The Health Care Reform Thread

RAMSTORIA

RAMSTORIA

CAGiversary!
Feedback
34 (100%)
I went ahead and made this thread after we had a couple of threads derail this week (and others in the past) into a health care debate. So let's have at it in this one thread. I'll do my best to update the OP from time to time with relevant stories. If you find a relevant story feel free to PM me and I have no problem with updating the OP.

As we know Obama has used his first budget to put a "down payment" towards universal health care.

The Budget takes the first steps towards universal health care...
President Obama is proposing to begin a vast expansion of the U.S. health-care system by creating a $634 billion reserve fund over the next decade, launching an overhaul that most experts project will ultimately cost at least $1 trillion.

The "reserve fund" in the budget proposal being released today is Obama's attempt to demonstrate how the country could extend health insurance to millions more Americans and at the same time begin to control escalating medical bills that threaten the solvency of families, businesses and the government.

Obama aims to make a "very substantial down payment" toward universal coverage by trimming tax breaks for the wealthy and squeezing payments to insurers, hospitals, doctors and drug manufacturers, a senior administration official said yesterday.

Embedded in the budget figures are key policy changes that the administration argues would improve the quality of care and bring much-needed efficiency to a health system that costs $2.3 trillion a year.

By first identifying a large pot of money to underwrite health-care reform -- before laying out a proposal on who would be covered or how -- Obama hopes to draw Congress to the bargaining table to tackle the details of a comprehensive plan. The strategy is largely intended to avoid the mistakes of the Clinton administration, which crafted an extensive proposal in secret for many months before delivering the finished product to lawmakers, who quickly rejected it.

"We aim to get to universal coverage," administration budget aide Keith Fontenot told health-care activists last night. Obama is "open to any ideas people want to put forward. He wants to work openly with the Congress in a very inclusive process."

Virtually every major player in the health-care sector will find something to object to in Obama's plan, an intentional decision made in the hope that "a little bit of pain" will be offset by the appeal of insuring millions more people, said one White House adviser.

About half the money for the new fund would come by capping itemized tax deductions for Americans in the top income bracket. The proposal, which administration officials characterize as a "shared-responsibility issue," would reduce the value of tax deductions for families earning more than $250,000 by about 20 percent, according to administration documents.

Nearly one-third of the money would be generated by eliminating subsidies that the government pays insurers that sell Medicare managed-care plans. Instead, the Medicare Advantage plans would be put under a competitive bidding process, for a savings of $175 billion over the next decade.

"The administration believes it's time to stop this waste," according to the documents.

Even before the budget proposal became public, the Obama team began selling it to groups that will be central to the upcoming debate. Top lawmakers were brought to the White House for briefings, while constituency groups heard the highlights in an evening conference call yesterday.

"This is the first step towards getting health-care reform done this year," White House domestic policy adviser Melody C. Barnes told allies in one call. "We can't underestimate the importance of rallying around this budget. It serves as a footprint for something bigger."

During the campaign, Obama promised to reduce the number of uninsured Americans, improve the quality of care and save the typical family $2,500 a year in medical costs.

"We know that this is not enough to achieve our overall goal of getting health care for every American, but it is a significant down payment," Neera Tanden, a top Obama health adviser, said during a conference call.

Given the economic crisis and the soaring federal deficit, many had begun to fear that health reform would be postponed, said Drew Altman, president of the nonprofit Kaiser Family Foundation.

"What this does is, it allows the train to move forward," he said. "But there are still big issues to work out about how to reform health care and how to come up with the rest of the money."

Many of the targeted savings are familiar and controversial.

If the tax-deduction cap is enacted, it is likely to hit many small businesses, said House Republican Leader John A. Boehner (Ohio).

"Everyone agrees that all Americans deserve access to affordable health care," he said, "but is increasing taxes during an economic recession, especially on small businesses, the right way to accomplish that goal?"

If the budget is approved by Congress, drug companies will be required to increase the rebate they pay on medications sold to Medicaid patients from 15 percent to 21 percent. The proposal, which would raise $19.5 billion over 10 years, is likely to spark strong opposition from the industry, which has argued that the current rebate cuts into profits.

Wealthy senior citizens would also be asked to pay higher premiums for Medicare drug coverage, similar to the higher premiums they now pay for physician visits, according to the Obama blueprint.

The budget figures also represent significant shifts in how the United States will pay for medical care.

For example, experts have identified hospital readmissions -- especially for elderly patients -- as a sign of poor care and unnecessary expense. About 18 percent of Medicare patients are readmitted to the hospital within 30 days of an original visit. The new approach would establish flat fees for the first hospitalization and 30 days of follow-up, sometimes done by separate facilities. Hospitals or clinics with high readmission rates could be paid less.

Obama, who is set to host a White House summit on health reform next week, has argued that reining in health spending is critical to the nation's long-term fiscal outlook.

Medicare and Medicaid, the government's two primary safety-net health programs, currently consume 5 percent of the gross domestic product, or $660 billion a year. At their current growth rates, absent restructuring, the two programs will equal 12 percent of the GDP by 2050.

Health-care costs are "one of the major reasons why small businesses close their doors and corporations ship jobs overseas," Obama said in a speech to Congress on Tuesday night.

"This is a cost that now causes a bankruptcy in America every 30 seconds. By the end of the year, it could cause 1.5 million Americans to lose their homes," he said. ". . . Given these facts, we can no longer afford to put health-care reform on hold."
Click to expand...
http://www.washingtonpost.com/wp-dyn/content/article/2009/02/25/AR2009022502587_pf.html
 
Let people buy into medicare. Any private insurance company that can compete with medicare can stay. It wont be possible for most of them to do that and they'll go out of business. A few that cater to the super rich will hang around.

The massive profits that private health insurance gained by denying health care to people makes up most of the difference as far as the increased cost. Per capita spending goes way, way down.
 
if it can work in Canada, and most of Western Europe it should be able to work here, as long as they tell the lobbyists to piss off.
 
The key is a focus on preventive care--regular physicals/screenings covered and required by insurance, promoting healthy diets and exercise etc.

Regardless of any other reforms, that's the key. Along with cutting costs and making things more efficient.
 
That will never happen, Ikon.

Sorry about derailing BigT's CA->France thread.

Back in the Clinton years, my dad and I discussed government health care over private health care.

He didn't seem to care who controlled the health care as long as he could receive treatment.

As stated by Rush, I pointed out the government never does anything better than the private sector.

16 years later, my dad is pushing 58 and my stepmother is pushing 63.

They have no bills, a few hundred thousand in savings and a moderate pension that would allow them to live better than my wife and I.

Why are they still working? Healthcare.

My dad's healthcare premium for the two of them is $1,600 per month. (She has high blood pressure and he took care of some prostate cancer.) Under the current union contract, the company pays for the healthcare of retirees. However, my dad is a cynic and believes the next contract may "forget" to have that provision in it.

So, he continues to toil at a job whereas he could be a retired crank in any other Western country.

Let's beg the question already: Would my father be better off spending his last full usable decade working 40-50 hours a week or doing whatever he feels like?

...

I'm not for socialized medicine, but the private sector really needs to start convincing me they can do a better job.
 
How does having the Government pick up the tab make it cost less? Sure, it might cost less on the hospital bills, but then you have to start paying for it with taxes. Those taxes also have to pay the triple redundant government employees that are pretty much hired for life. If anything, I see costs going up and service going down. What about people that have private health coverage? They're still going to have to pay taxes for everyone else to get government health care.

Even if the government doesn't raise taxes to cover this BS and decides to print more money, we're still screwed because that'll just give inflation another kick in the ass.
 
[quote name='Kayden']How does having the Government pick up the tab make it cost less? Sure, it might cost less on the hospital bills, but then you have to start paying for it with taxes. Those taxes also have to pay the triple redundant government employees that are pretty much hired for life. If anything, I see costs going up and service going down. What about people that have private health coverage? They're still going to have to pay taxes for everyone else to get government health care.

Even if the government doesn't raise taxes to cover this BS and decides to print more money, we're still screwed because that'll just give inflation another kick in the ass.[/QUOTE]

The general theme you will find in this discussion with pro-nationalized health care people is that it's ultimately most important to have health care available to everyone, at literally any cost. If it takes higher taxes and lowering the quality of care, so be it, as long as it happens.

They won't come right out and say that, but if you read between the lines, that's what they really believe.
 
[quote name='thrustbucket']The general theme you will find in this discussion with pro-nationalized health care people is that it's ultimately most important to have health care available to everyone, at literally any cost. If it takes higher taxes and lowering the quality of care, so be it, as long as it happens.

They won't come right out and say that, but if you read between the lines, that's what they really believe.[/quote]

Socialized medicine will require higher taxes, but that is offset by not buying private health care.

Lowering the quality of care? Maybe. I can see that on an individual basis, but not necessarily on an aggregate basis.
 
It all depends on how it's done. If the implemented plan has some type of standardized pay scale for doctors, you bet your ass quality will go down. I have met two doctors who have said they will cut the days they work or retire, if there is any type of forced pay scale implemented. They can't be alone.
 
What about companies that provide benefits to their employees? You stop getting benefits and start having to pay more taxes. It's highly unlikely they'll give you a raise to compensate.

[quote name='fatherofcaitlyn']Socialized medicine will require higher taxes, but that is offset by not buying private health care.

Lowering the quality of care? Maybe. I can see that on an individual basis, but not necessarily on an aggregate basis.[/quote]
 
[quote name='thrustbucket']It all depends on how it's done. If the implemented plan has some type of standardized pay scale for doctors, you bet your ass quality will go down. I have met two doctors who have said they will cut the days they work or retire, if there is any type of forced pay scale implemented. They can't be alone.[/quote]

If the government takes over the industry, doctors and nurses are effectively government employees. Make the education to enter the industry free and reimburse practitioners like BigT who mortgaged everything in the hopes of a pot of gold at the end of a very long rainbow.

Then, more people will become doctors.

Will the average doctor be as good as they are now? No, but I didn't need a brain surgeon from Johns Hopkins to tell me I have strep throat.
 
Doctors make a lot of money anyway, so they need to STFU. Being a doctor should be about the profession and not SOLEY about the money.

"Oh no! I'll get pay capped at $150,000 a year!!! UNFAIR!"

:roll:
That's pretty much why we're in this shit hole already.
 
[quote name='Kayden']What about companies that provide benefits to their employees? You stop getting benefits and start having to pay more taxes. It's highly unlikely they'll give you a raise to compensate.[/QUOTE]

It won't happen automatically but it is a good bet it will happen eventually.
 
I'll support this logic if you push it across the board. No one should make millions upon millions a year, but if anyone should, it should be the people saving lives.
[quote name='lilboo']Doctors make a lot of money anyway, so they need to STFU. Being a doctor should be about the profession and not SOLEY about the money.

"Oh no! I'll get pay capped at $150,000 a year!!! UNFAIR!"

:roll:
That's pretty much why we're in this shit hole already.[/quote]
 
[quote name='Kayden']What about companies that provide benefits to their employees? You stop getting benefits and start having to pay more taxes. It's highly unlikely they'll give you a raise to compensate.[/quote]

Fair enough.

Employers pay money for group benefits. If the employers are no longer spending that money to provide those benefits, the employers still have the money.

Where will that money go?

A higher hourly wage to workers? (SHHH!! Stop laughing.)

Hiring another worker to increase the company's output and raise the employer's profit? (Hmm. Maybe if it is enough profit.)

The employer's back pocket (There you go!) before getting jacked by the government in higher taxes like they already do. (Ah, damn it!)

http://taxes.about.com/od/payroll/qt/payroll_basics.htm
FICA Taxes

FICA stands for the Federal Insurance Contributions Act. The FICA tax consists of both Social Security and Medicare taxes. Social Security and Medicare taxes are paid both by the employees and the employer. Both parties pay half of these taxes. Employees pay half, and employers pay the other half. Together both halves of the FICA taxes add up to 15.3%. The 15.3% FICA tax is broken down as follows:
  • Social Security (Employee pays 6.2%)
  • Social Security (Employer pays 6.2%)
  • Medicare (Employee pays 1.45%)
  • Medicare (Employer pays 1.45%)
...

That's right, bitches. The gubmint already jacks 7.65% of your gross income and it isn't even listed on your paystub. Why would the government have to make the entire cost of socialized medicine visible to the taxpayer on a paycheck?
 
To be honest, i haven't found many doctors that i consider very good as it is. My current doctor won't listen to me when i try to tell him about what medications have worked in the past, even though he's supposed to keep that in my file anyway. Instead he gives me things i've never tried. He also started charging more after remodeling his office, completely unrelated i'm sure. I miss the doctor i used to see, he was great, he's just too far away now.

The doctor i'm seeing now also has some sort of advertising setup in his office, it's a LCD TV attached to i assume some sort of video player, it advertises medications and gives little bits of health advice. I'm sure he's getting something in return for having that there.
 
[quote name='Kayden']I'll support this logic if you push it across the board. No one should make millions upon millions a year, but if anyone should, it should be the people saving lives.[/QUOTE]

I agree that those types of people should be paid extremely well.
BUT.
How much do people REALLY need?! I mean.. come on. People don't NEED millions and millions of dollars. Personally, anything over $250K is just pointless and excessive (for anyone).

If the people who make millions and ZILLIONS didn't make as MUCH..and it lead to other people being paid well...there will be more money to go around, IMO.
 
[quote name='lilboo']Doctors make a lot of money anyway, so they need to STFU. Being a doctor should be about the profession and not SOLEY about the money.

"Oh no! I'll get pay capped at $150,000 a year!!! UNFAIR!"

:roll:
That's pretty much why we're in this shit hole already.[/quote]

my girlfriend's brother just started residency... he works 100 (even though they are suppose to cap at 80) hrs a week for 43k for the next 7 years... i'm sure that the money/ hr ratio is much less than minimum wage.

on top of that, he has loans from college and medical school with cumulative debt of 270k, I think he should be making more than 150k once he finishes residency at age of 36 and starts getting a "real" salary.


most of the money drain in health care goes to insurance companies, big pharmacy, and wasteful administration. That's want needs to be cut out... Doctor's salaries are a small percentage of the total health care cost...
 
[quote name='billyrox']my girlfriend's brother just started residency... he works 100 (even though they are suppose to cap at 80) hrs a week for 43k for the next 7 years...

on top of that, he has loans from college and medical school with cumulative debt of 270k, I think he should be making more than 150k once he finishes residency at age of 36 and starts getting a "real" salary.[/QUOTE]

Yes, and that goes to another argument that college should not be so expensive.
I've had asthma all my life and been the doctors and hospitals a ton of times...they should get paid well for what they do and what they deal with. I just think there SHOULD be a cap on salaries (in general). A doctor making like.. $200K a year, IMO, is fair.
 
Thats pretty much what I was getting at...

As far as FICA, it's listed on my pay stubs... I think the whole thing should be done away with anyways. Why should the government maintain a retirement plan for me that will be wholly inadequate anyways... assuming you even live long enough to collect on it. If you die at 59, the government just smiles and takes the money.




[quote name='fatherofcaitlyn']Fair enough.

Employers pay money for group benefits. If the employers are no longer spending that money to provide those benefits, the employers still have the money.

Where will that money go?

A higher hourly wage to workers? (SHHH!! Stop laughing.)

Hiring another worker to increase the company's output and raise the employer's profit? (Hmm. Maybe if it is enough profit.)

The employer's back pocket (There you go!) before getting jacked by the government in higher taxes like they already do. (Ah, damn it!)

http://taxes.about.com/od/payroll/qt/payroll_basics.htm
FICA Taxes

FICA stands for the Federal Insurance Contributions Act. The FICA tax consists of both Social Security and Medicare taxes. Social Security and Medicare taxes are paid both by the employees and the employer. Both parties pay half of these taxes. Employees pay half, and employers pay the other half. Together both halves of the FICA taxes add up to 15.3%. The 15.3% FICA tax is broken down as follows:
  • Social Security (Employee pays 6.2%)
  • Social Security (Employer pays 6.2%)
  • Medicare (Employee pays 1.45%)
  • Medicare (Employer pays 1.45%)
...

That's right, bitches. The gubmint already jacks 7.65% of your gross income and it isn't even listed on your paystub. Why would the government have to make the entire cost of socialized medicine visible to the taxpayer on a paycheck?[/quote]
 
I'd be a little more generous than that though, this is America after all.

One problem I do see though, if something like this was instated in the US, there would be a massive exodus of everything from pro sports to corporate CEOs... Which really wouldn't be that bad in perfectland. In all actuality, what would probably happen is the top 1% just make permanent residence outside the US and continue to claim 50% of the companies earnings.

[quote name='lilboo']Yes, and that goes to another argument that college should not be so expensive.
I've had asthma all my life and been the doctors and hospitals a ton of times...they should get paid well for what they do and what they deal with. I just think there SHOULD be a cap on salaries (in general). A doctor making like.. $200K a year, IMO, is fair.[/quote]
 
[quote name='Kayden']As far as FICA, it's listed on my pay stubs...[/quote]

Unless you have line items that state how much money your employer paid towards FICA, you're half right.
 
[quote name='Kayden']I'd be a little more generous than that though, this is America after all.

One problem I do see though, if something like this was instated in the US, there would be a massive exodus of everything from pro sports to corporate CEOs... Which really wouldn't be that bad in perfectland. In all actuality, what would probably happen is the top 1% just make permanent residence outside the US and continue to claim 50% of the companies earnings.[/quote]

Not likely.

1. If the government wants something, they're going to get even if they have to make up new laws to get it.

2. The upper crust would simply pass off more living expenses as company expenses. "That 8000 square foot house isn't mine. It's a rental property my company leases to me for $100 per month. They're losing a lot of money with it every month, but what are you going to do? I can't afford more than $100 per month."
 
[quote name='thrustbucket']The general theme you will find in this discussion with pro-nationalized health care people is that it's ultimately most important to have health care available to everyone, at literally any cost. If it takes higher taxes and lowering the quality of care, so be it, as long as it happens.

They won't come right out and say that, but if you read between the lines, that's what they really believe.[/quote]

I'll say it. I barely make any money, but if my taxes went up even 10% I would not care, if I knew that every person was receiving basic health care.

Although, I highly doubt quality would go down as drastically as many people believe, I also believe that any health care is better than no health care.

For those with money that want premium health care....fine than just pay for it. Just like receiving protection from the government funded police it may not be the most efficient or best security for people, but if one need more protection, then one goes to the private sector and hires body guards and buys security systems. As for the rest of us at least we have some line of defense that doesn't cost us anything.

Thrustbucket--I am curious in a previous thread you said the only role of government is to protect its citizens from harm and death (to paraphrase). How is it that you believe that the role of government isn't to provide basic health care and preventative medicine to all its citizens?
 
What kind of Health Care is Obama trying to come up with? Would we still pay co-pays for Doctor's visits? Co-Pays for prescriptions?
 
[quote name='Msut77']It won't happen automatically but it is a good bet it will happen eventually.[/QUOTE]


I sell health insurance for a living, mostly commercial health insurance... I can think right now that 50-90% of my clients would cancel their group if this goes into force... Same as the mcCain idea about the rebate... a big fat cxl on their group provided benefits...

This is going to create a shit storm the more they dig into it.
 
[quote name='JolietJake']To be honest, i haven't found many doctors that i consider very good as it is. My current doctor won't listen to me when i try to tell him about what medications have worked in the past, even though he's supposed to keep that in my file anyway. Instead he gives me things i've never tried. [/QUOTE]


Uh yeah its due to that guy or gal that walked in before you with the rolling briefcase... they are pushing their drugs and bonus and perks are a good sales tactic.

RX company sales reps, that is why you are trying new drugs..
 
[quote name='Kayden']Thats pretty much what I was getting at...

As far as FICA, it's listed on my pay stubs... I think the whole thing should be done away with anyways. Why should the government maintain a retirement plan for me that will be wholly inadequate anyways... assuming you even live long enough to collect on it. If you die at 59, the government just smiles and takes the money.[/QUOTE]

If you die then dependants collect some of your money... Do you not get the annualized Social security statement showing you this?
 
No. I'm only 24, but in 6 years you'd think they'd get me something.[quote name='Snake2715']If you die then dependants collect some of your money... Do you not get the annualized Social security statement showing you this?[/quote]
 
[quote name='gareman']I'll say it. I barely make any money, but if my taxes went up even 10% I would not care, if I knew that every person was receiving basic health care.

Although, I highly doubt quality would go down as drastically as many people believe, I also believe that any health care is better than no health care.

For those with money that want premium health care....fine than just pay for it. Just like receiving protection from the government funded police it may not be the most efficient or best security for people, but if one need more protection, then one goes to the private sector and hires body guards and buys security systems. As for the rest of us at least we have some line of defense that doesn't cost us anything.

Thrustbucket--I am curious in a previous thread you said the only role of government is to protect its citizens from harm and death (to paraphrase). How is it that you believe that the role of government isn't to provide basic health care and preventative medicine to all its citizens?[/QUOTE]

Um have you been rejected at a hospital due to them being over full? I have and it sucks I cannot imagine what would happen if people all had health coverage... you would still have the slackers that didnt give a rats ass and waited to go to ER to get whatever taken care of on their deathbed... and then we would all be waiting and that is exactly how the quality goes down.
 
[quote name='Snake2715']Um have you been rejected at a hospital due to them being over full? I have and it sucks I cannot imagine what would happen if people all had health coverage... you would still have the slackers that didnt give a rats ass and waited to go to ER to get whatever taken care of on their deathbed... and then we would all be waiting and that is exactly how the quality goes down.[/QUOTE]

We build more hospitals then. That would create more jobs.
 
[quote name='Kayden']No. I'm only 24, but in 6 years you'd think they'd get me something.[/QUOTE]

You will get them eventually you have benefits now. Its a 4 pager normally and it explains what children or spouse would get if you passed now, how much you will get (if) benefits are around when you retire at age 62, 65, 70 etc.

Interesting paper.
 
[quote name='lilboo']We build more hospitals then. That would create more jobs.[/QUOTE]

So after those hospitals pop up over night where does that money come from? Who trains and works in them? I dont want to go to the free hospitals if the experience is lower there.

This is a very deep process. I honestly cannot forsee this coming to pass.

And when i say its deep there are a lot of things at play that are more concerning than the hospitals being over populated and each states individual set of rules etc.
 
All the same, I don't see how it is any concern of the government to hold my hand making a retirement account. I also don't see how they think they have the right to dictate how much we can put in private accounts. If I sell a house and want to put 100K in my IRA, I should be able to.

The government offers an inferior product and then charges us even more because they have to hire 2 bureaucrats to do the work of one competent person. The government coddling people is part of the reason the economy is turning to shit. They spend money we don't have to make jobs we don't need.


[quote name='Snake2715']You will get them eventually you have benefits now. Its a 4 pager normally and it explains what children or spouse would get if you passed now, how much you will get (if) benefits are around when you retire at age 62, 65, 70 etc.

Interesting paper.[/quote]
 
[quote name='Dr Mario Kart']Let people buy into medicare. Any private insurance company that can compete with medicare can stay. It wont be possible for most of them to do that and they'll go out of business. A few that cater to the super rich will hang around.
[/QUOTE]

i actually really like this idea, but medicare still needs a huge overhaul, especially if it was to be open to everyone. first of all, medicare costs $96.50 a month for recipiants, that number needs to be reduced. there are programs out there that help the bottom 15% or so but that wouldnt be enough to make it "universal". so there would still be need of big reform, but medicare it self would be an easy solution. you can have the standard government plan or youre able to sign up with a private companies medicare plan. its actually quite diverse and youre not limited to HMOs in the least, PPOs are widely available and luxurious PFFS' are also available.

plus, you dont give the government full control, so that should make some people happier with the situation, you can still sign up for Kaiser if you want, itll just be regulated by the government.

[quote name='DJSteel']another way to cut down on costs is to fix the malpractice insurances...talk about ridiculous...[/QUOTE]

oh yes. this too. its certainly not the root cause of our problems, but its still a huge one.


[quote name='thrustbucket']It all depends on how it's done. If the implemented plan has some type of standardized pay scale for doctors, you bet your ass quality will go down. I have met two doctors who have said they will cut the days they work or retire, if there is any type of forced pay scale implemented. They can't be alone.[/QUOTE]

this would be the single biggest hurdle with a universal medicare. doctors get paid SHIT when they see a medicare patient. and they have to accpet what they are paid. i look at medicare claims every day (yeah im in the biz:cool:) and the difference between what doctors charge and what they get paid by medicare is drastic. some private insurance companies pay a little more, but its not a huge amount, maybe like 1-3% higher than medicare.


[quote name='Kayden']What about companies that provide benefits to their employees? You stop getting benefits and start having to pay more taxes. It's highly unlikely they'll give you a raise to compensate.[/QUOTE]

under the current medicare system there are plenty of employers that pay for their retirees medicare, most of the time they have much better benefits than those with just a run of the mill plan.
 
[quote name='Snake2715']Um have you been rejected at a hospital due to them being over full? I have and it sucks I cannot imagine what would happen if people all had health coverage... you would still have the slackers that didnt give a rats ass and waited to go to ER to get whatever taken care of on their deathbed... and then we would all be waiting and that is exactly how the quality goes down.[/quote]



No I have never been rejected by a hospital because it was too full. I have had to wait 2-3 hours before. The thing about an ER is people go there when they need medical attention ASAP, whether or not they have insurance, so if there was Universal health care it would not increase the number of people going to ER, but rather, it would only alleviate the stress and financial burden after the fact.

As far as the "slackers" go, yes there would those who wait and suffer/die because of it, and the that would be their own fault. Just as if someone didn't call the police after a break in because they were lazy and didn't want to do the paper work involved. The consequences would be their fault. That is better than someone not going to the hospital because they were afraid of the financial burden it would cause them and their families.

No one has answered me about why people have no problem pouring trillions of their dollars into military and defense to protect our citizens, but most people shudder at the idea of saving people with free health care.
 
[quote name='gareman']
No one has answered me about why people have no problem pouring trillions of their dollars into military and defense to protect our citizens, but most people shudder at the idea of saving people with free health care.[/QUOTE]

A military is required to prevent an invasion and keep order, although I don't think there are that many people that think we should be spending even 1/5th as much as we are now (just google military spending; we spend nearly as much as the rest of the world combined). Universal health care isn't required for our nation to exist or prosper, although I do think we would be much better off with it. Just looking at our rank in the world health organization (37) and comparing the amount of money we spend compared to France (who is in first place) should tell you something is wrong. We spend about $6000 per person per year while France only spends around $4000. If we spend the most we should have the best.
 
[quote name='lilboo']What kind of Health Care is Obama trying to come up with? Would we still pay co-pays for Doctor's visits? Co-Pays for prescriptions?[/quote]

I believe there was a study done on people receiving free health care that showed that visits declined with no appreciably decline in health when a small (I believe it was like $5 or $10) co-pay was added.
 
I don't mind $5-$10 for medicine.
I just hate when the medicine is expensive and even with insurance you are paying like $25+.

I get advair every month for my Asthma, and it retails at $250...with insurance I pay $38 :(
Of course I'll take $38 over $250 anyday, BUT..$38 a month gets a bit ridiculous. I'd love to get it down to around $10 and go to the doctor a few times a year..but my insurance only covers 1 check up per year. :roll:

So in regards to a universal healthcare, I wouldn't mind paying more tax...however, there should not be limitations. If one person wants to go for a checkup 2-3x a year they should and only have to pay a small co-pay. Medicine shouldn't exceed $10 (co-pay). There shouldn't be like a $500ish charge JUST because you stepped foot in the damn emergency room.

IMO, a doctor visit & prescriptions seem sorta easy to figure out..but, what about hospital stuff? Like giving birth, x-rays, surgeries, anaesthesia, etc? What kind of bill, if any, would be fair under a universal healthcare lifestyle?

I def think major things should be free--COMPLETELY. I think any type of preventive checkup (like a mammogram, prostate exam, cat scan, etc) should be covered.
 
[quote name='RAMSTORIA']
this would be the single biggest hurdle with a universal medicare. doctors get paid SHIT when they see a medicare patient. and they have to accpet what they are paid. i look at medicare claims every day (yeah im in the biz:cool:) and the difference between what doctors charge and what they get paid by medicare is drastic. some private insurance companies pay a little more, but its not a huge amount, maybe like 1-3% higher than medicare.
[/quote]
Comparatively speaking, Medicare pays well: For Medi-cal (medicaid) ppl, we get paid pennies on the dollar. Cash-pay illegals and homeless people (those who often have medical problems due to poor medical follow up, nutrition, drug use, alcoholism, etc.) never pay anything. As you pointed out most other insurance reimbursement is based on Medicare rates.

The problem is the whole reimbursement structure. I can't bill per hour like lawyers do. Seeing a patient in clinic or in the hospital pays very little. Focusing on preventative health care pays very little (except the procedures or imaging studies... colonoscopies, mammograms, etc.). Doing procedures, surgeries, and imaging studies pays much more.... I'll leave the implications of such a pay structure for you guys to figure out...
 
[quote name='Snake2715']Um have you been rejected at a hospital due to them being over full? I have and it sucks I cannot imagine what would happen if people all had health coverage... you would still have the slackers that didnt give a rats ass and waited to go to ER to get whatever taken care of on their deathbed... and then we would all be waiting and that is exactly how the quality goes down.[/quote]

As much as I would like to screen people for insurance and post a "we reserve the right to refuse service to anyone" sign at the hospitals in which I work... EMTALA prevents me from doing so... ;)

But in all seriousness, people are triaged in the ED on the basis of the severity of their presentation... so if you come in with a hangnail, you may wait 10 hours... but if you come in with massive rectal bleeding with a blood pressure of 70/40 and a fingerstick hemoglobin of 6, you'lll be seen right away... regardless of any other factors...
 
Insurance? What the hell is insurance? I was covered under my families' policy until i was 18, that was 16 years ago. Since then, I've had insurance for maybe 3-5 years of that, since NO employers around here will offer it(even though it's listed as a benefit after 90 days, but good luck getting them to get you the paperwork).

During the times when I HAD insurance, the damn insurance company was squirreling away almost a billion dollars in reserves(Blue Cross/Blue Shield of Northeastern Pennsylvania), yet during that time my rate for the most basic plan they had went up 200% EASILY.

I rarely used the plan, since I don't go to the doctor or hospital for a friggin' hangnail, yet every time I was told the rate was going up it was 'due to overuse of the plan and newer tech and blah blah blah'.

Basically, it was a bunch of horseshit doublespeak. Sure, there might have been people(the old, the sickly) who were really using the plan I was on excessively, but why the hell did the rates go up across the fuckin' board because of those who need to overuse the plan?

I wasn't sick, so really I could do without and after seeing so many rate hikes, that's what I did.

Aside from one employer who actually came through and gave out insurance on DAY ONE of being employed there, I've been without for many a year now.

As for the malpractice thing, if doctors didn't fuck up in the first place, they wouldn't need to be sued. I mean, sure, there's suing for frivilous reasons, but if a doctor amputated the wrong leg/arm/etc and I'm now left without any of that appendage, you damn well better believe I'm suing that motherfucker to hell and back and getting a couple million for being an invalid for the rest of my life.

One of my parents almost became of victim of medical negligence when they were in the hospital about 15 years ago for spider bites(brown recluse). They awoke in the middle of the night to find one of the nurses about to give them a shot of insulin, even though they weren't diabetic.

Further on the topic of doctors who screw up severely, I was given a prescription for Depakote about 8 years ago from a shrink who I had told my entire medical history to.

This included the fact that I was at that time taking phenobarbital for a childhood seizure condition. I asked and asked and asked if that drug would have any adverse reactions with the phenobarbital and it was like it went in one ear and out of the other.

However, a week later I was bleeding severely every time I ummm 'evacuated'. Did I sue? No, I didn't. Should I have? I certainly think so, since ever since then I have some stomach pains, though they're very infrequent.

Doctors screw up and should be held accountable and insurance companies are a bunch of greedy fuckers who need to be shut down and don't even get me started on the pharmaceutical industry.

What was the last disease we actually CURED in this world? Seriously? Everything is about TREATMENT nowadays and 'managing your pain/condition'. fuck managing it, spend all the billions and trillions given to foundations to find a cure to actually find a fuckin' cure.

In the end, it's all about $$$$$.

In this country, we've given trillions to overseas nations for 'aid', yet millions of our own people starve and/or are homeless. If we're such a rich and prosperous nation, then why is there such a divide between the haves and the have nots? It's sickening.
 
[quote name='IAmTheCheapestGamer']Insurance? What the hell is insurance? I was covered under my families' policy until i was 18, that was 16 years ago. Since then, I've had insurance for maybe 3-5 years of that, since NO employers around here will offer it(even though it's listed as a benefit after 90 days, but good luck getting them to get you the paperwork).

During the times when I HAD insurance, the damn insurance company was squirreling away almost a billion dollars in reserves(Blue Cross/Blue Shield of Northeastern Pennsylvania), yet during that time my rate for the most basic plan they had went up 200% EASILY.

I rarely used the plan, since I don't go to the doctor or hospital for a friggin' hangnail, yet every time I was told the rate was going up it was 'due to overuse of the plan and newer tech and blah blah blah'.

Basically, it was a bunch of horseshit doublespeak. Sure, there might have been people(the old, the sickly) who were really using the plan I was on excessively, but why the hell did the rates go up across the fuckin' board because of those who need to overuse the plan?

I wasn't sick, so really I could do without and after seeing so many rate hikes, that's what I did.


Aside from one employer who actually came through and gave out insurance on DAY ONE of being employed there, I've been without for many a year now.
[/quote]

If you are young and rather healthy, all you really need is a high deductible/low premium plan for emergencies - most likely, you'll never have to use... I don't remember the last time I had to go to a doctor for a visit...


As for the malpractice thing, if doctors didn't fuck up in the first place, they wouldn't need to be sued. I mean, sure, there's suing for frivilous reasons, but if a doctor amputated the wrong leg/arm/etc and I'm now left without any of that appendage, you damn well better believe I'm suing that motherfucker to hell and back and getting a couple million for being an invalid for the rest of my life.
Click to expand...

Everyone is human... when you prescribe several hundreds of medications per day, you are bound to make a mistake somewhere... we have pharmacists who help to double check. Cutting off the wrong limb is pretty damn bad... that's why people mark Operation sites with markers and then do a "time-out" prior to procedures to verify things.

One of my parents almost became of victim of medical negligence when they were in the hospital about 15 years ago for spider bites(brown recluse). They awoke in the middle of the night to find one of the nurses about to give them a shot of insulin, even though they weren't diabetic.
Click to expand...

In the face of infection, one's blood sugar can be elevated. They might have been put on a "sliding scale insulin" order... (basically, your blood sugar gets checked with meals or every 6 hours and a certain amount of insulin is given depending on the blood sugar level)... and the nurse might have been giving a small dose for coverage... that should be harmless...


Further on the topic of doctors who screw up severely, I was given a prescription for Depakote about 8 years ago from a shrink who I had told my entire medical history to.

This included the fact that I was at that time taking phenobarbital for a childhood seizure condition. I asked and asked and asked if that drug would have any adverse reactions with the phenobarbital and it was like it went in one ear and out of the other.

However, a week later I was bleeding severely every time I ummm 'evacuated'. Did I sue? No, I didn't. Should I have? I certainly think so, since ever since then I have some stomach pains, though they're very infrequent.
Click to expand...
I just looked this up on clinical pharmacology http://www.clinicalpharmacology-ip.com/

There is no major contraindication to using both drugs together. There is a moderate interation defined as: "The interaction may be bothersome or unnoticeable with limited clinical effects. Manifestations of the interaction may consist of an increase in the frequency or severity of side effects or decreased effectiveness of a drug but normally would not require a major alteration in therapy."

Basically, valproic acid increases phenobarbital levels by ~50%. Bleeding is associated more with valproic acid alone, so I doubt the interaction was a significant cause of your problems.

Doctors screw up and should be held accountable and insurance companies are a bunch of greedy fuckers who need to be shut down and don't even get me started on the pharmaceutical industry.
Click to expand...

Once again, mistakes happen.

What was the last disease we actually CURED in this world? Seriously? Everything is about TREATMENT nowadays and 'managing your pain/condition'. fuck managing it, spend all the billions and trillions given to foundations to find a cure to actually find a fuckin' cure.

In the end, it's all about $$$$$.

In this country, we've given trillions to overseas nations for 'aid', yet millions of our own people starve and/or are homeless. If we're such a rich and prosperous nation, then why is there such a divide between the haves and the have nots? It's sickening.
Click to expand...

As we are saving people from acute death, many chronic conditions take over. It's hard to really "cure" anything. I assure you, we don't withhold cures on purpose... :D
 
[quote name='BigT']As much as I would like to screen people for insurance and post a "we reserve the right to refuse service to anyone" sign at the hospitals in which I work... EMTALA prevents me from doing so... ;)

But in all seriousness, people are triaged in the ED on the basis of the severity of their presentation... so if you come in with a hangnail, you may wait 10 hours... but if you come in with massive rectal bleeding with a blood pressure of 70/40 and a fingerstick hemoglobin of 6, you'lll be seen right away... regardless of any other factors...[/QUOTE]

Possibly true, but when I have the best insurance available in my State, BCBS 100% plan $0 deductible, and I went to a local hospital due to a appendix and ended up with an appendectomy. Next thing I know I am sick with 105 fever and packed literally in a bed of ice for 15 hours.

Over the course of two weeks they cannot tell me why I am sick, just to deal with it and take another shot of Morphine or delotin(sp?). "It must be a side effect of the surgery", not that they left infection inside me and stiched me back up... it took me to find the lump of infection in my gut, and to tell them that it shouldnt be there.

I went in at 189 lbs and eventually got transfered out at 160 lbs after a 3 week period, there were issues with that first hospital. Had a family member not had a contact (doctor) in the new hospital I would have sat in the original hospital and may be dead.

I was in severe status, but since I was at a hospital they didn't give two shits. So that is why I say watch and see what happens to care when we all get the same "factory" treatment. patient in, back out, and lets get the next one in here to hit our quota for the government check at the end of the month.....
 
My doctor has told me many times how much he hates insurance companies. Saying that they basically dictate how he can treat his patients. Incredible thing is that the insurance companies have doctors working for them too. So you basically have doctors fighting other doctors over patient treatment.
 
The supply of health care is limited. No matter how hard we push various reforms, incentives to increase the number of doctors etc., there are a limited number of health care professionals we can support (After all, no one country can be dedicated to health care and nothing else... someone has to grow food). Given that supply is limited, it must be divvied up based on demand.

Right now, demand is artificially low, held back by price and availability of insurance. This limited demand means that supply goes farther for those that CAN access the system. I can make an appointment with my doctor and see him tomorrow or the next day. If he determines I need to see a specialist, that happens a couple of days later. The specialist orders an MRI, which happens later that week. This is not speculation, this is what happened when I popped my Achilles tendon. I do NOT have top-shelf health insurance, I have the cheapest HMO option my company offers.

Once health care becomes universal, demand will be nearly unlimited. A new rationing method will need to be found, most likely based on 'need' as determined by the government agency responsible for overseeing health care. To see where that leads, we need only look at where it has already led in other single payer systems. Canada has a 7-9 month waiting list for MRI's.... and that's for people with confirmed cancer.

The point is, given a limited supply, there are only a couple of ways things can go. In out current system, very few get incredible health care, the majority get good health care, and a minority get no health care (beyond emergency services). Universal health care generally means mediocre health care for everyone. My wife is Japanese, my boss is Canadian. Both countries have the sort of health care we 'aspire' to. I think it speaks volumes that both prefer the American system.
 
You must log in or register to reply here.
bread's done
Back
Top