Obamacare and the GOP: Watch What Happens!

[jpccusa]

My "c&p BS" had nothing to do with how good the Obamacare is. Perhaps you should re-read the rhetoric of my op.

As for your direct question, I work with hemophilia patients. The medicine that they use to prevent/treat bleeds is really expensive. All of them are really happy that lifetime caps and pre-existing conditions are going away. They are also happy about being able to stay on their parent's health plan until they are 26 years old if needed - ALL OF THEM, without exceptions.

I also have friends all over the world (Canada, New Zealand, South Africa, Brazil, Paraguay, England, France, Spain, etc.) and many of these countries have a government regulated health care systems. Many of my friends don't understand why there are people against Obamacare (hopefully with your help I'll be able to tell them a reason). As examples, AIDS medicine in Brazil is free of charge, as well as many types of vaccines.

So by all means Gulf Coast Girl, please elucidate us with your vast knowledge on this issue... I'm always up for a good debate with knowledgeable people who present good points.

 

[tyflier]

Question to the OP.....Do you actually have knowledge of the Obamacare legislation AND the inner workings of healthcare industry or are you just spewing rhetoric in an attempt to get sheep to follow you?

Since when does one need knowledge of the inner workings of an administration to support it's policies? Also...since when does one need intimate knowledge of the inner workings of a hospital to know that they are not being treated fairly by insurance companies?

I ask because I actually DO have experience in the healthcare industry... over 20 years in fact.... and on all sides of the business.... so I'm WELL aware of what this Obamacare BS REALLY means.

So what? Does your work experience change my insurance company experience? No? I didn't think so. Neither does your work experience change my hospital experience, doctor visitation experience, or ability to afford the exponentially rising cost of private insurance.

Fortunately, the individuals responsible for writing and passing the legislation know alot more than you do...

If you would like to debate it, then by all means state clearly YOUR thoughts on it and not some c&p BS you picked up on some left wing blog.

I look forward to this.... I really do....

Well...we know what your thoughts are. But I'd still be interested in seeing which parts, specifically, you find utterly detrimental to our healthcare system. And if you could, please refrain from using propogandists phrases such as "Obamacare" when doing so. It would be really interesting if you could state concisely and clearly exactly how the healthcare reform is going to make things worse for us, as civilians.

Bear in mind that most of us don't care how it effects insurance companies, only how it effects us, individually, and our own level of affordable care and insurance.

There is an awful lot of big talk in your post. Hopefully you can bring something more than "socialism" and "death panels" to the table to back it up...

 

[Outcast]

Fortunately, the individuals responsible for writing and passing the legislation know alot more than you do...

I sincerely doubt that the individuals responsible for writing and passing legislation actually care, look at how big this legislation for healthcare is. How many of them do you think actually read it? With that in mind, how many of them voted for/against it, just because it was proposed by someone from their party?

From what I have seen, and this goes for every group ever elected in the time I can remember, is that they want to be remembered for something, whether it is good or bad, they was to make a change so dramatic that they go into the history books, no matter how good or possibly detrimental to our society it is.

 

[Fatman608]

jpccusa said
"Obamacare and the GOP: Watch What Happens!"

The GOP will get more seats in the House and Senate.

Love the Fatman

 

[Fatman608]

tyflier is right "Obamacare" is nothing more than propoganda. For a president that will last only one term.

 

[wstphal]

As for your direct question, I work with hemophilia patients. The medicine that they use to prevent/treat bleeds is really expensive. All of them are really happy that lifetime caps and pre-existing conditions are going away. They are also happy about being able to stay on their parent's health plan until they are 26 years old if needed - ALL OF THEM, without exceptions.

As long as we don't run out of $$, these provisions are going to be very good for the patients you work with. My concern is that like NHS in Britain, there will be more and more limitations on what medications are covered, with the most expensive medications, like the ones the patients you work with need, becoming harder and harder to get. (Likewise, the most expensive tests and procedures may well get harder and harder to obtain, like MRIs, elective heart surgeries and elective orthopedic surgeries.) Right now we have a 3 tier system IMHO. People with no insurance get nothing, people with bad insurance get some health care and people who are rich or who have excellent insurance get every health care service that could benefit them even slightly and some that clearly don't benefit them.

The NHS found out that there is NO financial way to give everyone all the health care they could possibly derive any benefit from. So they started trimming around the margins. Here's an example:

http://www.guardian.co.uk/society/2009/aug/14/nhs-cancer-drugs-postcode-lottery

It may well be more fair than how we do it. I'm not, in this post, advocating one way or the other. Just pointing out that NO country has figured how to give everyone everything. Britain spends a lot less on military spending than we do, so you can't say their inability to have the NHS give everyone every health care option that has been invented is due to spending too much on their military, but they still can't manage to do it.

IMHO, we need to have a national conversation about how much health care is enough in what circumstances, and figure out, as a society, where we can best cut back health care spending and where we should add more health care spending. Again, IMHO, the people you work with are a good place to invest our money. The medications they need may be expensive, but in return we as a society gain years of their activities in working, raising families, doing volunteer work and otherwise making useful contributions to our society. I do NOT think that only taxes paid matter. Someone who does volunteer work benefits all of us too.

I'm not advocating for "Obamacare" or for the Republican Party opposition to it, or for the tea party-ers here. Nor am I a shill for the health insurance companies. I work in health care too and I DETEST them, I spend 10-20% of my time trying to justify to them what our patients need and it gets more time consuming and annoying every month.

But we could spend well nigh the entire GDP on health care and have NONE for defense, Social Security or other programs that we might want to have continue, and to avoid going down that path, we need to have this conversation as a society, person to person, and then make our opinions known, loudly if need be, to our elected officials, so that as "fixes" for the health care legislation are crafted, they include measures that will help. Simply chopping health insurance companies' profits down to a smaller level will only help us ONCE and then the problem will come back if we don't do the thinking and the communicating with one another.

 

[wstphal]

As examples, AIDS medicine in Brazil is free of charge, as well as many types of vaccines.

The entire world piggybacks on US spending for drug and vaccine development. That's one of the reasons why AIDS medications are free in Brazil. The NIH, along with various other organizations, paid for huge chunks of the cost of developing these drugs. Large pharmaceutical companies also spent money on it. Almost all of the recovery of those development costs paid by industry is paid by US residents in the high costs of prescription medications here. The US taxpayer pays for NIH. The Bill and Melinda Gates Foundation is paying out immense sums of money to develop vaccines for various diseases. A lot of that money came from US in the form of $$ paid to Microsoft over the years. Mind you, I think the Gates Foundation is a GREAT thing. Bill Gates is so rich it's mindboggling and I am happy he is putting some of that money to work helping people instead of buying exotic cars, but a lot of it came out of the US economy in the first place.

Most industrialized nations have capped payments to pharmaceutical companies at the cost of drug manufacturing. So have many developing nations. Some have decided to ignore the patent laws and manufacture the medications themselves and pay NOTHING to the patent owners. I believe Brazil is in this latter category with regards to AIDS medications. Never mind profits, if the pharmaceutical companies simply want to break even on drug development costs, they have to charge high prices here because they get paid drug MANUFACTURING costs (which are much lower, pennies to a few dollars per dose) in the rest of the world. Then, of course, pharmaceutical companies are in the business of business, which includes profits so that raises the price even higher for us. I would really like to see drug development costs spread out over the other industrialized nations. It just doesn't seem fair that, say, French or German citizens aren't paying for drug development. I'm not talking about PROFITS here. The issues are separable. I am talking about the cost of laboratory research and clinical research to find medications that are reasonably safe & effective.

 

[kathylove]

You must spread some Reputation around before giving it to wstphal again.

THANKS for all of the logic and facts! I want to put you in charge of the whole mess, lol! (but you would be crazy to accept the appointment, even if I could make it!!)

 

[danielle]

I love you Betsy we have had these discussions more than once and the points remain the same. Government funded health care in other countries do not work to serve the majority with what they need in a timely fashion- waiting 6-12 months for an MRI IS the difference between life and death for many patients. Having a government decide what medication we can and can't take also does nothing to serve the people that need them- politicians do not have a medical degree and HAVE NO place in deciding what they will and will not cover. My insurance covers what my doctor prescribes and that works for me.

I also resent the idea that people think this is going to be free care- it's not going to be free the money has to come from somewhere. So we will have to decrease our military, federal spending, and raise taxes to half ass support a program we can't afford- look at our national debt! I also don't get the argument this plan is not socialist. Asking a nation to up the ante so all can have one service makes the service socialist. I have private insurance yet I won't get a tax break for paying for my own care and my kids won't be allotted extra money for their education. I don't have a choice to support or decline government care because either way it is going to come out of my families pocket. Money will be taken from those with private care until the government program is all we can afford. Private insurance is going to go up as people dump their monthly insurance payments for government care creating a monopoly. The less private companies take in the more their premiums will be to recoup costs- government wins in the end and they know it covering their deceit with the notion it will be a choice- choice my arse!!

The government is also NOT going to shell out what private insurance companies do a year in R&D because like now they can't afford to which only retards medical advancements and RAISES the overall cost of care.

Why not create a government program that only covers what private care will not, all citizens 65 and older, and all children under 21 without private care?

Make the government kick in when lifetime caps threaten care or when those with chronic issues are dropped which by the way happens rarely if you actually look at statistics. I'm not against our government funneling more of our tax dollars to us instead of their pockets, but a program of this scale is going to deplete money we don't even have and degrade the care we get now

 

[v_various]

The entire world piggybacks on US spending for drug and vaccine development. That's one of the reasons why AIDS medications are free in Brazil. The NIH, along with various other organizations, paid for huge chunks of the cost of developing these drugs. Large pharmaceutical companies also spent money on it. Almost all of the recovery of those development costs paid by industry is paid by US residents in the high costs of prescription medications here. The US taxpayer pays for NIH. The Bill and Melinda Gates Foundation is paying out immense sums of money to develop vaccines for various diseases. A lot of that money came from US in the form of $$ paid to Microsoft over the years. Mind you, I think the Gates Foundation is a GREAT thing. Bill Gates is so rich it's mindboggling and I am happy he is putting some of that money to work helping people instead of buying exotic cars, but a lot of it came out of the US economy in the first place.

Most industrialized nations have capped payments to pharmaceutical companies at the cost of drug manufacturing. So have many developing nations. Some have decided to ignore the patent laws and manufacture the medications themselves and pay NOTHING to the patent owners. I believe Brazil is in this latter category with regards to AIDS medications. Never mind profits, if the pharmaceutical companies simply want to break even on drug development costs, they have to charge high prices here because they get paid drug MANUFACTURING costs (which are much lower, pennies to a few dollars per dose) in the rest of the world. Then, of course, pharmaceutical companies are in the business of business, which includes profits so that raises the price even higher for us. I would really like to see drug development costs spread out over the other industrialized nations. It just doesn't seem fair that, say, French or German citizens aren't paying for drug development. I'm not talking about PROFITS here. The issues are separable. I am talking about the cost of laboratory research and clinical research to find medications that are reasonably safe & effective.

Wait, what? France was tied with the US for a lot of aids research credit. IDK, I've read a lot about this subject and not a lot of what you say makes sense.

http://www.virusmyth.com/aids/hiv/phgallonyt.htm

http://www.pbs.org/wgbh/pages/frontline/aids/view/

 

[jpccusa]

You must spread some Reputation around before giving it to tyflier again.

You must spread some Reputation around before giving it to wstphal again. (thanks for both very well explained posts Betsy!).

 

[wstphal]

Wait, what? France was tied with the US for a lot of aids research credit. IDK, I've read a lot about this subject and not a lot of what you say makes sense.

http://www.virusmyth.com/aids/hiv/phgallonyt.htm

http://www.pbs.org/wgbh/pages/frontline/aids/view/

France did a wonderful job on researching what caused AIDS and how it does so, and was absolutely tied with the US or ahead of the US (depending on what sources you read) in that area. Absolutely! I'm talking about development of 2nd & 3rd generation medications, not the elucidation of the cause of the disease or the isolation of the virus, or the understanding of how the virus kills. All of those areas were worked on extensively in France and French scientists deserve their fair share of the credit for it. And indeed, getting back to the money, French citizens ponied up a lot of their tax Euros to finance that critical fundamental science. Sorry if you thought I was discounting the French contribution to the science of AIDS. For that matter, researchers around the world have done immense amounts of work on the basic science, and on figuring out how best to use the medications at hand to fight the disease, and even more on trying to find ways to prevent the spread of the disease (other than trying to convince people not to have sex, which has been a whole separate issue that I don't consider scientific although it has a role to play). What the US economy is paying for that other developed countries aren't paying their share of, IMHO, is the cost of getting from "here's this cool molecule that based on its shape might well help fight AIDS" to "here's this medication which is approved in the Eurozone, Japan and the USA and is shown to work in conjunction with other medications to reduce viral load and allow the immune system to rebuild."

Edit: when I say "cost of getting from <here> to <here> I don't mean drug manufacturing company PROFITS. I mean the cost of reagents, tissue cultures, scientists' salaries, lab techs' salaries, copiers, computers, lab equipment, statisticians' salaries, things like that.

 

[wstphal]

Why not create a government program that only covers what private care will not, all citizens 65 and older, and all children under 21 without private care?

Make the government kick in when lifetime caps threaten care or when those with chronic issues are dropped...

Those are REALLY good ideas. That's one option we could pursue as a nation. That would make sure everyone had at least a minimal level of care, and that people with chronic or expensive diseases didn't get the shaft. Currently they do.

From rhrealitycheck.org:
"... a recent Reuters report reveals that insurer WellPoint has been systematically targeting recent breast cancer patients and dropping them from insurance coverage. This practice, known as rescission, was one that was supposed to be addressed in the healthcare overhaul recently signed into law."

Rescission is actually not uncommon. I heard an NPR interview with a patient who was dropped the day before she was scheduled to have a mastectomy. The insurance company told her it was because she had failed to disclose she had had skin cancer years earlier. Only she had NOT had skin cancer, she had had a lesion that was thought to be skin cancer so it was removed, and the pathology proved it wasn't skin cancer at all. But her insurance claimed her breast cancer was an undisclosed prior condition. It took months for her to sort it out, and I think her mastectomy got delayed for 6+ months IIRC, until she could get Medicaid.

From minnesotamedicine.com:
"Parents grapple with fears that their children will exceed their policies’ lifetime spending caps, which typically range from $1 million to $5 million. Johnson says it’s something he watches, but he has never reached a cap because his employers either changed insurance plans (which resets the cap) or he changed jobs. Right now, he has a policy with a $5 million cap."

So your suggestion could help a bunch of people for a relatively small cost to the rest of us. Hooray for lateral thinking! I wish more people would THINK as you did rather than reacting with knee-jerk slogans from other end of the political spectrum. Thanks for commenting on my post.

 

[wstphal]

[THANKS for all of the logic and facts! I want to put you in charge of the whole mess, lol! (but you would be crazy to accept the appointment, even if I could make it!!)

If I had enough dictatorial power, I would probably take the job. The main thing I would use my power to do is to get people thinking by public service spots, Youtube videos, etc, etc, and start moderated forums to get the conversation going without all the FBs & political posturing.

Americans have common sense, if somebody lays out the realities and options, they CAN come up with better than what we got in the reform bill. Danille just proved it with a great commonsensical suggestion that would not be a budget destroyer.

 

[danielle]

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

 

[wstphal]

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

So start a letter writing campaign. Outline what you are recommending. Send a copy by USnailMail to every member of the gang of 535 idiots and to President Obama. Send follow up letters every couple of months. See if you can meet your member of the House when s/he goes home after the lame duck session & pitch your idea. Keep trying. Single citizens can get heard if they are politely but unstoppably persistent.

 

[danielle]

Me take on health care,lol I'm one loud idiot and quite persistent, but I don't see our government responding to me Maybe circulating an internet petition with my ideas and lots of other similar minded people doing the same with mass mailing- but how would one start something of that scale. I work at the courthouse and am quite friendly with many judges, SA's, and lawyers- maybe I will pitch my gibberish to them and see if anyone bites.

 

[kathylove]

Kathy's fix for the health system (lol!)

What I always thought would really help is if virtually everyone was on some sort high deductible insurance that would cover the really expensive stuff - maybe $5K deductible. Then you would be covered for those really scary diseases or injuries. This high deductible insurance should be separate from any other coverage, and all insurance companies should be required to offer 1 or 2 basic policies that cover (and exclude) exactly the same things. Then shoppers can compare "apples to apples" and don't need a law degree to understand it all. They could also offer a zillion other, more confusing, options if they want to, as long as there are a couple of standardized policies to choose from.

These basic, high deductible policies should be kept to a reasonable cost, even for those who have preexisting conditions. Seems like a couple of good ways to accomplish that would be to allow anyone in any state to buy their insurance from any company in any state. And to allow groups of people, or maybe similar small businesses, to group together to get EXACTLY the same rates that a single, giant, company with the same number of members would get. Maybe there would have to be some government subsidies for low income people, although maybe Medicaid would take care of them.

But if that first $5K was coming out of a Health Savings Account that you put the money into (or maybe shared with your employer), then YOU would have the motivation to shop as carefully for those expenses as you do for groceries. I wouldn't mind expanding low cost (sliding scale, maybe) clinics for those who can't pay that first $5K. The services at such clinics should be as good as at private offices, but not as convenient. People who can afford it, will avoid long lines at free / low cost clinics, but the clinics should be there for those who have no other option. And those who run up a $5K bill (at the clinic or for private services) are much more likely to be able to make payments rather than be forced into bankruptcy, as so many are today. Maybe those clinics should be built next door to the hospital ER so that triage nurses could funnel the ear infections and other non emergency cases to the clinic with less expensive equipment and staff than an ER requires.

And that is not even discussing figuring out how to change our lawsuit happy culture so that patients still have rights, but that doctors don't have to perform unnecessary tests, and only the lawyers really do well from it all.

In my opinion, instituting reforms of some variation of the above would probably do more to help our mess of a system, with far less government growth and control, than what we are likely to get from what we are on the road towards right now (I haven't read it - I am guessing after seeing what has happened with other huge government programs). At the very least, "tweaking" it with programs such as the above, FIRST, before getting more government involvement, would have given some clues as to what else still needed to be done. Then we could have tackled each issue, preferably with common sense instead of political vote getting tactics.

 

[danielle]

Kathy and Betsy I need to enlist you too,lol The problem with the deductible only being 5K though is any hospital stay that exceeds 3 days exceeds 5K which is where our government could kick in again. So many better ideas and paths than the one we're on..........relieve do not destroy our private sector Obama.

 

[Outcast]

You guys are awesome, I love these idea's. I only wish I knew more about this kind of stuff.