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Old 01-20-2010, 04:21 PM   #41
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This would be a benefit IF other insurance reforms were made.
Absolutely.

This is why we end up with complicated legislation.
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Old 01-20-2010, 04:23 PM   #42
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(Have any Free Marketeers turned down government run Medicare?)
Not a fair question until I'm offered the choice of not contributing (plus get a refund of my share of the deficit $, since it all goes into a general fund anyhow), and there would need to be a free market in place so that I had a place to take my business to.

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Old 01-20-2010, 04:50 PM   #43
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The most amazing part of this vote to me is listening to the Conservative talk show hosts (Hannity, Limbaugh, etc) crowing about how this is the end of all of Obama's legislative priorities. So the Democrats don't have 60 seats anymore, they still have 59, which is far more than the 53 or 54 the Republicans had when they still got a lot of laws passed. There's penty of opportunity for health care reform, with just the slightest dash of bipartisanship added. I think there's a little too much attention being paid to the national aspects of the election, and not enough being paid to the fact that Martha Coakley was a horrible candidate. Overreacting much?
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Old 01-20-2010, 05:16 PM   #44
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How about cutting the waste and fraud from Medicare & Medicaid that has been pointed out? Is anyone (voters that is, not the crooks perpetrating the fraud, or the small minority benefiting from the waste) philosophically opposed to that?

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People can get their arms around fraud and abuse but that is the easy part and Medicare already is working on that. Fraud control units recovered over a billion dollars in 2008. Same with digitizing health records, already in the works with last year's stimulus bill. Electronic billing also will save money and make fraud harder. I don't know the status of moving to electronic billing.

Lots of other waste but those are more difficult issues, such as why does excellent health care in one part of the country cost half as much as excellent health care in another part of the country. This is a tougher nut and there has been opposition to even experimentation by Medicare and Medicaid on new reimbursement mechanisms to reward efficient, quality providers.
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Old 01-20-2010, 05:21 PM   #45
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I think there's a little too much attention being paid to the national aspects of the election, and not enough being paid to the fact that Martha Coakley was a horrible candidate. Overreacting much?
Yes. If I lived in MA I would have had a big problem deciding what to do. Her actions as a prosecutor would make it almost impossible for me to have voted for her, I don't know if I could have yellow dogged it or not.
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Obama urges pared-back health care bill
Old 01-20-2010, 05:42 PM   #46
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Obama urges pared-back health care bill

Obama urges lawmakers not to try to jam a bill through Congress

Obama urges pared-back health care bill - Health care reform- msnbc.com
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Old 01-20-2010, 07:11 PM   #47
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I think you are touching on why the current bills failed. I don't think the current bills had much to do with solving the problems (few "good" ideas), they were attempts towards achieving more govt control by the party in power.

I think there have been a number of proposals made in the last few posts that would meet the "good" criteria. I don't know how specific you can get, I think this (from ziggy) was pretty specific:
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I'd like to see a combination of some sort of "super-COBRA" type thing where someone continuously insured for (say) 5 years can stay in a group plan indefinitely without underwriting (the five year requirement might reduce the incidence of adverse selection). And I'd like to see more employer group plans offer high-deductible plans with more affordable premiums.
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I'd like to see small businesses able to have some anti-trust laws suspended for the purpose of banding together to get more affordable group rates than are possible if they try to negotiate alone.
These are specific enough for me. I think the indefinite COBRA would initially meet my criteria of getting at least 50% support from the public.

But the insurance companies would say that the cost of keeping uninsurable people in the group indefinitely would raise costs and premiums by an unknowable amount. Employers would say (correctly) that the higher premiums would either be passed on to the active employees in terms of lower wages, or cause the employer to drop group insurance for everyone. This type of argument is used against the current bill.

So I imagine that we'd end up with just as many congressmen against this provision as there are against the current bill. I could be wrong, maybe the very limited scope and simple provisions (this doesn't take 2,000 pages) would pull a few across the line.

Regarding high deductible plans, they are already legal, and even encouraged through tax-deductible HSA's. So I don't see any legislation here.

Regarding small employers forming buyers co-ops, I didn't think they were illegal today. I'm not an expert in anti-trust law, I always think of it targeting price fixing and monopolies within one industry. If buyers co-ops are really illegal under current law, this is one thing which I'd expect to get my 50% of voters and 50% of Congress to agree on.

So, I get two maybes for my list.
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Old 01-20-2010, 07:23 PM   #48
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Obama urges lawmakers not to try to jam a bill through Congress

Obama urges pared-back health care bill - Health care reform- msnbc.com

A strategy now might be to have a pared-back health care bill (retaining the things that there is a consensus on) and to dare others to vote against it.

His state of the union address next week is going to be interesting. Will, it have the tone of "We tried, have come so close to health care over-haul, but stil have some more to go" or will he come out swinging.
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Old 01-20-2010, 08:30 PM   #49
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Lots of other waste but those are more difficult issues, such as why does excellent health care in one part of the country cost half as much as excellent health care in another part of the country. This is a tougher nut and there has been opposition to even experimentation by Medicare and Medicaid on new reimbursement mechanisms to reward efficient, quality providers.
Let's just give anybody who lives in an expensive area $500 and a one way plane ticket to a cheap area.

Ha
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Old 01-21-2010, 05:52 AM   #50
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