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Cody's Health care plan.

I started typing a comment to kinda sum up how I felt about the comments on this post (which were all incredible by the way) and it got so stupid long... I just made it a post. Here it is:

See Nate,

I told you this (for me anyway..) has been very educational.

He is where I am sitting opinion wise.

Current system is broke, no doubt in my mind.

I still don't have faith in Government controlled health care working because we are so far down the road into this system we have now... I am just not sure it could work. Now, I would really love it if no one took my last sentence to read as "Government health care is stupid and Obama hates babies" not what I said, I just can't see how the transition could happen. Even after reading the plan on Obama's website, I think the for profit health care people will make it impossible. Please don't take that sentence to read "I love people that over charge for health care and little bity pills" I don't but they are big and powerful and have the ability to screw things up.

What I do see working is improvements. On 3 different fronts.

1. We need to upgrade the system to the point of making it WAY more affordable. Obama deals with that in his plan a lot and I like that. The stickler that someone has to enforce is actually making the price go down once the efficiency is increased. That would be alot easier if the whole thing was non-profit, I give you that. I just don't see in our nation how you are ever gonna take this colossal beast that is for profit health care and just change it that much. Anyway lot's of ways to work to get it to be cheaper, Obama details alot of those in the plan and I am behind them all. The details are there in his plan, I like details but I don't want to retype them so go read Obama's plan. Dillons and Wal-Mart are now offering $4.00 subscriptions, with or with out a card. Period, it's $4! I know some medicines aren't incl;uded.... But it's proof there are ways to simplify and lower the cost of the system.

2. Pay for those who CAN'T pay for themselves. CAN'T physically/mentally work and pay for themselves. There needs to be mass oversight on this. The expense upfront of overseeing this will be big, but it will be nothing compared to the expense if we let it get taken advantage of. My plan for this is to find the best plan for these people and pay a private insurance companies premiums for it. Point number 2 deals with the elderly, disabled and children, that's it, they can be "point 2 people". We just pay for them, if they can't pay for it themselves, mass oversight of the program as well as mass oversight of the premiums the insurance companies are charging the government. Should be turned out to lowest adequate bidder, not as a cross country plan... On a case by case basis it is bid out. Point 2 kids need to become Point 3 people as soon as they turn 18.

3. Pay for those who can't afford it Right NOW as well. Point 3 deals with the working poor/lower middle class whose employer doesn't provide health care. These plans should not be the best plan possible. They should be able to handle small medical bills. They can pay some of a co-pay. These should be moderately catastrophic plans. Take care of them for something big but they get a cut that needs a few stitches... They gotta take some of the bill, they have jobs, or they could have jobs, cause they aren't Point 2 people. Here's the kicker... this is a blue light special, limited time only offer. You can get on the program fast and immediately, but it will all be coordinated with a Job Corps, Welfare Assistance, Financial Education Programs and any other educational/ financial programs.It will have a goal date that you must be off.

It shouldn't be set up so when you walk into the office to get Point number 3 health care, they hand you a brochure about the possibility of you going to Job Corps classes and Welfare Assistance Classes and the other... You have a case manager who sees to it that you go to those things because they are all under one roof, or you aren't eligible for the system. And a plan, a no kidding plan with a finish line that gets you off the system.

Oversight, overisght, oversight..... that's the key. Will it get distorted? Yes. Can the distortion be controlled? Yes and... it has to be. Spend the money upfront to oversee. Spend the money upfront to realize folks don't/won't go to 15 different places to get all the help they need. Our current system of helping folks in need is so complicated that all they end up taking the time to do is deal with the one place where they actually get the money. (Please know that I realize that is a stereotype and that there are some people out there doing everything right to better their situation.)

I think the whole system of aiding those that are in need, for whatever reason, is broke and if we just hand out health care.... It will not fix that system, it will be fought by the for profit Health Care people so hard, that the speedbumps it incurs may be insurmountable and it just won't work. And we aren't helping people to help themselves. Please don't take that last sentence and spin it into "Screw 'em, they are on their own", not what I said but we gotta help them to get to a situation where they can help themselves if they are capable.

I kinda made this up on the fly, so feel free to tear holes, but I want to summarize.

My 3 points, really 4.

1. Make the system more affordable, both Obama and McCain (I went and checked McCain's so I wouldn't leave him out, Obamas plan is more detailed though) give details, you just gotta oversee it.

2. Starting tomorrow pay for everything for those who can't, period. If they are never gonna be able to pay a medical bill becuase of physical/mentally reasons. Pay for their premiums. and the bill afterwards. This needs to be overseen bigtime. Oversight in the beginning will lead to huge savings in waste in the future.

3. Pay for those who can't afford it RIGHT NOW as well. They need to be on catastrophic plans. They can pay the $20 co-pay when the kid needs stitches. There has to be a plan to get the #3 group off the plan as well. The plan to get them off the plan, depends on my number 4 below and Oversight, Oversight, Oversight.

4. This is actually the big kicker now that I have reread this novel. All of the systems to help those who need help need to be moved under one roof. It needs to become one system to Aid people and not 40 programs that half of the folks that could use them don't get exposed to.

If a woman walks into the new "Department of Help" cause her husband beat her up threw her out and she has no-where to go with the kids. She needs to be able to, in that building, get Health Insurance immediately, just BAM! No shit...here's your card for you and all your kids, while we get the rest of this figured out. That card for right now would cover everything and then gradually see will be moved to a point 3 person. On the spot, immediately receive a vision card so her kids never miss a meal, the card has gigantic limitations and each month the refill of it has to be reapproved starting at the 6 month mark. She will meet with a job counselor, right there, in that building. She will literally be immediately taken to a semi-permanent apartment that she can stay in as long as she meets the criteria. Her kids will receive a physical the next day and be delivered to a school. She will be picked up bright and early to be taken to look for a job. In the evenings, the same Case manager will pick her up, provide a sitter for the kids and take her to her financial responsibility classes. No kidding, pick her up and take her. If she doesn't go, the benefits go away and we just take care of the kids. People want help, we just have to make sure they get the kind they need and all of it. This all sounds expense, but I htink if we did this for a year, it would be cheaper than her being on vision card with her kids for the next 10 years.

OK here's the deal, this plan may have so many holes that it would just sink. I just started typing. So... please feel free to tear it up and down, but don't be an ass. I just admitted it may suck, I just want folks to talk about it.

I do believe right now that it would work, I don't think the fact that we have 47 million with out health care is a seperate issue from the fact that we have XX million homeless and XX million on food stamps and XX million orphaned kids without homes and XX Million unemployed.

I also no this, it's corny as shit but the Give a man a fish... parable is gigantic, I have been there and I promise you the lessons people helped me learn were way better than the charity. I know sometimes you gotta have the charity but... we also gotta teach them to fish.

7 comments:

  1. I like the points that you have made and believe in a perfect world it could work. I am completely on board with the point you made about, not necessarily free health care, but affordable health care. Prairie Star here in Hutch is set up similar to that premise where what you pay for your services is based on your income. A more global set up such as this with other health care options/services I think is very feasible. That along with the $4 prescriptions would be helpful and is helpful to many in Hutch.
    Your second point is already in place, albeit broken. I work in the Medicaid world everyday with people I provide services to. MediKan is our state insurance for the uninsured who are disabled with NO income. It is fairly easy to obtain through SRS. The problem, as I see it, is once on it you can't work one hour of gainful employment before they take it away. There is no option to pay a scaled premium to keep it. You can qualify for cash assistance, which last time I checked, was around $210 a month I think. I don't care how creative you are you can not survive on $210 a month.
    Let me move on to Medicaid (which is part of a 20 page application process with many additional hoops to navigate) This is the card you apply for through Social Security, is a part of the process of getting on SSI/SSDI (monthly money) and provides very decent coverage. You get all of your prescriptions and Dr's visits for a $3 co-pay, can get a yearly eye exam, and a new pair of glasses every 5 years. My problem with this medical system is Disability Determination Services is charged with reviewing the claim and can take literally years before they come to a conclusion (after several appeals and so on). I feel strongly that this system also traps people. Once you get it you had better not do anything to better your situation. Here is an example. A man I worked with has schizophrenia and was in the revolving door of the hospital due to symptomatic complications associated with this mental illness. He finally received disability and everything was looking good (I say this with a bit of sarcasm). He was put on medications that cost upwards of $1000 per month one of which later caused him to have diabetes and TD's. He was managing his symptoms fairly well, well enough that he wanted to work. He was hired doing janitorial work making minimum wage and because he worked over 20 hours a week his disability was terminated. Now he has to find a way to pay for all of the medications that keep him out of the hospital, has to find a way to pay for the services he needs to manage his diabetes, has to find a way to pay for his regular doctors appts to check his levels due to the meds he is on, and still has to find a way to keep a roof over his head and food in belly. They recently developed a program into Medicaid where you can pay a premium and work however you might as well get BCBS and pay the premium because it is just as high which is the same reason why the working poor don't have insurance...they can't afford it.
    There is much more to the Medicaid system that I could go into but I have simplified this as to not make it as long of a post as Cody :)
    I don't like free health care, necessarily, especially the kind that traps people into complacency. If everything is given to us 1) we expect that it should be and 2) we loose motivation to try and get it for ourselves.

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  2. I still think it's nice to say we are going to have universals health care, but I honestly don't see a way that doesn't have a big hole in the system.

    I think Aaron made a good point with the affordable medicine. That's one of the bigger problems. People can't afford medicine that they need.

    To much of our health care is dependent upon pills. It's just my opinion, but I don't think pharmaceutical companies care about a cure. There is no money in a cure. But there is a lot of money in a treatment. How many people do you know have to take a certain pill, but then have to take another pill to take care of the side effects of the one they need? My grandparents took several pills during breakfast and lunch, and several of them served the purpose of taking care of one of the side effects of the other pills. They lived on a limited income, and struggled because they had to spend half their money on pills every month!

    We want a better health care plan? We need to start with affordable drugs that don't require other drugs to take care of a side effect caused by a needed drug!

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  3. Cody, if moving to government-based universal care was easy, would you be for it? I think what I am hearing from you is that you are in favor of it, but think that we are too entrenched in the current system to change to a government plan.

    If that is right, then the first thing we need to discuss, before rolling out alternate plans, is what the transition would look like. After all, shouldn't our goal to be to provide the best system, which you agree is universal coverage?

    The transition question is a good one. I don't remember Hillary's plan in '93 or whenever it was very well, but it almost got passed. What would the fallout have been if it would have gone through?

    Hopefully Dave can give us some perspective on what he thinks the real world transition process would look like. It seems to me that this isn't something we need to be scared of, because it is question that probably has an easy answer. It's not unusual for the government to enact regulations that impact the business sector, and businesses have to react. If the US decided to outlaw cigarettes, the fact that Phillip Morris is a big company with a big lobby wouldn't really matter, they would just have to adjust their business accordingly.

    I personally don't spend a lot of time worrying about the logistics of change, but many people do, so I think it is worth talking about.

    Dave, if congress passes universal health care during Obama's first term, what will happen next? Will there be a coup by UnitedHealth, unseating Obama in favor their CEO? I think that working through this, and letting people know that change is actually doable, in a practical sense, is important.

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  4. Aaron,

    Great points... But my whole plan is to DRASTICALLY improve the current system. IF we error, it needs to be on the side of the human being not the system. Let this guy have his medications paid for maybe just a little bit longer than her really needs them paid for as oppossed to strip them instantly once he gets a minimum wage job. This gentleman you refer to is still in my point 2 group. He can work, but is probably not ever going to get a job that will be able to pay for every thing. Due to on going Medical issues.
    The system is broke. My first thing to do is get more power to the Aaron E's of the world. The frontline guys, they gotta be supervised and reprimanded if the distort the system, but Aaron E should be able to move this guy back to being a point 2 person even though he has a job. Aaron E's supervisor needs to be checking on Aaron E's decision's and OVERSEEING things and he needs to have a supervisor as well all the way to the top, but you gotta put the power at the Aaron E level. You would eliminate waiting times. I also think this: Put the decision making power at the Aaron E level on just about everything and give him this rule.

    1. Take care of these people but have a plan to help them take care of themselves. Again, mass oversight needed to monitor all the tens of thousands of Aaron E's out there, but that's still cheaper than the way the system is abused and over complicated right now. Literally Aaron E would have the power to hand a single Mom a insurance card, a vision card ($$$), enroll her in job corps classes and then pick her kids up, make sure they get to school and then take Mom to job interviews. I know that sounds extreme, but it would fix problems instead of band-aiding them and be cheaper in the long run.

    Lizalde,

    Absolutely!!!! It's one of Obama and McCain's points on making the whole damn thing cheaper. I agree, it is point number one of the Codytalks Health Care Plan. Everything has to be more efficient and cheaper.

    Nate,

    What you are saying is exactly right, I would modify it slightly to say that I think it might be impossible to completely switch to Universal. I think Hillary's plan was just Universal for Children, right?? Maybe not??? Thats what the Codytalks Plan calls for all kids that aren't already covered get covered. All they gotta do is go see Aaron E. He takes 10 minutes confirms they are eligible and hands them a card that works immediatley and literally disentegrates slowly after they turn 18 and they have to go back to Aaron E to see if they qualify to be in Point 2 group or Point 3. Aaron E would also have the Authority to Deny!! (Not Kids)They could literally appeal by walking around his desk and talking to his boss and on up but he has denial power.
    Power to The Codytalks Health Care Plan.

    Seriously read Aaron's last point about trapping people into complacency. Realize that Aaron is in this system because he wants to help people and then realize that he is saying "We are not helping folks in need by just giving it away to everyone" I think that is a legitimate point.

    Now if we can get to a system that is like Law Enforcement. A system that says if you call and we come, no bill we be sent. I like that, I think. But Holy Mackarel folks will abuse it.

    I don't know.

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  5. While we do need major inprovements in our health care system, the last thing that would help is turning it over to the government. If we allow the government to essentially take over health care, we will have an incredible mess that will dwarf any problems we have now.

    We do need some reform in health care, but universal care courtesy of the government is not the solution.

    And Nate, a transition to a government plan would not be easy at all. Nothing is ever easy with the government.

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  6. I'm a little late weighing in on this post, but I'm going to make this personal.

    I am a college educated working professional who has been working in the non-profit field for 10 years. In those 10 years I have had employer provided health insurance only twice for a total of less than three years. I do not have health insurance now. My employer does not provide it and I can't afford to self insure for my self, my husband and my child. We make too much money to qualify for any programs (we make less than $50,000 joint income.) Our insurance premiums would be $350-$500 a month. No one in my family is on any prescription drugs; previously I have been on birth control. We are a healthy family, even with an infant. (She's never even had a fever.) Our income is just high enough to have no benefit for the sliding scale at Prairie Star (and the service I've received there is AWFUL and DISRESPECTFUL.) A few months ago I called a few doctor's offices in town and I needed to provide $200-$300 "cash deposit" before even being seen by a Dr. because I didn't have insurance. This is ridiculous. I am a working professional, my husband is a hard working laborer - we should be able to take care of the basic needs of our family.


    I don't need welfare or financial education. This is just a cautionary tale that this health care system is crushing smart capable hard working people like me and my family. Where do we fall in the CodyTalks Healthcare Plan?

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I love the discussion in the comments.. so... GO FOR IT!

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