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View Poll Results: What should Congress do about "Obamacare"
Overturn Obamacare and start over 20 24.69%
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Old 12-24-2010, 09:42 AM   #41
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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?
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Old 12-24-2010, 11:29 AM   #42
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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.

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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.

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Old 12-24-2010, 11:59 AM   #43
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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.
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Old 12-24-2010, 12:32 PM   #44
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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.

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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 . . .
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Old 12-24-2010, 01:04 PM   #45
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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.
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Old 12-24-2010, 01:23 PM   #46
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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'.


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Old 12-24-2010, 01:47 PM   #47
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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...
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Old 12-24-2010, 02:20 PM   #48
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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.
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Old 12-24-2010, 02:33 PM   #49
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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?
Quote:
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(Best mocking mother tone, with hands on hips) "If Johnny Smith jumped off a cliff, would you jump off a cliff?"
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Old 12-26-2010, 02:01 PM   #50
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Quote:
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:

Quote:
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
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Old 12-26-2010, 02:27 PM   #51
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Yes, people are dying because they have no insurance. They can go to the ER to be STABILIZED for urgent life-threatening issues (assuming they live near and can get to an ER). But there is no mandate that says continuing care happens.

We absolutely (currently) have no mandate for preventive care that keeps people healthy enough to not need ER type care.

There are many people in this country who have to choose between much-needed medicine, and food or utility bills. Or - who have no money for any of the above. The food banks are seeing many more people in the past 2 years.

If you are a diabetic and can't afford insulin, or have a heart condition and can't afford whatever meds you need... You've got a big problem with the current system if you are uninsured.

Or if you have SOME assets and develop cancer - your entire life savings (assuming you have some) can go in a second with no insurance. And then if you need more care, with no more money, you can die. It's just that simple.

As far as I'm concerned the USA is living in the dark ages when it comes to health care. And our health statistics are dismal. We have excellent health care... IF you can afford it or have good insurance...

If not, you are SOL.
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Old 12-26-2010, 02:28 PM   #52
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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.
+1
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Old 12-26-2010, 02:29 PM   #53
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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:
Medicaid is means tested for both assets and income. Eligibility is a lengthy and onerous process. It is not a reasonable option for an uninsured individual needing medical care in the short term.

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

-ERD50
Study links 45,000 U.S. deaths to lack of insurance | Reuters
Quote:
(Reuters) - Nearly 45,000 people die in the United States each year -- one every 12 minutes -- in large part because they lack health insurance and can not get good care, Harvard Medical School researchers found in an analysis released on Thursday.
"We're losing more Americans every day because of inaction ... than drunk driving and homicide combined," Dr. David Himmelstein, a co-author of the study and an associate professor of medicine at Harvard, said in an interview with Reuters.
Overall, researchers said American adults age 64 and younger who lack health insurance have a 40 percent higher risk of death than those who have coverage.
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Old 12-26-2010, 02:31 PM   #54
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Medicaid is means tested for both assets and income. Eligibility is a lengthy and onerous process. It is not a reasonable option for an uninsured individual needing medical care in the short term.


Study links 45,000 U.S. deaths to lack of insurance | Reuters
Exactly.
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Old 12-26-2010, 02:36 PM   #55
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There are limits for Medicaid. Not everyone, even those living in poverty, can get care through Medicaid. In California, for example, Medicaid is run through the Medi-Cal program.

Find Out if I Qualify

If someone can't get into one of the eligible channels, they won't have care. In Mendocino County, some of the folks I mentioned before did eventually get into end-of-life care through Phoenix Hospice out of Willits, which was covered as a Medi-Cal program.

In general, it would be preferable to address medical care issues prior to the patient entering terminal care, though. What we currently have is a bit of a patchwork of employer care, individual policies for those who qualify and can afford them, high risk pools for those who can afford that, Medicare for those 65 and older with 40 eligible quarters of work experience or cash to pay the premiums, Medicaid for others over 65, or in eligible care channels, and some charitable organizations.

There's some more information on Medicaid and the uninsured here:
www.kff.org/uninsured/upload/7613.pdf
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Old 12-26-2010, 03:17 PM   #56
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Medicaid is means tested for both assets and income. Eligibility is a lengthy and onerous process. It is not a reasonable option for an uninsured individual needing medical care in the short term.


Study links 45,000 U.S. deaths to lack of insurance | Reuters
About 2.5 million people die each year in the USA. If 45,000 die due to lack of health insurance then 2.45 million die who have health insurance die. It doesn't look like health insurance is doing much good.

The headline should read: "2.45 Million Die Each Year In Spite of Paying High Health Insurance Cost"
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Old 12-26-2010, 03:32 PM   #57
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About 2.5 million people die each year in the USA. If 45,000 die due to lack of health insurance then 2.45 million die who have health insurance die. It doesn't look like health insurance is doing much good.

The headline should read: "2.45 Million Die Each Year In Spite of Paying High Health Insurance Cost"
*SIGH*

In other news, 100% of the current population will eventually die, with or without health insurance. So, why would anyone want this stuff?
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Old 12-26-2010, 03:41 PM   #58
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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.
I agree. We can work to improve the current plan if we want to keep health insurance in the mix. If we just junk it the odds of doing something to replace it in the immediate future are next to nothing.

There is no political will for a government run program.

I would like our time spend on trying to figure out how to reduce costs, or at least stop the huge inflation in costs. Parts of the health care plan put in place mechanisms to study the cost issues. Let's do that.
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Old 12-26-2010, 05:41 PM   #59
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I have to mention.... I am not sure if it was 60 minutes or some other program (now I think it was Nightline).....


They were showing some clips from a program in the UK... people come it with some strange malady and show it to the viewers... then the docs go about 'fixing' it... now, the ones I saw were very ugly problems... and this in a country that is supposed to have national health care....

They said they saved the life of one 9 YO girl... so it seems that there are problems with a system that sick people will not even go to the doc for free!! Not saying they would go if they were paying for insurance, but when all you got to do is go in.... strange....
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Old 12-26-2010, 05:42 PM   #60
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I agree. We can work to improve the current plan if we want to keep health insurance in the mix. If we just junk it the odds of doing something to replace it in the immediate future are next to nothing.
Also agree. Start again is mostly code for leave it the way it was...it worked alright for me.

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There is no political will for a government run program.
But don't touch Medicare or Tricare.

Quote:
I would like our time spend on trying to figure out how to reduce costs, or at least stop the huge inflation in costs. Parts of the health care plan put in place mechanisms to study the cost issues. Let's do that.
Yeah. Maybe we could also figure out how to do away with the abusive price gouging for people with no insurance.
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