National Health Care

[Will]

I'm for single-payer and frustrated with anything short, but based on my understanding of countries like Canada, it can be a gradual process and the public option in H.R.3200 is a step towards universal healthcare and away from private insurance.

[shanster]

The only reason I'm not liking it is because Obama doesn't have enough balls to push what needs to go through to make it a better system. At first he wanted a public option then the Dems and Reps started crying so he was like OKAY no public option! Then the dems decided hey..maybe public option isnt too bad so now its back on board.  Obama is trying to hard to please everybody trying to keep us his promise of "bipartisanship" and it's ruining every bill that he tries to make

[Ultima22689]

The only reason I'm not liking it is because Obama doesn't have enough balls to push what needs to go through to make it a better system. At first he wanted a public option then the Dems and Reps started crying so he was like OKAY no public option! Then the dems decided hey..maybe public option isnt too bad so now its back on board.  Obama is trying to hard to please everybody trying to keep us his promise of "bipartisanship" and it's ruining every bill that he tries to make

Actually he just had a speech the other day to a university. Sounds like Obama is taking off his gloves. I think he is going to go for nothing but dem votes and shove it through. Pelosi's comment backs it up too. She said there will be a public option plan in the bill. Obama may have been playing Mr. Rogers for awhile but the guy is incredibly intelligent and he knows the gloves come off now.

[shanster]

Actually he just had a speech the other day to a university. Sounds like Obama is taking off his gloves. I think he is going to go for nothing but dem votes and shove it through. Pelosi's comment backs it up too. She said there will be a public option plan in the bill. Obama may have been playing Mr. Rogers for awhile but the guy is incredibly intelligent and he knows the gloves come off now.

I didn't get to see that speech, but I am glad that he's manning up. There's no sense in being president if you're going to bow down in defeat every time somebody disagrees with you. I do support a NHC because I'm sick of not being able to afford health care, and how my only choice of getting health care is by getting it from my job but my job won't promote me to full time to avoid giving me benefits, and do so by having me work ONE hour less then the full timers get. I went to the dentist yesterday to get a normal teeth cleaning, with the x-rays required for new clients, and the teeth cleaning it came to a grand total of 470 dollars. For 20 minutes of work. It's ridiculous, and to get insurance without going through your job it's even more expensive and more ridiculous.  For all the poverty America has, and all the Middle class who can barely afford their houses at it is, America desperately needs something that will be offered to all citizens, at virtually no cost, or at the least a cost that is clearly affordable.

[Tom62]

I've got a private health care insurance here in Germany, which makes the doctors very happy because they can charge me the full pound for each treatment. Nethertheless the costs of these treatments are just a fraction of what the doctors charge in the US. A dentist visit to get my teeth cleaned and X-rayed would cost me around 120 bucks. My wife , who lives in the USA is outraged by these overinflated doctor bills. She thinks that these prices are extremely huge, because the doctors want to cover themselves against liability charges. Personally, I don't see any reason why these bills have to be 3 to 4 times higher than everywhere else in the western world.

[LARA]

I'm strongly against the plan.  The main reason is that there will be a mandate for every individual to buy and keep health insurance that includes fines for non-compliance.  So if both the government and private plans are a problem in some way for someone, they can't opt out of the whole thing.

The government seems to be operating under the delusion that the median income family of around $40,000 can buy a livable house for $50,000 or find rent for under four hundred dollars a month and a new car for $12,000 and you can feed a family of four lean meat fruits and veggies for less than a hundred dollars a week. They should be able to afford to buy health insurance, too, right?  Well, if they can't, it will be the government that decides, not them.  So if money's tight but you are over the line, you're feeding your family mac and cheese five nights a week to afford healthcare, all the while getting less healthy.

This plan is going to cost a lot of money, which was a large part of the problem with people not having insurance in the first place.  Those awful poor people coming to the emergency room without healthcare who are making it so tough for those pitiable poor people who can't afford health care are the same poor people.  The same people who are living off the system now will be living off the system if national health care goes through.  The only difference is more paperwork and government interference.  

Also, why do we assume that people who don't have health insurance don't pay their medical bills and people with health insurance always do?  Lots of people who are self-pay have something called a savings account where the money they don't spend on health insurance plans they can't afford can be used to pay medical bills.  It's not as good as having enough money, but it still covers a lot of the costs.

Other reasons are that it gives the government too much involvement and control into an area that's private, a person's health history and it's just blatantly socialist.  I'm not opposed to every social program, mind you, but this overhaul is made screamingly socialist by it's involuntary nature.

I think we would do better to take individual steps on this.  Pass a bill exclusively on tort reform to help doctors manage malpractice costs, then try expanding some of the funding and income levels for some of the existing programs to get more people in.  See how these ideas effect things and go slowly.  I think we need to find better options for everyone, but not by passing a law that just forces everyone to buy insurance and does little to fix the problem besides a a few tax credits.  And always keep it voluntary.  Americans have to have a reasonable option to get out if the plan goes sour.

[iNow]

There are a few misconceptions in that post, Lara.


Here is the entire Obama plan in FOUR minutes:

[youtube:1n14z1x5]http://www.youtube.com/watch?v=hUNCpnRBf9o[/youtube:1n14z1x5]

[McQ]

There are a few misconceptions in that post, Lara.


Here is the entire Obama plan in FOUR minutes:

[youtube:wukxtbdh]http://www.youtube.com/watch?v=hUNCpnRBf9o[/youtube:wukxtbdh]

And there are a few misconceptions in this video as well, the most prominent (to me) is that the opening statement is now changed and it will be possible for those with insurance to have their plan and/or doctor switched. This video is not the current plan. Additionally, the plan itself is so vague in parts that there is more than ample wiggle room for the administration or whoever gets to run this, to make major changes to it (and if history is any indication - and it is - things will change in a patchwork fashion).

Has anyone here tried to deal with Medicare yet? If you like that, just wait until you see what the government can do with the health plan for ALL Amercians! LOL! It's going to be ugly, folks. Look what they did with Medicare Part D when they enacted that a couple of years ago. It's terrible. How about a nice $4500 co-pay for your first month of an oral cancer drug? They made a complete mess of Medicare Part D because a bunch of moron politicians who have no idea how health care works, made it go through too fast, and didn't listen to the people who actually have to try and deliver that health care.

None of this has been thought through enough. Again, I'm for change, but not change for change sake. This needs time and real, blood, sweat and tears planning and implementation. That has not happened yet.

[i_am_i]

I don't support it because it's basically just going to strengthen the insurance companies' hold on health care, as I understand it anyway.
Anything less than government-sponsored health care, free health care for all citizens, isn't good enough for me. I see all the misinformation tossed out about how terrible health care is in "socialized" countries and it's really silly. I lived in England for four years and the only thing I paid for was prescription medications, and at prices so low that it makes what we pay in America look insane.
If you were to tell Americans that they had to start paying for public school education for their children there would be rioting in the streets. That's how strongly the British feel about their health care system.
Putting up more profit centers between health care and the people is not a solution at all. Obama has made a real mess of this and I'm pretty dissapointed, especially since I was an rabid Obama volunteer. I'm almost embarassed to admit that now.
Now don't even get me started on Afghanistan.

[Ultima22689]

The way things sound I'm packing for Europe. HERE I COME AMSTERDAM!!!

[iNow]

And there are a few misconceptions in this video as well, the most prominent (to me) is that the opening statement is now changed and it will be possible for those with insurance to have their plan and/or doctor switched.

Can you elaborate on this?  My reading suggests that switching will not be required... While it's possible that your employer will choose a different option, and hence change the plan under which you're currently covered, that's really no different than your employer today... Who can switch to ANY cheaper plan they wish.  Is that the point you're making?  That the employers may decide to dump their current provider in favor of the government plan?  Also, you mention they can switch your doctor.  That one just doesn't pass the smell test with me, but I've read your posts, and you strike me as a very serious guy who is more than capable of supporting an argument.  So, with that said, can you please elaborate?

I've heard/read nothing about not being able to choose your own doctor (unless maybe they are incompetent and/or refuse to play within the rules of the system).

This video is not the current plan.

Understood.  There are many different "plans" out there.  The video summarizes what the president is asking for, and what he is asking be part of any final plan put forth.  To your point, though, I understand we do not yet have a final bill, so it's not chiseled in stone yet, not by any means.

Additionally, the plan itself is so vague in parts that there is more than ample wiggle room for the administration or whoever gets to run this, to make major changes to it (and if history is any indication - and it is - things will change in a patchwork fashion).

An interesting concern, but clearly based on "crystal ball" debate style.  There is ample history to support your intended point, but neither of us can say for certain what will specifically be written/allowed/prohibited.

Has anyone here tried to deal with Medicare yet? If you like that, just wait until you see what the government can do with the health plan for ALL Amercians! LOL! It's going to be ugly, folks.

I don't find fear and ridicule to be very compelling arguments.  Perhaps you can focus on something specific?

Look what they did with Medicare Part D when they enacted that a couple of years ago. It's terrible.

Completely agree.  That bill was pushed through and it was a big blowjob for the insurance industry and pharmaceutical companies.  We had no way identified to pay for it, and we surrendered our ability to negotiate lower prices for bulk purchases.  Instead of buying in bulk (buying more and paying less per unit), we simply buy more pharmaceuticals at price (buy more, and pay retail for each unit), ultimately padding the profits of pharma and insurance providers.

However, implicit in your argument is that the new approach/bill will simply be more of the same... repeating the same mistakes we made with Medicare part D back in 2003.  Nothing I've read yet implies this is the case.  To what specifically are you referring that gives you this concern?  If you're referring to the Baucus bill, then we are both completely on the same page.  It's crap, and makes things worse, not better.  However, IMO the Baucus bill will never get any further because it's another handjob for the insurance companies (I could be wrong, though... maybe it will pass, I just think the outrage about it has been too great thus far, and that the more intelligent bills and proposals will be the ones to move forward... something more akin to the Waxman bill).

Again, I'm for change, but not change for change sake. This needs time and real, blood, sweat and tears planning and implementation. That has not happened yet.

I, for one, favor a single payer option... basically "Medicare for Everyone."  By spreading the risk pool across the entire nation, only paying for treatments and tests with proven efficacy, and having a focus on preventative (instead of catastrophic) care, we would bring down the individual costs to each of us rather significantly while simultaneously covering more people.  It's the same logic used in the business world.  Small business struggle to get affordable care for their employees because they have so few of them, and the risk pool is not spread out enough... This results in huge premiums, high deductibles, and pathetic care.  However, with larger corporations with thousands of employees, the risk pool is larger... there are more people paying into the system, so the individual costs are much lower and the leverage to afford better coverage is much better.  Now, apply this logic to the country as a whole.  You spread the risk pool out across the whole country, and the individual costs are minimized.

Unfortunately, that's completely off the table right now, so in that sense I agree that the current approach simply isn't good enough.  I do, however, see the current approach as a "foot in the door" to make things better, as we absolutely can't go on with the way things have been going... Where premiums skyrocket, people can't afford it, and those that can tend to be under-covered.


Did you ever check out the Frontline video I linked for you?  It showed how universal coverage is done in five other nations, and my own feeling is that we could rather easily replicate (borrow the best ideas from) one or more of those systems.

Cheers.

[iNow]

The main reason is that there will be a mandate for every individual to buy and keep health insurance that includes fines for non-compliance.  
<...>
They should be able to afford to buy health insurance, too, right?  Well, if they can't, it will be the government that decides, not them.  So if money's tight but you are over the line, you're feeding your family mac and cheese five nights a week to afford healthcare, all the while getting less healthy.

For readers who have not been following the discussions very closely, all of the above is plainly false.  People who make too little money to afford care will be granted exceptions.  It's that simple.

Also, I wonder why people freak out about the mandate idea.  You're mandated to carry auto-insurance.  Why the sudden problem carrying health insurance?  Are cars more important than people's health?  The simple fact is that the mandate helps everyone to avoid having to pay for people "gaming the system."  If you don't mandate care, you have too many people willing to "chance it," who will avoid getting coverage.  Then, when they get sick, they show up at the emergency room and get care (which is mandated by law) despite being unable to pay for it.  Then, the rest of us absorb those costs with our own premiums.

By mandating coverage, you ensure that there is enough money in the system to care for all people... Precisely as it works with auto-insurance.  The only difference is that people can choose not to drive a car, but they cannot choose not to get sick.


Again... We mandate coverage for automobiles... We mandate coverage on our mortgages and homes...  We mandate all sorts of sensible things, and the logic underlying those mandates is very plain, clear, and understandable.  Yet, we talk about mandating health care coverage, and everyone starts screaming about socialism?  Give me a break.  Go open a book.

[McQ]

iNow, I don't want to just gloss over the points you've made, as they are thoughtful and thorough. I'm kind of pressed for time tonight and tomorrow, so I may be a bit slow on getting to them. I just don't want you to think I'm ignoring your post.   I haven't been very active recently due to significant family and work obligations, something I don't think will change anytime soon.

Briefly, the reason I mention the potential switching of physicians, is because the President changed his wording in his address between August and September. One of the sources, aside from just listening to his speech, is The Annenberg Public Policy Center (for better or worse!). I've found their summaries to be pretty accurate, as well as their in-depth fact checking.

Also, just to be sure I'm clear, I didn't say that the new plan will require you to switch your doctor. I said it will be possible for those with insurance to have their plans switched. In his change of wording, the President went from guaranteeing existing health coverage would not change (something that would have been highly unlikely) to backing off and leaving it open. To me it is a different scenario than an employer offering different plans (I also don't think employers should necessarily shoulder the burden anyway). And it has always been the case that any insurer at any time can drop health care coverage. Same with any insurance.

http://www.factcheck.org/2009/09/obamas ... re-speech/

I haven't yet viewed the Frontline video. I will watch it. thank you for the reminder.

I disagree that using history as a guideline for predicting future behavior is using a crystal ball. It is a sound method of predicting events, insofar as anything can be. It is not perfect, and I realize that change is inevitable. Just because something has been a certain way, does not necessarily mean it will always be that way. I get that. But history is a good method of predicting behavior, so I give it credence.

I have dealt with, and deal with a variety of Medicare and Medicaid issues every day. It is the most screwed up thing I have ever tried to deal with. I know people who are experts, and I mean with a capital E, and they cannot keep it all straight. If it is fair game to say our current health care system is broken, as our administration is saying, then why is it not fair to say that Medicare is broken and a complete mess?

I have to disagree with your assessment of my argument as using fear and ridicule to make my point. The fact is that Medicare is a complete mess and has been. The same people that currently run Medicare would be the ones running universal health care, unless you've heard something different. If calling Medicare a mess falls under the category of ridicule, I'm sorry if you find fault with that. The fact is that it is a mess.

I'd like to see those who think otherwise prove to me that things won't be a mess somehow. This is what I find disturbing. That otherwise rational, clear thinking people can simply just "buy" the message without asking for details. As a skeptic, I find it bizarre.

Yes, I'm worried about the Baucus bill, but again, I find that history is a pretty decent yardstick. As you've read nothing that implies repetition of mistakes, I've read nothing that implies we won't. What I want to see is detailed information and detailed plans that show exactly how we will not repeat that past and muck it up. If you've found that information, please share it. I have not found it, and will not support this plan until I do see it.

And I know that I may be wrong on some of these points, or that my opinions will simply differ. I'm ok with that. All of us should be checking this out though and looking for holes in the plans and in the arguments for and against.

I do agree with your last point about spreading risk, but I'm not sure how economically viable it will really be. I suck at economics, but something seems to be nagging at me about the ability to sustain that risk management (I know a nagging feeling is not evidence of anything - LOL!). I just can't nail it down yet.

Damn, I just looked at all I typed. I guess I ended up spending more time answering than I thought I would. But I felt your post deserved as much as I could give it for now.

Hope that clarifies at least some of what I wrote. I suppose my bottom line in all of this is that I do not automatically trust any ONE agency for all of anything. Ever. That includes this, or any government, with health care. But I do admit that it is something we need to get under control and make available to all citizens because right now, it ain't!

Cheers!

[iNow]

Thank you for your very thoughtful reply, McQ.  We most definitely agree on much more than was at first obvious.  

The potential for failure here is huge, but so is the potential for meaningful change.  There is really nothing in your post above with which I disagree, so I'm going to leave it here and call it a day.

I wish you all the best in finding simple solutions to the challenges and responsibilities with which you are faced right now, and I thank you tremendously for this really meaningful exchange.  It's really quite amazing what can happen in just two short posts.  Cheers to you, as well, my good man.

[LARA]

For readers who have not been following the discussions very closely, all of the above is plainly false. People who make too little money to afford care will be granted exceptions. It's that simple.

And readers who have been following the discussions very closely already know that this is true.  If you watched Obama's speech promoting healthcare a few weeks ago, he mentioned the individual mandate to buy health insurance.   If there was no individual mandate iNOW, then why would you even need to write

People who make too little money to afford care will be granted exceptions

. ??    This mandate is included in the Baucus Bill unless something has changed.  It includes tax credits for those who don't meet the income guidelines, true, but iNOW do you know how a tax credits work?  You take it directly off of your taxes, it's not a rebate.  Lower middle class families aren't going to benefit all that much from a credit.

The bill previously to the Baucus plan set premiums at around $400 a month for a family of four at the median income.  I don't think this bill is in play at this point, unless this part gets resurrected somehow.  Now compared to private insurance this is a pretty good price tag, but if you consider a dual career family with a high cost of work, childcare, car payments, etc.  It starts to get painful quite quickly.

If the Baucus bill includes these same income levels and ideas of affordability, then a mandate, which has been thrown on the table by Obama himself, is going to put a lot of economic pressure on families in the lower middle class.

Now I want to address some of your false analogies.  I am not a car, nor am I house.  These things can have a finite value placed on them.  A person's life can't be translated to dollars and this is part of the reason healthcare costs so much in a free market system.  Additionally, you can choose not to own a vehicle or buy a home if you can't afford it.  You cannot choose not to live, at least legally in the United States.  Additionally, not all States require all the same levels of coverage for automobile insurance, and if you buy your own home you are not required to insure it.  The reason it appears that homeowners insurance is enforced in law is because most of us have mortgages and the lien holder requires it.  And lastly, compare the annual cost of an auto premium and a home owners policy to health insurance.  It's not even in the same ballpark.

Now please do note I did not say I was against some redistribution of wealth or improving the healthcare system.  It really needs improving, this is not a point of contention.

What I would like to explain is that I am opposed to strongly socialist economic systems because they remove a great deal of freedom from the individual and reduce incentive to work harder.  I do however realize that not all us us have an altruistic sense and some will strip everyone else of their hard earned cash at any opportunity.  A little redistribution is necessary, so are antitrust laws and fair business practices.

If Obama loses the idea of an individual mandate, then I would  most likely support it.