U.S. Healthcare Difficulties Solved...

Tom,

Some regulatory oversight is needed, for sure.  None of us still living are angels.  But strict enforcement of basic common sense regulations would go a long way towards solving all problems.  A standardized accounting practice for all businesses would help.  A common man should be able to understand 90% of the finanacial standing and business practices of a corporation.  Dciphering current accounting methods, as a shareholder or customer is currently impossible.  I think much of the gobbledygook is intended to make one throw up their hands in despair.

And regulations by definition come with a cost.  Requiring an "insurer" to cover the cost of every expected healthy patient test or treatment, such as oral contraceptives or screening colonoscopy, simply adds the additional administrative costs of passing the paperwork through the third party payor unnecessarily.  Requiring an insurer to cover cosmetic procedures spreads the cost of elective therapies to those who may simply not want to bear that burden, but now have higher insurance costs to subsidize their fellow man.  Thoughtful intelligent regulations not driven by emotion could help bring costs down.

The "self-tax" could be applied to the insurance industry, too.  My goal is to keep the money from going to Washington where it will be diiverted to other causes, an undeniable reflex of politicians.  The insurance company's pool of profit that might otherwise be doled out as compensation could be progressively assessed the "self-tax".  Say it was 5 million total, the self tax could require 30% on the first million, 50% on the second million, and 70% on up, goes to the tax pool (totally arbitrary numbers).  The executive still has incentive to maximize profits, but the set-aside self tax now has a pool of money to use for the benefit of providing healthcare.  This set-aside self tax could be administered at the local, regional or state level, perhaps with volunteer or selected boards.  This would keep the money in the healthcare system, give control to the people, and keep executive salaries under control.  We'd have to see how big the contentions about the use of the pool of money went.  That's back to the problem of poor intrinsic personal accountability and ethics.  Big money brings big problems.  Big governemnt brings big problems.

Deregulation of the financial industry might be part of the problem in that industry, but I firmly believe it was a failure to enforce existing regulations.  Do you truly believe there was no one in the government who knew there were timebombs set all over the financial system?  Good luck convincing me of that one.  Here's a novel idea! NO CAMPAIGN CONTRIBUTIONS FROM BUSINESSES!  No businesses, no exceptions.  That would include any legally organized group specifically designed to influence the govrenment.  I know, freedom of speech will come up.  Freedom of speech was a right given to individuals and the press.  Talk all you want.  But I don't find passing money to politicians through a business or organization to be in that amendment.  Certainly individual citizen contributions should be continued.

I'll think about your ideas.  Any regulations should be the minimum needed to prevent fraud and gross excess (a point for contention).

I trust that you're bight, but you probably didn't know anything the regulators didn't know.  I think there were willing co-conspirators in the government.

I don't think we see the world the same.  Virtually all Americans have opportunities not afforded anywhere esle in the world.  Trying to ensure equal opportunity is noble, thrying to ensure equal outcomes is futile.

The average American is probably not looking for a handout, but the average American would sure take something given them with no strings attached, I believe.  That is a downfall of our political system.  Promising people something for free in return for a vote works, because they will take that that freebie.

There are large numbers of Americans who do have the entitlement attitude.  I deal with them myself.  We've got to discourage that attitude.

I'm having to make my own terms since I'm not a business student.  We currently have a government taxation system where the government takes money and decides what to do with it.  The self tax would be a mandated set aside percent of profit that remains at the level of the business entity and is locally controlled by non-politicians.  Using a community hospital, for profit, the mandated progressive set aside amount would go into a separate account in the name of the business, but no longer under the control of the hospitals board, but rather a board of community volunteers or appointees, to decide on the use of the money.  The mandated use would be for healthcare needs of the area.

If the facility made a 10 million profit, some would go for executive bonuses, and some to stockholders and some into the set-aside, say 40% or 4 million.  The community board that would direct use of the funds could use the money for say pharmaceutical benefits for the needy, health insurance subsidies for the qualified, or transportation for healthcare needs.  Keeping the money out of the hands of the government would stop the administative loss incurred in cycling the money through the government and would keep the money locally.  And the executives would still have an incentive to keep up profits (hopefully through skilled management rather than gouging).  Obviously, the details would have to be hammered out, but I favor this over profit caps or nationalizing healthcare.

The other thing people ignore when they shout that is that some sharing of the wealth is ultimately the pragmatic choice: as wealth disparity increases, so does the possibility of violent revolution and other social disruption that could cost the "haves" everything that they've got.

Ultimately, property cannot exist without social consent, and that consent can be withdrawn when the majority sees a privileged minority hoarding it while their children die. Blood is thicker than political philosophy.

donkeyrider, from your comment;

 Good schools, good healthcare, equals good for America.  But once that magical adulthood emanciption occurs, it is back to the school of hard knocks.

Funny you should mention the 'school of hard knocks'....you also mention darwinian thinking within your comment, so let's presume you're insinuating the great advantage that people in perfect health have over those bums, who are always getting sick, and how they are entitled to relegate those of us who just don't 'cut it' to homelessness, and endless debt....Oh, what a great man you must be...so authoratative...so very wise.....hard knocks...let us have more of them, so that we can become even greater than we already are....we'll be like the marines compared to the losers.....surviving, lying, cheating, stealing our way if we have to....hard knocks philosophy...what a crock...I'm sitting here, at risk..one step away from homelessness, and I'm supposed to go out and work for people like you, who see me immediately as a liability, because my resume is dotted with firings brough on by my health issues, that eventually, through lack of medical care, and chronic illness brought me to become relegated to temporary work positions, and odd jobs...  I've got 3 teeth that need to be pulled, I'm 58, and management is so adversarial to people like me....I'd love to have some health care... I'd like to know that, in my struggle to get back on my feet that I had such a partner as my country, to give me at least my dignity....hell, I'll pick up trash alongside of the road, but, don't fire me when the day comes when my survival instinct tells me to take off some day, when my illness progresses to the point where the cost to my health is more than the benefit of working....so far, it has been the management that, because they do so little actual physical labor, who have benefitted, with the best wages, health care, and best working conditions, who've managed to 'survive'...  big woo to you...

   I'm excluded...went to good schools....have no access to private health care any more...good for YOU, that you can do better....

Lovetrust and Tom,

I was discussing general philosophy and potential government policy options.  I wasn't trying to cover the exceptions, and Lovetrust, you are an exception.  I don't want to comment on individual cases, because as one dissects out an individual's past, it might cause hard feelings.  There should be some safety net for all, and there is, but it could be improved.  My comments were about how we get out of the subcultures where anything you do is ok even if it wrecks your health and your community.  A major financial burder is generated from these activities and most people, liberals and conservatives and middle ground people alike, would not willingly put their own family's security and revenue on the line to pay for say, a liver transplant in a felony convict for a violent crime, the liver transplant needed due to alcohol and drug liver failure.  That is an actual patient I have now, on hemodialysis in a hospital, and the current hospital bill will be in the $60,000 to $80,000 range, at least.  There is not enough wealth in the world to pay for all of the potential demands for services that are available with our advanced technology, even if we reduced the costs by 50%.  And the money that might otherwise cover lesser cost services for thousands can be consumed by a few.

The employer based health insurance idea is doomed to fail.  Why should employers have to adopt an employee?  Get all responsibilities and liabilities for anything except the wages off of the employers backs.  Where did this idea come from in the first place?  It makes about as much sense as demanding that your nearest neighbors pay for your healthcare.  I think they'd move real quick.  The government and liberals have this notion that businesses have and inexhaustible supply of cash and that they hoard it and are mean and cruel and viscious, conspiring each day to take more from their employees.  Hogwash.  As an employer, I have a duty to my family, my emplyees (too keep them in a job), and my customers.  In a small business, the insurance premiums are directly affected by the insurer's estimated outlay risk.  An identified high cost employee can ruin the business if the health insurance burden is assumed, take from the other employees (through job loss or non-availablity of revenue for wage increases or other benefits), and adversely affect the customers (loss of access).  No one wins if there are no jobs.  Banish this foolish employer based healthcare funding!!!

Good Day Care?  Two problems there.  There aren't enough trustworthy and decent people around that I would want to leave my kids with, much less for millions of kids.  Maybe its different where you are.  Second, if you can't afford your own family, you've most likely failed to think through the consequences of having that family.  The philosophy I'm seeing here bothers me, because it is is not a safety net to care for those who have catastrophic life circumstances, but assumption by the public of responsibility for day to day expected obligations.  There will be no end under that paradigm -- food, homes, energy, clothing, trinkets, gadgets.  We didn't get to be the most prosperous country in the world by turning over our responsibilities and ambition to the government.

And Lovetrust, I see charity cases every day, voluntarily.  I also see the Illinois public aid patients, who in Illinois, are basically charity care.  But it is cause for concern about my fellow man when the public aid patient comes and says they can't afford their $2 copay, while they are talking on their cell phone and have a $5 pack of cigarettes in their shirt pocket.  It happens all of the time.  I am inclined to direct my charity to those who have their priorities straight and demonstrate continued efforts at recovering from their medical problems when possible.  The school of hard knocks was directed at subcultures, not individuals who have failing health for other reasons.  I'm familiar with the impairments health issues cause, frequently insurmountable, and frequently a source of permanent disability.  But I also know a subtantial percentage of "disabled" persons could work, but take the easy way out.  Some do continue to work "under the table".  There is no program that won't bankrupt America if we don't hold people to certain behavior and ethical standards.

Tom,  I think you misunderstand the current hospital payment system.  Since you are in business school, it will probably come up.  While there are exceptions, hospitalization is paid for by the disease diagnosis, not the charges submitted, for Medicare and many private insurers.  The wealth of the community wouldn't matter for the Medicare population about the revenue coming in to a predominately Medicare facility.  The community hospital is frequently the largest employer and largest source of "outside" money coming in.  A well run community hospital could make millions and millions for the community.

All right, Tom.  You and your son have fun!

By the way, I was trying to think of one time when the have-nots overthrew the haves when the haves were not the governnment itself.  Now I could have looked it up on the internet, but those I recall from my schooling were the people overthrowing the ruling class.  Can you remember any (they mught have been in the book you read, that I haven't read.

I'm not recalling any overthrow of a free market society by the have-nots because the haves kept all of the wealth.  I am more fearful of my governnment than I am of successful private businesses.

It is not the laws I necessarily want people to learn.  Something more rudimentary but important, such as borrowing carries risk, certain behaviors carry risk, disrespect might be reciprocated, etc.  The laws can change but the basics are immutable.

Thanks, donkeyrider, for 'talking me down'... I'm not your enemy, and, you're not mine... the perspective you hold as a healer ( and, I presume that is what you are ) is important to me.... What you said about the employer-based insurance being doomed to fail, I agree...It's a shell game...

     I'd like to hear some feedback from you on how you'd create an inclusive society that excludes the compromised because of health....  I've had help, with the voc-rehab, and I wouldn't be here but for those involved in making that possible... but, still, though I'm grateful, I have disabilities that effect how I'm percieved by an employer.  My work history is full of instances where my weak constitution has been my downfall.  Now, mind you, I'm very grateful at every opportunity to work, and, I work hard at becoming an asset to my employer, and earn recognition for my devotion to my duties... but all that goes, when my health suffers...employers make token offers of health plans that I cannot afford...that's been my experience...You have to make a living wage....you gotta pay the bills...I'm barely holding onto my car insurance...The world has not been functional for me, but I still know I'm lucky to be here.  I still want to help make the world a better place for us all...I just don't see the point in my neglecting my health to accomplish that...It's just not sensible, when push comes to shove, though it costs me my job, I still know I cannot neglect my health, and it's a shame that I'm required to choose, for the sake of my job.  You, at least, truly have all the tools to maintain your good health...you earned it....I'm sorry I've been a sickly man.  It has been a long, hard road... I'd just like to think that those who come after me, with similar afflictions can somehow address their health issues more intelligently and promptly...