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  • Posted by  $  Temlakos 8 months, 2 weeks ago
    Here's an expansion on Point Six: "Stop boxing out specialty hospitals with burdensome certification requirements." To which I would add: "Stop boxing out centers of alternative medical practice with burdensome certification requirements, and while you're at it, stop boxing out alternative medical practitioners with burdensome licensure requirements."

    I scarcely hold it Objectivistic to have the government "examine" for medical qualifications. Let the patient judge for himself, or affiliate with a group that will do the judging for him.

    I hold that conventional medicine gets a lot of things wrong, and that's the real reason for any worse healthcare outcomes the proponents of statist medicine keep citing the United States for.
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    • Posted by  $  8 months, 2 weeks ago
      I think one of the things that even savvy doctors will admit is that which the power of the mind holds over one's healing capabilities. Regardless of treatment regime, one's mental outlook has much to do with the actual outcome. That isn't to imply that medicine is all mind-over-matter, but simply that much of modern medicine doesn't take anything of the mind into account and much of "alternative" medicine places too much credence in the mind. I'd like to see a little more moderation.
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  • Posted by  $  jbrenner 8 months, 2 weeks ago
    Although there are many good ideas in this list, the one that could do the most improvement rather quickly is removal of the "certificate of need" process. In my area, the two healthcare networks in my county have used it against each other to basically set up monopolies in the northern and southern ends of the county. These networks have also effectively made it nearly impossible for doctors to be members of both healthcare networks. Many doctors and small networks of doctors who had independent practices have been given ultimatums to either join or be excluded.
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  • Posted by chad 8 months, 2 weeks ago
    Most of the ideas are great. Four are not. Making (means use force) health insurance plans cover pre-existing conditions encourages people to wait until the house is on fire then purchase insurance. It severely reduces the pool if you can buy insurance when you discover you are having a heart attack. Eliminate Health Savings Accounts. The government will do what it is doing now, monitor your account and take what you don't spend. Eliminate Medicade. Government involvement in any production or consumption of any product cannot be controlled and cannot be made to work in a free market. Medicare should not exist for the same reason. I have paid 10's of thousands of dollars into to this program then when I retired they want another $200 a month for very minimal coverage! Where did the money go that I paid in all those years. A scam of this nature operated in the free market would be punished.
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  • Posted by CircuitGuy 8 months, 2 weeks ago
    The title is about curing a healthcare crisis, but the content comes down mostly to one items: Stop treating healthcare as a crisis in need of a gov't cure.

    BTW, I really liked #13. I thought of it several years ago, and I haven't seen the idea anywhere else.
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    • Posted by ewv 8 months, 2 weeks ago
      Insurance on insurance premiums? A market for insurance would already allow for that either directly or through a more expensive option that limits increases in future premiums.

      There should be no government interference in the form of mandating plans that must be available. Government planners confuse reform with more government planning, then sell it in the name of a "solution". The solution is for them to get out of it and stop planning other people's lives, then pushing more planning to 'fix' the problems they already caused and blaming it on a "crisis" in the market. Get rid of that and there is no need to suggest to them lists of ideas, the medical and insurance industry is perfectly capable of developing and offering valuable new ideas.

      The one fundamental item is deeper than rejecting claims of a "crisis" needing their help: it's the false premise that health care is a "right" that government must turn into a coercive entitlement. Egalitarian nihilists see "crises" requiring more statism everywhere they look. They won't stop that until the collectivist premises are eliminated.
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  • Posted by Solver 8 months, 2 weeks ago
    Start with people accepting that being provided healthcare is not some natural, individual or God given right.
    (And neither is being provided slaves)
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  • Posted by  $  WilliamShipley 8 months, 2 weeks ago
    It's got a lot of my favorites in it. HIPAA is a major villian. But a variation on #4 Streamline the FDA would be to remove the phrase "and effective" from the mission. If you must have an FDA (and pretty much everyone except those of us here thinks you do) restrict it to verifying safety. Once it's safe, then it's the market's job to determine it's effective.
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  • Posted by  $  CBJ 8 months, 2 weeks ago
    The Republican replacement for Obamacare appears to ignore most of the issues brought up by the article. Aren't there at least a few GOP members of the House and Senate that would be willing to team up and introduce a bill that would include these much more meaningful and effective proposals?
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    • Posted by  $  8 months, 2 weeks ago
      Rep Jim Jordan appeared on MSNBC to advocate that the House first simply send to Trump the same bill Obama vetoed.

      I am also aware that Rand Paul has presented an alternative plan, as have at least two others in the House. The problem is that these don't have the House Leadership stamp of approval and are being held up in Committee.
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  • Posted by  $  kddr22 8 months, 2 weeks ago
    Nice start. I have actually came up with a plan that would cover the uninsured and underinsured for a cost of 40 cents on the dollar and have it be a benefit to the Doctors as well. Amazing how hard it is to get politicians to pay attention since the control is with the drs not the govt.
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    • Posted by  $  8 months, 2 weeks ago
      Would you mind sharing it here? It is certainly as worthy a look as anything the politicians can come up with! ;)
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      • Posted by  $  kddr22 8 months, 2 weeks ago
        The simple version is that if you divided the number of under/non insured pts like a panel and allowed drs to deduct the care off out gross at the end of the year max cost 40% on dollar if limited to say 50k of office based care for a year per dr most would be willing as we write off more than that as uncollectable all the time. For meds used tax dect based vouchers that the pharmaceuticals co can deduct etc more complicated than this but this is the overall basis
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        • Posted by CircuitGuy 8 months, 2 weeks ago
          "allowed drs to deduct the care off out gross at the end of the year "
          Couldn't providers do this under current tax law? Any business can chose to give away product or services, which decreases its profit, which decreases its tax obligation.
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          • Posted by  $  kddr22 8 months, 2 weeks ago
            no we are not allowed
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            • Posted by freedomforall 8 months, 2 weeks ago
              Please explain what specifically stops a doctor from doing so.
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              • Posted by  $  kddr22 8 months, 2 weeks ago
                It is written into the tax code that noncollectable services cannot be written off, considering that any material costs were already expensed. We end up with a lot of unpaid bills that we ultimately just have to write off...
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                • Posted by freedomforall 8 months, 2 weeks ago
                  So you expense all the costs (except your personal time) and they are tax deductible. You want to deduct something more than all your costs?
                  Who do you suppose would be paying for the services then? TANSTAAFL.
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                  • Posted by  $  kddr22 8 months, 2 weeks ago
                    you are forgetting the time I pay my employees that do the work and my own time and services provided that are not collected. Every service has a value rbrvs unit. For the un/underinsured if you divided it up between drs it would cost less than the current ACA mess and care could still be provided by using it as a tax credit not a direct payment. Not perfect but it trying to problem solve a more economical way that benefits both sides
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                    • Posted by freedomforall 8 months, 2 weeks ago
                      You deduct your payment to employees for their time as it is tax deductible regardless of whether you collect fees for the services, so I am not forgetting it, and I did mention the exception of your time, so I didn't forget it either.
                      As a consultant, I had the same issues when I provided any service gratis or at a lower fee that did not cover my costs. I understand the tax aspects (and I am qualified via experience and education to prepare tax returns for others although I do not do so as a paid service as a matter of principle. I refuse to profit directly from an unconstitutional government law that loots from producers.).
                      Government should not be involved in either your business, nor mine.
                      I respect you for trying to create a different way than the current process, but allowing government to continue to interfere is not an acceptable solution because it continues the errors that have created the problem.
                      The GOP "solution" to Obamacare is also nothing more than a continuation of the same problem under a different name.
                      That was completely predictable, and many have posted the prediction of continued GOP interference in health insurance and health care. Trump should act to make every provision of Obamacare null and void, and to veto any replacement of it .
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                  • Posted by  $  kddr22 8 months, 2 weeks ago
                    also think that it would be better to take several different ideas and test them in several areas to see which way works best instead of some massive one size fits all govt program
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                    • Posted by freedomforall 8 months, 2 weeks ago
                      While I agree that competition would be a good idea, the private sector should devise the "programs" and government has no constitutional power to interfere, meddle, or direct the process.
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                      • Posted by  $  kddr22 8 months, 2 weeks ago
                        sorry so,long to reply was at kids soccer games but this would be a private program from the drs pharm hosp and lab component as that is part of what it is to show that a private system can work more efficiently. The only govt part is what we do not pay in taxes for services rendered . There are many more details but hard to place all in comment area
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                        • Posted by freedomforall 8 months, 2 weeks ago
                          No worries, I hope you are enjoying your day and the kids;^)
                          All fine except the government reimbursements. Establishing a local charity to make up the difference is a better voluntary answer that keeps the government out of your business.
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  • Posted by Herb7734 8 months, 2 weeks ago
    Based on what Trump is going through at present, I doubt if we'll ever see such reforms. Yes, I would like to see them happen, but there is no way they will, except incrementally. Even then, as administrations swing from left to right and back, the possibility seems remote.
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  • Posted by unitedlc 8 months, 2 weeks ago
    Drugs are one of the biggest problems with health care costs. Something that could make an enormous difference would be to lower drug patent durations. It shouldn't be done on existing drugs, because that would be reneging, but any future drug that applied for a patent after a certain date (future drugs) would have a much shorter life span (say 10 years). That still gives the manufacturers plenty of time to make their money.

    I know this idea may sound counter intuitive to an Objectivist, but the drug companies have gone insane. I am all for maximizing profits, and there shouldn't ever be regulation on what they can sell drugs for, but if we want to keep from having a single payer system some day, then we have to start opening up competition for generics.
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    • Posted by  $  8 months, 2 weeks ago
      I'm going to disagree simply by giving you the actual timeline of a drug under the current system. My brother worked for a company who managed drug trials, so I'm operating from a pretty firm foundation here based on my extensive discussions with him about the matter.

      When a drug is first discovered in the laboratory, the firm files a patent which lays out the structure of the drug chemically. That means that from the date the patent application is filed, every single one of a company's competitors have access to what the drug is, what ailment it targets, and the chemical makeup - all for nothing. The only thing they have to do is figure out a way to mass-produce it. And the patent only lasts seventeen years.

      Now, while all those competitors are figuring out how to mass-produce generic knock-offs, the filing company now has to go through an 11-year FDA vetting process of clinical trials in three stages: animal trials, limited human trials, extensive human trials. Each stage takes time and literally hundreds of millions of dollars. It's not atypical for the trial costs of medication to exceed $1 billion - and that's besides the research and development price tag which also commonly runs $1 billion.

      Now assuming that they get to the end and the FDA signs off on the drug, they now have approximately five to six years left to market the drug and recoup their costs before the generic competition destroys their margins and their hopes of breaking even - let alone turning a profit. Add to this the fact that most drugs are now specialty drugs which target rare or very specific diseases drastically limiting their pool of prospective clients and you begin to see the true picture. I think that the patent coverage should extend for seventeen years after the FDA issues its approval/disapproval so as to give the developer more time to gain back their investment and enabling them to charge lower prices in the meantime.
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      • Posted by unitedlc 8 months, 2 weeks ago
        And that is why solving the healthcare "crisis" would not be a good job for me. My ignorance to the intricacies of the drug market is outstanding.
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        • Posted by  $  8 months, 2 weeks ago
          “The more I learn, the more I realize how much I don't know.”
          ― Albert Einstein

          If all people were willing to change their minds when presented with more information, we'd have a much better world. I applaud you wholeheartedly for being more concerned with good policy than any preconceptions. Can we please elect more people to office like you?!?
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          • Posted by unitedlc 8 months, 2 weeks ago
            Haha! You know the funny thing, I actually believe Trump may be like that in some respects. He acts like he knows everything, but when presented with problems his idea may cause, I think he alters his decisions. Let's hope anyway...

            While changing our minds can certainly be beneficial in many cases when new evidence presents itself, I would never want to be regarded as a "pragmatist".
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            • Posted by  $  8 months, 2 weeks ago
              I won't dare to speak for Trump. I'll wait to see. The way his television show went and how he conducted his campaigns dealt very little with being open to other ideas. In most ways he was just as narcissistic as Obama, he just held to different values.

              I think what's funny is that the original Greek for "pragmatikos" or pragmatic is from the root "pragma" meaning a real thing. Being pragmatic means being a realist dealing with real things. I would think that Objectivists would identify heartily with being all about what is real and tangible but I think that the word pragmatic has been morphed into meaning compromise - a notion that was never present in the original word.
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              • Posted by ewv 2 months ago
                Pragmatism is not a "morph" and doesn't mean "compromise" or "identifying with the real and tangible". It is the name of the philosophy of William James and Charles Peirce, beginning in the late 19th century, and their followers, including John Dewey (who called it Instrumentalism), throughout the 20th century. That is what Objectivism opposes, not being "practical". It's about the content, not etymology.

                Pragmatism dominated American philosophy, beginning with the entire department at Harvard when Harvard was American philosophy. It came from the European philosophy of Kant, Hegel and the anti-conceptual Empiricists. The term itself came from Kant. It has dominated American thought in all realms with its emphasis truth is what "works" and opposition to principle on principle. Trump is a typical product of it.
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                • Posted by  $  2 months ago
                  That people can change and alter words to mean something other than what they originally meant (take liberalism for example) does not alter the original meaning. And studying where things came from and how they have changed along the way is incredibly valuable. The process of change is just as important to understand as the change itself, and possibly more so.

                  On another note, why reply to post six months old? Why manufacture disagreements for the sake of arguing with others? Is that your only joy in life - to try to make yourself feel good by putting others down? If so, you deceive yourself. Peace comes internally as a result of knowing you are doing what is right.
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                  • -1
                    Posted by ewv 2 months ago
                    Stop your hostile personal attacks in your speculative misrepresentations and condescending pronouncements and instructions on my life. You are dead wrong. You lack objectivity.

                    The reason why Objectivism rejects Pragmatism has nothing to do with what you wrote. We don't speak ancient Greek. The term Pragmatism has been established philosophically for over a century and came from Kant. That is not a "manufactured disagreement for the sake of arguing". You do not understand Ayn Rand's philosophy or the people you are so hostile to.
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                    • Posted by  $  2 months ago
                      I find meaning and learning in knowing how things came to be: in the history of cultures both my own and others. If you choose to overlook these opportunities, that's up to you. Whether or not I am objective isn't up to you to decide, however. The presumption and arrogance of such a statement should be so obvious. Any kind of real objectivity wouldn't attempt to manufacture a non-existent controversy - especially on a six-month-old conversation.

                      There is this thing in psychology called projection where insecure people tend to see in others the very faults present in themselves. You have it and it adversely affects how you deal with others. You are not as superior as you think you are.

                      Hint: the English language is the biggest hodgepodge of other languages which exists. Very few words are originally derived from actual English - most are imported from other languages, including many Greek and Latin words, but interspersed heavily with German and French (as well as several others). Any assertion that English is some kind of master language will get you laughed out of any anthropology or linguistics department in the world, but you're welcome to go down that rabbit hole if you really want to...

                      Truth is truth. If you want to be objective: start with yourself. If you want to view me as hostile to you, that's your dream world. I don't waste my time hating other people. It's not worth the emotional investment as there's no payback. If argument and hostility is all you have to sustain your life, I truly do pity you.

                      In all seriousness there is a better way. It involves coming to grips with reality: that you can be reasonable and hospitable even with those you disagree with. You can step down off that pedestal you put yourself on and treat everyone else the way you want to be treated: as equals rather than supposed inferiors. I know it can be a tough thing to do, but the dividends are real. Try it - you might be surprised at the results.
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                      • -2
                        Posted by ewv 2 months ago
                        Stop your personal lecturing and speculating about my personal life and motives. You know nothing about it. Your snarling personal accusations and insinuations are false and do not belong on a civilized forum. I am not interested in your psychologizing and personal feuding, let alone the irrelevant rambling rationalizing about international linguistics and "rabbit holes" trying to justify it. You confuse "hostility" with the conceptual content of posts you do not understand. Your imagination is not objectivity. You speculate, personalize, and spread malicious gossip. It is not "arrogant" and "hostile" to reject your personal attacks on this forum. You lack objectivity and relevance. Knock it off.
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                        • Posted by  $  2 months ago
                          As the self-appointed "exemplar", I would ask why you do nothing to clean up your own attitude before accusing others. You're a whited sepulchre. You have no problems casting aspersions of others yet pretending that you are above any such. You lie only to yourself.

                          If you aren't interested in my opinions, why did you go to a six-month-old post and specifically respond to mine by manufacturing an argument which didn't exist? "Methinks thou doth protest too much."

                          I am a paid member of this forum for four years now - something you can't claim despite all your self-titled "Objectivist" leanings. Put your money where your mouth is or you are nothing but a hypocrite.

                          Don't like what I have to say? Ignore my posts. There's a little "Hide" link that makes it very easy. My objectivity and relevance are in that 18,000+ ranking - and I didn't have to vote myself up to get there.
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                          • Posted by ewv 2 months ago
                            Please consult the guideline for posting here and stop your personal attacks and paranoid speculations about other people's motives. Blarman could not be more wrong.
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                            • Posted by  $  2 months ago
                              "Physician, heal thyself."
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                              • Posted by ewv 2 months ago
                                No one is personally attacking you. Your false and libelous speculations about other people's motives, thoughts and actions are contrary to fact, smears based on your own emotions. You lack objectivity. The kinds of very personalized attacks you are posting don't belong on this or any other civilized forum at all.
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              • Posted by unitedlc 8 months, 2 weeks ago
                No doubt he is a narcissist. Let's hope he measures his narcissism by "results" rather than by just wanting to be right with his first ideas.

                The pragmatist question would probably be a great new thread, as it is definitely something that gets thrown around both positively and negatively with objectivism. My biggest problem with pragmatism is that it fully involves an evolutionary use of thought. That is the whole premise. In order for capitalism to be successful, we need stability in rules and laws. We can't change the rules just because someone is winning and some are losing. As long as all rules apply to all people exactly the same, then fairness exists by definition. Pragmatists like to alter the rules as they go to try to level the playing field if there is a perceived imbalance. When they do this, it can create a new imbalance the opposite direction. Pragmatism creates a seesaw of what is seen as truth and reality. Truth and reality do not change, only perceptions change. Pragmatists tend to attempt to alter perceptions.

                My 2 cents.
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                • Posted by unitedlc 8 months, 2 weeks ago
                  Of course I have just called myself a pragmatist by my first comment about lowering the patent timetable... Oh jees... Since we live in a world that tends to constantly lean towards Socialism/Communism, I guess we have to be pragmatic in order to slow down the progression. If we don't get a handle on health care costs, then we will become socialist sooner than later.
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                  • Posted by  $  8 months, 2 weeks ago
                    lol. That's why I find it so funny when people say they are pragmatists (or accuse others of so being). Whether or not they are right so often depends on their perception. ;)
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  • Posted by  $  kddr22 8 months, 2 weeks ago
    As for posting prices keep in mind what we would charge a self pay pt is often very different from insurance billing though medicaid has made it illegal for us to charge self pay less than a medicaid pt !
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