Health Care

[htz31361849782]

Boy it has been awhile since I posted one of these let's see if I remember how to do it. :eyes: It may surprise those of you who know me but I happen to agree with the President that we need health care reform.There is no bill to talk about yet but a Republican on one of the Sunday news shos said he had seen the bill that they will bring to the house floor about 2 weeks after they get back to work.There are however some things the President has said that the bill must have such as a public option. It will probably be paid for by employers either directly or by fine for not offering health care to their employ's. There are a couple of other ways people have purposed as ways to pay for it such as the plan Sen. McCain purposed during last years Presidential race, I haven't heard anyone who thinks that would work with only $5,000 per year for a family since most plans cost $1,000 a month or more. There has been some talk about a tax on the health plans that cost over a certain amount such as $15,000 a year.Which ever way they do it I hope they go slowly and consider the unintended consequences. With the retail industry hurting already if they use the employer mandate you will see many retail employ's loosing thier jobs. Most retailers use part time empoy's to do the daily work in the stores. Let me explain this using myself as an example.As those of you who know me know I worked for 18 years at Toys R Us part time. When I started if you were a full time employee you could get health care if you stayed there for 5 years. So after my first 5 years I got the health insurance, I really didn't use it till I had been there for almost 9 years. At 16 plus years they decided that all part timers would be taken off the health plan unless they worked a minumum of 25 hours and then they didn't give any part timer that many hours. There was a program where you could keep your health care if you paid the cost of having it. The total was more money than I made so I was droped.The full time job I had was a small company and they offered no health paln.If they do the employer mandate and I was still working at these 2 jobs I would loose both jobs most likely.Most retailers as I said use part timers to get the everyday jobs done. If the mandate gose into effect it will cost many if not most of those people working at Toys R Us, Walmart, K-Mart, Sears, Penny's, ect their jobs. You think it's hard to find a clerk at one of these stores now wait till thisst one fith mandate goes into effect.I really wish the President would stop saying that if you like your doctor nothing will change. He cannot guarantee that unless you pay for you health plan and not someone else. Employers may decide to opt out and pay the fine and that would mean you would have to change plans and that could effect if you can keep your doctor.I dislike the public option because the government can operate the program at a loss where the private plans can't do that. After some time it may well be used to swith everything to a single provider by low balling the insurance companies.Would you really want the same people running Medicaid, Medicare, and Social Security to be responsible for almost 20% of the US economy? Those programs are always on the brink of disaster. I would more favor the idea of regulating the insurance industry more. Maybe some more controls on hospitals as well. If any of you have ever been in a hospital and the insurance company sends you that thing where they ask if the hospitals really did everything they charged you for it probably gave you a good laugh how they inflated the bill.Okay anyone got any ideas on how to do this?

[Caer Rialis]

First, the U.S. doesn't have a crisis in health care; it has a crisis in how to pay for health care. now for my answer.

Okay anyone got any ideas on how to do this?

Yes. A single-payer system.



Everything in your examples points to a single-payer system as the solution. What has occurred in each of these cases is a prime example of why health insurance should not be tied to employment. Employers are less and less willing to hire people for full-time employment because then they will have to offer health insurance. That leads to the syndrome of ?Well, if I hire you to work 37.5 hours, you get insurance, so you?re going to only be scheduled for 30 hours.? How is that good for the economy?



Similarly, people find that more and more their insurance provider covers less and less of their healthcare needs. Deductibles are on the rise, co-pays are on the rise, and insurance providers work harder to find reasons to deny coverage. When a woman suffering from breast cancer finds that her insurance won?t cover the treatments because she forgot to mention she was treated for acne as an adolescent, something is horribly, horribly wrong.



But let?s go further. The argument ?it will cost jobs? comes up whenever people talk about increasing the minimum wage, increasing workplace safely, you name it. However, that just ain?t so. When wages are increased, when safety issues are dealt with, there often can be a temporary loss of jobs (more often a loss due to attrition, rather than firings), but after that short period, more people are hired because, when people earn more, they can afford to spend more, which allows people to sell more and make more products.



However, let?s talk abut the jobs lost because the health insurance industry in the U.S. is so archaic and byzantine. People are often fearful of changing jobs because they cannot afford the insurance, or have a pre-existing condition. That means they might find themselves stuck in a dead-end job. Entrepreneurs and would-be small business owners are less likely to quit their jobs (with its employer-provided health care) because they either might not, or cannot, afford the risk of going without insurance for themselves and their families. Shoot, I myself had to check, before we adopted our youngest, to see if my insurance would cover my youngest son because he was born with a condition and would need medical help for it.



Furthermore, look at the savings a single-payer system would offer employers. American automobile manufacturers are struggling these days, and I remember how in the fall, it was expected that the UAW and other unions would have to make more and more concessions to keep GM, Chrysler and Ford afloat. People on Wall Street and financial newspapers railed about the ?overly generous? pensions given to autoworkers. However they ignored the cost of insurance to the Big Three. GM came out with a recent study that demonstrated that it cost $1700 per car cheaper to produce an automobile in Canada than in the U.S. <strong class='bbc'>solely because of healthcare insurance costs</strong>. How many jobs are lost in the U.S. because of these costs?



Now I know that in the U.S. we get all these horror stories about ?healthcare rationing? in Canada, and thousands of Canadians fleeing to the U.S. for healthcare, but, and here?s the kicker, when I read <em class='bbc'>Macleans</em> or the <em class='bbc'>Toronto Globe and Mail</em>, I don?t see loads and loads of Canadians clamoring to bring an American system of health insurance to Canada.

Would you really want the same people running Medicaid, Medicare, and Social Security to be responsible for almost 20% of the US economy? Those programs are always on the brink of disaster.

These programs are not on the brink of disaster because they are run by the government. The financial issues which may arise in Medicare and Social Security arise because the President and the Congress, ever since Ronald Reagan, used the trust funds that had developed to keep the budget deficit lower. Stop this usage, and you?ll fin that Social Security will be fine for years to come and tweak Medicare rules and all will work. Medicaid is largely handled through the states. Similarly, it?s a bon mot to claim that the government can?t do anything right. That just ain?t so. My national parks run smoothly, my roads are pretty well done, the water that comes to my home is clean and disease free, and I trust the way my military keeps me from harm.



And, if you want to go further, the banking industry wasn?t run by the government and it was on the verge of collapse until the government helped it. Enron and WorldCom fell apart, and how many companies have gone belly up. Do we really want private industry, with its failings, to run our health care industry?

[htz31361849782]

But let?s go further. The argument ?it will cost jobs? comes up whenever people talk about increasing the minimum wage, increasing workplace safely, you name it. However, that just ain?t so. When wages are increased, when safety issues are dealt with, there often can be a temporary loss of jobs (more often a loss due to attrition, rather than firings), but after that short period, more people are hired because, when people earn more, they can afford to spend more, which allows people to sell more and make more products.

We are not talking about a dollar an hour increase here we are talking about an increase which amounts to 2-3 times the annual salary of the part time employ's.

Full time hourly employs it might not be as drastic a difference but this is nothing like a dollar an hour increase. This is like comparing apples and oranges.

And, if you want to go further, the banking industry wasn?t run by the government and it was on the verge of collapse until the government helped it. Enron and WorldCom fell apart, and how many companies have gone belly up. Do we really want private industry, with its failings, to run our health care industry?

Truthfully the only people I distrust more than these bussiness men are politicians who will sell this country down the river as long as they benifit from it that applies to both parties by the way

These programs are not on the brink of disaster because they are run by the government. The financial issues which may arise in Medicare and Social Security arise because the President and the Congress, ever since Ronald Reagan, used the trust funds that had developed to keep the budget deficit lower. Stop this usage, and you?ll fin that Social Security will be fine for years to come and tweak Medicare rules and all will work. Medicaid is largely handled through the states. Similarly, it?s a bon mot to claim that the government can?t do anything right. That just ain?t so. My national parks run smoothly, my roads are pretty well done, the water that comes to my home is clean and disease free, and I trust the way my military keeps me from harm

You think that will stop if you do I have a bridge here in Brooklyn and I'm selling cheap.

[Caer Rialis]

I'm going to go one further here

Which ever way they do it I hope they go slowly and consider the unintended consequences.

Going slowly won't work. Going slowly will keep us in the same boat we've been in, when looking at healthcare, for decades. Look at the increase in healthcare premium costs. From 1989 through 2008, healthcare premiums have increased in the double digits for each year, save for 1993 and 1994 when the Clintons tried to reform health care That effort got killed by the insurance lobby. But, let's consider this fact, as testified on Congress by Wendell Potter, a former senior analyst for Cygna

Unless required by state law, insurers often refuse to tell customers how much of their premiums are actually being paid out in claims. A Houston employer could not get that information until the Texas legislature passed a law a few years ago requiring insurers to disclose it. That Houston employer discovered that its insurer was demanding a 22 percent rate increase in 2006 even though it had paid out only 9 percent of the employer's premium dollars for care the year before.

Huh? The rates increased 22% even though they only paid out <strong class='bbc'>9%</strong> of the previous year's dollars for health care???????



No. Forgot going slowly. Going slowly will allow the health insurance industry to offer small little changes which, in the end, will amount to window dressing as they laugh at us.

[j delight1361849785]

I agree with CR, except I'd say we ARE having a health care crisis.How many people are turned away from basic care, die of preventable diseases, do not receive education or follow up on medications and eat crappy food in the land of plenty?We are already paying twice as much as England (for instance) ($7,000 per person per year v. $3,600 pp/py) and yet we are ranked well below many countries one would not expect - we are 37th in the world in indicators for health. Comparitively:We have higher infant death ratesHigher rates of diabetes, heart problems and conditions that result from chronic hunger.We have low vaccination ratesHigh teen pregnancy rates, and the list goes on.How do we address these things? By excluding from coverage (=access to) many of the treatments and basic medications for these conditions.The VA, bless their little souls, and the Medicare system, have been good, and President Johnson was right - if Congress had known how much it would cost, they would never have passed the bill in the first place.Too late for this Congress, but CR is right, we have to change it now. I'd rather have a proven system that is adequately funded and regulated than a proven system that leaves me to the wolves.

[Guest]

As long as you don't do it the Dutch way: introduce a system that was a proven failure in other countries. This proven failure has not so much to do with the system as such, but with the budgeting system between health care suppliers and insurance companies. This system is based on "disease-treatment-units" i.e. all diseases and their treatments are standardized, ignoring the effect that all human bodies are different. Another problem the Dutch health care system is facing is that more and more, not doctors but insurance companies decide what treatments and medicines a patient needs.

[j delight1361849785]

Insurance companies currently decide for us, too, which is teh sux system.And yes, flexibility of treatment has to be a part of it, esp in the U.S. because we all need our special teddy bears and such. LOL

[tsunamy]

Now, I only saw part of the "report" but on 20/20 there was a piece explaining how the only medical procedure that went down in cost was Lasik surgery because insurance doesn't cover it and therefore people shopped for the best price.The argument was that people don't care if they aren't paying for it. Interesting thought ...

[Guest]

Well, that's true. The goal of health care, however, should not be to offer the cheapest possible health care, but the best.

[htz31361849782]

Thing is we always pay for it or at least our insurance dose if we don't but we do pay for that insurance.

[Caer Rialis]

How do we address these things? By excluding from coverage (=access to) many of the treatments and basic medications for these conditions.

That's precisely what I mean. If we disagree, JD, its over semantics.

Now, I only saw part of the "report" but on 20/20 there was a piece explaining how the only medical procedure that went down in cost was Lasik surgery because insurance doesn't cover it and therefore people shopped for the best price.

The argument was that people don't care if they aren't paying for it. Interesting thought ...

Was that a John Stoessel report? I'm always careful with his reports, not because he is a free enterprise libertarian, but more because he has been known to doctor up his reports in less than ethical ways. Amazing he still has a job while Dan Rather was sent packing.

You could argue that insurance has been a bane for us all. That if there were no medical insurance, there would be lower prices for health care over all. You also would more than likely find people who didn't receive adequate care because they couldn't afford it, see more epidemics ravage the country, and watch more people declare bankrupcy because, once some catastrophic illness or cancer sets in, they simply can't afford even a "lower cost due to market principles".

You have to remember, health care in the U.S. has been provided by employers since the 1950s. Because the U.S. infrastructure wasn't completely demolished byt eh Second World War, the route of having the government take a greater role in health care and/or health insurance never really took hold. Instead, in order to keep wage increases down employers offered their employees health care, which, as prices were low and employers, like many today, were self-insured, actually made profits for the employer. however, once the grubby little hands of the insurance industry really gained strength in the 1980s, that all shifted.

Thing is we always pay for it or at least our insurance dose if we don't but we do pay for that insurance.

Those of us who can, or who can afford it. Those who can't get told by <a class='bbc_url' href='http://www.youtube.com/watch?v=gPrYviZtVrs'>representatives</a> from Kansas to become adults and pay for it ourselves.

[htz31361849782]

I heard a very interesting suggestion about the public option tonight.That the public option only be made available to those who currently are not insured or to people who work for small companies. Now of course you would need to add a clause ending the limitations in say five years to be reviewed or something that may be shorter or longer length of time.Also there will have to be a mandate that everyone gets a health plan or the whole thing will turn out to be a waste of time and money. There are 48 million with no insurance and about 9-10 millionof those could have insurance they choose not to have it. That will have to change no matter what the number is.Cr I know we aren't going to agree on this but I think this is a good idea over all.

[Caer Rialis]

I would not go for that plan for a public option unless its for ten years, not five. A five year window is really not enough time to see if the program is working. I'd far rather have a single-payer system. The costs of health care are not, as some would have you believe, driven by out-of-control lawsuits or overweight Americans, or, in one of Rush Limbaugh's more ridiculous statements, people who keep themselves physically fit, but by an insurance industry driven to maximize profits It's as if insurance executives honestly believe that not only should profits go up each year, they should go up at least in the double digitis each year. Case in point, Columbia HCA, while run by Rick Scott, the founder of Conservatives for Patients Rights, saw its profits increase 450% over a five-year period. Somehow something seems wrong there.This 450%, by the way, was not connected to the 1.7 billion in Medicare Fraud from ColumbiaHCA under Mr. Scott, either.

[j delight1361849785]

<blockquote class='ipsBlockquote' >How do we address these things? By excluding from coverage (=access to) many of the treatments and basic medications for these conditions.

That's precisely what I mean. If we disagree, JD, its over semantics.





</blockquote> Definitely not in disagreement at all.

[Guest]

I heard a very interesting suggestion about the public option tonight.



That the public option only be made available to those who currently are not insured or to people who work for small companies. Now of course you would need to add a clause ending the limitations in say five years to be reviewed or something that may be shorter or longer length of time.



Also there will have to be a mandate that everyone gets a health plan or the whole thing will turn out to be a waste of time and money. There are 48 million with no insurance and about 9-10 millionof those could have insurance they choose not to have it. That will have to change no matter what the number is.



Cr I know we aren't going to agree on this but I think this is a good idea over all.

That's pretty much the system we had here for a long time (and still have in other European countries). The drawback of that is that you get two-tier health care, where care providers look whether you are privately or publicly insured, and give better care to those who are privately insured. Also, we do have mandatory health care insurance, and I think that's a good thing.



The problem with insurance companies determining costs in health care is that it is not directly in their best interest to give the best care, just the most efficient care. The idea is that those two things amount to the same, but there are some factors, such as the quality of life, that cannot be expressed monetarily. The problem with having health care being determined by doctors is that they can be susceptible to pressure from the pharmaceutical industry (and boy do they try!). The trick is to find a system that is dominated by some stakeholder whose interest is to provide good <em class='bbc'>and</em> efficient health care.

The costs of health care are not, as some would have you believe, driven by out-of-control lawsuits or overweight Americans, or, in one of Rush Limbaugh's more ridiculous statements, people who keep themselves physically fit, but by an insurance industry driven to maximize profits

That, but I suspect it also has to do with insuring things that we can afford to pay for ourselves. A hospital stay cannot be paid for by most of us. A one time set of prescription drugs should be no issue, though.

[Caer Rialis]

A one time set of prescription drugs should be no issue, though.

Correct, especially if it is over-the-counter or a generic drug. Some drug prices are out of this world and, in the US, current agreements do not allow the federal government to negotiate a greater than 2% discount with the pharmaceutical companies

[htz31361849782]

I would not go for that plan for a public option unless its for ten years, not five. A five year window is really not enough time to see if the program is working. I'd far rather have a single-payer system.

The costs of health care are not, as some would have you believe, driven by out-of-control lawsuits or overweight Americans, or, in one of Rush Limbaugh's more ridiculous statements, people who keep themselves physically fit, but by an insurance industry driven to maximize profits It's as if insurance executives honestly believe that not only should profits go up each year, they should go up at least in the double digitis each year. Case in point, Columbia HCA, while run by Rick Scott, the founder of Conservatives for Patients Rights, saw its profits increase 450% over a five-year period. Somehow something seems wrong there.

This 450%, by the way, was not connected to the 1.7 billion in Medicare Fraud from ColumbiaHCA under Mr. Scott, either.

The length of time would be one of the things to be negotiated.

[j delight1361849785]

I really resent the assumption that those who don't have insurance or are "whining" about the cost are lazy or make bad lifestyle choices.I don't understand why people who have long-term, genetically-based diseases who can benefit most by early intervention are considered "uninsurable." MS, rheumatoid arthritis and some forms of type II diabetes all fall in that category. I heard one guy at a public forum tell those without insurance to get up off the couch and get a job.Heartless bastard.

[tsunamy]

I really resent the assumption that those who don't have insurance or are "whining" about the cost are lazy or make bad lifestyle choices.

I don't understand why people who have long-term, genetically-based diseases who can benefit most by early intervention are considered "uninsurable." MS, rheumatoid arthritis and some forms of type II diabetes all fall in that category.

I heard one guy at a public forum tell those without insurance to get up off the couch and get a job.

Heartless bastard.

To jump in here JD, I think what you're arguing and what that guy was saying are two different things.

You're citing specific things that need to be changed ... such as people no being deemed uninsurable. He was referring to those not working and living off food stamps. They are radically different things.

[Caer Rialis]

To jump in here JD, I think what you're arguing and what that guy was saying are two different things.

You're citing specific things that need to be changed ... such as people no being deemed uninsurable. He was referring to those not working and living off food stamps. They are radically different things.

Of course they are. However, in the eyes of many on the right, any calls for universal coverage are interferring with the market and only those who want something for nothing are calling for universal coverage. They're wrong, but it's never stopped the group who think Obama's a socialist before.

[htz31361849782]

Well not everyone on the right disagrees with universal coverage. I consider my self a member of the right yet I have stated here I am for universal coverage.

[j delight1361849785]

<blockquote class='ipsBlockquote' > I really resent the assumption that those who don't have insurance or are "whining" about the cost are lazy or make bad lifestyle choices.

I don't understand why people who have long-term, genetically-based diseases who can benefit most by early intervention are considered "uninsurable." MS, rheumatoid arthritis and some forms of type II diabetes all fall in that category.

I heard one guy at a public forum tell those without insurance to get up off the couch and get a job.

Heartless bastard.

To jump in here JD, I think what you're arguing and what that guy was saying are two different things.

You're citing specific things that need to be changed ... such as people no being deemed uninsurable. He was referring to those not working and living off food stamps. They are radically different things.
</blockquote> LOL Actually Tsunami, the guy I'm talking about was responding to a woman who had just spoken up for those who have pre-existing conditions and those who are "not insurable." The insurance you can buy, if any at all, is extremely expensive, and not because of any condition they had control over.

The man stood right up, pointed at her and told her that those people should "get up off the couch and get a job, and quit expecting the government to give them things."

To me that is cruel and makes no logical sense.

To be fair, though, I thought the guy who shouted something like, "Get the government out of my Medicare!" was worse. LOLOL

[tsunamy]

<blockquote class='ipsBlockquote' > <blockquote class='ipsBlockquote' > I really resent the assumption that those who don't have insurance or are "whining" about the cost are lazy or make bad lifestyle choices.

I don't understand why people who have long-term, genetically-based diseases who can benefit most by early intervention are considered "uninsurable." MS, rheumatoid arthritis and some forms of type II diabetes all fall in that category.

I heard one guy at a public forum tell those without insurance to get up off the couch and get a job.

Heartless bastard.

To jump in here JD, I think what you're arguing and what that guy was saying are two different things.

You're citing specific things that need to be changed ... such as people no being deemed uninsurable. He was referring to those not working and living off food stamps. They are radically different things.
</blockquote>LOL Actually Tsunami, the guy I'm talking about was responding to a woman who had just spoken up for those who have pre-existing conditions and those who are "not insurable." The insurance you can buy, if any at all, is extremely expensive, and not because of any condition they had control over.

The man stood right up, pointed at her and told her that those people should "get up off the couch and get a job, and quit expecting the government to give them things."

To me that is cruel and makes no logical sense.

To be fair, though, I thought the guy who shouted something like, "Get the government out of my Medicare!" was worse. LOLOL
</blockquote> See, this is the problem when people speak without actually understanding all of the issues.

And it's amazing how FOX News and MSNBC ... and even CNN ... allow people to think such action is not only tolerable, but desirable.

And "get the government out of my medicare" ... oy vey. where to begin. :blink:

[j delight1361849785]

I would probably have never heard that remark, but for Jon Stewart. Youtube the video of that show -- he really exposed the idiocy when it began."I'm afraid of Obama!" is not a legitimate question on health care, or any issue for that fact.LOL