Health care

[kronus]

We should clearly go to war with Europe so that we can conquer their healthcare.

[joshh]

The system wont be able to support it.

[mrsleeve]

WELL FUCK

it passed a cloture vote in the senate here we go

For all the kiddies

http://www.msnbc.msn.com/id/34080216/ns/health-health_care/

for the rest of us

http://www.foxnews.com/politics/2009/11/21/senate-crucial-vote/

bend over all were gonna get dry, this is gonna get really ugly, dont say you weren't warned, hope this is the change you all wanted

[Ryan Stewart]

Jesus. You don't have any conscious at all, do you?

'I'm sorry Ms. hard Working Single Mother of 3, you don't have enough income from your minimum wage job to pay $10K a year in healthcare costs you you deserve to die.' - Restoman

Someone has obviously never gone without healthcare in their lives :loco:

Ive gone without healthcare and I agree with him. I dont believe that access to great doctors is an inalienable human right and you open up a pandora's box of grey area. Where do you draw the line? Is it a human right for an 80 year old man to have access to millions in healthcare to extend his life a few years?

[TexasTerp]

Der Affe, I meant in no way whatsoever to say that you were crapping on docs or hospitals. In fact I was supporting your point from a different angle. I completely agree with your position and was trying to confirm show that the mix between the government programs and suppliers is a major factor is raising costs from someone whose job it was to collect reimbursements and make purchases.

[der affe]

terp just to make sure you understand, i was not crapping on the docs or the hospital. that is why i brought up the fact that, while things were bad at county hospital, i know that it is due to the fact that they handle more indigent patients than any other hospital in greater phx. that means that they are either dealing with medicare/medicade or no payment at all which means waiting for payments for 6 months or never. they did and are doing the best with what they have to work with. they kept me alive, stabilized me, patched me up (not the prettiest job, but that is not what they are there for and it is not how burns work). although when they were loading me in the ambu and someone asked what hospital they were taking me to they replied "county!k i shot up off the gurney and shouted"don't take me there! i have health insurance!" for what they did, i am greatfull!

i know that thehmedical suppliers and insurance providers have their hands in each others pants and the doc's hands are tied.

back in june when i was in pt, the woman who owns the clinic (who was also my pt person) told me that she got a letter that day from medicare/medicade telling here she would not be recieving any $ from them until after the 1st of the year begining aug 1st. that is a long time to go when you run a clinic and the majority of your patients are elderly and on gov. health care. there was nothing she could do about it, but suck it up until the 1st of the year.

[dinanm3atl]

Not looking forward to it. Senate will probably knock it down though. That is my hope. Too many Dems that want to keep their job next voting session...

[TexasTerp]

There's no way I'm going to go through and quote everyone, but Ken, Der affe, and Hallen all make very excellent points.

On Ken's first point, being one of those people considered in the "poor" column (I made 18k last year, and 12k the year before). If I can find a way to keep myself healthy (which is 75% of my job as an opera singer) everyone else can, sure mom and dad help out buying me a plane ticket back for Thanksgiving but that's an irrelevant issue. I make my $300 monthly payment for great coverage, $600 for rent and utilities in a nice house, and then have just enough left for a social life, food, travel and the e30, not to mention keeping myself healthy. Having lived in New Orleans and DC, I can personally say that the MAJORITY of the low income population is the medical burden because of their personal irresponsibility and not because they are incapable by any means of keeping themselves healthy.

I'll have to find the med report I read about Medicare's spending but here's my story on another side of der affe's. I used to work for a doctor in Houston, my entire job was to make collection calls to insurance companies (yeah it was fun, i know, ). Medicare and Medicaid were the absolute WORST companies I have very had to deal with, between the mountains of paperwork to the bullshit run around and them literally not wanting to pay for anything whatsoever, it would take 3-4 months just to get reimbursments compared to 3-4 weeks with private companies. Then on top of all that, when medications or equipment was necessary for a patient we had to order it through their suppliers or it wouldn't be covered. If you want to know why both Medicare and Medicaid are the two highest dropped coverages with doctors (ie docs don't accept them) combine all the bullshit run around with equipment, like say an oxygen tank, that costs medicare $1900 while the open market sells the exact same tank for $400. It happens with the private sector too, but not nearly to the extent that it is with the government run programs, it's one of the main reasons Medicare was projected to cost 1 billion by 1990 and ended up costing 109 Billion, and why in 2008 alone it cost 508 Billion!! $7500 for those sleeves is highway robbery and we all know it. If you got rid of the insurance-supplier bullshit and let doctors purchase whatever they needed on the open market then I guarantee that overall care cost would be cut in half, no more of this bullshit "bulk-rate" crap.

It would be good to completely remove the insurance companies. The only reason they exist is because very few people have a lump sum that they can use to start their own medical savings account. If you have just started working and are hurt, you wouldn't have near enough money to cover it. Sure, if you work for 10 years and keep paying into your own account, you'd probably have enough. So what would be nice would be the availability of catastrophic insurance, for those big ones, and then use your own savings (taken pre-tax directly from your check. That program exists today, btw, but I don't know what the cap is and you can't roll it over from year to year). So in essence, you are self insured. Then you pay a small fee for your catastrophic account. Pay something like $300 per month for your account in 5 years you'll have 18k for your medical payments, plus interest, minus any amount that you had to use.

But the current plan in the house won't let you do that, I'm pretty sure. You won't be allowed to self insure even though it is probably the best option out there. If you never need to use it, you can pull the money (probably after paying taxes on it). It's your money though.

Right on the money! Sprint actually has a program that creates a medical savings account that does roll over, on top of the insurance coverage packages that they offer. Every paycheck I would have a certain percentage of my earnings put into the account and I could use it for whatever I needed: prescriptions, co-pay, didn't matter and i still had full insurance coverage. Creating savings accounts like those are the absolute best way, much the same way you can use Escrow accounts instead of auto insurance (which I am considering switching to btw)

Anyway, like I said, I'm no expert. I realize that assembly line practices won't work for medicine... and thank goodness for that. I wouldn't want to be treated like a Ford truck. I also realize that none of this is simple. I just feel strongly that the plan that passed the house is absolutely the wrong thing to do.

Totally agree with all of y'all that no way in hell do I want this to turn into anything remotely close to a factory system, and it is extremely complicated on the patient care side of it which of course will always demand a higher cost.

Competition in insurance via removal of the state barriers will most likely not lower quality. There will be a full range of choices.

If you pay for cheap insurance, then expect lousy service in your claim processing. Also expect a lot of hassles about what is and is not covered, much like Geico car insurance. It'll work sometimes, but it is going to be a hassle. Or, go for a slightly more expensive program and get much better service. It's up to you.

Look at the car insurance business for an example. They deal with risk pools and you can find insurance to meet your needs for reasonable amounts of money. Competition drives both cost reductions, often through innovation, and also will drive service up. People will not put up with horrible service if they have a choice (which I will point out that a government plan does not provide).

Dead on, 100% my point exactly!

-----------

On another note, I would like to mention, that for those who have not heard, the LONE Republican Congressman who voted FOR the Bill (who I'm sad to admit I have met in person), had been called into several meetings with Pelosi and Obama and was promised 108 Billion dollars of "recovery aid" for his district in New Orleans. Now I'm glad for any aid that can be brought into NOLA because I love that city but it is absolutely despicable that the President of the United States is BRIBING the Congressman into order to ram a bill through. I don't care if this bill was the most perfect piece of legislation in the history of the world, there is NO EXCUSE whatsoever for the President to be committing these crimes (well it would be a crime if he was an ordinary citizen). He LITERALLY is BUYING Votes for the bill!!!!!!! This isn't Lobbying, it's BRIBING!!!!

He also gave a Californian Rep 164 million for the Cal Medical School in exchange for a YES vote!!!!

I don't understand how anyone, Democrat, Republican, Liberal or Conservative can not be outraged by these actions, it's one thing to lobby and campaign for legislation, it's a whole other thing to be bribing people for votes!!!

[Hallen]

Yeah, well we all know that the dollar amounts shown on our bill is not what they insurance companies or medicare pay. However, that is the amount that an individual has to pay if they don't have insurance. One of the main reason that huge disparity exists IS because of medicare. The medicare payout system is based on a percentage of usual and customary. In order to get something close to enough money, the prices have to be hiked up. The insurance companies then go in and negotiate to get as close to medicare as they can. It is a racket for sure. But medicare payment practices are responsible for some of the problems here.

It would be good to completely remove the insurance companies. The only reason they exist is because very few people have a lump sum that they can use to start their own medical savings account. If you have just started working and are hurt, you wouldn't have near enough money to cover it. Sure, if you work for 10 years and keep paying into your own account, you'd probably have enough. So what would be nice would be the availability of catastrophic insurance, for those big ones, and then use your own savings (taken pre-tax directly from your check. That program exists today, btw, but I don't know what the cap is and you can't roll it over from year to year). So in essence, you are self insured. Then you pay a small fee for your catastrophic account. Pay something like $300 per month for your account in 5 years you'll have 18k for your medical payments, plus interest, minus any amount that you had to use.

But the current plan in the house won't let you do that, I'm pretty sure. You won't be allowed to self insure even though it is probably the best option out there. If you never need to use it, you can pull the money (probably after paying taxes on it). It's your money though.

Now, how to reduce costs? Ken makes a good point that there are people working on that kind of thing. Basic efficiencies won't get you everything. However, if medical supplies are anything like airplane parts, then there's a large amount of the problem. Getting certified to supply a medical product is probably a multi-year deal that costs millions (I know we pay $40k to $100k to get CE, FCC and UL certifications on our products and they aren't used for medical). Streamlining that process shouldn't be all that hard. I mean, $7500 for special sleeves? Why is that? Are they made out of wonderflonium (tell me the reference for that stuff ;) )? Or is the certification and verification process so extensive that it turns a $50 item into a $7500 item. I bet it is the latter. I know that spark plugs for an aviation engine used to cost $20 EACH (2 per cylinder). The going rate for a similar car plug was about $2. Sure, the aviation one was better. But it was the testing, certification, annual certification, and liability costs that drove the price as high as it was. And that's for something simple like a spark plug.

Anyway, like I said, I'm no expert. I realize that assembly line practices won't work for medicine... and thank goodness for that. I wouldn't want to be treated like a Ford truck. I also realize that none of this is simple. I just feel strongly that the plan that passed the house is absolutely the wrong thing to do.

[joshh]

You don't need to leave, this shit for bill will never make it, thankfully.

[kishg]

I'm moving to another country asap.

see ya!


funny how i never see the people making this claim ever leaving. please leave. same goes for the left wingers who made the promise to leave when bush was here, please go.

[LEANE30]

Affordable and healthcare do not go in the same sentence. Sorry, it just doesn't go well. How can you ask for the best and brightest when your arm gets chopped off and then want to pay "Shade Tree Mechanic" rates? You have to pay to play this game of life. If you can't afford healthcare then you can't afford to live. As you can see I'm no bleeding heart.

Wow, you have no soul.

and you are a waffleswaffleswaffleswaffleswaffles.











all i will add to this very decent thread is that it's all about natural selection.

We slow the herd down to the point where the lame and weak can keep up and then the entire group fails to escape. ...but atleast we kept everyone together and didn't loose any individuals on the way to our inept failure to arrive as a species to our targeted destination.

..and by "species" i mean "country."







fuck the Republi-crats, the stage is already set for an uprising of a new or possibly older dormant political "party".

for One, I'm gonna be on the sidelines enjoying the show. It's inevitable.

i realize this, but what i am saying is that there is plenty of blame to go around the whole system. it is i cut you a break because you "scratch my back so i'll scratch your back" but i am not really going to give you a break, but i am going to let you think i am giving you a break.....who's on first.....



i really feel that the coverage or service will be reduced to lower the premiums, not the insurance companies profit margins. i am supprised that noone has seemed to bring that we really have no idea of the insurance companies profit margins.

point made and made correctly.
Insurance is a leech type of business. they are middle-men. it's about time they were treated like the monkeys they are and the american public side-steps them entirely.

how many of you have sat down and added up how much money you've paid insurance in even just the past decade? ...how many times have you been to the doctor?


I'd be all for the government extending "healthcare lines of credit" that you pay into say via taxes... an account that is individual TO EACH CITIZEN, if you go into the red, then your "tax" percentage is increased till it's back in the black. if it stays in the black long enough with a high enough balance, then your percent can decrease, or even be withdrawn for living, similarly to social security. ...in a way that is currently feasible with modern technology for digital records and automated account management. the government would "get ahead" with all it's bad debt and failed ideas by being the holder of all health care funds, and thus being able to collect interest yields by title.

then there is no pointless phone line juggler and bureacratic skipper making wage bonuses on how many claims that they denied, hence saving the insuance company money on annual reporting intervals.

no "free ride" for people doing things that they shouldn't be doing AKA coined association with the term "illegal"

Extending healthcare to illegals without making them pay anything ..even the "fines" proposed in this legislation for non-coverage.. is a complete outrage.

...
I'm moving to another country asap, maybe with enough time away i'll come to truely appreciate all the BS that we put up with.

[der affe]

i realize this, but what i am saying is that there is plenty of blame to go around the whole system. it is i cut you a break because you "scratch my back so i'll scratch your back" but i am not really going to give you a break, but i am going to let you think i am giving you a break.....who's on first.....

i really feel that the coverage or service will be reduced to lower the premiums, not the insurance companies profit margins. i am supprised that noone has seemed to bring that we really have no idea of the insurance companies profit margins.

i hope things do not turn into treatment the way it was when i was taken to county hospital here in AZ after my accident (it is the 2nd best burn unit in the US) while in the burn unit things/treatment was excellent. once i was stabilized and moved into the regular burn unit, it was a whole different world. county is like the indigent hospital in greater phx, they incurr the greatest amount of non paying patients of any of the hospitals in greater phx. while they did keep me alive, it was pretty horrible there, but they were doing the best they could with what they had to work with. i can not fault them with that at all and am greatful for what they did for me.
a good analogy would be county hospital is like going to a the MASH 4077th they scoop you up patch you together and get you stable. good sam, st joes, or scottsdale memorial is like when they ship you down to tokoyo to finish the job.

[KenC]

Hospital bills can be shocking and hard to dechipher. The "uninsured" price is often misleading and necessarily inflated because hospitals only receive a small amount of what they bill. It's all a "volume discount" situation. Groups buy insurance to get a volume discount, insurance groups provide clincs with large groups of patients in turn for a discount on service. The discounted price given to insurance companies is often VERY close to the actual cost to provide the service (in the case of Medicaid/Medicare, it's less). That is, hospitals aren't overcharging insurance companies to greatly increase profits... The increased opperating costs are often reflected in their "uninsured" sticker price, but that's not what they're getting paid for the service/supply. I'm curious to see the profit margins of the insurance companies. I know there is a lot of competition between equipment companies.
So again we come back to the question regarding insurance premium reductions. In order to stay competative, how much are the companies willing to decrease their profits? Or will they reduce coverage instead?

[der affe]

ok here is something that has not brought up...i think. i was burned in an accident at work, no big secret there. because i was burned at work it was concidered an industrial accident and workman's comp took care of the bill. i was also privy to every bill/statement sent to the insurance company as i recieved a copy in detail along with every proceedure.

at one point i was having to wear compression bandages/garments on my arms and hands. 3 pairs of sleves and gloves replaced every 2 months. the cost of one set according to the statement sent to me was $2500.00????
that was for 2 gloves and 2 sleves! (that is $7500.00 every 2 months in addition to everything else like meds, bandages etc, Dr visits, and surgeries. BTW right now my bill is over 3 mill and i am having more surgery around Xmas time.)
i was shocked by this and asked my case worker (which you are assigned in every WC claim) what was up with that. she did a little investigating and found out that they only pay 60% of that for the garments, because they have an agreement with the medical supply company that makes them (Hanger) that they will give them the business if they give them a discount. this was no secret to me that insurance companys have agreements with medical suppliers and care givers to get a discount on fees, sometimes using strong arm tacticts.

next i talked to the the Hanger Rep without my case worker present about this pricing deal, after all they are just tight fitting custom garments similar to this http://www.compressionmanagement.com...rngarments.htm
not some super high tech machine.
the rep told me that they set the pricing so that after they give the discount to the insurance company, they are still getting the money that they want/need to get for the product no matter what and that this was really nothing unusual. i asked her what if someone paid for them out of pocket, what would the price be then? she told me that it would be the full price, but that 99.9% of the time it is coved at least in part by insurance so that is never really a concern that comes up.

so at least in my opinion, based from talking to alot of Dr's that i have been having to deal with in the last 2 years along with other health professionals i know the insurance companies are at least partially to blame for the spiraling costs. they force a discount to cut their cost, the supplier/Dr/hospital raises their price to make up for the discount given, the price goes up. nothing is really accomplished in the way of cost spending control. i don't have an answer for this though. the insurance companies pay the med bills that keep things going (however difficult they are to deal with!) so that gives them the leverage to demand the discount, but in the end it really is not a discount, and the price of health care continues to rise.

i know that this is not totally to blame and there are other factors to the equasion, but i thought i would bring up that point.