Why are special interests like the AMA and Pharma co.'s supporting Obama's plan???

[DoNoHarm]

When Bill Clinton tried it, they made all these cheezy ads to get people scared. It seems that this time, everyone is on board. Will the Obama plan just give more money to Pharmaceutical companies? Why else would they support it? What gives?

Cheezy ads from '94 and today:

http://thecaucus.blogs.nytimes.com/2009/07/17/harry-and-louise-return-with-a-new-message/

[killerrobot]

The AMA supports him, as far as I can tell from the last AMA convention, because the rising costs of health care and of malpractice insurance is putting doctor's jobs at risk.

As far as pharmaceutical companies, you'd have to me more specific.
IMO, if they do support it, it's probably because they'd have a possibility to get their drugs to another 50M Americans if everyone is covered.

http://www.huffingtonpost.com/2009/06/15/obama-ama-speech-full-tex_n_215699.html

[opinioncircle]

Yeah it's a sure way to open a whole new market for them. I mean companies will be able to slash prices, when government won't. Kind of easy money if you ask me...

[it5five]

Because Obama's plan is not going to be that good. Obama himself is very centre-right, so he was never going to introduce real healthcare reform. Plus, Republicans have put hundreds of amendments into this thing despite the fact that almost none of them will vote for it. I sort of expect that this healthcare bill will go over like the stimulus plan. It will fix the surface of the problem, but will never address the root causes for our current disastrous health problem: private, for-profit corporations in charge of our insurance coverage.

HR 676, which was introduced years ago, is a much better proposal. But it had never been seriously considered, and probably never will, because we have no national leader willing to stand up against the insurance industry.

[mgguy]

. It will fix the surface of the problem, but will never address the root causes for our current disastrous health problem: private, for-profit corporations in charge of our insurance coverage.

Would you also advocate government takeover of other forms of insurance, such as auto and home? If government can do a better job with health insurance, why not other types too?

[it5five]

Are you seriously trying to compare auto and home coverage to health coverage? Not everybody owns a car and not everybody owns a home. However, everyone in this country has a body that needs to be healthy in order to survive. Profit should not be made off of the health of people. A great profit is made by denying coverage to as many people as possible. They still pay their premiums, but can get screwed when the insurance corporation denies coverage, usually blaming a "pre-existing condition" as reason for refusing to pay.

Which again, is the biggest problem I have with the proposed health care plan. It mandates that people buy into this system. Luckily, it seems I'm poor enough to be eligible for Medicaid coverage under the new plan, but I would not be happy at all if I were forced to pay premiums to a company that could well deny me coverage at a later date.

[leekohler]

Are you seriously trying to compare auto and home coverage to health coverage? Not everybody owns a car and not everybody owns a home. However, everyone in this country has a body that needs to be healthy in order to survive. Profit should not be made off of the health of people. A great profit is made by denying coverage to as many people as possible. They still pay their premiums, but can get screwed when the insurance corporation denies coverage, usually blaming a "pre-existing condition" as reason for refusing to pay.

Agreed. The free market does not work with regards to health care. By it's very nature, it can't.

[Zombie Acorn]

Agreed. The free market does not work with regards to health care. By it's very nature, it can't.

Yes it does, when you allow it to work. Health insurrance is trying to cover everything which defeats the sole purpose of insurrance, you spread the disaster cost over a wide number of people. Health insurrance should have never became a maintenance entity, people should pay for their regular health checkups.

[mgguy]

Are you seriously trying to compare auto and home coverage to health coverage? Not everybody owns a car and not everybody owns a home. However, everyone in this country has a body that needs to be healthy in order to survive. Profit should not be made off of the health of people. A great profit is made by denying coverage to as many people as possible. They still pay their premiums, but can get screwed when the insurance corporation denies coverage, usually blaming a "pre-existing condition" as reason for refusing to pay.

Which again, is the biggest problem I have with the proposed health care plan. It mandates that people buy into this system. Luckily, it seems I'm poor enough to be eligible for Medicaid coverage under the new plan, but I would not be happy at all if I were forced to pay premiums to a company that could well deny me coverage at a later date.
Fair enough; I get your point.

You say that people would have to buy into this system. If you mean that they would have to pay for the coverage they get, even if the government were the insurance provider, I don't believe this is true. As I understand it, people would only be required to pay if they earned above a certain amount. My main problem with many of the proposals is that it provides for too many people being able to get coverage and therefore treatment free, including illegal immigrants and their children. If everyone would have to pay for coverage, I would have less of a problem with universal care. But that isn't what is going to happen.

[leekohler]

Yes it does, when you allow it to work. Health insurrance is trying to cover everything which defeats the sole purpose of insurrance, you spread the disaster cost over a wide number of people. Health insurrance should have never became a maintenance entity, people should pay for their regular health checkups.

No it doesn't work. What's the goal of the free market? To make as much money as possible. Therefore, people get denied procedures that they need because the insurance company won't pay for them- too expensive and not profitable. People get denied insurance money for treatment because of "pre-existing conditions". The free market is antithetical to health care. It's insane to think it would ever work in the first place.

[it5five]

You say that people would have to buy into this system. If you mean that they would have to pay for the coverage they get, even if the government were the insurance provider, I don't believe this is true. As I understand it, people would only be required to pay if they earned above a certain amount. My main problem with many of the proposals is that it provides for too many people being able to get coverage and therefore treatment free, including illegal immigrants and their children. If everyone would have to pay for coverage, I would have less of a problem with universal care. But that isn't what is going to happen.

I think we're a bit confused here. While I haven't read the entire bill (and I doubt anyone else here has either), I found this:

http://www.msnbc.msn.com/id/31925037/ns/politics/

It is comparing both the Senate and the House versions of the bill. The particular part of it I was referring to was this.

Would establish requirement for legal residents to obtain insurance; would impose financial penalty on most people who did not do so. Size of penalty would vary with income.

If the individual or the family is wealthy enough, they would not be eligible for extended Medicaid plan proposed under the house plan.

People with income below 133 percent of the federal poverty level -– which is about $29,000 for a family of four -- would be eligible for Medicaid coverage. Federal government would pay all costs of covering the newly eligible people.

I think this discussion could be aided if there were a good break-down of the various bills available somewhere online. Unfortunately, that comparison link I posted is the best I've been able to find so far.

What I meant to suggest was that rather than grant universal coverage, the proposed health care bills would simply mandate that people find health coverage. Its a rather assbackwards way to ensure universal coverage, in my opinion.

[it5five]

If anyone is looking for a critical view of the Obama's health care bills from the left, I found this article (http://socialistworker.org/2009/06/18/real-reform-off-the-table) to be quite good.

It may also explain why the industry is supportive of Obama's plan.

[Zombie Acorn]

No it doesn't work. What's the goal of the free market? To make as much money as possible. Therefore, people get denied procedures that they need because the insurance company won't pay for them- too expensive and not profitable. People get denied insurance money for treatment because of "pre-existing conditions". The free market is antithetical to health care. It's insane to think it would ever work in the first place.

I think you aren't gettig what I am saying. Preexisting conditions should be covered and they are part of the disaster umbrella. If everyone pays insurrance under the disaster umbrella the system works. Where it goes wrong is including regular maintenance. People choose their doctors on quality and price efficiency. The people control the free market, not the businesses.

Health should be broken into two seperate entities. In fact I wouldn't even mind a government mandated disaster health tax because it would lower premiums to basically nothing when spread over millions.

[mgguy]

What I meant to suggest was that rather than grant universal coverage, the proposed health care bills would simply mandate that people find health coverage. Its a rather assbackwards way to ensure universal coverage, in my opinion.
The bill would perhaps mandate that people find health coverage, and would penalize those who don't, but would do so only for people making above a certain income. Those who are below this income cutoff would be provided coverage free, if I understand it correctly. In addition, any program that covers illegal immigrants beyond providing emergency services before deporting them should be rejected out of hand in my opinion. I don't believe that people who are here on work visas and other arrangements should be provided free or discount-priced health insurance or coverage at taxpayers' expense either.

[killerrobot]

I don't believe that people who are here on work visas and other arrangements should be provided free or discount-priced health insurance or coverage at taxpayers' expense either.

If you have a work visa and a job in the US, you pay US taxes period. You become a US taxpayer. The only way around this is if you lie (don't know why you would if you've got a work visa) or your employer lies.

[Eraserhead]

Would you also advocate government takeover of other forms of insurance, such as auto and home? If government can do a better job with health insurance, why not other types too?

Because the auto and home insurance industries are actually competitive.

Yes it does, when you allow it to work. Health insurrance is trying to cover everything which defeats the sole purpose of insurrance, you spread the disaster cost over a wide number of people. Health insurrance should have never became a maintenance entity, people should pay for their regular health checkups.

If the "free market" in healthcare is so great, why to the Americans spend more money on healthcare per person than any other country?

[leekohler]

I think you aren't gettig what I am saying. Preexisting conditions should be covered and they are part of the disaster umbrella. If everyone pays insurrance under the disaster umbrella the system works. Where it goes wrong is including regular maintenance. People choose their doctors on quality and price efficiency. The people control the free market, not the businesses.

Then no one would go for regular check ups. Come on- you know they wouldn't. Then your "disaster umbrella" gets even bigger, and people are even less healthy. The free market isn't the answer to everything all the time.

[.Andy]

Yes it does, when you allow it to work.
Hospitals and doctors triaging patients to give priority to the most profitable instead of the most ill will work a charm.

[mgguy]

If the "free market" in healthcare is so great, why to the Americans spend more money on healthcare per person than any other country?
Possibly because healthcare is better and therefore more costly here, there is more extensive and costly primary research that needs to be paid for, more expensive effects of government control of quality and integrity of health care and related industries, the add-on cost to cover services given to those who are not covered and are not paying anything into the system, possible greater use by Americans of non-essential services, unnecessary checkups, and treatment for every little ailment like a cold and dry or oily skin that they can and should treat themselves, and treatment for illnesses that by their nature will never get better. These are just a few hypotheses I thought of, none of which I researched or can validate. My point is that any difference in costs per person can be due to other factors and not necessarily the result of whether health care is free-market or government run. Perhaps it is up to you to establish any causal relationship here.

[bobber205]

]Possibly because healthcare is better [/B]and therefore more costly here, there is more extensive and costly primary research that needs to be paid for, more expensive effects of government control of quality and integrity of health care and related industries, the add-on cost to cover services given to those who are not covered and are not paying anything into the system, possible greater use by Americans of non-essential services, unnecessary checkups, and treatment for every little ailment like a cold and dry or oily skin that they can and should treat themselves, and treatment for illnesses that by their nature will never get better. These are just a few hypotheses I thought of, none of which I researched or can validate. My point is that any difference in costs per person can be due to other factors and necessarily the result of whether health care is free-market or government run. Perhaps it is up to you to establish any causal relationship here.

If it's "better", than why do we live shorter lifespans compared to countries with a national healthcare plan?

Colbert had a good guest on the other day. He said that the fact that if everyone got cancer that was in the audience, it was be *good* for the economy and the industry.
That should never be true and is a good example of what's wrong. Our healthcare industry profits from people not getting better. Huge conflict on interests in my opinion.

[LethalWolfe]

Possibly because healthcare is better...
According the last comprehensive study done by the WHO in 2000 the US was ranked number 37 (http://www.photius.com/rankings/healthranks.html) out of 190 countries.


Lethal

EDIT: And in 2010 an estimated 6 million (http://www.cnn.com/2009/HEALTH/03/27/india.medical.travel/index.html) Americans will travel overseas for medical treatment.

[rhsgolfer33]

If it's "better", than why do we live shorter lifespans compared to countries with a national healthcare plan?

There are plenty of things other than national healthcare that could account for lifespan differences, for instance, diet.

According the last comprehensive study done by the WHO in 2000 the US was ranked number 37 (http://www.photius.com/rankings/healthranks.html) out of 190 countries.

Well, that is if you buy into the indicators that WHO uses as indicating quality of care being given. WHO's measures don't focus much on whether the healthcare is better, but rather the level of population health (which is easily affected by characteristics outside of the healthcare realm), health inequalities within the population, level of system responsiveness (a combination of patient satisfaction and how well the system acts), distribution of responsiveness within the population (how well people of varying economic status find that they are served by the system), and the distribution of the health system's financial burden within the population.

WHO's measures don't really say much about the actual quality of the healthcare that is being given, instead they seem to focus more on who is treated (rather than the quality of that treatment), who pays for it, and fairness. The rankings are probably push America out of higher positions, not because American's receive poor quality care, but because there are large systemic issues with who receives healthcare, who pays for, etc.

Its interesting to note that the WHO study found that America has the highest level of responsiveness (defined in their study as a combination of patient satisfaction and how well the system acts).

I'm certainly not saying that there doesn't need to be some level of reform so that more people are covered, but that study definitely doesn't mean that the care people who are insured in America get is any better or any worse than any other nation.

[bobber205]

There are plenty of things other than national healthcare that could account for lifespan differences, for instance, diet.



Well, that is if you buy into the indicators that WHO uses as indicating quality of care being given. WHO's measures don't focus much on whether the healthcare is better, but rather the level of population health (which is easily affected by characteristics outside of the healthcare realm), health inequalities within the population, level of system responsiveness (a combination of patient satisfaction and how well the system acts), distribution of responsiveness within the population (how well people of varying economic status find that they are served by the system), and the distribution of the health system's financial burden within the population.

WHO's measures don't really say much about the actual quality of the healthcare that is being given, instead they seem to focus more on who is treated (rather than the quality of that treatment), who pays for it, and fairness. The rankings are probably push America out of higher positions, not because American's receive poor quality care, but because there are large systemic issues with who receives healthcare, who pays for, etc.

Its interesting to note that the WHO study found that America has the highest level of responsiveness (defined in their study as a combination of patient satisfaction and how well the system acts).

I'm certainly not saying that there doesn't need to be some level of reform so that more people are covered, but that study definitely doesn't mean that the care people who are insured in America get is any better or any worse than any other nation.
Fine. Discount the WHO. How do you know that American's is the "bestiest"?

[mgguy]

If it's "better", than why do we live shorter lifespans compared to countries with a national healthcare plan?

rhsgolfer33 beat me out of the gate with his response. A shorter average life span could be had even with better care. To draw confident causal conclusions about the effect of quality of care on life span, it would be necessary for all other factors affecting life span to be controlled. Since it is not practically to do this experimentally (using random assignment of people to the different health care conditions being evaluated), it would have to be done by statistically adjusting the life span measures to account for differences between the groups on other factors that may affect their life spans (demographics, diet, atmospheric conditions, exposure to risk factors like complex traffic environments, etc.). Can you site any studies of the causal affect of health care quality on life span that attempted to control these other factors? Alternatively, you could try to make a case that these other factors aren't relevant, but I think that would be a losing argument.

[rhsgolfer33]

Fine. Discount the WHO. How do you know that American's is the "bestiest"?

I never said I did know that America was the best, I said that I don't feel the WHO's measure actually measures quality of care, rather the measure is weighted towards things like access, payment, and other issues not related to the quality of care individuals who are insured receive. That certainly doesn't mean their measure is a faulty measure in any way when applied towards the things that it actually does measure or to analyzing the effectiveness of a system in reaching a population as a whole. You're certainly free to disagree with me, but even the WHO's study had the U.S. at number one in responsiveness, which partially takes into account patient satisfaction. If patient satisfaction is any indicator of quality of care (and I'm not saying it necessarily is), then the U.S. probably has pretty good quality care provided you are insured. If you take into systemic issues, like access, payment, and other inequalities, then of course the U.S. system is going be ranked lower than a system that provides access to everyone for limited costs.

[CorvusCamenarum]

Then no one would go for regular check ups. Come on- you know they wouldn't. Then your "disaster umbrella" gets even bigger, and people are even less healthy. The free market isn't the answer to everything all the time.

Sure they would. People with auto insurance still change their oil and get their tires rotated. The point mgguy is making is that we don't expect Geico to pay for our trips to Jiffy Lube.

[LethalWolfe]

If patient satisfaction is any indicator of quality of care (and I'm not saying it necessarily is), then the U.S. probably has pretty good quality care provided you are insured. If you take into systemic issues, like access, payment, and other inequalities, then of course the U.S. system is going be ranked lower than a system that provides access to everyone for limited costs.
If one is ranking an entire healthcare system then everything from "how was the doctor" to "did you get to see the doctor" should be asked. If one were just ranking medical services provided then of course one wouldn't need to talk to the people that couldn't afford to see the doctor in the first place.


Lethal

[Ugg]

Sure they would. People with auto insurance still change their oil and get their tires rotated. The point mgguy is making is that we don't expect Geico to pay for our trips to Jiffy Lube.

What's a trip to Jiffy Lube? $30-35? Of course the frequency of those trips depends upon how much we drive, so all we have to do is look at the odometer and we can not only know when to schedule that trip but how much it will cost.

So, by the same token, we can budget for an annual physical, because that price is a given. But, it's virtually impossible to budget for all the other possible medical expenses and I'd like to know where you draw the line? What's covered and what's not? is there a monthly maximum? $500 for a family of four in addition to the cost of insurance? What if little Susie has asthma? Is that a trip to Jiffy Lube?

You love to throw out this idea that "maintenance" should be paid for out of a family's petty cash, but fail to provide any guidelines. A human body is a heck of lot different than an automobile.

[Eraserhead]

If one is ranking an entire healthcare system then everything from "how was the doctor" to "did you get to see the doctor" should be asked. If one were just ranking medical services provided then of course one wouldn't need to talk to the people that couldn't afford to see the doctor in the first place.

But if you exclude them, then the costs spread among the rest of Americans would be even higher :eek:.

rhsgolfer33 beat me out of the gate with his response. A shorter average life span could be had even with better care. To draw confident causal conclusions about the effect of quality of care on life span, it would be necessary for all other factors affecting life span to be controlled. Since it is not practically to do this experimentally (using random assignment of people to the different health care conditions being evaluated), it would have to be done by statistically adjusting the life span measures to account for differences between the groups on other factors that may affect their life spans (demographics, diet, atmospheric conditions, exposure to risk factors like complex traffic environments, etc.). Can you site any studies of the causal affect of health care quality on life span that attempted to control these other factors? Alternatively, you could try to make a case that these other factors aren't relevant, but I think that would be a losing argument.

Can you find a reputable study which thinks US healthcare is the best in the world? Bearing in mind that the Americans spend significantly more on healthcare than any other country (i.e they spend thousands of dollars a year per person more than the #2 country).

But, it's virtually impossible to budget for all the other possible medical expenses and I'd like to know where you draw the line?

This is the main reason I get travel insurance. OK the legal liability is useful too. But really everything else is really a "nice to have" and isn't actually that useful - if you get robbed you can always afford to re-buy the stuff you had before and the absolute worst case scenario on accommodation/transport is that you are out a couple of thousand dollars.

Whereas if you had a heart attack while skiing and had to be helicoptered off the mountain and treated in hospital for weeks that would probably cost hundreds of thousands of dollars which I cannot possibly afford.

[rhsgolfer33]

Possibly because healthcare is better and therefore more costly here.

If one is ranking an entire healthcare system then everything from "how was the doctor" to "did you get to see the doctor" should be asked. If one were just ranking medical services provided then of course one wouldn't need to talk to the people that couldn't afford to see the doctor in the first place.

We are entirely in agreement with that fact. That being said, I'd say its reasonable to assume that mgguy was talking about the quality of the care received, not systemic issues such as inequalities, payment, etc, leading to the U.S. systems high cost. I just take issue with the WHO study being cited to refute the claim that the quality of care received is better in the U.S.; the ranking of the U.S. at 37 doesn't disprove that claim. I don't necessarily think the quality of care in the U.S. is better than many other globalized nations and I haven't seen any proof that it is (other than the WHO study ranking it number one in responsiveness). I think that globalization is only going to lead to better quality care around the world, and even if the U.S. does have better quality care now, it probably won't in coming years.

[opinioncircle]

Can you find a reputable study which thinks US healthcare is the best in the world? Bearing in mind that the Americans spend significantly more on healthcare than any other country (i.e they spend thousands of dollars a year per person more than the #2 country).

Can't think of one really. What seems to be the plan is actually propose an insurance to the millions of people who aren't insured. I mean for insurance companies that has to be great. They'll be able to get the government to support those they can't insure and those who were close to be will fall in their nets...

[LethalWolfe]

We are entirely in agreement with that fact. That being said, I'd say its reasonable to assume that mgguy was talking about the quality of the care received, not systemic issues such as inequalities, payment, etc, leading to the U.S. systems high cost.
There is more to 'healthcare' than how much you like your doctor or how fancy your local hospital is. If that's all that is being talked about here then the term 'healthcare', which is all encompassing, shouldn't be used.


Lethal

[DoNoHarm]

Fair enough; I get your point.

You say that people would have to buy into this system. If you mean that they would have to pay for the coverage they get, even if the government were the insurance provider, I don't believe this is true. As I understand it, people would only be required to pay if they earned above a certain amount. My main problem with many of the proposals is that it provides for too many people being able to get coverage and therefore treatment free, including illegal immigrants and their children. If everyone would have to pay for coverage, I would have less of a problem with universal care. But that isn't what is going to happen.

You're allready paying for illegal immigrants even if you have private insurance. When they use a hospital and don't pay, the private insurance pays for it. You're also already paying for uninsured people. When they use the ER, you pay for it. It's a fact of life and nobody can change it. You can't let an illegal immigrant die at the footsteps of the hospital because they don't have insurance.

If you had universal coverage, the illegal immigrants you are blaming for your problem could get preventative health care and not cost you so much.

[NT1440]

It makes me sick when people who (for some strange reason) are against reform under the slogan "we have the best healthcare in the world!". Well heres some non news for you, our system sucks compared to much of the world. Are system is worse than some countries that an American would never dream of traveling to for medical reasons. Our system is in it for the money, not the good of the people, and thats disgusting.

[leekohler]

It makes me sick when people who (for some strange reason) are against reform under the slogan "we have the best healthcare in the world!". Well heres some non news for you, our system sucks compared to much of the world. Are system is worse than some countries that an American would never dream of traveling to for medical reasons. Our system is in it for the money, not the good of the people, and thats disgusting.

Couldn't have said it better.

[Rodimus Prime]

My problem with Obama system is it is expanding on Medicare. A system that is already broken and already does not work.

how you you expanded on a known broken failed system. While in theory it is a great idea and is needed it needs to be done correctly. FIX THE BROKEN MEDICARE SYSTEM FIRST. Then worry about expanding it.

A huge part of the medical problem is not the insurance. It is the run away out of control cost of health care. When health care cost is going up at double digit numbers every year and well out pacing inflation that tells me that there is another problem at work.

Get healthcare cost done by insurance is not going to fix the that problem. Hell it will make it worse. This plan has NOTHING in it to stop the out of control cost increase in health care. It has NOTHING to bring down that number.

[mgguy]

You're allready paying for illegal immigrants even if you have private insurance. When they use a hospital and don't pay, the private insurance pays for it. You're also already paying for uninsured people. When they use the ER, you pay for it. It's a fact of life and nobody can change it. You can't let an illegal immigrant die at the footsteps of the hospital because they don't have insurance.

If you had universal coverage, the illegal immigrants you are blaming for your problem could get preventative health care and not cost you so much.
Unfortunately, yes we are now paying for services provided to illegal immigrants. This will probably only get worse under most health care reform proposals. This should be changed. If they need emergency services, provide them and then initiate deportation actions. I don't buy the argument that providing additional, preventative health care to them would lower overall costs for their care. It certainly would be more costly than the deportation option. If you can cite a good study showing that extending coverage beyond emergency services reduces overall costs to an illegal immigrant population in this country, I would be glad to read and discuss it.

I would be more favorable to a health care system revamp that made people pay for all or a good portion of health insurance coverage that would pay for essential medical services, even if that is done over a period of time following care. Too many are already being given a free ride, and that will get worse under the leading proposals passed by the congressional committees.

[Ugg]

My problem with Obama system is it is expanding on Medicare. A system that is already broken and already does not work.



What's "broken" with Medicare? It may not be perfect, but then neither is "private" health insurance. At least Medicare doesn't abandon its customers due to pre existing conditions.

[mgguy]

It makes me sick when people who (for some strange reason) are against reform under the slogan "we have the best healthcare in the world!". Well heres some non news for you, our system sucks compared to much of the world. Are system is worse than some countries that an American would never dream of traveling to for medical reasons. Our system is in it for the money, not the good of the people, and thats disgusting.

Why sholdn't doctors be able to make a profit? Are you proposing the government set an hourly rate or some such thing for doctors and health researchers?

[NT1440]

Why sholdn't doctors be able to make a profit? Are you proposing the government set an hourly rate or some such thing for doctors and health researchers?

I'm saying I don't want a doctor that got into the game for profit, I want one that genuinely wants to help people. Our system isn't set up to help people, thats just the way they go around getting what they really want, to make money. Healthcare should not be a business, it should be a service.

Edit: where the hell did you pull my "proposal" from? You seem to be coming into the debate with all the standard rebuttals I'd expect from a politician that wants the status quo to remain the same. I'm not looking for a sprucing up of the system, I want a complete teardown of it and for it to be built back up in a way where people come first and formost, not the bottom line. If it requires higher taxes, so be it.

[Rodimus Prime]

What's "broken" with Medicare? It may not be perfect, but then neither is "private" health insurance. At least Medicare doesn't abandon its customers due to pre existing conditions.

Medicare kills practices. It chokes them and clogs the system. It cuts what it pays doctors to a point where they will struggle to pay the bills. The US is already facing a huge shortage of General doctors.

The new system does NOTHING to fix the larger problem of run away health care cost. Hell it will make the problem worse because now it will spike demand while not increase supply. Hell it might reduce the supply side.

So instead you will spike the system with more demand which general cost the cost to go up.

The pre existing condition argument people use is nowhere near as bad as people make it out be. Yes it is bad but not as bad as it seems. Currently if you have insurance they can not slap it on you. You ahve to go with out insurance for 90 days for a pre existing condition to be slap on you. If you go with an employer who offering insurance then pre existing condition can not be used at all.

[mgguy]

I'm saying I don't want a doctor that got into the game for profit, I want one that genuinely wants to help people. Our system isn't set up to help people, thats just the way they go around getting what they really want, to make money. Healthcare should not be a business, it should be a service.

Edit: where the hell did you pull my "proposal" from? You seem to be coming into the debate with all the standard rebuttals I'd expect from a politician that wants the status quo to remain the same. I'm not looking for a sprucing up of the system, I want a complete teardown of it and for it to be built back up in a way where people come first and formost, not the bottom line. If it requires higher taxes, so be it.
Why do you care what a doctor's motives are (money, altruism, etc.) as long as they get the job done? Would you not accept medical care from a doctor that could heal you if they were doing it more for the money than to make you better? I don't agree with you that healthcare shouldn't be a business. It can be a business and a humanitarian service, but if the care helps people I don't care if one of these motivations, or both, are absent. I'm not sure that you would get enough people to go through the rigor and expense of becoming doctors if all you wanted to license to practice were those who were only doing it for altruistic reasons and not profit.

You can advocate for higher taxes to get the kind of system you want, but remember that that money is theirs and not yours, and they may not want to part with it to further purposes you support but they don't. It is also unrealistic to expect that the system can be completely torn down and then rebuilt the way you want it, though I guess it doesn't hurt to dream.

[LethalWolfe]

The pre existing condition argument people use is nowhere near as bad as people make it out be. Yes it is bad but not as bad as it seems. Currently if you have insurance they can not slap it on you. You ahve to go with out insurance for 90 days for a pre existing condition to be slap on you. If you go with an employer who offering insurance then pre existing condition can not be used at all.
I got denied individual coverage once because I take prescription medicine for seasonal allergies (the longest I've ever been uninsured in my life is 30 days). I've also had individual plan rates nearly double in less than a two year period and I never even filed a claim. If you aren't part of a good group plan you are really up ***** creek in the US. I have friends and family in various parts of the medial community and they all worried about my coverage when I was working as a freelancer 'cause they know better than most how much individual plan holders are at the mercy of the insurance companies.


Lethal

[Rodimus Prime]

I got denied individual coverage once because I take prescription medicine for seasonal allergies (the longest I've ever been uninsured in my life is 30 days). I've also had individual plan rates nearly double in less than a two year period and I never even filed a claim. If you aren't part of a good group plan you are really up ***** creek in the US. I have friends and family in various parts of the medial community and they all worried about my coverage when I was working as a freelancer 'cause they know better than most how much individual plan holders are at the mercy of the insurance companies.


Lethal


That is more than likely true but still this "new plan" I will say does not fix the larger issue of run away health care cost

[LethalWolfe]

That is more than likely true but still this "new plan" I will say does not fix the larger issue of run away health care cost
I'm not advocating for anyone's plan specifically I'm just saying the system is busted and needs to be fixed.


Lethal

[.Andy]

That is more than likely true but still this "new plan" I will say does not fix the larger issue of run away health care cost
Why do you say this? And what specific suggestions do you think would fix the issue of run away health care costs?

[Rodimus Prime]

Why do you say this? And what specific suggestions do you think would fix the issue of run away health care costs?

Not sure but providing health insurance for everyone is NOT going to fix it. If anything it will make it worse because the government is not massively increasing demand but doing NOTHING to increase supply (aka doctors)

But when health care cost have been climbing at double digits every year for years now we have a problem. It is massively out pacing inflation. Something needs to be done to bring it more in line.

[anjinha]

Not sure but providing health insurance for everyone is NOT going to fix it. If anything it will make it worse because the government is not massively increasing demand but doing NOTHING to increase supply (aka doctors)

But when health care cost have been climbing at double digits every year for years now we have a problem. It is massively out pacing inflation. Something needs to be done to bring it more in line.

Other countries manage to do it. Is the U.S. too stupid to figure it out?

[DoNoHarm]

There are plenty of things other than national healthcare that could account for lifespan differences, for instance, diet.
......

WHO's measures don't really say much about the actual quality of the healthcare that is being given, instead they seem to focus more on who is treated (rather than the quality of that treatment), who pays for it, and fairness. The rankings are probably push America out of higher positions, not because American's receive poor quality care, but because there are large systemic issues with who receives healthcare, who pays for, etc.

I'm certainly not saying that there doesn't need to be some level of reform so that more people are covered, but that study definitely doesn't mean that the care people who are insured in America get is any better or any worse than any other nation.

Don't you think that diet is part of a healthcare strategy? The point being made earlier was that the hospitals actually have a financial INCENTIVE to have us get fat and obese and require costly procedures. There's something horribly wrong with this system.

And to address the point you made in your third paragraph, from the perspective of someone who can't afford health insurance because their crappy job doesn't give it to them, the fact that the USA has the worlds most technologically advanced hospitals means absolutely nothing. Period. The choice between not having health insurance in the USA and having health insurance in the crappiest, most po-dunk third world country with universal healthcare is a clear one. I'd go with the third world country that offers universal healthcare.

The fact that there are US CITIZENS who don't have healthcare is a national EMBARASSMENT. We're stronger than this.

[.Andy]

Not sure but providing health insurance for everyone is NOT going to fix it.
You're able to distill a whole proposed health policy and determine that it isn't going to work, but you're unable to make suggestions about how the system could be improved to make it more equitable?

If anything it will make it worse because the government is not massively increasing demand ut doing NOTHING to increase supply (aka doctors)
I'll assume you meant increasing demand here. But that's not true. The demand is already there. The people just don't have the means to access it with the result that people are languishing in the US with third world healthcare. What's proposed and aimed for is to facilitate access to the healthcare people already need. And more doctors is something that's relatively easy to fix.

You don't maintain the healthcare standards of group X by placing barriers for access for group Y.

But when health care cost have been climbing at double digits every year for years now we have a problem. It is massively out pacing inflation. Something needs to be done to bring it more in line.
Such as? And why is this reason to not provide basic healthcare to the most vulnerable?

[rhsgolfer33]

If it's "better", than why do we live shorter lifespans compared to countries with a national healthcare plan?

Don't you think that diet is part of a healthcare strategy? The point being made earlier was that the hospitals actually have a financial INCENTIVE to have us get fat and obese and require costly procedures. There's something horribly wrong with this system.

I don't see how this is related to the issue of life expectancy as a point that national healthcare is superior. All I see is someone trying to link national healthcare to life expectancy without any support what so ever. I provided a statement that lifespan takes into account many other factors than a national healthcare plan, including diet. There are plenty of national healthcare countries with lower lifespan and higher lifespan than the United States.

I also have serious doubts as to whether national healthcare will have any effect on the diet American's have. American's aren't going to just suddenly change their diet because of the availability of healthcare to 37 million of them. I know people with and without healthcare who eat plenty of **** and are told not to do so by doctors, do they change? Rarely.

The fact that there are US CITIZENS who don't have healthcare is a national EMBARASSMENT. We're stronger than this.

The new plan won't cover all Americans. Its estimated that at least 7 million citizens will remain uncovered.

[Rodimus Prime]

I'll assume you meant increasing demand here. But that's not true. The demand is already there. The people just don't have the means to access it with the result that people are languishing in the US with third world healthcare. What's proposed and aimed for is to facilitate access to the healthcare people already need. And more doctors is something that's relatively easy to fix.



You do not understand how Supply vs Demand working in this case.

Goverment health care would effectly drop the price Joe would have to pay to see a doctor vs if he had no insurance. This causes an INCREASE in demand because his out of pocket cost drops. Because this is going to happen for millions of people it causes a huge spike in demand with NOTHING to combat the LACK of supply of doctors.

If they want government health care then something needs to be done with controlling the runway cost increases because with out the government system cost would just go out of control.

As it stands our Federal government wants health care for everyone but has no way to pay for it. They have to be able to pay for it and have a way to control its cost. That means controlling the massively increasing healthcare cost.

one big part they could target in the Pharma companies. They are a huge part of the cost increase. All they push are have this problem take this pill. That should not be how it is done. Pharma should not be advertising on TV. They NEED to get out of the med schools so doctors can treat with out always turning to pills. Huge part of the problem is the pharma.

[.Andy]

Goverment health care would effectly drop the price Joe would have to pay to see a doctor vs if he had no insurance.
Meaning Joe could go and get his healthcare requirements seen to whereas before he couldn't. This is a good thing. You are arguing from a supply and demand ideology where people will be attracted to a product purely because of it's price. This is not the case with healthcare. People aren't going to seek out appendectomies because the price has suddenly dropped.

Like it or not it's the poorest and most vulnerable in society that need the most access to healthcare. Like it or not it's something that the more fortunate of us have an ethical obligation to supply them. We can't justify excluding them from having their basic healthcare needs satisfied on the grounds that it will make it harder for us to see a doctor.

Because this is going to happen for millions of people it causes a huge spike in demand with NOTHING to combat the LACK of supply of doctors.
Or alternatively (in the short term) everyone will still get seen, it will just take longer to be seen. Investing in more medical education and more doctors isn't that hard an issue to overcome. It's been done in Australia over the last decade with an expansion of medical schools, intake numbers, and medical schools. It's a relatively easy problem to overcome.

If they want government health care then something needs to be done with controlling the runway cost increases because with out the government system cost would just go out of control.
Not necessarily. It depends entirely on what is covered by government healthcare. Government healthcare need not be cutting edge nor extensive. It only need be to satisfy the basic requirements of the population to ensure they don't go needing.

[Rodimus Prime]

damn computer....

[.Andy]

You do not understand how Supply vs Demand working in this case.

Goverment health care would effectly drop the price Joe would have to pay to see a doctor vs if he had no insurance. This causes an INCREASE in demand because his out of pocket cost drops. Because this is going to happen for millions of people it causes a huge spike in demand with NOTHING to combat the LACK of supply of doctors.

If they want government health care then something needs to be done with controlling the runway cost increases because with out the government system cost would just go out of control.

As it stands our Federal government wants health care for everyone but has no way to pay for it. They have to be able to pay for it and have a way to control its cost. That means controlling the massively increasing healthcare cost.

one big part they could target in the Pharma companies. They are a huge part of the cost increase. All they push are have this problem take this pill. That should not be how it is done. Pharma should not be advertising on TV. They NEED to get out of the med schools so doctors can treat with out always turning to pills. Huge part of the problem is the pharma.
Did you make exactly the same post by accident or were you under the impression that it was such a great post that covered all bases that you'd make it again :p?

[NT1440]

Other countries manage to do it. Is the U.S. too stupid to figure it out?

Seems like it sometimes doesn't it. :rolleyes:

[Rodimus Prime]

Meaning Joe could go and get his healthcare requirements seen to whereas before he couldn't. This is a good thing. You are arguing from a supply and demand ideology where people will be attracted to a product purely because of it's price. This is not the case with healthcare. People aren't going to seek out appendectomies because the price has suddenly dropped.

Like it or not it's the poorest and most vulnerable in society that need the most access to healthcare. Like it or not it's something that the more fortunate of us have an ethical obligation to supply them. We can't justify excluding them from having their basic healthcare needs satisfied on the grounds that it will make it harder for us to see a doctor.



With out a long term thing in the plan to curb the out control rising cost of health care from the government I will not support anything bill for it. There is no point to throw money at it just to give everyone insurance because it only will make the run away cost even more of an issue.

Perosnally I think the Pharma co. are a huge part of the run away cost problem. Everything is have problem X take pill Y.

Run away cost I think are the largest issue that needs to be addressed. With out doing fixing that or having something in place to fix it government health care is worthless and just will be come another money pit.

Did you make exactly the same post by accident or were you under the impression that it was such a great post that covered all bases that you'd make it again :p?

accident. noticed the edit...... It was a ping time lag out error on that tab and it got resent when I refreshed it.

[.Andy]

With out a long term thing in the plan to curb the out control rising cost of health care from the government I will not support anything bill for it. There is no point to throw money at it just to give everyone insurance because it only will make the run away cost even more of an issue.

Perosnally I think the Pharma co. are a huge part of the run away cost problem. Everything is have problem X take pill Y.

Run away cost I think are the largest issue that needs to be addressed. With out doing fixing that or having something in place to fix it government health care is worthless and just will be come another money pit.
So in conclusion you think that it's justified that people don't have basic access to healthcare because you are worried it might cost too much.

[Rodimus Prime]

So in conclusion you think that it's justified that people don't have basic access to healthcare because you are worried it might cost too much.

no. what I am saying is there is no point for it unless the cost can be controlled.

As it stands there seems to be no way to pay for it or no plans to pay for it and more importantly no way to control the future cost which makes it impossible to plan for.

The rising healthcare cost in the CURRENT system are going to cause more and more people not to be able to afford it. Much less the government. To me the more long term problem that needs to be addressed before a nation wide healthcare system will work is stop the out of control cost or at least have a workable plan for it.

If they include a workable plan to stop the run away rising with the nation wide health insurance I am all for it.

[shinji]

Therefore, people get denied procedures that they need because the insurance company won't pay for them- too expensive and not profitable

I support universal healthcare, but keep in mind that countries with universal healthcare do not cover every single procedure and drug out there. There are drugs not covered in Canada...just one example http://www.cbc.ca/canada/nova-scotia/story/2007/07/13/drugs-avastin.html and the decision is made based on cost.

[.Andy]

what I am saying is there is no point for it unless the cost can be controlled.
Irrespective of the cost involved the the point is actually access to adequate basic healthcare. If the costs can be controlled or not that point will remain. You seem to be losing sight of what the actual point is.

it stands there seems to be no way to pay for it or no plans to pay for it and more importantly no way to control the future cost which makes it impossible to plan for.
It need not be repeated that healthcare is an investment in your population. It's not just lost dollars. It's a positive thing. Again other countries can do it. There's nothing special about the US in this regard that requires healthcare be out of reach of a significant proportion of the populace to make it workable.

To me the more long term problem that needs to be addressed before a nation wide healthcare system will work is stop the out of control cost or at least have a workable plan for it.
Why do these necessarily have to be two different initiatives separated by time? Why can't the problem of healthcare costs be addressed whilst also initiating a system whereby a significant percentage of the population doesn't languish with inadequate basic healthcare?

[Ugg]

I support universal healthcare, but keep in mind that countries with universal healthcare do not cover every single procedure and drug out there. There are drugs not covered in Canada...just one example http://www.cbc.ca/canada/nova-scotia/story/2007/07/13/drugs-avastin.html and the decision is made based on cost.

Absolutely and the question is, is every discovery of a Lorenzo's Oil, something that should be paid for with the public purse?

One of the biggest increases in medical costs in the past years has been in the over 65s. Unnecessary heroic measures for those with chronic conditions, trying to extend someone's live for six months or less and more positively, replacing knees, elbows, hips, etc so people over 65 can lead a productive life.

I personally know of a case where a morbidly obese woman who retired at age 55 from the military has had three knee replacements. The last one didn't take and she is now permanently confined to a wheelchair. At what point does insurance continue to pay for hopeless procedures?

It's a well known phenomena, that the poorest and the most religious are most likely to demand heroic end of life measures.

I believe Britain has a price tag of 50,000 pounds for extending a person's life for one year.

This is a question I've been trying to force more debate about. If we're unwilling to address end of life issues, then costs will balloon to the point where health care will be unaffordable for everyone, not simply the middle class.

[leekohler]

Absolutely and the question is, is every discovery of a Lorenzo's Oil, something that should be paid for with the public purse?

One of the biggest increases in medical costs in the past years has been in the over 65s. Unnecessary heroic measures for those with chronic conditions, trying to extend someone's live for six months or less and more positively, replacing knees, elbows, hips, etc so people over 65 can lead a productive life.

I personally know of a case where a morbidly obese woman who retired at age 55 from the military has had three knee replacements. The last one didn't take and she is now permanently confined to a wheelchair. At what point does insurance continue to pay for hopeless procedures?

It's a well known phenomena, that the poorest and the most religious are most likely to demand heroic end of life measures.

I believe Britain has a price tag of 50,000 pounds for extending a person's life for one year.

This is a question I've been trying to force more debate about. If we're unwilling to address end of life issues, then costs will balloon to the point where health care will be unaffordable for everyone, not simply the middle class.

Ugg, pardon me- but it sounds as if you're saying we refuse people medical care because they're too old. That's more than a bit creepy to me. I myself will need knee replacements in the future, but they don't want to do them until I'm in my 50's or later, if we can manage it.

[Ugg]

Ugg, pardon me- but it sounds as if you're saying we refuse people medical care because they're too old. That's more than a bit creepy to me. I myself will need knee replacements in the future, but they don't want to do them until I'm in my 50's or later, if we can manage it.

In your case, absolutely not. It makes sense for a person in their 50s to have knee replacements. It doesn't make sense for a 85 year old with Alzheimers to have knee replacements.

What I'm mostly trying to get across is that for most people who are approaching the end of their life, we shouldn't be spending hundreds of thousands of dollars on their last few weeks or months of life.

My paternal grandmother died in a hospice at the age of 98. She had kidney failure and was made comfortable rather than being forced to go in the hospital again for useless treatment.

My maternal grandmother collapsed at a friend's funeral. She was rushed to the local hospital where she wasn't able to be treated and then flown by helicopter to a larger hospital. She lived two more days and died at the age of 87 in the intensive care unit.

The thing was, is that she had made clear to everyone around her that she didn't want any heroic measures taken. When her time came, she was ready. She was in extreme pain those last few days and was in and out of consciousness.

I've no idea how much was spend on her on those last few days, but it had to have been a great deal of money. It's not what she wanted.

There needs to be some way of preventing the system from throwing hundreds of thousands of dollars on heroic measures for people who don't want them. And providing less expensive hospice care for those who are nearing the end of their lives.

[leekohler]

In your case, absolutely not. It makes sense for a person in their 50s to have knee replacements. It doesn't make sense for a 85 year old with Alzheimers to have knee replacements.

What I'm mostly trying to get across is that for most people who are approaching the end of their life, we shouldn't be spending hundreds of thousands of dollars on their last few weeks or months of life.

My paternal grandmother died in a hospice at the age of 98. She had kidney failure and was made comfortable rather than being forced to go in the hospital again for useless treatment.

My maternal grandmother collapsed at a friend's funeral. She was rushed to the local hospital where she wasn't able to be treated and then flown by helicopter to a larger hospital. She lived two more days and died at the age of 87 in the intensive care unit.

The thing was, is that she had made clear to everyone around her that she didn't want any heroic measures taken. When her time came, she was ready. She was in extreme pain those last few days and was in and out of consciousness.

I've no idea how much was spend on her on those last few days, but it had to have been a great deal of money. It's not what she wanted.

There needs to be some way of preventing the system from throwing hundreds of thousands of dollars on heroic measures for people who don't want them. And providing less expensive hospice care for those who are nearing the end of their lives.

That's fine- but it has to be the individual's choice.