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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?
Nothing is as bad for the future of America as Fox says.
BTW, I've seen thousands of comment trolls, but I think this is the first story submission troll I've seen.
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?
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...
But then everyone knew that already.
I expect it will at least mitigate my issues getting health insurance after getting kicked off my parents' plan, so there's that.
As for the Republicans' complaints, I'm not really clear on what there is in this bill the Republicans didn't argue for. If the left had written the bill, it would dismantle the insurance industry and set up single payer. The only thing it's missing is tort reform, and the fact is that tort reform is a red herring. It accounts for 1-2% of healthcare expenditures, and that sounds about right. There should be a process for handling legitimate malpractice claims, and it's never going to be free.
Slashdot is packed with the entitlement generation and you're asking if they approve of the government creating another entitlement? Might as well go to Hell and ask the Devil if sinning is bad.
The Americans really need a single payer system like the rest of the world, so no this is not the correct way. However it think it appears a lot better than the current mess they have.
Nothing will improve in health care in the US until we have more doctors. Prices are high because demand is high and supply is low. Unfortunately the AMA carefully controls how many new MDs are granted every year, and purposely keep the number low to keep their salaries high.
Requiring people to buy health insurance will only make our problems worse. It will drive up prices higher. Until the MD cartel is broken, health care will be a big mess.
Not enough clickbait today, Taco?
I'm sure "SlashdotMedia" will improve on all the wonders that Dice Holdings blessed us all with
It's nothing like the health care bill we should have had, something to create a health care system comparable to other modern countries. The Democrats have no backbone and kept watering it down and morphing it until it was only vaguely acceptable to just barely enough of them to possibly pass. This sort of thing leads to awful legislation.
The Republicans, of course, are chanting "wait, wait, this is being rushed," but the facts are that they had years in which they could have pushed through health care reform - years where it was clearly necessary. Despite what they say, your average Republican simply doesn't believe in health care reform, which is why it didn't happen under Clinton and wouldn't happen under Obama if they could figure out a way to delay it. So instead of pushing for a fiscally responsible and conservative health care reform, the Republicans are really pushing for the status quo, without trying to seem like they're doing that.
Both parties stink. I'm kind of hoping this passes, but then the Republicans come into power. It'll be impractical for them to repeal this, but perhaps they'll be smart enough to tinker with it to make it better. Past history is not encouraging, though.
I don't know how mandating citizens to purchase health insurance is going to pass Constitutional muster.
Dark Reflection
In less than 8 months time the entire House will be up for reelection. This is a critical issue and at this point everyone points to their own polls to pitch their case and prove the population wants what they want. Let the results of the House elections decide the issue once and for all who wants and who doesn't.
As you might expect, this bill is heavy on the benefits and light on the necessary pain. There's virtually only one effective cost-control measure, the tax on high-cost health benefits, and that has been pushed off so far in the future that it will be killed before it sees the light of day. The bill recognizes that coverage of pre-existing conditions requires an individual mandate, but then implements it in a half-assed way that won't achieve the objective of forcing healthy people to get coverage. (It also puts a dual drag on job growth by both raising taxes on private investment and directly increasing the cost of employing people. Way to go.)
I would much prefer a bill that provided funds to the states to let them structure their own solutions to the health-care problem, as Massachusetts has done. But the top-down command-and-control midset in Washington is too strong for that.
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.
The evidence for the efficiency and quality of government-run healthcare in other countries is indisputable.
However, too many people have been making money hand over fist in the US to let any system where they would be the cut cost pass. Overall, it's an opportunity for the government to provide what the market cannot. Either affordable healthcare or writing into law corporate profits. I don't trust our congressmen to avoid the latter.
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.
There's only one thing you need to know and the rest is pure diversion:
The taxes start now and the benefits start later.
The reason this bill is being shoved through against so much opposition is because the government is frantically trying to raise tax revenue before the debt black hole sucks them in. Too bad we've already crossed the event horizon.
Is there anything that the government runs that really functions correctly/efficiently?
Why do you hate the troops so much?
Damn_registrars has no butt-hole. Damn_registrars has no use for a butt-hole.
Political debate in the United States is *dead*.
Every number you have heard or will hear about health care is a lie. It used to be that the Congressional Budget Office put out good numbers, but politicians have gotten too good at manipulating the process. Now, even CBO numbers are untrustworthy.
The rate regulation in the Senate health care bill is a disaster. The first problem is that no one in their right mind would ever enter a market which is rate regulated. The bureaucratic red tape will keep newcomers out. The second problem is that rate regulation removes any incentive that health care insurers have to control costs. Why? Because under the Senate bill, 90% of total health care insurance revenue must be paid out for health care. So, total revenue is x. All profit must come from y, which includes profit and all non health related expenditures. The last variable is z, health expenditures. x = y + z. y = 10% of x. z = 90% of x. How do you increase your profit in such a system? Easy. Increase z.
If I ran a health insurance company, on day 1 of the new health care regulations, I would shut down my fraud department. Not only would I get rid of a nonhealth care expenditure that must be counted against y (and thus my profits), but it would also increase fraudulent health care expenditures, which will be included in z. If the feds want to stop fraud, let them spend *their* money to do so. I don't care anymore.
So my insurance premiums go up because I am spending more money on health care. Won't my customers just go to my competitors? Well, because of rate regulation, there won't be very many competitors. The few existing competitors will be very likely to do the exact same things I'm doing.
Aren't I afraid that my customers will just drop health insurance altogether? That's the beauty of it. The Senate bill requires everyone to buy insurance. They can either buy my ridiculously overpriced insurance or they can pay a fine. And guess what the fine is used for? That's right, subsidies for other people to buy my insurance, so one way or another, I get the money.
Even if you want european style health care (which many Americans do not), the Senate bill is not the way to do it.
who the hell could possibly know? the bill has more pages than a dictionary. no one really knows what's in it. i doubt even the people voting on it for us know what's in it.
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
I do not have anything of actual use to say about this bill, other than common talking points, unsourced blather about what this bill will accomplish, and vague appeals to antiauthoritarianism. But please mod me +5 Insightful like you're doing with everyone else, just to be fair.
Libertarians somehow believe that private businesses should be stronger than governments but weaker than individuals.
Rather than bashing one side or the other based upon perceived biased information, go get the document and read it yourself. Then, weep for future generations, either way.
-- Karl --
If the health care reform plan goes through then it signals the end of civilization as you know. Just look at where I am from, Canada, where we introduced universal health care in 1962. Since then, we've been living in barbaric fiefdoms, the likes of which have not been seen outside of the Hyborian kingdom.
The problem is that it is too big. Being able to do a large bill is good politically but not for the american public. There are a lot of things going on in big bills. Almost everyone has something they don't like about it. So by passing a bill you really kinda force pass a bunch of bills, with no real debates on each section.
Smaller bills will be much easer to handle.
Laws to prevent insurance companies from denying coverage based on medical reasons. Probably an easy pass.
Laws to require everyone to get healthcare a difficult slim pass and probably will take some extra time to perfect.
Laws about funding for abortions as part of the plan. Probably will be filibuster out. However filibusters take a lot of work and filibustering everything will probably literally kill a party. So they will not overuse the filibuster allowing passing for other details.
If something is so important that you feel the need to post it on the internet... It probably isn't that important.
Doesn't she ever learn? Fox's paranoia is always proven justified in the end.
The issues aren't the system. The problem are the paranoid people who goto the emergency room because they have a cold. The problem is that the pharmaceutical industry push doctors to over prescribe, causing even more visits to the hospital and clinic for follow ups and what not.
Also, universal healthcare in Canada is more like a federal mandate telling the provinces to setup such a system. Each province has their own healthcare system that's partially funded by the federal government. I'm not sure about the US, but I'm sure this would have been more palatable to americans if the healthcare law was the same, giving the individual states more autonomy over healthcare services.
In any case, Canada's system isn't perfect, and yours won't be either. It won't do much for reforming the pharmaceutical industry. It will have a positive effect on the over all health of society though.
Or it might drive you all into civil war, which would be pretty fun too.
I'm god, but it's a bit of a drag really...
Any bill that expands power for the IRS (does anyone else think that the IRS has no place in making health care decisions?), places an entire sector of the economy under Government control (Biden's words, not mine) and will create lots more opportunity for people to go to jail is just not the prescription.
As it is, this law basically raises taxes, forces healthy, young people to buy insurance and creates a class of people who are too wealthy to get assistance and not wealthy enough to afford insurance, and then jails them for being squarely in the middle class. Why not take a little more time and do this right, and make it so health care becomes a right, not an enforced purchase of insurance bundled with a tax increase?
-- $G
Greatest Generation and Baby Boomer's are costing 10k's to 100k's of thousands of dollars of year in health care costs and you blame this generation? Who smokes less, drinks less and is in overall better health than the three previous generations? Give me a break. My Uncle who worked maybe 10 years of his adult life started receiving Medicare last year and he is already up to half a million in costs with his congestive heart failure alone.
An Education is the Font of All Liberty
If I take what you're stating correctly, then Article 10 would also be able to shoot down Medicare, Fannie/Freddie, the NEA, the DOL.... NASA. In other words, it sounds right, but ever since the Civil War, I don't think it's been enforced in the manner you describe. There are specific exceptions in case law when dealing with commerce, and with health care spending in the top 5, it's a pretty easy out for the SC. I think you need look no further than the DEA's position on medical marijuana laws to realize that the 10th isn't that powerful. I'm not arguing that the 10th shouldn't be the law of the land, just that it plainly isn't, and a court challenge on strict 10th amendment grounds would cause an upheaval to the federal government.
most of the time I pay CASH (about $200 a year), which means I deal *directly* with my doctor.
I live in a country that has government-run universal insurance, and I deal *directly* with my doctor, too. I'm not sure why you believe this isn't possible.
If you get a chronic condition (MS, Diabetes, etc.), you will regret your catastrophic insurance choice. Your routine, non-covered expenses will go through the roof. It will get worse if the condition is such that you have problems working full-time, or you lose your job, etc.
"Will this bill do what the administration claims to do"?
Yes it will. It claims to tax the households in the upper 5% much greater than it does today, it claims to increase insurance costs for a large percentage of folks, and it will re-distribute the wealth it collects into the medical industry to provide health care for the lowest percentage of folks who mostly don't have insurance because they would rather have multiple TV's, cars and luxury items rather than buy health insurance.
- real hackers don't have sigs -
Can I sign up for your newsletter? I argue the 10th amendment pretty much every time a debate like this comes up and people dismiss it because they only know the first 2-3. Here at college I have seen a disgusting trend towards "the constitution is broken so let's just ignore it" among both students and teachers and I can't wrap my mind around how they came up with such a idiotic idea.
Government intrusion into healthcare caused the cost to go up, restricting the number of doctors, requiring cookie cutter instead of modular health insurance plans, "oversight" and "control" which create bureaucratic empire building jobs, all increasing the cost while doing little to help.
Even if it were constitutional, the public wanted it, and it got signed into law, does anyone really want the people who can't manage the programs already there? Medicare is billions of dollars in debt, the Post Office is as well, and the VA hospital is one of the most poorly run, inefficient, and costly medical service there is. If they cannot even give affordable, quality healthcare to our veterans, how well do you think it will work for everyone?
(Note, "you" is not referring to parent, it's a plural argumentative "you")
Orwell was an optimist.
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 ??
higher insurance premiums and longer wait times in the emergency room
Read it for yourself. What I read is a wet dream for the insurance companies and penalizes anyone who is self-reliant.
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.
I do software.... all software has bugs. Bills are a lot like software that is interpreted by people. I'm a little bit skeptical of something this large being thrown into production all at once with almost no testing to replace an aging program that has worked (albeit with flaws) for decades. This has all the feel of a Dilbert comic, but with a completely new level of pointy haired bossedness (Ph. B.)... we tried this once where I work on a $20millon project, and it ended up costing over $75M to fix!
Taco,
You're old enough to answer this one for yourself. Look back in your lifetime, as ANY government run project EVER come in on budget or accomplished what it said it would?
It's not in the best interests of the bureaucrats or politicians to resolve problems, it's in their best interest to appear to WORK on problems. If the WORK on problems, then more funding and more power can be gotten by saying, "Well, we just don't have enough to get the job done."
I think Fox does exaggerate things a bit, but if you took Fox on one side of the scale, and NBC on the other, what's in the middle is still pretty damned bad.
The simple truth is, we cannot afford this and it's never a good thing to give more power to the government. That has historically always led to problems, and with 15-20% of our economy involved here, the scale of the problem could become disastrous.
"I don't think software should necessarily be free
Other people have said it but essentially, a very LOOSE intepretation of allows for this kind of thing:
1) Wrap it up in tax code
2) Commerce Clause
3) General Welfare Clause
Do you remember when Sonia Sotomayor was being grilled during her confirmation hearings? It was either Diane Fienstien or some other person explicity asked about how loosely she interpreted the Commerce Clause because they use it as the basis for so many laws and that overly strict interpretation would make their job harder or somesuch nonsense.
"Fighting the underpants gnomes since 1998!" "Bruce Schneier knows the state of schroedinger's cat"
It amazes me that with the high percentage of negative public opinion on the health care bill that congress is still considering it. This is supposed to be government by the will of the people, right? To me, the will of the people is not being executed here.
Also, this is apparent in the back door manner in which they are trying to pass the bill by some trick of house/senate rules. This isn't some bill to appropriate a few million dollars for federal park support but a bill involving a trillion dollars of outlay. Given the current administration's massive spending and addition to the national debt with little to show for it, does anybody have any real confidence that this will work?
Some comments on health care industries making money hand over fist. Everybody seems to be in an outrage with doctors making hundreds of thousands of dollars per year, but nobody bats an eye when some sports star signs a multi-million dollar contract. If you were going to the hospital for open heart surgery, would you want the lowest paid doctor that has no incentive for good performance cutting you open? I'd want the super-star doctor that drives the Porche. If he's good enough to earn that much money, he's got to be worth his salt.
If they were really serious about health care reform, why didn't they start with the biggest money issue in health care: tort reform. Why? Because Congress is made up with a bunch of lawyers that don't want to see their industry lose out on billions of dollars per year in fees brought about by the misery of other people. People are incensed about million dollar bonuses at financial firms, but nobody shines the light on lawyers that, for the amount of work put in, end up making thousands of dollars per hour in a settlement or ruling. Consider, also, that even though that doctor is making a quarter of a million dollars per year, he's paying 25 or 30 percent of that in malpractice insurance to protect himself from every Tom, Dick and Harry that decides to sue because they didn't follow instructions and ripped their stitches out.
Some lawyers are a blight on society, but unfortunately, their buddies are crawling all over Washington as lobbyists or in Congress/DoJ/White House/etc. The more I think about it, the more I agree with what Get Out of Our House is doing.
Have you ever considered piracy? You'd make a wonderful Dread Pirate Roberts.
This bill has been neutered so badly that I don't think it matters whether it passes or not. If it does pass, the Democrats will claim victory despite the fact that most of the important stuff had to be cut out of the bill just to get it to pass. The Republicans will claim it's the end of the world despite the fact that the bill does very little to actually reform health care. At the end of the day, we're basically right where we started.
And on that note, trying to improve anything in this country is a waste of effort. Americans seem happy with what we have and there is no motivation to make things better despite the fact that there's plenty of room for improvement. It's gotten to the point where anyone who tries to make things better here is either an idiot or completely masochistic. But on the bright side, at least it's Friday!
Let us know if you finally do decide to join the civilised world America.
It's a simple question to see where you stand on the issue. 1. Are you willing to pay more than you are now so other people can have health insurance? 2. If you aren't already paying for insurance are you willing to start paying about 10% of your current income to have it? (up to a max of about $15,000 or so).
It all starts at 0
Now that there's gov-run healthcare, we can start to have beauty contests for which disease/disorder/medical convenience is the most popular and therefore the most subsidized. Viagara is probably already covered by the drug-benefit to seniors, but there will be other popular diseases too. We can all get our popular flu-shots, too. And there's never been a better time to get in a free abortion and weightloss surgery! Don't forget to give the government a DNA sample while you're at it, and get your own free organ-donating clone with your next visit to the government mandated blood-donation center. Unfortunately those of you with unpopular diseases will just have to hope they blow over... otherwise you're really not contributing to the genepool of quality disorders and diseases. You can wait in a subcommittee waiting-room until you're blue in the face... though I hear blue-face may be the new trend... in which case you're covered!
http://www.beanleafpress.com
From my perspective, you have it all wrong. Taking care of fellow humans is simply respecting humanity and being willing to love and cherish this one life we have to live.
The only "Entitlement Generation" i know are people of faith who entitle themselves with the only path to salvation. They entitle themselves with absolute truth. They entitle themselves with morality.
And yet, people think helping out our fellow brothers is "Entitlement"
Don't give me that, you snotty-faced heap of parrot droppings! Shut your festering gob, you tit! Your type really makes me puke, you vacuous, coffee-nosed, malodorous, pervert!!!
Best Slashdot Co
Obviously here in the states, this bill is a huge deal for us especially considering the price tag attached. I noticed several non-US based posters chiming in about how they don't care about this topic, etc. etc. Understandable since this is a widely read site across the globe. But instead of just posting a negative comment about our health care situation, how about helping us understand how health care works in your country. Pros...cons...whatever. Not being fully versed in what other countries offer and certainly not believing what the major news outlets spew, I figured this would be the best place to ask. Thanks.
"Klaatu, verada, necktie!" -Ash
I know we're getting trolled, but it's too important an issue to ignore.
In an ideal world, we would tackle the problem properly by decoupling health insurance from employment. Linking health care to employment was the worst mistake ever made in health care in America. There are probably too many powerful lobbyist in Washington to hope for that to ever change. So we're left with imperfect alternatives. Such is politics, such is life.
And yes, this is an imperfect bill, but it's a first step towards badly needed reform. Is going to hurt? There's no way health care reform can NOT hurt some interests, while helping others. That's why leadership - political or otherwise - is supposed to take courage. Too bad we don't get that from our leaders.
See: Comedy Central.
As a Brit, the "quality" of TV news in the US depresses me no end; I'm amazed that anyone has been able to hold even vaguely rational debates about the Healthcare reform bill given the utter bollocks spewing from all sides of the media. At least The Daily Show doesn't pretend to be a serious news organisation.
The only conclusion I can draw from the coverage I've seen is that the Healthcare reform bill will either cure cancer or mandate the killing of anyone over 40, it could go either way.
I don't think anybody said they are ALL frivolous. Some certainly are. I don't think anyone including yourself would argue that doctors should have to pay the outrageously high malpractice insurance rates that they do now. Those high rates most certainly can not be caused by only (or even mostly) valid lawsuits.
The healthcare bill is so huge and complex that it is difficult to have any intelligent debate over it. People mostly make simple, sound bite sized remarks. Very few people seem to understand the bill. I don't understand it myself.
That said, the conventional wisdom states that the bill will be extremely expensive, on the scale of Social Security or Medicare. While I agree the current health care system leaves a lot to be desired, I think the timing is terrible. Our financial house is not in order and the economy seems to be in the middle of a long term case of fatigue. In short, I don't think we can afford it. I'm worried it could be the straw, or bale, that breaks the camel's back.
If we can't afford to give my neighbor health care, we can't afford a trillion dollars a year for warfare and imperialist adventures, or any other corporate welfare programs.
When we gave Wall St hundreds of billions to fix their fuckups, they continued bonusing themselves tens of millions of dollars. I don't think access to basic medical care is in the same universe of entitlement of the wealthy.
I'm still reading and wondering HOW this applies or even belongs in this forum. This accomplishes nothing but to start the much-heated bantering again.
This is a hot-button POLITICAL issue that *supposedly* bears no value here unless we find there is hidden wording (what? in over 2000 pages of legislation from OUR congress? I must be off my rocker!) pertaining to the way data or information or privacy will be (ab)used in the future whether this pork-laden by-product passes or not.
In the end isn't this OP trolling??
This is covered in the FAQ. Also, you can remove categories from the front page by personalizing it in your settings. Not trying to be snide, it helps me avoid topics I don't care about.
That being said the summary was a complete troll. They make it seem as if logical intelligent people will automatically want this bill to pass. But anyone with that intelligence realizes it's much more complicated than the black and white issue it's been spun as in the media. If they were paying attention they'd realize that the Republicans, and Fox News and their Libertarian base along with them, are sitting on the side lines watching the real fight happen inside the Democratic party as they fight over the bill. This is why "deem and pass" procedure is such a big deal. The Democrats want to move the bill forward and go into election mode because they see this bill as sapping their political energy and really pissing off the public in the meantime.
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
In my personal experience, anything that Fox says is "bad for America" usually means "bad for the republican agenda". I'm not exactly inclined to believe any sort of fearmongering they promote.
Keep government out of the doctor's office.
The doctor/patient privilege is one of the few sacrosanct sociopolitical relationships (along with husband/wife and clergy/parishioner).
As for who pays for it, that's between the patient, doctor, and any insurance company the two VOLUNTARILY choose.
You have a touching anecdote? come up with legislation which helps that situation, without interfering with the >250,000,000 cases where there isn't a problem.
Any "democracy" which passes legislation without voting on it isn't.
And no, this isn't a suitable topic for /.
Can we get a "-1 Wrong" moderation option?
Much as I would vilify Fox specifically for treating its viewer base like children who cannot comprehend intelligent debate, let's be fair here: All of the news organizations really screwed the pooch on this matter.
Anyone looking for intelligent discussion on Health Care gave up on the media a long time ago.
Between the general welfare clause and the commerce clause (insurance being an interstate commerce issue) of the constitution, their constitutional authority is pretty strong.
The morality issue that the health insurance industry is set up to rape its "customers" at the cost of their health?
There's a reason why every other civilized nation has publicly funded, universal health care - the government of a state, no matter how inept it may be, is in place to serve the needs of its citizens.
Private health care, no matter how competent, is in place to generate profit for the private corporation operating it.
The primary lever operating on a public-run system is voter outrage. This tends to apply pressure on the government to improve the system for the benefit of customers.
The primary lever operating on a private system is the generation of profit. This tends to apply pressure towards raising costs and reducing services.
The current American system is defective by design and is ruining the health of your citizens. And the shills of the insurance companies have convinced a large portion of you that it is immoral to try and fix the system. THAT is what you should be outraged about - that you have been successfully PSYOPed into believing that universal public healthcare is somehow immoral and wrong.
DG
Want to learn about race cars? Read my Book
Thirty plus million more people getting access to care with no plan to increase the number of primary care providers - not good. Most of the newly insured not part of the tax contributing population - not good. No incentivization to have health insurance or maintain a healthy lifestyle - not good. More healthcare administration from CMS that has brought us Medicare and Medicaid and its $500B in fraud and waste - not good.
>>>the Supreme Court to rule the action as unconstitutional/illegal
They won't. The Supreme Court serves the same master as the Congress and the President - the United States Government. Just as they rammed through the unconstitutional rationing of farmers' *privately-owned* crops (Wickard v. Filburn), so too will the uphold this Pelosicare bill. And then all three branches will all go have a party to celebrate.
The only hope we have is that the independent States, not having to rely on the U.S. Government for a paycheck, will nullify the bill as violating amendments 9 and 10.
"But the Chief Justice says, 'There must be an ultimate arbiter somewhere.' True, there must; but does that prove it is either party? The ultimate arbiter is the people of the Union, assembled by their deputies in convention, at the call of Congress or of two-thirds of the States. Let them decide to which they mean to give an authority claimed by two of their organs. And it has been the peculiar wisdom and felicity of our Constitution, to have provided this peaceable appeal, where that of other nations is at once to force."
--Thomas Jefferson to William Johnson, 1823
"I disapprove of what you say, but I will defend to the death your right to say it." - historian Evelyn Beatrice Hall
Study after study has completely debunked the myth that high malpractice insurance is due to frivolous lawsuits. High malpractice insurance is for the same reason their is high medical insurance. The insurance companies made bad investments and lost their shirts now they're raking everyone over the coals while still pulling down 20 to 40% profits.
Over-the-top Response Guy! Giving "Over-the-Top Responses" since 1970.
I'm all for the *reform*, as long as I don't have to pay for it. I've been paying for 40 years, time for you young fellas to pony up. BTW, which company has a working DB for handling the health records of over 350 MILLION people, the kind of DB the single payer system would require?
Its worse, its not that they fine you, THEY CAN THROW YOU INTO JAIL FOR FIVE YEARS for not having what they feel is sufficient health insurance. It makes not having sufficient health care A CRIMINAL OFFENSE.
The "truth" is, the same people that want anything the Obama Administration does to fail are the same people that created the Third Largest Government Agency.
How has that worked out? And where was their outrage over its creation and its current status of operation?
Try sending a letter or small package through the USPS, UPS and FedEx and let me know which one was more cost effective.
Now try building a straw man and knocking him down.
I like microcars
The major lawsuit-related driver of medical costs is not frivolous suits. It is jackpot verdicts, where someone with no lasting harm or even short-term disability can be awarded tens or hundreds of millions of dollars in punitive and other special damages. Because the number is big, jurors think that this sends the right message, and because a faceless insurance company will pay most or all of it, they're not afraid of the costs it will incur for the doctor. That's why tort reform usually tries to impose caps on damages, and that in turn is why courts usually throw the laws out (because the laws are seen as a legislative infringement on the judicial function).
One specific beef. One of the tax proposals is to extend the Medicare tax to unearned income for anyone who makes more than $200,000 ($250,000 if filing jointly). Specifically, it means that if you make $199,999 you're not taxed on any investment income or capital gains, but if you make another dollar then the tax applies retroactively to any capital gains you have whatsoever, possibly costing you hundreds of dollars.
That's bad tax design, and it will probably bite a bunch of middle-class/upper-middle-class types who have sudden large expenses and need to liquidate something to pay for them.
The World Wide Web is dying. Soon, we shall have only the Internet.
I think this matters for when you your internet enabled sex toy gets stuck and you need the emergency room to get it off you...after making a hasty retreat from your parents' basement of course without being seen....
:)
But seriously geeks get sick. Some have chronic illnesses which is what gives them so much time to lay in bed and read/play with the computer. It's not uncommon to see geeks with glasses (although I'm not sure the bill covers eye care...but anyway). Or geeks with asthma. Also look at Stephen Hawking. He needs a lot of medical care and he is an uber geek... Look at Steve Jobs, he needed an organ. What happens if you don't run apple. Although his geek status is a question. But a reality distortion field is very geeky
What you will find is what you always find however, the extremes. I personally know a few friends in the States that are doing really not so well just now because they have pre-exisiting conditions and can't get insurance so they don't mind that they have fingers falling off because they can't afford to do anything about it. But again that's at the extreme, obviously for you the system of health care is working quite well, I believe that one of the main purposes of this bill is to extend that system to those who it isn't working out so well for.
Good luck on getting them to pay the bills because most of them deny over half of the claims if not more. Go Google your provider, I'll wait here.
I have heard nothing but bad things about catastrophic insurance from college students I know who used it to register for classes and you should pry read your policy right now to see if you can even litigate them if they deny you coverage, I doubt it. Who is going to end up paying your health care costs if you get sick? Oh yeah, that's right everyone but you. You are no better than the welfare moms you bitch about.
Your paranoid delusions about this being some left-wing conspiracy to force you into some politically correct lifestyle would be funny if it was not so pitiful.
An Education is the Font of All Liberty
This thread is going to be full of so many +5's and -1's, it's going to be ridiculous. Too many people have mod points left unused right now? Is that why this 'article' was posted? LET THE FLAME WAR COMMENCE!
I'm torn on the subject. There are some negatives in the bill I am not too happy about... there are also some badly needed positives. I'd rather have seen as a first small but serrated-edged move the creation of a public option available to ALL people. It does nothing more than offer something for the insurance cartels to compete against... just to stay alive, they'd have to shape up. Then again, insurers are not the only problem... regional hospital cartels are partially responsible as is pharma and their ludicrous advertisements for drugs, not to mention the hypochondriac nation these things have engendered over the last fill_in_the_blank years. One thing is true, though... the status quo is fatal, and one sure sign of insanity is to keep doing the same thing and expect different results.
This is not a 'health care reform'.
This is not even an 'insurance reform'.
What is going to pass is a few regulations that are supposedly going to make it not possible for an insurance company to drop coverage, to do rescission and a few more items. - This is good.
Here is what you are not going to get:
1. No optional public insurance against private insurance, the prices will not go down. Worse than that, what is happening is private insurance is raising prices to offset any of the new changes that will be coming with this 'reform'. Does not look good.
2. You probably are going to get a mandate, which is unfortunate given that you will have no public option. You will be forced to buy into expensive private insurance, there will be no choice or it looks like you will get some sort of a fine. Does not look good.
3. No cheaper drugs imported from other countries. The bill was introduced earlier this fall, but Obama actually killed it very very personally because he signed a deal with the manufacturers to do this: no competition from cheaper imported drugs AND the patents are to be extended from 5 years to something like 12 years. Does not look good.
4. Looks like US is one of the backwards countries that will try to limit women's access to health care they need. You going to get the 'reform' that will prevent any private insurance coverage for women that includes abortion. This is no joke, even for those who have coverage today, looks like they will actually lose it with this 'reform'. Does not look good.
The other part of it, the cost of it, that's a moot point. It was calculated that if Medicare was provided as a buy in for anyone at all, at cost (at cost - means whatever it costs, but no money is made for profit), or if there was a public option, then the reform could even save money. The way it is going to happen with no public negotiations with hospitals, no public negotiations with drug manufacturers, no import of cheaper drugs, no generics because the patents will be extended, well, I don't know if this will be cost neutral. It does not matter really, if US just cut its WAR cost, it's defense contractors costs they could probably fund the entire reform in health insurance and there would be enough money for the public education reform. Of-course that's not going to happen.
Anyway, Pelosi and Obama and the rest of them are lying sacks of shit. They do not want to take a vote on the public option, they will not take a vote on Grayson's proposal to just allow anyone to buy into Medicare at cost. This is not a health reform, this is just a little chunk of 'change' you were promised. Take it and be happy, cause you are not going to get anything better at all.
You can't handle the truth.
The purpose of health care reform originally stated during the presidential campaign was to reduce the cost of health care, thereby extending health care to more than 38 million uninsured Americans. Being a healthcare provider, I skimmed an early draft of HR 3200 and was struck by how little politicians understand how our health care system works, the problems within, and how to elucidate possible solutions. And there are solutions, like repealing the anti-trust exemption for health insurance providers (in the works), streamlining Medicare benefits, regulating the prices of pharmaceuticals, developing methods to evaluate and approve generic biopharmaceuticals, and so forth. There just aren't any meaningful reductions in the cost of health care in this proposal. We're looking at a situation similar to the extension of Medicare to part D, championed by the Bush administration and a noble idea, but has cost much more than initially anticipated. And honestly, the largest barrier we face is ourselves, by the inordinate amount of dollars we spend on preventable disease in this country. Low cost, affordable health care would be easily attainable if Americans just took better care of themselves.
Links? Why bother, I'm sure there aren't any. I've read over and over again exactly the opposite of what you are claiming. I could dig up links for you but I'm too busy making money and paying ridiculously taxes to pay for the health care for you and all the other socialist bums on this site.
I just can't help but think this bill isn't going to do it. I'm sad about the lack of a public option and I'm disappointed in the Democrats for their lack of solidarity. The GOP is a stubborn bunch but they remain effective in their unity.
I went to eat some animal crackers and the box said, "Do not eat if seal is broken." I opened the box and sure enough..
Seems to me you already have a government-run healthcare system in the way of the Department of Veteran Affairs. Or am I missing something?
You'll change your tune once you have a family, assuming you're not gay. You're obviously not having any annual checkups or medical tests if you only pay $200/year. More often than not, doctors will charge double what they do with insurance companies for cash / self-pay people. It would appear you are avoiding health services, because just walking into a door will give you at least a $100 for a 3 minute consultation. Had your eyes checked lately? Dental care? Don't be fooled into thinking because you don't feel anything you are in great health.
It's a good job that the USA has absolutely no far left in its government then! The Democratic Party, for example, fits in well with "mainstream right" parties in other countries such as the UK Conservatives who share some advisers with them.
So if the Repubs see them as wayyy left, where does that leave them if they are well right of moderate right wingers?
I'll see your Constitution and raise you a Queen.
The point of this article is to discuss the reform in a constructive manner, not to bash entire ideologies just because they are not your own.
Obviously, you've never seen a single hour of Fox. Imagine several schizophrenic paranoid white men, who are afraid of gays, Mexicans, muslims, the poor (that's code for minorities), hate equality, love war, and instead of using a values system as a starting point for their worldview, they start out with a worldview and then selectively apply their values system in nonsensical rants. Give them an audience and editors and producers that only care about ratings and pushing ideology handed directly to them from GOP and other ultra-conservative sources.
Now pretend that it's news so people think they are using journalistic standards, when in fact they are simply opinion shows.
All of the media outlets are rather stupid. Fox News is dangerously delusional.
Provide links to examples of such Jack-Pot verdicts. I used to believe that, but, everytime I looked into what was being bantered about as "Jack-Pot" verdicts turned out to be something where the medical system did fuck up big and the person was harmed very substantially.
Over-the-top Response Guy! Giving "Over-the-Top Responses" since 1970.
This isnt communism. Read the bill.
Its more fascism. This isnt a government run health care program, its a mandate that buy private insurance from the insurance industry.
Thats not quite communism.
And Single Payer, Universal health care wouldnt be communism either, anymore than the military would be. Not that this bill is Single Payer. The democrats failed to bring real health care reform. What we are left with is a corporate welfare bill, that the democrats will praise like the republicans praised no child left behind and the patriot act. This not to say I support the republicans in anyway. More so that the democrats are just as lame and bought out by the corporations we ask them to regulate.
For some reason SOME people are ok with spending all of our money on military defense, but when it comes to spending it on health defense... certain people cry communism.
Brain-washing and indoctrination.
Listen. Just because the person you meet and discuss intimate details with at the "doctor's" office is wearing a lab coat and a stethescope, it doesn't mean he or she is a doctor. They are actually just civil servants who have hidden microphones and very discrete ear pieces, that allows what you're telling them to be heard by a 13-person death-panel, who will then instruct the "doctor" what to do.
The death-panel consists of:
This is how socialized "medicine" works. The only medicine involved with it, is making sure your body is sold off in parts to raise money for the party leaders! WAKE UP AND SMELL THE ROSES! Actually, those aren't roses but the perfumes used to cover up the stench of rotting corpses in the streets.
</sarcasm>
and there has been no reform to the health care system.
just a legal requirement to be part of a broken insurance system.
fix it and people will be drawn to it.
If there are so many studies to that effect, why didn't you link to any of them? Will you remedy that shortcoming so that the rest of us have data rather than a single anecdote with an inflammatory contrary response?
You do realise that in countries with universal health care systems, there are still private hospitals, right? Just because there is a public option, does not mean that there is not still a private option.
FWIW in my country, there's about a 50/50 split of private vs public hospitals.
Also don't confused government-PAID healthcare (i.e. single payer, but doctors themselves are still private businesses free to do what they want), with government-RUN healthcare (where the government actually runs the clinics/treatments themselves). Most countries have the former, not the latter. So comparisons with the Soviet Union etc are a bit ... wrong.
Funny, I don't remember any slashdot mod that caused giant mechanical arms to reach out of your keyboard and compel you to read every article. ...I mean, maybe it's part of that 2.0 thing everybody's talking about...?
Freedom isn't free; its price is the well-being of others.
universal healthcare is a form of investment in your society that pays dividends
if you don't pay for it overtly, you pay for the lack of universal healthcare in terms of easily preventable heart conditions complicating into more expensive conditions, breadwinners out of work because they can't treat their diabetes leading to their children to become street criminals, mumps and whooping cough outbreaks because vaccination is too complicated for the poor, people out sick more often because of inadequate healthcare, personal bankruptcies leading to losses at financial institutions due to sudden and expensive healthcare, etc.
in other words, you pay for healthcare, one way or another, no matter what your policy is
its just that universal healthcare is the CHEAPEST way to pay for it. but since the cost is overt and in your face, you reject it. but this simply means you don't understand the roundabout MORE EXPENSIVE and hidden ways you pay for it if you DON'T have universal healthcare
in other words, libertarian and tea bagger rejection of universal healthcare is based on a lack of ability to understand that life is complicated. what happens if you DON'T pay for healthcare as a society? people who get sick just disappear off the face of the earth? they are all paragons of personal financial virtue and never need aid? you yourself never need a helping hand? think about reality, then form an opinion
there are PLENTY of areas of life that should NEVER be public, and should always be private, for a number of reasons. capitalism, in fact, is the most useful engine for the creation of wealth ever invented by man. the point is, for SOME sectors of life, not all, making some thing run by the government actually is the CHEAPEST AND MOST EFFICIENT way for that sector to function
in other words, simplistic, fundamentalist adherence to the idea of free markets does NOT answer all questions in life, JUST AS TRUE as a simplistic, fundamentalist adherence to communist ideas does not work. but socialism, as understood by the rest of the first world, is simple the concept that SOME, not ALL, sectors of life require the government to run it for MAXIMUM FINANCIAL EFFICIENCY
a society with a capitalist engine, with socialist safety nets grafted on, is SUPERIOR and MORE EFFICIENT than a purely capitalist society. this really is the objective financially solid truth, not an opinion. lose your utopianism please: in life, simplistic absolutist philosophies, such as a fanatic devotion to individual reliance, DOES NOT WORK IN ALL FORMS. you are part of a society. as such, you contribute financially to it so that SOME functions in your life. by doing that some functions in your life are simply handled MORE CHEAPLY than if you handled them yourself. life is complicated, and requires a moderation between competing needs. understand this about the world, and drop your extremist ideologies
there is such a concept as the common good. there is such a concept as personal reliance. both are paragons of virtue that, in the real world, exist in tension in how they work. the idea is to find a BALANCE between the two ideals, not to simplemindedly adhere to one or the other polar extreme
teabaggers and libertarians: in SOME avenues of life, not all, the government is good, and works for you. you reject it at the price of your own impoverishment. that's the simple obvious truth
intellectual property law is philosophically incoherent. it is your moral duty to ignore it or sabotage it
Much ado has been made about the length of the bill. If you actually look at the bill text, there are approx. 25 lines per page, tabbed way in, yielding approx. 100-150 words per page, including line numbers and a whole lot of in-text references to other sections. If you trim out the legalese, references, line numbers, etc. the actual summary of what it does MIGHT make it to 20 pages.
stuff |
Don't worry, IT will get regulated. Our industry has far too much power that, quite frankly, scares the shit out politicians. They can't leave well enough alone. Never have, never will.
Life is not for the lazy.
The moment you come down with diabetes or another life changing illness and no insurance company will cover you because of a pre-existing condition, I want you to imagine me pointing at you and laughing, you giant idiot.
Dirty Pirate Hooker
Shouldn't computing be a right in this day and age?
Finland has already declared a right to broadband.
It's time for the US to take a leadership position.
If it doesn't, the poor are going to fall further and further behind.
Every resident (whether citizen or not, taxpayer or not) has this right, because rights are not dependent upon citizenship status.
Everyone should get a computer, LCD monitor, mouse and keyboard with Windows. (That's every person, not every household. People have rights, not groups.) Everyone would get a new computer every 3 years, and free virus cleaning and computer "physicals". People might have to wait in a waiting list to get a computer, but this is better than the current system, which is based on a profit-motive, first-come, first-served basis.
I'm not a lawyer, but I play one on the Internet. Blog
http://eh.net/encyclopedia/article/thomasson.insurance.health.us the question isnt healthcare do this or that, question is, does it come from the federal gov't? yes, than we dont need it. its a simple study in liberty, gov't kills liberty.
1. Obama has said that with this bill employer's healthcare costs will go down 3000%. Either he doesn't understand the math or he thinks health insurance companies are going to pay employer's. I think he thinks people are stupid and will think to themselves 3000%, my boss is going to save so much money. Do we want someone like that controlling our healthcare? 2. Everybody has to get insurance even if they don't want to. (What country are these people living in?) What happened to freedom of personal choice? 3. Insuring 30 million people will not make anything cheaper. 4. If the health care system is screwed up who could really think that the Feds could make it better if they controlled it? Think about how efficient our Fed. Govt. is.
Not entirely true. The legislative actions (ending recissions, forcing insurance companies to cover everyone, etc) take effect immediately. Only the benefits that cost money have been delayed. There will be a big, positive effect right away.
Genocide Man -- Life is funny. Death is funnier. Mass murder can be hilarious.
Its worse, its not that they fine you, THEY CAN THROW YOU INTO JAIL FOR FIVE YEARS
[citation needed]
I have catastrophic insurance, so if I get cancer and my bills go over $20,000 then THEY will cover the cost. Like a safety net.
Thats what you hope at least...
http://crooksandliars.com/nicole-belle/health-insurer-targets-hiv-patients-d
You are probably happy with the setup because you are are probably young and without a doubt, healthy, and because you are young and healthy, you've never had to use it...
There is absolutely nothing wrong with taking care of fellow humans, with loving and cherising their lives as much as your own, and with giving them your money so they can live longer and healthier lives. Except that this bill is not about that. It's about forcing you to do these things at gunpoint (and yes, a gunpoint is somewhere in your future if you stop paying your taxes) by raising taxes (by 3.8%) and by forcing you to buy health insurance when you don't want to do so. This is the core problem of socialism: it's not that we should hate helping our fellow man, it's that we should hate being forced to do so. It's that we should hate not being able to choose whom to help with our efforts, and so to not be able to value the lives of the people we love more than the people we don't.
I will also be concerned what else "they" might force down my throat.
So, how does it feel being a republican mouthpiece? Is it fun parroting lines straight from Fox News? OTOH, at least you don't have to think for yourself...
I tend to agree with this, but I am in favor of a Single Payer Not for Profit system.
The reason I agree with what you said is... that this bill will force everyone to buy private insurance from one of the major companies.
Thats a strange way to reform an industry... ie: send everyone to the enemy for massive profits.
They want to tax soda here in NY... and now they want to tax Pizza...
Whats next? They will start taxing anything they do not want you to participate in. Which may be America as a whole.
Freedom is dead, especially when you're being taxed and not represented. In this case... we're being taxed and by law we're now going to be forced into making a deal with the devil (the insurance industry). We elected the democrats to contain and control the insurance industry... not feed us to them.
In many cases they are frivolous.
The typical lawsuit against a healthcare provider is not suing over any obvious error, it's about suing over an outcome, and claiming healthcare provider should have done some thing in addition to or other than what they did (even if that thing is not common, or standard process).
For example "They should have tested for extremely rare disease PQRS". They didn't, the patient was diagnosed with something less severe, and they died, now their family sues.
So... they get these huge legal expenses. But more importantly... now suddenly they will have to start testing all people for PQRS, even though it's a genetic disease that effects 1 out of 10 million. Every single person will have to be tested, to avoid future lawsuits. So the lawsuit itself increases costs, but so do lawsuit-created modifications to medical practice: providers now have to waste money and compel tests and practices that the average person would not want to pay for, just to avoid the possibility of lawsuits.
A lot of expenses have to be imposed in 'practice modifications', and paperwork.
Your typical example is also people suing over something that went poorly for them, even though normal medical procedures were followed.
For example, patient died of X or suffered Y, when they were being treated for Z.
Even if X was not a reasonably avoidable outcome, or X/Y would not be prevented by generally accepted medical practice, there is a chance that a lawsuit will still be generated.
People sue when bad things happen to them. Of course all bad things are always someone else's fault. And the medical provider must be in full control at all times of everything that happens right?
If you leave with condition Y, or (for one reason or another) they can't or fail to cure it, it must be their fault. If they induce condition Y, but it's not any error on their part, or problem with their facilities, then their practitioners really must still be liable, right?
Even though they disobeyed your medical provider's direct instructions, the provider must be to blame, because they supposedly have the cash.
The public option makes the most sense from a game theory perspective: the "players" (insurance companies) in the "game" would have to adapt to a new set of rules, be more competitive, and eventually be more effective in providing services. Is that status quo, where the players all know each other's strategies and plan accordingly to preserve an oligopoly, really what we want?
(I love the conservative argument against the public option: "Heavens, how can we expect a private company to *innovate* their way out of a situation, that's anti-capitalist!" Cry me a river, fellas.)
--- The American Way of Life is not a birthright. Hell, it's not even sustainable.
Here's the graph. Health Care expenditures, as a percentage of US GDP, have increased pretty significantly over the last 40 years. Keep in mind that health care costs are PART of GDP (so when WellPoint raises insurance rates, it actually shows up as an increase in GDP, which helps illustrate why GDP might not be the best indicator of our national economic health). That means that the expenditures in the health care sector have been growing much faster than those in most other sectors of the economy - if they were all growing equally, the portion of the GDP associated with health care would stay flat.
I have my own opinions about how to solve this mess, but I'm not in congress and I have trouble making my fish agree with me, let alone other people. So I won't talk about those, just about the facts of the situation.
All well and good, but for some reason no one is willing to do that. Neither of the two most powerful parties ever work on that whenever they're on top, and they've had decades in which to do it. Nobody runs on that as a platform issue and gets votes. So while that issue is worth pushing, it's pretty safe to assume that 99% of America is violently opposed (ok, so I overstate it: they're violently apathetic) to it, and it's not going to happen.
If it does happen some day, that's great. But without any voter support at all, it just doesn't make sense to say "do it first." And it turns out there are reforms that many voters are willing to support. Might as well take advantage of that right now while people's enthusiasm is still whipped up. Tort reform can happen asynchronously, whenever its prerequisite resources (votes) get unblocked.
But there you have it: lots of different people say "x" is the most important part. Your pet is tort reform. All these different reforms should be running in parallel, so that the consensus ideas can go ahead and the unpopular ones wait until people want them. Instead, we have a multi-thousand page monolith. WTF? Why a health care bill, instead of 50 health care related bills?
As copyright owner of this comment, I authorize everyone to defeat any technological measure which limits access to it.
Then they should be executed for treason. They swore an oath to the Constitution, not the Government. Not their party. Not the President. Not the people. To the Constitution. So if they don't live up to it, they should be held accountable to it...
There are only 7-8 million U.S. citizens (key word) that are chronically uninsured. i.e. Not covered by an existing government program (SCHIP, medicare, SS), or their own private insurance (like me).
That's less than 3% of our citizens. All we need to do is extend existing programs to help those persons in need, not screw the other 97% by forcing them to adopt something they don't want.
LINK - http://www.google.com/search?q=%22chronically+uninsured%22
"I disapprove of what you say, but I will defend to the death your right to say it." - historian Evelyn Beatrice Hall
People are forever comparing the US to individual countries in Europe. But that is not an apples-to-apples comparison. France, for example, is demographically and economically the size of the state of Virginia. To get a fair comparison, you'd have to compare the entire US to the entire EU.
Surprisingly, the EU does not have universal health care. In fact, it has exactly the same plan as the US: each member country/state decides for itself. We have states such as Massachusetts and Tennessee that have plans as generous as those in Europe, and other states where there is very little centrally-planned health care.
What the Democrats are asking the US to do is something even the EU won't do.
"We receive as friendly that which agrees with, we resist with dislike that which opposes us" - Faraday
In France, we call the country you quote as "anglo-saxon". We use them as scarecrows of the kind of practice we don't want to see...
Why don't you just use life expectancy as a metrics for evaluating countries practice in healthcare ?
The Wise adapts himself to the world. The Fool adapts the world to himself. Therefore, all progress depends on the Fool.
This bill does the following 1. They want to claim a ride to fame, when in reality it will be infamy 2. They want to control America, this is without a doubt 3. This is only the beginning, as several politicians lay claim to it being akin to a "Starter Home" 4. This bill also includes student loans, and it makes the new graduates subservient to the government 5. Through this bill they will be able to control various aspects of American's lives as this and that will have an impact on your government imposed insurance. Things to remember. 1. Healthcare insurance is not a right, but a good / service that is to be purchased. 2. It is in no way constitutional to force this upon Americans 3. Equating this to car insurance is BS, not all of us have cars, but all of us that are alive do not need insurance. 4. Under this imposed system the rich will all the much more have the unequal distribution of health care that they claim to not like. Look at Canada, every time someone rich / powerful needs some health care right now they take a trip to USA. 5. This bill is so bad that it's been stalled by the Democrats for over a year. The Republicans have not had enough senators, until recently, nor enough democrats to stall, or otherwise interfere with the legislation. With most of the legislation being one sided anyway. 6. When was the last time the government budget estimations lived up to what they actually spent?
Those big, positive effects don't come for free. Insurance companies will raise premiums to compensate which will cause some businesses and individuals to drop their coverage because it's cheaper than paying the fine for being uninsured.
The underlying problem is that we are engaged in a panic economy. As fickle consumers of media, we have a taste for the loudest and the shrillest of voices, and even when we vehemently disagree or even mock them, we lavish hem with our attention. And in the age of 24-hour cable news and the Internet, attention is money. So, we essentially pay people to wave their hands in the air and yell "boo!" at the screen. It seems silly that so many of us are honestly surprised that people are scared.
The bill is going to be streamlined and fixed over the next few years in smaller bills. But who cares about that? It's so much easier to reject the whole thing out of hand over deliberate lies (death panels) or language that isn't actually in the bill (coverage for illegal aliens). Best of all, rejection gives you the freedom to sit back and complain without accepting any civic responsibility.
This thing is a long, dull process that's going to require that people stand up and state their case, over and over again, until this thing is right. So, at a time like this you have to ask yourself something. Are you the stand-and-fight sort of person or a rejectionist?
Personally, I'm spoiling for a fight.
>>>there are still private hospitals, right?
Yes just like we have private schools here in the U.S. Too bad most citizens can't afford them, unless they are wealthy, so essentially you're stuck with what the government provides (or does not provide, due to neglect).
"I disapprove of what you say, but I will defend to the death your right to say it." - historian Evelyn Beatrice Hall
Here's an idea, instead of forcing everyone to GET expensive health care, lets try lowering it's cost first. You realize that with the government paying for healthcare, the cost of that care is just going to go up? Prices that companies charge individuals are generally cheap. Prices they charge companies are high and prices they charge goverments are INSANE? We're all going to be getting $800 toilet seats.
So, instead of the current plan, lets try this first.
1. Buy insurance across state lines. This gives people the opportunity to search for cheap insurance. Right now you can only get insurance in your state... Imagine if you couldn't buy anything over the internet across state lines.
2. Limit lawsuit payouts. The lawyers (sharks with lasers) are making a KILLING on lawsuits. Reduce the payouts and the sharks will have less to feed on, there will be fewer ambulance chasers because the $$$ will become reasonable.
3. Reduce the FDA requirements. Wow, meds sure are expensive. Oh, they aren't in canada? Oh, and canada sells the same meds for much less and they don't have such a stringent approval process? Hmmm
4. Promote Savings Health Accounts (see 1. first) - If you put in $xxx dollars tax free into an account that's YOUR money. Once you cap it at a certain level you just pay the maintenance (the insurance part in case something catastrophic happens) Now, it's your task to shop around for an affordable healthcare provider. You'll think twice before paying $300 for a checkup.
5. This topic wasn't designed to discuss immigration, but guess what, that's a major cost in health care. The country will fail if the people paying into healthcare are expected to support every ILLEGAL immigrant that wants healthcare. Especially if the hospitals are charging those goverment rates for it ($30 for an aspirin anyone?) I'm just going to say, if you can't reasonably prove your an american, you don't get american health care, unless you can pay cash.
Exercise: Call 3 local providers and tell them that you have some common malady and tell them that you have Blue Cross insurance, ask them what it will cost you, and what they will bill BC. The next day, call them all back, same malady and tell them you're paying out of pocket. If day 2 isn't a third of day 1 I will eat my shoe.
Do not meddle in the affairs of sysadmins, for they are subtle, and quick to anger.
Wickard v. Filburn dealt with a poorly written law that should have set limits on sales, instead set limits on crop growth, with the intention of setting limits on sales.
If this was today, Filburn would run 2 companies, one would run a livestock farm with a wheat field and the other would grow wheat for market. Heck, he would most likely get a grant too.
And why shouldn't they? They're in a position with much, much better leverage than your standard insurer, because by the time one of their customers needs his "catastrophic" insurance, the situation is already "catastrophic" and he's an easy victim in a lawsuit.
The UK system works very well but is not perfect. If you want a quicker service you can use private healthcare.
My previous boss had to had a triple heart by-pass which he had on his firms private health insurance. The consultant said that the treatment was 95% effective if treated straight away yet under NHS cover his condition would have been treated with medication until it got so serious that the by-pass was necessary to prevent death at which point it would be only 60% effective. Incidentally, the procedure is carried out by the same consultant in either case as he works for NHS and private healthcare firms.
What is apparent is that you *will* get treatment no matter what your financial position - this includes all all types of treatment rather than emergency procedure only. This can only be a good thing.
I would welcome the US to lead the way and implement a system from the ground up. The UKs NHS system is antiquated and one of the most inefficient systems around. It is bloated with many tiers of overpaid management which leads to underpayment of important people such as nurses. It employs around 1.3 million people for a population of around 65 milion yet still has no unified computer system despite allocating billons to this task (the budget was quadrupled and the time estimate tripled with no sign of conclusion).
Have to say "ditto", as an Australian who spends ~6 months a year in the US. Two main observations with US news:
- It's quite partisan. You tend to hear one side of the argument from one channel, and the other from another. Rarely do you hear a well-balanced story out of a single source. I think the lack of a well funded public broadcaster (ala BBC or Australian ABC) is most of the reason behind this.
- The emphasis placed on local, national, international is almost completely the opposite of what I'm used to in Australia. Generally in Australia, an international story or major domestic (but never local) story would be first in the bulletin. From my trips to the UK it appears to be similar there. Local stuff would be relegated to 2/3rds through the news, with sport and weather at the end. In the US it seems to be mostly local/domestic, then maybe if you're lucky one international story near the end (and only if its really major ... you never hear 'interesting but not that important' stories from overseas like you do elsewhere).
The other odd thing (to me at least), is that even if you compared a US local news with an Australian local news bulletin, the type of stories they run are quite different. In the US they have local stories like "the mall is getting extended" or "they are putting traffic lights in on this intersection". That'd never get reported at home ... the local stories are more along the lines of what the local/State govt. is doing, or any major crime incidents etc.
On the other hand, the US does one thing way better than anyone else - weather. Even little local stations in small towns have their own meteorologist and often their own Doppler radar, and they actually know what they are talking about! In Australia you just get some vacant blonde chick who knows NOTHING about weather, reading the script sent to her by the weather bureau. :)
>>>Why don't you just use life expectancy as a metrics
Because life expectancy is a correlation, not a causation. Yes Americans have lower expectancy, but the cause is not lack of government care. The cause is hard living (dangerous jobs like farming/logging with premature deaths, and/or simply being fat slobs).
If you think U.S. life expectancy would suddenly rise if healthcare was provided "free" by the government, then you're thinking wrong. We would still have a deathage that is earlier than Europeans due to how we live.
"I disapprove of what you say, but I will defend to the death your right to say it." - historian Evelyn Beatrice Hall
As I have pointed out [codemonkeyramblings.com], IT is as wasteful, if not more so, than the health care system.
Well, the minute IT is responsible for routinely bankrupting people because of conditions that are completely outside their realm of control, let me know. And the minute IT is responsible for truly astonishing levels of drag on the economy, placing a massive burden on the small businesses which are the engine of the American economy, well maybe then you might have a point. And when IT, like healthcare, becomes a service that everyone will, at some point in their lives, be forced to personally avail themselves, well, then your little metaphor might be worth considering.
Until then, I think it's safe to say that healthcare and IT are such drastically different industries that to compare the two is the height of idiocy.
I hope it's rushed through, because then it may give ammo for the Supreme Court to rule the action as unconstitutional/illegal... Not to mention that Fed healthcare as it stands is unconstitutional... Amendment 10 of the constitution states:
So explain to me how the US government has the power/right to do this?
It's in the Constitution, Article 8:
The Congress shall have power To lay and collect taxes, duties, imposts and excises, to pay the debts and provide for the common defence and general welfare of the United States; but all duties, imposts and excises shall be uniform throughout the United States;
In short, Congress has been granted pretty broad power to govern the US.
I'm a consultant - I convert gibberish into cash-flow.
The only reason I am opposed to it is because my taxes will go up; but they are going to go up anyway. If my taxes don't go up it will only be because we are increasing our debt, which will in turn devalue my dollar. In either case I will be poorer because of it.
Ron Paul? You're on Slashdot now??
The rationale is laid out in the Preamble ("promote the general Welfare") and the power in Article I (Congress) Section 8 ("The Congress shall have Power... to pay the Debts and provide for the common Defence and general Welfare").
Besides which, as this is a bill about health *insurance* (not health *care*), and as it does not really establish any public insurance plan, it's really a corporate regulation bill. That's squarely within Congress' power according to the Commerce Clause.
Freedom isn't free; its price is the well-being of others.
I have catastrophic insurance, so if I get cancer and my bills go over $20,000 then THEY will cover the cost. Like a safety net.
You mean like a safety net not everyone can afford, not available to everyone who can afford a reasonable price if they've had illness in the past, and a safety net which has huge holes in it because it's provided by a company whose best financial interest is it to fail. Getting catastrophic insurance to pay out is difficult. Trying to do it while very ill is more so. I've been through all this with the insurance company. Needless paperwork and delays and requirements and mistakes and hassles, all while you're very ill. In most cases, you end up paying yourself and then, if you survive, suing them.
But most of the time I pay CASH (about $200 a year), which means I deal *directly* with my doctor.
In places with universal single payer healthcare, you deal directly with your doctor as well. The difference being, your doctor is not motivated to cut costs, is motivated to provide preventative treatments, and is not profiting or working for people profiting the more the longer you are ill.
If this Pelosicare Bill forces me to abandon my system of paying cash for product (or else be fined by the government), then I will be very very angry.
You're probably going to be very angry then. But a lot of people will get to keep their homes and get their insulin and fresh needles for it, and fewer children will die needlessly and fewer people will go blind from preventable causes (the US is the worst in the first world on this now). So you'll forgive me if I don't value your stress levels all that highly. Oh, and as a side bonus, we'll finally be reducing the deficit so maybe, in the conceivable future, we could lower taxes overall, and not just for the ultra wealthy.
I will also be concerned what else "they" might force down my throat.
This is called the "slippery slope" logical fallacy.
This is not freedom. This is like a return to 1770 when Parliament dictated to citizens as if they were Serfs.
Why is it the people electing representatives who tax us and provide the service of health insurance is "not freedom" but people electing representatives who tax us and provide the service of arresting serial killers is? Both directly work to protect the lives of the citizenry. Sensationalist pseudo journalists like to spin healthcare reform in the US as though it were fundamentally a new concept, evil socialism or some such nonsense. It's no more socialist than the FBI and our socialist police force and it's just an extension of our current, partially socialist healthcare system that already provides socialized healthcare to the very poor, the elderly, military veterans, and members of congress. It's an incremental change. Of course these are the same sensationalist pseudo journalists that claim setting tax levels/disparity to the same as they were in the early eighties and significantly less than they were in the 50's-70's is some sort of radical measure, instead of what it actually is, a conservative move back towards our historical system and away from the current radically unbalanced level of taxation.
Cited from the voices inside Glenn Beck's head.
An Education is the Font of All Liberty
First, I don't think anything that shields consumers from prices will bring down costs.
But even if this bill is conceptually sound, it will still fail and bankrupt the nation. Why?
We don't have enough young people. Around 1940, we had about 44 people for every 1 retired person. Now the ratio is 3.3 to 1.
You can't have a welfare state and a low birth rate long-term. It will bankrupt us all. The only conceivable way around that scenario is strong economic growth, but the high taxes needed to pay for the welfare state will snuff that out.
It's not my place to tell people how many children to have, nor is it the government's place. Ironically, liberals tend to have less kids, the same kids their welfare state relies on.
We're basically a few years behind Greece.
Except for ending slavery, the Nazis, communism, & securing American independence, war has never solved anything.
Currently the U.S spends the largest amount of it's Gross Domestic Product on health care 15%, then any other country. The next largest spender is Switzerland at 11%. So the U.S. spends 4% on health care then next largest spender. With this additional spending does this mean that the U.S. has a higher life expectancy, then any other country? No. The U.S life expectancy is ranked 50th in the world. The current system does not produce good results. Other systems do, and it is good that the USA is going to change to a better system.
Fair point. I did not realize that was in the Articles of the Constitution (I knew it said that in the introduction). I will concede my second point, but I still feel my first is valid...
If a man isn't willing to take some risk for his opinions, either his opinions are no good or he's no good
And the reason why it is linked with employment is because of tax incentives and policy decisions made by government in the 1940's.
Government breaks your legs and tells you they are the only people to give you crutches.
Except for ending slavery, the Nazis, communism, & securing American independence, war has never solved anything.
I'm stunned by the comments of those in favor of this mess above me. One can only surmise that they spend their time alternating between coffee shops and the computer in their mom's basement....
Sic gorgiamus allos subjectatos nunc
I live in a country that has government-run universal insurance, and I deal *directly* with my doctor, too. I'm not sure why you believe this isn't possible.
Brain-washing and indoctrination.
The funny thing is, your tongue-in-cheek post spoofing the right-wing mentality in the US actually answers the question quite factually right there.
I'm American. I've lived most of my life in the United States, but have lived numerous times, for a number of years, outside of the United States (Germany, France, Japan, Hong Kong, and currently the United Kingdom) and had occasion to use the healthcare system myself, or have one in my family use it, in nearly all those locations (to be pedantic: I did not need to use the healthcare system in Japan).
The US system is by far the worst system I have used, in terms of delivery of service, cost, and effeciency. The healthcare (when provided) was adequate most of the time, but subpar more often than you might imagine (my wife got a staff infection from a routine vaccination that nearly killed her...mainly because the hospitical couldn't figure out how to diagnose such an obvious problem for an indordinate amount of time. And don't get me started on the weeks-long waiting lists for critical tests like angiograms, and the lab test results that show up months late, the lack of follow-through by doctores, and the billing mistakes that are perpetual to the point of absurdity, and always favor the hospital).
In contrast, we've had no trouble whatsoever with the medical system in Germany, France, or Hong Kong (though this was back when Hong Kong was a part of the British Empire, so YMMV these days), and with the NHS in England, only the occasional hassle of having to follow up on getting test results (but at least when you do follow up, they show up within a couple of weeks, unlike Northwestern, where they routinely go AWOL for 6 months or longer).
But try telling that to any of my fellow Americans. They simply will refuse to believe it (and most likely label you a liar for daring to reveal such uncomfortable truths that challenge their world-view of us having the best system in the world). Why? Years of rhetoric and brainwashing, founded on absolutely no facts.
Want another datapoint? Guess where the richest (non-American) people in the world tend to travel to for their private medical treatment. And I'm talking about Richer-Than-God, I can fly in my gold-plated jet anywhere in the world I like (including the US) and spend more than the GDP of a small country on my medical care people.
It isn't the US. Not most of the time, anyway.
The US is a distant fourth, behind France, the UK, and Germany? Why? Because a lot of the leading-edge research Americans (like one who has posted here) think only happens in the US, and excuse our rediculously lousy price/performance ratio on, actually take place and is funded by those countries that are paying 25-50% of what we pay for our substandard medical care.
But then, we're the best in the world. We don't need to learn anything from anyone else, do we? (cue patriotic music and refrains of "God Bless America" here)
The Future of Human Evolution: Autonomy
The best thing that a health care bill could do is to open up competition and transparency.
If only you could buy health care insurance as an individual from anywhere in the US. If only doctors and hospitals would be forced to give health care consumers basic pricing information that applied equally whether I was paying with insurance or cash. These games they play with the insurance companies to increase revenue for both is ridiculous.
For example, I was planning to have a minor routine procedure this year; so last year I was considering carefully how much money to put into my FSA. My doctor had done thousands of this procedure, but his office could not give me a price or even a good ballpark. As a developer, if I couldn't give a customer a price ahead of time for something routine that I had specialized in and been doing for years, I wouldn't expect that customer to work with me.
Why are you letting these clowns ruin our country?
Another problem with the proposal is that since insurance companies must cover pre-existing conditions is that one could choose to pay the fine (which could cost less than insurance) and then when a major medical bill arises apply for insurance. Doesn't quite seem fair to have someone not paying for coverage until they need it.
Art by Mindy Herman, my wife.
While there are some 60+ year olds around here (the people who would punish politicians at the polls if they even suggested eliminating Social Security and Medicare) they're still a pretty small minority. Most of slashdot is young enough that SS will be long gone by the time they turn 65. So WTF do you mean by "packed with the entitlement generation?"
As copyright owner of this comment, I authorize everyone to defeat any technological measure which limits access to it.
Will this bill do what the administration claims to do, or is it as bad for the future of America as Fox says?
Or perhaps it will do neither.
As long as you don't mind the difference of about an order of magnitude in population and GDP, yes. FYI: Population of Virginia: about 8 million, population of France: about 60 million. GDP of Virginia: about $400B, GDP of France: over $2T.
> The typical lawsuit against a healthcare provider is not suing over any obvious error
You need to stop swimming in the cool-aid and stop getting your knowledge of the courts from the Brady Bunch.
Most medical malpractice suits are infact for medical errors and they don't even represent all of them. Lots of stupid sh*t goes on in hospitals and with doctors that treat medicine like a get rich quick scam. If you are counting on the media to clue you in, then you're probably going to remain ignorant. They want to create headlines and shocking stories. They tend to leave out key details or just get the technical aspects horribly wrong.
This "horribly innacurate yellow journalism" isn't even limited to the torts issue. They do this with everything. That's part of why corporate news is bleeding money.
A Pirate and a Puritan look the same on a balance sheet.
It's not really the 10th amendment that is going to govern this issue. This issue will be governed under the commerce clause of the constitution. This means Congress will get to do it. Right now, legal scholars have a great debate going on concerning the commerce clause. The SCOTUS has defined it so broadly that just about anything that Congress wants to do it can in the name of interstate commerce. Healthcare is something that affects commerce across the states. That means Congress has a very broad discretion to meddle into it. This legacy comes down from the reinterpretation of both the general welfare clause and the interstate commerce clause that occurred in the same era as New Deal legislation.
In Modern times, the 10th amendment is (normally) only violated when Congress attempts to commandeer a legislative or other process of the states. An example is the old laws where: Congress provides that each state must arrange for toxic waste disposal of waste generated within its borders. Congress requires the state to "take title" of the waste if it fails to comply and thus become liable for tort damages stemming from it. (New York v. United States) Congress can't compel state legislatures to enforce federal policy under the 10th amendment.
Another example is administrative offices: Congress can not compel a state's sheriff's to perform background checks on applicants for handgun permits. (Printz v. US) Congress can make it illegal and enforce it with federal agencies, but they can not force a state agency to do anything specifically to enforce federal policy.
As for the commerce clause, generally, Congress may enact laws that cover four broad categories:
1. The Channels of interstate commerce: This covers the regulation of highways, waterways, and air traffic.
2. The instrumentalities of commerce: This refers to people and machines (trains and semi trucks) used in carrying out commerce.
3. Articles moving in interstate commerce: The goods themselves crossing state lines etc.
And finally the big catch all that gives them so much power:
4. Anything "substantially affecting" commerce: So long as the activity is "arguably commercial" then it doesn't matter if the particular activity itself directly affects interstate commerce so long as it is part of a general class of activities that, collectively, substantially affect interstate commerce.
Medical insurance falls into category 4. You can't buy insurance over state lines. That means that most "particular instances" of insurance are not interstate commerce. However, taken collectively, insurance has a substantial affect on commerce when you look at it countrywide. Now, you can see all kinds of examples where this will make Congress have an almost unlimited right to legislate. So many things, when taken in the aggregate, fit this definition. Legal scholars are still wondering what exactly can Congress -not- do? Only a few recent cases have put any real limits on it. It's sad, but we are now seriously waiting to not find out if Congress -can- do a thing.... We're asking "is this one of the rare instances where they -can't- do it?"
It's messed up, but that's the current state of constitutional law.
The free care that Americans get is billed to the patient, If they can not pay they go into bankruptcy. Then the costs are absorbed by the corporations. Except the corporation will see a drag on their bottom line, and increase the prices to their products (Insurance, cost of medicines and care). And as an end user I have to perform a cost/benefit analysis when said megarich corporation raises my rates, and if I am the breaking point I will drop my coverage or decline service and I doubt that I would be alone.
Now the corporations will see that less people are purchasing their services and will have to raise their prices a bit more to cover their costs.
And now that there are just a few more people who are out of the system they will get sick and go to the ER, and be billed for the services incurred. Being unable to pay they will, eventually, file for bankruptcy and leave the corporation with the vast majority of the bill.
If this were a flow chart I would say go back to the point where the corporation has to raise rates.
This is a feed back loop with the main cause being the law that was signed in the 1986 ( http://en.wikipedia.org/wiki/Emergency_Medical_Treatment_and_Active_Labor_Act ).
Now really, as a good capitalist, should we really be providing free care to so many people? They should be required to pay, or demonstrate the ability to pay, ER's before they, the ER, treats them. Should we really let people shrug off their financial obligations upon the rest of us unwillingly?
Shouldn't you only receive services that you are able to pay for? If I have not saved for those chemo treatments, should I receive them? If I do not have to ability to pay for, either through insurance or my private finances, should I receive the services of an ER after a car accident? Remember if I can't pay for it, then eventually you will pay for it through higher insurance premiums and higher hospital costs.
If I buy insurance I am volunteering to share the cost burden with those who I am pooling my money together with. But to be forced to cover people who do not contribute anything is a horrible idea. It leads only to the products that my insurance should cover increasing in price. It essentially gives insurance to those who have not paid for it.
This is unfair for the 250 Million (it's more depending on who you ask) Americans who pay for their insurance.
~Zehaeva
Is it a great bill? Fuck no. None of them ever are.
Is it the worst bill in history? Um, are you fucking retarded? Have you read a history book?
I mean, you're saying a very flawed form of universal healthcare would be worse than the Mann Act? The 18th Amendment? The Alien and Sedition Acts? The Missouri Compromise?
Seriously, dood. The language doesn't wholly belong to you, so please avoid butchering with your titty baby histrionics.
And for the record, if you don't like what we do in power, don't drive the country into a ditch the next time you're in power.
I scream. You scream. I assume that means we're both acquainted with the problem. We proceed.
As all ins co. have "deals" with hospitals. If you look at the bill, then you'll see that the ins co only pays a fraction of the charge. Indeed - most doctors only collect about 21-22% of what they bill.
80% off
that's right.
..........FULL STOP.
I have a genetic disorder that requires metabolic and orthopedic treatment, AKA a pre-existing condition. I've never been denied insurance. I've never been denied care. My costs are reasonable, about $600/year for my portion of the plan my employer provides. My out of pocket for my first hip replacement will be about $4000. I have no fear that the current system will provide me with access to additional replacements as these wear out. I'm optimistic that new technology will come about under the current system that will continue to improve on the quality of my care. I have access to specialist care as I desire. I use the current system. It works for me. It works for me with my pre-existing condition. It worked for me when I was in a car accident. It works for my friend with high blood pressure. It worked for my nephew who had a complicated birth, and for his mother. It works for my wife's grandfather who is alive due to heart surgery. My grandfather fell off a roof and broke his back at 70, then lived another spry 15 years in good health because the current system worked.
Heart surgery, childbirth complications, broken backs, hip replacements...none of these have bankrupted us. We are not weighed down by the burden of the cost of our insurance. So, adjust things incrementally if you like. Let a state or two try it out and see what happens. However, you will pardon me if a sweeping comprehensive rewrite of the current health care system is something I do not embrace. The government has undertaken to radically change the system that has provided good care and life saving medicine to myself and my family. I remain unconvinced. I do not need this. I do not want this.
Moderation : -1 Conservative Viewpoint
No it doesn't. They won't even vote until Sunday. Which is not today. Even then, depending on what they actually vote on it might go back to the Senate and then back to the House.
I'll try anything once. Twice if it tastes good
Just one, I'm sure there are more: http://www.aolnews.com/opinion/article/opinion-obamas-health-care-myths-exposed/19402359 [aolnews.com]
Umm, that linked article is an opinion piece that says it would "threaten people with jail time" but provides no citation. He doesn't even use the correct term since jail would be for a local offense and prison for a federal crime. You'll have to do a lot better than that, like a citation in the bill, perhaps. I searched the text of it and there were no matches for "prison," "imprisonment," or "jail". I can give you a hundred references and cite the portion of the bill where is says you can be fined up to $750 per uninsured adult in a household. I can't find anything about a prison sentence. I'm calling bullshit on this one, unless you can provide a real citation.
Dear Liberty, You've always been true to me and loved me unconditionally, that's why its hard for me to write this letter. I've met someone else. She's everything I've ever wanted in a woman, she's educated in European ways and speaks with a sexy accent. Although I don't always understand what she says I'm sure she has my best interests at heart. As soon as she leaves her current lover overseas we are going to run away together and spend the rest of our lives living truely free. I'll always remember the good times we had together, I hope you can find someone that makes you as happy I know she is going to make me. Sincerely, The people of these United States
10: PRINT "Everything old is new again."
20: GOTO 10
And I paid for two years of it with my own earnings and help from my family.
repaying loans isn't that much of a factor
Now torte reform - that would bring about some cost savings.
..........FULL STOP.
And don't forget:
The benefits start after the next presidential election
That way, they can take credit for their success, get re-elected, and still fail.
Because life expectancy is a correlation, not a causation.
But the correlation is not only between America and France. The trend is between countries with healthcare against countries without.
Yes Americans have lower expectancy, but the cause is not lack of government care. The cause is hard living (dangerous jobs like farming/logging with premature deaths, and/or simply being fat slobs).
Don't forget gun violence.
I stand corrected anyway. I looked at stats about premature death and that is right, US ranks fairly bad. I tend to think that the fact that farming (we do that a lot here too, comparatively more) is more harmful in the richer US than in other countries says a lot about health policies.
The Wise adapts himself to the world. The Fool adapts the world to himself. Therefore, all progress depends on the Fool.
They do need to fix the healthcare system we all know that. But a government take over is not the answer. Social Security as well as other government controlled services are any example when the Federal Government gets involved it usually screws things up even worse. The main stream news media echos this administration on all the information they put out. We have a right to questions these numbers and I am also in full agreement with Mark Levine that if congress passes this bill it should be immediately challenged in a court of law. To pass a bill that is not finished is not constitutionally correct and legal. Just have the up or down vote and you will see this will fail to pass. They know this. They are trying to buy off people to push this through. The whole problem with this program the way they have it setup is the working class will have to bear a lot of the cost. The wealthy will get hit even worse. I am sorry but I don't agree with that. It is not a sin in the country to be wealthy and we should not be able to force them to pay for something more then a fair share. Until this country cleans up the entire system (Welfare, public aid, illegal immigration) this should not pass. I for one have a problem with taking money from my check to pay for healthcare for someone who is not a legal citizen in this country. When this gets passed the flow of immigration will increase even more as we will get over run. Just watch and see if this passes besides bankrupting the country. I know this post will probably get alot of people angry or disagree but it is everyone's right to speak their mind/opinion in this country. I for one will be watching and if my representatives vote for this I will be voting to get them out of office when their terms come up. 70% of polled people are against this but they still want to pursue it. WTF?!?
At this point in the process, regardless if you like what's in the bill or not, every US citizen should be opposed to the procedures that are being skipped to "pass" this bill. Here's a history lesson:
The US government is setup in three branches: Executive (President), Legislative (Congress), and Judicial (Judges). The legislative is broken down into two groups, the senate and house (called congress), and are the only groups that can actually pass a bill. The founders decided that the best way to keep the country from turning into a dictatorship and for everyone to have representation is to split up the law making process. Therefore before any bill can be signed into law by the president both chambers of congress must pass the same IDENTICAL bill, then the president can sign it into law.
Regarding the current proposed bill, the Senate has voted on and passed the bill while the House has not. What is proposed and is currently happening is that the house has decided that the they will not vote on the original senate bill and are deeming that the bill has been passed. What they will be voting on on Sunday are proposed changes to the bill. This means the president will sign the exact bill the Senate passed not the changes the house is proposing. Then the senate has to decide to vote on the changes from the house before the president can sign the changes into law (which has no guarantees of happening).
The major problem I have with this is the lack of accountability. When our constitution was created, there was a process put in place for a reason and I am against skipping the process. I realize this has been used in the past but and I am opposed to how those bills were passed as well. I doubt the majority of US citizens actually knew this was taking place. If one process is going to be skipped how long before congress starts skipping other ones and eventually leading to the president basically having sole power of what becomes law. I know it seems like a stretch but it's the little things that add up.
Art by Mindy Herman, my wife.
I teach high school. I run on economics lessons that demonstrates that the types of bill that get passed have the following characteristic. Benefits now cost are later. That benefits are to a few, people but cost are wide spread. The U.S sugar tariff is an example of this. Bill that are unlikely to pass are the reveres. High costs now benefits much later. Radioactive storage, global warming. High tax on a few, small benefits to many. The death tax affects only 0.05% of the population.
Somebody help this guy. His TV's perpetually stuck on repeats of The Colbert Report and he thinks it's Fox News. Not that I'm a fan of Fox news, or anything.
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.
It appears that the majority of /. endorses a solution that has not been subjected to a thorough code review, which they will have little personal ability to modify for their own use, be required to use in specific ways, will appropriate their system resources even if it is not running, has not been subjected to testing, without any readily available ability to rollback.
Moderation : -1 Conservative Viewpoint
The fundamental problem with the American healthcare system is its high cost. That's why so many people don't have coverage, and that's why attempting universal coverage right now is going to cost so much more than it should. Universal access is a noble goal, but far better to lower costs first. This report does an excellent job of breaking down exactly where we spend more money than the rest of the world. My platform is based around lowering costs in four areas: administrative costs, prescription drugs, malpractice insurance, and practitioner conflict of interest. Based on that report, my proposals would lower the average American's health care costs by over $1000 per year, without requiring any new federal spending or expansion of government power.
If I can figure all this out in my spare time, you know Congress has to know it too. Which means either A) I'm horribly wrong, or B) both parties define the problem differently than I do. Which raises the question, exactly what do they see as the problem?
Former US House candidate, TN-5
Actually, there are provisions in place to keep them from just charging whatever they want: they have to pay out at least 85% of revenues on actual medical care. Given that insurance companies have their own staff that they have to pay, this puts pretty strict limits on how much they can actually profit.
Well the rates for malpractice insurance can be pretty high. Neuro surgeons in NYC probably pay around $100k EACH YEAR. And so who do you think gets those costs passed along.
..........FULL STOP.
Except in the UK where people are apparently dying of thirst and/or left sitting in their own shit (due to government neglect): http://www.google.com/search?q=UK+patients+die+of+thirst
That's reported badly in the Daily Mail (which has been copied by lots of US Republican/whatever websites) and different case is reported in The TImes. Neither case is anything like as simple as dying of thirst -- both have complicated medical problems. Both say a coroner is to investigate what happened, but the result didn't seem to make the news. Don't you think that's strange?
Or dying of cancer because they are denied the right of preventative care (PAP smears).
Maybe read this (in the results of your search). You'll see she refused the treatment (the person that died), and the doctors decided screening very low risk people did more harm than good.
Or hospitalization/drugs are rationed by an organization called NICE that is now nicknamed "nasty" - http://www.google.com/search?q=UK+NHS+NICE
And? You can't provide everything unless you're willing to pay for everything. I think you'll find your health insurer does the same, except it's decisions aren't open for debate.
Anyway, what happened to the American we-can-always-do-better attitude?
Also, what happened to actually being aware of the issue, and realising that the NHS is nothing like any of the systems that have been proposed (or even advocated) in the USA, and is mostly irrelevant to your argument?
People can get free care simply by walking into the ER
Oh? Including follow-up care? Preventative care? A check-up, and an investigation by the appropriate medical specialist? There's more to public health than sticking people back together.
I think that's a good system, and certainly better than if Uncle Sam Care was run like Uncle Sam Amtrak or Uncle Sam Postal Service (both nearly-bankrupt).
Why should a public service make a profit?
Most medical malpractice suits are infact for medical errors and they don't even represent all of them.
Who said anything about malpractice suits?
You are obviously misinformed. I'm going to stop here, since you made it abundantly obvious that you have no fucking clue.
1) Virtually every Western democracy has public health care (http://en.wikipedia.org/wiki/Universal_health_care).
2) By some miracle, they manage to pay for it.
3) By and large, if you read the blogs of people actually living in those countries, they appear reasonably happy with their imperfect but functioning health systems (http://www.thehealthcareblog.com/the_health_care_blog/international/).
So, the opponents are essentially claiming that America is too "special" (i.e. lame) to do what virtually every other country can do. That may not be what they say, but that's what they imply.
Any questions?
Please do not read this sig. Thank you.
the government loses money when it treats people who are sick.
I had no idea insurance companies were different. It's a good thing! Otherwise, they'd be kicking people off insurance programs and denying payment while their former customer died from treatable diseases.
Were you involved at all in the public relations debacle around the 2008 death of 17-year-old Nataline Sarkisyan of Northridge, Calif. who passed away after being denied a liver transplant by Cigna?
Yes, I was. At that time, I was the chief spokesperson for the company. I was the person who was responsible for putting out the company’s statements and answering questions from reporters when they called about it.
Her request for a liver transplant was denied, and then Cigna reversed itself under pressure, but she ended up dying because the transplant came too late.
Yes, that’s right. The transplant had been requested by her doctors weeks before her death. Her doctors felt that it was her last resort and had recommended it. Cigna felt that the transplant in her case would have been experimental and on those grounds chose to deny coverage for it. The family sought the assistance of the California Nurses Association and reached out to the media and it became a very, very highly publicized case. And I can’t tell you how many calls I got from all over the world regarding that. Then, in the midst of all that publicity, Cigna decided to reverse itself and decided to cover the procedure. But you’re right. She died just about two hours after the family was told that Cigna changed its mind.
At the time, some people argued that it was just an isolated incident. But now there is data showing that Cigna denied 33 percent of claims and PacificCare denied up to 40 percent. Does this data cause you to speak about that experience in a new way?
Well it does. One of the talking points that I used when reporters called was that 90 percent of requests for a transplant are approved by Cigna. I haven’t seen data to know whether that is still accurate...
Looking back, do you think Cigna was in the right?
I can’t comment on that. I was not among the group that reviewed the claim when it first came in. What I do know is that I think the California Nurses Association was right in pointing out that this is not an isolated case. People need to realize that there is a corporate executive who often stands between a patient and his or her doctor. That’s the reality. And I think the insurance industry is now fear-mongering during this debate on health care reform, saying that a government bureaucrat could stand between someone and his or her doctor. But the current situation is just as bad, if not worse, because you have people doing that now who are denying care to meet Wall Street’s expectations.
Wendell Potter is former head of corporate communications for Cigna Corporation, where he worked for 15 years. He is now a fellow at the Center for Media and Democracy.
http://news.newamericamedia.org/news/view_article.html?article_id=33655d70ff9cd7509f16bfd2bfbafa9f
Simply not true. The Defense Department, for example, is probably the most enormous government agency in the world, and by all accounts it does a fine job in providing defense services. And more to the point: which provider of health services gets the highest marks for patient outcomes and patient satisfaction? That would be the VA. Which insurer has the lowest costs and highest customer satisfaction? That would be Medicare.
The meme of the federal goverment being ineffective is popular, but it has no basis in reality.
Its worse, its not that they fine you, THEY CAN THROW YOU INTO JAIL FOR FIVE YEARS...
Not a bad deal really.
Then you'll get free room, board AND healthcare.
Beauty is in the eye of the beerholder.
Of course there is the requisite pork. (has any bill ever been past since anyone was reading this has been alive. that didn't include some pork?) But there are also provisions to expand Medicaid to more people(I think this is in there, but I am not absolutely sure). It also makes insurance companies allow parents to keep their children on their policy until they are 26. It prevents insurance companies from discriminating against people with pre-existing conditions (meaning no higher rates or refusing coverage). It will set up exchanges for those who are self employed or don't get insurance from their job. Insurance companies will not be able to cancel insurance because someone gets sick. It will cap total out of pocket expenses for consumers. There will be subsidies for those making up to 400% of poverty level to buy insurance. It will mandate that everyone, the exception of the most poor, get insurance or face a fine. It would require employers with more then 50 workers, who don't offer medical insurance, to pay $2000/employee, if any of the workers qualify for the federal health care subsidy. It would close the "doenut hole" in Medicare by 2020. Those are the highlights of what the bill will do.
If you are wondering if it will really address the rising cost of health care, I doubt it. The problem with health care in this country is that doctors are paid per procedure. So some, maybe even most, in contravention of the Hippocratic Oath, act in their own best interest preform procedures that aren't necessary. They have little to no motivation to work to make the patient healthier.
Its a first step. I am hoping they don't stop here. It will at the very least, get more people covered by health insurance.
The States have some great health care as long as you make enough and do not get sick enough to question it. All Hail Faux News! Every single person who votes should disclose how much of their money comes from health insurance companies. That is directly and indirectly.
In fact, per the bill, insurers have to pay out 85% of their revenues in actual medical care, which means it's more or less impossible for them to just charge whatever they want. Yes, a public option would be better, and single-payer would be better still... but this bill is still a huge improvement on the status quo.
I haven't read the latest bill or watched the news about it recently, but my personal feelings on it are mixed.
I've never tried green eggs and ham, but I do not like them, Sam-I-Am.
If there is a centralized healthcare system, then it will be their job to regulate the substances we can take into our bodies as part of the health care coverage they provide.
Well, then I suppose it's a very good thing that "a centralized healthcare system" was never under debate. The current deliberations started with a government-administered insurance plan that would compete with the private industry in order to exert pressure through competition. And even that's been off-the-table for months now.
Other people say "This works in my country" but have you seen our population or our budget? We're broke and to offer coverage to millions of people is just ridiculous.
American exceptionalism rears its head again. Our economic situation isn't great, but we're by no means the worst off in the world, nor do we labor under the greatest deficit. That other nations can manage it doesn't necessarily mean that we can manage it, but it suggests that a close evaluation may be in order.
Besides which, the cost question is a bit misleading. Our current health care industry is eating a huge chunk of our economy, and growing larger all of the time. Part of the point of reform is to stem that growth in order to save the country money: the long-term savings offset the upfront costs. Or so the argument goes, and so the CBO has found each time a new revision of the bill gets punted off to them.
Sean Daugherty "I have walked in Eternity -- and Eternity weeps."
I don't know much about fox news (not being a resident in the US), so I can't comment much about that but what I don't understand it is people are so against this reform. Yes it is a 'socialist' policy but the lives of so many people will be helped by this policy. I know a number of people who have had there lives saved or dramatically improved due to the intervention of the NHS here in the UK. yes the NHS has problems, but rarely is there anything that doesnt. The bill isn't communism, you don't have to have government run healthcare, go private if it bothers you. Granting cheap/free healthcare to those who can't afford insurance isn't a bad thing it would help the US become a better nation I've used the NHS many a time and never had a problem, In fact I've only used my medical isurance for minor little problems that are more annoying than serious. Don't slam government run healthcare. It's a good thing
Just declare a war on high healthcare costs, wrap the american flag around it & yourself and commit a $700b/yr budget to bomb the problem to the stone age.
Just run healthcare like the military! Big bloated budgets, heavy fist shaking, and pour in a whole lot of flag wrapped mccarthyism and BINGO!
G.W. Bush advocated no nation building and humble foreign policy when campaigning for pres in 2000, and previous stated formula worked wonders to turn the republicans around 180 degrees.
Thank goodness it worked in catching Binny and boys!
Don't listen to this guy, it's just random spew of talking points emailed to him from the DNC.
The biggest push that Marxism or socialism in general has is the 'right to health care'. So when people are concerned about government run health care and socialism their fears are based in reality.
The military is not a business. I don't know how that is even an argument. Our constitution requires the government to have a military to protect our citizens.
Ignoring the George Bush comments, that's just name that's invoked to gain acceptance of other like minded liberals/socialists.
I agree with the change to metric, although the reason we don't switch over is the huge cost associated with such a large country.
"In God We Trust, All Others Pay Cash"
Canada's health care bill is over $5,000 per man, woman, or child.
Anything else you'd like to know?
I'm a Programmer. That's one level above Software Engineer and one level below Engineer.
You've been here for about 10 years - are you seriously just now realizing that there are some US-centric articles on here?
The case of Texas is instructive - they strictly limited damage payouts for medical malpractice cases... and their medical malpractice insurance premiums continued to escalate at exactly the same rate as the rest of the country. Nor was there any particular change in overall health-care cost escalation. So I think we can safely ignore this particular line of argument.
Links? Why bother, I'm sure there aren't any. I've read over and over again exactly the opposite of what you are claiming. I could dig up links for you but I'm too busy making money and paying ridiculously taxes to pay for the health care for you and all the other socialist bums on this site.
Bullshit!! You're posting to Slashdot. You're not doing anything productive.
Aah, change is good. -- Rafiki
Yeah, but it ain't easy. -- Simba
This bill, of course, is about health insurance, not providing actual care. And it's really hard to see how anyone could foul up health insurance more than the private companies currently raping us in this business.
The U.S. Postal Service is really pretty good at what they do. For starters, you can mail a letter anywhere in the country for $0.44 and be pretty sure it will get there within a week. Stay within the same general postal zone (first three digits), and the letter will probably get there overnight, or certainly within two days. I don't believe UPS or Fedex could do first class mail service any better, or for any less.
Secondly, you don't have to worry about your letter being lost in the mail, as it's a rare occurrence. The U.S. Treasury did a cost analysis for the loss of collectible coins sent through first class mail and found that the cost of the few losses that did occur was well below the cost of insuring or tracking the items. (Source: a friend who retired from Treasury 2-3 years ago.) I can only recall one letter I have sent in the last ten years that did not arrive at its destination. People I know from other countries tell me this is not the case where they used to live.
Thirdly, USPS is cheaper than the private companies. You can now get online tracking and delivery information for $2.80 beyond the basic postage. With the private companies, you get this as well, but you can't opt out of it to save money.
The only problems I have with USPS at the moment are that I can't print postage using Linux the way I can with UPS, and because of the Unabomber, I can't just drop a package in the mail if it's over 12 ounces.
"Who controls the past controls the future. Who controls the present controls the past." -- George Orwell
1. Buy insurance across state lines.
...canada sells the same meds for much less and they don't have such a stringent approval process?
The current plans include a national marketplace for selling insurance across state lines, so you're getting that. The Republicans reject this because they simply want the system opened and free, but many liberals are leery of this idea after seeing what good it did to the credit card industry. Simply opening everything up would allow health care companies to move to the state that affords them the least possible regulation and consumer protection and sell to the country from there.
2. Limit lawsuit payouts.
A handful of states have already done this, to the effect of not bringing consumer prices down by any appreciable amount. The bill as it was being worked on a few months ago included pilot programs to reduce the number of lawsuits as a whole by providing for more doctor openness and mediation to prevent the cases from going to court in the first place.
3. Reduce the FDA requirements.
I'd imagine that Canada also has more stringent price controls, and the government won't pay for drugs for which the price outweighs the effectiveness. Conservatives have consistently opposed negotiating for prices on drugs, however.
4. Promote Savings Health Accounts.
We already give a tax deduction on medical fees, and if you already have health insurance, then it's very likely that you already have access to an HSA for smaller amount. There's nothing to stop you from using your HSA and shopping around at doctors right now.
5. This topic wasn't designed to discuss immigration, but guess what, that's a major cost in health care.
Citation needed. Many illegals avoid health care for fear that being under anyone's control for a while would give away their illegal status, as they do with other social services. I doubt you're going to see a lot of illegal immigrants will access to Medicare, unless they "prove" that they're natural citizens by providing a stolen social security number or the like, in which case your fixes won't make much difference anyway. I can only imagine that the place illegals might be adding more cost to the system is in emergency room care, and I'm not sure how many doctors will jive with your idea to stop and demand identification from a severely injured person.
Exercise: Call 3 local providers and tell them that you have some common malady and tell them that you have Blue Cross insurance, ask them what it will cost you, and what they will bill BC. The next day, call them all back, same malady and tell them you're paying out of pocket. If day 2 isn't a third of day 1 I will eat my shoe.
That actually happens quite a bit, considering that BCBS is a big enough provider that they can negotiate and demand discounts for services. From the anecdotes I've heard, smaller providers, general practitioners and the like, are more likely to give you the discount for paying cash, while larger providers, hospital work, are more likely to provide a discount to the healthcare provider.
Libertarians somehow believe that private businesses should be stronger than governments but weaker than individuals.
Sign me up baby! I want one of those snazzy brown shirts!!
Would that be from UPS, or SS?
"Who controls the past controls the future. Who controls the present controls the past." -- George Orwell
to see the hidden costs
there are many costs that you do not outline that are hidden, but cost you MORE than all of the numbers you have outlined above
there are two ways to pay the healthcare bill:
1. in your face, upfront, and immediate
2. in hidden ways that hurt you more over time than if you had just bitten the bullet and paid the bill up front
the difference between the two approaches is also largely the difference between wisdom and ignorance. teabagger and libertarian philosophy is simply based on the ignorance of the hidden costs. that's why its so appealing to the unintelligent rabble
oh you will pay, one way or another, for healthcare, mark my words
universal healthcare just happens to be the cheapest way to do it. but its also the most overt. that's the only reason you reject it, because its in your face, rather than in the subtle and hidden costs that are much larger
intellectual property law is philosophically incoherent. it is your moral duty to ignore it or sabotage it
Right, because when I'm suffering chest pain, or my wife goes into premature labor, or I fall off a ladder and break my leg, obviously I'm going to have plenty of time to "shop around for the best deal". Or when I get diagnosed with colon cancer, I'm certainly going to be qualified to decide which of the various doctors along the price/quality scale are right for my needs.
This argument is just ridiculous. There are lots of things for which the market excels at providing the best deal for the customer - making cars, say. But for things like basic services - defense, fire protection, and yes, medical care - the incentives behind market-based provision of the service are so screwed up that it's virtually guaranteed you'll get hosed... like we all are now.
When the government has to pay for your health, they have a rational for controlling your life choices. "I'm sorry sir, the government forbids me to put bacon on your burger. Your cholesterol is too high. May I suggest the garden burger? If you really want the beef burger, you'll have to pay the fatty fat fatso tax."
For all its flaws the U.S. is still superior to government-run hospitals. People can get free care simply by walking into the ER, with the cost borne by the megarich corporations (who can easily afford it). I think that's a good system, and certainly better than if Uncle Sam Care was run like Uncle Sam Amtrak or Uncle Sam Postal Service (both nearly-bankrupt).
Actually, according to every study that I've ever head of, the U.S. (like http://assets.opencrs.com/rpts/RL34175_20070917.pdf for example) has middling to poor outcomes compared to other developed nations and pays more than any other country in the world for average, at best, results.
Canada and the U.K. actually get better results than the U.S. for less money. There are certainly horror stories that can be told about every health care system, like the ones linked above. But the pural of anecdotes is not data. When you look at the whole system the most (if not all) of world's government run health care systems are more effective and cheaper than the U.S. system.
The best systems both on results and cost tend to be mixed public/private systems, but for some reason Americans seem to be afraid of such systems.
Fanatically anti-fanatical
About 3 or 4 hectomegaseconds ago, we started gradually phasing that in, starting with NASA. Probe crashed. Stupid government. We need private industry metricism!!
As copyright owner of this comment, I authorize everyone to defeat any technological measure which limits access to it.
Most Americans think some reform or change is needed in Health Care.
Most americans also Don't think government managed care is the answer either (and before you say there is no single payer option hold that thought) So many progressives are saying this is a good first step. Even Kuccinic (sp?) who just flip flopped has said as much, and noone was a more vocal supporter of a single payer system.
Here are my gripes with the legislation:
1. Slashing Medicare will adversely affect seniors, those least in position to make up additional income to pay for insurance gaps in Medicare
2. Mandates. Since when has the Federal Government Ever mandated anything like this in all of History? The Mandate is unconstitutional at best, at worst it is a Federal Power grab to weasel in and turn the US into a Big Brother Society where sugary drinks will be gone (sorry coke and pepsi), fun foods will be a thing of the past (Snickers, Hershey, Doritos, etc) and you will eventually see a very plain supply of food offered at higher prices than today and probably breadlines like they had in the USSR.
3. Puts restrictions and penalties on small businesses who cannot afford to fully fund insurance for their poorest employees. (Yes its fine, the Businesses who already struggle thus killing many small businesses.)
4. Does absolutely zero to ensure increased supply of providers which right now is an even bigger problem that cost.
5. Will force more americans into a High Risk Pool that will cost as much as 20% or more than normal premiums, and when that cost overruns those premiums, you can bet that one of two things will happen. Regular premiums will rise, States will have to make up short fall with taxes on policy owners (another way of increasing premiums) or some other way to tax or soak either Sin Taxes, Sales Taxes, Income Taxes, or some other means of basically hitting those that probably can't afford the offset in higher premium on their own but now will get taxed for it anyways.
6. It is the least transparent bill to come out of congress in a long time. It's negotiation was not conducted in front of cameras of CSPAN as Obama promised, and the moving of assumptions in a rather unchanged bill to get better CBO numbers is like trying to have your grade score based on number of problems completed not the actual number of problems on the test.
7. The American people don't want it. Polls all across the country show that only about 30% of the population are actually in favor of this legislation, and what's worse a majority oppose this plan, either for reasons of fiscal trouble for the government, its policies, or just in general not liking its provisions.
So there are probably some reasons I didn't list, but this bill will do very little to cut costs, it will result in increased costs, will stifle insurance competition as more companies just leave the sector entirely, oh and more providers will opt out. How great is that?
> Is really there someone who DONT want to have a health insurance?
Yes. I don't have health insurance and I don't want it. It's a simple matter of economics; insurance costs too much for no reason. If I were to buy a plan, it would cost me ~$6400/year (national average, probably higher here where I live). A doctor costs me about ~$100 per visit. ~$150 to see a specialist (I went to an ENT specialist to get my throat examined with a fiber optic probe). $300 for a course of brand name antibiotics; about $30 if I were to buy it from an online pharmacy in India. That one year with my throat problem I had paid maybe $1000 for the above plus a few tests. The next year I got a chest X-ray for $250. And that was the entirety of my medical expenditures in the last ten years. If I had insurance, I would have still have had to pay a smaller fee for each of the above, maybe 15%. So that's $1250 without insurance versus $64190 (that's SIXTY FOUR THOUSAND DOLLARS) with insurance.
Ok, you say, but maybe something really bad were to happen to me? I answer, like what? Of the really expensive treatments there is organ failure, heart attacks, cancer, and spinal injuries. Having an organ failure or a spinal injury is a very rare event, and I'm quite willing to put them in the same category of "death from a falling meteor". Yes, I could die, and so could you, and so shall we all in the end. If I can't afford it, I won't pay for it and I'll die. Tough cookies. Pretty much the same with cancer. First, I really don't have to worry about it until I hit 50. Second, barring breast and testicular cancer, the survival rate is pretty much zero anyway. Yes, you can extend your life for another five or ten years with chemo or radiotherapy, but it always comes back and kills you, except that you'll be a lot more miserable if you let the hospital "fight for your life" to the bitter end. Much better to just let nature take its course, take painkillers or whatever helps. I would much prefer a quicker death to five years of misery. And finally, as far as heart disease is concerned, the treatment is to lead a healthier lifestyle (quit smoking, maintain a normal weight, don't eat a diet consisting exclusively of Cheetos, etc). Surgical interventions usually do more harm than good. Oh, and when they happen, they are expensive, but not THAT expensive. You might pay something like $30000 to get a stent installed. Compare that with the $64000 for ten years of insurance. Or, considering that most people have their heart attacks after the late 40's, that's over $128000 for insurance.
Overall, people need to stop being so friggin' scared of dying. You'll all die anyway, and the less medical intervention you have, the less you will suffer.
Okay, the system is broken. There are things that should be done. But what is on the verge of passing now is the entirely wrong thing on moral, constitutional, and economic grounds.
Our system is broken because the consumer (patient) isn't the purchaser (the employer) of the insurance. The provider of benefits (the doctor) is paid by a party (insurance company) hired by someone other than the consumer (the patient). If the consumer (patient) is unhappy it does not good to talk to the provider of service (the doctor), he calls the payer (insurance company) who knows that the consumer (the patient) isn't the purchaser (the employer) and therefore isn't all that likely to be cooperative with the service provider (the doctor) or the consumer (the patient). The consumer (patient) can go the the purchaser (HR at his company) who didn't receive any service and has no direct relationship with the provider (the doctor), but wants to keep the cost of the payer (insurance company) down. No wonder its messed up. The private system is pretty much a more efficient version of a government one!
So we replace that with a system where we pay taxes for four years before most of the benefits kick in. Then the thing balances out for the next six. But what happens when that four-years of pay-without-service money isn't there to cover the costs? Tighter regulation and 'prioritizing' of patients (ie rationing). We've yet to see the governments health-care systems: Medicare and Medicaid come in anywhere near on budget while providers are running away from them. VA hospitals are great as long as you don't get too sick, but they don't have the resources to provide consistent high quality healthcare.
This is really about co-opting a big chunk of nearly free-market money to cover the failure of the other programs. Medicare is broke, Medicaid is busting the budget, and Social Security is at cross-over - we'll be paying more money out to recipients than we've taken in AND there's no more money for the government to take from it to fund the budget, AND we have to start paying Social Security "Trust Fund" back. Think about how many times Pelosi will make odd references to medicare and medicaid. Less so Obama and Reid, but they still do it. It's because they know the only way to save those programs is to get more resources redirected from the healthcare system the rest of us use.
Get employers out of providing healthcare (let them offer a reimbursement or stipend to employees as part of the incentive package). Now we all go out hunting for health insurance like we do for our house, car, and death. I'll bet the health insurance companies get much more client friendly when its the client who can take their money elsewhere and not some drone in HR. Yeah, we'll need to tweak pre-existing conditions to deal with portability and the transition to a real independent system.
We'll need to fix tort. The lawyers won't like it, but the system is too litigious. We have to allow for doctors to not be perfect, and they can quit trying to act like they are. I'd rather have a doctor, especially in an emergency, more worried about how to save my life than cover his butt from a lawsuit later.
And that's just it: where's the bill? People have been bitching about this for decades. The people bitching about it, must not be voting in congressional elections, because Republicans and Democrats in Congress sure aren't serious about it. If they are, then I repeat: where's the bill?
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Since it answers all these objections.
1. An overwhelming number of Americans will not see any changes to their health care plans under this bill. They'll just get protection from fun industry practices like "recission" and lifetime caps.
2. Which is why this bill changes the way government taxes health care plans - so-called "cadillac" plans will now be subject to excise taxes.
3. Your point is incoherent: you are simultaneously claiming that Medicare spends too much, and that it doesn't spend enough. In any case, this bill saves TRILLIONS of dollars over 20 years.
4. As pointed out below, Switzerland is one of the least cost effective systems in the world - only ours is worse (and ours is a LOT worse).
5. By almost any measure, Americans pay more and have worse outcomes than anywhere else in the civilized world. We're way down the list in life expectancy. We're way down the list in infant mortality. We're way down the list in outcomes of a whole slew of conditions.
Our current system sucks hard. This bill is not perfect, but makes it better.
Look at all the +5/-1 moderations! Full of Heated, irrational and emotional responses! Trolling and counter trolling! Massive amounts of comments, Full of sound and fury signifying nothing.
And best of all it has nothing essential to do with News for Nerds, its purely political, and US oriented. SlashKos is now in session, Bravo!
Rob Malda, you astound and amaze! You finally beat out John Katz, Goatse, NataliePortman+HotGrits, a beowulf cluster of Soviet Russias, and the GNAA...
Kudos to Taco -- This article is the all-time biggest meta-troll ever on SlashDot
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I also pay cash and usually get a 50% discount. The amount I pay is about the same as my share would have been if I still had insurance. If I had done that since I started working my 401K would be much larger today.
Who do you get your catastrophic insurance from?
There are too many players between you and the person that provides your medical services. That's where the big cost is.
I don't know why the democrats have pursued the avenue that they have. It makes the least amount of sense. Its is basically an adaptation of Massachusetts' mandated program. "Have health care or else" If you do not have health care then the IRS can withhold your tax refund. I am a libertarian, fiscally conservative but socially progressive. The USA should be able to use its wealth provide healthcare and make this an even better country. It is inevitable that the more prosperous a country the better it should treat its inhabitants. health care is a human issue (not a right but a privilege) but that should not stop us fro having a common-sense plan.
I have constructed a simple plan that would give everyone in the nation health care at a level that will appease liberals while not irritating conservatives. It is a simple 3 part plan, with Step 4 being profit.
emergency hospital visits and life-necessary prescription medications.
Using that system has several advantages:
Slashdot's rate-of-post filter: Preventing you from posting too many great ideas at once.
$200 per year? You're clearly talking about a Ph.D. doctor, not an M.D. doctor, right? One set of immunizations for a child (usually young children get these several times a year) can cost over $600 just for the shots. A single night in the hospital can easily top $2000. Heck, even a couple of stitches in the emergency room easily breaks $500.
So you're saying that only two countries in Europe have proper universal health care?
It seems your zipper is wide open; it's showing your stupid.
- These characters were randomly selected.
I've seen a lot of posts wanting capitalist reform (some would say republican ideas). FYI, alot of these things are in the bill. http://www.whitehouse.gov/health-care-meeting/republican-ideas
Yes, and we also spend more per capita than any other country in the world... and we don't even freakin' cover everyone! And we are pretty far down the list in effectiveness too - far from being number one, we're in the low teens in life expectancy, infant mortality, and a host of other measures. The system we have is a total mess and needs to be fixed NOW.
I used your search and what I found was some different numbers depending on which of the links I clicked on, and no links back to original source for this information. Where's it is credited, it's attributed to the census. On some of the pages they claim it was 7-8 million on others they claimed 10-14 million who had no insurance for the entire year and would have paid for it if they could.
Of course, this doesn't address the other large group of people who are sometimes referred to as "underinsured", and no I'm not talking about the so-called "Invicibles" who don't want to "waste money" on health insurance for themselves. I'm talking about a large and rarely discussed group of Americans who have health insurance but can't afford to actually use it because the deductibles and co-pays are too high and they risk having their rates raised and their insurance cancelled if they do.
Fanatically anti-fanatical
I fail to see how narrowing some choice among health insurers (or the choice of not having insurance and paying cash) compares remotely to single-payer (no choice) government snail-mail health care.
Your newsletter: I wish to subscribe to it.
This is possibly the best Health Insurance Reform idea I've seen.
Too bad what we're going to get instead is a giant giveaway to the Insurance companies that the democrats will pat themselves on the back for getting sumthin done, and the right will get pat on the back by their insurance company funders.
Win-Win-Lose (left, right, the people in that order)
The Digital Sorceress
Let me count the ways:
Constitutionality:
The constitution says people cannot be coerced into signing a contract. By anyone. If you don't like it amend the constitution, but you cannot just make up your own laws. That's called anarchy. So right there the bill is dead. But let me go on.
Common sense
The kings of inefficiency. The same people who spent so much of your social security and medicare money on things besides social security and medicare, to the point that the two programs have unfunded liabilities of over $100 trillion, are now going to, according to the bill, take 500B from medicare to pay for the new program and supposedly expand the roles of people on medicare and the new plan. Do some simple math! If you have a system that's already out of money, and you take more money from it to start a similar system, more than triple the number of people receiving benefits, it's going to cost more not less! You have to be insane if you think adding people to the government's dole will somehow lower costs as progressives claim. Keep in mind that in 1965 lawmakers predicted it would only cost 9$ billion by 1990, unfortuanly the real cost was $67 billion. But don't worry they were only off by A FACTTOR OF 7. I'm sure they are better and more trustworthy in making cost estimates today. Congress would never deceive us!
This bill causes lack of care (not coverage)
Sure the government will cover you for all preexisting conditions, there will just be no faciliteis or doctors to treat you! OH BUT YOU'RE COVERED!!! Tell it to the people in the UK or Canada who are waiting 6 months for a CT scan, where here in the U.S. it's unusual to wait for more than a few days. The New England Journal of Medicine estimates that a full 1/3 of doctors will "QUIT PRACTICING MEDICINE" if the bill passes, further eroding our resources. So ya, you're covered, but you're going to have to wait a few years for that liver transplant now. People other countries will no longer have a "capitalist health care system" to save them, unfortunately nether will we. We will have a government panel deciding who is worth said liver transplant and deciding who gets to live and die, instead of your doctor or a panel of your doctors. A healthy 19 yr/old kid, who hasn't put a dime into the system will be placed higher on the list than say a 60 yr/old man who has paid into the system his whole life. In essence the 60 yr/old man worked his whole life paying into a system that will deem him unworthy and spend his money on someone whom he has never met while he suffers and dies while younger "more economically viable" people will get treatment first. In the existing system, the same 60 yr/old man would be able to do whatever it takes for him to get his liver (insurance,debt,sell car/house etc.). While dems try and portray private insurers as evil for turning down procedures, drugs etc. keep in mind that the number 1 denier of care per capita is medicare! So there's another false argument made to try and pass this bill.
How much is too much?
People in this country continue to live longer and longer. This is attributable not to better diets or healthier living, but as a direct result of having invested such large sums of money into our health care system. I've heard 17% from democrats, decrying the amount. Dems say that our private insurance is increasing at too fast a rate (3%/yr) but they want to change us to a system that is similar to the unfunded medicare, but medicare is increasing at a rate much faste
I'm tired of hearing the opinions of Fox & friends as well as MSNBC. The stations call themselves news stations, but really their nothing but pundits. If either one really wanted to be a REAL new channel, they would report on both sides of the debate and LEAVE IT UP TO THE VIEWERS to form THEIR OWN OPINION!
- Mark.
The election where this was in question was LAST YEAR. It was, you know, the biggest topic of the entire election season? People sent THIS CONGRESS to DC to do HCR. It's time for them to do it.
There is still a vote. The "self-executing rule" combines what would have been the vote for the Senate bill with a vote for amendments to that bill. When the Republican party is the majority, they use this rule too. And more often than the Democrats do.
Could the KISS principle be applied to the medical sector? ("Keep It Simple, Stupid"). For example, how about a simple system without insurance in which everyone pays the doctor or hospital a price that is proportional to their income? would that work? would it be fair? would it create problems?
Number one, it's a complex topic and the law is not exactly going to fit on the back of a goddamn cereal box. Number two... have you ever looked at an actual bill? The use enormous fonts and huge amounts of white space. A resolution honoring National Dogcatcher Recognition Day would fill up a hundred pages.
We the People of the United States, in Order to form a more perfect Union, establish Justice, insure domestic Tranquility, provide for the common defence, promote the general Welfare, and secure the Blessings of Liberty to ourselves and our Posterity, do ordain and establish this Constitution for the United States of America.
Many people believe that the federal goverment's entire set of authorities is enumerated in the Constitution, and that it has no legal basis for making federal law in this area
There's a clause about general welfare and a clause about common defense. We didn't have to get constitutional amendments for the Air Force, and the CIA is certainly unconstitutional. I hear no complaints on constitutional grounds on either issue. We know some founders believed in publicly funded education. I don't think publicly funded healthcare is much different.
Why can't this be done by the states, individually, as each state sees fit? Having it be a federal law is, in some senses, anti-democratic, because there are more localities in which it lacks the consent of the governed.
Because states couldn't survive the inundation of health care costs from citizens of states that decided to keep private care. Federal funding spreads the cost over the whole country, from areas like New York and California, which are economically vibrant and already pay for roads and other infrastructure in states that couldn't possibly afford them, like Louisiana.
Having it be a federal law is, in some senses, anti-democratic, because there are more localities in which it lacks the consent of the governed
I'd buy this argument if the conservatives paid it more than lip service.
Is it automatically the case that the Federal government is the best agent to fix this situation? They've fsck'ed up a lot of other areas of governance in the past.
Well, the evidence from every other western nation in existence points to yes. Of course, those are scary communist stalinist nazi fascist states, like Belgium, Denmark, and Spain.
Why should people who earned their wealth through hard work, careful investment, and self-sacrifice have to pay for lazy people?
The American aristocracy is no different from the old French aristocracy. Wealth inequality is way up, which means that the middle class mostly failed at the illusion of the American dream. They work twice as hard and make the same amount of money as they did in 1980. They have spent their savings. They can afford health care, or safe housing, or fresh fruits and vegetables, or college tuition for their kids, but not all of these things. 45% of American households make less than $40,000 a year. Subtract taxes, two vehicles for two working parents, gas, and rent, and you're not left with enough to have what your parents did.
I'm not saying that all poor persons are lazy; I'm referring to the fraction of poor persons who truly don't deserve to have other people pay for their bills
We are all on welfare. No American would be willing to pay at the pump for the true price of gas. And the fact is, providing for basic needs of food and health care is much cheaper than criminalizing poor behavior and then paying for 1.5 million of your countrymen to rot in jails for the rest of their lives. Most of these people are mentally unstable, and should be in state-run halfway houses or hospitals where their behavior can be monitored and hopefully improved through counseling, instead of mixing them with violent criminals where they are raped and beaten, and then thrown out into the streets again so the cycle can repeat itself.
Example: should I have to pay for treating emphasema in a smoker?
You could make tobacco products illegal. They kill millions of people worldwide ever year. But I guess that clashe
I have wondered in times past what would drive me to drop out. I think this is it. I shall not be forced under pain of fine and imprisonment to purchase another's private product. No. Enough.
Worse still than this bill's moral absurdity is the precedent it sets. There are legal scholars now who promote the idea of mandatory tort liability insurance for everone ([1]). No doubt they would be pleased to see this camel's nose lifting the tent's edge.
Mandatory medical insurance or go to prison? The irony is too rich.
[1] http://papers.ssrn.com/sol3/papers.cfm?abstract_id=844210
Three points:
1. The healthcare bill will likely be the bill that brings the country to financial ruin. We can't afford to maintain what we have now, let alone pay for a huge, new program. Even if you think this is otherwise a good program, is it fair to destroy your children's future over it?
2. Historically, the government has a bad track record running public services. Since there is no competition, there is no incentive to excel. While some on the low income side who couldn't afford it will receive healthcare, the overall quality of healthcare will drop. There will also be little incentive for major medical and pharmaceutical companies to innovate.
3. On the other side of things, just saying "no" to this bill is not enough. America needs healthcare reform, just not as presented in this bill. It's shameful for those opposing the bill not to provide alternatives.
You could argue that those people who feel "entitled" to earn money to another persons detriment are the supposed "Entitlement Generation".
Every damn time I hear someone slander a concept such as universal health care as an "Entitlement", I want grab a bat and hit some balls...
We are, after all, still all human here right?
Opinion:=TMyOpinion.Create(Me);
The health care problem in America is not what is being said in most discussions. There are actually 6 problems, 1 big, 2 little, 2 unsolveable, 1 crazy, and 1 hidden.
The big problem is that the government spends at least about 1 in 2 health care dollars, and the prices are going up..so the government is going to have a money problem around health care real soon here. If we don't cap the $ spent by the government on health care, we're all up a creek.
The first little problem is that in healthcare, there are no real incentives to cut costs. The consumer, the provider, the payer, and the decider are all different people, which makes things bad. In addition, costs are hidden further by the fact that most Americans with insurance have the insurance paid by their employer (not seeing the full cost of the insurance), insurance regulations which don't allow (real) competition on which services are covered, and huge tax advantages for employer-provided insurance.
The second little problem is that in America, 50% of healthcare spending occurs in the last 6 months of a person's life. A big portion of our cost vs. other countries costs is sitting right here.
Unsolveable problem #1 is that the supply of medical care is massively restricted in the US. In some other countries, there are Bachelors' of Medicine who can do simple stuff like give shots, draw blood for tests, etc. There are not huge scary FDA "effectiveness trials" which insanely increase the price of drugs (well, and they piggyback off the drugs developed by relying on US profits).
Unsolveable problem #2 is that new medical procedures, which sometimes work better, are often more expensive. Basically, all older care is dropping in price, just like all other products...but there's so much new stuff....
The crazy problem is that no one actually knows what works/is cost effective. It's well known in medicine that about 50% of all medical spending has no discernable impact at all.
The hidden problem is that it remains important to get new procedures and drugs, so as to continue (despite not knowing which ones work, some do) getting healthier.
Data comparison:
If you require insurers to cover everyone who applies, but don't force everyone to get coverage... you get the so-called death spiral. Healthy people don't get insurance until they get sick... then apply and get covered. Premiums have to go up as a result. More people decided not to get covered until they get sick. Premiums go up more. Before long, insurers go out of business because no one can afford their product.
To be successful, the plan has to include all three elements: 1) no rejections for pre-existing conditions, 2) an insurance mandate, and 3) subsidies for those who can't afford the mandate. Of course, single payer would be simpler and better, but it's not politically possible right now.
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
The public has a compelling interest to unify and use force to prevent private individuals from arresting suspected criminals. Yet the job still needs to be done, so we have no choice but to form government and stick it with that responsibility.
If you're out there, working on your own with no oversight or due process, to capture and punish suspected serial killers, you actually might (yourself) be a serial killer. I have to stop you; I might even be your next victim. Maybe that's "not freedom" either, but it's a justified limitation.
The public has no compelling interest to unify and use force to prevent people from obtaining health care on their own.
If you're out there, working on your own with no oversight or due process, obtaining or failing to obtain health care, you pose no risk no any innocent third parties. I'm not worried about you. Using government to make you do it how "we" want you to, is "not freedom" but also not justified.
I think there are some good reasons for "reform." There are anecdotes out there about just plain fraud: someone pays for insurance and then their claims are denied. Years of tech advances happen and yet costs are going up instead of down (that is utterly damning proof that the current system is somehow malfunctioning spectacularly). Government is backing and creating monopolies (whether we're talking about the AMA, or medicine patents) without regard for getting the public a quid for its quo. And so on.
But supporting public-funded health care finance because it's "like" public-funded law enforcement, is just absurd. The two are nothing alike at all, when you look at it in terms of the people's relationship with government. That isn't a good reason to support the current efforts.
As copyright owner of this comment, I authorize everyone to defeat any technological measure which limits access to it.
America does not have a super-majority cultural/ethnic enclave as does most of Europe or the rest of the world. Yes, us whiteys are the majority, but we are not the supermajority we once were. We are also founded on the notion that a man (or woman) is responsible for his/her own success - and while we're willing to give a hand out to help someone up, we will not prop someone up for a lifetime
There are two big problems with America adopting a single-payer system: 1) It gives "the other" equal access to resources, and 2) it encourages the government to take a greater interest in our personal affairs. The first point has to do with the lack of a ethnic super-majority in the US. While we've made great strides against racism, we still have a problem with granting "free" health care to those who are "not like us". If we did magically go to a single payer system, our news channels would be filled with stories of welfare queens and illegal immigrants hogging up all our health care - which would do *wonders* for our race relations. We don't want to give free stuff away to those not like us if it means we ourselves don't get it. The second point is that Americans intrinsically have a distrust of intrusive government. All-in-all, our government is one of the least-intrusive systems in the world, when compared to Europe and Asia. We expect that our fellow citizen is responsible for him/herself and his/her success/failure. We don't like the idea of a welfare state or a dole because we were a frontier nation and part of our culture is based on the idea that we do things ourselves.
For the US, it's too much to expect a single payer system, absent a massive catastrophe that forces us to it. The best we can do is manipulate our private health insurance sector to provide good medical coverage at a fair cost - and that is what this reform package is going to start doing. It won't do it all... we'll actually need a Republican President with a Democratic congress to make the changes that really need to be made (or vice versa - the US has only really ever done well when one party controls the Presidency and the other Congress - they have to work together then to get anything done).
Here's to hot beer, cold women, and Glaswegian kisses for all.
Those under 65 have had their right to life revoked to create a false market so health insurance companies can siphon billions from hospitals and doctors.
You are quick to blame insurers, but the problem is really the providers. The Feds can go a long way toward health care reform with much simpler legislation... just make it a crime for health providers to charge vastly different rates to individuals and insurance companies.
A few months ago Quest Diagnostics sent me a bill for $186.20 for a set of blood tests yet "negotiated" a rate of $30.44 with my insurance company. That is completely insane... if I didn't have insurance they would gouge me 6 times over.
If not for these overinflated bills I, and probably most people, wouldn't even need insurance for most things other than catastrophic illnesses. And that's exactly how the insurance companies want it.
Do you have even the faintest idea what health care coverage costs on the individual market? I was looking into starting my own business at one point... until I researched individual medical coverage. The costs for a plan equivalent to my employer provided plan was going to cost more than my freaking mortgage. I'm really pretty sure that the "lowest percentage of folks" are not spending enough on TVs and "luxury items" to cover even a catastrophic plan. And in any case, insurance companies will rescind your coverage at the drop of a hat the minute you come down with any expensive condition.
So yeah, keep bitching about those lucky poor folks. That makes a lot of sense.
Modern treatments for tuberculosis (TB) may have changed this but for a long time, among all the states Arizona had the highest rate of death from TB. This wasn't because the climate of Arizona was bad for TB sufferers, but because the climate was good for TB sufferers. Thus lots of people with TB moved to Arizona to help their health. Thus many people with TB lived and eventually died in Arizona.
I hope you see the parallels with health care costs. High spending could mean inefficiencies or it could mean high quality of care or it could be we are just a country of fat people who are of course less healthy or it could mean any number of other things. The GDP number on its own means next to nothing.
So, you're saying that only one portion of the cost incurred from out of control tort will save us an entire 2% all by itself?!!
I love how these studies conveniently choose to ignore the collateral cost (unnecessary procedures) imposed by lawsuits.
Aah, change is good. -- Rafiki
Yeah, but it ain't easy. -- Simba
The media makes it look like people are opposed because government is involved, but in reality most people are opposed because they don't want to be forced to buy from the same corrupt insurance companies. There's very little "socialist" in this bill, just corporate welfare
Current support for the bill is running about even - around 45-45, with the remainder undecided. And if you ask people whether they're in favor of what's actually in the bill, they're overwhelmingly in favor. It's just that the Republicans (and their benefactors, the insurance companies) have done a good job of making the bill look bad in the public eye.
The republican house in 2005-06 used the same "back door manner" to pass almost a third of all the legislation they passed, and no one said a word. This argument is just dumb. The house is just going to vote on the original bill and the reconciliation fix at the same time. There's nothing "back-door" about it.
With respect to tort reform - this is nothing more than a thinly veiled attempt by the Republican party to get back at a group of people that traditionally gives more money to the other party (lawyers). Study after study has shown that tort reform would have a negligible effect on medical costs.
Disclaimer: I'm an American, but live in Europe.
Right now the situation with health insurance in the USA is so awful that any change is welcome, just as long as that change does not actually come from the health insurance industry itself.
The problem with the health insurance industry in the USA is that it is hardly regulated at all. It's unforgivable that the law currently allows them to choose not to insure people based on their personal medical histories, and even worse that people who are insured (and pay the highest premiums of any developed nation) can be (and often are) given such a hard time when health insurance companies decide that they simply don't want to pay.
Still, so many people in the States seem reluctant to accept any new government proposals for change, because they fear that their already bad situation may actually get worse. They shouldn't be. The only ones who really have anything to fear are the health insurance companies, who are, incidentally, fighting the proposed legislation tooth and nail. That alone should allay people's fears, but amazingly, few seem to notice.
This coming weekend, if Obama fails to pass his health care plan, it will be a very sad day indeed for the American people. But, I won't blame Obama: as president, he can only do so much when congress refuses to cooperate. I want to see that Americans are still capable of helping themselves, but I fear they are not.
Let's face it, America has been a plutocracy for decades: it's run by the rich top percentile who cynically manipulate public opinion to their advantage... not hard to do in a country where most people have a pretty miserable education. Wake up, Americans: your country's star is fading fast.
... nothing in this bill has anything whatsoever to do with your relationship with your doctor. It has everything to do, however, with your relationship with your health insurance company. And if your insurer isn't screwing you already, you can bet they're about to. With respect to your choice: you almost certainly don't have one. Your employer is deciding for you which company you'll use, what benefits you'll get, and what you'll contributed to the costs. And more and more, they're deciding not to offer coverage at all, which leaves you to the tender mercies of the individual market.
The problem is the lack of doctors. If there were ten time as many physicians in the USA, the cost of health care would not be an issue. Instead, we make getting an MD the hardest and most expensive of all professions, and our medical educational institutions' output is limited to the point that NOW one third of all practicing doctors are foreign trained. Today the trend among private practices is to stop taking insurance, including Medicare. When you have a lock on the market you can make the rules.
So, why don't politicians pass laws to make it easier/cheaper to open medical schools and get medical degrees? When was the last time a politician got elected by promising a solution to an immediate problem that would take 20 years to implement?
Imagine if Microsoft were the only operating system -- no Mac OS, Linux, anything else -- and Microsoft could restrict the development of other OSes AND they could charge whatever they wanted without government restrictions. They would be Dr. Microsoft. Would having an OS insurance policy help you?
I think healthcare is broken already, and the gov't is certainly not the one to fix it. In fact, what is planned will break it even further. How many people have healthcare costs that are because they chose to smoke, or chose to eat crappy fast food every day instead of something decently healthy? I don't want to have to pay for other people's unwillingness to take care of their own bodies. Maybe we should have government-run car insurance. If I drive for 2 years without changing oil and the engine blows up, oh well, the government will fix it out of the taxpayers' pocket. Ridiculous, right? Government health care carries the same scenario. Don't even get me started on the abortion stuff. If I say any more though, it'll just start a flame war and that will be anything but productive, so i'll leave it at that
No, there is no "-1 I'LL NEVER ADMIT BEING WRONG!!!" mod.
"Many of the current tort reform initiatives, such as caps on noneconomic damages, are motivated by a perception that ‘jackpot’ awards in frivolous suits are draining the system....But nearly 80% of the administrative costs of the malpractice system are tied to resolving claims that have merit."
- Michelle Mello, Associate Professor of Health Policy and Law at the Harvard School of Public Health
caritj.org
From my experience, healthcare insurance companies are disgustingly inefficient from an IT standpoint. I've worked at two, including one major national provider and one that is the main provider for state employees where I live. Both of them were using outdated technologies and hiring entire departments of people to manually push claims through the system, since their software was consistently unreliable. Quality software in this industry would cut out a huge amount of overhead. It would also force a lot of lazy people to find new jobs, so there is a big political force in these companies opposing this sort of change. I think the best hope for this market is competition. The industry needs some startup companies who are doing things smarter, faster and better, and are taking huge swaths of customers away from them. That's the only thing that will actually motivate them to change. I'm looking for a bill that actually finds a way to encourage and help new companies get started in the industry.
There are a number of problems with the GP, including the fact that nearly every country that has a single payer system ALSO has a private insurance option.
True, but the current system rations based on affordability. Rationing wouldn't necessarily be anything new.
I agree with this, btw. Real reform would make non-emergency medical care subject to similar consumer protections as, say, getting your car fixed. You know, make you get an estimate, check with your insurance as to whether it is covered in advance, etc. and put the consumer in the center of that. This bill doesn't really address the place of the consumer relative to cost control and hence it won't work. My prediction is that costs will increase. Furthermore, the 9.5% cap doesn't include addional taxes needed to pay for everyone's subsidies, so it is a bit disingenuous.
Anyway, my prediction is higher costs and higher mortality rates from this bill. The higher mortality rates don't come from rationing per se, but rather from the fact that state regulators tend to be more responsive to complaints by a doctor that a given treatment wasn't authorized than federal regulators are likely to be at least while the bugs are getting worked out.
There are reforms that need to be done. This bill however is deeply misguided.
LedgerSMB: Open source Accounting/ERP
"We have to pass this bill so you can find out what's in it..."
To quote Eugene Volokh, "It's going to be very, very exciting!"
LedgerSMB: Open source Accounting/ERP
I'm a conservative. Sucks sometimes, but that's the way it is. Fox news is evil.
Needless to say, I was against health care reform from the start. But, I listened, and thought about it. At some point it occurred to me that it would be nice to separate my health insurance from my employer; changing jobs should not impact the coverage I provide for my family and myself. My current job is with a DoD contractor, which provides plenty of evidence that I wouldn't be happy with the government in charge of health care. If there were a free and open insurance market, one where price levels could be tied to services provided, and costs were not hidden, then buying medical insurance would be similar to buying auto or home insurance. Oh well, it didn't happen.
I think this bill will help, some. I also think more is needed. Getting rid of the pre-existing condition cop out is a big gain. But, we've just provided the insurance companies with millions of new customers, some of whom are young and healthy and won't use their insurance, and we haven't significantly changed the way they do business.
Your points are good ones, but health insurance, even with competition is still going to be overly expensive.
This is because market forces do not primarily drive competing health insurance companies to control costs to the customer, but rather their own payout costs.
Insurance companies employ an army of bureaucrats whose main function is to avoid paying out. Doctors offices must employ their own bureaucratic warriors to fight their customer's insurance companies to get paid. A doctor's office who made the customer do this would find itself with no patients fast.
This pointless bureaucracy war is paid for in the price of insurance premiums.
If ever an insurance company tried to control costs by cutting bureaucracy, it would still find itself paying for the bureaucracy on the doctor's office side of things included in the price of care, and that bureaucracy would then saddle the insurance company with as large a bill as possible, negating any possible gain. Competition among insurance companies is competition to cut the cost of supplying insurance (via bureaucracy and dirty tricks) so as to be able to collect the going rate.
An insurance company that fights over every asprin raises the rate for medical care for everyone, even those that fight less, increasing their costs to the point where the insurance companies prices and what they deliver and how they behave is largely indistinguishable. This ever escalating an pointless bureaucracy war means prices for consumers tend toward infinity.
...
It's because people here are stupid. They are so desperate to avoid any trappings of Socialism that they'd rather die because they can't get medical care than to let Big Evil Government help them out.
So, I'm stupid because I have a world view that I, not Obaman, own my body. Thank you, Mr. Sheep, but, yes, I would rather die than let "Big Evil Government" help me out. You see, in order to let BEG help me out, I will have to turn control of my life over to them...a fate worse than death.
The truth is that we desperately need a single-payer system, just like every industrialized country in the world that realized a long time ago that health care is a basic infrastructure need for a productive, thriving population.
Yes, because people are dropping dead left and right around me. It's a picture straight out of "Zombieland"
But the American people are collectively so scared, stupid, and easily swayed, even by outright lies ("Death panels! Federally funded abortion! Rampant costs! Elderly care cuts!") posted on bumper stickers, they they would literally show up with torches and pitchforks in Washington if Congress actually did what is right.
Only half of us are scared of that. The other half run screaming for their mothers if you whisper "Pay your own damn way" in their ears.
The funny thing to me is that these stupid people who are so quick to bash Socialism are usually fanboys of one of the most huge, expensive Socialist organizations in the entire world: the U.S. military.
When we set up this country, you know, with that silly "Constitution" and all, they enumerated some things that the government would be responsible for. Things that made sense. A federal military to protect the federation made sense. A federal bureaucracy to direct individual health care is nonsense in an American context.
Now, I'm not bashing the military, I have a lot of respect for it, Socialist as it is and everything. But it's just kind of funny how when George Bush sunk trillions of dollars into it, you didn't see these idiots showing up in Washington with caricatures of him as Hitler.
Ahem....http://semiskimmed.net/bushhitler.html...now you have.
But consider this. The U.S. is the only country, other than Myanmar, that still has not converted to the metric system. If this country is so stubborn and stupid as to not do things the right way just to spite those damn commies in Europe (and not have to buy a new set of wrenches), seriously, what hope do we ever have of really moving to a single-payer health care system?
And now, you demonstrate what a simpleton you are. It isn't just some lone mechanic having to buy a new set of wrenches. It is about replacing trillions of dollars worth of machine tools, trillions of dollars worth of machines, and trillions upon trillions of dollars worth of supporting infrastructure. You're willingness to slur others over your academic concept of replacing a massively entrenched system overnight with something that works better in your mind belies your inexperience and ignorance. Come back and talk to us when you grow up.
Aah, change is good. -- Rafiki
Yeah, but it ain't easy. -- Simba
>>>Americans who have health insurance but can't afford to actually use it because the deductibles and co-pays are too high
I have no idea what you're talking about. I don't belong to an HMO now but when I did the copays were only $10-30 per visit. Hardly excessive.
I guess if they can't afford those, then they truly are "chronically uninsured" and would be the 3% of citizens I said need help (perhaps via Welfare). That requires a TWEAK of the current system, not a wholesale takeover by government.
And finally there's the matter of "freedom of choice". A monopoly by government is no better than a monopoly by Microsoft or Comcast sucking ~$100 out of your wallet every month (even if you use neither product).
"I disapprove of what you say, but I will defend to the death your right to say it." - historian Evelyn Beatrice Hall
3) provide insurance to 30 million people who now lack it
This bill doesn't actually do that. It is designed to help some fraction of those 30 million purchase insurance, it doesn't provide much of anything to much of anyone beyond that which is already provided to those who already have something.
So while
Obama is instituting a new national policy - health care, a basic fundamental right ina civilized society
Sounds great and all, it has already been stricken from the bill.
Damn_registrars has no butt-hole. Damn_registrars has no use for a butt-hole.
This bill actually makes these problems worse by requiring 90% of premiums to go to payouts. The end result will be more emphasis on payouts, but this will mean higher insurance rates.
LedgerSMB: Open source Accounting/ERP
Your description of the CEO of United Healthcare receiving a 1 billion dollar bonus is false.
He received options from a time period when the stock was much less valuable. Over several years the company's value rose dramatically, and he exercised the options.
I like how you followed your falsehood immediately with a string of discombobulated emotional arguments, socialistic ranting and wealth redistribution ideas.
The public has a compelling interest to unify and use force to prevent private individuals from arresting suspected criminals. Yet the job still needs to be done, so we have no choice but to form government and stick it with that responsibility.
We don't have to. We can have corporations form private police forces and hire them either individually or as communities. We just choose to hand that over to the government because people aren't stupid enough to trust for profit companies to do their job.
The public has no compelling interest to unify and use force to prevent people from obtaining health care on their own.
It has a great compelling interest to hand health insurance (sort of a twisted term these days) over to the government because like police work, our individual lives are on the line. We don't trust the funds to actually be there when this duty is performed by for profit companies, because realistically they often aren't and because the private companies are refusing to provide service to a lot of us.
If you're out there, working on your own with no oversight or due process, obtaining or failing to obtain health care, you pose no risk no any innocent third parties.
Companies that refuse to pay when their clients get sick are failing, but it is not an oversight it is a business plan. The same goes for people who cannot get insurance at all.
I think there are some good reasons for "reform." There are anecdotes out there about just plain fraud: someone pays for insurance and then their claims are denied.
We're not talking about anecdotes, we're talking about an endemic problem effecting a significant portion of our society and reflected in the numbers of uninsured and in the cost we pay and the relatively poor results compared to public systems.
But supporting public-funded health care finance because it's "like" public-funded law enforcement, is just absurd.
This is yet another strawman argument. No one suggested supporting it because it is "like" law enforcement. I made comparison between the two challenging why healthcare was fundamentally different from a legal perspective from law enforcement in response to comment claiming this was transforming our society into a non-free society like a feudal system, instead of just applying the same legal and ethical principals we already apply, but in a different area.
Look at the portion of my comment you quote. Does it say we should support healthcare because of my comparison or does it simply ask how one is freedom and the other is tyranny?
The two are nothing alike at all, when you look at it in terms of the people's relationship with government.
I disagree completely. Both are service based markets that can be provided by the private sector, but which many feel is too important to our very lives and should be handled as a public service by the government. You've provided no reason why private police forces regulated by the government are qualitatively different from private insurers regulated by the government.
[citation needed that isn't an OPINION column]
If you have insurance and you don't use it, the money you spent is going to another consumer of insurance for that company who does use it. I don't see why people are against the idea of a public option for this. It's the same idea, but the "insurance company" has no profit motive. Insurance has nothing to do with capitalism because it is a service which produces no innovations. All they can do is change what they cover and how much it is.
Theoretically, the insurance companies won't have to raise premiums because they'll be getting millions of additional mandated customers.
Whether that works out or not depends on how greedy the insurance industry is. So...yeah.
The economic principles of the reform bill are sound. If they go bad, it'll be due to human nature. At which point more legislation will be needed -- hopefully IMHO, a public option, since that will force real competition and cheaper rates.
Genocide Man -- Life is funny. Death is funnier. Mass murder can be hilarious.
It's called offshoring to the Third World and has been used against IT after the dotcom disaster.
Twitter supports and protects racists - by smearing their critics with the "Hate Speech" label.
> Did you also resent having your money taken at gunpoint to go into Iraq? Afghanistan?
Damn right I do! Neither Iraq nor Afganistan have any ambition to invade the US, nor did they ever. We're in Iraq to control the oilfields and to build huge military bases there. We do that to keep telling the Middle East to do our bidding and to create profits for Haliburton and its ilk. We're in Afganistan because US oil companies want to build a pipeline there. Or, at least, they did, before it became obvious that Afganistan will never become the sort of stable country where such a project can succeed. Neither of these goals does anything to enhance my personal safety and security. They're just about the power elite grabbing more power. Why should I pay for that?
> To fund your local fire and police departments?
To fund them to oppress and terrorize us? If you have ever had to deal with the police, you'd swear not to ever, under any circumstances, call them again. And as for the fire department, why should I pay to put out your fire? In most cases, it will have been your own stupid fault for leaving candles around (it's the single major cause of fires).
> To provide clean drinking water in your community?
Clean drinking water is not free. Maybe you don't know that if you live in an apartment, since the landlord pays the city water bill for you. Out in the country many people have their own wells and don't have to pay for water. If the city government did not provide the water service, someone would start a company doing it if it were cheaper to do so than to have everyone install their own well.
> To provide education for the children in your neighborhood?
Who's providing education? The quality of public schooling is atrocious. And with all the government propaganda children are exposed to in public schools, there is no friggin way I'm sending my child there, and I certainly don't recommend anyone else to do so. Instead get together with your neighbors and homeschool your kids. If you stagger your days off, four adults could educate their children while working full time. Your kids will likely have a better relationship with you and be happier too, if you just spend more time with them.
> It is THE COMMUNITY that you live in, that allows for a rule of law, so that when your neighbor
> decides that he doesn't love you as much as he loves his other neighbors and decides that he
> should roll up in your house and take all your possessions in the dead of night, that there
> is a system in place to protect you from that.
Contrary to what you government advocates belive, most people respect private property. I have no interest in robbing my neighbors, and I know they have no interest in robbing me. If you live in a neighborhood where they do, maybe it's time to move.
Furthermore, you don't need an official police force to prevent such things, even if you do decide you need to. Back in the middle ages, a small village in the middle of nowhere would have been able to handle the above situation just fine. The neighbors get together and confront the thief, and he'll probably apologize and never do it again.
If you really want to have a police force, a private police force works much better than a squad of government goons. For an example see the special police of San Francisco; it's a private police force (although it does have official recognition), funded entirely through subscriptions by individuals and business in the area.
> The COMMUNITY is what allows you to live a non-third-world existence.
The lack of excessive population growth is what allows me to live a non-third-world
I register as a Republican and self identify as a Libertarian. I dislike this bill because it's crap.
The only thing we should be talking about is how we're going to fund the "Public Option" that starts 1/1/2011.
For me it's a business issue. We can't continue to saddle our companies, and workers, with our tremendously high health care costs and expect them to remain competitive with other 1st world nations...all of whom have publically funded health care.
The "reform" needs to be scrapped and they need to start over with how to pay for the public option being the ONLY discussion. Period.
health care just costs too darn much.
Individuals can't afford it anywhere.
Corporations can't afford the insurance premiums for their employees in America
Governments can't afford if for their citizens in other countries.
The problem is not who pays for it (taxpayers vs. insurance companies). The problem is that no entity of any kind can properly afford it.
This is what happens when you insist on using the market to assign equilibrium pricing to something which is not a luxury good or service - if you're dying, you'll take on as much debt as you have to. If you're a democracy with an unhealthy and unhappy electorate, you'll take on as much government debt as you have to.
There is no equilibrium price in this situation - the only market pressure points upwards, and encourages price gouging at every step of the supplier chain.
Pharmaceutical companies overcharge for prescriptions. Makers of medical equipment overcharge for machinery which in many cases is orders of magnitude less complicated than a commodity desktop computer. Doctors and their practices overcharge for consultation time. Labs overcharge for test results. Insurers have to actually pay all these costs and therefore resort to high premiums and really sketchy reasons for denying coverage.
This is a dramatic failure of the market to regulate prices and benefit anyone, least of all the consumer of health care services.
This flies in the face of market capitalism.
This flies in the face of economics.
And yes, it flies in the face of common sense.
Finally, as a non American, I'm tempted to argue that the USA's insistence of following this abuse of the market not only drives up costs for American individuals, but it drives up costs for the government-run systems in other countries. Why would Canadian or Australian doctors stick around when they can price-gouge with impunity in America, for example?
I'm not an American, but I saw an episode of Real Time with Bill Maher where they showcased a "Health Care Bazaar" where thousands of Americans (some who had health insurance) were lining up at 4:00 am to use the free services being provided by a charity that normally operates in third world countries.
According to the people there, many of them had health insurance but wouldn't be able to afford the services otherwise.
From what I understand, about 50,000 Americans die every year because they don't have health insurance or don't have enough insurance.
Fanatically anti-fanatical
Anyone believing that the so-called reform of the health insurance industry is going to be positive needs to understand the numbers. My wife read something yesterday from an Arizona politician that said this would give insurance to 33,000 people in Arizona and improve insurance for over 300,000 people in Arizona. Not only that, but it would give $54 million dollars to hospitals that no longer had to treat people that couldn't afford to pay.
Let's see... Today, if you do not have any health insurance you are working but not at a great job - making enough so that you don't qualify for assistance (which would include Medicaid) but not enough to actually pay for insurance. So how are these people going to get insurance? Goverment subsidies.
Since the payout to the hospitals is going to be coming from insurance premiums, that means in one state with mostly a rural population $54 million is going to be coming from the government and going to the hospitals. Because of some administration costs, this is actually likely to be more like $60 or $70 million. Multiply that by 50 (at least - Arizona is a pretty small state population-wise) and you can see on an annual basis this is a huge investment by the government. Probably the biggest single investment ever made by any government anywhere.
Obviously, this is going to pass - even if nobody votes for it, it will pass because of sidestepping the actual voting process for it. So we are going to get this no matter what.
The money for it is going to come from somewhere. Probably cuts in Medicare and Medicaid. Today, health care spending in the US is focused on end-of-life treatments to (perhaps) extend the life of people. This is fairly unique in the world. As much as 90% of all health care spending in the US is spent in the last year of life, regardless of the person's age. There are plenty of people that believe this is a horrible way to spend money. I believe with the passage of this reform act we will see this spending end. It will create an extremely large amount of social turmoil because Americans have a different outlook on life and death than most of the rest of the world, which is why the spending is skewed in the first place. I don't think Obama and most of the other politicians understand this at all.
Because life expectancy is a poor metric for evaluating a country's performance in health care. A number of reasons for this, but demographic differences play a large part in the differences in any number of statistics in America and European countries.
Cost is a poor metric as well. Spending in health care is directly related to discretionary income, and increases at the margin.
Another problem with comparing a country like the UK to a country like the US is the scale difference. The UK has 61 million people (France has 62 million). The US has 307 million. We also span a continent, while you could fit the UK or France inside of Texas. It takes 10 hours to drive from the top of the UK to the bottom of the UK, it takes 14 hours to drive from the north of Texas down to the southern tip. The US is a large country with a fairly distributed population. Our medical servicing needs are a little bit different and costs are generally going to be higher for the same service because of the distribution problem.
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
Fox "News" has shown repeatedly that they cannot seperate opinion from fact. I have now problem with them having any opinion they want, but they cannot make up their own facts, which they habitually do. That makes thier opinions suspect.
It's a bad bill even liberals should concede that. It basically says the federal government will MANDATE that you buy health insurance in exchange for their corporate masters in the insurance industry agreeing to not withhold coverage due to a pre-existing condition. Never mind that you are self employed or can't afford health coverage unless you are incredibly poor and qualify for Medicaid you will get no help. There will be no public option so there will be no pricing pressure on private insurance providers. And if you don't get coverage how will they enforce it? The IRS of course, and since IRS agents carry guns and have the authority to charge you with crimes that could get you sent to one of America's humane pound me in the ass anal rape prisons. It is basically enforced by the threats of the barrel of a gun and potential anal rape and complete loss of freedom, USA USA USA!
I am betting most people reading this think I am trolling and don't believe that's what it says. Don't take my word for it go read the bill. And you might be thinking why would sane reasonable senators vote for that? I think they know it's a badly broken piece of legislation. I think even Obama knows that. I am guessing the point is to get something anything passed. And if it is broken so be it the resulting cluster fuck and outcry will create the real crisis necessary to pass a real healthcare bill with some public option and maybe eventually work towards single payer or a national health service type of situation. It's totally fucked.
Post here if you think the entire healthcare 'debate' in the States is completely fucked. Hell, did I read right that there is no public option? What the hell is the point of this entire exercise!
Like most thing political most ideas are never as bad as they are characterized or never as rosy as they are triumphed to be. I suspect that the increasing sense of entitlement will be a drag on our society going forward but things like mandatory coverage is a really good thing to have.
Interestingly things like pre-existing conditions could be done away with with a three-prong approach:
Where are conversations like this in the political arena? Instead of trying to get to root causes, we make it a debate of force vs. choice and then nothing but posturing gets done.
The principal problem with "overcharging" is two things:
This style of thinking is quite different from much of the rest of the world. Between the cost-shifting and the "at any cost" philosophies we are in a difficult position. Unfortunately, to fund the program that is going to be enacted government folks are going to have to change this, virtually overnight. This means telling the daughter her father is just not worth saving. This means telling the mother that the government can't afford to fix her child's heart problem and the child will die now instead of in 10 years. Americans are not used to getting this kind of news, especially from some government person.
This is going to change things in a big way in the USA. Probably a lot bigger than people in Washington understand.
Mass here. Self-employed, using the state mandated marketplace. - Costs were up 38% last year, year over year (not to mention the obvious, but on top of already having the highest cost in the nation...)
Each insurer should publish what they cover electronically in such a way that a single connection to a single claims settlement system will allow all claims to be resolved in one pass. Otherwise it takes hours of my time, my wife's time and the doctor's support staff time to get things approved and paid for. That would be a great step toward better efficiency.
Nullius in verba
My health care payments, for the same coverage and the same provider and the same source (everything the same) went from $670 to $1184 this month.
I am trying to decide, quickly, what to do about it.
Secondarily, I wonder if this increase actually reflects cost increases, and if it has something to do with positioning profits of the provider in advance of the limits that will be invoked if HCR passes.
Right now I am at their mercy.
I have never thought of it this way. I have yet to read the actual bill (just the summaries from misc sources) and my conclusion was that a) the current system really really sucks and therefore b) at least try something new. The qauntify that though, the idea that someone without health insurance will have to play 3000 in taxes is ridiculous to me. Regardless, there are a couple things that seem to be fundamental problems of the system that are not being addressed at all. Above all of this, I find that America will never have fair and balanced (Fuck both parties) legislation until we somehow cap, limit or prevent the lobbying "business" ability to pour money into political campaigns and control issues.
"It's ok, I'm completely secure as long as my iron is off"
I don't understand how someone could say that tort reform is a red herring.
In terms of the direct financial impact of malpractice insurance and litigation costs, tort reform doesn't help more than a few percent or so. But in terms of the hundreds of billions of dollars wasted on unnecessary treatment because doctors are paralyzed to do anything besides order the extra tests and procedures, tort reform would make a HUGE difference.
The Congressional Budget Office studied this and agrees with you that the savings for "less utilitization of health services" due to tort reform is important... 150% bigger than the direct financial impact. But it disagrees with you about the amount... and says that even combined, it's less than 1 percent of the total cost of health, all things considered.
First, we're going to get the insurance companies' profits and doctor's salaries reigned in. Then we are going to vote out the dems. THEN we are going to make sure the repubs get tort reform in place. It's all good...
Opinion:=TMyOpinion.Create(Me);
I don't understand how someone could say that tort reform is a red herring.
In terms of the direct financial impact of malpractice insurance and litigation costs, tort reform doesn't help more than a few percent or so. But in terms of the hundreds of billions of dollars wasted on unnecessary treatment because doctors are paralyzed to do anything besides order the extra tests and procedures, tort reform would make a HUGE difference.
The Congressional Budget Office studied this and agrees with you that the savings for "less utilitization of health services" due to tort reform is important... 150% bigger than the direct financial impact. But it disagrees with you about the amount... and says that even combined, it's less than 1 percent of the total cost of health, all things considered.
Also, the Congressional Budget Office says in their analysis that "Those estimates take into account the fact that because many states have already implemented some of the changes in the package, a significant fraction of the potential cost savings [of the federal bill] has already been realized."
Did you see Caterpillar's announcement that this plan would cost them $100 million per year? Once this passes companies are going to evaluate the costs and drop health coverage if paying the fine is cheaper than the new compliance costs.
For some reason SOME people are ok with spending all of our money on military defense, but when it comes to spending it on health defense... certain people cry communism.
The reason is that the federal government contracted with the people to provide for a federal military when the country was created. We did not contract to have the federal government provide doctors. Yes, the military is a form of communism. We accept that as a necessary evil. It's a compromise with reality. The "need" for federal health care is just "compromised reality".
Aah, change is good. -- Rafiki
Yeah, but it ain't easy. -- Simba
Clearly the only proper way to control the Insurance Industry is to start a coalition and begin buying their stocks in small pieces, so the poison pill doesn't kick in. Proxy the shares to a non-profit regulation organization (that's a tough nut to crack though) which will control the companies through stock holder action. It will also funnel their ridiculous profits back into the organization. I think this could work for all but Kaiser which is already non-profit.
Why bother
a politician, for example, cannot afford to call people teabagger morons
however, i am not a politician. i am not trying to appeal to anyone. i traffic in ugly truths, not serene lies
i am simply stating the facts. and the simple facts are, plain as day evident to anyone except themselves, the tea party philosophy is the philosophy of the low iq
you won't find those words on any lips of any politician, at least in public. either those politicians gleefully courting their easily manipulated votes, or those politicians loathe to deal with the cesspool of mental filth that they are, or both, at the same time
so: thank you for the advice. at the moment i become a politician (meaning, never), i will begin to worry about offending teabagger retards
intellectual property law is philosophically incoherent. it is your moral duty to ignore it or sabotage it
Many would disagree with you, including the worlds' most famous economists.
See http://en.wikipedia.org/wiki/American_Medical_Association#Criticisms
There is no artificial supply shortage.
Then why have doctor costs risen so much in the last 30 years? (No, it's not all malpractice insurance. No, it's not all insurance companies).
Why do I always sit for an hour in the doctor's waiting room?
Why are 1/2 of doctors in the US millionaires?
I am a medical student, by the way.
I guessed that before I read your whole post.
Just give me one Government program that has worked as planned. If you can do this do, then I might buy off on it.
It actually wouldn't be like what you describe, because all of the insurance companies would set up shop exclusively in the states with the least regulation. So in your example, you'd only have the choice to buy your policy from New Jersey. And remember that most people don't actually choose their insurer--their employer chooses it for them.
The whole "buy insurance across state lines" is a health insurer proposal to crassly deregulate the market in their favor, turned into a Republican talking point by a flimsy claim that it would lower costs. (Which it easily would, by reducing the insurers' operating costs while further enabling them to not pay your claims.)
Are you adequate?
the way the usa currently works, the economic incentives are to treat diabetes and heart disease when they are extremely expensive end stage deadly conditions. that's why american health care is "better": it delivers lavish expensive care when you are extremely sick. other countries PREVENT YOU FROM BECOMING THAT SICK IN THE FIRST PLACE. imagine fucking that
in a country that actually *gasp* values the health of its people, there is economic inventive to PREVENT people from becoming dangerously diabetic or with heart disease. gee, what a radical fucking concept
of course, the teabagger morons will complain the government is trying to run their lives. you know, they should be free to weigh 400 pounds, chain drink 42 ounce big gulp soft drinks and chain smoke. and that anyone should suggest this is unhealthy and that they should change their lifestyle to save society cash, well this is of course deeply offensive and freedom destroying socialism, right?
as patriotic americans, they should have extremely expensive end stage heart failure care at a relatively young age... that they can't even afford. see, its ok to expect lavish services... just not ok to pay for them
fucking teabagger morons
intellectual property law is philosophically incoherent. it is your moral duty to ignore it or sabotage it
Most people are opposed because 1) they're selfish and 2) they have no compassion, because they have never had to deal with devastating medical debt.
If you can't see the value in jet powered ants you should turn in your nerd card. - Dunbal (464142)
All it tells us is exactly what you quoted: that Congressmen were willing to vote yes on a bill when it was amended to not harm their constituents as much.
I happen to think that's silly, given the topic, but many seem to think that wrangling pork out of the mix for one's home state is what they're for.
If you can't see the value in jet powered ants you should turn in your nerd card. - Dunbal (464142)
every criticism you have delivered and do not in any way deny the negatives you cite
i would like to clue you into to one small teensy weensy point you seem to have overlooked:
even with all of those negatives you elucidate...
ITS STILL WAY FUCKING BETTER THAN OUR CURRENT SYSTEM
duh!
"compare and contrast": its a useful mental skill. examining government run healthcare in a vacuum of all other choices, and it looks like shit. but examined in the context of other possible systems, it simply comes out better
oh sure, i'm certain you can find some small avenues where government run healthcare is worse than what we have now, but as an OVERALL system, examining the overall web of costs and benefits, it comes out ahead of what we currently have
next time:
1. compare and contrast with other choices
2. examine it in the universe of all financial and societal effects, not small avenues of loss or gain
then you have wisdom. but right now, whether willfully or out of honest ignorance, you only have propaganda: half-truths
intellectual property law is philosophically incoherent. it is your moral duty to ignore it or sabotage it
is bigger than the Health care bill. Who has time to read it?
you object to the term teabagger because of negative connotations
but fascist is perfectly acceptable to describe government run healthcare
hey, asshole: is canada fascist? is denmark fascist?
in many objective measurements of freedom, these countries, with universal socialist healthcare, and high taxes, are much more free than the usa. the usa, in fact, is already highly fascist, according to your methodology, in a number of ways, while socialist countries are more free in the avenues you care about
so you play your retarded propagandistic game of label-making for the purpose of smearing. i'll tell you what: as an objective measure of maximizing my freedom in this world, i see many "fascist" "socialist" countries besides the usa doing a much better job of that (how about FREEDOM FROM DISEASE you fucking ignorant "patriots")
you meanwhile keep up the good fight... for maximizing corporate profits. pffffffffft
fucking teabagger morons
intellectual property law is philosophically incoherent. it is your moral duty to ignore it or sabotage it
I wish people would stop spreading this meme that "insurance is supposed to be a hedge against catastrophe." No, insurance is simply risk transfer; some kinds of insurance protect only against catastrophic risk, but other kinds protect against much milder risk.
I'm not going to pick apart your two examples (viagra and "elective surgery"); however, I will point out that much of the care that people who make your argument claim is not "catastrophic" and should not be insured, overall, reduces the risk and cost of catastrophic care. The insurer can afford to spend $1,000 per person on some relatively minor non-catastrophic care if this prevents 2% of them from requiring later catastrophic care that would cost them $50,000 bill later on.
One of the usual analogies here is to compare health insurance to a hypothetical and absurd auto insurance policy that paid for your gas. However, the thing is that while a health insurer that pays you for routine care decreases your chances you'll need catastrophic care, an auto insurer that paid for your gas would encourage you to drive more, which would increase your chance of having an accident, and therefore, the insurer's costs.
Are you adequate?
Apparently, you need to do some research into health insurance and insurance law.
OK, we pay a tax AND have health insurance policies. But, who decided whether a specific disease or injury is "lifestyle liability"?
Which of those will or will not be covered?
There is no real competition among the insurers. In almost every state, there is one insurer who has over 85% of the market. From state to state, the majority insurer may change, but in each state that majority insurer has an effective monopoly. This is because one does not buy insurance from "Blue Cross/Blue Shield" but rather "Blue Cross/Blue Shield of [insert state here]". And, this state by state monopoly system is not just allowed but actually encouraged by the current laws.
There is no "-1 offended" or "-1 you don't agree with me" mod options for a reason.
If the Bill is the answer then why hasn't it passed long before now, when the Democrats had super majority in both House and Senate?
Hey what can I say i'm weird
1. what you are describing is what is currently done right now by private insurers. so exactly what is your point?
2. fatty lard ass and his chain smoking and his 42 ounce big gulp soda IS COSTING ME MONEY. so why don't i, through my govt, have the ability to force fatty lard ass to not cost me so much money?
you're worried about the govt telling you to eat the garden burger? why the hell aren't you worried about fatty lard ass costing your health insurance premiums to be so high? and finally, WHY THE FUCK INDEPENDENT OF ANY OTHER CONSIDERATION AREN'T YOU CONCERNED FOR YOUR OWN FUCKING HEALTH?
you want to talk about impinging on freedoms? fatty lard ass COSTS ME MONEY, and therefore IMPINGES ON MY FREEDOM
its pretty much a constant problem with people fighting for their freedoms: there are genuine freedoms which hurt no one else, like freedom of speech, or freedom of religion, and then there are "freedoms" which have a solid qunaitifiable real cost on society and on me. so yes: i have a RIGHT to tell you not to smoke because it COSTS me money and therefore LIMITS my freedom. WHO is paying for your healthcare asshole, in ANY healthcare system. and i have a RIGHT to tell you to eat responsibly because IT LIMITS MY FREEDOM
there is no such thing as a freedom or a right to LIMIT OTHER PEOPLE'S FREEDOMS OR RIGHTS. limits on your freedom is not always from your government, its also from your fellow ignorant, selfish citizens, no matter WHAT your government's policy
so, in the name of freedom: fuck you fatty, eat the fucking garden burger, asshole
intellectual property law is philosophically incoherent. it is your moral duty to ignore it or sabotage it
I had no idea the font size in a bill was so large. It really makes it seem as though the media networks exaggerate the size of the document. I wonder how large it would be if given in a standard font size.
There is much criticism of insurance companies. But the fact is that they are just providing a service to people. People don't have to buy that service, but they do. Why? Because doctors and health care is so freaking expensive!
Insurance companies have worked to reduce this expense. A hospital charged my insurance company $1500. The insurance company paid them $600 and the hospital took it. Whoa! If had not had insurance I would have had to pay $1500! And people say insurance companies are the problem? I don't think so.
Yeah, but they always do it by stretching the commerce clause. I hope that one day it snaps back. And with SCOTUS being 5-4 to the right, if someone can push a challenge up through the appeals process before a conservative dies/retires, then this is could be declared unconstitutional.
But I ain't holding my breath
- doug
My health care is renewing, and I have a choice to reduce my costs by $1000 per year for a disaster-only high deductible plan or raise them by $1000 by taking the HMO. The PPO is $2000 higher. That's after we switched health insurance companies to try and save costs. So the prices are up for everyone I assume.
The real question is do these changes provide a method to reduce individual costs by enlarging the pool and providing more power to the government to rein in these insurance companies? Recently I saw an ABC News article about some college kid who took out a health policy at the beginning of the school year and tested HIV positive later that year. The company dropped him on a technicality and after investigation it was found to have embraced that tactic for scores of others. It makes me sick that this is someone who did the right thing by paying for insurance and then had to go through this brouhaha. The stigma of the disease is one thing, not receiving care you need is heartless.
I assume you mean the baby boomers who started this shit in the first place. Aka the greediest generation.
Read the bill. I have, and I see nothing the backed what the people who don't want it claim. not a single thing.
If someone can point out something, I would be glad to discuss it. If you have NOT read the bill, then STFU about what's in the bill.
Secondly, Shame on you CmdrTaco. You know damn well this will only cause a huge flamewar. Are you really so stupid as to think /. is where to go to get honest well read opinions?
The Kruger Dunning explains most post on
1) You get to deal with the IRS and they get to know you much better.
2) You pay now and it doesn't take effect until 2014
3) It's called the biggest deficit reduction bill ever signed!
4) Your money will as safe as your social security payments are(their locked away awaiting our retirement aren't they).
5) Clerical error never happen in government agencies and they always care about the captive^h^h^h^h^h^ustomer.
It has the feeling of a tax passed to keep the Federal government afloat so it can continue to operate, but with some health care tacked on. Basically, they lost me at IRS.
-- Prepared at the direction of, or to be sent to Legal Counsel, in anticipation of litigation. Attorney Client Pri
Well, you have to foregive my brevity. It was written for ADD-enhanced Slashdotters. I avoid the detailed discussion.
While I won't run down the list exactly, but the general principal is that:
Personal choice that increases risk will have to be judged accordingly. If a behavior marginally increases cancer rates then it should be covered. If a behavior markedly increases rates then it should not be covered in the national coverage. What this is exactly, but 5% seems a good cut-off. Also to be balanced with this is by how many people are engaging in the behavior. If we all do it as Americans, then monetarily it makes sense to include it in the national policy.
Then your questions dive into gunshots crashes. These are not medical conditions. These are discrete unpredictable events requiring medial treatment. The insurance industry has already made the actuarial tables and decided what factors are statistically relevant to the premium. We can simply re-use these.
Yes, over time the plan will change. The government will try to reduce coverage, but it also will be balanced by keeping the costs low. If the government sheds responsibility, then we transition back closer to where we are today. But remember, the insurance companies don't want to pay out, so they will push coverage back on the government. I expect that we would be informed by people crusading for coverages to be added to the plan that "Coverage for XXX will save $YYYM by including it in the national plan". And I expect that the hallmark of the national plan is that it would provide the widest services at a lower premium than the insurance companies can provide today.
There will never be an end to the debate of what the national plan covers, and that is just how it is. It will allow it to change to meet the needs of Americans, as those needs change over time.
There is no "perfect" plan, and I don't for an instant think this is perfect. But it is a compromise that will be effective. If you read the current bill, and compare with what I describe here, which do you want to vote for?
But look at what this sets up - some framework for government coverage, which is competitive and expandable, while capturing the best of both sides.
Slashdot's rate-of-post filter: Preventing you from posting too many great ideas at once.
Congress passes all kinds of law which get tossed out. The heal care bill seem like it should be one, because I don't know what the foundation of Constitutional right granted to the Federal government which would allow this. I reserve the right to be completely wrong. But please listen for a second.
In the Constitution is clearly states that those powers which are not reserved for the Federal government belong to the states should they want them, and anything which they do not claim goes to the people. The default here is to clearly narrow the power of the Federal government, so that it cannot assume too much power. Health Care doesn't seem to have any mention in the Constitution, so the state of Massachusetts enacted health care for all. It could not do this is that Federal government had the ability to also do this.
So, there it is. I'm no lawyer, but it seems to me the Federal government is not the place for this. Health Care is important, and we need to be able to take the fight to the right people(legal fight, not literal). It's easer to work within your own states since you are more significant a vote. At the Federal level you are as nothing, and some are further away from Washington DC than the original states were form England.
Take a gander through the Constitution and see if the 10th amendment has any meaning when it comes to the Federal Government, and don't give the old catch-all "commerce clause" argument.
-- Prepared at the direction of, or to be sent to Legal Counsel, in anticipation of litigation. Attorney Client Pri
I think you may be right, since insurance companies were the only force against unrestained marginally useful care designed to cover doctor's liability asses and pad medical bills. If health insurance companies are forced to lay down and accept abusive billing practices, then rates will still rise until almost nobody can afford health insurance.
I hope a failed attempt at reform doesn't cause reversion to what we have now, or a hopeless mindset where we don't believe reform can work. Emperically a single payer limited budget pool works elsewhere much better than what the US has now. The alternative is eventually almost nobody is insured, and medical consumers ( without the benefit of MDs in their employ ) are faced with deciding whether to A) get angioplasty to lower the risk of a heart attack or B) keep their house. ( those without a house/money would presumably get the angioplasty and also a lien against their future income if any in the case of B).
Elsewhere, even if it's far from perfect, I believe they do better than that last alternative.
...
You seem to think no money is accounted for and everything is twice what it should be.
Care to name any studies? show in examples?
"After that, completely dismantle the current tax system,"
Why? it works pretty well.
" make a flat income tax where everyone pay"
Flat tax has been throughly debunked as a working tax strategy. Unless you goal is to divide everyone into the very rich and very poor category. It would take about 15 years for that to happen. Simply mathematics can show you why, but I suspect you head is so far up Ron Paul's ass you can be bothered to actually think.
The only major tax change I would make would be to remove charitable contributions deductions as well has taxing charitable organizations.
in 2009 there was 308 billion dollars in deductions. Put that money into science education.
The Kruger Dunning explains most post on
the constitution is open to interpretation. your interpretation of it is not the only plausible legal interpretation that exists. legal rulings, in fact, have drifted and contradicted each other over the years owing to this tension. the constitution paints broad concepts that people interpret on their own, and then a few us, as if in a fundamentalist religion, say that their interpretation is the only constitutionally valid one. bullshit. there is NOTHING in the constitution that says universal healthcare is not a valid constitutionally sound concept. if you describe a legal avenue in which it is made it unconstitutional, i will find some other modern governmental practice you hold dear that defies the constitution in the same way, but you make an exception for, because its simply common fucking sense. much like universal healthcare is simply common fucking sense. finally: the world changes, the challenges change, and the constitution's broad important concepts must be adhered to... NOT some minor clause that when creatively expanded upon can maybe block this common sense legislation, simply because you don't agree with it, at first. like the eras surrounding the abolishment slavery: the legal precedents ran fast and furious in either direction. simply put: in a generation or two, the majority of the children and grandchildren of those reading these words, including those who violently oppose universal healthcare, will agree its a no brainer common sense obvious facet of sound society and sound government
#2: you want common sense?
ok: goverment run healthcare is extremely inefficient
ready for some more common sense?
its STILL BETTER THAN THE INEFFICIENCY OF WHAT WE ALREADY HAVE. examined in a vacuum, government run healthcare sucks. examined amongst other possible choices, its simply the LEAST suckiest choice
#3: that this bill will cause coverage to fall is fearmongering. the doctors who threaten to leave medicine are whining much as the democrats who threatened to go to canada when bush was elected in 2004. when the for-profit companies parasitically siphoning off cash, and all the inefficiency that goes with their insertion is finally removed, doctors will make out the same, or even better, under a one payer system. sure the government could mandate doctors get paid little. and doctors, as you suggest, will disappear or suck in quality. so the government needs to mandate good standard of living for doctors. you tell me about the quality of life for doctors in the uk, canada, denmark, etc.
#4: you don't think we're spending enough on healthcare?
ok
well why don't we spend some money on HEALTHCARE. rather than some parasitically inserted companies that siphon off cash, insert inefficiences (paperwork storms worse than govt bureaucracy), work hard to make sure you get LESS healthcare, and are accountable to no one except the almighty buck? govt bloat inefficiency and indifference looks FAR better to me than a corporate entity actively attempting to make sure less goes to my health than i deserve. how does it look to you?
intellectual property law is philosophically incoherent. it is your moral duty to ignore it or sabotage it
Yes, because people are dropping dead left and right around me.
Yup. 45000 a year from not having insurance.
If corporations are people, aren't stockholders guilty of slavery?
Is it wrong to want to be in a pool of health conscious individuals? I eat healthy, exercise, and don't smoke ect. Why the hell should I have to pay for those who do?
Fascism? Maybe oligarchy would be more appropriate. Not sure how you end up subordinating your life to the state by having to buy health insurance. I'd say you, my friend, just violated Godwin's law.
Uhh, insurance companies make about a 3% profit margin on average. Google for yourself if you don't trust this link.
More often than not, doctors will charge double what they do with insurance companies for cash / self-pay people.
Yeah, I was just baffled at his idea he was somehow saving money.
Well, yes, if he only gets $200 worth of medical services a year, it's cheaper than insurance...but if he had insurance, and used it, and insurance paid for that visit, it'd pay like $50.
Incidentally, who here thinks that people who've never had any actual medical problem (And $200 a year is, essentially, a sinus infection.) should have their kneecaps broken before being allowed to comment on what they imagine their 'insurance' will cover?
If corporations are people, aren't stockholders guilty of slavery?
the innumerate are numerous
intellectual property law is philosophically incoherent. it is your moral duty to ignore it or sabotage it
If this poorly crafted bill - which is going to cost far more than they say and is making its numbers with guesses and sleight of hand - passes, we are going to be fixing it - that is, reforming the reform - for decades to come.
This was rushed through far to quickly and is too poorly considered for something this important. What both the House and Senate need to do is scrap the current versions, go back to the drawing board, get input from their constituents on what *they* think needs to be reformed, rather than a bill done primarily in response to what the White House asked for, and then pass *that* bill and send it to the President.
Sure, there are some things in the current bill that are good: the first thing that comes to my mind is doing away with pre-existing conditions. That's unconscionable. So is charging people more if they actually use their insurance. I don't like lifetime maximums, either. Some treatments are very expensive.
There are countries that have reasonably well-run national health insurance systems (Japan, for one, which is a single-payer country) and countries that have terrible ones. One thing they have in common is that the standard of care covered by insurance tends to be non-great. I've been hospitalized in Japan and can speak from experience about that. Doctor care can also be hit or miss, although that seems to have more to do with general culture and standards and little or nothing to do with insurance.
Some other countries have really poorly run national health care systems that result in serious rationing of medical procedures. I have a friend in Winnipeg who is on a waiting list right now, whereas if she were a US resident, she would have had it done long ago. Lest someone start up some BS about "What if she needed surgery but didn't have insurance?" every hospital I have ever been to, or that any member of my family has been to, has had an explicit written statement that inability to pay will not keep you from treatment. They have programs and foundations in place for that. Yes, those programs make my own bill higher - I'm sure the two weeks one of my kids spent in the pediatric ICU last year would have been cheaper otherwise, but I'm also certain of two things:
1) The cost increase to me would be even worse with the government involved.
2) I'd much rather have that between me and the hospital and the poor who are receiving help from the hospital than between me and the government and those parties. Anything that puts more layers between patient and caregiver is bad. It's kind of like the reasons that start-ups are more nimble than large, established companies: at every start-up I've worked for, the CEO not only knew me by name and face, I had no more than two levels of management between myself and the CEO. At the company I currently work for - which is pretty nimble as big companies go, but it's still more oil tanker than speed boat - I can't even tell you how many managers are between me and the CEO, or who they are. I know who the managers are three levels up from me and who the last one before the CEO is, but there are some more in between.
Look at point 2, above, and remember that to err is human; to really screw things up requires a bureaucracy. To screw things up so badly that there is no reasonable hope of ever fixing them properly requires a government bureaucracy.
The economic principles of the reform bill are sound. If they go bad, it'll be due to human nature.
Yeah! Wait - what?! Economic principles that don't take into account human nature can be considered sound?! Well, that's good news for this new Grand Unified Theory I've been working on - if it fails it'll be due to the nature of energy (which I didn't include into my calculations, as it would've screwed up my theory). The principles are sound, though.
Now that I think about it, I'm pretty sure everything I just said is completely wrong.
Everything you just said is complete and utter bullshit. I'd pick it apart point by point, but I don't have time.
"I disapprove of what you say, but I will defend to the death your right to say it." - Evelyn Beatrice Hall, re Voltaire
This part you got right - there is nothing in the Constitution that suggest the federal government can require citizens to sign contracts with private companies. Nothing. But don't expect that to stop hacks like Alito and Roberts from rubber stamping it.
FTFY. Social Security and Medicare have 2%-4% overhead. Compared to the 20%-30% for private insurance. Because with Medicare, you get what you pay for - health care. As opposed to private insurance, who's entire business model depends on charging you the most they possibly can for premiums while denying your claims as much as possible. And federal officials are paid far less ($400,000 for the president vs $10 million for an insurance CEO) and their salaries aren't tied to the aforementioned business model.
Lies, damned lies, and statistics. These are based on pulled-from-the-ass numbers over an indefinite timeline, while only looking at "entitlements" - how about that Pentagon spending?
This bill doesn't cause the lack of care, it just doesn't help it any. Because Obama and the rest of the corporatist Democrats in power decided that extending the broken insurance industry to the non-insured (by force/taxpayer subsidization) rather a public option, or even better, single payer.
Ah, the old "you'd have to wait in lines" canard. This is a batch of sophistry, as it's comparing non-emergency wait times in other countries to ideal conditions in the United States - where we have plenty of lines ourselves.
A right wing lie with zero basis in reality. Seriously, pull your head out of Sarah Palin's hypocricial ass.
Actually, it's barely budged for decades, and we're far behind other nations in both life expectancy and infant mortality.
3% on what planet?!? We've seen double digit increases in the cost of insurance just about every year in the last decade. And insurer in California announced an increase of 39% this year.
That the wealthy can afford to travel all over the world to find the best specialists says....what exactly about the level of care in this country?
Not when it only looks at those who are treated and not thrown off their insurance because of a job loss or benefit cap, it's not.
I practice internal medicine near Los Angeles (http://drgagne.com). It's clear to any physician currently in practice that the health care system is broken and falling apart rapidly. If reform fails to pass, unless you work for a Fortune 500 firm, you will almost certainly lose your insurance within the next few years. Opponents of reform are using FUD to scare you, but almost all of their claims are lies. For example, there NEVER were any "death panels." Here are some great descriptions of what's in the bill and what's not: 1. Quick summary from the Washington Post: http://www.washingtonpost.com/wp-srv/special/politics/health-care-reconciliation/ 2. Nice graphic of how much it costs and why it lowers the deficit: http://www.latimes.com/features/health/la-031910-sc_health_care_costs-g,0,6098627.graphic 3. Fabulous answers to "twenty questions" about what's REALLY in the bill: http://www.latimes.com/features/health/la-oe-kmiecweb19-2010mar19,0,6451390.story ---Jim Gagne, MD---
Why do you believe corporations have a better track record regarding your interests? They don't. Money is power (re gaming using Markov processes to examine probability of success). Why wouldn't you want an advocate for your rights?
Don't know where you live, but I think it's amazing that you can send a snail mail for less than 50c; the roads are ok where I live and my public schools are great. In the US, government is reasonably efficient and it provides a different price/performance/access point that private industry.
You want next day delivery ? use FedEx, but pay $20 (or more ?). Have you seen private toll roads ? I grew up in Mexico, where they're common; you pay about $40 to go from Merida to CanCun (about 200 miles). You want to go into a good private school ? be prepared to spend $15000/yr, and make sure your kid is really good, or he/she won't get in. I'm not saying private companies offer bad choices, but they're *different* choices, I like that the govt provides decent basic services.
Sure, if they could force a bunch of people to get more expensive surgeries, they'd make more money. But really, how would that work? Insurance goons show up at my door and drill out my kneecaps if I don't get my appendix removed?
If what you're saying is that this rule would force insurers to pay for insurance that they should have been paying for all along... um, what was the problem again?
I agree. From what I've read, the 85% cap provides an incentive for the health care industry to become even more expensive and less efficient.
The Health Care Reform Act is a door opener. Apparently in order to overcome fears or resistance from the right wing this bill simply gets the ball rolling for better and cheaper health care for Americans.
Obviously the bill will be altered as time passes so that areas that need more attention can be taken care of. Getting everything just right in one draft is next to impossible. And the only reason it is so convoluted is right wing resistance. For example simply extending the Federal Employee Health Care Insurance to every American would have been better and a far,far, shorter bill. But the right wing wants more protection for big businesses such as hospitals and wealthy doctors.
But even more important than saving countless lives and preventing needless suffering this bill may keep America from total collapse as the current medical system is bankrupting America. That truth is blatantly conspicuous. As an example our returning soldiers who are severely wounded in combat often get poor medical treatment because the government can not afford to repiar these people. And then because they get poor medical care they often are doomed to stay on military disability forever at several thousand dollars a month for decade after decade.
No, you're stupid because you think that this bill is going to take away your ability to make decisions regarding your own health care. Or a liar. Which do you prefer?
There, I highlighted the part you deliberately overlooked to create your strawman. It's not a matter of people dying in the street, it's a matter of people going bankrupt because they have a screwed up gene, they fall down, they get into an auto accident, the get pneumonia,...
You mean things like, "promote the general Welfare?" (Right there in the first sentence, in case you weren't paying attention.) Or maybe you're referring specifically to the enumerated power of Congress to "lay and collect Taxes, Duties, Imposts and Excises, to pay the Debts and provide for the common Defence and general Welfare of the United States?" Inconvenient it is, that zany Constitution, isn't it?
This idiot doesn't understand a simple metaphor and calls me a simpleton. That's golden. Anyway, it shows the amazing arrogance of these idiots, that they completely neglect the fact that the entire rest of the world somehow managed to do it, a combined economy that is emphatically much larger than ours. But then, most of the rest of the world isn't so boneheaded that, when they see a much better idea, they deliberately run away from it. There are exceptions, of course--witness Myanmar--but then it's sheer lunacy to sit here declaring, "Yeah, we want to be like them!"
I know how to pay for healthcare and more quite simply: end the failed, horribly antiquated 'war on drugs' (+$19 billion) save on jail and federal prison sentencing and jailing (+10 billion) legalize pot & tax the bejeesus out of it (+ 3 billion) monitor, legislate and control other narcotics (+1 billion) That wouldn't be a bad start. You would end alot of violence, broken families and the unemployment rates would go down since future 'convicts' will be able to land jobs. Being that they're not a 'criminal' anymore.
Our country is going into a tailspin because government promises more and more money to more and more poor and old people. Once again, the middle and upper classes will be funding a program designed to 'pull' the millions of poor, uneducated, oft-unemployed or otherwise economically idle lower class out of the shithole they're in.
This is unsustainable. We need to stop letting low-tech workers into this country. We need to document (not necessarily deport; too much work) all illegal occupants of the country, and keep more from coming in illegally. We need to stop providing myriad social services to those who not only don't pay in, but aren't even on the books as being in this country!
It is a true problem, and I don't wish ill health on anyone. Any normal, decent human wants everyone to be healthy. That doesn't make it feasible to tax the life out of one group of people to fund a marginal increase in living for another.
Lifeboat Ethics: There are only so many resources for a given number of people. Not only are some resources (jobs, money, land, food) in a balancing act or being depleted, huge numbers of both low- and high- skilled workers (and a lot of unemployed parasites) come to this country every year. At least the high-tech ones contribute to useful research and are a valuable commodity. Get rid of the minimum wage so legal workers can compete with the Mexicans.
HOW DOES THIS RELATE TO HEALTH CARE REFORM? This is just one more example of government doing what I'm talking about: subsidizing a service that will continue to cost more (the government did nothing to fix health care costs) while paying for it by printing money, borrowing from China, and stealing from the top two classes.
|| You seem to think no money is accounted for and everything is twice what it should be. ||
Nope, no studies.
The U.S. federal government, by my own estimate is more than twice the size it needs to be to fulfill its constitutional mandated actions/activities. Period. Nothing more, nothing less. On top of that, taxes should come down drastically, as a result of this drastic down-sizing of the U.S. federal government.
Health care reform and any other numerous problems touted by the U.S. federal government are, in large part, problems that the U.S. federal government either A) created or B) greatly exacerbated. On top of this, the U.S. federal government is trying to cram their solutions down the U.S. citizenry's collective throats. And that, my friend, is tyranny, plain and simple.
It's not just a problem with the current House, Senate and Administration, the last set had their part, but the current set is hell bent on making sure it gets a whole lot worse.
In a way, yes.
Their market was completely untapped by the other mainstream news outlets. The market demanded it.
If you don't like it, I have a suggestion for you: don't watch it!
I avoid all cable news like the plague myself - it's turned into a parody of talking heads desperate for ratings.
FUNK!
More often than not, doctors will charge double what they do with insurance companies for cash / self-pay people.
They'll often bill everyone identically, which means that insurance companies negotiate it down to about half. This is a carry-over from when insurance companies would pay a fixed portion (e.g. 100%) of the bill, so doctors would bill more in hopes of getting paid more. If you speak with your doctor then there's a pretty good chance they'll reduce the bill to whatever the insurance companies pay (or less, many doctors are charitable if you're uninsured due to economic hardship).
A couple years ago I heard a presentation about the intricacies of healthcare and the Amish. Apparently they (as in the local ones) don't believe in using insurance (no clue about how that'll fly if this bill passes). Instead, they pool their money and pay collectively whenever a member of the colony gets sick (they also use a lot of herbal medicine and don't go to "extremes" to keep people alive). One issue that came up was that they paid 100% of their bills, which was about twice that of what insurance companies paid. It became cheaper for them to pay for someone to drive them to another hospital a couple hours aways. Obviously the local hospital thought this was ridiculous and changed their policy. The problem was that nobody at the hospital really noticed until the Amish stopped showing up.
Don't even get me started on MSNBC. When was the last time you saw a conservative on Olbermann's show?
Ron Paul (a conservative) has been on MSNBC 3 times in the last month. He was on the Rachel Maddow show, Morning Joe, and the Dylan Ratigan show.
There are very few fiscal conservatives around these days. The Republican party mostly abandoned fiscal conservatism back in the 80's, if not earlier.
For every retard elected POTUS or Governor of Alaska, there are millions of retards who cast ballots for them.
Don't blame the elected for the failures of the electorate. You get what you vote for.
When you point your finger at government, there are 3 fingers pointing back at you!
We are the retards we've been waiting for. Hope and retards. Retardation we can believe in! RetardNation.
Mod this post "retarded".
Um. Neither?
I personally think healthcare is one of the few fundamental rights the government should provide. However if the government does not want to provide it then be equal. Take it away from the elderly and the poor or give it to everyone
The US talks about equality but it's time to put up or shut up. Now give it to everyone or take it away from everyone.
and go with a more basic one that has things most everyone can agree on? Insurance sales across state lines (surely a real interstate commerce item)
Nobody agrees on this idea, because it's a rotten idea. Implemented the way it's usually been proposed, what it means is that insurance companies can move to whichever state offers them the sweetest regulatory and tax treatment, i.e., is small and hungry, and willing to rubber-stamp whatever laws the insurance companies propose. Their customers (i.e., residents of other states) don't get to vote on the regulation of those companies, and they don't get to ban them.
Ever wonder why so many credit card companies hail from South Dakota? Because it's a tiny state and they can more or less buy the rules they want. Ever wonder why the credit card industry is so completely unfair to the typical consumer? Same reason.
The fact that this is your number one suggestion, and you think everyone can agree on it, that worries me. I like some of your other ideas, but I definitely don't think we need to hash this out anymore. The plan in Congress is basically the Romney plan which passed in MA several years ago, and has been quite successful. We've been debating the plan for over a year now! It could use lots of tweaking, and I hope once it's passed the Republican party will help with those efforts.
If you don't like the plan, take it to the voters in November. Let's get Congress done with this and move on to other work.
Option A or Option B is how the health care "debate" is being presented. I don't mind a single payer system. I just don't want the Federal government doing it. If your state wants it, fine. However, the polls are clearly showing that health care reform as it is being presented by Congress is NOT wanted by the American people.
'Political power grows out of the barrel of a gun.' - Mao Tse-tung
I disagree. Polls have repeatedly shown that the public is in favor of this sort of bill if a strong public option is included, but opposed if it is not. This is not because they're selfish, but because they don't see the point in having insurance if the insurance company is randomly going to deny treatment anyways.
I thought Americans were already aware - providing publicly subsidized medical treatment of any kind automatically turns the patient into a communist nazi drug-zombie hell bent on feasting upon small, patriotic, human brains.
In my country, I can see any doctor, any time, including specialists, psychologists etc, for free. Totally free. Bulk billing means you never give them anything besides ID. Finally, all prescriptions cost me $5.30. For anything. Even for nicotine replacement therapy drugs.
And do you know the worst thing? Per capita, our economy is absolutely destroying the US's on almost every measure.
You guys need to invade Texas. Impliment "regime change" - knowwhatimean? Ey? Wink wink ;)
I enjoy the claims that universal health care will make doctor's visits like going to the DMV. When I moved states in 2008 I had to go to the DMV to switch my license and registration. There was a convenient online appointment system. When I arrived the staff helped me take care of my business and I was out in about an hour. When we switched healthcare plans this year we had a problem getting a prescription filled. The pharmacy preferred to use a mail-order system but they got our address wrong. In trying to resolve this my wife had difficulty reaching a real person. There was additional difficulty reaching a _competent_ real person. It took about a dozen phone calls and a lot of headaches over several days. So I am actually looking forward to health care becoming more like the DMV.
You say the 20 to 40% is a made up number. That instead they have 3 to 5% profits. Well, maybe on paper that they're reporting. Why is it that the latest health care bill mandates that by 2012 (I think) that Health Insurers must have no more than 15% overhead (85% must go to health care and health improvement programs) including administrative costs and profits. Social Security operates with 2% overhead. So, they're allowing for 13% profit. The insurance companies are screaming like it is the end of the world. Why? Because currently they're yanking down way more in profits. They're hiding the profits in bullshit "Administrative Overhead" (like taking Golf trips to Bangladesh to have sex with underage children). I don't trust this industry as far as I can spit!
Over-the-top Response Guy! Giving "Over-the-Top Responses" since 1970.
The entire first page of references on Google when I search for "Healthcare Tort Costs" say that Tort is not a big factor in the overall costs of Healtchare
Over-the-top Response Guy! Giving "Over-the-Top Responses" since 1970.
Well, it was unconstitutional until they passed the 16th amendment. Unless, of course, one believes that they decided to pass that amendment "for the lulz".
There is a reason that we have an amendment procedure in the Constitution. If we really feel that it should be legal to have the Federal government force people to obtain health insurance, then an amendment is required. I know the 10th amendment isn't popular anymore, but that doesn't mean it is void.
Of course, the Feds could always use coercion (that is popular) to force the states to fall in line. This is what they have done with RealID (threaten states who don't comply with denial of their citizens access to domestic air travel without a passport), or forcing states to increase the minimum drinking age to 21 by threatening to cut off their highway funds:
The Constitution doesn't illegalize coercion. Threatening highway funding is very popular. It's dirty to sidestep the Constitution with coercion, but that's life in the post-Progressive era--government money always comes with coercion. The best way to avoid being coerced is to never accept the money in the first place.
Next thing you know they'll be invading American schools and teaching metric.
.
If you had made any effort to read about the actual bill, you would know. Mainly from a payroll tax expansion, cuts in the Medicaire Advantage program, and a bunch of pilot programs to move us away from a fee for service model. This more then pays for the medicaid expansion and subsidies for employer insurance, which is why the bill ends up cutting the deficit by a massive amount over the first ten years and over 1.2 trillion in the second.
"Why can't they do a simple bill, with some main points everyone can agree on...in about 10 pages of simple language everyone can understand and agree on? Start from there and build on it?"
Legislative language is like coding in assembly. It literally denotes the exact instructions to modify previous laws. Stuff like "Insert article B after clause C in bill X". Because of this, any bill that does...anything, has to be really long if you want to avoid lawsuits and legal ambiguity later. But that has nothing to do with the actual complexity of the bill. It's really simple! I can describe it in a paragraph:
The bill sets up an exchange where companies competitively bid on standardized health insurance plans. The government bans discrimination based on pre-existing conditions, but in order to avoid an insurer death spiral (Prices drive away healthy people which drives prices up which drives away healthy people...), people are mandated to buy insurance. But, the government provides generous subsidies to pay for this insurance. Money to pay for these subsidies is found by slashing the Medicaire advantage program passed by the Bush Administration, a payroll tax expansion on people who make more then $250,000 a year, and a fixed excise tax on extremely generous health-care plans. The government will also begin a bunch of pilot programs on things like bundling and electronic medical records in order to find ways to make health care cheaper. There are also a couple of regulations on health insurance companies that prevent them from raising premiums without cause and a rule saying that administrative expenses can't take up more then 15% of premiums. (This is necessary because due to the fact that pricing power is proportional to size, there are going to be local monopolies or duopolies in most health care markets. Without government, there wouldn't be anything preventing insurers from jacking up premiums once everyone was required to buy insurance). Lastly, some more community health centers will be set up, and there will be a expansion of medicaid to people who make less then 133% of poverty, or $14,000 a year. ((Which actually saves money, because medicaid has the lowest health-care costs of anything in the US outside of the VA). And yes, there is a lot of mal-practice and tort reform and the ability to sell insurance across state lines. (And no, neither of those things are remotely as important as Republicans like to claim)
And that's pretty much it. Actually implementing that is going to take a lot of pages, but any bill would! Laws are like code for the executive to execute, and anything that gives instructions to the entire federal government is going to be complicated. But the actual ideas are quite simple! There really isn't simpler opposing ideas out there sort of single-payer that would accomplish anything of the same scope.
"I'm also concerned about what will happen to what is left of this bill after the SCOTUS challenges to it with regard to the Federal Govt. mandating that individual citizens be required to buy health insurance. "
Doesn't strike me as different from the mandate to buy auto-insurance, and that's been held up a bunch of times. And it's not really a mandate, if you don't have health insurance, you just pay a relatively small fine and still get the right to use emergency rooms. They don't send you to prison or anything. There's a reason no serious legal scholar thinks that it would get struck down...
If I walk into a store and buy a shirt off the rack, it costs a certain amount no matter how I choose to pay (cash, card, whatever). Same for most goods and services.
Health care should be the same. The government should mandate that a given item must cost the same amount no matter how its being paid for. Medicare. Corporate health plan. Individual health plan. Cash payments. Also, ban insurance companies from saying "we will only give benefit if you go to OUR hospital or see OUR doctor". And ban insurance companies from saying that they will give benefit for treatment X but not for treatment Y (even when treatment Y may be a better option or in fact a cheaper option than treatment X). Oh and this applies to drugs, operations, surgery, hospital stays, doctor visits, tests, x-rays/CTs/MRIs/etc, implants, prosthetics, transplants, everything that the health care provider provides.
Change and simplify the tax rules for health care. Every American would be allowed to take up to $x in pre-tax income (the amount would be the same for everyone no matter their actual income) and that amount would be able to be used to buy any health insurance policy anywhere OR to put into a special health savings account that can only be used to pay for health expenses.
The amount would be identical no matter whether you are earning hourly wages, fixed yearly salary, commissions, self-employed, business owner or any other source of income.
Right now many medical tests are done that are likely not necessary due to the risk of lawsuits. Pass whatever laws are required to put an end to these unnecessary tests, if that means medical malpractice reform, so be it.
Make it easier for people to switch providers without penalty. Ban providers from declaring something as a "pre-existing condition" if you have had health coverage for that item in the past year from any provider (Medicare included). They can still stop someone who hasn't had health coverage in years getting hit with something major and signing up for insurance just to get coverage for their sudden injury/illness.
Make it easy for people to choose from any insurance company anywhere in the US. Remove red tape and paperwork required in the running of health insurance and make it easier for new providers to enter the market. Put pressure on the states to remove or reform any state legislation that applies to health care and insurance. Remove any rules governing what insurance companies are allowed to charge, who they are allowed to insure and what they are allowed to give coverage for.
And finally, eliminate the corporate health plan. If all the other stuff is done, it should be possible for people to get insurance on their own without a corporate health plan. With my points about increasing competition, it encourages new players to enter the market that can offer better service (including actually paying decent benefits when people get injured or sick and giving coverage to people who have been rejected in the past due to previous illness which may or may not still be a problem)
No need to force people to get insurance, if the market is opened to competition (anyone who thinks the health system is anything like a free market right now has no clue about economics) it will solve a lot of the problem.
People who cant get insurance right now (the "uninsurable") may be able to get insurance from a new player. Or they could opt for a health savings account instead if they think the amount they could put in (both the allowed pre-tax amount and any extra post-tax amount they can afford to put into it) would be enough to cover health costs in the future.
To cover those unable to afford regular insurance, the government could run a subsidized insurance scheme for these people that provides them coverage. Anyone who can demonstrate a low enough income that they cant afford even the most basic insurance would be eligible.
Also insurance companies would be encouraged to offer coverage for preventative health measures such as regular checkups at a doctor that can pick up health problems BEFORE they turn into major dramas requiring a long stay in hospital.
Rules governing medical malpractice claims are one of a host of factors potentially affecting the delivery and cost of health care services in the United States. Although this analysis provides some evidence of links between tort limits and health care spending, the results are inconsistent and depend on the particular relationships and specifications tested. The mixed results also demonstrate the difficulty of disentan- gling any effects of tort limits from other factors that affect levels of spending for health care. CBO continues to monitor the work of other researchers and conduct its own research on the issue.
Over-the-top Response Guy! Giving "Over-the-Top Responses" since 1970.
Rules governing medical malpractice claims are one of a host of factors potentially affecting the delivery and cost of health care services in the United States. Although this analysis provides some evidence of links between tort limits and health care spending, the results are inconsistent and depend on the particular relationships and specifications tested. The mixed results also demonstrate the difficulty of disentan- gling any effects of tort limits from other factors that affect levels of spending for health care. CBO continues to monitor the work of other researchers and conduct its own research on the issue.
Over-the-top Response Guy! Giving "Over-the-Top Responses" since 1970.
This is absolutely false. I'm unemployed, have diabetes, high blood pressure, and have suffered from disabling back pain for 10 years(the reason I'm unemployed after 30 years in the work force). I currently am getting no medical treatment for any of my health issues.
I'm against this bill for several reasons:
1. We cannot afford this with the shape our economy is in.
2. The true costs of this bill are being hidden behind a veil of lies and deceit.
3. The government here has never administered an entitlement and come in at anywhere near the estimated cost. They have always been far more expensive than what the politicians say the program will cost.
4. We are being told that much of the savings will come from getting rid of the fraud in Medicare and Medicaid. However, if that were true why haven't we gotten rid of the fraud already? We need to create another entitlement, and new huge government bureaucracy, to get rid of the existing fraud? What a raft of crap.
5. $500 million of the "savings" taken from Medicare/Medicaid that is supposed to be used for deficit reduction in the 1st 10 years is money taken from Medicare and then spent elsewhere, not applied to deficit reduction. It's as dishonest as hell to count that money twice and to say it's going to be used as deficit reduction. It's not. So, instead of a $120 billion dollar budget deficit reduction it's $380 billion added to the deficit, and that's before counting all the things in the bill that are supposed to be done later that will never get done as no Congress in the future is going to want to do what this one didn't. Too politically unpopular.
6. This has been the most corrupt political process I've ever seen in my 56 years of life. If it was all it is supposed to be the process would have been above-board and far more transparent.
There's more reasons I'm against this bill, but the above will do for starters. Yeah, I'd love to have health insurance and have my medical issues treated, but not at the expense of bankrupting my country. I'm not that selfish.
"while democracy seeks equality in liberty, socialism seeks equality in restraint and servitude." de Tocqueville
The price of computers has been deflating pretty uniformly for the last 30 years. By your theory, consumers will stop spending when their money is deflating because anything they could buy would cost less later. Again, in your system of economics (Hi, JMK!), it's stupid to have bought a computer at any time, because you could get a better computer just by waiting. And yet, here you are on Slashdot, disproving your own theory at about 3 billion cycles per second.
In the long run, Keynes' theory is dead.
Don't piss off The Angry Economist
In trying to make the point that Tort is not the problem, I used a little hyperbole with respect to insurance profits. My Bad!
Over-the-top Response Guy! Giving "Over-the-Top Responses" since 1970.
How hard is it to immegrate to Australia? My wife and I qualify for Canada but it is really cold there...
Dude, the Republicans already did that. Go look at the changes that were made to our patent laws by the Republicans. Look at the tax laws they passed that makes it cheaper for a company manufacture a product outside the US and import it that to manufacture it in the US. Look at the banking rules they killed off and the collapse of the economy that resulted from their actions. The Republicans, with a little help from a few particularly corrupt Democrats have already done everything you are worried about.
I don't know you and you don't know me. You may well be someone I would enjoy drinking beer with and going shooting or hunting with. My family were ranchers until the great depression. My father wound up working on a crew where he was paid 25 cents a carcass to gut and skin his, and everyone else's, heards. Most of my Uncles were underground coal miners.
But, my father went to college and I went to college. So I guess you would call me a pseudo intellectual college moron. You know what? One advantage of a pubic school education back in the '50s and '60s is that I actually learned the meaning of the word "socialism" and I have enough background in history, logic, and law that I can read the Constitution and understand what it says. I didn't get that in college. I got it in junior high and high school. Since then the Republicans in the state I grew up in have gutted the school system and dumbed down the curriculum to the point that high school graduates are lucky if they can read, let alone understand something as complex as the Constitution.
Yeah, I'm no fan of the modern Republican party. I was one once. But they don't want people who ask questions. They just want people who follow orders.
As far as I can see this is by far the least socialist way a bill like this could be written. And, it is at least as constitutional as social security and Medicare. Both of those have been challenged all the way to the Supreme Court and stood up as constitutional. If it were socialist there would be no health insurance companies left after it was signed into law. But, not only are the health insurance companies being left in place, their stock price is zooming up because they are going get 30 or 40 million new customers. That is not socialism.
Here is the definition of socialism:
Main Entry: socialism
Pronunciation: \s-sh-li-zm\
Function: noun
Date: 1837
1 : any of various economic and political theories advocating collective or governmental ownership and administration of the means of production and distribution of goods
2 a : a system of society or group living in which there is no private property b : a system or condition of society in which the means of production are owned and controlled by the state
3 : a stage of society in Marxist theory transitional between capitalism and communism and distinguished by unequal distribution of goods and pay according to work done
This bill will not result in any government owning the health care industry. Doctors will not be forced to work for the government. Counties like the UK do have socialized medicine. In the UK the government owns the hospitals and clinics and the doctors work for the government, where the government says they will work for a salary set by the government. There is nothing like that in this bill. It is a major change in business regulation, but there doesn't seem to be any "socialism" in it anywhere.
You obviously care about America. I'm glad for that. So many people I meet don't seem to care about anything but themselves. But, you might want to look up words to see if they mean what you think they mean rather than what some radio DJ says they mean.
If I had my way they would just have lowered the age for Medicare down to conception. That would be a good way to go.
By the way, I would much rather be called a "Tax and Spend Democrat" than to be a "Borrow and Spend Republican". At least the Democrats want to pay for their programs. The Republicans just seem to want to borrow and borrow and b
While we need major health care reform, THIS was NOT the way to go. First off, this violates our 4th amendment rights. Let me explain. Our money that we have worked so hard for is our property to spend as we see fit. It is also a MAJOR component to our security. It is, in effect, an essential core component of the 4th amendment. This is an unreasonable seizure of our personal effects and papers, and a violation to our personal security.
Next off, this is nothing more than a thinly-veiled handout to the HI Industry. Requiring us to purchase health insurance "in case something happens" is like requiring us to purchase condoms "in case we have sex.' It's already happened with car insurance. With an adequate universal health care system in place, car insurance wouldn't really be necessary, except to repair the vehicle, not pay for damages done to a human being.
But next thing you know, they'll be passing a law requiring us to buy a car by the time we are a certain age, which of course comes with the prerequisite that you must get insurance for the car - instant handout/bailout to the car/truck and insurance industry.
Don't celebrate your 'victory' too hard, now. Really you're just fooling yourselves.
Still waiting on Serviscope_minor to wake up to fucking reality and realize that Jessica Price isn't going to fuck him.
And after being diagnosed - whats his chances of getting health cover from anyone else?
I know a number of people who have moved out of mainland USA due to being unable to get health insurance due to medical conditions. Fortunately they were able to move to places where social healthcare is provided.
And now, you demonstrate what a simpleton you are. It isn't just some lone mechanic having to buy a new set of wrenches. It is about replacing trillions of dollars worth of machine tools...
This idiot doesn't understand a simple metaphor and calls me a simpleton. That's golden. Anyway, it shows the amazing arrogance of these idiots, that they completely neglect the fact that the entire rest of the world somehow managed to do it, a combined economy that is emphatically much larger than ours. But then, most of the rest of the world isn't so boneheaded that, when they see a much better idea, they deliberately run away from it. There are exceptions, of course--witness Myanmar--but then it's sheer lunacy to sit here declaring, "Yeah, we want to be like them!"
KingSkippus must have skipped history class. Get this buttwipe, Europe and most of the rest of the world had nothing close to the industrial base of the US when they developed the metric system. Then there were a couple of world wars that wiped out a good part of the industrial base they had.
Why is this important to health care? Because it points out cultural, physical and economic realities that you choose to ignore. I say I have perfectly good wrenches and an infrastructure in place to support them. You whine that I should throw out everything I have and move to your standard. IOW, you're a damn fool.
Aah, change is good. -- Rafiki
Yeah, but it ain't easy. -- Simba
I would ask for a reference, but the entire premise is stupid. Not a single person in all of history has ever died of not having insurance. Still, you might want to do some research to discover where that 45000 number came from. Quoting it doesn't do much for your credibility.
Aah, change is good. -- Rafiki
Yeah, but it ain't easy. -- Simba
Not a single person in all of history has ever died of not having insurance.
There's a Anatole-France-like quote somewhere in there.
And, incidentally, you're wrong. They're dying because they lack money. They're dying because they lack health insurance. They're dying because they lack a 30 kilogram bar of gold. They're dying because they lack a winning lottery ticket.
They're dying because of they lack any of those things, they lack anything they could use to pay for their care, and it's perfectly correct to blame their death on any specific lack I want to, because if they had that specific thing, they would not be dying.
Still, you might want to do some research to discover where that 45000 number came from.
I know where that number comes from. It comes from basic statistics. People who don't have health insurance have approximately a 60% higher mortality rate. (And this includes people who voluntarily don't have insurance, aka, they consider themselves healthy.)
You're hoping it came from some sort of subjective 'What did people die from, and could it have been prevented if insured?'. It did not.
It simply looked at people who were insured, and people who were not, and at what rate they died of medical problems. People who are not insured die at a much higher rate, period. It is not some subjective thing, it is not possible to argue with it.
Of course, this is slightly skewed because of rescissions, where insurance companies drop sick people from their rolls, so they become uninsured on the way to dying.
But that's a slightly surreal argument to use. 'They doesn't really count, lack of insurance didn't didn't cause their death, their eminent death causes their lack of insurance. They were going to die anyway, so we thought we'd make them poor as they did so.'
That's one of those 'I couldn't have murdered X, I was busy raping Y at the time' alibis.
If corporations are people, aren't stockholders guilty of slavery?
s/No, I was expecting someone else to pay for it/No, I not was expecting someone else to pay for it/
They're dying because of they lack any of those things, they lack anything they could use to pay for their care, and it's perfectly correct to blame their death on any specific lack I want to, because if they had that specific thing, they would not be dying.
Thank you for displaying your complete inability to put together a cohesive thought, let alone a simple logical statement. People die, because they're sick. The lack of insurance did not cause them to get sick.
If NASA would fly me to the space station when I'm 80, I might be able to live to 83 due to the reduced gravity. NASA not flying me to the space station would not be the cause of me dying at 81. I do NOT have a right to be flown to the space station. I do NOT have a right to a doctor's time. I DO have a right to purchase a doctor's time. I do NOT have a right to force someone else to pay for me to purchase a doctor's time. I DO have a right to invest my resources into purchasing a doctor's time to attend to someone else's health as I see fit.
You think that it is ok to enslave part of the population and force them to work as you see fit. I think you're wrong, disgustingly so, but that's fine. I live in a country where people are allowed to disagree. But that doesn't mean that completely illogical statements must be allowed to pass unchallenged.
Now, if your claim was that "45000 fewer people would die each year if everyone had a doctor's care", your statement would be logical. It would still be completely wrong, but it would at least be logical.
Still, you might want to do some research to discover where that 45000 number came from.
I know where that number comes from. It comes from basic statistics. People who don't have health insurance have approximately a 60% higher mortality rate. (And this includes people who voluntarily don't have insurance, aka, they consider themselves healthy.)
You're hoping it came from some sort of subjective 'What did people die from, and could it have been prevented if insured?'. It did not.
Thank you for reiterating the democratic talking points and displaying your complete lack of knowledge. The number comes from a study conducted by David Himmelstein, M.D. and Steffie Woolhandler, M.D. It was a completely skewed "study", without any sort of proper controls. The study method did not even make sense. Not that you'll look it up and investigate for yourself, and I'll be damned if I spoon feed it to you. The short story is that it wasn't a study, it was propaganda.
Aah, change is good. -- Rafiki
Yeah, but it ain't easy. -- Simba