H.R. 3950 - Patient Protection and Affordable Care Act

[Gawain 0]

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So, now you don't have "full VA benefits"? Is that what you're saying? I wasn't the only vet on here calling you out at that time. I am not doing so now, because how you carry yourself is not my concern. You did say however, "I have full VA benefits".

Yes, for a 1-term vet I have full vet benefots. Not as a lifer. I'm not sure what I can get with teh VA as a 1-term vet, but I think it's sketchy, they don't cover everything and if you make toomuch they cut you. I briefly checked it once. With all the cuts, they're even talking about limiting or taxing/charging lifers for their medical.

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Now I will ask, what Group are you in the VA? You know that the moratorium for Group * vets has been lifted. So, how can you not have coverage, if not by choice?

I think I heard there was a moratorium, probably under that humanitarian GHWB, but no, I haven't checked it. Again, this HC isn't about me, it's the nation. As well, they could limit or exclude 1-termers anyway, so to hang my hat on vet HC is not wise. This problem needs to be fixed regardless of me, unless a person is a Republican and feels having a military 8 times that of #2 and being the most indebted nation in the world because of it is more important.

Well, as out of touch as you are with what's been happening with the VA this year, let along a multitude of other factors, I submit that you are being less than honest as to your disposition as a whole (regardless of status as a vet, person, etc.). Especially with the VA, we had a grand discussion about some of that here.

Hang your hat where you want - you are discredited. You can't tell the difference between "real" media, and satire. You claim to be a vet with full VA benefits without knowing what those benefits are (or even know what "Group" you might fall under or what the criteria of how they're determined), and are woefully uninformed in facets of common components surrounding this debate as a whole.

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!

[Ron 7]

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The problem comes exactly from the fact that some people do not want pay those premiums.

And people don't want to pay taxes either and 50% of the US does not pay taxes now.

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If you have other ideas how would we prevent people from getting medical service and not paying for it, I'd like to hear it.

Unless you plan on making EVERYONE to include illegals pay taxes.... They are still going to be getting services and not paying for them.

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Apparently the problem here is that "personal responsibility" thing just does not work. Even here when recently discussing about skydiving without health insurance (and the sport is expensive, so the people obviously have enough money to get at least some insurance), and some people still said it's fine to do so.

Yes, so your solution is to create a Govt agency when in the past Govt agencies have proven to NOT run well?

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What about UPS/FedEx?

They do not compete with the USPS. For example UPS and FedEx are not allowed to deliver to Post Office Boxes by LAW. And by LAW UPS and FedEx are not allowed to deliver non urgent letters. The relevant laws are called Private Express Statutes.

So in this case to be comparable, Private HC providers would not be allowed to say, give physicals or immunizations.

Also the Post Office *IS* in the US Constitution: Article I, section 8, Clause 7

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What about private schools? What about Stanford University?

Care to compare the level of education between those and the average public school?

PLUS, in your examples the public entities can tap into the deficit and private company's cannot.

Care to discuss AMTRAK?

Started with 40B in 1970.
1981 1.25B in Govt funds.
1986 was a good year and we only had to put in 608M
1995 it was almost bankrupt and 1997, 1998, 1999, 2000, a 2001 it ate up 5.2B in tax dollars.
2004-2005 it ate another 1.2B
2006 it took another 1.4B
The "Rail Safety Improvement Act of 2008" now gives AMTRAK 2.6B a YEAR till 2013.

All the while it has been cutting services.

That the kind of HC program you want?

Lets talk about the VA system:

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In December 2004, it was widely reported that VA’s funding crisis had become so severe that it could no longer provide disability ratings to veterans in a timely fashion.

2009 the HC budget was $38.7B and that was to cover only 5.5M people who used the services. 38.7B for 5.5M people.... With over 300M people in the US how much do you think THAT would cost?

http://www1.va.gov/opa/fact/vafacts.asp

Medicare a good example?:

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A looming Medicare shortage is seven times the size of the one that Social Security faces and nearly four times the entire federal debt

Its running even worse than Social Security.... In 2004 it started paying out more than it took in in taxes... Now anyone with ANY business sense knows you can't pay more out than you take in.

Social Security a good example?

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Social Security supports 47 million people, most of whom are elderly and disabled. It is the largest federal program at $517 billion this year.

And it is not running well by any standard. It is the largest program and it only covers 47M out of the 307M you propose should be covered.

"No free man shall ever be debarred the use of arms." -- Thomas Jefferson, Thomas Jefferson Papers, 334

[georgerussia 0]

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So, stated another way, because some people are not responcible, you think gov should take this over for all of us?

Yes, this is correct. If everyone was responsible and act honestly and reasonably, we wouldn't need police and prisons. We wouldn't even need tax withholding, security guards, and so on. But so far no country in the world succeed here, so it's utopia.

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( I should have said "punished" all of us but I will leave it as I did for debates sake)

Yes, this would be wrong. If you're a reasonable person and understand that you need to maintain insurance, the law which requires it (the "punishing" part) would have no effect on you at all.

* Don't pray for me if you wanna help - just send me a check. *

[georgerussia 0]

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USPS is not the federal government. Sure it gets around 96 million from the feds annually but turns a profit of about 1 billion.

According to Wiki, "The United States Postal Service (USPS) is an independent agency of the United States government". If you go ">there to check the list of other "indepentent agencies", you'd find there CIA, EPA, FCC, FTC, NASA, SSA; so they ARE government agency pretty much as those are.

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Love it when you guys say private schools compete with state schools. The top 10 have tuition and fees of nearly $40K per year. Some more than that. Without grants and scholarships, many which are paid by the government, not many of the average folks in this country would be able to afford $160K for a degree.

Government-paid scholarship for a private school? That's the first time I heard about it; could you please provide more details? And why would one go to a so expensive private school instead of going to a free public school? It is obvious a private school cannot compete on price - they cannot pay students to attend school - and still it's not easy to get into one!

Some private universities have their own aid program; Stanford university, for example, provides deep discounts (down to full subsidy) for eligible students.

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I haven't read the bill. I haven't read War and Peace either.

Seems like somehow reading became a dying skill in US, which is unfortunate. Well - sorry, pal, such a complex legislation simply cannot fit into a couple of Twitter messages.

* Don't pray for me if you wanna help - just send me a check. *

[georgerussia 0]

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And people don't want to pay taxes either and 50% of the US does not pay taxes now.
Unless you plan on making EVERYONE to include illegals pay taxes.... They are still going to be getting services and not paying for them.

You should understand that there is a difference between someone who is legally not required to pay federal tax, and someone who just does not want to pay federal tax because they want to spend money on new iPhone instead.

My understanding is that healthcare bill should deal with healthcare issues. Dealing with illegal immigration should be another issue. A lot of people already complain about 2,000 pages bill - do you really wanna it to come to 5,000?

However I'm open to hear your ideas how would you implement providing service to everyone but illegals? Share your wisdom please.

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Yes, so your solution is to create a Govt agency when in the past Govt agencies have proven to NOT run well?

They do not compete with the USPS. For example UPS and FedEx are not allowed to deliver to Post Office Boxes by LAW. And by LAW UPS and FedEx are not allowed to deliver non urgent letters. The relevant laws are called Private Express Statutes.

They ARE competing with the USPS. For example, this year I only used USPS for all my deliveries (using standard rate priority box), while last year I mostly used UPS for the same stuff.

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So in this case to be comparable, Private HC providers would not be allowed to say, give physicals or immunizations.

Well, if you claim that public option would set up government hospitals, which employs doctors who would be government employees on government-regulated salaries, I would challenge you to find such provisions in the bill. If not, please explain what you mean by "private HC providers".

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Also the Post Office *IS* in the US Constitution: Article I, section 8, Clause 7

Is CIA? Is SSA? Is FCC? Is FTC? They are all pretty much same independent agencies as USPS is.

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Care to compare the level of education between those and the average public school?

That's another option. Like health insurance - if you want good quality, pay more. If you want it cheap, pay less - you'll get lower quality. And not everyone strives for quality - my kids, for example, go to public school.

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Care to discuss AMTRAK?

Please remind me whether is it the same AMTRAK the government had to take over from private railroads when they bankrupted, while those private industries should have been much more superior to lousy government management?

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That the kind of HC program you want?

Now let's compare the numbers before government takeover, and we will see!

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Lets talk about the VA system:
In December 2004, it was widely reported...

Sorry, I do not believe in facts when they are introduced as "widely reported" or "someone said". Such arguments are only useful to fox "news" viewers, and probably not even to all of them.

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2009 the HC budget was $38.7B and that was to cover only 5.5M people who used the services. 38.7B for 5.5M people.... With over 300M people in the US how much do you think THAT would cost?

I didn't know the healthcare bill supposed to provide free healthcare to everyone in the US. Are you claiming that? If so, could you please quote the bill? If not, why are you trying to scale VA spending to everyone?

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A looming Medicare shortage is seven times the size of the one that Social Security faces and nearly four times the entire federal debt.

And again you're not comparing the numbers with the private industry. If they followed the private health insurers, who kick out (likely into Medicare) everyone too expensive, and increases premiums 20% yearly during last ten years, they would be in much better shape. Instead they accept everyone, and increase their costs around 0.9% yearly.

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Its running even worse than Social Security.... In 2004 it started paying out more than it took in in taxes... Now anyone with ANY business sense knows you can't pay more out than you take in.

Is it still paying its claims, or it already followed superior private industries like Enron, WorldCom, AIG, Lehman, GM, Madoff... ?

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And it is not running well by any standard. It is the largest program and it only covers 47M out of the 307M you propose should be covered.

You might want to be more careful regarding standards. I wonder how well the Social Security would run if the trust fund was managed by a superior private industry company like the one owned by Bernie Madoff?

* Don't pray for me if you wanna help - just send me a check. *

[Gawain 0]

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Also the Post Office *IS* in the US Constitution: Article I, section 8, Clause 7

Is CIA? Is SSA? Is FCC? Is FTC? They are all pretty much same independent agencies as USPS is.

No they are not. Not even by a long shot. All of those agencies you cited are headed by political appointments by the President and confirmed by the Senate.

The USPS is not a political appointment. Hasn't been about 40 years when they restructured the department and it used to be a cabinet level department.

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!

[georgerussia 0]

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No they are not. Not even by a long shot. All of those agencies you cited are headed by political appointments by the President and confirmed by the Senate.

Who heads them is irrelevant in discussed content. My point was that all those agencies are still part of the government.

* Don't pray for me if you wanna help - just send me a check. *

[d16842 0]

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I'll repeat it again. How will this make it more affordable?

- by cutting down the number of people who go to ER and do not pay, therefore having someone else (you and me) paying for it through increased premiums;

It doesn't cut costs at all, for those of us who earn enough to pay taxes. At best it just changes the mechanisim of how we pay for it. Today we pay for the poor's medical expenses through our insurance cost. Tomorrow it willl be paid via our income taxes. Either way, we are going to pay for health care of the poor.

But remember, most people's employers pay the majority of insurance costs. They don't pay your income taxes. This bill may end up shifting payment for the poor, from companies to us.

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- by increasing the insurance pool by requiring people to buy insurance;
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I strongly disagree with that one. While that is the bill's intent, I believe the language of the bill could do exactly the opposite. Here is the math that explains why.

Today, people pay $12,000 or so per year for a full family plan. Few healthy families have even 1/4th that in medical costs, but purchase insurance because it mitigates the huge financial risk of a major illness down the road.

But under the new law, insurance companies will be required to cover pre-existing conditions. This removes any risk in not purchasing insurance.

So with the new law, you can safely elect to forgo insurance, and pay your on medical costs. For most healthy families this is no more than $3,000 per year. Add to that the $750 fine for not buying insurance. You annual cost drops from $12,000 (plus deductable, plue co-pay, etc.) all the way down to $3,750. If this law passes with the pre-existing condition language, and only a $750 fine, healthy people will be nuts to purchase insurance untill they have an expensive illness.

If many people do that, the insurance companies will go bust. The only income source they have to pay the really expensive cases, is with healthy people buying the $12,000 insurance.

I have company funded insurance. But if I paid for my own, the first thing I would do after this bill passes is to cancel my health insurance. I would save a lot of money. So would most.

Tom B

[georgerussia 0]

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It doesn't cut costs at all, for those of us who earn enough to pay taxes. At best it just changes the mechanisim of how we pay for it. Today we pay for the poor's medical expenses through our insurance cost. Tomorrow it willl be paid via our income taxes. Either way, we are going to pay for health care of the poor.

I'm not talking about taxes. Didn't your insurance premium go up at all during last 10 years beyond switching the age group? Then you're lucky, as according to statistics average premium went up 219% during last ten years.

The cost saving goes from the fact that treating sore throat in ER is much more expensive than threating it in doctor's office or urgent care clinic. At this moment those have no other options where to go.

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But remember, most people's employers pay the majority of insurance costs. They don't pay your income taxes. This bill may end up shifting payment for the poor, from companies to us.

Then the employer would just pay you more.

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So with the new law, you can safely elect to forgo insurance, and pay your on medical costs. For most healthy families this is no more than $3,000 per year. Add to that the $750 fine for not buying insurance. You annual cost drops from $12,000 (plus deductable, plue co-pay, etc.) all the way down to $3,750. If this law passes with the pre-existing condition language, and only a $750 fine, healthy people will be nuts to purchase insurance untill they have an expensive illness.

Lawmakers obviously understand that, and that's why the fine will likely be higher (in my opinion it should be the same as the cheapest insurance which provides the amount of coverage required by the government standards). Note that insurance lobby would fight for it as well.

Another issue here is that applying for insurance is not something you can do in five minutes (even now it takes a week or more), and if you have an appendix burst or broken ankle, you are unlikely to wait this week until your application is approved. Then it would likely eat all the savings from last five years.

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I have company funded insurance. But if I paid for my own, the first thing I would do after this bill passes is to cancel my health insurance. I would save a lot of money. So would most.

If you're a young healthy family, why wouldn't you just get a 80/20 HSA plan with something like 5K deductible? It would cost then something like $3000 a year, which is pretty cheap insurance policy for a family, and your medical expenses are tax deductible using your HSA account.

* Don't pray for me if you wanna help - just send me a check. *

[airdvr 200]

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Then the employer would just pay you more.

Umm...yea...from the money machine they have in the back room. I'd laugh if that statement wasn't so sad. This bill will most likely shift the burden of insurance even more onto the back's of business. Most group plans require the employer to participate at least 50%. There are a ton of smaller businesses out there that won't be able to survive.

Please don't dent the planet.

Destinations by Roxanne

[Ron 7]

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You should understand that there is a difference between someone who is legally not required to pay federal tax, and someone who just does not want to pay federal tax because they want to spend money on new iPhone instead.

If you read the quote again, you will see it has two parts separated by the AND.

But YOU clearly dodged the question.... How do you expect to pay for this program? Are you going to start taxing those that currently pay no taxes?

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My understanding is that healthcare bill should deal with healthcare issues. Dealing with illegal immigration should be another issue. A lot of people already complain about 2,000 pages bill - do you really wanna it to come to 5,000?

Are you going to ignore all the issues that influence the HC problems? Coverage of illegals adds COST with no remuneration and creates a situation where the program cannot be sustained. Not having a program that does not add to the deficit means the program is bound to either fail, or take something else down to try and keep it floating.

You think that just passing a bill means it will work? You think just throwing money at a problem is the answer?

How do YOU plan on paying for this bill? Are you going to tax people who currently DO NOT pay taxes? How are you going to absorb the cost of illegal HC? All of these are issues that need to be solved, not ignored.

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They ARE competing with the USPS. For example, this year I only used USPS for all my deliveries (using standard rate priority box), while last year I mostly used UPS for the same stuff.

By law THEY ARE NOT ALLOWED. I bet you never sent a non-urgent service letter with UPS. I don't know how much clearer that could be... I cited the names of the law as well AND gave examples. You can't just ignore the facts when it does not suit you.

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Well, if you claim that public option would set up government hospitals, which employs doctors who would be government employees on government-regulated salaries, I would challenge you to find such provisions in the bill. If not, please explain what you mean by "private HC providers".

You need to read my example again. For the USPS example you claim to be the same as the medical issue.... Then the Govt would pass laws that ONLY Govt Dr's could perform certain functions and that it would be illegal for private Dr's to perform those functions.

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Is CIA? Is SSA? Is FCC? Is FTC? They are all pretty much same independent agencies as USPS is.

They are nowhere NEAR the same.

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If you want it cheap, pay less - you'll get lower quality. And not everyone strives for quality

Not everyone wants their HC in the hands of the Govt. The same Govt who did syphilis testing on civilians.

AND you know that would never be the case. People want HC for free... Next they will want the same HC Bob gets for free.

Ever had US Govt HC? I have and I can tell you that my private Dr is MUCH better.

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Please remind me whether is it the same AMTRAK the government had to take over from private railroads when they bankrupted, while those private industries should have been much more superior to lousy government management?

So to compare... You think that the failed HC system will somehow work better when the Govt takes over even though we know from AMTRAK that is not the case?

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Sorry, I do not believe in facts when they are introduced as "widely reported" or "someone said". Such arguments are only useful to fox "news" viewers, and probably not even to all of them.

So you don't have answers to simple questions, but will not listen to data unless you have vetted it? Ok, here is the cite,

Cheryl L. Reed, “VA chief orders inspector to probe disability rating system,” Chicago Sun-Times, 11 December 2004

Now, quit dodging and discuss the TOPIC since I have provided the source.

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If not, why are you trying to scale VA spending to everyone?

It does not matter the SCALE the current system is running a deficit, you think a LARGER system will not?

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Is it still paying its claims,

It is pretty clear you don't care one bit about the economics problems and just want free HC. You have avoided giving any answers that discuss economics and just keep spouting how you want free.

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You might want to be more careful regarding standards. I wonder how well the Social Security would run if the trust fund was managed by a superior private industry company like the one owned by Bernie Madoff?

Again, how about you answer the questions about the programs?

This pretty much says all you want is a check: "* Don't pray for me if you wanna help - just send me a check. * "

Now care to discuss the issues or are you just going to continue to avoid them and demand free stuff?

"No free man shall ever be debarred the use of arms." -- Thomas Jefferson, Thomas Jefferson Papers, 334

[d16842 0]

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It doesn't cut costs at all, for those of us who earn enough to pay taxes. At best it just changes the mechanisim of how we pay for it. Today we pay for the poor's medical expenses through our insurance cost. Tomorrow it willl be paid via our income taxes. Either way, we are going to pay for health care of the poor.

The cost saving goes from the fact that treating sore throat in ER is much more expensive than threating it in doctor's office or urgent care clinic. At this moment those have no other options where to go.

This is an example of why we score so badly in math. While the bill you speak of is much higher, the actual COST of treating a cold in an ER is only marginally different than in an urgent care clinic. The doctor and nurses are paid about the same, as are the instruments, drugs, etc.

Only the bill is different, because of all the overhead burden included in it. But guess what. That overhead still must be paid for when you pull all of the non emergency cases out of the ER. It will show up somehow, somewhere, and we still must pay it, lest the hospital go bankrupt.

I agree we need to move those cases out of the ER, but we need to stop kidding ourselves about the great savings it will bring, as they just are not there.

Tom B

[d16842 0]

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It doesn't cut costs at all, for those of us who earn enough to pay taxes. At best it just changes the mechanisim of how we pay for it. Today we pay for the poor's medical expenses through our insurance cost. Tomorrow it willl be paid via our income taxes. Either way, we are going to pay for health care of the poor.

I'm not talking about taxes. Didn't your insurance premium go up at all during last 10 years beyond switching the age group? Then you're lucky, as according to statistics average premium went up 219% during last ten years.

I know you are not talking taxes, that is the problem. Your share of the national health care bill is what you pay for medical care (directly or with insurance) PLUS what you pay in taxes for other peoples care. If you only look at insurance costs it might look great, but you are only seeing part of the costs of the new system.

If your insurance costs go down $1,000, but your taxes go up $2,000, you have not saved $1,000, instead you lost that much.

None of this bill addresses the root problem. That is the actual cost of delivering health care. Not the bills, but the delivery cost. All we are doing is smearing the bills around differently, and on a national policy level, that accomplishes nothing.

But if you don't pay taxes, it must look great. Because you push your share off on other people to pay.

Tom B

[Gawain 0]

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I'm going back to this particular point, because this flies directly in the face of a post you made some time ago:
http://www.dropzone.com/...post=3330479#3330479

So your saying due to me being a vet I have benefits? I've never applied to the VA for that, just my VA loan qual years ago. I don't know that they accept everyone and they can deny based upon income, etc. A lifer has comprehensive benefits for life, a 1-termer I don't think does and they can be limited.

And let's take the spotlight offf of me, I want all Americans to have HC regardless of vet status.

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How can you have full VA benefits and not have health care? Remember, the benefits you earned serving in the Air Force (so you say), with hopefully some pride?

So now you doubt my vet status. OMG, as if a 4-year stint in the military is a big accomplishment . If I were gonna lie, I could do better than that.

You must not be a vet, a 1-termer doesn't have the golden slipper for lifetime HC. Again, even if I did, explain how the other non-vets get covered. See, your example illustrates my point that conservatives are just worried about themselves, I want all Americcans to have HC regardless of anything.

emphasis mine...

Do you even know who you're talking/writing to? How I missed that little gem I'll never know. If you were a vet, which you clearly aren't, then you'd know what health-care options you have with the VA, whether service connected or not.

Later dude. Keep bragging about your service. I'm sure it impresses someone, somewhere...

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!

[georgerussia 0]

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I know you are not talking taxes, that is the problem. Your share of the national health care bill is what you pay for medical care (directly or with insurance) PLUS what you pay in taxes for other peoples care. If you only look at insurance costs it might look great, but you are only seeing part of the costs of the new system.
If your insurance costs go down $1,000, but your taxes go up $2,000, you have not saved $1,000, instead you lost that much.

According to bill there are two categories which would see more taxes: those whose plan cost exceeds 24K (can't remember exact number), and those families making over 1M a year. In both cases all I can say about this - I wish I had their problems.

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None of this bill addresses the root problem. That is the actual cost of delivering health care. Not the bills, but the delivery cost. All we are doing is smearing the bills around differently, and on a national policy level, that accomplishes nothing.

So I'm looking to how would YOU fix this problem of lowering down the actual cost of delivering health care? You already acknowledged the cost is too high, and therefore something need to be done, but what?

* Don't pray for me if you wanna help - just send me a check. *

[georgerussia 0]

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This is an example of why we score so badly in math. While the bill you speak of is much higher, the actual COST of treating a cold in an ER is only marginally different than in an urgent care clinic. The doctor and nurses are paid about the same, as are the instruments, drugs, etc.

Ok, let's see the math. I went to ER once for a sore throat when I just arrived to the country and didn't know about urgent care clinics. According to insurance statements, the total cost of my visit charged by ER + physician was ~$2500, for which insurance paid $800 plus my $100 copay. This was in 2005, so the numbers must be higher in 2009. Now, checking urgent care: $25 copay, the facility charged $325 and the insurance paid $125. The difference I see is at least 4x in actual costs, and 8x in charged costs.

If you have other numbers, please share them.

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I agree we need to move those cases out of the ER, but we need to stop kidding ourselves about the great savings it will bring, as they just are not there.

As I always say, it's very easy to criticize everything. It's only when you start seriously think what would YOU do, it gets more complex, and then most of the bill suddenly makes sense.

* Don't pray for me if you wanna help - just send me a check. *

[Gawain 0]

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This is an example of why we score so badly in math. While the bill you speak of is much higher, the actual COST of treating a cold in an ER is only marginally different than in an urgent care clinic. The doctor and nurses are paid about the same, as are the instruments, drugs, etc.

Ok, let's see the math. I went to ER once for a sore throat when I just arrived to the country and didn't know about urgent care clinics. According to insurance statements, the total cost of my visit charged by ER + physician was ~$2500, for which insurance paid $800 plus my $100 copay. This was in 2005, so the numbers must be higher in 2009. Now, checking urgent care: $25 copay, the facility charged $325 and the insurance paid $125. The difference I see is at least 4x in actual costs, and 8x in charged costs.

If you have other numbers, please share them.

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I agree we need to move those cases out of the ER, but we need to stop kidding ourselves about the great savings it will bring, as they just are not there.

As I always say, it's very easy to criticize everything. It's only when you start seriously think what would YOU do, it gets more complex, and then most of the bill suddenly makes sense.

In all honesty, we need to move insurance out of the routine care business. There are some doctors that do not accept insurance. They can operate more efficiently without having a full staff to manage nothing but insurance paper work. Ask any doctor what a "cash" fee is. In many cases, they can offer a break, because the overhead from insurance is virtually eliminated.

Catastrophic coverage for health care is a far better option. It is the basis for every other type of insurance we use.

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!

[justinb138 0]

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In all honesty, we need to move insurance out of the routine care business. There are some doctors that do not accept insurance. They can operate more efficiently without having a full staff to manage nothing but insurance paper work. Ask any doctor what a "cash" fee is. In many cases, they can offer a break, because the overhead from insurance is virtually eliminated.

Catastrophic coverage for health care is a far better option. It is the basis for every other type of insurance we use.

What we consider "health insurance" isn't insurance. It's pseudo-prepaid medical coverage. The closest comparison I can make would be auto insurance coverage covering car washes and oil changes.

What other type of insurance covers routine and expected events?

[Gawain 0]

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In all honesty, we need to move insurance out of the routine care business. There are some doctors that do not accept insurance. They can operate more efficiently without having a full staff to manage nothing but insurance paper work. Ask any doctor what a "cash" fee is. In many cases, they can offer a break, because the overhead from insurance is virtually eliminated.

Catastrophic coverage for health care is a far better option. It is the basis for every other type of insurance we use.

What we consider "health insurance" isn't insurance. It's pseudo-prepaid medical coverage. The closest comparison I can make would be auto insurance coverage covering car washes and oil changes.

What other type of insurance covers routine and expected events?

Exactly. That's why this whole farce in the Senate and the House has nothing to do with reform, but with mandates and control, ultimately rationing of money, care, quality...add to the list.

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!

[georgerussia 0]

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If you read the quote again, you will see it has two parts separated by the AND.
But YOU clearly dodged the question.... How do you expect to pay for this program? Are you going to start taxing those that currently pay no taxes?


Yes, the bill starts taxing things which weren't taxed before, and increases taxes for some income groups. Maybe it's time for you to stop listening to fox "news" and actually read the bill yourself.

While I do not like the way only the "rich" pay for it (I'd rather have it the way Social Security is built - everyone pays their share, small or not), I also understand that you cannot really tax a couple making 40K a year, as there is not a lot of money.

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Are you going to ignore all the issues that influence the HC problems? Coverage of illegals adds COST with no remuneration and creates a situation where the program cannot be sustained. Not having a program that does not add to the deficit means the program is bound to either fail, or take something else down to try and keep it floating.

This has been already addressed in legislation - being in country illegally is against the law. It doesn't make any more sense to address it from a legislative branch - it is already illegal, and they should not be there.

And I see you yourself have no ideas how would you provide healthcare to anyone but illegals.

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How do YOU plan on paying for this bill? Are you going to tax people who currently DO NOT pay taxes? How are you going to absorb the cost of illegal HC? All of these are issues that need to be solved, not ignored.

Have you read the bill? A significant part of it is devoted to how it is going to be paid for. If you're really interested, why wouldn't you just read it?

The cost of illegal HC is already being absorbed, and will not increase unless more illegals come to the country - illegals already use ERs for non-emergency services.

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By law THEY ARE NOT ALLOWED. I bet you never sent a non-urgent service letter with UPS. I don't know how much clearer that could be... I cited the names of the law as well AND gave examples. You can't just ignore the facts when it does not suit you.

So are you saying that delivering letters is what most commercial delivery companies do, and is the core of their business? Because if it's not, then your example is kinda irrelevant, right?

From what I know, majority of shipping revenue comes from packages, especially urgent packages - and this is where the main competition is. Note that despite this horrifying disadvantage USPS has over private companies, they are still in a much better shape than privately run Enron or GM.

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You need to read my example again. For the USPS example you claim to be the same as the medical issue.... Then the Govt would pass laws that ONLY Govt Dr's could perform certain functions and that it would be illegal for private Dr's to perform those functions.

You need to read the actual bill, so your examples would represent what is being discussed in legislature, not what your pastor or favorite talk show host thinks about it.

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They are nowhere NEAR the same.

According to Wiki, they are in the same category "government independent agencies". You did not provide any proof to support your statement.

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Not everyone wants their HC in the hands of the Govt. The same Govt who did syphilis testing on civilians.
AND you know that would never be the case. People want HC for free... Next they will want the same HC Bob gets for free.
Ever had US Govt HC? I have and I can tell you that my private Dr is MUCH better.

This is my favorite. Since "not everyone wants their HC in the hands of the Govt", then public option should be obviously banned - and this is coming from Republicans, who claim they want to offer people choice!

It is fine if YOU personally do not want to use public option - just keep your private insurance, the bill allows it. However there are people around who might find public option better for them in terms of price/quality. You might say that with shrinking pool of people willing to pay for private insurance it will cost you more, but then why should everyone subsidy your choice if they believe public option is better for them? You know, it's kinda socialist from your side to restrict other people choices by forcing them to do what YOU consider to be "the only right thing".

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So to compare... You think that the failed HC system will somehow work better when the Govt takes over even though we know from AMTRAK that is not the case?

Well, it IS the case. You just need to compare with what would happen with Amtrak if the government did NOT take it over - and you will see.

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So you don't have answers to simple questions, but will not listen to data unless you have vetted it? Ok, here is the cite,

Cheryl L. Reed, “VA chief orders inspector to probe disability rating system,” Chicago Sun-Times, 11 December 2004

Now, quit dodging and discuss the TOPIC since I have provided the source.

I see no facts introduced by your cite, and you did not provide a link, so there is nothing to discuss. If you expect me to go to a library to request 2004 Chicago Sun-Times, then think again.

You're saying VA is run poorly? Bring the numbers, and compare with the numbers from private industry I posted recently. Then we will see.

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It does not matter the SCALE the current system is running a deficit, you think a LARGER system will not?

It does, because VA system is not subscription-based, while the current larger system is.

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It is pretty clear you don't care one bit about the economics problems and just want free HC. You have avoided giving any answers that discuss economics and just keep spouting how you want free.

Because you're not discussing anything. You're trying to turn the discussion your way, pretty much as your talk show hosts do. As it doesn't work, you start your typical "avoided giving answer" drama. Unfortunately you didn't read the bill, so everything you're discussing did not come from the actual law, and there is little value in such discussion anyway.

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Again, how about you answer the questions about the programs?

What program? You said Social Security is not running well by any standard. Well, by the standard AIG, Madoff and Lehman were running (and a lot of banks are), Social Security is running very well. This is pretty obvious why you didn't comment on the facts as they contradict what you said, and lowered yourself down to typical right-wing propaganda. Unfortunately, the facts are against you - somehow you expect the government to run things perfectly, and give huge leeway to private industries when comparing standards.

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This pretty much says all you want is a check: "* Don't pray for me if you wanna help - just send me a check. * "

No, this is not all I want - I would also like a free blowjob from Jesus.

* Don't pray for me if you wanna help - just send me a check. *

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[kelpdiver 2]

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This is an example of why we score so badly in math. While the bill you speak of is much higher, the actual COST of treating a cold in an ER is only marginally different than in an urgent care clinic. The doctor and nurses are paid about the same, as are the instruments, drugs, etc.

Ok, let's see the math. I went to ER once for a sore throat when I just arrived to the country and didn't know about urgent care clinics. According to insurance statements, the total cost of my visit charged by ER + physician was ~$2500, for which insurance paid $800 plus my $100 copay. This was in 2005, so the numbers must be higher in 2009. Now, checking urgent care: $25 copay, the facility charged $325 and the insurance paid $125. The difference I see is at least 4x in actual costs, and 8x in charged costs.

WTF do you keep going to the hospital for 'sore throats?' Drink fluids and rest. The reason why costs won't go down when people don't have to go to the ER is that they will go more often.

And you missed his point, as well as the difference between charges and costs.

Charge = what you + your insurance paid. This isn't the list rate, it is the actual amount paid.

Cost = what it took the hospital to provide the service - mostly labor costs. The difference of charge - cost = profit.

His point was that the cost is essentially the same for the ER and the urgent care clinic. They charge different rates because they can in our current system. And to discourage people from going to the ER for issues they could resolve at home on their own.

[georgerussia 0]

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What we consider "health insurance" isn't insurance. It's pseudo-prepaid medical coverage. The closest comparison I can make would be auto insurance coverage covering car washes and oil changes.

Only very small part of it is prepaid, and this is pretty much negligible. For example, all insurance plans I've been on only covered one routine checkup per year - not a significant source of savings. So if insurance company pays the doctor up to $100 for this visit, subtracting a $20 copay (assuming you're on a good plan) you're prepaying $7 a month for this routine checkup. Not a significant source of savings.

* Don't pray for me if you wanna help - just send me a check. *

[justinb138 0]

What surprises me is that little reference has been made to the Mass. plan, on which, if I'm not mistaken, the federal program is modeled after.

Here's a link to a recent Rasmussen poll .

In short, it says only 32% consider the plan successful, and that 75% believed that the quality of care stayed the same (51%), or got worse (24%).

The original projections for the program were to cover 215,000 people at a cost of 725 million, but now is expected to cover 342,000 at 1.35 billion.

I don't know the numbers, but I know it's had budget issues. Here's an article about it, although I'm not familiar with the source:

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With drop in employment, this year the programs has a budget shortfall of over $300 million. State is trying to devise a ways to close the shortfall.

Under the ideas being tossed around, over a million low income Massachusetts residents covered by medicaid will be required to pay more for doctor visits and receive prior approval for some medications. Some of the notable changes will be in dental care. Adults will no longer receive dentures or other cares except the cleanings and emergency services.

This itself is going to bring in about $15 million. Interim Medicaid Director Terence Dougherty said ” “What other states are doing is eliminating services. What we are charged with doing” is to keep as many necessary services as we can, “and to realize that people won’t get every single thing they got in the past.”

[georgerussia 0]

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WTF do you keep going to the hospital for 'sore throats?' Drink fluids and rest. The reason why costs won't go down when people don't have to go to the ER is that they will go more often.

Urgent care is not hospital or ER. It's like a regular doctor office which employs several doctors, does not require appointments and charge the same copay as doctors. They do not treat uninsured as well unless you pay cash. It's also close to my home, and since I do not have my doctor, when I feel sick, I just go there.

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And you missed his point, as well as the difference between charges and costs.
Charge = what you + your insurance paid. This isn't the list rate, it is the actual amount paid.
Cost = what it took the hospital to provide the service - mostly labor costs. The difference of charge - cost = profit.

So what I quoted was charge (actual amount - I received it on "explanation of benefits"). My point was that ER charged significantly more for the same service, and it's likely because their costs are significantly larger.

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His point was that the cost is essentially the same for the ER and the urgent care clinic.

No, they are not. UC clinics are not required to treat uninsured, or even to accept state insurance or Medicare, so every service they provide is paid for. This is not the case for ERs.

* Don't pray for me if you wanna help - just send me a check. *

[justinb138 0]

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Only very small part of it is prepaid, and this is pretty much negligible. For example, all insurance plans I've been on only covered one routine checkup per year - not a significant source of savings. So if insurance company pays the doctor up to $100 for this visit, subtracting a $20 copay (assuming you're on a good plan) you're prepaying $7 a month for this routine checkup. Not a significant source of savings.

My point is that it's not designed to cover an unexpected or catastrophic event like all other forms of insurance are. How often are people expected to make claims on Homeowner's or Auto insurance policies? It's a fairly rare event for most people.

Health insurance is expected to cover routine events, like a doctor's visit due to a common illness - an expected and likely event.

How much would car insurance cost if the government said it had to cover oil changes and car washes? How much of an increase in administrative costs for the insurance company would there be? How much more would your $20 oil change cost if each service place had to hire a few people to bill insurance companies?