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Old 07-23-2009, 12:42 PM   #21
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A wonderful program. I got a job through CETA.
Comments like this concern me. Now, I don't know the numbers so this is just hypothetical, but it is relevant to the health care debate.

Just because a program benefited someone or some group, does not mean that that program is a good idea. We live in a democracy, and we need to ask if the program was good for the nation (and maybe CETA was). We need to look at how much was put in, how much we got out, and also consider if alternatives would have provided a better bang for the buck.

As a parallel, I'm sure a sugar producer would say that sugar subsidies are a "wonderful program", but are they good for the nation?

I've posted enough on this topic, I should probably take a little break... so rather than comment point-by-point on some of the recent posts (and I support many of the comments) I'll just say again that I wish we had some documents like that one about the energy sustainability without the hot air. We can go back and forth on individual issues, but it is pretty meaningless w/o a real big picture view. What % of our current costs go to supporting illegal immigrants, what % of our costs goes to internal medical technology funding that helps subsidize other country's health care, what % of our costs could be reduced by more preventative care to poor people (and what % would utilize it?), etc, etc, etc?

W.O more hard numbers, I feel like so much of this goes in circles. And the emotional aspect of something that can totally turn around our lives makes it that much harder to get to the numbers.

The more I think about that, the more I think that Congress is NOT the place to deal with the details. Set up a voucher system, get some group like that MedPac to define terms and basic coverage options, and let the system work outside of Congress. Something like that.


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Old 07-23-2009, 01:22 PM   #22
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Originally Posted by ERD50 View Post
Comments like this concern me. Now, I don't know the numbers so this is just hypothetical, but it is relevant to the health care debate.

Just because a program benefited someone or some group, does not mean that that program is a good idea. We live in a democracy, and we need to ask if the program was good for the nation (and maybe CETA was). We need to look at how much was put in, how much we got out, and also consider if alternatives would have provided a better bang for the buck.

As a parallel, I'm sure a sugar producer would say that sugar subsidies are a "wonderful program", but are they good for the nation?

I've posted enough on this topic, I should probably take a little break... so rather than comment point-by-point on some of the recent posts (and I support many of the comments) I'll just say again that I wish we had some documents like that one about the energy sustainability without the hot air. We can go back and forth on individual issues, but it is pretty meaningless w/o a real big picture view. What % of our current costs go to supporting illegal immigrants, what % of our costs goes to internal medical technology funding that helps subsidize other country's health care, what % of our costs could be reduced by more preventative care to poor people (and what % would utilize it?), etc, etc, etc?

W.O more hard numbers, I feel like so much of this goes in circles. And the emotional aspect of something that can totally turn around our lives makes it that much harder to get to the numbers.

The more I think about that, the more I think that Congress is NOT the place to deal with the details. Set up a voucher system, get some group like that MedPac to define terms and basic coverage options, and let the system work outside of Congress. Something like that.


-ERD50
I figured it would be too far off topic to give lots of facts and figures about CETA.

You are not going to get all the hard numbers on health care because the GAO can't figure out some of the savings. For example, it has said that it can not look into savings from best practices and eliminating redundancies.

A lot of the answers regarding costs (in contrast to savings) can be found. I have read several books and many studies. This place is not the place where you can talk about all of them. But it may be surprising all that we do know.

As I have said many times, we can get our arms around some of the savings by comparing different parts of the country and why some areas and some providers cost a lot less with as good or better outcomes. We also know that there will be savings to offset cost that we all bear through higher insurance premiums which go to pay for uncompensated costs that providers end up eating.

One big problem still remains the high admin costs we have as compared to other countries, resulting from the fact that we have too many reimbursement plans and every state with their own plan regulations. Even if we keep insurance companies I would like to see this attacked through some kind of standardization. Thirty one percent admin costs is a big area to save money.

One thing that is intriguing me more and more is changing reimbursement for medicare and medicaid to move the emphasis off of procedures and more on prevention and best practices. This could end up being a model for insurance companies to follow in the future, which could save costs (by eliminating unecessary procedures and focusing on prevention) and improve outcomes. I think that specialists will have to take a hit, which is going to be tough, and I think that primary care providers should be paid more and be more of a gatekeeper, especially for the elderly.

My sister is in California, in HMO land. She has a number of health problems due to life threatening asthma. She recently had pneumonia. She can stay in touch with her doc through email. It is very efficient for the both of them to communicate that way to make sure that day by day she is doing fine and can stay out of the hospital. They can only do that because of the way her doctor is compensated. I have asthma as well. The only way my doctor gets paid is through visits. She will not get reimbursed for phone calls and email is not an option. When I get sick due I have to make more visits to the doc which ends up more costly.

My doctor has gone to electronic records. It has been a bit frustrating for her as it slows her down as she imputs data, but it is growing on her. I recently had my physical. Her computer program would prompt her to be sure that she asked certain questions and checked certain boxes. It reduces her risk of error. Plus, she could press a button to print out prescriptions, which are now legible, and sign them on the spot.

A few years ago I had an accident where a huge container of sand fell on my hands. My hands were badly bruised and swollen. I went to the doctor. She said that compression injuries such as that rarely had broken bones. I said I was a piano player and wanted to make sure so she did an x-ray anyway. All was fine. That probably was unnecessary care in retrospect. Maybe I should not have been able to get the x-ray. Unless I was Van Cliburn. But it is tough on doctors, who likely do not want to spend a good part of the day arguing with patients.


I tell these stories as just a small examples of how we can make delivery of heath care more efficient. Government can do that through the medicare and medicaid system now.
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Old 07-23-2009, 03:15 PM   #23
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I tell these stories as just a small examples of how we can make delivery of heath care more efficient.
Well, I'll keep it short (that's almost like taking a break )...

I totally agree that there are many opportunities to make delivery of health care more efficient.

I'm far less certain that we can rely on the govt to deliver those efficiencies. That's one reason I offer the option of doing the cost savings first, then apply that to expanded coverage. By August 2013, we ought to have considerable savings.


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Government can do that through the medicare and medicaid system now.
OK, go. And it begs the question, why haven't they done them already?

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Old 07-23-2009, 03:29 PM   #24
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If these "reforms" are so good, why has congress exempted themselves from them??

Just more "do as I say, not as I do politics."

Leave me out of it too.
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Old 07-23-2009, 03:46 PM   #25
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Well, I'll keep it short (that's almost like taking a break )...

I totally agree that there are many opportunities to make delivery of health care more efficient.

I'm far less certain that we can rely on the govt to deliver those efficiencies. That's one reason I offer the option of doing the cost savings first, then apply that to expanded coverage. By August 2013, we ought to have considerable savings.




OK, go. And it begs the question, why haven't they done them already?

-ERD50
Inertia. Lobbies. Fear.

Certainly the private system has done next to nothing to reduce costs and build in efficiencies.
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Old 07-23-2009, 07:16 PM   #26
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After reading portions of the bill, it is very lacking. I don't see where I will save any money and in fact will pay more for health care. A perfect example. The DW had a surgery a few years ago. My total cost for the surgery plus care immediately before and after was about $350. Due to how the prices of the insurance is dictated under the bill it appears the cost of insurance will go up. The companies will not use the cheapest cost as their basis they will use the most expensive cost and cut it in half. The companies must pay back all money over the medical loss ratio. Nobody currently knows what that is or how to figure it. A person appointed after the bill is passed will figure that out. With those few points I can make a few assumptions. The three minimum standard levels will be all that are offered. Charging more for a policy that offers a simple co-pay or other benefits over paying a percentage wouldn't make much sense. The best the insurance company can hope for is to break even and that is figured on a yearly basis. So if the company loses money this year they can't make it up next year. With that stated comparing the two policies resulted in the DW having the premium plus plan. This plan limits her payout for health care to 5% of the bill up to $10,000 per year. The cost of the DW's surgery to me under this bill would have been over $3000. We could not afford that at the time and most likely would not be able to afford it now, even though we are considered middle class.

The most recent numbers I've seen are we have 13 million illegal aliens in this country most, if not all don't have insurance. There are many people who made a conscious decision to not have health insurance, I'm guessing somewhere between 5-10 million. there are the few people who qualify for Medicaid or Medicare, but have not for whatever reason signed up for it, I'm guessing about 1 million. So in total there are between 19 and 24 million without health insurance. In 2007 there were only 45 million people total without health insurance so we are going to spend a boat load of money to insure between 21 and 26 million people. Actually less, because many people probably won't sign up for this health insurance either.
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Old 08-05-2009, 12:14 AM   #27
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From the WSJ: Obama Advisers Set Groundwork to Raise Taxes on Middle Class - WSJ.com


So waiting in the wings is the biggest middle-class tax increase of them all: a European-style value added tax, or VAT. This tax would apply to every level of production or service, and it is beloved by politicians in Europe because it raises so much money so easily without voters noticing. Ezekiel Emanuel, a White House aide and brother of Chief of Staff Rahm Emanuel, has advocated a 10% VAT to finance national health care. Look for a VAT to be one of the prominent options when Mr. Obama’s tax reform commission issues its report later this year.
The undeniable reality is that you can’t run a European-style welfare-entitlement state without European-style levels of taxation on the middle class (and eventually without low European-style growth and high jobless rates). It’s looking more and more like Mr. Obama’s no-middle-class-tax pledge was one of the greatest confidence tricks in American political history.
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Old 08-09-2009, 12:10 AM   #28
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There is great confusion here because no one understands what is being discussed here. If you think that any one in Washington is concerned about your personal well being or "Health care" Try this little experiment Write to your representative , Senators and your President. Pose this simple question to each of them. I am ill and need money for my medicine. Please send me some of your personal money. I don't want the money that has been taken through taxes from my neighbors. I want you to send me some of your personal money. I'll Give you a hint what the response will be.....Obama has a half brother living in utter squalor in Kenya as we speak. He is not willing to do anything for his own Brother much less you and I.

This discussion has nothing to do with health care. That is why it seems so confusing.This entire issue is about Buying votes with "free health" care. Once you understand this is all make sense.

Once the Democratic party can put another huge block of voters on the Free health care rolls those recipients will block vote for the Democratic party for the rest of their life's. That is why the Democratic party is willing to pay any price to get this done. Once this new program is in place You will have about 50 million people on Medicare, 50 million on Medicaid and this program will put about another 50 million on the rolls. Wow Batman! that comes out to 150 million that will get free health care as a gift from the Democratic party. In a country of 350 million or so that means you have bought close to 50% of the vote in every election. That is exactly why all those kind generous people in Washington who care about you so much are suddenly Determined to shove Socialized medicine down every ones throat. Once it is done there will be no turning back. My personal opinion is that the Democratic party with become exactly like the PRI party of Mexico that totally controlled Mexico for 71 years.

Hang on and Hope. That's all we can do now!
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Old 08-09-2009, 07:08 AM   #29
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Sevo--Something I find interesting, is when the Democrats stage protests over whatever law the Republicans were contemplating it was a grass roots movement. Now that conservatives seem to be doing the same thing it is a fake grass roots movement and our representatives refuse to answer questions. Whether it is a fake demonstration or not, if the law is a good law it doesn't matter who's asking questions critical of it. Answer the questions, quit running from constituents, and quit chastising people for demanding answers to questions on what will be one of the largest spending bills in Congress.

This Congress passed laws in the recent past that were not read. That angered many people, who now feel they were betrayed by the very people sent to represent them. Now the Congress critters are getting angry that people don't trust them to know what is in a law and explain why it is a good law before they pass it. It sounds an awful lot like the Representatives are forgetting that they are there to serve the people, not the other way around. I have talked to a to of people who are very angry about the situation in Congress, granted I do live in a typically red state. Many are starting to speak of the need for violent actions against our government, it's kind of scary actually.

If the law is good it doesn't matter what the talking head are saying. People are getting more and more angry that the Congress critters can't explain why this bill is good for them. The Congress critters are refusing to explain why the bill is good, even to those actually seeking knowledge. These are definitely interesting times we live in.
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Old 08-09-2009, 02:49 PM   #30
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Sevo--Something I find interesting, is when the Democrats stage protests over whatever law the Republicans were contemplating it was a grass roots movement. Now that conservatives seem to be doing the same thing it is a fake grass roots movement and our representatives refuse to answer questions. ...
I don't know if these are "manufactured" or not, but consdidering the strong negative numbers in the polls for the health care propositions, it should not be surprising that more people are turning out and turning up the heat.

edit: some numbers to back that up:

Two in Three Doubt Congress’ Grasp of Healthcare Issues

http://www.gallup.com/poll/121916/Tw...re-Issues.aspx

The numbers on the Clunkers program have me worked up enough to try to ask some tough (which should be easy) questions at the next town hall I can attend. Respectfully of course. The shouters are counter-productive IMO. Anyone with vocal cords can shout, it means nothing.

Quote:
This Congress passed laws in the recent past that were not read. That angered many people, who now feel they were betrayed by the very people sent to represent them.
I found this mildly interesting:

Let Freedom Ring | Pledge to Read

I think he lets them off easy. In one of the interviews, he said he doesn't expect Congress to read *every* bill, just the "important" ones I think that is a huge part of the problem with Congress. They are so micro-managing this country. Why the heck are they wasting their time on "unimportant" bills. OK, some may be routine and just normal dreary business, fine - how long can it take to read them?

I seem to recall a few "True North" principles:

1) Don't invest in anything you don't understand.
2) Don't sign anything w/o reading and understanding it.

I think #2 is especially relevant when your job description is "vote on bills".

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Old 08-10-2009, 04:28 PM   #31
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Lets -retire. Our present rulers can't explain why any of the laws they are going to pass are for the "General Welfare" because those laws simply are not. They are for one reason and one reason only and that is to keep incumbents in power for ever.

Next please talk to your friends and acquaintances that are making any statements about Any form of violence or semi violence against any officials. Just making that statement is a Federal felony. Any citizen that makes such statements and is over heard by the wrong person can have their lives totally destroyed by the Federal Government.



Both sections of this link should be mandatory watching for any citizen.

Next we started this thread with the question about how your experience has affected your feelings about the delivery of health care. Well I could write a book but I will give one example. I can tell this because the statute of limitations has passed.

When I started in my practice I Always "charged insurance only" for all veterans and people that I thought just could not make the 20% co-pay on medicare. In other words I sent a bill to Medicare and accepted what every they payed me and I did not send a bill for the other 20% to the patient. This practice cost me a lot of money but it was worth it because I thought it was the right thing to do. As usual the laws and mandates just got more and more complex so after years of going it alone several Doctors went into a group and hired a management team to do the work of dealing with the Government and the insurance companies. Good so far right?

The first thing that happened when we got professional management, people who really understood the laws involved, was they came to me and said you can't do that any more.....?? My first response was I'm doing what is in my opinion an honorable thing and no one is going to tell me I can't give veterans and other people who are honest but down on their luck a break. Boy was I in for a surprise when they informed me that what I was doing was a FEDERAL FELONY EACH AND EVERY TIME I DID IT. I had committed hundreds of Federal Felonies. I could have lost every thing I had including my medical license and my freedom. . Such is the power of a run away government......

Hang on and Hope!
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Old 08-10-2009, 05:25 PM   #32
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A wonderful program. I got a job through CETA.
My family got their jobs through the Chicago political machine and patronage. A wonderful program! Without it I wouldn't have been able to attend college. We need more political machines and partronage employment!
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Old 08-17-2009, 11:51 AM   #33
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Write to your representative , Senators and your President. Pose this simple question to each of them. I am ill and need money for my medicine. Please send me some of your personal money. I don't want the money that has been taken through taxes from my neighbors. I want you to send me some of your personal money. I'll Give you a hint what the response will be.....Obama has a half brother living in utter squalor in Kenya as we speak. He is not willing to do anything for his own Brother much less you and I.
What does this have to do with the price of tea in China?
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