Join Early Retirement Today
Reply
 
Thread Tools Search this Thread Display Modes
Old 07-27-2009, 12:46 PM   #101
Moderator Emeritus
Martha's Avatar
 
Join Date: Feb 2004
Location: minnesota
Posts: 13,212
Quote:
Originally Posted by youbet View Post
As stated in my post above Martha, I'm sure that looking at how other countries do this is not appropriate. We are a country of immigration and where we have have looked away from the problem of controlling our borders. Now we have many millions of undocumented folks living here and many millions of voters supporting them. And, of course, a number of high profile politicians fighting for them too.

Yes, Canada controls its borders and doesn't insure non-citizens. We don't control our borders and we'll likely (but perhaps as a modification to the original plan for political reasons) insure all who arrive, legally or illegally. Our history would be congruent with that.
I disagree on the likelihood of insuring illegals. Want to put $20 bucks on it?
__________________

__________________
.


No more lawyer stuff, no more political stuff, so no more CYA

Martha is offline   Reply With Quote
Join the #1 Early Retirement and Financial Independence Forum Today - It's Totally Free!

Are you planning to be financially independent as early as possible so you can live life on your own terms? Discuss successful investing strategies, asset allocation models, tax strategies and other related topics in our online forum community. Our members range from young folks just starting their journey to financial independence, military retirees and even multimillionaires. No matter where you fit in you'll find that Early-Retirement.org is a great community to join. Best of all it's totally FREE!

You are currently viewing our boards as a guest so you have limited access to our community. Please take the time to register and you will gain a lot of great new features including; the ability to participate in discussions, network with our members, see fewer ads, upload photographs, create a retirement blog, send private messages and so much, much more!

Old 07-27-2009, 01:00 PM   #102
Moderator Emeritus
Martha's Avatar
 
Join Date: Feb 2004
Location: minnesota
Posts: 13,212
Current house bill and proposals do not allow illegals to get the public option. The issue is whether someone will be properly identified as illegal immigrants if they applied for the public option and the republicans want better ways to identify those who are not here legally.
__________________

__________________
.


No more lawyer stuff, no more political stuff, so no more CYA

Martha is offline   Reply With Quote
Old 07-27-2009, 01:14 PM   #103
Give me a museum and I'll fill it. (Picasso)
Give me a forum ...
youbet's Avatar
 
Join Date: Mar 2005
Location: Chicago
Posts: 9,965
Quote:
Originally Posted by Martha View Post
I disagree on the likelihood of insuring illegals. Want to put $20 bucks on it?
Yes, but we'll have to agree on a timeline. I would say it will happen during Obama's second administration, 5 or 6 years from now and 2 or 3 years after the start date of whatever national health plan comes out of Congress.

I believe my position is the conservative one most likely to allow a national health plan to succeed and endure. I want to estimate costs conservatively allowing for increases that seem unlikely today. This would be congruent with what Roosevelt should have done with SS. Then we should tax ourselves real time to cover costs as we incur them.

So, to determine the number of additional souls whose medical care costs will need to be paid for, I'd add all of today's insured plus all of today's uninsured plus a reasonable estimate of undocumented residents.

Whether it's undocumented residents being allowed to attend our public schools, hold jobs or, in this case, use publicly provided health care resources doesn't seem to matter. For example Martha, if ten years ago you would have asked me whether we would pay for "illegals" to attend public school in my town (about the equivalent of health care costs), I would have said of course not. But it turns out today that in my town, which is very diverse - less than 50% white, we have large numbers of "illegal" children in our school system. I think it will go the same way with health care since the costs are similar on a per person basis.

I wonder why you would think that if we're willing to pay for an "illegal" child to receive a public education, including special ed benefits if required to accomodate special needs (Downs, Autism, cerebral palsy, etc.), we would not also provide coverage if that child falls in the school yard and needs a few stitches?

Again, I have zero problem with this as long as we pay for it as a current expense and not load it onto the backs of tomorrow's tax payers.
__________________
"I wasn't born blue blood. I was born blue-collar." John Wort Hannam
youbet is offline   Reply With Quote
Old 07-27-2009, 01:16 PM   #104
Give me a museum and I'll fill it. (Picasso)
Give me a forum ...
 
Join Date: Sep 2005
Location: Northern IL
Posts: 18,299
Quote:
Originally Posted by Martha View Post
The problem is that a discussion board is not a good place to talk about these things in detail. How many studies should one cite? I don't really want to sit here with a lap full of Dartmouth, Harvard, and congressional committees studies, hearing transcripts, census and BLS stats, and GAO reports to work up a good response to every issue. At best, we seem good at pointing to possible issues.
That sounds a lot like "I've already made up my mind, don't confuse me with the facts".

Same as the energy debate, w/o some real numbers (and often a rough estimate is all you need) one can talk endlessly about a topic, w/o having any idea of whether it has any meaningful impact or not.

I'm guessing we could find rough numbers to put some perspective to it. It doesn't have to get to the 5th decimal point to have an idea if it is a major impact or not.

-ERD50
__________________
ERD50 is offline   Reply With Quote
Old 07-27-2009, 01:18 PM   #105
Moderator Emeritus
Martha's Avatar
 
Join Date: Feb 2004
Location: minnesota
Posts: 13,212
Quote:
Originally Posted by ERD50 View Post
That sounds a lot like "I've already made up my mind, don't confuse me with the facts".

Same as the energy debate, w/o some real numbers (and often a rough estimate is all you need) one can talk endlessly about a topic, w/o having any idea of whether it has any meaningful impact or not.

I'm guessing we could find rough numbers to put some perspective to it. It doesn't have to get to the 5th decimal point to have an idea if it is a major impact or not.

-ERD50
I have spent a significant amount of time looking at facts, thank you.
__________________
.


No more lawyer stuff, no more political stuff, so no more CYA

Martha is offline   Reply With Quote
Old 07-27-2009, 01:20 PM   #106
Moderator Emeritus
Martha's Avatar
 
Join Date: Feb 2004
Location: minnesota
Posts: 13,212
Quote:
Originally Posted by youbet View Post
Yes, but we'll have to agree on a timeline. I would say it will happen during Obama's second administration, 5 or 6 years from now and 2 or 3 years after the start date of whatever national health plan comes out of Congress.

I believe my position is the conservative one most likely to allow a national health plan to succeed and endure. I want to estimate costs conservatively allowing for increases that seem unlikely today. This would be congruent with what Roosevelt should have done with SS. Then we should tax ourselves real time to cover costs as we incur them.

So, to determine the number of additional souls whose medical care costs will need to be paid for, I'd add all of today's insured plus all of today's uninsured plus a reasonable estimate of undocumented residents.

Whether it's undocumented residents being allowed to attend our public schools, hold jobs or, in this case, use publicly provided health care resources doesn't seem to matter. For example Martha, if ten years ago you would have asked me whether we would pay for "illegals" to attend public school in my town (about the equivalent of health care costs), I would have said of course not. But it turns out today that in my town, which is very diverse - less than 50% white, we have large numbers of "illegal" children in our school system. I think it will go the same way with health care since the costs are similar on a per person basis.

Again, I have zero problem with this as long as we pay for it as a current expense and not load it onto the backs of tomorrow's tax payers.
I understand your point, but I'll still take the bet on your terms. Where I might lose is with the kids, not the adults. Hope we are still around for Obama's second term!
__________________
.


No more lawyer stuff, no more political stuff, so no more CYA

Martha is offline   Reply With Quote
Old 07-27-2009, 01:27 PM   #107
Give me a museum and I'll fill it. (Picasso)
Give me a forum ...
youbet's Avatar
 
Join Date: Mar 2005
Location: Chicago
Posts: 9,965
Quote:
Originally Posted by Martha View Post
Current house bill and proposals do not allow illegals to get the public option.
I agree with your earlier post that the political implications of passing a national health plan bill that includes illegals will keep the politicians from honestly dealing with the issue now. But remember, originally the legislation creating public education did not account for non-citizens attending on the tax payer dime. Today, of course, citizenship is not required, only showing up on registration day. We are not Canada, Australia or any of the others commonly referred to as a comparison of health care systems. They enforce their borders and are tough on illegals trying to receive benefits. That's just not us, at least historically.
Quote:
The issue is whether someone will be properly identified as illegal immigrants if they applied for the public option and the republicans want better ways to identify those who are not here legally.
I think we are being very successful at keeping the minority party at bay and it is unlikely anything they want or propose will be enacted.
__________________
"I wasn't born blue blood. I was born blue-collar." John Wort Hannam
youbet is offline   Reply With Quote
Old 07-27-2009, 01:51 PM   #108
Give me a museum and I'll fill it. (Picasso)
Give me a forum ...
haha's Avatar
 
Join Date: Apr 2003
Location: Hooverville
Posts: 22,387
Forget the details. Look at the odds.

Other than perhaps the space program and Brown vs. The Board, how much has the US done well in the last 50 years?

Why should we expect this to be done well?

I say legalize mj, allow OTC Viagra and party on till we all fall down.

It's coming anyway, why not enjoy the descent?

Ha
__________________
"As a general rule, the more dangerous or inappropriate a conversation, the more interesting it is."-Scott Adams
haha is offline   Reply With Quote
Old 07-27-2009, 01:54 PM   #109
Moderator Emeritus
Martha's Avatar
 
Join Date: Feb 2004
Location: minnesota
Posts: 13,212
Quote:
Originally Posted by haha View Post

Other than perhaps the space program and Brown vs. The Board, how much has the US done well in the last 50 years?



Ha
MS Dos?
__________________
.


No more lawyer stuff, no more political stuff, so no more CYA

Martha is offline   Reply With Quote
Old 07-27-2009, 02:00 PM   #110
Give me a museum and I'll fill it. (Picasso) Give me a forum ...
REWahoo's Avatar
 
Join Date: Jun 2002
Location: Texas Hill Country
Posts: 42,149
Quote:
Originally Posted by haha View Post
I say legalize mj, allow OTC Viagra and party on till we all fall down.

It's coming anyway, why not enjoy the descent?
Are you sure you aren't addressing your own personal decline rather than of the US in general?
__________________
Numbers is hard

When I hit 70, it hit back

Retired in 2005 at age 58, no pension
REWahoo is offline   Reply With Quote
Old 07-27-2009, 02:30 PM   #111
Thinks s/he gets paid by the post
 
Join Date: Feb 2006
Posts: 1,183
Quote:
Originally Posted by haha View Post
Forget the details. Look at the odds.

Other than perhaps the space program and Brown vs. The Board, how much has the US done well in the last 50 years?

Why should we expect this to be done well?

I say legalize mj, allow OTC Viagra and party on till we all fall down.

It's coming anyway, why not enjoy the descent?

Ha
Instead of the addition to birth control in the water supply maybe they could toss in the Viagra and Prozac and then follow it by the poison to send us out with a smile!
__________________
crazy connie is offline   Reply With Quote
Old 07-27-2009, 04:31 PM   #112
Give me a museum and I'll fill it. (Picasso)
Give me a forum ...
 
Join Date: Sep 2005
Location: Northern IL
Posts: 18,299
RE: numbers...

Quote:
Originally Posted by Martha View Post
The problem is that a discussion board is not a good place to talk about these things in detail. How many studies should one cite? ....
Sorry, but this is looking one-sided to me. You don't want to see numbers in a discussion that you apparently don't want to talk about, but when it comes to promoting single-payer, numbers and studies are what you use to back up your views.

Quote:
Originally Posted by Martha View Post
Here is one of the studies showing the percentage differences in admin costs between the US (31%) and Canada (17%): NEJM -- Costs of Health Care Administration in the United States and Canada
My gut says the immigrant thing isn't that huge, but until I have some grasp of the numbers I am in no position to defend that view.

-ERD50
__________________
ERD50 is offline   Reply With Quote
Old 07-27-2009, 07:47 PM   #113
Moderator Emeritus
Martha's Avatar
 
Join Date: Feb 2004
Location: minnesota
Posts: 13,212
Quote:
Originally Posted by ERD50 View Post
RE: numbers...



Sorry, but this is looking one-sided to me. You don't want to see numbers in a discussion that you apparently don't want to talk about, but when it comes to promoting single-payer, numbers and studies are what you use to back up your views.



My gut says the immigrant thing isn't that huge, but until I have some grasp of the numbers I am in no position to defend that view.

-ERD50
I am not following you at all. Of course I want to see numbers people give so I can evaluate them. What didn't I want to talk about? I gave out what I knew on the immigration issue, which is worthy of discussion. I explained the problem, which many people don't understand. The problem is in how the uninsured numbers are calculated. So I don't get it. I am not avoiding anything. Yes, Connie had a link about alien numbers, but we still don't know the number of illegals counted in the census. That was my point. And no one has quoted anything from Connie's link for me to even talk about. In fact, no one is really arguing about the immigrant issue at all, we were just exploring what we knew and didn't know. There was one article from 2000, almost in the nature of a press release, linked in Connie's site that claimed an analysis of the portion of the uninsured which were illegal immigrants based on census figures, but I am questioning their claims. As I guessed in another post, likely they are undercounted. Are illegal aliens going to answer the census? The census asks if you are an alien, but not your legal status.



I would like to know the extent providers are not reimbursed due to care of people who are not here legally. I don't know if there is any really reliable data because of the problem of knowing whether someone is illegal or not when the service is provided. However, without insurance most likely the service being provided is going to be emergency room service and related service to stabilize the person (including baby delivery) as required by federal law. I have seen figures estimating that close to 1.5 billion is not reimbursed in California due to these costs, but I don't know the accuracy or how it is determined. Texas and Arizona come in somewhere between .5 and .8 billion. This was as of 2004.

I didn't give out everything I know about admin costs, but I gave a link to a leading study comparing the US and Canada admin costs which is cited by many. I have more but without internet links. That was my point, it is hard to present an argument here on these issues because of the pile of evidence you need to build up to present a cogent position.
__________________
.


No more lawyer stuff, no more political stuff, so no more CYA

Martha is offline   Reply With Quote
Old 07-27-2009, 08:21 PM   #114
Moderator Emeritus
Martha's Avatar
 
Join Date: Feb 2004
Location: minnesota
Posts: 13,212
Democrats cite CBO report to bolster healthcare case | Deals | Regulatory News | Reuters

The CBO report estimated only about 10 million to 11 million people would sign up for the public option by 2019, far fewer than the 83 million cited in another analysis by the Lewin Group. The Lewin Group is part of Ingenix, a wholly-owned subsidiary of UnitedHealth Group.
The CBO report also estimated that about 12 million people who otherwise would not be enrolled in employer-based plans would fall under the Democratic proposal because the mandate for individuals to be insured would increase workers' demands for employer-based insurance.
__________________
.


No more lawyer stuff, no more political stuff, so no more CYA

Martha is offline   Reply With Quote
Old 07-27-2009, 09:07 PM   #115
Give me a museum and I'll fill it. (Picasso)
Give me a forum ...
 
Join Date: Sep 2005
Location: Northern IL
Posts: 18,299
Quote:
Originally Posted by Martha View Post
I am not following you at all. Of course I want to see numbers people give so I can evaluate them. ... Yes, Connie had a link about alien numbers, but we still don't know the number of illegals counted in the census. That was my point.

I would like to know the extent providers are not reimbursed due to care of people who are not here legally. I don't know if there is any really reliable data because of the problem of knowing whether someone is illegal or not when the service is provided. However, without insurance most likely the service being provided is going to be emergency room service and related service to stabilize the person (including baby delivery) as required by federal law. ...
Sorry, part of the problem here is that *I* have not had a chance to really go through that site, but at a glance it looked like a place where we *might* get some good estimates. Iwas kinda hoping someone else might distill it while I was busy with other things. That often happens, since there are so many smart people on this forum.

I understand the census isn't going to give us good data, but I don't care, I would not expect it to, so I'm not going to look there. There must be other ways to estimate this. And we don't always need accurate data, sometimes even a very, very rough ballpark number is enough to give perspective. For example, *if* an estimate made with some reasonable methodology indicated that 0.1% of our HC expenditures went to illegal immigrants, then even if it was off by a factor of 10 or even 20, it would tell us that it is not a significant explanation for the differences in costs between us, and say, Canada.

That's what I'm trying to get to, so we can either put it aside as an issue, or recognize it as some rough % of the delta. I think it is reasonable to think that Canada does not spend the same % as the US on illegal immigrant care, but I don't know if that is significant relative to the total costs.

And w/o some perspective, this keeps getting tossed out as a "reason" for our HC costs - I'm just trying to find out if that is true or not (I suspect it is not). With some numbers, I can shut down that distraction by shining light on it, if it does seem to be a small number.


-ERD50
__________________
ERD50 is offline   Reply With Quote
Old 07-27-2009, 11:43 PM   #116
Thinks s/he gets paid by the post
 
Join Date: Feb 2006
Posts: 1,183
I have not read the available numbers in depth either. I gave up analysis paralysis when I left Mega Corp. Mine is more antecdotal. In Phoenix the ER's are filled to overflowing with people chatting in Spanish with ill babies. The urgent care is less than 1 mile down the street. The parking lots at the Urgent Care for $50 to see a Dr are rarely full. My darling daughter works in IT for a multi-state health care institution. On occasion I go to have coffee with her during system upgrades (never from 8am to 5pm), and usually park in the ER area because it is out of visiting hours and I do not trust the safety of the empty parking ramps. I am only telling you what I see and chat with daughter and her clients about during coffee. Due to the recession the numbers are down but frequently the babies do not even get Tylenol at home. That is a direct quote from an ER RN who said it is happening several times a shift. ER visit, get interpreter and info from parent in Spanish, no signs of infection give a dose of Tylenol and advise on hydration.

The local TV and Radio here runs ER alerts when waits exceed 12 hours. I have not heard one in a while but usually on a National channels here as I prefer to read my local stuff. I get too sickened on all the drive by shootings/gang crap to enjoy listening to the locals.

If I can find AZ Hospitals write offs I will provide.
__________________
crazy connie is offline   Reply With Quote
Old 07-27-2009, 11:56 PM   #117
Give me a museum and I'll fill it. (Picasso)
Give me a forum ...
haha's Avatar
 
Join Date: Apr 2003
Location: Hooverville
Posts: 22,387
Quote:
Originally Posted by REWahoo View Post
Are you sure you aren't addressing your own personal decline rather than of the US in general?
Well, I am solvent while the US is flat broke- so perhaps not? Anyway, haven't you appointed me chief board curmudgeon? Responsibility comes with that honor.

Ha
__________________
"As a general rule, the more dangerous or inappropriate a conversation, the more interesting it is."-Scott Adams
haha is offline   Reply With Quote
Old 07-30-2009, 10:02 AM   #118
Thinks s/he gets paid by the post
 
Join Date: Feb 2006
Posts: 1,183
Just saw this and thought it could be a bit of a basis. Down 30% in bad times (now) up 30% or 40% in better times. That is a lot of people to pay healthcare costs for. A good % are just here to send the money south. I think that the US remittences (maybe oil is #1 though) are the largest income source to the country of Mexico. Not sure on the other countries south of the border.

Illegal-immigrant populace in Ariz. falls by a third, study says
by Daniel González - Jul. 30, 2009 12:00 AM
The Arizona Republic

Illegal-immigrant populace in Ariz. falls by a third, study says

"The report by the Center for Immigration Studies estimates that the nation's illegal-immigrant population fell from a peak of 12.5 million in the summer of 2007 to 10.8 million in the first quarter of 2009, a drop of 13.7 percent. "

Also, remember we have Sheriff Joe Arpaio here (pink boxer shorts fame) who has worked hard to get these folks and the associated crimes eliminated. It has not been hospitable here in many ways. But, we have built extra schools and provided tons of services with little assistance from the Feds. Our prisons have a ton of non-citizen residents that we provide for over many years before they are returned to their homeland.
Mostly only violent criminals are incarcerated here. Many are just re-patriated to thier home countries.
__________________
crazy connie is offline   Reply With Quote
Old 08-01-2009, 09:38 AM   #119
Give me a museum and I'll fill it. (Picasso)
Give me a forum ...
Moemg's Avatar
 
Join Date: Jan 2007
Location: Sarasota,fl.
Posts: 10,038
I read every body's arguments on health care and I'd like to add a few observations from my forty years in the field . You want to cut costs do something to stop frivolous law suits . They have added costs to every part of health care . Secondly we need to move universally to more basic care for very elderly people . It's more humane . Have hospice more universally used . It takes the terminal patients away from the one more test or trial into a peaceful death situation .Lastly hospitals and all medical facilities need to cut the non medical staff . I've watched hospitals progress over the years from real hospitals to Big Businesses with a lot of paper pushing non essential workers .
__________________
Moemg is offline   Reply With Quote
Old 08-01-2009, 09:51 AM   #120
Moderator Emeritus
Martha's Avatar
 
Join Date: Feb 2004
Location: minnesota
Posts: 13,212
Moe, you have a great point about the very elderly and terminal patients, but politics has somehow turned that into painting it as a position where elderly aren't going to get hip replacements (as I saw in one commercial yesterday) or all care is cut off and patients are encouraged to die.

The paper pushing non-essential working are probably working on getting reimbursement for care and working on silly HIPAA forms.
__________________

__________________
.


No more lawyer stuff, no more political stuff, so no more CYA

Martha is offline   Reply With Quote
Reply


Currently Active Users Viewing This Thread: 1 (0 members and 1 guests)
 
Thread Tools Search this Thread
Search this Thread:

Advanced Search
Display Modes

Posting Rules
You may not post new threads
You may not post replies
You may not post attachments
You may not edit your posts

BB code is On
Smilies are On
[IMG] code is On
HTML code is Off
Trackbacks are Off
Pingbacks are Off
Refbacks are Off


Similar Threads
Thread Thread Starter Forum Replies Last Post
Long-Term Care - Part of Health Care Reform Bill chinaco Health and Early Retirement 3 07-19-2009 03:53 PM
New Health Care Proposal -- If it happens what does it mean? chinaco FIRE and Money 9 06-11-2007 04:04 PM
How to cut your food bill by 90% and FIRE even quicker chinaco FIRE and Money 5 04-29-2007 10:27 PM
health insurance and effect on increased health care costs Martha Other topics 9 08-08-2006 02:54 PM
Health Care Lovecraft Young Dreamers 3 02-20-2004 09:28 PM

 

 
All times are GMT -6. The time now is 01:19 AM.
 
Powered by vBulletin® Version 3.8.8 Beta 1
Copyright ©2000 - 2017, vBulletin Solutions, Inc.