(Political) To the Left wing of the Democratic party

[ISiddiqui]

Btw, I come from the other side of lynchjim. I work for the US government enforcing ERISA, making sure companies follow health care regulations for the group health plans, and I completely agree with lynchjim's observations on pre-ex and mandates. I wonder who that makes a shill for?

[flere-imsaho]

The issue with pre-existing conditions and mandates is common sense. Why in the world would private entities agree to "insure" (read: pay for) people with known expensive conditions? Even if these entities are non-profit? Even with the "greedy profit motive" aside, it still makes no sense.

If we force insurance companies to pay for people with pre-existing conditions, the result will be insurance companies needing to offset these costs with higher premiums on healthy (or at least currently healthy) people. To me, the eventual outcome of this is that healthy people don't pay insurance premiums until they develop a costly condition, at which point they get "insurance". Of course, you can force them to own insurance, which is basically forcing them (or their employer) to pay into, in effect, a national system of "health care cost distribution".

So, if you're going to do all this, through a complex system involving 50 states and hundreds of insurance companies, might it not be better, simpler, and easier simply have the government pay for everything, and distribute the cost to all taxpayers evenly?

Oh wait, but then we get death panels. My bad.

[lynchjm24]

Originally Posted by SteveBollea

I'm a shill for those who die because your bosses bosses bosses boss believe it's better they make millions of dollars. Also, for understanding it so well, it's weird how your argument always comes back to, "the insurance companies are better."

Oh, insurance companies are killing people. Well when you put it like that I'm convinced.

[lynchjm24]

Originally Posted by DaddyTorgo

i found your last couple sentences to be interesting and somewhat...refreshing i guess you'd say? that you think the bill is a total shitshow and you agree there needs to be government involvement.

I think most people agree there should be coverage for everyone. I really don't know many (any) who don't agree with that.

This bill is a fiscal boondoggle though. Even if it truly was deficit neutral for a decade (if it is it's only because they tax for 3 years before they spend any money), in the decades after it would make the bank bailouts look like chump change.

[DaddyTorgo]

Originally Posted by flere-imsaho

The issue with pre-existing conditions and mandates is common sense. Why in the world would private entities agree to "insure" (read: pay for) people with known expensive conditions? Even if these entities are non-profit? Even with the "greedy profit motive" aside, it still makes no sense.

If we force insurance companies to pay for people with pre-existing conditions, the result will be insurance companies needing to offset these costs with higher premiums on healthy (or at least currently healthy) people. To me, the eventual outcome of this is that healthy people don't pay insurance premiums until they develop a costly condition, at which point they get "insurance". Of course, you can force them to own insurance, which is basically forcing them (or their employer) to pay into, in effect, a national system of "health care cost distribution".

So, if you're going to do all this, through a complex system involving 50 states and hundreds of insurance companies, might it not be better, simpler, and easier simply have the government pay for everything, and distribute the cost to all taxpayers evenly?

Oh wait, but then we get death panels. My bad.

quite the well-reasoned and simple explanation.

[lynchjm24]

Originally Posted by SteveBollea

You mean the European models that cost less, get better outcomes, are having a lowered rise in costs than private insurance in the US? So, if they're supposedly "falling apart", what does that say for private insurance?

Also, there's plenty of ways to pay for it. Reversing the Bush tax cuts would pay for the current health care bill. Going back to Reagan-era tax cuts would make things even better. Actually cut some of the massive bloat in the Pentagon and it'd be even easier.

Why don't you do some research on how things really are tracking going forward in Europe and we'll catch up after that. The demographics don't work in the future. There are too many old people and not enough workers. Some of the countries are starting to fray and when the demos catch up with them it will turn south quickly.

Raise taxes? Are you a senator or just a lowly member of the House?

[JPhillips]

Originally Posted by Mizzou B-ball fan

Fixed.

Republicans don't inherently have a problem with health care reform. They just differ on how they'd do it. A small clarification, but a very important one. While the tactic is used to villianize the minority party, there's nothing wrong with wanting a bill to fail if you don't believe that it's the best way to structure a policy. It just depends on where you stand as you correctly state.

There is no way to construct a healthcare reform bill that would gain GOP support. They've decided, rightly I think, that Obama losing offers greater political gain than any other option. Now I think it's a cynical game to play with people who are dying due to lack of insurance, but it is what it is.

[molson]

Originally Posted by flere-imsaho

Oh wait, but then we get death panels. My bad.

This is why the Dems don't have to accomplish anything - they can just blame others for their failures.

[lynchjm24]

Originally Posted by flere-imsaho

So, if you're going to do all this, through a complex system involving 50 states and hundreds of insurance companies, might it not be better, simpler, and easier simply have the government pay for everything, and distribute the cost to all taxpayers evenly?

To even ask the question you've got a lot more faith in government then I do. It could potentially be simpler, but I don't see any way in the world that it could be better.

This isn't with respect to your post but I'm not in the mood to hear about Europe and Canada. Give me a call when:

A. The US doesn't have to play defender of freedom to the world and can move spending from the military to health care.

B: Americans are willing to be treated like patients in those countries. Chicago has more MRI machines then Canada. Let me know when Americans are willing to stop having expensive tests like that.

C: The sort of medical providers you'd want treating you are willing to work for what medical professionals in those countries make. My wife has a cousin who is a brain surgeon in a European country with socialized medicine and has a standard of living about 4 levels below us.

Oooooohhh.. our system is so much better then you Americans... but if someone tries to invade us please stand up to them.

[flere-imsaho]

Originally Posted by lynchjm24

Why don't you do some research on how things really are tracking going forward in Europe and we'll catch up after that. The demographics don't work in the future. There are too many old people and not enough workers. Some of the countries are starting to fray and when the demos catch up with them it will turn south quickly.

Arguably the demographics work worse for our private/public (don't forget Medicare) system.

Future workers will be paying more in taxes to pay for Medicare (because more people will be on Medicare than even before, just due to aging, not even the increased costs due to this bill) while also paying more in health care premiums because of the ever-rising cost of health care itself.

At least a fully-public system can:

1. Use huge economies of scale to aggregate and manage cost inflation.

2. Adjust based on demographic trends by tapping sources of funding not available to private entities.

[sterlingice]

Originally Posted by Kodos

I don't understand why the democrats aren't stripping Lieberman of everything including his parking spot at this point.

I'm not sure I mentioned this here- but I've been fairly impressed with what Pelosi has done in the House with rounding up the troops and getting votes done. A much better health care bill, cap and trade, financial regulation, card check, and more are already signed, sealed, and delivered. I never liked her, but I've been impressed by how things have gone in the past 3 years in the House so I've had to change my opinion.

So, here's the big "but". It turns out Reid is as bad as we thought he was. He has a much more difficult situation to deal with but he's unwilling to do anything even with his job in jeopardy. A lot of this lies at his feet because you know if, say, Tom DeLay were running things on the Democratic side and, mercifully, he's not as they don't tend to employ lesser demons, Lieberman wouldn't just be threatened with losing his seat but the life of his firstborn and his firstborn's firstborn.

SI

[DaddyTorgo]

Originally Posted by lynchjm24

To even ask the question you've got a lot more faith in government then I do. It could potentially be simpler, but I don't see any way in the world that it could be better.

This isn't with respect to your post but I'm not in the mood to hear about Europe and Canada. Give me a call when:

A. The US doesn't have to play defender of freedom to the world and can move spending from the military to health care.

B: Americans are willing to be treated like patients in those countries. Chicago has more MRI machines then Canada. Let me know when Americans are willing to stop having expensive tests like that.

C: The sort of medical providers you'd want treating you are willing to work for what medical professionals in those countries make. My wife has a cousin who is a brain surgeon in a European country with socialized medicine and has a standard of living about 4 levels below us.

Oooooohhh.. our system is so much better then you Americans... but if someone tries to invade us please stand up to them.

we also have higher GDP than those other countries and thus can pay higher salaries to the medical professionals that we have and will have going forward.

we also already have all of those machines - not like they're all going to up and magically dissapear.

your point A is very well-taken and true though. wayyyyyyy too much spending going into the military-industrial complex in this country as a result of our playing unilateral defender of the free world.

[panerd]

Originally Posted by SteveBollea

I'm a shill for those who die because your bosses bosses bosses boss believe it's better they make millions of dollars. Also, for understanding it so well, it's weird how your argument always comes back to, "the insurance companies are better."

What about the soldiers that die for unecessary wars? What about police officers that die fighting the war on drugs? Nah, government accountability is only needed for the private health care industry.

[Mizzou B-ball fan]

Originally Posted by JPhillips

There is no way to construct a healthcare reform bill that would gain GOP support. They've decided, rightly I think, that Obama losing offers greater political gain than any other option. Now I think it's a cynical game to play with people who are dying due to lack of insurance, but it is what it is.

That's just flat-out wrong. A 'take it or leave it' stance by Democrats would put the crosshairs squarely on the GOP and result in much less backlash against the Dems. They could show that they really mean that they want true reform.

As it is, the Democrats look like a group looking to stay in office for 4-6 more years rather than anyone looking out for the interests of 'people dying due to a lack of insurance'. Once again, the Dems have the power and promised to do something. So do something already.

[Warhammer]

Originally Posted by SteveBollea

Um, were you asleep from 2001 to 2006? Even conservatives agree the GOP got shit done in that time period. Now, that shit may not be popular on this board (NCLB, massive tax cuts, Patriot Act, etc. etc.), but it's accepted knowledge that the Republican Party is always much more organized from the top-down with much more party discipline.

Uh, the Patriot Act passed the Senate with 98 yes votes. That is bi-partisan support, not the majority cramming something down the throat of the minority.

NCLB passed the Senate with 87 to 10. Again, this was a bi-partisan vote. Also, VT, MN, and NE both senators voted against it, 3 R and 7 D voted against the bill.

Tax cuts are arguably the one conservative item he passed.

My point is that the GOP was in a position to shove anything down the throats of the Dems. They did not do so. They split the committee chairs with the Dems, which frustrated many GOP members. You had Trent Lott removed from his leadership position, due in part to the way he handled the Dems.

Outside of the war and associated legislation, much of what Bush passed was not conservative. That was one of my problems with him, he ran as a conservative, and governed as a moderate.

[Passacaglia]

Originally Posted by DaddyTorgo

we also have higher GDP than those other countries and thus can pay higher salaries to the medical professionals that we have and will have going forward.

we also already have all of those machines - not like they're all going to up and magically dissapear.

your point A is very well-taken and true though. wayyyyyyy too much spending going into the military-industrial complex in this country as a result of our playing unilateral defender of the free world.

Those machines cost a LOT to operate, though. It's not so much the fact that we have the machines -- it's that we're accustomed to having those tests performed more often.

[sterlingice]

Originally Posted by lynchjm24

Why don't you do some research on how things really are tracking going forward in Europe and we'll catch up after that. The demographics don't work in the future. There are too many old people and not enough workers. Some of the countries are starting to fray and when the demos catch up with them it will turn south quickly.

Well, our solution of pricing the poorest 30% of the populace out of the market so they have no care is a much better model.

SI

[lynchjm24]

Originally Posted by flere-imsaho

Arguably the demographics work worse for our private/public (don't forget Medicare) system.

Future workers will be paying more in taxes to pay for Medicare (because more people will be on Medicare than even before, just due to aging, not even the increased costs due to this bill) while also paying more in health care premiums because of the ever-rising cost of health care itself.

At least a fully-public system can:

1. Use huge economies of scale to aggregate and manage cost inflation.

2. Adjust based on demographic trends by tapping sources of funding not available to private entities.

Once you build a single payer system and there is no incentive whatsoever for the individual to control costs at a personal level you can forget any chance of managing cost inflation. All you need to see is how people utilize their employer plans once they reach their deductible and out of pocket limits. They get care just for the sake of getting care.

The only way to ever slow down the cost of health care growth is to force people to take care of themselves. If you've got a non-financial way to do that I'd love to hear it.

The demographics are an issue here as well as there, the difference is that no one here is pounding their chest about how great the system is. Many of those countries are about to watch their programs strangle their economy. We probably are as well, but running to their method that worked 15 years ago is no way to solve our problem.

[lynchjm24]

Originally Posted by sterlingice

Well, our solution of pricing the poorest 30% of the populace out of the market so they have no care is a much better model.

SI

If you really believe that you might want to start over. First of all you might want to be aware of Medicaid, secondly stop confusing 'health care' and 'health insurance'. Stop by your local emergency room for a crash course.

[lynchjm24]

Originally Posted by DaddyTorgo

we also already have all of those machines - not like they're all going to up and magically dissapear.

Uh.. they don't run themselves. They aren't cell phone towers, it takes well compensated people to run them.

[JPhillips]

Originally Posted by Warhammer

Uh, the Patriot Act passed the Senate with 98 yes votes. That is bi-partisan support, not the majority cramming something down the throat of the minority.

NCLB passed the Senate with 87 to 10. Again, this was a bi-partisan vote. Also, VT, MN, and NE both senators voted against it, 3 R and 7 D voted against the bill.

Tax cuts are arguably the one conservative item he passed.

My point is that the GOP was in a position to shove anything down the throats of the Dems. They did not do so. They split the committee chairs with the Dems, which frustrated many GOP members. You had Trent Lott removed from his leadership position, due in part to the way he handled the Dems.

Outside of the war and associated legislation, much of what Bush passed was not conservative. That was one of my problems with him, he ran as a conservative, and governed as a moderate.

But you can't compromise with a party that sees defeat as their primary goal. Bush ran up some big vote totals because Dems negotiated in good faith. On HCR the Gang of Six's Republicans made it very plain over the summer that any bill would be opposed. They're set to filibuster every major piece of legislation, which the Dems didn't do under Bush.

[flere-imsaho]

Originally Posted by lynchjm24

To even ask the question you've got a lot more faith in government then I do. It could potentially be simpler, but I don't see any way in the world that it could be better.

If the U.S. government administrates programs so much more poorly than private entities, then why are even the most vehement HCR opponents so attached to Medicare?

If the U.S. government administrates programs so much more poorly than private entities, why is the Veterans Health Administration such a success?

A. The US doesn't have to play defender of freedom to the world and can move spending from the military to health care.

For someone who purports to be cost-conscious, I'm surprised that you're unwilling to look for cost savings in the vast military budget, especially with the many egregious examples that are ripe for the picking.

B: Americans are willing to be treated like patients in those countries. Chicago has more MRI machines then Canada. Let me know when Americans are willing to stop having expensive tests like that.

I lived in England and was a patient in that system. My quality of care was just as good as the quality of care I've received in the U.S., and I have excellent insurance.

Further, I'll bet that a resident of East London has far more equitable access to an MRI than a resident of the South Side of Chicago.

C: The sort of medical providers you'd want treating you are willing to work for what medical professionals in those countries make. My wife has a cousin who is a brain surgeon in a European country with socialized medicine and has a standard of living about 4 levels below us.

How do you define "4 levels"? Is he unhappy? Why doesn't he quit practicing or move to the States?

On the down side, he gets paid less. On the plus side, he probably doesn't have student loans to pay and almost certainly doesn't have to pay for a ridiculous level of malpractice insurance.

And anyway, how is the cause of "providing coverage for everyone", which you admit should be the goal, served by making every doctor a millionaire?

[JPhillips]

Originally Posted by Mizzou B-ball fan

That's just flat-out wrong. A 'take it or leave it' stance by Democrats would put the crosshairs squarely on the GOP and result in much less backlash against the Dems. They could show that they really mean that they want true reform.

As it is, the Democrats look like a group looking to stay in office for 4-6 more years rather than anyone looking out for the interests of 'people dying due to a lack of insurance'. Once again, the Dems have the power and promised to do something. So do something already.

I'm not arguing the Dems have handled things well, but there was no way to garner GOP support. They haven't been negotiating in good faith, and, yes, the Dems should have had the sense to go it alone. However, the moderates don't roll that way and now we'll get a shit sandwich of a bill that won't be nearly as effective as it could have been.

[JPhillips]

Originally Posted by flere-imsaho

If the U.S. government administrates programs so much more poorly than private entities, then why are even the most vehement HCR opponents so attached to Medicare?

If the U.S. government administrates programs so much more poorly than private entities, why is the Veterans Health Administration such a success?



For someone who purports to be cost-conscious, I'm surprised that you're unwilling to look for cost savings in the vast military budget, especially with the many egregious examples that are ripe for the picking.



I lived in England and was a patient in that system. My quality of care was just as good as the quality of care I've received in the U.S., and I have excellent insurance.

Further, I'll bet that a resident of East London has far more equitable access to an MRI than a resident of the South Side of Chicago.



How do you define "4 levels"? Is he unhappy? Why doesn't he quit practicing or move to the States?

On the down side, he gets paid less. On the plus side, he probably doesn't have student loans to pay and almost certainly doesn't have to pay for a ridiculous level of malpractice insurance.

And anyway, how is the cause of "providing coverage for everyone", which you admit should be the goal, served by making every doctor a millionaire?

I don't think the primary issue is insurance costs. The problem is the continuing increase in costs for providers and services. Regardless of whether it's a government program or private insurance the only solution is to reduce the rate of growth for expenditures. That means doctors and drug companies and medical service providers need to accept that they can't continue to have income rise well above inflation.

[flere-imsaho]

Originally Posted by lynchjm24

Once you build a single payer system and there is no incentive whatsoever for the individual to control costs at a personal level you can forget any chance of managing cost inflation. All you need to see is how people utilize their employer plans once they reach their deductible and out of pocket limits. They get care just for the sake of getting care.

The only way to ever slow down the cost of health care growth is to force people to take care of themselves. If you've got a non-financial way to do that I'd love to hear it.

You're taking anecdotal evidence and trying to extrapolate it into data.

Due to having a toddler, my family blew through our deductible much earlier this year, and also our out-of-pocket maximum as well. So by your logic, I'm heading off to get a chest X-Ray whenever I feel a bit wheezy, or a CAT scan when I have a headache, and I always pick brand name drugs over generics, right?

If what you say were true, then everyone in my position would abuse the system, right? And all these insurance companies would be bankrupted by our egregious expenses, right?

But they're not, which means there's a flaw in your reasoning.

[sterlingice]

Originally Posted by lynchjm24

B: Americans are willing to be treated like patients in those countries. Chicago has more MRI machines then Canada. Let me know when Americans are willing to stop having expensive tests like that.

That sounded a lot more impressive until I looked up populations. Chicago has almost 10M (9.52M in the MSA) versus 33.1M in Canada in 2007. Wow: Chicago has basically 1/3rd the population of Canada. Hell, NYC + LA are almost as populous as all of Canada (31.8M vs 22.1M). Never realized how few people lived in Canada.

That still means there are 1/3rd the MRI machines in Canada vs the US, at the minimum. But, who can afford to get an MRI? Hell, I know a lot of us are afraid to get basic blood tests because it's a fight to get back the $200+ that we get charged for preventative care. Lord knows if I were actually ever seriously hurt, I'd spend most of my time in the hospital bed worrying about how badly bankrupt I'm going to be, even tho I've been told I have good coverage.

And that a lot of people don't know how covered they actually are because they've never gotten seriously sick so they think their coverage is fine. I swear I need a lawyer just to go through my insurance renewals at work and we "streamline" stuff compared to a lot of companies.

It seems like we're trying really hard to protect the super high levels of care that only the wealthiest 2-10% of the population can afford at the expense of the other 90%.

C: The sort of medical providers you'd want treating you are willing to work for what medical professionals in those countries make. My wife has a cousin who is a brain surgeon in a European country with socialized medicine and has a standard of living about 4 levels below us.

What European country? We're not talking about Eastern Europe, right? And what is 4 levels below us? Can he only buy a BMW instead of a set of Porsches or is he having problems feeding his family and paying his student loans (which he probably doesn't have)?

Again, it's not like we only have the best and the brightest in that field right now. Just like any other field, there are good doctors and there are bad doctors. I've already been reading lots of stories about how we're badly short on primary care physicians in this country. Right now. Today. Not because off what we're talking about doing. But right now. Because of the system in place.

So what we have now is a really mercenary force that only goes into the fields that make the most money. I'm not sure how that really equals better care, just that you have a greedier bastard treating you.

SI

[JPhillips]

Originally Posted by flere-imsaho

You're taking anecdotal evidence and trying to extrapolate it into data.

Due to having a toddler, my family blew through our deductible much earlier this year, and also our out-of-pocket maximum as well. So by your logic, I'm heading off to get a chest X-Ray whenever I feel a bit wheezy, or a CAT scan when I have a headache, and I always pick brand name drugs over generics, right?

If what you say were true, then everyone in my position would abuse the system, right? And all these insurance companies would be bankrupted by our egregious expenses, right?

But they're not, which means there's a flaw in your reasoning.

I thought chronic disease management and end of life care were the biggies in health costs. I don't think some extra office visits make much of a difference given the dollar amounts we're talking about.

[flere-imsaho]

Originally Posted by JPhillips

I thought chronic disease management and end of life care were the biggies in health costs. I don't think some extra office visits make much of a difference given the dollar amounts we're talking about.

Oh, I agree. I was just responding to the point I think Jim's trying to make that in a UHC system people will just take advantage of everything because it's free to them. It's demonstrably not the case, and even if they did (as you point out), it might not be the major cost factor anyway.

[Warhammer]

Originally Posted by JPhillips

But you can't compromise with a party that sees defeat as their primary goal. Bush ran up some big vote totals because Dems negotiated in good faith. On HCR the Gang of Six's Republicans made it very plain over the summer that any bill would be opposed. They're set to filibuster every major piece of legislation, which the Dems didn't do under Bush.

I would disagree that the Dems negotiated in good faith. The Dems fought GWB on every major piece of legislation from say summer of 03 on. They threatened fillibusters and other items. I'll say now what I said them, if you believe in what you are doing, force the other side to fillibuster.

Typically, a fillibuster makes the opposing side look like fools. Don't let them get away with a threat, call their bluff.

[flere-imsaho]

Originally Posted by Warhammer

I would disagree that the Dems negotiated in good faith. The Dems fought GWB on every major piece of legislation from say summer of 03 on.

So the Democrats negotiated in good faith with the GOP and Bush for the first 2 1/2 years of his Presidency, by your metric (with which I agree, by the way). As opposed to the GOP now, which has negotiated in good faith with the Democrats and Obama since...?

Key legislation:

Economic Growth and Tax Relief Reconciliation Act (May, 2001) - 230/197, 62-38 (if I read the details correctly, elements of this were passed through the reconciliation process to avoid filibusters)

Authorization of Military Force (Sept, 2001) - 420-1, 98-0

USA PATRIOT Act (Oct, 2001) - 357-66, 98-1

No Child Left Behind (May/June, 2001) - 384-45, 91-8; (Dec, 2001 - after conference committees) - 381-41, 87-10

Iraq War Resolution (Oct, 2002) - 297-133, 77-23

Jobs and Growth Tax Relief Reconciliation Act (May, 2003) - 231-200, 50-50 (Cheney tiebreaker)

Partial-Birth Abortion Ban Act (Nov, 2003) - 281-142, 64-34

Medicare Modernization Act (June/July 2003) - 216-215, "unanimous"; (Dec, 2003 - after conference committees) - 220-215, 54-44


There was little in the way of major legislation passed in 2004.


Bankruptcy Abuse Prevention and Consumer Protection Act (April, 2005) - 302-126, 74-25

Energy Policy Act (July, 2005) - 275-156, 74-26

USA PATRIOT Act Reauthorization (July, 2005) - 257-171, "unanimous"; (Dec 2005/Mar 2006 - after conference committees) - 251-174, 89-10

Military Commissions Act (Sept/Oct 2006) - 250-170, 65-34



Also of note are that all of Bush's 12 vetoes came from 2006 onwards (the Democrats gained control of the House & Senate in the 2006 elections, but some vetos happened just before this).

[JediKooter]

Welcome to Washington DC everyone!!! Where a politicians only job is to do whatever it takes to get relected (since there's no term limits) and not what is best for their constituents, regardless of what party they align themselves with.

[JPhillips]

Originally Posted by Warhammer

I would disagree that the Dems negotiated in good faith. The Dems fought GWB on every major piece of legislation from say summer of 03 on. They threatened fillibusters and other items. I'll say now what I said them, if you believe in what you are doing, force the other side to fillibuster.

Typically, a fillibuster makes the opposing side look like fools. Don't let them get away with a threat, call their bluff.

A filibuster doesn't make people look like fools. The procedures are such that it's much harder on the majority than the minority to force an old fashioned filibuster. It's gotten to the point where sixty votes in the Senate is seen as the norm when it was never meant to be used to such a degree.

[duckman]

Originally Posted by flere-imsaho

If the U.S. government administrates programs so much more poorly than private entities, why is the Veterans Health Administration such a success?

HAHAHAHAHAHAHA! I really needed a good laugh with all the shit I've been going through lately.

If the system is such a success, then why did I wait nearly two months to get a MRI for a possibly debilitating neurological disorder (multiple scelorisis) or further degeneration of my cervical spine? The ONLY reason I even got in that early is because I requested a night appointment, or it would have been 3-4 months. Then, I get to wait another 3 weeks to find out what it is that I have. Yup, it's a great system alright!

While I admit that the quality of care has improved significantly over the years, there are still too long of waits, overstressed overworked and undercompensated staff, and inefficency in the process of providing care to veterans. I attend several veterans organization meetings and as much as 75% of veterans are dissatisfied with the system. What makes it worst is that the VA don't even listen to us when we complain about the system! They brush us off in our surveys because they don't get adequate resources to carry out what they are here to do: treat veterans.

[ISiddiqui]

Here is Ezra Klein (no conservative):

http://voices.washingtonpost.com/ezr..._insurers.html

To put this a bit more sharply, if I could construct a system in which insurers spent 90 percent of every premium dollar on medical care, never discriminated against another sick applicant, began exerting real pressure for providers to bring down costs, vastly simplified their billing systems, made it easier to compare plans and access consumer ratings, and generally worked more like companies in a competitive market rather than companies in a non-functional market, I would take that deal. And if you told me that the price of that deal was that insurers would move from being the 86th most profitable industry to being the 53rd most profitable industry, I would still take that deal.

And that may be the exact deal we're getting. The profit motive is not, in and of itself, a bad thing.

[Raiders Army]

Originally Posted by lynchjm24

The only way to ever slow down the cost of health care growth is to force people to take care of themselves. If you've got a non-financial way to do that I'd love to hear it.

Hey, stupid question: USAA gives us money back at the end of the year on our auto insurance if we've been good (no accidents, tickets, etc.). I know above you talked about a non-financial solution, but would it be possible for health insurance companies to refund some money at the end of the year if you've undergone a physical and are healthy and have been healthy for the year?

Or would that just not work?

[JPhillips]

Originally Posted by Raiders Army

Hey, stupid question: USAA gives us money back at the end of the year on our auto insurance if we've been good (no accidents, tickets, etc.). I know above you talked about a non-financial solution, but would it be possible for health insurance companies to refund some money at the end of the year if you've undergone a physical and are healthy and have been healthy for the year?

Or would that just not work?

I'd be in favor of some sort of discount for getting a physical/check up, but being healthy is too much of a lottery. Many diseases have genetic components that can't be controlled no matter how healthy your lifestyle may be. It doesn't seem fair to punish people because they are predisposed to MS or breast cancer.

[Raiders Army]

Originally Posted by JPhillips

I'd be in favor of some sort of discount for getting a physical/check up, but being healthy is too much of a lottery. Many diseases have genetic components that can't be controlled no matter how healthy your lifestyle may be. It doesn't seem fair to punish people because they are predisposed to MS or breast cancer.

Ah, you're absolutely correct. Comparing auto insurance where you have control over tickets/accidents isn't the same as health insurance.

[Karlifornia]

Originally Posted by lynchjm24

My wife has a cousin who is a brain surgeon in a European country with socialized medicine and has a standard of living about 4 levels below us.

Oooooohhh.. our system is so much better then you Americans... but if someone tries to invade us please stand up to them.

Standard of living 4 levels below us? What does that mean? He can't order useless crap from the Brookstone catalog?

And it's not like we don't ask other countries to stand with us when we go to war.

[DaddyTorgo]

some of the limitations of this new legislation as far as ways insurance companies could still game the system?

so they're required to provide coverage for people with say kidney disease? Maybe they just won't have any nephrologists in their network. and maybe their out-of-network paperwork will be 10x as complicated as it is now.


also a worry with this new bill: because subsidies don't kick in until 2014, it's possible that in a nightmare scenario, they could be dramatically cut or even eliminated before seeing the light of day. In the absence of any systemic reform, then, we face the unpleasant possibility that with a realignment of power in Washington, DC, we could end up with a mandate -- and fewer, or even no, subsidies.

[sabotai]

Originally Posted by Raiders Army

Hey, stupid question: USAA gives us money back at the end of the year on our auto insurance if we've been good (no accidents, tickets, etc.). I know above you talked about a non-financial solution, but would it be possible for health insurance companies to refund some money at the end of the year if you've undergone a physical and are healthy and have been healthy for the year?

Or would that just not work?

My brother's insurance gives him X% off per month for joining a health/fitness club. I forget the exact numbers, but the money he gets off per month more than makes up for the cost of membership.

[DaddyTorgo]

Originally Posted by DaddyTorgo

also a worry with this new bill: because subsidies don't kick in until 2014, it's possible that in a nightmare scenario, they could be dramatically cut or even eliminated before seeing the light of day. In the absence of any systemic reform, then, we face the unpleasant possibility that with a realignment of power in Washington, DC, we could end up with a mandate -- and fewer, or even no, subsidies.

pulling this out - wouldn't this just be a kick in the fucking balls. dream scenario for the insurance companies too - a government requirement to buy their product, no incentive to lower cost, and no help for those who can't afford it.

[SirFozzie]

Angry liberals: Why didn't Obama fight? - - POLITICO.com

This sums up the situation well.

Especially this bit of wishful thinking:

Dean said there are some good elements in the bill, but lawmakers should pull the plug and revisit the issue in Obama’s second term, unless Democrats are willing to shortcut a GOP filibuster. “No one will think this is health care reform. This is not even insurance reform,” he said.

It's not a given Obama will have a second term! You take what you can get, because you will never come this far again!

[Buccaneer]

Originally Posted by Mizzou B-ball fan

This is a fun little game. When a fiscal conservative points out the numerous flaws in this bill and where the money is going, it's called 'hoping the bill will fail'. When a liberal points out the same issues at a later date, it's called constructive criticism from supporters.

I like this game.

Is that the same thing as those supporting the passage of the bill only because it will give brownie points to the Democrats in hoping that the Republicans don't realize any gain in 2010?

I swear, some of the comments I have read (not here, per se) is all about making their party look good at the expense of making the enemy party look bad. That's why it's funny to see the many partisans trying to debate this (when it doesn't really affect most of them) while trying not to say it's all about political power and self-esteem.

[lynchjm24]

Originally Posted by flere-imsaho

You're taking anecdotal evidence and trying to extrapolate it into data.

Due to having a toddler, my family blew through our deductible much earlier this year, and also our out-of-pocket maximum as well. So by your logic, I'm heading off to get a chest X-Ray whenever I feel a bit wheezy, or a CAT scan when I have a headache, and I always pick brand name drugs over generics, right?

If what you say were true, then everyone in my position would abuse the system, right? And all these insurance companies would be bankrupted by our egregious expenses, right?

But they're not, which means there's a flaw in your reasoning.

It's not anecdotal evidence. It's actuarial science.. you know the type of work that would be done to figure out what healthcare costs will be. Maybe everyone won't abuse the system, but if you don't think that people know how to utilize their health insurance to best serve them then you need to start over. It's not even worth debating, it's reality.

[lynchjm24]

Originally Posted by flere-imsaho

Oh, I agree. I was just responding to the point I think Jim's trying to make that in a UHC system people will just take advantage of everything because it's free to them. It's demonstrably not the case, and even if they did (as you point out), it might not be the major cost factor anyway.

Sure if you want to qualify your statement with "everyone" it's not true. For someone as bright as you are, you are pretty out of touch with how people behave.

[lynchjm24]

Originally Posted by duckman

HAHAHAHAHAHAHA! I really needed a good laugh with all the shit I've been going through lately.

If the system is such a success, then why did I wait nearly two months to get a MRI for a possibly debilitating neurological disorder (multiple scelorisis) or further degeneration of my cervical spine? The ONLY reason I even got in that early is because I requested a night appointment, or it would have been 3-4 months. Then, I get to wait another 3 weeks to find out what it is that I have. Yup, it's a great system alright!

While I admit that the quality of care has improved significantly over the years, there are still too long of waits, overstressed overworked and undercompensated staff, and inefficency in the process of providing care to veterans. I attend several veterans organization meetings and as much as 75% of veterans are dissatisfied with the system. What makes it worst is that the VA don't even listen to us when we complain about the system! They brush us off in our surveys because they don't get adequate resources to carry out what they are here to do: treat veterans.

I'll be honest. I have no idea where the military can cut costs. I don't have any knowledge about how they spend the money or if it's appropriate. I assume that there are people (I'm guessing a small minority) who push for things to be handled correctly.

I also know nothing about the Veteran's Health Administration. I'm assuming they have something to do with Walter Reed, and if they do then they are a disgrace, not something that should be aspired to.

[lynchjm24]

Originally Posted by Karlifornia

Standard of living 4 levels below us? What does that mean? He can't order useless crap from the Brookstone catalog?

And it's not like we don't ask other countries to stand with us when we go to war.

No, it means I've spent a week with them in WESTERN Europe and the standard of living pales in comparison to the people that live in my upper middle class neighborhood in eastern Connecticut. He's a brain surgeon, my neighbors are firemen and work on IT help desks.

[lynchjm24]

Originally Posted by Raiders Army

Hey, stupid question: USAA gives us money back at the end of the year on our auto insurance if we've been good (no accidents, tickets, etc.). I know above you talked about a non-financial solution, but would it be possible for health insurance companies to refund some money at the end of the year if you've undergone a physical and are healthy and have been healthy for the year?

Or would that just not work?

Isn't that financial? Many employers are giving people money for taking part in wellness programs in the hope that this drives down their long term costs. The programs cost money though so it's mostly large employers.

I don't know many people in the insurance industry who wouldn't support preventative care being provided at no copay and no costs to members. The problem becomes that in the short term this drives costs UP and many employers aren't in a position to increase their costs in the short term especially since many industries experience enough turnover that it's a wasted investment.

[lynchjm24]

This is the thing that gets me about this entire debate: The idea that the government will do a better job controlling costs then insurance companies is so wrong that it's painful. The human resources that the insurance companies are using to try and control costs are so much better then what the government would use they can't even be compared. Health care costs are out of control for a thousand reasons, the profits of insurance companies are a drop in the bucket.

[lynchjm24]

Originally Posted by SteveBollea

So, it's all about the Benjamin's? But, by the way, here's a list.

The chart is impossible to make sense of, but it seems that in France the GPs make 1/3 what they make in the United States. Of course there are a ton of factors that come into play, but if you don't think that reducing what doctor's make will drive some talented people away from the field... I don't know what to tell you. Some people are motivated by the desire to help others and it won't matter, but plenty are motivated by material desires.