Why Obamacare is the Best Thing To Happen To EMS Since Johnny and Roy

[RocketMedic]

For the money (public and private) spent on health care, what sort of a health-care system could be built?

 

[Achilles]

For the money (public and private) spent on health care, what sort of a health-care system could be built?

What have other countries done?

 

[Bullets]

I think this is something we have seen for awhile and will continue to see, and I think it will show itself too in EMS.

We, (American society) are dividing up increasingly into economic segments. While the has always been a notion of economic "class" in the US, it generally hasn't been very pronounced, the very wealthy were a small segment, and the poorer classes were generally comprised of minority races. We segmented much more on the basis of race (wrongly), and now the divides are much more of the economic nature.

I think 1900s America was far more economically stratified then current society

I really dont think this will affect us as an industry. Those with insurance arent going to lose it, and they will always be reliable payers, those with BCBS and such.

Those on the public dole will still be on the public dole

and those that slip through the crack will slip through the cracks

As long as insurance providers cant compete across state lines the system will be expensive and cumbersome. I dont see the government system standing as a sole provider who can span state line with a legal challenge. Larger payer base results in decreased individual cost and hope fully more easy coverage, as more companies compete for the same pool of payers

 

[Arovetli]

I think 1900s America was far more economically stratified then current society

Indeed. This is known as the Great Economic Arc.

Also, what I meant by 'notion of economic classes' wasn't in terms of absolute numerical income inequality but rather the notion of upward mobility in our modern history.

In reference to the arc, early 20th century, when data was first available, income inequality was great. During the progressive New Deal era it converged and income distribution narrowed. Presently it is arcing back the other way, and all progressive federal attempts to narrow it seem to be furthering the divide and inequality is increasingly growing.

The more homogenized the middle class becomes with the poor, and the further away the upper class gets. This is a big deal for us when we are presently depending on taxing the rich and increasing corporate taxes to fund Obamacare.

There's no positive benefit to EMS with no viable funding and a side effect of dragging down the backbone of the country.

 

[Carlos Danger]

For the money (public and private) spent on health care, what sort of a health-care system could be built?

I don't think we need to "build" a new healthcare system. We have a pretty solid one. Not perfect, not nearly as efficient as it should be, but I don't think there there are many countries I'd rather get badly injured in.

Look, we have a large population who is simultaneously aging rapidly and suffering from more and more chronic diseases, yet we are constantly living longer and more productive lives. Is that not the very definition of an effective healthcare system?

First of all, I think we all need to simply accept the fact that quality healthcare is damn expensive. Period. You don't get care in comfortable facilities with short wait times from top physicians using state of the art technology for nothing. Of all the things that people do that confuse me, probably the one thing I have the hardest time wrapping my brain around is the notion that we should be able spend years and years making poor lifestyle choices and taking no responsibility at all for our own health, and then receive prompt, expert, flawless healthcare at no or very little cost to us, as often as want.

We wouldn't expect to be able to buy a new car, beat the crap out of it and never maintain it for 20 years, and then take it back to the dealer and have them restore it to new condition again, at no cost to us. Why do people think that is how medicine should work?

As far as how to improve what we have? I honestly think that's quite simple. Many of the inefficiencies and problems with our system have to do with the tens of thousands of absolutely oppressive federal regulations which completely stifle competition and innovation.

Do away with federal insurance regulations. Let people buy whatever insurance they want. Get rid of CMS. Get rid of the VA. Limit the ability of the AMA and other interests to enact protectionist regulations. Let the states each develop their own programs for dealing with those who can't afford healthcare.

 

[RocketMedic]

Get rid of the VA? Great, now America's veterans get to trust Humana and United Healthcare to approve them for new prosthetics. Throw those who cannot afford healthcare to state-based programs? Welcome back to 1960.

In many cases, those "oppressive federal regulations" are the only thing keeping insurance companies and hospitals from simply abandoning public health at anything even approaching affordability.

 

[Carlos Danger]

Get rid of the VA? Great, now America's veterans get to trust Humana and United Healthcare to approve them for new prosthetics. Throw those who cannot afford healthcare to state-based programs? Welcome back to 1960.

There is nothing at all special about the VA. It is just another hospital system, and they turn vets away all the time, ESPECIALLY for prosthetics.

The VA does nothing that civilian systems don't do, better and more efficiently in many cases. The VA is a bureaucracy on an unmatched scale, and a duplication of effort that is just nonsense.

Is there any reason the military can't simply pay for care in civilian hospitals?

In many cases, those "oppressive federal regulations" are the only thing keeping insurance companies and hospitals from simply abandoning public health at anything even approaching affordability.

That "the only thing saving us from being taken advantage of is the federal government" is a complete fallacy.

The idea that businesses (the insurance companies) actually WANT to turn away business is absolutely illogical.

Do insurance companies sometimes do crappy things to people? Yes. So does the government.

Am I saying the healthcare industry needs no regulation whatsoever? No. I'm saying the states would do a far better job of it.