until they are blue in the face about the horrors of socialized medicine, take a look at what the feds are actually trying to work on instead of "this is how it is in one state, so we should abandon it completely."

Quoting Seb146 (Reply 2): Before everyone starts screaming until they are blue in the face about the horrors of socialized medicine, take a look at what the feds are actually trying to work on instead of "this is how it is in one state, so we should abandon it completely."

And exactly what would it be that the "feds are actually trying to work on"???

So one state made a poor attempt to try and implement government sponsored health care and failed and that is all the evidence we need to never have NHC? Right. Bear in mind that millions of Americans are who are above the poverty line and (in theory) can afford private health care are in the middle class which is being squeezed ever tighter. When health care insurance costs as much as $10K a year it's not easy for a family when they also have to pay for housing, food, transportation, etc.

NHC does have its flaws and if implemented without the correct safeguards it can become very costly to the public. However, I have seen way too much evidence that our current system has failed to not want to try something new. We know about the 40 million or so that are uninsured but do we hear about the rest who have coverage and still end up paying thousands of dollars just to receive basic care? Something's not right when private plans drop people left and right just because they are "expensive" patients (as one insurer put it) or when college educated, hard working, tax paying professionals (many of whom I know) end up with debt passing $20K because their employer provided insurance barely covers the minimum. I know several doctors who are close to changing careers because they are under constant pressure to bring profit to their bean counters that simple (and often needed) tests for patients have to be justified until they are blue in the face. Let's face it, private industry is only concerned about profits (and rightly so), not if a particular patient is healthy or not. And all for what, so that I can have lower taxes while my health deteriorates and not receive the medical attention I deserve when my number's up?

We do a good job gloating around the world about how we are the most prosperous nation in the Earth, ever; you would think we could do something about the health of our own people.

I had routine blood work done a few months ago. I received my EOB from BCBS and Lab corp billed them over $900.

With BCBS "contracted" rate it was down to less then $100 and thats what they paid.

Obviously the true cost to Labcorp was less then $100 as they are not an airline and would not contract a rate that would cost them money.

Then why is it that they bill this super high rate? If I didn't have insurance I wouldn't get this "discounted" rate and would have to cough up $900. How can LabCorp justify charging a "cash" customer so much?

This was just routine wellcare. I can only imagine what the cost is if someone was actually sick and need expensive tests.

Quoting Charles79 (Reply 4): We do a good job gloating around the world about how we are the most prosperous nation in the Earth, ever; you would think we could do something about the health of our own people.

Or you would think that our citizens would drop the expensive new gadget in favor of picking up the proper plan. What ever happened to "personal responsibility"? Now days is seems it's the "governments responsibility".

As noted in the story, no truly needy children in Hawaii will be left without health coverage as other state programs are available to them.

Quoting Seb146 (Reply 2): take a look at what the feds are actually trying to work

Lets take a look at the three programs the feds do run, The VA(Veterans Admin), IHS (Indian Health Service), and the DOD (Department of Defense).

Not one of those programs have historically or currently been able to be held up as a model of what a health care system can and should be. If the feds can't run these three smallish programs why do you think they can run a national program?

Quoting ADXMatt (Reply 5): With BCBS "contracted" rate it was down to less then $100 and thats what they paid. Obviously the true cost to Labcorp was less then $100 as they are not an airline and would not contract a rate that would cost them money. Then why is it that they bill this super high rate? If I didn't have insurance I wouldn't get this "discounted" rate and would have to cough up $900. How can LabCorp justify charging a "cash" customer so much?

This system of differing rates is definately part of the problem. If people where charge reasonable charges for their lab work and tests then you would see more cash transaction. Add to that the complex coding system. All that admin costs money and drives up costs.




Again, national health care is just rationed health care! At what point do you stop? I could see the day where people could be forced into "Camps" against their will to "treat" for risk factors such as weight and smoking.

I think in Australia they have a 2 part program with a public system one can be part of and pay a premium and co-pays based on their income or have a private policy which can give you more flexibility of choice of doctors and other services. Having a mandate of some medical insurance, either via the NHC program as expansion of Medicaid along with the private policy option might be the best way to go in the USA.

There would also have to be sufficient incentives in an NHC to encourage healthier lifestyles, weight control, getting proper preventive tests and care depending on need and family history. You would need sufficient controls to limit possible abuse. It must allow sufficient authority of doctors and patients to make the decisions as to what is best. While there needs to be reductions of underutilized facilities, we don't want any 'rationing' or excessive use of facilities.

The most important things are to make sure one can get the care they need with a minimum of hassles, improve the quality of life of all as well as prevent the impoverishment of those that need medical care and their families.

Quoting L-188 (Reply 7): All that admin costs money and drives up costs.

   The administrative costs of the multi-payer system add a layer of costs when compared to the single-payer system.

Quoting Michael Kirby & Wilbert Keon, “Why Competition is Essential in the Delivery of Publicly Funded Health Care Services,” Policy Matters 5, no. 8 (2004): 11.: The single-payer system also substantially reduces the administrative cost to hospitals of processing and administering health insurance claims. For example, a 2004 study** (using 1999 figures, in US dollars) concluded that the overall administrative costs (including hospitals and doctors’ offices) accounted for 31 percent of total health care expenditures in the US ($1,059 per capita), compared to 16.7 percent in Canada ($307 per capita) (Woolhandler, Campbell and Himmelstein 2004). If its administrative costs were the same as Canada’s, then the United States would save $209 billion per year, more than enough to insure the 40 million Americans who currently have no health insurance. Examining insurance overhead only, the overhead cost per capita for health care insurance was $259 in the US, compared with $47 in Canada, representing 5.9 percent and 1.9 percent of total health care expenditures, respectively. **Steffie Wollhandler, Terry Campbell, and David Himmelstein, “Health Care Administration in the United States and Canada: Micromanagement, Macro Costs,” International Journal of Health Sciences 34, no. 1 (2004).

The quote feature is being wonky, so I couldn't include this in my previous post...

Quoting L-188 (Reply 7): I could see the day where people could be forced into "Camps" against their will to "treat" for risk factors such as weight and smoking.

Are you implying that government funded health care would lead to WWII style "forced" "camps"?

Quoting ADXMatt (Reply 5): I had routine blood work done a few months ago. I received my EOB from BCBS and Lab corp billed them over $900. With BCBS "contracted" rate it was down to less then $100 and thats what they paid. Obviously the true cost to Labcorp was less then $100 as they are not an airline and would not contract a rate that would cost them money. Then why is it that they bill this super high rate? If I didn't have insurance I wouldn't get this "discounted" rate and would have to cough up $900. How can LabCorp justify charging a "cash" customer so much?

The first thing that needs to be done to fix our health care mess is some sort of price parity. If you compare what the government pays, what insurance companies pay, and what uninsured persons pay, you'll come up with wild variances. It would be worth having Blue Cross even if they didn't pay any claims just to get the discount rates.

Your example was for outpatient lab work. It gets worse when you look at inpatients. Medicare pays according to the DRG and all the big insurance companies have followed suit. The hospitals get paid a set fee per procedure. This is a big incentive for them to get you in and out. For example, if you have an appendectomy, the hospital is paid the same whether you're in overnight or for a week. That's why they're pushing you out the door.

We really need a single payor system administered by private business. People could buy additional coverage if they desired, similar to Medicare supplements.

Quoting SKYSERVICE_330 (Reply 10): Are you implying that government funded health care would lead to WWII style "forced" "camps"?

Yes.

Probably closer to a victorian style "Debtors" prison where you have to stay until the government forces you to work through whatever issue you have though.

After all if they don't follow their doctors instructions it will be costing the government money.

Quoting L-188 (Reply 12): Yes. Probably closer to a victorian style "Debtors" prison where you have to stay until the government forces you to work through whatever issue you have though.

Oh yes, because this is what has happened in every other country with nationalized healthcare.

Quoting L-188 (Reply 12): Yes. Probably closer to a victorian style "Debtors" prison where you have to stay until the government forces you to work through whatever issue you have though. After all if they don't follow their doctors instructions it will be costing the government money.

May I respectfully suggest that you travel to Scandinavia, Canada, France or the Benelux (and a bunch of other places) and take pictures of the camps you mention?

 

Quoting LTBEWR (Reply 8):

In Australia, everyone pays a 'Medicare levy' of 1.5% of their income, and those on incomes of more than $50,000 p.a. for singles (soon to be more than $100,000) pay an extra levy of 1% if they do not have private health insurance.

Those in the public system have access to the usual medical care however for things like elective surgery, you do not have a choice of surgeon & you can be on a lenghty waiting list depending on your condition. Those with private cover have a choice of surgeon, usually treated in private hospitals depending on the condition & are not subject to lenghty waiting lists. Private cover also covers things like chiros, physio & remedial massage where those on Medicare have to pay full rate

http://en.wikipedia.org/wiki/Medicare_(Australia)