Should we return to prior healthcare system

[samclem]

I don't understand how that happened. I don't follow politics closely at all but I thought the Dems had something like 2/3 of the seats in both House and Senate after the 2008 elections. With that kind of majority they should have been able to pass whatever they wanted to, even a single-payer plan, regardless of what the Republicans thought about it. What kept that from happening? How did we end up with this big complicated Act that nobody is really satisfied with?

Lots of reasons, but chief among them:
- In the Senate they needed 60 votes. There were 60 Democrats/pseudoDemocrats until there was an election in Massachusetts (one of the more liberal states) and a Republican won (many people believe the election was decided by public reaction to the Bill and the shenanigans used to craft it. It was a precursor of the 2010 election). This put a big kink in any plans to modify the "awkward" bill that Democrats had already passed in the Senate.
- Not all the Democrats are liberal, and they needed a lot of them in both houses. To get the needed votes, a lot of ugly deals were struck.

The Republicans put forth many ideas and plans, but there's not much of that in the present law. What's there is almost solely the product of Democratic politicians. You are right--they controlled the House, the Senate and the Presidency.

 

[FinanceDude]

The Republicans put forth many ideas and plans, but there's not much of that in the present law. What's there is almost solely the product of Democratic politicians. You are right--they controlled the House, the Senate and the Presidency.

Past tense now.....DID control..........

 

[DeborahB]

Some think that the greatest problem of our healthcare system is that it is not universal. That includes me but, I gather from comments in the other thread, none of you. At any rate, to fix that problem requires wealth redistribution, which in turn requires government involvement. Increasing competition, rationalizing prices, tort reform, and similar ideas bandied about here are not relevant.

Nope, I agree - we need universal healthcare. I vote for a single payer system and a lot of doctors do too. Oooh, I just found this cool emoticon that kind of sums it up:

 

[Midpack]

You would think "the greatest country in the world" could figure this out, there are a few examples. Mexico is working on it now, maybe we should ask them...

Country	Start Date of Universal Health Care	System Type
Norway	1912	Single Payer
New Zealand	1938	Two Tier
Japan	1938	Single Payer
Germany	1941	Insurance Mandate
Belgium	1945	Insurance Mandate
United Kingdom	1948	Single Payer
Kuwait	1950	Single Payer
Sweden	1955	Single Payer
Bahrain	1957	Single Payer
Brunei	1958	Single Payer
Canada	1966	Single Payer
Netherlands	1966	Two-Tier
Austria	1967	Insurance Mandate
United Arab Emirates	1971	Single Payer
Finland	1972	Single Payer
Slovenia	1972	Single Payer
Denmark	1973	Two-Tier
Luxembourg	1973	Insurance Mandate
France	1974	Two-Tier
Australia	1975	Two Tier
Ireland	1977	Two-Tier
Italy	1978	Single Payer
Portugal	1979	Single Payer
Cyprus	1980	Single Payer
Greece	1983	Insurance Mandate
Spain	1986	Single Payer
South Korea	1988	Insurance Mandate
Iceland	1990	Single Payer
Hong Kong	1993	Two-Tier
Singapore	1993	Two-Tier
Switzerland	1994	Insurance Mandate
Israel	1995	Two-Tier

 

[samclem]

You would think "the greatest country in the world" could figure this out, there are a few examples. Mexico is working on it now, maybe we should ask them...

(Best mocking mother tone, with hands on hips) "If Johnny Smith jumped off a cliff, would you jump off a cliff?"

 

[Texas Proud]

And what is two tier



Also... reading this it seems that Nazi's had an insurance mandate


(OK... this should kill this thread referring to Nazis.... but hey... I am serious...who would have thunk it)...


Oppp... edit to add... a number of countries started a LONG time ago... so why did the US not do it We had a lot of liberal politicians before WWII and even after... heck, if Johnson did not do it I do not think many others could....

 

[Alan]

And what is two tier..

Basic single payer Plus private insurance. Although the UK is listed above as single payer (the default), we had company provided health insurance as well when we changed jobs in 1979. Fortunately we never had need to utilize our private plan.

Two-tier health care - Wikipedia, the free encyclopedia

Most countries have both public and privately funded health care

 

[aaronc879]

Why blame the R's when the D's were holding all the cards?
I say that as an independent, just observing the facts.

-ERD50

Why blame the D's when the R's are the ones refusing to go along with anything Obama proposes simply because he proposed it no matter how good it is. They(the R's) are to blame for the lack of change in the healthcare and tax reforms that Obama tried to make. The president has limited power. Congress has more power.

I say that as an independent, just observing the facts.

 

[REWahoo]

Here we go with the partisan finger pointing...

I think I hear Porky's sleigh landing on the roof...

 

[kyounge1956]

And what is two tier

A combination of a government insurance program with private insurance to supplement? I'm only guessing but France has two tier, and based on the description of the French system in another thread, that's what it would be.

Also... reading this it seems that Nazi's had an insurance mandate

(OK... this should kill this thread referring to Nazis.... but hey... I am serious...who would have thunk it)...

You mentioned them in a purely historical context. Who else could it have been in Germany in 1941? I hope that's not enough to get the thread locked!

Oppp... edit to add... a number of countries started a LONG time ago... so why did the US not do it We had a lot of liberal politicians before WWII and even after... heck, if Johnson did not do it I do not think many others could....

I recently listened to an audiobook, Conscience of a Liberal. IIRC this author's hypothesis is, universal health coverage wasn't put into place in the US in the 1930's because the southern Democrats who were part of the New Deal's political backing wouldn't have voted for anything that would have required desegregation of hospitals. Then during WWII, as I understand it, health insurance got linked to jobs—it was a perk that could be offered even when wage controls were in place. By the time Johnson came along, maybe it appeared that main problem with health care in the US was that some people—the elderly and low income—weren't getting it through jobs, so Medicare and Medicaid were created specifically for those groups, instead of a "start from scratch" revamp of the whole system. But again, that's just a guess.

 

[ERD50]

Why blame the D's when the R's are the ones refusing to go along with anything Obama proposes simply because he proposed it no matter how good it is. They(the R's) are to blame for the lack of change in the healthcare and tax reforms that Obama tried to make. The president has limited power. Congress has more power.

I say that as an independent, just observing the facts.

You missed a fact - the D's controlled Congress. They could pass anything they decided w/o a single R vote. There is nothing the R's could do to stop them. You are right, Congress has the power, all the President can do is veto it, but that wasn't the issue here since he is a D also.

Though I'm not 'blaming' anyone , I was responding to those blaming the R's.

-ERD50

 

[kyounge1956]

Here we go with the finger pointing...

I think I hear Porky's sleigh landing on the roof...

Nooooo! Pleeeese don't close the thread! I'm sorry I asked!! I really wasn't trying to start a fight. My bad!

 

[kyounge1956]

You would think "the greatest country in the world" could figure this out, there are a few examples. Mexico is working on it now, maybe we should ask them...

Country	Start Date of Universal Health Care	System Type
Norway	1912	Single Payer
New Zealand	1938	Two Tier
Japan	1938	Single Payer
Germany	1941	Insurance Mandate
Belgium	1945	Insurance Mandate
United Kingdom	1948	Single Payer
Kuwait	1950	Single Payer
Sweden	1955	Single Payer
Bahrain	1957	Single Payer
Brunei	1958	Single Payer
Canada	1966	Single Payer
Netherlands	1966	Two-Tier
Austria	1967	Insurance Mandate
United Arab Emirates	1971	Single Payer
Finland	1972	Single Payer
Slovenia	1972	Single Payer
Denmark	1973	Two-Tier
Luxembourg	1973	Insurance Mandate
France	1974	Two-Tier
Australia	1975	Two Tier
Ireland	1977	Two-Tier
Italy	1978	Single Payer
Portugal	1979	Single Payer
Cyprus	1980	Single Payer
Greece	1983	Insurance Mandate
Spain	1986	Single Payer
South Korea	1988	Insurance Mandate
Iceland	1990	Single Payer
Hong Kong	1993	Two-Tier
Singapore	1993	Two-Tier
Switzerland	1994	Insurance Mandate
Israel	1995	Two-Tier

I am kind of surprised by the dates. About two thirds of these countries started their systems within my lifetime, and nearly half of them since I've been an adult. I had gotten the impression (I don't know where from) that most countries with universal health coverage had had it since the 40's or before.

 

[Texas Proud]

I am kind of surprised by the dates. About two thirds of these countries started their systems within my lifetime, and nearly half of them since I've been an adult. I had gotten the impression (I don't know where from) that most countries with universal health coverage had had it since the 40's or before.

I looked at the list again... and have the same surprise....



pssst.... not trying to point fingers or get the thread closed... but if you listen to what was being said when the bill was passed... Obama told the Rs that he had won and they should get on board... they did not listen... the Ds said we have enough votes to get it passed without you... so we do not have to put in anything to get your votes (or very little to get Snowe and the other one).... it was a power play, pure and simple... it backfired on the Ds... a lot of them lost their seat and we will see where we go from here....


BTW, I am against all the spending.... but am for some of the regulations... I still wish they had passed a bill that did what they said there wanted to do which was do something about the cost... not about who pays... (sorry... I know the arguments about bending the curve and we have to have everyone on board etc. etc.. I just do not believe them to be true... so, to keep Porky away... let not go down this road much)...

 

[MichaelB]

It's the D's. No, it's the R's. No, it's the P's.

Actually, it's the people.

It's worse than before - start again. No, it just needs tweaking.

It was lousy before and still is. Just a little less so.

We cannot have a vibrant and effective system that enables everyone access to reasonable healthcare in a country where the majority of citizens seem to feel it is acceptable for 1/4 of the population to earn less than a "living wage" - what is needed to pay for health care or meet other minimum standards of modern life.

The most vocal critics of the recent reform are those that made every effort to discourage and impede the process, threw up every possible obsticle, and now criticize the outcome.

There are no simple fixes to a system that is built around healthcare intermediation, is rampantly discriminatory and overflows with conflict of interest, allows individuals and investors to profit by exploiting regulatory loopholes and the misfortune of some.

The only real "fix;' is single payer universal healthcare.

 

[Midpack]

(Best mocking mother tone, with hands on hips) "If Johnny Smith jumped off a cliff, would you jump off a cliff?"

And they all have substantially lower per capita health care costs - I'd post the data again, but many have several times before. So your solution is the status quo?

The US is well down the list for longevity and infant mortality, so the 'we have better care' argument is certainly not a given. So we're better off as the only developed country without universal health care? Where do you think all the extra per capita costs go BTW?

 

[ERD50]

And they all have substantially lower per capita health care costs

(I'll say it again) As they have substantially lower per capita public education costs - and also with better results. So that is a hollow argument.

So your solution is the status quo?

Clearly, you have not been listening to samclem. He has posted an outline of some solutions he thought would be workable, and referenced it several times. None of them were the 'status quo'.

Questions like that just serve to weaken your own position. And I'm saying that in a helpful, not critical way. If you want to make your point, use sound logic, else people will think you don't have any good arguments when they see you resort to flawed ones. I'm sure you don't want that.

-ERD50

 

[obgyn65]

In my view we cannot afford to overturn Obamacare and start over. Too many people are dying every year because of lack of healthcare insurance.

 

[samclem]

And they all have substantially lower per capita health care costs - I'd post the data again, but many have several times before. So your solution is the status quo?

??The only options are "what Congress did" and "the non system we have now"?? This kind of binary approach is unlikely to lead to a satisfactory solution. Like nearly everyone else, I think we need to make major changes.

The US is well down the list for longevity and infant mortality, so the 'we have better care' argument is certainly not a given. So we're better off as the only developed country without universal health care? Where do you think all the extra per capita costs go BTW?

As others have mentioned, there are a lot of problems with using either infant mortality or longevity as metrics for health care quality--lots of countries fudge the numbers or count infant mortality differently than we do. On longevity: How much of the differences do you suppose might be due to caloric intake (obesity), exercise, smoking, traffic deaths, etc, and how much might be due to health care?

These other 32 countries could learn a lot from us. Our democracy is older than any of theirs. Our GDP per capita is higher than 30 of them. That has a lot to do with taxation rates and government drag on their economies in general. Which brings us back to this health care law and govt intrusions. Higher GDP per capita is not just about having nicer cars and bigger homes--it can extend lives and make them more enjoyable. There will be tradeoffs . . .

 

[Brat]

I would like to see a two tier system. The basic, universal, policy should be basic and focus on care that restores health or prevents disease. It should not do all things, if a citizen wants more coverage they purchase an additional policy. The policy would also pay for emergency room care where the emergency room also has an affiliated urgent care facility for patients who show up but are not appropriate for emergency room treatment.

IMHO all physicians who choose internal, family, geriatric obstetric and pediatric specialties should have their tuition and educational costs paid. That alone should help with the cost of providing care. As a practical matter physicians in this program need to be affiliated with a group so that patient records can be made available electronically. There needs to be incentives to prevent physicians from duplicating tests. We need to get away from the fee for service model.

 

[ERD50]

In my view we cannot afford to overturn Obamacare and start over. Too many people are dying every year because of lack of healthcare insurance.

Is this even true?

I know people who had no health insurance and got excellent care for some serious injuries. And these injuries were pretty much self-inflicted.

I think it is true that one can be driven into bankruptcy if they don't have health insurance (or the coverage is limited). That's bad and needs fixing, IMO. But it isn't the same as people 'dying because of lack of healthcare insurance'.


-ERD50

 

[bright eyed]

I wouldn't support a repeal - the bill while not perfect (what bill is?) accomplished important things, for kids in particular - already implemented (some CA specific items here) are:

Pre-existing conditions: Health insurance companies will no longer be allowed to deny coverage to children seeking insurance or deny treatment to children already covered due to pre-existing conditions (such as asthma, diabetes, or even chronic ear infections).

Young adults stay covered: Insurance companies will be required to allow young adults to stay on their parent’s insurance until age 26, even those who are not full-time students.

​

Coverage when kids need it most: Insurance companies won’t be allowed to drop people when they get sick (a common practice today, called "rescission"). They also won’t be allowed to limit the lifetime dollar value of coverage, which is important for kids with lifelong conditions like diabetes or asthma or serious health problems like cancer.

​

Free preventive services: Insurance companies will have to cover immunizations and other preventive health services for infants, children, and adolescents – at no cost to families.

​

Children can keep Healthy Families and Medi-Cal coverage: The successful Healthy Families and Medi-Cal initiatives are protected so children won’t lose coverage even if the state has a deficit.

Additional improvements coming in 2014...

I think peoples feelings about the bill will change as they start to see the difference it makes in their or their neighbors lives...
​

 

[M Paquette]

Is this even true?

I know people who had no health insurance and got excellent care for some serious injuries. And these injuries were pretty much self-inflicted.

I think it is true that one can be driven into bankruptcy if they don't have health insurance (or the coverage is limited). That's bad and needs fixing, IMO. But it isn't the same as people 'dying because of lack of healthcare insurance'.

A person can get quick immediate care, without health insurance, courtesy of the law requiring emergency rooms to treat and stabilize patients without regard to ability to pay, and in some areas, free clinics staffed by generous folks.

You really don't want to be someone suffering from a chronic or long term debilitating disease, particularly in one of the many smaller communities located a long ways from a charitable or public health facility.

Up until her death, my mother, a retired RN, tried to sneak help to some of these folks in the rural area where she lived (Sneak, because there are legal limits on what an RN can do, but no doctor was available to help beyond writing a few scripts. Things are bad there. The only ER for a hundred miles was shut down til recently because it couldn't be staffed to meet requirements.) When I was visiting I went out to help her, driving and carrying, basically there to do grunt work. What I saw reminded me too much of places like Sierra Leone.

No insurance meant no money to pay for assistance from visiting professional caregivers. No insurance meant no money for pharmaceuticals. No insurance meant no palliative care for terminal patients. These people knew that, but they couldn't afford the insurance when they were working, and certainly not after the jobs went away (The region was dominated by a single business that shut down there.) Now that they were ill, they couldn't get one of the rare jobs in the region that included health care coverage. Relocate? That costs money, too, and where would they move to? Someplace where they could live as homeless indigents and receive free care, giving up their old home?

Without insurance, they knew they couldn't afford to see the doctor for that odd lump on their neck, or that persistent cough, so they try to get by without. They certainly can't afford surgery, so they do without. Their families couldn't afford the funeral, but the county will provide a pauper's grave at no charge. So that's something.

 

[Midpack]

Questions like that just serve to weaken your own position. And I'm saying that in a helpful, not critical way. If you want to make your point, use sound logic, else people will think you don't have any good arguments when they see you resort to flawed ones. I'm sure you don't want that.-ERD50

Not in a critical way, but like this?

(Best mocking mother tone, with hands on hips) "If Johnny Smith jumped off a cliff, would you jump off a cliff?"

 

[ERD50]

Originally Posted by ERD50
Is this even true?

I know people who had no health insurance and got excellent care for some serious injuries. And these injuries were pretty much self-inflicted.

I think it is true that one can be driven into bankruptcy if they don't have health insurance (or the coverage is limited). That's bad and needs fixing, IMO. But it isn't the same as people 'dying because of lack of healthcare insurance'.

A person can get quick immediate care, without health insurance, ...

No insurance meant...

Without insurance, ...

Yes, but doesn't Medicaid kick in? I'm not commenting about how good/bad Medicaid is, but this was in response to the comment:

Originally Posted by obgyn65 ... Too many people are dying every year because of lack of healthcare insurance.

Again, people may be going bankrupt because they don't have or can't get ins, but are they dying because of it?

-ERD50