Some Schmo wrote:My opinion would be that co-pays would need to be progressive, based on income, like income taxes. Just enough to make whoever is paying them only go when they really want to see a doctor. (That means filthy rich people pay full price).
Of course, the obvious problem with this is how do you determine a person's income at the time they need a doctor?
AWS is how.
God belief is for people who don't want to live life on the universe's terms.
Some Schmo wrote:My opinion would be that co-pays would need to be ... Just enough to make whoever is paying them only go when they really want to see a doctor.
In public health terms, dissuading people from going to the doctor until they 'really want to' is an effective way of ensuring that people end up presenting with conditions that are:
(a) more advanced than they would have been if they had been treated earlier; (b) more expensive for the health system overall than they would have been if treated earlier.
The US does not need to re-invent the wheel on this one. There are many universal provision systems that might serve as a model that could be adapted for US needs, and all of them have their problems. They need to be critically studied. But pretty well nobody living under any of those systems would be likely to want to change to the US model as it is at present. However, this is all pie in the sky, since the last thing Trump's America is likely to do is to try to learn from the experience of others ...
Zadok: I did not have a faith crisis. I discovered that the Church was having a truth crisis. Maksutov: That's the problem with this supernatural stuff, it doesn't really solve anything. It's a placeholder for ignorance.
Some Schmo wrote:My opinion would be that co-pays would need to be ... Just enough to make whoever is paying them only go when they really want to see a doctor.
In public health terms, dissuading people from going to the doctor until they 'really want to' is an effective way of ensuring that people end up presenting with conditions that are:
(a) more advanced than they would have been if they had been treated earlier; (b) more expensive for the health system overall than they would have been if treated earlier.
These are fair points, but I still don't think it should be completely free. You're right that we don't have to reinvent the wheel, but we also don't need to inherit every system's problems either.
If people are waiting until advanced stages of whatever ails them to do something about it, that's a personal responsibility issue as well. Some people are just lazy, or procrastinate, and it doesn't matter what the cost is. Your system can't completely fix people.
I'm not talking about huge co-pays. I'm just saying that making it completely free is going too far, and I can certainly understand people's reservations with that.
God belief is for people who don't want to live life on the universe's terms.
Some Schmo wrote:Of course, the obvious problem with this is how do you determine a person's income at the time they need a doctor?
AWS is how.
But the American Weather Service doesn't have access to either people's bank accounts or their tax records.
"Finally, for your rather strange idea that miracles are somehow linked to the amount of gay sexual gratification that is taking place would require that primitive Christianity was launched by gay sex, would it not?"
Maybe a good way to get people to go to the doctor early is to charge them a co-pay up front, then refund it if the doctor finds something really wrong.
I'm trying to find a solution for hypochondriacs and drama queen types draining the system and wasting people's time.
God belief is for people who don't want to live life on the universe's terms.
Some Schmo wrote:My opinion would be that co-pays would need to be progressive, based on income, like income taxes. Just enough to make whoever is paying them only go when they really want to see a doctor. (That means filthy rich people pay full price).
Of course, the obvious problem with this is how do you determine a person's income at the time they need a doctor?
AWS is how.
Another incentive for employers to pay under the table and employees to look poor on paper at least once they get their home loans.
And some old people do need a professional to clip their toenails. Replacing the free market often creates unintended consequences.
Medicine isn't really a free market system now which is partly why there are so many problems with the status quo.
And when the confederates saw Jackson standing fearless as a stone wall the army of Northern Virginia took courage and drove the federal army off their land.
DoubtingThomas wrote:I will probably vote for Sanders and I do like the idea of universal healthcare, but I do have some concerns. The US is by far leading in medical research. According to Brookings, "One issue that often gets raised is whether the profits from higher prices will all go directly into research and development. They almost certainly won’t. Owners and employees would share in any gains in the form of dividends, retained earnings, and compensation. There are other ways to finance innovation other than high prices, for example through public research (paid by taxes) and philanthropy. At the end of the day, however, evidence conclusively demonstrates that higher expected revenues leads to more drug discovery, with the most recent numbers suggesting that on average every $2.5 billion of additional revenue leads to a new drug approval."
Some Schmo wrote:Maybe a good way to get people to go to the doctor early is to charge them a co-pay up front, then refund it if the doctor finds something really wrong.
I'm trying to find a solution for hypochondriacs and drama queen types draining the system and wasting people's time.
In designing a very large system like a universal health care service, you have to accept that it can never be economically and ethically perfect - after all, individual insurance-based systems certainly aren't.
Yes, any system will have to deal with a minority of people who make excessive use of it. But you have to gather real data to decide whether that problem is significant enough for you to need to give the system features (such as penalties) designed to reduce its effects. It can be the case that the negative effects on non-excessive users of measures to penalise excessive use by a small number of people are greater than the benefits from eliminating the misbehaviour of a minority.
That is why we have to be careful about starting the discussion with language like "hypochondriacs and drama queen types draining the system": the word "draining" takes it for granted that the loss of resources caused by a small minority of excessive users is so large that the system no longer has enough funds to do what it needs to to for other users. We simply don't know whether that is the case, and until we do we should use more judgement-free wording, if we want to make the best decisions possible in the real world.
Zadok: I did not have a faith crisis. I discovered that the Church was having a truth crisis. Maksutov: That's the problem with this supernatural stuff, it doesn't really solve anything. It's a placeholder for ignorance.