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Health Care Reform
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?
It is a desperate grab for tax revenue to shore up a faltering budget.
Real health care reform would either include a single payer system or a rational free-market plan. Nether party is willing to do this, however. I wonder why...
It won't do anything. This will go down as the 2010 Health Insurance Bailout act. Few Americans who currently don't have insurance will be helped, and few who do will notice one iota of difference. The largest group of people who will see positive change from this is the top executives at our health insurance companies.
Damn_registrars has no butt-hole. Damn_registrars has no use for a butt-hole.
You know the AMA only represents about 20% of physicians right? And they are actually usually very conservative and have blocked health care reform in the past? Which is one of the reasons they don't have more doctors as members.
The most important thing is not if the government is able run health as efficiently as possible. The important question is who earns money on what. In case of 100% private health care, everybody (even insurance companies!) earns money when someone is sick. In the case of government run health care the government loses money if people are sick. So they have an incentive to keep people well and only recommend useful medications. I think that's the important incentive here to take into consideration. Do people really want a system where the doctor earns more money if you're more sick and so on?
How has private industry done so far with american healthcare? Cost more, gets less. Yup, that is a sign of success.
Oh and how has private industry been managing the economy?
It kinda amazes me that people with a healthcare system that is useless in the middle of a global recession all under the management of private industry, then dare to ask whether government can run things.
Imagine a discussion in North Korea: "Can private industry be expected to handle food production?"
Answer: "Who knows, but the question is silly when the current system is such an obvious mess".
Sometimes you got to take a chance. Do anything because when you are nose deep in shit, chances are anything is an improvement.
Can the government do a better job? It would be hard to imagine how they can screw it up even more.
MMO Quests are like orgasms:
You may solo them, I prefer them in a group.
From our perspective (I'm a health policy person based in Europe), US health care is staggeringly expensive, very variable, and very unfair. It's the single biggest cause of personal bankruptcy in the States.
Your health is poor, overall, especially you have poor child health, and relatively poor maternal and infant health.
A large part of your population have no access to good quality health care, and this imposes large costs on your society.
Your major companies find high health care costs for staff a major burden, and this sharply reduces the competitiveness of good US employers.
You have the highest administrative costs for heath care that I know of, now running over 30%, and at current rates of increase, in thirty years you will be spending 100% of your GDP on health services.
At the top end, there is no better health care anywhere for acute illnesses, but very few people can access this.
The proposed changes are a start, and only a start. With no public option, there is a real risk that the insurance companies will continue to combine together to rip you off. However, the current proposals will save a lot of money over the next decade, which is why the insurance companies are spending millions buying ads, and influencing politicians to stop the change.
I hope it passes!
-- Anthony Staines
As i understand it, the bill has 3 major parts
1) a whole bunch of programs to evaluate new ideas; basically grants to researchers of one sort or another
2) regulations to rein in the bad behaviour of insurance companies
3) provide insurance to 30 million people who now lack it
lets leave 1 aside and look at 2 and 3
Do you really think that this bill will stop the insurance companies ? For instance, there is a section (109 in HR3967) that bans lifetime benefit caps. and you can read it yourself, and it looks pretty straightforward. I don't know how the insurance companies will get around it, but htey have, literally, hundreds of millions of dollars to buy armies of lawyers and lobbyiest and politicians to overturn this over the next 5-10 years
So my conclusion is tthat at best, (2) will have some moderate effect over a few years
As to 3 - I think what will happen, based on the MA model(I live in MA) is that yes, there will be a lot of people who will get insurance, but we won't have the money to pay for it. So, to save money, we will make this new insurance cheap and not very good (eg, low payments to doctors and hospitals, so only really bad hospitals will take people on this plan), so what will wind up happening is that we will create a permanent underclasss of people who have "insurance' that doesn't really work - it is like poor people who get charged with a capital felony crime; we pretend to provide lawyers, but dont' do anything really effective
If you look at the down side, it is Huge.
Obama is instituting a new national policy - health care, a basic fundamental right ina civilized society, is providd by for profit companies, and the FED. Govt requires you to pay these for profit compnies its horrible
Another way to look at this is Obama's track record, say with the wall street bail out, where he made sure bankers got their million dollar bonuses - with tax dollars that came from your pocket.
how on earth could anyone trust this guy with a track record like that ??
I have catastrophic insurance, so if I get cancer and my bills go over $20,000 then THEY will cover the cost.
That's what they want you to think. Of course, fighting a lawsuit when you're the one who has cancer and five-figure bills to pay, while the other side has a large legal department specialized on just that kind of case, is going to be fun.
Catastrophic health insurance is a scam.
If you really want to fix healthcare, do tort reform first. Then break up the AMA cartel. Then look at other things that may need to be changed.
Is there anything that the government runs that really functions correctly/efficiently?
Dude - you really need to stop reading World News Daily and watching Sean Hannity - they've made you innumerate.
The only people who talk about tort reform and aren't full of shit are the people who have never looked at any numbers. Malpractice claims amount to somewhere between 0.5% and 4% of total healthcare costs - i.e. if you eliminated all malpractice and other tort costs from healthcare bills, within a month you wouldn't even be able to notice the difference.
As for AMA - only about 25% of the nation's MDs are members.
The government used to do lots of things really well - until Ronald Reagan and his corporatists successors dismantled everything, sold it off to campaign contributors, and bought your votes with your own money.
Mudge
In theory, theory and practice are the same.
In practice, they're not.
The reality is that the government doesn't seem to get anything done. I recall Arlen Spector saying that the patriot act was flaws, but he would vote for it as is and fix it later... Well as you can see, no one has really changed it to fix it. In 1992/1993 when Bill Clinton tried to make health care, no one agreed with him and he couldn't pass the bill. The republicans that later got in control of congress failed to make another health care bill. I think it will be similar with this bill. The republicans are calling to scrap the bill and start over, or why the hurry. But pretty much they (and the democrats who vote no) will forget about it.
Still a lot of provisions I don't like. For example if you get cancer you are screwed with a 5 million per year benefits cap. But then again my insurance at work has a 5 million dollar lifetime cap, so I am even more screwed. People like my brother who didn't go to college and work at hourly jobs without benefits need this bill. He doesn't make enough money to afford health insurance, and the company does not provide it. So there's really nothing he can do. If he gets poison ivy, even real bad, he has to sit at home and suffer rather than visiting a doctor to get a prescription for a cortico steroid that could cure it. That's not right.....
Also an awful lot of personal bankruptcies are due to medical bills. There was a time when I graduated college and I was unemployed for almost a year before finding a job. If I got into a traffic accident or I broke my foot jogging, I would have been in deep trouble. Sometimes surgeries go into the hundred thousands or even millions.... I don't have that kind of money. Even now, if I got cancer and went over that 5 million lifetime cap on my company's insurance, I'd have to somehow borrow massive amounts of money that I would never pay back, or just die... Any system that doesn't value human life over all else is broken....
This bill pretty much sucks. The more provisions I see of it, the more I hate it. Also the parties are busy taking pot shots about things like abortion funding instead of fixing the bill. I don't really care about abortion funding. Most Americans don't give a damn either except for a few religious right nuts. I just want a bill that gives me some security that if I lose my job and get sick, I'm not going to have to declare bankruptcy or suffer with my illness until it gets better or I die......
Considering the Trillions we spend on wars, I think one trillion for health insurance is worth it. It is an investment in the american people... And unfortunately if this shitty bill doesn't pass, the same thing that happened in 1992-1993 will happen again, people will scream it is the other party's fault, and then it will go away..... But it's a shitty Bill for sure. It is overly complicated, probably on purpose so that no one can read/understand the whole thing before voting on it. I'm sure there are lots of special interest payments in here......
It also does nothing to address the over charging on medical supplies. Ie the $500 paperclip. Not only that but when you don't have insurance all the rates are way higher than the rates negotiated with insurance companies. So not only is it harder to pay, it is even more expensive without insurance. Because those companies have people to say $500 for a paperclip, you're full of shit, we'll give you $1 and the hospital will be like okay, we still make $.95. And the people doing the billing try to double/triple charge me all the time. The insurance company and hospital billing often fight for 6 or 7 months before they get the entire bill properly worked out........ The hospital will bill twice, the insurance company will see two bills and reject all the bills, etc... Then you have to act as mediator to teach the hospital how to code the bill....And the insurance company to be ready for a payment....it wastes a long time.... By yourself you don't have a chance.... The rates are crazy too. I was well over $1,0
Tort reform is good, but it is only so good. Look at Texas: Doctors in Texas have been helped a lot by tort reform, but consumers are still getting royally fucked by the insurance companies. The solution to HC needs to encompass everyone, and tort reform alone does not do that.
First off, this isn't health care reform. It doesn't change all that much about the health care system. It's health insurance reform.
To that end, there are some small gains: insurance companies will be forbidden from doing some seriously awful things, like retroactively revoking the insurance of patients who get expensive illnesses, on the flimsiest of possible excuses (and in some cases based on faulty data that they refuse to investigate further).
In exchange, there are a lot of parts that are a big giveaway to insurance companies: because we've focused on giving everyone insurance instead of giving everyone health care, individuals are forced to buy insurance, but with inadequate oversight to ensure that insurance companies don't just gouge prices. Further, there isn't any choice for an insurance plan governed by democracy instead of stockholders, so we can probably expect that the small number of insurance companies will behave oligopolistically and raise prices, as usually happens when a small number of huge players control the market.
There will be some savings relative to the current system -- on the government's part -- but nothing like what could be achieved by a system that allows everyone to buy in to Medicare (and couples that with Medicare reforms like more careful monitoring of doctors who prescribe medically needless tests & procedures to make more money, and allowing Medicare to negotiate lower prices for its prescription drug benefit). The present bill is probably slightly better than not having it, but only very slightly.
Freedom isn't free; its price is the well-being of others.
There is at least one part of this bill that, being a diabetic and a contractor, am hoping gets through. That is that the pre-existing condition exclusions that insurance companies do. Because of how much of a difference it would mean for me personally it is almost impossible for me to not want it to pass. I guess, if possible, it would be nice to just have that part as a separate bill or something similar. Otherwise, having used the healthcare in England, I had really hoped that a single payer system could have been gotten through. I know that is almost impossible here in the US, but I can dream.
The whole insurance industry for healthcare is based on a flawed premise that normal care need insurance.
Here's the car analogy... if our cars were done like healthcare:
1. Gas would cost 10$/gal at the pump for cash/credit.
2. You would pay 25$ for every time you fueled up and your car insurance company would actually pay them 3.75$/gal for the gas
3. You would pay 150$/month for this "wonderfully cheaper gas"
4. Ohh... and if you need roadside assistance you have to pay for the first 5 fully before the insurance company starts picking up the tab.
So let's go back to why health insurance is flawed. Normal healthy individuals may make 3 (annual plus 2 cold/flu) trips to the doctor in a year. I pay 218$ per month for insurance through my employer (not counting the portion they pay). This means that I am effectively paying 872$ per trip to my doctor... ok... lets let that sink in... even if you count a nurse, doctor and receptionist out front splitting it and them only seeing 3 patients per hour (rough cases might take that long) we are still talking they would be making 1.74 MILLION DOLLARS PER YEAR EACH! Now if you have any friends that are medical professionals I bet you know that there are VERY few that are making that much per year... especially receptionists :)
Now the argument is that "well this money helps balance out all the catastrophic claims"... fine then why are we using insurance for non-catastrophic claims? I have home owners insurance in case a tornado takes my house out but I don't run my water-softener salt or home improvement projects through the insurance company.
Why when it comes to health insurance do we loose the common sense that the more people that touch the money the more we have to pay for the same service.
Leave insurance for catastrophic claims and lets get rid of the day-to-day shenanigans. This should quell a lot of the issues in the industry and make it so that people could pay for what they need instead of padding peoples pockets for day-to-day necessities.
Telcos have alot of dark fibre in the States. Most people assume that's optical fibre...but it's actually moral fibre.
That's the problem, and it is a real problem. However this bill is not the answer. The answer is regulation at the state level.
The US health insurance industry is currently regulated by individual states. Different states have different rules. However, one element to the current system is that the state government (which is more responsive to the needs of citizens usually than the federal government) tends to have offices for dealing with these sorts of complaints. Additionally, the same offices take complaints from doctors about lack of authorization for procedures. While this means that some states have better health insurance requirements than others, it means there is a clear point of contact when a problem exists that needs to be resolved quickly.
The problem with this bill is it entirely supplants the state health insurance regulation structures and replaces them with a shiny new federal system. There is no way that the main protections that the states offer against insurance abuses will work right away in the federal system. By pre-empting a fairly mature system of state regulation, this bill will not save lives but rather cost them.
The secondary problem is that the bill has inadequate cost control provisions. In Massachussets, after they passed a similar bill, health insurance rates went up. We can expect the same here. Quite frankly, I have no idea how I will afford it when the rates go up. Right now, when insurance companies raise their rates, I can drop off until they lower them again. This bill makes me part of a captive market.
The real underlying problem left unresolved is that we have inadequate consumer protections in the areas of health care and health insurance. While this bill purports to improve these conditions, it fixes, IMO, the wrong problems and leaves major issues unresolved. Why is it that I have more consumer protections when getting my car repaired than in obtaining non-emergency medical care?
LedgerSMB: Open source Accounting/ERP
If being required to pay out 85% for medical care is the only restriction, then it actually will encourage an increase in medical costs. Look at it this way: If what they pay out doubles, they can charge double and keep double. Staff is a fixed cost, so all that extra dough becomes profit.
The world is made by those who show up for the job.
Similarly, the overall level of health might be improved if the feds stopped subsidizing meat, dairy, and corn (as in high fructose corn syrup). But not only is that not something being done outside of a healthcare reform bill, that's not even in this bill. You would think if the problem is how much it costs to make fat people not die, the first step would be to stop spending money that helps make them so fat in the first place.
Space game using normal deck of cards: http://BattleCards.org
So anyway, now it covers the routine stuff, but often not the catastrophic stuff. They'll deny you coverage! WTF!
The real fun is when you have a preexisting condition and hence can't get covered for routine stuff, either.
I had a congenital heart defect, meaning I needed open heart surgery the first day of my life. I had it. It solved the problem, but, as early open heart surgery can often do, it damaged my heart's natural pacemaker, so now I have an artificial one. (Aka, what everyone calls a 'pacemaker', they actually mean 'artificial pacemaker'. Everyone has a 'pacemaker'.)
Fair enough. It's about $15000 in expenses every eight years or so, and, frankly, I can cover that out of my pocket. I'm not a moron, I know the batteries die, I know roughly the costs, I can save up.
But now I can't get insurance for anything else. Forget heart conditions, they won't even bother to attempt to cover me for anything. I call them up, inform them I have a pacemaker, and they politely inform me they will not cover me.
Private insurance is stupid. They simply don't want to actually provide useful insurance. No, everyone needs to pay into a government catastrophic care fund, and whoever needs it can use it. And we should, of course, continue to help subside the care of the poor.
Likewise, we should probably subside a little preventative maintenance, also. A free checkup a year or something will reduce problems down the road.
I'm really having a hard time figure out why we shouldn't provide all care, free, like NHS over in England.
I can vaguely see the argument that costs will be reduced if some people pay for some of their care, but frankly, costs can be just as reduced if the government pays hospitals and doctors set amounts for specific procedures, obviously resulting in them reducing their costs to increase profit.
But the entire manner we're going about solving this problem is backwards, solving it with 'insurance'. Sadly, we're so fucked up that solving it backwards is also helping solve it, like a car stuck in the mud. If nothing else, it will cut into insurance company profits, thus making it harder for them to fuck with the next reform.
If corporations are people, aren't stockholders guilty of slavery?