E-mail updates
Follow on Twitter
Subscribe to RSSUpdated at 4:05pm ET In one week, the Supreme Court will hear oral arguments surrounding the key provision of the 2010 health care law – the individual mandate.
But outside of the courts, efforts in Congress to tinker with the complex and controversial law continue, including a vote this week to abolish a central piece of the 2010 health care law: the Independent Payment Advisory Board.
Related: House GOP fights to notch signature wins
The intent of the board was to try and take the politics out of Medicare by giving some of its spending decisions to independent experts. The controversy around the panel’s very existence, however, shows just how difficult that goal will ever be to achieve.
The board fulfills a promise President Barack Obama made in his 2009 health care speech to a joint session of Congress: “We will also create an independent commission of doctors and medical experts charged with identifying more waste in the years ahead.”
IPAB supporters say that setting up a non-politicized cost-cutting process is necessary in order to control the growth in Medicare costs, with IPAB as a backstop if other cost-limiting parts of the law do not work.
IPAB would be akin to the idea of the Base Realignment and Closure Commission. Past BRAC panels have been successful in eradicating redundant military bases.
Mandel Ngan / AFP - Getty Images
West Virginia Democratic Sen. Jay Rockefeller said in 2009 that the Independent Payment Advisory Board is "a large idea with large consequences for the future."
“This is a game-changer,” said the father of IPAB, Sen. Jay Rockefeller, D-W.Va., in 2009 when he and other Democrats were drafting the law in the Senate Finance Committee. IPAB is “a large idea with large consequences for the future.”
This week’s vote, coming as early as Wednesday, will be an election-year propaganda event, allowing House Republicans to tell conservatives in their districts, “We killed part of Obamacare.”
The White House issued a veto threat Tuesday, in a Statement of Administration Policy, which said the bill "would repeal and dismantle the IPAB even before it has a chance to work. The bill would eliminate an important safeguard that, under current law, will help reduce the rate of Medicare cost growth responsibly while protecting Medicare beneficiaries and the traditional program."
From the start, Obama’s opponents started calling IPAB a “death panel” which would deny older people treatment they needed -- even though the law states that the board can’t ration care, restrict benefits, increase the premiums Medicare recipients must pay, or alter the eligibility for Medicare (which is open to most Americans aged 65 and older).
What’s important in this battle is not the all-too-familiar “death panel” rhetoric, but the 19 House Democrats who cosponsored the bill to abolish IPAB -- 15 of whom voted for the Affordable Care Act in 2010.
One of those Democrats, Rep. Allyson Schwartz of Pennsylvania, said, “The promise of health care coverage to our seniors must not be broken. Abdicating this responsibility, whether it is to insurance companies or to an unelected commission, undermines our ability to represent the needs of our seniors and disabled individuals. IPAB is the wrong approach to the right goal.”
Another Democrat who voted for the 2010 health care overhaul but voted last month in a House committee to abolish IPAB, Rep. Frank Pallone of New Jersey, said “IPAB, like other independent commissions, encroaches upon legislative authority ... It's not the job of an independent commission to make decisions on health care policy for Medicare beneficiaries.”
But it’s congressional involvement that is exactly the problem, say Rockefeller and other IPAB supporters.
When Congress tries to control Medicare spending, Rockefeller complained in 2009, there are “too many lobbyists involved and it's very, very difficult if you have a lobbyist that comes in … who represents an industry in your state which could gain an enormous advantage by having an increase in the reimbursement rates for Medicare , for oxygen or for something else.”
Rather than members of Congress deciding what Medicare will pay for, Rockefeller said, “These are decisions that should be made by professionals, people who are public policy professionals. They're not lobbyists. And they're not necessarily sitting with congressmen or senators.”
Uwe Reinhardt, a health care economist at Princeton University and an IPAB supporter, said Congress “micro-manages in the most amazing way” in deciding how Medicare operates.
And yet, he said, members of Congress are “beset by incredible conflicts of interest. With Congress, you really always have to worry: Whom do they represent: the people, or particular interest groups that give them money?” Companies that sell services to Medicare also contribute to congressional campaigns, he noted.
IPAB will be composed of 15 experts, yet to be appointed by Obama, who’ll be given the task of keeping per-capita growth in Medicare spending from exceeding a target: national income growth rate, plus 1 percent.
IPAB’s recommendations must be carried out by the secretary of the Department of Health and Human Services unless Congress acts to block them, by a two-thirds vote in each chamber, or passes its own bill which achieves the same cost reductions as the IPAB recommendations. Under Rockefeller’s original proposal, Congress wouldn't have voted on IPAB decisions at all.
The law says IPAB can’t ration care or restrict benefits, so what could IPAB do to curb spending?
It could change how Medicare pays hospitals and doctors “in ways that would encourage more efficient delivery of care,” said Paul Van de Water, a health care analyst at the Center for Budget and Policy Priorities, a think tank that strongly supports IPAB. Medicare could reallocate its payments from medical specialists that get relatively higher reimbursements to specialists that get relatively smaller payments, or could pay primary care doctors more and specialty doctors less than it currently does, Reinhart said.
The fate of IPAB won’t be settled this week and will need to wait at least until the Supreme Court renders its judgment on the 2010 health care law -- and probably until after the November elections.
The vote this week is being muddled by House Republican leaders’ decision to tack on a separate provision putting a limit on damages awarded in medical malpractice cases. Almost all Democrats are likely to oppose that idea, and thus, the larger anti-IPAB bill.
But some Democrats still want to put their opposition on IPAB on the record. Schwartz said GOP leaders ought to bring a clean abolish-IPAB bill to a floor vote and forget about their attempts to limit malpractice awards.
Leave a Comment:
Move all you want Bohner. JERK
We need to get rid of this Know-Nothing Congress, and install politicians who will do what is good for the country.
It's time for Boehner, Lamar Smith, and the rest of the buffoons to get real jobs. They have proven themselves incompetent time and time again in this one.
So Boehner and the GOP House are going to say loudly that they want to kill an ADVISORY GROUP that IDENTIFIES redundant health care costs?
This group has no authority, they don't cut costs, they simply identify where costs are redundant. Sounds like a pretty good thing to have and the GOP wants to abolish it, which tells you how much they really care about cutting health care costs.
GOP = Goodbye Old Pharts
I must say besides Jemma, pretty damn typical responses so far from the left.. Now if people want to discuss the bill, and keep your party out of it... I will gladly discuss it with ya
The Affordable Healthcare Act needs to go away.. The sooner the better. IF the majority of yall would look at it without your partisan ( from both sides ) glasses on you would see that is is a horid bill.
The NUMBER 1 complaint about health care I hear.... It is too expensive, and it goes up every year. Well look at the bill... NOTHING in the bill controls costs, or makes it less expensive. The bill raises taxes ( most already in effect ) and warps the commerce clause to force people to buy insurance to
" spread the cost" of health care more.
Now about this board.. 15 members APPOINTED by the POTUS, to control costs of Medicare. Let me ask all of the supporters of this bill... When the Republicans get into the White House again, and they will it is just a matter of time. Do you really want 15 unelected officals to decide what should be done with Medicare and the Health Insurance in this country? I do not want 15 people deciding crap for me.. I want to be able to shop around and get the insurance I WANT. You wouldnt know it if you only look at MSNBC for your news, but the CBO has been doing many many rewrites to what the bill will cost us ( more expensive then when it was passed ) and last week said point blank, that due to Gvmnt Mandates it estimates over 20 million people will lose their private health care they currently have.
This bill is and should be doomed... It should never have been passed because it does nothing to solve the root problem that is health care. The cost.
"The Affordable Healthcare Act needs to go away"
You first.
Just put capitalism back into health care, there is none in it and will be less if 'Obamacare' takes hold.
Capitalism is the greatest equalizer and cost saving instrumrnt in the history of the world and is what made this country great.
Yes, you can have proper regulations, just don't let government become a player instead of a referee.
Obamacare is apply named. It means Obama cares for himself and no one else. If this is a healthcare bill, then the American public should get ready for the sickness that is coming. Obama wants to control the medical system in the US so that he can garner more votes for himself from his voter base that pays no taxes whatsoever or else they are on the government dole. While there are others who support Obama, they are misinformed miscreants who want the US to become an entitlement society like the European countries, with their well-being totally controlled by a socialist form of government. All it will take is one more Obama term, and the US is down the economic and social drain forever. Obama is definitely the worst US president in our history. He is a total failure, unqualified and incompetent to lead, and he is taking us over the brink to destruction from which we might never recover.
What does the market have to say about the efficacy of steroid infusion as a treatment for optic neuritis?
The bill was passed on the premise of lowering cost and we see that is utterly false.
But, to your question. If we have competition and companies actually trying to lower cost, that procedure would cost less, therefore more likely to be covered.
How so? It hasn't been implemented yet.
Who the heck are you kidding? The GOP showed their true colors when in Medicare Part D they REFUSED to allow any negotiation with big drug companies over drug costs... and you have not noticed (I guess) that the same procedure costs far less overseas than it does in the USA... Get your facts straight before you go FAX news....
Jeremy I agree,
I actually support Obama, but this bill is the pits. From the beginning it has done nothing to address the outrageous costs for medical care. Tort reform needs to be addressed among many other items. My personal opinion was that if you are going to force everyone to buy insurance, then you must force all insurance companies to become non-profit and put a cap on the executive pay. What now is to stop insurance companies from raising prices even higher once everyone must, but law, buy their product... This is bad all around.
We all need afordable health insurance and should not be denied or dropped if we do get sick, but this bill just isn't going to do it
You are aware that the ACA requires all insurance companies to spend 80% of revenue on paying claims or refund the difference?
The IPAB will reduce tort costs better than caps on malpractice awards. When you have specific guidelines for doctors to follow and discourage excess treatments, they have less cause for defensive medicine and the lawyers have less grounds upon which to base a lawsuit.
FYI: costs have been going up for decades. I am an HR manager and in 2008, United tried to raise us 22%. We switched to Tufts. 2 years later, another double digit increase, so we are now with Blue Cross. My employees are happy their kids are on coverage, lab work is covered, preventative procedures are covered, and this year, our plan went up 4.9%. It actaully went down .2% last year when we switched from Tufts to BCBS. Two years ago, I had an employee living in PA, (we're in RI). He inquired about getting his own coverage and we reimbursing him. There were three pages of conditions of automatic denial. THREE PAGES! Insurance companies want to selectively eliminate pre-conditions so that they lower their risk of exposure. This drives us to a smaller and smaller market, yet anyone can go to the hospital and get treatment. Who is paying for that? That dwindling population of insureds, that's who.
Jeremy: apparently you have not been keeping tabs on the ACA. According to the latest estimates from the CBO, the cost of the ACA have actually gone down.
Until the SCOTUS rules this summer, anything anyone says is just speculation.
IMO, the SCOTUS is unlikely to rule the law unconstitutional. They ususally do not like to get into what truly is a political fight.
Unless the SCOTUS deems the law unconstitutional, it will take place and the changes will happen. Many of them already have. For the majority of people, that will be a good thing. Basic health insurance coverage will no longer be dictated by the whims of your employer.
Yeah. That's it. Keep everything exactly as it is, because it's working great.
Some parts have and companies have raised rates on the knowledge of increased cost. It is how all big businesses operate. They have actuaries that predict future cost. That is not argued by most.
Did you even know that most states, therefore it is nationwide, limit what the companies can make?
If that is the case, then how do the companies still rape us? Easy, there is zero competition, so they just overpay for everything. Grossing 25% on billions is much sweeter than on millions.
We need competition and companies fighting to lower cost. That is capitalism and will lower cost.
As an independant voter with a track record of voting Republican for most of my life, I would like to ask you one thing. What would you do to stop health insurance companies from denying coverage to people like me, with a pre-existing condition?
Like so many others, I am waiting for 2014, the year I no longer have to be deathly afraid to lose my job, or go without health insurance for as little as a day.
In a similar train of thought, what would you do about the millions of children that are now being covered by insurance, that had been denied coverage before the reform?
BTW: this is just more political grandstanding by the House, trying to score political points before facing the music in the next election.
There is not one member of the majority who is running for reelection who deserves to be reelected. They have done nothing but grandstanding for the last 15 months.
The Constitution has a term limit for HOUSE members: vote them out !!!!
bob, Typical.. how about you contribute or just not post anything at all..
Man of Knowledge,
As I said above, you will not find it on MSNBC, but go look at the recient CBO figures that came out last week. YES not all of the Bill is in effect, but a lot of the taxes already are. The CBO is even saying the bill will not do what it says. THAT is how we know it will not control the cost of Insurance. The Gvmnts own comissions are saying so.
Man of Knowledge, that 80% limit, which is currently 75% in many states is one of the 2 things that make rates so high.
If I own a company and can only gross 20% and have no competition, the second major problem, how do I make more money?
I pay a hospital $100 for an aspirin, because I just made $25 on that pill!
The sole reason the GOP fought so hard to put off the healthcare reforms' effective date is so they could lie and fearmonger about what it would do and try to repeal it.
I guarantee that once Americans realize what it actually does (covers people who can't get Medicaid now, does away with preexisting conditions limits, allows them to keep their healthcare wherever they work, forces insurance companies to pay for care instead of overhead), the GOP is out of ammunition.
People already don't want to give up the parts that have taken effect, like coverage for kids up to age 26. The GOP is in desperation mode - but watch out, desperate people can be dangerous!
The non-partisan CBO stated that REPEALING the Affordable Care Act would cost $120 billion over the next decade. We can't afford that.
"The Congressional Budget Office said enactment of a House of Representatives measure last month to scrap the healthcare overhaul would eliminate a number of provisions aimed at reducing federal healthcare costs as well as strip out new revenue-creating taxes and fees."
http://www.reuters.com/article/2011/02/18/us-usa-healthcare-cbo-idUSTRE71H77N20110218
I understand that Republicans are doubling down on their vow to make President Obama a one term President, rather than fixing the country's problems. But with 10% approval, isn't it time to admit that Obama won on passing the health care overhaul? It's been two years; it's not going away.
Jeremy respectfully your facts are not entirely accurate. From a non-partisian prospective we need this bill. Agreed, we all have different ideas of how health care costs should be controlled simply because it's relative. Your health care costs from the private sector are constantly increasing due to those who are under or not insured seeking medical attention. Hospitals, private insurers and the government pass along those costs to the rest of the insured and taxpayers. Someone has to pay for those services of treating people who enter the emergency room for any purpose. Do you want your taxes to continue to sky rocket because so many are either under or uninsured?
The bill does not remove your ability to choose your insurer nor dictate price. The bill does include provisions to obtain health insurance at an affordable price contrary to COBRA which always has been a justifier to say insurance is available. Can you afford more then 1K a month to remain insured on your own not including spouse and kids? Heaven help you if you have a pre-existing condition or take medications because your insurance cost would be pro-rated by underwriters for each assuming future related claims. If you haven't checked into Cobra do your homework and find out how much it would cost you. Find out how much you would pay for COBRA to keep your insurance currently. Don't be shocked at what you learn as so many have been forced to go without medical insurance as a result. Your argument is poor when you haven't even given the bill a chance to take full effect or considered the reviews by independent studies and sources regarding it's impact. Over 272 of our nation's top economists have endorsed this bill because it effectively does reduce and keep costs down to our nations deficit. Like Social Security once people realized it's benefits it became the so called third rail of politics. Health Care Refrom if allowed to take effect most likely will be added to that list. The provision the house wants to eliminate supports the bill and it's intended purpose to contain costs. Effectively, the house is attempting to use a political strategy to undermine the bill of it's necessity rendering it not feasible. I agree, I don't like anyone dictating my insurance but you seem to forget Medicare falls into that category for millions. Unless you are extremely fortunate and can afford the out of pocket costs alone these provisions are the only way millions will be able to afford and have insurance. Again this is political strategy pure and simple not the real McCoy. Oh, I might add my insurance has consistently gone up without fail including my deductble. However, my coverage without fail has consistently gone down over the course of time regardless of Health Care Reform. Explain that to me and others like myself.
Once again, the reps put in a poison pill knowing dems wont vote for this. This is a no=brainer. Yeah. we really need congress to get involved with who pays, gets paid, etc. Lobbyist control everything in congress.
I will pray for $12 billion a year clotho. That would be a great savings!
Jeremy-960164
The CBO adjusted its figures because a year has passed. They freely admint the make those estimate based on a lot of assumptions and there is error. They have not said it would not do what it is supposed to to do, they have said the have to make different assumptions. As time passes their original assumptions prove wrong.
The main taxes have not gone into effect. The biggest tax is the increase in Medicare tax on people earning over $200,000 and the Medicare tax on investment income do not go into effect until 2013.
Besides what has that got to do with the statement that it is not working?
lvingbarefoot
I disagree. You make more money by increasing volume the same way as every other company does. The ACA adds 30 million people as customers. That alone will make them a lot of money. In addition the 20% is not profit margin it is overhead and profit. If you run a more efficient operation you can increase profits. Many of the features of ACA make administration of health insurance less expensive. Guaranteed issue, community rating, standardized forms, and standardized policies eliminate the departments the insurers now employ to determine elegibility and to deny claims whenever possible.
In addition, to compete they will have to offer standardized policies on the health insurance exchanges which will make the main difference between companies price. It will be a much more competitive market and it will drive premium prices down.
The Affordable Care Act is just a step in the right direction, will require continuous improvement but over time as it drifts toward a single payer system it will have the potential to significantly control and reduce costs. A cost driver of healthcare is a derivative of the cost of entry (board certification and continuing education) into practice. Other factors include pharma technologies, healthcare delivery systems and facilities all of which are passed onto the consumer.
Canada figured this out and removed this from the equation by offering free medical school to qualified candidates.
The new Ryan budget today is yet another attempt to voucher the Medicare program while touting a ~$800B deficit versus the presidents current projected budget deficit of $977B. The difference is the president's proposal does not come at the expense of the most vulnerable of our population.
I work on the payer side of this industry and I can say with 90% certainty that most seniors would forgo required chronic care on a voucher program. Now that is just the glaring problem. There is a host of other issues like being responsible for navigating the healthcare system at a time when you need care the most. That is a nightmare.
OBAMA IN 2012
70+ SEATS FOR DEMS IN THE SENATE
CONTROL OF THE HOUSE
the house is playing games , while Rome burns;
MARCH 16, 2012; Obama, under authority of the Patriot act, amended title 50 united states code sec. 301; by executive order gave the president in time of a national crisis(which only the president can declare) authority to seize all fuel, food ,medical supplies, close all financial institutions and banks, and declare all contracts involving same to be null and void, and to use armed forces to control all shipments of same ;
in plain words dictorial powers, congress does nothing .
saxon:
But nothing about seizing tin foil hats - lucky for you!
From the article: When Congress tries to control Medicare spending, Rockefeller complained in 2009, there are “too many lobbyists involved and it's very, very difficult if you have a lobbyist that comes in …blah, blah, blah.
It's called being a man doing what's right you pathetic loser. No one forces you to bend over for lobbyist, you spineless, piece of political garbage.
Politicians make me sick.
IPAB is one of our ONLY options to keep prices down and quality up. this independent board would not be beholden to special interests and Congress would have to vote all their recommendations up or down.
Congress wants to get rid of it because special interests like drug companies, insurance companies, and doctor would lose profits.
Money talks, as usual. What a disappointing Congressional move. They are in it for the special interests, not average Americans.
This is the tough nut for many to allow....
IPAB will be composed of 15 experts, yet to be appointed by Obama
Speaker of the House John Boehner and his masters the Tea Party contingent of the House are once again trying to inflick damage to the Obama Healthcare Bill. Some of these corrupt members want the medical and pharmaceutical special interest groups to vie for their patronage! They want to eviscerate any professional medical panels which would be independent of Congress. If lobyists are allowed to continue to influence the members of Congress the money would be swept into the pockets of the GOP members, and yes, Democrat members, of the House and Senate. In short the "favors" would flow to the highest and most influential bidders. The only question would be who pays the most in the way of money to the members of the Congress and not for the benefit of the patients. This corruption will continue to cost ALL of us, Republicans, Democrats, and Independent citizens, and will line the pockets of the corrupt U.S. Congress Members! It is well past time for our 'leaders' to put the American Citizens first and the lobyists be damned!
saxon - Ever watched that new show called something like 'Doomsday Preppers'. Another reason to stockpile and go off the grid???
I can't help but notice that every country that I have been to that has "socialized" medicine also has i(n relation to the U.S.):
Cleaner streets
Better infrastructure
Lower crime rates
Better educated middle-class
And a whole host of other things that make day-to-day living many, many times better.
Hmmmmmm. Now, why don't you right-wing knuckle-draggers think about that next time you're shouting "USA! USA! USA!" If you had a clue about how the rest of the civilized world REALLY lives, you'd be singing a different tune. Oh, but that's right...you're all too busy trying to turn America into Somalia...
Okay, Jeremy, let's discuss
For one, it's never going away - stomp your feet and whine all you want, it won't do any good. It's not a horrid bill, it actually does wonderful things for millions of American citizens, just like you and I.
You mean the taxes that have done nothing but go down since the President took office? Those taxes?
What people like you fail to point out in all of your "get government out of my life" arguments is that the inverse of government involvement IS NOT INDIVIDUAL LIBERTY. It's not. I repeat, IT IS NOT. As much as you want us all to believe that when the government goes away, we'll all be free to do as we wish, it's not true. It is a farce, a fairy tale or more succinctly, a lie.
The truth is that as soon as you push the government back, your insurance is not governed by you, but rather by private health insurance companies - or corporations. Corporations that bond together to take advantage of the consumer. Corporations that have shareholders to answer to, not consumers.
You may want to put your life in the hands of greedy CEOs and shareholders and call it individual liberty, but if it smells like garbage, it probably is.
This is either shortsightedness on your part or just plain politics. The bill solves many, many, many problems with healthcare in America. You either can't see it or refuse to acknowledge it.
To those who oppose this bill....go ask daddy for some more allowance.
My wife fell in the shower last year and we didnt have insurance. She ended up rupturing a disc, and has been bed ridden (at 38 yrs old) for 11 months now. The ONLY insurance we could get due to the fact that she had a pre-existing condition was obamacare. Yes it is expensive. So fricking what? I doubt many of you know the true cost of health care without insurance these days. Try this on for size,,,10 min ambulance ride and 20 min in the emergency room costs 5000 dollars. Her surgery without insurance will be in the neighborhood of 120k give or take a few thousand, they arent really sure. So yes, I am happy as hell to pay 264 a month for really good coverage with a low out of pocket per year....
So basically my point is...if you want to kill this coverage, go screw yourself.
It's been a year now since I moved to France (not by choice, my work took me here). My first trip to the dentist was an eye opener. After waking up in pain I feared I wouldn't be able to see a dentist for weeks because, God forbid, they have socialized medicine. I had to wait till 10, that same morning. The dentist visit required quite a bit of work. An hour later I walked out of the dentists office, the final payment was zero. I walked across the street to the pharmacy where I bought the pain meds the dentist perscribed. A total of 20 euro, which I got back in the form of a check about 2 weeks later.
My point is why do Americans not want this? I understand I am paying for some of those that don't have enough to pay taxes themselves, but it's a small price to pay knowing I will never go bankrupt over medical bills. I never have to worry about waiting out some kind of pain or discomfort for fear it's not anything serious and I've just wasted $400.
real American first;
why is it that supporters of this administration can not be wary of their grab for control ; you can go on line and pull up the new executive order; after you read it and you still do not have a fear of centralizing power in one person (who ever is in the White house), then you may not totally understand the reasons our Constitution divided the powers among the executive, legislative and judicial branches, power corrupts, absolute power corrupts absolutely.
Caligula
Then just go to one of the other countries you prefer over the USA. The United States of America was founded to give people a way to live free from government intrusion. You can go as far as you like in the USA, it is dependent on you alone. That is the way it should be anyway but the progressives are trying to screw it all up. The shellacking will continue in November. I can't wait.
If healthcare costs are increasing then its because hospitals aren't being paid enough. The government has decreased reimbursements for Medicare because we simply can't afford it anymore thanks to Mr. Bush's tax cuts and 11 year war! Aren't people tired of paying high insurance premiums and wondering where their money is going?? What insurance companies like to do is keep a large pool of healthy, rich people and keep a tiny, tiny pool of people who are rich, but sick (because only sick people who are rich can afford insurance anyway). That way, MOST if not all, of the money they receive goes into their pockets and million dollar bonuses for execs. What the ACA won't change is the greed and corruption that pervades our American culture. Medicare fraud, greedy insurance companies, and the widening disparity between the rich and poor are the real issues in dealing with healthcare costs and availability. Mr. Obama now is barely scratching the surface and once 2014 hits you can expect at least the former 2 of the 3 to vanish.
Aside from the glaring fact that Teapublicans fail to offer a solution of their own for our broken health care system... How do they plan to defend the loss in savings, kids getting kicked off their parent's insurance, people denied coverage for pre-existing conditions, etc.?
The Affordable Health Care Act is merely regulation of insurance, which was very much needed. Health care is still provided by the private sector. It's not anything close to the "socialized medicine" fear-mongering from the right-wing. Unfortunately it is still provided through employers, which no other country does.
Quite frankly, that's the problem with it -- Having a mandate without removing the greedyinsurance middlemen and profit from providers. Perhaps the GOP/TP will help make it clear to the public that we need a single-payer Medicare-style Universal health care for all.
Teapublicans can keep attacking workers, waging war on women, and trying to dismantle any progress made on behalf of the American people, and my guess is it will backfire. Throw the Teapublicans out - Obama/Biden - 2012!
It is now more important to keep the profiteers and their shareholders safe and healthy than the very clients they are being paid by to be keptsafe and healthy. TORT REFORM does the same thing. It puts a cap on the victims and rewards the criminal behaviors of all ccompanies wither they are Industrial, Privet, Insurance, Medical Facilities or Doctors and staff.
Lobbyists know companies and medical facilities can afford to pay off a lot of fines and kill a lot of victims when States have caps on those victims for wrongful death and medical malpractice. That's good for business and when there is real money to be made, why not victimize the victims as much as the law allows. When the caps are so low that the victim can't find an attorney to take their case becase there's a cap on their ability to prosecute also, it will cut down on any victims ability to do anything about it. The Corps and their Share Holders WIN and they will be able to run the show. They are.
Affordable health care Act for the win.
those who are against it are the problem...
Guess what, JH. If someone goes to the Emergency Room for care and does not have insurance, your intrusive government picks up the tab. Please quote to me, since you seem so informed, how much money the federal and state governments have paid to treat the uninsured. Give me a breakdown, annually, starting in the year 2000 of how much more tax payer money is being spent, yearly, as more and more people lose their insurance coverage. Can you do that, JH?
Since you seem to be quoting directly from the teabagger manifesto, let me remind you that your "movement" has been exposed for the sham it is. You are part of a religious movement that is pretending to be in support of fiscal responsibility that has done nothing but strip hard working Americans of their freedom. Jesus would be very ashamed that you wish for all poor people to die if they become ill...but that is between you and him.
"Progressives" are just as much a part of the United States as idiot, hateful teabaggers and have an infinitely more Christ-like attitude towards the poor and sick than you evangelical minions...so go staple a tea bag to your forehead and have your little rapture-thing. The adults in this country are trying to take care of this country. I'll be waiting for those numbers if you can figure out how to find them.
Maybe Obama will have to restore the half trillion he gutted from Medicare. You know, the half trillion the socialist/progressives don't want to talk about.
Besides, if his health care abomination is so good, why is it that he exempted himself and congress from having to be covered by it? Why is it that he had to give so many exemptions in order to get support for it?
All hail Obama.. destroyer of our children's future.
Actually, TruePatriot, the Republicans offered several options, carefully targeted at the things which a consensus agreed needed to be fixed , but the lamestream media buried them and the Democrat-controlled House and Senate refused to consider them. Here is just one: S.1099, Patients' Choice Act, Sponsored by Tom Coburn in the 111th Congress on 5/20/2009. Here is the LoC Thomas search page to locate it: http://thomas.loc.gov/home/LegislativeData.php
What the HELL. What do we even have Congressmen for if not to do this very thing? This is the shape of things to come, folks. A dictator with a Congress rubberstamping decisions made by Expert Committees.
Hah......
Once ANY ObamaCare legislation passed by the House hits Mr. Reid's desk, it will be immediately sent to the corner desk drawer to NEVER be seen again.
Yep, you can count on Mr. Obstructionist to take care of Mr. Obama's matters.
Umm, 'your intrusive government picks up the tab' only works if the patient is indigent or illegal. Said government is the State, not the federal government. I speak from firsthand knowledge. The uninsured often pay MORE because the hospital is looking to make up for losses from covering the aforementioned group. Don't give your real name, social security number or address and you can walk, otherwise they come after you. Pretend not to have a home and you're ok.
As to the costs, they are inflated to cover the shareholders involved in the hospital company. Most hospitals are for-profit, they look to make a profit and often they do so by inflating costs. Case in point, the hospital lab charges here are three times higher than what a local lab charges for the exact same tests. Why is that? Why are treatments or exams like xrays three and four times higher than at a commercial clinic not attached to a hospital?
Then, why do doctors charge the fees they do? Minor emergencies can be treated at a 'doc in the box' and the fee for the doc is $76.00 compared to a regular doc's visit that starts at $126.00 and goes up from there. Medicare, if you qualify, is not taken at many doc's offices these days.
So, in a nutshell, the system is indeed broke, there need to be caps placed on medical charges (sorry, but an ambulance to the hospital should not cost $5,000.00 unless they are going many miles to get to the hospital) Medicaid and Medicare are indeed raising costs since the padding done to compensate exists as does the fact that, because there are no caps, the hospitals and other 'care' providers will look to compensate elsewhere. Insurance companies place limits on what they will pay for procedures, they also determine what is necessary, and, since they're not doctors, they arbitrarily determine healthcare needs based on costs.
The obstructionists are the Republicans, who have used the filibuster more times than in history.
Those so called Republican jobs bills in the Senate are merely give aways to big oil and the deregulation of clean air and water.
Republicans have yet to create a reasonable infrastructure bill.
I personally want what congress gets via healthcare. Let us all be covered like congress is covered or else let them have to have our coverage. Interesting how when a group of legislators, making laws that affect the lives of everyone, exclude themselves from having to follow those laws. New law I propose...congress shall also have to follow and be responsible for each and every law they pass. No insider trading, fine. No congress person should be allowed to insider trade. Medical insurance? Obamacare? Great, now each and every congress person shall be covered in exactly the same manner that they force the rest of us to follow.
I guarantee that if you force congress to follow each and every law they create that laws would suddenly be reasonable, affordable and fair.
I'm not sure about this part but I don't think the regulations in the bill will be as set in stone if it is put into effect as the democrats say. Medicare they are already talking about raising the age from 65 to 67 and then to 70 No changes in elegibility? The new proposal to handle the contraceptive issue is a 3rd party to pay for it. So The patient won't pay, the employer won't pay but some third party is supposed to pay without getting premiums from either. Somebody is going to pay. I got one pea and three walnut shells who wants to play?
lvingbarefoot
Capitalism already IS in health care, and will still be if and when all provisions of the Affordable Care Act take effect.
You bet they're great at cost saving! Nobody runs "death panels" as effectively as health insurance companies under the current system. If the Supreme Court overturns the ACA, insurance companies will continue to do what they do so well now: figure out ways to deny coverage to people who've paid insurance premiums for their entire adult lives when they get sick. If the government gets involved, it will deprive corporations of their sacred right to make as much money as they can off of sick people.
The ACA requires Congress to use insurance plans the meet ACA requirements.
Federal employees in general including Congress have typical corporate group health care insurnace.
Yes, but unlike large corporations that cover the costs (up to 72%) of insurance, the federal government pays that percentage. Now, where does the federal government get the money to pay for that amount? What does the federal government produce to create income? What products do they make? The only source of revenue that the federal government has comes in the form of taxation and fees. So, in essence, the taxpayers are funding the federal employees health insurance. That was my point. Don't go pointing fingers at the military either. That is a different contract entirely and they service members are expected to give the ultimate sacrifice, ie: die, for their country. Can't say that about congress.
If there was one major failure in the affordable health care act it was not implementing it sooner. If today were 2014, there would be no debate. Anyone who even remotely suggested repealing parts of the law would be drummed out of office within days.
But the fact is that already millions have already benefited and they are not about to vote to give those benefits up. Those in relatively good health with no real knowledge of the AHCA, are still vehemently against it because they believe the propaganda against it. Most of their issues are purely politically motivated. Republicans are already treading on dangerous ground because their efforts to repeal ACHA are already going to have a negative impact on some of their base. For some of these people, they still hate President Obama, but they aren't anxious to give up their gains either.
Time will tell, but it is entirely possible that the Republican rhetoric may actually cost them votes come November. The healthy die hards aren't about to change their minds, but those who have personally seen the benefits of AHCA in their own lives will look at it differently. Had the Democrats crafted AHCA to be implemented two years earlier, the current discussion would be entirely different and Republicans would be claiming credit for it. This is a desperate attempt by Republicans to pull off a "late term abortion" on AHCA. Even some of their own base is going to have a problem with that.
From what I have been hearing the health care law is not what the President promised and should be repealed for that reason. The house already voted to repeal it once. The President promised that he would go over the health care law "line by line" with my congressman and that everything would be broadcast on C-SPAN. When they go over the health care law "line by line" they can try to determine weather it provides all that the President promised the American people. Implementation of the health care law should be suspended until the President has completed going over the Health care bill "line by line" with every law maker in Washington who requests it with all proceedings being broadcast on CSPAN. My congressman was one of those who requested it but there were others as well. I wish that my senators would also request to go over the health care bill will with the President, "line by line", so that they can better understand it. The President complained that many did not understand the health care bill. I am sure that the public, after watching on CSPAN, the President going over the health care law "line by line" with every law maker in Washington, that they will understand it much better and will be in a better position to advise their representatives in Washington as how to proceed regarding health care law related matters. Does anyone know when the broadcasts are scheduled to begin?
I love jay Rockerfeller and I hate house republicans. Still, over a year after they assumed the position (of power) they are revisiting the past on things that have had no ill effect on the nation and doing nothing about hose things that have proven to have ill effects on jobs and the economy. Jobs, jobs, jobs was their battle cry for the 2010 elections and I have seen them try to do nothing substantial for jobs. Jobs across the board, not just oil derrick work in 3 states, but across the board, good paying American jobs. That is far from their intentions.
So, should we start with these?:
So the House is spending its time passing a bill that: 1) Has zero chance of passing the Senate and becoming law, 2) Attempts to repeal a portion of a law that is in front of the Supreme Court and may or may not be struck down (making the House bill moot), 3) will repeal a part of the ACA that identifies and eliminates, with the APPROVAL of CONGRESS, fraud, waste and abuse.
Where are those jobs we heard about in 2010? Is there something about jobs in this? According to today's news, the Health Care industry is thriving and hiring more and more people. Wouldn't the House bill put a damper on the hiring? Or is that the point?
"I personally want what congress gets via healthcare."
Then you're in luck, because starting in 2014, Congress and all federal employees will be getting their insurance through the healthcare exchanges, the same way you'll be able to. See here: http://www.healthcare.gov/law/timeline/
I have seen mergers that took longer to pull together than Obamacare. Bottom line Obamacare is the largest project the government has ever tried and base of it preformance of running the government can not do this. Just look at Medicare and Medicaid today and that is just for only part of the people. The IRS also does not handle this volume. If you send a government employee to the store with a $20 tell him he can spend $10 for candy he is going to spend the twenty and then some because he need a dish to put it in. Right or Wrong the government can not manage Health care from cradle to grave.
hhabilis -- My guess is that Tom Coburn's proposal hasn't gotten much traction because it is vague (especially the tax credit part), and seems to be the status quo with minor tweaks that won't do much to improve the system or are already a part of the ACA.
At the outset, I am wary of a Republican (especially from one of the least progressive states of Oklahoma), but also I am wary of doctors like him who benefit from the status quo. But this is what I take away from reading about his plan:
The US is the only country where employers provide health care as a benefit to employees. This makes it harder for US companies to be competitive in the global market, or more efficient domestically because they are having to spend so much resources on something that is not what they do as a business. Why propose continuation of this? We need to convert everyone to individual plans that they can buy directly, but make it affordable (via a large pool of all citizens).
Also, the current system fails because health insurance (auto insurance too) competes at the state-level only, rather than at a national (or global level for pharmaceuticals). Many states have only one insurance provider, which is otherwise referred to as a monopoly. Okay, so Coburn wants to create exchanges at the state level to create competition, which is exactly what the ACA will do. So? But this still isn't as competitive as it would be at the national level, and insurance still isn't portable this way. Why not improve upon it and make it national?
And his plan is still based upon the insurance middlemen, rather than buying into a universal system of providers. What congress has enjoyed is for-profit insurance purchased with government subsidies -- Workers pay one-third of the cost of insurance, the government pays the other two-thirds. That's terrible -- It just gives for-profit insurance companies our tax dollars!
Jeff -725167 -- Wrong. There are some things that only government can do, like large infrastructure projects, going to the moon, defending the nation, and there are some things that government can do better than the private sector like health care.
hhabilis -- I also was appalled by the fear-mongering lies in Tom Coburn's website, and I quote:
Jeff -725167 -- Wrong. There are some things that only government can do, like large infrastructure projects, going to the moon, defending the nation, and there are some things that government can do better than the private sector like health care.
We need Medicare for all. This would not only make Medicare solvent, it would provide affordable health care to everyone. But let'sface it, Teapublicans like Coburn are making good money from the status quo, getting large donations from health insurance companies and Big Pharma, and have NO sincerity about helping the American people get affordable health care.
So I repeat my statement in my post above "that Teapublicans fail to offer a solution of their own for our broken health care system."
Because, if you pay close attention, the big Pharma, big Insurance and most other large corporations of that ilk are lobbying heavily to maintain the status quo. In order to have true, universal coverage you would have to do away with those entities and they don't die readily. Also, to naively believe that there is a difference between the parties is rather sad.
So, the one provision of the Affordable Healthcare Act that is specifically designed to look for waste and reduce costs is the first one the Teapublicans are targeting? Hmm, so when they claim they want to cut the cost of Government, they don't really mean it, do they... Why are they opposed to efficiency measures? Because it would cut into the profit margins of certain medical corporations.
The Teapublican program is: tax cuts and corporate welfare for the rich, screw everyone else.
Will Haas,
There in lies the problem. How is it that a controversial law such as this has been in force for a fairly long time already and people with opinions about it still don't really know what is in it, except for "what they have heard"?
If one is intelligent enough to post on a comment board, they ought to be capable of finding the official government website where you can get the actual bill in a nice, searchable PDF format. Yes the AHCA is a long bill, with a lot in it. And some of it is written in legalese that on the surface is tough to understand, but it isn't brain surgery either. Remember, Congress passed it. Part of the problem with complex documents like the AHCA is that often little bits and pieces get taken out of context and misinterpreted. One has to get used to reading this stuff and realize that there are multiple sections and each section only applies to certain things within that section.
Seems to me that a responsible citizen, recognizing that this issue is such a hot button issue that some are actually campaigning on to repeal, would take the time to really understand it. But no, many people would rather take the 30 second sound bites from their favorite pundits, some email your crazy cousin sent you or some You Tube video that tells you what you really want to hear anyway.
Now I will admit that AHCA is not your typical bill and is very involved and lengthy, but we have all had ample time now to read it and try to understand it. So if you haven't read it, do yourself a favor and do so rather than go by "what you have heard".
I will just add that CSPAN had many many hours of coverage on this issue. It was humanly impossible to watch it all. There were floor debates and many committee hearings. If anyone thinks that there was going to be a couple hours scheduled to explain it all to everybody, you are just being naive. Even members of Congress could not personally be a part of every piece of it. But they have staffs who do the grunt work, thinking and analysis for them.
Without a doubt, something this large will have a lot of compromises in it and parts that not everyone could support completely, but something like this needs to be taken as a whole. There are a lot of parts I would change or do differently, but as a whole it is great progress. Virtually all my complaints are that the law doesn't go far enough in some areas. There are a few things I don't like, but they are not "deal breakers" and I am not so self centered that I can't see that some things are better for others than they are for me personally.
The Affordable Care Act first corrects inequities in coverage in many many areas... it promotes coverage for people that need coverage and had trouble getting it. It forces people to stop gambling with my money and to be responsible by getting their own insurance... it's THE RESPONSIBLE thing for them to do for those GOPers that have forgotten those words.
The ACA then attacks costs with just such boards as the IPAB. It's very existence is to get politics out of the decisions.
The GOP hates the very concept of an IPAB because the lobbyists that support them will lose control.
The GOP has successfully undermined the ACA and anything else put into play since Bush. They have successfully demonized ACA to the point that is very founder... Romney... has to deny it's success and his involvement (a.k.a. lie).
It is currently IMPOSSIBLE for the likes of you and I to separate fact from fiction about ACA because of the lying @!$%#s that have spent $Millions to screw up the conversation.
This latest move by the House is political bull@!$%# and these people should be condemned for it.
The main reason they don't want over sight is simple, that don't want any sort of regulations on the pricing of health care, I have some Republican friends and that's where they make their investments, and the simple reason is this is a necessity, people will always get old and need medical care, same as Oil among other things like Cigarettes and liquor which are habits, these people are cold blooded, anything to make a buck and the problem with Obama is he knows it and is taking all the gravy away, so people can change the America is and stop the greed come 2012, Vote for someone that don't give a RAT's azz about you and your family or Vote for someone that is making a difference, remember this, Obama ran on the health care platform and it's not his fault he could not get everything he wanted out of it you can thank the obstructionist GOP for that one, just remember that these people will try their best to protect their way of making money and health care is a very big part of it, once the government enters with the so called Obamacare the Government will want to know why it cost so much and all the who, what, and why this is not something these people want the Government poking their noses into .... OBAMA 2012
Someone please explain, If Obamacare is so great, Why are there so many waivers, particularly for unions? Also, why is there still the same number or more of people without health insurance? I really want to know.
RObert,
Most of the Affordable Care Act has yet to be implimented.
The Affordable Care Act in NO WAY is some type of Government take over of health care. If you believe that you are misinformed. The waivers say, if you want to opt out of the pool and get health coverage somewhere else, by all means, go ahead.
Then why is this bill sponsored by 18 democrats?
You can read the original law. You can then read the two dozen or so "interim final rulings" clarifying and changing the law. (Another was issued last week) You can read the list of waivers issued to account for very common things the drafters of the original law didn't even know existed.
The law is a bad law on so many fronts it's difficult to describe. Not because it was a bad idea necessarily, but because it was sooooo poorly done.
The Republican House is sounding out loud and clear that they are the true death panel!!!
Robert-2302414
The waivers aren't for unions or any companies they are for insurance policies the unions and companies offer. They are temporary waivers for mini-med insurance plans.
These plans are expensive to administer because they are primarily offered to part-time and low income workers where there is a lot of job turnover. The insurance companies wanted to drop the plans if they needed to adhere to the 80% revenue is spent on claims requirement. Rather than having the insurance company drop the plans HHS granted temporary waivers to that rule. The mini-med plans will be obsolete in 2014 because they don't meet the minimum coverage requirements of ACA and the part-time and low income workers will have help getting comprehensive insurance plans.
Mini-med plans have a low maximum yearly benefit cap. Usually between $2000 and $5000.
So JH...that's all you have to say? The old "love it or leave it" nonsense. That is typical from the right. Instead of wanting to make things better than they are and move FORWARD, the right-wing is always looking backward to some mythical better-time (when blacks were slaves and women couldn't vote). No, JH...we will not allow your kind to turn this country into a $hithole...it is the right that will be "shellacked" because people are finally waking up to the right's real agenda...but the right is so afraid of the popular will that they have to try pass voter ID laws and engage in redistricting to eliminate democratic representatives because they know you can't win a fair fight. But in spite of this, the people who want a better country and a better life for themselves and their children will ultimately vote in their own best self-interest...not in the interest of big money and racist rednecks (what a strange combination the right-wing is).
Having affordable health-care, clean street and no-crumbling infrastructure has nothing to do with your statement about how far people can go in America. The undeniable truth is that if we had these things, individuals would be able to go MUCH further because the crushing burdens that would be eliminated. But, obviously, this all involves too much thinking for you to handle.
"Also, why is there still the same number or more of people without health insurance?"
Because the majority of people still get their health insurance through their employers and unemployment is still pretty high. When the health insurance exchanges come on line in 2014, those folks can be covered.
Once again.....the bill is sponsored by 18 democrats. So 18 democrats now equals a republican death panel.
I'm not sure I'll ever learn to follow the thought processes of liberals.
They can be covered now. They can either buy private insurance, or..if they don't qualify, they can participate in one of the high risk pools.
So why aren't they?
Maybe they're not high risk folks. And being unemployed, maybe they couldn't afford the private insurance premiums. Why is this so hard for you to understand?
It's difficult, until you realize that they love America just as much as you do. They just believe the facts you discount, and discount your facts as lies. It really does work both ways.
I agree that a clean bill should be brought to abolish the IPAB. Don't muddle it with the medical malpractice stuff.
It's high time the sponges stopped getting free medical care paid for by the rest of us.
Everyone needs health insurance, and everyone needs to pay their own premiums through their employer or otherwise.
It would be really nice to see clean bills on everything. Too bad that would never happen.
That's the ENTIRE nature of health insurance. Your health care costs are paid for by other people's premiums.
That's exactly what I do. It goes up $100 a month every year. Currently it's over $500 a month. That's a little too much.
where do seniors submit their premium payments? Or the disabled?
Seniors have to pay for part of their Medicare, and the premium comes out of their retirement checks. As for the disabled, well my Brother is on disability because he can't work, and he gets no retirement, so he doesn't pay any premium. Then again, he also doesn't get much money to live on, either.
As to where seniors submit their premium payments, they are deducted from our Social Security checks. Also in our case since we are both cancer survivors and my husband has had a serious heart attack so we have chosen to also carry a supplemental health insurance policy. Between the Medicare payments coming out of our SS checks and our supplemental health insurance policy which we pay ourselves our monthly cost for health insurance is nearly $900 per month. That is a lot of money, especially when you are living on a fixed income but we have always believed in paying our own way and not relying on taxpayers or anyone else to supplement our hospital bills which we could not pay if one of us were to become very ill again. For that $900 per month we could take some wonderful trips or otherwise have a much higher standard of living but for us it's worth it to know our bills will be covered and no one else will have to step up and take care of us.
I believe Obamacare should be allowed to go into effect and for those who think they should not be required to carry health insurance, you are very selfish. Why should some of us pay higher insurance premiums because you are too selfish to buy insurance for your medical bills if you were to become sick or injured in an accident? If we can sacrifice to take care of ourselves why are you any different? You may be very young and think you will always be healthy, and I hope you are, but everybody knows that some day our bodies will fail us and we will require medical care. For some it comes late in life, for others it happens very early and without warning. Last year my 24 yr old granddaughter who worked out all the time, not overweight, worked her 40 hr a week job, lived a healthy lifestyle suddenly without warning began having seizures. She has required hospitalization, ambulances, medications and many doctor visits. If she had not been responsible enough to pay for health insurance through her workplace she could have never gotten all these bills paid. You never know, no matter your age when in the matter of an instant your life can be totally changed either by a sudden illness or accident. Then somebody has to pay the bills. You should be a good American citizen and prepare for these things yourself. Until the day comes when we have single payer healthcare for every American citizen everyone should be required to carry health insurance to cover their medical expenses. It's the only fair and right thing to do, anything else is just plain selfish and wrong.
As T Bourlon stated, seniors make premium payment to the Medicare Premium office. The cost is now based on income, the more, the higher the premium. Persons with a disability make the same payment to the same department.
Putting a cap on wrongful death and malpractice awards is meant to ensure that the victims are victimized to the fullest extent that the law allows. This means that any amount over the legislated cap is taken from the victim and re-awarded back to the perpetrator. Now ante that a corporate written law for you to think about. Legislators decide what you get for what you've gone through even with intended death cases without even hearing the case or any circumstances surrounding the issue. I thought the jury was the only ones who hear the case and have the power and knowledge to make those judgments and remedies, not someone who doesn't know anything about your case. You are supposed to be protected under the constitution but the lobbyist are taking you liberties. This is what some call Tort reform. And it does not bring down costs, it brings up profit margins. Period!
When an Insurance Company saves money it's just a Blacker bottom line. More profit for the Stock Holders, bigger bonuses for the racketeers just like any for profit business. Business is Business and you can afford to accidentally kill lots of employees at $150,000.00 a pop when there's real money to be made!
Socialize health care is the only answer for the future. Medicare is there, Medicaid is there and even health insurance companies are there (everyone pays in and the money is redistributed) except they take a huge profit in moving that money around. The AHA helps Americans in part by allowing millions that want to buy health insurance but not finding any company that will sell it and by making health insurance companies spend more of the premiums on health care instead of profit
Something to remember for 2012, Obama was voted in office mostly with the promise of the health care issue and I haven't seen Americans change in that they don't want to buy and have health insurance anymore.
"except they take a huge profit in moving that money around."
The money the insurance companies take in profit for their shareholders (Americans) and themselves is about the same as the government will waste in inefficiency.
Medicare is over $20 TRILLION in unfunded liabilities. Sad but either way we end up bankrupted.
Say you live in a State with a Medical Malpractice wrongful death cap of $2000,000.00.
That's the TOTAL AMOUNT a victim can be awarded. It will cost about $100,000.00 or more to go to court. The Attorneygets 1/3 or $66,666,67 of the award. That leaves $33,333.33 for the victims or victims. Is that what you call justice when someones mother or father is killed leaving the three kids $11,111.11 each to live on for the rest of their lives? That's pain, suffering, all future compensation, loss of love and on and on.
It's really too bad isn't it? But that is all the legislators believe your loved one is worth in these States with caps. That's how the rich and powerful ensure that no one poor leach is going to get their hands on their money just because someone killed their loved one. They are very sorry but business is business and they have stock holders to be concerned with, not someone trying to gouge them because their mom died needlessly.
Texas passed tort reform and it didn't bring down health care costs. End of story.
Seniors and the disabled on medicare pay $99.90 a month taken from their check before it is sent to them. It is not a free ride. That is the minimum rate by the way.
Business does not lower profits because they make more money. Insurance companies make money by not paying out claims and increasing their premiums. Insurance is no exception to that rule!
Abolish a program to identify waste and cost cutting measures that would save the Government (and taxpayers) money? Do you really want bigger deficits that eventually lead to higher taxes?
Oh, I get it, you're one of the folks bilking Medicare for big bucks. No wonder you don't want the Government to cut costs - it would cut into your income!
t
The first question asked when you go to a medical facility for heath-care is do you have insurance? The first question you should ask them is what is the cap, (If any) for wrongful death or malpractice in that State!
It seem that the bigger and more predominate the States medical communities are tells allot about what their profit margins are for those facilities and how that is being accomplished. States get big bucks in revenue from these facilities and they don't like or want little people cutting into their take of the share with frivaless and petty law suites. You know, death and mutilations and such. Those victims are just leaches trying to rape this legitimate busnesses.
This goes to prove the big lie theory. The repubs have told a big enough lie long enough that some people actually believe it.
they are inside the bubble so its kinda hard to send them a fact sheet or something.
I feel that the whole health care law is a POS that should be totally reworked. Some of the things it does are good but most of it will run the United States broke. Take a look at the recent CBO report. It is a complete turn around. The two Senators from my state that voted for the POS said they voted because it would reduce our debt. Should they be allowed to vote again? Would they vote no this time?
I received a letter from my health care insurer last week. It stated that they had gone to the Obama administration and told them that in order to apply all of the provisions in the POS my premiums would skyrocket. The administration gave them a waiver until January 2014. So in January 2014 my premiums will skyrocket. Obama will have been gone for two years by then. Not to mention that I got a premium change notice just yesterday and my premiums are going up 50% on 4/1/2012. So much for "change" we can believe in and "keeping what I have". This President has failed in his attempt to reduce costs in health care. Isn't that his reason for change?
You lefties can keep bashing anyone who wants to get rid of Obamacare but you will open your eyes in a couple of years and wish you had been on the other side. You should go ask your elected officials in your county and state to see how much they are going to have to kick in to cover their "cadillac plans" when that provision kicks in. You will be suprised. And you can count on your taxes going up to cover it.
I don't know how long you have been paying for health insurance or even aware of the cost if your employer pays it, but believe me the real POS is the insurance companies. Health insurance has increased by 200% since 1990. People are not receiving 200% better care, inflation has not gone up 200%, wages have not increased by 200%, etc. since 1990.
There are more people (percentage wise and numbers wise) without health insurance now than there was 20 years ago. Fewer employers offer (because of the expense) and fewer carry it for themselves and their families (because they can't afford it).
Now all that being said I don't care for the idea of an "independent commission" making decisions that should be done so by an ACCOUNTABLE legislative body. However if you don't think these FOR PROFIT insurance companies have "death panels" then you are surely dislusional.
I will remind you the GOP had complete control of all 3 branches of government for 6 years (2000-2006) and in that time they did absolute nothing about the sky rocketing costs of health care. Bush passed the medicare Part D plan at the cost of 800 billion dollars to the tax payer. He had the guy fired that tried to warn him how much it was going to cost.
No sir, the POS you speak of overall is greed and the staus quo.
Well spoken -626321. I also think BUSH made it so the government agencies (like medicare) could NOT negotiate the price of prescription drugs. A nice WIN for the pharmaceutical companies.
Defend America - Vote out the Republicants!
Cut the defense budget in half and then extend Medicare to cover everyone. Problem solved.
Of course, too many republicans are getting huge campaign contributions from defense contractors and insurance companies, so I'm just dreaming here.
So...the republicans will make sure Obama's health care reform gets overturned. Then we'll just keep letting poor American children go without health care so our military can keep dropping bombs on other people's children.
Fish- total agreement. Blue Cross Blue Shield has a monoply in health insurnace. The only job raises I have had in the past 5 years have been given because good ole B.C.B.S. RAISE their rates. The shareholders are making a killing in profits & now I can not afford to retire -I do not care what it's called (Obamacare, B.C.B.S. or Plan 9 from outer space I NEED AFFORDABLE HEALTHCARE (as do all of US) I truly believe England & Canada have the best health care systems for their people.
Fish, you do realize there is no capitalism in health insurance and that is why we are so screwed.
If we make the companies play by the same rules as the rest of industries, rates will go way down.
There are no share holder in BCBS. Its a not for profit company. I have my health care policy with them and although it is VERY COSTLY, its cheeper than than any policy that I can get from a for profit company. The driver to get the cost of the coverage down is that EVERYONE has to be in the pool and PAYING.
No, the driver to lower cost is applying capitalism back which was thoroughly removed and BCBS is not not-for-profit in all states.
http://www.carrborocitizen.com/main/2007/03/29/flux-up-yonder/
Barefoot,
Yes Capitalism is a great thing in the health insurance non-profit sector. Sarcasm intended.
Fishhead, what has the price of healthcare done since 1990? In case you don't know, they too have gone up about the same amount with an annual average increase in cost between 10 & 15%. Also, if an employer sponsered plan has a loss ratio for the year of 110%, they are going to get a large increase to try to recoup the losses incurred by the company.
About 55% of the employers who do cover their employers (49% of all coverage for insureds in the US) are self-insured. This means the cost is born by the employer and not some insurance company.
fishhead, there has not been any capitalism in the health insurance industry for decades. That is my point.
Fish
I am an employer. I pay for insurance for my employees. This POS is killing small business and doing nothing to cut costs. Our President started out sayiong that we must reduce the cost of health care in this country. Has he done that? HELL NO! Should we ignore the fact that his bill has increased costs? HELL NO! Are insurance companies to blame? Not totally. If you were an insurance company woud you just forget about the losses you are going to incurr by doing all the crap that will be mandated? I doubt it. Look at what is going on, free this, free that, NOTHING'S FREE! Take this POS and start over.
Remember that insurance premiums doubled between 2001 and 2010, when the bill was signed into law. So saying that costs have increased needs to account for how much they would have increased if nothing had been done as well.
In addition, it's impossible to fully understand the entire health care law until it begins to go into effect in a couple of years. I will say, if the impossible happens and Repubs manage to undo every piece of the health care law, there will be millions of people very angry. People who could not get insurance because of pre-existing conditions, including children. Who really wants to give full control of your life to the insurance companies?
"Starting over" means that the broken insurance system remains unchanged for a few more decades. Now that we've gotten some control over our insurance, it's time to improve on the existing laws, not undo it just because these people don't like the President to be successful.
I believe the reason this "POS" is doing nothing to cut costs is because it left the staus quo in place - i.e. capitalism for a necessary component in everyone's lives. At some point in time everyone will need healthcare. Many pay and many do not.
As a business owner (kudos to you by the way for your success and providing your employees with health insurance) I do not believe you would want some of your clients to pay and others to pay absolute nothing. This country is unto itself a business. The overall practice of what is going on currently is bad business for everyone - you, my neighbor, myself, everyone. I'm 41 years old, in good health, and my benevolent employer who provides me a job and provides a service and goods and pays taxes on profits PAYS nearly $10k a year for my health insurance, up $3k/year in the last 5 years. Likewise I have not seen a raise in 4 years. Is that good for my employer? No. Is that good that I have not seen raise in 4 years? No.
I don't understand the GOP mantra that EVERYONE should pay taxes yet everyone should not pay for health insurance. Really that is what it comes down to. You are paying more because so many pay nothing. That and greed. Both can be solved, but it scares people because they don't want "socialism". Well a nation of sick and broke people is a social problem.
Just the way power and water companies use to be be quasi municipal entities (everyone needs and uses power and water) so does health insurance (everyone gets hurt or sick eventually). I agree nothing is free and that is why everyone should pay - i.e. universal healthcare.
As far as this bill increasing the cost of health insurance what else would you expect from the health insurance companies? Another excuse to raise rates while the getting is good. Just like the oil companies raising the price of gas all the time, beacuse they can and some butterfly crapped on a tree leaf the wrong way. It's called gouging for a needed commodity. Ever been through a hurricane and the cost of a generator that use to cost $500 is now a $1000 or more, know why - because they know you need it and can take advantage of you.
We do have one thing in common. You don't like the cost and I don't like the cost.
And THAT'S the problem - this POS legislation does NOTHING to hold down costs of health care OR insurance, yet it requires EVERYONE to buy insurance whether they can afford it or not! So you don't like the cost - then WHY ON EARTH are you supporting this bill??? Obamacare is driving costs UP, not DOWN. It's a lousy bill that puts all the burden on the individual - nothing from employers or insurance companies, and no public option. Yeah, there, I said it. NO PUBLIC OPTION, just a stupid "Health Exchange" where people can shop for a product they CAN'T AFFORD!!! WHY do you think that's such a great thing? Telling me "Oh, it would be so much worse if we DIDN'T do this" -- Really??? Where's your proof? We do nothing, rates go up. We do this, rates go up, but this will cost people who can't afford it. And don't give me that crap about government subsidies, not when we're running such a huge deficit, those alleged subsidies will be the first things cut, I guarantee it.
Obama's an IDIOT for not seeing this coming - like you said, what do you expect? Oh, but all the "experts" were saying "this should force rates down." Yeah, I have so much faith in "experts." Even Nixon used price freezes, Obama should have, too.
Obama's an IDIOT for not seeing this coming - like you said, what do you expect? Oh, but all the "experts" were saying "this should force rates down." Yeah, I have so much faith in "experts." Even Nixon used price freezes, Obama should have, too.
I don't think he's an idiot, I think he did a very poor job of taking this bill to the American people and worse he backed down from the GOP and left it in private insurers' hands and DID NOT impose the price freezes you speak of. However, could you imagine the backlash if he had imposed price freezes, hell he couldn't even impose freezes on Wall Street bonuses after the bailout, because that would be well - Socialist.
We are going to have to agree to disagree. As I said earlier the GOP had their chance (6 full years) to adress this issue and they did not. I think we can agree that something needs to be done and what was in place in the past has gone off the rails.
Anyway, good debate.
fish
What is needed is reform. Everyone agrees with that. This POS "changes" things but does not reform anything that has to do with costs. Why don't our elected aholes tell the medical industry that they have to compete for their clients like most other businesses in this country? Why can't I go into an office and ask what the price of a certain procedure will cost and then decide if I want to have it done there or go and get other quotes. I know that some times it is an emergency and there isn't time for getting bids but a lot of what goes on can be price competitive if we demand it. An example is, I had a hernia repair done. The total cost that was billed to my insurance company was $8,600.00, my payment was the $600.00. When I called to pay my share I was told that the insurance company took a $6,000.00 discount. I asked if I could have walked in off the street and had the procedure done for $$2,600.00 and was told NO WAY. We need reform but we do not need this POS that the dems had to bribe one another to pass. Start over and get it right.
And as for your statement of the republicans having all that power for 6 years, if they could have just waved a magic wand and got reform they would have been blocked by the democrats just like every lib says the repubs are blocking everything now. We have two parties screwing us every day just for votes for themselves. The Bush administration ytried many times to reform the housing mess and got blocked. Bush tried to reform social security and the dems refused to even come to the table and discuss it. The democrats like to think that they are the party of health care reform so we all have to sit back and buy exactly what they are selling? HELL NO! It sucks and it costs too much.
LOL! Do you people not see that this is the plan? Obamacare explodes like Medicare and becomes a monstrosity that cannot be paid for. Solution: Complete takeover of the healthcare system by the government. That has been the plan all along.
"I think if we get a good public option, it could lead to single payer and that's the best way to reach single payer. Saying you'll do nothing until you reach single payer is a sure way never to get it." - Barney Frank
DING DING DING DING DING!!!
All insurance companies should be non-profits. Profiting off people suffering is morally wrong, but somehow it escapes these so-called Christians.
Whats ina Name
Should all grocery stores be non-profits? People who are starving suffer too. How about oil companies? People who have to walk are suffering because they cannot afford gas.
What about elective surgery? Should a single payer system pay for sex changes and breast implants?
Why do you bring up Christians? I thought most doctors where Jewish or Asian....
lvingbarefoot
get real capitalism is exactly why healthcare cost are skyrocketing.. They take better care of CEO pay and stock holders then the people paying the premiums. They always try to find ways out of paying, and there ar eplenty of denials that you have ot fight through to get something covered.
What the USA is all about is irresponsible capitalism, and I and many many many more will support more and more socialist changes as long as the trickle down economics that is destroying this country is kept in effect.
you want to preserve a healthy capitalism, then the constant pushing of the wealth upwards needs to be changed... All money pushed down low to the workers will trickle all the way up through the economy... Saddling workers with outrageous healthcare costs suck the money needed to keep the capitalist machine rolling
You are very very confused.. you are supporting a fascist plutocracy and not capitalism, it is you who needs to rethink the reality
The reason for health-care reform was the rising costs. During the reform the cost continued to rise. People were going broke, getting sick and many die. They want to repeal that?
Wake up now!:
You can grow your own food if you need to. And walking is good for you. If you can't afford a car, then you should not have one, or you should move to a place where you do not need one. However, You cannot operate yourself, You cannot make your own medication, You cannot self-diagnose accurately.
When is the last time you saw an insurance company that covered elective surgery? Single payer should not pay for those things either, nor do they in most other countries. Even in more socialized health systems you still have private doctors that you can pay for with your own money if you want.
Why do I bring Christians into this? Because full-on-capitalism and Christianism are not compatible. All you have to do is pick up a Bible, read the Gospel and think about what you just read, (instead of just listen to the talking heads which are only interested in promoting their own agendas). The Republican party calls itself the party of Christians, but their actions and proposals are anything but Christ-like.
" this POS legislation does NOTHING to hold down costs of health care OR insurance"
Actually, it does. Someone above mentioned that insurance companies are now required to demonstrate that insurance companies as of 80% (for smaller companies) - 85% of money paid in by premiums was used for direct healthcare costs of premium holders or REFUND the difference. This took effect January 2011. Additionally, states were awarded grants for implementing or planning measures aimed at requiring insurance companies to justify any rate hikes. This took effect in 2010. There are other ways costs are contained as well; these are just two.
The original purpose of ACA was to ensure better access to healthcare (via insurance coverage) for those who had little or none. It has done so. Insurance companies can no longer deny coverage to children with pre-existing conditions, impose lifetime caps, or rescind coverage at a whim, the way they used to. Wouldn't THOSE measures reduce the costs of healthcare for those affected?
hopefully. this will fail too. GOP is constantly pushing bills they know wont pass just to be symbolic. instead of working on other things they focus on things that already are happening and then blame other for nothing being done right now. oh well OBAMA 2012
You can predict it wil pass the House and never even come up in the Senate. Even if it did and somehow passed, it would be quickly vetoed. The GOP will still go back and tell their lemmings that they "killed Obamacare"... and they will believe it.
KILL the WHOLE OBAMA-NATION called "Hussein Less Than Zero Care"
KILL all IDIOTS that make stupid comments like yours!!!!!!
scoobydobdo, click the ignore button instead. Call for the death of fellow Viners again and you're banned. You're suspended for a week for violating #1 of the Code of Honor.
Washington is so far out of control that no one there could find waste even if had a label identifying it as such. This commission, that commission, this board, that board, a new team, a new czar, another joke. Washington is awash in waste, fraud, and abuse. Some of it sanctioned by the White House like Solyndra. Which was crony capitalism and nothing less then fraud and waste. As if anything any of these clowns we have in Washington will do anything to rein it in.
It is all kickbacks.
That's the GOP for you. Screw over the poor and middle class.
And, just how are they doing that, Job1? This is about the panel, not the recipients.
They better hurry before more people start to realize the benefits to this law.
dirt...dirt...dirt. Read the article.
More lobbyist influence= fewer patient rights
more legislative control=less medical-based decisions
less cost-cutting=higher premiums for patients
The GOP can't stand it when they don't get to control our lives.
zhovti, if you continue to decrease the reimbursement, you will end up wil less medical care available to seniors because providers will begin refusing to see the patients.
If you were a manufacturer of widgets and it cost you $10 to make each widget, how long would you continue to make widgets if you were only getting paid $8 per widget.
I'm not saying that what the providers are charging is realistic. The problem is that the providers are being reimbursed by the government at the $8 level of the widget example. The difference is that instead of charging everyone $11 for widgets, the government gets charged $8 and the non-government patients get charged $15.
That won't happen. The Medicare market is a major percentage of the total market. If they stop accepting Medicare they will also close down completely.
You have to control cost. You don't do it by reimbursement you do it by defining services clearly. The doctor or hospital is rewarded by achieving better outcomes not for inflating the number of procedures they do. If you set a clear standard of care and compare performance among the players the better players get a higher payout than the inefficient ones.
Medicare is 12% of the market according to The Kaiser Foundation. The uninsured "market" is 16%.
If you are running a business and are losing money on 12% of your market, would you continue to do business with them? I wouldn't.
The remainder of what you say is spot on, in my opinion. The cost control is not through cost controls but rather outcome based reimbursement. As an example, how many times does someone present to a physician with symptoms of the flu and is given a bunch of prescriptions. Does the physician ever follow up to know whether or not what was given did actually work?
Do you have a link to that data? I can't find it. It seems low.
The democrats wouldn't have the problems they do with the law if they hadn't ramrodded it through congress in the first place. Can you really tell me what pg 801 sec 1751 Government will decide which healthcare conditions will be paid really means. Today, Tommorrow. If conditions change.Can you tell me what pg 354 sec 1177 Government will restrict enrollment of special needs people means. And can you tell me what pg 335-339 Government establishes outcome based measures means What outcome and for who? And if you can explain the new creative bookkeeping plan to handle contraceptive coverage where neither the party covered nor the employer who objects to it pays but some third party does and nobody pays premiums to this magical third party. Where is the money going to come from?
@Bookem'Danno
Apparently you are ignorant of how a primary health care provider (PCP) works. It is not a realistic expectation that a PCP should follow up with EVERY patient that they see. It is the PATIENT'S job to notify their provider if they are still suffering from symptoms after the visit. A typical provider can see upwards of 20 patients a day (100-120 a week if the clinic is open on Saturdays), a number driven by the shortage of PCPs, and expecting them to conduct a follow-up on every patient is unrealistic.
In the S.O.A.P. format that PCP's use for documenting a patient visit (Subjective - what the patient reports, Objective - what the PCP observes, Assessment - the diagnosis and differential diagnosis, as well as ordering lab tests etc, and Plan - explanation of the diagnosis, patient education, health maintenance, and RETURN INSTRUCTIONS (aka - under what conditions should they return to the office for a follow-up); it is under the "P" section that the Dr.'s instruction to the patient is something along the lines of "take this pill 2x daily (b.i.d) and return to the office if your symptoms have not improved in 10 days." to assess the effectiveness of treatment.
If you want to look into ways to cut medical costs, there is an older study (2003) that showed that out of 9 countries, the U.S. pays between 6% and 30% more for the same medications:
So, in effect, the U.S. is subsidizing the cheaper medications of other countries' citizens. While the U.S. does have more generic drug Rx's, and our generic drugs are cheaper than most, the endless legal machinations of the drug companies to limit new generic drugs to counter their brand name drugs has greatly contributed to the price of Rx's.
The Pharm companies can lobby all they want. The bottom line is still the same. It may cost millions to develop that 1st pill, but it only costs fractions of a penny to produce every pill after that. The majority of what you pay for in Rx's goes not to R&D for new medications, but to pay for the advertising campaigns that they run every night between 5:00 and 10:00 to get you to ASK your PCP for THEIR pill. 2008 -
If one Pharm company's medication was so much better than the competition's, than they should not need to advertise. The results that PCPs see in their patients when prescribing the drug in question should be the deciding force in what medications to prescribe (i.e. - the results should stand for themselves).
But what if you aren't actually "losing money", just not making as much on 12% of your market, would you continue to do business with that 12%?
It depends: If you've got so much business you can't keep up with demand, perhaps even turning away potential customers, then it might be wise to drop your less profitable customers and concentrate on the "big money" customers. But if business isn't that hot and you're looking for more business, then a low paying customer is better than no customer.
Here is the thing ---- I'm a democrat, and closer to the left edge than the center.
I oppose getting rid of the IPAB board and I would love to see them cap damages for malpractice. If they capped the damages then sharks (lawyers) wouldn't be so hot to take every stupid case they can find. It would unclog the courts some, and also reduce the cost of doctor's malpractice insurance. Reducing the cost of malpractice insurance in turns reduces medical costs (doctors and hospitals have less overhead).
Democrats in Washington have always had the malpractise thing wrong.
Actually Austin0, I live in Texas where they passed a Tort Reform bill, and it did nothing to reduce our Health Care Premiums. As a matter of fact, health care costs in Texas are probably higher than most states.
verno, I wonder what happened to the premiums for malpractice insurance. I would guess they went down. What did not happen then is that the providers did not pass along their savings through reduced charges for services. Therefore, the cost of health care insurance premiums also did not go down because the benefits paid still had to pay for the costs being charged.
Well, the question is, did they not increase as much as they would have otherwise.
I hear people from Mass. complaining that their mandate did not lower their premiums; but when you compare their increases with the rest of the country, then you realize that in other states the premiums have gone up 5 to 8 times as much during the same time.
We wouldn't need IPAB style independent commissions if Congress were a competent and responsible entity. Sadly it is neither.
Even if they were competent and responsible, it is delusional to think that these people can make specific and correct decisions about healthcare. (or anything else for that matter)
One person cannot know everything, and these people are mostly lawyers or career politicians; they are not engineers, they are not architects, they are not merchants, they are not teachers, they are not doctors. It is hard enough for a doctor to keep up with current developments in narrow sections of their fields. We cannot seriously expect every person in congress to keep up with every single possible issue in ALL fields.
Knowledgeable commissions are the solution, (as long as they are not compromised). This commission should exist regardless of the Obama HR reform. It is beyond me how republicans expect to claim victory when they are trying to defeat a cost cutting measure.
This is, of course, politics and a waste of time by the Republicans in the House.
Folks, you would do yourselves and the country a favor by working on something that has a prayer of becoming law, and doing something to resolve some of the problems we have in America.
Unemployment who cares-lets attack something that can only help people.
How anyone can vote for these clowns is unbelievable.
If the Repugs win one seat it is to many.
Party in death-spiral.
It helps others by making those that work to pay their own way pay more. Soon nobody will be able to pay then what?
Pre-Obamacare, people were still getting sick, hurt etc... without insurance, Dan T. You were still paying for it through Government subsidies. At least this way they can help control the amount the insurance companies/hospitals are charging for services.
If you think that just because of Obamacare, all of a sudden these costs started surfacing, you really are delusional.
Because of uninsured ER visits, every person who has health care insurance pays $1000.00 per year more than if the uninsured had coverage.
So, you say don't let the uninsured pay - you want to pay for them. Right?
Political posturing for re-election. What a joke politicians have become. Forget obamacare. Vote for term limits. The country is already bankrupt. We are borrowing to support spending. It is a recipe for disasater. The rats will never kill their golden parachutes, but they will jump ship when we are so deep under water that we will all be drowning in debt.
Term limits, sandnomad? I expect, since term limits are very crucial in the teabagger world, that every teabagger that gained a seat in the House in 2010 will willingly abandon it in November, right? I'll be interested in seeing how many of them are willing to stand by their convictions.
5 Myths About Health Care Around the World
By T.R. Reid
Sunday, August 23, 2009
"As Americans search for the cure to what ails our health-care system we've overlooked an invaluable source of ideas and solutions: the rest of the world. All the other industrialized democracies have face problems like ours, yet they've found ways to cover everybody – and still spend far less than we do.
I've traveled the world from Oslo to Osaka to see how other developed democracies provide health care. Instead of dismissing these models as "socialist," we could adapt their solutions to fix our problems. To do that, we first have to dispel a few myths about health care abroad:
1. It's all socialized medicine out there.
Not so. Some countries, such as Britain, New Zealand and Cuba, do provide health care in government hospitals, with the government paying the bills. Others -- for instance, Canada and Taiwan -- rely on private-sector providers, paid for by government-run insurance. But many wealthy countries -- including Germany, the Netherlands, Japan and Switzerland -- provide universal coverage using private doctors, private hospitals and private insurance plans.
In some ways health care is less "socialized" overseas than in the United States. Almost all Americans sign up for government insurance (Medicare) at age 65. In Germany, Switzerland and the Netherlands seniors stick with private insurance plans for life. Meanwhile, the U.S. Department of Veterans Affairs is one of the planet's purest examples of government-run health care.
2. Overseas, care is rationed through limited choices or long lines.
Generally, no. Germans can sign up for any of the nation's 200 private health insurance plans -- a broader choice than any American has. If a German doesn't like her insurance company, she can switch to another, with no increase in premium.
The Swiss, too, can choose any insurance plan in the country. In France and Japan, you don't get a choice of insurance provider; you have to use the one designated for your company or your industry. But patients can go to any doctor, any hospital, any traditional healer. There are no U.S.-style limits such as "in-network" lists of doctors or "pre-authorization" for surgery. You pick any doctor, you get treatment -
and insurance has to pay.
Canadians have their choice of providers. In Austria and Germany, if a doctor diagnoses a person as "stressed," medical insurance pays for weekends at a health spa. As for those notorious waiting lists, some countries are indeed plagued by them. Canada makes patients wait weeks or months for nonemergency care, as a way to keep costs down. But studies by the Commonwealth Fund and others report that many nations -- Germany, Britain, Austria -- outperform the United States on measures such as waiting times for appointments and for elective surgeries.
In Japan waiting times are so short that most patients don't bother to make an appointment. One Thursday morning in Tokyo, I called the prestigious orthopedic clinic at Keio University Hospital to schedule a consultation about my aching shoulder. "Why don't you just drop by?" the receptionist said. That same afternoon, I was in the surgeon's office. Dr. Nakamichi recommended an operation. "When could we do it?" I asked. The doctor checked his computer and said, "Tomorrow would be pretty difficult, perhaps someday next week?"
3. Foreign health-care systems are inefficient, bloated bureaucracies.
Much less so than here. It may seem to Americans that U.S.-style free enterprise -- private-sector, for-profit health insurance – is naturally the most cost-effective way to pay for health care. But in fact, all the other payment systems are more efficient than ours.
U.S. health insurance companies have the highest administrative costs in the world; they spend roughly 20 cents of every dollar for nonmedical costs, such as paperwork, reviewing claims and marketing.
France's health insurance industry, in contrast, covers everybody and spends about 4 percent on administration. Canada's universal insurance system, run by government bureaucrats, spends 6 percent on administration. In Taiwan, a leaner version of the Canadian model has administrative costs of 1.5 percent; one year, this figure ballooned to 2 percent, and the opposition parties savaged the government for wasting money.
The world champion at controlling medical costs is Japan, even though its aging population is a profligate consumer of medical care. On average, the Japanese go to the doctor 15 times a year, three times the U.S. rate. They have twice as many MRI scans and X-rays. Quality is high; life expectancy and recovery rates for major diseases are better than in the United States and yet Japan spends about $3,400 per person annually on health care; the United States spends more than $7,000.
4. Cost controls stifle innovation.
False. The United States is home to groundbreaking medical research, but so are other countries with much lower cost structures. Any American who's had a hip or knee replacement is standing on French innovation. Deep-brain stimulation to treat depression is a Canadian breakthrough. Many of the wonder drugs promoted endlessly on American television, including Viagra, come from British, Swiss or Japanese labs.
Overseas, strict cost controls actually drive innovation. In the United States, an MRI scan of the neck region costs about $1,500. In Japan, the identical scan costs $98. Under the pressure of cost controls, Japanese researchers found ways to perform the same diagnostic technique for one fifteenth the American price. (And Japanese labs still make a profit.)
5. Health insurance has to be cruel.
Not really. American health insurance companies routinely reject applicants with a "preexisting condition" -- precisely the people most likely to need the insurers' service. They employ armies of adjusters to deny claims. If a customer is hit by a truck and faces big medical bills, the insurer's "rescission department" digs through the records looking for grounds to cancel the policy, often while the victim is still in the hospital. The companies say they have to do this stuff to survive in a tough business.
Foreign health insurance companies, in contrast, must accept all applicants, and they can't cancel as long as you pay your premiums.
The plans are required to pay any claim submitted by a doctor or hospital (or health spa), usually within tight time limits. The big Swiss insurer Groupe Mutuel promises to pay all claims within five days.
"Our customers love it," the group's chief executive told me. The corollary is that everyone is mandated to buy insurance, to give the plans an adequate pool of rate-payers.
The key difference is that foreign health insurance plans exist only to pay people's medical bills, not to make a profit. The United States is the only developed country that lets insurance companies profit from basic health coverage.
In many ways, foreign health-care models are not really "foreign" to America, because our crazy-quilt health-care system uses elements of all of them. For Native Americans or veterans, we're Britain: The government provides health care, funding it through general taxes, and patients get no bills. For people who get insurance through their jobs, we're Germany: Premiums are split between workers and employers, and private insurance plans pay private doctors and hospitals. For people over 65, we're Canada: Everyone pays premiums for an insurance plan run by the government, and the public plan pays private doctors and hospitals according to a set fee schedule. And for the tens of millions without insurance coverage, we're Burundi or Burma: In the world's poor nations, sick people pay out of pocket for medical care; those who can't pay stay sick or die.
This fragmentation is another reason that we spend more than anybody else and still leave millions without coverage. All the other developed countries have settled on one model for health-care delivery and finance; we've blended them all into a costly, confusing bureaucratic mess.
Which, in turn, punctures the most persistent myth of all: that America has "the finest health care" in the world. We don't. In terms of results, almost all advanced countries have better national health statistics than the United States does. In terms of finance, we force700,000 Americans into bankruptcy each year because of medical bills. In France, the number of medical bankruptcies is zero. Britain: zero. Japan: zero. Germany: zero. Given our remarkable medical assets -- the best-educated doctors and nurses, the most advanced hospitals, world-class research – the United States could be, and should be, the best in the world. To get there, though, we have to be willing to learn some lessons about health-care administration from the other industrialized democracies."
Thank you T.R. Reid
Thank you for this wonderfully informative piece. It's the sort of thing average Americans should be reading instead of listening to hysterical, uninformed, under-educated, and flat-out corrupt politicians who are taking in lots under the table.
Thank you, thank you, THANK YOU!! You've laid it all on the line, here, and the truth will out. The US reliance on a greedy, corrupt corporate system that really doesn't care whether it's customers live or die has got to come to an end. I've worked in the health insurance industry and I've seen many of the behaviors you've listed here first hand. Recission departments looking for reasons to deny policy holders their death benefits. Cancelling policies for conditions that customers were treated for 10, 20, even 30 years prior to coverage. My own autistic son denied coverage *because* of his condition. I've always said that the insurance industry in this country was the biggest organized racket in the history of mankind and, now, that truth is coming home to roost for the American people. The GOP needs to get it's nose out of our health care needs - particularly out from under the skirts of American women! - and get back to the "promises" they made about creating jobs and fixing our economy!!
But we will still all hear conservatives say that they have a friend who's cousin's nephew's classmate's neighbor is a nurse in Canada that sees people die in the waiting rooms all the time- despite no real evidence, and despite the fact that there are several videos of Americans dieing, literally, in waiting rooms.
GOP- they sure do love that Goebbels' propaganda.
Thank you for your explanation. It is amazing how many people in this country are so brain washed. I had a daughter go overseas for one year to Europe in her college junior year. She went to the doctor one time for a foot injury and no expense. We paid about $25 per month for her coverage since she was an American studying abroad. Now she wants to go back and hopefully live there. Can't say I blame her when I see and hear the deteroriation of our healthcare system and more on a daily basis. I hope she actually does move to Europe and gets married with kids there. I am truly afraid for my kids now to have kids in this country in the future. The country is headed in the wrong direction and everything is so money driven instead of compassion and taking care of everybody. The country has no more dignity and puts a price on everybody's life when some can and cannot afford insurance. What is the point of saving anything when eventually you will declare bankruptcy for medical bills at some point in your life time. Only the millionaires will avoid the bankruptcy rankings in the future if we do not have a national healthcare plan. Right now even with Obamacare that you are all against the future is dim. The future unfortunately for many is not here in the U.S. but in another country and 99% just don't see it or choose to ignore the facts.
Thank you for your contribution! I hope people who oppose health care really read it.
Thank you, T.R. Every bit of that information should be in every news story about the fight over Obamacare. I have saved your piece to send to my friends.
The real problem with Obamacare is that it does little to eliminate the greed, corruption, and quid pro quo that is running our healthcare system now. I am in physical therapy for two body parts and told that I must come on a different day for my shoulder than for my back, because Medicare doesn't allow the therapist to bill for more than one part on one day. This is just another way of rationing care and building revenue that makes no sense for the patient. Our healthcare "system" is mostly a sophisticated set of profit centers for the insurance companies. And Medicare, which is a highly socialized system, is the quickest and most reliable payer to the providers. But for those of you who haven't reached 65 yet, be prepared. It is not free. My husband and I paid out over $10,000 last year for basic and supplemental care, plus drugs. Any non-generic drugs, we bought from Canadian pharmacies, where we aren't held up for access to pharmaceuticals, another component of US "health care" that needs complete revision.
Excellent post, T.R.
I have had some very scintillating conversations with my brother who is an insurance executive currently employed with Kaiser Permanente, a non-profit organization that provides "socialized" health care on the west coast.
He, too, has traveled the world and has nothing to say but good things about the health care in other industrialized nations and is appalled at the anti health care system propaganda denigrating those systems, spewed forth by our right wing politicos and their big insurance company contributors.
It seems our "leadership" is more interested in the accumulation of wealth for themselves and their cronies than they are concerning the welfare of the citizenry.
Wow, the cheerleaders are bright and perky today! Get a life and your own opinion. I am an American living in Canada and I get laughed at when I talk to the locals about getting a family doctor, for my wife and I (because waiting list are years). Sure there are urgent care centers but you can't even get anti-biotics there. How about you people crawl out from under your rocks and stop believing everything that makes you "feel good".
I also agree and thank you for the post. The US spends 125% per capita what the other developed countries spend yet we cover about 80% of our prople compared to the others covering 100%. Europeans , Japanese do not allow PharmCo ads like we see 100 times per day. US Pharmacy Co.s spend 25% of total receipts buying ads to convince you to convince your doctor that you have restless leg syndrome and need the medicine. Can't do that in other countries - they expect the Doctor to be a doctor and they should know if you have restless legs and then they will prescribe what is needed. You un-medically-educated folks don't need to start acting like the doctors you are not trained to be by watching commercials from for profit companies paid by medical premiums. Our Medical Professional Class have a much higher standard of living than people in these other countries. The Docs, Insurance agents, Insurance Execs, Clinc and Hospital administrators don't all live in 8,000 ft houses, on a 10 acre suburban rangette, with a beach house besides and exotic vacations every year. The US medical comunity will try any new Technology at any cost because they send the bill on to somebody and it always gets paid. These other countries have experts to determine if those new things are ready for everyone or should stay in experimental tracks until proven. US approves drugs and therapies for use and 2 or 3 years later we see a flood of lawyers advertising the problems with these new therapies and offer to sue your provider. The medical patients in the US are guinea pigs for the for profit experimenters. Not so much in these other countries. The "for profit" guys get to determine if you should have what they are selling. They got that permission from the gubmint - which they lobbied to get. And Doctors do self dealing too. They own clinics, machinery and refer patients for tests and therapies that are un-needed but serve to put cash in the Docs pocket. This is how we spend more then the other guys and cover fewer people. Meanwhile, there are insurance agents wiht $500,000 boats on Tampa Bay thanks to your medical premiums.
It is nice you gave us all this information except those plans are not the ones we will be dealing with and if the congress had been allowed to do their job and review the parts of the bill before a vote we wouldn't have all this confusion. When you tell your senator in an e-mail that 1) you do not understand parts of the bill and 2 ) you cannot find it online. and you ask her if she can explain the sections hoping some clerk of course can send it to you. She answers I don't know what is in it either and I don't know where to get it either. There is something seriously wrong with the process.
The ACA law is available online in its entirety at healthcare.gov along with lots of other information about the law.
Whenever I hear a pundit bloviating over how terrible medical care is in those "socialized medicine" nations, I note that Japan, Taiwan, Canada and all those European nations have free elections, an elected legislature, press freedoms, even conservative political parties - yet they are not making any effort to get rid of that terrible awful horrible no-good evil "socialized medicine" and replace it with an American style health care system.
Methinks all those horror stories, are just that - stories made up by pundits, with no basis in reality.
Having lived and worked overseas for many years I certainly used the national health services of those countries. When people in the U.S. point out how great Europe's systems are they seem to forget that Europeans are used to paying for those systems in the form of taxes, like 4 dollars a gallon tax on gasoline, and 20pct VAT. The reform Act that was passed in 2010 is a hodgepodge that promises many things and takes account of the fact that no one wants to be taxed to pay for it.
So it really doesnt matter how good or bad European systems are, we cant copy them since Americans wont put up with a 4 dollar a gallon tax on gas, making a gallon 8 bucks. And by the way some of the better systems, such as Germany, Switzerland and Holland are not single payer systems. I only mention that since many on the Vine confuse the aim of universal coverage with single payer systems.
Good info Lampell. thanks
obama couldn't do anything to help people in america as long as republicans block him or scare people making up nonsense like they do.
of course the republicans have an interest in not doing it, the insurance companies and lobbyists for that industry are campaign funders for their party... and also corporations and the rich ....
even if obama as trying to do the very best thing ever for the people, republicans would block him just because he is a democrat, or to make him look bad and say he didn't do anything, when all the while it was their fault he didn't or couldn't.
wake up people... if you put another republican in office, you will regret it.
Sounds like another go-nowhere bill by our do-nothing congress. More wheel-spinning. Zzzzz.
Silly, silly Democrats. Don't they know that legacy admission, buisness school graduates with no medical degrees but multi-million $$$ compansation packages from the healthcare/insurance companies they sit on top of are the ones who get to tell you no after you've paid into their system for years?
And this is exactly the policy of greed and corruption that the GOP would like to continue indefinitely at the expense of the American people. NO WAY!! Vote them out and do away with the party of "no"!!
Have people paid by the government under civil service done better? Do you think this review board will be made up of geniuses? Do you think this review boadrd will even be the one reviewing your case? Not it will be done by some staffer with a computer that when certain infomation is keyed even if the information is incorrect who will send a form letter saying sorry Charley.
Of course, the House of Reps all have THEIR evil 'government health care'.
They just want to make dam sure no one else has it.
It's as noble a cause as you'll ever see a Republican espouse.
GOP would move mountains to kill Obamacare, but they have yet to put forward any other real solutions to the problem of rising medical costs. They dont really care about solving the problem, only whining about how unfair any Democrat solution is. Of course, this is because they represent a higher percentage of the wealthy that can afford healthcare....and their own is better than anything the average working man can afford.
So true! And they think everyone who can't afford their own private health care are just losers - so why should we pay anything for them. Nevermind the fact that employers often do not offer it, that it is insanely expensive, and that people who have chronic or serious health issues (and disabilities) often cannot work. I would love for their to be a new type of Survivor reality show, where rich people have to live the lives of the average Joe!
What you see as a problem ( medical care, condition of the people, etc) they do not see as a problem. They view medical care as a financial system. They are supported by the PharmCos, Ins Companies, Hospital Associations Etc. They want those supporters to get their rewards. so they keep up this charade of a medical system so it will funnel monsterous amounts of cash to the people in the industry. IT's not about what you say is the problem. It's about making money. You health care is secondary to that.
Good thing I'm not sick...yet.
You would think we should be at the top in terms of health care and standard of living...instead we are near the bottom, in relation to other industrialized countries. The answer isn't more red tape.
the GOP will do anything in their power to derail Obama. we the people need to remove all the repubs in office. they have been a huge pain the ass these last 6 dozen or so years. they do not need any health care thir far too wealthy to need any *poor mans* health care and refuse to help make it happen. when is America going to wake up and smell the @!$%# these guys bring to the table.
Just go single payer, put the insurer ghouls out of business and start cutting big pharma's profits.
Yes, and we should take over the oil indurstry and the auto industry and the agriculture production too.
We don't have to, they already own the government.
I hope they kill the whole thing but, if anything, I especially hope they kill the individual mandate. I do not want to be forced to buy something I do not want. I have an inalienable right to self-determination and it is not the government's role to try to take that right from me. Power to the people; NOT the medical industrial complex.
When will people like you get it? IT'S NOT ABOUT YOU. It's about everyone. It's not about the good of the one. It's about the good of the many. Selfishness like yours means that millions of people across this country go without medical treatment. It means that thousands die every year because they can't afford the treatment they need to continue living. Those people who are sick and/or dying directly impact our economy because they can't be as productive as they would be if they were healthy. The lousy economy directly affects YOUR WALLET - there's something you might be able to understand! Get over yourself and get behind the needs of this country at large or selfishness like yours will be our ultimate undoing.
Fine, then when you get sick you can drop dead. Just don't stick me with your medical bills.
Fine, then when you get sick you can drop dead. Just don't stick me with your medical bills.
Sounds like a fair bargain to me. You let me pay for my own medical bills instead of being forced to buy insurance, and I'll gladly pay with my life if I'm unable to do so. Give me freedom or give me death.
This is not sarcasm. I'm being dead serious (no pun intended). I fully understand what I am asking for when I say I want the government out of my health care.
Then when you visit the ER because you don't have insurance, let's hope they say they don't want you either.
And I don't like being forced to pay higher insurance premiums and fee for service costs because of deadbeats who take no responsibility to provide for their own medical expenses, PPinLA. This is especially true for those who can meet that responsibility ~ but don't.
In order to have a better society, we all have to buy stuff we do not necessarily want. Some people scream about paying any taxes, yet they use our shared roads, parks, emergency services, etc. Angie said it perfectly - it is not about YOU. People who can, but won't, pay for their own heath insurance just drains the health care system when they get sick. Doctors and hospitals cannot just let someone die because they didn't pay into the health care system - so the argument that 'if I don't pay, let me die' doesn't work here. Everyone who can pay - should pay. And with this simple idea, that means that everybody could get the health care they need. Those that can't pay are also protected. Republicans should start asking themselves, "How would Jesus vote?" since they hold the license on dictating morals.
People who can, but won't, pay for their own heath insurance just drains the health care system when they get sick.
Where do you get this? Yes, some people who don't get insurance do drain the system. But not everybody. Do you think Bill Gates has health insurance? Why would he? He can just pay for his health care directly. Don't assume that everyone that doesn't want insurance is going to take your money to pay for their care.
"How would Jesus vote?" since they hold the license on dictating morals.
I don't think Jesus would be in congress. The Bible makes no mention of Jesus being involved in public policy, nor of his disciples being involved. I'm a Christian, and I think the New Testament makes it perfectly clear I have no business in politics or voting. There I said it. Let the flames (from both the right and left) begin.
@ PP and Bernardo,
Have it your way. Let the GOP install an RFID to identify you as a non-payer, so when they wheel your freedom-loving, helmet-less, non-covered sack of bones into ER after your motorcycle does an endo in traffic.....the clerk reads your RFID, sees your non-coverage, and wheels your bloody pulp to the alley.
Wouldn't it be better to be part of a large "group"?....like 333 million other Americans.
Maybe you understand - or at least believe that you do understand...
.... but you are hardly the only one out there waving that "freedom to die" flag, and I have no doubt that if most of those "freedom loving" people were suddenly facing death without medical intervention, either them or their families would be screaming "save me, save them, whatever it costs!".
And then the rest of us would get the bill.
Your freedom interferes with my freedom to not pay for your problems.
Your freedom interferes with my freedom to not pay for your problems.
I'll see to it that you that you will never pay for my health care. Your freedom to not pay my bills is as important to me as my freedom to not buy insurance if I choose not to do so.
The way the current law is written, you can go for months/years without having insurance coverage and once you get sick, you can buy it and you will be completely covered for everything. There may be a small tax you have to pay (yes, it is a tax according to Sen. Max Baucus, D - MT as I heard him say recently) but that will be small in comparison to the premiums you would pay over the years.
Instead of trying to address an uninsured population, the government (as usual) went far beyond what was needed in order to create a solution where there was not a major problem. Why didn't the government attempt to get those who already qualify for Medicaid to enroll. Why not work with states to increase Medicaid eligibility and address those who cannot afford the premiums instead of forcing what was actually working for the vast majority into requirements that only add cost without increasing overall benefits.
Because we are a civilized nation that doesn't allow people to die and rot in the street, you can't make that promise.
Because we are a civilized nation that doesn't allow people to die and rot in the street, you can't make that promise.
We are also a nation that allows people to refuse medical care for any reason, so I can make the promise.
"Because we are a civilized nation that doesn't allow people to die and rot in the street, you can't make that promise."
Where do you people get the notion that you are in a position to allow or disallow my life. I choose to live and die a natural life and it is my inalienable right to do so. Don't presume to allow me anything because I do not owe my life to you. Unlike you, I am not afraid to die. It is, after all, just a natural part of the life cycle. You realize that there was very little in the way of modern medicine until after the Civil War, don't you? How is it that it has come to be everyone's right? Who benefits from this, other than the medical industrial complex (includes providers and insurance companies)? I intend to live free and die free. I owe you nothing. Peace.
PPinLA
What happens when it isn't up to you? Who pays then? It happens all the time. If your're in an accident and unconscious or can't leave under your own power an ambulance will be called for you even if you refuse it. Its a matter of liability.
MoK - We already have organ donor cards and DNR orders, so what is so difficult about it?
The reason I am afraid of the individual mandate is not because I can afford insurance and don't want to pay; it is because I will not be able to afford it and couldn't use it if I did pay for it. I will be retiring to Thailand in a few years on a very limited fixed income (i.e., $1,600.00/Mo.). The care providers there will not accept any insurance I might carry and I cannot afford to fly to the States every time I might want to visit a doctor. The thing is, I can afford to pay cash for most things and, if I contract something that is potentially terminal, I have the option to just die naturally at home. If I stay here, I will just have to keep working until I die because I will never be able to retire here. If I did, I would have to rely on some social programs because I still wouldn't be able to afford to buy insurance.
The majority of my life has been lived below the poverty line. I went bare on medical and dental insurance for all those years. It wasn't until I was in my mid-30s that I broke 30K per year in income. I earned an undergraduate degree at age 44 and a graduate degree at age 46. I have always paid my own way and don't expect anything from anyone. If you ask me, we need a few million more people in this country with the same attitude.
PPinLA
You are aware the under ACA you can purchase insurance on a state run exchange for group rates and they cannot deny you coverage and they cannot price your coverage based on your health.
Anyone earning under 138% of the federal poverty standard is exempt from the minimum coverage requirement and is automatically eligible for Medicaid. I think that is about $12,000 per year if your single.
Between 138% and 400% of the federal poverty standard you are eligible for tax credits on a sliding scale to help you purchase health insurance.
I'm pretty sure no matter what insurance you buy it will not cover you if your residence is in Thailand.
"Anyone earning under 138% of the federal poverty standard is exempt from the minimum coverage requirement and is automatically eligible for Medicaid. I think that is about $12,000 per year if your single"
I refuse to allow myself to be a burden to others; hence, I don't want Medicaid.
"I'm pretty sure no matter what insurance you buy it will not cover you if your residence is in Thailand'
Which is why I resent anyone trying to make me buy something I don't want or need.
All of the arguments for this unconstitutional law claim that it is important because it will force people to take responsibility for their own healthcare. The truth is that those who can't afford to pay still get by on the backs of others.
The reason I can afford to pay cash in Thailand is because most people do, not having insurance. The cost reflects what the market will bear. When the government and insurance companies get involved, prices skyrocket. That's why the army pays $250.00 for a hammer and why the hospital bills your insurance company $10.00 for a Tylenol.
These systems are corrupt to their core and are only supported by the takers. Those who are willing to stand on their own two feet would never support such a Ponzi scheme.
All insurance relies on the fact that those with low medical costs subsidize those with high medical cost. But unless you deny treatment completely someone shares the cost. Medicaid is taxpayer funded. If you pay taxes how is that being a burden on others? If you don't want insurance just don't buy it. If your below income level it doesn't matter and you don't have to take Medicaid if you don't want to.
The army pays $250 for a hammer because that hammer has to have the chemical composition documented. It has to be heat treated to specification. It has to undergo nondestructive examination and have that documented. It has to have third party inspection. All of these things add to the cost, but if it is used on a helicopter maybe the quality control is necessary.
I'll bet you the healthcare available in Thailand is subsidized by the government just as health care is here. Or it is substandard by our way of measuring things.
"If you pay taxes how is that being a burden on others?" You're kidding, right?
"Or it is substandard by our way of measuring things."
Thailand is the #2 destination for medical tourism, second only to India. The quality of care one receives for the money far exceeds what you could get here. You really should get out more.
You're right. We should all go to Thailand and forget about fixing this system.
What we should do is learn from best practices instead of worst practices. The government rarely, if ever, "fixes" anything. That is why the Constitution limits the scope and authority of the federal government.
Back to your "you pay taxes" argument. You stated that I would be eligible for $12,000.00 per year in Medicaid. Let's say that I live and collect this 'benefit' for 20 years. I have received $240,000.00 over the 20 years and I paid an average of $3,000.00 per year in federal taxes over 35 years ($105,000.00). Where does the rest of the money come from? Oh, that's right; it comes from other people. It's just another big pyramid scheme.
If people could only afford to pay $20.00 per office visit, then doctors could only charge $20.00 per office visit. If people could only afford $3,000.00 for a appendectomy, then hospitals could only charge $3,000.00. Once the government and insurance companies partner up, the whole 'system' gets messed up. Getting government out of it and making insurance companies compete in a free market is how to fix this system.
"Oh, that's right; it comes from other people. It's just another big pyramid scheme."
That's only assuming that no one in this country has an investment in anyone else's health and wellbeing. As long as we live interdependently (and each individual continues to be entitled to a vote), it seems to me we should be concerned about doing what we can to help everyone be healthy (and educated, but that's another topic) enough to be productive. Access to health care via insurance coverage is one step.
I don't care to invest in you or anyone else. I invest in myself and my family. I also willfully contribute to charity from time-to-time; however, that is not an 'investment.' I do not, however, want to be forced to invest in some stranger's healthcare or education. I'm also glad you raised the "...each individual continues to be entitled to a vote..." issue because that is what we call they tyranny of the majority. As the pool of producers shrinks and the pool of takers increases, the takers continue to vote themselves more of the products of the labor of the producers. This type of system is morally, and soon literally, bankrupt.
Of course the teapublicans don't want an insurance mandate. They are perfectly happy driving up everyone elses health care costs and premiums when they show up to the ER without insurance
I agree with the fact that many without insurance do drive of costs for the rest of us, but don't paint everyone with the same brush. There are lots of people that show up at ERs with no insurance and do not take a dime from anyone else. Just because somebody does not have insurance doesn't mean they do not have the ability to pay.
My family hasn't had health insurance for years. We are part of a large group of people that have committed to sharing each other's health expenses. A person from our group that shows up at the ER and runs up a hospital bill (even in excess of 1 million dollars) pays every penny of their bill with the help from the rest of us. We've been doing this for years. It works a whole lot better than any insurance plan and is cheaper because we don't have to pay for marketing, insurance agents, and lobbyists.
Furthermore, there are also millionaires that do not have health insurance because they have the means to pay directly.
I don't have a problem with mandating that a person is responsible to take care of their own medical bills, but I don't like being forced to pay hundreds more than I'm paying now for health insurance I do not want or need.
FYI, I'm not a Republican of any flavor.
There are not too many millionaires so stupid as to not have health insurance.
In about 95% of such cases, they don't have the ability to pay. Bernardo, I'm in the funeral business and well more than half of Americans do not even have the money to bury their dead, much less face the continual and demanding costs of keeping them alive through health care and medication providers. In many cases, families have to pool resources or collectively borrow to cover funeral costs which are a fixed price. Medical costs are infinite and borrowing against collateral (if there is any) is not a good risk for the lender. The argument that I will pay for my own care is both hollow and insincere. Even those who can, those will unlimited resources, normally carry insurance against such risk.
It is well known that more than $40 billion a year of unreimbursed medical costs get shifted to the people who do pay for their care. That's $1000 added to every health insurance annual premium.
The funeral business is a big ripoff.
In about 95% of such cases, they don't have the ability to pay.
I do not dispute that - you are in the position to know. But that means there's still a heck of a lot of us in the 5% that do not want to purchase a product we don't need.
It's the Democrats that don't want to expect people to have the ability to get their own insurance. Republicans just don't want to pay for those unwilling to prepare for themselves.
Bernardo My mothers funeral was handled for $4000 dollars because we knew what we wanted when we went in. We didn't get an expensive coffin because we were having her cremated. We didn't have a three day visitation because the friends lived 1400 miles away and the family lived a eight hour drive and weren't healthy enough to travel. So we made a memorial DVD which we played at the church and sent to everyone.Your funeral director only does what you tell him to.
IPAB will be composed of 15 experts, yet to be appointed by Obama, who’ll be given the task of keeping per-capita growth in Medicare spending from exceeding a target: national income growth rate, plus 1 percent.
Medical costs far exceed that rate of increase, so to keep the above mandate the IPAB will have to limit covered services or pay to providers (causing more providers to refuse taking Medicare patients).
That said, I think the IPAB is a good thing because it will essentially shrink this entitlement and cause more people to buy their own coverage or pay for their own care, which for several reasons (beyond the scope of this comment) I think will improve senior health care in the long run.
Keep in mind that the IPAB only has control over taxpayer-funded health benefits. It does not limit or effect the care that a person wishes to purchase on their own.
This is one of those political paradoxes where the Republicans are taking a liberal stand by not wanting to limit the growth of an entitlement program, and Obama and many democrats are taking a more conservative stance of cutting Medicare growth.
There is no irony or paradox at play. Lobbyists for big med and Pharma don't want to lose their investment in politicians to independents over whom they have little or no control.
Pretty darn obvious to someone who actually pays a premium.
Maybe I don't trust your panel of experts to make decisions concerning the healthcare this government promised me when I paid into it for 40 years. And for which I will pay 99.90 a month starting this fall. And those with bigger checks already pay higher premiums for this coverage that everyone thinks is a gift from you to us NOT.