US Healthcare reform

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OK, so I just read JetLag's post. There's way too much to comment on and I'm tired, but I will say this: You could easily replace "gov't" with "insurance company" to represent our current status. Is witholding care to the sick as insurance companies are doing now not rationing? What's the difference if an insurance company knows your bank account #, or the government? The government already knows our bank account #'s if you've ever received a direct deposit for a refund. As far as privacy goes, anyone who thinks it is still possible to keep their personal information private has not been paying attention. If someone really wanted access (gov't, business, hacker joe down the street) they could easily get it. I also find it amusing that the right wing is generally more protective of unborn fetuses and people who are circling the drain than they are of anyone else.

This bill 1200 pages long or so. I could easily grab a few pieces here and there to represent the good and needed changes proposed.

Subtitle A sec.102 - Protecting the choice to keep current coverage.
Subtitle B sec.111 - Prohibiting pre-existing exclusions.
Subtitle D sec.137 - Application of administrative simplification
Subtitle F sec.152 - Prohibiting discrimination in health care
Subtitle c sec.246 - No federal payment for undocumented aliens

Oh, and I speciafically read read the entire section 1177 about "restricting" special needs enrollment as it directly impacts my family, and all it says is that a contract already exists to cover special needs individuals through an integrated Medicaid-Medicare State program and that the Secretary of Health and Human Services will provide an analysis report, through an independant health services evaluation organization, no later than 12/31/11, on the cost, quality of care, and patient satisfaction of the current setup and see if changes are neccesary. This is a prime example of the right-wing, fear mongering, propoganda I was talking about earlier. Also section 1141 has nothing to do with gov't regulation of wheelchairs. It is a section that informs of the replacement of the term "power-driven wheelchair" with "certain complex rehabilitative power-driven wheelchair" as wheelchairs have become much more advanced these days and some can climb steps and others can allow you to stand.

I urge anyone interested in knowing the truth to actually read the bill, not just some hacked up piece of false propaganda. The link provided by JetLag is real and acurate, though. I coudn't even tell you where he/she came up with those "summaries."

Ed, you are either misreading my post or just don't want to look at the facts openly published.

If the current proposal does not either eliminate private insurance or restrict it so that it dies out in time, the motivation of the people pushing for this is to ULTIMATELY eliminate private insurance and have only the mandated national health plan. Sooner or later, it will happen if it is allowed to begin. You don't fight something when it reaches a point you don't like...you stop it before it ever gets started. You reasoning is akin to fixing a leaking pipe after the basement is flooded and not when you first notice the dripping on the floor.

Likewise, while the ultra wealthy can always get "special treatment" from the system or find a way to get private care, "self insurance" won't be an option. In Canada, it is illegal for doctors to not be part of the national system. Maybe some do stuff on the side and off the books, but it is a criminal offense.

The average person in America will not have the legal option to go to a private doctor and pay cash. As soon as such a system starts, you can bet that the government will criminalize it because it undermines their system.

I don't like health decisions made by a private carrier, but they are not the final word, and what they can refuse to pay for is fairly well spelled out in the contract I have with them. The government can set standards without my input or consent, change those standards at whim, and with no alternative, I can't take my business elsewhere. Insurance companies have failed because they can't attract customers. Government would have a captive market.

No. I am uninsured. What medical, vision, dental needs I have I have paid 100% out of my own pocket. If I get seriously hurt of sick, I'm screwed.

Nonetheless, what government wants me to give up to have insurance through them is too high a cost to pay. My LIBERTY and FREEDOM and PRIVACY is too valuable to trade for such a half-baked benefit as is being offered now or in the foreseeable future. I refuse to trade a silk purse for a sow's ear.



You are so wrong. If they wanted to eliminate the pre-existing condition clause and mandate that carriers must insure anyone who comes in wanting coverage, a very simple 10-page bill could accomplish that. This bill is well over 1,000 pages and the final draft still has not been released for public review....and it likely will not be until AFTER it is signed into law (if that happens at all).

IIRC, and I don't have the time to re-research the issue now, UPS and FedEx were fought by the USPS initially because they were illegally competing with the USPS (a legal monopoly). The independent enterprises previaled by arguing that they were not competing with traditional mail service (no 1 ounce mailings for less than 25 cents, no postcards, no bulk and media mailings) and that they provided a service that the USPS was not meeting to the needs of the consumer.

That ruling was many years ago, and if we see national health care come around, the questions are (1) can private health care legally obtain a Supreme Court ruling that they cannot be prohibited from competing with the government program; and (2) will the private health care industry be able to economically survive against the government run program.

The Government tried to shut down UPS and FedEx early on because it was illegal competition. They knew they couldn't beat the quality of service, so they sought to say it was illegal. The courts did not agree. Had UPS/FedEx tried to deal with domestic mail, I'm certain a ruling against that would have been a certain win for the USPS.

In national health care, I'm sure ENOUGH people would choose inferior national health care than costlier (but better) private health care. Even if the courts side with the private health care industry, I don't doubt (especially in a worsening economy) that they would go under simply by the government taxing people (and businesses) to death to subsidize national health care.

Legally, you can not be forced to obtain a Social Security Number because it is a VOLUNTARY program. However, you will still have Social Security taxes taken from your paycheck. That alone is the main reason why millions get their number even though it's only "voluntary." The perception of paying for something but getting nothing back does more to coerce someone into "volunteering" than anything else does. That number is used to track and control a man's life in ways that are unconscionable, but the masses have been sold into participating purely by economics.

No, everyone else is screwed. If you can't pay a major medical bill, then it winds up being paid for by those responsible enough to get health insurance. I support requiring you to get health insurance, even if it's just a cheap policy that only kicks in for large bills.

Who controls postage?

Ah, but even that isn't "cheap" anymore, and the last time I tried, they wanted overbroad exclusions that would leave me (or as you say...everyone else) holding the bag if something happened.

...so your choice is to let everyone else pay your medical bills for you if you get sick. Damn, that almost sounds like socialized medicine to me!

Can't we sort of "reverse engineeer" the solution based on priorities?

Priority One: Every single person regardless of income, employment status or citizenship should have a certain minimum level of heatlhcare.

Some would argue we have that now, because federal laws require that a hospital admit and treat any person WITHOUT considering their ability to pay if the person is not medically stable (or something like that). Meaning, if a homeless illegal alien drops unconscious on a hospital floor, they have to treat him and stabilize him and eat the cost.

Okay, two problems with this system. First, many would argue that merely providing care when a person is dying is not setting the bar high enough, with respect to the minimum level of care that everyone should receive. For example, if you are "stable" with dialysis, but you need a kidney transplant, and you have a family donor, you might still not get the operation if you cannot afford it because you are technically "stable." (I'm not sure that example holds true, but I'm sure some one can think of an example where people do not get life-saving surgery or treatments due to inability to pay, which would shock the conscience of most of us.)

Second problem is that simply telling hospitals to "eat the cost" of this treatment is not a sustainable system. Hospitals left and right are GOING OUT OF BUSINESS! Necessariy, hospitals in the worst neighborhoods will get the most of these penniless walk-ins, so the cost is not well-distributed through the healthcare industry.

So, as I see it, we agree on a certain basic level of care, certain basic surgeries and treatments and medications, that everyone should have and we give that out FREE FOR ALL. No form of insurance -- government sponsored or private -- does this. The very notion of a government sponsored, lower cost health insurance program indicates that it will still cost something, and you will still have people who do not buy that, or any other, insurance. What happens when they drop uncosncious in a hospital? We are still at the "Eat it, hospital" solution. Dumb, dumb, dumb.

Personally, I like the notion of government-run hospitals. People would have a choice to go to a free government hospital or to a pricey private hospital. It would be akin to public and private schools.

I've read criticism on here about how the government sucks at running anything, as evidenced by the sad state of public schools. However, this critic seems to ignore the fact that, without public schools, we would not have such an egalitarian society, but would instead have a two class society with a huge, illiterate, uneducated lower class. Visionaries saw that we needed universal education to give every person a certain minimum level of education. They implemented it. It worked. You can thumb your nose all you like at the public school system, but it's infinitely better than a system where school can only be afforded by the rich and upper middle class.

Plus, I'm sick of hearing people say, "The government sucks at running things, it always turns into over-priced bureacratic s**t, like the army paying $12,000 for a hammer." They say this like its inevitable. Like because the government HAS sucked at running things, and because bureacracy DOES tend to get corrupted and self-serving, such a result is inevitable. Honestly, to me that is the cowards way out. Let's see...the universe is about 14 billion years old. American bureacracy has been around less than 250 years....yeah, let's resign ourselves to the notion that it is unfixable. That makes loads of sense. (That's sarcasm.) The point is, how about turning that critical thinking over to the task of MAKING the government run more efficiently? Figure out what is fundamentally corrupting about government operations and then figure out a way to change / fix that flaw, or compensate for that influence. Don't tell me it is impossible based on what is, in the larger scheme of things, an infinitismal track record.

Businesses hire efficiency experts all the time. I wonder what the greatest efficiency experts of our day, if called upon to review government operations, would have to say. Off the top of my head, I can think of a few things. First, there isa problem with the budgeting process. Every government agency gets a certain annual budget. If they spend less than their budget, they get less the next year. Therefore, THEY ALWAYS MAKE SURE TO SPEND EVERY PENNY. The result is, bureacracy tends to create a one-way street, where it grows but never shrinks.

Look at the DEA. The entity which was eventually named the DEA grew huge under prohibition, fighting to stop illegal trafficking of liquor. When prohibition was lifted, you had a this huge national bureacracy that should have just gone away. But governments don't work that way. Those who had interest tied to this agency wanted to keep it alive, keep it growing, so they had to pick something else to fight against. They picked marijuana, a drug that was causing no one any harm, but was mainly used by minorities and poor people who had no power. The DEA never shrank at all, but kept rolling right along, growing year after year. Eventually, they added more things to their fight, to justify bigger budgets.

Yeah, that stuff sucks. But am I going to say it is inevitable? In the infinite span of future time, there can never be any solutin to make a government-run program efficient? Give me a break.

To look at it another way, people seem to be focusing on the shadows, not the object causing the shadows. When you say, "We can't have a government-run healthcare system because the government sucks at running things," you are NOT saying that a government-run healthcare is a problem, or is inherently a bad idea, you are saying that government inefficiency is a problem. Focus on the PROBLEM. Hell, if all the nay-sayers took all the energy they spend trying to convince us the government cannot be trusted to run anything, and they applied that energy to figuring out a way the government COULD be trusted to run things efficiently, they would solve not only the problem of universal healthcare, but just about every other problem facing this country.

Thanks for the thoughtful post, frinj.

It's sort-of like the abortion debate, where if the two sides stopped fighting over making it illegal, but instead used all that energy to reduce the number of abortions, the problem could be solved.

Yes frinj, but an efficiently run government doesn't make anyone filthy stinkin' rich! Let's not forget the motivation of the nay-sayers. I do not believe any of the nay-sayers here have greedy intentions, but I believe they have been brainwashed by the capitalist agenda of the powerful politicians. Almost every argument set forth has been nothing more than the same rhetoric that spews out of the mouths of lobbyists, highly paid pundits, and bought-out politicians whose real interest is in their own bank accounts.

Listen to how people are terrified (mostly on the right, but not all) of a downward spiral of socialism. People really believe that if our government helps sick people that soon bread will be rationed. It's completely absurd, but then again, so were WMD's and many bought into that load of crap. Special interests have made fools of our society. We need to open our eyes and seek the truth.

The problem is that some big-money Republicans have started a campaign to spread a bunch of lies about the health insurance bill, and persuade otherwise-rational people to behave in a very un-rational way. The people on here who are posting these things are good people, but their prime news outlets are lying to them, and they are believing it.

I'm pretty good at smelling a rat, and I don't smell any here .

I realize there has been a ton of discussion on this topic that I have not read, and that may well influence or alter my current views, but as a brief summary, here is where I currently stand on the question the OP posed.

I actually love the idea of putting the government in direct competition with the insurance companies, for both currently have far different advantages and disadvantages and the competition is going to force both to address and try to deal with their flaws. I don't think it matters who wins, or if anyone wins; it will be interesting to see how the push and pull works. Insurance companies have been too profit driven in an area that involves fundamental human rights. Government has tended to be inefficient and overly beaurocratic. Under a competitive model, both will need to make important changes to their way of being.

It is a travesty that medical costs are the major source of bankruptcy in the US. It is a travesty that people will cling to unsuitable jobs out of fear of not being able to get insured (a point that those who oppose reform seem to be completely unable to comprehend is that is quite possible to want insurance, be able to afford insurance, and yet be unable to obtain it because of some item in one's medical history). It is a travesty that access to appropriate and quality care can vary so widely and be dependent on so many factors that have absolutely nothing to do with merit. I've seen the stories first hand, I've lived some of the injustices. You cannot effectively blanket with assumptions about public hospitals (not every area has them) and other perceived safety nets; the holes are huge and people really do fall through them. Reform, absolutely, is necessary, and it must include some requirement to insure all at a reasonable cost regardless of what it says in the medical record.

How to carry that out? Honestly, I've heard good ideas from all sides of the political fence, even if most are not complete and without their own unique flaws. We don't really know what will work until we've tried it. The government competing with the private sector model is the easiest to get to, and the one that will accomplish the most of the immediate goals with the least disruption to those comfortable with the status quo. It will shed a lot of light on where to go next.

Opposition is a fear tactic; if government is as bad as it is feared to be, then it will not win this competition, while insurance companies will have made some necessary changes. Insurance companies don't want to have to change, and they don't want to accept what will inevitably be a lower profit margin, but they don't honestly believe they will lose.

No. It's the common sense to not spend money on a worthless policy that could leave me without coverage and spend that money on real medical services that do keep me healthy.

Would you spend $3,000 or more a year to get effectively NOTHING in return? That's what the insurance carriers wanted to do to me.

I've said that America needs to shift to a health care paradigm where you pay every month but your basic medical care is paid for whenever you need it. The idea of buying a policy that covers you only when you are in extreme medical debt but the cost of that policy deprives you of the ability to see a doctor early on when you need to is insanity.

An interesting proposal.

I agree that everyone, regardless of income, should have access to fundamental health care. You are also correct that how to pay for it is an issue. Clearly, some people need to be shown the door. America has a massive problem with illegal aliens. Ever look at how Canada runs their system? They don't cover everyone, just CANADIANS.

Such a plan in America can only be given to those here lawfully. Likewise, funding such a plan (be it run by government or private enterprise), would likely come in the form of payroll taxes. To allow those here illegally to benefit is to reward people for breaking the law. One could argue that those here illegally are likewise paying taxes, but it is also fair that many are working and being paid illicitly with no taxes being withheld.

I have felt that government's role should be only in two capacities:

1. Set what constitutes "minimum standards" in the form of a mission statement.

2. Serve as an "oversight" entity for when complaints arrive of the health care industry NOT meeting those standards.

I can support the idea of a "legalized monopoly" on fundamental health care being granted to a private entity who must perform the task or have the job taken from them and given to someone else more capable of doing the job.

The simple fact is that PRIVATE doctors, hospitals and even health insurance companies know how to best trim the fat that drives up the cost of providing care and still turn a profit. Government just wants to throw more money at the problem, and they specialize in making ever more complex paperwork requirements.

Sadly, we will never see meaningful reform in America because the problem isn't just the medical community.

It's corporations wanting money over serving people (paradigm shift needed).
It's government agencies with political agendas.
It's the legal community hungry to make a fortune suing doctors and hospitals over any mistake, substantial or inconsequential.
It's illegals and the poor who can pay money for booze and drugs but won't pay a medical bill, but they know how to exploit the law to get free care and scoot town without paying.
It's YOU and ME who want something for nothing.

There's enough blame to go around, and if all points are not dealt with, someone's going to get shafted in favor of another with the result being failure.

So you rail against the insurance companies, while fighting tooth and nail to ensure that nothing happens to curb their abuses. Instead of fighting for the insurance companies, why don't you try fighting for yourself?