Health Insurance Debate

[MarylandMark]

Good morning to all of you.

GM as well and great Clay quote fix!

The main thing I see people not talking about in health care is the Doctors? Medicine is a business- a huge business- and who is going to go $200K in debt becoming a Doctor to make $50K a year? BTW- Every Doctor I know is a cheap SOB (not saying they all are but the 20ish I know are) and healthcare comes right after business for all of them even if they won't admit that to most people. Making money 1st, your health 2nd.

My GF is a Nurse Practitioner- 1st degree was a BS in Nursing/Peds, then a MS in Nursing/Peds and added on a post Masters degree for Womens Health. I think her degrees have cost her around $110K in school- that is not room and board, only tuition.

The US has a major shortage of "family doctors" because for the same schooling they can play with b00bies all day for 4 times the pay as a plastic surgeon and don't have to deal with medical assistance patients or any of those hassles...

[LaughingCat]

GM to you too.


I don't have any hard facts to back this up. But I spoke with a client who is a cardiologist and devout Republican. When I asked him about this talk of universal HC, he said he welcomes it. I was shocked and asked why.

He said that right now, he employees a team of people whose careers are focused on gaming the insurance companies. They constantly resubmit requests for payment which are continually denied. When the insurance co's realize they are not going away, they will pay the claim at maybe 20% of the asking price.

Apparently, Medicare gives little flack and pays about 30% of the asking price. So he figures he can get ride of the economic mercenaries (saving those salaries) and see a 505 increase in revenue by getting paid from the government.

I am not sure of the validity, although I will say, he is extremely successful and a loyal Republican and he wants something where he doesn't have to fight for his money.
As far and I understand, the HC reform being discussed says nothing about all medical peoplebecoming $50k/yr slaves of the gub-ment. But maybe they are going to find it easier to practice what they love, fixin' people and less of the mess the system has become. But maybe not, I just don't know.

I would hate to see medical professionals being stuck with such debt and no large income to help pay for it. Doctors seem to always end up Ok and making very good money for what they do. I have been less-than-impressed with the HMO/PPO BS we've had where doctors get squeezed by the insurnace companies from both ends. They have huge malpractice premiums and get shafted on the claims reimbursements. If universal HC means less or no malpractice premiums and more consistent and lucrative income flow, I'll bet the doctors lead the parade for the rollout of universal HC.

But I'm am speaking from a biased eye of a business owner that is furious at how high the HI premiums are for me and my employees.

A $50k/yr salaried employee with family on my plan pays 30% of their gross income to HI premiums and deductible.

[Sea-Dated]

Obama's health care plan will be:
written by a committee whose head says he doesn't understand it,
passed by a Congress that hasn't read it,
signed by a president who smokes,
funded by a treasury chief who did not pay his taxes,
overseen by a surgeon general who is obese, and
financed by a country that is nearly broke.

What possibly could go wrong?

[pullmytrigger]

Even in countries like Canada and the U.K. , there is no intrinsic right to health care. Rather, citizens in these countries are told by government bureaucrats what health-care treatments they are eligible to receive and when they can receive them. All countries with socialized medicine ration health care by forcing their citizens to wait in lines to receive scarce treatments.

Well....this I know about the above.....

A Few yrs back my ex and I went to to an Amusement Park for a day in the sweltering heat.....on the way home she started to complain about chest pains etc etc......heart attacks are very prevalent on both sides of her family so we dropped in at Emerg at our local Hospital on the way home......I brought her up to the desk at the front and told the woman I had a possible heart attack victim.....

WELL!....the woman dropped what she was doing, ran around to our side.....hurried Donna to a Critical care room and within 5 minutes had 4 people attending to her and was hooked up to everything imaginable, tubes coming out everywhere......and yeah I imagine the people with the skinned knees and the sore throats had to wait.....thats probably true.......she was there for 2 days and was diagnosed with an extremely mild heart attack.....was given to a specialist that prescribed a bunch of meds and diet suggestions...had to go back for tests a couple times a week for months blah blah blah.....and not one thin dime was paid out of pocket.....ever!

It may not be the perfect system but I also have never known a Canadian that has his collector car or boat for sale "to pay off medical expenses" either......something like that is unimaginable to me......see it all the time in the OSO classifieds....sad....and scary.

[2112]

and not one thin dime was paid out of pocket.....ever!

And what is your tax rate? Do you own or run a business? Have employees?

Yeah, My guess it is those who do and those who work hard pay a pretty fat dime to give you your "free" care. You are paying somewhere, maybe not at the ER but everywhere else.

I manage to keep care of myself, live within my means and pay my bills. I just don't find much compassion in my soul for those who choose to pay for things they cannot afford but skip out on buying health insurance.

BTW the poor are covered down here already.

Oh yeah, catastrophic coverage, you know, the kind that prevents the boat or collector car sale, is dirt cheap. In fact alot less than the fuel used when boating.
.

[Ratickle]

If you read the facts of Canadian Health Care, and British which is almost identical in every way, there are glaring discrepencies to what we enjoy in the US.

Your example would be the same in the US if you had no money or insurance.

In both countries, same day doctor visits, to a general practitioner, are much higher than here. Why? Because we don't have as many per capita. They all go on to be specialists who make a lot more.

The average wait for elective surgery, torn ACL for instance, in Canada and England is 18 months. In the US it's less than a week. Why they call taht elective is beyond me. But check with Bob the Builder, he'll tell you.

The average wait in both countries for tests like MRI, CATSCAN, etc. 3 months. Here, same or next day.

The figure I've heard, not seen it documented that high except in a Dr's organization flyer, just under 80% of all patients waiting for specialized, multiple, bypass surgery in the combined Canadian/British health care systems die before receiving it.

Our government says their gonna save money by doing it their way.

Currently Medicare/Medicaid is underfunded here. So, to improveit, they are gonna take half of the money and put it towards funding those who currently have no health care. That will improve medicaid/medicare solvency.


There are two main things that bother me about their plan.

1. It is a nationalization of a capitalistic system which created the best health care in the world. Another seizure of the private sector business, by socialists, using the plight of the poor which they created in the first place.

2. It is once again taking something away from those who earned it, and giving it to those who did not, which is a direct violation of our Constitution, and has FAILED in every country it's been tried in.


If the other countries they were talking about had to protect their own borders, help pay to keep shipping lines open from energy rich areas of the world, etc. Not only would they not have their health care because they couldn't afford it, they also would not be able to afford to buy our drugs our companies develope, use our specialized equipment our companies build, or enjoy any of the other perks we provide them by policing the world for them.

It's been that way since WWI, and hasn't changed since.

If you want the best health care in the world, you come here. The only reason it currently costs so much is because we are currently subsidizing those who don't have it (all 47 million people they talk about can walk into any hospital and get care if they are hurt or sick, EVERY ONE (even though 13 million of them are illegals), and because IT'S THE BEST IN THE WORLD.

[Ted]

Canadians pay for their poor healthcare system every day in the form of huge gas taxes, so the poor are contributing way more as a percentage of income than their fellow citizens. As for elective surgery. Last year I pulled my bicep loose at the tendon. I was diagnosed and operated on in a span of ten days. I also joined a forum for the injury that had members from Canada and the UK. They were typically waiting as much as 180 days for each phase of treatment 1. See Doc 2. See Ortho Doc. 3. Get X ray. 4. Get MRI. 5. Get surgery. 6. Start physical therapy. I am 8 months out from the injury and my bicep is probably at 60 % or so. I cannot imagine the atrophy these guys have after being disconnected for a year or more. Most will likely never regain more than 50% back. This is for a completely disconnected muscle, think of that, no way it should be "elective" surgery. We cannot allow this system to fail as theirs have, there will be NO place left to get proper care.

[jayboat]

This thread needs some cut-and-paste.

Here's Paul Krugman's take:

It was the blooper heard round the world. In an editorial denouncing Democratic health reform plans, Investor’s Business Daily tried to frighten its readers by declaring that in Britain, where the government runs health care, the handicapped physicist Stephen Hawking “wouldn’t have a chance,” because the National Health Service would consider his life “essentially worthless.”

Professor Hawking, who was born in Britain, has lived there all his life, and has been well cared for by the National Health Service, was not amused.

Besides being vile and stupid, however, the editorial was beside the point. Investor’s Business Daily would like you to believe that Obamacare would turn America into Britain — or, rather, a dystopian fantasy version of Britain. The screamers on talk radio and Fox News would have you believe that the plan is to turn America into the Soviet Union. But the truth is that the plans on the table would, roughly speaking, turn America into Switzerland — which may be occupied by lederhosen-wearing holey-cheese eaters, but wasn’t a socialist hellhole the last time I looked.

Let’s talk about health care around the advanced world.

Every wealthy country other than the United States guarantees essential care to all its citizens. There are, however, wide variations in the specifics, with three main approaches taken.

In Britain, the government itself runs the hospitals and employs the doctors. We’ve all heard scare stories about how that works in practice; these stories are false. Like every system, the National Health Service has problems, but over all it appears to provide quite good care while spending only about 40 percent as much per person as we do. By the way, our own Veterans Health Administration, which is run somewhat like the British health service, also manages to combine quality care with low costs.

The second route to universal coverage leaves the actual delivery of health care in private hands, but the government pays most of the bills. That’s how Canada and, in a more complex fashion, France do it. It’s also a system familiar to most Americans, since even those of us not yet on Medicare have parents and relatives who are.

Again, you hear a lot of horror stories about such systems, most of them false. French health care is excellent. Canadians with chronic conditions are more satisfied with their system than their U.S. counterparts. And Medicare is highly popular, as evidenced by the tendency of town-hall protesters to demand that the government keep its hands off the program.

Finally, the third route to universal coverage relies on private insurance companies, using a combination of regulation and subsidies to ensure that everyone is covered. Switzerland offers the clearest example: everyone is required to buy insurance, insurers can’t discriminate based on medical history or pre-existing conditions, and lower-income citizens get government help in paying for their policies.

In this country, the Massachusetts health reform more or less follows the Swiss model; costs are running higher than expected, but the reform has greatly reduced the number of uninsured. And the most common form of health insurance in America, employment-based coverage, actually has some “Swiss” aspects: to avoid making benefits taxable, employers have to follow rules that effectively rule out discrimination based on medical history and subsidize care for lower-wage workers.

So where does Obamacare fit into all this? Basically, it’s a plan to Swissify America, using regulation and subsidies to ensure universal coverage.

If we were starting from scratch we probably wouldn’t have chosen this route. True “socialized medicine” would undoubtedly cost less, and a straightforward extension of Medicare-type coverage to all Americans would probably be cheaper than a Swiss-style system. That’s why I and others believe that a true public option competing with private insurers is extremely important: otherwise, rising costs could all too easily undermine the whole effort.

But a Swiss-style system of universal coverage would be a vast improvement on what we have now. And we already know that such systems work.

So we can do this. At this point, all that stands in the way of universal health care in America are the greed of the medical-industrial complex, the lies of the right-wing propaganda machine, and the gullibility of voters who believe those lies.

[Ratickle]

This thread needs some cut-and-paste.

Here's Paul Krugman's take:

But the truth is that the plans on the table would, roughly speaking, turn America into Switzerland — which may be occupied by lederhosen-wearing holey-cheese eaters, but wasn’t a socialist hellhole the last time I looked.:

"Every resident of Switzerland is required to buy health insurance. If they don't, they pay stiff monetary penalties. Companies have no role. Health-care plans are chosen at the kitchen table, not through employee benefit departments.

And the plans can be costly. A family of four in Switzerland pays an average of $680 a month in premiums. Swiss insurers charge a premium for each family member. Children have a lower premium than adults, but for a family of four, insurance premiums for the basic coverage plan are about $8,167 a year. An American family with employer-provided health insurance pays an average of $2,713 a year in premiums, according to a survey by the Kaiser Family Foundation." Dallas Star

Every wealthy country other than the United States guarantees essential care to all its citizens. There are, however, wide variations in the specifics, with three main approaches taken.

In Britain, the government itself runs the hospitals and employs the doctors. We’ve all heard scare stories about how that works in practice; these stories are false. Like every system, the National Health Service has problems, but over all it appears to provide quite good care while spending only about 40 percent as much per person as we do. By the way, our own Veterans Health Administration, which is run somewhat like the British health service, also manages to combine quality care with low costs.

The second route to universal coverage leaves the actual delivery of health care in private hands, but the government pays most of the bills. That’s how Canada and, in a more complex fashion, France do it. It’s also a system familiar to most Americans, since even those of us not yet on Medicare have parents and relatives who are.

Again, you hear a lot of horror stories about such systems, most of them false. French health care is excellent. Canadians with chronic conditions are more satisfied with their system than their U.S. counterparts. And Medicare is highly popular, as evidenced by the tendency of town-hall protesters to demand that the government keep its hands off the program.

Absolutely false. Every Canadian I know is envious of the US system and quality of care. And I know of several, some on this site, who have come to the US to get the quality of care completely unavailable in Canada.

The British system and Canadian systems have an average wait for elective surgery, like shoulder seperations, heart bypasses, and knee replacements, of 18 months.

Finally, the third route to universal coverage relies on private insurance companies, using a combination of regulation and subsidies to ensure that everyone is covered. Switzerland offers the clearest example: everyone is required to buy insurance, insurers can’t discriminate based on medical history or pre-existing conditions, and lower-income citizens get government help in paying for their policies.

Talking about the Swiss again. Highest taxes in the world, almost four times as much paid by their citizens as we currently pay. See above Dallas Star research.

In this country, the Massachusetts health reform more or less follows the Swiss model; costs are running higher than expected, but the reform has greatly reduced the number of uninsured. And the most common form of health insurance in America, employment-based coverage, actually has some “Swiss” aspects: to avoid making benefits taxable, employers have to follow rules that effectively rule out discrimination based on medical history and subsidize care for lower-wage workers..

The Massachusetts plan is broke and they just kicked 30,000 covered Massachusetts citizens off of their plan to try to balance their budget. Good example.

"The new state budget in Massachusetts eliminates health care coverage for some 30,000 legal immigrants to help close a growing deficit, reversing progress toward universal coverage just as Congress looks to the state as a model for overhauling the nation’s health care system." New York Times

So where does Obamacare fit into all this? Basically, it’s a plan to Swissify America, using regulation and subsidies to ensure universal coverage.

If we were starting from scratch we probably wouldn’t have chosen this route. True “socialized medicine” would undoubtedly cost less, and a straightforward extension of Medicare-type coverage to all Americans would probably be cheaper than a Swiss-style system. That’s why I and others believe that a true public option competing with private insurers is extremely important: otherwise, rising costs could all too easily undermine the whole effort.

But a Swiss-style system of universal coverage would be a vast improvement on what we have now. And we already know that such systems work.

So we can do this. At this point, all that stands in the way of universal health care in America are the greed of the medical-industrial complex, the lies of the right-wing propaganda machine, and the gullibility of voters who believe those lies.

So here we are back at the Swiss plan. A system with no allowed lawsuits (a good thing), a system where everyone buys it or else (what about the 13,000,000 illegals that are included in the 42,000,000 with no coverage discussion stats? No more treating them?), and a system where even though every person is covered, the per person cost Out Of Pocket is greater than our current system.

Who Killed Health Care?" by Harvard business professor Regina Herzlinger.


A consumer-driven health care system actually exists in Switzerland, which could be a model for the United States, but the administration and congressional Democrats haven't looked at it.

Switzerland has an individual mandate requiring everyone to be covered by private insurance. There is no employer-provided or government-managed coverage, and poor people are subsidized to help them buy insurance.

Switzerland has health care outcomes comparable to the most affluent U.S. states.

"Consumer-driven health care," she insists, can be universal, efficient and end up costing less money than the current system - or any system being considered this year by Congress.

She acknowledges that the plan initially would be expensive - as much as $2 trillion over 10 years - but that competition among insurance companies and providers would bring costs down over time.

She told me she thinks that current plans being discussed in Congress will cost far more than the current $1 trillion estimate and will not lower costs in the long run unless rationing is put into effect.

[LaughingCat]

Children have a lower premium than adults, but for a family of four, insurance premiums for the basic coverage plan are about $8,167 a year. An American family with employer-provided health insurance pays an average of $2,713 a year in premiums, according to a survey by the Kaiser Family Foundation." Dallas Star[/I]



[/I]

'm quotng The Dallas Star and not making an attack on you.


That is PRECISELY what ****es me off about the status quo. I will let Obama try something just becasue our current situation allows people to compare apples and oranges - They pay 8,187 while Americans pay 2,713. because i am the employer who pays the rest. And when you add up my share, the citizen costs $14,400/year PLUS the MF'ing deductible of $2250.

So when we are ranked #30 in the world for health care, somewhere behind Ghengis Kahn, I think I'll strap my saddle to someone willing to try something new.

would much rather the government spends money subsidizng HC for its citizens than socially giving out to buy-off insurgents, rebuild 3rd world mistakes and find other private mercenary companies to dump pallets of my cash on.

people need to see the light. Japan and China do all the manufacturing becasue they get sales and export taxes, then use some of that revenue to subsidize HCV. Why, because it frees up more profit tot he company to spend on R&D, marketing and quality. Then they sell more product and generate more sales and export tax revenue.

People are stuck with dated ideas of how government revenues and spending can work. We're doomed with that thinking.

[pullmytrigger]

So when we are ranked #30 in the world for health care, somewhere behind Ghengis Kahn

there you said it......I didnt have to.
hey,I dont pretend to know much about your healthcare I was just stating some real world experiences of mine but If yours is such a great system why are you ranked SO FAR down the list......????
answer......its great.....as long as your Bob the Builder.....

[pullmytrigger]

a question.....
what in Gods name is a "CO Pay"????????????
you mean you pay for insurance to be covered then you still have to pay part of the bill????......wtf is that??
is it the same if you smash your car up down there?.....you pay insurance, then still get stuck with part of the bill?.......is that the way your "insurance" works?

[Ratickle]

#30 is a BS number used by those who want to make statistics show something not truely there. We are ranked #1 in the world for those who reach age 65 making it to age 85. Why, because we spend so much freaking money. And, because the crack heads, heroin addicts, meth users, crack babies, etc. never make it to age 65. If the drug users are left out of the stats, we're #1 by far. The problem, we have the largest percentage of drug users........


Dig into the "facts", don't just copy and blindly believe what is printed.

[Ratickle]

Japan and China do all the manufacturing becasue they get sales and export taxes, then use some of that revenue to subsidize HCV. Why, because it frees up more profit tot he company to spend on R&D, marketing and quality. Then they sell more product and generate more sales and export tax revenue.

People are stuck with dated ideas of how government revenues and spending can work. We're doomed with that thinking.

All we have to do to pay for it is tax the Japanese and Chinese products at the exact same rate they tax our exports to their countries. Problem solved.

Why is it that everyone seems to think taking more away from working Americans to pay for things for those who do not work, or currently pay, fo them is a good thing. It's the number one problem in this country.

Idiot politicians who think that by taking more form a business or person in America, and giving it to someone who does not earn it by creating things people want, somehow creates new jobs and opportunities......

And they also seem to think, as do some of you I guess, 100% of the people currently in the United States are going to pay an average, out of their pockets, of $8000 + for a family of four. Wanna bet future on that?

[Ratickle]

Quality. In a comparison with five other countries, the Commonwealth Fund ranked the United States first in providing the “right care” for a given condition as defined by standard clinical guidelines and gave it especially high marks for preventive care, like Pap smears and mammograms to detect early-stage cancers, and blood tests and cholesterol checks for hypertensive patients.

Gallup polls in recent years have shown that three-quarters of the respondents in the United States, in Canada and in Britain rate their personal care as excellent or good, so it could be hard to motivate these people for the wholesale change sought by the disaffected.


New York Times

[Ratickle]

On the other hand, as early as 2004 a study conducted by John Hopkins Hospital reported that the number of graduates of U.S. medical schools who enter OB/GYN had dropped 23% since 1996. Malpractice insurance for OB/GYNs is reported to have one of the highest premium for medical malpractice, with some areas reporting premiums of $100,000 per year for OB/GYN coverage. Premiums in major metropolitan areas can be as much as $250,000 per year.



Maybe they should do something about this.....

[Ratickle]

According to the 2009 Annual Reports of the Social Security and Medicare Boards of Trustees, "Medicare's Hospital Insurance (HI) Trust Fund is expected to pay out more in hospital benefits and other expenditures this year than it receives in taxes and other dedicated revenues." This was also the case in 2008.

Forbes

[Ratickle]

When President Obama says he wants to overhaul the health care system and provide coverage for 46 million uninsured Americans, he surely is aware that Medicare, Lyndon Johnson's program that provides medical coverage at the government's expense to 45.2 million Americans 65 years and older, is now--or soon will be--bankrupt.

Medicare looked like a much better bet to Lyndon Johnson's domestic advisers than it proved to be. In 1965, the average life expectancy for American men was 66.8, for women 73.8. Today, the comparable figure is 75.42 for men and 81.28 for women.

When LBJ asked for new modes of payment and warned that annual costs would soar to $100 billion by 1975, Congress rejected the projection as exaggerated. In fact, the Medicare number for 1975 came to $133 billion. Today, the annual cost comes to over $440 billion, which is roughly 3.2% of gross domestic product and 16% of all federal spending.

Forbes

And here is the main kicker that should tell you they are absolutely lying.....


Medicare alone is $440 Billion Annually. But we're gonna insure more people than currently covered by Medicare for $1 Trillion over the next ten years. If they are that good, why does it cost over 4 times that now? And many of these people also buy extra coverage insurance currently because of all the things that Medicare does not currently cover. But those things will be covered in Obama's new plan for all......

[Ratickle]

The things we rank last in, things which drive our ranking down in world studies, are things like survival rates of organ transplants, how long it takes to see a doctor in a NON-EMERGENCY situation, etc.

It's because you can get a kidney transplant here at age 60, no other country does that. And if you don't have an emergency, are just making an appointment for your annual checkup, who cares if it takes 3 or 4 weeks?

[Audiofn]

I don't know about you guys but I could call up my doctor and see him in about 2 hours if I needed to. It cost me 20 bucks out of pocket when my son was born and my wife was in the hospital for almost 1 month out of that time with kidney stones. Honestly the health care "crisis" is a little dramatic. We have a lot of poeple in this country that would rather drive a Lexus with pimpin rims then buy insurance. Well if your priorities are that screwed up then you get what you get as far as I am concerned. We were at one of my customers places in Hartford back when I worked on store fronts and my father was with me. He looked at all the kids in the store with babies and said "I can't afford to put the stuff in my car that these guys are how can they afford to." My father is a lawer! I said "the difference is that I wanted for nothing as I grew up. If I needed a special school I got it, when I had to have a serious surgery you got me into the best doctor, out of school with out any debt. These kids will be lucky if they even get out of high school, but hey dady will have a pimping sound system in his car". We do not prioritize things well in this country simple as that.

I listened to Obama yesterday with his interview with Michael Smirkonich and what he said sounded so nice but when you get down to brass tacks IT WONT WORK!!! He uses Medicare and Mass Health as examples of how things can be better. Great example Mr. President, those systems are failing big time! I am willing to bet that most doctors would rather not have to deal with Medicare because it pays out at such a small percentage of the bill.

There are problems with the system and the only way that I see them being able to cut costs is go get all the 20-30 year olds who go with out insurance to get involved. This will help spread out the costs. Maybe some tax incentive for the 20-30 years olds to have health insurance. Make tricks like pre tax dollars for medical costs more well known. We simply can not afford another free ride for the 50% of the coutry that does not pull the wagon.