1950 hospital maternity bill

[Greg Peterson]

Eric - Because we'd rather cut our nose off in spite of our face. We care more about taking care of maintaining the status quo than we do above teh 'general welfare' of the citizens of this nation.

I'm sure there were similar arguments when a public education program was first discussed.

I'd settle for a health care plan that delivered the same level of service and outcome for the same cost as our neighbors to the north of us.

[Mike Henderson]

The major issue is how to pay for "universal health care". And it's must be paid for by someone - there's no free health care.

I'd like to see it paid for by the citizens. That is, everyone should be part of the "health insurance pool" and there should be only one pool. It would be as if everyone worked for the same company and were part of that company's health insurance plan.

So each person would pay a premium. If you work for a company, perhaps that company would pay the premium for you. But one way or another, everybody pays. For those too poor to pay the premium, there would be assistance, same as we provide welfare.

By putting everyone into the same risk pool, the expenses of the the pool are distributed over the largest group of people, which means premiums are as low as possible.

Since everyone is paying, everyone has an interest in reducing the cost of health care. And in my plan, everyone has to pay something when they actually use health care - just enough to make them think about whether they really need to see the doctor. The payment would be adjusted based on the individual or family's income. The purpose of this payment is not to raise money, but to make health care more market oriented. One problem with Medicare, for example, is that it doesn't cost anything to actually see the doctor or have any service. You pay a fixed fee each month whether you use medical care or not. So no one thinks twice about whether they really need to see a doctor, or if they need that test, or anything else that costs money. In fact, since the payment is fixed each month, there's a perverse incentive to use as much as you can.

Medicare part D has been a success in getting people to search for the lowest cost drugs. We need something like that for doctor's visits, hospital stays, and medical tests.

So that's my idea. What's yours?

Mike

[Scott Shepherd]

Scott,

His theory as you presented it here might work well with the Japanese society. Their society has a totally different attitude than the US society.

Ken, before you prejudge it based on culture, you should know there are 10's of thousands of USA companies following his principles. It's not a geographic culture issue at all. It's fine to be cynical, but at some point, one has to actually look at facts, and the facts are that this has worked in the USA for 4 decades now and is still working.

[Larry Edgerton]

$125.00 for a girl!! I wonder how much boys cost back then?,

Quite a change in the last sixty years.


That's pretty cool Mitch.

I was the last on purpose home delivery in my county, and the doctor bill was $35 in 1957.

I may have my faults, but what do you expect for $35?

One question that has to be brought up at some point with ever increasing tech advances and and the associated costs spiraling out of control, what is a human life worth?

[Glenn Clabo]

Actually many large corporations have better healthcare benefits than those working in the federal government...which includes senators. I am not complaining…in any form…because I would have been bankrupted a few times in my life if I didn’t have the insurance…but I think many people would be surprised to know that as someone who has the same benefits...I went a quarter of million dollars into debt while my wife was sick. I also had to pay almost $20K out of pocket to get a tumor removed from my jaw. I get $20 towards a dentist visit, etc. I pay more than $200.00 every other week toward my healthcare provider fee...ie insurance company. I really don’t know what the government pays…but I’m sure it’s more than I do.
Again I’m not complaining about me…I think everyone should have at least what I have. I’m trying to support those who have less…or no insurance…and those who are coming to the end of their life and finding that death or going bankrupt is the only way out.

[Neal Clayton]

The major issue is how to pay for "universal health care". And it's must be paid for by someone - there's no free health care.

I'd like to see it paid for by the citizens. That is, everyone should be part of the "health insurance pool" and there should be only one pool. It would be as if everyone worked for the same company and were part of that company's health insurance plan.

So each person would pay a premium. If you work for a company, perhaps that company would pay the premium for you. But one way or another, everybody pays. For those too poor to pay the premium, there would be assistance, same as we provide welfare.

By putting everyone into the same risk pool, the expenses of the the pool are distributed over the largest group of people, which means premiums are as low as possible.

Since everyone is paying, everyone has an interest in reducing the cost of health care. And in my plan, everyone has to pay something when they actually use health care - just enough to make them think about whether they really need to see the doctor. The payment would be adjusted based on the individual or family's income. The purpose of this payment is not to raise money, but to make health care more market oriented. One problem with Medicare, for example, is that it doesn't cost anything to actually see the doctor or have any service. You pay a fixed fee each month whether you use medical care or not. So no one thinks twice about whether they really need to see a doctor, or if they need that test, or anything else that costs money. In fact, since the payment is fixed each month, there's a perverse incentive to use as much as you can.

Medicare part D has been a success in getting people to search for the lowest cost drugs. We need something like that for doctor's visits, hospital stays, and medical tests.

So that's my idea. What's yours?

Mike

the problems run so deep at this point that i don't see solutions.

a) medicare and medicaid are ripe with blatant theft. yes, everyone, your doctor and hospital are screwing the rest of us. this has been apparent for some time. see bobby jindals' investigations in louisiana a few years ago. he actually jailed quite a few hospital administrators and doctors for fraud. and i highly doubt louisiana is an isolated case.

b) my grandmother wound up in the hospital with pneumonia a year ago. she was 87 at the time. they kept her up for 18 hours without sleep running MRIs, CAT scans, multiple new sets of X rays, blood pressure tests, diabetic tests, you name it. they were so busy running up a tab for medicare that they forgot to start her on the antibiotics for the pneumonia. this is a woman who was working in her yard a week before, she's abnormally strong for her age, and takes very little medication. only threat of lawsuit from my mother was able to get them away from the walking, coughing ATM they had lying in the bed in front of them.

the best idea i can come up with is turning control of medicare/medicaid over to the university systems and having them regulate standards, by placing hard caps on what can be billed per patient without pre-existing conditions. the bottom line is hospitals and doctors need to earn less, and there's no need whatsoever for insurance companies to be middle men for profit. but no politician will look a camera in the eye and say this so i don't expect it to change any time soon.

[Brent Leonard]

I'm glad someone in the government has the cojones and is finally hellbent on doing something about the problem, even if it may be his political undoing. It has never made sense to me to think that doing nothing about a problem is a solution.

I believe any plan, even a very well devised plan, always requires later modifications to make perfect. This will be no different, and I don't subscribe to the thinking that a national program of whatever form will destroy us. Too many other countries have done it with major success.

[Ken Fitzgerald]

Brent with all due respect, no other country tried to do for 300 million people. You can't compare parking a 16 foot bass boat with parking an air craft carrier. Like wise you can't compare creating a system that handles healthcare for 20 million to a system that will have to handle 300 million.

To rush a program could very well lead to financial problems just like the State of California.....they meant well but sooner or later someone's got to pay the piper. And who are they coming to pay the bill?

NO to a quick fix. Take the time to think it out.

While having the courage to do it is one thing, the big long term question is do they have the brains to do it right?

[Mike Henderson]

The 300 million people problem doesn't worry me that much. Most people already have health insurance - the issue is how to cover the people without insurance.

But I agree with Brent. Do something and get started. Then make changes as needed. No matter how much thinking we do, there will be problems. And lots of people have done lots of thinking about "universal health care" for a lot of years. There have been proposals made long before the Clinton effort and that was about mid 1990's if I remember correctly.

Mike

[Bonnie Campbell]

One thing people can do on their own (basically) to cut back on outrageous bills is to check over the itemized statement of care given/provided. Example... LOML had been using a nebulizer and the medicine for at least a few years. After he passed I got another Medicare statement saying they had paid the medicine supplier for the month of December. He never GOT medicine in December. This wasn't the first time that company lied. I dealt with it before. They had before claimed more supplies were sent than were.... Anyway, I told Medicare THEY could deal with it, it was up to them to straighten it out. I had to 'file' an official complaint against the company, which just amounted to telling the person I spoke to I wanted it done. Lo and behold, three months later I get SIX large envelopes of copies of denial of payment to that company. Because of their shoddy record keeping THEY had to pay all moneys back to the government. So figure approximately $500 a month over all them years. I bet they start keeping better records after that. So, if the government (we) need to save money we ALL need to be watching for stuff like that.

[Ken Fitzgerald]

To start something without finding a viable way to pay for it is IRRESPONSIBLE.


Period.

There are no free rides in this world. Sooner or later you have to pay your bill or your IOU's aren't any good anymore.

Wake up!

HELLO!

[Ed Hazel]

I think the biggest problem is not insurance it is the cost of health care. Health care providers know how to get the most out of the insurance companies, most people that have health care insurance don't car what the cost is.

You should be able to "shop around" for many of the services like a MIR or ultrasound, my daughter needed an ultrasound when I called to set up an appointment I ask what would it cost an they had no idea what it would cost and were actually annoyed that I would ask such a thing.

Several years ago I elected to have a procedure done the doctor I went to advertised this as a specialty and he would do it for I think 300.00 dollars when I went in for the consultation he suggested that I would be comfortable doing this in a hospital he said my insurance would cover it in the hospital based on his recommendation. Well the 300.00 procedure ended up close to 10,000 this is the kind of activity that needs to stop.

I once had a doctors office try to bill my insurance company for a 350.00 office call for a post operation follow up, the doctor spent less than 5 minutes in the room, ($4,200.00 per hour) he asked if everything was ok? no pain? everything looks good, shedual another appointment for 2 weeks from now(I didn't). My insurance company declined payment and they sent the bill to me now for 175.00 I called and explained to them that this what is wrong with the amercan health system and they dropped the charges.

I knew a retired doctor who worked several days a month just doing consultations for a doctors office he never saw a patient he just looked over files so the office could charge a consultation fee.

It is a vicious cycle the health care industry milks the insurance companies and the insurance companies pass the costs on the health care providers make more money the insurance compies make more money and we all pay and pay.

[Mike Henderson]

To start something without finding a viable way to pay for it is IRRESPONSIBLE.


Period.

There are no free rides in this world. Sooner or later you have to pay your bill or your IOU's aren't any good anymore.

Wake up!

HELLO!

No one is advocating doing anything without being able to pay for it. What I'm advocating is to choose a path and get going (that includes how to pay for it). There may be problems that turn up after we get going and we should make the appropriate changes as we see the need.

But no one (especially me) is advocating doing anything without figuring out how to pay for it.

Mike

[Mike Henderson]

I think the biggest problem is not insurance it is the cost of health care. Health care providers know how to get the most out of the insurance companies, most people that have health care insurance don't car what the cost is.

You should be able to "shop around" for many of the services like a MIR or ultrasound, my daughter needed an ultrasound when I called to set up an appointment I ask what would it cost an they had no idea what it would cost and were actually annoyed that I would ask such a thing.

Several years ago I elected to have a procedure done the doctor I went to advertised this as a specialty and he would do it for I think 300.00 dollars when I went in for the consultation he suggested that I would be comfortable doing this in a hospital he said my insurance would cover it in the hospital based on his recommendation. Well the 300.00 procedure ended up close to 10,000 this is the kind of activity that needs to stop.

I once had a doctors office try to bill my insurance company for a 350.00 office call for a post operation follow up, the doctor spent less than 5 minutes in the room, ($4,200.00 per hour) he asked if everything was ok? no pain? everything looks good, shedual another appointment for 2 weeks from now(I didn't). My insurance company declined payment and they sent the bill to me now for 175.00 I called and explained to them that this what is wrong with the amercan health system and they dropped the charges.

I knew a retired doctor who worked several days a month just doing consultations for a doctors office he never saw a patient he just looked over files so the office could charge a consultation fee.

It is a vicious cycle the health care industry milks the insurance companies and the insurance companies pass the costs on the health care providers make more money the insurance compies make more money and we all pay and pay.

It's one thing to complain and another to propose viable solutions. I have a number of friends who are doctors. The primary care doctors are not making a killing. The do okay (about $100K/yr) but when you consider the amount of training and the investment in equipment in their office, it's not excessive. That's why medical students won't go into primary care - it just doesn't pay enough. And rural areas are having real problems finding primary care doctors to serve their area.

As one doctor said to me recently, "Every year my expenses go up maybe 5% but the amount I'm paid by Medicare and the insurance companies goes down by 5%. And my malpractice insurance goes up every year."

So don't think you can take a lot of cost out of the system by reducing payment to "greedy" doctors, especially not primary care doctors.

As I said earlier, rather than complain, propose a viable solution.

Mike

[Mike Henderson]

One thing people can do on their own (basically) to cut back on outrageous bills is to check over the itemized statement of care given/provided. Example... LOML had been using a nebulizer and the medicine for at least a few years. After he passed I got another Medicare statement saying they had paid the medicine supplier for the month of December. He never GOT medicine in December. This wasn't the first time that company lied. I dealt with it before. They had before claimed more supplies were sent than were.... Anyway, I told Medicare THEY could deal with it, it was up to them to straighten it out. I had to 'file' an official complaint against the company, which just amounted to telling the person I spoke to I wanted it done. Lo and behold, three months later I get SIX large envelopes of copies of denial of payment to that company. Because of their shoddy record keeping THEY had to pay all moneys back to the government. So figure approximately $500 a month over all them years. I bet they start keeping better records after that. So, if the government (we) need to save money we ALL need to be watching for stuff like that.

Your story illustrates why I believe that people should have to pay a portion of their medical bills. If you don't have to pay anything, many people just wash their hands and say "Let the insurance companies and doctors work this out." But if some of the money is coming out of your pocket, you get interested and watch what's charged. And also seek out lower cost care.

Part D proved that this technique works. People seek out the lowest cost drugs, whether it be generics or just places that charge less.

Mike