The root of the problem is the tie between insurance and employment (a legacy of WWII wage and price controls, enforced by the fact that the tax code treats insurance as a deductable expense if provided by the employer but not if provided by the employee).
There was an attempt to patch up some of the problem with medical savings accounts, but those got screwed up by a system where one has to either 1)have insurance that meets a bunch of irrelevant requirements or 2)forfeit any unused funds at the end of each year.
Well I’m new to all this wonderfulness myself, so I may be minsunderstanding. But the “Medicare Drug Plan for Dummies” web instructional seemed to indicate that was the case.
Silly ralph. Undergoing chemotherapy is never a guarantee that your cancer isn’t going to kill you.
Did You Know: Socialized medicine has been in use throughout Western Europe for fifty years! They won’t admit it, but all that time they’ve really just been working out the legal niceties. That way, when we Americans get socialized medicine, everything will work out nice and smoothly. Wasn’t That Nice Of Them?
While you try to wrap your head around the idea that the government buying us cough syrup isn’t the end of the world as we know it, perhaps you can explain to me why it is that firefighters never bill you after they put out your fire and yet doctors do? What is it, exactly, about emergency medical care that makes it different from other emergency services?
The discount cards were big fun. You had to go through a bunch of cards to determine which was best for you .If you took muntiple prescriptions It required a lot of wprk. Plus many retirees are not computer efficient. Then once you picked out a card that you liked you were locked in for a year.However the prices were not locked in. If your card was no longer the best. tough luck. The bill was written by and for the drug companies.
You missed a big chunk here, ralph124c. The government is a fourth party in the long-distance transaction. The insurance companies are big campaign contributors, so dozens of different “plans” get a piece of the pie, needlessly, as the tax dollars flow through Medicare and Grandma’s premiums flow from her purse through the insurance companies, to the drug companies and into dear Mamaw’s pill bottles.
The drug companies contributed a massive amount (IIRC, second only to the banks,) so they got a clause that says they get paid list price for every pill, with no negotiation for price. Medicare (your tax money) pays them whatever they ask. It’s the law.
I got your drift about the liability issues, but it’s chump change compared to the sweetheart deal with the insurance and drug lobbies.
I’ve made this assertion before as well. Political pressure is beginning to boil in the electorate for some form of National Health Service that will reduce the cost of health care to a negligible amount.
You really think the baby boomers are going to tolerate paying that much for heatlh care into their 70s and 80s when they could, as ever, demand government provide it? Hell, no. Politicians who stand foresquare against such a program will be looking for work PDQ.
“According to a recent report by the organization, the median difference between what Medicare and the Veterans Administration pay for the top 20 drugs is 46 percent. The prices of a few drugs differ by much more than that. Medicare pays 901 percent more for a year’s supply of Zocor, for example, and 418 percent more for a year’s supply of Protinix.”
And, of course, the VA and its patients are widely known as radical, commie pinko, subversive, fascist, socialist revolutionaries. If we can do it, why can’t the rest of the gubmint?
I just love it when the Republicans defend how good a job the VA does and then slams the government’s involvement in health care. And they do that little two-step a lot.
“Our VA hospitals are great! The government can’t get involved in health care! The government will ruin health care! The VA is super duper!”
I dunno about the scenerio that SteveMB describes, but I do know that about 15 or so years ago an employer of mine offered “medical savings accounts” and if you didn’t use the money at the end of the year, you forfeitted it.
Well, I don’t know about 15 years ago, but I DO know that right now, today. A MSA consists of a high deductible insurance plan(max 2500 per individual, 5000 per family, pretty basic with no “irrelevant requirements”, but the plan has to qualify) with a savings account that rolls over into the next year; if you never use the money in the savings account you get it all back at retirement. Think of it as an IRA with a lousy return, 'cuz basically, that’s what it is.
Until they have to pay for it. Your “negligible amount” is a fantasy, a carrot held out to ignorant mule. Are you ready for 40-50% tax rates? I’m not. You want UHC, than that’s the price.
Ah, what you’re describing is a “Flex” plan. Flex plans come in two flavors. Medical flex plans and Dependant Care flex plans. The are useful if you know that you’re going to have to spend a set amount for medical expenses. For example, Mrs Magill has to spend $X for her Synthroid and $Y for semi-annual endocrinologist appointments, so we deposit $X+Y in her flex account. We also spend $Z on Fang’s daycare, so we deposit that in the other Flex account. The Medical Flex account comes with a debit card that we use at the Doctor’s and the Pharmacy, then we send copies of the receipts to the account provider (to keep the IRS goons off our backs). The Dependant Care account cuts us a reimbursement check twice a year.
Since Flex accounts are Pre-tax deductions from our paycheck, we do not have to pay taxes on that money. This is nice. The downside is that I have to further segregate my receipts into ones covered by the account and those not covered, so I don’t double deduct come tax time.
If you do not know and cannot reasonably estimate what your medical expenses will be for the next year, I would not recommend a flex account. As you mentioned above, if you don’t use it, you lose it.
As opposed to what, Dave? Health care taking 20%+ of gross domestic product? Cite.
I’m speaking politically. Voters will demand it upon pain of firing congressmen and such. At that point it’s provide or die they’ll provide and damned to the cost.
I’m pretty doubtful about your numbers. Again, by my cite above the average cost in 2004 was over $6200 per person. Even a transfer of 50% of that figure in NHS taxation (which I’m not willing to concede) would allow for $930,000,000,000
And I concede your knowledge of insurance, Dave, you know that. But simply saying ‘nothing will work’ isn’t finding a solution for a system that’s pretty clearly unsustainable. It’s broken and we need a fix. The issue becomes what sort of fixing and what sort of rationing we want.
Well, as i say, you might well wish to use a different chemotherapy drug-say a new drug developed in , say France. the Medicare people only approve the offered drug-so, you are SOL. it is YOUR life, don’t forget-some faceless bureaucrat doesn’t give hoot in heel whether you survive or not! :eek:
Heh. I find it bizarre that the US spends a far greater proportion of its income on health than any other developed country and still manages to have tens of millions of people with no coverage. The average figure for Europe is about 8.7% of GDP. Even the notoriously expensive German system (regarded as a huge drag on employment and economic recovery) is about 11% of GDP. For the US it’s currently 16% of GDP for partial coverage. The quality for those who do have coverage is probably better, but still, it seems like very poor value for money.
This is definitely a problem in the UK - the so-called postcode lottery where some health authorities will pay for certain treatments and others won’t. How does that work in the US insurance system? What happens if you need some thousand-dollar-a-dose drug three times a day for six months to take your survival probability from 40% to 80%? If I was an insurance company, I’d duck that wherever possible.
I think our (USA) ENORMOUS expenditure on healthcare is due to 2 factors;
-1) malpractice insurance. We have 1 million lawyers; all of them looking for work. Some doctors (neurosurgeons) have to pay $250,000 for insurance!
-2) we employ large numbers of people to process medical-related paperwork (claims, proof of claims, rejected claims, legal challenges, etc.). this costs a LOT of money.
We have the wealthiest lawyers and the largets healthcare system in the world-and most of it is NOT directed at actual healthcare! :smack:
