Doctors Planning Exit Under Obamacare

Off Topic Politics & World Issues
281

[quote]jbpick86 wrote:

[quote]dmaddox wrote:

[quote]pushharder wrote:

[quote]Professor X wrote:

You think doctors will all come down on prices of procedures because you pay out of pocket?

[/quote]

I know they will because I have experienced it firsthand. Lately.[/quote]

I have to admit my doctor has told me if I pay in cash I will get a better rate.

My dentist I pay in cash and she charges me 25% less than what she charges insurance companies. She makes more money and I pay less overall than insurance premiums by almost $500 a year.
[/quote]

My optometrist and my dentist both give discounts if you don’t have insurance.[/quote]

I don’t personally see a 20% decrease as taking anything away from the doctor (and agree, a small decrease like that is normal). I also don’t see that making most procedures available to people who truly are low income.

For some of the people I treat, getting a tooth fixed means no rent this month.

282

Lets look at Term Life Insurance. It is equal to catastrophic health insurance with a $10k-$20k deductible.

My wife got a $1,000,000 20 yr term policy for $570 a year. Why is it so cheap? Actuaries know that only so many people are going to die during that 20 yr period of time so Premium includes payouts and profit into the premium.

Health insurance is the say way. If you have a $10,000 deductible the insurance company knows you will not need the insurance in most situations so your premium is going to be VERY LOW. You then can take the difference in the amount of premium you are pay and save that money for the $10,000 deductible.

Car insurance is the same thing. The higher the deductible the cheaper your premium. Many people will use their insurance to fix their car because they do not save money. This is why Auto Insurance companies use your credit score with driving history to determine your insurance premium.

283

[quote]Professor X wrote:

[quote]jbpick86 wrote:

[quote]dmaddox wrote:

[quote]pushharder wrote:

[quote]Professor X wrote:

You think doctors will all come down on prices of procedures because you pay out of pocket?

[/quote]

I know they will because I have experienced it firsthand. Lately.[/quote]

I have to admit my doctor has told me if I pay in cash I will get a better rate.

My dentist I pay in cash and she charges me 25% less than what she charges insurance companies. She makes more money and I pay less overall than insurance premiums by almost $500 a year.
[/quote]

My optometrist and my dentist both give discounts if you don’t have insurance.[/quote]

I don’t personally see a 20% decrease as taking anything away from the doctor (and agree, a small decrease like that is normal). I also don’t see that making most procedures available to people who truly are low income.

For some of the people I treat, getting a tooth fixed means no rent this month.[/quote]

Why does it have to be rent? What type of cell phone did they have? What type of car do they drive? What type of shoes do they wear? How many children? Do they have a job?

I am saying these things not to be an ass but to make a point, because a lot of people have their priorities out of order. Food, Clothing, Shelter. Some people will add transportation, but in Houston you can get around, slowly, but still can be done, on Public Transportation for cheap. IMO everything else is a luxury. Many people can clean up their lives by just focusing on those 3-4 priorities, and save money and get the other luxury items later. I did not get a cell phone until my last job paid for mine. That was 8 years ago.

284

[quote]Professor X wrote:

[quote]jbpick86 wrote:

[quote]dmaddox wrote:

[quote]pushharder wrote:

[quote]Professor X wrote:

You think doctors will all come down on prices of procedures because you pay out of pocket?

[/quote]

I know they will because I have experienced it firsthand. Lately.[/quote]

I have to admit my doctor has told me if I pay in cash I will get a better rate.

My dentist I pay in cash and she charges me 25% less than what she charges insurance companies. She makes more money and I pay less overall than insurance premiums by almost $500 a year.
[/quote]

My optometrist and my dentist both give discounts if you don’t have insurance.[/quote]

I don’t personally see a 20% decrease as taking anything away from the doctor (and agree, a small decrease like that is normal). I also don’t see that making most procedures available to people who truly are low income.

For some of the people I treat, getting a tooth fixed means no rent this month.[/quote]

But how necessary is the fixed tooth. Maybe if you don’t have the money you should just suck it up and deal. Now a medical emergency is one thing, but if it hurts and you don’t have money to fix it then just suck it up and deal. Save your money till you can try to get it fixed or pull it. That’s how we should live, every person responsible for themselves. If people are truly in need turn to private charity. The government should not be in the charity business.

285

[quote]dmaddox wrote:

[quote]Professor X wrote:

[quote]jbpick86 wrote:

[quote]dmaddox wrote:

[quote]pushharder wrote:

[quote]Professor X wrote:

You think doctors will all come down on prices of procedures because you pay out of pocket?

[/quote]

I know they will because I have experienced it firsthand. Lately.[/quote]

I have to admit my doctor has told me if I pay in cash I will get a better rate.

My dentist I pay in cash and she charges me 25% less than what she charges insurance companies. She makes more money and I pay less overall than insurance premiums by almost $500 a year.
[/quote]

My optometrist and my dentist both give discounts if you don’t have insurance.[/quote]

I don’t personally see a 20% decrease as taking anything away from the doctor (and agree, a small decrease like that is normal). I also don’t see that making most procedures available to people who truly are low income.

For some of the people I treat, getting a tooth fixed means no rent this month.[/quote]

Why does it have to be rent? What type of cell phone did they have? What type of car do they drive? What type of shoes do they wear? How many children? Do they have a job?

I am saying these things not to be an ass but to make a point, because a lot of people have their priorities out of order. Food, Clothing, Shelter. Some people will add transportation, but in Houston you can get around, slowly, but still can be done, on Public Transportation for cheap. IMO everything else is a luxury. Many people can clean up their lives by just focusing on those 3-4 priorities, and save money and get the other luxury items later. I did not get a cell phone until my last job paid for mine. That was 8 years ago.
[/quote]

This, we had a couple applying for our pre-k daycare and were filling out the low income forms while the child was getting interviewed. Both of the parents had Iphones. If you can afford to live and have an Iphone and smartphone plan then you are not low income.

286

[quote]jbpick86 wrote:

[quote]Professor X wrote:

[quote]jbpick86 wrote:

[quote]dmaddox wrote:

[quote]pushharder wrote:

[quote]Professor X wrote:

You think doctors will all come down on prices of procedures because you pay out of pocket?

[/quote]

I know they will because I have experienced it firsthand. Lately.[/quote]

I have to admit my doctor has told me if I pay in cash I will get a better rate.

My dentist I pay in cash and she charges me 25% less than what she charges insurance companies. She makes more money and I pay less overall than insurance premiums by almost $500 a year.
[/quote]

My optometrist and my dentist both give discounts if you don’t have insurance.[/quote]

I don’t personally see a 20% decrease as taking anything away from the doctor (and agree, a small decrease like that is normal). I also don’t see that making most procedures available to people who truly are low income.

For some of the people I treat, getting a tooth fixed means no rent this month.[/quote]

But how necessary is the fixed tooth. Maybe if you don’t have the money you should just suck it up and deal. Now a medical emergency is one thing, but if it hurts and you don’t have money to fix it then just suck it up and deal. Save your money till you can try to get it fixed or pull it. That’s how we should live, every person responsible for themselves. If people are truly in need turn to private charity. The government should not be in the charity business.[/quote]

What you are recommending isn’t plausible. So no kids get treated now with tooth pain until the parents can pay full price?

That would lead to a national crisis of health care with people avoiding treatment until near death.

287

[quote]dmaddox wrote:

[quote]Professor X wrote:

[quote]jbpick86 wrote:

[quote]dmaddox wrote:

[quote]pushharder wrote:

[quote]Professor X wrote:

You think doctors will all come down on prices of procedures because you pay out of pocket?

[/quote]

I know they will because I have experienced it firsthand. Lately.[/quote]

I have to admit my doctor has told me if I pay in cash I will get a better rate.

My dentist I pay in cash and she charges me 25% less than what she charges insurance companies. She makes more money and I pay less overall than insurance premiums by almost $500 a year.
[/quote]

My optometrist and my dentist both give discounts if you don’t have insurance.[/quote]

I don’t personally see a 20% decrease as taking anything away from the doctor (and agree, a small decrease like that is normal). I also don’t see that making most procedures available to people who truly are low income.

For some of the people I treat, getting a tooth fixed means no rent this month.[/quote]

Why does it have to be rent? What type of cell phone did they have? What type of car do they drive? What type of shoes do they wear? How many children? Do they have a job?

I am saying these things not to be an ass but to make a point, because a lot of people have their priorities out of order. Food, Clothing, Shelter. Some people will add transportation, but in Houston you can get around, slowly, but still can be done, on Public Transportation for cheap. IMO everything else is a luxury. Many people can clean up their lives by just focusing on those 3-4 priorities, and save money and get the other luxury items later. I did not get a cell phone until my last job paid for mine. That was 8 years ago.
[/quote]

Many of these people walk to this clinic. Many don’t even speak English. I don’t think you understand how bad some people have it.

288

[quote]usmccds423 wrote:

[quote]Professor X wrote:

[quote]usmccds423 wrote:

I did give more than 1 option didn’t I?
[/quote]

To your credit you did…but your solutions miss one big thing…that those catastrophic events happen due to IGNORING THE SMALLER SHIT for years…which is what you are eliminating.

This is human nature we are talking about…people will now wait until the problem gets out of hand and then the doctor will have to cash out big time to cover his overhead.

You keep ignoring that docs don’t become docs to be poor. That’s just reality.[/quote]

Which is why I added the preventative insurance option. [/quote]

Actually, the best model to copy is the veternarian model. Yes, there is insurance, but it is not the majority of the market and so does not materially disrupt the market.

Vets compete, which keeps the price what it should be. People think the price is too high, they go elsewhere.

Not that complicated.

Remember, the solution to a government-created-problem is never more government.

289

[quote]Professor X wrote:

[quote]dmaddox wrote:

[quote]Professor X wrote:

[quote]jbpick86 wrote:

[quote]dmaddox wrote:

[quote]pushharder wrote:

[quote]Professor X wrote:

You think doctors will all come down on prices of procedures because you pay out of pocket?

[/quote]

I know they will because I have experienced it firsthand. Lately.[/quote]

I have to admit my doctor has told me if I pay in cash I will get a better rate.

My dentist I pay in cash and she charges me 25% less than what she charges insurance companies. She makes more money and I pay less overall than insurance premiums by almost $500 a year.
[/quote]

My optometrist and my dentist both give discounts if you don’t have insurance.[/quote]

I don’t personally see a 20% decrease as taking anything away from the doctor (and agree, a small decrease like that is normal). I also don’t see that making most procedures available to people who truly are low income.

For some of the people I treat, getting a tooth fixed means no rent this month.[/quote]

Why does it have to be rent? What type of cell phone did they have? What type of car do they drive? What type of shoes do they wear? How many children? Do they have a job?

I am saying these things not to be an ass but to make a point, because a lot of people have their priorities out of order. Food, Clothing, Shelter. Some people will add transportation, but in Houston you can get around, slowly, but still can be done, on Public Transportation for cheap. IMO everything else is a luxury. Many people can clean up their lives by just focusing on those 3-4 priorities, and save money and get the other luxury items later. I did not get a cell phone until my last job paid for mine. That was 8 years ago.
[/quote]

Many of these people walk to this clinic. Many don’t even speak English. I don’t think you understand how bad some people have it.[/quote]

Of course you as a doctor should take care of the unfortunate. My wife certainly does.

What is not needed, however, is taxpayers involuntarily (which is how ObamaCare is funded – by a tax on each person for existing in this country — well, except for illegal aliens who get to skate by) paying for your charitable works.

290

[quote]Professor X wrote:

[quote]jbpick86 wrote:

[quote]Professor X wrote:

[quote]jbpick86 wrote:

[quote]dmaddox wrote:

[quote]pushharder wrote:

[quote]Professor X wrote:

You think doctors will all come down on prices of procedures because you pay out of pocket?

[/quote]

I know they will because I have experienced it firsthand. Lately.[/quote]

I have to admit my doctor has told me if I pay in cash I will get a better rate.

My dentist I pay in cash and she charges me 25% less than what she charges insurance companies. She makes more money and I pay less overall than insurance premiums by almost $500 a year.
[/quote]

My optometrist and my dentist both give discounts if you don’t have insurance.[/quote]

I don’t personally see a 20% decrease as taking anything away from the doctor (and agree, a small decrease like that is normal). I also don’t see that making most procedures available to people who truly are low income.

For some of the people I treat, getting a tooth fixed means no rent this month.[/quote]

But how necessary is the fixed tooth. Maybe if you don’t have the money you should just suck it up and deal. Now a medical emergency is one thing, but if it hurts and you don’t have money to fix it then just suck it up and deal. Save your money till you can try to get it fixed or pull it. That’s how we should live, every person responsible for themselves. If people are truly in need turn to private charity. The government should not be in the charity business.[/quote]

What you are recommending isn’t plausible. So no kids get treated now with tooth pain until the parents can pay full price?

That would lead to a national crisis of health care with people avoiding treatment until near death.[/quote]

Na let charity pay for the kids, and the adults too if they need it. However you wont have people working 18 hours a week and complaining because the boss doesn’t let them work over when they were late and saying that they want a second job but wont work certain places getting charity from a private institution. If these people who sit at home and don’t want to work ever had to feel consequences for not towing their weight in society, consequences like hunger, then you may have some people get off of it and find something for them to do. There would be no need to hire illegals to do the horrible jobs no one wants because we would all of a sudden have people willing to work any job coming out of the woodworks. Privatizing charity and welfare would solve a lot of our problems.

291

[quote]Professor X wrote:

[quote]dmaddox wrote:

[quote]Professor X wrote:

[quote]jbpick86 wrote:

[quote]dmaddox wrote:

[quote]pushharder wrote:

[quote]Professor X wrote:

You think doctors will all come down on prices of procedures because you pay out of pocket?

[/quote]

I know they will because I have experienced it firsthand. Lately.[/quote]

I have to admit my doctor has told me if I pay in cash I will get a better rate.

My dentist I pay in cash and she charges me 25% less than what she charges insurance companies. She makes more money and I pay less overall than insurance premiums by almost $500 a year.
[/quote]

My optometrist and my dentist both give discounts if you don’t have insurance.[/quote]

I don’t personally see a 20% decrease as taking anything away from the doctor (and agree, a small decrease like that is normal). I also don’t see that making most procedures available to people who truly are low income.

For some of the people I treat, getting a tooth fixed means no rent this month.[/quote]

Why does it have to be rent? What type of cell phone did they have? What type of car do they drive? What type of shoes do they wear? How many children? Do they have a job?

I am saying these things not to be an ass but to make a point, because a lot of people have their priorities out of order. Food, Clothing, Shelter. Some people will add transportation, but in Houston you can get around, slowly, but still can be done, on Public Transportation for cheap. IMO everything else is a luxury. Many people can clean up their lives by just focusing on those 3-4 priorities, and save money and get the other luxury items later. I did not get a cell phone until my last job paid for mine. That was 8 years ago.
[/quote]

Many of these people walk to this clinic. Many don’t even speak English. I don’t think you understand how bad some people have it.[/quote]

I do understand that their is true poverty in this country. I have been to a couple areas in super rural Kentucky and West Virginia on mission trips where those people are truly in a bind. I would venture to say that there are areas in Detroit that are feeling the sting as businesses jump ship from that city. I am sure there are more, but I think you aren’t acknowledging the massive amount of poverty by choice that exists. Perfectly capable people choosing not to work, then spending the money on non-essentials like cell phones, tv service, and nice clothes then complaining because the cant pay their light bill and asking the govt (ie you and me) to foot the bill for their groceries.

292

[quote]Professor X wrote:

What you are recommending isn’t plausible. So no kids get treated now with tooth pain until the parents can pay full price?

That would lead to a national crisis of health care with people avoiding treatment until near death.[/quote]

I discussed something like this with you a few years back- I had a broken tooth that became infected. I left it untreated due to lack of insurance until it made me extremely sick. Fortunately I found a dentist/oral surgeon who took it out and the other wisdom tooth for a couple hundred dollars cash.

People take for granted that some very simple things can take a person out if left untreated.

293

[quote]SkyzykS wrote:

[quote]Professor X wrote:

What you are recommending isn’t plausible. So no kids get treated now with tooth pain until the parents can pay full price?

That would lead to a national crisis of health care with people avoiding treatment until near death.[/quote]

I discussed something like this with you a few years back- I had a broken tooth that became infected. I left it untreated due to lack of insurance until it made me extremely sick. Fortunately I found a dentist/oral surgeon who took it out and the other wisdom tooth for a couple hundred dollars cash.

People take for granted that some very simple things can take a person out if left untreated.
[/quote]
Rampant decay increases the risk of heart disease. It is all related.

I was asked above how important that hurt tooth is. Answer: it can cost you your life.

294

[quote]Professor X wrote:

[quote]SkyzykS wrote:

[quote]Professor X wrote:

What you are recommending isn’t plausible. So no kids get treated now with tooth pain until the parents can pay full price?

That would lead to a national crisis of health care with people avoiding treatment until near death.[/quote]

I discussed something like this with you a few years back- I had a broken tooth that became infected. I left it untreated due to lack of insurance until it made me extremely sick. Fortunately I found a dentist/oral surgeon who took it out and the other wisdom tooth for a couple hundred dollars cash.

People take for granted that some very simple things can take a person out if left untreated.
[/quote]
Rampant decay increases the risk of heart disease. It is all related.

I was asked above how important that hurt tooth is. Answer: it can cost you your life. [/quote]

Not to go off on a tangent, but would you guess that this was a major factor in pre-historic life expectancy?

I’ve noticed that in archaeological digs finding human skulls and jaw bones, they always find evidence of impacted and abscesses in the bone piles. Just curious as an archaeology documentary geek.

295

[quote]Jewbacca wrote:

[quote]usmccds423 wrote:

[quote]Professor X wrote:

[quote]usmccds423 wrote:

I did give more than 1 option didn’t I?
[/quote]

To your credit you did…but your solutions miss one big thing…that those catastrophic events happen due to IGNORING THE SMALLER SHIT for years…which is what you are eliminating.

This is human nature we are talking about…people will now wait until the problem gets out of hand and then the doctor will have to cash out big time to cover his overhead.

You keep ignoring that docs don’t become docs to be poor. That’s just reality.[/quote]

Which is why I added the preventative insurance option. [/quote]

Actually, the best model to copy is the veternarian model. Yes, there is insurance, but it is not the majority of the market and so does not materially disrupt the market.

Vets compete, which keeps the price what it should be. People think the price is too high, they go elsewhere.

Not that complicated.

Remember, the solution to a government-created-problem is never more government.[/quote]

The only problem here is that if the procedure is too expesive the animal can just be put down. I don’t think we can put people down, yet. Give it a few years.

296

One simple thought…many of these “idea or options” are only plausible if you are ok with killing off a large portion of society.

It was stated that children can get treatment from charities.

I spent some time wondering if that person understand that pedodontics or pediatrics are entire fields dedicated to children’s health…so it would take charity like 5 Bill Gate’s to treat Texas.

You can only be ok with some of these statements if you are ok with killing a few thousand people off.

I agree that there are poor people abusing the system. I have seen the new cell phones also…but that isn’t everyone…and I am not sure most here understand what taking away all preventive care will do to this country or to the lives of those who live here.

297

[quote]SkyzykS wrote:

[quote]Professor X wrote:

[quote]SkyzykS wrote:

[quote]Professor X wrote:

What you are recommending isn’t plausible. So no kids get treated now with tooth pain until the parents can pay full price?

That would lead to a national crisis of health care with people avoiding treatment until near death.[/quote]

I discussed something like this with you a few years back- I had a broken tooth that became infected. I left it untreated due to lack of insurance until it made me extremely sick. Fortunately I found a dentist/oral surgeon who took it out and the other wisdom tooth for a couple hundred dollars cash.

People take for granted that some very simple things can take a person out if left untreated.
[/quote]
Rampant decay increases the risk of heart disease. It is all related.

I was asked above how important that hurt tooth is. Answer: it can cost you your life. [/quote]

Not to go off on a tangent, but would you guess that this was a major factor in pre-historic life expectancy?

I’ve noticed that in archaeological digs finding human skulls and jaw bones, they always find evidence of impacted and abscesses in the bone piles. Just curious as an archaeology documentary geek.
[/quote]

It no doubt contributed…not to mention once they lost their teeth, full nourishment became even harder which could lead to malnutrition.

This is one of the first generations (baby boomers) in history where most adults keep their teeth well into old age.

298

[quote]SkyzykS wrote:

[quote]Professor X wrote:

[quote]SkyzykS wrote:

[quote]Professor X wrote:

What you are recommending isn’t plausible. So no kids get treated now with tooth pain until the parents can pay full price?

That would lead to a national crisis of health care with people avoiding treatment until near death.[/quote]

I discussed something like this with you a few years back- I had a broken tooth that became infected. I left it untreated due to lack of insurance until it made me extremely sick. Fortunately I found a dentist/oral surgeon who took it out and the other wisdom tooth for a couple hundred dollars cash.

People take for granted that some very simple things can take a person out if left untreated.
[/quote]
Rampant decay increases the risk of heart disease. It is all related.

I was asked above how important that hurt tooth is. Answer: it can cost you your life. [/quote]

Not to go off on a tangent, but would you guess that this was a major factor in pre-historic life expectancy?

I’ve noticed that in archaeological digs finding human skulls and jaw bones, they always find evidence of impacted and abscesses in the bone piles. Just curious as an archaeology documentary geek.
[/quote]

It no doubt contributed…not to mention once they lost their teeth, full nourishment became even harder which could lead to malnutrition.

This is one of the first generations (baby boomers) in history where most adults keep their teeth well into old age.

299

[quote]Professor X wrote:

[quote]dmaddox wrote:

[quote]Professor X wrote:

[quote]jbpick86 wrote:

[quote]dmaddox wrote:

[quote]pushharder wrote:

[quote]Professor X wrote:

You think doctors will all come down on prices of procedures because you pay out of pocket?

[/quote]

I know they will because I have experienced it firsthand. Lately.[/quote]

I have to admit my doctor has told me if I pay in cash I will get a better rate.

My dentist I pay in cash and she charges me 25% less than what she charges insurance companies. She makes more money and I pay less overall than insurance premiums by almost $500 a year.
[/quote]

My optometrist and my dentist both give discounts if you don’t have insurance.[/quote]

I don’t personally see a 20% decrease as taking anything away from the doctor (and agree, a small decrease like that is normal). I also don’t see that making most procedures available to people who truly are low income.

For some of the people I treat, getting a tooth fixed means no rent this month.[/quote]

Why does it have to be rent? What type of cell phone did they have? What type of car do they drive? What type of shoes do they wear? How many children? Do they have a job?

I am saying these things not to be an ass but to make a point, because a lot of people have their priorities out of order. Food, Clothing, Shelter. Some people will add transportation, but in Houston you can get around, slowly, but still can be done, on Public Transportation for cheap. IMO everything else is a luxury. Many people can clean up their lives by just focusing on those 3-4 priorities, and save money and get the other luxury items later. I did not get a cell phone until my last job paid for mine. That was 8 years ago.
[/quote]

Many of these people walk to this clinic. Many don’t even speak English. I don’t think you understand how bad some people have it.[/quote]

I have held dying children in my arms because they have not eaten in 2 weeks. Children that should be black or a dark brown color that were gray from malnutrition. Children that dig through trash cans just to find a morsel to eat. I know what it is like to actually be poor.

This country does not understand what poor is. You have a government that supplies everything to you, and charities that hand out food every day. Yet these “poor” in this country still want more for free. Our priorities are out of whack. Food, Clothing, and Shelter and that is it. Food =/= steak, clothing =/= Lebron Nike’s, shelter =/= $850/month rent for 1 person, and transportation =/= Cadillac Escalade. And yes I saw a lady the other day filling up her Escalade with $5 cash and wearing an employee’s uniform to Goodwill.

I know what actual poor is. If you have food in the refrigerator then you are not poor. Poor has no clue where the next meal is coming from and they have to go work or dig in trashcans for it. Every Elementary in Houston supplies Breakfast to every child, and lunch to every child that qualifies. They even offer food to the parents and children during summer vacation.

It is a tough life no doubt. I give thousands of dollars a year to charities to help people. I go and donate my time to charities to help the poor every year. I put my wallet and time where my mouth is. I care about people. I love people.

300

[quote]Professor X wrote:
One simple thought…many of these “idea or options” are only plausible if you are ok with killing off a large portion of society.

It was stated that children can get treatment from charities.

I spent some time wondering if that person understand that pedodontics or pediatrics are entire fields dedicated to children’s health…so it would take charity like 5 Bill Gate’s to treat Texas.

You can only be ok with some of these statements if you are ok with killing a few thousand people off.

I agree that there are poor people abusing the system. I have seen the new cell phones also…but that isn’t everyone…and I am not sure most here understand what taking away all preventive care will do to this country or to the lives of those who live here.[/quote]

The only way it something like this happenes would be if a saftey net was built in for lower income family and children. It’s a pipe dream to think changes this drastic would happen without that. I mean no way dems vote for this without both of those.

I think we should:
1.) Open up insurance both interstate and internationallly to increase competition.
2.) Offer preventative + catestrophic plans (or a combination) with all else A la Carte.
3.) Offer full coverage plans for those that are willing to pay for it.
4.) Assess and fix medicare/medicaid
5.) Offer above to low income family and cover all children that are either a part of a low family or don’t have a family.