No matter which side of the issue members come down on, they will find that the people who put them in office remain deeply confused about what the still-being-written overhaul might bring.
And most Americans are equally suspicious of ”” and confused by ”” claims being made by both supporters and opponents of President Obama’s most ambitious domestic initiative.
With Congress still struggling to fashion legislation and Obama letting the details take shape on Capitol Hill while he sells its broader parameters during appearances that include town hall meetings, most outside Washington have no idea what the overhaul will look like, what it will cost and how it could affect them personally, says Mark Blumenthal of Pollster.com.
“Much of this story has been a big, inside-Washington debate about cost and bending the cost curve,” he says. “It’s a remote, technical discussion.”
I wonder if any serious effort has ever been made……and I mean REALLY serious effort……to drastically slash the costs of research and development of new drugs, and to place a mandatory cap on what drug companies can charge for the drugs they make, beginning at the point where low income Americans can actually afford to pay for them, and to make those drugs free for those who can’t afford to pay for them? And this includes generic drugs.
While still ensuring that the drug companies can make at least a modicum of profit.
Well, this is one member of the public who is not the least bit baffled, don’t know who he is talking about, but its sure not any of my friends.
Note: I’ll be 72 in October, I’m not a bit “baffled”, but more than a little frightened. Here’s why:
**********************
“The bill’s provisions regarding life sustaining treatment include physician orders to “limit some or all or specified interventions… [including]…the use of antibiotics…and artificially administered nutrition and hydration.”
The counselling regarding the physician’s order for such life-terminating interventions is to include “the reasons why the development of such an order is beneficial to the individual and the individual’s family.” Anyone who doubts that formerly loving family members sometimes exert inordinate pressures on medically-vulnerable family members simply hasn’t been around many families stressed by long-term care.
You can read it all here VERY SCARY HEALTH “CARE” BILL . The portions I have quoted above are found on pages 425-30. The 1018-page text of this proposed bill should be on every citizen’s reading list so that they can give their Congressional representatives a well-informed earful. As with the ridiculously ineffective and expensive “stimulus” bill, chances are your standard Democratic representatives haven’t even read it.
That’s enough for me!
Grandmother in SC
Cennydd, how would you go about “drastically slash[ing] the costs of research and development of new drugs”? I doubt very much that the pharmaceutical researchers deliberately make their projects more expensive. They must chase down numerous blind alleys before finding one application that works, and then it takes a lot of research to get that promising drug into a form that can be manufactured and administered effectively. Government cost controls will result in less innovation.
Tort reform.
It’s not baffling at all. One can understand it completely by reading the Greek myth of Procrustes and his bed.
There was a letter in the Pittsburgh paper the other day saying, “they’re going to take away my Medicare and replace it with socialized medicine . . . .”
Bruce Robison
Cenydd, my impression is that we are already 5-10 years behind in research for the next generation of antibiotics. You want to [i]cut[/i] research?
No, I don’t want to cut research, but I DO want them to find less expensive ways of doing that research. I want their costs cut to the bone. I also demand tort reform, but at the same time, I don’t want the government telling me or my family what we can and can’t have, either! I want insurance companies to come under the gun and make sure that some statistician doesn’t decide what kind of medical care we’ll get. Fortunately, MY medical care is furnished by the VA, as is my wife’s care because she’s also a vet. Our children and their families, however, are a different story……and that really irks me, since this bill would affect them directly and disastrously!
I also don’t want ANYONE to decide who lives and who doesn’t.
We risk stepping out on the way towards becoming a [b]Soylent Green[/b] type of society if we are so stupid as to let this happen.
The President, his administration and pro-reform congressional members have been unwilling to say clearly that abortion won’t be a benefit paid for by tax dollars. I am a physician, I’m in favor of reform — but I will work against the bills unless they come clean on this issue.
3. Grandmother wrote:
What bill? There are something like a half dozen or more health care reform bills in Congress at the moment. Yes, opponents of health care reform are using scare tactics.
9. Cennydd wrote:
I rather doubt that significant cuts to research costs are possible without compromising the benefits of new drugs. Possibly something that would reduce the cost of drugs is somehow reducing the amounts being spent in advertising drugs.
5. francis wrote:
That may be a possibility. Although the trial lawyers and the victims of malpractice won’t like it. (And it’s a bit odd for “conservatives” arguing that the federal government should be telling the state courts what to do.)
Oh, one state has a way to reduce costs of medical care — pay for assisted suicide instead of chemotherapy.
Very few folks are baffled by this: deals cut behind closed doors in Washington are NOT going to be good for us in the long run. Mystery solved!
Reducing the cost of health care is about EFFICIENCY and EFFICACY not nipping the profit margins of everyone in the supply chain. That is the mindset difference between Government and the Free Market.
Innovative ideas are:
1. Unleash the insurance companies from regulation. Let them issue catastrophic care policies leaving individuals to manage their own preventative and routine care. Think what an oil change would cost if your auto insurance paid for it (after your copay of course).
2. Implement a free market approach to care delivery. Get you dental check ups, physicals, flu shots, as well as eye glasses at Wal Mart while they put new tires on your car. Leverage the marketing savy of the private sector to drive out costs and increase customer satisfaction.
3. You do not need a lawyer for wills, Powers of Attorney, Living wills, or other routine documents. Leverage the same technology and targeted training to enhance the efficiency of highly trained physicians to manage those health issues suited to their training.
We have not even begun to scratch the surface on transforming healthcare to achieve 21st century levels of efficiency.
Nor have we educated people that much of healthcare begins with personal responsibility for preventative care.
The LAST thing we want is an Oregon-type system that knows nothing but grinding the last penny out of a rigid, stuck-in-the-past service model.
14. Capt. Deacon Warren wrote:
[blockquote]Innovative ideas are:
1. Unleash the insurance companies from regulation. Let them issue catastrophic care policies leaving individuals to manage their own preventative and routine care. Think what an oil change would cost if your auto insurance paid for it (after your copay of course).[/blockquote]
It’s not particularly innovative. We’ve essentially done that in Texas and, as a result, have the highest insurance rates in the nation and the largest population of uninsured.
Cap’n Warren:
4. Loosen the twin impediments to experimental development of new treatments: tort law, and the onerous requirements of the FDA.
Why would the choice of some Texans to go for high-deductible catastrophic policies have caused Texas rates and insured numbers to go bad? I don’t see the logic of this.
The largest problem is that we all have the idea that we are entitled to medical treatment and that somebody else should pay. Instead of a pooled risk so individuals who have the really big cases don’t lose everything, we’ve gotten the idea that the smaller and routine things shouldn’t cost us much. It doesn’t make any sense. The wonderful medical advances of recent decades cost money to develop and money to implement. Medical care isn’t free. Any system change which causes more people to think “somebody else should pay” will only make things worse.
17. Katherine wrote:
[blockquote]Why would the choice of some Texans to go for high-deductible catastrophic policies have caused Texas rates and insured numbers to go bad? I don’t see the logic of this.[/blockquote]
It probably doesn’t. But deregulation/lax regulation of insurance companies in Texas across the board (not just health insurance) has resulted in rates going through the ceiling and large numbers of uninsured who, at least in many cases, simply cannot afford insurance–whether it be auto, property or health insurance. Deregulation simply does not produce lower costs; the same effect of deregulation has resulted in higher electrical costs in Texas. But the insurance industry is pouring huge sums of money into lobbyists in Austin and campaign chests of Texas politicians to keep their rates high.
[blockquote]The largest problem is that we all have the idea that we are entitled to medical treatment and that somebody else should pay. Instead of a pooled risk so individuals who have the really big cases don’t lose everything, we’ve gotten the idea that the smaller and routine things shouldn’t cost us much. It doesn’t make any sense. The wonderful medical advances of recent decades cost money to develop and money to implement. Medical care isn’t free. Any system change which causes more people to think “somebody else should pay†will only make things worse.[/blockquote]
Of course the idea of including preventative medical care is to reduce the costs of insurance by reducing the costs of “catastrophic” illness. It is, for example, much more cost effective to detect cancer in its earliest stages than to attempt to cure cancer in an advanced stage. It is more cost effective to provide flu shots than to treat pneumonia. I seem to recall that this idea was advanced by the insurance companies back in the 70s. At least that is when I first encountered it from Blue Cross/Blue Shield.
Of course, we can adopt the philosophy of Thomas Malthus and Ebenezer Scrooge: “Let them die and decrease the excess population.” Thus as in one state, provide doctor assisted suicide instead of chemo to cancer victims. That way we can keep insurance rates down and improve the insurance companies’ bottom line at the same time. It’s win-win for everybody — except those who get sick.
RE: “Of course the idea of including preventative medical care is to reduce the costs of insurance by reducing the costs of “catastrophic†illness.”
Well actually, the idea of [i]forcing taxpaying employed citizens to pay for other people’s preventative care who choose to not spend what it costs to get simply physical exams and dental care[/i] has nothing at all to do with “reducing the costs of insurance” — it causes insurance costs to go up — but has everything to do with the Central Planning Politburo attempting to control individual choices and force other individuals to pay for that control.
RE: “Of course, we can adopt the philosophy of Thomas Malthus and Ebenezer Scrooge: “Let them die and decrease the excess population.â€
Certainly many individuals take that attitude. But of course, you are speaking of using the power of the State to force compliance which is an entirely different thing from individual Scrooges.
That’s what this always comes down to. Individual Peck wishes to use the power of the State to *force* other individuals to pay for things that he deems should be given to others [or even himself, who knows].
It’s immoral and thievish to use the power of the State to force some individuals to pay for what Ken Peck values, not to mention in gross violation of our Constitution.
But when has that ever stopped liberals who favor the collectivization of the US?
Hopefully conservatives will actually have candidates who care about such matters to run in 2010. Sure hope so.
Strange that competition reduces costs in all instances except for medical insurance, Ken Peck. Could it be because states get involved in deciding what kind of coverage people MUST have? That’s the federal proposal. Plans will be “qualified” by what they offer, and every bell and whistle is the routine and has been for some decades. Insured people pay for pretty teeth, lots of alternative medicine treatments, and so on, and insured also pay, by higher charges, the amounts that providers can’t get from people in government plans (Medicare, Medicaid) which have capped payments. When, if this nightmare passes, we ALL end up with capped payments, rationing and the loss of practitioners will result.
So far as I know medical insurance companies make slightly lower than average earning rates. The Pelosi vision of insurance companies as the bad guys is mostly hype and hot air.
19. Sarah1 wrote:
That’s simply wrong. It is much cheaper to pay for preventative medical care than to treat major illnesses that could have been prevented or treated much less expensively early on. Numerous examples could be given in addition to the examples I’ve already given. Some more would be heart disease, hypertension, diabetes etc.
Ultimately, we are forced to pay. For example, if Sarah1 chooses not to go to the doctor for a flu shot or periodic exams and consequently contracts the flu, has a heart attack, or cancer which end up putting her in the hospital, the rest of us end up paying for it through higher medical bills (because the doctors and hospitals must somehow pay for her treatment) or higher taxes (because the public hospital makes up the difference that way) if she also chose not to have catastrophic illness insurance and/or is unable and/or is unwilling to foot the bills, then the rest of us end up paying for it either through higher medical bills (because the doctors and hospitals must somehow pay for her treatment) or higher taxes (because the public hospital makes up the difference that way).
(By the way, I’ve always had medical insurance, so the policy holders–including myself–pay for. At 72, I do now have Medicare which I have paid for–and continue to pay for–through taxes. Although even that has to be supplemented by insurance that I pay premiums for.)
Letting everybody “do their own thing” is a recipe for disaster which affects everyone one way or another. Back when I was a young boy around 1950, there were major polio epidemics. Now, it so happens that treating polio is expensive. I was in the hospital for six weeks followed by months of physical therapy with it. And my case was quite mild; I didn’t need long term care in an iron lung or as a paralytic. Now in my case my mother had taken out a polio insurance policy, which did cover it. If she had not, then the costs would have shown up either in higher bills for the other paying patients, or their insurance companies or their taxes.
A few years later (that expensive research, paid for largely through the March of Dimes) the oral polio vaccine was developed. And that nasty old government forced parents to see to it that their children took the vaccine. (It also had the beneficial side effect of immunizing others.) As a result polio was virtually eliminated, saving untold dollars in medical costs, not to mention lives.
There are many other examples of this. But folks like Sarah1 insist that the government shouldn’t force anybody to do anything. God forbid! And, as a consequence, some of those old childhood diseases that were at one time virtually unknown, are returning — and guess who ends up paying the bills?
As a result of the whole wonderful philosophy of “deregulation” (and also lax regulation) we have seen widespread salmonella outbreaks, in some cases simply because the unregulated businessman saw a way to improve his bottom line by not enforcing the most basic sanitary conditions in his facilities. We have seen poisons put into our food and drug supply by foreign companies. We have had a near collapse of the economy. And on, and on and on, from ages to ages, world without end.
And so we all get stuck with the bills, and Malthus and Scrooge reign supreme.
21. Katherine wrote:
[blockquote]Strange that competition reduces costs in all instances except for medical insurance, Ken Peck.[/blockquote]
That simply has not proved to be the case in Texas, which has some of the highest insurance rates (whether one is talking about health, property or auto insurance) in the nation. Homeowner’s insurance along the Gulf Coast of Texas (allegedly because of the threat of hurricanes) are higher than in Florida (which have a lot more major hurricanes than Texas). Nor is it true when it comes to utilities. “Deregulated” electricity is more expensive than “regulated” electricity. There is a reason why insurance companies and utility companies spend millions to lobby Texas politicians for “deregulation”; and it isn’t so they can lower rates. And there is a reason that insurance companies and banks spend literally billions to lobby Congress for “deregulation”; and it isn’t so they can lower rates.
Competition? Insurance companies don’t like competition. That’s why they are vigorously lobbying against a “public option” or a “co-op option”. Yeah, there is “competition” in Texas. Strange how they all raise their rates here in Texas in unison — and never, ever reduce their rates either singly or in unison.
[blockquote]Insured people pay for pretty teeth, lots of alternative medicine treatments, and so on, and insured also pay, by higher charges, the amounts that providers can’t get from people in government plans (Medicare, Medicaid) which have capped payments.[/blockquote]
I’m not sure where this nonsense comes from. For years, I’ve had non-government medical insurance. None “pay for pretty teeth, lots of alternative medicine treatments, and so on.” None covered dental care in any form. All dictated to my doctor (and some dictated who my doctor could be), what medications he could prescribe and what treatments he could undertake.
Medicare does not cover “pretty teeth, lots of alternative medicine treatments, and so on”. Dental care is not covered by Medicare. I have had, before I retired, private dental insurance and also have a separate private dental policy. Such policies cover basic routine preventive care and some other care such as fillings and caps with a high co-pay. They do not cover “pretty teeth”.
[blockquote]So far as I know medical insurance companies make slightly lower than average earning rates.[/blockquote]
Lower than what? Probably lower than Exxon-Mobil last year, or TXU most any year. But still, insurance stock is usually a pretty good investment.
It should also be noted that there are various ways to figure insurance company “earnings”. And yes, they make sure that they go before the legislature with an argument based on direct premium income versus direct payment, ignoring income generated by invested premiums and reserves. It makes them look a lot less profitable than they really are.
Actually, Ken Peck, I’ve seen studies showing that preventive care doesn’t, in fact, reduce the aggregate cost of health services. We all die of something; the last year of life is the larger part of Medicare costs. But because we get preventive care and live longer, our total cost to the system is more. This is a GOOD thing, of course.
The foundational problem here is the system which evolved because of tax policy. Employers can deduct the cost of medical insurance for their employees. It was a way to de facto increase pay without increasing taxability. I can remember my father filing income tax returns in the 1960s and deducting the full cost of all our medical bills plus insurance premiums. Now the deductibility for individuals is severely limited. The fix would be to make all health insurance, if paid by the employer, taxable to the employee, AND allow all individuals to deduct their own out-of-pocket medical expenses and insurance premiums from their taxable incomes. This is essentially what Health Savings Accounts do. Expand this to include everybody, allow people to chose policies they really want rather than what states and the feds say they should have, and the insurance market will rapidly provide better and cheaper coverage, and medical costs in general will fall.
The current proposal goes the opposite direction. It will restrict care and increase costs.
Ken Peck, there are hundreds of thousands of American children who got their teeth straightened basically for cosmetic reasons because policies are required to cover orthodontics. One of my kids is among them; the other had valid reasons (narrow jaw, missing adult teeth). That’s just one example.
Insurance companies oppose the so-called “public option” because they know perfectly well that its intention is to put them out of business. There’s a You Tube floating around showing Obama, Barney Frank, and another Democratic representative saying exactly that. It’s not to provide competition. It’s to take over.
So, Texas has somehow beat the laws of free markets and competitive capitalism so that companies can compete, raise prices as high as they want and don’t lose market share. Ain’t so.
You CANNOT have a free market where competition for a fixed demand is unlimited AND have prices go up. There is always one guy who wants a little more market share than the other guy and cuts price to get it. Or, there is one guy who develops a better mousetrap, gets more share without cutting price because he delivers more value to customers. But then, the other guys retaliate by cutting price to regain lost share.
So, in fact you don’t really have a free market—–maybe the politicos have just told you that.
My guess is that you have market allocation, fixed territories, or some type of state sponsored anti-competitive regulations that are giving companies the oppty to keep rates high enough to be profitable at levels they like.
Deregulated utilities do lower rates if you have real competition. Heck, our local cable guy is deregulated, but guess what? He has a monopoly on cable deliver. So guess what, rates have gone up and up. But, AT&T is going to start delivering TV over phone lines and that will be a game changer. Want to place any bets on where cable prices will go after that?
We know in our guts that competition works, but in healthcare for some reason we just don’t want to trust our guts. We put our trust in a snake oil salesman in Washington DC who just happens to live at 1600 Pennsylvania Avenue. Amazin!
27. Capt. Deacon Warren wrote:
O.K. So it is impossible.
As I said, there are multiple insurance companies “competing”. But somehow, when one raises rates, they all do; and they never lower rates. (Oh, and its the couple with the largest market share that usually raise the rates first–then everybody else gets on the band wagon.
But somehow or other, the Texas Legislature and the insurance lobby in Austin have not only dreamed the impossible dream, they’ve actually accomplished the impossible!
On the other hand, it may be that “the laws of free markets and competitive capitalism” aren’t quite as immutable as you would like to have us believe. Possibly the reality of human sin is more certain than economic ideology.
Which is one reason we have government and why we the people have found it desirable to have anti-trust, monopoly and conspiracy laws–which aren’t perfect either and sinners figure out how to bribe legislators and regulators to look the other way.
I just saw an interesting statistic.
[blockquote]Private plans currently serve about 150 million citizens of the USA at a cost of $1.4 trillion. Government programs including Medicare, Medicaid, Tricare and Veteran’s Administration serve 141 million at a cost of $800 billion.[/b][/blockquote]
RE: “It is much cheaper to pay for preventative medical care than to treat major illnesses that could have been prevented or treated much less expensively early on.”
No. It is much cheaper for people to die young. Your statement is completely false.
RE: “Ultimately, we are forced to pay. For example, if Sarah1 chooses not to go to the doctor for a flu shot or periodic exams and consequently contracts the flu, has a heart attack, or cancer which end up putting her in the hospital, the rest of us end up paying for it through higher medical bills (because the doctors and hospitals must somehow pay for her treatment) or higher taxes (because the public hospital makes up the difference that way) if she also chose not to have catastrophic illness insurance and/or is unable and/or is unwilling to foot the bills, then the rest of us end up paying for it either through higher medical bills (because the doctors and hospitals must somehow pay for her treatment) or higher taxes (because the public hospital makes up the difference that way).”
Heh.
Right — that’s one of many reasons why we should repeal EMTALA.
You continue to operate under the foundational assumption that others [the employed] are required to pay for the health care of everyone else. Putting the State even more in charge of the expenditure of the dollars required for health care is an even bigger mistake.
Incidentally, your touting of Medicare and Medicaid — both failed, bloated programs that year by year 1) require vastly more sums of money than was originally projected and 2) decrease services and providers, since so many physicians are now not taking new patients, seeing as how the government simply does not pay even the barest costs of delivery of care. Despite the fact that the government delivers such shoddy care, it *still* takes $800 billion to do it poorly. And of course the huge cost inflation that we are experiencing is in part because hospitals use private insured patients to supplement their losses in the treatment of Medicare and Medicaid.
But by all means, carry on promoting health care [sic] collectivization, and I’ll carry on hoping and praying that we will actually have conservative principled candidates who will resist and defeat such failed, and immoral, practices.
Sarah, by what criteria are medicare and medicaid failed? By and large people are happy with them. When polls are taken, satisfaction is far higher under medicare and medicaid than private insurance.
Same with the VA. I know several former soldiers who get excellent care from them.
I might be wrong, I would just like to have some data, or even criteria.
The bloat happens because of the incentive structure: patients are seen as profit centers. The Mayo Clinic has kept costs down; In texas (in spite of Tort reform) they haven’t in McAllen Texas.
However, administrative costs are much less under medicare and medicaid than private insurance.
30. Sarah1 wrote:
[blockquote]RE: “It is much cheaper to pay for preventative medical care than to treat major illnesses that could have been prevented or treated much less expensively early on.â€
No. It is much cheaper for people to die young. Your statement is completely false.[/blockquote]
So we are back to Malthus and Scrooge. Let them die and decrease the surplus population. We can solve the health care problem with doctor assisted suicide. No need for research either, as there are already ample ways to kill people and put them out of their misery.
[blockquote]RE: “Ultimately, we are forced to pay. For example, if Sarah1 chooses not to go to the doctor for a flu shot or periodic exams and consequently contracts the flu, has a heart attack, or cancer which end up putting her in the hospital, the rest of us end up paying for it through higher medical bills (because the doctors and hospitals must somehow pay for her treatment) or higher taxes (because the public hospital makes up the difference that way) if she also chose not to have catastrophic illness insurance and/or is unable and/or is unwilling to foot the bills, then the rest of us end up paying for it either through higher medical bills (because the doctors and hospitals must somehow pay for her treatment) or higher taxes (because the public hospital makes up the difference that way).â€
Heh.
Right—that’s one of many reasons why we should repeal EMTALA.[/blockquote]
Right. No more dead beats in emergency rooms.
So we are back to Malthus and Scrooge. Let them die and decrease the surplus population. We can solve the health care problem with doctor assisted suicide. No need for research either, as there are already ample ways to kill people and put them out of their misery.
Such a simple, obvious approach. It can be paid by the government at much less cost.
[blockquote]Incidentally, your touting of Medicare and Medicaid—both failed, bloated programs that year by year….[/blockquote]
Well actually, Medicare isn’t failed. I’m finding it much easier to deal with Medicare the past eight years–and especially the past six since Medicare is my primary insurer–than I did with private insurers for the previous couple of decades. I have more freedom of choice of doctors and hospitals than when insurance companies were telling me which doctors I could see, that I had to go to my primary care physician to get referred to a specialist, etc.
The insurance companies that are spending hundreds of millions of dollars to fight health care reform aren’t doing it out of concern for the general welfare or your health care. They are doing it to protect their bottom lines.
An interesting statistic about government run healthcare versus private healthcare:
[blockquote]Private plans currently serve about 150 million citizens of the USA at a cost of $1.4 trillion. Government programs including Medicare, Medicaid, Tricare and Veteran’s Administration serve 141 million at a cost of $800 billion.[/blockquote]
And, oddly, in recent decades, government single payer plans in Europe and Canada are increasing life spans and live births, while the U.S. with its private plans is experiencing shorter life spans and higher infant mortality.
RE: “By and large people are happy with them.”
Are you kidding me? I mean — are you kidding? Is that a joke?
If not, then wow — talk about clueless. People can’t even find physicians, John.
RE: “When polls are taken, satisfaction is far higher under medicare and medicaid than private insurance.”
Feel free to provide links to the quantitatively rigorous and unbiased “polls” asking objective questions to the correct audience.
RE: “The bloat happens because of the incentive structure . . . ”
No — the bloat happens because it’s Other People’s Money — what always happens with Other People’s Money, not to mention the immense bureacracy and regulations that encourage more spending.
RE: “Sarah, by what criteria are medicare and medicaid failed?”
Oh yeh, in response to your question — under [i]no[/i] criteria suitable for you, John Wilkins. Collectivists will always think that expanded State power is “successful.”
RE: “So we are back to Malthus and Scrooge.”
Heh — not at all. I was merely exposing the rank falseness of your statement.
And beyond that, again, Scrooge is an *individual* — you however are not advocating for the transformation of Scrooge, but for forced thievery from individuals for the benefit of the State — something quite different from “Scrooge” — Stalin’s Five Year Plan springs to mind, for instance. ; > )
RE: “An interesting statistic about government run healthcare versus private healthcare:”
Um . . . you already said that. And my response is just as useful the second time as the first: [blockquote]”Despite the fact that the government delivers such shoddy care, it *still* takes $800 billion to do it poorly.”[/blockquote]
But as I pointed out to John . . . Collectivists will always think that expanded State power is “successful.”
33. Sarah1 wrote:
[blockquote]RE: “By and large people are happy with them.â€
Are you kidding me? I mean—are you kidding? Is that a joke?
If not, then wow—talk about clueless. People can’t even find physicians, John.[/blockquote]
I have Medicare, and have had for seven years, and for five its been my primary insurance. I’m quite happy with it, happier than with the private insurers of my employers for a couple of decades. I have no problem finding physicians. All accept Medicare; I’ve not run into one that doesn’t.
[blockquote]RE: “The bloat happens because of the incentive structure . . . “
No—the bloat happens because it’s Other People’s Money—what always happens with Other People’s Money, not to mention the immense bureacracy and regulations that encourage more spending.[/blockquote]
Actually, government plans provide coverage to more people at less cost per person than private plans. Government plans are more economical. That is why insurance companies are spending hundreds of millions of dollars to defeat any sort of public or co-op plan.
I chose Medicare as my Primary Care Provider, and the Veterans Administration Health Care System as my Secondary. I have the option of choosing which one I use the most, and for the past ten years, I’ve chosen to use the VA system. I have never once had reason to complain about my medical care received at VA facilities, and I give them high marks for the care I’ve received. My injuries suffered while on on active duty were severe enough that I was retired from the USAF, and eventually was rated at 90% disabled plus 10% for Individual Unemployability. I am called into the San Jose VA Clinic every six months for checkups, and I have never had reason to complain……the system is that good. I wish ALL Americans could receive the quality care that I receive.
It’s good to hear Cennydd’s testimonial about VA care. He and every other veteran deserves top-flight care. It’s very reassuring to know that he’s getting it. Thanks for your service, Cennydd.
Ken’s positive statements about Medicare conform to what I hear from others who are eligible. I’m fast approaching that threshold, so I hope the program can be sustained at its current level of utility.
I am truly glad that Medicare and VA are getting such high scores with you folks. If things continue along the same path in a few years I will be doing Medicare. I have been helping my mother with her Medicare travels and it has been pretty darn good.
The bad news (for the economy) is that Medicare has a horrible unfunded liability—ie, the current care model as us boomers head to Medicare is unsustainable. Among my concerns for bigger involvement of the Federal Government in healthcare is an even larger unfunded liability. Or, crushing taxes to try and whittle the unfunded liability down, or letting inflation go wild to reduce the absolute value of the unfunded liability. Neither option looks good to me.
I left private practice for the VA hospital. I took a 35% pay cut, but my work week dropped from 100 hours/week to 50 hours/week. I think vets get better care than do civilians in private practice. It is immeasurably more pleasant for the physician. I have a lot more time to answer questions, the computerized medical record is a joy to use, and it really, really helps that I no longer have to ask myself, when I order a study “will this bancrupt my patient?”. It really really helps that when I see a patient who is very reasonably upset about his medical condition (why am I still having seizures? How could I possibly have cancer? Could it be the new medication you gave me for my blood pressure?) I do not have to worry about being bancrupted by a baseless lawsuit.
Having said that, what is being proposed is not a take over by the government of the responsibilities of medicine. That would involve expanding the VA to all americans and making physicians government servants with governmental protections. That would work pretty well. Instead, what is to happen is a takeover by the government of payments, with all the responsibilities (for the uninsured, for liability, for costs of care) continuing to be borne by the physicians and hospitals. That is why civilian medicine is about to be destroyed. I fully expect half the nations hospitals to close in the next 10 years. A third of them will likely close in the next 3 years. At least a third of the physicians will leave medicine (they will have to. They will get further in debt every day they practice). Many of the rest will focus on Botox and other peripheral items. Costs will come down because there will be effective rationing by access. The liberals will call it a “success”.
I feel very blessed to work in the VA. Recently we have been innundated with very highly qualified physician applicants. I have been encouraging the medical students who rotate with me to join the Military so as to get out of debt.
RE: “I have Medicare, and have had for seven years, and for five its been my primary insurance. I’m quite happy with it, happier than with the private insurers of my employers for a couple of decades. I have no problem finding physicians. All accept Medicare; I’ve not run into one that doesn’t.”
In my old home town only two — and inferior at that — physicians now accept new Medicare patients. The travel time for getting to specialists and even general practice physicians that accept such is horrendous.
RE: “Actually, government plans provide coverage to more people at less cost per person than private plans.”
And as I said — now for the third time — [blockquote]. . . the government simply does not pay even the barest costs of delivery of care. Despite the fact that the government delivers such shoddy care, it *still* takes $800 billion to do it poorly. And of course the huge cost inflation that we are experiencing is in part because hospitals use private insured patients to supplement their losses in the treatment of Medicare and Medicaid. . . . ” [/blockquote]
But . . . All Is Well!
40. Sarah1 wrote:
[blockquote]RE: “I have Medicare, and have had for seven years, and for five its been my primary insurance. I’m quite happy with it, happier than with the private insurers of my employers for a couple of decades. I have no problem finding physicians. All accept Medicare; I’ve not run into one that doesn’t.â€
In my old home town only two—and inferior at that—physicians now accept new Medicare patients. The travel time for getting to specialists and even general practice physicians that accept such is horrendous.[/blockquote]
Around here there are doctors who do refuse to take on [b]new[/b] patients, but Medicare/Medicaid have nothing to do with it. The ones not taking on new patients simply already have more patients than they are able to handle. My experience (and that of others I know) is that we have more choice of doctors under Medicare than we did when our primary insurer was private. There is a serious shortage of physicians, particularly primary care or general practice physicians.
[blockquote]RE: “Actually, government plans provide coverage to more people at less cost per person than private plans.â€
And as I said—now for the third time—[/blockquote]
Simply because you have said it doesn’t make it so–no matter how often you say it.
I have run across an interesting site that has a lot of data on the subject of health care. [url=www.randcompare.com]RandCompare[/url] There’s the story about the student who, completing a unit on giraffes, summarized the experience by writing, “I learned more about giraffes than I ever wanted to know.” This site will probably leave most with something of the same reaction. But it doesn’t, as far as I can tell, support the hundreds of millions of dollars being spent by the health insurance industry to kill health care reform and for propaganda to convince Sarah that public health care is evil.
39. Clueless wrote:
[blockquote]I left private practice for the VA hospital. … the computerized medical record is a joy to use…[/blockquote]
This is one of the things that Obama advocates for “private” medical care. It will, of course, have a big upfront cost for equipment and the labor of converting paper records to digital records.
Let me, as a patient, share something of my reaction. My primary care physician uses paper records which, after 17 years is now several inches thick. My experience is that a significant amount of his time when I see him involves his digging through that stack of papers looking for history–when was the last time I had a colonoscopy, when was the last time I had a certain vaccination, when was the last time I had a cardiac stress test, etc.–information which, if it were stored in a computer data base, could be brought up in a matter of a few seconds.
Contrast that to my dentist, who now is pretty much computerized. He and his technicians can bring up my dental records, including the most recent x-rays, instantly. His system sends me e-mail reminding me that I am due a check up, that I have a scheduled appointment, etc.
Now these systems are expensive initially, but they do make the health care provider more efficient, with more time for interaction with the patient and probably, over time, pay for themselves. It also may help the provider give better care.
Now I need to sign off and follow my doctor’s advise and get some exercise.
I’ve got five years to go until Medicare. I realize that many people today are getting health services at reasonable cost to them through this system, as people have posted here. The problem is that the current system is unsustainable. Medicare taxes on working people plus Medicare premiums paid by participants will not cover the increasing costs as more of us retire. Costs are being kept down now by squeezing doctors and hospitals. A system which operates with price controls and insufficient funding is going to crash, and when I’m, say, 70 or 75, it will have to refuse payment for treatments which it pays for today. So I’ll end up paying all these taxes AND paying for medical procedures myself, and that’s better than people who won’t be able to pay. They’ll just die or suffer. That’s where the nation as a whole is heading if this “reform” passes.
I am on Social Security in addition to my VA Disability Compensation package. My wife is also on Social Security, and we pay taxes on those Social Security payments. Our tax money therefore goes in part to help pay the costs of the Medicare system……just like everyone else’s. So it’s not as if Social Security recipients don’t support the system……which needs much better management and modernization. Unfortunately, computerization costs money……a LOT of it……but it’s the price we all have to bear.
“Unfortunately, computerization costs money……a LOT of it……but it’s the price we all have to bear. ”
The VA medical record is public domain, devised by the government. If the government would simply make it the national standard, and insist that everybody use it (for free), costs would be minimal. However that would upset the current administrations IT friends. Therefore hospitals and physicians are being forced to pay upfront for various different and EXPENSIVE computerized medical records which don’t even talk to each other. Thus, care will still be fragmented in the civilian sector.
My computerized record pulls up VA and DOD records from Hawaii, and Alaska as well as every one of the 48 mainland states. The DOD records extend to Guam and Germany. However the family physician at St. Mary’s in Rogers, Arkansas will not be able to get the records from Northwest in Rogers because even though they both have invested in a computerized medical system they aren’t linked, and they don’t have software that will permit them to be linked.
As far as I can see, the IT component of Obabamacare is simply a gift to his technologically savy friends.