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Thread: The U.S. Health Care Debate

  1. #121
    Hope guides me Senior Member Hosakawa Tito's Avatar
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    Default Re: The U.S. Health Care Debate

    Quote Originally Posted by KukriKhan View Post
    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.
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  2. #122
    Part-Time Polemic Senior Member ICantSpellDawg's Avatar
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    Default Re: The U.S. Health Care Debate

    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.
    Last edited by ICantSpellDawg; 07-23-2009 at 15:09.
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  3. #123
    The very model of a modern Moderator Xiahou's Avatar
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    Default Re: The U.S. Health Care Debate

    I thought this was a fun analysis of Obama's healthcare talk. I snickered a couple times....

    Obama: Things Stink

    Spoiler Alert, click show to read: 
    —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.

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  4. #124
    TexMec Senior Member Louis VI the Fat's Avatar
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    Default Re: The U.S. Health Care Debate

    Quote Originally Posted by Xiahou's article
    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.
    Last edited by Louis VI the Fat; 07-23-2009 at 21:33.
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  5. #125
    Jillian & Allison's Daddy Senior Member Don Corleone's Avatar
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    Default Re: The U.S. Health Care Debate

    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?
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  6. #126
    Part-Time Polemic Senior Member ICantSpellDawg's Avatar
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    Default Re: The U.S. Health Care Debate

    Great article by Peggy Noonan, as always.

    Spoiler Alert, click show to read: 

    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?

    Last edited by ICantSpellDawg; 07-24-2009 at 05:16.
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  7. #127
    Prince of Maldonia Member Toby and Kiki Champion, Goo Slasher Champion, Frogger Champion woad&fangs's Avatar
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    Default Re: The U.S. Health Care Debate

    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.
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  8. #128
    Nobody expects the Senior Member Lemur's Avatar
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    Default Re: The U.S. Health Care Debate

    Quote Originally Posted by woad&fangs View Post
    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.

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    Arena Senior Member Crazed Rabbit's Avatar
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    Default Re: The U.S. Health Care Debate

    Quote Originally Posted by Lemur View Post
    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.

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    L'Etranger Senior Member Banquo's Ghost's Avatar
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    Default Re: The U.S. Health Care Debate

    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 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.
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  11. #131
    Master of useless knowledge Senior Member Kitten Shooting Champion, Eskiv Champion Ironside's Avatar
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    Default Re: The U.S. Health Care Debate

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

    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?
    We are all aware that the senses can be deceived, the eyes fooled. But how can we be sure our senses are not being deceived at any particular time, or even all the time? Might I just be a brain in a tank somewhere, tricked all my life into believing in the events of this world by some insane computer? And does my life gain or lose meaning based on my reaction to such solipsism?

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    Iron Fist Senior Member Husar's Avatar
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    Default Re: The U.S. Health Care Debate

    Quote Originally Posted by Banquo's link
    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.


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    Part-Time Polemic Senior Member ICantSpellDawg's Avatar
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    Default Re: The U.S. Health Care Debate

    Quote Originally Posted by Banquo's Ghost View Post
    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 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.

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    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.
    Last edited by ICantSpellDawg; 07-26-2009 at 15:23.
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  14. #134
    L'Etranger Senior Member Banquo's Ghost's Avatar
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    Default Re: The U.S. Health Care Debate

    Quote Originally Posted by Husar View Post
    Happens again and again that "customers" get dumped or tricked or whatever just to please the shareholders.
    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.
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    Part-Time Polemic Senior Member ICantSpellDawg's Avatar
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    Default Re: The U.S. Health Care Debate

    Quote Originally Posted by Banquo's Ghost View Post
    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.
    Last edited by ICantSpellDawg; 07-26-2009 at 15:44.
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    Arena Senior Member Crazed Rabbit's Avatar
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    Default Re: The U.S. Health Care Debate

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

    Spoiler Alert, click show to read: 
    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
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    Nobody expects the Senior Member Lemur's Avatar
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    Default Re: The U.S. Health Care Debate

    A little more info on our current system of rationing:

    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.)

  18. #138
    L'Etranger Senior Member Banquo's Ghost's Avatar
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    Default Re: The U.S. Health Care Debate

    Quote Originally Posted by Lemur View Post
    A little more info on our current system of rationing:

    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.
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    Master of Few Words Senior Member KukriKhan's Avatar
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    Default Re: The U.S. Health Care Debate

    Quote Originally Posted by Banquo's Ghost
    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.
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    Nobody expects the Senior Member Lemur's Avatar
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    Default Re: The U.S. Health Care Debate

    Quote Originally Posted by Banquo's Ghost View Post
    I would be interested in the original for your quote.
    Gah! Evil NPR moves teh linkies. Here's the original referencing article.

    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.

  21. #141
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    Default Re: The U.S. Health Care Debate

    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.
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    Arena Senior Member Crazed Rabbit's Avatar
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    Default Re: The U.S. Health Care Debate

    Quote Originally Posted by Lemur View Post
    Gah! Evil NPR moves teh linkies. Here's the original referencing article.
    We should simply make a law only allowing rescission in the first month or two after being granted insurance.

    CR
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    L'Etranger Senior Member Banquo's Ghost's Avatar
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    Default Re: The U.S. Health Care Debate

    Thanks, Lemur. Fascinating.

    Quote Originally Posted by Crazed Rabbit View Post
    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?
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    The very model of a modern Moderator Xiahou's Avatar
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    Default Re: The U.S. Health Care Debate

    Quote Originally Posted by Banquo's Ghost View Post
    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.

    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.

    Quote Originally Posted by KukriKhan
    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....
    Last edited by Xiahou; 07-29-2009 at 03:47.
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    L'Etranger Senior Member Banquo's Ghost's Avatar
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    Default Re: The U.S. Health Care Debate

    Quote Originally Posted by Xiahou View Post
    Front load how?
    I would assume that premium costs would go up high enough to cover the profits now made by recission.

    Quote Originally Posted by Xiahou View Post
    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.

    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.

    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.
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    Arena Senior Member Crazed Rabbit's Avatar
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    Default Re: The U.S. Health Care Debate

    Quote Originally Posted by Banquo's Ghost View Post
    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
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  27. #147
    Nobody expects the Senior Member Lemur's Avatar
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    Default Re: The U.S. Health Care Debate

    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.

  28. #148
    Kanto Kanrei Member Marshal Murat's Avatar
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    Default U.S. Healthcare Reform

    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) 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"?
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  29. #149
    Darkside Medic Senior Member rory_20_uk's Avatar
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    Default Re: U.S. Healthcare Reform

    Here 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.

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    L'Etranger Senior Member Banquo's Ghost's Avatar
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    Default Re: The U.S. Health Care Debate

    I have merged this new thread with the existing one.

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