Health Care Politics

[FlamingRed]

Originally Posted by purplehawk

Where were you six years ago when the second round of Bush's tax cuts were enacted with no way of recouping the loss of revenue? Or when we went to was in Iraq - a war that has been totally funded by money borrowed from the Chinese and Japanese?

One of the problems health care proponents are having is finding the right mix of funds to cover the program... something entirely new in Washington.

The GOP response to this is that the revenue should be pulled from inefficient or wasteful programs elsewhere in the government. Bush wanted our country's tax dollars going to a movement to protect National Security rather than going to government programs that don't always benefit the greater society. Whether one agrees with his decision or not, it was valid.

My issue is that the answer funding this healthcare plan means more money out of my pocket, rather than weeding out wasteful spending to afford yet another government program.

Originally Posted by Wab

And for a person who works from home LA's public transport system is perfect.

But healthcare isn't about serving the healthy and in less than a heartbeat a person can go from healthy to requiring intensive care.

The question was in regards to my impression of the healthcare system. My impression is that it has worked just fine for me, a person who chooses to take care of myself and work into a job that offers me health coverage. A person in another position might appreciate a healthcare plan that does all the thinking and work for them, but I like to make my own choices.

[Overdose]

Originally Posted by flamingred

The question was in regards to my impression of the healthcare system. My impression is that it has worked just fine for me, a person who chooses to take care of myself and work into a job that offers me health coverage. A person in another position might appreciate a healthcare plan that does all the thinking and work for them, but I like to make my own choices.

Well that's great but since a successful healthcare system should really work best for people who are essentially the opposite of your situation i.e. unhealthy with recurring problems/serious diseases/ongoing conditions/inherited conditions etc then it doesn't really show off an insurance-based system as particularly good.
Healthcare is a natural monopoly anyway. At least in the case of National Insurance the providers of that insurance are answerable to their consumers rather than select shareholders.

[pensieve_master]

Originally Posted by purplehawk

Where were you six years ago when the second round of Bush's tax cuts were enacted with no way of recouping the loss of revenue? Or when we went to was in Iraq - a war that has been totally funded by money borrowed from the Chinese and Japanese?

One of the problems health care proponents are having is finding the right mix of funds to cover the program... something entirely new in Washington.

Back to Bush again? What does he have to do with the proverbial price of eggs? At least he delivered an affordable prescription drug benefit.

Obama is completely out of touch with the economic realities of the government and the people. He reminds me of a person who has been given a credit card and goes on a binge. This is why his honeymoon is over and his ratings are tanking.

Originally Posted by FlamingRed

This is why I take issue with the "czars" being hired by the current administration. They answer to no one but the President, and this goes directly against our fundamental system of Checks and Balances.

Right. It's the New Big Government that the liberals have always loved....only Bigger.

Obama just loves it even more, debt and taxes be damned. When it comes to the budget, the man is tone deaf.

[Siriusandme]

Originally Posted by FlamingRed

Countries with universal or socialized healthcare may have a handful of positive things to say upon which we could build a program, but ultimately it goes against American values. Our system is based on being able to access your own healthcare system and take care of your own needs. Having a mandated system will require people to follow the fold and base their lives upon dictations from Washington DC. I don't think Americans are built that way and shouldn't have to live under the thumb of an overly powerful government. That is not to say that any country with this type of system has an overly powerful government, but I believe adding the control of healthcare to the already overflowing plate of the US government would be a huge mistake.

Not necessarily. We (The Netherlands) used to have a socialized healthcare system but it was privatised a few years ago. Now everyone is insured. In fact, assurance is mandatory. If you're not insured you have to pay a hefty fine. Basic healtcare insurance costs € 85,-- (well this depends on the insurance company) and if you want a better insurance you'll have to pay extra. But this isn't mandatory. If you're below a certain income you get a taxrefund. For me (I live alone) that would be € 58,--.
The only downside to the privitisation is the fact that insurance companies try to save money where ever possible. They'll often refuse to pay for certain medication, but the government has nothing to do with this.

[FlamingRed]

Originally Posted by Siriusandme

Not necessarily. We (The Netherlands) used to have a socialized healthcare system but it was privatised a few years ago. Now everyone is insured. In fact, assurance is mandatory. If you're not insured you have to pay a hefty fine. Basic healtcare insurance costs € 85,-- (well this depends on the insurance company) and if you want a better insurance you'll have to pay extra. But this isn't mandatory. If you're below a certain income you get a taxrefund. For me (I live alone) that would be € 58,--.
The only downside to the privitisation is the fact that insurance companies try to save money where ever possible. They'll often refuse to pay for certain medication, but the government has nothing to do with this.

The government has everything to do with that! That's the problem with the proposed system -- it will drive up the cost for everyone because the insurance companies and healthcare providers have to make up for what they have to put toward the government system.

[Siriusandme]

Originally Posted by FlamingRed

The government has everything to do with that! That's the problem with the proposed system -- it will drive up the cost for everyone because the insurance companies and healthcare providers have to make up for what they have to put toward the government system.

What you want is a system where only people who can afford a private health care system can have, even if this means a "large" group of people is uninsured because this means a cheaper insurance and more freedom in choosing... right?? Correct me if I'm wrong. Problem is, I don't.. A perfect system doesn't exist and I find this perfectly acceptable when it means everyone is insured. Even homeless people, refugees of poor people (or people without jobs for whatever reason). Since I'm not the only person who lives here I see no reason to only think of myself...

[rigdoctorbri]

Originally Posted by Klio

Bri - this is a great post - thanks for summarising your views and expertise for all of us.
I totally agree on the lawsuits. This is a scandal, and it is starting to come over here to Eurpe as wel, which I find very worrying. I think there are cases of serious professional misconduct, but these are very rare, and (even more rarely) cases of harm done maliciously. But these qare exceptions. I would go a bit further than you and include 'serious professional misconduct' (i.e. unacceptable incompetence) in the failings that can be prosecuted - or there has to be a professional body to monitor this. But facetious lawsuits have to stop, as do the astronomical payouts which positively invite the vultures in.

I appreciate your opinion on the idea of including professional misconduct and gross negligence as cases for which a lawsuit would be permissible, but I must respectfully disagree.

On the surface it would seem logical, but unfortunately, lawyers will try to make a case of simple malpractice or a medical mistake into something much larger than it is. If we leave the door open for them to try to make a mountain out of a mole hill, then we defeat the idea of tort reform entirely. This would render the whole thing moot.

The only thing that should be done is to suspend or revoke the license of the practitioner. It is unfortunate that the victim of a medical mistake must live with it, but for our system to survive we must protect the doctors and hospitals from the fear of litigation. The only way to do that is to truly draw the line.

Concerning the financing system - I think it is right that some kind of mix of public and private, with a good deal of choice is a good way to go, especially for the US.

I am not sure whether I'd suggest a total either/or syste as you seem to do, simply because even in a big country expertise can be pooled better if public healthcare is accessible to all (while your system sounds as if you choose between one set of hospitals or another, but not both).

That is why I suggest John Q. Taxpayer is only committed to one system or the other on an annual basis. Just like most companies that offer insurance to their employees, there would be an open enrollment period when we get to pick and choose what kind of coverage we have for the year.

This is obviously a very crude sort of idea - unlike Bri, I am no expert!

I am hardly an expert either. I am a healthcare professional, but by no means an expert.

Originally Posted by purplehawk

Great post, Bri!

I'm delighted a public option is still on the table because the competition should bring the cost of private insurance down. I'm sorry the single-payer option isn't politically feasible right now. It would make things so much easier and coverage more accessible for those who need it. The marketplace feature President Obama spoke of in his weekly address is a good stop-gap in lieu of single-payer.

Ultimately, for our system to be successful, there must still be a private pay-option, which will force competition. It will force the competition even between the private pay providers and the public taxpayer one. If the services of the government paid providers dip too far below the standards of private providers, then next year more people will opt for the private pay option. This will take money away from taxpayer providers. Their bean-counters will realize this.

Originally Posted by FlamingRed

1. What is your impression of the state of the health care system in the United States?
My impression is that a lot of complicated policies and procedures are in place that make it difficult even for insured patients to reach their doctors and get specific care for their needs. Prescription drug policies are very complicated for patients because of people who abuse them. However, for an overall healthy person who takes care of themselves and have few healthcare needs, I believe the current system is functioning just fine.

3. What countries do you think the United States may be able to look to for inspiration or lessons, good or bad? If you are covered under such systems, what are the positives and negatives of your country's system?
Countries with universal or socialized healthcare may have a handful of positive things to say upon which we could build a program, but ultimately it goes against American values. Our system is based on being able to access your own healthcare system and take care of your own needs. Having a mandated system will require people to follow the fold and base their lives upon dictations from Washington DC. I don't think Americans are built that way and shouldn't have to live under the thumb of an overly powerful government. That is not to say that any country with this type of system has an overly powerful government, but I believe adding the control of healthcare to the already overflowing plate of the US government would be a huge mistake.

These two answers to two different questions contradict each other. On the one hand--and believe me, if anyone is interested in honoring what our Founding Parents outlined 234 years ago, it is me--you are in favor people taking care of their own needs, by their own means. However, you complain that the system is too convoluted for people to attain access to good healthcare.

Unfortunately, one is the byproduct of the other. The Constitutional question is What is a God-given right of an American? Well, we have a right to be safe. We have a right to have a vote. We have a right to have the government defend us from all enemies, foreign and domestic. Bureaucratic healthcare is an enemy of the people. I believe it is a right to have full access to healthcare, guaranteed with the wording about Life, Liberty, and The Pursuit of Happiness.

5. Any other thoughts?
I believe there is too much focus on "fixing" things by completely overhauling them in a short period of time. This is all being pushed through too fast. Surely things in the healthcare system could be improved, but the solutions being proposed are not well thought out and are rather short-sighted. There are few checks and balances happening in our government right now and thus a rather one-sided plan is being shuffled through our system without the lawmakers or the people really knowing what's going on and what the details are. It's way too complicated to be considered a solution to an already complicated system.

It is not "too fast". These problems have been growing, with space widening between the insured, uninsured, and governmentally subsidized for over four decades. Every President since Nixon has been talking about "their healthcare plan", but so far none have gotten anything pushed through. Not that I am an Obama fan, but at least he has a plan, and has demanded solid, written proposals on his desk on this matter.

[FlamingRed]

Originally Posted by Siriusandme

What you want is a system where only people who can afford a private health care system can have, even if this means a "large" group of people is uninsured because this means a cheaper insurance and more freedom in choosing... right?? Correct me if I'm wrong. Problem is, I don't.. A perfect system doesn't exist and I find this perfectly acceptable when it means everyone is insured. Even homeless people, refugees of poor people (or people without jobs for whatever reason). Since I'm not the only person who lives here I see no reason to only think of myself...

No. Basically, I don't think ANYONE should require insurance. If a person takes care of themselves and also happens to have a job with a benefit of health insurance, then great. Theoretically, healthcare costs should be affordable enough WITHOUT insurance. My family did it for years before this whole debacle blew up onto the international stage.

I don't think it's a matter of "who should have insurance and who shouldn't," it's a matter of the cost should be affordable whether you choose insurance or not. If someone has a case of the sniffles, they shouldn't have to pay astronomical prices to see a doctor and get a prescription for antibiotics just because they don't have insurance. For our basic healthcare needs, I believe it should be affordable to get a doctor's opinion, basic care, and prescriptions without insurance being necessary.

In the case of someone who is getting older and has medical needs, then yes, getting themselves to a place where they can either afford to purchase their own insurance at an affordable cost or take advantage of an employment benefit would be ideal.

In summary, I don't think it's necessary for the nation to be requiring and supplying insurance to all Americans. If a person feels they need or want it, they should be able to make the choice, and if they choose to take advantage of insurance then it should be affordable and not astronomically priced in order to pay for everyone, including those for whom it is not necessary.

Originally Posted by rigdoctorbri

These two answers to two different questions contradict each other. On the one hand--and believe me, if anyone is interested in honoring what our Founding Parents outlined 234 years ago, it is me--you are in favor people taking care of their own needs, by their own means. However, you complain that the system is too convoluted for people to attain access to good healthcare.

Unfortunately, one is the byproduct of the other. The Constitutional question is What is a God-given right of an American? Well, we have a right to be safe. We have a right to have a vote. We have a right to have the government defend us from all enemies, foreign and domestic. Bureaucratic healthcare is an enemy of the people. I believe it is a right to have full access to healthcare, guaranteed with the wording about Life, Liberty, and The Pursuit of Happiness.

I don't see how those things are contradictory. I believe Americans have the right to choose for themselves and not have choices dictated upon them by the government. However, the government's job IS to handle issues on a national scale, of which the corruption in insurance/healthcare is one. I believe the solution for this is the government to solve the existing problems in the system rather than introduce an entire new system, which may or may not work, and will inevitably have problems of its own.

[Klio]

Originally Posted by rigdoctorbri

I appreciate your opinion on the idea of including professional misconduct and gross negligence as cases for which a lawsuit would be permissible, but I must respectfully disagree.

On the surface it would seem logical, but unfortunately, lawyers will try to make a case of simple malpractice or a medical mistake into something much larger than it is. If we leave the door open for them to try to make a mountain out of a mole hill, then we defeat the idea of tort reform entirely. This would render the whole thing moot.

The only thing that should be done is to suspend or revoke the license of the practitioner. It is unfortunate that the victim of a medical mistake must live with it, but for our system to survive we must protect the doctors and hospitals from the fear of litigation. The only way to do that is to truly draw the line.

Yes, I would agree with this. I am not sure whether I made it clear, but my reason for including professional misconduct etc. was to make sure that hospitals and individuals have a strong incentive to do their best.

I am less concerned with compensation (although some 'hard cases' are a tricky issue - like the example someone mentioned above where someone's healthy leg was amputated instead of the bad leg).

Thing is, that cases of removing someone's lience would still have to involve some legal process - but obviously, lawyers would have little reason for self-interested pushing for law-suits because this would not be an obvious target for the despicable 'no-win-no-fee' deals .




I also agree with the idea that a mix of public and private is better for quality because it creates some competition. I think this mechanism is probably not used enough here in Europe. However, one has to construct the system very well to make sure that competition does indeed have an effect on quality in terms of medical performance (as opposed to other things - i.e. insurance companies driving costs down, if they are essentially the 'customers' who determine the direction of the competition). Competition will always have an impact, but not necessarily the desired impact unless the system is designed well.

[rigdoctorbri]

Originally Posted by Klio

Yes, I would agree with this. I am not sure whether I made it clear, but my reason for including professional misconduct etc. was to make sure that hospitals and individuals have a strong incentive to do their best.

That is where "peer review" is so important.

I am less concerned with compensation (although some 'hard cases' are a tricky issue - like the example someone mentioned above where someone's healthy leg was amputated instead of the bad leg).

In that case the mistake happened at the radiologist office. They marked the leg as the wrong one, and the film was backwards. Easy mistake back then, when they didn't have wording emblazoned upon the film. Of course, the surgeon should have checked for himself. It was a series of mistakes that culminated in one huge "HOLY $%^$*#^!!!!"

Thing is, that cases of removing someone's license would still have to involve some legal process - but obviously, lawyers would have little reason for self-interested pushing for law-suits because this would not be an obvious target for the despicable 'no-win-no-fee' deals .

Sure, but why does it need to be so difficult. Lawyers have an organization called THE BAR, and to be disbarred a lawyer has his license revoked by his peers. It is a legal process, but is essentially done internally through peer review. The doctors can do the same.

Originally Posted by FlamingRed

I don't see how those things are contradictory. I believe Americans have the right to choose for themselves and not have choices dictated upon them by the government. However, the government's job IS to handle issues on a national scale, of which the corruption in insurance/healthcare is one. I believe the solution for this is the government to solve the existing problems in the system rather than introduce an entire new system, which may or may not work, and will inevitably have problems of its own.

There comes a point when a system is so broke that it needs replacing. My TV quit working. It was less trouble and money to replace it than to fix it. However, I don't believe that the current system is so far gone that it can't be fixed. That has to start with tort reform, but it must end in available and afford able healthcare for All Americans.

With 50 million Americans with little or no health coverage, but still having medical needs, the system needs to find a way to cover them too. Either, the government picks up the check through taxes, or the hospital eats the cost. More often, the hospital eats it, but makes up for it by raising its prices. If all providers charge similarly for the same services, then it becomes "reasonable and customary." This means the insurance company pays for it. Hence, they must raise their rates to make up for it.

Ultimately, we must find a cost-effective, yet complimentary system that will cover those 50 million uninsured and underinsured.

[Klio]

I get the peer review suggestion now, Bri. As long as there is due process, that would obviously be sufficient, IMHO.

Originally Posted by rigdoctorbri

With 50 million Americans with little or no health coverage, but still having medical needs, the system needs to find a way to cover them too. Either, the government picks up the check through taxes, or the hospital eats the cost. More often, the hospital eats it, but makes up for it by raising its prices. If all providers charge similarly for the same services, then it becomes "reasonable and customary." This means the insurance company pays for it. Hence, they must raise their rates to make up for it.

Thing is, that those worried about taxes are already paying so much more for insurance premiums simply for the reason that others aren't insured which drives up the costs without any controls. Any mechanism which will bring those costs under control (i.e. linking them to each person who needs the services, rather than opaque rice rises to somehow cover the shortfalls, combined with random exclusions of services from insurance policies as happens now).

I think it's very short-sighted not to see these wider implications of the system, the hidden but very high costs. This isn't at the moment the state taxing people for health care, but it's the insurance companies extracting the money (who also have to make an extra buck, or a billiion, to please their share holders).

It's similar with the protests about 'the government can't decide which treatment I can have' - well, now some insurance company is doing that for most people, with sometimes scandalous outcomes, especially when hardworking people with an insurance suddenly find that chronic deseases aren't covered.

IMHO - if such decisions really have to be made, and if money has to be handed over, I'd prefer to have those decisions and funds handled by someone with as little ouside interest (shareholders, profit, bonuses) as possible. That's why I am always surprised that so many people are SO distrustful of the state but don't seem to see a problem with the private companies. There is nothing wrong with distrusting the state, but I think it's very naive not to distrust private companies just as much, if not more.

[FlamingRed]

Originally Posted by rigdoctorbri

There comes a point when a system is so broke that it needs replacing. My TV quit working. It was less trouble and money to replace it than to fix it. However, I don't believe that the current system is so far gone that it can't be fixed. That has to start with tort reform, but it must end in available and afford able healthcare for All Americans.

With 50 million Americans with little or no health coverage, but still having medical needs, the system needs to find a way to cover them too. Either, the government picks up the check through taxes, or the hospital eats the cost. More often, the hospital eats it, but makes up for it by raising its prices. If all providers charge similarly for the same services, then it becomes "reasonable and customary." This means the insurance company pays for it. Hence, they must raise their rates to make up for it.

Ultimately, we must find a cost-effective, yet complimentary system that will cover those 50 million uninsured and underinsured.

This goes back to my thoughts on WHO we're insuring and WHY. If covering all the uninsured is such a burden and requires such turmoil to establish, why not determine WHO necessitates government assistance with their healthcare and address that group? I suppose it could turn into an abuse situation such as Welfare, but I just don't understand why a program that makes blanket requirements across the country is the solution for a problem which is defined as simply insuring the quantifiable group of uninsured. There are plenty who are already insured who do not need the government's assistance with their insurance, yet will be at the mercy of this program in the name of providing insurance to others.

Yes, it is the government's responsibility to care for its citizens, but should it be at the expense of another group of citizens?

[purplehawk]

Originally Posted by pensieve_master

Back to Bush again? What does he have to do with the proverbial price of eggs? At least he delivered an affordable prescription drug benefit.

He did not. Like NCLB, the Medicare D program was, and is, nowhere near affordable. Conservatives like to mutter about Social Security, but Bush has made a much greater mess with Medicare in terms of financing shortfalls in the near future.

Medicaid in Crisis as Bush Administration Tries to Shift Billions in Cost to States Senior News, February 2008.

Geithner on the Medicare Crisis: Two Possible Solutions Worth Mentioning May 2009.

Originally Posted by Bri

These two answers to two different questions contradict each other.

Good catch, Bri. There is way too much "Me, Me, Me" in some of the arguments I'm hearing from conservatives.

Originally Posted by FlamingRed

Yes, it is the government's responsibility to care for its citizens, but should it be at the expense of another group of citizens?

Yes. Those who've benefitted from years of tax cuts - paid for by borrowing from foreign governments - need to realize there is no such thing as a free lunch. Some of us have had the next best thing over the past eight years, but it is now time to pay the piper.

ETA:

I just read today's "Progress Report" from Think Progress and thought this particular item appropriate for those wondering about the funding of the Bush tax cuts and how that plays into the debate on health care.

Progress Report RECOVERING FROM THE BUSH TAX CUTS: As House Ways and Means Committee Chairman Charles Rangel (D-NY) explained, "This is a tax on less than 1 percent of the wealthiest people in the United States of America." According to estimates from Citizens for Tax Justice (CTJ), 98.7 percent of Americans will be totally unaffected by the surcharge. And the roughly one percent of Americans that will see their taxes increase under the surcharge have benefited from years of skyrocketing income and a falling effective tax rate. Between 1979 and 2006, the inflation-adjusted after-tax income of the top 1 percent of households increased by 256 percent, compared to 21 percent for families in the middle income quintile. Meanwhile, over the ten year window from 2001-2010, the Bush tax cuts gave the richest one percent of Americans about $715 billion in tax breaks. This comes out to about $518,000 per household over ten years or about $51,800 per year. The surcharge, meanwhile, would raise $544 billion from those same households over 10 years. So as CTJ pointed out, the surcharge "would require the richest one percent to give back some, but not all, of the tax cuts they received over the 2001-2010 period." "It certainly is okay for me to tell my friends on Wall Street, who just got a bonus of $600,000, that they're going to pay more in taxes so that we can lower health care costs in America," Sen. Bernie Sanders (I-VT) said.

This truly makes the argument for paying the piper, does it not?

[Chris]

I'm already beginning to see signs of over-generalization and labeling of the other side using derogatory terms in the debate. Thus, it's already time to be a bit more careful with the posting...

[rigdoctorbri]

Originally Posted by Klio

Thing is, that those worried about taxes are already paying so much more for insurance premiums simply for the reason that others aren't insured which drives up the costs without any controls. Any mechanism which will bring those costs under control (i.e. linking them to each person who needs the services, rather than opaque rice rises to somehow cover the shortfalls, combined with random exclusions of services from insurance policies as happens now).

By having an OPT OUT choice, whereby the taxpayer buys their own healthcare plan, you eliminate that risk. If anyone is not insured, it is their own fault, and has nothing to do with whether or not a private or governmental agency is price gouging or price fixing.

I think it's very short-sighted not to see these wider implications of the system, the hidden but very high costs. This isn't at the moment the state taxing people for health care, but it's the insurance companies extracting the money (who also have to make an extra buck, or a billiion, to please their share holders).

What would those hidden, but high costs be?

I have mentioned two of the most prominent hidden costs that are passed along to the patient: Uninsured patients and litigation/malpractice insurance costs. What else is there that might be "hidden?" Normal employee costs, building maintenance, liablility insurance (slip/trip/fall), administrative costs...these are all normal and customary for any business, and not hidden.

It's similar with the protests about 'the government can't decide which treatment I can have' - well, now some insurance company is doing that for most people, with sometimes scandalous outcomes, especially when hardworking people with an insurance suddenly find that chronic deseases aren't covered.

Yes, this has been a problem, but more so in the private sector. HMO's come to mind. A person who is on Medicare or Medicaid (the state public aid medical coverage branch), can generally get just about any kind of healthcare needs met, upto and including major surgery. I have even treated patients who received transplants, and some experimental procedures not normally covered by private insurance.

Again, by opening up more options to taxpayers to join government funded healthcare coverage, you put private insurers to the task of bringing their coverage up to a more open standard. Otherwise, next year, when open enrollment comes around, they will lose customers to the government's plan.

IMHO - if such decisions really have to be made, and if money has to be handed over, I'd prefer to have those decisions and funds handled by someone with as little ouside interest (shareholders, profit, bonuses) as possible. That's why I am always surprised that so many people are SO distrustful of the state but don't seem to see a problem with the private companies. There is nothing wrong with distrusting the state, but I think it's very naive not to distrust private companies just as much, if not more.

Private companies are smaller entities, and thus, more susceptible to the words and threats of their clients. The government is a machine. It breaks down, it works slowly, and it goes awry...but so do private companies, from time to time. The shareholders and clients keep them in line a heck of a lot better than the government. But, by dividing the options between them, they can also keep each other in check.

[Chris]

Rig - one small quibble with an earlier post of yours - many of the docs who choose not to pursue Ob/Gyn are already in medical school and just deciding between their options. My wife is at that exact stage of her career now - choosing which specialty to apply to - so I hear a lot about all of the various choices .

Personally, I think we do need an overhaul that makes is harder for frivolous lawsuits to be won (while still leaving the door open for truly bad doctoring to be dealt with), that makes it easier for patients to get preventative treatment, and gets everyone insurance. I think that it's OK to criticize the proposals that are out there, but at least criticize them honestly. Ads that prey on people's fears of big government, rationing, and installing a Canadian style system that aren't factually accurate really bug me because it means that people who oppose the health care reform may do so because they are under a false impression. And that does no one any good. If one opposes the health care reform proposals and they have an accurate understanding of the proposal, I'm cool with that (though I certainly reserve my right to disagree!).

In general, it bugs me tremendously when in politics people are completely misrepresenting the other side's proposals and policies in order to try and win public support. There's no law against lying in ads, but I think it does a disservice to society as a whole whenever groups attacking proposals get their facts wrong, thus sowing seeds of discontent with proposals that aren't actually the true proposals.

[Redhart]

Bri, I do like the idea with going for tort reform as part of a package. Reducing the enormous costs in this area of the medical industry seems like a valid response under the circumstances. I also like the idea of peer review boards as oversight to medical practices in the industry, and the identification of "problem" links that are truly hazardous to leave in practice.

I like the idea of holding the individuals who are making the bulk of mistakes responsible without punishing all doctors, all patients and all businesses involved. Exactly how this tort reform and peer review would be structured, is something that would need to be worked out carefully so that the public is still protected from both gross malpractice (and reparations for it) ...but also from high prices due to the legal system that threatens to cut them off from health care all together.

Also, I do like the blended public/private health care system proposition. This is one of the reasons I decided to vote for Obama over Clinton in the primaries. I can see how this is beneficial yet still catalystic to reform through natural competition.

I remember a time as a young woman where I did not have health insurance, hit my head and ended up in an ER. I was young and healthy (and not a lot of money yet), so not having insurance didn't seem like an overly big deal.

When I received the bill from the hospital for ER services, I was able to pay it in a few installments. I think it was about $400 (and I had a hairline fracture due to this hit and a severe concussion). If I remember correctly, I head head X-rays, an EKG and even crash-cart services (because I convulsed when I hit and momentarily lost heart function---yah, hit it hard!), observation and other ER considerations.

Sometimes, stuff just happens--even if you take good care of yourself, are young and healthy and don't normally need medical services.

If something similar were to happen today, it might cost as much as $10-$15K for the same care. Cat Scans and x-rays running can run about $5K all by themselves for the head, not to mention all the other charges for blood tests, etc.. For some people who are barely making it already, even in installments, this can slide them in to bankruptcy. Anyone want to calculate the increase? Is it no wonder that some doctors won't even see patients on a cash basis anymore unless they have insurance? For uninsured, that can mean "no care at all"...and again, where I live, you can walk in with $10K, cash in hand, and they still won't see you because of the financial liability you represent. Insurance has become the golden ticket..and if you are someone over 50 (even if very healthy), that can mean premiums of $1500-2,000 mo for some couples. Again, who can afford that?

And if you DO have a condition, illness or a past record of such, you might not get any insurance at all due to that dreaded "pre-existing condition"...or get it, as long as it has nothing to do with your major health issue (what's the point, then?).

Or...you may be sailing along at 45, healthy and good with your long-time insurance policy then get into an auto accident and start having seizures due to head trauma. Your long time friend, the insurance company, may suddenly decide they have made enough off you from years before and you are now a liability and drop you like a hot potato (good luck finding another, at that point--at least for any reasonable amount of money).

The Government plan for those who cannot afford it, need not be fancy--just basics. Basic prevention (checkups and routine checks) to catch minor issues before they become major and/or catastrophic and basic, reasonable treatment in the case of illness or accident. We aren't talking plastic surgery for bored housewives or hair transplants for the prematurely bald to be more attractive--I'm talking "basics". Set and monitor broken bones if you fall. Remove that appendix if it goes ballistic one day, or reasonable comfort and compassionate treatment for those who cannot be helped, but just want to leave this Earth with a bit of dignity.

Basic can be more restrictive. Frankly, that's a good incentive to work your way up to a premium private policy. But, it should allow for the basics, that the men and women who are trying to save lives can do so and receive fair compensation (because they have bills, too), and because hospitals, doctors and insurance companies no longer have to up their prices to cover those uninsured, everyone's expenses come down--especially for those who are keeping those policies they DO like.

Government spending, eventually, will also go down...The Government is already subsidizing ERs to cover those uninsured who can't pay and offering Medicare and Medicaid to low income and elderly. If the base prices go down, the government subsidies and health costs will also go down. Insurance premiums will go down, normal low income citizens don't have to worry about losing everything for a simple fall down some steps. They might actually address less serious conditions before they become calamities in an ER. People will have somewhere else to go for simple cuts, flu, minor ailments OTHER than the ER because the uninsured would now be able to make less expensive doctor office visits (and there would be doctors that would actually take them and see them!).

I really don't understand the premise of "we'll lose our choice"--because you still have it. Keep your private insurance, or shop for another private insurance if you don't like yours (or it's too expensive). There will be more choice, if you ask me.

Uninsured will actually have A choice now (other than risk bankruptcy at the ER or stay home and die). It may not be "premium"..with fancy hospital rooms and elective surgery, but it will at least save their lives and maybe allow them to get back into the work force and become actual tax payers again! More revenue INTO the system if you have a healthier, working citizenship.

[purplehawk]

Originally Posted by chparadise

Rig - one small quibble with an earlier post of yours - many of the docs who choose not to pursue Ob/Gyn are already in medical school and just deciding between their options. My wife is at that exact stage of her career now - choosing which specialty to apply to - so I hear a lot about all of the various choices .

Wowzers, do I remember those days!

In general, it bugs me tremendously when in politics people are completely misrepresenting the other side's proposals and policies in order to try and win public support. There's no law against lying in ads, but I think it does a disservice to society as a whole whenever groups attacking proposals get their facts wrong, thus sowing seeds of discontent with proposals that aren't actually the true proposals.

They succeeded in doing just that in 1993-94. I sure don't intend for it to happen again this time around. Here's video of President Obama's words on the need to health care, and the not-so-honest folks who'd like to tank it for reasons of sheer political survival.



Red, I fell out of a tree when trying to rescue my cat three years ago. Between the life flight helicopter and all that the trauma team did for me, plus an overnight hospital stay, the total bill was about $30,000.

[SSJ_Jup81]

Originally Posted by FlamingRed

No. Basically, I don't think ANYONE should require insurance. If a person takes care of themselves and also happens to have a job with a benefit of health insurance, then great. Theoretically, healthcare costs should be affordable enough WITHOUT insurance. My family did it for years before this whole debacle blew up onto the international stage.

Was your family completely healthy? Do any genetic conditions run in your family? Not everyone is granted that luxury. I know mine isn't. Employers now can't afford to give out healthcare and try to find ways to worm their ways out of it. For instance, as an assistant teacher, I got gypped on benefits because of a half-hour rule, meaning, I didn't qualify for it. Some places do have full time employees, but the company doesn't offer health benefits. Of course not everyone needs it, but seems the one who truly do need it, are the ones who don't.

I don't think it's a matter of "who should have insurance and who shouldn't," it's a matter of the cost should be affordable whether you choose insurance or not. If someone has a case of the sniffles, they shouldn't have to pay astronomical prices to see a doctor and get a prescription for antibiotics just because they don't have insurance. For our basic healthcare needs, I believe it should be affordable to get a doctor's opinion, basic care, and prescriptions without insurance being necessary.

I agree with you, but there are some cases, where one must see a doctor for routine check ups. For example, I'm a diabetic. I'm supposed to see the doctor every three or four months. I can't afford it, because I can't afford health insurance or the doctor's visit. Lucky for me, though, I found a free clinic that runs on donations.

In the case of someone who is getting older and has medical needs, then yes, getting themselves to a place where they can either afford to purchase their own insurance at an affordable cost or take advantage of an employment benefit would be ideal.

But some places of employment, are trying to find ways to get out of paying for healthcare benefits for their employees or find loopholes. What do you propose?

In summary, I don't think it's necessary for the nation to be requiring and supplying insurance to all Americans. If a person feels they need or want it, they should be able to make the choice, and if they choose to take advantage of insurance then it should be affordable and not astronomically priced in order to pay for everyone, including those for whom it is not necessary.

If we're all paying for the same thing, what's wrong with that? Why is it seen as a bad thing that we are helping our fellow Americans in need? That's pretty much how it is in other countries. EVERYONE puts into it, therefore, everyone has access to it. It's no different than schools, fire departments, police departments, highways, etc. Everyone uses these things, even those who don't have kids (schools), and therefore, everyone pays into it.

I don't see how those things are contradictory. I believe Americans have the right to choose for themselves and not have choices dictated upon them by the government. However, the government's job IS to handle issues on a national scale, of which the corruption in insurance/healthcare is one. I believe the solution for this is the government to solve the existing problems in the system rather than introduce an entire new system, which may or may not work, and will inevitably have problems of its own.

There's no such thing as a perfect system and what we have now, obviously isn't working effectively, so why not try something new, and hope that it does okay?

[Siriusandme]

Originally Posted by FlamingRed

Yes, it is the government's responsibility to care for its citizens, but should it be at the expense of another group of citizens?

Yes, ofcourse.... There is always a decision made by the government that's at the expense of another group. And there is always a group complaining. Over here the government partly pays for child daycare facilities. There are people (the ones without children) who say they should not have to pay for this. At the same time they conveniently forget that todays children pay for tomorrows elderly.

IMHO there is a shared responsibility. You are responsible for yourself, but if (for whatever reason) you can't take that responsibility then the government should step in.

As for mandatory insurance. That's more than fine with me. Can't imagine what would happen if a child can't get the required medical treatment because his mom and dad don't have enough money. And I'm not just talking about antibiotics...