Republicans, what is your "end game" on health care?

[TLB]

mrbigstuff wrote:
$tevie is correct, but it would never happen. Well, except for the military. It's OK if they have healthcare, right? I agree with that. Maybe everyone should sign up. Get down to your local recruiter for healthcare.

Perhaps that's a starting point to build a healthcare system. As an alum of the system it ain't bad, but many of my co-workers find it as constraining as military service itself.

1. Point of entry to the system is through a Primary Care Manager (PCM). I'd guess roughly 90% of PCMs are PAs or nurse practitioners. Co-workers don't like that they wouldn't see a "real" doctor.
2. Although you are assigned a PCM, there is no guarantee you will see them, especially with overseas conflicts and transfers. Continuity of care is often an issue.
3. No choice or self selection of providers. Need a specialist, need a referal. The PCM decides and then another appointment and another wait.
4. Mandatory physicals. Missing a physical is grounds for punitive action.
5. Mandatory immunization. Missing a shot is grounds for punitive action.
6. Mandatory physical fitness and height/weight standards. Fail standards once is remediation, twice is grounds for punitive action, three times could be job loss.

There's the rub. One of the ways to help minize system costs is to have the healthiest population possible. To do that here, we need a major modification of human behavior. The military has the structure to do that, how do you do that in society? Education? That doesn't seem to be working. Economic disincentives? Perhaps denying healthcare to those with unhealthy habits--kinda defeats the purpose of the system. Become more fascist and deprive individuals of liberty and choice as if they were in the military?

I don't have answers, just lots of questions.

[Mike Sellers]

J Marston wrote:

Number three: give states the tools to create their own innovative reforms that lower health care costs.

They forgot to include "out of the box thinking". Did they misplace their BS Bingo guide?

[davester]

J Marston wrote:
Well, here's the Republican plan http://www.gop.gov/solutions/healthcare:

Number one: let families and businesses buy health insurance across state lines.

Number two: allow individuals, small businesses, and trade associations to pool together and acquire health insurance at lower prices, the same way large corporations and labor unions do.

Number three: give states the tools to create their own innovative reforms that lower health care costs.

Number four: end junk lawsuits that contribute to higher health care costs by increasing the number of tests and procedures that physicians sometimes order not because they think it's good medicine, but because they are afraid of being sued.

Note that there's no requirement for accepting pre-existing conditions, and that tort "reform" is one of the main points. It also leaves the insurance companies free to decide what is and isn't medically necessary.

Some "plan"! It does NOTHING to address any of the problems we have (as elucidated by TLB above)

Number 1: "Allowing" people to buy insurance across state lines is a red herring. The insurance companies themselves are the ones restricting coverage because they want to hold semi-monopolies. Buying across state lines would allow insurance companies to escape state consumer protection laws. This is simply a way to skirt consumer protections. I have heard no rational explanation of how it would reduce prices in the antitrust-exempt insurance industry.

Number 2: There is no restriction on doing this now as far as I know. Are we going to force insurers to have guaranteed issue insurance to these groups? If so, why not require it for everybody...the "group" idea is not needed. What about those who can't get into a group...allow them to continue with no choices? This "idea" makes no sense to me at all.

Number 3: i.e. "not our problem...let the states do it". This is the way it is already.

Number 4: Will have almost no impact on medical costs since this the total dollar amount is microscopic compared to the healthcare budget (but it sure makes for a good soundbite....repubs standing up to them slimey ambulance chasers).

[kap]

mrbigstuff wrote:
$tevie is correct, but it would never happen. Well, except for the military. It's OK if they have healthcare, right? I agree with that. Maybe everyone should sign up. Get down to your local recruiter for healthcare.

Umm, but there is an age limit and pre-existing conditions to be considered: which military agency wants a 50 year old with a back problem and arthritis?