"An unfair assault on 'workers'"

[nvsked]

How is the price (for services rendered) determined; by the private care provider or the public/quasi-public agency?

 

 

4. In a democracy, the public should set overall health policies. Personal medical decisions must be made by patients with their caregivers, not by corporate or government bureaucrats.

 

How is it determined now? By what is reasonable and customary. In Beverly Hills Calif, on Rodeo Drive, I imagine a knee replacement goes for more, than one in Bismark North Dakota. Does National Health Care stop a person with the money from paying Rodeo Drive prices NO! But, anything above reasonable and customary, is on the consumer. Freedom of Choice!

Right now if I wanted to be seen by the person on Rodeo Drive, it's out of my network!

 

Had a dentist a few years back, who decided he would no longer accept what Blue Cross dental paid for certain procedures. He said pay me in cash, and then you could seek whatever Blue Cross pays, but I want what I want up front, you deal with your insurance company.

 

Even though I went to this person for years, I dropped him. I still get post cards saying to come back, he now accepts BC payments. Sorry I found a new dentist, it was my choice.

[RangerM]

4. In a democracy, the public should set overall health policies. Personal medical decisions must be made by patients with their caregivers, not by corporate or government bureaucrats.

 

The question is A or B

 

WHO determines the price for services rendered?

 

a. the doctor (a.k.a. the private care provider)

b. the public/quasi-public agency

Edited December 30, 2008 by RangerM

[nvsked]

What was the last Federal Government program that came in at (or under) budget that provided a good or service (at no retail cost) to anyone who demanded it?

 

Outside of TARP..... I don't know the Federal Highway Commission. The National Parks Administration, Yellowstone is beautiful.

 

Roosevelt and the CCC, TVA Tennessee Valley Authority, Hoover Dam.

 

You tell me, you seem to have all the answers.

[RangerM]

What was the last Federal Government program that came in at (or under) budget that provided a good or service (at no retail cost) to anyone who demanded it?

 

Outside of TARP..... I don't know the Federal Highway Commission. The National Parks Administration, Yellowstone is beautiful.

 

Roosevelt and the CCC, TVA Tennessee Valley Authority, Hoover Dam.

 

You tell me, you seem to have all the answers.

 

The Federal Highway Commission includes the Federal Highway Trust Fund (remember it?) You think they aren't running a deficit?

 

The last time I went to Yellowstone and the Hoover Dam, there was an admission charge. That is a retail cost.

 

TVA does not provide electricity for free, nor is it self-sustaining. That is why the government is looking to sell it.

 

I do not have all the answers, but I know that the Federal Government is not high on the list of any of them.

[nvsked]

The question is A or B

 

WHO determines the price for services rendered?

 

a. the doctor (a.k.a. the private care provider)

b. the public/quasi-public agency

 

Do you have insurance NOW! Who established what was your portion and what portion the insurance company pays! YOU, your Aunt, WHO! Market conditions (What everyone else is getting for that x-ray)

 

Who decides what you're going to pay for a set of tires. "You Better Shop Around"

[RangerM]

Do you have insurance NOW! Who established what was your portion and what portion the insurance company pays! YOU, your Aunt, WHO! Market conditions (What everyone else is getting for that x-ray)

 

Who decides what you're going to pay for a set of tires. "You Better Shop Around"

 

The doctor and insurance company have an agreed-to price scale for services. The doctor can agree to accept them or not. He is free to decline, therefore (ultimately) the doctor decides what price he will provide services for.

 

This is different from the government.

 

Will the government be willing to pay any price? What if it's a small town with only one doctor? What then? Does the doctor still get to decide, or does "what's good for society" dictate that the only available M.D. in town MUST accept what the government will pay him? If he doesn't, does that present a problem with the "universal" in "universal healthcare" if those in the small town don't get the same care?

 

If the system is truly universal the doctor cannot refuse the government, because the government is the only entity that can legally use force to attain its goals. At that point, the doctor's individual rights have been violated.

 

What you need to realize is that when government is involved in healthcare, somewhere/somehow an individual's rights (either the Dr. or patient or both) will likely be violated. You need to accept, and be more upfront about that.

 

"Universal" anything is a way to spread the misery, not the wealth.

Edited December 30, 2008 by RangerM

[mettech]

The doctor and insurance company have an agreed-to price scale for services. The doctor can agree to accept them or not. He is free to decline, therefore (ultimately) the doctor decides what price he will provide services for.

 

This is different from the government.

 

Will the government be willing to pay any price? What if it's a small town with only one doctor? What then? Does the doctor still get to decide, or does "what's good for society" dictate that the only available M.D. in town MUST accept what the government will pay him? If he doesn't, does that present a problem with the "universal" in "universal healthcare" if those in the small town don't get the same care?

 

If the system is truly universal the doctor cannot refuse the government, because the government is the only entity that can legally use force to attain its goals. At that point, the doctor's individual rights have been violated.

 

What you need to realize is that when government is involved in healthcare, somewhere/somehow an individual's rights (either the Dr. or patient or both) will likely be violated. You need to accept, and be more upfront about that.

 

"Universal" anything is a way to spread the misery, not the wealth.

 

+1

 

I do not want any of my money to provide health care for the fat, lazy, smoker that drinks to much and is depressed because he is lazy.

 

Increase the tax on smokes, fast food and alcohol to pay for the unhealthy habits of the lazy. Give a tax break to the people that have a healthy life style. A physical fitness program must be tied in with a socialized program.

 

Give each person X amount of money/year and let them buy the type of insurance they need.

[nvsked]

The doctor and insurance company have an agreed-to price scale for services. The doctor can agree to accept them or not. He is free to decline, therefore (ultimately) the doctor decides what price he will provide services for.

 

This is different from the government.

 

Will the government be willing to pay any price? What if it's a small town with only one doctor? What then? Does the doctor still get to decide, or does "what's good for society" dictate that the only available M.D. in town MUST accept what the government will pay him? If he doesn't, does that present a problem with the "universal" in "universal healthcare" if those in the small town don't get the same care?

 

If the system is truly universal the doctor cannot refuse the government, because the government is the only entity that can legally use force to attain its goals. At that point, the doctor's individual rights have been violated.

 

What you need to realize is that when government is involved in healthcare, somewhere/somehow an individual's rights (either the Dr. or patient or both) will likely be violated. You need to accept, and be more upfront about that.

 

"Universal" anything is a way to spread the misery, not the wealth.

 

Importantly, the term “single payer” is different from “socialized medicine” and “universal health care.”

 

4. In a democracy, the public should set overall health policies. Personal medical decisions must be made by patients with their caregivers, not by corporate or government bureaucrats.

 

WOW! You've got this government thing....If you have so much distrust of the government, what keeps you in the U.S.?

 

There is no amount of discussion that will change your opinion, which is your prerogative. Assuming we ever get National Heath Care to a vote, you'll be allowed to vote anyway you see fit. Enjoy your misery, but be careful I think big brother is watching you. Discussion closed.

[RangerM]

Importantly, the term “single payer” is different from “socialized medicine” and “universal health care.”

 

4. In a democracy, the public should set overall health policies. Personal medical decisions must be made by patients with their caregivers, not by corporate or government bureaucrats.

 

WOW! You've got this government thing....If you have so much distrust of the government, what keeps you in the U.S.?

 

There is no amount of discussion that will change your opinion, which is your prerogative. Assuming we ever get National Heath Care to a vote, you'll be allowed to vote anyway you see fit. Enjoy your misery, but be careful I think big brother is watching you.

 

You are using euphemism in the hope that the less-informed will not see it for what it really is.

 

My love of freedom, and my wish to retain it is what keeps me in the U.S. Given where we are in this country, what has kept you here?

 

No, there is no amount of discussion that will make me believe that a government bureaucrat will have anywhere near the concern for my (or my family's) well-being that I will.

 

I will keep my misery, if you keep yours, and I won't be watching you because (so long as it doesn't affect me or my family) I could not care less what you do.

 

Discussion closed.

 

The "Al Gore" method of debate. This would be if it weren't sad.

[nvsked]

I have to apologize to the people reading these threads. The title of this thread is "An unfair assault on 'workers'", no doubt I am an "autoworker". It seems trendy to bash auto workers, I can't tell you the amount of times I've heard the expression "you autoworkers" like I'm public enemy. Whether you know it or not the UAW is:

 

A voice for all

As impressive as it is, the UAW's success record at the bargaining table is only part of the story. From our earliest days, the UAW has been a leader in the struggle to secure economic and social justice for all people. The UAW has been actively involved in every civil rights legislative battle since the 1950s, including the campaigns to pass the Civil Rights Act of 1964, the Voting Rights Act of 1965, the Fair Housing Act, the Civil Rights Restoration Act of 1988 and legislation to prohibit discrimination against women, the elderly and people with disabilities.

 

The UAW also has played a vital role in passing such landmark legislation as Medicare and Medicaid, the Occupational Safety and Health Act, the Employee Retirement Act and the Family and Medical Leave Act. In Washington and state capitols, the UAW is fighting for better schools for kids, secure health care and pensions for retirees, clean air and water, tougher workplace health and safety standards, stronger worker's compensation and unemployment insurance laws and fairer taxes.

 

People want to verbally attack autoworkers as the reason for some of the countries issues, well I disagree. The money that everybody else makes is fair, but "you autoworkers" are over paid. Ok you're entitled to your opinion, but as a social organization we do offer a voice to everybody.

 

And, one of the biggest ways we can level the playing field with the other industrial nations is with a National Health Care Plan. Not to mention there is no reason why, when the US has $700 billion and counting for other nations, why there can't be a domestic agenda that takes into account the needs of U.S citizens such as health care. Does this take people, who are entrenched in a comfort zone, out of a comfort zone? Probably, but I make no apologies, in my opinion we need a National Health Care Plan.

 

So for the Mettech's, and Rangers's I guess we will agree to disagree, but I appreciate the spirited conversation on a public forum. Without the discussion we cannot bring attention to the issues.

 

Take care

[nvsked]

You are using euphemism in the hope that the less-informed will not see it for what it really is.

 

My love of freedom, and my wish to retain it is what keeps me in the U.S. Given where we are in this country, what has kept you here?

 

No, there is no amount of discussion that will make me believe that a government bureaucrat will have anywhere near the concern for my (or my family's) well-being that I will.

 

I will keep my misery, if you keep yours, and I won't be watching you because (so long as it doesn't affect me or my family) I could not care less what you do.

 

 

 

The "Al Gore" method of debate. This would be if it weren't sad.

 

big brother is a reference to the government, I could careless.... Al Gore method I'll have to look up? But I see you like Plato....Try of the republic.... reflections on the wall. Have a good day.

[RangerM]

big brother is a reference to the government, I could careless.... Al Gore method I'll have to look up? But I see you like Plato....Try of the republic.... reflections on the wall. Have a good day.

 

You may want to add the following titles to your reading list:

 

Tragedy of the Commons; and

The Diary of William Bradford

[RaZor]

The doctor and insurance company have an agreed-to price scale for services. The doctor can agree to accept them or not. He is free to decline, therefore (ultimately) the doctor decides what price he will provide services for.

 

This is different from the government.

 

Will the government be willing to pay any price? What if it's a small town with only one doctor? What then? Does the doctor still get to decide, or does "what's good for society" dictate that the only available M.D. in town MUST accept what the government will pay him? If he doesn't, does that present a problem with the "universal" in "universal healthcare" if those in the small town don't get the same care?

 

If the system is truly universal the doctor cannot refuse the government, because the government is the only entity that can legally use force to attain its goals. At that point, the doctor's individual rights have been violated.

 

What you need to realize is that when government is involved in healthcare, somewhere/somehow an individual's rights (either the Dr. or patient or both) will likely be violated. You need to accept, and be more upfront about that.

 

"Universal" anything is a way to spread the misery, not the wealth.

 

Too bad that you apparently know nothing about "universal" health care and are just repeating the mis-information that which is espoused by the right wing media.

 

What Obama has said over, and over, and over is that his plan would be that people should be able to keep employment-based coverage if their employers provide it (with new government help to lower the cost). If they don't have workplace coverage, they should be automatically enrolled in a national framework that gives them a choice between a good public insurance plan (the same that Congress has) and competing private plans. If that happens, that would put the private plans in direct competition with the "public" plans. That would force them to sharpen their pencils AND make them more competitive (and less wasteful). Even McCain (when asked because he has had gov't provided health insurance his entire adult life) could not bad-mouth the coverage - and I sincerely doubt any of his doctors would complain about the payments that they receive for providing services.

 

$300+ billion in unnecessary administration costs are used up by the private plans each year. That will go a long way to providing health care for a lot of people. Small town and rural doctors and hospitals have been in trouble for over 30 years and are being left behind at an ever increasing rate because of the demographics of who lives in those areas (older and more impoverished than urban areas).

 

Although health care providers across the United States face rising prices for malpractice insurance, general liability, workers' compensation, and even their own health care insurance coverage, many rural health care providers are struggling to keep insurance coverage of any kind.

 

Premiums there are doubling and even tripling in some cases. Worse, some rural providers simply cannot get private commercial coverage, as carriers pull out of the market or go bankrupt. As a result, providers of all types in rural areas-physicians, ambulance services, and hospitals-are struggling to obtain affordable coverage and keep their doors open. There is not a better example of the private insurance market's inability to provide insurance coverage (in any form) - than small-town/rural America with the current system.

 

Once universal health care is enacted and the faster that it happens, the better situated we are to start the difficult but essential task of controlling long-term health spending. Without runaway health spending, as the Brookings Institution has shown, the future fiscal picture of the federal government looks surprisingly rosy, even if taxes stay right where they are as a share of the economy.

 

With runaway health spending, the federal government fiscal picture looks catastrophic. Plus, as bad as the federal picture looks, it's prettier than what businesses and workers are facing. According to the New America Foundation, if employer-sponsored insurance premiums and family income rise at the same rate they have for the past decade, an average family health plan will cost more than 45 percent of a typical family's income by 2016.

 

Think for a moment. What percentage of your total income goes to health insurance and out-of-pocket health care costs? For many that is probably around 10% (+/-). Now picture that rising to 45%.

 

Lowering costs might not happen fast, but it is possible in the long term. There are some relatively easy and quick ways to bring down costs, like streamlining administration (The U.S. has the most bureaucratic health care system in the world. Over 31% of every health care dollar goes to paperwork, overhead, CEO salaries, profits, etc.) and reducing the rate of payment increase for specialty services and prescription drugs. But a good deal of the savings have to come from using resources more efficiently--and here, again, spending now will help us spend less later.

 

The federal government invests a mere pittance in health-information technology and comparative-effectiveness research, and history has shown that the private sector won't make these investments on an appropriate scale. These are public goods that require public investment. We need to collect health-outcomes data, develop new practice guidelines and quality measurements, and really test the effectiveness of new medical technology won't come cheap. But it will make health care cheaper--and, more important, better at improving health--in the long run.

 

The beauty of this federal spending is that it will mean higher wages and employment, a more flexible labor market in which people feel free to change jobs or strike out on their own without risking their health and finances, and, yes, less pressure on both public and private budgets down the road. We'll be running up hefty federal bills for a while. But we'll be doing so confident we're going to improve the economic standing of millions of Americans and our long-term budget situation in the bargain.

 

And for those of you that cannot think past "I've got mine - you get yours" or "I do not want any of my money to provide health care for the fat, lazy, smoker that drinks to much and is depressed because he is lazy", apparently you guys are unaware that over sixty percent of current health care spending in the U.S. is funded by government. Now go back up a few paragraphs and see what that 31% figure goes for again. I would assume that you, who cannot see past your own horizons, would want to get the best bang for your (money) tax dollar.

 

Health care isn't a luxury good, like a flat-screen television--something you can put off when money is tight. People do economize on health care when times are tough, but only so much and with serious risks, both physical and financial. The better way to think about health care is like an upfront deduction from family income. If you make that deduction smaller, families have more to spend on other things, improving their own situation and the economy in general. Now think about what you'll have left to spend come 2016 - if we keep things like they are now.

 

And if you are worried that it will mean health care rationing, the U.S. already rations health care. Rationing in U.S. health care is based on income: if you can afford care, you get it; if you can’t, you don’t. A recent study by the prestigious Institute of Medicine found that 18,000 Americans die every year because they don’t have health insurance. Many more skip treatments that their insurance company refuses to cover. That’s rationing. Other countries do not ration in this way.

 

You have nothing to fear with UHC. I suppose that you weren't thinking about those 18,000 and their families when you used the word "misery", eh? Must be that you haven't got to Psalms 82:3-4 in your reading yet.

[mettech]

Too bad that you apparently know nothing about "universal" health care and are just repeating the mis-information that which is espoused by the right wing media.

 

What Obama has said over, and over, and over is that his plan would be that people should be able to keep employment-based coverage if their employers provide it (with new government help to lower the cost). If they don't have workplace coverage, they should be automatically enrolled in a national framework that gives them a choice between a good public insurance plan (the same that Congress has) and competing private plans. If that happens, that would put the private plans in direct competition with the "public" plans. That would force them to sharpen their pencils AND make them more competitive (and less wasteful). Even McCain (when asked because he has had gov't provided health insurance his entire adult life) could not bad-mouth the coverage - and I sincerely doubt any of his doctors would complain about the payments that they receive for providing services.

 

$300+ billion in unnecessary administration costs are used up by the private plans each year. That will go a long way to providing health care for a lot of people. Small town and rural doctors and hospitals have been in trouble for over 30 years and are being left behind at an ever increasing rate because of the demographics of who lives in those areas (older and more impoverished than urban areas).

 

Although health care providers across the United States face rising prices for malpractice insurance, general liability, workers' compensation, and even their own health care insurance coverage, many rural health care providers are struggling to keep insurance coverage of any kind.

 

Premiums there are doubling and even tripling in some cases. Worse, some rural providers simply cannot get private commercial coverage, as carriers pull out of the market or go bankrupt. As a result, providers of all types in rural areas-physicians, ambulance services, and hospitals-are struggling to obtain affordable coverage and keep their doors open. There is not a better example of the private insurance market's inability to provide insurance coverage (in any form) - than small-town/rural America with the current system.

 

Once universal health care is enacted and the faster that it happens, the better situated we are to start the difficult but essential task of controlling long-term health spending. Without runaway health spending, as the Brookings Institution has shown, the future fiscal picture of the federal government looks surprisingly rosy, even if taxes stay right where they are as a share of the economy.

 

With runaway health spending, the federal government fiscal picture looks catastrophic. Plus, as bad as the federal picture looks, it's prettier than what businesses and workers are facing. According to the New America Foundation, if employer-sponsored insurance premiums and family income rise at the same rate they have for the past decade, an average family health plan will cost more than 45 percent of a typical family's income by 2016.

 

Think for a moment. What percentage of your total income goes to health insurance and out-of-pocket health care costs? For many that is probably around 10% (+/-). Now picture that rising to 45%.

 

Lowering costs might not happen fast, but it is possible in the long term. There are some relatively easy and quick ways to bring down costs, like streamlining administration (The U.S. has the most bureaucratic health care system in the world. Over 31% of every health care dollar goes to paperwork, overhead, CEO salaries, profits, etc.) and reducing the rate of payment increase for specialty services and prescription drugs. But a good deal of the savings have to come from using resources more efficiently--and here, again, spending now will help us spend less later.

 

The federal government invests a mere pittance in health-information technology and comparative-effectiveness research, and history has shown that the private sector won't make these investments on an appropriate scale. These are public goods that require public investment. We need to collect health-outcomes data, develop new practice guidelines and quality measurements, and really test the effectiveness of new medical technology won't come cheap. But it will make health care cheaper--and, more important, better at improving health--in the long run.

 

The beauty of this federal spending is that it will mean higher wages and employment, a more flexible labor market in which people feel free to change jobs or strike out on their own without risking their health and finances, and, yes, less pressure on both public and private budgets down the road. We'll be running up hefty federal bills for a while. But we'll be doing so confident we're going to improve the economic standing of millions of Americans and our long-term budget situation in the bargain.

 

And for those of you that cannot think past "I've got mine - you get yours" or "I do not want any of my money to provide health care for the fat, lazy, smoker that drinks to much and is depressed because he is lazy", apparently you guys are unaware that over sixty percent of current health care spending in the U.S. is funded by government. Now go back up a few paragraphs and see what that 31% figure goes for again. I would assume that you, who cannot see past your own horizons, would want to get the best bang for your (money) tax dollar.

 

Health care isn't a luxury good, like a flat-screen television--something you can put off when money is tight. People do economize on health care when times are tough, but only so much and with serious risks, both physical and financial. The better way to think about health care is like an upfront deduction from family income. If you make that deduction smaller, families have more to spend on other things, improving their own situation and the economy in general. Now think about what you'll have left to spend come 2016 - if we keep things like they are now.

 

And if you are worried that it will mean health care rationing, the U.S. already rations health care. Rationing in U.S. health care is based on income: if you can afford care, you get it; if you can’t, you don’t. A recent study by the prestigious Institute of Medicine found that 18,000 Americans die every year because they don’t have health insurance. Many more skip treatments that their insurance company refuses to cover. That’s rationing. Other countries do not ration in this way.

 

You have nothing to fear with UHC. I suppose that you weren't thinking about those 18,000 and their families when you used the word "misery", eh? Must be that you haven't got to Psalms 82:3-4 in your reading yet.

 

 

Should everyone in the USA get the same type of health care? I say no. Excellent and good health care should be treated as compensation to draw excellent employees to a company or agency. That is one of the main reasons I joined the military is because of the health care for me and my family.

 

Health care cost is due to............... wages, R&D, equipment, facility overhead, trial and error, and the medication.

 

Minimal health care is provided to everyone that needs it. Anyone that needs medical attention can go to a hospital and receive treatment.

 

Why should companies or wage earner that has health care be penalized with higher taxes to support a larger government health care system?

[RangerM]

Too bad that you apparently know nothing about "universal" health care and are just repeating the mis-information that which is espoused by the right wing media.

When you begin your discourse with an ad hominem attack, how do you expect a "reich"-winger (as you have referred to me before) to respond? I will overlook it.

What Obama has said over, and over, and over is that his plan would be that people should be able to keep employment-based coverage if their employers provide it (with new government help to lower the cost). If they don't have workplace coverage, they should be automatically enrolled in a national framework that gives them a choice between a good public insurance plan (the same that Congress has) and competing private plans. If that happens, that would put the private plans in direct competition with the "public" plans. That would force them to sharpen their pencils AND make them more competitive (and less wasteful). Even McCain (when asked because he has had gov't provided health insurance his entire adult life) could not bad-mouth the coverage - and I sincerely doubt any of his doctors would complain about the payments that they receive for providing services.

 

And once the employers figure out that they no longer have to provide health care coverage (in order to compete in the employer marketplace), what is the likelihood that they will decide to let Obama's program take over?

 

At what cost? What is limit that the government will cover? Is there a limit? If so, what is it? Who will make that decision for you?

 

What is an insurance company's incentive to compete with an entity with no perceived budgetary limits (similar to what happened with Fannie Mae/Freddie Mac)?

 

$300+ billion in unnecessary administration costs are used up by the private plans each year.....

 

Somehow I don't see the Federal Government as a paragon of efficiency. Apparently your knowledge and experience differ.

 

Although health care providers across the United States face rising prices for malpractice insurance, general liability, workers' compensation, and even their own health care insurance coverage, many rural health care providers are struggling to keep insurance coverage of any kind.

 

Premiums there are doubling and even tripling in some cases. Worse, some rural providers simply cannot get private commercial coverage, as carriers pull out of the market or go bankrupt. As a result, providers of all types in rural areas-physicians, ambulance services, and hospitals-are struggling to obtain affordable coverage and keep their doors open. There is not a better example of the private insurance market's inability to provide insurance coverage (in any form) - than small-town/rural America with the current system.

 

I'll agree with you here, but where we may differ is the root cause of, and the solution to, this problem.

 

Once universal health care is enacted and the faster that it happens, the better situated we are to start the difficult but essential task of controlling long-term health spending. Without runaway health spending, as the Brookings Institution has shown, the future fiscal picture of the federal government looks surprisingly rosy, even if taxes stay right where they are as a share of the economy.

 

With runaway health spending, the federal government fiscal picture looks catastrophic. Plus, as bad as the federal picture looks, it's prettier than what businesses and workers are facing. According to the New America Foundation, if employer-sponsored insurance premiums and family income rise at the same rate they have for the past decade, an average family health plan will cost more than 45 percent of a typical family's income by 2016.

 

How do you "control" health spending without limiting coverage or limiting access? What happens to the cost of something that's "free"? Don't think that happens? That's exactly what is happening now. People with insurance are disconnected with the costs of healthcare, and have no incentive to economize (not withstanding the uselessness of making people purchase coverages they don't need through regulation). Once the cost of healthcare is 'felt' (just like gas prices), the people will seek ways to reduce their consumption.

 

Think for a moment. What percentage of your total income goes to health insurance and out-of-pocket health care costs? For many that is probably around 10% (+/-). Now picture that rising to 45%.

 

Lowering costs might not happen fast, but it is possible in the long term. There are some relatively easy and quick ways to bring down costs, like streamlining administration (The U.S. has the most bureaucratic health care system in the world. Over 31% of every health care dollar goes to paperwork, overhead, CEO salaries, profits, etc.) and reducing the rate of payment increase for specialty services and prescription drugs. But a good deal of the savings have to come from using resources more efficiently--and here, again, spending now will help us spend less later.

 

The federal government invests a mere pittance in health-information technology and comparative-effectiveness research, and history has shown that the private sector won't make these investments on an appropriate scale. These are public goods that require public investment. We need to collect health-outcomes data, develop new practice guidelines and quality measurements, and really test the effectiveness of new medical technology won't come cheap. But it will make health care cheaper--and, more important, better at improving health--in the long run.

 

The issue of streamlining is one that all companies face. How to do more with less; that is the question. Any for-profit organization is always seeking ways to reduce costs (not just insurance companies).

 

But, the government is NOT a for-profit entity. It simply writes a check (for multiple billion dollars) when it says it needs to. If government is that flippant with non-essentials, what makes you think a sudden wave of fiscal responsibility will occur with healthcare?

 

The beauty of this federal spending is that it will mean higher wages and employment....

 

Paid for by whom?

 

And for those of you that cannot think past "I've got mine - you get yours".... I would assume that you, who cannot see past your own horizons, would want to get the best bang for your (money) tax dollar

 

I'd rather get the most bang for MY dollar; WITHOUT the sugar daddy's cut taken out first, thanks.

 

Health care isn't a luxury good....

 

Nor is it free. It has to be provided by a doctor, a nurse, and/or medical technician.

 

This "health care is a human right" would be true only if it didn't depend on someone else's willingness to trade it for something of value.

 

ACCESS to health care, as in you have the right to walk up to the doctor and request he care for you, is a right. It's his right to refuse.

 

And if you are worried that it will mean health care rationing, the U.S. already rations health care. Rationing in U.S. health care is based on income: if you can afford care, you get it; if you can’t, you don’t. A recent study by the prestigious Institute of Medicine found that 18,000 Americans die every year because they don’t have health insurance. Many more skip treatments that their insurance company refuses to cover. That’s rationing. Other countries do not ration in this way.

 

You have nothing to fear with UHC. I suppose that you weren't thinking about those 18,000 and their families when you used the word "misery", eh? Must be that you haven't got to Psalms 82:3-4 in your reading yet.

 

By extension, is income rationed as well? Since you brought it up, if healthcare is a right, what about simply forcing everyone to equalize their incomes, so everyone could purchase health insurance? Good idea?

 

That way no one would be hungry, everyone would have a home, and we all could get cable TV and nothing would be "rationed" to only those who worked for it.

 

Except, once everyone receives equal benefit, they will equalize (and minimize) their contribution. THAT is what you have to fear from UHC; the contribution will eventually end up at its lowest common denominator.

 

I will address your Biblical references in another thread (if you wish), in the "Off Topic Discussion" section. For now, let's keep things secular.

[mettech]

I have not found anything in the Constitution that guarantees anyone an income, home or health-care. :shades:

 

As such, the "social" edge of our government should only provide the minimum.

 

And the minimum must be helping hand up, not a standard of living.

 

People should be free to succeed with minimum interference from the government,,,,, or free to fail with minimum interference from the government.

 

The government should not be pig sow for everyone to suckle off of...

[RaZor]

And once the employers figure out that they no longer have to provide health care coverage (in order to compete in the employer marketplace), what is the likelihood that they will decide to let Obama's program take over?

 

At what cost? What is limit that the government will cover? Is there a limit? If so, what is it? Who will make that decision for you?

 

From what I understand about the plans available to fed gov't workers, there are several plans available - there are many levels. If one's employer does not provide insurance, you can opt for the gov't worker plan and I suspect that there will continue to be many insurance companies that will provide insurance plans to individuals. If one cannot afford to pay, my guess is that there won't be as many choices - just a basic plan. If you can afford to pay for it - you do (pay for it) and will most likely have several choices of the level you desire (of coverage).

 

What is an insurance company's incentive to compete with an entity with no perceived budgetary limits (similar to what happened with Fannie Mae/Freddie Mac)?

 

Somehow I don't see the Federal Government as a paragon of efficiency. Apparently your knowledge and experience differ.

 

I'll agree with you here, but where we may differ is the root cause of, and the solution to, this problem.

 

Where did you get the idea that the gov't plans do not have limits? If an insurance company wants to stay in the business of health insurance, first they will have to cut their overhead and make plans more suitable to their clients. Many individual plans (like mine) for people over 55 still have pregnancy coverage (I don't need it , don't want it and cannot take it out of the plan - but still have to pay for it).

 

In short, they will have to become competitive (an analogy here would be the D3 and foreign auto manuf's) There probably is not any industry that needs more reform than the insurance industry in this country.

 

Medicare runs on a 3% overhead. Most private insurance companies (including HMOs) run at around 15 - 25% overhead. I'd say that is a whole lot better, wouldn't you?

 

More than 50 million Americans live in areas classified by the U.S. Office of Management and Budget (OMB) as non-metropolitan. They comprise one-fifth of the U.S. population. Rural populations are found to be older, poorer, sicker, less educated and to have a perception of worse health status than their urban counterparts. They also have higher infant mortality and injury-related mortality rates, fewer hospital beds and physicians per capita, and are much less likely than urban residents to have private or public health insurance. The rate of uninsured is more than 20 percent higher in rural areas than in urban areas. Fewer rural people enroll in Medicaid. States in the Southwest and Southeast have the highest percentage of uninsured people.

 

So let's take Mettech's attitude: screw them - they decided to live where they did - they could have moved to the city, etc.,etc, etc. They were the one's that didn't get their education, etc., etc. etc.

 

Who do you think pays for Medicaid? Did you know that in almost all of Florida, there are essentially no doctors that will see a patient that is on Medicaid? I am sure that holds true for most of the Southeast also. So they go the ER (Bush's idea). Then the hospital doesn't get any money. What then happens to the hospital? Do you think that the rural/small doctor would rather get payment from a national insurance plan . . . or Medicaid?

 

States from Rhode Island to California are being forced to curtail Medicaid with 19 states lowering payments to hospitals, doctors and nursing homes, etc., as they struggle to cope with the deteriorating economy.

 

How do you "control" health spending without limiting coverage or limiting access? What happens to the cost of something that's "free"? Don't think that happens? That's exactly what is happening now. People with insurance are disconnected with the costs of healthcare, and have no incentive to economize (not withstanding the uselessness of making people purchase coverages they don't need through regulation). Once the cost of healthcare is 'felt' (just like gas prices), the people will seek ways to reduce their consumption.

Actually this is true but does not that exist with our current system? Of course it does. That is one of the problems with our current system. That does not mean that we should not progress toward a UHC system where the overall cost for health care for our citizens in general is lower. By the way, the best answer (IMO) to this problem is to require all patients to review their bills and report inequities. 75% of all hospital bills are over billed for services/medication/supplies not rendered. Of course, those are all just (unintentional) billing errors (yeah, right). With uniform medical codes and billing (and benefit statements sent to patients), it would much easier to spot these "discrepancies".

 

About 10 years ago, the GAO did a short analysis of Medicare and found extensive fraud (they speculated that there were over 100,000 providers that had committed fraud). But they did little about it because they didn't have enough agents to follow up. I say give the patients a "finders fee" for identifying fraud and have a zero tolerance (like Canada has) for providers that commit fraud, with no statute of limitations, automatic mandatory repayment in full, plus 50% penalty, & and most important -loss of license. The fraud would stop rather quickly.

 

The issue of streamlining is one that all companies face. How to do more with less; that is the question. Any for-profit organization is always seeking ways to reduce costs (not just insurance companies).

 

But, the government is NOT a for-profit entity. It simply writes a check (for multiple billion dollars) when it says it needs to. If government is that flippant with non-essentials, what makes you think a sudden wave of fiscal responsibility will occur with healthcare?

 

Actually, Medicare has proven to be the most efficient cost containment health care cost system this country has ever seen. That is even including the roughly $33 billion worth of fraud by providers - which is still far, far better than $300 billion in unnecessary admin/overhead/etc in the private industry, isn't it? They don't have a chart for private insurance costs on that site, but if they did it would go from the lower left corner to the upper right hand corner - over the same period.

 

The bottom line is that we (as a country) will not be able to compete in any form of business when we are the only country NOT controlling our health care costs.

 

Paid for by whom?

D'ah. If we can lower the overall health care costs for all Americans (as a percentage of their income), families have more to spend on other things (further education etc), improving their own situation and the economy in general AND businesses can afford to pay their employees better wages. . . and still be competitive as the lower the percentage of HCC is of GDP, the more businesses have some room to play with - to get better employees.

 

I'd rather get the most bang for MY dollar; WITHOUT the sugar daddy's cut taken out first, thanks.

That's exactly what we have now - sugar daddies (insurance companies) - remember that government pays for 60% now figure (like. . . who do you think pays for that?)

 

Nor is it free. It has to be provided by a doctor, a nurse, and/or medical technician.

 

This "health care is a human right" would be true only if it didn't depend on someone else's willingness to trade it for something of value.

 

ACCESS to health care, as in you have the right to walk up to the doctor and request he care for you, is a right. It's his right to refuse.

Correct-o-mundo. It's a fact of life. Why in the hell would we want to continue to pay for the most inefficient health care system in the world? Doesn't make sense to me. I have several doctor friends that would love to see single-payer because that would cut their overhead costs substantially. Right now, there are literally thousands of insurance companies and everyone one of them has a different claim form. That ends up costing him a small fortune (his words) for a billing staff.

 

In case you are not aware, Medicare has a complete coded billing system - every covered medical procedure has its own code. A doctor does not have to contact the insurance carrier to get approval - but with an ever increasing number of private ins plans, more and more things must have prior approval before treatment. Now multiply that by how many patients a doctor has and maybe you'll get the picture. The amount of time that a doctor's office billing personnel spend on these issues is rather staggering (my friend got so worked up - it screwed up his golf game talking about it). Ask any doctor how much time his staff has to spend on private insurance approval/billing issues vs. Medicare billing.

 

By extension, is income rationed as well? Since you brought it up, if healthcare is a right, what about simply forcing everyone to equalize their incomes, so everyone could purchase health insurance? Good idea?

 

That way no one would be hungry, everyone would have a home, and we all could get cable TV and nothing would be "rationed" to only those who worked for it.

 

Except, once everyone receives equal benefit, they will equalize (and minimize) their contribution. THAT is what you have to fear from UHC; the contribution will eventually end up at its lowest common denominator.

 

The above are all your extension words/thoughts -- not mine. Not one suggestion for any of them from me. Bottom line is UHC is just more efficient. Benefits will not all be the same. Insurance companies will not all disappear (the bad/inefficient ones most probably will - but they deserve to go IMO). The sky will not fall. The earth will not implode. We'll just end up paying less for health care costs than if we keep on doing what we are doing. I don't know where you guys come up with this notion that UHC means that it is going to be free -- those who have the means to pay for it - will pay for it. Those that have ins through their employer - will probably continue to receive it (but that employer may receive some help in lowering their cost). All it does is gives us better choices for what we pay for.

[J-150]

I have not found anything in the Constitution that guarantees anyone an income, home or health-care. :shades:

 

 

theres nothing in the constitution that says a government can tax you either.

[RangerM]

Where did you get the idea that the gov't plans do not have limits? If an insurance company wants to stay in the business of health insurance, first they will have to cut their overhead and make plans more suitable to their clients. Many individual plans (like mine) for people over 55 still have pregnancy coverage (I don't need it , don't want it and cannot take it out of the plan - but still have to pay for it).

 

In short, they will have to become competitive (an analogy here would be the D3 and foreign auto manuf's) There probably is not any industry that needs more reform than the insurance industry in this country.

 

Remember, what the private plans have to compete with. Here is what I mean.

 

Let's take Medicare (since you cite it below).

 

Medicare Part A is funded by the Medicare Health Insurance Trust fund, whose revenues originate from the payroll taxes collected from working people. It is a "pay as you go" system, similar to Social Security. As of 2003, the Trust Fund was in surplus, but is expected to be insolvent, sometime between 2020 and 2030. When a private company becomes insolvent, usually it goes out of business.

 

Medicare Part B (a supplemental insurance program) is funded by the $96.40 per month premium that participants voluntarily pay. In fiscal year 2004, Medicare Part B took in $31.4 Billion in premiums, yet it paid out $135.4 Billion in benefits. How did it accomplish this? Answer: General Revenue.

 

There is no "general revenue" component to private health insurance. There is no fallback. If benefits paid outweigh premiums collected in the private sector (for long enough), the company goes out of business.

 

A private insurance company simply doesn't have the outside resources to draw from, therefore it can never compete with a government program.

 

Medicare runs on a 3% overhead. Most private insurance companies (including HMOs) run at around 15 - 25% overhead. I'd say that is a whole lot better, wouldn't you?

Ask yourself, "how is this overhead rate calculated"? An overhead rate (in this case) is defined as the cost of administering the program (numerator) over the total benefits paid + administrative costs (denominator). Example: $100 in administrative costs are incurred, and $900 in benefits paid, results in a 10% administrative rate.

 

Why is the significant? Because the more benefits paid, the lower the overall administrative rate. In 2003, Medicare paid out about $6,600 in benefits per enrollee. Private health insurance paid out $2,700. (Lost the link)

 

Medicare's administrative rate is low because it pays out a hell of a lot more in benefits, but that's not all.

 

Private insurers have certain administrative costs that aren't included in Medicare's rate. First, Medicare does not incur costs of collection of premiums. The 2.9% payroll taxes and Part B premiums' collection costs are largely covered by the employers, the IRS, and the Social Security Administration.

 

Second, Medicare largely doesn't scrutinize claims whereas private insurers must. These are costs incurred by the private company that isn't by the government. (except in cases of massive fraud, there is no incentive since that "general revenue" is there).

 

Third, Private Insurance premiums are taxed at the State level (often around 2%). Medicare revenues are not. This adds to the cost of doing business (and the overhead rate) for the private Health Insurance Company.

More than 50 million Americans live in areas classified by the U.S. Office of Management and Budget (OMB) as non-metropolitan. They comprise one-fifth of the U.S. population. Rural populations are found to be older, poorer, sicker, less educated and to have a perception of worse health status than their urban counterparts. They also have higher infant mortality and injury-related mortality rates, fewer hospital beds and physicians per capita, and are much less likely than urban residents to have private or public health insurance. The rate of uninsured is more than 20 percent higher in rural areas than in urban areas. Fewer rural people enroll in Medicaid. States in the Southwest and Southeast have the highest percentage of uninsured people.

 

Who do you think pays for Medicaid? Did you know that in almost all of Florida, there are essentially no doctors that will see a patient that is on Medicaid? I am sure that holds true for most of the Southeast also. So they go the ER (Bush's idea). Then the hospital doesn't get any money. What then happens to the hospital? Do you think that the rural/small doctor would rather get payment from a national insurance plan . . . or Medicaid?

I think I know why doctors in Florida may be reluctant to serve Medicaid recipients. A doctor (in Florida) receives $27 for an office visit for a Medicaid patient, but the cost of providing the service is about $75.

 

I'll try to get around to addressing the rest of your post tomorrow. It's late and I'm tired.

[RangerM]

theres nothing in the constitution that says a government can tax you either.

 

16th Amendment, and it should be repealed in favor of the FairTax.

[RangerM]

Actually this is true but does not that exist with our current system? Of course it does. That is one of the problems with our current system. That does not mean that we should not progress toward a UHC system where the overall cost for health care for our citizens in general is lower. By the way, the best answer (IMO) to this problem is to require all patients to review their bills and report inequities. 75% of all hospital bills are over billed for services/medication/supplies not rendered. Of course, those are all just (unintentional) billing errors (yeah, right). With uniform medical codes and billing (and benefit statements sent to patients), it would much easier to spot these "discrepancies".

 

It's this "progress toward a UHC system where the overall cost for health care for our citizens in general is lower" where I have a problem.

 

I understand where you are coming from in the "administrative costs" area, but I have addressed this in my above post. This 3% overhead cost is misleading because it ignores the differences in the way the two costs(public vs. private) are calculated and incurred.

 

According to the law, the Federal Employees Health Benefits Program (the one you cite as being the one for Federal employees, although there are far more programs than just this one) is prohibited from covering more than 75% of the insurance premium. What has happened to that program? In the last seven years, the cost to the federal employee has increased by 62.3% (on average), and due to the dropout of 14 of the plan options in 2008, some saw increases of 132% in one year. link These increases exceed anything in the private sector.

 

An important point to remember. The FEHBP is financed not only through premiums by the workers, but it's (up to) 75% financed by TAXPAYERS (the postal workers program is up to 85% taxpayer-funded). What this means is that the FEHBP has more premium "payers" than beneficiaries. NO private-sector plan can make that claim. And even with this advantage, 14 of the options couldn't afford to stay afloat.

 

About 10 years ago, the GAO did a short analysis of Medicare and found extensive fraud (they speculated that there were over 100,000 providers that had committed fraud). But they did little about it because they didn't have enough agents to follow up. I say give the patients a "finders fee" for identifying fraud and have a zero tolerance (like Canada has) for providers that commit fraud, with no statute of limitations, automatic mandatory repayment in full, plus 50% penalty, & and most important -loss of license. The fraud would stop rather quickly.

 

If I remember my own plan, there is some sort of consideration for finding and identifying inaccuracies. When I first daughter was born, I accounted for all costs to make sure I was paying only my deductible. (I was)

 

Actually, Medicare has proven to be the most efficient cost containment health care cost system this country has ever seen. That is even including the roughly $33 billion worth of fraud by providers - which is still far, far better than $300 billion in unnecessary admin/overhead/etc in the private industry, isn't it? They don't have a chart for private insurance costs on that site, but if they did it would go from the lower left corner to the upper right hand corner - over the same period.

 

Remember. Medicare Plan B supplemented its $31 Billion in premiums with another $100 Billion in taxpayer monies. There is no private-sector equivalent, and only the beneficiarys' premiums cover the cost of benefits.

 

Overhead costs for much of Medicare are borne by those outside the medicare program (employers, the IRS, and the SSA).

 

The bottom line is that we (as a country) will not be able to compete in any form of business when we are the only country NOT controlling our health care costs.

 

D'ah. If we can lower the overall health care costs for all Americans (as a percentage of their income), families have more to spend on other things (further education etc), improving their own situation and the economy in general AND businesses can afford to pay their employees better wages. . . and still be competitive as the lower the percentage of HCC is of GDP, the more businesses have some room to play with - to get better employees.

 

Agreed that reduction in overall healthcare costs would benefit the country greatly, but I'll say again the reason for increased costs is the lack of any form of accountability by the insurance beneficiaries.

 

And it's only going to get worse as the population ages.

 

That's exactly what we have now - sugar daddies (insurance companies) - remember that government pays for 60% now figure (like. . . who do you think pays for that?)

 

Correct-o-mundo. It's a fact of life. Why in the hell would we want to continue to pay for the most inefficient health care system in the world? Doesn't make sense to me. I have several doctor friends that would love to see single-payer because that would cut their overhead costs substantially. Right now, there are literally thousands of insurance companies and everyone one of them has a different claim form. That ends up costing him a small fortune (his words) for a billing staff.

 

In case you are not aware, Medicare has a complete coded billing system....

 

I can certainly see your point with a common billing code system greatly streamlining the process, and reducing costs, but if that were a primary driver, the private insurers would have adopted it. Maybe some have? I really don't know.

 

I do know that most of the time "one size fits all" winds up fitting noone.

 

.....We'll just end up paying less for health care costs than if we keep on doing what we are doing. I don't know where you guys come up with this notion that UHC means that it is going to be free -- those who have the means to pay for it - will pay for it. Those that have ins through their employer - will probably continue to receive it (but that employer may receive some help in lowering their cost). All it does is gives us better choices for what we pay for.

The notion that it's "free" comes from the same notion that it is now. People don't perceive the true costs, and have no reason to be sensitive to them.

 

Once everyone is separated from the true cost of health care (under UHC), the cost will rise faster than it does now.

 

In sum, I guess we'll have to agree to disagree.

[Extreme4x4]

I refuse to get drawn into the "breakdown post to quotes, and answer each quote," rhetoric. However, it does make for good reading.

 

That said, I do have a couple of points.

 

First, if you want to make a profound improvement in healthcare in the US, make preventative coverage mandatory.

 

You want something that will, ultimately, lower the cost of healthcare.............. that is it. Since the insurance industry............. and ultimately, the entire healthcare industry................. makes the bulk of their profits on "the treatment," preventative healthcare is rarely offered, or covered.

 

We treat the disease, and the effects of the disease. We do not try to stop the disease, or the effects from happening in the first place.

 

When I look at the exclusions in my health insurance, pretty much anything that can be perceived as preventative, is not covered. You want to stop obesity............... offer counseling, meal planning, education, and excercise/weight loss programs. If this does not keep someone from being obese, cover bypass or lapband surgery. Any and all of this is much cheaper than dealing with the diabetes, heart problems, joint problems, and every other problem that can be an effect of obesity. Cover stop smoking programs, and/or stop smoking medications.

 

The list goes on and on. The savings, when taken as a whole on society............. would be enormous............. as would be the health of the nation. A healthier populace is a happier populous.

 

Also, I agree completely with Ranger, as to the benefits vs costs of "nationalized" healthcare. You add in 1 layer of government, and the additional costs will far outweigh any savings. Not trusting our government................. you got it. That is why we have a constitution. Short of national defense, and we have all witnessed the abuses there, the government has never proven to me that they can handle anything in an efficient way. Money is power, and feeds greed. Give them more, and they will find new and creative ways to squander it.................. and to raise our taxes, and continue to raise our taxes, with the explanation of the "national good."

 

Razor and nv, you find it incredulous that we do not trust our government.................... and I find it incredulous and scary that you do.

 

All that said, for every "happy happy, joy joy" story, that one can find, on the wonderful benefits of "nationalized healthcare,"................. I can find a horror story. As most of my relatives live in Canada, there are plenty of them to be had................ and that is just in my family.

 

While I do agree that changes need to be made................ if given the choice of keeping what we have now, or getting nationalized healthcare................. I will keep what I have.

[g48150]

Honestly, if the UAW let guys have multiple job "titles" and let anyone fix anything that's busted somewhere in the plant, and not require 2 millwrights to move some heavy equipment, we'd all be in business in the USA.

 

Have two job classifications: Move Heavy Shit, Move Light Shit, nuff said.

[nvsked]

Honestly, if the UAW let guys have multiple job "titles" and let anyone fix anything that's busted somewhere in the plant, and not require 2 millwrights to move some heavy equipment, we'd all be in business in the USA.

 

Have two job classifications: Move Heavy Shit, Move Light Shit, nuff said.

 

the moving of equipment is covered by a pre-tast job summary written by Ford Engineering

[dork270]

I have not found anything in the Constitution that guarantees anyone an income, home or health-care. :shades:

 

As such, the "social" edge of our government should only provide the minimum.

 

And the minimum must be helping hand up, not a standard of living.

 

People should be free to succeed with minimum interference from the government,,,,, or free to fail with minimum interference from the government.

 

The government should not be pig sow for everyone to suckle off of...

Excellent post!