[ October 18, 2007, 02:18 PM: Message edited by: Javert Hugo ]
Posted by Scott R (Member # 567) on :
I think the proper way to phrase this is:
quote:The President just used his fourth veto of his administration to kill [...] children.
Posted by Synesthesia (Member # 4774) on :
Pretty much. What is he thinking? Is he trying to get people to hate on Republicans right before the next presidental races?
Posted by Javert Hugo (Member # 3980) on :
Wow, and I thought my phrasing of it was a bit inflammatory.
We were just complaining that Congress was wasting their time writing entries in their slam book about Move On. Well, they did something real and good and productive, and the President killed it, and there's still a chance to save it.
Posted by MrSquicky (Member # 1802) on :
The Republican party is trying to regain the label of fiscal conservatives after the whole spending like drunken sailors when they were in power and the President feels that the expansions in the CHIP bill are too much and that it is a step towards socialized healthcare.
But yeah, vetoing health care for poor kids is going to be a pretty unpopular move and is going to likely going to bite some people right on the butt come elections.
Posted by Scott R (Member # 567) on :
My stupid representative didn't vote.
I sent her a stern letter.
Posted by ClaudiaTherese (Member # 923) on :
Oh, my heavens, no. Posted by Javert Hugo (Member # 3980) on :
So your representative was one of the eight weenies who didn't participate in this vote? I just hate it when reps do that - come on people, you're hired to take a stand.
CT, I thought immediately of you.
Posted by BlackBlade (Member # 8376) on :
At first I thought their had to be a rider or something that Bush objected to, but I just don't see one, and Bush cited "federalising healthcare" as his reason.
This just makes no sense to me. When Orrin Hatch and President Bush are on opposite sides of an issue, something is seriously wrong.
I hope they can rally the remaining 15 Republican votes needed in the house to override the veto and that the vote in the Senate remains consistant the next time around.
edit: My stupid representative voted nay. I'll be writing him tonight.
Posted by MrSquicky (Member # 1802) on :
The non-voters will likely vote for it later. I think they were staking out advantageous positions for the post veto bargaining without voting against health care for poor kids.
Posted by MrSquicky (Member # 1802) on :
quote:At first I thought their had to be a rider or something that Bush objected to, but I just don't see one, and Bush cited "federalising healthcare" as his reason.
I think it may have lacked an important part of the Bush supported federalized healthcare medicare drug program that the Republicans pushed past Democratic objections: huge cash payouts to drug companies.
Posted by Scott R (Member # 567) on :
I hate providing information to political people. It feels like giving my kids' photos to pedophiles.
Posted by Javert Hugo (Member # 3980) on :
Are you talking about the process of e-mailing your congressman?
Posted by kmbboots (Member # 8576) on :
I am pretty sure my Representative voted for this.
edit: By "pretty sure" I mean, I haven't found the roll call but she would likely have to have been tied up in a basement somewhere not to have voted for this.
I have given up writing anything but "atta girl" letters to my Representative. She is usually way ahead of me.
Posted by dkw (Member # 3264) on :
I just faxed a letter to my congressman. And John and I will be at a rally tomorrow urging him to change his vote and override the veto.
Hmmm . . . Baby's First Protest Rally. We'll have to get a picture for his baby book.
Posted by MrSquicky (Member # 1802) on :
My rep created the CHIP program for PA when she was a state senator. I haven't checked for her Yes vote either.
Posted by kmbboots (Member # 8576) on :
edit: (And while you're at it, notice on your left, the liberal, religious people.)
[ October 03, 2007, 03:51 PM: Message edited by: kmbboots ]
Posted by dkw (Member # 3264) on :
No doubt. Unless he's got a darn good explanation he just lost my support in the caucus.
Posted by The Pixiest (Member # 1863) on :
Too little too late.
I don't know why the republicans think that they can buy the votes of people who believe in entitlements. Those people will always vote for democrats.
He should have been vetoing grotesque spending bills like this his entire time in office, not right now at the end.
He's already earned the ire of the fiscal conservatives. He can't get us back. I'm glad he vetoed this appalling waste of money, but he's already poured the treasury down the Kharybdis of entitlement.
You may now go back your regularly scheduled cries of "...but the children!"
Posted by ClaudiaTherese (Member # 923) on :
quote:Originally posted by Javert Hugo: CT, I thought immediately of you.
katharina, it breaks my heart. If SCHIP isn't funded sufficiently, the real-world implications for tens of thousands of kids are staggering.
And oh my god, the ERs are going to be even more overstretched. They can't turn anyone away by federal regulation. So the asthma attacks, the pneumonias, the abscesses that seed out heart valves ... Good God.
---
Edited to add: not a regularly scheduled cry, The Pixiest, but a well-informed cry.
I appreciate that you may find this a stalwart rallying point, but I am not convinced that you are fully aware of how the outcomes of this program have been measured, both overall and as a dollars per head cost savings.
Posted by Megan (Member # 5290) on :
Hmm, my representative who is a Democrat voted nay. That's odd.
Posted by dkw (Member # 3264) on :
Pixiest, it will cost thousands upon thousands of dollars more to treat these kids in the country's ERs. Not to mention being much, much, worse for their health.
Posted by ClaudiaTherese (Member # 923) on :
quote:Originally posted by The Pixiest: I'm glad he vetoed this appalling waste of money ...
So .. by what qualifications is this a waste in your assessment, The Pixiest?
Posted by ketchupqueen (Member # 6877) on :
My rep voted Yea.
Posted by ketchupqueen (Member # 6877) on :
(And darn straight, considering that half the kids in his district are on CHIP. Including mine.)
Posted by MrSquicky (Member # 1802) on :
quote:I'm glad he vetoed this appalling waste of money
I'm not sure you and I have the same defintion of waste here. Money spent on preventive care, as a significant portion of at least the PA CHIP is, results in overall less societal costs for health care. This is especially true in the case of children. If the government is spending $5 of my tax money now so that I don't see a $20 increase in my health insurance premiums later, that isn't, to me, a waste of money.
Posted by fugu13 (Member # 2859) on :
There are several possible reasons to vote against it.
First, the budget estimates are intentionally deceptive. They're based on the assumption that, after a short period of time, SCHIP funding will be reduced to even less than the level it is currently at (heh, so everyone who voted for it could be accurately said to have 'voted to reduce SCHIP funding below current levels'). Of course, the bill's supporters know that won't happen. The actual cost of the bill is probably over twice what it purports to be. This is not a small problem.
Second, there's research suggesting it will have significant unintentional adverse affects. Specifically, when cheaper (but with much less coverage) health insurance has become available to lower middle class families before, they have strongly substituted for the new health insurance, dropping their previous, more expensive, but much better insurance. The upwards expansion of the income cap on eligibility is into that income range. The estimate I'm seeing is that one in three kids moving to SCHIP under the eligibility expansion would be doing so by dropping better insurance.
The intended funding source is a tobacco tax. Tobacco taxes are regressive. That is taxing the poor in order to help the poor avoid health insurance.
Posted by The Pixiest (Member # 1863) on :
CT: All social programs are an apalling waste of money. Most of the money goes to pay the administration and a little bit dribbles out to the people they're supposed to help.
Of course, it doesn't help in the long run. Government becomes Daddy. This harms the family, encourages illegal immigration ("That job is below me, I'll just take government assistance and let someone else do it." ) and slows the economy. On TOP of the injustice that is wealth redistribution. But this is a debate fit for another thread. A debate we've beaten to death before already.
But don't worry. As a libertarian, especially in the bay area, my vote doesn't count.
Posted by dkw (Member # 3264) on :
There are 9 million uninsured kids in the US. If 4 million kids drop out of private insurance in favor of SCHIP in order to get those 9 million covered, I'm okay with that.
Posted by ketchupqueen (Member # 6877) on :
Oh, and I'm strongly in favor of tobacco taxes-- research has shown that they reduce the rate of tobacco use, especially among teens, and that is something I am fond of. It's a pet cause, in fact.
Posted by ClaudiaTherese (Member # 923) on :
quote:Originally posted by The Pixiest: CT: All social programs are an apalling waste of money. Most of the money goes to pay the administration and a little bit dribbles out to the people they're supposed to help.
Ah. So, if a social program were to have most of the money going to those it serves rather than administration, and if that money were to be shown by rigorous outcomes standards to be successful in achieving the stated goals, then you'd be for that particular program?
Or this an ideological stance for you, independent of the facts of the situation? (Honest question, because it seems to me to be the latter, although I read you now as claiming the former.)
---
fugu13, that is useful information to pursue further. Thanks.
---
[Edited to add: At this point, I agree with dkw and ketchupqueen, but I am willing to keep reading and discussing it.]
Posted by The Pixiest (Member # 1863) on :
CT: And free of unintended consquences? Are these magic social programs?
I figured I'd been around long enough for everyone to know that I'm against every social program on principle.
Limited, voluntary, charity is great. So long as you don't let people get dependant on it.
So long as the question "Who will take care of my son/daughter?" is still firmly lodged in the back of the minds of every father... and his friends, family and neighbors.
But that's gone now. Everyone knows the government will take care of them.
Posted by fugu13 (Member # 2859) on :
dkw: it isn't just dropping out of private insurance, its dropping out of substantially better private insurance. Are you okay with 4 million kids having worse healthcare so that 9 million can be covered?
Posted by dkw (Member # 3264) on :
"Everyone" has never tried to get public assistence if "everyone" thinks that the government will take care of them.
Posted by dkw (Member # 3264) on :
Fugu: If they still have the basic level of care offered by SCHIP, yes I am.
And if it means their parents have a little extra money to buy them better food, new clothes, and maybe take them to the zoo now and then, I like that too.
Posted by ClaudiaTherese (Member # 923) on :
quote:Originally posted by The Pixiest: CT: And free of unintended consquences? Are these magic social programs?
[Edited out for snark. My apologies.]
quote:I figured I'd been around long enough for everyone to know that I'm against every social program on principle.
I had thought that about you, too, which is why I was surprised to see you giving claims of fact rather than just ideology here. It seems it may have been rhetoric, which I can better understand (if identified as such), even if I disagree. It is the rhetoric that looks like a testable claim of fact which perturbs me.
Posted by MrSquicky (Member # 1802) on :
I'm not terribly familiar with the studies you are talking about fugu, but from what I picked up in the NPR segments about this, aren't they pretty heavily dipsuted?
Also, as I understand it, one of the major aims of the expansion of this program is to allow states to expand coverage in high cost of living areas. That is, the eligibilty requirements are tied to the federal poverty rate, which can cause a problem when you looking at the disparity between families in NYC versus, say, North Dakota. If I understood correctly, the drop out numbers get kind of skewed when you factor in local cost of living.
Posted by The Pixiest (Member # 1863) on :
CT: Can you show me some social programs that have a high percentage of wealth transfer that actually reaches their intended targets without unintended consquences?
We get social program after social program. All with the best of intentions. They sound GREAT on paper. They never live up to what they're supposed to do, they always cost more and they NEVER go away.
How many times do we have to get burned before we say "No More?"
Posted by ClaudiaTherese (Member # 923) on :
quote:Originally posted by The Pixiest: CT: Can you show me some social programs that have a high percentage of wealth transfer that actually reaches their intended targets without unintended consquences?
Hmmm.
I don't think I'll go to the effort, since it is a rhetorical exercise for you. I have done this elsewhere at this site before, should anyone be so inclined to search, but it drains me to do it over and over again. [Edited to add: I do not know whether you would consider it a "high percentage," but it was certainly "more," which is all your initial claim in this thread asserted in negation.]
That drain isn't worth it to me when it is explictly acknowledged that the outcomes wouldn't make a difference to you.
quote:We get social program after social program. All with the best of intentions. They sound GREAT on paper. They never live up to what they're supposed to do, they always cost more and they NEVER go away.
Interestingly, this is not true, but I understand and accept that you believe it to be so, and will continue to believe it to be so regardless of what I say. That's okay. I certainly do not wish to prevent you from stating your beliefs, and I have no intention of bringing more useless clanging discord into the world (and Hatrack, as a part of it). I do think disagreement is appropriate and worth noting, though.
quote:How many times do we have to burned before we say "No More?"
If you insist on assuming a priori that everything is burning, regardless of whether reality resists that preconception, then yes, you will continue to "burn."
[ October 03, 2007, 05:07 PM: Message edited by: ClaudiaTherese ]
Posted by dkw (Member # 3264) on :
Let's see . . . an example of a program that has a ten year history of doing exactly what it set out to do . . . maybe a federal-state partnership with block grants and matching funds that allows a fair measure of local control while holding states responsible for meeting the goals of the program . . . something like . . . The State Children's Health Insurance Program!
This is a good and sucessful program. It needs to be reauthorized.
Posted by ketchupqueen (Member # 6877) on :
Well, if it wasn't for CHIP, my kids wouldn't have health care.
We make too much to qualify for Medi-Cal once the kids turn one; my husband has insurance through work but it would be too expensive to add me or my kids to his insurance. We couldn't make ends meet if we did.
Instead, we pay into Healthy Families (based on our income) and my kids get coverage through the same HMO as my husband, but have a lower co-pay, no deductible, and better coverage than he does. If my daughter has a medical emergency, I can actually take her in. She gets checkups instead of just shots at the free clinic.
I really don't mind the "unintended consequences" if it means that my kids have health coverage.
Posted by fugu13 (Member # 2859) on :
Keep in mind there was no disagreement between Congress and the President on re-authorizing, or that some increase in funding was needed.
I'm fairly sure there are far better approaches to the problem than this bill. I am much less sure whether or not this bill was good enough to warrant passing it, particularly in view of the alternative (also a funding increase, just not as big a one).
And I am not a fan of consequences, unintended or intended, that significantly harm the health of millions even if that improves the health of some other millions.
Posted by scholar (Member # 9232) on :
What private insurance out there is better than CHIP? In what way is CHIP not as good?
Posted by ketchupqueen (Member # 6877) on :
(That's what I want to know. My kids get much better coverage than you can buy privately, on a par with group plans, and better than most of those.)
Posted by Synesthesia (Member # 4774) on :
I don't see how most people can afford private insurance and I work for an insurance company. Without some limited social programs, the country would be a lot worse off. Sure, there's abuse, there's abuse in any situation or system. The key is to get rid of the corruption or limit it while still helping people who need it. Most people who are on public assistant are not lazy people who will just collect checks. A lot have children they need to care for, their circumstances have shifted. Besides, I'd really rather my tax dollars go towards helping people, even if there are a handful of sloths.
Posted by scholar (Member # 9232) on :
Bin will be using CHIP when she turns one. I know a lot of people making use of these programs. Keep in mind, that jobs that require large amounts of education pay little to nothing while training. So, doctors, lawyers, phds, etc- if they had kids before like 28, they are going to qualify.
Posted by Artemisia Tridentata (Member # 8746) on :
I agree that CHIP is a successful, needed program, and a model for appropriate Federal intervention. (In fact, as an old conservative socialist, I am not, in principal, opposed to a national single payer type plan.) However, the specter of families dropping avalable insurance does have some validity. Our guard union negotiated a "buy-out" provision for health insurance. It was supposed to have been a benefit for older guards who had other insurance in retirement plans from previous employment. In practice, young families have taken that option, (bought new pickup trucks) and moved their children to the CHIP. The parents are young and therefore invincible. As of this date the "plant" union has refused to follow suit.
Posted by Lyrhawn (Member # 7039) on :
Ironic that the leader of a party that advocates strong family values doesn't much seem to support the health of the children of the poorest of those families.
Strong family values...right.
More than ever I'm in favor of MORE nationalized healthcare and less private healthcare. If you want to buy your own super expensive plan that covers everything, then go for it. But the least among us who can't afford healthcare cost us MORE when they are uninsured than it would cost for us to insure them, so why not insure them? It's the same argument I used when it comes to the Green movement, it's not about socialized vs. unsocialized, it's not about economy vs. environment, it's about doing what is more efficient and cheapest. People just can't wrap their heads around the idea that a focus on preventive care is important and largely ignored at the moment, it makes overall healthcare cheaper in the same way that more expensive energy efficient products now make all energy consumption later cheaper.
This isn't about creating a nanny state. It's about creating a healthy population, cheaper. Hating socialized medicine just because you want to hate socialized medicine is stupid. Do what is best. Private insurance isn't best. Private industry is by its nature out for ONE THING above all else: Profit. National healthcare would be for one thing above all others too: Healthy people. So long as it is in the best financial interests of private insurers to deny claims, and for hospitals to not focus on preventing healthcare for people with diabetes because they make more money when they have to amputate a limb, our system is broken.
So, CHIP, good or bad? Good. Children are uninsured, their parents can't afford it, and without, kids wouldn't get regular checkups without putting their families in financial peril and ruination. When kids don't get regular checkups, it means they will get that care at the most expensive place possible: The ER. No CHIP means more expensive care, it means more unhealthy kids, and it keeps more families in despair and poverty. If you can have that and still feel good about America, then I really have to wonder where you're coming from. We champion self-reliance in America, but we also champion a people who take care of their own and each other.
Posted by AvidReader (Member # 6007) on :
Did we have another thread covering the expansions to the program or did I dream that? Cause I swear I remember seeing that Congress was going to raise the family income to $80,000 a year. People making that much can afford their own. Stay out of my pockets, please.
I don't mind helping people who make less than me. Or even as much as me with kids. I know I couldn't afford them on what I make. But we don't need to be covering everybody.
Posted by ketchupqueen (Member # 6877) on :
I'd still like to see proof that CHIP insurance is not as good as other insurance. 'Cause from what I've seen, it's as good or better.
Posted by Icarus (Member # 3162) on :
I'm intrigued as well [EDIT: to know why CHiP is inferior to private insurance] because of the constant claim that any publicly-paid-for insurance is worse. I don't know anything about CHiP, but my kids get Medicaid, and I would say that their coverage and service is better than my HMO.
Posted by ketchupqueen (Member # 6877) on :
Yeah, my last pregnancy my doctor referred me for a diagnostic 4-D ultrasound-- something that people with other insurance generally have to pay 20-40% of, even when it's medically warranted. (The lab skipped my screening tests and it was too late to re-do them by the time my doc found out. He was rather livid.)
Medi-Cal (CA state Medicaid) paid 100% of it, no questions asked.
I've never had to pay more than $5 for my kids for medical care on Healthy Families, and that's at a specialty clinic; regular preventive care is 100% free. With Healthy Families (CA state CHIP) they get great dental, vision, and health benefits, and they are covered for ANYTHING that might come up. Even our co-pay for ER visits is $5 (nothing if they're admitted.)
Posted by Icarus (Member # 3162) on :
I've never made a copayment for the girls. Never paid a cent, basically. And they've had all the referrals they need and stuff, with never a complaint. And I really like their pediatrician.
The only quibble I ever had was when they declined to cover Xopenex (Levalbuterol) and I had to switch them back to albuterol. I suspect that if I had fought that fight harder, I could have won it, but the girls seemed to have outgrowned their tendency to get hyper on albuterol, so I didn't really care that much. But I have much worse complaints about my HMO service.
Posted by ketchupqueen (Member # 6877) on :
Yes, Medicaid is great. I never paid anything with either of mine when they were on it (they stop qualifying at a year.)
Even OTC meds were free. The doctor would just write a prescription and they would be covered. Same with baby vitamins.
Posted by Dan_raven (Member # 3383) on :
When in doubt see what Fact Check. Org has to say.
Posted by Belle (Member # 2314) on :
quote:Yes, Medicaid is great. I never paid anything with either of mine when they were on it (they stop qualifying at a year.)
Even OTC meds were free. The doctor would just write a prescription and they would be covered. Same with baby vitamins. --------------------------------------------------------------------------------
No, the meds were not free. Somebody paid for them. Maybe not you, but somebody, somewhere did.
It sounds great to say "Hey, let's make sure every single kid has health insurance and their parents don't have to pay anything." Sounds great, doesn't happen in the real world without also finding the money to pay for it.
Don't most states have programs to cover children without insurance? We have AllKids here in Alabama. Is this bill cutting funding to state programs, or is it cutting funding to something that is separate from state programs? I'm just too busy with school right now to read up on everything properly, so I apologize if those are basic questions or if I'm missing the bigger picture.
Posted by Icarus (Member # 3162) on :
You're arguing a different side of the issue, Belle. Neither of us were discussing the ideological value of government-provided services versus everybody paying for their own. The specific complaint that I wanted addressed was the "quality of service" complaint. I simply have not found the quality of Medicaid service to be inferior.
Posted by Belle (Member # 2314) on :
I get that, Icarus, and as far as I know the AllKids insurance here is not inferior either.
I just don't think we can lose sight of the fact that funding for programs dosn't magically appear when it's written down in a budget. It does have to come from somewhere.
Does anybody know what the federal vs. state contributions to these programs is? Because I think it's mostly a state-funded program. As a staunch believer in local government over federalizing everything, I'd prefer that, myself.
And I don't mean to be crass here, or unsympathetic. I can certainly understand being in circumstances that are difficult and needing help to properly care for your kids. But, as somebody who fights like heck to come up with the money for our premiums and copays and sees it as a losing battle - for the past three years any raise my husband received was negated by an accompanying increase in insurance premiums - it sort of rubs me the wrong way to see people talking blithely about not even having to pay for OTC meds.
But forgive me, I don't mean to be aggressive toward you or kq, I'm tired. I will bow out of the conversation since I probably don't have much substantive to add.
Posted by ClaudiaTherese (Member # 923) on :
Belle, each state in the US is required to have a program (as a part of SCHIP, the State Children's Health Insurance Program, which is Title XXI of the Social Security Act) that provides healthcare coverage to children who do not have it otherwise.
AllKids is Alabama's version. BadgerCare is Wisconsin's version, and KidCare is Florida's. These are exactly the programs being discussed here.
Basically, each state is required (federally) to have such a program, and the state funds are matched with federal funds up to a certain cap. The states have a lot of leeway to tailor the program's benefits and its adminstration within each state itself, although there are minimums set for coverage.
Posted by Icarus (Member # 3162) on :
I'm not offended or anything, Belle. I don't have a lot to add either. I don't know enough about the specifics of this program. All I have is my limited experience of Medicaid.
Philosophically, I happen to be of the belief that this country can and should make adequate medical care a right instead of a privilege. "Adequate medical coverage" to me means access to a regular doctor, and not just running up credit-rating-crushing-debts at the emergency room. I am also swayed by the arguments that say that making this occur will be a sound investment, economically, compared to the cost of footing the bill for unpaid emergency room bills after preventive care has not taken place. But I fully admit that that's not a position I have researched, other than reading posts here. I have simply chosen which experts I find most convincing. Posted by scholar (Member # 9232) on :
AvidReader- Dan_Raven's factcheck link addresses how much a family of four can make and be on CHIP and where the $80,000 number comes from.
Posted by porcelain girl (Member # 1080) on :
Oh, and if anyone wasn't sure, I am completely for universal healthcare. It really does cost us less on the long run, since emergency medicine is much more expensive than preventory medicine.
Also, I have to spend around $400 dollars a month just to BREATHE. That doesn't include doctor visits or emergency room visits. Even with health insurance I couldn't afford my medication. It is actually more cost effective for me to stay below the poverty line and get my medication from the free clinic than to get a wage job with health insurance. I ended up significantly poorer with health insurance. The majority of my money went to medical costs. This is just about respiration, mind you. Nevermind GYN visits, that I've had thrush since April, and the fact that if I don't get to see an orthopod and a physical therapist soon my career as a dancer may be prematurely snuffed out thanks to a brilliant knee injury.
I also had the harrowing experience as a teenager of being caught in a state that had next to zero public health programs if you weren't pregnant. I couldn't even afford to go see a doctor to get a prescription for the medications I needed, much less actually get the meds. I went at least six months barely breathing. Every other night I stopped breathing in my sleep. Great life for a dancer, huh? Of course I couldn't dance in this period of my life. Or run half a block, or walk in the cold, or, well, anything.
I would gladly give up much of what truly is luxurious (television, high heels, haircuts, conditioner, ice cream, gasoline) in my life if it meant no one else had to go through that sort of desperation and fear. I already donate more than I can afford to the Family Clinic that has been providing my basic healthcare for a couple years now.
I truly feel that in the long run it would benefit us all, as a society. So many of the people I know work their butts off and still can't get the healthcare they need. Right now healthcare for Americans is determined by Pharmaceutical Companies and Health Insurance Companies. The former being incredibly capitalistic in their means and ends, the latter being more about sheisting than helping.
The fact that this particular issue is about CHILDREN'S access to healthcare makes this a black and white issue for me. Either you give a crap about innocent people, or you don't. ::shrugs:: And if you don't, I wish you'd go live somewhere else. Alone. /rant.
quote:If they'd rather die, they had better do it and decrease the surplus population. Good night, gentlemen.
[ October 04, 2007, 03:43 AM: Message edited by: porcelain girl ]
Posted by Lyrhawn (Member # 7039) on :
quote:Originally posted by: porcelain girl
quote:If they'd rather die, they had better do it and decrease the surplus population. Good night, gentlemen.
Republicans vote Scrooge in 08!
Posted by AvidReader (Member # 6007) on :
quote: The fact that this particular issue is about CHILDREN'S access to healthcare makes this a black and white issue for me. Either you give a crap about innocent people, or you don't. ::shrugs:: And if you don't, I wish you'd go live somewhere else. Alone. /rant.
And to be totally cynical about it, that's what the politicians are hoping for. They can put anything they want in bills like this if they get us used to the mindset that it saves poor children.
As for the factcheck numbers, Florida's looks great. $40,000 is enough for two people if they're careful with their money. It wouldn't be enough for kids. $50,000 in states with more taxes makes sense, but what's the cost of living in NJ that families making $70,000 a year qualify?
Is that $70,000 when they have a kid with a birth defect insurance won't cover, or is that anyone? Cause I'd think you could reasonably afford decent insurance on your own. I'm even leery of the $60,000 amounts in most states. I just have a hard time seeing that as low-income.
Frankly, it looks like a lot of these states need to be reigning in their spending, not expanding it. I don't mind helping people who need it. But again, I don't feel the need to help people who make a lot more than me cover their insurance.
Unless the kids have birth defects. I think there should be a seperate program that just covers that. You need a procedure or medicine that costs a certain percentage of your household income, and the rest of us pick up the tab. You can wipe out a family no matter how much they make with a couple expensive surgeries.
Posted by AvidReader (Member # 6007) on :
Actually, I think I'd expand that idea to everyone. Get the job you want, and medical expenses over a certain percentage would be shared by everyone. We have 300 million Americans, you'd think we'd do ok spreading out the cost. The hard part would be figuring out how to prevent fraud and legal junkies from abusing the system. But I think it's a good starting point.
Posted by Samprimary (Member # 8561) on :
To all those concerned, who bemoan waste 'inherent' to social medical systems:
Our own private system costs two and a half times the industrialized world's median costs per capita and is worse than all the G8 social medicine systems and pours bucketfuls of money into bureaucracy and paperwork.
If one is concerned about waste and inefficiency and has a fairly truthful and honest understanding of the situation involving healthcare, the only real option is an abandonment of the private model.
Let's start with cries of 'but the children!' since they take us in the right direction (hint: preventative care is good for all of us)
Posted by Wendybird (Member # 84) on :
What frustrates me about the guidelines in my state is if we were to make enough to cover all our bills, including the student loans that continually accrue interest but aren't being paid on because we can't afford it, we would lose our healthcare through the state. My husband works as a teacher for a small charter school who doesn't provide benefits. I looked at working at my son's school so I could still ferry kids too and from school but I would make less than the health insurance premiums for our family not to mention the increase in out of pocket expenses.
So our only option, to keep our kids insured is to maintain this level of poverty, continue to defer our student loans (and watch them increase ) to keep the health care that we can not go without. Stephen's medication costs alone if paid out of pocket would total over $1000 a month. Add in monthly, sometimes semi-monthly, lab work and quarterly specialists visits and we'd be sunk deeper than we are now. And I hate it. I want to pay my bills. I want to have some left over to save, I want to have some to do something fun once in awhile. Sure it was our choice to have kids, but we didn't choose my son's heart problem and transplant. We didn't choose my daughters asthma.
I don't know how to fix the system. I'm not naive enough to think it can be done without the dishonesty (and don't get me started on the illegal immigrants getting free healthcare). Its quite a despairing situation.
And I really think Bush did his party some major harm making this one of his last issues. Wonder if those against him realized it and planned it this way knowing he would veto.
Posted by The Pixiest (Member # 1863) on :
quote: And if you don't, I wish you'd go live somewhere else. Alone.
Where?
Believe me, I'd love to get away from people.
Posted by Christine (Member # 8594) on :
I have to admit, I've become a bit softer on the idea of socialized medicine lately. I can't say that in front of my husband, though, so I guess I'll ahve to say it here.
Every year health care costs go up sooo much. We just got word that our premiums may go up this year as much as 50%...AGAIN. And our insurance sucks big time. I guess that's one reason I'm keener on socialized health care -- I didn't realize how much insurance sucks and how little choice we really have until my husband changed jobs this Spring. All of a sudden the only choice we had was how large of a deductible to go with. Our insurance doesn't pay a dime until we rack up $1,000 in medical expenses for each person each year. And that is just not hard to do. After that, we still have to pay %15.
But the trouble with socialized medicine is that I worry that instead of everyone getting to go to a good system, we all have to go to a bad system. Most people don't really have choices now, but a few companies have chosen good (if expensive) insurance for their employees. If we had socialized medicine we might not even be able to improve our health insurance by going to a different company.
I sometimes just wish we had honest choices.
And I'm very confused about the cost of health care. Why does it keep leaping every year so much faster than inflation? Why do private companies waste so much money in bureaucracy?
Posted by dkw (Member # 3264) on :
CT has explained this in more than one thread, but I don't have the time to go looking for it -- there is a difference between socialized medicine and universal health insurance. In socialized medicine the hospitals, clinics, etc are all run by the government and doctors & other medical workers are government employees. With single-payer health insurance the doctors, hospitals, etc work the same way they do now, but they file their reimbursement claims to a single agency. (Although some of the plans for universal health insurance still have multiple competing insurance agencies too.)
Posted by TomDavidson (Member # 124) on :
quote:If we had socialized medicine we might not even be able to improve our health insurance by going to a different company.
That's unlikely. Supplemental insurance will continue to be available, and may well become cheaper if baseline insurance costs are standardized.
Posted by mr_porteiro_head (Member # 4644) on :
quote:With single-payer health insurance the doctors, hospitals, etc work the same way they do now, but they file their reimbursement claims to a single agency. (Although some of the plans for universal health insurance still have multiple competing insurance agencies too.)
With there being a single agency paying the bills, that agency will have enormous power and influence over the doctors and hospitals. It would not work the same way it does now.
Posted by Christine (Member # 8594) on :
quote:Originally posted by dkw: CT has explained this in more than one thread, but I don't have the time to go looking for it -- there is a difference between socialized medicine and universal health insurance. In socialized medicine the hospitals, clinics, etc are all run by the government and doctors & other medical workers are government employees. With single-payer health insurance the doctors, hospitals, etc work the same way they do now, but they file their reimbursement claims to a single agency. (Although some of the plans for universal health insurance still have multiple competing insurance agencies too.)
Actually, that's not a bad way of explaining the difference. It makes some sense. I still wonder how such a plan would work. It is often our health insurance plans themselves that limit access to care. So there may still be worse access to doctors and hospitals. Are we talking about an HMO with strict guidelines about which doctors we can see when? Or maybe a needlessly complicated system with so many exceptions that the average genius can't follow?
Posted by dkw (Member # 3264) on :
quote:Originally posted by Christine: Or maybe a needlessly complicated system with so many exceptions that the average genius can't follow?
Kind of like we've got now, you mean?
Posted by Christine (Member # 8594) on :
quote:Originally posted by dkw:
quote:Originally posted by Christine: Or maybe a needlessly complicated system with so many exceptions that the average genius can't follow?
Kind of like we've got now, you mean?
Yes! Exactly!
I would hate to see us go to this whole new system and it turns out nothing is really different.
Posted by Javert Hugo (Member # 3980) on :
It would be different - the 40 million Americans without health insurance would be covered. You could change jobs without worrying about the health insurance aspect. There would more preventative care.
Even if it stayed just as complicated, it would be better.
Posted by MrSquicky (Member # 1802) on :
quote:that agency will have enormous power and influence over the doctors and hospitals.
And drug companies. Don't forget the drug companies.
Posted by Noemon (Member # 1115) on :
quote:Originally posted by dkw: CT has explained this in more than one thread, but I don't have the time to go looking for it -- there is a difference between socialized medicine and universal health insurance.
Here's one of the most recent of them. I was just rereading this thread, actually. CT's first post on the subject is a little less than halfway down the first page.
Posted by Javert Hugo (Member # 3980) on :
Incidentally, I'm really happy that Wal-Mart is getting into the drug business.
There are 300 common prescriptions that are now $4. I'm thrilled that they are putting that notorious pressure to keep prices low on pharmaceutical companies. In Wal-Mart vs. pharmaceutical companies, I am definitely backing Wal-Mart.
For the answer of why do health care costs rise so much faster than other goods, part of reason has been that Wal-Mart has not been in the business of providing health care.
Posted by dkw (Member # 3264) on :
quote:Originally posted by Javert Hugo: Wal-Mart has not been in the business of providing health care.
Or health insurance to most of their employees, either.
Posted by Javert Hugo (Member # 3980) on :
Yep,they're not perfect. Still, this is a pleasant development.
Posted by Christine (Member # 8594) on :
"Not perfect" is an understatement. They are also in the midst of tons of lawsuits for not paying their employees overtime....
cut and edited: I don't want to derail this thread. If anyone really wants to discuss the pros and cons of Wal-Mart, it would probably best be moved to another thread. Posted by Javert Hugo (Member # 3980) on :
I realize that anything other than 'Wal-Mart=Evil!Eeeeeevviill!' is going to seem odd.
Still, I think this is a very good thing. I also think keeping the lid on inflation in general is a very good thing.
Posted by ClaudiaTherese (Member # 923) on :
quote:Originally posted by mr_porteiro_head: With there being a single agency paying the bills, that agency will have enormous power and influence over the doctors and hospitals. It would not work the same way it does now.
You might be interested in the Canadian system. The insurance agency power is balanced by the power of the physicians, who negotiate as a group to set compensation standards. They negotiate well.
Overall healthcare costs are low, although Canadian physicians do make somewhat less than their US counterparts in general. However, the compensation is still affords a very comfortable lifestyle in the 6 figures. That is nothing to complain about.
---
Edited to add: I'll also note that the healthcare given yields better morbidity and mortality rates for the population, which I've noted before. Canadians are only hurting now (when they do hurt, which is primarily access in rural communities) because the (already more cost-effective system than in the US) has had funding cut again and again by the recent conservative government here.
[ October 04, 2007, 08:20 PM: Message edited by: ClaudiaTherese ]
Posted by ClaudiaTherese (Member # 923) on :
Thanks for digging that up, Noemon.
quote:Originally posted by Christine: Actually, that's not a bad way of explaining the difference. It makes some sense. I still wonder how such a plan would work. It is often our health insurance plans themselves that limit access to care. So there may still be worse access to doctors and hospitals. Are we talking about an HMO with strict guidelines about which doctors we can see when? Or maybe a needlessly complicated system with so many exceptions that the average genius can't follow?
Well, the way it works in Canada is that each citizen has a healthcare number card assigned by the province in which they are enrolled. As a consumer, you can take that card anywhere in Canada --
-- that's anywhere in Canada, any province, any doctor's office, any ER ... just that one card --
-- and that's it. The physician's office, hospital, or ER bills the agency for you. As a consumer, all you need is the one card.
As far as outside Canada, the provincial insurance can be extended for stays up to 2 years. That insurance will cover at least some of the costs for medical bills racked up outside the Canadian system, but coverage is not as complete as when you are within Canada (for one thing, costs in the US (e.g.) are much higher). Travel insurance is recommended as supplemental coverage for some particular people, or for those with long stays.
---
Edited to add: Of note, the health outcomes of Canadians are better than US citizens. So though you may wait an extra 2 months for elective bunion surgery, everyone does have access to that surgery -- and those who are acutely ill (as I was with endocarditis) are taken care of immediately.
Plus, Canadian physicians have no idea of what it is like to have to argue with an insurance company to cover something for a given patient. That takes time and resources to do, and it is common for US physicians -- who were found to spend ~44% of their time doing paperwork (primarily to establish sufficient documentation to bill the insurance company).
And "pre-existing conditions" is a foreign language up here. Nobody has any idea what it might mean.
(Lovely. )
Posted by Dan_raven (Member # 3383) on :
What I think this all boils down to is President Bush does not want to waste Tax dollars on something that can be bought on the open market. He doesn't want this extra resources to be wasted.
Of course, the fact that this 5 year expense is less than the cost of 1 month in Iraq is not important.
What is important is that while this administration wants to fight its own poor and middle class people on whether they deserve/get government paid insurance in order to save tax $ they stone wall most attempts to audit companies like Haliburton and Blackwater on their bills in regards to Iraq and Katrina.
Why is 20 Billion for healthy kids too much, but 20 Billion for Haliburton not to be questioned? Is the threat of Terrorists greater or lesser than the threat posed by being denied services and medicine because 40 million of us citizens are not insured?
Denying this claim seems to benefit only the insurance corporations. Continuing to pay crooked and fraudulent bills sent in by Iraq contractors seems to benefit only the rebuilding corporations. It just sound like this administration is resolved that thise government of the Corporation, and For the Corporation shall not parish from this earth.
Posted by porcelain girl (Member # 1080) on :
I would like to clarify that I see healthcare for children as a black and white issue, not this specific bill. It needs to be done right, but it NEEDS to be done.
It's also hard on the other side of the table. My father is a healthcare provider, and constantly battles to get the medications needed by his patients ok'd by their HMOs...they just don't want to pay for it, and he can't give them the proper treatment.
Right now all the adults living in the U.S. without health insurance make up half the states in the union. There is _obviously_ a problem. It's not like people want to be sick and hurting. I've definitely considered swaying my moral alignments for a little healthcare. Anybody seen that Wanda Sykes sketch?
Edited to note that I realize I have reduntantly echoed the very knowledgable CT.
[ October 05, 2007, 02:18 AM: Message edited by: porcelain girl ]
Posted by BlackBlade (Member # 8376) on :
quote:Originally posted by dkw:
quote:Originally posted by Javert Hugo: Wal-Mart has not been in the business of providing health care.
Or health insurance to most of their employees, either.
Whether they are in the business of paying their employees is highly suspect as well.
Posted by Javert Hugo (Member # 3980) on :
Eeevvvviiiiill!!1!!
[ October 05, 2007, 02:57 PM: Message edited by: Javert Hugo ]
Posted by Belle (Member # 2314) on :
Publix has a list of antibiotics that they give free. No questions asked, they don't even ask to see my insurance card. If my kids are prescribed amixicillin, I get the prescription free. Everyone who has a prescription for those antibiotics gets it free, regardless of whether you have other prescriptions at Publix or not.
I think it's pretty cool. Not that those prescriptions are very high anyway, usually they're under the amount of my copay, but still, every little bit helps and when you have four kids and one gets sick they almost always get sick, so getting four (or five, if I get it too) prescriptions free does help me.
Posted by ClaudiaTherese (Member # 923) on :
quote:Originally posted by Belle: Publix has a list of antibiotics that they give free. ... every little bit helps and when you have four kids and one gets sick they almost always get sick, so getting four (or five, if I get it too) prescriptions free does help me.
Belle, I don't think those medications are "free" either, not any more than ketchupqueen's were.
Somebody pays for them. In ketchupqueen's case, you had argued that the cost was distributed one way; but for the antibiotics you received, it was distributed another way (my guess would be to people who actually paid for those or other prescriptions -- those prices would be moderately higher to recoup the costs of what was given out "free").
---
Mind you, I don't object to either of you referring to the medications you got as "free." For each of you, they were. But if one objects to one usage of the term because it obscures hidden costs, I think one has to do so in the other case, as well.
[ October 06, 2007, 03:55 PM: Message edited by: ClaudiaTherese ]
Posted by Speed (Member # 5162) on :
quote:Originally posted by ClaudiaTherese: Belle, I don't think those medications are "free" either, not any more than ketchupqueen's were.
Somebody pays for them. In ketchupqueen's case, you had argued that the cost was distributed one way; but for the antibiotics you received, it was distributed another way (my guess would be to people who actually paid for those or other prescriptions -- those prices would be moderately higher to recoup the costs of what was given out "free").
I wouldn't go so far as to say the situations are equivalent. In one situation a private entity has decided of its own free will to provide certain items below cost, either out of compassion or because loss leaders make business sense, or due to some combination of factors. In the second situation someone has been unwillingly compelled by a powerful government entity to give up their private resources to buy things for someone they've never heard of.
I can understand someone making a distinction between the degrees of "freedom" in those cases.
Posted by AvidReader (Member # 6007) on :
I'm pretty sure Publix said it was covered by their marketing budget. They're hoping giving away cheap but widely used medicine will bring folks back when they need other prescriptions filled.
Posted by ClaudiaTherese (Member # 923) on :
quote:Originally posted by Speed: I can understand someone making a distinction between the degrees of "freedom" in those cases.
That's an error of categorization. Free as in "freedom of choice" != free as in "does not cost money." You are talking about two different uses of the word and conflating the two.
Somebody still bears that cost. They are just as "free" to the people that get them, and the cost doesn't go away.
Sure, you may like how the cost is distributed more in one case than another, but there is no magic wand that makes the cost disappear in either case.
Belle wasn't critiquing the system of cost distribution when she addressed ketchupqueen, Speed. She was critiquing ketchupqueen's use of the word "free," because "No, the meds were not free. Somebody paid for them. Maybe not you, but somebody, somewhere did."
Mind you, I don't quibble with either ketchupqueen or Belle getting those meds, or for either of them referring to them as "free" (because, in the context of their own choices, thet are "free" for them). However, the fact that there are hidden costs borne out by others holds true in both cases, not just in one.
I don't care if you prefer one way of distributing those costs over another, either. That is not my concern. It also has nothing to do with the existence of those other costs -- which is the appropriate concern when assessing the relevance of "free"-ness [in regards the referenced section of the prior conversation], not the further issue of how those costs may be distributed elsewhere.
-----
AvidReader, the costs still exist, then. They are just distributed within that particular budget.
Again, you may find it more palatable that the costs are budgeted for by the company in advance, as a line on a spreadsheet. Fine. That is different from the critique that was leveled at ketchupqueen, which wasn't that the distribution of costs was unfair, but that she implied there were no costs.
To the extent that there are no costs for Belle's case, there are no costs for ketchupqueen's case. But on the level of context at which we say there are costs in ketchupqueen's case, so too there are in Belle's.
If you want to discuss fairness of distribution of costs, that is a different matter than the existence of the costs.
Posted by Speed (Member # 5162) on :
I wasn't talking about freedom of choice. The business that provides the goods/services decides the cost to the consumer, and there's a difference between the business deciding that the cost is zero, and the business charging full price, which is extorted from a third party. In both cases the consumer doesn't pay, but they are not both "free" in the same sense of the word.
As for the business distributing the costs elsewhere, it doesn't necessarily work like that. Loss leaders often work when business make back the money in increased volume, not increased markup.
Posted by ClaudiaTherese (Member # 923) on :
quote:Originally posted by Speed: The business that provides the goods/services decides the cost to the consumer, and there's a difference between the business deciding that the cost is zero, and the business charging full price, which is extorted from a third party.
So you are saying that if the business decides "the cost is zero [to the consumer]," then the medications have no associated costs for anybody (not for development, not for production, not for anybody)? Honest question -- the only way I can make sense of how I read you is to assume this is the stance you take, but it doesn't make sense to me.
quote: In both cases the consumer doesn't pay, but they are not both "free" in the same sense of the word.
Hmmm. I think this question would help enormously: Would you agree there are costs still associated with providing the drug in each case?
---
Edited to add: When I wrote "just the same," I was addressing a particular portion of a particular conversation. If it helps for understanding, you may read it as "just the same at the level of your particular criticism" (i.e., whether there are any costs born elsewhere or not).
However, I am not going to reword it that way in my original post, because it would then read as excessively confrontational to my eyes. I am not wishing to be excessively confrontational about it, just to point out that the same objection (re: existence of costs) would apply to one as the other.
Of course nothing is ever "just the same" unless the relationship is an identity. To interpret the use of that analogy phrase always that way -- without reference to the context of the ongoing discussion -- would be an absurdity, so I am sure you are not doing that either.
[ October 06, 2007, 07:50 PM: Message edited by: ClaudiaTherese ]
Posted by Speed (Member # 5162) on :
The word "free" doesn't mean that there were never material or labour costs to anyone, and that the item was magically created by fairy dust and wishes. It wouldn't have much use if it did.
All I'm saying is that if I decide to give you something without charging you for it, that's a different situation than if I decide to sell you something and you get the money from a source that was unwilling to give it to you.
They're not equivalent circumstances, and if someone wants to differentiate between them by using different words to describe them, it makes perfect sense to me. If it doesn't make sense to you, that's okay too.
Posted by ClaudiaTherese (Member # 923) on :
quote:Originally posted by Speed: The word "free" doesn't mean that there were never material or labour costs to anyone, and that the item was magically created by fairy dust and wishes. It wouldn't have much use if it did.
All I'm saying is that if I decide to give you something without charging you for it, that's a different situation than if I decide to sell you something and you get the money from a source that was unwilling to give it to you.
They're not equivalent circumstances, and if someone wants to differentiate between them by using different words to describe them, it makes perfect sense to me. If it doesn't make sense to you, that's okay too.
Ah. You see, that was not the critique leveled against ketchupqueen. That critique was against her saying using the word "free" because
quote:No, the meds were not free. Somebody paid for them. Maybe not you, but somebody, somewhere did.
You can see that she clarified her use of the term immediately afterward, and it was to her use of the term "free" I was responding.
If she had been making a claim about a different matter (say, what you are making a claim about), then I would have had no comment about the later use of the word "free." However, as she used the word initially in the critique -- ""No, the meds were not free. Somebody paid for them. Maybe not you, but somebody, somewhere did." -- so the same critique applies [to using the word "free" in the context of drug company giving out "free" medications].
You are speaking of something that wasn't a part of that discussion at that time. I can see it is interesting and probably a fruitful line of inquiry, but I do not see how it relates to my post, or the ones I was responding to. But to your continuing to discuss it as a separate matter, I have no quibble.
---- Edited to reiterate: Mind you, I have no problem myself with either Belle or ketchupqueen using the word "free" in the contexts that they used the term. I also certainly have no problems with each of their families receiving those medications. On the contrary, I am quite glad about it for both cases.
My initial comment merely was that the critique of the use of "free" in one case would apply for the same reasons (namely, the reasons spelled out yet more clearly in the quotation above) in the other case.
I am concerned that my multiple quoting of Belle and the extended conversation with Speed about the terminology used in the discussion will read as jumping up and down on Belle for her comment, over and over. That would be horrible. I have quoted her multiple times in order to explain my initial comment, not to underscore a criticism of Belle.
[ October 06, 2007, 08:23 PM: Message edited by: ClaudiaTherese ]
Posted by Speed (Member # 5162) on :
I guess we read her statement differently. When she said that "somebody paid for them," I was assuming that she meant somebody paid the seller for the drugs in order to complete the transaction. If she was including the seller's wholesale cost, or the labour of the people who mined the ore that was used in building the machinery that processed the medication at the manufacturing plant, then I guess you're right and both of the situations are the same under her definition. I'll leave it to her to clarify her intentions.
In any case, calling one of those drugs "free" and not the other makes sense to me regardless of what exactly was said, implied, or intended by the original post.
Posted by ClaudiaTherese (Member # 923) on :
quote:Originally posted by Speed: In any case, calling one of those drugs "free" and not the other makes sense to me regardless of what exactly was said, implied, or intended by the original post.
I'm sure it does.
As I said, I have no quibble with that at this time, as it is not the topic I was discussing. Please, do carry on.
---
Edited to add in clarification:
quote:Originally posted by Speed: When she said that "somebody paid for them," I was assuming that she meant somebody paid the seller for the drugs in order to complete the transaction. If she was including the seller's wholesale cost, or the labour of the people who mined the ore that was used in building the machinery that processed the medication at the manufacturing plant, then I guess you're right and both of the situations are the same under her definition.
(I am working under the assumption that those costs were redistributed to other consumers or purchasers of products, thus recouping the outlay. I doubt that they were just absorbed by the seller [specifically, by the shareholders of the company], although I suppose it is possible. How wonderful if so!
Of note, AvidReader suggest that it may have come out of an advertising budget. How wonderful if that did not affect the other medications' prices whatsoever! It is a possibility.)
[ October 06, 2007, 08:59 PM: Message edited by: ClaudiaTherese ]
Posted by Speed (Member # 5162) on :
quote:Originally posted by ClaudiaTherese: As I said, I have no quibble with that at this time, as it is not the topic I was discussing. Please, do carry on.
That's okay, it appears I've done all I had intended here. Posted by ClaudiaTherese (Member # 923) on :
(If only more issues were so gently settled! *smile)
Posted by AvidReader (Member # 6007) on :
You're right, CT, my post would be more of a comment on the way the cost is handled. I like Publix's better than the government's.
Publix decided they had a good idea, and they figured out how to pay for it. Maybe the cost of some items went up a little. Maybe they just made less elaborate tv commercials this year. We'll see when we get to the holidays if they rerun the CGI pilgrims and tree full of doves.
Medicare, on the other hand, is a giant sucking hole in the budget. Government knows they have to pay for it and that it will come out of the budget, but they don't seem to think of it beyond that. There never seems to be discussions of decreasing other costs or paring things down to the essentials. Obviously, it's a hard discussion to have here in Florida with all the retirees, but it still ends up looking amazingly irresponsible.
Businesses are never perfect, but on this particular issue, Walmart and Publix seem to have the government beat hands down.
Posted by scholar (Member # 9232) on :
Madicaid vs Medicare- aren't they different? Which is also different from CHIP- I have to pay some money for CHIP- just not the $300 a month private would cost.
Posted by ketchupqueen (Member # 6877) on :
Medicaid is different from Medicare. Medicare and Medicaid have separate budgets, separate classes of recipients, and Medicare is more "permanent" while Medicaid is generally shorter-term (although some people will qualify forever.) Some things may not be covered for some people on Medicare that may be covered on Medicaid, and vice versa.
Posted by Miro (Member # 1178) on :
Roughly speaking, Medicare is a federal program that covers the elderly and disabled. Medicaid is a federal program that provides money to state programs for people living in poverty. SCHIP is a federal program that provides money to state programs for children. Because Medicaid and SCHIP are state-administered, eligibility requirements and benefits differ from state to state.
AvidReader - What Walmart and Publix have done, while commendable, falls far short of what Medicare has accomplished. Comparing two companies providing some medicines at low costs to a program that provides health insurance to a huge segment of the population (that generally requires more care than the population as a whole) isn't just apples and oranges, it's peas and watermelons.
Posted by Belle (Member # 2314) on :
Wow, your wireless adapter goes out, and you get quoted ten thousand times in a couple days! Cool!
Had I come back quickly I would have clarified my statement to say that yes, I do realize the drugs Publix is giving away free to consumers are not "free". But I see a big, big difference in a private entity choosing to take a loss on a product as a way of enticing customers, and government aid.
Publix is not hurting for money or business, and indeed I do get all my prescriptions filled there, though I did before they started giving away antibiotics, mainly because of convenience. It's located between my pediatrician's office and my home, so it's the best and most convenient place for me to get prescriptions filled. I appreciate their giving me free antibiotics, but I was already a customer.
Posted by AvidReader (Member # 6007) on :
I understand the government programs are bigger and harder to deal with. But that doesn't mean we should keep throwing money at them without evaluating what we're doing. Free comes from somewhere in both cases, but the Medis cover a whole lot more money.
I'd like to see government be as responsible with their aid as these businesses are. I'd like them to think about where the money is coming from - preferably before the boomers all retire - and what can reasonably be funded every year with a growing black hole in the budget.
I'm not saying it's not a noble cause. I'm just saying it's expensive, something like a fourth of Florida's budget IIRC. What's our plan for paying for it? What are we giving up in the federal budget, or are we just chalking that up to debt? At some point Congress will have to adress the nation's spending, and the two Medis are going to be a huge piece of that puzzle.
Posted by MrSquicky (Member # 1802) on :
What makes you think people haven't and aren't evaluating what is being done with the SCHIP program? Do you have any information that suggests it, or is it just an ideological thing?
Posted by ClaudiaTherese (Member # 923) on :
SCHIP programs are among the most extensively studied programs out there. This was discussed on a prior page. The evidence is very clear.
Posted by Lyrhawn (Member # 7039) on :
For the sake of curiosity, does anyone have a study on hand on how wasteful Medicare is in comparison to private run health insurance companies? I've always been under the assumption that it's vastly more efficient and far less wasteful, but opponenets of national healthcare like to throw out scare phrases like "huge government beauracracy" and what not.
Is this just one of those scare tactic assumptions? That government by its very nature can't do ANYTHING right, so let's not even bother looking up the facts and just assume that we're throwing money at a wasteful system?
I don't have any facts or figures the other way either, but I haven't seen anything against Medicare. My opinion on the matter is that healthcare is probably the one thing government can do better than private health insurance, because they don't spend on advertising, they are more interested in keeping you healthy than in making a buck, they aren't working in partnership with the drug companies, and they are more efficient administratively.
I understand where this negative assumption comes from, but I've yet to ever see any facts back it up.
Posted by ClaudiaTherese (Member # 923) on :
(You might -- or might not! -- be meaning "Medicaid" instead of "Medicare," or perhaps both.)
Posted by Lyrhawn (Member # 7039) on :
Medicare is what senior citizens are on right? National healthcare for the elderly? Whichever one that is, is the one I'm referring to.
To be fair, I'm not even sure really what the other one does, so I don't even have a clue as to the efficiency or wastefulness of it.
Posted by scholar (Member # 9232) on :
There was an issue with Medicaid and the government pandering to prescription drug companies (I am sure that is an oversimplification of the issue).
Posted by dkw (Member # 3264) on :
It would be hard to compare directly, since private health insurance companies spread the risk over people of all ages and all health-statuses. Folks on Medicare are higher-cost, pretty much by definition.
Posted by ClaudiaTherese (Member # 923) on :
What dkw said. I didn't think you were going for Medicare, since it it is really difficult to assess cost-effectiveness there -- something like (don't quote me -- I'd have to dig it back up) 70% of a current typical US person's medical costs are incurred in the last 3 months of his or her life.
The comparisons can be made, it's just more difficult. Most of the complaining I've read has been about the cost-effectiveness of Medicaid.
Then again, we likely read different things and talk to different people.
Posted by Miro (Member # 1178) on :
AvidReader - I'll grant you that more needs to be done to ensure that the money for these programs is there and will be there in the future. Still, I don't agree with your comparison. WalMart and Publix can pick and choose what drugs and services they supply. If something isn't cost-effective, they have no obligation to provide it. The US and state governments do have obligations to their citizens even when it's expensive.
Lyrhawn - I'll ask my mother for specifics and get back to you. She's done a lot of research in this area.
Posted by AvidReader (Member # 6007) on :
I actually think the Medis are one of the few times government didn't ruin what makes the free market work. You don't have to go where the government says and put up with a bad doctor. You go to the best doctor who takes the program. As long as they keep the rules bearable for the doctors so they keep a lot of doctors in the program, they've got the best of both worlds.
My problem is the assumption that the government is where you go to get health insurance after you retire. We've got a lot of retirees already and more getting ready. That money has to come from somewhere and I think the government needs to make an effort to figure out where.
There's only three options. Raise taxes, cut services, or cut other items in the budget to make up the difference. At the moment, Congress seems to prefer not addressing it at all and putting us in debt. Except we're already in debt. At some point, I'd like to see us with a surplus again, and we can't do that if we're constantly expanding programs, even good and noble programs, without looking at what the budget can support.
Posted by scholar (Member # 9232) on :
quote:Originally posted by AvidReader:
As for the factcheck numbers, Florida's looks great. $40,000 is enough for two people if they're careful with their money. It wouldn't be enough for kids. $50,000 in states with more taxes makes sense, but what's the cost of living in NJ that families making $70,000 a year qualify?
Is that $70,000 when they have a kid with a birth defect insurance won't cover, or is that anyone? Cause I'd think you could reasonably afford decent insurance on your own. I'm even leery of the $60,000 amounts in most states. I just have a hard time seeing that as low-income.
Looking at my insurance, for a family of four, health insurance would cost a $1000 a month. Other people have told me this is about what theirs charge as well. My insurance has a $250 deductible on dr visits, $100 on prescriptions. So, before that health insurance pays a dime, a family of four could pay as much as $1400. So, we are at $13,400 a year (with health insurance paying nothing). When they finally pay, they pay 70%, but only after you have fought with them for about a year (these are the people who claimed my pregnancy was a pre-existing condition from 18 months prior- yup, I'm an elephant). A family of four making $60,000 a year could easily have problems with paying 20% of their salary. I think the real question in this debate needs to be why is insurance so expensive that a family of four making 60,000 can't afford it.
Posted by Morbo (Member # 5309) on :
This quote below is from a 2003 NEJM paper. Roughly 1/3 of health care costs go to an enormous bureaucracy. I don't have similar cost breakdowns of paperwork for Medicare and Medicaid, but I'm sure it's less than 1/3. The Canadian single payer system's paperwork overhead is estimated by the study to be 1/9.
quote:Our studies document the enormous administrative waste in U.S. health care. In 1999, our nation spent at least $294 billion on health care bureaucracy. This year[2003], health care bureaucracy will cost at least $399 billion, nearly one out of three health care dollars. On a per capita basis, Canada spends only one-third as much as we do on health care paperwork, and the difference between the U.S. and Canada is widening.
Our research analyzed detailed cost reports submitted by thousands of hospitals, home care agencies and nursing homes in the U.S. and Canada. We analyzed data on practitioners’ overhead from surveys of physicians in the two nations. For figures on insurance overhead we relied on the insurance industry’s own reports of their costs. Finally, we used detailed labor force data from the U.S. and Canadian Census Bureaus to compare the numbers of administrative workers in health institutions and offices over the past 3 decades
Our estimates of administrative costs are conservative. We excluded the administrative costs of health businesses for which reliable administrative cost data were unavailable – for instance, drug firms, pharmacies, and ambulance companies.
Our data are the most detailed and comprehensive analysis of administrative costs ever undertaken. They underwent painstaking review during the editorial process at the New England Journal of Medicine
America’s Health Insurance Plans, a national association of health insurance companies “representing nearly 1,300 member companies providing health insurance coverage to more than 200 million Americans” has issued statements firmly in support of the SCHIP reauthorization bill.
They don’t seem to agree with the president’s concern that it will be bad for private insurance.
quote: Press Release FOR IMMEDIATE RELEASEAugust 2, 2007 Contact:Mohit Ghose(202) 778-8494 AHIP Praises Bipartisan Senate Vote on SCHIP
Washington, D.C. – Millions of children will receive health care coverage through the State Children's Health Insurance Program (SCHIP) under the bipartisan legislation passed by the U.S. Senate today. The legislation would raise tobacco taxes to fund the reauthorization of SCHIP. “The Senate has acted to ensure the health security of millions of low-income children,” said Karen Ignagni, President and CEO of America’s Health Insurance Plans (AHIP). “The Senate also took a strong stand for public health by putting in place a funding mechanism that will discourage children from starting smoking.” AHIP also noted that the Senate came together in a bipartisan fashion to reauthorize SCHIP without putting at risk the health security of the more than eight million seniors who depend on Medicare Advantage. ###
Posted by Bella Bee (Member # 7027) on :
I live in a country where freely available healthcare is a right, as well as a privilege. Yes, the system has flaws - not every drug is deemed cost effective - and people with money can have health insurance or go the private route if they wish. But most of the time, nobody even thinks about how they're going to afford healthcare, from checkups to heart bypass surgery.
By the way - this has not caused society, family, charity or the economy to break down.
From a economic and a socio-political standpoint, I understand why there is all this resistance to tax funded healthcare in the US. I've also accepted that this resistance is one of those cultural differences that I'll never fully emotionally (perhaps even morally?) comprehend. I understand it. I just don't get it.
In this country if a politician tried to veto something like this, that would be the end of his career.
If there was ever a no-brainer, it's guaranteed healthcare for every child. Even the rich ones. Even the illegal foreign ones. You'd like it if you had it, I promise.
Posted by ketchupqueen (Member # 6877) on :
quote:In this country if a politician tried to veto something like this, that would be the end of his career.
Well, Bush doesn't really have to worry about that; it's his second term and he won't have another... Most presidents get done and write books, work for charities, etc. So I don't think Bush is too worried about his political future.
Posted by Icarus (Member # 3162) on :
George W. Bush writing a book
Posted by ketchupqueen (Member # 6877) on :
Yeah, I figure he'll be one of the ones who sits back and takes money as a "consultant" for oil companies or something, not really so much the books (unless they're ghostwritten) or charity work.
Posted by ketchupqueen (Member # 6877) on :
Yeah, I figure he'll be one of the ones who sits back and takes money as a "consultant" for oil companies or something, not really so much the books (unless they're ghostwritten) or charity work.
Posted by AvidReader (Member # 6007) on :
quote: I live in a country where freely available healthcare is a right, as well as a privilege.
If you don't mind me asking, Bella, what does that do to your taxes? We already have half our federal budget going to Medicare, Medicaid, and Social Security. I would think we'd need to increase from our system now.
I didn't realize the tax bracket was different from the amount that actually gets paid. This calculator breaks it down; apparently taxes are paid for each bracket as you go. So a person making $100,000 is in the 33% bracket but their total tax is closer to 24% of their income.
Anyway, I was thinking that if a family of 4 needs $1,000 a month to buy health insurance and Medicare is 20% more effective, wouldn't their taxes have to go up by $800 a month to give everyone paid healthcare? I'm just not sure I see where the big savings would come from since the increase in cost would be spread out over all tax payers.
Posted by TomDavidson (Member # 124) on :
quote:Anyway, I was thinking that if a family of 4 needs $1,000 a month to buy health insurance and Medicare is 20% more effective, wouldn't their taxes have to go up by $800 a month to give everyone paid healthcare?
No. For one thing, a substantial amount of that $1,000 represents profit.
Posted by AvidReader (Member # 6007) on :
But if Medicaid or care or whichever is only 20% more effective, wouldn't that negate the savings by eliminating profit? I mean, the doctors and their staffs still have to operate on a profit or they won't do it. Pharmacies need a profit to invest in new medicines. I wouldn't think we could eliminate it entirely.
Posted by imogen (Member # 5485) on :
quote:Originally posted by Christine:
quote:Originally posted by dkw: CT has explained this in more than one thread, but I don't have the time to go looking for it -- there is a difference between socialized medicine and universal health insurance. In socialized medicine the hospitals, clinics, etc are all run by the government and doctors & other medical workers are government employees. With single-payer health insurance the doctors, hospitals, etc work the same way they do now, but they file their reimbursement claims to a single agency. (Although some of the plans for universal health insurance still have multiple competing insurance agencies too.)
Actually, that's not a bad way of explaining the difference. It makes some sense. I still wonder how such a plan would work. It is often our health insurance plans themselves that limit access to care. So there may still be worse access to doctors and hospitals. Are we talking about an HMO with strict guidelines about which doctors we can see when? Or maybe a needlessly complicated system with so many exceptions that the average genius can't follow?
In Australia, we have government run public hospitals and privately run (usually religious) hospitals. The public hospitals are usually the premier hospitals in each state and territory.
Everyone is entitled to a Medicare card. Your medicare card means you either get free GP visits (if you go to a clinic which "bulk bills") or you get a rebate if you go to a non-bulk billing clinic. The clinics are not government run.
Any treatment at a public hospital is free. Treatment at a private hospital will cost you, but you also get a rebate from Medicare.
Many people chose to have private health cover on top of Medicare.* For us, this costs about $400 pp/year. This includes full dental, optical (all of which is subject to a Medicare rebate if you don't have private health insurance) plus private rooms at hospitals and other benefits (maternity etc).
I think the system works pretty well. It's by no means perfect, but the idea that someone can't afford basic or emergency medical treatment is unthinkable in our system.
*There is a Medicare tax levy surcharge for people earning over $50 000 a year who don't have private health insurance.
Posted by imogen (Member # 5485) on :
(Oh and our taxes are ok, I think. We have a GST of 10%, a tax free threshold of $6000, then it's 15c in the dollar to $30 000 pa, 30c in the dollar to $75 000 pa, 40c in the dollar to $150 000 and 45c in the dollar over that.)
Edit - And we pay a medicare levy of 1.5% of taxable income (with reductions for low income earners).
Posted by Kettricken (Member # 8436) on :
quote: If you don't mind me asking, Bella, what does that do to your taxes? We already have half our federal budget going to Medicare, Medicaid, and Social Security. I would think we'd need to increase from our system now.
I'm not Bella, but I'm from the same country.
Our tax rates are - 0% on the first £5225, 22% up to £33,300 and 40% on any income above that.
That means someone on £25,000 (just under $50,000) pays 17.4% income tax and someone on £50,000 (just under $100,000) pays 25.7%.
In addition there is National Insurance (supposed to cover things like unemployment benefit and the state pension). This is complicated but I think it works out at 7.4% for someone on £25,000 and 5.9% for someone on £50,000 (there is a ceiling, above which you do not pay additional National Insurance, so high earners pay less National Insurance as a percentage of their income).
Posted by TomDavidson (Member # 124) on :
Kettricken, in all fairness, I think you need to include the VAT in that kind of equation, too. Sales tax in American is generally considerably lower, and isn't distributed federally.
Posted by Kettricken (Member # 8436) on :
I did wonder it I should include VAT, but since no one else mentioned sales taxes, I left it off.
VAT is is a sales tax on goods sold to consumers (excluding food, childrens clothes and books which are zero rated) of 17.5%.
There is no VAT when a company buys something (the VAT is charged at the end of the chain only).
How much is sales tax generally (I know it varies from state to state)?
Posted by dkw (Member # 3264) on :
5-7% Some states exempt groceries and/or clothing. And some have a "sales tax free" day or weekend right before school starts each fall.
Posted by Javert Hugo (Member # 3980) on :
6.25% in Texas, and cities/counties will add a percent or two. However, there is no state income tax and the necessities are exempted.
Posted by Fusiachi (Member # 7376) on :
In PA is it 6 percent. Some states don't have sales tax. The highest they reach is 8.5% or so, including local sales taxes. Most are in around 5%, I'd say.
Posted by DarkKnight (Member # 7536) on :
Some are much higher, 11% when you include local Tax rates Posted by ketchupqueen (Member # 6877) on :
In CA the sales tax is generally 8.25%, but some cities add an additional tax, so you can go as high as 9.75% on some items in some cities. Food is the only non-taxed salable item. And food in restaurants and candy are not included in "food."
Posted by Lyrhawn (Member # 7039) on :
6% in Michigan. We just raised the tax last week to cover a lot of services that were previously taxed.
Of course, the Republicans wanted to cut almost a billion dollars from the Education budget, and Democrats who wanted to actually raise Education funding now face recall drives across the state because no one wants to pay more in taxes. Pfft. I'll stop now before I go into a major rant on Michigan and politics. Damned Republicans. And damned national Democratic Party.
Posted by PSI Teleport (Member # 5545) on :
It's never too late to talk about something that was mentioned earlier in the thread!
Question for other parents of children on CHiP:
Have any of you had this experience? Any time one of my kids gets sick and the doctor finds out they are on CHiP, instead of trying to fit them in they say, "You're on CHiP? Oh, just go on in to the emergency room because we wouldn't be able to see you until [Monday, Thursday, whatever. Three days away.] I've been to the emergency room for something as simple as a sore throat, a mid-grade fever, and diarrhea. It makes me feel stupid for even calling the doctor.
Posted by ketchupqueen (Member # 6877) on :
Nope. My kids are treated just like any other Kaiser Permanente patients (except with lower copays and better benefits.)
Posted by Icarus (Member # 3162) on :
My kids are on Medicaid, not (as I understand it) CHiP. Still, I would think it would be the same thing. In their case, that is absolutely not my experience. Also, I have never had their pediatrician not be able to see them on the same day I called. Even when I call in the afternoon, it has always been "Come on over and we'll work you in." I seem to have the last doctor who doesn't overbook. The wait times aren't bad either.
Posted by PSI Teleport (Member # 5545) on :
Maybe it's just the doctor(s) I've had.
Posted by scholar (Member # 9232) on :
I'm still Medicaid (3 more months), but my dr has been really good about seeing my baby whenever we need to. They discourage er visits (don't want baby around all those sick people). If my dr ever replied like that, I would switch drs. We did have a really bad wait time last appt, but my dr's wife had a baby and was still in the hospital, so, he was backlogged from all the patients he had put off while being with his baby. The latest I have called my dr for an appt that day is like 10am, so not sure how well they would handle that.
Posted by MrSquicky (Member # 1802) on :
PSI, I would not be suprised if what you described is actually illegal.
Posted by ketchupqueen (Member # 6877) on :
Yes, you should probably report your doctor to the CHIP people. Just in case. (Although you might want to talk to his other patients first if you know any and find out if they have had the same experience. Maybe he's just really overbooked.)
Once a doctor says they will accept insurance and will accept a patient, I believe they have an obligation to treat that patient like any other (at least to the limits of what the insurance will cover and the patient is able to pay for.)
Posted by Lyrhawn (Member # 7039) on :
quote:Originally posted by Icarus: George W. Bush writing a book
Writing a book? I'd be impressed if he read a book.
Posted by PSI Teleport (Member # 5545) on :
This doctor used to be amazing. They went from having the office open 7 days a week from 5am to 11pm and getting you in at any time to foisting off everyone on the ER. It never occurred to me that it might be illegal. (Random aside: I love that Firefox checks spelling now.)
Posted by Icarus (Member # 3162) on :
I love that feature too. Posted by James Tiberius Kirk (Member # 2832) on :
Republican businessman Montgomery Burns today joined with Mayor Joe Quimby, D-Springfield, to support the Senate’s gazillion-dollar SCHIP bill.
“If the poor children can get a piece of the action, why can’t I?” explained Burns at a MoveOn.org rally in Capital City. “The little darlings are needy? Me, too. I need somebody to pay. Quimby here says he knows a bunch of low-income nobodies who are ripe for the picking. Excellent.”
“You need this?” wondered the mayor. “Well, why not. I’ve got needs, too. Why, I’ve got 27 paternity suits pending and to quote the Speaker, ‘suffer the little children.’ The Quimby Compound is overflowing with those little sufferers. Vote Quimby.”
Inexplicably, the mayor then leaned toward a comely MoveOn organizer and whispered in her ear, “Ah, if anyone asks, you’re my niece from out of town and you don’t get SCHIP.”
“But Uncle Joe, I am your niece from out of town, and I do get SCHIP.”
“Good Lord, I’m a monster!” exclaimed the mayor.
Posted by Icarus (Member # 3162) on :
Posted by Morbo (Member # 5309) on :
Icarus, it's really on a house.gov server. I'm confused too. Posted by Samprimary (Member # 8561) on :
Uh, .. wow.
Posted by TomDavidson (Member # 124) on :
Joe Barton is a gamer and Simpsons fan who also happens to be an opinionated jerk.
Posted by Javert Hugo (Member # 3980) on :
House failed to override veto. Posted by Architraz Warden (Member # 4285) on :
By 13 votes.
Posted by Morbo (Member # 5309) on :
I didn't realize the override vote was today. GOP press release: "Exx-cellent!"
Posted by erosomniac (Member # 6834) on :
Posted by Dagonee (Member # 5818) on :
The program is still going to exist and will have a higher level of funding than it does now. There's actually a very good chance that the overall level of funding will be very close to the level of funding in the vetoed bill.
Posted by Morbo (Member # 5309) on :
Maybe, Dag, but that little green kid at the end of the wave will still be uninsured.
Posted by Dagonee (Member # 5818) on :
And with the vetoed plan, there's a little pink girl who got cropped out of the wave who will still be uninsured. Damn those heartless Democrats!
Posted by MattP (Member # 10495) on :
Yeah, but she's pink.
Posted by erosomniac (Member # 6834) on :
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George W. Bush writing a book ![[Razz]](tongue.gif)
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I will bow out of the conversation since I probably don't have much substantive to add.
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