The Pinocchio President

[jdonn]

If more people have to buy insurance, and there is no public option to buy insurance, the private insurance companies will make a lot more money. That doesn't mean it was somehow bad or wrong to force more people to buy insurance.

 

I would feel remiss if I didn't point out how incredibly Obama-apologetic this sounds.

 

 

I will give Obama credit for being really good at politics - at making smoke and mirrors illusions of change appear to be real.

Do you just always pick another slogan to support one of the 3 or 4 points you like to make, or do you actually disagree with something specific? Or do you just disagree with supporting.... anything that anyone ever does?

 

I didn't even use the word "Obama" or the word "change" in that quote, nor in the rest of the post that you didn't quote. If I did, I could have said something along the lines of Obama wanting there to be a public insurance option which would have cost the private insurance companies a great deal of money.

[Winstonm]

If more people have to buy insurance, and there is no public option to buy insurance, the private insurance companies will make a lot more money. That doesn't mean it was somehow bad or wrong to force more people to buy insurance.

 

I would feel remiss if I didn't point out how incredibly Obama-apologetic this sounds.

 

 

I will give Obama credit for being really good at politics - at making smoke and mirrors illusions of change appear to be real.

Do you just always pick another slogan to support one of the 3 or 4 points you like to make, or do you actually disagree with something specific? Or do you just disagree with supporting.... anything that anyone ever does?

 

I didn't even use the word "Obama" or the word "change" in that quote, nor in the rest of the post that you didn't quote. If I did, I could have said something along the lines of Obama wanting there to be a public insurance option which would have cost the private insurance companies a great deal of money.

I wonder if you actually believe what you are saying ... that's all.

[kenberg]

Taxes, health care, and a little about the war

 

I can use a couple of recent events to fairly well mark my view about taxes and such.

 

Event 1: I got something from the government telling me the cost of medicare next year. There will be a surcharge. Since paying the full cost is tough for some, they will get a break, and since the books have to balance (well, balance in some generalized sense) I have to pay more.

 

Event 2: I have no idea how this actually works but apparently medicare or maybe medicaid is set up so that some of the money comes from the state. A state can get an exemption from paying its share, and in order to get Sen. Nelson's vote, Nebraska gets an exemption. The entire bill goes to the feds. Again, if the books have to balance, then if Nebraskans pay less, I pay more. I am not sure I understand this correctly so as a factual matter I hold it open to correction, but to illustrate my views let's take it as approximately true.

 

 

So:

 

I am fine with Event 1. Of course I don't like paying more money but in so far as it is true that I am paying more so that some other less lucky folks can pay less, it's ok by me.

 

 

I am not at all fine with Event 2. I do not wish to pay more, living in Maryland, so that someone can pay less based on the fact that he lives in Nebraska. To the extent that anything at all like what I describe is true, I find it outrageous. I repeat that I am open to factual correction here, but it does illustrate what sort of payments I find acceptable and what I do not.

 

 

As I said earlier, I see the health care reform as something that will not be helping me individually, and I think it is not going to be much (if any) of a help in the nations finances. If it helps folks with limited means get better health care then that is definitely in its favor. It was once advertised as something that would also help keep costs down. That seems to be of only historical interest.

 

Should I believe that it does help the strugglers? Scam artists often try to appeal to our wish to get rich quick, they are generally a joke, but we need also be wary of those who enrich themselves promising to do good works for others. Money given to charity does not always reach the people that are in need. Sometimes it is scam, sometimes incompetence. So it is fair to take at least a skeptical, wait and see, approach here. I hope the bill stands up to scrutiny, but there has been a lot of pushing and shoving, and insurance companies have people paid full time to make sure that they come out fine. I lack such assistance.

 

 

Here is how I form my views on quite a few issues: I know that I lack the expertise, the time, and often the interest to learn in great detail exactly what is best. So I listen, and see how things stand up on review. I will switch over to the war to illustrate, using an example I mentioned earlier. In his speech, Obama described the deployment of troops as taking place in the first half of 2010. It now turns out, I think everyone agrees, that no such thing is possible. What am I to think. A guy spends months reviewing a situation of life and death, one that has grave national importance, prepares a speech with the help of well-paid advisers, and then screws this up? Should I believe him on anything?

 

If I am asked to help someone, one of my most hard and fast rules is that when they describe the situation, then it had damn well better be the situation. On health care, and on the war, we shall see.

[Chas_P]

I am not at all fine with Event 2. I do not wish to pay more, living in Maryland, so that someone can pay less based on the fact that he lives in Nebraska. To the extent that anything at all like what I describe is true, I find it outrageous.

 

Apparently some state attorneys general agree with you.

 

http://www.politico.com/news/stories/1209/30949.html

[andrei]

In Germany, we pay a little bit more in taxes ...

is it twice more "a little bit" ?

 

 

ok, maybe twice more is as exaggeration, but "a little bit more" it is too.

 

edit again: it seems that twice more might be quite accurate:

 

a 75000 euros/year will pay 33% income tax

a 75000 US/year will pay 20% income tax

 

if you factor in the sales tax, 19% versus 4%-8% you are getting there ...

Edited December 24, 2009 by andrei

[cherdanno]

In Germany, we pay a little bit more in taxes ...

is it twice more "a little bit" ?

 

 

ok, maybe twice more is as exaggeration, but "a little bit more" it is too.

 

edit again: it seems that twice more might be quite accurate:

 

a 75000 euros/year will pay 33% income tax

a 75000 US/year will pay 20% income tax

 

if you factor in the sales tax, 19% versus 4%-8% you are getting there ...

Lol, maybe you should start by comparing similar incomes, instead of comparing a 75k $ salary with a 105k $ salary.

You might also be aware that the German income tax offers a lot more tax exemption. And if you start factoring in VAT, you might also want to add in corporate taxes.

 

For 2007, the percentage of the total tax revenue as part of the GDP was 36% in Germany and 28% in USA, according to OECD figures.

 

Edit: I guess I should have added that even though I trust the OECD to try to come up with comparable numbers, it is really impossible to compare. At which point does the premium for an extremely heavily regulated not-for-profit mandatory health insurance become part of the tax revenue? Where is the line between tax exemptions and subsidies? Still "twice more" is beyond what we call reality, and "twice as much" also ridiculous.

[jdonn]

If more people have to buy insurance, and there is no public option to buy insurance, the private insurance companies will make a lot more money. That doesn't mean it was somehow bad or wrong to force more people to buy insurance.

 

I would feel remiss if I didn't point out how incredibly Obama-apologetic this sounds.

 

 

I will give Obama credit for being really good at politics - at making smoke and mirrors illusions of change appear to be real.

Do you just always pick another slogan to support one of the 3 or 4 points you like to make, or do you actually disagree with something specific? Or do you just disagree with supporting.... anything that anyone ever does?

 

I didn't even use the word "Obama" or the word "change" in that quote, nor in the rest of the post that you didn't quote. If I did, I could have said something along the lines of Obama wanting there to be a public insurance option which would have cost the private insurance companies a great deal of money.

I wonder if you actually believe what you are saying ... that's all.

Why would you wonder that?

[hrothgar]

I am not at all fine with Event 2. I do not wish to pay more, living in Maryland, so that someone can pay less based on the fact that he lives in Nebraska. To the extent that anything at all like what I describe is true, I find it outrageous. I repeat that I am open to factual correction here, but it does illustrate what sort of payments I find acceptable and what I do not.

I don't like that my tax dollars get spent on inane abstinence based education programs.

 

I think that we spend way too much money on defense and not nearly enough on foreign aid.

 

I think that we spend way too much subsidizing automobiles and don't fund public transport nearly enough...

 

Don't get me started on school funding.

 

***** happens

***** will continue to happen

Learn to live with it...

[kenberg]

Of course I live with it, what else. But I also note it, and it affects my views of whom I trust and whom I support. When polls find that Congress is not trusted, this sort of thing may have something to do with it. When polls show that people doubt that health care reform is in their best interest, this sort of thing may have something to do with it. I have no belief at all that the reform is in my best financial interest, the issue is who will benefit.

 

So far, the early beneficiaries of the health care reform bill are Senator Nelson and his constituents. I gather that the insurance industry is also doing ok. We can all hope that the long term effect will be favorable. Perhaps it will.

[PassedOut]

I think it will be quite interesting if this gets to the Supreme Court because there is so much existing disparity in the distribution of federal funds among the states. As with the present Nebraska payoff, the disparity takes money from the more productive states, known as the "blue states," and hands it out to the more dependent states, the so-called "red states."

 

For most of the republican attorneys general, this would be a classic case of "be careful what you wish for -- you might get it." My guess is that this uproar will die quickly once the red states realize that, if successful, they might not get to suck so much from the federal teat.

[kenberg]

I presented it as something that I was prepared to be factually corrected on, it seemed too bizarre to be true. So it's real! Somehow, no matter how cynical I get, reality has a way of making me seem naive.

 

 

With any large scale spending bill, there will be well-connected people with their hands in the government's, meaning our, pockets. Of course. But here I am, with nothing to gain from this bill, hoping it will help others, finding we have to pay off some slimeball senator in order to get it passed. It's probably best that I am not the president since my inclination would be to tell him to go ***** himself.

[spwdo]

you american people should realise that 12% of your medicost goes to administration due to the crazy system you developed. if only half of that money was recovered(lets say: all the medipeople now accepting, denying, checking, investigating sicks peoples helpclaim) then all the people now without insurance would have insurance.

 

What you rich folks with insurance do is think that your bill will go up if the guy next door gets a bargain on his insurance. you seem to forget that per person you spend as much as the next country where everyone is insured and noone goes bankrupt due to medical bills.

 

A belgian doctor went to las vegas on holiday, he got a heartproblem there, was brought to the clinic. spend there two days, returned home with a 76.000 dollar bill.

 

Sooner or later this will start to affect your tourisme, people slowly start to be afraid of visiting USA and having the bad luck of falling over a bananaleeve, breaking a leg and having to sell their home in their own country to pay for the medical bill.

 

Given my luck i wont be visiting america in this lifetime. Always wanting to see the grand cayon but what if i stumble over a rock and need plaster. Damm, i cant afford it. Lets go to paraguay instead.

[cherdanno]

You know, health insurance for travel is ridiculously cheap.

[mike777]

you american people should realise that 12% of your medicost goes to administration due to the crazy system you developed. if only half of that money was recovered(lets say: all the medipeople now accepting, denying, checking, investigating sicks peoples helpclaim) then all the people now without insurance would have insurance.

 

What you rich folks with insurance do is think that your bill will go up if the guy next door gets a bargain on his insurance. you seem to forget that per person you spend as much as the next country where everyone is insured and noone goes bankrupt due to medical bills.

 

A belgian doctor went to las vegas on holiday, he got a heartproblem there, was brought to the clinic. spend there two days, returned home with a 76.000 dollar bill.

 

Sooner or later this will start to affect your tourisme, people slowly start to be afraid of visiting USA and having the bad luck of falling over a bananaleeve, breaking a leg and having to sell their home in their own country to pay for the medical bill.

 

Given my luck i wont be visiting america in this lifetime. Always wanting to see the grand cayon but what if i stumble over a rock and need plaster. Damm, i cant afford it. Lets go to paraguay instead.

I do find it amazing that, we, the USA spends about twice the GDP as many other countries do for what seems worse and less than universal health coverage.

 

Note in the USA without universal health care coverage we are short over 16,000 primary care doctors. With universal health care coverage we are short many more doctors. Yet other countries have enough doctors to provide cheap reliable coverage for all....simply amazing!

 

As for your point about not checking up on health insurance claims, if other countries do not check and double check, how do they avoid massive fraud claims?

With our single payer system, medicare, we check and double check and still have massive fraud and waste.

 

 

In any event you guys do claim to get great health care at about 50% of our cost, somehow.

[Winstonm]

I am in a catch-22. I am in favor of a single payer system yet I do not trust this government to run it. Perhaps we should outsource single payer to a country who knows how to do it.

[Trinidad]

As for your point about not checking up on health insurance claims, if other countries do not check and double check, how do they avoid massive fraud claims?

With our single payer system, medicare, we check and double check and still have massive fraud and waste.

By keeping the health care system simple and transparent. That way it is easy to find fraud. But in a system that is complicated where no one has any overview of what is paid for what, fraud is easy to commit and hard to detect.

In any event you guys do claim  to get great health care at about 50% of our cost, somehow.

I don't know the exact numbers, but I will say this: Simpler is cheaper.

 

(And yes, the USA is the only country in the world that my standard, 13 in a dozen health insurance doesn't cover. Guess why.)

 

Rik

[Trinidad]

I am in a catch-22.  I am in favor of a single payer system yet I do not trust this government to run it.  Perhaps we should outsource single payer to a country who knows how to do it.

That's probably the most costly in the USA: The fundamental lack of trust in the government.

 

I will not judge whether this lack of trust is justified or not, but it does cost you an awful lot of money.

 

Rik

[mike777]

As for your point about not checking up on health insurance claims, if other countries do not check and double check, how do they avoid massive fraud claims?

With our single payer system, medicare, we check and double check and still have massive fraud and waste.

By keeping the health care system simple and transparent. That way it is easy to find fraud. But in a system that is complicated where no one has any overview of what is paid for what, fraud is easy to commit and hard to detect.

In any event you guys do claim  to get great health care at about 50% of our cost, somehow.

I don't know the exact numbers, but I will say this: Simpler is cheaper.

 

(And yes, the USA is the only country in the world that my standard, 13 in a dozen health insurance doesn't cover. Guess why.)

 

Rik

Simple and transparent.....you mean the health care bill in our Congress?

 

 

 

Whatever Sweden, etc do to make health care simple and transparent seems impossible in real life or beyond us.

 

One does wonder how these simple and transparent country plans avoid massive fraud and waste, I have no idea how.

 

 

I mean in the headlines today there are claims that Russian hackers are stealing millions and millions from our banks via computers. If we cannot keep money safe in banks..then....how do we protect a multi trillion health care system from hackers?

[andrei]

In Germany, we pay a little bit more in taxes ...

is it twice more "a little bit" ?

 

 

ok, maybe twice more is as exaggeration, but "a little bit more" it is too.

 

edit again: it seems that twice more might be quite accurate:

 

a 75000 euros/year will pay 33% income tax

a 75000 US/year will pay 20% income tax

 

if you factor in the sales tax, 19% versus 4%-8% you are getting there ...

Lol, maybe you should start by comparing similar incomes, instead of comparing a 75k $ salary with a 105k $ salary.

I am wondering if you try to be sarcastic, but whatever ...

 

You might also be aware that the German income tax offers a lot more tax exemption. And if you start factoring in VAT, you might also want to add in corporate taxes.

what exactly is the connection between corporate taxes and personal taxes?

I am only trying to compare how much Fritz is paying versus Jim.

 

and "twice more" was wrong, I meant to say "double the amount".

[cherdanno]

When you go to a store in Germany, and buy s.th. for 20 Euros, then the store pays the VAT as part of the 20 Euros. Is that so different from the store taking all of the 20 Euros, then paying corporate tax from that revenue?

[spwdo]

What fraud are you talking about?

 

if health insurance is there for everyone how can one fraud. there's never any money paid to the sick people so the only fraud possible is doctors claiming to have given care that they haven't and receive money for it.

 

Again in most developed country's most money spend on healthcare goes to actual healthcare. If the USA was to cut administration cost in half every single person in the US without healthcare would get it and get it for free at the same cost.

 

they way it goes with you is like this

 

Person A wants insurance and goes to firm B

Firm B opens a dossier, checks the history of person A and decides whether or not person A gets insurance. if yes person A gets sick, another person( A doctor!!!) in firm B investigates if person A should receive financial support for that sickness. If yes cost are taking care off. if not bankruptcy lies ahead for the sick person and the doctor saying No might receive a bonus for denying healthcare. That is sick!!!!!!!!!!

 

Over here everyone gets automatically insurance, only extra insurance is possibil. you can buy the option you get a single room when hospitalised and those cost are covered or a insurance for pay check lost when sick. Stuff like that, none is discussing/insuring the basic health need , everyone gets that for free....

 

 

As for having to get insurance when ones to visit usa beeing cheap....

 

I been to India and my healthcare was never an issue, yes india. While there i heard storys about usa folks visiting india to get treatment , treatment combined with the travel was at a lower cost then receiving the same treatment in de states. Thats sick!!!!!!!

[spwdo]

something else .

 

overhere if we go to a doctor we pay for that visit, then we get most of that money back from the healthcare organisation. So it means that medical cost is actualy forced into a marketsystem where the clients(sick people) checks up on the bill.

If doctor A was to ask double for the same as Doctor B then doctor A would not be in business long.

 

paying for medical care is only the lower bills, its to keep some folks to see a doctor/dentist/spychiatrist every day. Hospital bills are paid for a large portion from the goverment direct and the sick people receive a small (own portion) later on.

 

Then theres the annual maximum bill, means once you spend over a certain amount a year(people with a ongoing condition) the goverment takes care of eevry bil.

then there are the people who cant afford even the annual bill, well they get it for free. Noone wants to be in that situation since it means you are very poor , but at least you have healthcare.

[mike777]

What fraud are you talking about?

 

if health insurance is there for everyone how can one fraud. there's never any money paid to the sick people so the only fraud possible is doctors claiming to have given care that they haven't and receive money for it."

 

 

Yes fraud, you talk as if there is no fraud in these systems...geez

 

 

Fraud here in the USA runs tens of billions, tens and tens of billions of bucks for health care claimed but not given.

 

Yes that means, doctors, patients, medical equip companies, pharmicies, and just plain fake companies with fake invoices etc etc are involved

 

 

Common example,,,,a fake company sets itself up, bills millions in bills. They get the money. They move and start a new company.

 

The patients get their copy of bills months later and medicare follows up even more months later. They are overwhelmed.

[kenberg]

I am not sure of the extent of fraud, I certanly can see opportunities for it here. To some extent, it depends on definitions. Smoe examples:

 

1. My father died in 1977 aafter a stay in one hospital and then a stay at the ICU in another hospital. I took care of the bills, I received bills from doctors whom i had never met for services that I was unaware of. I paid them without tracking down the validity. At the time, I thought that it would be better if one doctor, or one administrator, submitted one bill with the charges of every doctor on it. That doctor, or that administrator, would take legal responsibility for the bill being correct.

 

 

 

Of course 1977 is a while ago. Much more is covered by insurance now. We move on to

 

 

 

2. A couple of years back, I awoke around 3 am with severe pains throughout my back and chest. I called the doc, he told me to go to the hospital. We had recently moved, we went to the one hospital that we knew the location of. A pretty decent one, as it turned out. Anyway, they did lots of tests. Lots and lots. After a while, the pain subsided some and was predominantly in my back. All of the written records emphasize chest pain. They did lots of tests on my heart, and I assumed (possibly wrongly but I don't think so) that if you are going to do tests for the heart it is better if the patient has chest pains instead of back pains. Fraud? Or just knowing how to write a report so that it gets covered by the insurance? The problem was a slightly worn out neck disk that has given me no trouble since. At any rate, I have a very thoroughly examined heart.

 

3. Last summer I had a rash. The dermatologist checked that I had prescription insurance and gave me a prescription for a lotion, a small tube for $250. I eventually needed a refill so that's $500. There would normally be a co-pay. Not to worry. Along with the prescription I got a coupon entitling me to a discount. The discount covered the copay. So actually the lotion was not $250, but rather $250 minus the value of the coupon. Let's say $210, although I an not sure. So I got a $210 lotion, arranged to avoid the co-pay. Fraud? Or just a nice coupon to help sales?

 

 

 

 

 

Here is where, I am coming to think, the fundamental problem lies: In this country at least, we have a strong belief in the wisdom of the marketplace. This ideology won't be changing anytime soon. But in medical care, we have circumvented this. I got a little embarrassed with all the heart tests they were doing in item 2. It was tempting to say "Guys, get real, it's not my heart!" But then, hell, I'm not getting the bill and maybe the tests will find something interesting. I guess they did, there was some follow-up, but nothing serious, rather just things that your average guy walking down the street might have.

 

 

 

With health care we seem to be neither fish nor fowl. We believe in market discipline, we have set things up so there is no discipline. Whatever the merits of the expanded coverage in the bills being put together, it's not clear to me that this aspect is being addressed at all.

 

 

Yes I know that not everyone agrees with market discipline but most of us, even those who know nothing of Glenn Beck, do.

[PassedOut]

With health care we seem to be neither fish nor fowl. We believe in market discipline, we have set things up so there is no discipline. Whatever the merits of the expanded coverage in the bills being put together, it's not clear to me that this aspect is being addressed at all.

Of course we won't know for sure what is included until after reconciliation (presuming that happens), but my understanding is that the bill will contain seed money for a fairly large number of initiatives that the legislators believe might increase the efficiency of US health care services and cut the waste that exists today. The intention (as I understand it) is to measure and evaluate the effectiveness of each and then to go with what works best.

 

This is most certainly not the approach I would have preferred because I think much of what should be done is obvious, and I hate unnecessary dithering. But I'm not a politician and often have a devil of a time figuring out what they think they are looking at.

 

I do believe that the healthcare bill contains some very important provisions, and I can see that it's very important for (most) businesses that it pass. It at least makes it possible to get a handle on the ballooning federal deficit, but it is only the first step of many that will be needed.

 

I can't help but note that the republicans are again 100% against getting control of the federal deficit as they were in 1993, and as they have mostly been since Reagan was elected. (Yes, I'm still irritated that the party I once supported has flipped on so many issues.)