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US House Democrats Unveil a Health Care Plan
gollum123 sends in this piece from a political blog in the NY Times. Here is the text of the bill in question (PDF). "House Democrats on Friday answered President Obama's call for a sweeping overhaul of the health care system by putting forward [an] 852-page draft bill that would require all Americans to obtain health insurance, force employers to provide benefits or help pay for them, and create a new public insurance program to compete with private insurers — a move that Republicans will bitterly oppose. ... But the chairmen said they still did not know how much the plan would cost, even as they pledged to pay for it by cutting Medicare spending and imposing new, unspecified taxes. The three chairmen described their bill as a starting point in a weeks-long legislative endeavor that they said would dominate Congress for the summer and ultimately involve the full panorama of stakeholders in the health care industry, which accounts for about one-sixth of the nation's economy. ... House Republicans, who have had no involvement in the development of the health legislation so far, quickly denounced the Democrats' proposal as a thinly disguised plan for an eventual government takeover of the health care system. ... The House Democrats' plan is one of three distinct efforts underway on Capitol Hill to draft the health overhaul legislation. In the Senate, both the Finance Committee and the health committee have separate bills in the works, and in recent days those efforts seem to have stumbled."
Will this bill stop the pre existing condition BS? Let you buy any plan that you want? UN tie it from your job?
How about having a Bankruptcy that is just for Health stuff and does not show up on any back round check?
Not let people ask about you medial history before offering your a job?
Make it so you can not be dropped by a insurance provider.
It's so much more complicated than that. It's a debate where two sides can argue opposite points, and both be absolutely correct. Here is an article that addresses one side of it:
Short answer: there's no easy fix. Medical costs are rising for several reasons:
* Rising costs and quality of medical care (30 years ago there were no MRIs, hip replacements).
* Corrupt doctors, ordering tests because they are profitable (read the article, it goes into great detail on that point)
* Corrupt insurance agencies (sometimes charging 30% overhead)
* Incompetent government (a point which you outlined)
* Clueless patients wanting every possible test (I can't blame them for this, it's not like we have medical degrees) and not taking care of themselves (Safeway for example managed to reduce health insurance costs by 40% or so by encouraging their employees to take care of themselves)
* Oh yes, and how can any such list be incomplete without including pharmaceutical companies and medical lobbies? Many problems there.
I'm sure I'm missing some. The good news is with all these problems, there is lots of room for improvement. The bad news is that these problems exist, and the path to fixing them isn't entirely clear. I am not sure that I favor this bill, but I think it is good we are having a debate about it. We should have had this debate 10, 20, or 40 years ago.
Qxe4
Let's require that whatever bill they propose, that all of the US government, especially congress & house, have to operate under that bill for one year before it can be forced on the rest of us. Whatever plan they currently have is gone. They are not allowed to work outside of their proposed system. They have to use only what their bill contains, and the funding has to come as a deduction (tax) out of their salaries. The money used to provide their health care services must come from whatever they paid in, and if (when) it runs out, nobody gets any more services until more funding is available. Also, any government employee who goes outside the system must declare it on some specified national forum, so we can know about its deficiencies before it takes effect on the rest of us.
This will show us if it is a viable plan, and that it is has enough money coming in so that extra funding is not hidden in additional taxes. Let's see how they like their own plan before we're forced into another stupid plan.
Who would win this election: Andrew Weiner vs Andrew Weiner's weiner.
They get government jobs denying or delaying medical procedures they deem unnecessary or low priority.
Bad news: your 15% figure is out of date. We're now spending 17% of our GDP on health care, and if the trend of the 2000s continues, we'll be at 30% by 2020.
Unfortunately, the Republicans will oppose any type of health care legislation, because the truth is that they don't think anything's wrong. Most won't admit it, or will make the wholly unsubstantiated claim that malpractice insurance is the only thing wrong with our system. This is despite the fact that all estimates put tort at least than 0.5% of our health spending. Of course, while the effects of 'defensive medicine' are tougher to estimate, there's fortunately empirical proof showing that it makes no difference. Texas has the strictest malpractice tort limits in the country (you can get at most $250k, even in cases of gross negligence causing permanent disability or death), causing malpractice claims to plummet, yet their health spending increases have continued to outpace the rest of the country in the six years since it was passed. So much, in fact, that Texas now spends more than any other state for decidedly mediocre results. Essentially, it's a microcosm of the U.S. as a whole.
There was a great article in the New Yorker a few weeks ago wherein a reporter visited McAllen, Texas, home of the largest health care spending in the world. What he found was a perfect example of what we see across the country: when doctors treat their practice as a revenue generator, costs go way up, and quality actually suffers. The doctors think that they're doing their best for their patients, but they subconsciously make more referrals when it brings in money. It's long, but it's definitely worth the read.
Wrong. When German Railways (Deutsche Bahn) was still state owned, the trains were always on time, there were many more connections, the fares were lower and easier to understand and the trains and tracks were better in shape.
Now Deutsche Bahn is a private company. Trains run notoriously late (often because the trains are damaged or the tracks are in the sore need of repair), many connections are inoperative, the prices soar.
I never have seen a high speed train being evacuated in the middle of nowhere because of some motor damage in the early nineties. I had to live through it twice last year.
"It's such a fine line between stupid and clever" -- David St. Hubbins, Spinal Tap
I am not in favor of this bill of any further government regulation of health care but your statement is factually incorrect. A substantial portion of those 47 mil CANNOT get health insurance at any price, due to previous medical history. If you are not covered by a group plan (such as self employed, unemployed but not dead broke or over 60 or under whatever, and do not have a spouse or somebody to cover you) good luck getting private coverage. Even minor problems such as acid reflux are enough to make you not profitable enough for insurance companies to insure.
Negative moral value of force outweighs the positive value of good intentions.
As someone who knows many doctors, I will tell you flat out that if that figure includes malpractice insurance it's either a flat out lie, or product of ridiculously bad methodology.
Or maybe you shouldn't rely on the anecdotal testimony of a small group of people who make up only one part of the sizable cost structure of the whole health care system? Even if there was something wrong with the study (which you only stated, but did not demonstrate), how do you attribute the negative correlation between malpractice caps and health spending?
and your medieval healthcare system practically KILLS poor by neglect, or treatment that arrives somehow too late ?
Read radical news here
The US has the highest cancer survival rates in the world, and by a pretty large margin. That has to be worth something in your metrics of "better".
Well, duh! That's where the money is.
The overwhelming majority of health care expense in the USA is in the last 6 months of life, often after there is little question that no matter what is done, the patient is gonna die. Patients are typically guided into increasingly expensive treatments without any meaningful discussion about the quality of life of those final few months. It is not as bad as all the doctors consulting with each other over how to wring a few dollars more out extending Joe Smoker's life another 3 weeks. But it is much closer to that extreme than telling Joe "Hey you don't have much longer, and in 3 months your going to feel really bad no matter what we do, so now is your last good opportunity to take that Summer-long fishing vacation you've been promising yourself the last thirty years. When you get back, we'll see what we can do to make the last few weeks as comfortable as we can."
No, USA health professionals don't know how to have that conversation with a patient as a general rule. The general attitude is that it is much better for the patient to keep him hopeful that this treatment or the next can keep him going for a good long time. That this is also more lucrative for the doctors and the health care institutions is purely a side effect (according to the doctors and the health care institutions, and they do say we should trust them about this kind of thing).
Will
You can cut down a lot of timewasting if it's in your interest to prevent waste of resources rather than maximise profits.
e.g. I know "antibiotics don't work on colds or flu" as I heard it on an NHS "commercial" on TV.
There's a call centre full of nurses telling people with colds and flu to get some rest and drink lots of water (dial 08 45 46 47 from a UK phone). The same information is online ("NHS Direct").
Then there's things encouraging people to seek help -- e.g. there's an advert on a bus shelter by the college near me, telling teenagers about chlamydia and how they can get a confidential test (and free condoms).
There's also billboards with messages like "a chest pain is your body telling you to call 999" [for an ambulance], and offering help to quit smoking, or diet advice.
Something else that is popular in Canada is wait insurance. People are signing up by the truck load and most Canadian insurance providers offer wait coverage. In case you don't know what that is, it's where they guarantee the wait for procedures will be under a certain time or they take you to another country if necessary and have the procedure done there.
And yes, this was brought before Canada's high court because Quebec attempted to enforce it's no private insurance laws and the court said it was a fundamental human right to have the coverage because the lack of it would endanger the lives of the people it serves.
Don't sit there and sugar coat government health car as if nothing is ever wrong with it and everyone is satisfied with it's results. Obviously enough people aren't otherwise there wouldn't be a need for wait insurance and there wouldn't be a market so profitable in it that they took it all the way to the highest court in Canada or that every other insurance provider has a plan that covers wait times.