Health Care

[Westside Steve]

Heck, I didn't want to completely hijack the tobacco thread. But:

 

 

I'm not taking issue with anyone. I'm just wondering what you think.

 

And no, I'm not a single payer guy. I also don't think single payer is a horrible thing. But I think would could craft a better system than that, something more like France has.

 

But you know what polls the lowest of all health care reforms? The mandate to carry insurance. I've never understood that. Like you said, it leaves people like you carrying the bag. And especially you, because you're in the individual market. (My insurance costs are spread out over a larger pool and less subject to fluctuations than yours is.) You'd think that'd piss people off. But the government requiring you to carry health insurance is what pisses people off.

 

What I find far more frustrating is that the proposal that polls the best is the ban on denying people because of pre-existing conditions. That's very popular, and both parties say they're for it. But you can't have that ban without the mandate. It doesn't work. One requires the other, or else it's entirely useless.

 

But guess which party's plan says it's for the popular one and not for the negative one? And guess which party has a plan for the popular one and requires the negative one because that's the only way the policy works?

 

Ah, politics.

 

So here's my take.

I have no beef with a public option.

(once you were gonna bet one would make it's way into the final bill)

As I saw it if the insurance company didn't want to insure people with pre existing conditions, fine.

Let the government put them on a plan.

It's costs would be higher than for healthy people BUT you'd have such a large pool it might offset that some.

Still the sick guys is going to pay a lot.

And really why shouldn't he?

 

Then again a government plan to go apples to apples with Blue Cross.....hmmmmm

 

I'm all for the public mandate.

One reason it polls so badly is becasue so many would rather not spend anything for a policy.

Understandable. Oh well.

Toop disagreed with me but we sorta came to a compromise where at least everybody needs a catastrophic policy.

I'm still a little left of that but....

 

I have no beef picking up part of the tab for people who really can't afford it.

Still I'd like to see it cost everybody something so that a trip to the ER isn't first option for a kid with sniffles.

 

And to your point in another thread, yes I think too many of the great unwashed think it's going to be free.

And nobody ever said it would be. I understand that.

But if they worry about paying $XXX for an Aetna policy paying $XXX for a government policy isn't any better.

 

Most (or lots of) people don't want to pay the $XXX at all.

 

BTW I also understand that a lot of insurance companies don't really want to sell across state lines.

I don't think that's up to the fed anyway. It's a state licensing thing.

 

WSS

[heckofajobbrownie]

I don't think you could do that - leave all the pre-existing people to a government plan. It'd be enormously expensive. Then you're going to put real pressure on costs and tax rates. I don't think anyone wants that.

 

As for the sick guy should pay a lot, that's tough to weed out. I just had a friend, an otherwise perfectly healthy guy who was still very athletic, die of a brain tumor at 36. His treatments were enormously expensive, obviously. And the only reason he could pay for them was because he had insurance because he was employed at the time they found the tumor. (By a big health insurance company, ironically.)

 

Can you imagine what would have happened if he weren't employed at the time? His entire family would be bankrupt.

 

So I think it's tough to make a policy that tries to make sure no one who is a fat smoker who never gets off the couch isn't covered. You can only incentivize healthier living. And that's an even larger issue than health care delivery. It's also about how we make the most unhealthy food really cheap, and the healthy food expensive. There are lots of reasons why we're unhealthy, and not all of them government can address.

 

As for the public mandate, I think you're mostly right. People don't want to be force to buy something, especially when it's expensive. It's tough enough to make ends meet. I think the argument against that, though, is that they're paying for it anyway, just in other ways. Everyone should want this system to be more efficient and cost effective than it is now. It has to change.

 

As for you picking up the tab for people who can't afford it, I don't think you should be doing that, unless you want to donate to St. Jude's. (Which you should! It's an amazing organization.) But I don't think your tax dollars should be going to fund someone else's health care. Not at your income level. You're already doing your part. You're in the market and you're paying out the ass already.

 

There are better ways to get the subsidies than from the middle class.

 

As for the selling across state lines, I don't think there's too much to be said for that idea. If I'm in Massachusetts, where health care is expensive, it's not going to save me much to own a policy in Wyoming, where health care is less expensive. I'm still going to be getting treated in Massachusetts. The savings -- which isn't much -- comes from insurance companies finding the state that figures out a way to lower costs for the insurance company the most. Some of those might end up being a good idea - cumbersome regulations and the like. But more likely it's going to be a race to the bottom, much in the same way all credit card companies are located in Delaware. They'll go where the fewest regulations are - in other words, consumer protections.

 

Whatever savings there will be won't add up to much and you'll probably end up with more problems than it was worth.

 

Tort reform doesn't really save all that much either, or allow more people to afford insurance. In fact, there's a lot that indicates that actually devising a system to review malpractice claims that's more efficient and fair to both patient and doctor would cost more money than the current system does, not less. But the Republican proposals aren't really about devising a better system. They're only about capping damage amounts, and limiting malpractice costs for doctors and hospitals.

 

That said, something should be done to help doctors and hospitals in this regard, as malpractice lawsuits are out of control and an inefficient and costly time-waster.

 

 

[osusev]

There is one thing I am TOTALLY on the side of the Republicans about..... TORT Reform is ABSOLUTELY necessary...... funny the Admin is not pushing that. I bet it has something to do with the "deal" they cut with the insurance companies...... That revenue has to be huge for the insurance companies.....

 

I get sick of seeing these ambulance chaser type law firm commericials..... than again i hate the drug commercials also...

 

this "meeting" is political theatre Obama is putting on.... however it is a necessary one strategically.

 

[heckofajobbrownie]

But you've got to be aware of the political dynamic here. Why do you think Republicans want to limit the amount of money trial lawyers make?

 

As Grover Norquist put it plainly, "The political implications of defunding the trial lawyers would be staggering.”

 

If you want to create a better system for doctors and patients, that's one thing. But let's stop pretending that what the Republican Party is really interested in is protecting doctors and patients.

 

So yes, put some real ideas on the table, not "Limit jury awards to $250,000." We all know what that's for. Or at least we should.

[calfoxwc]

Heck, you had a fine post the second one up...

 

but you are suspicious about Republicans wanting to limit lawyers and frivious lawsuits?

 

Why not be suspicious of Democrats who want desperately to protect those outrageous fees and

 

friviolous awards to lawyers and those who initiate frivolous lawsuits?

 

Seriously.

[calfoxwc]

http://www.physiciansforreform.org/index.php?id=17,

 

but Heck, and others, you can reply in the thread I just started if you want to.

[heckofajobbrownie]

Heck, you had a fine post the second one up...

 

but you are suspicious about Republicans wanting to limit lawyers and frivious lawsuits?

 

Why not be suspicious of Democrats who want desperately to protect those outrageous fees and

 

friviolous awards to lawyers and those who initiate frivolous lawsuits?

 

Seriously.

 

I am. I just said that's what I wanted.

[osusev]

Heck I dont for ONE minute think either party is really interested in protecting doctor/patient interactions. I dont think the Republicans like the Dems about any specific issue except for how it affects their fund raising coffers.

 

Of course the narrative is about responsibility..... really its a distraction because even with tort reform its not going to drastically change the cost landscape.... However it is the right thing to do because the providers need relief from frivolous lawsuits.

 

I see it as one way the dems can easily pursue that would get bipartisan support.... they dont have to wrap this into just one bill.....maybe only as leverage.... but really people are tired of one party trying to leverage the other one for political gain.

 

there is nothing wrong with tort reform or cross state pools along with getting rid of the anti trust exemption... those three pieces have enough support from each party to pass.

 

I do think the Dems perception of trying to do everything with one bill is what is hurting them. they can add in cost protections along pre-existing coverages...... they would get those 5 things passed and receive wide general public support.

[heckofajobbrownie]

Actually, I should take that back. There are some conservatives and Republicans who are very interested in protecting the doctor/patient relationship, and aren't using this as a purely political tool. We don't have to view everything as cynically as I just did. It's not the case.

 

Perhaps a more on point critique is that most of the Republican caucus has a very limited understanding of the health care problem, or the various fixes. It's simply not an issue most of them care about, as witnessed by the utter lack of movement on the issue while they controlled the agenda. It never came up. Even to this day you can hear them saying "Best health care in the world." They don't really get it.

 

But yes, I agree. If you can get a tort reform bill that's well thought out and not some hack job I'm all for it.

 

What I think you're wrong about is that this would lead to Republican support for the bill. It's not. My guess is that he's going to offer tort reform and still get no takers. For one thing, their plan is to oppose everything he does. (And it's working, so why would they change?) The other part is that the Republican base is so full of crazies who think Obama is a Marist/socialist who is trying to ruin America that there's simply no political cover for them to vote on an Obama initiative, especially health care reform, which makes them the craziest.

 

You don't have to look much further than this board to see how this is true. They actually believe that signing more people up for private insurance is some crazy leftist scheme.

 

 

[calfoxwc]

Heck, you started out great again. But painting us on the board as being looney because we don't want anymore people signed up for health insurance is completely silly.

 

I just said earlier that surely, nobody wants people to remain uninsured, assuming that most all want to be.

 

The idea that they can go to emergency rooms, yeah, it works, but the cost is enormous, and it strains efficiency.

 

Just fix the freakin problem. Let's say, a gov endorsed health insurance, low cost, ? subsidized by the gov, is

 

available to be purchased, and at the TIME it goes into effect, pre-existing conditions will not be a deal killer for them.

 

But, that is a limited time offer. Say, after 6 months, whatever, they don't get insurance with a pre-existing condition,

 

they lose via their own discretion, or lack thereof.

 

Companies will not be eligible to have their employees switch because they dropped hc insurance. Well, if you can

order everybody to BUY it, I reckon you can order companies to CONTINUE TO PROVIDE IT> @@

 

But to cause 18 to 20 million currently insured to LOSe their health coverage? bogus. It's no solution.

 

To set the stage and stack the deck against all private health insurers ? It's no solution.

 

To refuse to consider tort reform, interstate sales, etc, and construct a bill so as to NOT hurt current insureds......as part of the package, is just bogus. Anybody on either

Dem or Rep side has to wonder "What the heyl ? Do they want a genuine solution, or just a gigantic government expansion

in a Woodrow Wilson style political power grab?... or ... what?

[osusev]

you are probably right about the obstructionist strategy..... screaming about the deficit and government takeover resonates with some right leaning moderates.

 

Unfortunately the public does not care about causation....all they care about in general is the moment of right now.....

[Mr. T]

TORT Reform?

 

We have the fox in charge of the hen house so dont expect it to see the light of day.

 

Meanwhile their is nothing in the current HC Bill that will help anyone. Unless you consider paying off this state and that states old bills.

 

Will any member of congress or Obama himself put their families at risk with the offered government controled HC? Hell NO!

 

 

The HC Bill is dead issue with the American people in its current state. So why is it the democrats keeping wanting to push this through? 50 Million Illegals will get amnesty and be allowed to vote democrat! Thats a Win Win for the Bad guys!

[heckofajobbrownie]

They don't really care about the deficit. They care about cutting taxes. When you ask Republicans what they'd cut to get to this spendthrift America (that exists only in their head) they're remarkably silent. They don't want to touch the military - they want more spending on the military. They don't want to touch Medicare, Social Security, education. It's ridiculous.

 

Look at Marco Rubio's speech from CPAC. He was the big star. He started listing off all these tax cuts he wanted to see and they all went crazy - and all were geared toward the wealthiest American, and shifted the tax burden on to the middle and lower class. Eliminating capital gains taxes, the estate tax, corporate taxes. They went crazy for each one.

 

And then they turned around and complained about deficits. After just cheering a plan to take hundreds of billions of dollars out of the federal treasury and make those deficits far worse.

 

Comical.

 

So forgive me if I don't take these supposed deficit hawks seriously. They're not.

[Mr. T]

The only thing the estate tax was good for was that it screwed over Art modell.

 

Otherwise it was nothing more than another reason why many of those more fortunate people move their wealth outside of this country so they can pass along what they have gained to their children than seeing it being stolen from them after years of hard work.

 

I remember talking with a business owner back when Clinton was in office, he stated that we are the dumb ones for working so hard. Maybe we should stay home and sit on our ass and let big brother pay our bills.

[Westside Steve]

But you've got to be aware of the political dynamic here. Why do you think Republicans want to limit the amount of money trial lawyers make?

 

As Grover Norquist put it plainly, "The political implications of defunding the trial lawyers would be staggering.”

 

If you want to create a better system for doctors and patients, that's one thing. But let's stop pretending that what the Republican Party is really interested in is protecting doctors and patients.

 

So yes, put some real ideas on the table, not "Limit jury awards to $250,000." We all know what that's for. Or at least we should.

 

No kidding.

We all realize that since the trial lawyers are in the Dems pocket the Reps want to f*ck with them.

(same with unions)

Just like the Dems look the other way while they ride roughshod over the system.

 

And lets not pretend the Dems care about justice for the injured. (anymore than the Reps)

Hell, if some doctor or hospital is criminally negligent put someone in jail rather than turn the legal system into the lottery.

That'd put a stop to it.

 

" They don't really care about the deficit. They care about cutting taxes. When you ask Republicans what they'd cut to get to this spendthrift America (that exists only in their head) they're remarkably silent. They don't want to touch the military - they want more spending on the military. They don't want to touch Medicare, Social Security, education. It's ridiculous.

"

 

And equally ridiculous that Dems want to cut waste and fraud from Medicare.

We could do that tomorrow.

 

But as far as it goes (and I don't speak for John Boehner) I'd be glad to freeze spending and put that tax money directly against the deficit.

 

At least in the short term that should inspire a little more confidence.

 

 

WSS

[calfoxwc]

Heck, painting all Republicans with a broad bigoted brush doesn't help your argument.

 

It helps ours. These progressive/statists/socialists/communist radicals in the White House

 

display that kind of arrogance.

 

Their "we are so superior that they can't possibly be serious in disagreeing with anything we want to do"

 

and "while we never lie, they always lie"... when the dangerous statists in our gov DO lie ....

 

it's reeking of the old Soviet Union. They lied as a matter of political power exercised. They learned,

 

eventually, that statism/communism/socialism was taking the life out of their society, and that with all the power

 

and violence and KGB and all.... that kind of government cannot be sustained.

 

We can't sustain it either. It does NOT WORK, historically.

 

Yes, Heck, we are serious in our disagreement. Shep was "frightened" by the evil Bush and Cheney.

"These are sad days" he said, the patriot act was a horrific imposition on our freedoms.

 

Now? Who cares. A whole socialist gov takeover of our country, and Shep has nothin.

 

This Dem controlled, marsist leaders influenced Congress has now only a 20 percent favorability rating.

 

That is an American all time record low. And Obamao, somehow, keeps contradicting himself, as in, lying out his wazoo...

 

Pelosi, Reid, et, and the Obamaos aren't leaders. They are arrogant and vicious liars and manipulators.

 

But, we had to listen to eight years of the frightening sky overhead of us all because of Cheney and Halliburton.

 

Now, we have communists and socialists, and whacko radicals in our wh, and all around him, and in Congress, and

 

people like Shep et all are happy little clams?

 

Stop hating Bush and Cheney so you support anything this gov does and wants to do and lies about.

 

Heck - seriously, the leftists in Congress and the White House are contradicting themselves about many, many issues,

 

then they are lying about it ever taking place. We may as well have elected Nikita Krushchev sp? and some of the kgb to our White House.

[heckofajobbrownie]

Malpractice is rarely a criminal matter, Steve. It's almost always a civil case. We don't have a lot of criminal doctors.

[Westside Steve]

Malpractice is rarely a criminal matter, Steve. It's almost always a civil case. We don't have a lot of criminal doctors.

 

 

So as long as all those thousands of incompetent ones who ruin peoples lives can pay the huge fee they keep on working.

Great.

Well, great for the lawfirms anyway.

WSS

[heckofajobbrownie]

The job is to try to find a mechanism that better weeds out bogus claims, but gives serious weight to the real ones. Some states have tried stuff like this already, with medical review boards and the like.

[Westside Steve]

The job is to try to find a mechanism that better weeds out bogus claims, but gives serious weight to the real ones. Some states have tried stuff like this already, with medical review boards and the like.

 

 

Not only bogus claims but those claims with just enough merit that it's cheaper to throw away more money than it's worth to save the legal fees as they drag on.

You don't really need to prove so much as convince scare and or bully a jury.

And keeping jurors who hope to win the accident lottery someday mindful that most slip ups aren't worth enough money to make the victims extended family and three generations of heirs rich.

 

 

As to the 36 year old who got the tumor, had he been under my plan he'd have had a policy whether he got one at worlk or not.

And he'd have had that policy well before diagnosis so he wouldn't have been paying high risk.

 

Yes he might have hated to drop a few hundred as a twenty something but glad when it was needed.

And if he were destitute or just poor he'd still have had to pay a percentage of income.

Not seeing the downside here.

 

WSS

[heckofajobbrownie]

I think there's a lot of truth to the top part. There's a difference between "malpractice" and "mistake" that I'm not sure most of the public understands. An advisory board could weed out a lot of that.

 

But it's also going to mean that hospitals are going to have to be more open about their records, which they always protect for these very reasons. It's not like you can wave a magic wand and make all of these bogus claims go away.

 

You can also fine people who make truly bogus claims. Some states do that already too.

 

As for the bottom part, you're talking about him being covered if he'd been unemployed and bought an individual policy like you have. I think we're talking around the same thing. Young and healthy people especially don't want to spend their money on health care. I didn't when I was that age. I went without insurance from age 23 to 27. I couldn't afford it even if I did want it.

 

So you're going to have to set up a system that helps some of these people afford it if you're going to mandate that they carry it.

[Chicopee John]

>>I went without insurance from age 23 to 27.>>

 

IMHO, that was reckless, Heck. I am happy that you gambled and won.

 

 

 

>>I couldn't afford it even if I did want it.>>

 

I seriously doubt it, Heck, and I don't intend disrespect. Many Americans - especially young ones - cannot distinguish wants from needs.

 

In this hypothetical - they 'need' an iPhone, LED TV, and vacations and don't 'want' to have insurance premiums detract from their enjoying their 'needs'.

 

I'm not sure what you marital situation was, but for a single person, a policy could not have cost all that much.

 

[heckofajobbrownie]

Well, I wasn't talking about someone who bought flat screens and IPhones. I was talking about me. And no, when I was starting my business and losing money, and waiting tables at night to pay the bills, I was not in a position to afford the COBRA coverage once my college policy lapsed.

 

So I gambled that I'd make it through without getting seriously ill or injured, which I managed to do.

 

I don't know why you'd think you'd be able to answer the question of whether or not I was able to afford an individual health insurance policy during that time better than me.

[heckofajobbrownie]

Are any of you watching this health care summit?

 

I wonder if watching the president hold court on health care for an entire work day ever makes you stop and realize how ridiculous your rhetoric is.

 

Steve, still look like an empty suit to you? Really?

 

Can you imagine George Bush trying to do this?

[Chicopee John]

Well, I wasn't talking about someone who bought flat screens and IPhones. I was talking about me. And no, when I was starting my business and losing money, and waiting tables at night to pay the bills, I was not in a position to afford the COBRA coverage once my college policy lapsed.

 

So I gambled that I'd make it through without getting seriously ill or injured, which I managed to do.

 

I don't know why you'd think you'd be able to answer the question of whether or not I was able to afford an individual health insurance policy during that time better than me.

 

Heck, we both know that I was talking about generalities. I do, in fact, know more than one young person that fit my description.

 

Just curious and I don't want to get personal but, at what fraction of the COBRA cost would have made you purchase Health Insurance? 75%, 50%, 25%?

 

In any event, I do agree that everybody should have coverage. We differ on a couple of the details, however.

 

What happens if somebody without insurance gets sick? Do we pay for that persons care as, oftentimes, we do now? Should we hold that person accountable for paying back, at least part of the costs - an amount way above the cost of an insurance policy.

 

A basic tenant of Insurance is that you cannot only insure people who will need that insurance. That is referred to as 'Adverse Selection'. Therefore, it is necessary to have a blending of healthy and unhealthy, young and old. I believe we agree so far.

 

Another element in setting a rate is to 'encourage' risk management. An example would be a deductible on an automobile policy. One should be discouraged from driving fast and wrecking a car because 'the insurance company will pay for it'. The deductible means that YOU TOO will pay for it.

 

It sounds like some simply HOPE that people who might be used to getting medical coverage for free will be willing to PAY for it. I don't know what the incentive would be unless there was severe 'tough love' served as a consequence.

 

Without doubt, I believe that many folks without insurance can afford it and refuse to pay. Then they either get free care and/or constantly rail against the government for not providing affordable health care.

 

I don't have a clear answer and the solution is very complex but people need to have insurance and insurance or taxpayers cannot be counted on to pay for those unwilling to do their part. I used a lot of subjective terms in the last sentence, I know.

 

If somebody is found to lack health insurance - at a price he or she might have to stretch to pay premiums - then some type of consequences need to be paid. Jail sentence? Wage garnishment? There might be more but each of these will be considered unpalatible by many.

 

[heckofajobbrownie]

Everything you just worried about is in the current bill. No one gets a free ride. Deductibles don't suddenly disappear. There are sanctions/fines for people who don't buy insurance.

[Westside Steve]

Are any of you watching this health care summit?

 

I wonder if watching the president hold court on health care for an entire work day ever makes you stop and realize how ridiculous your rhetoric is.

 

Steve, still look like an empty suit to you? Really?

 

Can you imagine George Bush trying to do this?

 

I can't remember praising Ws oratory skills.

I wouldn't expect either one to be an expert on medicine finance or insurance, no matter how glib.

Then again if that's the criteria Limbaugh is a much better extemporaneous speaker.

 

But no, I had stuff to do today, I'll watch parts of it later.

 

Was there anything other than the dog and pony?

WSS

 

 

[calfoxwc]

NO, there wasn't. There was tons of attempted domination of time to speak by the Dems, there was partisan

 

insults by Obamao and other Dems, Obamao brilliantly, yet stupidly, avoided answering any questions legitamately.

 

The only reason they had this, is because the Dems and Obamao are being absolutely hammered by the polls of the American public,

 

and this was a last ditch effort to put Republicans on the defensive and make them look stupid.

 

It worked the opposite. Half of one audience polled voted for Obamao. The entire audience thinks that the fed gov

 

is NOT listening. All but three of that audience want the entire bill(s) scrapped and for ALL of Congress to start over again,

 

and fix problems the right way.

 

Obamao may not be the antiChrist, but he is the first American chavez/Castro/Seleya in our history.

[Chicopee John]

Can you imagine George Bush trying to do this?

 

What the hail does George W. Bush have to do with this??

 

This is Obama's show and he will sink or swim regardless of whether GWB got out of bed today or not.

 

[calfoxwc]

No, I can't imagine Bush lying like a Napoleonic Chavez. At all.

 

But Obamao does. Obamao is a serial liar.

 

I wonder why Obamao the brilliant won't release his grades....