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?
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: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:It is bad, wrong way to go about it (Score:1, Informative)
Um, the US Postal Service is always in the red and is currently unsustainable. That's the way you want healthcare?
Re:Single payer system (Score:5, Informative)
Re:I hope it's rushed through (Score:3, Informative)
Other people have said it but essentially, a very LOOSE intepretation of allows for this kind of thing:
1) Wrap it up in tax code
2) Commerce Clause
3) General Welfare Clause
Do you remember when Sonia Sotomayor was being grilled during her confirmation hearings? It was either Diane Fienstien or some other person explicity asked about how loosely she interpreted the Commerce Clause because they use it as the basis for so many laws and that overly strict interpretation would make their job harder or somesuch nonsense.
Re:What frivolous lawsuits? (Score:1, Informative)
I don't think anybody said they are ALL frivolous. Some certainly are. I don't think anyone including yourself would argue that doctors should have to pay the outrageously high malpractice insurance rates that they do now. Those high rates most certainly can not be caused by only (or even mostly) valid lawsuits.
Not so. (Score:5, Informative)
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:I don't have health insurance. (Score:2, Informative)
Good luck on getting them to pay the bills because most of them deny over half of the claims if not more. Go Google your provider, I'll wait here.
I have heard nothing but bad things about catastrophic insurance from college students I know who used it to register for classes and you should pry read your policy right now to see if you can even litigate them if they deny you coverage, I doubt it. Who is going to end up paying your health care costs if you get sick? Oh yeah, that's right everyone but you. You are no better than the welfare moms you bitch about.
Your paranoid delusions about this being some left-wing conspiracy to force you into some politically correct lifestyle would be funny if it was not so pitiful.
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.
Obviously (Score:2, Informative)
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.
Obviously, you've never seen a single hour of Fox. Imagine several schizophrenic paranoid white men, who are afraid of gays, Mexicans, muslims, the poor (that's code for minorities), hate equality, love war, and instead of using a values system as a starting point for their worldview, they start out with a worldview and then selectively apply their values system in nonsensical [colbertnation.com] rants [mediamatters.org]. Give them an audience and editors and producers that only care about ratings and pushing ideology handed directly to them from GOP and other ultra-conservative sources.
Now pretend that it's news so people think they are using journalistic standards, when in fact they are simply opinion shows.
All of the media outlets are rather stupid. Fox News is dangerously delusional.
Re:It is bad, wrong way to go about it (Score:2, Informative)
That won't really accomplish much. Even the quickest search reveals that the cost of medical malpractice is less than 2% - a rounding error compared to total costs.:
So, please stop listening to Republicans and/or watching Fox News and learn some real facts.
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, 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:Well, lets see (Score:2, Informative)
"How has private industry done so far with american healthcare? Cost more, gets less. Yup, that is a sign of success."
Considering that the government pays for over 50% of health care - I'd have to say that blaming this mess on the private industry is wrong. Costs are on the runaway because it's no longer a free market with pricing transparency, and people no longer pay for their own healthcare. Comprehensive insurance pays for everything and so people don't shop around for the best deal. Without real competition, of course prices have risen. Government takeover will really just mean forced rationing, because when it's free, everyone wants a slice.
"Oh and how has private industry been managing the economy?"
Great, except when government intervention screwed it up. Seriously, the housing thing that triggered all this? Fannie Mae and Freddie Mac caused it - two government organizations.
So can the government screw it up? Yes, because they did it once already. The solution isn't to give them more control, they've already proven they can't do it without screwing up, the sollution is to find a way to restore the basic economic forces that drive costs down and quality up - real competition in a free market.
Re:It is bad, wrong way to go about it (Score:2, Informative)
Re:Single payer system (Score:3, Informative)
There are a lot of drug companies doing research in other countries than Europe. ;)
Maybe you should do a bit of research
If you look at this list [wikipedia.org] you can see that some of the biggest pharmaceuticals are based outside of the US. There is a lot of research going on in medicine in the universities around here as well.
Another wikipedia article [wikipedia.org] states:
"In terms of pharmaceutical R&D spending, Europe spends a little less that the United States (22.50bn compared to 27.05bn in 2006) and there is less growth in European R&D spending."
So the research argument doesn't really bite.
Re:A false choice, of course... (Score:3, Informative)
Some interesting statistics (Score:3, Informative)
Here's the graph [wolframalpha.com]. Health Care expenditures, as a percentage of US GDP, have increased pretty significantly over the last 40 years. Keep in mind that health care costs are PART of GDP (so when WellPoint raises insurance rates, it actually shows up as an increase in GDP, which helps illustrate why GDP might not be the best indicator of our national economic health). That means that the expenditures in the health care sector have been growing much faster than those in most other sectors of the economy - if they were all growing equally, the portion of the GDP associated with health care would stay flat.
I have my own opinions about how to solve this mess, but I'm not in congress and I have trouble making my fish agree with me, let alone other people. So I won't talk about those, just about the facts of the situation.
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.
Re:Not so. (Score:3, Informative)
Re:A false choice, of course... (Score:3, Informative)
Annoying thing is, I read the bill (off the senate site) around sept/oct of last year, and rather liked it.
I need to get around to reading the newer bill, but there are already a lot of huge changes I know of that I don't like...
Re:This bill has nothing to do with health care. (Score:3, Informative)
Yes prelim findings are great. Except those findings are for the OLD bill, not the one coming-up for vote today or Saturday, so they are *irrelevant* except as interesting historical/obsoleted data.
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:Not so. (Score:2, Informative)
"Overall, the profit margin for health insurance companies was a modest 3.4 percent over the past year, according to data provided by Morningstar. That ranks 87th out of 215 industries and slightly above the median of 2.2 percent. By this measure, the most profitable industry over the past year has been beverages, with a 25.9 percent profit margin." http://www.usnews.com/money/blogs/flowchart/2009/08/25/why-health-insurers-make-lousy-villains.html [usnews.com]
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.
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:A false choice, of course... (Score:3, Informative)
A system of governance based on "what is good for me personally", applied over the population, is simple democracy. It sucks, but I haven't seen any form of large-scale government that doesn't suck more.
Forcing a company to do things that aren't in its best immediate financial interests is hardly new, or theft for that matter. Lots of businesses thrive in regulated fields. It's just a cost of doing business.
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.
Also not true. (Score:5, Informative)
Re:Neither. (Score:2, Informative)
Any Republican or Democrat that wants to expand government and spend more money is destroying this country. Don't even get caught up in the R or D Left or Right argument, it's a game. Become an independent, vote for people that match your standards and if they let you down kick them out of office.
Put the cool-aid down.
Re:A false choice, of course... (Score:3, Informative)
People might think you're joking when you say "go to reading", but the CBO report is only 25 pages, and the tables are very compact sources of interesting information.
Here's an interesting fact I gleaned from Table 2. In 2010, 40 million people get their insurance through Medicaid, the government program to provide insurance to the poor. In 2019, despite broadening Medicaid eligibility, that number drops to 35 million.
At the same time the number of people getting *private* insurance goes from 150 to 162 million.
So *some* of the savings are due to something that looks very much like *privatizing* some of the services currently provided through Medicaid. On the other hand, the combined cost of Medicaid and CHIP jumps to 29 billion/year in 2014 and 98 billion/year in 2019. The total increase in outlays for Medicaid and CHIP in the next decade will be increased by 434 billion total.
Alarming, isn't it? But still this bill manages to cut the Federal deficit by 138 billion over the same period. Yet the net increases in program spending are actually quite small, more like 7 billion over the coming decade, most of which goes into bringing provider payments up to market rate. So how do we get from 7 billion to 434 billion?
What you need to know is that Medicaid and CHIP are jointly funded by states and the Federal government, and that under this legislation the Federal government share of Medicaid goes from 57% to 90%, and of CHIP from 70% to 93%. So the 434 billion represents a 427 billion dollar decrease in *state* deficits, not even counting the effect of a 12.5% reduction in case load.
The infamous sweetheart deals we've been hearing about (the Cornhusker Kickback and the Louisiana Purchase) amount to something like 1/8 of a percent of this 427 billion. The Cornhusker Kickback has been removed in reconciliation, but Mary Landrieu successfully argued that the "Louisiana Purchase", a Medicaid subsidy that ends in 2016, was necessary to help the state complete its recovery from Katrina. This accounts for 300 million of the 427 billion, less than 1/10 of a percent.
So to recap, the bill reduces the Federal deficit by 138 billion, and state deficits by well over four hundred billion dollars.
Re:A false choice, of course... (Score:3, Informative)
Insurance sales across state lines (surely a real interstate commerce item)
As far as this one point is concerned, I can tell you why this is unlikely to ever happen. The individual state laws regarding insurance companies and what they have to cover/can't cover/etc varies wildly from state to state, even between neighboring states. It would be nigh impossible to do this.
Say you live in Maryland, and want to buy Insurance A from New Jersey. Say Maryland has a law stating insurance companies have to cover a specific condition, but they DON'T have that law in New Jersey. You will have bought insurance that isn't guaranteed to cover you the way it should because the laws are different in the two states...this is why companies have different "arms" in every state, because every state has vastly different laws. This is a very simplistic example, but they only get worse from there.
The only way interstate shopping of insurance would happen would be for the federal government to require all states to have the same insurance requirements...and we surely don't want the federal government trampling on states rights, now do we?
Source: I work in the healthcare industry.
Re:A false choice, of course... (Score:4, Informative)
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:Well, lets see (Score:2, Informative)
In my country we have what you would call 'socialized medicine' and have had since the early 70's.
7% of our budget goes toward Health. 17% of yours goes toward Health.
We have a higher life expectancy than people in the US, and a lower child mortality rate.
Under the public coverage 100% of people are covered for 85% of their health costs ... and 60% of people are fine with this.
The other 40% take out private health insurance. I'm one of them. Private health insurance in this country 'fills in the bits'.
Private health insurance premiums have increased by an average of 6% per annum for the last 20 years ... but I still only pay a 1.5% tax levy for my socialised system (that reimburses me 85% of my costs).
Private health insurance has a 15% administrative overhead in this country ... the public scheme has a 3% administrative overhead. Private health funds run for a profit ... so all manner of exclusions are introduced, but the public scheme funds everyone for everything (although not for the full costs, as I said.)
Most other Western countries (in Europe, Canada, Australia and New Zealand) have some sort of public health insurance scheme. Most seem to be running OK. All seem to be cheaper than the AMerican scheme, all seem to generate better public health outcomes, and all seem to be widely appreicated by their various publics. Any threat to same usually resuls in the politicians or political parties who do the threatening either losing or failing to win office.
I think the American thing has been clouded by illogical and self-intrested ideology (hey, if not for health and infrastructure, exactly waht do American's pay their taxes for?), self interest on the part of the American health funds and health establishment (who seem to be generating huge profits from the current unregulated situation), and the potboiling of various political pundits (being funded by the aforementioned funds and establishment in that uniquely American verison of privatised politics they call lobying and election funding.
Bottom line: If you don't do anything about it, it will expand to consume greater and greater amounts of your budget and it'll eventually implode under the pressure. If you got with this scheme you'll just slow the inevitabel down a little. If you eventually do come to realise that it's not a crime to whack tax dollars into a universal public health scheme, and have a private system there to pick up the gaps you may eventually manage to rein in the expenditure.
Else: The HMO suits, the fund shareholders, and the medical fraternity will ride your system down in flames ... in pretty much the same manner the banking fraternity did your economy.
Re:Need a little more research on Article 10 (Score:2, Informative)
That states the reason for drafting the constitution. It's not explicitly granting the power to do that (as is required by the text of the 10th amendment). Sure, it will be argued that health care falls within that, but it won't be the first time that an invalid argument was made in an attempt to prove a point...
Except that that exact section of the Preamble has already been used to argue successfully for government power for the greater Welfare of the people - and in a healthcare case, no less!
See: Ellis v. City of Grand Rapids.
I quote "Substantively, the case was about eminent domain. The City of Grand Rapids wanted to use eminent domain to force landowners to sell property in the city identified as "blighted", and convey the property to owners that would develop it in ostensibly beneficial ways: in this case, to St. Mary's Hospital, a Catholic organization. This area of substantive constitutional law is governed by the Fifth Amendment, which is understood to require that property acquired via eminent domain must be put to a "public use". In interpreting whether the proposed project constituted a "public use", the court pointed to the Preamble's reference to "promot[ing] the general Welfare" as evidence that "[t]he health of the people was in the minds of our forefathers". "[T]he concerted effort for renewal and expansion of hospital and medical care centers, as a part of our nation's system of hospitals, is as a public service and use within the highest meaning of such terms. Surely this is in accord with an objective of the United States Constitution: '* * * promote the general Welfare.'"
Re:Not perfect, but a start (Score:1, Informative)
The number of Americans without health insurance is 47 million [medicalnewstoday.com], according to the U.S. census.
Go and check the methodology for that number, firstly it is not sourced from the census it is sourced from two surveys. Secondly it covers everyone including resident aliens and those on temporary visas. Thirdly when you drill down in to the data you will note a significant number (~30 million) are firmly in the middle classes and can afford insurance but choose not to.
Many people do not want insurance.
Further, according to Paul Krugman, the U.S. spends over 15% of GDP on healthcare, nearly twice that of the U.K at around 8% [nytimes.com].
Again you get a much clearer idea with the raw data as compared to the opinion on the issue - countries report healthcare spending in extremely different ways, primarily the US reports on all spending including cosmetic and other quazi-healthcare spending whereas other countries do not.
Besides this I clearly stated that non-medical costs consume 80% of the spend, the expense is largely down to people wrongly assuming that they need full coverage insurance, they don't and until fairly recently insurance didn't cover visits to the dr etc.
Perhaps rather than mandating insurance government should be raising awareness on why the alternatives are often preferable.
According to Google the life expectancy of the UK is 79.3 years [google.ca], and 78 years in the U.S [google.ca].
Supportive healthcare is less important then lifestyle, a minority of early deaths can indeed be explained by lack of access to healthcare but as the US already has supportive care for the elderly (not to mention in excess of that in most of Europe) but lifestyle choices such as eating habits and smoking (Both of which are generally higher in the US) have a much larger impact. As an indication of this 8 times the number of Americans have heart attacks compared to Britons yet the survival rate is better then the UK (In the UK 48% die within 28 days of having a heart attack, in the US this is 12%).
The infant mortality rate in the U.S. is higher than the U.K. also (by about 1% I understand).
Again lifestyle choices are in play here as much, if not more, then healthcare access.
All to say this post – like many on this topic with an agenda – is utter, mindless drivel.
You don't have an agenda here? clearly you support socialised medicine of one form or another so clearly you have an agenda as much as I do, the difference being I don't want to force my view on to other people - they can have their single payer system as long as it remains voluntary and doesn't restrict my property rights via taxation.
The U.S. would have a much better healthcare system (among other things) if there weren't so many people like this with baseless yet entrenched positions.
As I mentioned earlier I recently migrated to the US. I have used the healthcare systems in the UK, France, SA and the US. While France was marginally better then the UK (I was able to actually visit a dentist for instance) they are both nothing in comparison to my experiences with the US system. I am middle class earning slightly above average (~2%) for where I live which is precisely the same to my situation in the UK. How many healthcare systems have you used first hand rather than simply reading aggregated statistics that can be used as opinion pieces as much as an article in the Guardian or Washington Post?
Do you just re
Re:A false choice, of course... (Score:3, Informative)
Pelosi has said this is only the first bill and that we should expect many more. I would assume that means trying to push for public options, and perhaps eventually build on the populist anger towards private insurance to remove it from most of the market. I think the push for socialized medicine is exactly what a large part of the Democratic party is fighting for, though by no means enough to win the day right now.
Remember though, a single-payer system affects only insurance companies. Private companies would still be building medical equipment, doctors would still run independent practices, and pharmaceutical companies would still exist. You could consider single-payer to be socialized insurance, but not socialized healthcare.
The bill empowers the DHHS to waive most of the fines for things like long-term care facilities' employees abusing patients if the facility serves an under-served population, and this is defined as rural areas or ethnic minorities. This is just Jim Crow under a new name: it means that facilities serving ethnic minorities are held to a lower standard, and African-American patients of them are not entitled to the same protections of the laws that white patients are. That's just wrong.
Interesting, I must have missed that part...can you provide me with page/line numbers from the bill? here's a link if you don't have a copy handy: http://www.scribd.com/doc/28572002/Reconciliation-HR-4872-Full-Text [scribd.com]
Re:A false choice, of course... Mass here... (Score:3, Informative)
Re:This bill is so wrong. (Score:3, Informative)
Re:This bill is so wrong. (Score:2, Informative)
The constitution says people cannot be coerced into signing a contract. By anyone.
Which is why you can receive a subsidy to purchase insurance if you can not afford it or "opt out" by paying a fine. Moving on...
Do some simple math! If you have a system that's already out of money, and you take more money from it to start a similar system, more than triple the number of people receiving benefits, it's going to cost more not less!
Unless you are simultaneously reducing costs for Medicare by similar amounts or funding the proposals in other ways (i.e. the "Cadillac" plan tax and Medicare tax increase.) Please read the CBO report, which is party-neutral and sanctioned by both parties to do its analysis.
Keep in mind that in 1965 lawmakers* predicted...
*(not professional governmental accountants or the CBO) Your point? Long distance forecasts are entirely less than accurate. Which is why they call them "official estimates." There are also provisions within the bill to take steps to meet the necessary reductions should the plan not work as intended. Next?
Tell it to the people in the UK or Canada...
Who have a single payer, government run system entirely unlike what is proposed in the bill?
The New England Journal of Medicine estimates that a full 1/3 of doctors will "QUIT PRACTICING MEDICINE" if the bill passes...
http://mediamatters.org/blog/201003190027 [mediamatters.org] The "estimates" you refer to were not "conducted, commissioned or published" by the NEJM.
We will have a government panel deciding who is worth said liver transplant and deciding who gets to live and die, instead of your doctor or a panel of your doctors. A healthy 19 yr/old kid, who hasn't put a dime into the system will be placed higher on the list than say a 60 yr/old man who has paid into the system his whole life. In essence the 60 yr/old man worked his whole life paying into a system that will deem him unworthy and spend his money on someone whom he has never met while he suffers and dies while younger "more economically viable" people will get treatment first. In the existing system, the same 60 yr/old man would be able to do whatever it takes for him to get his liver (insurance,debt,sell car/house etc.)
Really? Your example truly shows the lack of understanding and confusion perpetrated about this bill. Please cite to me the section within either bill that states a government panel will hear cases on liver transplants and decide their validity, expediency, etc.
...the feigned outrage at %3/yr is totally false when the alternative they suggest is higher.
Comprehensive Medicare reform is not the core of this bill. However, cost-saving measures that will affect Medicare are included in its provisions. Will it solve the Medicare crisis? No. Will it provide health insurance to the uninsured? Yes.
Re:Also not true. (Score:3, Informative)
Re:A false choice, of course... (Score:3, Informative)
Re:A false choice, of course... (Score:3, Informative)
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.
HSAs and FSAs are a poor substitute for what should simply be tax-deductible expenses in the first place. FSAs are needlessly complicated, and screw you by design if you spend more or less than anticipated, which is not surprising, because the rules were written by the very organizations that benefit when you lose.
Let's nuke HSAs and FSAs and make their eligible expenses tax deductible. There would be no downside whatsoever, except for the employers and account service providers -- overhead we don't need.
Re:A false choice, of course... (Score:3, Informative)
We are a republic not a democracy.
Oh god please, not this crap again. I don't know why they teach you the definitions of the word "democracy" and "republic" that's over 200 years old in schools (or do they?).
In modern English, a "democracy" is a form of government when all people are involved in the decision making process. When the involvement is direct, we call that a "direct democracy". When representatives are elected to make decisions, it is a "representative democracy". Neither case implies "mob rule" (though neither one precludes it; indeed, there have been many cases of what is effectively mob rule in U.S. history as well).
"Republic", historically, just means that the country is not a monarchy. To some extent, it also implies some degree of popular rule, though it needs not be a true democracy (e.g. San Marino was a republic in all meanings of the word since its inception, but it is a democracy for much shorter than that).
U.S. is indeed a republic, and it's also a representative democracy - thus, a democratic republic (federal constitutional democratic republic, to be even more precise). There is no contradiction here.
I'm not advocating replacing the government with anarchy and capitalism, I'm saying they must work together. Letting one overwhelm the other would be bad, very bad. Government should be constrained with checks and balances, and capitalism should be constrained by competition.
I agree with that in principle, but, judging by your previous comment in this thread, your perception of the desired balance between the two is rather different.
By the way, when you say that "capitalism should be constrained by the competition", do you imply that government has the obligation to step in and ensure competitive market, even if that means direct intervention?
Re:A false choice, of course... (Score:1, Informative)
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...?
Being in Canada, that's a foreign concept to me. I pay $54/month and that covers everything from going to the doctor to one time when I spent three days in hospital following an accident which required surgery. Walking in, presenting my government-issued health care card, and walking out days later I never had to sign one piece of paper and didn't pay a dime.
Yes, it's a tax-funded system and totally socialist... but I can't fathom it being any other way. Hearing stories from the US of people being involved in accidents who didn't have enough money/coverage and being asked by their doctors "You don't have enough money to save both arms. Which one would you like to keep?" is barbaric.
Re:dear libertarians and tea baggers: (Score:3, Informative)
socialized heath care is everything but good heath care.
Canadian here.
I've been following this all pretty closely. And as soon as the public option is off the table, I just have to sit back and laugh. Conservatives/Libertarians/name-your-right-wing-group-member just don't get it, and never will. I almost understand. It's baked into the fabric of America. Take advantage by any means necessary to gain wealth no matter what the ramifications. Case in point - insurance-based healthcare.
What is good health care and what is bad heath care? Go ask these four people: A poor American, a poor Canadian, a rich American, and a rich Canadian.
And for all those who think socialized medicine is evil, well I guess the rest of the world is just evil and America is, as it always was, the epitome of "good".
Oh, and BTW, since you already have socialized postal, fire, school and police services, you should return those. They are evil.
Just imagine a society where someone's house is burning down and the fire dept. checked to see if you had insurance before dispatching a truck. It boggles the mind.
Re:Well, lets see (Score:3, Informative)
First, life expectancy being lower in the US has to do with a different culture, specifically regarding eating and exercise habits. Unless you're suggesting that a government official force you to eat the government approved diet and force you to do government mandated exercises, you're never going to change that element with laws. Secondly, the infant mortality numbers are a lie. Even just a cursory glance at Wikipedia shows that other countries alter their data to decrease their infant mortality rate (if you take the time, you can find better sources for it as well). How do they do this? Things such as if the baby doesn't weigh X pounds and dies, they don't count it as a live birth. If it isn't X inches / cm long and dies, they don't count it. If it's less than 24 hours old when it dies, they don't count it. If it's more than X days premature and dies, they don't count it. In the US if a baby is born alive, even if it's only alive for a minute and is ridiculously tiny and premature, they still count it as a live birth.
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.
Oh great, a false claim where you say that anyone who disagrees with you is bought off! I disagree with you because I value my rights, believe in upholding the Constitution (the bill is unconstitutional, fyi - check out the 10th Amendment to the US Constitution), and don't want to see my costs go up or my taxes go up to pay for someone else's health treatment. None of those things come from "interests in the insurance or pharmaceutical industries", they come from me having an Economics degree, having read the US Constitution, and having seen (not just in reports / new stories, but first hand from friends / relatives themselves in Europe) that the wonders of government run health care are a myth.
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".
And they pay out the ass for that "privilege". In the US, federal income tax is between 15% - 35%, with state income tax being on average about 5% - so a US citizen (that pays taxes, the lower income ones don't) pays 20% - 40% in income taxes. They then (depending on state) pay anywhere from 0%-10% on sales tax. In Denmark, income taxes are 38%-59% and then they pay a 25% VAT on everything they buy. If you want to cut your income by 25% just to get "free" insurance, then you really need to retake some math / finance / economics classes.
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.
I agree, that sucks, and we should probably pass a law to prevent that. However, changing doctors and complaining about it is like complaining about having to go to a new mechanic - there are others you can go to. Yes, it's a bit of a hassle to take the time to find one, but it's nothing critical.
Oh, I also want to note the
Re:Every other European democracy has this. (Score:3, Informative)
Bullshit. [lmgtfy.com] Not to mention the fact that the Soviet Union has been gone for a long time now. Just what belligerent power is threatening Europe, exactly?
Re:A false choice, of course... (Score:3, Informative)
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?
We already have it; unfortunately it hasn't gotten much attention. H.R. 676 [wikipedia.org] would provide single-payer health care to every American resident, and includes information on how it would be funded, in 26 pages.
Granted, it's not 10, but it's much closer.
Re:Sure. (Score:3, Informative)
First link was full of fallacies, inconsistencies and straw-men.
For instance it talked much about color tvs. Do you know how much a 19" color tv costs? I got one at goodwill for $10 last year. Point rebutted.
It suggested that poor people shouldn't have cars... but a car is a necessity in most any city/county with under 1 million people. Public transportation isn't great here in the US... a car is about as close to a necessity as it gets (if you want them to work, which I suppose you do). Point rebutted.
It talked much about the "crowding" of poor households, but have you ever drove around the ghetto? They have big houses... that nobody wants to live in. It did mention that the idea of "poor" is perhaps skewed and that is true. But poor doesn't mean you have to live in a shanty to qualify. Point rebutted.
It also noted the comparison of poor crowding to Europe, but that's an obvious straw man. We could do the same by comparing the poor of rural AZ to the poor of Southern CA. In whole the US has more room than Europe... point rebutted.
The poor are much better off than median just a few decades ago... but if we keep adding time we can easily get to the point that we define poor as worse than when Jesus lived (or better than slaves, etc.), and 99.9 percent of the country wouldn't be "poor". Times change, things improve and the level of comfort for the poor will go up just as it does for others. I have heard this argument before and can understand part of it... but many people struggle. The definition of struggle may be debated and change over time, but we are not to a point that we can stop helping the poor.
Re:A false choice, of course... (Score:3, Informative)
Also, wha? Are you serious? China has no welfare? Well, Jeez, why all the fuss about them being Communist then? China has a huge [wikipedia.org] welfare program, and it's going to get bigger [chinadaily.com.cn].
Yeah, sure, stop buying insurance from UHC. And trade in the bargaining power of my company for the bargaining power of just me? Sounds like a good deal.
Re:A false choice, of course... (Score:1, Informative)
Social Security, Medicare, Medicaid and various welfare programs put together accounted for 48% of the 2009 Federal budget. Various defense and war activities accounts for 30%. We spend far more on "social welfare" than anything else.