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xiphiasA five-part plan:
1) The government pays for really basic stuff. Basically, if you feel ashamed when you hear about someone dying from a lack of this, it's paid for. If it's cheap and does a hell of a lot of good, that's the stuff we're talking about. Basic checkups without significant tests, tooth cleanings, real basic stuff.
If I hear about someone dying because they couldn't get open heart surgery, that makes me sad, but not ashamed. I'm aware of how expensive that is. Or not getting a transplant -- again, sad, but not embarrassed. So those sorts of things wouldn't be covered.
This would just be a billing code. A hospital or doctor's office could just bill this stuff to the government, and it would be paid promptly.
2) People could form into negotiation blocs who could negotiate lower rates from drug companies, hospitals, doctors, and so forth. If you wanted to, you could sign up for whatever bloc or blocs you wanted to be in, for a small fee (which would basically cover administration and negotiators' salaries), and, if you were a doctor or hospital or whatever, you could sign up for the same bloc which would mean that you'd agree to the rates they negotiated. As a doctor, your benefit would be that there would be a group of people who would count you as a preferred doctor.
Actually, I don't know how necessary this part is. After all, if you were a doctor and WEREN'T part of the bloc, you could still agree to take whatever fee the bloc charged, in order to poach customers. Which would also be fine.
3) There would be health insurance. As in, you pay a monthly fee, and, if something bad happens, they pay whatever your insurance coverage pays for. It wouldn't pay for routine stuff, although the insurance plan could give lower rates for people who demonstrated that they did take care of the routine stuff routinely.
This insurance could be "we pay 80% of your charges, up to a limit, and you pay 20%", it could be, "we pay 100% after a deductible", y'know, whatever. These health insurance plans might be associated with negotiation blocs, but need not be. If they started to pay for routine stuff as well, you begin to run into exactly the same problems we have right now, but, well, if they WANTED to do exactly the things that we have now, sure, they could. Why not?
4) Drug patents would expire seven years after they were approved for sale. That number is somewhat negotiable, if drug companies could prove that they couldn't make a profit in seven years, but whoever was doing the negotiation should be DAMN skeptical.
I mean that we could argue that drug patents should expire ten years, or twelve years, or whatever, as the law. I'm not a financial analyst -- I don't KNOW that drug companies can make a profit, in general, in seven years. But I really, really suspect so. I DON"T mean that an individual drug could be patented longer. Because, if you did that, with negotiations all the time, the negotiators would be corrupt. It just would happen.
5) And the gaps would be filled by private charities. And doctors and hospitals doing pro-bono work. I don't think, in the United States, you could do it any other way. I don't think it would be possible for the government to pay for everything that really ought to be done, and I think that you'd need charity to fill in.
What do people think?
1) The government pays for really basic stuff. Basically, if you feel ashamed when you hear about someone dying from a lack of this, it's paid for. If it's cheap and does a hell of a lot of good, that's the stuff we're talking about. Basic checkups without significant tests, tooth cleanings, real basic stuff.
If I hear about someone dying because they couldn't get open heart surgery, that makes me sad, but not ashamed. I'm aware of how expensive that is. Or not getting a transplant -- again, sad, but not embarrassed. So those sorts of things wouldn't be covered.
This would just be a billing code. A hospital or doctor's office could just bill this stuff to the government, and it would be paid promptly.
2) People could form into negotiation blocs who could negotiate lower rates from drug companies, hospitals, doctors, and so forth. If you wanted to, you could sign up for whatever bloc or blocs you wanted to be in, for a small fee (which would basically cover administration and negotiators' salaries), and, if you were a doctor or hospital or whatever, you could sign up for the same bloc which would mean that you'd agree to the rates they negotiated. As a doctor, your benefit would be that there would be a group of people who would count you as a preferred doctor.
Actually, I don't know how necessary this part is. After all, if you were a doctor and WEREN'T part of the bloc, you could still agree to take whatever fee the bloc charged, in order to poach customers. Which would also be fine.
3) There would be health insurance. As in, you pay a monthly fee, and, if something bad happens, they pay whatever your insurance coverage pays for. It wouldn't pay for routine stuff, although the insurance plan could give lower rates for people who demonstrated that they did take care of the routine stuff routinely.
This insurance could be "we pay 80% of your charges, up to a limit, and you pay 20%", it could be, "we pay 100% after a deductible", y'know, whatever. These health insurance plans might be associated with negotiation blocs, but need not be. If they started to pay for routine stuff as well, you begin to run into exactly the same problems we have right now, but, well, if they WANTED to do exactly the things that we have now, sure, they could. Why not?
4) Drug patents would expire seven years after they were approved for sale. That number is somewhat negotiable, if drug companies could prove that they couldn't make a profit in seven years, but whoever was doing the negotiation should be DAMN skeptical.
I mean that we could argue that drug patents should expire ten years, or twelve years, or whatever, as the law. I'm not a financial analyst -- I don't KNOW that drug companies can make a profit, in general, in seven years. But I really, really suspect so. I DON"T mean that an individual drug could be patented longer. Because, if you did that, with negotiations all the time, the negotiators would be corrupt. It just would happen.
5) And the gaps would be filled by private charities. And doctors and hospitals doing pro-bono work. I don't think, in the United States, you could do it any other way. I don't think it would be possible for the government to pay for everything that really ought to be done, and I think that you'd need charity to fill in.
What do people think?
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(no subject)
Date: 2007-03-14 03:55 pm (UTC)As far as drug patents go, I like it in theory, but what I would be worried about is drug companies using addictive additives to "hook" people before their patent ran out. Kinda like Effexxor does. They claim it's so you won't forget to take pills...and it works in the capacity, if I forget a day, I get SICK!!!
but that's not really nice when I'm somewhere where I can't get access to these precious (and expensive - - my dosage is about $3 a day) little red pills.
That said, here in Canada, as long as a drug company holds a patent (before the generic version of the drug comes out) the company has to make available "compassionate doses", which is how I get my drugs, free, through my doctor.
Since Effexxor is about to go generic, I'll probably do what I did when Zoloft went generic and switch to something newer and less well tested...just call me a working class guinea pig.
(no subject)
Date: 2007-03-14 05:33 pm (UTC)(no subject)
Date: 2007-03-14 07:04 pm (UTC)severe nausea, headaches, chills, body aches, petit mal seizures, irritibility (though that's to be expected if you go off an SSRI), sweats, dizzy spells, tunnel vision, disorientation, short term memory loss...
Zoloft was bad, when I went off that, but nothing compared to Effexor. I used to "joke" going off Zoloft that I felt like an extra from Trainspotting.
Thing is, I'm one of those folks who actually DOES have a neurological reason to take SSRI's and for as evil as they are, they're a damn sight better than the alternative (lithium, etc.)
(no subject)
Date: 2007-03-15 02:47 am (UTC)Anyone that's undergoing treatment with psychological medications should always consult their doctor before stopping treatment, and you should never go off them cold turkey if you've been on them long enough to reach theraputic levels, unless you're in the middle of an allergic reaction and the consequences of discontinuation is the lesser evil (and if that's happening, you should definately be calling your doctor, if not heading to the hospital).
(no subject)
Date: 2007-03-15 02:22 am (UTC)The big difference is that if something is expensive or high-risk like heart surgery, it's still offered to everybody equally. Under this proposed plan, you still have more options if you have money. (Not that rich people don't have more options here as well, but at least access to the actual procedures is equal.)
We may get ourselves into a position where we have to do triage on certain medical procedures due to rising costs, but I dealy hope (and intend to vote) that acess to those procedures is still provided to everybody.
Though we don't cover teeth or eyes, for reasons I can't fathom.
By the time doctors figured out how much teeth affect the rest of your health, we were already facing a funding crunch.
(no subject)
Date: 2007-03-15 02:42 am (UTC)I know for a fact that all of the SSRIs are incredibly *physically* addicting, by their very nature. Which doesn't mean that the drug companies did anything to make them that way. It just means that your body gets acclimated to them in such a way that stopping treatment or missing a dose can have nasty consequences.
I've heard anecdotal evidence to the effect that Effexor is particularly nasty to discontinue, but this is the first time I've ever heard it alleged that that is at all deliberate. And I've done a fair bit of my own research on psycho-pharmacology.
(no subject)
Date: 2007-12-21 04:21 am (UTC)