Do you have healthcare currently? What is your view on the bill?

[mnealtx 0]

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I think most of these people who are so vociferously bitching about this HC bill COMPLETELY forget about preventative care, which saves vast amounts of money by virtue of catching things before they become catastrophic...requiring vastly greater amounts of money to "fix" what could have been prevented in the first place

Like the mammograms that gov't has decided you don't need until after age 50, you mean?

Mike
I love you, Shannon and Jim.
POPS 9708 , SCR 14706

[mnealtx 0]

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If you have health insurance you are already REQUIRED to pay for those who can't afford or don't have insurance. They turn up at the ER when sick or injured and the cost of their care ends up in our premiums. whether or not we want it to. Trouble is, that is just about the least efficient way imaginable for the cost of their care to be spread around.

So, we pay more in premiums because the hospitals pass on the cost to insurance companies, but we're not going to pay more in premiums once they can get ALL their care paid for?

Yeah, ok....

Mike
I love you, Shannon and Jim.
POPS 9708 , SCR 14706

[kallend 1,621]

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If you have health insurance you are already REQUIRED to pay for those who can't afford or don't have insurance. They turn up at the ER when sick or injured and the cost of their care ends up in our premiums. whether or not we want it to. Trouble is, that is just about the least efficient way imaginable for the cost of their care to be spread around.

So, we pay more in premiums because the hospitals pass on the cost to insurance companies, but we're not going to pay more in premiums once they can get ALL their care paid for?

Yeah, ok....

Preventive care is a whole lot cheaper than curative care.

...

The only sure way to survive a canopy collision is not to have one.

[DanG 1]

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Like the mammograms that gov't has decided you don't need until after age 50, you mean?

I know it's the party line and you're required to say it, but do you really believe this shit? Do you really believe that a medical panel announcing their opinion that mammograms for women under 50 do more harm than good is the same as, "gov't has decided you don't need [a mammogram] until after age 50?"

Not everything is a conspiracy by Obama to kill you and take your money.

- Dan G

[airdvr 197]

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Like the mammograms that gov't has decided you don't need until after age 50, you mean?

I know it's the party line and you're required to say it, but do you really believe this shit? Do you really believe that a medical panel announcing their opinion that mammograms for women under 50 do more harm than good is the same as, "gov't has decided you don't need [a mammogram] until after age 50?"

Not everything is a conspiracy by Obama to kill you and take your money.

How can you be so sure?

Please don't dent the planet.

Destinations by Roxanne

[Ion01 1]

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If you have health insurance you are already REQUIRED to pay for those who can't afford or don't have insurance. They turn up at the ER when sick or injured and the cost of their care ends up in our premiums. whether or not we want it to. Trouble is, that is just about the least efficient way imaginable for the cost of their care to be spread around.

And this is actually the problem with the system. Its government invovlement that was the problem so more government is not a fix. Government requires that everyone be treated whether they have insurance or can pay or not which raises premiums making it less affordable and provides no real incentive for people to ensure themselves as they will get treated anyways either due to governement regulation or lawsuit.
If the government was out of it cost would drop providing care to more people and if you didn't have money you either didn't get treated or you had to take a loan and actually pay for it somehow then there would be huge incentive for people to insure themselves. I know I will get the regular claims that I am an evil person because people would die becuase they didn't have insurance but listen to what is really being said there. What your really saying is that some people will die because they are responsible for thier own decisions just like in skydiving.
In addition, healthcare would actually treat far more people and be far more available that the socialized system which always results in long waits and refusal of treatments due to government debt. How is that a solution? How is that better? Fact is its not. If you really want to help people and provide care to as many as possible then get government out which will reduce cost and make people responsible for themselves.
Why should I have to work so hard to insure myself just to be punished for being responsible by having to pay for everyone else? Freedom does not mean equal results just equal opportunities. Everyone had the same opportunities to work hard in school and get good grades and work full time while going through college so you have no debt and to get a degree so you could get a job and work hard so you could provide for yourself and wife but if you didn't make that decision and your not in as good a position as I am don't claim its not fair. It actually is fair that you and I reap what we have sown. Its not fair to punish me for working so hard for the vast majority of my life and that is exactly what things like this and tax brackets and such are really about. Its about punish the successful. Its about punishing the people who worked hard or risked all they had to get investors so they could start a company (or fail and litterally loose everything).
And yes.....its fair that the children of successful people reap the benefits of thier parents success! I don't even have kids yet but even while in high school I worked hard so I could ultimately provide a good life for my children one day. Why should they be punished for my hard work and success? Its my money and I should be able to do whatever I want with it which mean if I want to spoil my children or if I want to blow it all on skydiving its my money but things like tax brackets, the healthcare bill, and ideas like redistribution of wealth (also known as communism) is about not letting me do what I want with MY money. Thats not freedom and if you want to do whats best for everyone then give them freedom. This is the only "greater good". It is the only way to truly provide for the most people.
And if you don't work hard for the first part of your life in school and don't go to college because you don't want to work full time to pay for it and because you didn't think it would help you get anywhere and you don't work hard at your job because you think your entitled to advance because of your age why should you not have to live with the consequences of your actions? How does rewarding people for not working hard and not making the right decisions benefit anyway? Fact is it doesn't.
We all understand that we are supposed to reward children for doing good and punish them when they do something bad. We even do it in skydiving! Do you think it would be good if everytime someone pulled low rather than punish them we rewarded them because supposedly wasn't fair? Would people stop pulling low? No soon everyone would be and we would have people dieing all the time and then we would regulate that everyone have AAD's and we would tax the people who jump more, becuase they can afford it, to pay for the AAD's and then we would regulate the manufacturers because its not fair they should make a profit on a life saving device and they couldn't produce enough AAD's for everyone so there would be a 6 month wait for then and you would only get one after you hurt yourself landing in trees due to a low pull, etc. Yet this is exactly the socialized healthcare system as seen in any country with socialized medicine. Its not a solution!

[mnealtx 0]

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but do you really believe this shit?

Want me to look up the reporting on it for you?

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Do you really believe that a medical panel announcing their opinion that mammograms for women under 50 do more harm than good is the same as, "gov't has decided you don't need [a mammogram] until after age 50?"

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Women younger than 50 do not need routine screening mammography for breast cancer, according to new government recommendations, which constitute a departure from other clinical guidelines for breast cancer prevention.

And women ages 50 to 74 need a screening mammogram only every two years, according to the new U.S. Preventive Services Task Force recommendation statement.

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Not everything is a conspiracy by Obama to kill you and take your money.

I don't recall making that statement - I'm sure it makes a nice strawman for you to flog, however.

Mike
I love you, Shannon and Jim.
POPS 9708 , SCR 14706

[wmw999 2,116]

Breast cancer is a topic near and not dear to my heart. My mother and her twin both died of it, so I'm considered high risk. Based on data, I'm not sure they're as effective as originally thought -- studies like this one in Denmark indicate they're not on a macro scale.

Upshot: Women with mammograms had a decrease in breast cancer. Women without mammograms had a similar decrease in breast cancer. Study conducted in Denmark.

Now, what's true on a macro scale might not be true for me, either because of individual circumstances (like predisposition towards breast cancer) or emotionally (let's say a good friend died of it and I'm just scared).

If the data does not support its providing enough good for the government to pay for it, then maybe the government shouldn't pay for it. Nothing says that women can't pay for them out of pocket. Average cost for a mammogram is about $100. I pay that much for my dermatologist when I go (every 5 years for a skin cancer screening) because I like her and she doesn't do insurance.

It's a lot if you don't have the money. But for the vast majority of people reading this, it's only a lot when you don't feel like paying for it.

Wendy P.

There is nothing more dangerous than breaking a basic safety rule and getting away with it. It removes fear of the consequences and builds false confidence. (tbrown)

[pirana 0]

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I think most of these people who are so vociferously bitching about this HC bill COMPLETELY forget about preventative care, which saves vast amounts of money by virtue of catching things before they become catastrophic...requiring vastly greater amounts of money to "fix" what could have been prevented in the first place

The tricky part is providing access to the care that will save money (or break even) without opening the floodgates to overutilization. It is proven that opening channels to increased care (especially when it is perceived as "free" by many at point of care) increases utilization across the board - to fraud, unnecessary care, needed care - everything. There is no definitive data available to determine whether the savings from improved preventive care and increased utilization will balance out. It will almost certainly lead to at least a slightly healthier population, but at what price.

Overutilization was a big problem back in the days of 100% coverage with no patient costs at point of care.

Kind of like crime prevention. We could quadruple our police forces and probably dramatically reduce crime, but at what price.

" . . . 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

[pirana 0]

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If you have health insurance you are already REQUIRED to pay for those who can't afford or don't have insurance. They turn up at the ER when sick or injured and the cost of their care ends up in our premiums. whether or not we want it to. Trouble is, that is just about the least efficient way imaginable for the cost of their care to be spread around.

It may not be the most efficient, but there is no proof it is the most expensive. It depends on the changes in consumer behavior (utilization) as a result of the changes.

I know it grates on people who's arguments are grounded in emotions, but there is a price threshold at which improved health becomes too expensive.

Similarly, we could turn the majority of kids in the world into highly educated, smart as a whip, knock your socks off professionals - but would we be willing to foot the bill for a 1:2 teacher to student ratio?

Everything has it's price, and that price should be known before commiting to a plan.

" . . . 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

[pirana 0]

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Nothing in this bill addresses the root cause of the problem...high costs of delivering the product. Until you address why it's so expensive to go to the doctor you have accomplished nothing.

Bingo. I spent less than 24 hrs in the system for a relatively routine surgery. The bill was $44K. When I see the doc at the office, I'm in the system for maybe 10 minutes, and the bill is anywhere from $100 to $500. Nothing in this addresses that (at least none of the stuff I've read so far).

I think the docs are going to get a rude awakening once it becomes apparent that rationing and price fixing will be the only way under a government run plan to bring costs down. Can you imagine ther response if we end up with a mandate that all docs accept reimbursements rates along the lines of Medicare - or even less?

" . . . 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

[pirana 0]

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Nothing in this bill addresses the root cause of the problem...high costs of delivering the product. Until you address why it's so expensive to go to the doctor you have accomplished nothing.

And that is because the insurance companies have no incentive to bargain costs down because they just pass them along, and the healthcare consumer is insulated from the cost. A single payer system is the way to fix that problem.

Why does a hospital charge $10 for an aspirin tablet? Because it can.

You know not what you speak of. That comment just showed me you are sorely lacking for information in this debate.

Insurance companies bargain like a MF with providers. And multiple companies bargaining with multiple providers is THE single biggest source of downward price pressure.

I directly participated in several negotiations over the years with major health care systems in the Twin Cities. In every single one the provider group was asking for at least double the cost indicated by pricing and utilization trends, and at least 4 times the cost of CPI. The only thing that kept them in check was the bargaining power of the large insurance companies via the cash flow they provided in the form of direct payments. If those large systems had to rely on direct payment from patients - they'd all be bankrupt.

Reminds me of when Wellstone/Clinton said they wanted more competition, but also wanted a single payer. 3 companies were not enough, but 1 was just right?

" . . . 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

[mnealtx 0]

It just seems to fly in the face of the stated need for MORE preventative medicine. Has the incidence of breast cancer in the 40-49 age decreased so much that it's no longer necessary?

From a Bloomberg article discussing the possible effects upon insurance coverage:

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J. Leonard Lichtenfeld, the American Cancer Society’s deputy chief medical officer, said the panel’s guidelines may affect insurance payouts. ‘Our hope is that insurers will not make any change in coverage,” Lichtenfeld said.

WellPoint Inc., the top U.S. health insurer by enrollment with 34 million members, pays for annual mammograms for women age 40 in the majority of its health plans. The Indianapolis- based company periodically reviews its reimbursement policies and “doesn’t adhere to any one source” for guidance, said Jill Becher, a company spokeswoman in Milwaukee.

The new guidelines, if widely adopted by physicians and insurers, could reduce the number of U.S. mammogram screenings by 58 percent, from the current 37.2 million annually to 15.6 million under a “worst-case scenario,” Junaid Husain, a Boston-based analyst at Soleil Securities, wrote in a note to investors today.

Mike
I love you, Shannon and Jim.
POPS 9708 , SCR 14706

[wmw999 2,116]

However, we need to evaluate what preventive medicine is effective. And, periodically, re-evaluate when more data is available. Just because something is statistically true at one time doesn't mean it is always statistically true. The conditions around it change.

Wendy P.

There is nothing more dangerous than breaking a basic safety rule and getting away with it. It removes fear of the consequences and builds false confidence. (tbrown)

[kallend 1,621]

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but do you really believe this shit?

Want me to look up the reporting on it for you?

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Do you really believe that a medical panel announcing their opinion that mammograms for women under 50 do more harm than good is the same as, "gov't has decided you don't need [a mammogram] until after age 50?"

***Women younger than 50 do not need routine screening mammography for breast cancer, according to new government recommendations, which constitute a departure from other clinical guidelines for breast cancer prevention.

Would that be a government sponsored panel of INDEPENDENT EXPERTS to which you refer?

If you're so SURE than all screenings are always good, go and have your prostate biopsied right now.

...

The only sure way to survive a canopy collision is not to have one.

[kallend 1,621]

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Nothing in this bill addresses the root cause of the problem...high costs of delivering the product. Until you address why it's so expensive to go to the doctor you have accomplished nothing.

And that is because the insurance companies have no incentive to bargain costs down because they just pass them along, and the healthcare consumer is insulated from the cost. A single payer system is the way to fix that problem.

Why does a hospital charge $10 for an aspirin tablet? Because it can.

You know not what you speak of. That comment just showed me you are sorely lacking for information in this debate.

Insurance companies bargain like a MF with providers. And multiple companies bargaining with multiple providers is THE single biggest source of downward price pressure.

I guess that's why pharmaceuticals are so much cheaper here than in Canada.

Oh, wait...

...

The only sure way to survive a canopy collision is not to have one.

[mnealtx 0]

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Would that be a government sponsored panel of INDEPENDENT EXPERTS to which you refer?

The one that is part of the US DEPARTMENT OF HEALTH AND HUMAN SERVICES, yes.

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If you're so SURE than all screenings are always good, go and have your prostate biopsied right now.

Being over 40, I've already had a prostate exam - that, not a biopsy, being the equivalent of a first level test like a mammogram.

Mike
I love you, Shannon and Jim.
POPS 9708 , SCR 14706

[Amazon 7]

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I think most of these people who are so vociferously bitching about this HC bill COMPLETELY forget about preventative care, which saves vast amounts of money by virtue of catching things before they become catastrophic...requiring vastly greater amounts of money to "fix" what could have been prevented in the first place

The tricky part is providing access to the care that will save money (or break even) without opening the floodgates to overutilization. It is proven that opening channels to increased care (especially when it is perceived as "free" by many at point of care) increases utilization across the board - to fraud, unnecessary care, needed care - everything. There is no definitive data available to determine whether the savings from improved preventive care and increased utilization will balance out. It will almost certainly lead to at least a slightly healthier population, but at what price.

Overutilization was a big problem back in the days of 100% coverage with no patient costs at point of care.

Kind of like crime prevention. We could quadruple our police forces and probably dramatically reduce crime, but at what price.

And how easy would it be to increase the medical people in this country?
If a few changes in the way doctors and nurses were trained and treated that would upen up a lot more people desiring to be in the career. Take away all the negatives they have to deal with and the financial incentives take over. I would rather see doctors and hospitals making profits for good work.. than the scummy insurance caste that is currently running things into the ground doing so.

[kallend 1,621]

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Would that be a government sponsored panel of INDEPENDENT EXPERTS to which you refer?

The one that is part of the US DEPARTMENT OF HEALTH AND HUMAN SERVICES, yes.

It's good, isn't it, that they use INDEPENDENT EXPERTS rather than politicians to make their recommendations.

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If you're so SURE than all screenings are always good, go and have your prostate biopsied right now.

Being over 40, I've already had a prostate exam - that, not a biopsy, being the equivalent of a first level test like a mammogram.

But you NEED the biopsy to be SURE.

...

The only sure way to survive a canopy collision is not to have one.

[labrys 0]

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Or I could rally people to vote the bastards out of office

The bastards were already voted out of office.

Owned by Remi #?

[mnealtx 0]

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Would that be a government sponsored panel of INDEPENDENT EXPERTS to which you refer?

The one that is part of the US DEPARTMENT OF HEALTH AND HUMAN SERVICES, yes.

It's good, isn't it, that they use INDEPENDENT EXPERTS rather than politicians to make their recommendations.

I wouldn't expect a medical council to use politicians to formulate suggestions.

Your mileage, evidently, varies.

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If you're so SURE than all screenings are always good, go and have your prostate biopsied right now.

Being over 40, I've already had a prostate exam - that, not a biopsy, being the equivalent of a first level test like a mammogram.

But you NEED the biopsy to be SURE.

More misdirection.
I'll do that on medical recommendation AFTER the first level test shows cause - just like would happen with a mammogram.

Mike
I love you, Shannon and Jim.
POPS 9708 , SCR 14706

[billvon 2,380]

>The bastards were already voted out of office.

And have been over a hundred times. But next time I'm sure things will be different.

[pirana 0]

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Nothing in this bill addresses the root cause of the problem...high costs of delivering the product. Until you address why it's so expensive to go to the doctor you have accomplished nothing.

And that is because the insurance companies have no incentive to bargain costs down because they just pass them along, and the healthcare consumer is insulated from the cost. A single payer system is the way to fix that problem.

Why does a hospital charge $10 for an aspirin tablet? Because it can.

You know not what you speak of. That comment just showed me you are sorely lacking for information in this debate.

Insurance companies bargain like a MF with providers. And multiple companies bargaining with multiple providers is THE single biggest source of downward price pressure.

I guess that's why pharmaceuticals are so much cheaper here than in Canada.

Oh, wait...

Different issue, different factors. Nice try at diverting though.

You made a blanket statement that insurance companies have no incentive to bargain prices downward. That is absolutely false and shows you have limited to no knowledge on the topic of provider/financer negotiations.

Let me spell it out for you. They are very incented to bargain down prices because their reimbursement rates are in competition with every other insurance companies reimbursement rates; directly impacting the rates at which they sell their contracts.

Go to single-payer and remove that single most effective pressure on price and the only option remaining is price-fixing.

The providers can not compete directly - or more accurately do not need to - because the AMA makes certain the supply remains below demand. Something that may come to an end if the government has to resort to fixed pricing (which effectively places salary caps on physicians).

" . . . 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

[pirana 0]

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And that is because the insurance companies have no incentive to bargain costs down because they just pass them along, and the healthcare consumer is insulated from the cost. A single payer system is the way to fix that problem.

Why does a hospital charge $10 for an aspirin tablet? Because it can.

If there is anybody here who has ever sat on the other side of the table (negotiating reimbursement rates on behalf of a provider system), please chime in so Mr Kallend doesn't think I'm making this all up.

Is your experience that the insurers pay whatever the provider requests, and that they have no incentive to bargain?

" . . . 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

[pirana 0]

I directly participated in several negotiations over the years with major health care systems in the Twin Cities. In every single one the provider group was asking for at least double the cost indicated by pricing and utilization trends, and at least 4 times the cost of CPI. The only thing that kept them in check was the bargaining power of the large insurance companies via the cash flow they provided in the form of direct payments. If those large systems had to rely on direct payment from patients - they'd all be bankrupt.

Reminds me of when Wellstone/Clinton said they wanted more competition, but also wanted a single payer. 3 companies were not enough, but 1 was just right?