Quote :

"This is an absurd example. Healthcare has evolved to be the way it is for a reason, it makes no sense to try and argue that this system should be turned upside down by illogical comparisons to the fast food industry. McDonalds can turn people away because you won’t die my missing a meal at mcdonalds, and you don’t risk injuring or making other people sick. "

So if the idea is to stop the spread of disease or potential complications, why bother with insurance reform at all? Why not just mandate that all doctors everywhere have to treat anyone regardless of ability to pay? Lets take that burden off the hospitals and spread it to all of the doctors. After all, isn't that the theory here, that spreading the costs around makes it all cheaper? So lets spread that cost, and cut the middle man right out. We don't need a public insurance option, we'll just mandate that doctors treat everyone, regardless of ability to pay, and just have them pass the costs along to those that can pay. Much more efficient that way.

I mean, you say that the system has evolved the way it did for a reason, so surely there is a reason why we only mandated that ERs treat everyone. Now it appears that the opinion of some (like myself and presumably eyedrb) is to ensure that life saving procedures are performed in emergency situations (hence the term Emergency Room) without waiting to check to see if the guy's insurance clears, and not to treat every illness that comes through the door, just because it might get more serious later. It appears that you are of the opinion that it was designed as a catch all for everyone who falls through all the other systems, which as I said, makes me wonder why we bother with insurance when there are plenty of doctors to expand that catch all to.

And incidentally, you might very well die if you miss a meal at McDonalds if you haven't eaten in a while, just as you might very well die if you contract pneumonia from a cold. We still don't mandate that McDonalds hand out free food.

Interestingly though, if someone were to die on a McDonalds door step from lack of food, we would blame McDonalds and the employees of that store for being heartless and cold, not Visa for denying the man a credit card. But when someone dies from a treatable disease, we don't blame the hospital and the doctors, we blame the insurance companies for being so expensive.

[Edited on December 2, 2009 at 12:03 AM. Reason : dsfa]

12/1/2009 11:59:32 PM

Quote :

"And incidentally, you might very well die if you miss a meal at McDonalds if you haven't eaten in a while, just as you might very well die if you contract pneumonia from a cold. We still don't mandate that McDonalds hand out free food. Interestingly though, if someone were to die on a McDonalds door step from lack of food, we would blame McDonalds and the employees of that store for being heartless and cold, not Visa for denying the man a credit card. But when someone dies from a treatable disease, we don't blame the hospital and the doctors, we blame the insurance companies for being so expensive. "

If you want to run with this example, there are gov. as well as private agencies that make getting food very, very easy for poor people. We don’t mandate food places give starving people food because the gov. already does so, via homeless shelters (and funding for charities). How about we do that with healthcare…?

On top of this, you are still acting like people using the ER as primary care is the back-breaking straw of our healthcare system, when that’s simply not true…

Quote :

"Not only are the majority (86 percent) of walk-in visits to hospital emergency departments appropriate, but one in 20 patients who are initially felt to be "non-urgent" actually requires admittance to the hospital after a complete evaluation, reported researchers from Emory, the University of California at San Francisco and others, in the Aug. 13 issue of the Journal of the American Medical Association."

http://www.emory.edu/EMORY_REPORT/erarchive/1996/September/ERsept.9/9_9_96most_nonurgent.html

14% of people who visit are non-urgent. When you consider how much of that 14% might be due to loss of coverage from quitting their job, or being downsized, or dropped coverage because of pre-existing conditions, or because their primary care physician wasn’t open on a day, how many people are left that are simply too lazy or incompetent to get proper healthcare?

This is not the back-breaking straw, and this isn’t the huge issue eyedrb is playing it up to be. This is merely the symptom of a problem, not the root cause, and you’re not going to be able to really treat the overall issue by attacking this one symptom. I’m a little surprised that people are getting stuck on such a short-sighted tactic. (there are more puns than I am comfortable with in there, i’m sorry)

12/2/2009 12:16:57 AM

Quote :

"How about we do that with healthcare…?"

Don't we already do that with healthcare? medicare, medicaid? what? how has that worked out for us... oh, right, it's caused our prices to skyrocket. shit...

12/2/2009 6:41:08 AM

Quote :

"If you want to run with this example, there are gov. as well as private agencies that make getting food very, very easy for poor people. We don’t mandate food places give starving people food because the gov. already does so, via homeless shelters (and funding for charities). How about we do that with healthcare…? "

We do. Medicare / medicaid, free clinics, low cost clinics and charities (often better than the government programs) all exist, every drug manufacturer has a low income assistance program of some type. Of course, there's more we can do, even stuff the government can do to improve things. Make usual billing rate of a doctor completely tax deductible for every hour spent volunteering at a free clinic etc etc.

12/2/2009 7:50:54 AM

^thank you. And allowing doctors to deduct from their taxes the full cost of seeing non paying patients will reduce the load on hospitals and provide better treatment to patients. But in the end, someone has to pay to keep the lights on.

12/2/2009 12:44:00 PM

^^ so what then is the issue with what amounts to expanding medicare/medicaid via health reform?

12/2/2009 1:00:21 PM

Because that isn't what's being done. Never mind that medicare and medicaid are broken and the we don't even enroll everyone who's eligible for them. Then there's the fact that both are bleeding money left and right to fraud. Can't imagine why I might want to see something different than more of the same.

12/2/2009 3:23:27 PM

you cant expand them. They are heading off the cliff as is. You have to reform them by CUTTING, not expanding. You can start by stop covering braces for medicaid. People who are working cant afford those for thier own kids, yet have to pay for medicaid so they can get braces. Totally upside down.

12/2/2009 3:24:12 PM

lack of covereage is a symptom, not the problem. Expanding medicare would treat the symptom but not the cause.

The problem is high healthcare costs. These are what get billed by docs and hospitals NOT what an individual pays their insurance provider. Not what we pay in taxes for medicare.

If you decrease the costs of healthcare, you could cover the same ammount of people currently in medicare with fewer tax dollars or expand coverage for the current price.

This retard fest thats going on in congress is all about expanding covereage with no thought to cost.

12/2/2009 4:16:44 PM

Quote :

" Breaking a three-day stalemate, the Senate approved an amendment to its health care legislation that would require insurance companies to offer free mammograms and other preventive services to women. The vote was 61 to 39, with three Republicans joining 56 Democrats and the two independents in favor. "

http://prescriptions.blogs.nytimes.com/2009/12/03/senate-passes-womens-health-amendment/?hp
This happened directly after the release of evidence showing that many mammograms do not pass a comparative effectiveness test. Once the test became a public issue at all...well, now you see what happens. CBO, take note.

12/3/2009 4:16:48 PM

i want my free checks for penis and ball cancer (only oral and hand checking vis-a-vie a hot nurse ofc)

12/5/2009 1:26:47 AM

I'd like free stomach and colon cancer checks, since those cancers kill more people than breast cancer.

12/5/2009 10:02:37 AM

Quote :

"This retard fest thats going on in congress is all about expanding covereage with no thought to cost."

Then explain why the CBO report says that the current Democratic plan being debated in the Senate will save billions of dollars over the next 10 years, and even more over the next 20? Fact check your sweeping assumptions much?

12/5/2009 10:08:06 AM

Because it collects taxes for 10 yrs while providing services for 6 (maybe 7). It will NOT save money, logically, how can it?

They are saying they are going to cut medicare, but im not sure they have the political will to face that. They have been putting off the planned cuts for years now.

btw, I think the Iraq war was only going to cost like 40B.

[Edited on December 5, 2009 at 10:13 AM. Reason : .]

12/5/2009 10:12:56 AM

^^ If this were really about cutting costs, no one would be talking about insurance. Seriously, insurance is a god awful way to pay for anything. It substantially raises the costs of day to day expenses on the bet that you will need significantly more payout later. But by definition, that can't happen for most people. In order for insurance to work, most people must pay in substantially more than they will ever get back out. But we're not talking about cutting costs, we're talking about forcing people to buy insurance, taxing them if they don't, and substantially expanding failed systems in the (proven wrong time and again) theory that if the government just throws more tax money at the problem, the problem will go away.

It truly fascinates me that any one on this board can tell you buying an extended warranty is a good way to piss away money, but so many of the same people are hell bent on making sure everyone buys an extended warranty for their life. There are other and better ways to solve this than mandating everyone buy insurance. Unfortunately, no one in congress is actually interested in solving this problem.

[Edited on December 5, 2009 at 11:01 AM. Reason : sadf]

12/5/2009 10:59:22 AM

Interesting thought... we could ban full coverage health insurance and mandate everyone buy catastrophically high deductible ($5,000/year) health insurance... If you're going to put guns to people's heads, might as well be to implement a system that should work.

12/5/2009 11:33:49 AM

Quote :

". Seriously, insurance is a god awful way to pay for anything. It substantially raises the costs of day to day expenses on the bet that you will need significantly more payout later. But by definition, that can't happen for most people. In order for insurance to work, most people must pay in substantially more than they will ever get back out."

This does help keep costs down, because it means hospitals can operate without having to worry that they’ll have to eat the costs of their more costly operations.

Insurance came about naturally, because health care is important, but expensive, and a collective payment system is the best choice.

If there was no insurance, then people would either have to pay out of pocket for serious illnesses (which most people can’t afford to do), there would be less money spent on medical research, and/or hospitals simply couldn’t afford to operate. This is very likely the reason the US doesnt’ have a socialized health system, but many poorer countries do; because we started from the ground up with an insurance system, where as developing countries have to use the expensive technologies we designed, but they can’t afford, so their gov. had to cover the costs.

It’s easy to hate insurance, but having watched a friend require $300,000 dollars in medical bills after an unfortunate car accident, it’s not something I despise anymore, between decent car and health insurance, he wasn’t devastated financially like so many people would have been if they had lesser coverage.

12/5/2009 12:35:41 PM

If your friend had shopped around some he could have slashed his bill at least in half.

As such, why do you believe it is impossible to use this information in a medical system? And the incentives are pervasive: "I have a cold, spend $5,000 doing tests" causes "car accident, spend $300,000 fixing me up." If the hospital had any incentive to compete on price, when you friend came in with or without insurance he would have walked out with the insurance provider paying far less.

Force everyone to shop around when it is not an emergency, such as the cold, so they don't bankrupt the country when they have the car accident.

12/5/2009 4:25:59 PM

^^ Right, I understand insurance and why it came about. It's a gamble, but the point is, for it to work, the majority of people have to loose the bet, which makes it a shitty way of paying for day to day care. Getting more people on insurance doesn't change that fact, as Massachusetts has shown us, they have the highest insured rate, but the number of people using the ER for basic care keeps climbing, and most of the people with insurance still can't afford the deductibles, procedures aren't being paid for and costs haven't actually gone down.

^ This is another problem with this debate. We keep conflating general health care with emergency health care. Emergency care is exactly what insurance is for. But day to day care has plenty of space for shopping around and is where insurance becomes a horrible way to pay for care.

12/5/2009 5:02:29 PM

http://www.newsobserver.com/news/health_science/story/229063.html

"Concierge" medical practices - For those graduated and with careers, would you be interested in this type of service as a patient? If not now, in the future? For those still in school, given a very loosely estimated college graduate salary of ~50K/year, would you spend $1,500 to have essentially unlimited access to your physician.

I can see why a physician would want to create this type of practice - $1,500 x 500 patients = $750,000. Even taking away half for overhead, which is a very generous estimation because overhead would likely be much less than in a normal practice anyway, you are talking about much more money than an internist would make on average. For the same or greater compensation the physician gets to practice just as I think many would ideally want to practice - you have a greater connection to your patients, you don't constantly feel rushed, etc.

12/7/2009 12:12:07 PM

As I've mentioned many times before, I think two of the huge problems with our health system are subsidized, employer-provided benefits, and the fact that insurance is now used for all medical expenses, not just emergencies. Now, the solution to the first problem is easy enough: stop giving companies tax breaks to provide benefits, which would force people to buy their own individual plan. There would be an incentive to stay healthy, as it would result in a decreased premium.

On the second issue though, what is the solution? The insurance companies, as far as I know, are the ones that chose to start covering everything, not just catastrophic illness. They're still making money, but it's not good for the cost of the average person. The only thing I know to do is to let all insurance companies compete across state lines, which could only bring down premiums. Even that isn't a solution for the actual cost of healthcare, though. Office visits without insurance will destroy you. Hospital without insurance...you're done, son.

So, I'm sort of at a loss. Is this just a situation where we have greatly increased demand for healthcare due to a predominantly unhealthy "American lifestyle"? Are "reasonable and customary" charges by the insurance companies forcing doctors to charge less for certain services than they would normally, resulting in increasing prices across the board? What's really driving prices up?

12/7/2009 12:24:38 PM

^^ Inevitable, as the costs of caring for patients goes up, while reimbursement goes down, doctors will start trading volume for quality. As I've mentioned at least a half dozen times in this thread, everyone having insurance does not in any way mean that everyone has access to health care, or can afford that care, and no matter where you set the base line, there will be haves and have nots and the haves will have better care.

Quote :

"On the second issue though, what is the solution? The insurance companies, as far as I know, are the ones that chose to start covering everything, not just catastrophic illness. They're still making money, but it's not good for the cost of the average person. The only thing I know to do is to let all insurance companies compete across state lines, which could only bring down premiums. Even that isn't a solution for the actual cost of healthcare, though. Office visits without insurance will destroy you. Hospital without insurance...you're done, son."

I think the simple act of moving payment of insurance from companies to individuals would improve this. As people realize they can't afford $500 / month cover all plans, they'll demand cheaper plans, maybe with less coverage but lower prices. And one of those features they might be willing to give up is co-pays for office visits. More competition as well as eliminating coverage mandates would help too. But really the only way to solve it is to start putting the cost of health care in the hands of the people rather than companies.

12/7/2009 1:22:42 PM

Quote :

"In Polls, Much Opposition to Health Care Plan Is From Left by Nate Silver @ 8:09 AM Don't know why I didn't catch this earlier, but it strikes me as fairly important. Ipsos/McClatchy put out a health care poll two weeks ago. The topline results were nothing special: 34 percent favored "the health care reform proposals presently being discussed", versus 46 percent opposed, and 20 percent undecided. The negative-12 net score is roughly in line with the average of other polls, although the Ipsos poll shows a higher number of undecideds than most others. Ipsos, however, did something that no other pollster has done. They asked the people who opposed the bill why they opposed it: because they are opposed to health care reform and thought the bill went too far? Or because they support health care reform but thought the bill didn't go far enough? It turns out that a significant minority of about 25 percent of the people who opposed the plan -- or about 12 of the overall sample -- did so from the left; they thought the plan didn't go far enough."

12/7/2009 4:10:50 PM

i would be Favors Health Care Reform: Opposes Plan (Prevents Real Reform)

12/7/2009 4:28:49 PM

^^ link?

12/7/2009 4:34:18 PM

Yeah, you have to wonder why they didn't include that option.

12/7/2009 4:35:13 PM

^ because everyone is trapped in the retard group think that its either public insurance or private insurance and theres no other possible solution

12/7/2009 4:40:23 PM

http://www.fivethirtyeight.com/2009/12/in-polls-much-opposition-to-health-care.html

12/7/2009 6:13:23 PM

Quote :

" The bill will also increase taxes to "European levels of taxation," while failing to provide European-style universal coverage. It will vastly increase the costs of our health care system, rather than reducing it to European levels. It reinforces foolish restrictions on national competition in health insurance, which do not exist in Europe. And you cannot get sued for such behavior in my country!Doctors afraid of being wrongly sued for malpractice despite providing good quality care order unnecessary tests (or defensive medicine), which wastes at least $200 billion annually. That's nearly as much money as France spends on health-care for all its citizens. The bill does nothing to reduce such costs, ignoring lessons from Europe. (Many European countries have specialized health courts, rather than American-style jury trials, to cut lawyers’ bills, speedily compensate the injured, and prevent American-style baseless lawsuits against doctors.) In European countries like France, doctors don't need to be paid as much, because competing professions, like lawyers, are paid less. European law is generally much more conservative than American law when it comes to lawsuits, including lawsuits against doctors. Punitive damages are generally forbidden, and lawsuits are discouraged by making unsuccessful plaintiffs pay the other side's legal bills."

http://www.examiner.com/x-7812-DC-SCOTUS-Examiner~y2009m11d15-Obamas-costly-healthcare-plan-jeopardizes-seniors-and-healthcare-for-millions-federal-experts-say

12/9/2009 12:21:19 AM

^that article is a month old, not sure how accurately it reflects the current debate. I also notice that, unlike most news agencies that usually start off by referring to the President as President before switching to Mr. Obama or just Obama, that article never mentions title. It is a small thing, but it can often give away one's political sentiments.

A a more relevant article to post today might be something like:

http://www.cnn.com/2009/POLITICS/12/08/health.care/index.html

Quote :

"Senate Dems agree on how to handle health bill's public option STORY HIGHLIGHTS * Senate Dems reach "broad agreement" regarding public option, said Sen. Harry Reid * Sources said deal includes proposal to replace public option with nonprofit private option * Two senators opposed to public option, say they're open to private option"

or something mentioning "Lawmakers defeat measure to restrict federal funds for abortion coverage"
http://www.msnbc.msn.com/id/34326187/ns/politics-capitol_hill/

12/9/2009 1:11:59 AM

nonprofit private option + buy-in for medicare for those 55-65. that seems like a pretty important piece.

12/9/2009 1:31:21 AM

I already have a nonprofit private option in my BC/BS

12/9/2009 10:06:47 AM

Racist

12/9/2009 10:24:57 AM

lol

12/9/2009 3:11:27 PM

12/10/2009 8:06:08 AM

haha wow... race-card card

12/10/2009 10:24:39 AM

http://www.cnn.com/2009/POLITICS/12/11/health.care.benefit.caps/index.html

i'm so sick of this damned healthcare debate. i mean seriously, the senate and house bills are so damned far apart now that it's going to take forever to get this shit merged, and then it'll probably go back to committee and start this bullshit all over again.

i'm sorry obama i really wanted you to succeed on this, but it's going to [FAIL]

12/11/2009 5:15:17 PM

well i dont think many people thought anything would pass the house or the senate so its gotten further than people thought
but both sides know that they cannot affort to have no reform passed soon

12/11/2009 10:50:39 PM

which means that some half-assed, watered down, concessions riddled piece of shit will pass, just for the sake of passing something. terrific.

12/11/2009 11:48:17 PM

thats the situation america is in, a divided country with a president who insists on bipartisanship

12/12/2009 12:33:26 AM

^lol. wow

12/12/2009 9:51:45 AM

^ Now there is some illuminating analysis ...

12/12/2009 11:25:35 AM

haha, i knew that saying obama insists on bipartisanship would raise a few eyebrows
but the fact is he could've taken a much more partisan route and pushed the bill through, and you must admit that

12/12/2009 11:54:33 AM

^ obama definitely is insisting on bipartisanship more than he needs to, and there are gripes about this in the liberal netizens. This is possibly a source of some of his loss of support among the independents, i would wager.
for example:
http://www.wired.com/underwire/2009/12/alt-text-obama-science/
Wily Obama Won’t Let Science-y Stuff Divide Us

12/12/2009 12:09:31 PM

lafta, the bill isnt going through because it lacks democratic support, not bc Obama wants the republicans to like it. haha

You will see them push through something. imo

12/14/2009 10:49:40 AM

Quote :

"which means that some half-assed, watered down, concessions riddled piece of shit will pass, just for the sake of passing something. terrific."

agreed.

seems to me that there are simple steps we can take to try to improve health care without blowing the whole system up. we can;

1. allow people to buy policies across state lines
2. allow people to select the type of coverage they want within the plan...i dont need acupuncture
3. give individuals the same tax breaks on buying coverage that the government gives employers
4. allow insurers to pool individual policies to reduce risk...ie..have the 'male under 30 pool' or something like that

just my $.02 im curious if some of you who are better-informed can tell me why simple things like this would not help.

12/14/2009 10:56:02 AM

Quote :

"3. give individuals the same tax breaks on buying coverage that the government gives employers"

In addition to this, if they don't eliminate the employer tax break, there needs to be a provision that gives the employer a tax break if they pay for an employee chosen plan/provider. Individuals getting that tax break doesn't help if the employers don't give them that money. Not sure how you would make it work, but I picture something along the lines of insurance companies setting up a direct deposit system like the banks and funds that are direct deposited by your employer to those accounts are subject to the same tax breaks as if the employer were buying the plan directly.

This also has the added benefit of employees at places with lousy insurance to buy up into better insurance without having to shoulder the full cost.

12/14/2009 1:14:48 PM

i say we build a healthcare bill that not only gives a minimum required healthcare to our own citizens who are entitled to it via birthright, but to the rest of the world.

b/c why be racist and selfish? aren't we all humans?

12/14/2009 1:27:55 PM

In honor of his continually evolving excuses for obstruction and his general douchebaggery ever since he realized that he can hold the Dems by the balls and squeeze all he wants, I have decided to send Senator Joseph Lieberman a box of douches from Walgreens.

Yes it's juvenile, but it's quite satisfying.

[Edited on December 14, 2009 at 1:43 PM. Reason : I keep not wanting to spell it LIEberman...]

12/14/2009 1:40:06 PM

Joseph Leiberman is the cockblocking man. And the other >40 people that agree with him. Love it. Right up your motherfucking liberal assholes too.

ha

12/14/2009 1:42:59 PM