Something to consider about healthcare

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cannotaffordit's picture
cannotaffordit
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Something to consider about healthcare

There have been lots of comments on this site, including some of my own "emotional ones", regarding healthcare in this country, and the best way to provide it, and pay for it. Here are a few more thoughts, for us to chew on.  Some of this is not original from me, although I have added many of my own ideas to the text.

Ben A

So, here goes my rant..... Laughing

There are still many people who wonder what single payer heath care is all about, and why is it necessary. Considering the fact that the whole game plan of the health insurance/private hospital/big pharma interests,(which are gouging the American people now) is to sow confusion and misinformation.  I, for one, believe some considerable light-shining might be helpful. I'll so what I can, and you are most welcome to do the same. 

IMHO, the core problem is that right now about 30% of every health care dollar goes to insurance conglomerates and big pharma's overhead and profit, a lot which the get from care that is simply denied.  If you are looking for so-called "death panels" (actually death czars), please know that there is already an existing business model for that in place  - within the existing corporate health care insurance industry.  In this model,  individual bureaucrats, a lot of whom are simply clerks, following a chart of who can get care and who cannot, are operating under specific directives to deny as much care as they can get way with.

Every other major industrial country, long ago, switched to some form of single payer system, where full and comprehensive health care is deemed appropriate for every tax paying family.  And what's especially interesting is that not 
one of those countries has switched back to their previous inefficient, private-for-profit systems. 


And yet all that we hear,(primarily on cable TV) are unrelenting smears (and lies) about the systems of these other countries.  We are told that such a system is basically some kind of socialist conspiracy, (as if that language was not old and tired enough already.)  Sean Hannity recently recruited some guy with a British accent, to denigrate his own country's health care (which we learn later he had never actually used.  In fact, this same spokesman against the British system, was denounced by the British parliament.  Interesting.  

An investor's paper asserted that Dr. Stephen Hawking would have died, if he had depended on UK health care, when in FACT it had saved his life. But when you expose these lies, they just make up new ones and keep on trucking. 


What single payer does, in essence, is pool the interests of all those who need care, and this provides the power to negotiate, through whatever is established as the funding agency, more favorable and truly competitive pricing from the health service providers.  (But then, our government has gotten away from competitive price negotiating on a lot of things)

With a single payer system, government does not "take over" the administration of health care. It just takes responsibility for paying for it.  And by eliminating complicated coverage bureaucracies it can be a much more efficient system, with much lower overhead.   And that is the primary reason why the existing "system" is so mortally opposed by those who are currently profiting, big time, from our existing inefficient, un-economically sound system now. 

We are hearing a lot of talk about a so-called "public option," which is just another way to stall against eliminating the greedy businesses that are making huge profits on people's personal health issues.   What, exactly, is the difference between that "public option" and single payer health care?  The first thing we must understand about what is being called the "public option" is that it was designed by the existing system (and their paid puppets in D.C) to be a distraction, to give the American people a false choice.  What the corporate interests, orchestrating this whole charade, want to do is transform the debate, such as it is, into an argument about whether there should be a "public option" or not. 

But as designed, the "public option" being propounded would do none of the effective things that a single payer system would do. It would NOT provide the clout to actually compete with the existing corrupt system.  It would not eliminate the outrageous overhead inherent in the miserable "topsy" mess we have now. It would NOT eliminate bureaucratic denying care.  In other words, it is being designed to fail in all that would be in the overall best interest of the American people.  

Heads they win, tails we lose.

 They last thing the health insurance industry wants is actual meaningful competition, and  to give up their greedy profits. This is why they have worked so hard (and spent so much money)  to keep true single payer out of the debate entirely. 


One symptom of this was talk over the weekend that the Senate is working on a "streamlined" proposal, because even the congressional budget office recognizes that their proposal is a massive scam.  But why do we have to reinvent the wheel?   HR 676, a true single payer bill, has been on the table for years already, with more sponsors in the House than any other proposal. So why don't they just pass it already?  Because the insurance companies won't allow it!

 
What about the overall best interests of the American public?  

And why is it that most physicians, who have always been so against government interference in medicine, now see the advantage of single payer, when they know it will clearly reduce their own incomes.  

Under the guise of so-called reform, the one proposal you can count on surviving is a REQUIREMENT that you pay for whatever they come up with. You say you can't afford health insurance now and that is why you have no coverage?  Well guess what?  They want you to  be FORCED to become a customer of these same greedy conglomerates, or pay effectively the same amount  for a phony "public option" -  all at the cost of single payer but NONE of the real benefits. 
It is just as sick as it sounds.  (excuse the pun)

If we are ever going to have real policy reform in this country, on this or any other subject, we're going to have to wrestle the power away from those who answer only to the ones with the most money.  And the first step in that is to learn the real truth for yourself (instead of just parroting some clown on television, or personally operating in fear that even more of our rights will be taken away) and begin to speak out about the truth we discover, in our own research.  This is something which, IMHO, not many folks have done.

I sincerely believe the entire so-called debate, such as it is, is being driven by a handful of loudmouths, given over-sized coverage in the corporate media, from lunatics (disrupting town hall meetings to the point that nobody can be heard)  to a whole host of folks who are so fed up with government that they simply  don't want to give government any more power. Be assured that I am strongly one of those.  There's far too much power in D.C. now, to suit me.  But the thing we may have overlooked is that the power is not ours right now.  It is in the hands of a bunch of self-serving folks who only what's best for them.  How is that very different from the government? 

So I suggest that rather than listening too carefully to any of the "paid" pundents, on either side, we do some serious and careful research on what we actually have now, (how good, really is the care, and what is it really costing) and what some other countries really have - countries where the vast majority of the citizens are well satisfied with their single payer programs, despite what we are told by those who have every reason to keep it from happening here.

Thanks for taking the time to read this rather long opinion piece.  More than my wanting to influence you to be swayed one way, I hope it will serve to make us think for ourselves.

 

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xraymike79
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Re: Something to consider about healthcare

Do you have any links discussing the public versus single payer option. I was told that the public option is a "single payer" option.

The Veterans Administration is able, using its bargaining power, to lower the price it pays for patent medicine by 40 percent, and it's government-run.

"The insurance companies also love the way "reform" is going. With hints of a public option off the table, the insurance companies stand to make beaucoup profits. Under the proposed health plan, the government will require most uninsured Americans to buy health coverage. The young and healthy will be steered into the industry's welcoming arms. With the lack of competition from a public option, private health insurance industry record profits can be expected to continue."

Maybe its just semantics here. But from what I understand, the insurance companies don't want a "public' or "single-payer" system.

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cannotaffordit
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Re: Something to consider about healthcare

"Maybe its just semantics here. But from what I understand, the insurance companies don't want a "public' or "single-payer" system."

I think that's the whole idea Mike.  Get us talking about two options, with nether really acceptable to them, and when the two sides completely obliterate each other, then they can slyly move their own position back into the forefront, at the last minute.

I'll be glad to look for some websites.  I just want to be careful that I do not recommend one that has a personal agenda or its own bent, either way.

Thanks.

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cannotaffordit
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Re: Something to consider about healthcare

Mike, et al

Here's a rather interesting site.  I also suggest that you Google "Public Option vs Single Payer."

http://www.canow.org/canoworg/2009/06/public-option-vs-single-payer-expl...

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ReginaF
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Re: Something to consider about healthcare

Hello at all,

I'm from Germany.

As I'm an employee with under app. 50.000 € Pay per year, I'm in the health care insurance "by law". That means, I can choose between a lot of insurance companies, but have to be insured. With me, all my family members who had no own income (kids, spouse) are insured. We paid 7,5 % of our income to health care, the other 7,5 % were paid by our employer. With this, nearly all essential mediacal care is covered especially for children. I can choose my doctors myself (and believe me, I did!). Adults have since a few years pay for eyeglasses, 40-60 % of the fee for  artificial teeth  and some Euros for Massage and so on. For prescipted drugs (Medikamente) I have to pay a small feeI. When I get unemployed or in retirement, the "by law" insurance would be paid for me.

If I would earn over 50.000 € a year or I'm a enterpriser or freelancer I could choose between "by law" and "private insurance". Even if I had the choice, I personally would never leave the "by law" insurance - if you left once, you never have the chance to get in it again & private insurance is only cheap if you are young and healthy. 

Our system is really not perfect - but  I would'nt change it for another one!

If you have any questions don't hesitate and ask me!

 

Regina

 

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xraymike79
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Re: Something to consider about healthcare

I think we are confusing people here with the "public" and "single payer" terminology. Hopefully this article will clear it up:

Five Myths About Healthcare Around the World

by T.R. Reid August 25,2009

 

As Americans search for the cure to what ails our health-care system, we've overlooked an invaluable source of ideas and solutions: the rest of the world. All the other industrialized democracies have faced problems like ours, yet they've found ways to cover everybody -- and still spend far less than we do.

I've traveled the world from Oslo to Osaka to see how other developed democracies provide health care. Instead of dismissing these models as "socialist," we could adapt their solutions to fix our problems. To do that, we first have to dispel a few myths about health care abroad:

1. It's all socialized medicine out there.

Not so.

Some countries, such as Britain, New Zealand and Cuba, do provide health care in government hospitals, with the government paying the bills. Others -- for instance, Canada and Taiwan -- rely on private-sector providers, paid for by government-run insurance. But many wealthy countries -- including Germany, the Netherlands, Japan and Switzerland -- provide universal coverage using private doctors, private hospitals and private insurance plans.

In some ways, health care is less "socialized" overseas than in the United States. Almost all Americans sign up for government insurance (Medicare) at age 65. In Germany, Switzerland and the Netherlands, seniors stick with private insurance plans for life. Meanwhile, the U.S. Department of Veterans Affairs is one of the planet's purest examples of government-run health care.

2. Overseas, care is rationed through limited choices or long lines.

Generally, no. Germans can sign up for any of the nation's 200 private health insurance plans -- a broader choice than any American has. If a German doesn't like her insurance company, she can switch to another, with no increase in premium. The Swiss, too, can choose any insurance plan in the country.

In France and Japan, you don't get a choice of insurance provider; you have to use the one designated for your company or your industry. But patients can go to any doctor, any hospital, any traditional healer. There are no U.S.-style limits such as "in-network" lists of doctors or "pre-authorization" for surgery. You pick any doctor, you get treatment -- and insurance has to pay.

Canadians have their choice of providers. In Austria and Germany, if a doctor diagnoses a person as "stressed," medical insurance pays for weekends at a health spa.

As for those notorious waiting lists, some countries are indeed plagued by them. Canada makes patients wait weeks or months for non-emergency care, as a way to keep costs down. But studies by the Commonwealth Fund and others report that many nations -- Germany, Britain, Austria -- outperform the United States on measures such as waiting times for appointments and for elective surgeries.

In Japan, waiting times are so short that most patients don't bother to make an appointment. One Thursday morning in Tokyo, I called the prestigious orthopedic clinic at Keio University Hospital to schedule a consultation about my aching shoulder. "Why don't you just drop by?" the receptionist said. That same afternoon, I was in the surgeon's office. Dr. Nakamichi recommended an operation. "When could we do it?" I asked. The doctor checked his computer and said, "Tomorrow would be pretty difficult. Perhaps some day next week?"

3. Foreign health care systems are inefficient, bloated bureaucracies.

Much less so than here. It may seem to Americans that U.S.-style free enterprise -- private-sector, for-profit health insurance -- is naturally the most cost-effective way to pay for health care. But in fact, all the other payment systems are more efficient than ours.

U.S. health insurance companies have the highest administrative costs in the world; they spend roughly 20 cents of every dollar for non-medical costs, such as paperwork, reviewing claims and marketing. France's health insurance industry, in contrast, covers everybody and spends about 4 percent on administration. Canada's universal insurance system, run by government bureaucrats, spends 6 percent on administration. In Taiwan, a leaner version of the Canadian model has administrative costs of 1.5 percent; one year, this figure ballooned to 2 percent, and the opposition parties savaged the government for wasting money.

The world champion at controlling medical costs is Japan, even though its aging population is a profligate consumer of medical care. On average, the Japanese go to the doctor 15 times a year, three times the U.S. rate. They have twice as many MRI scans and X-rays. Quality is high; life expectancy and recovery rates for major diseases are better than in the United States. And yet Japan spends about $3,400 per person annually on health care; the United States spends more than $7,000.

4. Cost controls stifle innovation.

False. The United States is home to groundbreaking medical research, but so are other countries with much lower cost structures. Any American who's had a hip or knee replacement is standing on French innovation. Deep-brain stimulation to treat depression is a Canadian breakthrough. Many of the wonder drugs promoted endlessly on American television, including Viagra, come from British, Swiss or Japanese labs.

Overseas, strict cost controls actually drive innovation. In the United States, an MRI scan of the neck region costs about $1,500. In Japan, the identical scan costs $98. Under the pressure of cost controls, Japanese researchers found ways to perform the same diagnostic technique for one-fifteenth the American price. (And Japanese labs still make a profit.)

5. Health insurance has to be cruel.

Not really. American health insurance companies routinely reject applicants with a "preexisting condition" -- precisely the people most likely to need the insurers' service. They employ armies of adjusters to deny claims. If a customer is hit by a truck and faces big medical bills, the insurer's "rescission department" digs through the records looking for grounds to cancel the policy, often while the victim is still in the hospital. The companies say they have to do this stuff to survive in a tough business.

Foreign health insurance companies, in contrast, must accept all applicants, and they can't cancel as long as you pay your premiums. The plans are required to pay any claim submitted by a doctor or hospital (or health spa), usually within tight time limits. The big Swiss insurer Groupe Mutuel promises to pay all claims within five days. "Our customers love it," the group's chief executive told me. The corollary is that everyone is mandated to buy insurance, to give the plans an adequate pool of rate-payers.

The key difference is that foreign health insurance plans exist only to pay people's medical bills, not to make a profit. The United States is the only developed country that lets insurance companies profit from basic health coverage.

In many ways, foreign health care models are not really "foreign" to America, because our crazy-quilt health care system uses elements of all of them. For Native Americans or veterans, we're Britain: The government provides health care, funding it through general taxes, and patients get no bills. For people who get insurance through their jobs, we're Germany: Premiums are split between workers and employers, and private insurance plans pay private doctors and hospitals. For people over 65, we're Canada: Everyone pays premiums for an insurance plan run by the government, and the public plan pays private doctors and hospitals according to a set fee schedule. And for the tens of millions without insurance coverage, we're Burundi or Burma: In the world's poor nations, sick people pay out of pocket for medical care; those who can't pay stay sick or die.

This fragmentation is another reason that we spend more than anybody else and still leave millions without coverage. All the other developed countries have settled on one model for health-care delivery and finance; we've blended them all into a costly, confusing bureaucratic mess.

Which, in turn, punctures the most persistent myth of all: that America has "the finest health care" in the world. We don't. In terms of results, almost all advanced countries have better national health statistics than the United States does. In terms of finance, we force 700,000 Americans into bankruptcy each year because of medical bills. In France, the number of medical bankruptcies is zero. Britain: zero. Japan: zero. Germany: zero.

Given our remarkable medical assets -- the best-educated doctors and nurses, the most advanced hospitals, world-class research -- the United States could be, and should be, the best in the world. To get there, though, we have to be willing to learn some lessons about health care administration from the other industrialized democracies.

T.R. Reid, a former Washington Post reporter, is the author of "The Healing of America: A Global Quest for Better, Cheaper, and Fairer Health Care."

 

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Re: Something to consider about healthcare

The T. R. Reid article provided by xraymike is very informative. If 'reform' were the real objective, 'what works' elsewhere would be carefully studied, aired at Congressional hearings, and used as the basis for constructive change.

What's actually happened is that a new administration rolled in, breezily proclaimed 'let's 'do' healthcare while our honeymoon lasts,'  and engaged the legislative sausage factory to produce foot-thick stacks of goobledygook, ghostwritten by industry lobbyists.

The U.S. political system is even more dysfunctional than its health care system.  It shows no interest in fixing the single-payer systems we already have -- Medicare and Medicaid --which are so deeply insolvent that they eventually will take the U.S. government down with them.

This is smelling like a replay of Hillarycare in 1993, which began with secret meetings of handpicked insiders. Then, six legislative committees labored mightily and produced ... exactly nothing. In 1994, voters punched the majority party in the teeth so hard that it became the minority party.

[Ed. note: Removed text]

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Re: Something to consider about healthcare

I'm so pissed I can't even see straight. And I can' afford an opthamologist.. We've been pimped out, hollowed out, and sold out by corporations aided by our own government.

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Re: Something to consider about healthcare

Ben A,

Thanks for the post, I think this is an important issue and one that is not easy to figure out.  First I think your conclusion is premature and that a bill should not be written until goals and alternatives are properly discussed.  Let me start with second guessing some of your statements:

Ben said:

The core problem is that right now about 30% of every health care dollar goes to insurance conglomerates and big pharma's overhead and pharmas

If the core problem is the 30% profit that the insurance companies and big pharmas are taking - how much of that can be saved?  If you cut that in half, you are only saving a potential of 15% while accepting government intrusion and probable rationing?  Are saying this program will reduce costs while adding 45 million new participants? 

 

Ben said:

With a single payer system, government does not "take over" the administration of health care. It just takes responsibility for paying for it.  And by eliminating complicated coverage bureaucracies it can be a much more efficient system, with much lower overhead.

How can you say that government does not "take-over" the administration of health care when you allow that government would "only" be responsible for paying for it?  If government handles health care like they have social security and medicare then it will quickly be broke or at a minimum, rationed.  Social security may begin running short within a year or two - what happens then?  Will FICA income shortages represent reduced benefits?

I think it would be very likely that health care would become a "supply" based system instead of a "demand" based system or again, rationing.

You mention "bureaucracy" in the private sector and suggest government is less bureaucratic?  Can you back that statement up?

With Washington, the devil is always in the details (and usually everywhere else). I think it is a farce that we are discussing a bill that few have read and fewer still understand.  Here is copy of one of the bills, Bill #3200 (I say "one" of the bills because I think there are others floating around - does anyone know if there is a final or official version?).

So, let's look at some of the "details" in this bill and please let me know if there is another version you like better:

  • Page twenty two of the Health Care Bill mandates that the U.S. Government will audit books of all employers who self insure.
  • Page thirty, section 123 of the bill states that there will be a Government committee which decides which treatments & benefits you get
  • Page three hundred fifty four, section 1177 states the Government will restrict the enrollment of Special Needs people
  • Page fourty two of the bill states the Health Choice Commissioner will choose your health care benefits for you.
  • Page fifty, section one hundred fifty two in health care bill states health care will be provided to all non U.S. citizens, illegal or otherwise
  • Page 170, lines 1-3 of the health bill states all non resident aliens will be exempt from individual taxes...meaning resident americans will pay.
  • Page fifty eight states Government will have real time access to individuals finances & a national Id healthcard will be issued.
  • Page fifty nine, lines 21 thru 24 states that the Government will have direct access to you bank accounts for electronic funds transfer, no choice at all.
  • Page seventy two, lines 8 thru 14 state that the Government is creating an Healthcare Exchange to bring private health care plans under Government control.
  • Page eighty four, section 203 of the bill states that the Government will mandate all benefit packages for private health care plans in the Exchange.
  • Page ninety five of the bill, lines 8 thru 18 states that the Government will use groups to sign up individuals for Government health care plan.
  • Page one hundred twenty four, lines 24-25 of the bill states no company can sue Government on price fixing. No "judicial review" against Government monopoly.
  • Page one hundred twenty seven, lines 1 thru 16 states the Government will tell you what your salary will be. (AMA)
  • Page one hundred fourty five, lines 15 thru 17 states that all employers must auto enroll employees into public option plan. No option for choice.
  • Page one hundred fourty nine, lines 16 thru 24 states that any employer with payroll of 400k and above, who does not provide public option, pays 8% tax on all payroll.
  • Page one hundred sixty seven, lines 18-23 states any individual who doesnt have acceptable health care according to the Government be taxed 2.5% of income.
  • Page one hundred ninety five health care bill states officers and employees of health care administration (Government) will have access to all americans finances and personal records.
  • Page two hundred thirty nine, line 14-24 health care states the Government will reduce physican services for medicaid seniors and low income people.
  • Page two hundred fourty one, line 6-8 of the bill states that doctors, no matter what specialty you have, you will be paid the same.
  • Page four hundred twenty five, lines 4 thru 12 states that the Government mandates Advance Care Planning Consultations (Seniors)
  • Page four hundred twenty five, lines 17-19 states that Government will instruct & consult regarding living wills, durable powers of attornies. This is mandatory.
  • Page four hundred twenty five, lines 22 thru 25 also page four hundred twenty six lines 1 thru 3 states Government provides approved list of and of life resources, guiding you in death.
  • Page four hundred twenty seven, lines 15 thru 24 states that the Government will mandate program for orders for end of life. Ther Government will have a say in how your life ends.
  • Page four hundred twenty nine, lines 1 thru 3 states that an "advanced care planning consult" will be used frequenrly as patients health deteriorates.
  • Page four hundred twenty nine, lines 10-12 "advanced care consultation" may include an Order For End Of Line planes An "ORDER" form the Government on when your life ends.
  • Page four hundred thirty, lines 11 thru 15 of the bill states that the Government will decide what level of treatment you will have at end of life.

I think that's probably enough and there are still 600 more pages.  Maybe you can comment on this list but if it is close to accurate - the plan stinks!

Here is a comment that I agree with regarding government health care:

"The Government has been selling it's citizens up the river (albeit at a slow pace) for YEARS. Why would they stop now? What has surprised me is the pace and time in which they have been trying to pass this enormous bill. I find it odd that Obama wanted the bill passed by the end of this month (which is not possible now). The reason I say this is because of all the news surrounding a new, more vicious outbreak of the swine flu this FALL."

"Get the bill passed by the end of August, get a pandemic rolling and big Government can call the shots on basically who gets to live or die (lets not even mention the vaccines which haven't been supposedly trial tested and have all types of nasties such as formaldehyde, mercury, etc). I'm curious to see if Obama will let up on the health reform debate for now seeing as another hurdle for the U.S. Government is coming up by the end of September (start of the next fiscal year) which could mean POSSIBLE financial mayhem for the U.S. Well, all the excitement is in watching.."

Larry

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cannotaffordit
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Re: Something to consider about healthcare

Hey Larry,

I really appreciate your comments.  I especially like the idea that we abandon the whole crazy thing (currently offered bills) right now, do a very careful study of all the "successful" health care systems in the world (like Taiwan did) and then offer the American people the very best plan in the world. Others have come close to doing it, even though everything is open for some improvement, and it hasn't bankrupted their countries, nor has it caused the world to call them socialist.  My strong suspicion is that a well researched and thought out plan would be extremely different that what we have now, and would cover every citizen, if we can keep the d _ _ _ private insurance companies, money-grubbing private hospital corporations, and big pharma out of the writing of same. 

For a clearer understanding of some of the questions you ask, I simply suggest you (we all) re-read the excellent article by T.R. Reid, posted here by xraymike79.

The analysis you offer regarding the various parts of these bills has been floating around the internet for a few weeks now, and I have read it carefully, and am darn frightened by the points it makes.  All I can say is I don't like anything presently being offered in congress.  And, I don't like what we presently have either.  So there you have it.  You won't get any argument from me on the, sometimes ridiculous, parts of these bills, which, btw were primarily written by the insurance lobby, like most everything in congress is these days.

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Re: Something to consider about healthcare

Ben A,

I agree with your idea that at least one study be done to determine the good and bad experiences of other nations.  From what I read, the quality of our health care is excellent and my personal experience is that we have a lot of freedom in choosing, along with our doctor, the best remedy. 

The big problems that I see are:

  • Cost is high
  • Prediagnosed conditions can limit or restrict an individual from seeking insurance with a new company
  • Health insurance is very expensive for individuals to buy on their own.  Many work at jobs that they don't like because they need health insurance and if they leave a company, they may not find insurance elsewehere
  • 45 million have no insurance (not including illegal aliens)

Here are a few ideas that I have heard/read about that may have some merit:

  • Allow co-operatives/groups for individuals - for example, individuals may join bigger groups to gain leverage for better pricing from insurance carriers.  And, pre-diagnosed conditions must be accepted as part of the plan - no physical required.  Companies may use pre-tax dollars to buy insurance coverage which is a savings proportional to your tax bracket - why not allow members of groups to enjoy the same benefit.
  • Allow health (tax exempt) savings plans.  If you've bought car or home insurance you probably know that by increasing your deduction upon a claim, you reduce the cost of insurance.  A savings plan could allow individuals to save $2,000 a year without charging any income tax.  The money could roll-over so that a fund can be built over time to pay for the little things not covered by the deduction.

    As long as the person buys health care products/services the money may spent at the discretion of the saver.  For example, one could buy vitamins, herbs or whatever they deem as preferable.  This makes people consumers as opposed to thinking that any care they need is free.

  • In my state, (Pennsylvania) drivers who have a bad driving record (accidents, tickets, DUI) may have a hard time getting any insurance.  The state requires that these people must be taken by insurance carriers and they keep track to make sure the insurance companies accept these individuals as a proportion to the state wide policy holders.  These drivers will pay more than desirable drivers but the point is they get the coverage.
  • In the U.S., many insurance companies are territorial and dominate the markets that they serve.  They have arrangements with local hospitals that may be better than an outside company.  Why not require a minimum specification or approval process and then make it mandatory that qualified companies all receive the same pricing.
  • Prescriptions are less expensive in Canada and Mexico because the American companies have formed a cartel backed by the government.  In my opinion, this is illegal price fixing and it should be stopped.
  • Many have suggested that tort reform is drastically needed to reduce liability costs.  It is not discussed much because the trial lawyers are generous campaign donors and a very vocal group.
  • A safety net could and should (in my opinion) be provided to help those unable to pay for insurance.  I am not sure which is the best way to address the problem - private or government paid.

Anyways, I think we both agree that there may be many steps that can be taken to improve what is a terribly expensive system.  But, I think it is very important that we protect the quality and privacy of our current system.  Thanks for the interesting discussion!

Larry

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Re: Something to consider about healthcare

Oh, one more thought.  We all know that M'care and M'caid are in a mess, poorly administered, extremely costly, full of fraud  and about everything else we could say that's wrong with it.  How about this?  IF we could get a good, well thought out plan (like some other countries) that operates far more efficiently, why not just shut down Medicare and Medicaid, and throw those folks under the new plan?

I'd love to see an overall system that could produce the same quality of care as some other countries have, and at a modest 3 to 5 % overhead.  Wonder what would have to change about our government, in order for it to operate anything that way?

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Re: Something to consider about healthcare

If we had true free enterprise without lobbyist-Govt corruption & smart hard working responsible people that saved & managed their money none of this would be much of a problem......I know I am dreaming. I would just like to manage my own life instead of being forced & herded into the lines of the masses with few if any options.

At this point I think it will be bad either which way we go....pick your poison.

It does not take much imagination to see how bad this is going to get & fast. Not enough money with too many old people with health problems over whelming a failing system. Everybody wants the "best" but no one wants to pay the bill for this. There are not going to be enough highly skilled medical people to provide what is to come. They are not going to work that hard under a capitated system...I know I will not.

Medicine is very complicated & very hard for someone out of the field to truly understand. It is hard for them to see & understand what they could have had & how the outcome could have been better. Tie up & waste the medical professionals’ time with ambulance chasing attorneys, tones of mindless paper work & protocols that justify or satisfy everyone but the outcome of the patient & you have one hell of a mess.

Better stay healthy people...keep the weight off....don't abuse yourself & hope you don't get sick. Prevention is the best medicine that only you can provide.

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Re: Something to consider about healthcare
Congressman Mike Rogers' opening statement on Health Care reform in Washington D.C.

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Re: Something to consider about healthcare

Larry

Here is copy of one of the bills, Bill #3200 (I say "one" of the bills because I think there are others floating around - does anyone know if there is a final or official version?).

The version I have been reading is headed Bill #3200, House of Representatives, July 14/09, (same as the one you mention) and as I understand it it is the current "Official" document pending changes that may be introduced

Page four hundred thirty, lines 11 thru 15 of the bill states that the Government will decide what level of treatment you will have at end of life.

doesn't say anything like that as I read it,  but rather refers to administering the wishes of the patient that were set and written down in consultation with his/her doctor sometime previously - so I wonder if we interpret the same information differently or is this comment pasted from one of those misleading posts that have been floating around?

Jim

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Re: Something to consider about healthcare

Everyone is giving such thoughtful and detailed and well informed responses, I cannot resist adding my 2 cents now that I am calmer about this issue. Smile

idoctor-in my opinion you are right on target about the heatlhcare providers' experience. Regarding mandated public option, I would hate to force a national healthcare plan, it seems unfair, but the private insurers are soaking up so much money I sometimes think it would be cheaper to be rid of that option.  

Ben-

I have read Dr. Hawking and in my reading I thought  he had admitted that he had huge out of pocket expenses which he covered with his book royalties, etc.... Nonetheless, I think he is being honest when he says he has gotten excellent care, but the NHS did not cover everything. I mean things like his special computer translation system, home aides, etc....  Perhaps I am not remembering this correctly but I thought he mentioned this in one version of A Brief History of Time. However, I do not know how he would have fared here.  If he were in a state with generous medicaid benefits like California he might have done a little better, but since he works he would not be eligible and would be stuck with a private group policy that I think would have been worse in all likelihood.

Regarding single payer options vs Medicare/Medicaid, I think the other cost for these programs relates to the high level of medical morbidity seen in the poor and the elderly. Perhaps if we dilute the risk pool by enrolling younger healthier people in Medicare, the average cost per person will be less expensive. Why do you think the private insurers want these younger ones? Same reason I suspect.  As ridiculous as I may sound, I think this is the only single payer option that might work. The problem is, the private insurance industry definitely will not benefit unless they are allowed to run Medicare (privatization like the part D program for Medicare).

Larry-I appreciate the video of congressman Rogers.  I sometimes worry that I could get bumped as a provider if I am too critical of this bill (paranoid I know).

The new bill requires a whole new administrative set up and this will entail hiring and firing a bunch of people and is bound to be costly.  I still think it would be cheaper to throw everyone under Medicare and pare down Medicare (perhaps drastically).  There are enough regulations already.  Physicians get audited by them all the time. 

I think the overhaul is way too ambitious.  I will admit my bias in that I want to see a public plan even though I may make less money. I think the coverage has to be much more bare bones but that is better than nothing. There is no good answer here.

 

Just a few thoughts.

Be Well

Denise

 

 

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Re: Something to consider about healthcare

Medicar...I mean cash for clunkers is so efficient & going so well (what a brain storm to ruin something that worked so you can go into debt to buy something new)......we know Govt Motors pushing electric cars is smart right LOL. They don't mention that these zero carbon cars have to charge off the grid where 50% of that juice is from burning coal with a 25% line loss to get to your house. Hum yeah they should be able to run Healthcare without a hiccupSmile.

I cannot stand the leeches in the Insurance Companies. We need to get rid of this big corrupt mess also. There has to be a better way to function with all of this.

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Re: Something to consider about healthcare

I just want to take an opportunity to say "thank you" to each of you who have contributed to this thread.  I have learned some important things from your very careful responses, based on your own backgrounds, etc. I have also had some personal beliefs authenticated by idoctor, Denise and others.  It is always to great when people who really have something to contribute, out of their own experiences, are willing to share what they know.  This has been, in my opinion, one of the most interesting, and enlightening, threads I've been a part of recently.  And I especially want to thank each of you for sharing what you know, without some personal agenda to be right.  I happen to think that this is really the way to solve issues.

SO thank you, to each of you.   This is not to say we should END this thread.  I think it is great!  Just wanted to pause, for a moment, to thank you to each of you, for the information, and ideas, you have already shared with all of us.

"Come let us reason together" is one of the admonitions I love, and try to live by."

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Re: Something to consider about healthcare

Larry,

Somehow, in my infinite wisdom and freedom from mistakes Frown  I missed reading your post #11.  It was great, and very thoughtful.  I like what you had to say, and will continue to give it some serious consideration.  Thanks you!.

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Re: Something to consider about healthcare

Congressman Mike Rogers' opening statement on Health Care reform in Washington D.C.

 

I don't think I've heard this much nonsense in a long time. He says something about "Just let the private sector solve the problem". As far as I can see the private insurance compnies ARE the problem and have had many years to fix the mess they've made -- and it just gets worse. And supposedly the 85% that have this wonderful insurance are going to be worse off -- they are all on the edge of losing their insurance given the right/wrong circumstances - just get seriously sick and see how quickly you get dropped.

And then suggest that cancer treatment is better in the US than anywhere else when millions of Americans have nowhere to go for treatment leaves me wondering. The study Rogers bases his cancer survival times for US vs other countries appears to be flawed according to Lancet. a more recent study done by National Program of Cancer Registries indicates that the US survival rates are 2 to 4% lower than previously claimed in the much smaller study done by SEER that Rogers appears to be getting his information from.

See Lancet at   http://www.thelancet.com/journals/lanonc/article/PIIS1470-2045(08)70179-7/fulltext#article_upsell      for more details

Jim

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Re: Something to consider about healthcare

IMO, Universal healthcare would be great.....but not one created or administered by this government.  What has this administration done (or any of the previous 7) that tells you that this is being done for the greater good of the avg. American?  Nothing!  In fact, history and current events tell us that this administration is pushing this through for evil intents.  I don't trust this gov't to provide me healthcare!  Period!

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Ted Kennedy RIP

Senator Ted Kennedy, one of the political figures most associated with universal health care, has died.  What does the timing of his departure symbolize, if anything?

To me, it suggests that Goddess does not want House bill 3200. [YMMV]  Maybe we should push the 'reset' button and get it right the first time.

As an aside, here's a tidbit of history from Blomberg's article about Kennedy's succession:

When Kennedy’s older brother was elected president in 1960, Ted Kennedy was too young to hold the seat, so five days after John Kennedy’s Dec. 22 resignation, the Massachusetts governor appointed a caretaker lawmaker, Benjamin Smith, until Ted Kennedy reached the minimum age under the Constitution for serving in the Senate. Kennedy turned 30 and won the seat in a special election in 1962, almost two years after his brother’s inauguration.

http://www.bloomberg.com/apps/news?pid=20601087&sid=aAWmWZK9iJdI

Whoa -- you're telling me that the governor could appoint a 'caretaker senator' to serve at his pleasure for nearly two years without consulting the people ... and then yank him out when the oligarchy's anointed candidate became old enough to run?

Sounds more like Honduras than Massachusetts. I love them tasty Chiquita bananas from those leafy plantations in the Berkshires.

A quote in the same article daintily mentions 'little turnover in the Massachusetts [Congressional] delegation.' This is true nationwide, and tells you why the phenomenon of 'industry capture' is so strikingly evident in grand initiatives such as healthcare legislation. Incumbents having better than 98 percent probability of re-election really have no effective democratic accountability, despite the periodic 'elections.'

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Re: Something to consider about healthcare

jpitre said:

doesn't say anything like that as I read it,  but rather refers to administering the wishes of the patient that were set and written down in consultation with his/her doctor sometime previously

Jim, I'll have to get my attorney to look it over and get back to your attorney with our interpretation...Yea, I'm kidding but Bill #3200 is written in confusing legalize.  I thought congressmen and senators were to be regular people but as this bill shows, apparently they must be attorneys.

John Conyers (D-Mich) Says "Health Care Bill is Filled With So Much Garbage Only a Lawyer Could Interpret" - During his speech at a National Press Club luncheon, the chairman of the House Judiciary Committee, Democratic Congressman John Conyers (D-Mich.), questioned the point of lawmakers reading the health care bill.  “I love these members, they get up and say, ‘Read the bill,’” said Conyers.  What good is reading the bill if it’s a thousand pages and you don’t have two days and two lawyers to find out what it means after you read the bill?”

I think this is legislative malpractice when congressmen admit they neither read nor understand the bills that they vote on.  In my opinion, this is intentionally done as part of the dialectic deciet.  Make it very confusing to churn the people emotionally - establish battle between groups that have different understandings.

And it even gets better.  There are indeed other bills floating around, for example the Kennedy bill was "leaked" this past weekend.  This is a mess and it should be stopped.  Why can't the bill be written in a language that the common man can understand?  I'll answer my own question - they don't want people to understand because if they did, they would demand that the bill be stopped.

Why are we delving into this huge issue now?  The country is going bankrupt and instead of discussing immediate emergencies, they are trying to see how they can spend more money. 

Let me remind everyone of an important detail - my understanding is that it would be 2013 before the bill takes effect.  Again, who can be sure as there is no "official" bill.  Obama has been out pushing for passage but he refuses to define which bill he likes and further, he is free from discussing the details of the bill.  Change we can believe in...freedom to tyranny.

Larry

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Re: Something to consider about healthcare

Larry

With all due respect to the good politicians out there (there are a few, but at higher levels not so much) the legalese allows for significant loopholes to benefit the rich and the corporate interest. As you obviously know, we elected an attorney for president and have done so repeatedly, and much of congress is attorneys, (notable exception, Ron Paul, a physician!).

D

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Re: Something to consider about healthcare

DrKirbyLuv wrote:  

"This is a mess and it should be stopped.  Why can't the bill be written in a language that the common man can understand?  I'll answer my own question - they don't want people to understand because if they did, they would demand that the bill be stopped.

Why are we delving into this huge issue now?  The country is going bankrupt and instead of discussing immediate emergencies, they are trying to see how they can spend more money. 

Let me remind everyone of an important detail - my understanding is that it would be 2013 before the bill takes effect."

(btw, sorry I can't get my Mac, with Safari, to pick up the quotes of others with rich text)

Larry,

      Just another thought.  Wouldn't it be interesting to read the "health care" bills that were approved in those countries that are now offering good care at a half-way reasonable cost?  Wonder what "anti-people - for-me-only" corporations in those countries affected what was adopted, and how? 

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Re: Something to consider about healthcare

DrKrbyLuv said:

Bill #3200 is written in confusing legalize.

Larry -- I couldn't agree more, but sometimes we have to play the hand we are dealt -- I haven't seen any legislation even at the State level that is written in a way so as to be reasonably understandable by the mere mortals. Our system has become so legalistic that unless a bill is written in obtuse legalese, it won't make the cut. Every time I tell a lawyer to make a deal a simple one pager that I can understand, I get a $250 dissertation as to why it ended up being 25 or 50 pages costing $5,000. Something to do with the legal system and how it has to be done, or I'll end up on the losing end of the stick or in jail.

It appears that the Kennedy draft (thanks for posting) at least starts off with some clarity with a statement of rights, so maybe hope if they can get more of the final bill to be in more straight forward English ..........

SEC. 2. DECLARATION OF RIGHTS.
7 (a) RIGHTS OF PATIENTS TO CHOOSE THEIR DOC-
8 TOR.-It is the right of patients to select the doctor of
9 their choice.
10 (b) DOCTOR-PATIENT RELATIONSHIP.-A strong
11 doctor-patient relationship is essential to the practice of
12 medicine, and patients have a right to an effective doctor-
13 patient relationship.
14 (c) HEALTH PROFESSIONALS SHOULD JUDGE WHAT
15 Is BEST FOR THEIR P ATIENTS.-Doctors, nurses, and
16 other health professionals have the right to judge what
17 is best for their patients.
18 (d) No INTERFERENCE WITH THESE RIGHTS.-
19 Nothing in the this Act or the amendments made by this
20 Act interferes with the rights described in this section.

I think that with thousands more each week losing their current health insurance, there is even more urgency than ever to get a bill passed. I suspect that it is a complicated enough problem that no matter what urgency is in place that it will take a lot longer than one would hope for to get any system in place, so we need to get on with the job. My guess is that we are spending most of the money already in hidden ways, so hopefully a good plan will be in all our best interests.

Jim

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Re: Something to consider about healthcare
Ben A wrote:

Wouldn't it be interesting to read the "health care" bills that were approved in those countries that are now offering good care at a half-way reasonable cost? 

Ben,

This question is not meant to be inflammatory but I had asked it before and never received an answer.  Which country or countries do you think offer good care at a reasonable cost? 

As far as I can see, the main drivers for excessive costs in this country are the insurance companies, the pharmaceutical industry, and the legal profession and until the strangehold of those entities on our system is loosened, whatever system we adopt will continue to have the same problems. 

 

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Re: Something to consider about healthcare

Dr. KrbyLuv hit on one of my pet peaves. In cases where previous legislation is amended in a bill, you will see provisions such as,

Line 3 of Section 3(A)2(c) of the HIPAA  Act of 1996 is amended by replacing 'or' with 'and.'

Some staffer has spent hours of time to make a very precise change -- which could cost billions -- unintelligible unless you have the time to blaze the same research path she took.

So reading a bill is often fruitless.

Larry is right. This is done on purpose. Not only to exclude public participation, but also to sneak bold changes past most members of Congress in plain sight. Typically only a handful of key committee members, and their staffers, know what the obscure details actually do. The rest of the caucus is simply told, 'Vote for it. Nancy and Barney are happy with it.'

This process subverts democracy, and is intended to do so.  Probably the best heuristic rule is, 'Oppose any bill which contains more than 100 pages.' Invariably, there are nasty surprises concealed in the foot-thick blunderbusses, with malice aforethought. Just say no.

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Re: Medical care is the leading cause of death in the U.S.

Anyone suffering under the delusion that the U.S. healthcare system is the best in the world and will somehow deteriorate in quality under a single-payer system should read this article I recently wrote on my blog:

The Failure of U.S. Healthcare

The U.S. spent 16 percent of its Gross Domestic Product (GDP) – a cool $2 trillion – on health care in 2005.1 Considering this enormous expenditure, we should have the best medicine in the world. We should be reversing disease, preventing disease, and doing minimal harm. However, careful and objective review shows the opposite.

The U.S. ranks just 34th in the world in life expectancy and 29th for infant mortality. Of 13 countries in a recent comparison, the United States ranks an average of 12th (second from bottom) for 16 available health indicators.2

40 million people in this country do not have health insurance. The exorbitant cost of health care seems to be tolerated based on the assumption that better health results from more expensive care, despite studies that as many as 20% to 30% of patients receive contraindicated care.3

Even worse, a recent study by Dr. Barbara Starfield published in 2000 in the prestigious Journal of the American Medical Association demonstrated that iatrogenic incidents (events caused by medical intervention) are the 3rd leading cause of death in this country, causing more than 250,000 deaths per year. Only heart disease and cancer kill more people.

Dr. Starfield estimates that, each year, medical errors and adverse effects of the health care system are responsible for:

  • 116 million extra physician visits
  • 77 million extra prescriptions
  • 17 million emergency department visits
  • 8 million hospitalizations
  • 3 million long-term admissions
  • 199,000 additional deaths
  • $77 billion in extra costs

As grim as they are, these statistics are likely to be seriously underestimated as only about 5 to 20% of iatrogenic incidents are even recorded. Other analyses which have taken these oversights into consideration estimate that medical care is in fact the leading cause of death in the U.S. each year.

Starfield believes that a major contributor to the poor performance of the United States on health indicators is the high degree of income inequality in this country. Countless studies in the medical literature document the adverse effects of low socioeconomic position on health. New research suggests the adverse effects not only of low social position but, especially, low relative social position in industrialized countries.6

Perhaps the words “health care” have given us the illusion that medicine is about health. In fact, western medicine is not a purveyor of healthcare but of disease-care. When the number one killer in a society is the health care system, that system has no excuse except to address its own urgent shortcomings. Unfortunately, until this happens partaking in allopathic medicine itself is one of the highest causes of death as well as one of the most expensive ways to die.

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Re: Something to consider about healthcare

Politico reports that 'ailing Senator Robert Byrd, one of only two to have served longer than Kennedy, suggests in an emotional statement renaming the pending health care legislation for the late Massachusetts Senator:'

Oh my. This is really tempting fate.

The hidden agenda here is that Senator Byrd, who's pretty old and infirm himself, anticipates that it would become the 'Kennedy-Byrd Health Care Act' if he himself should depart this mortal coil.

Opponents will denounce it as 'Give Kennedy the Byrd Health Care Act.'

[cue sound of clashing egos]

 

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