SDNcare: if YOU where the president

[TedyBearSuicide]

If you were the president, how would you reform the current healthcare system?

Please do NOT criticize anyone's viewpoint, the aim of this thread is to speak freely…..and well to basically rant.

There are several threads discussing this topic. However this one can be the first without arguments, which eventually lead to the entertaining SDN fights.

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[Pinkertinkle]

two tier health, one for the poor one for the rich

 

[URHere]

The only way we are going to be able to expand affordable healthcare to everyone is by shutting down the insurance companies, and using tax money to pay for a national system. Unfortunately, that isn't a possibility for Americans just yet - no one would vote for the increase in taxes, and too many people have a vested interest in the insurance companies to let them go by the wayside. So, in the meanwhile, I think these are reasonable adjustments:

-Limit malpractice costs. If we want to squeeze more money out of the medical system, physician reimbursements are going to have to go down, but they can't go down until there is a limit on the money patients can demand in a lawsuit. Medical expenses, and lost wages are fair game, but millions of dollars in pain and suffering is ludicrous.

-Adjust physician reimbursements. How much a doctor makes should depend on how much liability they have, how much they have to work, how inconvenient those work hours are, and how many patients they routinely see. Currently, some specialists are horribly overcompensated, and primary care reimbursements are ******edly low. That needs to change.

-I think that Obama's current plan to mandate insurance is a good one, but I think that we need to control the deductibles, copays, and services on the most affordable plans. If people need to buy insurance, the poor will buy the cheapest plan available. If the deductible is too high or the coverage too low, they just won't use it and will still overburden ED workers. If insurance plans are controlled, I also think it would be a good idea to offer a tax break to those who see their physicians for annual check-ups or wellness visits.

 

[Narmerguy]

This is not to criticize but merely to point out that we fail to account for the wide scope of problems that we would have to address. Plenty of what will follow will appear to be great on paper but hardly feasible in reality (true, not unlike what the gov't often pushes through). I'm just advocating that we try to be realistic and inclusive when making propositions.

 

[Homoochan]

Canada and pretty much all the major players in Europe?

 

[rl2317]

i think i agree with homoochan. health insurance companies aren't really necessary. i think a single payer system would work best. i've heard people often point out that people won't be happy with the taxes but i dont think it will mean more taxes out of the majority of our pockets. firstly 60 Percent of Health Spending is Already Publicly Financed also, single payer will save a lot of money from a 30% to 5% overhead costs. if you look at hr 676 one of the single payer bills in congress, it talks about how to finance this reform, and i dont think you have to worry about paying much higher taxes. physicians for a national health program has a lot of resources discussing this if anyone is interested: pnhp.org. obama's mandate program looks similar to massachusetts model which i dont think has really resolved the issue of affordable or universal coverage. these are my two cents.

 

[Bernoull]

I'll REMOVE the profit motive from healthcare to the extent possbile. This means salaried physician - thus decoupling physician compensation from decisions about patientcare. It also means that all for-profit hospitals and insurers must become non-profit or be nationalized. Public and private insurers must negotiate for competitive drug prices with Big Pharma. The significant savings from all of this should be reinvested in promoting wellness and preventitive medicine, drug/disease research and covering the un/under-insured.

My $0.02 cents...

 

[rl2317]

bernoull, i agree with you. actually hr 676 will make all for profit participating health care providers convert to non-profit. single payer will also make it possible to negotiate with big pharma which individual insurance companies dont really have an interest in. and since the title of this thread is about our pres, i want to throw in that obama at an afl-cio event in 03 backed single payer and said we'll get it after we take back the white house, the senate.

 

[jkurtz02]

i think i agree with homoochan. health insurance companies aren't really necessary. i think a single payer system would work best. i've heard people often point out that people won't be happy with the taxes but i dont think it will mean more taxes out of the majority of our pockets. firstly 60 Percent of Health Spending is Already Publicly Financed also, single payer will save a lot of money from a 30% to 5% overhead costs. if you look at hr 676 one of the single payer bills in congress, it talks about how to finance this reform, and i dont think you have to worry about paying much higher taxes. physicians for a national health program has a lot of resources discussing this if anyone is interested: pnhp.org. obama's mandate program looks similar to massachusetts model which i dont think has really resolved the issue of affordable or universal coverage. these are my two cents.

While I agree with the single payer idea, I don't think our country is quite ready for it yet and thus need to be a little more extensive than the Canadian model. That being said another advantage of what you were describing is that you would no longer be paying ridiculously high premiums, thus those tax increases wouldn't really be increases they would just be a restructuring of everyone's bills.

 

[afugazzi]

single-payer, salary-based doctor pay, push for employer-sponsored weight-loss and other preventative health programs (which usually save more money in health insurance than they cost)

 

[Beta Cell]

This was an exact UF Junior Honors Medical Program interview question. URHere shared a lot of my same ideas which the interviewer didn't seem to be too keen on.

 

[Daz105]

So I don't know much more about this issue than anyone else but I'm curious if it would be a reasonable idea to open several government operated and funded hospitals to absorb some of the indigent patients that cannot pay their bills so that private hospitals won't have to waste resources on those that aren't inclined to pay for them. If the government operated hospitals are set up properly and manage to decrease the insane amounts of overhead in health care, maybe this could bring about a situation in which private hospitals will have to compete or risk losing their patients to more efficient (but significantly less luxurious and thorough) establishments. Seems like a long shot that it would work out in practice, and I would assume finding all the extra docs needed to staff these places would be a problem as well, but just a thought.

 

[cliffhuxtableDO]

If I was president,
I'd get elected on Friday, Assasinated on Saturday,
Buried on Sunday,
Then go back to work on Monday.

 

[Kaustikos]

Extreme penalty for cheating the system - deportation
More restrictions for getting into government-paid insurance (medicaid)
Incentive programs for preventative care

 

[Narmerguy]

If I was president,
I'd get elected on Friday, Assasinated on Saturday,
Buried on Sunday,
Then go back to work on Monday.

Well done

 

[TedyBearSuicide]

From SDN's homepage:

http://www.studentdoctor.net/2009/07/healthcare-reform-what-can-we-really-expect/

“Quality of life” and income are not necessarily related. Physicians motivated primarily by income will be disappointed and possibly seek other ways to make a living. Those of us who value the rewards of patient care, service, and life-long learning of new biomedical science will still find being a doctor very rewarding.

Says the guy who lived a life of high salaries and now about to hit the road for good.

 

[autodf06]

There is a reason that health care costs more than tuning fixing your car and pharmaceuticals cost more than fertilizer. They make more cars everyday, if the mechanic screws up or the car is damaged beyond repair you buy another one, if YOU get damaged you can't go buy another you, so one would be inclined to pay to stay healthy and be fixed as best as possible when damage occurs. My point about pharmaceuticals is that, if plants die no one really cares, sure you might upset your flowers are ugly but Home Depot will have plenty more just like them. If human drugs don't work then people die and then their families usually get upset and that isn't good. Their is a reason health care costs so much, it is because people value human life, more importantly their own lives. I would much rather pay a private insurance company X amount of dollars every month to know that I could get prompt competent medical service I deem necessary, than rely on the government to determine if I am a viable candidate for procedure X. Patients have the right to be treated by competent doctors, and those same doctors have the right to be compensated for their services. I believe doctors earn every bit of their pay checks whether we think those paychecks are inflated or not. They deal with human lives, not car parts or flowers or trivial things. I know that if I get through medical school, residency, and all the BS to become a doctor, then deal with the everyday stress that entails, I would want to be compensated for my troubles more than Joe Schmo working at a department store. Feeling warm and fuzzy inside from helping people doesn't pay back medical school loans or bills or put food on the table. Sorry, it just doesn't. Anyways, if I had to over-haul the health care system, I would start a law that requires everyone to have health insurance, just like everyone must have car insurance now (at least in AL, pretty sure it is nationwide). Plenty of low cost car insurance companies popped up and the low income people got car insurance. Same with health care, either the big companies will offer a low rate policy or small insurance companies will start up focused on the low income population. Granted this is a free market idea in which people will make money (which is an awful thing, I know *sarcasm*), but I believe it would be a viable solution to the problem.

 

[WilsonFan]

The only way we are going to be able to expand affordable healthcare to everyone is by shutting down the insurance companies, and using tax money to pay for a national system. Unfortunately, that isn't a possibility for Americans just yet - no one would vote for the increase in taxes, and too many people have a vested interest in the insurance companies to let them go by the wayside. So, in the meanwhile, I think these are reasonable adjustments:

-Limit malpractice costs. If we want to squeeze more money out of the medical system, physician reimbursements are going to have to go down, but they can't go down until there is a limit on the money patients can demand in a lawsuit. Medical expenses, and lost wages are fair game, but millions of dollars in pain and suffering is ludicrous.

-Adjust physician reimbursements. How much a doctor makes should depend on how much liability they have, how much they have to work, how inconvenient those work hours are, and how many patients they routinely see. Currently, some specialists are horribly overcompensated, and primary care reimbursements are ******edly low. That needs to change.

Spot on. First, hire a bunch of doctors and lawyers to review every malpractice lawsuit, discarding those that are frivolous. Then lower physician's salaries accordingly so that they get the same base pay. Use this money to subsidize health care for those who cannot afford needed care.

Also, I'd support making medical school free (heavily subsidized) and lowering physician's salaries to where those who would otherwise have to get a higher salary to make up for debt would break even. The tricky part here would then be having older doctors earning significantly more than younger ones.

 

[ChubbyChaser]

Let the poor, lazy, sick ppl die off.

* i did not call all poor ppl lazy btw.

 

[TexasFight]

Spot on. First, hire a bunch of doctors and lawyers to review every malpractice lawsuit, discarding those that are frivolous. Then lower physician's salaries accordingly so that they get the same base pay. Use this money to subsidize health care for those who cannot afford needed care.

Also, I'd support making medical school free (heavily subsidized) and lowering physician's salaries to where those who would otherwise have to get a higher salary to make up for debt would break even. The tricky part here would then be having older doctors earning significantly more than younger ones.

Funny how you think that is the best solution. I'm glad you aren't the president. At least the guy you quoted (whom though I disagree with) supplemented his idea to change salaries with reasons, rather than an across the board cut of salaries to the same base pay.

 

[TexasFight]

i think i agree with homoochan. health insurance companies aren't really necessary. i think a single payer system would work best. i've heard people often point out that people won't be happy with the taxes but i dont think it will mean more taxes out of the majority of our pockets. firstly 60 Percent of Health Spending is Already Publicly Financed also, single payer will save a lot of money from a 30% to 5% overhead costs. if you look at hr 676 one of the single payer bills in congress, it talks about how to finance this reform, and i dont think you have to worry about paying much higher taxes. physicians for a national health program has a lot of resources discussing this if anyone is interested: pnhp.org. obama's mandate program looks similar to massachusetts model which i dont think has really resolved the issue of affordable or universal coverage. these are my two cents.

I think a single payor system would work well too, if they actually reimbursed doctors and hospitals appropriate amounts. I definitely think that would be possible if every family contributed about half of their regular insurance bill to the national system. A large majority would save money and an even larger majority would have access to better care. It would take out those who try and profit from health care out of the system.