Seriously thoughtful American Health Care

[Ham88]

Originally Posted by Kostas

Thanks formerroadie, interesting discussion indeed.
I don't want to launch a contentious debate, but there's something I cannot understand.
While media are reporting fierce battles about an annouced/launched health care reform in the states, reading what you wrote one gets the impression that nothing's gonna or is about to change... So pessimistic?

Well the current situation is that there is a bill that is being prepared to be brought to congress. The reason why people are so pessimistic now is because all of the 'town hall' meetings have turned in shouting matches with conservatives comparing Obama to Hitler, and talking about 'death panels'. These 'death panels' were proposed by a republican originally and are about living wills. IN addition all of the conservatives are against the public option because they think that it would drive their precious insurance companies out of business because it would be cheaper. Ohhh, I almost forgot, a lot of politicians here are idiots who aren't willing to compromise at all with members of any opposition party.

Sooo in recap a lot of my fellow americans are being excessively dumb and believing all of the miss information they hear (mayhaps due to our subpar school systems?). I also apologize for the bias in the post as I am to say very liberal.

Off topic but I can't wait for the crazies to say that the President (who was in Martha's vineyard) formed a death panel that killed Ted Kennedy. ( is too early to joke about that?)

[Elfwreck]

Originally Posted by Kostas

Thanks formerroadie, interesting discussion indeed.
I don't want to launch a contentious debate, but there's something I cannot understand.
While media are reporting fierce battles about an annouced/launched health care reform in the states, reading what you wrote one gets the impression that nothing's gonna or is about to change... So pessimistic?

Things will change. Different people will get the money. Since it's a lot of money, there's a lot of noise.

Those of us who have no money to offer believe our wishes will be ignored; history says that's what happens. Our health care industry is hostage to a swarm of special interest groups: insurance companies who work to remove coverage from anyone who costs them money, pharmaceutical companies who work to force the industry to push their drugs, religious wackos who try to insist their morality be a major part of any health care plan.

For many years now, most of the US has had abstinence-only sex education in its public schools. (California was the only holdout for a long time; I believe we're up to 25 states that don't have it.) This means teens weren't taught how to avoid pregnancy or sexual diseases other than "don't have sex until you're married." It also means that, once they got married, they had no idea how to prevent pregnancies or mitigate risky behavior.

We had (still have) kids who didn't know you could get pregnant if it was your first time. Or thought that if you did it standing up, you can't get pregnant. Or thought that oral sex had no risks, because they'd picked up the idea that anything that prevents pregnancy, prevents all other risks of sexual activity. And I've met women who thought "since it takes the Pill a month to start working, that means it takes a month to wear off."

Our families, our children, are held hostage by an industry that's beholden to gambling companies, drug pushers, and religious propagandists.

And all of those have a lot of money, and a lot of political pull. The rest of us believe there will be changes... we've just got no faith that those changes will include "the average middle-class family can stop fretting over losing their house if one of their kids gets hit by a car."

[formerroadie]

Originally Posted by Kostas

Thanks formerroadie, interesting discussion indeed.
I don't want to launch a contentious debate, but there's something I cannot understand.
While media are reporting fierce battles about an annouced/launched health care reform in the states, reading what you wrote one gets the impression that nothing's gonna or is about to change... So pessimistic?

As we move closer to a final bill, yes, I am becoming pessimistic. Many in the senate, both Dems and Republicans are backing down under the pressure of the wealthy insurance companies. They are buckling. The Dems attempted to compromise with the conservatives, which was stupid, but this brought about the move toward the public option. Then the conservatives wanted more and more and more of the bill to be undone. If the public option is not in the bill, it will become a nothing bill that just favors the insurance companies again.

We pay almost twice as much for our meds than other countries and far more for our health care. It's a way to rip us off all in the name of the great god of capitalism. Anyway, it's getting rather depressing. Moving to Canada or Europe is becoming more and more attractive.

By the way, here are some of the things the conservatives say the bill will do. This is the their propaganda and lies. The bill will:

Kill all old people
Raise health premiums sky high (which is already happening by the way)
Kill innovation
Fund abortion (yes, this is a uniquely US argument)
Kill private Insurance
Take away choice
Kill Medicare
Illegals will get free insurance
Government will set wages for doctors so that we go no more doctors of quality.

It's insanity.

[GlennD]

Originally Posted by formerroadie

By the way, here are some of the things the conservatives say the bill will do. This is the their propaganda and lies. The bill will:

Kill all old people
Raise health premiums sky high (which is already happening by the way)
Kill innovation
Fund abortion (yes, this is a uniquely US argument)
Kill private Insurance
Take away choice
Kill Medicare
Illegals will get free insurance
Government will set wages for doctors so that we go no more doctors of quality.

It's insanity.

It's not accurate. It sounds like a very exaggerated version of concerns that conservatives are trying to raise.

"Kill all old people"
Some folks read the language in one of the reform bills that included end of life counseling. They took that to mean that there would be conditions that would not be paid for, and some idiot (whom I believe was Sarah Palin, at least that's the first source I heard it) coined the phrase "death panel". Both conservatives and liberals here are stretching each other's words and meanings way beyond their original intent.

"Raise health premiums sky high (which is already happening by the way)"
It IS happening, I can't argue that. And benefits are changing yearly. I don't see that a government run insurance program would reduce premiums, that's for sure.

"Kill innovation"
It's cynical, but most capitalists believe that profit motivates innovation. Remove the profit motive and there's less reason to innovate.

"Fund abortion (yes, this is a uniquely US argument)"
Yep, it's a big concern. I don't want to derail the thread with another discussion that has strong opinions both ways, so I'll just admit that you're right. It's a concern.

"Kill private Insurance"
Wouldn't it? Why on earth would anyone pay twice for insurance? If my taxes are already paying for my government-run health care why would I take more out of my pocket to pay for more insurance? Every time I see the term "public option" I laugh - will I have the option to NOT pay for the public insurance if I prefer my private 'option'? I can't see insurance companies surviving, at least without changes that would make them completely unrecognizable. They would have to market purely to people that could afford to pay twice, for a higher level of care.

"Take away choice"
See above. No competition means no incentive to improve.

"Kill Medicare"
Seems the government is already doing a fine job of that. I cringe when I walk into a doctors office and see a notice that they don't accept Medicare. In fact, Medicare is the biggest argument against a federal health care program for me - they've already proved they can't run one efficiently, why expand it?

"Illegals will get free insurance"
*shrug* I dunno, but illegals are getting free schooling in some states. To be honest, at least there would be a payer for illegals - right now if they need care they head to the emergency room, which is the most expensive care available. If they DID get free insurance maybe it would help get them into less expensive care. (Another uniquely American discussion I suspect...and again I don't want to derail the thread)

"Government will set wages for doctors so that we go no more doctors of quality."
I've never heard this argument, despite reading several conservative newsletters. Today, insurance companies and health care providers negotiate the amount that will be paid for various procedures. At some level, whether by mandate or negotiation, a government program would have to do the same thing. In fact, that is why some doctors don't accept Medicare - the amount that the Medicare program is willing to pay is, according to the providers, below the cost of the services. So the doctor would have to take a loss to provide the care.

I'm very frustrated by a lot of the debate over health care in the US. In my view, there are problems that have nothing to do with cost. We have a shortage of doctors. We have grossly overpriced medications. We could be talking about real fixes, such as allowing nurses to prescribe non-narcotics (already happening in some states) and diagnosing some common ailments. We could be spending money to help get more qualified students into (and graduating from) medical school.

I've NEVER seen a discussion about health care reform that didn't revolve around who was paying, and typically making the insurance companies look like the big bad guy. I admit I'm biased - I work for one of those insurance companies (albeit a non-for-profit one). Much of our discussion internally revolves around how to get more out of premium dollars, how to reduce the percentage of administrative costs that comes out of what our customers pay in to the system.

And as a conservative, one of my biggest gripes about the current discussion is that our Constitution reserves any power not specifically granted to the federal government to the states and the people. That means that the federal government has NO business even talking about this issue (unless I'm missing the clause that says Congress should be providing health care to the country?). I would have very little issue with individual states talking about health care reform.

[Kostas]

Originally Posted by Ham88

I also apologize for the bias in the post as I am to say very liberal.

I like your bias!
Thanks a lot!
PS: I guess that you know that "liberal" in Europe usually has the opposite meaning vs. in the States

[Kostas]

Originally Posted by formerroadie

As we move closer to a final bill, yes, I am becoming pessimistic...

Thanks for the explanation.
Strange to see how obvious things in Europe can be so controversial in the States.
I guess that we could find opposite examples too...

[formerroadie]

Originally Posted by GlennD

It's not accurate. It sounds like a very exaggerated version of concerns that conservatives are trying to raise.

"Kill all old people"
Some folks read the language in one of the reform bills that included end of life counseling. They took that to mean that there would be conditions that would not be paid for, and some idiot (whom I believe was Sarah Palin, at least that's the first source I heard it) coined the phrase "death panel". Both conservatives and liberals here are stretching each other's words and meanings way beyond their original intent.

"Raise health premiums sky high (which is already happening by the way)"
It IS happening, I can't argue that. And benefits are changing yearly. I don't see that a government run insurance program would reduce premiums, that's for sure.

"Kill innovation"
It's cynical, but most capitalists believe that profit motivates innovation. Remove the profit motive and there's less reason to innovate.

"Fund abortion (yes, this is a uniquely US argument)"
Yep, it's a big concern. I don't want to derail the thread with another discussion that has strong opinions both ways, so I'll just admit that you're right. It's a concern.

"Kill private Insurance"
Wouldn't it? Why on earth would anyone pay twice for insurance? If my taxes are already paying for my government-run health care why would I take more out of my pocket to pay for more insurance? Every time I see the term "public option" I laugh - will I have the option to NOT pay for the public insurance if I prefer my private 'option'? I can't see insurance companies surviving, at least without changes that would make them completely unrecognizable. They would have to market purely to people that could afford to pay twice, for a higher level of care.

"Take away choice"
See above. No competition means no incentive to improve.

"Kill Medicare"
Seems the government is already doing a fine job of that. I cringe when I walk into a doctors office and see a notice that they don't accept Medicare. In fact, Medicare is the biggest argument against a federal health care program for me - they've already proved they can't run one efficiently, why expand it?

"Illegals will get free insurance"
*shrug* I dunno, but illegals are getting free schooling in some states. To be honest, at least there would be a payer for illegals - right now if they need care they head to the emergency room, which is the most expensive care available. If they DID get free insurance maybe it would help get them into less expensive care. (Another uniquely American discussion I suspect...and again I don't want to derail the thread)

"Government will set wages for doctors so that we go no more doctors of quality."
I've never heard this argument, despite reading several conservative newsletters. Today, insurance companies and health care providers negotiate the amount that will be paid for various procedures. At some level, whether by mandate or negotiation, a government program would have to do the same thing. In fact, that is why some doctors don't accept Medicare - the amount that the Medicare program is willing to pay is, according to the providers, below the cost of the services. So the doctor would have to take a loss to provide the care.

I'm very frustrated by a lot of the debate over health care in the US. In my view, there are problems that have nothing to do with cost. We have a shortage of doctors. We have grossly overpriced medications. We could be talking about real fixes, such as allowing nurses to prescribe non-narcotics (already happening in some states) and diagnosing some common ailments. We could be spending money to help get more qualified students into (and graduating from) medical school.

I've NEVER seen a discussion about health care reform that didn't revolve around who was paying, and typically making the insurance companies look like the big bad guy. I admit I'm biased - I work for one of those insurance companies (albeit a non-for-profit one). Much of our discussion internally revolves around how to get more out of premium dollars, how to reduce the percentage of administrative costs that comes out of what our customers pay in to the system.

And as a conservative, one of my biggest gripes about the current discussion is that our Constitution reserves any power not specifically granted to the federal government to the states and the people. That means that the federal government has NO business even talking about this issue (unless I'm missing the clause that says Congress should be providing health care to the country?). I would have very little issue with individual states talking about health care reform.

I wish more conservatives were as clear as you and avoided the lies. I don't agree with your interpretation of the constitution, but we are going to disagree with that. The states have had their chance to fix this for decades and have made things worse. Time to up the ante.

[formerroadie]

Originally Posted by Kostas

Thanks for the explanation.
Strange to see how obvious things in Europe can be so controversial in the States.
I guess that we could find opposite examples too...

ya, I am often crazed by it .

[Greg Anos]

My problem is our government has had one opportunity to run a healthcare program for over 40 years. it starting to disintegrate economically....

Why would they do better the next time?

[vivaldirules]

Originally Posted by Ralph Sir Edward

My problem is our government has had one opportunity to run a healthcare program for over 40 years. it starting to disintegrate economically....

Why would they do better the next time?

I hear you. But I hold out one (very) small hope that Medicare struggles to stay solvent because it is a government run program amidst a larger free market health care system. I can imagine that it doesn't reap all the benefits of lower insurance costs and maybe of lower costs in general. Perhaps (I confess that I'm reaching here, so don't beat me up) that if the majority of health care was a federally run system, those benefits might be gained.

Next up, I'll recite from the tale of the Easter bunny.

[Ham88]

I once heard the only country where you could advertise prescription drugs was the US. Is this right? If it is then I think this is part of the reason why we pay so much for medical treatment, and medicine. People convince their doctors they need to get such and such name brand prescription which costs more and that insurance companies will help pay for and raise costs for everyone to compensate. If I'm wrong about the advertising thing just ignore this entire paragraph.

Originally Posted by vivaldirules

I hear you. But I hold out one (very) small hope that Medicare struggles to stay solvent because it is a government run program amidst a larger free market health care system. I can imagine that it doesn't reap all the benefits of lower insurance costs and maybe of lower costs in general. Perhaps (I confess that I'm reaching here, so don't beat me up) that if the majority of health care was a federally run system, those benefits might be gained.

I agree with you mainly because one of the local tv stations here ran a segment about cost of medical procedures at different hospitals. According to the segment the prices of the same procedures varied by up to 200-ish% for the same procedure. With a government run healthcare program the cost should be more uniform... right???

[formerroadie]

Originally Posted by Ralph Sir Edward

My problem is our government has had one opportunity to run a healthcare program for over 40 years. it starting to disintegrate economically....

Why would they do better the next time?

Actually, that has a lot to do with the private health care systems (both insurance and medical side) charging far too much to make a profit. You see, the elder population in this country is growing and that causes the Medicare pool to grow way beyond the population of the young people. If we were all in the same pool, that would not be the case. It would actually make medicare solvent and in the black while the rest of us would get lower health care costs due to a larger pool of people being able to negotiate price. It's a misgnomer that the government has done such a poor job. My grandparents are (were) on medicare and they got great care.

[formerroadie]

Originally Posted by Ham88

I once heard the only country where you could advertise prescription drugs was the US. Is this right? If it is then I think this is part of the reason why we pay so much for medical treatment, and medicine. People convince their doctors they need to get such and such name brand prescription which costs more and that insurance companies will help pay for and raise costs for everyone to compensate. If I'm wrong about the advertising thing just ignore this entire paragraph.



I agree with you mainly because one of the local tv stations here ran a segment about cost of medical procedures at different hospitals. According to the segment the prices of the same procedures varied by up to 200-ish% for the same procedure. With a government run healthcare program the cost should be more uniform... right???

Yes, part of the plan is to make price uniform. This is one of the huge problems with the system. It's also another reason why states should not run this individually. If there was a mandate to have state insurance across the country, can you imagine the discrepancies? Texas' health care would be wretched (as it is now) and say Washington would have a far better option. This is definitely a federal issue that needs taking care of now, not later.

[PKFFW]

I just can't understand how anyone would think an insurance company, that has as its sole motivation the making of a profit(disregarding those very very few and far between not-for-profit organisations), would be the best choice for providing health care services. What else are they going to do but charge as much as they can for premiums and find any way they can to deny service should a claim arise?

Regardless of how badly managed a government run system may appear to be, surely the mere fact that such a system is run primarily to ensure that all people have adequate medical care, rather than to provide as large a profit for shareholders, would be a better choice? At least when it comes to ensuring all people have basic healthcare provided? Then if one wants to move to the head of the waiting list for a procedure or choose their preferred doctor, choose their hospital or whatever then they can opt into private health insurance to get those benefits.

I guess it depends on priorities though. If one's society values profits over the provision of health care for all, then the insurance industry would be the logical choice for providing health care.

Unfortunately throughout the recent 11 years of Liberal(right wing conservative party) rule in Australia our government did it's level best to destroy the public health service and force everyone into private health insurance. Now that the damage has been done the Labour(left wing party) government in power seems to be happy to sit back and claim they can't do anything to fix it because of what the Liberals did previously. I see a time in the not too distant future where Australia will be much the same as the USA with the insurance industry deciding whether or not a profit can be made on the medical treatment a citizen needs and deciding whether or not to provide said treatment based on that analysis.

Sad but true.
PKFFW

[Kostas]

Originally Posted by PKFFW

Regardless of how badly managed a government run system may appear to be...

Well, we admired the outstanding results of privately managed banks, car manufacturers,... Most of them have been saved of bankrupting by the taxpayers.

Originally Posted by PKFFW

If one's society values profits over the provision of health care for all, then the insurance industry would be the logical choice for providing health care.

I'm impressed to see that nearly bankrupted insurance companies still have any negotiation power or influence on decision-making.