What is the most effective way to slow the rising cost of health care?

[Klukie]

I don't hear many people talking about this when discussing medicare. Isn't this the primary reason that the system is strained?

[Liberal Veteran]

1. Get rid of insurance companies skimming profits off the top.

[RKP5637]

7. Insurance companies are of no value added in healthcare than as a ripoff. All they

do is take in and pass out money, and dish out a bunch of propaganda. The gov. can do a far better job. If I had my choice the insurance companies would be gone. They are a waste of money.

[ingac70]

2. Hospitals and doctors double and triple charging don't help. n/t

[Donnachaidh]

46. and the hospitals purchasing large equipment and then playing games with leasebacks

So they can keep playing with depreciation for taxes (IE -- CHEATING) has to stop too.

[xchrom]

3. To start: a strong public option.

Finished off w/ Medicare for all.

[RKP5637]

4. I share the same concern, all I hear is about how rising costs can be

met, but nothing about cost containment and why it costs 50% more in this country than other countries that provide just as good and better healthcare.

[Klukie]

8. Agreed..that is all I hear also

I think we need to shift the discussion to this, otherwise there is no real solution to this mess. Meeting costs should not be our goal.

[Faygo Kid]

5. Tax cuts for the rich?

I'm sure that will be the GOP recommendation.

[LiberalEsto]

6. Create a single-payer system for everybody

Standardize the cost of every procedure and prescription and treatment. .
Do not allow overcharges.
If necessary, nationalize the pharmaceutical industry, if they can't be controlled by taxing their excess profits.

[RKP5637]

9. + 1,000,000 +++ n/t

[slackmaster]

10. The problem is people. The solution is death.

:sarcasm:

[notesdev]

11. Make people pay their own money for it

all of a sudden, people will start asking how much things actually cost

It's not a big surprise to see costs rising out of control when nobody knows what the costs actually are and nobody has the slightest incentive to take care of oneself in lieu of having a doctor attend to every scratch, scrape, and sniffle.

[Klukie]

15. That might do it.

You are right..nobody ever really sees the actual costs.

[notesdev]

16. Also on my list

- have everyone learn basic first aid and stop requiring a medical professional for little stuff

- legalize marijuana in all 50 states, this stupid little plant in some cases is more effective medicine than outrageously expensive pharmaceuticals



At some point however we're going to have to say, "at X years old if it costs more than Y to pay to keep you alive, you pay it yourself or you don't get it." There's really no getting around that, the only question is what values get assigned to X and Y. We do need to confront questions like, if someone is 80 years old and it costs $10,000/month to keep them alive, is declining to pay for that treatment an acceptable and moral decision?

[Bluenorthwest]

36. People do pay for their own healthcare in the US, kid

Everyone on Medicare pays premiums, co-pays, deductibles, the works. No free lunch. It is exactly like 'regular' insurance in that regard. Odd that you would think otherwise.

[notesdev]

53. It's not like regular insurance at all

I bet if you added up what you pay in all health care related expenses it comes to several times the actual cost of providing the care you consume. Because you pay for it through these financial vehicles and not directly out of pocket, the true costs are hidden from you. If they weren't, you'd see that you were being overcharged by a factor by a three-figure percentage.

[Phoenix63]

39. Can you tell me where this place is where I don't have to

spend my money on health care? I would love to live there...

[Bluenorthwest]

42. No kidding, what Planet are they living on?

I'm not sure.

[HysteryDiagnosis]

12. Enable insurance coverage for non toxic highly therapeutic supplements that

are used (prescribed) in Europe. The first thing you are prescribed after a heart attack in Europe is omega three fatty acids. Ask their doctors.

[ThomWV]

13. Most effective? Easy. Socializ them, because its clear privatization of medical care hasn't worked

The opposite of privatization is socialization - privatization of the medicine hasn't worked, so let's have a full Government takeover of all things medical, cradle to grave.

[no_hypocrisy]

14. Get rid of insurance companies as middlemen and have physicians

work on optimizing the best health status via diet, exercise, better monitoring. If patients refuse to take these recommendations, then they literally pay the price for their decisions.

[Edweird]

17. Get rid of insurance companies.

[GKirk]

18. Preventative medicine...

...waiting till you're sick is not a good long term idea to anyone's overall health.

[w8liftinglady]

24. agree 100%... it would have saved many of my patients.

[Odin2005]

19. Do what the Canadians and Europeans do, rationing via waiting lists.

You heard me right. That angers people because we Americans think we MUST get the "very best possible" care and we want it "RIGHT NOW", which is why the Health Insurance industry is able to use anecdotes about healthcare rationing in Canada to scare people.

[Cleita]

26. Really and we get it right now? I guess you haven't

been sick lately. Unless it's an emergency I wait up to three months for an appointment and have you been to the ER lately?

[Odin2005]

29. I'm talking about expectations.

[w8liftinglady]

31. The reality of American medicine is...we have to wait now.

especially for specialists.
i spent 36 hours in the ER before being seen...with a blood clot in my lung.There are just too many people sick with no insurance who use the ER as a doctor's office.

With the grace of karma,I plan to open a free chronic care clinic and specialize in diabetes,hypertension and copd.hopefully,this will help people manage their chronic diseases so that the frequent ER visits won't be necessary,and hospitalizations will lessen.

[Cleita]

38. I've been thinking that people need to look into

founding free clinics in their neighborhoods and communities. It may be the only way to get to universal health care. People have to band together for this.

[peace13]

20. My mom is on medicare, $150.00 a month.

My 61 year old employee costs me $900.00 a month in health insurance. When I wish mom luck with her $150.00 voucher she goes ghost white. Where does she think the other $750 is coming from?

[Davis_X_Machina]

21. Nationalize the entire system. NHS-USA.

Bricks and mortar owned by the state. Health care personnel all employees of the state.

Paid for by steeply progressive taxes.

America's tax allergy will do the rest. It'll starve the system from the day it is created.

And that will control costs.

[Cleita]

22. No the system is strained because Medicare Advantage

and Medicare Part D are being drained by the for profit insurance companies who run them.

[Klukie]

30. I have always believed that Medicare Advantage was a backdoor for the Insurance companies

[Cleita]

37. It's a fact. You don't need to believe it.

Now they want to up the ante to vouchers.

[Klukie]

41. I am with you..something I posted a while back..

http://www.democraticunderground.com/discuss/duboard.php?az=view_all&address=389x6282656

[w8liftinglady]

23. Couple of things.

1.Our pharmaceutical costs are obscene.The FACT that many Americans are obaining their medications from other countries or doing without should be a head's up.I can not tell you how many patients have suffered.Hell,had it not been for the grace of my family and friends,I would have died after my blood clots- my medication on insurance was $800/week.
2.The AFL/CIO has an interesting list of CEO salaries...drug company and healthcare company CEOs lead.
http://www.aflcio.org/corporatewatch/paywatch/
3. Despite the increasing number of uninsured,the profit margin for drug and medical supply companies continues to rise.I have no issue with a company making a profit,but these corporations are making obscene profits.
4. Preventative care for ALL Americans would save SO MUCH in the long run.Mammograms,prostate and colon exams alone would give early diagnoses to cancer cases- early,more easily treatable,more curable...and LESS EXPENSIVE.

I care for SO many people who would not have been admitted to the hospital for lengthy treatment had the proper outpatient resources been available.

[spooky3]

49. great post and good on you for taking good care of these people

[Kip Humphrey]

25. Where to begin? ...single payer, preventive care, clean air/water, dump agribusiness, take research

away from pig Pharma and put it back into non-aligned universities (untainted by pig Pharma money), get rid of health insurance companies and revert to non-profit hospitals run by doctors... for starters.

[Festivito]

27. Do you have any intention of admitting it would be going to a public option?

Going toward the public option does not just slow the rising cost of health care, it lowers the cost, while insuring more and more until having it for everyone lowers the cost to its lowest while covering everyone.

Do the mechanisms have to be explained to you. I don't want to retype it all unless you want to listen.

[Klukie]

33. Why the nasty tone?

I asked this question about cutting costs because I don't hear it in any recent discussions about Medicare. I have no problem with the public option. I would love to see single payer eventually. I was trying to point out that meeting costs are the only thing being discussed and if rising costs are the actually problem in the system, then we need to bring that into focus. Please feel free to type it because we need to get back on message. I am listening.

[dkf]

45. Yes you are right.

Fighting just for Medicare ignores the central problem. Our health care system will soon be unaffordable for all of us. Insisting on keeping medicare as is will simply put double the burden on workers as they need to cope with their increasing costs AND those of seniors. I don't see how a young family survives that.

[Festivito]

60. Sorry about the tone. Fact seems to be that the public option is the only option that will work.

The current bill now in effect and being instituted over time reduces costs while insuring more people by becoming closer to a public option. That means that by coming even closer to the public option, costs go down, and while the percentage of insured goes up. These relationships can seem pie-in-the-sky silly, but they're not.

You see, the problem with an insurance company system during an era of DECREASING regulation means insurance companies start to drop people. Let's say you get MS. Your boss goes to renew insurance next year and it's unreasonably high. The insurance company lets him know that if he did not have the employee, you, with MS, it would be lower. He likes you and pays it this year, then he starts to watch what you do and trumps up a reason to lay you off or fire you. Incensed, you get another job. Then, they do the same thing. Now, you've been fired from three or four jobs for cause -- you're not getting another job. Disabled, you go onto MEDICARE. To recap: you collect social security and medicare and don't work even though you could. Medicare starts collecting all the people the insurance companies don't want to carry any longer. That's why their CEOs get billion-dollar salaries.

That is also why, when we force insurance companies by regulation to not drop people and not put caps on coverage, the total cost to government goes DOWN. Medicare doesn't go broke.

Oh, if your boss is great and continues to pay higher and higher premiums, the insurance companies pull another trick. They find some fault in your application and claim that they don't have to cover you. One person did not put down an acne problem from their youth and had their insurance pulled out from underneath them. To get you to update application, insurance companies increase policy prices so you have to get a different policy or a different company which requires everyone to resubmit an application. One error or omission, and you're out as soon as you're sick. Then, with no insurance you can no longer afford to work that job not making enough, so it's back to SS and MC for you.

MC, medicare, has all the old people and lately more and more of the really sick people on its roles while insurance companies collect premiums that are much higher and be sure they lobby to keep medicare for everyone from creeping into their clientele. Medicare runs on roughly 3% of income. Some insurance company policies are starting to run up to 50% of income, it's crazy.

We currently pay over $7500 per capita, or 2.4T$/year.
Single payer costs $3000 per capita, or 0.9T$/year.
That leaves a 1.5T$/year HEALTH CARE DENIAL INDUSTRY.

That $3000 figure comes from countries that have single payer. Britain, Japan, Sweden, about 3000; Canada, 3500 (but, I figure that's in part because of Americans coming across the border forcing them to have cards and extra procedures).

Malpractice runs about 2% in other countries and ours. We can try not to pay it, but then not biting those particular doctors keep biting costs later, so you can try as Republicans do to delay that cost, but in the long run I don't think that idea works. It can even be more expensive.

In the end, the only way to decrease the cost is to put everyone into the system. Enough of us do not like to just watch people die. We'll try to cover them, but doing it on a case by case basis slows the health care that single-payer would have handled on time and more cheaply with better outcomes.

Lower cost equals closer to single payer.

[HockeyMom]

28. Let us seniors just die

Frankly, that would be my choice. I would die than that put up with all this BS. I am still "only" 62 yet that is how I feel.

[mopinko]

32. don't let people get paid to fix their own mistakes.

bad medicine is expensive medicine, because you have to go back and do it right. these people get paid for every attempt, instead of only being paid for success.

let nurses do more. i always learned more from nurses than doctors.

and let people have more say in their own care. especially at the end of life, doctors fight after the battle is lost, then send a bill.

[w8liftinglady]

35. thanks Mopinko- from your mouth to Karma's ear!

I'm waiting to see if I was accepted to grad school as we speak.
You can come to my clinic anytime.I'll need the help!

[mopinko]

58. best of luck. you deserve it.

[many a good man]

34. Death panels

Just kidding. But seriously, strong government regulation of prices and some form of rationing of medical services is necessary. Cutting out insurance company profits will only get you so far. You have to control the runaway costs coming from the health care providers, too.

Government needs to be able to negotiate better prices. Hell, government needs to dictate prices. Single payer would make that easy, but it's possible under alternative systems.

[Klukie]

43. I agree ...price regulations have to be in the equation

[TransitJohn]

40. Medicare for all.

Put everybody on it. Sorry scumbag insurance companies, you have to go find another scam.

Dennis was right!

[mmonk]

44. Adopt a citizen oriented system model from a modern country

that contains costs and maximizes health outcomes.

[Celebration]

47. put the crooks ripping off the system in jail

Put a couple of CEOs behind bars, and those billings in error will go down substantially.

[Uncle Joe]

48. National single payer universal health care.

Thanks for the thread, Klukie.

[Klukie]

56. You are welcome

:hi:

[jerseygal]

50. What we eat is killing us - and costing lots of money as well -

Suppose we outlawed high fructose corn syrup, sodas containing HFCS or sugar, and all processed foods.

Suppose we taxed foods at McDonalds and Burger King and Popeyes and the rest of the fast food chains at 100% of price to pay for health care for those eating processed food.

Suppose we subsidized the growing of vegetables, beans, grains and fruits and chicken and turkeys.

Suppose we legalized having your own chickens up to 4 in every municipality in the United States.

We could save a lot of money if people ate a healthy and nutritious diet.

And how about building tracks and bicycle paths and encouraging people to exercise on a daily basis. Maybe we should subsidize those who lose weight - $100 for each pound lost and kept off for a year.

No one talks about these things but the contribution that our unhealthy food makes to health care costs is enormous - almost as enormous as some of the people who eat at McDonalds and other junk food restaurants.

I see these people in my office daily - they come in carrying their large size Coca Cola and don't seem to know why they are large sized themselves.

[MichiganVote]

51. K&R

[KurtNYC]

52. Outsource it to high value provider countries

Start with the stuff which has the highest price disparity and fly the patients out for services. Have MRIs done at WalMart for $48 and read by doctors in India. Take medical tourism and expand it, subsidize it.

[SoCalDem]

54. Tell insurance companies that the free ride on the Gravy Train's over

They are all off at this stop..

then nationalize the hospital corporations and "hire" the doctors..

Eliminate the VA, medicaid and everyone goes on medicare..

Insurance companies can offer "gap coverage" for the 20% that's not covered..

The money now paid by employers would be added to paychecks of the employees in the form of WAGES..

There would need to be taxes paid for the coverage, but surely doubling FICA & adding a medicare surcharge based on income would do it..as well as eliminating the cap for people paying into SS/Medicare..

and for people making over $500K, they could have an additional surcharge added it.

We could always ask for assistance for the other nations who are making this system work..I;m sure their experts would be happy to help us figure it out,..,

[eridani]

55. Make our current health care business model flat out illegal

That model is like a stand in the middle of the Sahara selling water for $10,000 a bottle. One way or another, government dictates health care prices in other advanced countries.

[philly_bob]

57. Reduce non-healthcare costs by eliminating insurance bureaucracy.

In other words, Medicare for all...

[tabbycat31]

59. ban most direct to consumer marketing

Seriously there is no reason for me to turn on the radio and every other ad is for a hospital. Most patients are referred to a hospital by their doctor, and in an emergency they go to the closest one.

Don't even get me started about the prescription drug ads. I once had a 4 yo (girl) ask me what erectile dysfunction was after seeing a Viagra ad.