My health care overhaul

[jdonn]

I'll stick with the opinion of the author. It's ok I just passed inquiry, nothing can bring me down now.

[hrothgar]

I think that the "Because"s in P.O.'s post are consistent with my reading of that post, i.e. not just "success" in that a bill that was supported did in fact pass, but "success" in that it would provide a massive cost savings that would translate into better care, etc.

If you equate the word "huge" with "long-term," we differ in our understandings of the English language. Perhaps I have not mentioned enough that I would have preferred more aggressive cost savings.

No, that was hurried typing while not looking at your first post while typing.

 

The gist I took from your post, though, is that the political benefit that would presumably accrue to Obama would be due to the content of the bill and it's beneficial results; not generic political capital that would come from sponsoring a major bill that passed.

 

Then you are pretty damn ignorant about the topic being discussed...

 

1. Almost any serious discussion of this topic includes questions related to political momentum

 

2. No one in their right mind believes that we'll be able to make an objective evaluation about the "success" of health care reform in the near term. The only way to evaluate this is in terms of short term political gains.

[Lobowolf]

I think that the "Because"s in P.O.'s post are consistent with my reading of that post, i.e. not just "success" in that a bill that was supported did in fact pass, but "success" in that it would provide a massive cost savings that would translate into better care, etc.

If you equate the word "huge" with "long-term," we differ in our understandings of the English language. Perhaps I have not mentioned enough that I would have preferred more aggressive cost savings.

No, that was hurried typing while not looking at your first post while typing.

 

The gist I took from your post, though, is that the political benefit that would presumably accrue to Obama would be due to the content of the bill and it's beneficial results; not generic political capital that would come from sponsoring a major bill that passed.

 

Then you are pretty damn ignorant about the topic being discussed...

 

1. Almost any serious discussion of this topic includes questions related to political momentum

 

2. No one in their right mind believes that we'll be able to make an objective evaluation about the "success" of health care reform in the near term. The only way to evaluate this is in terms of short term political gains.

I'm responding to a specific post. That post suggests that one of the reasons Republicans have been trying to block reform is solely to prevent Obama from having long-term success that he is certain to gain if the bill becomes law BECAUSE "anyone with a head for business can see [that]."

 

"That" appears to = "it is absolutely clear that the reforms Obama advocates will cut costs now and in the future."

 

I agree that almost any serious discussion of the topic INCLUDES questions related to political momentum, but it seemed pretty obvious to me that the post I was responding to wasn't LIMITED to political capital, but rather was a comment on the substance of the legislation, as well. To suggest otherwise would pretty much eviscerate P.O.'s post, which was about the content of the bill, not the politics of whether or not it passes.

 

But if the question is really going to be construed as, "Are there Republicans who oppose the bill in part because Obama supports it?" then sure there will. Just like every other bill sponsored by either party. But answering that question implies nothing favorable about the content of the bill, which is why it appears pretty clear to me that it wasn't the question in question, so to speak. This construction is essentially tautological; bills that have no purely partisan opposition whatsoever are few and far between.

 

The more interesting question, and the question that I still think was obviously implied by the post, is "Are there Republicans who oppose the bill because it's so obviously good that those Republicans perceive that it will have a beneficial impact and don't want that impact attributed to Obama?".

 

I agree the answer to the silly question is, "Yes, WTP?" Sorry for briefly hijacking the thread by perceiving a meaningful question.

[Winstonm]

The infamous liberal Glenn Greenwald calls out the Demacrats and especially Marxist (if you believe my idiot brother) Obama on healthcare:

 

If -- as they claimed all year long -- a majority of Congressional Democrats and the White House all support a public option, why would they possibly whip against it, and ensure its rejection, at exactly the moment when it finally became possible to pass it?   If majorities of the House and Senate support it, as does the White House, how could the inclusion of a public option possibly jeopardize passage of the bill?

 

I've argued since August that the evidence was clear that the White House had privately negotiated away the public option and didn't want it, even as the President claimed publicly (and repeatedly) that he did.

 

So if you say publicly you support a public option, but in private negotiate with the insurance companies to make certain public option never sees the light of day, are you simply another politician or are you a liar - or am I being redundant?

[cherdanno]

Because anyone with a head for business can see that too, I suspect that one of the reasons the republicans have been trying so hard to block reform is solely to prevent Obama from having the long-term success he is certain to gain if the bill ever becomes law.

I think this is unlikely enough that you could count the number of republicans trying to block reform for this reason on one hand, and pay down the national debt with 5 leftover fingers.

Have you read Mitt Romney's suggestions for health care reform?

http://blogs.usatoday.com/oped/2009/07/mr-...s-the-rush.html

It is hard to find a fundamental difference between his suggestions and Obama's compromise plan.

[y66]

The more interesting question, and the question that I still think was obviously implied by the post, is "Are there Republicans who oppose the bill because it's so obviously good that those Republicans perceive that it will have a beneficial impact and don't want that impact attributed to Obama?".

 

...

 

Sorry for briefly hijacking the thread by perceiving a meaningful question.

Is it possible that you recast P.O.'s assertion that "this bill will clearly cut costs" as "a bill that is so obviously good" because this serves your argument better?

 

I realize this conflicts with your expression of regret for misperceiving (misrepresenting?) the gist of P.O.'s post.

[luke warm]

The more interesting question, and the question that I still think was obviously implied by the post, is "Are there Republicans who oppose the bill because it's so obviously good that those Republicans perceive that it will have a beneficial impact and don't want that impact attributed to Obama?".

 

...

 

Sorry for briefly hijacking the thread by perceiving a meaningful question.

Is it possible that you recast P.O.'s assertion that "this bill will clearly cut costs" as "a bill that is so obviously good" because this serves your argument better?

 

I realize this conflicts with your expression of regret for misperceiving (misrepresenting?) the gist of P.O.'s post.

this seems to be the post being argued about

I've mentioned before that I wish Obama and the democrats had gone more aggressively after the waste in the system, but I understand that they had to consider the firestorm of opposition from those who feed on that waste. However, it is absolutely clear that the reforms Obama advocates will cut costs now and in the future.

 

Because anyone with a head for business can see that too, I suspect that one of the reasons the republicans have been trying so hard to block reform is solely to prevent Obama from having the long-term success he is certain to gain if the bill ever becomes law.

it seems to me that he's saying here that the bill obama favors will obviously cut costs, and since "anyone with a head for business" can see this, there is only one reason ("solely") for opposition to "reform" - to prevent obama from having long-term success... i don't think that's an accurate view... while it's likely that some may oppose it for that reason, it's also possible that there are people who actually think it will cost money in the long run (those without po's 'head for business' maybe)... and some may oppose it for purely philosophical reasons

[PassedOut]

i don't think that's an accurate view... while it's likely that some may oppose it for that reason, it's also possible that there are people who actually think it will cost money in the long run (those without po's 'head for business' maybe)... and some may oppose it for purely philosophical reasons

And, of course, that is why I used the phrase "one of the reasons" instead of "the only reason." To avoid confusion, I should have left out the word "solely."

 

I've discussed in these forums some of the philosophical objections the republicans have expressed, such as not wanting the federal government to set minimum standards for policies in the insurance exchange.

[Lobowolf]

The more interesting question, and the question that I still think was obviously implied by the post, is "Are there Republicans who oppose the bill because it's so obviously good that those Republicans perceive that it will have a beneficial impact and don't want that impact attributed to Obama?".

 

...

 

Sorry for briefly hijacking the thread by perceiving a meaningful question.

Is it possible that you recast P.O.'s assertion that "this bill will clearly cut costs" as "a bill that is so obviously good" because this serves your argument better?

 

I realize this conflicts with your expression of regret for misperceiving (misrepresenting?) the gist of P.O.'s post.

I don't think I recast or mischaracterized it at all. I simply assumed (and still believe) that he included the words "Because anyone with a head for business can see that to" because they were relevant, i.e. they added non-redundant meaning to the sentence, and from the rest of the post I inferred what that meaning was.

 

P.O. is intelligent, articulate, and well-organized in his thoughts and posts. I think that it would be insulting to assume that the phrase in question was meaningless. I also think that it's fairly obvious what the phrase referred to, i.e. what the entire preceding portion of the post was about - the substance of the bill.

 

"Sorry for briefly..." was intended as irony, in the form of sarcasm. I don't think I misperceived the gist of his post. I think, as usual, that he expressed himself more than clearly enough; frankly, I'm surprised at many of the responses to my response. But you know what happens when you predict a unanimous poll!

[Lobowolf]

And, of course, that is why I used the phrase "one of the reasons" instead of "the only reason." To avoid confusion, I should have left out the word "solely."

I think it made for a very interesting sub-thread on semantics!

 

On the other hand, I think I was one of two or three people who enjoyed the class "Statutory Interpretation."

[Lobowolf]

Because anyone with a head for business can see that too, I suspect that one of the reasons the republicans have been trying so hard to block reform is solely to prevent Obama from having the long-term success he is certain to gain if the bill ever becomes law.

I think this is unlikely enough that you could count the number of republicans trying to block reform for this reason on one hand, and pay down the national debt with 5 leftover fingers.

Have you read Mitt Romney's suggestions for health care reform?

http://blogs.usatoday.com/oped/2009/07/mr-...s-the-rush.html

It is hard to find a fundamental difference between his suggestions and Obama's compromise plan.

Thanks for the link...I had not seen this. I'm very interested in seeing what ends up happening with this. In my case, it's more than a political/philosophical topic; my girlfriend has M.S. Thus far, it's been mostly well-behaved, with periodic flares that go away (i.e. the relapsing remitting version), but as pre-existing conditions go, it's an expensive one, and one that certainly limits her options.

[y66]

... frankly, I'm surprised at many of the responses to my response.

"The devils' advocate's life is terrible hard" -- says* Alice [with irony ;)].

 

*paraphrasing.

[kenberg]

As I read the Romney article, the cost for Mass is $723,000,000 per year. I looked up the population. It's 6,593,587. So that works out to a little less than $110 per person. That's the cost to the government of the program, not the total health care costs!

 

Now the US population is 307,006,550 so we are up somewhere between 33 and 34 billion to run a US program at the same per capita cost as the Mass plan. Help me out here.What are currently accepted estimates of the cost to the government (again, cost to gov, not total cost of health care) of the Obama plan?

 

At the moment I am not claiming anything about the value of any plan, I am just trying to fit the numbers together to see what is being said when the cost to the state government of the Mass plan is discussed along with the cost to the US government of the Obama plan.

[luke warm]

do you think we're in for this type problem?

A union representing Dutch nurses will launch a national campaign Friday against demands for sexual services by patients who claim it should be part of their standard care. The union, NU'91, is calling the campaign "I Draw The Line Here," with an advert that features a young woman covering her face with crossed hands.

 

The union said in a statement Thursday that the campaign follows a complaint it had received in the last week from a 24-year-old woman who said a 42-year-old disabled man asked her to provide sexual services as part of his care at home. The young woman witnessed some of the man's other nurses offering him sexual gratification, the union said. When she refused to do the same, he tried to dismiss her on the grounds that she was unfit to provide care. "This type of action is not part of the job responsibilities of carers and nurses," NU'91 said.

probably only applies to the head nurses

 

finally some health care reform we can get behind

[Winstonm]

do you think we're in for this type problem?

A union representing Dutch nurses will launch a national campaign Friday against demands for sexual services by patients who claim it should be part of their standard care. The union, NU'91, is calling the campaign "I Draw The Line Here," with an advert that features a young woman covering her face with crossed hands.

 

The union said in a statement Thursday that the campaign follows a complaint it had received in the last week from a 24-year-old woman who said a 42-year-old disabled man asked her to provide sexual services as part of his care at home. The young woman witnessed some of the man's other nurses offering him sexual gratification, the union said. When she refused to do the same, he tried to dismiss her on the grounds that she was unfit to provide care. "This type of action is not part of the job responsibilities of carers and nurses," NU'91 said.

probably only applies to the head nurses

 

finally some health care reform we can get behind

If they gave hookers a nursing license. it would bring a whole new meaning to the phrase "Charge Nurse".

[mike777]

Because the US spends twice as much per capita for medical care as do countries with more advanced systems -- while obtaining poorer results -- it is obvious that around 50% of the money spent is wasted. Even folks who are not in business can grasp that, but to business people that fact stands out like a sore thumb.

 

Consider this: For every dollar the nation spends on health care, 50 cents is wasted.

 

According to a 2008 report by Pricewaterhouse Cooper's Health Research Institute, wasteful spending accounts for $1.2 trillion of the $2.2 trillion spent on health care in the United States. The medical waste includes costs associated with inefficient insurance claims processing, defensive medicine, preventable hospital readmissions, medical errors, and unnecessary emergency room visits.

 

"Our best estimate is that for the country as a whole, probably half of what we're spending on health care delivery today is technically waste from a patient's perspective. There are better ways of doing it," said Dr. Brent James, chief quality officer for Intermountain Healthcare, a nonprofit health system in Salt Lake City, Utah.

 

The way a doctor chooses to treat a patient may also contribute to waste. Variations in treatments waste the health system $10 billion annually, according to the report. When a hospital like Intermountain swaps out expensive procedures for cheaper, equally effective treatments it actually loses money. It can no longer charge for those pricier procedures.

Because there is so much waste, any reasonable measures taken now cannot help but cut medical costs. There is just too much low-hanging fruit ready to be picked. With the amount spent on medical care in the US today, every US citizen should be receiving the best medical care in the world -- with the money left over being applied to the national debt.

 

I've mentioned before that I wish Obama and the democrats had gone more aggressively after the waste in the system, but I understand that they had to consider the firestorm of opposition from those who feed on that waste. However, it is absolutely clear that the reforms Obama advocates will cut costs now and in the future.

 

Because anyone with a head for business can see that too, I suspect that one of the reasons the republicans have been trying so hard to block reform is solely to prevent Obama from having the long-term success he is certain to gain if the bill ever becomes law.

this really repeats many posts here on the forum.

 

USA health care costs 100% more than most western countrieswith poorer results.

 

 

 

Funny enough no one, that means me and you, have a solution.

 

ya attack waste, right....

--------

 

 

OP repeats the issue that most of us care less about costs...we do not pay for it or so we think.

 

-------------

 

 

 

The perception...worry is that the EU sucks at innovation and health care.......that is the unspoken worry...

 

That the EU is going broke on govt health care and that govt health care in the Eu really sucks..damn the who studies......

[kenberg]

I'm still working on the basics.

 

Browsing around, I see that the health care bill is estimated to cost the government about a trillion over the next ten years. So figure 100B a year. It appears that this is about three times (on a per capita basis) what the Massachusetts bill costs their state government. Cherdano has observed that what Romney suggests looks a lot like what Obama suggests. But if the Obama bill costs the government three times as much, one would hope there are some productive things in it that are not in the Massachusetts plan. What are they?

 

 

Also I am still wondering about the notorious Cadillac plans. Are they substantially better than what senators have? The announced intention, or at least a frequent argument, is to offer everyone in the country the equivalent of what a senator has, right? But the implication seems to be that the Cadillac plans are excessive. In what way are the Cadillac plans so much more extensive than what the senators get? Are the senators ok with this?

 

I don't know if I have a head for business, probably I don't. But I have little tricks that help me out. A billion dollars of government spending is about three dollars a person. 100B is about $300 a person. Kids won't be paying (too young) and the poor won't be paying this $300 (no money), and those with low incomes won't be paying much. So I suppose that I will, if the books are to be balanced (don't hold your breath for that), be paying maybe $1200 to $1500. That's to pay for the government plan. I will still need to pay medicare and my supplemental insurance. I guess I can come up with the money, but I would like to know what I will be getting for it. And if Massachusetts can do roughly the same thing at a third the cost, I wouldn't mind.

[PassedOut]

As someone who looks at charts and graphs a lot, I use this trick that helps me out: When I see a cost line taking off like a rocket for outer space, I want that line to begin an arc that returns it back to earth.

 

Without government control, health care costs right now are heading for outer space, and nothing is in place to stop that momentum.

 

Except for stronger tort reform, which the republicans could have had in exchange for a few votes, Obama's health care bill contains every feasible cost-cutting measure suggested by health care experts -- democrat, republican, and independent. Over time, these measures will start to bring the cost line back toward earth. That's what is meant by "bending the cost curve."

 

To vote against Obama's bill is to vote for letting the cost line continue toward outer space. That would be a continuation of the fiscal irresponsibility that took hold after Clinton left office.

[y66]

No offense but I think arguments by kenberg and lobowolf about the finer points of cost cutting are copouts.

 

Yes, there are many unknowns about how the real long term costs of the proposed health care reform will shake out and yes these unknowns are worrisome as are unknowns in general.

 

I don't understand the argument for fearing these unknowns more than the known, continuously worsening problems that proposed reforms attempt to remedy, however imperfectly.

 

Spare me the boogey-man stuff. It is time to pass this bill.

[Lobowolf]

No offense but I think arguments by kenberg and lobowolf about the finer points of cost cutting are copouts.

None taken, since I didn't make one.

[PassedOut]

Yes, there are many unknowns about how the real long term costs of the proposed health care reform will shake out and yes these unknowns are worrisome as are unknowns in general.

When a system is already run efficiently, it can be very painful (although sometimes necessary) to cut costs. I know.

 

But when a system is bloated with 50% waste as is the US health care system today, cost cutting could hardly be easier. Any reasonable approach will work, so Obama is pretty much guaranteed to have success if his reforms pass. And people in business necessarily understand that.

 

Personally, I don't like to be in positions where I have to spend time convincing other people that essential actions should actually be taken, so I conduct my life and business accordingly. But the government can't really dictate all necessary actions, nor would we want it to, so its approach must be different.

 

To reduce waste, the government can alter incentives in ways that make it advantageous for businesses and professionals to work on cutting waste in their own particular arenas. I can say from experience that business people do respond quickly to changes in incentives.

 

If you look at the Obama reforms, that is exactly they accomplish. He's put in pretty much every good cost cutting idea that anyone has proposed, regardless of which party proposed it, except for stronger tort reform.

[helene_t]

The perception...worry is that the EU sucks at innovation and health care.......that is the unspoken worry...

I don't think EU sucks at health care. Maybe compared to Japan and Taiwan and South Korea. But compared to USA? No way. Now this may or may not be relevant to this discussion. Even if USA copied the Dutch or the French health care system (which nobody is suggesting) it may turn out that the excessive US health costs are related to other things which cannot be addressed through health care reform. Then again, it might not.

 

Yeah, EU sucks at innovation, compared to USA. What does that have to do with anything? You guys are not talking about socializing insurance, let alone socializing hospitals. Maybe the scope for innovative declarations of unnecessary or fictive treatments, or for innovative ways of avoid people with health issues becoming customers of one's insurance company, will be reduced. Maybe not. But if it happens it won't be a bad thing.

 

BTW it is not exactly an "unspoken" worry. The anti-reform propaganda produces loads of ridiculous nonsense about how bad the British health service is.

[kenberg]

No offense but I think arguments by kenberg and lobowolf about the finer points of cost cutting are copouts. 

 

Yes, there are many unknowns about how the real long term costs of the proposed health care reform will shake out and yes these unknowns are worrisome as are unknowns in general.

 

I don't understand the argument for fearing these unknowns more than the known, continuously worsening problems that proposed reforms attempt to remedy, however imperfectly. 

 

Spare me the boogey-man stuff. It is time to pass this bill.

No offense taken by me either, but I do not intend it as a cop out. I also don't agree that what I am saying is worrying about some vague unknowns. "Don't bother with the small print buddy, you want the car don't you?" Some sort of estimate can be made of the cost, and I gather that the one trillion over ten years is a more or less agreed upon ballpark figure. I am not worried that it may not be exactly on target, rather I am trying to estimate what this will cost me. It appears that the cost will be around $300 per person per year for the program. I could phrase it as a question, asking if that's about right, but it's what a trillion bucks over ten years works out to, approximately. It is certainly a given that not every citizen will be paying $300. If the books are to balance, I think estimating my cost at $1,000 per year is conservative, and make it $2,000 counting my wife.

 

It seems to me to be completely reasonable to ask if I have the fiigures roughly right. If the cost of $100B per year is right but the money won't be coming from me who will be paying it?

 

I could agree, sort of, that the stuff about the Cadillac plans is not particularly vital. But I get tired of hearing the argument that every citizen should be entitled to a health plan as good as the one available to senators. I seriously doubt that those who use that argument have thought it through to its logical conclusion. It's a snazzy slogan, but I expect that the senators have something at least somewhat comparable to the dissed Cadillac plans, so how could this work out? Of course what else is new. Arguments are not required to stand up to scrutiny to be useful.

 

Not only with health care but with general suggestions for government spending I often divide the proposed total by 300+ million to estimate my share of the bill. I find it useful. Maybe indeed this bill should be passed. Maybe I should buy a Porsche. Whichever is contemplated, I like to see the price tag prominently displayed before I put my signature to the contract.

[luke warm]

To vote against Obama's bill is to vote for letting the cost line continue toward outer space. That would be a continuation of the fiscal irresponsibility that took hold after Clinton left office.

that doesn't necessarily follow... i've heard different motives for passing a (or this) bill... some say it's because there is a moral imperative to do so and some say to save money... some say both of those, and some say neither (just as there is philosophical objection by some, there is also philosophical support)... your arguments seem to lean toward the economics of the issue

 

but if the aim is to do either or both of those things, imo there is only one sure way - complete state-run health care with fees and salaries fixed... as long as there is a (real or perceived) difference in quality of care, the have nots will always have a bone to pick with the haves

[PassedOut]

but if the aim is to do either or both of those things, imo there is only one sure way - complete state-run health care with fees and salaries fixed...

You won't find universal agreement (to say the least) with your "one sure way," and it certainly wouldn't be able to pass congress any time soon. The current bill is the only way to get started with this in a serious way now, whether the bill is perfect (and I don't think it is) or not.

 

Otherwise none of the cost control measures will take effect, and health care costs will continue the trajectory toward outer space. The goal of equal care for all is not practical for now, but Obama's reforms will certainly bring better care for quite a number of people.