21
   

Republicans using Healthcare as a political game.

 
 
revel
 
  1  
Reply Wed 22 Jul, 2009 09:43 am
@H2O MAN,
I could make some lame comment about it sauce for the gander, but on the whole, the Obama administration is not living up to many of its claims, transparency being one of them and the detainee situation and all related such issues.

On the other hand it is at least good to know they are getting opinions from some of the people involved in the health field.
Miller
 
  -3  
Reply Thu 23 Jul, 2009 07:41 am
@ebrown p,
ebrown p wrote:

Senator Jim DeMint (R) wrote:
If we're able to stop Obama on [reforming Health Care], it will be his Waterloo. It will break him.


If you disagree with Obama's health care proposal, fine. But to see failure to reform health care as part of a general campaign to attack the president...

What jerks.



Jerks? I'd say that Prof Gates is a jerk, wouldn't you?

Why would a black man, proud to be black, run around claiming his DNA is 56% WHITE?

That's typical Cambridge ( Harvard ) BS!
0 Replies
 
Miller
 
  -3  
Reply Thu 23 Jul, 2009 07:45 am
@ebrown p,
ebrown p wrote:

Quote:
President Obama is committed to working with Congress to pass comprehensive health reform this year in order to control rising health care costs, guarantee choice of doctor, and assure high-quality, affordable health care for all Americans. The Administration believes that comprehensive health reform should:

* Reduce long-term growth of health care costs for businesses and government
* Protect families from bankruptcy or debt because of health care costs
* Guarantee choice of doctors and health plans
* Invest in prevention and wellness
* Improve patient safety and quality of care
* Assure affordable, quality health coverage for all Americans
* Maintain coverage when you change or lose your job
* End barriers to coverage for people with pre-existing medical conditions


Obama's role is to push the issue and to set broad guidelines as to what constitutes a good solution. However, he is being very careful to let Congress wrestle over the specifics-- as the health care plan will come from Congress.

You should look to the House bill to see what is coming up. We are fighting for a public option (i.e. a public way to get insurance as an alternative to the current private companies) and figuring out how to pay for it.

The specifics will come from Congress.



You forgot Obama's plan to cut Medicare spending by 50% and to also limit terminal care for the dying elderly.

Apparently, Obama doesn't think he'll ever be old and require tender, loving medical care during his final days on Earth.
parados
 
  3  
Reply Thu 23 Jul, 2009 08:03 am
@Miller,
Quote:

You forgot Obama's plan to cut Medicare spending by 50% and to also limit terminal care for the dying elderly.


Forgot it? Could you provide evidence such a plan ever existed? I can find nothing about Obama planning to cut Medicare spending by 50% or limit the care for dying elderly.

I won't hold my breath waiting for you to reply.
0 Replies
 
H2O MAN
 
  -4  
Reply Thu 23 Jul, 2009 11:40 am
@revel,


I seriously doubt they are meeting with people involved in the health field to get their opinions.
I'm thinking Obama is spoon feeding people involved in the health field talking points that reflect PrezBO's ambitions.
FreeDuck
 
  5  
Reply Thu 23 Jul, 2009 01:01 pm
@roger,
I know everyone has moved on, but roger had some points I wanted to address

roger wrote:

I'm sure they love their work, as you do yours. Under the Medicare schedule, my doctor is required to accept a 35% discount. How many legal business have net income in excess of 35% that you know of? Bernie Madhoff perhaps, but I said legal business.

But health insurance companies also demand and receive deep discounts to doctor's fees.

roger wrote:
You mean, competition is good when a private company financed by premiums competes with a government system financed by taxes?

Health insurance premiums paid into employer sponsored plans are, IMO, functionally equivalent to a tax. The employer gets to offer you plans at a much cheaper rate than you can buy them yourself because of the artificial pooling mechanism which ensures that bigger companies can offer their employees better benefits. The true cost of the insurance is hidden by the fact that the employer pays one portion and the employee pays another, neither of which seem particularly expensive until they separate and the employee tries to use COBRA to continue coverage. Once you're out of that big company pool you're on your own and the costs rival your mortgage (and I'm speaking from experience). Also, current premiums are also somewhat financed by tax anyway, as the pretax mechanism reduces your tax burden -- or another way to look at it, you're shifting your taxes away from the government and toward the insurance companies. (The same applies for banks and mortgage interest, but I digress.)

My point is that it's not a free market with loads of competition now, as consumers are not really free to choose their health plans, nor are they able to decide what levels of care they want to receive without the interference of a bureaucrat. At some point many years ago, our government passed on the opportunity to provide universal health coverage and gave us this employer sponsored bullshit instead, and that's why we are where we are. I really don't want to imagine how much worse they can make this problem by not having the will to address it this time.
FreeDuck
 
  7  
Reply Thu 23 Jul, 2009 01:08 pm
And one other thing about Medicare and Medicaid and Tricare and their varying degrees of suckishness. I'd like to point out that these programs insure people that private industry would not (or could not at a profit). By taking them off the hands of insurance companies we've allowed for privatized profits but socialized losses. We all have to pay in to a program to care for people that insurance companies won't, but that extra money that healthy and young people pay in but never use, private industry gets to keep that.

All of that said, I don't know what the right solution is and I have zero faith in Congress to sort it out. It would have been better for Obama to find some really smart people to come up with a plan instead of leaving it to the morass of indecision that is Congress with all their lobbyists. I know he was trying to make it not about him, but they simply don't have the smarts and/or the cojones to do this. Ideally, each state would implement their own single payer system and compete with each other, but they're all strapped right now.
0 Replies
 
Advocate
 
  1  
Reply Thu 23 Jul, 2009 01:43 pm
@H2O MAN,
You say he is not meeting with people in the medical field. Then why is the right making a big deal about O not turning over records showing who showed up at his big meeting with such people?

Btw, O was brilliant in his speech and news conference last night. It is great to have a president who is intellectually 100 %. The last one was Clinton.
H2O MAN
 
  -1  
Reply Thu 23 Jul, 2009 01:44 pm
@Advocate,
Advocate wrote:

You say he is not meeting with people in the medical field.


I never said that.

I said:
"I seriously doubt they are meeting with people involved in the health field to get their opinions.
I'm thinking Obama is spoon feeding people involved in the health field talking points that reflect PrezBO's ambitions. "
0 Replies
 
roger
 
  3  
Reply Thu 23 Jul, 2009 02:10 pm
@FreeDuck,
FreeDuck wrote:

I know everyone has moved on, but roger had some points I wanted to address

roger wrote:

I'm sure they love their work, as you do yours. Under the Medicare schedule, my doctor is required to accept a 35% discount. How many legal business have net income in excess of 35% that you know of? Bernie Madhoff perhaps, but I said legal business.

But health insurance companies also demand and receive deep discounts to doctor's fees.

True, but the fact remains that doctors and hospitals just loved the company paid health insurance I used to have. Typically, and I'm not going to dig up cites, Medicare pays about 80% of the amount paid by private insurance. I ran up a hospital bill in 2007 that totaled somewhat over $15,xxx. Co-pay was $1,000.00, with insurance paying either 7,000 or 8000. The other roughly 7,500 was discounted acording to contract agreement negotiated between the hospital and the insurance co. Again, the hospital seemed quite happy. I may be proving your point here, but I'm guessing that the amount collected by hospitals, doctors, and therapists from privately insured patients is about what is needed to cover costs plus a reasonable profit. I'm also guessing they usually take a small hit on Medicare patients, and a killer on patients who can't or won't pay.

roger wrote:
You mean, competition is good when a private company financed by premiums competes with a government system financed by taxes?


Might depend on exactly what you mean by 'functionally'. Participation is voluntary, which is not typical of taxes.

Quote:
Health insurance premiums paid into employer sponsored plans are, IMO, functionally equivalent to a tax.


Quote:
The employer gets to offer you plans at a much cheaper rate than you can buy them yourself because of the artificial pooling mechanism which ensures that bigger companies can offer their employees better benefits.


Not sure the pool is that artifical. Privately purchased insurance has a very carefully defined pool, and the definition definately favors the insurance company. In a company pool, the insurance co. takes what it gets. They cover you if you have diabetes, even if you use insulin, which is virtually impossible to cover privately. They cover people with cardiac histories, and those that offer dependent coverage cover pregnancies. There are people with chronic conditions who would retire, except for the insurance benefits.

<snip>

Also, current premiums are also somewhat financed by tax anyway, as the pretax mechanism reduces your tax burden -- or another way to look at it, you're shifting your taxes away from the government and toward the insurance companies. (The same applies for banks and mortgage interest, but I digress.)

True, but if the goal is to get everyone covered by quality insurance, what is the advantage of taxing employer paid or assisted insurance? I've had enough envolvement in payroll and accounting that I know this is a really big bite for the employer. Deny its taxable expense deduction and a fair percentage of them will simply drop the coverage. Employees may opt out of the remaining plans, anyway. I noted elsewhere that only about 30% of eligible employees were willing to pay what amounted to about 1/3 of the costs. That percentage could decline if it weren't paid with pretax income. The ones remaining would contain a higher percentage of the people having the largest medical expenses - thus poisoning the pool.

<snip>
revel
 
  2  
Reply Fri 24 Jul, 2009 06:44 am
@H2O MAN,
Quote:
I seriously doubt they are meeting with people involved in the health field to get their opinions.
I'm thinking Obama is spoon feeding people involved in the health field talking points that reflect PrezBO's ambitions.


Yea, and all those in the health field he is meeting are just so gullible and easily led. Rolling Eyes
H2O MAN
 
  -3  
Reply Fri 24 Jul, 2009 06:59 am
@revel,


Perhaps they are easily bullied or bribed...
0 Replies
 
FreeDuck
 
  4  
Reply Fri 24 Jul, 2009 11:58 am
@roger,
roger wrote:

Quote:
Health insurance premiums paid into employer sponsored plans are, IMO, functionally equivalent to a tax.


Might depend on exactly what you mean by 'functionally'. Participation is voluntary, which is not typical of taxes.

Depends on the state and the company. The last three companies I have worked for in GA did not allow opting out without proof of other coverage, which of course is even less affordable than employer sponsored plans. I don't know if that's a state thing or an insurance thing, but for quite a few people it is not in fact optional.

Quote:
Quote:
The employer gets to offer you plans at a much cheaper rate than you can buy them yourself because of the artificial pooling mechanism which ensures that bigger companies can offer their employees better benefits.


Not sure the pool is that artifical. Privately purchased insurance has a very carefully defined pool, and the definition definately favors the insurance company. In a company pool, the insurance co. takes what it gets. They cover you if you have diabetes, even if you use insulin, which is virtually impossible to cover privately. They cover people with cardiac histories, and those that offer dependent coverage cover pregnancies. There are people with chronic conditions who would retire, except for the insurance benefits.


The insurance companies draw a line around a group of people and say, ok, we ran the numbers and we can calculate the risk and we know we can make a profit off of all of you if we charge each of you x amount. So the risk of the few cancer patients is spread across everyone in the company. Then if a solo person shows up, that person has to pay for all of their own risk. But all of the money goes into and comes out of the same place. I've worked at three different companies who all had the same insurance carrier -- why should it make any difference which company I work for? The actual pool is all of the subscribers.

Quote:
True, but if the goal is to get everyone covered by quality insurance, what is the advantage of taxing employer paid or assisted insurance? I've had enough envolvement in payroll and accounting that I know this is a really big bite for the employer. Deny its taxable expense deduction and a fair percentage of them will simply drop the coverage.

And then I imagine that the insurance companies would reduce their prices. That's kind of my point, actually. The goal of the employer sponsored plans was to get everyone who had a job covered by quality insurance. But people don't stay at a job for 20 or 30 years anymore, and they shouldn't lose their coverage when they separate from their employer. And regardless of the goal, the effect is a health insurance market subsidized by our taxes and protected from real competition.

Quote:
Employees may opt out of the remaining plans, anyway. I noted elsewhere that only about 30% of eligible employees were willing to pay what amounted to about 1/3 of the costs. That percentage could decline if it weren't paid with pretax income. The ones remaining would contain a higher percentage of the people having the largest medical expenses - thus poisoning the pool.


I don't actually have a problem with it being paid pretax, I just think that paying for insurance with pre-tax income and paying a tax for universal health care are not significantly different.
0 Replies
 
sstainba
 
  1  
Reply Fri 24 Jul, 2009 02:34 pm
For what it's worth, I do not think Obama has actual practicing physicians anywhere near him advising him on this issue - and that's a problem. Many of the things he's said point to this. The other day he was talking about how a child may show up with a soar throat and the physician will opt to remove his tonsils because he knows he'll get paid more for the procedure. Well, that's simply not the case. The primary care physician does not make any more or less money either way. The primary car physician gets paid based on the time he spent with the patient and the diagnosis. If a tonsillectomy is required, that would be done by an ENT surgeon and none of that money goes to the PCP.

Obama seems to be overlooking a lot of the problems in healthcare. This, of course, is because he doesn't have the actual practicing physicians talking to him. He wants to reduce spending and waste. Well, what do we do about the patient who is admitted to the hospitalist for leg pain and demands an MRI even though the MRI is not medically indicated? If the doctor doesn't order the MRI the patient can write a complaint to the state board of healing arts. That physician would then need to list that on future job applications even if it was bogus. The patient may even try to sue. Even if the person lost, the physician must list that suit on future job applications. So most physicians will do what the patient demands even if it is not necessary. This same situation is largely to blame for antimicrobial resistance. Parents bring their children to a physician for a common (viral) illness and demand antibiotics. The physician knows they won't do any good, but the parent demands it. And suppose one doctor does not write for them... the patient will often times go to another clinic until they get what they want.

These are the types of things that need to be addressed.
0 Replies
 
Finn dAbuzz
 
  -2  
Reply Fri 24 Jul, 2009 11:31 pm
@revel,
Finn wrote:
Sounds a lot like the Democrat's strategy when Republicans held power in the White House and Congress. I could be wrong, but I doubt you were chastising the Dems for their obstructionism back then.


Revel wrote:
Since nearly everyone one of Bush's proposals or bills (however to word it) I fundamentally disagreed with, I didn't have a problem with democrats trying to stop them if in fact they did do so, however, for the most part they rolled over and played dead after talking a good game. But there is fine line between objecting to proposals and just saying no to everything in order for the president to fail so that your own party will win next election. Since democrats went along with a fair number of Bush's proposals, I don't think the comparison is accurate.


Of course you don't think the comparison is accurate.

The Republicans are evil and need to be stopped.

The Democrats are righteous and trying to stop them is evil obstructionism.

Thank you for proving my point revel.
Finn dAbuzz
 
  -2  
Reply Fri 24 Jul, 2009 11:35 pm
@ebrown p,
ebrown p wrote:

For the record, I have never said, or even thought, that a bill should be defeated simply to make Bush fail.

There were several times I supported Bush-- particularly the immigration bill, and a couple of times I praised him -- for example right after 9-11 when he made the Islam is Peace speech.

I opposed most of Bush's policies (probably as much as anybody here), but I would never oppose a good policy simply because it came from Bush.



Off the record: Bullshit!

But, I am not inclined to expend the effort to research all of your posts in this forum to prove you wrong, and so you are entitled to make this false claim. I promise I will not, on the record, deny you.
0 Replies
 
revel
 
  3  
Reply Sat 25 Jul, 2009 06:37 am
@Finn dAbuzz,
The comparison is not accurate because the democrats didn't obstruct Bush's bills, they actually supported them in the end by voting for them more often than not.
0 Replies
 
hawkeye10
 
  2  
Reply Sat 25 Jul, 2009 11:05 am
Quote:
But Mr. Obama is under growing pressure to choose between wooing a small band of Republicans or struggling to rally his party to use its big majorities in Congress to get the job done. The bipartisanship exhibited in the passage of two other ambitious domestic programs that offer one historical backdrop for this debate " Social Security in 1935 and Medicare and Medicaid 30 years later " seems increasingly improbable in today’s Washington.

To some extent, achieving any kind of bipartisan accord seems almost a luxury given the struggles Mr. Obama has had in corralling his own party behind a health care plan

http://www.nytimes.com/2009/07/26/us/politics/26partisan.html?_r=1&hp

for all of those who have not wised-up yet, this is a lesson. Washington no longer works. Reform of national politics is needed, to include the replacement of both parties.
0 Replies
 
Chumly
 
  2  
Reply Sat 25 Jul, 2009 05:16 pm
You could always visit Canada and watch as many Canadians complain about Canada's socialized medical plan causing very high taxes; and further note numbers of Canadians traveling to the US for speedier medical attention.

Also of note is that Big Fast Food and Big tobacco and Big Alcohol indirectly and directly cause lots of the high medical costs in the US and Canada.
hawkeye10
 
  1  
Reply Sat 25 Jul, 2009 05:25 pm
@Chumly,
Quote:
You could always visit Canada and watch as many Canadians complain about Canada's socialized medical plan, and note a number of Canadians traveling to the US for speedier medical attention


the state plan should provide for a reasonable cost reasonable care for all with fairness to all. For those who decide that this is not good enough for them, and are willing to pay out of personal funds for better, should be free to do so. Nobody wants to face being told no ever, of being in a situation were something they want is rationed. The enlightened amongst us know that it must be that way, and we are not immune from the impulse to bitch and moan when we can't have what we want. Considering that you Canadians have not scraped your rationed care system I suspect that the majority is smart enough to know what is best for Canada, and want to keep it.

From what I know about the Canadian plan is seems that the problem is that you allow the capitalists too much of a skim to operate the system. If you had a more socialistic system you could provide more output (care) for the same input (money)
0 Replies
 
 

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