Health Care Reform Gearing Up

See, I only heard first hand stories from friends, and they are too amused by the Republicans criticisms.

Ssshhh!!! C'mon guys, you're going to screw it all up.

This is like the Iran / US situation right now, better to not have Canadians come out for this publicly or the Republicans are going to use this against reform!

"Martin Savage supports government healthcare and French cheese, therefore it most be wrong!"

"Anti-American and Communist lover 'Prankster' says our healthcare system is inferior, be patriotic ... pay for it!"

The blatantly obvious way in which Republicans champion the needs of the very few, and just shit all over the normal people, is staggering. I mean, this is nothing but trying to sabotage a plan so the small man doesnt get healthcare thats actually working.
And people still vote for these dipshits? Crazy World, I tell you.

Ah, one of my favorite topics. Surprised it took so long to get this back on the political thread. I'm sure we'll have some great discussions here and to get us started here are couple of comments:

- From what I've read so far the plans being presented will still leave at least 30 million Americans without coverage. How in the world can they justify a cost of $1 Trillion dollars for a plan that won't cover everyone?

- I highly doubt this will pass with a govt sponsored public plan. That will destroy all private plans as companies drop their current plans to save costs and stick folks with the govt plans. I do not think they have the votes to do this.

- My eeevvvvilll capitalist roots would like to point out that socialized medicine that destroys the private insurers will put hundreds of thousands of Americans out of work. Aetna, BCBS, United, etc. employ thousands across the entire country and entire regions would be decimated by this loss of employment.

Anything we can do to change the fact that only $1 out of every $25 spent goes to preventative health care is good with me.

Call me un-compassionate, but I'd rather see my tax dollars go towards something other than providing free health care to millions of people.

And this is coming from someone who until recently, was without health insurance and still has cruddy vision and dental.

I'd rather see tax dollars going towards providing better opportunities for Americans to go to college or community college. Make public universities completely paid for and eliminate the cruel practices of government student loan debt. Making education more accessible leads to a smarter, larger, and more innovative work force that would increase the tax base and make life much easier for Americans and the world.

How do reasonable americans survive the absolute fucking idiots they apparently must deal with every day? I once tried to seek out the dumbest (of which I may be among, I'm always unsure!) and debate them, trying to figure out why they are so dumb, but they would just chant slogans at me put in their mouths from somebody else. They yell, "Abortion!?! What are you, a liberal?!" and then advocate smaller government! These people are just fucked! And there are so many of them. Right? It does work both ways, though - I've heard "the liberals" decry people as rednecks for simply not toeing the party line.

Anyways, yes, just don't dignify these insane people by thinking you can have reasonable discourse with them. Then you'll get your health care.

Those educated Americans you talk about would have a better chance at good paying jobs if corporations didn't have to bear the burden of providing healthcare to their employees.

I also like how you make health in general sound like a frivolous concern.

Isnt there a massive overabundance of college grads anyway, leading to a breakneck competition? I mean, its already bad in a lot of areas in Europe, where you got even minor universities churning out hundreds of business school clones by the year.
I mean, it really isnt a lack of well-educated people thats causing so much trouble these days and kills off living standards.

Anyway, you guys will figure it out by yourselves. In my opinion, a hybrid system of private and government health care is the way to go.

http://washingtontimes.com/news/2009...home_headlines

I do find it amusing that the republicans are opposing the current iteration of health care reform with the argument that it's detrimental to private insurers, defending an industry whose financial impetus is to deny reimbursements for health care services. Then they go on national TV and brag that our system is the best in the world.

Only in America.

That was only a version of a bill. There are three in the Senate right now, and only one on the house. The CBO also did not take into consideration the savings the bill would create.

This will probably change. Latest poll numbers indicate a sizable majority, across the political spectrum, support a public option in a health plan.

Not necessarily, and this bears upon the central paradox in this debate. We hear two arguments against a public plan: a) the public plan will drive the insurance companies out of business because they couldn't compete with health care services offered at a lower cost, and b) the government will provide inefficient and bad health care.

Well, if we're all believers in a free market, how could this be the case? If the insurance companies offer a better product than a public plan is able to, won't those consumers choose the private insurance? And wouldn't that private insurance be more affordable, if there is a big player in the market driving down costs? Isn't this a win for the consumer?

Think about it: if every thing government does is inherently shitty (as the GOP would have us believe), why would the insurance companies be fighting this so hard? It seems to me that having a really crappy public health option would effectively kill this debate once and for all, leaving the private insurance companies the ultimate victors.

Are the conservatives for the free market or not? Do consumers ultimately make better choices or not? Let's test this by giving consumers an actual choice.

hehe

I've spent over a decade in the health insurance/employee benefits/hospital administration field, and I can tell you this: From a dollars standpoint, a nationalized version of what we have now will never -EVER - work.

The best outcome we can hope for here is that this scares providers and insurers into finding new and effective ways of forcing people to adopt a more active role in how healthcare is delivered. By this, I mean that preventative care/lifestyle choices MUST become the primary focus of our system. The co-pay needs to be eliminated and the cost/reimbursement circus that doctors and hospitals have to wade through with insurers has to be scrapped and rebuilt.

The current method cannot be supported by federal dollars. We're already seeing that with medicare. If a national health plan is the future, then it's going to have to be a completely different animal than what we have now.

What's the incentive to do that when things are working great -- from the insurers perspective, that is.

Well, no, because the government is not on equal footing with private companies. It's not "true" competition when one player makes the rules that the others have to follow - also when it gets to tax them, haul them in for hearings, etc. So it's definitely possible to have skewed results in such a "market."

That said, Obama's plan may well be better than the current situation - which is also far from a competitive environment.

The devil's in the details on this, since there are many ways to implement a public option. But, that being said, any player -- public or private -- eventually has to follow rules set by Congress and has to answer to the regulators. This would be nothing new and other quasi-government agencies do it all the time.

However, one could argue that the government is not on equal footing with a private company either, since, according to our GOP friends, anything government run is slow moving and shitty. According to that orthodoxy, the private insurers should be able to market a better product by getting rid of inefficiencies and making it cheaper.

As with any large legislation, there are always many variants of the bill (i.e. Republican version, liberal version and moderate (in charge) version) generally speaking the one being discussed is the front runner, as is the case in this one.
The latest poll numbers also indicate they want the government to find a way to fund it and not put us deeper in debt.. they also don't want new taxes... and they also want to become multi-millionaires and lose weight while eating anything they want and not working for it. Not all of these things are feasible.

You want government run health care? It's going to cost you more money and whatever price tag they try and sell to you, expect there to be more costs.

I have (twice) and recommend everyone call and email their senators and representative in support of single payer health care. The big multinational corporations that have been bilking the American people for years are going to fight this one tooth and nail, and its only hope lies in populist support.

Snaieke, you do realize that the government already spends more per capita than any other industrialized nation in the world and insures fewer people? I would love it if you could actually look at the big business behind health care and see what a rip off it is. Single payer costs less (with up to 3% overhead as opposed to 30 - 50% at for-profit companies) and works better. Any doctor or nurse not propagandizing for the insurance companies will tell you that medicare is 100% easier for them to deal with than the myriad for-profit companies that fight tooth and nail not to pay for care. Fact.

Wait. Where was I when business's all of a sudden had to become non-profit?

ETA:

Oh, I forgot to address your completely fabricated doctors for medicare portion ... 'ya right'.

Doctors are dumpin medicare because they keep cutting their repayments, been that way for years.. especially considering all the hoops they have to go through and forms they have to fill out.

http://www.nytimes.com/2009/04/02/bu.../02health.html

I hope you get a good working public health care system but how it's going to get implemented over a short period is immensely hard to imagine. We have one of the better systems in the world but it has taken more than 30 years to get to where we are today. We still suffer from a lack of doctors to cope with so many patients so we import those from all over the world.

One thing is sure, whoever was concerned over the firings of thousands of employees due to a transition to public health, must realize that you will need thousands upon thousand of new nurses and doctors. So if anything I bet it will create even more jobs than will be lost.

... and yet every major tertiary care hospital gets the majority of their income from Medicare patients. If a doctor doesn't want to hire a person for his practice to take care of the billing and would rather not see Medicare patients, that's more a reflection upon his/her business model. Academic centers have no issues keeping on their Medicare patients, but they're not in it for the profit.

A major problem with Medicare is that the sustained growth formula for modifying physician reimbursement is flawed and has been a problem for almost a decade, but instead of solving the problem Congress passes eleventh-hour suspensions of the inevitable reimbursement cut. It's like putting a band-aid on a gunshot wound.

(an issue with the SGR is that it essentially pays physicians for the quantity, not quality of procedures. Whoever came up with it clearly didn't think their cunning plan all the way through)

And for yt: Ask any doctor about the time they were audited by Medicare when some 2-year-college graduate came in, rummaged through their paperwork and lectured them about clinical management of patients, and how easy THAT was to deal with.

ETA: Bitches, through my shenanigans I've been an inpatient in hospitals both in Denmark and the US. And while parts of the Danish system are great, there are other areas where it's far behind the American one.

That's true, my mom had 2 already!

A question for you Americans. The last of the numerous operations my father had was for hip replacement. It was done in a private hospital, by one of the top doctors in the field and they used a ceramic joint. For this plus a week's stay in the hospital, physiotherapy and transport in an ambulance to and from the hospital the cost was 1000€. Considering that it was arguably an elective procedure how far would it set him back if he was in the US? He worked as a mid-level accountant before having to retire early due to health reasons.

If your Father had health insurance, he'd probably be thousands of dollars in debt.

If he had my insurance, $50. One of my parents had surgery recently, it cost them $150 but they don't have my insurance and they have slightly higher copays.

ETA, that was through a Nevada medicare type plan as they're over 65 and retired.

Depends on the type of insurance. Mid-level accountant, you say? Hmm, then again it would depend in which business sector he was employed too. I'll hazard a guess and say that your dad would most likely have had a PPO plan with a 80/20 coverage. After the deductible (most likely $2K, your dad would paid 20% of the overall cost).

He said he's retired due to health reasons, so he'd be on Medicare.

Not necessarily. Depends entirely on his retirement benefits. But nice try going for the lowest cost.

He retired early due to health reasons, this puts him squarely into early social security benefits and medicare territory and depending upon time in the company probably excludes him from any form of pension retirement benefits.

We'll have to wait until he responds with more information before concluding I guess.

OK more info if you want to. Severe rheumatoid arthritis since his early twenties so he's been in heavy medication for 40+ years. Up to now had arthroplasty in one elbow, both knees (one replaced ) and the already mentioned hip replacement. Plus a severe stroke seven years ago, which forced him into retirement and a heart attack caused by coronary thrombosis a year and a half ago. Also after the stroke he did six months of logotherapy and a little over a year of physiotherapy.

On the insurance side he had both public and private health insurance. The private one was cashed out shortly after his stroke, as the company were being so uncooperative and arbitrary about what they should cover and what they shouldn't that we either had to take them to court or cash out at a pretty big penalty. Through all that, not without effort, we managed to stay middle class, although not comfortably so. I realize my case is kind of extreme but I feel that without a minimum questions asked, wide coverage, public health system I'd be in severe economic trouble by now.

So I'm going to happily keep paying whatever percentage of my salary I'm supposed to towards the public health system, smile and hope that some other family can get the same amount of help mine did.

Robert Reich has a good column about this up at Talkingpointsmemo.com. Here's a great graf:

Read the rest here.

Meanwhile, from the awesome Sen. Bernie Sanders:

Source

Medicare releases their new payment policies for 2010, cutting some physician fees up to 30%.

So this fee schedule is imposed will likely cause more doctors to drop medicare patients. But senators and house reps won't care as long as they have their sweetheart plans.

Richard Shelby needs the world's hardest dickpunch.

Most of my knowledge of American healthcare comes from Sicko (I know, I know), but after reading up a little I'm now more thankful than ever for the NHS. It's not perfect and it get's lot of (mostly unjustified IMO) bad press here, but its a pretty incredible system for the price.

Especially the cancer care/treatment, I've had experience of it from someone in my family. Not bad for a relatively small tax

Sure, but what's it like living in a socialist hell-state?

I do not agree with the "no health care tax" in this bill for a business with at least 500k in payroll and no health care. Why should they be punished for not being able to afford health care? You would think the best plan of action would to find ways to change it so they could afford it.

Why on earth are they trying to pass this so fast??

Because if it sits around, it will die on the vine. The 2010 elections are just around the corner.

Because if the American sheeple return from summer vacation they will realize what the hell is going on and put a stop to this travesty.

Is it not possible to just beat the insurance companies over the head with some common sense? When they're charging $10 for an aspirin to someone who is uninsured when the going rate is about $.05, the system is broke. All the bogeyman talk about how it's going to 'cost us so much frikkin money!' is ignorant. It's already costing us so much frikkin money. It's costing us more money, per capita, than anyone else by an impressive margin.

Well said, Zhukov. The reason the entire counter-argument doesn't make sense is it's reverse-engineered from the desired conclusion and therefore has to leave out inconvenient facts.

inconvenient facts like its the HOSPITAL or Doctor that changes $10 for an asprin, not the insurance company. Nothing is being done to address the actual COST of health insurance all that is happening is shuffling it from a private company to a government run entity that will baloon our deficits and still leave 20+ million americans without insurance. Bottom line, this will cost jobs -- both current and future created jobs and that's the absolute worst thing you can do right now.

The hospital charges you $10 because you are uninsured; the insurance companies negotiate the rates at which they are paid by the hospital. It is not an equitable system at all.

I realize the retort is 'just make sure you have insurance, numbnuts!' If it were that easy, if employers were still offering employer based insurance, if insurance were affordable for a huge cross section of Americans, than there would be no need for the hospital to bill the uninsured $10 for an aspirin. But reality is non-negotiable. The sort of price deviations seen between insurers, and between the insured and non-insured, overwhelmingly points to the fact that the system is broken.

The cost of treating the uninsured is absolutely and inexorably tied to the COST of health insurance for everyone.

http://www.pbs.org/moyers/journal/07102009/watch2.html

Former Cigna PR hack talks to Bill Moyers. Good stuff.

Jesus christ, that's one of the scariest transcripts I've ever read. More people with no health insurance than the population of canada? Not good.

And according to the CBO -- ALL plans being discussed still leave 20-30+ million americans uninsured which means costs will not be changed using your logic.

Next.

Google "medical loss ratio" and it just gets worse.