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  • #61
    Why would you both to mention one plan isn't taxpayer funded if none of them are?


    Maybe because he isn't the clearest writer, meaning to distinguish it from Conyers/Sanders, and failed to add a caveat for the set of options. I'm pretty sure that my theory is better than yours.
    "Beware of the man who works hard to learn something, learns it, and finds himself no wiser than before. He is full of murderous resentment of people who are ignorant without having come by their ignorance the hard way. "
    -Bokonon

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    • #62
      Errr...because even with user fees there would be a public subsidy to doctor's visits which are probably not really necessary (they are comfort issues which will resolve themselves given time). I'm trying to offload as many of the costs as possible to private parties while:

      1) Retaining some care for every individual
      2) Reducing adverse selection problems as much as I can
      12-17-10 Mohamed Bouazizi NEVER FORGET
      Stadtluft Macht Frei
      Killing it is the new killing it
      Ultima Ratio Regum

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      • #63
        By the way, since the national insurance plan would reduce the costs of employer-provided insurance (by paying for some large fraction of treatments) it would probably increase coverage rates...

        There's also the possibility it would reduce coverage rates, since people would no longer be as scared of going without employer coverage, but my feeling is that most people are fairly risk averse for even non-catastrophic medical costs, so will still want to be lumped in with everybody else in a nice big insurance pool
        12-17-10 Mohamed Bouazizi NEVER FORGET
        Stadtluft Macht Frei
        Killing it is the new killing it
        Ultima Ratio Regum

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        • #64
          Note: employer provided coverage is either for all full-time employees or for nobody. Individual employees cannot choose to opt out.
          12-17-10 Mohamed Bouazizi NEVER FORGET
          Stadtluft Macht Frei
          Killing it is the new killing it
          Ultima Ratio Regum

          Comment


          • #65
            Originally posted by KrazyHorse View Post
            Errr...because even with user fees there would be a public subsidy to doctor's visits which are probably not really necessary (they are comfort issues which will resolve themselves given time). I'm trying to offload as many of the costs as possible to private parties while:

            1) Retaining some care for every individual
            2) Reducing adverse selection problems as much as I can
            Right, there would be a public subsidy. By a user fee, I mean similar in scale to a copay.

            Why do you think that's a bad idea? The current system oversubsidizes secondary care, but I'd say that preventative care that goes beyond an annual physical would be prudent. I don't think people generally go to the doctor for the sniffles (except kids, but they'd be covered under your scheme). Lots of hassle, and you have to deal with the copay.

            You don't have selection issues if it's automatic.
            "Beware of the man who works hard to learn something, learns it, and finds himself no wiser than before. He is full of murderous resentment of people who are ignorant without having come by their ignorance the hard way. "
            -Bokonon

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            • #66
              By a user fee, I mean similar in scale to a copay.


              Yes, and I'm trying to reduce PUBLIC subsidies to these types of doctor's visits. There's a utility issue for those who truly cannot afford optional visits, so I'm willing to give them a chance at the public purse. But if I send the costs to private insurers we might at least HOPE that over time employees will agitate for higher pay at the cost of higher copays/deductibles for such visits. If it's given as an entitlement, on the other hand, it will not be reduced without a huge hassle.

              And if you don't think that people go to the doctor for sniffles then you are sadly mistaken.
              12-17-10 Mohamed Bouazizi NEVER FORGET
              Stadtluft Macht Frei
              Killing it is the new killing it
              Ultima Ratio Regum

              Comment


              • #67
                Or is your threshold for "catastrophic" really low? Say, I dislocate my kneecap and am unemployed. How much of that should I have to pay?
                "Beware of the man who works hard to learn something, learns it, and finds himself no wiser than before. He is full of murderous resentment of people who are ignorant without having come by their ignorance the hard way. "
                -Bokonon

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                • #68
                  I don't understand why you think it's necessary to cover people with reasonable incomes for non-catastrophic care.

                  There's not too much of an efficiency issue because the cost of this type of care (sniffles visits) is relatively low, thus covering it for low-income individuals doesn't increase marginal tax rates in the phase-out region too much.

                  So why should we cover somebody who could afford to pay for it (even without insurance)?
                  12-17-10 Mohamed Bouazizi NEVER FORGET
                  Stadtluft Macht Frei
                  Killing it is the new killing it
                  Ultima Ratio Regum

                  Comment


                  • #69
                    Originally posted by Ramo View Post
                    Or is your threshold for "catastrophic" really low? Say, I dislocate my kneecap and am unemployed. How much of that should I have to pay?
                    ???

                    If you're unemployed then you should be included in part (2), no?
                    12-17-10 Mohamed Bouazizi NEVER FORGET
                    Stadtluft Macht Frei
                    Killing it is the new killing it
                    Ultima Ratio Regum

                    Comment


                    • #70
                      I suppose this is an empirical question, and I don't have the data to argue this point. But my intuition is that primary care is heavily underutilized.

                      ???

                      If you're unemployed then you should be included in part (2), no?


                      The Medicaid comparison implies severe means testing. You generally need to be poor with kids or some kind of disability. The Kennedy plan, for example, would be a lot more generous.
                      "Beware of the man who works hard to learn something, learns it, and finds himself no wiser than before. He is full of murderous resentment of people who are ignorant without having come by their ignorance the hard way. "
                      -Bokonon

                      Comment


                      • #71
                        Originally posted by Ramo View Post
                        I suppose this is an empirical question, and I don't have the data to argue this point. But my intuition is that primary care is heavily underutilized.
                        From what I've seen it's heavily overutilised by large minority of the population and mildly underutilised by the rest (who are more motivated by inconvenience than cost).


                        The Medicaid comparison implies severe means testing. You generally need to be poor with kids or some kind of disability. The Kennedy plan, for example, would be a lot more generous.


                        If you're short term unemployed then cobraish coverage should be fine. If you're long-term unemployed and have no assets (and yeah, I'm including a primary residence) then I'd be fine with providing some coverage. With this much of a means test you're not going to get much in the way of moral hazard. Plus, I don't know why you brought up the example of a dislocated knee. The treatment for that involves manipulation of the knee back into position and bracing of the joint. Not particularly expensive. 400$?

                        There are surgical options to prevent recurrences, but I don't see why the public should cover that...
                        12-17-10 Mohamed Bouazizi NEVER FORGET
                        Stadtluft Macht Frei
                        Killing it is the new killing it
                        Ultima Ratio Regum

                        Comment


                        • #72
                          Not a meaningful example, just something I know the costs associated with (happened to me three times). Ambulance, emergency room, doctor's visit, physical therapy. Last time, I had insurance (crappy school insurance covering only 70%), and out of pocket was ~$4k. I never ended up tallying the exact figure, since those bills were depressing the hell out of me.
                          "Beware of the man who works hard to learn something, learns it, and finds himself no wiser than before. He is full of murderous resentment of people who are ignorant without having come by their ignorance the hard way. "
                          -Bokonon

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                          • #73
                            Ambulance, emergency room, doctor's visit, physical therapy.


                            the first two are the expensive part, no? And I don't see why the public should fund the last one

                            Why did you get an ambulance for a dislocated knee? You could have taken a trip to a clinic the next day.
                            12-17-10 Mohamed Bouazizi NEVER FORGET
                            Stadtluft Macht Frei
                            Killing it is the new killing it
                            Ultima Ratio Regum

                            Comment


                            • #74
                              By the way, the last injury I had was a complete rupture of the anterio-tibular ligament in my ankle.

                              And no, I didn't visit the doctor. I just bought a set of crutches and used them for the next 2 weeks.
                              12-17-10 Mohamed Bouazizi NEVER FORGET
                              Stadtluft Macht Frei
                              Killing it is the new killing it
                              Ultima Ratio Regum

                              Comment


                              • #75
                                The issue with a lot of treatments is that it is in the publics interest to do them to save costs later.

                                For example, if the knee was fixed after the first time, it would save the public from repeatedly paying for the same ailment over and over again. Besides decreasing the cost to society in work lost.

                                I think that national public health shuold be focused on preventative measures and on doing what is needed to decrease the likelyhood of future visits.

                                JM
                                Jon Miller-
                                I AM.CANADIAN
                                GENERATION 35: The first time you see this, copy it into your sig on any forum and add 1 to the generation. Social experiment.

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