Universal Health care Question

[liberalpress]

OK, all you Dean and Kucinich supporters. I have been to both websites, but cannot find the answer to this question... will the plans offered by these candidates allow you to choose your own doctor?

[liberalpress]

1. P.S.

I don't want to just limit this to Dean and Kucinich. Any other candidate wonks want to chime in, that's fine.

[Interrobang]

2. Speaking as someone who has it, why wouldn't it?

Really. Why wouldn't such a plan allow you to choose your own doctor? I'll tell you a little secret: The AMA flat out LIES about universal health care. Not only do I get to choose my own doctor, I can fire a doctor I don't like, and get a new one. (I had one friend who fired his doctor while he was in the ICU, because the doctor in question wouldn't medicate him on demand.) Despite what the AMA tells you, the government doesn't assign us doctors; it has far too much else to do to be concerned about that kind of picayune business.

[liberalpress]

3. Thanks for your response..

UHC is new to us here in the states.. all we hear about is that it's part of a socialist plot to take over our lives, and if you want it you have to be a damn pinko faggot commie! Maybe it's just me, but I figured that probably wasn't true.

[roughsatori]

4. I am a " damn pinko fag commie" and proud of it

and I want universal health-care. It is part of the homosexual-agenda to force you to have a sex change and make the tax-payers pay for it. (sarcasm off)

[elfling]

5. UHC is business-friendly

The only thing I can imagine that would be worse than having my government in charge of health insurance would be having my employer in charge of health insurance.

All the plans I've seen proposed are either too convoluted to help, or cannot be passed politically.

If you've tried to start a small business or do anything entreprenurial, you'll discover that the health insurance system is a mess.

Unless you're funded well enough to have people working for you, you won't count as a group. It's better now - groups can be 2, and if you jump through enough hoops you can get a husband/wife pair to count. Currently, it's almost impossible to buy insurance as an individual. My daughter, who has never been sick, is ineligible for an individual insurance plan because she has a tiny heart murmur. It will probably close on it's own, with no treatment.

Note I'm not even talking about the expense. I'm talking about getting the company to write you a policy.

Health insurance is tied to companies by an historical accident - when wages were frozen during WW2, insurance and other perks were a way for companies to attract employees.

The problem is, your employment has nothing to do with your need for health insurance. If I want to work for a small company, all the people in that company have to be on the same plan. Why is it reasonable to assume my insurance needs are the same as the 5 people I work with? And if I become sick and lose my job, I lose my health insurance... thus I get sicker and more indigent until the government will pay.

The fact of the matter is that the government is already in the health care business. It buys care for millions of federal employees, including our legislators and President, and our military. It buys health care for the elderly and for the indigent. Heck, it buys health care for convicted felons!

Why is it that congressment and convicted felons are entitled to better health care than people who produce and prepare our food, or even the aides and orderlies that work in our hospitals?

And why should businesses have to shoulder the overhead of selecting and managing insurance plans for their employees and their employees' dependents?

My plan is this: the government should give a voucher to every American to buy a basic health insurance policy.

The insurance companies in turn should agree to offer two plans that will be paid for by the voucher in its entirety, one HMO-style, and one PPO/big deductible. They would not be allowed to turn anyone away.

Anyone with a voucher would be allowed to use it to purchase more upscale policies as well, with the addition of cash. So your employer could take your voucher, add money, and buy something better, if they wanted. Or you could.

Yes it would be paid for by higher taxes. But, that would be offset by employers and individuals not having to pay for health insurance. It's an expense either way - and it's not better or worse if it goes direcly to Insurance Inc or the IRS.

This plan has the advantage of covering everyone with a minimum of hassle and red tape, while also leaving the insurance companies in the loop. The last is important - they have a big lobby and aren't going to just disappear quietly. This works with them, and even possibly increases their business. It keeps competition, because each company has to fight for their share of the vouchers. It also solves a headache for them - the problem of healthy people opting out of the system while sick people opt in.

And, it solves a problem we're about to have, which is genetic testing that will tell you that you're likely to get certain catastrophic illness. Insurance doesn't work when everyone knows their risk.

What do you think?

[roughsatori]

6. The part that might make your idea more feasible than mine

Is your idea of the voucher for the insurance program. Insurance companies are heavily funded and lobbied. So a paln like mine, to just get rid of the middle-man (the insurance companies) and make it a contract between the payee (US gvernment) and the provider (doctors, etc.)would never see the light of day due to the lobby system in US politics. Your way, would be, as you say, business friendly--and might have a better chance of passing.

The draw-back is that it would most likely end up like the school voucher programs. They give you a voucher for 2,000 dollars, yet the private school in your area costs 6,000 dollars a year. So in effect only middle-class and higher can actually use what is being sold as a way to help the "poor."That is the way the new medicare "plan" works. It only helps people wealthy enough to already afford health-care.

[elfling]

8. I agree with your concern

I do agree with your worry that it might be too low. But I think that can be addressed. My thought is that the minimal level would be some sort of HMO. It probably wouldn't be a great plan. How great it could/would be would depend on how much political will could be gotten for the base funding level.

And since the voucher might be, say, a flat $2k per person, the various companies would have incentive to provide better plans for that same voucher. They won't have quite the same problem as a school, where geographic location is so critical and adding capacity is such a high and fixed cost. You can expect 3-4 companies at least in each area, and in general they would/should have the capacity to take on everyone who chose them.

For myself, I prefer the high deductible plan - that is, I accept a liability of say $2k of my expenses, and then after that I see coverage.

But I also think that it's okay to expect people to take the burden upon themselves to understand their plan and to pick one that works for them. I think the system works best when people have some incentive to manage cost - to look over their bills and make sure that they got everything that was billed, to ask the doctor about the relative cost of different therapies. Unfortunately, when you give something away without cost, I think people don't value it like they should.

[tinnypriv]

7. Question

Is Britain communist? :D

Virtually every industrial country in the world has some kind of UHC. Either you've got a crap system, or everyone else is an idiot.

[Mairead]

9. Kucinich: publicly paid, privately delivered universal healthcare

The answer to your question, with Dennis's plan at least, is 'yes' (note my emphasis below, second paragraph).

The Kucinich plan is enhanced 'Medicare for All' -- a universal, single-payer system of national health insurance, carefully phased in over 10 years. It addresses everyone's needs, including the 40 million Americans without coverage and those paying exorbitant rates for health insurance. This approach to healthcare emphasizes patient choice, and puts doctors and patients in control of the system, not insurance companies. Coverage will be more complete than private insurance plans, encourage prevention and include prescription drugs.

Health care is currently dominated by insurance firms and HMOS, institutions that are more bureaucratic and costly than Medicare. People are waiting longer for appointments. Fewer people are getting a doctor of their choice. Physicians are given monetary incentives to deny care. Pre-existing illnesses are being used to deny coverage.

Over time, the Kucinich plan will remove private insurance companies from the system -- along with their waste, paperwork, profits, excessive executive salaries, advertising, sales commissions, etc -- and redirect resources to actual treatment. Insurance companies do not heal or treat anyone, physicians and health practitioners do ...and thousands of physicians support a single-payer system because it reduces bureaucracy and shelters the doctor- patient relationship from HMO and insurance company encroachment.

Non-profit national health insurance will decrease total healthcare spending while providing more treatment and services -- through reductions in bureaucracy and cost- cutting measures such as bulk purchasing of prescriptions drugs. Funding will come primarily from existing government healthcare spending (more than $1 trillion) and a phased-in tax on employers of 7.7% (almost $1 trillion). The employers' tax is less than the 8.5% of payroll now paid on average by companies that provide private insurance. For budgetary details, click here.

This type of system -- privately-delivered health care, publicly financed -- has worked well in other countries, none of whom spend as much per capita on healthcare as the United States. 'We're already paying for national healthcare; we're just not getting it, says Kucinich. The cost- effectiveness of a single-payer system has been affirmed in many studies, including those conducted by the Congressional Budget Office and the General Accounting Office. The GAO has written:
"If the US were to shift to a system of universal coverage and a single payer, as in Canada, the savings in administrative costs (10% to private insurers) would be more than enough to offset the expense of universal coverage."

Over the years, groups and individuals as diverse as Consumers Union, labor unions, the CEO of General Motors, the editorial boards of the Atlanta Journal-Constitution and St. Louis Post Dispatch, and Physicians for a National Health Program have endorsed a single-payer approach. It is sound economics -- what actuaries call 'Spreading the Risk' -- to extend Medicare to younger and healthier sectors of our population, thereby putting everyone in one insurance pool. It permanently saves and improves Medicare, while eliminating duplicative private and government bureaucracies.

While enhanced Medicare for All makes economic sense, it has not made political sense to some, due to the power of the private insurance lobby. The streamlined Kucinich plan is very different than the 1993 Clinton HMO-based plan, a complex proposal that left big insurance firms in a central role. After Clinton's 'Managed Competition' plan failed without coming up for a vote, talk-radio host Jim Hightower asked President Clinton why he hadn't put forward a "simple, straightforward" single-payer plan "instead of all this bureaucracy." Clinton replied, "I thought it would be easier to pass" a bill that left the insurance industry in place. "I guess I was wrong about that."

Note, too, Clinton's response to Hightower's question (last paragraph).

[MaverickX]

10. Uh don't all politicians claim..

Their health plans will promote more choices for patients. I take a different approach which is that choice of doctors isn't as important as expanding coverage to include more treatments and medications.

[elfling]

11. All I need is one

Choice of doctors is irrelevant as long as my doctor is included. :)

But I assume that what most people mean by that is not having to go through a gatekeeper physician - ie, if you have something funny on your skin, to be able to go straight to the dermatologist of your choice without having to get a referral from your primary care doc.

[newyawker99]

12. Hi elfling!!

Welcome to DU!! :toast: