Originally posted by TomDavidson:
For what it's worth, I'm confident that a single-payer system would produce tort reform within a couple years. Sadly, that's not what we're looking at.
![[Frown]](frown.gif)
quote:
The problems listed in this are very real, but the purposed healthcare bill will only make it MUCH worse. Here is why. HR3200 is the on bill in the house and the only one available for review. Google or Bing it. According to it, you will be able to keep your insurance as long as you keep your job or the insurance does not change in any way. Otherwise you will be forced to be on a government approved plan. Good so far right??
1. Ok, the government can tell you which procedures, medications doctors and hospitals are on the approved list. If yours isn't too bad, you can't sue them as you can an HMO.
2. Tenncare was the posterchild of the Clinton healthcare plan which was going to prove to everyone how great it was. Well Jane was on it when we first Married and it came close to killing her. The only approved specialist were over 100 miles away and they were the worst of the worst. The medication she needed was not on the approved list. out of room, but this is BAD
quote:I replied with my frustrations over people not getting the healthcare that they need under the current system, and asked what he thought about everyone paying the same amount to spread out the costs. He replied:
Oh yes one more thing. We need a solution for pre-existing, but forcing the companies to take them will only make them go bankrupt immediately. Those who have severe illness will always cost the insurance company MUCH more than they will ever make from them.. The only way that the insurance company will be able to afford to cover them is a. raise rates for everyone (thus the million dollar surcharge mentioned in this article) or b. raise rates for those who are high risk, but this is unaffordable and eliminates any benefit of having insurance in the first place.
What Obama's "plan" aka hr3200 will do is put insurance companies out of business and force everyone on a single payer socialised system..
I propose that the government pay insurance companies to take high risk customers. They will audit the company and pay the extra cost for those with high risk. This is not perfect, but MUCH better than anything being considered now...
quote:
COST: Katarain, in 2007 it cost $7,421.00 per man, woman and child in the USA. So if the insurance company made NO money and has NO overhead it would cost $1855.25 per month for you to insure your family of three.. If we shared cost to everyone.. Does that sound Fair? Can you afford it?
Source: http://www.kaiseredu.org/topics_im.asp?imID=1&parentID=61&id=358
quote:
THE POOR: There is already a federal government medical insurance program for the poor. It is called Medicare and is sucks. It is full of read tape and eligibility requirements.. Welcome to a government ran healthcare system. I and most against socialised medicine are not saying "get a job or die", we simply know the truth, and the truth is that many people will die from poor care, and no-one will get good care if the USA goes to a socialised system. We ARE NOT saying that the current system is great, only that this current proposal is a death sentence for many..
quote:I then said something about the idea that costs will go down if everyone has preventative care available to them, and doctors and hospitals won't have to inflate costs to cover what is unpaid by the uninsured. Then the conversation died.
REGULATION: In the story that you link to, the problems are all related to cost savings measures of the insurance company. This will only get worse with a socialised system. The cost numbers I give above assume that ALL families work and pay premiums. The truth is that many are retired or too poor to pay premiums, so the rest of us will have to make up the difference, so rather than paying 1855.25 a month you may pay more like $3000.00 a month or more, which could approach 100% of your income. So that leaves one solution, and that is to cut cost. Well how will the government cut cost? We can only assume that it will be like other socialised systems and insurance companies, which will be "managed care". "Managed Care means that they will tell you what care you can get and who can give it and where you can go to get it... Unlike an insurance company, your family can't sue the government when you die from their "care"...
quote:I remember a thread we had about that at one point. The big pilot program somewhere up north helped a bunch of people but didn't actually save the government any money. Can't find it now, but maybe someone who understands our search button remembers it. (I never find the threads I want with the search button.)
I then said something about the idea that costs will go down if everyone has preventative care available to them, and doctors and hospitals won't have to inflate costs to cover what is unpaid by the uninsured.
quote:http://www.pnhp.org/news/2005/august/m_gladwell_on_the_m.php
Health insurance here has always been private and selective, and every attempt to expand benefits has resulted in a paralyzing political battle over who would be added to insurance rolls and who ought to pay for those additions.
Policy is driven by more than politics, however. It is equally driven by ideas, and in the past few decades a particular idea has taken hold among prominent American economists which has also been a powerful impediment to the expansion of health insurance. The idea is known as “moral hazard.” Health economists in other Western nations do not share this obsession. Nor do most Americans. But moral hazard has profoundly shaped the way think tanks formulate policy and the way experts argue and the way health insurers structure their plans and the way legislation and regulations have been written. The health-care mess isn’t merely the unintentional result of political dysfunction, in other words. It is also the deliberate consequence of the way in which American policymakers have come to think about insurance.
“Moral hazard” is the term economists use to describe the fact that insurance can change the behavior of the person being insured. If your office gives you and your co-workers all the free Pepsi you want—if your employer, in effect, offers universal Pepsi insurance—you’ll drink more Pepsi than you would have otherwise. If you have a no-deductible fire-insurance policy, you may be a little less diligent in clearing the brush away from your house. The savings-and-loan crisis of the nineteen-eighties was created, in large part, by the fact that the federal government insured savings deposits of up to a hundred thousand dollars, and so the newly deregulated S. & L.s made far riskier investments than they would have otherwise. Insurance can have the paradoxical effect of producing risky and wasteful behavior. Economists spend a great deal of time thinking about such moral hazard for good reason. Insurance is an attempt to make human life safer and more secure. But, if those efforts can backfire and produce riskier behavior, providing insurance becomes a much more complicated and problematic endeavor.
In 1968, the economist Mark Pauly argued that moral hazard played an enormous role in medicine, and, as John Nyman writes in his book “The Theory of the Demand for Health Insurance,” Pauly’s paper has become the “single most influential article in the health economics literature.” Nyman, an economist at the University of Minnesota, says that the fear of moral hazard lies behind the thicket of co-payments and deductibles and utilization reviews which characterizes the American health-insurance system. Fear of moral hazard, Nyman writes, also explains “the general lack of enthusiasm by U.S. health economists for the expansion of health insurance coverage (for example, national health insurance or expanded Medicare benefits) in the U.S.”
What Nyman is saying is that when your insurance company requires that you make a twenty-dollar co-payment for a visit to the doctor, or when your plan includes an annual five-hundred-dollar or thousand-dollar deductible, it’s not simply an attempt to get you to pick up a larger share of your health costs. It is an attempt to make your use of the health-care system more efficient. Making you responsible for a share of the costs, the argument runs, will reduce moral hazard: you’ll no longer grab one of those free Pepsis when you aren’t really thirsty. That’s also why Nyman says that the notion of moral hazard is behind the “lack of enthusiasm” for expansion of health insurance. If you think of insurance as producing wasteful consumption of medical services, then the fact that there are forty-five million Americans without health insurance is no longer an immediate cause for alarm. After all, it’s not as if the uninsured never go to the doctor. They spend, on average, $934 a year on medical care. A moral-hazard theorist would say that they go to the doctor when they really have to. Those of us with private insurance, by contrast, consume $2,347 worth of health care a year. If a lot of that extra $1,413 is waste, then maybe the uninsured person is the truly efficient consumer of health care.
The moral-hazard argument makes sense, however, only if we consume health care in the same way that we consume other consumer goods, and to economists like Nyman this assumption is plainly absurd. We go to the doctor grudgingly, only because we’re sick. “Moral hazard is overblown,” the Princeton economist Uwe Reinhardt says. “You always hear that the demand for health care is unlimited. This is just not true. People who are very well insured, who are very rich, do you see them check into the hospital because it’s free? Do people really like to go to the doctor? Do they check into the hospital instead of playing golf?”
For that matter, when you have to pay for your own health care, does your consumption really become more efficient? In the late nineteen-seventies, the rand Corporation did an extensive study on the question, randomly assigning families to health plans with co-payment levels at zero per cent, twenty-five per cent, fifty per cent, or ninety-five per cent, up to six thousand dollars. As you might expect, the more that people were asked to chip in for their health care the less care they used. The problem was that they cut back equally on both frivolous care and useful care. Poor people in the high-deductible group with hypertension, for instance, didn’t do nearly as good a job of controlling their blood pressure as those in other groups, resulting in a ten-per-cent increase in the likelihood of death. As a recent Commonwealth Fund study concluded, cost sharing is “a blunt instrument.” Of course it is: how should the average consumer be expected to know beforehand what care is frivolous and what care is useful? I just went to the dermatologist to get moles checked for skin cancer. If I had had to pay a hundred per cent, or even fifty per cent, of the cost of the visit, I might not have gone. Would that have been a wise decision? I have no idea. But if one of those moles really is cancerous, that simple, inexpensive visit could save the health-care system tens of thousands of dollars (not to mention saving me a great deal of heartbreak). The focus on moral hazard suggests that the changes we make in our behavior when we have insurance are nearly always wasteful. Yet, when it comes to health care, many of the things we do only because we have insurance—like getting our moles checked, or getting our teeth cleaned regularly, or getting a mammogram or engaging in other routine preventive care—are anything but wasteful and inefficient. In fact, they are behaviors that could end up saving the health-care system a good deal of money.
Sered and Fernandopulle tell the story of Steve, a factory worker from northern Idaho, with a “grotesque looking left hand—what looks like a bone sticks out the side.” When he was younger, he broke his hand. “The doctor wanted to operate on it,” he recalls. “And because I didn’t have insurance, well, I was like ‘I ain’t gonna have it operated on.’ The doctor said, ‘Well, I can wrap it for you with an Ace bandage.’ I said, ‘Ahh, let’s do that, then.’ ” Steve uses less health care than he would if he had insurance, but that’s not because he has defeated the scourge of moral hazard. It’s because instead of getting a broken bone fixed he put a bandage on it.
quote:http://www.thefreelibrary.com/Susan+Starr+Sered+and+Rushika+Fernandopulle,+Uninsured+in+America:...-a0151099654
Starr Sered and Fernandopulle interviewed a wide range of uninsured Americans with many levels of education, including graduate degrees. Many were employed at the time of their interviews and some had the opportunity to purchase insurance, but for amounts that would significantly reduce their take-home pay, making it unaffordable. Others could not work because of untreated or under-treated health care issues. Still others had been laid off after plant closings, but their chances of securing employment again if the economy improves are slim due to health conditions that have been exacerbated with lack of care. They also demonstrate that adhering to the work ethic guarantees neither health insurance nor steady work and income.
The final chapter of the book outlines suggestions that have been made for universal health coverage in America, but there is no easy solution. The authors argue that the current system for the poor is not economically sound. Without access to preventative care, problems worsen until there is no choice except to visit the emergency room or receive other exorbitantly priced treatment, which may be paid for by Medicaid or may never be paid. They contend that any feasible solution must sever the link between paid employment and insurance and must provide a minimal level of health care for all Americans, much as we provide a minimal level of education via the public schools. They argue that not only is this a humane way to treat citizens, but it is much more cost-effective than the current system.
quote:http://www.latimes.com/business/la-fi-insure9nov09,0,3065397,full.story?coll=la-home-center
One of the state's largest health insurers set goals and paid bonuses based in part on how many individual policyholders were dropped and how much money was saved.
Woodland Hills-based Health Net Inc. avoided paying $35.5 million in medical expenses by rescinding about 1,600 policies between 2000 and 2006. During that period, it paid its senior analyst in charge of cancellations more than $20,000 in bonuses based in part on her meeting or exceeding annual targets for revoking policies, documents disclosed Thursday showed.
The revelation that the health plan had cancellation goals and bonuses comes amid a storm of controversy over the industry-wide but long-hidden practice of rescinding coverage after expensive medical treatments have been authorized.
quote:http://www.rockridgeinstitute.org/health/logic_of_the_health_care_debate.pdf
In a number of respects, this disparity between health insurance and health care comes from the fact that everyone gets sick, will age, and die. At some point in their life, every insured person will cost an insurance company money. Insurance companies can’t make much profit on human health care, unless they exclude or limit people from coverage and benefits. Otherwise, premiums aren’t profit centers, they are just pre-payments for health care we know we’ll need in the future.
To increase profits, insurance policies with benefit limits are commonplace, and no benefits are paid if those limits are exceeded, regardless of needs. You get a debilitating illness, such as cancer, and you receive a maximum payment from the insurance company that is a fraction of the total medical costs. It's as if you were a car and had reached your Blue Book value; you're declared totaled. From there, you pay the full cost of continued treatment, which can be hundreds of thousands of dollars. For people with health insurance, this is one of the main causes of bankruptcy: people have to use up their savings and sell their homes in order to pay uncovered medical costs.
quote:http://www.cnn.com/2006/HEALTH/parenting/05/08/mothers.index/index.html
An estimated 2 million babies die within their first 24 hours each year worldwide and the United States has the second worst newborn mortality rate in the developed world, according to a new report.
American babies are three times more likely to die in their first month as children born in Japan, and newborn mortality is 2.5 times higher in the United States than in Finland, Iceland or Norway, Save the Children researchers found.
Only Latvia, with six deaths per 1,000 live births, has a higher death rate for newborns than the United States, which is tied near the bottom of industrialized nations with Hungary, Malta, Poland and Slovakia with five deaths per 1,000 births.
"The United States has more neonatologists and neonatal intensive care beds per person than Australia, Canada and the United Kingdom, but its newborn rate is higher than any of those countries," said the annual State of the World's Mothers report.
quote:
On Feb. 3, Joyce Elkins filled a prescription for a two-week supply of nitrogen mustard, a decades-old cancer drug used to treat a rare form of lymphoma. The cost was $77.50.
On Feb. 17, Ms. Elkins, a 64-year-old retiree who lives in Georgetown, Tex., returned to her pharmacy for a refill. This time, following a huge increase in the wholesale price of the drug, the cost was $548.01. ...
The increase has stunned doctors, who say it starkly illustrates two trends in the pharmaceutical industry: the soaring price of cancer medicines and the tendency for those prices to have little relation to the cost of developing or making the drugs.
Genentech, for example, has indicated it will effectively double the price of its colon cancer drug Avastin, to about $100,000, when Avastin's use is expanded to breast and lung cancer patients. As with Avastin, nothing about nitrogen mustard is changing but the price.
quote:nyt
people who analyze drug pricing say they see the Mustargen situation as emblematic of an industry trend of basing drug prices on something other than the underlying costs. After years of defending high prices as necessary to cover the cost of research or production, industry executives increasingly point to the intrinsic value of their medicines as justification for prices.
Last year, in his book "A Call to Action," Henry A. McKinnell, the chairman of Pfizer, the world's largest drug company, wrote that drug prices were not driven by research spending or production costs.
"A number of factors go into the mix" of pricing, he wrote. "Those factors consider cost of business, competition, patent status, anticipated volume, and, most important, our estimation of the income generated by sales of the product."
In some drug categories, such as cholesterol-lowering treatments, many drugs compete, keeping prices relatively low. But when a medicine does not have a good substitute, its maker can charge almost any price. In 2003, Abbott Laboratories raised the price of Norvir, an AIDS drug introduced in 1996, from $54 to $265 a month. AIDS groups protested, but Abbott refused to rescind the increase.
And once a company sets a price, government agencies, private insurers and patients have little choice but to pay it. The Food & Drug Administration does not regulate prices, and Medicare is banned from considering price in deciding whether to cover treatments.
quote:http://news.yahoo.com/s/kmbc/3257367
Two years ago, Tracy Pierce's life changed dramatically when he was diagnosed with kidney cancer.
"I have no treatment. Three months has gone by and I haven't had any treatment," Tracy Pierce told KMBC's Jim Flink in May 2005.
When Flink talked to Tracy Pierce, his cancer was attacking his body. Despite being fully insured, every treatment his doctors sought for him was denied by his insurance provider. First-Health Coventry deemed the treatments were either not a medical necessity or experimental.
"I don't know what else to do but just wait," Tracy Pierce said last May.
As he waited, his doctors appealed again and again, including a 27-page appeal spelling out that Tracy Pierce would die without care. Coventry dismissed each request.
quote:http://www.wfaa.com/sharedcontent/dws/wfaa/latestnews/stories/wfaa051214_lj_african.bb0e76d.html
Tirhas Habtegiris was an East African immigrant and only 27 when she died Monday afternoon.
She'd been on a respirator at Baylor Regional Medical Center at Plano for 25 days.
"They handed me this letter on December 1st. and they said, we're going to give you 10 days so on the 11th day, we're going to pull it out," said her brother Daniel Salvi.
Salvi was stunned to get this hand-delivered notice invoking a complicated and rarely used Texas law where a doctor is "not obligated to continue" medical treatment "medically inappropriate" when care is not beneficial.
Even though her body was being ravaged by cancer, this family says Tirhas still responded and was conscious. She was waiting one person.
"She wanted to get her mom over here or to get to her mom so she could die in her mom's arms," says her cousin Meri Tesfay.
quote:nyt
In the Treatment of Diabetes, Success Often Does Not Pay
With much optimism, Beth Israel Medical Center in Manhattan opened its new diabetes center in March 1999. Miss America, Nicole Johnson Baker, herself a diabetic, showed up for promotional pictures, wearing her insulin pump.
In one photo, she posed with a man dressed as a giant foot - a comical if dark reminder of the roughly 2,000 largely avoidable diabetes-related amputations in New York City each year. Doctors, alarmed by the cost and rapid growth of the disease, were getting serious.
At four hospitals across the city, they set up centers that featured a new model of treatment. They would be boot camps for diabetics, who struggle daily to reduce the sugar levels in their blood. The centers would teach them to check those levels, count calories and exercise with discipline, while undergoing prolonged monitoring by teams of specialists.
But seven years later, even as the number of New Yorkers with Type 2 diabetes has nearly doubled, three of the four centers, including Beth Israel's, have closed.
They did not shut down because they had failed their patients. They closed because they had failed to make money. They were victims of the byzantine world of American health care, in which the real profit is made not by controlling chronic diseases like diabetes but by treating their many complications.
Insurers, for example, will often refuse to pay $150 for a diabetic to see a podiatrist, who can help prevent foot ailments associated with the disease. Nearly all of them, though, cover amputations, which typically cost more than $30,000.
Patients have trouble securing a reimbursement for a $75 visit to the nutritionist who counsels them on controlling their diabetes. Insurers do not balk, however, at paying $315 for a single session of dialysis, which treats one of the disease's serious complications.
Not surprising, as the epidemic of Type 2 diabetes has grown, more than 100 dialysis centers have opened in the city.
"It's almost as though the system encourages people to get sick and then people get paid to treat them," said Dr. Matthew E. Fink, a former president of Beth Israel.
quote:http://news.yahoo.com/s/nm/20051103/hl_nm/errors_dc
Patients in the United States reported higher rates of medical errors and more disorganized doctor visits and out-of-pocket costs than people in Canada, Britain and three other developed countries, according to a survey released on Thursday.
Thirty-four percent of U.S. patients received wrong medication, improper treatment or incorrect or delayed test results during the last two years, the Commonwealth Fund found.
Thirty percent of Canadian patients reported similar medical errors, followed by 27 percent of those in Australia, 25 percent in New Zealand, 23 percent in Germany and 22 percent in Britain, the health care foundation said.
"Driven up by relatively high medication and lab or test errors, at 34 percent, the spread between the United States and the countries with the lowest error rates was wide," Cathy Schoen, senior vice president of Commonwealth Fund
quote:
PART THE FIRST: CHEAP RHINOPLASTY IS THE RESULT OF A COLLAPSING MEDICAL SYSTEM
The most important doctor in society, the most important doctor you will ever have, is the family doctor. The GP who knows your weight, your blood pressure, complains when you smoke, all of that. As has been noted, they make a decent salary but nothing special. They're in line with what European doctors make.
Until you factor in malpractice insurance, which has been increasing its rates about 20% a year for the past decade or more, while doctor salaries have not kept in line. On account of this, the take-home pay of these doctors most critically associated with health and well-being is going down. (http://www.gnyha.org/3283/File.aspx).
A perfect example of how disastrous this trend is is to look at New York City hospitals' malpractice insurance, which has gone up 147% in five years, to the point where they are shutting down obstetrics divisions.
The end result of all this is that doctors are being chased into lucrative sub-fields in order to maintain their lifestyle. They have bills to pay, but under our current system, doctors are not paid to make people well, they are paid to perform procedures. Even worse, they are only really paid for the procedures they didn't have to perform on people who cannot pay. Many doctors, to maximize their income, are learning to perform the most expensive procedures possible, and they are competing to get into fields where they don't have to do work that they won't get paid for.
If they paid doctors to make people well, you'd have a lot more GP's, who are the ones on the front lines actually doing this. Instead, the 'winners' in the current system are carving out transplant hearts and vacuuming out fat and stapling stomachs and crowding quickly into any and all available fields where you don't have to do shit for anyone who can't pay, and thus, are not forced to accept the poor people of society as a financial liability. Since medical professionals are all crowding these optional procedure fields as fast as possible, prices for these services are going down. It's not a demonstration of how uninfluenced competition is working to our benefit in some fields as much as it it is another hilarious symptom of a malfunctioning medical system.
Cosmetic surgeons and the like are the 'winners' of our current system. They do completely optional and expensive procedures, only for people who pay out of pocket, they are not forced to work through thieving bureaucratic intermediaries, they are not forced by financially 'unfortunate' policies to care for those who cannot pay, and despite being under the catchall term of a medical profession, they're a little different -- they are actually all but irrelevant to our general health. They cater only to those who have the excess wealth to spend on optional procedures.
The end result is that the government has already been forced to bribe doctors with taxpayer money to remain as essentially skeleton crews in necessary medical fields which HAVE to be staffed (city hospitals, etc) but nearly NO competent doctor would stay in business in if they were forced to rely upon the profit model. Just about every single top doc in places like North Dakota or Arkansas is essentially bribed by the government with huge amounts of supplemental income to not leave. It's another example of how we're trying inefficiently to sneak in socialized solutions to float the broken moral hazard model and still somehow pretend, for the benefit of some schmucks, that it's seaworthy of its own accord.
PART THE SECOND: HELLO MEDICARE PLEASE KEEP MY ILLUSIONS, PRETENSES, AND PARENTS ALIVE
There's also another issue and it becomes evident when you ask seniors what form of healthcare they want. The big old socialized medical care program called Medicare, known alternately as being 'the most popular program in America' and 'the politically untouchable juggernaut.' Socialism, right here in the heart of the dear old U.S. because private medical care wouldn't touch the issue of care for the elderly.
Why? The elderly have the same sort of issue which leaves orphan diseasers to sit in a corner and die. There is no way to make taking care of old people profitable. Good thing that private insurers get to bypass the issue of maintenance of the elderly.
Thanks, Medicare, for being the big bad socialized medical program that makes 'private' health coverage remotely feasible!
PART THE THIRD: KILL GRANDMA
A free market health care system can work but only if nothing forces our hospitals and care networks to do anything for those who cannot pay upfront. In a free market system, you either pay or you don't. If you can't pay, you don't get the service. In the case of medical care, if you don't pay, you die. It's tough, but it's the only way the system can work. Right now, medical providers HAVE to treat people regardless of their ability to pay, in life-threatening situations. This ****s the entire system right up. Because uninsured people don't get stuff looked at when it's minor (because they can't afford to pay), they let things get worse, go to the ER, where they either die or live, and in any event run up huge bills. If the hospital can't get that person to pay, they have to make up for the shortfall elsewhere, or go out of business. So everyone else pays higher rates for things. Which FORCES a kind of socialism on the system anyway.
In order to be a good capitalist, you have to kill grandma. If you cannot pay during a life-threatening ordeal, you have to die. If you don't practice this then all you get is incredibly ------ socialism where everyone ends up absorbing all the costs for the old and the poor anyway even though we're not giving them effective care, just 'necessary' care. Kill grandma. Kill grandma kill grandma and squint real hard and pretend that the mere existence of paltry private charity that will save some people absolves you of any guilt for supporting a system that will leave scores more out on the streets in front of hospitals to die. The problem here is that people's will to actually follow through with their "free market will save the Universe" rhetoric is not strong when faced with an uninsured sick person. Especially an uninsured sick OLD person (who tend to vote in large numbers, and whose population is always increasing) So we start building slipshod systems like Medicare and Medicaid. Kill grandma, otherwise you're a ------ capitalist. You're welcome to say that the free market is the solution to our current woes but you can't pretend that it comes without some extraordinarily worrying sacrifices. If you don't have the balls to kill grandma, then you're going to have to swallow your pride and your 'the free market will save the world' bull and stick up for a socialist model.
quote:Right now, the insurance companies are telling you which doctors you can see and what procedures you can have and as far as I can tell, the ability to sue them is not helping matters. I'm not sure about Tenncare, but it's not universal health insurance. Neither, for that matter, is the current Obama plan. I might argue against it only in that it doesn't go far enough and that these halfway measures never seem to work out right.
1. Ok, the government can tell you which procedures, medications doctors and hospitals are on the approved list. If yours isn't too bad, you can't sue them as you can an HMO.
2. Tenncare was the posterchild of the Clinton healthcare plan which was going to prove to everyone how great it was. Well Jane was on it when we first Married and it came close to killing her. The only approved specialist were over 100 miles away and they were the worst of the worst. The medication she needed was not on the approved list. out of room, but this is BAD
quote:As far as I can tell, nobody has actually read the details of the bill and cannot possibly know this. This argument fails to convince me that the poster knows what he's talking about largely because it is throwing around Republican buzz words designed to scare people - ie socialized (which he didn't even spell right). The credibility factor here is 0. Obama insists his health care plan won't put anyone out of businesses. Republicans insist that it will. Who doy ou believe? They're all a bunch of lying politicians, so you believe the words that scare you the most.
What Obama's "plan" aka hr3200 will do is put insurance companies out of business and force everyone on a single payer socialised system..
quote:That sounds about like what we're paying, yes, between the employer, our premium, and our outrageous deductible.
COST: Katarain, in 2007 it cost $7,421.00 per man, woman and child in the USA. So if the insurance company made NO money and has NO overhead it would cost $1855.25 per month for you to insure your family of three.. If we shared cost to everyone.. Does that sound Fair? Can you afford it?
Source: http://www.kaiseredu.org/topics_im.asp?imID=1&parentID=61&id=358
quote:No, it's not. It's called Medicaid. If you can't get your fact straight, it's best to look them up because missteps like this really hurt credibility. Medicare is a program for the elderly and disabled and actually works pretty well. Medicaid is for the poor and may have issues, but my sister in law on Medicaid delivered her baby for free. My last baby, WITH insurance, cost me about two grand.
THE POOR: There is already a federal government medical insurance program for the poor. It is called Medicare and is sucks. It is full of read tape and eligibility requirements.. Welcome to a government ran healthcare system. I and most against socialised medicine are not saying "get a job or die", we simply know the truth, and the truth is that many people will die from poor care, and no-one will get good care if the USA goes to a socialised system. We ARE NOT saying that the current system is great, only that this current proposal is a death sentence for many..
![[Smile]](smile.gif)
quote:Heck, the bill isn't that long. It's over a thousand pages, yes, but that's in very large type with big margins. (Seriously.) I've read the vast majority of it, and it's not even my job to do so. I'm pretty confident that a fair number of people have read the whole thing by now.
As far as I can tell, nobody has actually read the details of the bill and cannot possibly know this.
quote:Maybe the guy's British. He's fairly consistent in his spelling of the word.
Originally posted by Christine:
This argument fails to convince me that the poster knows what he's talking about largely because it is throwing around Republican buzz words designed to scare people - ie socialized (which he didn't even spell right). The credibility factor here is 0.
quote:LOL, well, maybe some people have, but I keep seeing interviews with congressmen who haven't so it gives me little hope. I haven't read it, but like with you, it's not my job.
Originally posted by TomDavidson:
quote:Heck, the bill isn't that long. It's over a thousand pages, yes, but that's in very large type with big margins. (Seriously.) I've read the vast majority of it, and it's not even my job to do so. I'm pretty confident that a fair number of people have read the whole thing by now.
As far as I can tell, nobody has actually read the details of the bill and cannot possibly know this.
quote:Not while Lawyers make the Laws.
Originally posted by TomDavidson:
For what it's worth, I'm confident that a single-payer system would produce tort reform within a couple years. Sadly, that's not what we're looking at.
quote:Dan, then that's just wrong! (of the insurance companies). The whole purpose of tort reform should be to drop malpractice premium rates for doctors, so they can treat patients for less.
Originally posted by Darth_Mauve:
The state responded with torte reform, limiting the amount of compensation that I could get if a doctor or hospital leaves me in pain for life.
The mal-practice rates, however, did not go down.
quote:There are a lot more people who still need to live when they don't have health insurance than there are people who still need to drive when they don't have car insurance. That is, the cost of the uninsured always exists; the problem with profit-driven health insurance is that it incentivizes dropping expensive subscribers when those are precisely the people who most need coverage.
Originally posted by Farmgirl:
I still think there has to be a better way (less government involvement) to improve on our current system, make it more competitive, etc. Kind of like car insurance in that it might be mandated, but companies have to compete against each other to give the best offer & rates.
quote:The rates didn't go down, but they also didn't rise as quickly as the national average, which is the more salient point. I'm having trouble finding good sourced data, but this brief outlines the 2002 increase in malpractice insurance rates in each of the 26 states that have caps on awards. The average rate increase in 2002 across the US was 25%. In Missouri, the increase was only 13%. Of all the states with caps only six (of 26, or about 1/5) exceeded the mean national rate increase.
Originally posted by Farmgirl:
quote:Dan, then that's just wrong! (of the insurance companies). The whole purpose of tort reform should be to drop malpractice premium rates for doctors, so they can treat patients for less.
Originally posted by Darth_Mauve:
The state responded with torte reform, limiting the amount of compensation that I could get if a doctor or hospital leaves me in pain for life.
The mal-practice rates, however, did not go down.
quote:I know this is going to sound crazy at first blush, but I don't know that that's as terrible a thing as we make it out to be. No, bankruptcy isn't great. But if the options are buy health care you can't afford, declare bankruptcy, and fight against a terrible disease or get minimal coverage paid for by insurance and maybe it's enough, well, I think I'd rather take the credit hit for seven years.
The leading cause of personal bankruptcy in the United States is unpaid medical bills; the United States has more lost productivity and a lower average working age range than any of the other 'modernized' high-income nations such as the G8.
quote:That is an insanely inefficient way of getting anything done. The idea that the system actually works because people's financial futures are ruined (and you're not mentioning the effects of that on personal lives, children, education, financial support of parents, work, ie productivity, and the financial system in general), while it doesn't sound crazy to point out, is indeed thoroughly nuts to actually promote as positive. Though such a scenario can and does happen, the fact is that many people don't even have the means or the credit to financially ruin themselves in pursuit of treatment in the first place kind of goes to show that pointing out one cludgy and downright nauseating option doesn't justify the status quo. That and intentionally planning to default on massive debts before incurring them, even in the pursuit of medical treatment, is fraud.
Originally posted by AvidReader:
I know this is going to sound crazy at first blush, but I don't know that that's as terrible a thing as we make it out to be. No, bankruptcy isn't great. But if the options are buy health care you can't afford, declare bankruptcy, and fight against a terrible disease or get minimal coverage paid for by insurance and maybe it's enough, well, I think I'd rather take the credit hit for seven years.
quote:Well, those people spent money that wasn't theirs, and then were excused from paying it back. The people that lent it to them got screwed, and it was all perfectly legal. I haven't met many people who have ever been bankrupt, and I have no statistics on it to use here, but I'm certainly not going to make the assumption that it's a panacea for middle class financial strife. It's also a huge net negative for the banking system.
No one I've know has ever been permentantly harmed by bankruptcy, so if there's some huge impediment it causes that I'm not aware of, please let me know.
quote:1. also don't you dare get sick in those next seven years!
No, bankruptcy isn't great. But if the options are buy health care you can't afford, declare bankruptcy, and fight against a terrible disease or get minimal coverage paid for by insurance and maybe it's enough, well, I think I'd rather take the credit hit for seven years.
quote:
Medicare and Medicaid are on an unsustainable path. Medicare is slated to go into the red in about eight to 10 years. I don't know if people are aware of that.
quote:The Republicans have a similar dissonance problem, when they argue that *gasp* UHC will be paid for with Medicare cuts (think rationing, death panels, etc.) while arguing that socialized medicine is fundamentally bad.
I do think it's important for particularly seniors who currently receive Medicare to understand that if we're able to get something right like Medicare, then there should be a little more confidence that maybe the government can have a role—not the dominant role, but a role—in making sure the people are treated fairly when it comes to insurance.
quote:You keep arguing against this as if it is an inevitability. Even in nations with UHC, where people don't routinely die waiting for treatment by the way (as the currently do here), you can *still* pay for treatment as well.
Originally posted by The Pixiest:
And how long before UHC becomes unsustainable just like medicare and medicaid?
If rationing is inevitable, and it sure seems like it is, shouldn't the people who are able to buy their insurance be the ones to benefit from their money?
Yes, it's awful to die untreated because you can't afford it... but imagine how awful it will be to die under treated when you COULD have paid for treatment, but under UHC it went to someone else.
How fair is that?
quote:I've got wonder about the sense of scale here. Even if this nightmare scenario were at all likely to come true, we're not talking one to one. Maybe it's more like a thousand to one or ten thousand to one.
Originally posted by The Pixiest:
And how long before UHC becomes unsustainable just like medicare and medicaid?
If rationing is inevitable, and it sure seems like it is, shouldn't the people who are able to buy their insurance be the ones to benefit from their money?
Yes, it's awful to die untreated because you can't afford it... but imagine how awful it will be to die under treated when you COULD have paid for treatment, but under UHC it went to someone else.
How fair is that?
quote:This is nothing but unfounded assumption. The government never does things better or cheaper. When they get bloated, they don't cut the fat, they raise taxes. It is absolutely INSANE to think that the government can handle this more efficiently than the private sector.
So, yeah, either ten thousand people die because they can't afford care or one person dies though they could afford it because of rationing...oh, and the cost of medical care is significantly decreased and people as a whole are healthier.
quote:I was raised to believe that the value of a thing is not directly proportional to its cost. I was also raised to know the difference between spending money and wasting money. And finally, I was raised with the oft repeated expression from my father: "you can always stay home, but if you go out, you pay for it." Meaning, to him, that his money was meant to be spent, and shouldn't be counted too dearly against the benefits of living well.
Originally posted by The Pixiest:
Orincoro: You keep acting like UHC is free.
quote:Then I suppose we might as well add "social Darwinist" to your list of accolades. I didn't know you could be so selfish, or more exactly, I didn't know you were so self interested. It makes me wonder why you expect any sympathy as a member of an oppressed minority yourself. By dint of my position in life, if not for my own personal accomplishments, I can both afford health care and am not a member of any American minority. Maybe all that was gotten to cheaply for me to truly value it enough to deny it to other people in service of my own interests.
Originally posted by The Pixiest:
You can call me as many names as you like.
quote:This assumes an interest in the private sector to view health care from a position of wanting to increase efficiency of service rather than simply wanting to increase profits.
It is absolutely INSANE to think that the government can handle this more efficiently than the private sector.
quote:Correction: it's a basic premise of capitalism. It's clearly not a rule.
Competition pushes them to increase efficiency of service.
If they can provide more for less they will get the customers. That's a basic rule of capitalism.
quote:This is just a reformulation of "if you're poor, you're lazy" and that's bull. I know many people who are relatively poor who work long hours at difficult jobs and yet still can't afford much medical care or insurance. My brother-in-law went through law school battling Crohns Disease and took his finals in the hospital following surgery that required him to crap into a bag through a hole in his stomach for the next couple years. That experience left him tens of thousands of dollars in debt.
Those of us who plan ahead, work hard, save hard, and take care of ourselves should not be called upon to sacrifice ourselves for those who don't.
quote:Not to mention, it also assumes that an absolutely frightening percentage of the developed world outside America is insane.
Originally posted by FlyingCow:
quote:This assumes an interest in the private sector to view health care from a position of wanting to increase efficiency of service rather than simply wanting to increase profits.
It is absolutely INSANE to think that the government can handle this more efficiently than the private sector.
quote:Only if you assume that these people believe that American exceptionalism means that they believe that America is exceptionally good. If you think of it from the perspective that they just believe that America is exceptionally bad, then it starts to make much more sense
Originally posted by Orincoro:
... Why are the people who are so massively enthralled with American exceptionalism so pessimistic about our actual abilities to do anything as a nation? It makes you wonder why a conservative like Limbaugh (as an extreme example) would have faith in our nation's ability to basically start another entire nation over again, or even two at the same time, but have absolutely zero confidence in our ability to run our own medical system. Is that not bizarre to anyone else?
![[Wink]](wink.gif)
quote:If they can make better profits by covering fewer people, they will do so. That's a basic rule of capitalism, too.
If they can provide more for less they will get the customers. That's a basic rule of capitalism.
quote:From their eyes, it isn't. When you got your insurance, you were healthy and cost little. When you got sick, you cost a lot more. In their eyes, you should be paying a greater amount because you are using a greater amount of money.
I WOULD like to see the law tweaked to make sure they don't take your money in health and drop you or jack up your rates in time of sickness. That's fraud.
quote:That's actually usually forbidden by the contract between the insurance company and the doctor/hospital/etc.
Originally posted by The Pixiest:
OR hospitals and doctors could just bill the insurance company the whole amount and pass it on to the insured if the insurance company refuses to pay (thus making a very unhappy customer.)
quote:Well, I come from the belief that medical care should be a right, in practice the same as the right to fire and police protection, and protection under the law, all of which the state provides through taxation. That you will surely never agree with.
Originally posted by The Pixiest:
I'm also fine with charging more (or denying service) for people who wait till they're old or sick to seek insurance.
quote:I think we're seeing that an insurance industry is untenable in the sense that it cannot achieve a reasonable mission of providing health care where it is most needed, including preventative care as well as other types of care. Sometimes you need the government to do things because it makes no sense for private businesses to do them, and in fact private businesses' motivations make their handling of the system unresponsive to real needs, rather than bottom lines. I think we have such a case here.
(btw, not everyone costs a million dollars. If they did, insurance, private OR government, would be untenable.)
quote:Not really. Health care "creeping" up is not viable for an individual insurance plan. It either goes up in equal measure to the expected need of the individual, or the increased cost of the individual has to spread out through increases in premiums to a larger (healthy) group.
Cow: Yes, they should be charging more while you're young and healthy to cover what you will cost when you're old and sick. I'm fine with rates creeping (that's creeping, not soaring) up as you age... people usually earn more money as they get older too... I'm also fine with charging more (or denying service) for people who wait till they're old or sick to seek insurance.
That was your question, right?
quote:Ah, I see the misunderstanding.
It's a bet. They look at the books and see, spread over a large enough population, what they need to charge to make a profit. People who stay healthy till they suddenly drop dead from a heart attack = winning bet. People who die slowly from cancer/AIDS/Alzheimer's = Losing bet.
quote:Pix, not so long ago I would have agreed with you. The unfairness of such a thing would have made me livid. The I came to realize that "fair" is overrated. Life itself is not fair. It is not fair that I was born to parents who did a good job raising me and that some are born to parents who don't or can't - any more than it is fair that some people will never have to work for a living and that some people will never be able to. It isn't fair that cancer strikes some people and not others. Nor is it fair that some people can eat anything and not gain an ounce and that some have nothing to eat. Or that I can sing but not do calculus. You get the idea.
Originally posted by The Pixiest:
And how long before UHC becomes unsustainable just like medicare and medicaid?
If rationing is inevitable, and it sure seems like it is, shouldn't the people who are able to buy their insurance be the ones to benefit from their money?
Yes, it's awful to die untreated because you can't afford it... but imagine how awful it will be to die under treated when you COULD have paid for treatment, but under UHC it went to someone else.
How fair is that?
quote:And yet many people are wealthy who are not so responsible, and many people are responsible who are not wealthy. I don't think you're going to be able to prove a strong correlation there.
Our wealth is ours because we're responsible.
quote:http://news.bbc.co.uk/2/hi/americas/8162616.stm
The truth is that the US sits with the UK at the bottom of the international league table of social mobility.
Family background has as strong an influence on socio-economic opportunity in the classless United States as it does in the supposedly hidebound class-ridden UK.
quote:http://www.irpp.org/events/archive/20081128/corak.pdf
Countries differ in the extent
to which family economic
status is related to labour
market success of
children in adulthood
More than 40% of a father’s
earnings advantage is
passed on to sons in
France, the US, Italy and
UK, less than 20% in
Canada, Finland, Norway
and Denmark
quote:Well, first off, the current bill on the table is not the same as Universal Health Care. It is creating a parallel government-run option alongside existing insurance companies - much like the tax-subsidized US postal service exists in a world with FedEx and UPS.
Cow: I know they're doing that. And it's fraud. and it should be fixed. But we don't need UHC to fix it.
quote:I just want to remark that this is a beautifully expressed idea.
The best we can do, I believe, is to make it the kind of world we would want it to be if we had no idea who we were going to be.
quote:Pretty sure you're thinking of John Rawls.
Originally posted by kmbboots:
Thanks. I can't take credit for it. I wish I could remember where I first heard it (and where it was much better expressed).
quote:"I'll give you the final word... ... you're an idiot"
Originally posted by The Pixiest:
Orincoro: Then there's no sense in us debating. You'll take UHC no matter how bad it is.
quote:That isn't where I heard it, but yes, it certainly fits.
Originally posted by Vadon:
quote:Pretty sure you're thinking of John Rawls.
Originally posted by kmbboots:
Thanks. I can't take credit for it. I wish I could remember where I first heard it (and where it was much better expressed).
quote:(Edit: I'll amend the personal attack)
Originally posted by The Pixiest:
But the hard working middle class and upper classes who are there because they scrimped and saved and worked for it should not be looted to pay for those unwilling to do the work.
quote:I think it would be more useful to the debate to point out WHY Ayn Rand is NOT to be taken seriously and focus on the discussion as to why it is ethical for those with more to care for the those with less. Could be wrong but I think Utilitarianism I think may provide some of the better thoughtout arguments.
Originally posted by Orincoro:
quote:To put it mildly, you disgust me. When and how did you become such a hatefully arrogant person? Because I really hadn't seen any indication of this kind of petty selfishness and misanthropy from you before this issue came up. Now it's written all over everything you say.
Originally posted by The Pixiest:
But the hard working middle class and upper classes who are there because they scrimped and saved and worked for it should not be looted to pay for those unwilling to do the work.
quote:
Originally posted by kmbboots:
Thanks. I can't take credit for it. I wish I could remember where I first heard it (and where it was much better expressed).
A favorite of mine, too. [Even if we know it's not J Rawls!]:quote:
As a thought experiment, the original position is a hypothetical designed to accurately reflect what principles of justice would be manifest in a society premised on free and fair cooperation between citizens, including respect for liberty, and an interest in reciprocity.
In the state of nature, it might be argued that certain persons (the strong and talented) would be able to coerce others (the weak and disabled) by virtue of the fact that the stronger and more talented would fare better in the state of nature. This coercion is sometimes thought to invalidate any contractual arrangement occurring in the state of nature. In the original position, however, representatives of citizens are placed behind a "veil of ignorance", depriving the representatives of information about the individuating characteristics of the citizens they represent. Thus, the representative parties would be unaware of the talents and abilities, ethnicity and gender, religion or belief system of the citizens they represent. As a result, they lack the information with which to threaten their fellows and thus invalidate the social contract they are attempting to agree to.
quote:http://justoneminute.typepad.com/main/2009/08/there-he-goes-again.html/
Folks who really want to stick it to Obama and sow hysteria about "death panels" will extract this from Obama's same fateful interview with David Leonhardt of the Times (my emphasis):
THE PRESIDENT: So that’s where I think you just get into some very difficult moral issues. But that’s also a huge driver of cost, right?
I mean, the chronically ill and those toward the end of their lives are accounting for potentially 80 percent of the total health care bill out here.
DAVID LEONHARDT: So how do you — how do we deal with it?
THE PRESIDENT: Well, I think that there is going to have to be a conversation that is guided by doctors, scientists, ethicists. And then there is going to have to be a very difficult democratic conversation that takes place. It is very difficult to imagine the country making those decisions just through the normal political channels. And that’s part of why you have to have some independent group that can give you guidance. It’s not determinative, but I think has to be able to give you some guidance. And that’s part of what I suspect you’ll see emerging out of the various health care conversations that are taking place on the Hill right now.
So Obama "suspects" that the legislative process will produce some sort of independent group that can give non-determinative "guidance" on end-of-life care for the chronically ill, with an eye towards saving money. Just don't call them death panels!
quote:And there you have it. An independent group set up find ways of saving money. Brilliant. It's 1984! It's 1984! There are independent groups! It's not determinative! A single line in an interview that is not concerning actual litigation is more telling than everything discussed within that litigation or by the countless legislators and officials who mght preside over that system, NOT TO MENTION THE VOTERS! FUR RLZZ> OH NOOZZZ WE HAZ TEH DEPTH PANULLZZZZ!!!
It’s not determinative
quote:I like him too.
Originally posted by ClaudiaTherese:
Oops, just saw Rawls was already suggested and declined.
Was on a dying computer and missed it -- ah well. Still, good to jog my memory. I like Rawls.
quote:Should we also fool ourselves into believing that the equivalent doesn't *already exist* in the private sector?
Originally posted by scifibum:
do you mean "legislation" there where you wrote "litigation", Orincoro?
I think Obama was only stating the obvious: when you have a limited pool of resources, something/somebody will have to decide where to allocate them. So what? Would it be better if he publicly fantasized that everyone will get the equivalent of millions of dollars worth of care for as long as they care to continue receiving it?
quote:
And that’s part of why you have to have some independent group that can give you guidance. It’s not determinative, but I think has to be able to give you some guidance.
quote:you spend too much time on Encyclopedia Dramatica.
Originally posted by Orincoro:
quote:And there you have it. An independent group set up find ways of saving money. Brilliant. It's 1984! It's 1984! There are independent groups! It's not determinative! A single line in an interview that is not concerning actual litigation is more telling than everything discussed within that litigation or by the countless legislators and officials who mght preside over that system, NOT TO MENTION THE VOTERS! FUR RLZZ> OH NOOZZZ WE HAZ TEH DEPTH PANULLZZZZ!!!
It’s not determinative
(edit: I'm Srsly)
quote:Is now a good time to point out that the post office is millions in debt? </tongue in cheek> I'm only nervous about the government option in conjunction with the universal insurance requirement. Telling people they have to buy insurance when you know the only plan they can afford is yours is conflict of interest. I much prefer the non-profit idea I'd heard floated around. But I work for a credit union, so I'm biased towards the non-profit approach.
Originally posted by FlyingCow:
Well, first off, the current bill on the table is not the same as Universal Health Care. It is creating a parallel government-run option alongside existing insurance companies - much like the tax-subsidized US postal service exists in a world with FedEx and UPS.
quote:I suppose that depends on what it would take the insurance companies and doctors to renegotiate. If they won't do it without government pressure, than I suppose the market has left us no choice and it's corporate Darwinism at work. But maybe they just need a few incentives. Maybe groups that negotiate better prices for doctors that coordinate care and promote wellness could get a spiffy tax break or grant dollars. I guess I'm not convinced we need the stick yet when a carrot might suffice - and doesn't seem to have been tried.
Though I think the regulatory changes that would be needed to "fix" the current system and wrangle the existing insurance companies would be such top-down pressure that it would be as though the government was in charge of all the insurance companies.
quote:Right now, the insurance companies seem willing to agree to take pre-existing conditions if everyone has to buy insurance. While many boards and CEOs are probably happy to fiddle while Rome burns, I do think enough want to save the industry and ensure future profits to make some changes. What we could really use is a way of telling one group from the other and encouraging HR departments everywhere to only use the latter. Enough money changing hands might be all it takes to ensure the system we want to see.
You would need to force the insurance companies to do things like taking customers they don't want to insure, raising costs on healthy customers evenly, forcing a tiered payment structure among all companies to enforce fairness, etc.
quote:Well, that's a different problem. I'm not sure how we'd know until we tried it. I suppose it'd be FDR all over again. Keep putting something out there until something sticks.
I don't know if all of those things are even constitutional.
quote:I didn't expect you to have any real sense of proportion. And you don't!
Originally posted by katharina:
I didn't expect you to acknowledge the plausibility of it, Orincoro. Goodness knows people will lie to themselves to an amazing degree in order to keep thinking well of themselves.
quote:This is completely untrue and is the second startlingly untrue statement which you have based your opposition to UHC upon.
Originally posted by The Pixiest:
The government never does things better or cheaper.
quote:that one,
the government is a monopoly with no incentive to reduce waste.
quote:that one (especially considering that this apparently 'insane' notion is actually strongly evidenced by every single other high-income nation on earth and that a case directly rebutting your statement is presented in this very thread), etc
It is absolutely INSANE to think that the government can handle this more efficiently than the private sector.
quote:Those numbers seem very optimistic to me. The $200 billion from penalties is a little frightening as well.
HOW IT'S PAID FOR: Revenue-raisers include: $544 billion from a new income tax surcharge on single people making $280,000 a year and households making $350,000 and above; $37 billion in other tax adjustments. About $500 billion in cuts to Medicare and Medicaid. About $200 billion from penalties paid by individuals and employers who don't obtain coverage.
quote:So if you fail to have health insurance for a day you are penalized for it? Now I see how they can raise $200 billion in tax penalties.
REQUIREMENTS FOR INDIVIDUALS: Individuals must have insurance, enforced through tax penalty with hardship waivers. The penalty is 2.5 percent of income.
quote:This is from the AARP website:
SEC. 59B. TAX ON INDIVIDUALS WITHOUT ACCEPTABLE HEALTH CARE COVERAGE.
`(a) Tax Imposed- In the case of any individual who does not meet the requirements of subsection (d) at any time during the taxable year, there is hereby imposed a tax equal to 2.5 percent of the excess of--
`(1) the taxpayer's modified adjusted gross income for the taxable year, over
`(2) the amount of gross income specified in section 6012(a)(1) with respect to the taxpayer.
quote:I find this to be a little misleading. If I reading the bill correctly, Employers, on a sliding scale up from $250,000, MUST pay 8%. If you choose not to have health insurance from your employer (ie. covered by spouse's insurance) then your company, depending on payroll, must pay an average payroll amount of 8% to the Health Insurance Exchange Trust Fund. So even though you are covered by health insurance you are still going to lose a percentage of your salary to pay for health care. The exact percentage could be higher than 8% unless your employers spreads the tax across all employees.
REQUIREMENTS FOR EMPLOYERS: Employers must provide insurance to their employees or pay a penalty of 8 percent of payroll. Companies with payroll under $250,000 annually are exempt.
quote:
SEC. 313. EMPLOYER CONTRIBUTIONS IN LIEU OF COVERAGE.
(a) In General- A contribution is made in accordance with this section with respect to an employee if such contribution is equal to an amount equal to 8 percent of the average wages paid by the employer during the period of enrollment (determined by taking into account all employees of the employer and in such manner as the Commissioner provides, including rules providing for the appropriate aggregation of related employers). Any such contribution--
(1) shall be paid to the Health Choices Commissioner for deposit into the Health Insurance Exchange Trust Fund, and
(2) shall not be applied against the premium of the employee under the Exchange-participating health benefits plan in which the employee is enrolled.
quote:This is the heart of the libertarian philosophy -- that those who have many have (generally) earned it and those who haven't have (generally) done something wrong. It's the part that sounds nice on paper. Unfortunately, in real life I have seen no such clear breakdown of who has wealth and who doesn't based on level of responsibility. Even though we theoretically live in a society with "equal opportunity" the vast majority of us end up in approximately the same social class as our parents. We have approximately the same opportunities they did. Knowing the right person still is a better way to get a job than actually being competent. Plenty of people who have middle class jobs are useless and weigh their company down and plenty of them don't get fired because they go out to lunch with the boss and know how to brown nose. My father has a government job and calls it "welfare for the middle class" because of all the people who do nothing and yet earn a paycheck.
Originally posted by The Pixiest:
boots, dear, we work for it, we save it, we don't frivolously blow it, we don't spend it on meth, alcohol or other drugs, we don't commit crimes and go to prison, we plan for the future, we skip fun things that are too expensive...
Our wealth is ours because we're responsible. To take it away for those who do not do all those things is downright evil. Further it rewards laziness, drug use, crime and frivolous wastes of money. Simply because there's no reason to work hard and be frugal.
quote:As a total aside, I find it interesting to be the product of one parent who lived in low class poverty, and another parent who grew up in what 1950's California would have termed upper middle class surroundings. I suppose if you do the math, I should statistically be driven towards the middle, and what's even more interesting is that my parents encourage all of their children in their higher education pursuits, *none* of which was in what could be called a money making field of study.
Originally posted by Christine:
Even though we theoretically live in a society with "equal opportunity" the vast majority of us end up in approximately the same social class as our parents. We have approximately the same opportunities they did. Knowing the right person still is a better way to get a job than actually being competent.
quote:The guy has started naming threads after TV Tropes topics, so I think we're not seeing any attempt at subtlety here.
Originally posted by kmbboots:
Blayne, you might want to time your posts or phrase them in such a way that it isn't quite as obvious that you are getting all your news from Jon Stewart.
quote:Examples out of curiosity?
Originally posted by Orincoro:
quote:The guy has started naming threads after TV Tropes topics, so I think we're not seeing any attempt at subtlety here.
Originally posted by kmbboots:
Blayne, you might want to time your posts or phrase them in such a way that it isn't quite as obvious that you are getting all your news from Jon Stewart.
Which is fine with me- Blayne's gotten funnier since he started reading a little more widely.
quote:From http://abcnews.go.com/Politics/HealthCare/Story?id=8341010&page=1
So Conrad has come up with an alternative: public cooperatives. These non-profit groups, run similarly to rural electric co-ops would be given several billion dollars of government money to get started and would -- in theory -- compete with insurance companies to offer better and cheaper medical coverage.
quote:Such subsidies (up to 400% of poverty level) are a part of Sen. Wyden's plan. He essentially funds them by repealing the employer tax <edit>deduction</edit>. Repealing the tax <edit>deduction</edit> is anathema to unions which is why his plan has caught a lot of flak from the Democratic establishment.
Originally posted by Katarain:
(And that means I would also be in favor of government subsidies for people who still can't afford whatever options are out there.)
quote:What a great article, Senoj. I loved the history of how other countries came to have their systems. I think he's right. I don't think any of those systems would work best for us since we're not in the same situation as any of those countries were.
Originally posted by SenojRetep:
Here's an interesting New Yorker article (linked to in the Slate article from the last post) by a cancer surgeon on the pragmatics of health-care reform. The central premise is that any transformation of the health care system needs to be based around small increments from the current state.
quote:http://online.wsj.com/article/SB125072573848144647.html
Sen. Mike Enzi (R., Wyo.) said the Democrats would be making a mistake by forging ahead on their own. "We need to get a bill that 75 or 80 senators can support," he said. "If the Democrats choose to shut out Republicans and moderate Democrats, their plan will fail because the American people will have no confidence in it."
quote:http://www.foxnews.com/story/0,2933,540941,00.html
Well, we're talking about one sixth of the American economy. This is a pretty important thing. And I always look at bipartisan bills as somewhere between 75 and 80 votes, both Democrats and Republicans. And one reason why I decided to leave the group of seven is because -- well, there were a number of reasons. Number one, I don't think they've given Senator -- the Democrats have given Senator Baucus very good flexibility to really be able to put something together. Eighty of the top Democrats in the House are insisting upon a government option or a government plan. I can't be for that, and I don't think -- I don't know of any Republican who is really for that.
quote:http://www.washingtonpost.com/wp-dyn/content/article/2009/08/19/AR2009081904125.html
As the senior Republican on the Finance Committee, Grassley has the potential to attract GOP votes by giving his blessing to a bill, and congressional Democrats and the White House consider him the key to winning bipartisan support for President Obama's top domestic priority. In recent days, however, some Democrats have accused Grassley of trying to undermine the reform effort, for example by refusing to debunk rumors that the Democratic health bills would create "death panels" empowered to decide whether the infirm live or die.
On Wednesday, he denied those claims and fired back at Obama, saying the president should publicly state his willingness to sign a bill without a controversial government-run insurance plan. Such a statement, he said, is "pretty important . . . if you're really interested in a bipartisan bill."
"It's not about getting a lot of Republicans. It's about getting a lot of Democrats and Republicans," Grassley said. "We ought to be focusing on getting 80 votes."
quote:They did give the impression of wanting to compromise. It was just false. This is because they have no strategic option besides stonewalling any health care reform. If health care reform works, they lose.
Originally posted by Vadon:
The Republicans have seen this and are now crying for bipartisanship, but as Nate Silver pointed out at 538 today, they have no real interest in bipartisanship with their complete rejection of the co-op proposal as an alternative to the public option. They didn't even give the impression of wanting to compromise.
quote:Why are you so confident that this exact language will be preserved in the final bill, or that should it happen this way, there will not be legislation undertaken to amend such an unfair policy? I mean, I'm against this particular picayune, but it's not a deal breaker for me at all. I believe if this were the only sticking point, congress would be able to smooth it out fairly easily.
Originally posted by DarkKnight:
Is that really what you want? Change jobs and most likely have to pay a whopping penalty because you went without health insurance for a day?
quote:Except that they are not and they plan on $200 BILLION coming from tax penalties against individuals and employers...so how do you remove that and not come up $200 billion short?
Why are you so confident that this exact language will be preserved in the final bill, or that should it happen this way, there will not be legislation undertaken to amend such an unfair policy? I mean, I'm against this particular picayune, but it's not a deal breaker for me at all. I believe if this were the only sticking point, congress would be able to smooth it out fairly easily.
quote:It is a deal breaker to me because I am sure the are other small sentences in the bill that are just like that one.
What you're pointing out is important, but in what way is this one point a deal breaker, or something you think couldn't or wouldn't be resolved?
quote:Irrelevant point. The issue is not whether this particular bill just needs to be tweaked slightly or not. The issue is that they are trying to tackle a gigantic complex issue in one massive plan which is bound to fail because of unintended consequences.
Do you believe legislation can actually be passed on anything without us having to go back in time and fix things like this so that they work better?
quote:This is the same question you asked before.
Do you think all legislation, no matter how important, should be held up until there is no objection to any fine point?
quote:Honest answer: The Cash for Clunkers program should have been a simple easily run program yet is far behind in payments and is managed terribly. The government couldn't deal with a small, popular, billion dollar program yet they are going to perform well with a gigantic trillion dollar plus program?
Honest question: how do you think this is a different case from the myriad legislation congress deals with every session?
quote:"A supermajority is not enough! Your legislation doesn't truly have the public's support unless a superdupermajority voted for it!"
Sen. Mike Enzi (R., Wyo.) said the Democrats would be making a mistake by forging ahead on their own. "We need to get a bill that 75 or 80 senators can support," he said. "If the Democrats choose to shut out Republicans and moderate Democrats, their plan will fail because the American people will have no confidence in it."
quote:You are perfectly aware of the political ramifications of either slowing or hurrying the process. In an ideal situation, yes, the administration could afford to enact reform on a longer time scale. However, I'm not entirely sure that would ever work. The pace of reform has raised the collective blood pressure in Washington, but it's also made public and in the open a lot of the handwaving done about reform by conservatives. Given a longer time frame, I would expect conservatives to simply have more time to stonewall and win smaller victories against reform, whereas doing this all at once, in the broad daylight with all eyes focused on the prize, certainly catches public attention and shows people that there is a debate going on, and encourages them to join it. Do you think we'd be discussing this with any vigor if it were yet another of dozens of bills passed slowly over years, for which either party had plenty of time to invent rationales for failure or handwaving dismissals of success?
Originally posted by DarkKnight:
Start small. Keep going forward but allow the changes you made to take place before you keep throwing changes at a massive system.
Sure it will take time but it has a much better chance of being done right