Actually, single payer is a big part of how you get rid of that bureaucracy and cost.
You're a funeral director, eh?
the dead are the cheapest part of this whole thing.
You seen the US government try and run something without piles of beauracracy?Actually, single payer is a big part of how you get rid of that bureaucracy and cost.
What is preventing companies from marketing the old EpiPen design? Or from marketing pre-loaded syringes? I'll give you a hint: it can be spelled with three letters.
You seen the US government try and run something without piles of beauracracy?
You seen the US government try and run something without piles of beauracracy?
Drugs and medical devices (even generic) need testing and regulatory compliance for the FDA to deem them safe. This, of course, takes time and money. Thus, when the margins are low, people live with a single manufacturer. This has proven to be a new exploit (e.g. epipen, Daraprim).
It isn't inherently an FDA problem. They're just doing their job in protecting the public from a drug or device that hasn't been adequately tested.
A simple solution would be legislation to set limits on price fluctuation for single supplier medications.
Likely this would cause manufacturers to price slightly higher, but that will also open up more margin for competitors to get in the game. Still, there are R&D costs to develop the manufacturing and marketing costs to compete. Thus, a free market might not be best for consumers.
But it could help close the loophole, and also help prevent drug shortages.
Worth it? I'm not sure. It's telling that this doesn't happen more often. Pharma is not well thought of on the ethics front, but I don't think their relative kindness here is just for optics (perhaps to keep regulation farther away). But personally I think event these ruthless businesses still care about the general public health good.
Another big part of the equation, to me, is eliminating the artificial restrictions on the supply of healthcare providers. I work for a 400+/- employee organization, which operates an on-site clinic. The clinic employs a full-time nurse practitioner, and an RN. These two professionals provide 90% of the healthcare services for our entire workforce and their families. The prescriptions the NP writes are signed off by a local doc, and that's about the extent of his involvement.
You don't need 8 years of expensive medical school to effectively provide most of the healthcare that people need. The military trains expert-level emergency care providers every day. You don't need 8 years of medical school to be an effective ER physician. These are facts.
It's time to break the AMA cartel on the supply of doctors, and watch the prices fall.
I'm not sure about weight.
Why? Obesity is hardly any better than smoking, and it's a tiny percentage of lardasses that can legitimately claim they have a hormonal issue. Car insurance companies already discriminate against men on the basis that men are more likely to get into bad accidents, health insurance should absolutely discriminate as much as possible.
Another big part of the equation, to me, is eliminating the artificial restrictions on the supply of healthcare providers. I work for a 400+/- employee organization, which operates an on-site clinic. The clinic employs a full-time nurse practitioner, and an RN. These two professionals provide 90% of the healthcare services for our entire workforce and their families. The prescriptions the NP writes are signed off by a local doc, and that's about the extent of his involvement.
You don't need 8 years of expensive medical school to effectively provide most of the healthcare that people need. The military trains expert-level emergency care providers every day. You don't need 8 years of medical school to be an effective ER physician. These are facts.
It's time to break the AMA cartel on the supply of doctors, and watch the prices fall.
Those skimpy policies sucked pre-ACA, despite what you might think. They also had maximum payout caps - end up in the ICU for a few days, congratulations, you just hit your cap and are now facing medical bankruptcy. Or your doctors in the hospital weren't covered, only the hospital was covered, etc...If the Republicans were smart, small changes to ACA could be done that are consistent with what Republicans can actually sell to their base:
The individual mandate can be formed into something that can work. do away with penalties and enrollment periods. Instead, pre-existing conditions are not covered for some amount of time proportional to how long you had been without insurance (min 6 months, max 12 months). That would discourage some people from signing up only after they are sick since they would have to wait a long time to get care. Switching from one plan to another should still be done with enrollment periods rather than at any time.
The coverage requirements can be reduced to make the program more feasible. I personally am fine with the level of coverage, but many people resent it and are electing representatives to fight it. Certain treatments (birth control) are lightening rods for critics regardless of their cost, so removing them means the program has a better chance of success. Not everyone needs free preventive care or free birth control either, though some do. If your plan covers all proven technologies and there are no maximum payouts, and your out of pocket maximum isn't awful, you've got pretty decent to not awful coverage. have small co-pays for preventive services and birth control. As long as that's transparent and consumers know what they are buying.
Before the ACA, insurers would sell "catastrophic coverage" policies, which would sometimes refer to as "falling off a mountain" coverage, they didn't cover everyday medical stuff (like preventative care), but they'd keep you from going bankrupt if you were a 26 year old who, say, liked mountain climbing, and had an accident. But, under the ACA, all individual policies had to cover a broader range of things, and some Insurance companies killed off the catastrophic policies.
But, it seems the Republicans goal with this bill is not to have a bill that passes, it's to have a bill that fails that they can blame on someone else (Democrats) and use to win reelection; "if you want to repeal Obamacare, we need more Republicans elected".
Or: "We tried to pass a bill that would replace Obamacare with something better, but they blocked us, and now (insert administrative/regulatory sabotage of Obamacare here) Obamacare is imploding, just like we said it would! So totally "not our fault".
Well then it should be far more important to go back to discriminating on pre-existing conditions than obesity or anything else. Is that correct?
I can see the sympathetic argument that those with medical issues beyond their control should be given support to get them on a level playing field with those born healthy. People that eat 6000 calories of carbs and fat each day have no excuse.
I can see the sympathetic argument that those with medical issues beyond their control should be given support to get them on a level playing field with those born healthy. People that eat 6000 calories of carbs and fat each day have no excuse.
Surprisingly, I think that makes a lot of sense. One of my pet peeves is calling something insurance and then expecting it to pay for things we know are going to happen. Insurance only works when it's reserved for large but rare expenses. Otherwise, it has to cost the sum of the expenses plus the overhead, making it a net loss.I would actually go the opposite way, where everyone has universal catastrophic coverage to cover things like cancer and then everything else is paid for by HSAs or whatever. The primary cost driver in US health care is not the routine stuff, it's the end of life care, the cancer care, etc. This is where single payer can really shine if we let it.
Why would that make any more sense from an insurance perspective?