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Old 04-27-2004, 06:57 PM   #1 (permalink)
Psycho
 
Location: NC
Just the issues...

Since every Bush supporter thinks Kerry is an asshat and every Kerry supporter thinks Bush is a bigger asshat, let's change the tone here. I'd like, when you have a bit of extra time, to give me your take on a hot-button issue, and what YOU WOULD DO TO FIX IT!

I don't care what party your in, I don't care who your voting for. I want your issue with your repair. Then, we may just get somewhere in understanding each other's positions instead of picking sides and tossing diatribes and rants at each other.


My issue: Healthcare Reform.

Yes, the abuses of the past have made it what it is today, and even attracted its own parasite ( the trial lawyers), but something has got to give. Normal household budgets cannot afford it. Health insurance is skyrocketing and coverage is collapsing. I pay twice what I used to for half the coverage. AND I WORK IN HEALTHCARE!!!

We have to start by tort reform! There is no other way. Most of our emergency rooms are being strangled by physicians ordering tests based on their ability to win in a lawsuit versus the true needs of the patient. Luckily for patients, the physicians order more comprehensive studies than are required to ascertain their condition.

Case in point...You enter the ER with an atraumatic headache. Now, each patient that enters the ER with a headache always rates their pain as excrutiating. Well, maybe one out of ten actually are. And that's generous. Most are people seeking attention, a work excuse, or narcotics. A full one out of ten will actually look as if they're in pain and deserve the benefit of the doubt. So, one out of ten actually would compel you to work them up.

Now a good eight of these ten will get a very simple and safe exam called a CT scan of their brain. These are relatively quick to perform, BUT COST OVER TWO THOUSAND DOLLARS!!!. These are done mainly to absolve the ER physician of any liability because he worked it up to the fullest of his capabilities.

Now the chances of any of these actually having any radiographic descernible pathology is minute, however I'm all for trying to diagnose real pain, but DAMN two thousand a pop? In the old days, a doc would do a quick exam to rule out any focal neuro defecits, give you something for the pain and tell you to come back the next day if it didn't help.

He can't anymore, the risk of a lawsuit can truly put him in the poorhouse. Lose a case and you may not be able to afford to work.
Doc's can't work parttime anymore either, because the of the same reason: malpractice insurance is too high (even for those who have never been sued).

So, my point is we have to stop diagnosing people by the lawyers rules. They are going to have to bear some brunt of the costs of litigation.

Firstly, I would set a cap on lawyer fees.

Secondly, any one sued for malpractice may, at the same time, counter sue for legal fees if a case is found to be meritless, with the attorney footing the bill. A good portion of lawsuits are settled with the insurance company extorted into paying a lower price for a pay off, than higher one for a court win.

Thirdly, I would privatize medicare. Look at Blue Advantage, their doing good reimbursement as cheap as medicare.

It's gotta start with tort reform, any other attack will have no teeth!!

I hope this is somewhat cohesive, it's late for me.

So, debate mine or post your own.

BUT LET'S HIT THOSE ISSUES!!!
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Old 04-27-2004, 07:02 PM   #2 (permalink)
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You really don't want to know what I would do to fix things
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Old 04-27-2004, 07:08 PM   #3 (permalink)
can't help but laugh
 
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Location: dar al-harb
i would debate ya if i didn't wholeheartedly agree with your assessment/solution of this issue.

i would add to your reforms by putting stricter limits on the availability of public health-care monies to illegal immigrants. in many places, it is unlawful for a 911 dispatch to deny someone ambulatory medical service. there are places where an illegal alien can call the ambulance for a sprained ankle, be picked up and treated in an ER, and then released without giving any payment or insurance guarantee.

this isn't a problem on the national level as much as the tort reform is... but it is bankrupting medical systems near the souther border.
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Old 04-27-2004, 07:20 PM   #4 (permalink)
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health system has its own problems and illegal immigrants isn't that big a part of it - its honestly rarely mentioned here anyways
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Old 04-27-2004, 07:31 PM   #5 (permalink)
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Location: wisCONsin
you want to start with health care issues then start with mcdonalds and the fast food nation. this country thinks it can have it all. Crap ass food, and cheap health care. last nite i was in a work meeting to try and get cheaper health care, here they order fast food and some of them are smoking cigarettes. WTF!!!!!!
we need to put a tax, a heavy one on bad unhealthy food and realize what the hell we are doing to ourselves. this is an endless cycle that we need to break. sure you can go after the lawyers, the cost of a doctor....big friggin deal. lets go after the junk food and grease that we are littering our bodies with. I've sworn off chain resturants and junk food and i feel great.

whose with me???

mr b
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Old 04-27-2004, 07:48 PM   #6 (permalink)
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i'm w/ya mr. b in that people can't have it both ways... destroy their bodies then expect cheap healthcare.

but i'd rather not make it the federal governments business to try to regulate my diet and weight (by way of tax). people choose to ruin themselves... but we've got to continue to let people make that choice if that is what they want.

perhaps insurance companies would be permitted to base their premium rates on the body fat levels of their customers? that might be a sticky issue... but if overweight people are soaking up more healthcare money then i don't think it would be unreasonable for them to foot a greater portion of the bill.
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Old 04-27-2004, 07:55 PM   #7 (permalink)
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Quote:
Originally posted by mrbuck12000
we need to put a tax, a heavy one on bad unhealthy food and realize what the hell we are doing to ourselves....

whose with me???
I was with you on everything except this part. We don;t need a tax, we need to be responsible for our own decisions....not tax them so we can continue to make them with the gaurantee that the tax payer will bail you out.

You smoke...you die a horrible miserable lonely death from lung cancer. TOUGH shit.

You eat Big Macs six times a week...you die from heart disease a fat waste of life obese sack of shit. Who gives a rat's ass.

THE LAST thing we need to do is become dependant on sin taxes, to pay for things not even related to the 'sin.'

The ONLY thing we need is to hold people responsible for their actions. It isn't McDonald's fault that you are to weak to say NO or to lazy to prepare a healthy meal for children, nor is it the governments responsibilty to help you through any consequences of your BAD decisions.

I am completely on board with tort reform of the exact nature presented earlier. I fully support law suits or ALL types, frivolous included. It's the looser who should be required to pay ALL COSTS incurred by both sides.

I think the governement which legislates should be barred from exempting itself from anything imposed on the citizens.

Finally, I do not believe that such a thing as compelling government interest should EVER TRUMP the constitution. EVER. If it is compelling then the constitution needs to be changed. Period. No exceptions because five of the nine most removed from the common man elites deem it compelling. If it is that compelling then a change should be rather straight forward.

I've got more from my slightly right of libertarian camp, but I'll leave at this for now.

-bear
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Old 04-27-2004, 08:22 PM   #8 (permalink)
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Location: wisCONsin
I know that people should have a choice to eat what they want and when they want it. BUT....these people that are eating what they want when they want it are making me pay for their poor health when i have to pay for higher health care. Maybe i should have a choice then to pay for lower health care based on my health, what i decided to put in my body.

mr b
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Old 04-27-2004, 10:31 PM   #9 (permalink)
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Actually, most insurance companies do (or at least used to) "rate up" for factors such as overweight, smoker, prior history, etc. Another problem with Healthcare being so expensive is a number of government intrusions into health insurance that try to prevent them from doing so, cuz "it's not fair". It -should- be reasonably expected that someone who could reasonably be assumed to dip into the insurance pool more should pay more for the privelege, but there's too many people who cry that it's unfair that the smoking, overweight, 50 yr old with diabetes and a history of heart disease does not recieve the same rate as the 20 yr old nonsmoker who probably works out regularly and eats right, and has no history of disease. The government listens, passes a law, and the usual result is a reduction in coverage for all, and higher premiums/deductibles/coinsurance percentages, copays, because it's just a cold fact that an insurance company cannot stay in business if it spends more than it makes.

Another issue, in addition to the abovementioned illegals who recieve service and don't pay (in addition to indigents and just-plain deadbeats), your healthcare costs are driven up to subsidize Medicare, which in many cases does not even pay enough to cover the providers expenses, much less allow them to make a reasonable profit (Surprise! a doctor's practice is a -business-, where people expect to be able to make a living!). This is purely anecdotal, but my boss (I work for a Health plan for union employees) told me of a conversation he had with an anesthesiologist who stated that he had given a women a local anesthetic in a shot, and the Medicare payment hadn't even covered the cost of the materials used to administer the drug, much less allow him to be paid for his services. Thus, he has to charge everyone else more to make up the difference.


Quote:
Originally posted by irateplatypus

perhaps insurance companies would be permitted to base their premium rates on the body fat levels of their customers? that might be a sticky issue... but if overweight people are soaking up more healthcare money then i don't think it would be unreasonable for them to foot a greater portion of the bill. [/B]

Last edited by BlueMan; 04-27-2004 at 10:39 PM..
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Old 04-27-2004, 11:08 PM   #10 (permalink)
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Location: College
One health care proposal that I like can be traced back to Milton Friedman. Essentially, the government would provide high-deductable health insurance to everyone. I forget what sort of number he proposed, but it would be in the ballpark of $2000 or more. This would do two good things. One, it would protect families that required very expensive procedures from bankruptcy. Two, it would free insurance companies from having to pay for very expensive operations. This would reduce their claim costs, and make private insurance cheaper for everyone. True, every taxpayer would have to pay for the government insurance, but it's a good compromise that keeps the sytem private, and still makes the system better.

Tort reform is a very touchy subject for me. Frivolous lawsuits are very VERY easy to bash. By taking a more cautious attitude towards tort reform, I risk being unfairly accused of supporting frivolous lawsuits, or whiny victims who want a free ride and mess it up for everyone. But, that's a risk I'm willing to take. This is the tfp after all.

So, all that said, I think tort reform on the whole is a misguided idea, and that the current rhetoric and attitudes towards lawsuits neglect some of the good reasons for having civil law. First, it allows victims to have a recourse. If someone or some group wrongfully harms you, you can be compensated. By the same token, the public enjoys a lot of protections because corporations try to avoid situations that result in lawsuits. These are positive things that must be kept in the system under any tort reform scheme.

I think that making the victims pay all the costs, including the legal expenses of the defendants, is not a good idea. This would deter working class people from filing legitimate suits, and wouldn't stop frivilous ones.

The point of tort reform is that lawsuits are the cause of high malpractice insurance. However, there are other reasons. One is that the insurance companies have poorly managed their money. Another is that bad doctors aren't removed from practice. The old-boy network protects bad doctors, and harms the public. I don't know about you, but I can't think of a single instance of a doctor in my city getting bankrupted by a massive lawsuit. Sure, they complain about malpractice insurance, but I don't think lawsuits are the biggest cause of those increases.

http://www.onlineathens.com/stories/...40307049.shtml

That's an editorial I found that opposes tort reform. I kinda skimmed through it, but other arguments might as well get out there.

So, my solution is the thing I talked about earlier, and perhaps some minor, cautious tort reform. I don't think the system is pefect, but I don't necessarily think it's broken either. Oh, and give bad doctors the punishment they deserve.
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Old 04-27-2004, 11:08 PM   #11 (permalink)
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My two issues would be...

Legalize drugs, tax their sales, spend the proceeds on education and treatment programs. This has been debated on and on, no use in starting it up again, but what we've got going now isn't working, time to try something else.

Number two, I'd reform the tax system. Take out ALL the loopholes. Make it like a progressive flat tax. How much money did you make? Pay X amount. Simple. Currently there's a problem with the tax enforcement where the biggest tax cheats aren't pursued because tracking them down and suing them would consume a huge amount of resources since the cheats have the means to fight the enforcement forever. So many billionaires don't even bother to file tax returns at all. Which leads into my second point, the IRS should be handing out good citizenship awards to citizens who pay their taxes. Perhaps peer pressure could work to make the super wealthy do their part. "Gee Mr. Gates, I don't see your tax payment plaque. Where is it?"

This is kind of a half formed idea, but it might help.
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Old 04-28-2004, 05:09 AM   #12 (permalink)
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Location: Camazotz
Quote:
Originally posted by j8ear
I was with you on everything except this part. We don;t need a tax, we need to be responsible for our own decisions....not tax them so we can continue to make them with the gaurantee that the tax payer will bail you out.

You smoke...you die a horrible miserable lonely death from lung cancer. TOUGH shit.
Yeah, except you die slowly in a hopsital draining the resources of the healthcare system, so it costs other people.

Quote:
Originally posted by j8ear

You eat Big Macs six times a week...you die from heart disease a fat waste of life obese sack of shit. Who gives a rat's ass.
See above.

Quote:
Originally posted by j8ear

THE LAST thing we need to do is become dependant on sin taxes, to pay for things not even related to the 'sin.'

The ONLY thing we need is to hold people responsible for their actions. It isn't McDonald's fault that you are to weak to say NO or to lazy to prepare a healthy meal for children, nor is it the governments responsibilty to help you through any consequences of your BAD decisions.
So if I guy gets lung cancer from smoking, he gets no healthcare? What if he gets lung cancer from working a job? Does he get healthcare then, or it his fault for picking a bad carrer path? How far does your indifference toward your fellow man go?

Quote:
Originally posted by j8ear

I am completely on board with tort reform of the exact nature presented earlier. I fully support law suits or ALL types, frivolous included. It's the looser who should be required to pay ALL COSTS incurred by both sides.

I think the governement which legislates should be barred from exempting itself from anything imposed on the citizens.

Finally, I do not believe that such a thing as compelling government interest should EVER TRUMP the constitution. EVER. If it is compelling then the constitution needs to be changed. Period. No exceptions because five of the nine most removed from the common man elites deem it compelling. If it is that compelling then a change should be rather straight forward.

I've got more from my slightly right of libertarian camp, but I'll leave at this for now.

-bear
I want to agree with you about this, but how would you change the constitution? Give an example of a change to the constitution that would allow the government to exempt itself from, say, workplace safety regulations, given that we hate changing the constitution and try to do it as little as possible.
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Old 04-28-2004, 06:48 PM   #13 (permalink)
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first thing we need to do in missouri is stop that ass bag Bob Holden from vetoing the suit caps that pass every year so he can veto them

also another way i know of to fight back that i know is happening this very moment in Florida is. in a hospital in pensecola is that most of the doctors there refuse to do elective procedures on any trial lawyer or patient who brought up a wrongful suit (they keep records with each other) this means that if there life is in danger they will be helped but you want plastic surgery no help for you

i think this a start but maybe not the best idea
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Old 05-01-2004, 11:53 PM   #14 (permalink)
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all this talk about private healthcare gives me a headache.


then again, I'm Canadian, and I pay a fraction of what you americans dish out for broad medical coverage (about 1/10th of your prices, depending on the person)

I'll give you a different perspective on healthcare, just so you have something to sink your teeth into:


as a Canadian, I get my healthcare (up front) for free. the tax rate of my househol sits at approx. 45%-55% (depends on province) when you add Municipal, Provincial, and Federal rates into the mix.

Canada's Federal government contributes 16% (approx) of the healthcare budget for each province. the rest is paid for by the province.

This basic coverage, when also mixed with premium coverage at about 100-150 dollars a year gives me all the necessities of medical care, with less long term stress on tax payers.

I can walk into an ER with my head split open and not have to worry about insurance coverage, because only cosmetic surgery is not covered.

There is no siginificant portion of the population without coverage at all, so there is no extra bills for the government to cough up the cash for.

Canada's socialized healthcare is not perfect, and I will be the first to admit that, but as a portion of the GDP, Canada spends less, while the U.S. tops the list of countries (GDP spending) on healthcare despite the privatized system. This is all despite the fact taht over 44 million american citizens do NOT HAVE MEDICAL COVERAGE.

So, for the whole, which is better? a system that punishes the poor but provides the best service that money can buy, or a system that allows everyone to access a system on equal grounds, hence ensuring the health of the populace?


I realize, as americans, you embrace the idea of private healthcare, and minimal economic interferance by the government, but as a Canadian I see any corporate involvement in essential services as a bane on society.



just my 2 cents. carry on folks, nothing to see here.
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