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Old 02-15-2009, 06:50 PM   #141
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The reason I say it is part of the problem is it pulls on the heart strings but does not represent the majority of the population. It is like the stimulus bill. You would think there was not a person in the U.S. that had a job, or were not about to loose their job. Lots of people paraded before the press with their hard luck stories to convince us Congress just has to spend 800B they don't have. However, at the same time, we hear that the economy will recover weather they spend or not.
I certainly share your disdain for political hacks exploiting the pull-at-the-heartstrings cases where people through no fault of their own suddenly got horribly screwed by the system. I think these cases are quite rare as a percentage of the population, but they do happen and I'd like to see us be able to address those situations without watching baby go out with the bathwater. No one who works hard, prepared reasonably and had two or three bad things happen at once deserves to choose between treatment and bankruptcy. At the same time, it should take more than that to drive a complete overhaul of how health care is funded and delivered.

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I do not question you see these cases. I do not question that medical expenses can ruin an early retirement. However, IMO, Congress could have taken the 800B they just spent and provided for all these cases forever and all the others that will pop up. I promise you a Health Care Reform bill will be just as full of PORK as the bill they just passed, and within the first 5 years the horror stories, will still be out there.
True to a point. I don't buy all the hype that this will save jobs and create 2-3 million jobs, but if all you do is give everyone health care, in the longer term you could see a public come to the conclusion that you don't NEED to work if Uncle Sugar is giving away health care to those of lesser means. Providing health care to all without a requirement for cost sharing or working (for those of sound mind and body) would be a recipe for disaster.
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I have no faith in the Federal Government's ability to solve this problem without wrecking the health care for the rest of us. I've said it before 'Be careful what you wish for'. I also believe the Doctors may end up carrying the brunt of the cost.
That last sentence is possible, especially if the universal coverage takes the "Medicare for All" form as pushed by Dennis Kucinich in HR 676. A growing number of doctors won't even take Medicare because of the pathetic reimbursement rates, and that would ultimately mean that either (a) there will be fewer and fewer doctors willing to work with patients under HR 676 or (b) doctors will be *forced* to accept HR 676 patients, meaning they suck it up and take a big pay cut or retire.

The bottom line is that this isn't an easy nut to crack. But I don't think that's an excuse to not deal with the things that are blatantly and glaringly wrong, and start there.
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Old 02-15-2009, 07:11 PM   #142
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First off, again, I do not believe the health care system is blatantly and glaringly wrong.

Second. Why stop with health care. There are blatant and glaringly wrong stories about how people get food, jobs, transportation, housing, clothing, you name it. There are people in our society that don't have what you and I have. Where does it end? What will be the next Government give away? IMO, it is not governments responsibility to provide it!
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Old 02-15-2009, 07:25 PM   #143
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Rich,
The reason I say it is part of the problem is it pulls on the heart strings but does not represent the majority of the population. It is like the stimulus bill. You would think there was not a person in the U.S. that had a job, or were not about to loose their job. Lots of people paraded before the press with their hard luck stories to convince us Congress just has to spend 800B they don't have. However, at the same time, we hear that the economy will recover weather they spend or not.

I do not question you see these cases. I do not question that medical expenses can ruin an early retirement. However, IMO, Congress could have taken the 800B they just spent and provided for all these cases forever and all the others that will pop up. I promise you a Health Care Reform bill will be just as full of PORK as the bill they just passed, and within the first 5 years the horror stories, will still be out there.

I have no faith in the Federal Government's ability to solve this problem without wrecking the health care for the rest of us. I've said it before 'Be careful what you wish for'. I also believe the Doctors may end up carrying the brunt of the cost.
I have a lot of uninsured stories, but I told those two because both had insurance, lost it through no fault of their own, and their healthcare broke the bank.

I understand being concerned about what might be done, but we still need to do something to make things better. As it is we as a nation spend too much for what we as a nation are getting. We need to hear the stories to know the problems. It hasn't been getting better, it is getting worse, with more and more small employers dropping insurance coverage as it becomes unaffordable.

I do not buy the slippery slope argument that insuring health care for all is a step away from socialism. We provide education. We provide infrastructure. I think that providing health care separate and apart from employment will help us be more competitive. There are few countries any more that don't have a form of universal coverage.
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Old 02-15-2009, 07:37 PM   #144
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I have a lot of uninsured stories, but I told those two because both had insurance, lost it through no fault of their own, and their healthcare broke the bank.

I understand being concerned about what might be done, but we still need to do something to make things better. As it is we as a nation spend too much for what we as a nation are getting. We need to hear the stories to know the problems. It hasn't been getting better, it is getting worse, with more and more small employers dropping insurance coverage as it becomes unaffordable.
To the degree that voters will have anything to say about this issue, the stories will count far more than statistics. What sunk Hillary Care was not any studies or projections, but Harry and Louise. (And of course the usual lobbyists.)

My guess is that there will be legislation on this issue within Barack's first half term. The Republicans have been so discredited that I don't believe any anti-health care reform ad campaign could sink it, no matter how cleverly mendacious the ads might be.

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Old 02-15-2009, 08:40 PM   #145
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I understand being concerned about what might be done, but we still need to do something to make things better.
With the first bailout ("The Emergency Economic Stabilization Act of 2008") we had to quickly "do something" so we dumped $350 billion so far (another $350 billion already in the dump trucks) and nobody knows what was accomplished or how we could even measure what was accomplished. Last week Congress voted $787 billion more, but there's not a single legislator who claims to have even read the whole thing--there's no time to even post it on the internet--it must be voted on and signed into place immediately because we must "do something." Hopefully, whatever we spend on this future re-wickering of health care will involve a more deliberate plan than we've seen to date. Maybe some debate, maybe some time for public comment--that "openness and transparency" that were supposed to be the hallmarks of change we can believe in. That has been a belly laugh. In addition to the latest outrages, it sure didn't happen the last time an administration dreamed up a healthcare revamp, and the indications to date are that the new mantra of "just do something" is intended allow opaque expediency to replace open deliberate action. I know that's not your intent, but I hope we're about done with "doing things" without a plan.


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As it is we as a nation spend too much for what we as a nation are getting.
That's probably true. But, we are individuals, and we don't spend money on health care or receive our health care "as a nation." We get it as individuals. And those who have good health care (because they provided for themselves, or because they negotiated to get it as part of their employment (the dumb way Washington designed the system to work)) may be forgiven for being less than confident that this restructure won't leave them worse off. There are many equities at stake here, and the providers of health coverage will look to do all they can to reduce their expenses if given legal cover by Washington. Who, exactly, will be looking out for the interests of those who now have coverage, particularly if that coverage exceeds whatever new "good enough" standards are enacted? Trick question: When is a contract not a contract? When Uncle Sam says one side can walk away from it.

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I think that providing health care separate and apart from employment will help us be more competitive.
I agree that separating health care from employment will make our industries (and our workforce) more productive.
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Old 02-15-2009, 08:42 PM   #146
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I do not buy the slippery slope argument that insuring health care for all is a step away from socialism. We provide education. We provide infrastructure. I think that providing health care separate and apart from employment will help us be more competitive. There are few countries any more that don't have a form of universal coverage.
I remember when, so it can't be that long ago, that similar arguments were used to provide lunch for school kids that could not afford it. Now the majority of students in the Houston Independent School District get free or discounted lunch and breakfast.

It is a slippery slope and the fact we are even considering it means we have already traveled down that slope. You and I disagree on this issue, and that's OK. But to say it is not pushing the country further towards socialism is wrong. It is, and that is why many of us are against it.
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Old 02-16-2009, 09:30 AM   #147
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With the first bailout ("The Emergency Economic Stabilization Act of 2008") we had to quickly "do something" so we dumped $350 billion so far (another $350 billion already in the dump trucks) and nobody knows what was accomplished or how we could even measure what was accomplished. Last week Congress voted $787 billion more, but there's not a single legislator who claims to have even read the whole thing--there's no time to even post it on the internet--it must be voted on and signed into place immediately because we must "do something." Hopefully, whatever we spend on this future re-wickering of health care will involve a more deliberate plan than we've seen to date. Maybe some debate, maybe some time for public comment--that "openness and transparency" that were supposed to be the hallmarks of change we can believe in.
Given that government has worked on this issue off and on for years, I think legislators are much better informed than they are on the economic stimulus stuff. Several proposals were worked on extensive several years ago, during the Bush administration, so there are a number of legislators who are knowledgeable. My worry isnt that something will get rammed through, but that it all will get caught up in details and the desire to please various lobbies that we have a convoluted mess. That is what in large part killed Hillary's bill. Or, that more patchwork will be done which will do little to address the cost issues, especially administration costs. As the children's book says, please all please none.
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Old 02-17-2009, 11:08 AM   #148
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Ok, how about this.

Individual/family is responsible for all medical expenses up to $5k after that a Gov policy takes over and pays the remaining expenses. You could have it reset each year or continue paying for service if it is for the same disease.

Individual either pays the first 5K or gets insurance to supplement. Insurance co must take all. The insurance co would know that in any given year they would only be responsible for 5k and set policy accordingly.

The poor are still taken care of by Medicaid, and the old by Medicare, however, even Medicare could be made to conform.

The numbers may not be right, but the idea of the Gov taking care of catastrophic expense and individuals the day to day stuff makes since to me.
I think you are on the right track. I'll adjust the details:

1) We replace Medicare and much of Medicaid with universal catastrophic health insurance.
2) The format looks like Medicare - private hospitals/doctors paid by tax dollars.
3) Initially, a "catastrophe" is defined as spending more than 15% of your gross income on health care.
4) The plan is funded by a single, visible, flat tax on all income.
5) Once a year, the voters adjust the tax up or down, and Congress adjusts the deductible/benefits to match the tax dollars.
6) You can cover the first 15% however you want - direct pay, individual insurance, group insurance. But, no gov't subsidies.

Note that this plan covers everyone (if you have no income, then you have no deductible). But, the annual vote avoids run-away costs by keeping the price in front of all of us.

I'd like to believe that free markets can solve everything. But, there are a number of problems with that attitude and health care. One that I can't get around is that people develop conditions that dramatically impact the likely cost of future health care. I don't see a way of dealing with that without some sort of gov't mandate.
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Old 02-17-2009, 11:34 AM   #149
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I think you are on the right track. I'll adjust the details:

1) We replace Medicare and much of Medicaid with universal catastrophic health insurance.
2) The format looks like Medicare - private hospitals/doctors paid by tax dollars.
3) Initially, a "catastrophe" is defined as spending more than 15% of your gross income on health care.
4) The plan is funded by a single, visible, flat tax on all income.
5) Once a year, the voters adjust the tax up or down, and Congress adjusts the deductible/benefits to match the tax dollars.
6) You can cover the first 15% however you want - direct pay, individual insurance, group insurance. But, no gov't subsidies.

Note that this plan covers everyone (if you have no income, then you have no deductible). But, the annual vote avoids run-away costs by keeping the price in front of all of us.

I'd like to believe that free markets can solve everything. But, there are a number of problems with that attitude and health care. One that I can't get around is that people develop conditions that dramatically impact the likely cost of future health care. I don't see a way of dealing with that without some sort of gov't mandate.
Is private care outside the system allowed? I'd want to be free to buy care, and to buy insurance that covers care that the government won't pay for. When I'm 70 and need my knees replaced, I don't want to have to settle for the govt issued "suitable substitute" roller dolly and knuckle pads.
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Old 02-18-2009, 09:20 AM   #150
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Since I'm making the proposal, the answer is "yes". I'd like to believe that the voters who have to make a decision on taxes every year would think it's a fine idea for some people to pick up some of their own costs.

Whether or not the gov't pays for knee replacement or roller dollies will eventually depend on the trade-offs the voters are willing to make.
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Old 02-18-2009, 09:50 AM   #151
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And don't forget, Canada and European countries do pay for knee replacement.

Bailout industry by bailing them out of expensive health care costs, especially legacy costs. (My political statement of the week).
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Old 02-18-2009, 10:06 AM   #152
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In the Houston paper today. Kelsey-Seybold clinics opt out of Medicare coverage
Now it seems that is Basic Medicare. It sounds more like a plan to force members into their medicare sup. plan. At any rate, I still say 'Be careful what you ask for'.
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Old 02-20-2009, 05:26 PM   #153
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I remember when, so it can't be that long ago, that similar arguments were used to provide lunch for school kids that could not afford it. Now the majority of students in the Houston Independent School District get free or discounted lunch and breakfast.
We could always not give them free/discounted lunches. That'll teach those children to not choose a poor family next time!
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Old 02-20-2009, 07:53 PM   #154
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If you want to give them free lunches be my guest! Hey, but make sure you include breakfast, and while you are at it what are they going to do for dinner. And, don't forget the popcorn at the movie! Heavens, don't expect their parents to feed them, heck, that's what government is for.

I must be old school, I actually thought before I had kids, and made sure I could afford to feed them, clothe them, and pay for their schooling.
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Old 02-20-2009, 08:49 PM   #155
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If you want to give them free lunches be my guest! Hey, but make sure you include breakfast, and while you are at it what are they going to do for dinner. And, don't forget the popcorn at the movie! Heavens, don't expect their parents to feed them, heck, that's what government is for.
We could always feed them by cutting military pensions.
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Old 02-20-2009, 09:01 PM   #156
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Easy guys.
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Old 02-20-2009, 09:42 PM   #157
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Free lunches.

I'm all in favor of providing free meals to kids in need. The problem I see is, if you do that in isolation, you won't solve the underlying problem - why the parent is not providing meals for that kid.

If it is to get over a short term bump in the road, fine, that problem will take care of itself. If it is because the parent can't provide, something long term needs to be done, there are deeper problems. And if the govt just provides regardless of the reason, some people are going to use that as a crutch, why earn the money for lunch if someone else will pay for it?

It is frustrating for me. We live in a fairly well off community, but like most there are some needy people. Because of privacy issues and the source of my info (someone who sees this first hand), I can't really say anything, but lets just say I am aware of some families that have plenty of money, take fancy vacations etc, but still are on the free lunch program in our district, which also waives the fees for most activities.

I know Martha doesn't like to hear this, she claims that it is too hard for people to qualify for this stuff, but it just isn't so, in my experience. I got curious about it, so I looked at the forms you need to fill out to apply for free lunch programs. They are very vague, they don't ask for any hard numbers like what is on Line such-and-such of your 1040 or W2, they just ask you to enter a monthly income. Now, is that earned income, investment income, pension, SS? Doesn't say. I suppose I could qualify by filling out the form, our earned income is pretty low. If questioned, I could (honestly) claim that I thought they meant wages/salary. I really don't know. But I don't think that someone with $1M/year in dividends should be able to get free lunches for their kids on my dime.


I am not aware of any efforts to validate these numbers. This is what gets some of us upset when we see govt handouts. Fine, do 'em where needed, but be responsible with *our* money.

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Old 02-21-2009, 05:43 AM   #158
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We could always feed them by cutting military pensions.
Or cut the school taxes for those without children in the home so those with children at home could educate and feed them with their own money! Now that I said that I probably will be banished for the rest of the day, month, or ? by the Moderators.
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Old 02-21-2009, 07:31 AM   #159
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ERD50, I have no idea as to the procedures to qualify for free lunches, so you could be right. I am sure the qualification procedure is not nearly as stringent as it is for things like food stamps, cash assistance and medicaid.
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Old 02-21-2009, 08:09 AM   #160
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Or cut the school taxes for those without children in the home so those with children at home could educate and feed them with their own money!
Nah, that's okay. We'll get it back when "everyone else's kids" are working to pay for our Social Security checks and Medicare coverage.
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