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"Mandatory end of life Counseling" and other Health Care Reform woes

Started by July 24, 2009 08:35 PM
863 comments, last by nobodynews 15 years, 1 month ago
Quote: Original post by Chris Reynolds
CBO analysis found that 36 million people would remain uninsured even if the Senate’s $1.6 trillion health care plan is passed.

And for the House plan that you were citing in this thread, the CBO finds that that only ~3% of the non-elderly citizens of the country would be uninsured.
Quote: Original post by Chris Reynolds
I understand some of your points (I'm sure from reading the bill you can understand it's quite daunting), but many of the problems arise in that the bill, like any bill, may not explicitly define itself, but the meanings are in there.

No, that is interpretation, and that's an opportunity for specious argumentation. The reason that bills like this are so voluminous is precisely because they take pains to clarify as much as possible of what they pertain to. Ambiguities are loopholes, and further legislation is frequently passed to close them via amendments.

Quote: 1.) Do you think that illegal immigrants are going to be excluded? How will they do that? Certainly someone in this country that does not pay taxes shouldn't be allowed healthcare coverage.

I don't think illegal immigrants are going to be excluded, nor do I think they should. They contribute to our economy by doing work that many of us do not want to do, by buying food and clothing and paying for shelter. They enroll their children in our schools - children who are often citizens by right of birth - and thus their health is in the interest of the welfare of a number of our citizens.

Illegal immigration is a complicated issue, but I do not see it as a problem with a single-payer or public healthcare system, especially since they already go to emergency rooms (and pay cash) in extreme situations.

Quote: 2.) Regarding physicians all being paid the same:

(A) PREFERRED PHYSICIANS.-Those physicians who agree to accept the payment rate
established under section 223


PARTICIPATING, NON-PREFERRED
PHYSICIANS.-Those physicians who agree not
to impose charges (in relation to the payment
rate described in section 223 for such physicians) that exceed the ratio permitted under section 1848(g)(2)(C)


So all physicians that participate will be affected by this.

The document states that those who agree to accept the payment rate will be bound by it. Duh? The rates will be set and published before the physicians elect to opt in. If they find those rates unacceptable, they can elect not to participate. What's the big deal?

I should point out that Health Maintenance Organizations do this, too. Health insurance companies negotiate rates that they pay to in-network and out-of-network doctors (in the rare instances where they agree to cover out-of-network referrals). This maps perfectly to "preferred" and "participating, non-preferred." It's good enough for private industry; I'd think you'd find that to be good for government, too.

The problem that you and many who share your attitudes have is tremendous ignorance about how the existing, private healthcare system actually works. Consequently, when you see something explicitly spelled out in the proposed public option(s) that is a normal, existing practice in the private sector, you have a fit. It's kinda embarrassing, really - for you.

Quote: 3.) Your comparison of a company that contributes to the private healthcare that THEY provide to THEIR employees to a company being TAXED for not participating in the public option really doesn't make any sense.

Well, it would if that's what anyone was saying. §311, Health Coverage Participation Requirements, states that an employer meets the requirements if it does all of the following:
  1. Offer coverage;

  2. Contribute toward coverage if the employee accepts; and

  3. Contribute in lieu of coverage if the employee declines but still obtains coverage through means other than being covered by spousal or dependent benefits.


That is, the company is only taxed if an employee declines coverage offered by the company, obtains coverage from a third-party, and is not covered by a spouse or individual with whom the employee has a dependent relationship. "He's not taking the health plan you offer, so kick some of the money you would be laying out anyway into a pot that pays for his public option."

Quote: Republicans read the bill implicitly, noticing that the bill gives the government more control over their health and well-being.

Nah. You don't read the bill, but then you claim it does things that it doesn't. Your greatest failing is not reading all the sections that are cross-referenced against one another. §313, which you cite (carelessly and somewhat erroneously) defined specifics for an option in §311. By not considering the two sections together (and, really, along with §312, at a minimum), you arrive at poor understanding of what the bill actually proposes, and then proceed to knot your panties.

Quote: That seems to be the central debate. I don't think it's fair to call Republicans (not all of them at least) "fear-mongers" for reading the bill this way, it's just a fundamental difference in trusting the government.

It's got nothing to do with trust and everything to do with comprehension.

Quote: Original post by Chris Reynolds
I wouldn't be nearly as opposed to this bill if I didn't think it would effectively run private insurance into the ground.

Why is it so important to have private insurance? They have failed to provide sufficient and cost-effective healthcare. Why are you so dedicated to preserving these inefficient fossils?
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Quote: Original post by Chris Reynolds
Quoted

Two economists working at the National Bureau of Economic Research concluded that 25 to 75 percent of those who do not purchase health insurance coverage “could afford to do so.”

Nearly 10 million (9.7) of the 45.7 million uninsured are “not a citizen.”

More than 17 million of the uninsured make at least $50,000 per year

8.4 million make $50,000 to $74,999 per year

9.1 million make $75,000 or higher

25 percent of the uninsured already qualify for government health insurance programs.

CBO analysis found that 36 million people would remain uninsured even if the Senate’s $1.6 trillion health care plan is passed.


Kind of makes you wonder why we are going through so much of an effort to cover what appears to be a smaller number than we are being told. Obviously the system in place needs change, but this plan is going to change many people's lives for a relatively small number of people who are citizens that cannot afford healthcare currently.


Actually, it makes me wonder what her sources are. She doesn't provide them, for example, the way that these groups do: Who are Who are the uninsured?, The Number Of Uninsured Americans Is At An All-Time High, Health Coverage in an Economic Downturn: Impact of Tight Budgets on Families and States. The July Health Tracking Poll finds that about half of all adults say they have put off some sort of needed medical care over the past 12 months because of costs. That strongly suggests that more than 75 million people are defacto uninsured.

Poking around google, I find that Julia Seymour's supposed myth busting article is frequently cited by people opposed to health care reform. It would seem they are eager to grasp whatever supports their preconceptions without bothering to do any fact checking. Fortunately, others do bother to check the facts: The ‘Real’ Uninsured. There is no hard data on how many "non-citizens" lacking health insurance are undocumented. By suggesting that documented immigrants are not deserving of inclusion Seymour demonstrates what amounts to an appeal to nativism at best and racial prejudice at worst. As for the people earning enough money to afford to purchase health insurance, Seymour clearly glosses over the reality that ability to purchase isn't enough. It's almost as if she has never heard of people getting denied coverage for pre-existing conditions. Maybe it's more like she would rather that people who read her article forget about that harsh reality. Or that they not be made aware that: The percentage of Americans who are uninsured rose largely because the percentage of people with employer-sponsored coverage continued to decline, as it has in the past several years. Remember ... half of all adults say they have put off some sort of needed medical care over the past 12 months because of costs. As for the uninsured who qualify for government programs, factcheck.org details the reality of that claim too, but it seems to me that is partially by design. Politicians opposed to government programs tend to like it when government programs go unused. And regarding the CBO study, that just goes to show how lame the Senate plan is and why it should be scrapped for single-payer.
"I thought what I'd do was, I'd pretend I was one of those deaf-mutes." - the Laughing Man
Quote: Original post by Oluseyi

Quote: Original post by Chris Reynolds
I wouldn't be nearly as opposed to this bill if I didn't think it would effectively run private insurance into the ground.

Why is it so important to have private insurance? They have failed to provide sufficient and cost-effective healthcare. Why are you so dedicated to preserving these inefficient fossils?



this. If private insurance can't compete with government insurance, then they have failed. Governments shouldn't hold back from reviewing a sector just because the crap business models in that sector will fall apart if any sort of reform is made. Even in countries with government run healthcare, private insurance still exists (eg Bupa in the UK). Quite a few companies provide Bupa cover as part of your contract with them, although it tends to only be basic cover, which really just amounts to a slightly nicer hospital to stay in while you're being treated, and even then only for a few days. Personally I can't say it influences my choice in employer at all) .
To add to the comments of the people from the UK and Australia, the system in Nordic Countries (and indeed, in other western European countries) is somewhat similar and seem to be working. There are problems, of course, but it doesn't seem to cost as much per capita and provides healthcare I'm satisfied at least. Private options haven't gone anywhere despite public healthcare has to actually perform and it's the doctors deciding if treatment is needed and not some vague bureaucrats. Judging from the general impression I've got concerning the U.S. healtchare, a controlled change shouldn't at least make things worse (if not better either).

">This is completely
off-topic, the anti-government connection based on the closing remarks is just so hilarious. I thought of sharing, quite humorous.
---Sudet ulvovat - karavaani kulkee
Quote: Original post by LessBread
Quote: Original post by Eelco
Quote: Original post by Promit
Quote: Original post by Chris Reynolds
This is why it's a little tiring to hear people say things like "ohhh the stupid republicans think this is socialized healthcare! it's NOT its just a public OPTION"
In case it wasn't clear from the last post, I would love to see the health insurance companies go broke. They're incredible leeches on society. I'm disappointed that the political landscape in this country is that not only do politicians not have the balls to go single payer, but the effort will likely fail entirely. Polls show massive favorabilities for public option (60%+) and it still won't happen.

Leeches on society? In what way exactly?

Surely you are not talking about their profit margins? Those are pretty lame as a percentage of invested capital.


Did you come late to the party? Reviewing the first few pages of this thread, I see the answer to that is no. Clearly, you haven't bothered to inform yourself, because why bother with facts when numbers can be manipulated, right? Why bother with reality, you know? And reality has a well-known liberal bias.

Iirc, leeches secrete an enzyme that numbs the host to their presence, so that they can feed at will, sucking as much blood as they can. It makes perfect sense that you would not be aware of these leeches on society. Here are links to posts in this thread that linked to articles and studies detailing the scale of insurance company leeching. [1], [2], [3], [4], [5], [6], [7], [8], [9], [10].

If you're not familiar with the basic aspects of the issue by now, then you're just wasting other people's time and should excuse yourself from the discussion.


Perhaps its you who should excuse yourself from the discussion, because none of that seems to relate to my comment. The profit margins of private insurers are not what makes american insurance expensive. Why dont you just admit it?

Regardless of the nobility of not denying people care, how anyone can believe that extending care by itself will bring down costs is beyond me.
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Bring down cost? Maybe for those without any money, but not for taxpayers.

The taxpayers, especially wealthy tax payers, foot the bill for those who cannot afford it. Apparently the costs will be lowered through cutting administrative costs and efficiencies and blah blah blah, but it is a 1.3 trillion dollar bill

The government isn't "providing free healthcare", as many would like to put it. It's often disguised as a public option provided for by the government. It's provided for by tax payers.

They are simply collecting money from wealthier individuals, and using it to pay for the healthcare of people who don't make any money. It's really that simple.

And they're already being taxed to the hilt anyway. The top 5% of wage-earners are already paying more than half of the entire country's taxes.
Quote: Original post by Chris Reynolds
We've exhausted quite a few of the potential problems, and I appreciate people informing me and others of things we might not have known.

Pretty much the only thing left to discuss is the economics of it all. Members of both parties are arguing that America cannot afford to do this, and that it will drive up the deficit. But the administration says that it is "deficit neutral".

What do you guys think?


With regards to the economic argument, correct me if I'm wrong here...

Is it good for the economy when large numbers of your work force end up getting into a state where they can't work, because they can't afford preventative health care? Possibly even having to be supported by the tax payer?

Is it good for the economy when people are regularly bankrupted by healthcare costs? Presumably defaulting on loans, and possibly even their mortgage?

Is it good for the economy if someone that has the potential to become a successful entrepreneur or a great scientist, ends up flipping burgers because they're spending all their money on health care costs instead of going to university?

Is it good for the economy for companies and individuals to be paying much more on health care than they need to be?

Quote: Original post by Chris Reynolds
Bring down cost? Maybe for those without any money, but not for taxpayers.

The taxpayers, especially wealthy tax payers, foot the bill for those who cannot afford it. Apparently the costs will be lowered through cutting administrative costs and efficiencies and blah blah blah, but it is a 1.3 trillion dollar bill

The government isn't "providing free healthcare", as many would like to put it. It's often disguised as a public option provided for by the government. It's provided for by tax payers.

They are simply collecting money from wealthier individuals, and using it to pay for the healthcare of people who don't make any money. It's really that simple.

And they're already being taxed to the hilt anyway. The top 5% of wage-earners are already paying more than half of the entire country's taxes.


Correct me if I'm wrong, but aren't you already paying for uninsured people? When someone ends up in the emergency room because they couldn't afford preventative health care, and then can't afford to pay their hospital bills, it puts up your hospital bills and insurance premiums, doesn't it?

With regards to taxes, you guys are spending more on health care (2-3 times as much), than people in countries with UHC pay in taxes.
Quote: Original post by Stab-o-tron
With regards to taxes, you guys are spending more on health care (2-3 times as much), than people in countries with UHC pay in taxes.


50% more than where im from, from what ive seen. That can be explained in various ways.
Quote: Original post by Chris Reynolds
And they're already being taxed to the hilt anyway. The top 5% of wage-earners are already paying more than half of the entire country's taxes.
This figure is meaningless without knowing how much of the total income is being made by the top 5%. Wikipedia claims that:
Quote: The aggregate income distribution is highly concentrated towards the top, with the top 6.37% earning roughly one third of all income, and those with upper-middle incomes control a large, though declining, share of the total earned income.

It cites a book and a USA Today article for that line. This tends to suggest that paying half of all taxes is not nearly as distorted as you make it out to seem. (Of course it's more than their share of total income -- we're a progressive tax system.) Actually it's my understanding that our tax system is incredibly friendly to high income people, compared to how it was set up in the past.
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