Side by side comparison of Dem candidates' health care blueprint

[Texarkandy]

Gee, maybe someone should have sent this to Congress when they passed the Patriot Act.

Agreed.

 

[Texarkandy]

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

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

"seriously"

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?

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.

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"

YouTube - The Philosophy of Liberty

 

[Texarkandy]

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)

 

[chinaco]

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

 

[Texarkandy]

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".

 

[ziggy29]

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...

 

[Martha]

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.

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.

 

[Texarkandy]

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.

 

[whitestick]

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.

 

[chinaco]

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.

 

[Texarkandy]

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.

 

[Texarkandy]

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.

 

[Rich_by_the_Bay]

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.

 

[Insanity]

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.

 

[Gumby]

The best "mandate", of course, being a system funded by our taxes.

 

[Texarkandy]

...... and you would have exposed untold hundreds or even thousands of people to contagious tuberculosis.

That's already happening with the rampant illegal immigration into this country from TB ridden parts of the world - so what's one more TB carrier

 

[Texarkandy]

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.

Maybe it's because it's late & I'm tired, but that statement makes no sense to me whatsoever.

 

[Texarkandy]

The best "mandate", of course, being a system funded by our taxes.

That one either.

 

[cute fuzzy bunny]

Last time I checked, you needed insurance on your car to drive it around.

While CA is more liberal with the lack of insurance, MA sent someone over to take your plates if your insurance lapsed.

I'm fine with people who choose not to buy health care insurance. Providing they agree to not seek any health care. If you cant afford a few hundred bucks a month for insurance, you sure as hell cant afford a five figure bill from a doctor or hospital.

I just have a hard time with folks who want to be independent freewheelers until they get a bad cough, then take the express cab to the emergency room with no ability/intention of paying the bill.

By the way, statistically thats a white person thats a US citizen.

 

[Gumby]

That one either.

Try again in the morning. I think you will understand both.

 

[Texarkandy]

So we mandate everyone to buy health insurance (privately or the govt run plan) - what do we do if they don't? Fine them? they're mostly relatively poor and don't pay any taxes anyway - I suppose you could take away their EIC (which is the only reason many even bother to take their W-2 to a preparer to have it filed).

Who is going to enforce these fines? - suppose we'll need a whole new federal bureaucracy just for that - of course they'll have appeal rights - and they will need Administrative Law Judges to decide those cases - and suppose in the end they don't pay the fines? Ya gonna put em in jail? Seize their (financed) Escalade? Deny them treatment next time they show up at the ER?

No, this whole thing about "mandates" is just a scheme to force those of us who are already providing for our own health care through private insurance companies to pay even more to support a new inefficient expensive federal "big government" bureaucracy.

And in the end, the E.R.'s will take care of them the same as now because they are mandated by the Fed Govt to do so.

Now of course we don't want poor people dying in the streets & illegal aliens spreading TB all around - so why don't we just call it what it is for these people (charity) & let the States run a separate federally & state funded "charity" health care system (on the cheap - no semi-private rooms even) for those who cannot provide for themselves - give them accessibility and affordability & if the quality happens to be a little less, so be it -

But leave me & my insurance company out of it.

 

[Texarkandy]

Last time I checked, you needed insurance on your car to drive it around.

You can buy a high quality counterfeit auto insurance card for about $25 bucks from the same vendors (one in every small town and many in cities) who will sell you a counterfeit Resident Alien Card for $50 bucks or somebody else's genuine birth certificate and social security card for about $800

 

[cute fuzzy bunny]

Oh, i'm sorry. I mistook this for a legitimate debate on the issues surrounding health care.

I'll let you get back to whatever the hell it is you're outraged about.

 

[Texarkandy]

Oh, i'm sorry. I mistook this for a legitimate debate on the issues surrounding health care.

I'll let you get back to whatever the hell it is you're outraged about.

Well, I think you mischaracterize me as "outraged" -

disgusted, maybe - but "outraged"?, well, no not really

The point was brought up that we are required to buy insurance for our cars, as if that was a valid rationale for requiring everyone in the US to purchase health care insurance from either the govt or a private insurance company. Buying insurance for your car is a requirement for operating it on govt owned roadways. And there's lots of folks who ignore this requirement (or succesfully circumvent it via fraud insurance cards)

My point is that you can vote for the govt to "mandate" people do things all you want - in the end though, those who don't want to spend their money on it (if they have any) aren't going to - then the govt is put in the position of havng to enforce the "mandates" - thus creating more
govt. (Sorry to burst anyones bubble with the truth about "mandates")

Our system of fed govt (in my opinion) was deliberately designed to have limited powers (things like - natl defense, enforcement of contracts, immigration, regulating interstate commerce, etc) mucking around in the health care business is not one of them and creating a federal "national health care system" is a real stretch of the interstate commerce clause. People forget this (if they ever learned it). If people want a different kind of fed govt - (all-powerful, nanny, full of mandates for the people) they need to pass a new constitution.

(If you only want to "debate" with people who agree with you, that's your choice.)

 

[cute fuzzy bunny]

Eh, I only like debating people who are using actual facts rather than a bunch of anecdotal irritation.

The problem with healthcare is that there is too much profit being drawn out by too many layers of bureaucracy and overhead, that its unaffordable to most, and that people who need it the most cant get it.

The private sector has demonstrated its failure to execute. We spend too much and get too little. By a longshot.