Health Care Reform 2044
It appears that today might be the end of a very long road to health care reform. There's been a lot of debate on the subject really leading back before the election. The mainstream sounds like an echo chamber, so I'm hoping you guys have better insight. Will this bill do what the administration claims to do, or is it as bad for the future of America as Fox says?
A false choice, of course... (Score:5, Insightful)
Nothing is as bad for the future of America as Fox says.
BTW, I've seen thousands of comment trolls, but I think this is the first story submission troll I've seen.
Re:A false choice, of course... (Score:5, Funny)
We have nothing to fear but Fox itself.
Re:A false choice, of course... (Score:4, Insightful)
We have nothing to fear but Fox itself.
So true. Because any voice contrary to what we already believe should be feared and silenced!
Re:A false choice, of course... (Score:5, Insightful)
The truth is, the non-left of the American public (i.e. centrists, libertarians, independents, right, etc) would better trust the government to run healthcare if they actually had a better track record of running other programs. Find any government agency that's tried to do exceptionally well and you'll find that the smaller the scope of their responsibility the better they did. Medicare, Medicaid, Social Security, Postal Service, any regulatory agency - you get the picture. The federal government simply doesn't have a good resume; you can't blame the unbiased peoples for not loving the idea of the government running yet another program.
Thanks for the TRUTH (Score:5, Insightful)
How has that worked out? And where was their outrage over its creation and its current status of operation?
Try sending a letter or small package through the USPS, UPS and FedEx and let me know which one was more cost effective.
Now try building a straw man and knocking him down.
Re:Thanks for the TRUTH (Score:5, Insightful)
The USPS is in debt up to its eyeballs because electronic documents are causing a drop in volume. FedEx and USPS have adjusted their rates , fleets and staffing to accommodate this drop. The USPS is less nimble because it faces restrictions imposed by the government (what kind of business it can do, what rates it can charge, etc.). If we ran healthcare like this, you can bet it would have the exact same problem.
Furthermore, various states run insurance companies, but often they are used by private companies to dump their risky products. Since the state then holds the risk, they are supposed to set the rates to a level that can cover it, but the politicians intervene and drop the rates. The result is a company that either has to rely on a taxpayer bailout or failure altogether.
Here in Florida, they created a property insurance company to be the last resort for people who cannot get property insurance, which is required if you finance your house. The private insurance companies started divesting their risky properties, and the state insurance had to take them. When the state insurance company adjusted the rates to accomodate the risk, the policyowners yelled at their politicians, who in turn forced the company to limit the increases. This has resulted in a company that does not have enough money to cover losses in the event of a Hurricane. You can bet that if we get a major hurricane or two (we've had few since the scheme was concocted) that Florida taxpayers will be on the hook for the payouts.
Government healthcare would suffer the same problem with premiums becoming a political football that politicians use to get elected.
Re:A false choice, of course... (Score:4, Insightful)
do private insurers have better resume???
NO.
Re:A false choice, of course... (Score:5, Insightful)
Re:A false choice, of course... (Score:5, Insightful)
And when social security was being debated, Republicans screamed up and down that this was government socialism, and will be the ruin of everything good and democratic.
The baby boomers are about to test that proposition rather thoroughly.
Re:A false choice, of course... (Score:4, Insightful)
"Nothing is as bad..."
Yeah. Keep saying that. When our government starts taking away our liberties (forcing people to buy health care, taking away private property to give to another private party are just two examples), I'd say that's bad for America. When it continues to spend us into either runaway iflation or economic ruin, I'd say that's bad for America. But that's just me.
Any rational person can see this "budget neutral" bill is a hoax. 10 years of taxes, 6 years of real benefits. WTF? Additional budget trimming based on rasing the capital gains tax with estimates of increases in tax revenue that are NEVER going to materalize (as they never have in the past when estimates like this were used).
If I STILL wasn't paying a tax to help support the spanish american war [wikipedia.org], I'd think this was a joke.
Re:A false choice, of course... (Score:4, Informative)
(forcing people to buy health care, taking away private property to give to another private party are just two examples)
I'm not a fan of the bill -- the lack of a public option creates, as you say, a major problem by forcing people to give money to insurance companies that have little incentive not to gouge their captive market. A mandate *is* necessary, though, for insurance-based health reform to work. (That's why single-payer was the way to go...)
As for the other, that's inevitably always going to happen. Unless the government carries out its necessary functions entirely itself (which wouldn't be a bad thing, but would probably be considered "socialist" or something), there will always be government contractors and the like. But redistributing income is a core part of every government, ever. Taxing the serfs to keep your warriors in meat and mead fits that description just as well as does Social Security, the Space Program, and the local fire department.
When it continues to spend us into either runaway iflation or economic ruin, I'd say that's bad for America.
We are nowhere near runaway inflation. In fact, there is a substantial risk of a very bad deflationary spiral at present. (see e.g. graph here [nytimes.com]). Deflation is bad; it means wages decrease, consumer spending drops, and job losses keep mounting. I mean, deflation is wonderful if most of your assets are dollars. If you own anything of value though, like say a gold stockpile, or a house, or if you like jobs, deflation is very very bad. And there is approximately zero chance of Zimbabwe-style inflation in any imaginable non-post-apocalyptic America over the next fifty years.
This is a frequent misconception (Score:4, Informative)
In fact, per the bill, insurers have to pay out 85% of their revenues in actual medical care, which means it's more or less impossible for them to just charge whatever they want. Yes, a public option would be better, and single-payer would be better still... but this bill is still a huge improvement on the status quo.
Re:A false choice, of course... (Score:5, Insightful)
When our government starts taking away our liberties (forcing people to buy health care, taking away private property to give to another private party are just two examples)
I'm guessing that you chose those two examples because they are hot-button issues, but the reality of it is: you never had those liberties, but because they never affected you, you thought that you did.
Eminent Domain [wikipedia.org] predates the founding of this country. It sucks, especially when it affects you (my great-grandfather's farm was largely seized to build a school), but there are many, many cases where there is indeed a greater good served by it. The discussion really shouldn't be "should we have it?" but "when should we have it?" Eliminating it is not practical.
You already pay for health care, but like so many other things (roads, police, schools, car insurance), you don't see those costs directly. If, for instance, you saw an itemized car insurance bill explaining that most of your insurance money goes to paying out drunk driving accidents, or say, minor scratches on someone's Lexus, you would probably be pissed off (fun story: I bumped a Lexus once with my car-- it cost the insurance $1200, for a SCRATCH-- given that my insurance bill for the year is roughly half that, who do you think pays for it? Hint: you). Now there are many, many reasons why health care costs are going up. Medical practitioners are in short supply, medicine and equipment are very expensive (sometimes for good reasons, sometimes not), but most importantly, because the ratio of healthy people to sick (and by sick, I really mean, people needing care) people is swinging rapidly toward more sick people: baby boomers.
If you're insured, you're paying for them already. Because I work for a large company, and they have good bargainers, we only pay about $300/mo per single employee. I contribute half of that. But ever try to get insurance yourself on the private market? Good luck affording it!
Now, it can (and should) be argued that health insurance itself is part of the problem, and I agree. Insurance is supposed to be a hedge against catastrophe. You know, brain cancer. The kind of thing where the expense is so astronomical, that it would ruin you. Instead, we have insurers covering viagra (only actually necessary in very rare cases-- I have a friend with a rare pulmonary disorder, and strangely enough, viagra is an effective treatment for her) and elective surgery, because people don't want to pay for them themselves. This abuse has done nothing to control costs. It's a travesty that an out-of-pocket visit to your general practitioner can cost you a week's wages. I had an X-ray done recently-- it was $1000. We're talking about 19th century technology here, people. So anyway, now it covers the routine stuff, but often not the catastrophic stuff. They'll deny you coverage! WTF!
But hey, this is what we have. Do we:
Keep in mind that while there are millions of people who can't get healthcare at all, due to cost, the CEO of United Healthcare recently received a 1 billion dollar (US) bonus [cnn.com]. That, my friends, is fucked up. This man could personally pay for doctor visits for hundreds of thousands of people.
As many people here have said, they're trapped in their bad employment situations because they have a sick spouse or child. Imagine having to go to work someplace where they treat you like dirt for years on end because, without them, your loved one dies? That is slavery, plain and simple.
Personal health is a prerequisite for a healthy economy. If that guy could leave his job for a better one, without worrying that it would end his wife's leukemia treatments, or
Re:A false choice, of course... (Score:4, Interesting)
So anyway, now it covers the routine stuff, but often not the catastrophic stuff. They'll deny you coverage! WTF!
The real fun is when you have a preexisting condition and hence can't get covered for routine stuff, either.
I had a congenital heart defect, meaning I needed open heart surgery the first day of my life. I had it. It solved the problem, but, as early open heart surgery can often do, it damaged my heart's natural pacemaker, so now I have an artificial one. (Aka, what everyone calls a 'pacemaker', they actually mean 'artificial pacemaker'. Everyone has a 'pacemaker'.)
Fair enough. It's about $15000 in expenses every eight years or so, and, frankly, I can cover that out of my pocket. I'm not a moron, I know the batteries die, I know roughly the costs, I can save up.
But now I can't get insurance for anything else. Forget heart conditions, they won't even bother to attempt to cover me for anything. I call them up, inform them I have a pacemaker, and they politely inform me they will not cover me.
Private insurance is stupid. They simply don't want to actually provide useful insurance. No, everyone needs to pay into a government catastrophic care fund, and whoever needs it can use it. And we should, of course, continue to help subside the care of the poor.
Likewise, we should probably subside a little preventative maintenance, also. A free checkup a year or something will reduce problems down the road.
I'm really having a hard time figure out why we shouldn't provide all care, free, like NHS over in England.
I can vaguely see the argument that costs will be reduced if some people pay for some of their care, but frankly, costs can be just as reduced if the government pays hospitals and doctors set amounts for specific procedures, obviously resulting in them reducing their costs to increase profit.
But the entire manner we're going about solving this problem is backwards, solving it with 'insurance'. Sadly, we're so fucked up that solving it backwards is also helping solve it, like a car stuck in the mud. If nothing else, it will cut into insurance company profits, thus making it harder for them to fuck with the next reform.
Re:A false choice, of course... (Score:5, Informative)
Full bill: http://www.scribd.com/doc/28572002/Reconciliation-HR-4872-Full-Text [scribd.com]
CBO report: http://www.cbo.gov/ftpdocs/113xx/doc11355/hr4872.pdf [cbo.gov]
Get to reading!
Re:A false choice, of course... (Score:5, Insightful)
Re:A false choice, of course... (Score:4, Insightful)
Full bill, but not the final bill. Deals are still being made. Even the CBO says that the numbers are preliminary.
And frankly, 10 years of taxes and 6 years of benefits means they are cooking the books.
That's not true at all. If we had no healthcare costs in the U.S., then that would be reasonable. However, what we have is the single most expensive per-capita healthcare system in the world,, right now, so to analyze where we'll be in 10 years after we implement this plan 4 years out is entirely reasonable.
Re:A false choice, of course... (Score:5, Insightful)
Trouble is...I don't think this mammoth of a bill is going to fix that.
I'm quite worried that they are going to be adding a TON of new people to the medicare roles...a program which is already WAY in the hole. I believe Medicare is already, as is, slated to be many trillions of unfunded entitlement in the next 15 or so years. How are we going to help it by adding millions of new people? Where will the money come from?
Why can't they do a simple bill, with some main points everyone can agree on...in about 10 pages of simple language everyone can understand and agree on? Start from there and build on it?
From what I can see...this new thing is an attempt to build a model similar to what Mass. put into place, and from what I understand it is a HUGE financial burden on the state, and not quite working out as it was intended. Anyone from Mass that can comment on this?
I'm also concerned about what will happen to what is left of this bill after the SCOTUS challenges to it with regard to the Federal Govt. mandating that individual citizens be required to buy health insurance. I really do believe this will be struck down. Already there are laws and the like passed in many states actually banning the state from participating in this program, and I understand some are working on state constitutional amendments to battle what the feds are trying to do. This may turn into a large fight over the 10th amendment...which may not be a bad thing considering it has been largely ignored for years.
But say the individual insurance mandate is struck down...but the rest of the law exists? What will fund it?
This bill is serious, and the implications are large...I think much more study is required, however, at this point, it is ONLY about politics IMHO...citizens' be damned as long as one side of the other can claim victory.
Re:A false choice, of course... (Score:4, Insightful)
> Why can't they do a simple bill, with some main points everyone can agree on...in about 10 pages of simple language everyone can understand and agree on? Start from there and build on it?
You only think there is something everyone agrees on, but there isn't. Any kind of reform will necessarily step on the toes of the players making money off of it, insurance, pharmaceuticals, and providers. And they have all been involved in trying to water things down. Someone below suggested that everyone agrees on drug reimportation, not the pharmaceutical companies. Removing the insurance companies' anti-trust exemption out to be a no-brainer, but you know the insurance companies will oppose it. Something like 75%+ of the country thinks we ought to have a public option, if not a single payer, but the insurance companies won't allow it.
And after all that, the GOP has radically different ideas for health care reform than the rest of us. Fundamentally, they don't agree with the very concept of insurance. Collectivized risk? Socialism! They have Godwined the debate a countless number of times over very mundane suggestions. When the Democrats talk about collectivizing risk, they want to individualize it. When the Democrats talk about reducing premiums, they talk about raising them. When the Democrats talk about making health care cheaper, they say it should be more expensive. Their very ideas for reform are the complete antithesis of what the Democrats are trying to do. And even so, if the Democrats were to completely capitulate and implement an idea they loved, right now they are pursuing a scorched earth political strategy of obstructing everything they can, just so they can run on how the Democrats can't get anything done.
Re:A false choice, of course... (Score:4, Insightful)
Where do you get this?
I'm on a W2 gig right now, but previously working through my own S corp, I was VERY happy with my deal.
I set up a high deductible BCBS account, for catastrophic problems...and was then qualified to set up a HSA (Health Savings Account) where I could load it up (up to about $3K last year I believe) pre-tax. I used THAT money for my routine medical care. It isn't use it or lose it either like the FSA's they offer at W2 jobs. Why shouldn't everyone save for routine medical care just like you save aside money for house payments, retirement, etc...? I remember when Health Insurance used to be called "Hospitalization"....which was only there for catastrophic emergencies, not for every time Sally got the sniffles.
Using insurance the wrong way, along with HMOs and all the bean counters has a LOT to do with rising health care costs...I know this because when I was paying my own way, and went to DR's or even for some medical tests (MRI, lab..etc) as soon as I told them I was paying on my own, I got at least 15% knocked right off the top of their billing rate.
Why is that I wonder?
One Major trouble with the health care bill they're trying to pass is...that it actually goes in and cut amounts people can load up HSA's and FSA's...this part of it sucks.
Re:A false choice, of course... (Score:5, Insightful)
I think the CBO is a great place to start from...but again, this is a preliminary report they just came out with. I'd rather the congress not rush to try to pass this, till thorough study has been made!! What is the rush? I mean, if this is going to affect roughly 1/6th of our economy, let's study and get it right.
I'm concerned about the money shuffling congress has done to try to get this to look like it will save money and reduce deficit, I'm seriously concerned they are in some ways counting money twice. I'm also worried about them with regard to the bills to 'fix' the scheduled decrease in Dr's reimbursements for Medicare...they will likely raise those fees back in a separate bill, but really it should be figured into the cost of this one.
I like a lot of things that are in the bill, but honestly...would it not be easier to get rid for 2000 pages of a bill with God knows what all else is hidden in there...and go with a more basic one that has things most everyone can agree on?
These would all be popular starters, and I doubt we'd need a Lousiana Purchase or Nebraska deal to pass this through...?
How About Killing Subsidies for Fattening Foods? (Score:4, Interesting)
Similarly, the overall level of health might be improved if the feds stopped subsidizing meat, dairy, and corn (as in high fructose corn syrup). But not only is that not something being done outside of a healthcare reform bill, that's not even in this bill. You would think if the problem is how much it costs to make fat people not die, the first step would be to stop spending money that helps make them so fat in the first place.
Re:A false choice, of course... (Score:4, Informative)
Re:A false choice, of course... (Score:5, Insightful)
Except Fox. Fox is bad for America.
Just because Fox says the health care reform is bad doesn't mean that we should therefore support the reform. It disappoints me that this is the first comment I saw when I opened up this page. The point of this article is to discuss the reform in a constructive manner, not to bash entire ideologies just because they are not your own.
I am temporarily residing outside the U.S. at this time, and I haven't been paying attention to the argument. My mind is still malleable on this, so convince me one way or the other! Now, let's get back to a real discussion regarding the pros and cons of health care reform!
Re:A false choice, of course... (Score:5, Insightful)
Re:A false choice, of course... (Score:5, Funny)
Hey! I walk in on my own accord. Nobody needs to throw me!
Re:A false choice, of course... (Score:5, Funny)
One does not simply walk into Slashdot.
Re:A false choice, of course... (Score:5, Interesting)
First off, this isn't health care reform. It doesn't change all that much about the health care system. It's health insurance reform.
To that end, there are some small gains: insurance companies will be forbidden from doing some seriously awful things, like retroactively revoking the insurance of patients who get expensive illnesses, on the flimsiest of possible excuses (and in some cases based on faulty data that they refuse to investigate further).
In exchange, there are a lot of parts that are a big giveaway to insurance companies: because we've focused on giving everyone insurance instead of giving everyone health care, individuals are forced to buy insurance, but with inadequate oversight to ensure that insurance companies don't just gouge prices. Further, there isn't any choice for an insurance plan governed by democracy instead of stockholders, so we can probably expect that the small number of insurance companies will behave oligopolistically and raise prices, as usually happens when a small number of huge players control the market.
There will be some savings relative to the current system -- on the government's part -- but nothing like what could be achieved by a system that allows everyone to buy in to Medicare (and couples that with Medicare reforms like more careful monitoring of doctors who prescribe medically needless tests & procedures to make more money, and allowing Medicare to negotiate lower prices for its prescription drug benefit). The present bill is probably slightly better than not having it, but only very slightly.
This is not quite true. (Score:5, Informative)
Actually, there are provisions in place to keep them from just charging whatever they want: they have to pay out at least 85% of revenues on actual medical care. Given that insurance companies have their own staff that they have to pay, this puts pretty strict limits on how much they can actually profit.
Re:This is not quite true. (Score:4, Interesting)
Re:A false choice, of course... (Score:5, Informative)
The economic logic is as follows: We want to regulate the insurers such that they don't exclude people based on pre-existing conditions. This makes sense.
However, once you try to apply that in practice, it gets hairier: if you cease to enable insurers to do that, then you get what's called an "adverse selection death spiral", wherein some healthy people drop coverage (since they know they can get it back as soon as they get sick) which worsens the risk pool. Because it's worse, those remaining members left in this new risk pool get charged higher premiums. These higher premiums cause more healthy people to drop coverage (since they're getting less for their money) which causes a repeat of the same cycle. As this goes on, the price of insurance gets so astronomical that only the sickest have it and nobody can afford it because the cost approaches the cost of the procedure you're supposed to be insured for.
The way we work around this is the unpopular part. We put a mandate on everybody that says "alright, since they can't kick you out anymore, you can't game the system: everyone has to be insured". Whether it's better to do this by putting the mandate on individuals or on employers is debatable, but what's on the table is an individual one.
Now that we're mandating everyone have insurance, we need to address its affordability, since mandates to buy things that people can't afford don't really work. This is where the subsidies (ie, costs) come in. This package is basically $900bn in subsidies for people who have trouble affording comprehensive insurance--including everyone from the average joe to a reasonable percentage of the slashdot crowd. The latest bill has caps on premiums set as follows [tampabay.com]: "[f]or people who buy insurance on the exchanges, a family of four making $88,000 would have a cap of 9.5 percent of their income." The penalty for not buying insurance is $695/person/year with exemptions for financial hardship, etc.
The $900bn comes by way of medicaid as well as direct subsidies.
The rest, once those things are in place, are to cut costs/cut the deficit and regulate insurers. But the above is by far the bulk of the bill. While I personally wouldn't mind killing the insurance companies so we can institute a single-payer system, if you want pre-existing conditions gone, this is what you get.
Re:A false choice, of course... (Score:4, Insightful)
This entire argument is a total fallacy. It starts with the assumption that health insurance and single payer regulation will somehow control costs. The only way that will work is through rationing, and that's not really controlling costs - it's lowering services.
The way to control costs is to get consumers to ... watch costs. The reason health care costs have gotten so out of control in the first place is because patients never look at the costs, because the vast majority of health care is paid for by third parties. So patients demand all the best care and all the tests they want and costs be damned. Then they complain when insurance companies want to deny some services that seem unnecessary or reduce coverage.
So to reduce costs, you force consumers to pay out of pocket for lots of services, and relegate insurance back to just catastrophic coverage, like it used to be. Another useful reform is to un-tie insurance from employment. It's irrational the way the system now is mostly controlled by employer-based insurance, with no reasonable way for individuals to shop for insurance on their own, or to be able to buy it at reasonable costs when then change jobs.
If you look at the market for the typical services that insurance generally does not cover, like cosmetic surgery, lasic eye surgery, etc. you can see how costs for health services can be greatly reduced when people have to pay the bill themselves. If I had a monthly bill for all my food regardless of what I ate, I'd be demanding steak and lobster all the time. And guess what? If lots of other people had it too, food prices would skyrocket. What then? Government-based, single-payer food?
Re:A false choice, of course... (Score:5, Insightful)
Diabetes (along with many serious conditions) is buggery expensive to treat. In the real world, many sufferer's options are realistically:
Most civilised countries decided that the final option on that list wasn't a particularly desirable one some years ago.
True, but I still oppose the bill (Score:5, Interesting)
That's the problem, and it is a real problem. However this bill is not the answer. The answer is regulation at the state level.
The US health insurance industry is currently regulated by individual states. Different states have different rules. However, one element to the current system is that the state government (which is more responsive to the needs of citizens usually than the federal government) tends to have offices for dealing with these sorts of complaints. Additionally, the same offices take complaints from doctors about lack of authorization for procedures. While this means that some states have better health insurance requirements than others, it means there is a clear point of contact when a problem exists that needs to be resolved quickly.
The problem with this bill is it entirely supplants the state health insurance regulation structures and replaces them with a shiny new federal system. There is no way that the main protections that the states offer against insurance abuses will work right away in the federal system. By pre-empting a fairly mature system of state regulation, this bill will not save lives but rather cost them.
The secondary problem is that the bill has inadequate cost control provisions. In Massachussets, after they passed a similar bill, health insurance rates went up. We can expect the same here. Quite frankly, I have no idea how I will afford it when the rates go up. Right now, when insurance companies raise their rates, I can drop off until they lower them again. This bill makes me part of a captive market.
The real underlying problem left unresolved is that we have inadequate consumer protections in the areas of health care and health insurance. While this bill purports to improve these conditions, it fixes, IMO, the wrong problems and leaves major issues unresolved. Why is it that I have more consumer protections when getting my car repaired than in obtaining non-emergency medical care?
Re:A false choice, of course... (Score:5, Insightful)
Re:A false choice, of course... (Score:5, Insightful)
You people don't get it.
Fractions of a penny? My favorite charity happens to be Children's Healthcare of Atlanta. I donate a hell of a lot more than fractions of a penny, not that you should believe anyone posting on the internet; but the point is that it's charity: taxes and health insurance aren't charity. I don't buy health insurance for my family out of the goodness of my heart to help other people.
And it's not fractions of a penny for one guy... it's tens of thousands, if not hundreds of thousands of people who waited too long to buy insurance and want everyone else to pony up for it. And don't fool yourself with the phony "it's only..."
Income taxes went from 1% on the the highest income of the wealthiest people of the country to everybody paying taxes in brackets approaching 40%, and it was always "it's just a percent more... what's one percent more? Surely you can afford that?"
Sales taxes... from 1% to 9 and 10% in some places; where does it stop? It's always just "one more penny! Just one more penny for every dollar you spend!"
Do I think people with preexisting conditions deserve some help? Of course I do - stop pretending the alternative to government take over of 1/6th the economy is people dying in the streets.
Re:A false choice, of course... (Score:5, Informative)
This thread, and news coverage at large, are incredibly sparse on what the plan actually is! So here it is [reuters.com]:
INSURANCE MARKET REFORM
COVERAGE MANDATES, SUBSIDIES AND MEDICAID
FINANCING
MEDICARE
Re:A false choice, of course... (Score:5, Funny)
I think the issue the OP has with Fox has nothing to do with the Healthcare bill. A position that I also support.
maybe not nothing, if Fox raises your blood-pressure that much you might have a personal interest in health care provision.
Re:Obviously (Score:5, Insightful)
Wow. You complain about skewed information from Fox News, then post links to a satire site and ... Media Matters!
Hey, pot, kettle says you're black!
Re:A false choice, of course... (Score:4, Insightful)
The argument is essentially: hey, we're going broke trying to provide healthcare and doing it radically worse with fewer covered than any other developed nation Vs. you're a socialist tyrant who wants to destroy our way of live, kill our elderly relatives and force all of our women to have abortions! That's not an argument, it's a reasoned position vs. a rabid chicken.
Wow, distorting things from bias much?
Try "this sounds like a great idea on paper (even though the countries that do it are suffering massive problems due to costs), but we're sure we can make it work" vs. "it's unconstitutional, it violates peoples rights, and it's going to put costs off the chart when our country is already massively in debt".
I love how you start out complaining about people not having a real debate and then end by slandering anyone who disagrees with you by calling them "a rabid chicken".
It is bad, wrong way to go about it (Score:3, Insightful)
If you really want to fix healthcare, do tort reform first. Then break up the AMA cartel. Then look at other things that may need to be changed.
Is there anything that the government runs that really functions correctly/efficiently?
Re:It is bad, wrong way to go about it (Score:5, Informative)
Is there anything that the government runs that really functions correctly/efficiently?
Is there anything about the proposed act that is government-run? If there is, I'd missed it. It mandates a bunch of things that private insurance companies are required to do, but it doesn't set up a public option (aka government-run health care).
Re:It is bad, wrong way to go about it (Score:4, Insightful)
Is there anything about the proposed act that is government-run? If there is, I'd missed it.
That's right, you missed it. Medicare and medicaid (the largest expense our government has today, costing more per-citizen (not per covered citizen) than any healthcare system in the developed world, will be expanded to cover something like 15-20 million additional Americans. Everyone else gets mandated employer insurance. I'm not sure what the un- or self-employed get, but I believe that this is modeled on the Massachusetts option, and here in Mass. we are required to buy our own insurance unless our incomes are below the poverty line. In some of those cases, the government then provides subsidies for a private plan
Re:It is bad, wrong way to go about it (Score:5, Interesting)
Re:It is bad, wrong way to go about it (Score:5, Insightful)
In the case of government run health care the government loses money when it treats people who are sick.
Fixed that for you.
Well, lets see (Score:5, Interesting)
How has private industry done so far with american healthcare? Cost more, gets less. Yup, that is a sign of success.
Oh and how has private industry been managing the economy?
It kinda amazes me that people with a healthcare system that is useless in the middle of a global recession all under the management of private industry, then dare to ask whether government can run things.
Imagine a discussion in North Korea: "Can private industry be expected to handle food production?"
Answer: "Who knows, but the question is silly when the current system is such an obvious mess".
Sometimes you got to take a chance. Do anything because when you are nose deep in shit, chances are anything is an improvement.
Can the government do a better job? It would be hard to imagine how they can screw it up even more.
Re:Well, lets see (Score:5, Insightful)
Is your premise true? That the US health care system is under the management of private industry?
I would argue that the health care system we have is a monopoly that is shored up by wiling politicians who at best refuse to take simple steps to promote competition and transparency of costs and who pays what to consumers.
Re:Well, lets see (Score:4, Insightful)
4. Many of the successful systems in the world , e.g. Switzerland, are largely privately based albeit with governmental regulations.
Switzerland is not the rule, it's the exception. And by pure coincidence, they have the second most expensive health care system in the world. (Although they're still quite a ways behind #1, the US).
Re:Well, lets see (Score:5, Insightful)
Police? Or would you prefer to have privatized crime fighters? "Sorry, maam. You didn't pay, so we aren't interested in tracking down the person who shot your husband and kids and ran off with your jewellery".
Army? Or would you prefer it if the defence of the US was run by Xe Services LLC [wikipedia.org]?
Coast guard? "I'm sorry. We can't send a helicopter out to rescue your husband and child. You didn't buy our insurance, and your credit rating shows you cannot afford to pay the US$50,000/hour it costs to run the search and rescue operation. Thank you for calling the Coast Guard - have a nice day."
Fire departments? "Well, we'd love to put out the fire in your house, but you see, you don't pay the insurance company that we work for. No, sorry, no other fire department works in this town. But if you run in and fetch US$10,000 in cash, we'd be happy to help you."
Food and drug administration? You'd prefer it if there were no government checks on the safety of foods and drugs? I suggest that you not only look at the milk scandals that hit in China a few years ago, but also look at the history of the US itself. Not just the US, but pretty much all of the western world.
Re:Well, lets see (Score:4, Interesting)
Look up the history of fire departments.
The only reason health insurance is rival and excludable is that the US has decided it should be. Look at pretty much every other western country, and you'll find that health insurance isn't rival nor excludable, because they see an advantage to cheap and readily accessible health care.
And I realise that part of this is because the US has somehow convinced itself that anything that even resembles social anything is somehow evil. But that doesn't mean it is the gospel truth. In fact, if you really want to be pedantic, you'll find that social medicine IS gospel truth - why else would Jesus talk about the Good Samaritan [wikipedia.org]? I'm pretty sure that parable wasn't about how the priest and Levite were right in leaving the beaten and half dead jew alone.
"Fore they knew, he did not hath Health Insurance, and thus they leveath him to die in a ditch. And God looked upon these actions and saw that they were good."
I'm not a religious man, but I'm pretty sure that part isn't in the Bible.
Re:Well, lets see (Score:4, Informative)
Cost more, yes. Gets less, I don't think so.
Overall cost of health care is up because the tests, treatments, and medications that are now mainstream are all dramatically better than they were not all that long ago, when they were prohibitively expensive and rarely employed. They are used more widely now because they are less expensive (economies of scale), and, after all, nobody wants sub-standard treatment.
Absolutely provably false.
Harvard Business Review published a piece [hbr.org] on this recently. It uses raw data to compare the US health care system to other developed nations. It's conclusions:
Americans realize amongst the poorest health outcomes of developed nations. Americans have the lowest life expectancy amongst developed nations -- 78.1 years, compared to 81 in the UK, and 82 in Switzerland. [...] And America has the highest infant mortality rate -- 6.9 deaths per 1000 live births, compared to 5.4 in Canada, or 4.7 in Belgium.
The numbers are preliminary, but suggest a visible trend. Where survival rates have increased in other countries -- sometimes significantly -- in the US, cancer survival rates have dropped over the last two decades.
Americans pay more for healthcare because they trade more expensive products for less service, realizing poorer outcomes. Why? Because that is what maximizes near-term profits along the value chain. [...] Healthcare in America is a textbook example of thin value. The healthcare industry maintains significantly supernormal profitability -- yet, those profits are divorced from people being relatively better off. An American healthcare industry that "creates value" by limiting how much better off people are is simply transferring value from society to shareholders.
(emphasis theirs)
The article also goes on to state that most pharmaceutical companies spend over TWICE as much on marketing as they do on R and that the gap between R&D and marketing continues to grow. By moving to a government single payer health insurance system, the pharmaceutical industries would have to forego their ~20% annual profit margins and live with profit margins in line with the state of the economy.
The outraged opposition from "Real Americans" to public health care is entirely a manufactured product [alternet.org], supported by those who have interests in the insurance and pharmaceutical industries.
On a personal note, I talk with some friends from Europe on a regular basis about this, and they don't really understand the fuss, or the need for insurance to be involved. One friend from Denmark summed it up by saying "If you're a citizen, you pay taxes and get health care. If you're sick, you go to the doctor, you get treated, the doctor sends the bill to the government. The end".
As opposed to my current situation, where the Family Practitioner that my family has been going to since my son was born (the OB/GYN that delivered him works there) is now suddenly not covered by my insurance company - EVEN THOUGH the insurance company's own website says that certain doctors at the practice participate, and EVEN THOUGH we have previously had coverage for things performed at the doc's place. We got a bill for over $500 for a STATE MANDATED health checkup for my son that was required before he could enroll in Kindergarten - not a drop of it was covered. My employer stepped in and reimbursed me for a portion of it, but told me sadly that they couldn't fight the insurance company and that I'd have to change doctors.
We need health care reform. The Right Wing in Washington opposes it. They will fight it at any cost, because it cuts into their backing funds from the insurance and
Re:It is bad, wrong way to go about it (Score:5, Interesting)
Not so. (Score:5, Informative)
Re:What frivolous lawsuits? (Score:5, Insightful)
The major lawsuit-related driver of medical costs is not frivolous suits. It is jackpot verdicts, where someone with no lasting harm or even short-term disability can be awarded tens or hundreds of millions of dollars in punitive and other special damages. Because the number is big, jurors think that this sends the right message, and because a faceless insurance company will pay most or all of it, they're not afraid of the costs it will incur for the doctor. That's why tort reform usually tries to impose caps on damages, and that in turn is why courts usually throw the laws out (because the laws are seen as a legislative infringement on the judicial function).
Also not true. (Score:5, Informative)
This bill has nothing to do with health care. (Score:3, Interesting)
It is a desperate grab for tax revenue [market-ticker.org] to shore up a faltering budget.
Real health care reform would either include a single payer system or a rational free-market plan [market-ticker.org]. Nether party is willing to do this, however. I wonder why... [opensecrets.org]
Re:This bill has nothing to do with health care. (Score:5, Insightful)
You know, you're right. And I say this as an Australian living with our wonderful (and I'm not being sarcastic) universal, single-payer health care system here.
In the past on Slashdot, when the issue of US healthcare reform has come up, you inevitably get all the Canadians/Europeans/Australians/New Zealanders on here going "OMG of course you should reform - your system sucks, and ours works pretty well". It seems like a no-brainer ... why would you not want to move to a system like ours. It's cheaper, more efficient, everyone is covered, health insurance is not tied to your employer, and the health outcomes returned are better. I was one of those people ... it seemed absolutely crazy (as in, literally mind-bendingly insane) that someone would want to oppose moving from the overpriced, inefficient and inequitable system you currently have to a system like most of the rest of the world employs.
BUT... ...now that I actually ~read~ something about the proposal itself, I see why Americans are debating it so much. It isn't really giving you guys a system like that in CA/EU/AU at all! Rather, it's just modifying the current system somewhat. It isn't really a fresh, new or particularly efficient system. It's tacking something onto what's already there ... giving it a coat of paint if you will, but not really addressing the underlying problems. It's not introducing a single payer system like in most other developed countries. And although I would personally still support it on balance, had I been an American, I would agree that it's not really a straightforward decision and it does have some significant flaws.
So to non-Americans mystified at the opposition to this, take a read of the actual proposal. It's not a stark choice between "the system they have now" and "a system like in other countries". Rather the proposal is for something kinda inbetween, which runs the risk that it may not work as well as ~either~.
Re:This bill has nothing to do with health care. (Score:4, Insightful)
No... Most of us already know that they're getting a half-assed health reform bill since it's been mentioned enough times in the international media.
We just realize something is better than nothing, and that the US will never get its fingers out of the insurance companies collective asses.
Re:This bill has nothing to do with health care. (Score:5, Insightful)
I have Australian and American citizenship, I have lived in both countries and experienced both health care systems.
The US bill is not single payer public health insurance, it would be better for the American people if it was, but the reality of the situation is that such a system cannot pass in the US as things stand. The Republicans are against anything the Democrats do, more than half the Democrats are in the pockets of big corporations and the Libertarians are always up in arms about anything at all which costs them money no matter how large a benefit it might provide society at large. That's not even taking into account the Tea Party and all the crazies that have come out of the woodwork because Dick Cheney proved to the American people that the government was out to get them and made every right wing conspiracy theorist and Militia member seem sane.
That's not even counting the Americans of all political persuasions who are irate because Obama can't magic more than 11 million jobs out of his ass to fix unemployment. I mean presuming an average salary of 40k a year that'd involve finding 440 billion dollars a year somewhere, but never mind.
Single payer health insurance cannot pass in that environment it's too radical, too different, too much like the government actually doing something useful with the tax dollars. Never mind the fact that the US pays almost twice as much in terms of percentage of GDP than any other western nation, has poorer health outcomes, and leaves more than 10% of its population uninsured, it just won't pass.
As such this bill, which is very much imperfect is the best the American people can really hope for. Yes it leaves the insurance companies intact, yes it's full of corruption, pork, and special interest anti-abortion clauses, and yes it will probably mean that individuals who believe that they can cover the couple of grand a night for a hospital bed if they get sick might have to take on some of the burden of minimizing the insurance risk pool to keep down costs.
On the other hand it will give 30 million Americans insurance, require insurance companies to insure people with preexisting illnesses, and remove the bonds forcing people to keep a job at any cost to keep their insurance when they need it. It would also save the insurance companies from their current death spirals by bringing healthy people back into the risk pool which would in turn reduce over all costs. It would do this while, at least according to projections, actually lowering the deficit.
This is an ugly bill, and there are things about it which will need to be fixed, sections which are almost unconscionable. It will also require tort reform, medical practice reform, and educational reform to along with it to give it its greatest potential. Despite all that it is miles ahead of the current situation, and the best we can hope for. If Republicans had been more willing to vote yes, or there was more cost to minority filibusters we might have had a better one, with less pork, lower costs, and better results, but that's not the reality of the situation. This bill is the best the American people are likely to get under the current circumstances, and while it doesn't affect me personally I have a lot of family and friends who would be helped out tremendously by its passage.
Re:This bill has nothing to do with health care. (Score:4, Insightful)
Heeeeey... you know, that's about half of what the Iraq War costs per year. Maybe if we hadn't had a complete moron for president twice in a row in the last decade, we could actually magic those jobs out of someone's ass! And instead of spending all that money blowing shit up and killing people in a foreign country, we could spend it improving our goddamn infrastructure so we don't have any more bridge collapses, or building a long, high-speed transcontinental rail line so we have a workforce that can compete with China in the mass transit area, or laying more fiber optic cables so we don't have stone-age Internet access, or hell just sending all those 11 million people to college so we'll actually have an educated workforce (and solve the problems with university funding at the same time!)
Pity that would all be socialist though, not good and republican like a nice big war.
Re:This bill has nothing to do with health care. (Score:4, Insightful)
Only the absurdly rich come to the US for care, and they come here for absurdly expensive care that most Americans don't have access to. You're only making an argument that the very best care in the US is better than the very best care in these other countries while ignoring the fact that 99% of Americans don't care, because they aren't able to buy the very best care anyway. The average citizens in these nations do better than the average citizens in our own, and from a public policy perspective, that means a whole lot more than 'but the Prime Minister of X flies his private jet to the US when he needs surgery!'.
Re:This bill has nothing to do with health care. (Score:4, Insightful)
Kucinich is a politician. The dude knew that in the end, as a Democrat, he would have no future if he didn't vote for this bill; he was just blowing smoke. It is my opinion that he always intended to vote for it, and after the CBO analysis, he would be completely stupid (from a political standpoint) to still refuse to vote for it.
Somewhere in between. (Score:5, Insightful)
But then everyone knew that already.
I expect it will at least mitigate my issues getting health insurance after getting kicked off my parents' plan, so there's that.
As for the Republicans' complaints, I'm not really clear on what there is in this bill the Republicans didn't argue for. If the left had written the bill, it would dismantle the insurance industry and set up single payer. The only thing it's missing is tort reform, and the fact is that tort reform is a red herring. It accounts for 1-2% of healthcare expenditures, and that sounds about right. There should be a process for handling legitimate malpractice claims, and it's never going to be free.
Re:Somewhere in between. (Score:4, Insightful)
I don't understand how someone could say that tort reform is a red herring.
In terms of the direct financial impact of malpractice insurance and litigation costs, tort reform doesn't help more than a few percent or so. But in terms of the hundreds of billions of dollars wasted on unnecessary treatment because doctors are paralyzed to do anything besides order the extra tests and procedures, tort reform would make a HUGE difference.
Unnecessary treatment should have been dealt with head on, and tort reform is a key part of it since being sued is the excuse that doctors give for ordering all of that and the excuse that insurance companies give for allowing it. In reality, they LOVE it. Doctors get paid extra per procedure, and insurance companies just pass the costs on through premiums, making sure to collect their extra percentages.
Law suits are like terrorism. They affect the whole system in an extremely disproportionate measure beyond their direct impact due to the way that people change their behavior.
Re:Somewhere in between. (Score:5, Insightful)
Wrong forum (Score:4, Insightful)
Slashdot is packed with the entitlement generation and you're asking if they approve of the government creating another entitlement? Might as well go to Hell and ask the Devil if sinning is bad.
Re:Wrong forum (Score:5, Funny)
/agree mod the parent :-)
obligatory welfare joke:
A guy walks into the local welfare office, marches straight up to the counter and says, "Hi . . . You know, I just HATE drawing welfare. I'd really rather have a job".
The social worker behind the counter says, "Your timing is excellent. We just got a job opening from a very wealthy old man who wants a chauffeur/bodyguard for his nymphomaniac daughter. You'll have to drive
around in his Mercedes, but he'll supply all of your clothes. Because of the long hours, meals will be provided. You'll be expected to escort her on her overseas holiday trips. You'll have a two-bedroom apartment above the garage. The starting salary is $200,000 a year".
The guy says, "You're bullshitting me!"
The social worker says, "Yeah, well, you started it."
Neither. (Score:5, Insightful)
It's nothing like the health care bill we should have had, something to create a health care system comparable to other modern countries. The Democrats have no backbone and kept watering it down and morphing it until it was only vaguely acceptable to just barely enough of them to possibly pass. This sort of thing leads to awful legislation.
The Republicans, of course, are chanting "wait, wait, this is being rushed," but the facts are that they had years in which they could have pushed through health care reform - years where it was clearly necessary. Despite what they say, your average Republican simply doesn't believe in health care reform, which is why it didn't happen under Clinton and wouldn't happen under Obama if they could figure out a way to delay it. So instead of pushing for a fiscally responsible and conservative health care reform, the Republicans are really pushing for the status quo, without trying to seem like they're doing that.
Both parties stink. I'm kind of hoping this passes, but then the Republicans come into power. It'll be impractical for them to repeal this, but perhaps they'll be smart enough to tinker with it to make it better. Past history is not encouraging, though.
Re:Neither. (Score:5, Informative)
>>>Republicans had years in which they could have pushed through health care reform
They did.
Or have you forgotten the new Prescription Medicine Reform where people can get "free" medicine? Or the Tort Reform to help reduce expenses?
Re:Neither. (Score:5, Insightful)
You mean the one that will cost about a trillion dollars that isn't paid for: [slate.com]
This is typical of Republican governance, they bitch and moan all the time about fiscal responsibility, but they acted in the most inconceivably fiscally irresponsible way again and again during the decade or so they were in power. Now we the taxpayer and the democrats are at least attempting to clean up after the unmitigated spending spree that was the Bush Administration and Republican Congress (Iraq war, tax cuts for the wealthy, "free" prescriptions drugs) and are getting dinged for not being fiscally responsible? If this is a joke, it's not funny.
Very expensive half-assed bill (Score:5, Insightful)
As you might expect, this bill is heavy on the benefits and light on the necessary pain. There's virtually only one effective cost-control measure, the tax on high-cost health benefits, and that has been pushed off so far in the future that it will be killed before it sees the light of day. The bill recognizes that coverage of pre-existing conditions requires an individual mandate, but then implements it in a half-assed way that won't achieve the objective of forcing healthy people to get coverage. (It also puts a dual drag on job growth by both raising taxes on private investment and directly increasing the cost of employing people. Way to go.)
I would much prefer a bill that provided funds to the states to let them structure their own solutions to the health-care problem, as Massachusetts has done. But the top-down command-and-control midset in Washington is too strong for that.
Neither (Score:4, Interesting)
Too many hands in the Cookie Jar (Score:5, Insightful)
The evidence for the efficiency and quality of government-run healthcare in other countries is indisputable.
However, too many people have been making money hand over fist in the US to let any system where they would be the cut cost pass. Overall, it's an opportunity for the government to provide what the market cannot. Either affordable healthcare or writing into law corporate profits. I don't trust our congressmen to avoid the latter.
Not perfect, but a start (Score:4, Interesting)
From our perspective (I'm a health policy person based in Europe), US health care is staggeringly expensive, very variable, and very unfair. It's the single biggest cause of personal bankruptcy in the States.
Your health is poor, overall, especially you have poor child health, and relatively poor maternal and infant health.
A large part of your population have no access to good quality health care, and this imposes large costs on your society.
Your major companies find high health care costs for staff a major burden, and this sharply reduces the competitiveness of good US employers.
You have the highest administrative costs for heath care that I know of, now running over 30%, and at current rates of increase, in thirty years you will be spending 100% of your GDP on health services.
At the top end, there is no better health care anywhere for acute illnesses, but very few people can access this.
The proposed changes are a start, and only a start. With no public option, there is a real risk that the insurance companies will continue to combine together to rip you off. However, the current proposals will save a lot of money over the next decade, which is why the insurance companies are spending millions buying ads, and influencing politicians to stop the change.
I hope it passes!
Dear readers with mod points... (Score:5, Insightful)
do you trust obama and the dems ? (Score:5, Interesting)
1) a whole bunch of programs to evaluate new ideas; basically grants to researchers of one sort or another
2) regulations to rein in the bad behaviour of insurance companies
3) provide insurance to 30 million people who now lack it
lets leave 1 aside and look at 2 and 3
Do you really think that this bill will stop the insurance companies ? For instance, there is a section (109 in HR3967) that bans lifetime benefit caps. and you can read it yourself, and it looks pretty straightforward. I don't know how the insurance companies will get around it, but htey have, literally, hundreds of millions of dollars to buy armies of lawyers and lobbyiest and politicians to overturn this over the next 5-10 years
So my conclusion is tthat at best, (2) will have some moderate effect over a few years
As to 3 - I think what will happen, based on the MA model(I live in MA) is that yes, there will be a lot of people who will get insurance, but we won't have the money to pay for it. So, to save money, we will make this new insurance cheap and not very good (eg, low payments to doctors and hospitals, so only really bad hospitals will take people on this plan), so what will wind up happening is that we will create a permanent underclasss of people who have "insurance' that doesn't really work - it is like poor people who get charged with a capital felony crime; we pretend to provide lawyers, but dont' do anything really effective
If you look at the down side, it is Huge.
Obama is instituting a new national policy - health care, a basic fundamental right ina civilized society, is providd by for profit companies, and the FED. Govt requires you to pay these for profit compnies its horrible
Another way to look at this is Obama's track record, say with the wall street bail out, where he made sure bankers got their million dollar bonuses - with tax dollars that came from your pocket.
how on earth could anyone trust this guy with a track record like that ??
bad (Score:5, Insightful)
Random health care thoughts (Score:5, Insightful)
It amazes me that with the high percentage of negative public opinion on the health care bill that congress is still considering it. This is supposed to be government by the will of the people, right? To me, the will of the people is not being executed here.
Also, this is apparent in the back door manner in which they are trying to pass the bill by some trick of house/senate rules. This isn't some bill to appropriate a few million dollars for federal park support but a bill involving a trillion dollars of outlay. Given the current administration's massive spending and addition to the national debt with little to show for it, does anybody have any real confidence that this will work?
Some comments on health care industries making money hand over fist. Everybody seems to be in an outrage with doctors making hundreds of thousands of dollars per year, but nobody bats an eye when some sports star signs a multi-million dollar contract. If you were going to the hospital for open heart surgery, would you want the lowest paid doctor that has no incentive for good performance cutting you open? I'd want the super-star doctor that drives the Porche. If he's good enough to earn that much money, he's got to be worth his salt.
If they were really serious about health care reform, why didn't they start with the biggest money issue in health care: tort reform. Why? Because Congress is made up with a bunch of lawyers that don't want to see their industry lose out on billions of dollars per year in fees brought about by the misery of other people. People are incensed about million dollar bonuses at financial firms, but nobody shines the light on lawyers that, for the amount of work put in, end up making thousands of dollars per hour in a settlement or ruling. Consider, also, that even though that doctor is making a quarter of a million dollars per year, he's paying 25 or 30 percent of that in malpractice insurance to protect himself from every Tom, Dick and Harry that decides to sue because they didn't follow instructions and ripped their stitches out.
Some lawyers are a blight on society, but unfortunately, their buddies are crawling all over Washington as lobbyists or in Congress/DoJ/White House/etc. The more I think about it, the more I agree with what Get Out of Our House [goooh.org] is doing.
Hard to have a debate (Score:4, Insightful)
That said, the conventional wisdom states that the bill will be extremely expensive, on the scale of Social Security or Medicare. While I agree the current health care system leaves a lot to be desired, I think the timing is terrible. Our financial house is not in order and the economy seems to be in the middle of a long term case of fatigue. In short, I don't think we can afford it. I'm worried it could be the straw, or bale, that breaks the camel's back.
The bill appears to suck but.... (Score:4, Interesting)
Still a lot of provisions I don't like. For example if you get cancer you are screwed with a 5 million per year benefits cap. But then again my insurance at work has a 5 million dollar lifetime cap, so I am even more screwed. People like my brother who didn't go to college and work at hourly jobs without benefits need this bill. He doesn't make enough money to afford health insurance, and the company does not provide it. So there's really nothing he can do. If he gets poison ivy, even real bad, he has to sit at home and suffer rather than visiting a doctor to get a prescription for a cortico steroid that could cure it. That's not right.....
Also an awful lot of personal bankruptcies are due to medical bills. There was a time when I graduated college and I was unemployed for almost a year before finding a job. If I got into a traffic accident or I broke my foot jogging, I would have been in deep trouble. Sometimes surgeries go into the hundred thousands or even millions.... I don't have that kind of money. Even now, if I got cancer and went over that 5 million lifetime cap on my company's insurance, I'd have to somehow borrow massive amounts of money that I would never pay back, or just die... Any system that doesn't value human life over all else is broken....
This bill pretty much sucks. The more provisions I see of it, the more I hate it. Also the parties are busy taking pot shots about things like abortion funding instead of fixing the bill. I don't really care about abortion funding. Most Americans don't give a damn either except for a few religious right nuts. I just want a bill that gives me some security that if I lose my job and get sick, I'm not going to have to declare bankruptcy or suffer with my illness until it gets better or I die......
Considering the Trillions we spend on wars, I think one trillion for health insurance is worth it. It is an investment in the american people... And unfortunately if this shitty bill doesn't pass, the same thing that happened in 1992-1993 will happen again, people will scream it is the other party's fault, and then it will go away..... But it's a shitty Bill for sure. It is overly complicated, probably on purpose so that no one can read/understand the whole thing before voting on it. I'm sure there are lots of special interest payments in here......
It also does nothing to address the over charging on medical supplies. Ie the $500 paperclip. Not only that but when you don't have insurance all the rates are way higher than the rates negotiated with insurance companies. So not only is it harder to pay, it is even more expensive without insurance. Because those companies have people to say $500 for a paperclip, you're full of shit, we'll give you $1 and the hospital will be like okay, we still make $.95. And the people doing the billing try to double/triple charge me all the time. The insurance company and hospital billing often fight for 6 or 7 months before they get the entire bill properly worked out........ The hospital will bill twice, the insurance company will see two bills and reject all the bills, etc... Then you have to act as mediator to teach the hospital how to code the bill....And the insurance company to be ready for a payment....it wastes a long time.... By yourself you don't have a chance.... The rates are crazy too. I was well over $1,0
no reform. (Score:5, Informative)
This is not a 'health care reform'.
This is not even an 'insurance reform'.
What is going to pass is a few regulations that are supposedly going to make it not possible for an insurance company to drop coverage, to do rescission and a few more items. - This is good.
Here is what you are not going to get:
1. No optional public insurance against private insurance, the prices will not go down. Worse than that, what is happening is private insurance is raising prices to offset any of the new changes that will be coming with this 'reform'. Does not look good.
2. You probably are going to get a mandate, which is unfortunate given that you will have no public option. You will be forced to buy into expensive private insurance, there will be no choice or it looks like you will get some sort of a fine. Does not look good.
3. No cheaper drugs imported from other countries. The bill was introduced earlier this fall, but Obama actually killed it very very personally because he signed a deal with the manufacturers to do this: no competition from cheaper imported drugs AND the patents are to be extended from 5 years to something like 12 years. Does not look good.
4. Looks like US is one of the backwards countries that will try to limit women's access to health care they need. You going to get the 'reform' that will prevent any private insurance coverage for women that includes abortion. This is no joke, even for those who have coverage today, looks like they will actually lose it with this 'reform'. Does not look good.
The other part of it, the cost of it, that's a moot point. It was calculated that if Medicare was provided as a buy in for anyone at all, at cost (at cost - means whatever it costs, but no money is made for profit), or if there was a public option, then the reform could even save money. The way it is going to happen with no public negotiations with hospitals, no public negotiations with drug manufacturers, no import of cheaper drugs, no generics because the patents will be extended, well, I don't know if this will be cost neutral. It does not matter really, if US just cut its WAR cost, it's defense contractors costs they could probably fund the entire reform in health insurance and there would be enough money for the public education reform. Of-course that's not going to happen.
Anyway, Pelosi and Obama and the rest of them are lying sacks of shit. They do not want to take a vote on the public option, they will not take a vote on Grayson's proposal to just allow anyone to buy into Medicare at cost. This is not a health reform, this is just a little chunk of 'change' you were promised. Take it and be happy, cause you are not going to get anything better at all.
dear libertarians and tea baggers: (Score:4, Insightful)
universal healthcare is a form of investment in your society that pays dividends
if you don't pay for it overtly, you pay for the lack of universal healthcare in terms of easily preventable heart conditions complicating into more expensive conditions, breadwinners out of work because they can't treat their diabetes leading to their children to become street criminals, mumps and whooping cough outbreaks because vaccination is too complicated for the poor, people out sick more often because of inadequate healthcare, personal bankruptcies leading to losses at financial institutions due to sudden and expensive healthcare, etc.
in other words, you pay for healthcare, one way or another, no matter what your policy is
its just that universal healthcare is the CHEAPEST way to pay for it. but since the cost is overt and in your face, you reject it. but this simply means you don't understand the roundabout MORE EXPENSIVE and hidden ways you pay for it if you DON'T have universal healthcare
in other words, libertarian and tea bagger rejection of universal healthcare is based on a lack of ability to understand that life is complicated. what happens if you DON'T pay for healthcare as a society? people who get sick just disappear off the face of the earth? they are all paragons of personal financial virtue and never need aid? you yourself never need a helping hand? think about reality, then form an opinion
there are PLENTY of areas of life that should NEVER be public, and should always be private, for a number of reasons. capitalism, in fact, is the most useful engine for the creation of wealth ever invented by man. the point is, for SOME sectors of life, not all, making some thing run by the government actually is the CHEAPEST AND MOST EFFICIENT way for that sector to function
in other words, simplistic, fundamentalist adherence to the idea of free markets does NOT answer all questions in life, JUST AS TRUE as a simplistic, fundamentalist adherence to communist ideas does not work. but socialism, as understood by the rest of the first world, is simple the concept that SOME, not ALL, sectors of life require the government to run it for MAXIMUM FINANCIAL EFFICIENCY
a society with a capitalist engine, with socialist safety nets grafted on, is SUPERIOR and MORE EFFICIENT than a purely capitalist society. this really is the objective financially solid truth, not an opinion. lose your utopianism please: in life, simplistic absolutist philosophies, such as a fanatic devotion to individual reliance, DOES NOT WORK IN ALL FORMS. you are part of a society. as such, you contribute financially to it so that SOME functions in your life. by doing that some functions in your life are simply handled MORE CHEAPLY than if you handled them yourself. life is complicated, and requires a moderation between competing needs. understand this about the world, and drop your extremist ideologies
there is such a concept as the common good. there is such a concept as personal reliance. both are paragons of virtue that, in the real world, exist in tension in how they work. the idea is to find a BALANCE between the two ideals, not to simplemindedly adhere to one or the other polar extreme
teabaggers and libertarians: in SOME avenues of life, not all, the government is good, and works for you. you reject it at the price of your own impoverishment. that's the simple obvious truth
So why don't we try something else... (Score:5, Interesting)
The whole insurance industry for healthcare is based on a flawed premise that normal care need insurance.
Here's the car analogy... if our cars were done like healthcare:
1. Gas would cost 10$/gal at the pump for cash/credit.
2. You would pay 25$ for every time you fueled up and your car insurance company would actually pay them 3.75$/gal for the gas
3. You would pay 150$/month for this "wonderfully cheaper gas"
4. Ohh... and if you need roadside assistance you have to pay for the first 5 fully before the insurance company starts picking up the tab.
So let's go back to why health insurance is flawed. Normal healthy individuals may make 3 (annual plus 2 cold/flu) trips to the doctor in a year. I pay 218$ per month for insurance through my employer (not counting the portion they pay). This means that I am effectively paying 872$ per trip to my doctor... ok... lets let that sink in... even if you count a nurse, doctor and receptionist out front splitting it and them only seeing 3 patients per hour (rough cases might take that long) we are still talking they would be making 1.74 MILLION DOLLARS PER YEAR EACH! Now if you have any friends that are medical professionals I bet you know that there are VERY few that are making that much per year... especially receptionists :)
Now the argument is that "well this money helps balance out all the catastrophic claims"... fine then why are we using insurance for non-catastrophic claims? I have home owners insurance in case a tornado takes my house out but I don't run my water-softener salt or home improvement projects through the insurance company.
Why when it comes to health insurance do we loose the common sense that the more people that touch the money the more we have to pay for the same service.
Leave insurance for catastrophic claims and lets get rid of the day-to-day shenanigans. This should quell a lot of the issues in the industry and make it so that people could pay for what they need instead of padding peoples pockets for day-to-day necessities.
Re:Health care: break the MD cartel (Score:4, Interesting)
Re:Health care: break the MD cartel (Score:5, Insightful)
Your supply is high. In the UK we have 1.5 doctors per 1,000 people, in the USA, 2.4. Of course, we treat our doctors like crap.
The USA spends more per head on medical care than the rest of the world but gets poorer service. Either your efficiency is really low, or too much is getting creamed off the top as profit.
Part of the efficiency problem is that due to your liability culture you throw too many tests and treatments at things.
Part of the profit problem is that your medical system is run like a business that considers 15% a low profit margin.
Re:Health care: break the MD cartel (Score:4, Insightful)
Part of the problem is a McDonalds on every fucking street corner.
Re:Health care: break the MD cartel (Score:5, Informative)
In 1999, administration cost $1,059 per capita in the US, versus $307 per capita in Canada, per New England Journal of Medicine [nejm.org]. So much for private businesses being better than the government. I've lived in Cyprus, UK, Canada, USA, Australia and China, and my experience, the UK has the most encompassing system, and Canada (Ontario at least) the most proactive and efficient. I totally hated the American system, and I can't say I'm much of a fan of what I saw in Melbourne. China was great as an expat because it was so bloody affordable, but that's not what we're discussing here.
Re:NO ONE here can tell (Score:4, Insightful)
There's only one thing you need to know and the rest is pure diversion:
The taxes start now and the benefits start later.
The reason this bill is being shoved through against so much opposition is because the government is frantically trying to raise tax revenue before the debt black hole sucks them in. Too bad we've already crossed the event horizon.
Re:NO ONE here can tell (Score:4, Informative)
Not entirely true. The legislative actions (ending recissions, forcing insurance companies to cover everyone, etc) take effect immediately. Only the benefits that cost money have been delayed. There will be a big, positive effect right away.
Re:Single payer system (Score:5, Informative)
Need a little more research on Article 10 (Score:5, Insightful)
Re:I don't have health insurance. (Score:5, Insightful)
most of the time I pay CASH (about $200 a year), which means I deal *directly* with my doctor.
I live in a country that has government-run universal insurance, and I deal *directly* with my doctor, too. I'm not sure why you believe this isn't possible.
Re:I don't have health insurance. (Score:5, Funny)
Brain-washing and indoctrination.
Listen. Just because the person you meet and discuss intimate details with at the "doctor's" office is wearing a lab coat and a stethescope, it doesn't mean he or she is a doctor. They are actually just civil servants who have hidden microphones and very discrete ear pieces, that allows what you're telling them to be heard by a 13-person death-panel, who will then instruct the "doctor" what to do.
The death-panel consists of:
This is how socialized "medicine" works. The only medicine involved with it, is making sure your body is sold off in parts to raise money for the party leaders! WAKE UP AND SMELL THE ROSES! Actually, those aren't roses but the perfumes used to cover up the stench of rotting corpses in the streets.
</sarcasm>
Your humor is unwittingly accurate factually (Score:4, Insightful)
I live in a country that has government-run universal insurance, and I deal *directly* with my doctor, too. I'm not sure why you believe this isn't possible.
Brain-washing and indoctrination.
The funny thing is, your tongue-in-cheek post spoofing the right-wing mentality in the US actually answers the question quite factually right there.
I'm American. I've lived most of my life in the United States, but have lived numerous times, for a number of years, outside of the United States (Germany, France, Japan, Hong Kong, and currently the United Kingdom) and had occasion to use the healthcare system myself, or have one in my family use it, in nearly all those locations (to be pedantic: I did not need to use the healthcare system in Japan).
The US system is by far the worst system I have used, in terms of delivery of service, cost, and effeciency. The healthcare (when provided) was adequate most of the time, but subpar more often than you might imagine (my wife got a staff infection from a routine vaccination that nearly killed her...mainly because the hospitical couldn't figure out how to diagnose such an obvious problem for an indordinate amount of time. And don't get me started on the weeks-long waiting lists for critical tests like angiograms, and the lab test results that show up months late, the lack of follow-through by doctores, and the billing mistakes that are perpetual to the point of absurdity, and always favor the hospital).
In contrast, we've had no trouble whatsoever with the medical system in Germany, France, or Hong Kong (though this was back when Hong Kong was a part of the British Empire, so YMMV these days), and with the NHS in England, only the occasional hassle of having to follow up on getting test results (but at least when you do follow up, they show up within a couple of weeks, unlike Northwestern, where they routinely go AWOL for 6 months or longer).
But try telling that to any of my fellow Americans. They simply will refuse to believe it (and most likely label you a liar for daring to reveal such uncomfortable truths that challenge their world-view of us having the best system in the world). Why? Years of rhetoric and brainwashing, founded on absolutely no facts.
Want another datapoint? Guess where the richest (non-American) people in the world tend to travel to for their private medical treatment. And I'm talking about Richer-Than-God, I can fly in my gold-plated jet anywhere in the world I like (including the US) and spend more than the GDP of a small country on my medical care people.
It isn't the US. Not most of the time, anyway.
The US is a distant fourth, behind France, the UK, and Germany? Why? Because a lot of the leading-edge research Americans (like one who has posted here) think only happens in the US, and excuse our rediculously lousy price/performance ratio on, actually take place and is funded by those countries that are paying 25-50% of what we pay for our substandard medical care.
But then, we're the best in the world. We don't need to learn anything from anyone else, do we? (cue patriotic music and refrains of "God Bless America" here)
Re:I don't have health insurance. (Score:5, Interesting)
I have catastrophic insurance, so if I get cancer and my bills go over $20,000 then THEY will cover the cost.
That's what they want you to think. Of course, fighting a lawsuit when you're the one who has cancer and five-figure bills to pay, while the other side has a large legal department specialized on just that kind of case, is going to be fun.
Catastrophic health insurance is a scam.
What about the other morality issue? (Score:4, Insightful)
The morality issue that the health insurance industry is set up to rape its "customers" at the cost of their health?
There's a reason why every other civilized nation has publicly funded, universal health care - the government of a state, no matter how inept it may be, is in place to serve the needs of its citizens.
Private health care, no matter how competent, is in place to generate profit for the private corporation operating it.
The primary lever operating on a public-run system is voter outrage. This tends to apply pressure on the government to improve the system for the benefit of customers.
The primary lever operating on a private system is the generation of profit. This tends to apply pressure towards raising costs and reducing services.
The current American system is defective by design and is ruining the health of your citizens. And the shills of the insurance companies have convinced a large portion of you that it is immoral to try and fix the system. THAT is what you should be outraged about - that you have been successfully PSYOPed into believing that universal public healthcare is somehow immoral and wrong.
DG
Re:Comunisam (Score:4, Insightful)
This isnt communism. Read the bill.
Its more fascism. This isnt a government run health care program, its a mandate that buy private insurance from the insurance industry.
Thats not quite communism.
And Single Payer, Universal health care wouldnt be communism either, anymore than the military would be. Not that this bill is Single Payer. The democrats failed to bring real health care reform. What we are left with is a corporate welfare bill, that the democrats will praise like the republicans praised no child left behind and the patriot act. This not to say I support the republicans in anyway. More so that the democrats are just as lame and bought out by the corporations we ask them to regulate.
For some reason SOME people are ok with spending all of our money on military defense, but when it comes to spending it on health defense... certain people cry communism.
Comment removed (Score:5, Insightful)
Re:This bill is so wrong. (Score:5, Insightful)
The constitution says people cannot be coerced into signing a contract.
So then all laws requiring motor vehicle insurance are unconstitutional? That would be interesting.
The kings of inefficiency.
We spend 17% of our GDP on health care right now. Other nations get the same or better overall results spending less than half of this. Yes you might have to wait for some services but there is clearly huge inefficiencies in the current system, so much so that it is easy to argue that even a government run program would be better.
Tell it to the people in the UK or Canada who are waiting 6 months for a CT scan, where here in the U.S. it's unusual to wait for more than a few days.
There is quite a bit of evidence that the US has a huge and expensive overcapacity in exotic medical devices brought about by our current insurance system. We also clearly pay far more for the same drugs than people in other countries.
We supposedly pay 17% now, and we live longer lives
People in Canada, France, Germany, UK, Japan, Singapore, Hong Kong, Sweden, Switzerland and Italy all have longer life expectancies than Americans and pay far less than 17% of their GDP for that life span.
Your article is full of factual errors. Try doing some research next time.
Re:Every other European democracy has this. (Score:4, Insightful)
Which sort of implies that we, like the Romans and the British, are diverting just a wee bit too much of our resources on military activity, eh?
You can't have everything.