2009-06-17, 01:01 | Link #101 | |
Senior Member
Join Date: Oct 2007
Location: Detroit, MI
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As far as the health care costs, they're not going to magically go down just by changing who handles the insurance. At best that would reduce some of the administrative overhead which isn't really all that much in terms of overall spending. It might be enough to pay for the bureaucracy that's going to be needed to manage a system like that but I have my doubts there as well. Something big that they could do that would improve things regardless of whether we end up private, public, or hybrid (which is what we really currently are) is Tort reform. Medical malpractice claims are way out of control and a huge factor in health care cost increases. |
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2009-06-17, 01:13 | Link #102 |
Obey the Darkly Cute ...
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Join Date: Dec 2005
Location: On the whole, I'd rather be in Kyoto ...
Age: 66
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Aye, tort reform (or at least standardization of damages and grievance protocol) is a must-have. The we could shake a stick at the prices of malpractice and liability insurance that takes a good chunk of doctor income (those two being another accelerator of costs).
To give a specific example on exploding costs directly due to the current insurance system, the mail-order specialty drugs pharmacy my wife works employs about 130 people -- over 70 of those are non-medical staff whose sole purpose is to deal with the several hundred insurance companies who all have different: forms, formularies, rates of automatic rejection on first submittal (yeah, her facility tracks that), coverage or not for a treatment, protocols for claim handling, etc. Oh and the formularies (what drugs they'll cover) and "treatments recommended by accountants" (who stand between you and your doctor since the bottom line is their profit) can change every single month or faster. There's a fair amount of labor spent helping patients who get dumped by their carrier and have to choose between bankrupting their family or dying -- so the facility tries to help by connecting them to foundations (or their congressman). Sometimes the drug companies themselves have special reserves set up for patients who have been dumped with no other recourse... sometimes. With a single payer system - those costs would be dramatically reduced. If "single payer" is too hard to stomache, then at least standardization of forms, processes, controls, and regulation. Let the carriers compete on who delivers those standardized services most effectively.
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Last edited by Vexx; 2009-06-17 at 01:32. |
2009-06-17, 16:04 | Link #103 | |
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Join Date: Dec 2005
Location: On the whole, I'd rather be in Kyoto ...
Age: 66
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Addressing the "front end problem" of healthcare -- 4 critical steps to reducing societal costs no matter what system we adopt.
Ken Dychtwald Ph.D. Psychologist, Gerontologist and Author The Biggest Problem With U.S. Health Care -- And How To Fix It! Quote:
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2009-07-24, 23:17 | Link #104 |
Bittersweet Distractor
Join Date: Nov 2007
Age: 32
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So I thought I would bump this thread for discussion now that health reform is about to come crashing down into the U.S.
What I would like to ask is... What information is right, what information is wrong? It seems that many different sources are throwing many different ideas and numbers out there. Could this be the end of the Democratic congress? And is there a well explained summary of Obama's plan out there? I seem to be out of the loop here . The comments out there that have been pissing me off the most out there are things like "It's going to Canadian-style health care!" (This largely being just a scare tactic where people don't have any factual basis or real experience to draw from when talking about Canada's health care) or "the government is going to control what how they treat you!" (This is when the health insurance companies pretty much already do this for you, and they probably care less about you.)
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2009-07-24, 23:26 | Link #105 |
Observer/Bookman wannabe
Join Date: Oct 2006
Location: Singapore
Age: 38
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Politics-wise, the Republicans aren't all that wrong in seeing health-care as Obama's D-Day. The thing is: will they fare better than the Germans?
If we go by the mantra "If it ain't broke, don't fix it.", then it is time to fix something, for the system is broken.
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2009-07-24, 23:49 | Link #106 |
Obey the Darkly Cute ...
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Join Date: Dec 2005
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Its pretty clear to anyone paying attention that the health insurance industry is pouring pressure to retain, if not the status quo, something so watered-down in terms of a result that it will be almost worthless in terms of reducing overall costs (reducing costs directly equals reducing profits to the insurance lobby). Its becoming less and less likely that many of the things like:
1) health insurance not dependent on an employer 2) freeing small business of needing to worry about benefits 3) developing large pools of insured who can bargain down price 4) being one medical problem away from bankruptcy 5) being uninsurable because of pre-existing condition (like diabetes, high blood pressure, etc) .... oh whatever, I could list a dozen things that don't seem to be happening. Basically, whether Dem or Repub - a large cadre of both parties swear fealty to the insurance lobby against the interests of their citizens. Corporate rule and the ultra-wealthy end up keeping most of the tax avoidance they got in over the last 30 years in the largest shift of money into the smallest number of hands the US has ever seen.
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2009-07-25, 08:01 | Link #107 | |||
Moving in circles
Join Date: Apr 2006
Location: Singapore
Age: 49
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I am, however, very curious how the American health-care system ended up in this situation. Is it really a case of capitalism run amok? And how is it that companies ended up shouldering the responsibility for their employees health insurance? Is anyone aware of any paper out there that explains the history behind this mess? In the meantime, I could probably do some research to explain Singapore's approach to health care. The gist of it is easy enough to describe, but the devil is in the details and it's not quite as straightforward to elaborate. For a start, all Singapore citizens and permanent residents (PR) are covered under a public health insurance scheme. This insurance is funded by the Medisave portion of each individual's Central Provident Fund account, which is, in effect, a government pension scheme funded by monthly contributions by each citizen/PR and his employer. The exact rate of contribution varies according to age and income level, but it works like how a progressive tax rate would (in fact, it works a bit too much like income tax, something which many Singaporeans complain bitterly about). However, it is a universally accepted fact that Medisave alone will not cover all hospitalisation and medical bills. Singaporeans, in general, are aware of the need to buy personal health insurance plans to cover such eventualities and we have become generally more savvy about the various kinds of insurance we need for adequate coverage. (Many companies do provide insurance for their employees, but the payout from these schemes usually amount to no more than a token sum. Most people here don't rely on company insurance as a result.) Life insurance is the worst possible kind of coverage you can get with respect to health insurance -- the payout comes after you die. It's comforting to know that you'd be leaving something behind for your loved ones after you bite the dust. It's not so comforting, however, if you end up with a debilitating disease that destroys your ability to work but doesn't, at the same time, kill you. That's why an individual also needs to buy hospitalisation, critical-illness and accident plans on top of plain old life insurance. And, yes, the premium costs do add up, although it helps that we can claim tax subsidies against the premiums paid. And, yes, the ugly truth also remains that there is a significant minority of Singaporeans who can't afford private insurance and are also too poor to have had much cash stashed away in their Medisave accounts. Hence the grim observation by many Singaporeans that we can afford to die, but we can't afford to fall sick. Make no mistake, the Singapore Government is well aware that this is a political hot potato. It therefore does its best to keep the issue out of mainstream media. Nonetheless, both health-care and insurance costs are very low here compared to the United States. The Government claims that it's the result of careful management. I haven't studied the issue closely enough to say otherwise. Meanwhile, a random search of the Internet threw up a couple of glowing observations by foreigners about Singapore's health-care system: Oxford's Journal of Public Health and another from the Library of Economics & Liberty. For a more contrarian view, there is this article ("Medisave, Medishield...Medi-crisis?", Jan 2008) re-printed by the Ministry of Health on its website. The Government's reply is printed at the bottom. EDIT Found another article which, in my opinion, does a fairly good job at explaining the pros and cons of the Singapore health-care system: Health Care in Singapore. It's not a bed of roses and, moreover, what works in Singapore is unlikely to work in the whole of the United States, since there are obvious differences in geographical size, demographics, genetics and socio-cultural backgrounds. But our model does certainly provide a good example of how government intervention can go a long way towards ensuring health care for as many citizens as possible. Last edited by TinyRedLeaf; 2009-07-25 at 08:36. Reason: Additional reference |
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2009-07-25, 23:47 | Link #108 |
Senior Member
Join Date: Jun 2008
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What's your measure of success?
If your measure of success has any notion of diversity of choice, self determinism, and right to privacy, then NO existing single payer system is successful. If your measure of success is restraining costs in a sustainable manner, then no model offered by current planners is successful (not medicaid, not the Massachusetts plan, not the Hawaiian plan that only lasted 7 months). If your measure of success is hi tech/quality health care quickly available to all, then no current model is successful, not Canada, not any in Europe. These all depend heavily on government rationing. They also heavily depend on the US health care system providing a majority of the research and pharm breakthroughs, as they do not happen in tightly rationed environs. Here's what we need to be able to do: Write into any legislation specific metrics that define the desired outcomes of the legislation and what constitutes success or failure. These metrics should have time frames associated with them. If those outcomes are not realized within the time frames, the legislation becomes invalid. Would you go for something like that? |
2009-07-26, 01:01 | Link #109 |
Observer/Bookman wannabe
Join Date: Oct 2006
Location: Singapore
Age: 38
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Today, the trend in Congress and the Senate is the inability to kill programs that are inefficient. Why do you think the Senate's vote to stop building the F-22s was hailed? It's an exception, rather than the norm. I don't think a bill containing such metrics would be passed.
While you do need rocket science for certain illnesses, the vast majority of illnesses can be prevented if people bothered to take care of themselves. You don't need expensive drugs, at least not all the time.
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2009-07-26, 02:39 | Link #110 | |
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Join Date: Mar 2006
Location: Boston
Age: 35
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During the presidential election John Edwards often said he wanted to give all Americans the same health insurance members of Congress receive. That idea would obviously be extremely expensive.
An op-ed in the New York Times suggests that idea is possible if the care Congress receives is made more affordable, so the plan could be extended to the poorest of Americans. The article suggests having different types of insurance for primary care and emergency care, which would combine the Democratic goal of extending coverage to all with Republican goals of creating cost saving incentives with competition. http://www.nytimes.com/2009/07/22/op...36f&ei=5087%0A Quote:
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2009-07-26, 03:55 | Link #111 | |
(ノಠ益ಠ)ノ彡┻━┻
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Join Date: Mar 2006
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Essentially, if one considers the cost of insurance to be too high, the cost of not having it is higher. You can't afford to *not* have insurance, because you will pay heavily (most likely bankrupting) and/or you will go to jail when something goes wrong. Insurance companies use this power to tell you what is and is not acceptable according to them. There are many problems of abuse, and companies are not bound by contract to keep you in your policy. Private insurance is expensive and most employees take their companies policies because it is better than nothing. The government solution appears to be "more insurance", and they want in on the action. The real solution should be "insurance is a way to hedge your bets, but you should only require it when the chips are down". For normal situations (you have a cold, you dinged someones car door, you got your teeth cleaned, etc.) you shouldn't *require* insurance just to cut the costs. So in other words, insurance became the consumers way to subsidize the rising costs of living, and in turn propelled insurance from a "good idea" to a mandated institution that only encourages rising costs in a spiraling cycle. This is the same issue with college. Most students cannot afford tuition costs, so they are forced into taking loans and finding grants to cover as much as possible, automatically going into debt for years on the hope that their education will pay off and increase their personal living standards. Hopefully their chosen field of study will have jobs ready or they will run into problems. Instead of easing the burden on citizens by trying to reduce the costs of living, companies and government have only increased their power over society under the disguise of protection. It's not all that different from the old days of mob protection, where you were forced to pay them a fee in exchange for them not destroying your life. Hooray for feudal policies! There's more profit in treatment than there is in prevention or curing.
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2009-07-28, 13:31 | Link #112 | |
Senior Member
Join Date: Jun 2008
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I guess the Congressional Budget Office is in the pocket of the health insurance industry? Because even they say the Obama's plan will not bring costs down but rather cause them to skyrocket. |
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2009-07-28, 22:13 | Link #113 |
Obey the Darkly Cute ...
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Join Date: Dec 2005
Location: On the whole, I'd rather be in Kyoto ...
Age: 66
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Obama .... doesn't really have a plan - he hasn't proposed anything more than a mission statement or outline. What we have are a cavalcade of competing plans circulating around Congress that make it difficult to even isolate just what the hell who is talking about what when they don't even use the same terms to describe the same thing.
The plan the CBO analyzed, frankly, isn't the plan most progressives were thinking of when they voted the Democrats in -- because it basically guts most everything that would actually reduce costs. The Democrats are pwnzored by the status quo goblins -- aka the big money machines currently pouring millions of dollars per day to derail any substantial changes to the status quo.
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2009-07-28, 22:19 | Link #114 | |
耳をすませば
Join Date: Mar 2006
Location: Toronto, Canada
Age: 34
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I live in Canada. I've had multiple surgeries growing up. I want to know what is so bad about this Canadian health care system that the Americans like to get worked up over. There's never been a single moment where I've ever thought "this darn Canadian health care!".
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Last edited by Theowne; 2009-07-28 at 22:46. |
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2009-07-28, 22:35 | Link #115 |
Observer/Bookman wannabe
Join Date: Oct 2006
Location: Singapore
Age: 38
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Well, the US doesn't really have a model to emulate. The sheer size of the US population (300 million and counting. Largest population with democracy>150 years and second largest democracy on this planet) means that the US can only take other countries' models as references, at best. They need to come up with a plan which is theirs, and with lobbies in the way, some have simply given up and went with the status quo.
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2009-07-30, 23:58 | Link #116 |
Prospective Cog
Join Date: Jan 2008
Location: Los Angeles, CA
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I wonder if health care is ultimately the issue that fosters greater understanding by the American public at large (or, to be more realistic, the subset that gives a damn about politics) that Barrack Obama is frightfully devoid of the ability to craft legislation. He is a spokesman. Nothing more. And if you think that reality slightly uncomfortably, consider that he is actually the spokesman for legislative initiatives brought to fruition by Nancy Pelosi, Harry Reid, and their respective minions. In short, Barrack Obama is Billy Mays in a suit, except he is not selling us OxiClean, rather, billion dollar programs that defy explanation. And this is coming from a registered Democrat; imagine what someone in Topeka, Kansas thinks?
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2009-08-01, 17:47 | Link #117 |
Senior Member
Join Date: Jun 2008
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John Stossel on 20/20 last night on government controlled health care.
This is what the Obama's minions, aided by the Brawndo swillers want to shove up your ass. Of course, this is from that wildly right-wing network, ABC. An informative 6 minutes for those of you that haven't allowed the Brawndo to shorten your attention span to less than that. http://abcnews.go.com/video/playerIndex?id=8227482 |
2009-08-01, 18:14 | Link #118 |
Obey the Darkly Cute ...
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Join Date: Dec 2005
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Why change anything? .... "everything is just fine the way it is"
http://www.newsweek.com/id/209817 Newsweek is also considered a right-leaning news source by most. Spoiler for text of Newsweek editorial report:
20/20 is not "Frontline" :P - it has never been much more than tabloid journalism. Another "48 Hours" clone. ABC is a corporate media outlet owned in part by Disney and other large corporations. That said, they are revealing some of the garbage sailing under the radar with the Dems that do not really address the problems. Now.... what the Democrats are actually *doing* is turning the reform into a ball of crap as all the special interests of pharma and insurance patiently gut, delay, subvert whatever the original intent was. This is probably the clearest demonstration that the discussion in the US is between ultra-exteme-right 'fascism' (corporate-directed government) and at best, a corporate influenced 'pragmatic' center. Any thing remotely "left wing" or "progressive" has been effectively put out of the picture. Small and medium businesses trying to compete against the global market are being eaten alive by benefit costs - that is being totally ignored in this discussion. The siphoning of money by the for-profit insurance industry, their interference with patient treatment, their revealed tactics of claim denial, dropping coverage on trivialities, the impossibility of *getting* coverage once you have a condition and lose it, the lack of portability in insurance --- that's all okay according to the status quo supporters.
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Last edited by Vexx; 2009-08-01 at 18:35. |
2009-08-11, 22:38 | Link #119 | |
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Join Date: Mar 2006
Location: Boston
Age: 35
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Explanation of how eliminating insurers' ability to discriminate against the sick could do more harm than good.
http://online.wsj.com/article/SB1000...googlenews_wsj Quote:
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2009-08-11, 22:49 | Link #120 |
Obey the Darkly Cute ...
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Join Date: Dec 2005
Location: On the whole, I'd rather be in Kyoto ...
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Whee for Murdoch... does the upside-down logic sound that appealing? This is a non-starter complaint that every other country the US considers a competitor seems to have gotten around or not had as an issue to begin with.
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