Is there any form of Government HealthCare you could get behind?

[involuntary_serf]

Originally Posted by FloorJack

Maybe they should regulate the quality of the food you eat and a minimum number of calories a day. A maximum level would be helpful too.

Careful...don't give them any ideas.

But seriously, if the government ends up paying for your health care, could such things be far behind? I mean your diet and exercise regime has profound impacts on your health and your cost to the government, so they would have a vested interest and say in it. Much like they have a say in how much people working for companies that take bailout money should be paid.

[dmz]

Originally Posted by Dr Millmoss

At the risk of starting a pointless thread digression, this show is not associated with NPR but rather is produced by PRI (Public Radio International). It runs on a variety of outlets, including satellite. Also, NPR (which produces All Things Considered among other new programs) has done a great deal of completely "lucid" reporting on health care issues. In fact, they are nearly the only ones who have, the vast majority of the other "reporting" being mainly a superficial rehash of political talking points.

It was a joint production with NPR.

[NoahJ]

Originally Posted by FloorJack

Maybe they should regulate the quality of the food you eat and a minimum number of calories a day. A maximum level would be helpful too.

Perhaps they could legislate a minimum amount of daily exercise or physical activity. Those who fail to comply would be taxed higher than those who did comply.

(Any bets on how many of these we will jokingly post before we hit one that really does exist?)

[NoahJ]

http://news.yahoo.com/s/ap/20091106/..._care_overhaul

As the debate goes on around the country the House is having problems lining up their votes.

House Democrats acknowledged they don't yet have the votes to pass a sweeping overhaul of the nation's health care system, and signaled they may push back the vote until Sunday or early next week. Majority Leader Steny Hoyer, D-Md., told reporters in a conference call Friday that the make-or-break vote on President Barack Obama's top priority that had been set for Saturday could face delay.
The apparent problem: Democrats have yet to resolve intraparty disputes over abortion funding and illegal immigrants' access to health care.
Hoyer sought to pin the blame for any possible slippage on delaying tactics expected from Republicans, who unanimously oppose the health care remake. But he acknowledged that Democrats are still short of the 218 votes they need to pass the bill.

It is all the Republicans fault, but we can't get dem's to vote for it either...



Perhaps the issue is that the legislation they are trying to pass is not ready yet? NAH!

[Dr Millmoss]

Right, the legislation will be "ready" somewhere around 2026. We can wait.

[NoahJ]

Originally Posted by Dr Millmoss

Right, the legislation will be "ready" somewhere around 2026. We can wait.

Sure, its not like they could break the legislation up and only pass parts at a time either. You know, reform medicare. Or Tort reform. Or any number of other big parts of the package that could make a difference and get people feeling more comfortable with the overall package.

But that would not work and people are going to die in the streets in droves without this today...

[sammi jo]

To those who voted in this poll for the "let the free market do its work" option... there is no such thing as a truly free market. It's the tooth fairy, the pot at the end of the rainbow, yet another utopian fantasy. What is so often referred to as "free trade" and "free markets" are as controlled and un-free as the markets that are compromised by the very government interventions and regulations that they despise so much. Human nature does not allow for a truly "free market" any more than it allows for an "ethical mafia", or the "success of communism on a national scale", for a pair of examples.

[Dr Millmoss]

Originally Posted by NoahJ

Sure, its not like they could break the legislation up and only pass parts at a time either. You know, reform medicare. Or Tort reform. Or any number of other big parts of the package that could make a difference and get people feeling more comfortable with the overall package.

Actually, no they couldn't. One of the cornerstones of reform of the health care system is prohibiting the insurance industry from discriminating against the sick. The other is allowing people in the individual insurance market the ability to buy into some form of group insurance. The industry will be implacable foes of any reform which requires them to do this, without bringing at least most of the currently uninsured into the system. That costs money. These things cannot be pulled apart as if they are unrelated.

If you don't understand this, then it's impossible to understand health care reform, and why it is needed NOW. If you think we're in dire economic straits now, wait until health care takes up 50% of GDP. At the present rate, it's coming much sooner than you think. So no, this can't wait. It's already decades overdue.

People would more "comfortable" with health care reform if they were not so eager to accept the lies told by those who would prefer that nothing change.

[NoahJ]

Originally Posted by Dr Millmoss

Actually, no they couldn't. One of the cornerstones of reform of the health care system is prohibiting the insurance industry from discriminating against the sick. The other is allowing people in the individual insurance market the ability to buy into some form of group insurance. The industry will be implacable foes of any reform which requires them to do this, without bringing at least most of the currently uninsured into the system. That costs money. These things cannot be pulled apart as if they are unrelated.

If you don't understand this, then it's impossible to understand health care reform, and why it is needed NOW. If you think we're in dire economic straits now, wait until health care takes up 50% of GDP. At the present rate, it's coming much sooner than you think. So no, this can't wait. It's already decades overdue.

People would more "comfortable" with health care reform if they were not so eager to accept the lies told by those who would prefer that nothing change.

Interesting thoughts. So if one believes that this could be broken up into smaller pieces they are out of touch or cannot possibly understand healthcare reform. Also, after all the things that actually caused the economic problems now we find that the real problem all along was healthcare? Fear, uncertainty and doubt much?

[SDW2001]

Originally Posted by Wormhole

To call the current system "free" is crazy.
I have insurance but I am not free to choose my doctor or the hospital I want to go to. I have to go to "in network" facilities or I will be charged a 50% deductible.

We can call this the uninsured tax.

It is possible to negotiate prices if you do not have insurance. Most doctors will give a 15% discount for cash. This however pales in comparison to the 70% discount the insurance company gets.

It's not a tax because it's not collected by the government. So no, we can't call it that. And it's not my fault that your health plan sucks. I can go nearly anywhere with my plan.

Originally Posted by sammi jo

To those who voted in this poll for the "let the free market do its work" option... there is no such thing as a truly free market. It's the tooth fairy, the pot at the end of the rainbow, yet another utopian fantasy. What is so often referred to as "free trade" and "free markets" are as controlled and un-free as the markets that are compromised by the very government interventions and regulations that they despise so much. Human nature does not allow for a truly "free market" any more than it allows for an "ethical mafia", or the "success of communism on a national scale", for a pair of examples.

And to those who voted for a single payer system:

1. Where would we get the money? Newsflash...we're bankrupt.
2. On what Constitutional grounds would we pass this?
3. Do the private insurers just go out of business? What about the millions they employ?
4. Do you really think other countries' single payer healthcare systems have worked?

[SpamSandwich]

Originally Posted by NoahJ

I am surprised that more people have not chosen:

One of the above with tort reform and follow through on medicare savings.

It covers all the top options but requires some form of savings as well.

Perhaps because it sounds like an impossible option.

[Dr Millmoss]

Originally Posted by NoahJ

Interesting thoughts. So if one believes that this could be broken up into smaller pieces they are out of touch or cannot possibly understand healthcare reform. Also, after all the things that actually caused the economic problems now we find that the real problem all along was healthcare? Fear, uncertainty and doubt much?

Yes, that's exactly right. It can't be broken up into smaller pieces, for the reasons I've outlined. The health insurance industry will simply never permit the basic underwriting rules to be changed unless they get mandated insurance for all Americans. If you want to see what piecemeal and ineffective reform looks like, examine the Republican plan. It requires nothing of the industry, and consequently, accomplishes nothing.

I did not say that our current economic problems are caused by runaway health care costs (though it certainly is a contributing factor). What I did say is that our current economic woes will pale in comparison to what we will be facing in just a few years if the growth of healthcare costs are not reined in. Unfortunately in this regard, the Democratic plan doesn't do enough either -- but at least it's a start. Many don't even want that much. They are the ones spreading FUD.

[NoahJ]

Originally Posted by Dr Millmoss

Yes, that's exactly right. It can't be broken up into smaller pieces, for the reasons I've outlined. The health insurance industry will simply never permit the basic underwriting rules to be changed unless they get mandated insurance for all Americans. If you want to see what piecemeal and ineffective reform looks like, examine the Republican plan. It requires nothing of the industry, and consequently, accomplishes nothing.

All or nothing then? Either the government runs it and you get taxed if you don't participate, or the system fails and people die? I don't have a problem with parts of the package, but some of the mandates in it go too far. Have they held on to the "Cadillac Plan" tax? I have not seen if that is still in or if it was removed.

I did not say that our current economic problems are caused by runaway health care costs (though it certainly is a contributing factor). What I did say is that our current economic woes will pale in comparison to what we will be facing in just a few years if the growth of healthcare costs are not reined in. Unfortunately in this regard, the Democratic plan doesn't do enough either -- but at least it's a start. Many don't even want that much. They are the ones spreading FUD.

I can see how your post would say that so I won't argue the point. However, healthcare cannot bankrupt the country unless it is allowed to. Eventually there comes a tipping point where people cannot and will not pay the higher costs, and things will have to change. Putting those costs over to the government and pretending that will make a difference is a bit short sighted. After all, they have done wonders with Medicare spending right?

As far as I am concerned you need to prove you can be fiscally responsible with a smaller program before you are allowed to take on a much larger one. They have not done that so far.

[NoahJ]

And so it begins:

http://news.yahoo.com/s/ap/20091107/..._care_overhaul

President Barack Obama's landmark health care overhaul moved toward a vote in the House Saturday after anti-abortion lawmakers won a chance to knock out language that would let people who get federal subsidies buy insurance plans that include abortion coverage.

Why not? Take an issue that affects most every aspect of a persons life and make it all about abortion.

Stupak's amendment would deny abortion coverage to anyone who gets federal insurance subsidies or buys a policy from the government. People could buy separate policies covering just abortions using their own money.
DeGette called Stupak's amendment "the biggest restriction on a women's right to chose that's been considered on the floor of the House" in her 13 years in office.

Is she serious? Since the government will not pay for it they are restricting the persons right to choose? Really?

[NoahJ]

Originally Posted by SpamSandwich

Perhaps because it sounds like an impossible option.

I didn't ask if you thought it was possible, I asked what plan you would be willing to get behind. Do you only get behind things you are sure will succeed?

[NoahJ]

http://www.opencongress.org/bill/111-h3962/show

OpenCongress Summary

This is the big health care reform bill in the House of Representatives that will be debated and voted on during the week of November 2nd. It is the final, reconciled version of the health care bill that was amended by three House committees over the summer. Broadly, it seeks to expand health care coverage to the approximately 40 million Americans who are currently uninsured by lowering the cost of health care and making the system more efficient. To that end, it includes a new government-run insurance plan (a.k.a. a public option) to compete with the private companies, a requirement that all Americans have health insurance, a ban on denying coverage because of a pre-existing condition and, to pay for it all, a surtax on individuals with incomes above $500,000.

The Affordable Health Care for America Act (H.R. 3962) is the final, merged version of the health care reform legislation that the House has been working on for much of 2009. The bill contains a moderate compromise on the public option by requiring the HHS Secretary to negotiate provider reimbursement rates rather than having them tied to Medicare. The bill also would require all individuals to have insurance, establish a new health insurance exchange, require most employers to provide insurance, ban insurance companies from denying coverage because of pre-existing conditions and more.

The Official summary is as follows:

Official Summary

10/29/2009--Introduced.Affordable Health Care for America Act - Requires the Secretary of Health and Human Services (HHS) to establish:

(1) a temporary national high-risk pool program to provide health benefits to certain uninsured individuals who have a medical condition; and
(2) a temporary reinsurance program to assist participating employment-based plans with the cost of providing health benefits to retirees and their beneficiaries. Amends the Public Health Service Act, the Employee Retirement Income Security Act of 1974 (ERISA), and the Internal Revenue Code to set forth provisions governing health insurance plans and issuers, including to:

(1) provide for rebates to enrollees based on a plan's medical loss ratio;
(2) prohibit rescission of health insurance coverage without clear and convincing evidence of fraud;
(3) require the option of extending coverage for children under 27 years of age;
(4) limit preexisting condition exclusions; and
(5) prohibit aggregate dollar lifetime limits on benefits. Extends COBRA coverage (health insurance continuation benefits) until an individual becomes eligible for health insurance coverage through the Health Insurance Exchange under this Act. Provides for grandfathered health insurance coverage. Establishes standards for qualified health benefits plans, including standards to:

(1) prohibit any preexisting condition exclusions;
(2) require guaranteed availability and renewability of health insurance coverage;
(3) limit premium variances, except for reasons of age, area, or family enrollment;
(4) prohibit discrimination based on health status factors; and
(5) require parity for mental health benefits. Requires qualified health benefits plans to provide coverage that meets the standards for the essential benefits package. Prohibits an essential benefits package from imposing any annual or lifetime limits on coverage. Lists required covered services, including hospitalization, prescription drugs, mental health services, maternity care, and children's oral health, vision, and hearing services. Prohibits cost-sharing for preventive items and services. Limits annual cost-sharing to $5,000 for an individual and $10,000 for a family. Prohibits abortion services from being required under an essential benefits package or under a qualified health benefits plan. Establishes the Health Choices Administration as an independent agency to be headed by a Health Choices Commissioner. Establishes the Health Insurance Exchange within the Administration to facilitate access of individuals and employers to a variety of choices of affordable, quality health insurance coverage, including a public health insurance option. Requires the Commissioner to:

(1) contract with entities to offer health benefit plans through the Exchange to eligible individuals;
(2) coordinate the distribution of affordability premium and cost-sharing credits; and
(3) establish a risk-pooling mechanism for Exchange-participating health plans. Authorizes state-based Health Insurance Exchanges to operate in a state or group of states instead of the Health Insurance Exchange, with approval of the Commissioner. Requires the Commissioner to establish a Consumer Operated and Oriented Plan program (CO-OP program) under which the Commissioner may make grants and loans for the establishment and initial operation of not-for-profit, member-run, health insurance cooperatives that provide insurance through the Health Insurance Exchange or a state-based Health Insurance Exchange. Requires the HHS Secretary to offer an Exchange-participating health benefits plan. Sets forth provisions regarding the operation of the Public Health Insurance Option. Provides for an affordability premium credit and an affordability cost-sharing credit for low-income individuals participating in the Exchange. Requires employers to offer health benefits coverage to employees and make specified contributions towards such coverage or make contributions to the Exchange for employees obtaining coverage through the Exchange. Exempts businesses with payrolls below $500,000 from such requirement. Amends the Internal Revenue Code to:

(1) impose a surtax on the income of individuals who do not obtain health care coverage and on employers (other than small business employers) who fail to satisfy health coverage participation requirements;
(2) allow a new tax credit for small business employers who provide health care coverage to their employees;
(3) increase the penalty for distributions from health savings accounts not used for qualified medical expenses;
(4) modify rules and contribution limits for certain employee benefit plans;
(5) allow an exclusion from gross income for the value of certain medical care provided to members of Indian tribes;
(6) impose a 5.4% surtax on individuals whose adjusted gross income exceeds $500,000 ($1 million for married couples filing joint returns);
(7) impose a 2.5% excise tax on medical devices;
(8) delay until 2020 tax rules applicable to the foreign tax credit for the worldwide allocation of interest;
(9) set forth rules for the application of the economic substance doctrine and impose penalties for underpayments of tax due to transactions lacking economic substance; and
(10) extend the tax exemption for employer-provided health care benefits to certain eligible beneficiaries of the taxpayer. Amends title XVIII (Medicare) of the Social Security Act (SSA) to revise provisions relating to payment, coverage, and access, including to:

(1) permit physician assistants to order post-hospital extended care services, and to provide for recognition of attending physician assistants as attending physicians to serve hospice patients;
(2) provide adjustment to Medicare payment localities for physician services;
(3) modify the Medicare payment systems to address geographic inequities;
(4) limit cost-sharing for individual health services under the Medicare Advantage program;
(5) eliminate the coverage gap under Medicare Part D (Voluntary Prescription Drug Benefit Program);
(6) eliminate Medicare part D cost-sharing for certain non-institutionalized full dual eligible individuals;
(7) cover marriage and family therapist services and mental health counselor services; and
(8) expand access to vaccines. Requires the HHS Secretary to establish within the Agency for Healthcare Research and Quality a Center for Comparative Effective Research. Establishes accountability requirements for long-term care facilities and provides for transparency with respect to them. Provides enhanced penalties for fraud and abuse. Amends title XIX (Medicaid) of the SSA to:

(1) expand Medicaid eligibility for low-income individuals and families;
(2) require coverage of additional preventive services; and
(3) increase payments for primary care services. Sets forth provisions to prevent health care fraud. Sets forth miscellaneous provisions relating to:

(1) extension of the qualifying individual (QI) program;
(2) the Medicaid and CHIP Payment and Access Commission;
(3) prohibitions against federal Medicaid and CHIP payments for undocumented aliens;
(4) the repeal of the comparative cost adjustment program;
(5) grants to states for quality home visitation programs for families with young children and families expecting children;
(6) establishment of the Center for Medicare and Medicaid Innovation; and
(7) application of emergency services laws. Amends the Public Health Service Act to set forth provisions related to:

(1) community health centers;
(2) health care provider scholarship and loan repayment programs;
(3) training programs;
(4) health care workforce diversity and data collection; and
(5) the 340B drug discount program (a program limiting the cost of covered drugs to certain federal grantees). Requires the HHS Secretary to establish:

(1) the Advisory Committee on Health Workforce Evaluation and Assessment;
(2) a community-based overweight and obesity prevention program;
(3) a demonstration project for medical-legal partnerships to assist patients navigating health-related programs and activities;
(4) the Emergency Care Coordination Center;
(5) the Council of Emergency Care;
(6) the Interagency Pain Research Coordinating Committee;
(7) a national pain care education outreach and awareness campaign; and
(8) a national medical device registry. Establishes:

(1) a Prevention and Wellness Trust for carrying out prevention and wellness activities;
(2) the Center for Quality Improvement to focus on quality improvement activities in the delivery of health care services; and
(3) the position of Assistant Secretary for Health Information. Provides grants for:

(1) school-based health clinics;
(2) nurse-managed health centers;
(3) federally qualified behavioral health centers;
(4) influenza vaccinations to children in elementary and secondary schools;
(5) evidence-based education programs to reduce teen pregnancy or sexually transmitted diseases;
(6) services to children and adults with autism and their families;
(7) University Centers for Excellence in Developmental Disabilities Education, Research, and Service;
(8) medication management services;
(9) infant mortality pilot programs;
(10) community-based collaborative care networks; and
(11) trauma centers and emergency medical care systems. Requires the HHS Secretary to make an incentive payment to each state that has an alternative medical liability law. Provides for:

(1) nutrition labeling of standard menu items offered for sale in chain restaurants and vending machines; and
(2) standards to make medical diagnostic equipment accessible to, and usable by, individuals with disabilities. Prohibits certain practices related to patent infringement claims against generic drugs. Allows a person to submit an application for licensure of a biological product based on its similarity to a licensed biological product (the reference product). Establishes a national, voluntary disability insurance program to purchase community living assistance services and supports (CLASS program) under which:

(1) all employees are automatically enrolled, but are allowed to waive enrollment;
(2) payroll deductions pay monthly premiums; and
(3) benefits are provided, based on the level of disability, to purchase nonmedical services and supports that the beneficiary needs to maintain independence. Makes states eligible for federal funds under the Public Health Service Act only if they agree to be subject as an employer to the obligations under this Act. Establishes Offices of Women's Health within the Department of Health and Human Services and its agencies. Indian Health Care Improvement Act Amendments of 2009 - Amends the Indian Health Care Improvement Act to revise requirements for health care programs and services for Indians, Indian tribes, tribal organizations, and urban Indian organizations. Establishes the Indian Catastrophic Health Emergency Fund. Replaces the Urban Health Programs Branch with a Division of Urban Indian Health. Authorizes grants to urban Indian organizations for health information technology, telemedicine services development, and related infrastructure. Directs the HHS Secretary, acting through the Indian Health Service, to provide programs of comprehensive behavioral health, prevention, and treatment. Reauthorizes the Indian Health Care Improvement Act. Amends the Indian Self-Determination and Education Assistance Act to direct the HHS Secretary to establish the Native American Health and Wellness Foundation. Expands coverage for qualified Indians in the State Children's Health Insurance Program (CHIP, formerly known as SCHIP) under title XXI of the SSA, as well as under Medicare (SSA title XVIII) and Medicaid (SSA title XIX). Authorizes related payments to Indian Health Programs operating in the state.

And here is their link to the text:
http://www.opencongress.org/bill/111-h3962/text
Can't find a pdf that can be downloaded so far.

[Dr Millmoss]

Originally Posted by NoahJ

All or nothing then? Either the government runs it and you get taxed if you don't participate, or the system fails and people die? I don't have a problem with parts of the package, but some of the mandates in it go too far. Have they held on to the "Cadillac Plan" tax? I have not seen if that is still in or if it was removed.

What is being proposed is hardly all. In fact it's hardly even a half-measure. It's a mystery to me why it's being portrayed as too much, when it leaves so many issues unaddressed. What's more, the government doesn't "run" much under this plan. The private insurance system we've got is pretty much left in place. The "pubic option" currently under consideration is the weakest one which has been considered. The big costs in the plan are the government paying insurance premiums for those who can't afford private insurance.

I can see how your post would say that so I won't argue the point. However, healthcare cannot bankrupt the country unless it is allowed to. Eventually there comes a tipping point where people cannot and will not pay the higher costs, and things will have to change. Putting those costs over to the government and pretending that will make a difference is a bit short sighted. After all, they have done wonders with Medicare spending right?

Again, not my argument. Health care won't "bankrupt" the country, but it can seriously impede economic growth, as it eats up more and more of GDP. This process is already well underway, so we're not talking theories here, but realities.

As far as I am concerned you need to prove you can be fiscally responsible with a smaller program before you are allowed to take on a much larger one. They have not done that so far.

I beg to differ. Health care costs have skyrocketed in the U.S. not because of the government, but because of the structure of the current private system. We already dedicate a far larger share of our GDP to health care than any other nation in the world, yet our results are verging on third world. It's a full-blown crisis. Yet, some still think we can get away with a little tinkering here and there, and even half-measures are seen as being too much.

[sammi jo]

Originally Posted by SDW2001

It's not a tax because it's not collected by the government. So no, we can't call it that. And it's not my fault that your health plan sucks. I can go nearly anywhere with my plan.

And to those who voted for a single payer system:

A single payer system is only a part of a nation's health care system, don't forget. Every nation in which there is a single payer option (ie every industrialized nation on the planet), private insurance is available for those who prefer; the public option provides a safety net for those who cannot afford private insurance. Some may resent their tax dollars going towards providing health care for the poorest in society.. and I can (sort of) understand the sentiment.

1. Where would we get the money? Newsflash...we're bankrupt.

Where there's a will, there's a way. We just provided at least $13 trillion in a socialistic type of rescue package so the bastions of capitalism in the US didn't collapse under the weight of their own greed and incompetence.

2. On what Constitutional grounds would we pass this?

Again, where there's a will there's a way. We have provided at least $1 trillion in funds to fight two wars, both of them extra-constitutional. To quote H. Kissinger: "the illegal we can do right away; the unconstitutional takes a little longer".

3. Do the private insurers just go out of business? What about the millions they employ?

Why should they go out of business? Private insurers thrive in nations with a single payer system, such as the UK and Canada. The single payer option just provides a bit of extra competition.. whats wrong with that?

4. Do you really think other countries' single payer healthcare systems have worked?

Nothing works perfectly. Government run systems are largely unwieldy, but its better than nothing, for the current 45 million of the poorest in society. Our HMO/insurance based system is no great shakes either; its riddled with ripoffs, scams, vastly inflated costwise and full of arbitrarinesses re. coverage. Our litigation-obsessed society doesn't help matters either. However (IMHO) it is uncivilized that a large section of the country, (through no fault of their own except that their income is static while the cost of basic living is undergoing relative inflation) lives in a state of being terrorized by the constant specter that the astronomical cost of a sudden illness or accident will more than probably wreck their lives, as well as the financial standing of family members who are obliged to help, and get left with the tab. This is a type of "financial terrorism" (and associated blackmail) that kills far more people in this country than the bullshit over which we are fighting multi-trillion dollar wars. Its amazing that we have few problems with providing $trillions in state welfare for the wealthiest corporations and banks, and fight tooth and nail against helping the poorest. Perhaps its because we have become a punitive society.. where stomping on the small guy is easy, simply because we can. Abu Ghraib was the same deal, in a microcosm.

We must get out of the mindset that every value we hold in our society can be reduced to a "bottom line". America is a greater entity than just a set of bottom lines. No?

[Dr Millmoss]

A couple of factual clarifications, assuming anyone cares.

First, the UK has a fully socialized health care system, not single-payer. Canada has a private heath care delivery system, with single-payer government insurance. Very different systems -- not that we're considering anything remotely like either one here.

Second, the number of uninsured people in the U.S. is currently 47 million. These are not the poorest Americans, by any means. Most are middle-class working people who either are not covered by an employer healthcare plan, the self-employed who can't afford to pay for one on their own, or are uninsurable due to preexisting medical conditions. Truly poor people don't have this problem -- they are covered under Medicaid.

[NoahJ]

Originally Posted by Dr Millmoss

What is being proposed is hardly all. In fact it's hardly even a half-measure. It's a mystery to me why it's being portrayed as too much, when it leaves so many issues unaddressed. What's more, the government doesn't "run" much under this plan. The private insurance system we've got is pretty much left in place. The "pubic option" currently under consideration is the weakest one which has been considered. The big costs in the plan are the government paying insurance premiums for those who can't afford private insurance.

The big costs are you and I paying premiums for those who cannot or do not. The big difference being, currently you may pay more for care when you have to have it now, whereas under the Gov't plan, you have to pay, whether you want or need the care and insurance or not.

Again, not my argument. Health care won't "bankrupt" the country, but it can seriously impede economic growth, as it eats up more and more of GDP. This process is already well underway, so we're not talking theories here, but realities.

Reality is people will pay for what they can afford and what is important to them. Who are you and I to say how much someone should or should not pay for something? Much of the costs of health care now are for elective surgeries and procedures (not all of it). This will not change under public health care likely, and so instead of overall costs going down I instead see them climbing.

I beg to differ. Health care costs have skyrocketed in the U.S. not because of the government, but because of the structure of the current private system. We already dedicate a far larger share of our GDP to health care than any other nation in the world, yet our results are verging on third world. It's a full-blown crisis. Yet, some still think we can get away with a little tinkering here and there, and even half-measures are seen as being too much.

Once again, what the people in America spend their money on is not really yours to control. If we spent half of the GDP on New Macs for everyone, so long as that was the decision of the person purchasing, why should you care or legislate against it? If you cannot afford it, you will not buy a Mac. If they cannot afford an elective surgery or procedure, they should not pay for it. IF they cannot afford care from a particular hospital, they need to shop around. However as we get further down this line I do feel that there should be something that helps those that truly do need it. Is it a government mandate like we are seeing now? No.

[Dr Millmoss]

This is all so wrongheaded and erroneous, it's difficult to know where to begin.

First, we all pay for the medical care of people who can't afford it, one way or another. Either we do it with the grossest possible inefficiency, as we do now, or we find a better way. Unless you are advocating for placing dumpsters outside of hospitals to put the people who can't pay for health care, then some other method of providing that health care that employs some form of logic is demanded. At least some people think so. Some apparently believe that ideology is the same as logic.

Second, your argument that "much of the costs of health care now are for elective surgeries and procedures" is just plain bizarre. You sound like someone who has never been seriously ill. Or what else, I don't know.

Third, health care for the most part is not elective. Again, you sound like someone with no experience with serious illness. Trust me, when you get older, the chances of you becoming seriously ill increase dramatically. One day you'll find yourself in a hospital and coming home with a bill for a hundred grand. Then you'll know that buying health care is not like picking up a quart of milk from the 7-11. Maybe not until then, I don't know.

FInally, if you don't think the mandate is a good idea, then some alternative for bring the currently locked-out 47 million into the system seems to be demanded. What's your solution?

[screener]

Originally Posted by Dr Millmoss

This is all so wrongheaded and erroneous, it's difficult to know where to begin.

First, we all pay for the medical care of people who can't afford it, one way or another.

Yeah, couldn't figure out what the thinking was here.

[bsenka]

Originally Posted by Wormhole

To call the current system "free" is crazy.
I have insurance but I am not free to choose my doctor or the hospital I want to go to. I have to go to "in network" facilities or I will be charged a 50% deductible.

Is it the norm in the US to have the insurance company dictate where you can go to get your medical services?

[franksargent]

Originally Posted by Dr Millmoss

This is all so wrongheaded and erroneous, it's difficult to know where to begin.

First, we all pay for the medical care of people who can't afford it, one way or another. Either we do it with the grossest possible inefficiency, as we do now, or we find a better way. Unless you are advocating for placing dumpsters outside of hospitals to put the people who can't pay for health care, then some other method of providing that health care that employs some form of logic is demanded. At least some people think so. Some apparently believe that ideology is the same as logic.

Second, your argument that "much of the costs of health care now are for elective surgeries and procedures" is just plain bizarre. You sound like someone who has never been seriously ill. Or what else, I don't know.

Third, health care for the most part is not elective. Again, you sound like someone with no experience with serious illness. Trust me, when you get older, the chances of you becoming seriously ill increase dramatically. One day you'll find yourself in a hospital and coming home with a bill for a hundred grand. Then you'll know that buying health care is not like picking up a quart of milk from the 7-11. Maybe not until then, I don't know.

FInally, if you don't think the mandate is a good idea, then some alternative for bring the currently locked-out 47 million into the system seems to be demanded. What's your solution?

I can sum up all of what you said in a single word, and that word is not wrongheaded or erroneous, the word is ...

... Naïveté.

[Dr Millmoss]

Originally Posted by bsenka

Is it the norm in the US to have the insurance company dictate where you can go to get your medical services?

Pretty much, yes. Depending on the type of insurance plan, they also decide whether you are going to receive a given service. Most of the time, they have to approve a service your doctor requests, but sometimes they decide it's not "medically necessary" and deny coverage. Some of the insurance companies have also been known to cancel customer's plans when they get sick. Other than that, it's a great system in no need of overhaul.

[SpamSandwich]

Originally Posted by NoahJ

I didn't ask if you thought it was possible, I asked what plan you would be willing to get behind. Do you only get behind things you are sure will succeed?

Certainly not. I voted for Ron Paul even though I knew he hadn't a prayer of becoming president. The alternatives were damn terrible... as we've all come to see.

[franksargent]

Originally Posted by SpamSandwich

Certainly not. I voted for Ron Paul even though I knew he hadn't a prayer of becoming president. The alternatives were damn terrible... as we've all come to see.

The above does not make any sense from a logical standpoint. Alternatives? Were as in past tense?

We can not see what a total fucktard Dr. No would have been as he was not elected.

We can not see what a total fucktard McLame would have been as he was not elected.

We can not see what a total fucktard <insert candidate's name here> would have been as they were not elected.

However, we all do know that Bush 43 was a total fucktard, and that using Bush 43 as the fucktard benchmark (below absolute zero temperature-wise), all other POTUS's were relativistic geniuses.

[bsenka]

Originally Posted by Dr Millmoss

Pretty much, yes. Depending on the type of insurance plan, they also decide whether you are going to receive a given service. Most of the time, they have to approve a service your doctor requests, but sometimes they decide it's not "medically necessary" and deny coverage. Some of the insurance companies have also been known to cancel customer's plans when they get sick. Other than that, it's a great system in no need of overhaul.

Yikes. I'm glad we don't have to deal with that kind of stuff here.

[Dr Millmoss]

Originally Posted by bsenka

Yikes. I'm glad we don't have to deal with that kind of stuff here.

Could you say that a little louder, please? Far too many people in my country think this is perfectly normal, and the best it can ever be.

The people who ought to be marching on Washington carrying angry placards are the 47 million with no health insurance, the many millions more who have already been screwed by their insurance companies, and the many millions more who can expect to be screwed by their insurance companies. If that happened, health care reform would have happened yesterday. Instead, the looney tunes are calling the shots.

[SpamSandwich]

Originally Posted by franksargent

The above does not make any sense from a logical standpoint. Alternatives? Were as in past tense?

We can not see what a total fucktard Dr. No would have been as he was not elected.

We can not see what a total fucktard McLame would have been as he was not elected.

We can not see what a total fucktard <insert candidate's name here> would have been as they were not elected.

However, we all do know that Bush 43 was a total fucktard, and that using Bush 43 as the fucktard benchmark (below absolute zero temperature-wise), all other POTUS's were relativistic geniuses.

Frank, you seem a little angry.

[franksargent]

Originally Posted by SpamSandwich

Frank, you seem a little angry.

Meh.

[NoahJ]

Originally Posted by Dr Millmoss

This is all so wrongheaded and erroneous, it's difficult to know where to begin.

First, we all pay for the medical care of people who can't afford it, one way or another. Either we do it with the grossest possible inefficiency, as we do now, or we find a better way. Unless you are advocating for placing dumpsters outside of hospitals to put the people who can't pay for health care, then some other method of providing that health care that employs some form of logic is demanded. At least some people think so. Some apparently believe that ideology is the same as logic.

All or nothing, just put people in dumpsters? Health care is a need for people and in a market people will find a way to meet that need for a price. If the price is too high alternatives will become available. Ones that people can afford. Perhaps it will not come with an MRI or prescriptions for the latest fad medications, but America, like many other countries, will provide what is demanded. For now the costs go higher because there has not been a groundswell of people saying, NO. They just accept that it costs that much and keep paying.

Second, your argument that "much of the costs of health care now are for elective surgeries and procedures" is just plain bizarre. You sound like someone who has never been seriously ill. Or what else, I don't know.

I did not say all of it or even a majority of it. Much is a relative term.

Third, health care for the most part is not elective. Again, you sound like someone with no experience with serious illness. Trust me, when you get older, the chances of you becoming seriously ill increase dramatically. One day you'll find yourself in a hospital and coming home with a bill for a hundred grand. Then you'll know that buying health care is not like picking up a quart of milk from the 7-11. Maybe not until then, I don't know.

Health care has more elective parts than it should. Where I live I see people going to the doctor for a hang nail that costs them hundreds to have looked at when others would simply pull it out and deal with it on their own. Not infected, not swollen, just a bit painful. They go in for a cold that would be just fine if the stayed home and rested for a day or two. That is elective. They are not required to go in for those things. The lists go on and on. Yes I have dealt with high cost medical bills. And I had coverage for most of them. You work out the others one way or another. Just like any other unexpected expense. And if you cannot afford it, there are lots of programs to help. I have had to use them at times. Fortunately not recently.

FInally, if you don't think the mandate is a good idea, then some alternative for bring the currently locked-out 47 million into the system seems to be demanded. What's your solution?

Criminalizing not paying for health insurance is not a good idea.

[Dr Millmoss]

In short, you don't understand the issues, don't understand what is being considered, and you don't know what else should be done. And you think anyone should respect your opinion on this subject?

[NoahJ]

Originally Posted by Dr Millmoss

In short, you don't understand the issues, don't understand what is being considered, and you don't know what else should be done. And you think anyone should respect your opinion on this subject?

In short, if I don't agree with you then I am wrong. Must be nice.

[Dr Millmoss]

Originally Posted by NoahJ

In short, if I don't agree with you then I am wrong. Must be nice.

No, you are simply lacking in knowledge of the subject, or any apparent interest in gaining knowledge of it. Sadly, this is the state of the healthcare debate today. People who know nothing, and who don't care, believe that their views are the ones that should prevail.

[NoahJ]

Originally Posted by Dr Millmoss

No, you are simply lacking in knowledge of the subject, or any apparent interest in gaining knowledge of it. Sadly, this is the state of the healthcare debate today. People who know nothing, and who don't care, believe that their views are the ones that should prevail.

And you KNOW this how? I have not put forth a view that I think should prevail. I have stated that the plan which requires under threat of fines and imprisonment that people purchase health insurance is not right.

[Dr Millmoss]

Originally Posted by NoahJ

And you KNOW this how? I have not put forth a view that I think should prevail. I have stated that the plan which requires under threat of fines and imprisonment that people purchase health insurance is not right.

First, there's no "imprisonment" in the bill. Second, I've asked you directly to tell me how you'd bring the 47 million Americans with no health care into the system, and you have declined to do so. This tells me that you either (1) don't know, or (2) don't care. Both, more likely. I think it's very sad that so many people with this don't know/don't care attitude have such a major influence on this debate. What is the point of discussing the immense problems with the current healthcare system with someone who denies their existence? Would a clergyman try to discuss the nature of God with an atheist?

[NoahJ]

Originally Posted by Dr Millmoss

First, there's no "imprisonment" in the bill. Second, I've asked you directly to tell me how you'd bring the 47 million Americans with no health care into the system, and you have declined to do so. This tells me that you either (1) don't know, or (2) don't care. Both, more likely. I think it's very sad that so many people with this don't know/don't care attitude have such a major influence on this debate. What is the point of discussing the immense problems with the current healthcare system with someone who denies their existence? Would a clergyman try to discuss the nature of God with an atheist?

The bill places the responsibility of gathering funds over to the IRS. If you do not purchase health insurance you will have to pay the IRS. If you refuse to pay the IRS for said health care bill what happens? Sorry, yes it does include possible imprisonment.

As for how I would bring 47 million people into the system, I would not. I would only do something to help those who truly could not afford health insurance. All the rest can fend for themselves. For a percentage, they make a choice not get health care. Others do not have health insurance for a short time when they are in between jobs and others feel they are indestructible and do not need health insurance. Why force them in?

You do not know me at all if you feel you can judge what I do not care about. Read all my other posts on the health care debate and get a better picture instead of trying to polarize your image of me.

I do not deny there are problems with the health care system, but I do not agree that this government mandate being proposed is the answer.

If you truly want to help, do the things that make sense first. Tort Reform, Tax breaks for the people that buy insurance, whether it be the employers or the people at home. Get those savings out of medicare that we have heard so much about.

And do not forget that people are responsible for their own health and well being. Just because the Government wants to "help" does not mean it is supposed to take the full responsibility for it. How far can this go before you are uncomfortable with gov't involvement? Exercise mandates? Nutrition mandates? Monitoring of vices? Criminalization of smoking, drinking, etc? When the gov't has to pay for your health, do you not believe that they will look down these avenues? It is already a crime to smoke in public places in Oregon, and they are looking to make it a crime to smoke outdoors in public parks and in your own cars if you have children. How nicely would that tie into health care reform down the road? Wake up.

[Dr Millmoss]

Utter claptrap. Discussion over.

[SDW2001]

Originally Posted by sammi jo

A single payer system is only a part of a nation's health care system, don't forget. Every nation in which there is a single payer option (ie every industrialized nation on the planet), private insurance is available for those who prefer; the public option provides a safety net for those who cannot afford private insurance. Some may resent their tax dollars going towards providing health care for the poorest in society.. and I can (sort of) understand the sentiment.

This will not be the result of the government option debacle in this country. There will not be competition for long, because the government will "compete" insurers right out of business. They don't have to make a profit. In addition, employers will drop their private plans because they cost too much. It might take 10, 15 or 20 years. But, it will happen.

Where there's a will, there's a way. We just provided at least $13 trillion in a socialistic type of rescue package so the bastions of capitalism in the US didn't collapse under the weight of their own greed and incompetence.

That's not accurate. Sure, with lending from the Fed and the bailouts, it may total that amount. But that's not direct government spending (wrong as it may be).

Again, where there's a will there's a way. We have provided at least $1 trillion in funds to fight two wars, both of them extra-constitutional. To quote H. Kissinger: "the illegal we can do right away; the unconstitutional takes a little longer".

Please explain to me how they are "extra-Constitutional." Both were undertaken in completely Constitutional ways.

Why should they go out of business? Private insurers thrive in nations with a single payer system, such as the UK and Canada. The single payer option just provides a bit of extra competition.. whats wrong with that?

See above. That's what's wrong.

Nothing works perfectly. Government run systems are largely unwieldy, but its better than nothing, for the current 45 million of the poorest in society.

That is not accurate either. Millions upon millions make over $50,000 a year. It's not the poorest in society.

Our HMO/insurance based system is no great shakes either; its riddled with ripoffs, scams, vastly inflated costwise and full of arbitrarinesses re. coverage. Our litigation-obsessed society doesn't help matters either.

It's no more imperfect than a government system. You have to know that. And if litigation is the problem, let's have reforms to fix that problem.

However (IMHO) it is uncivilized that a large section of the country, (through no fault of their own except that their income is static while the cost of basic living is undergoing relative inflation) lives in a state of being terrorized by the constant specter that the astronomical cost of a sudden illness or accident will more than probably wreck their lives, as well as the financial standing of family members who are obliged to help, and get left with the tab.

First, no one's income is truly static in this country. Second, everyone in this country is entitled to emergency care, regardless of ability to pay. Third, if were going to provide additional taxpayer funded coverage, let's cover the 10 million citizens who need it...with a basic policy. This would cost 100x less what is being proposed. Hell, give them vouchers for health insurance. Make it tax deductible.

This is a type of "financial terrorism" (and associated blackmail) that kills far more people in this country than the bullshit over which we are fighting multi-trillion dollar wars. Its amazing that we have few problems with providing $trillions in state welfare for the wealthiest corporations and banks, and fight tooth and nail against helping the poorest. Perhaps its because we have become a punitive society.. where stomping on the small guy is easy, simply because we can. Abu Ghraib was the same deal, in a microcosm.

We must get out of the mindset that every value we hold in our society can be reduced to a "bottom line". America is a greater entity than just a set of bottom lines. No?

I understand your anger about the bailouts and corporate welfare. On the other hand, we tax the hell out of businesses, regulate the hell out them, etc...and then wonder why they pass the costs on to consumers. Your statement about "fighting tooth and nail" against the poor leaves me dumbfounded. We've spent trillions on the poor, and the poor have not gotten any less poor. We have social programs of every kind and have developed a near cradle to grave society in terms of reliance on government. This has happened because of one reason: Giving the poor other people's money doesn't make them richer, it just makes the "other people" more poor.