Seriously thoughtful US Health Care Plan

[The Straven]

Logseman, your point was very clearly made. A comprehensive list.

Spoon Man (please just call me James, btw), if health care is scarce (demand greater than supply), should it be sold with bulk discounts, which are intended to increase consumption? Should it be sold with bulk discounts just like any other commodity? Should it be rationed like a commodity at all? Is that fair?

pietvo, should insurance be allowed to treat health care like it treats any other commodity (and insurance was invented for the transport of commodities)? A doctor must look the patient in the eye and tell him that he can't afford the treatment. Actuarial tables and spreadsheets have no qualms, because they are things, not people, and thus have no conscience--only statistics.

In the end, the law of supply and demand compels that we ration health care. I don't want to rely solely on a system that by nature rations health care like a commodity.

Well, I hope someone will point out where I'm wrong, because I'm by no means certain that I'm right, and because we need real debate amongst ourselves and stop letting the media debate (and think) for us. Spoon Man, you did well opening this topic despite the risks.

[pshrynk]

Originally Posted by wodin

All bottom lines result in the question, how will this affect me?

My wife and I have spent two lifetimes working to insure that we would have adequate health care coverage in our retirement, resulting in our being over insured. In my case triply and in my wife’s, doubly. And when she becomes eligible for Medicare, she will also be triply insured.

It’s sometimes amusing watching the various insurance plans vying to see which one will pay, and how much, but that aside; how does the health care reform act affect us?

A half trillion dollar cut in already overextended Medicare, and the threat of an extra tax on “Cadillac” policies, to pay for insurance for 32 million people who have not spent their lives securing their golden years threaten two of my three hard earned safety nets. That’s how!

I’m reminded of Aesop’s fable of the ant and the grasshopper. It would seem that I’m the ant!

Isn't there some sort of program in Hawai'i that makes sure everyone is covered? I have to admit that my knowlege about that is completely from the Daily Show, so it's fairly sketchy.

[Spoon Man]

James, as Logesman said, if you provide everyone with health care, the system becomes too highly taxed to be effective. The fact of the matter is that the money just isn't there to provide everyone with state funded health care. The money is barely there to provide everyone with schooling. We don't have the funds, which means that we have to sacrifice. Funding needs to get cut until we can get our budget back in order, and we can't do that if we are starting to spend more money.

Another issue that I have with this bill is that we are going to start spending into it, but we won't be able to reap any of the supposed benefits until 2014 if I'm understanding things right. The fact is, that money isn't going to go to the health care system at all for the first 4 years, it is going to be spent on other projects.

The US simply does not have the resources or the infrastructure currently to provide an effective national health care system. I wish it did, but we have to look at what we have, not what we want to have. We need to cut the budget, which means dropping or suspending programs that are not decreasing our deficit. We need to look at programs that are going to encourage more corporations to move into the US, because while the percentage of corporate taxes don't need to be high, we can also tax like Wal-Mart sells, lower price, higher volume of income.

Once we have that down, then the states can look at providing a health care system individually. If people want such health care, they can move into those states. If people don't, they can move to another state. It'll be more about competition to get tax revenue for the states I suppose.

Yes, this means dropping a lot of programs that help people, but we have to look at it like this: We can kind of help people now, and dig ourselves into a deeper debt which could lead to more problems down the road; or we can dig ourselves out now, and help people for another few hundred years down the road.

If we stay on the path we are now, with the spending that we have currently, our credit lines will eventually be cut off, and all things will be for naught because no one will have health care when our country collapses.

[wodin]

Originally Posted by pshrynk

Isn't there some sort of program in Hawai'i that makes sure everyone is covered? I have to admit that my knowlege about that is completely from the Daily Show, so it's fairly sketchy.

Yup!

Except for those folks who make too much to qualify for welfare, but don't have a "full time" job (>20 Hours/week) or are self employed.

Employers are required to provide a portion of health care insurance to “full time” employees, but not “part time” ones. And there are a lot of folks who work 19 hours/week.

Some people have three or four part time jobs just to make ends meet, and don’t qualify for employer provided insurance. Welfare recipients get a State provided plan called Quest, which is often better insurance than the employer provided ones.

I’ve heard some rumors about the State seeking some kind of waiver because our laws exceed some of the provisions of the HCR act, but I don’t know any details. I strongly suspect that any waivers will be in the what we get side, not on the paying for it side.

[wodin]

Originally Posted by Spoon Man

... we can also tax like Wal-Mart sells, lower price, higher volume of income.

Hmmmm.

Isn’t that what used to be called “Reganomics”? Or the fiscal policies instituted by Ronald Regan. (Liberals don’t like to be reminded of that).

Which, by the way, led to the greatest period of prosperity that our country has ever known, but was largely attributed to President Clinton instead.

BTW, President Regan didn’t invent Reganomics, but he used it most effectively.

[pshrynk]

Originally Posted by wodin

Yup!

Except for those folks who make too much to qualify for welfare, but don't have a "full time" job (>20 Hours/week) or are self employed.

Employers are required to provide a portion of health care insurance to “full time” employees, but not “part time” ones. And there are a lot of folks who work 19 hours/week.

Some people have three or four part time jobs just to make ends meet, and don’t qualify for employer provided insurance. Welfare recipients get a State provided plan called Quest, which is often better insurance than the employer provided ones.

I’ve heard some rumors about the State seeking some kind of waiver because our laws exceed some of the provisions of the HCR act, but I don’t know any details. I strongly suspect that any waivers will be in the what we get side, not on the paying for it side.

In the table of contents there is a section of HCR that addresses Hawai'i, but I did not read it.

[pdurrant]

Originally Posted by Spoon Man

James, as Logesman said, if you provide everyone with health care, the system becomes too highly taxed to be effective. The fact of the matter is that the money just isn't there to provide everyone with state funded health care.

This is clearly wrong. The US spends far more on health care than any other industrialised country. The money is there to provide healthcare for everyone. It's just a question of how it's spent.

[happy_terd]

Maybe us Americans should just "cowboy up" and not go see the doctor with every little booboo.

I blame the bottled water industry. Ever since they came out real men have been scared to drink out of the sink or garden hose. They turned us into little miss prissy.

[Elfwreck]

Originally Posted by Spoon Man

The fact of the matter is that the money just isn't there to provide everyone with state funded health care. The money is barely there to provide everyone with schooling. We don't have the funds, which means that we have to sacrifice. Funding needs to get cut until we can get our budget back in order, and we can't do that if we are starting to spend more money.

The money is there. The *management of resources* is not.

High school graduation rates have been dropping in the US for forty years. We spend twice as much now in *adjusted* dollars as we did then, and it's not getting more graduates, better-educated kids, or more overall literacy. The problem isn't money; it's that what schools are designed to teach isn't reading & math.

Health care has the same problem--by funding *insurance* rather than care & prevention, we're throwing money at the wrong end of the problem. We're promoting the idea that people should gamble on being healthy, as if a healthy populace were a matter of good luck and special tricks, with prizes for the "winners," rather than a life-long plan for good health for almost everyone.

There will always be exceptions--people with diseases that very expensive treatments can only alleviate the symptoms of, accident victims who need expensive care to be barely functional again. But those aren't what's holding back our health care system.

What's killing us is people who avoid flu shots because the $25 co-pay and $20 flu shot (plus the loss of half a day of work) is more than they think they can afford this winter, and they don't notice how many $5 packs of antihistamines they bought instead. And whether or not "that's stupid of them," they're spreading flu to other people at the same time, and their productivity at work is down.

What's killing us is the $1000 emergency room visit for something that could've been treated for $75 if it'd happened during working hours. And the same symptoms, with a price tag of $15,000 including the ambulance trip to the hospital and extensive diagnostics because the person had no health care history on record so nobody could say quickly, "this is not pneumonia or cancer; it's allergies to the mold from the cheap hotel he spent last night at; give him some steroids and let him sleep it off."

By making health care an optional luxury service, instead of something everyone expects to grow up with, we've made it much more expensive than it needs to be.

[Spoon Man]

So, the US spends more on health care than most, and we aren't spending that money correctly, am I getting the picture here?

The fact is, we are spending into a DEFICIT. We are spending (and have been spending) money that we DO NOT HAVE. I'm not saying we shouldn't have some sort of health care option, I'm saying this isn't the one we need at the time, because we can't fund our own bloody paychecks right now. So, woot, we are going to spend ourselves into a bloody economic collapse, the government will enact stringent controls on everything (as history shows time and time again) and we'll fall into a more communist esque society than we already are. Do Not Pass Go, Do NOT collect $200.

[SimonSays]

IMHO, this bill is going to do nothing to improve health CARE. It is only about health COVERAGE and it is going to be one heck of a tax increase to ALL citizens of the US.

[pietvo]

I think the health care money stays inside the country, so it doesn't add towards the nation's deficit. The national deficit is caused mostly by consumers buying foreign goods, i.e. imports. The government's deficit on the other hand, is caused mainly by the wars in Afghanistan and Irak I think. And now also by supporting the banks but that is a recent addition. And by financing these with loans instead of taxes.

The USA government's deficit is mainly caused by Ronald Reagan and the two Bushes. Bill Clinton succeeded in getting rid of the deficit of the first two and then Bush jr. created a new one. Now there is a crisis and two war heritages Obama has a much tougher time to get rid of the deficit.

And the USA public should change their spending habits. They should not spend money they don't have, and they should spend more inside the country. Of course the temptation to buy cheap Chinese goods is great. But buying American stuff will also strengthen the USA economy which is much needed. And the USA auto manufacturing really needs innovations to produce cheaper, more economic and sustainable cars. And in general there should be a much greater awareness of sustainability in the USA. IMHO this is the only way that can really recover the USA economy. But too many people prefer to keep their heads in the sand.

[Spoon Man]

Well, the way the US economy is set up (in my understanding, I could be horribly wrong here, if so, please correct me) allows for buying things from outside the US, because the money doesn't completely leave our shores. What we buy from a brick-and-mortar store in the US still goes to paying the paychecks of people in the US. You are correct about the US auto industry however, that does need serious overhaul or it will fail miserably (well, would have until the government took it over, I think it should have). However, protectionism within the country won't do anything for the citizens of the US. Its been proven time and time again, such thoughts will ruin the economy. We don't need to "Buy All American" we need to buy smart. If the US really wants increase business, it should drop corporate taxes. This would bring in business, and allow for more money going into the pockets of US workers.

Now, the deficit is all about the money we borrow, and if we're borrowing money that we put into the country, we're still borrowing money. We need to stop this. The fact is that some country could try to collect if things get really bad, and thats the last thing that we want. Aside from that however, the spending of the country is a damned powerful example to the US people. If the government can get away with borrowing exorbitant amounts of money, why can't they? Happy_Terd was right in most regards, the American male has become too much of a "little miss prissy" and is no longer willing to make sacrifices in order to sure up the future. There was a time where the majority of people just did without if they didn't have the cash on hand or wouldn't be able to pay for something else more important later, and that time is long gone now.

I'm not going to sit here and get into a pissing match about which party and which president did what and where and whose boogers ended up on the wall, but I will say that its not one president to be blamed here, its a trend that no single president or group has had the cajones to put an end to. Current president withstanding.

[pshrynk]

You are talking about two different types of deficit. The Federal deficit that comes of the government spending more than it takes in with taxes. Then the Trade deficit, which comes of importing more than you export. The two are linked in some very esoteric ways, but not directly.

The health care bill starts out by increasing the Federal deficit and then ends up by lowering it over the long run. That is. if all the projections made by the CBO come true. They don't, most of the time. But they are off in either direction about the same frequency.

Reagan caused a big deficit in the service of making Communism go away. He succeeded, but it cost a lot. Bush Sr had a big deficit because the economy was in the tank for much of his four years. Clinton had budget surplus because the dot.com boom took place during his term. Bush Jr had a deficit because the dot.com and housing bust took place during his terms. We have yet to see what will happen with Obama, since it's only been a year.

Terribly over-simplified, I realize. However, the point I am trying to make is that the guy in office has very little to do with what actually happens in an economy, which is a huge chaotic system.