Congr. report shows little or no savings with new drug card

[Ugg]

Link (http://baltimorechronicle.com/071204VIEW.shtml)

ODENTON, MD, JULY 12, 2004--At a Town Hall meeting at the Catherine O'Malley Senior Center in Odenton, US Rep. Benjamin L. Cardin today released a congressional report analyzing the 33 Medicare-approved prescription discount drug cards available to seniors in Maryland's Third Congressional District. The report found that the "drug cards are failing to provide significant discounts for seniors."

For example, the report showed that seniors using the Medicare-approved discount card to purchase a 30-day supply of the cholesterol-lowering drug Lipitor paid $68.48. For the same drug and quantity, the Canadian price was $49.85, the VA price was $36.48, and the retail price using Drugstore.com was $62.99. The discount drug cards can cost seniors up to $30 per year and are not accepted at all pharmacies.

The name for this fiasco should be "The Drug Company Benefit Act".



Now this sounds like a real benefit:

The Congressman has introduced the Preserving Medicare for All Act (HR 3702), which would lower prescription drug costs by allowing the US Department of Health and Human Services to use the purchasing power of 40 million Medicare beneficiaries to negotiate lower drug costs with pharmaceutical companies. It also would provide a guaranteed, universally available drug benefit option through Medicare, end discrimination against employer retiree plans, repeal the competition provisions that will threaten traditional Medicare, eliminate excess payments to private health plans, and repeal the expenditures cap that will result in harsh cuts to Medicare providers and patients.




We can only hope it gets some attention.

[Neserk]

Went to pick up a maintance medicaiton. Price for one monthe went from $20 to $30. Same med :rolleyes: Thanks for nothing, Dubya.

[bousozoku]

ABC News recently did an investigation that showed the price of various meds, esp. those televised, went way up three months before the cards took effect. Now, those same meds with the discount cards are even more expensive than they were.

[Sayhey]

Doesn't seem like Bush is going to be able to crow about a piece of legislation he lied about the cost and then doesn't even help the people it's suppose to help. It will be interesting to see how he explains this in the debates.

[Neserk]

Doesn't seem like Bush is going to be able to crow about a piece of legislation he lied about the cost and then doesn't even help the people it's suppose to help. It will be interesting to see how he explains this in the debates.


My prediction? He'll crow and continue to ignore the truth. That *is* his way!

[CandelLife]

A co-worker of mine pays some $600.00 a month for the prescription plan for herself and her husband to cover their medicines....the older you get, the more you need...and it's all pricey.

What gets me is you have few choices....people with ultra low to no income get medicaid.....people with full time jobs luck enough to work for a company that offers health insurance may or may not have a good plan. For what it costs for the family rate you'd think you'd be better off with your own personal health Insurance away from the company....but then we come to the in-between....

The ones (Like myself who works 30 hours a week) will not have company sponsored health insurance, and does not qualify for freebie-medicaid either....can't afford my own....Kids are covered through medicaid because they basically cover all kids.....but for myself, I better hope to NEVER get sick....

Some prescriptions I have had to fill are $90.00 and up for a very small quantity......There's alot more people out there not covered than they talk about.

[zimv20]

My prediction? He'll crow and continue to ignore the truth. That *is* his way!
indeed. it'll be painted as a win no matter what, probably w/ some BS anecdote about one person who now pays a little less.

[Flex]

A long time ago I worked as a field service technician for a company that wrote software that various private pharmacies used to fill prescriptions. Because of the potential slanderous remarks I'm about to make I will not name names.

First off it had a psuedo discount imbedded in the code. This code takes the cash price of the prescription in the event of being presented a senior citizen discount will first raise the price of the prescription 10% placing that amount in the cash field then giving the customer a 10% discount. Pharmacist didn't like this code because the idiots who coded didn't realize raising 100 bucks by 110% and then decreasing 110 bucks to 90% got you 99 bucks a loss of 1 buck to the pharmacist. This 1 dollar represented their real profit on medispan patients.

The pharmacist argument for ripping off their customers is that whenever they fill a prescription it did not matter whether the presciption cost them 5 bucks or 500 bucks they were still only allowed to make 1.50 dollars profit off of the sale. Medispan also knew about their rebates that they received from drug companies for paying on time and therefore assumed they would always pay their drug suppliers on time and took that into account in the equation. However, They usually did not pay on time because they would have to wait 6 - 12 months for Medispan to pay their tab.

This is why so many pharmacies don't take medispan or medicare. The big chains like Walgreens, Wal-mart, Eckerds, etc could make better deals and thus bigger profits and for some reasons medispan did not take their profit away from them or if they did they simply considered it an investment in getting the customer into their store.

Issueing a drug card does not change how much drugs cost. They have to compensate for any loss through the raising of pricing of the drugs themselves or somewhere else to compensate. These places that sale the drugs to the customers are already at rock bottom pricing and any lower they will not make a profit. In fact in several cases they actually take a loss in the sale.


If you make it cheaper on poor people you make it more expensive on other folks and that isn't right either. Buy generics, use tums or some cheap ant acid instead of the best on the market. You don't automatically expect to be able to have the best food, house, or car on the market neither should you expect the best medical care on the market, at least not without paying what it actually costs to provide.

Personally though I think they should allow us to buy drugs from anywhere we want to, including Canada and Mexico. Folks who buy from none FDA approved facilities will have to take their own risks though so buyer beware.

[Ugg]

Issueing a drug card does not change how much drugs cost. They have to compensate for any loss through the raising of pricing of the drugs themselves or somewhere else to compensate. These places that sale the drugs to the customers are already at rock bottom pricing and any lower they will not make a profit. In fact in several cases they actually take a loss in the sale.






You do have a good point, the bigger bird always gets the biggest worm, there's nothing unusual in that. What the drug benefit does however is disallow Medicare from negotiating directly with the drug companies and by doing so removes one of the cornerstones of US economic activity, volume pricing. It also allows drug companies to raise prices on a WEEKLY basis, while only allowing the consumer the chance to change plans once per year.

Both of these show that gw & co. is less interested in market based pricing and more interested in gouging the little guy while charging the US treasury billions of dollars. While it can be argued that business activity will increase as a result, it will increase only on the backs of those who can least afford it.

[Chip NoVaMac]

My prediction? He'll crow and continue to ignore the truth. That *is* his way!

My feeling exactly!

And the way AARP rolled over for this just makes me sick. I was all set to join them till their backing of the Drug Company Benefit Act.

As the only remaining Super Power it is sad that people die because there is not rational healthcare policies that don't make people choose the basics of life (food and shelter).

[Chip NoVaMac]

If you make it cheaper on poor people you make it more expensive on other folks and that isn't right either. Buy generics, use tums or some cheap ant acid instead of the best on the market. You don't automatically expect to be able to have the best food, house, or car on the market neither should you expect the best medical care on the market, at least not without paying what it actually costs to provide.

Personally though I think they should allow us to buy drugs from anywhere we want to, including Canada and Mexico. Folks who buy from none FDA approved facilities will have to take their own risks though so buyer beware.

More of "I have mine. now you get yours". I just hope Flex/Sly/Voltron is always able to have his.

My own home situation has shown how things can change for the worse, even if only temporary. My other half just got turned down for his own "cheaper" health insurance because he was treated for ashama (sp) about 6 months ago. So he is still tied to a high cost COBRA policy ($500 a month); but only for another 12 months or so.

[CandelLife]

Personally though I think they should allow us to buy drugs from anywhere we want to, including Canada and Mexico. Folks who buy from none FDA approved facilities will have to take their own risks though so buyer beware.


My friend that pays $600.00 a month does get her meds from a place in Canada, over the internet....she also talks to them on the phone, and still, it costs her $600.00 a month.

[zimv20]

the only remaining Supper Power
that made me laugh :-)

[Chip NoVaMac]

that made me laugh :-)

Now we have spelling police :D

[IJ Reilly]

Now we have spelling police :D

Feat back and spread 'em!

[zimv20]

Now we have spelling police :D
nah, i was just thinking of UN Resolution 1642 on Chili con Carne

[Chip NoVaMac]

nah, i was just thinking of UN Resolution 1642 on Chili con Carne

Now with the right chili peppers that can be a true WMD! :D

[skunk]

Now we have spelling police :D
NOBODY expects the Spellish Inquisition...

[Chip NoVaMac]

NOBODY expects the Spellish Inquisition...

And in true US fashion we have the Spelling Police and the Grammar Police, each doing their own thing! :D

Next will be the addition of the Smiley Police. :)

Oops, BRB there is a knock at the door....

[Sun Baked]

Next will be the addition of the Smiley Police. :)

Oops, BRB there is a knock at the door....
http://forums.macrumors.com/attachment.php?attachmentid=9395&stc=1

Mexico has probably arrested a dozen people going down there to get "cheap" meds.

So you have to watch out for yourself if you go south for meds.

[Chip NoVaMac]

http://forums.macrumors.com/attachment.php?attachmentid=9395&stc=1

Mexico has probably arrested a dozen people going down there to get "cheap" meds.

So you have to watch out for yourself if you go south for meds.

Is this enforcement new? Or is it something they have always done?

[Sun Baked]

Is this enforcement new? Or is it something they have always done?It's something they've always done, but the majority of the people getting nailed were the ones coming across the border to traffic in pain pills.

http://www.azcentral.com/12news/news/articles/0709prescription09-CP.html

[skunk]

The Hispanic Inquisition?

[Backtothemac]

Why should the government have to pay to keep us alive? Or better yet, why should all of you have to pay for my fathers precriptions? Would that not be his responsiblity? And if he can't then mine?

Social welfare is a joke.

[skunk]

Why should the government have to pay to keep us alive? Or better yet, why should all of you have to pay for my fathers precriptions? Would that not be his responsiblity? And if he can't then mine?
And if YOU can't, what then?

It has been said many times here before, but we ALL suffer from our fellow humans' desperation and destitution. Enlightened self-interest requires social welfare.

[Chip NoVaMac]

It's something they've always done, but the majority of the people getting nailed were the ones coming across the border to traffic in pain pills.

http://www.azcentral.com/12news/news/articles/0709prescription09-CP.html

Very sad. I guess I was asking, since I wonder if back channels from the Bush administration (not bashing here, but the people he places into positions drive policy that he has to accept blame for) were used to increase detection of this sort of thing.

[Sun Baked]

Very sad. I guess I was asking, since I wonder if back channels from the Bush administration (not bashing here, but the people he places into positions drive policy that he has to accept blame for) were used to increase detection of this sort of thing.About the only thing to blame for the increase in the number of seniors getting nailed in Mexico is probably just the cost of their drugs and the increased willingness of seniors to travel to get them.

I thought it was illegal on the US side now anyway (the law used shut down RxDepot), but the fed law enforcement said they were not planning on arresting seniors going to get their meds from Mexico or Canada.

[Chip NoVaMac]

Why should the government have to pay to keep us alive? Or better yet, why should all of you have to pay for my fathers precriptions? Would that not be his responsiblity? And if he can't then mine?

Social welfare is a joke.

Now you are scaring me.

If you, or your father was unable to afford medications to improve your quality of life; then I for one have no problem with my tax dollars being spent on that.

You are a good son to come to the aid of your Dad. Many others are not. Some for personal reasons due to deep family issues. Others because they can barely care for themselves.

So are you saying that we should have laws that demand that children pay all costs of caring for their parents? Or that parents be required to pay all costs of caring for their adult children?

Please let me know what politicians you support that believes in these thoughts of yours in your post. I would like to make sure that they don't get into office.

[Chip NoVaMac]

About the only thing to blame for the increase in the number of seniors getting nailed in Mexico is probably just the cost of their drugs and the increased willingness of seniors to travel to get them.

I thought it was illegal on the US side now anyway (the law used shut down RxDepot), but the fed law enforcement said they were not planning on arresting seniors going to get their meds from Mexico or Canada.

That doesn't stop them from asking Mexico to step up enforcement.

Sorry, it is that I have little trust in the administration at this point of doing the right thing.

[Backtothemac]

Now you are scaring me.

If you, or your father was unable to afford medications to improve your quality of life; then I for one have no problem with my tax dollars being spent on that.

You are a good son to come to the aid of your Dad. Many others are not. Some for personal reasons due to deep family issues. Others because they can barely care for themselves.

So are you saying that we should have laws that demand that children pay all costs of caring for their parents? Or that parents be required to pay all costs of caring for their adult children?

Please let me know what politicians you support that believes in these thoughts of yours in your post. I would like to make sure that they don't get into office.

In many cultures, it is law that the children support their parents late in life. I really don't like tax dollars going to things such as this. We spend billions keeping people alive that eventually will die. If someone is 80, why spend thousands upon thousands of dollars a year to keep them going for what? Another year or two? Why? I am not talking about someone that is 30 and has to take Diabetic medicaiton, I am talking about the rich getting richer off of medicine. Like my mom for example. Before my mother died in 1986, we were having to spend over 2,000 a month in medications. That was a lot of money in 1986. We did that for over two years. Now, did the two years that she was here, was it worth the money, the suffering, the pain to spend the money on the drugs? There was no hope for cure, just sustaining her until she died.

The alternative would have been to let her die. That would have been an additional 24,000 that I would have had for college, etc. That would have been 2 years less of suffering that she would have had to endure. I guess I equate expensive drugs with not curing people, but sustaing them.

If the law would pay for life saving drugs, then yes, I would support it. But if the drugs only sustain a level of life that can hardly be considered life, then what is the point. That is what I don't want my money going to.

[Backtothemac]

And if YOU can't, what then?

It has been said many times here before, but we ALL suffer from our fellow humans' desperation and destitution. Enlightened self-interest requires social welfare.

No, policy requires social welfare. This country has been involved in social welfare for what? 70 years? Before that what? None. It is something that has been sold on our society. The taxes that we pay to support the social welfare system are taxes that we should not be forced to pay. Why should I pay social security? What so the government can earn 1.5%? I could invest that money and make 10 times that. But, going back to my thread. They know better than the individual. I can't accept that. This is one of the things that Bush has screwed the pooch on. We don't need bigger governmnet taking our money, and doing things that they should leave us to do. They should not get bigger, and point the finger at me to do more. They should let the individual decide their own fate.

[skunk]

No, policy requires social welfare. This country has been involved in social welfare for what? 70 years? Before that what? None.
You want to go back to the thirties?

[blackfox]

No, policy requires social welfare. This country has been involved in social welfare for what? 70 years? Before that what? None. It is something that has been sold on our society. The taxes that we pay to support the social welfare system are taxes that we should not be forced to pay. Why should I pay social security? What so the government can earn 1.5%? I could invest that money and make 10 times that. But, going back to my thread. They know better than the individual. I can't accept that. This is one of the things that Bush has screwed the pooch on. We don't need bigger governmnet taking our money, and doing things that they should leave us to do. They should not get bigger, and point the finger at me to do more. They should let the individual decide their own fate.
BTTM, while it is perhaps true that institutionalized welfare has been around for only a fairly short time, society has changed much from then to now (obviously)...among these changes is a relative breakdown of the traditional family safety-net/cooperative as people migrated to cities, birth-rates lessened and competetive individualism took hold in regards to getting ahead...I would say that it is the very attitude you expouse that requires an institutionalized safety-net, as we as a society no longer look at ourselves as a large group needing to cooperate, but as individuals who need to look out for #1...
I do not think the government knows better than the individual in some senses, as it cannot be as particular as that implies, but it does try to take care of the needs of the whole, which although sometimes averaged or imperfect, have a greater scope and inclusiveness than narrowed self-interest or just the scope of an individuals connection to the society around them.

I do not think the government needs to necessarily get bigger, I think that is often used as a red herring...there is much that can be slimmed down about modern government, a program of social welfare is not one of them...this comes down to efficiency, not morality here. I can understand not wanting to add to the bloat, but I believe that bloat can be addressed and savings be channeled into appropriate social services.

[zimv20]

Why should the government have to pay to keep us alive? Or better yet, why should all of you have to pay for my fathers precriptions? Would that not be his responsiblity? And if he can't then mine?

Social welfare is a joke.
at least part of the idea of any group program is the ability to negotiate lower rates

[IJ Reilly]

To suggest that social welfare programs in the US are something very recent isn't totally accurate. The government has been making things economically possible for various individuals and groups a very long time. One of the biggest social welfare programs of all time was the Homestead Act of 1865.

[mactastic]

Why should the government have to pay to keep us alive? Or better yet, why should all of you have to pay for my fathers precriptions? Would that not be his responsiblity? And if he can't then mine?

Social welfare is a joke.

OK, I'm quoting you here so this one's aimed right at you. Why should the government be involved in social programs? Because if they don't the economic consequences will be worse. They pay (or less rhetorically loaded, they HELP pay) for your fathers medication so it doesn't break him financially and send him out onto the streets where it becomes a local government burden. Even if the local government declines to help him you have to factor in the economic consequences of homeless old guys on the streets begging for change. That can really put a crimp in your downtown redevelopment plan if there are a few hundred elderly on your streets. In addition, who pays for the medical care they receive when they require a trip to the emergency room? ER trips cost a hell of a lot more than regular doctor visits, but because we deny preventative care yet allow unquestioned trips to the ER which route do you think the poor will use when they are in dire need? That's right, the costly ER visit.

I suppose you could say that we should just allow those without insurance or any kind of saftey net to simply die rather than take them to the hospital, but what happens the day you (assuming you have health insurance, I don't want to assume that I know you) forget your card and get hit by a bus crossing the street. Do you deserve to die that day because you can't prove you can afford care? Or do hospitals have to help you regardless?

The idea that society can do without social welfare is a joke.

[IJ Reilly]

I suppose you could say that we should just allow those without insurance or any kind of saftey net to simply die rather than take them to the hospital, but what happens the day you (assuming you have health insurance, I don't want to assume that I know you) forget your card and get hit by a bus crossing the street. Do you deserve to die that day because you can't prove you can afford care? Or do hospitals have to help you regardless?

If the government would just stop providing services to people who didn't deserve them, then nobody would ever have to worry about getting hit by a bus.

[mactastic]

If the government would just stop providing services to people who didn't deserve them, then nobody would ever have to worry about getting hit by a bus.

Impeccable logic as always IJ. :p

[Backtothemac]

If the government would just stop providing services to people who didn't deserve them, then nobody would ever have to worry about getting hit by a bus.

Actually, even though this is tounge in cheek, it is 100% right. For example, Scottie Pippen (you know, Chicago Bulls) owns a farm. Scottie recieves over $40,000 a year in subsidies.

Does he really ****ing need that? That is the waste that pisses me off.

How about the woman that comes into my store with 7 kids. No job, and pregnant with another, and when I confront her says that she will never work because why would she want to when everything is paid for her.

Mactastic......
Yea, saw the quote. Thanks for clarifying that you were talking to me, although I am certain when someone is and isn't.

To answer for you. My family, we don't have medical insurance. So, in February when I went to the ER, it cost me a ton of money. NOT THE GOVERNMENTS FAULT, OR RESPONSIBLITY. I will be very clear on this. I am not a person that says one thing and lives another. I don't want government insurance. I pay my own way in life. Whether my family has what it needs, it is my fault, and mine only. If my dad doesn't have his money it is my fault or his.

Re read the post about my mom. We as a society will allow for abortion, pay millions to keep rapists, and child mollesters alive, and yet someone that is dying can't choose to die. What does that say about us.

It was once said that you can judge a society by the way in which it treats its prisoners, I think that a society can be judged by whether it forces life, and thus debt on its elderly.

I don't want to pay to keep grandpa alive and suffering for a couple of extra years so some fat cat rich guy can make a bit more money. That is why I say social welfare is a joke, because it really does damn more people than it helps. I remember the people when I was a kid that was on welfare and food stamps, etc. Of all of the people that were on it, guess what, they are all still on some sort of government assistance.

We need a radical change in this society where someone has the balls to say, take care of your damn self. Now I am not talking about someone that was in a bad accident an can't work for a year. Or the worker that was laid off from his job of 20 years. But the people that are a drain on the system, and who break the law by cheating the system. Those are the ones that I don't want to support.

So let me be clear. I support helping those people that really need help. But, the largest part of the budget every year is the social welfare costs. Can we not find a way to fix them, really help people, and force those that lie their way through it to change, thus allowing us to more for the country as a whole.

That is why it is a joke.

[Neserk]

Or do hospitals have to help you regardless?


Hospitals have to help you regardless. If you can't pay the bill and they refuse to acknowledge that you have 1 choice: File for Bankruptcy, in which case everyone pays for it.

They write it off and get a tax break. It is better that the gov't steps in and provides care for all. In many cases it is better that they provide *preventive* care which is much cheaper than ER care!

[LethalWolfe]

More of "I have mine. now you get yours". I just hope Flex/Sly/Voltron is always able to have his.

My own home situation has shown how things can change for the worse, even if only temporary. My other half just got turned down for his own "cheaper" health insurance because he was treated for ashama (sp) about 6 months ago. So he is still tied to a high cost COBRA policy ($500 a month); but only for another 12 months or so.

I don't believe the "I have mine. Now you get yours." is a bad basic foundation. And this comes from someone who's run the gambit when it comes to having, and not having, medical insurance.


Lethal

[Chip NoVaMac]

I don't believe the "I have mine. Now you get yours." is a bad basic foundation. And this comes from someone who's run the gambit when it comes to having, and not having, medical insurance.


Lethal

This is so sad that we have come to this as a "national policy". Did we not learn from the '80's and '90's that greed is not good?

I agree that changes in the social welfare system are needed. It is said give a man a fish, and he'll eat for a day. Teach him to fish and he'll eat for a lifetime.
As long as politicians have access to healthcare through the government (much better than what you and I can get) paid by our tax dollars, nothing will change.

One possible solution is to tax the hell out of the drug companies. Use that money to fund a universal healthcare system.

[mactastic]

Mactastic......
Yea, saw the quote. Thanks for clarifying that you were talking to me, although I am certain when someone is and isn't.

Not to belabour the point, but I don't think you do. Or you get mixed up sometimes.

To answer for you. My family, we don't have medical insurance. So, in February when I went to the ER, it cost me a ton of money. NOT THE GOVERNMENTS FAULT, OR RESPONSIBLITY. I will be very clear on this. I am not a person that says one thing and lives another. I don't want government insurance. I pay my own way in life. Whether my family has what it needs, it is my fault, and mine only. If my dad doesn't have his money it is my fault or his.

But how do you propose to deal with those who abuse the system? What if they use the hospital and then skip out on the bill? Who pays then? I'm glad you personally are responsible and all, but (and don't take this the wrong way) I don't have that much faith in the rest of the world.

Re read the post about my mom. We as a society will allow for abortion, pay millions to keep rapists, and child mollesters alive, and yet someone that is dying can't choose to die. What does that say about us.

Ok, lets look at this line by line. "We as a society allow for abortion" Well at least you aren't directly saying federal funds pay for abortions this time. But you ARE insinuating it, and I believe you've been corrected on this point before. "Pay millions to keep rapists and child molesters alive" Versus paying millions to execute them. Would you rather err on the side of not executing the innocent, or would you rather err on the side of saving money when you face your Lord? "And yet someone that is dying can't choose to die" I think we're in agreement here, I support the right to die as a personal freedom. But don't assume everyone who is old and poor wants to die.

It was once said that you can judge a society by the way in which it treats its prisoners, I think that a society can be judged by whether it forces life, and thus debt on its elderly.

Personally I'm more of the view that you judge a society by how it treats the least among it. Elderly are not the least among us. Although in our society they sure don't get the respect they get elsewhere.

I don't want to pay to keep grandpa alive and suffering for a couple of extra years so some fat cat rich guy can make a bit more money. That is why I say social welfare is a joke, because it really does damn more people than it helps. I remember the people when I was a kid that was on welfare and food stamps, etc. Of all of the people that were on it, guess what, they are all still on some sort of government assistance.

How about keeping grandpa alive for a few more years so he gets to meet his grandchildren? Even if some fat cat does get rich off it. Besides, I thought you were passionate about the right of fat cats to get fatter? And how does grampa have anything to do with the chronic abusers of social systems? And why are they more deserving of your ire than government workers using government credit cards for boob jobs for their girlfriends?

We need a radical change in this society where someone has the balls to say, take care of your damn self. Now I am not talking about someone that was in a bad accident an can't work for a year. Or the worker that was laid off from his job of 20 years. But the people that are a drain on the system, and who break the law by cheating the system. Those are the ones that I don't want to support.

I agree. But scrapping the social welfare programs isn't the way to fix this. Reform is fine. But what makes you think these scammers won't just go scam the churches instead of the government if that was where the money was? Lets not toss the baby out with the bathwater, ya know?

So let me be clear. I support helping those people that really need help. But, the largest part of the budget every year is the social welfare costs. Can we not find a way to fix them, really help people, and force those that lie their way through it to change, thus allowing us to more for the country as a whole.

Yes, we can and we should. But a blanket statement like 'social programs are a joke' aren't helpful in the least.

That is why it is a joke.

How do you propose we fix it? How do you write the rules such that you help all those that need it without helping any that don't? It's analogous to the discussion we were having about What Is Trolling? The conclusion seemed to be that there was no way of defining it, and it came down to respect. In that case it comes down to responsibility. And how do you legislate responsibility? I've yet to hear a good answer on that one.

[Neserk]

We spend billions keeping people alive that eventually will die. .


We are ALL going to die. I swear you said you were a social liberal. What exactly does that mean to you?

[Backtothemac]

We are ALL going to die. I swear you said you were a social liberal. What exactly does that mean to you?

I am a social liberal in that I believe that no one can make moral judgements for someone else. Now, that doesn't apply across the board, i.e. murder. However, no one can tell someone that they can't have an abortion because God would not approve. That person may not believe in God. I am personally 100% against abortion, but since I cannot give a valid reason against it other than every life should have the right to live, than I cannot deny a woman one based on my opinion.

I also belive that society should not tell you who you can and cannot love. If a man loves a man, good for him. At least he is loving. Isn't that point of Jesus anyway? Love? 1st Corinthians Chapter 13. Yea, that would justify a ban on Gay marriage right? No, it would not, it would tell everyone to learn to love.

I also believe in helping people, but not on a federal level. I think that states should create their own systems that help those in their communities better. The requirements in Alabama are far different than for someone that lives in Hollywood. Folks there need more help when they need it than someone from Alabama.

I speak of people dying from experience. I think we need a Euthenasia law that would allow those that are termanially ill the right to die. We have the right to life, it is ours, we own that right. Should we in turn not have the right to refuse that right as if we could refuse our right to a jury trial. Or to a lawyer? No right is absolute, not even the right to life, thus the justification of abortion in my mind. So, I am liberal, but I am common sense. As I have said, I don't think the government paying private industry top dollar for drugs that may, or may not help someone is not a good thing. However, if the drug can cure, or radically improve the quality of life, then I say do it. If it maintains the individual on a level of life that is continually degrading (i.e. my mother's example) then no, I don't support that one. If a family chooses to keep someone alive when there is no benifit to the person, other than the benifit that the family doesn't have to deal with the person's death a little long, then I don't support the government paying for that. That should be the family's responsiblity.

[Neserk]

You might consider yourself socially liberal but I would not call you that.

[Backtothemac]

You might consider yourself socially liberal but I would not call you that.

Really? What would you call it? Just curious.

[blackfox]

Mac, excellent post (the longer one)...and BTTM, your post was also excellent.

Why did I choose to mention two posts which argued against each other? Because they were both right. They were both right because this is an extremely complicated issue evolving over time involving tens-if-not-hundreds-of millions of people.

From BTTM's perspective his argument is justified. Mac's argument shows why in a larger.different frame of reference it is wrong, incomplete, or simplistic.

The truth is, I don't believe any of us can encapsulate the sheer complexity of the situation, and our individual limitations on our perceptions the scope and causes of the problem will always make are judgements incomplete.

It is for that reason that I want the government to provide and be in charge of social services.

Even a good and wise individual, cannot come as close as a government and the consensus (however imperfect) implied, to understanding the problem and providing a solution.

IMO, it really comes down to that.

[LethalWolfe]

This is so sad that we have come to this as a "national policy". Did we not learn from the '80's and '90's that greed is not good?

I agree that changes in the social welfare system are needed. It is said give a man a fish, and he'll eat for a day. Teach him to fish and he'll eat for a lifetime.
As long as politicians have access to healthcare through the government (much better than what you and I can get) paid by our tax dollars, nothing will change.

One possible solution is to tax the hell out of the drug companies. Use that money to fund a universal healthcare system.

I don't think it's greed. I think it's fair. Of course I also think sense we are on the opposite sides of this we are invisoning opposite worst case scenerios. I'm not in favor of "tossing people out into the cold" anymore than I think you are in favor of taxing people to the point of financial success becoming more penality than reward.
If someone needs a helping hand I think they should get it. I think everyone should have access to basic heathcare. And if someone is able to afford better services they should be able to purchase them. But I don't think we should force everyone onto the same tier. Of course ideally it would be wonderful, but life isn't fair let alone ideal. ;)

I like B2TM's view of shifting it from Federal to State level.


Lethal

[Chip NoVaMac]

I am a social liberal in that I believe that no one can make moral judgements for someone else.

BTTM, you are an example that the liberal/conservative labels are just that, labels. And a label doesn't always fit.

I tell people that that I am a conservative liberal fiscally responsible Democrat with moderate leanings :D

[Chip NoVaMac]

I don't think it's greed. I think it's fair. Of course I also think sense we are on the opposite sides of this we are invisoning opposite worst case scenerios. I'm not in favor of "tossing people out into the cold" anymore than I think you are in favor of taxing people to the point of financial success becoming more penality than reward.
If someone needs a helping hand I think they should get it. I think everyone should have access to basic heathcare. And if someone is able to afford better services they should be able to purchase them. But I don't think we should force everyone onto the same tier. Of course ideally it would be wonderful, but life isn't fair let alone ideal. ;)

I like B2TM's view of shifting it from Federal to State level.


Lethal

I just look at the changes in the last 20 years or so and shake my head. It used to be a company had layoffs and their stock went down, today the stock goes up.

Use to be that you did right for your employer and they did right for you. Now you have companies that move jobs and themselves offshore.

We have lost sight of the Golden Rule. Do unto others as you would have them do unto you. Either that, or it now meant that you better ****** someone over, before they ****** you over.

[takao]

nice discussion on a very interesting topic
it gives the reader outside of the US an idea of problems he might not have been aware of (at least i didn't know about the US having problems with healthcare)

personal opinion: i will keep out of this discussion because....i think i am too "spoiled" by the system here ...

[Chip NoVaMac]

nice discussion on a very interesting topic
it gives the reader outside of the US an idea of problems he might not have been aware of (at least i didn't know about the US having problems with healthcare)

personal opinion: i will keep out of this discussion because....i think i am too "spoiled" by the system here ...

Please don't stay out. It would be great to hear the realities (through your eyes of couse) of what a national healthcare system can be like. As with our politics we have two polarized views of a national healthcare system. One is that is good for what ails the current healthcare system; the other is that is is the worst medical care one can have.

[skunk]

Please don't stay out. It would be great to hear the realities (through your eyes of couse) of what a national healthcare system can be like.
It's a pity there aren't any CESMs on this forum: they have one of the best national healthcare systems around. Ours is a bit clogged up, but it works, eventually. You may have to wait a bit, but as a trade-off for not having a crippling bill arrive on the doorstep every month, I reckon it's worth it. I doubt if our taxes are that much higher than yours, overall. And our Budget is relatively balanced...

We can, of course, opt for private treatment, with or without insurance, but the principle is that everybody pays towards the NHS willy-nilly.

[takao]

It's a pity there aren't any CESMs on this forum: they have one of the best national healthcare systems around. Ours is a bit clogged up, but it works, eventually. You may have to wait a bit, but as a trade-off for not having a crippling bill arrive on the doorstep every month, I reckon it's worth it. I doubt if our taxes are that much higher than yours, overall. And our Budget is relatively balanced...

We can, of course, opt for private treatment, with or without insurance, but the principle is that everybody pays towards the NHS willy-nilly.

off topic: what does "CESM" mean ?

well it all comes down what you want

here we have a system where you have to be insured: and you can choose what you want: pay 3,7% of your income and have your _whole_ familiy protected (as long as your kids are students or going into schools...i'm 21 since today..my sister is 23,5 , my small brother is 12,5 and we are all covered by the 3,7% our father pays ...our mother only is working perhaps 10 hours a week and not paying healthcare because of the small income)...or your other choice is a private insurance (which is in fact a lotmore expensive but also more luxury...) sure some people are whining about the 3,7% beeing soooo much (as long as they are healthy) but how much of the population is covered ? 99% ...and most of the 1% of the people who remain don't know that they are not insured (divorce etc.) anymore...

the other choice is a system where health care is voluntary and with only private companies available (who want to make profit of course) where perhaps 90% (?) are covered by insurance and complaining about high prices ...

so my choice is the former where more people are covered because people complain about healthcare being expensive in either way ;)

[skunk]

off topic: what does "CESM" mean ?
A Frenchman. Courtesy of Homer Simpson. :)

[takao]

A Frenchman. Courtesy of Homer Simpson. :)

ahh the "cheese eating surrender monkey"

i always forget that sentence..perhaps because this sentence was translated more senisitve into the german version ;)

[Chip NoVaMac]

off topic: what does "CESM" mean ?

well it all comes down what you want

here we have a system where you have to be insured: and you can choose what you want: pay 3,7% of your income and have your _whole_ familiy protected (as long as your kids are students or going into schools...i'm 21 since today..my sister is 23,5 , my small brother is 12,5 and we are all covered by the 3,7% our father pays ...our mother only is working perhaps 10 hours a week and not paying healthcare because of the small income)...or your other choice is a private insurance (which is in fact a lotmore expensive but also more luxury...) sure some people are whining about the 3,7% beeing soooo much (as long as they are healthy) but how much of the population is covered ? 99% ...and most of the 1% of the people who remain don't know that they are not insured (divorce etc.) anymore...

the other choice is a system where health care is voluntary and with only private companies available (who want to make profit of course) where perhaps 90% (?) are covered by insurance and complaining about high prices ...

so my choice is the former where more people are covered because people complain about healthcare being expensive in either way ;)

3.7% is not bad whether one is single or a family. My insurance is $100 a month, my employer picks up the rest (I think their portion is like $125) for a single. Family coverage is $250 a month.

What about the quality of care? There are those that say any national healthcare system leads to poorer quality of care.

[skunk]

3.7% is not bad whether one is single or a family. My insurance is $100 a month, my employer picks up the rest (I think their portion is like $125) for a single. Family coverage is $250 a month.

What about the quality of care? There are those that say any national healthcare system leads to poorer quality of care.
Our "National Insurance Contributions" are about 10% of earnings up to a ceiling. Whether this is ring-fenced, and whether it covers the true costs, I am not so sure.

[Backtothemac]

Ok, for a federal model how about this.

1st Unemployment assistance. Three times during the course of your life for up to 12 months at a time in non concurrent years, you can qualify for unemployment assistance if you have worked in the previous 6 months, and were either laid off, or fired from your job. The assistance that you get will be equal to the average household income in your state. The number of children that you have is irrelevant. During the 12 months, you will also be eligible for education assistance so that you will be better qualified to go into the workplace, you will recieve consultation on how to keep a job, or how to better market yourself.

2nd Medical Assistance. Everyone who makes less than 1/2 of the average income of the state in which they reside will be entitled to free medical care. 100% coverage, with full drug card benifit. Although the drugs will have to be approved by three Doctors so that no one doctor could make a deal with a drug company and exploit the system. Everyone who makes the average income will recieve a drug card for their children that will pay for all of the childrens meds, again when approved by three Doctors. The children will have free healthcare through subsidies from the state in which they live. Everyone making the average or over will not be entitled to any government assistance at all for medical.

3rd Housing. Everyone who is earning less than 1/2 of the average income of the state in which they reside will be entitled to government subsided houseing. Not the getto's that exist now, but new, nice wonderful neighborhoods that give people a sense of pride about where they live. But, here is the catch. If the law isn't mowed, if the house isn't clean, if pride is not taken in their house, they will be charged with a criminal offense, removed from the progam, and banned for life.

4th Education. Every child that has a 3.0 GPA, and above average scores on the SAT or ACT will have a free education to a state school. Everyone below that will be eligible for financial aid. A students aid ability will no longer be based on their parents income, but based on the IQ, GPA, and SAT scores of the student. The parents income is irrelevant. Students can receive loans for up to 15,000 a year from the federal government starting as Freshman and progressing to 20,000 a year as a junior and senior. However, failure to payback your student loans will result in a criminal charge of fraudulent misrepresentation. Not default of a loan. In other words, if you use it, you pay it back. Period.

5th Social enrichment. Everyone that donates either 5 hours a week, or a 1/10th of their income will be exempt from paying 1/2 of their federal income tax burden. THis will encourage people to volunteer for all of these programs instead of having to pay people to do it, thus saving money in the end.

That is all I can think of now, ask questions if you have them.

[Chip NoVaMac]

Very strong ideas there BTTM. Though I question tying many of the proposals to the average state income. At least in Virginia there is great disparity in the income levels based on location.

Before I give figures of the disparity, it would be helpful how you are defining "average income". Is it household or individual? And would not the median income for either of those be a better gage?

Though your employment assistance is maybe too generous. And depending on the sector of the workforce you are in, three times in your career may not be right either. Sure beats the $225 a week unemployment that Virginia provides right now. Given the cost of living in the Northern Virginia area (1 to 2 bedrooms are $800+ a month, if you can find them that low).

[pseudobrit]

Very strong ideas there BTTM. Though I question tying many of the proposals to the average state income. At least in Virginia there is great disparity in the income levels based on location.

Before I give figures of the disparity, it would be helpful how you are defining "average income". Is it household or individual? And would not the median income for either of those be a better gage?

Though your employment assistance is maybe too generous. And depending on the sector of the workforce you are in, three times in your career may not be right either. Sure beats the $225 a week unemployment that Virginia provides right now. Given the cost of living in the Northern Virginia area (1 to 2 bedrooms are $800+ a month, if you can find them that low).

Unemployment compensation is currently nowhere near as generous as BTTM's plan is, and I agree it should have no "three strikes" limit. There is simply no way you can ensure you're not laid off or fired from a job. It's not your fault if the economy sucks or your boss is a dick and the only thing UC really does is keep you out of the gutter; many still go bankrupt.

I think one thing to consider in the healthcare arena would be a graduated assistance programme. Have the government cover a certain percentage of the healthcare needs all the way up to the average income.

[Backtothemac]

Unemployment compensation is currently nowhere near as generous as BTTM's plan is, and I agree it should have no "three strikes" limit. There is simply no way you can ensure you're not laid off or fired from a job. It's not your fault if the economy sucks or your boss is a dick and the only thing UC really does is keep you out of the gutter; many still go bankrupt.

I think one thing to consider in the healthcare arena would be a graduated assistance programme. Have the government cover a certain percentage of the healthcare needs all the way up to the average income.

Well, that is the idea. Be very generous when someone has that emergency, however, do we really need it more than three times in our life for a year? I was laid off two weeks before 9/11. It took me 4 months to find a job. But I am 34, and that is the only time in my life that I have been without a job longer than one week.

So, how many times should it be eligible? 4, 5? I want a fixed amount, because it is so generous. I don't want someone on, then off, then on, then off, then on, then off, etc. That would not work. So, what would be a good set number of times?

[Chip NoVaMac]

Well, that is the idea. Be very generous when someone has that emergency, however, do we really need it more than three times in our life for a year? I was laid off two weeks before 9/11. It took me 4 months to find a job. But I am 34, and that is the only time in my life that I have been without a job longer than one week.

So, how many times should it be eligible? 4, 5? I want a fixed amount, because it is so generous. I don't want someone on, then off, then on, then off, then on, then off, etc. That would not work. So, what would be a good set number of times?

Maybe 36 months over a career might be workable.

But the other side of the unemployment coin is the age discrimination that is going on. If a worker is over 40 it is harder for them to re-enter a decent job.

One of the women that I work with has a husband that has been unemployed since 9/11. They live on the Jersey shore, in-between Phili and NYC. He has no problem commuting to either of those cities. He is 47 years old.

Some companies are "laying-off" their staffs. Only to "replace" them shortly after with a younger and cheaper workforce.

[pseudobrit]

Well, that is the idea. Be very generous when someone has that emergency, however, do we really need it more than three times in our life for a year? I was laid off two weeks before 9/11. It took me 4 months to find a job. But I am 34, and that is the only time in my life that I have been without a job longer than one week.

So, how many times should it be eligible? 4, 5? I want a fixed amount, because it is so generous. I don't want someone on, then off, then on, then off, then on, then off, etc. That would not work. So, what would be a good set number of times?

I don't think any set number is good simply because there is no set number of times someone will be fired or laid off. Some sectors have slow years where they have plant shutdowns for a month or two at a time. Some types of jobs (think specialty & contracted workers) will see a worker out of a job for a few months and then overworked for a few, continuing in a cycle depending on demand.

There are simply too many variables to punish those who fall out of bounds of a typical field of work.

As it is now, the state benefits run out after six months and federal supplementary compensation kicks up another six months. I think it's fair to say that no one wants to be on, off, on, off, on, off with a job. It doesn't work for them either.

[pseudobrit]

Some companies are "laying-off" their staffs. Only to "replace" them shortly after with a younger and cheaper workforce.

Like setting up offshore, only with twenty-something Americans instead of child-labor Chinese.

Gotta love the corporate greed. The 80's weren't the greed decade. They were the beginning of an Era of Greed that we're still climbing into.

[takao]

What about the quality of care? There are those that say any national healthcare system leads to poorer quality of care.

of course 3,7% does not have to be everything ...of course you have to pay for example if you want white ceramic thing instead of amalgam you have to pay more...or when you need glasses (like myself ) you have to pay more for plastic glasses instead ....
and per prescription for medication you have to pay 3,20 € once (but in certain cases you don't have to pay this either...like chronical diseases etc.)

the whole system is perhaps too complicated to sum it up...

and for quality: i don't feel that there is a big difference...(wasn't the first heart transplantation outside of south africa in innsbruck ? and i think they set a few milestones in other things too


(offtopic: boy..i wrote this post 8 hours ago... went for dinner and completly forget about submiting the reply...then after 8 hours i come back checking if somebody answered to my replay and recognize that i didn't finished the post...

[LethalWolfe]

I just look at the changes in the last 20 years or so and shake my head. It used to be a company had layoffs and their stock went down, today the stock goes up.

Use to be that you did right for your employer and they did right for you. Now you have companies that move jobs and themselves offshore.

We have lost sight of the Golden Rule. Do unto others as you would have them do unto you. Either that, or it now meant that you better ****** someone over, before they ****** you over.

I completely agree. I've worked for small companies/Mom & Pop places as well as large corporations, and if I have the choice I'll never work for a large corporation again. It's a nightmare. Especially if your comany/parent company doesn't really understand your department/company. Ugh.

There is a very strong work ethic in my family and the changing relationship between employer and employee is something my parents lived thru and warned us kids about. Do your best. Work hard. But don't expect your employer to look out for you. Those days are long gone.

A friend of mine's dad was a counsultant for a major retail chain (this was a few years ago) and the chain had to downsize a significant amount of their sales associates. So what did they do? They randomly pulled names until they met their downsizing goal. Nice, huh?


Lethal

[Neserk]

It's a nightmare. Especially if your comany/parent company doesn't really understand your department/company. Ugh.



I was going to say I never worked for a large corp. Then I realized that I do :eek: It is called the government. And what you say above applies.

[mactastic]

Ok, for a federal model how about this.

OK, first off I thought you were arguing for the feds to get out of the entitlement racket? Why the sudden change? But lets look at the proposals, I like the sentiment involved.

1st Unemployment assistance. Three times during the course of your life for up to 12 months at a time in non concurrent years, you can qualify for unemployment assistance if you have worked in the previous 6 months, and were either laid off, or fired from your job. The assistance that you get will be equal to the average household income in your state. The number of children that you have is irrelevant. During the 12 months, you will also be eligible for education assistance so that you will be better qualified to go into the workplace, you will recieve consultation on how to keep a job, or how to better market yourself.

A couple issues. As others have said, 3 seems to be an arbitrary number. I understand that it's your attempt to curb the gaming of the system, but there are simply too many variables in life to guarantee that 3 will cover you. I'd prefer to see a more flexible system, capable of realizing that someones situation is extraordinary and easily allowing them such and agency to deal with that. I think of it as analogous to zero-tolerance policies that force a principle to suspend the honors student who forgets that their prescription meds are still in their backpack from their weekend trip and brings them to school by accident.

Also, I don't know about your state, but average income varies widely in mine from county to county, and even within counties. If you aren't careful here you will force people to move to afford to live under your program. Others will be getting far more than they need because their areas are much less expensive. $1,000 a month for rent here versus in California's Central Valley is a huge difference. And that doesn't even take into consideration places in the Sierra foothills or way up north that are even cheaper. But more to the point, why waste money in places that don't need it, and why force people to move? If you've lived all your life in one town and you are forced to move that can negatively impact your job-hunting prospects if you are suddenly without the network so vital to 'being in the right place at the right time' that lands you work. In addition, family connections could be broken, requiring child care payments suddenly, or even something as simple as someone to give your kid a ride when you can't.

Anyway, it all boils down to flexibility. If the program can't deal with exceptional situation I have a problem.

2nd Medical Assistance. Everyone who makes less than 1/2 of the average income of the state in which they reside will be entitled to free medical care. 100% coverage, with full drug card benifit. Although the drugs will have to be approved by three Doctors so that no one doctor could make a deal with a drug company and exploit the system. Everyone who makes the average income will recieve a drug card for their children that will pay for all of the childrens meds, again when approved by three Doctors. The children will have free healthcare through subsidies from the state in which they live. Everyone making the average or over will not be entitled to any government assistance at all for medical.

What's the commercial I keep seeing? If it were this easy we wouldn't need the AARP, I think it goes You know you're talking about something the GOP would ride you out of their party on a rail for, right? And just how do you propose to pay for this program? I know you won't be proposing a tax hike, but damn! How much will it cost? Also, what kind of 'average' will you be using? That alone can make a huge difference in numbers covered. Personally I'd rather see a simpler system, where catastrophic coverage is guaranteed by the government, with private insurers picking up the premium packages for those who want more. Those who need more but can't afford it should be given it. Also I'd be more than willing to discuss some reasonable tort reforms in exchange for discussions about strict controls over the relationship between pharmaceutical companies and doctors.

3rd Housing. Everyone who is earning less than 1/2 of the average income of the state in which they reside will be entitled to government subsided houseing. Not the getto's that exist now, but new, nice wonderful neighborhoods that give people a sense of pride about where they live. But, here is the catch. If the law isn't mowed, if the house isn't clean, if pride is not taken in their house, they will be charged with a criminal offense, removed from the progam, and banned for life.

Hooweeee! OK, I take it back. You're lefterer than I am. Government subsidized housing for half the population? That's incredibly generous of you. And while in the special case that is California's real estate market, yes there are places where less than half of the population can afford the median priced house (actually last I looked it took an income of about $80,000/year to purchase the median house here, meaning only some 20% of the counties residents were able to afford to buy) I can't imagine that's the case everywhere.

I just doubt that that many people need to be given subsidies for housing. And even if they did, how the heck do you propose to get cities to agree to massive public housing developments? You can't even get a permit here for a tri-plex. Everyone's worried about the value of their neighborhood. NIMBYism is a powerful force. Although I'd love to talk more about the dire need for cities to stop acting in their own interests and start thinking regionally when it comes to development of new housing. Personally I'd rather see more development of affordable housing as a high priority. Too many cities only care about developing the houses for the wealthy and not enough about the houses for those who the wealthy employ. If it costs less to buy a house, less people will be unable to afford them without government help.

4th Education. Every child that has a 3.0 GPA, and above average scores on the SAT or ACT will have a free education to a state school. Everyone below that will be eligible for financial aid. A students aid ability will no longer be based on their parents income, but based on the IQ, GPA, and SAT scores of the student. The parents income is irrelevant. Students can receive loans for up to 15,000 a year from the federal government starting as Freshman and progressing to 20,000 a year as a junior and senior. However, failure to payback your student loans will result in a criminal charge of fraudulent misrepresentation. Not default of a loan. In other words, if you use it, you pay it back. Period.

I am almost smitten with this proposal. But I do have a few issues. First, it creates an instant incentive (not that there aren't already enough out there) for grade inflation at the HS level. How many kids do you know already that graduate with a 4.5 GPA or some other ridiculous number like that because teachers feel pressured to help kids get into a good college, and the kids could take AP classes? Not all teachers are like that (before Neserk comes after me with a stick;) ) but there are enough that it is a problem. Kids expect an 'A' for what is essentially 'C' work. Couple that with federal threats to fire people and in extreme cases to take over the school if grades slip and you create a situation where handing out 'A's is protecting your job. But the idea of free education for those who can't afford it is intriguing. I'd still rather see those who can afford it to pay something, if only because that would mean there was more money left to help additional kids.

5th Social enrichment. Everyone that donates either 5 hours a week, or a 1/10th of their income will be exempt from paying 1/2 of their federal income tax burden. THis will encourage people to volunteer for all of these programs instead of having to pay people to do it, thus saving money in the end.

I'd love to see something like this. Although I'd rethink the 50% tax break if I were you. Plus if you only give the federal tax break you're not really encouraging the lower income people to volunteer, you're really only gonna get those who pay a bunch of federal tax.

That is all I can think of now, ask questions if you have them.

I'll think on it some more. Generally I think you're heart's in the right place here, but none of this is very conservative. You'd have to run as a progressive.