Stupid (but sincere) Questions about the USA

[HisArpy]

Healthcare used to be affordable. Then the insurance guys moved in and suddenly it wasn't so affordable unless you had insurance. Now you can't afford the insurance and everyone keeps trying to "fix it". Meanwhile the prices for everything keep getting worse.

Anyone else ever look at the insurance biz and realize it's a ponzi scheme? Everyone pays in but only the guys at the top of the insurance company get rich.


Re; Phone plans...

I think the difference between European plans and the plans here is that here people have more disposable income. So the companies take advantage of it and charge more for everything.

A new S7 costs $750 if you buy it from AT & T. You can buy it for HALF that price if you go to one of the independent retailers/walmart/etc but that may mean you can't use that phone with your carrier.

 

[clistenovena]

Anyone else ever look at the insurance biz and realize it's a ponzi scheme? Everyone pays in but only the guys at the top of the insurance company get rich.

~raises hand~ I look at it that very same way. Why is this allowed?? Oh, yeah. Politicians in bed with whomever pays the most.

I was speaking with a doctor friend of mine. His idea- make health insurance totally open market to increase competition (which, in theory, would lower prices), and either place salary caps on how much the guys at the top can make, or make them not-for-profit companies (different than non-profit, mind you). Great ideas that could feasibly transform how insurance in the U.S. works. Unfortunately, these scenarios ain't gonna happen. Greed, in all it's forms is a powerful controller.

Not that any idea is perfect, but I do think more companies should open on-site health clinics for their employees to have access to no-cost routine medical services. I realize this option is usually only available to people who work at large, major corporations, but smaller businesses could co-op and fund one together. It's a great concept. Except for prescribed meds (which are mostly low-cost generics), included medical services are provided at no cost to the employee and their families (sans co-pays and such). Companies still provide traditional insurance plans (partly employee-funded), but costs are reduced overall and employees have access to a great benefit. Best of all, it's run by the private company, not greed-mongering politicians who really do fuck up most things they get involved in. I do prefer these type win-wins.

 

[HisArpy]

~raises hand~ I look at it that very same way. Why is this allowed?? Oh, yeah. Politicians in bed with whomever pays the most.

I was speaking with a doctor friend of mine. His idea- make health insurance totally open market to increase competition (which, in theory, would lower prices), and either place salary caps on how much the guys at the top can make, or make them not-for-profit companies (different than non-profit, mind you). Great ideas that could feasibly transform how insurance in the U.S. works. Unfortunately, these scenarios ain't gonna happen. Greed, in all it's forms is a powerful controller.

Not that any idea is perfect, but I do think more companies should open on-site health clinics for their employees to have access to no-cost routine medical services. I realize this option is usually only available to people who work at large, major corporations, but smaller businesses could co-op and fund one together. It's a great concept. Except for prescribed meds (which are mostly low-cost generics), included medical services are provided at no cost to the employee and their families (sans co-pays and such). Companies still provide traditional insurance plans (partly employee-funded), but costs are reduced overall and employees have access to a great benefit. Best of all, it's run by the private company, not greed-mongering politicians who really do fuck up most things they get involved in. I do prefer these type win-wins.

I actually had an interesting idea on how to ensure that everyone had access to healthcare.

Allow Hospitals to create an insurance plan with group coverage.

Think about that for a second. Hospitals would be allowed to enroll ANYONE on the spot for insurance coverage. They get all the information, enroll the patient regardless of any preexisting conditions or treatment issues, and the patient gets medical care asap. No waiting.

Pay the co pay, pay the premiums and you're good to go. No coverage gap and regular doctor visits can be done at a hospital run clinic rather than the ER. If insurance companies can make it profitable, MAYBE we can get hospitals to be profitable for once too. Which should lower healthcare costs.

Win-win.

 

[clistenovena]

I actually had an interesting idea on how to ensure that everyone had access to healthcare.

Allow Hospitals to create an insurance plan with group coverage.

Think about that for a second. Hospitals would be allowed to enroll ANYONE on the spot for insurance coverage. They get all the information, enroll the patient regardless of any preexisting conditions or treatment issues, and the patient gets medical care asap. No waiting.

Pay the co pay, pay the premiums and you're good to go. No coverage gap and regular doctor visits can be done at a hospital run clinic rather than the ER. If insurance companies can make it profitable, MAYBE we can get hospitals to be profitable for once too. Which should lower healthcare costs.

Win-win.

This is actually pretty genius. Totally outside-the-box thinking! We need more of that in this world!

A few questions:

Would individuals be able to use this coverage from hospital to hospital, or only at that one treatment facility? For example, if someone moves from one area or state to another, would patients then apply at whatever hospital is nearby or are they good to go because they've already enrolled?

Who sets prices for services? The hospital? An outside source?

What about those who are economically disadvantaged? How do they fit into the system?

Again, REALLY grand idea!

 

[Blue]

I've got a better idea...

Abolish the entire industry of private health insurance and do public universal healthcare already.

 

[BiBunny]

I've got a better idea...

Abolish the entire industry of private health insurance and do public universal healthcare already.

Yes, please.

 

[La damnee elle la licorne]

 

[Blue]

If there were only what is available through public health care in the country in which we live I would be dead.


It's good, and I don't necessarily think that's the wrong call but obviously I have a vested interest in more choice for myself.

Can I ask what it was? Since the only things I'm aware of the NHS denying to provide patients with is super-extremely-expensive cancer drugs, and that was on a regional basis.

I wish the NHS provided/covered everything so you would never be in that position. But while it is the case that not all treatments are covered I would still rather risk a metaphorical handful of people's lives (sorry ) on a public healthcare system than stick with anything like the USA's abomination where tens of thousands die every year due to lack of access to healthcare.

~ ~ Edit for clarity~ ~
If public healthcare doesn't provide a treatment somebody needs then I'm perfectly fine with allowing for-profit organizations filling in until they do, hopefully with no cost to the recipient. Healthcare should be a guaruantee, not a privilege like the Americans have.

 

[yukonnights]

~raises hand~ I look at it that very same way. Why is this allowed?? Oh, yeah. Politicians in bed with whomever pays the most.

I was speaking with a doctor friend of mine. His idea- make health insurance totally open market to increase competition (which, in theory, would lower prices), and either place salary caps on how much the guys at the top can make, or make them not-for-profit companies (different than non-profit, mind you). Great ideas that could feasibly transform how insurance in the U.S. works. Unfortunately, these scenarios ain't gonna happen. Greed, in all it's forms is a powerful controller.

Not that any idea is perfect, but I do think more companies should open on-site health clinics for their employees to have access to no-cost routine medical services. I realize this option is usually only available to people who work at large, major corporations, but smaller businesses could co-op and fund one together. It's a great concept. Except for prescribed meds (which are mostly low-cost generics), included medical services are provided at no cost to the employee and their families (sans co-pays and such). Companies still provide traditional insurance plans (partly employee-funded), but costs are reduced overall and employees have access to a great benefit. Best of all, it's run by the private company, not greed-mongering politicians who really do fuck up most things they get involved in. I do prefer these type win-wins.

Sadly, GREED is not only a powerful controller...it is beginning to control virtually every aspect of our societies worldwide. It's an ingrained human trait, but the scope and power of the greed had mutated into very dangerous forms. I want to say it's as if we are lurching backwards to a system reminiscent of Royalty and commoners. This is a very disturbing and concerning issue, IMO. The world upon which we all live and depend appears to be in the process of morphing into a much more distinct system of the "Have's" and the "have-nots". I don't see it slowing or changing, and since it is non-sustainable for the long run...sigh

 

[HisArpy]

This is actually pretty genius. Totally outside-the-box thinking! We need more of that in this world!

A few questions:

Would individuals be able to use this coverage from hospital to hospital, or only at that one treatment facility? For example, if someone moves from one area or state to another, would patients then apply at whatever hospital is nearby or are they good to go because they've already enrolled?

Who sets prices for services? The hospital? An outside source?

What about those who are economically disadvantaged? How do they fit into the system?

Again, REALLY grand idea!

Write your Congresscritter and tell him.

I don't see why it couldn't be portable. Most hospitals are huge corporations these days owned by only a few distinct companies. A larger pool also spreads the risk for any individual entity. As a sort of aside, did yo know that your COUNTY medical center HAS to accept you as a patient for treatment regardless of whether you can pay or not? Yep, by Federal law if I remember correctly. If that's the case, then why shouldn't they be able to offer a Healthcare plan to those who need it? Especially at the Urgent Care level rather than in the ER?

Pricing is dependent on the same influences as private HC. Risk pool management and all that. However, Hospitals are generally not for profit so they can likely set their premium schedules a bit lower. Kaiser Perm actually would be a decent model for this program.

On the one hand, I would think that there could be various plans for the "economically challenged" person. Catastrophic only, some sort of halfway thing, where you would pay low premiums for limited services up to a point. After that point you have to automatically step up your enrollment to the higher cost plans and can't go back absent a verifiable change in status (like the kids moving out and on their own so you don't need the full coverage family plan any longer). And, of course, full option (Cadillac) plans. On the other hand, individual States/muni entities could choose to assist with either subsidies or programs to help the working poor/disadvantaged. It's also possible to adapt Medicare to provide assistance payments directly to the Hospitals for treatment of individuals on certain plans.

Note however, I am not in the HC industry and this was only an idea which floated across my brain in the middle of the night. It would have to be up to experts in the industry and Congress to work out the details. As it stands neither ObamaCare or the new plan solve anything and only muck up the water further.

 

[clistenovena]

I've got a better idea...

Abolish the entire industry of private health insurance and do public universal healthcare already.

This is a wonderful idea...in theory. In the U.S., we have a version of universal healthcare, for honorably discharged veterans. It's run by the Veteran's Administration (ie. The Government). It's not 100% horrendous, but it's mostly a freaking mess. If these veterans don't live in or near a sizeable city, they are out of luck for available facilities, or they have to drive hours to get to a VA approved clinic. Wait times for treatment is weeks, sometimes months, and in many cases, the treatment is uber subpar. In just this case, the U.S. government has proven once again that it can and will fuck up even the best of ideas and intentions.

Healthcare run by my country's government? No thanks! Legislative reform aimed at private insurance companies that guarantees quality coverage for all? YES! Please.

Sadly, GREED is not only a powerful controller...it is beginning to control virtually every aspect of our societies worldwide. I want to say it's as if we are lurching backwards to a system reminiscent of Royalty and commoners. This is a very disturbing and concerning issue, IMO. The world upon which we all live and depend appears to be in the process of morphing into a much more distinct system of the "Have's" and the "have-nots"...sigh

I couldn't agree with you more on this point. A group of us were having this very discussion on the disturbing chasm that has developed and seems only to be widening.

Write your Congresscritter and tell him.

Had a discussion with one of them about 3 months ago, but since I put zero faith in any politician, I don't expect much to come of it. Doesn't mean I stop trying, though. Even if I am swimming upstream, basically drowning.

I don't see why it couldn't be portable. Most hospitals are huge corporations these days owned by only a few distinct companies. A larger pool also spreads the risk for any individual entity.

Maybe I will go back to said Congressman and discuss this proposal of yours. They don't have any decent answers, and this is a viable option. Well, it is until they get hold of it and tack on all their pork-barrel projects and hidden agendas. Gah, I really do detest politicians.

As a sort of aside, did yo know that your COUNTY medical center HAS to accept you as a patient for treatment regardless of whether you can pay or not? Yep, by Federal law if I remember correctly.

Yes, quite familiar with EMTALA laws (aka "Get 'em transferred asap!") These laws are why so many emergency facilities are closing up shop. It's just not viable financially. It hurts low-income, rural areas the most. Urgent Care clinics have become the go-to for these folks. At least there's that option.

If that's the case, then why shouldn't they be able to offer a Healthcare plan to those who need it? Especially at the Urgent Care level rather than in the ER? Pricing is dependent on the same influences as private HC. Risk pool management and all that. However, Hospitals are generally not for profit so they can likely set their premium schedules a bit lower. Kaiser Perm actually would be a decent model for this program.

Agreed that this idea is completely feasible and workable! But it's also too logical and reasonable. Congress would never go for it. Pardon me. I realize my disdain for anything related to politicians is showing.

 

[La damnee elle la licorne]

 

[Blue]

Why do Americans hate the congress so much?

http://content.gallup.com/origin/gallupinc/GallupSpaces/Production/Cms/POLL/g0ltyh6km0kw18e3tuylua.png

Not even Trump's approval ratings are that low...

 

[BiBunny]

Why do Americans hate the congress so much?

http://content.gallup.com/origin/gallupinc/GallupSpaces/Production/Cms/POLL/g0ltyh6km0kw18e3tuylua.png

Not even Trump's approval ratings are that low...

Because they're the most useless group of people ever gathered together in one building.

My question is, if everyone hates them so much, why do we insist on voting the same bunch of assholes back into office Every. Single. Election.?

 

[Cumference]

In the scandinavian countries we have universal healthcare.

And it is working perfectly well. No one is left uncovered and the quality is very high.

The really funny thing about it is, that the price per capita is only half of what it is in the US.

..... But neither our doctors nor our lawyers are as fat and wealthy as the American ones.

 

[Blue]

In the scandinavian countries we have universal healthcare.

And it is working perfectly well. No one is left uncovered and the quality is very high.

The really funny thing about it is, that the price per capita is only half of what it is in the US.

..... But neither our doctors nor our lawyers are as fat and wealthy as the American ones.

The price per capita cost of care in the USA is so high mainly 'cause healthcare is for-profit. Right now for every dollar spent on healthcare by people it's not uncommon for 80% of it to go to the cost of care and 20% to administrative overhead which include things like executive's pay, bonuses, investor payout and insurance paperwork. Contrast with European models where a much higher percentage of of every [currency] goes to cost of care because public systems aren't trying to make a buck off of people. And it's only as much as 20% admin because the Affordable Care Act mandated that be the case, a decade ago it could almost be 50/50.

 

[Cumference]

Yup.

And it actually has the perverse effect, that there is no real reason to heal the patient. It is much better to keep him as a slightly sick cash cow.

Not to mention the insurance fees any health care provider has to pay (and thus extract from the patients).

Compared to the rest of the world, the US health care system is impressively dysfunctional.

 

[HumasWanderingWeiner]

I need to read through this thread more when I get a chance. I was hoping to find questions like "what is the longest you have driven and not left the state you are in." And "are there vast open stretches of land out west?" Having lived in the west 90% of my life, I think that there are things there that people from other countries would have no comprehension of. I think I baled hay in fields as large as some countries. . Sorry, didn't mean to stop the discussion on health care. I just hope there are questions about the vastness of the country and what certain states are like. I've made it to 49 of them. Alaska remains elusive.

 

[La damnee elle la licorne]

 

[clistenovena]

Why do Americans hate the congress so much?

Because they're the most useless group of people ever gathered together in one building.

What she said. And I'll add self-serving, greedy, power-hungry, and a complete waste.

My question is, if everyone hates them so much, why do we insist on voting the same bunch of assholes back into office Every. Single. Election.?

Same question. People cannot be that mindless, so why do the same mistakes keep getting voted into office??

I was hoping to find questions like "what is the longest you have driven and not left the state you are in." And "are there vast open stretches of land out west?" Having lived in the west 90% of my life, I think that there are things there that people from other countries would have no comprehension of. I think I baled hay in fields as large as some countries. . Sorry, didn't mean to stop the discussion on health care. I just hope there are questions about the vastness of the country and what certain states are like. I've made it to 49 of them. Alaska remains elusive.

I'm glad you interrupted the healthcare thing. One can only think on it so much before singularly negative thoughts invade the mind. So thanks.

I live in the USA, so I guess it's not my place to answer, really, but I'll still go ahead and answer that first question you asked about how long you've driven without leaving the state- 8 hours. Alllllllllllll the way across Kansas. It was one loooooooooooong drive, straight and more straight, across the absolutely flattest land I've ever seen. It was like being on a treadmill. The scenery never changed. I did rather enjoy being able to go 100mph, though.

I have a close friend who lives in Alaska. He just moved from the tundra (one of those little villages only accessible by plane and, at times, by boat) to a bigger village on the road system. Still in the middle of nowhere, but he likes it that way. If you ever get there, enjoy!

 

[gracie920101]

And it's only as much as 20% admin because the Affordable Care Act mandated that be the case, a decade ago it could almost be 50/50.

And that's exactly why everyone's rates went up. The mandated 20% now equals the former 50%.

Do not believe the BS about rates going up to cover the less healthy individuals insurance companies were "forced" to cover. It was really all about greed and their profit margin.

 

[HumasWanderingWeiner]

Which are your favourites? Why?

My favorite will always be Colorado. It's my home state, although I no longer live there full time. I do own a house there however. It's a tale of two opposites. The eastern is vast plains full of ranches and farms. The west is all mountains and skiing and ranching. My home is in the mountains in ranching country at 8500 feet.

I don't really have others that I love other than to say there are amazing things in so many of them. The vast forests of Washington and Oregon. The empty vast buttes along the highway in Idaho. The plains of Wyoming where you can drive for 50 miles and not pass a town and there is nothing but plains as far as you can see. Just barronness that used to be filled with buffaloes. I'm not even touching on Mt Zion in Utah or the Grand Canyon in Arizona. Or that you can drive from Shasta to San Diego in California and never leave the state, taking about 10.5 hours to do it.

 

[FL30]

Because they're the most useless group of people ever gathered together in one building.

My question is, if everyone hates them so much, why do we insist on voting the same bunch of assholes back into office Every. Single. Election.?

This question was actually answered by either a newspaper or a TV show a few years ago.

Here's the general answer:

Most people think that Congress overall is worthless and have very low opinions about them. However, when asked about their own representatives, they had high praise for them.

So overall low remarks/opinions as a whole, but for their own reps, very high remarks/opinions.

 

[HumasWanderingWeiner]

I'm glad you interrupted the healthcare thing. One can only think on it so much before singularly negative thoughts invade the mind. So thanks.

I live in the USA, so I guess it's not my place to answer, really, but I'll still go ahead and answer that first question you asked about how long you've driven without leaving the state- 8 hours. Alllllllllllll the way across Kansas. It was one loooooooooooong drive, straight and more straight, across the absolutely flattest land I've ever seen. It was like being on a treadmill. The scenery never changed. I did rather enjoy being able to go 100mph, though.

I have a close friend who lives in Alaska. He just moved from the tundra (one of those little villages only accessible by plane and, at times, by boat) to a bigger village on the road system. Still in the middle of nowhere, but he likes it that way. If you ever get there, enjoy!

I have driven the drive you did, however I did the L shaped route as I came up from Dallas and went through Wichita before going west on I70. Yes, it's a long drive. And driving at near triple digit speeds is quite enjoyable. Clearly the Europeans have us in that regard, but we can afford to do it with our cheap "petrol".

I must go to Alaska at some point, check that box. Have some family up there so there is no excuse.

In my previous post, I didn't mention South Dakota and Mt. Rushmore. Another site that just blows you away and the journey getting there is just awesome, so unlike the other parts of the Western US.

 

[DeepGreenEyes]

I've got a better idea...

Abolish the entire industry of private health insurance and do public universal healthcare already.

Yes, please.

As painful as the current leeching is, I really think the insane debacle that is "repeal and replace" is actually moving us closer. Someday these Medicaid-slashing, billionaire-taxcutting, "just-don't-buy-a-cellphone-if-you-can't-afford-health-insurance" fuckheads are going to wish they'd worked frantically for Obamacare at every turn.