Archived Topic

Three Best Health Care Reform Ideas

by BoiseBYU · 1/21/2010

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BoiseBYU
Here are mine; I'm curious what yours might be



1. Prohibit pre-existing condition insurance exclusions

2. Elminate antitrust exemption for health insurance and the ban on competing interstate

3. Allow the federal govt to negotiate drug prices for Medicare recipients
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Guest
I like #2 the best, I think that would be huge in driving down costs.
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BYULV
How about getting doctors out of the insurance business. Do not allow doctors to bill insurance plans directly, rather require each individual to bill their own claims. This accomplishes a number of positive things:



1) the potential for fraud/abuse is nearly eliminated (I have heard estimates of $billions yearly due to false claims);

2) patients will know what their costs are upfront, before they see the doctor (medical services will start to become commodities sensitive to supply and demand which they currently are not)

3) medical office operating expenses will be cut by $50K - $100K yearly per physcian by eliminating interactions with insurance companies (multiplied by # physicians in America = $$$$$$).

4) patients become more active participants in their healthcare by being sensitive to the insurance coverage they have, by knowing what things cost and by being the true consumer of healthcare from the physician rather than through the 3rd party insurance companies.

5) other benefits I'm sure, but these are just off the top of my head.
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Qman
1) Interstate competition

2) Bill the patients for all the reason BYU LV listed

3) Change health insurance into 'emergency' only coverage - checkups and most procedures are payed for with tax free accounts

4) remove the corporate health care tax deduction and just pay the employees the addition amount. Let us find our own insurance

5) have strict laws about malpractice suits a la Texas-only malpractice suits that have been signed off on by a practicing doctor in the same field go to court. Lower costs in malpractice insurance, lower overall costs.
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ABYUFAN
BYULV wrote:
How about getting doctors out of the insurance business. Do not allow doctors to bill insurance plans directly, rather require each individual to bill their own claims. This accomplishes a number of positive things:



1) the potential for fraud/abuse is nearly eliminated (I have heard estimates of $billions yearly due to false claims);

2) patients will know what their costs are upfront, before they see the doctor (medical services will start to become commodities sensitive to supply and demand which they currently are not)

3) medical office operating expenses will be cut by $50K - $100K yearly per physcian by eliminating interactions with insurance companies (multiplied by # physicians in America = $$$$$$).

4) patients become more active participants in their healthcare by being sensitive to the insurance coverage they have, by knowing what things cost and by being the true consumer of healthcare from the physician rather than through the 3rd party insurance companies.

5) other benefits I'm sure, but these are just off the top of my head.


We had a family vacation in Yellowstone and there my son's finger was shut in the van door. Fearing a possible broken finger we took him to the local medical clinic for an x-ray (not broken, we just put a splint on it.) I paid for that out of my own pocket and sought reimbursement from the insurance company directly. Over the course of more than a year, I literally heard five (FIVE!) different reasons why they wouldn't pay for that claim - one person indicated that I should have driven the 15 hours back to my region to see his primary health care provider who would then have referred us back to the local guy in Yellowstone, so we could then drive the 15 hours back there to have to possible broken finger looked at.



Ultimately I had to initiate the mandatory arbitration provision of the policy for me to get my $100.00 that I was owed.



I can see why a Doctor would want out of that crap, but I cannot see how by giving an insurance company more latitude to screw over the average American, we would end up with a better system.



If they fought me that hard over $100.00 imagine how hard it would be to collect on a $50,000.00 surgery.
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BYULV
ABYUFAN wrote:
How about getting doctors out of the insurance business. Do not allow doctors to bill insurance plans directly, rather require each individual to bill their own claims. This accomplishes a number of positive things:



1) the potential for fraud/abuse is nearly eliminated (I have heard estimates of $billions yearly due to false claims);

2) patients will know what their costs are upfront, before they see the doctor (medical services will start to become commodities sensitive to supply and demand which they currently are not)

3) medical office operating expenses will be cut by $50K - $100K yearly per physcian by eliminating interactions with insurance companies (multiplied by # physicians in America = $$$$$$).

4) patients become more active participants in their healthcare by being sensitive to the insurance coverage they have, by knowing what things cost and by being the true consumer of healthcare from the physician rather than through the 3rd party insurance companies.

5) other benefits I'm sure, but these are just off the top of my head.


We had a family vacation in Yellowstone and there my son's finger was shut in the van door. Fearing a possible broken finger we took him to the local medical clinic for an x-ray (not broken, we just put a splint on it.) I paid for that out of my own pocket and sought reimbursement from the insurance company directly. Over the course of more than a year, I literally heard five (FIVE!) different reasons why they wouldn't pay for that claim - one person indicated that I should have driven the 15 hours back to my region to see his primary health care provider who would then have referred us back to the local guy in Yellowstone, so we could then drive the 15 hours back there to have to possible broken finger looked at.



Ultimately I had to initiate the mandatory arbitration provision of the policy for me to get my $100.00 that I was owed.



I can see why a Doctor would want out of that crap, but I cannot see how by giving an insurance company more latitude to screw over the average American, we would end up with a better system.



If they fought me that hard over $100.00 imagine how hard it would be to collect on a $50,000.00 surgery.


If you had to fight for even the most basic reimbursements all the time like you did in this case, you would be looking for a new insurance plan. Insurance plans would have to start catering to their subscribers and be more honest to keep their clients. It's a self-correcting problem. Your experience is what a doctor's billing office goes through every day with a huge portion of claims. Currently doctor's offices are paying this cost and the insurance companies are getting away with this type of abuse. Doctors can do very little about correcting this problem because they are not the subscriber of the insurance plan - and as patients we don't do anything about it because we don't usually realized there is any kind of problem because the doctor's office is dealing with the insurance company's denials. Think about an auto insurance plan giving you that much trouble, it wouldn't happen becuase they know you would find another company.



Additional evidence to support this theory is the advertising of auto insurance companies. How often do you hear ads for auto insurance based on customer service related issues (quick claims approvals, immediate call response, roadside assistance, etc)? The auto insurance industry is driven by providing good coverage at comptetitive rates with good customer service. Making health insurance more direct to consumers in a similar fashion will naturally bring health care insurance more along these lines as well.
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ABYUFAN
BYULV wrote:

If you had to fight for even the most basic reimbursements all the time like you did in this case, you would be looking for a new insurance plan. Insurance plans would have to start catering to their subscribers and be more honest to keep their clients. It's a self-correcting problem. Your experience is what a doctor's billing office goes through every day with a huge portion of claims. Currently doctor's offices are paying this cost and the insurance companies are getting away with this type of abuse. Doctors can do very little about correcting this problem because they are not the subscriber of the insurance plan - and as patients we don't do anything about it because we don't usually realized there is any kind of problem because the doctor's office is dealing with the insurance company's denials. Think about an auto insurance plan giving you that much trouble, it wouldn't happen becuase they know you would find another company.



Additional evidence to support this theory is the advertising of auto insurance companies. How often do you hear ads for auto insurance based on customer service related issues (quick claims approvals, immediate call response, roadside assistance, etc)? The auto insurance industry is driven by providing good coverage at comptetitive rates with good customer service. Making health insurance more direct to consumers in a similar fashion will naturally bring health care insurance more along these lines as well.


In the last 15 years I've had half a dozen different health insurance companies (but amazingly one car insurance company) I've hated every single health insurance company. perhaps they would be easier to deal with in a more open system, but it won't be an easy transition.



And I figured that that is the kind of crap doctor's offices had to deal with on a daily basis, which is why I super-bolded my belief that Doctors would love to get out of that system. And, perhaps it would lead to lower cost of services when a Doctor's office isn't paying hundreds of thousands of dollars every year for employees that do nothing more than try to get the money from the insurance company that the doctor's office rightfully earned.



So maybe it would work, but I'd hate to see it "as applied" in the transitional phase
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CougarClaw
are any of you running for office? I'll vote for you.



I really like the transparency idea. have the doctor's give me a "menu" of things I want done INCLUDING PRICES and let me make my own decisions. I would hate dealing with insurance companies, but if it meant service improved and prices came down, I'd live with it.



Limiting medical malpractice has to come in here somewhere since doctor's two largest expenses are 1) customer who don't/can't pay and 2) malpractice insurance. I'm all for having recourse against truly negligent and poor care, but the proliferation of trial lawyers and predatory medical cases only clogs up the judicial system and prevents people from forgiving each other.



And here's something that will take a real political hero to attempt: Get rid of Medicare/ Medicaid and Chip (frees up about 40% of the federal budget instantly) and replace the institutional elderly supportive care (no more free electric wheelchairs!) with infant through teenager preventative medicine. Sorry Grandma, I love ya, but babies are more important than you.



As long as AARP is the most powerful lobby group in america, it'll never happen, but we can't keep supporting this level of care. The money simply is not there. It's going to break the system.
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BYULV
CougarClaw wrote:
are any of you running for office? I'll vote for you.



I really like the transparency idea. have the doctor's give me a "menu" of things I want done INCLUDING PRICES and let me make my own decisions. I would hate dealing with insurance companies, but if it meant service improved and prices came down, I'd live with it.



Limiting medical malpractice has to come in here somewhere since doctor's two largest expenses are 1) customer who don't/can't pay and 2) malpractice insurance. I'm all for having recourse against truly negligent and poor care, but the proliferation of trial lawyers and predatory medical cases only clogs up the judicial system and prevents people from forgiving each other.



And here's something that will take a real political hero to attempt: Get rid of Medicare/ Medicaid and Chip (frees up about 40% of the federal budget instantly) and replace the institutional elderly supportive care (no more free electric wheelchairs!) with infant through teenager preventative medicine. Sorry Grandma, I love ya, but babies are more important than you.



As long as AARP is the most powerful lobby group in america, it'll never happen, but we can't keep supporting this level of care. The money simply is not there. It's going to break the system.


I agree with you on these points.



hopefully when the insurance companies are required to be more transparent and people actually know what their policies do and don't cover there will be a need for the insurance companies to become more subscriber friendly. Right now they can make claim denials a commonplace thing because the people paying the bills (policy holders) aren't involved and therefore won't take any action. If you actually have to provide services to the people who are buying the policies, then you will automatically become customer service friendly or will go out of business.
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scott715
So why do we have hearings with politicians on how to fix it? Why don't we get a room of Doctors and see what they suggest?
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CougarPeasant
In addition, get rid of Pelosi and Reid.



Just my 2 cents.
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scott715
Best idea yet.
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BYULV
Being in NV we may have some say in Reid's destiny this fall. Hopefully we can come up with a good candidate to run against him, because he is very vulnerable right now. 3-4 decent candidates so far, but no one has really stood out yet . . . hopefully soon.
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Mars
CougarPeasant wrote:
Get rid of Pelosi and Reid.

As a Californian and a Mormon, AMEN and AMEN!!
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nuk13
There are many problems with health care. From what I can see (no I haven't read the 2500 pages) they aren't fixing the problems, just paying for them.



I haven't heard anything about the hyper cost of med school. When someone goes to school 9 to 11 years and pays $300,000 and more we ain't gonna have reasonnable health care costs.



I also think lawyers and law suits needs to be addressed. That will be hard if there's as many lawyers in Washington as I've heard there are.



How much do medical people pay for government paperwork? Has that been addressed?
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BYULV
nuk13 wrote:
There are many problems with health care. From what I can see (no I haven't read the 2500 pages) they aren't fixing the problems, just paying for them.

I agree. Fixing healthcare would be much easier if we addressed one problem at a time, actually attacking the problem and not complicating the issues with unrelated. Make 10 small bills, each adressing a separate problem. Let the debates roll and see what we can come up with to actually solve each problem. (side note: I hate it when I hear people defending this healthcare bill by saying, "well at least they are doing something. Something is better than nothing." The next person that says that to me is going to get a prescription for their cold . . . "Here's your cyanide tablet Mr. Jones. Doing something, anything is definitely better than just leaving it the way it is." ;)



I haven't heard anything about the hyper cost of med school. When someone goes to school 9 to 11 years and pays $300,000 and more we ain't gonna have reasonnable health care costs.

I kind of agree with you here as well, however, healthcare costs are not on the rise because doctors are making more and more money every year. I started practicing medicine nearly 8 years ago and every expense I pay has gone up nearly every year. On the other hand, every reimbursement I receive from insurance companies has either stayed the same or gone up during that same 8 years. I'm probably a little sensitive on this point, because there seems to be a growing sentiment out there that doctors are getting rich on this system. I also see a trend toward devaluing the services physicians provide, especially in primary care... anyway, this cost of med school problem is now solved since Pres. Obama declared last night that we won't have to pay back our school loans if we work for the government for 10 years or if we pay back 10% a year they'll take care of whatever else is leftover... I love all this free money :whistle:



I also think lawyers and law suits needs to be addressed. That will be hard if there's as many lawyers in Washington as I've heard there are.

Way important. You hit right on the problem here. With all the lawyers in Washington and in the States lobbying it is an uphill battle. There is an ever increasing attack by lawyers on doctors, hospitals, pharmaceutical and medical device companies, and any other provider or supplier of healthcare services and supplies. All I see on daytime TV are ads for Plaintiffs attorneys and companies trying to sell gold.



How much do medical people pay for government paperwork? Has that been addressed?

It's a lot of work and expense to keep up with the government's demands and it keeps getting more onorous. OSHA, HIPPA, ADA, FMLA and other legislation aimed at protecting Americans in one way or another are becoming beuracratic nightmares for doctors and employers. We need an overhaul big time.
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bigbluepuma
Excellent assessment, byulv. The problem isn't with the healthcare, at least not yet. That will change if this bill goes through. The problem is with runaway costs. The first thing that should be addressed is the out of control court system. That does more to increase the costs than anything. The second thing is the beurocracy. Unfortunately, that will be as likely to change as the court system. The third thing is the idea that it can AAAAAALLLLLL be fixed in one fell swoop with a single gigantic bill. What that is going to do, by all reports , is raise the cost of health care (see the original problem). I don't see any hope for relief other than keeping the government out of it as much of it as possible.
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BroncoBot
http://bigjournalism.com/kashiver/2010/02/10/willful-blindness-msm-ignores-republican-half-of-the-story-on-healthcare-reform-efforts/



Not a huge fan of republicans, just a fan of stopping the federal govt from stepping on our toes at the moment. But I did find this article interesting. Repubs have had some good ideas on the table for a while now. And amazingly their bills are less than 200 pages long. Too bad non of them have been taken seriously by this so called "bipartisan" effort.
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bigbluepuma
declocoug wrote:
http://bigjournalism.com/kashiver/2010/02/10/willful-blindness-msm-ignores-republican-half-of-the-story-on-healthcare-reform-efforts/



Not a huge fan of republicans, just a fan of stopping the federal govt from stepping on our toes at the moment. But I did find this article interesting. Repubs have had some good ideas on the table for a while now. And amazingly their bills are less than 200 pages long. Too bad non of them have been taken seriously by this so called "bipartisan" effort.


Last night, Obama was on TV saying that bipartisanship didn't mean him agreeing with everything the republicans want to do. He didn't make any mention of agreeing with something from the republicans, or of the fact that the only chance for "bipartisanship" that has been offered to the republicans is to agree with everything the democrats want.
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CrimsonCoug
A scattershot of thoughts:



A public system should:

cover low-probability, high cost events. Work backwards down the probability/cost spectrum to the point where the polity (median voter) believes the cost in taxes is too high--probably somewhere just below emergency appendectomies.



A public health care system should not:

cover behavior induced or exacerbated problems. No public money paying for problems caused by over-eating, bad dietary choices, smoking, drug use, etc.



Other related thoughts:

ban soda, candy, and high-calorie, low nutrient foods in school cafeterias and vending machines, and vendors of such within a half mile radius. And government subsidy of healthy school lunches and snacks is totally appropriate.



Give tax breaks to fat farms and drug rehab centers (are we already doing this?) and let attendees write off a share of the cost.
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