The U.S. Health Care Debate

[ICantSpellDawg]

Am I missing the other thread on this? Where is it?

Anyway, healthcare is a big and intimidating question in the U.S. Many on the left would like to see a single payer plan, many from the center left would like a hybrid system that will eventually turn into a single payer plan (maybe with private suplementals)

The right is confused, and rightfully so. We are tasked with coming up with a plan that is new and will be hard to sell. What is very important is that we first find out what the main prolems are:

A. Exponentially rising cost.
This is the most important aspect of the discussion. Cost of premium is a real concern for most Americans, but that is due to the cost of care in the first place. One reason that cost is so radically out of control is a lack of transparency. co-payments, while used as a tool to give the insured an incentive have become relatively meaningless in relation to cost. As an example; I could visit doctor A and pay $20 or I could visit doctor B and pay $20. Actual cost to the insurer would msot liekly be very different - both doctors may have the same level of proficiency, but one costs much more than the other. As it stands today, there is no real way of knowing as the insured and no real reason to care in the short term. In the long term, this ignorance of cost leads directly to higher premiums. A way needs to be developed to adequately give an incentive to the insured to go with the value and what works - but they need to be ably to quantify it and feel the benefit and consequence of wasteful medical spending.

Another problem with rising costs is that, contrary to assumption, insurance companies prefer higher medical costs. the higher the cost, the higher the premium and the larger the percentage of your income they can expect, giving rise to company growth and investment. Even if they are payign more, thsi is offset by the amount that they will charge in the long run. I'd rather make 8% of 100 than 12% of 10.


I've got quite a bit more I wrote a whole list I-VII at home, but I'm at work now, so I'll try to post more her when I get home. I focus on insured pools, adverse selection, current working plans etc.

[ICantSpellDawg]

Anyway, I watched a bit of the Obama show last night and was not impressed. He really isn't that great at explaining detailed plans. Most of it seemed to be "why not?"

[Lemur]

Was his telethon last night? Missed it. Does anybody know if an actual proposal has been put forward?

[Husar]

We have a commission here that tests medications for their effectiveness, weighs that up against the price etc. and then decides which the ensurance companies have to pay for, if a new medication has essentially the same effect as an old one wrapped into a new package with a higher price tag, then they will decide the insurance companies only have to pay for the old one etc.
Of course this system is criticized as well but it might help keeping the premiums down, here you usually get the impression that insurances would rather not pay at all anyway. :sweatdrop:

[Lemur]

I'm just guessing from your response, but you haven't had much contact with Health Insurance companies, have you, Gelatinous Cube? 'Cause you're glossing over a whole lot if you have.

[rory_20_uk]

Mmm.. healthcare debate. I've always sympathized more with Democrats than Republicans on most issues, but the whole universal healthcare thing... :inquisitive:

I believe tax breaks or some other form of subsidizing cheap Health Insurance is the way to go. The Canadian or British model is not. Doctors go to school for 12 years to do the very difficult and specialized job that they do. They deserve the pay--on top of that, the pay is necessary to keep incentive for people to keep wanting to be doctors. Health Insurance is the easy out. You pay less to go to the doctor, the doctor still gets his giant paycheck.

In the UK doctors take 6 years to qualify. Where do your lot waste the other 6 years?
The pay incentive is there to help in part cover the vast bills that doctors have after over a decade in training; the pay is also more than in most european countries. These are not struggling to get doctors.
If the UK / Canadian way isn't to your liking - and it ain't perfect - then look at Switzerland: Americans pay 17% GDP, Swiss yet 12% their outcomes are better than America's.

~:smoking:

[KukriKhan]

I'm just guessing from your response, but you haven't had much contact with Health Insurance companies, have you, Gelatinous Cube? 'Cause you're glossing over a whole lot if you have.

Well, he's a young man in an organization that provides the largest socialized medical care in the world. So, the whole thing is likely kinda theoretical for him.

In the end, this issue is not even about health care at all, right? Rather, the issue is "insurance".

[Philippus Flavius Homovallumus]

I'm a firm believer that Medical Care is one of the "big three" along with Law Enforcement, and Fire & Rescue. It should be free at the point of use. That could either mean that A: it comes direct from your taxes, or B: everybody pays for state health insurrance that does not go up if you use it and is affordably low to begin with.

After all, you wouldn't expect to have to pay the fireman to put our house out or save your child, you shouldn't have to pay a state Doctor for his services, either.

[rory_20_uk]

I'm a firm believer that Medical Care is one of the "big three" along with Law Enforcement, and Fire & Rescue. It should be free at the point of use. That could either mean that A: it comes direct from your taxes, or B: everybody pays for state health insurrance that does not go up if you use it and is affordably low to begin with.

After all, you wouldn't expect to have to pay the fireman to put our house out or save your child, you shouldn't have to pay a state Doctor for his services, either.

If you're storing petrol in open containers and go around the house smoking I do think you should pay for cleaning up the resulting explosion.

Similarly with healthcare. There are some risks we can't alter in our lives for certain diseases be it gender, ethnicity or other underlying genetic problem, but the vast majority we can, be it the drunk morons that come in on Friday night to the 45 year old drinker / smoker / no exercise / high fat diet for the last 30 years who'se finally had his overdue heart attack.

There are several ways of doing this. A tax on alcohol / tobacco that is ring-fenced for the healthcare, these people should pay more insurance - in the same way that if I drive a Ford Fiesta I'll pay significantly less insurance than if I choose to drive a Nissan GTR - and / or a charge for attending A&E. £5 or £10 still means about a 90% subsidy by the state assuming no treatment is required, but at least this discourages the true timewasters. If you've had an MI then £10 for over £1,000 treatment is still the bargain of the century.

~:smoking:

[LittleGrizzly]

There are several ways of doing this.

I don't completely disagree with your first suggestion, I don't think we should charge at the medical end of the scale but when they actually buy the product. So alcohol and cigerettes for example should have tax on them at the point of purchase. I don't think alcohol does but considering ive heard figures of around 75% of the price of a pack of cigerettes is tax i think cigerettes more than make up for thier bruden on the health service (the fact that that money doesn't go to the health service is the goverments fault) Alcohol in comparison seems quite cheap, junk food also, is dirt cheap for the harm it causes long term.

[Evil_Maniac From Mars]

I'm a firm believer that Medical Care is one of the "big three" along with Law Enforcement, and Fire & Rescue. It should be free at the point of use. That could either mean that A: it comes direct from your taxes, or B: everybody pays for state health insurrance that does not go up if you use it and is affordably low to begin with.

After all, you wouldn't expect to have to pay the fireman to put our house out or save your child, you shouldn't have to pay a state Doctor for his services, either.

You may not have to pay the fireman to put out the fire in your house, but you or your insurance company will have to pay for the damages to the house.

[Crazed Rabbit]

Safeway, the US company, has had success in keeping insurance payments for their employees steady - as in not increasing while the rest of the nation does. They've done that by providing incentives, ie lower insurance prices, for healthier employees. The result is healthier employees and non-increasing costs. But they are still limited in the size of incentives they can provide to healthy employees.

In Texas they had success in putting a lid on malpractice payoffs.

Of course, Obama wants to go with neither of these two proven methods.

We should allow insurance companies/employers to charge unhealthy employees the full amount more that it costs to insure them (ie charge a smoker $1400 more per year instead of being limited to charging only $300 more per year compared to a non-smoker [approximated costs, of course]), and pass a federal law putting a lid on malpractice payoffs.

CR

[Seamus Fermanagh]

...I'm in the Military, and currently dealing with a very serious injury to my foot--the treatments and surgeries for which are entirely free to me.....

You paid your taxes, just as did the rest of us, and that's what paid for your "free" healthcare. The contract is simple: you agree to risk getting your *** shot off to protect mine and my neighbor's, and we agree to pay for your healthcare. No gripes here about that.

But NOTHING IS EVER FREE. TANSTAAFL is a universal norm.

[KukriKhan]

Even though I'm a smoker, I agree with this.

I'm on-board too. I'm convinced that my vices (cigarettes, beer) will probably statistically not only shorten my life, but also make end-of-life measures more expensive. I'll pay for that, for the privilege of indulging my bad habits.

But again, we're not talking about health care here, we're talking about insurance, and betting with or against "the odds", and putting down the appropriate ante into the insurance "pot".

-edit-
I have a (:crosses fingers:) stellar driving record: no accidents or citations in 44 years and 2.5 million miles driven. Yet I know that I will pay more to GEICO to insure a fire engine red convertible Corvette, than I will for a beige tudor ford escort. The Corvette will cost more to replace, and it's a both citation- and accident-magnet.

[Proletariat]

I'm on-board too. I'm convinced that my vices (cigarettes, beer) will probably statistically not only shorten my life, but also make end-of-life measures more expensive. I'll pay for that, for the privilege of indulging my bad habits.


They don't, tho. The 'smokers should pay' garbage is just a guilt trip. If you get lung cancer and die of it, you'll spend 6 months in a hospital dieing on pain meds around age 70. If you live to 98 with full blown Alzheimer's you'll need round the clock care, often costing as much as 7-8k a month until you finally pass. Plus, you paid more into the healthcare kitty with all your sin tax contributions from buying your cigarettes (I know you get your's from the Ukraine, but you get the idea).

Whether it's more expensive or not, it shouldn't matter. Should homosexual men pay more for insurance since their lifestyle puts them at higher risk for disease? Should blacks pay more for their higher incident rates for heart conditions? How about the obese? You eat more than two cheeseburgers a week and you better pay, fatty. What about scuba divers and their burden on emergency care?

:dizzy2:

Make it honestly universal or don't bother at all, sez I.

[Beskar]

I like how Gelantinous Cube pretty much has the free universal healthcare option because he is in the army, but is against it. In America, isn't it 60% cannot afford Health Insurance? I remember seeing Americans get chemo-treatment then stay in tents outside the hospital as they couldn't afford to have a bed on the inside due to the costs.

Basic and Essential Healthcare should be free as a human right. However, if you want cosmetics or anything like that, you pay for it. (outside grievous injury and other things)

[Crazed Rabbit]

They don't, tho. The 'smokers should pay' garbage is just a guilt trip. If you get lung cancer and die of it, you'll spend 6 months in a hospital dieing on pain meds around age 70. If you live to 98 with full blown Alzheimer's you'll need round the clock care, often costing as much as 7-8k a month until you finally pass. Plus, you paid more into the healthcare kitty with all your sin tax contributions from buying your cigarettes (I know you get your's from the Ukraine, but you get the idea).

Whether it's more expensive or not, it shouldn't matter. Should homosexual men pay more for insurance since their lifestyle puts them at higher risk for disease? Should blacks pay more for their higher incident rates for heart conditions? How about the obese? You eat more than two cheeseburgers a week and you better pay, fatty. What about scuba divers and their burden on emergency care?

:dizzy2:

Make it honestly universal or don't bother at all, sez I.

The opinion essay about the Safeway insurance said that it cost the company $1400 more per year to insure a smoker. I can't speak for whatever method they used to come up with that number. They also did do health check-ups on employees, so obese people did pay more.


In America, isn't it 60% cannot afford Health Insurance?

:inquisitive:

No. Much, much less.


I like how Gelantinous Cube pretty much has the free universal healthcare option because he is in the army

No, he doesn't. He earned that healthcare and it was not free.


Basic and Essential Healthcare should be free as a human right.

Why should it be a right for a sick person to take money from others to get care for themselves?

CR

[LittleGrizzly]

Why should it be a right for a sick person to take money from others to get care for themselves?

Because whereas some animals leave thier sick to look after themselves we like to think we are above that.

[Louis VI the Fat]

It remains one of the world's great mysteries - how come Americans pay fifty to 100 percent more for healthcare than the rest of the developed world, but have results that are not, shall we say, stellar.
And healtcare and rising costs aren't very rosy in Europe, Canada and Japan to begin with.


To throw in a thought - would you pay 10% of your annual income, for your entire life, to add eightteen months to your life spend in ill health at the age of 81? Cause basically, that is what we are doing.


Prole - I take it you naughty girl still haven't given up smoking? :smoking:

Neither have I. One day, one day...:shame:

[KukriKhan]

It remains one of the world's great mysteries - how come Americans pay fifty to 100 percent more for healthcare than the rest of the developed world, but have results that are not, shall we say, stellar.
And healtcare and rising costs aren't very rosy in Europe, Canada and Japan to begin with.


To throw in a thought - would you pay 10% of your annual income, for your entire life, to add eightteen months to your life spend in ill health at the age of 81? Cause basically, that is what we are doing.


Prole - I take it you naughty girl still haven't given up smoking? :smoking:

Neither have I. One day, one day...:shame:

Not me, man. I don't demand much of myself, but I do insist on honesty when I'm talking to myself. And the truth is: I will continue with the smokes until it hurts too much. So far, it doesn't. I offer supportive words of admiration to anyone who quits smoking, but I know, deep down inside, that I never will. Except when I also quit breathing, of course.


(I know you get your's from the Ukraine, but you get the idea).

Heh. You should see the huge black-bordered warning they put on their packs. I assume it says something like: "This chit gon' kill you, Comrade."

So yeah, I'll pay for the privilege of being left to my own neferious devices.

[Lemur]

Uhm, unless you have a terrible doctor, the results are hardly less than stellar.
I think Louis is referring to common indexes of a nation's health; infant mortality, life expectancy, etc. On most measures we don't do well. Last I heard we were 36th in results and number on with a bullet in costs. I'll let a more statistically-inclined Orgah hunt down the numbers. Like Barbie says, "Math is hard."


Universal healthcare can't work for America, but examples of nearly universally affordable health insurance have occured in the past, and can occur again.
I don't understand why universal or "single-payer" healthcare simply can't work in the U.S.A. I'm not saying it's the best solution, or arguing that we should adopt it, but to flatly state that it cannot work here is interesting, and requires elaboration on your part. Every other major industrialized nation has some sort of universal healthcare. Japan, Germany, Taiwan, France, Sweden, Finland, France, South Korea, Australia, Britain, Netherlands ... the list goes on. And let's not forget the Canucks.

If just about every first-world nation can make it work, why is it flatly impossible here? I'd like to hear your reasoning.

[Crazed Rabbit]

Well, for one, a public plan would likely be able to drive drug costs down, as other nations have. But the US currently pays for most of drug R&D through higher drug prices in our country. So if the public plan was successful at lowering drug costs, we'd destroy a lot of the R&D budgets for drug companies. The other nations that have public entities negotiating low drug prices get away with it because us Americans are currently picking up the tab.

I'd love for someway to force all those free-loaders to pay higher prices, so we in the US could pay lower prices.

As for not working; even the recent democratic plan would leave some 30 millions or so uninsured. Over half of the amount of people who are not insured right now.

CR

[Alexander the Pretty Good]

America has decided two things. One, that we don't want capitalism any more. Two, that we have infinite money.

Lets live it up. Bring it on. Free healthcare and insurance and prescriptions for everyone.

[Beskar]

If I remember right, Canada has the best healthcare in the world and I think Cuba is second. (This is on average per citizen)

Anyway, America can remove money from its over inflated defence budget to fund it easy. It's sad you rather pay more money in killing people than saving lives.

[Evil_Maniac From Mars]

If I remember right, Canada has the best healthcare in the world

:dizzy2:


and I think Cuba is second.

:inquisitive:

[Alexander the Pretty Good]

If I remember right, Canada has the best healthcare in the world and I think Cuba is second. (This is on average per citizen)
https://i275.photobucket.com/albums/jj294/hellbender38/Citation-Needed-wikipedia-819731_50.jpg


Anyway, America can remove money from its over inflated defence budget to fund it easy. It's sad you rather pay more money in killing people than saving lives.

If I'm reading the budget summary right (http://www.gpoaccess.gov/usbudget/fy10/pdf/budget/summary.pdf) we spent about $600B on the DoD and about $1T on Social Security + Medicare + Medicaid in 2008. I'm far from sure that I read it right, but we're already paying more in welfare programs than in killing people. Course, I'd like to drastically cut the killing people part, but when you have infinite money, who freakin' cares...

[Crazed Rabbit]

If I remember right, Canada has the best healthcare in the world and I think Cuba is second. (This is on average per citizen)

Really? In Canada, people die on waiting lists. Some pay thousands of their own money so they can travel to the US and buy treatment because they don't want to wait for years.

Cuba - maybe you should consider the possibility that such claims are propaganda.

CR

[Banquo's Ghost]

Well, for one, a public plan would likely be able to drive drug costs down, as other nations have. But the US currently pays for most of drug R&D through higher drug prices in our country. So if the public plan was successful at lowering drug costs, we'd destroy a lot of the R&D budgets for drug companies. The other nations that have public entities negotiating low drug prices get away with it because us Americans are currently picking up the tab.

I'd love for someway to force all those free-loaders to pay higher prices, so we in the US could pay lower prices.

:inquisitive:

I thought you were a free market sort of fellow? Maybe a different system would force drug companies to reduce their current extortionate prices? For example, the British system of NICE (a quango that assesses treatments for the NHS on grounds of cost-benefit) has often rejected a drug for use in the health service because its cost per quality life year is too high - and amazingly - assuming their subsequent "moral" crusade in the papers fails - the drug company concerned often drops its price or comes to a deal.

I think there is great scope for reducing drug costs and therefore medical costs across the globe. Not least because nations fund vast universities which could be doing a great deal of public research for the benefit of many.

I am intrigued to understand more about the US system because of Lemur's thread in The Other Place. As far as I know, our resident prosimian is a intelligent middle class professional. A couple of weeks ago, he tried amateur surgery during which his fingers came off worst. Despite the severe risk of tetanus, infection etc, he could not face the potential cost of having a quick check up and asked for advice on this forum. IIRC, he cited the fact that to claim on his insurance would cost him a great deal of time and hassle, if it was paid at all. Moreover, he noted that it was not possible to change the insurance company to a more supportive one.

The issue about people being uninsured under the system is certainly one concern. But if people who are insured feel so constrained by its workings that they won't even get a simple check up, there is a whole other problem.

Is it actually true that it is difficult/impossible to change one's insurer? How then does the market drive efficiency through choice? Is it true that check-ups like the example above are fraught with concerns and possible costs so that preventative examinations are foregone - thus increasing the likelihood of major (and far more costly to the system) interventions later? Is it true that Lemur is too manly and therefore disdained the ministrations of kindliness when lesser mortals would have fled to the doctor weeping like little girls?

I would be interested in the answers to the above to inform my understanding of the debate.

[Philippus Flavius Homovallumus]

I'm inclined to agree. Monday I have to call my GP to tell him one of my friends has Swine 'flu. I will likely get swabbed and then have anti-virals. It's not going to cost, and because I don't work I don't pay National Insurrance right now.

[rory_20_uk]

They don't, tho. The 'smokers should pay' garbage is just a guilt trip. If you get lung cancer and die of it, you'll spend 6 months in a hospital dieing on pain meds around age 70. If you live to 98 with full blown Alzheimer's you'll need round the clock care, often costing as much as 7-8k a month until you finally pass. Plus, you paid more into the healthcare kitty with all your sin tax contributions from buying your cigarettes (I know you get your's from the Ukraine, but you get the idea).

Whether it's more expensive or not, it shouldn't matter. Should homosexual men pay more for insurance since their lifestyle puts them at higher risk for disease? Should blacks pay more for their higher incident rates for heart conditions? How about the obese? You eat more than two cheeseburgers a week and you better pay, fatty. What about scuba divers and their burden on emergency care?

:dizzy2:

Make it honestly universal or don't bother at all, sez I.

Smokers don't just kill themselves. They also help kill others. In this way they are worse than Heroin users who generally just kill themselves.

Blacks aren't renowned for heart disease. That is persons from the Indian subcontinent. This is an unalterable genetic factor.
Obesity is a choice, as is scuba diving. These should pay more.


Well, for one, a public plan would likely be able to drive drug costs down, as other nations have. But the US currently pays for most of drug R&D through higher drug prices in our country. So if the public plan was successful at lowering drug costs, we'd destroy a lot of the R&D budgets for drug companies. The other nations that have public entities negotiating low drug prices get away with it because us Americans are currently picking up the tab.

I'd love for someway to force all those free-loaders to pay higher prices, so we in the US could pay lower prices.
CR

Generic drugs are cheap, and slightly worse. The cycle is that healthcare costs a load. When you get ill, since it's cost a fortune you want the best, not the most cost efficient. One drug is 5% better and twice the cost? Great - bring it on. Treatment was massively expensive, and so is insurance.

Lots of R&D is done in Europe, but all with the eye to the American market.

~:smoking:

[Husar]

Make it honestly universal or don't bother at all, sez I.

Commie!

But I agree, this whole complicated system based on risks is a really weird capitalist's dream as it would also require significantly more bureaucracy than a simpler system, and we all know bureaucracy is bad and costs way too much money.

Concerning the whole choice thing, joining the military in the US is also a choice, does that mean soldiers would have to pay the most? Don't let patriotism get in the way of your judgement here...

[rory_20_uk]

AS far as I am aware, soldiers get free healthcare, and support after discharge. So it's a non-issue with the employer picking up the tab.

Massive detail into lifestyle would be difficult, but considering here in the UK most of the needed data is held by GPs it would be very simple to develop quite complex pictures about health. Would some lie? Probably. But as with all insurance it is invalidated if falsification is found.

~:smoking:

[KukriKhan]

AS far as I am aware, soldiers get free healthcare, and support after discharge. So it's a non-issue with the employer picking up the tab.

Massive detail into lifestyle would be difficult, but considering here in the UK most of the needed data is held by GPs it would be very simple to develop quite complex pictures about health. Would some lie? Probably. But as with all insurance it is invalidated if falsification is found.

~:smoking:

You've hit on another aspect of the talked-about but not yet written down plan over here: cut costs by digitizing med records, the easier to share patient history and treatment among Docs.

Makes sense to avoid duplication of effort, but many are worried about the security of such a system, and the use of the info by gov't, insurance and employer groups to deny treatment, coverage, or even employment, based on risk actuarial tables.

Why hire a 40-year old welder for your factory, if his father, mother & grandfather all died of heart attacks in their late 40's?

-edit-
Just thought I'd throw in this BBC story (http://news.bbc.co.uk/2/hi/europe/3409859.stm) about an entire village smoking cigarettes one day every year.

[Hosakawa Tito]

Here's a take (http://www.jpands.org/vol14no2/kurisko.pdf) from a former Canadian doctor. Like BG, I was also concerned and disgusted that Lemur felt the need to doctor himself with that hand injury rather than jump through hoops with his insurance company. I think Kukri was on the money when he said it appears to be more of an insurance problem than a health care one. I really don't know what a viable solution would be, but something needs to be done. A not for profit health insurance company for those that don't have any sounds like a good idea to keep costs down, but will it eventually lead to all employers just dumping their health plans for employees and forcing most people into this government plan?

From a personal stand point, if what this doctor says about the Canadian health care system is true about waiting lists for CT/MRI scans... I'd not have survived that brain aneurysm several years ago.

[Evil_Maniac From Mars]

Concerning the whole choice thing, joining the military in the US is also a choice, does that mean soldiers would have to pay the most? Don't let patriotism get in the way of your judgement here...

There is a bit of a difference between smoking and joining the military, and American soldiers certainly should enjoy subsidized health insurance because:

1) They are working for their country in one of the most difficult jobs it offers.
2) There is a large difference between working in a necessary job and killing yourself with junk food.
3) For all the things that they sacrifice it is the least that we can do in return.

[Louis VI the Fat]

Some thoughts:

The litigation culture in the US drives up healthcare costs. This is partly owing to individual risks not being socialised. In Europe, if you become disabled, welfare will take care of you. In the US, somebody responsible must financially compansate you. (To put it very schematically, but the mechanism is there, and not just in healthcare)
Are European healthcare costs shifted to social welfare costs? Americans by contrast pay less for welfare, more for healthcare. Is a good deal simply a matter of where costs appear? I lack numbers, but I expect so.
(There are pro's and con's to either system. For the proponents of individual responsibility - which always at first glance sounds the more reasonable choice - the following joke, that I unfortunately don't know how to tell well: a man falls down on a New York pavement in agony, grabbing his heart with his hands. One man rushes towards him, another flees the scene. The former is a lawyer, the latter a doctor)


Surely, (insurance for) litigation can not account for several percent of GDP? Litigation is rampant in the US, but it can not account for the huge gap in healthcare spending between the US and other developed nations. I need numbers. (We are in dire need of statisticians and number crunchers in this thread!)


Capitalism has two meanings. Free market, and putting the interests of corporations first. American families suffer because they believe that what is good for corporate America, is ultimately good for them. The medicinal-industrial complex knows otherwise.
Free markets are great, therefore corporations will do anything to destroy them. The federal government ought to resume control of the healthcare market and put better incentives into place. Currently, they work to the disadvantage of the people.


The US scores very low on international healthcare comparison lists. Infant mortality and the like. Yet, America also scores near the top on other lists. I think this is more a matter of income distribution than healthcare. Simply put, poor babies die out of want, and the well-to-do have a $100.000 heart surgeory.
This is a cultural difference, a political and societal choice. Not a matter of disorganised healthcare.

[Alexander the Pretty Good]

Corporations are not free-market, as they take protection and privileges from the state.

[Crazed Rabbit]

Surely, (insurance for) litigation can not account for several percent of GDP? Litigation is rampant in the US, but it can not account for the huge gap in healthcare spending between the US and other developed nations. I need numbers. (We are in dire need of statisticians and number crunchers in this thread!)
I think malpractice insurance for one doctor can be in excess of $100,000 per year. So even if they never get sued, simply insuring against it can put them in dire finances.


Capitalism has two meanings. Free market, and putting the interests of corporations first. American families suffer because they believe that what is good for corporate America, is ultimately good for them. The medicinal-industrial complex knows otherwise.
Free markets are great, therefore corporations will do anything to destroy them. The federal government ought to resume control of the healthcare market and put better incentives into place. Currently, they work to the disadvantage of the people.

The Federal government very rarely helps the free market instead of corporations (see the latest tobacco bill, AKA The Phillip Morris Protection Act). Almost every time they put in a regulation it will help corporations and bind the free market. This is because 1) Politicians are dim witted morons who understand very little economics 2) They are eager to grab money for their districts, even at the expense of the nation 3) They are fond of giving privileges to special interests that support them.

There is probably a good deal the Feds could do to help simply by removing onerous restrictions, though I can't point out specifics.

I'd recommend reading the paper Hosakawa Tito linked to, as it shows the importance of allowing profits.

CR

[a completely inoffensive name]

It needs to be fixed.

[Adrian II]

Where does this story come from that 'people in Canada die on waiting lists' whereas this doesn't happen in the US? Can anyone show me where it says that in the US people don't die waiting for crucial treatments?

EDIT
Or any other country for that matter?

[Louis VI the Fat]

Where does this story come from that 'people in Canada die on waiting lists'From a Canadian doctor who moved to Minneapolis because he can make obscene amounts of money there. He's now trying to convince the Americans that they mustn't adopt the Canadian healthcare system. Because, erm...the US system is good for the patients.

No, really, it is good for Americans.

Really.

[Adrian II]

From a Canadian doctor who moved to Minneapolis because he can make obscene amounts of money there. He's now trying to convince the Americans that they mustn't adopt the Canadian healthcare system. Because, erm...the US system is good for the patients.

No, really, it is good for Americans.

Really.I see. So it comes from someone who practices social darwinism in the guise of medicine, a bit like our rory?

[Meneldil]

There's absolutely no valid reason to explain why members of the military have free healthcare and other people don't.
Breach of equity of the worst kind. Nationalism is definitely stupid.

[Husar]

There's absolutely no valid reason to explain why members of the military have free healthcare and other people don't.
Breach of equity of the worst kind. Nationalism is definitely stupid.

Why do you hate freedom? :rolleyes:

[Alexander the Pretty Good]

But to say it's a breach of equity that the Military should offer me outstanding healthcare? :inquisitive:

I believe Meneldil is saying it's a breach of equity that you need to sign up to bomb foreigners in order to get free state healthcare.

[Beskar]

My apologises to my earlier post. It was something I read some where and remembered it. I will however, post a proper source and proper results.

Best Healthcare in Rank according to the World Health Organization 2000 report.

1 France (Universal Healthcare Insurance System)
2 Italy (Universal Healthcare State-funded)
3 San Marino (Universal Healthcare State-Funded)
4 Andorra (Universal Healthcare Insurance System)
5 Malta (Universal Healthcare State-funded)
6 Singapore (Universal Healthcare Hybrid of Public and Private)
7 Spain (Universal Healthcare State-funded)
8 Oman
9 Austria (Universal Healthcare State-funded)
10 Japan (Universal Healtcare Insurance System)
...

37 United States of America (Does not have a Universal Healthcare System) (72nd by overall level of health)

[Alexander the Pretty Good]

I think it's the total opposite. You shouldn't look at it like it's state healthcare. It's not. It's employer-provided healthcare, subsidized by the government. The Army is a non-profit organization, after all.
Like welfare with more collateral damage.

Though then again, it certainly is for-profit for all the "defense" contracts we no-bid to people.

[Louis VI the Fat]

There's absolutely no valid reason to explain why members of the military have free healthcare and other people don't.It strangely makes sense within the US system. Your employer pays your healthcare insurance. Great healthcare benefits are one of the perks of joining the military - together with education. Both not readily accessible to all in the US.

The system makes a person beholden to her employer for healthcare insurance. Power is the reverse of what it ought to be. To me, not corporations, but people ought to be the focus of society. Citizens should be free and healthy, at least, independent in access to healthcare. Then employers can bid for the services of these healthy, independent and free citizens - on their knees.

[Alexander the Pretty Good]

Nobody joins the Army on behalf of the Corporations that equip the military. Similarly, the military does not work for corporations. The Army works for the President. The President works for the people who elected them.

I really do appreciate the conspiracy theories, but the Army is hardly anything sinister. Uniformed opinions abound.

:inquisitive:

Technically the President works to get re-elected, which only sometimes coincides with the best interests of the people who elected him (which is only sometimes a slim majority of the people who pay the taxes that fund his military).

But regardless, the military is a state organization, and healthcare it provides is state healthcare. Hell, you have separate state hospitals if you'd prefer it.

Furthermore, what does it say about the military that recruitment goes up when the economy is bad? Maybe it's not all about "defending" America and apple pie...

[Crazed Rabbit]

Where does this story come from that 'people in Canada die on waiting lists' whereas this doesn't happen in the US? Can anyone show me where it says that in the US people don't die waiting for crucial treatments?

I don't think as many people die waiting for them - more may die because they can't pay for them. My point is that Canada's system is no great advantage over our current one.

CR

[Lemur]

I don't think as many people die waiting for them - more may die because they can't pay for them. My point is that Canada's system is no great advantage over our current one.
I think CR has hit on a very important distinction. My argument is as follows:

(1) The appetite for healthcare is infinite.
(2) No society can appease all healthcare needs and wants and survive.
(3) Therefore, rationing of some sort takes place in every market.

In our society, that rationing takes place in two ways: Either you are uninsured and must decide what you can afford, or you are insured badly, and must decide what level of bureaucratic hell you wish to endure.

Personally, I'd rather see the rationing hashed out in a more public way, but that's just me.

[Alexander the Pretty Good]

And since most don't see combat, it's a pretty sweet gig. Sure, you got to do the king's bidding for a few years, and it might be a bit unpleasant at times, but then you get the king's shilling...

[KukriKhan]

And since most don't see combat, it's a pretty sweet gig. Sure, you got to do the king's bidding for a few years, and it might be a bit unpleasant at times, but then you get the king's shilling...

Hahahahahahahahahahahaha!

:inhale:

Hahahahahahahahahahahahaha!

[Evil_Maniac From Mars]

There's absolutely no valid reason to explain why members of the military have free healthcare and other people don't.

Yes, there is, as I pointed out above. But it is like that almost everywhere - members of the military of Canada also get extra benefits of that nature.

[Alexander the Pretty Good]

Hahahahahahahahahahahaha!

:inhale:

Hahahahahahahahahahahahaha!

Oh come on. I could get an air force job no problem. If you've ducked the PBI, all you have to do is get through boot camp.


Mechanics still fix the crap we break, medics still fix the people we break, desk jockies still fix our paperwork problems...

So what's the big deal? You get better healthcare despite being comparable to civilian jobs.

[Alexander the Pretty Good]

How much better is the pay when you account .mil healthcare and all expenses paid world tours?

I assume that mechanic also gets combat theater bonuses as well?

[Alexander the Pretty Good]

Not my problem. None of you guys should be in theater because we don't have any reason to be there.

[Alexander the Pretty Good]

Can't make war without soldiers.

[Alexander the Pretty Good]

You joined an organization that hasn't made war to defend the United State since 1945.

:shrug:

[Alexander the Pretty Good]

Go to Bagdhad some time and ask your average citizen if he's happy to see us pulling out. That answer will almost universally be "No."
There's a difference between having wanted us to invade in '03 and wanting us to leave now. I'm sure the Iraqis agree whole-heartedly with the "you break it you bought it" line of thinking, as they are currently broken. But I don't know if they'd all say they wanted breaking in the first place.

I'm not saying our intentions are bad, at least on the part of the average servicemen and women. But the road to hell (and apparently financial ruin) are paved with good intentions, not to mention foreign civilians we've delivered high-explosive liberty to.

[HopAlongBunny]

I'm Canadian but I know a few Americans :p

In one case; friend has absolutely stellar health insurance-has heart attack falls of bike and spends an uncomfortably long time on hot pavement; rushed to hospital, resuscitated, treated for burns; the receiving hospital was not covered by his plan - 3/4 of a million for treatment; fortunately he did get shipped to a hospital under his coverage for recovery.

I shudder to think that that is the "best health care" in the world; how many ppl plan for $750,000 dollar hit? how many can afford it? and this, despite having coverage that costs more than my yearly income! I hope Obama injects some sanity into American Health Care.

[Lemur]

Whoa, this is a thread about healthcare, not Iraq, not Bush, not soldiers, except as regards their healthcare. I don't mean to be both a rules geek and a stick-in-the-mud, but the GC-ATPG exchange seems to be wandering far afield.

Just gonna re-state my position:

The appetite for healthcare is infinite.
No economy can sustain "full" healthcare for everyone at all stages of their lives.
Ergo, some sort of rationing is not only inevitable, it's the reality. Everywhere.

So the only real question is "How would you like your triage served, sir?"

[Evil_Maniac From Mars]

Just gonna re-state my position:

The appetite for healthcare is infinite.
No economy can sustain "full" healthcare for everyone at all stages of their lives.
Ergo, some sort of rationing is not only inevitable, it's the reality. Everywhere.


This is something that concerns me deeply, especially here in Europe. We have all of these fancy healthcare systems set up, but as more and more people become older, and as our population pyramid inverts more and more, we have less workers paying for more people needing the services. These health and welfare systems already cost a fortune, they already consume large portions of our financial resources. Just how are we going to keep paying for them? Will we go into debt? Will we have to cut services? What is the price that I, or more importantly my descendents are going to end up paying for the continued maintenance of such extravagant systems?

[Alexander the Pretty Good]

Just gonna re-state my position:

The appetite for healthcare is infinite.
No economy can sustain "full" healthcare for everyone at all stages of their lives.
Ergo, some sort of rationing is not only inevitable, it's the reality. Everywhere.

So the only real question is "How would you like your triage served, sir?"

So...

You agree with the idea of scarcity
See point one
Prices are a method of rationing


Excellent! Another free marketer. :yes:

[Xiahou]

There's absolutely no valid reason to explain why members of the military have free healthcare and other people don't.
Breach of equity of the worst kind. Nationalism is definitely stupid.There is absolutely a valid reason. It's a benefit provided by the state to help encourage people to sign up for the armed forces. It's essential for a nation to have armed forces, therefore it's essential for the nation to compensate their military well enough to maintain adequate numbers, it's really as simple as that.


(1) The appetite for healthcare is infinite.
(2) No society can appease all healthcare needs and wants and survive.
(3) Therefore, rationing of some sort takes place in every market.
The demand for anything is infinite when price is removed as a consideration. As it stands, our health "insurance" makes about as much sense as grocery insurance. Why not let people buy grocery insurance- or better yet, have it provided by their employer. You can go to the grocery store as often as you want and you'll pay the same premium for your insurance no matter what. What do you think would happen to the price of groceries?

What I think we need to do is 1) divorce health insurance from employment. It should be something you can choose based on your personal needs/preferences and it should be something you can continue to purchase regardless of who your employer is- or even if you're employed at all. 2) I think insurance should actually be insurance- against catastrophic events. If I get the sniffles, I should be able to pay out of pocket for a doctor's visit and antibiotics. If I'm in a car wreck and severely injured, insurance should kick in. We could probably engineer some kind of tax credit the goes into something like a health savings account that people could use on non-insurance type expenses. Each year, anything that you haven't spent you can pocket. Give people some real incentives to keep healthcare costs down. :yes:

Do most people even know what a doctor's visit costs? I'm sure people know what their copay is, but do they know or even care what the total cost is?

[Papewaio]

Immunisation has a benefit for not just the individual, if enough of the population has it a disease can be stopped in its tracks because it can't find vectors to viable hosts. So immunisation of most diseases should be subsidised by the state.

What I think the healthcare system should be aiming for is outcomes. Increase the health of society. Take a more holistic approach. Put more medicos in per dollar and less bureaucrats. Make it harder to sue for accidents and easier to prosecute malicious Drs (less monetary gains and more criminal)... malpractice insurance should go down as it should be harder to sue for accidents. While actual criminal actions should be handled by the state, no vigilante justice by suing.

Allow the state to handle emergency and the private system to handle boob jobs.

[HopAlongBunny]

Okay.

Not an in-depth study but why does the USA private insurance system cost the gov't more (per capita) than the Canadian gov't insurance system? If you cover less ppl (proportionately) by spending more money, this speaks to a very peculiar transfer of resources. Efficient? How?

No doubt beneficial to some segment of society

[rory_20_uk]

Allow the state to handle emergency and the private system to handle boob jobs.

Whilst I agree with this, sadly there's a massive amount of grey between these two cases. Even with these two there's some variance. And it is the case that State would be free?

For example, although most women have boob jobs to, uh, uplift their self image, there are some who have very unequal breasts and this causes significant psycological distress. Then there's post cancer / trauma or even infection.

And if someone is having recurring flare ups of gall stones, it would over time be cheaper to whip it out once and have a 3 day inpatient stay than have attacks every few months requiring far more state resources.

~:smoking:

[Lemur]

Do most people even know what a doctor's visit costs? I'm sure people know what their copay is, but do they know or even care what the total cost is?
Based on my experience with my Insurer From Hell, I can tell you what the doctor says the visit costs, what his employer says the visit costs, what my insurer says the visit costs and what I'm told at the paperwork station about its cost. The cool thing is that you get four wildly different answers.

If you think HSAs are the way, with some sort of catastrophic insurance to gild the lily, cheers. How would you address people with chronic illnesses? Pay for treatment until they can't anymore? Then what?

[rory_20_uk]

How would you address people with chronic illnesses? Pay for treatment until they can't anymore? Then what?

They die. Just like they do anywhere else in the world when they can't afford treatment. OK, often this is for things that are pitifully easy to treat.

Living beyond one's means now can also mean living for too long, unless the burden should just fall on the young exponentially whilst the elderly and infirm have 24 hour care from healthcare professionals plus meds and the rest.

Healthcare economics is an area where hard decisions have to be faced.

~:smoking:

[KukriKhan]

They die. Just like they do anywhere else in the world when they can't afford treatment. OK, often this is for things that are pitifully easy to treat.

Living beyond one's means now can also mean living for too long, unless the burden should just fall on the young exponentially whilst the elderly and infirm have 24 hour care from healthcare professionals plus meds and the rest.

Healthcare economics is an area where hard decisions have to be faced.

~:smoking:

Blatantly stated, this is nevertheless the decision facing the US electorate and their rep's.

[Hosakawa Tito]

Exerpt from the link in my earlier post:


The United States is unique among nations in that it was
originally based upon the value of individual liberty: freedom from
coercion. No individual or government had a presumptive claim to
the property or labor of others.
Liberty requires rights. Rights are a just claim to freedom of
action. The original rights as recorded were “negative” in that they
implied the absence of interference. The only individual obligation
was to refrain from interfering with others. In contrast, positive rights
impose an obligation for someone to do something for others. The
Bill of Rights is a list of negative rights.
A “right to health care” implies that someone has to provide it.
But what of the liberty rights of physicians, nurses, and other medical
workers? Or the property rights of taxpayers and entrepreneurs?
Some rights must be abrogated to meet the demands of a positive
right. President Obama and other politicians who call a professional
service a “right” do not understand the founding principles of the
United States.


I find it difficult to argue this statement. However, I agree that something needs to be done without driving us into bankruptcy.

Regarding the WHO health performance rankings, I wonder if they polled people's satisfaction with their health care system by asking those that actually use it, the chronically ill or those with debilitating conditions that aren't immediately life threatening but are very painful and affect quality of life. Access to a waiting list is much different than access to health care, and for some health care delayed is health care denied.

In the US the COBRA Laws & EMTALA (http://emedicine.medscape.com/article/790053-overview) require that any person who comes to the emergency room must be examined and/or treated regardless of the person's ability to pay.

[rory_20_uk]

What if people present to ER with hip pain for example.

An X-ray shows the hip is wrecked. Severe loss of joint space - the bones are basically rubbing on each other.

To treat:

Up the pain meds.
Admit for a joint replacement.

Which one is undertaken?

~:smoking:

[Adrian II]

Immunisation has a benefit for not just the individual, if enough of the population has it a disease can be stopped in its tracks because it can't find vectors to viable hosts. So immunisation of most diseases should be subsidised by the state.This principle does not apply to immunisation only.

Society as a whole benefits from a high level of general health, hygiene, prevention and disease control. Like fire prevention and the maintenance of public order, health is a common good, not a private issue.

That's why health care systems with socialized funding compare favourably to health care systems based on private funding. Lemur and Louis already pointed to longevity, infant mortality and related criteria. Only three OECD member states have no universal health care: the US, Turkey and Mexico. On most relevant indicators in the latest comparative OECD study Health at a glance 2007, those three are at the bottom of the table. For a rich country like the US this should be unthinkable, but it is the truth. Infant mortality, age expectancy, mortality from heart disease and stroke, all cancers, low birth weight and infant mortality, you name it - in all instances the US rates well below the OECD average or well below expected outcome based on GDP.

Sorry guys, your system stinks because it is based on private funding. Socialised medicine (also known as state health care) has its drawbacks as shown by the NHS, but that is not the same as socialised funding.

Switch to socialised funding, cut costs, live longer and send your kids to a school where not one in three kids has missing teeth and one in ten has problems due to premature birth, obesity &cetera.

[Meneldil]

I'll be the first to say that the Army makes someone out of touch with the civilian world. I still get culture shock when I go on leave--and it gets worse every time, especially after Iraq. But to say it's a breach of equity that the Military should offer me outstanding healthcare? :inquisitive:

Yes, it is. If the military is the only state organization that receive free healthcare, I don't see how you could claim otherwise.

I don't care what's your job, where you'd been fighting and what not. You signed up, for I guess a few reasons. You're doing your job, which involve getting shot at. That's dangerous and brave, but that's what you signed up for.
Having a military is not essential for a nation, it's essential for the US, because of their honestly war-focused foreign policy and their role as a superpower. That doesn't change the fact that a soldier shouldn't have more rights than the average citizen.

That's kind of funny if you think about it. American right-wing people keep claiming universal and free healthcare is crap and would doom their entire country, but when it comes to the army, it's the fair reward for a dangerous job and serving your country. Talk about hypocrisy.

I guess we're kind of getting used to it by now
- "The state shouldn't offer free healthcare. Except for the military"
- "The state shouldn't rule our lives. Except when it comes to abortion and homosexuals"

[Kralizec]

Yes, it is. If the military is the only state organization that receive free healthcare, I don't see how you could claim otherwise.

I don't care what's your job, where you'd been fighting and what not. You signed up, for I guess a few reasons. You're doing your job, which involve getting shot at. That's dangerous and brave, but that's what you signed up for.

Uh, how is that unequal? Someone working for the IRS may not get the same health care benefits, but that's because of his own career choice - he could have signed up for the military, but decided not to despite the health care.

I suppose one could argue that the military shouldn't pay for medical treatments that have no relation to the work done, but suggesting that getting shot isn't any different from a sprain limb after doing construction work is pretty daft

:balloon2:

[Evil_Maniac From Mars]

Having a military is not essential for a nation

Yes, it is, and if it isn't immediately, it will be.

[LittleGrizzly]

Yes, it is, and if it isn't immediately, it will be.

Costa Rica seem to have done okay for themselves, and without the expense of an armed forces...

[Evil_Maniac From Mars]

Costa Rica seem to have done okay for themselves, and without the expense of an armed forces...

Fifty years is a paltry amount of time. Eventually they will need a military.


Ignoring the fact that their police force is fairly powerful and retains some military equipment.

[LittleGrizzly]

Im not saying never have a military, But tell me what threat should they be worried about requiring the build up of thier military now ?

If the situation changes in 50 years time sure. As things stand they have saved themsleves 50 years of unnessecary expense, and i see them saving themselves another 50 years of unnesecary expense... all to the benefit of Costa Ricans and the dismay of wargamers and military enthusiasts !

[Adrian II]

Um, Grizz.. who wants Costa Rica? :inquisitive:

[Crazed Rabbit]

Yes, it is, and if it isn't immediately, it will be.

Costa Rica seem to have done okay for themselves, and without the expense of an armed forces...

Only because everyone knows we, the US, won't let them be invaded.

Yes, it is. If the military is the only state organization that receive free healthcare, I don't see how you could claim otherwise.

I don't care what's your job, where you'd been fighting and what not. You signed up, for I guess a few reasons. You're doing your job, which involve getting shot at. That's dangerous and brave, but that's what you signed up for.
Having a military is not essential for a nation, it's essential for the US, because of their honestly war-focused foreign policy and their role as a superpower. That doesn't change the fact that a soldier shouldn't have more rights than the average citizen.

Preposterous. He is not receiving health care. Nor did he agree to be in the military for free. The military agreed to compensate him for his service - with both a salary and complete health insurance.

CR

[LittleGrizzly]

Only because everyone knows we, the US, won't let them be invaded.

During the cold war... its a possibility. Since the collapse of the soviet union theres has been no need for that American threat either.. the sanctions they would get from alot of countrys around the world would make invading Costa Rica not worthwile...

The only country (s) where any sanctions wouldn't make a difference as they are already there would not be able to launch an invasion of Costa Rica anyway, besides North Korea has more pressing concerns... any other country would be so battered by sanctions that even if everyone agreed not to take military action against thier invaders the invasion would be extremely counter productive...

Um, Grizz.. who wants Costa Rica?

The same people who want a cold damp rock just off mainland europe (uk) the evil boogey men who will came and get us if we don't have a military...

[Evil_Maniac From Mars]

Im not saying never have a military, But tell me what threat should they be worried about requiring the build up of thier military now?

Not the most stable of regions, is it?


If the situation changes in 50 years time sure. As things stand they have saved themsleves 50 years of unnessecary expense, and i see them saving themselves another 50 years of unnesecary expense... all to the benefit of Costa Ricans and the dismay of wargamers and military enthusiasts!

It costs a lot to progressively wreck, underfund, or even destroy a military over the course of fifty years and then suddenly be forced to build it back up, as Canada is figuring out right now. When Trudeau and his ilk shattered the military, many people either ignored it or had a similar attitude that you have (oh, we don't really need it now, but if we do in the future...), and now and in the near future they will have to pay the price.

So who pays? It's kind of like my earlier post on the health systems around here. ~;)

[rory_20_uk]

:focus: :whip:

~:smoking:

[Papewaio]

Whilst I agree with this, sadly there's a massive amount of grey between these two cases. Even with these two there's some variance. And it is the case that State would be free?

For example, although most women have boob jobs to, uh, uplift their self image, there are some who have very unequal breasts and this causes significant psycological distress. Then there's post cancer / trauma or even infection.

And if someone is having recurring flare ups of gall stones, it would over time be cheaper to whip it out once and have a 3 day inpatient stay than have attacks every few months requiring far more state resources.

~:smoking:

Essentially if it is elective and not health related (health including psychological as mentioned) then it should be paid by the individual. I would include gall stones within the non-elective state funded side of the equation. If a patient wants there own Dr or single room then that is a user pays (private health) add on.

[Louis VI the Fat]

Bankruptcy, social Darwinism, and the War on the American Middle Class:

NIGHTMARES OF AMERICAN MEDICAL#CARE

As someone who has lived roughly half my life in the United States and half in Canada, and as an economist by profession, I think I can provide a vivid sketch of American healthcare.

There actually is no system.
There is private health insurance for most middle-class people, and the tradition, not a requirement, is that this is paid by your employer as an employee benefit.
Since there are about 1,500 insurance companies looking for this business, the nature and quality of the policies vary immensely.

For a privileged cut of the population – those working for the government and large corporations and legislators – the benefits are very good, and they get excellent medical care.

As you may imagine, the quality and quantity of the benefits goes down as you move down the prestige scale. For a more typical office worker, there will usually be many limits on the policy. Examples: an annual $1500 deductible; a 15-20% deductible for each procedure; and, in some cases, coverage that is as low as 60% of costs.

This is why health care is the single largest cause of personal bankruptcy in the U.S. Inflation in fees and costs by the health-providing industry means that a single-day as an outpatient with some relatively minor procedure – has a full cost on the order of $7,000 when all the bills are in.


I say ‘when all the bills are in’ because the patient for weeks after the procedure will receive bills: from each doctor, from the anesthetist, from the hospital, from laboratories, from the ambulance company, etc. There will be items on your bill, on a long computer list, like $150 for the use of a scissors or $10 for some aspirins in a cup.

Under some insurance policies, you pay and are later reimbursed. This can still cause a cash crunch where the bills are high. Under other policies, the bill you receive will be for the residual after separate billing to your insurance.
In any case, if you do not pay the balance fairly promptly, your file will be turned over to a collection agency who will then hound you daily for the money.
There are invariably disagreements with the insurance company over specifics. You usually have an 800-number where you will often wait a long time to talk to call center about the issue. Because of the complexity of the terms of a given policy, you will have to be well-informed even to discuss your point.
On some policies, even pretty decent ones, you are required to call an 800-number before going to the emergency room to get the insurance companies permission for what you are doing. Otherwise, you will pay the emergency-room bill yourself.

But even for pretty good insurances, typically policies have lifetime limits on benefits. If you are struck with something really seriously expensive, you will reach the end of your benefits.
Note the fact that very good to excellent coverage for upper-middle class and government people effectively silences those who would be active in changing the system.

This is a key reason why the healthcare chaos never becomes a burning political issue. It also provides a lever to be used if someone, as the Clintons did, wants to reform things. Upper middle-class people were directly appealed to, being told in a barrage of ads that the excellent level of their care would be reduced, a very effective ploy.

For many of the privately insured however, benefits range from mediocre to terrible. America has more than forty million with no benefits, but a statistic never given, and more important, is the huge number of under-insured.
Note that you can approach some companies to buy your own insurance if your employer provides none. Because you are not part of pool in these circumstances, your fees will be very high. The benefits are also likely to be poor to mediocre.

The industrial sector of the U.S. has badly declined for decades, and with its decline the opportunity for decent, employer-paid insurance for most working people. The growth sector of the economy is services, and these places typically offer poor or no insurance. Of course, many of these are the infamous McJobs.
People in non-union factory or middling office jobs or much of the service industry get benefits so limited that a serious event can throw them into bankruptcy. This is how the policies, where they are available, are priced low enough for such employers to afford.

There are many other disturbing elements in this national healthcare chaos.
For example, your private health records are in the hands of private insurance companies, and this is marketing information in which they trade for profit.
It is possible for your private health-care information to disqualify you from employment somewhere else.
People with better policies hang desperately on to their jobs for fear of losing coverage in middle-age, just when you most need it.
Morality enters American health care, as some private companies will not cover procedures such as abortion.

You may have a policy with which you are quite satisfied, but for some reason, usually cost-cutting, your employer may change insurers suddenly. You will be faced with a whole new set of qualifiers, requirements, 800-numbers, deductibles, and limits. And this can happen a number of times in your career, and it is very unsettling.

Companies deeply concerned about costs will gradually work their way down from excellent policies to mediocre ones. You must adjust accordingly.
There are hundreds off details not possible to cover outside of a major essay. As an example, not many years ago, if you lost your job, you, in most cases, immediately lost your insurance. Too bad if you or your child had chronic needs. Now, there is a time-limited bridging mechanism – for which you must apply, fill out forms, and pay – that allows you to be insured until you secure your new job with new insurance.

The chaos includes often-impoverished county hospital emergency wards for the really poor. These will still try getting some degree of payment out of you according to your means. In general, the care in such places is poor. There is the Veterans’ Administration system for qualified ex-soldiers. There is Medicare for retired Americans, a system whose benefits are completely inadequate to modern needs. If you retire without a supplemental insurance – either paid by your past employer in a good job or by yourself in other cases – you may face serious problems.

There is the Medicaid system for poor Americans. It is an extremely complex system, and the extent and nature of benefits vary considerably from state to state. If you move from one state to another you can lose coverage for the services you were using before. Again, depending on the state, you may be required to make co-payments for services. You really do have to be needy to qualify for benefits, and your means are examined in detail. For some Medicaid services, officials are entitled to recover expenses from a beneficiary’s estate.
Private hospitals in the U.S. – generally the best but not always – are in various jurisdictions required to take a certain quota of non-insured patients. This quota is never generous. The cost of this effectively gets dumped onto the insured, increasing the cost of insurance.

This also leads to some bizarre results. Suppose you are an uninsured person picked up on the street by an ambulance after an accident. The ambulance will be calling ahead to the nearest hospital to see whether they can take another uninsured. If the answer is no, another hospital is called. This continues until there is a taker, however, by that time, you may expire in the ambulance, a not uncommon event.
Imagine the horrors as an uninsured person, whether a citizen or a visitor from abroad, of getting mugged in the United States? First, there is the horror of the mugging or rape or assault, and then the horrors of dealing with the Medical Kremlin.

This brief review gives you a realistic sketch of healthcare in America. If you are young and healthy, you need not be overly concerned. Of course, it is precisely the pool of young and healthy people that insurers love, because their employers pay but the employees don’t use many benefits. That is why institutions like the high-tech industry or huge multi-national corporations have such good policies. They get used comparatively little.
Note the fact that very good to excellent coverage for upper-middle class and government people effectively silences those who would be active in changing the system.

This is a key reason why the healthcare chaos never becomes a burning political issue. It also provides a lever to be used if someone, as the Clintons did, wants to reform things. Upper middle-class people were directly appealed to, being told in a barrage of ads that the excellent level of their care would be reduced, a very effective ploy.


The entire ‘system’ segments the population into many different pools, from low risk with excellent benefits to high risk with terrible benefits. It truly is medical Social Darwinism, organized by lawyers and financiers.link (http://chuckmanwords.wordpress.com/2009/06/06/nightmares-of-american-medical-care/)

[Louis VI the Fat]

Do you dislike socialised healthcare? Do you insist on individual freedom? Then don't take your cue from socialist countries like Canada and the UK. There are other options:
An understanding of how France came to its healthcare system would be instructive in any renewed debate in the United States.

That's because the French share Americans' distaste for restrictions on patient choice and they insist on autonomous private practitioners rather than a British-style national health service, which the French dismiss as "socialized medicine."link (http://www.boston.com/news/globe/editorial_opinion/oped/articles/2007/08/11/frances_model_healthcare_system/)

[Proletariat]

Hm, great article. If this thing is inevitable for America, than I hope we go with the French style, if anything at all.

[ICantSpellDawg]

Do you dislike socialised healthcare? Do you insist on individual freedom? Then don't take your cue from socialist countries like Canada and the UK. There are other options:link (http://www.boston.com/news/globe/editorial_opinion/oped/articles/2007/08/11/frances_model_healthcare_system/)


While it gets into very sparse detail, the article makes the system sound promising - especially after they find a way to cut it off from payroll taxes.

[Louis VI the Fat]

While it gets into very sparse detail, the article makes the system sound promising The nice people over at the embassy translate lots of stuff for curious Americans.

http://ambafrance-us.org/IMG/pdf_Universal_Health_Insurance_in_France_How_Sustainable.pdf

Not all is rosy, of course. As the questions about sustainability above and the more brief and factual article below show.

France is often seen by liberals as the ideal system. It has universal health care, with few waiting lists. France has the highest level of satisfaction with their health care among all European countries. How can this be? What is their secret?

France provides a basic, universal health insurances through large occupation-based funds. The General National Health Inusrance Scheme covers 83% of French workers, while other occupational specific (e.g.: for agricultural workers, for the self employed, for miners, etc.) cover the remainder. About 99% of individuals are covered by this universal health insurance system.
However, France utilizes more market-based ideas than most people realized. Copayment rates for most services are 10%-40%. About 92% of French residents have complementary private health insurance.

In essence, the French system avoids widespread rationing because, unlike true single-payer systems, it employs market forces. Even the OECD says that the “proportion of the population with private health insurance” and the degree of cost sharing are key determinants of how severe waiting lists will be.
Insured. About 99% of French residents are covered by the national health insurance scheme.
Cost. France is the third most expensive health care system (~11% of GDP). http://healthcare-economist.com/2008/04/14/health-care-around-the-world-france/

[Beskar]

The thing about waiting lists is that they need to build more hospitals to meet the demand and also that fact everybody can get healthcare treatment, opposed to people simply not getting any treatment as they can't afford it.

[Adrian II]

Not all is rosy, of course. As the questions about sustainability above and the more brief and factual article below show.The French system is very expensive and probably unaffordable in the long term. Besides, drug prescription and use in France are insanely (and irresponsibly) high. On the plus side, the availability and 'bedside manner' of French doctors are exemplary and chronic diseases like for instance diabetes are fully covered under the system.

Like I said before, health is a common good just like public order or fire prevention. It only works well if it works for everybody. And the key to a good system is socialised funding, not socialised medicine (or state medicine).

[Strike For The South]

We spend a trillion dollars on various programs and have nothing to really show for it. Quite frankly that's retarded.

What we're doing is not working and anyone who can't see that is either and idoit or an imbecile.

How we fix the problem is a whole nother problem entirely but I think we can start with some common sense solutions.

I agree with Adrian; for everyone or no one. One of our problems is all our bloated programs which hamstring everyone and only cater to a few people who fit a mold that is probably outdated.
-

[Lemur]

Let's not forget the bureaucratic overhead incurred by all of these organizations trying to shift the costs off onto each other. Can't find the linkie, but I clearly recall reading that something between 7%–10% of all healthcare costs are created by this shuffle.

I know this: Costs are rising geometrically, and neither the nurses, doctors or patients are seeing that money. Too many parasites.

[ICantSpellDawg]

The French system is very expensive and probably unaffordable in the long term. Besides, drug prescription and use in France are insanely (and irresponsibly) high. On the plus side, the availability and 'bedside manner' of French doctors are exemplary and chronic diseases like for instance diabetes are fully covered under the system.

Like I said before, health is a common good just like public order or fire prevention. It only works well if it works for everybody. And the key to a good system is socialised funding, not socialised medicine (or state medicine).

I agree to some extent. The Common good is best served by individual responsibility and consumer choice. Find a way to make that happen and we may find more common ground.

[Adrian II]

The Common good is best served by individual responsibility and consumer choice.With all due respect, this thread has advanced beyond slogans. We are talking about the pros and cons of certain systems such as the French one. There is a wealth of English language information about it. So why don't you read up on it and join us?

[Lemur]

The AMA reverses its position. Again (http://cnnwire.blogs.cnn.com/2009/07/01/ama-president-group-open-to-government-funded-insurance/).


The new president of the American Medical Association, which represents the interests of the nation’s doctors, said Wednesday the group is open to a government-funded health insurance option for people without coverage.

Dr. J. James Rohack told CNN that the AMA supports an “American model” that includes both “a private system and a public system, working together.”

In May, the AMA told a Senate committee it did not support a government-sponsored public health insurance option.

[Xiahou]

The AMA reverses its position. Again (http://cnnwire.blogs.cnn.com/2009/07/01/ama-president-group-open-to-government-funded-insurance/).


The new president of the American Medical Association, which represents the interests of the nation’s doctors, said Wednesday the group is open to a government-funded health insurance option for people without coverage.

Dr. J. James Rohack told CNN that the AMA supports an “American model” that includes both “a private system and a public system, working together.”

In May, the AMA told a Senate committee it did not support a government-sponsored public health insurance option.
I wonder what sort of blackmail that involved?

[Hosakawa Tito]

I've been hearing about this local situation (http://www.buffalonews.com/home/story/721335.html) on talk radio for several days now from the health care debate side as well as the "everybody needs a passport, enhanced driver ID" border control side. It's finally been reported in the local paper so I could provide a link.
Thank goodness the Border Patrol does have flexibility in enforcement for these type of emergencies, and hopefully this particular case has a happy ending.

Ontario is Canada's most populous province, and I find it troubling that this type of situation arises as frequently as it does. It receives more press now than in the past because of the need for passports, passport cards or enhanced driver ID's, where in the past all one had to do is verbally declare their residence and move on.

Whatever the outcome of the drive to change the US healthcare system I hope we don't end up with too many situations like this on our side of the border.

[Adrian II]

Whatever the outcome of the drive to change the US healthcare system I hope we don't end up with too many situations like this on our side of the border.I dont buy your talk radio stuff. Every time I speak to American friends lately, I thank heaven that we don't have your health care system over here. The mere thought that I might develop a cancer or a heart condition and my entire family would go broke because, hey, the insurance company just retracted some clause or cut my entitlement on some technicality... I'd rather die without treatment than see my family go bankrupt and end up in the gutter. The New York Times had some harrowing stories (http://www.nytimes.com/2009/07/01/business/01meddebt.html?pagewanted=2&_r=1&partner=rss&emc=rss) yesterday, and there must be many millions, judging by the figures. A friend of mine in New York just lost his job and insurance, then lost his leg in an accident. Since he had a small melanoma that was removed twenty years ago, no US insurance company will admit him for a decent premium.

What does your talk radio say about people like him?

EDIT

Another beauty here: six out of ten Americans skip or delay health care for financial reasons.


Apreil 2009 - The April Kaiser Health Tracking Poll finds that six in ten Americans continues to say that they or a member of their household have delayed or skipped health care in the past year. A solid majority of the public believes health care reform is more important than ever because of current economic problems.

The country’s overall economic problems have not dampened their interest in pursuing health care reform: a solid majority of the public (59%) believes health care reform is more important than ever compared with the thirty-seven percent who say we can’t afford health reform because of economic problems.

The most common actions taken due to costs were substituting home remedies or over-the-counter drugs for doctors visits (42%) and skipping dental care or check ups (36%). Additionally, three in ten (29%) did not fill a prescription for medicine and two in ten (18%) cut pills in half or skipped doses.And what do you think will happen in the majority of these cases? The health issues will pop up in worse form and require much more expensive treatment. Way to go, guys.

I wonder how many people in the US are calculating right now: shall I get that essential treatment this year and sell my home to pay for it, or shall I die and let my family inherit the home?

[Lemur]

Wal-Mart comes down in favor of the Obama plan, whatever it turns out to be. Interesting (http://www.walletpop.com/blog/2009/07/06/wal-mart-eyes-super-savings-by-backing-obamas-health-care-p/).

[Xiahou]

Wal-Mart comes down in favor of the Obama plan, whatever it turns out to be. Interesting (http://www.walletpop.com/blog/2009/07/06/wal-mart-eyes-super-savings-by-backing-obamas-health-care-p/).Sounds like they're betting on it not happening and trying to ride a good PR wave in the mean time....
"We are entering a critical time where those of us who will be asked to pay for health care reform will have to make a choice on whether to support this legislation. The choice will require employers to consider the trade off of a coverage mandate and higher taxes for the promise of a reduction in health care cost increases. We also believe that a mandate must be accompanied by provisions that will reduce health costs and dramatically improve the value we get for our health care dollar.

"And the promise of savings in the bill must be more than just words. The bill should contain 'trigger' provisions that guarantee that promised savings take place both for the federal government and for employers who provide insurance. Walmart believes that if we support a mandate and are being asked to pay higher taxes, we should be assured in return, that savings will be real."

[Crazed Rabbit]

Wal-Mart comes down in favor of the Obama plan, whatever it turns out to be. Interesting (http://www.walletpop.com/blog/2009/07/06/wal-mart-eyes-super-savings-by-backing-obamas-health-care-p/).

What a fabulous way to get rid of all your small-store competitors with the extra government costs and regulations.

CR

[rory_20_uk]

What a fabulous way to get rid of all your small-store competitors with the extra government costs and regulations.

CR

"But the mandate doesn't require small businesses to provide health insurance"

The article even states this. Talk about a knee jerk response...

~:smoking:

[Major Robert Dump]

Sounds like they're betting on it not happening and trying to ride a good PR wave in the mean time....

No, they hope it will cause the other retailers to go broke, since they already offer more insurance than most retail companies and for all intents halfway there when it comes to the Obama plan and all the others will have to play catch-up. It's the Wal-Mart way.

[Melvish]

If I remember right, Canada has the best healthcare in the world.

It use to be in the 70's and 80's (good old days: no waiting time & all drugs are covered) but in the last 2 decades it came crashing down because of all of the abuse the system had taken. Irresponsible change by the governments (like the flawed Private&Public partnership) and ... how to say this without sounding too xenophobic : lots of peoples came to Canada, get welfare while they stayed then get threaded for free then move away to a sunnier country or stay and 'enjoy' a life on welfare (the money is waisted on them because they don't pay taxes). There is also lack of doctors: get free education then leave the country and make big buck and enjoy easier work down south. Sometime i think we should do like the military: we pay your education but you have to give X years of service to the community in return (of course peoples who pay for their education are free to go where-ever they wish).

[Evil_Maniac From Mars]

Irresponsible change by the governments (like the flawed Private&Public partnership)

:inquisitive: If I recall correctly, Alberta, which uses a partnership similar to this, is one of the better provinces in Canada for healthcare.

[Melvish]

:inquisitive: If I recall correctly, Alberta, which uses a partnership similar to this, is one of the better provinces in Canada for healthcare.

Yes they fixed the biggest flaws by using strong regulations.
One of the flaw i was making allusion is like : private clinics giving higher priority for botox injection than cancer screening test because the former net bigger profit.

The biggest problem we face now is that a vast proportion of doctor leave Canada, so the waiting time are very long and finding a family doctor is near impossible.

585 doctors departed in one year (http://www.mult-sclerosis.org/news/Aug2000/DoctorsLeavingCanada.html)

[Crazed Rabbit]

Yes they fixed the biggest flaws by using strong regulations.
One of the flaw i was making allusion is like : private clinics giving higher priority for botox injection than cancer screening test because the former net bigger profit.

The biggest problem we face now is that a vast proportion of doctor leave Canada, so the waiting time are very long and finding a family doctor is near impossible.


Gee, almost sounds like a failure of the system.:inquisitive:


"But the mandate doesn't require small businesses to provide health insurance"

The article even states this. Talk about a knee jerk response...

Well, not now. And just how small is small? 10 employees, 50, 100?

Any way, it's going to hurt their smaller competitors. Like regional chains that liberals in the US are always whining are getting driven out of business by Walmart. And then said idiots demand a slew of more regulations that will hamper the smaller stores more than Walmart.

CR

[ICantSpellDawg]

I think that we can all agree that healthcare in the US is broken and needs to be reformed. Very few people don't believe that there is a major problem with our system. As I don't see health-care as a God provided right, but rather a recent man-made privelage, I expect that there would be problems with a modern system that would cover 300 million people without stealing from the wealthy to pay for people who don't care enough to provide for themselves or their families.

We all agree, but where some of us are open to keeping the problems going - but stealing a rich man's wallet to pay for the system, others recognize that the underlying problems need to be resolved before "who is paying" will matter in the long term.

We don't know what we are paying for. Simply using someone elses money to pay for it as a solution is just adding to the the inequity and long term unsustainability of the system. Lets resolve the issues that can be resolved in short order. Once this happens, we can leave it up to the States like we leave auto and home insurance etc; some have State backed options, others don't.

We are starting to rely on hairbrained, massive, unread, partisan, treatises as legislation. Peoples hired hands don't even read the bills anymore. We are spending more money on things that we understand less in the hopes of solving problems.

[Crazed Rabbit]

In the UK, some people are suggesting (http://news.bbc.co.uk/2/hi/health/8156279.stm) a fee for visiting the doctor:

The Social Market Foundation said the only way for the NHS to cope was to raise taxes to put more money into the system, limit demand or work more effectively.

The NHS is already looking to make savings and the think-tank said there was little appetite for tax rises.

Instead, they said charging for GPs would be a good way to reduce demand.

Report author David Furness said: "It would get people thinking twice about whether the visit was essential.

"If we don't introduce rationing like this, there will be rationing by stealth through waiting lists, crumbling hospitals and poor quality services."

CR

[Lemur]

The truth, which I've never seen any politician admit, is that rationing of some sort is not only inevitable, it's already in place. Everywhere. The only question is how do you implement it.

[Xiahou]

The truth, which I've never seen any politician admit, is that rationing of some sort is not only inevitable, it's already in place. Everywhere. The only question is how do you implement it.
If I can buy as much of something as I can afford, it's not rationing... or am I missing your meaning?

Edit:
Unsurprisingly, the current Democrat proposal is basically a turd (http://www.washingtonpost.com/wp-dyn/content/article/2009/07/16/AR2009071602242.html).
Though President Obama and Democratic leaders have repeatedly pledged to alter the soaring trajectory -- or cost curve -- of federal health spending, the proposals so far would not meet that goal, Elmendorf said, noting, "The curve is being raised." His remarks suggested that rather than averting a looming fiscal crisis, the measures could make the nation's bleak budget outlook even worse. That completely undercuts the administration's argument for hurriedly ramming this bill through Congress. According to the CBO, the cost of doing nothing would indeed be cheaper than rushing through the current proposals- not the other way around, as has been suggested.

If we're going to do this, can we at least take some time and try to put a little thought into it? How many times are artificial deadlines and threats of impending doom going to be used to rush bills through Congress (often before they can even be read)?

[Lemur]

If I can buy as much of something as I can afford, it's not rationing... or am I missing your meaning?
Unless you are independently wealthy and wish to blow your fortune on medical treatment, your healthcare choices are rationed by your insurance company.


According to the CBO, the cost of doing nothing would indeed be cheaper than rushing through the current proposals- not the other way around, as has been suggested.

If we're going to do this, can we at least take some time and try to put a little thought into it?
Sounds good to me. Where are the experts, the visionaries, the eggheads who can really examine this problem? Shouldn't there be blue-ribbon commissions or something, or are we already past that? Rushed, sloppy reform sounds worse than no reform at all.

As broken and untenable as I think our current system is, I despair of the congresscritters improving on it.

[Hosakawa Tito]

Unless you are independently wealthy and wish to blow your fortune on medical treatment, your healthcare choices are rationed by your insurance company.


Sounds good to me. Where are the experts, the visionaries, the eggheads who can really examine this problem? Shouldn't there be blue-ribbon commissions or something, or are we already past that? Rushed, sloppy reform sounds worse than no reform at all.

As broken and untenable as I think our current system is, I despair of the congresscritters improving on it.

The best way to achieve that is to demand the congresscitters to be in it. same with their pension plan & cola's.

[ICantSpellDawg]

Unless you are independently wealthy and wish to blow your fortune on medical treatment, your healthcare choices are rationed by your insurance company.


Sounds good to me. Where are the experts, the visionaries, the eggheads who can really examine this problem? Shouldn't there be blue-ribbon commissions or something, or are we already past that? Rushed, sloppy reform sounds worse than no reform at all.

As broken and untenable as I think our current system is, I despair of the congresscritters improving on it.


I've never had my treatment "rationed". I spend around $800 a month (Plan, Meds, co-pays, etc) and get whatever I need. I get numerous procedures every year. Empire blue Cross has been pretty good. I'm worried because I can't pay more than $800 per month and the rate of increase is faster than I am earning by a mile.

Health Care is broken partially because of adverse selection in the private system, partially because there is a veil over the prices that have an indirect but eventual impact on premium.

The system is broken because the care is becoming too expensive for anyone to afford. There is no magic bullet to solve this. Make a government plan and you've gotten rid of adverse selection, but they have no intention of increasing transparency, which will just mean that in a few years we have an even more broken government plan.

[Lemur]

A coherent political analysis (http://swampland.blogs.time.com/2009/07/20/dr-no/) from Klein:


There are problems with the Democrats' approach to health care. It places too much of a burden on employers. The House bill is quite deficient when it comes to changing the incentives for doctors and hospitals (which is the only real hope for controlling costs). But the Republicans have absolutely no credibility on this issue. Indeed, they have spent 30 years allowing the current system to deteriorate or actively making it worse (caving to Pharma on the Medicare drug plan, for example).

This is the moment for the Democrats to demonstrate that they can lead and legislate. If they can't bring this off, they will--rightly--be back in electoral trouble before long.

[KukriKhan]

So. Just watched POTUS's Kabuki press conference, where he said that Doc's over-prescribe drugs and treatment based on compensation schedules, and that Big Pharma overcharges by 50%, based on their recent cave-in to reduce drug costs. Oh, and suggested that a blue-ribbon panel of unelected, administration-appointed medical experts outta decide what treatment should be provided to what patient, and that he, being POTUS, would not reduce his personal medical plan to a level commensurate with that of an "average" American. And that the reason for the big hurry is that if you don't set deadlines "in this town (DC)", things never get done.

Since the bills are still being crafted in congressional commitees and aren't even on the floor for vote (and therefore details are still speculative and negotiable) I can only regard this media event as not directed at me at all, but rather to the congresscritters.

Q: Do we (citizens and taxpayers) pay for this network coverage? I watched it on C-Span, which I pay for on my cableTV bill.

Maybe a day will come when a POTUS will have a press conference where mid-question by Helen, POTUS will say "And by the way, have you made a will yet? Go to LegalDocuments.com for a cheap, state-recognized document. Meanwhile, Helen, as to Iran....".

Q: Did POTUS O sell health care reform to the citizens?

[Crazed Rabbit]

My dad heard about one provision where, after age 65 and every five years thereafter, you'd have to meet some government appointee and get counseling or something on your health. Needless to say, he is not pleased with that kind of crap.


Oh, and suggested that a blue-ribbon panel of unelected, administration-appointed medical experts outta decide what treatment should be provided to what patient

More stupid government enforced decisions, here we come!

One problem is states deciding what has to be included in health insurance plans, taking choices away from the consumer, and forbidding (IIRC) people to buy health insurance from companies in other states. And rules limiting how much more companies can charge unhealthy lifestyle people. Because giving people choices about what they want to buy and letting there be incentives to be healthy is much too rational for the dems!
:wall:
CR

[Hosakawa Tito]

So. Just watched POTUS's Kabuki press conference, where he said that Doc's over-prescribe drugs and treatment based on compensation schedules, and that Big Pharma overcharges by 50%, based on their recent cave-in to reduce drug costs. Oh, and suggested that a blue-ribbon panel of unelected, administration-appointed medical experts outta decide what treatment should be provided to what patient, and that he, being POTUS, would not reduce his personal medical plan to a level commensurate with that of an "average" American. And that the reason for the big hurry is that if you don't set deadlines "in this town (DC)", things never get done.

Since the bills are still being crafted in congressional commitees and aren't even on the floor for vote (and therefore details are still speculative and negotiable) I can only regard this media event as not directed at me at all, but rather to the congresscritters.

Q: Do we (citizens and taxpayers) pay for this network coverage? I watched it on C-Span, which I pay for on my cableTV bill.

Maybe a day will come when a POTUS will have a press conference where mid-question by Helen, POTUS will say "And by the way, have you made a will yet? Go to LegalDocuments.com for a cheap, state-recognized document. Meanwhile, Helen, as to Iran....".

Q: Did POTUS O sell health care reform to the citizens?

I didn't listen to the speech, but from what I've heard from news commentators who critiqued it afterwards....no details just rhetoric & politician-ese. Some of the alleged details that have been talked about sound quite disturbing, and if true, means either POTUS O hasn't read the thing or he's not being honest. Like:

People with private plan coverage get to keep it. "Alleged detail" - If the terms of the private plan are changed then you are required to drop it and must be enrolled in the public option, thereby eventually squeezing out private plans.

End of life medical decisions....dodgy evasive answers that say a whole lot of nothing. "Alleged detail" - Your 80 year old grandmother's need for surgery *let's say a knee-joint replacement* will be determined by bureaucrats who will decide if she's worthy of the cost.

Tort reform....not a peep. Doctors pay huge premiums to protect themselves against lawsuits. They also prescribe many expensive diagnostic tests & procedures whose sole purpose is to CYA to avoid culpability in unforeseen medical malpractice suits.

Medicare & medicaid. The guvment hasn't fixed these programs to make them financially viable into the future, but we need to rush this new legislation through with little to no time to actually read and comprehend what it entails. Why?

My biggest pet peeve - Our legislators private health coverage will not be affected by any of this health reform. Like their 100% pensions & yearly cost of living increases that are vested after one measly term in office, they are safely insulated from any effects of the health plan legislation they determine is best for the rest of us. You want them to get this right and fix health care then they have to be in it.

[ICantSpellDawg]

Obama is empty. Its pointless to listen to him, unless you want to understand an issue less.

Last night was more of the same. "Our plan will save money - Republicans are politicians who would rather attack me than save you money. This isn't about me. Saving money is good because it saves you money"

His described rationale is a nightmare.

[Xiahou]

I thought this (http://www.politico.com/news/stories/0709/25315.html) was a fun analysis of Obama's healthcare talk. I snickered a couple times.... :beam:

Obama: Things Stink
—Barack Obama has seen the present, and it doesn’t work.

In the present, we all go broke. In the present, our health care “premiums and out-of-pocket costs will continue to skyrocket.”

In the present, “if we don’t act, 14,000 Americans will continue to lose their health insurance every single day. These are the consequences of inaction. These are the stakes of the debate that we’re having right now.”

So said Obama Wednesday night in a news conference. And make no mistake, the present stinks because the past stank.

In the past, an (unidentified) Republican administration left Obama and the nation with a “$1.3 trillion annual deficit” as kind of an inheritance tax. And now Obama must deal with it.

How will he do this while at the same time providing 97 to 98 percent of the American people with state-of-the-art, affordable health care that they can never lose even if they lose their jobs or get sick?

He will do this by eliminating waste, fraud and abuse in the health care system. He will do this by making health care more efficient.

That’s the future. The future is really going to be sweet. And we’re not even going to have to wait that long for it.

“We will pass reform that lowers cost, promotes choice and provides coverage that every American can count on,” Obama said. “And we will do it this year.”

Obama understands that upon hearing this, some of you may grow “anxious” or “skeptical” or “cynical.” He even understands that you might feel “queasy.”

Fight those feelings. And fight the impression that every president promises to eliminate waste, fraud and abuse and yet those things remain with us.

President Obama promises something else: He will soak the rich. Getting rid of waste, fraud and abuse will pay for only two-thirds of his health care plan. The remaining third will be paid for by limiting “the itemized deductions for the wealthiest Americans.”

What about the S-word? What about “sacrifice” for the rest of us? Happily, the future contains no such need.

Jake Tapper of ABC News specifically asked Obama about sacrifice and whether ordinary Americans will have to “give up some things” in order to enjoy the enormous benefits Obama is promising.

“They will have to give up paying for things that don’t make them healthier,” Obama said. “If there is a blue pill and a red pill and the blue pill is half the price and works just as well right now, why not pay half-price?”

Why not indeed? And so all we have to do is find a whole lot of blue pills.

But don’t worry, we will. And they won’t cost much. “We inherited an enormous deficit,” Obama said. But “health care reform will not add to the deficit; it is designed to lower it.”

And as it is designed, so it shall be. Because that is the way of Washington, isn’t it?

I admit that the promise of enormous benefits at little or no cost — the deficit will actually shrink! — makes me a little “anxious,” “skeptical,” “cynical” and “queasy.” Perhaps it makes you feel the same way.

But what choice do we have? The past is a mess. The present stinks. And the future?

Well, if there is one political promise you can believe, it is this one: Our future is ahead of us.

Feel better?

[Louis VI the Fat]

providing 97 to 98 percent of the American people with state-of-the-art, affordable health care that they can never lose even if they lose their jobs or get sick?How did America get to a state where it is considered hilarious satire to suggest health care for...the sick?

I think Obama is on the right track. The man has three great qualities: he has a 'can do' mentalitity, he has a knack for finding the right advisors to surround himself with, and he is a natural born salesman who can pitch his policies. Obama might just succeed in giving back the American middle class such 'outlandish' amenities as access to health care for the actual sick.

I think Obama knows where the problem's at. A liberal use of the rod for those with their snout in the through sounds like just the ticket. Every international comparison shows Americans pay much more for much less actual healthcare. It is time to give the money back to the American people.

The rich, for their part, will have to get used to the fact that if a person falls ill at the age of twenty five, it is not his family's income and inherited fortune that decides whether he'll be a productive citizen or be doomed to poverty. That America can be the land of opportunity again. Instead of the country with the lowest social mobility in the entire developed world. I support anything that returns America to its middle class. Obama's effort to overhaul health care seems a good start.

[Don Corleone]

I find it interesting, Louis, that you selected a 25 year old man, for your narrative. Much of your vaunted universal health care system includes rationing, and employs metrics which heavily favor the young, not necessarily the deserving or those able to pay for their own treatment, no?

[ICantSpellDawg]

Great article by Peggy Noonan, as always.


Common Sense May Sink ObamaCare

It turns out the president misjudged the nation’s mood.


By PEGGY NOONAN


This is big, what’s happening. President Obama appears to have misstepped on a major initiative and defining issue. He has misjudged the nation’s mood, which itself is news: He rose from nothing to everything with the help of his fine-tuned antennae. Resistance to the Democratic health-care plans is in the air, showing up more now on YouTube than in the polls, but it will be in the polls soon enough. The president, in short, may be facing a real loss. This will be interesting in a number of ways and for a number of reasons, among them that we’ve never seen him publicly defeated before, because he hasn’t been. So we may be entering new territory, with new struggles shaped by new dynamics.

His news conference the other night was bad. He was filibustery and spinny and gave long and largely unfollowable answers that seemed aimed at limiting the number of questions asked and running out the clock. You don’t do that when you’re fully confident. Far more seriously, he didn’t seem to be telling the truth. We need to create a new national health-care program in order to cut down on government spending? Who would believe that? Would anybody?

The common wisdom the past week has been that whatever challenges health care faces, the president will at least get something because he has a Democratic House and Senate and they’re not going to let their guy die. He’ll get this or that, maybe not a new nationalized system but some things, and he’ll be able to declare some degree of victory.

And this makes sense. But after the news conference, I found myself wondering if he’d get anything.

I think the plan is being slowed and may well be stopped not by ideology, or even by philosophy in a strict sense, but by simple American common sense. I suspect voters, the past few weeks, have been giving themselves an internal Q-and-A that goes something like this:

Will whatever health care bill is produced by Congress increase the deficit? “Of course.” Will it mean tax increases? “Of course.” Will it mean new fees of fines? “Probably.” Can I afford it right now? “No, I’m already getting clobbered.” Will it make the marketplace freer and better? “Probably not.” Is our health care system in crisis? “Yeah, it has been for years.” Is it the most pressing crisis right now? “No, the economy is.” Will a health-care bill improve the economy? “I doubt it.”

The White House misread the national mood. The problem isn’t that they didn’t “bend the curve,” or didn’t sell it right. The problem is that the national mood has changed since the president was elected. Back then the mood was “change is for the good.” But that altered as the full implications of the financial crash seeped in. The crash gave everyone a diminished sense of their own margin for error. It gave them a diminished sense of their country’s margin for error. Americans are not in a chance-taking mood. They’re not in a spending mood, not after the unprecedented spending of the past year, from the end of the Bush era through the first six months of Obama. Here the Congressional Budget Office report that a health care bill would not save money but would instead cost more than a trillion dollars in the next decade was decisive. People say bureaucrats never do anything. The bureaucrats of CBO might have killed health care.

The final bill, with all its complexities, will probably be huge, a thousand pages or so. Americans don’t fear the devil’s in the details, they fear hell is. Do they want the same people running health care who gave us the Department of Motor Vehicles, the post office and the invasion of Iraq?

Let me throw forward three other things that I suspect lessen , or will lessen, support for full health-care reform, two of them not quantifiable.

The first has to do with the doctors throughout the country who give patients a break, who quietly underbill someone they know is in trouble, or don’t charge for their services. Also the emergency rooms that provide excellent service for the uninsured in medical crisis. People don’t talk about this much because they’re afraid if they do they’ll lose it, that some government genius will come along and make it illegal for a doctor not to charge or a hospital to fudge around, with mercy, in its billing. People are afraid of losing the parts of the system that sometimes work—the unquantifiable parts, the human parts.

Second, and this is big, some of the bills being worked on in Congress will allow for or mandate taxpayer funding of abortion. Speaking only and narrowly in political terms, this is so ignorant as to be astounding. A good portion of the support for national health care comes from a sort of European Christian Democrat spirit of community, of “We are all in this together.” This spirit potentially unites Democrats, leftists, some Republicans and GOP populists, the politically unaffiliated and those of whatever view with low incomes. But putting abortion in the mix takes the Christian out of Christian Democrat. It breaks and jangles the coalition, telling those who believe abortion is evil that they not only have to accept its legality but now have to pay for it in a brand new plan, for which they’ll be more highly taxed. This is taking a knife to your own supporters.

The third point is largely unspoken but I suspect gives some people real pause. We are living in a time in which educated people who are at the top of American life feel they have the right to make very public criticisms of . . . let’s call it the private, pleasurable but health-related choices of others. They shame smokers and the overweight. Drinking will be next. Mr. Obama’s own choice for surgeon general has come under criticism as too heavy.

Only a generation ago such criticisms would have been considered rude and unacceptable. But they are part of the ugly, chafing price of having the government in something: Suddenly it can make big and very personal demands on you. Those who live in a way that isn’t sufficiently healthy “cost us money” and “drive up premiums.” Mr. Obama himself said something like it in his press conference, when he spoke of a person who might not buy health insurance. If he gets hit by a bus, “the rest of us have to pay for it.”

Under a national health-care plan we might be hearing that a lot. You don’t exercise, you smoke, you drink, you eat too much, and “the rest of us have to pay for it.”

It is a new opportunity for new class professionals (an old phrase that should make a comeback) to shame others, which appears to be one of their hobbies. (It may even be one of their addictions. Let’s stage an intervention.) Every time I hear Kathleen Sebelius talk about “transitioning” from “treating disease” to “preventing disease,” I start thinking of how they’ll use this as an excuse to judge, shame and intrude.

So this might be an unarticulated public fear: When everyone pays for the same health-care system, the overseers will feel more and more a right to tell you how to live, which simple joys are allowed and which are not.

Americans in the most personal, daily ways feel they are less free than they used to be. And they are right, they are less free.

Who wants more of that?

[woad&fangs]

Does anyone know where I can find a copy of the health care bill? I saw a list of "O NOZE, LOOK WHAT TEH EVIL DEMS PUT IN HERE!!!", and I wanted to see how much of it was true. Specifically, it said that page 241 contains a part that mandates all doctors be paid the same, regardless of specialty. I really hope that is not the case, as there are much better ways of dealing with the shortage of primary care physicians.

Also, has there been any talk at all about how to solve the issue of supply? Any succesfull reform of insurance and medical costs will inevitably increase demand for the health care system. In order for reform to work, many more doctors, nurses, and technologists must be trained. Unfortunately, the next couple of years are going to be awfull no matter what because it will take several years for future nurses to earn their degrees and 8 years before the current crop of high school graduates can graduate from Med school.

[Lemur]

Does anyone know where I can find a copy of the health care bill? I saw a list of "O NOZE, LOOK WHAT TEH EVIL DEMS PUT IN HERE!!!", and I wanted to see how much of it was true.
Last I heard, there was one bill in the House and two in the Senate, each on 1,000+ pages long. I doubt there's a human being on Earth who knows exactly what's in each one, especially given that they're being debated and amended right now.

[Crazed Rabbit]

Last I heard, there was one bill in the House and two in the Senate, each on 1,000+ pages long. I doubt there's a human being on Earth who knows exactly what's in each one, especially given that they're being debated and amended right now.

Which is why for the sake of common sense it shouldn't be rushed through. To me, it speaks ill of a desire for real leadership on Obama's part if he wants it rammed through.

CR

[Banquo's Ghost]

There's a difference between "ramming" something through and trying to maintain momentum against powerful status quo forces that are playing for a humiliation which will rob the president of the influence necessary to change things.

This seems to be the ultimate Achilles heel of the greatest democracy - along with the bizarre ability to add pork amendments - the legislature seems utterly incapable of constructive debate to find solutions. It seems to me any bill that breaks the barricades will be a victory (especially if it challenges the insurance industry to innovate) and in normal democracies, that would be the start of further amendments to make the thing ever better. FUD is no substitute for governance.

It just appals me that anyone can think Third World healthcare of this magnitude (http://www.guardian.co.uk/world/2009/jul/26/us-healthcare-obama-barack-change) is worth defending.

I will never forget the astonishment I felt on reading Lemur's post some while back. An intelligent professional avoiding being checked for tetanus and infection because he was wary of the possible bill. Insanity for any country, let alone the leading economy. Adrian, as ever, is dead right.

[Ironside]

Well put Banquo, I was thinking something simular, but couldn't formulate it as eloquent. :bow:

I'll just add, if this reform fail, when will someone attemt on it again? I'll suspect that Obama will have to deal with bedget sanitation the next few years and the next election will probably be about the debt. That's about 5-6 years, but probably earliest two elections from now, so 2016. And as two presidents have failed, unless the system is on the brink of collapse, that president won't touch it either. So about 2020 at earliest?

[Husar]

all so they can satisfy their Wall Street investors.

Happens again and again that "customers" get dumped or tricked or whatever just to please the shareholders. :thumbsdown:

[ICantSpellDawg]

There's a difference between "ramming" something through and trying to maintain momentum against powerful status quo forces that are playing for a humiliation which will rob the president of the influence necessary to change things.

This seems to be the ultimate Achilles heel of the greatest democracy - along with the bizarre ability to add pork amendments - the legislature seems utterly incapable of constructive debate to find solutions. It seems to me any bill that breaks the barricades will be a victory (especially if it challenges the insurance industry to innovate) and in normal democracies, that would be the start of further amendments to make the thing ever better. FUD is no substitute for governance.

It just appals me that anyone can think Third World healthcare of this magnitude (http://www.guardian.co.uk/world/2009/jul/26/us-healthcare-obama-barack-change) is worth defending.

I will never forget the astonishment I felt on reading Lemur's post some while back. An intelligent professional avoiding being checked for tetanus and infection because he was wary of the possible bill. Insanity for any country, let alone the leading economy. Adrian, as ever, is dead right.


We need a blood enemy. Rome Fell when there was no blood enemy. Lashing and drinking the blood of our large competitors keeps us alive.

I can't wait for China to get big enough for us to slaughter. Bet your biscuits that our parties will agree way more then.

Hell, I'd settle for Ruskies or even Europeans.

[Banquo's Ghost]

Happens again and again that "customers" get dumped or tricked or whatever just to please the shareholders. :thumbsdown:

Like many market failures, this market appears to disenfranchise the customer. As I understand things, one is largely at the mercy of one's employer - and whatever choice they have made.

Now, if individual customers could choose widely between insurance companies independently of employment, and anti-monopoly laws ensured there was a competitive market free of collusion, we might see some innovation and accountability. I understand that in theory one can choose, but that it is prohibitively expensive so de facto, such cover has become a perk of employment.

Corporations will always tend towards monopoly, removing customer choice and use political power to deflect change.

And then one factors in the very high cost of modern healthcare, so the majority of people require a subsidy to access it. This may be from employers "bulk buying" and building some of that cost into remuneration packages, or a direct government subsidy from taxation. The former leads to the inequality of a dysfunctional market - the latter argues for health being a public service entirely.

[ICantSpellDawg]

Like many market failures, this market appears to disenfranchise the customer. As I understand things, one is largely at the mercy of one's employer - and whatever choice they have made.

Now, if individual customers could choose widely between insurance companies independently of employment, and anti-monopoly laws ensured there was a competitive market free of collusion, we might see some innovation and accountability. I understand that in theory one can choose, but that it is prohibitively expensive so de facto, such cover has become a perk of employment.

Corporations will always tend towards monopoly, removing customer choice and use political power to deflect change.

And then one factors in the very high cost of modern healthcare, so the majority of people require a subsidy to access it. This may be from employers "bulk buying" and building some of that cost into remuneration packages, or a direct government subsidy from taxation. The former leads to the inequality of a dysfunctional market - the latter argues for health being a public service entirely.

One problem is that health care through employment encourages that only those well enough to work have easier access to health care. If you seperate it from that qualifier (which you should for moral reasons) the prices should be expected to go up because of increased adverse selection.

The system here is obviously broken, but somehow still functioning. We should take the time to bring everyone to the table on this and hack out a solution that adequately make everyone unhappy but extends health care to the large majority.

Allow people to understand cost and contain costs on their own; current deductible and co-pay systems don't work. Maybe a very low percentage system, not to deter care, but rather to impact who the consumer uses based on value for the dollar - it needs to be enough to get people looking for more basic care that actually works.

Encourage Insurance companies not to seek higher costs for built premiums and then obscure our view of what will impact our prices in the future. This will be harder to do.

The Democratic idea of a Salary based system could work. Obviosly salaries don't have to be the same, but based on some sort of accredidation. Salaries will dissuade "tack-on sales" tactics that Doctors are known for and encourage an understandable pricing system based on previous averages and cost of materials, not just throwing a dart at the wheel of fortune.

Some ideas, but I think that most are on board for this.

What I am not on board for is paying more so that poor gamblers and alchoholics can keep spending their money on booze and drugs while me, my parents and people who actually drive the economy are taxed to death for it.

Their kids are one thing, but scumbags who have no interest in their own health can die in the street if they can't find a charity willing to work for free, as far as i'm concerned. Here lies the snag in current negotiations.

[Crazed Rabbit]

From CNN Money, five items of grand stupidity and lies from Obama in the health care bill:

5 freedoms you'd lose in health care reform
If you read the fine print in the Congressional plans, you'll find that a lot of cherished aspects of the current system would disappear.
...
1. Freedom to choose what's in your plan

The bills in both houses require that Americans purchase insurance through "qualified" plans offered by health-care "exchanges" that would be set up in each state. The rub is that the plans can't really compete based on what they offer. The reason: The federal government will impose a minimum list of benefits that each plan is required to offer.
0:00 /2:07Health reform and you

Today, many states require these "standard benefits packages" -- and they're a major cause for the rise in health-care costs. Every group, from chiropractors to alcohol-abuse counselors, do lobbying to get included. Connecticut, for example, requires reimbursement for hair transplants, hearing aids, and in vitro fertilization.
...
2. Freedom to be rewarded for healthy living, or pay your real costs

As with the previous example, the Obama plan enshrines into federal law one of the worst features of state legislation: community rating. Eleven states, ranging from New York to Oregon, have some form of community rating. In its purest form, community rating requires that all patients pay the same rates for their level of coverage regardless of their age or medical condition.

Americans with pre-existing conditions need subsidies under any plan, but community rating is a dubious way to bring fairness to health care. The reason is twofold: First, it forces young people, who typically have lower incomes than older workers, to pay far more than their actual cost, and gives older workers, who can afford to pay more, a big discount. The state laws gouging the young are a major reason so many of them have joined the ranks of uninsured.
...
Second, the bills would ban insurers from charging differing premiums based on the health of their customers. Again, that's understandable for folks with diabetes or cancer. But the bills would bar rewarding people who pursue a healthy lifestyle of exercise or a cholesterol-conscious diet. That's hardly a formula for lower costs. It's as if car insurers had to charge the same rates to safe drivers as to chronic speeders with a history of accidents.
3. Freedom to choose high-deductible coverage

The bills threaten to eliminate the one part of the market truly driven by consumers spending their own money. That's what makes a market, and health care needs more of it, not less.

Hundreds of companies now offer Health Savings Accounts to about 5 million employees. Those workers deposit tax-free money in the accounts and get a matching contribution from their employer. They can use the funds to buy a high-deductible plan -- say for major medical costs over $12,000. Preventive care is reimbursed, but patients pay all other routine doctor visits and tests with their own money from the HSA account. As a result, HSA users are far more cost-conscious than customers who are reimbursed for the majority of their care.

The bills seriously endanger the trend toward consumer-driven care in general. By requiring minimum packages, they would prevent patients from choosing stripped-down plans that cover only major medical expenses. "The government could set extremely low deductibles that would eliminate HSAs," says John Goodman of the National Center for Policy Analysis, a free-market research group. "And they could do it after the bills are passed."

4. Freedom to keep your existing plan

This is the freedom that the President keeps emphasizing. Yet the bills appear to say otherwise. It's worth diving into the weeds -- the territory where most pundits and politicians don't seem to have ventured.
...
So for Americans in large corporations, "keeping your own plan" has a strict deadline. In five years, like it or not, you'll get dumped into the exchange. As we'll see, it could happen a lot earlier.
...
The employees who got their coverage before the law goes into effect can keep their plans, but once again, there's a catch. If the plan changes in any way -- by altering co-pays, deductibles, or even switching coverage for this or that drug -- the employee must drop out and shop through the exchange. Since these plans generally change their policies every year, it's likely that millions of employees will lose their plans in 12 months.

5. Freedom to choose your doctors

The Senate bill requires that Americans buying through the exchanges -- and as we've seen, that will soon be most Americans -- must get their care through something called "medical home." Medical home is similar to an HMO. You're assigned a primary care doctor, and the doctor controls your access to specialists. The primary care physicians will decide which services, like MRIs and other diagnostic scans, are best for you, and will decide when you really need to see a cardiologists or orthopedists.
...
The danger is that doctors will be financially rewarded for denying care, as were HMO physicians more than a decade ago. It was consumer outrage over despotic gatekeepers that made the HMOs so unpopular, and killed what was billed as the solution to America's health-care cost explosion.

The bills do not specifically rule out fee-for-service plans as options to be offered through the exchanges. But remember, those plans -- if they exist -- would be barred from charging sick or elderly patients more than young and healthy ones. So patients would be inclined to game the system, staying in the HMO while they're healthy and switching to fee-for-service when they become seriously ill. "That would kill fee-for-service in a hurry," says Goodman.

In reality, the flexible, employer-based plans that now dominate the landscape, and that Americans so cherish, could disappear far faster than the 5 year "grace period" that's barely being discussed.

Well this would certainly screw the country over.

CR

[Lemur]

A little more info on our current system of rationing (http://thislife.org/Radio_Episode.aspx?episode=386):


The legal basis for rescission is that when you sign an insurance application, you are warranting that the information on the application is true; if it turns out not to be true, the insurer can get out of your insurance contract. It’s particularly nasty in practice because the insurer does not immediately investigate your application to determine if it is accurate before selling you the policy (that would be impractically expensive); instead, the insurer waits – years, in many cases – until you actually need expensive health care, and then does the investigation, which at that point is worth it because of the payments the insurer could potentially avoid. Also, you can lose your coverage for innocent mistakes, which are easy to make since the application form asks you if you have ever seen a doctor for any one of a long list of medical conditions that you are certain not to recognize or understand. (In a Congressional hearing, the CEO of a health insurer admitted that he did not know what several of the conditions listed on his company’s application were.)

[Banquo's Ghost]

A little more info on our current system of rationing (http://thislife.org/Radio_Episode.aspx?episode=386):


The legal basis for rescission is that when you sign an insurance application, you are warranting that the information on the application is true; if it turns out not to be true, the insurer can get out of your insurance contract. It’s particularly nasty in practice because the insurer does not immediately investigate your application to determine if it is accurate before selling you the policy (that would be impractically expensive); instead, the insurer waits – years, in many cases – until you actually need expensive health care, and then does the investigation, which at that point is worth it because of the payments the insurer could potentially avoid. Also, you can lose your coverage for innocent mistakes, which are easy to make since the application form asks you if you have ever seen a doctor for any one of a long list of medical conditions that you are certain not to recognize or understand. (In a Congressional hearing, the CEO of a health insurer admitted that he did not know what several of the conditions listed on his company’s application were.)

Your link takes me to a radio station page about fine print: which is sort of relevant, but none of the stories mentioned are health care.

I would be interested in the original for your quote. :bow:

[KukriKhan]

I understand that in theory one can choose, but that it is prohibitively expensive so de facto, such cover has become a perk of employment.

Hence our current confusion. Two hundred years ago, only rich folks were treated by Doc's. One hundred years ago, local (neighborhood or small town) Gen Practioners did the job - often as a town employee. Sixty years ago, the auto companies spear-headed the drive to keep their sizeable workforce stable by keeping them healthier, so purchased bulk group insurance as a job perquisite (and at first, doctors and nurses on the job site), as you've said. Other industrial companies followed suit. HMO's got invented in the 1970's, merging doctors, hospitals and insurance together into an uneasy alliance, to serve industry.

Medical treatment and its guarantor, insurance, is such a widespread perk that it's no longer seen as a perk, but a right. Add the governmental programs Medicare and Medicaid (for the old and indigent) and you have a persuasive argument that de facto, tho' almost by accident, since most people are covered by some kind of insurance, we think all people should be.

In short: what was once a privilege, then a product, then a perk, has become a right. Just like police, fire, water, sewer, roads, libraries and electricity (and down the line: TV, radio, telephone & internet).

We're, as I understand the state of discussion in the US currently, haggling over the money part: who pays, who gets paid, how much, and how often. That there is some entitlement to medical treatment doesn't get discussed much. It's already an assumption on all sides.

[Lemur]

I would be interested in the original for your quote. :bow:
Gah! Evil NPR moves teh linkies. Here's the original referencing article (http://baselinescenario.com/2009/07/27/health-insurance-innovation/).


The This American Life crew [...] has a segment in this weekend’s episode on rescission of health insurance policies — insurers’ established practice of looking for ways to invalidate policies once it turns out that the insured actually needs significant medical care. (The segment is around the 30-minute mark; audio should be available on that page sometime on Monday.) The story describes a couple of particularly egregious cases, such as a woman who was denied breast cancer surgery because she had been treated for acne in the past, and a person whose policy was rescinded because his insurance agent had incorrectly entered his weight on the application form.

[drone]

If I remember correctly, HillaryCare failed because the administration came up with the plan and foisted it on Congress, which balked when their paymasters squealed.

ObamaCare is different, Congress is creating the plan. Which means the lobbyists are in full force, hands extended, trying to get a piece of the pie. This is why ObamaCare should fail, at this point it has nothing to do with getting the best care for the people, just the best deal for the industry. If Obama actually believes that the finished product will reduce the overall medical expenditures of government programs and improve care of patients, he's more naive than I thought.

[Crazed Rabbit]

Gah! Evil NPR moves teh linkies. Here's the original referencing article (http://baselinescenario.com/2009/07/27/health-insurance-innovation/).


We should simply make a law only allowing rescission in the first month or two after being granted insurance.

CR

[Banquo's Ghost]

Thanks, Lemur. Fascinating. :bow:


We should simply make a law only allowing rescission in the first month or two after being granted insurance.

That was my first thought but then wouldn't the insurance companies just front load the costs and healthcare get even more expensive?

[Xiahou]

That was my first thought but then wouldn't the insurance companies just front load the costs and healthcare get even more expensive?Front load how?

Want an example of how screwed up our system is? I am currently unemployed. I shopped around and found insurance that provided better coverage than what I had under my employer and cost less than what my share of the monthly premium (which was about 1/3 of what the total monthly charge was) for my employee sponsored insurance was. Rather than providing economies of scale, as you suggested, employer coverage quite often costs more because healthy individuals have to pay more to even out the premiums of high health risk employees.

What's even better is that were I still employed and if I wanted to refuse my employer's coverage and purchase this private plan, I would be prohibited from doing so. I would be free to refuse my employer's coverage, but just being eligible for it would make me ineligible for purchasing an individual plan. :dizzy2:

Sadly, ObamaCare, from what I've seen, does nothing to address any of this insanity. The simplest thing we could do to reform our dysfunctional healthcare would be to separate medical insurance from employers. :yes:


Hence our current confusion. Two hundred years ago, only rich folks were treated by Doc's. One hundred years ago, local (neighborhood or small town) Gen Practioners did the job - often as a town employee. Sixty years ago, the auto companies spear-headed the drive to keep their sizeable workforce stable by keeping them healthier, so purchased bulk group insurance as a job perquisite (and at first, doctors and nurses on the job site), as you've said. Other industrial companies followed suit. HMO's got invented in the 1970's, merging doctors, hospitals and insurance together into an uneasy alliance, to serve industry.Don't forget about how employee medical benefits were popularized as a way around FDR's wage controls since they weren't treated as income....

[Banquo's Ghost]

Front load how?

I would assume that premium costs would go up high enough to cover the profits now made by recission.


Want an example of how screwed up our system is? I am currently unemployed. I shopped around and found insurance that provided better coverage than what I had under my employer and cost less than what my share of the monthly premium (which was about 1/3 of what the total monthly charge was) for my employee sponsored insurance was. Rather than providing economies of scale, as you suggested, employer coverage quite often costs more because healthy individuals have to pay more to even out the premiums of high health risk employees.

What's even better is that were I still employed and if I wanted to refuse my employer's coverage and purchase this private plan, I would be prohibited from doing so. I would be free to refuse my employer's coverage, but just being eligible for it would make me ineligible for purchasing an individual plan. :dizzy2:

Sadly, ObamaCare, from what I've seen, does nothing to address any of this insanity. The simplest thing we could do to reform our dysfunctional healthcare would be to separate medical insurance from employers. :yes:

Don't forget about how employee medical benefits were popularized as a way around FDR's wage controls since they weren't treated as income....

That's an example of why I am concerned about the model. One might be able to judge if private insurance funded healthcare worked if there was a decently free market - the insurance companies would be competing to lower prices and increase cover security. However, they would also cherry pick the very best risks - and so even more citizens would be left without cover.

[Crazed Rabbit]

That's an example of why I am concerned about the model. One might be able to judge if private insurance funded healthcare worked if there was a decently free market - the insurance companies would be competing to lower prices and increase cover security. However, they would also cherry pick the very best risks - and so even more citizens would be left without cover.

Or those people who smoked and didn't exercise would simply have to pay more, as with automobile insurance, where people who crash and get speeding tickets pay more.


I would assume that premium costs would go up high enough to cover the profits now made by recission.

Are they making a significant amount of revenue from that? I'm just guessing, but I don't think they'd be a large rise in premiums.

CR

[Lemur]

Well, if you want to see what it looks like when the government imposes insurance mandates and does nothing to control costs, just look at MA. Ir don't work. Or hell, look at Medicare Part D (http://en.wikipedia.org/wiki/Medicare_Part_D).

[Marshal Murat]

Talk about starting a bombshell, eh? I figure since Congress has adjourned for the summer, we can take a look back at what they've done concerning Healthcare. To my knowledge, the current legislation has passed through the House committee concerning it, but lying in wait until Congress re-convenes.

I'm not going to pretend that I know much about Healthcare reform, because I don't. I especially don't know or understand anything that's happening concerning the current bill (which is causing some frustration amongst voters (https://www.youtube.com/watch?v=J-Bpshk5nX0)) and I figure I'm more lost than most because I haven't had to worry about health insurance. So I figure I'll get some education.

SO, what I want to get from y'all is

1. What exactly is the current Congress Healthcare Bill doing for Americans? What are the parts of the Bill?

2. I know Switzerland has a pretty sweet system, what makes that system "sweet"? Conversely, what makes the American system "bad" or "broken"?

[rory_20_uk]

Here (http://www.mckinseyquarterly.com/Health_Care) is a link to a page that has a good number of articles looking at healthcare in different ways. Of course they've got an agenda, but that is mainly "see how bright we are! Hire us to sort it out" so in the way you're looking at it they're pretty neutral.

~:smoking:

[Banquo's Ghost]

I have merged this new thread with the existing one.

:bow:

[Marshal Murat]

Thank you BQ

[Lemur]

The status quo rocks (http://www.doublex.com/section/news-politics/health-insurance-woes-my-22000-bill-having-baby)!


Our six-month-old daughter cost over $22,000.

You’d think, with a number like that, we must have used fertility treatments—but she was conceived naturally. You’d think we went through an adoption agency—but she is a biological child. So surely, we were uninsured.

Nope. Birthing our daughter was so expensive precisely because we were insured, on the individual market. Our insurer, CareFirst BlueCross BlueShield, sold us exactly the type of flawed policy—riddled with holes and exceptions—that the health care reform bills in Congress should try to do away with. The “maternity” coverage we purchased didn’t cover my labor, delivery, or hospital stay. It was a sham. And so we spent the first months of her life getting the kind of hospital bills and increasingly aggressive calls from hospital administrators that I once believed were only possible without insurance.

[Xiahou]

The Healthy Americans Act (http://en.wikipedia.org/wiki/Healthy_Americans_Act)

A reform proposal that could cover everyone, help fix Medicaid, and according to the OMB, would be budget neutral the first year and would actually start saving money thereafter. I'm not intimately with this proposal, but it has support from both parties and wouldn't throw us trillions of dollars further into debt. But, we're not discussing any alternatives....

The status quo is far from perfect, but sometimes no reform is better than bad reform- and that seems to be what our current choice is. :sweatdrop:

[Hosakawa Tito]

The Healthy Americans Act (http://http://en.wikipedia.org/wiki/Healthy_Americans_Act)

A reform proposal that could cover everyone, help fix Medicaid, and according to the OMB, would be budget neutral the first year and would actually start saving money thereafter. I'm not intimately with this proposal, but it has support from both parties and wouldn't throw us trillions of dollars further into debt. But, we're not discussing any alternatives....

The status quo is far from perfect, but sometimes no reform is better than bad reform- and that seems to be what our current choice is. :sweatdrop:

Your link is broken, Xiahou.

[Xiahou]

fixed....

stupid netbook.... grumble...

[Seamus Fermanagh]

IThat's an example of why I am concerned about the model. One might be able to judge if private insurance funded healthcare worked if there was a decently free market - the insurance companies would be competing to lower prices and increase cover security. However, they would also cherry pick the very best risks - and so even more citizens would be left without cover.

Insurance uses sub-standard ratings to insure higher risk applicants and/or exclusions of certain specific risk factors in an otherwise complete coverage package. I suspect that you wouldn't see a very great increase in the number of uninsureds, though the premium cost would be allocated quite differently.

[seireikhaan]

The Healthy Americans Act (http://en.wikipedia.org/wiki/Healthy_Americans_Act)

A reform proposal that could cover everyone, help fix Medicaid, and according to the OMB, would be budget neutral the first year and would actually start saving money thereafter. I'm not intimately with this proposal, but it has support from both parties and wouldn't throw us trillions of dollars further into debt. But, we're not discussing any alternatives....

The status quo is far from perfect, but sometimes no reform is better than bad reform- and that seems to be what our current choice is. :sweatdrop:
I'm looking at on the senator's website, and I'm surprised your in support of it. Link (http://wyden.senate.gov/issues/Legislation/Healthy_Americans_Act.cfm).


Under the Healthy Americans Act, insurance companies will have to enroll every individual who signs up and insurers will be prohibited from raising prices or denying coverage if individuals are sick or are at risk of becoming sick. Previous and existing health problems, occupation, genetic information, gender and age could no longer be used to determine eligibility or the price paid for insurance. Insurance companies will be forced to compete to keep their subscribers healthy.
So insurance companies will be mandated to accept anyone who wants to sign up? :inquisitive:


Individuals will choose from a variety of private plans offered in their state, including any employer-based option that may be available to them. Sign-up will be as simple as checking a box on a tax form. Consumers will get help and advice on choosing the best coverage for them from state-based Health Help Agencies (HHAs) and Human Resource departments.
So we're still prohibited from looking for plans out of the state, and we get advice from the gov't on what plan is best....


All employers, along with individuals and the government, will share the responsibility of financing health care. Employers who provide employee health benefits would be required to convert their workers' health care premiums into higher wages for two years after the bill is enacted. Employees, in turn, would be required to purchase private health coverage with their higher wages. To ensure that health care coverage is affordable, the plan would fully subsidize the premiums for those who live below the poverty line. Those people earning between 100 percent and 400 percent of the federal poverty line ($10,400 annually per person) would also receive subsidies on a sliding scale to help pay their premiums. The bill also creates a generous standard deduction to help Americans pay for health coverage regardless of whether they get coverage on their own or through their employers.
More mandates. So not only are insurance companies forbidden from denying anyone who asks, but workers are forced to get insurance. And, of course, businesses are required to jack pay up to workers to compensate for the workers being required to pay for insurance. This basically forces every company to provide "health insurance pay" since if workers are all required to pay for health insurance, they're going to only seek jobs where employers have the ability to offer health pay. So basically, either moderate/low income workers are punished, or small businesses.




The Healthy Americans Act gives every American control over their health care choices and their budgets, with a transition to the new system that will be seamless for many people. Premiums will be paid from a deduction on their paychecks just like many other deductions currently withheld. The only change many people will notice is that they can see how much their health care costs them. And any costs incurred for health care will be balanced out by the raise they get from their employer to pay for it.
No, it doesn't give us control because it forces people to buy insurance and won't even open up state lines to offer more choices. And the method of paying premiums amounts to nothing more than another tax, which is either paid by the business or the person.





Employers who don't currently offer health benefits would have to make phased-in "Employer Shared Responsibility Payments," which would be used to provide financial assistance to individuals and families of modest income.
Isn't this something very similar to what obama was proposing?





Now, don't get me wrong, I like that it apparently cuts out costs(somehow, I'm not quite understanding the explanation of how that is), but I'm failing to see why you're in support of it given all this other junk.

edit: to be fair, it does seem more coherent and sensible than some of the alternatives being floated.

[Hosakawa Tito]

There aren't enough specifics to judge whether this is a good idea or not.


Individuals will choose from a variety of private plans offered in their state, including any employer-based option that may be available to them. Sign-up will be as simple as checking a box on a tax form. Consumers will get help and advice on choosing the best coverage for them from state-based Health Help Agencies (HHAs) and Human Resource departments.

So there will still be wide disparity on what one pays for coverage dependent on where one lives. Where's the "cost control" in that?


Under the Healthy Americans Act, insurance companies will have to enroll every individual who signs up and insurers will be prohibited from raising prices or denying coverage if individuals are sick or are at risk of becoming sick. Previous and existing health problems, occupation, genetic information, gender and age could no longer be used to determine eligibility or the price paid for insurance. Insurance companies will be forced to compete to keep their subscribers healthy.

One of the problems with the current system is that doctors are paid for treatments to patients, but not outcomes *quality/effectiveness of care*. However, where in this new proposal is patient responsibility?
If you become ill because you don't follow prescribed treatments *diet, weight reduction, stop smoking, medications, etc...* should you be covered?

No mention of tort reform...that's a crock.

I want to know, in detail, what treatments/medications for illnesses are not covered or are there no limits?
Will there be out of pocket copayments for medications & procedures?

Can you seek treatment outside your prescribed coverage and pay all costs out of pocket?

Why is there a seperate system for our Legislators or are they covered by this too?

[Xiahou]

I'm looking at on the senator's website, and I'm surprised your in support of it. Link (http://wyden.senate.gov/issues/Legislation/Healthy_Americans_Act.cfm).

I'm not really sure where you read that I supported it. :inquisitive:
However, a cursory glance seems to suggest that it accomplishes many of the same goals of current proposals without trillions in new debt. That alone makes it better than what's being bandied about now. I'm not yet convinced that it's better than the status quo, but we should jettison the current proposals and use something like this as a jumping off point.

[Marshal Murat]

Protesters are, in fact, fascists (http://www.realclearpolitics.com/video/2009/08/05/pelosi_town_hall_protesters_are_carrying_swastikas.html)

While the possibility of astro-turfing is no doubt there, I think the way that some representatives (i.e. those I dislike) are imploding as they lash out. It seems more like a paranoid attempt to explain away unfavorable protesters to a healthcare bill that no one really understands, which leads into my next point.

If the Democrats were more intelligent in the "carrying-through" of the healthcare bill, it would be a paper that says This is what the Healthcare Bill will do for you than simply say "Trust us guys, this is in your best interests". I don't really know what is in the bill, and I'm not planning on surfing the web to find an 18-page report on the first paragraph of the bill, let alone a summary of what the bill will do, what it will cover, etc. etc. I will say that the Republican "let's just hate on it because it's a Democrat bill" is a little childish, but I do wish they'd figure out a nice bill to counter the Democrats one.

[Centurion1]

The protesters are nothing of the sort. This is just the liberal left and their leftist media sources trying to pin everyone unfavorable to the new health plan as being "fascists" which is exactly what Pelosi wants you to think with her swastikas comments, which was just a scummy thing to say.

As i heard Michelle Malkin say today, "the republicans wish they could drum up this sort of response to the health care plan. This is normal Americans saying enough is enough."

[HopAlongBunny]

Astro-turfing is present w/o much doubt. That's the game.

As usual, the democrats fail re: organization, mobilization, explanation and selling of their ideas.

The bill has been so thoroughly surrounded by fog that those who support it have trouble finding firm footing.

[Hosakawa Tito]

Protesters are, in fact, fascists (http://www.realclearpolitics.com/video/2009/08/05/pelosi_town_hall_protesters_are_carrying_swastikas.html)

While the possibility of astro-turfing is no doubt there, I think the way that some representatives (i.e. those I dislike) are imploding as they lash out. It seems more like a paranoid attempt to explain away unfavorable protesters to a healthcare bill that no one really understands, which leads into my next point.

If the Democrats were more intelligent in the "carrying-through" of the healthcare bill, it would be a paper that says This is what the Healthcare Bill will do for you than simply say "Trust us guys, this is in your best interests". I don't really know what is in the bill, and I'm not planning on surfing the web to find an 18-page report on the first paragraph of the bill, let alone a summary of what the bill will do, what it will cover, etc. etc. I will say that the Republican "let's just hate on it because it's a Democrat bill" is a little childish, but I do wish they'd figure out a nice bill to counter the Democrats one.

That shouldn't be that difficult. How about something along the lines of the healthcare plan they receive themselves *for life* that is subsidized by "we the people".

[Xiahou]

That shouldn't be that difficult. How about something along the lines of the healthcare plan they receive themselves *for life* that is subsidized by "we the people".

Nah, that's too good for us peasants.

[Crazed Rabbit]

The status quo rocks (http://www.doublex.com/section/news-politics/health-insurance-woes-my-22000-bill-having-baby)!


Our six-month-old daughter cost over $22,000.

You’d think, with a number like that, we must have used fertility treatments—but she was conceived naturally. You’d think we went through an adoption agency—but she is a biological child. So surely, we were uninsured.

Nope. Birthing our daughter was so expensive precisely because we were insured, on the individual market. Our insurer, CareFirst BlueCross BlueShield, sold us exactly the type of flawed policy—riddled with holes and exceptions—that the health care reform bills in Congress should try to do away with. The “maternity” coverage we purchased didn’t cover my labor, delivery, or hospital stay. It was a sham. And so we spent the first months of her life getting the kind of hospital bills and increasingly aggressive calls from hospital administrators that I once believed were only possible without insurance.

For games, this sort of situation calls for a RTFM.

People are able to purchase individual insurance for their homes and cars, and they do so effectively by reading the fine print. Yeah, the insurance provider was a jerk about slipping that fine print in there, and maybe there could be a little reform about having to state explicitly all benefits up front. But that's a far cry from the health care 'reform' going on now.

One article from the WSJ: (http://online.wsj.com/article/SB10001424052970204619004574324361508092006.html)


How to Fix the Health-Care ‘Wedge’
There is an alternative to ObamaCare.

By ARTHUR B. LAFFER
President Barack Obama is correct when he says that “soaring health-care costs make our current course unsustainable.” Many Americans agree: 55% of respondents to a recent CNN poll think the U.S. health-care system needs a great deal of reform. Yet 70% of Americans are satisfied with their current health-care arrangements, and for good reason—they work.

Consumers are receiving quality medical care at little direct cost to themselves. This creates runaway costs that have to be addressed. But ill-advised reforms can make things much worse.

An effective cure begins with an accurate diagnosis, which is sorely lacking in most policy circles. The proposals currently on offer fail to address the fundamental driver of health-care costs: the health-care wedge.

The health-care wedge is an economic term that reflects the difference between what health-care costs the specific provider and what the patient actually pays. When health care is subsidized, no one should be surprised that people demand more of it and that the costs to produce it increase. Mr. Obama’s health-care plan does nothing to address the gap between the price paid and the price received. Instead, it’s like a negative tax: Costs rise and people demand more than they need.
...
Thus, health-care reform should be based on policies that diminish the health-care wedge rather than increase it. Mr. Obama’s reform principles—a public health-insurance option, mandated minimum coverage, mandated coverage of pre-existing conditions, and required purchase of health insurance—only increase the size of the wedge and thus health-care costs.

According to research I performed for the Texas Public Policy Foundation, a $1 trillion increase in federal government health subsidies will accelerate health-care inflation, lead to continued growth in health-care expenditures, and diminish our economic growth even further. Despite these costs, some 30 million people will remain uninsured.

Implementing Mr. Obama’s reforms would literally be worse than doing nothing.

The president’s camp is quick to claim that his critics have not offered a viable alternative and would prefer to do nothing. But that argument couldn’t be further from the truth.

Rather than expanding the role of government in the health-care market, Congress should implement a patient-centered approach to health-care reform. A patient-centered approach focuses on the patient-doctor relationship and empowers the patient and the doctor to make effective and economical choices.

A patient-centered health-care reform begins with individual ownership of insurance policies and leverages Health Savings Accounts, a low-premium, high-deductible alternative to traditional insurance that includes a tax-advantaged savings account. It allows people to purchase insurance policies across state lines and reduces the number of mandated benefits insurers are required to cover. It reallocates the majority of Medicaid spending into a simple voucher for low-income individuals to purchase their own insurance. And it reduces the cost of medical procedures by reforming tort liability laws.

CR

[Lemur]

Hooray for the status quo (http://andrewsullivan.theatlantic.com/the_daily_dish/2009/08/the-view-from-your-sickbed-4.html#more)!


When my son was born in 2006 we could not afford to put him on my employer-sponsored health insurance. It was $236.00 per month (just for him!!!) with $40.00 co-pays, $2,300 deductibles, etc. The insurance was terrible and did not include prescriptions. So, we kept him uninsured.

When he was around 8 months old he woke up with a fever.

We kept him home from daycare and gave him children’s Tylenol. Over two days the fever continued to rise. When the fever hit 102.5 we called his doctor to find out how much a visit costs and if the fever was high enough to warrant the money we’d have to spend. We were broke, barely covering formula, daycare, diapers, etc. The doctor said that it was not considered an emergency and to call back if it went over 103. We were freaking out and scared. I remember crying to my son’s father that our baby was sick but we were too scared of the costs to get treatment.

My son’s fever ended up spiking so high that he had a seizure. We called 911 as he was convulsing and an ambulance rushed us to the hospital. He had an ear infection. The seizure was a febrile seizure brought on by the high fever. Had we brought him to the doctor that first day, this would easily have been discovered and treated prior to the ER trip. However, the doctor demands payment upfront and would have charged us over $100.00 to see him. We did not have the money. Not even close. That emergency trip ended up costing us nearly $3,000.00. We are still paying for it today with $20.00/month payments when we can manage.

He’s nearly 3 now and perfectly healthy. Although he wound up with chronic ear infections and spent his first two years almost constantly on antibiotics. We ended up getting him insured through Florida’s Health Kids/Medicare program. IT IS FANTASTIC. We pay $160.50 per month with absolutely no out-of-pocket expenses. No co-pays. No deductibles. Everything is covered at 100%, even prescriptions. We also get $25.00/month in over the counter medicines, delivered right to our door.

I hope to never again experience the absolute terror you feel when your child is sick and you know that any trip to the doctor or hospital will bankrupt you. I cannot express to you how awful it was.

[Xiahou]

Why wasn't the baby on SCHIP or Medicaid to begin with? They got him on it eventually- what was the holdup? These anecdotes you keep dropping without comment leave tons of unanswered questions. If someone can't manage to get their baby available healthcare plans, how will reform help?

Again, anecdote is not the singular form of data. But continue with the emotional appeals. We all know that's how sensible laws are written. Think about the children!!!!

[Lemur]

Yeah, why didn't the family read the fine print? Why didn't the family get the kid on that bastion of socialism, SCHIP? Forget "Think of the children," let's roll with, "It's on you, sucker!"

Three cheers (http://andrewsullivan.theatlantic.com/the_daily_dish/2009/08/the-view-from-your-sickbed-3.html#more) for the Frankenstein creation we have now! Change NOTHING!


As an epileptic I have had a few cases of seizures occurring in public places. While not life threatening, this can often impact strangers intensely. A stranger's first response is usually to call an ambulance and get me to a hospital. When I was younger and putting myself through college by working part time, this simple act of generosity on the part of the well meaning observer would terrify me more than the seizure itself.

A previous commenter related their experience of getting sick in Texas and since that is my home state you can begin to understand my dilemma. The simple act of being picked up off the ground, transported to the hospital and ingesting a Tylenol offered by doctor there would run me over a thousand dollars. When I checked my bill I discovered that the two Tylenols I had ingested alone cost me over 50 dollars.

After the first time this occurred I would come to in a panic asking if an ambulance had been called and if so I would do my best to bolt from the scene before the technicians showed up and did their best to convince me that it was in my best interest to take a ride to the hospital. Since I was working a part time minimum wage job, I could not afford to pay those bills and my credit was destroyed for years. At other similarly less fortunate occasions in my life I have been forced to take part in studies, moderate my dosage without the approval of a doctor or simply do without the medication that makes my life livable. I am fortunate now that I work for a company that provides decent health insurance, but going from one job to the next is highly dependent on the level of coverage I can expect to get.

[Crazed Rabbit]

Enough of this, Lemur. You're just posting anecdotes, ignoring other posts, and propping up strawmen. Ridiculous. It's drive-by posting, and certainly doesn't help the debate we were having here at all.


Yeah, why didn't the family read the fine print?

Hell yeah, why didn't they - they didn't even know the insurance limit.

CR

[Centurion1]

You should explain your anecdotes more. They shouldn't be used as the entirety of your statement.............

[Marshal Murat]

Lemur is tugging at all of our heartstrings, arousing indignation that this could happen in America to people who didn't necessarily do anything bad, just didn't have enough to guarantee that they could keep food on the table and pay for medicine...

[Samurai Waki]

The only reason why I am for Public Health Care, is because I am tired of having to deal with these Health Insurance :daisy: morons who make it their mission in life to screw you at every corner, and then do everything in their power to back out of an already legally binding contract after something has happened which they are entitled to pay. I shouldn't have to threaten my insurance company with legal action every time I have to take one of my daughters to the Hospital, and they won't make the co-pay even though it states clearly in our signed contract that they have too, and then after I threaten them with legal action, they try to settle the coverage for less than what they owe the Hospitals, so then it turns into more work for me to get the big dogs where I intern to start barking, and then they finally relent because they know I'm right, and they don't want a massive lawsuit on their hands. I'm not giving BlueCross my money so that they can wipe their :daisy: with it, and nobody should have to deal with these scum bags. Even if our Public Health Care was the biggest piece of :daisy: excuse, it would still be ten times better than these greedy privatized mother :daisy:.

And I've heard similar horror stories about every other Insurance Company... so, switching isn't much of an option, if you have to deal with the exact same mouth breathers as your current coverer.

[KukriKhan]

This is why there is no "U.S. Health Care Debate". Rather, we have a shouting match.

I guess it's because August, with Congress in summer vacation recess, is a slow news month, and therefore a slow blogosphere and radio/TV talk-show month.

It's funny to hear the talk shows talk about "the Bill" or "ObamaCare", when there are several bills pending, in both houses, none endorsed by the POTUS, who has offered no Bill of his own, but has gone on national TV to support... health care reform. Or something.

Meanwhile, Fannie Mae quietly wants 11 Billion more Dollars (http://online.wsj.com/article/SB124960826802413197.html?mod=googlenews_wsj) to cover its losses (total bailout so far: $46B).

Distraction? You decide.

[Marshal Murat]

Peggy Noonan Rides Again (http://online.wsj.com/article/SB10001424052970204908604574334623330098540.html)


We have entered uncharted territory in the fight over national health care. There’s a new tone in the debate, and it’s ugly. At the moment the Democrats are looking like something they haven’t looked like in years, and that is: desperate.

They must know at this point they should not have pushed a national health-care plan. A Democratic operative the other day called it “Hillary’s revenge.” When Mrs. Clinton started losing to Barack Obama in the primaries 18 months ago, she began to give new and sharper emphasis to her health-care plan. Mr. Obama responded by talking about his health-care vision. He won. Now he would push what he had been forced to highlight: Health care would be a priority initiative. The net result is falling support for his leadership on the issue, falling personal polls, and the angry town-hall meetings that have electrified YouTube.

In his first five months in office, Mr. Obama had racked up big wins—the stimulus, children’s health insurance, House approval of cap-and-trade. But he stayed too long at the hot table. All the Democrats in Washington did. They overinterpreted the meaning of the 2008 election, and didn’t fully take into account how the great recession changed the national mood and atmosphere.

And so the shock on the faces of Congressmen who’ve faced the grillings back home. And really, their shock is the first thing you see in the videos. They had no idea how people were feeling. Their 2008 win left them thinking an election that had been shaped by anti-Bush, anti-Republican, and pro-change feeling was really a mandate without context; they thought that in the middle of a historic recession featuring horrific deficits, they could assume support for the invention of a huge new entitlement carrying huge new costs.

The passions of the protesters, on the other hand, are not a surprise. They hired a man to represent them in Washington. They give him a big office, a huge staff and the power to tell people what to do. They give him a car and a driver, sometimes a security detail, and a special pin showing he’s a congressman. And all they ask in return is that he see to their interests and not terrify them too much. Really, that’s all people ask. Expectations are very low. What the protesters are saying is, “You are terrifying us.”

What has been most unsettling is not the congressmen’s surprise but a hard new tone that emerged this week. The leftosphere and the liberal commentariat charged that the town hall meetings weren’t authentic, the crowds were ginned up by insurance companies, lobbyists and the Republican National Committee. But you can’t get people to leave their homes and go to a meeting with a congressman (of all people) unless they are engaged to the point of passion. And what tends to agitate people most is the idea of loss—loss of money hard earned, loss of autonomy, loss of the few things that work in a great sweeping away of those that don’t.

People are not automatons. They show up only if they care.

What the town-hall meetings represent is a feeling of rebellion, an uprising against change they do not believe in. And the Democratic response has been stunningly crude and aggressive. It has been to attack. Nancy Pelosi, the speaker of the United States House of Representatives, accused the people at the meetings of “carrying swastikas and symbols like that.” (Apparently one protester held a hand-lettered sign with a “no” slash over a swastika.) But they are not Nazis, they’re Americans. Some of them looked like they’d actually spent some time fighting Nazis.

Then came the Democratic Party charge that the people at the meetings were suspiciously well-dressed, in jackets and ties from Brooks Brothers. They must be Republican rent-a-mobs. Sen. Barbara Boxer said on MSNBC’s “Hardball” that people are “storming these town hall meetings,” that they were “well dressed”, that “this is all organized,” “all planned,” to “hurt our president.” Here she was projecting. For normal people, it’s not all about Barack Obama.


The Democratic National Committee chimed in with an incendiary Web video whose script reads, “The right wing extremist Republican base is back.” DNC communications director Brad Woodhouse issued a statement that said the Republicans “are inciting angry mobs of . . . right wing extremists” who are “not reflective of where the American people are.”

But most damagingly to political civility, and even our political tradition, was the new White House email address to which citizens are asked to report instances of “disinformation” in the health-care debate: If you receive an email or see something on the Web about health-care reform that seems “fishy,” you can send it to flag@whitehouse.gov. The White House said it was merely trying to fight “intentionally misleading” information.

Sen. John Cornyn of Texas on Wednesday wrote to the president saying he feared that citizens’ engagement could be “chilled” by the effort. He’s right, it could. He also accused the White House of compiling an “enemies list.” If so, they’re being awfully public about it, but as Byron York at the Washington Examiner pointed, the emails collected could become a “dissident database.”

All of this is unnecessarily and unhelpfully divisive and provocative. They are mocking and menacing concerned citizens. This only makes a hot situation hotter. Is this what the president wants? It couldn’t be. But then in an odd way he sometimes seems not to have fully absorbed the awesome stature of his office. You really, if you’re president, can’t call an individual American stupid, if for no other reason than that you’re too big. You cannot allow your allies to call people protesting a health-care plan “extremists” and “right wing,” or bought, or Nazi-like, either. They’re citizens. They’re concerned. They deserve respect.

The Democrats should not be attacking, they should be attempting to persuade, to argue for their case. After all, they have the big mic. Which is what the presidency is, the big mic.

And frankly they ought to think about backing off. The president should call in his troops and his Congress and announce a rethinking. There are too many different bills, they’re all a thousand pages long, no one has time to read them, no one knows what’s going to be in the final one, the public is agitated, the nation’s in crisis, the timing is wrong, we’ll turn to it again—but not now. We’ll take a little longer, ponder every aspect, and make clear every complication.

You know what would happen if he did this? His numbers would go up. Even Congress’s would. Because they’d look responsive, deliberative and even wise. Discretion is the better part of valor.

Absent that, and let’s assume that won’t happen, the health-care protesters have to make sure they don’t get too hot, or get out of hand. They haven’t so far, they’ve been burly and full of debate, with plenty of booing. This is democracy’s great barbaric yawp. But every day the meetings seem just a little angrier, and people who are afraid—who have been made afraid, and left to be afraid—can get swept up. As this column is written, there comes word that John Sweeney of the AFL-CIO has announced he’ll be sending in union members to the meetings to counter health care’s critics.

Somehow that doesn’t sound like a peace initiative.

It’s going to be a long August, isn’t it? Let’s hope the uncharted territory we’re in doesn’t turn dark. (Personal Bolds for my view of key ideas)

[Tribesman]

The protesters are nothing of the sort.
Would that be the protesters who are writing to the newspapers without knowing they have written to the newspapers?
Amazing isn't it , concerned citizens putting their name to pieces that they havn't written and don't know about.
So if the Dewey Square Group that is working for the AHIP lobby group mailing fictitious protest letters to the media isn't a case of astro-turfing I don't know what is.

[Lemur]

This is why there is no "U.S. Health Care Debate". Rather, we have a shouting match.

I'm sure I don't understand what you mean ...


https://img.photobucket.com/albums/v489/Lemurmania/ErvaP.jpg

My worry is simple: I think the status quo is untenable, but I despair of the Dems in Congress getting reform right. And I don't think the Repubs are negotiating in good faith either; they're just looking to score points (with the exception of a couple of truly thoughtful Repubs, such as Paul Ryan).

The Dems are their usual disorganied, shambolic selves, and the Repubs are playing for a team win, not any sort of improvement in the lives of normal people. So what are the chances that something good will happen? Greater than zero, I guess, but rather lower than 50%.

I feel the same sort of grinding despair that I get whenever I read too much about Israel and Palestine.

[drone]

I'm sure I don't understand what you mean ...


https://img.photobucket.com/albums/v489/Lemurmania/ErvaP.jpg

I see LaRouche is still at it. :laugh4:

[Ariovistus Maximus]

So, I'm no economist, but I think that Universal Health Care would be easy to exploit.

I'd be glad to hear from supporters of the system as to whether or not my issues are realistic:

1. There would be a tendency for people seriosly needing care to be overlooked or forced to wait.

I would cite in examples Canada, where some patients have died while on the waiting list for major operations, and England, where there is a law that patients cannot be in the waiting room for longer than 4 hours, and as a result sometimes patients have to be left in the ambulance they arrived on.

(These could be rumors as I am not especially tuned in to Canada or the UK.)

2. There could be a tendency for people who really don't need aid to skim off the system. The idea being similar to wellfare, where people who could easily go out and get jobs apply for wellfare simply because it's easier.

Thus, couldn't the system be flooded with moochers and slobs, thereby wasting resources and denying aid to those who really need it?

I mean, look at any such program in the world. If you offer it as FREE, there will be a lot of people who ordinarily wouldn't be interested in it, but just come because it's free and they want to make a buck or because they're lazy.

3. It would not be hard at all for the system to be used as almost a weapon against opposition.

"You don't agree with my policies? Fine! I'll put you on the waiting list for a kydney transplant until you croak. Problem solved."

And it wouldn't have to be some kind of high-level conspiracy either. Supporters of the current administration just happen to be higher on the list by and large...

4. Obviosly it's a considerable amount of money to spend, especially considering the success of other recent measures...

5. In any kind of organization, a thing will become more awkward and sluggish as it becomes larger and more complicated. This would tie in with #1.

As a thing grows larger, there is less time and less resources available to pay as great of attention to detail. The best you can do is compartmentalize it, but it still isn't as efficient.

As in business. A great big corporation simply doesn't have the diversity and flexibility of several small companies. In short, it's like putting all your eggs into one basket.

So why are we in a big rush to put the whole system under one management? Sure, it can regulate easier, and perhaps you would avoid some problems that way, but you would also become less effective in general.

Beauracracy tends to become sluggish as it grows, you know? Look at any other government agency? They often become downright sloppy. Do we really want health care like that, or do we think "Oh, it will work THIS time (even though it hasn't worked before)."

Take schools, for instance. Does anybody want to take the side that public schools are turning out really fine students these days, and that any public school kid is better off than in private school?

[Ironside]

So, I'm no economist, but I think that Universal Health Care would be easy to exploit.

I'd be glad to hear from supporters of the system as to whether or not my issues are realistic:

1. There would be a tendency for people seriosly needing care to be overlooked or forced to wait.

I would cite in examples Canada, where some patients have died while on the waiting list for major operations, and England, where there is a law that patients cannot be in the waiting room for longer than 4 hours, and as a result sometimes patients have to be left in the ambulance they arrived on.

(These could be rumors as I am not especially tuned in to Canada or the UK.)

Long waiting lists are a problem, but all systems have flaws. Your currently one is rather the opposite of an exception, as you rank low on many indirect measurements for health care quality (child mortality, life expectancy etc). Never heard about that ambulance thingy (not from Canada or UK though)


2. There could be a tendency for people who really don't need aid to skim off the system. The idea being similar to wellfare, where people who could easily go out and get jobs apply for wellfare simply because it's easier.

Thus, couldn't the system be flooded with moochers and slobs, thereby wasting resources and denying aid to those who really need it?

I mean, look at any such program in the world. If you offer it as FREE, there will be a lot of people who ordinarily wouldn't be interested in it, but just come because it's free and they want to make a buck or because they're lazy.

Here it's a lot of nominal fees, partially to cut down, partially because most patients aren't particaullary sick. Wisiting the doctor cost about 10-15 dollars. We also have a "high cost protection", making the highest yearly sum you possibly pay about 870 dollars (divided into 4 different posts, that is hospital care and doctor visits, pharmacies, medical equipment at home and sick travels), no matter how sick you are.

Besides, healthcare is oddly enough something healthy people don't usually abuse.


3. It would not be hard at all for the system to be used as almost a weapon against opposition.

"You don't agree with my policies? Fine! I'll put you on the waiting list for a kydney transplant until you croak. Problem solved."

And it wouldn't have to be some kind of high-level conspiracy either. Supporters of the current administration just happen to be higher on the list by and large...

Well, except from if media would even hint about something like this, the scandal would be bad enough to bring down a political party (as it's the equvivalent to murder of political opponents), unless you know for certain your doctor's political alignment the doctor could do it today.

Besides, anybody important enough for it to be viable are usually rich and/or gotten media attention.


4. Obviosly it's a considerable amount of money to spend, especially considering the success of other recent measures...

Tricky one. By taxes probably yes, by the total money in your wallet probably no, unless it a huge failure. You got the most expensive health care in the world atm. And it doesn't pay the bang for the buck.


5. In any kind of organization, a thing will become more awkward and sluggish as it becomes larger and more complicated. This would tie in with #1.

As a thing grows larger, there is less time and less resources available to pay as great of attention to detail. The best you can do is compartmentalize it, but it still isn't as efficient.

As in business. A great big corporation simply doesn't have the diversity and flexibility of several small companies. In short, it's like putting all your eggs into one basket.

So why are we in a big rush to put the whole system under one management? Sure, it can regulate easier, and perhaps you would avoid some problems that way, but you would also become less effective in general.


As mentioned, you already get very little bang for your bucks. And while a larger organization is more rigid, it can also reap benefits of it's size. Less paralell jobs and easier for regulating oversite for example, something more important in health care than in the normal market.
Evidently, companies prefers to fusion sometimes and somehow I suspect that it is not to be less efficient and thus less profitable.

[Hosakawa Tito]

This is why there is no "U.S. Health Care Debate". Rather, we have a shouting match.

I guess it's because August, with Congress in summer vacation recess, is a slow news month, and therefore a slow blogosphere and radio/TV talk-show month.

It's funny to hear the talk shows talk about "the Bill" or "ObamaCare", when there are several bills pending, in both houses, none endorsed by the POTUS, who has offered no Bill of his own, but has gone on national TV to support... health care reform. Or something.

Meanwhile, Fannie Mae quietly wants 11 Billion more Dollars (http://online.wsj.com/article/SB124960826802413197.html?mod=googlenews_wsj) to cover its losses (total bailout so far: $46B).

Distraction? You decide.

Every single issue is so politicized, and both parties are equally to blame here, that getting any kind of meaningful "discussion" turns into a WWF slagging match. Much of it has nothing to do with the real issue/issues, it's all about "how do I retain my power and get re-elected" positioning. Disinformation, lies by omission, dual party goon squads, unknown backroom deals with the affected big corporations & labor unions, media bias & "cherry-picking of info provided", and on and on....I'm disgusted with the whole process.

Meanwhile, those most affected, with genuine concerns/fears for what's really in the fine print are having a very difficult time figuring out who is lying to me/cheating me/holding back on me/selling me out the least.

All I know is, as a NY State employee, I'm very satisfied with the health coverage I have. I can't recall any major issues with "denial of coverage" for any of my life's medical catastrophes/emergencies, and there has been a few of those. The premiums & co-payments are affordable and have provided me with a "peace of mind" that I can depend upon.

I can only hope that whatever comes of this current reform, that families like Lemur's will be provided with the same options at a price they, and I, can afford. Hope guides me... but I'm not very confident the way things appear so far.

[Marshal Murat]

Meanwhile, those most affected, with genuine concerns/fears for what's really in the fine print are having a very difficult time figuring out who is lying to me/cheating me/holding back on me/selling me out the least.


This debate (as I've realized) isn't so much about better healthcare but how much we trust our representatives to do "what is best".

[Lemur]

This debate (as I've realized) isn't so much about better healthcare but how much we trust our representatives to do "what is best".
Well, at the moment we trust insurance companies to do "what is best." Whether you want to look at statistics, national costs or hair-raising anecdotes, the results ain't pretty.

I would really, truly like to hear about some real-world examples of the kinds of plans being put forward by Paul Ryan. In other words, we can examine the French model or the British model or the Japanese model or the Korean model of single-payer healthcare, and we can examine what works and what does not.

But the purely free-market model of healthcare? I would be much more comfortable putting everything into HSAs and private insurance if we could look at another country that has already done this.

Frankly, this should be the essence of conservatism: Show me how it works in the real world. Ditch the ideology and the theory, and show me how it functions when the rubber meets the road. (And in my private world inside my head, this is the real distinction, not between "left" and "right," but between pragmatic "conservatism" and ideology-driven "idealism." Results are what matter, not abstract political/economic theory.)

So can anyone cite an example of a first-world, industrialized nation that has gone with a (more or less) free-market healthcare system on all levels? I'm not asking this as a rhetorical question—there must be some first-world nation somewhere that has tried this. What were the results? Were costs contained? How broad did coverage wind up being? Were the common indexes (operation survival, birth survival, etc.) improved?

[Crazed Rabbit]

Some Union thugs practice their own special brand (http://www.breitbart.tv/businessman-assaulted-at-tampa-town-hall-says-police-officer-threatened-him/) of health care (http://www.breitbart.tv/protester-beaten-by-union-members-at-st-louis-town-hall-recounts-assault/). And of course I mean hitting and assaulting.

I'll say I don't know of any completely free-market health care plans. But 'radical' free market ideas have worked before. And limiting ourselves to what's been done in the past seems like quite an onerous restriction, given the nature of politicians.

CR

[Hosakawa Tito]

Here's an article (http://online.wsj.com/article_email/SB124958049241511735-lMyQjAxMDI5NDA5NzUwODcwWj.html#mod=igoogle_wsj_gadgv1) on the system in France. Perhaps some of our French members could elaborate?


France claims it long ago achieved much of what today's U.S. health-care overhaul is seeking: It covers everyone, and provides what supporters say is high-quality care. But soaring costs are pushing the system into crisis. The result: As Congress fights over whether America should be more like France, the French government is trying to borrow U.S. tactics.

[Lemur]

I'll say I don't know of any completely free-market health care plans. But 'radical' free market ideas have worked before.
So ... we're to adopt a purely free-market healthcare system based on faith? Surely there must be some testing, some evidence, someplace where a more-or-less pure pay-for-play heathcare system has been tried. If not, then I'm kind of shocked. We're to adopt an untested, untried experiment at a national level because we have faith?

Say what you like about single-payer, at least it's been road-tested in the real world by just about every industrialized nation. Its drawbacks, problems and benefits are at least understood.

I wish we could do a 50-state test bed, allowing every state to adopt whatever system they think best, then circling back and checking the results in, say, five years. That would be rocking. Not politically doable, and there's no doubt a lot of people would suffer and die in the "failed" experiments, but at least we'd be dealing with actual results and reality instead of theory, ideology and faith.

[Ariovistus Maximus]

Long waiting lists are a problem, but all systems have flaws. Your currently one is rather the opposite of an exception, as you rank low on many indirect measurements for health care quality (child mortality, life expectancy etc). Never heard about that ambulance thingy (not from Canada or UK though)

True; so I guess it's about whether we want a flawed governmental system or a flawed private system.


Besides, healthcare is oddly enough something healthy people don't usually abuse.

Yes, that makes sense. Mooching meds is perhaps not so lucrative as wellfare. :beam:



Well, except from if media would even hint about something like this, the scandal would be bad enough to bring down a political party (as it's the equvivalent to murder of political opponents), unless you know for certain your doctor's political alignment the doctor could do it today.

Besides, anybody important enough for it to be viable are usually rich and/or gotten media attention.

True enough, but keep in mind that we're talking about a permanent system.

Thus, the health care plan might work under one administration, but could be easily turned around by the next.


Tricky one. By taxes probably yes, by the total money in your wallet probably no, unless it a huge failure. You got the most expensive health care in the world atm. And it doesn't pay the bang for the buck.

And the problem is, not only might the ideal Socialised Medicine program be rather expensive, but who knows what kind of madness we'll actually get???

I don't think anyone (in a healthy state of mind) is under the illusion that our legislative body is composed of saints by any means.

[Ironside]

Yes, that makes sense. Mooching meds is perhaps not so lucrative as wellfare. :beam:

Mooching meds would require that you got a doctor who's very generous with his prescriptions and an actual selling market. If medical drugs are fairly cheap, why buy them black?



True enough, but keep in mind that we're talking about a permanent system.

Thus, the health care plan might work under one administration, but could be easily turned around by the next.

Considering how stiff the resistance is for this one, I would hardly call it easy to turn around.


And the problem is, not only might the ideal Socialised Medicine program be rather expensive, but who knows what kind of madness we'll actually get???

I don't think anyone (in a healthy state of mind) is under the illusion that our legislative body is composed of saints by any means.

Comparing what the US pays in health care costs (about 15% of the GDP) compared what the rest of the western world pays (about 10%), you have a pretty good shot of firing them all on grounds of incompetence if they fail to get it cheaper. They do have a considerble margin to play around with.

[Centurion1]

But our current health care bill includes social security which is possibly the worst run organization in the history of mankind

[Seamus Fermanagh]

But our current health care bill includes social security which is possibly the worst run organization in the history of mankind

But you gotta LOVE the rate of return on Social Security....not.


Advocates of privatization point out - correctly - that Logue's analysis compares theoretical stock returns with what the Social Security Trust Fund earned - not what he himself would get from the system.

From that perspective, the investment approach looks better, they argue. Over the long run, a typical worker can expect to earn 4.6 percent a year (after administrative costs) on a diversified portfolio of stocks and bonds and only about 2 percent or less from Social Security, according to federal estimates reported by Michael Tanner of the Cato Institute, long a proponent of privatization. Hypothetically, someone earning $30,000 annually would at the end of a 40-year career receive nearly twice as much under the investment approach ($344,000) than with Social Security ($185,000).

[Lemur]

An insightful piece by David Frum (http://www.newmajority.com/what-if-we-win-the-healthcare-fight) today. Excerpt:


What would it mean to “win” the healthcare fight?

For some, the answer is obvious: beat back the president’s proposals, defeat the House bill, stand back and wait for 1994 to repeat itself.

The problem is that if we do that… we’ll still have the present healthcare system. Meaning that we’ll have (1) flat-lining wages, (2) exploding Medicaid and Medicare costs and thus immense pressure for future tax increases, (3) small businesses and self-employed individuals priced out of the insurance market, and (4) a lot of uninsured or underinsured people imposing costs on hospitals and local governments.

We’ll have entrenched and perpetuated some of the most irrational features of a hugely costly and under-performing system, at the expense of entrepreneurs and risk-takers, exactly the people the Republican party exists to champion.

Not a good outcome.

[Ariovistus Maximus]

Considering how stiff the resistance is for this one, I would hardly call it easy to turn around.


Which is why we resist so stiffly. :2thumbsup:

[Tribesman]

Stupidity knows no limits
http://www.kansascity.com/news/politics/story/1373035.html
What sort of idiot goes protesting about the percieved threat to his private health insurance when he hasn't even got any private health insurance.
Could this be the new Joe the not the plumber who was protesting about taxes when he didn't pay them anyway?

[rvg]

The kind of idiot that does not expect to remain unemployed perpetually.

[Lemur]

My personal favorite: "Keep your government hands off my Medicare!"

-edit-

This testimony makes complete sense to me. I didn't avoid the doctor for my cut-up hand because I couldn't afford it; I stayed away because you never freaking know what it's going to cost.


I'm a bankruptcy lawyer, so I'm in one of the two groups that will be hurt by real health care reform (insurance companies being the other). About a third of my clients are in bankruptcy due to medical bills (another third have some medical bills, but it's not what pushed them over the edge). Almost all of them thought their health insurance would cover the problems they had. Many had gone to great lengths ahead of time to make sure their treatment would be covered, only to find out after the fact that their insurance company wouldn't pay. They've heard every excuse in the book (or in the fine print of the policy): experimental treatment, lifetime cap, high deductible, missed deadlines, lack of notification, pre-existing condition and so on. To me, the worst part of the American health care financing system is that you can't tell what your treatment will cost. I know folks who have flown to Pakistan to have operations they couldn't get in the US because nobody in the US (unlike Pakistan!) would agree in writing ahead of time what it would cost them.

[Tribesman]

The kind of idiot that does not expect to remain unemployed perpetually.

Yes, perhaps he can get a job with one of those firms who the taxpayer bails out because their healthcare costs are bankrupting them.
Or he could get really lucky and get a job with one of those firms who ship their workers off to the far east for medical care, together with their spouses to have a holiday and keep the ill person company..... because its cheaper than using the current US system.

[rvg]

Yes, perhaps he can get a job with one of those firms who the taxpayer bails out because their healthcare costs are bankrupting them.
Or he could get really lucky and get a job with one of those firms who ship their workers off to the far east for medical care, together with their spouses to have a holiday and keep the ill person company..... because its cheaper than using the current US system.

Or perhaps he can get a job with a normal company that provides normal benefits.

[Tribesman]

Or perhaps he can get a job with a normal company that provides normal benefits.
You should know that over the past few years companies and health care providers have been narrowing the scope of what they consider normal.

[Ironside]

Which is why we resist so stiffly. :2thumbsup:

:inquisitive:
Not sure if protecting a lousy system is worth :2thumbsup:.

Anyway does anybody know how the profit margins for the insurance companies has changed during the years (aka why they are getting skilled on insurance dodging)? Or any other nice data sets showing more exactly what's causing this slow spiral into a total collapse?

[rvg]

You should know that over the past few years companies and health care providers have been narrowing the scope of what they consider normal.

No, they've been increasing the share that the employees have to shell out. Quite different from redefining the standards of normalcy. My insurance, for example has remained unchanged of last...umm...10 years. Still covers same stuff as it used to.

[Tribesman]

No, they've been increasing the share that the employees have to shell out.
So your employer still provides for the normal cover but the employee has to pay more for the normal cover.
Yep thats not redifining the normalcy

[rvg]

So your employer still provides for the normal cover but the employee has to pay more for the normal cover.
Yep thats not redifining the normalcy

Not in my book.

[Tribesman]

Not in my book.
Perhaps you had better send your book back to the publishers with a note complaining that their proof readers were asleep on the job.

[rvg]

Perhaps you had better send your book back to the publishers with a note complaining that their proof readers were asleep on the job.

oooo I burn..... Can't believe you didn't sense being goaded. You're becoming way to predictable.

[Marshal Murat]

President talks sense (http://finance.yahoo.com/news/Obama-Canadian-health-system-apf-3773617092.html?x=0&.v=1)

Basically Obama says that the Canadian healthcare system wouldn't work in the US.
:2thumbsup:

[Xiahou]

Pelosi and Hoyer call those protesting healthcare reform "un-American (http://blogs.usatoday.com/oped/2009/08/unamerican-attacks-cant-derail-health-care-debate-.html)".... but, I thought dissent was the highest form of patriotism.... I guess it depends on whether or not you agree with her.


The problem is that if we do that… we’ll still have the present healthcare system. Meaning that we’ll have (1) flat-lining wages, (2) exploding Medicaid and Medicare costs and thus immense pressure for future tax increases, (3) small businesses and self-employed individuals priced out of the insurance market, and (4) a lot of uninsured or underinsured people imposing costs on hospitals and local governments.Frum must've missed the part where the CBO said that the proposed bills would accelerate cost increases. None of the proposals in Congress do anything meaningful in terms of controlling costs, so yeah, I'd consider it a win if none of them passed.

[Tribesman]

Pelosi and Hoyer call those protesting healthcare reform "un-American"....
No, they said those that just shout nonsense devoid of facts in an effort to drown out opposing voices are un-american...though I would just describe those people as incredibly stupid individuals.

[a completely inoffensive name]

Just wanting to put in my contribution. Was lurkin on Reddit and found this informative submission:
http://finance.yahoo.com/insurance/article/107498/health-care-six-money-wasting-problems.html?mod=insurance-health

In the comments section this looks to be the most favored comment:

"I've worked in health care for more then 30 years and I've been politically active for health care reform for about 10 years. I think this article is a good summary of the symptoms of health care. However, what may not be evident is the underlying disease which is causing these symptoms to occur.
The health care system didn't use to waste money this way. The waste probably began when the government started making it possible to pay health insurance premiums using pretax dollars, but kept directly paying for health care after tax (during WWII). The waste really began in the 1960's when Medicare and Medicaid were enacted and doctors and hospitals had to start coding everything they did and submitting claims for reimbursement. This coding rewarded doing more procedures and ordering more tests. Soon, private insurance followed Medicare and Medicaid, and costs went through the roof. In 1973, Nixon tried to get things under control by introducing HMOs. In the 1980s, Medicare tried to get costs under control by paying for entire hospital stays, rather than each day in the hospital separately. Nothing has worked; health care costs still go up faster than inflation while the value of care doesn't go up nearly as fast.
I think health care needs to be reformed, but I am pessimistic that the reform proposals now being discussed are going to be effective. I think we're going to have to be more radical: either have the government take over health care like the UK (not a good choice, IMHO, but better than what we've got now), or practice some tough love on the U.S. populace and explain that 60% of health care is more efficiently purchased directly and not through the government or insurance companies."

Just wanted to pitch in with this to stimulate conversation, here is the actual comments page:
http://www.reddit.com/r/Economics/comments/99c3s/12_trillion_waste_found_in_usa_health_care_most/

[Lemur]

None of the proposals in Congress do anything meaningful in terms of controlling costs, so yeah, I'd consider it a win if none of them passed.
You're in excellent company (http://theplumline.whorunsgov.com/president-obama/on-private-conference-call-tea-party-organizers-say-no-reform-at-all-is-goal/):


On a private conference call, a group of top Tea Party and conservative organizers offered a surprisingly frank description of their goal, according to a source on the call: Completely blocking any kind of bipartisan compromise, and completely preventing any type of health care reform bill at all from ever becoming law.

[Xiahou]

You're in excellent company (http://theplumline.whorunsgov.com/president-obama/on-private-conference-call-tea-party-organizers-say-no-reform-at-all-is-goal/):
Thanks.... I guess. :shrug:


Here's an analysis (http://junkfoodscience.blogspot.com/2009/08/no-american-can-ever-say-they-didnt.html) of the mandatory end of life counseling provision in the bill. It's a long post, but worth reading if you're at all interested in what's actually in the bill. Here's just a small excerpt:
Did you get all that? Of course not. It’s mostly gobblety goop and legalese, with repeated edits and references to other laws that makes it next to impossible for most anyone to comprehend. But, as the Bioethics Defense Fund has concluded, this broad and vaguely written bill is wide open to being interpreted as giving the government the power to require all Medicare recipients to receive advance care consultations and giving the government the unprecedented authority to define exactly what such counseling must include, who can deliver it, and when it must be given.

More importantly, it is clearly an effort to coerce seniors to sign such an order. There are multiple loopholes that open doors for its misuse, and abuse of the elderly, while also including no protections for these patients.

[seireikhaan]

Here's an analysis (http://junkfoodscience.blogspot.com/2009/08/no-american-can-ever-say-they-didnt.html) of the mandatory end of life counseling provision in the bill. It's a long post, but worth reading if you're at all interested in what's actually in the bill. Here's just a small excerpt:
Well, a couple of points I'll make before diving in:

1) Its not "the bill", per se. There's a multitude of bills that were floating around before congress went on vaca, and to label any of them as "the bill" is probably a rash judgement.

2) I am irked by their style. Yes, they list the bill, and its language. Which is good. What's not good is them trying to discourage people from reading it when they label it as incomprehensible when it is already intimidating and long.

Ok, I'm trying to figure out what the overall point is as pertaining to the actual language of this particular bill. Basically, that the state can control what medical professionals would tell seniors in these meetings, based on what this secretary proposes as "appropriate" measures that medical professionals could use. Yet what the blogger does not take note of is this bit:
The Secretary shall provide for a period of public comment on such set of measures before finalizing such proposed measures.' So basically, the secretary has to tell everyone what these "appropriate" measures are before said person is allowed to finalize them. Meaning that they are put to the fire of public opinion before being put forth, and said secretary stakes their reputation on the line, as well as that of the current admin, when they publish these. The blogger apparently thinks this unimportant, as the entire rest of that paragraph was bolded and this was not.

Further, the blogger bold-faced lies when they claim this:
Note: It makes no provisions that the patients must consent to these orders or that the doctor writing these orders must be the patient’s own personal healthcare provider., as by this:

`(5)(A) For purposes of this section, the term `order regarding life sustaining treatment' means, with respect to an individual, an actionable medical order relating to the treatment of that individual that—
...

`(ii) effectively communicates the individual's preferences regarding life sustaining treatment, including an indication of the treatment and care desired by the individual;

`(B) The level of treatment indicated under subparagraph (A)(ii) may range from an indication for full treatment to an indication to limit some or all or specified interventions. Such indicated levels of treatment may include indications respecting, among other items—
`(i) the intensity of medical intervention if the patient is pulse less, apneic, or has serious cardiac or pulmonary problems;
`(ii) the individual's desire regarding transfer to a hospital or remaining at the current care setting;
`(iii) the use of antibiotics; and
`(iv) the use of artificially administered nutrition and hydration.'.

So basically the requirements for patient protection the blogger so wanted are there, and the blogger decided to ignore it, and feigned bipartisanship by giving the bill only to try and intimidate people into not reading anything that wasn't bolded by said blogger.

[Hosakawa Tito]

I watched the Rachel Maddow program (http://www.msnbc.msn.com/id/26315908/#32380712) on MSNBC last night as they did a piece on these so called grass roots protests at the health care debate town hall meetings. FreedomWorks have every right to their expressing their views, but they misrepresent/lie & deceive who they really get paid to speak for and need to be exposed as the charlatans they are. These tactics anger me very much.

[Centurion1]

There are a few astro-turfers i am sure hidden among the protesters of healthcare. But i think the vast majority are simply people who do not want this bill passed. Remember, over 40% of the country voted for a republican, conservatism isn't completely dead yet.

[Xiahou]

Further, the blogger bold-faced lies when they claim this: , as by this:

So basically the requirements for patient protection the blogger so wanted are there, and the blogger decided to ignore it, and feigned bipartisanship by giving the bill only to try and intimidate people into not reading anything that wasn't bolded by said blogger.Wow, you need to go read what she said again, you're missing the boat entirely. You're referencing the section on the contents of the actual medical orders, not the counseling itself. I don't have the time to go point by point right now, but seriously, look again.

[Crazed Rabbit]

In terms of having faith in a free-market system, in reply to Lemur -
It's not 'faith', it's trust in sound economic theory that has worked before. Example - right now we can't buy out of state insurance. Getting rid of that prohibition means the market becomes freer, there's more competition, more choices for the consumer, and cheaper insurance. That's not faith - that's the reasonable expectation using proven economic theory.

Along those lines, another proposal for health care reform from John Mackey, CEO of Whole Foods; (http://online.wsj.com/article/SB20001424052970204251404574342170072865070.html)


Remove the legal obstacles that slow the creation of high-deductible health insurance plans and health savings accounts (HSAs).
Equalize the tax laws so that that employer-provided health insurance and individually owned health insurance have the same tax benefits.
Repeal all state laws which prevent insurance companies from competing across state lines.
Repeal government mandates regarding what insurance companies must cover.
 Enact tort reform to end the ruinous lawsuits that force doctors to pay insurance costs of hundreds of thousands of dollars per year.
Make costs transparent so that consumers understand what health-care treatments cost.
 Enact Medicare reform.
 Finally, revise tax forms to make it easier for individuals to make a voluntary, tax-deductible donation to help the millions of people who have no insurance and aren’t covered by Medicare, Medicaid or the State Children’s Health Insurance Program.


An analysis (http://online.wsj.com/article/SB10001424052970204908604574332293172846168.html)of the impact of what Obama wants to do, in terms of what states that have implemented it have experienced;

Because the tax code subsidizes private insurance only when it is sponsored by an employer, the individual market is relatively small and its turnover rate is very high. Most policyholders are enrolled for fewer than 24 months as they move between jobs, making it difficult for insurers to maintain large risk pools to spread costs.

Mr. Obama wants to wave away this reality with new regulations that prohibit "discrimination against the sick"—specifically, by forcing insurers to cover anyone at any time and at nearly uniform rates. But if insurers are forced to sell coverage to everyone at any time, many people will buy insurance only when they need medical care. This raises the cost of insurance for everyone else, in particular those who are responsible enough to buy insurance before they need it; they end up paying even higher premiums. And the more expensive the insurance, the less likely people will buy it before they need it.

That's one reason that only five states—Maine, Massachusetts, New Jersey, New York and Vermont—have Mr. Obama's proposal for "guaranteed issue" on the books today. New Hampshire and Kentucky repealed such laws after finding that they soon had an even smaller individual insurance market as companies fled the state.

Another proposed reform known as "community rating" imposes uniform premiums regardless of health condition. This also blows up the individual insurance market, by making it far more expensive for young, healthy or low-risk consumers to join pools—if they join at all. And if the healthy don't join risk pools, then premiums go up for everyone and insurers have little choice but to reduce their risk by refusing to cover those who have a high chance of getting sick, such as people with a history of cancer. This is why 35 states today impose no limits whatsoever on how much insurers can vary premiums and six states allow wide variation among consumers.

New York, New Jersey and Massachusetts have both community rating and guaranteed issue. And, no surprise, they have the three most expensive individual insurance markets among all 50 states, with premiums roughly two to three times higher than the rest of the country. In 2007, the average annual premium in New Jersey was $5,326 for singles and in New York $12,254 for a family, versus the national average of $2,613 and $5,799, respectively. ObamaCare would impose New York-type rates nationwide.
...
University of Chicago economist John Cochrane also argues that in a more rational individual insurance market, people could insure not merely against medical expenses but also against changes in health status. This kind of insurance would cover the risk of premiums rising as you get older and your health condition changes.

In turn, that would free insurers to compete for the business of all patients, including those with pre-existing conditions, because then they could charge enough to cover the costs—instead of passing them to others. As for those with rare conditions ("orphan diseases") that require a lifetime of special care and are thus uninsurable, this is where government subsidies could be both appropriate and affordable.

ObamaCare would impose on all 50 states rules that have already proven to be failures in numerous states. Because these mandates would raise the cost of insurance, ObamaCare would then turn around and subsidize individuals to buy the insurance that the politicians made more expensive. Only in government could such irrationality be sold as "reform."


I think freeing up the market, making costs transparent, preventing fine-print trickery, would all go so much farther then Obama's "reform".

CR

[Tribesman]

Remember, over 40% of the country voted for a republican, conservatism isn't completely dead yet.

OK , given the past two terms and the current bunch of Republican incumbents, how do you make the relation with voting for conservatism?

[LittleGrizzly]

God, guns and gays...

Or God, guns and less gays... and stopping the damn commies... thats pretty much conservatism isn't it ?

~;)

[Tribesman]

Or God, guns and less gays...
OK apart from the foot tapping oxycontin fueled meth taking bible bashing poofs which ones?
The corrupt lunatic self publicing use my family don't use my family clothes horse type perhaps?

[Xiahou]

God, guns and gays...

Or God, guns and less gays... and stopping the damn commies... thats pretty much conservatism isn't it ?

~;)
When all else fails, resort to name-calling. Right? :wink:

[Centurion1]

Excuse me, not conservatism, i meant the republican party.

[Don Corleone]

Stupid question...

If the Democrats want to outlaw private insurance and force everyone into a one-payer system, why don't they just let us into their plan.... the one that Congress & their staffers get?

That'd solve the whole problem right there, correct?

This whole insurance reform sounds a lot like "ALL Animals are equal, and some are more equal than others".

[Centurion1]

So true. Because those elder statesmen (seriously disgusted with all politicians at the moment) have such an amazing plan. It is so good and expensive it would probably cost the American taxpayer trillions a year. What i want to see is these old ***** coming down and joining this hybrid bull plan they have developed. Maybe then i would have some faith in it.

end rant :sweatdrop:

[rory_20_uk]

Things the taxpayer concerns themselves with:


Cost in their taxes
Perceived access


Things they are not bothered with:


Overall cost in terms of GDP
Sustainability
Anything that they feel won't affect them


So, although most agree that America (nor anywhere else for that matter) can continue increasing the percentage of GDP on health, the money required can not ration treatment, cause waiting times to increase or cost them any more in tax, nor penalise their lifestyle.

The average American appears to be unaware that their life for the last 30+ years has been based on others buying their debt. Something has to give - just not the quantity, quality or availability of the healthcare... :wall:

~:smoking:

[Tribesman]

"People such as scientist Stephen Hawking wouldn't have a chance in the UK, where the National Health Service would say the life of this brilliant man, because of his physical handicaps, is essentially worthless."
What a silly bunch these anti reform wingnuts are .
Do you think they got embarrased when Stephen Hawking wheeled into the fray to say they was talking bollox?

[Tsavong]

Are you referring to this?


UK newspapers the Guardian and Daily Telegraph reported Prof Hawking as saying that he "wouldn't be here today if it were not for the NHS".

http://news.bbc.co.uk/1/hi/world/americas/8198084.stm

I also find it funny that some idiot Torrie criticized the NHS so much that there party has had to reassure us (UK voters) that the NHS is "safe in there hands" lol

http://news.bbc.co.uk/1/hi/uk_politics/8200817.stm

[Tribesman]

I also find it funny that some idiot Torrie criticized the NHS so much that there party has had to reassure us (UK voters) that the NHS is "safe in there hands" lol

Whats funny is that it was the part privatisation of aspects of the NHS done by the tories and continued under Thatcherlite Blair which have given rise to many of the cost and treatment problems the NHS has now

[Idaho]

What a silly bunch these anti reform wingnuts are .
Do you think they got embarrased when Stephen Hawking wheeled into the fray to say they was talking bollox?

Right-wingers are unsurpassed in their ability to have heard about things that discount their arguments. Something to do with only reading news sources that provide them with shop-bought opinions with 'facts' neatly bulleted after for easy reading.

[Xiahou]

Right-wingers are unsurpassed in their ability to have heard about things that discount their arguments. Something to do with only reading news sources that provide them with shop-bought opinions with 'facts' neatly bulleted after for easy reading.
Left-wingers are unsurpassed in their ability to have heard about things that discount their arguments. Something to do with only reading news sources that provide them with shop-bought opinions with 'facts' neatly bulleted after for easy reading. :yes:

Sure, it's entirely off-topic and inflamatory, but it feels good to say, right? :2thumbsup:

[Centurion1]

It is amazing whenever a right winger finds anything sort of anti reform fact. Because almost all of the news sources are left, msnbc, ney york times, washington post, cbs,........ you name it. :laugh4:

[LittleGrizzly]

Maybe Mr Hawking said it in Persian or Arabic or something else originally, right wingers seem to have problems translating such statements without turning them into support for thier own position... ?

[Ser Clegane]

Could we perhaps focus on the actual topic instead of beating the poor old dead "right/left/whatever-wingers are sooo stoopid"-horse?

Highly appreciated.

[LittleGrizzly]

But the right wingers are really....

~;)

If the Democrats want to outlaw private insurance and force everyone into a one-payer system, why don't they just let us into their plan.... the one that Congress & their staffers get?

AFAIK thats kinda how its done in Britian, the politicians have access to the same tax paid healthcare we do... or they can pay extra for private healthcare... like any wealthy Briton can....

So its a pretty fair system... the one part I wasn't sure about is if they get some kind of private health insurance as part of thier job perks...

In my ideal system the politicians would have to use exactly the same system that people who cannot afford private health insurance have to use, I don't think they would be so quick to cut funding then....

[seireikhaan]

Wow, you need to go read what she said again, you're missing the boat entirely. You're referencing the section on the contents of the actual medical orders, not the counseling itself. I don't have the time to go point by point right now, but seriously, look again.
You know, I keep going over that, and apparently I just keep missing the boat, because I don't see how else to interpret the statements.

[Philippus Flavius Homovallumus]

But the right wingers are really....

~;)

If the Democrats want to outlaw private insurance and force everyone into a one-payer system, why don't they just let us into their plan.... the one that Congress & their staffers get?

AFAIK thats kinda how its done in Britian, the politicians have access to the same tax paid healthcare we do... or they can pay extra for private healthcare... like any wealthy Briton can....

That is the system. Everyone pays, anyone can use. Though "everyone" only includes those who work.


So its a pretty fair system... the one part I wasn't sure about is if they get some kind of private health insurance as part of thier job perks...

You mean does the UK government pay for private healthcare for MP's etc.

No, of course not. That would be utterly absurd.

[rory_20_uk]

You mean does the UK government pay for private healthcare for MP's etc.

No, of course not. That would be utterly absurd.

That's what expenses are for, or just using one's clout to jump the que (mrs Blair had an extra SpR in Obstetrics with her in her NHS hospital).

~:smoking:

[Idaho]

Could we perhaps focus on the actual topic instead of beating the poor old dead "right/left/whatever-wingers are sooo stoopid"-horse?

Highly appreciated.

That's what the debate eventually boils down to isn't it?

"You're stupid because you don't understand"
"No you are"
"No you"
etc...

Why let all the issues and other distractions get in the way?

[Idaho]

That's what expenses are for, or just using one's clout to jump the que (mrs Blair had an extra SpR in Obstetrics with her in her NHS hospital).

~:smoking:

Not so much using one's clout. More what Tudor Hart referred to as the "inverse care law". What happens with supposedly universal services is that the wealthier and more educated you are, the more you end up getting out of the system, based on 3 major factors:

- You are on the same/similar social class as the doctors and beauraucrats and understand how the system works
- You live, or can move, to the better provisioned areas (this happens a lot with state schooling in the UK)
- You can afford to embellish the universal care with extras.

I am still entirely in favour of universal schooling and medical treatment - it just has issues.

[Philippus Flavius Homovallumus]

Not so much using one's clout. More what Tudor Hart referred to as the "inverse care law". What happens with supposedly universal services is that the wealthier and more educated you are, the more you end up getting out of the system, based on 3 major factors:

- You are on the same/similar social class as the doctors and beauraucrats and understand how the system works
- You live, or can move, to the better provisioned areas (this happens a lot with state schooling in the UK)
- You can afford to embellish the universal care with extras.

I am still entirely in favour of universal schooling and medical treatment - it just has issues.

Well, no system is perfect.

[Louis VI the Fat]

Stupid question...

If the Democrats want to outlaw private insurance and force everyone into a one-payer systemThe answer is that Obama doesn't want to do that. Number two, and number three (http://pol.moveon.org/truth/lies.html)

Obama is going to stop Washington-protected monopolies. And use Washington to create competition.

Want market and choice? Support reform, to put an end to lucrative state-protected monopolies.

The health care fight has turned ugly, fast. And lies about reform are spreading via anonymous email chains. Below are the real facts you need to know.


Top Five Health Care Reform Lies—and How to Fight Back


Lie #1: President Obama wants to euthanize your grandma!!!


The truth: These accusations—of "death panels" and forced euthanasia—are, of course, flatly untrue. As an article from the Associated Press puts it: "No 'death panel' in health care bill."1 What's the real deal? Reform legislation includes a provision, supported by the AARP, to offer senior citizens access to a professional medical counselor who will provide them with information on preparing a living will and other issues facing older Americans.2



If you'd like to read the actual section of the legislation that spawned these outrageous claims (Section 1233 of H.R. 3200) for yourself, here it is. It's pretty boring stuff, which is why the accusations that it creates "death panels" is so absurd. But don't take our word for it, read it yourself.





Lie #2: Democrats are going to outlaw private insurance and force you into a government plan!!!


The truth: With reform, choices will increase, not decrease. Obama's reform plans will create a health insurance exchange, a one-stop shopping marketplace for affordable, high-quality insurance options.3 Included in the exchange is the public health insurance option—a nationwide plan with a broad network of providers—that will operate alongside private insurance companies, injecting competition into the market to drive quality up and costs down.4 If you're happy with your coverage and doctors, you can keep them.5 But the new public plan will expand choices to millions of businesses or individuals who choose to opt into it, including many who simply can't afford health care now.





Lie #3: President Obama wants to implement Soviet-style rationing!!!


The truth: Health care reform will expand access to high-quality health insurance, and give individuals, families, and businesses more choices for coverage. Right now, big corporations decide whether to give you coverage, what doctors you get to see, and whether a particular procedure or medicine is covered—that is rationed care. And a big part of reform is to stop that.

Health care reform will do away with some of the most nefarious aspects of this rationing: discrimination for pre-existing conditions, insurers that cancel coverage when you get sick, gender discrimination, and lifetime and yearly limits on coverage.6 And outside of that, as noted above, reform will increase insurance options, not force anyone into a rationed situation.





Lie #4: Obama is secretly plotting to cut senior citizens' Medicare benefits!!!


The truth: Health care reform plans will not reduce Medicare benefits.7 Reform includes savings from Medicare that are unrelated to patient care—in fact, the savings comes from cutting billions of dollars in overpayments to insurance companies and eliminating waste, fraud, and abuse.8





Lie #5: Obama's health care plan will bankrupt America!!!


The truth: We need health care reform now in order to prevent bankruptcy—to control spiraling costs that affect individuals, families, small businesses, and the American economy. Right now, we spend more than $2 trillion dollars a year on health care.9 The average family premium is projected to rise to over $22,000 in the next decade10—and each year, nearly a million people face bankruptcy because of medical expenses.11 Reform, with an affordable, high-quality public option that can spur competition, is necessary to bring down skyrocketing costs. Also, President Obama's reform plans would be fully paid for over 10 years and not add a penny to the deficit.12

[ICantSpellDawg]

Most Insurance policies do not include coverage for elective abortions, only to save the life of the mother from impending doom. The new single payer trainer would. Democrats say "It would be taking away coverage if we didn't include it" they are lying here as well. BTW

[Philippus Flavius Homovallumus]

Most Insurance policies do not include coverage for elective abortions, only to save the life of the mother from impending doom. The new single payer trainer would. Democrats say "It would be taking away coverage if we didn't include it" they are lying here as well. BTW

Yeah, and proper healthcare reform will ensure that children with Cancer ALWAYS get treated.

If abortion is what you are going to focus on, you're seriously missing the point.

[Louis VI the Fat]

Most Insurance policies do not include coverage for elective abortions, only to save the life of the mother from impending doom. The new single payer trainer would. Democrats say "It would be taking away coverage if we didn't include it" they are lying here as well. BTWYes, healthcare reform is the holocaust.

Well that is a bit harsh of mine. I would say that abortion is constitutional. One has to live with it as much as many on the left will have to learn to cope with constitutional firearms. But this is not how a moderate state ought to function.
Considering that many have profound moral objection to abortion, I would prefer a system that gives people a way out. Where there is compulsory military service there usually is, and ought to be, a way to accomodate those with grave moral objections too.



Actually, if I were the Democrat strategy department, I'd use this as leverage.

I'd propose a bill that a) destroys indulgence of industry by Washington and stimulates competition through consumer choice, and b) includes abortion in compulsory coverage. Then, at some point, I'd grant b to the Republicans in exchange for their support for a, that is, a functioning market in healthcare.
Then the hardright - the GOP - can present abortion as a victory to their base, and the centrist right - the Democrats - have it their way too: market, consumer choice, competition, and an end to bureaucratic industry pork and Washington-protected monopolistic practises.

[ICantSpellDawg]

Yeah, and proper healthcare reform will ensure that children with Cancer ALWAYS get treated.

If abortion is what you are going to focus on, you're seriously missing the point.


No, You're missing the point. If they want to start a fight with every interest group who argues with the purist left then they will fail at reform. This administration is simply making enemies. We need to keep fighting until they take the most upsetting parts of the bill out. Make friends in this. Everyone wants to see insurance companies stabbed and bleeding in the streets, but we don't want the government to take their place and have no recourse. Weaken insurance companies, open costs up to the free market, provide portable insurance incentives, reduce canadian drug restrictions, allow groups of people to create their own pools. If you can do this, you will have succeeded in reform. Don't just push for euthanasia to control elder care and government paid abortion on demand - that isn't the kind of reform most people want or need - that is special interest attempting to hijack legitimate issues.

After this we can work on universal coverage and it will be easier

[ICantSpellDawg]

Yeah, and proper healthcare reform will ensure that children with Cancer ALWAYS get treated.

If abortion is what you are going to focus on, you're seriously missing the point.


Yes, healthcare reform is the holocaust.

Well that is a bit harsh of mine. I would say that abortion is constitutional. One has to live with it as much as many on the left will have to learn to cope with constitutional firearms. But this is not how a moderate state ought to function.
Considering that many have profound moral objection to abortion, I would prefer a system that gives people a way out. Where there is compulsory military service there usually is, and ought to be, a way to accomodate those with grave moral objections too.



Actually, if I were the Democrat strategy department, I'd use this as leverage.

I'd propose a bill that a) destroys indulgence of industry by Washington and stimulates competition through consumer choice, and b) includes abortion in compulsory coverage. Then, at some point, I'd grant b to the Republicans in exchange for their support for a, that is, a functioning market in healthcare.
Then the hardright - the GOP - can present abortion as a victory to their base, and the centrist right - the Democrats - have it their way too: market, consumer choice, competition, and an end to bureaucratic industry pork and Washington-protected monopolistic practises.

Leave it out of governemnt insurance except in extreme circumstances and allow people who want it to buy supplemental policies. Keep my money out of elective abortion.

Do you want it to cover plastic surgery? Not unless it is to repair function lost from burns, car accidents, etc JUST LIKE INSURANCE COMPANIES DO IT. The more coverage, the more prices will go up in new areas - the more prices go up in unneccessary areas , the more money for healthcare is diverted to waste or unethical use. That does not control cost, nothing in this expansive program does.


Look on the birghtside everyone - we are arguing about a real issue, unlike that retarded gay-marriage nonsense.

[Xiahou]

The answer is that Obama doesn't want to do that. Number two, and number three (http://pol.moveon.org/truth/lies.html)

Obama is going to stop Washington-protected monopolies. And use Washington to create competition.

Want market and choice? Support reform, to put an end to lucrative state-protected monopolies.

The health care fight has turned ugly, fast. And lies about reform are spreading via anonymous email chains. Below are the real facts you need to know.


Top Five Health Care Reform Lies—and How to Fight Back


Lie #1: President Obama wants to euthanize your grandma!!!


The truth: These accusations—of "death panels" and forced euthanasia—are, of course, flatly untrue. As an article from the Associated Press puts it: "No 'death panel' in health care bill."1 What's the real deal? Reform legislation includes a provision, supported by the AARP, to offer senior citizens access to a professional medical counselor who will provide them with information on preparing a living will and other issues facing older Americans.2



If you'd like to read the actual section of the legislation that spawned these outrageous claims (Section 1233 of H.R. 3200) for yourself, here it is. It's pretty boring stuff, which is why the accusations that it creates "death panels" is so absurd. But don't take our word for it, read it yourself.





Lie #2: Democrats are going to outlaw private insurance and force you into a government plan!!!


The truth: With reform, choices will increase, not decrease. Obama's reform plans will create a health insurance exchange, a one-stop shopping marketplace for affordable, high-quality insurance options.3 Included in the exchange is the public health insurance option—a nationwide plan with a broad network of providers—that will operate alongside private insurance companies, injecting competition into the market to drive quality up and costs down.4 If you're happy with your coverage and doctors, you can keep them.5 But the new public plan will expand choices to millions of businesses or individuals who choose to opt into it, including many who simply can't afford health care now.





Lie #3: President Obama wants to implement Soviet-style rationing!!!


The truth: Health care reform will expand access to high-quality health insurance, and give individuals, families, and businesses more choices for coverage. Right now, big corporations decide whether to give you coverage, what doctors you get to see, and whether a particular procedure or medicine is covered—that is rationed care. And a big part of reform is to stop that.

Health care reform will do away with some of the most nefarious aspects of this rationing: discrimination for pre-existing conditions, insurers that cancel coverage when you get sick, gender discrimination, and lifetime and yearly limits on coverage.6 And outside of that, as noted above, reform will increase insurance options, not force anyone into a rationed situation.





Lie #4: Obama is secretly plotting to cut senior citizens' Medicare benefits!!!


The truth: Health care reform plans will not reduce Medicare benefits.7 Reform includes savings from Medicare that are unrelated to patient care—in fact, the savings comes from cutting billions of dollars in overpayments to insurance companies and eliminating waste, fraud, and abuse.8





Lie #5: Obama's health care plan will bankrupt America!!!


The truth: We need health care reform now in order to prevent bankruptcy—to control spiraling costs that affect individuals, families, small businesses, and the American economy. Right now, we spend more than $2 trillion dollars a year on health care.9 The average family premium is projected to rise to over $22,000 in the next decade10—and each year, nearly a million people face bankruptcy because of medical expenses.11 Reform, with an affordable, high-quality public option that can spur competition, is necessary to bring down skyrocketing costs. Also, President Obama's reform plans would be fully paid for over 10 years and not add a penny to the deficit.12

I love it when "debunking" sites get their facts wrong. There's something so deliciously ironic about it. :2thumbsup:

[Philippus Flavius Homovallumus]

No, You're missing the point. If they want to start a fight with every interest group who argues with the purist left then they will fail at reform. This administration is simply making enemies. We need to keep fighting until they take the most upsetting parts of the bill out. Make friends in this. Everyone wants to see insurance companies stabbed and bleeding in the streets, but we don't want the government to take their place and have no recourse. Weaken insurance companies, open costs up to the free market, provide portable insurance incentives, reduce canadian drug restrictions, allow groups of people to create their own pools. If you can do this, you will have succeeded in reform. Don't just push for euthanasia to control elder care and government paid abortion on demand - that isn't the kind of reform most people want or need - that is special interest attempting to hijack legitimate issues.

After this we can work on universal coverage and it will be easier

No, you are missing the point. You can have universal coverage now by making the State a health insurer. If every sallaried American is in the pool costs will go way down, once people realise that the State-run hospitals wont check their insurance or credit rating before treating them, and they wont get kicked out after two weeks they'll drop their useless private insurer. Then un-profitable companies will go bust, the rest will pick the people who want to go private and not wait in line.

The average American, the State and the Employer will all pay less because your corrupt Victorian system will no longer be a black hole sucking in money. Oh sure, waiting times will go up, but that will be because the system has to take more capacity.

Once you have universal coverage under one policy Medicare and Medicaid will become irrelevant. They can be rolled up, reducing wastage. At the same time, the State can reel in lawsuits against State-paid and funded doctors. People are also much less likely to sue someone if they know that person is being paid with their tax-dollars anyway.

Why you people have such a blind spot on this issue I don't know, from this side of the pond it looks universally weird in America.

[ICantSpellDawg]

No, you are missing the point. You can have universal coverage now by making the State a health insurer. If every sallaried American is in the pool costs will go way down, once people realise that the State-run hospitals wont check their insurance or credit rating before treating them, and they wont get kicked out after two weeks they'll drop their useless private insurer. Then un-profitable companies will go bust, the rest will pick the people who want to go private and not wait in line.

The average American, the State and the Employer will all pay less because your corrupt Victorian system will no longer be a black hole sucking in money. Oh sure, waiting times will go up, but that will be because the system has to take more capacity.

Once you have universal coverage under one policy Medicare and Medicaid will become irrelevant. They can be rolled up, reducing wastage. At the same time, the State can reel in lawsuits against State-paid and funded doctors. People are also much less likely to sue someone if they know that person is being paid with their tax-dollars anyway.

Why you people have such a blind spot on this issue I don't know, from this side of the pond it looks universally weird in America.


The law of large numbers has a cost decreasing affect, yes. An effect that will be easily overcome by non-existant underwriting guidelines and millions more non-paying named insureds.

Credit related Insurance scores help me pay less for my insurance and guarantee the insurance company money to pay claims. A dollar is a dollar and if Americans believe that this plan will lower their cost of living, they are either fools or unemployed.

We simply need to know what is being paid before a procedure, a way to shop around and to feel the effects or irresponsible treatments that don't work on our pocketbooks. This plan is smoke and mirror parlor games designed for a purpose entirely opposed to increasing the amount of income we keep. Most americans are complaining about the amount of money that they pay in health care. Democrats have responded with a plan to take even more money from us and spend it on non-contributing citizens.

Our country is designed as a lab with many different compartments - each one closer to the direct needs of the people than the central government. We have the ability to test health care plans on a State by State basis. Our governement refuses to facilitate this. Those that want reform want it for very different reasons than those they are supposed to represent.

[Tribesman]

Most americans are complaining about the amount of money that they pay in health care. Democrats have responded with a plan to take even more money from us and spend it on non-contributing citizens.

Since you pay for the non-contributing citizens already your arguement falls apart.
If other countries can pay for full universal healthcare and get far better medical care results for less than half the money the US pays for its jumbled part universal healthcare, then why woud America not be able to get the same results in full universal healthcare for the same level of funding as other countries do?


We simply need to know what is being paid before a procedure
That sounds like rationing , I thought that was what the protesters were complaining about.

[Crazed Rabbit]

The answer is that Obama doesn't want to do that. Number two, and number three (http://pol.moveon.org/truth/lies.html)

Well he's said he wants to do that, and the Obamacare bill will set up regulations so that you must get government approved insurance, and can't continue to get your current insurance, if your current insurance doesn't fulfill every little government mandate.

CR

[Tribesman]

Well he's said he wants to do that, and the Obamacare bill will set up regulations so that you must get government approved insurance
Wow regulation of the insurance industry, scary stuff.
Not as scary as the results of the experiments the free marketeers had with their non-regulation ideals.

[Idaho]

Most Insurance policies do not include coverage for elective abortions, only to save the life of the mother from impending doom. The new single payer trainer would. Democrats say "It would be taking away coverage if we didn't include it" they are lying here as well. BTW

You yanks are obsessed with abortion. I really don't understand it.