Health Care Bill It's about Fire and Money

[wallygator69]

Hi Folks.

Even you retirees not on medicaid need to look into the new Healthcare bill. To his Credit Obama says he wouldn't sign a bill that makes "individual private medical insurance illegal" but the fact that he doesn't know what congress is doing is disturbing to me and hopefully you.. IBD article that first brought this up is first.

I contacted my Congressman....

Wally

IBDeditorials.com: Editorials, Political Cartoons, and Polls from Investor's Business Daily -- It's Not An Option

Morning Bell: Obama Admits He’s “Not Familiar” With House Bill - The Foundry

 

[beowulf]

As written, it's pure socialized medicine with eventually no options for anyone. You won't have any freedom other than to use government approved plans and a bureaucracy will determine your treatment. No different than Canada, Britain and countless other countries.

There are some (a few) good things in the bill, but its size alone and the fact that very, very few of our elected officials, apparently including the President, have read it should signal that something is seriously wrong. I'm all in favor of having some sort of umbrella health care for those who can't afford it or can't get it through their employer, even if it results in slightly higher taxes. But I don't understand why doing that has to result in everyone else being forced into a national healthcare program. I've seen what happens with Medicare when my parents had it and it wasn't pretty.

My opinion, FWIW, is that anyone who has adequate health care should be left alone, anyone who doesn't has the option of some sort of government program and those who want nothing be allowed to stay out (as long as they don't then decide to ask everyone else to pay for their care when they get sick). Not sure how all this would work, but the current proposals are unacceptable.

 

[Martha]

Too many political slogans going around and not enough thought. "Making private insurance illegal" is a phrase that means nothing without context. Instead of talking in phrases that are meant to rile people up, we should talk about what is the best way to make things work better than they are. I have to say that after all the reading that I have done over the past 5 years I think that the private for profit health insurance system is a problem, not a solution. But our politicians won't even talk in any detail about whether that is the case. Nothing should be off the table when we talk about options.


Well, you vented Wally and now I vented. I also have contacted my representatives and senators. I do so frequently.

 

[ziggy29]

Yeah, health care and health insurance reform is about FIRE and money, but seeing as the primary thrust of this thread is politics, that's where it is being moved.

 

[haha]

Too many political slogans going around and not enough thought. "Making private insurance illegal" is a phrase that means nothing without context. Instead of talking in phrases that are meant to rile people up, we should talk about what is the best way to make things work better than they are. I have to say that after all the reading that I have done over the past 5 years I think that the private for profit health insurance system is a problem, not a solution. But our politicians won't even talk in any detail about whether that is the case. Nothing should be off the table when we talk about options.


Well, you vented Wally and now I vented. I also have contacted my representatives and senators. I do so frequently.

Martha, you will be disappointed, and those who like private insurance can sleep well, because Senator Baucus, D. Montana, is not going to let anything happen to his buddies and major contributors the health insurers.

"Elsewhere in health care news, The Washington Post’s Perry Bacon Jr. and Michael Fletcher report on the newest Republican strategy – linking the administration’s handling of health care to its economic policies, both of which may becoming less popular, according to recent polls. The Post also takes a look at where the health care industry’s political contributions are going, finding that the political committees of Senator Max Baucus, the chair of the Senate Finance Committee, received close to $1.5 million in 2007 and 2008."

The Early Word: Shifting Timetables on Health Care - The Caucus Blog - NYTimes.com

By the way Gator, what you mean is Medicare, not Medicaid.

Ha

 

[homestead]

Canada health care
Free Market Cure - A Short Course in Brain Surgery

 

[youbet]

Canada health care
Free Market Cure - A Short Course in Brain Surgery

Now that we actually need Michael Moore to solve a problem, where the heck is he? Certainly he has the answer to all this..........

 

[Gone4Good]

Canada health care
Free Market Cure - A Short Course in Brain Surgery

So what happens in the US to someone without insurance who doesn't have a spare $28K lying around? (and $28K for brain cancer surgery and treatment seems suspiciously light considering the MRI probably cost a couple of grand all on its own).

Maybe something like this . . .

http://www.venturacountystar.com/news/2007/nov/18/uninsured-cancer-victim-fights-for-treatment/

Or this study by the American Cancer Society that found cancer "patients who were uninsured were 1.6 times as likely to die in five years as those with private insurance."

http://www.cancer.org/docroot/MED/content/MED_2_1x_Insurance_Status_Linked_to_Cancer_Outcomes.asp

 

[ERD50]

I'd agree that the articles in the OP may have a strong political bias, but this comment from the mayo clinic is hard for me to ignore(bold mine):

Mayo Clinic’s reaction to House Tri-Committee bill « Health Policy Blog

Mayo Clinic’s reaction to House Tri-Committee bill

Although there are some positive provisions in the current House Tri-Committee bill – including insurance for all and payment reform demonstration projects – the proposed legislation misses the opportunity to help create higher-quality, more affordable health care for patients. In fact, it will do the opposite.

In general, the proposals under discussion are not patient focused or results oriented. Lawmakers have failed to use a fundamental lever – a change in Medicare payment policy – to help drive necessary improvements in American health care. Unless legislators create payment systems that pay for good patient results at reasonable costs, the promise of transformation in American health care will wither. The real losers will be the citizens of the United States.

-ERD50

 

[Gotadimple]

Ummm . . . a key reason health care is expensive is the desire to assure positive patient outcomes. So, "patient-focused" does mean more studies of what works/does not work, more protocols, more paperwork, etc.

While I am appreciative of the intent of the Mayo Clinic, they don't offer an alternative, just a criticism. With a limited resource ($), which is more important: patient-focused protocols, or actually deploying resources to treat those who don't have access to health care?

-- Rita

 

[haha]

Ummm . . . a key reason health care is expensive is the desire to assure positive patient outcomes. So, "patient-focused" does mean more studies of what works/does not work, more protocols, more paperwork, etc.

While I am appreciative of the intent of the Mayo Clinic, they don't offer an alternative, just a criticism. With a limited resource ($), which is more important: patient-focused protocols, or actually deploying resources to treat those who don't have access to health care?

-- Rita

I know you worked in the field, so you are an expert. However, in my opinion getting it right is much more important. If you broaden coverage w/o getting a handle on cost/benefits, costs spiral and we all lose.

Ha

 

[ERD50]

So, "patient-focused" does mean more studies of what works/does not work, more protocols, more paperwork, etc.

... With a limited resource ($), which is more important: patient-focused protocols, or actually deploying resources to treat those who don't have access to health care?

-- Rita

Why is it one or the other?

Finding out what works and what does not should help contain costs, and those cost savings can be applied to cover more people. Win-Win.

Yes, it might take some studies and paperwork to uncover best practices, but if reasonably designed, the payback should be huge. Should we not require degrees/certification for our Doctors and Nurses - too much paperwork?

I'm with haha - if it isn't sustainable it isn't a solution.


-ERD50

 

[Martha]

Ummm . . . a key reason health care is expensive is the desire to assure positive patient outcomes. So, "patient-focused" does mean more studies of what works/does not work, more protocols, more paperwork, etc.

While I am appreciative of the intent of the Mayo Clinic, they don't offer an alternative, just a criticism. With a limited resource ($), which is more important: patient-focused protocols, or actually deploying resources to treat those who don't have access to health care?

-- Rita

Mayo proposed a different system of reimbursement, led by changes in the Medicare reimbursement system. Keep in mind too that Mayo in large part is considered to be a model of efficiency and cost containment.

 

[ziggy29]

If you broaden coverage w/o getting a handle on cost/benefits, costs spiral and we all lose.

I would agree. In my opinion, any reforms which do not focus first and foremost on cost containment are non-starters. Once we can adequately figure out a way to control costs, then universal coverage is much more easily attainable and implemented. Until then it's another fiscal disaster waiting to happen like Medicare, Social Security and state/local pension plans.

I'm fairly non-ideological about this issue in terms of the "philosophy" of the implementation of reforms, with the notable exception of being vehemently opposed to changes which don't have realistic and substantial cost-containment measures.

 

[youbet]

I'll judge the outcome of all this by whether the feds choose to include or not include themselves. If Congresscritters and all fed employees are full participants in the new system, at least I'll know they made a sincere try at creating something good for the country. If they are excluded and continue on their current plans, then I'll know their intention has been to screw Ms/Mr Average American all along.

The exception would be active military, of course.

Anyone seeing anything on whether fed employees will be full paricipants or whether they are holding themselves above the fray?

 

[crazy connie]

The Congresscritters (aka vermin) see no reason to include themselves. I have been reading bits and pieces of the proposed bill and it struck me as odd that there is absolutely NO LIFETIME CAP of any sort. Now you may have to jump thru some hoops but I am not sure that is a good thing. My current plan does have a 3M cap currently and I hope to never reach it. I do see this as a problem to continue to maintail life at all costs. Stop to think about the extreme preemies and the family who wants Grandpa around at all costs. I am not in support of unlimited healthcare for certain situations. Really think about this for a bit and share your thoughts please.

 

[HFWR]

The Congresscritters (aka vermin) see no reason to include themselves. I have been reading bits and pieces of the proposed bill and it struck me as odd that there is absolutely NO LIFETIME CAP of any sort. Now you may have to jump thru some hoops but I am not sure that is a good thing. My current plan does have a 3M cap currently and I hope to never reach it. I do see this as a problem to continue to maintail life at all costs. Stop to think about the extreme preemies and the family who wants Grandpa around at all costs. I am not in support of unlimited healthcare for certain situations. Really think about this for a bit and share your thoughts please.

Qloud - Popular Songs By Austin Lounge Lizards - Grandpa's Hologram

 

[ziggy29]

I do see this as a problem to continue to maintail life at all costs. Stop to think about the extreme preemies and the family who wants Grandpa around at all costs. I am not in support of unlimited healthcare for certain situations. Really think about this for a bit and share your thoughts please.

I agree you in philosophy there, but the problem is: Inevitably, if we're talking about curtailing end-of-life care which has a very low chance of positive outcome, somewhere there has to be a line which determines what qualifies for ongoing treatment and which are, well, allowed to die (perhaps only given palliative treatments such as pain meds).

Where is the line and who draws it? And will mounting cost pressures continue to cause the line to be redrawn so more and more people are refused treatment?

I agree with the concept that heroic end-of-life measures to prolong a low-quality life for a little while is a bad "investment" to the extent cost has to be a factor in health care. But I worry that drawing a line is a slippery slope to having redrawn again and again as cost pressures continue to force more and more people to be considered "beyond hope" and effectively sentenced to certain death.

 

[crazy connie]

Qloud - Popular Songs By Austin Lounge Lizards - Grandpa's Hologram

Also got to listen to "The Drugs I Need" it is spot on! Thanks for the smiles and laughs HFWR I needed that!

 

[youbet]

The Congresscritters (aka vermin) see no reason to include themselves. I have been reading bits and pieces of the proposed bill and it struck me as odd that there is absolutely NO LIFETIME CAP of any sort. Now you may have to jump thru some hoops but I am not sure that is a good thing. My current plan does have a 3M cap currently and I hope to never reach it. I do see this as a problem to continue to maintail life at all costs. Stop to think about the extreme preemies and the family who wants Grandpa around at all costs. I am not in support of unlimited healthcare for certain situations. Really think about this for a bit and share your thoughts please.

You can't control end of life care or efforts to save extreme preemies through lifetime caps. You would need to detail circumstances and allowed procedures. This would likely be a political shot in the head to whichever congresscritter sponsored it. It isn't going to happen...........

 

[ziggy29]

You can't control end of life care or efforts to save extreme preemies through lifetime caps. You would need to detail circumstances and allowed procedures.

I would think that a "gatekeeper" would have to determine the probability of a good outcome from the treatment.

Someone with a 20% chance of being "saved" with a $1 million price tag might be allowed treatment whereas someone with a 1% chance seeking a $500,000 treatment might not be.

And even in cases which are 100% terminal, when talking about treatments which could extend lives, you'd need to factor in at least three things: (a) the cost of the treatment, (b) the length of time we're talking about, and (c) the likely quality of that extra time.

 

[youbet]

I would think that a "gatekeeper" would have to determine the probability of a good outcome from the treatment.

Someone with a 20% chance of being "saved" with a $1 million price tag might be allowed treatment whereas someone with a 1% chance seeking a $500,000 treatment might not be.

And even in cases which are 100% terminal, when talking about treatments which could extend lives, you'd need to factor in at least three things: (a) the cost of the treatment, (b) the length of time we're talking about, and (c) the likely quality of that extra time.

And even more interesting.......

If you could afford to private pay for disallowed treatments, should that be allowed or be considered illegal? That is, a multi-millionare mom pays $1 million to keep her preemie alive. Then, the feds find out and she, the doc and hospital officials all get the cuffs slapped on and sent to jail!

 

[beowulf]

Sounds a lot like a cross between Soylent Green and Logan's Run - with Jack Kevorkian as "The Decider"

Section 1233 of H.R. 3200. The section, titled “Advanced Care Planning Consultation” requires senior citizens to meet at least every 5 years with a doctor or nurse practititioner for End of Life counseling.

Seriously, do you really want bureaucrats deciding who should live and who should die based on economics? You know the rich will still get the care they need and the poor will die. That's the way it's always been and that's the way it will always be.

You can forget about being a centenarian, heck, you probably can forget about being an octogenarian. Watch Logan's Run if you want to see what really happens when health care is rationed.

 

[Martha]

More scary words. The conversation is only interesting with substance. What is so wrong with having end of life counseling? So many are unprepared and leave their families unprepared.

 

[Martha]

And even more interesting.......

If you could afford to private pay for disallowed treatments, should that be allowed or be considered illegal? That is, a multi-millionare mom pays $1 million to keep her preemie alive. Then, the feds find out and she, the doc and hospital officials all get the cuffs slapped on and sent to jail!

Why should it be illegal? Is there a good reason for it?