Yay Government health care:(

[wstphal]

I can always control my own costs, and those of my family. That's my responsibility. Just because I have insurance doesn't mean I'm going to run to the doctor or hospital for every sniffle and bruise. Much of my life will remain unchanged. I will still only go to the hospital when it's absolutely necessary.

There's one more thing you can do to control costs. Think about how much care is enough. Does your daughter need a brain MRI if she has 1 headache? Do you want your grandmother put on a ventilator? If you do, under what circumstances? What do you want done if you are in a catastrophic accident & you are brain dead? These are examples of "how much is enough?" in our own lives. Once you know some of the answers for you & your family, share those answers with other adults in your family!

You have no idea, unless you work in healthcare, how often nobody knows what someone wanted, so the doctors do EVERYTHING simply because no one has an idea what this person would have wanted. Families feel guilty if they don't put the grandmother on a ventilator. But if they know she DIDN'T want it, they don't feel guilty.

And people get really frightened by symptoms and want every imaginable test done that very same day, even if there is a small chance of dangerous disease. Hence the remark about brain MRIs for 1 headache. If people think about these issues ahead of time, they don't freak out and demand 5 imaging studies on the day of the symptom.

If everyone thought & then shared, we'd save a ton of $ and get at least as good outcomes, and help control costs so that this HCR legislation can work.

 

[tyflier]

There's one more thing you can do to control costs. Think about how much care is enough. Does your daughter need a brain MRI if she has 1 headache? Do you want your grandmother put on a ventilator? If you do, under what circumstances? What do you want done if you are in a catastrophic accident & you are brain dead? These are examples of "how much is enough?" in our own lives. Once you know some of the answers for you & your family, share those answers with other adults in your family!

I generally dislike doctors and hospitals. It's been instilled in me since birth. I, personally, don't go to the hospital unless a bone is sticking out, it just doesn't stop bleeding, or something from the inside is now outside. I despise the idea of a doctor telling me something I already know, anbd charging a small fortune for it, especially if there is nothing to be done about it.

In short, I am not a hypochondriac, and neither is my daughter. We live "tough", in that we deal with our pains and illnesses, unless there is a real issue to be looked at. Living Will? I don't want to kept alive unless I am capable of living. Don't fill me full of tubes and man-generated electrical components while I rot in a bed and call it a life. Put me, and my family, out of my misery. I'm a supporter of Kevorkian and my right to end my own life when my life is no longer a celebration, but becomes a burden on me and my family.

You have no idea, unless you work in healthcare, how often nobody knows what someone wanted, so the doctors do EVERYTHING simply because no one has an idea what this person would have wanted. Families feel guilty if they don't put the grandmother on a ventilator. But if they know she DIDN'T want it, they don't feel guilty.

Everyone around me knows what I want, from a Living Will to my disdain for coffins and cemetaries.

And people get really frightened by symptoms and want every imaginable test done that very same day, even if there is a small chance of dangerous disease. Hence the remark about brain MRIs for 1 headache. If people think about these issues ahead of time, they don't freak out and demand 5 imaging studies on the day of the symptom.

How much of this is media-related? Everyday there are hundreds of commercials asking if you have any of thousands of very generic symptoms. "Ask you doctor if 'Killulater' is right for you". You can't blame people for being scared when the biggest marketing tactic of pharmeceutical companies is to strike fear in our hearts and minds at every case of angina or a muscle cramp.

The flip side to that is you can't really blame doctors for making sure that every single possible avenue is not only explored, but thoroughly exhausted. We live in such a litigious society, that smokers actually sue tobacco companies for "giving them cancer". I'm a smoker and I know how ridiculous that is. But this is where our society is. So who can really blame a doctor for covering his own hind-quarters against a potential lawsuit that will likely put him out of business and into bankruptcy?

If everyone thought & then shared, we'd save a ton of $ and get at least as good outcomes, and help control costs so that this HCR legislation can work.

We'd probably have LOWER costs and BETTER care. But you can't change public knowledge when advertisements and marketing are designed to make people hypochondriacs. And you can't change the way doctors and hospitals operate when people are actually looking for that multi-milion dollar malpractice lawsuit...

 

[wstphal]

Everyone around me knows what I want, from a Living Will to my disdain for coffins and cemetaries.

Excellent!!!!

We'd probably have LOWER costs and BETTER care. But you can't change public knowledge when advertisements and marketing are designed to make people hypochondriacs. And you can't change the way doctors and hospitals operate when people are actually looking for that multi-milion dollar malpractice lawsuit...

Yes, we can change people. And if people are less hypochondriacal, less unnecessary healthcare spending will occur. And if more people talk about the real outcome of multimillion dollar malpractice suits in the absence of malpractice, there will be fewer of them. Right now, people feel like it's "free money", the "lawsuit lottery", but this can be changed.

You've clearly done your thinking & talking to your family so I'll quit hammering on you. Now I gotta find another victim who hasn't thought it thru and pound on them instead.

Thanks!

 

[wade]

You know if attorneys were not allowed to take suits on contingency or set a much lower percentage they could take on contingency, people would not be so quick to sue. If I have to take 5K out of my own pocket I might give it a little more thought.

 

[wstphal]

You know if attorneys were not allowed to take suits on contingency or set a much lower percentage they could take on contingency, people would not be so quick to sue. If I have to take 5K out of my own pocket I might give it a little more thought.

The problem with this idea is that it shuts out poor people with legitimate malpractice claims. I personally favor
1) having special medical malpractice courts where the people deciding the case are a mix of health care workers + trained patient advocates, rather than random jurors, plus
2) financially punishing the heck out of plaintiffs' lawyers who take cases where there is clearly no malpractice plus
3) setting up some kind of no fault system to compensate people when the doctors did nothing wrong but the outcome is horrible anyway. (I overheard a conversation once between different families of children with cerebral palsy -- they had both sued the obstetricians involved, and one of them said something like "I know it wasn't the doctor's fault but every wheelchair costs $20,000 and isn't covered by insurance and we have to buy a new one every year so that's why I sued," and the other family agreed that this was reasonable. Neither family was lazy, or bad, or anything else like that. They had these horrendously handicapped children, and they were making the best decisions they could to give their kids a good chance in life. There has to be a better way for those families than suing the doctors that delivered the children, and we could come up with one.)

I am sure there are other possibilities. Again, this is kind of like the thread about bullying. First, we have to THINK. Then we have to ACT. And even if we are "little people" we can talk to our friends, family & neighbors, and we can write to our Congresscritters and others.

 

[wade]

Betsy, I love you but trust me, I'm not a "Little People".

 

[Lucille]

There has to be a better way for those families than suing the doctors that delivered the children, and we could come up with one.)

I work for a state program that provides funding for handicapped/ill children. I agree, suing doctors (unless they have in fact been guilty of malpractice) is not the answer.

 

[wstphal]

Betsy, I love you but trust me, I'm not a "Little People".

You mean, you're NOT a hobbit?! You've been LYING to me!

 

[kathylove]

I vote for Betsy to be the new "health czar" who will probably be appointed soon, if it hasn't already happened!!

No, no, no - on second thought, they wouldn't choose somebody with LOGICAL and REASONABLE ideas, lol!

 

[Austin M]

He was saying that since 65% of their patients are a loss to the hospital, and must be paid by the private sector, the price of insurance from private companies must keep going up to make up for the shortfall. And as the price goes up, more employers and individuals drop coverage. So the price goes up some more to cover Medicare / Medicaid shortfalls, AND the rising number of uninsured. And as the price goes up because of that, more drop insurance...and so on...unsustainable.

I understand what your saying about "more drop insurance" so insurance prices go up intamately. I agree it is unsastainable and that's why I said insurance has to fail. Sooner or later no one will be able to afford insurance. How did this country get to the point we need a financial instrument to pay for a service anyway? Who has insurance these days, government employees and employees of rich corperations???? Oh, and small business owners who can't afford insurance for their employees? The company I work for has been lobbying for years for help. We are on the front lines with double digit cost increases for insurance year after year.

I think the point was made earlier...if the government can't afford to cover the full costs of Medicare now, what happens as even more are added to Medicare and whatever other programs are implemented?

I get the point and agree with the point, but the point comes with VERY tough decisions. We can't afford Medicare now, and what happens when we have a flood of baby boomers who need Medicare? In my eyes the heart of this debate is...Who is going to pay for grandma and grandpa? Because no matter how much money grandma and grandpa have it will not be enough to cover the amount of care they will need. And yes that's without any other programs being implemented. If Medicare stopped today almost every nursing home in this country would stop with it. We may not want our government to ration our health care, but rationing is coming wether we like it or not, government control or free market.

This rich country isn't as rich as we think it is, or we're not as rich as we used to be. I like Warren Buffets illustration of America as an island. He called us squanderville. http://www.youtube.com/watch?v=bGo_NL-eclw
And your property isn't worth what it used to be either.

 

[wade]

I understand what your saying about "more drop insurance" so insurance prices go up intamately. I agree it is unsastainable and that's why I said insurance has to fail.

No Austin I don't think you understand what she is saying. He is saying that 65% of the patients are on Medicare and Medicare doesn't pay the hospital enough to cover the cost of their care. The hospital is loosing money of 65% of it's patients. That means the remaining 35%, you and me, have to pay enough to make up the difference. With the HCR we will all be on the governments teat. There won't be a 35% to pay the difference.

Who has insurance these days, government employees and employees of rich corperations???? Oh, and small business owners who can't afford insurance for their employees?

That is not quite true. In most states if not all, an employer cannot qualify for group insurance unless he also insures all of his employees. No Fat-Cats here either. As an employer if I offer insurance to anyone I have to insure everyone. No pick and choose. According to Obama, 85% of Americans have insurance. So it is not quite as bleak as you paint it.

I get the point and agree with the point, but the point comes with VERY tough decisions. We can't afford Medicare now, and what happens when we have a flood of baby boomers who need Medicare?

Good question? Better question, if we can't afford Medicare how are we going to afford to insure everyone instead of just the elderly?

We may not want our government to ration our health care, but rationing is coming wether we like it or not, government control or free market.

If we are to have rationing on the present market, I will chose what is right for me and my family. I will choose what I can afford and what I can live without. In the future Government Market a bureaucrat will make that choice for you.

This rich country isn't as rich as we think it is, or we're not as rich as we used to be. I like Warren Buffets illustration of America as an island. He called us squanderville. http://www.youtube.com/watch?v=bGo_NL-eclw
And your property isn't worth what it used to be either.

No question this country is not as rich as it used to be. Nobody will argue that point. Everyday I hear on the news about how Mr. Obama is spending more money than we have. Everyday. Makes me want to cry.

 

[Austin M]

No Austin I don't think you understand what she is saying. He is saying that 65% of the patients are on Medicare and Medicare doesn't pay the hospital enough to cover the cost of their care. The hospital is loosing money of 65% of it's patients. That means the remaining 35%, you and me, have to pay enough to make up the difference. With the HCR we will all be on the governments teat. There won't be a 35% to pay the difference.

Wade, your going to build me a house. I'm only going to pay you 65% of market falue. You better figure out how to make that house for less than 65% of maket value, or your out of business! If they cut cost they will be fine. Ford motor comany comes to my company every year and demands that we will make parts for less. We have no choise but to cut cost. Manufacturing can cut cost at unbeleavable levels, why can't health care? I am in the business of competing with slaves from the open world market, is the health care industry? I think I do understand from a business point of view....cost are too high. Pull governement money out and health care has less money in the system, whether it is profitable money or not.



That is not quite true. In most states if not all, an employer cannot qualify for group insurance unless he also insures all of his employees. No Fat-Cats here either. As an employer if I offer insurance to anyone I have to insure everyone. No pick and choose. According to Obama, 85% of Americans have insurance. So it is not quite as bleak as you paint it.

Ok, sorry small business owners are out then. I guess it's me AKA big bisiness and government employees that make up the majority of people with insurance? I'd like to see some official stats on who has insurance. Obviously this is just my opinion.

Good question? Better question, if we can't afford Medicare how are we going to afford to insure everyone instead of just the elderly?

Borrow more money, that's how. It will be awesome for a little bit! For those who don't know, BONDS are government debt. Bonds are our govenments credit card! Get out of American bonds while you still can!

If we are to have rationing on the present market, I will chose what is right for me and my family. I will choose what I can afford and what I can live without. In the future Government Market a bureaucrat will make that choice for you.

I could not agree more. I'm just saying everyone should be prepared for less than what they are used too?

No question this country is not as rich as it used to be. Nobody will argue that point. Everyday I hear on the news about how Mr. Obama is spending more money than we have. Everyday. Makes me want to cry.

I heard that for 8 years before him too, and many years before that too. Boy oh boy are we in for some hard times!

 

[wade]

Borrow more money, that's how. It will be awesome for a little bit!

Boy oh boy are we in for some hard times!

Let me guess, Democrat right?

I don't know what planet you live on by my planet is experiencing real hard times. For Real!

 

[Nova_C]

I've been following this thread for a little while and haven't really wanted to post in it, but there's something I'm not getting.

Currently, there are many private health insurance companies with various levels of insurance offerings. There are reports of people with pre-existing conditions being denied coverage as well as something like 32 million uninsured. From what I've been able to find out, many, if not most, of the uninsured use the ER as their 'family practice' when they have an issue they want to talk to a doctor about. The bill is then either written off by the hospital or covered by the government (State or Federal, not sure) if the people can't pay, and they usually can't.

Through all these threads on this forum, there have been many assurances that the insurance reform the Democrats have passed will make the system worse. Wade has talked about his child who was born with a heart defect (I was as well, although I haven't required surgery yet. I can understand how frightening that must've been, especially when he was a child) and how he was always able to get coverage so that needed care was provided.

So here's what I've been able to figure out between the two systems:

Currently, private insurance is doing a pretty good job covering for the people with coverage. Enormous health care costs aren't the result of insurance company gouging (They have profit margins averaging 2 - 6%, nothing egregious, but I've read a couple reports of their public quarterly announcements that show they spend anywhere from 20% to 40% of their revenue on advertising, which is a pretty serious amount), but of rising costs of materials, labor and equipment. Sounds reasonable. Further, there is a strong feeling that if someone wanted to get coverage, they could, under the current system and it is those too lazy or irresponsible who don't have coverage.

With the passed insurance reform, insurance companies will not be allowed to deny coverage for pre-existing conditions and the government mandates that everyone is covered, fining those that choose not to get coverage. This will add 32 million people to the insurance pool in the United States. I'm also pretty certain that the public option, that is, government sponsored insurance, was taken off the table in order to secure more conservative votes in the Democratic party. So this bill is more a regulatory bill, an insurance reform bill, than it is a health care reform bill as they aren't really changing the way health care is provided, but the way insurance is managed in the country.

Okay, so, following that information logically:

People with pre-existing conditions are, for the most part, getting the coverage they want.

People who don't have coverage are people who don't want it.

This insurance reform bill will force the people who don't want it to get it.

So this will add 32 million paying people (Through premiums or fines) to the insurance pool without actually changing the way health care is delivered.

My question is: If the expensive people are getting the coverage they need already, how is adding 32 million people to the insurance pool supposed to make health care more expensive? Doesn't logic dictate that adding that much revenue mean premiums can go down?

Further, how is reforming insurance in the country supposed to restrict R&D? Insurance companies don't perform medical R&D, universities and hospitals, pharmaceutical companies and tech companies do, and they'll still be getting their revenue streams.

Why are some doctors saying that they're going to quit being doctors when private insurance will still be the bulk of their billing? Obama is expanding Medicare and Medicaid, but not like what people are suggesting.

How is this supposed to be such a massive expense for the government and for hospitals when the uninsured are currently paying nothing into the system while going to the ER for medical care, and with mandated insurance, they'll be forced to pay into the system, regardless of whether they get a GP or continue to go to the ER for medical care?

 

[Austin M]

Let me guess, Democrat right?

Is that what you see me as? Or is that a comment meant to mean Democrats borrow money?

I don't know what planet you live on by my planet is experiencing real hard times. For Real!

I think I live on your planet? I may see things different than the majority? I was saying hard times are coming 5 years ago, while my co-workers thought I was nuts. Now I don't think we've seen the depths of where we're going yet.

 

[danielle]

Nova insurance companies give pharmaceutical companies and labs BILLIONS a year for R&D outspending our governments current grant money- this is a big deal in my opinion.

The uninsured pay into the system now without even knowing it- it's called state tax which in part allows the state to allow hospitals to write off a portion of their no pays- it's not 100% of course, but its a hefty portion hospitals are reimbursed and in most states when the uninsured go to the ER and are kept for a stay the state will go ahead and pay the hospital off.

I'm not sure how you figure private coverage will still make up the bulk of doctors salary when most corporations will be switching to government insurance because it will be cheaper by 20-80 percent from what I've read, but this means doctors will have to take a 20-80 percent pay cut per visit, procedure, test, ect... So I don't know about you, but if my job said take a 20-80 percent pay cut or quit- I'd quit. Why do you think the US currently has more doctors and nurses and Canada has a shortage? If your universal health care paid them more there would be more doctors and nurses eh?

"My question is: If the expensive people are getting the coverage they need already, how is adding 32 million people to the insurance pool supposed to make health care more expensive? Doesn't logic dictate that adding that much revenue mean premiums can go down?"

No logic does not dictate this Nova. 32 million people will be added to the GOVERNMENT health care plan which reimburses less hence driving up the cost of private insurance the same way no pays and Medicaid/Medicare recipients do now. The reason is hospitals and doctors will fight their lower wages by driving up private costs until those privately insured drop their private insurance which is what is already happening now on a smaller scale and the reason we have 32 uninsured in the first place. This new government plan will only intensify this effect not cancel it out.

"With the passed insurance reform, insurance companies will not be allowed to deny coverage for pre-existing conditions and the government mandates that everyone is covered, fining those that choose not to get coverage. This will add 32 million people to the insurance pool in the United States. I'm also pretty certain that the public option, that is, government sponsored insurance, was taken off the table in order to secure more conservative votes in the Democratic party. So this bill is more a regulatory bill, an insurance reform bill, than it is a health care reform bill as they aren't really changing the way health care is provided, but the way insurance is managed in the country.

Um no- when you add more people to a program that uses government funds to fund it you have LESS money for the program and more people to spread that money around to meaning we all get less...not more.

Okay, so, following that information logically:

People with pre-existing conditions are, for the most part, getting the coverage they want.

YES!
People who don't have coverage are people who don't want it.

NO, many people will still not be able to afford even this government care since there will still be a premium to pay. Those who are unemployed will feed their families, pay their mortgage, and cloth their children before paying insurance premiums because these are necessities and the reason why we have 32 million uninsured.

This insurance reform bill will force the people who don't want it to get it.

No, people who can't afford it will just be fined money they don't have

So this will add 32 million paying people (Through premiums or fines) to the insurance pool without actually changing the way health care is delivered".


How do you figure? Again more people with a need and limited funds to fund the program mean less service for more people. How is that good?

I think you have a vague understanding of how the American government works and how private insurance works. We are in a recession with the highest unemployment rates we have seen in a long time. Asking people to pay for something they can't afford now or be fined is not what this country needs right now by a long shot. Other government funded programs will lose money because this program will eat away a bulk of our resources and private insurance will fail in the next decade taking away funds that could further medical breakthroughs. Those that think bonds are simply the governments credit card are on a strange planet...bonds get cashed out at maturity so those who invest in these bonds will be expecting their guaranteed return and then what? Why do you think we owe China so much?

 

[Nova_C]

Why do you think the US currently has more doctors and nurses and Canada has a shortage? If your universal health care paid them more there would be more doctors and nurses eh?

Lots of studies have looked at this - in Canada, our malpractice insurance is cheaper by orders of magnitude, essentially evening the profitability of being a doctor or nurse. Our current shortage is the result of a lack of focus on education. That is, the government stopped encouraging people to train as doctors or nurses by no longer offering grants and burseries to people in those classes and as a result, we've seen less doctors and nurses graduate school. It has nothing to do with UHC.

No logic does not dictate this Nova. 32 million people will be added to the GOVERNMENT health care plan which reimburses less

How much less? I haven't heard any numbers regarding how much they plan on paying, just a lot of assumptions based on the Medicaid/Medicare programs, which are different than government sponsored insurance.

Um no- when you add more people to a program that uses government funds to fund it you have LESS money for the program and more people to spread that money around to meaning we all get less...not more.

Users of the government insurance plan are paying into it, something that the currently uninsured aren't doing, thereby increasing the amount available.

NO, many people will still not be able to afford even this government care since there will still be a premium to pay. Those who are unemployed will feed their families, pay their mortgage, and cloth their children before paying insurance premiums because these are necessities and the reason why we have 32 million uninsured.

Here you even admit that people are paying into the system - but the poor who can't afford it will be subsidized - as they already are, meaning the money is already being spent. Or are we assuming people who currently use the ER for non-emergency issues are going to be costing the system more after becoming insured?

I think you have a vague understanding of how the American government works and how private insurance works. We are in a recession with the highest unemployment rates we have seen in a long time. Asking people to pay for something they can't afford now or be fined is not what this country needs right now by a long shot. Other government funded programs will lose money because this program will eat away a bulk of our resources and private insurance will fail in the next decade taking away funds that could further medical breakthroughs.

That's pretty reactionary - private insurance will fail? That's a bold prediction considering the sheer amount of money flowing through the industry. Can you elaborate?

Those that think bonds are simply the governments credit card are on a strange planet...bonds get cashed out at maturity so those who invest in these bonds will be expecting their guaranteed return and then what? Why do you think we owe China so much?

I don't understand the relevance of this part.

 

[danielle]

Nova, Medicare and Medicaid are government health insurance so yes they are the same thing and as it is the elderly can't afford their insurance and prescriptions because most are low income.

With insuring more low to moderate income individuals we will be spending more to insure them so yes I assume cost will rise wouldn't you? If you buy one gallon of milk it is cheaper than buying ten yes?

I also know for a fact government health care reimburses less than private insurers thats why the US currently spends so much more compared to other countries, why people complain about the cost of private insurance, and why the elderly accept Medicare in the fist place. Go on Medicare's site and look at their reimbursement schedules to providers- its a fraction of what private insurance pays for the same procedures.

As to why I see the private industry going under its because there WON'T be a ton of money going through it anymore and you need money to operate any business. In my State employers are already looking into the government plans to save money on employees plans. With our government mandating business's to offer coverage on a larger scale than they do now they won't have much choice. Either lose a ton of money, or go with the government plan so yes the private industry will lose money and slowly but surely we will see fewer and fewer private insurance companies in business.

My comment about bonds was directed toward Austin. People buy into government bonds that mature usually in 10-20 years. That means our government pays out the bonds at maturity to the investors at a premium. Bonds earn interest so whatever you buy them at once they mature you get what you paid in plus interest. If our government sells health care bonds like say treasury bonds they will get a quick influx of money to start, but have to pay it all back plus some which is counterproductive unless you expect to make a lot of money with government health care. Since Medicare and Medicaid are negative in funds I don't see this national plan making our government rich- does that make sense?

I don't get your point about people using the ER when insured or not. My point is the government is mandating we have insurance or fining us. Even with subsidizing the poor like they already do with Medicaid these people will have to pay something and many many families simply aren't in the position to do this. People are losing their homes, defaulting on mortgages, and scraping by to feed their families using food banks at alarming high rates- they can't afford a premium and now they will be fined

 

[Austin M]

Those that think bonds are simply the governments credit card are on a strange planet...bonds get cashed out at maturity so those who invest in these bonds will be expecting their guaranteed return and then what? Why do you think we owe China so much?

Let me explain my strange planet. All I was trying to say is our government spends more money than is brings in. It does this by selling bonds. It owes the debt plus interest. So I was saying our government uses bonds kind of like individuals use a credit card. You know, you don't have enough money to buy something so you "charge it". The governments bill it owes plus interest from it's bonds are outrageous.

On the flip side of the coin, those individuals who own American bonds are holding the governments debt. The government might as well give bond holders a piece of paper that says IOU. It is my personal belief that the government's debt plus interest, in the form of bonds, is so high it is only a matter of time before it defaults on those bond obligations. That's why I said get out of bonds while you can. Again, it is my opinion that American bonds are a VERY risky investment these days.

It seems my strange planet is foreign to most people?

 

[danielle]

Well Austin than I misunderstood you because that was my point exactly The government will lose money on this health care bill and anyone silly enough to invest in it might as well kiss that money goodbye because theres no way government will make a profit with a plan as widespread as this.