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Old 02-23-2008, 12:55 PM   #21
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COBRA was $800/mo, with about half the benefits we had while working.
This does not make sense. By ERISA law COBRA must be identical to the Plan that is offered to those who continue to work for the firm. The cost can be as high as 102%, but many employers only charge 100% of the actual employer cost and waive the 2% admin. fee.
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Old 02-23-2008, 05:29 PM   #22
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One thing I did not see in this summary is Clinton's statement that she would look to garnish the wages of those who do not purchase the mandated health care insurance. At a certain income level, the choice may well be between eating this month or having health insurance. That is a choice people should not be required to make.

My own choice would be to eliminate health insurance entirely and go to a single government payer, tax funded system. No matter how ethical, insurance companies exist to make a profit. Thus every dollar put into the system does not result in a dollar's worth of health care. Some is siphoned off to pay the shareholders.
Personally, I am philosophically opposed to garnishment (confiscation) of a citizen's wages for ANY reason whatsoever.

And, as much as I am against a "single government payer, tax funded system", I think I would be less opposed to that than I am to the Hilary mandating I buy health insurance & garnishing my wages if I don't. Besides, what if one doesn't have any wages - will she garnish their investment earnings?

I think Hilary has as much as admitted that her health care "solutions" are only first steps to get us on the road to nationalized (govt run) health care anyway.
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Old 02-23-2008, 08:58 PM   #23
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Texarkandy,

While I agree that in general that the individual should be responsible for their lives, there are critical services such as fire and police protection that seem to be better managed by the having a governmental entity tax the population to pay for their service in a non-profit manner.

Regardless of what we think, it seems clear that our current health care system is seriously flawed given that US health care performance measured in life expectancy, infant mortality, etc is at or near the bottom of all developed countries while our health care costs are near the top.

Conclusion - the current US health care system is inferior to systems of most other developed countries. The obvious thing to do is to review best practices and incorporate them into our system. We can't do much worse than what we are doing now.
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Old 02-23-2008, 09:18 PM   #24
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Texarkandy,

While I agree that in general that the individual should be responsible for their lives, there are critical services such as fire and police protection that seem to be better managed by the having a governmental entity tax the population to pay for their service in a non-profit manner.

Regardless of what we think, it seems clear that our current health care system is seriously flawed given that US health care performance measured in life expectancy, infant mortality, etc is at or near the bottom of all developed countries while our health care costs are near the top.

Conclusion - the current US health care system is inferior to systems of most other developed countries. The obvious thing to do is to review best practices and incorporate them into our system. We can't do much worse than what we are doing now.
I have a problem with this concept when those "best practices" of other countries infringe upon our uniquely American ideas of limited government, individual liberty, & personal responsibility -

As to the "social safety net" - I can only remark that:

"Those who would give up Essential Liberty to purchase a little Temporary Safety, deserve neither Liberty nor Safety. " B. Franklin
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Old 02-23-2008, 09:24 PM   #25
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"Those who would give up Essential Liberty to purchase a little Temporary Safety, deserve neither Liberty nor Safety. " B. Franklin
Gee, maybe someone should have sent this to Congress when they passed the Patriot Act.
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Old 02-23-2008, 09:28 PM   #26
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Gee, maybe someone should have sent this to Congress when they passed the Patriot Act.
Agreed.
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Old 02-23-2008, 09:31 PM   #27
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Texarkandy,

While I agree that in general that the individual should be responsible for their lives, there are critical services such as fire and police protection that seem to be better managed by the having a governmental entity tax the population to pay for their service in a non-profit manner.
I note 99% of police & fire protection is local - not federal

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Regardless of what we think, it seems clear that our current health care system is seriously flawed
"seriously"

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given that US health care performance measured in life expectancy, infant mortality, etc is at or near the bottom of all developed countries
And you ascribe those facts more to health care than to lifestyle?

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while our health care costs are near the top.
& could some of that conclusion be flawed by the apples-to-oranges effect of trying to compare costs in a more capitalistic system to those in more socialistic ones? It would be cheaper for the nation if everyone drove a Yugo - let's have the fed gov make us all buy Yugo's. On the other hand, how about Volvo's if everyone drove those we would be safer in an accident & it would thus help keep health care costs down.

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Conclusion - the current US health care system is inferior to systems of most other developed countries. The obvious thing to do is to review best practices and incorporate them into our system. We can't do much worse than what we are doing now.
Can't say I can agree with your conclusion at all - while there are flaws & inequities, I don't think I would go so far as to say things are horrible or the sky is falling & we therefore need big brother to come in and save us from ourselves.

The difference in that kind of thinking & mine (& some others) is that, while I agree we could always stand to improve our health care system & the federal government can assist in that in certain limited ways, I don't believe it's the federal government's job to try & fix it by taking (confiscating) people's money & redistributing it for them - or forcing them to spend their money on things for themselves they don't want.

When I want to subsidize other people's health care - I give to the Shriners.

How about a government mandate everyone has to buy a TV & subscribe to cable because it's "good for them" if everyone would only watch Obama's "inspiring" speeches.

"The solution is for people to stop asking government officials to initiate force on their behalf"

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Old 02-23-2008, 09:42 PM   #28
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But - to get back to the original subject of the this thread - I just read where Obama's plan does not require citizens to purchase health insurance for themselves, but does require them to purchase health care for any children they have.

(whose kids are they anyway? And whose money is it?)

(At least here in Texas, we still have enough liberty the government can't make you send your kid to school if you don't want to)
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Old 02-24-2008, 02:47 AM   #29
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But - to get back to the original subject of the this thread - I just read where Obama's plan does not require citizens to purchase health insurance for themselves, but does require them to purchase health care for any children they have.

(whose kids are they anyway? And whose money is it?)

(At least here in Texas, we still have enough liberty the government can't make you send your kid to school if you don't want to)
I read your posts. It is easy to misread... But I am thinking your message is leave me alone big govt I do not want you making my decisions or intervening in my life. Kinda libertarian.

I think we all have a little of that sentiment. At some level, I think we all have some degree of common ground.

On wage garnishment and Health Care... Unfortunately, some people game the system. The garnishment is forced participation. It is just not called a tax. The government would be better off instituting a sales tax...

One basic issue about health care that I think some people miss. Health care is being rendered for everyone in the country. What may be left out for certain people is early treatment because they cannot afford it. But you can be sure that when a person has a serious or major problem, they wind up in the emergency room (the doctors office for some). Guess who pays. We pay. How... through cost shifting and higher prices. The hospital covers the expense by charging you or the insurance company more. Why, because the hospital (even a non-profit) has to pay for wages, equipment, medical supplies, etc. It is part of the inflation of overall medical costs... and not a trivial component of it.

There are no really great answers from an individuals point of view. From a collective point of view, there is a system that will strike a reasonable middle ground
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Old 02-24-2008, 07:41 AM   #30
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Not too sure the "history" of this - but I recall when I was a youngster (not that long ago) the poor folks went to the "county clinic" for routine health care, and if they needed something major like an operation they went to the "state hospital".

I'm actually O.K. with the State funding a certain minimal level of healthcare for those who absolutely can't afford it as a matter of charity & the "public good" (and not having people dying in the streets, of course) - perhaps "county clinics" and "state hospitals" staffed by a voluntary National Health Care for the Poor Service that subsidizes training, education, or payback of loans taken for medical education as incentive for staff to enlist for a few years.

- just don't force me & everyone else into it if we (with the assistance of our insurance which we pay dearly for) can get our health care on the private market.

- and I don't think those people getting their health care on the public dime should have the same level of "choice" or "comfort" in their health care as those of us who are paying for it if there are cheaper alternative facilities/treatments they could use.

I note we can somehow manage to provide free lawyers for the poor - in the federal system lawyers are pretty much drafted from the local bar to do a certain amount of "pro-bono" work (a condition of admittance to the local federal bar) - and there's always the Federal Public Defender's Office - perhaps some of our higher paid medical specialists (Neurologists and Anesthesiologists for example) would be a little more motivated to do more pro-bono work if they got a tax deduction for their time & insulation from malpractice suit for that type work with the "state hospital"/"county clinic".
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Old 02-24-2008, 07:55 AM   #31
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I note we can somehow manage to provide free lawyers for the poor.
Well, there aren't many doctors in Congress, so they feel no need to pass "full employment for our profession" laws.

Lawyers, on the other hand...
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Old 02-24-2008, 08:08 AM   #32
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Not too sure the "history" of this - but I recall when I was a youngster (not that long ago) the poor folks went to the "county clinic" for routine health care, and if they needed something major like an operation they went to the "state hospital".
Mississippi had a system something like that with charity hospitals. The shortage of money led to substandard care.



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I note we can somehow manage to provide free lawyers for the poor - in the federal system lawyers are pretty much drafted from the local bar to do a certain amount of "pro-bono" work (a condition of admittance to the local federal bar) - and there's always the Federal Public Defender's Office - perhaps some of our higher paid medical specialists (Neurologists and Anesthesiologists for example) would be a little more motivated to do more pro-bono work if they got a tax deduction for their time & insulation from malpractice suit for that type work with the "state hospital"/"county clinic".
As a lawyer I did plenty of pro bono work. There always was more work then lawyers available. I think it would be even much worse in the medical system. After all, legal jams are much more rare than the need for medical care.
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Old 02-24-2008, 07:25 PM   #33
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Mississippi had a system something like that with charity hospitals. The shortage of money led to substandard care.
"substandard" is a relative term -

what an American might consider "substandard" someone in a different part of the world might think is just the cats-meow.
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Old 02-25-2008, 12:43 AM   #34
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Maybe I'm missing something here, but, in all of the plans, they seem to believe that by spending a few billion per year on Health IT (3-10b), they will generate 77 to 162 billion per year in savings. Does that pass the sniff test for you? If that were true, why hasn't that already been included in the spending/budget plans? The Federal Govt. especially has not been noted for accurately estimating, nor successful implementations of, IT projects anyway, so basing such a large portion of the yearly savings on this doesn't fit well with my acceptance of a viable plan.
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Old 02-25-2008, 03:52 AM   #35
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Maybe I'm missing something here, but, in all of the plans, they seem to believe that by spending a few billion per year on Health IT (3-10b), they will generate 77 to 162 billion per year in savings. Does that pass the sniff test for you? If that were true, why hasn't that already been included in the spending/budget plans? The Federal Govt. especially has not been noted for accurately estimating, nor successful implementations of, IT projects anyway, so basing such a large portion of the yearly savings on this doesn't fit well with my acceptance of a viable plan.
Better IT will help... but that is only part of it. Certainly administrative costs are soaring.

Some say that the highly fragmented delivery system is inefficient (many small independent health care suppliers). A larger consolidated implementation would benefit from economies of scale.

IMHO - Medicaid should be overhauled and expanded to enable the working poor to buy-in. And it should be HMO style implementations using private providers such as Kaiser Permanente, Humana, etc to provide the care.

Medicare is similar to the private insurance model. I think most people wold prefer choice. Since people covered under Medicare are paying for the services, that choice should be available. But it is likely that the HMO-style of care may be the only affordable option for many medicare recipients also. Medicare offer HMOs. I suspect that many will take advantage of it to reduce costs in the coming years.

The area that is not being addressed is LTC. The last few years of life is the most costly.
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Old 02-25-2008, 06:53 AM   #36
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IMHO - Medicaid should be overhauled and expanded to enable the working poor to buy-in. And it should be HMO style implementations using private providers such as Kaiser Permanente, Humana, etc to provide the care.
Believe it or not - this is a compromise my libertarian self could potentially go along with - just leave those of us who don't want to participate out of it. No mandates! on individual citizens. It could probably be funded out of the monies we spend intervening in the affairs of other countries.

Agree also with HMO's for the poor. Personally, I won't choose an HMO again (had Kaiser once) - but then again, I & my employer pay for my health insurance. were my circumstances to change & I had to go on the public dole I wouldn't complain about the plan being HMO - I would just be happy to have it for me &my family & grateful that everyone else was subsidizing it for me.
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Old 02-25-2008, 06:58 AM   #37
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Mississippi had a system something like that with charity hospitals.
Who knew Mississippi was so progressive even way back then.

I've heard Oprah grew up poor in Kosciusko - she looks plenty healthy.
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Old 02-27-2008, 02:20 PM   #38
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Late to the thread, I didn't see reference to this site which I had posted a couple of months ago. It's a side-by-side put together by the Kaiser Foundation (not the Kaiser HMO); generally highly regarded for objectivity and research.
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Old 02-27-2008, 03:50 PM   #39
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Believe it or not - this is a compromise my libertarian self could potentially go along with - just leave those of us who don't want to participate out of it. No mandates! on individual citizens.
And what happens when you have persistent congestion and a cough? Without treatment that could perhaps develop into a lack of energy, wheezing, coughing up blood . . . then you'd wind up in the emergency room somewhere, the taxpayers would wind up having to pay for your care, and you would have exposed untold hundreds or even thousands of people to contagious tuberculosis.

No mandates work really well until the taxpayers wind up not only having to pay your bill, but get sick themselves and have to pay for healthcare for themselves as well.
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Old 02-27-2008, 05:01 PM   #40
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The best "mandate", of course, being a system funded by our taxes.
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