Healthcare reform article

[modhatter]

You don't have to be a foreigner to wind up in that position. There are several local families that have a similar story, ending with a mom and a whole bunch of kids living off of a WIC card, general assistance, and the local food bank.

None of these folks are likely to have bought health insurance, and are probably not paying cash in advance at the clinic or hospital.

In another post "A Modest Proposal" I suggested that we implement a strict Pay As You Go policy to eliminate free use of healthcare facilities. That would address the problem that people have with others getting 'free' health care on their dime, and reduce the surplus population.

Yes, that is correct you don't have to be a foreigoner to be in that position. I read "A Modest Proposal". We are caught between a rock and a hard place as far as care for illegals. I twice while traveling outside of my home state needed medical attention (both times with bladder infection) I did not want to go to emergency room so I searced for someplace that would take me as a walk in. Both times I ended up in a doctors office set up to treat what I assumed were mostly illegals. The waiting room was filled with at least 25 or 30 people. I saw them paying after their consultation. One lady before me was counting out $1.00 bills. I think as I recall she paid $18.00. One of these doctors was a freind of a neighbor who I later met at a dinner party at her house.

He told me that he made enough money to live in a comfortable house, though very modest, and was here in the US with the purpose of helping his people with medical attention they could afford. He told me he collected whatever they could afford to pay. if they required something too expensive for them to pay for all at once, they made monthly payments to him. He was a real inspiration.

How many other doctors would be willing to come to the US and set up similar practices. If the government allows them to stay here we have only four options it seems. 1.) Allow the current system to continue. 2) Create a Pay As you Go (not going to with current medical costs) 3. Deny health care (very difficult ) 4. Bring in doctor's from their country willing to set up clinics to care for them on a very reduced rate as the doctor I mentioned. Of course this only addresses Primary Care, not surgery, chemo, and hospitalization and other expensive treatment.

Perhaps our government could agree to pick up part of the tab of medical school for new doctors if they signed an agreement to set up a practice for a given period of time, say at least ten years, running these clinics. They do this in the military.

 

[modhatter]

I have a question. I didn't know how to reference someone elses post as you all do (when it is highligted in blue) so I read the FAQ and did as it said. However, when you don't want to highlight the whole post - just reference one sentence - how do you do this?

 

[Martha]

I have a question. I didn't know how to reference someone elses post as you all do (when it is highligted in blue) so I read the FAQ and did as it said. However, when you don't want to highlight the whole post - just reference one sentence - how do you do this?

Press the "quote" button and the entire text will appear. You can delete the parts of the text that you do not want to quote. Just do not delete the stuff in the brackets at the beginning and the stuff in the brackets at the end.

 

[modhatter]

Press the "quote" button and the entire text will appear.

Thank you Martha. Hope this works.

 

[Sevo]

Thanks Martha I couldn't quite figure that one out. Is it possible to take quoted from more than one post at a time?

 

[Martha]

At the bottom of the posts you want to quote you will see a button that looks like " marks, the next to the last button. Click on that button on each post you want to quote. Then hit the quote button on one of the posts. What will come up quoted language from each of the posts.

 

[tjscott0]

Here is an article regarding out of wedlock births in USA.

Out-of-wedlock births hit record high - CNN.com

"Nearly 40 percent of babies born in the United States in 2007 were delivered by unwed mothers, according to data released last month by the National Center for Health Statistics. The 1.7 million out-of-wedlock births, of 4.3 million total births, marked a more than 25 percent jump from five years before."

Not the 80% Sevo cites for his hospitals, but statistic is staggering to me. My how society has changed!

 

[Sevo]

Hawaii doesn't have universal health care.
.

Eridanus You are absolutely right, my bad. Hawaii does not have universal health care coverage but they have tried very hard to achieve it. unfortunately the unintended consequence is that they have made it very very hard for businesses to operate there.

Recently Hawaii tried to establish universal insurance coverage for children by instituting a program that would cover any child that was not covered by "free medicaid" and private insurance. It had to be canceled.

To quote CBS
A state official said families were dropping private coverage so their children would be eligible for the subsidized plan.

"People who were already able to afford health care began to stop paying for it so they could get it for free," said Dr. Kenny Fink, the administrator for Med-QUEST at the Department of Human Services. "I don't believe that was the intent of the program."

"It's also odd to advocate moving to another country so that the US can continue its current, inefficient, health care system."

I will be the first to admit that I am a poor communicator. I didn't mean that at all. My point is simply this. We desperately need to change our system to a more efficient humane one and the only way to do that is to go to a more market based system that allows people to make decisions for themselves. We have had more that 40 years now of Centralized planing from Washington. The end result is that we are broke and at a crisis because now the cost of health care has skyrocketed just like every thing else the government gets involved in. Please let's not try more of the same thing.

I also know that I failed my sensitivity classes I certainly do not want to tread on any ones feelings. I want to try to present a few facts and then I will bow out of this discussion.

1. I love this country. I have traveled enough to know that the United States is a unique country and I don't want give up the liberty that this country offers. Liberty entails some risks.

2. Societies are very complex. Every attempt by a Large Powerful Government at centralized planing results in many unintended out comes that are far removed from the original intent. History gives us almost unlimited examples of this. A case in point is the sudden increase in illegitimacy that followed our experiment with medicaid and other free programs that started in the 1960's.

3. As far as health care goes most people only see 2 options.
A) Continue with what we have or
B) Give the Federal Government unlimited power to dictate how we will be taken care of. In fact actually giving the feds control over our physical selves.
There is a 3rd option though I understand that even presenting this idea strikes at lot of peoples firmly held belief that they are helpless with out the intervention from the Federal Government even though they are surrounded by City, County and State governments that they have far far more chance of actually having a voice in. Because of that a lot of people get scared and angry with this suggestion.

C) We can work to limit the power of the Federal Government in the control of any individuals personal life, especially when it comes to things as intimate and personal as who gets a hip replacement and who doesn't. There is nothing in the Constitution that gives the Federal Government the right to dictate who will get what kind of health care.

4. By population the United states is the worlds 3rd largest country. And I believe the most ethically diverse country the world has ever seen. From Native Alaskan Indians that live above the Arctic Circle to the last cab driver that I rode with who was brand new in the US from a Somalia Refuge camp. Each and every one of those people are individuals with different idea's about what kind of medical care they want and how they want to spend their health care dollars. To try to mandate a one size fits all 10,000 page formula/ law is nothing less than silly on the humorous side and a national tragedy for the people who's lives are going to ruined by this experiment.



2

India 1,167,830,000

United States 307,183,000


4

Indonesia 229,965,000


5

Brazil 191,723,000


6

Pakistan 167,208,500


7

Bangladesh 162,221,000


8

Nigeria 154,729,000


9

Russia 141,865,000


10

Japan 127,580,000


11

Mexico 107,550,6
5. We are Broke. We are the biggest Debtor nation in the world. We are being publicly lectured by the Chinese about or financial recklessness. We simply can not afford our present experiments in social engineering much less adding more to it.

Thanks for letting me put in my 2 cents worth. I will bow out now and leave any discussions about health care to others. Always remember though when you rob Peter to pay Paul you will ALWAYS have the support of Peter.

 

[haha]

. Always remember though when you rob Peter to pay Paul you will ALWAYS have the support of Peter.

Wow! Peter must be very altruistic.

Ha

 

[Sevo]

Wow! Peter must be very altruistic.

Ha

Told you I don't communicate well!!!!

When you rob Peter to pay Paul you can always depend on the support of PAUL!

 

[modhatter]

B) Give the Federal Government unlimited power to dictate how we will be taken care of. In fact actually giving the feds control over our physical selves.

This is the only statement I have a hard time accepting. What we are doing is trading who gets the power. It currently is the insurance companies, and they are not doing so good with it. I don't know why you think the government could not possibly be an improvement

Having to choose who I would trust with my life decisions, I would pick the government over the insurance companies. I think we would all like those decisions be left up to our doctors and ourselves, but that's not on the table, and obviously their must be some limits set.

We would be so much better off if we could get rid of the middle man (insurance company) who really does not contribute to our health care. They only skim profits from it, at the expense of many. That money could be used so much more effectively. This would help with the financial burden.

 

[M Paquette]

Having to choose who I would trust with my life decisions, I would pick the government over the insurance companies. I think we would all like those decisions be left up to our doctors and ourselves, but that's not on the table, and obviously their must be some limits set.

Imagine, if you will, that your mother has just been admitted to hospital after a severe stroke. You go to your mother's bed, and there is already a woman there in business attire. She is trying to place your mother's hand around a pen and place a clipboard underneath.

The clipboard holds a Consent For Do Not Resuscitate form. The woman is from the HMO business office.

As I said to the nice lady while urging her to depart, "I don't trust advice from anyone with a profit motive."

 

[samclem]

We would be so much better off if we could get rid of the middle man (insurance company) who really does not contribute to our health care. They only skim profits from it, at the expense of many. That money could be used so much more effectively. This would help with the financial burden.

Would we also be better off if we could get rid of auto insurance companies and life insurance companies? They also make profits (which, BTW, you can enjoy if you'd like by simply buying stock in a public one. The government doesn't give us that option when they take over a function). These insurance companies perform a service by allowing people to cover unlikely but devastating risks that they are unable to cover on their own. That's a valuable service, and health insurance ( to cover unusual expenses) would be similarly valuable.
One big problem is that "health insurance" in the US isn't really "insurance" in the traditional sense, since people don't buy it to cover unusual risks--they buy it (or rather, their employer buys it) to cover a part of all their health care expenditures. It shouldn't surprise us that the premiums are high, and that costs spiral up. If car insurance covered every oil change and shopping cart ding, I'd expect that it would be expensive and that people would be getting a lot more dents filled.

 

[modhatter]

Would we also be better off if we could get rid of auto insurance companies and life insurance companies? .
One big problem is that "health insurance" in the US isn't really "insurance" in the traditional sense, since people don't buy it to cover unusual risks--they buy it (or rather, their employer buys it) to cover a part of all their health care expenditures. It shouldn't surprise us that the premiums are high, and that costs spiral up. If car insurance covered every oil change and shopping cart ding, I'd expect that it would be expensive and that people would be getting a lot more dents filled.

I feeled compelled to point out the difference here. Auto insurance and life insurance, and in fact most other types of insurance is highly profitable for the insurance compaies and affordable for individuals. The two (in certain states) insurances that are not affordable for individuals now is health care and home insurance for some.

Here in Florida (and I assume some other states) monthly premiums rose so high after we had a three hurricanes that peoples premiums were jacked up three and four times (and I'm not talking people living on the water) I lived inland and saw my premium go from $1,300 to $4,200. Many people were forced to drop their home insurance or the insurance company dropped them. The state had to intervene and offer insurance for those who could not get insurance. The hurricane deductable got larger and the exclusions got bigger as well. They are still to this day the predominant insurance available here in Florida. (government interfernce)

The second insurance (health insurance), and the most important and vital insurance to have is not available for all, because it is either too expensive for lower income families, or because of a pre-existing condition for someone who lost their insurance when they lost their job or tried to change their job or because they were purged because they were too sick.

We are not talking about things here. We are talking about peoples lives and human suffering, and I don't know about you, but this makes this type of insurance very different to me. It also tells me that the current system being offered to us by the middleman (insurance companies) is not working and they are either not willing or unable to change it.

Since the government is able to do it cheaper, and has no need for profit, doesn't it make sense for someone to take it over? For those of you who have the means, I am sure you could buy a supplimental policy to improve on the basic plan, and thus sleep better knowing everyone has some coverage. Wouldn't you too be willing to pay slightly higher taxes to insure this?

I can't help feel sometimes listening to people talk that there are too many people who are of the mind set that "I have mine and I'm covered, so I don't want to do anything to rock the boat." I have insurance too. I have medicare, so I'm grandma who you can pull the plug on. Though I do not adhere to this propaganda, I am willing to take the chance if it will help the masses.

The only problem with offering lower income families a "catistrophic insurance" and not include doctor visits, is that these people will not go to the doctor when they should, cause a doctor's visit and medicine can be their weeks salary. So these people go undiognosed until they become very ill, and then their illness and treatment becomes catastrophic.

 

[lets-retire]

Since the government is able to do it cheaper, and has no need for profit, doesn't it make sense for someone to take it over? For those of you who have the means, I am sure you could buy a supplimental policy to improve on the basic plan, and thus sleep better knowing everyone has some coverage. Wouldn't you too be willing to pay slightly higher taxes to insure this?

I can't help feel sometimes listening to people talk that there are too many people who are of the mind set that "I have mine and I'm covered, so I don't want to do anything to rock the boat." I have insurance too. I have medicare, so I'm grandma who you can pull the plug on. Though I do not adhere to this propaganda, I am willing to take the chance if it will help the masses.

The government hasn't shown where they will do anything cheaper. So the assumption that they can, is a rather big assumption (not to mention a primary argument for socialism). They haven't in the past and they aren't in the bill being discussed. The two principle statements I've seen as far as affability goes is, "we'll see cost improvement from implementing best practices", or "we'll deal with the cost later". The latter is a very bad argument to make. Every time the government has made it they have failed to deal with the costs later. The former doesn't address the numbers it is just a blanket statement. Even the CBO pointed out that the bill being discussed does not do anything to contain costs.

After reading the bill (I know it is changing. The final one probably won't be released for review by the public) it stipulates a minimum standard. The best policy will have a minimum standard of paying 95% of the health care costs. Any money collected by an insurer above a certain medical expense ratio is to be returned to the consumers. The term "medical expense ratio" has not been defined and the method of figuring the ratio has not be determined. It would be in the companies' best interest to maximize medical expenses. Talk about a messed up system. The health care providers would be encouraged to increase the prices (which would be good for them because they get to increase their standard of living) by the insurance companies. The insurance companies would be increasing their profits by encouraging the doctors to increase their prices. That does not sound like a very good way of encouraging reasonable costs in health care.

 

[modhatter]

Lets-Retire. I can not argue that point with you, as I have not read that in the bill. If you can point me to the pages, I would gladly read it.

So, if that is your interpretation of the bill, and you are opposed to it. May I ask what you would propose?

 

[lets-retire]

Used the incorrect term, it is medical loss ratio. I also had the way it works backward. If the insurance provider does not spend enough toward the medical loss ratio they must refund receipts back to the consumer up to the loss ratio. So if the loss ratio is 50% the insurer is guaranteed to spend half of it's receipts either on health care or in refunds. The insurance companies might spend more, but they cannot spend any less. This still leads to the same result. They can encourage providers to increase their wages, because as long as they meet the 50% loss they are good to go and can charge more for their product. The higher the ratio the worse it is for the health insurance companies. On page 25 it appears the law wants the medical expense ratio to be as high as possible to ensure as much money is used for health care and not for the operation of the insurance company.

http://energycommerce.house.gov/Press_111/20090714/aahca.pdf Pages 24-25

My position is to hit the biggest inefficiencies and make them more efficient with the co-operation of the health insurance provider, health care providers and the rest of the health care industry. Make them sit down and come up with a system that works, if they don't get it done, then they don't get to play in the game. I gave an example in a thread about how to go about getting the admin more efficient, it might even be in this thread.

 

[target2019]

What is the agreed-upon definition for socialized medicine? Maybe I'll like it?

 

[M Paquette]

What is the agreed-upon definition for socialized medicine? Maybe I'll like it?

Just for amusement:

Socialized medicine: A system of health care in which all health personnel and health facilities, including doctors and hospitals, work for the government and draw salaries from the government. Doctors in the US Veterans Administration and the Armed Services are paid this way. And the Veterans and US military hospitals are also supported this way. Examples also exist in Great Britain and Spain.

socialized medicine
Function: noun
Date: 1937
: medical and hospital services for the members of a class or population administered by an organized group (as a state agency) and paid for from funds obtained usually by assessments, philanthropy, or taxation.

so·cial·ized med·i·cine

noun
Definition:

U.S. health care subsidized by government: a system of national health care that provides medical care to all and is regulated and subsidized by the government.

The Harvard School of Public Health conducted a poll on the subject of 'socialized medicine.' I'll just note that trying to paint current proposals for health care as socialized medicine might just backfire.

These graphs illustrate the statistics gathered by the poll.

 

[samclem]

The Harvard School of Public Health conducted a poll on the subject of 'socialized medicine.'

Just for completeness: The poll was conducted in Jan and Feb 2008. I think most people will admit that a lot of water has passed under the bridge since then.

Here's what a more recent poll found regarding American desires for a "single payer" system (which is not necessarily the same as "socialized medicine"--but neither is Medicare):

Thirty-two percent (32%) of voters nationwide favor a single-payer health care system where the federal government provides coverage for everyone. A Rasmussen Reports national telephone survey finds that 57% are opposed to a single-payer plan.

As one would expect, Republicans and Democrats come down on opposite sides of the issue. Surprisingly, independents (the folks who decide most elections) appear to be fairly unified in their thinking. I think the smart politicians are looking at these numbers and thinking of their next election as they work on the current legislation.

There's wide political disagreement over the single-payer issue. Sixty-two percent (62%) of Democrats favor a single-payer system, but 87% of Republicans are opposed to one. As for those not affiliated with either major party, 22% favor a single-payer approach while 63% are opposed.

 

[target2019]

Is single-payer system the application of socialized medicine?

 

[MichaelB]

A "socialized" system would be a single payer that administers the health care facilities and determines rates of compensation.

Controlling cost requires some things that aren't really being talked about. A much more prominent role for the primary care physician, a remake of reimbursement practices focusing on primary care and a reduction in administrative burden.

Family doctors will do a much better job of improving the efficiency of the health care system than employees of any agency or business.

 

[target2019]

A "socialized" system would be a single payer that administers the health care facilities and determines rates of compensation.

Controlling cost requires some things that aren't really being talked about. A much more prominent role for the primary care physician, a remake of reimbursement practices focusing on primary care and a reduction in administrative burden.

Family doctors will do a much better job of improving the efficiency of the health care system than employees of any agency or business.

So, there is only one way to socialize the system, and that is by having a single payer? And this single payer would be the only entity administering the facilities? Do I have that correct?

 

[samclem]

So, there is only one way to socialize the system, and that is by having a single payer? And this single payer would be the only entity administering the facilities? Do I have that correct?

Among the widely differing definitions of "socialized medicine" posted by MPaquette, the "MedicineNet Medical Dictionary" definition looks closest to what I associate with socialized medicine. And, in that case, the government administers the facilities and is a single payer. All socialized medicine systems are single payer, but not all single payer systems would need to be socialized (the single payer could make payments to private medical care providers).

 

[target2019]

Among the widely differing definitions of "socialized medicine" posted by MPaquette, the "MedicineNet Medical Dictionary" definition looks closest to what I associate with socialized medicine. And, in that case, the government administers the facilities and is a single payer. All socialized medicine systems are single payer, but not all single payer systems would need to be socialized (the single payer could make payments to private medical care providers).

What does "administer the facilities" include?

Our high school has an administrator. I see what she does, and know she is paid by the school board. She lives in a nearby town. If she gets out of line, the school board gets involved.

Does single payer mean that our hospital administrator will become a federal employee?