The Future of US Healthcare

[wontaek]

Originally Posted by iLney

Lolz, they're too fat to go anywhere.

Since US airlines are proposing additional payment due to passenger's weight, this might become true.

[autobachs]

Originally Posted by Ledgem

I can't really figure this one out. You're claiming that Obama is spouting nonsense, that he can't know whether illegals will be covered or not, yet you're aware that illegal immigrants are currently raising the cost of your and my hospital visits daily by cramming into the emergency rooms, where they can't be denied treatment. It sounds to me like Obama wants to make sure that illegal immigrants are not legitimized under this new healthcare plan - that's all. They'll probably still be able to get treatment the way that they do now. What are you so riled up about?

So, why are you proving my point that obama lied? BTW, I am hardly riled. What I pointed out was that unless there is positive proof that the individual receiving care was a citizen, how do you know they deserve it? Do you remove the basic oath that all health care professionals make or do you accept the fact that as long as there are illegals in the country, we cover them. Seriously, obama saying they aren't covered is a bold faced lie. Unless he starts denials of coverage for illegals, he LIED about them being covered.

Do you understand that? He LIED. That is the premise of the argument.

[Vexx]

Originally Posted by solomon

Mentar, you make good points but with another government program, wouldn't that mererly add to the deficit problem? THis is the only thing bothering me about the proposal and one of the few legitmiate beefs the opposition has in my opinion.

There are *real* problems with the current bills being proposed.... but oddly those are rarely addressed by an opposition who seems to prefer making utter fools of themselves to the world by misstatement and myth propagation.

Now let me see.... unelected insurance industry bureaucrat whose bonus depends on minimization of successful claims and answers to only their profit-driven executives? .... or government employee who has to deal with elected politicians hot on their ass for mistreating a likely voter?

Do we free businesses from having to worry about healthcare so they can compete in the global market? Or do we continue to throttle every business sector except one (insurance) which is bleeding them and their employees dry?

Do we like preventative care that is much cheaper to provide or reactionary disaster care? Any engineer could tell you which one is cheaper, much less the medical professionals. (well, unless you're an insurance exec who uses reactionary disaster care coupled with denial and droppage - meaning you avoid both front end and back end costs to maximize profit)

Hmmmm.

[wontaek]

Originally Posted by autobachs

So, why are you proving my point that obama lied? BTW, I am hardly riled. What I pointed out was that unless there is positive proof that the individual receiving care was a citizen, how do you know they deserve it? Do you remove the basic oath that all health care professionals make or do you accept the fact that as long as there are illegals in the country, we cover them. Seriously, obama saying they aren't covered is a bold faced lie. Unless he starts denials of coverage for illegals, he LIED about them being covered.

Do you understand that? He LIED. That is the premise of the argument.

If he lied, what do you propose we should do?

Also, what is your opinion on all the USA citizens going overseas to receive medical care and buy their medicines? Over there, USA citizens are not receiving any different treatments compared to citizens of those countries.

Does anyone know whether USA is exporting more medicine or importing? I have heard that much of the pills sold in USA stores were made outside USA. If so, how did USA come to importing medicines? Who are being paid to make the medicines by the pharmaceuticals?

[wontaek]

Originally Posted by Vexx

There are *real* problems with the current bills being proposed.... but oddly those are rarely addressed by the opposition who seems to prefer making utter fools of themselves to the world by misstatement and myth propagation.

Now let me see.... unelected insurance industry bureaucrat whose bonus depends on minimization of successful claims and answers to only their profit-driven executives? .... or government employee who has to deal with elected politicians hot on their ass for mistreating a likely voter?

Do we free businesses from having to worry about healthcare so they can compete in the global market? Or do we continue to throttle every business sector except one (insurance) which is bleeding them and their employees dry?

Hmmmm.

Good questions. I like to add this question: Is healthcare reform good for overall economy or bad? Why is it that healthcare bills are the biggest reason why people and even large corporations gets bankrupt, not the taxes? In fact why doesn't the companies like GM, Ford, Chrysler, and other corporations struggling with healthcare premiums lobbying the government, or is it because of their lobbying that we are having this debate? By the way Japan has universal health care and it is because of this, that the animators can continue to work on animes despite their low salary.

[Vexx]

Originally Posted by wontaek

If he lied, what do you propose we should do?

autobachs is conflating the words "covered" and "to treat" so that it appears Obama lied... Obama said they wouldn't be *covered* by the insurance (public option or private), not that they wouldn't be *treated*. This is not lying.. though I think its pretty wussy of the Democrats in general NOT to directly address the problem because they're afraid of xenophobes. It seems to be "hard" for some people to grasp they're paying for care of the UNinsured (legal or illegal, citizen or not) right now in the most expensive way possible - disaster mode in the ER which drives up everyone's bill for everything.

Also, what is your opinion on all the USA citizens going overseas to receive medical care and buy their medicines? Over there, USA citizens are not receiving any different treatments compared to citizens of those countries.

Most civilized tech countries have protocols and ways of handling non-citizens (whatever their status).... care of the patient comes first.

Does anyone know whether USA is exporting more medicine or importing? I have heard that much of the pills sold in USA stores were made outside USA. If so, how did USA come to importing medicines? Who are being paid to make the medicines by the pharmaceuticals?

Most drugs are now manufactured OUTSIDE the US (yay... we make even less of anything than we used to :P). In fact, much of the pharmaceutical industry is located outside of the US --- and often drugs are manufactured at single-point failure locations (facility goes down... that drug is unavailable all over the world, yay "globalization/centralization").

The US pays more because the market is less regulated, the government is not allowed to negotiate prices for Medicare Part D, and they allow marketing/advertisement of prescription drugs which drives costs up. My wife is a pharmacist and has first-hand knowledge of the pharma business and the health "insurance" industry - she works in specialty pharmaceuticals and gets to see a lot of middle-class bankruptcy, claim denial, claim delay (patients die if insurance dallies long enough), out-of-network usurious charges, patients deciding to die to keep from destroying their family's assets, etc. I'll keep saying you do NOT want to stand in a room with a bunch of doctors and pharmacists while touting the status quo.

[Ledgem]

Originally Posted by autobachs

So, why are you proving my point that obama lied? BTW, I am hardly riled. What I pointed out was that unless there is positive proof that the individual receiving care was a citizen, how do you know they deserve it? Do you remove the basic oath that all health care professionals make or do you accept the fact that as long as there are illegals in the country, we cover them. Seriously, obama saying they aren't covered is a bold faced lie. Unless he starts denials of coverage for illegals, he LIED about them being covered.

Do you understand that? He LIED. That is the premise of the argument.

I think you're pretty riled, given that you're using "lied" in all caps and sound generally pissed off

Vexx already said my thoughts on what you wrote, but I'll expand on it anyway, just in case you missed his reference to you in his post. You're mixing the definitions of being legally covered by proposed plan for universal healthcare and being treated.

Will illegals be covered under Obama's proposed plan? No - the plan itself, as it stands, does not include any provisions that would cover the treatment of illegal residents. That is, money that goes into funding treatment through this plan would not be used toward illegal residents.

Would illegals be treated under Obama's proposed plan? Not applicable - as far as I can say, the plan does not address whether illegals should or should not receive treatment. That means that how hospitals treat illegal residents would likely be the same as it is now - that is, they get treatment through the emergency rooms, and it still comes at our expense (by raising the cost of hospital fees in general).

This isn't an "emergency room defense plan" nor is it a "how to deal with illegal immigrant health" plan. This is a plan for creating a public health insurance option for United States citizens (not sure about legal immigrants who are not yet naturalized). You'd do well to remember that in the midst of your concern over illegal immigrants.

Within the scope of this thread, you're not off-topic by bringing up the issue of illegal immigrants in the emergency rooms, because that is certainly a big issue facing our healthcare system. However, you're misguided by bringing it up as an argument against Obama's proposed plan. The plan doesn't touch on the issue of illegals in the ER's other than to say that it won't condone it. I don't see why anyone should have any reason to believe otherwise.

That aside, I'm calling you out as simply disliking Obama and/or the concept of the public health insurance option while providing little constructive reasoning. You're making an awfully big fuss over this "he lied" bit, even though it isn't clear whether he did or did not (I admit bias before saying this, but I'm pretty sure we'll find out that no lie took place). What - do you think that even if he did lie, that the rest of the plan is flawed? So whether this helps millions of Americans to get proper healthcare or not, we'd better scrap the whole thing because nothing good can come from it?

I admit I'm a bit envious that people who are so offended over lies (or potential lies, I should say) were seemingly on vacation when the whole "there are WMD's in Iraq" issue came up. Would've been nice if there'd been massive protests and vehement arguments (regardless of how irrational) back at that time - might've saved a lot of lives and a lot of money if that war could have been prevented.

Hmm, saving a lot of lives and a lot of money... that sounds familiar. That almost sounds like... no, it can't be! It sounds just like the reason to reform the US health care system! Don't tell me that you're in favor of wasting money and killing people?! (OK, this last paragraph is a sarcastic joke. I'm not really accusing you of being in favor of wasting money and disrespecting human life. I'm just curious as to why this is really bothering you.)

[LynnieS]

Originally Posted by solomon

Mentar, you make good points but with another government program, wouldn't that mererly add to the deficit problem? THis is the only thing bothering me about the proposal and one of the few legitmiate beefs the opposition has in my opinion.

To be honest, the amount of money owed by the U.S. is a lot already - although likely not at the same level of GDP as Japan's perhaps - esp. when you take into account the amount of interest that the U.S. will need to pay out. Adding a trillion or two... possibly not a super big deal if it means, at the end, you end up with (1) healthy and productive taxpayers and (2) innovative companies that contribute to the country's productivity gains and tax rolls.

Of course, as the sitting president, it will be Barack Obama who will get whatever blame there is and the future president who will get the kudos. That's politics, and it's likely to be the reason - along with the 2010 elections - why the U.S. will eventually end up with a health care system by the end of the day that has many loopholes and patches.

What can also be problems, IMHO, are:

1. Said people and companies hiding profits overseas and thereby bypassing tax collectors - i.e., reaping the benefits but not paying the costs.

2. Continued escalation of the U.S. deficits by propping up various parts of the economy. The recent tax receipts were already low, and if the U.S. decides to spend more, it means issuing more bonds - and risking default or a collapse of the USD. Depending on who you read, the U.S. is likely to lose its AAA rating by, what, 2010 or 2011 (need to confirm this later...) if things continue? That could be a problem sooner if this happens as well.

[autobachs]

Baucus' plan aims to make health insurance more affordable for self-employed people and those working for small companies, who now have the biggest problems in getting and keeping coverage.

People insured through large employers would not see major changes, but some of their health care benefits would be nicked to help pay for the cost of the plan. The Baucus proposal would limit to $2,000 a year the amount people can contribute to flexible spending accounts, which are used to cover co-payments and deductibles not paid by their employers. That provision would raise $16.5 billion over 10 years.

Total cost of the new health care bill over ten years is expected to be $850 billion plus. Obama said if you liked your old plan, you could keep it the way it was. Not the case here! There won't be major changes, but you will lose some parts, that go to pay for others, and your tax free flex spending accounts are nicked down in total contribution, for more money to pay for others. It also raises the issue of taxation on your health care benefits, which, starting next year would be reported on your W-2.

The illegal immigrant issue is not fully addressed! but Baucus says they will not be covered. How they will not be "essentially" covered is beyond me when all they have to do is go into the emergency room to seek treatment, and by law the health care professionals must treat them. It's not like INS is going to put a bus behind every hospital and deport them once they receive health care. Even if they did, they (illegals) are still receiving health care for free and we are going to pay for it! The rediculous "anchor baby" issue is allowed to continue and they actually include a provision for ILLEGALS to obtain health care for their child born here! They need to bounce these illegals back across the border or start charging the country of origin for all costs associated with their being in this country for the duration they are here! Again, illegals are still getting free health care

Lastly, the plan includes $507 billion in cuts to medicare which is massively under funded that will be used to pay for the new plan. It also includes $350 billion in new "fees and taxes" to help pay for it. This still leaves it underfunded and fails to address the issue that medicare is horribly inefficient. Add to that, again obama lied about not taxing the majority of Americans!

This is a ridiculous bill being rushed through to try and appease those seeking entitlement.

[Proto]

Your source being?

[autobachs]

Originally Posted by Proto

Your source being?

http://news.aol.com/article/sen-max-...re-bill/661296

[Ledgem]

Originally Posted by autobachs

Obama said if you liked your old plan, you could keep it the way it was. Not the case here! There won't be major changes, but... blah blah blah, whining and trying to sound like there's something to be really angry over

Nothing more needs to be said.

Originally Posted by autobachs

The illegal immigrant issue is not fully addressed!

THAT'S BECAUSE IT HAS ABSOLUTELY NOTHING TO DO WITH THESE PROPOSALS. Do you not understand that what's currently being debated is how health care coverage for Americans can be overhauled? This isn't a debate about how to lock down hospitals so that only those with insurance and/or who can afford it can receive treatment.

[solomon]

Even if there is some stipulation about illegal immigrants recieving healthcare shoehorned into the bill, a loophole will appear and the same problem will occur I think.

Immigration is too large and complicated an issue that is distinct from the healthcare debate. It wasn't solved last election cycle and won't be solved this one either, because that's talking about major economic and cultural changes that need to be made. Illegals are going to get access to the emergency room for the time being. Unless someone out there knows something else, I don't see how this will change.

[LynnieS]

Originally Posted by autobachs

Total cost of the new health care bill over ten years is expected to be $850 billion plus. Obama said if you liked your old plan, you could keep it the way it was. Not the case here! There won't be major changes, but you will lose some parts, that go to pay for others, and your tax free flex spending accounts are nicked down in total contribution, for more money to pay for others. It also raises the issue of taxation on your health care benefits, which, starting next year would be reported on your W-2.

This isn't Barack Obama's plan, but Max Baucus's. To lay this at Obama's feet at this time isn't doable. It has not been finalized by Congress, nor has it been signed into law by the President.

As for "nicking", yes, so? A flexible spending account provides a payroll tax benefit to its owner, but it operates on a "use it or lose it" basis. If the employee contributes US$5,000 for that year and does not use the full amount, the excess is given to the company. The employee does not get that money back even though it came out of his salary.

In my case, when I had a FSA back in the U.S., I usually fund it based on a low-ball estimate of my expected health costs - e.g., eyeglasses replacement - since I do not want my company to get the cash. Are there lots of people in my situation? No idea, but would many people want to actively give up their salaries to their companies if they have a choice? To be honest, I expect companies, if FSA's limit is set at US$2000, to lobby for their removal or remove the plan themselves. The costs of running such a problem for small amounts can be high. If so, then the workers would lose a tax benefit, but the Real Cost to them would have to first be calculated by finding out (1) how many people use the plans, (2) how much they are putting in - and actually using and (3) what is the replacement plan?

You also cannot expect the national government to spend this kind of money without having a way to recover some of the costs. It's a valid way to offset the costs by reducing expenditures elsewhere.

I don't really like the idea of having exchanges or co-ops, but that is not due to considerations for either conservative or liberal ideas.

Exchanges for this kind of "comparison shopping" are ripe for abuse by companies and bureaucrats. Even with a large number of buyers, economy of scale will make sure that the exchanges' number shrink in a couple of decades, IMHO - unless you (1) set up regions of effect and (2) enforce the limits by unchangeable law. I also expect the costs to the shoppers to grow over time.

Co-ops, IMHO, are too dependent on everyone getting along through consensus, but they also strongly depend on the structure and bylaws. These can be weak and ineffective, but OTOH, can be good in bad times. However, small co-ops do not get the pricing benefits unless they de-fragment, and large co-ops are harder to run well.

Originally Posted by autobachs

The illegal immigrant issue is not fully addressed! but Baucus says they will not be covered. How they will not be "essentially" covered is beyond me when all they have to do is go into the emergency room to seek treatment, and by law the health care professionals must treat them. It's not like INS is going to put a bus behind every hospital and deport them once they receive health care. Even if they did, they (illegals) are still receiving health care for free and we are going to pay for it! The rediculous "anchor baby" issue is allowed to continue and they actually include a provision for ILLEGALS to obtain health care for their child born here! They need to bounce these illegals back across the border or start charging the country of origin for all costs associated with their being in this country for the duration they are here! Again, illegals are still getting free health care

The U.S. was built on immigration - pre-Revolutionary War even. While you do not want the "bad" immigrants like drug dealers, IMHO, I don't see why limiting the "good" ones who want to better themselves is a problem - even for a person who thinks "offshoring" is a bad word.

Of course, I think the whole idea of "moving jobs to the cheaper location" is stupid and ignorant (not due to the loss of jobs locally, but rather due to the reasons given), but that's not the point here.

Originally Posted by autobachs

Lastly, the plan includes $507 billion in cuts to medicare which is massively under funded that will be used to pay for the new plan. It also includes $350 billion in new "fees and taxes" to help pay for it. This still leaves it underfunded and fails to address the issue that medicare is horribly inefficient. Add to that, again obama lied about not taxing the majority of Americans!

This is a ridiculous bill being rushed through to try and appease those seeking entitlement.

I don't really expect Medicare, by the end of this exercise, to remain the same. Underfunding at this time does not guarantee that it will be that way in the future. It's too early to tell.

As for "Obama lied about not taxing the majority of Americans", did you really expect a politician to always keep his word 100%? It's not always possible in the real world - no matter from what party he is.

[Vexx]

Originally Posted by autobachs

Total cost of the new health care bill over ten years is expected to be $850 billion plus. Obama said if you liked your old plan, you could .... (meh)

This is the Baucus proposal ... it is rather heartily disliked by most Democrats (and more than a few Republicans). I believe the insurance industry likes it somewhat though it only shovels $800 billion+ at them instead of $1 trillion (or the several trillion they'll get if they continue their double digit increases and burgeoning profits picture).
Both sides of the aisle here appear to have been at least partially "0wnzrd" by the insurance industry -- single payer was taken out of the discussion without a debate and public option is being skinned and boiled (or just thrown out). The co-ops are worse than a joke.

I expect to see a few Democrat Senators lose their primaries in 2010.

I'll just repeat the Baucus plan isn't Obama's plan.... seriously Obama still really doesn't have a plan - he was wanting Congress to thrash out a plan. The *public* is burying Congress with requests for a public option and you can see Congresscritters sweat because their $$$ masters (the insurance industry) doesn't want any real competition (which strikes me as hilarious, I thought the government couldn't do anything well). Look at insurance profits and executive bonuses over the last 20 years and it should be intuitive they don't want anything to change.

I won't make any secret - I think the health insurance industry is lethal to American business (small or large) if left as is. Getting business out of the "employer provided" healthcare trap frees them to compete. Healthcare becomes a shared load for all citizens (as managed by an elected government instead of an unelected corporation using profit-by-denial to maximize the looting). None of the GOP and few of the Democrat plans address this.

The Economist (yeah, that hotbed of liberalism...not):

Originally Posted by USNews

The Economist recently derided American critics of Britain's National Health System for creating a bogus bogeyman meant to scare Americans anxious about reform. "Painting an inaccurate picture of the British system . . . helps blind Americans to weaknesses in their own one," the magazine wrote. "The NHS costs half as much per person as the American system costs. Yet it delivers results which are on some plausible measures actually superior. . . . And it does this while avoiding the disgrace that so shames America, of leaving around 46 million people, some 15 percent of its population, without any form of health insurance."
But don't bother asking the Brits about their own system. What do they know?
(source: Four Countries with Better Healthcare Than the US from US News)

[Mentar]

Originally Posted by autobachs

The illegal immigrant issue is not fully addressed! but Baucus says they will not be covered. How they will not be "essentially" covered is beyond me when all they have to do is go into the emergency room to seek treatment, and by law the health care professionals must treat them. It's not like INS is going to put a bus behind every hospital and deport them once they receive health care. Even if they did, they (illegals) are still receiving health care for free and we are going to pay for it!

And this is the level of knowledge displayed by most anti-healthcare screamers. The know nothing about the law, yet show incredulous outrage about what they hate.

That nobody must be turned away from an ER - illegal immigrant or not - is not part of any new bill, it's been standing law for ages. And yet, PPPP sheep are riled up by republican fearmongers, because they trust the propaganda outlets and have no independent knowledge of their own. Another interesting result is that they don't really mind being lied to - as long as it satisfies their prejudices. They rather prefer satisfying lies over the disconcerting truth. And this is why in all comparisons, Foxnews viewers are consistently the worst-informed about political facts. That's how 60% of Foxnews viewers still think that Saddam was behind 9/11 (and a terrifying 40% of Americans overall). Bah.

So an illegal immigrant stumbles into the ER and you want to deny him service and let him die on the doorstep, autobachs? Well, at least that's honest, I guess. Repulsive and inhuman, but honest.

[MeoTwister5]

I'd just like to say that based on medical ethics, denying treatment for a critically ill/injured person in an emergency situation where the person seeks/wants treatment and treatment is available is completely unethical.

Honestly though, if this is the way American doctor's treat their patients, I'm seriously reconsidering finding a residency in the States.

And speaking of residency, I was told that in order for a foreigner like me to get an approved medical residency in the US I'm supposed to be able to understand the basics and the primary concepts of American healthcare. Healthcare that, as everyone else here has already said, is convoluted as it is. Someone please tell me I don't have to put up with your ridiculous medical laws if I'm going to study there.

[Narona]

Originally Posted by Mentar

So an illegal immigrant stumbles into the ER and you want to deny him service and let him die on the doorstep, autobachs? Well, at least that's honest, I guess. Repulsive and inhuman, but honest.

That's what is surprising (if not amusing). The United States of America who are seen by some/many as the world savior, a great democracy, the ones who are fighting the evil people who are/were killing others for wrong reason, are also the ones who sometimes seem to think:

"you don't have a mere piece of paper, so we will just kick your ill kid from the emergency and look at him dying from the window with a big smile. Those damn illegal immigrants"

Some americans really lack of Humanism (and then see France and such countries as Fascist and nazi, that's hilarious), and then some of them dare comparing Obama to Hitler.

[ZephyrLeanne]

Originally Posted by Narona

That's what is surprising (if not amusing). The United States of America who are seen by some/many as the world savior, a great democracy, the ones who are fighting the evil people who are/were killing others for wrong reason, are also the ones who sometimes seem to think:

"you don't have a mere piece of paper, so we will just kick your ill kid from the emergency and look at him dying from the window with a big smile. Those damn illegal immigrants"

Some americans really lack humanism (and then see France and such countries as Fascist and nazi, that's hilarious), and then some of them dare comparing Obama to Hitler.

Just another day of neo-cons, isn't it? They, the immigrant-phobic, call themselves Christian too! I'm ashamed of being a Christian thanks to them.

[justsomeguy]

Actually, many hospitals are named after Christian faiths, so I don't think the anti-health care, anti-immigrant forces are associated with Christians, especially since many Christians are arguing in favor of those things.