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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.
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
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