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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?
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.
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.
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?
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