Health care

[der affe]

i have no sympathy for people who suffer at the hands of their own neglect.

This had better not make it any farther.

+100

[ejnight]

"The Congressional Budget Office Wednesday night released its cost analysis of the Republican health care plan and found that it would reduce health care premiums and cut the deficit by $68 billion over ten years.

The Republican plan does not call for a government insurance plan but rather attempts to reform the system by creating high-risk insurance pools, allowing people to purchase health insurance policies across state lines and instituting medical malpractice reforms."

http://www.washingtonexaminer.com/opinion/blogs/beltway-confidential/CBO-Prepublican-health-plan-would-reduce-premiums--69270747.html

Saw this on the Bimmerfest PolySci board.

Where were all these great ideas when Bush was in office and they could have made these changes. The Dem's have had control for three years. Bush and the Reps had 5 years to make it happen.

I don't like what is going on. But I hate the BS even more. Nothing will Change unless there are term limits and no life time free rides once you get voted in.

[mrsleeve]

Very true but that is a whole different thread in and of it self

I don't like what is going on. But I hate the BS even more. Nothing will Change unless there are term limits and no life time free rides once you get voted in.

[Hallen]

Where were all these great ideas when Bush was in office and they could have made these changes. The Dem's have had control for three years. Bush and the Reps had 5 years to make it happen.

I don't like what is going on. But I hate the BS even more. Nothing will Change unless there are term limits and no life time free rides once you get voted in.

That's a good question of course. The answer is, faced with something much, much worse, lobbies and powerful congressional groups are willing to actually do something. In other words, in some cases, repeal stupid laws that have been on the books for far too long.

I doubt term limits and such will help too much. People who gain office will work quicker, but not necessarily better, to garner the big contracts and book deals so they can live high once they are out of office. Nothing will change until politicians understand that ethics are important and doing the right thing sometimes means doing the hard things.

[kishg]

do you not read the whole thread or some thing look on the 1st page. That and I have said it upteen times before.

here click ------> http://www.r3vlimited.com/board/show...04&postcount=9

yeah i read that and dismissed it because it was some hype about anti-trust and not any concrete proposals to alow more entrants into the health insurance market. this maybe one market where the pure free market model isn't the most efficient simply because we've already decided that we won't let people die. real free market would be that. i'm not saying i'm for that, im just pointing out that the problem isn't as simplistic as what you imagine.

[kishg]

I was addressing this ^^^^^^^

yeah, i can come up with my own half-assed plan too ;)

[kishg]

if the local drugstore was giving away free anal-eeze do you think kishg and lbjefferies would wait until they needed it?

actually, we wouldn't get any of it because the old fart geezer in the forum would have the entire stock so his minion of forum sluts can keep his anus filled whenever he so desires.. this while he collects his social security checks that we pay for his to live his out his wastrel life.

[markseven]

Where were all these great ideas when Bush was in office and they could have made these changes. The Dem's have had control for three years. Bush and the Reps had 5 years to make it happen.

I don't like what is going on. But I hate the BS even more. Nothing will Change unless there are term limits and no life time free rides once you get voted in.

Tomorrow I'll post a list of healthcare legislation that was passed during Mr. W's terms.

yeah, i can come up with my own half-assed plan too ;)

Run for office, dangit! ;)

[TexasTerp]

As it stands right now you cant be denied treatment, based on your ability to pay. You will be treated and will be taken care of regardless!!!

Well sort of, Hospitals are only required to stabilize a patient regardless of insurance coverage or money, once they are stable it is entirely up to hospital to determine if they keep treating the patient. This is also the reason why people will get turned away after being stabilized even though they weren't fully treated.

exactly. guess who is paying that 98k?

I agree with you, The US Government has been subsidizing almost 40% of the entire healthcare industry for the past 20 years or more.

yeah but it does little to expand coverage, isn't that the entire point of this exercise?

Well that's actually the question, is it about expanding coverage or reforming the way hospitals deal with the red tape of private insurance companies (which is why I state there is a difference between health CARE reform and health INSURANCE reform.) In my opinion, which is why I disagree with the bill, we need to get rid of the red tape from insurance companies, and return the power back to the doctors, then we open up policies across state lines, this will drastically lower the cost of insurance as well as improve healthcare. Thus making it far more affordable to purchase insurance and expand coverage. I'll give a better explanation and analogy below.

and how do you propose to expand competition?

One of the easiest ways to lower premiums and expand coverage is by opening up coverage across state lines. Auto Insurance works on the exact same principle as Health insurance with two HUGE Exceptions, 1) it is required by both the state and federal government and 2) it is universal across state lines, whether I purchase my insurance in Texas and get into an accident in Maryland is irrelevant, Either way I'm covered. Nobody seems to be overly complaining about HAVING to buy auto insurance! Why is that?? National Coverage allows major companies to compete across the board, sure there are only about 5 major companies and 20 or so local companies per state (guesstimating) but the competition between those few has significantly driven down costs, which is why I have no complaints about paying $40 a month for liability for my e30. If we opened up Health Insurance coverage across state lines there would be 300+ companies available overnight, more than half will go out of business and leave us with 10 or so major players but premiums would drop drastically because of the competition, thus wildly expanding coverage. Combine that with thinning the red tape between Insurance and Pharmaceutical companies, doctors and their patients and you will boost revenue, immensely reduce wasteful spending and boost the overall care of patients. We also need to do far more to protect doctors from ridiculous malpractice lawsuits (ie TORT Reform) that way they can concentrate on taking care of a patient and not worry about their license and practice.

I'm only about 400 pages into the new 1990 page House Bill, but what I have learned from a few friends (judges, doctors and lawyers) this bill still does little to none of what I have mentioned. On the other hand the Republican bill that I have read (which is also the only one I can get my hands on) pushes directly in this direction and significantly reduces the deficit and creates real reform.

Where were all these great ideas when Bush was in office and they could have made these changes. The Dem's have had control for three years. Bush and the Reps had 5 years to make it happen.

Well I think there were far more pressing issues like two wars and Social Security Reform (sadly failed) at the time.

[Vedubin01]

^^^^^ well put!

[mrsleeve]

Oh I see you dismiss something because of a known fact that the Health Insurance industry is exempt from the Anti trust laws, that allow them to hold monopolies or near monopolies of entire populations of states. Allowing them to charge what ever they want to those residents. :rolleyes

Yes it would bring down the costs across the board, along with current Govt, programs, would have the desired effect, to get coverage available to those that want it but cant afford it.

yeah i read that and dismissed it because it was some hype about anti-trust and not any concrete proposals to alow more entrants into the health insurance market. this maybe one market where the pure free market model isn't the most efficient simply because we've already decided that we won't let people die. real free market would be that. i'm not saying i'm for that, im just pointing out that the problem isn't as simplistic as what you imagine.

All that said here is a letter confirming that if you dont comply with all this, you could face prison time and fines up too $250,000 (yes a 1/4 mill)

PELOSI: Buy a $15,000 Policy or Go to Jail
JCT Confirms Failure to Comply with Democrats’ Mandate Can Lead to 5 Years in Jail
Friday, November 06, 2009

Today, Ranking Member of the House Ways and Means Committee Dave Camp (R-MI) released a letter from the non-partisan Joint Committee on Taxation (JCT) confirming that the failure to comply with the individual mandate to buy health insurance contained in the Pelosi health care bill (H.R. 3962, as amended) could land people in jail. The JCT letter makes clear that Americans who do not maintain “acceptable health insurance coverage” and who choose not to pay the bill’s new individual mandate tax (generally 2.5% of income), are subject to numerous civil and criminal penalties, including criminal fines of up to $250,000 and imprisonment of up to five years.

In response to the JCT letter, Camp said: “This is the ultimate example of the Democrats’ command-and-control style of governing – buy what we tell you or go to jail. It is outrageous and it should be stopped immediately.”

Key excerpts from the JCT letter appear below:

“H.R. 3962 provides that an individual (or a husband and wife in the case of a joint return) who does not, at any time during the taxable year, maintain acceptable health insurance coverage for himself or herself and each of his or her qualifying children is subject to an additional tax.” [page 1]

- - - - - - - - - -

“If the government determines that the taxpayer’s unpaid tax liability results from willful behavior, the following penalties could apply…” [page 2]

- - - - - - - - - -


“Criminal penalties

Prosecution is authorized under the Code for a variety of offenses. Depending on the level of the noncompliance, the following penalties could apply to an individual:

• Section 7203 – misdemeanor willful failure to pay is punishable by a fine of up to $25,000 and/or imprisonment of up to one year.

• Section 7201 – felony willful evasion is punishable by a fine of up to $250,000 and/or imprisonment of up to five years.” [page 3]

When confronted with this same issue during its consideration of a similar individual mandate tax, the Senate Finance Committee worked on a bipartisan basis to include language in its bill that shielded Americans from civil and criminal penalties. The Pelosi bill, however, contains no similar language protecting American citizens from civil and criminal tax penalties that could include a $250,000 fine and five years in jail.

“The Senate Finance Committee had the good sense to eliminate the extreme penalty of incarceration. Speaker Pelosi’s decision to leave in the jail time provision is a threat to every family who cannot afford the $15,000 premium her plan creates. Fortunately, Republicans have an alternative that will lower health insurance costs without raising taxes or cutting Medicare,” said Camp.

According to the Congressional Budget Office the lowest cost family non-group plan under the Speaker’s bill would cost $15,000 in 2016.

http://republicans.waysandmeans.house.gov/News/DocumentSingle.aspx?DocumentID=153583

[xwill112x]

welp,




were fucked.

[Vedubin01]

welp,
were fucked.

Not so fast, its still got to get through the Senate.

[KenC]

If we opened up Health Insurance coverage across state lines there would be 300+ companies available overnight, more than half will go out of business and leave us with 10 or so major players but premiums would drop drastically because of the competition, thus wildly expanding coverage. Combine that with thinning the red tape between Insurance and Pharmaceutical companies, doctors and their patients and you will boost revenue, immensely reduce wasteful spending and boost the overall care of patients.

Can't we also assume that in an effort to drive down premium prices between these competing insurance companies that coverage to individuals will be reduced to drive down the bottom line of opperation to have a competative ROI to shareholders? Although, I work within a not-for-profit managed care health system (Kaiser Perm. NW), the private practice providers I've spoken with are at wits end with the cumbersome task of justifying procedures to insurance companies (no matter how hard you try, you can't stremline medicine like a manufacturing plant, the variables are too great and the risks even higher)... which often takes as long to deal with as seeing multiple patients in clinic. I guess this necessary within our system, as the providers chief concern is that of his or her patient, while the insurance company answers to a board and investors.

You're making a huge assumption that decreasing costs will lead to an increase in the quality of care delivered. The US has the best doctors in the world, it's access to them that's the issue here.

I think it's going to be a combination of a lot of things that will make our system not only effective, but also efficient. Included within the current bill that went through the house is a repeal of the anti-trust exemption, which I'm happy about. I would also like to see an aggressive, yet realistic tort cap (Google "OHSU Tort Cap" if you want to see an atrocious example). I would agree that we also need to open up health insurance accross state lines as you pointed out auto insurance is currently.

However, even with all of the potential cost reductions and assumed premium reductions, I don't see how we can rely on the private sector to adequately provide our entire nation with health care/insurance. If all of the above mentioned were to happen and premiums reduced to "affordable" levels, I would be curious to see what the plans associated with the cheaper premiums cover, as the often overlooked population of the "underinsured" is a huge issue as well. I see this as an issue because as any healthcare administrator, or physician for that matter, will tell you is that it is the lower-income populations that regularly require the most medical care. I think it will be necessary for the public to supplement this population just as they do the uninsured... but I guess that's just something that I feel we, as a society, are obligated to do. If it's a subsidised public option that's made available to them, I'm all for it, however, it doesn't look like the one in the bill has it quite right yet.

I find it odd that it hasn't been addressed in this thread yet, but there is a underlying question that no one has posed: Is health care a right, or a privilege? It's a moral issue that is essentially impossible to debate upon, yet is still driving the heart of the reform debate.

[KenC]

I was also thinking about this on my drive home. I'm not convinced an increase in competition between insurance companies will lower premiums significantly. In order to pass savings along to consumers, they'll either need to GREATLY increase internal efficiency within the actual insurance company itself, decrease coverage to its customers, or reduce profits. Administrative costs are only a small fraction of healthcare costs, and I'm not convinced that physicians are overly inefficient in their practices. I work with many of them and there isn't one that's willing to subject a patient to unnecessary tests (especially expensive imaging, but mostly due to radiation exposure). The fact is that it's expensive to provide care. Equiment, and especially qualified staff aren't cheap. Tort reform is probably th best way to reduce costs on the provider side of care, but even that isn't going to drastically reduce costs (although it's necessary and will definitely help).