Who is best qualified to fix the US health care system?

Who is best qualified? Probably a panel of public health specialists, medical policy academics, and economists, preferably vetted by a consortium of major research universities.

But we’re not going to get that. The core problems with healthcare are not exactly complicated, and can be understood by any citizen with an elementary understanding of probability.

Sweden

Thanks, @bolwerk & @janbb.

This Tom Toles cartoon from today’s Washington Post seems to sum up the illness pretty eloquently.

For anything to change, American culture has to change. I think it will slowly over time, hopefully.

We use the other countries as examples, but these are places with smaller and more homogeneous populations. They don’t mind paying more taxes for their neighbors. The average American cares less about their neighbor and more about getting rich one day.

Walmart.

It might not be pretty, it might not be patriotic, but by gosh it would be efficient and inexpensive.

Sorry, I held that in as long as possible in a effort to not derail the thread.

Congress. The cost of prescriptions, medical care, doctors and all other aspects need to be strictly controlled if health care is going to work for all. Call it socialized medicine because that is what is needed.

I think having nationalized healthcare is a great idea. However, putting the government in charge… of anything… is a disaster waiting to happen. It’s not just about having no faith in the powers that be. It’s about the big business of healthcare openly lining the pockets of those running the program. In theory, it’s a benefit to the people. In practice, it’s an expensive hellish mess and we’ll be worse off for it. I honestly don’t know if privatization would be any better but surly it can’t be worse… We’re stuck between a rock and a bandaid.

^ I don’t know if you’ve noticed, but big business is already lining the pockets of government officials who make laws regarding healthcare.

Nothing better illustrates exactly who owns the government. Our corporate whorehouse openly churns out legislation that is CLEARLY against the public interest. For those of us reduced to spectators, has anyone seen the petition being circulated by Al Franken? It’s a start.

I think the petition thing is completely ignored.

MacGyver.

It would be simple, brilliant, and done just in the nick of time.

@DWW25921 – Your answer was right on. However, like in the court system of the US, innocence must be assumed. In your answer’s case, the right thing must be done for it to work instead of assuming the worse and not even trying.
“With great power comes great responsibility.” – Stan “The Man” Lee

@kritiper I can better answer @ETpro ‘s question by saying… We Are best qualified! Sadly, we are not represented by the people we elect and until we are we will never be able to effectively make any positive changes.

I would say patients and their physicians.

In my opinion it should be a federal crime for anybody to attempt to know the details of a transaction between physician and patient other than it happened.

Too late for that however.

@Blackberry I think that realization is starting to skink in now. Real progressives like Elizabeth Warren give me hope.

@ibstubro Walmart for open heart surgery somehow isn’t working for me. I don’t want cheap open heart surgery imported from China and performed by minimum-wage workers that are kept part time so they get no benefits.

@kritiper I completely agree.

@DWW25921 The vast right-wing noise machine has done a fabulous propaganda job demonizing government over the past 33 years. How would one have nationalized healthcare without government involvement. That sounds disturbingly like this.

The US has a privatized system and we spend the most per capita of any nation on Earth while every other developed nation with a government run single payer insurance system of national healthcare system outranks us in healthcare outcomes.

@Seek_Kolinahr Excellent point. Right now, we have a corporatocracy running healthcare, and ever more massive profits are the God of that scheme.

@stanleybmanly How sadly true.

@josie So you would eliminate insurers, Medicare, Medicaid, everything save Doctors and their patients. Those without enough money for the life saving procedure they need could just die. Thanks, but no thanks.

@ETpro
Didn’t say that.
What I said was that they may not know anything other than that a transaction occured.
Most people don’t have “insurance” anyway. They simply have a pre paid program that the insurance company hopes they will pay more into than they take out.
People could still have pre paid plans, and catastrophic care coverage. The actuarial tables might have to be re-written, but that is happening with Obama care.

@ETpro Maybe it was the big words but I don’t get your point. The government doesn’t need any help demonizing itself. It’s not a right or left thing, it’s a integrity thing.

@josie & @DWW25921 Can you answer focusing on the Congress’ move to require by law that Medicare and Medicaid must pay big-Pharma their full asking price. All private, for profit insurance companies are allowed to negotiate good prices based on the volume of business they can offer the pharma companies. But Medicare and Medicaid, with their vast purchasing power, are forbidden by Republican legislation for asking to pay anything short of retail pricing. Why? Are the people that put this rule in place likely to actually reduce medical costs if given the chance?

^ Guaranteed, it’s so they can turn around in five minutes and complain that Medicare and Medicaid are costing more money than is sustainable, and these programs need to be ended immediately.

@Seek_Kolinahr Republican politics 101. Take a program that benefits average people as well as the 1%. Pass legislation that makes it impractical. Then claim it doesn’t work (because GOPers made sure it couldn’t) and replace it with policies that only benefit wealthy GOP donors.

WTF is with this Obamacare doesn’t work meme? It has already begun working. Don’t let them turn the good into the enemy of the perfect.

@bolwerk Hey, if a person has to choose between buying insurance or food, there’s a problem! Lots of stories like this- it’s breaking people’s backs, just like I said it would. http://www.weeklystandard.com/blogs/mother-forced-obamacare-choose-between-new-health-plan-or-putting-food-table_762408.html

@snowberry: I didn’t say there wasn’t a problem. I said the good is being made the enemy of the perfect. It’s covering more people and reducing cost growth, which translates into saved lives.

As for the problems, why not blame the crackservatives at places like the Weekly Standard who make it politically infeasible to actually solve that woman’s problem? She’d probably be fine with medicaid or more food stamps. But. hurr, socialism!

Under Obamacare, the maximum amount of your monthly income you are supposed to pay for premiums is 8%. Correct me if I’m wrong.

If premium is more than 8%, you qualify for a subsidy. If your income is so low that even with the subsidy your premiums are prohibitively expensive, you either qualify for Medicaid (if you live in a Blue state) or are generally fucked, but not subject to a penalty (if you’re in a Red state like I am).

If you can’t make your household work on 92% of your income and still afford to eat, someone needs to figure out a budget. Maybe downgrade that sports package.

John Q. Public. Unfortunately J.Q.P. wants the government to take over all his responsibilities and he does not want them back for any reason. This is one of the tendencies that guarantees eventual collapse. Symptoms of collapse have been showing since WW2. National collapse is predictable, but details and timing are random. It is looking like it’s going to be this year or next.

Erm, our system is privatized. You didn’t know? The free market is why we have the costliest system on Earth by far, and why our healthcare outcomes score at the bottom of the developed world, @SmartAZ.

I cannot say who, or what would be the most qualified to redesign the health care system. I can however state that the insurance industry is not in any way capable. Given that the Affordable Care Act was part and parcel designed by the best the insurance industry could provide, I think the last year has proven that and I do not chance for improvement in the foreseeable future.

I am not certain that a single payer system would be adequate unless you could eliminate the requirement for private insurance firms from their position as middlemen between the patient and the medical community for the vast majority of citizens in the US.

@ETpro read a newspaper now and then, ok?

Here’s the way it works. When most people pay their own medical bills, the doctor sits down with the patient and they discuss options and costs and decide what to do. When most people have insurance, that discussion does not take place. Tests and second opinions that would otherwise have been optional are automatic. The doctor hires more staff to fill out the insurance forms and keep extensive records. The doctor has to have the latest equipment to be sure his diagnoses are legally defensible. Everybody knows the bills are covered, and services are assumed to be competent. All of this, the extra tests, the second opinions, the documentation, the equipment, has to be paid for, and the cost goes on the patient’s bill. The insurance company’s only concern is that charges are necessary and reasonable.

Please notice that I have not suggested any form of deception. All of this is normal, honest, and unavoidable. Increased medical costs are automatic when most people have insurance.

But normal market forces are still at work. Demand is limitless, but services are scarce. In a normal market, demand is controlled by costs. When that restraint is removed some other method must be found to keep demand equal to supply. One way to limit demand is to make patients wait. When there aren’t enough doctors to treat people as fast as they come in, patients must wait. Those that can’t or won’t wait go away. Travel to a treatment center has the same effect. When the market is controlled by costs, people who really need treatment can get it by paying the cost. When the market is controlled by some other method, individuals are prevented from making their own decisions about what they really need. They can only get treatment by waiting, or by obtaining some sort of official approval or professional reference, that is to say, by political influence.