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09/16/2009 19:01 #49789

Healthcare reform that doesn't help
Category: healthcare
Honestly this whole Healthcare thing is making me tired and frustrated. I'm not sure that we are going to get something that actually helps. Washington DC doesn't really care about average people... cause they can't buy campaign commercials.

They released another Healthcare plan today, we waited all summer for this one because it was supposed to be magically "bi-partisan". The bill is proposed by Senate Finance Committee Chairman Max Baucus, the Finance Committee is supposed to vote on the bill by next week.

I'm calling it the "Baucus Bill" because he proposed it and he's probably the only guy who likes it (besides Insurance Company executives). I'm sure he worked his ass off trying to get Republicans and Democrats to agree, and that's a fine goal, but if the bill doesn't work, it's useless.

The Baucus Bill is the worst of both worlds.... I'm reading more details of this plan as I write, and it just gets worse.

1) Everyone is forced to buy Health Insurance. If you don't you will pay a fine.....
2) No Public Option. You are forced to buy Health Insurance from a Private Company.
3) And you can't buy insurance across state lines.

If you can't afford Health Insurance now, you will be forced to buy it. How much is it going to cost? Nobody knows, but there's nothing in this bill that will make it cheaper. The government option would be cheaper, because they don't have to buy advertisements or pay bonuses, but we don't get a government option. There is no added competition for the insurance companies, there is no incentive for them to lower costs.

4) Some of us get tax credits or subsidies to help us buy insurance. how much and who, is a little fuzzy.
5) Medicaid Income eligibility becomes 133 percent of poverty ($30,000 a year for a family of four) Childless adults making up to 133 percent of poverty ($14,400 for an individual) would be eligible for the first time, after but not till 2014...

This is what bugs me, Health Insurance is expensive, confusing, cruel, and an all around terrible product... Now we are being forced to buy it, and we still have no guarantees that the government will protect us from abuse.

The Washington Post analyzes the cost to individuals more specifically "as many as 4 million of the 46 million people who are currently uninsured would be required to buy coverage on their own, without government help, by some estimates. Millions more would qualify for federal tax credits, but could still end up paying as much as 13 percent of their income for insurance premiums -- far more than most Americans now pay for coverage. People further down the income scale would receive much bigger tax credits, effectively limiting their premiums at 3 percent of their earnings."

Alright, so the government is forcing us to spend money, they do that with car insurance too right? Yes, but you only buy it if you have a car, and nobody forces you to buy a car.

I have a problem with this plan, even if the government picks up all of the tab. If the government told all of us, "Private Health Insurance is too expensive, so we'll buy it for you!" I'm sure that would make a lot of people happy, but it does nothing to control costs! All it is is a gift to the health insurance companies that allows them to keep doing things the same way. "yea but they have to cover all pre-existing conditions now", thanks... apparently we're giving them a huge bailout for the favor.

OK, well, this is not the final plan, this is one bill out of many, but there's been so much emphasis on bi-partisan love that this bill seems like the most important for now... and it's absolute garbage.

A Public Option government plan will be cheaper because it is not for profit, it does not have to advertise and it will have enough people to bargain with insurance companies. Co-ops cannot do that, it would take 8-15 years for them to be competitive.

How are we eliminating waste, inefficiency and redundancy in the healthcare system? That's how we bring down costs. The Baucus plan is useless because it doesn't save us any money, maybe years down the road when a couple of those state based co-ops get enough bargaining power to help people within that state.

We need more guarantee than that. A Public Option or Medicare for All would save us money because it eliminates waste and inefficiency, it could offer cheaper insurance, and it would break the private insurance monopoly.

We have to do something that works.

The news is mostly bad, I'm tired of it. I was going to post some pictures, but I'm still working on that. And in the meantime news keeps happening. I liked the president's speech on healthcare, I think his plan might work, but I don't know how we get there.

Sorry for the rant. I swear I'm going to post about something besides healthcare soon. :)

heidi - 09/17/09 19:50
Good question, (e:Joshua). Are you referring to this perspective? :::link:::

or :::link::: (expanding Rivkin & Casey, focusing on freedom of religion issues)

Here's a broader exploration, likening mandated health insurance purchases to the minimum wage:
:::link:::
Particularly see the link to this PDF from Georgetown Law professor Mark Hall. :::link:::

All of them toss the car insurance analogy - driving a car is a societal privilege and a choice where being alive isn't.

If the proposal was for a universal health system/Medicare for all, this wouldn't even be an issue.
joshua - 09/17/09 15:22
I have a question over the constitutionality of mandating personal health insurance. I've heard comparisons to car insurance, but that doesn't wash.
heidi - 09/16/09 21:04
What he said.

08/13/2009 21:17 #49529

Healthcare Yell Meetin' in Buffalo
Category: healthcare
Not sure if you saw me on TV or not, but I did go down to the, thingy, yesterday outside Brian Higgins' fundraiser at DiTondos

I guess my role was to show that people do support Healthcare Reform, there are a lot of loud people on TV trying to stop it, but there's plenty of people who want big changes, so I was one of those guys, I stayed for about an hour. My sign said "Medicare for All, HR 676" our side of the street was pretty united, "Healthcare for people, not for Profit" "Healthcare for all" that kind of stuff.

There was a big group of anti-people on the other side of the street, I'd say about 80, about double the size of the Pro Healthcare reform side. It was hard to figure out what they wanted. "Stop Socialism" "I'm not your ATM" "Brian we want your Healthcare Plan" anti communism, seemed like they came to vent about everything.. they shouted at us "Get a Job"... lots of stuff. I'd have liked to talk to them, you know me, always up for a good discussion, but they didn't seem to be in a conversational mood.

I took 2 videos, but I found one that is way better.



From WNYmedia.net

That video pretty much sums it up. Personally I enjoy talking to people with different views, finding out what their values are, learning new information, new perspectives... I probably could have had a conversation with a few people in on the Conservative(?) side of the street, but they were drowned out by the Angry Mob crowd who just wanted a target they could shout their frustrations at. They were in no mood to have a conversation with anyone who didn't think like they did. I'm not sure what they were so angry about, lots of different things, it was pretty incoherent. If you believe Limbaugh, they fear that Democrats are trying to sneak Socialist Tyranny into America to take your money and control everything everyone does through an incompetent government bureaucracy... but that's irrational, we live in a Democracy, you're not going to wake up tomorrow and find President Stalin canceling elections and killing off the opposition. Maybe they were protesting corruption, and career politicians.. but I didn't hear much of that. To quote my old teacher, "empty cans make the loudest noise", because of the angry 'Fringe' I don't think anyone got their point across. And why were they chanting "Get a Job"? isn't that kinda like "Get a Haircut Hippie"

Our side was shouting stuff too, about healthcare, but I wasn't really into it, I might want to shout slogans at a politician, but my neighbors? not realy, I'd rather talk about over a beer... But not after we were drunk.. people start swingin'.. not me, but there was some hostility in that crowd.

Oh, and the TV News reports sucked, I hate how they sensationalize everything and frame it as a battle. Yea we were shouting and chanting, that's what you do when you't in the streets with a sign. Eh, who knows, If Brian did have a town hall maybe it would look the same as all the other nonsense I don't know.


more Comedy :) Satire from Red State Update




dcoffee - 08/14/09 14:00
I guess the problem is that people are opposed to healthcare reform based on paranoid rumors about things like "death panels" and "pulling the plug on grandma". The Republican leadership like Newt Gingrich, Chuck Grassley, and Rush Limbaugh are perpetuating these lies. People believe this stuff, and it filters into the discussion (big time, because of a timid media). So we can't even get to rational discussion about what role the Government should play in making Healthcare more affordable, accessible, and better quality. Private Insurance has obviously failed, but we can't even discuss changes in a reasonable manner because the discussion has been poisoned by lies and rumors that inflame people's emotions.

Our democracy is suffering. And this issue is too important.
dcoffee - 08/14/09 11:10
Yea, the current bill is so big and complicated, and there's 2-4 of them so far, we don't even know what the final bill will look like. I think the Democrats should have started with Medicare for All, and negotiated from there. Medicare for All is so much simpler, and we can tell people exactly how it would effect their lives.

It's just amazing the things people are scared of, Eugenics, puling the plug on grandma, death panels, socialism, communism, etc. And it's unfortunate that the news is focusing on the 10% of people who don't really want to have an honest discussion because they won't listen to the other side.

oh, and I'm not scared to be called a Liberal or a Progressive or whatever, but I have no dogma :)
jason - 08/14/09 08:40
BTW, David, I admire that you went out there and demonstrated for your cause. Hardly anyone wants to "get" the other side so it's no surprise some people don't understand why the others are upset. I know you're not a dick and you're sincere about talking over a beer instead of shouting.
jason - 08/14/09 08:36
Why are they upset? Does that question really have to be asked? The government wants to reshape a giant chunk of the American economy, slip the bill through shadily without scrutiny and without debate, lie about the costs and the coverage, call 35-40 percent of the American public extremists, Un-American, a "mob", "Astroturf", and a variety of other unsupportable bullshit terms? And *I* get fucked with from people for calling them Liberal instead of Progressive? People honestly don't understand why their neighbors are freaked out? The Democrats have handled this situation poorly from top to bottom. They have not sufficiently convinced everyone that it is in their best interest to support a dog shit bill.
vincent - 08/14/09 01:21
Thanks for going out and being a counter weight those nut jobs. It just amazes me how people that aren't part of the top 25% tax bracket can be so passionate against their best interest. Not too many of looked like they had any real wealth to protect from the "Millionaires Tax" that has been floated around as a partial way to finance reform. The crotchety old bag was a trip "...Sign a Release! Ha"

If it doesn't pass now it never will, so I can logically understand the push from the Dems. It just saddens me to see how stupid can be, they're the one's "Drinking the Kool-Aid."

08/12/2009 12:21 #49515

Healthcare CEO Profits, & Public Option
Category: healthcare
Today's Special

It bothers me that America spends all this money on Healthcare, but a lot of it doesn't go to medicine, or treatment, or doctors or anything that actually makes us healthy. It goes to profit.

Today I'm picking on this poor millionaire Stephen Hemsley at United Healthcare

image

Including those stock option he makes this much money.
image


Let's just take his salary and bonuses for last year, 3.2 million, that's $3,200,000

That means that per day he made $8,767.12...... every day of the year, even weekends and holidays. almost $9 thousand per day? really? I guess it's because he does such important work right... making people wealthy by denying medical treatment to millions of Americans.

I guess he's getting richer by the day, I looked it up on Forbes.com and they say he's worth $5 billion now.

See for Yourself that goes to a list of healthcare CEOs

And he's not at the top of the list either.

Americans are going bankrupt all the time because of Healthcare bills. Over half of all personal bankruptcies are due to healthcare bills, the average cost of those bills is around $12,000. Funny thing is, 75% of those people, had Health Insurance when they got sick. Either it was canceled, part of it wasn't covered, or whatever
... But this guy makes $16,000 on the weekend.

Public vs Private Health Insurance Options

Critics of Obama's Healthcare plan are most upset about the "Public Option" they don't want to see a "government takeover" of the healthcare system, This is one of the main sticking points in the Senate Finance Committee, people like Chuck Grassley ask "Why do we need a public Option?"

I think the question really should be, why do we need a private option at all? We have publicly funded options like Medicare, and it's very successful.

Then why do we even need the insurance companies? What constructive role do they play? What benefit do they bring to the table? The whole point of the market is to increase efficiency and innovation and productivity, do Health Insurance Companies do any of these things?

I think they're parasites who make money by denying care. We've enabled this economy to exist, but all they do is waste our money.

I think the market and the entire economy would function better without Health Insurance companies and without the burden of worrying about how you're going to afford to protect your family from illness. All that worry and cost creates friction in our economic engine.

Think about it,
Guy works for large company, thinks he could do a better job than his boss, has a great idea, BUT if he leaves and tries to start a new business he loses healthcare for his family..... American companies are sacrificing quality to save money, they have to compete with Japanese companies that don't pay for healthcare, our companies aren't competitive overseas, and our balance of trade is awful which leads to a declining standard of living in the US..... Labor in the US is expensive, partly because of the cost of Healthcare, so companies move jobs out of the country..... Businesses pay more for healthcare every year, this eats up money that should go to expanding the business, buying equipment, marketing, moving the economy...... Individuals pay more every year too, that money should be going into home improvement, neighborhood businesses, vacations....... That's the story of the economy slowing down.

Here's the big question:
"Why are we wasting our money on an industry that brings us no value?"

Yea, Free Market at all costs... but if you look at it objectively, you start to realize that the economy would function better without the burden of healthcare.
.......


More on how Insurance Companies make money




think about it

Medicare for All
HR 676

jenks - 08/13/09 06:39
Oh don't get me wrong. I would love for everyone to have the same, fantastic, level of care. I just don't know how that's possible. And medicare (specifically medicaid) is sort of seen as the lowest common denominator. At least it's insurance, and the docs will be paid- but it's not great.

The sad truth is that, in some specialties (more elective type stuff) the most important piece of information in a person's medical history is: what insurance do they have. And certain doctors just won't accept certain plans. I have seen plenty of patients turned away because we don't accept their insurance. And patients with medicare/medicaid get shuffled to the "clinic"- where maybe they still get good care, but they do not get the VIP treatment that privately insured patients do.

So if we could come up with some amazing plan that is like some super premium HMO that everyone just gets for free, that doesn't bankrupt employers, and that still reimburses the doctors well- I'd say hell, go for it.

I just fear that SOMEone will get screwed with a big universal plan- whether it's patients getting lousy coverage/long waits/less choice, or doctors getting lousy pay/no autonomy...

But maybe there will be some universal minimum plan... like everyone gets some bare bones plan for free, and those who want more, can buy it? But I guess that's sort of what we have now...

The thing is, to be honest I know next to nothing about the whole situation, and am just speaking on my gut feelings (which isn't something I usually like to do, b/c I'm embarrassed at how little I know about the issue).
james - 08/12/09 23:53
Jenks, I ask because you work in health care (a term, in this debate, that insufficiently defined as it means both insurance and treatment), but what is so bad about a one size fits all approach? I mean, because I have diabetes I have certain needs, but I don't see why covering those needs for both me and someone who is perfectly healthy is such a bad thing. Giving me, someone like Stephen Hawking (poor chap, pulled into this debate in the strangest way) and Joe on the street the same coverage seems wonderful to me.

But you have more experience with this. What is your opinion?
jenks - 08/12/09 18:18
I for one would prefer blue cross to medicare.

Maybe private insurance companies should be not for profit- but I do not think a giant one-size-fits-all medicare type program is the best solution.

But, i'm not sure what is.
drew - 08/12/09 17:55
I want to be the guy that works for the insurance company that looks at the employess to see how much of a risk they are for cosmetic surgery.


Or maybe they would just farm it out to hotornot.com

dcoffee - 08/12/09 16:57
It's all good, it does show that people will still buy insurance even if there is Medicare for all, for things like cosmetic surgery, or other non-necessary stuff.

I'm just wondering if anyone can think of a reason to keep Private Insurance companies. Do they add any value to the system? can we afford them? How do they help the economy? Or is it we just don't trust government, so, it's not an option.

I did think of one reason to keep private insurance companies, it enables some people to become millionaires. I mean, it doesn't matter where the money comes from.
james - 08/12/09 16:54
WHAT! That is some crazy shit! Why on earth would they have that in the contract?

I mean, if it was free, sure. But why would an insurance company even offer that?

This world. It is made of crazy.
jenks - 08/12/09 16:11
ack, and dave, sorry for hijacking. again. :(
jenks - 08/12/09 16:11
from a quick google search- Granted it's 2004. But it seems to me there are better ways to spend that 1.5mil.

"Cosmetic surgery, it’s not a big issue with us,” said Phil Rumore, president of the Buffalo Teahers Federation. “It’s something that was part of our contract for years. It used, it didn’t cost anything for the districts to provide it. It was sort of like a throwaway.”
Today, that “throwaway” is costing taxpayers millions of dollars.
----In 2004, the city school district paid $1.5 million for 2,400 elective cosmetic surgery procedures, both for employees and their families.---
“It’s not an issue that we’re going to throw down our lives for. It was something that was part of the contract for years and years and years. It’s gotten to be a big issue cause it’s something to point to,” said Rumore."
jenks - 08/12/09 16:03
Yes, cosmetic rider. maybe it's not there any more (I would hope not) but it absolutely was a couple years ago.
jason - 08/12/09 16:02
I've got a note out to a number of teacher friends in the district. I'm asking them if the cosmetic rider is still there, or if it went away.
dcoffee - 08/12/09 16:00
I doubt any public plan would cover cosmetic riders. If you are rich and you want to pay for extra stuff there's one option.
jason - 08/12/09 15:55
Jaime Moses referencing the cosmetic rider.

:::link:::

I really wish I could just see the damned contract.
jason - 08/12/09 15:54
It's called a cosmetic rider.
jenks - 08/12/09 15:51
Ok, sorry, I don't know the details. And I guess I meant city employees, not state. (I just meant 'not private'). And it is the teachers/firefighters/police I am talking about- they have a special/different contract?
I obviously don't know everything about this.
But I know that I have A- performed cosmetic procedures on more than one teacher, and was informed that this would be 'free' to them (i.e. covered by their insurance), and B- there was a big article about it in the buffalo news a few years ago that got me all fired up.
Things very well may have changed since then.
jason - 08/12/09 15:49
I found that in '06, Donna Fernandes was the commencement speaker at the UB GSE, and she said then that elective cosmetic surgery was covered by the teacher's union contract. Eh, anecdotal. I do recall a big todo about it back then. I don't know if it has been re-negotiated since. It wouldn't shock me in the least to have it be in there.
james - 08/12/09 15:10
cops and teachers are not state employees and each union has a different contract. I have the same health coverage and compensation as the members of the state's white collar union and I can tell you that we do not have any such part in our contract. In fact, I have the same plan as most city works excluding teachers, firefighters, and police. I couldn't tell you what their contracts are like but I am willing to bet you are wrong about the cosmetic surgery.
jenks - 08/12/09 14:12
Yeah.
There are no words for how much that infuriates me.
When we are in a massive healthcare crisis, fucking insurance CEOs should not be making 3 million dollars. Say he made 1 million dollars, or even 2, (still a pretty cushy salary) and put the rest back into the system...

Another one that kills me- that buffalo state employees (cops, teachers, etc) have some crazy healthcare plan that includes a "cosmetic rider". I guess it came up years ago from independent health and blue cross (or whatever) competing for the huge contract...

Bottom line- when buffalo is in a major budget crisis, I would think that fucking breast implants and hair plugs for teachers and cops could be CUT before, say, school funding.

Argh.

08/11/2009 13:53 #49506

Healthcare and Business - Rush's Mob
Category: healthcare
I could go on and on about how our current Healthcare system hurts businesses, especially small businesses which make up 90% of the business community. I don't think it should be the Employer's responsability to provide healthcare for workers and their families. I think that it hurts businesses and makes them less competitive around the world. It's too expensive, workers and businesses would have more money to go around the economy if they didn't have to worry about healthcare.

I just wanted to share a personal tidbit. My mom works for a Catholic charity, OLV Father Bakers, the basilica... they have schools, homes for troubled teens, people with disabilities, seniors, etc, all good charity work. And they treat their employees well.

This year their healthcare costs went up 35%.

Just this year. And they go up every year. Her part of the charity has about 70 employees. She didn't get a raise this year because of the crazy healthcare increase. She said that is the biggest jump they've ever seen. I told her they need the money to lobby congress to crush Healthcare reform and protect their profits :) I know, it's not funny. 35% is a lot.


On another note, I decided to listen to Rush Limbaugh today.

I've been amazed by the lies floating around about the Healthcare Bills, I even got that email about "encouraging seniors to commit suicide" or "mandatory end of life counseling sessions", there's no such thing, by the way, I read the bill. I'm also astounded by the frightened protesters who've been attacking Democrats. They're scared of the government telling them who should live or die.. These fears seem irrational to me, this is America you know, it's a democracy, and 99% of Americans would never let such a thing happen.

Anyway I wanted to try and understand the rationale, so I tuned in to Rush Limbaugh. I found it fascinating. He paints a very frightening picture of America. He's afraid of authoritarianism, totalitarianism, the government controlling every aspect of your lives. He believes that our liberties and freedoms are being taken away. He doesn't blame the right wing protesters for being irate or un-civil, their liberties are about to be snatched away. The government will decide who lives and who dies.

He also says that his listeners are more informed than our congresspeople about what's in the bill. He says that our congresspeople haven't read the bill, they don't know what's in it. This may be partly true, but they do have a lot of staff to read the bill and it was drafted in a committee, most of the people in that committee know exactly what is in the bill. I was a bit disappointed that Democratic House members didn't take full advantage of the info-session provided to go over the bill and educate members about what exactly is in it.

But Rush, and the other conservative talkers I'm sure, believe that they have uncovered the awful secrets in this bill, and that their listeners have the inside scoop. They are telling their listeners that they are more informed than anyone else in America and it is their patriotic duty to alert the nation to the dangerous tyranny in this bill, and stop it by any means necessary. They're immersed in the conservative bubble of Fox news, Limbaugh, and the Drudge report, but they actually know what's in the bill, better than congress, and the people who wrote it?

There are so many lies and exaggeration coming from the right about this healthcare bill, I've seen some of this stuff, emails, scarry 'summary' of the bill etc. I've double checked the bill itself, and they're not mandating anything, you're just getting more options and more coverage, and more security from the abuses of insurers.

I think it's fascinating, bad for democracy, but really interesting anyway.

heidi - 08/12/09 17:04
(e:dcoffee) - I wish i could take credit for those words, but they're a quote from the article that's linked. :-)
jason - 08/11/09 23:12
(e:Heidi) - Thanks for the links. I'm not one of these people that are above reading what other people think. Even when it's tough it's okay. =)

I read the article you quoted, and it was an interesting read. I do have a problem with the particular section you quoted. Nobody takes any particular pleasure in the inequality within American health care. It is a non sequitur argument, like saying Progressives who want to take away a chunk of the miltary budget do so because they want another 9/11. Again, the rhetoric has gotten too heated. I admit that I've gotten mad on occasion. If I do, remind me to stop.
jason - 08/11/09 23:04
(e:James) - I agree the GOP isn't offering an alternative at this point. The time for it was two months ago or so. The GOP, and Boehner in particular, outlined what they wanted, but they have never been in a position to dictate policy. They haven't, and won't, be heard. I'm not saying that it's wrong, elections matter. All they can do is snipe at what the Democrats lay out.

I'm going to agree that the radio mullahs and a number of the GOP politicians have gone off the deep end. They might have a nugget of a good point in there somewhere but it will be lost in the filth. Again, they aren't in a position to offer anything else, and this is the cornered position they're in.

As far as the town halls are concerned, I'm not going to question the motive of every blue hair at the meeting. Whether or not organized groups show up, and I'm sure they do, every day Americans are getting demonized. I really don't think it was smart for Democrats to do that.

In the end, I think the fault is laid at the feet of the Democratic leadership when they wanted to rush it through - I mean when Congressmen are on video questioning the merits of reading the bill...Jesus. We need to just get it right. Obama and the rank and file are paying an unnecessary price. They haven't delivered on what O asked for.

Thanks for the link, BTW.
dcoffee - 08/11/09 21:07
Jenks, I'll confess I don't know how these things usually go, and I don't know much about the hospital you work in. I's post the whole section here but it's about 2 pages, it's called "advance care planning consultation" section 1233. Sweet, I can link straight to that section :::link:::

Heidi I've gotta quote you again "if a captain of industry can't buy better health care than the guy who cuts his lawn can, then the world just isn't functioning as it should."
this totally cracks me up. This bill won't screw up that hierarchy, and the Canadian system doesn't either. But that is very insightful and hilarious at the same time.

I'm going to have to post some real details about how our Healthcare system hurts businesses, the entire economy and the country. I think it's obvious but maybe I'm a schmuck.
jenks - 08/11/09 18:21
just a quickie-

"This provision actually just ammends medicare and says that the government will now reimburse you for the cost of a Living Will consultation with your doctor. You or your doctor choose weather you want to do it or not, all the big bad government does is pay the cost."

WTF is a living will consultation?!

I have talked to families about living wills (and health care proxies) plenty of times. Basically I say "here's the form" and they read it and fill it out, and that's about it. I certainly don't get paid for it, and I'm fairly certain the hospital doesn't charge, either.

Why are we suddenly assigning a cost to that? That the gov't has to pay? WTF?

Rather than make it part of medicare that the gov't pays for, why not make lawyers do it for free, or something like that?

Ack.
dcoffee - 08/11/09 18:08
To me, it seems like conservatives are misinterpreting the bill on purpose. Or maybe they are just very paranoid about Obama and the Democratic party, they have pre-conceived notions and are inclined to jump to conclusions instead of trying to understand exactly what the bill is saying. Sure the bill isn't easy to read, maybe I have an advantage because I studied Political Science. But a lot of these outrageous claims are false, and when they're told that, "That's not in the bill, and I would never support such a thing" they just don't believe you. to Illustrate my point, here's Newt Gingrich on ABC's This Week :::link::: I admire Gingrich here, he bullshits through this like a great politician, but he's still just trying to scare you.

But you don't have to look at Left Wing blogs to try and get the story straight, I found answers on About.com and FactCheck.org, and other non-partisain places. Or you can just look at the Buffalo News, there was an article on Sunday :::link::: make sure to click the Related Content link too. People on Liberal blogs take different angles all the time and you may not find what you're looking for, they assume the audience is on their level so they don't rehash every point of misinformation. Just search for "Health care reform euthanasia" and you'll find some answers.

Anyway, here are some of the big lies.

The Government will pull the plug on Grandma to save money. Or, the bill sets up "mandatory" end of life counseling sessions where you decide how you want to die. First of all, there's nothing Manditory about this bill, It gives you more choices, not less. This provision actually just ammends medicare and says that the government will now reimburse you for the cost of a Living Will consultation with your doctor. You or your doctor choose weather you want to do it or not, all the big bad government does is pay the cost. This part of the bill was actually introduced by Johnny Isakson, a republican pro-life guy. But it's a democratic conspiricy to kill you?

Illegal Aliens will get benefits. not true, check section 246, and I quote "No Federal payment for undocumented aliens".

There's a new one, this is a good example. The Government will come to your house and tell you how to raise your kids. Chuck Norris wrote something about this today, it was picked up by Limbaugh, and I'm sure it's made it's way around the conservative echo chamber by now. The article's called "Dirty Secret No. 1 in Obamacare." Here's the actual text of the section "..improve the well-being, health, and development of children by enabling the establishment and expansion of high quality programs providing voluntary home visitation for families with young children and families expecting children." uummmm it's Fucking Voluntary!!

I think that is a good example, because it's one guy, selectively reading the text of the bill, sourcing the sections and quoting them for credibility, and then making it sound like Stalin has landed in America. But when you read the text, it's totally benign whoopty-do stuff.

That's how most of these things get started. All the conservatives believe eachother, and they repeat whatever they hear on the Radio or the TV or the Internet, without checking it, without asking questions and without thinking to themselves, nah, this is America, let me look that one up. Like the Euthenizing Seniors thing, started on Fred Thompson's Radio Show with some guest. I have that link cause I got the email :::link:::

But honestly it's such a stretch to get these sinister interpretations of the bill that I can't help but believe that it's deliberate. I don't know why they would want to make up lies, to kill healthcare reform and keep things the way they are. But it seems intentional, at least for those who originate the lies. Not for the poor saps who believe Fox News and Limbaugh, I don't think they mean any harm, but they've been whipped into a fearful frenzy by the Conservative echo chamber.

This might be a good way to read the actual text of the bill :::link:::

AH HA! I found it. This is the bill that conservatives are reading, it's on a lot of different blogs, it's the shortened bullet point version of HR 3200 that is total bullshit. It just has sources and section numbers, so people think it's true, and they'll believe some dude with a blog over any Democrat. :::link:::

Ooh, I found something directly responding to a bunch of claims in that Lie-Sheet :::link:::

For Debunking this guy may be a good source, I stumbeled into a few of his pieces. :::link:::

heidi - 08/11/09 17:00
10 dumbest arguments against health care reform (The American Prospect) :::link:::

Whatever we do, we shouldn't ruin "the best health-care system in the world." Progressives confronted with this common argument often respond with incredulity. "Are you kidding me?" they shout. Fifty million uninsured, the highest per-capita costs in the world, millions of people pushed into bankruptcy by medical bills, worse health outcomes than most of the industrialized world? Are you kidding me?

But this is not a practical argument -- it's a moral argument. Those who make it believe that our system is the best precisely because of its inequality. Systems like those of our European friends, in which everyone has access to high-quality care at a reasonable price, just don't sit right with many conservative Republicans. If a captain of industry can't buy better health care than the guy who cuts his lawn can, then the world just isn't functioning as it should.
heidi - 08/11/09 16:54
I think Joe Conason is in the same vapid writing field as huffpo, but this does provide a nice little bit of background on Betsy McCaughey :::link:::

Here's more on the issues & debates from Salon.com, which overall isn't vapid.

:::link:::

Alternet.org has some decent journalism, although the quality can vary :::link:::


About "rationing" and denial of care.
:::link:::
james - 08/11/09 16:16
Well, if you want vapid commentary HuffPo or MoveOn is great.

But, essentially, I said the conservatives talking points have not actually talked about the bill. For example, you cited the mandated end of life counceling. Here is a nice bit on that with sufficient quotations :::link:::

So, they are reading the bill. But they aren't looking to improve it in anyway. They are looking for talking points to feed the lunatic fringe of the conservative base.

So the Dems actually go to town hall meetings to build consensus among their constituents and who should be there but astroturfing tea baggers. That is not a genuine debate or a conversation. It is the primal scream of people who are fundamentally incapable of working on this issue.

During the stimulus package debate the GOP made an alternative bill. I would like to see them do that now. Again, the leadership of the GOP is not about policy, but bullshit talking points. I fail to see any core conservative values in their opposition. I only see opposition. It is the same perpetual-campaign bullshit of Rove. The same stuff that has made that incarnation of the GOP useless and irrelevant.

I look forward to genuine debate.
jason - 08/11/09 16:02
I couldn't find your comment in the graveyard, either. =/

I'm being honest about wanting more information. I don't know where the wonky lefties hang out.
james - 08/11/09 15:58
I just wrote a long ass response and it did not appear. Oh man, that makes me so angry.

But the short of it is: I respectfully must inform you that you are incorrect. Will repost later.
jason - 08/11/09 14:55
One clarification - the bit about small states having too much power wasn't in HuffPo, it was in WaPo.
jason - 08/11/09 14:52
No. I said as far as I know. I'm looking for liberal interpretations of the bill. When Conservatives point to specific things, and say for example the Mandate for end of life counseling is somewhere in Page 425-430, I want a response from a left winger addressing the point. Instead I'm getting ironic objections and conspiracy theories about protests, and an article today on HuffPo re-hashing the same poppycock about how small states have too much power. Federalism sucks! Seriously though, point me to a liberal resource where the bill is scrutinized and I'll look at it. I am trying to seek out this information.
james - 08/11/09 14:38
These conservatives are the only ones looking at the bill?

That is rich.
jason - 08/11/09 14:37
As far as I know, these Conservatives are the only ones scrutinizing the bill, or asking questions about what's in it. I wonder how many of these Congresscritters are reading poll tested talking points instead of talking about what's in the bill. Most proponents don't give a damn what's in it, as long as their Obamacare card paid for by their neighbor arrives in the mail. I'm glad you've actually given the bill a look.

07/28/2009 21:18 #49404

Healthcare Ramblings
Category: healthcare
image

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.





tinypliny - 07/30/09 09:06
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.
jenks - 07/29/09 20:30
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.
jenks - 07/29/09 20:27
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."
jenks - 07/29/09 20:23
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.
dcoffee - 07/29/09 20:22
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.
tinypliny - 07/29/09 19:09
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. :(
jenks - 07/29/09 18:09
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.
jason - 07/29/09 16:32
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.
heidi - 07/29/09 13:50
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>

dcoffee - 07/29/09 12:52
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.
heidi - 07/29/09 12:03
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.

tinypliny - 07/29/09 09:12
"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.
jason - 07/29/09 08:41
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.

dcoffee - 07/28/09 23:38
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.
tinypliny - 07/28/09 22:13
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.
joshua - 07/28/09 22:12
d:

You've suggested that Obama is barely a liberal - you've finally rendered me speechless.
tinypliny - 07/28/09 22:08
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?