Health Care Reform: Here We Go Again!

[RandomGuy]

http://www.credoaction.com/comics/TMW2009-07-01original.gif

[101A]

http://www.credoaction.com/comics/TMW2009-07-01original.gif

You know, debating YOUR prejudiced view of the opposition is pretty easy.

[RandomGuy]

http://www.credoaction.com/comics/TMW2009-07-01original.gif

You know, debating YOUR prejudiced view of the opposition is pretty easy.

It is indeed satire and exaggeration.

You do have to admit that the tactic of calling anything having to do with the goverments involvement with health care as "socialised medicine" is a pretty standard schtick, regardless of whether it is socialized or not.

The strip also called the proposed reforms half-assed, and seemed to expect that Democrats would f*** that up anyways, right?

A bit of criticism for both sides, and, I think, fair criticism.

Something needs to happen, you and I can both agree on that much at least.

[Wild Cobra]

Something needs to happen, you and I can both agree on that much at least.
Yes. Tort reform and less government interference. All insurance plans should have co-pays, but that's a free market choice.

[Viva Las Espuelas]

WASHINGTON, July 14 (Reuters) - A sweeping overhaul of the U.S. healthcare system to be announced on Tuesday in the U.S. House of Representatives will include a surtax on millionaires of 5.4 percent, congressional sources said.
The tax rate is higher than the 3 percent surtax lawmakers had been discussing earlier and would be imposed on those making more than $1 million a year, the sources said.

[Wild Cobra]

WASHINGTON, July 14 (Reuters) - A sweeping overhaul of the U.S. healthcare system to be announced on Tuesday in the U.S. House of Representatives will include a surtax on millionaires of 5.4 percent, congressional sources said.
The tax rate is higher than the 3 percent surtax lawmakers had been discussing earlier and would be imposed on those making more than $1 million a year, the sources said.
And they wonder why people want to shelter their money. What are the details?

[Viva Las Espuelas]

And they wonder why people want to shelter their money. What are the details?
since when has this administration dealt with details? details schmetails. just take what comes your way and don't complain.

[Wild Cobra]

When will demonrats ever learn. No matter how much they tax a group of individuals, the federal revenue settles to somewhere between 18% and 18.5% average of GNP. More taxation reduces economic activity, and thus, reduces revenue.

http://www.project.org/images/graphs/Receipts-by-Percentage-of-GDP.jpg (http://www.project.org/info.php?recordID=151)

[DarkReign]

People that earn over $1 million a year pay 45% in taxes with this new legislation.

What nobody seems to realize is this program isnt designed to cover every American, its designed to cover those Americans who do not have health insurance currently.

It would seem that me, as an employer, now has a disincentive to actually continue to offer health insurance (especially if health benefits become taxable). Why should I, as an employer, pay for health insurance to employees who could freely get it (without weekly deduction to them) without me?

This is bizarro world, where politicians think up and agree to the most inefficent methods for tackling problems they perceive as large.

Healthcare = Total disastrous approach
Cap+Trade = Total disastrous approach

At least the President and his Congress are two-for-two, I guess.

[LnGrrrR]

People that earn over $1 million a year pay 45% in taxes with this new legislation.

What nobody seems to realize is this program isnt designed to cover every American, its designed to cover those Americans who do not have health insurance currently.

It would seem that me, as an employer, now has a disincentive to actually continue to offer health insurance (especially if health benefits become taxable). Why should I, as an employer, pay for health insurance to employees who could freely get it (without weekly deduction to them) without me?

This is bizarro world, where politicians think up and agree to the most inefficent methods for tackling problems they perceive as large.

Healthcare = Total disastrous approach
Cap+Trade = Total disastrous approach

At least the President and his Congress are two-for-two, I guess.

Yes, that's what 101A was concerned about. He offers healthcare as a benefit, and there won't be a point to offering such.

[Wild Cobra]

House health plan to boost taxes on rich (http://www.google.com/hostednews/ap/article/ALeqM5jlMpJGn28kqCcgU-aGcYE_ZHW-ywD99EF3CO0)
The legislation calls for a 5.4 percent tax increase on individuals making more than $1 million a year, with a gradual tax beginning at $280,000 for individuals. Employers who don't provide coverage would be hit with a penalty equal to 8 percent of workers' wages with an exemption for small businesses. Individuals who decline an offer of affordable coverage would pay 2.5 percent of their incomes as a penalty, up to the average cost of a health insurance plan.Fuck that penalty bullshit. I'm fine with paying for my own doctors visits during the times I worked and had no insurance.
The tax would raise an estimated $544 billion over 10 years.No it won't. It might collect that much under the program, but with less money going elsewhere in the economy, jobs will be lost, and other revenue will decrease. The federal government will still only get about 18% to 18.5% of the GNP.
The liberal-leaning plan lacked figures on total costs, but a House Democratic aide said the total bill would add up to about $1.5 trillion over 10 years. The aide spoke on condition of anonymity to discuss the private calculations.It even costs $1T more than they claim they will get in revenue.

Are any of you libtards stupid enough to buy this?

[coyotes_geek]

It sucks, but it's probably going to happen. Obama is determined to put the petal to the metal on the path to financial ruin.

[Wild Cobra]

It sucks, but it's probably going to happen. Obama is determined to put the petal to the metal on the path to financial ruin.
I was trying to find the vote when the Department of Education was formed. Thomas doesn't have easy to find records that old. The vote was 215 to 201 in the house with 277 democrats and 158 republicans. 69 to 22 in the senate with 58 democrats and 42 republicans. The of course President Carter signed it into law. I assume it was a very partisan vote, but I couldn't find the dem/rep spits.

Oh well, not only will the health care set us back likely 1/3 or more trillion a year, it will be another nearly complete democrat failure.

[SonOfAGun]

Maybe democrats should stop thinking about their own selfish agenda and think what's best for the hard working normal people who keep the country running and don't want their health care quality to turn to shit.

Granted my politicians, whom I have the same health care as, will for sure be standing in line with me. :downspin:

[Winehole23]

If the government doesn't kick big pharma and insurance in the nuts, they will eat us alive.

They are eating us alive already. Letting them continue to do so is the essence of the "free market" solution, and, unfortunately, is the ostensible end of so-called health care reform as well. Either way, they'll fuck us.

The little guy always gets screwed. Status quo or reform makes little difference. The same interests write the bills.

[ElNono]

If the government doesn't kick big pharma and insurance in the nuts, they will eat us alive.

They are eating us alive already. Letting them continue to do so is the essence of the "free market" solution, and, unfortunately, is the ostensible end of so-called health care reform as well. Either way, they'll fuck us.

The little guy always gets screwed. Status quo or reform makes little difference. The same interests write the bills.

+1
I think we can debate all day wether a free system would work or not, but I do honestly think there are 3 things that must absolutely get done in any kind of healthcare reform: 1) Get big pharma in check, 2) Get Insurance companies in check and 3) Tort reform.

I don't think you can have an effective system, free or otherwise, if you don't seriously address those issues.

[101A]

It is indeed satire and exaggeration.

You do have to admit that the tactic of calling anything having to do with the goverments involvement with health care as "socialised medicine" is a pretty standard schtick, regardless of whether it is socialized or not.

The strip also called the proposed reforms half-assed, and seemed to expect that Democrats would f*** that up anyways, right?

A bit of criticism for both sides, and, I think, fair criticism.

Something needs to happen, you and I can both agree on that much at least.

I think that healthcare, in a country as wealthy as ours, ought to not be something that any individual does not have access to. And, frankly, people are not. People are not turned away at hospitals, or ER's - and many, many bills are written off.

Of course this patchwork, hit and miss coverage is NOT efficient or reassuring for those without insurance or govt. sponsored coverage.

We ought to develop a mechanism to get coverage for the majority of them through the private sector. Bringing a govt. "competitor" into the mix will ultimately lead to that being the ONLY payor. I know Obama says that is not the goal, and that it won't.....but it will. We all know it. It may take 20 years, but eventually Congress will stack the deck in favor of that option to the point that it will be THE ONLY option.

Also, I have a fundamental problem with the conventional wisdom statement that healthcare is "TOO EXPENSIVE" in this country. Yes, it is getting more and more expensive - and we DO spend more of our GDP on it than just about any 6 other countries....but stop with the knee jerk rhetoric for a minute, and look at the numbers:

Healthcare is 17 - 18% of our economy.

Healthcare (and related industries) provides 17 - 18% of our jobs.....

SO - when Obama talks about cutting healthcare costs, what is the natural conclusion to draw about the effect that will have on the job market? Seems to me that healthcare is doing a good job of providing jobs and expanding work opportunities as many other (manufacturing anyone?) contract. You can't outsource a nurse, an insurance salesman, or his secretary, can you? There has to be Pharmasists and techs in Walgreens, right? Hell, healthcare is about the ONLY part of our economy that's providing jobs, growing, improving (in terms of product/service advancement), etc.....why screw it up? You "cut" expenses...you cut jobs, IMO.

Once the govt. gets involved in the employer/employee healthcare system (which is the controversial party of Obama's solution) - the govt. plan will get its ass kicked. The will not underwrite properly, probably not pay efficiently, but that won't matter - insurance companys are at a distinct disadvantage in that they can't print money to make up for shortcomings in those areas - it is impossible to compete with an entity that can.

[sam1617]

My vote for providing health care to the masses is along the lines of credit unions and co-operatives. If a co-op can provide quality electricity or phone service, why can't we have a co-op provide health insurance, or just direct health care?

If a co-op is the one providing the health care, you know that A) they won't be out to make a profit, because all profits go back to the members. B) They are probably actually going to care about you as a human, because they are in the community.

[coyotes_geek]

Once the govt. gets involved in the employer/employee healthcare system (which is the controversial party of Obama's solution) - the govt. plan will get its ass kicked. The will not underwrite properly, probably not pay efficiently, but that won't matter - insurance companys are at a distinct disadvantage in that they can't print money to make up for shortcomings in those areas - it is impossible to compete with an entity that can.

Bingo. I'd be a lot more open to the idea of a government run plan if I knew as undisputable fact that 100% of the costs of funding that plan would be bourn by those covered under the plan. A not-for-profit government insurance plan needs to be a not-for-loss one as well in order to make any sense. But that's not what we're fixing to get. The government plan will just arbitrarily charge whatever premiums they think people can afford to pay with absolutely no regard for what it actually costs to provide those services. The plan will end up operating at huge losses and the taxpayers will end up subsidizing those losses so that the plan can keep going.

[coyotes_geek]

It would be nice if we as a nation would have the balls to look in the mirror, recognize that we're a nation of couch potatoes and accepted our portion of the respobility we have in rising health care costs. But we'd much rather have the freedom to do as we please and make it someone else's responsibility to take care of us when we don't like where our choices led us to.

[101A]

Chart of Democratic Health Plan (http://docs.house.gov/gopleader/House-Democrats-Health-Plan.pdf)
(http://docs.house.gov/gopleader/House-Democrats-Health-Plan.pdf)

[Aggie Hoopsfan]

My vote for providing health care to the masses is along the lines of credit unions and co-operatives. If a co-op can provide quality electricity or phone service, why can't we have a co-op provide health insurance, or just direct health care?

If a co-op is the one providing the health care, you know that A) they won't be out to make a profit, because all profits go back to the members. B) They are probably actually going to care about you as a human, because they are in the community.

Because co-ops have to compete with other electric companies, not a government that can fire up the printing presses and print another trillion to pay for the public option and undercut private insurers.

Oh, and just wait - all those small businesses that the government is going to fine 8% for not providing health care - when this pile of crap passes they're going to do whatever they have to in order to survive, which is going to mean wage reductions and more firings.

Hope everyone is ready for their government mandated lowered standard of living. Just be sure you send your thank you card to the lord Messiah and the Demo thugs in Congress. :td

[Aggie Hoopsfan]

Bingo. I'd be a lot more open to the idea of a government run plan if I knew as undisputable fact that 100% of the costs of funding that plan would be bourn by those covered under the plan. A not-for-profit government insurance plan needs to be a not-for-loss one as well in order to make any sense. But that's not what we're fixing to get. The government plan will just arbitrarily charge whatever premiums they think people can afford to pay with absolutely no regard for what it actually costs to provide those services. The plan will end up operating at huge losses and the taxpayers will end up subsidizing those losses so that the plan can keep going.


It won't be arbitrary. Those with jobs will pay, those without won't. This isn't about fixing health care, it's about the Dems keeping themselves in power. And what better way than to provide free health care to the idiots who keep voting for them while sticking it to the 'man' with a job and 'wealth'.

[SonOfAGun]

Just wait until healty able-bodied men have to sit and watch their family members, who once had great health-care, now waiting weeks or months for both simple and serious treatment.

That's about as personal an assault on an individual as government can get.

[Aggie Hoopsfan]

Just wait until healty able-bodied men have to sit and watch their family members, who once had great health-care, now waiting weeks or months for both simple and serious treatment.

That's about as personal an assault on an individual as government can get.

All so about 16 million people can get insurance (and have their votes bought by the Dems)...

[ElNono]

Just wait until healty able-bodied men have to sit and watch their family members, who once had great health-care, now waiting weeks or months for both simple and serious treatment.

That's about as personal an assault on an individual as government can get.

You mean those able-bodied men that decided to save a buck and went for the public plan instead of paying for a private one? I mean, it's not like you don't have a choice.

[Viva Las Espuelas]

All so about 16 million peopleillegal and legal
can get insurance (and have their votes bought by the Dems)...

[RandomGuy]

Yes. Tort reform and less government interference. All insurance plans should have co-pays, but that's a free market choice.

I am for tort reform if it truly did what its proponents say it would.

I am willing to try it to see if it works. The data that I have seen in the form of the white papers that analyse health care cost increases is that malpractice insurance and such things are far from the primary cost drivers tht some think they are.

[RandomGuy]

I think that healthcare, in a country as wealthy as ours, ought to not be something that any individual does not have access to. And, frankly, people are not. People are not turned away at hospitals, or ER's - and many, many bills are written off.

People who need routine medical care are given free doctors visits if they show up at any clinic or hospital?

There is a huge difference between mandatory ER admits and the kinds of healthcare that is inaccessable to a lot of people that would keep them out ofthe ER in the first place.

[101A]

People who need routine medical care are given free doctors visits if they show up at any clinic or hospital?

There is a huge difference between mandatory ER admits and the kinds of healthcare that is inaccessable to a lot of people that would keep them out ofthe ER in the first place.

Don't know if you read the rest of my post or not; I DO think everyone needs coverage - a 3rd party payor, if you will....

However; just a little anecdote:

My wife has a cousin - 27 years old. VERY big girl (5'2" 300+ lbs (thank God doesn't run in the family). Anyway, has no job; not on Medicaid, is a hypochondriac to boot - no insurance. She goes to the doctor weekly, takes a number of maintenance drugs; in the hospital a couple of times a year......never has to pay for any of it. If SHE is able to get all the healthcare she needs (and more)...who is being denied?

And again, as I said earlier, I do not believe this is a good, or efficient way to handle our uninsured.

[LnGrrrR]

Don't know if you read the rest of my post or not; I DO think everyone needs coverage - a 3rd party payor, if you will....

However; just a little anecdote:

My wife has a cousin - 27 years old. VERY big girl (5'2" 300+ lbs (thank God doesn't run in the family). Anyway, has no job; not on Medicaid, is a hypochondriac to boot - no insurance. She goes to the doctor weekly, takes a number of maintenance drugs; in the hospital a couple of times a year......never has to pay for any of it. If SHE is able to get all the healthcare she needs (and more)...who is being denied?

And again, as I said earlier, I do not believe this is a good, or efficient way to handle our uninsured.

You bring up a good point, that there are people that will abuse the system.

I can't think of any good way to combat that, in all honesty.

[RandomGuy]

You bring up a good point, that there are people that will abuse the system.

I can't think of any good way to combat that, in all honesty.

There is abuse in any system. No way around it, one has to understand this, as it is a rather important bit.

[101A]

You bring up a good point, that there are people that will abuse the system.

I can't think of any good way to combat that, in all honesty.

My point is not that she abuses the system; it's that the system allows her to abuse the system; get all the care she desires; without "coverage".

Proponents of changing the system constantly cite people not getting treated - my point is: If my cousin in law, with no coverage or money whatsoever, can get treated - who cannot?

And again, so we don't get off track - I want everyone covered because it will be more efficient; and everyone should be.

[101A]

Gimme some of that European Healthcare!
(http://www.dailymail.co.uk/health/article-1199714/A-9-month-wait-arthritis-treatment-Delay-mean-lifetime-agony-victims.html)


A 9-month wait for arthritis treatment: Delay can mean a lifetime of agony for victims


By Daniel Martin (http://www.dailymail.co.uk/home/search.html?s=y&authornamef=Daniel+Martin)


Thousands of rheumatoid arthritis sufferers face a lifetime of agony because they are not being treated quickly enough, a report says.
Guidelines state that patients should receive treatment within three months of the first symptoms appearing.
But the average wait is nine months - and GPs are not trained well enough to know what help to offer.
There is no cure, but experts say that if arthritis is diagnosed in the first three months, drugs can be given which limit its progression. This means the disease will not be as painful as it would have been if the condition was diagnosed later.
The study by the National Audit Office found that patients do not know enough about the condition, and therefore delay going to see their GP.
Between half and three-quarters of people with symptoms wait more than three months before seeking medical help, and about a fifth delay for a year or more.
GPs lack the specialist knowledge required to diagnose the condition quickly, and on average it takes four visits before a patient is referred to a specialist for diagnosis and treatment, the report adds.

Its author, Chris Groom, said: 'This is a nasty disease, a progressive auto-immune disease, which attacks otherwise healthy joints. Early symptoms are joint pain and stiffness and it leads to inflammation and loss of strength.
'It also affects other parts of the body, such as the heart and lungs, and is also associated with increased risk of cardiovascular disease.'
The report found that the average length of time from the onset of symptoms to treatment has not improved in the past five years. Mr Groom said that services needed to be better coordinated and designed around people's needs, including helping them remain in work.

Three-quarters of sufferers are of working age when diagnosed, meaning delays cost the economy almost £2billion a year - about £560million a year in NHS healthcare costs and £1.8billion in sick leave and work-related disability.
'Once people fall out of the job market with this disease, it is very hard to get back in', Mr Groom said.
The report also found that 50 per cent more people have rheumatoid arthritis than was previously thought.
Mr Groom added: 'We estimate that 580,000 adults in England have the condition, which is higher than existing estimates of 400,000 for the UK, and that there are 26,000 new cases each year in England, compared to estimates of 12,000 for the UK.'
Neil Betteridge, chief executive of the charity Arthritis Care, said: 'The report echoes what people with rheumatoid arthritis have been telling Arthritis Care for years.
'Early diagnosis and referral for suitable treatment is crucial as it can stop this debilitating condition in its tracks.
'We applaud the audit's recommendations that the Department of Health and Primary Care Trusts replace their often scattergun delivery with joined-up services.'
Tory MP Edward Leigh, chairman of the Commons public accounts committee, said the NHS needed to improve support services for people with arthritis.

Health minister Ann Keen said: 'We welcome this report and will consider it carefully before responding.'

[ElNono]

I am for tort reform if it truly did what its proponents say it would.

I am willing to try it to see if it works. The data that I have seen in the form of the white papers that analyse health care cost increases is that malpractice insurance and such things are far from the primary cost drivers tht some think they are.

Having a few medical practices as customers, I can tell you that malpractice insurance is the number two cost driver. Insurance companies being the number one. At least in their case.
I don't know how this applies to hospitals, etc.

[ElNono]

Don't know if you read the rest of my post or not; I DO think everyone needs coverage - a 3rd party payor, if you will....

However; just a little anecdote:

My wife has a cousin - 27 years old. VERY big girl (5'2" 300+ lbs (thank God doesn't run in the family). Anyway, has no job; not on Medicaid, is a hypochondriac to boot - no insurance. She goes to the doctor weekly, takes a number of maintenance drugs; in the hospital a couple of times a year......never has to pay for any of it. If SHE is able to get all the healthcare she needs (and more)...who is being denied?

And again, as I said earlier, I do not believe this is a good, or efficient way to handle our uninsured.

It's not just patients abusing the system. There was an article about McAllen, TX not long ago having the most expensive care cost per person under Medicare. What the reporter found out was that doctors were gaming the system by ordering all these completely unnecessary tests.

There has to be a checks and balances system in place, obviously.

[101A]

It's not just patients abusing the system. There was an article about McAllen, TX not long ago having the most expensive care cost per person under Medicare. What the reporter found out was that doctors were gaming the system by ordering all these completely unnecessary tests.

There has to be a checks and balances system in place, obviously.


(Evil) Insurance companies help keep those in check.

[ElNono]

My point is not that she abuses the system; it's that the system allows her to abuse the system; get all the care she desires; without "coverage".

Proponents of changing the system constantly cite people not getting treated - my point is: If my cousin in law, with no coverage or money whatsoever, can get treated - who cannot?

And again, so we don't get off track - I want everyone covered because it will be more efficient; and everyone should be.

I was reading this the other day about my state. According to state law here (Family act, or some such), In Vitro fertilization is obligatory for insurance companies to pay for on companies with over 500 employees, the sole exceptions being if the insured is a government employee or if the company is 'self-insured' (whatever that means).
Guess what? Most of all companies with 500 or more employees in the state are now magically 'self-insured'.
This is the kind of loophole bullshit I really want to do away with.

[ElNono]

(Evil) Insurance companies help keep those in check.

Well, Evil Insurance companies actually have been raising the cost for uninsured patients for a long time now.
Since they're only going to pay for a % of the actual value of a procedure, doctors end up having to overcharge in order to get the amount that they want. This is how the last time I went to the dentist, he did x-rays and fixed 2 cavities and he charged the insurance $1250, of which he only got paid back $300.
It fucked me over, because I only get 80% coverage on dental. Which means I had to pay almost $250. It goes without saying I won't be going to that dentist anymore.
What's even more aggravating is that if I had to actually pay out of pocket, the cost would have been $1250. Which is simply delusional.

[Extra Stout]

There is abuse in any system. No way around it, one has to understand this, as it is a rather important bit.
The amount of abuse in the system is a function of the culture in which the system is operated. This is why, for example, Germany can have a generous unemployment insurance system where few try to game the system, while in Argentina you can't even order food without a regimented system of tickets and stamps to ensure people don't steal one another's orders.

Americans are not very honest compared to other countries' citizens, which is both why we end up needing more social services, and why they are horribly corrupt and wasteful.

Public policy can't turn shit into gold, no matter how many ways it comes up with to polish the turd.

[101A]

I was reading this the other day about my state. According to state law here (Family act, or some such), In Vitro fertilization is obligatory for insurance companies to pay for on companies with over 500 employees, the sole exceptions being if the insured is a government employee or if the company is 'self-insured' (whatever that means).
Guess what? Most of all companies with 500 or more employees in the state are now magically 'self-insured'.
This is the kind of loophole bullshit I really want to do away with.



ERISA (Federal Level) forbids states from regulating Self-Insured plans. It's not magic; most employers over 250 employees are self-insured, and have been for years.

In Vitro a requirement? :lol Leads to multiple, premature births (very expensive to deal with, and is expensive in its own right).

And people wonder why health care is so damned expensive.

[101A]

Well, Evil Insurance companies actually have been raising the cost for uninsured patients for a long time now.
Since they're only going to pay for a % of the actual value of a procedure, doctors end up having to overcharge in order to get the amount that they want. This is how the last time I went to the dentist, he did x-rays and fixed 2 cavities and he charged the insurance $1250, of which he only got paid back $300.
It fucked me over, because I only get 80% coverage on dental. Which means I had to pay almost $250. It goes without saying I won't be going to that dentist anymore.
What's even more aggravating is that if I had to actually pay out of pocket, the cost would have been $1250. Which is simply delusional.

Always get a "predetermination" when getting dental procedures; that'll NEVER happen again.

[Extra Stout]

At some point in time, it became the quintessential American attitude for one to demand lots of goods and services, but refuse to pay for them.

It is both the reason for the drive towards Big Government and the reason it is doomed to fail.

[ElNono]

Always get a "predetermination" when getting dental procedures; that'll NEVER happen again.

What will never happen again? Me getting my tooth fixed?
The dental was just a personal example. It happens on medicine in general at every level.

[ElNono]

And people wonder why health care is so damned expensive.

I do wonder. Because that exact same procedure costs $25,000 here in the US, while it costs $5,000 overseas.
The last time I had multiple cavities fixed back in my country, it cost me a succulent $30 dollars. Compare that to $1,250 in the US.

The fact that you don't wonder why they can do the exact same procedures for 500+% cheaper is the reason you keep paying through your nose for everything you get done here.

[101A]

What will never happen again? Me getting my tooth fixed?
The dental was just a personal example. It happens on medicine in general at every level.

No, your not having to pay more than the benefit available.

[101A]

I do wonder. Because that exact same procedure costs $25,000 here in the US, while it costs $5,000 overseas.
The last time I had multiple cavities fixed back in my country, it cost me a succulent $30 dollars. Compare that to $1,250 in the US.

The fact that you don't wonder why they can do the exact same procedures for 500+% cheaper is the reason you keep paying through your nose for everything you get done here.

I can buy leather wallets in Mexico for a buck; Whiskey at 30 cents on the dollar, and can stay in a 5 star hotel for 40 dollars a night. I had a friend from German visit last year; Timex watches cost a quarter here of what they do back home; he bought a dozen for his clients; and was excited as hell; they're gonna think he's generous as hell. That's right. Timex.

Why should healthcare be different than everything else?

[ElNono]

No, your not having to pay more than the benefit available.

But I didn't pay more than the benefit available. I don't think you understood my example at all. Which would explain a lot.

[ElNono]

I can buy leather wallets in Mexico for a buck; Whiskey at 30 cents on the dollar, and can stay in a 5 star hotel for 40 dollars a night. I had a friend from German visit last year; Timex watches cost a quarter here of what they do back home; he bought a dozen for his clients; and was excited as hell; they're gonna think he's generous as hell. That's right. Timex.

Why should healthcare be different than everything else?

Because I do honestly believe there's a clear distinction between luxury items (your items) and people's access to health care. I don't necessarily mind doctors or companies making SOME profit, but I draw the line where the greed actually gets in the way of providing care to those who need it.

[Spursmania]

You mean those able-bodied men that decided to save a buck and went for the public plan instead of paying for a private one? I mean, it's not like you don't have a choice.


Remember the government option will always be subsidized, thus it will be cheaper. The great MD's and better Doctors can decide they don't want to take people who on that cheaper subsidized government plan. And, usually those MD's are the ones people want to see.

You think Congress will elect the government option for themselves. That will be the day.:lol

Government run health-care will never result in a more quality efficient system. Government interference has never been the answer and never will. The government is not supposed to be running our healthcare.

We are in a deep recession, the plans to pay for this 1 trillion dollar health reform need to be carefully debated, not pushed through without careful contemplation. Nobody can afford this right now. We are leaving a terrible debt to our children and grandchildren.

[Spursmania]

At some point in time, it became the quintessential American attitude for one to demand lots of goods and services, but refuse to pay for them.

It is both the reason for the drive towards Big Government and the reason it is doomed to fail.


It's really frustrating how people believe Government is the answer.

[Aggie Hoopsfan]

You think Congress will elect the government option for themselves. That will be the day

They already exempted themselves within the bill. Kinda nice touch, don't you think?

[Wild Cobra]

Well, Evil Insurance companies actually have been raising the cost for uninsured patients for a long time now.
Since they're only going to pay for a % of the actual value of a procedure, doctors end up having to overcharge in order to get the amount that they want. This is how the last time I went to the dentist, he did x-rays and fixed 2 cavities and he charged the insurance $1250, of which he only got paid back $300.
It fucked me over, because I only get 80% coverage on dental. Which means I had to pay almost $250. It goes without saying I won't be going to that dentist anymore.
What's even more aggravating is that if I had to actually pay out of pocket, the cost would have been $1250. Which is simply delusional.
This is a problem on your part. You didn't shop around. Last time I had X-Rays and cavities filled, it was $58. It's probably about $300 for two cavities now. Why do you expect the insurance to pay an inflated rate?

Next time, shop around. I do. I have dental available, but I opt out. It's cheaper for me to pay out of pocket than the insurance rates, but again... I shop around. And as a cash paying client, they don't have to take the man-hours to bill insurance. Cash payers do pay less when they shop around.

I was reading this the other day about my state. According to state law here (Family act, or some such), In Vitro fertilization is obligatory for insurance companies to pay for on companies with over 500 employees, the sole exceptions being if the insured is a government employee or if the company is 'self-insured' (whatever that means).
Guess what? Most of all companies with 500 or more employees in the state are now magically 'self-insured'.
This is the kind of loophole bullshit I really want to do away with.
That's a procedure that is ridiculous to mandate. May as well mandate that insurance pays for woman's breast enhancements too.

What will never happen again? Me getting my tooth fixed?
The dental was just a personal example. It happens on medicine in general at every level.
I think he meant that next time, because you have a financial stake in the game, that maybe you'll shop around for a better price.

I do wonder. Because that exact same procedure costs $25,000 here in the US, while it costs $5,000 overseas.
The last time I had multiple cavities fixed back in my country, it cost me a succulent $30 dollars. Compare that to $1,250 in the US.

The fact that you don't wonder why they can do the exact same procedures for 500+% cheaper is the reason you keep paying through your nose for everything you get done here.
Can you sue them if they fuck-up? Do they pay the same insurance premiums? Are they mandated by their government to have the same quality checks that we do?

Want to have cheaper medical here. Get some serious tort reform for starters.

[boutons_deux]

TX has tort reform, didn't lower anybody's medical bills, only fucked over victims and enriched the docs.

It's WC, so of course he's for fucking over citizens and consumers to the benefit of the rich and corps.

[Spursmania]

Wealth redistribution here we come.

Who's not going to want free health care paid for them by the people who are successful and wealthy.

Yep, looks like I'll be paying for hundreds of people's health care. Socialist health care here we come! There are limited amount of doctors in this country, and to believe that health care won't be rationed after this partisan socialist bill passes is simply naive.

My spouses' colleagues are already talking about cutting their hours, since they will be getting taxed to death, and paying for the health care.

Rationing here we come, and if you don't think it's true good luck when you have a serious illness and you have to wait in line to see a Doctor who (based on their pay cuts, medicare cuts, and the new health care tax) will not be staying late to see you.

Welcome to Obamacare where the rich get plowed for being successful and the rest applaud free healthcare --that will be nowhere near the quality they were used too. :lmao

[LnGrrrR]

I can buy leather wallets in Mexico for a buck; Whiskey at 30 cents on the dollar, and can stay in a 5 star hotel for 40 dollars a night. I had a friend from German visit last year; Timex watches cost a quarter here of what they do back home; he bought a dozen for his clients; and was excited as hell; they're gonna think he's generous as hell. That's right. Timex.

Why should healthcare be different than everything else?

Here's what I don't get.

If you feel that way, do you also feel the same about police and fire departments? That it would be fair to pay for certain levels of coverage? I'm guessing now, but I'd like to hear your thoughts.

[Spursmania]

Always get a "predetermination" when getting dental procedures; that'll NEVER happen again.


Have fun standing in line or getting on waiting lists for good Doctors to see you. You think Doctors who go through college, then 4 years medical school, then residency and internship all the while taking out hundreds of thousands of dollars of loans should give you free health care for 30 cents on the dollar?:lmao:lmao:lmao

Well, with this free Obama socialist health care, I can guarantee you, you will be waiting in line for your health care. I also know my spouse and colleagues will begin cutting their hours and services because of this government run health care.

And, I'm sure the very good doctors would want to opt out of the Government plan since it will be cheaper and not pay as much. You get what you pay for or shall I say you get what the rich have paid for for you!

America will never be the same. Hope you don't come down with a terminal disease.:toast

[Winehole23]

I thought today's Daily Show segment on "socialized medicine" was tone perfect, if also fact-free. It made me laugh.

[Spursmania]

I thought today's Daily Show segment on "socialized medicine" was tone perfect, if also fact-free. It made me laugh.


You won't be laughing when you or a loved one has to be put on a waiting list to see a doctor. Book it.:toast

If you don't believe me why don't you research how many doctors we have in the US? Than calculate all the free health care people will be getting and now you tell me if it's ridiculous to think health care will be rationed out like the socialists do.

This has to do with supply and demand. Lastly, do you think an MD would prefer to see a government run health care plan in his office or a private insurer? Demand will be high and I guarantee you, the MD will not chooses the government run plan. Quantity does not mean quality.

[Wild Cobra]

You won't be laughing when you or a loved one has to be put on a waiting list to see a doctor. Book it.:toast

If you don't believe me why don't you research how many doctors we have in the US? Than calculate all the free health care people will be getting and now you tell me if it's ridiculous to think health care will be rationed out like the socialists do.

This has to do with supply and demand. Lastly, do you think an MD would prefer to see a government run health care plan in his office or a private insurer? Demand will be high and I guarantee you, the MD will not chooses the government run plan. Quantity does not mean quality.
I already get upset just having to wait 20 minutes. I cannot imagine having to wait 20 weeks!

[Winehole23]

You won't be laughing when you or a loved one has to be put on a waiting list to see a doctor. Book it.:toastOh, so I shouldn't laugh now? :rollin




http://www.itsallabouteeyore.awoodman.net/images/eeyore6.jpg


If you don't believe me why don't you research how many doctors we have in the US? Than calculate all the free health care people will be getting and now you tell me if it's ridiculous to think health care will be rationed out like the socialists do.If you've already done your homework why not share it with all of us? Sending me home to do my own homework is most inexpeditious, if you are already a professor of it.

Don't hoard the knowledge, Spursmania; please favor us with more of your impressions.


This has to do with supply and demand. Lastly, do you think an MD would prefer to see a government run health care plan in his office or a private insurer? Demand will be high and I guarantee you, the MD will not chooses the government run plan. Quantity does not mean quality.I agree with you that any proposed reform will probably tend to reinforce a multi-tiered health care system. Some animals are just more equal than others.

[ElNono]

This is a problem on your part. You didn't shop around. Last time I had X-Rays and cavities filled, it was $58. It's probably about $300 for two cavities now. Why do you expect the insurance to pay an inflated rate?

Next time, shop around. I do. I have dental available, but I opt out. It's cheaper for me to pay out of pocket than the insurance rates, but again... I shop around. And as a cash paying client, they don't have to take the man-hours to bill insurance. Cash payers do pay less when they shop around.


Don't pre-assume things. This has been my 7th different dentist in 10 years. I HAVE shopped around and nobody gave me an estimate under $800.
It's an inflated price no matter where you go over here. About 5 years ago I had a dentist that would charge me $100 per cavity if I paid out of pocket. I fixed a couple of them with him, but then he claimed I had half a dozen cavities, which I most definitely didn't have (according to every other dentist I've seen since).

So ten years later, I'm still trying to find a reliable and affordable dentist here in the northeast. Considering my wife is on the same boat as me, and my inlaws that live in the valley and go to Mexico because they can't afford the US dentist, I have the impression it's a fairly common occurence.


That's a procedure that is ridiculous to mandate. May as well mandate that insurance pays for woman's breast enhancements too.


I'm not arguing wether the mandate is a good thing or not. I would actually agree it's not. My point of contention is that if there is a mandate, the insurance companies should obey it, instead of clinging into loopholes to maximize their bottom line. It's not like they pass the savings down to the consumer.


Can you sue them if they fuck-up? Do they pay the same insurance premiums? Are they mandated by their government to have the same quality checks that we do?

Want to have cheaper medical here. Get some serious tort reform for starters.

We've gone through this before with you, and you know that I'm a supporter of tort reform. But that alone is not enough, as seen in Texas. You also need to either regulate or reform both insurance companies and big pharma.
As long as they care more about their bottom line and investors than to provide fair and reasonable care nothing is going to change.

[Wild Cobra]

Don't pre-assume things.
<snip>
OK, then I will assume that your area is one where the free market of dentistry has been killed by regulations. So many dentists have left private practice, or something else occurred reducing the supply of dentists to the population.

I'm glad it's not that bad in Oregon yet.

[Spursmania]

I already get upset just having to wait 20 minutes. I cannot imagine having to wait 20 weeks!


Well, since it will be free, I guess they can't complain. :lol
Those of us with medical connections will never have a problem being seen. But I guess since we're the only ones paying for the health care reform via the surtax, I won't feel too bad about it.

[Spursmania]

Oh, so I shouldn't laugh now? :rollin




http://www.itsallabouteeyore.awoodman.net/images/eeyore6.jpg

If you've already done your homework why not share it with all of us? Sending me home to do my own homework is most inexpeditious, if you are already a professor of it.

Don't hoard the knowledge, Spursmania; please favor us with more of your impressions.

I agree with you that any proposed reform will probably tend to reinforce a multi-tiered health care system. Some animals are just more equal than others.

I'd rather laugh away at your ignorance. You know what they say ignorance is bliss. Afterall, I won't be the one on a waiting list.:toast

[ElNono]

OK, then I will assume that your area is one where the free market of dentistry has been killed by regulations. So many dentists have left private practice, or something else occurred reducing the supply of dentists to the population.

I'm glad it's not that bad in Oregon yet.

Actually, my point of contention is that free market is what got us in this hole.
Now, I don't necessarily think that a competing free insurance is the only answer, but I do see how it would drive costs down. It's either that or capping profits, IMHO.

[ElNono]

I'd rather laugh away at your ignorance. You know what they say ignorance is bliss. Afterall, I won't be the one on a waiting list.:toast

LOL @ the waiting list fearmongering.
I'm actually willing to bet you've never lived in a country with a mixed (free public, paid private) healthcare system and used it. Am I correct?

[Spursmania]

LOL @ the waiting list fearmongering.
I'm actually willing to bet you've never lived in a country with a mixed (free public, paid private) healthcare system and used it. Am I correct?


Incorrect, I have lived in Europe for ten years of my life. Germany and France.

[ElNono]

Incorrect, I have lived in Europe for ten years of my life. Germany and France.

So exactly what waiting lines are you talking about? Actually the cost of seeing a doctor paying out of pocket is ridiculously low compared to the US, not to mention they gladly spend more than the 30 seconds you see the average US doctor.

[Spursmania]

LOL @ the waiting list fearmongering.
I'm actually willing to bet you've never lived in a country with a mixed (free public, paid private) healthcare system and used it. Am I correct?

I am not fearmongering, but rather laying out a simple truth. Do you ever have to wait for an appointment and/or make one ahead of time? The AMA has already articulated the shortge of physicians we will have, and the need for more physicians due to the demand we will be seeing.

I do agree that Healthcare reform is needed. However, the way Congress is burdening only the wealthiest Americans with a surtax to pay for health care reform is socialistic. If all Americans want this reform, then all should have to pay a tax to cover their load. Would you like to pay 45% of your taxes for the rest of us?

At least in Germany, everybody is required to pay into a medical insurance system. But, I would hardly call it the highest quality of healthcare available that's for sure. My friend's brother died because they misdiagnosed his cancer read. Moreover, I didn't get an epidural when delivering my fist child. I hardly call that state of the art health care.

[Spursmania]

So exactly what waiting lines are you talking about? Actually the cost of seeing a doctor paying out of pocket is ridiculously low compared to the US, not to mention they gladly spend more than the 30 seconds you see the average US doctor.


I am talking about the wait lines you will see in the US. :toast
When's the last time you went to see a DR? I went to my pediatrician a month ago, 3 hours! And that was after waiting a few days for an appointment. If you believe healthcare will only get better you are in for a disappointment.

Your cost may go down a bit, but your quality of care will go down much more drastically. A vast and sweeping reform like this needs to take into account all participants. Obama's proposal hardly does that. He's trying to get it passed quickly without any open dialogue or transparent debates. As a result, it will be a partisan bill, and as written will destroy the greatest free choice health care system in the world.

[sabar]

Health care is never going to be cheap, so drop that fantasy world. Students don't go to school until their almost 30 and take out massive loans to get paid 40k a year. It is a very specialized field and it isn't surprising at all that medicine costs what it does. The problem is people want bleeding edge technology without the costs. Well, high tech plastics, electronics, $4 million dollar MRI machines and so forth have to get paid somehow. X-rays are so routine now, but they cost a fortune to maintain, use, and buy in the first place.

Socialized medicine looks good on paper because taxes are inevitable and most people don't realize that they are just paying into their own health care through those taxes (or paying for someone elses).

The whole thing is a very tricky situation. Is health care even a vital need, or a luxury? We've doubled/tripled our life expectancy through expensive technology. Most animals get through the majority of their adulthood without needing health care. Can people? Protecting people from crime and fire is different than from disease. Crime can be stopped by underpaid and unskilled workers. Same with fire. Health? Not so much.

There is a wealth of issues at stake.

If the government has a stake in health care, do they have an implied right to restrict things like transfats, smoking, alcohol?

What are solutions to an industry with massive demand and little supply?

How do you draw the line between luxury and necessary health care? Dental cleanings? Cavities? What is considered cosmetic and what is necessary?

What is the cost?

Who bears the burden?

Is this even ethical?

[sabar]

By the way, I am of the probably minority that thinks health care by and large, is a luxury good. People are spoiled

I think government should only bear the cost of emergency medicine. All routine check-ups, dentistry work, vision/hearing problems, fractures, disease should be paid by those who can afford it.

You know, where do you draw the line? Poverty is sad, the class gap is sad, but that's life. You can't artificially prop them up, it just doesn't work. Time and time again, government has tried to close this gap and failed every time. Like it or not, humans operate on capitalistc greed.

[Spursmania]

Health care is never going to be cheap, so drop that fantasy world. Students don't go to school until their almost 30 and take out massive loans to get paid 40k a year. It is a very specialized field and it isn't surprising at all that medicine costs what it does. The problem is people want bleeding edge technology without the costs. Well, high tech plastics, electronics, $4 million dollar MRI machines and so forth have to get paid somehow. X-rays are so routine now, but they cost a fortune to maintain, use, and buy in the first place.

Socialized medicine looks good on paper because taxes are inevitable and most people don't realize that they are just paying into their own health care through those taxes (or paying for someone elses).

The whole thing is a very tricky situation. Is health care even a vital need, or a luxury? We've doubled/tripled our life expectancy through expensive technology. Most animals get through the majority of their adulthood without needing health care. Can people? Protecting people from crime and fire is different than from disease. Crime can be stopped by underpaid and unskilled workers. Same with fire. Health? Not so much.

There is a wealth of issues at stake.

If the government has a stake in health care, do they have an implied right to restrict things like transfats, smoking, alcohol?

What are solutions to an industry with massive demand and little supply?

How do you draw the line between luxury and necessary health care? Dental cleanings? Cavities? What is considered cosmetic and what is necessary?

What is the cost?

Who bears the burden?

Is this even ethical?


All excellent points. I wish there were an easy answer.

But I will say this, total health care reformation in the middle of a recession that will cost 1 trillion dollars over the next ten years doesn't seem like the answer to me. We should at least take care of the economy first before we add on to our already bloated debt with a health care proposal that we're not even sure will work and will cost at least 1 Trillion dollars over the next ten years. And, more often times than not, the programs end up costing more than originally projected.

[Spursmania]

By the way, I am of the probably minority that thinks health care by and large, is a luxury good. People are spoiled

I think government should only bear the cost of emergency medicine. All routine check-ups, dentistry work, vision/hearing problems, fractures, disease should be paid by those who can afford it.

You know, where do you draw the line? Poverty is sad, the class gap is sad, but that's life. You can't artificially prop them up, it just doesn't work. Time and time again, government has tried to close this gap and failed every time. Like it or not, humans operate on capitalistc greed.


I really couldn't agree with you more. I strongly believe health care is not a right but a privilege. By the way, the government already provides emergency health care to all. People cannot be turned away at ER's.

[Winehole23]

I'd rather laugh away at your ignorance. You know what they say ignorance is bliss. Afterall, I won't be the one on a waiting list.:toast:lol

Laughing at your ignorance of my point of view. I'm not in favor of healthcare reform as proposed, and you failed to notice I partially agreed with you upstream.

You're not much of a reader, are you?

[ElNono]

I am not fearmongering, but rather laying out a simple truth. Do you ever have to wait for an appointment and/or make one ahead of time? The AMA has already articulated the shortge of physicians we will have, and the need for more physicians due to the demand we will be seeing.

Depends. If it's specialized medicine I do. If it's your run of the mill cold, I go to a walk-in clinic and I'm normally seen within 15 minutes.


I do agree that Healthcare reform is needed. However, the way Congress is burdening only the wealthiest Americans with a surtax to pay for health care reform is socialistic. If all Americans want this reform, then all should have to pay a tax to cover their load. Would you like to pay 45% of your taxes for the rest of us?

I don't necessarily disagree with you in that there could be possibly better ways to pay for this. At least different ways that would be considered more 'fair'. But I also don't see you complaining about how much of your taxes go to bailout Wall Street executives. Or being wasted on inordinate military spending. The reality is that we're going to be taxed no matter what, so I would rather see some of that tax money go to provide a modicum of health care and help drive some of the costs of healthcare down.


At least in Germany, everybody is required to pay into a medical insurance system. But, I would hardly call it the highest quality of healthcare available that's for sure. My friend's brother died because they misdiagnosed his cancer read. Moreover, I didn't get an epidural when delivering my fist child. I hardly call that state of the art health care.

The reason doctors are required to have malpractice insurance here in the US is because malpractice happens here too. But without serious tort reform that's also one of the biggest drivers of care cost.


I am talking about the wait lines you will see in the US. :toast
When's the last time you went to see a DR? I went to my pediatrician a month ago, 3 hours! And that was after waiting a few days for an appointment. If you believe healthcare will only get better you are in for a disappointment.

One of the reasons for the lack of availability has to do with the current insurance system. At least two of my doctor clients simply do not see walk-in patients anymore and moved to only see patients under a personalized care program. They simply got fed up of fighting with insurance companies to get paid. I'm not really concerned about doctor's availability under a mixed program. If third world countries figured this stuff out a long time ago, I don't think it's going to be a problem for the US.


Your cost may go down a bit, but your quality of care will go down much more drastically. A vast and sweeping reform like this needs to take into account all participants. Obama's proposal hardly does that. He's trying to get it passed quickly without any open dialogue or transparent debates. As a result, it will be a partisan bill, and as written will destroy the greatest free choice health care system in the world.

I'm not against debate, but if it's only to stall and prevent any kind of reform happening, much like what happened under Clinton, then I would say pass it, and we'll tweak it as we go along. We need something to shake up the current system.

[ElNono]

Health care is never going to be cheap, so drop that fantasy world. Students don't go to school until their almost 30 and take out massive loans to get paid 40k a year. It is a very specialized field and it isn't surprising at all that medicine costs what it does. The problem is people want bleeding edge technology without the costs. Well, high tech plastics, electronics, $4 million dollar MRI machines and so forth have to get paid somehow. X-rays are so routine now, but they cost a fortune to maintain, use, and buy in the first place.

Healthcare costs worldwide are a lot cheaper than in the US. There's simply no denying that. And short of the niche of very high tech specialized medicine (which probably accounts for under 1% of total care, and it's here to stay since most insurance companies don't cover them anyways), the vast majority of doctor's visits don't involve any of that equipment.


The whole thing is a very tricky situation. Is health care even a vital need, or a luxury? We've doubled/tripled our life expectancy through expensive technology. Most animals get through the majority of their adulthood without needing health care. Can people? Protecting people from crime and fire is different than from disease. Crime can be stopped by underpaid and unskilled workers. Same with fire. Health? Not so much.


I think CERTAIN basic care is vital. I don't think the entire spectrum of healthcare necessarily is. I think there's some basic care everyone should have access to, and then the luxury items reserved for those that can afford them. And I don't even think the line that separates the two is necessarily a static line. I would also like to think that we've evolved enough to do better than your run of the mill animal. And I completely disagree that crime and fire can be stopped by unskilled workers. Otherwise, anybody could prevent a crime or stop a fire, and we would not need to call the cops or the firemen.
That said, medicine is probably the one that requires the most skill and training.


There is a wealth of issues at stake.

If the government has a stake in health care, do they have an implied right to restrict things like transfats, smoking, alcohol?

What are solutions to an industry with massive demand and little supply?

How do you draw the line between luxury and necessary health care? Dental cleanings? Cavities? What is considered cosmetic and what is necessary?

What is the cost?

Who bears the burden?

Is this even ethical?

Sure there are massive issues at stake. And everybody is going to have a different opinion about those issues. The question is wether we do something to shake up the elitist and expensive system we have, we just sit on our asses and do nothing about it.

[101A]

But I didn't pay more than the benefit available. I don't think you understood my example at all. Which would explain a lot.

I guarantee you I know what I am talking about.

You wrote:


This is how the last time I went to the dentist, he did x-rays and fixed 2 cavities and he charged the insurance $1250, of which he only got paid back $300.

Had you had the dentist submit a predetermination, you would have found out beforehand EXACTLY how much the insurance company was going to pay him (btw, HE is way out of line with his fees), and could have chosen to either pay his excessive price, or find another provider.

Or maybe, because you're such a prick, ANY dentist is going to nail it to you, having to spend 2 hours listening to your annoying ass in their chair and all.

[101A]

Here's what I don't get.

If you feel that way, do you also feel the same about police and fire departments? That it would be fair to pay for certain levels of coverage? I'm guessing now, but I'd like to hear your thoughts.


I'm not talking about "level" of coverage; I'm talking about price.

Do you have any doubt that Police and Firemen make more in the U.S. than they do in Mexico...they cost "more". El Nono is on record as wanting doctors to be regulated to accepting modest salaries on moral grounds; should police and firemen as well? (his comparison was with Mexico, or some S. American country, I think).

I'm already on record as saying that health care ought to be a right in a country as wealthy as ours - and by that I don't limit it to basic, or rudimentary procedures. People ought to have access to the best we have to offer; and those that provide it ought to be both rewarded and have financial incentive to develop and provide the best.

[101A]

Healthcare costs worldwide are a lot cheaper than in the US. There's simply no denying that. And short of the niche of very high tech specialized medicine (which probably accounts for under 1% of total care, and it's here to stay since most insurance companies don't cover them anyways), the vast majority of doctor's visits don't involve any of that equipment.

Bullshit. You have no idea what you are talking about. Damn near every insurance contract out there pays for EVERY procedure, drug or device, regardless of price, if it is approved by the FDA, and administered/prescribed by a licensed MD/DO.

[ElNono]

Had you had the dentist submit a predetermination, you would have found out beforehand EXACTLY how much the insurance company was going to pay him (btw, HE is way out of line with his fees), and could have chosen to either pay his excessive price, or find another provider.


As I already explained in this thread, I did shop around, and there was nothing under $800. This is the system we have right now.


Or maybe, because you're such a prick, ANY dentist is going to nail it to you, having to spend 2 hours listening to your annoying ass in their chair and all.

If not wanting to be ripped off makes me a prick, then so be it.
In the meantime, you can keep on getting anally raped in a chair while you smile thinking how well the current free market system works. I'm sure your dentist appreciates your business. :tu

[ElNono]

Bullshit. You have no idea what you are talking about. Damn near every insurance contract out there pays for EVERY procedure, drug or device, regardless of price, if it is approved by the FDA, and administered/prescribed by a licensed MD/DO.

Sure as hell I do. My doctor prescribed Prevacid for me 4 months ago. The insurance company filled it for the first month and now refuses to keep on filling up the very same prescription. My doctor has been fighting with them for 3 months now, and I still don't have my medicine. My wife needs to take MetanX for her arthritis, which is prescription strength folic acid. Insurance won't pay for it because it's classified as 'vitamins'. But you can't buy it without a prescription. Out of pocket, here we go.

I'm really glad that you have a nice insurance plan. Not all of us are that lucky. For us, it's either this plan or being uninsured.

[101A]

As I already explained in this thread, I did shop around, and there was nothing under $800. This is the system we have right now.

Then you're lying about what you had done, or you have some really crappy insurance. The vast majority of plans limit charges to a "percentile" of an area's dentists going rates. Cheap plans limit to the 50th or 60th - meaning they will provide benefit for up to what 50 or 60% of dentists in an area charge. MOST plans pay at the 80th, and good ones pay at the 90th; meaning they are only cutting back charges on the most expensive 10% of dentists. There are several private companies in this country that payors (insurance companies) buy the billing data from.



If not wanting to be ripped off makes me a prick, then so be it.
In the meantime, you can keep on getting anally raped in a chair while you smile thinking how well the current free market system works. I'm sure your dentist appreciates your business. :tu

My job is to make sure that not only I, but 20,000 other people specifically DO NOT get rip off their self-insured employers.

[ElNono]

Then you're lying about what you had done, or you have some really crappy insurance. The vast majority of plans limit charges to a "percentile" of an area's dentists going rates. Cheap plans limit to the 50th or 60th - meaning they will provide benefit for up to what 50 or 60% of dentists in an area charge. MOST plans pay at the 80th, and good ones pay at the 90th; meaning they are only cutting back charges on the most expensive 10% of dentists. There are several private companies in this country that payors (insurance companies) buy the billing data from.

Again, I think you're missing my point. Out of those $800 I would have had to pay $160, since my insurance covers 80%. The same exact procedure paid out of pocket where I grew up costs $30. Obviously, standards of living differ between here and there, but the difference is definitely not 266%. I would actually say that the actual cost of the procedure here is most likely the amount the insurance paid. But those prices are simply not available to those without insurance.


My job is to make sure that not only I, but 20,000 other people specifically DO NOT get rip off their self-insured employers.

:tu

[101A]

Sure as hell I do. My doctor prescribed Prevacid for me 4 months ago. The insurance company filled it for the first month and now refuses to keep on filling up the very same prescription. My doctor has been fighting with them for 3 months now, and I still don't have my medicine.

They might be asking the doc why you need the Rx drug, when there are OTC brands that do very similar, or the exact same thing. Believe me, this is one place where the govt. will be LESS flexible than even the insurance companies; wouldn't surprise me if drugs like Prevacid didn't disappear altogether.....try Pepsid, Zantac, etc, for your heartburn.....



My wife needs to take MetanX for her arthritis, which is prescription strength folic acid. Insurance won't pay for it because it's classified as 'vitamins'. But you can't buy it without a prescription. Out of pocket, here we go.

Metanx is NOT FDA approved for that - vitamins or not. And again, you blame the insurance, but remember what Obama is saying he wants to fight....out of control costs. Both things that are happening to you are because someone is trying to control costs. You think these things will improve when the govt. takes over? They'll get much, much worse.


I'm really glad that you have a nice insurance plan. Not all of us are that lucky. For us, it's either this plan or being uninsured.

I do understand that my understanding of the system makes all of this much easier for me - it is a confusing system, and people such as yourself are NOT treated with any care, usually, from any side of the equation (provider OR payor) - they are also both real good at blaming the other. I would recommend YOU call your insurance company on the Prevacid issue; chances are they are asking for some information that your doc. isn't providing - believe me, it costs them more to have an ongoing issue than to just pay the claim for a cheap Rx like that.

[Aggie Hoopsfan]

Sure as hell I do. My doctor prescribed Prevacid for me 4 months ago. The insurance company filled it for the first month and now refuses to keep on filling up the very same prescription. My doctor has been fighting with them for 3 months now, and I still don't have my medicine. My wife needs to take MetanX for her arthritis, which is prescription strength folic acid. Insurance won't pay for it because it's classified as 'vitamins'. But you can't buy it without a prescription. Out of pocket, here we go.

I'm really glad that you have a nice insurance plan. Not all of us are that lucky. For us, it's either this plan or being uninsured.

If you think your wait is long now, wait until ObamaCare...

[ElNono]

They might be asking the doc why you need the Rx drug, when there are OTC brands that do very similar, or the exact same thing. Believe me, this is one place where the govt. will be LESS flexible than even the insurance companies; wouldn't surprise me if drugs like Prevacid didn't disappear altogether.....try Pepsid, Zantac, etc, for your heartburn.....


I've tried them all. Even prescription ones. I'm actually fortunate enough that I make a living writing practice management software, including insurance claim processing, and I have direct access to the doctors. I've been using sample packs for the past 3 months. The status of my prescription is "In Review". It's been like that for the past 3 months. They have my entire clinical history on this matter, including the drugs I've tried. Prevacid actually does not have a generic, but it's rumored there will be one soon. I've called. My doctor called. They're still reviewing, and I still don't have my medicine. I guess if I keep busting their balls eventually they're going to give in. It just simply shouldn't be this hard.


Metanx is NOT FDA approved for that - vitamins or not. And again, you blame the insurance, but remember what Obama is saying he wants to fight....out of control costs. Both things that are happening to you are because someone is trying to control costs. You think these things will improve when the govt. takes over? They'll get much, much worse.

Don't get me wrong. I'm not 100% on the boat with the proposed plan. But I'm also way, way tired of the current system. I want SOMETHING done.


I do understand that my understanding of the system makes all of this much easier for me - it is a confusing system, and people such as yourself are NOT treated with any care, usually, from any side of the equation (provider OR payor) - they are also both real good at blaming the other. I would recommend YOU call your insurance company on the Prevacid issue; chances are they are asking for some information that your doc. isn't providing - believe me, it costs them more to have an ongoing issue than to just pay the claim for a cheap Rx like that.

I believe I understand the system pretty well. I understand that insurance companies fight to control costs, and increase their bottom line. That simply did not bring down the costs of health, or provide better access to it. That plan FAILED. Now it's time to try something else. I'm not saying it's necessarily what's being proposed, but we can definitely do better than what we have been doing, IMHO.

[Wild Cobra]

Actually, my point of contention is that free market is what got us in this hole.
Now, I don't necessarily think that a competing free insurance is the only answer, but I do see how it would drive costs down. It's either that or capping profits, IMHO.
I disagree. Maybe your area has a shortage of dentists. If that's the case, it's because government red tape has chased them out one way or another. More government will make things worse. Not better.

By the way, I am of the probably minority that thinks health care by and large, is a luxury good. People are spoiled

I think government should only bear the cost of emergency medicine. All routine check-ups, dentistry work, vision/hearing problems, fractures, disease should be paid by those who can afford it.

You know, where do you draw the line? Poverty is sad, the class gap is sad, but that's life. You can't artificially prop them up, it just doesn't work. Time and time again, government has tried to close this gap and failed every time. Like it or not, humans operate on capitalistc greed.
I agree with you. For how many millennium have people not had health care anywhere close to today's medicine? Our race has done rather well. Al;l nicities of life should be earned. Not given or taken for granted. They should be something that motivates people want to strive for, to better themselves, rather than be a burden on society.

[DarkReign]

So you know, ElNono, youre arguing with a guy who runs a medical claim company (correct me where thats wrong, 101). 101A does nothing alllllll day but deal with insurance companies in just about every facet of the medical field in America.

Instead of arguing, take the advice. What you say happened to you, I believe you. But 101 is giving you some pointers for future reference in order to avoid being...well, fucked like you were before.

[ElNono]

So you know, ElNono, youre arguing with a guy who runs a medical claim company. 101A does nothing alllllll day but deal with insurance companies in just about every facet of the medical field in America.

I'm fully aware who I'm having a conversation with.


Instead of arguing, take the advice. What you say happened to you, I believe you. But 101 is giving you some pointers for future reference in order to avoid being...well, fucked like you were before.

I do take his advice, which is appreciated. I also want to present him with a different perspective from somebody that lived 20+ years under a mixed system, and that it's been living for over 10 years under the US system.
My experience is that they both have their pro and cons. That's all.

[LnGrrrR]

I'm not talking about "level" of coverage; I'm talking about price.

Do you have any doubt that Police and Firemen make more in the U.S. than they do in Mexico...they cost "more". El Nono is on record as wanting doctors to be regulated to accepting modest salaries on moral grounds; should police and firemen as well? (his comparison was with Mexico, or some S. American country, I think).

I'm already on record as saying that health care ought to be a right in a country as wealthy as ours - and by that I don't limit it to basic, or rudimentary procedures. People ought to have access to the best we have to offer; and those that provide it ought to be both rewarded and have financial incentive to develop and provide the best.

101A, I'm sorry if I wasn't clear, but I wasn't asking rhetorically.

What I meant is... police and firefighters are often state government, right? As such, they probably have salaries.

Now, when they respond to an issue, they don't require that the people they protect pay a certain amount monthly on fire or police insurance, right?

It has always seemed to me that medics are as an essential part of a functioning society as police. After all, even tribes have medicine men, right? (Though they usually function as the religious person as well. :)

Anyways, I have no expertise in this, and am just asking for information/opinions.

[DarkReign]

I'm fully aware who I'm having a conversation with.

Shit, my bad then.

[Spursmania]

:lol

Laughing at your ignorance of my point of view. I'm not in favor of healthcare reform as proposed, and you failed to notice I partially agreed with you upstream.

You're not much of a reader, are you?


Winehole, the reform, as proposed will have a devastating effect on many segments of the health care field but not all in effective or positive ways. I certainly believe insurance companies and pharmaceutical companies need to be reigned in more, so their policies are affordable and drugs are affordable.

However, this bill will kill Doctors. And, since MD"s make up a very small segment of society Obama doesn't care how drastically this bill affects doctors. First, the proposal will cut Doctor fees by 40%. This is called the "CMS fee changes". Secondly, only the so called wealthiest Americans will be paying a surtax 5.4% so the rest of America can have this health care reform. Is this fair? Where are people's own responsibilities for the reform? Everybody wants reform but no one wants to pay for it.

MD's already get killed with the medical malpractice fees the insurance companies charge. I don't see any reform that will control medical lawsuits? Tort reform is not enough.

These MD"s have gone through years and years of schooling, with college, medical school, internship, residency and then their specialty, if they choose to specialize, like my spouse. Hundreds of thousands spent on education, so they can provide the best healthcare Americans would want, and now they are getting screwed by this socialist bill.That is why I am calling Obama's reform a redistribution of wealth. A small amount of businesses and individuals, the so called "rich Americans" will be footing the bill for the rest of America's healthcare.

This bill should focus more on insurance industries and pharmaceuticals rather than biting the hand that feeds them-the Doctors. Most people are happy with their Doctors. Doctors are not the problem. This reform is a mess and only creates class warfare. This bill is astronomically expensive.
Those people and small businesses that have made it with their blood and sweat will now be paying for the rest of America health care, literally carrying them on their backs. This is not Capitalism, this is socialism at it's finest.

The economic stimulus package is hardly making a dent. Yet we passed the bill quickly because Obama thought the sky would fall if we didn't do it right away. It is not working. And, now the sky is falling again on healthcare. This plan doesn't even consult with the very people who will be providing the real healthcare-the Doctors. This is just a bunch of congressman guessing as to how they think a system should be run.

This bill will revolutionize health care and change the way you receive healthcare. Any bill that will cost 1.5 trillion dollars over ten years will definitely cost more than that. Since when has the government underspend?

Government run health care is the last thing people would want if they want quality. There are other options for reform, but without transparencies and real debates, this will be a partisan bill. And our children, and grandchildren will carry the load of our debt for generations to come. This is not what I want for them. I think we can do better.

[Spursmania]

http://www.foxnews.com/politics/img/healthchart_GOP.jpg
This is the proposed health care chart. It is difficult to get directly to your Doctor without going through many bureaucratic loopholes. I'm trying to find a bigger chart.

[Spursmania]

Fear the chart. A day after House Democrats rolled out their plan for universal health care coverage, the GOP struck back hard on Wednesday with one of the toughest weapons in a politician's arsenal: a flowchart.

Via TPM's Brian Beutler (http://tpmdc.talkingpointsmemo.com/2009/07/after-brightly-colored-chart-failed-to-win-waxman-markey-fight-gop-brings-it-to-the-battle-over-heal.php?ref=fpa) comes this flowchart from the GOP. The message of this great big collection of lines, shapes, colors and boldface fonts? Health care reform legislation involves just too much government.

http://www.blogcdn.com/www.politicsdaily.com/media/2009/07/gophealthchart.png











"If anybody thinks that all of this bureaucracy will fix our health-care system, I politely disagree," House Minority Leader John Boehner said of the chart to MSNBC (http://firstread.msnbc.msn.com/archive/2009/07/15/1997180.aspx). Trouble is, though, that very few of the agencies on the charts are ones that most Americans will ever have to interact with.

The president is on the chart. Every time I want a flu shot, I'm going to have to call Barack Obama first. And he's probably just going to want to keep me on the phone all day suggesting more exercise and asking if I'm getting a full eight hours of sleep.

The plan from House Democrats would cover 97 percent of Americans, cost $1 trillion over 10 years, according to the Congressional Budget Office; and offer individuals the option to participate in government-funded insurance. Rep. Kevin Brady (R-Texas), whose office generated the chart, may be remembering back to 1994 -- the last time health care reform legislation looked ready to roll through Congress -- when another scary-looking flowchart from then-Republican Sen. Arlen Specter did raise concerns (http://blogs.usatoday.com/onpolitics/2009/07/flowchart-politics.html) that health care legislation was too complicated.

Acting under the maxim that the only way to fight charts is with charts, though, House Democrats have been passing around their own (also via TPM):

http://www.blogcdn.com/www.politicsdaily.com/media/2009/07/democrathealthchart.png












An even better counterpoint in this game of chart vs. chart, though, may be this one from the The New Republic (http://blogs.tnr.com/tnr/blogs/the_treatment/archive/2009/07/15/rube-goldberg-already-lives-here.aspx) explaining how our health care system currently works:

http://www.blogcdn.com/www.politicsdaily.com/media/2009/07/tnrhealthcaremap.jpg

[Aggie Hoopsfan]

Stupid chart by the Dems.

The Republicans did offer a plan, but the Dems told them they didn't care because the Waxman plan is the one they are going with.

They also pretend that doing their kneecap job on the American health care industry is better than no reform at all, which is comical at best, criminal in reality.


The economic stimulus package is hardly making a dent. Yet we passed the bill quickly because Obama thought the sky would fall if we didn't do it right away. It is not working. And, now the sky is falling again on healthcare.

Obama didn't think that, that's just how he justified his political payback bill.

[Spursmania]

Stupid chart by the Dems.

The Republicans did offer a plan, but the Dems told them they didn't care because the Waxman plan is the one they are going with.

They also pretend that doing their kneecap job on the American health care industry is better than no reform at all, which is comical at best, criminal in reality.



Obama didn't think that, that's just how he justified his political payback bill.

:tu

And, what's up with Czar's he's created? Just more government and control I guess.

[Wild Cobra]

I didn't see Cap and Trade on the chart.

Aren't we going to cap how much care someone gets, and trade our unused benefits with others?

What about roll-over care?

[Winehole23]

aFlF04SRbas

[Wild Cobra]

WH, I usually "preview" my posts before posting them. You apparently didn't. You only have 8 of 11 Youtube characters, and you post doesn't work.

[ElNono]

So, the excuse here is that we should stand pat because 'its too complicated'? :rolleyes

I mean, really. There's 20 different things you can attack this thing on that are much more valid. Like where the funding will come from, wether it will be effective at all without other reforms like tort, inclusion of other parties in the conversation (as Spursmania brought up), etc.

I mean, the current system has a complexity of it's own, as explained by 101A earlier in this thread.

[Wild Cobra]

So, the excuse here is that we should stand pat because 'its too complicated'? :rolleyes

I mean, really. There's 20 different things you can attack this thing on that are much more valid. Like where the funding will come from, wether it will be effective at all without other reforms like tort, inclusion of other parties in the conversation (as Spursmania brought up), etc.

I mean, the current system has a complexity of it's own, as explained by 101A earlier in this thread.
One thing for certain. I will never agree with socializing our medicine without trying so many other things first, starting with serious tort reform.

[ElNono]

One thing for certain. I will never agree with socializing our medicine without trying so many other things first, starting with serious tort reform.

I think part of the problem is that the two parties basically don't want to sit down and talk about it. I mean, what I see here is the Dems trying to push their shit, but I suspect they won't pass it without some kind of GOP support (much like the TARP program), while the GOP is not even looking at the negotiation table.

Then you take the usual suspects (Peloni, Barney, etc) and they're going to try to pass it anyways.

And the end of the day we might end up with something that most likely sucks or basically the status quo, which, IMHO, sucks too.

[spurster]

We already have 50% socialization of our medicine.

We already have tort reform in Texas, which has done little to control costs.

The charts are funny. We could just put WC in charge of all decisions. That would simplify the charts and save us money.

The scary stories from other countries are funny in their own way, too. You would think our country could produce plenty of scary stories given our partially socialized system.

My view is that nobody is convincing on controlling costs. Some groups are going to make a lot less money if universal health care is going to cost less. I am wondering who that is going to be and how that is going to happen.

I think we need medicine based on evidence, outcomes, and reviews. There is too much use of expensive drugs and treatments, which are new and unproven. There is too much medicine for dying patients. Expensive medicine with bad outcomes should be reviewed and the doctors, hospitals, etc., should be fined to take the profit away from it. I think tort reform in the form of some kind of no-fault insurance would save money if bad doctors were banned and injured patients were taken care of.

[SonOfAGun]

It's doable competing against a force with unlimited funds on the printing press and not even focused on any form of profit whatsoever.

Crumble away America. You had a good run.

[Spursmania]

These are all debates we need to be discussing. I think most reasonable people want access to quality healthcare, quality Doctors, fair prescription and insurance policy prices. But this massive reform does not solve our problems. It will only create a bureaucratic mess and cost an astronomical amount of money. We are in a recession for God's sake.

There is no need to ram this partisan bill down the American people's throat without honest discussion about the main problems we have with the insurance industry, drug companies, and medical malpractice issues.

[Spursmania]

The Congressional Budget Office. Otherwise known as CBO. What is it?

As bills move forward in the legislative process, CBO will prepare estimates of their costs and other effects.

Appointment of the Director
The Speaker of the House of Representatives and the President pro tempore of the Senate jointly appoint the CBO Director, after considering recommendations from the two budget committees.

Director
Douglas W. Elmendorf is CBO's Director. He has been appointed to serve from January 22, 2009, to January 3, 2011, completing the most recent four-year term of office.


The CBO (Congressional Budget Office), with the head hired by Nancy Pelosi, just proved another major surprise that American people didn't know about the health care reform bill.

The CBO report released today tells us that the plan will actually increase medical costs while reducing service, proving Obama is not being honest about one of his major goals being to reduce costs.

The CBO released today tells us that to pay for all the new Obama programs to date, not including health care, EVERYONES TAXES WOULD NEED TO BE INCREASE BY 44% WITHIN THE NEXT 10 YEARS!!


This is coming from Nancy Pelosi's pick to head the Congressional Budget Office. This is not the republicans trying to scare people, although admittedly it is very frightening.

[ElNono]

The Congressional Budget Office. Otherwise known as CBO. What is it?

As bills move forward in the legislative process, CBO will prepare estimates of their costs and other effects.

Appointment of the Director
The Speaker of the House of Representatives and the President pro tempore of the Senate jointly appoint the CBO Director, after considering recommendations from the two budget committees.

Director
Douglas W. Elmendorf is CBO's Director. He has been appointed to serve from January 22, 2009, to January 3, 2011, completing the most recent four-year term of office.


The CBO (Congressional Budget Office), with the head hired by Nancy Pelosi, just proved another major surprise that American people didn't know about the health care reform bill.

The CBO report released today tells us that the plan will actually increase medical costs while reducing service, proving Obama is not being honest about one of his major goals being to reduce costs.

The CBO released today tells us that to pay for all the new Obama programs to date, not including health care, EVERYONES TAXES WOULD NEED TO BE INCREASE BY 44% WITHIN THE NEXT 10 YEARS!!


This is coming from Nancy Pelosi's pick to head the Congressional Budget Office. This is not the republicans trying to scare people, although admittedly it is very frightening.

http://www.fileitunder.com/uploaded_images/panic-767792.gif

Not frightened at all over here.

[boutons_deux]

Many doctors already refuse to take Medicare and Medicaid patients because those programs pay less than the commercial health insurers. This is "cost reduction" that is being resisted by the "cost producers".

I'm 1000s more docs, clinics, tec will refuse to take patients covered by a public options.

the exorbitant health costs to be reduced are "care" providers incomes. Don't worry, relax, they for-profit health industry will buy enough Congress whores, esp business-friendly/anti-citizen Repugs, to block a true public option.

[Marcus Bryant]

The Congressional Budget Office. Otherwise known as CBO. What is it?

As bills move forward in the legislative process, CBO will prepare estimates of their costs and other effects.

Appointment of the Director
The Speaker of the House of Representatives and the President pro tempore of the Senate jointly appoint the CBO Director, after considering recommendations from the two budget committees.

Director
Douglas W. Elmendorf is CBO's Director. He has been appointed to serve from January 22, 2009, to January 3, 2011, completing the most recent four-year term of office.


The CBO (Congressional Budget Office), with the head hired by Nancy Pelosi, just proved another major surprise that American people didn't know about the health care reform bill.

The CBO report released today tells us that the plan will actually increase medical costs while reducing service, proving Obama is not being honest about one of his major goals being to reduce costs.

The CBO released today tells us that to pay for all the new Obama programs to date, not including health care, EVERYONES TAXES WOULD NEED TO BE INCREASE BY 44% WITHIN THE NEXT 10 YEARS!!


This is coming from Nancy Pelosi's pick to head the Congressional Budget Office. This is not the republicans trying to scare people, although admittedly it is very frightening.

It's cool. The country will blindly accept it if the Asians don't lend it to us. The people are trained well.

[coyotes_geek]

Not frightened at all over here.

Nope. No reason to worry at all. It's not like we're in a global economic crisis caused by massive debt obligations or anything.

[ElNono]

Nope. No reason to worry at all. It's not like we're in a global economic crisis caused by massive debt obligations or anything.

I know, poor JPMorgan just posted $2.3 billion in profits.
But I feel for you, it's going to be tough to live without that 42" HDTV.
:jack

[coyotes_geek]

I know, poor JPMorgan just posted $2.3 billion in profits.
But I feel for you, it's going to be tough to live without that 42" HDTV.
:jack

42"? Please.

[Spursmania]

BO says costs will rise as healthcare expanded

Thu Jul 16, 2009 4:30pm EDT

WASHINGTON (Reuters) - Congressional Budget Office director Douglas Elmendorf told lawmakers on Thursday legislation to expand health care coverage would increase federal healthcare costs "to a significant degree" and revenue will need to be found to keep from increasing the deficit.
Asked by the tax-writing House Ways and Means Committee about his remarks to a Senate committee earlier Thursday that the legislation would not hold down healthcare costs, he said, "The point I made earlier this morning is that it raises future federal outlays more than it reduces future federal outlays."
Elmendorf told the panel, "The coverage proposals in this legislation would expand federal spending on health care to a significant degree and in our analysis so far we don't see other provisions in this legislation reducing federal health spending by a corresponding degree."
He said ways to pay for the healthcare programs could include further savings from the Medicare health program or changes to the current exclusion from taxes of employer-paid insurance premiums.
The nonpartisan budget analysis arm of Congress has not yet estimated the cost of the full House healthcare legislation working its way through three House committees.
The House bill pays for the roughly $1 trillion 10-year cost of the healthcare overhaul with a combination of estimated savings in health costs and taxes worth $587 billion over the period. It sets up a government-run health plan to cover many of the uninsured and expands coverage in other government health programs.
The Senate Finance Committee is considering other options, including a tax on health insurers and a tax on employer-paid premiums. Chairman Max Baucus, a Democrat, said their task was not helped by President Barack Obama (http://www.reuters.com/news/globalcoverage/barackobama)'s opposition to counting the value of employer-paid premiums as income.
Republicans seized on the CBO director's comments as evidence the legislation should be rejected or at least more time should be taken to examine it. Obama has urged Congress to pass it out of each chamber by August.
"Today's CBO testimony should be a wake-up call," Senate Republican Leader Mitch McConnell said. "Instead of rushing through one expensive proposal after another, we should take the time we need to get things right -- especially at a time when hundreds of thousands of Americans are losing jobs every month."
Backers of the House bill disputed this assertion. "It is true that we don't know how much reform will bend the cost curve (slow the increase in healthcare spending); but we know it is better than doing nothing," Jonathan Gruber, a Massachusetts Institute of Technology economist who backs the House bill said on a call organized by backers of the bill.
House Speaker Nancy Pelosi told reporters that she hoped the formula for paying for healthcare reform could change. Instead of half of the more than $1 trillion in costs being covered by savings program spending and the other half from new revenues, Pelosi said, "I hope that we can change that percentage" and "squeeze more savings."
(Editing by Bill Trott)

[Spursmania]

Health reform bills won't reduce costs

Congressional Budget Office director tells Senate panel that 2 health reform bills would increase government spending and not do enough to contain costs.

NEW YORK (CNNMoney.com) -- The health reform bills released so far would increase government spending on health care without sufficiently reining in health care costs.

And at least initially they aren't likely to significantly lower premiums for the majority of Americans with employer-sponsored health insurance.
That's the sobering takeaway from testimony Thursday by Congressional Budget Office Director Douglas Elmendorf.
Elmendorf's preliminary conclusions were based on a bill jointly released by three committees in the House this week and another bill passed by the Senate health committee on Wednesday.

"The creation of a new subsidy for health insurance ... would by itself raise federal spending on health care. ... [T]o offset that there have to be substantial reductions (on the tax or spending sides of the ledger]," Elmendorf told the Senate Budget Committee. "The changes we've looked at so far don't represent the fundamental change on the order of magnitude that would be necessary."

CBO analyzes the costs of legislation. Congress is not obligated to follow their lead on estimates, but the agency can play a key role in shaping bills.
Both the House bill and the Senate health committee bill would use federal money to subsidize financially strapped Americans so they can buy health insurance. They would also create a national insurance exchange from which eligible Americans could choose among insurance plans. And they would establish a public health plan to compete with private insurers on the exchange.
Elmendorf did not offer any assessment of a bill in the works at the Senate Finance Committee, which has yet to release draft legislation.
Health policy analysts support two ways to "bend the curve" on health care costs above others, Elmendorf said.


Change how employer-paid premiums for workers are treated -- currently they're tax-free to the worker.
Change how Medicare pays providers to reward cost efficiency and quality of outcome rather than the a la carte approach of fees for service.

The prospect of taxing a portion of employer-provided health benefits has become a political lightening rod on Capitol Hill as many lawmakers and unions expressed staunch opposition, and President Obama did not offer his outright support.
Consequently, while taxing a portion of health benefits was a leading "pay-for" idea -- at least in the Senate Finance Committee -- the political pushback has muted its prospects for being a serious contender at this writing.
"Basically, the president is not helping us," Senate Finance Committee Chairman Max Baucus, D-Mont., told reporters Thursday. "He does not want the exclusion and that's making it difficult."
In response, White House spokesman Bill Burton told reporters that Obama has consulted lawmakers of both parties about how to "save money and find revenue to pay for our health care reform. If that's disagreeing with Baucus, somebody else will have to make that determination."
The tricommittee House bill proposes to pay for half the cost of reform by taxing the richest households -- imposing a surtax as high as 5.4% for income over $1 million, and imposing lower rates on households making at least $350,000.
Asked if cost containment becomes more difficult by relying primarily on Medicare cost savings without taxing employer-provided health benefits, Elmendorf said, "Tying one of the two hands behind one's back makes the job that much harder."
The long-term concern
The CBO has said numerous times and in numerous ways that the federal budget is on an unsustainable course. The economic crisis has made the debt situation more urgent, but it is not the primary cause.
"Over the next 50 years, with rising health care costs, the retirement of the baby boom generation, and the permanent extension of the 2001 and 2003 tax cuts, federal debt will climb to more than 400% of the gross domestic product," Senate Budget Committee Chairman Kent Conrad, D-N.D., noted during Thursday's hearing.
But there will be risk to the economy within the next 10 years. The country's debt is on track to exceed 60% of GDP next year and will top 80% by 2019. And that assumes interest rates stay low.
Should buyers of U.S. debt grow concerned, however, that the country is not addressing its debt situation adequately they will start demanding higher rates, which would make the country's debt situation even worse. That's why fiscal policy experts have been calling on lawmakers to rein in health care costs, find ways to boost tax revenue and cut spending as soon as the economy is in recovery.
Premiums unlikely to go down soon
When asked whether the health bills released so far would help reduce premiums for Americans with health insurance, Elmendorf said the people most likely to see a decrease in what they pay are those who currently buy policies on their own because their employer doesn't provide a policy.
That group could see their costs go down for three reasons: the creation of an insurance exchange; the additional competition from a public plan option in the exchange; and guarantees that insurers could not refuse coverage to anyone with a pre-existing condition, Elmendorf noted.
But for the vast majority of Americans -- those who get their insurance through their employers -- the cost-reducing potential of the exchange and public plan, at least initially, would have "fairly small effects relative to the level and trajectory that health care premiums are taking," he said. "We don't think those workers will see noticeable changes in their premiums."
That's in part because the two bills as they're written currently would limit eligibility for who may use the exchange.
- CNN's Ted Barrett contributed to this report

[Aggie Hoopsfan]

http://www.fileitunder.com/uploaded_images/panic-767792.gif

Not frightened at all over here.

So, the idea of costs growing exponential while the standard of care decreases exponentially is appealing to you?

[Shelly]

Sure as hell I do. My doctor prescribed Prevacid for me 4 months ago. The insurance company filled it for the first month and now refuses to keep on filling up the very same prescription. My doctor has been fighting with them for 3 months now, and I still don't have my medicine. My wife needs to take MetanX for her arthritis, which is prescription strength folic acid. Insurance won't pay for it because it's classified as 'vitamins'. But you can't buy it without a prescription. Out of pocket, here we go.

I'm really glad that you have a nice insurance plan. Not all of us are that lucky. For us, it's either this plan or being uninsured.

El Nono--my son has GERD and has tried every PPI/antacid in the book. Initially, my insurance company denied Prevacid, but his GI doc got it approved. However, it didn't work and he was switched to Nexium which was the only PPI that worked for him. My insurance company would not pay for it no matter how many times his doc called them. I finally had to call and got a very nice customer service rep. I explained that we have tried everything and Nexium was the only thing that worked for him and she got it approved. Of course, with insurance it's still $50. So you should try calling them yourself and tell them you've tried others and nothing worked. Anyway, good luck with it. I know how frustrating it is.

Now his GI doc doesn't take my insurance because of what they paid, but there are so few pediatric GI docs in SA and 3 or 4 of them are in his group. Luckily, he only goes every 6 months so I can eat the cost.

Since my husband is a doctor, I'm very interested to see what happens with health care. The bulk of his payments are from Medicare, but I can assure you if Medicaid becomes the norm, patients are not gonna be seen. Medicaid pays crap. I know my GYN doesn't take it.

[ElNono]

So, the idea of costs growing exponential while the standard of care decreases exponentially is appealing to you?

Where did I say that, Aggie? Are you making stuff up again?
I'll comment on the bill when it's finalized and it's presented to vote both on the House and the Senate (if that ever happens). In the meantime, all this doom and gloom is frankly pretty retarded.

[ElNono]

El Nono--my son has GERD and has tried every PPI/antacid in the book. Initially, my insurance company denied Prevacid, but his GI doc got it approved. However, it didn't work and he was switched to Nexium which was the only PPI that worked for him. My insurance company would not pay for it no matter how many times his doc called them. I finally had to call and got a very nice customer service rep. I explained that we have tried everything and Nexium was the only thing that worked for him and she got it approved. Of course, with insurance it's still $50. So you should try calling them yourself and tell them you've tried others and nothing worked. Anyway, good luck with it. I know how frustrating it is.

I feel you. I started off with Aciphex and it stopped working. Nexium didn't cut it either. Then we kept on trying: Prilosec OTC, etc etc etc. Prevacid is what works for me ATM.
I definitely will keep on calling, and so will my doc. I mean, I know they're just stalling and eventually I'll get my prescription filled. It just doesn't need to be like this, that's all.


Now his GI doc doesn't take my insurance because of what they paid, but there are so few pediatric GI docs in SA and 3 or 4 of them are in his group. Luckily, he only goes every 6 months so I can eat the cost.

Since my husband is a doctor, I'm very interested to see what happens with health care. The bulk of his payments are from Medicare, but I can assure you if Medicaid becomes the norm, patients are not gonna be seen. Medicaid pays crap. I know my GYN doesn't take it.

Portability is also an issue. My wife has a very rare immunodeficiency disease (Uveitis), and there's only a handful specialists in the country. Fortunately, we've been keeping it under control. We used to be insured under Universal Healthcare and they covered the eye specialist in Philly. When my wife switched jobs, the new insurance (Qualcare) only does NJ, so we lost access to this guy. The 'specialist' in NJ is a hack. He really truly sucks and on top of that is an asshole. So we're back to Philly and paying out of network coverage which is a good chunk of dough. This whole thing reeks. Pisses me off also because they sure take a good chunk of change off my wife's salary. But what you gonna do? I'm still grateful she's been doing ok and that so far we won't go bankrupt doing this. But I'm definitely not happy about it.

[Shelly]

I had to call about 3-4 times. The doc gave me a number to call. Called that number and they said you need to call this other number. I called that number and they said tell your doc to say blah blah blah and call it back in. Doctor's office says they did say that, etc. Call back the original number given and again am told I need to call the other number. Anyway, I told them that my son was just starting high school and that he was up all night in pain and he needed his sleep and the customer service rep was very sympathetic. Got a letter in the mail a few saying Nexium was approved through 2099 :lol.

I had to look up Uveitis. Yikes! How do they treat that? Unfortunately, some Docs that GOD is after their name.

I agree that healthcare needs to reformed. I just don't know what the answer is on both sides of the coin.

[ElNono]

I had to look up Uveitis. Yikes! How do they treat that? Unfortunately, some Docs that GOD is after their name.

There's no cure. You have to take Methotrexate the rest of your life to keep it in remission. The problem is that Methotrexate is an abortifacient, and we're looking to have kids. So right now she stopped with it and she's having steroid injections in the back of her eye every 4-5 months. It worked so far while we try, but eventually she's gonna have to go back to the drug.
But fortunately she's been doing fine for the past couple of years. We just need to check up on it.


I agree that healthcare needs to reformed. I just don't know what the answer is on both sides of the coin.

I'm actually a pessimist when it comes to believing that a reform will happen. Way too many interests at stake in the middle. I'm also tired of all the political talking, stalling and posturing, only to be left again with the status quo.

Thanks for sharing your story about your kid.

[Winehole23]

The whole intro is funny enough, but the Daily Show *socialized medicine* segment starts at 6:16 (http://www.hulu.com/watch/83171/the-daily-show-with-jon-stewart-wed-jul-15-2009), and the Sibelius interview is, well, a good intro to Kathleen Sibelius, the HHS chief.

[RandomGuy]

I think part of the problem is that the two parties basically don't want to sit down and talk about it. I mean, what I see here is the Dems trying to push their shit, but I suspect they won't pass it without some kind of GOP support (much like the TARP program), while the GOP is not even looking at the negotiation table.

Then you take the usual suspects (Peloni, Barney, etc) and they're going to try to pass it anyways.

And the end of the day we might end up with something that most likely sucks or basically the status quo, which, IMHO, sucks too.

I have a sinking feeling that this will be what happens, i.e. the status quo.

[spurster]

Too long to post all of it, but an interesting read.

http://www.nytimes.com/2009/07/19/magazine/19healthcare-t.html

Why We Must Ration Health Care

By PETER SINGER
Published: July 15, 2009

You have advanced kidney cancer. It will kill you, probably in the next year or two. A drug called Sutent slows the spread of the cancer and may give you an extra six months, but at a cost of $54,000. Is a few more months worth that much?

...

Health care is a scarce resource, and all scarce resources are rationed in one way or another. In the United States, most health care is privately financed, and so most rationing is by price: you get what you, or your employer, can afford to insure you for. But our current system of employer-financed health insurance exists only because the federal government encouraged it by making the premiums tax deductible. That is, in effect, a more than $200 billion government subsidy for health care. In the public sector, primarily Medicare, Medicaid and hospital emergency rooms, health care is rationed by long waits, high patient copayment requirements, low payments to doctors that discourage some from serving public patients and limits on payments to hospitals.

The case for explicit health care rationing in the United States starts with the difficulty of thinking of any other way in which we can continue to provide adequate health care to people on Medicaid and Medicare, let alone extend coverage to those who do not now have it. Health-insurance premiums have more than doubled in a decade, rising four times faster than wages. In May, Medicare’s trustees warned that the program’s biggest fund is heading for insolvency in just eight years. Health care now absorbs about one dollar in every six the nation spends, a figure that far exceeds the share spent by any other nation. According to the Congressional Budget Office, it is on track to double by 2035.

...

[coyotes_geek]

You have advanced kidney cancer. It will kill you, probably in the next year or two. A drug called Sutent slows the spread of the cancer and may give you an extra six months, but at a cost of $54,000. Is a few more months worth that much?

I don't know if it is or not, but I do know that's not a decision I want the government making for me.

[101A]

I know, poor JPMorgan just posted $2.3 billion in profits.
But I feel for you, it's going to be tough to live without that 42" HDTV.
:jack

JPMorgan = Walstreet investments, etc...

Wtf healthcare?

[Spursmania]

I don't know if it is or not, but I do know that's not a decision I want the government making for me.

Exactly. It really shouldn't be the government's decision at all.

[Marcus Bryant]

Hasten the demise of the sick and let the true Americans live, LIVE my friends!

[spurster]

I don't know if it is or not, but I do know that's not a decision I want the government making for me.

Who's decision do you want it to be?

[ElNono]

JPMorgan = Walstreet investments, etc...

Wtf healthcare?

Exactly.
I was responding to the 'It's not like we're in a global economic crisis' comment.

[ElNono]

Hasten the demise of the sick and let the true Americans live, LIVE my friends!

I'll drink to that. :toast

[coyotes_geek]

Exactly.
I was responding to the 'It's not like we're in a global economic crisis' comment.

That was a response to you saying that you're not worried about the CBO saying that we'll have to raise taxes by 44% to pay for all of Obama's other programs, health care not included. Personally I think being in the middle of a global economic crisis is something we ought to keep in mind when deciding whether or not to dramatically hike taxes and/or create massive new expenditures we can't pay for, but I guess that's just me.

[coyotes_geek]

Who's decision do you want it to be?

That's a decision that should be made between me, my doctor and whoever has to foot the bill, most likely my insurance provider. Who's decision do you want it to be?

[CosmicCowboy]

Anybody catch the language on the bill that cleared committee? You can keep the private insurance you have, but if you give it up you have to go with the public plan.

I am probably the last employer in the country that still pays for 100% of health care for employee and family. i put this out to bid every year and choose the provider/plan that makes the most sense. i rarely stay with one provider more than a couple of years because they get complacent and jack my rates...

This means I CAN'T get competitive bids anymore.

What a crock of shit!

[ElNono]

That was a response to you saying that you're not worried about the CBO saying that we'll have to raise taxes by 44% to pay for all of Obama's other programs, health care not included. Personally I think being in the middle of a global economic crisis is something we ought to keep in mind when deciding whether or not to dramatically hike taxes, but I guess that's just me.

The global economic crisis is for small rats like you, me and the vast majority of tax payers in this forum. The big boys keep on making the big bucks at our expense. That's not only reserved for Wall Street execs, but also big pharma. Which is the one funneling that money to the representatives you voted to make sure the status quo stays in place.
There's also something to be said for all the doom and gloom over something that's not even finalized yet. We still don't actually, really know what the final cost is going to be, because the legislation is actually not finalized. So everybody loves to panic tossing around their favorite trillion dollar figures. I'll tell you what. I'm actually a subscriber of Keynesian economics. And under Keynes, the way to get out of a recession is for the government to spend, spend, spend. So the cost actually is not what really concerns me. It's wether the reform addresses some of the things that need to be addressed. Like keeping in check big pharma and insurance co's, and things like comprehensive tort reform. But until the bill is actually final (if that ever happens at all), the entire bitching is fictional drama.
Thats is why, I'm not really frightened at all.

[ElNono]

That's a decision that should be made between me, my doctor and whoever has to foot the bill, most likely my insurance provider. Who's decision do you want it to be?

If YOU selected the government to be YOUR insurance provider then YOU are leaving the decision to the government. It's YOUR decision all the way. I don't know why it's so complicated for people to understand it's a MIXED system, and you get to decide wether you go with private (if you can afford it) or public insurance.

[ElNono]

Anybody catch the language on the bill that cleared committee? You can keep the private insurance you have, but if you give it up you have to go with the public plan.

I am probably the last employer in the country that still pays for 100% of health care for employee and family. i put this out to bid every year and choose the provider/plan that makes the most sense. i rarely stay with one provider more than a couple of years because they get complacent and jack my rates...

This means I CAN'T get competitive bids anymore.

What a crock of shit!

I don't understand why you can't get competitive bids anymore, please explain.

[DarkReign]

I don't understand why you can't get competitive bids anymore, please explain.


You can keep the private insurance you have, but if you give it up you have to go with the public plan.

Whether true or not (or it was misinterpreted), thats his reasoning.

[Marcus Bryant]

The obvious solution here is to let the sick die and rid the population of the useless, antiseptically referred to as "rationing." Abortion access should be extended through subsidization to trim the lower, generally non-white, classes.

[DarkReign]

The obvious solution here is to let the sick die and rid the population of the useless. Abortion access should be extended through subsidization to trim the lower, generally non-white, classes.

I think a lot of programs with intentions of propping up the unproppable are good for business.

Yes, I sense the sarcasm in your post.

[DarkReign]

nvm

[Marcus Bryant]

Private insurers might at least keep your arse alive for a while, but the federal government will cut to the chase and stuff you in its bureaucratic bowels before it shits you out.

[CosmicCowboy]

I don't understand why you can't get competitive bids anymore, please explain.

The language literally says you stay with THE SAME PRIVATE HEALTH PLAN or go into the public plan...meaning that if I'm with Humana I can't take bids from Blue Cross, Aetna, etc. If I leave Humana my only choice is to go into the public plan.

[Marcus Bryant]

It's amazing how "progress", "liberty", and "democracy" have been defined as that which is most efficient to control the masses. Will we have to say the pledge every morning in our hospital beds while we wait for some flunky physician with a MD from the Zaire School of Tribal Medicine to receive the ok from a Civil Service technician (grade GS-1) to medicate us with the latest veterinary grade medication produced by some large corporate pharmaceutical manufacturer? Jesus Christ, the country is fucking stupid.

[ElNono]

The language literally says you stay with THE SAME PRIVATE HEALTH PLAN or go into the public plan...meaning that if I'm with Humana I can't take bids from Blue Cross, Aetna, etc. If I leave Humana my only choice is to go into the public plan.

My understanding of what you posted is that if you do not want to offer private insurance you have to at least provide public one. If that's not it, then I agree it's retarded. The former is how it works on most every other country.

[Spursmania]

Anybody catch the language on the bill that cleared committee? You can keep the private insurance you have, but if you give it up you have to go with the public plan.

I am probably the last employer in the country that still pays for 100% of health care for employee and family. i put this out to bid every year and choose the provider/plan that makes the most sense. i rarely stay with one provider more than a couple of years because they get complacent and jack my rates...

This means I CAN'T get competitive bids anymore.

What a crock of shit!


Did you know that you have to be on a private plan by the 1st day the law goes into effect otherwise you will be defaulted to the government option? Look it up my friend. It's true. Anybody who thinks they are still allowing us to have a private option are not reading the details.

Goodbye free choice.

[Spursmania]

It's amazing how "progress", "liberty", and "democracy" have been defined as that which is most efficient to control the masses. Will we have to say the pledge every morning in our hospital beds while we wait for some flunky physician with a MD from the Zaire School of Tribal Medicine to receive the ok from a Civil Service technician (grade GS-1) to medicate us with the latest veterinary grade medication produced by some large corporate pharmaceutical manufacturer? Jesus Christ, the country is fucking stupid.

This country is now full of people who don't think for themselves and believe Government is better being in every facet of people's life. No time to read and contemplate the details-that's the government's job now isn't it?

Lol...

[Spursmania]

The language literally says you stay with THE SAME PRIVATE HEALTH PLAN or go into the public plan...meaning that if I'm with Humana I can't take bids from Blue Cross, Aetna, etc. If I leave Humana my only choice is to go into the public plan.


Exactly Cowboy! Most people don't even know that. Can you believe we will all be in a government plan like it or not in a few years. We cannot switch from one private company to another. If we leave our plan, we will be defaulted to the government plan. No more choice. If this isn't socialism than I don't know what is. People are so desperate to have the government provide for them that they don't realize the slippery slope we are now going down.

[Spursmania]

You guys are arguing on both extremes of the health care insurance dilemma. The problem is inefficiency and the middleman. A crapload of insurance premiums go to the worthless middlemen handling the paperwork and making sure profit is obtained. People with insurance are getting ripped off and often don't realize it to the extent that many can't afford it. That is the problem.

Stop acting like fools.

So you think the government taking over health care will make it more efficient and have less middlemen? You think you will get more quality care if you are on a government plan? Have you ever known the government to be efficient and not have middlemen? Come on...

Did you know the Medicaid government run program will run out of money in 7 years? And you think government controlled health care is the answer to these problems? You really need to read and do research about this. It really seems like you're just thinking it's going to keep premiums down, but you're missing a lot of the problems inherent in this reform bill. I urge you to read and research, please. This program is unsustainable and will not cut medical costs. Please see the CBO statement.

[Spursmania]

All so about 16 million people can get insurance (and have their votes bought by the Dems)...


It's shameless how Obama talks about the 46 million people that don't have insurance without being truthful about why they don't have insurance.
The fact is that about 17 million or so are between the ages of 18-34 choose not to buy insurance because they believe they are healthy enough. The other 10 million are on Medicare and choose not to use it.

So, you are right, all this unsustainable debt just to cover 16 million people.

I don't even feel like I'm in America anymore. I feel like I'm in Europe except EVERYBODY there had to pay into the system unlike this proposal. This proposal is essentially instigating class warfare. The so called rich will pay for everybody's health care. The sad thing is they don't realize this debt is unsustainable, and we will all pay dearly. The small businesses will begin to cut jobs left and right.

And, yes it will pass. Obama will "Rahm" that bill down our throats in a partisan manner by August first, like it or not.

[Spursmania]

If you have a good way to enable coverage for those 16 million, I suggest you post it. The reason why things like this have the will to pass is because it's been ignored for a quite a long time. Bitching about how Obama is going to destroy the country, make Islam the state religion, etc. isn't really helping.


And neither is it helping to blindly agree with proposals that don't make sense and the country cannot afford. Obama care is easy out for people who think Government is the answer to all our problems.

By the way, you're the one as you call it"bitching and talking about Islam state religion". I never mentioned religion nor do I discuss religion which I believe is none of my business or yours. LOL.

Do you know what the CBO says or what proposals are in the health care bill. Because if you've read it , you would understand that this bill is unsustainable and will not decrease medical costs. And the decrease in medical costs was the goal for this reform.

So this reform just does not make sense as is. Both sides need to come up with a better solution. But as long as it's free, people are all for it and don't want to think about the consequences.

[Spursmania]

http://barackobamaexperiment.com/

[ElNono]

Second, even with House committees working in marathon sessions this week, it was clear that Democrats could not meet their goal of passing bills before the summer recess without barreling over the concerns of Republicans and ending any hope that such a major issue could be addressed in a bipartisan manner.

Third, a growing minority of Democrats have begun to express reservations about the size, scope and cost of the legislation, the expanded role of the federal government and the need for a raft of new taxes to pay for it all. The comments suggest that party leaders may not yet have the votes to pass the legislation.

Excerpted from:
Democrats Grow Wary as Health Bill Advances (http://www.nytimes.com/2009/07/18/health/policy/18health.html?_r=1&hp)

[Wild Cobra]

Unlike, the rest of you partisan hacks I actually have a workable solution that saves money and gets things done.

http://www.nonprofithealthcare.org/

But then again, I only have a PhD in economics AND engineering which essentially means I'm not worthy of input. Go ahead and continue to listen to your Partisan hack journalists.
Is it a free market approach? How about a summary of how it works. I'm not feeling like reading much today. Got off work a few hours ago, and an ready to sleep.

[Spursmania]

Oh Geeze. Since when did I say "I" agree with any of it? Secondly, I was just using Islam as an example of continuous bitching, which is about 99% of the content in the thread. Lastly, Thanks for the suggestions. Just further proof this country is full of whiners without solutions

Unlike, the rest of you partisan hacks I actually have a workable solution that saves money and gets things done.

http://www.nonprofithealthcare.org/

But then again, I only have a PhD in economics AND engineering which essentially means I'm not worthy of input. Go ahead and continue to listen to your Partisan hack journalists.


So then, you don't agree with the proposal?

Also, since you have an economic PH.D, doesn't the CBO study bother you and cause you to worry about the funding of this massive bill? This study is done by a director (Elmendorff) who was chosen by Pelosi/Senate leader and the President. This CBO indicates the costs are unsustainable. This was a huge blow to the posturing the Dems have had about how this massive bill would not add to our deficit, when in fact, the CBO proved them wrong. The CBO also concluded that this bill would not reduce medical costs.

I know the State of Massachussets is having huge problems with the universal health care plan they passed. The hospitals and Doctors are not being compensated in numerous cases, and not at all at all in many cases by the government. The discounted fees the Govt. pays are not covering the physician, hospital and medical fees. As a result, the hospitals are now suing the State of Mass.

Further, this Mass. universal system cannot sustain all their people, so they are cutting about 56,000 legal US residents out of the system. If this is an example of Universal healthcare, I am sure many people would not want their Congressman to pass this bill.
Remember the Massachussets bill was introduced by Kennnedy and by no coincidence, he is one of the originators of the inception of this massive government run health care bill.

Lastly, we voted for Obama, so I am not just partisan bickering. I thought he was a moderate and not a spend and tax president. (Yes, the laughs on me, I know)
There are a lot of problems with this government health reform bill. I hope people don't agree with this bill because they think there is no other alternative proposal. We are in a recession, Obama says, not seen since the "great depression." So why does he continue to add 400% to our deficit with this government health bill? He should stop the spending until we get this economy under control.

Partisanship aside, we are all in this together, but we must know the details of this bill. What we are getting into, and how this is going to be paid for not only in ten years but beyond. It's a travesty to vote on a bill that the American people don't know much about.

We all know problems come from insurance companies and drug companies. Accessabilty is not the problem, it's costs. I would like to hear other ideas, what section of the link should I read?

[boutons_deux]

"Accessabilty is not the problem"

yes, it is. There is a huge shortage of primary care doctors now, and will be catastrophically short if 50M uninsured become covered.

But the fleeing of docs from primary care to specialties is very often "costs"-driven. ie, they can raise their costs to patients, ie the docs' revenues, by going to the specialties.

Very often, docs can't make enough in primary care because their overheads of dealing/fighting with insurance companies are high, like $250K/year for an independent primary care doctor.

The "free market" in health care has totally fucked up the country, and the "free market" in health care will never "self correct" because fucked up system is how the health care industry makes the most dollars.

[boutons_deux]

"shouldn't be the government's decision at all"

but it just wonderful if some corporate middle-manager or phone jockey on commission is making the decision, including canceling your insurance completely. Then you can make your own "ratiooning" decision of finding a $100K, on you own, as you end you life with cancer or other incurable disease.

Of course, that $100K is available according to the Repugs' health plan: "Just Go to the Emergency Room"

[angrydude]

Yea, punish the rich, make them die like the poor do. Yea!

[Winehole23]

Yea, punish the rich, make them die like the poor do. Yea!God forbid the great should eat shit and die like the poor. :wakeup

[Spursmania]

I think we should all just hold hands and sing Kumbaya together as the government strips the wealth out of the rich and redistributes it to everybody.

Afterall, why would someone who has worked all their life for what they have expect to be have anything more than someone who never went to school for umpteen years and worked 70 hour weeks. We should all be one.

Go Obama. I just wonder why his wife sports 5,000 dollar purses now? That purse must be stripped from her and given to the poor soul huddled in the corner of Washington. :cheer






NOT!

[boutons_deux]

"someone who has worked all their life for what they have"

The $800B cut in estate taxes by the Repugs, much of which cash pumped up the lending in the real estate bubble, exemplifies that much of the huge wealth, the top 3% or 4%, is not "worked" for, but inherited.

[Spursmania]

"someone who has worked all their life for what they have"

The $800B cut in estate taxes, much of which cash pumped up the lending in the real estate bubble, by dubya exemplifies that much of the huge wealth, the top 3% or 4%, is not "worked" for, but inherited.


Kumbaya, my Lord. Kumbaya...I love you too, man.

P.S. yeah, it was Bush's tax cuts that made me rich:lmao
You're a true socialist. Thanks for proving it. "Inherited money" as if the government worked for it. Well if it makes you feel better,, Bush gave my spouse an M.D. degree and myself, (a lawyer) A J.D. LMAO...

[ElNono]

Kumbaya, my Lord. Kumbaya...I love you too, man.

P.S. yeah, it was Bush's tax cuts that made me rich:lmao
You're a true socialist. Thanks for proving it. "Inherited money" as if the government worked for it. Well if it makes you feel better,, Bush gave my spouse an M.D. degree and myself, (a lawyer) A J.D. LMAO...

So when you're potentially on the losing end of class warfare, everyone else is a socialist? Is that how it works?
I see why you're panicking now. You might actually have to bend over and take it for once.
Although I really doubt it's going to happen.

[Spursmania]

So when you're potentially on the losing end of class warfare, everyone else is a socialist? Is that how it works?
I see why you're panicking now. You might actually have to bend over and take it for once.
Although I really doubt it's going to happen.


No the idea that the income we make is "inherited" from the government is truly nonsensical. As if we didn't have to pay and earn the degrees we received. That is my point.

[ElNono]

No the idea that the income we make is "inherited" from the government is truly nonsensical. As if we didn't have to pay and earn the degrees we received. That is my point.

I believe what he meant is that the top 3% or 4% of the richest out there inherited their fortunes, never necessarily worked for them.
Now, I don't know the accuracy of that statement, I'm just translating boutons to English.

[Spursmania]

I believe what he meant is that the top 3% or 4% of the richest out there inherited their fortunes, never necessarily worked for them.
Now, I don't know the accuracy of that statement, I'm just translating boutons to English.


Well, we didn't inherit anything. We both came from meager backgrounds and worked while attending school to pay for loans, and everything else associated with the paths of Md's and JD's.

Also, the health reform taxes begin with people making 280K not just CEO Millionaires or Daddy's money millionaires. But even if they inherited the money or whatever, I still do not believe this country believes that only a small segment of the society should pay and be responsible for everyone's healthcare.

[boutons_deux]

The super wealthy don't work, they own.

In the same direction, upward mobility has been greatly restrained in the past few decades.

Born lower class and uneducated, you've got a high probability of dying lower class and uneducated, and of being sicker throughout and dying earlier. Goes for whites as well as for blacks and browns.

[Spursmania]

The super wealthy don't work, they own.



Well, I can agree on that, but there is nothing wrong with that. This health care reform tax hits people and small businesses making 280K and up-hardly considered the "super wealthy."

[boutons_deux]

The increase in tax only goes back to where it was during the boomin 90s. People seemed to get along just fine at that percentage.

When the Repugs were wasting $3T in their bogus war for oil, nobody minded, because nobody paid. All debt, and US gets nothing in return as Iraq will go to hell when the US pulls out.

Super-patriotism would wither if dubya had raised income and other taxes, 5%-10% to pay for Iraq and the decades of Iraq vet care.

People "support the troops" as long as they don't have to put their money where the mouth is.

The stimulus is actually going to build things, repair/increase infrastructure, while Repug spending on their bullshit wars evaporated unproductively in the sands.

[Wild Cobra]

Why do liberals insist on destroying the Republic? That is the only reason our form of democracy has lasted so long, because we are in theory, a republic.

The federal government has way too much power. Like anything, there will be good and bad policies. Bad policies affect all 50 states in the republic, The diversity of the republic makes for a stronger nation. Different stated doing different things, and the good an bad policies are seen. The bad policies can then be avoided by others and the good ones implemented.

No... liberals believe in an all seeing government to fix things. This is how this nation will die. Lack of diversity, and bad moves that affect the entire nation. Nationalizing health care is the biggest bad move to come along in ages.

[ElNono]

Why do liberals insist on destroying the Republic? That is the only reason our form of democracy has lasted so long, because we are in theory, a republic.

The federal government has way too much power. Like anything, there will be good and bad policies. Bad policies affect all 50 states in the republic, The diversity of the republic makes for a stronger nation. Different stated doing different things, and the good an bad policies are seen. The bad policies can then be avoided by others and the good ones implemented.

No... liberals believe in an all seeing government to fix things. This is how this nation will die. Lack of diversity, and bad moves that affect the entire nation. Nationalizing health care is the biggest bad move to come along in ages.

But you are OK with a federally mandated ban on gay marriage. Gotcha.

[Wild Cobra]

But you are OK with a federally mandated ban on gay marriage. Gotcha.
Did I ever say that? I don't think so. I only approve of government defining marriage as to it historical relevance, and not allowing the definition to be changed. I would prefer government get completely out of the marriage business.

Please point me to the offending post. I am against gay marriage, but I don't think I ever stated it close to that. I am for the government getting out of our lives, to include not recognizing any marriage. Government has no right to interfere with religion, and a marriage is a religious sanction. Government has made it a government sanction.

[Aggie Hoopsfan]

"shouldn't be the government's decision at all"

but it just wonderful if some corporate middle-manager or phone jockey on commission is making the decision, including canceling your insurance completely. Then you can make your own "ratiooning" decision of finding a $100K, on you own, as you end you life with cancer or other incurable disease.

Of course, that $100K is available according to the Repugs' health plan: "Just Go to the Emergency Room"

I'll happily take that over some bureaucrat in D.C. making that same call.

[Aggie Hoopsfan]

So when you're potentially on the losing end of class warfare, everyone else is a socialist? Is that how it works?
I see why you're panicking now. You might actually have to bend over and take it for once.
Although I really doubt it's going to happen.

So you think class warfare is fair?

Why should some lazy fuck welfare queen get handed the money and benefits of someone who went to college, has 20K in student loans to payoff, got a degree, and is working 60 hour work weeks?

Fuck you.

[Aggie Hoopsfan]

The super wealthy don't work, they own.

In the same direction, upward mobility has been greatly restrained in the past few decades.

Born lower class and uneducated, you've got a high probability of dying lower class and uneducated, and of being sicker throughout and dying earlier. Goes for whites as well as for blacks and browns.

They also employ.

[Marcus Bryant]

So you think class warfare is fair?

Why should some lazy fuck welfare queen get handed the money and benefits of someone who went to college, has 20K in student loans to payoff, got a degree, and is working 60 hour work weeks?

Fuck you.

The biggest federal "welfare" whores are the middle class, agribusiness, GE, financial services firms, and defense contractors.

[2centsworth]

The biggest federal "welfare" whores are the middle class, agribusiness, GE, financial services firms, and defense contractors. the geezers are the biggest welfare babies and also the largest Voting block

[Marcus Bryant]

the geezers are the biggest welfare babies and also the largest Voting block

I count them as middle class, but regardless, yes, they are the true federal welfare kings and queens.

[boutons_deux]

A lot of the geezers, and their lifelong savings, have been totally fucked by Repugs and their capitalists enablers/johns, but that's OK, the free market never fucks up and is always self-correcting, while guaranteeing a fair distribution of society's wealth.

[ElNono]

So you think class warfare is fair?

Why should some lazy fuck welfare queen get handed the money and benefits of someone who went to college, has 20K in student loans to payoff, got a degree, and is working 60 hour work weeks?

Fuck you.

Class warfare happens all the time at every level. The fact that you're only aware of it when it touches your wallet speaks volumes about your faux indignation. Furthermore, when estate taxes went down 10% and the budget kept on growing, it meant everyone else had to make up for it. If not now, then in the future. That includes your wallet. But you're too dumb to realize that and bitch in that case.

Now, I never claimed class warfare to be fair. We can argue about that all day. But to claim it only happens when you get taxed is retarded.

[ElNono]

Did I ever say that? I don't think so. I only approve of government defining marriage as to it historical relevance, and not allowing the definition to be changed. I would prefer government get completely out of the marriage business.

Please point me to the offending post. I am against gay marriage, but I don't think I ever stated it close to that. I am for the government getting out of our lives, to include not recognizing any marriage. Government has no right to interfere with religion, and a marriage is a religious sanction. Government has made it a government sanction.

Oxymoron?
You don't believe in states being able to determine by themselves what marriage is?
At any rate, I'll look for a post, but I seem to recall quite clearly that you were and spoke in favor of Bush's proposal to amend the Constitution in order to introduce language that defined marriage as a union between man and woman.

[LnGrrrR]

Oxymoron?
You don't believe in states being able to determine by themselves what marriage is?
At any rate, I'll look for a post, but I seem to recall quite clearly that you were and spoke in favor of Bush's proposal to amend the Constitution in order to introduce language that defined marriage as a union between man and woman.

ElNono, IIRC, he is in favor of that, but he would be MORE in favor of just getting rid of government-sponsored marriage between any parties.

[ElNono]

ElNono, IIRC, he is in favor of that, but he would be MORE in favor of just getting rid of government-sponsored marriage between any parties.

I think a bunch of us are. My original point is that he would have no qualms supporting a federal order that overrides the state mandates in that case if it were the only option on the table.

[boutons_deux]

The problem with the govt taking itself out of marriage is that marriage is less of a religious bond that it is a contractual bond, having legal and financial implications and obligations, pensions, etc. But WC never let practical considerations puncture his ideological fantasy world.

[ElNono]

The problem with the govt taking itself out of marriage is that marriage is less of a religious bond that it is a contractual bond, having legal and financial implications and obligations, pensions, etc. But WC never let practical considerations puncture his ideological fantasy world.

You could have civil unions for everybody granting all the rights.

[Wild Cobra]

You could have civil unions for everybody granting all the rights.
Exactly. Two men, two women, a man and a woman. I don't care. Let there be a legal government document to convey tax differentiation and legal rights. Let marriage and a legal/civil union be separate things. Get the government out of marriage.

[Spursmania]

Angry Docs Say Proposed Government-Run Health Care Plan Will Drive Physicians out of Medicine
Friday, June 26, 2009


By Pete Winn, Senior Writer/Editor
http://media.eyeblast.org/resources/50163.jpg
President Barack Obama appears at the American Medical Association meeting in Chicago, June 15, 2009. (AP photo/Charles Rex Arbogast)


(CNSNews.com) - You do not have to be a brain surgeon to see that government-run health care will bode ill for doctors and medicine, says Dr. David McKalip of the Association of American Physicians and Surgeons.

But McKalip, who happens to be a St. Petersburg, Fla.-based neurosurgeon, predicts an eventual mass exodus of doctors out of medicine if Congress passes a health care reform bill that contains a mandatory government insurance option.

“I think you’ll see an incremental change where doctors will be squeezed so hard, they will simply start migrating out of medicine,” McKalip said at a unique virtual town meeting broadcast on the Internet Thursday evening.

“The older doctors, 55 or 50 they will leave early. The other ones who are mid-career, mid-generation, young 40s – Well, I’m already supplementing my income in other ways so that I can support my family. I’ll practice as long as I can, but I can’t practice by paying to work.”

McKalip, who is president of the Florida Neurosurgery Association, was one of more than 20 speakers – including two doctors in Congress, Reps. Tom Price (R-Ga.) and Phil Gingrey (R-Ga.) – who "took to the air" from 7:30 p.m. to 9:00 p.m EDT to complain about President Obama’s government-run health insurance plan.

“Unfortunately what’s coming is a government takeover of medicine,” McKalip said. “The goal is to ration care. Whenever the government takes over medicine, they always ration care. When you bring this up to the proponents, they always say that ‘Rationing happens anyway, we just want the government to do it.’ They never deny that there will be rationing.”

Doctors will be forced to ration for the government, he said.

“They will be forced by being paid less if they don’t comply with certain bureaucratic protocol set up in a committee,” he said. “They will be forced if they don’t do what the hospital tells them to do – because there is a big plan to move all the money into the hands of the hospitals, so that doctors will have to do what they are told, and as it turns out, the hospitals are doing what the government tells them to do.”

Doctors are already being told how to practice medicine, McKalip said, because of Medicare/Medicaid.

“Doctor’s feel hopeless because they don’t see any way out of the system without becoming a sort of slave to the system,” McKalip said.

Low reimbursements from Medicare/Medicaid are already forcing some doctors to pay expenses out of their own pockets, just to keep practicing medicine.

“There was an oncologist today who told me that last month he worked just as hard as he had ever worked, did all they things he had to do to take care of his patients – but he had to go to the bank and take out $3,000 to pay his practice costs because there were cuts in chemotherapy payments – and the way they were paid,” McKalip said. “That doctor is going to go out of business – and then where will patients get their cancer care?”

McKalip said he personally has had a Medicare/Medicaid patient who wanted to go to the biggest cancer care center in the region.

“They wouldn’t take her because she had Medicaid,” McKalip said. She had coverage, he said, but the government wouldn’t allow him to make up the difference between what Medicaid would pay and what the facility cost.

“Even if I form a private charity in my county, which I’m doing, to pay the difference the government forbids that patient to use private money to pay the difference to get the care she deserves,” McKalip said.

It’s time to “take back medicine for patients,” he added.

"I think Americans need to stand up and say, 'There is another way – no third-party control. No government control. Give the patients the control and we can solve these cost problems.'"

On July 17, the physicians group plans to conduct hundreds of events across the country protesting the proposed health care reform.

[101A]

A note I just got from my CFO (my business has two sides: we are a TPA that manages employer's self-insured medical plans, and we supplement that as an employee benefits brokerage firm):


I think I heard the scenario we will come to live with this morning on CNBC. Representative Paul Ryan, (R) Wis, was a guest host on Squawk Box. Basically, here's his take on how things will play out in the real world.

Apparently the current, most favored, proposals that include a government-run health plan also include an 8% of payroll "penalty" for employers who do not offer health insurance to their employees. But is it a penalty, really?

Lets take our company as an example. For the fiscal year just ended June 30, our company's cost of health insurance equalled 12.6% of payroll. For the previous year it was 9.7%. So, for our company, would 8% be a penalty or an opportunity to reduce costs while their employees would still have health insurance? By default, the government plan wins unless private insurers can reduce costs to their customers to something under 8%. We don't yet know what the cost to employees or the uninsured would be. At least I don't. Maybe there's no cost? Or, no cost initially. Some of you may know what the proposals on that side are.

But competition for benefit packages offered to employees is NOT likely to go away. And, probably, net cost to employers is not like to go down, regardless of what the Congress does. A good guess would be, as with Medicare, there will be an explosion of "supplemental" plans offered by employers to cover what the government does not. Kind of like the real function of the minimum wage is to provide a "baseline" for wages, the government plan may become the minimum standard for healthcare. But, all said and done, I doubt the overall cost to employers, or employees, is going down. We just have a major new player.

From a practical standpoint, we'd probably best stop worrying about "whether" there will be a government plan and start worrying about what it will cover and what it will cost our employees. It's beginning to look like a done deal. According to Representative Ryan, about the only role the Republicans will likely play is to possibly "negotiate the terms of defeat."

Have a nice day! Fred
Our company is probably average in terms of medical costs to payroll; our average age is a little high, so we have higher claims, but we pay pretty well. If that's the case, and employers have an opportunity to STOP covering employees medical for little to no penalty? Well, you see what one CFO thinks about it......the goal is a single payor system without CALLING it a single payor system.....if it goes through, well played by Obama (if you like that kind of thing).

Change my ass. Say one thing, but have alternate goals that go unspoken (Iraq & WMD;s anyone?). Business as usual; just a different agenda.

I'm writing my CFO back, seeing if I have enough to buy an island. If I do, I'll P.M. a couple of you with invitations...

[LnGrrrR]

A note I just got from my CFO (my business has two sides: we are a TPA that manages employer's self-insured medical plans, and we supplement that as an employee benefits brokerage firm):

Our company is probably average in terms of medical costs to payroll; our average age is a little high, so we have higher claims, but we pay pretty well. If that's the case, and employers have an opportunity to STOP covering employees medical for little to no penalty? Well, you see what one CFO thinks about it......the goal is a single payor system without CALLING it a single payor system.....if it goes through, well played by Obama (if you like that kind of thing).

Change my ass. Say one thing, but have alternate goals that go unspoken (Iraq & WMD;s anyone?). Business as usual; just a different agenda.

I'm writing my CFO back, seeing if I have enough to buy an island. If I do, I'll P.M. a couple of you with invitations...

Make sure to buy a lot of those small umbrellas for your drinks... you'd be surprised how many people forget that. :D

[2centsworth]

Healthcare needs to be reformed, yes. Vouchers with medi-gap type of regulation is about the only solution that would work.

[Spursmania]

PJTV Invites Citizens to Engage in Virtual Health Care Forum on July 22 http://pr-canada.net/images/M_images/pdf_button.png (http://pr-canada.net/index2.php?option=com_content&do_pdf=1&id=111472) http://pr-canada.net/images/M_images/printButton.png (http://pr-canada.net/index2.php?option=com_content&task=view&id=111472&pop=1&page=0&Itemid=65) http://pr-canada.net/images/M_images/emailButton.png (http://pr-canada.net/index2.php?option=com_content&task=emailform&id=111472&itemid=65) Posted by Editor Monday, 20 July 2009 Pajamas TV will host key lawmakers, health care specialists, and policy experts in a Virtual Forum on Health Care at 7:00 p.m. ET on Wednesday, July 22 that will be streamed live at www.PJTV.com. PJTV is encouraging citizens to join the discussion about the consequences of government-run health care by submitting questions, comments and ideas through email, PJTV.com, YouTube and Twitter. Questions will also be accepted during the forum on July 22.
In the days leading up to the July 22 forum, citizens can submit their text or video input via several online communications channels. They can visit http://www.pjtv.com/healthcare, and follow the instructions there. They can also email their text or video questions to [email protected] e-mail address is being protected from spam bots, you need JavaScript enabled to view it . For video submissions, participants must include their full name, hometown and a contact phone number, and videos must be 30 seconds or less. During the July 22 webcast, viewers will be able to send in their comments via email and Twitter.

"PJTV is bringing the health care debate into the homes of our nation's online community with this interactive forum. With the future of our health care system at stake, concerned citizens deserve to have their voices heard on this issue, and PJTV is providing the forum to make that happen," said Roger L. Simon, CEO of Pajamas TV.

Featured participants in PJTV's Virtual Forum on Health Care include House Republican Whip Eric Cantor (R-VA), Congressman Tom Price (R-GA), Chairman of the House Republican Study Committee, and Congressman Dave Camp (R-MI), the top Republican member on the House Ways and Means Committee. John Goodman, President and Founder of the National Center for Policy Analysis will also be participating along with other experts on health care policy. The forum will be hosted from Pajamas TV's Washington, D.C. studio by "Instapundit" Glenn Reynolds and will include PJTV commentators and bloggers from studios in Los Angeles and New York City.

This forum is the latest installment in PJTV's coverage of the health care debate. Just this week, PJTV released an eye-opening hidden camera video expos , hosted by PJTV entertainer Steven Crowder, that reveals the failures of the Canadian socialized medicine system. To watch the video, visit http://www.pjtv.com/v/2153.

About Pajamas TV

Pajamas TV (www.PJTV.com) is a conservative and center-right Internet TV company. Working with conservative think tanks and bloggers, Pajamas TV started production in September 2008 as the first online TV venture to be given a sky box at the Republican National Convention in Minneapolis. The Pajamas TV headquarters studio is located in El Segundo, Calif., with remote studio locations in New York City and Washington, D.C. In addition, PJTV brings in many contributors via web cams.

For more information about the online forum or to schedule an interview with a Pajamas TV representative, please contact Megan Franko (ext. 148) or Romney Beebe (ext. 118) at (703) 683-5004.

Source: Pajamas TV

[Winehole23]

Source: Pajamas TV

[Spursmania]

July 21, 2009 The CBO Death Knell For "Obamacare"

Pejman Yousefzadeh: The Fine Print Ought To Set Off Alarm Bells In Washington

http://wwwimage.cbsnews.com/images/2009/07/21/image5176435g.jpg Photo President Obama talks about his plan for health care reform. (AP Photo/J. Scott Applewhite)

Stories
Health Care's Democratic Dissenter (http://www.cbsnews.com/stories/2009/03/05/politics/washingtonunplugged/main4846121.shtml?source=related_story)
Obama Battles Health Care Reform Critics (http://www.cbsnews.com/stories/2009/07/21/politics/main5176433.shtml?source=related_story)


(CBS) Pejman Yousefzadeh writes a blog for The New Ledger. (http://www.cbsnews.com/stories/2009/07/21/opinion/www.thenewledger.com/)


I cannot remember where I read it, alas, but some news story, some months ago, pointed out that in anticipation of health care reform, the former Director of the Congressional Budget Office--and the current Director of the Office of Management and Budget--Peter Orszag, increased the hiring of staff economists well versed in the fiscal and economic consequences of any changes in the health care system. With these new hires, Orszag hoped that CBO would be well-prepared to turn out quick and accurate estimates of any health reform legislation.

One imagines that while the current CBO Director, Doug Elmendorf, is happy about these hires, OMB Director Orszag regrets them. Why? Because CBO issued a fairly blistering report concerning the ability of the current health care reform plans to save money and control health care costs for the long term.

CBO's hammer blow to the prospects of the reform packages currently on the table was buried in this Politico report, (http://www.politico.com/news/stories/0709/25031.html/) but its issuance ought to have alarm bells going off in Washington:

In an ominous sign for proponents, Congressional Budget Office Director Doug Elmendorf told the Senate Budget Committee that none of the bills he has seen would contain health care costs to reduce them significantly over time. This is the main argument offered by Obama and Democrats as to why Congress can spend $1 trillion and save money.

“In the legislation that has been reported we do not see the sort of fundamental changes that would be necessary to reduce the trajectory of federal health spending by a significant amount,” Elmendorf said.

“And on the contrary, the legislation significantly expands the federal responsibility for health care costs.”Far from burying the lede, this report (http://www.foxnews.com/politics/2009/07/16/house-dems-votes-health/) highlights CBO's undercutting of the Obama Administration's claims. Hilariously, Senator Harry Reid's response to Elmendorf's unwelcome-but-devastating analysis was to suggest that Elmendorf, "who in recent months has set back health care efforts with his office's cost analyses of the plans being floated," should run for Congress, "suggesting [Reid] found the CBO estimate to be partisan in its results." Of course, it goes without saying that Reid is unburdened by any experience in having attended charm school, and one can understand his remarks in light of this fact. But charming or not, Reid's reply does nothing to alleviate the concerns of any halfway respectable policy wonk that the claims of the Obama Administration and Congressional Democrats notwithstanding, health care costs will not be contained or reduced under the health care reform plans at issue.

Cost control and reduction are the goals that any health care reform worthy of the name should be shooting for. Too many people have gotten hung up on the concept of universal coverage, neglecting to note that universal coverage helps drive health care providers out of business (http://newledger.com/2009/07/the-high-costs-of-universal-health-coverage/), that it leads to incredibly onerous increases in taxes (http://newledger.com/2009/07/the-tax-consequences-of-health-care-reform/), and that current Congressional plans promising universal coverage will only serve to push down wages, increase the complexity of the health care system, and stick us with yet another unaffordable entitlement (http://newledger.com/2009/07/keith-hennessey-on-health-care-reform/).

The emerging picture that comes out of the current health care reform bills under consideration validates the general statement of principles that make up Michael Cannon's Anti-Universal Coverage Manifesto (http://www.cato-at-liberty.org/2007/07/06/the-anti-universal-coverage-club-manifesto/).

Last week, David Brooks--the New York Times columnists who, despite his putative conservative leanings, is more than delighted to throw rhetorical bouquets towards the general direction of 1600 Pennsylvania Avenue--pointed out (http://www.nytimes.com/2009/07/10/opinion/10brooks.html?partner=rss&emc=rss&pagewanted=all) that the current bevy of health care reform legislation would do nothing to control costs. Among the other points he makes, Brooks highlights the fact that the lower administrative costs that will supposedly eventuate through the implementation of a public plan will do nothing whatsoever to drive down costs, since they do "not affect the fundamental incentives driving inflation." This is because "the public plan would pay providers of health care at rates comparable to privately negotiated rates,” according to--you guessed it--a CBO analysis of the plan provisions in the health care reform bill issued by the Senate Committee on Health, Education, Labor, and Pensions. Quoting Brooks:

Keith Hennessey, the former chief of the National Economic Council, studied the HELP bill and wrote on his blog that aside from one provision, “I can find nothing that would provide information and incentives to consumers, medical professionals, health plans, employers or government to slow the growth of long-term private health care spending.”

Wait, it gets worse.

The bills not only fail to reduce health care inflation, they make it harder to fix the larger fiscal mess later. They do that by taking the chits we could use to balance the overall budget and using them to cover the $1.3 trillion in new federal health spending.One may take issue with some of the solutions offered by Brooks to fix the fiscal mess we face because of rising health costs. But there is no denying the problem. And there is no denying that the health care reform bills we are seeing batted around the halls of Congress do nothing to fix that problem.

The CBO report has clearly worried advocates of health care reform. Ezra Klein (http://voices.washingtonpost.com/ezra-klein/2009/07/rules_for_commenting_on_the_cb.html) tries to promulgate "rules" concerning comments on CBO's findings, including the requirement that those who trumpet CBO's critiques on the issue of cost control also accept CBO's call for the elimination of tax breaks that support employer-provided health insurance, a public insurance option that can bargain at Medicare rates, allowing MedPAC (http://www.medpac.gov/) to reform Medicare, support cost-sharing that will effectively ration care, and support cost-effectiveness of treatments, which will serve to set reimbursement rates. To which, the proper response is something along the lines of "No, Ezra, we don't have to accept these conclusions." These CBO proposals are given with the assumption that universal health care is a desirable goal. But it may not be. Rather, the desirable goal, as Cannon writes (http://www.cato-at-liberty.org/2007/07/06/the-anti-universal-coverage-club-manifesto/), may better be described as "making health care of ever-increasing quality available to an ever-increasing number of people.," with the understanding that the policy consequences of universal coverage may not be desirable, that people ought to have the right to refuse health insurance, and that there are plenty of other--and better--ways to subsidize people who do not have health care.

Perhaps the worry of people like Klein is not limited to a mere CBO report, devastating though that report is. Perhaps the concern of universal coverage advocates also centers around the fact that for all of the hoopla surrounding health care reform, polls (http://www.freep.com/article/20090716/NEWS15/907160398/Americans-torn-over-health-care-strategy--poll-finds) show that the American public is divided over the issue of reform. The political advantages enjoyed by the Obama Administration and Congressional Democrats are not nearly as pronounced or overwhelming as universal coverage advocates (the vast majority of them sympathizing with the Democratic party) thought they would be, and a significant number of Americans believe that neither their care, nor their pocketbooks will see much improvement in the aftermath of health care reform.

Sometimes, public skepticism is not justified by the facts. But in this case, the skepticism of the American people is borne out by the most serious of policy critiques, thus reinforcing public wariness. Health care reform advocates may try bluff and bluster to overcome public concerns. But with any luck, they will be forced instead to go back to the drawing board, and return with a better plan.

[Spursmania]

Politics News

More Disapprove Than Approve of Obama on Healthcare (http://www.gallup.com/poll/121814/More-Disapprove-Than-Approve-Obama-Healthcare.aspx) NEW

July 21, 2009
http://sas-origin.onstreammedia.com/origin/gallupinc/www_jpg/090721obama.jpg (http://www.gallup.com/poll/121814/More-Disapprove-Than-Approve-Obama-Healthcare.aspx)
The latest USA Today/Gallup poll finds more Americans disapproving (50%) than approving (44%) of the way Barack Obama is handling healthcare policy. In general, Obama receives higher marks on his handling of international issues than on domestic issues.