This is my thoughts on health-care and this is how I would try to fix the very complicated problem of expensive health-care.
First I would make health insurance like how we have car insurance. by law you have to have health insurance, because it costs the community way too much if those who don't have it get hurt and go to the ER. If you don't have a health insurance card or id with you when you go to the ER then you will not get help.
Second, for those who are poor and can't afford health-care, then they get the basic kind of insurance with an addition of help from the state governments. The national government gives X amount of money to the states, but it is the states who decided how much they will help pay for the insurance for those who can't afford it. This may mean 10% help of pay or even all, if that state wants that. But it is out of the hands of the national government. If a state can't afford to even help the poor pay for health-care than thats really not that great of state and the poor should leave to a state that does.
Third, i have noticed alot of the costs in health-care come from doctors doing too much unneeded tests. It is because their pay is based on how many tests and exams they do on each patient. I would look into paying doctors just a salary as they have done in some places already with good results. A basic doctor gets paid X, a surgeon Y and a specialist Z. In theory this would make the doctors more worried about treating the patient instead of trying to make some money.
Those are just ideas...
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those are good ideas and i agree with them for the most part. here are my thoughts on top of them.
ReplyDeleteWith a flat rate government subsidy, you may be giving the same amount of money to a state that has no people (wyoming), one that has wealthy people (the Northeast) and one that has many poor people (the south). that doesn't seem like the best way to distribute the cash. There would need to be some sort of percentage of people below the poverty line or something like that.
i agree with you about the unneeded tests. The article i read talks about MDs getting paid by the service which seem ridiculous. Getting them salaried would be a great solution to that problem.
Here's another thing. These articles on health insurance talk about how expensive it is for healthcare in the US. Twice as expensive as Sweden, blah blah blah. There is probably something valuable in those statistics but it also seem to me like we have a generally unhealthy population and that probably factors a bit into the cost of healthcare. These are statistics from 2007: 66% of America is overweight, 31% is obese. That is just people over 20. Less than 1/3 of people under 20 are "at a healthy weight." Those are not the statistics of a healthy country to begin with.
Like you said in your first sentence, this is a very complicated issue with many layers. It would be nice if we could address some of the underlying issues at the same time. But it is hard to adjust people's private habits in America. Especially ones based on consumption.
Great idea about distrubiting the money amoung the states. The one thing with that, that i can see happening, is one section of a poor state could get more money, which would then encourage other poor people from other states to move to that state. although this, i think, is a small problem it is one to look into.
ReplyDeleteYou are right on about comparing the US to European countries. That is so true. In addition, the populations of those countries are smaller. California has somewhere around 30-40 million, that would make CA in the top 5 most populated european countries. We are dealing with a massive population. In addition you are very right about how americans are more unhealthy. I don't see how the government could solve that issue.
The only way to cahnge peoples' habbits is to make it an economic issue. We need to make it more economical to be healthy than to be fat. right now it is cheaper to be unhealthy and it is very expensive to be healthy. you need gym mebership, eat expensive foods that go bad after a few days. The cities of america are not built for healthy living either. I guess you could tax unhealthy foods, but that would be taxing the poor and would it really be helping the poor economically. I really can't think of a solution. Can you?
i don't think the only solution is an economic. it might the quickest though. We are Americans after all. As far as poor people moving, i think you overestimate their mobility. I think poor people are generally stuck in the place they are The people who move to better conditions are the middle class because they have more freedom to do so. I'm pretty sure (though not positive) that the US v European costs were per capita, so population isn't exactly a factor. (Sorry that the first paragraph was so muddled. It ended up being my trash can where i just threw the things i wanted to say but they didn't really have a place to go)
ReplyDeleteIts true though, less healthy food is cheaper than more healthy food. I just bought canned pineapple over fresh cut pineapple because i saved $3.50. That being said, i'm still eating fruit and not pop tarts. So i think there are many, many, many healthier choices that could be made without resorting to locally grown, organic, cage free humus--or whatever it is they sell on those hippie aisles. And exercise surely does not require a gym membership.
I will readily agree with you that American cities are not built for healthy lifestyles. We drive every-fucking-where! Its ridiculous. But i think that what is more detrimental is the American lifestyle in general. I am living it right now and i want shoot myself. Wake up at 7. Shower. Shave. Eat breakfast. Drive to work in traffic. Work for 8 hours, probably a little more. Drive home in traffic. Get home at 6 too tired to do anything like exercise or cook a decent meal. Everybody gets 2 weeks off a year and we call it good. Its called 'the daily grind' for a reason. It grinds you into dust. My roommate and some og his friends just went to japan and there they have what seems like semi required morning exercise. Something like that would be great (but too communist for the American people). Maybe everyone gets to work at 8 and has to run 3 miles on the treadmill before starting at 9. they still get an hour for lunch and leave at 5. Or maybe its as simple as getting people to stop smoke: run a smear campaign. Talk about the dangers of unhealthy living. Stigmatize fat people as 'uncool' like smokers are 'uncool.' Problem with that (side stepping the ethical problems) is that some people are genetically disposed to obesity and so its not a voluntary action like smoking.
You are right in saying that poor people have a harder time moving, but they still can and are free. 12 million people from europe came to the US and many of them with little to no money. 12 million people have travelled to the US for jobs, and I don't think they are middle-class folk. I think it was after or during WWII millions of southern blacks moved to the richer cities in the north in what is call the Great Migration. millions of people went out west in search of a better life and they weren't that rich. So I still think the poor can move around just fine, but in the moment they may think they can't and so they stay. Its more of a mental thing than an economic one.
ReplyDeleteyour shopping for some reason reminded me of the price is right.
it would be good to promote healthy living, but i still think economics is the way to go. Since the beginning of time, poor people were skinny because they couldn't afford food period. now poor people are fat because they can't afford good food. Change that, and people will be healthier, the only thing is i don't know how you change that. You are right about how after one is done with work they are not in the mood to cook or workout. The whole idea of making americans healthy would demand such a cultural revolution that i think it will never be started. The government would have to get too much involved that it would be even worse that having an unhealthy population and there are so many cultural aspects to our unhealthy style that not all of them could change quickly enough or change at all, such as; the car, eating late in the day, eating fast meals, drinking, drugs, layout of the cities, type of food we eat and so on. some of them can change, but most couldn't.
you may be right about the poor. i just want to say one thing: historians need to be more creative! i know of at least one other Great Migration (and i think i am familiar with another). We need to name one of them the Greatest Migration.
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