IT'S TIME FOR UNIVERSAL HEALTH CARE

I have been researching income levels, primarily to answer calls for/against health care reform.

I think we need universal or single payer . . . because, at the present time, business people make decisions in re: which treatments a doctor may pursue and which medicines a doctor may prescribe.

Sound familiar? A little like sarah palin's Death Panels?

Now, an argument against universal or single payer is that it will bankrupt our kids and grandkids.

However, according to the Congressional Budget Office, wages for the bottom four quintiles . . . now, a quintile is 1/5 or 20% of the population, which, multiplied by 4 yields 4/5 or 80% of the population. . . have remained stagnant since 1979.

So, isn't the real reason our kids and grandkids will be bankrupt the fact that we are now? That we are trying to live in 2010 on the same money we earned in 1980?

And, doesn't that mean that 80% of the workers in this country probably can not afford health insurance, let alone health care?

BTW, remember the Clintons? Remember how Hilary set up a health care reform project in the WH, which I thought was exploratory in function, ie, an attempt to learn the best way to conduct health care reform.

Remember how the Republicans were against it because it was a project of the First Lady . . . who had worked in health care from the side of its legal ramifications.

The next chapter on health care reform came with the election of Barack Obama. The Republicans want a year's worth of work dismantled . . . which, perhaps, it should be in order to begin again with the ideas put forth for years by John Conyers, but, that is another thread . . .because said work was conducted behind closed doors.

Isn't it strange that everyone knows what was going on? Doors must not have been locked.

Doesn't it seem to you that something is missing?

If the Republicans were so 'het up' about health care reform, why didn't they propose any ideas during the eight years bush was in office?

No. It only means that you don't read carefully. The wages you cited that have " remained stagnant" since 1979 have been stagnant only with respect to the GDP. That means purchasing power is at least the same today as it was then.

The top quintile of the earning ranking is very unstable - people rise into it and fall out of it fairly quickly - it isn't a fixed group of people.

However, I doubt that a few obvious facts will alter your fixed opinions.

Only if you think of wages in the limited and old fashioned manner of the accountant.

Compensation is a better word. And compensation for what. Hiring yourself out of course. Reducing your leisure in other words.

And taken by the hour, say, I do believe that the average man is compensated more now for that terrible loss, an hour of real leisure, as opposed to working leisure, meeting A2Kers for example, wherin he might contemplate the mysteries of this world, appreciably more now than in 1979 which was before electric windows and central locking in motor vehicles of the common type.

And now you need instructions from the driver on how to wind the window down to throw a cigarette butt out and to get out of his car at the lights when you have been given a lift. That's progress George in compensation.

Not only does he make you look like a complete idiot but he gets to show off all his control freakery widgets as well. That was harder to do way back then.

So was being able to take your pick of the football games being played around the continent and flipping your 47 inch screen, with the sound set to "Stadium", over to Mumbai for the Test Match during half-time.

Today's pleasures are often taken for granted tomorrow. Particularly by children and ladies. So the accountant's figures don't tell the real truth. We are driving our leaders ruthlessly. We all want universal health care cradle to the grave rockabyebaby **** and none of us want to lose out getting it. The elections are the knife edge on which our leaders sit. And not sidesaddle. The rich haven't enough votes to matter much.

The survival rate of heart surgery is probably much improved since 1979. If I had the inclination I could make a longish list of un-noticed benefits which an accountant would not have in his neat columns of numbers. He probably had to use a pen then. And got repetitive strain injuries.

Your point is correct George but you failed to ram it home with the necessary force required to have it stick in what are, afterall, very distracted memories.

It's something you should look to in your literary work.

Why do you suggest that I would not think that stagnation is anything but having the same purchasing power? that is exactly what the chart documented.

And the top 1% is more stable than the lower 80%. Unemployment is far lower there at the present time than it is in the bottom rungs.

There is little point in continuing to pour into an obviously overflowing cup.

There is if you like to see the table awash.

Anyone who was interested could have gotten the secret health care bill in its entirety on the internet. All it took was time and interest and the ability to read and reason which lets out a large number of people on this site.

How to win friends and influence people.

Georgies claims are actually *not* baseless. A twenty-one percent reduction in compensation just went into effect because congress failed to postpone it. In response, the AMA has published a guide for physicians to opt-out of taking medicaid and medicare payments.

Primary care physicians are already under-compensated as compared to all other physicians. A growing trend in the past several years is to leave public practice and instead go into a boutique or concierge practice. These physicians usually charge yearly rates, like a retainer, plus a fee at the time of the visit. In return, the patients get more face time with the doc and in many cases, personal email addresses and phone numbers for questions.

It won't do much good to have "universal" care if it is so poorly compensated that there aren't any physicians to treat the new patients.

I have tried to make that point in the past. Lotsa luck.

There is an argument that the less physicians we have the healthier we will be.

Not that I accept it but I can often see the point. Evolution theory can do no other than accept it. But then again, not many people understand evolution theory. The health of a species is not the same the health of any individual.

So it depends on who "we" are.

I'll grant the possibility without spending much time thinking it over. Yet, if that is the way to go, how much should we be spending to not have them?

Is there any data to back up this position? I only ask, because on one hand, it's been a long-standing meme from Conservatives that 'there are less and less doctors who will accept Medicare.' But, when polled, people report high levels of satisfaction with their Medicare.

How are these two points reconciled?

Cycloptichorn

You may be reading too much into those polls. You are assuming that the survey took into account the availability of providers, which it may not have done.

And really, a physician's willingness to accept medicaid/medicare is a completely different subject than the patients satisfaction with the system.

Here is an article written by an ER physician who blogs about health care and current issues. I seriously suggest you read it. Most people assume they know how compensation in medicine works, when in reality they have no idea. He explains much of that along the way.

http://thehappyhospitalist.blogspot.com/2010/03/medicare-cut-21-goes-through-is-it-time.html

I don't know. It's not really my position. I merely concede the possibility, and noted that I had not put much thought into the matter.

On Medicare satisfaction, I see no contradiction. I don't know why people find this puzzling. My own physician accepts Medicare from existing patients, but not new patients. Since I am an existing patient, I am very satisfied. If he changes policy, or retires, I am Seriously Out of Luck. My eye doctor accepts Medicare. I don't know whether he takes new Medicare patients or not. In his case, he has three technicians, least two people at front desk, and unknown staff doing billing and insurance. I know what Medicare pays him, and I have done enough payroll and accounting to know the money* is just not there. If all his patients were on Medicare, he just wouldn't be in practice.

* I am not trying to calculate building rental, depreciation, insurance, or any other expenses. Medicare wouldn't cover wages.

Here are several articles explaining why physicians are opting-out and/or not accepting new patients:

http://www.nytimes.com/2009/04/02/business/retirementspecial/02health.html

http://online.wsj.com/article/SB123993462778328019.html

http://hubpages.com/hub/Why-Doctors-Are-Opting-Out-of-Medicare

The Times' article mentioned New York, where the situation is probably atypical. Most doctors accept Medicare, and need to in order to make a living. Insurance companies pay little more than Medicare, and some pay less, depending on the procedure. I wager there is only a very small percentage of the population enrolled in concierge practices, which cater to the well-to-do. Doctors often charge too much, and this should somehow be controlled. Quite a few doctors make over a million per year.

Regarding each point; Horseshit!