Single-payer plan

[Johan]

I give up and give in. I'm going to support a comprehensive single-payer government plan for health care under the following conditions, without which I see it as incredibly irresponsible and doomed to failure.

* Tort reform - lower the costs medical practitioners face due to insurance premiums which have been skyrocketing because doctors need to defend against ambulance chasers. After all, the medical field will be working for the government now and we shouldn't sue 'ourselves;' unionization will follow.
* Mandatory coverage for all - everyone must have insurance, and everyone must pay for it on a monthly basis. This way, the young and healthy can contribute more of their income to the old than they presently do. On another topic, we'll need to cut the benefits the young will get from SS, but not cut their payments, since we need the money for present benefits.
* Monthly insurance payments for coverage - beginning with a basic fee based upon a fixed percentage of your gross income (like the Finnish system of traffic fines being dependent upon income). A flat percentage rate of your income, based upon your filing status on your tax return. No itemization or deductions of any sort. This fee will be directly deducted from your paycheck, or from your welfare/benefits check.
* Generic prescriptions only. We spend too much on drugs.
* Mandatory physical exams once every three years as part of determining your monthly insurance payment. The physical is free, but if you refuse to take it, you pay the highest possible rate for your monthly premium. When you take it, you will be assigned "points" for certain risk categories that are behavioral in nature, and you will pay more on a monthly basis for each of them. If you wish to take more than one physical every three years, you pay for that out of pocket, but could see lower monthly insurance rates if you have a change in risk factors. After all, it's only fair you pay for your own personal choices, especially when they're stupid.
-----Overweight? Higher premium
-----Obese? Higher premium
-----High cholesterol? Higher premium
-----Smoker? Higher premium
-----Drink more than one drink a day? Higher premium
-----STDs? Higher premium
-----Drug use or evidence thereof? Higher premium
-----Conviction of a violent criminal offense? Higher premium
-----Traffic tickets? Higher premium
-----Many more will be added later. We've got lots of pages to fill, and medical costs to lower. Changing behavior through the benevolent guidance of government will lower our costs. I say we go for it. Why not? America has never needed a big brother more than it does now.

I encourage you to add further ideas that should be incorporated into this single-payer system.

[Hawkzombie]

Why would yo want your criminal record or traffic tickets to apply to your health care? That makes as much sense in taking a blood test to ensure you don't have diabetes for car insurance.

[Johan]

Why would yo want your criminal record or traffic tickets to apply to your health care?

Both are risky behaviors people choose which lead to higher statistical probabilities of injury and medical costs.

I thought that would have been quite obvious. :confused:

[Chris_D]

Sounds suicidal for whoever would try to implement that program.

[Laughing Penguin]

[QUOTE=Johan;344211 After all, it's only fair you pay for your own personal choices, especially when they're stupid.
-----Overweight? Higher premium
-----Obese? Higher premium
-----High cholesterol? Higher premium
-----Smoker? Higher premium
-----Drink more than one drink a day? Higher premium
-----STDs? Higher premium
-----Drug use or evidence thereof? Higher premium
-----Conviction of a violent criminal offense? Higher premium
-----Traffic tickets? Higher premium
-----Many more will be added later. We've got lots of pages to fill, and medical costs to lower. Changing behavior through the benevolent guidance of government will lower our costs. I say we go for it. Why not? America has never needed a big brother more than it does now.
[/QUOTE]

As long as we're being so draconian regarding risk factors, may as well add some others:

- Eating foods not specifically listed on a government-approved list? Higher Premium (after all, poor diet leads to health problems, so any deviations from the recommended food pyramid should be ruled out)
- Living in a high-crime location - Higher Premium (chooing to live in a bad area increases your odds of being mugged, raped, shot, etc)
- Having children - Higher Premuims, with sharp increases with every extra child (you're adding more dependants to the system which need ot be supported by childless individuals, plus associated costs resulting from pre- and post-natal care and the increased susceptibility many parents have to common ailments spread by children in schools)
- Income below X (to be determined later) - Higher Premium (as lower income individuals tend to eat poorer and seek out medical care less often)
- Over a certain age - Higher Premiums, with more points as you advance past certain age categories (health problems become more common as you get older)
- Not excersizing X hours a week at a government-recognized gym or health program - higher premiums

... really, Johan, your list has some merit, but quickly gets absurd. If traffic tickets will really cost you, we've entered some crazy territory. You already get penalized for such tickets through your mandatory car insurance, which also covers the medical costs for victims of the risky behavior. Beyond that, if you're going to start hyper-regulating people's lives and behaviors, at what point can you draw the line and say you've hit the proper criteria? There will always be cases where you can find what someone will consider risky behaviors. Hell, at the extreme end you can penalize anyone having any kind of sex outside of marriage with the intention of conception, since that can increase the odds of getting an STD... and you will find people very willing to support that. You need to keep the criteria reasonable from the start, or these risk factors get way out of control.

[Johan]

Eating foods not specifically listed on a government-approved list? Higher Premium

Agreed. Add it! We need a list of foods, too.

Having children - Higher Premuims

That's already factored in. You pay a percentage of your salary as premiums based upon your filing status (dependents are a part of that, but are not deductible). Larger family? Higher fees.

Living in a high-crime location - Higher Premium

No, no...penalize the criminals, not the law-abiding.

Income below X (to be determined later) - Higher Premium

Premiums are a percentage of pay, not a fixed dollar figure, and vary based upon all the factors listed. I disagree with adding this one.

Over a certain age - Higher Premiums

We can't do that. After all, the government is in the business of moving money from the young to the old, not the other way around.

Not excersizing X hours a week at a government-recognized gym or health program - higher premiums

Agreed. Add it!

Johan, your list has some merit, but quickly gets absurd.

Ya think? ;)

[Kelegacy]

I agree that if you are contributing to your own ill health (obese, smoker, etc) you should be paying more than the rest of us. It's their fault (the obese, the smokers, the poor eaters, etc) that are making premiums higher and higher each year because they are the ones seeing the doctor more. Essentially they are ruining it for the rest of us.

[ShivaX]

I agree that if you are contributing to your own ill health (obese, smoker, etc) you should be paying more than the rest of us. It's their fault (the obese, the smokers, the poor eaters, etc) that are making premiums higher and higher each year because they are the ones seeing the doctor more. Essentially they are ruining it for the rest of us.

Actually most of those people just die and don't cost much.

Smokers cost less to health care systems than non-smokers, because they don't generally make it to old age where you generally get most of your health care. They usually die of lung cancer which is pretty much untreatable and thus saves a lot of cash.

Theres a lot of links out there to the study so I'll just pick one at random:
http://www.newsli.com/2008/02/06/study-shows-obese-people-and-smokers-cheaper-to-treat/

In a recent study conducted by researchers worldwide with the hopes of determining the cost for the government in maintaining a healthy living among people ranging from 20 to 56 years old, results showed that obese people and those who constantly smoke cigarettes and tobacco every day actually save the health system much more money than those people who are physically fit. Reason being, healthy people live longer than those who struggle with obesity and addiction to cigarettes, and thus cost more money.
The result showed that of the three groups, the “physically fit” people had an average life expectancy of 84 years old. Obese people lived until 80 years old while the group of heavy smokers generally dies at the age of 77. Findings also showed that from 20 years old onwards, the cost of healthcare for the “Physically fit” people was at $417,000. Obese people cost $371,000 while heavy smokers spend around $326,000.

[Johan]

Actually most of those people just die and don't cost much.

Yes, but we need their revenue for a single-payer plan, so they'll pay.

[ShivaX]

Yes, but we need their revenue for a single-payer plan, so they'll pay.

Well sure, but they shouldn't pay more. They wont be paying as long anyway. Make the health nuts pay more, that way they're around longer and the system is better funded. Sure it might encourage some to become heavy smokers or fat asses, but ultimately that saves the system money, so more power to em!

Time to let Marlboro start making cartoons again.

[Ultima Thulian]

-----Overweight? Higher premium
-----Obese? Higher premium
-----High cholesterol? Higher premium
-----Smoker? Higher premium
-----Drink more than one drink a day? Higher premium
-----STDs? Higher premium
-----Drug use or evidence thereof? Higher premium
-----Conviction of a violent criminal offense? Higher premium
-----Traffic tickets? Higher premium
-----Many more will be added later. We've got lots of pages to fill, and medical costs to lower. Changing behavior through the benevolent guidance of government will lower our costs. I say we go for it. Why not? America has never needed a big brother more than it does now.

I encourage you to add further ideas that should be incorporated into this single-payer system.

I was behind your single payer plan for the most part (even if you were likely using it as a tongue in cheek jab), it reflects my ideas fairly well. But your list of what causes higher premiums I think is unfair. Some make sense (drug use, for example), some don't. For example, overweight? According to the joke that is the BMI? Come now. Anyone who builds a little muscle at the gym is now overweight, which is ironic since those who regularly work out will likely be healthier.

I think the list should only allow higher premiums on risks that are absolutely necessary and/or obvious and easy to prove. Again, illegal drug use makes sense, as does generic prescriptions only. I get the idea of what you're trying to do with this, but even so, I'll bite.

[Dark Acre Jack]

A link to something that tries to claim that healthy people cost medical systems more than unhealthy people.

She-fricking-nanegans.

If I never have to go to the hospital, I cost the system exactly zero.

Nice try, though.

[ShivaX]

She-fricking-nanegans.

If I never have to go to the hospital, I cost the system exactly zero.

Nice try, though.

I didn't make it up. You cost the system exactly zero right now but when you live to be 100 you're costing the system out the ass. A fat ass smoker isn't living that long so he dies before end-of-life care kicks in.

Go hunt through the studies over here if you're so inclined.
http://www.plosmedicine.org/home.action

Or just ignore reality because it doesn't correspond with what you thought it should be. You can join up with these guys (http://www.theflatearthsociety.org/) and fight the power while you're at it.

[Chris_D]

Try looking at it as cost per year etc. Obviously the healthy person will cost less per year than the chronic smoker, especially during the first 60 years. Also, the healthy person will contribute more via taxes, labour, etc.

[Dark Acre Jack]

I didn't make it up. You cost the system exactly zero right now but when you live to be 100 you're costing the system out the ass. A fat ass smoker isn't living that long so he dies before end-of-life care kicks in.

Go hunt through the studies over here if you're so inclined.
http://www.plosmedicine.org/home.action

Or just ignore reality because it doesn't correspond with what you thought it should be. You can join up with these guys (http://www.theflatearthsociety.org/) and fight the power while you're at it.
Nice.

Again, you're assuming that I'm going to somehow be an unhealthy centenarian.

The "reality" is that healthcare, like any insurance system, works because people who don't use it contribute to the people that have to. The issue I have is that if I'm forced by mandate to pay too much for a service that I may never use (again, throw a bunch of fear-factors at me, I won't blink) because a large number of people can't take care of themselves and oftentimes make themselves sick, well shit I think that's just a bit unfair.

Also, this:

Try looking at it as cost per year etc. Obviously the healthy person will cost less per year than the chronic smoker, especially during the first 60 years. Also, the healthy person will contribute more via taxes, labour, etc.

I guess having a flat earth means having a broader horizon?

[ShivaX]

Nice.

Again, you're assuming that I'm going to somehow be an unhealthy centenarian.


Yes I should assume you'll live a long life and never see a doctor. Nevermind that its a 1 in a billion proposition, you'll obviously be that one woman in Nairobi who lives to be 111 with basically no medical care. You wont be the one of the hundreds of millions who need medical care after the age of 60.

Unless you're planning to go Logan's Run and off yourself at a young age for the good of society or something. Then, I stand corrected.

[Esquilax1138]

Unless you're planning to go Logan's Run and off yourself at a young age for the good of society or something. Then, I stand corrected.

Careful there, you can't mention Logan's Run in times like this! We got enough people freaking out about the coming socialist society already, if they remembered to watch this movie they'd totally lose it and start hurting someone. :p

Have to admit though, it was one hell of a low cost health care plan!

[Shieldmaiden]

Higher premiums for overweight people? Fuck that. I eat well within my daily intake limits, take more than the recommended amount of excercise, don't smoke, rarely drink and I'm at least seven stone heavier than my alleged ideal weight. I can't afford to go to the gym or to buy any kind of workout equipment for home and I can't just go out for a jog because of a foot deformity I was born with.

Being lumped in with people who choose to poison themselves on a regular basis is insulting.

[Ink Asylum]

Careful there, you can't mention Logan's Run in times like this! We got enough people freaking out about the coming socialist society already, if they remembered to watch this movie they'd totally lose it and start hurting someone. :p

Have to admit though, it was one hell of a low cost health care plan!

It isn't Logan's Run, but Fox News actually brought up the specter of another population control movie to attack the health care plan:

_fL3cBbV_Yo

[Hemalin]

To be fair, people are delicious.

[Narradisall]

To be fair, people are delicious.

Taste just like chicken.