Anyone afraid of universal healthcare?

[Laker]

The more I hear of this the more afraid I become of decreasing future income and higher taxes.

Not to mention the problems associated with actually getting the care when you need it.

[DCJenn]

I've accepted the fact that there is no more money in medicine.

I'm not bothered one way or the other about universal health care. It'll never happen here anyway because Americans want champagne service with burger budgets.

Jenn

[samssugarmomma]

Umm.....terrified!

[Vishenka69]

Have you heard the talk in CA about potentially taxing 1% of physician gross income to help finance CA universal healthcare? I can't imagine that ever coming to pass and if it did all the docs would get the heck out of there. :run:

They're already starting to avoid the state. We know some people who couldn't get malpractice tail and as a result will be practicing in other states.

[Vanquisher]

malpractice tail

:huh: What is this?

The "tail" is a lump-sum payment you make to the malpractice insurance company when a doc leaves a job to continue protecting them from any malpractice suits brought for a defined number of years (5?). We're getting ready to pay this now for one of DH's moonlighting jobs.

[Rapunzel]

From what I understand "tail" coverage is malpractice insurance covering a physician's decisions and procedures during his/her time with a group even after said physician leaves the group.

In other words, if Dr. B joins a group and, then, five years later leaves the group to form his own and then faces a malpractice suit arising from patient care during his time with the FIRST group this "tail" coverage will kick in.

It "covers your tail" basically.

not something always paid by the doc. most negotiate it into their contract for the practice or institution to pay it

probably not as negotiable for moonlighting.

[Rapunzel]

We posted at the same time.

[Rapunzel]

not something always paid by the doc. most negotiate it into their contract for the practice or institution to pay it

probably not as negotiable for moonlighting.

For rads it is usually included in moonlighting from what we have seen and experienced.

And, again, in dh's and I experience you do negotiate it into your contract. It is so valuable!

[Vanquisher]

Wow, thanks for all that info. I think that is something to definitely put into a contract.

[SuzySunshine]

Malpractice is one of the reasons DH wants to stay academic, if you're a nsurg in private practice in most states all you can do is backs b/c of the insurance rates.

I know universal healthcare will change academic positions too but is there really anything we can do about it?

re: the tail coverage. I think the length of years that it covers depends...on what I don't know. But it isn't necessarily 5 years, at least I don't think so.

Back to healthcare...some random thoughts off the top of my head.

First, in many ways we already pay for the uninsured in what we pay for healthcare. I don't think that government run healthcare is the solution but some of the expense associated with the uninsured is already paid for. I agree with Annie that people are used to urgent care and changing that would take a while (maybe a long while) but if the uninsured eventually got care in a more efficient way, that would save money. Not to mention that healthier people would probably be more productive. Add in other ways we pay for healthcare -- like the tax break that corporations get for providing coverage -- and you have another way that we are already paying.

Second, I think we need insurance. A catastrophic illness is way more than just about anyone can ever afford. As much as I have moaned about already hitting our deductible this year, I have to admit that what we pay is really rather reasonable. Who else should I expect to pay for this?

Third, I have doubts about employer-based health care coverage. It seems strange to me that so much of employment decisions are based around health care. IMO, it creates odd incentives to stay at a job. I guess that a health care benefit is just one way that employers can compete for employees but maybe there are better ways.

So...if employer based health care went away, I would also have some doubts about individually purchased coverage. How do we protect high-risk subscribers and keep the insurance companies from cherry-picking health subscribers and leaving higher risk patients at risk? And how do you make everyone participate -- such as the young and healthy who might be willing to forego insurance -- so that the idea of insurance works? There are stories here and there about the problems people have with getting dropped, sometimes retroactively, from their individual policies. An individual fighting back legally is no match for an insurance company with deep pockets. And large employers have been able to demand a better "product" from insurance companies because of their buying power and leverage -- I'm not sure I would want that to go away and be replaced with some sort of government-imposed mandates.

A while ago, I heard the health economist JD Kleinke present something like this: high deductible coverage for most with the option to pay costs through an HSA with some sort of subsidized product for those below, say, 400% FPL. It's been a while and this is my interpretation of what he said. On a high level, I think it is a good idea but certainly has some pitfalls as well.

[Rapunzel]

Something I heard in the Republican debate the other night has had me pondering the following:

Why wouldn't we have, say, universal auto insurance? After all, thousands upon thousands of wrecks happen every year, autos encounter numerous minor issues, and the vast majority of Americans must have a working automoblile in order to live productive lives (ie have jobs, for example).

So, what would be the arguments for or against universal auto insurance? It is expensive. It is very often necessary. And, it concerns something incredibly basic regarding quality of life in the U.S.

It is an interesting analogy but I think one's personal health is different than the functioning of their car. Also, aren't there some easier alternatives to having a car, such as a bike, bus, feet? I can't quickly think of alternatives to health (positive ones, anyway ).

Both states I have lived in recently have mandatory insurance coverage laws. I had to put my policy company and number on my car registration application. I don't know if they verify it. Though that is different than a "single payer" system where I suppose I would get car insurance through a government agency? Seeing how well the DMV works...