I'm hoping this won't devolve into a discussion of the Affordable Healthcare Act (so-called "Obamacare"). Let's do that under a more specific topic.

Rather let's discuss the current system in America, what's wrong with it and what's right, whether it needs fixing, and how to fix it. Non-Americans are encouraged to chime in.

Here's my take:

1) There is no healthcare system on a national level beyond Medicare and Medicaid. Any other systems are local to some degree or other.

2) Pretty much everyone who doesn't have their head up their hind end can see that the current way of handling healthcare is not sustainable. within a decade or two, assuming costs continue to rise, healthcare will become unaffordable for most Americans.

3) Healthcare isn't a normal market where competition functions to lower cost. Yes, insurance companies exclude certain high-risk, high-cost people in an effort to maximize their profits and keep their rates down. However, that doesn't work because for the excluded people the local ER becomes the primary care provider. Somebody has to pay for this care, so it's passed along to the people who are insured through their insurance company. This is one reason why hospital Tylenol can cost $25. The marketplace actually RAISES costs.

4) Do you think it's ethical to throw 30+ million under the healthcare bus in order to keep rates low for those with insurance, especially considering that it  ends up (as explained in the 3rd point) making costs higher anyway.

5) 30+ million people need affordable healthcare, and indigents need free healthcare. Is it so bad to have socialized healthcare for them, especially if it will function to bring costs down for the rest?

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Not that I disagree with you, but good luck getting a cap put on litigation. If the outcry against "deathpanels" was bad enough, then attempting to put a cap on litigation will have detractors saying, "Now the deathpanels determine how much your life, your child's life, and your parents' lives are worth."

It doesn't matter if that's true or not or whether it's a huge distortion. If a panel of experts determines an award outside of a court especially considering our general distrust of government as a nation, people are going to be up in arms over the issue and nothing will change except that we will never be able to publicly suggest the idea for another generation.

It may have to wait till the time when a majority of the people who have insurance now are unable to have insurance. It may come to a moment of crisis like that for the public to see the wisdom of such an action.

Right now a doctor who has followed standard procedure to a "T" and yet has lost a patient in an operation that has a certain fatality rate anyway may be sued for millions of dollars and may lose due to the fact that it's far easier for the average jury member to sympathize with the survivors than the doctor.

A basic step that might pass public muster is to force medical liability cases into adjudication by a judge, no jury.

actually george w bush was in favor of putting a cap on it.

I've no doubt you're right, but you didn't see him offering to cap the tax cuts for the rich --

To those who blame people eating junk food and not getting enough exercise for being refused by the insurance companies, consider that if they had proper healthcare, a large percentage of them might be convinced by a primary care physician to improve their diet and get more exercise. I'm not sure what interest is served be leaving them outside of the healthcare system.

So now we have to have a PCP tell ppl that not exercising and eating excessive junk food is bad for u....how is that going to lower costs.....

Healthier patients lower costs.

Preferences for Fords and Chevys lower costs as well --

have u been to a doctors office recently, they seem to have a lot of time to discuss commonsense issues with the patients (sarcasm). how long should the discussion last and how much are u willing to pay for it. usually PCPs do tell patients to loose weight and exercise but u cannot control individual behavior. 

A person who doesn't end up with a bad heart or type II diabetes will save the system a lot of money.

There was a time when people entered the health care field because they wanted to be able to help people. Now they enter it because they'e discovered that a Mercedes is a really sweet ride.

Any self-sustaining healthcare program needs to find a way to leverage doctors against each other - and not just doctors, but hospitals, clinics, pharmacies, and goods suppliers - to bring health care costs down.

"Oh, we can't do that, there'll be a drop in quality!" Or maybe there'll be a rise in doctors who practice medicine because they really care.

I think one of the reasons doctors (and dentists) become so wealth oriented is that their education puts them into tremendous debt which can take decades to pay back.

How about subsidizing their education tied to a pro bono obligation?


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