Richard "Rick" Ungar

is a contributor to and the Washington Monthly where he writes on American health care policy and politics

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rickungar21 karma

That's extremely hard to answer because not everyone is in the same circumstance, even if they are in similar financial circumstances. I think people should assess their own potential for falling seriously ill. If you have a father and a grandfather who each had heart problems, don't kid yourself into imagining that it cannot happen to you. If this is case, you may want to buy a plan with a lower deductible. In my case, I come from a perfectly awful gene pool so there was always a strong possibility that, no matter how well I took care of myself, I might face problems-which I did. Figure out what is going to give you and your family the best protection and assign the appropriate priority.

rickungar20 karma

Very interesting question! First, you have to acknowledge that the VA system is as close to a purely socialistic medical system as one can get. Depending on who you ask, the VA is either the greatest thing since chopped liver or an absolute disaster. I find that it varies from city to city. While I think it would be an interesting experiment to begin by moving Medicaid patients to the VA system, it would have to be done slowly and carefully so as not to overwhelm the system. Also, there would be some complications in financing as states and the federal government share the cost of Medicaid. As for Medicare, again, moving everyone over to the VA would swamp the system. This is the sort of thing that must be done carefully and slowly or some serous disasters could result. But, in theory, there is something to the idea-if the American people were ever willing to accept the idea of 100 percent government provided healthcare for so many Americans.

rickungar17 karma

First, it's a lot of fun and that matters! Secondly, cable news is news these days, like it or not. As for why Fox, I simply enjoy debating more than I enjoy sitting at a table where everyone is agreeing. That's kind of boring. The art of making points on television, in small soundbites, is what it is. I admit I much prefer radio because you can wind out discussions far more effectively. But one can't dismiss the large audiences that come with TV.

rickungar17 karma

Probably not. I most certainly do think that every American should have access to health care. Indeed, we are the only industrialized nation in the world where health care is a privilege and gun ownership is a right. In every other industrialized nation, it is exactly the reverse. But I doubt that that the politics can ever be removed as, at the heart of the question, are true ideological points of disagreement that are too attractive to politicians to avoid. As for financing, it is a problem the world over. Health care continues to get more expensive-partially for bad reasons and partially for good reasons (all the technology that keeps us alive and functional for so much longer costs a lot of money). As a result, we are going to face the financing issue for a very long time until someone can figure out a way to deliver high quality care at a price that does not suck up so much of our GDP.

rickungar16 karma

I don't think there is a 'one answer fits all' to that question. There are instances where government can play a very useful role in the delivery of healthcare. Other instances where it may not be necessary. If you can get a bit more specific, I may be able to give you a more direct response.

rickungar16 karma

Typically, there is some portion of this type of care that is picked up either by local, state or the federal government - but not enough to keep hospitals from experiencing serious financial trouble as a result of unpaid care. The real 'payers' of unpaid care in hospitals are those of us who purchase health insurance as the hospitals boost their charges for services to include their loses from charity care and it is passed along to the rest of us.

rickungar13 karma

I do like the idea of a government option - but I would do it by extending Medicare to anyone who wants to participate. The reality is that Medicare operates at a far better efficiency than private insurance companies companies. I think we all benefit if it is opened to all ages with premiums established based on age-the younger you are, the more you pay.

rickungar12 karma

Oddly, a major driver of healthcare costs are things that we really like. There is technology today that keeps us alive and happy that would not have been available in the past. Of course, that tech is expensive and has to be paid for. A lot of the other drivers of cost are also more complicated that people think. We can all agree that when physicians 'over test' in order to drive up the bill, this is wrong. However, when your doctor tells you that you need tests, you are not going to be concerned about the policy issue-you want every test required to discover a problem or simply tell you that you are fine. And if it is your child at issue? You will be begging for additional tests as would I. It is the very personal nature of healthcare that makes it so difficult to control costs.

rickungar11 karma

If he does, he certainly isn't sharing them! I don't think we will know what his ideas really are until we are (a) faced with a Romney presidency should that occur and (b) the Senate flips thereby allowing the repeal of Obamacare. On the other hand, if we credit Governor Romney with what has taken place in Massachusetts, I would say he had some very good ideas- he's just turned his back on them for political benefit. Romney is not alone in pushing this 'repeal and replace' narrative...without bothering to tell us what is going to be the replacement. This has been the GOP meme for a few years now and we still have no idea what they have in mind. I think we all know why...they have nothing in mind.

rickungar10 karma

Economics always plays key role. Using outcomes as guidance is a bit more controversial. At the end of the day, it only makes sense to use outcomes to guide treatment policy. But we have to acknowledge that there will be instances where that data may not be the best answer when you are the patient and your doctor wants to try something unconventional. We need to use outcomes-but allow for exceptions so long as the exceptions are not over utilized by physicians.