Universal healthcare (California)

[tristar]

Universal healthcare........Should I be looking for another job? Anyone have thoughts on how this will effect worker compensation i.e., lien litigation.

[jobmdpsych]

Something to think about.

If you have health insurance, and they deny you a life saving bone marrow transplant, that's a very winnable denial of coverage lawsuit.

Good luck trying to sue to the government for the same under single payor.

All the UR hassles of comp under single payor will be there, and people won't have a lawyer at their side to go to bat for them.

It will be two tiered, and most of us in the doctor/lawyer category will get impatient and opt out paying privately. Much like we do with private schools.

[vampireinthenight]

The government is not going to pick up WC treatment, so I think you're job is safe. What might happen is that EVERY case will need a set-aside for C&R.

[jobmdpsych]

I'm not worried about my job.

In the least.

I'm worried about my future medical care.

I see all the problems in WC UR and getting treatment to the nth degree when rationing inevitably happens.

[stevepsca]

I see all the problems in WC UR and getting treatment to the nth degree when rationing inevitably happens.

Isn't treatment rationed now ?
Look at the folks treating in UHC's Secure Horizion HMO's... PCP's 'ration' treatment every day.

Comp treatment is limited/denied/modified as medical is a 'benefit' under the exposure to the ER/IC liability for the specifc injury, not the whole person. IW isn't the 'insured party'. Comp medical is not 'health coverage'.

I'm not advocating universal health care... though we have some of that now.
But, nor am I in favor of mandatory health coverage as we see with automobile.
Health care is not an 'entitlement' in the US. It's pay for service. If you can't afford what you need, buy coverage.
If the gov't is going to subsidise coverage, private carriers will evenatully wash out. IC are based on profit... we all know the gov't isn't. They can't even manage Medicare on a cost effective basis. Not to mention Amtrak, USPS... the military. Medical under the VA/TriCare is the best... but there again...profit (?)

EVERY claim should have had a setaside arrangement for the last 20 years of more.
FMC money transfers medical liability to the IW, not the gov't. FMC isn't ''award'' for suffering the injury. There are a lot of 'hogs' on the street paid for with FMC money.

[jobmdpsych]

If you were 22 years old, would you go to medical school under these uncertain conditions? 70-80 percent of doctors are telling their children NOT to go, consider veterinary. Would you spend a billion to develop a drug if you knew it would be price controlled to the point of a loss upon its release?

There are a few simple reforms that would solve problems without leading to rationing, decline in innovation and decline in quality of care.

1. end relationship of insurance to employment--this is an artifact of WWII
2. reduce mandates for coverage except catastrophic illness or injury (if your homeowners covered painting and maintenance, the premiums would triple)
3. make it so you can keep your policy for life like life insurance
4. uninsured emergency care would be paid at Medicaid rate
5. Medicaid included as part of unemployment

In Canada and Britain, there are long lines for procedures, and there's no attorney to help you get through the system. And in Britain, they WILL cut off your dialysis in certain cases.

As far as health insurance, none of my employees or I have ever had the trouble getting services paid like injured workers through comp and because its a PPO we could see the doctor of our choice. I do not want to give that up.

[rider001]

This is going to be a bad lesson in Political Science with far reaching implications.

[stevepsca]

I believe there is a huge misconception of the health care system in Canada.
There are IC's providing 'supplemental' coverage to the social services. There are long lines...for elective surgeries. Medically necessary treatment is afforded the same as in the US. The CA system works pretty much like our Medicare... CA residents wouldn't exchange their system for ours.

I don't know about UK... in Sweden, everytime a candidate runs on a platform of reducing taxes, or changing the medical/health care system, they lose significantly...no one is unhappy with the services they receive in exchange for a 55% tax rate. plus.

There are a few simple reforms that would solve problems without leading to rationing, decline in innovation and decline in quality of care.

1... agreed
2...agreed...but then you are able to purchase any type or level of coverage, to a level you can afford.
3...agreed, and reasonable suggestions to a revised health care plan.
I would change the medication pricing structure to that of Canada... it's kinda long, so I won't detail that here..but IF there is a medication providing the same basic relief already avaialble...a 'new' med can't be priced more than 10% above the currently available medication... (or to that affect anyway) in the US...'we' are collectively paying for a FDA review/approval for new medications... a FDA that is already being supported by our taxes...there are SO many dollars added into the "R&D" of a new med... how long would the discussion have to be...(?) Drug prices are no where reasonable in this country.

At any rate.. there was an interesting commentary on CNN this morning... what the Constitution does not specifically grant to the federal government is to be left to the states... BUT, over decades the states have turned to the feds for financial assistance.. the feds have the money. With the money, of course comes the power... that power translates to oversight.
One of the main points was education... eg the Bush "No child left behind'' legislation... The federal government has no oversight to education, it's state issue. But, as the feds have the money, comes the control.

rider... nice point.

There are few arenas in our system that wouldn't benefit from major reform. Americans' could build a automobile the quality of MB/BMW through GM or FORD... with the same technology, but the MSRP would be twice that of the imports... does ''union labor/contract'' come to mind. Wonder what is the driving force behind the cost of health care in this country.

[jobmdpsych]

Actually, Sweden is throwing in the towel on its welfare state as we speak:

http://www.forbes.com/forbes/2009/0803/ ... izing.html

Despite massive taxes, which succeeded only on alienating and expatriating their greatest citizens, i.e. Ingmar Bergman, they still managed to get to a debt of 600 percent GDP, making them essentially bankrupt.

I don't know why we have to reinvent the square wheel.

I'm not opposed to expanding Medicaid for the unemployed but let people who like their plans keep them.

[stewshe]

jobmdpsych,

Re reinventing the square wheel:

BC has been one of my favorite comic strips for years.

Quite a while ago they had a series about the square wheel. Thor was the inventor, as I recall, and was trying to improve it.

He invented the triangular shaped wheel!

BC asked if Thor was sure it was an improvement.

His answer was a clasic! "It eliminates one bump!"

stewshe@comcast.net