adrenaline said:By the way, if it wasn't for government funded health care medicare, the private plans would not have been so economically prosperous. Medicare "socialized " the eldery and disabled, ( thus diminishing the subset of the population that over utilizes health care) and privatized the young, working class. Once again, I support a single payer system, not obama's patchwork of competing public options. And don't forget, the cry of socialization also was also cried in vain when l. johnson signed medicare into law, people screamed american medicine would become socialized. It didn't happen with medicare.
adrenaline said:outlaws private contracts? here is a fact check, for the record, britain ( the standard of socialized medicine) has a very health private insurance market ( half the population uses the private sector.)
About 11% have private health insurance. Private GP services very small.
Private health coverage as % of UK population: 2003, 11.2%
Well, I saw it right away. And of course it's in the text of the bill. Why would your link point out that some private policies wouldn't be outlawed if none were outlawed? Why am I wasting my effort explaining the obvious?adrenaline said:I still don't see where the link confirms private contracts will be outlawed.
That's just false. Government intervention created the problems. Government created the artificial demand for bad mortgages. There was never any private demand for them.And it was precisley the laissez free economics that destroyed the banking industry and put us in the mess we are in.
WhoWee said:Please explain the danger of "patchwork" as you described the plan.
I often hear it referred to as over-layed, and other descriptions - basically layers of regulations imposed instead of fixing the initial problem. As is often the case with Government efforts, they often transform one problem into a different problem (or worse).
That's the Kool-Aid talking, Al. The government did not create the demand for bad mortgages, and there is no way that you can back that up. The government (GOP administration) refused to rein in highly leveraged investments made on bundled mortgages of dubious value. Government was NOT the problem, but should have been the solution, and it was not. The GOP has made a name for itself claiming that government causes all problems and cannot work, and then when they get elected, they obstruct everything possible to make that come true. I quit the GOP when then became the party of jingoism and nihilism. There are precious few conservatives left on the "right".Al68 said:That's just false. Government intervention created the problems. Government created the artificial demand for bad mortgages. There was never any private demand for them.
Short of congressional action to reform the tax code, the burden to improve health coverage rests with state officials. The best way to enable individuals and families to buy, own, and keep health insurance from job to job—without losing the tax advantages of the employment-based coverage—is to transform the balkanized and dysfunctional state health insurance market into a single health insurance market. This new market would function well for all sorts of individuals and small businesses, not just workers employed by large companies....
The best option is a health insurance market exchange. A properly designed health insurance exchange would function as a single market for all kinds of health insurance plans, including traditional insurance plans, health maintenance organizations, health savings accounts, and other new coverage options that might emerge in response to consumer demand. In principle, it would function like a stock exchange, which is a single market for all varieties of stocks and reduces the costs of buying, selling, and trading stocks. For the same reasons, other types of market transactions are also centralized, such as farmers’ markets, single locations where shoppers can purchase a variety of fresh fruits and vegetables, and Carmax, where consumers can choose from among all kinds of makes and models of automobiles.
In the case of a statewide health insurance exchange, employers would designate the health insurance exchange itself as their “plan” for the purpose of the federal and state tax codes. Thus all defined contributions would be tax free, just as they would be for conventional employer-based health insurance. The major benefits of this arrangement for employers, particularly small employers, are a reduction in administrative costs and paperwork and the ability to make defined contributions to their employees’ preferred plans.
As a vehicle for a defined-contribution approach to health care financing, an exchange would expand coverage and choice. Rather than have to decide whether to pay for full coverage or not, employers could make defined contributions of any size to the exchange. Moreover, employers could also enable employees, including those working part-time and on contract, to buy health insurance with pre-tax dollars. Under a Section 125 plan, any premium payments made by workers, even part-time workers or contract employees, would be 100 percent tax-free. This is especially important for workers in firms that require them to pay part of the health insurance premium. Employees, not employers, would buy the health care coverage with pre-tax dollars, would own their own health plans, and would take them from job to job without the loss of the generous tax benefits of conventional employer-based coverage. This is a revolutionary change in the health insurance market.
Unlike other state-based initiatives, the creation of a statewide health insurance exchange would not violate the Employee Retirement Income Security Act of 1974 (ERISA). This approach complies with ERISA because employer participation in an exchange is voluntary—though, given the benefits of an exchange, few small businesses would turn down the option. An exchange can be designed within the existing framework of other federal insurance laws, including the Consolidated Omnibus Budget Reconciliation Act (COBRA) and the Health Insurance Portability and Accountability Act (HIPAA).
No, it doesn't allow the same policies it bans. It outlaws private policies, then in the other section, it allows only private policies that meet the criteria and are part of the "exchange", or temporarily grandfathered.adrenaline said:The way the bill is written, it completely bans private policies in one section - but in the next, it allows them again, through a new mechanism.
Yeah, banks were just making loans they knew would lose money for themselves. It had nothing to do with Fannie Mae and Freddie Mac wanting them. And of course F&F didn't want bad mortgages bundled with the good ones. :uhh:turbo-1 said:That's the Kool-Aid talking, Al. The government did not create the demand for bad mortgages...
Evo said:I have to sy, that as an employee of a large company that has incredible health insurance, this plan scares the crap out of me. For me, it means higher health costs to maintain the same level of healthcare, if I can even get the same level of healthcare, my doctor is afraid that if this passes he will no longer be free to fight the battles to get the best care for his patients. He feels he will be forced to accept whatever is deemed "acceptable".
Adrenaline, I know you are one of those saints that helps the poor in your area. So, you care more about universal care. But what are your thoughts on the future of cutting edge medicine in the US if the health industry is limited to government fixed costs?
Canadian first for totally endoscopic closed-chest robotic bypass surgery...
Media ReleaseCanadian first for totally endoscopic closed-chest robotic bypass surgery
On May 4, 2007, CSTAR (Canadian Surgical Technologies & Advanced Robotics) announced that a cardiac surgery team led by Dr. Bob Kiaii, cardiac surgeon and director of Minimally Invasive and Robotic Cardiac Surgery, performed a totally endoscopic closed-chest robotic coronary artery bypass surgery on a patient’s beating heart at University Hospital.
Canadian first for robotic assisted gallstone surgery..
LHSC physicians achieve a Canadian first in using new technology to treat atrial fibrillation...
A world first at CSTAR: surgical robot helps to reduce stroke in common cardiac disorder
Canadian first for robotic assisted gallstone surgery... etc.
turbo-1 said:That's the Kool-Aid talking, Al. The government did not create the demand for bad mortgages, and there is no way that you can back that up.
The government (GOP administration) refused to rein in highly leveraged investments made on bundled mortgages of dubious value.
Government was NOT the problem, but should have been the solution, and it was not. The GOP has made a name for itself claiming that government causes all problems and cannot work, and then when they get elected, they obstruct everything possible to make that come true.
I quit the GOP when then became the party of jingoism and nihilism. There are precious few conservatives left on the "right".
Evo said:Before I delete more off topic threads...this is about HEALTH CARE.
adrenaline said:If you think the government rations care, think again...when a government plan forgoes say an expensive 35,000 dollar defibrillator in a 95 year old it is socialism, if a private insurance plan "rescinds" it is less evil since free market forces have dictated their actions.
It's less evil because no one is using force against their fellow man to coerce them. Or are you just pretending to not understand what is meant by the term "socialist" when used by those opposed to this proposal?adrenaline said:...when a government plan forgoes say an expensive 35,000 dollar defibrillator in a 95 year old it is socialism, if a private insurance plan "rescinds" it is less evil since free market forces have dictated their actions.
This is a good point. We have seen decades of government regulation repeatedly being used to correct problems caused by previous regulation. Then each time regulation causes more problems, they are blamed on capitalism, and the solution is more regulation. And now after decades of ever increasing regulation causing increasing problems, we're told that the solution is, guess what: government regulation.WheelsRCool said:Right now, U.S. healthcare is not really free-market. It is about 50% government (Medicare and Medicaid) and the private insurance sector I believe is very highly regulated by the states, some so heavily that it is nearly impossible for them to function in the states they're in. It isn't really a free-market in the normal sense.
adrenaline said:http://www.care2.com/causes/health-...practice-of-canceling-insurance-for-the-sick/
Probably my biggest reason for some sort of health care reform from the goverenment is the continued practrice of "rescinding" health care policies that is happening at a more alarming rate with my privately insured patients. I am right now struggeling with a 42 year old I diagnosed with burkitts lymphoma. I have been his doc for 11 years and his insurance carrier told him his diagnosis was a preexisting condition based on some fatigue complaints he expressed to a nurse practioner 4 years ago. ( at the time he was working second shift and was diagnosed with shift work disorder and improved when he was able to get first shift duty). His physicals year after year did not relieve any lymphadenoapthy until his last one. They dropped him. He can't obtain private insurance, I have had him put all his assets in his exwifes name and soon he will qualify for medicaid which will pick up all his treatment 100% this was a man who worked full time since he was 17 for this paint production factory.
Though not an example of rescinding I had a 41 year old diagnosed with cutaneous t cell lymphoma, two years into her treatment ( full body radiations, sepsis from repeated pseudomonas infections etc.) she reached her one million dollar lifetime maximum and was essentially going to have to pay 100% of any future medical costs and treatments. her employer did not offer her any other type of plan. I put her on disabilty and now medicare and medicaid secondary has stepped up to the plate and has been paying for her treatments for the last 9 years. ( she is now 50).
If you think the government rations care, think again...when a government plan forgoes say an expensive 35,000 dollar defibrillator in a 95 year old it is socialism, if a private insurance plan "rescinds" it is less evil since free market forces have dictated their actions.
adrenaline said:...Let's not forget, the best avante garde basic medical research is done by NIH, government funded, ( socialized) without profit motive. ...
drug companies are resorting to "me too" drugs or slight modifications of existing drugs ( ie: nexium from prilosec, lexapro from celexa) for the quick profit turn around.
That seems like asking someone with a tumor what he would replace it with. The answer is just to get rid of it, not replace it. That's what I'd say about socialist policies in the U.S. They don't need to be replaced, just eliminated. And certainly not expanded even more.wildman said:This is what I mean when I say we already have socialism. The problem is that it is an uncontrolled crazy form of socialism. It is far more expensive (if you figure in emergency room costs that are spread over all the insured, medicare and medicaid) than the more rational forms of socialism in other countries. It is literally driving us bankrupt. I am not sure what we should replace it with...
adrenaline said:The way the bill is written, it completely bans private policies in one section - but in the next, it allows them again, through a new mechanism. It merely changes the way they are sold, instead of banning them. But the law has to be written all legal-like. This is typical legal crap.
If you go read the bill, you see the language in Title I referred to in this article, and you see that it contains an exception. That exception is Title II, which allows PRIVATE insurers to offer PRIVATE plans through a new mechanism called a Health Insurance Exchange. I don't know the details yet, but it looks like it's basically one-stop shopping for health insurance, to make it easier for people to compare plans. They could choose a private plan, the government's plan, or Medicare, etc. if they qualify. I think it also makes it possible to choose a plan from any state, nationalizing the health insurance market and making more competition possible. It has some kind of tax benefits too. I found this article praising the idea, from a CONSERVATIVE think tank:
http://www.heritage.org/research/healthcare/wm1230.cfm
Personally, as a small business owner who spends an exorbitant amount of my overhead on health insurance premiums this "stock exchange" set up for when I shop around for health insurance can be very appealing.
As a doctor, it sucks, because that means many more players to deal with and it does not streamline my adminstrative work and overhead.
WheelsRCool said:Healthcare seems like a double-edged sword. With the private health insurance sector, you have corporate bureaucrats making decisions. With government, you have government bureaucrats.
For example, Medicare and Medicaid I believe are government-run health insurance companies, and they are monuments to waste, fraud, corruption, etc...
Lawsuits I also think are a contributing factor.
In theory, that would mean one way to begin to control healthcare costs in the private sector is to get Medicare and Medicaid under control.
We also have the example of the Massachusettes universal care experiment, which was supposed to not balloon out of control cost-wise, yet that is what has happened. And the fears that creation of a public option would be a Trojan horse to destroy the private insurance industry to eventually push the country onto a single-payer system.
Al68 said:It's less evil because no one is using force against their fellow man to coerce them. .
all true in the past, but the current environment of quick profit turnovers now force the "innovative "drug companies to spend 80 percent of their research dollars "extending" patents on on say left handed isomers on old racemic drugs, new "drug delivery" encapsulation for the same drug etc...mheslep said:No doubt NIH research has produced countless nobel prizes. It's a national resource for basic research, especially from what little I know about the reported cancer, heart disease, and of course genome research there. But it's hardly the beginning and end of day to day medical advances in this country as I read the history. In that line, a couple years ago Health Affairs published a survey of internists on the top 10 most useful high tech medical innovations world wide, and I can't find NIH footprints on any of them.
* MRI/CT
* ACE inhibitors
* Balloon angiography
* Statins
* Mammography
* Coronary Artery Bypass Graft surgery
* H2-receptor antagonists
* Selective serotonin reuptake inhibitors (SSRIs)
* Cataract extraction and lens implants
* Hip and knee replacements
http://healthaff.highwire.org/cgi/reprint/20/5/30
NIH certainly had no fundamental role in the development of the MRI. Some of the rest:
- Statins come from the work of Japanese biochemist Akira Endo while working at Sankyo, with later work by Merck to isolate a statin from Endo's fungus.
- Captopril, the first available ACE Inhibitor, was developed by Bristol Meyers Squib scientists, based on the fundamental work of English scientists K. K. F. Ng & J. R. Vane.
- Angiography was invented by radiologist Charles Dotter out of the University of Oregon and the first devices made by entrepreneur Bill Cook.
- The first CABG was done at the Albert Einstein college of medicine by US Drs. Goetz, Rohman, Haller, Dee. The first five SSRIs (antidepressants) came out of five different drug companies: Lundbeck, Solvay, Eli Lilly, SmithKline-Beecham, and Pfizer.
- Modern cataract surgery was enabled by the invention of phacoemulsification by US Opthamologist Charles Kelman.
- The MRI was developed by P. Lauterbur of the University of Illinois at Urbana-Champaign and P. Mansfield of the University of Nottingham, Nobel prize winners for their work.
Sorry if this is pedantic, but the above comment is not the first on the 'who needs industry, government/academia does it all anyway' line. There's some notable academic pushing that concept recently, against what seems to me a mountain of evidence to the contrary.
http://www.pubmedcentral.nih.gov/articlerender.fcgi?tool=pmcentrez&artid=101126
http://www.preskorn.com/books/ssri_s2.html
http://ophthalmologytimes.modernmedicine.com/ophthalmologytimes/article/articleDetail.jsp?id=98075
No, they are not being coerced by force. They have the insurance they chose. Just claiming someone has no choice doesn't make it true. Claiming someone has no choice because their employer only offers one plan is absurd. That's like claiming I have no choice about what kind of food to eat because a hot dog cart only offers hot dogs.adrenaline said:They are coerced, if you cite lack of choice.
Most of my patients have no options regarding the plan their employer provides.
The woman with t cell lymphoma did not have an option from her employer for a higher lifetime limit plan.( past the million dollars.) Instead, the private plans dumps her after they have spent too much money on her and our tax dollars now have to take care of her ( despite 15 years having wages suppressed and garnished paying the premiums). The man with burkits lymphoma did not have a choice in a company plan that practices rescinding more than others.
I myself can only offer my employees humana ppo or hmo, nothing else. WHen two of my nurses developed breast cancer I could not afford to change insurance carriers.
So your suggest they change jobs, for the sake of health insurance benefits? That is equally absured especially in this economic climate.Al68 said:No, they are not being coerced by force. They have the insurance they chose. Just claiming someone has no choice doesn't make it true. Claiming someone has no choice because their employer only offers one plan is absurd. That's like claiming I have no choice about what kind of food to eat because the hot dog cart only offers hot dogs.
That kind of logic only works for people incapable of thinking for themselves.
Gee, most people have no options regarding what kind of food the local hot dog cart offers. So they're "coerced" into eating a hot dog. Silly, huh?
I'm unable to speak to the more recent innovations, except to say that if the US has had all these accomplishments in the past (majority of the 10 were US based), then what's changed now? I don't buy that its all or even mostly on industry - that today's industry is all about quick profits but somehow that twenty, thirty years ago they were not. I'd be more inclined to open up the hood on the today's FDA imposed costs of developing truly new medicines/procedures measured against the government imposed costs of that era, or perhaps the coupling behind today's big pharma and today's FDA that prevents new smaller players from entering.adrenaline said:all true in the past, but the current environment of quick profit turnovers now force the "innovative "drug companies to spend 80 percent of their research dollars "extending" patents on on say left handed isomers on old racemic drugs, new "drug delivery" encapsulation for the same drug etc...
My point was that there is healthy biomedical research going on in these other counteries. Not denying our own accomplishments...
WhoWee said:adrenaline,
It might help if you explain how the Government indirectly sets the payment standards for insurance companies through Medicare fee schedules.
http://www.cms.hhs.gov/FeeScheduleGenInfo/
I blame the growing wave of any advanced scientific research, not just biomedical, being done in most other countries to the hemmohraging pool of foreign basic scientists and engineers returning to their country of origin. That in itself is multfactorial ( china and India's living standards are better so more advanced degreed chinese and indian scientists and engineers voluntarily return to their countries rather than stay with a company here.) When I look at journals and look at many of the medical directors of the academic medical facilities,they are now mostly foreigners ( at least by name). I am assuming since they are the ones pursuing the advanced research degrees. I'm sure that is another whole discussion.mheslep said:I'm unable to speak to the more recent innovations, except to say that if the US has had all these accomplishments in the past (majority of the 10 were US based), then what's changed now? I don't buy that its all or even mostly on industry - that today's industry is all about quick profits but somehow that twenty, thirty years ago they were not. I'd be more inclined to open up the hood on the today's FDA's imposed costs of developing truly new medicines/procedures measured against the government imposed costs of that era, or perhaps the coupling behind today's big pharma and today's FDA that prevents new smaller players from entering.
No, I'm suggesting that they can choose their own medical insurance like I do.adrenaline said:So your suggest they change jobs, for the sake of health insurance benefits?
That's because you gave no examples of coercion.Your statements make no sense with both examples I used.
wildman said:This is what I mean when I say we already have socialism. The problem is that it is an uncontrolled crazy form of socialism. It is far more expensive (if you figure in emergency room costs that are spread over all the insured, medicare and medicaid) than the more rational forms of socialism in other countries. It is literally driving us bankrupt. I am not sure what we should replace it with, but if you don't think we are paying already then I got a bridge to sell you (cheap!).
The 62 year old whose wife had a prior history of lymphoma would have had to pay close to 3,000 a month to insure his family ( he also had multiple basal cell cancers.) on a private plan. He had no choice.Now, I have 3,000 a month extra to boot the bill but I bet 99 % of the posters here cannot suddenly afford 3,000 dollars a month to insure their family because they don't like their insurance. Before his wife was diagnosed, it made no sense to insure his family on his own since only 32 dollars a months was being garnished from his wages to insure him, his wife and three kids. do you know how expensive it is to insure all those together?Al68 said:No, I'm suggesting that they can choose their own medical insurance like I do.
A hot dog cart choosing to only offer hot dogs isn't "coercion" simply because I "needed" to buy one today for practical reasons. Having limited practical choices is not the definition of coercion.