Health Care "Overhaul"

[Gawain 0]

The House Ways and Means Committee voted to move a bill which would raise taxes by half-a-trillion dollars. But it's on the "rich" so it's okay right? http://news.yahoo.com/s/ap/20090717/ap_on_go_co/us_health_care_overhaul

This is what pisses me off about the democrat party most: they have effectively moved the discussion on this topic so far to the left, that to be considered "center", you have Sen. McConnell saying we shouldn't be rushing on the matter. Not even against it. Just sell out, and slow the sh*t down, even in the face of the CBO saying the following:

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CBO Director Douglas Elmendorf said of the legislation so far, "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. And on the contrary, the legislation significantly expands the federal responsibility for health care costs."

So, costs go up???

What the hell happened to the debate to reform insurance? You know why health care costs so much here?

-- Malpractice insurance
-- Over cautious testing on the insured to cover every contingency, effectively going beyond "preventative"

Another factor is over regulation at a local level. States mandate minimum coverages for health plans by insurance providers. It increases the overhead costs, as well as costs to consumers and/or small businesses.

Health Savings Accounts have proven to be very beneficial because it removes the tax liability to the user, while having a higher deductible, while providing vastly superior coverage once the deductibles are met.

Another factor to reduce costs: reduce insurance involvement. Doctor offices have to recoup the costs of playing the insurance paperwork game, often double, or triple booking appointments and maintaining an entire staff of people to manage all the paperwork.

To revive a recently noted link: http://www.projo.com/news/content/HEALTH_ACCESS_01-17-08_7A8L2NU_v19.24317c9.html This solution all but eliminates the need to comprehensive 100% coverage, and an insurer could do much better by offering an a-la-carte of urgent/emergency coverages.

The reality is though, that the conservatives are on the sidelines, they aren't even a factor in this debate because the democrats and liberals can push this through with no need of bi-partisan support. The debate is solely on the side of the democrats -- "how much to tax or spend?" is the discussion...

So I try and I scream and I beg and I sigh
Just to prove I'm alive, and it's alright
'Cause tonight there's a way I'll make light of my treacherous life
Make light!

[Andy9o8 0]

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The reality is though, that the conservatives are on the sidelines, they aren't even a factor in this debate because the democrats and liberals can push this through with no need of bi-partisan support. The debate is solely on the side of the democrats -- "how much to tax or spend?" is the discussion...

You grossly over-estimate the political ability of some on the Democratic side to make that happen. Public hue and cry will not be successfully ignored. The end product will be a compromise, or it won't happen.

[TomAiello 25]

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You know why health care costs so much here?

While I'm not arguing your points, which I think are valid...

I've been to the hospital in several other countries, and in the USA. It's my opinion that one reason why our healthcare costs more is simply because it's better.

I realize that this is a very politically incorrect view. Nowadays, we all have to agree that we need to find "efficiencies" because other countries deliver healthcare cheaper. Honestly, I don't think they're more efficient. I think they're cheaper largely because they are buying less healthcare at relatively similar prices.

This whole "we can do it better for cheaper" is basically a pipe dream.

Remember the old saw: "Speed, Quality, Price--pick any two" ?

It applies here. In the USA we've got Speed and Quality, and we pay a bit more for them. Other countries have sacrificed both speed and quality, and I, for one, would rather that we not do the same.

Could we make our system more efficient? Sure. Could we change some things (mostly government imposed things) about insurance and government payment, and cut some costs? Sure.

But are those things really going to deliver our same quality of care at a fraction of the cost? I don't think so.

"I want everything, and I want it for free" seems to be the American Mantra these days. Unfortunately, at some point, reality must take precedence over public relations, and we have to realize that we can't get everything we have now and pay a fraction of the cost.

-- Tom Aiello

[email protected]
SnakeRiverBASE.com

[TomAiello 25]

Here's a cute video.

-- Tom Aiello

[email protected]
SnakeRiverBASE.com

[Darius11 12]

Lets see in a state where not every one is covered there is less wait, but in a state where every one is there is more wait? Hmmmmmm i wonder why.


Could it be that everyone who needs to go see a dr. actually can in MA?? and in the other state you can go to the emergency room after an easy fix turns in to a life-threatening emergency.


I mean if I can afford health insurance, why would I want the poor to have health insurance too, that could be a waist of time for me........How patriotic.

I'd rather be hated for who I am, than loved for who I am not." - Kurt Cobain

[justinb138 0]

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Lets see in a state where not every one is covered there is less wait, but in a state where every one is there is more wait? Hmmmmmm i wonder why.


Could it be that everyone who needs to go see a dr. actually can in MA?? and in the other state you can go to the emergency room after an easy fix turns in to a life-threatening emergency.


I mean if I can afford health insurance, why would I want the poor to have health insurance too, that could be a waist of time for me........How patriotic.

Nice try.

Only about 10-11% of people that are uninsured truly "can't afford it".

A very significant percentage of the uninsured make $50k+ annually, and simply chose not to purchase insurance.

So I should have to pay for health care for those that choose not to purchase insurance? How patriotic.

[Darius11 12]

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Nice try.

Only about 10-11% of people that are uninsured truly "can't afford it".

A very significant percentage of the uninsured make $50k+ annually, and simply chose not to purchase insurance.

Really So where did you get these numbers?


And do you really think people making over 50K say fuck my health or they choose to pay their bills? I can't think of anyone who thinks health is no big deal. Most don't get it because guess what it costs too much.



As for patriotism I thought saving your fellow citizens lives would be a high priority, but I guess for some it only applies when we kill some brown people, or put a yellow ribbon on the truck.

I'd rather be hated for who I am, than loved for who I am not." - Kurt Cobain

[justinb138 0]

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Really So where did you get these numbers?

http://www.nber.org/digest/may03/w9281.html

Where'd you get yours? Oh, wait, you didn't give any, you just made an emotionally-based blanket statement. Good times.

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And do you really think people making over 50K say fuck my health or they choose to pay their bills? I can't think of anyone who thinks health is no big deal. Most don't get it because guess what it costs too much.

Yes, I do. People may just choose to spend their money on other stuff.

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As for patriotism I thought saving your fellow citizens lives would be a high priority, but I guess for some it only applies when we kill some brown people, or put a yellow ribbon on the truck.

For me I'd like to have the option to help people. How is the government taking my money at the point of a gun patriotic in any way, shape, or form?

I believe that people are generally good and will help those in need, whereas you appear to believe that they're not and the government must force them to.

Why is that?

[rickjump1 0]

And do you really think people making over 50K say fuck my health or they choose to pay their bills? I can't think of anyone who thinks health is no big deal. Most don't get it because guess what it costs too much.

...........Darius, there are people who can afford health insurance, but pass. It's a gamble they are willing to take. Under my company's plan, I paid an extra premium for my family. A co-worker cancelled his, and his wife broke her back in an vehicle accident. It was his choice.


As for patriotism I thought saving your fellow citizens lives would be a high priority, but I guess for some it only applies when we kill some brown people, or put a yellow ribbon on the truck.
........ You don't have a yellow ribbon on your pickup?

Do your part for global warming: ban beans and hold all popcorn farts.

[Darius11 12]

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Where'd you get yours? Oh, wait, you didn't give any, you just made an emotionally-based blanket statement. Good times.

Will its more a belief, that everyone should have health care. For all the things our taxes get spent on I can’t think of a better priority then the health of my fellow citizen.

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Yes, I do. People may just choose to spend their money on other stuff.

Yea like food, and rent.

At over 300 bucks a month I would say that it is not affordable. Not to mention you can get dropped, and denied claims are a source of adding to the profit for the ins companies. Again I am ok with insurance companies not making mopney on peoples illness.
I rather see them get treated.

As for emergency care anyone can tell you prevention is a lot cheaper then letting a problem get to a point of emergency.

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For me I'd like to have the option to help people. How is the government taking my money at the point of a gun patriotic in any way, shape, or form?

When your money save another citizens life i would say that is very patriotic.

The government takes your money and my money for so much shit I just find it very odd that guys always perching about morals, and patriotism have dug their heals in when it comes to their fellow citizens health. Knowing that we all get sick knowing that if you do get something horrible and not a millionaire your fucked.

Again Helth care is not 10 bucks a month, i am young and healthy and got a very midocare plan it was about 300 a months. I don;t know about you but thats a lot of money.

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I believe that people are generally good and will help those in need, whereas you appear to believe that they're not and the government must force them to.

Why is that?

Because I live in the real world, and know plenty of good hard working people who simply can not afford insurance. If every one was being treated because of others good will then we would not be having this discussion would we.

I'd rather be hated for who I am, than loved for who I am not." - Kurt Cobain

[TankBuster 0]

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I realize that this is a very politically incorrect view.

Precisely - that's why it makes so much sense. I'll go a step futher. Medical care is a market driven service, just like any other service, not a right guaranteed by the constitution. Any attempt to make it so only changes the method of rationing. Price or bureaucrats. Pick one.

The forecast is mostly sunny with occasional beer.

[TomAiello 25]

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Lets see in a state where not every one is covered there is less wait, but in a state where every one is there is more wait? Hmmmmmm i wonder why.

And it costs 3 times as much? Seems to me we're already losing out on price _and_ wait time.

-- Tom Aiello

[email protected]
SnakeRiverBASE.com

[TomAiello 25]

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It's a gamble they are willing to take.

Of course, if they lose the gamble, they want us to bail them out.

Sounds a bit like AIG Financial Products, doesn't it?

-- Tom Aiello

[email protected]
SnakeRiverBASE.com

[TankBuster 0]

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Again I am ok with insurance companies not making mopney on peoples illness.
I rather see them get treated.

Any company that doesn't make money won't be in business long. That would be wonderful for the medical industry. IF the feds would get out of the picture totally, and we had some sanity in malpractice laws, those companies that provided the best care at the best price would rise to the top. But that would require me to put down my beer and cigarettes, get out from in front of the TV or xbox, and actually make my own informed decisions on how to proceed, wouldn't it?

In a free society, how do you get them treated? In your "forced goodwill" society you either rob from the populace at gunpoint to pay the doctors or you put a gun to the doctor's head and force him to do it. I'd rather have a free society.

Wake up. This is all about political power and money, not helping your fellow citizen. Social security was sold under the same false premise, and look at the shape its in.... We can't be trusted to take care of ourselves, so we need a huge federal government to do it. Same shit different day.

The forecast is mostly sunny with occasional beer.

[TomAiello 25]

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Will its more a belief, that everyone should have health care.

It would be very easy, and cost a fraction of the price, to provide health care for every uninsured person in the USA today.

All you need to do is open up this existing government health plan to open enrollment from any US citizen. At current rates, if we funnelled every single uninsured person into this plan and had the federal government pay their premiums, it would cost less than any proposal currently in Congress.

It would even be fairly simple to set up some kind of means testing, and pay for (for example) anyone who had a household income less than 50k/yr. And it would still be cheaper than anything being considered by congress.

Why aren't we doing this?

Simple. Because the people in power don't want the "commoners" reducing the quality of their health plans.

-- Tom Aiello

[email protected]
SnakeRiverBASE.com

[TomAiello 25]

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Again I am ok with insurance companies not making mopney on peoples illness.

Did you ever read that article I linked for you the last time we talked about this? The one comparing for profit and non-profit care, and finding that the non-profit was charging five times as much as the for-profit hospital across town?

Or is it easier to just ignore the evidence and keep claiming that "non-profit" somehow makes things cheaper, despite plentiful evidence to the contrary?

-- Tom Aiello

[email protected]
SnakeRiverBASE.com

[TomAiello 25]

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At over 300 bucks a month I would say that it is not affordable. Not to mention you can get dropped, and denied claims are a source.

Someone making $50,000 per year can't afford $3,600 per year for health coverage?

Sounds to me like they made a choice to buy something else (maybe jump tickets?) instead. Why do I have to pay for their choice?

-- Tom Aiello

[email protected]
SnakeRiverBASE.com

[Darius11 12]

I am not saying the bill in congress is the end all be all solution.

All I am saying is that every one should have health insurance. I just don’t think having millions of people who can not afford it, or the expanse is so high that at times they have to choose not to get it is good for the country.

I don’t understand the arguments against that. I can understand if you disagree with the method, or have different viewpoint about how it should be done. However I don’t think the option of some people are just fucked as they are now should even be on the table. I also don’t think when someone gets sick really sick they should have to worry about how and if they can afford treatment.

We are too good of a country to allow that to happen.

I'd rather be hated for who I am, than loved for who I am not." - Kurt Cobain

[TomAiello 25]

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I don’t understand the arguments against that.

People have a right to choose to take risks. They can go skydiving, ride a motorcycle, have unprotected sex and engage in other risky behavior. They also have a right to not buy a health plan, and spend their money on jump tickets instead. It's risky, but that's their right.

Forcing them to buy a health plan eliminates their right to choose.



If you're worried about poor people, all you'd need to do is open up the federal employees plan to (for example) anyone making less than 20k for an individual or 50k for a family, with the government paying the premiums.

It's simple, effective, and ready to roll tomorrow. It's also cheaper than anything currently on the table.

But our "leaders" will be damned if they're going to let the common people into their own health plan. I mean, where's the privilege of being in Congress if that happens? It's exactly the same reason DC won't give poor children vouchers to go to the same school as Sasha and Malia Obama--we can't have the riff-raff in here where we are.

Your outrage (and that of people like you) is being hijacked to push a political agenda. Welcome to Washington!

-- Tom Aiello

[email protected]
SnakeRiverBASE.com

[pirana 0]

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CBO Director Douglas Elmendorf said of the legislation so far, "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. And on the contrary, the legislation significantly expands the federal responsibility for health care costs."

What the hell happened to the debate to reform insurance? You know why health care costs so much here?

-- Malpractice insurance
-- Over cautious testing on the insured to cover every contingency, effectively going beyond "preventative"

Another factor is over regulation at a local level. States mandate minimum coverages for health plans by insurance providers. It increases the overhead costs, as well as costs to consumers and/or small businesses.

Health Savings Accounts have proven to be very beneficial because it removes the tax liability to the user, while having a higher deductible, while providing vastly superior coverage once the deductibles are met.

Another factor to reduce costs: reduce insurance involvement. Doctor offices have to recoup the costs of playing the insurance paperwork game, often double, or triple booking appointments and maintaining an entire staff of people to manage all the paperwork.

To revive a recently noted link: http://www.projo.com/news/content/HEALTH_ACCESS_01-17-08_7A8L2NU_v19.24317c9.html This solution all but eliminates the need to comprehensive 100% coverage, and an insurer could do much better by offering an a-la-carte of urgent/emergency coverages.

Insurance is not why health care costs so much (unless that reference is to malpractice). The admin fees paid to insurance companies (not-for-profits at least) are roughly the equivalent of 1 year's increase in cost of care (what the providers charge). And in all the negotiations I've been involved in, I've never ever seen a provider start out by asking for anything less than a double-digit increase in their reimbursement rates. It's absolutely ridiculous what they ask for - usually to make up for the abysmally low rates they get for Meidcare patients and for the indigent care they provide. In years when we had 2 to 4% inflation, the typical Twin Cities hospital starting point has been for about a 20% increase. That's fucking criminal!

Very dissappointing to see that what this administration is addressing largely ignores the fact that cost of care continues to rise at 2 to 4 times the rate of overall inflation. Very politically incorrect though to go after actual cost of care. And the paperwork game is a myth. They can shuffle codes all they want, the providers are going to get paid for the services rendered no matter. If anything, fraudulent coding practices are the only thing added by that activity. The codes are very standard in their value and their intended use; playing with them to run up the bill is fraud - pure and simple.

At least they seem to be discussing malpractice. Not sure how big of a component that is in doctor and hospital bills, but it must be significant.

What the Obama approach appears to be doing is just shuffling the burden around. I do not see any effort to decouple employment from insurance. Much of what they are doing by burdening small employers with insurance mandates and penalties is going to hurt small business - simply assinine.

Their version of reform appears to be to get the government deep into the commercial insurance biz, offering subsidized plans that commercial carriers are supposed to "compete" with, mandate that everybody play, tax the shit out of people to pay for it all, impose penalties on small businesses that already can not afford to offer coverage (that makes a lot of fucking sense), etc.

Ignored is the need to regulate all insurance at the Federal level, decouple insurance from employers, and eliminate the loopholes afforded to large business/political subdivisions/collective bargaining units.

That would be a good start.

Yes, I understand that much of this appears to be in agreement with what you posted, with maybe a couple of points in opposition. It just boils me that we have this chance to get it right, and they are going to just play the usual bullshit political games and end up making it worse.

" . . . the lust for power can be just as completely satisfied by suggesting people into loving their servitude as by flogging them and kicking them into obedience." -- Aldous Huxley

[AdamLanes 1]

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All I am saying is that every one should have health insurance.

Hey Darius, you are one of the wealthiest people in the world! Why are you advocating and waiting for the government to redistribute your wealth through force? Give away all your possessions now, and live like the majority of the people in the world, in dire poverty! Do you believe that citizenship in a certain country somehow makes you a better person, and therefore more deserving, than everyone else living in the world? Do you know the definition of racism? You are a hypocrite.

[TomAiello 25]

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-- Over cautious testing on the insured to cover every contingency, effectively going beyond "preventative"

Just an aside, but you know why doctors are overcautious, right?

Two words:

"John Edwards"

-- Tom Aiello

[email protected]
SnakeRiverBASE.com

[Darius11 12]

?????????????

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Darius, you are one of the wealthiest people in the world!

???????????????????????

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Why are you advocating and waiting for the government to redistribute your wealth through force?

just free healthcare


????????????????????????????????


was that a spasm or a post?

I'd rather be hated for who I am, than loved for who I am not." - Kurt Cobain

[TomAiello 25]

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Darius, you are one of the wealthiest people in the world!

???????????????????????

[TomAiello 25]

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To revive a recently noted link: http://www.projo.com/news/content/HEALTH_ACCESS_01-17-08_7A8L2NU_v19.24317c9.html This solution all but eliminates the need to comprehensive 100% coverage, and an insurer could do much better by offering an a-la-carte of urgent/emergency coverages.

Yes, but that's a private solution, being created and used by private parties. As such, there's no way for a politician to "save" us by using it, and nothing for them to take credit for after they "solve the crisis." Obviously, that's not going to fly in Washington.


Rules for political behavior:

(1) Can I call something (anything) a "crisis"?
(2) Can I give a bunch of money to my friends, and preferably tax the hell out of my opponents in the name of "saving" them from the "crisis"?
(3) Can I then take credit for "saving" everyone, even if I've made things worse?

Otherwise, how do you expect the politicians to justify their behaviors?

-- Tom Aiello

[email protected]
SnakeRiverBASE.com