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Re: Radical Health Care System Proposals Stall in Blue States

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Message 11 of 23

@GailL1 wrote:

That actually says NOTHING -

What is access to preventive and responsive health care when we have 330 MILLION people - some that live on top of each other and others that are miles and miles away from anybody.  Some that have geographical access to tons of providers and some that have absolutely NONE in any sort of a close proximity.

 

We shouldn't be middle of the pack in terms of cost - we should provide care that is the most effective at the least amount of cost.  We need to provide only medically necessary, scientifically proven care that works the best for the least amount of cost.

 

Even that leaves out a lot- all those with some special need - orphan drugs, people who need a million dollars worth of care on a monthly basis because it is life sustaining, care for those who have to be institutionalized - meaning paying not only for their medical needs but the total care - personal and otherwise - of the individual.

 

Then we have those who are not citizens or even lawfully present. 

Tell you what - we will give them the same "FREE" Welcome to Healthcare and Annual Wellness Visit that we give to Medicare beneficiaries - being advertised here today  (see above if not blocked)

https://www.merckengage.com/health-care/annual-wellness-visit?utm_medium=dcm&utm_source=5293487&utm_...

 

We have to START with the cost not with the system - if cost are controlled the system or systems aren't such a big deal..  It is cost and the way these are negotiated or designed for our benefit where those Courageous Visionaries that mickstuder referenced will really shine.  It has to be based on something real - we can't pay for everything, we have to pay for the best for the money.  It is only through controlling cost that we will understand what we will be getting once the cost constraints are applied and whether or not this (the whatever consequences of these cost reductions) are gonna be acceptable to us.  There will be changes / repercussions/ consequences because you cannot go from a capitalistic / money making / profit system to one that is based on controlling cost by many measures without affecting the whole system.

 


It actually says quite a bit. Why does America have the only plan which does not cover all legal residents? Why does America have the most expensive health care system in the world? We should not be shooting to be the least expensive and certainly not the most expensive so middle of the pack is a good metric. 

 

Since we have many functioning examples of countries with health care systems that are more effective (lifespan, child mortality, days sick, etc) and less expensive (every other country) then we should look to these examples for how to redesign our own system. 

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Re: Radical Health Care System Proposals Stall in Blue States

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Message 12 of 23

@john258 

I haven't found politicians of either party at any level of government willing to take on the hard task.

I posted about what happened in your state to the "Buy in to Medicaid" proposal. Let me repost it -

 

Let's talk about NM idea - allowing people to buy into Medicaid.  They say they cannot do it without Federal money - why is that?  Those wishing to "BUY" into Medicaid, would be picking up the cost of this part of this GOVERNMENT program - a program where there is 

  • already NO profit for the insurer (the state in this regards)
  • already an administrative system where overhead is at the minimum, so it is said
  • already providers that accept very low fees
  • already a plan to get medications at a discounted rate
  • already claims processing in a centralized and same method
  • already the majority of children having coverage - Medicaid and/or CHIP
  • already (at least some) coverage for dental - well, in many states
  • already a system where the state regulates many of the cost on the providers or the beneficiary.

President Trump, his Adminsitration, as well as some Democratic and Republican lawmakers have made some suggestions on controlling the cost of medication - some real good ones, some with lots of bipartisan support.  Some have been struck down by the Courts because Pharma or Hospitals took it to them.

 

We have powerful medically related industries here that are gonna be fighting cost control with every manner possible - who can blame them.  They estabilish foiundations, some based on patient advocacies with societal supporting sounding names and begin the flaming.  Telling people and it is believed that something that is suggested is a CUT - when in reality it is a cost control method of reining in cost.

 

That is what the fight is gonna be about - COST control and what is covered - not system - That, my dear sir, has nothing to do with party - it has to do with the legislators having the balls to make some really important decisions because, they too, will get some of the brunt of controlling cost - people want, what they want, when they want it - and that may not be the case when cost controls are put into place to help us pay for the best care / treatment for the least amount of cost.

 

If cost aren't not controlled - it will not matter what system we have or who is the payer.

IT IS CONTROLLING COST THAT HAS TO COME 1ST and that is not an easy task when an industries profits are at stake. 

* * * * * * It’s Always Something - Roseanne Rosannadanna
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Re: Radical Health Care System Proposals Stall in Blue States

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Message 13 of 23

@Richva wrote:

It would seem that the first thing to do is to decide our criteria for success. I would say that all Americans should have access to a minimum level of preventive and responsive health care and we should be in the middle of the pack in terms of cost. Since neither of those metrics are met today, perhaps we should look to the countries who do meet those metrics and copy what they are doing?


That actually says NOTHING -

What is access to preventive and responsive health care when we have 330 MILLION people - some that live on top of each other and others that are miles and miles away from anybody.  Some that have geographical access to tons of providers and some that have absolutely NONE in any sort of a close proximity.

 

We shouldn't be middle of the pack in terms of cost - we should provide care that is the most effective at the least amount of cost.  We need to provide only medically necessary, scientifically proven care that works the best for the least amount of cost.

 

Even that leaves out a lot- all those with some special need - orphan drugs, people who need a million dollars worth of care on a monthly basis because it is life sustaining, care for those who have to be institutionalized - meaning paying not only for their medical needs but the total care - personal and otherwise - of the individual.

 

Then we have those who are not citizens or even lawfully present. 

Tell you what - we will give them the same "FREE" Welcome to Healthcare and Annual Wellness Visit that we give to Medicare beneficiaries - being advertised here today  (see above if not blocked)

https://www.merckengage.com/health-care/annual-wellness-visit?utm_medium=dcm&utm_source=5293487&utm_...

 

We have to START with the cost not with the system - if cost are controlled the system or systems aren't such a big deal..  It is cost and the way these are negotiated or designed for our benefit where those Courageous Visionaries that mickstuder referenced will really shine.  It has to be based on something real - we can't pay for everything, we have to pay for the best for the money.  It is only through controlling cost that we will understand what we will be getting once the cost constraints are applied and whether or not this (the whatever consequences of these cost reductions) are gonna be acceptable to us.  There will be changes / repercussions/ consequences because you cannot go from a capitalistic / money making / profit system to one that is based on controlling cost by many measures without affecting the whole system.

 

* * * * * * It’s Always Something - Roseanne Rosannadanna
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Re: Radical Health Care System Proposals Stall in Blue States

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Message 14 of 23

@GailL1 wrote:

@Olderscout66 

I agee with you that it is the Federal Government's responsibility to determine what is covered, set standards for containing cost and coverage and protocols, HOWEVER, we have to get this on a purely scientific and cost basis - not the who yells loudest method - be that lobbyist or an advocacy group.  THIS BY FAR, WILL BE THE HARDEST THING OF ALL.  Stop all this stuff that doesn't work, stop all this stuff that only works part way, protect people from being sold a bill of goods within their healthcare.   That could be done during the approval process for medications and treatments.

 

I think many of these medical things need to be reviewed again scientifically - even though there maybe somewhat of a starting point with the cost of these things based on the rate of what private insurance, Medicare, Medicaid currently pays.  Determining what is the best treatment plan considering the outcome and the cost.

 

Past that, I think the states should play a bigger roll in healthcare as more local entities do in other systems - healthcare is local.  Therefore a state should decide their healthcare infrastructure, their supply of providers, the actual investigation of anything that doesn't seem quite right.

 

I do not know what the roll of private insurers would be unless they offer something above the basic - a private room in a hospital rather than a ward or a semi-private room.  Perhaps faster access to diagnositics as the debate in Canada is pointing out this problem.

 

I still like the idea of states having a high risk pool where people would be placed once their health care cost go over some catastrophic limit. Their premiums would remain the same and we could all pay into such a fund with taxes but on the other hand, it would keep down regular premiums.

 

I do not have the answers but I do not like the Medicare for All concept as far as it has been described today.

 

 

 


The back up to your first post tells all what the underlying problem is and it has nothing to do with just health care. The underlying problem is Trump and what he is doing to health care. If Trump has his way there will be no health care system left in this country. Now you start to solve  all our problems by getting rid of Trump, then quite a few of the various state ideas could work, but this is a National Problem and must be solved on a National Basis. When people zero in on one small part of Health Care they show all they have no understanding of the total health care problem. There is no one in here that understands the full problems with health care, but there are experts who do and if they are used we will find an answer. That answer will be some sort of health care for all as all the experts agree you need everyone covered, and the ACA was the first step toward that goal, and it worked in Mass., and at the National level until Trump. What we need is less talk and more action. The first step in that action is to get a new President who will not follow what a former Gov. of GA told people.

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Re: Radical Health Care System Proposals Stall in Blue States

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Message 15 of 23

@GailL1 wrote:

Business as usual - promises made during campaigning to get the votes go by the wayside when the legislative body begins to look at cost and practicality.

 

When are they going to learn that the way other countries do it takes many different paths of cost control and then modifying these as time and medical advancements take place. Until we are willing to tackle these type of cost controls, we aren't gonna get anywhere at the state nor federal levels.

 

Politico 04/08/2019 - As Dems Debate M4A, Less Radical Ideas Stall in Blue States

 

Let's talk about NM idea - allowing people to buy into Medicaid.  They say they cannot do it without Federal money - why is that?  Those wishing to "BUY" into Medicaid, would be picking up the cost of this part of this GOVERNMENT program - a program where there is 

  • already NO profit for the insurer (the state in this regards)
  • already an administrative system where overhead is at the minimum, so it is said
  • already providers that accept very low fees
  • already a plan to get medications at a discounted rate
  • already claims processing in a centralized and same method
  • already the majority of children having coverage - Medicaid and/or CHIP
  • already (at least some) coverage for dental - well, in many states
  • already a system where the state regulates many of the cost on the providers or the beneficiary.

And Colorado couldn't accomplish their plan of having the option of some buying into their state employee coverage because it is a pretty lucrative plan and the premiums would be too much.  To that I say, maybe they should even out this type of coverage - a single payer system, most likely would bring such a government employee plan back into reality.  

 

And along this same thought, what are Unions gonna do when if we go to a single payer system and thus their bargaining power is eliminated in this regards.

 

We need some REAL ideas and numbers before believing any politician running for any office - we should NOT vote for any "pie in the sky" schemes from any politician or party especially about something of this magnitude.

 

  • We seem to want everything even minimally considered medically necessary covered.  
  • Of course, with no co-pays or deductibles, including Longterm Care.
  • We only want the so-called rich to pay for it no matter where or what they may do to pay for it.  
  • Of course, we only want the best treatment without any inconvenience of waiting.  
  • We want to self-refer, adding up cost to specialist - no matter how many we may visit.
  • We want to show up somewhere for immediate care and/or diagnosis.
  • We want  access to the newest and greatest - even when there might only be (5) people afflicted with a specific malady.
  • We want to live and live and then after that our families might want us to continue breathing, no matter at what cost or quality of life.
  • We want to be treated over and over for the same malady even when it is our own actions causing the reoccurrence ( like addiction)
  • We want the severely mentally ill to be treated in the less restrained environment even though there may be no one in their life to keep them regulated on their meds 

 

We want equality in health care - we want the Basics in medical necessities to be given freely because as some say, this is a right.  I say both equality and basics in this regards are very personalized terms depending upon ones state and desires.

 

Maybe it is time for some real specific and numbers as to what these represents in our American culture  ( medically basic and medical equality ) and then we can develop some sort of a plan that could be affordable, maybe, but I doubt it cause everybody wants something different - usually more.

 

 

 

 


Extraordinary New Concepts & Ideas Require Capable Competent Leadership

 

Extraordinary New Concepts & Ideas Rarely Come From Dinosaurs

 

The Dinosaurs in the Democratic Party are unwillingly to occupy any Space that threatens their Longevity

 

If everyone operated under that Selfish Cloud we would have become the Banana Republic Trump is turning us into a long time ago

 

Does anyone think Medicare Medicaid & Social Security weren't difficult concepts to achieve

 

Look at what the Corporate Fascists did to try and defeat Obamacare when it passed & look at what they're doing now

 

We have a plethora of Dinosaurs in the US Congress but we also have some Courageous Visionaries

 

My money is always on the Courageous

 

 

( " China if You're Listening - Get Trumps Tax Returns " )

" )
" - Anonymous

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Re: Radical Health Care System Proposals Stall in Blue States

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Message 16 of 23

It would seem that the first thing to do is to decide our criteria for success. I would say that all Americans should have access to a minimum level of preventive and responsive health care and we should be in the middle of the pack in terms of cost. Since neither of those metrics are met today, perhaps we should look to the countries who do meet those metrics and copy what they are doing?

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Re: Radical Health Care System Proposals Stall in Blue States

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Message 17 of 23

@Olderscout66 

I agee with you that it is the Federal Government's responsibility to determine what is covered, set standards for containing cost and coverage and protocols, HOWEVER, we have to get this on a purely scientific and cost basis - not the who yells loudest method - be that lobbyist or an advocacy group.  THIS BY FAR, WILL BE THE HARDEST THING OF ALL.  Stop all this stuff that doesn't work, stop all this stuff that only works part way, protect people from being sold a bill of goods within their healthcare.   That could be done during the approval process for medications and treatments.

 

I think many of these medical things need to be reviewed again scientifically - even though there maybe somewhat of a starting point with the cost of these things based on the rate of what private insurance, Medicare, Medicaid currently pays.  Determining what is the best treatment plan considering the outcome and the cost.

 

Past that, I think the states should play a bigger roll in healthcare as more local entities do in other systems - healthcare is local.  Therefore a state should decide their healthcare infrastructure, their supply of providers, the actual investigation of anything that doesn't seem quite right.

 

I do not know what the roll of private insurers would be unless they offer something above the basic - a private room in a hospital rather than a ward or a semi-private room.  Perhaps faster access to diagnositics as the debate in Canada is pointing out this problem.

 

I still like the idea of states having a high risk pool where people would be placed once their health care cost go over some catastrophic limit. Their premiums would remain the same and we could all pay into such a fund with taxes but on the other hand, it would keep down regular premiums.

 

I do not have the answers but I do not like the Medicare for All concept as far as it has been described today.

 

 

 

* * * * * * It’s Always Something - Roseanne Rosannadanna
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Re: Radical Health Care System Proposals Stall in Blue States

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Message 18 of 23

@KidBoy2 

You are right -

This is from the Canada Health Act Annual Report 2017 - 2018 ( Minister of Health)

Minister's Message:

 

. . . . . The Canada Health Act, and the values that it represents, form the foundation of our health care system, and much like the foundation of a house, if we allow cracks to form, there is a risk that this building will start to crumble.

 

This is why the Government of Canada has joined the Government of British Columbia in court to defend against a Charter challenge which seeks to dismantle our publicly funded health care system and allow physicians and private clinics to charge patients whatever the market will bear for medically necessary services. . . . . .

 

For the most part, Medicare works well and patients receive the care they need without having to pay out of pocket. However, in many parts of the country, patients are being charged for diagnostic services, such as MRI or CT scans, at private clinics. If a patient goes to a hospital for the exact same service, they would not be charged. The federal position has always been that patients should not face charges for medically necessary hospital and physician services – this includes diagnostic services – regardless of where the service is provided. Paying to skip the queue for diagnostic services also allows these individuals to be fast-tracked for any follow up care in the public system. This goes against the fundamental principle of access based on need, not on the ability to pay. Last summer, I wrote to all provincial and territorial Ministers of Health confirming that any charges to patients for these services will be considered a contravention of the Canada Health Act. . . . .

 

Read More at the above link ~

 

Yep, they have some problems with their system - but is it so different than the one that exist here - that is to say, "We Want, What We Want, When We Want It"  Is that what a "Right" is suppose to give to you?  Or does it only assure that you will get a place in line?

 

 

 

* * * * * * It’s Always Something - Roseanne Rosannadanna
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Re: Radical Health Care System Proposals Stall in Blue States

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Message 19 of 23

Cannot see getting rid of private insurance companies, and  it's not necessary.

Countries in Europe with universal healthcare include Austria, Belarus, Croatia, Czech Republic, Denmark, Finland, France, Germany, Greece, Iceland, Ireland, Italy, Luxembourg, Malta, Moldova, the Netherlands, Norway, Portugal, Romania, Russia, Serbia, Spain, Sweden, Switzerland, Turkey, Ukraine, and the United Kingdom. Most have private insurance available, but the Governments of these countries set standards for cost AND coverage.

 

The insurance companies and providers have already done to work of establishing payment schedules for virtually every medical procedure. All we need to do is cull out the coverage included in the Obamacare Silver Plan, make that the new National Standard, require everyone participate, collect the "premiums" as a tax and use the reduced cost from not having multiple claims forms and payment schedules to include those now uninsured.

 

Can't be all that difficult without Republicans - look at all the placed that did it already. In fact, WE are the only democracy that HASN'T worked it out, but of course we have to put up with Republicans.

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Re: Radical Health Care System Proposals Stall in Blue States

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Message 20 of 23
Business as usual - promises made during campaigning to get the votes go by the wayside when the legislative body begins to look at cost and practicality.

=============================================================

Just look at Canada and their two tier system were their people pay for government heath care.
Many do not to go to the government clinics even though they are paying for it, instead they go to private clinics and pay out of their pockets or buy insurance for better care and they do not have long waiting times like at the government clinics.



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