Where health reform stands now
August 7, 2009 by Jim GiulianoPosted in: Employment law, Health care, Special Report
Four congressional committees have approved healthcare-reform bills. Here’s what’s been OK’d so far.
The approved stipulations are sure to be blended with and modified by other bills being considered, but here’s what’s on the table right now
- How much it’ll cost: $1.5 trillion spread over 10 years.
- How it’ll be paid for: $500 billion from cuts in Medicare and Medicaid, $580 billion in taxes, $200 billion in employer penalties for not providing coverage.
- Employer requirements: Except for small businesses — with annual payrolls of less than $500,000 — employers must provide health coverage.
- Employee requirements: Must have coverage or face a tax penalty, with exemptions for hardship.
- Who’s eligible for subsidies for coverage: Starting on 2013, those with incomes of up to 400% of the poverty level.
- What types of benefits coverage will provide: Hospitalization, doctor visits, prescriptions; no denials for preexisting conditions.
- How plans can be chosen: A National Health Insurance Exchange.
- Government plan: Available through the exchange.
- Uniform changes to Medicaid: The program will be available to all with incomes up to 133% of the poverty level, instead of leaving eligibility requirements up to the state.
Tags: congress, healthcare, reform
August 10th, 2009 at 8:06 am
So we are spending 1.5 trillion on roughly 50 million Americans with an estimate that 10 million of those are illegals. If you give them all $1 million, they can buy their own insurance for years and we’d only spend $50 million. Do the math Washington!!!
August 10th, 2009 at 8:51 am
So irresponsible! I find it unthinkable that Washington is dismissing the voices of honest, hardworking Americans, as a “manufactured mob”. Don’t they understand there would be no yelling if they would just listen!
August 10th, 2009 at 9:43 am
Deb – your math is a little off (1 million each for 50 million people is 2.5 quadrillion) but your point is well taken. It would be much cheaper to offer tax credits (or even cash payments direct to health insurers) on behalf of qualified (income qualification not health) and uninsured citizens. But this action by our government has little to do with health care. There is amazingly little problem solving being done and it is because the solution must fit their agenda and core beliefs first, and fix health care second. It is easier to understand what is happening when you understand the core beliefs they are operating from.
First, they believe that large corporations (perhaps all employers) are self serving and corrupt. There is no demonstrable confidence within our current government that private enterprise has any place in trying to solve any problem. In fact, the core belief seems to be that private enterprise is the problem. (unless we are talking about large contributing financial institutions.)
Second, they believe that the free market system, at least as applied to the health care industry, is broken and can not be trusted to correct health care cost issues.
Third, they believe the American public is incapable of understanding the problem and participating in the solution. What’s worse is that at least some elected officials believe the outcry of the American public is actually evil.
These three beliefs, combined with the belief that they alone truly understand the problem and can create a solution, prevents them from considering any option that does not include strong government control. They ignore the overwhelming evidence of government corruption; they discount the decades, actually centuries, of success demonstrated by the free market system; and they lack the humility to even consider that anyone but a politician or financial elitist can have any good ideas about solutions.
Our only hope is to threaten their livelihood by actually hold them accountable at the voting booth. Until we stand up and select individuals with integrity over arrogance, conviction over positioning, and transparency over smooth talking, we will get more of what we have had for more than 16 years; disconnected, power hungry, and self serving elitists that don’t really care about America or its people.
I am most afraid that we elect these people because they are like us. And that presents a set of problems that make health care look like Sunday brunch.
August 10th, 2009 at 9:51 am
BLC, please put this in a letter to your congress people. Well said!
August 10th, 2009 at 9:53 am
I wonder what the incentive is for small businesses is to grow if when they reach a certain level of success they are crushed under the weight of the cost of health insurance for their employees. The majority of the members in the legislative branch need to be fired. They are SO irresponsible.
August 10th, 2009 at 9:55 am
BLC – you are right on!!!!!
August 10th, 2009 at 9:57 am
I ditto dozer – BLC’s note should be forwarded to Congress and as many voters as possible.
August 10th, 2009 at 10:18 am
My letter to the President yesterday….
Dear Mr. President,
I got to thinking over the weekend that we HR (human resources) folks spend a lot of time counseling people (even CEOs) about their ideas, their organization structure, their weaknesses and strengths, all with the hope we can strengthen the company and help it grow.
I thought I’d take a shot at this reform thing in an open letter to you that perhaps might help move reform to some conclusion.
First off, marketing and sales. Everyone knows how critical the marketing and then the follow through with the sales force is to the success of any effort. I don’t think the product you are selling to the public matches the specs of the product the Congress is producing. This is the result of you not make a specific proposal and letting Congress work on that. Instead you gave them some ideas and they’ve produced something different than what you asked. You talked a lot about covering everyone and cutting costs yet Congress has produced a product that does neither – it adds to the cost at a time when cost (the economy) really matter and it doesn’t cover every one. So there is a big disconnect between the product and the sales message.
Secondly, you have the wrong sales force – and perhaps, the worse sales force. Every poll shows Congress is at a new low with the public so every time a team of your sales people open their mouths, your credibility goes down (and theirs). You’d be better off hiring used car salesmen to push this – they truly have a higher credibility level with the public than Congress. Also, the people you send out from the Whitehouse to speak on your behalf have no experience in health care so they too add to your problem. Your Treasury Secretary was at the controls at the Fed during the financial meltdown and forgot to pay his taxes even when given the money to do so. Hardly credible. You, as a sales person, are losing credibility rapidly with the public because what you say doesn’t match the product in your hand. You need to toss what Congress has given you and ask them to produce that which you have been campaigning.
Now, you also have a problem with your “organizers”. They sold you to the public during the last election and there were a lot of promises made, yet the reality, in today’s world, is everything is getting worse, not better. American’s believed those people once and look what they have at the moment – even you stress this point – 14,000 people a day are losing health care. Why? No one is fixing the economy, putting people back to work, putting people back on employer’s insurance rolls. While health care reform is a great idea, much more pressing is the need to work and feed your family. So your “organizers” have lost a tremendous amount of credibility – they didn’t deliver what they promised and they won’t be believed this time that you will deliver.
Another big problem for you and Congress (and the media) is that all of you talk down to the American people. It makes them feel like you think they are stupid, that they won’t understand, that they can’t look at something and make a decision about what is good and what is not. Start talking with people, not at them.
Let’s get to the marketing messages for a moment – these keep changing as well which does two things (1) makes you look like you are hiding something because the story keeps changing as to why reform is needed and (2) when you start to demonize an industry it makes you look very un-presidential. Its kind of sandlot, grammar school playground speak that most don’t appreciate, especially at your level. You need to take the high ground, not the low ground. You also can’t simply lump dissenters who have legitimate concerns with the other party and minimize their real concerns as political. If you haven’t been over to the AARP forums in awhile, you’ll see that there is a diversity of people – republicans, democrats and independents that are all disillusion by your approach to all of this – people who voted for you are dismayed and they are angry. Don’t mistake their genuine anger and fears for politics. A lot of them voted for you.
Another problem you have is the legacy of Medicare. Much the same words we heard in 1965 are being echoed today to sell the public. Yet the history of Medicare is clear. Costs exploded on that program despite the careful, conservative cost estimates Congress claimed it made. Frankly, the government’s poor performance with managing health care insurance via Medicare is a huge stumbling block in getting people to believe any “public” plan has a prayer of being successful.
A final thought – you really need to surround yourself with people who are perceived to know what they are doing. There is no one on your staff that I can tell that understands or who has worked with health care insurance, been in the trenches with employers and employees handling their insurance issues – and for that matter, no one in Congress. From a believability and credibility point of view, you really need some people who have had considerable hands-on experience who will be patient and explain to people how the system works and how the change you are proposing will help. Without that expertise and credibility, reform won’t happen. By the way, infomercial style programs with ABC aren’t the right approach because they (ABC) have credibility problems as well.
Your Whitehouse blogger quotes Adams: “facts are stubborn things”. Indeed they are. You can’t have someone say this will make costs go down while CBO is saying just the opposite. You instantly lose credibility. Indeed “facts” are stubborn. Your blogger should have picked a more appropriate Adams quote:
“The moment the idea is admitted into society that property is not as sacred as the laws of God, and that there is not a force of law and public justice to protect it, anarchy and tyranny commence. If `Thou shalt not covet’ and `Thou shalt not steal’ were not commandments of Heaven, they must be made inviolable precepts in every society before it can be civilized or made free.” Madison had an equally important thought that applies now: “Government is instituted to protect property of every sort…. This being the end of government, that alone is not a just government,…nor is property secure under it, where the property which a man has in his personal safety and personal liberty is violated by arbitrary seizures of one class of citizens for the service of the rest.” And that’s exactly how a lot of people are feeling at the moment – their property is being seized and transferred to others.
If you’d like someone who has long-term, hands on experience in this area, to sit and talk with you on how to move forward, lets have a beer together.
Warm regards,
Jim
August 10th, 2009 at 10:22 am
BLC when are you running for office? Can you find a few more like you so we can finally have someone who can understand what is needed for the PEOPLE to get things done the right way? We have a relatively small company, less than 100 employees, been in business for over 85 years but at the rate they are going with the health care situation we’ll be out of business.
August 10th, 2009 at 10:38 am
It nice to see we still have intelligent people in this country that are against government takeover of our health care. I have read sections of the proposed bill and quite frankly, it scares me. Not just for the livelihood of our company, but for the welfare of our country. Couldn’t have said it better myself BLC & Jim. Please call and write your elected representatives.
August 10th, 2009 at 10:40 am
Yes, Medicaid and Medicare have worked so well all these years, and yet our government wants to create another healthcare program that won’t work?! Why not fix those two first rather than cutting their cists, expand on them to include those currently with no insurance before creating another headache program that will be nothing more than a hassle and a pain…I smell HMO all over again.
Every day I become more and more scared where our country is headed!
August 10th, 2009 at 10:43 am
Hopefully, Americans are waking up to the fact that Obama and Pelosi are all about controlling people and not helping them. If Obamacare is enacted, say good bye to top notch medical research. Yes, a lot more people will have care, but it will be substandard compared to what we have today.
August 10th, 2009 at 10:47 am
BLC – Very well put. As a civil servant, I had the privilege to live in Europe and to experience both the German public health system and the American military health care system, and be covered by a private insurance company. I am not an expert on any of these. I do know that all Germans are covered by the national insurance and that they all receive the level of care that the government determines they will receive. I also know that many Germans buy private insurance to receive the higher level of care they believe they need and deserve. The private pay health care beneficiaries go to their own private doctors and their own private hospitals to receive better and more timely care. My wife and I used our private American insurance to go to doctors and hospitals where our insurance was accepted. The doctors in the public system were unionized and were on strike in “our state” a few days each week because their pay was so low they couldn’t live on it. The trash collectors were on strike less than the doctors. My wife went to a German doctor for mammograms because the military system was so understaffed that they could not see her for quite some time after a lump was detected. The private German doctor saw us right away, did all the tests himself, was incredibly helpful and we were amazed at how reasonable the cost was. Our private American insurance completely covered the cost. The American military system closed clinics and centralized specialists at a facility 60 miles away because they were so short on staff. Long waits for appointments were routine and there were strict “priorities” on who would receive treatment and when and in what order. Staff shortages caused the wives of male soldiers, some of whom were deployed in Iraq, to be sent to German public hospitals to give birth – only active duty women soldiers were delivered in American military hospitals. This caused many wives to return to the United States to give birth in a system they understood. (The German system was adequate but very different.) When it came time for my cancer surgery, I returned to the United States, at my own expense, to have the operation performed. We experienced Government control from start to finish both German and American. We were fortunate to have options, albeit expensive ones. But we did have choice to avoid being “issued” health care at a government’s decision. Just one person’s experience.
August 10th, 2009 at 11:05 am
I think the insurance companies, Dr’s, Hospitals and any other medical supplier need to be the ones the government looks at and make all of them lower their prices. That would be the best Health Reform.
August 10th, 2009 at 11:10 am
Before you put BLC in office, note that his math isn’t any better than Deb’s. 1 million times 50 million is 50 trillion.
As a fellow HR professional I applaud Jim’s letter to the president because the last words I want to hear are “I’m from the government and I’m here to help you.”
August 10th, 2009 at 11:15 am
Great input from everyone! All I can say is the last thing I want is the govt. telling me what treatment I can or can’t have, and dictating what I MUST have (forced treatment – which is happening more and more).
This is the last thing we need in this country, so please everyone — write to your congressmen. There are petitions all over the place, and easy ways to fax your reps.
Here’s one to not have to be forced to take a swine flu shot (numerous deaths have occurred – in Japan in 2005). http://salsa.democracyinaction.org/o/568/campaign.jsp?campaign_KEY=27275
Here’s an amendment by Congressman John Fleming to require politicos to submit to their health care system (they are exempt!) http://fleming.house.gov/
Make your voices heard!
August 10th, 2009 at 11:27 am
Another note, I have friends in England, Australia, New Zealand and Canada, they and most everyone they know pay extra for private insurance even though they can’t always afford it. For the simple things like colds, sprains, etc, national insurance is ok, but anything more serious, forget it, they don’t want to take the risk…and neither would I.
I’ve been without insurance twice, it is scary and I prayed nothing bad would happen to me, so I understand wanting to insure everyone. However, the government’s plan is not the answer. And it’s not right or fair to give insurance to those illegally in this country. About the only idea in the current plan that I agree with is eliminating the pre-existing conditions, that was the one thing that prevented me from getting an individual plan and even using an insurance broker, they couldn’t find me a plan because of the pre-existing condition clause…and my PEC was very minor.
August 10th, 2009 at 11:31 am
I agree with BLC, very well said.
We need healthcare reform, not a government takeover of healthcare.
This is obvious. There are two main problems with our current system:
1. the uninsured, the number is somewhere between 35 and 50m.
2. the rising cost of healthcare.
Reform/government then should focus on those two problems, especially now considering the state of our economy by
1. providing for a system of individual tax credits or other subsidies that coordinates with the tax exclusion for employment-based health insurance.
2. providing for greater national uniformity of market regulation across health insurance markets, regardless of type of submarket (e.g., large group, small group, individual), geographic location or type of health plan.
August 10th, 2009 at 11:33 am
Roger – Thanks for the correction
August 10th, 2009 at 11:56 am
^^^ Let’s just keep complaining about every proposal and block any progress – keep everything the same. Yep, uh-huh that’s the way to fix the problem. We’ve been operating under the free market system for how long? And costs keep going which direction?
August 10th, 2009 at 12:07 pm
Let’s not forget the financial rape of the elderly by the pharmaceutical companies! The cost of drugs is excessive and several times that of most other countries. No wonder the pharmaceutical lobbys are spending over $150 million this year to sway congressional votes.
August 10th, 2009 at 12:08 pm
Gordon – I’m not sure we’re complaining so much as saying we’re going in the wrong direction. Medicare has demonstrated that that direction is the wrong way. Many good proposals have been put on the table but unfortunately with this administration, it is “my way or the highway”. The administration’s ultimate goal is a single-payer system and the elimination of a private industry. The current proposals are interim steps to that goal. That should give you pause – that’s un-American. As I pointed out to the President in Madison’s words, the government exists to protect private property (including your wages, not to seize it and redistribute it for the whims of others.
August 10th, 2009 at 12:12 pm
I agree with much of what has been said, but with a few caveats. First, the “experts” need to negotiate legislation with the various congressional committees to overhaul prescription drugs, medical services, and health insurance. Most of the three industries have already suggested changes, however, they cannot be trusted to reduce their profits and maintain reductions and/or changes long enough and thoroughly enough to have the kind of impact necessary to overhaul healthcare in this country. Our biggest challenges (affordable and quality healthcare) are certainly obtainable, but government needs to hold the various industries accountable without making them moral monsters. Do what we preach every day in HR, set the standards, then the expectations and hold them accountable. But keeping everything as is most certainly has not been suggested by any of the industries before mentioned as they see the writing on the wall. The Obama administration is to be commended for pushing for changes in the healthcare system. However, change for change sake is not acceptable. We simply must continue to let our voices be heard by articulating what we feel those changes should be. In this way, we all will not get exactly what we want, but, most will, ideally get something better than what we have.
August 10th, 2009 at 12:12 pm
Gordon,
Obviously, you have not worked in or around insurance or as an employer providing health insurance, or you would know the current system is at best a quasi free market system. Government at state and federal levels already determine numerous facets of how insurance and health benefits work. As with most government intervention into free market activities the bad has out weighted the good.
I am not against improvements, but I do not want to have Congress cut off my head because my toe hurts. The bill as readable on http://thomas.loc.gov/cgi-bin/query/z?c111:H.R.3200 is not a solution. It is more like a bill to finally squash the health insurance industry, so government competition goes away. If you cannot beat them fairly, change the rules. Without government interventions with burdensome restrictions which afford no value to end users, the free market would likely have already solved the problem of the uninsured.
August 10th, 2009 at 12:13 pm
Thank you Gordon! People think that they are going to be forced to have a gov’t plan and get rid of the coverage that they have now. After 8 years of Bush, I can see why they may think that! Maybe it’s time to listen to some real ideas – or come up with some better ideas instead of being so critical. Something needs to be done – THAT’S the message here! Maybe the gov’t should be out enforcing the existing illigal immigration issue as well! Now that would be progress too!
August 10th, 2009 at 12:15 pm
What a lot of folks don’t know is that the short pay from Medicare ($.91 for every dollar of services provided) and the Medicade short pay ($.85 for every dollar of services) already adds $1877 in healthcare premium costs to the average family of 4 each year and now the Gov’t wants to cost shift more away from those programs and onto the private sector. Where does the Congress think the Dr’s and Hospitals are going to go to make up for the cuts but to us.
Teri
August 10th, 2009 at 12:17 pm
Some people still don’t get the Obama master plan – as you debate this one element of total control they are ruining something else as we speak like the auto industry.
August 10th, 2009 at 12:18 pm
It will be chaeper for an employer to pay the tax or fine or whatever it is called at 8% than provide healthcare – that’s the whole point. Eliminate choice.
August 10th, 2009 at 12:21 pm
Thank you Lori! No matter how many times, or how clearly, President Obama says you will not have to change your plan or your doctor, the average joe believes otherwise. But let some blogger say that a government plan will ruin everything and everyone jumps on that wagon.
August 10th, 2009 at 12:21 pm
Me again, Deb, the one with the horrible math skills. I stand corrected – BIG TIME! Anyway, my biggest fear isn’t health care reform itself, it’s that government may actually control it. They can’t even manage Social Security yet we are willing to allow them to potentially have a say in life or death situations? It may start out in a small way but once they have control, we will not have any. It will be their program with the freedom to amend as they see fit inyears to come. And I believe some people out there still believe it would be FREE yet talk to any Canadian and they will tell you how roughly 60% of their wages go to the government and they still purchase health insurance independently and still come to the US for serious ailments.
We need to use California as a model of how you can’t take care of everyone. Or the nightmare in Massachusetts which is very close to what Congress wants to pass. It is simply cost shifting, not reform. It has done absolutely nothing to control costs.
August 10th, 2009 at 12:27 pm
After working in healthcare (non-profit hospital) I realized that Healthcare is actually quite efficient in its current state. The big problem left on the table is the uninsured. So, instead of calling this healthcare reform, it should be called government healthcare required. To me, this is not a free-market policy, rather a socialist policy to make all people at the same level. If people truly want catastrophic insurance, anyone can obtain it for like $50/mo. Just ask your auto ins. person. I had that insurance between college and my first job. Some people just plain don’t want coverage because they don’t want to pay the bills. Anyone who is too poor, or out of work can get on Medicaid. This leaves me begging the question, “Why are we trying to fix something that ain’t broke?
August 10th, 2009 at 12:35 pm
Gordon, you haven’t been paying attention. Free market went out the door as soon as the federal government stuck their incompetent, dirty little fingers in years ago. As a result costs have risen steadily since. The best example is that morass known as Medicare. It is one of the most fraud heavy examples of bad management ever devised. If you want the government to throw your money down the toilet into a sewer of graft and corruption be my guest, they take checks.
August 10th, 2009 at 12:36 pm
RWHRD
I would suggest a paradigm shift. Stop thinking regulations will save the day.
Why are so many uninsured? Various reasons, but one prime one is the ready access to health care at no cost for anyone who is uninsured. You might be quite surprised at how many choose not to have coverage. Even when insurance premiums are as low as $60 a month for comprehensive medical and prescription insurance, many choose the no cost care of our government programs. If they have enrolled previously, many will drop coverage if a pregnancy occurs just to avoid the nominal copays and deductible they may incur. Many will willingly leach off government programs diluting the revenue for legitimate recipients, and the bureaucracies do little to combat the problem because the more they spend the more they get.
Why don’t we start by limiting the amount of government care you can get? Refuse coverage under a government plan for 6 months after loss of coverage (a permanent COBRA subsidy would be cheaper than present direct costs). Limit duration of coverage under a government plan. (similar to COBRA limits)
My strongest belief, is to stop trying to fix everything federally. We as American citizens are less represented when laws are passed on the federal level, but much better represented at the state level. Example, how many senators can you vote for? Two of 50. So your direct representation is only 2% of that legislative body.
If the state of NY, NJ, PA, CT, RI, etc wants to do something for their constituents, the state is the place to do it. We have too much influence by non-representatives upon non-constituents.
We should do a quick shift from federally funded programs to state funded programs, then the change we need will happen.
August 10th, 2009 at 12:38 pm
This is for Tom.
Tom, Do you know why the cost of prescription drugs are so high? There are only two countries that have the highest prscriptiondrug rates in the free world, The United States and New Zealand. Why you ask? They are the ONLY two countries with unrestriced media advertising for pharmacutical companies. Television, radio, magazines and newspapers. Do you know what the cost of just a 30 second spot during prime time costs? Stop the advertising and the cost of drugs will come down.
August 10th, 2009 at 12:47 pm
Jim – you’re quite right that we are moving in the wrong direction. Have been for at least 8 years. And Congress and the President are changing that direction. I’m interested in how you “know” that “The administration’s ultimate goal is a single-payer system and the elimination of a private industry.” Is your intuition telling you that? Even though he has stated the contrary numerous times. Are we to believe your intuition or some other “intuitive” blogger rather than the President? The problem with this country is that people don’t know where to get information and far too many believe the @#$% they read on the internet.
August 10th, 2009 at 12:47 pm
How can you say healthcare is not broken when family coverage, with employer paying 50%, can costs almost $1,000 monthly and more? Never mind if there is an actual illness or injury. Should employers pay more than 50%? Many do. However, why should they? Free enterprise, great! But insurance is not competitive enough in this country. They are making billions and billions of dollars a year and still not covering many individuals because of pre-existing conditions. Does anyone recall that more than 50% of the bankruptcies in this country are caused by the inability to pay medical bills? Are all of these people irresponsible? Something must be done, but the insurance companies and providers of healthcare, who are the experts, must be at the table without being completely demonized. Still, they must be held accountable as they did help create much of this debacle.
August 10th, 2009 at 12:49 pm
Gordon and Lori-
Thank you for listening to what is being said and not twisting what is being said.
Why is it that those that have think it is okay to leave those that do not out?
I was laid off in December, got a new job in April and until this month did not have insurance. Because I could not afford COBRA. I was lucky and didn’t need any medical treatment during this time. I also didn’t qualify for state ACESS medical insurance because I made to much money while receiving unemployment ($270 a week). I’m not complaining just stating the facts. To think we live in a country that is said to be a leader in the world and yet we don’t even help our citizens with medical insurance.
August 10th, 2009 at 12:49 pm
thanks bdbd on your comment about rx advertising. The number of, content and costs of those ads are disgusting!
August 10th, 2009 at 12:50 pm
Interesting that big drug companies entered this discussion.
While I’m not a huge fan of Robert Reich, his blog is an interesting read every once and awhile. He recently wrote about the secret deal the Whitehouse struck with the big pharmaceuticals – they’d provide $80B in savings over 10 years in exchange for the government agreeing not to use its large leverage power via Medicare, Medicaid, a “public option” to lower drug prices for all. In return for this secret deal, “Big Pharma” is now spending a ton of money advertising for “reform” – more in fact than John McCain spent on TV advertising running for President. Reich’s comments is especially important to understand:
“But I also care about democracy, and the deal between Big Pharma and the White House frankly worries me. It’s bad enough when industry lobbyists extract concessions from members of Congress, which happens all the time. But when an industry gets secret concessions out of the White House in return for a promise to lend the industry’s support to a key piece of legislation, we’re in big trouble. That’s called extortion: An industry is using its capacity to threaten or prevent legislation as a means of altering that legislation for its own benefit. And it’s doing so at the highest reaches of our government, in the office of the President.”
Keep this in mind as different groups like AMA and big pharma “support” reform. They are supporting their own interests, not the health care of Americans.
August 10th, 2009 at 12:51 pm
Dear Gordon,
I suppose you are comfortable being told all is safe without reading the fine print regarding how that is being done.
Here’s the fine print:
SEC. 102. PROTECTING THE CHOICE TO KEEP CURRENT COVERAGE.
(a) Grandfathered Health Insurance Coverage Defined- Subject to the succeeding provisions of this section, for purposes of establishing acceptable coverage under this division, the term `grandfathered health insurance coverage’ means individual health insurance coverage that is offered and in force and effect before the first day of Y1 if the following conditions are met:
(1) LIMITATION ON NEW ENROLLMENT-
(A) IN GENERAL- Except as provided in this paragraph, the individual health insurance issuer offering such coverage does not enroll any individual in such coverage if the first effective date of coverage is on or after the first day of Y1.
(B) DEPENDENT COVERAGE PERMITTED- Subparagraph (A) shall not affect the subsequent enrollment of a dependent of an individual who is covered as of such first day.
(2) LIMITATION ON CHANGES IN TERMS OR CONDITIONS- Subject to paragraph (3) and except as required by law, the issuer does not change any of its terms or conditions, including benefits and cost-sharing, from those in effect as of the day before the first day of Y1.
(3) RESTRICTIONS ON PREMIUM INCREASES- The issuer cannot vary the percentage increase in the premium for a risk group of enrollees in specific grandfathered health insurance coverage without changing the premium for all enrollees in the same risk group at the same rate, as specified by the Commissioner.
(b) Grace Period for Current Employment-based Health Plans-
(1) GRACE PERIOD-
(A) IN GENERAL- The Commissioner shall establish a grace period whereby, for plan years beginning after the end of the 5-year period beginning with Y1, an employment-based health plan in operation as of the day before the first day of Y1 must meet the same requirements as apply to a qualified health benefits plan under section 101, including the essential benefit package requirement under section 121.
(B) EXCEPTION FOR LIMITED BENEFITS PLANS- Subparagraph (A) shall not apply to an employment-based health plan in which the coverage consists only of one or more of the following:
(i) Any coverage described in section 3001(a)(1)(B)(ii)(IV) of division B of the American Recovery and Reinvestment Act of 2009 (Public Law 111-5).
(ii) Excepted benefits (as defined in section 733(c) of the Employee Retirement Income Security Act of 1974), including coverage under a specified disease or illness policy described in paragraph (3)(A) of such section.
(iii) Such other limited benefits as the Commissioner may specify.
In no case shall an employment-based health plan in which the coverage consists only of one or more of the coverage or benefits described in clauses (i) through (iii) be treated as acceptable coverage under this division
(2) TRANSITIONAL TREATMENT AS ACCEPTABLE COVERAGE- During the grace period specified in paragraph (1)(A), an employment-based health plan that is described in such paragraph shall be treated as acceptable coverage under this division.
(c) Limitation on Individual Health Insurance Coverage-
(1) IN GENERAL- Individual health insurance coverage that is not grandfathered health insurance coverage under subsection (a) may only be offered on or after the first day of Y1 as an Exchange-participating health benefits plan.
(2) SEPARATE, EXCEPTED COVERAGE PERMITTED- Excepted benefits (as defined in section 2791(c) of the Public Health Service Act) are not included within the definition of health insurance coverage. Nothing in paragraph (1) shall prevent the offering, other than through the Health Insurance Exchange, of excepted benefits so long as it is offered and priced separately from health insurance coverage.
————————————————————————————————–
Here is what they call protecting your choice!
No new enrollments! Whether this means new “policies” or the actual word used “enrollments” the result is devastating. If the traditional insurance industry term is applied, no existing plan (policy) can add new members except as dependents of existing members. If it means policies, then present employers without policies, will not be able to get one. How does either of these help the uninsured get coverage?
No updating of plan is like saying no oil changes or fill ups for your car. This will prevent inclusion of new coverages or types of care no presently covered. It prevents cost changes to deductibles and copays for inflation purposes. If your deductible is $500 per year now, it must remain the same forever. Any change to the policy in restricted areas as mentioned results in loss of the grandfathered status; which means the policy is unlawful.
In quick summary, you can keep your coverage if you want, but there will be #$@$# to pay if you do.
Just because the fox is going to watch the hen house, no one should be concerned, right?
August 10th, 2009 at 1:00 pm
mkh, Thanks. I actually read the language of the proposed legislation you provided. I wonder if anyone else in Washington has?
August 10th, 2009 at 1:06 pm
Gordon – the President has made that statement publicly in 2003 – you can find it on YouTube. Other supporters of his have made similar statements.
I find it interesting how people talk about the last 8 years as if this was something created in those years. This problem started with FDR and social engineering. The Great Society amplified the problem through Medicare. Previous presidents to FDR resisted providing federal assistance least they become dependent on government. As Adams, Lincoln, Madison and others said repeatedly, its not the role of government to be involved.
I tell people who will listen that when my grandfather was alive and working, there was no health insurance. People paid for their health care from their own pocket. If they did not have enough, charity was abundant. When people died it was a tragedy but not a “moral imperative” that government swoop in and pick up the tab. We’ve grown accustom to others paying our bills and the right we declare to health care is but an economic right.
We pay a lot for “health care” today mostly to extend our lives. The length of our lives should not be determined by the amount of money a society can extract from its citizens. Health care reform is not about health at all, but rather who pays the bills – private companies or the government. In either case, the health of someone goes unchanged. We spend tremendous amounts of money treating diseases, many brought upon ourselves because of lifestyle choices. Spending increasing amounts of money to treat self-inflicted disease seems ludicrous at best.
Most of us frown upon stealing from another regardless of the reason and regardless of the wealth of either individual. When a government does it in the name of reform we seem to go numb.
I have a right to life which includes a right to dispose of the fruits of my labor as I see fit. To deny me this right is to deny me the right to support my life. There is no such thing as ‘partially’ destroying a right. You can not create some new medical “right” (which is an economic “right” rather than an unalienable provided in the Constitution) without negating the right to property, and thus the right to life. This is true of any so called economic ‘right.’ If someone receives without working, then someone has worked without receiving. If the “work without receiving” was not voluntary, that man or woman is a slave. This is wrong and needs to be called wrong for the right reasons. It is to bleed dry the life from the healthy and productive in the name of fighting disease. This is true in all economic endeavors that place the so called interests of group or “society” above the actual, self evident, rights of the individual. It is especially ugly to do so in the name of health.
The government has no more business in the health care insurance arena then it does in running banks or car companies. As I already mentioned above, we often forget the words of our founding fathers.“Government is instituted to protect property of every sort…. This being the end of government, that alone is not a just government,…nor is property secure under it, where the property which a man has in his personal safety and personal liberty is violated by arbitrary seizures of one class of citizens for the service of the rest.” – Madison
If my grandfather were alive today he would ask you where is your sense of personal responsibility and since when is my health crae your responsibility? Indeed.
August 10th, 2009 at 1:06 pm
I think BLC needs to better understand the difference between the free market and an oligarchical economic system. Health insurance is not operating in a free market system in which genuine competition amongst small-scale entrepreneurs creates consumer choice and a rational pricing model. It operates in an oligarchical model in which a few large “competitors” collude
to maintain the status quo and profit. It’s like saying our political system is open and free and yet two political parties have a strangle hold on every institution of goivernment.
August 10th, 2009 at 1:19 pm
mkh – Do you understand the idea of a grandfather clause? It means if you have something before a certain date you are allowed to keep it. Wouldn’t it be ridiculous if there was a grandfather clause but others were allowed to join afterwards, or if the insurance company was allowed to change any/all of the parameters of the plan? The “fine print” that you posted just specifies the details of what is and what isn’t allowed. Try enforcing a law without details.
August 10th, 2009 at 1:25 pm
Back in the day, healthcare was not in the institution or bill of rights because there wasn’t the modern system as we have it now. If there was, the founding fathers may have written that every citizen has the right to healthcare, not just the protection of property. This isn’t the wild west for goodness sakes. We have evolved as a people to decide that we are not an every man for himself type nation, but that we need to take care of our elderly, infirm, etc. The question is now, just how? Since the fed gov is the only unifying body that presides over all of us (however corrupt it may be) that is where it must begin. Now the devil is in the details. But I never want to return to a time where people die from easily treated diseases because their employer does not provide healthcare and/or they do not make enough money to pay for both their prescriptions and their rent. Oh wait, that is the time we live in now.
August 10th, 2009 at 1:26 pm
constitution, not institution. fast typing- sorry
August 10th, 2009 at 1:28 pm
As an employer I see health insurance slip-sliding away. The premiums, co-insurance, deductibles and co-pays relentlessly increase. We now only insurance the new employee alone, not their family.
I question whether the employees that we let go during this recession will be able to find employment with insurance benefits. Only 2 of the 7 were able to afford the ARRA COBRA.
August 10th, 2009 at 1:29 pm
hwk – Well put…thank you!
August 10th, 2009 at 1:29 pm
Gordon,
I do understand the idea of grandfathering. I means allowing an exception to permit the continuation of something after conditions change which would not allow it to otherwise occur.
We are expected to believe Congress is grandfathering existing policies, so we can keep our policy if we like it. The problem is the law is preventing anything likable or sustainable from being grandfathered.
I guess you believe your store receipts on how much you saved also…
August 10th, 2009 at 1:30 pm
Typo, sorry. Meant to say “We now only insure…” not insurance.
Thanks, AW
August 10th, 2009 at 1:33 pm
Caryn,
It is not the goverments “job” to “help it’s citizens with health insurance”. I know this seems like a harsh reality but the goverment is not responsible for anyone in this manner. This entitlement mentality is really getty bad. As has been stated previously, you can get an individual catastrophic plan for a reasonable amount of money. If we start allowing the goverment to control what we have and what we don’t, when does it end? Maybe they should provide everyone with a house or a car or a cell phone or a big screen tv – all in the name of “fairness”. Just remember – nothing in life is really free.
August 10th, 2009 at 1:33 pm
HWK. I don’t think I could have said it better. Thank you!
August 10th, 2009 at 1:40 pm
hwk,
Guess you can’t wait until we evolve to the point everyone gets a island retreat at government expense because those sorry employers do not provide one.
People have gotten sick and needed care for centuries, the problem we face is not because of the need, but the means and associated complications regarding how this is achieved. In the spirit of ‘helping’ we are now expected to ‘do’ rather than help. But doing cannot be an individual choice, but a collective burden mandated by the “wiser ones” from Washington.
More good is done thru local organizations, churches, charities than government can dream of accomplishing. And at much better fiscal efficiency.
By the way, the federal government is the farthest thing from unifying. The more federal regulations we get the more divided the country becomes.
August 10th, 2009 at 1:42 pm
thanks Lynn for your comment. And then if the government provided for a tax credit or subsidy for the catastrophic plan that individuals could claim on their tax bill it would be even more affordable.
August 10th, 2009 at 1:57 pm
Exactly mkh – we’ve become an entitled society – we’re entitled to everything at every one else’s expense. You can only argue for the current reform bills from a position of entitlement.
This has nothing to do with timing in our society but everything to do with personal responsibility – a nation of dependent citizens is not what the Founding Fathers had in mind. Nor did they support a notion that socialism was in the people’s best interest.
John Dingell has proposed a Constitutional amendment for health care. I say that’s the proper avenue because you can’t ram through legislation with a simple majority at the 11th hour. However, the right should be, as others are frame, Congress shall make no law that infringes upon people’s access to health care. It would be impossible to construct a constitutional right that requires the government to provide health care – how would you define health care, at what level, for how much, for how long? I think the Founding Fathers knew exactly what they were doing – no where else in the Constitution is there an economic right (such as health insurance) granted to the people.
“The problem with socialism is that you eventually run out of other people’s money.” – Margaret Thatcher
August 10th, 2009 at 2:04 pm
Get real. The prices go up because there are no alternatives! I am on medicare and have medicare supplemental. Last year the supplemental, including part D (prescription coverage) was $83 a month. This year, it is $143 for the same coverage, same geographical location. What would your customers do if you cranked your prices 75% year to year? Go to the competition? Oh yeah, there isn’t any!
Another example: Generic drugs… 90 days’ supply for $25 from my health insurance company’s mail order pharmacy. Without insurance, I get the same prescription from Target for $10. Hhmmm, lessee here, insurance mail order = no bricks and mortar but costs 2 and a half times as much as retail without insurance.
Tell me again how the health insurance system works for all of us.
August 10th, 2009 at 2:08 pm
Jim – It takes a blogger to agree with something as ridiculous as mkh’s comments. Yes the founding fathers knew that in two hundred years there would be heart transplants and that some seniors medication would cost more each month than the value of their plantations – and they took that all into account when they decided that they wouldn’t include health care in the constitution.
August 10th, 2009 at 2:08 pm
I guess we need to decide what role government has in the society.
We provide police and fire services on a single payer system – plan a yearly budget and get a check once a month to run the service. Is health care not that important to allocate for the greater good this type of service and for those who want/need more buy additional coverage as they see fit.
I suggest to you those against reform are healthy people – not facing financial ruin, uncertainty or imminent preventable death – or are facing a potential loss of profits or a body blow to their ego.
August 10th, 2009 at 2:22 pm
PSG – Thank you for the correction. The health insurance industry is a very good example of an oligopoly (not an oligarchy) and does not represent perfect competition. That being said, your assumption that health insurers are in collusion on pricing (you infer collusion is a part of the definition of an oligopoly which it is not) is exactly the kind assumption that prevents effective problem solving; much the same way that attacking the current administration for ulterior motives does.
Additional general comments (not pointed at you PSG)
Macroeconomic semantics aside, an Oligopoly (fair competition among a few large suppliers) is much preferable to a single payer government solution. If one does not like an oligopoly, how can they defend a monopoly?
And, in the spirit of offering solutions rather than just complaining, here is one idea (one of many that have been offered but not considered). Make health insurance portable. Creating more consumers that are able to stay with their insurer regardless of job changes will cause insurers to target individuals with marketing instead of selling to big business (I know that small businesses provide insurance as well.). With insurers more focused on individuals, competition would increase and we could reasonably expect costs to drop.
Also, I do support government funding of health insurance for individuals that can not afford it or can not get it due to pre-existing health conditions. Government funding should be in the form of tax credits or voucher payments directly to insurers to limit government intervention and overhead as well as consumer fraud. Can you imagine the competition among health insurers for government funded consumers? Maybe we would start to see meaningful health insurance advertised on the People’s Court instead of every PGA event.
Fortunately, we are not tasked with solving this problem. As Americans, we are tasked with being informed about the problem (I could say a lot about this aspect but won’t), informed about the proposed solution, and vocal about or agreement and our disagreement. Any effort to shut down debate, engage in personal attacks or misrepresent the facts is unacceptable. We need real, honest and agenda free discussion. Here is a good place to start.
August 10th, 2009 at 2:27 pm
Fred,
$143 a month, huh. Do you have any idea what the average employer is paying per month for a single insured? 10 times that much. Your premium is being subsidized by tax payers. What do you think your cost will be when private insurance goes away, and no longer helps offset your Medicare/Medicaid costs through reimbursements?
As for your prescription example, Target is an artificial price on that prescription alone. This marketing scheme draws you for the ‘cheapo’ knowing most prescriptions are not on that list. When you fill another prescription there, (or any other similar retailer) see how the cost compares without insurance. Another factor is the waiver of the filling fee for these ‘draw you in’ prescriptions. An average of $2.50 per prescription is charged for the administrative costs associated with filling, verifying and processing the prescription and filling the insurance.
August 10th, 2009 at 2:29 pm
It takes a thinker to understand that the country was not founded on providing economic resources for all, simply opportunity. You may want to recall why this country is here to begin with – the repression of a government that took from its citizens.
Fire, police, etc.. are all local services paid for by property tax which varies in coverage, expertise, outcome and resources based on the communities ability to pay. It is not a valid comparison for health care or single payer.
mkh is right on – you can only argue against that position if you feel you are entitled to something at everyone elses expense. Throughout most of this countries history, this country did without intervention by government, by design.
Again, what business is my health care to you?
August 10th, 2009 at 2:32 pm
As I was saying, my son finished 4 years of college, 2 years of masters, 4 years of dental school and just finished 4 more years of medical school to become a Maxillofacial Surgeon. Would you like me to tell you how much that cost. He is now 32 years old and just received his first check. How are we going to continue to interest young persons to spend years of their life training to save our lives? Under the Canadian system and other national health systems in place, there is no way anyway can pay this kind of money back. A young girl, under 20, had a motorcycle wreck and broke over 20 bones in her face. My son spent over 8 hours putting this girls face back together. What happens in 10 years when there is no one trained to do it?
Our present system certainly isn’t perfect but it is the envy of the world. Twick it, improve it, help those without insurance, implement stop gaps for those between jobs, etc., but please do not ruin the greatest health care system in the world.
August 10th, 2009 at 2:33 pm
MKH – Thanks for posting the excerpt and everyone should read as much of the legislation as possible. It is clear that the legislation eventually eliminates private insurance options.
As a general rule, I do not believe what politicians say. When it comes to politics, I’m a show me kind of guy.
August 10th, 2009 at 2:39 pm
Jim – Your ‘thinker’ comment is uncalled for. The country was founded on providing opportunity and in its wisdom provides support in key essential areas that support that vitality. Safety and Security – military, police , firefighting -rescue. Health care is in that area as well. Granted it is not that sexy Sick people are a drag on the economy and that affects us all directly and indirectly – if you ‘think’ this out – it hits you in the pocket book each day when people resort to other means to satisfy their needs. Or we can just resort to our superficial understanding of our society and hope it all goes away.
Who owns it – then move health care to the state level with an overall standard nationally. According to the OECD it works. Emperical date
August 10th, 2009 at 2:40 pm
Steve,
You assume way too much.
1) That because someone does not support this particular bill, they are against changes to the current system.
2) That fire and police are the same as health care.
a) When is the last time the fire department was sued for malpractice, and the homeowner awarded more than the value of their possessions?
b) How is fighting fire or crime similar to health care beyond importance?
c) By the way, how effective is the legal system at keeping criminals off the street in a cost-effective manner? http://www.dcor.state.ga.us/pdf/CorrectionsCosts.pdf – for example
3) Nutrition is important and directly effects one’s health, so we now need a government chef and grocer, right?
4) Getting to work is important, so now we need a government supplier car and driver, right? You know some folks cannot afford a car or even a bus pass.
P.S. this bill is not about additional coverage if needed. It is about government directed health care. Read for yourself, and stop believing every word a politician says. Check the facts. It is the difference between verbal and written agreements. The Ink Wins!
August 10th, 2009 at 2:41 pm
MKH,
What you don’t understand is that we pay an additional $93 a month for medicare which comes out of our social security check. The medicare supplement is neither subsidized by or affiliated with medicare.
WRT the generic drug program, I have been taking one of the drugs for many years for hypertension. Five years ago, the insurance company charged me $3.92 for 90 days supply. My brother, who is a pharmacist, told me the cost has come down since them. Two conclusions: Target is making money on the script and the insurance company continues to pillage and plunder.
August 10th, 2009 at 2:41 pm
Gordon – do you support an amendment requiring legislators to participate in the same healthcare solution that the rest of the country does?
August 10th, 2009 at 2:46 pm
When you are escaping your own country and founding a new one, there is not much that exists beyond “opportunity” so I always think it is silly when anyone fights an argument using the founding fathers as a beginning. Also it is a far ways to go to suggest that we should take responsibility for the health of our nation’s people to securing their inalienable right to an island or a flat screen tv. I think everyone is entitled to healthcare regardless of income in the same way I think all children are entitled to an education regardless of income. It wasn’t so long ago when that was a crazy idea too. Now just how to go about it? All debate is good debate.
August 10th, 2009 at 2:46 pm
Steve – I ask again, where is people’s sense of personal responsibility and why is my health care their responsibility? The country was founded to provide equal opportunity, not equal outcome. It only hits me in the pocketbook if paying for someone else’s health care is not voluntary…. It should be my choice, not the government’s.
August 10th, 2009 at 2:47 pm
Gosh my grammar is horrible in these posts. apologies everyone.
August 10th, 2009 at 2:55 pm
BLC, again I appreciate and agree with your comments.
What I see here are differences between having more or less confidence in government run programs versus through private markets.
I have more confidence in the private market.
Also, someone earlier here stated that the AMA supports health care reform and negatively went on to say that the AMA supports their own interests. That statement is unfair, misleading and incomplete.
AMA supports health care reform, but they oppose a government-sponsored insurance plan.
August 10th, 2009 at 2:55 pm
Fred,
Do you suppose it costs less than $93 a month for your part D benefit? If it were only worth $93 dollars, would you buy it? Part D is optional.
One thing people keep forgetting…who reimburses providers at the lowest rate? Medicare/Medicaid! So, as the government is requiring more and more from these providers, and willingly letting trial lawyers consume profitability thru frivolous law suits (some anyway), they slash their proceeds from REQUIRED business. Imagine if you had to sell your product to the government, they only paid you a fraction of its true cost, and then allowed you to be sued for almost any reason, required you to label, tag, triple inspect and still lose in court, HOW WOULD YOU BE FORCED TO PRICE your product? INFLATE TO SURVIVE. Like a sale at some retailers, we mark it up, so it can be discounted.
Villains or survivors! Probably some of both after a while…
If you think they are so bad, perhaps you have found a business opportunity – start a better drug company Freddie’s Rx.
August 10th, 2009 at 2:57 pm
Stop giving the pharmecutical companies such a hard time too. They do all the research and invest in people’s future health. How are they supposed to recoup that investment? Plus, they want to make a profit, but who doesn’t? Why is it that only the oil and pharmaceuticals get chosen for making too much profit? And is it really too much profit? What kind of margin did they make on that profit?
I just get so upset when americans get upset with someone making money. When will the coveting stop?
August 10th, 2009 at 2:57 pm
hwk,
Thanks for the input comparing government intervention in health care to government intervention in education. The opposition rests!
August 10th, 2009 at 2:58 pm
Jim, MKH – quit naval gazing. that is the issue – you care about you and no one else despite the peril it puts you in. Health care speaks to the primary security of the person and the community. without that you do not have a funtioning and performing society.
Its not about you – but its about you
August 10th, 2009 at 3:01 pm
Has anyone told the American trial lawyers that medical malpractice lawsuit will be a thing of the past. The Government will not allow itself to be sued for incompetence.
The cost to bring a new drug to your pharmacy is staggering. Millions are spent on tens of thousands of potential candidates that never get to human testing. Only about one in ten are successful presented to the FDA. That one drug that makes it must pay for all the debt that was incurred to develop it and the ones that fail.
The way the real world works is that great accomplishments that require Great Risk, must have the potential of great reward upon success.
What I hear and see are “one issue” advocates that only see pharmaceuticals as a cost of health care. They poo poo any other considerations. They do not see the industry that provides high paying jobs for well educated and skilled people. They do not understand the risks involved in getting a drug to market and that there needs to be a way to recover the expenses incurred. And they do not see that with out the reward no one would pay to develop the drugs that keep us all going.
August 10th, 2009 at 3:02 pm
yeah- I’ll take a health care system run like our education system! (sarc) – not much of an argument – our education system is NOT the best in the world and we spend more per student than anyone! (gotta luv that tenure too!!!)
August 10th, 2009 at 3:03 pm
I don’t think our forefathers predicted the “middle-man” in our economy. Just think if we could eliminate that guy! Not just in health care…that’s how prices get crazy. Then they put it on wallstreet as ‘futures’ and bet on it.
August 10th, 2009 at 3:03 pm
Steve,
Wow, didn’t know you had researched my charitableness. Oh, you didn’t or else you would know, I am very charitable to my fellow citizen. But that is just my point as well, I, not the government on my behalf, am charitable. Perhaps, the problem is some what their neighbor helped, just not by them.
If I give a dollar, a dollar is received by the one needing help. If the government collects a dollar from me, little gets to the needy.
By the way, how did our great grandparents ever live long enough to get us here without government health care?
August 10th, 2009 at 3:14 pm
I didn’t say that healthcare should be modeled on education, but that both are rights we should have as a society for the good of the whole. I suppose that people who can’t afford a private education for their children should have them working by the age of 12? That is what I am talking about. It is good for our society to have an educated and healthy population, not each be allowed to choose if we can afford to send our kid to school or have to send them to work; or to choose if we can afford to have our children or our elderly parents or ourselves insured. And don’t anyone say it is good for everyone to have flat screeen tv, that is silly. There is no point in even talking about a new healthcare overhaul if people think that affordable healthcare is not a right for everyone. So there is no point in parsing through the president’s plan, since this is the ultimate goal. We should just stay where the lucky and wealthy aren’t wiped out financially by a cancer scare and others are.
August 10th, 2009 at 3:18 pm
mkh – everyone must assume that when my grandfather was alive 70 years ago and paying for his own health care, he was unenlightened. In the past 70 years, apparently we’ve become “enlightened”.
Education is a great example of how the government does things – a monopoly run by a labor cartel that is failing our children. Medicare is an example of how not to do health insurance. Social Security is an example of how not to construct a “safety net” that has now become most people’s only retirement. If you look carefully at the trustee reports, you will see that we have pledge to ourselves in retirement income and health care through Social Security & Medicare twice the total private net worth of the nation – an impossible situation yet the predictable outcome of a society that feels entitled.
August 10th, 2009 at 3:20 pm
also,
why do we pay for prisons and libraries and such? Everyone should have their own gun and take care of their own family and property, right? If you can’t afford a book, then you will just have to stay stupid. If your house burns down, then you and your neighbors should all pull out their garden hoses. Your burning house is not my problem, right? wrong. That is why we live in a modern society and not the middle ages. We take care of our own society and each other and the community at large benefits.
August 10th, 2009 at 3:24 pm
hwk,
Perhaps a worthy concept, but do you really believe the federal government is capable of accomplishing this tasking better than another venue?
My opinion based on prior experience is NO!
What is government supposed to be compared to what it has become? The government began answerable and granted power to act by the people; now the people are answerable and granted power by the government, and it is getting worse. The further removed from local guidance and accountability, the poorer government performs. Big government fosters big wastes. If you have ever worked for or in conjunction with government entities, you know what I mean. Ever seen perfectly functional equipment discarded or unneeded supplies ordered just to use up the budget, so you don’t loss it. How can one imagine government run health care on a national basis will be any better.
August 10th, 2009 at 3:25 pm
I lived in Canada for 17 years and I get really sick and tired when I hear how bad their system is. I have Kaiser right now. My experience is that Canadian system was a little better than I have it now. Better because I could choose my family doctor and my doctor sent me to specialists he trusted. I was in a serious car accident and did not have to wait for any test I needed. I know when I was there, I was not afraid to be sick. I did not worry about my house being in any danger when I had the car accident. I partially understand people who have good insurances who oppose the changes because they feel they would pay for others but anybody can loose it and then what? People who oppose changes say they do not want to have government telling them what to do but they are ok when insurances do it. Presently I deal with paying medical bills for our members and medical bills are something nobody can fully understand. I have to deal constantly with their mistakes and try to correct them. There are voices about paying for illegals; why not to use the same method Canada uses – you can use their system for free if you have a medical ID card. If you afraid about your privacy, you already have other plastic cards you use each day like driving licenses, banking and credit cards and you really do not have much privacy left. Today I have what is considered a good insurance; will I have it tomorrow? Nobody can answer this question until we all are insured. At the same time, if US had one health system, the cost of it would not be included in US products and would help US products to compete with other countries. How about all hospitals that had to close their doors because they could not handle all these people whose only emergency was they did not have insurance (many of them US citizens). I believe that people who defend the present system do not take time to learn more about it and about many US citizens who suffer because they do not have insurance or are under-insured.
EB
August 10th, 2009 at 3:28 pm
Wow – you don’t have a grasp of what this country was like before the 30’s , do you? We’re talking about social engineering beginning with the New Deal and the War on Poverty and The Great Society and how they have wasted so much money and accomplished little. Ask your elders how they lived before they government became their nanny. This country functioned just fine before an income tax (as do 8 states today) and without social security taxes and a whole host of other taxes that squander rather than benefit. There were always fire departments and law enforcement at the local levels before the New Deal. And you are right – we took care of each other by giving freely and not under duress. It was only since the invention of income taxes that duress was brought into the equation and the community pitted against one another.
August 10th, 2009 at 3:31 pm
hwk,
Unfortunately, we are almost as modern as Rome before it fell!
August 10th, 2009 at 3:36 pm
Yes – we’d all do well to relive the history of Rome and why it fell!
August 10th, 2009 at 3:39 pm
Hwk – I will go out on a limb and say that everyone in this forum wants quality health care for every American (everyone in the world, but that is out of scope for now). The question is how we get there. What is government’s role?
There are precious few things that government does well. For this reason, I would like to see some solution options that do not include government take over and control. Unfortunately, there is no evidence that a non government solution has been considered. Worse yet, there is no evidence that our current government is willing to speak with anyone but themselves.
If you (or anyone reading this) believes that our government has the ability to take over healthcare and create a better system than we have now, tell me why you believe that? Tell me what part of the plan will lower costs and how? Tell me how many, if any, will still be uninsured after this plan is in place? If our next administration and legislature is republican controlled, do you trust them to run it? When has government successfully run any similar endeavor?
August 10th, 2009 at 3:44 pm
Excellent and to the point! Thanks.
August 10th, 2009 at 3:48 pm
BLC. This is why I think we are debating. Yes I work with government every single day and it is the most wasteful and frustrating experience ever. I am not saying I think socialism is the way to go. I think we are talking now about how far to push government intervention- should we live in a total regulation free market economy or a government controlled state? Where do we set the mark? Hopefully somewhere in the middle. These discussions on the proposal are great. I only take issue with those that can’t understand how healthcare could possibly be considered a right by asking everyone to look back before a lot of the programs we take for granted were in place. Those weren’t the “good old times” by any means.
August 10th, 2009 at 3:48 pm
So many factors work together to create the negatives (problems) driving a need for ‘reform.’ {I prefer to say improvement.}
The introduction of insurance lessened the cost burden on individuals with coverage, increasing individual buying power and subsequently the demand for services; economics dictates where demand increases, prices do also. As prices creep up, the disparity felt by the uninsured increases. Introduction of no cost care for low-income individuals fosters more increased demand.
Subsidized premiums (by government or employer) and the pricing influence gained thru group policies, particularly a large group, increases the cost to individual disparity for the uninsured.
Our health care industry has flourished with improved methods and means for improved health. We do not want to undermine this great feature of our system. But the absence of access to affordable health insurance is crippling to the uninsured. The cost of social medicine is crippling to our nation’s finances.
To address both of these concerns, we need more access to affordable insurance. How do we get there?
1) Alter the insurance model away from employer based groups. I did not say eliminate them, but foster development of group plans based on other entities. Any association of persons, church, clubs, memberships, community organizations, etc. Allow grouping of smaller employers and self-employed thru associations or chambers of commerce. Do not provide government subsidies to these entities. Let them force competition in the industry.
>This will foster broad access to larger group policies and multiple choices for a group plan for all individuals. If my employer offers the best option fine, if it is my local credit union, NAACP, NRA, ACORN, AARP, church, alumni association, or whatever, I have options each possessing the strength and benefits of group policy status.
2) Require all medical insurance policies to cover all care associated with the physical well being at some level. Do not specify the level; let competition drive this. Do not require coverage for nonessential care – non-essential meaning it does not alter the general health of the individual. Do not force coverage of care not specifically for the direct improvement or preservation of the patient’s physical health. Allow plans to offer add-on coverage for anything they wish, but do not require the group to provide nonessential care coverage, which is cost-shared by all group members. These items should be, pay if you want it, but not if you don’t. Similar to I can buy a car a basic warranty, but if I want the enhanced warranty, I pay for it separately.
3) Set a deadline to phase out government programs; Medicare, Medicaid (as individuals become insured thru other plans, we will not need these any more) and the redirect individual taxes for them to HSAs type funds, which can be used for premiums or coinsurance/copays. Employer contributions (50% share) will encourage employment in some capacity thru a viable employer, and also help assure all income is subject to proper taxation. (Could somewhat reduce the cost of unemployment, food stamps, welfare, etc., which is not a negative.)
4) Lastly, tort reform. Why do we have so much “malpractice” by licensed physicians? If they cannot practice soundly, take away their license. It lowers cost of health associated with unnecessary repeat treatment and preserves life and limb suffering due to these incompetent or negligent practitioners. This measure will likely force a healthier definition of malpractice as well. Limit damages to real costs. Existing worker’s compensation models could be used to establish the quantification of such losses. Eliminate cash settlements for these claims. Too often in the past, when a settlement occurred, it was followed by a spending spree, and then government programs got stuck with the future treatment and unemployment bills.
I am not a guru of all of life’s wisdoms on these matters, but my exposure to health insurance as a group plan administrator, a covered individual, a veteran subject to that system, and a recipient of the welfare system as a youth, I do have exposure to varied perspectives.
If we take the best of where we have been and hone it, we can have an even greater health care system. The rest of the world may not like that, as we already have the best system in the world. Why is that, I would say it is because we have birthed or naturalized into us a yearning for excellence. We favor no obstacle to achieving it. In this our forefathers were ingenious. The ‘pursuit of happiness’ drives us to want the best for ourselves and our fellow man. This inner will has afforded this nation the greatness we enjoy, the innovations that enrich our lives, and the liberties we cannot imagine the absence of. Let us and our leaders not settle for the way of other nations, we were not therein created, but find the resolve and wisdom to craft a better more refined mechanism to ensue our goal, the general welfare of all American citizens. Our forefathers founded the greatest nation on earth, not through the notion of the strength of a government, but the unimaginable strength found in the power of the people, as the preamble notes, “We the people,” not we the leaders. Let’s not lose this power by thinking the government has a strength greater than the people. Leave choice where it belongs, with the people.
August 10th, 2009 at 3:57 pm
That was excellant MKH– I agree 100%- Thanks for taking your time and expressing it a way everyone should be able to understand.
August 10th, 2009 at 4:02 pm
I love reading all of these discussions but it makes me wonder if any of you people have time to do your jobs??? (Talk about waste…) Good Grief! So many soap-boxes, so little time!
August 10th, 2009 at 5:20 pm
LC- It’s only wasteful if nothing productive comes out of it.
Jim, BLC, and mhk . . .thanks so much for your informative posts!!! mhk . . .The ideas you presented in your latest post are the best I’ve heard thus far. I hope you don’t mind me sharing them with everyone I know!
August 10th, 2009 at 8:17 pm
Everyone complains but few demand term limits that would get rid of the professiona ploiticians who care onl about themselves and thier privlages. We are in the mess we are because we don’thave people in office who understand how normal, working people live. Many Senators and Representatives never had a private industry job so of course they believe there is a bottomless pit of money. We do get the governmentwe elect and by not demanding term limits we agree to the peoplewe have. If we want change we have to demand term limits.
August 11th, 2009 at 7:27 am
Congress needs to be ridden out on a rail. When elected officials fail to heed the discontent of the people it’s time to start over….
“Whenever any form of government becomes destructive of these ends [i.e., securing inherent and inalienable rights, with powers derived from the consent of the governed], it is the right of the people to alter or abolish it, and to institute new government, laying its foundation on such principles, and organizing its powers in such form, as to them shall seem most likely to effect their safety and happiness.” –Thomas Jefferson: Declaration of Independence, 1776. ME 1:29, Papers 1:315
August 11th, 2009 at 8:28 am
Hey Deb,
I agree, Washington needs to do the math. So do you. 50 million people given 1 million dollars each would not be 50 million dollars. Try adding another 6 zeros to the end of that! I’m certain it’s math like that that makes the politicians think this is such a good deal.
August 11th, 2009 at 8:34 am
In 2003, Hillary Clinton screeched “I am sick and tired of people who say that if you debate and you disagree with this administration somehow you’re not patriotic. We should stand up and say we are Americans and we have a right to debate and disagree with any administration.”
Big Pot Calling the Kettle Black it Seems
August 11th, 2009 at 11:10 am
From Rasmussen today:
“Public support for the health care reform plan proposed by President Obama and congressional Democrats has fallen to a new low as just 42% of U.S. voters now favor the plan. That’s down five points from two weeks ago and down eight points from six weeks ago. A new Rasmussen Reports national telephone survey shows that opposition to the plan has increased to 53%, up nine points since late June.”
So as opposition climbs to the current plans, how do we get the ideas like mkh mentions moving forward? Perhaps an interim solution is to cover those who truly need to be covered and begin a longer process of vetting some of the ideas mentioned here. Unfortunately, this is an ideological argument in Washington where the decisions are made where one position believes it is the governments responsibility to do this while the other believe reform of the private sector makes better sense. I’m on the reform the private sector side to include allowing cross-state buying, standardized mandates (they vary by state now plus the federal government), no denial for pre-existing conditions, premiums based on life-style choices (there has to be incentives for people not to add cost to the system as a result of lifestyle choices).
That said, people must begin to be good consumers. As long as there is just a co-pay, good choices will not be made. Redirecting tax monies from Medicare and other welfare programs to HSA’s where people are responsible for first dollar coverage makes sense. Insurance should pick up the big ticket items – that’s what sharing the risk is about. All of this will require people to be more responsible, take better care of themselves via lifestyle choices and be good/knowledgeable consumers. We’ve raised two generations of people to feel entitled when it comes to health care insurance because someone else (like employers or government is paying the bulk of the cost).
Someone in an earlier post mentioned that we are more “enlightened” today than we were 70 years ago, thus government must solve our problem. I would suggest that we are more “entitled” today rather than enlightened. We have to break that mindset to really reform.
August 11th, 2009 at 11:13 am
Amen Jim!
August 11th, 2009 at 11:56 am
I’ve been reading what everyone’s been writing and to tell you the truth I don’t know what to think. One thing I will say is we can’t expect the Health Care issue to be solved over night. Also if people don’t like what the government is proposing then come up with a better solution. I hear everyone gripping that this proposed solution won’t work, but no one has actually come up with a solution that would work. I am posting a web site that encourage you to view. It is from a Bill Moyers interview with Wendell Potter who worked for the insurance company CIGNA for 15 years: http://www.pbs.org/moyers/journal/07102009/watch2.html. It’s pretty interesting to hear what Mr. Potter has to say.
August 11th, 2009 at 12:26 pm
WENDELL POTTER: The industry has always tried to make Americans think that government-run systems are the worst thing that could possibly happen to them, that if you even consider that, you’re heading down on the slippery slope towards socialism. So they have used scare tactics for years and years and years, to keep that from happening. If there were a broader program like our Medicare program, it could potentially reduce the profits of these big companies. So that is their biggest concern.
August 11th, 2009 at 12:32 pm
Thanks for posting that MRH. Everyone should read it!
August 11th, 2009 at 12:45 pm
The fact that the industry tracks loss ratios is not in itself shocking. All insurers do (as do employers who watch their insurance closely). If the ratio gets out of hand, they go out of business. A public plan would have to control its ratio or require huge taxpayer bailouts. Medicare’s version of controlling it’s ratios is to limit payments to doctors and hospitals or cover less or eliminate certain coverages altogether. I’ve posted (a brief) history of Medicare here: http://hrside.blogspot.com/2009/08/lessons-of-medicare.html
You can see many parallels to what is being said today and what was said in 1965.
As I’ve posted before, we’ve pledged to ourselves (according to the SS Trustees) more than twice the total private wealth of this nation to Social Security & medicare recipients – that’s not a sustainable position. We have to be careful that we don’t justify another Medicare program simply because we failed to regulate the insurance companies properly (or the banks, etc…) Frankly, of the two choices, reforming the private sector is better than a public plan that allows politicians to control spending (funding of health care) to manipulate votes.
August 11th, 2009 at 12:46 pm
Potter sure makes you think…the description of our own countrymen living in such shameful conditions is aweful…..but are we going to address these concerns or are these citizens being left to fend for themselves or get a hand up (not hand out). We don’t hear about them…..we are asked to go on blind faith and no information and sign on to a plan never before conceived and with great expense that could bankrupt us forever……we are rightfully concerned – especially when the leader of this effort can’t articulate what it entails. KISS is needed here.
August 11th, 2009 at 12:52 pm
MRH – In all fairness, there have been reasonable suggestions for alternatives put forward in this forum. Yes, we are concerned about the current proposal and we are expressing those concerns. You refer to it as complaining and maybe you’re right in some cases; but don’t generalize.
Allow me to make a suggestion. Instead of just complaining about the complaining, offer your case for discussion. As I have asked earlier in this discussion . . . If you (or anyone reading this) believes that our government has the ability to take over healthcare and create a better system than we have now, tell me why you believe that? Tell me what part of the plan will lower costs and how? Tell me how many, if any, will still be uninsured after this plan is in place? If our next administration and legislature is republican controlled, do you trust them to run it? When has government successfully run any similar endeavor?
Pulling Wendell Potter into the discussion distracts us from good debate on the merits of the current proposal. If you think the current proposal solves the challenges raised by Potter (except corporate profits) tell me how. If those that oppose the current plan are operating out of an unsubstantiated fear of government, debate on the topic will reveal that and maybe even change some minds. Personal attacks and name calling don’t get us any closer to the best solution.
August 11th, 2009 at 1:09 pm
BLC – you are being unfair to MRH. I don’t see any name calling or personal attacks being made by him/her. And there are many posts that are “griping” and not offering solutions.
I believe our government COULD take over health care and create a better system than we have now, because they don’t have the overriding profit motive of insurance and pharmaceutical companies. What will probably happen is that those special interests will exert enough influence to prevent any plan from being the best it can be.
August 11th, 2009 at 1:14 pm
credibility check?
Check out what he has been doing: http://www.prwatch.org/cmd/bios.php/Wendell_Potter
Amazing how months after his awakening, he pens this: http://blogs.phillynews.com/inquirer/phillyinc/cigna-sarkisyan-employees.pdf
August 11th, 2009 at 1:24 pm
Gordon,
Please explain why you have this confidence in government. What examples bring you to this conclusion?
August 11th, 2009 at 1:29 pm
It is a choice between two evils. I see why most of the posts distrust government, it is wasteful and corrupt. However, leaving it completely to free enterprise is soulless and corrupt. One group is motivated by voters and lobbists money to get more votes, the other is motivated by money- period. It comes down to who do you distrust more, not who do you trust more.
August 11th, 2009 at 1:35 pm
mkh – because they don’t have the overriding profit motive of insurance and pharmaceutical companies – Its as simple as that. Again I say they COULD be successful, but special interests will do their best to prevent that. And what makes me angry is that people make it a lot easier for them by suckering into their propaganda and proliferating it.
August 11th, 2009 at 1:39 pm
I also agree that it is wasteful and corrupt. But take a hard look at why it is that way…lobbyists.
August 11th, 2009 at 1:39 pm
hwk,
I would disagree. Companies have to retain customers, so their product must be at least palatable, however, government can legislate even against the will of the people they supposedly represent. Companies have to manage cash flow, government can tax us against our will and borrow from our grandchildren.
Companies can be sued regarding their actions, but the US government is shielded from such, and even if a case was presented and won, who pays the bill?
I trust the one with the most accountability; the free market.
August 11th, 2009 at 1:43 pm
Gordon,
Lobbyist regardless of their cause are weakened when legislation is left to state levels. A federal program will give a one-stop shopping place for lobbyists.
If you will review my post from 3:48pm yesterday, you’ll see that is one of my recommendations; keep the specifics at state levels.
August 11th, 2009 at 1:47 pm
it seems that majority of people who take a part it this discussion say, the US government is unable to be a part of our health system. It means that France, England, Canada and many more countries who successfully created government health systems that produce better results when comes to overall health of their nations than presently US system does have better governments than US. I wonder….
August 11th, 2009 at 1:49 pm
mkh
unregulated free market leads to no accountability because a few business grow to such a degree that they can fix prices and become “too big to fail.” Then who bails them out? For example, I have no idea who owns my mortgage anymore. It was once a small bank. At least you can vote out your representatives. And in principle, there is a balance of power, Even if some administrations choose not to recognize that. A nation run by corporations, which is what we are, is heartless and owing to nobody even in principle, let alone practice, except shareholders. At least government is founded on the idea of for and by the people and occasionally it works- notice the free debate going on right now, voters writing their legislators, etc. For my money, I distrust the free market more. I advocate a regulated private insurance run program that I believe you had put forth in earlier posts.
August 11th, 2009 at 1:53 pm
I trust free enterprise over the government – to be more creative, provide more and better choices for less cost. Of course there is corruption in the free market – people cheat, people are greedy. That’s where government is needed, to help regulate the free market, but not to take it over. That’s going down the path of socialism. I’m for social reform, social improvement, but not government takeover.
August 11th, 2009 at 1:54 pm
Then there is the 64 year old lady in Oregon where they have universal care who had a medical condition that could be treated by $3000 in medicine but the state said “NO” and she was authorized to get $50 of medicine to kill herself.
The big bad pharma came to the rescue and provided the medicine. The state: “go kill yourself – you’re too old and worthless” Universal care was abused in Hawaii, doesn’t work in Mass and not all that friendly in Oregon either it seems…..
August 11th, 2009 at 1:55 pm
MRH – I did not intend to infer that you were name calling; yet I did. I am sorry. (thanks Gordon)
August 11th, 2009 at 2:00 pm
MKH – The free market is regulated by consumer choice. A much more active and effective force than periodic elections. Also, if we take your logic to the extreme, we should governemnt run grocery stores etc.
The best comparison I can give is that government is a monopoly. As such, there is little or no motivation to change and improve. At least with an oligopoly, consumer choice can still drive change and even if driven by profits only, suppliers will improve service in order to improve market share. It is Adam Smith’s “invisible hand”.
August 11th, 2009 at 2:02 pm
EB – By what measure are France, England and Canada better the the US health care system?
August 11th, 2009 at 2:07 pm
Keep spinning those anecdotes everyone…the insurance companies love it – kaching! Sure what we need is to drop it on the heads of state government already overburdened so we end up with 50 different versions of a watered down insurance/pharmaceutical friendly bill. That would be even more efficient – right?
August 11th, 2009 at 2:09 pm
I believe our government is unique – a representative Republic. We can not make comparisons to other nations directly when it comes to running commerce. Our government was designed to allow the free flow of commerce but not actually operate it.
EB – I’m not sure you can make direct comparisons between our system and that of France, England, Canada, etc… Most of the better “results” seen in those country are differences in lifestyle – by that I mean in the US, 1 in 3 are now consider obese creating a huge additional load on our system – CDC estimates 300,000 dies early each year in the US as a result of being overweight. In fact, lifestyle choices, eating too much, drinking, smoking, car accidents, probably account for most of the difference in “life expectancy” differences. Also, life expectancy varies greatly across the country – more than 20 years in some cases – which according to a Harvard Study could not be the result of the health care system. There are also disparities in the costing of each system – for example, the US includes the cost of labor and capital improvements in health care – other countries do not in all cases. You also need to understand how those countries control costs – Germany sets strict budgets above which they stop reimbursing. England has the dreaded NICE system.
We need a solution that is uniquely ours and not necessarily one that mimics that of another country.
August 11th, 2009 at 2:15 pm
BLC – by World Health Organization – here is the link
http://www.photius.com/rankings/healthranks.html
here is another link showing why US is on 37th place
http://www.photius.com/rankings/world_health_performance_ranks.html
August 11th, 2009 at 2:22 pm
trying to find a perfect solution that probably is impossible to achieve we let US citizens who are either not insured or under-insured suffer. It is easy to complain and discuss when you have insurance you can relay on and wait till the solution that would please everybody is found. I have this insurance but I do not believe I should be an exception and health insurance a privilege for some. I also believe that the present system ruins this country in many ways. I wish we had somebody without insurance to be part of the discussion but I am afraid they probably do not have jobs (if any) that would allow them to do what we do now
August 11th, 2009 at 2:44 pm
EB,
Who has insurance they can rely on? I thought the insurance companies were the villains? Which one can we all trust?
August 11th, 2009 at 2:46 pm
Thanks – well aware of the OECD and WHO data – some criteria of which is subjective rather than objective. They also measure on basis of things like life expectancy which I previous discussed as not good measures of quality.
Perhaps I am unusual, but I’ve managed insurance for employers and employees for many years. I consider my health insurance as a benefit, not a right or entitlement from my employer. I’ve had the good fortune of having but one increase in premium in the past 5 years and none expected this year. We pay 95% of the employee cost and 85% of the family cost. I work very closely with our carriers – can pick the phone up and talk with their CEO if there is a problem. I sit with their underwriters each year to understand where our claims dollars are spent and what we are paying in overhead and profit for them. I have formed non-profit organizations with groups of smaller employers to co-op very successfully for better/lower rates for medical and Rx. It can be done better within the current system with effort. I refuse to sit back and let the insurance companies decide our fate.
August 11th, 2009 at 2:54 pm
Jim you are one of very few who can do it. There are many people who need insurance and do not have any voice that represents them. I believe that in the country like US health insurance should not be a privilege. And it should not be up to an employer to decide if I have an insurance; what happens if I do not have employment even if I want to work? There are many who know the answer to this question.
August 11th, 2009 at 3:03 pm
I have to say there are some pretty knowlegeable folks contributing to this discussion.
My question is why our representives with all their resources cannot seem articulate these facts during their now sequestered town hall meetings?
August 11th, 2009 at 3:12 pm
I don’t disagree. As you know, employers provide medical, life, disability and pensions as benefits. There was a time, not long ago, when insurance companies were mostly private – mutual companies, owned by their policy holders. I’d like to see those days return for the benefit of all. I’d like to see relaxed standards for forming insurance companies that are mutual so that organization, associations, etc… can form them for the benefit of their members. Individual policyholders can then band together (just like I’ve done with employers) to negotiate better rates and coverage for their members. The coverage could be life long. Insurers would base premium on your entire lifetime instead of how long you work (and then go off their plan to Medicare).
Too many examples exist today that demonstrate the government’s inability to promote the good of society. We can’t educate our children to the world’s standards because education is a monopoly run by a labor cartel. Medicare is a financial disaster. Social Security is woefully underfunded. The War On Poverty and all its programs has done nothing to improve the poverty levels of the citizens. I cannot, in good faith, entrust the health care of the entire nation in the hands of government. The government should enable commerce (and regulate for the good of its citizens) but I do not think the founding fathers ever envisioned it running commerce.
August 11th, 2009 at 3:12 pm
EB,
Health care is already treated as a privilege, but unfortunately many choose not to contribute to the funding of this care. They expect it to be free of charge. Before you get the wrong idea, I do not mean the masses, nor the one most hurt by the status quo. If we venture any further toward care at no cost, we will bankrupt the country.
The ones hurting in the present system are those with coverage, their cost sharing is soaring due the weight of the freebies riding the government system. The same ones who will drop or decline any coverage offered regardless of the value it possesses or how small the cost. Eliminate this, and open the door for group policies via non-employment associations, and health care dollars can be better spent. One of the continual arguments I see is how much more we are spending compared to other countries, these freeloaders are a large part of the problem. Cannot help but wonder how many foreigners we may provide free treatment thereby lowering their home countries costs.
August 11th, 2009 at 3:28 pm
My point exactly mkh!!! I refuse to support any more social programs until the government address the problem with illegal immigration. We can no longer afford to give them everything that we have worked so hard for.
August 11th, 2009 at 3:42 pm
In England for example anybody who is legally there (meaning visitors too) has the right to use their medical system without paying horrendous fees (mostly free). Every system has good and bad sides; aiming for profit when comes to health can lead to bad decisions too. One of the worst part of the present system is ability to drop somebody with preexisting conditions. I deal with medical payments at my work and I can see in many instances how badly the present system works.
August 11th, 2009 at 3:46 pm
Jim said- ” I have formed non-profit organizations with groups of smaller employers to co-op very successfully for better/lower rates for medical and Rx. ”
Jim would be very interested in learning more about this.
August 11th, 2009 at 3:58 pm
EB,
Really, so if I get cancer or need a major surgery, I could handle it with just a little trip to Canada?
By the way, you cannot get dropped due to preexisting conditions. You can be delayed from coverage for those preexisting conditions if not previously insured and received treatment or medication within 3 months prior to enrollment.
A pre-existing condition is an Illness or any related condition for which a Member received services, supplies or medication during the 3 months before the enrollment date of the Member under this medical Plan.
A person will receive credit toward this Plan’s Pre-Existing Condition Limitation periods for the time covered under another health plan, but only if the person was covered, under another health plan that meets the definition of “Creditable Coverage”, within the 63-day period just before his or her enrollment date under this Plan. Any eligibility waiting period that the person must satisfy under this Plan will not be considered in determining the 63-day period.
August 11th, 2009 at 3:59 pm
Sure – its quite simple. You need to understand the laws of incorporation in your state for non-profits, then establish the legal documents and file as a non-profit organization. Us a local HR organization (or your insurance broker) to find companies in your immediate area and solicit members – charge them a nominal fee or membership dues to cover any overhead you might have (say the cost for an attorney to prepare and file your documents). Once you have a representative group of your local employers decide what it is you want to co-op for – the easiest to do is a Rx plan. medical plans are more complicated to get agreement on amongst employers but not impossible. I would advise asking the head of a local regional clinic (usually a doctor) to be a member for the medical advise you’ll need to compare plans. Once your decided on a plan that the group would be willing to purchase for the right price, invite representatives from the drug companies (PBMs) and insurance companies to a meeting and tell them you collectively are interested in purchasing a product of theirs that meets your standards if the price is right. You could also formally go out to bid as an alternative. Once you have the product committed to by a provider use it and sell your co-op to other potential employers as a way to lower their costs. Leverage the size of additional members to increase your savings as you recruit members. It works – we were able to get a better rate with a PBM for example than an insurance company received by leveraging our size. Brokers may also want to join in for the benefit of their customer base increasing the size of the co-op. You have to be careful not to represent yourself as an insurer or a broker since other laws would apply. The contract with the provider would be with the individual members and not the co-op itself to avoid insurance regulations. It takes some effort – we spent Friday afternoons after work for a few months in the design and development phase. Ultimately, we turned the co-op over to an agency that uses it for its customers. Have fun.
August 11th, 2009 at 6:06 pm
EB – I understand the lack of effective comparisons for health care between countries, and the WHO measures have real problems. Jim and MKH have pointed out some major points and I will add 2.
First, the WHO itself recognized its challenges with effective comparisons and stopped doing them in 2000. Their comparison is 10 years old. Second, the WHO data lists the US as 1st in responsiveness. I believe responsiveness is a very important measure and would not want to sacrifice that for less important measures.
In addition, for purposes of this discussion, it is important to note that there are universal healthcare programs above and below us on the overall ranking; showing that universal (government run) health care is not a panacea.
Finally, don’t assume that people in opposition to the current health care initiative have health insurance or even a job. I know that assumption to be false.
August 12th, 2009 at 8:20 am
Here is one possible solution to reducing health care costs….allow the 1300 or so medical insurers to access across state lines to sell policies so you could have competition (capitalism) and people can shop for the best policy instead of being held hostage by a limited number of plans in their state.
The following links might be informative….
http://www.youtube.com/watch?v=VQnwdTxgvJ4&feature=response_watch
http://www.youtube.com/watch?v=gdx_2cuPgQQ
http://www.youtube.com/watch?v=siFSNs2cbEA
http://www.youtube.com/watch?v=puCubjusLyo&feature=related
http://hotairpundit.blogspot.com/2009/08/john-conyers-mocks-sarah-palin-at.html
http://www.youtube.com/watch?v=w5IInBP9D_s
August 12th, 2009 at 8:49 am
At least someone has interjected humor into the mix – accurate or not…..
http://www.youtube.com/watch?v=q2jijuj1ysw&NR=1&feature=fvwp
August 12th, 2009 at 9:18 am
I can only tell what I know from my experience; as I said at the beginning of my participation in this discussion; I lived in Canada for 17 years and having free medical services was something I really enjoyed. I paid more taxes but I was willing to do so as I am willing to pay for my car or home insurance despite not needing it even once. It lets me sleep well. At the same time about three years ago I had an operation here that lasted an hour and I spent less than 24 hours in a hospital. It did not cost me anything but I got bills and this operation was calculated as around $60,000+. A lot of people are against any government plan telling how wasteful this is going to be. Can you explain that? And it is not an exception that insurances are charged amounts that are unbelievable high. I know the argument that hospitals have to charge so much because all these people who use their resources without paying. The reform should address it so hospitals and people do not go bankrupt because of treating illnesses.
August 12th, 2009 at 9:47 am
Thanks BLC again for your comments.
EB – My husband is self employed and we can not afford to pay the health insurance premium for him, just me and our children. And both of us are against the health care reform where it stands now. We are more supportive of a plan that would be along the lines of Senator Tom Coburn’s proposal, “The Patients’ Choice Act of 2009″.
August 12th, 2009 at 9:56 am
Rebecca, could you tell me why you are against? I would like to understand your point of view
August 12th, 2009 at 3:39 pm
I read all these comments and can’t help but wonder how many of you actually voted for him!
August 12th, 2009 at 3:40 pm
You have to copy and paste the link below into your internet browser and listen to the interview with Betsy McCaughley, a Patient Rights Advocate, on the Fred Thompson Show (7/16/09). When I listened to this interview it chilled me to the bone.
Ms. McCaughley is probably one of the few people who has read all 1400 pages of the proposed health care bill and points out many things that you will be shocked at, including whether or not, at our age, there’s any point of having any medical care for certain conditions to help us live longer. And, a plan to to save money on health care by denying coverage and services to the elderly (our parents and soon to be us) and the way the government will advise and promote early patient termination of their lives when they have incurable diseases, etc.
http://fredthompsonshow.com/premiumstream?dispid=320&headerDest=L3BnL2pzcC9tZWRpYS9mbGFzaHdlbGNvbWUuanNwP3BpZD03MzUxJnBsYXlsaXN0PXRydWUmY2hhcnR0eXBlPWNoYXJ0JmNoYXJ0SUQ9MzIwJnBsYXlsaXN0U2l6ZT01
August 12th, 2009 at 4:58 pm
Jim,
VERY good comments.
This was posted on yahoo by Fortune on CCNMoney, it is very good and to the point. I will put the link at the end if you want to see the whole thing.
1. Freedom to choose what’s in your plan
The bills in both houses require that Americans purchase insurance through “qualified” plans offered by health-care “exchanges” that would be set up in each state. The rub is that the plans can’t really compete based on what they offer. The reason: The federal government will impose a minimum list of benefits that each plan is required to offer.
More from Yahoo! Finance:
• What Health Care Reform Might Mean for You
• How Obama Could Transform Your Finances
• The Growing Price Tag on Your Waistline
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Visit the Insurance Center
Today, many states require these “standard benefits packages” — and they’re a major cause for the rise in health-care costs. Every group, from chiropractors to alcohol-abuse counselors, do lobbying to get included. Connecticut, for example, requires reimbursement for hair transplants, hearing aids, and in vitro fertilization.
The Senate bill would require coverage for prescription drugs, mental-health benefits, and substance-abuse services. It also requires policies to insure “children” until the age of 26. That’s just the starting list. The bills would allow the Department of Health and Human Services to add to the list of required benefits, based on recommendations from a committee of experts. Americans, therefore, wouldn’t even know what’s in their plans and what they’re required to pay for, directly or indirectly, until after the bills become law.
2. Freedom to be rewarded for healthy living, or pay your real costs
As with the previous example, the Obama plan enshrines into federal law one of the worst features of state legislation: community rating. Eleven states, ranging from New York to Oregon, have some form of community rating. In its purest form, community rating requires that all patients pay the same rates for their level of coverage regardless of their age or medical condition.
Americans with pre-existing conditions need subsidies under any plan, but community rating is a dubious way to bring fairness to health care. The reason is twofold: First, it forces young people, who typically have lower incomes than older workers, to pay far more than their actual cost, and gives older workers, who can afford to pay more, a big discount. The state laws gouging the young are a major reason so many of them have joined the ranks of uninsured.
Under the Senate plan, insurers would be barred from charging any more than twice as much for one patient vs. any other patient with the same coverage. So if a 20-year-old who costs just $800 a year to insure is forced to pay $2,500, a 62-year-old who costs $7,500 would pay no more than $5,000.
Second, the bills would ban insurers from charging differing premiums based on the health of their customers. Again, that’s understandable for folks with diabetes or cancer. But the bills would bar rewarding people who pursue a healthy lifestyle of exercise or a cholesterol-conscious diet. That’s hardly a formula for lower costs. It’s as if car insurers had to charge the same rates to safe drivers as to chronic speeders with a history of accidents.
3. Freedom to choose high-deductible coverage
The bills threaten to eliminate the one part of the market truly driven by consumers spending their own money. That’s what makes a market, and health care needs more of it, not less.
Hundreds of companies now offer Health Savings Accounts to about 5 million employees. Those workers deposit tax-free money in the accounts and get a matching contribution from their employer. They can use the funds to buy a high-deductible plan — say for major medical costs over $12,000. Preventive care is reimbursed, but patients pay all other routine doctor visits and tests with their own money from the HSA account. As a result, HSA users are far more cost-conscious than customers who are reimbursed for the majority of their care.
The bills seriously endanger the trend toward consumer-driven care in general. By requiring minimum packages, they would prevent patients from choosing stripped-down plans that cover only major medical expenses. “The government could set extremely low deductibles that would eliminate HSAs,” says John Goodman of the National Center for Policy Analysis, a free-market research group. “And they could do it after the bills are passed.”
4. Freedom to keep your existing plan
This is the freedom that the President keeps emphasizing. Yet the bills appear to say otherwise. It’s worth diving into the weeds — the territory where most pundits and politicians don’t seem to have ventured.
The legislation divides the insured into two main groups, and those two groups are treated differently with respect to their current plans. The first are employees covered by the Employee Retirement Security Act of 1974. ERISA regulates companies that are self-insured, meaning they pay claims out of their cash flow, and don’t have real insurance. Those are the GEs and Time Warners and most other big companies.
The House bill states that employees covered by ERISA plans are “grandfathered.” Under ERISA, the plans can do pretty much what they want — they’re exempt from standard packages and community rating and can reward employees for healthy lifestyles even in restrictive states.
But read on.
The bill gives ERISA employers a five-year grace period when they can keep offering plans free from the restrictions of the “qualified” policies offered on the exchanges. But after five years, they would have to offer only approved plans, with the myriad rules we’ve already discussed. So for Americans in large corporations, “keeping your own plan” has a strict deadline. In five years, like it or not, you’ll get dumped into the exchange. As we’ll see, it could happen a lot earlier.
The outlook is worse for the second group. It encompasses employees who aren’t under ERISA but get actual insurance either on their own or through small businesses. After the legislation passes, all insurers that offer a wide range of plans to these employees will be forced to offer only “qualified” plans to new customers, via the exchanges.
The employees who got their coverage before the law goes into effect can keep their plans, but once again, there’s a catch. If the plan changes in any way — by altering co-pays, deductibles, or even switching coverage for this or that drug — the employee must drop out and shop through the exchange. Since these plans generally change their policies every year, it’s likely that millions of employees will lose their plans in 12 months.
5. Freedom to choose your doctors
The Senate bill requires that Americans buying through the exchanges — and as we’ve seen, that will soon be most Americans — must get their care through something called “medical home.” Medical home is similar to an HMO. You’re assigned a primary care doctor, and the doctor controls your access to specialists. The primary care physicians will decide which services, like MRIs and other diagnostic scans, are best for you, and will decide when you really need to see a cardiologists or orthopedists.
Under the proposals, the gatekeepers would theoretically guide patients to tests and treatments that have proved most cost-effective. The danger is that doctors will be financially rewarded for denying care, as were HMO physicians more than a decade ago. It was consumer outrage over despotic gatekeepers that made the HMOs so unpopular, and killed what was billed as the solution to America’s health-care cost explosion.
The bills do not specifically rule out fee-for-service plans as options to be offered through the exchanges. But remember, those plans — if they exist — would be barred from charging sick or elderly patients more than young and healthy ones. So patients would be inclined to game the system, staying in the HMO while they’re healthy and switching to fee-for-service when they become seriously ill. “That would kill fee-for-service in a hurry,” says Goodman.
In reality, the flexible, employer-based plans that now dominate the landscape, and that Americans so cherish, could disappear far faster than the 5 year “grace period” that’s barely being discussed.
Companies would have the option of paying an 8% payroll tax into a fund that pays for coverage for Americans who aren’t covered by their employers. It won’t happen right away — large companies must wait a couple of years before they opt out. But it will happen, since it’s likely that the tax will rise a lot more slowly than corporate health-care costs, especially since they’ll be lobbying Washington to keep the tax under control in the righteous name of job creation.
The best solution is to move to a let-freedom-ring regime of high deductibles, no community rating, no standard benefits, and cross-state shopping for bargains (another market-based reform that’s strictly taboo in the bills). I’ll propose my own solution in another piece soon on Fortune.com. For now, we suffer with a flawed health-care system, but we still have our Five Freedoms. Call them the Five Endangered Freedoms.
Copyrighted, Fortune. All rights reserved.
http://finance.yahoo.com/insurance/article/107408/5-freedoms-you-would-lose-in-health-care-reform.html?mod=insurance-health
August 12th, 2009 at 5:14 pm
Thanks for posting this Rachel. Its a great summary.
Since we are into the reform mode and the Congress and President can’t seem to focus on anything else, I am worried that far more serious issues have been shoved to the back and ignored. I posted some today and I’ll list some of them here.
* Unemployment went down in July to 9.4% even though more people lost their jobs – odd. New jobs are not being created as private sector employers have retrenched themselves and shelved any expansion or growth. To blame here is the Stimulus Bill that does nothing to stimulate private industry, the anticipation of higher taxes to pay for the mounting deficits rapidly accumulating and the uncertainties of future taxes to pay for things like reform. Private employers will not venture into a growth mode until they understand how these issues will be addressed and how that impacts the bottom line.
* While the market is up, there are no signs of sustainable growth at the moment (see note on unemployment)
* No regulations have been enacted that will prevent another housing bubble or sub-prime mess that created the last financial meltdown. In fact, the government via FHA and Ginnie Mae are increasing their sub-prime lending leading some to fear yet a second crisis as unemployment grows and more people lose their jobs. Default rates have risen to 7%, double the level considered safe. The FHA’s reserve rate has fallen to 3%. We are watching another slow moving financial train wreck in the making. The Inspector General issued a scathing report and suggests “Congressional appropriation intervention to makeup the shortfall” is needed – ie, a tax-payer bailout. You and I are the backers of nearly $1T in sub prime mortgages that continue to be generated by FHA/ Ginnie Mae. (Given this latest revelation, that the US is still sponsoring sub prime mortgages in the face of the financial meltdown of last year and the current recession, how willing will foreign investors be in continuing to but Treasurys that help pay the US bills now?)
* Over at Fannie/Freddie – you remember them – they failed because of government sponsored subprime mortgages which later required tax-payer bailout. The latest reports from them show that 9.6% of their “credit enhanced” portfolio is delinquent. “Credit enhanced” means loans with less than 20% down.
* We’ve bailed out the banks and now they are paying million dollar bonuses to employees. Meanwhile credit for business and consumers remains tight.
* Credit is so tight that the next anticipated meltdown is the commercial loans – nearly 30% of loans of the $3.5T in commercial loans are non-performing.
* Corporate profits have looked good of late (driving up the market) but that is the result of (a) slashing jobs and closing facilities and (b) expanding operations in places like China where economies are doing well. That does not bode well for America. The outlook for jobs in America is poor through next year.
* Education is continuing to falter as our children fall farther behind the world in achievement. A monopoly run by a labor cartel is failing our children.
With all this else going on, is reforming health care really the most important issue at the moment? Is reform really worth the time and effort being put into this by the President and Congress rather than the other issues listed here? Would you rather have a job and avoid the next financial meltdowns and bailouts or reform?
August 13th, 2009 at 9:57 am
Amen Gordon!
August 13th, 2009 at 4:28 pm
Since there are so many rumors and so much invented nonsense about the pending health care legislation being considered in Congress, I thought it might be helpful to look at some of the things this legislation would actually provide.
Look at the list below and tell us which of the following you’re against. And tell us why. Personally, I’m a strong supporter of all of these:
-Ends Discrimination for Pre-Existing Conditions: Insurance companies will be prohibited from refusing you coverage because of your medical history.
-Ends Exorbitant Out-of-Pocket Expenses, Deductibles or Co-Pays: Insurance companies will have to abide by yearly caps on how much they can charge for out-of-pocket expenses.
-Ends Cost-Sharing for Preventive Care: Insurance companies must fully cover, without charge, regular checkups and tests that help you prevent illness, such as mammograms or eye and foot exams for diabetics.
-Ends Dropping of Coverage for Seriously Ill: Insurance companies will be prohibited from dropping or watering down insurance coverage for those who become seriously ill.
-Ends Gender Discrimination: Insurance companies will be prohibited from charging you more because of your gender.
-Ends Annual or Lifetime Caps on Coverage: Insurance companies will be prevented from placing annual or lifetime caps on the coverage you receive.
-Extends Coverage for Young Adults: Children would continue to be eligible for family coverage through the age of 26.
-Guarantees Insurance Renewal: Insurance companies will be required to renew any policy as long as the policyholder pays their premium in full. Insurance companies won’t be allowed to refuse renewal because someone became sick.
Now, if I were an insurance company executive, making millions every single year from the current system, I’d object to each and every one of these. But most people don’t have that job, and thus we see these as positive changes.
As a small business owner, I’m a very strong supporter of all of the above
August 13th, 2009 at 4:51 pm
FYI – I’ve copied a letter that I have already sent to:
Senator Sherrod Brown (D-OH)
Senator George V. Voinovich (R-OH)
Representative Steven C. LaTourette (R-OH 14th)
I also received a response from Reprentative Steven C. LaTourette which I have also copied. I urge all of you to contact your State Reprentative and Senators and express your concerns. Below is the letter that I sent and also I have included a copy of the response that I received.
As you consider comprehensive health care reform for America, I urge you to proceed carefully and focus on getting any reform legislation “right” rather than be bound by arbitrary deadlines.
I do agree that our current health care system is in need of reform and appreciate the efforts of Congress to control rising health care costs and provide coverage options for all Americans. However, sustainable and workable health reform is a significant and complex endeavor, and will impact the economy as a whole and the lives of every American. Therefore, I implore you and your colleagues to take your time in drafting comprehensive health care legislation and not simply speed through it to meet an August deadline.
Health care reform is needed throughout this country, but it is a heavy challenge for America to tackle and we must do it right. The future of the nation’s health care system deserves nothing less than an open, bipartisan and transparent debate by Congress. This is particularly important given that, this week, Congressional Budget Office Director Douglas Elmendorf said that plans being considered in the House approved by the Senate Health, Education, Labor and Pensions would drive the nation further into debt—not create the savings repeatedly promised by President Barack Obama.
It is important that we focus on finding common ground to create a comprehensive health care reform that will truly work for Americans by lowering costs and providing access.
While I see the urgency behind bringing health care reform to American families as quickly as possible, we must remember that if health care reform is not considered carefully, we could be creating massive unfunded tax burdens on our economy and future generations.
I applaud you all for your efforts to truly make health care accessible for all Americans and support you in this goal. But I ask you to take the time to craft bipartisan comprehensive health care reform that will work for America instead of rushing through to pass “something” prior to a specific deadline.
Imposing an employer mandate, although well-intentioned, would severely hurt American business and the economy and cause countless unintended consequences. While we should encourage more employers to offer health insurance coverage, it would be misguided to mandate such coverage. Once we go down the path of some government mandate on employers for coverage, it will be forever consumed by the political whims and budgetary picture of the day. I urge you to oppose the creation of an employer mandate for health insurance coverage, and look forward to hearing your views on the matter.
Below is a copy of the response that I recieved from Representative Steven C. LaTourette (R-OH 14th)
Thank you for contacting me concerning healthcare. I appreciate you taking the time to share your thoughts with me about this very important issue.
As you may be aware, Congressman John Dingell introduced the America’s Affordable Health Choices Act of 2009, H.R. 3200, on July 14, 2009. I think most people will agree with me that our healthcare system is in need of some reform. There is no question that medical costs are skyrocketing out of control. Healthcare needs to be more affordable to more people and small businesses. Unfortunately, I do not believe that H.R. 3200 is the solution. This $1.6 trillion plan does nothing to reduce costs for people with coverage or for the companies that provide health care. All it does is continue to add to our already record deficit. I am puzzled how we can spend more than a trillion dollars reforming health care and the only reform achieved is higher taxes on people and business, less care, and endangering more than 160 million people with good quality health care. Last but not least, to approach this important piece of legislation at a frantic pace with arbitrary deadlines is dangerous and prevents the best solutions from being worked out.
I’ve been asked what my solution is, since I do not like this plan. As you may be aware, Representative Marcy Kaptur (D-OH) and I have introduced H.R. 956, the HealthCARE Act, which would establish insurance pools at the state level very similar to the program federal employees participate in. Specifically, these pools would allow small businesses to purchase coverage benefits for their employees, and individuals up to 200% of the federal poverty level would also be eligible to participate. You may wish to visit the Library of Congress’ website at http://thomas.loc.gov/ to review either piece of legislation more closely.
Once again thank you for your correspondence. Should you have any questions, please do not hesitate to contact me again.
Very truly yours,
Steven C. LaTourette
Member of Congress
August 13th, 2009 at 5:58 pm
BLC – You talk about the U.S. being 1st in responsiveness, well that might be true in some cases but let me tell you a little story. A friend of mine has Blue Cross. While at a football game he began bleeding internally from his colon. Not feeling it was too serious at the time (and with the help of his girlfriend) they left the game early. By the time they got home the bleeding was out of control, and the paramedics were called ASAP.
Arriving at the nearest hospital emergency room he was asked for his membership card, but he was unconscious so his girlfriend provided it (this hospital was not Blue Cross “approved”). His girlfriend had called me, and I was THERE when the nurse took his card! Under the rules of Blue Cross, he must notify his HMO within 24 hours or he’s responsible for the bill. His girlfriend didn’t know this and assumed the hospital would notify BCross, but that didn’t happen.
Turns out that because HE didn’t notify Blue Cross within that 24hour window of opportunity, he was now obligated to pay for the medical bills himself. To cut to the chase: he had major surgery, was in intensive care for many days, and then moved to a private room for a few more before he could be transferred to a Blue Cross facility (a risky thing even then considering the dangerous nature of his surgery). All his medical attention at the non-Blue Cross hospital were paid for by Blue Cross, but now HE was obligated to reimburse out-of-pocket EVERYTHING! Even the ambulance ride from one hospital to the next! After all was totaled, the bill for all non-Blue Cross medical attention was over $230,000!
He then went through an appeals process, with his main argument being he was unconscious when initially transported by ambulance until his recovery allowed transportation to the Blue Cross hospital, & the fact someone had presented his card on his behalf. This was to be presented to an arbitrator, but not an independent one…one APPOINTED by BLUE CROSS! He was up against a stacked deck! He went through a 3-stage appeal processes, losing in each one! When the last ruling was made, Blue Cross immediately began garnishing his wages…over $2000 per month! After more complaints, there really wasn’t anywhere else he could go or anything else he could do…except file bankruptcy.
After this episode, I don’t trust ANY of these HMOs! Not their medical care, but their bureaucracy. They could have the friendliest and best qualified doctors and medical facilities in the western world, but kill their clients with frustration, hypertension, exasperation, etc. What scares the hell out of me is I had the same HMO!
Could this same medical event occur in Canada or England…Yes! Would it be handled the same…NO WAY! Traveling in Ireland & Wales with a group of 35 students, 17 became sick (flu, food poisoning, ?). On the first occasion in Ireland, a doctor saw 2 of them immediately. On another in Wales, 2 doctors visited our hotel to see about 10. The last were given medical attention at the University of Edinburgh in Scotland. How much did this cost tourists? ZERO! People should not tear down the Canadian and UK heath systems and pontificate about ours if they don’t know all the facts or experiences! Also, privately owned hospitals ARE available in the UK that will accept additional money along with the gov. health plan, and provide instant treatment. Even these hospitals charge reasonable rates!
August 14th, 2009 at 8:38 am
Really Deb… you do the math! I am not in favor of the health care reform, but we do not do our argument any good when we post faulty figures.
August 14th, 2009 at 8:48 am
TP – right on the mark – I administer health care for the US, Canada, UK and Western Europe for my employer. The US system is a dog’s breakfast of rules, exclusions etc.. Medical decisions are made on a financial basis – not a medical basis – it is extremely short sighted with no long term perspective for the benefit of society.
August 14th, 2009 at 9:04 am
TP – I am very sorry to hear about your friend and I agree that the situation was completely unfair and unacceptable. If you have the idea that I think our health care system is working acceptably, be assured that I don’t. Please also understand that I am not intentionally “tearing down” any other healthcare system.
I think the problems in our current healthcare system are better solved by more thoughtful and lobbyist free regulation of the market. I think the current solution on the table creates more problems than it solves and the details are provided in the posts above so I won’t restate them.
Perhaps we can clarify our difference with a question; all things other factors being equal, would you prefer a government owned single payer solution or a properly regulated market solution?
August 14th, 2009 at 9:07 am
Steve – I think you have overstated the situation a bit. Certainly some insurance decisions are made on a profit basis, but most medical decisions are not. Also, I think you are mistaken if you believe that a government run single payer solution will not make medical decisions based on cost rather than individual need. You have to ignore a lot of hard evidence to continue in that belief.
August 14th, 2009 at 9:10 am
STN – I will address your individual points later when I have more time. In the mean time, are you saying that a governement run single payer system is the only or best way to solve the issues you identify?
August 14th, 2009 at 10:19 am
STN – I have thoughts on these as well. (I’m sure BLC will do a better job at this), but my 2 cents
I sit with underwriters each year for our employees health insurance to understand what it costs to add and subtract coverage (and I was an underwriter much earlier in my career), and while all of these items sound good on the surface and certainly would make life easier for those who have actually been impacted by these types of situations, everything in this bill you have cited will add substantial cost.
One must understand the fundamental principles of insurance – of asking (in exchange for a premium, or a fraction cost of potential future loss) someone else to share your risk. To do so successfully, an insurer (whether its for your car, your small business, your doctor bills, your liability from your actions, etc…) looks at all the risks and future costs and sets a premium. Adding each of these items would result in a substantial increase in cost to the insurer and thus your premium. In granting these things, you must accept that the cost for coverage will rise. Insurance companies average some 4.7% in profit – hardly huge but in dollars seems quite large. So, one must expect and CBO rightly costed, that such a bill will add, not subtract from the rising cost.
Out-of-pocket expense, deductibles and co-pays share the cost of the medical expense. Limiting them or eliminating does one of two things – either your coverage goes down or your premium goes up. Unfortunately, insurance companies can not print money like the government.
In my view, everyone must have substantial “skin” in the game – and thus must pay a substantial portion of their own health care cost including anything called “preventative”. If preventive is good, you should help pay for it. You can demand that an insurance company pay for that cost, but it will again raise your premium. There is no “free” ride.
I personally don’t think of children as a 26 year old although I’ve seen many parents treat their 26 year olds like children. This is a perfect example of an indulgent society that has produced generations of entitled people – people who demand others pay their way. Sorry, but a 26 year old should be paying their own way. According to IRS records released just the other day, the top 1% of tax returns pay a startling 40% of all income taxes yet many seem to think that still isn’t “fair”, including those crafting a “reform” bill. 47 million returns paid no income tax or received a net payment from the government. The top 5% of returns paid 60% of all income tax.
We can say that there are some good things in each of the bills now floating in Congress but there is much that is bad. The bad needs to be removed and the “good” needs to be understood in terms of the additional cost. Better solutions can be found and have been offered, yet so far, ignored.
Since you are a small business owner, I could ask if
- Do you fail to do business with someone you know is a bad credit risk for your services or do you do the work and pay out of your own pocket if your customer defaults?
- Do you lower the cost of your services in your business even though your costs are rising?
- Do you provide free maintenance or service on your product (without including in the cost of your services)?
- Do you drop customers for any reasons?
- Do you charge different prices for things that cost you different amounts to source?
- Do you provide lifetime services and warranties on your product regardless of cost?
Most people (including business people surprisingly) demand more from insurance companies than they would give themselves or their own business. Odd.
August 14th, 2009 at 10:33 am
http://www.nohealthbenefitstax.com/
Great site to calculate how your paycheck will be impacted if the current versions of reform are enacted and FSAs and HSAs go away. You may not be taxed, but the lost tax benefits of these accounts will impact your pay.
August 14th, 2009 at 10:41 am
JIM FOR PRES!!!! whose with me?! thanks for all the great information Jim! (I know there are others sharing good info as well, but I think Jim is right on!)
August 14th, 2009 at 11:14 am
STN
“rumors and invented nonsense”
Not certain specifically what you categorize here, but much of what some are calling rumors and fabricated nonsense is derived from what is written in the bill. Unfortunately, what several politicians who are pushing HR 3200 are saying the bill does, simply cannot be found so written.
I am very much for reform. Like Jim, I spend much time and effort to gain the best, cost sustainable coverage for our employees. It is not easy or inexpensive to provide. Amazingly, even though we pay over 80% of the premium, and have generous cost sharing provisions, many do not want to spend one penny for coverage until they get sick. Others drop the plan when pregnancy or other issue arises, to avoid any cost whatsoever. The expense of health care is partially being driven up by abuse of government programs. Does everyone really need an electric chair for free? Should the government provide cost-free coverage even to those who could afford coverage?
The pains of insurance are largely due to “waiting until you need it” to try to get coverage. Such actions change the cost modeling. Could you imagine the cost of car insurance, if you waited to buy it until after the wreck, and expected it to cover the damage already present? Pre-existing conditions were installed not to escape paying valid claims, but to encourage coverage before the need arises. Anyone with prior credible coverage is exempted from the pre-existing provisions.
If the coverage is to be of any real value, the insurer must be solvent. What good is an insurer, without the money to pay your claims? (Might consider national debt before jumping at the opportunity for the gov to be your insurer) To be solvent, an insurer must have and generate sufficient revenue to cover all insured losses. Overestimation is essential to ensure adequate funding. Profits for insures are a sign of strength financially, not a weakness and abuse of the insured.
Competition is key in any market to drive quality and cost-efficiency. Our present insurance model (hindered by regulations in many cases) is limited in competition. The individual plan market is competitive, but lacks the value-added advantage of risk pooling found in mid-large group plans. Group plans are limited in competition due to the narrow venue (employment) for group coverage (some states permit wider formation of groups) Individuals can be denied and dropped from coverage, group participants cannot. What would serve well as at least a starting point for reform would be: 1) federal legislation requiring states to permit non-employment forms of group policies (specifics defined by the state), 2) tax policy changes to permit any for-profit entity providing group coverage to gain the same tax advantages employers receive for coverage, 3) require payment (via loan-like plans) for uninsured receiving care at government expense (credit any refund or payout from IRS to the outstanding debt)
My biggest concern with HR 3200 is the written text of the bill does not match the spoken claims by supporters. The text of the bill includes, whether by poor communicative skills or purposed deception, items which discourage private coverage, and provide too much control by Washington. We can accomplish much good reform without further empowering the government in this area.
August 14th, 2009 at 11:34 am
Good stuff mkh. Thanks.
August 14th, 2009 at 11:42 am
Life never is as simple as theory; seeing constant problems I do not believe that free market and competition are enough to create fair prices when comes to big money. Look around, look at gas prices; with free market and competition why gas prices are so similar? We presently have a health system that drives long lines in LA for free medical help that was offered for few days in the LA Forum. If you saw news yesterday, these lines were not about illegals but working people without health insurance. This medical team who offered it, normally serves so called third countries. And it is not the first time they offer their free medical help and each time their offer brings long lines and people waiting many hours to get in. These people come with real problems not just check ups. Is this what we want for this country, having some who have health insurance and then others who do not have and unless we do not know these people we can drag this reform forever preventing it from happening under the pretext we have to create something superior? I would rather have a faulty system that covers everybody than a superior system that covers some.
August 14th, 2009 at 11:43 am
HWK – I am responding to your post of 8/11, I am sorry it is delayed and I hope you are still engaged in this productive exchange.
HWK “unregulated free market leads to no accountability because a few business[es] grow to such a degree that they can fix prices and become “too big to fail.”.
- BLC Rarely does this occur in a free market and I ask that you provide a couple of examples. In the rare case where it does, our market system breaks up the monopoly through regulation. This increases competition and favors consumers; empowering there ability to “vote with their checkbook”
HWK “At least you can vote out your representatives. And in principle, there is a balance of power, Even if some administrations choose not to recognize that.”
- BLC There is only a balance of power when the legislative, administrative and judicial branches are controlled by differing philosophies and agendas. That is not the case now. For the record, republicans don’t have a great track record when they have controlled the administration and the legislature either. We have more impact on our country through our spending than we do through our vote (I know this is arguable and I hope it doesn’t detract from our focus on the issue at hand).
HWK “A nation run by corporations, which is what we are, is heartless and owing to nobody even in principle, let alone practice, except shareholders.”
- BLC I contend that corporations on the whole are more responsive to consumers than the government. Yes, they are profit driven, but if they don’t meet consumer needs their profits go away. That is an operating principle in favor of the consumer. Government, politicians specifically, only need your vote once every few years. And they lie and cheat to get it. In addition, they are influenced (purchased) by lobbyists, who represent corporations (meaning unions, non-profit activists and commercial industry). If this country is run by corporations, it is because they bought our government.
HWK “At least government is founded on the idea of for and by the people and occasionally it works- notice the free debate going on right now, voters writing their legislators, etc.”
- BLC We are debating, our government is not. YET.
HWK “For my money, I distrust the free market more.”
- BLC We disagree. I believe the government has greater potential for corruption because they have less accountability.
HWK “I advocate a regulated private insurance run program that I believe you had put forth in earlier posts.”
- BLC After all that is above, we agree on this point. Different paths to the same outcome; what a great country we live in.
August 14th, 2009 at 11:51 am
EB – All other factors being equal, do you prefer a governemnt run single payer system or a regulated market system?
August 14th, 2009 at 12:04 pm
EB – I don’t understand . . . “I would rather have a faulty system that covers everybody than a superior system that covers some.” Even if I accept that these are the only two options (which I don’t), I would still disagree.
In a faulty system, all consumers of the system are impacted by the system faults. Some will receive substandard care and suffer because of it. Perhaps some people will even die. Furthermore, they will have very little (if any) to go outside the system for help.
In the superior system, people get excellent care. If some do not have coverage, they have the option to pay out of pocket, raise money, seek charitable help, go into debt, or go to where there is free substandard care.
In both cases some win and some lose. If both scenarios have winners and losers, why don’t you choose the superior system?
August 14th, 2009 at 12:11 pm
BLC, there is no possibility that all factors can be equal. As I said, I lived for 17 years in a single payer system (Canada) and I was functioning with much problems. I compare my experience with it to my present insurer Kaiser but at the same time I had this insurance no matter what, employed, unemployed or not working. It was not perfect but I was not scared when being sick or injured. I believe that health is not commodity that can exist on a free market system. Having it regulated, it means it is under government control anyway. I also believe that one system is cheaper and most of all much less complicated than the present one (and again, I am talking from my experience, dealing professionally with different insurance companies). At the same time, I am not opposed to have additional insurances and many Medicare recipients have them. The bottom line is, I want people around me to have health insurance, period.
August 14th, 2009 at 12:12 pm
BLC-
EHWK “unregulated free market leads to no accountability because a few business[es] grow to such a degree that they can fix prices and become “too big to fail.”.
- BLC Rarely does this occur in a free market and I ask that you provide a couple of examples. e
examples of companies that grow too big to fail without taking down lots of other smaller related markets- Auto Companies, Oil Companies, Insurance companies, Walmart, Credit card companies, Large Banks (what are there, 6?) I bought my home through a credit union and now Stearns owns it. Proctor and Gamble, Unilever, Colgate Palmolive, Kraft. Walk into the detergent aisle and try to find a brand of detergent that is not made by one of 2 or 3 companies. Even Toms of Maine and Ben and Jerrys are now owned by the large corporations. There is no antitrust legislation against them. If I choose to support Toms of Maine, I am now supporting the large conglomerate I was previously voting against with my dollar power. If any of these corporations goes under, they will take down so many others. Also, they now have the power to buy our legislators. And there is not much I can do about it except vote out my legislators that take their money, which is all of them. It is all corrupt, but at least I can influence my legislators. Not my bank, not other large conglomerates unless I choose to live in a tent and wash my clothes on the rocks in the river.
August 14th, 2009 at 12:20 pm
HWK “At least you can vote out your representatives. And in principle, there is a balance of power, Even if some administrations choose not to recognize that.”
- BLC There is only a balance of power when the legislative, administrative and judicial branches are controlled by differing philosophies and agendas. That is not the case now. For the record, republicans don’t have a great track record when they have controlled the administration and the legislature either. We have more impact on our country through our spending than we do through our vote (I know this is arguable and I hope it doesn’t detract from our focus on the issue at hand). HWK “At least government is founded on the idea of for and by the people and occasionally it works- notice the free debate going on right now, voters writing their legislators, etc.”
There is a balance of power until one party abuses their power to the extent that the nation says, “throw the bums out” or the general pulse of the nation changes and the pendulum swings the other way. Then the nation turns around and gives a mandate to the other party, then that one does the same thing. This is why reaching across the aisle, such a cliche’ but great when it happens, is so important and necessary, although rare. When it doesn’t happen, the pendulum just keeps swinging back and forth, giving more ammunition to the party who is not in power to just sit there for 4 years, tearing the other one down. That is why, in my heart, I want a single payer system, but I know, for practical reasons, we need the regulated private insurer option- to split the difference.
- BLC We are debating, our government is not. YET.
Our government is debating. There are different bills. gov. committees, townhall shouting matches. That is debate.
August 14th, 2009 at 12:32 pm
BLC,- What you are saying just isn’t the case! You said “In a faulty system, all consumers of the system are impacted by the system faults”. This is flat out WRONG! If ANYONE is impacted by our system it shows a fault and should be changed or altered! We both know who is! Some will receive substandard care and suffer because of it. Perhaps some people will even die. Furthermore, they will have very little money (if any) to go outside their system for help. I’m sure if YOU were affected by a poor medical decision you might think differently.
EB is right! Did you ever think about why this heated debate is occurring nationwide? Who the people are that are affected by disease, injuries, and age….and without any place to go? To lose your home, future and possibly life to someone/thing that only sees the $$ totals at the bottom of the page? The baby boomers, unemployed, underprivileged!
When it comes to medical knowledge, expertise, innovation…what is “on the table now”…at least SOMETHING on the table! I mean if you want to move a tree it begins with the first shovel full of dirt. Can anyone honestly feel that our current healthcare community will police itself? That it will do what is right for the people, country and corporate investors? Maybe for the investors/owners! The medical treatment itself that my friends, family and I have received for the past half century is without a doubt top notched (with brilliant doctors, nurses, researchers), but sometimes at a cost…extreme cost! This is a story played out across our country every single day, and it’s this cost (or their charges) that must be somehow regulated.
A “national” program will begin to put the people first when it comes to reasonable charges for healthcare services and medications. A balancing act of providing coverage and protection at affordable rates to our population, while still allowing corporate investors to make reasonable profits for their investments/investors. I don’t think we need a government-owned single payers solution, we need government to, in some way, regulate the system we now have…if at all possible.
The government (and I should say “representative” government BY the people WE elect) has never been in the business of building anything. Our highway system was built and is maintained by private contractors! So has our defense infrastructure (planes, ships, tanks, spacecraft), by companies like Boeing, Raytheon (and uh Haliburton?) This could be an internal regulatory problem we have, but it is the American way! I don’t see this as a need for “change”…just as a need for change in what they “charge” sick!
What we currently have in Washington is reaction and over reaction, etc. But it IS a debate to find a system that will work for OUR country. Maybe an idea from here, a technique from there. This simple fact remains: there are severe problems in healthcare that must be changed by the American people with sound and reasonable debate on all issues! But what I see happening across America is a desire by some to close their eyes and ears, and to do whatever they can to squash any sort of debate on this issue. That is not the American way, it’s the Eastern Bloc way! These tactics were used in pre-WWII Germany, and everywhere else behind the Iron Curtain! Please keep your eyes and ears open, listen, contribute and accomplish great things! Don’t devote your life and soul to tear down the goals of others.
August 14th, 2009 at 12:42 pm
EB,
True, life is not as easy as theory, whether the theory is ‘free market solution; or ‘government solution.’
You cannot effectively say “free market” has failed. A lot of the complications with the market is due to restrictions and limitations on adapting the market. The insurance market like every other market strives to provide a good product, and is priced according to cost of production and market demand. Without competition, pricing is skewed upward and quality diminishes.
You reference gas prices as an example of “free market” as well without considering the heavy taxes included in the pricing or the restriction on sources of supply. What kind of salary would you need if you were told you could not look for work in the state where you live, but had to commute to another? Could you take less? We have oil resources here in our own country, but the ‘unfree market’ cannot tap it, so we pay more to go overseas to get it. Health care is no different, we do not really know what the free market can do until we set it free to explore alternatives.
As for the LA Forum, be cautious. Were the recipients legitimate, (meaning not staged and without other means) Some people will come out for these things just to skip any costs, others because they were previously negligent (declined to enroll or save for expenses) These type events can be grand theatrics in selling a point. Much is being spent to “market” reform. Remember “free” care is already available at any state funded hospital, so why get care from a “third-world setting” as you called it?
August 14th, 2009 at 1:05 pm
mkh – when you refer to what occurred at the LA Forum, you are not only way off base, but out of line! If there are a few illegitimate or “staged” recipients that managed to sneak in it wouldn’t change the fact that there were thousands of people who needed medical attention! In fact if there was ONE person that needed this attention it was WELL worth it!!!
These “things” occur all over the country, but in mall parking lots, public parks, etc. and away from a news camera! The fact that it was at the Forum and in a large scale shouldn’t make any difference. What you imply with you comment was that, for various reasons, these people were out to get something for nothing by attending a “staged” event to “skip any costs”….give me a break!
I hope you have good health care so you don’t have to attend one of these “things”! I know in their circumstances it was not a pleasure trip to skip some costs by standing long hours in a hot parking lot in hopes of getting the treatment not available to them in a timely manner. I’m sure this wasn’t some sort of “PR” stunt! I’m proud of these people who did whatever they could to get the medical treatment for their families. Heaven only knows what other financial problems they might have at this point in our economy. But in a country that would take care of ALL it’s population equally this kind of event would never occur!
August 14th, 2009 at 1:10 pm
We are going round and round in this discussion; suspecting others having alternative motives even if they want to help; on one hand explaining whatever wrong is going in the economy due to different factors and then not seeing that a new plan is not going to be perfect because of the same factors that make everything more or less imperfect. The bottom line is, I believe that US is long overdue to have one basic health system that includes all. If it is a conglomerate of different insurances including one public plan so be it. If it is imperfect, we can work on changing it to be a better one but do it. We all have different opinions how it should happen. This time Democrats were chosen to do the job; let them do it and if they do not do a good job and are not willing to improve it, elect others who promise to improve it but the bottom line is, finally do it!
August 14th, 2009 at 1:20 pm
TP,
Something on the table?
Think about what you said. “At least there is something on the table.” About supper time, I will not be satisfied to have “something” on the table. Something could include an old shoe or mud pie, neither of which is acceptable to me. I need nourishment, but just “something on the table” is not a solution. And rest assured, I am taking action well in advance of the need to ensure it is filled. An old saying: Wish in one hand, and act in the other, and see which one fills up first.) Wishing does not put food on my table. I have to act. IT IS MY RESPONSIBILITY!
Health care reform is needed, but not just “something on the table.”
Good healthy reform would include:
1) Reforming expectations
a) Everyone should expect to provide for themselves
b) Assist others as needed
c) Not expect a free lunch to be a five star meal (Beggars cannot be choosy) Please note, I do not wish for anyone to beg, but if your begging due to lack of planning, do not complain.
2) Reform mechanisms
a) Treat health insurance similar to social security, you cannot opt out without forfeiture of benefits and proof of alternative arrangements.
b) Change laws to permit and encourage competing group options adding non-employment entities to group status
c) Redirect medicare/medicaid taxes to individual HSA-type accounts for use on premiums or copays/deductibles
d) Eliminate Medicare/Medicaid requiring all to possess coverage or alternative funding to cover expenses as mentioned
3) Present laws prohibit most of the protections supposedly gained thru the drafted reform bill, but many only apply to group policies. Getting more access to group policies and creating more competition among groups will foster better pricing and products.
As for national programs putting people first, I have not been living in the same country I guess. Government has been the most self-serving, self-rewarding institution around for some time. Giving them more will not change that. They are like the “freebie seekers” who the latest cell phone, TVs, car rims, boom box, etc, but need others to pay for their daily essentials. Less to Washington will help reform proper respectful representation of the people.
August 14th, 2009 at 1:36 pm
TP & EB,
I did not mean to state for fact these events were illegitimate. My point is more that we must look to the root of the problem, not just the symptoms. Why are these people here? Why do they not have other avenues, or why did they choose this one? If they are unemployed, why? If they lost group coverage, why did they not choose COBRA, or enroll in another plan?
We might also be wise to consider: Why are these providers doing this? (no assumptions) Why here in this setting? (Couldn’t they have just opened their clinic or hospital for free and had a better more sterile location, or provided coupons for free care at a facility via cooperative amongst providers)
I do not want to see anyone suffer, but some people won’t help themselves. I believe everyone deserves an opportunity, but failure to cease opportunity does not defer responsibility of that decision to another. A second chance, definitely when evidence exists it is due. Helping requires activity by the recipient first and in conjunction with the assistance provided.
We need as much effort in reform poor personal choices as we do market choices. The government, which if you recall is the people, cannot supply all things to all people. Every time you introduce another middle man efficiency and quality drops. Government has proven over time to be the less effective middle man around, it has no direct “skin in the game.”
More options + more self accountability = positive reform
August 14th, 2009 at 1:42 pm
MKH, you are contradicting yourself. Using your analogies, on one hand you want to have a gourmet meal for yourself but then you write beggars cannot be choosers. It means that the system should be rich and good for people like you (meaning those who can plan and have money and education to prepare a good plan for themselves) and then the others should have what is left meaning maybe an old shoe or mud pie if that what is left after you ate. I believe the system should be equal for everybody but I agree, if you want to have more than a nutrition meal than you should have ability to upgrade it to a gourmet meal. This should be a plan you should be in no matter what. How come you see all this corruption and wasteful spending in the government but do not see it in big corporations we hear about so much? Example: how many people lost their private pensions (I am one of them who lost a lot). I still hope I get my SS in the next 10 years even the system is having problems.
August 14th, 2009 at 1:43 pm
”I’m going to have all the negotiations around a big table. We’ll have doctors and nurses and hospital administrators. Insurance companies, drug companies — they’ll get a seat at the table, they just won’t be able to buy every chair. But what we will do is, we’ll have the negotiations televised on C-SPAN, so that people can see who is making arguments on behalf of their constituents, and who are making arguments on behalf of the drug companies or the insurance companies. And so, that approach, I think is what is going to allow people to stay involved in this process.” – Barrack Obama
Have you seen any of this? Some of you wonder why people are upset, why they protest, why they are angry, why they are using ACORN tactics – they were told something that has not happen. What has happened is largely in secret like the deal with Big Pharma. Why are people so cynical about all of this? Quoting from Robert Reich:
“But I also care about democracy, and the deal between Big Pharma and the White House frankly worries me. It’s bad enough when industry lobbyists extract concessions from members of Congress, which happens all the time. But when an industry gets secret concessions out of the White House in return for a promise to lend the industry’s support to a key piece of legislation, we’re in big trouble. That’s called extortion: An industry is using its capacity to threaten or prevent legislation as a means of altering that legislation for its own benefit. And it’s doing so at the highest reaches of our government, in the office of the President.”
August 14th, 2009 at 1:50 pm
The People’s Genie
He sat and watched in silence as the TARP bill passed. Told the sky was falling, he looked up and saw it wasn’t. But he shrugged, trusting the bipartisan nature of the effort. Then, as TARP rolled out, he stood up. The bailouts plowed a furrow across his forehead; his eyebrows lowered; his gaze intensified. But he stayed inside the bottle.
Along came the Stimulus Bill. Or, in the language of the big spenders, The American Recovery and Reinvestment Act of 2009. The Genie smelled the bacon through the glass bottle. He heard the squeals coming next from the Omnibus Appropriations Act of 2009. Another stampede of pigs.
Inside the bottle, the Genie’s leaned forward, pressing his hands and nose flat against the glass. As he watched banks and car companies yield to government control, his jaw slid up. His lips pressed tight. His breathing shortened. But he stayed inside the bottle.
In his peripheral vision he saw a dancing troupe dressed like Cossacks enter the side door of the White House and disappear within. The Czars had come. The Genie watched, and wondered.
Events outside the bottle picked up speed. More crisis talk was in the air. He checked the sky again. Still no signs of a falling.
Then, ever heavier and more complicated legislative tomes rolled out of Congress in carriages drawn by hubris and arrogance. Cap & Trade and Healthcare Reform. Their long official titles no longer impressed the Genie. But their huge price tags did. As did the mounting federal budget deficit for 2009. Now at $1.84 trillion, with more to come.
By this time, the Genie was rocking his bottle back-and-forth. He tried and failed to get the big spenders’ attention. His mouth moved, but no sound escaped his bottle, at least in the ears of the big spenders and the old news media, becoming ever more irrelevant with each news cycle as they peddle into obscurity.
The people felt powerless because they were. They had no voice that carried. The big spenders pretended to listen, but then condescendingly told the people that everything happening was for their own good. It was meant to be, they said. Doing nothing, they said, is worse.
When the people protested, they were called rightwing extremists, disruptive malcontents, organized mobs, Nazis brown shirts, and other names which they are not. In fact, they’re average American citizens in a nation where nothing is average about them. On the planet, they are the most extraordinary of citizens.
Calling the people names was the last straw. The Genie tipped the bottle over, put his feet against the cork, and kick his way out. Beware of an uncorked Genie.
August 14th, 2009 at 1:52 pm
TP – don’t assume that people who oppose the proposed legislation are well insured and unimpacted by the shortfalls in our current health care system. I have very personal examples of its failure and the effects will be with me and my family for the rest of my life.
To TP, EB and others that support the proposed legislation. We want the same thing. I want every American citizen to have access to affordable healthcare. We just want it in different ways. I think we are best served to look at the proposed solution and evaluate its effectiveness and long term impacts.
Best estimates (Washington Post and CBO) are that 17 million Americans will still be uninsured after ten years and 1.5 trillion dollars. Is this acceptable to you?
Are you willing to consider any option that does not include government take over?
August 14th, 2009 at 2:08 pm
here are some information I found on the net. I am willing to consider any option that would allow all to have not only access but to have health insurance. At the same time look below: · Medicare operates with 3% overhead, non-profit insurance 16% overhead, and private (for-profit) insurance 26% overhead. Source: Journal of American Medicine 2007
Health Insurance
· The United States is the only wealthy, industrialized nation that does not have a universal health care system. Source: Institute of Medicine of the National Academy of Sciences
· In 2006, the percentage of Americans without health insurance was 15.8%, or approximately 47 million uninsured people. Source: US Census Bureau
· Among the 84.2% with health insurance in 2006, coverage was provided through an employer 59.7%, purchased individually 9.1%, and 27.0% was government funded (Medicare, Medicaid, Military). (There is some overlap in coverage figures.) Source: US Census Bureau
· The primary reason given for lack of health insurance coverage in 2005 was cost (more than 50%), lost job or a change in employment (24%), Medicaid benefits stopped (10%), ineligibility for family insurance coverage due to age or leaving school (8%). Source: National Center for Health Statistics
· More than 40 million adults stated that they needed but did not receive one or more of these health services (medical care, prescription medicines, mental health care, dental care, or eyeglasses) in 2005 because they could not afford it. Source: National Center for Health Statistics
· Medicaid, which accounted for 12.9% of health care coverage in 2006, is a health insurance program jointly funded by the federal and state governments to provide health care for qualifying low-income individuals. Source: US Census Bureau
· Medicare, a federally funded health insurance program that covers the health care of most individuals 65 years of age and over and disabled persons, accounted for 13.6% of health care coverage in 2006. Source: US Census Bureau
· Medicare operates with 3% overhead, non-profit insurance 16% overhead, and private (for-profit) insurance 26% overhead. Source: Journal of American Medicine 2007
Health Care Expenditures
· In 2005, personal health care expenditures were paid by private health insurance 36%, federal government 35%, state and local governments 11% , and out-of-pocket payments 15%. Source: National Center for Health Statistics
· The United States spends twice as much on health care per capita ($7,129) than any other country . . . and spending continues to increase. In 2005, the national health care expenditures totaled $2 trillion. Source: National Center for Health Statistics
· 75% of all health care dollars are spent on patients with one or more chronic conditions, many of which can be prevented, including diabetes, obesity, heart disease, lung disease, high blood pressure, and cancer. Source: Health Affairs
· From 2000 to 2006, overall inflation has increased 3.5%, wages have increased 3.8%, and health care premiums have increased 87%. Source: Kaiser Family Foundation
· The average family health insurance premium, provided through an employer health benefit program, was $11,480 in 2006. Employees paid an average of $2,973 towards the premium amount. Source: Kaiser Family Foundation
Infant Mortality
· The United States ranks 43rd in lowest infant mortality rate, down from 12th in 1960 and 21st in 1990. Singapore has the lowest rate with 2.3 deaths per 1000 live births, while the United States has a rate of 6.3 deaths per 1000 live births. Some of the other 42 nations that have a lower infant mortality rate than the US include Hong Kong, Slovenia, and Cuba. Source: CIA Factbook (2008)
· Approximately 30,000 infants die in the United States each year. The infant mortality rate, which is the risk of death during the first year of life, is related to the underlying health of the mother, public health practices, socioeconomic conditions, and availability and use of appropriate health care for infants and pregnant women. Sources: CDC and National Center for Health Statistics
Life Expectancy
· Life expectancy at birth in the US is an average of 78.14 years, which ranks 47th in highest total life expectancy compared to other countries. Source: CIA Factbook (2008)
Bankruptcy
· About half of the bankruptcy filings in the United States are due to medical expenses. Source: Health Affairs Journal 2005
August 14th, 2009 at 2:18 pm
EB,
Not sure what you felt was contradictory.
You seem to assume I am wealthy, you would be wrong in terms of most. I drive older cars, less expensive clothes, eat out less, have less expensive cell phones, etc. than most on welfare. Imagine being teased for having “junk” by someone you are indirectly supporting via welfare. While I am working, living inexpensively to have means to help others in genuine need, the “government” is steady taxing away more of my earnings to provide even more to those who are leaching off society. NO, I do not think they deserve the same as I have earned.
I am not a self-serving stingy rich guy who is hoarding my riches and looking down my nose at the less fortunate, I simply do not feel unequal effort should bring equal results “guaranteed”
If we remove the obstacles to having access to non-employer group health insurance, we will find more affordability for all, fewer uninsured against their will, fewer deemed uninsurable (group plans cannot decline anyone), fewer uninsured due to employment changes, more competition for business as venues for coverage increase, and no need to have another layer of middle man (government) involvement.
I have known government (military & VA) health care first hand, and the waste is astonishing. The lack of coordination of care is awful. Military spent 3 years and untold amounts of money studying my heart, lungs, etc. because I had nose bleeds due to a failed (military-provided) nose surgery due to negligence. (government not subject to malpractice) The symptoms: when I run, all is fine until the damaged nasal tissue started bleeding, then I would get choked on the blood and could not breathe well enough to continue running. All I asked for and needed was a minor repair to the damaged nasal tissue to diminish the bleeding, that came three years later after much missed work, countless unneeded diagnostic test, etc. How can I possibly think this type government system can provide better care more cost effectively than the private market? In the military, I had no choice in treatment or coverage. Almost $65k worth of care to solve a $2k problem. Not to mention all the aggravation and almost getting discharged for malingering since test kept coming back normal.
Like the military care I was received, this bill is the wrong medicine for the problem. If government health care provisions are as successful as government retirement provisions (social security), we can all see what’s next!
August 14th, 2009 at 2:27 pm
Statistics are wonderful but are often used to tell a story that isn’t there. By that I mean, these do not necessarily tell us that our system is bad.
Example, the WHO stats on quality of health care are more subjective than objective and the last time they tried to measure quality was 2000. They gave up doing this because they said that attempting to quantity health care in different nations was too difficult. However, we still see the US ranked 37th, a 10 year year old number, floating around as a measure.
OECD continues to try to measure quality yet they are often comparing apples to hand grenades since not all nations report the same data as the US. For example, some countries fail to report their capital expense for health care and their cost of labor. Note too that the US is in the upper middle of their tables, surrounded by other countries that have government sponsored plans. The fact that we are in the middle of those types of plans by their incomplete measure does not support a government plan.
None of the stats presented would argue for a government sponsored health plan.
Life expectancies are flawed, especially since the United States is the only country that reports deaths under all 4 required categories – other countries report using only one or two criteria. Data skewed.
Interestingly, when medicare passed in 1965, wages were being outpaced by rising healthcare cost yet the congress stated that would not continue for long and certainly not beyond 1978.
No country has ever contained the rising cost of health care, regardless of system used.
You do not show what people pay in other countries in taxes for the cost of social programs. You would be interested to see that but often it is hidden in general revenue funds.
August 14th, 2009 at 2:27 pm
I “believe” that we are victim of “the Big Lie”. It’s a common Political tactic is to repeat something over and over again until people begin to believe it. The Lie. -”Health care is Broken”
The truth is that health care in this country is great for most of us.
By the numbers 85% of the people in this country have health insurance.
By any measure, the American Medical Care is better than what most of the world has.
The new plan at best will cover only an additional 10% of the population.
To my way of thinking we have some tweaking to do to the current system, not throw the whole thing out.
Currently, the federal and state government to some extent regulate what Insurance companies do. Who will watch over the health care system if the government runs it.
O’bama has state many times that the “new plan” won’t be perfect that it will be a work in progress. Why does he want to trade a “broken” plan for another “broken” plan.
My last point is that based on my 30 years of dealings with industry and with government. I trust Corporate America far more than any politician or bureaucrat. Yes, I have dealt with great people in both, but I have found far greater accountability in the private sector and more honesty.
August 14th, 2009 at 2:37 pm
EB,
· 75% of all health care dollars are spent on patients with one or more chronic conditions, many of which can be prevented, including diabetes, obesity, heart disease, lung disease, high blood pressure, and cancer. Source: Health Affairs
What is the leading cause of these conditions? Lack of preventive care? or Lack of preventive lifestyles?
· The average family health insurance premium, provided through an employer health benefit program, was $11,480 in 2006. Employees paid an average of $2,973 towards the premium amount. Source: Kaiser Family Foundation
Wicked employers only paid 80% on average; shameful? If you paid 80% of my electric bill for me, would you deserve to be criticized because I had to pay 20%?
· The United States ranks 43rd in lowest infant mortality rate, down from 12th in 1960 and 21st in 1990. Singapore has the lowest rate with 2.3 deaths per 1000 live births, while the United States has a rate of 6.3 deaths per 1000 live births. Some of the other 42 nations that have a lower infant mortality rate than the US include Hong Kong, Slovenia, and Cuba. Source: CIA Factbook (2008)
Where is Canada, England, etc. All of the wonderful social medicine success stories? Again to get value from this data, we must determine the root cause of the condition. How many of these children were conceived intentionally? We might should be praised for so many undesired children surviving rather than some not making it.
· Approximately 30,000 infants die in the United States each year. The infant mortality rate, which is the risk of death during the first year of life, is related to the underlying health of the mother, public health practices, socioeconomic conditions, and availability and use of appropriate health care for infants and pregnant women. Sources: CDC and National Center for Health Statistics
This data would be more useful for purposes of health care reform if it was limited to public health practices and availability of appropriate health care. Health care reform will not change the other factors.
Reform (improvement) YES, more government programs/control, NO!!!
August 14th, 2009 at 3:14 pm
As a closing thought on government providing for its citizens, I find this comment about the War On Poverty, now 40 years old, most appropriate. The WOP has spent some $7T taxpayer dollars with no improvement in poverty levels. Yet it has created an entire voter base that never before existed that is dependent on the government and can be pandered to by politicians at elections:
“You cannot legislate the poor into freedom by legislating the wealthy out of freedom. What one person receives without working for, another person must work for without receiving. The government cannot give to anybody anything that the government does not first take from somebody else. When half of the people get the idea that they do not have to work because the other half is going to take care of them, and when the other half gets the idea that it does no good to work because somebody else is going to get what they work for, that my Brother, is about the end of any nation.”
You can make you own up for government health care.
August 14th, 2009 at 3:24 pm
Sobering and true. It takes amazing will to pass up a free lunch. The pessimist in me says the majority won’t. Which means that our collapse is only a matter of time. And history tells us that those that take advantage and fill in the gap fo a collapse is seldom good.
August 14th, 2009 at 3:34 pm
Saw this clip…
Senator Chuck Grassley of Iowa, top Republican on the Senate Finance Committee, said in a statement Thursday that the provision had been dropped from consideration because it could be misinterpreted or implemented incorrectly.
Hopefully, the rest of Congress and the White House will soon follow, as the whole bill as written “could be misinterpreted or implemented incorrectly.” The latter be most likely over time.
August 14th, 2009 at 4:20 pm
Single payer is the only system that will work. People who think otherwise are entitled to be wrong and/or paid off by the big insurance companies.
Unfortunately, Single Payer is “off the table”. Too bad. It’s the only way to cover every citizen at a reasonable cost.
Calling what is now being proposed in Congress “government healthcare” is laughable. What is now being debated is so moderate, and so watered-down that only a right-wing extremist or someone very uninformed could think otherwise. Sorry, boys.
August 14th, 2009 at 4:24 pm
So you’ve done the math and calculated that it is the only way? Please share your data… Thanks.
August 14th, 2009 at 4:31 pm
Well, Jim. It’s not the “only way to go” unless you want all citizens to have comprehensive health care coverage at a lower cost.
If you’d like to give your money to private, for-profit insurance companies that will give you lousy coverage at a very high cost, cancel your policy for any reason, charge you extremely high “co-pays”, refuse to pay for your treatment and then drive you into personal bankruptcy after you get seriously ill or injured, you can do that instead.
Just leave me out of it.
August 14th, 2009 at 4:35 pm
The buck usually stops when those who propose using other peoples money to fund a social endeavor are asked to donate themselves. They are no where to be found. Lets add a line on your tax return for you to donate to this worthy cause. How much would you personally give to pay for others? I find people are terribly generous with other people’s money but not there own.
August 14th, 2009 at 5:01 pm
Sorry STN, but calling it anything but Government Healthcare is disingenuous at best. We could easily maintain a private health care industry and all of the benefits that go with it if government would limit its aid to the truely indigent and needy. Oh yeah, and stop “requiring” insurance companies to cover optional procedures (invitro fertilization being one).
August 14th, 2009 at 5:04 pm
Oh and I think you would be shocked at you just called a right wing extremist (and a boy for that matter) That kind of dismissive labling is what has so much of the country agitated about this topic. But I suppose it serves someone’s purpose to keep the discussion superficial and ad-hominem instead of reasonable and fact based.
August 14th, 2009 at 5:51 pm
BLC – I do support some sort of legislation to improve health care in our country. When that “FINAL legislation” is presented to the public and legislature, THEN I will say whether or not I support or oppose it. Like you, what I will do is express my opinion for all it’s worth! What we have up to this point are proposals that must be hammered out in one house, refined in the other, sent back and forth, etc., etc., etc. I support some sort of legislation (whatever it may be as long as it moves our country forward), but there is only talk and negotiation at this point. I am in favor of negotiation. I am in favor of compromise.
I am not in favor of the system as it currently is. As of now there IS no “legislation or bill in front of Congress for a vote! There are only proposals, discussions, counter proposals, negotiation, etc., etc., etc. Both houses are assembling their own versions! Some are trying to derail this process by mislabeling it.
Currently, only basic plans exist. Those who are so strongly opposed to any kind of proposal are doing everything they can to deny others their right to express their views (happily not here). To cut off ANY negotiation out of fear. Fear of what? Change! Do you feel there is harm in Congress (Republicans and Democrats together) working on some sort of plan that can provide health care for all Americans? Are you afraid you will lose your health care?
I think we want the same things. I would like every American citizen to have access to health care, one type or another. I want it to be affordable. I want it not to discriminate against young in favor of elderly, or rich in favor of poor.
We all pay taxes based on our income. This tax money goes to pay for roads…which we all use, education…which we all receive and continue to acquire, public services (street cleaning, police, fire departments, etc.) which we continue to use until the day we die. I don’t see health care to be any different, just more refined and equitable and available to all! Not a scrapping of what we have now, just a modification. When a person with health care gets sick, they are treated by their doctor. However there a too many in our country that cannot afford health care, and who suffer needlessly. No American should suffer! No elderly citizens, infants, middle aged, handicapped, etc. should suffer because they cannot afford health care under our current system. Americans are always among the first to help victims worldwide from earthquakes, fires, tsunamis, & droughts, so why not help our own people too? Not through charity, but providing equal medical attention to those who cannot currently afford it, so they can be healthy and live a productive life.
Too much has been said by some about this health program being “NAZI” in nature, however it’s the opponents of ANY kind of modified health coverage for everyone that are using NAZI tactics. Even though this was the National Socialist German Worker’s Party, it was initially built on private ownership of industry, etc. I think you can see where I’m going. We are not a Fascist or Socialist state! But we have a brilliant democracy that allows people (like on this site) to express their feelings. I know I’ve learned and changed some from what I’ve read, and I think if everyone does this kind of thing…listened, learned, participated, our country is the better for it.
Would I approve of a “government take over”? Well, this is already a government “of the people, by the people, and for the people operated by people. A government take over? Not hardly, but elected people doing their jobs by trying to fix a major problem in our country…a country that should be second to none! What works for one might not work for another, but then open talk and negotiation must occur for everyone in our country to have a chance for a better life.
One last note: They DO have private hospitals in England (GB) as well, ones that are supported by people who prefer to have faster service than the government supported hospitals and clinics. It involves an additional expense (in some cases additional or supplementary insurance), but the immediate response to illness/injury is faster. I know this to be a FACT from personal experience. Even good old GB has an option!
August 14th, 2009 at 6:01 pm
I think this subject is emotional to most people. I just wonder if there is anybody reading these opinions and has changed his or her mind and move to the “other side”. The problem I see is that many people express opinions and take them for facts not really knowing that their conclusions are real or not. I personally am willing to pay more if needed to have everybody insured. I do not believe that when everybody is insured, suddenly many will change to freeloaders and quit what they do right now and start using health insurance only because they have it. I also believe that if we all have health insurance we may use it more at first as it will be possible to those who presently do not have insurance or they are under-insured.
August 14th, 2009 at 6:06 pm
thanks TP- my feelings exactly!
August 14th, 2009 at 6:59 pm
BLC – I would never assume that “people who oppose the proposed legislation are well insured and unimpacted by the shortfalls in our current health care system.” I also have very personal examples both positive and negative (alzheimer’s/cancer). But I will never say there isn’t room for improvement! How much improvement? That’s based on the needs of the families and individuals involved.
Don’t misread what I say, and remember one important thing: there is no country in the world with better doctors than ours! Our hospitals are second to none! What we need to fix is the situation where someone who (for one reason or another) cannot afford the health coverage on their own or has no benefits through their employer. This doesn’t mean anyone else would lose their current coverage! It doesn’t mean that the quality of our current health care would go down! It means that more workers would lead more productive lives when healthy. We need coverage, but not scrapping what we have, modifying it! Make sure someone isn’t gouged by a health care provider simply because they can and do!!!!
The original goal of heath care reform was huge in scope, however it is much smaller now and becoming something that might benefit a great deal more people and be manageable! That’s the important thing to remember, to help the “tired, poor, huddled masses yearning to breathe free”. I Think that might be applied to any era of our history.
August 14th, 2009 at 7:51 pm
So much for “Townhall Meetings”. More like “The Little Rascals Meetings”. Maybe they should be “Townhall Beatings”? Chaos never achieves anything, nor does anarchy.
Everyone deserves an uninterrupted moment to express their view, opinions, and solutions! Then they should be silent while others express theirs. But when some in the crowd don’t hear what they want, they interrupt the speaker and try to “yell” their views into the heads of their enemies. This is not democracy, it’s the WWF! It happens every week in the British Parliament (questions for the Prime Minister), but they are given their opportunity to speak and then the other side theirs. They might yell after an issue is brought up, but then they listen to what the other side has to say. It’s open debate (and even more entertaining in person…even if you don’t know the subject matter). It’s emotional! It’s confrontational! It’s reactionary! It’s CIVIL! This is what should happen in our country at these “town hall jokes”, eject people that don’t allow others a chance to exercise their “freedom of speech”. “F. of. S.” is great, but it shouldn’t be like a hockey game. Speak your point, then sit down!
August 15th, 2009 at 2:02 pm
To all who is afraid of “government take over”, socialism and one payer system –
Do you know how much it costs to process a single medical claim due to the overcomplicated multiple payer system? Have you noticed the ever increasing number of the support personnel at your doctor’s office or the size of the hospital’s billing department? It is estimated that about 30% of the healthcare cost goes towards claims processing! So if you think the government is inefficient…
Now, imagine that god forbid, we have a single payer system and let’s do some math:
In 2007 US spent $2.2 trillions on healthcare; that is $7,421 per resident
(http://www.kaiseredu.org/topics_im.asp?imID=1&parentID=61&id=358)
If we still spend 10% on claims processing (how much your organization spends, anyways?), then we save about $440 billions a year;
That is enough money to provide healthcare to 59,291,201 US residents per year.
Hey, I just covered everybody!
Sorry, insurance industry, you just lost your profits…
August 17th, 2009 at 8:23 am
Lot of flawed logic and acquiescence to large bullying labor unions (SEIU/Acorn) to accept “faulty medical service” .
If what is being offered so great why resort to tactics like having one of your campaign workers (Senator Dingel) pose as a protester with a Nazi sign when the TV cameras are there and when they go away have him return to distributing your propaganda literature…not too smart. Or prohibit posters inside the meetings but allow union thugs with posters in the side door.
Citizens of this country have used town hall meetings in this manner for over 200 hundred years and now weak knee dems who insult anyone with a brain want an end to the very forum where we can yell if we want – Hillary Clinton said it was AOK to yell as loud as you want against ANY administration if we disagree…..so we are.
There are no organized citizen groups – except the unions who stand to benefit and are used as intimidation and enforcers (Sol Alinsky “Rules for Radicals” training again) at these events just really pissed off people who continue to be insulted and lied to.
Funny how Mr Obama said the AARP was infull support of his program when the day before they said they were not and two days after AARP comes out with an advertisement insulting people opposed to the new health care bill as if they are in full support…..so who is lying??
When the speaker of the house calls citizens exercising their right to free speach as “astroturf” (meaning phonies) then screw her because she no longer respects the constitution or any one of us. Like Obama she is a “user”.
August 17th, 2009 at 8:48 am
Exactly Deceived! I did a posting on that same topic this morning.
People forget the President was a trainer for Acorn, one of the most “in your face” organizations – his campaign gave them almost $1M in the last election. Congress funded them twice last year. When they use assault tactics, there is no mention of them by the press – when they are bused to AIG headquarters or the homes of AIG employees for the media to film “protesting”, no one says anything.
“Acorn protesters have disrupted Federal Reserve hearings, but mostly deploy their aggressive tactics locally. Chicago is home to one of its strongest chapters, and Acorn has burst into a closed city council meeting there. Acorn protesters in Baltimore disrupted a bankers’ dinner and sent four busloads of profanity-screaming protesters against the mayor’s home, terrifying his wife and kids. Even a Baltimore city council member who generally supports Acorn said their intimidation tactics had crossed the line.”
Whats good for the goose is apparently not good for the gander when it comes to their agenda.
As the former first lady, NY senator and now Secretary of State said: “I am sick and tired of people who say that if you debate and you disagree with this administration somehow you’re not patriotic. We should stand up and say we are Americans and we have a right to debate and disagree with any administration.”
Apparently her boss isn’t listening.
August 17th, 2009 at 9:27 am
Elena, you either need to show your work or redo the math – it’s not clear what you point is.
There was an interesting piece about all of this in the WSJ – the Koolaid on this issue is that somehow the $2.4T Americans spend on health care (or 17% of GDP) is some how bad. So where does the money go? It goes to other Americans for goods and services. No one seems to complain that 20% of the GDP goes to manufacturing for example so people can buy all their little toys, cars, homes, etc… But somehow, spending almost as much on health care is bad. Yes, someone will argue that other countries don’t spend as much in other countries – those numbers have been discussed and shown to not be valid comparisons to US health care expenditures. (We won’t redo that here)
One may not have noticed during the current recession that the health care industry has actually adding jobs – 19,600 alone in July – some 200,000 this year. In 2008, they added 30,000 jobs a month. Meanwhile the rest of the economy lost 6.7 million jobs. To demonize the industry for putting people to work is short-sighted at best. The industry can be viewed as one of the few growth industries the US has. Medical equipment exports have increased 65% between 2004 and 2008. Pharmaceutical exports other countries were up 75%. Future growth is projected to be impressive in areas of bio, nano, stem cell and human genone research, but only in a freee economy not dominated or run by the government. In 2008 alone, 400,000 non-residents sought medical treatment in the US because of wait times or technology lacking in their own countries – this area is expecting steady growth provided there is no government intervention. 3.5% of all inpatient treatments were from people coming from places like Canada where wait times are excessive.
We Americans love our technology especially when it comes to the latest medicines, procedures and equipment. They cost money and the increasing dollars going towards health care, health care manufacturing and real, long-term jobs should neither be a surprise nor demonized. Unless, of course, you want less innovation, less care…. Spending 30% on GDP won’t be bad at all if more Americans have jobs both directly and indirectly, would it?
August 17th, 2009 at 9:30 am
Elena,
You might be well served to inquire further, and learn what claims processing is so time consuming. You might be surprised to learn most providers have little trouble with private insurance, but hate Medicare/Medicaid.
August 17th, 2009 at 10:01 am
Elena,
My wife was at her doctor last week and was told by him that our local hospital follows Medicare/medicaid guidelines for all its billing and so do many hospitals and doctor’s offices. One might conclude that the increase in office staff is due to stringent medicare/Medicaid rules.
Do you really think that some “big fat civil servant” in Washington D. C. is going to be more efficient at processing claims than a clerk at a Insurance company who is being driven by some “greedy insurance company executive” whose massive bonus are based on productivity.
August 17th, 2009 at 10:37 am
You are right Paul – I’ve had the same conversation with my doctor on this.
There was a study done in 2007 on administrative cost – private sector vs. Medicare.
In 2005 there were 39.21M Medicare Primary Beneficiaries. The total non-benefit administrative spending was $19.94B. The total, non-benefit spending by Medicare was thus $509 per beneficiary. In the same year there were 201.2M beneficiaries in the private sector where a total of $91.1B was spent on non-benefit administrative spending. That works out to $453 per beneficiary, about 12% less than Medicare. Sources for the studies data included Centers for Medicare & Medicaid Service, National Health Expenditure Accounts. Specifically then, private sector administrative costs were 5.8% of patient care costs while Medicare was at 13.2%. Note that administrative costs include taxes paid to states and programs like preventative health programs for disease management. As the study concluded, even if the administrative costs in dollars were the same, the percentage would look lower for Medicare because the average Medicare claim far exceeds the average private sector claim. Thus, the 3% number thrown around for Medicare is a misnomer which excludes other Medicare non-benefit expenses per beneficiary and a calculation done based on size of claim, not total program cost.
August 17th, 2009 at 10:54 am
STN What you wrote about business and health is another proof that health should NOT be treated as business because profit should not be a part of the equation. At the same time, I believe you should have an option to sign for your health service with an insurance company where a profit is the bottom line but I believe I should also have an option to have a government plan if I choose so. I cannot believe that majority of the people who have a lot to loose by not having a public option are too blind to see it or to afraid to say something because of a loud opposition to the idea.
To those who believe in the right to voice an opinion, I believe anybody who has an opinion has the right to voice it. But there is a difference between voicing and bulling an opinion. Unfortunately in US a loud opposition even if it does not represent majority of voters is enough to change a direction of any debate. This is why people who have opposite views have to learn to shout loudly too.
Jim, I do not know where your information about adding jobs by insurance companies comes from but if this is true, it makes me wonder why this industry needs more jobs when number of people who are insured is getting lower due to growing unemployment rate. I wonder what makes this industry growing. At the same time, I heard last week that Kaiser was going to lay off people.
MKH, I pay bills on behalf of our members and the bills from private insurances and doctors take most of my time.
Paul, I believe productivity should not be a major word used when dealing with my health. Do you know that the picture you used – “big fat civil servant” was (and maybe still is) used in communist countries when talking about Americans in general? I sometimes wonder how on one hand government services are criticized and at the same time requested any time something goes wrong (demanding regulations, or criticizing for a lack of regulation if something goes wrong). We have this love-hate relation with our government.
Jim, you cite all these numbers for Medicare and private insurances but at the same time if you consider that Medicare deals mostly with older people who have more health issues than younger maybe then you may look at these numbers differently. Also you proved one thing: the more recipients a plan has the lower cost of administration per person is. That is known to any business. If we had one plan, I believe the cost per person would be lower.
August 17th, 2009 at 11:12 am
EB, the growth is coming in the biotechnology, nanotechnolgy, stem cell research and human genone areas. These are areas where capital and long-term reseacrh are being invested for future treatment and cures. America (as I pointed out) is filling a demand that other countries with government controlled health care can not in innovation and technoloy (just as we are in other high tech areas). Also the population is aging….
My comments on cost would suggest that just the opposite should occur. If the private sector spends less per person ($453 vs $509) on non-benefit administrative expense, why shift it towards government? That was the point of the study.
August 17th, 2009 at 11:14 am
Just to be clear – you can’t think of the 16% of GDP that health care costs as just insurance companies – there is a ton of industry that provides jobs in medical manufacturing, pharma, research and development for the health care industry that has nothing to do with insurance companies.
August 17th, 2009 at 11:38 am
EB – Productivity in processing claims should have very little to do with the quality of care you receive and is part of the cost we are all trying to reduce.
My reference to “big fat civil servants” was tongue-in-check. It seems to me that insurance, pharmaceutical companies and the people who run them have been demonize by those pushing reform. The terms “Greedy” & ” Evil” and similar words are used with Insurance and Pharmaceutical companies. Also profits and bonuses have acquired modifiers such as “excessive” Etc. I just thought I would have a little fun with with descriptive writing.
Does anyone know what the main driver is in the rise in the cost of health care? I can not believe it is the ‘outlandish” profits made by insurance and pharmaceutical companies
August 17th, 2009 at 11:58 am
My question is if a gov run healthcare option would be so wasteful and costly to administer, etc. Why does everyone always worry that the private sector won’t be able to compete? Certainly both can’t be true.
August 17th, 2009 at 12:12 pm
Well hwk, the government rights the rules and mandates (which by the way they don’t follow with Medicare for example). I’d let a public plan run as long as they provide the same coverage, follow their own mandates and pay premium tax to every state they do business. Also, they would be required to deposit reserves for future claims from the premiums they collect not fund from general revenues).
That would be a level playing field. But no where in the Constitution is government permitted to run commerce. So having a “public plan” operating in the private sector is really not what the founding father envisioned for American. It may be okay for other governments not constructed as we are who do not have a constitution that puts the rights of individuals right above any group and secures all property to the individual, not the government.
August 17th, 2009 at 1:01 pm
Jim, if private industries invest in future care and cures, they are usually well reward if something works out and should not be mixed in our discussion about health reform. Health insurances are to serve our present health needs. Insurances are against using any new methods and you have to fight them to get approvals for new methods and cures and even then people are not successful. And no matter what is a goal of any study, you can use statistic given and proof something else.
August 17th, 2009 at 1:28 pm
EB,
“MKH, I pay bills on behalf of our members and the bills from private insurances and doctors take most of my time.”
I cannot follow your comment. What private insurance or doctors bill you? Private insurance doesn’t bill for medical care; it pays for it according to plan provisions.
If you have private health insurance, why are you paying those bills. And who ever heard of a private insurance company billing a doctor or the patient.
August 17th, 2009 at 1:42 pm
MKH, I pay on behalf of our members we help with their payments for whatever is not covered by insurances they have. And believe me insured people still pay bills and I am not talking about co-pays. I have a long list of problems I have with these bills; trying to make sure we do not pay twice for the some procedures or pay for something it is covered by an insurance. There is no one uniform way of billing; bills are sent by doctors’ offices for payment when insurance(s) payments are not received; getting full documentation can be a major headache. Some members have two insurances and still have to pay partially or for procedures insurance companies do not want to approve. Insurances sent bills to patients and doctors sent their bills too and everything often finishes on my desk. Dealing with all these papers is not an easy task.
August 17th, 2009 at 2:27 pm
EB,
I am well aware of cost sharing, and believe it is an essential element of the health care system. When something cost nothing, abuse ensues.
As for your activities, it sounds like you work for a non-profit or something similar trying to help “low income” persons cover medical expenses whether insured or not. Some of the grief you express could be easily eliminated by adopting the practice of paying nothing until an explanation of benefits is provided for insured persons. Providers often use third party billing services that will routinely send bills prematurely, and even threaten collection, however, most employer group insurance plans utilize networks, and any network provider is contractually bound to: 1) file the claim 2) not charge the patient (except copays) until claim has processed. Almost every explanation of benefits I have seen in recent years will indicate all the information you need to know how much the individual owes.
Medicare/Medicaid is much more hassle to providers, as the paperwork is complex and payment is slooooow at best. It further impact private insurance negatively due the the three years allowed for reimbursement claim submission by Medicare/Medicaid. Much could be saved if Medicare/Medicaid was more timely, and had mechanisms to avoid paying claims on insured persons.
August 17th, 2009 at 2:47 pm
I do not want to take our discussion towards my problems so here is a short addition: if they were my bills I would know what to do but they are not and people on behalf I paid are often sick, old and often easily threaten by any letter and even more if they receive a collection letter. I believe if we did not have to deal with these bills at all and the payments were between companies no matter if public or private, sick people would be allow to use all of their energy to get better. When you have a cancer treatment you do not want to deal with anything else but your treatment. If you have to deal with payments and your next treatment is threatened or refused then your treatment may not be successful under the stress. I do not believe in mass overuse of a system that would make health care free in this country; however, I believe that presently we as a nation pay dearly for all these people who for one reason or another do not go to doctors when problems start and wait till they are catastrophic. If you really poor there is some hope but if you not exactly poor you have to decide if your family matters more or your health. In developed countries people should never be presented with this decision. I also do not believe that anybody who really can afford to pay for insurance does not. There are always exceptions to any rules but what is important what are the main reasons majority of these under or not insured do not have insurances.
August 24th, 2009 at 3:57 pm
mkh “Why are so many uninsured? Various reasons, but one prime one is the ready access to health care at no cost for anyone who is uninsured. You might be quite surprised at how many choose not to have coverage.” I totally agree. I handle our company insurance. My husband and I have always had coverage through our companies. I carried our children on my,froup health and it certainly was not cheap, but I felt a necessity. (You will too if you find yourself in a major medical tragedy like my son did in an auto accident.) I now carry a private policy on them – my son lost his job and my daughter just graduated and has not been able to find a job. At any rate, health care is free to those who don’t want to pay at the working person’s expense. As an example, we had an employee that had to have an emergency appendectomy the DAY BEFORE his insurance was effective. He got bills which he brought to me (Mexican and didn’t speak English) and gave HIPPA permission for me to handle it. The bill was reduced in half after a month. And after 9 months, when the employee made no payments, it was dropped completely! Another employee that had quit voluntarily had to have surgery (not emergency) on his leg. It was within the 60-day period for Cobra. He had refused Cobra, but because it was still within the 60 days, can you believe the hospital paid for his Cobra for 6 months!!! Taxpayer’s dollars at work.
August 28th, 2009 at 11:14 am
From Ann Coulter….
With the Democrats getting slaughtered — or should I say, “receiving mandatory end-of-life counseling” — in the debate over national health care, the Obama administration has decided to change the subject by indicting CIA interrogators for talking tough to three of the world’s leading Muslim terrorists.
Had I been asked, I would have advised them against reinforcing the idea that Democrats are hysterical bed-wetters who can’t be trusted with national defense while also reminding people of the one thing everyone still admires about President George W. Bush.
But I guess the Democrats really want to change the subject. Thus, here is Part 2 in our series of liberal lies about national health care.
(6) There will be no rationing under national health care.
Anyone who says that is a liar. And all Democrats are saying it. (Hey, look — I have two-thirds of a syllogism!)
Apparently, promising to cut costs by having a panel of Washington bureaucrats (for short, “The Death Panel”) deny medical treatment wasn’t a popular idea with most Americans. So liberals started claiming that they are going to cover an additional 47 million uninsured Americans and cut costs … without ever denying a single medical treatment!
Also on the agenda is a delicious all-you-can-eat chocolate cake that will actually help you lose weight! But first, let’s go over the specs for my perpetual motion machine — and it uses no energy, so it’s totally green!
For you newcomers to planet Earth, everything that does not exist in infinite supply is rationed. In a free society, people are allowed to make their own rationing choices.
Some people get new computers every year; some every five years. Some White House employees get new computers and then vandalize them on the way out the door when their candidate loses. (These are the same people who will be making decisions about your health care.)
Similarly, one person might say, “I want to live it up and spend freely now! No one lives forever.” (That person is a Democrat.) And another might say, “I don’t go to restaurants, I don’t go to the theater, and I don’t buy expensive designer clothes because I’ve decided to pour all my money into my health.”
Under national health care, you’ll have no choice about how to ration your own health care. If your neighbor isn’t entitled to a hip replacement, then neither are you. At least that’s how the plan was explained to me by our next surgeon general, Dr. Conrad Murray.
(7) National health care will reduce costs.
This claim comes from the same government that gave us the $500 hammer, the $1,200 toilet seat and postage stamps that increase in price every three weeks.
The last time liberals decided an industry was so important that the government needed to step in and contain costs was when they set their sights on the oil industry. Liberals in both the U.S. and Canada — presidents Richard Nixon and Jimmy Carter and Canadian P.M. Pierre Trudeau — imposed price controls on oil.
As night leads to day, price controls led to reduced oil production, which led to oil shortages, skyrocketing prices for gasoline, rationing schemes and long angry lines at gas stations.
You may recall this era as “the Carter years.”
Then, the white knight Ronald Reagan became president and immediately deregulated oil prices. The magic of the free market — aka the “profit motive” — produced surges in oil exploration and development, causing prices to plummet. Prices collapsed and remained low for the next 20 years, helping to fuel the greatest economic expansion in our nation’s history.
You may recall this era as “the Reagan years.”
Freedom not only allows you to make your own rationing choices, but also produces vastly more products and services at cheap prices, so less rationing is necessary.
(8) National health care won’t cover abortions.
There are three certainties in life: (a) death, (b) taxes, and (C) no health care bill supported by Nita Lowey and Rosa DeLauro and signed by Barack Obama could possibly fail to cover abortions.
I don’t think that requires elaboration, but here it is:
Despite being a thousand pages long, the health care bills passing through Congress are strikingly nonspecific. (Also, in a thousand pages, Democrats weren’t able to squeeze in one paragraph on tort reform. Perhaps they were trying to save paper.)
ADDED: Just this week, Dr. Howard Dean at a Town Hall Meeting flat out said tort reform was not addressed in the healthcare bill simply because the “writers of the bill did not want to confront the objections of trial lawyers to get the bill passed”. How true. They are the 2nd largest contributor to the Obama campaign.
These are Trojan Horse bills. Of course, they don’t include the words “abortion,” “death panels” or “three-year waits for hip-replacement surgery.”
That proves nothing — the bills set up unaccountable, unelected federal commissions to fill in the horrible details. Notably, the Democrats rejected an amendment to the bill that would specifically deny coverage for abortions.
After the bill is passed, the Federal Health Commission will find that abortion is covered, pro-lifers will sue, and a court will say it’s within the regulatory authority of the health commission to require coverage for abortions.
Then we’ll watch a parade of senators and congressmen indignantly announcing, “Well, I’m pro-life, and if I had had any idea this bill would cover abortions, I never would have voted for it!”
No wonder Democrats want to remind us that they can’t be trusted with foreign policy. They want us to forget that they can’t be trusted with domestic policy.
August 28th, 2009 at 11:17 am
Since someone will ask for proof here you go…knock yourself out….
The “Death Panel” already exists.
It is called the Federal Coordinating Council for Comparative Effectiveness Research.
It ISN’T in the Obamacare bill because it was already approved, funded to the tune of $1.1Billion, and signed into law by Obama in February as HR 1, the Recovery and Reinvestment Act, AKA Stimulus 1, AKA Porkulous.
Para 804, page 73 of the Adobe PDF file I downloaded from Thomas (http://thomas.loc.gov)
August 28th, 2009 at 11:42 am
I stopped reading after “From Ann Coulter.”
August 28th, 2009 at 11:54 am
I’ve tried to read what Not Distracted Either Says wrote but it was tough to understand his/her logic if there was any. I’ve never met anybody similar to this person and I feel really lucky. Wow!
August 28th, 2009 at 1:51 pm
A little advice to “Not Distracted Either”…
Don’t quote Ann Coulter if you want your words to be taken seriously by anyone beyond right-wing extremists.
August 28th, 2009 at 2:02 pm
Let’s refocus on the basics:
Every American citizen deserves comprehensive health care coverage. That coverage should be reasonably priced and cover everything for each citizen and their children.
Each American citizen should get this regardless of the job they have or their amount of personal wealth.
The models for doing this exist in every developed country in the world. Create a plan using one of them, or using a combination of the best ideas from all of them.
The only people against this idea appear to be 1) ideological conservatives who almost always vote against Democrats and/or 2) insurance company employees, their lobbyists and their lawyers.
Any questions?
August 28th, 2009 at 2:05 pm
STN you have my vote
August 28th, 2009 at 2:19 pm
Okay,
(1) How do you propose to pay for it?
(2) Who pays for it?
(3) Which developed country has found an effective way of controlling costs without restricting or rationing care?
(4) You need to think broader than your assumptions, unless of course you think most Americans fall into these two groups.
* Sixty-nine percent of respondents believe Obama’s plan will hurt the quality of their own healthcare.
* Seventy-three percent believe it would limit their access to tests and treatment.
* Sixty-two percent believe Democrats’ proposals would require them to change doctors.
* Seventy-six believe healthcare reform will lead to them paying higher taxes.
* A whopping 77 percent expect their healthcare costs to rise.
New York Times/CBS August poll
August 28th, 2009 at 2:26 pm
I agree, democrats are not good in fighting these believes but what you cite here are believes not facts. I believe most of these believes are wrong and nobody who believes them can prove them. It never stops to amaze me why people tend to follow scare tactics instead of looking what is in their best interest in a long run and for most of us is to have a health system that covers all Americans.
August 28th, 2009 at 2:35 pm
Ok then I will quote the Congressional Budget Office that says short and long term projections on cost and support for the program by the Obama administration is not achievable and understated by trillions of dollars.
Last Friday Obama issued an announcement that their deficit projections were off by $2Trillion dollars…..approximately the cost they quote for the program….meaning we can’t afford it.
Basic math any 6th grader outside of Detroit can understand.
August 28th, 2009 at 2:42 pm
Oh wait…we can’t believe the CBO either…..now can we……
August 28th, 2009 at 2:48 pm
“Jim” says:
(1) How do you propose to pay for it?
A: Through our income taxes that come out of the general fund; the same pot of money that also pays for things like the occupation of Iraq and the Pentagon.
(2) Who pays for it?
A: All citizens.
(3) Which developed country has found an effective way of controlling costs without restricting or rationing care?
A: Switzerland, France, Canada, Taiwan, Japan…and about 40 more countries. (However, you’ll make an excuse to ignore this, I suspect, no matter how long the list.)
(4) You need to think broader than your assumptions, unless of course you think most Americans fall into these two groups.
A: Was #4 a question, or just a rant?
According to the latest polls, 72% of American voters want the option of a voluntary public option for health care. I suggest that the minority who lost the last two national elections and who are trying to deny us a choice in our health care, stop trying to intimidate the majority with threats of violence and shouting down those they disagree with.
August 28th, 2009 at 2:52 pm
Insofar as “rationing care” is concerned, no country “rations” health care as much as the USA. We ration based on how much money you have and how good your workplace insurance policy.
Then, after you make your first significant claim, your insurance company will either refuse to pay it, or leave you with a “co-pay” for tens or hundreds of thousands of dollars. And that’s only if they don’t first cancel your policy for any reason, at any time, after you’ve paid thousands in premiums.
If you want to kneel before the insurance companies and trust them to take care of you, go for it. I want an alternative that will scare them straight.
August 28th, 2009 at 3:00 pm
Thank you STN! I am so sick of right wing radicals like NDE. I’m also tired of Dems that don’t fight the lies and inuendos but the lies that are out there about this health care stuff are ridiculous! It’s unbelievable how many people believe that crap!
August 28th, 2009 at 3:39 pm
(1) How do you propose to pay for it?
A: Through our income taxes that come out of the general fund; the same pot of money that also pays for things like the occupation of Iraq and the Pentagon.
>>So there is enough money to pay for the $9T in debt plus another $1.5T for health care )which doesn’t cover everyone by the way)?
(2) Who pays for it?
A: All citizens.
>> Interestingly – most Americans say they want care for all but only 26% want to actually pay for it, when asked.
(3) Which developed country has found an effective way of controlling costs without restricting or rationing care?
A: Switzerland, France, Canada, Taiwan, Japan…and about 40 more countries. (However, you’ll make an excuse to ignore this, I suspect, no matter how long the list.)
>>All of those countries are experiencing rapidly rising costs – none have found a way to adequately control costs even when rationing.
(4) You need to think broader than your assumptions, unless of course you think most Americans fall into these two groups.
A: Was #4 a question, or just a rant?
>>No there are more to people than just dems and repubs. Liberals tend to silo people into buckets and cannot think in broader terms. Many dems and repubs are against reform as it now stands not for ideological reasons but because its just plain wrong. I quoted the polls to demonstrate that a majority of Americans (Dems and Reps combined) say no – 54% say do nothing this year.
Last I checked, people are entitled to their opinions and entitled to voice them. The backlash by many Americans, regardless of party, is surprising to the liberals and progressives and they are having trouble dealing with it. Their views are just as valid as yours – characterizing people who don’t hold your view as intimidators and the like simply diminishes your position and shows you are not open-minded to other people’s ideas..
August 28th, 2009 at 3:52 pm
“How many of us take for granted the things created by our profit-driven, competitive system of capitalism? Someone seeking profits created the computers we use, the chairs we sit on, the clothing we wear, the food we buy, the cars we drive.
To many people, profits — when it comes to health care — represent pure evil. But how many of the same people turn down salary increases in order “to equalize incomes” of their colleagues? How many sell houses for less than they could get for them when other would-be buyers offer more? No, only the greed of others requires government to rein them in — lest they lie, cheat, steal.
Health care and insurance are not “rights.” Freedom of speech is a right. A fair trial — in which one is judged by a jury of one’s peers — is a right. Protection against government discrimination based on race or religion or against being victimized by unreasonable searches and seizures are rights. One is no more entitled to health care or insurance than one is to a Lexus or a mansion or courtside seats at a Los Angeles Lakers game. Desirable? Sure. A “right”? No. Yet unlike the Lexus, extending health care to the unfortunate is a moral imperative. That’s the definition of charity. But it’s not a constitutional right. ”
Larry Elder
August 28th, 2009 at 4:23 pm
It is not a constitutional right because there was no healthcare insurance back then, but some of us believe healthcare and basic education should be a right independant from personal wealth. We also believe clean air and drinking water should be a right (even though the constitution does not guarantee those either.) Far cry from a mansion or Lexus.
August 28th, 2009 at 5:29 pm
Call me what you like…, but comprehensive health care is not, has never been and hopefully will never be adopted as the responsibility of the federal government. Our federal constitution was never intended to intrude to this level in the lives of common citizens. State’s Rights allows any state to act beyond the scope of the federal government to legislate for and upon its citizens as the citizens of the state desire or permit.
The very center of the formation of this great republic (United States of America) was to unharness citizens from government (specifically taxation) without due representation. Moving such matters to the federal level continues to erode the level of representation the common citizen has within the controlling government. The constitution was not void of addressing such matters because they did not exist, but rather to prevent the centralization of an all powerful government body. By keeping the finite legislation at state levels, the representation of the people was stronger, and no single governing body could wield its way upon the whole of the republic. If one will recall, originally senators were not separately elected federal representation from each state, but legislators from the state level who served on the federal level also.
I do not support nor believe the government, particularly the federal government, should try to prop up anyone on an extended basis. Odd events may well justify intervention of a brief nature, but the biggest help government can offer its citizens is the freedom to pursue happiness. Material things do not create happiness, nor eliminate poverty or sickness. Lifestyles do however highly influence each of these. If government is to ‘provide’ these things to its citizens, it must usurp the control from the citizens in doing so or else fail.
I, like our founding fathers, want freedom ahead of all else. I have vowed to give my life to preserve it, (veteran) and will not condone, support or turn a blind eye to those who would betray us by removing that freedom.
A fundamental element of freedom is responsibility. Present leaders in Washington do not seem to think responsibility should fall to the ‘lesser fortunate’ as they call them. Hogwash, no one succeeds without responsibility. Neither can true happiness be found without it.
When Washington stops trying to run the lives and ensure the happiness of everyone, we as Americans will be more free, happier and more prosperous in the things of truest value than government can dream of providing.
Trying to eliminate ‘lesser fortunate’ is like trying to elevate the bottom of a box by lifting it. The bottom may be higher, but the top was lifted also to no real gain by the bottom. If you prevent the top from rising also, the box get crushed in the process. Our nation is one of the most generous nations on earth, yet we have those among us who belittle the citizens generosity, and try to replace it with forced charity at the loss of genuine good will giving. I have never had a neighbor who lacked daily needs unless they refused to help themselves. Likewise, I have never been down, but what a neighbor helped me get back on my feet. Life has its struggles, but just like falling when we are learning to walk or ride a bike, we cannot achieve genuine success without the lumps and bumps. A caring hand to help and coach is more valuable than one that won’t let me do for myself. If I am never allowed to let go and possibly stumble, I never learn to do it. Our welfare system and social progressives are like parents who cannot let go. They willingly trade what is best for the other to satisfy their needs.
Let’s not be so unwise. There are numerous opportunities for improvement in our present health care and related industries. Government intervention is as much the problem as it could hope of being a cure. Restrictions on how, when, who, etc related to health insurance purchasing does not foster competitive prices for consumers. If government would step away and again empower the citizens to act in their own best interest and be responsible for the consequences, we would find a vested citizen far more creative and efficient than any government on earth could ever be. The more we run toward increasing government’s responsibility for our every day life, the less and less free and innovated we become.
Like it or not, I will not surrender my freedom bought with the blood of our forefathers with a cowardly submission. My voice, my vote, and then my blood sweat and tears if it need be again. As once said, so say I again, Give me liberty or give me death.
August 28th, 2009 at 6:04 pm
Thank you!!! Amen!
August 28th, 2009 at 6:09 pm
There are so many of us veterans that feel our sacrafices, and those of our fellow soldiers, who served to keep this land free, have served in vain, as we watch freedom destroyed.
August 28th, 2009 at 6:18 pm
I thought the main cause for health care reform was to lower health care costs.
Adding another entitlement program adds costs. We can not afford such a program at this time without first:
Fixing the shrinking economy – we need more private jobs not more government jobs.
Reform Social Security and Medicare – each of these entitlement programs are going bankrupt.
Tort reform – there is huge cost savings in this.
I believe:
Affordable health coverage should be available for all US citizens, key words affordable (not free) and available (not provided).
Individual owned health insurance should have same tax benefits as employer-provided health benefits.
Insurance companies should be able to compete across state lines.
Promote the creation of affordable individual owned HDHP/HSA accounts from any insurance company in any state. Such plans should be portable everywhere.
I would support an individual mandate to have such a plan as minimum coverage or pay tax penalty.
No denial of preexisting conditions
August 28th, 2009 at 6:48 pm
Rebecca,
Unfortunately, it is not about affordable health care.
It is about using Health Care to Reform the American way of life. Health care reform is part of it, but the missing elements are what is referred to as the devil in the details.
I fear too many who have gained power over the last decade or two are foreign to the republic formed by our forefathers and the priceless values it has offered its citizens. It seems so many would blindly trust their way into servitude to a class of self proclaimed nobles who sense they are wiser than the poor peasants who cannot fend for themselves but must live off of the crumbs falling from their tables.
One need look no further than the massive amounts of money spent to to get elected. Genuine love of the ‘lesser fortunate’ would have seen that money put to direct use to resolve the needs rather than gamble on government’s ability to someday make a difference. Why go that route? Power, greed and pride! It is sad so few seek office out of genuine desire to serve than to be served.
If Washington does not wake up, look out in 2010/12, more like me may be on ballots everywhere. I have worked all my life and felt my basic and best applied service was to first tend to my own responsibilities, and then provide help to those who are struggling as I can. However, if the greater need is true honest statesmen of simple integrity to restore the foundations of our republic, I will willingly and of genuine earnest pursue and wane not from stepping to the calling. There can be no freedom, where silence and apathy prevail in the face of peril. America is still full of warmblooded freedom loving people ready to rise to the need of their country and fellowman. I see it every day in the news at town halls (even thought media slants the coverage), it is still evident that regardless of party affiliation, we are freedom lovers. As the threat of freedom begins to unveil itself, the people are awakening.
Those who so earnestly believe other nations are better and do more for their citizens, I have but one comment. Go to those greener grasses. Leave this field alone, for if it is lost, where shall freedom be found. If you do not love freedom, the world is full of place devoid of it. However, before you go, remember what make the grass green…look out for the fertilizer mixed therein.
August 29th, 2009 at 4:33 pm
yes, let us waste more time to demonize the insurance companies…they caused all this……next time you are in a car accident….call one of your friends here to help pay your bill.
keep focusing on this one (non) issue as everything you trusted that allows you to make comments here freely is taken away…..
http://news.cnet.com/8301-13578_3-10320096-38.html
you are gonna need more than health care….. useful idiots……
August 31st, 2009 at 8:18 am
In December 1917 Bolshevik Russian leaders, including one of the founders of Socialist thuggery Vladimir Lenin, established the Cheka — Russia’s first political secret police. With almost unlimited power, the Cheka implemented “campaigns of terror” against the wealthy, land owners and those who opposed Lenin and Bolshevism. !n 1922, once most of Russia’s opposition to their new absolute rulers had lessened, the Cheka was disbanded. However, under the singularly oppressive Josef Stalin, Cheka was reinstated and ultimately renamed “The People’s Commissariat for Internal Affairs” (NKVD) and what would be known as Stalin’s “Great Terror of the 1930s” began.
The NKVD was used against any and all Russian citizens who opposed Stalin or those who had the audacity to practice their religious beliefs. During this time period, hundreds of thousands of them were sent to the then frozen wasteland of Siberia. But, these were the lucky ones. During Stalin’s brutal reign, over 20 Million (some reports advise at least 28 Million) were executed in one way or another for opposing Stalin and his policies — 14.5 million were starved to death, over 1 Million were directly executed, 9.5 Million were deported to Stalin’s goon-run work camps or Gulags (political prisons). Note: Some historians place the number sent to Stalin’s Gulags at 18 Million.
As the resistance to ObamaCare (aka ObamaTotalControl) continues to grow within the American populace, America’s dictator-in-chief and his increasingly radicalized entourage had to find something to switch the attention of US citizens away from their looming demise under ObamaCare-Part 2 (did you know part 1 had already been covertly passed?). Therefore, Obama chose the ever-popular-amongst-the-leftists attack on the CIA. Besides this will be the proverbial stone that kills, at least, two birds at the same time. The non Obama-run CIA (Obama already has his personal replacement White House Secret Police interrogation Unit ready to go) is being replaced by ObamaThugs. Considering Obama’s swift and certain establishment of the ObamaCzars (now at around 50) who report only to him, Obama’s version of the NKVD should expand rather quickly.
Obama lackey and US Attorney General Eric Holder has called for “investigations” of the CIA’s alleged torture against those who attacked the USA — some who killed at least 3,000 people on 9/11/2001 and/or continued to kill and fight Americans worldwide. This is the same Eric Holder who dismissed the legally obtained convictions of New Black Panthers who had physically intimidated those they deemed non-Obama voters during the 2008 elections. It also allowed Obama and his media a new story to cover that they can now use in their attempts to — once again — stop the bloodletting and reporting brought on ObamaCare and silence the American people. And to what purpose and what end are those newly-refurbished-and-now-being- staffed encampments on nationwide military bases to be used? To date, no one in government or the military has answered the question.
David H. Janda, M.D. recently wrote his column “The Obama Health Care Plan — in One Word.” In this he explains how part ObamaCare Part 1 has already been passed, as it was covertly placed in the Obama Stimulus bill. In H.R. 1: Final Stimulus Bill pages 136, 151, 63, 73, 135, 153 and 351 “healthcare” and establishment of the Obama bureaucrats committee known as the Federal Coordinating Council for Comparative Clinical Effectiveness Research is addressed. Thus began the attack on American’s healthcare — without our knowing it. This was due to Obama and his minions shouting “You MUST pass this bill without reading it!” And so they did. Do you see why WE must now slow down or stop Obama & Co in their tracks? Obama’s variation of Soviet style rule — NOT governance — is already becoming law.
http://www.keyc.com/node/26686
http://www.ibiblio.org/expo/soviet.exhibit/secret.html
August 31st, 2009 at 9:49 am
Well said, MKH. You have my vote!
August 31st, 2009 at 10:29 am
mkh. I still disagree with you about the role of government in this matter, however I love to hear your thoughtful and considered viewpoints. If you were the mouthpiece of the republican party instead of the ones I hear constantly, I might not think the party was a group of hating, fearmongering liars, but just idealists like you with an opposing viewpoint to my own. Maybe you should run for office.
August 31st, 2009 at 10:45 am
hwk-you’re a nicer person that I am…I think mkh has taken the hate and fear that the right-wing uses to spread its lies and simply put it into his patriotic and diplomatic passage. There are many viewpoints but I still feel that mkh has been duped by the lies that the right has devised. Even the news talk shows know that the Reps are upset that a Dem will be responsible for the health reform, not a Rep. Both sides had a health reform package during the election – how soon we forget!
August 31st, 2009 at 11:00 am
true, but the bloggers on this post that continue this debate are looking at other countries’ systems, doing research, reading the proposals, etc and having a thoughtful discussion. Normally, all I hear from the right is lies and propaganda, scaring seniors and lighting up townhalls with fear of illegals getting healthcare and we’re all turning into socialists, etc. All very vitriolic and hyperbolic to the max. Hate, Hate, no, no. no. that our president is a foreigner, fear, Fear. I like actually hearing the viewpoints of people with fundamental differences who actually have an argument to make. All the immigrant haters have seemed to drop off this board. And now there is reasoned discussion. Still don’t agree, but I honestly never hear this from conservatives before. What does that say about the state of things?
August 31st, 2009 at 11:09 am
True – you don’t hear reasonable right-wing comments very much these days. The internet garbage that is being spread that people actually believe is so ridiculous. I have been watching this discussion from the beginning and have learned a lot – even changed some of the way I think about some things -but not without checking the facts. This is good stuff. Love the Anne Coulter comments and how quickly that passed! Made my day!
August 31st, 2009 at 11:40 am
Oops, LC- I spoke to soon. Here comes “History Lesson.” Sorry Jim and Mkh and others, This is what I was talking about. too bad.
August 31st, 2009 at 11:44 am
I know – don’t they realize that we all had to support that last president because we all wanted to unite in support of the U.S. because of 911 and dems have been fairly silent to the garbage for
August 31st, 2009 at 11:45 am
OOPS – FOR
August 31st, 2009 at 11:47 am
(SOMETHING WRONG WITH MY COMPUTER…GEE who can I blame this on…) what I wanted to say is that we have put up with Bush for EIGHT YEARS and we need to learn to unite again because most of the righteous right are going to continue to fight us rather than unite. It’s quite sad.
August 31st, 2009 at 12:16 pm
hwk,
It is very tempting to want or believe that “government” could and should provide such things for its people. However, our nation nor its government was designed to do so. The founding fathers worked diligently to devise a ‘necessary evil’ they called government, but was most careful to construct limitations on power held by government, checks and balances for the power held and refer almost all of the day to day governance to the individual states. These mechanisms are what has made this nation most unique, prosperous and free country on the planet.
So many things are good, but the means to acquire them may well be corrupt. It is good for me to want a family, a home, a car, an education, etc., but wrong to steal or cheat to acquire them. An old saying suggests that power has a way of corrupting and absolute power corrupts absolutely. Knowledge of just how power hungry and vile government can become, the forefathers sought above all to defuse such capability within our government. Breaking down these will and already are setting the stage for a return to a land absent of freedom except as permitted by government. We can do what they say, and go where they say, etc. Some government is necessary, but very limited government is most wise. Every age has known power hungry people, we have fought how many wars since wining our independence all to squelch the oppression of dictator-like regimes. The problem within the hearts of men will not cease to exist, hence the need for mechanisms constructed with the authorization of government itself that dilutes power, and preserves the freedoms of our citizens.
We are at a stage in this country where political insight is adolescent. What I mean is many are like children, who must try it rather than believe the experience of their seniors. When I was young, I was such a child. If dad said be careful the stove is hot, I touched it, and found he was right. The light pain quickly faded, but I did not have a foe seeking after me. The stove was stationary. Our forefathers had learned how government can burn its citizens, and strove ingeniously to prevent the potential abuse of power within the federal governance. We can move forward believing it won’t happen here, but the power hungry are not a stationary foe. They are lingering, looking for an opportunity. Crisis is opportunity, and we have seen no shortage of crisis lately, some real some exaggerated or fabricated. How many times have you heard a politician say leave no crisis unused?
I may not be able to bring you to a conclusion that health care is best served outside of government control, but I hope you will at least see the core of my concerns. I do not find genuineness in the political pursuit for health care reform. Instead, realizing how many non-government controlling options are available to greatly improve the state of health care coverage affordability for the uninsured, I find this as an ‘opportune crisis’ for the sole purpose of acquiring greater power over the people. The more we depend on government rather than the opposite, the less free we are and the more defenseless we become against would be power grabbers. (dictator-like leaders)
We are supposed to be a nation with a government that is ‘by the people and for the people’, but very little emphasis is being placed on ‘by the people’ these days. ‘For the people’ alone is not strong enough to maintain our liberty. The whole of governance was most largely placed on individual responsibility with very narrow provision for national intervention in the daily lives of the common citizen. States were second in the level of governing authority. More and more the federal government has gained “purse-string’ control of the several states, until many provisions not welcomed by the local citizens are forced via loss of funding threats. Where did that funding originate? Citizens, and if citizens are the origin, why is someone else in control of it?
My concerns, as you may well see, are much larger that “health care reform.” Health care reform, as the proposed bills are being called, is so little about improving the state of affairs for common citizens and much more about increased influence and control. I have read the proposed bills, and was gravely disappointed that in lieu of measures to enhance livelihood and well-being of ‘needy persons’ the bills grow government jobs, and leverage over people not even needing assistance. I am not against helping my fellow citizen or even foreigners, but am most adamant about preserving something greater than health care or prosperity, the freedom of the citizens of this nation. If this is lost anymore than present, we will have forfeited a true treasure for a worthless piece of bread.
LC,
I will close by saying, I am not a student of any left – right or other leaning person, but an individual who has learned to give due heed to warnings learned by predecessors. There is no insurance policy for freedom! If lost, it is gone. If you choose to have faith in those who seek more control over your life in the name of helping others, you have that choice. But may I ask, if the citizens of this nation have the resources to aid each other, could they not do more without a government middle-man? Could they not offer a tax incentive for citizens and businesses for contributing to the health care of those in need and again without the expense of a middle man? The answer is yes to each, so why are they not pursuing those approaches at least first? None of those offer power, control or revenue channeling.
August 31st, 2009 at 12:44 pm
Still waiting for one fact from the so called liberals here to support their positions…..just one. All I see is regurgitation of Bush Derangement Syndrome talking points….not one fact.
Oh wait…why would I ask for them to actually do some work…..they want a free ride there too.
I noted that Senator Kennedy didn’t subscribe to ObamaCare Principle on Dying when he was diagnosed with terminal brain cancer….he didn’t just take a “pain pill” like Dr Obama prescribed on the ABC Commercial and just “die”…..instead he sought out all kinds of high cost medical treatment and had surgery from the best money could buy…..much unlike what we will be expected to do…..hypocrites all of you.
August 31st, 2009 at 12:48 pm
mkh,
We agree in principle of limited government, just not in details. I don’t want my gov. telling me who I can and cannot marry, what God I should worship, what I can and cannot do with my body, etc. I don’t want government controlling me either. No red blooded American wants government control. But I do want Gov options for education and healthcare because unlike you, I do not trust the unfettered free market to always come up with the best or most ethical decisions for the people. I don’t like having a government controlled by only two parties and I don’t like having a world controlled by 6 banks, or a handful of insurance companies or having our food supply controlled by a few huge agribusinesses. I don’t like huge businesses gobbling up everything and making all decisions based on nothing but profit. And I recognize that the gov. is another huge business, but we can vote out the bums when they do the wrong things if everyone is educated, not by AM talk radio, but by measured and thoughtful discussion.
August 31st, 2009 at 12:56 pm
I think there is a feeling many have felt for quite sometime (not just the last 6 months), which is now being galvanized over the debate on the government running anything, let alone health care. It’s a debate between those who live lives of personal responsibility and those who live lives of dependency on government. You cannot deny our history – we are here because of an oppressive government that intruded in every part of our lives – and so the declaration of independence details. The constitution was an attempt to never allow the oppression to occur again.
Some argue the purpose of the government is to promote the general welfare and things like nationalized health care does so. But the founding fathers had a different meaning for the words general welfare:
“With respect to the words general welfare, I have always regarded them as qualified by the detail of powers (enumerated in the Constitution) connected with them. To take them in a literal and unlimited sense would be a metamorphosis of the Constitution into a character which there is a host of proofs was not contemplated by its creators.” – James Madison
I neither lean towards the right or left and have not voted in either direction. I have tried to vote for America and for freedom. I have not been a fan of any government program going back to Medicare in 1965, or the War on Poverty (that is still going with no results), or any other program that redistributes the fruits of one’s labors to others. This is not something that for me has arisen in the last 6 months, but throughout my entire work experience.
The government should regulate commerce such that we, for example, are not left with banks to large to fail, but they were never intended to run commerce. They should not be in the housing business hawking sub-prime loans through F&F and now FHA & Ginnie. They should not own car companies or insurance companies. They should regulate (and we’ve failed to do that properly over the past 30+ years), not operate.
August 31st, 2009 at 12:59 pm
Wow. thanks for your insight, History Lesson. More thoughtful discussion from the right. And because reading this makes me sick, this is the last you’ll hear from me. It was nice having a good debate while it lasted.
August 31st, 2009 at 1:14 pm
You are a very angry, close-minded person, History Lesson. I’m sorry for you.
August 31st, 2009 at 1:25 pm
People like “History Lesson” (this name is very ironic) who do not have any sense or real knowledge about “history” they are talking about are too far gone to be argue with; they will never be open to arguments based on facts and reality. Comparing what is going right now to what happened in Soviet Union during the worst time of communist regime is not only offensive to what is going right now in America but also very offensive to all victims who lost their lives during that time. The worst part is that when participants of this discussion forum get offended and decide not to be a part of the discussion because for people like “History Lesson” think they won the argument. That how a perception that these ridicule arguments are winning is created. I know there is not much left but to shake your head but at the same time, people who believe in the health care reform with a public option should never stop voicing their approval of it. It seems that in this country people who are louder win so learn to voice your opinion loudly too.
To those who do not want to be told what to do with their bodies and health, they can stay within the present system when insurance companies tell them what to do instead of US government. However, those who rather trust the government should have this option too.
August 31st, 2009 at 1:43 pm
Yeh, you’re sorry alright…
“A government big enough to give you everything you want, is strong enough to take everything you have.”
Thomas Jefferson
August 31st, 2009 at 1:53 pm
hwk,
Interesting how you mention “unfettered” free market. we do not have unfettered free market existing today. In fact, many of the problems with health insurance could be quickly (and might have already been) resolved, if government did not prevent various venues of solutions. An unfettered free market would dictate the ability of insurance companies to insure any individual or group of individuals, but government will not allow certain groupings of people for insurance purposes. If employment was not the most readily available means for group coverage apart from government coverage, we would see competition in the insurance market not only among insurers seeking groups to cover, but between the venues for acquiring group status. Having group coverage access apart from employment would further eliminate the side effects of job loss or change. The only group of individuals affected by preexisting coverage limits that justly deserve protection are largely those who have lost coverage due to job loss, and do not again qualify for coverage until credible coverage is expired. If group coverage could be affordably acquired through other non-employment based groups, this problem could be resolved. For those who choose not to have coverage due to personal choice, the absence of premium is just reward for the cost of care once something arises. As I mentioned in an earlier post, I cannot buy house insurance once the fire starts and expect coverage, so likewise it is fitting that the same be true for medical or any other insurance.
As for huge corporations and such, government has fostered these in many ways. Survival, which is a prime objective of any business, is often tied to managing the hurdles placed by government, or fertilized by government funding via grants, subsidies and contracts. So often, the huge ones are getting paid to middle man small independent businesses actually doing the work. This fosters lobbyists, etc. which more and more each day push us further from our origins as a nation. If markets were set free from the unnecessary hurdles, solutions abound, but when government hinders market influences (pure competition) problems abound.
I do not find consolation in the voting rights of citizens. How much effort has been put forth to stifle honest election processes. I live in a state where our government was “forbidden” by the federal government from requiring positive identification to vote. How can we trust a government that resists integrity in something so basic as an honest American election? The notion of disenfranchised voters, those who either choose to or cannot obtain valid id even for free, have a right higher than the right of true American citizens have to the absence of non-citizen interference in their voice in leadership. If I am too lazy or unconcerned about voting to go to the poll, are we soon to require someone bring a ballot to me? If I am too lazy or unconcerned to register, should that be treated any different than getting a free ID card? Should I be allowed vote anyway? Another example of our how our nation’s foundation is eroding away.
How many expressed disdain for Bush, yet he was in office 2 terms? Can we remove Congressmen from other states? No, but they can collectively override our representation and dictate laws upon us. This was not the foundation of our government as designed and put forth by our founding fathers. The federal government was greatly limited in its scope and responsibilities. States had a greater role, which permitted more customized government representation for its citizens.
The American population is increasingly becoming more child-like in its dealings with government. A bag of goodies, and all wiser judgement is forfeited. We need to get some backbone (will power) and tell Washington NO. As long and the more we seek their ‘goodies’, the weaker we will become as citizens and a nation. This nation was formed, not on the back and strength of government, but individuals with the drive and resolve to act. If this strength and will to do for onesself continues to wane, where shall strength be found in the day of need? A drafted soilder is the poorest soldier on average. (Please do not misuse my words, I am referencing the unwilling soldier, not a drafted one who then chooses to serve valiantly, that one is then motiviated by inner will not dictated orders) A soldier who does not personally know and be motivated by what is being fought for, does not constitute the strongest army on earth. Our forefathers were not regimented well-skilled armies, yet they won. How, the earnest fervent yearning ffor the freedom they sought motivated their inner strength and ingenuity resulting in an inquenchable force stronger than the finest of armies of the time.
They did not hope and trust in a government, but instead formed a government intended to preserve that for which they had risk and given life and limb. A government that responded to the voice of the people not a government to whom the people must respond.
August 31st, 2009 at 2:14 pm
EB,
Apparently, you have overlooked the provisions in HR 3200 section 102 designed to protect my right to keep my current coverage. It does no such thing. 1) It limits what coverages can be kept; 2) It prohibits cost of living type adjustments to coverage costs; 3) It amazingly PROHIBITS new enrollments in even the approved coverages that are permitted, while penalizing employers who are not offering coverage to ALL employees. If an employer cannot enroll new employees, how can they possibly comply? No new hires? (Poor encouragement with so many unemployed) Do they expect employers to gleefully continue to offer the coverage presently offered after they are forced to pay the penalty as if they offered no coverage due to new employees not being allowed to have the grandfathered plan? One need not read further to quickly realize the legislation is less about providing more coverage for Americans. It is designed to get employers to so called willingly drop coverage in lieu of the fee, which all employers subject to the law would end up paying even if they had an excellent no cost plan for employees. Again, the first new employee renders the employer non-compliant with the law and the fee (8% of payroll) applies from that point forward.
Reading the rest of the bill offers no additional consolation nor hint of genuine initiative to better the state of the common citizen. It does, however, grant unprecedented controlling mechanism to unelected government entities to exercise control over something as fundamental as health care.
In the market place, I have choice without direct penalty. The insurance company cannot lock me up, or take away my home, but we have a government who can. My employer cannot force me to work for them. True, there are consequences for my choices, but I am getting to choose those consequences, and govern the remediation of them. Government does not afford me that, it simply tells and often unmercifully punishes for non-compliance.
If I disagree with a tax, I cannot choose to ignore it without the government exercising the authority to take my possession or imprison me against my will. The free market has no such power. The bank can cease collateral offered, or garnish a meager portion of wages, but cannot clean me out completely or imprison me. So yes, I prefer to fall to the mercy of free market ahead of government against my will. Everyday of the week! For richer or poorer, in sickness or health, for I have espoused freedom ahead of other fleeting things.
August 31st, 2009 at 2:32 pm
Jim,
Some cannot see the difference between wanting control over one’s resources and greed. Greed is the desire for more by any means usually by means other than honest earnings.
I am not greedy, but, quite contrarily, often ridiculed as too generous. I do however, believe that the only honest and viable user of my goods is me. Someone else using what is mine is theft, except by taxation. Thereby, government is the only lawful thief around. Where will the greedy be found? Where the most gain without risk is found? Government!
Who has benefits and salary for life regardless of performance? Corporate CEOs? No! Wicked insurance companies? No! If not these among these egregious mongrels, then where? Government!!! Paid for by the workers tax dollars!!! Can you get a lifetime salary with benefits without relation to job performance? Can you vote to increase the wages your employer gives you?
We need to lessen government’s power over us and remove the lure of corruption brought by bigger money than found in any corporation. The power to tax or perhaps better described as extract revenue from citizens and spend according to the whims of politicians and government agencies needs to be decentralized and thereby nearly eliminated. Greed like poverty will never be fully eradicated, but it is so profoundly advanced by big centralized government.
August 31st, 2009 at 2:52 pm
Frankly, I think reasonable debate and discussion is woefully lacking on both sides of this issue. One side uses names like socialist and communist while the other says fearmonger and liar. Neither add productively to the solution. Unfortunately we have both represented in this blog as well. At the risk of being diverted by all the ad hominem garbage, let me say two things; it is not inherently socialist to desire a better American Healthcare System, and it is not a lie to say the current proposal will severely limit choice and freedom. If you disagree with someone, give a reason.
I could go on with that but its useless drivel. Those that get it, get it. Those that don’t, don’t. Instead, let me offer an olive branch to those that will not consider a solution without a public option. I am willing to change my mind and support a public option solution if it includes all of the following components.
- It replaces Medicare and Medicaid
- Those who can afford it pay fair premiums (based upon published actuarial tables) for the coverage (no subsidy provided by the government)
- The legislation must include a full summary plan description (description of exactly what is covered and what is not)
- Excepting coverage provided to those unable to pay (I am sure there would be discussions about the wage cutoff) the plan must support itself without additional subsidy.
- All required funds must come from “individual income taxes” and not corporate taxes, penalties or other hidden fees.
- The public option can not use the power of the government to dictate prices to providers. They can of course dictate what they will pay for particular procedures, treatments and/or drugs.
- The government can in no way encourage, induce or force any individual or group of individuals to participate in the public option
- The public option will be subject to all legislation and rules, both state and federal, that the rest of the healthcare industry is.
If the government is a better administrator, the costs will bear that out and more people will join the public option. If they fail, only those that have no other option for insurance will be covered and tax payer costs will at least be mitigated.
Any takers? Any thoughts?
PS – The Government is a business, businesses buy the government. Trusting either business or government is equally foolish.
August 31st, 2009 at 2:57 pm
Agreed – as I posted much earlier:
Most of us frown upon stealing from another regardless of the reason and regardless of the wealth of either individual. When a government does it in the name of reform we seem to go numb.
I have a right to life which includes a right to dispose of the fruits of my labor as I see fit. To deny me this right is to deny me the right to support my life. There is no such thing as ‘partially’ destroying a right. You can not create some new medical “right” (which is an economic “right” rather than an unalienable provided in the Constitution) without negating the right to property, and thus the right to life. This is true of any so called economic ‘right.’ If someone receives without working, then someone has worked without receiving. If the “work without receiving” was not voluntary, that man or woman is a slave. This is wrong and needs to be called wrong for the right reasons. It is to bleed dry the life from the healthy and productive in the name of fighting disease. This is true in all economic endeavors that place the so called interests of group or “society” above the actual, self evident, rights of the individual. It is especially ugly to do so in the name of health.
The bigger issue I see now is the mounting debt – the president’s own people missed by $2T in forecasting future debt in only a 90 day time frame. I’m concerned about what the largest peace-time debt will mean to my son and daughters as they grow through life. I would predict that they will be the first generation whose standard of living is less than the generation before them. I blame this squarely on both parties, as both have continued to spend – something you and I and everyone on this board cannot do. Based on our presidents calculations (and some believe them light), we’ll have a debt to GDP ratio of 76% by 2019, unheard of since WWII. Some suggest it may actually be closer to 100%. The largest it has ever been is 24%. This before we spend any money on health care reform.
We’ve become accustomed to the government borrowing to meet its obligations – something you and I cannot do indefinitely. If debt to GDP ratios do hit 75-100%, who will continue to buy our debt and finance government spending? No one. Thats a disaster far greater than the small potatoes on the table now called “reform”.
Regardless of party, one must face up to the mounting debt. We need to have people in Congress who have worked for a living, are not lawyers, are not career politicians and who have a respect for the constitution for which they have sworn to uphold.
I used to be quite generous – I’ve helped build churches, raise poor children in the US and elsewhere and a thousand other causes. Charity was always important in this country and plentiful before the income tax. It was part of a sense of personal responsibility NOT forced upon me by a government.
I saw a poster the other day who was attempting to argue that health care premiums are just too expense after paying for all the other expenses (mortgage, cars, etc…). I gently responded, if health care is so important to you, then why is that premium last on your list after you pay for all the consumerism you’ve just innumerated? No answer. He was so caught up in keeping up with the Jones that there just wasn’t any money left for health care – so is it really that important? Mre than the house you really can’t afford, that third car, Jimmy going to private college vs state college, etc…?
I ask again, as my grandfather would ask today, “What business of yours (congressmen) is my health?” and “Where is your sense of personal responsibility?”