And the Alternative is ... ... ... Lacking?

[GernBlansten]

In the spirit of compromise, if we give in and say no federally funded abortions, can your side give us a public option? Heck, just to sweeten the pot, I'll toss in keeping illegals from public healthcare and no death panels. OK?

[SequoiaWDL]

"Polling figures show that as many as 85% of americans with health insurance are happy with what they have"

 

How the pollster frames the question has a lot to do with the response. How it is framed depends on who is paying for the poll.

 

Am I happy with my insurance? Better than not having any.

 

BUT

Here are some stats for you to chew on?

In 1995 I first started receiving health benefits from my employer. They pay 80%, I pay 20%.

Every other Friday, I had $25 deducted from my cheque to cover my share. Copays were $5 as were Rx.

 

Last year, same company, same share: I had $120 deducted from each payday.

Dr visits $20, specialist $35, Rx $25-40.

You do the math. But the CEO of my insurer took a pay cut too. From 24M in 07 to 12M in 08.

 

Medical malpractice, by the way, is a state issue. Google California MICRA details.

(This message has been edited by SequoiaWDL)

[Hal_Crawford]

So they have had tort reform in California since 1975. How much has it saved? Is health care in California less expensive than states without tort reform? Is it a little cheaper? A lot cheaper? Or is it the same? Does anyone know the answer?

 

Hal

[GernBlansten]

Ok, Ok, Ok. I'll throw in federal TORT reform too. Can we just have a public option? Look we've given you guys everything you want. What do we get in return?

[scoutingagain]

"Polling figures show that as many as 85% of americans with health insurance are happy with what they have"

 

So what % of Americans without coverage are satisfied with what they have?

 

SA

 

 

 

[Beavah]

Yah, I confess I haven't heard anything resemblin' an intelligent plan from the GOP side of the aisle.

 

My list of things to fix?

 

Health care costs bankrupting U.S. manufacturers and other businesses.

 

Health care costs making our businesses less competitive with those overseas in a global market.

 

Small businesses and self-employed folks who work hard and make a decent living, but have difficulty or find it impossible to get health care coverage because of their age, prior conditions, and/or lack of purchasing power.

 

Hard-workin' folks who get laid off and lose coverage.

 

Hard-workin' folks who get laid off, find a new job, and are denied coverage for their son's pre-existing condition on their new employer's plan. Heck, I know someone who changed jobs and the new employer's plan denied coverage to his wife for childbirth because they claimed pregnancy was a "pre-existing condition".

 

Headaches takin' a lad in for care on a campout. Seems like we should be at least as good as Canada at carin' for our kids. Basic health care for kids should be free and readily available. That's a just plain good investment, especially when compared with health care for us seniors.

 

The practice of carin' for the uninsured in emergency departments, where care is most costly.

 

Out-of-control, outrageously expensive, flogging-the-patient intensive care for the terminally ill. Sometimes when they don't even want it.

 

The gross inefficiency of the present billing system. My uncle was an accountant, and durin' his last 10 years it was a half-time job for him trying to keep track of the billin' and accountin' eccentricities for his care and his wife's.

 

Da payments system that rewards doctors for ordering unnecessary procedures, spending as little time as possible with patients, and going into specialties rather than family practice.

 

Da tort system that further encourages ordering unnecessary procedures (though I don't think it's as big a problem as the payment system which encourages ordering procedures).

 

And, horror of horrors, the notion that us folks over 60 who aren't workin' anymore are entitled to have our children and grandchildren pay for whatever we want. If our kids ever acted that spoiled, we'd have spanked 'em.

 

That's enough to be gettin' on with. I'm not hugely fond of government programs, eh? So many ways they can be bureaucratic messes or manipulated by parties in power. So often da government overpromises and fails to think about how to pay for it beyond da current folks' terms of office. But I have to be honest, da private insurers have made a complete mess of the thing, and are spendin' all their time trying to skim the demographic cream rather than perform the real service of distributing risk. I don't see a successful reform happenin' without a public option, to be honest. The goal should be to keep it modest.

 

Beavah

 

[skeptic]

Priorities:

 

Assuring most people "can" get coverage, at least at the minimal level.

 

Eliminating overlap in government programs already in place and making them more efficient. (I have been on V.A. since "losing" private coverage due to expense after downsizing. But now I am more or less forced into Medicare too with a $100 a month cost, even though my needs are met by V.A. So far, it does not appear that Medicare will cover my out of pocket for V.A., nor the reverse; and copays for Medicare are relatively high).

 

Making preventive care, especially basic physicals mandatory. This is the dumbest component out there in most "plans". Why would anyone not prefer $300-$500 a year preventive costs in lieu of possibly thousands should something show up due to lack of screening? Just simply does not make sense.

 

Taking profit component out of the public system. That, as has been shown many times, is probably the number one reason for much of the inflation in costs.

 

No denials for preexisting conditions, or cutting people off when it suddenly becomes unprofitable.

 

No clerks, or so called billing specialists, making medical decisions and denying coverage. Only "properly trained" medical specialist should do this.

 

Surely there are other things, but these are the things most irksome and unfair to me at the moment.

 

And, I would like to see opponents of suggested changes and proposals currently offered "publicly" publish their alternate proposals, rather than simply cry "NO" and endorse fear and half truths. (This last one of course would relate to more than just medical care).

[BrentAllen]

Beavah,

Look at the problem from the insurance company's side. They see people go for years without insurance, and then want to sign up only when they are deathly sick. That ain't how insurance works, eh? Those people need to be in the insurance pool during their healthy years, as well. If insurance companies are forced to take everyone, no matter what their health, everyone will drop their insurance and only buy it when they get sick. How long do you think an insurance company would be able to stay in business, operating under those conditions? No premiums collected until they have to turn around and start paying hundreds of thousands of dollars in claims. It would be like waiting until you are on your death bed to buy life insurance, and expecting to get a $1 million policy for $30/month.

 

Can Obama force everyone to buy insurance? I don't see that power listed in the Constitution. Will it stand up to a challenge, which will surely come? I don't know.

 

Obama wants a government plan for those who can't afford insurance. This plan will cost substantially less than any other plan out there, yet Obama thinks no one else will want to participate in it. And this plan must fund itself, and will be able to do so, because it is administered by the government? This sounds like the camel getting his nose in the tent.

 

Finally, we are going to save $200 - $250 billion in Medicare when they clean up the waste and abuse. What? Silly question, but why not go ahead and do that NOW? Do you really need a new bill to do that?

[scoutingagain]

"Can Obama force everyone to buy insurance? I don't see that power listed in the Constitution. Will it stand up to a challenge, which will surely come? I don't know."

 

Obama certainly can't by executive order but congress can legislate such a requirement just as they can require everyone to pay taxes, register for the draft or any of a number of other laws that require citizens to do something for the common good. Now it might be determined that it is outside the Federal govt's jurisdication to impose such a requirement and it would fall to the states. If that's the case the Federal Govt could withold funding for any one of a number of Federally funded healthcare initiatives for those states that did not require it's citizens to have health insurance. Done all the time for Federal highway funds, education funds etc.

 

In Massachusetts all adults are required to have health insurance. If you don't you are subject to a potential fine. When you file your state income tax return you must submit proof of insurance with the return. It is returned along with your W2.

 

This commi law was signed into law by another pinko liberal from Massachusetts Mitt Romney.

 

It can be done.

 

I'm not saying Massachusetts has a perfect system. But something like 95% of adults are covered by some form of health insurance. There is not a public option but there is choice available for anyone who is not employed or who's employer does not provide health insurance. Our experience has not been that businesses have abandoned their employees. However, just like Bush's perscription drug benefit, the cost has been more than was expected. There are lessons to be learned from Massachusett's experience, but it isn't to keep the current system.

 

If somone wanted to call Obama a liar, it should have been when he said the program won't increase the deficit, not when he said something that was pretty clearly true.(ie. his program does not cover illegal immigrants)

 

 

From FactCheck:

 

OBAMA: "The reforms I'm proposing would not apply to those who are here illegally." One congressman, South Carolina Republican Joe Wilson, shouted "You lie!" from his seat in the House chamber when Obama made this assertion. Wilson later apologized.

 

THE FACTS: The facts back up Obama. The House version of the health care bill explicitly prohibits spending any federal money to help illegal immigrants get health care coverage. Illegal immigrants could buy private health insurance, as many do now, but wouldn't get tax subsidies to help them.

 

FWIW I'm in a private insurance program through my employer. Pay approx 50% of the cost. Yes it's gone up quite a bit in the last 5 years, and I suspect if something isn't done it will continue to eat into my paycheck. But I have seen no difference in coverage or service since the Massachusetts laws requiring coverage were enacted.

 

As Beavah noted. Something must be done. The current system is too expensive, leaves out too many people and is crippling our ability to compete in the world economy.

 

SA

 

 

 

 

[gcnphkr]

Okay, I'll admit that some of the things I listed are libertarian (little "L") ideas, not Republican.

 

CalicoPenn, You are incorrect about which ones are in the feds scope. Certainly removing the barriers to interstate competition is in the power of the federal government. It easily falls under the commerce clause. It also removes the state mandates (although the feds would likely impose their own).

 

That most people get their medical insurance through their employer and all the problems that go with it is the direct result of federal tax law. Change that so that individuals receive the tax benefit instead of the employer.

 

Of course a most popular method of tort reform would be to just fulfill Dick the Butcher's wish. Utopia indeed.

 

But, if this is all going to be paid for by eliminating fraud and waste from system then why not do that first. If it goes well then we can talk about a public option. That was the funniest line from his speech. He deadpanned it so well you might half think he believes it.

[Eamonn]

So far no one has asked me for my opinion.

For which I'm really grateful. As I kinda think that I'd stutter a lot, feel a little dumb and have to say that I'm a little overwhelmed by what is going on.

 

For many years, as a family we were happy with just ambling along. The hospital where HWMBO had Blue Cross /Blue Shield as a benefit. As time past things changed, we paid for part of the insurance and the Blue Cross /Blue Shield became Blue Cross /Blue Shield Keystone. Which took away some of the choice we had about where we could go and who we had to talk to before we went.

Still what we paid for the family really wasn't a lot of money. The co-pays tended to be more of a nuisance than a hardship.

I have to admit that I thought that we were sitting pretty.

Then HWMBO got sick.

By this time Blue Cross /Blue Shield Keystone was gone and the plan offered by the hospital where she works was a Home Host Plan. Which I thought made a lot of sense. It made people use the services that the hospital offered.

I was thinking of retiring. Just playing with money and real estate. I thought I might buy an ice cream store.

Our insurance has been great all the time she has been sick. It paid for everything, all the chemo all the drugs, doctors bills.

But...

She was off work.

For the first six months we paid what we would have paid had she been working. Less than $150 a month.

After the first six months we found that we had to pay the group rate $950 a month.

Thankfully she wasn't off work for very long after the first six months.

But...

If she had been off for a year, we would have found ourselves without any insurance.

I don't know how many companies would have wanted to insure her?

Thats when I decided that my retirement plans would go on hold.

I now have really good insurance, it costs me 4% of what I earn. It covers everything, dental, glasses, hearing aids, the whole nine yards.

Better yet, if I can put in 15 years (Yipes!!) I can keep it when I retire. - If I live that long.

The idea of not having health insurance scares the bejebbers out of me. So much so that I'll put in the time.

 

I think one of the reasons I'm so scared is because I was born and bred in the UK.

Sure the system isn't perfect and I do much prefer having what I have here. But there is a lot to be said for the peace of mind knowing that if you are sick, money isn't a big worry.

I know very little about the programs that we have here in the USA for the poor? I have never had to use them.

I know from looking at the bills that came in for HWMBO chemo treatments (About $35,000 a month) That I could go through a lot of my money in a very short time.

Then of course there is who pays for the National Health Service in the UK?

I don't have all the facts.

I do know that anything that can be taxed is taxed and somethings are taxed a lot!

Petrol is costing about one pound six pence a liter (3.78 liters = 1 US Gal. British Pound = 1.67 US$. If my math is right that's about $6.70 for a gal of gas!) A pack of cigarettes is about $10.00.

Value Added Tax (a nasty sales tax!) Which was reduced from 17.5 per cent for 13 months down to 15% will return to 17.5 per cent on 01/01/10.

If you have income over 37,400 be ready to be taxed at 40%.

 

 

I don't know. But if there is one thing that Americans really dislike? It's paying taxes.

I really don't think the average guy in the street who now has insurance is going to be willing to exchange what he has now for higher taxes?

I think most of us hate the idea that some poor soul can lose their home and be faced with bankruptcy just because he or she got sick.

But with the mountain of debt that the USA is now in, adding more right now? Is not such a great idea.

Eamonn.

 

[BrentAllen]

I'm a big Dave Ramsey fan (if you don't know him, look him up). I like his take on health care:

 

"The government is not the answer. Not to your debt problems, what kind of car you drive, or how well you prosper. And it certainly is not the answer to the healthcare issue. When the government gets involved with how healthcare is handled, it's an invitation to disaster.

 

Three key points to remember here are:

 

Healthcare is not a basic liberty. Because you breathe, you have the right to life, liberty and the pursuit of happiness. You dont have the right to healthcare unless you work for it and contribute to something.

 

We have to get back to personal responsibility. You eat too much, you get fat. You cant have someone else take the blame for you. By the same token, you cant expect someone else to take care of you. Be accountable for your own well-being instead of handing it off to Washington and saying, You take care of this.

 

Health Savings Accounts (HSA) are a great thing. This type of plan, where you put money into a tax-deductible savings account and pay a high deductible, puts healthcare control back in the consumers hands and can help keep prices in check. Dont you want to have a say in your own healthcare policy instead of the government doing the saying for you?"

 

My employer offers a high deductible, HSA plan. Out of around 300 employees, I'm the only one who has signed up for this option. Well care visits covered, $2,300 deductible, $2,900 max out of pocket. Lower monthly premiums.

 

The plan covers a lot of the problems mentioned in the debate:

Cost is lower, more affordable.

Well care visits are covered.

Financial catastrophy is avoided if major illness.

We fund the HSA, which rolls over every year, and we can invest the balance.

 

We can put nearly $6,000 (tax free) into the HSA every year. We can use it for vision, dental, prescriptions, etc. We don't spend anywhere near the $6,000 amount, so our plan is to have a nice health plan nest egg when we retire.

 

As Dave Ramsey says, act your wage.

[Beavah]

Look at the problem from the insurance company's side. They see people go for years without insurance, and then want to sign up only when they are deathly sick.

 

Yah, fair enough. Except that da person WAS on insurance (perhaps even with da same carrier) with his/her former employer, and in switchin' jobs can still be denied. Or, as Eamonn points out, if da person gets sick enough to no longer be able to work, they can be bankrupted.... and effectively sentenced to death ... after payin' insurance premiums for decades.

 

How many folks in da modern economy stay with one employer at one location their whole life?

 

The point of insurance is to spread risk, eh? When insurers do their best to exclude the risky for profits' sake, they're no longer spreadin' the risk. They're robbin' folks.

 

HSA's are an OK government option, eh? But why did yeh need da government for that? Yeh couldn't have gone and taken out a high-deductible plan and saved money on your own without a tax incentive? Of course, da point is that without that government intervention and "public option", yeh couldn't have - you couldn't have afforded da health insurance part, and without the tax incentive (which upped our federal deficit) yeh couldn't have afforded da HSA contribution. So yeh took the "public option."

 

Problem is, it was a pretty weak public option. If yeh leave your employer, the company that's insurin' your High Deductible plan will drop you, eh? And a new employer's plan might refuse to cover your wife's cancer.

 

How long do yeh suppose that HSA is goin' to survive in that case?

 

That's da problem with this sort of thinkin'. If everyone in your family is healthy and in a low-risk demographic group, of course yeh want to get favorable treatment from a high deductible plan and squirrel money away in a tax-incentive savings account. Until someone gets sick, eh? Or loses a job. Then you're hurtin'.

 

And hopin' yeh make it to Medicare....

 

Beavah

 

[GernBlansten]

My sister is 55 and just got unemployed because her company went under. She now has ZERO health insurance. Can't go on COBRA because the company has to still be in business. She has pre-existing conditions so no insurance company in their right mind would take her.

 

How does your solution Brent, handle her case?

[BrentAllen]

Get real, Beavah. So, by your definition, are all of us homeowners living in public housing, since we deduct our mortgages? And are we all government employees, due to payroll taxes? Come back to reality, and give me a break.

 

Yes, I took advantage of a tax incentive to take care of myself. I get to keep more of MY TAX MONEY and use it in a manner where I get to make the decisions about my health care. No government intervention needed. No Big Brother government making decisions that affect my health.

 

Republicans have suggested more of this - give more tax incentives so more of those people who choose not to purchase health insurance will. You need to talk to more young workers in their 20's. Many of them choose not to participate in their company health insurance plans because they would rather keep the money. They are healthy and don't see a need for it.

 

To suggest that HSA's are "public options" is ridiculous. They are just like IRA's. Do you consider those "public options?" Both plans promote individual responsibility, not government reliance.

 

I don't understand your statement about a high deductible plan being ok until someone gets sick. My max out of pocket is $2,900 per year. I've got that covered with my HSA. What am I missing?

 

To answer Gern's question, I would say the solution would be to offer more tax incentives so more people buy insurance. I have no problems with reforming the insurance industry so plans become portable (no dropping or refusal for pre-existing). To do this without bankrupting insurance companies will require some type of action to help them on the revenue side. Tax incentives that would produce more customers would be one way to do so.

 

What I don't understand is why employees in a company can group together to get affordable rates, but others can't. Why can't all the small business owners in a city or county group together and get a group plan?

 

On the other side of the coin, many out there take "affordable" to mean free. Many can afford insurance, but won't pay.