Do you think universal healthcare is what America needs?

I'm old enough to remember the debate about Medicare in the early 1960s. It was going to be the end of Western Civilization, as I recall one side of the debate.
Universal Healthcare for elders seems to be a good thing, yes?

GA- I don't see this country as wealthy. We have an enormous debt that keeps growing. By the time I get to the age to receive social security there will probably not be any. We already have to pay huge taxes each year, being self empolyed, and therefore I could not afford more taxes to cover everyone's healthcare. Especially in a country that so many people are not health conscious and the amount of fast food and processed food and food with hormones and antibiotics, and so on.
It does not sound like a good idea to have the government that involved in our lives.
We would do better and it would be more affordable to pay people to live and eat healthy. Because only a few would be on board.

I don't fully agree with universal health care, because I am not a big fan of the idea of government-rationed care. However, the free market poses a problem as it stands now as far as affordability. A health savings account, on an average income, with the maximum saved per year for 30 years, would barely scratch the surface at covering 5 years in a nursing home later on down the road if I ever needed long term care, with the costs as they stand now.

Therein lies part of the problem, I believe, and it's somewhat of a conundrum. For example, in my opinion it's ridiculous that a hospital or other health care facility can charge $10 for one bandage or an aspirin, and grossly inflate costs, and that drug companies can triple the cost of epi-pens and insulin in a matter of months.  Of course, insurance doesn't necessarily pay what they ask, but the private payer does. 

Costs are far, far outpacing wages, and there are very few regulations in regard to price controls and transparency. Saving for a rainy day helps, but doesn't prevent illness from completely wiping you out very quickly, even if you've saved six figures.

But yet, wouldn't establishing those controls then be asking the government to step in and fix it for us, which could then lead to more government control in other areas that we might not want? It's definitely not an easy problem to solve.

NO! Universal Health Care only puts the government in charge of you. We are not a monarchy or a dictatorship. Look at what happened with little Alfie Evans in England. The government has to much say in our lives as it is. For them to be the ones to choose our health care and what our worth is, would be horrible. It would be genocide.

When it comes to health care we need to acknowledge several things.

First, Medicare and Medicaid are failures as a sustainable healthcare model. Medicaid expansion is bankrupting American healthcare. One not-for-profit healthcare system I know about loses money (reimbursement for services is less than the cost of providing those services) on all 72% of its patients on Medicare/Medicaid(48%) or uninsured(26%). It must balance the budget by over charging the 28% of its patients who have insurance or are private pay. As the ACA drives more people out of the private insurance market, small market and rural hospitals are closing at the rate of one per week.

Second, government is inefficient compared to private industry in every respect. Local government is a little inefficient, state government is more so, and federal government is grossly inefficient. The bigger the bureaucracy, the more factors are involved in decision making beyond providing good services at reasonable costs.

Third, we must return to a system that allows individuals and small businesses to choose the level of care they can afford. Obama's ACA established a minimum standard of coverage that requires ALL health care policies to include at no cost to the individual: an annual physical with all testing included, birth control of a woman's choosing, as well as pregnancy and abortion services, and unlimited lifetime treatment. Prior to the ACA, a small business could provide as much insurance as it could afford. It could pick and choose the services that best fit it's employee base. When the work force was older, pregnancy coverage could be waived in favor of annual physicals. For a younger workforce, pregnancy coverage could be included with physicals covered only every 2-3 years.

Fourth, we also need to allow reasonable co-pays. Everyone should have an economic vote in the system. Private insurance includes a co-pay for an office visit and a much larger co-pay for an non-emergency emergency room visit - not surprisingly parents with sick children make an effort to get their children into the doctor's office. Medicaid parents with no co-pay for either option tend to use the emergency room (with its much higher costs) more than the doctor's office. For people with lower incomes on Medicaid, co-pays should be less but still encourage good choices - maybe $5 office co-pay and a $25 emergency room co-pay.

Now to Real Universal Coverage Basics - the goal is to provide basic health care access to as many people as possible and allow individuals to choose the level of care they believe they need and can afford. Among able bodied adults, working people should have better access than people who refuse to seek and maintain employment.

First, every able bodied person should be required to work to have any health coverage - no Medicaid for the able bodied working age adult unless he/she is working. Having children does not excuse the work requirement. If you do not have a private sector job, then you can provide care giving for disabled family members, work for approved non-profits or the city/county doing whatever public service works will benefit your area - could be picking up trash, data entry, child care, warehousing, etc.

Second, government becomes a referee - not a provider. Federal government defines a series of standards for health care coverage (much like it has for Medicare Supplement Insurance) - Plan A, Plan B, Plan C. Each standard contains a list of minimal services the plan must include so individuals have a base to compare pricing on comparable coverages. The most basic plan might include a physical every 5 years and a maximum of 6 office visits a year with a doctor and another 6 with a nurse practitioner unless a doctor states you need more.

Third, health care providers can only price plans based on your age and your state - not your health status. Everyone age 43 in Tennessee would pay the same rate for Plan A.

Fourth, when entering the health care market after not having any coverage for more than 24 months in the previous 120 months (2 years without coverage in the last 10) there would be a significant penalty (25-100%) for the number of months you didn't have coverage. If you didn't have coverage for 6 months, then there's no penalty. If you didn't have any coverage for 27 months, you would need to pay 1.25 times the normal rate for the plan you pick to re-enter the market for 27 months, then your premiums would drop back to normal (2.0 if no coverage for 120 months). This encourages people to make having insurance a priority before chronic conditions develop.

Fifth, Health Care Spending Accounts could be used to pay health care premiums as well as co-pays and remaining funds in these accounts would roll over year to year. Lower income people would receive tax credits directly into their Health Care Spending Accounts equivalent to at least the cost of the most basic plan available in their state. Everyone would be able to contribute pre-tax dollars to these accounts. Choosing a high deductible plan with cheaper premiums would allow younger/healthier people to build a balance that would help fund higher premiums as they age or when a unplanned medical event causes them to pay maximum deductibles. Balances in these accounts would be transferable on death to designated beneficences.

I believe the individual has the right and most often is capable of making the good choices for themselves. Funding a government bureaucracy to make your decisions for you (and an appeals process when you don't agree) is costly and burdensome. Options need to be flexible with something available for every American. For example, if birth control and abortion services are important to you, then pay for them yourself from your spending account or choose an employer that offers them in their health care plans; the government should not be wasting money trying to force faith based hospitals into providing services that violate their religious beliefs.

Tacy, I would add to your observation that hardworking people didn't cause the pollution that contaminates portions of the US, and the world for that matter. But businesses, special interests, lax or nonexistent government policies and monitoring did. And much as it grieves, so has the need for employment in some sections of the US and for that matter the world, plus exposure to war, whether as a soldier or combatant, has already raised exposure to significant portions of the population.

Technie, how would you suggest implementation of any universal health care be managed? By private contractors? That would create a competitive environment, but also possibly fracture contiuity of health care.

I'd be interested in hearing your position on that. I wish that our legislators would look to European and Scandinavian countries for guidance, but they're preoccupied with other issues now.

It's unfortunate that such a wealthy country as ours has such a problem, but there are a lot of areas that could be contained to create more funding for health care. Weekend trips to Florida for a certain individual are one area in which costs could (and perhaps should) be drastically slashed.

I sense this is going to be an interesting thread.

Universal health care is a desirable goal only if combined with universal labor and responsibility. And never when provided and controlled by the federal government.

The federal government in the era of the professional politician is too big and too controlled by special interests to make sound choices. Consider that Medicare will not cover a $75 transfer bench for the bath, but covers 80% of the treatment costs when a senior falls in the bath with an average immediate treatment bill of over $20,000. Private health insurance (with total coverage costs in mind) wants to pay for the transfer bench.

Health care, housing, and food are not divine rights of birth - they are the harvest of someone's hard work. By what moral justification do you take/steal someone's harvest? Because it would be easier for you if someone else provided and you just kept receiving? Permanent childhood?

If you believe in a permanent childhood of receiving without labor will you also accept a permanent childhood where someone else gets to make all the decisions? Where someone decides at age 80 you too old to get enough benefit from a hip replacement so even though you are in constant pain and have difficulty walking around your house you are not "eligible" for this simple treatment? Is that "fair" to the person that didn't smoke and didn't drink and has multiple relatives that lived independently into their mid 90s? Are you prepared to have disabled babies left to die because it would cost too much to provide treatments for a life of "limited quality". Would we save money by denying children with learning disabilities the early education that enables them to make the most of their limited abilities? Where smokers and drinkers and fat people have limited health care?

Universal coverage is only possible with rationed care and everywhere it has been implemented choices like the ones above have been part of that universal coverage. Universal coverage may indeed solve many of your parent's decisions - perhaps by eliminating options.

Personally i think its a great idea. I agree its going to be hard to pay for. I dont really have a hard time paying more taxes for this . What is really needed is someone who can talk for the patient and home care on the boards that decide what to pay for . Im disgusted daily that they will pay for Nursing home care and not home assistance

Universal health care sounds like a good idea until we need to stop to realize who will be paying for it, as GardenArtist had mentioned. We, the taxpayer, would be funding the project.

In other countries around the world, workers are use to paying high taxes to fund their countries health care. Gasoline tax can be half the cost of fuel, thus the reason one sees small economy cars on the road. And why people live in modest homes, McMansions are far and few between. When I was visiting in-laws in France, the refrigerator was the size of a college dorm refrigerator, not the size of a double bed standing up, that we have here.

Heavens, there are places were the majority of people vote "no" to school improvements or the building of a new firehouse safety center. Cannot see voters voting "yes" to double their real estate tax, sales taxes, property taxes, income taxes.

We here in the States need to go back to the old ways of saving money for those rainy days. Back before we were paying $200 a month just to watch TV, have telephone and internet service. One didn't need to pay $100's for a new phone. The telephone company would rent out the phones at a very low fee. Etc.

There are so many issues and aspects to this issue. Even if it would solve many issues, the basic underlying issue remains: who funds this? As a retired taxpayer on limited SS, I couldn't afford to sacrifice any of my meager funds to help others, even though so many are in dire straits.

This issue has been discussed so often in the past, by politicians of more compassionate inclination than the current administration. And that's a major issue as well - there has to be the support in DC, and right not, the "leader" is not a supporter of universal health care. Quite the contrary.

Support and a financial source - solve those two problems and then maybe we can become more enlightened about health care.

But I would also add that people need to take better care of themselves and eliminate unhealthy behaviors, including smoking.