View Full Version : Who has actually read Obama's Health Plan ?
Melonie
08-23-2009, 06:07 AM
And the Constitution was written and signed by men who....
... are rolling over in their graves at the very idea of a National Health Care system, which arguably violates said Constitution in an incredibly large number of ways !!!
- violation of states' rights to regulate health care ( federal mandates )
- violation of privacy rights of patients ( medical records + bank account access )
- violation of free market principles re pricing / access
- violation of 'takings' clause i.e. taxation without treatment
- violation of right to LIFE, liberty & the pursuit of happiness ( gov't denial of prompt / expensive treatment for elderly )
you don't want to get me started in this direction ...
hockeybobby
08-23-2009, 09:55 AM
My point was that the men who crafted the constitution weren't perfect either.
National Healthcare is an issue NOW...not 200 years ago. You are like a bible thumper, standing firm on ideas that are beyond outdated.
Melonie
08-23-2009, 04:45 PM
You are like a bible thumper, standing firm on ideas that are beyond outdated.
I'm sorry that you consider individual freedoms, non-oppressive government, and 'free enterprise' to be outdated concepts. Then again, you are Canadian ...
hockeybobby
08-23-2009, 05:55 PM
Hey! I resemble that remark! :)
threlayer
08-24-2009, 08:36 AM
All those "violations" have multiple precedents, including Medicare. And it's not a Nationa Health Care System. It's probably going to be not much more in that direction than the subsidized health plans now being offered to the lower income citizens of many states.
You may start now. :)
eagle2
08-25-2009, 10:16 PM
... are rolling over in their graves at the very idea of a National Health Care system, which arguably violates said Constitution in an incredibly large number of ways !!!
- violation of states' rights to regulate health care ( federal mandates )
- violation of privacy rights of patients ( medical records + bank account access )
- violation of free market principles re pricing / access
- violation of 'takings' clause i.e. taxation without treatment
- violation of right to LIFE, liberty & the pursuit of happiness ( gov't denial of prompt / expensive treatment for elderly )
you don't want to get me started in this direction ...
There are not plans for a national health cares system. That's right-wing misinformation. Under proposed health care reform, most people under 65 will get their insurance from private insurers.
Life, liberty, and the pursuit of happiness, is not in the Constitution.
Eric Stoner
08-26-2009, 06:42 AM
There are not plans for a national health cares system. That's right-wing misinformation. Under proposed health care reform, most people under 65 will get their insurance from private insurers.
Life, liberty, and the pursuit of happiness, is not in the Constitution.
Neither is a "right" to health care.
Actually there most certainly are plans for a National single payer system. Obama's plan is admittedly the first step in establishing one. The public option's REAL purpose is to ease private insurers into oblivion.
eagle2
08-26-2009, 06:55 PM
Neither is a "right" to health care.
Who said it was?
Actually there most certainly are plans for a National single payer system. Obama's plan is admittedly the first step in establishing one. The public option's REAL purpose is to ease private insurers into oblivion.
Conservatives are always saying how much more efficient the private sector is than the public sector. If that's the case, why are conservatives so scared of a public health insurance option?
miabella
08-26-2009, 08:14 PM
the countries with single payer are increasing their private options. canada has done so, the uk has done so, germany has done so, sweden is doing so presently, and i think france is as well. citizen pressure has led these countries to parcel more and more of their medical care out in private form rather than public form.
if single-payer is so awesome, why did the uk add private access explicitly in 1989? or canada stop prosecuting doctors just setting out their shingle and directly charging patients? why were any changes made in any country with single-payer that allowed for private practice if single-payer is soooo optimal?
the grass is always green in the other guy's yard.
hockeybobby
08-27-2009, 05:50 AM
^^^You can't expect any system to be perfect and never need tweaking. If there is a better way to do things, you should adapt and go with the times, even if you end up changing back later. The question is, what system does the most good for the most people...and gets the best bang for the buck.
Eric Stoner
08-27-2009, 09:37 AM
Who said it was?
Conservatives are always saying how much more efficient the private sector is than the public sector. If that's the case, why are conservatives so scared of a public health insurance option?
Because a PUBLIC plan can mandate participation by "drafting" those who don't join up.
It can run at a deficit. Like Amtrak and the Post Office.
It can advertise for free via PSA's.
Mostly we oppose ti because it is not needed when there are only 15 million people who need health coverage; want health coverage; can't afford it and don't have it. We can just use vouchers or subsidies instead of creating yet another Federal agency.
Melonie
08-27-2009, 10:53 AM
as coincidence would have it, this report on the UK's National Health Service was just released ...
hockeybobby
08-27-2009, 11:01 AM
Mostly we oppose ti because it is not needed when there are only 15 million people who need health coverage; want health coverage; can't afford it and don't have it. We can just use vouchers or subsidies instead of creating yet another Federal agency.
How about just to start getting real value for all the Private money being spent? You are being gouged and screwed down there. Have a public system that covers everyone for the basics, and the rich can spend extra if they want the premium services like they do for most things. The pharmaceuticals and insurers will survive, don't worry. Business can adjust to less usurious profits.
Eric Stoner
08-27-2009, 01:04 PM
How about just to start getting real value for all the Private money being spent? You are being gouged and screwed down there. Have a public system that covers everyone for the basics, and the rich can spend extra if they want the premium services like they do for most things. The pharmaceuticals and insurers will survive, don't worry. Business can adjust to less usurious profits.
While far from perfect and with plenty of room for improvement, the U.S. has the lowest waiting times for services and a high level of care. France's system which is touted as the "best" is frightfully expensive costing 1500 to 2000 Euros per worker, per month in premiums and France has a 10% unemployment rate. The problems in Canada and the U.K. have been highly publicized.
miabella
08-27-2009, 01:21 PM
How about just to start getting real value for all the Private money being spent? You are being gouged and screwed down there. Have a public system that covers everyone for the basics, and the rich can spend extra if they want the premium services like they do for most things. The pharmaceuticals and insurers will survive, don't worry. Business can adjust to less usurious profits.
your country has people coming over here for the 'basics'. that's my larger point.
all the countries i've listed are showing increases in PRIVATE healthcare for BASICS, not exotic treatments or unusual stuff, just checkups/minor surgeries/and other 'basics'.
Big Insurance makes 3% profit, as an average of the several largest. I know, I know, three percent profit is USURIOUS. they should be happy with .03%, right?
unlike canada, 3/4 of america isn't conveniently located to a country full of shiny cutting-edge treatment and specialists that they spit on as being too stupid to adopt single-payer while they reap the benefit of that other countries' cutting-edge-ness.
i live in WA state. we are flooded with canadians sneering at american healthcare but mysteriously filling our clinics and hospitals seeking treatment, often paying out of pocket.
miabella
08-27-2009, 01:22 PM
While far from perfect and with plenty of room for improvement, the U.S. has the lowest waiting times for services and a high level of care. France's system which is touted as the "best" is frightfully expensive costing 1500 to 2000 Euros per worker, per month in premiums and France has a 10% unemployment rate. The problems in Canada and the U.K. have been highly publicized.
don't forget that the french healthcare system has been in the red for 20 years now. they have reduced services in a vain hope of reducing (but of course not eliminating) their ongoing deficits.
BuxomBeauty
08-27-2009, 02:17 PM
I caught this on a professional investor's BBS ...
"Obama's health care plan will be written by a committee whose head, John Conyers, says he doesn't understand it. It'll be passed by Congress that has not read it, signed by a president who smokes, funded by a Treasury chief who didn't pay his taxes, overseen by a Surgeon General who is obese, and financed by a country that's nearly broke. What could possibly go wrong?"
And this would be the first time politicians said or did anything hypocritical, and the first time a law was passed without everyone involved knowing or understanding every last detail and potential consequence. lol
hockeybobby
08-27-2009, 04:05 PM
your country has people coming over here for the 'basics'. that's my larger point.
all the countries i've listed are showing increases in PRIVATE healthcare for BASICS, not exotic treatments or unusual stuff, just checkups/minor surgeries/and other 'basics'.
Big Insurance makes 3% profit, as an average of the several largest. I know, I know, three percent profit is USURIOUS. they should be happy with .03%, right?
unlike canada, 3/4 of america isn't conveniently located to a country full of shiny cutting-edge treatment and specialists that they spit on as being too stupid to adopt single-payer while they reap the benefit of that other countries' cutting-edge-ness.
i live in WA state. we are flooded with canadians sneering at american healthcare but mysteriously filling our clinics and hospitals seeking treatment, often paying out of pocket.
Tell that to the Americans coming up here to buy our reasonably priced drugs, and scamming our healthcare system with fraudulently obtained cards, because their own country cares about money instead of people.
Who do you think is chasing after your "cutting-edge treatment"? Poor folks aint I assure you. People who want to pay to get the best that money can buy or get it faster, that's who. They'll always do that, in your country and mine. It's the people who can't pay that need help, those are the people who need some compassion here.
miabella
08-27-2009, 06:07 PM
in my country, doctors give care for free. they treat poor people and then DO NOT CHARGE THEM ANY MONEY.
this is typical in fact, for doctors who do not accept medicaid or medicare. they just don't charge money to such patients.
but since that is voluntary aid to the needy, and doesn't require a bunch of cushy government jobs for social work majors, it's clearly an awful, awful thing.
and i am still curious how a three percent profit is usurious and horrible to earn.
hockeybobby
08-27-2009, 06:24 PM
What do you have against people working in the public sector. Don't you think they do an honest day's work just like you?
And nobody runs a business to get 3% roi. You can get that from some bank accounts. Pfizer had revenues of 44 Billion last year.
eagle2
08-27-2009, 06:43 PM
your country has people coming over here for the 'basics'. that's my larger point.
and over a million Americans travel to foreign countries for medical care because they can't afford it here.
miabella
08-27-2009, 09:19 PM
if they can afford plane tickets, they could afford to spend a few minutes calling doctors who perform free or reduced-price surgery and medical care. many doctors devote 10-50% of their practice to charity care, again particularly among those who will not take government health care (medicaid/medicare/etc).
miabella
08-27-2009, 09:26 PM
What do you have against people working in the public sector. Don't you think they do an honest day's work just like you?
And nobody runs a business to get 3% roi. You can get that from some bank accounts. Pfizer had revenues of 44 Billion last year.
ROI is not the same as profit margin, for one. for two, pfizer is not an insurance company. the insurance companies, which are the ones everyone is really firing up their hate-ons for, are the ones with the 3% profits.
for that matter oil companies earn princely profit margins of 6-8% themselves, among other ill-treated industries.
and working for the government is pretty much sinecures for the children of the bourgeoisie and upper class. except for the military and post office and public education, which are sinecures for people with no practical job skills whatsoever, and often no rich parents to fall back on.
eagle2
08-27-2009, 10:04 PM
if they can afford plane tickets, they could afford to spend a few minutes calling doctors who perform free or reduced-price surgery and medical care. many doctors devote 10-50% of their practice to charity care, again particularly among those who will not take government health care (medicaid/medicare/etc).
Maybe for basic care you can do that, but I doubt you can do that for major surgery. The doctor fee is only a small part of the total cost for major surgery. When you need heart surgery that costs $175,000 in the US, as the woman in this story did:
http://www.cnn.com/2009/HEALTH/03/27/india.medical.travel/index.html
I doubt there were any options in the US that were much cheaper.
miabella
08-28-2009, 01:44 PM
for surgery as well. there are even flat fee surgical centers in the US that charge 10-20k for major surgery. there are also flat fee clinics (concierge clinics) at a range of prices all over the country (although many of them get attacked for offering annual or monthly rates cheaper than insurance premiums for unlimited visits-- gee, why isn't obama trying to protect doctors reasonably pricing unlimited basic care and minor surgery?)
america really is this diverse in options, and it is lack of information about clever and cheap (for the patient) options ALREADY OUT THERE that is a greater problem than 'lack of access'. there are so many doctors who would love to practice the fixed-price way-- guaranteed income, ability to care for many patients who would otherwise go without, and no billing hassles with insurance. but instead of supporting this eminently sensible option for reforming healthcare, we get to hear about how we've got to print up an extra couple trillion for no damn good reason.
Eric Stoner
08-29-2009, 12:56 PM
Maybe for basic care you can do that, but I doubt you can do that for major surgery. The doctor fee is only a small part of the total cost for major surgery. When you need heart surgery that costs $175,000 in the US, as the woman in this story did:
http://www.cnn.com/2009/HEALTH/03/27/india.medical.travel/index.html
I doubt there were any options in the US that were much cheaper.
Why do you think that is ? Because the hospital has to cover all the care it provides to people who can't or won't pay.
BuxomBeauty
08-29-2009, 01:13 PM
in my country, doctors give care for free. they treat poor people and then DO NOT CHARGE THEM ANY MONEY.
this is typical in fact, for doctors who do not accept medicaid or medicare. they just don't charge money to such patients.
but since that is voluntary aid to the needy, and doesn't require a bunch of cushy government jobs for social work majors, it's clearly an awful, awful thing.
and i am still curious how a three percent profit is usurious and horrible to earn.Where is this free healthcare available?? I have looked many times and have found extremely little. I have found a few "free clinics" listed on occasion, but it is so hard to use their services, I can see why so many people still go to a hospital ER for services they can't afford.
As for the 3% thing, frankly I don't trust a health insurance company to accurately report on that. Considering that health insurance is simply out of reach for most people, I have to wonder about it all.
It is my strong opinion that the vast majority of people screaming about keeping our fucked-up healthcare system as-is, are those who don't have to deal with the reality of care and meds they can't pay for.
eagle2
08-29-2009, 03:03 PM
Why do you think that is ? Because the hospital has to cover all the care it provides to people who can't or won't pay.
No, it's because hospitals can charge that much. I doubt there are many hospitals that perform $200,000 surgeries for people who don't have the means to pay. In the example I gave, a women had to travel to India for open heart surgery because the hospital required her to pay $175,000 for the surgery. If she couldn't come up with the money, she couldn't get the surgery.
miabella
08-29-2009, 03:15 PM
Where is this free healthcare available?? I have looked many times and have found extremely little. I have found a few "free clinics" listed on occasion, but it is so hard to use their services, I can see why so many people still go to a hospital ER for services they can't afford.
As for the 3% thing, frankly I don't trust a health insurance company to accurately report on that. Considering that health insurance is simply out of reach for most people, I have to wonder about it all.
It is my strong opinion that the vast majority of people screaming about keeping our fucked-up healthcare system as-is, are those who don't have to deal with the reality of care and meds they can't pay for.
they're legally required to report their earnings accurately.
most people don't realise that it is normal in most industries to make less than 10% net profit, often less than 5%. 'evil' corporations are very typically making 1-4% profit margin after paying their employees and paying for their buildings and paying tax, etc.
i totally don't want to keep the current system. i just don't think adopting the broken systems of other places is a very good idea when we are frankly able to do better.
as for free healthcare, doctors provide it as part of their overall practice-- you call and ask, and then you go in. free/cheap care is a portion of their practice, not all of it. you can always search for concierge care locally and find out if there is a clinic providing such care near you. the cheaper ones tend to be in the south, but that is not a necessary condition. insurance companies tend to make it hard for concierge clinics to operate in this country-- i would be happy if that obstacle were removed and they were freer to operate in more markets.
miabella
08-29-2009, 03:16 PM
No, it's because hospitals can charge that much. I doubt there are many hospitals that perform $200,000 surgeries for people who don't have the means to pay. In the example I gave, a women had to travel to India for open heart surgery because the hospital required her to pay $175,000 for the surgery. If she couldn't come up with the money, she couldn't get the surgery.
she didn't explore the us options. if she'd been willing to travel within the us, she could have had the surgery done for cheaper and saved the long-distance plane fare, as there are fixed-price surgical centers in this country as well that offer such surgery at a fraction of that quoted price.
BuxomBeauty
08-29-2009, 03:39 PM
I do know a dancer who needed surgery (I want to say a hysterectomy but can't remember for sure) and it was going to cost her something like $20k at a regular hospital. She researched and found a place to get it done for something like $5k.
Miabella, I am cynical. Insurance companies may be legally required to report actual earnings/profits, but that doesn't mean they actually do that. How many people/companies do we know of who haven't followed the letter of the law on such matters?
I do appreciate the information about concierge clinics, and I'd love to see more of this service, and more education about it. I have done some reading and found that these doctors are doing this with drastically reduced patient loads so you can actually get appointments for the same or next day, call them on the phone after hours, and actually get time with a doctor rather than wait an hour for an appointment only to spend a whopping 2 minutes with the doc. Apparently they do this because they don't like rushing 30 patients a day through their offices and dealing with insurance companies, and supposedly they're able to make the same money as the factory docs.
With a little digging I found a doctor in my area who charges $60/month for membership plus $20 per 15 minutes of office visit, or $40 per 15 minutes of office visit for non-members. His rates for other services are 50% for members. He is part of a network so you can access doctors in other areas when traveling for the same fees if you're a member of his clinic. His website is very thorough and recommends obtaining cheaper high-deductible insurance / HSA to cover major issues.
A quick search tells me I could get high-deductible insurance to cover major stuff plus his membership program to cover minor stuff and still pay less than regular health insurance. I am impressed.
It would be nice to see more of this type of service available!
KiwiStrawberry Splenda
08-29-2009, 04:40 PM
Re: no coverage to illegal aliens.
So, in a perfect world for some, illegal aliens wouldn't have access to our healthcare system at all, correct? So what happens when contagious disease breaks out in those communities, and spreads to the general populace? Then, we can't control the disease because we still cannot treat the illegals..it has become, illegal.
Like it or not, illegals are here. Big business owners and people with the money don't want them gone, they want their cheap labor to exploit. So they do a little song and dance for Joe Middle-Class, but nothing will actually change. If that's going to be the case, we CANNOT, for the sake of the health of this country, and ethically, refuse to help illegals for medical services.
miabella
08-29-2009, 09:27 PM
illegals will get covered because you cannot prove citizenship when someone comes in having been run over by a fruit truck.
Sad Sally
09-01-2009, 07:47 PM
I get some peoples fear of Obama-Care but this country needs some health care reform. I'm sick to death of Republicans poo pooing all over this Bill and not making any real attempt to contribute to it in a meaningful way. All they want to do is rip it apart and not add anything to it. Several years ago I decided to purchase health insurance at the cost of $200 a month. After having said insurance for 6 months I went in for a pap-smear and was told I had a minor yeast infection and was given a prescription. Two months later I recieved a bill for almost $600 from my insurance company. They informed me that I had a PRE-EXISTING CONDITION. WTF! They made me pay for everything out of pocket. I complained all the way up the ladder and it did no good. I canceled said insurance, but not before it cost me $1200 in insurance payments and $600 for my office visit. Could I have sued? Sure. But I'm not the type. You people are so worried about the government miss spending our money on health insurance, but I have a feeling that I wouldn't end up paying $1800 for a damn yeast infection.
eagle2
09-01-2009, 10:30 PM
she didn't explore the us options. if she'd been willing to travel within the us, she could have had the surgery done for cheaper and saved the long-distance plane fare, as there are fixed-price surgical centers in this country as well that offer such surgery at a fraction of that quoted price.
Do you have any examples or references for these fixed-price surgical centers? Can you provide links to some of their websites?
Eric Stoner
09-04-2009, 11:51 AM
I get some peoples fear of Obama-Care but this country needs some health care reform. I'm sick to death of Republicans poo pooing all over this Bill and not making any real attempt to contribute to it in a meaningful way. All they want to do is rip it apart and not add anything to it. Several years ago I decided to purchase health insurance at the cost of $200 a month. After having said insurance for 6 months I went in for a pap-smear and was told I had a minor yeast infection and was given a prescription. Two months later I recieved a bill for almost $600 from my insurance company. They informed me that I had a PRE-EXISTING CONDITION. WTF! They made me pay for everything out of pocket. I complained all the way up the ladder and it did no good. I canceled said insurance, but not before it cost me $1200 in insurance payments and $600 for my office visit. Could I have sued? Sure. But I'm not the type. You people are so worried about the government miss spending our money on health insurance, but I have a feeling that I wouldn't end up paying $1800 for a damn yeast infection.
Some of the harshest critics of Obama's plan are Dems because they recognize that as written, it changes NOTHING. All it does is expand access to the same lousy pay for service plan that we have now. It does NOTHING to control costs; NOTHING to make people responsible for their own care; nothing to reverse the perverse incentives that we have now.
What Obama could and should do is junk the current plan and support Wylen- Bennet which inter alia increases portability and will help control costs.
miabella
09-06-2009, 11:54 AM
I get some peoples fear of Obama-Care but this country needs some health care reform. I'm sick to death of Republicans poo pooing all over this Bill and not making any real attempt to contribute to it in a meaningful way. All they want to do is rip it apart and not add anything to it. Several years ago I decided to purchase health insurance at the cost of $200 a month. After having said insurance for 6 months I went in for a pap-smear and was told I had a minor yeast infection and was given a prescription. Two months later I recieved a bill for almost $600 from my insurance company. They informed me that I had a PRE-EXISTING CONDITION. WTF! They made me pay for everything out of pocket. I complained all the way up the ladder and it did no good. I canceled said insurance, but not before it cost me $1200 in insurance payments and $600 for my office visit. Could I have sued? Sure. But I'm not the type. You people are so worried about the government miss spending our money on health insurance, but I have a feeling that I wouldn't end up paying $1800 for a damn yeast infection.
so because you chose to buy insurance for pap smears, which are practically given away free with a box of chocolates in many locales, you think we need single payer-- for paps, which you can easily get free or for about 100$, and which are annual.
you chose to pay 2400$/yr (annual cost) for something that is about 100$ in cash. even the scrip for the minor infection would have been cheap, too (tons of generics).
this is the problem-- people think 'insurance' should pay for annual basics that doctors really do keep low-price when directly dealing with the patient.
a lot of hospitals and clinics give away the sort of care you're talking about. there was no reason you needed insurance to pay for that at all.
Eric Stoner
09-21-2009, 10:13 AM
Obama has said he will not sign any health care plan that is not revenue neutral. Obama has said that: "To prove I'm serious, there will be a provision in this plan that requires us to come forward with more spending cuts if the savings we promised don't materialize." The problem is that there is nothing, NOTHING , that will require Congress to cut a penny. If you don't believe it, try to find out what's happened to the Medicare cuts that Congress enacted in a prior effort to restrain out of control Medicare spending. Every year since 2003, Congress has waived the cuts. Who seriously thinks that Congress won't do the exact same thing ? Cats don't bark.
Obama SAYS that illegal immigrants will not be covered BUT all 4 bills in Congress allow illegals to get in on the Health Insurance Exchange. The Democrats twice voted down provisions requiring illegals to present proof of citizenship.
Obama claims he will control costs by eliminating "waste, fraud and abuse" from Medicare. What has he been waiting for ? Why doesn't he eliminate it now ? Because it doesn't exist. It's a stock political phrase that is substituted for actual, real and serious cuts that are both painful and politically costly. Nobody wants to impose them because they will hit a large political voting bloc.
Obama's original rationale for health care reform was that it helped cause the financial crisis. Who seriously believes that Lehman Brothers failed because of a lack of universal health care ? Then it was supposed to cure the deficit. Any effort to keep a straight face tanked when the CBO demonstrated staggering deficits thanks partly to this health plan.
Now Obama is recoiling from the charge that his plan represents a substantial middle class tax increase. The CBO projects that requiring everyone to buy insurance will require them to pay 15% of their income for coverage. By 2016 someone earning $32,000 a year will have to pay about $4,000 in premiums BEFORE qualifiying for any subsidy. and that doesn't include deductibles and co-payments. A family of four with an income of $80,000 would have to pay over $10,000 in premiums plus co-pays and deductibles. If they don't, the fines for not doing so will almost equal the premiums. Nobody would be permitted to buy policies that only cover them for "catastrophic care" even though such policies are MUCH cheaper.
The whole purpose of the bill is to force healthy people who neither want nor need comprehensive coverage to buy it to subsidize those that need it.
threlayer
09-21-2009, 12:18 PM
Some of the harshest critics of Obama's plan are Dems because they recognize that as written, it changes NOTHING. All it does is expand access to the same lousy pay for service plan that we have now. It does NOTHING to control costs; NOTHING to make people responsible for their own care; nothing to reverse the perverse incentives that we have now....
Procedure based plans are still what we have come back to after toying with the concept of prepaid plans not based on procedures. That was called the HMO system. Big business got into it and commercialized many of the plans and also started doing dirty deeds too and so fell into disfavor. Non-profit HMO plans (which I believe were much better actors) and commercial HMO plans both are in severe disfavor. The problem with this HMO system is that charges to the HMOs were still procedure-based, and had to be reflected on their subscriber rates.
Obama's plan out line recognizes this problem and it encourages detailed plans ideas. The really big problem hereis that the Republicans want all of Obama's stuff to fail so they can win at the mid-term elections. As a result the whole health-care planning process is essentially partisan. I would like very much to see some Republican principles factored into this crucial topic. But they do not want to contribute, only to shoot down with little in the way of ideas. I can think of only a few contributions they have suggested, such as tort reform (limiting penalties for mistakes, an important topic which I have discussed in this forum a lot).
The problem with this tort reform idea is that it requires a much bigger system improvement (to greatly reduce mistakes) including introducing some technology that many doctors do not want to become involved with because it would point out the source of many errors. The idea should be to improve the system, not punish the mistaker makers, but they don't get it.
The big problem in Washington is that too many elected officials are much more loyal to their party (and themselves) than they are the the welfare of the US itself.
Eric Stoner
09-21-2009, 03:10 PM
Procedure based plans are still what we have come back to after toying with the concept of prepaid plans not based on procedures. That was called HMO system. Big business got into it and commercilized many of the plans and also starteed doing dirty deeds too and so fell into disfavor. Non-profit HMO plans (which I believe were much better actors) and commercial HMO plans both are in severe disfavor. The problerm with this HMO system is that charges to the HMOs were still procedure-based, and had to be reflected on their subscriber rates.
Obama's plan out line recognizes this problem and it encourages detailed plans ideas. The really big problem hereis that the Republicans want all of Obama's stuff to fail so they can win at the mid-term elections. As a result the whole health-care planning process is essentially partisan. I would like very much to see some Republican principles factored into this crucial topic. But they do not want to contribute, only to shoot down with little in the way of ideas. I can think of only a few contributions they have suggested, such as tort reform (limiting penalties for mistakes, an important topic which I have discussed in this forum a lot).
The problem with this tort reform idea is that it requires a much bigger system improvement (to greatly reduce mistakes) including introducing some technology that many doctors do not want to become involved with because it would point out the source of many errors. The idea should be to improve the system, not punish the mistaker makers, but they don't get it.
The big problem in Washington is that too many elected officials are much more loyal to their party (and themselves) than they are the the welfare of the US itself.
I'm sorry but you are completely ignoring the ACTUAL political situation. The Democrats do not need a single Republican vote in the House. Not one.
In the Senate, the problem for the Dems is NOT the Republicans. It is a shaky proposition that the Dems could even get a simple majority to vote in favor of the House plan . And the Baucus plan is on shaky ground in a number of quarters for a number of reasons. Even in Baucus' own Finance Committee where a LOT of his fellow Dems are pissed off that they were excluded from formulating the plan he came up with.
Why do you think Susan Collins has gained such huge importance in the Senate ?
Because if the Dems can get her to sign on they can point to her and her alone as evidence of their "bi-partisanship".
The Republicans have not had to be obstructionist. Democrats are doing all of their work for them. The Republicans have proposed their own solutions. At the top of the list is a TRUE bi-partisan bill; Wylen-Bennett.
threlayer
09-21-2009, 11:30 PM
Why do you say I'm ignoring it? I fully realize they have not (yet) obtained a single Republican vote for any Democratically-engineered plan. I'm saying it would be better for us all if they parties cooperated because they could (and should) come up with a better plan for all of us.
Again why do you say that? I thought I expressed myself well and that my post was actually worth a careful reading and possibly a comment. But sidestepping my posts and attributing to me something I did not say does not indicate a carefully crafted response.
The Republicans are as obstructionist as they most certainly ever have been with Clinton. I know there are individuals who people like to point to as the leaders of partisan politics here. But that's just so much political posturing. This not a kid's game where you can just take your marbles out and go home. Obama asked all to come up with productive ideas and try to mix and match the best ones. That is not being done. Their initial flat refusal to cooperate in a bpartisan solution has meant that the Dems have had to go it alone. Not even all the more centrist Dems like what has been proposed yet, indicaing that more bipartisan work is needed.
threlayer
09-21-2009, 11:50 PM
PROPOSAL: Maybe a plan with remuneration based on how healthy the subscribers are kept would be better than one based on how much work is given to sick patients. Individual providers would get a base rate per subscriber and an incentive rate based on how well they managed the health of their subscribers and the cost of items and meds required, with due consideration given to their individual conditions--not on how unhealthy they are. Facilities would be reimbursed based on how well and efficiently they managed their facilities and its contribution to the health of the subscribers. Insurance carriers (and all would have to carry insurance) would provide the service of distributing out the pay to providers and facilities following standardized rules. And subscribers woud be reimbursed (or their individual rated discounted) based on their compliance with healthcare directives assigned to them by their providers. This would also give employers an incentive to assure healthful working conditions and programs promoting compliance with healtful living practices.
This is very different than what we have and the dollars would come out differently. I believe such an outline could be made workable.
But with so much fear over how much additional costs adding yet another layer to our existing costs would be (following the existing unworkable and antiquated system), no one is able to go much further than fight about the public sector. And that may turn out to be the most unimportant factor in the productive and creative revolution in our healthcare system. Which we are not getting out of Congress.
Eric Stoner
09-22-2009, 08:00 AM
Why do you say I'm ignoring it? I fully realize they have not (yet) obtained a single Republican vote for any Democratically-engineered plan. I'm saying it would be better for us all if they parties cooperated because they could (and should) come up with a better plan for all of us.
Again why do you say that? I thought I expressed myself well and that my post was actually worth a careful reading and possibly a comment. But sidestepping my posts and attributing to me something I did not say does not indicate a carefully crafted response.
The Republicans are as obstructionist as they most certainly ever have been with Clinton. I know there are individuals who people like to point to as the leaders of partisan politics here. But that's just so much political posturing. This not a kid's game where you can just take your marbles out and go home. Obama asked all to come up with productive ideas and try to mix and match the best ones. That is not being done. Their initial flat refusal to cooperate in a bpartisan solution has meant that the Dems have had to go it alone. Not even all the more centrist Dems like what has been proposed yet, indicaing that more bipartisan work is needed.
Because the Republicans have every right NOT to sign on to any plan that is demonstrably disastrous. So far, ALL of the Democrat proposals would expand coverage but would NOT control costs. That is SUPPOSED to be the primary objective but NONE of their proposals comes close.
Secondly, because the Republicans have NOT been listened to. Instead they are expected to shoulder all the blame for the public's opposition to the Democrat proposals.
Third, because there are bi-partisan proposals that would pass immediately with about 70 votes in the Senate like Wyden- Bennett.
Fourth, because the Republicans are admittedly taking some partisan advantage just like the Dems did when Bush tried to make Social Security solvent.
It's amusing that the Republicans get blamed when it's the Dems who are shooting off their own toes.
threlayer
09-22-2009, 08:58 AM
^^ You're talking about the partisan situation in DC. Yet you complained that I was not aware of it in my post. I contend that is just not true and that you misread my post and started this unnecessary diatribe.
This thing has reguired, right from the start, "brainstorming sessions" where all ideas are spread out on the table with proposers able to refine their own ideas in the presence of others. Only then would such ideas be refined, combined, and picked apart to arrive at the best compromised plan. This technique is NOT used in DC at all, and likely cannot be used, by Congressional rules, until the Senate and House versions are combined.
Absent destructive partisanism and deep entrenchment, this technique can produce the best compromise. I know it can, because I've successfully used it for years in my profession. But in DC destructive partisanism and deep entrenchment is largely the rule, and so they can never come up with a decent path to compromise and thus to a best solution. Each party is fighting for its own ideas, thinking that the other party is the enemy. Where in actuality, the partisanism is the enemy and is destroying the country which they were elected to preserve. The problem with partisanism, again, is that it puts the country second or lower.
It's amusing that the Republicans get blamed when it's the Dems who are shooting off their own toes. That is much of a partisan statement as you have ever made here, and there are plenty of those. In reality both parties are to blame equally; just look at the last few decades of history in DC.
Because the Republicans have every right NOT to sign on to any plan that is demonstrably disastrous.But they also have the obligation to propose plans that actually try to solve the entire problem of healthcare quality and cost, not just their own ideas of low-bidder cost or selected lobbyist-endorsed projects.
Eric Stoner
09-22-2009, 09:30 AM
^^ You're talking about the partisan situation in DC. Yet you complained that I was not aware of it in my post. I contend that is just not true and that you misread my post and started this unnecessary diatribe.
This thing has reguired, right from the start, "brainstorming sessions" where all ideas are spread out on the table with proposers able to refine their own ideas in the presence of others. Only then would such ideas be refined, combined, and picked apart to arrive at the best compromised plan. This technique is NOT used in DC at all, and likely cannot be used, by Congressional rules, until the Senate and House versions are combined.
Absent destructive partisanism and deep entrenchment, this technique can produce the best compromise. I know it can, because I've successfully used it for years in my profession. But in DC destructive partisanism and deep entrenchment is largely the rule, and so they can never come up with a decent path to compromise and thus to a best solution. Each party is fighting for its own ideas, thinking that the other party is the enemy. Where in actuality, the partisanism is the enemy and is destroying the country which they were elected to preserve. The problem with partisanism, again, is that it puts the country second or lower.
That is much of a partisan statement as you have ever made here, and there are plenty of those. In reality both parties are to blame equally; just look at the last few decades of history in DC.
But they also have the obligation to propose plans that actually try to solve the entire problem of healthcare quality and cost, not just their own ideas of low-bidder cost or selected lobbyist-endorsed projects.
Initially I responded to your post that blamed the Republicans for lack of progress
When the Dems control both houses of Congress and the Presidency ? Likewise your suggestion of "brainstorming" was certainly ignored by the Dems in the House who sought ZERO Republican participation and arguably was ignored by Max Baucus who tried to write a bill with only six senators.
For decades, Republican proposals to actually control costs were stopped by the Dems. How soon we forget how Clinton not only vetoed Gingrich's attempt to control Medicaid costs AND used his re-write of history to get reelected in 1996.
There was also Republican legislation that passed to control Medicare increases but the Dems have refused to implement the cost controls.
In additon to Wylen- Bennet there ARE Republican proposals to increase access and control costs. The best one was introduced by Wisconsin Congressman Paul Ryan and Tom Coburn in the Senate.
threlayer
09-22-2009, 01:06 PM
Very few times has Congress (both parties) brainstormed about anything except about how to avoid effctive ethics rules.
I blame Republicans for not finding some way to participate, probably for fear that Obama would inevitably get the credit for any contribution they might make. We've got a huge problem to solve and they are thinking about what their own advantage is. I blame the Democrats for not trying to incorporate creatively the Repubs in the effort which should certainly be bipartisan. Soooo, I blame both, as I've clearly (or hope I did) stated a few times.
Eric Stoner
09-23-2009, 08:11 AM
Very few times has Congress (both parties) brainstormed about anything except about how to avoid effctive ethics rules.
I blame Republicans for not finding some way to participate, probably for fear that Obama would inevitably get the credit for any contribution they might make. We've got a huge problem to solve and they are thinking about what their own advantage is. I blame the Democrats for not trying to incorporate creatively the Repubs in the effort which should certainly be bipartisan. Soooo, I blame both, as I've clearly (or hope I did) stated a few times.
I'm sorry but this is one of the most nonsensical wish fathered thoughts you have EVER posted. The Republicans are supposed to somehow elbow their way into the bill writing process ? The Dems in the House did NOT want their participation. The Speaker is a Democrat. The Committee Chairman is a Democrat. They want a DEMOCRAT Health Plan.
We are dealing with POLITICAL animals more concerned with their own perks, privileges and reelection than anything else. Stop expecting them to act like statesmen unless they have a gun to their heads. Ever try to train a cat to bark ? Then stop expecting Congress to act other than it's perceived self interest.
Btw, who was it that proposed that ALL Americans get the same health plan as members of Congress get ? Hint- it was NOT the Democrats. That's right. The Republicans proposed that all Americans get to choose among over 300 different plans which they'd be able to do with interstate marketing.
threlayer
09-23-2009, 10:34 PM
I'm saying how it should be done, not describing the asinine way it is actually done. A more careful reading (taking a few seconds more) would have indicated that.
Eric Stoner
09-24-2009, 07:36 AM
I'm saying how it should be done, not describing the asinine way it is actually done. A more careful reading (taking a few seconds more) would have indicated that.
If I inadvertently gave short shrift to one or two of your posts then I apologize.
Afaic, how things ought to be with regard to Congress is essentially irrelevant. It's nothing more than wishful thinking.
Melonie
09-25-2009, 07:00 AM
yet more 'unintended consequences' being uncovered in the National Health Care bill ..
(snip)"There is one provision in the Baucus health care proposal that I believe needs to be changed. It’s known as the “free rider” provision.
Under the Baucus plan, if a worker cannot get health insurance from their employer, the government will provide a subsidy to help the worker purchase insurance (which they are mandated to do). The subsidy varies with the worker’s income level and other variables such as the number of children.
Employers who do not provide health insurance to their employees must pay a fee to compensate the government for the subsidy it gives to the firm’s workers, and to level the playing field between firms who do and do not offer coverage. The problem is that the fee the firm pays is linked to the size of the government subsidy the worker receives, and as just noted the subsidy depends upon the worker’s income level and other factors such as enrolling children in the plan.
The effect is that a firm not offering health insurance would pay a higher fee when it employs a low income individual or an individual with children. A low income single parent, for example, would cost the firm much more to hire than the spouse of a high income individual or a teenager from a high income household, meaning they’d be much less likely to hire that single parent."(snip)
from
In the way of discussion, under the latest proposal US businesses that do not provide health insurance to their workers will still be required to pay a new 'health care tax', but that new 'health care tax' will now be directly linked to the actual costs of gov't subsidies paid out to the company's workers to purchase health insurance. Earlier discussions of the new 'health care tax' on US businesses that did not provide health insurance for their employees involved flat percentages.
As laid out in the article or based on general health insurance principles, the cost of health insurance being purchased by any individual is primarily proportional to the size of their family (i.e. total number of insured dependents). Also, the amount of gov't subsidy payment which will / may be made available to that individual is inversely proportional to their income level, and directly proportional to the size of their family. If you put all of these pieces together, under the latest proposal any US employer who does not directly provide health care for workers will now have to pay the government back for the actual cost of their subsidy payments to those workers. This will result in far higher costs to that US employer if they ...
- hire a new employee who is married / has a family ( as opposed to a single person )
- hire a new unskilled employee whose low pay rate makes them eligible for higher gov't health insurance subsidy payments ( which the employer is required to reimburse the gov't for)
- hire a new employee who is not already covered under a parents' or spouses' employer provided health insurance plan
^^^ obviously all of these factors will wind up affecting future hiring decisions
I would also note that where independent contractor dancers are concerned, it is very probable that their 'business' will become subject to this new 'health care tax'. Thus some research needs to be quickly done as to whether uninsured independent contractor dancers are better off purchasing private health insurance coverage through their 'business', or purchasing private health insurance coverage as an individual. At the very least, it appears that the latest National Health Care proposal would de-facto eliminate any gov't subsidy payment for the purchase of health insurance regardless of the independent contractor's income level, since any gov't subsidy payment made to the individual dancer will be immediately 'taxed back' out of the independent contractor dancer's 'business' earnings.