Would this Fix Healthcare?

[Phatscotty]

First off, let me say this is just a crude idea. I have been thinking about it for some time, but never talked about it publicly. Before the usual a-holes come in here and start calling me dumb and insensitive, let me just say I am asking for people to shoot holes through these ideas. In fact just forget you know anything about me for one second, and just listen to what I am saying and respect the spirit in which it is said. I know a lot of this is very radical, and there are questions about where the money is going to come from and many many other questions as well. I am asking for your help.

Okay, so here it goes. Overall, the general idea is a public healthcare system, totally free for anybody who needs it. Public hospitals and doctors offices which are run by students, trainees, interns, volunteers, as well as professionals who are more interested in helping than making money. Yes for this system you will have to wait a while, much like most of the other public systems around the world. But hey, it's free and it will solve the healthcare crisis!

First off, this system would be for people who do not have insurance, and would cost nothing out of pocket. Users can make contributions if they like, or they can serve in the community if they like. For funding the facilities would run on donations from the public, and the government would help by allowing taxpayers to choose to pay something on our tax forms. We could donate a sum of money, our entire refund, agree to pay a certain % extra in taxes for the year...etc. For the buildings we would have to start from scratch, but I am pretty certain the government can turn over some of their buildings or open up some places in foreclosure or take advantage of distressed properties. For transportation we would rely on what we have already. I know there will be some difficulties here because the facilities are not going everywhere we need them to be, but I suppose we will have to make arrangements for that one way or another. For equipment, hospitals can donate their old stuff as it becomes outdated, and similarly be incentivized to do so, as well as there might be potential for a new industry to be created for healthcare tools that are focused on low cost and basic duties.

Now, as for who is going to staff these facilities. Many of you know I am favor of closing ALL loopholes in the tax system as it exists today. However, the reality that this is highly unlikely to happen must take precedent and it's important to realize that we have to work with the tax system we have, not the tax system we want. The point about the loopholes is that doctors and nurses and specialists would be incentivized to volunteer by earning a write offs or credits or any number of different things that could be considered a benefit. Students would need serve a certain amount of time in an array of different ways as part of their graduation program. Trainee's and interns would serve time as well.

I know there is a lot of stuff that I have left out, but I am counting on the posse to point all that out and we will deal with it as it comes.

[Woodruff]

Okay, so here it goes. Overall, the general idea is a public healthcare system, totally free for anybody who needs it. Public hospitals and doctors offices which are run by students, trainees, interns, volunteers, as well as professionals who are more interested in helping than making money. Yes for this system you will have to wait a while, much like most of the other public systems around the world.

An interesting idea. I have a bit of a qualm with it being run by non-professionals, to be honest, simply from a healthcare-standards perspective, but if that can be addressed somehow.

Now, as for who is going to staff these facilities. Many of you know I am favor of closing ALL loopholes in the tax system as it exists today. However, the reality that this is highly unlikely to happen must take precedent and it's important to realize that we have to work with the tax system we have, not the tax system we want. The point about the loopholes is that doctors and nurses and specialists would be incentivized to volunteer by earning a write offs or credits or any number of different things that could be considered a benefit. Students would need serve a certain amount of time in an array of different ways as part of their graduation program. Trainee's and interns would serve time as well.

This sort of addresses my concern above. Though it would probably have to be a fairly hefty writeoff for this to be worthwhile to them (I would think).

An interesting idea, though.

[jj3044]

One question Scotty... is this meant for those who do not have insurance (kind of like a massivly-expanded free clinic system), OR is meant for all Americans, eliminating insurance entirely and creating a true socialized healthcare system? It kinda sounded like the former... but I want to be clear before I respond.

[Woodruff]

One question Scotty... is this meant for those who do not have insurance (kind of like a massivly-expanded free clinic system), OR is meant for all Americans, eliminating insurance entirely and creating a true socialized healthcare system? It kinda sounded like the former... but I want to be clear before I respond.

He means this only for those who cannot afford insurance. In other words, the poor that he already doesn't like. <evil smile>

[Phatscotty]

One question Scotty... is this meant for those who do not have insurance (kind of like a massivly-expanded free clinic system), OR is meant for all Americans, eliminating insurance entirely and creating a true socialized healthcare system? It kinda sounded like the former... but I want to be clear before I respond.

Yes. I was thinking the person does not have insurance, and neither does the clinic! Perhaps the person getting the free health care will have to sign a waiver that says they understand they are getting healthcare absolutely free, and that the system they are using does not have any money to be sued for.

No insurance, period! Imagine what would happen to the prices! I do understand there will be some problems here, but if we keep in mind that theoretically the overall massive problem of the century would supposedly be solved. If someone has an accident happen to them, they still have free health care to address that, and I will just wildly speculate that anytime something go wrong during a procedure, they would make it a point to bring in a specialist to make sure the person get's the best chance that the problem is corrected.

Remember, I'm totally wingin this right now...

[Phatscotty]

Okay, so here it goes. Overall, the general idea is a public healthcare system, totally free for anybody who needs it. Public hospitals and doctors offices which are run by students, trainees, interns, volunteers, as well as professionals who are more interested in helping than making money. Yes for this system you will have to wait a while, much like most of the other public systems around the world.

An interesting idea. I have a bit of a qualm with it being run by non-professionals, to be honest, simply from a healthcare-standards perspective, but if that can be addressed somehow.

Now, as for who is going to staff these facilities. Many of you know I am favor of closing ALL loopholes in the tax system as it exists today. However, the reality that this is highly unlikely to happen must take precedent and it's important to realize that we have to work with the tax system we have, not the tax system we want. The point about the loopholes is that doctors and nurses and specialists would be incentivized to volunteer by earning a write offs or credits or any number of different things that could be considered a benefit. Students would need serve a certain amount of time in an array of different ways as part of their graduation program. Trainee's and interns would serve time as well.

This sort of addresses my concern above. Though it would probably have to be a fairly hefty writeoff for this to be worthwhile to them (I would think).

An interesting idea, though.

That's the thing though Woody, a professional is a professional because they get paid. When something is free, you normally won't be finding many professionals around. It's not the perfect answer, but it does address the problem while respecting the market and ensuring that people still find it worth it to become a doctor or nurse etc, and strive to be the best doctor/nurse they can be.

The writeoff ideally would not be hefty. Again this would only attract those health-care workers who are more interested in helping, and judging by the passion of some in the obamacare debate, I would actually bet you that some people would have the goal to work in the public system because they are so happy we finally fixed our healthcare problem and want to be a part of it or just help people in general.

[Woodruff]

Okay, so here it goes. Overall, the general idea is a public healthcare system, totally free for anybody who needs it. Public hospitals and doctors offices which are run by students, trainees, interns, volunteers, as well as professionals who are more interested in helping than making money. Yes for this system you will have to wait a while, much like most of the other public systems around the world.

An interesting idea. I have a bit of a qualm with it being run by non-professionals, to be honest, simply from a healthcare-standards perspective, but if that can be addressed somehow.

Now, as for who is going to staff these facilities. Many of you know I am favor of closing ALL loopholes in the tax system as it exists today. However, the reality that this is highly unlikely to happen must take precedent and it's important to realize that we have to work with the tax system we have, not the tax system we want. The point about the loopholes is that doctors and nurses and specialists would be incentivized to volunteer by earning a write offs or credits or any number of different things that could be considered a benefit. Students would need serve a certain amount of time in an array of different ways as part of their graduation program. Trainee's and interns would serve time as well.

This sort of addresses my concern above. Though it would probably have to be a fairly hefty writeoff for this to be worthwhile to them (I would think).

An interesting idea, though.

That's the thing though Woody, a professional is a professional because they get paid.

Maybe in the technical sense of the word, but not in the "able to get it done properly" sense. Just because some idiot is willing to pay me to extract their kidney does not make me a medical professional.

When something is free, you normally won't be finding many professionals around.

That's the problem. Poorly done medicine can absolutely create more problems than it fixes, health-wise.

[Phatscotty]

Right....but! The public system would mostly be a basic system. Hopefully most of the complicated thing would still be taken care of through the ER or a new system would be set up through a charity, like the public kidney foundation etc etc etc. or the public system can get money from the march of dimes or any of the charities that are always raising money. They can start funding this somewhat too

[Woodruff]

Right....but! The public system would mostly be a basic system. Hopefully most of the complicated thing would still be taken care of through the ER or a new system would be set up through a charity, like the public kidney foundation etc etc etc

We're seeing the bad effects today of just using antibiotic medications improperly and how serious that can turn out. It doesn't have to be anything complicated to turn into a very serious problem.

[jj3044]

Ok, a couple problems I see with this...

1) If you could get free healthcare if you needed it, the rest of the system would implode. No one would buy insurance, and companies wouldn't provide it. Just go on down to the free clinic.

2) One of the problem with free clinics today is donations... there are just not enough of them. Complicated/expensive procedures would still not be able to be handled in this system... such as cancer treatments or transplants, or a lot of other things.

3) The amount of providers you would need to volunteer would be staggering. I have a few doctors/nurses that I know. They sometimes work 24-36 hour shifts... by the time they are done they are exhausted and it takes a full day to recover... there often is not a ton of time to volunteer (although a lot still do, but they can't afford to spend the amount of hours you would need to make this work).

Just my 2 cents, but kudos for thinking out of the box.

[Woodruff]

Ok, a couple problems I see with this...

1) If you could get free healthcare if you needed it, the rest of the system would implode. No one would buy insurance, and companies wouldn't provide it. Just go on down to the free clinic.

No. I know that I, for one, would not attend a free clinic unless I literally had no other option. I'm quite certain I am not alone in that thinking.

[Woodruff]

Also, you need to adjust your poll. I selected "need more info", but since your poll answers cannot be changed, I will apparently never have enough info to make a determination.

[Symmetry]

Ok, a couple problems I see with this...

1) If you could get free healthcare if you needed it, the rest of the system would implode. No one would buy insurance, and companies wouldn't provide it. Just go on down to the free clinic.

Not exactly true- free, or mostly free healthcare is available in the UK, and there is still private health insurance, both in terms of general health insurance (in the US it'd be similar to life insurance) and as private providers of medical care. BUPA is one of the biggest companies if you're interested in looking up what might happen if a free option were available.

[Night Strike]

Ok, a couple problems I see with this...

1) If you could get free healthcare if you needed it, the rest of the system would implode. No one would buy insurance, and companies wouldn't provide it. Just go on down to the free clinic.

Not exactly true- free, or mostly free healthcare is available in the UK, and there is still private health insurance, both in terms of general health insurance (in the US it'd be similar to life insurance) and as private providers of medical care. BUPA is one of the biggest companies if you're interested in looking up what might happen if a free option were available.

It's not truly free in the UK because you're forced to pay taxes for it. And you still have to pay those taxes even if you don't like it and want to buy private insurance. Under Phatscotty's idea, the free system is funded by voluntary donations, not by forced taxation, so it really would be free to those who want/need it. And you wouldn't be charged for not using it.

[Symmetry]

Ok, a couple problems I see with this...

1) If you could get free healthcare if you needed it, the rest of the system would implode. No one would buy insurance, and companies wouldn't provide it. Just go on down to the free clinic.

Not exactly true- free, or mostly free healthcare is available in the UK, and there is still private health insurance, both in terms of general health insurance (in the US it'd be similar to life insurance) and as private providers of medical care. BUPA is one of the biggest companies if you're interested in looking up what might happen if a free option were available.

It's not truly free in the UK because you're forced to pay taxes for it. And you still have to pay those taxes even if you don't like it and want to buy private insurance. Under Phatscotty's idea, the free system is funded by voluntary donations, not by forced taxation, so it really would be free to those who want/need it. And you wouldn't be charged for not using it.

Nope, it's free even if you don't pay taxes. People who avoid their taxes also receive treatment for free. Indeed many people who don't pay tax get a free pass on the few things that actually have payments- prescriptions (heavily subsidised, usually), for example.

[Phatscotty]

Ok, a couple problems I see with this...

1) If you could get free healthcare if you needed it, the rest of the system would implode. No one would buy insurance, and companies wouldn't provide it. Just go on down to the free clinic.

2) One of the problem with free clinics today is donations... there are just not enough of them. Complicated/expensive procedures would still not be able to be handled in this system... such as cancer treatments or transplants, or a lot of other things.

3) The amount of providers you would need to volunteer would be staggering. I have a few doctors/nurses that I know. They sometimes work 24-36 hour shifts... by the time they are done they are exhausted and it takes a full day to recover... there often is not a ton of time to volunteer (although a lot still do, but they can't afford to spend the amount of hours you would need to make this work).

Just my 2 cents, but kudos for thinking out of the box.

to your #1. I don't really think so. Anyone who can afford insurance is not going to want to go through the public system. I hate paying for my health insurance, but I still would if this system were implemented. Maybe this will get ironed out more as we go. The public system I am envisioning would not be described as desirable, just free and accessible to all. Moreover on this point, I originally had meant to say that you would have to qualify for the public system. Let's just throw the number 20k out there. anyone who makes over 20k will be directed to the nearest ER unless it's an emergency.

#2 I agree there are not enough today, but I truly believe donations would increase tremendously if this became a reality. Many people would be very proud and put their money where their mouth is. Just look at the passion of the people in the Obamacare debate. I really do think they will chip in and pay their fair share, or at least just something. and don't forget, ideally the costs are going to be rock bottom.

#3 Yup you are right. I knew that was going to be a problem but I figured it would jive better if someone else asked about it rather than me starting with a statement about it. And that is where the lines come in. If a facility is understaffed, the person getting the free health care is going to have to put their name on a list, but this is pretty much how it works anyways for all non-emergencies in all the "free" HC systems right? We will have to make it work with whatever we have. Of course we both know that making healthcare free AND accessible to EVERYONE is a daunting task. It won't be anything close to easy, but I know we could do it.

[jj3044]

Ok, a couple problems I see with this...

1) If you could get free healthcare if you needed it, the rest of the system would implode. No one would buy insurance, and companies wouldn't provide it. Just go on down to the free clinic.

No. I know that I, for one, would not attend a free clinic unless I literally had no other option. I'm quite certain I am not alone in that thinking.

Might be true for you, but then we are back to the problem of all the younger/healthier people not buying into insurance just because they are "young and invincible", even if they have good jobs. Then someone gets very sick, and has to go to the free clinic and get treated.

[Phatscotty]

Also, you need to adjust your poll. I selected "need more info", but since your poll answers cannot be changed, I will apparently never have enough info to make a determination.

fixd

[jj3044]

Ok, a couple problems I see with this...

1) If you could get free healthcare if you needed it, the rest of the system would implode. No one would buy insurance, and companies wouldn't provide it. Just go on down to the free clinic.

Not exactly true- free, or mostly free healthcare is available in the UK, and there is still private health insurance, both in terms of general health insurance (in the US it'd be similar to life insurance) and as private providers of medical care. BUPA is one of the biggest companies if you're interested in looking up what might happen if a free option were available.

Again we are not fixing the crux of the problem in the US though... the healthier people wouldn't get insurance (driving the pooling costs up for everyone that WAS in the system). Then they get sick, cant GET insurance, and we end up paying for it anyway.

This part of the system is broken, and I am pretty sure most would agree with that point.

[Symmetry]

Ok, a couple problems I see with this...

1) If you could get free healthcare if you needed it, the rest of the system would implode. No one would buy insurance, and companies wouldn't provide it. Just go on down to the free clinic.

Not exactly true- free, or mostly free healthcare is available in the UK, and there is still private health insurance, both in terms of general health insurance (in the US it'd be similar to life insurance) and as private providers of medical care. BUPA is one of the biggest companies if you're interested in looking up what might happen if a free option were available.

Again we are not fixing the crux of the problem in the US though... the healthier people wouldn't get insurance (driving the pooling cots up for everyone that WAS in the system). Then they get sick, cant GET insurance, and we end up paying for it anyway.

This part of the system is broken, and I am pretty sure most would agree with that point.

Again, pointing to the British example, it's precisely the healthier (or more correctly richer) people who purchase private health insurance.

I agree with rest of your assessment, I simply wanted to point out that a free public system would not cause people to stop buying insurance.

[jj3044]

Ok, a couple problems I see with this...

1) If you could get free healthcare if you needed it, the rest of the system would implode. No one would buy insurance, and companies wouldn't provide it. Just go on down to the free clinic.

Not exactly true- free, or mostly free healthcare is available in the UK, and there is still private health insurance, both in terms of general health insurance (in the US it'd be similar to life insurance) and as private providers of medical care. BUPA is one of the biggest companies if you're interested in looking up what might happen if a free option were available.

Again we are not fixing the crux of the problem in the US though... the healthier people wouldn't get insurance (driving the pooling cots up for everyone that WAS in the system). Then they get sick, cant GET insurance, and we end up paying for it anyway.

This part of the system is broken, and I am pretty sure most would agree with that point.

Again, pointing to the British example, it's precisely the healthier (or more correctly richer) people who purchase private health insurance.

I agree with rest of your assessment, I simply wanted to point out that a free public system would not cause people to stop buying insurance.

I see what you are saying... do you happen to know what the percentage of uninsured is in Britain and what demographic makes up that population? I would be interested to know.

And I may have misstated my earlier point. I didn't necessarily mean the richer (healthier) people, I actually meant the younger (healthier) people.

[Phatscotty]

Ok, a couple problems I see with this...

1) If you could get free healthcare if you needed it, the rest of the system would implode. No one would buy insurance, and companies wouldn't provide it. Just go on down to the free clinic.

No. I know that I, for one, would not attend a free clinic unless I literally had no other option. I'm quite certain I am not alone in that thinking.

Might be true for you, but then we are back to the problem of all the younger/healthier people not buying into insurance just because they are "young and invincible", even if they have good jobs. Then someone gets very sick, and has to go to the free clinic and get treated.

If people come in without insurance but can afford it, they will be charged, I suppose.

[Symmetry]

Ok, a couple problems I see with this...

1) If you could get free healthcare if you needed it, the rest of the system would implode. No one would buy insurance, and companies wouldn't provide it. Just go on down to the free clinic.

Not exactly true- free, or mostly free healthcare is available in the UK, and there is still private health insurance, both in terms of general health insurance (in the US it'd be similar to life insurance) and as private providers of medical care. BUPA is one of the biggest companies if you're interested in looking up what might happen if a free option were available.

Again we are not fixing the crux of the problem in the US though... the healthier people wouldn't get insurance (driving the pooling cots up for everyone that WAS in the system). Then they get sick, cant GET insurance, and we end up paying for it anyway.

This part of the system is broken, and I am pretty sure most would agree with that point.

Again, pointing to the British example, it's precisely the healthier (or more correctly richer) people who purchase private health insurance.

I agree with rest of your assessment, I simply wanted to point out that a free public system would not cause people to stop buying insurance.

I see what you are saying... do you happen to know what the percentage of uninsured is in Britain and what demographic makes up that population? I would be interested to know.

And I may have misstated my earlier point. I didn't necessarily mean the richer (healthier) people, I actually meant the younger (healthier) people.

The NHS is free for any British citizen, National Insurance is basically the same as having a Social Security number in the US, (fun Sym fact- I have both), only a small number of people buy private healthcare. Many who do distrust it.

[patches70]

For the buildings we would have to start from scratch, but I am pretty certain the government can turn over some of their buildings or open up some places in foreclosure or take advantage of distressed properties.

I haven't read any other replies, so forgive me if this has been mentioned already.

Starting from scratch would not be necessary. Since your system is deemed for public use, immanent domain can be invoked to acquire property and such.

Okay, so here it goes. Overall, the general idea is a public healthcare system, totally free for anybody who needs it. Public hospitals and doctors offices which are run by students, trainees, interns, volunteers, as well as professionals who are more interested in helping than making money.

There are already teaching hospitals. Lots of them. In Richmond is one and is about one of the best hospitals in the nations for juvenile diabetes care.

Now, as for who is going to staff these facilities. Many of you know I am favor of closing ALL loopholes in the tax system as it exists today. However, the reality that this is highly unlikely to happen must take precedent and it's important to realize that we have to work with the tax system we have, not the tax system we want. The point about the loopholes is that doctors and nurses and specialists would be incentivized to volunteer by earning a write offs or credits or any number of different things that could be considered a benefit. Students would need serve a certain amount of time in an array of different ways as part of their graduation program. Trainee's and interns would serve time as well.

The government controls virtually the entire student loan business now. Students could work in such facilities and be compensated against the money owed on their loans.



The biggest problem is becoming overwhelmed. There is just not enough doctors. Let me amend that, there are too many specialists and not enough general practitioners.

The real way to fix healthcare and the costs related, or should I say, the most important first step, is having a sound currency. Without that, everything else is doomed to never meet goals and fall behind as the value of what everything (including healthcare and everything related to it) is priced in keeps falling. That is as the unstable fiat currency keeps losing value it requires more and more of in relatively short order. Once there is a sound currency for which a solid, and stable, foundation can be built on then the rest of what needs to be done becomes much easier. And doable. IMO.

Money, fix the money system, the rest will fall into line.

[Symmetry]

It's doable with the Canadian dollar. How is the US dollar so much worse that it can't do what the Canadian dollar has been doing for decades?