Obamacare and the GOP: Watch What Happens!

[kathylove]

I don't know enough about the statistics of what is spent, and where, to know the best amount for a deductible. But I am under the impression that A LOT of spending is just for rather minor stuff (compared to that which requires a hospital stay). But it all adds up, especially when nobody comparison shops, because "somebody else" is paying, and there is no incentive.

The deductible needs to be high enough to encourage a lot of shopping for as much non emergency care as possible to promote competition. But it needs to be low enough that most people won't be bankrupted by having to make payments to satisfy it, if they don't have some kind of supplemental coverage or an HSA to draw from. Exactly what that deductible amount should be, I would leave up to accountants and practicing health care professionals to suggest.

 

[danielle]

Oh Kathy I agree with a 5K deductible so long as our government would cover costs exceeding this amount per incident. This is where our government needs to be...on the outside with funds to help those who can not afford insurance or who's care exceeds what the private sector can provide. On a state level programs like these already exist, and on our federal level we have the disaster we call Medicaid. However, if the private sector COULD work together with the federal government and not be pumbled by them we could have a program where the two co-exist and set guidelines for where financial responsibilities lie.

For example:
All uninsured children under the age of 21 should be covered
Tax kick backs for companies that provide affordable health care should be in place
Subsidies on the state level should exist for smaller companies to give them the same opportunity in providing health care to their employees
All person's over the age of 65 should be covered without the crazy Medicaid limitations
A 2% per person tax increase annually to cover costs ONLY toward health care and not our governments pocket
Coverage for those privately insured for specific care because of preexisting conditions via the federal government
Coverage for lifetime caps via federal government as well
And finally the one that will raise hackles- kick backs to our private sector for their R&D endeavors

Most people don't realize private insurance companies only gross about 4% profit a year... 4% profit would close the doors of most business's and are the reason for the stringent qualifiers in place now. Insurance companies have a huge hand in the research and development of preventative care, prescription drugs, and studies on morbidity in the areas of cancer, cardiovascular, renal , respiratory, neurological, and hepatic disease which exceeds our federal governments contribution to these studies 10 fold literally. We need these companies to continue their research and we also need them to continue to provide the quality of care we receive now- they need help not a take over. Why not support them in their endeavors and lighten their load by insuring high risk and low income patients preserving the industry?

 

[kathylove]

"...We need these companies to continue their research..."

If we (US citizens) were allowed to import our drugs from Canada (or any other country with the same, or higher, standards as ours), then competition would probably make our prices fall, and prices for the rest of the world, rise. Then the prices wouldn't be artificially high or low anywhere, and prices would have to support the research as well as the production. I don't mind US citizens PARTIALLY subsidizing prices in really poverty stricken countries around the world. But I don't think prices here should subsidize those in Canada, Europe, or Japan.

 

[danielle]

I agree with that too. It's never made sense to me that our country is the primary developer of prescription drugs yet pays more for our prescription drugs than the countries we sell them too. I think we should be recouping costs via higher prices to market and sell our drugs abroad decreasing our costs here, and allowing for cheaper prescriptions. I have to say I am ignorant to why we endure the financial brunt though since it seems like common sense. Developers spend billions before and if their drugs ever meet the market yet we pay the price of medical advancement. I'd rather our government charge these other countries more instead of stoop to importing exported drugs though. I know the US owns and operates pharmaceutical companies all over the world, but buying drugs we invented abroad to cut our cost is backward. Make them pay for the labors of our hard work and reduce prices here keeping American money in America where it belongs.

 

[kathylove]

I don't know all of the ins and outs of pharmaceutical marketing. But I think it has to do with the way various buying groups use their power of volume buying. Whether it is big insurance companies or various governments that purchase in bulk, those who do the best negotiations probably get the best prices. I am just guessing this from various articles I have read over he past few years. I am guessing it also has something to do with campaign contributions from big pharma to various politicians here. If so, then buying from other countries would allow citizens to bypass the corruption of our own system to set the market right.

Sad, but possibly the best option. Good for discussion, anyway.

 

[danielle]

Never looked at it that way Kathy definitely something to think about. But aren't all governments corrupt in some ways? If pharmaceutical companies could recoup R&D costs by selling at a higher price outside the US costs could be lowered here. Assuming these other countries would continue to buy our drugs at an increased cost of course maybe thats our issue. We sell our drugs primarily throughout Canada, Europe, and Asia where socialism reigns. These countries can only afford to buy a drug at x amount of dollars, but make for more sales than we have here individually in the US. I guess we figure sales dropping would be more detrimental than asking our country to pay more? Never thought of that for sure, but then it raises the question if we buy abroad taking money out of our own mouths what happens to our pharmaceutical companies? They'd have to cut R&D and we'd be back at square one Kinda like outsourcing jobs saves money in the short run, but does nothing to provide jobs and stimulate the economy here- there are no right answers in some ways it's about choosing between 2 evils

 

[tyflier]

Thank you Betsy I've been screaming these ideas since before Obama was elected. There is a way to keep private insurance going and improving it. Allow some government competition in the form of insuring high risk patients who NEED it most. Private insurance would not crumble under a monopoly and citizens who can and chose to insure themselves would continue to have the same options they do now with a safety net should they be dropped. If private insurance doesn't want to cover them our government should. My niece has cerebral palsy and is 6- she maxed out her lifetime cap at the age of two

There just seems to be soooooo many common sense options our government has not looked into and I wonder why? A federal program can coexist without stifling the private sector by covering a smaller, but more needy portion of US citizens. Taxes and inflation would not be as drastically affected, more people would have coverage, and our quality of care could be increased. I'm at a loss with our governments all or nothing stance

I hate to say it, but this seems to be precisely what "Obamacare" IS offering...another option, one that protects those that are unable to be insured by private insurance companies, be it due to affordability, lifetime caps, or whatever other reason.

The healthcare reform does NOT do away with private insurance, it limits their ability to change the rules as they go along, such as charging someone premiums every month for 20 years, than denying them coverage when the cost exceeds the profit margin. You know...the little things.

Private insurance will still be available to all those that wish to continue paying in to it.

Not only that, any government offered options will require premiums and operate much along the same lines as private insurance does, except they don't make a profit.

Wstphal makes a lot of good points. There are a TON of issues in our healthcare system that NEED to be addressed that HAVE NOT been addressed. However, contrary to what many seem to think, the legislation is NOT socialism, is NOT a monopoly, and does NOT deny private insurance companies the right to exist or citizens the right to use them.

 

[kathylove]

"But aren't all governments corrupt in some ways?..."

IMO, governments, in time, will tend to become as corrupt as they are allowed to become. The more power at the top, the more secrecy, or the less power the citizens have, the more corruption in the upper levels. It is just "the nature of the beast" - IMHO. That is why it is important to keep power decentralized, and out of the hands of a few "ruling elites".

I am pragmatic - I go for whatever works in a logical and more or less fair manner. I think that big buying entities will try to bargain the price as low as possible. As long as big pharma knows their R & D is subsidized by US customers, they can afford to lowball in other countries. If it becomes clear that the subsidy has dried up - whether because of new, harder bargaining from US buyers (whether private or government agencies), or because of the US market drying up as buyers purchase offshore, then they will not be able to accept the prices they have accepted previously, and still stay in business. Pretty much like any other business.

Maybe somebody with actual experience in the way this market works will be able to comment more on the whole process.

 

[danielle]

Chris you know I agree our health care system needs reform- but we'd be ignorant to think the government will not make money from offering care, or that a monopoly will not arise in time. Many people who insure themselves privately do so at a huge financial cost which has become even harder with the state of our current economy. If government allotted money for only costs private companies won't cover it would be cheaper in the long run than what our government is proposing now with taking over the complete care of all patients under their system. Sure people CAN chose to continue paying for their private care but how many will with a free or reduced government option? There will be more people clambering for the government option with people dropping their private coverage creating in time a monopoly on health care. Insurance companies won't be able to recoup their 4% profit and we will see these private companies go under slowly. By then our government will have more people than money to go around and we will see the issues other countries see now with ridiculous waits, under staffing, and scarce medical resources. Yes we already have these issues here, but not like abroad.

ObamaCare wants to insure too large a population instead of work with the private sector. Why not just pick up the slack- the money these private companies won't give out, insure children, and our elderly? Not that our country is insuring our elderly well now though If we can't provide complete care to those with Medicaid we surely can't add another 40 million to this agenda- it won't work either. There needs to be more government support of business's that provide health care making it more affordable to them and government funds allotted to those who are privately insured, but can't have certain medications, treatments, tests, or care per their insurance company. Why can't our government pick up these extra needs and still support the private sector? Because the government knows there is money in health care and not because they care about increasing the number of insured Americans

 

[kathylove]

I suspect that it will turn out something like public education. Lots of people DO opt out of public schools and pay for private schools. Yet they still have to pay taxes to support the unused public school. Most families can't afford to pay for both, and so send their kids to public schools. I know that the government does not plan to run and fund the 2 systems exactly the same way. But I think there are enough parallels to make a person think about it.

The difference is that health care is such a bigger bite of the economy compared to educating children. Think of how much the average homeowner pays for schools in property taxes. Now consider how many of those homeowners have NO children in public school - but ALL in their household are likely to use health care at some point. That will be expensive, no matter who pays for it! Whatever positive or negative policies are put into place will be greatly magnified when compared to our public school system. And from what I gather after talking to a lot of teachers, this is another system that is not totally run by the Feds, yet the mandates coming from upon high prevent local school districts (especially teachers and parents) from making decisions that might be best for their own local needs. I have yet to meet a public school teacher who is at all happy with the efficiency and organization of their own school. Politics seem to have run amok in the public school system, and I have no reason to believe that politics will mix any better in our HUGE health care system.

 

[tsst]

... when the cost exceeds the profit margin.

Private insurance will still be available ...

These two things cannot coexist.

When private companies start to fail because of the forced extra costs the glorious gov will rush in to save the day. The political backers of this law will be preaching how they should have done more to begin with. We will end up with gov healthcare for all. Long lines and rationing. A new huge bureaucratic system driving ever higher taxation. Our wondrous DC reps will of course have another source to borrow from like SS is for them now. The borrowing will in turn lead to budgetary disasters for the system. We will then be looking at ways to cut costs like late life planning just as we are looking at raising the retirement age for SS now. :shrugs:

 

[jpccusa]

IMO Health Care Reform was needed. Private companies are abusing the system.

Is this reform a perfect one? No, just like an immigration reform won't be either. But I see as a positive change that can be tweaked here and there in time.

Hopefully we'll have Danielle's idea some day. Those who can afford a "Ferrari" pays for. Those who are happy with "public transportation" will have that available as well. The most important thing is for everyone to have means to get "from here to there."

 

[kathylove]

"IMO Health Care Reform was needed. Private companies are abusing the system."

That is ONE thing we can DEFINITELY agree on! I just hope that in this case, the "cure" isn't worse than the "disease". I would have rather seen the "tweaking" first, and resorting to these drastic changes only after the tweaking failed.

What I am afraid of is that it won't be the desire for a Ferrari that prompts people to forsake public transportation, but the desire for (and memory of) their solid, good, ol' Chevy or Ford that they may feel is out of reach once most are on the public bus system.

 

[Fatman608]

"Obamacare" Page 838 Brings Criticism

"Obamacare page 838, "Dirty Secret #1," or however you want to refer to it should terrify you. Basically page 838 of Obama's "plan" talks about providing and giving the right to people to enter homes if it is felt that parents aren't raising their children right. Page 838 reflects the fear felt by many people who are starting to feel that Obama either doesn't know what he is talking about or has a much different agenda."

by Gary Davis, Yahoo! Contributor Network

Love the Fatman

 

[Duff]

"Obamacare page 838, "Dirty Secret #1," or however you want to refer to it should terrify you. Basically page 838 of Obama's "plan" talks about providing and giving the right to people to enter homes if it is felt that parents aren't raising their children right. Page 838 reflects the fear felt by many people who are starting to feel that Obama either doesn't know what he is talking about or has a much different agenda."

by Gary Davis, Yahoo! Contributor Network

Love the Fatman

Do you EVER think for yourself?? This is yet another political spin to distort the truth and spread more fear and hate. This provision (or whatever you want to call it) is about establishing a VOLUNTARY service for those parents that want to take advantage of it. It's something to HELP parents. If I have missed the part that states this would allow the government to enter anyone's home, without invitation, then please post a link to the actual text, not another rehash of a slanted blog entry.

:headbang:

 

[Fatman608]

Do you EVER think for yourself??

Look on page 838 or is that to hard for you to do.

Love the Fatman

 

[jpccusa]

Look on page 838 or is that to hard for you to do.

Are you trying to say you actually read and understood page 838 of the Health Care Bill? Or are you just repeating what Gary Davis (or actually Chuck Norris who actually wrote the article in 2009) said?

Besides, page 838 of the bill may no longer be part of what we actually got as a health reform (president Obama actually compromised a lot of points proposed on the bill in order to have it passed).

 

[tyflier]

"Obamacare page 838, "Dirty Secret #1," or however you want to refer to it should terrify you. Basically page 838 of Obama's "plan" talks about providing and giving the right to people to enter homes if it is felt that parents aren't raising their children right. Page 838 reflects the fear felt by many people who are starting to feel that Obama either doesn't know what he is talking about or has a much different agenda."

by Gary Davis, Yahoo! Contributor Network

Love the Fatman

First of all, the article was written before the bill passed. It's very likely, given the amount of trimming the bill went through before passing, that it was removed.

Second of all...this already exists. It's called "Social Services", and if they recieve a report from any concerned citizen about possible neglect or abuse, they are required to investigate. This means they come to your house, knock on the door. If you answer, and they see any cause for concern, they can immediately recieve a warrant for police intervention. If you don't answer your door, they have every right to "snoop around" by looking in your windows, garbage, yard, vehicles, or any other location that does not require the opening of a door in an effort to discover reasonable suspicion.

All it takes is a single phonecall from one "concerned citizen" (or angry ex-spouse) to intiate a mandatory investigation. A bruise on your child's face could result in a phonecall from a teacher(required by Federal Law to report suspected abuse or neglect). Dirty clothes worn to school, prolonged sickness, bruising or swelling deemed "unnatural"...any of these things can result in an immediate investigation within which the parents have very few rights to privacy in an effort to protect their children from possible abuse or neglect.

Doesn't it suck when you get all bent out of shape about something that has existed for 35 years or more?:shrugs:

 

[wstphal]

...any of these things can result in an immediate investigation within which the parents have very few rights to privacy in an effort to protect their children from possible abuse or neglect.

And amazingly, the agencies in charge of these investigations manage to spend months "investigating" parents who probably haven't done anything wrong while overlooking parents who go on to murder their children.

I firmly believe that it's necessary to protect children from genuine abuse & neglect, and that these are very real problems. But here in MA we've had a couple of high profile child deaths that slid right past the agencies that were supposed to protect the children, and I've come in contact with people who spent months tangled in the CYS system after their ex-spouse dropped a dime on them for revenge reasons.

So although I am not advocating for elimination of these agencies, I do wonder how well they really function at protecting children. And in my relatively libertarian playbook, protecting those who cannot protect themselves is one of the KEY functions of the government, and children are the group most deserving of protection, because they are not physically, mentally or emotionally ready to protect themselves from things that most adults can handle, so they need help from private individuals and the government to keep them safe until they mature.

 

[Duff]

Do you EVER think for yourself??

Look on page 838 or is that to hard for you to do.

Love the Fatman

Ok, I'll prove my point, even though one of the most basic rules of debate is the one making the claim bears the burden of proof. But this is just too easy. So yes, I do indeed think for myself. I really wish there was a way to make that a requirement for voting registration.

___________________________________________________________

H. R. 3590—838
‘‘(e) ENVIRONMENTAL EXPOSURE AFFECTED INDIVIDUAL
DEFINED.—
‘‘(1) IN GENERAL.—For purposes of this section, the term
‘environmental exposure affected individual’ means—
‘‘(A) an individual described in paragraph (2); and
‘‘(B) an individual described in paragraph (3).
‘‘(2) INDIVIDUAL DESCRIBED.—
‘‘(A) IN GENERAL.—An individual described in this paragraph
is any individual who—
‘‘(i) is diagnosed with 1 or more conditions
described in subparagraph (B);
‘‘(ii) as demonstrated in such manner as the Secretary
determines appropriate, has been present for
an aggregate total of 6 months in the geographic area
subject to an emergency declaration specified in subsection
(b)(2)(A), during a period ending—
‘‘(I) not less than 10 years prior to such diagnosis;
and
‘‘(II) prior to the implementation of all the
remedial and removal actions specified in the
Record of Decision for Operating Unit 4 and the
Record of Decision for Operating Unit 7;
‘‘(iii) files an application for benefits under this
title (or has an application filed on behalf of the individual),
including pursuant to this section; and
‘‘(iv) is determined under this section to meet the
criteria in this subparagraph.
‘‘(B) CONDITIONS DESCRIBED.—For purposes of subparagraph
(A), the following conditions are described in this
subparagraph:
‘‘(i) Asbestosis, pleural thickening, or pleural
plaques as established by—
‘‘(I) interpretation by a ‘B Reader’ qualified
physician of a plain chest x-ray or interpretation
of a computed tomographic radiograph of the chest
by a qualified physician, as determined by the
Secretary; or
‘‘(II) such other diagnostic standards as the
Secretary specifies,
except that this clause shall not apply to pleural thickening
or pleural plaques unless there are symptoms
or conditions requiring medical treatment as a result
of these diagnoses.
‘‘(ii) Mesothelioma, or malignancies of the lung,
colon, rectum, larynx, stomach, esophagus, pharynx,
or ovary, as established by—
‘‘(I) pathologic examination of biopsy tissue;
‘‘(II) cytology from bronchioalveolar lavage; or
‘‘(III) such other diagnostic standards as the
Secretary specifies.
‘‘(iii) Any other diagnosis which the Secretary, in
consultation with the Commissioner of Social Security,
determines is an asbestos-related medical condition,
as established by such diagnostic standards as the
Secretary specifies.
‘‘(3) OTHER INDIVIDUAL DESCRIBED.—An individual
described in this paragraph is any individual who—