LOL, you really hate "conservatives," don't you? But glad to hear you're not for unlimited healthcare all the time.
Specifically, I really hate people who are actively trying make our broken healthcare system even worse. I was briefly hopeful that Donald Trump was actually going to try to improve things, based on his campaign rhetoric, but then all of the republican plans that were put forward seemed like steps backwards.
Rationed care is but one of the few ways that must be instituted.
Can we start by giving doctors the authority to ration that care, instead of insurance companies?
You work for the federal government and therefor your income depends on taxes.
I work for the federal government because it's the place I feel like I can do the most good in the world with my skill set. I assure you that this decision came with a considerable pay cut compared to doing the same work in the private sector. And as an aside, I find your casual judgment of my moral sensibilities to be condescending and offensive. You're entitled to be both of those things, though, so you go right ahead and judge me and I'll go right ahead and judge you for it. Deal?
In the US the answer is not as simple as single payer.
Definitely not! Have I somewhere suggested that single payer was a panacea for American healthcare? There are a whole host of associate issues that would have be simultaneously addressed if we tried to institute a single payer option. I'm also fine with private healthcare existing as a supplement to guaranteed basic services for everyone, and I'm even fine with corporations profiting off of being the middle man between people who need care and the government that ultimately pays for it. What I'm not fine with, and what pisses me off the most, is how the current American system deliberately exploits some groups of people while denying necessary and life saving care to others. Can we talk about ways to address some of those problems?
Sol,
Thank you for responding. Sorry for the delay, but my work and life take precedence over forum replies. Either way, here is my response.
1) Doctors can attempt to ration the care, but todays climate makes it very difficult due to some regulations such as:
a) Patient satisfaction which is tied with reimbursement. If patients don't get what they want, your scores suffer and so does your wallet. Family wants their decrepit with no quality of life great great grandfather to have their colon cancer treated with surgery, radiation, and a feeding tube.
b) Fear of missing something right away and the patient having a worse outcome as well as the physician getting sued in the process. When we ration care we need to also accept misses. For example, not every headache or abdominal pain needs a CT, but it may delay catching the appendicitis or the brain bleed on someone in the future. We need to decide if this is acceptable to our population and make the necessary changes to allow for it.
2) Regarding judging, I get judged on a regular basis and have no qualms of being judged by you or anyone else. My comment was intended to invoke a response which it did. Although you may be different, or maybe not different at all, most people who are paid by taxes are equally eager to make sure those taxes are collected, and as much as possible. It is a bit of self interest at play which may be conscious or subconscious. It is no different that myself being concerned about trying to fix healthcare costs by simply paying physicians less as opposed to fixing the inefficiencies of medical care today.
3) Actually I believe and may be wrong that you are a big proponent of single payer and have even written scenarios of how do accomplish that. Again, we currently have a single payer system for about 1/3 of the US population with private insurance covering almost everyone else. Yes there still exists a significant population who is not insured and has poor access to healthcare. This current single payer system is failing considering the cost of healthcare for Medicare/Medicaid patients continues to rise and the reason why this is such a hot topic. I also strongly disagree that we need an insurance middleman for the majority of our health expenditures. There is no need for the insurance middle man to take a cut on every inexpensive medication and doctors visit. It is just one additional item that increases the cost for those patients.
4)
What I'm not fine with, and what pisses me off the most, is how the current American system deliberately exploits some groups of people while denying necessary and life saving care to others. Can we talk about ways to address some of those problems?
Currently each and every person who shows up at the hospital will receive life saving care regardless of ability to pay so that discussion is off the table. What pisses me off is that we are stuck talking about who will pay for healthcare instead of discussing how to decrease cost. Because at the end of the day not everyone can receive healthcare the way it is currenlty expected/demanded. We simply need to cut costs and only then can we talk about making sure every person in the US can afford healthcare because currently it is unafordable. Just like on this forum both Democrats and Republicans are having the wrong discussion and it is the problem.
5) You mentioned that republicans want to cut taxes on the richest people. Yes, it is true but a little disingenuous for 2 reasons.
a) It removes the Obamacare surtax which was an added tax on higher income Americans. Obviously removing Obamacare will affect that tax.
b) Cutting taxes will always affect the wealthiest people because they pay the most taxes. Cutting 1% on someone who makes $1 million/yr vs cutting 1% on someone making $100k/year will affect both people differently.