Dcoffee's Journal
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07/28/2009 21:18 #49404
Healthcare RamblingsCategory: healthcare
I'm so frustrated. Usually my writing makes sense, and it's easy to understand, and gives some background and links.... but I just can't. I have no idea where to start. This freaking issue is huge and it's full of bullshit. I'm glad I don't have cable, because I would spend my days screaming at cable news and get nothing done.
I'm worried that the government is not going to change healthcare enough to make a differance. They may change some things, but it could make our lives worse, and make the insurence companies richer. Like making it mandatory that we get coverage, and mandatory that employers provide coverage, insurance companies would love that.
Insurance companies are just parasites, they add no value to healthcare whatsoever. It's not even insurance, there's a good chance that when you finally get sick or injured they won't even cover your ass. They'll claim you commited insurance fraud, then it's your lawyer versus theirs.
You know 60% of bankruptcys are due to healthcare bills? and 75% of those people had health insurance! Every 30 seconds in the United States someone files for bankruptcy in the aftermath of a serious health problem.
Socialized medicine.. Rationing care.. It's all scare tactics invented by pharmeceutical and insurance companies. You know we already ration care in this country, it's based on income. The working poor get nothing. Pay or Die.
They're trying to tell you that Obama's a socialist... he's not even a liberal! He's barely left of center, and all these conservatives are shaking in their boots that he'll turn us into Cuba. It makes me furious because all this fearmongering has nothing to do with policy, it's all politics. Some Republicans just want to see the president fail. and their happy to be on the side of insurance companies, because if they get tired of Washington they can always get more money working as a lobbyist anyway. They get rich, so fuck you, and your country.
Not sure, right.. nobody's that self centered.. here's just one case in point "one of the Blue Dog Coalition's founders: former Representative Billy Tauzin of Louisiana. Mr. Tauzin switched to the Republicans soon after the [Blue Dog] group's creation; eight years later he pushed through the 2003 Medicare Modernization Act, a deeply irresponsible bill that included huge giveaways to drug and insurance companies. And then he left Congress to become, yes, the lavishly paid president of PhRMA, the pharmaceutical industry lobby."
What's up with lobyists anyway? they're "so powerful", boo hoo, it's soo hard... even when 70% of the public is in favor of a Public option Seriously, in this country? 70% in favor of anything is a freaking landslide. But it's still a battle to the finish because of the money being thrown around Washington. And the people who are stalling or compromising are the ones raking in the cash, like Finance Committee chairman Max Baucus, and the 'Blue Dog' coalition in the house.
Ysterday news broke that the Senate Finance Committee version of Healthcare reform will not include a public option (mission accomplished health insurance pricks). Instead we'll be allowed to form health insurance co-ops that nobody has ever bothered to explain. Their plan also eliminates the employer mandate, which I think is a good thing, but within the narrow confines of washington Healthcare reform it actually raises costs for the government, especially if the individual mandate still exists.
Alright... that brings me to a really important point.
Why are employers responsible for the health of the American people?
Companies are just a bunch of people trying to make a living, why should they care where you go to the doctor? I don't think the burden of healthcare should be on employers at all. I understand offering benefits, to help you retain good employees, like paid vacations, cellphones, or whatever. But Healthcare? It's not a luxury, everybody will need healthcare at some point in their lives. Something that important should be guaranteed by the government. Like Fire, Police, Schools, Water, some things should not be left to chance. I think it's irresponsable for the government to expect business to cary the burden.
You know.. if my house is on fire, I call the fire department. If I've been robbed, I call the police. If I have a medical emergency...... Pay or Die. Something is wrong here.
I run a small business too, if I start hiring employees are they going to ask "where's my healthcare?", Really? I have enough to worry about, go ask Uncle Sam what the problem is.
Right now they're proposing taxing businesses that don't provide healthcare in order to pay for a new system. If you have over 20-30 employees you pay a fine of around $700 per person per year. Sure it makes sense if you expect to get healthcare from your employer, and we all want to get revenge on Wal-Mart for screwing their employees all these years..... But I don't think the employer based healthcare system makes sense, and I don't think coercing companies to provide healthcare coverage is a good idea, especially when we're losing jobs. Instead I think every individual should contribute, whether they employ people or not. I don't think employers should bear the burdin anymore.
I support a national Single Payer system, call it "nationalized", "government run", "socialized" or whatever you want. It's the only thing that makes sense. Abolish Health Insurance Companies, give that money to the government because they can do it cheaper and better, and they can cover everybody.
I want to choose my doctor, my hospital, my surgeries, I don't want to waste my time reading fine print in insurance contracts. You know which insurance plan gives you the most choice? Medicare. You can go to any doctor. You don't have to choose from a list of acceptable providers and get stuck with somebody far from your house. Just go to anyone accepting new patients. It's true, medicare gives you the most choice. And the Republicans want to say that a government will take away your choices? Give me a break.
I support Medicare for All. There's actually a bill that does that HR 676
How to do it? Phaise it in, the first 5 years expand it to people over 55, next, people over 45. That gives the insurance companies time to shift their business to hurricane insurance or something else.
I'm supportive of a strong public option, but I'm worried that it won't work.
alright, that's all for now, I should write more often...
here's a humorous parting shot.
07/07/2009 19:00 #49219
Healthcare, Action TimeCategory: healthcare
We won't get a better healthcare system unless we demand it. Some companies are getting filthy rich under the current system, and they don't want anything to change.
We pay more for healthcare than any other country, but all that cash is wasted on CEO bonuses, advertising, and in call-center employees whose job is to deny you care.
I've had enough. I have no healthcare, and no good options. Why? Because I decided to start my own business. But in this society, if you want health insurance you have to work for a big company that is kind enough to provide for you, or I can pay $500 per month (Just in case tragedy strikes, but there's really no guarantee they'll actually pay).
We're the only country that does it this way. And over 70 percent of the public thinks we should have a choice of a public option (#34a )
But nothing is going to happen, unless we all pitch in a little bit.
Call congress.
Attend the protest this Thursday July 09th, 12 noon, outside Senator Gillibrand's office. 726 Exchange Street, Buffalo, NY 14210
Write down this number, this is toll free access to congress.
1 800-828-0498
Just call, ask for your congress person's office, and they connect you for free.
you might say something like...
"We need a public Healthcare option, I do not trust the Health Insurance Companies to do what's best for the country. We need a more efficient government system to compete with Insurance Companies who make a huge profit every year because they charge more and cover less. We have the most expensive system in the world, but 1 out of 6 Americans has no health insurance, and the burden of paying for it is killing the economy."
Senate: Schumer, and Gillibrand
Congress: Brian Higgins, Louise Slaughter, and Chris Lee
If we can't fix this system now, we've failed as a democracy.
Washington DC really is where good ideas go to die. We focus on elections, then the Rules of DC politics take over, and we get screwed until next election.
If you want to stay up to date on this, sign up at Healthcare for America Now
PS. finally posting, summers are so busy, I miss (e:strip).
06/15/2009 11:52 #48981
US Chamber opposes HealthcareCategory: healthcare
Most of you know that I run my own Web-Design and Photography business, I'm a sole proprietor. This means that I get screwed on Healthcare. I have to pay something like a minimum $500 per month for some crappy high deductible insurance for my wife and myself. that's even the subsidized NYS version.
I'm part of my local Greater South Buffalo Chamber of Commerce, and somehow I ended up receiving 'urgent action' alerts from the US Chamber of Commerce. They sent me one on Saturday... to Debra, I just noticed, boy that was a happy accident for me. Anyway, here's their message
"This week, the Senate HELP Committee released a plan that will radically restructure health care for all Americans. The proposal goes above and beyond covering the uninsured. It threatens the private market and ailing economy.
Unable to compete with a public plan, many private companies would be locked into an unsustainable system and forced out of business. In fact, a report cites 130 million people potentially moving from private insurance to this new public plan.
Now is the time to stand up to Senator Kennedy's plan, which could devastate private health care, and ultimately force you into an entirely government-run plan. Click here to send a letter to Congress now.
Further, this proposal would restrict the way employers provide coverage, hurting flexibility and innovation: the cornerstones of American health care. For more of my thoughts on the danger of this proposal, click here.
The bottom line: Sen. Kennedy's bill is dangerous to your health.
This plan is being forced through at a lightning pace, preventing those who will be impacted from carefully considering the 615-page proposal."
That email takes you to this page
So instead of signing their petition I decided to use their contact form to express my opposition. Here's my message to them.
"I support a public Healthcare option. Why should business have to pay the cost of health insurance for our employees? Why should employees have to demand extra benefits from their employers just to ensure that their families are protected from tragedy? The current Healthcare system is broken. It forces businesses like mine to cut employees, and increase our prices to cover the extra costs. This should not be the burden of private business. The economy would be better off with a simplified system where government takes responsibility for the well being of all citizens.
I oppose your position on this issue. I do not support protecting the Health Insurance companies at the expense of all other businesses and the economy as a whole. This is not a responsible position for the US Chamber of Commerce to take."
If you want to call congress on this issue here's the
Toll Free Number
1 800-828-0498
Senators are:
Kristen Gillibrand
Chuck Schumer
House Representatives are:
Brian Higgins
Louise Slaughter
Chris Lee
(e:ajay), you're right that many people who would be entrepreneurs are too scared to drop their only affordable, reasonable health insurance option. My clients, small business owners, can't afford health insurance for themselves or their employees at $500/mo/person and $1200/mo/family. Why should bad health insurance (what you get at $500/mo is really crappy) cost more than your mortgage?
It pisses me off to no end that the US Chamber of Commerce opposes any universal option. National Federation of Independent Businesses also opposes a true public option. :::link:::(FINAL).pdf (PDF of their "principles". :::link::: PDF of small biz & healthcare stats) It makes no sense to me why they can say it's a major challenge - and in my experience it is a HUGE challenge - but be unwilling to address it with cost-effective public solutions. Thanks for posting, (e:dcoffee).
Big business doesn't want a public healthcare system. Health insurance is one of the major reasons that many employees stick to dead-end jobs, instead of branching out on their own.
06/16/2009 21:25 #48992
the Bible, gays, Jesus and the popeCategory: religion
I've read some of the bible, but I don't know enough about what it says yet.
anyway, straight to the point here. I read an article recently in Friends Journal that sheds some light on the biblical/theological basis for discrimination against homosexuality. and as it turns out, there is none.
Here's a link to the full article, unfortunately it's not on the Friends Journal site, and I haven't reread this whole page to know if it's exactly the same as what I read, but, here's the link
To summarize:
There's the New Testament and the Old Testament (Torah) in the Christian bible. The New Testiment is based on the life of Jesus and his teachings, it's the more Christian part, we're supposedly following Jesus Christ, hence the term 'Christ'ian. according to the article, homosexuality is only mentioned 3 times in the New Testiment, all of them by the same author, the apostle Paul.
I think I'd better quote the article here:
These homophobic remarks can be found in Paul's letters to the Romans (1:26-27), to Timothy (1:9-10), and to the Corinthians (6:9-10). That's it. I have found no other support for the Pope's homophobic position in the entire "new testament" other than these three short anti-gay comments made by a single Christian leader about 20 or 30 years after Jesus' death. It should also be noted that Paul's comments were made in angry response to some early Christian communities that did not support his homophobic views and, by his own report, actually included gays and lesbians as full and respected participants in their congregations.
The core theological question here, then, is what authority in our lives and religious communities are we to give to these three particular statements attributed to Paul? Are these three statements products of a historically-conditioned, culture-bound, patriarchal worldview not fully left behind by Paul or are they a deep revelation of the wisdom and way of God, the loving and liberating Spirit so fully embodied in human terms by Jesus of Nazareth? These three remarks by Paul were certainly never sanctioned by any recorded comment by Jesus, so this seems like a fair question. Even Paul says, "Do not despise the words of prophets, but test everything; hold fast to what is good, abstain from every form of evil."
And as much as I am deeply moved by so much of what is written in Paul's letters, and as much as I appreciate his efforts to organize and spread the radical Jesus movement in his day, I do see some of his remarks as violations of the best in Jewish and Christian wisdom and practice. For example, Paul also argues that women should not speak in church, that followers of Jesus should always obey governmental orders, that there is nothing wrong with slavery, that slaves should always obey their masters. He even once said that it was sinful for women to wear their hair in braids or to not cover their heads in church...
Furthermore, it must be remembered that Paul was not a close disciple of Jesus. He did not join the Jesus movement until after Jesus was crucified. He had never known Jesus intimately, or traveled with Jesus day in and day out, or discussed his own perspectives and confusions with Jesus at any length.
Kinda makes you go hmmmm
as for the old testiment, there are 5 refferances..
In total there are five additional passages that I have found in the entire Hebrew scriptures that might be legitimately considered anti-gay, or view gay and lesbian behavior as a sin, perhaps even a major sin. These passages are Genesis 19, Leviticus 19:22, Leviticus 20:13, Deuteronomy 23:17, and Judges 19-21. I say "might" here, however, because three of these passages are not even evaluating the moral worth of loving, committed gay and lesbian relationships at all, but actually speak out instead against male-on-male rape, or against men consorting with male or female ritual prostitutes, a practice that was common among some non-Jewish cultural traditions of the time.
The only significant theological support in the entire bible for the Pope's homophobia is found in Leviticus, which clearly says in one passage that gay male sexual behavior is a sin and an abomination before God and then goes on to another passage that says it is a moral imperative on the part of the faithful to kill all men who engage in homosexual behavior.
Regarding the 613 'laws' in the Torah...
Whether or not you agree with the murderous homophobia of these two laws attributed to God through Moses, one might be tempted to say that they do at least offer a firm theological support for the current Pope's homophobia. That would be true, however, only if the Pope actually supported all 613 of the religious laws listed in the Torah as legitimate commandments from God and as perpetual statutes to be followed by all generations of Jews and Christians. The Pope doesn't believe this, though--and neither did the Jewish prophet Micah, or Paul, or Jesus. If the Pope did believe everything that is said in all of the 613 laws attributed to the prophet Moses, he would order animal sacrifice as a core religious practice within the Catholic Mass and he would oppose Catholics eating shellfish or wearing cloth made from two types of fabrics. He would also demand that all Catholic men get circumcised. Indeed, he would demand that all faithful Catholics kill every child they know who has ever talked back to their parents, and demand that they also kill every woman who is guilty of adultery.
All of these actions and prohibitions are included among the 613 laws of Moses. Is it any wonder why Paul called the slavish following of all these religious laws "a curse" and warned people to stay faithful to the underlying spirit of the Law, but not the detailed letter of each one--as many of them are based on mere cultural convention and some are even rooted in deep human prejudices and cruelty.
Fascinating stuff right? I thought so. I'm interested to learn more about Jesus. Found a couple articles within Friends Journal that give context to his life like this one, I plan to read some gospels. Like Mark, and the newly discovered ones are very interesting to me. There were 12 disciples, but only 4 had their gospels included in Constantine's official bible, which is the basis of our current Bible.
Quakers are a Christian religion, and a diverse one, but I think we're more intent on following the path of Jesus, living up to his revolutionary ideals. Following and emulating the spirit of Jesus' life. Striving to create a 'beloved community' on Earth. Not worshiping, or idolizing him or the Church. And certainly not blindly following any Church's 'laws' without context.
This article was written in response to the pope's comments on homosexuality.. "saving humanity from homosexual or transsexual behavior was as important as protecting the environment."
Full Article Again
just wanted to put that out there.
Just to play the other side for a second (even though these arguments no longer convince me).
The Bible never mentions homosexuality in a positive light. Pauls writings are earlier than the Gospels, and teach more directly to the subject.
Also, the Old Testament is no less authoritative than the new (according to many) when it comes to moral laws. Purity laws and civil laws of Israel are no longer, in effect, they argue, but moral laws still are (and yes, they argue that this is a moral law, somewhat arbitrarily).
One more point worth mentioning. Homophobia existed before both Christianity and Judaism, and many other religions. We bear a lot of responsibility for the wrongs we have done, but homophobia would still be there even if all of us came around.
The article does quote different passages from the bible that refer to homosexuality being bad, sinful, whatever. And if you take those quotes out of context, put them on their own, there's about 5 passages that really target homosexuality, and you might claim those as justification. But if you put them in context, like with the other 613 'laws' in Leviticus and the Old Testament, some of those 'laws' are absurd, you start to wonder if these are god's commands, or if this stuff needs to be explored. Same thing with the New Testament, all the Quotes are from Paul, not Jesus, I think that's key (sorry to both Pauls) but if someone is a Christian, I think the words of Jesus are the most important, and if he never talks about it, I think it's open to interpenetration for all Christians.
So Pretty Rusty on the bible and the few parts I know, but isn't there some part that says something like "one man shall not lay with another Man".
I have my own theory or crazy idea about the 10 commandments. Now when people follow them they need to remember that they aren't the first 10. Didn't the tablet break and god had to resend them? Is my memory correct. So isn't it possible that, that is a why of telling people that over time things change.
I think the anti anal sex that (e:james) is talking about is a good point. If you think about it that was common (from what I have heard) in Greece I have even heard it called "Greek Style" I think that back then people where trying to distance them selves from the Greeks. The sex was part of it. But look at You shall not worship other gods. Well there where many gods for greeks.
The thing you have to remember is that The bible is used as the tool to teach or tell people stuff. But you can tell people stuff that isn't in the book. You can tell one story (with out editing it) and get different meanings from it. So maybe it isn't the bible that teaches homophobia maybe it is the people. Or it could be the fact that sex outside of marriage is a sin, so any sex that is gay has to be sin since you can't be married. I think it is also important to note that everyone uses the term Homophobia wrong. It means being affraid of gays, but most people use it to mean hating them, there is a differance.
Interesting. So, Pastor (e:drew) , since you're our local expert on the Bible and things theological, can you point us to the basis for homophobia? Just put on a fundamentalist hat for moment, and, like a prosecutor, lay out the exhaustive case, with quotes and references.
I'd like to understand where all of this comes from.
Thanks!
This issue is a bizarre one.
First, there were no homosexuals in Jesus' lifetime. Oh sure, there was a lot of man on man and girl on girl hot sex, no doubt. But no one was there who declared "I am a homosexual" just as there was no one to declare "I am a heterosexual". Sexual identity is a very recent invention, less than 200 years old.
Second, the Catholic Church's doctrine did not develop out of scripture, but rather Augustine and Aquinas' reading of Aristotle. In the early church homosexual acts was punished just as masturbation would be punished as the crime was the same: spilling semen rather than impregnating a woman.
Treatment of these people became different from treatment of other sexual sinners who the Church had its first dirty priest scandal. Namely, monks were not living a quiet life of prayer, work, and contemplation but were fucking like rabbits (rabbits, not rabbis). Manuals that would serve as prototypes for interrogation methods in the inquisition began appearing in the 13th century. They would have a series of questions to ask, a series of responses, and a series of penances.
What really sparked our modern anti-sex, anti-masturbation, anti-woman, anti-queer crusade was the rise of the middle class and the industrial revolution. Fake Social Science was applied and thousands of men were castrated, thousands of women had their clitoris hacked off, thousands of people received lobotomies. All to curb their very natural, very harmless desires. Of course, the bible was often retrofitted into this crusade.
In short, the bible is not anti-homosexual. Rather, it is anti-sodomy. It is 3,000 years of culture that is anti-homosexual. And while the bible will always be around, that culture is slowly fading away.
You will enjoy reading the Gospels. Mark is a great place to start as it is almost universally recognized as the earliest. You will probably like Luke, too--as it has all of Mark, plus the sermon on the mount, parables, and a special emphasis on women and the poor.
A great book to put Jesus "in context" is "the Secret Message of Jesus" by Brian McLaren (I can lend it, if you would like).
As you probably already guessed, I really like talking about Jesus, so I will be happy to answer any questions you have or help in any way I can.
And one more quick note--the quotes are accurate, and I agree with them, but what you said, about there being no biblical basis for discrimination, is overstating it. I don't think there is a solid one, but I do think we have to grant that people can read the Bible and honestly come to different conclusions. A lot depends on how you read the Bible.
06/01/2009 21:50 #48818
Photos from Saturday's partyCategory: life
It was a good time. Hope everyone had fun. I didn't take enough pictures. Enjoy these :)
Morning after
Fun times. we had a good crowd. Thanks everyone for coming.
I think I can speak for both Josh and I when I say that it was a really cool party, and that we enjoyed finally being able to BS and hang out. Nice house, nice people, and a great time. Next time we'll hang out and talk more.
Also it was good to see the other e-peeps at the party. I always very much enjoy chilling with you all.
Thank you for the party. We had a great time. You have a wonderful house. Enjoy!
Thanks for having us. I had a great time.
That was a good article. Makes me want to move away from US as soon as I can. heh. I need to locate that book now.
Yuck. Don't you hate those pesky little drug pushers?! My advisor (back home) used to have them thrown out of the clinic by security.
and dave, I am absolutely with you on knocking out big pharma. That direct-to-consumer advertising makes me crazy. "ask your doctor if they purple pill is right for you."
Um, no. How about "trust your doctor to know which medicines to use and when, and to give you the purple pill if you need it."
Or have the drug companies teach the doctors about their drugs and when to use them. Not over a $200 dinner- but a five minute chat in the hallway. But don't solicit patients to go pester their doctors and ask them for meds they probably don't need.
Here is the New Yorker article, and a teaser quote to make you actually want to bother to click the link-
:::link:::
"McAllen has another distinction, too: it is one of the most expensive health-care markets in the country. Only Miamiâ€"which has much higher labor and living costsâ€"spends more per person on health care. In 2006, Medicare spent fifteen thousand dollars per enrollee here, almost twice the national average. The income per capita is twelve thousand dollars. In other words, Medicare spends three thousand dollars more per person here than the average person earns."
Tiny, you might enjoy the book "Better" by Atul Gawande. It is amazingly insightful, and well-written. And he writes essays on things like 'how much should doctors be paid' and one on malpractice claims, and even one on trying to mop up a polio outbreak in india. Really great stuff. he also wrote a good article in the New Yorker a couple months ago analyzing health care costs.
As far as your visit to the ER- sadly I'd say $250 isn't bad. I honestly have no idea how much an xray costs, but I would guess a couple hundred dollars. But once the xray machine and all that is paid for- it really doesn't cost the hospital anything. But I will bet you, the resident didn't see one cent of that money, and the ER docs supervising him didn't get much of it.
However- while I think that charge is typical- I don't think you should have had to pay it. Usually student health centers are somehow subsidized by the university. I.e. even if you don't have formal insurance, you can usually be seen in the student health center for free/$20.
I had my tonsils out when I was 21, and saw the 'explanation of benefits' from the insurance company. My insurance covered it, so it just cost me a copay or deductible or whatever (and actually I was on my parents' at the time anyway)- but I just remember that the bill was thousands of dollars. A very large portion of that went to the anesthesiologists. Another very large portion went to the hospital for "fees" (operating room time, etc). And a modest portion went to the surgeon. But- the 'surgeon's fee' was listed as $1500 or something (I'm making that number up), and the "amount paid" was something like $600. So, the surgeon CHARGED 1500, and insurance paid him 600. And he no say in that- he just has to eat the difference.
My brother went to the ER a couple years ago with excruciating abdominal pain. They did some bloodwork and a CT to make sure it wasn't his appendix (which is unnecessary in my opinion, but this country is so litigious that ERs are notorious for overtesting, b/c they're afraid of missing something and being sued). In the end they said he had indigestion and sent him home with some pepcid. Which on the bill was $400. For the medication. $150 for phlebotomy. Etc.
That is the part I don't understand. Why does it cost $200 to give someone a liter of saline through an IV? $400 (or even 40, because I think there was a factor-of-ten math error on the bill) for something that would cost you $2 at walgreens? You know the nurse who started the IV and hung the saline isn't making that money. Where does it go?!
I still think that bad use of the ER is a LARGE part of health care waste. Some mom is either uninsured, or doesn't feel like waiting all day in the free clinic, or doesn't want to call her pediatrician to make an appt, so she takes her kid to the ER for sniffles. That is a waste of resources. It is called the EMERGENCY room. Not the "convenience department". People don't seem to get that.
And a tangent- listening to the radio today, heard all these ads for hospitals. Memorial Sloan Kettering, Columbia Presbyterian, etc.
And that makes me want to vomit.
HOSPITALS SHOULD NOT BE ADVERTISING TO TRY TO DRUM UP BUSINESS.
How much doctors should be paid I guess is debatable. But hospitals should ABSOLUTELY be non-profit as far as I'm concerned. But now they're like just another business, all competing with each other. PUKE.
Ok, enough ranting! Time to brave the rain and go find something to drink.
Wow, that is a freaking loan. Loans are another issue, and I've posted my outrage on that before too. Maybe I'll hijack my own thread here and say that there are three big changes this country needs: Society should act collectively to provide 1)Higher Education, 2)Retirement, and 3)Healthcare.
The cost savings in a new Healthcare system SHOULD come mainly from Insurance Companies, and Pharmaceutical Companies. That's my target, and I think those industries know that their proffits could be threatened, and that's why they are lobbying so hard in Washington.
Doctors provide care. It's hands-on stuff. They're the ones preforming surgery, and directly helping the patients, they're the ones who deserve to be paid. But I wonder if Doctors might find their profession easier if they were just paid a good salary, and got periodic raises. Instead of needing to file some paperwork for everything they do in order to get paid by some middleman insurance company.
We need to save money primarily by cutting out the insurance middleman. Medicare is much more efficient than private insurance because it is not for profit, and because they don't have to advertise like insurance companies. That's where we'll save the most money.
The other part is Pharmeceutical companies. Oh boy do they like to advertise. I posted about that too, I think 40-50% of their income goes straight into advertising. And most of the R&D for drugs is done by the government and the patents are just bought by insurance companies. And when the patent expires they just change one molecule and start the advertising bonanza all over again.
it seems to me that the best way to save money is to go to a single payer insurance system, like Medicare for all, and to tightly regulate the pharmaceutical industries. And in order to eliminate medicare fraud I think we need to abandon the Fee for Service model that most hospitals and doctors use. You've heard of the MAYO clinic, they don't use fee for service, that's part of the reason they're so efficient.
Can we get there? Can we go far enough? I think we need to. Or else we'll be bankrupt. so, it's now or never. This healthcare debate has been going on for 80 years.
Good point, ((e:jenks)) and I can't say I disagree at all. Your perspective on this issue might probably be more relevant to this debate than mine ever will be because I come from a completely different system altogether.
Healthcare doesn't just comprise the medical service in India and the other commonwealth nations. It also includes medical education. The government funds the complete healthcare system from the beginning to the end. My views are completely taken from that context. Even if some of the medical schools are expensive the best schools in India are government funded. Though you pay for the resources and the facilities, the salaries of the faculty are paid by the government.
I don't think I can even begin to imagine what medical education costs here.
Where I come from, doctor *are* almost like any other civil servants (with longer hours) because health is a basic need. If you get violently sick, you don't waste time looking for your health insurance card and wondering what doctor will see you, because you don't have to. It's your right to walk into a hospital and be treated. Obviously, this doesn't work as it should because we are abysmally ineffective when it comes to population control. Let me just say that I go to great lengths to NOT get sick here because I have learned that it is going to harm me in more ways than one. And that is really quite weird.
I never said that doctors don't deserve to get paid well but they certainly don't deserve to be overpaid at the expense of an ailing healthcare system. You make an excellent point when you point out the cost of pharmaceutical products and administrative fee of insurance companies. All these factors contribute blow by blow to the mess of healthcare in this country. (Yes, pharmacies and prescriptions at home are subsidized by the govt as well.)
Tell me something. How much does an X-Ray of a forearm really cost according to you? I fell off my bike in my first year here (I was learning how to ride, btw!). I severely sprained my wrist. I already had RSI and so the pain was unbearable to the point that I was close to fainting when they looked at my hand. It was swollen and ugly. Even then, I was fairly sure there were no broken bones but they decided to get an X-Ray anyway - and that was fine. The simple visit to the University health care system along with one x-ray of a single forearm and wrist cost me $250.
The resident saw me for 2 minutes. The nurse handed me an ace bandage and a strip of NSAID and it took 2 more minutes for the X-ray.
The break-up of the bill was:
$150 - X-Ray forearm
$100 - "UHS Medical Services"
Really? $100 for 2 minutes of the resident's and 30 seconds of the nurse's time? Does that sound logical as a serviee fee? At this rate, won't people earn several times of what they ever owed... and more in no time at all?
Again, this is just one isolated personal experience. I have no other first hand extensive personal dealings with healthcare here other than the patients and relative I occasionally talk to at Roswell. In the end, I can only be a spectator and comment on the scary dread of being a patient here and miss home where getting sick is never quite such a nightmare as it is here. :(
Ack, I have too much, and too little, to say about this.
but first of all- thank you jason.
To answer your question- according to SallieMae.com, my current outstanding balance is $186,666.60.
And I am fortunate enough to NOT have any undergrad loans.
Is the point of being a doctor to make money? No. If all I cared about was money, I'd go work on wall street or something.
But, doctors put a LOT of time/money/blood/sweat/tears into their training, and sacrifice a LOT.
Some financial planner guy came and spoke to us once, showed an earnings graph of doctors vs "average" jobs. and yes, the doctors' line is a lot steeper, but it starts about 20 years later, and in fact "average joe" is better off than a doctor until they are about 55.
And with that said- can you name anyone that works harder than a doctor?
If I don't "deserve" to be paid well, who does? Athletes? Actors? CEOs of insurance companies? At least what I do is of some benefit to society.
I know that is not the point of the post, and I don't mean to hijack. And obviously I am biased here and take it to heart.
I realize there is a problem, and I don't have a solution.
Healthcare in this country is good. But it's way too expensive. So how do we cut costs? it seems like "pay doctors less" is always the first solution.
But, I dunno, how about "tell pfizer their antibiotic can't cost $500/day" or "don't pay the insurance CEO millions for sitting on his ass and DENYING people the care that they need"?
tiny your point is well taken, but to say that doctors should be paid like any other civil servant, because they CHOSE to go into medicine and knew what they were getting into, and they should be in it for the patients and not the money is not entirely fair.
Says me.
But, as always, your opinions may vary.
Nobody has put forth any myths concerning waiting lists. They're a fact of life for everyone. The number of specialists won't increase in America by adopting one system over another. I would suggest that once government gets a hold of something, there is no reversal, which is why it's so important to discuss pros and cons honestly. Government is the only enterprise we know where failure is rewarded.
You know, I'm with you guys, and I think everyone is, when it comes to day-to-day administration of health care. There certainly is waste and fraud. That has to be remedied no matter what direction we go.
The CBO has already shown us that under the current bill there will be no cost savings. I have to ask again, where are these savings coming from? It's vaporware. The options to bridge those gaps are not very palatable. Here is a link to an excerpt of Kent Conrad interviewing the Director of the CBO:
:::link:::
For us, there really is no such thing as having more people enrolled, equal or better care than they get now, on less money overall. Do you know what that sounds like to me? A pipe dream. Partisan Democrats say the Non-Partisan CBO is ignoring savings, yet decline to tell us what those savings are. I think I know why. You know, I think the savings side of the argument really should be dropped at this point until a plan comes forward that actually does save us money.
Regarding Doctors, I just don't approve of telling them how much they can earn. I have very, very dark words to describe that. How much PERSONAL debt has (e:Jenks) taken on to get to where she can actually get a paycheck? Nobody has a right to tell them, in essence, to do it out of the kindness of their own hearts. I don't care if doctors are wealthy - I expect them to be due to the length of education and training they receive, and the importance of their work. If the left starts to treat them like they treat the people who pay the country's bills?? Like YOU OWE ME THIS? Mmm. Not very flattering.
Lastly - about usage. Someone who goes to the doc every week and pays a copay is still costing every one of us for their own greed and thoughtlessness. They would never do so if they had to foot the entire $65 bill (what my doctor visit recently cost). I think we all can agree misuse of the system should be eradicated.
Bottom line - I want people to have health care, but I want a better plan. None of us should be afraid of questioning the proposals or the politicians. To think that politicians want to push this thing through without even reading the bill? And responding to the CBO by saying in essence they're lying? These people don't have our best interests at heart. Give me a better plan and I'll back it.
There are already waiting lists - do you know how long it takes to get an appt with a specialist? Last year I scheduled something in January for JUNE!
I know too many people who are uninsured. They don't go to the doctor when they should because they can't afford it so they have complications from stuff that is so easily taken care of. Broken bones, months of digestive difficulties, diabetes & dialysis... <sigh>
I just think it's a myth that in America we can get whatever medical treatment we need without a waiting list. And to say that it will be worse when managed by the government is pure speculation. This is a democracy, if we're not satisfied with the care we get we can use the phone and the voting booth to get it changed. I think we have more influence over the government than the Health Insurance Companies.
If you don't like the care you get from your insurance, what can you do? Most of us don't have a choice, you can't take your business elsewhere. Your employer provides one or two options, usually with the same insurance company. And insurance is exempt from anti-trust laws so they're already allowed to dominate the market.
And if somebody wants to go to the doctor every week they'll still have to pay, nobody said that the government would get rid of copays, it'll still cost you $10-$20, individuals will still have some 'skin in the game' there will be user fees.
If you know anyone who works in a hospital they will tell you how happy they are to deal with government health programs because there is so little 'red tape' compared to private insurance.
The potential for savings is huge too. Apparently we spend an average of $6000 more per person per year than the international average. The government alone already pays the same amount as other governments that cover everyone. And we citizens pay the other 40% of the total cost for.. what? to cover their administrative fees? If we kept the cost where it is, there would be no rationing whatsoever, there's plenty of cash to go around, but maybe it would be used to provide medical care instead.
The incentives in the healthcare system are totally backwards. Endless treatment is encouraged. "take two aspirin and call me in the morning" isn't profitable. The amount of paperwork and redundancy and inefficiency... there's so much bullshit that we need real structural changes.
Like I said, I don't think the current proposals go far enough.
Part of the waste comes from the fact that doctors bill for each service they preform. That's a lot of paperwork. Plus the more treatments they give, the more profit they make. Are we really encouraging doctors to look at patients and think, "how can I get most profit off of this person's problems" Why not put all doctors on a salary, so the only concern is making the patient comfortable and helping them stay well.
Eliminating the bureaucracy of hospital and dr ofc insurance billing staff is where the real savings comes in - universal health care is the only way to really achieve this. Electronic medical record systems may reduce billing costs some, but those are incredibly complex systems to build and integrate. At the moment there are several EMR systems available and they don't talk to each other.
"I think you have to dictate to doctors and hospitals exactly what they will be earning, which puts them in a tough position."
It doesn't. Medicine is not supposed to be a free-for-all "make-as-much-money-off-my-patients-as-I-can because I did some extra schooling and put in long hours I WANTED to put in" deal.
Doctors are not superhumans who are above the criticism of everyone else. They just got an extra degree. So what if they work 50 hour shifts? Its what they signed up to do. Its a profession and money is not the main motivation.
Doctors know exactly what they will be earning in a state funded healthcare system. They don't have a free passport to riches because they are doctors. I think its wrong and snotty for the medical profession to act as if they were doing some un-repayable favours to the rest of the population. That is not the spirit of medicine at all. Doctors and hospitals should ALWAYS be non-profit. Anyone who thinks they are going to be rich and untouchable in the profession earns my disgust. :/
"Government has to exert more control because we sure as hell can't, going to the emergency room for bullshit, misusing hospital resources, or going to the doc for every little sniffle."
Very right. The only way to police this is setting limits to what the state will fund and what you need to spend out of your pocket. For this to happen you need a corruption-free health ministry and that is, I am afraid, such an impossibly lofty ideal, I might easily believe I am in heaven when I see it as a reality.
Rationing under a government system is a guarantee, not a scare tactic, and the experience of other nations bears that out. There are only X number of health care dollars. We would be going from "rationing" under insurance companies to the same thing, only it's a government starched shirt that is going to tell you no. What happens then? Who are you going to sue? Good luck? I see it as a wash.
In terms of the levels of red tape and bureaucrats, again I see it as a wash. These things are hallmarks of government operations. Have no doubts, you are going to be still dealing with bureaucrats under a government system. There is no "me and my doctor are going to take care of me and nobody is going to get involved in my care decisions" when someone in DC makes decisions about what medicines and procedures are covered. It isn't a holy grail solution.
What is intriguing is the potential for savings. If you take away the profit motive, what does that get you? Where are the savings? What nobody has shown me is how in the USA adopting a single payer plan is going to turn a $32,000 hospital stay into a $20,000 hospital stay. What do you do? I think you have to dictate to doctors and hospitals exactly what they will be earning, which puts them in a tough position. Government has to exert more control because we sure as hell can't, going to the emergency room for bullshit, misusing hospital resources, or going to the doc for every little sniffle.
In any event, I do agree our current system is unsustainable. It breaks my heart for someone to go bankrupt because of catastrophic costs. But the CBO has been clear, the current bill on offer does not save money and in fact drives us deeper off the cliff financially. To Obama's credit, he went back to them and asked "How can we save more money?" but if we can't afford it, we can't afford it.
Speaking of Conyers, why is it that he can say more or less that it's unreasonable to read the god damned bill? They don't want to read it, they don't care what's in it, they just want to rush things through with little thought or debate. They have contempt for the rest of us. If that were Brian Higgins, I would be calling for his head, although you can be sure he's not going to be bothered to read the bill either.
Tiny, you said it perfectly "How could you let some third party money making insurance company control whether you get treated for your illness?" so true. Doctors in other countries are free to practice medicine, and do what they think is best for the patient. Here we have a useless middleman trying to squeeze a profit out of someones misery.
I don't understand why employers, doctors or patients should have to worry about an insurance bureaucrat. Health Insurance companies are an artificial economy. A waste of money that we have accepted for years because we had money to waste. Now we just can't afford them.
If Obama was liberal he would at least talk about Single Payer. and he would have opposed that sham environmental legislation instead of trying to posture behind it like it was a victory.
India has a universal state funded healthcare system but the government does not want to take any responsibility or even look at the population problem in a sensible way. Even with an efficient healthcare system, we are doomed by apathy.
d:
You've suggested that Obama is barely a liberal - you've finally rendered me speechless.
Health is a basic right. I couldn't agree more. The health insurance system here completely baffles me. How could you let some third party money making insurance company control whether you get treated for your illness? How could you do that?
I was shocked when I heard that my university would cover my "health insurance" - everything about that statement was and is still alien to me. Maintaining a healthy population should be a priority for a country of people. Health is the true wealth of any people.
Ever wonder why Japan is dead bottom of that list and still has the healthiest living centenarians?