Health Care Reform

[jdonn]

You are welcome, America.

Thank you!

[Al_U_Card]

Hey, all we did here in northern Michigan was let him know that we would be unceremoniously tossing him out of Congress in this August's Democratic primary. One of our group announced she would oppose him in the Dem primary. That seemed to register with him.

 

The power of the people.

 

All that really matters.

[kenberg]

"Local film maker" Michael Moore and Bart Stupak in the same congressional district! Reality programming at its finest, to be completed when Stupak is voted off the island.

 

A couple of observations:

 

I am really glad that the bill was not sunk on the basis of abortion arguments. Whatever the merits of their arguments, abortion is not the only health issue. It's not clear Stupak changed his mind, he just changed his vote. But that's what it took.

 

Again from an ardent supporter of the bill, we see in Moore's last paragraph:

"Now, we have some real work to do if we really want to say we have universal health care. The sharks who run the insurance companies have every intention of turning this lemon into some very profitable lemonade."

Well, yeah, they just might do that.

 

I am wary of this. But it's done, and I take the attitude that now it has to be made to work. Michael Gerson, in a column today, points out that on the whole this is permanent. Republicans, and others, may try to alter some aspects of it and may succeed, but no politician of any stripe will run a campaign promising to restore insurance companies' prerogative to refuse coverage because of pre-existing conditions.

 

As to some of the protesters, they really ought to ask themselves if they would like their kids to see them on television acting like this. Go to bed without your supper if you can't behave!

[Winstonm]

Gee, I feel healthier already and it's only Tuesday.

[Winstonm]

Huffington Post:

Democrats didn't just get a health-care-related boost in the realm of public opinion. The Democratic National Committee reported raising more than $1 million in donations on Tuesday even without making a direct ask. The money is expected to pour in for other campaign committees as well.

 

No doubt this money is pouring in from all the uninsured just to say, thanks.

[Winstonm]

The last thing I want to hear as an argument is "we can't afford healthcare." A couple of facts:

 

1) The 2010 Department of Defense budget was nearly $600 billion excluding the wars.

2) The U.S portion of the world's output by GDP on military spending is 41%.

 

The third "ask" that AIPAC supporters will make of Congress on Tuesday is to once again pass the $3 billion in U.S. aid provided annually to Israel.  Among other major purchases, the Israeli government has announced plans to replace its aging fleet of F-16 fighter jets with new, American-made F-35 fighters, a major cost that Israel hopes will be substantially born for [sic] by American taxpayers.

 

Medicare and Social Secuity benefit cuts = NECESSITY???

Military-Industrial Complex Spending = NECESSITY???

[Al_U_Card]

Simple question of efficiency.

 

If you kill a person (X $) it is a fixed cost in present dollars.

 

If you "fix" a person and have to keep them healthy over time, it is a present cost (Y $) plus associated costs (Ya $).

 

When X < (Y + Ya) the calculation is easy and it seems that somebody has done the math.

[mike777]

My best guess is this thread will turn into a heated discussion on a USA VAT tax 12 months from today.

[Al_U_Card]

My best guess is this thread will turn into a heated discussion on a USA  VAT tax 12 months from today.

Well, SOMEBODY is going to have to pay for the bailout, the wars(?) and universal (except for the public option) healthcare!

 

(I didn't include a cap and trade option to pay for as there is still some hope that AGW will be debunked in time.) :)

[PassedOut]

there is still some hope that AGW will be debunked in time

This could happen in one of three ways:

 

1) Showing that CO2 is not really a heat-trapping gas.

2) Showing that mankind does not really pump billions of tons of CO2 into the air each year.

3) Showing that some as-yet-unknown mechanism rids the earth of that extra trapped heat.

 

Until one of these happens, no one (excepting the uneducated and the usual number of cranks) will consider it debunked no matter how convenient that would be for all of us.

[Al_U_Card]

there is still some hope that AGW will be debunked in time

This could happen in one of three ways:

 

1) Showing that CO2 is not really a heat-trapping gas.

2) Showing that mankind does not really pump billions of tons of CO2 into the air each year.

3) Showing that some as-yet-unknown mechanism rids the earth of that extra trapped heat.

 

Until one of these happens, no one (excepting the uneducated and the usual number of cranks) will consider it debunked no matter how convenient that would be for all of us.

1-No question there but the jury is still out on the "forcing" that CO2 provides in terms of temperature rise, globally.

 

2-Sadly, other than our own exhalations, this is a real problem on so many levels. Even just 5 billion extra "exhalers" is an issue.

 

3-The science will eventually expose the mechanisms of this type of energy and mass balance within our planetary system. We just want to make sure that science is not agendized into only looking in one direction with one intention.

 

That we should be greatly concerned by our profligate and poisonous presence, is a given. Whatever the agent and recourse for its control, efficient use of our resources is paramount. Spending trillions on what even the IPCC shows as providing a minor change in global temperature reduction is the issue.

 

The incentive to provide non-CO2 producing energy sources would be ideal. Wind, tidal, solar and geothermal (I dislike nuclear for obvious reasons) could all use our money without creating a "carbon exchange" that would be rife with speculators. I am reassured by the "unadjusted" global temp history, that normal cycles will continue to keep us in the "zone" so that we can get our act together.

[Winstonm]

My best guess is this thread will turn into a heated discussion on a USA VAT tax 12 months from today.

It will be hijacked into AGW or curling - guess which.

[hrothgar]

My best guess is this thread will turn into a heated discussion on a USA  VAT tax 12 months from today.

It will be hijacked into AGW or curling - guess which.

At least Al has given up on the 911 truther idiocy

 

We learn to take pleasure in the little things in life...

[PassedOut]

I don't know if this is going to work or not. I think some claims for it have been more along the line of wishes rather than of fact. Counting revenue from a tax that is to be implemented eight years from now seems to me to be very very optimistic. But I do think that Democrats will be seriously motivated to make it work. Contrary to some ways of thinking, I think that failure is always an option. But it would be very ugly.

Failure is always an option. But before health care reform passed the system was headed toward certain failure. When faced with a choice in bridge, I prefer the approach that might succeed over the one that is certain to fail.

 

The bill that our country adopted contains quite a number of cost control measures proposed by experts of all political persuasions. Only if those measures turn out to be counter-productive (and that surely won't be the case -- anyone can see that with a quick reading) will we be worse off than we were.

 

On the other hand, we will now have 32 million uninsured people brought into the US health care system. This will unleash a pent-up demand that will increase costs in the short term, and congress has reallocated some funds (taking some bankers off the public teat, for example) to cover those costs. In the long term, though, bringing those people in will help rein in costs for the rest of us.

 

For starters (as the republicans often point out) many folks without insurance can find emergency rooms that will treat them anyway. The cost of that treatment is already borne by those of us who do have health insurance. Furthermore, using emergency rooms in this manner is a tremendously expensive way to deliver health care. Now 32 million people will start contributing toward paying those costs, and they will also be able to get care in a more cost-effective way.

 

Speaking for the republicans, Lamar Alexander argues that these gains will be more than offset because some people today -- whether through pride or ignorance -- die without going to an emergency room to obtain the care they need. Now those people will be brought into the system, increasing costs.

 

I've not seen any hard numbers that support Alexander's position on this, but suppose he is correct? I still want to bring those folks into the system, and I would not want to be running for office on a platform of excluding them.

 

While passing this health care reform was necessary, it is far from sufficient. We definitely need to chip away at the huge amount of money wasted on undignified and largely unwanted contraptions attached to folks near the end of life. There are also some savings to be obtained by more aggressive tort reform. And -- maybe somewhere down the road -- the US can gain the efficiencies of the single-payer system that luke warm and many others want.

[luke warm]

On the other hand, we will now have 32 million uninsured people brought into the US health care system. This will unleash a pent-up demand that will increase costs in the short term, and congress has reallocated some funds (taking some bankers off the public teat, for example) to cover those costs. In the long term, though, bringing those people in will help rein in costs for the rest of us.

 

For starters (as the republicans often point out) many folks without insurance can find emergency rooms that will treat them anyway. The cost of that treatment is already borne by those of us who do have health insurance. Furthermore, using emergency rooms in this manner is a tremendously expensive way to deliver health care. Now 32 million people will start contributing toward paying those costs, and they will also be able to get care in a more cost-effective way.

most of those 32 million have never been to an emergency room, so yes costs should increase dramatically... and while the present cost of the uninsured visits to the ER is borne by those who pay premiums (as you note), future health care costs for those same people should spread out - depending on the court battle results

Speaking for the republicans, Lamar Alexander argues that these gains will be more than offset because some people today -- whether through pride or ignorance -- die without going to an emergency room to obtain the care they need. Now those people will be brought into the system, increasing costs.

 

I've not seen any hard numbers that support Alexander's position on this, but suppose he is correct? I still want to bring those folks into the system, and I would not want to be running for office on a platform of excluding them.

maybe not, but you'd also not want to say that you voted for this bill because of savings and deficit reduction (if alexander is right)

While passing this health care reform was necessary, it is far from sufficient. We definitely need to chip away at the huge amount of money wasted on undignified and largely unwanted contraptions attached to folks near the end of life. There are also some savings to be obtained by more aggressive tort reform. And -- maybe somewhere down the road -- the US can gain the efficiencies of the single-payer system that luke warm and many others want.

*if* the dems plan is to prevent the existence of private insurers* as a way of implementing a single payer system, i can understand this bill... otherwise, it's my view that this is a bill that is not in the best interests of the country or its people

 

*as more and more small and large businesses opt out of private health insurance for their employees, as will happen

[PassedOut]

most of those 32 million have never been to an emergency room, so yes costs should increase dramatically...

It does not matter that many of the 32 million have not yet been to the emergency room. What matters is that most will have to do so at some critical point in their lives.

 

The reason that many of the 32 million uninsured have not been to an emergency room is that they've not yet been ill enough to force it. Over time, most people, even the uninsured, do need serious medical care. It is cheaper to treat illnesses early on, before they become catastrophic.

 

Those of us who pay for insurance have been subsidizing the care for those people whose health situation has become intolerable, and we have also been on the hook for the large group whose situations will at some point become intolerable. Now 32 million will be added to the insurance roles and their medical problems will be treated in a more cost-effective way. There will be a short-term cost spike (accounted for in the legislation), but long-term savings.

 

Lamar Alexander and the republicans are correct only if many of those 32 million would never have made it to the emergency room even under life-threatening conditions. And even then, only if there are enough such people to eat up all of the insurance money that will now be contributed by that group as well as the savings resulting from earlier treatment.

 

Note that Alexander's argument directly contradicts the other frequent republican claim that "no one who needs treatment goes without it." And, in fact, first-responders bring the sick and injured to emergency rooms whether they are insured or not. So I doubt very much that the known savings from insuring the 32 million and providing earlier care will be overwhelmed over the long term by treating people who would otherwise never receive treatment.

 

But if treating those who now die without the care they need is going to be so very expensive that health care reform will not save money, let's get those facts out so we can all see them. Do you have any hard numbers to support that claim?

 

It will surely be important for voters to have this information for the elections in November.

[Winstonm]

I have no data only personal observation. I have worked in the hospitals and emergency rooms. From what I have seen, emergency rooms have metamorphasized into clinics for the uninsured. Lack of insurance also does not prevent physicians from admitting ER patients to the hospital when needed.

 

In my opinion, we are making a mistake by retaining the "for profit" model of healthcare. At the very least, we need a buy-in to Medicaire option to compensate for lack of competition.

[PassedOut]

I have no data only personal observation.  I have worked in the hospitals and emergency rooms.  From what I have seen, emergency rooms have metamorphasized into clinics for the uninsured.  Lack of insurance also does not prevent physicians from admitting ER patients to the hospital when needed. 

 

In my opinion, we are making a mistake by retaining the "for profit" model of healthcare.  At the very least, we need a buy-in to Medicaire option to compensate for lack of competition.

Although I don't have the personal experiences that you have, what you related matches what I have heard from others and what I have read. I'm sure that there are a few people who never get really sick before they drop dead, and some folks who just can't negotiate the health care system well enough to obtain treatment no matter how sick they get.

 

In my situation (possibly too insulated from the reality many face), I don't encounter such folks, and if I met someone who did not get the care he or she needed I'd take action to see that care was made available. Honestly, I don't think I know anyone who would behave otherwise.

 

So the argument that we can save huge amounts by denying such folks care just doesn't ring true to me, although I could be convinced by hard numbers. But even it it were true, I'd find it repugnant to deny people health care.

 

My guess is that a majority of voters are with me on that. So it's important that the facts about this see the light of day and that the issues presented to voters in November are framed along the lines I've outlined. I plan to do my bit to help do that.

 

I suppose that no one really considers the modest health reforms just passed to be ideal. But even those modest reforms -- which will both extend health care to many uninsured people and reduce the ballooning federal deficit substantially -- aroused rabid opposition from many quarters.

 

I've never much liked the approach that, "If I can't have my way, I'll just take my bat and ball and go home!" We need to do much more, but the alternative was to accept a much worse status quo.

[helene_t]

So the argument that we can save huge amounts by denying such folks care just doesn't ring true to me, although I could be convinced by hard numbers. But even it it were true, I'd find it repugnant to deny people health care.

Well there must be something to save by denying people treatment for non-lifethreatening conditions. Yes I know it may end up being more expensive if an easy-to-treat condition is allowed to escalate to something less easy to treat, but then again, it might not. We have similar discussions here in Europe about the economics of waiting lists. Certainly there are examples of patients becoming much more expensive because of the waiting lists, but as I understand it, most experts think it would cost money to get rid of the waiting lists. This is largely because waiting lists avoid losses due to idle capacity so it is not applicable to the US situation. But waiting lists also save money when people die or recover before they get treated (how often this actually happens is difficult to know because some of the "recovering" patients in fact never needed treatment but just asked the GP to refer them in case they develop an indication while being on the waiting list).

 

In the Netherlands, they have a similar problem, though at a smaller scale: people go to the ER for conditions that could be taken care of by the GP, not because of finances (both are covered 100%) but because of convenience (the ER is open 24/7, the GP clinic is not). So some hospitals have arranged for a GP clinic near the hospital to have wide opening hours, then the ER staff can refer non-urgent patients to them.

[Winstonm]

I suppose that no one really considers the modest health reforms just passed to be ideal. But even those modest reforms -- which will both extend health care to many uninsured people and reduce the ballooning federal deficit substantially -- aroused rabid opposition from many quarters

 

Perhaps it is simply the cynisism of age, but I do not view these two parts of the bill equally. IMO, and from what I have seen from JFK until now is that the insurance companies will treat this forced insurance bonanza as windfall profits, finding a billion and a half reasons not to lower any price for anything, while the inroads provided by the bill, i.e., the parts about guaranteed coverage and pre-existing conditions will be utilized as cause of rate increases.

 

Any actual cost savings in this bill was DOA when Rahm and co. agreed to toss out importation of Pharma and any type of real competition.

 

Isn't it curious how globalization is good for America when we want to outsource jobs to lower costs but it is treason when we want to import cheaper drugs. Buy American just doesn't have the same ring it used to.

[PassedOut]

In a sad, but perhaps inevitable postscript to healthcare reform in the US, anti-abortion terrorists have started crawling back out of their holes to threaten my congressman: Father and son threaten to kill Bart Stupak.

 

You wanted to get some Washington paint for the bridge? Not to worry, I will paint the Mackinaw Bridge with the blood of you and your family members. I will not say when and with who but I will save your blood for the high towers toward the end of this project. You will live long enough to truly experience the unfortunate but definite consequences of your decision.

The elder terrorist is dumb as a post. Although from Michigan, he nevertheless misspelled the name of our iconic Mackinac Bridge. And although supposedly a christian, he also misspelled the word "soul" as "sole." But stupid people can be deadly.

 

Still, as of this writing I have not heard of anyone calling for these terrorists to be denied their civil rights as US citizens. Nor have I heard anyone demand that they be jailed as enemy combatants. Were they Muslims, I suspect it would be different...

 

Note: Here is the complaint with a copy of the letter: You sir, have sold your sole to the devil.

Edited June 8, 2010 by PassedOut

[Winstonm]

In a sad, but perhaps inevitable postscript to healthcare reform in the US, anti-abortion terrorists have started crawling back out of their holes to threaten my congressman: Father and son threaten to kill Bart Stupak.

 

You wanted to get some Washington paint for the bridge? Not to worry, I will paint the Mackinaw Bridge with the blood of you and your family members. I will not say when and with who but I will save your blood for the high towers toward the end of this project. You will live long enough to truly experience the unfortunate but definite consequences of your decision.

The elder terrorist is dumb as a post. Although from Michigan, he nevertheless misspelled the name of our iconic Mackinac Bridge. And although supposedly a christian, he also misspelled the word "soul" as "sole." But stupid people can be deadly.

 

Still, as of this writing I have not heard of anyone calling for these terrorists to be denied their civil rights as US citizens. Nor have I heard anyone demand that they be jailed as enemy combatants. Were they Muslims, I suspect it would be different...

 

Note: Here is the complaint with a copy of the letter: You sir, have sold your sole to the devil.

Now THAT is STUPID: I"ll prove to you I'm pro-life by killing you.

[y66]

If Truman Capote were still around, he could probably do justice to this story, not just the psychopath element, but its progression in this guy, possibly as a result of dementia, and the weird way in which guys like this come to see themselves as servants of the neocults to which they claim to belong. Sad really.

 

By the way, what is the water cooler position on Bart Stupak? Is he a friend of bridge? Just asking.

[cherdanno]

I hope bridge has more intelligent friends than Bart Stupak.